Treatment of out-of-hospital cardiac arrest in Ljubljana: outcome report according to the 'Utstein' style.
We investigated survival of patients with out-of-hospital cardiac arrest in Ljubljana according to the 'Utstein' style. Ljubljana consists of urban, suburban and semi-rural communities which encompass an area of 1615 km2 with 397306 residents. The area is served by a single response emergency medical system and local family practitioners. Between January 1, 1995 and December 31, 1997 cardiac arrest was confirmed in 966 patients. Cardiopulmonary resuscitation was attempted in 454 patients (47%). Collapse of presumed cardiac etiology (337 patients) was either bystander-witnessed (89%), un-witnessed (9%) or EMS personnel-witnessed (2%). Asystole was documented in 55%, ventricular fibrillation or tachycardia in 36% and other non-perfusing rhythms in 9% of these patients. Lay-bystander basic life support was performed in 19%. Nineteen patients (5.6%) survived to hospital discharge and 12 of them were independent in daily life. The survival of subgroups with bystanders-witnessed collapse and bystanders-witnessed ventricular fibrillation was 6.4 and 13%, respectively. Collapse of non-cardiac etiology (117 patients) was preceded by either respiratory failure (41), politrauma (22), circulatory shock (19), cerebrovascular incident (ten), intoxication (nine), strangulation (seven), electrocution (five) or drowning (four patients). Only five patients (4.2%) survived to hospital discharge. Hospital treatment of patients after successful initial cardiopulmonary resuscitation was associated with high mortality and required considerable resources.


The effect of giving influenza vaccination to general practitioners: a controlled trial [NCT00221676].
No efficacy studies of influenza vaccination given to GPs have yet been published. Therefore, our purpose was to assess the effect of an inactivated influenza vaccine given to GPs on the rate of clinical respiratory tract infections (RTIs) and proven influenza cases (influenza positive nose and throat swabs and a 4-fold titre rise), while adjusting for important covariates. In a controlled trial during two consecutive winter periods (2002-2003 and 2003-2004) we compared (77 and 100) vaccinated with (45 and 40) unvaccinated GPs working in Flanders, Belgium. Influenza antibodies were measured immediately prior to and 3-5 weeks after vaccination, as well as after the influenza epidemic. During the influenza epidemic, GPs had to record their contact with influenza cases and their own RTI symptoms every day. If they became ill, the GPs had to take nose and throat swabs during the first 4 days. We performed a multivariate regression analysis for covariates using Generalized Estimating Equations. One half of the GPs (vaccinated or not) developed an RTI during the 2 influenza epidemics. During the two influenza periods, 8.6% of the vaccinated and 14.7% of the unvaccinated GPs had positive swabs for influenza (RR: 0.59; 95%CI: 0.28 - 1.24). Multivariate analysis revealed that influenza vaccination prevented RTIs and swab-positive influenza only among young GPs (ORadj: 0.35; 95%CI: 0.13 - 0.96 and 0.1; 0.01 - 0.75 respectively for 30-year-old GPs). Independent of vaccination, a low basic antibody titre against influenza (ORadj 0.57; 95%CI: 0.37 - 0.89) and the presence of influenza cases in the family (ORadj 9.24; 95%CI: 2.91 - 29) were highly predictive of an episode of swab-positive influenza. Influenza vaccination was shown to protect against proven influenza among young GPs. GPs, vaccinated or not, who are very vulnerable to influenza are those who have a low basic immunity against influenza and, in particular, those who have family members who develop influenza.


Casting a wider fish net on animal models in neuropsychiatric research.
Neuropsychiatric disorders, such as schizophrenia, are associated with abnormal brain development. In this review, we discuss how studying dimensional components of these disorders, or endophenotypes, in a wider range of animal models will deepen our understanding of how interactions between biological and environmental factors alter the trajectory of neurodevelopment leading to aberrant behavior. In particular, we discuss some of the advantages of incorporating studies of brain and behavior using a range of teleost fish species into current neuropsychiatric research. From the perspective of comparative neurobiology, teleosts share a fundamental pattern of neurodevelopment and functional brain organization with other vertebrates, including humans. These shared features provide a basis for experimentally probing the mechanisms of disease-associated brain abnormalities. Moreover, incorporating information about how behaviors have been shaped by evolution will allow us to better understand the relevance of behavioral variation to determine their physiological underpinnings. We believe that exploiting the conservation in brain development across vertebrate species, and the rich diversity of fish behavior in lab and natural populations will lead to significant new insights and a holistic understanding of the neurobiological systems implicated in neuropsychiatric disorders.


Hypomagnesemia in diabetic children.
Serum concentrations of iron, copper, zinc and magnesium were determined in 27 Swedish children with well controlled diabetes without longterm diabetic complications. Thirteen of the diabetic children had age- and sex-matched healthy controls. Significantly lower serum magnesium concentrations were found in the diabetic children than in the matched healthy controls (p less than 0.01). The levels of iron, copper and zinc did not differ in the diabetic children from those in the controls. A negative correlation between serum magnesium level and duration of diabetes was found (p less than 0.05). This is seemingly the first report of hypomagnesemia in diabetic children.


Development of an Italian version of the functional communication measures and preliminary observations in patients with severe acquired brain injury and emerging from a prolonged disorder of consciousness.
A proper assessment tool targeting communicative abilities in patients with severe acquired brain injury (sABI), and particularly for patients recovering from prolonged disorders of consciousness (pDoC), is lacking. The Functional Communication Measures (FCM) consists of a series of rating scales, ranging from 1 (least functional) to 7 (most functional), assessing cognitive requirements for communication and communicative abilities in patients with brain injury. Here we presented exploratory data concerning an Italian adaptation of FCM administered to patients with sABI. After the translation into Italian language, the FCM was blindly administered by 2 independent speech therapists to 19 patients (10 males; median age = 58; IQR = 25) admitted to neurorehabilitation unit after sABI with a level of cognitive functioning between 4 and 8. Two further patients who presented a pDoC after sABI and emerged from the minimally conscious state (a 64-year-old female and a 74-year-old female) were also evaluated by means of the FCM, the Coma Recovery Scale-Revised, and the Disability Rating Scale. Inter-rater agreement was almost perfect for attention, memory, and swallowing items, and substantial for communicative-augmentative communication, motor speech, spoken language expression, and spoken language comprehension. Importantly, in the two pDoC patients, the FCM identified two different functioning profiles in the attention, swallowing, motor speech, and spoken language expression scales, notwithstanding the two patients achieved the same scores on scales for functional disability and consciousness level. The FCM might be a promising and easy-to-administer tool to assess communicative functions in patients with sABI, independently from evaluation of functional disability.


Study on the Effect of Climate Changes on the Composition and Quality Parameters of Virgin Olive Oil "Zalmati" Harvested at Three Consecutive Crop Seasons: Chemometric Discrimination.
Trees of the olive (Olea europaea L.) cultivar Zalmati grown in Zarzis (Mednine) with different main climate traits (temperature, precipitation, humidity, and wind) were studied for 3 years to evaluate the impact of climate on the quality of olive oil. The effect on quality indices, free fatty acids, peroxide value, UV spectrophotometry, pigment content, and phenol and O-diphenol concentrations, of the three harvesting periods was considered. Linking to the purity parameters (fatty acid, triacylglycerol, total phenols, and tocopherols composition), our results showed a trivial reduction in fatty acid composition and polyphenols content caused by the high temperature. In fact, precipitation strongly affects the pigment content, which showed a significant decrease during rainy seasons. Nevertheless, principal component analysis allowed us to highlight the correlation between parameters and indicates that 57.8% of the variation of monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), MUFA/PUFA, α-tocopherol, C 18:1, and C 18:2 amounts was explained by the mean temperature.


The Ferdinando Rossi Memorial Lecture: Zones and Stripes-Pattern Formation in the Cerebellum.
The cerebellum has a complex architecture-highly reproducible and conserved through evolution. Cerebellar architecture is organized around the Purkinje cell. Purkinje cells in the mouse cerebellum come in many different subtypes, identifiable by expression markers, sensitivity to mutation, etc. These are organized first into five "transverse zones," each of which is further subdivided into dozens of reproducible "stripes." This arrangement serves as the scaffolding to organize afferent topography and restrict the distribution of excitatory and inhibitory interneurons. This brief review will survey some of the mechanisms that lead to the formation of this elaborate pattern during cerebellar development. Pattern formation in the cerebellar cortex is a multistage process that begins early in development with the generation of the various Purkinje cell subtypes, and matures through the dispersal of Purkinje cell clusters into stripes. Two developmental processes will be discussed in particular: the mechanisms that lead to Purkinje cell subtype specification (i.e., how different kinds of Purkinje cells are made) and the role played by Purkinje cell migration in pattern formation (i.e., how these Purkinje cell subtypes end up in a reproducible array of stripes).


Multicentre clinical trial of authentic recombinant somatropin in growth hormone deficiency.
A German multicentre trial of recombinant somatropin was commenced in March 1986. A total of 77 patients with hGH deficiency were recruited, with heights at least 2.5 SD below the normal mean. Of these, 49 were previously untreated (naïve) and 28 had previously received pituitary hGH. Recombinant somatropin, 12 IU/m2/week was administered subcutaneously, divided into six doses. In the naïve group, the height velocity reached 14.9 cm/year in the first 3 months, and thereafter stabilized at 12 cm/year. In the previously treated patients, the growth rate was 10.7 cm/year in the first 3 months, and 8.5 cm/year at 9 and 12 months. There were no abnormal findings in tests of laboratory parameters. No anti-hGH antibodies were detected in any of the patients; seven patients had anti-ECP antibodies, but in six of these the antibodies were already present before treatment.


Measures of Physical Activity and Body Mass Index in Hospital Workers: A Multisite Cross-Sectional Study.
This study examined physical activity (PA) profiles of hospital employees and evaluated associations between PA domains (occupation, commute, leisure, and domestic) and intensity levels (light, moderate, and vigorous) with body mass index (BMI). Nine hundred twenty employees across six Texas hospitals were enrolled in the multisite study, 2012 to 2013. Analysis of covariance tests assessed equality of means (minutes) across PA measures, and mixed effects analyses evaluated associations between PA measures and BMI, while controlling for covariates. Over 78% of participants were overweight or obese. Mixed effects models showed significant inverse associations with BMI: light leisure PA (β = -0.0183|P = 0.003), moderate leisure PA (β = -0.0182|P = 0.005), vigorous leisure PA (β = -0.0248|P = 0.000), moderate commute PA (β = -0.0315|P = 0.02), moderate domestic PA (β = -0.0087|P = 0.018), and vigorous occupation PA (β = -0.0158|P = 0.001). Delivery of effective interventions in this population must consider the nature of the work environment as well as employees' PA profiles.


