Measurement of the total purine contents and free nucleosides, nucleotides, and purine bases composition in Japanese anchovies (Engraulis japonicus) using high-performance liquid chromatography with UV detection.
Dietary purine restrictions are recommended for patients with hyperuricemia and gout. While measuring the purine contents of various foods in our laboratory using high-performance liquid chromatography (HPLC), we observed and reported changes in purine composition. In this study, we measured the total purine content and free purine of raw anchovies as well as after fermentation, using two methods by HPLC. Method 1 involved acid hydrolysis of all purines, such as nucleic acids and nucleotides, to form four corresponding purine bases. Method 2, which is a non-hydrolysis method, is used to measure the amount of free purines (nucleotide, nucleoside, purine base). As a result of method 1, after fermentation, adenine-related and hypoxanthine-related purines and the total purine levels decreased significantly. Regardless of being raw or fermented, each anchovy contained mainly hypoxanthine- and guanine-related purines. Among the hypoxanthine-related purines, the results of method 2 revealed that the raw anchovies contained a lot of inosine monophosphate (IMP), while after fermentation contained more inosine. In guanine-related and adenine-related purines, those nucleotides decreased by fermentation and nucleosides and bases increased. Measurements of free purines revealed that those reductions after fermentation observed in method 1 were derived from decreased nucleotides. These results indicate that purines are affected by the fermentation bacteria and period.


Remote collection of electrophysiological data with brain wearables: opportunities and challenges.
Collection of electroencephalographic (EEG) data provides an opportunity to non-invasively study human brain plasticity, learning and the evolution of various neuropsychiatric disorders. Traditionally, due to sophisticated hardware, EEG studies have been largely limited to research centers which restrict both testing contexts and repeated longitudinal measures. The emergence of low-cost "wearable" EEG devices now provides the prospect of frequent and remote monitoring of the human brain for a variety of physiological and pathological brain states. In this manuscript, we survey evidence that EEG wearables provide high-quality data and review various software used for remote data collection. We then discuss the growing body of evidence supporting the feasibility of remote and longitudinal EEG data collection using wearables including a discussion of potential biomedical applications of these protocols. Lastly, we discuss some additional challenges needed for EEG wearable research to gain further widespread adoption.


Potential of anaerobic co-fermentation in wastewater treatments plants: A review.
Fermentation (not anaerobic digestion) is an emerging biotechnology to transform waste into easily assimilable organic compounds such as volatile fatty acids, lactic acid and alcohols. Co-fermentation, the simultaneous fermentation of two or more waste, is an opportunity for wastewater treatment plants (WWTPs) to increase the yields of sludge mono-fermentation. Most publications have studied waste activated sludge co-fermentation with food waste or agri-industrial waste. Mixing ratio, pH and temperature are the most studied variables. The highest fermentation yields have been generally achieved in mixtures dominated by the most biodegradable substrate at circumneutral pH and mesophilic conditions. Nonetheless, most experiments have been performed in batch assays which results are driven by the capabilities of the starting microbial community and do not allow evaluating the microbial acclimation that occurs under continuous conditions. Temperature, pH, hydraulic retention time and organic load are variables that can be controlled to optimise the performance of continuous co-fermenters (i.e., favour waste hydrolysis and fermentation and limit the proliferation of methanogens). This review also discusses the integration of co-fermentation with other biotechnologies in WWTPs. Overall, this review presents a comprehensive and critical review of the achievements on co-fermentation research and lays the foundation for future research.


Cumulative maternal and neonatal effects of combined exposure to a mixture of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) during pregnancy in the Sprague-Dawley rat.
Globally, biomonitoring data demonstrate virtually all humans carry residues of multiple per- and polyfluoroalkyl substances (PFAS). Despite pervasive co-exposure, limited mixtures-based in vivo PFAS toxicity research has been conducted. Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) are commonly detected PFAS in human and environmental samples and both produce adverse effects in laboratory animal studies, including maternal and offspring effects when orally administered during pregnancy and lactation. To evaluate the effects of combined exposure to PFOA and PFOS, we orally exposed pregnant Sprague-Dawley rats from gestation day 8 (GD8) to postnatal day 2 (PND2) to PFOA (10-250 mg/kg/d) or PFOS (0.1-5 mg/kg/d) individually to characterize effects and dose response curve parameters, followed by a variable-ratio mixture experiment with a constant dose of PFOS (2 mg/kg/d) mixed with increasing doses of PFOA (3-80 mg/kg/d). The mixture study design was intended to: 1) shift the PFOA dose response curves for endpoints shared with PFOS, 2) allow comparison of dose addition (DA) and response addition (RA) model predictions, 3) conduct relative potency factor (RPF) analysis for multiple endpoints, and 4) avoid overt maternal toxicity. Maternal serum and liver concentrations of PFOA and PFOS were consistent between the individual chemical and mixture experiments. Combined exposure with PFOS significantly shifted the PFOA dose response curves towards effects at lower doses compared to PFOA-only exposure for multiple endpoints and these effects were well predicted by dose addition. For endpoints amenable to mixture model analyses, DA produced equivalent or better estimates of observed data than RA. All endpoints evaluated were accurately predicted by RPF and DA approaches except for maternal gestational weight gain, which produced less-than-additive results in the mixture. Data support the hypothesis of cumulative effects on shared endpoints from PFOA and PFOS co-exposure and dose additive approaches for predictive estimates of mixture effects.


The effect of broadband and monochromatic stimuli on the photopic negative response of the electroretinogram in normal subjects and in open-angle glaucoma patients.
The aim was to investigate the effects of monochromatic and broadband stimuli on the amplitude of the photopic negative response (PhNR) and to compare the sensitivities of these stimuli for the detection of ganglion cell damage in glaucoma patients. Forty-one healthy subjects were studied, along with 16 patients with open-angle glaucoma. Photopic electroretinograms (ERGs) were elicited with monochromatic red, amber, green, and broadband white stimuli of progressively brighter intensities in a blue background. Pattern ERGs were also recorded using a 0.8 degrees checkerboard pattern on a 21.6 degrees x 27.8 degrees screen. In the photopic ERGs of the control subjects, the PhNR amplitude was significantly higher (P < 0.01) to red than to monochromatic amber, green, and broadband white stimuli of the same intensity. In glaucoma patients, the percentage of amplitude reduction was greater for the PhNR to red (68%, P < 0.001) than to the broadband stimulus (38%, P = 0.001). The PhNR to red monochromatic stimulus appeared to be a more sensitive parameter, with a larger area enclosed by the receiver-operating characteristic curve (0.97) than for the PhNR to broadband stimulus (0.76). Also, the PhNR to red stimulus showed a more significant correlation with the pattern ERG and the visual field defects (P < 0.05) than the PhNR elicited with broadband stimulus. These findings suggest that ganglion cell activity can be more efficiently evaluated with the PhNR elicited with a red than with a broadband stimulus. The PhNR thus appears to be a promising test for the diagnostics of the ganglion cell dysfunction.


Successful treatment of ICE-rituximab chemotherapy and subsequent bone marrow transplantation in a patient with early-relapse Burkitt leukemia and inverted duplication of 1q.
Although childhood acute lymphoblastic leukemias are of good prognosis than leukemias of adulthood, some chromosomal abnormalities may have negative effects on their prognosis. Inverted duplication (1q) is a chromosomal abnormality with negative effect on outcome of Burkitt leukemia and lymphomas. We report a case of CD20 Burkitt leukemia with inverted duplication (1q) mutation, who had an early relapse during NHL-BFM 95 treatment. Two courses of ICE-rituximab treatment were administered after relapse and a successful HLA-full match bone marrow transplantation was carried out. He is in follow-up for 18 months without any problem after the bone marrow transplantation. We suggest the usage of ICE protocol combined with rituximab in childhood CD20 Burkitt leukemia with poor prognostic criteria such as inverted duplication (1q) mutation.


Pulse Sequence Dependence of a Simple and Interpretable Deep Learning Method for Detection of Clinically Significant Prostate Cancer Using Multiparametric MRI.
Multiparametric magnetic resonance imaging (mpMRI) is increasingly used for risk stratification and localization of prostate cancer (PCa). Thanks to the great success of deep learning models in computer vision, the potential application for early detection of PCa using mpMRI is imminent. Deep learning analysis of the PROSTATEx dataset. In this study, we show a simple convolutional neural network (CNN) with mpMRI can achieve high performance for detection of clinically significant PCa (csPCa), depending on the pulse sequences used. The mpMRI model with T2-ADC-DWI achieved 0.90 AUC score in the held-out test set, not significantly better than the model using Ktrans instead of DWI (AUC 0.89). Interestingly, the model incorporating T2-ADC- Ktrans better estimates grade. We also describe a saliency "heat" map. Our results show that csPCa detection models with mpMRI may be leveraged to guide clinical management strategies. Convolutional neural networks incorporating multiple pulse sequences show high performance for detection of clinically-significant prostate cancer, and the model including dynamic contrast-enhanced information correlates best with grade.


Factors controlling dissolved 137Cs activities in coastal waters on the eastern and western sides of Honshu, Japan.
The distributions of dissolved 137Cs in river, nearshore, and offshore waters on the east and west coasts of the Japanese island of Honshu were studied in 2018-2021, 7-10 years after the Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident. On the east side along the north western North Pacific (Fukushima Prefecture), estuarine processes, including desorption from riverine particles and dissolution into pore water from riverine particles that had settled to the seafloor, contributed to the maintenance of high dissolved 137Cs activities in nearshore and offshore waters. A survey and mass-balance calculation in a semi-enclosed estuarine area, the Matsukawa-ura, in the northern part of Fukushima, provided convincing evidence that rivers contributed to the influx of 137Cs to coastal waters. In contrast, the extremely low activities of dissolved and particulate 137Cs in the Tedori River of Ishikawa Prefecture on the western side of Japan along the Japan Sea suggested that inputs of riverine 137Cs made a negligible contribution to the increase of dissolved 137Cs activities in the nearshore and offshore waters. The relatively high dissolved 137Cs activities observed in the offshore waters of the Japan Sea were due to movement of FDNPP-derived 137Cs into the Japan Sea via the Tsushima Warm Current. Mechanisms controlling the distributions of 137Cs activities in coastal waters of the eastern and western sides of Japan therefore differ.


Idiopathic vitritis.
Vitritis is a relatively common clinical finding, and a significant number of patients present with vitritis as the major or only finding. The records of 199 patients coded "vitritis" at the Bascom Palmer Eye Institute were reviewed. Forty-seven patients fit in the category of "idiopathic vitritis" and formed a relatively distinct group of predominantly elderly woman who complained of floaters or blurred vision. The visual acuities were usually good and the anterior segments were generally normal. They had diffuse bilateral vitreous inflammation and either a normal fundus or reactive changes such as cystoid macular edema or preretinal "cellophane" membranes. Extensive medical evaluations were usually unremarkable. This study helps identify a group of patients with a typical presentation and rather characteristic eye findings. Additional work will be necessary to establish the pathogenesis, the natural course, and the efficacy of treatment.


