Changes in left atrial dimension and function and left ventricular geometry in newly diagnosed untreated hypertensive subjects.
It is known that a spectrum of changes in structure, size and function of the different chambers of the heart occur in individuals with hypertension. The earliest changes and the sequence of these changes are still being studied. The present study aimed to assess early changes in the left atrial size and function in hypertension, and its relationship with left ventricular geometry and other factors that may influence left atrial size. One hundred consecutive subjects who were newly diagnosed with hypertension and 50 apparently normal individuals were recruited into the study. Standard M-mode, two-dimensional and Doppler echocardiography were performed. The endocardial border of the left atrium was traced to obtain the atrial area and left atrial volumes and emptying fractions were derived from measured areas. The hypertensive patients and the controls were comparable by age, sex and body mass index. Thirty-seven (37%) of the hypertensive subject had increased left ventricular mass versus eight subjects (16%) in the normal controls. The patients with hypertension had a higher linear left atrial dimension (3.5 +/- 0.48 cm versus 3.1 +/- 0.47 cm, P < 0.0001), longer pre-atrial contraction length (3.8 +/- 0.56 cm versus 3.6 +/- 0.45 cm; P = 0.02) and higher peak late mitral inflow velocity (0.64 +/- 0.19 m/s versus 0.56 +/- 0.15 m/s; P = 0.010). Changes in the geometry of the left ventricle occur early in hypertension and precede deterioration in left ventricular systolic function. The corresponding left atrial changes are marginal and are indicative of increased left atrial length and accentuated atrial systolic function.


High resolution imaging of the knee on 3-Tesla MRI: a pictorial review.
The recent introduction of 3-Tesla MRI offers substantial advances in musculoskeletal applications. High resolution images can now be obtained with shorter data acquisition times. This article provides a pictorial review of 3-Tesla imaging in the knee with descriptions of both normal anatomy and the more common lesions involving the menisci, ligaments, and articular cartilage. A discussion of the issues associated with imaging at higher field strengths is also included.


A descriptive study of 42 cases of Branhamella catarrhalis pneumonia.
We studied the clinical and laboratory findings of patients with pneumonia due to Moraxella (Branhamella) catarrhalis to better characterize the types of patients who develop this pneumonia, the clinical features of the illness, and the type of and response to drug therapy, as well as the immediate and long-term survival of these patients. Patients with sputum samples that met cellular criteria as quality samples and that grew B. catarrhalis as the sole pathogen were identified retrospectively from microbiology records at a regional referral hospital for cardiac and pulmonary diseases. Records of these patients were reviewed to identify patients with radiographic findings of pneumonia. Clinical and laboratory characteristics of these patients were then studied in detail. Forty-two patients who met the criteria for B. catarrhalis pneumonia were identified. Most patients were elderly (over 65 years; 55 percent), malnourished (69 percent), and had severe chronic obstructive pulmonary disease or another serious underlying disease (98 percent). The seasonal incidence of this pneumonia was October through April (88 percent), with the annual number of cases having increased since 1982. The clinical presentation was typically mild. Interstitial or mixed interstitial-alveolar infiltrates superimposed on pre-existing chronic lung disease was the most common radiographic finding. Approximately 90 percent of sputa were acceptable for Gram stain and contained 10 to more than 50 gram-negative cocci/1,000 x field. All cultures produced a heavy growth of B. catarrhalis, with 67 percent of strains positive for beta-lactamase. No patient had identified bacteremia (zero of 25 tested). Therapy with numerous agents including cefotaxime, amoxicillin/clavulanic acid, and trimethoprim/sulfamethoxazole resulted in a good clinical and bacteriologic response. However, 45 percent of patients died of their underlying diseases on this admission or within three months. These findings provide a good profile of B. catarrhalis pneumonia. Despite the mild character of the illness, the pneumonia occurs in patients with end-stage pulmonary or malignant disease and almost 50 percent of patients die of their underlying diseases within three months.