Cardiopulmonary bypass influences the plasma levels of calcitonin gene-related peptides in dogs: effects of hemofiltration and hemodilution.
Calcitonin gene-related peptides (CGRP), which are potent vasodilators, are elevated during cardiopulmonary bypass (CPB) in humans. We evaluated the plasma levels of CGRP in dogs during CPB with hemofiltration with and without hemodilution. Female beagles were divided into control (n=5) and hemodilution (n=5) groups. The CPB with hemofiltration was performed with or without hemodilution. For the measurement of CGRP, blood samples were collected pre-CPB, during CPB, and post-CPB. The concentrations of CGRP in the hemofiltration solution were measured. Although the CPB elevated the plasma CGRP levels in both groups, its elevation was significant in the hemodilution group when compared to the pre-CPB levels. CGRP levels returned to normal post-CPB. Significant differences were found between the two groups in the CGRP amount in hemofiltration. The results show that hemofiltration should be used during CPB to decrease the plasma levels of CGRP.


Orofacial EMG in Congenital Multiple Cranial Neuropathies.
Investigators from Armand-Trousseau hospital and University of Paris studied 90 infants aged birth to 6 months with multiple cranial nerve involvement.


Liquid crystal polaroid glass electrode from e-waste for synchronized removal/recovery of Cr(+6) from wastewater by microbial fuel cell.
This study demonstrates the use of Liquid Crystal coated Polaroid Glass Electrode (LCPGE) material collected from disposed liquid-crystal display (LCD) computer monitor as electrodes in microbial fuel cell (MFC) for the simultaneous reduction/recovery of Cr(+6) from chromium wastewater. Fourier transform infrared spectrum (FT-IR) confirms the presence of NH2, CN, CO and OC and/or COC functional groups in LCPGE. An excellent electrochemical performance with distinct redox peaks were observed in cyclic voltammetry test (100 mV/s). The maximum current density of 110 mA/m(2) (10 mW/m(2)) was achieved by operating MFC in batch mode. At the cathode LCPGE (10.5 cm(2)) interface, toxic Cr(+6) ions readily accepted electrons and formed nontoxic Cr2O3 as confirmed by FT-IR and X-ray photoelectron spectroscopy analysis. Moreover, electrochemical impedance analysis shows that bacteria were readily attached to the surface of LCPGE (10.5 cm(2)) within 24 h in a Bioelectrochemical System (BES).


The effect of recasting on the oxidation layer of a palladium-silver porcelain alloy.
The oxidation zone of a commercial palladium-silver porcelain alloy was compared after repeated casting with and without the addition of new alloy. The intensity of palladium, silver, tin, indium, and O K-alpha near the oxidation zone was analyzed with XMA. The intensity curves of tin, silver, and oxygen increased progressively through each generation despite the addition of new alloy. The thickness of the oxidation zone and the microporosities at the internal oxidation zone increased through each generation without the addition of new alloy. Although the findings indicated that the oxidation zone was favorably formed by adding new alloy, 50% by weight, for four generations, the silver and metallic oxides of the oxidation zone increased through each generation. The reuse of the palladium-silver porcelain alloy remains questionable.


Effect of N-doping on the photocatalytic activity of sol-gel TiO2.
In order to study the visible light photocatalytic activity of nitrogen doped titanium dioxide, the interaction between nitrogen dopant sources and titania precursors during sol-gel synthesis is investigated. N-TiO(2) was synthesised using the sol-gel method using 1,3-diaminopropane as a nitrogen source. Samples were annealed several temperatures and the percentage of rutile present determined by X-ray diffraction to be 0% (500°C), 46% (600°C), and 94% (700°C). The reducing amounts of anatase at higher temperatures are studied using FTIR, which suggests the absence of any polymeric chains formed by the chelating agents, which would normally extend anatase-to-rutile transformation temperatures. Differential scanning calorimetry shows that crystalliation occurs before 500°C, providing the crystalline form determined by XRD at 500°C. Increased temperature also resulted in diminished visible light absorption capability, with only the 500°C sample showing significant absorption in the visible region. XPS studies revealed that nitrogen remained within the TiO(2) lattice at higher temperatures. Consequent with the reduced visible light absorption capacity, photocatalytic activity also reduced with increased annealing temperature. Degradation kinetics of methylene blue, irradiated with a 60 W house-bulb, resulted in first order degradation rates constants of 0.40 × 10(-2), 0.19 × 10(-2), and 0.22 × 10(-2)min(-1) for 500, 600, and 700°C respectively. Degradation of Degussa P25 was minimal under the same conditions, and that of undoped TiO(2) was 0.02 × 10(-2)min(-1). Similarly, using 4-chlorophenol under solar irradiation conditions, the N-doped sample at 500°C substantially out-performed the undoped sample. These results are discussed in the context of the effect of increasing temperature on the nature of the band gap.


Quality of life protocol in the early asthma diagnosis in children.
Asthma is considered an important problem in children and influences on their everyday functioning. This study was concerned with the impact of asthma on the health-related quality of life (HRQOL) of newly recognized pediatric asthma patients and their parents. Patients were identified by a general respiratory survey. HRQOL was assessed by self-report measures: disease-specific questionnaire for children, the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) and generic for parents-the Quality of Life in Child's Chronic Disease Questionnaire (QLCCDQ). Twenty-nine newly diagnosed asthmatic children aged 7-11 years (mean age = 8.6; SD = 1.4) were identified from a population-based respiratory health survey. The most impaired HRQOL domains differed in parents and children. In children, activity limitation was the most impaired; however in parents, emotional functioning and symptom perception domains were most impaired. There were no statistically significant differences in patient and parental HRQOL observed in either the group where symptoms were present or in the group were symptoms were not present. Baseline spirometry showed correlation for FEV(1)%FVC and PAQLQ symptom domain (r = 0.42). Exercise test showed correlations between FEV(1)%FVC and QLCCDQ emotional domain (r = 0.7); MEF 25-75% and family roles (r = 0.81), as well as social functioning (r = 0.81). Activity limitation on the PAQLQ correlated with the MEF 25-75% (r = 0.44) and PEF (r = 0.55). HRQOL newly recognized children with asthma and their parents does not correlate closely with clinical status. Patient and parental HRQOL should be considered as independent dimensions.


Kinetics of 14carbon dioxide excretion from 14C-urea by oral commensal flora.
Previous studies have shown that while performing the (14)C-urea breath test ((14)C-UBT) for the detection of Helicobacter pylori (H. pylori), there is possibility of false-positive results due to the other urease producing bacteria present in oropharynx, if breath samples are obtained within 30 min after administration of non-capsulated (14)C-urea. Therefore, we have exclusively evaluated the kinetics of (14)carbon dioxide ((14)CO(2)) excretion by oral commensal flora to theoretically propose optimum breath collection timings for (14)C-UBT. Multiple breath samples up to 15 min were collected in 0.25 mmol benzethonium hydroxide from 25 healthy volunteers after they withheld 37 kBq (1 muCi) of (14)C-urea in their mouths for 15 s and then expectorated the tracer. The test was repeated on the same subjects without and with mouth cleansing protocols. Breath (14)CO(2) content was measured by the Liquid Scintillation Counter (1409; Wallac, Turku, Finland) and results were expressed as (14)CO(2) excretion per mmol breath CO(2) (% administered dose). Peak breath radioactivity at 1 min in the former protocol was 3.53 times higher than the latter which declined subsequently with a half time of 1 min and 2.5 min, and reached baseline levels by 15 and 10 min, respectively. The peak radioactivity (100%) at 1 min declined by 94% and 97.8% in the former and later protocols, respectively, at 15 min. Although magnitude of the peak varied in different subjects, the shape of curve remained almost similar in all cases. Without mouth cleansing, oral micro flora excreted more (14)CO(2) up to 15 min after administration of non-capsulated (14)C-urea. Therefore, it is proposed that two breath samples may be obtained either at 15 and 20 min without or at 10 and 15 min with mouth cleansing protocols for reliable analysis of (14)C-UBT data for H. pylori detection.


[Update in infectious diseases. Part I: epidemiology].
A number of infectious agents has been newly detected in the last 10 years. Climatic changes and migration have been the most important factors in the emergence of new and old infections. Additionally, new methods for the detection of DNA and RNA have played an important role in the detection of agents difficult to culture. Relevant new bacterial pathogens are Bartonella henselae (cat scratch disease, bacillary angiomatosis), Tropheryma whippeli (Whipple's disease) and new Rickettsiae. Newly detected viral pathogens include Sin-nombre virus (pulmonary Hanta virus syndrome), Nipah- and Hendra virus and avian influenza. Bovine spongiform encephalopathy has been transmitted to humans causing the newly described syndrome of variant Creuzfeldt-Jakob disease. The extent of this new epidemic is not yet clear. These trends from the last years clearly indicate, that further new infections and infectious agents will be detected in the future.


Efficacy of Eat Breathe Thrive: A randomized controlled trial of a yoga-based program.
Evidence positions yoga as a promising intervention for enhancing positive embodiment and supporting the prevention of, and recovery from, eating disorders (EDs) by reducing ED symptomatology and building skills that facilitate an ongoing, embodied sense of wellbeing. However, yoga-based programs are few and rigorous literature on their efficacy is limited. This study examined the efficacy and feasibility of a yoga-based program called Eat Breathe Thrive (EBT) which aims to prevent EDs and support embodiment. Participants (N = 168, 93.5 % women) from a community sample in the United States and United Kingdom, ages 18-65, were randomly allocated to a 2-h, 7-week EBT program or waitlist-control condition. Compared to controls, EBT participants experienced significant decreases in ED behaviors, depression, and difficulties regulating emotions. They reported significantly greater use of mindfulness skills, such as interoceptive awareness, mindful self-care, and mindful eating. After a single session, participants reported immediate improvement in their sense of well-being, indicating increased state positive embodiment. Most effects were sustained at 6-month follow-up. The majority of individuals attended most sessions. Self-reported treatment integrity was excellent. Directions for future research are proposed. Results support the efficacy and feasibility of an integrated yoga intervention that fosters positive ways of inhabiting the body.