Immunocytochemical localization of glutaminase-like and aspartate aminotransferase-like immunoreactivities in the rat and guinea pig hippocampus.
There is considerable evidence that pathways of the hippocampus use an excitatory amino acid as transmitter. We have attempted to immunocytochemically identify excitatory amino acid neurons in the hippocampus of the rat and guinea pig using antiserum to glutaminase and antiserum to aspartate aminotransferase, which have been proposed as markers for aspartergic/glutamergic neurons. Glutaminase-like immunoreactivity was seen in granule cells in the dentate gyrus and fibers and puncta associated with the mossy fiber pathway in the hilus and stratum lucidum of the hippocampus. At the ultrastructural level, glutaminase-like immunoreactivity was observed in mossy fiber terminals in the stratum lucidum. Glutaminase-like immunoreactivity was also seen in pyramidal cells in regio inferior and regio superior and in cells in layer two of the entorhinal cortex. Schaffer collateral terminals, commissural fiber terminals and perforant pathway terminals were not seen at the light microscopic level. Glutaminase-like immunoreactivity is thus found in the cell bodies of proposed excitatory amino acid neurons of hippocampal pathways, but does not appear to label all terminals. Aspartate aminotransferase-like immunoreactivity was not seen in any cells, fibers or terminals in the rat or guinea pig hippocampus.


On the use of partitioning for scheduling of surgeries in the inpatient surgical department.
In hospitals, the efficient planning of the operating rooms (ORs) is difficult due to the uncertainty inherent to surgical services. This is especially true for the inpatient surgical department where complex and long surgeries are often performed along with surgeries on emergency patients. This paper aims to improve the scheduling of the inpatient department by partitioning the elective surgeries into the more predictable surgeries (MPS) group and the less predictable surgeries (LPS) group, based on surgery duration variability, and by scheduling each of the two surgery groups in different ORs. Through a simulation study that comprehensively investigates the impact of the partitioning on different performance measures under various environmental settings, we report important findings and insights. First, partitioning can effectively shorten the waiting times of elective patients for both MPS and LPS groups, but the option should be allowed to reassign patients from the MPS or LPS ORs to the other ORs when needed. Meanwhile, partitioning sometimes slightly increases the elective cancellation rate. Second, the ability to use the available capacity of the ORs as much as possible is key to reducing elective waiting times. Third, partitioning might slightly worsen the waiting times of emergency patients, while the slightly negative impact on emergency patients decreases when the number of ORs is higher. Fourth, the beneficial impact of partitioning on elective patients increases with an increased patient demand. Last, for the settings considered in this study there was no benefit in partitioning the elective patients into more than two groups.


A novel technique for the intraoperative monitoring of detrusor activity in intradural lesions of the cauda equina. Technical note.
Intradural pathology in the region of the cauda equina is uncommon and generally comes to attention secondary to pain or neurologic deficit. A number of surgeons choose to excise these lesions under EMG monitoring of the nerve roots supplying the lower extremity muscles, anal sphincter, and detrusor muscle. In this article, the authors describe a detrusor muscle monitoring technique that has been found to be simple, reliable, and cost-effective in the management of intradural pathology of the cauda equina. Fourteen consecutive patients with tumors of the cauda equina who underwent surgical management performed using the standard Foley catheter monitoring technique were included in this study and their outcomes analyzed. In 86% of patients, a gross total resection was achieved. Subtotal resections were performed in 2 patients because of involvement of critical nerve roots. In all cases, the nerve roots supplying the detrusor muscle were successfully identified using this technique. No patient suffered a clinically apparent decline in bladder function during the postoperative period. The standard Foley catheter detrusor monitoring technique is a simple, reliable, and cost-effective method to identify and prevent injury to the sacral nerve roots innervating the urinary bladder during intradural exploration of the cauda equina.


Epigenetic regulation of circ-HIPK3, circ-PVT1, miR-25, and miR-149 in radiosensitivity of breast cancer.
Assessing the radiosensitivity of cells before administering radiation therapy (RT) to individuals diagnosed with breast cancer (BC) can facilitate the selection of appropriate treatment regimens and minimize the incidence of adverse side effects in patients undergoing radiation exposure. In this research, blood samples were obtained from 60 women who had been diagnosed with Invasive Ductal Carcinoma (IDC) Breast Cancer. The average age of the patients was 47 ± 9.93. Additionally, the study incorporated 20 healthy women, with an average age of 44.43 ± 6.7. A standard G2 assay was conducted to predict the cellular response to radiation. Out of the 60 samples, the G2 assay identified 20 patients with breast cancer who exhibited radiosensitivity. Hence, molecular investigations were ultimately conducted on two equivalent cohorts comprising 20 subjects each, one with and the other without cellular radiosensitivity. The expression levels of miR-149, miR-25, circ-PVT1, and circ-HIPK3 in peripheral blood mononuclear cells (PBMCs) were evaluated using quantitative polymerase chain reaction (qPCR). Receiver Operating Characteristic (ROC) curves were used to evaluate the sensitivity and specificity of the RNAs. An analysis using binary logistic regression was performed to investigate the relationship between RNAs and both BC and cellular radiosensitivity (CR) in patients with BC. The findings revealed a significant upregulation of Circ-HIPK3 and circ-PVT1 in individuals diagnosed with BC. The levels of Circ-HIPK3 and Circ-PVT1 were found to be directly associated with CR in BC patients. The analysis of the ROC curve demonstrated that circ-HIPK3 and circ-PVT1 exhibit favorable specificity and sensitivity in accurately predicting both BC and CR in patients with BC. The findings from the binary logistic regression analysis demonstrated that circ-HIPK3 and circ-PVT1 were effective predictors of both BC and CR. The ROC curve and binary logistic regression analyses provide evidence that miR-25 is a reliable predictor for BC patients exclusively. Our research has demonstrated that circ-HIPK3, circ-PVT1, and miR-25 may be involved in BC regulatory processes. The circular RNAs Circ-HIPK3 and circ-PVT1, as well as miR-25, among other significant biomarkers, could potentially serve as promising biomarkers for predicting BC. Furthermore, Circ-HIPK3 and circ-PVT1 have the potential to serve as biomarkers for predicting CR in BC patients.


Some characteristics of cyclic photophosphorylation in maize bundle sheath chloroplasts.
PMS-dependent photophosphorylation in bundle sheath chloroplasts isolated from Zea mays was monitored by using a continuous method. Carbonyl cyanide p-trifluoromethoxyphenylhydrazone (FCCP) and venturicidin were shown to inhibit the ATP-synthesis. Venturicidin has been shown to inhibit ATP-formation in both mesophyll and bundle sheath chloroplasts. In contrast to the case in mesophyll chloroplasts, FMN was not able to promote photophosphorylation in bundle sheath chloroplasts. The effects of other cofactors and inhibitors on the ATP-synthesis in bundle sheath chloroplasts are shown. No photoinduced synthesis of inorganic pyrophosphate was seen, neither in bundle sheath chloroplasts, nor in mesophyll chloroplasts.


Photo-induced foveal injury after viewing a solar eclipse.
To study the injury to and possible recovery of the visual function and foveal morphology in patients with photo-induced foveal injury due to watching the solar eclipse of August 11th, 1999 in Stockholm, Sweden. Fifteen patients, all of whom viewed the solar eclipse, were followed for 1 year, during which their visual symptoms were recorded and visual acuity (VA) was tested, and ophthalmoscopy and scanning laser ophthalmoscopy were performed. Photo-induced foveal injury gave rise to subjective visual disturbances, reduced VA and morphological changes in the fovea. Central scotomas could still be seen in all patients 1 year after the foveal injury. Photo-induced foveal injury gave rise to subjective visual disturbances, reduced VA and morphological changes in the fovea. Scanning laser ophthalmoscopy offers the possibility of detailed examination of small retinal lesions, which can sometimes be difficult to localize with ophthalmoscopy.


High-density lipoprotein cholesterol and cardiovascular mortality: a prospective cohort study among 15.8 million adults.
We aimed to investigate whether the associations between high-density lipoprotein cholesterol (HDL-C) and cardiovascular disease (CVD) mortality and the optimal range differ by age and CVD subtypes. Korean adults (n = 15 859 501) with no CVD/cancer who received routine health examinations during 2009-2010 were followed until 2018 for CVD mortality. During a mean 8.8 years of follow-up, 108 123 individuals died from CVD. U-curve associations were found between HDL-C and CVD mortality, regardless of sex, age, and CVD subtype. The optimal range was 50-79 mg/dL (1.29-2.06 mmol/L), while it was 40-69 (1.03-1.80), 50-79 (1.29-2.06), and 60-89 (1.55-2.32) mg/dL (mmol/L) in adults aged <45 years, 45-64 years, and 65-99 years, respectively. Assuming linear associations <60 mg/dL, the multivariable-adjusted hazard ratios (HRs) per 39 mg/dL (1 mmol/L) higher level were 0.58 (95% confidence interval = 0.56-0.60), and they were 0.61 (0.52-0.72), 0.58 (0.54-0.62), and 0.59 (0.56-0.61) in individuals aged 18-44, 45-64, and 65-99 years, respectively [Pinteraction (age) = 0.845]. Assuming linear associations in the 60-150 mg/dL range, HDL-C was positively associated with CVD mortality (HR = 1.09, 1.04-1.14). The strongest association was for sudden cardiac death (SCD) (HR = 1.37), followed by heart failure (HF) (HR = 1.20) and intracerebral haemorrhage (ICH) (HR = 1.13). The HRs were 1.47 (1.23-1.76), 1.17 (1.08-1.28), and 1.03 (0.97-1.08) in individuals aged 18-44, 45-64, and 65-99 years, respectively [Pinteraction (age) < 0.001]. Both low and high levels of HDL-C were associated with increased mortality from CVD in the general population, especially SCD, HF, and ICH. High HDL-C levels are not necessarily a sign of good cardiovascular health, especially in younger adults.


Transcriptomic and cell wall proteomic datasets of rosettes and floral stems from five Arabidopsis thaliana ecotypes grown at optimal or sub-optimal temperature.
This article provides experimental data describing the RNA and the cell wall protein profiles of rosettes and flower stems of five Arabidopsis thaliana ecotypes. Four newly-described Pyrenees ecotypes [1] are analyzed in addition to the well-described and sequenced Columbia (Col) ecotype of A. thaliana. All five ecotypes have been grown at two different temperatures, 22 °C and 15 °C. We provide transcriptomics and cell wall proteomics data regarding (i) rosettes at the bolting stage, and (ii) floral stems at the first flower stage. These data are a valuable resource to study the adaptation of A. thaliana ecotypes to sub-optimal temperature growth conditions.