PAF and Haematopoiesis. I. 5-Fluoro-Uracil Induces PAF Production in Haematopoietic Organs of Rats.
Haematopoietic organs of rats were examined for the presence of platelet-activating factor (PAF) and acetylhydrolase before and after treatment with 5-fluoro-uracil (5-FU) (200 mg/kg) a chemotherapeutic compound with apoptotic effects. PAF was reported in thymus, spleen and femoral bone marrow of rats with or without 5-FU. Although acetylhydrolase activity in organs was not affected by 5-FU treatment, elevated levels of PAF were observed in thymus and spleen. For the first time PAF is reported in haematopoietic organs of rats, strengthening in vitro data suggesting its role in the apoptotic processes in thymus, in the modulation of the immune response, and in the regulation of haematopoiesis.


[Characteristics of the combined action of fentanyl and sodium oxybutyrate on respiration].
Experiments conducted with rabbits (86) and albino rats (28) demonstrated that with the use of sodium oxybutyrate (200 mg/kg) in combination with phentanyl (0,02 mg/kg) the former reduces the depressing influence of the latter on the external respiration and tissue processes.


Bioenergy generation and simultaneous nitrate and phosphorus removal in a pyrite-based constructed wetland-microbial fuel cell.
This study investigates the performance of a pyrite-based constructed wetland-microbial fuel cell (PCW-MFC) in chemical oxygen demand (COD), nitrate (NO3--N), total inorganic nitrogen (TIN), and total phosphorus (TP) removal and bioelectricity generation, and explores the mechanisms involved. Four microcosms were used: a constructed wetland (CW), a pyrite-based constructed wetland (PCW), a constructed wetland-microbial fuel cell (CW-MFC), and a PCW-MFC. After 180 days' operation, the PCW-MFC exhibited enhanced simultaneous nitrate and phosphorus removal and bioelectricity output. The maximum COD, NO3--N, TIN, and TP removal efficiencies in the PCW-MFC were 71.9%, 70.1%, 63.2%, and 91.2%, respectively, for a hydraulic retention time (HRT) of 6 h. The mean bioelectricity output of the PCW-MFC was 19.0-28.4% higher than that of the CW-MFC. The nitrate removal rate constant of the PCW-MFC was 1.04 d-1, which is significantly higher than those of the others. Geobacter and sulfate-reducing bacteria were enriched in the PCW-MFC.


Amino acids functionalized vascular-like carbon fibers for efficient capacitive deionization.
Porous carbons have attracted great attention in capacitive deionization (CDI), benefiting from their high surface areas and abundant adsorption sites. However, the sluggish adsorption rate and poor cycling stability of carbons are still concerns, which are caused by the insufficient ion-accessible networks and the side reactions (the co-ion repulsion and oxidative corrosion). Herein, inspired by the blood vessels in organisms, mesoporous hollow carbon fibers (HCF) were successfully synthesized via a template assisted coaxial electrospinning strategy. Subsequently, the surface charge of HCF was modified by various amino acids (arginine (HCF-Arg) and aspartic acid (HCF-Asp)). Combining structure design and surface modulation, these freestanding HCFs present enhanced desalination rate and stability, in which the hierarchal vasculature facilitates electron/ion transport, and the functionalized surface suppresses the side reactions. Impressively, when HCF-Asp and HCF-Arg serve as cathode and anode respectively, the asymmetric CDI device provides an excellent salt adsorption capacity of 45.6 mg g-1, a fast salt adsorption rate of 14.0 mg g-1 min-1 and a superior cycling stability up to 80 cycles. In short, this work evidenced an integrated strategy to exploiting carbon materials with outstanding capacity and stability for high-performance capacitive deionization.


The impact of natural resources, energy consumption, and population growth on environmental quality: Fresh evidence from the United States of America.
We examine the impact of the amount of natural resources, energy consumption, and population growth on the ecological footprint and CO2 emissions using data of the United States (USA) from 1971 to 2016. In the course of this study, we developed a comprehensive empirical analysis and applied structural break Zivot-Andrews and Breakpoint ADF unit-roots tests for stationary analysis. The co-integration analysis indicates long-run relationships among the variables. Subsequent findings of the generalized method of moments (GMM), generalized linear model (GLM), and robust least-squares reveal an inverse relationship of natural resources and renewable energy consumption with the ecological footprint and CO2 emissions, while non-renewable energy consumption, population growth, and biocapacity have a positive relationship with the ecological footprint and CO2 emissions. Overall, our findings suggest that natural resources and renewable energy consumption improve environmental quality in the long run, while population growth and non-renewable energy consumption contribute to its deterioration. In addition, the result of pairwise Granger causality reveals that bidirectional causality runs between natural resources and CO2 emissions and between natural resources and the ecological footprint, while unidirectional causality runs from population growth to energy consumption, the ecological footprint, and CO2 emissions. Policymakers in the USA are encouraged to establish policies that control the excessive use of natural resources, promote sustainable lifestyles, develop energy-efficient carbon pricing, and fix the ecological budget to secure a sustainable future for the country.


Ocular therapies with biomacromolecules: From local injection to eyedrop and emerging noninvasive delivery strategies.
The last two decades have witnessed a continuously increasing number of biomacromolecules approved for the treatment of ocular diseases. The eye possesses multiple protective mechanisms to resist the invasion of exogenous substances, but meanwhile these physiological defense systems also act as strong barriers, impeding absorption of most biomacromolecules into the eye. As a result, local injections play predominant roles for posterior ocular delivery of biomacromolecules in clinical practice. To achieve safe and convenient application of biomacromolecules, alternative strategies to realize noninvasive intraocular delivery are necessary. Various nanocarriers, novel penetration enhancers and physical strategies have been explored to facilitate delivery of biomacromolecules to both anterior and posterior ocular segments but still suffered difficulties in clinical translation. This review compares the anatomical and physiological characteristics of the eyes from those frequently adopted experimental species and profiles the well-established animal models of ocular diseases. We also summarize the ophthalmic biomacromolecules launched on the market and put emphasis on emerging noninvasive intraocular delivery strategies of peptides, proteins and genes.


Codon context effect in virus translational readthrough. A study in vitro of the determinants of TMV and Mo-MuLV amber suppression.
To assess the role of codon context on the efficiency of eukaryotic suppression of termination codons, we have compared, in a rabbit cell-free translation system, the readthrough efficiency related to two synthetic transcripts differing by the codon context around an amber codon. The codon contexts are derived from tobacco mosaic virus (TMV) and Moloney murine leukemia virus (Mo-MuLV) RNAs. The Mo-MuLV-like codon context does not promote suppression. Substituting TMV-derived triplets in the Mo-MuLV-like codon context shows that the two codons downstream from the TMV UAG signal are important determinants of suppression, as recently demonstrated in vivo.


VEGF therapeutic gene delivery using dendrimer type bio-reducible polymer into human mesenchymal stem cells (hMSCs).
The therapeutic potential of mesenchymal stem cells (MSCs) has garnered great attention in the expansive diversity of biomedical research. Despite this broad interest in stem cells, limited incorporation and poor viability are major disadvantages for accomplishing therapeutic success in the field of hMSC-based cell therapy, and an optimal approach for hMSC-based cell therapy using non-viral vectors has not been established. Hence, we examined the possibility of performing gene therapy using the biodegradable polymeric non-viral vector Arginine-grafted poly (cystaminebisacrylamide-diaminohexane) (ABP)-conjugated poly (amidoamine) (PAMAM) dendrimer (PAM-ABP) in hMSCs. PAM-ABP formed compact nanosized polyplexes and showed low cytotoxicity compared to bPEI 25k and Lipofectamine® 2000 in hMSCs. Although the cellular uptake was similar, the transfection efficiency and VEGF expression of PAM-ABP using gWiz-Luc and pβ-VEGF were higher than those of the control groups. Although hMSCs were transfected, their stem cell characteristics were retained. Our results suggest that PAM-ABP has the ability to deliver a therapeutic gene in hMSCs.


The gut as source of sepsis after hemorrhagic shock.
In a model of severe hemorrhagic shock in rats, blood culture findings became positive within 2 to 4 hours of shock. The organisms cultured were primarily gram-negative. To test the hypothesis that the gut was the source of the bacteria, E. coli labeled with carbon-14 oleic acid were fed to rats undergoing hemorrhagic shock. Their plasma was then assayed for carbon-14 activity. Seven of the 14 shocked animals demonstrated increased plasma carbon-14 activity during or after shock. The mortality rate was 100 percent 80 hours postshock, and all animals had E. coli on subsequent blood culture. The seven rats without increased plasma carbon-14 activity had a survival rate of 83 percent postshock. Sham-shocked animals did not exhibit plasma carbon-14 levels greater than the background levels. These data suggest that bacterial translocation occurs during hemorrhagic shock and that the gut is the source of the bacteremia seen during hemorrhagic shock.


How communication can help women who experience a maternal near-miss: a qualitative study from Tanzania.
This study aimed to explore experiences of communication as an element of quality of care, among women surviving a maternal near-miss event, thus women who nearly died but survived haemorrhage, or pre-eclampsia complication during pregnancy, childbirth or within 42 days of termination of pregnancy. A descriptive, phenomenological, qualitative study using semistructured interviews with women who survived a maternal near-miss in Southern Tanzania. The participants were recruited from two selected hospitals in Mtwara Region, where women sought child birth care and developed near-miss condition. Participants for this study were women who experienced and survived a maternal near-miss event and who had lived in the study area for at least 1 year. Women were recruited using an adapted version of the WHO criteria for maternal near-miss. We identified 16 women and were able to conduct 10 in-depth interviews with women at their homes, 4 weeks after they were discharged. The interviews were audiorecorded and transcribed and translated word for word from Kiswahili. Thematic analysis was used to identify emerging themes. Three major themes evolved: (1) Being informed about the care and interaction, (2) Being engaged and encouraged and (3) Being afraid to ask questions. The study highlighted that good communication with women during the provision of care helped women feel grateful, supported and cared for. Women who were unconscious during care were often not informed later of what happened. This created some negative feelings and anxiety. This study highlights the importance of communication, and of being informed of what happened and why. Empathetic communication with sufficient explanation on what happened and why created trust among women-a positive finding which should encourage the development of consistent approaches to strengthen healthcare provider communication skills.


The modified docking procedure for elbow ulnar collateral ligament reconstruction: 2-year follow-up in elite throwers.
Ulnar collateral ligament injury is most common in the overhead-throwing athlete. Jobe et al published the first report of ulnar collateral ligament reconstruction in throwing athletes with a 62.5% success rate. Recently, Altchek developed a new docking technique for reconstruction of the ulnar collateral ligament. The authors report the first series using a further modification of the docking technique using a 4-strand palmaris longus graft for reconstruction of the ulnar collateral ligament. The modified docking technique yields a high rate of successful return to preinjury level of competition in elite baseball players. Case series; Level of evidence, 4. The authors retrospectively reviewed 25 elite professional or scholarship collegiate baseball players who underwent elbow ulnar collateral ligament reconstruction using the modified docking procedure with a minimum 2-year follow-up. Twenty-three of 25 (92%) were able to return to their preinjury levels of competition. The mean time to return was 11.5 months (range, 10-16 months). Complications included 1 transient postoperative ulnar nerve neurapraxia and 1 stress fracture of the ulnar bone bridge that occurred at 14 months postoperatively, after a full return to pitching. The modified docking technique yields highly successful return to preinjury level of competition rates (92%) in a select group of elite baseball players.


Enamel matrix derivative as an adjunct to minimally invasive non-surgical treatment of intrabony defects: A randomized clinical trial.
To compare the efficacy of minimally invasive non-surgical technique (MINST) with or without enamel matrix derivative (EMD) in the treatment of intrabony defects ≤7 mm. Thirty-six patients were randomly assigned to the two groups. The control group received MINST, while the experimental MINST+EMD. Clinical measurements were recorded at baseline and at 6 and 12 months, and radiographic measurements were made at baseline and 12 months. All subjects completed the study, 18 in each group. Significant improvements were observed in both groups at 12 months (p < .001) with no differences in mean PD reduction (4.0 ± 1.4 vs. 4.2 ± 1.7 mm), CAL gain (3.5 ± 1.4 vs. 3.4 ± 1.6 mm), and defect resolution (1.9 ± 1.1 vs. 1.8 ± 0.9 mm) for the MINST and the MINST+EMD groups, respectively (p > .05). A trend for greater pocket closure (PD ≤4 mm and no BoP) was achieved with the application of EMD (77.8% vs. 55.6% sites), particularly for sites with baseline PD ≤8 mm (92.3% vs. 69.2% sites), accompanied by an increased number of successful composite outcome results (61.1% vs. 44.4% sites). MINST demonstrates significant improvements 12 months after treatment of intrabony defects ≤7 mm. The additional application of EMD does not further improve the mean clinical or radiographic outcomes. This study is registered in ClinicalTrials.gov (NCT03622255).


Outcome of women with inadequate cervical smears followed up for five years.
The clinical and prognostic significance of "inadequate" cervical smear is unknown, even though women with repeated inadequate smears are referred for colposcopy in the National Health Service (NHS) Cervical Screening Programme. To follow up a cohort of women with inadequate cervical smears over the following five years to examine outcomes, including detection of high grade cervical intraepithelial neoplasia (CIN). The study comprised 1972 women with an inadequate cervical smear reported at Walsall Hospitals NHS Trust between 1 April 1995 and 31 March 1996. Results of cervical smears and biopsies taken over the following five years were reviewed to confirm the outcome. Within five years, 2.2% of women with an inadequate cervical smear developed histologically confirmed high grade CIN, which was higher than the 1.3% seen among all women with cervical smear tests reported at the same laboratory over the same period, although the difference was not significant at the 95% level of confidence. Where inadequacy resulted from or was contributed to by "polymorphs obscuring", the risk of subsequent development/detection of high grade CIN was 2.6%. Women with inadequate cervical smears had an increased risk of detection of high grade CIN in the following five years compared with "all women". This increased risk was not significant, although if a larger number of women had been studied significance may have been reached, so that further studies are needed. The increased risk appeared to be at least partially dependent on the reason for inadequacy.


The Southern Polar Front as a key to mesoplankton migratory behavior.
Diel and seasonal vertical migrations of zooplankton represent a widespread phenomenon occurring in marine and freshwater environments. Diel migrations are panoceanic, while seasonal migrations usually occur in temperate and polar areas. This paper describes differences in the diel and seasonal vertical migrations in the Drake Passage north and south of the Polar Front (PF). We analyzed material of 85 stations collected in spring of 2008 and 2010 (October-November) and in summer of 2010 and 2011 (January) within the 0-300 m depth range during various time of a day. At each station we sampled the upper mixed (UL), the middle (ML), and the deeper layers (DL) bounded by hydrological gradients. Diel migrations were significantly different south and north of the PF in terms of total abundance, biomass, diversity and individual taxa density. In both seasons, mesoplankton dielly migrated between the ML/DL and the UL north of the PF and between layers below 300 m and the DL and ML south of the PF. Deeper range of diel migrations south of the PF was coupled with a general mesoplankton descent in summer period compared to spring. Conversely, north of the PF, mesoplankton ascended to upper layers in summer, which was mirrored in lesser depths of diel migrations. The differences in the plankton distribution on both sides of the PF are likely associated with variations of vertical distribution of phytoplankton. Some abundant taxa such as Aetideus sp. and Oithona plumifera showed both common (nighttime ascend) and inverted (nighttime descend) vertical migrations depending on season and position related to the PF.


Effect of mixing at weaning and nutrient density of the weaner diet on growth performance and welfare of pigs to slaughter.
Mixing pigs at weaning can compromise pig welfare and growth. Therefore, grouping littermates together may allow a diet nutrient and energy density reduction during the nursery period to reduce feed cost without affecting slaughter weight. This study investigated the combined effect of mixing and reducing dietary energy and nutrient density on growth performance, body lesions (BL), and behaviour in pigs from weaning to slaughter. Forty-eight litters [554 pigs, 11-12 pigs/litter; Danish Duroc × (Large White × Landrace)] were included in the trial. At 28 days of age, pigs were weaned and housed in nursery rooms in litter groups (INTACT, n = 24) or mixed with other litters and grouped by weight to reduce within-pen pig weight variation (MIXED, n = 24). A dietary regimen meeting pigs' nutritional requirements (CON) and a low-density dietary regimen (LOW; -10% energy and protein) completed a 2 × 2 factorial arrangement (Mixing x Diet, n = 12). On day 74 of age, pigs moved to the grower-finisher accommodation without further mixing and all pigs received the CON dietary regimen. Mixing increased FCR by 4.0% during the nursery period (p = 0.003). Nursery pigs fed LOW experienced a growth retardation which was maintained until slaughter (-2.6 kg slaughter weight; p = 0.025). Initial differences in the coefficient of variation (CV) between MIXED (10.4%) and INTACT (17.6%; p < 0.001) pigs were reduced in CON pens but not in LOW pens (interaction p = 0.025) at the end of the nursery period. MIXED pigs had more fights and BL (p < 0.001) at weaning and showed more aggression (p = 0.003) after being moved to the grower-finisher rooms. At the end of the nursery period, MIXED pigs fed LOW showed the highest number of aggressive behaviours around the feeder (interaction; p = 0.003) and pigs fed LOW showed more damaging behaviour (p < 0.001). Mixing animals at weaning had limited impact on growth performance but impaired welfare which was aggravated by energy and nutrient reduction in the nursery diet. Decreasing dietary nutrient density in the nursery stage retarded growth, which could not be compensated for during the growing-finishing period.


Characteristics of membrane progestin receptor alpha (mPRalpha) and progesterone membrane receptor component 1 (PGMRC1) and their roles in mediating rapid progestin actions.
Rapid, progestin actions initiated at the cell surface that are often nongenomic have been described in a variety of reproductive tissues, but until recently the identities of the membrane receptors mediating these nonclassical progestins actions remained unclear. Evidence has been obtained in the last 4-5 years for the involvement of two types of novel membrane proteins unrelated to nuclear steroid receptors, progesterone membrane receptors (mPRs) and progesterone receptor membrane component 1 (PGMRC1), in progestin signaling in several vertebrate reproductive tissues and in the brain. The mPRs, (M(W) approximately 40 kDa) initially discovered in fish ovaries, comprise at least three subtypes, alpha, beta and gamma and belong to the seven-transmembrane progesterone adiponectin Q receptor (PAQR) family. Both recombinant and wildtype mPRs display high affinity (K(d) approximately 5 nM), limited capacity, displaceable and specific progesterone binding. The mPRs are directly coupled to G proteins and typically activate pertussis-sensitive inhibitory G proteins (G(i)), to down-regulate adenylyl cyclase activity. Recent studies suggest the alpha subtype (mPRalpha) has important physiological functions in variety of reproductive tissues. The mPRalpha is an intermediary in progestin induction of oocyte maturation and stimulation of sperm hypermotility in fish. In mammals, the mPRalphas have been implicated in progesterone regulation of uterine function in humans and GnRH secretion in rodents. The single-transmembrane protein PGMRC1 (M(W) 26-28 kDa) was first purified from porcine livers and its cDNA was subsequently cloned from porcine smooth muscle cells and a variety of other tissues by different investigators. PGMRC1 and the closely-related PGMRC2 belong to the membrane-associated progesterone receptor (MAPR) family. The PGMRC1 protein displays moderately high binding affinity for progesterone which is 2- to 10-fold greater than that for testosterone and glucocorticoids, and also can bind to other molecules such as heme, cholesterol metabolites and proteins. The signal transduction pathways induced by binding of progesterone to PGMRC1 have not been described to date, although motifs for tyrosine kinase, kinase binding, SH2 and SH3 have been predicted from the amino acid sequence. Evidence has been obtained that PGMRC1 mediates the antiapoptotic affects of progesterone in rat granulosa cells. The PGMRC1 protein may also be an intermediary in the progesterone induction of the acrosome reaction in mammalian sperm. Despite these recent advances, many aspects of progestin signaling through these two families of novel membrane proteins remain unresolved. Biochemical characterization of the receptors has been hampered by rapid degradation of the partially purified proteins. A major technical challenge has been to express sufficient amounts of the recombinant receptors on the plasma membranes in eukaryotic systems to permit investigations of their progestin binding and signal transduction characteristics. Additional basic information on the molecular and cellular mechanisms by which mPRs and PGMRC1 interact with progestins, signal transductions pathways and other proteins will be required to establish a comprehensive model of nontraditional progestin actions mediated through these novel proteins.


Simple removable appliances to correct anterior and posterior crossbite in mixed dentition: Case report.
Different techniques have been used to correct anterior and posterior crossbites in mixed dentition. This case report illustrates the treatment of anterior and unilateral posterior crossbites during the mixed dentition. The patient was a 9-year-old boy with a crossbite of the maxillary right permanent central incisor and a unilateral right posterior crossbite, both expressed by a functional shift in the sagittal and transverse dimensions. Two upper acrylic removable appliances, each with an expansion jackscrew, were used to correct the crossbites. The total active treatment time was 4 months; the treatment outcomes were successfully maintained for the subsequent 4 months. General and pediatric dentists, as well as orthodontists, may find this technique useful in managing crossbite cases of the mixed dentition and utilizing the discussion and illustrations for further clinical guidance.