Synthesis and gelation property of a series of disaccharide triazole derivatives.
Low molecular weight gelators are important for the study of supramolecular chemistry and have useful applications for biomaterials. Glycomimetics that are easily accessible and have useful gelation properties are especially interesting molecules. In this research, nine per-O-acetyl lactosyl- and thirteen per-O-acetyl maltosyl triazole derivatives were synthesized and analyzed. Most of the maltosyl triazoles and one of the lactosyl derivatives were found to be effective molecular gelators. The supramolecular gels were characterized using rheology and optical microscopy and they exhibited morphologies ranging from fibers to planar sheets. The self-assembling properties of selected lactosyl and maltosyl triazole derivatives were studied using 1H NMR spectroscopy at different temperatures. The NMR studies revealed that the triazole moiety in these compounds played an important role in the formation of the supramolecular assembly, but the sugar moiety configurations are more influential towards gelation. Naproxen and chloramphenicol were used as the model drugs to assess the potential of these compounds in drug delivery applications. A pH responsive gelator showed faster delivery of chloramphenicol at mild basic conditions than neutral conditions. The effective disaccharide triazole-based molecular gelators are useful for the preparation of advanced soft materials that have potential applications as matrix for immobilization of drugs or biomolecules.


[Treatment of frostbite of the extremities by combined axillary plexus and peridural anesthesia: a case report including blood levels of bupivacaine].
To enhance peripheral perfusion after local frostbite, temporary or definitive interruption of the sympathetic activity in the region of injury is useful as an adjunct to systemic treatment. The common catheter techniques of axillary or epidural block provide the advantage of continued sympathicolysis without the risks of serial punctures or irreversible surgical alterations of the autonomic nervous system. bupivacaine into the three catheters (Fig. 2). A very satisfactory clinical result was observed. There was no loss of fingers


Hyaluronic acid-carboxymethylcellulose reduced postoperative bowel adhesions following laparoscopic urologic pelvic surgery: a prospective, randomized, controlled, single-blind study.
To assess the anti-adhesive effect of treatment with hyaluronic acid-carboxymethylcellulose following laparoscopic radical prostatectomy. This was a randomized, controlled, single-blind, parallel-group study using hyaluronic acid-carboxymethylcellulose in patients who underwent laparoscopic radical prostatectomy. Sixty patients were enrolled in the study. All patients were randomly assigned to either the hyaluronic acid-carboxymethylcellulose treatment group (n = 30) or the control group (n = 30). Viscera slide ultrasounds and plain X-rays were obtained at enrollment (V0), postoperative week 12 (V1), and 24 (V2). The primary end point was the difference in the excursion distance in the viscera slide ultrasound between V0 and V2. A total of 50 patients completed this study. The average excursion distance at V2 in the experimental group (n = 25) was significantly longer than in the control group (n = 25, 2.7 ± 1.2 vs. 1.3 ± 1.0 cm, respectively; p < 0.001). The differences in the V0 and V2 excursion distances were significantly higher in the control group than in the experimental group (1.48 ± 1.5 vs. 2.9 ± 1.2 cm, respectively; p < 0.001). None of patients showed adverse events associated with the use of hyaluronic acid-carboxymethylcellulose. This randomized study demonstrated that hyaluronic acid-carboxymethylcellulose treatment resulted in a reduction in bowel adhesion to the abdominal wall after laparoscopic pelvic surgery and had good clinical safety. ClinicalTrials.gov Identifier: NCT02773251 Date: May 12, 2016.


First-order antiferromagnetic transitions of SrMn2P2 and CaMn2P2 single crystals containing corrugated-honeycomb Mn sublattices.
SrMn2P2 and CaMn2P2 are insulators that adopt the trigonal CaAl2Si2-type structure containing corrugated Mn honeycomb layers. Magnetic susceptibility χ and heat capacity versus temperature T data reveal a weak first-order antiferromagnetic (AFM) transition at the Néel temperature [Formula: see text] K for SrMn2P2 and a strong first-order AFM transition at [Formula: see text] K for CaMn2P2 Both compounds exhibit isotropic and nearly T-independent [Formula: see text], suggesting magnetic structures in which nearest-neighbor moments are aligned at [Formula: see text] to each other. The 31P NMR measurements confirm the strong first-order transition in CaMn2P2 but show critical slowing down above [Formula: see text] for SrMn2P2, thus also evidencing second-order character. The 31P NMR measurements indicate that the AFM structure of CaMn2P2 is commensurate with the lattice whereas that of SrMn2P2 is incommensurate. These first-order AFM transitions are unique among the class of (Ca, Sr, Ba)Mn2 (P, As, Sb, Bi)2 compounds that otherwise exhibit second-order AFM transitions. This result challenges our understanding of the circumstances under which first-order AFM transitions occur.


A6 neurons simultaneously modulate active expiration and upper airway resistance in rats.
What is the central question of this study? Do A6 neurons modulate active expiratory and airway responses evoked by hypercapnia/acidosis? What is the main finding and its importance? Acute inhibition of A6 neurons reduced active expiratory, inspiratory and the associated oropharyngeal and laryngeal motor responses to hypercapnia/acidosis. A6 neurons provide excitatory synaptic drive contributing to the central generation of inspiratory and expiratory motor activity as well as the control of upper airway resistance. During rest, inspiration is an active phenomenon, whereas expiration is passive. Under conditions of high chemical drive, such as hypercapnia/acidosis, there is an increase in inspiratory activity, expiration becomes active and upper airway resistance is reduced. The locus coeruleus noradrenergic neurons (A6 neurons) are activated when exposed to elevated CO2 /[H+ ] levels and modulate respiratory brainstem neurons regulating ventilation. However, the role of A6 neurons in the control of upper airway resistance is not fully understood. We tested the hypothesis that A6 neurons contribute to the central generation of active inspiratory and expiratory responses and the associated changes in the motor nerves controlling upper airway resistance during hypercapnia/acidosis in rats. Using a perfused brainstem-spinal cord preparation, we inhibited A6 neurons using pharmacogenetics and evaluated the active expiratory (abdominal nerve), laryngeal (cervical vagus nerve), oropharyngeal (hypoglossal nerve) and inspiratory (phrenic nerve) motor nerve responses to hypercapnia/acidosis. Acute inhibition of A6 neurons did not produce significant changes in the respiratory pattern in normocapnia. However, the hypercapnia/acidosis-induced active expiratory response and the associated changes in the motor nerves responsible for control of oropharyngeal and laryngeal resistance, as well as the inspiratory response were all reduced after inhibition of A6 neurons. Our data demonstrate that A6 neurons exert an important excitatory synaptic drive to the central generation of both active inspiratory and expiratory activities and modulate the control of upper airway resistance during hypercapnia/acidosis.


Biomimetic Nanocarriers Guide Extracellular ATP Homeostasis to Remodel Energy Metabolism for Activating Innate and Adaptive Immunity System.
Metabolic interventions via targeting intratumoral dysregulated metabolism pathways have shown promise in reinvigorating antitumor immunity. However, approved small molecule immunomodulators often suffer from ineffective response rates and severe off-target toxicity. ATP occupies a crucial role in energy metabolism of components that form the tumor microenvironment (TME) and influences cancer immunosurveillance. Here, a nanocarrier-assisted immunometabolic therapy strategy that targets the ATP-adenosine axis for metabolic reprogramming of TME is reported. An ecto-enzyme (CD39) antagonist POM1 and AMP-activated protein kinase (AMPK) agonist metformin are both encapsulated into cancer cell-derived exosomes and used as nanocarriers for tumor targeting delivery. This method increases the level of pro-inflammatory extracellular ATP (eATP) while preventing the accumulation of immunosuppressive adenosine and alleviating hypoxia. Elevated eATP triggers the activation of P2X7-NLRP3-inflammasome to drive macrophage pyroptosis, potentiates the maturation and antigen capacity of dendritic cells (DCs) to enhance the cytotoxic function of T cells and natural killer (NK) cells. As a result, synergistic antitumor immune responses are initiated to suppress tumor progress, inhibit tumor distant metastases, provide long-term immune memory that offers protection against tumor recurrence and overcome anti-PD1 resistance. Overall, this study provides an innovative strategy to advance eATP-driven antitumor immunity in cancer therapy.


Posterior sacroiliac osteotomy: an alternative to the ilioinguinal approach for pelvic reconstruction in misalignment lesions.
Pelvic ring fractures occur in association with potentially fatal lesions, whose treatment is a priority in the polytrauma setting. As consequence, the definitive orthopedic approach may be postponed, leading patients to chronic and potentially disabling deformities. The treatment of these deformities is a challenge, requiring highly complex and staged surgical reconstructions. The ilioinguinal approach has been widely used in these surgeries, because it allows the release and mobilization of the hemipelvis and, in some cases, anterior fixation of the sacroiliac joint. However, in most cases, stable pelvic ring reconstruction requires this approach to be complemented by two other surgical approaches (posterior longitudinal and Pfannestiel). This requirement critically increases the surgical time and the risk of complications, such as neurovascular lesions and surgical wound infection. The current study presents a posterior osteotomy technique for posterior and anterior release of the sacroiliac joint, eliminating the need for ilioinguinal approach. The technique is performed by posterior longitudinal access; it allows adequate mobilization of the hemipelvis and reduction of vertical and rotational deformities, before the spinopelvic fixation and reduction of the pubic symphysis.


Shrinking multiplexed orbital angular momentum to the nanoscale.
Orbital angular momentum interactions at the nanoscale have remained elusive because the phase structure becomes unresolved. Now researchers have shown how to overcome this with tightly focused beams, demonstrating a record-high six-dimensional encoding in an ultra-dense nanoscale volume.


Effects of Dog-Based Animal-Assisted Interventions in Prison Population: A Systematic Review.
Animal-assisted interventions, in concrete dog-assisted intervention, have been introduced in prisons to reduce recidivism as well as to improve the well-being of prisoners. Therefore, the aim of the present systematic review is to provide an up-to-date analysis of the research on the effects of dog-based animal-assisted therapy in prison population. An electronic search of the literature was performed, and 20 articles were included. The PRISMA guideline methodology was employed. Included studies involved a total of 1577 participants. The vast majority of protocols included activities related with dog training, dog caring, or activities, which included vocational or educational components. Duration of dog-based therapies ranged between 60 and 120 min, with the frequency being between 1 and 3 days/week. Statistically significant improvements in prisoners were observed in 13 studies. Dog-based animal-assisted therapy may improve anxiety, stress, recidivism, and other social variables in male or female inmates.