Extensive Degeneration of Vertebral Body Leading to Baastrup's Disease: A Radiographic Review of an Image.
Baastrup's disease, known colloquially as "kissing spine disease", is a degenerative process, most commonly occurring in the lumbar spine, in which adjacent spinous processes closely approximate or even touch (Filippiadis et al. in Insights Imaging. https://doi.org/10.1007/s13244-014-0376-7, 2015). We present the case of an 86-year-old woman presenting with left low back, hip, and anterolateral thigh pain. Magnetic resonance imaging noted an approximation of the L2/3 spinous processes, with degeneration of the vertebral processes. This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors. Informed consent for publication was obtained from the participant.


Sleep disruptions mediate the relationship between early postoperative pain and later functioning following total knee replacement surgery.
Despite relatively standardized surgical procedures, patients undergoing total knee replacement (TKR) surgery differ dramatically in the speed of their recovery. Previous research has suggested a relationship between the experience of pain and sleep disruptions among patients with chronic pain or those undergoing surgery, such that more severe pain is associated with more frequent awakenings throughout the night. This study examined sleep disruptions 1 month following surgery as a mediator of the relationship between pain 1 month following surgery and functional limitations 3 months following surgery. A total of 110 patients scheduled to undergo unilateral TKR were examined at three time points: 2-3 weeks prior to surgery, 1 month following surgery, and 3 months following surgery. After controlling for presurgical levels of pain, sleep disruptions, and functional limitations, sleep disruptions 1 month following surgery partially mediated the relationship between pain 1 month following surgery and functional limitations 3 months following surgery. The present findings underscore the importance of adequate sleep during postsurgical recovery and suggest that interventions targeting sleep disruptions may improve the speed and quality of patients' recovery from TKR and other surgical procedures.


The reversible deactivation of beta-lactamase from Staphylococcus aureus by quinacillin and cephaloridine and its modification by antibodies.
The effect of antibody on the reversible deactivation of the beta-lactamase (penicillin amino-beta-lactamhydrolase, EC 18.104.22.168) from Staphylococcus aureus has been studied using quinacillin and cephaloridine as substrates. The latter has been shown to exhibit the characteristics of an A-type substrate Citri, N., Samuni, A. and Zyk, N. (1976) Proc. Natl. Acad. Sci. U.S.A. 73, 1048-1052) and reversibly to lower the activity of the enzyme towards benzylpenicillin in a manner analogous to quinacillin. Both divalent and monovalent antibodies reduce the activity of the lactamase to 60% of the native value in the absence of substrate. The reduction by monovalent antibody is slow (t1/2 approximately equal to 25 min). Both divalent and monovalent antibodies modify the time-course of reversible deactivation independently of being added before or subsequent to deactivation by substrate. The full recovery of activity is delayed in the case of quinacillin and accelerated for cephaloridine. The activity against benzylpenicillin in the deactivated states is unaffected. These effects are shown to reflect the changed rates of hydrolysis of the two substrates in the presence of antibody. The effect of antibody is mediated by minor conformational change. Continuous assays for following the hydrolysis of quinacillin and cephaloridine by optical rotation are reported.


In Vivo High-Frequency Ultrasound for the Characterization of Thrombi Associated with Aortic Aneurysms in an Experimental Mouse Model.
The development of abdominal aortic aneurysm (AAA) associated thrombi plays an important role during the onset and progression of AAAs. The aim of this study was to evaluate the potential of high-frequency ultrasound for characterization of AAA associated thrombi in an apolipoprotein-E-deficient mouse-model. Ultrasound measurements were performed using a high-resolution ultrasound system (Vevo770, FUJIFILM VisualSonics, Inc., Toronto, ON, Canada) with a 30 MHz linear-array transducer (RMV707 B). Magnetic resonance imaging with a 3 Tesla scanner (Achieva MR system, Philips Healthcare, Best, The Netherlands) and a single-loop microscopy coil was performed as a reference standard. All stages of aneurysm development were evaluated by histologic analyses. The "signal-thrombus-matrix" to "signal-blood" ratio on high-frequency ultrasound measurements showed a strong correlation (R2 = 0.81, p <0.05) with the state of extracellular matrix remodeling. Furthermore, size measurements derived from the high-frequency ultrasound correlated well with magnetic resonance imaging and histology. This study demonstrated that high-frequency ultrasound enables the reliable in vivo quantification of extracellular matrix remodeling at various stages of thrombus development, based on the thrombus echogenicity.


Geniposide Alleviates Traumatic Brain Injury in Rats Via Anti-Inflammatory Effect and MAPK/NF-kB Inhibition.
We aimed to investigate whether geniposide, a main component extracted from Gardenia jasminoides Ellis fruit, could exert neuroprotective functions against traumatic brain injury (TBI). Enzyme-linked immunosorbent assay (ELISA) was used for detection of plasma cytokines. Real-time polymerase chain reaction (RT-PCR) was employed for measurements of mRNA levels of cytokines. Neurological outcomes were evaluated by modified neurological severity score (mNSS) and Rota-Rod. Blood-brain barrier (BBB) integrity and brain edema were assessed. Protein expression was tested by Western blot. The plasma levels of interleukin (IL)-1β, IL-6, IL-8 and IL-10 were all elevated in patients with TBI compared to those of healthy controls. TBI rats treated with geniposide showed lower mNSS and longer fall latency time than untreated TBI rats. BBB integrity was maintained and brain edema was reduced by geniposide treatment in TBI rats. Plasma levels of IL-1β, IL-6 and IL-8 were significantly repressed by geniposide treatment in TBI rats, whereas IL-10 level was upregulated. mRNA expression levels of these cytokines in the brain tissues of TBI rats exhibited the same trends of changes. By testing p38 mitogen-activated protein kinase and NF-κB p65 activities, it was observed that phosphorylated (p)-p38 and p-p65 were dramatically inhibited by geniposide. In conclusion, geniposide exerts neuroprotective functions against TBI by inhibiting p-p38 and p-p65.


Comparison of the effect of clarithromycin triple therapy with or without N-acetylcysteine in the eradication of Helicobacter pylori: a randomized controlled trial.
Whether adjunctive N-acetylcysteine (NAC) may improve the efficacy of triple therapy in the first-line treatment of Helicobacter pylori infection remains unknown. Our aim was to compare the efficacy of 14-day triple therapy with or without NAC for the first-line treatment of H. pylori. Between 1 January 2014 and 30 June 2018, 680 patients with H. pylori infection naïve to treatment were enrolled in this multicenter, open-label, randomized trial. Patients were randomly assigned to receive triple therapy with NAC [NAC-T14, dexlansoprazole 60 mg four times daily (q.d.); amoxicillin 1 g twice daily (b.i.d.), clarithromycin 500 mg b.i.d., NAC 600 mg b.i.d.] for 14 days, or triple therapy alone (T14, dexlansoprazole 60 mg q.d.; amoxicillin 1 g b.i.d., clarithromycin 500 mg b.i.d.) for 14 days. Our primary outcome was the eradication rates by intention to treat (ITT). Antibiotic resistance and CYP2C19 gene polymorphism were determined. The ITT analysis demonstrated H. pylori eradication rates in NAC-T14 and T14 were 81.7% [276/338, 95% confidence interval (CI): 77.5-85.8%] and 84.3% (285/338, 95% CI 80.4-88.2%), respectively. In 646 participants who adhered to their assigned therapy, the eradication rates were 85.7% and 88.0% with NAC-T14 and T14 therapies, respectively. There were no differences in compliance or adverse effects. The eradication rates in subjects with clarithromycin-resistant, amoxicillin-resistant, or either clarithromycin/amoxicillin resistant strains were 45.2%, 57.9%, and 52.2%, respectively, for NAC-T14, and were 66.7%, 76.9%, and 70.0%, respectively, for T14. The efficacy of NAC-T14 and T14 was not affected by CYP2C19 polymorphism. Add-on NAC to triple therapy was not superior to triple therapy alone for first-line H. pylori eradication [ClinicalTrials.gov identifier: NCT02249546].


Cancer-related pain: a nationwide survey of patients' treatment modification and satisfaction in Taiwan.
We have limited knowledge about cancer patients' pain control satisfaction in outpatient departments in Taiwan and doctors' practice of adjusting analgesics according to their pain status. This survey examined pain management and satisfaction among cancer outpatients with pain and obtained information on their quality of life and treatment management for different pain intensities. The Short version of the Brief Pain Inventory was used as the outcome questionnaire. Participants comprised 2075 patients with different cancers and disease statuses at 14 oncological outpatient departments, of which 1051 reported pain within the week prior to testing. The impact of pain management on physical and psychological functioning, and satisfaction with doctors were evaluated. Information about doctors' prescriptions was collected. Logistic regression analyses were conducted to evaluate whether the interference scale performed identically in the different analgesic ladders. Pain was significantly linked to disease status and affected patients' physical and psychiatric functioning. Almost 100% of patients were satisfied with their pain control, but more than 70% of doctors did not change analgesics based on patients' current pain status. The results show that although patients were satisfied with their physicians, treatment of cancer pain was still suboptimal. Pain assessment and treatment need to be more thorough and management guidelines should be revised to improve pain control in patients with cancer.


Effects of alloxan on glucose-stimulated insulin secretion, glucose metabolism, and cyclic adenosine 3', 5'-monophosphate levels in rat isolated islets of langerhans.
Insulin secretion was stimulated and cyclic adenosine 3', 5'-monophosphate (cAMP) levels were elevated in isolated rat islets by 27.5 mmol/l glucose. Alloxan caused a dose-dependent decrease in both variables with complete obliteration of insulin release at a concentration of 1.25 mmol/l. D-glucose, in the presence or absence of extracellular calcium, or 3-0-methyl-D-glucose (both at 27.5 mmol/l) protected completely against the effects of alloxan on both glucose-induced insulin release and cAMP Levels. 3-0-Methylglucose did not stimulate insulin secretion or elevate cAMP and did not interfere with glucose-stimulated secretion or elevation of cAMP. When glucose-stimulated insulin release was abolished by alloxan, the metabolism of glucose, determined by the rate of 3H2O formation from [5-3H] glucose, was depressed by 20%. It is concluded that alloxan altered the adenylate cyclase system such that it could no longer be stimulated by glucose. Glucose-stimulated insulin secretion or elevation of cAMP did not appear essential for glucose to protect against alloxan. Protection by 3-0-methylglucose did not appear to be mediated through an alteration of cAMP metabolism. Alloxan did not inhibit glucose-induced insulin secretion by grossly altering glycolysis.


Heart rate response to breath holding at 18.6 ATA.
The heart rate (HR) responses to breath-holding (BH) with the without face immersion (FI) in 31 or 27 degrees C water was studied in 1 ATA air and hyperbaric He-O2 environments in 4 male subjects during a dry saturation dive to simulated depth of 580 ft (18.6 ATA). When a 60 sec BH or FI was performed while leaning forward, there was a significant linear correlation between the maximal bradycardial response (delta HRmax) and ambient pressure for simple BH (r-0.08, P less than 0.05) and 31 degrees C FI (r = 0.91, P less than 0.01), but not for 27 degrees C FI. A similar trend was seen during 30 sec BH's while seated erect. The facial cold-dependent component of the FI bradycardia was not significantly altered by pressure. In general, there were significant correlations between the initial HR and the initial thoracic conductive volume (TCV; measured by the four-electrode Minnesota impedance cardiograph), and between the initial TCV and delta HRmax observed during seated erect BH's. Since the TCV was generally higher at depth, it is suggested that a mechanical effect due to increased TCV at depth, possibly related to increased gas density, is at least partly responsible for the pressure dependence of BH bradycardia.


Inhibition of fast axonal transport by erythro-9-[3-(2-hydroxynonyl)]adenine.
erythro-9-[3-(2-Hydroxynonyl)]adenine, an inhibitor of protein carboxylmethylation and dynein-ATPase activity, inhibited fast axonal transport in vitro in frog sciatic nerves. Its site of action might be associated with an ATPase on which transport depends, since specific carboxylmethylation inhibitors lacked effects on transport. The levels of high energy phosphates and protein synthesis were unaffected by the drug at a transport-inhibiting concentration, making disturbances due to metabolic effects less likely. An erythro-9-[3-(2-hydroxynonyl)]adenine-sensitive ATPase was looked for in various nerve fractions but has so far not been resolved.


Identification of long intergenic repeat sequences associated with DNA methylation sites in Caulobacter crescentus and other alpha-proteobacteria.
A systematic search for motifs associated with CcrM DNA methylation sites revealed four long (>100-bp) motifs (CIR sequences) present in up to 21 copies in Caulobacter crescentus. The CIR1 and CIR2 motifs exhibit a conserved inverted repeat organization, with a CcrM site in the center of one of the repeats.


Influence of multiple categories on the prediction of unknown properties.
Knowing an item's category helps us predict its unknown properties. Previous studies suggest that when asked to evaluate the probability of an unknown property, people tend to consider only an item's most likely category, ignoring alternative categories. In the present study, property prediction took the form of either a probability rating or a speeded binary-choice judgment. In keeping with past findings, the subjects ignored alternative categories in their probability ratings. However, their binary-choice judgments were influenced by alternative categories. This novel finding suggests that the way in which category knowledge is used in prediction depends critically on the form of the prediction.


Effects of a dopamine D1 agonist on ketamine-induced spatial working memory dysfunction in common marmosets.
It is considered that functional deficiency of the NMDA receptors in the prefrontal cortex (PFC) is one of the causes of the cognitive impairment observed in schizophrenia. As non-human primates display more developed PFC than rodents, they are considered to be useful experimental animals for improving the predictive validity of models used to discover new drugs for treating cognitive dysfunction. The aim of this study was to develop a convenient model of the cognitive impairment observed in schizophrenia using common marmosets and the CANTAB system and to test whether a full agonist of the dopamine D1 receptor (SKF-81297) was effective against the cognitive impairment induced in this model. We administered the NMDA receptor antagonist ketamine (1.5-16mg/kg, i.m.) to the marmosets to induce cognitive impairment and then evaluated their working memory function using the CANTAB spatial working memory (SWM) test. The marmosets' working memory was impaired by subanesthetic doses of ketamine. Next, we tested the effect of SKF-81297 (3 or 10mg/kg, p.o.) on this ketamine-induced cognitive dysfunction. The marmosets were administered SKF-81297 30min before the ketamine injection. Pretreatment with SKF-81297 reversed the ketamine-induced cognitive deficiency. In this study, we found that a D1 receptor agonist, which has been reported to enhance cognitive function, reversed ketamine-induced cognitive impairment in marmosets, which suggests that our marmoset model could be a useful tool for predicting the clinical efficacy of cognitive-enhancing drugs.


Pharmacodynamic modeling of the effect of changes in the environment on cellular lifespan and cellular response.
Lifespan-based pharmacodynamic (PD) models of cellular response assume that the lifespan of cells is predetermined at the time of cellular production, despite recognized changes in the cellular environment following production that may alter the survival of the cells. This work extends previously proposed cellular lifespan PD models to incorporate environmental effects on the cell lifespan by considering two basic classes of models from survival analysis: accelerated life and relative risk models. Cellular responses using both model classes were simulated using a steady-state cellular production rate with changes in the environmental effects resulting from three different basic profiles. The environmental effect models were also fitted to the red blood cell (RBC) and hemoglobin concentration data from six sheep following hematopoietic ablation by busulfan administration. The simulations indicated that the basic shapes of the cellular responses were different between the accelerated life and relative risk models. Due to the more direct physical interpretation, relatively simple steady-state relationship between the cellular response and environmental effects, and the ability to reduce the model to a "point" baseline lifespan distribution, the accelerated life model appears to be a more realistic and flexible model. The analysis of the sheep RBC and hemoglobin data indicated that the environmental effect began to decrease the survival of cells 1-2 weeks following initiation of ablation and that the average "severity" of the environmental effect increased 3.49 (29.5%) (mean (C.V.)) fold under the accelerated life model. Alternative models without an environmental effect did not describe the observed data as well. The proposed environmental effect cellular lifespan PD models allow for the incorporation of arbitrary changes in the conditions of the cellular environment and modeling of environmentally dependent cellular survival. These PD models have potential applications in hematological management of end-stage renal disease, transfusion medicine, and patients undergoing chemotherapy, among other diseases and therapies.


Intra- and intercellular transport of substances: Models and mechanisms.
Non-equilibrium-statistical models of intracellular transport are built. The most significant features of these models are microscopic reversibility and the explicit considerations of the driving forces of the process - the ATP-ADP chemical potential difference. In this paper, water transport using contractile vacuoles, the transport and assembly of microtubules and microfilaments, the protein distribution within a cell, the transport of neurotransmitters from the synaptic cleft and the transport of substances between cells using plasmodesmata are discussed. Endocytosis and phagocytosis models are considered, and transport tasks and information transfer mechanisms inside the cell are explored. Based on an analysis of chloroplast movement, it was concluded that they have a complicated method of influencing each other in the course of their movements. The role of quantum effects in sorting and control transport mechanisms is also discussed. It is likely that quantum effects play a large role in these processes, otherwise reliable molecular recognition would be impossible, which would lead to very low intracellular transport efficiency.


Enteral nutrition during acute pancreatitis: feasibility study of a self-propeeling spiral distal end jejunal tube.
The aim of our study was to evaluate the feasibility of enteral jejunal nutrition for acute pancreatitis using a self-propelling spiral distal end jejunal tube. Sixteen consecutive patients with acute pancreatitis in whom Flocare tubes were placed for enteral nutrition were included in this open prospective study. All of them had pancreatic and/or peripancreatic necrosis (Balthazar >=D). The median computed topography index was 5 (range 3-10) and the median Ranson score was 2 (range 0-5). The nasoenteric Flocare tube (spiral distal end) was inserted in the stomach at the bedside. Self progression into the jejunum was assessed by X-ray at 1, 7 and 12 hours and then every 24 hours for 4 days. The rate of successful tube self-placement in the jejunum and the time to successful placement were noted. Insertion was successful in 12 of 16 patients (75%). Treitz's ligament was reached in a median of 12 hours (range 1-96 hours). For the remaining patients, the tube was successfully repositioned under fluoroscopic guidance in 2 and withdrawn in 2, one for oral renutrition and one to change to a weighted jejunal tube. No tube dysfunction or recurrence of pancreatitis occurred during the entire period of enteral nutrition. This study suggests that the nasoenteric Flocare tube can be used effectively and safely in early enteral jejunal nutrition for severe acute pancreatitis, without endoscopic or radiological manipulation.


Distribution of antibiotic resistance in urban watershed in Japan.
Antibiotic-resistant E. coli concentrations showed large spatial and temporal variations, with greater concentrations observed in tributaries and downstream than in the upstream and midstream. Twenty percent of the geometric mean concentrations of antibiotic-resistant E. coli in the Tama River basin (Japan) exceeded the maximum acceptable concentration of indicator E. coli established by the USEPA. The indicator E. coli concentrations were positively correlated with those of antibiotic-resistant E. coli and multiple-antibiotic-resistant E. coli (resistance to more than two kinds of antibiotics), respectively, but not the detection rate of antibiotic-resistant E. coli, implying that use of antibiotic-resistant E. coli concentration rather than the detection rate can be a better approach for water quality assessment. Multiple-antibiotic-resistant E. coli is a useful indicator for estimating the resistance diffusion, water quality degradation and public health risk potential. This assessment provides beneficial information for setting national regulatory or environmental standards and managing integrated watershed areas.


Developing a rapid diagnosis and treatment centre: estimating impact on hospital resources.
To determine the possible impact on hospital bed occupancy if a "rapid diagnosis and treatment centre" (RDTC) were operational; to determine the number of patients that such a unit should be able to accommodate to avoid delays in transfer to this unit. Retrospective review of accident and emergency (A&E) department notes from consecutive adults over a 16 day period. City centre teaching hospital with 1330 beds and 105 000 A&E new attendees per annum. Total number of bed days saved per annum (and daily average, assuming no variation by season or day of the week) and the expected occupancy of the RDTC according to the time of day. The expected daily bed saving was estimated to be 16. Average occupancy was expected to be between six and eight (with little diurnal variation) and a unit with 10 beds would be sufficiently large to avoid delays for 85% of patients transferred there from A&E. On the basis of a "paper exercise" an RDTC would be expected to be beneficial in terms of bed utilisation; careful evaluation of the effects of such a unit in operation should be undertaken.