From single extracellular unit recording in experimental and human Parkinsonism to the development of a functional concept of the role played by the basal ganglia in motor control.
Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects the whole basal ganglia (BG). Various techniques have been used to study BG physiology and pathophysiology. Among these, extracellular single unit recording remains of particular importance. An impressive number of studies of BG electrophysiological activity have been carried out, both in non-human and in human primates, but the data collected show many omissions and disparities. BG activity has been well defined in the physiological situation, but remains far from clear in the Parkinsonian and virtually unexplored in the dopamine (DA)-replacement situation. This paper provides a brief synopsis of (i) recording techniques and (ii) BG electrophysiological activity in normal, Parkinsonian, and dopamine-replacement situations. We have restricted the data used to those obtained in BG structures of human and non-human primates. Only single unit recordings have been reported and four electrophysiological characteristics retained: mean firing frequency, firing pattern, periodic oscillation, and response to both passive and active movement. We have attempted to summarize (i) the commonly accepted characteristics of each BG structure in the three situations, (ii) discrepancies that exist, and (iii) missing elements. Then, the main successive theories aimed to explain the role played by BG in motor control are presented and discussed in the light of the most recently obtained results using the latest technological advances.


Prediction of microvascular invasion of hepatocellular carcinoma: value of volumetric iodine quantification using preoperative dual-energy computed tomography.
To investigate the potential value of volumetric iodine quantification using preoperative dual-energy computed tomography (DECT) for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC). This retrospective study included patients with single HCC treated through surgical resection who underwent preoperative DECT. Quantitative DECT features, including normalized iodine concentration (NIC) to the aorta and mixed-energy CT attenuation value in the arterial phase, were three-dimensionally measured for peritumoral and intratumoral regions: (i) layer-by-layer analysis for peritumoral layers (outer layers 1 and 2; numbered in close order from the tumor boundary) and intratumoral layers (inner layers 1 and 2) with 2-mm layer thickness and (ii) volume of interest (VOI)-based analysis with different volume coverage (tumor itself; VOIO1, tumor plus outer layer 1; VOIO2, tumor plus outer layers 1 and 2; VOII1, tumor minus inner layer 1; VOII2, tumor minus inner layers 1 and 2). In addition, qualitative CT features, including peritumoral enhancement and tumor margin, were assessed. Qualitative and quantitative CT features were compared between HCC patients with and without MVI. Diagnostic performance of DECT parameters of layers and VOIs was assessed using receiver operating characteristic curve analysis. A total of 36 patients (24 men, mean age 59.9 ± 8.5 years) with MVI (n = 14) and without MVI (n = 22) were included. HCCs with MVI showed significantly higher NICs of outer layer 1, outer layer 2, VOIO1, and VOIO2 than those without MVI (P = 0.01, 0.04, 0.02, 0.02, respectively). Among the NICs of layers and VOIs, the highest area under the curve was obtained in outer layer 1 (0.747). Qualitative features, including peritumoral enhancement and tumor margin, and the mean CT attenuation of each layer and each VOI were not significantly different between HCCs with and without MVI (both P > 0.05). Volumetric iodine quantification of peritumoral and intratumoral regions in arterial phase using DECT may help predict the MVI of HCC.


Detection of visual field progression in glaucoma.
The aim of this study was to compare an event analysis and a trend analysis for the detection of progression in glaucomatous visual field loss. Excluding initial fields (Octopus, Haag-Streit AG, Köniz, Switzerland), baseline was defined as the average result of the second and third examinations. Eyes with at least 6 additional fields entered the study. The event analysis used the method of the Collaborative Normal Tension Glaucoma Study, and the trend analysis was based on a point-wise linear regression analysis. Of 251 glaucoma patients, 235 left eyes and 225 right eyes qualified for the study. Using the event analysis, 44 series suggested a progressive damage, while the point-wise regression approach disclosed only 14 progressing series. In 9 eyes, the two approaches were concordant. Among the latter, 1 - 5 additional fields were necessary in 7 series to disclose progression using the trend analysis. In one series, the event analysis showed progression 7 examinations later. The point-wise linear regression analysis classified fewer cases as progressing than the event analysis and determined progression later.


Insulinemic potential of diet and psychological disorders: A cross-sectional, population-based study.
Serum insulin levels and insulin sensitivity can impact mental disorders. This study investigates the association of the insulinemic potential of diet calculated using the empirical dietary indices for insulin resistance (EDIR) and hyperinsulinemia (EDIH) with psychological disorders, including depression, anxiety, and stress. This cross-sectional study was undertaken on 5405 individuals, aged 20-70, from the Yazd Health Study (YaHS). The food frequency questionnaire (FFQ) was used to collect dietary intakes. EDIR and EDIH were calculated from the FFQ data. Psychological disorders were assessed by an Iranian-validated version of the depression, anxiety, and stress scale questionnaire 21 (DASS 21). Multivariable logistic regression analysis was performed and odds ratio (OR) and 95 % confidence interval (CI) were reported. The mean ± SD of EDIR and EDIH were 0.32 ± 0.17 and 0.11 ± 0.08 in the total population, respectively. In the final adjusted model, participants in the highest versus the lowest quartile of EDIR had statistically higher odds of depression (OR: 1.28; 95 % CI: 1.01-1.62, P-trend = 0.032). However, no statistically significant association was observed between the EDIH score and depression. Also, EDIR and EDIH scores were not significantly associated with the odds of anxiety and stress. The cross-sectional design of the study prevented the inference of causality. Higher adherence to EDIR was positively associated with depression, but there was no significant association between EDIH and depression. EDIR and EDIH were also not significantly related to anxiety or stress.


[Detection of common determinants of HLA antigens A2 and B17 by absorption using human HLA serum].
Attempts of cross absorption where sera of anti-HLA A2 + B17, anti-HLA A2 and anti-HLA B17 with thrombocytes were absorbed from donors of HLA A2 positive, B17 negative and HLA A2 negative, B17 positive, revealed that anti-HLA A2 and anti-HLA B17 could be eliminated from the sera of both HLA types on the platelets. Thus, the findings allow the existence of a common determinant of HLA A2 and B17-antigens to be assumed. This is the first case where the evidence of a cross reaction between antigens of two different HLA loci with human sera could be established.


Prevalence of mange among West African Dwarf sheep and goats and associated haematological and biochemical parameters.
This study was carried out to assess the prevalence of mange in sheep and goats in five local government areas (LGAs) of Ogun State in South Western Nigeria. A total of 4,973 sheep and 7,902 goats of West African Dwarf breeds were sampled of which only 4 (0.08%) of sheep and 42 (0.53%) of goats were confirmed positive for mange infestation. In all the LGAs sampled, Odeda LGA had the highest concentration of sheep (39%) and goats (51%) while Abeokuta South had the least percentage of sheep (1%) and goats (1%). All the mange-infested cases in sheep were recorded in just one LGA (Ewekoro) which constituted 0.24% of the population within the location. For goats, three out of five LGAs namely: Obafemi Owode, Ewekoro and Abeokuta North had prevalence of 1.46%, 0.53% and 0.72% respectively. There was no significant (P > 0.05) difference between non-infested and infested animals in terms of packed cell volume (31.79 ± 0.87% vs. 31.41 ± 1.13%), haemoglobin (10.51 ± 0.21 g/100 ml vs. 10.28 ± 0.37 g/100 ml) and red blood cells (8.71 ± 0.29 × 10(12)/l vs. 9.40 ± 0.37 × 10(12)/l). The infested group however showed significantly (P < 0.01) higher white blood cells count (7.60 ± 0.22 × 10(9)/l) than the non-infested animals (6.81 ± 0.17 × 10(9)/l). Neutrophil, eosinophil, basophil and monocyte as well as chloride were not significantly affected by the health status of the animals. There existed significant (P < 0.01) difference between non-infested and infested animals in terms of total protein (5.42 ± 0.16 vs. 4.75 ± 0.20 g/dl), sodium (137.98 ± 1.53 vs. 128.92 ± 1.92 mEq/l) and potassium (4.04 ± 0.14 vs. 3.46 ± 0.18 mEq/l). It can be concluded from this study that the prevalence of mange mite infestation varied with location and was generally low or absent in some of the LGAs considered. Goats were particularly more susceptible to mange infestation than sheep. More concerted effort is needed to control mange in order to avoid spread since it is a contagious disease.


A two-step process for energy-efficient conversion of food waste via supercritical water gasification: Process design, products analysis, and electricity evaluation.
The huge amount of food waste (FW), containing high organic matter content and moisture, is difficult to be well treated. Supercritical water gasification (SCWG) can efficiently convert FW to H2-rich syngas. However, it requires high energy input due to the high temperature and high pressure. This study provided an innovative "two-steps heating process" for the SCWG of FW, which firstly utilized hydrothermal (HT) pretreatment to shorter time of SCWG. The effects of different HT temperature (200 °C, 250 °C, 300 °C, 30 min) to SCWG temperature (480 °C, 30 min) and the different residence time (20 min HT - 40 min SCWG, 30 min HT - 30 min SCWG, and 40 min HT - 20 min SCWG) on total syngas yield, carbon conversion efficiency (CE), cold gas efficiency (CGE), and hydrogen conversion efficiency (HE) were studied. Moreover, the energy input by means of electricity consumption in each experiment was measured to determine the energy saving rate. The optimal condition (200 °C, 20 min HT - 40 min SCWG), obtaining the gas yield (17.22 mol/kg), CE (20.10%), CGE (22.13%), and HE (41.54%), was higher than the gas yield (16.53 mol/kg), CE (19.98%), CGE (20%), and HE (38.08%) of directly SCWG (60 min, 0 °C-480 °C). Moreover, the TOC of derived liquid and the pyrolysis characteristics of solid residues were analyzed. Additionally, it was also observed the HT pretreatment helped to reduce the electricity consumption. The highest energy saving rate was 15.58%.


Association between GSTP1 Ile105Val polymorphism and glioma risk: a systematic review and meta-analysis.
Glutathione S-transferase P1 (GSTP1) gene Ile105Val polymorphism has been suggested to be involved in the development of glioma. However, the results from the studies regarding the association between GSTP1 Ile105Val polymorphism and glioma risk have been inconsistent. Thus, we performed a meta-analysis to investigate this association. Pooled odds ratios (ORs) with 95% confidence intervals (95%CIs) were calculated using random or fixed effects model. Nine studies with 2,078 cases and 3,970 controls were finally included into this meta-analysis. The results suggested there was no association between GSTP1 Ile105Val polymorphism and glioma risk under recessive model (OR = 1.138, 95%CI = 0.966-1.341, Pheterogeneity = 0.088, P = 0.123). Subgroup analyses by ethnicity showed there was also no association between GSTP1 Ile105Val polymorphism and glioma risk in mixed populations under recessive model (OR = 1.199, 95%CI = 0.928-1.549, Pheterogeneity = 0.060, P = 0.166) and Caucasian populations (OR = 1.097, 95%CI = 0.885-1.360, Pheterogeneity = 0.186, P = 0.398). In conclusion, the meta-analysis suggests that there is no association between GSTP1 Ile105Val polymorphism and glioma risk. However, more well-designed and larger studies are needed to further assess this association.