Risk factors for incident herpes simplex type 2 virus infection among women attending a sexually transmitted disease clinic.
To estimate the incidence of herpes simplex type 2 virus (HSV-2) infection, to identify risk factors for its acquisition, and to assess the protective effect of condoms. Prospective study of 293 HSV-2 seronegative women, aged 18 to 35 years, attending a sexually transmitted disease clinic in Alabama from 1992 to 1995. Incidence of HSV-2 infection was 20.5 per 100 woman-years [95% confidence interval (CI), 13.1-30.5]. Young women (18-20 years) had a significantly higher risk of incident HSV-2 infection [adjusted hazard ratio (HR), 2.8; 95% CI, 1.3-6.4] than older women. Women diagnosed with prevalent or incident bacterial vaginosis had a higher incidence of HSV-2 infection than those who were not so diagnosed (adjusted HR, 2.4; 95% CI, 1.1-5.6). No significant protective effect was observed for consistent (100%) condom use without breakage and slippage against HSV-2 acquisition (adjusted HR, 0.8; 95% CI, 0.2-2.3). Acquisition of HSV-2 infection among study participants was higher than previous estimates for adult female sexually transmitted disease clinic attendees, and no protective effect for condoms was demonstrated. The high incidence of HSV-2 infection with its potential for adverse health consequences emphasizes the need for better prevention strategies.


Sildenafil reduces aortic endothelial dysfunction and structural damage in spontaneously hypertensive rats: Role of NO, NADPH and COX-1 pathways.
Arterial hypertension is a condition associated with endothelial dysfunction, accompanied by an imbalance in the production of reactive oxygen species (ROS) and NO. The aim of this study was to investigate and elucidate the possible mechanisms of sildenafil, a selective phosphodiesterase-5 inhibitor, actions on endothelial function in aortas from spontaneously hypertensive rats (SHR). SHR treated with sildenafil (40 mg/kg/day, p.o., 3 weeks) were compared to untreated SHR and Wistar-Kyoto (WKY) rats. Systolic blood pressure (SBP) was measured by tail-cuff plethysmography and vascular reactivity was determined in isolated rat aortic rings. Circulating endothelial progenitor cells and systemic ROS were measured by flow cytometry. Plasmatic total antioxidant capacity, NO production and aorta lipid peroxidation were determined by spectrophotometry. Scanning electron microscopy was used for structural analysis of the endothelial surface. Sildenafil reduced high SBP and partially restored the vasodilator response to acetylcholine and sodium nitroprusside in SHR aortic rings. Using selective inhibitors, our experiments revealed an augmented participation of NO, with a simultaneous decrease of oxidative stress and of cyclooxygenase-1 (COX-1)-derived prostanoids contribution in the endothelium-dependent vasodilation in sildenafil-treated SHR compared to non-treated SHR. Also, the relaxant responses to sildenafil and 8-Br-cGMP were normalized in sildenafil-treated SHR and sildenafil restored the pro-oxidant/antioxidant balance and the endothelial architecture. In conclusion, sildenafil reverses endothelial dysfunction in SHR by improving vascular relaxation to acetylcholine with increased NO bioavailability, reducing the oxidative stress and COX-1 prostanoids, and improving cGMP/PKG signaling. Also, sildenafil reduces structural endothelial damage. Thus, sildenafil is a promising novel pharmacologic strategy to treat endothelial dysfunction in hypertensive states reinforcing its potential role as adjuvant in the pharmacotherapy of cardiovascular diseases.


Causal coherence and the availability of locations and objects during narrative comprehension.
The aim of this study was to examine whether locations of objects are encoded and available to the reader at different points in a narrative, depending on their causal relevance. Participants in five experiments read narratives in which the spatial relation between an object and its location either did or did not provide a causal explanation for a later critical event. Object and location target words were presented to the participants immediately before or after the critical event. Speeded recognition response times to target words demonstrated that both locations and objects were reactivated, but only after they became causally relevant. The results suggest that the causal structure of a text can influence the availability of spatial information and that at least some spatial relations are encoded during reading and are available to the reader when they are needed to build coherence.


Redirecting carbon to recover VFA to facilitate biological short-cut nitrogen removal in wastewater treatment: A critical review.
Wastewater treatment plants (WWTPs) are facing a great challenge to transition from energy-intensive to carbon-neutral and energy-efficient systems. Biological nutrient removal (BNR) can be severely impacted by carbon limitation, particularly for wastewater with a low carbon-to-nitrogen (C/N) ratio, which can significantly increase the operational costs. Waste activated sludge (WAS) is a valuable byproduct of WWTPs, as it contains high levels of organic matter that can be utilized to improve BNR management by recovering and reusing the fermentative volatile fatty acids (VFAs). This review provides a comprehensive examination of the recovery and reuse of VFAs in wastewater management, with a particular focus on advancing the preferable biological short-cut nitrogen removal process for carbon-insufficient municipal wastewaters. First, the method of carbon redirection for recovering VFAs was reviewed. Carbon could be captured through the two-stage A/B process or via sludge fermentation with different sludge pretreatment and process control strategies to accelerate sludge hydrolysis and inhibit methanogens to enhance VFA production. Second, VFAs can support the metabolism of autotrophic N-cycling microorganisms involved in wastewater treatment, such as AOB, NOB, anammox, and comammox bacteria. However, VFAs can also cause inhibition at high concentrations, leading to the partition of AOB and NOB; and can promote partial denitrification as an efficient carbon source for heterotrophic denitrifiers. Third, the lab- and pilot-scale engineering practices with different configurations (i.e., A2O, SBR, UASB) were summarized that have shown the feasibility of utilizing the fermentate to achieve superior nitrogen removal performance without the need for external carbon addition. Lastly, the future perspectives on leveraging the relationships between mainstream and sidestream, nitrogen and phosphorus, autotrophs and heterotrophs were given for sustainable and efficient BNR management.


Linagliptin protects human chondrogenic ATDC5 cells against advanced glycation end products (AGEs)-induced apoptosis via a mitochondria-dependent pathway.
Chondrocytes in joints are responsible for the formation and remodeling of articular cartilage. The accumulation of advanced glycation end products (AGEs) in cartilage is detrimental to the survival of chondrocytes. Linagliptin is one of the most commonly used anti-diabetes agents, and recent work indicates that it exerts an anti-inflammatory effect in different cell types. In this study, we showed that Linagliptin had a protective role in AGEs-induced chondrocyte injury. The presence of Linagliptin ameliorated AGEs-induced reactive oxygen species (ROS) induction and reduced cellular protein carboxyl content. Linagliptin mitigated AGEs-induced mitochondrial membrane potential (ΔΨm) reduction and NAPDH oxidase subunit NOX-4 induction, indicating that Linagliptin is a potent anti-ROS agent in chondrocytes. Additionally, Linagliptin inhibited AGEs-induced production of high mobility group box chromosomal protein 1 (HMGB-1), and the expression of matrix metalloproteases (MMPs)-2 and -9. Flow cytometry experimentation showed that Linagliptin inhibited AGEs-induced apoptotic subpopulation. Moreover, Linagliptin inhibited the AGEs-induced increased ratio of Bax to Bcl-2, translocation of cytochrome C from mitochondria to the cytoplasm, and release of cleaved caspase-3. Collectively, our data indicate that the anti-diabetes drug Linagliptin has a new role in rescuing chondrocyte from insult by AGEs, and may, therefore, have the potential to treat joint disorders.


An improved lightweight high-resolution network based on multi-dimensional weighting for human pose estimation.
Human pose estimation is one of the key technologies in action recognition, motion analysis, human-computer interaction, animation generation etc. How to improve its performance has become a current research hotspot. Lite-HRNet establishes long range connections between keypoints and exhibits good performance in human pose estimation tasks. However, the scale of this method to extract features is relatively single and lacks sufficient information interaction channels. To solve this problem, we propose an improved lightweight high-resolution network based on multi-dimensional weighting, named MDW-HRNet, which is implemented by the following aspects: first, we propose global context modeling, which can learn multi-channel and multi-scale resolution information weights. Second, a cross-channel dynamic convolution module is designed, it performs inter-channel attention aggregation between dynamic and parallel kernels, replacing the basic convolution module. These make the network capable of channel weighting, spatial weighting and convolution weighting. At the same time, we simplify the network structure to perform information exchange and information compensation between high-resolution modules while ensuring speed and accuracy. Experimental results show that our method achieves good performance on both COCO and MPII human pose estimation datasets, and its accuracy surpasses mainstream lightweight pose estimation networks without increasing computational complexity.


Galanin - a novel biologically active peptide from porcine intestine.
The isolation of a novel biologically active peptide, designated galanin, is described. The peptide was discovered by the detection of its C-terminal amide structure in porcine intestinal extract using a chemical method. It was found that galanin consists of 29 amino acids and the complete amino acid sequence is: Gly-Trp-Thr-Leu-Asn-Ser-Ala-Gly-Tyr-Leu-Leu-Gly-Pro-His-Ala-Ile-Asp-Asn-His -Arg-Ser -Phe-His-Asp-Lys-Tyr-Gly-Leu-Ala-NH2. Galanin was found to contract smooth muscle preparations from the rat and to cause a mild and sustained hyperglycemia in dog.


Survival, retention rate and immunity of the black shell colored stocks of pearl oyster Pinctada fucata martensii after grafting operation.
We have developed a black shell colored selected line observed to have higher survival ability. In this study, to understand its immune capacity, total carotenoid content (TCC) of the black shell colored line (BG) and the control group (CG) were compared. Survival and retention rates, immunity and antioxidant capacity of BG were compared relative to CG at different times after grafting operation. The results showed that BG had significantly larger TCC than CG (P < 0.05). BG had significantly higher survival and retention rates than CG on days 7, 30 and 360 after grafting (P < 0.05). On days 360, BG had significantly larger pearl thickness than CG (P < 0.05). BG exhibited increased ACP, AKP, SOD, CAT, TAOC and LZ activity than the CG on 0 h, 12 h, 1 d, 3 d, 5 d, 7 d and 30 d after grafting. BG had higher expression levels of Fascin, SOD, CDK-7, CDAP-1, IRAK-1, α2m, GST-1, TRAF-3 and Caspase-2 than CG. The results suggested that BG had higher immune competence and pearl production performances, which is promising to improve pearl quality and production.


Blocking toll-like receptor 2 and 4 signaling during a stressor prevents stress-induced priming of neuroinflammatory responses to a subsequent immune challenge.
Acute and chronic stressors sensitize or prime the neuroinflammatory response to a subsequent peripheral or central immunologic challenge. However, the neuroimmune process(es) by which stressors prime or sensitize subsequent neuroinflammatory responses remains unclear. Prior evidence suggested that toll-like receptors (TLRs) might be involved in the mediation of primed neuroinflammatory responses, but the role of TLRs during a stressor has never been directly tested. Here, a novel TLR2 and TLR4 antagonist, OxPAPC, was used to probe the contribution of TLRs in the stress sensitization phenomenon. OxPAPC has not previously been administered to the brain, and so its action in blocking TLR2 and TLR4 action in brain was first verified. Administration of OxPAPC into the CNS prior to stress prevented the stress-induced potentiation of hippocampal pro-inflammatory response to a subsequent peripheral LPS challenge occurring 24 h later. In addition, in vivo administration of OxPAPC prior to stress prevented the sensitized pro-inflammatory response from isolated microglia following administration of LPS ex vivo, further implicating microglia as a key neuroimmune substrate that mediates stress-induced sensitized neuroinflammation.