The radical SAM enzyme AlbA catalyzes thioether bond formation in subtilosin A.
Subtilosin A is a 35-residue, ribosomally synthesized bacteriocin encoded by the sbo-alb operon of Bacillus subtilis. It is composed of a head-to-tail circular peptide backbone that is additionally restrained by three unusual thioether bonds between three cysteines and the α-carbon of one threonine and two phenylalanines, respectively. In this study, we demonstrate that these bonds are synthesized by the radical S-adenosylmethionine enzyme AlbA, which is encoded by the sbo-alb operon and comprises two [4Fe-4S] clusters. One [4Fe-4S] cluster is coordinated by the prototypical CXXXCXXC motif and is responsible for the observed S-adenosylmethionine cleavage reaction, whereas the second [4Fe-4S] cluster is required for the generation of all three thioether linkages. On the basis of the obtained results, we propose a new radical mechanism for thioether bond formation. In addition, we show that AlbA-directed substrate transformation is leader-peptide dependent, suggesting that thioether bond formation is the first step during subtilosin A maturation.


Development of a biosensor for on-line detection of tributyltin with a recombinant bioluminescent Escherichia coli strain.
A biosensor was developed for the detection of tributyltin (TBT), using a bioluminescent recombinant Escherichia coli:: luxAB strain. Dedicated devices allowed the on-line measurement of bioluminescence, pH and dissolved oxygen values and the feed-back regulation of temperature. Bacterial physiology was monitored by the measurement of the cellular density, respiratory activity and the intracellular level of ATP, glucose and acetate levels. Our results showed that a synthetic glucose medium gave a better TBT detection limit than LB medium (respectively 0.02 micro M and 1.5 micro M TBT). High growth and dilution rates ( D=0.9 h(-1)) allowed maximum light emission from the bacterium. Moreover, simple atmospheric air bubbling was sufficient to provide oxygen for growth and the bioluminescence reaction. Real-time monitoring of bioluminescence after TBT induction occurred with continuous addition of decanal up to 300 micro M, which was not toxic throughout a 7-day experiment. The design of our biosensor and the optimization of the main parameters that influence microbial activity led to the capacity for the detection of TBT.


Radiotherapy in rectal cancer: is it time for change? A qualitative analysis of the national questionnaire survey of members of ACPGBI on preliminary CRO7 results.
A national questionnaire survey on management of rectal cancer suggested that despite the evidence of the CRO7 trial supporting the use of neoadjuvant short-course radiotherapy for operable rectal cancer, approximately two-thirds of consultant surgeons in the UK still have to implement this treatment regime routinely. However, 39% of surgeons have changed their practice following the early dissemination of trial results. Change in clinical practice is driven by a number of factors. To determine factors influencing changing clinical practice in the use of radiotherapy in rectal cancer. A 14-item questionnaire was designed to inquire into the current management strategy of operable rectal cancer and the possible role of neoadjuvant radiotherapy. A postal questionnaire survey was sent to all the active consultant members of the Association of Coloproctology of Great Britain and Ireland. Data for this article have been drawn from the subset of results constituting the comments section in the questionnaire. Qualitative methodology was adopted to analyse the comments section. Of 400 questionnaires, 200 (50%) were returned completed. Of these, only 52 (26%) surgeons completed the comments section. Themes that emerged from thematic analysis were: Patient groups, Treatment, Evidence-based practice (EBP), Professional consensus and Service provisions. The derived outcomes were: individualization of treatment, safer and less harmful treatment, increased role of multidisciplinary teams, need to increase awareness of the current evidence-based literature, develop protocols and guidelines along with shortening the delay in implementing EBP and good service provisions. In conclusion, change in practice is a slow and complex process influenced not only by data and scientific evidence, but also by a combination of other factors. Some of them are Clinical decision making, EBP/Education, Research Translation and Organizational factors with Infrastructure/Resources. Some of the above-mentioned conclusions will aid the policy makers and the opinion leaders in the National Health Service (NHS).


Stated Preference Research in Reproductive and Maternal Healthcare Services in Sub-Saharan Africa: A Systematic Review.
Understanding the preferred choice of healthcare service attributes for women is important, particularly in sub-Saharan Africa where resources are constrained and improving reproductive and maternal healthcare services is of high importance. The aim of this systematic review was to identify attributes of reproductive and maternal healthcare services in sub-Saharan Africa, and summarise the factors shaping women's preference to access these services. PubMed/MEDLINE, EMBASE, PsycINFO and CINAHL were searched from the inception of each database until March 2021 for published studies reporting stated preferences for maternal and reproductive healthcare services in sub-Saharan Africa. Data were extracted using a predefined extraction sheet, and the quality of reporting of included studies was assessed using PREFS and ISPOR (International Society for Pharmacoeconomics and Outcomes Research) checklists. The Donabedian's model for quality of healthcare was used to categorise attributes into "structure", "process" and "outcome". A total of 13 studies (12 discrete choice experiments and one best-worst scaling study) were included. Attributes related to the structure of healthcare services (e.g. availability of technical equipment, medications or diagnostic facilities, having good system conditions) are often included within the studies, and are considered the most important by women. Of the three dimensions of quality of healthcare, the outcome dimension was the least frequently studied across studies. All except one study explored women's preferences and the participants were pregnant women, women aged 18-49 years who had recently given birth and women living with human immunodeficiency virus. The included studies came from five sub-Saharan Africa countries of which Ethiopia and South Africa each contributed three studies. All of the included studies reported on the purpose, findings and significance of the study. However, none of the studies reported on the differences between responders vs non-responders. Nine of the 13 studies employed the ISPOR checklist and reported each item including the research question and the methods for identifying and selecting attributes, and provided the findings in sufficient detail and clarity. Aligning maternal healthcare service provision with women's preferences may foster client-oriented services and thereby improve service uptake and better patient outcomes.


Electric vehicle parameter identification and state of charge estimation of Li-ion batteries: Hybrid WSO-HDLNN method.
This manuscript proposes a hybrid method for measuring the battery's dynamic electrical response as it is compressed by an external-force. The proposed hybrid technique is the wrapper of the War Strategy Optimization algorithm and Hierarchical Deep Learning Neural Network, commonly called as WSO-HDLNN technique. The main aim of the proposed method is to lessen the battery-voltage error. The War Strategy Optimization method detects the parameters of the battery method. The Hierarchical Deep Learning Neural Network is used to predict the dynamic-electrical-response of the battery when it deforms during external-force. By using the proposed method, the estimated voltage and measured voltage error are reduced, and identifies the parameter effectively. Finally, the proposed method is done in the MATLAB platform and it is compared with different existing approaches. The error of the proposed method is 4 mV, the Jellyfish Search Optimizer method error is 6 mV, the Heap-based Optimizer method error is 12 mV, and the Grey Wolf Optimizer method error is 14 mV. The proposed method time is 0.7 s The proposed method shows better results in all methods, like Jellyfish Search Optimizer, Heap-based Optimizer, and Grey Wolf Optimizer, The proposed method provides less computation time and error than the existing one is proved from the simulation outcome.


Electroencephalographic discharges of temporal lobe seizures in children and young adults.
We investigated the discharge morphology and propagation patterns of electroencephalographic seizures of temporal lobe onset in 21 children and young adults who underwent invasive long-term EEG monitoring (LTM). Of those, 15 subsequently underwent anterior temporal lobectomy. The onset was focal in 63%. The most frequent discharge morphology was low amplitude beta (30%) or rhythmic/semirhythmic theta discharge (30%). Thirteen patients displayed several sequences of propagation with different spreading stages along a fixed path. Initial spreading to the ipsilateral frontal lobe was associated with a higher frequency of secondary generalization than initial spreading to the contralateral temporal lobe (P = 0.18). A comparison of 13 patients older than 18 years of age with 8 patients younger than 14 years showed a trend towards a lower rate of propagating from the temporal lobe (P = 0.13) in the younger age group. Discharge morphology was not correlated with age, focality, or outcome of surgery.


Direct and indirect effects of pollutants on algae and algivorous ciliates in an aquatic indoor microcosm.
An aquatic indoor microcosm was used to study effects of the pesticides parathion-methyl and prometryn on phototrophic flagellates (Cryptomonas sp.) and predatory ciliates (Urotricha furcata). Parathion-methyl caused effects to flagellates and ciliates at the range of low mg L(-1), regardless of whether the organisms were exposed separately or combined in the multi-species test system. Prometryn caused effects on the flagellates at low microg L(-1) concentrations, resulting in a NOEC of 6.9 microg L(-1) in the single-species test and a NOEC of 15.2 microg L(-1) in the multi-species microcosm. For ciliates the NOEC decreased by factor 145 in the multi-species test compared to the NOEC of 2.2 mg L(-1) in the single-species test when exposed to prometryn. The lower NOEC for ciliates exposed to prometryn in the microcosm was most likely caused by an indirect effect due to reduced availability of flagellates as food. The measurement of nutrient concentrations in the test media and organisms facilitated the modelling of effects. The presented aquatic indoor microcosm is considered as a tool which could be standardised and applied as an instrument to provide data for higher tier risk assessment.


Intraoperative bleeding: a mathematical model for minimizing hemoglobin loss.
The rationale for intraoperative blood transfusion is often based on incorrect concepts and criteria. A mathematical model based on physiologic measures and describing the usual pattern of surgical blood loss is presented, and a theoretical means of minimizing intraoperative hemoglobin loss with hypervolemic hemodilution is proposed. Intraoperative hemoglobin loss is often overestimated especially in connection with high-volume blood loss. The model of intraoperative hypervolemic hemodilution shows significant improvement in hemoglobin concentration in the immediate postoperative period, compared with normovolemic conditions. The difference is most marked at a high volume of blood loss and a high degree of maintained hypervolemia. The practice of intraoperative blood transfusion according to volume of blood lost is to be discouraged, and regular monitoring of the hematocrit is necessary to avoid unnecessary transfusion. The theoretical advantages of hypervolemic hemodilution warrant further testing of the model in a clinical setting.


Biomechanical study of oblique lumbar interbody fusion (OLIF) augmented with different types of instrumentation: a finite element analysis.
To explore the biomechanical differences in oblique lumbar interbody fusion (OLIF) augmented by different types of instrumentation. A three-dimensional nonlinear finite element (FE) model of an intact L3-S1 lumbar spine was built and validated. The intact model was modified to develop five OLIF surgery models (Stand-alone OLIF; OLIF with lateral plate fixation [OLIF + LPF]; OLIF with unilateral pedicle screws fixation [OLIF + UPSF]; OLIF with bilateral pedicle screws fixation [OLIF + BPSF]; OLIF with translaminar facet joint fixation + unilateral pedicle screws fixation [OLIF + TFJF + UPSF]) in which the surgical segment was L4-L5. Under a follower load of 500 N, a 7.5-Nm moment was applied to all lumbar spine models to calculate the range of motion (ROM), equivalent stress peak of fixation instruments (ESPFI), equivalent stress peak of cage (ESPC), equivalent stress peak of cortical endplate (ESPCE), and equivalent stress average value of cancellous bone (ESAVCB). Compared with the intact model, the ROM of the L4-L5 segment in each OLIF surgery model decreased by > 80%. The ROM values of adjacent segments were not significantly different. The ESPFI, ESPC, and ESPCE values of the OLIF + BPSF model were smaller than those of the other OLIF surgery models. The ESAVCB value of the normal lumbar model was less than the ESAVCB values of all OLIF surgical models. In most postures, the ESPFI, ESPCE, and ESAVCB values of the OLIF + LPF model were the largest. The ESPC was higher in the Stand-alone OLIF model than in the other OLIF models. The stresses of several important components of the OLIF + UPSF and OLIF + TFJF + UPSF models were between those of the OLIF + LPF and OLIF + BPSF models. Our biomechanical FE analysis indicated the greater ability of OLIF + BPSF to retain lumbar stability, resist cage subsidence, and maintain disc height. Therefore, in the augmentation of OLIF, bilateral pedicle screws fixation may be the best approach.


Pharmacogenetics and cancer chemotherapy.
Cancer chemotherapy is limited by significant inter-individual variations in responses and toxicities. Such variations are often due to genetic alterations in drug metabolising enzymes (pharmacokinetic polymorphisms) or receptor expression (pharmacodynamic polymorphisms). Pharmacogenetic screening prior to anticancer drug administration may lead to identification of specific populations predisposed to drug toxicity or poor drug responses. The role of polymorphisms in specific enzymes, such as thiopurine S-methyltransferases (TPMT), dihydropyrimidine dehydrogenase (DPD), aldehyde dehydrogenases (ALDH), glutathione S-transferases (GST), uridine diphosphate glucuronosyl-transferases (UGTs) and cytochrome P450 (CYP 450) enzymes in cancer therapy are discussed in this review.


Advanced Imaging and Sampling in Barrett's Esophagus: Artificial Intelligence to the Rescue?
Because the current Barrett's esophagus (BE) surveillance protocol suffers from sampling error of random biopsies and a high miss-rate of early neoplastic lesions, many new endoscopic imaging and sampling techniques have been developed. None of these techniques, however, have significantly increased the diagnostic yield of BE neoplasia. In fact, these techniques have led to an increase in the amount of visible information, yet endoscopists and pathologists inevitably suffer from variations in intra- and interobserver agreement. Artificial intelligence systems have the potential to overcome these endoscopist-dependent limitations.


Balloon Aortic Valvuloplasty Using a Non-Occlusive Balloon Catheter: First Animal Experience.
Transcatheter aortic valve implants (TAVI) have revolutionised the treatment of elderly patients requiring aortic valve replacement. These patients often do not tolerate balloon valvuloplasty well, and a valvuloplasty balloon that would allow a degree of continued cardiac output during expansion would be beneficial. We tested such a balloon and describe our results in the sheep model. We developed a non-occlusive balloon (NOB) catheter. An acute experiment was performed where the NOB was inflated in six sheep in the aortic valve position without any attempt to arrest cardiac output. Two inflations were performed per animal: the first for 30 s and the second for 2-3 min. Standard occlusive balloons were inflated in two animals under rapid ventricular pacing to serve as controls. Mean pressure gradient across the NOB was 9.7 ± 5 mmHg during the inflations and all animals remained hemodynamically stable during NOB inflations. The novel non-occlusive balloon catheter, which permitted uninterrupted cardiac output for a prolonged period without the need for pacing-induced temporary cessation of cardiac output, is both feasible and well tolerated in the acute sheep model.


[Comparative studies of breath-hold magnetic resonance cholangiopancreatography (MRCP) between different two sequences and between 1.0T and 1.5T units].
In this article, a comparative study in the diagnostic ability of a breath-hold MRCP between thin slice half-Fourier acquisition single-shot turbo spin-echo (HASTE) and thick slice rapid acquisition with relaxation enhancement (RARE), and between 1.5T and 1.0T units was made. Although thin slice HASTE sequence might be more excellent in the diagnostic ability than thick slice RARE, the ability of depiction of pancreaticobiliary system on MRCP was not statistically different between these two sequences and between 1.0T and 1.5T units. Thick slice RARE sequence was inferior to thin slice HASTE in the depiction of gallbladder stone. However, thick slice RARE sequence was useful for MRCP because a projection image of pancreaticobiliary system could be easily obtained without postprocessing and without misregistration. Thick slice RARE sequence should be used in combination with thin slice HASTE sequence for the diagnosis of pancreaticobiliary system.


Predictive value of preoperative clinical examination for subacromial decompression in impingement syndrome.
Subacromial decompression is the standard surgical treatment of subacromial impingement syndrome. Unsatisfactory results have been reported for concomitant lesions as well as inadequate diagnosis. We sought to determine the predictive value of the preoperative examination for the results of arthroscopic subacromial decompression in impingement syndrome. Forty-nine shoulder joints in 47 patients receiving arthroscopic subacromial decompression were prospectively followed for a mean 3.7 ± 0.4 years. Prior to surgery, the impingement tests according to Neer, Hawkins-Kennedy (in the neutral as well as abducted position), and the Jobe test (empty can position) were evaluated as well as the presence of a painful arc. The association between the presence of these sings, success of the operation, and improvement in Constant scores as well as WORC indices was analysed. Pre- to postoperative improvement in Constant scores as well as WORC indices was greater in case of a positive test result for every test studied. With the numbers available, significant greater improvements in Constant scores were observed only for patients with a positive Hawkins-Kennedy sign in the neutral position, Neer and Jobe tests, compared to patients with negative signs, respectively. No significant differences were observed for the improvement in WORC indices. Patients with at least four positive tests out of the five studied had greater improvement in Constant scores than patients with three or less positive test results. Five patients went on to receive subsequent shoulder surgery. There was no association between the necessity for revision surgery and the presence or absence of impingement signs. The impingement tests according to Hawkins-Kennedy, Neer, and Jobe are valid predictors of outcome after subacromial decompression, as is the presence of multiple impingement tests. This study may aid in improving patient outcome and especially patient selection for subacromial decompression. Prognostic, Level I.


Prevalence of ossification of the posterior longitudinal ligament of the cervical spine.
To determine the prevalence of ossification of the posterior longitudinal ligament (OPLL) in cervical spines in Koreans. We reviewed the reports of the radiologic examination of cervical spines from January 2002 to September 2005 in Hanyang University Hospital, Seoul, Korea. OPLL was indicated by the presence of heterotopic ossification in the posterior longitudinal ligament on lateral cervical radiograph. Among 11,774 adults aged 16 years or more, 71 cases of OPLL were found (0.60%). The male to female ratio was 42:29 (1.45:1). The highest prevalence was in patients aged 50-59 years. In terms of the types of OPLL, the continuous type was noted in 32.0% of the patients, the segmental type in 31.0%, the mixed type in 31.0%, and the localized type in 5.6%. C4, C5, and C3 were most commonly involved, in that order of frequency. Diffuse idiopathic skeletal hyperostosis, which is another common hyperostotic disorder, was also found in eight male patients. The prevalence of cervical OPLL in Koreans was 0.60%, which was lower than that of Japanese and some previous western reports.


Effects of cations on guanylate cyclase of sea urchin sperm.
Mn2+ and to some degree Fe2+, but not Mg+, Ca2+, ba2+, Sr2+, Co2+, Ni2+, La3+, or Fe3+ were able to serve as effective metal cofactors for sea urchin sperm guanylate cyclase. The apparent Michaelis constant for Mn2+ in the presence of 0.25 mM MnGTP was 0.23 mM. In the presence of a fixed free mn2+ concentration, variation in mngTP resulted in sigmoid velocity-substrate plots and in reciprocal plots that were concave upward. These positive cooperative patterns were observed at both pH 7.0 and 7.8 and in the presence or absence of Triton X-100. When Mn2+ and GTP were equimolar, Ca2+, Ba2+, Sr2+, and Mg2+ increased apparent guanylate cyclase activity. This increase in enzyme activity at least could be accounted for partially by an increase in free Mn2+ concentration caused by the complex formation of GTP with the added metals. However, even at relatively low GTP concentrations and with Mn2+ concentrations in excess of GTP, Ca2+, Sr2+, and Ba2+ significantly increased guanosine 3':5'-monophosphate production. As the total GTP concentration was increased, the degree of stimulation in the presence of Ca2+ decreased, despite maintenance of a fixed total concentration of Ca2+ and a fixed free concentration of Mn2+, suggesting that the concentration of CaGTP and MnGTP were determining factors in the observed response. The concave upward reciprocal plots of velocity against MnGTP concentration were changed to linear plots in the presence of CaGTP or SrGTP. These results suggest that sea urchin sperm guanylate cyclase contains multiple nucleotide binding sites and that stimulation of guanosine 3':5'-monophosphate synthesis by Ca2+, Sr2+, and perhaps other metals may reflect interaction of a metal-GTP complex with enzyme as either an effector or a substrate.


Assessment of mycoflora and infestation of insects, vector of Aspergillus section Flavi, in stored peanut from Argentina.
The occurrence of spoilage fungi and Aspergillus section Flavi populations, the aflatoxins incidence, the role of insects as vectors of mycotoxin-producing fungi and the AFs-producing ability of the isolated species throughout the peanut (Arachis hypogaea L.) storage period were evaluated. Analyses of fungal populations from 95 peanut seed samples did not demonstrate significant differences between the incidences in each sampling period. Aspergillus section Flavi were isolated during all incubation periods. Cryptolestes spp. (Coleoptera: Cucujidae) were collected in August, September and October with 18, 16 and 28% of peanut samples contaminated, respectively. Insects isolated during August showed 69% of Aspergillus section Flavi contamination. A. flavus was the most frequently isolated (79%) from peanut seeds and from insect (59%). The greater levels of AFB1 were detected in September and October with a mean of 68.86 μg/kg and 69.12 μg/kg respectively. The highest proportion of A. flavus toxigenic strains (87.5%) was obtained in June. The presence of Aspergillus section Flavi and insect vectors of aflatoxigenic fungi presented a potential risk for aflatoxin production during the peanut storage period. Integrated management of fungi and insect vectors is in progress.


Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents.
To investigate associations between exposure to air pollution and child and adolescent mental health. Observational study. Swedish National Register data on dispensed medications for a broad range of psychiatric disorders, including sedative medications, sleeping pills and antipsychotic medications, together with socioeconomic and demographic data and a national land use regression model for air pollution concentrations for NO2, PM10 and PM2.5. The entire population under 18 years of age in 4 major counties. We excluded cohort members whose parents had dispensed a medication in the same medication group since the start date of the register. The cohort size was 552 221. Cox proportional hazards models to estimate HRs and their 95% CIs for the outcomes, adjusted for individual-level and group-level characteristics. The average length of follow-up was 3.5 years, with an average number of events per 1000 cohort members of ∼21. The mean annual level of NO2 was 9.8 µg/m(3). Children and adolescents living in areas with higher air pollution concentrations were more likely to have a dispensed medication for a psychiatric disorder during follow-up (HR=1.09, 95% CI 1.06 to 1.12, associated with a 10 µg/m(3) increase in NO2). The association with NO2 was clearly present in 3 out of 4 counties in the study area; however, no statistically significant heterogeneity was detected. There may be a link between exposure to air pollution and dispensed medications for certain psychiatric disorders in children and adolescents even at the relatively low levels of air pollution in the study regions. The findings should be corroborated by others.


Role of radiotherapy in treatment of extramedullary relapse following total marrow and lymphoid irradiation in high-risk and/or relapsed/refractory acute leukemia.
Total Marrow and Lymphoid Irradiation (TMLI) is a promising component of the preparative regimen for hematopoietic cell transplantation in patients with high-risk acute myeloid leukemia (AML) and acute lymphoid leukemia (ALL). Extramedullary (EM) relapse after TMLI is comparable to TBI and non-TBI conditioning regimens. This study evaluates outcomes of patients treated with radiotherapy (RT) with EM relapse previously treated with TMLI. A retrospective analysis of five prospective TMLI trials was performed. TMLI targeted bones and major lymphoid tissues using image-guided tomotherapy, with total dose ranging from 12 to 20 Gy. EM recurrences were treated at the discretion of the hematologist and radiation oncologist using RT ± chemotherapy. Descriptive statistics and survival analysis were then performed on this cohort. In total, 254 patients with refractory or relapsed AML or ALL were treated with TMLI at our institution. Twenty-one patients were identified as receiving at least one subsequent course of radiation. A total of 67 relapse sites (median=2 sites/patient, range=1-16) were treated. Eleven relapsed patients were initially treated with curative intent. Following the initial course of subsequent RT, 1-year, 3-year and 5-year estimates of OS were 47.6%, 32.7% and 16.3%, respectively. OS was significantly better in patients treated with curative intent, with median OS of 50.7 months vs 1.6 months (p<0.001). 1-year, 3-year and 5-year estimates of PFS were 23.8%, 14.3% and 14.3%, respectively. PFS was significantly better in patients treated with curative intent, with median PFS of 6.6 months vs 1.3 months (p<0.001). Following RT, 86.6% of the sites had durable local control. RT is an effective modality to treat EM relapse in patients with acute leukemia who relapse after HCT achieving high levels of local control. In patients with limited relapse amenable to curative intent, radiation confers favorable long-term survival. Radiation as salvage treatment for EM relapse after HCT warrants further evaluation.


Xanthatin suppresses pancreatic cancer cell growth via the ROS/RBL1 signaling pathway: In vitro and in vivo insights.
As a malignant digestive system tumor, pancreatic cancer has a high mortality rate. Xanthatin is a sesquiterpene lactone monomer compound purified from the traditional Chinese herb Xanthium strumarium L. It has been reported that Xanthatin exhibits inhibitory effects on various cancer cells in retinoblastoma, glioma, hepatoma, colon cancer, lung cancer, as well as breast cancer. However, in pancreatic cancer cells, only one report exists on the suppression of Prostaglandin E2 synthesis and the induction of caspase 3/7 activation in Xanthatin-treated MIA PaCa-2 cells, while systematic in vitro and in vivo investigations and related mechanisms have yet to be explored. This research aims to explore the in vitro and in vivo effects of Xanthatin on pancreatic cancer and its molecular mechanisms. The anticancer effects and mechanisms of Xanthatin on pancreatic cancer cells were assessed through employing cell counting kit-8 (CCK-8) assay, lactate dehydrogenase (LDH) assay, carboxyfluorescein diacetate succinimidyl ester (CFDA SE) cell proliferation assay, colony formation assay, wound healing assay, transwell assay, Annexin V-FITC/propidium iodide (PI) dual staining, Hoechst nuclear staining, Western blot analysis, phosphoproteomics, and reactive oxygen species (ROS) measurement. The in vivo anticancer effects of Xanthatin on pancreatic cancer cells were studied using a nude mouse model. The present study showed that Xanthatin can prevent the proliferation and metastasis of pancreatic cancer cells and trigger the exposure of phosphatidylserine (PS), chromatin condensation, and caspase activation, thereby inducing apoptosis. Phosphoproteomic analysis indicated that Xanthatin inhibits the phosphorylation of the proliferation-associated protein RBL1, and oxidative stress can lead to RBL1 dephosphorylation. Further investigation revealed that Xanthatin significantly upregulates ROS levels in pancreatic cancer cells, and the antioxidant N-acetylcysteine (NAC) can reverse Xanthatin-induced cell proliferation inhibition and apoptosis. In addition, Xanthatin can suppress pancreatic cancer cell growth in a xenograft nude mouse model with low toxicity to the mice. Xanthatin may inhibit the proliferation of pancreatic cancer cells and trigger apoptosis through the ROS/RBL1 signaling pathway.


A controlled clinical trial of the effect of gastric bypass surgery and intensive lifestyle intervention on nocturnal hypertension and the circadian blood pressure rhythm in patients with morbid obesity.
Nocturnal hypertension, increased night-to-day systolic blood pressure (BP) ratio and nondipper status (night-to-day systolic BP ratio > 0.9) are associated with an increased risk of cardiovascular disease. Our aim was to compare the 1-year effect of Roux-en-Y gastric bypass (RYGB) versus a program of intensive lifestyle intervention (ILI) only on nocturnal hypertension and circadian BP rhythm. The study participants were part of a 1-year, controlled clinical trial comparing the effect of RYGB or ILI on obesity-related comorbidities. Ninety participants (49 in the RYGB group) successfully completed 24-hour ambulatory BP monitoring at baseline and follow-up and were eligible subsequently for analysis. A total of 71 subjects (79%) had nocturnal hypertension at baseline. The number of subjects with nocturnal hypertension decreased from 42 to 14 in the RYGB group (P ≤ .001) and from 29 to 27 (P = .791) in the ILI group. Subjects in the RYGB group had a lesser adjusted odds ratio (OR) of nocturnal hypertension at follow-up (OR 0.15; 95% confidence interval, 0.05-0.42; P ≤ .001); however, after further adjustment for weight loss, there was no additional beneficial effect of RYGB (P = .674). No differences between groups regarding improvement in the night-to-day systolic BP ratio were found after adjustment for 24-hour systolic pressure (P = .107). Both interventions showed a decrease in the proportion of subjects classified as nondippers, namely, 44% (P ≤ .001) and 28% (P = .002) in the RYGB and ILI groups, respectively. Only RYGB was associated with a decrease in the prevalence of nocturnal hypertension. Both interventions showed an improvement in dipper status, although RYGB was more effective.


Single-port transvesical enucleation of the prostate for benign prostatic hyperplasia with severe intravesical prostatic protrusion.
To introduce the surgical techniques of a single-port transvesical enucleation of the prostate (STEP) for enlarged prostates with severe intravesical prostatic protrusion (IPP) presenting with lower urinary tract symptoms (LUTS). Our study included 7 patients with prostates larger than 80 mL and with severe IPP who underwent STEP. All the procedures were performed using a home-made single-port device through a 3-cm midline incision at the level three fingerbreadths above the symphysis pubis. Rigid laparoscopic instruments and Harmonic Scalpels(®) were used to enucleate the large adenoma of the prostate. All the procedures were completed satisfactorily, with no intra and early postoperative complications. The mean resected prostatic weight was 54.14 ± 8.38 g, and the mean operative time was 191.86 ± 40.88 min. The mean time for catheterization was 5.29 ± 1.80 days. The postoperative 3-month international prostate symptoms score (IPSS) and maximal flow rate (Qmax) were improved following STEP (IPSS; 23.57 ± 2.15 vs. 11.43 ± 2.44, Qmax; 17.14 ± 3.44 mL/s vs. 6.71 ± 2.29 mL/s). Laparoendoscopic single-site surgery (LESS) and enucleation of the prostate with rigid laparoscopic instruments might be difficult but is feasible. STEP may be a new treatment option for use in open prostatectomies for enlarged prostates with severe IPP in carefully selected patients.


Increased tissue factor activity generation in vitro by canine blood leukocytes associated with allogeneic kidney transplantation and rejection.
Using a canine model, leukocyte populations enriched for monocytes and lymphocytes were isolated from blood during three week periods after kidney allotransplantation corresponding to episodes of acute rejection. Relative to controls, these cells incubated in vitro for five hours were found to generate increased amounts of PCA (procoagulant activity) characterized as tissue factor, the extrinsic clotting pathway activator. Controls included comparable blood leukocyte populations isolated from kidney autograft recipients and healthy animals. Differences in results for these two control groups were insignificant. These contrasts observed between allografted animals and controls demonstrate that leukocyte PCA generation is stimulated by the allogeneicity of histoincompatible kidneys rather than by direct effects of organ transplantation or non-specific postoperative effects. Results of in vitro transfer experiments provide evidence that cellular stimulation or induction in vivo accounted for the PCA increases observed. Stimulation of leukocyte tissue factor generation as a consequence of allogeneic kidney transplantation may in part account for coagulopathies and fibrin deposition during kidney rejection.


Hepatitis B Virus Reactivation in Kidney Transplant Recipients Treated With Belatacept.
Hepatitis B virus (HBV) reactivation in kidney transplant recipients has been reported in 3% to 9% of anti-HBc antibody (HBcAb)-positive HBs antigen (HBsAg)-negative patients. It has not been studied in patients receiving belatacept, a selective costimulation blocker. We performed a retrospective study of all transplant recipients receiving belatacept in 2 kidney transplantation centers in France. Among HBcAb-positive patients, we analyzed HBV reactivation rate, outcomes, and risk factors. A total of 135 patients treated with belatacept were included: 32 were HBcAb-positive and 2 were HBsAg-positive. Seven patients reactivated HBV (21.9% of HBcAb-positive patients), including 5 HBsAg-negative patients (16.7% of HBcAb-positive HBsAg-negative patients). Reactivation occurred 54.8 (± 70.9) months after transplantation. One patient presented with severe hepatitis and 1 patient developed cirrhosis. There was no significant difference in survival between patients that reactivated HBV and patients that did not: 5-year patient survival of 100% (28.6; 100) and 83.4% (67.6; 100), respectively (P = 0.363); and 5-year graft survival of 100% (28.6; 100) and 79.8% (61.7; 100), respectively (P = 0.335). No factor, including HBsAb positivity and antiviral prophylaxis, was statistically associated with the risk of HBV reactivation. HBV reactivation rate was high in patients treated with belatacept when compared with previous transplantation studies. HBV reactivation did not impact survival. Further studies are needed to confirm these results. A systematic antiviral prophylaxis for these patients should be considered and evaluated.