Suicide and homicide deaths of PAs: Analysis of the National Violent Death Reporting System.
This study describes physician associate/assistant (PA) deaths in the US CDC's National Violent Death Reporting System (NVDRS) from 2003 to 2020. PAs' violent deaths were analyzed and summarized in terms of decedents' numbers and demographics, methods of death, locations of death, and relationships with assailants. The NVDRS identified 93 suicides and 9 homicides in this period. PAs who died by suicide were mostly White (93.5%) and male (67.7%); mean age was 49.7 years. A third of the PAs who died by homicide were Black; most were female (55.6%), and the mean age was 48.7 years. Firearms (41.7%) were most commonly involved in deaths by suicide, and blunt impact (33.3%) was most commonly seen in deaths by homicide. A plurality (46.1%) of suicides and homicides occurred in the South. Homes (72.5%) were the most frequent location. No homicides were reported in medical settings. Known perpetrators were mainly relatives and male; none were patients. Incidence of PA death by suicide or homicide is low relative to the general population. These deaths generally are not related to PAs' work. Delineating the incidence of violent deaths is a step toward informing preventive efforts.


Herniation through the foramen of Morgagni in children.
Eight cases of herniation through the foramen of Morgagni are described. They fell into two distinct groups presenting either as neonatal respiratory distress or as an incidental findings in older children. Diagnosis is essentially radiological, stressing the importance of a lateral film. Surgical repair is advocated. the abdominal approach being perferred. Pneumopericardium is a rare but severe complication.


Two-dimensional electrophoretic analysis of hepatitis-associated polypeptides in liver of LEC rats developing spontaneous hepatitis.
High-resolution two-dimensional polyacrylamide gel electrophoresis in combination with silver staining was used to analyze between 800 and 1000 cytosolic and particulate polypeptides from age-matched livers of normal male Long-Evans rat with Agouti coat color (LEA) and Long-Evans rat with Cinnamon-like coat color (LEC) rats with hereditary trait of hepatitis at ages long before, immediately prior to, and just after the onset of hepatitis. Although the electrophoretic patterns of polypeptide expression were very similar with respect to the overall spot patterns, a number of polypeptides which differed either qualitatively or quantitatively were noted. Two constitutively expressed cytosolic polypeptides, P29.5 (Mr 29.5 kDa/pI 6.73) and P30 (30 kDa/6.70), were not detected in livers of LEC animals at any age. In the normal LEA rats both P29.5 and P30 were detected as early as one day after birth and both were expressed at similar concentrations at all ages. In the LEC rats P30-C (30 kDa/6.68) was constitutively expressed in close proximity to the expected position of P30, and P30-C was not detected in the LEA rats. By means of non-equilibrium pH gradient electrophoresis two relatively basic polypeptides were detected in the LEC rats. P18ne was detected immediately prior to and P27ne immediately after the clinical manifestation of hepatitis. Experiments in F1 backcross ([LEA x LEC] x LEC) animals, however, failed to demonstrate any genetic link between either the expression or lack of expression of P29.5, P30, P30-C, or P18ne and hepatitis development. P27ne was detected in all backcross animals exhibiting hepatitis, but was never observed in LEC rats prior to the onset of hepatitis. Although we were unable to identify any unique loss of expression of polypeptides which are genetically linked to hepatitis susceptibility in LEC rats, specific subsets of quantitatively modulated polypeptides were detected.


Laparoscopic management of ureteral lesions in gynecology.
To investigate the outcome of laparoscopic repair of ureteral injury in laparoscopic gynecologic surgery. Prospective trial. University hospital. Forty patients with a ureteral lesion in laparoscopic surgery between 1991 and 2007. Laparoscopic ureteral repair, laparoscopic-assisted or blind stent insertion. Treatment outcome of ureteral lesion analyzed by type of injury, time of diagnosis, and management. In 4,350 consecutive laparoscopic gynecologic interventions, 42 lesions occurred, 5 during hysterectomy, 1 during adnexectomy, and 36 during deep endometriosis surgery. In the latter group (n = 1,427), the incidence was 1.5% and 21% in women without and with hydronephrosis, respectively. In eight women in whom a stent was inserted after surgery without laparoscopic guidance, five were uneventful and three needed a second intervention. In all 34 women in whom a laparoscopic repair over a stent was performed, the outcome was uneventful, whether diagnosed and treated during surgery (n = 25) or after surgery (n = 9). Laparoscopic repair over a stent was uneventful for all lacerations, transections, and fistulas, whether performed during or after surgery, and was superior to blind stent insertion. In women with hydronephrosis and deep endometriosis, a preoperative stent insertion seems to be mandatory.


Protocol to knock in or out target genes in mouse epidydimal white adipose tissue by spot injecting adeno-associated viruses.
Visceral fat obesity is more strongly associated with ectopic fat deposition, lipotoxicity, and metabolic disease compared to generalized obesity. To study the function of visceral fat tissue, we describe steps to knock in or out target genes by spot injecting adeno-associated viruses (AAV) in visceral fat tissue. We provide details on anesthesia, incision, and spot injection into the epidydimal white adipose tissue (eWAT) of live anesthetized mice. Furthermore, we detail an efficient technique for expressing exogenous protein in mouse eWAT. For complete details on the use and execution of this protocol, please refer to Zhao et al. (2022).


SlMBP22 overexpression in tomato affects flower morphology and fruit development.
MADS-domain transcription factors have been identified as key regulators involved in proper flower and fruit development in angiosperms. As members of the MADS-box subfamily, Bsister (Bs) genes have been observed to play an important role during the evolution of the reproductive organs in seed plants. However, their effects on reproductive development in fruit crops, such as tomato (Solanum lycopersicum), remain unclear. Here, we found that SlMBP22 overexpression (SlMBP22-OE) resulted in considerable alterations in floral morphology and affected the expression levels of several floral homeotic genes. Further analysis by yeast two-hybrid (Y2H) and bimolecular fluorescence complementation (BiFC) assays demonstrated that SlMBP22 forms dimers with class A protein MACROCALYX (MC) and SEPALLATA (SEP) floral homeotic proteins TM5 and TM29, respectively. In addition, pollen viability and cross-fertilization assays suggested that the defect in female reproductive development was responsible for the infertility phenotype observed in the strong overexpression transgenic plants. Transgenic fruits with mild overexpression exhibited reduced size as a result of reduced cell expansion, rather than impaired cell division. Additionally, SlMBP22 overexpression in tomato not only affected proanthocyanidin (PA) accumulation but also altered seed dormancy. Taken together, these findings may provide new insights into the knowledge of Bs MADS-box genes in flower and fruit development in tomato.


Relationships between anger, symptoms, and cognitive factors in OCD checkers.
The purpose of this study was to examine whether individuals diagnosed with obsessive-compulsive disorder (OCD) with primary checking compulsions report higher levels of trait anger and anger expression compared with a student control group, and whether trait anger and anger expression are correlated with specific beliefs and interpretations that are common among individuals who compulsively check. A group of individuals with OCD reporting significant checking compulsions (n=33) and a group of undergraduate students (n=143) completed a questionnaire package that included measures of trait anger and anger expression, as well as measures of obsessive-compulsive symptoms and beliefs. The compulsive checking group reported greater trait anger, though not greater anger expression, than the student control group. Furthermore, beliefs concerning perfectionism and intolerance of uncertainty were positively correlated with anger expression and trait anger among compulsive checkers but not among the student control group. The implications of these findings are discussed in terms of cognitive-behavioural treatments for and models of compulsive checking in OCD.


Thyroid-associated orbitopathy: Current insights into the pathophysiology, immunology and management.
Half the patients suffering from Graves' disease develop thyroid-associated orbitopathy (TAO). The severity of TAO varies considerably with a mild form characterized by dry eyes and discomfort to the severe form with sight-threatening exposure keratopathy and optic neuropathy. The pathogenesis and immunologic mechanisms underlying Graves' disease and TAO is unknown, however, advances toward this understanding have indicated a prominent role of orbital fibroblasts, T cells and B cells. These advances have led to novel strategies for clinical treatment using immunomodulatory modalities. Initial results included use of infliximab and etanercept (anti-TNF agents), but currently there is an increasing interest in anti-B cell (Rituximab) therapy. Rituximab has shown promising results in progressive, sight-threatening TAO. It has also shown encouraging results in halting or slowing the disease process in patients unresponsive to corticosteroids. The primary advantage of these immunomodulatory agents is based upon targeting the molecular mediators of the disease and avoiding the potential side effects of non-specific therapies.


A semi-continuous algal-bacterial wastewater treatment process coupled with bioethanol production.
Harnessing the biomass energy potential through biofuel production offers new outlets for a circular economy. In this study an integrated system which combine brewery wastewater treatment using algal-bacterial aggregates instead of activated sludge was developed. The use of algal-bacterial aggregates can eliminate the aeration requirements and significantly reduce the high biomass harvesting costs associated with algal monocultures. A sequencing batch reactor (SBR) setup operating with and without biomass recirculation was used to investigate pollutant removal rates, aggregation capacity and microbial community characteristics under a range of hydraulic retention times (HRTs) and solid retention times (SRTs). It was observed that biomass recirculation strategy significantly enhanced aggregation and pollutant removal (i.e., 78.7%, 94.2% and 75.2% for d-COD, TKN, and PO43--P, respectively). The microbial community established was highly diverse consisting of 161 Bacterial Operational Taxonomic Units (B-OTUs) and 16 unicellular Eukaryotic OTUs (E-OTUs). Escalation the optimal conditions (i.e., HRT = 4 d, SRT = 10 d) at pilot-scale resulted in nutrient starvation leading to 38-44% w/w carbohydrate accumulation. The harvested biomass was converted to bioethanol after acid hydrolysis followed by fermentation with Saccharomyces cerevisiae achieving a bioethanol production yield of 0.076 g bioethanol/g biomass. These data suggest that bioethanol production coupled with high-performance wastewater treatment using algal-bacterial aggregates is feasible, albeit less productive concerning bioethanol yields than systems exclusively designed for third and fourth-generation biofuel production.