Subcutaneous golimumab to treat a biological naïve chronically active ulcerative colitis child. A case report.
Ulcerative colitis is an immune-mediated disease that carries challenges in pediatrics since it's frequently severe and extensive. Current pediatric ulcerative colitis guidelines offer a weak recommendation regarding the usage and the dosage of golimumab in low-weight children. We present a case of an off-label, unrecommended dose of subcutaneous golimumab to treat low-weight chronic active ulcerative colitis child. A 10-year-old Syrian girl, anti-TNF naïve, chronically active ulcerative colitis was weighs 25 kg, standing 142 cm tall, body surface area (BSA) of 0.993 m2, past medications included oral prednisone and mesalamine, no prior surgery. We used golimumab 200 mg, 100 mg at weeks 0, 2 as induction, then 50 mg every four weeks for about two years. The recommendation regarding the use of subcutaneous golimumab in pediatrics is weak since is based on an open-label pharmacokinetics cohort. It is available in 100 mg/1 ml, 50 mg/0.5 ml as a smart SmartJect, or in 45 mg/0.45 ml in VarioJect which provides golimumab from 10 mg to 45 mg in increments of 5 mg/0.05 ml. Golimumab Varioject is in short supply, and unavailable in several regions including Syria. The recommended golimumab maintenance dose always requires two injectors, which adds another burden. This case demonstrated that golimumab 200 mg, 100 mg at week 0, 2 as an induction then 50 mg every four weeks was efficacious and safe in<45 kg children, there were no side effects or adverse events during two years therapy period.


Rates and risks of depressive symptoms in a United States urban community.
The results of a U.S. urban community survey, conducted in 1967 and in 1969, show that 16--18% of the population have depressive symptoms at any one time. Similar rates are reported in five other studies where self-report depression symptom scales have been used. The relationship between depressive symptoms and the diagnosis of major depressive disorders still requires investigation since the presence of depressive symptoms does not necessarily indicate the diagnosis of a major or minor depressive disorder.


The Nexus of Physical and Psychological Pain: Consequences for Mortality and Implications for Medical Sociology.
Although physical pain lies at the intersection of biology and social conditions, a sociology of pain is still in its infancy. We seek to show how physical and psychological pain are jointly parts of a common expression of despair, particularly in relation to mortality. Using the 2002-2014 National Health Interview Survey Linked Mortality Files (N = 228,098), we explore sociodemographic differences in the intersection of physical and psychological pain (referred to as the "pain-distress nexus") and its relationship to mortality among adults ages 25 to 64. Results from regression and event history models reveal that differences are large for the combination of the two, pointing to an overlooked aspect of health disparities. The combination of both high distress and high pain is most prevalent and most strongly predictive of mortality among socioeconomically disadvantaged, non-Hispanic whites. These patterns have several implications that medical sociology is well positioned to address.


The relational determination of length illusions and length aftereffects.
When two lines were presented simultaneously, in an illusion paradigm, the judged length of one of the lines (the focal line) assimilated toward the length of the contextual line. When the lines were presented sequentially, in an aftereffect paradigm, the apparent length of the focal line was displaced away from the length of a previously presented contextual line (i.e. contrast). The largest effects obtained at inverse contextual-to-focal length ratios: 1.67:1 for contextual lines longer than the focal line and 0.60:1 for contextual lines shorter than the focal line. Overestimation of focal length was larger than underestimation for both illusions and aftereffects despite the fact that identical stimuli produced effects in opposite directions in the two paradigms. Results were discussed in terms of a neural length-coding model and were related to visual size constancy.


N-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine increases acetylcholine and decreases dopamine in mouse striatum: both responses are blocked by anticholinergic drugs.
The neurotoxin N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) produces neuropathology and clinical symptoms that resemble Parkinsonism in primates and humans. In mice it induces a long-lasting depletion of neostriatal 3,4-dihydroxyphenylethylamine (dopamine) content. Using the mouse, we found that MPTP induces a fall of dopamine and a rise of acetylcholine in the neostriatum. Both responses to MPTP can be blocked by prior treatment with atropine or trihexyphenidyl.


Thermal degradation of polybrominated diphenyl ethers over as-prepared Fe3O4 micro/nano-material and hypothesized mechanism.
The thermal degradation of decabromodiphenyl ether (BDE-209) featuring fully substituted bromines was investigated over an as-prepared Fe3O4 micro/nano-material at 300 °C. Degradation followed pseudo-first-order kinetics with kobs = 0.15 min(-1) higher than that for decachlorobiphenyl (CB-209). Twenty-six newly produced polybrominated diphenyl ether (PBDE) congeners were identified using the available PBDE standards, while four PBDE congener products were predicted using third-order polynomial regression equation. Analysis of the products indicated that BDE-209 underwent stepwise hydrodebromination over as-prepared Fe3O4. Similar to the case for CB-209, two initial hydrodebromination steps are favored at the BDE-209 meta-positions, giving the major products BDE-207 and BDE-197. However, the variance about the preferred products began to emerge from the start of heptabromodiphenyl ethers (hepta-BDEs). The majorly produced hepta-BDE isomer with BDE-183 is unbrominated at one ortho-position. However, this is different from the reported degradation of CB-209, which always produced the products chlorinated at all four ortho-positions until the ortho-position had to be removed for the formation of trichlorobiphenyls and dichlorobiphenyl still majorly chlorinated at three or two ortho-positions. The early BDE-209 hydrodebromination steps appear to be strongly influenced by steric effects, whereas subsequent hydrodebromination steps, as more bromine atoms are removed, will be gradually governed more by thermodynamics.


[Testing of the "retinal acuity" with the laser interference apparatus as a routine clinical method].
The retinal function may be tested by laser-interference-fringes formed on the retina independently of the refraction status of the eye. The perception of these fringes is a subjective test for the retinal function even in case of moderate opacities of the optical media. Experiences with a new apparatus described here showed that the determination of this "retinal acuity" is very simple to perform. The comparison of retinal acuity and visula acuity of several hundred cataratous eyes and the measurement before and after cataract extraction in about 100 cases are discussed. The method gives useful prognostic and diagnostic information to the ophthalmologist.


An usual elastophagocytic granuloma with involvement of the back: a possible variant of an annular elastolytic giant cell granuloma.
Annular elastolytic giant cell granuloma (AEGCG) is a very infrequent granulomatous dermatitis characterized by elastolysis and elastophagocytosis. It usually appears in middle-aged Caucasian women and is normally located in sun-exposed areas.We present a case of a 73-year-old woman with hypertension and type II diabetes, who was admitted to the hospital for an ischemic cerebrovascular accident. She presented with annular and serpiginous skin lesions on her back and arms that had appeared seven months earlier; a clinical and histological diagnosis of elastophagocytic granuloma was made. Our patient exhibited a florid presentation and a self-limiting course.


Correlation of pretransplant viral serology and complications of bone marrow transplantation.
Latent herpes viruses such as herpes simplex virus, cytomegalovirus (CMV), and varicella zoster virus are often reactivated after bone marrow transplantation, giving rise to infections. In contrast, Epstein-Barr virus infections rarely occur. Significant mortality is induced especially by pneumonitis, most often caused by CMV. Immunosuppression and pancytopenia caused by CMV increase the risk of bacterial infections and invasive fungal infections. Herpes viruses may increase the risk of acute and chronic graft-versus-host disease (GVHD). Thus, immunity to several herpes viruses was associated with an increased risk of acute GVHD. Seropositivity for CMV in recipient and donor increased the risk of chronic GVHD. Herpes viruses were also associated with a decreased risk of leukemic relapse. CMV infection, asymptomatic CMV infection, and seropositivity for several herpes viruses were associated with a reduced incidence of relapse in different reports. In spite of this possible antileukemic effect, leukemia-free survival was unaffected by herpes virus immunity in recipients or donors.


Clinical and radiological relationship between posterior lumbar interbody fusion and posterolateral lumbar fusion.
Posterolateral lumbar fusion (PLF) is the most popular technique for stabilizing the lumbar spine. Biomechanically, PLF decreases segmental motion in the posterior column, which presumably reduces facet joint pain. Posterior lumbar interbody fusion (PLIF) may decompress nerve roots by distracting the collapsed disc space, and achieving optimal fusion in relation to load-bearing capacity. The purpose of the study was to examine the role of interbody fixation vs pedicle fixation in transverse lumbar fusion and to assess treated and adjacent disc space height changes over time. One hundred patients who underwent PLIF and noninstrumented transverse process fusion (n = 55) or instrumented PLF (n = 45) between 1996 and 1998 were evaluated retrospectively. Outpatient charts and follow-up films were reviewed. Bone fusion was determined using Brantigan and Steffee's classification and clinical outcome by the Prolo scale. Disc space heights at the fusion and adjacent levels were measured. Analysis of variance and chi(2) statistical techniques were used for data analysis. Disc space height was increased and better maintained in PLIF patients. PLIF resulted in a nonsignificant tendency toward higher fusion rates. No differences in clinical and functional outcomes were found between the groups. There was no correlation between preservation of disc space height and clinical outcome. Disc space height does not seem to impact clinical outcome in lumbar fusion, and efforts to maintain it may be unwarranted.


The second genus and species of the extinct neuropteroid family Corydasialidae, from early Eocene McAbee, British Columbia, Canada: do they belong to Megaloptera?
Ypresioneura obscura gen. et sp. nov. from the early Eocene (Ypresian) McAbee locality (Canada, British Columbia) is described. It is assigned to the extinct neuropteroid family Corydasialidae, as the second known genus and species. The Corydasialidae was previously known only from late Eocene (Priabonian) Baltic amber. It was originally assigned to the Megaloptera, but the character states that support this conclusion are not strongly diagnostic. There is still doubt as to whether this family belongs to Megaloptera or to the Neuroptera. If this is a megalopteran (which we favor), it is the first specimen of the order from the insect-rich Okanagan Highlands series of Ypresian localities, which occur sporadically across the southern interior of British Columbia, Canada into north-central Washington, USA.