Discriminative stimulus properties of the atypical neuroleptic clozapine in rats: tests with subtype selective receptor ligands.
The interoceptive stimulus induced by clozapine (5 mg/kg, i.p.) has been characterized in an operant drug discrimination procedure in the rat using a wide range of receptor subtype-selective agonists and antagonists. Only the muscarinic receptor antagonist scopolamine generalized fully to clozapine (>80%). Partial generalization (defined here as 40% maximal generalization) was seen with the D1 receptor antagonist SCH 23390 (43% maximal generalization), the alpha1-adrenoceptor antagonist prazosin (67%) and the alpha2-adrenoceptor antagonist methoxyidazoxan (42%). All other specific agents tested induced <25% maximal generalization, including the alpha2-adrenoceptor antagonist yohimbine (24%), the histamine H1 receptor antagonist mepyramine (21%), the D2 antagonist typical neuroleptic haloperidol (23%), the D4 receptor antagonist L-745,870 (14%), the 5-hydroxytryptamine-1A (5-HT1A) receptor agonist S-14506 (8%), the 5-HT2A receptor antagonists ketanserin (0%) and M100907 (12%), the 5-HT2B/2C receptor antagonists SB 200646A (8%) and SDZ SER 082 (6%), and the 5-HT3 receptor antagonist ondansetron (0%). The clozapine discriminative stimulus was not blocked by the dopamine D1 receptor antagonist SCH 23390, or by the 5-HT1A receptor antagonist WAY 100635, when given concomitantly with clozapine. Although the results suggest that muscarinic antagonism plays a major role in the clozapine cue, the results have to be considered in the light of the full generalization to clozapine seen with various antipsychotic agents which have very low affinity for muscarinic receptors, including zotepine, quetiapine, JL13 and PNU 96415 (a finding replicated in rats from the same breeding colony as those which generalized to scopolamine). Thus, generalization to clozapine for antipsychotics with multiple affinities but with low muscarinic affinity is probably mediated by additive or perhaps supra-additive actions at other receptors, although extensive studies with various combinations of drug mixtures are required to validate this hypothesis.


Stimulus-feature specific negative priming.
We report the results of two experiments that showed that the time needed to respond to a feature of a stimulus increases when that particular feature of that particular stimulus previously had to be ignored. The data of Experiment 2 argue against the hypothesis that the observed stimulus-feature specific negative priming was due to a response conflict instigated by automatic episodic retrieval of prime responses. Experiment 2 also showed that the effects were not caused by difficulties in switching between prime and probe tasks and provided additional evidence for the fact that priming effects were stimulus-feature specific. The present results suggest that the selective inhibition or episodic encoding mechanisms that are assumed to underlie negative priming can operate in a more specific and powerful manner than has been previously assumed.


Economic impact of pharmacist interventions in pediatric ambulatory care clinics.
Ambulatory care pharmacists have a unique opportunity to identify and prevent adverse drug events (ADEs) throughout a patient's treatment course. These interventions can reduce unexpected clinic visits or hospitalizations, which may lead to decreased health care costs. However, research on this topic has not been conducted in the pediatric population. This study explored the economic impact of pharmacist interventions related to ADEs in pediatric ambulatory care clinics. The primary objective was to determine the total cost avoidance of pharmacist interventions associated with the prevention or management of ADEs in pediatric ambulatory care clinics. The secondary objectives were to describe and quantify pharmacist interventions related to the prevention and management of ADEs in pediatric ambulatory care clinics. Pharmacist interventions from pediatric ambulatory care clinics were collected from an electronic health record. These interventions were categorized into 1 of 4 categories: Drug interaction, drug not indicated, prevent or manage ADE, or prevent or manage drug allergy. A review panel consisting of ambulatory care pharmacists reviewed the interventions. The expected probability of the event occurring was classified according to the Nesbit method (0-0.6), and the level of care necessary to treat the potential ADE was determined. The levels of care included hospitalization, ambulatory care, and self-care. The cost avoidance associated with each prevented ADE was calculated by multiplying the probability of the ADE occurring by the average charge of the expected level of care. Of the 8755 interventions documented, 212 were included, leading to a total cost avoidance of $307,210 (range $76,802-$1,071,053). The estimated cost avoidance from each ADE subtype was $128,283 from drug interaction, $20,727 from drug not indicated, $157,993 from prevent or manage ADE, and $207 from prevent or manage drug allergy. Pediatric ambulatory care pharmacists optimize health care cost savings through the prevention and management of ADEs as integrated members of the health care team.


[Does the body mass index influence the results of revision total knee arthroplasty?].
Revision total knee arthroplasty (TKA) is one of the most demanding as well as increasing orthopaedic operations. The influence of a higher body weight or body mass index (BMI) on the results of revision TKA is not evident so far. We therefore hypothesised that obesity as well as a high body weight could influence the results of revision TKA. 75 consecutive revision TKA in 75 patients were included and stratified according to a BMI greater or smaller than 30 kg/m2 and a body weight greater or smaller than 90 kg. The Knee Society score (KSS), the function and the knee subscales were analysed pre- and postoperatively as well as the pre- to postoperative improvement. The duration of the procedure, the occurrence of complications, the blood loss and the length of hospital stay were collected. All patients showed a significant improvement of the KSS and function score (p < 0.05). There was a tendency to superior results in patients with a smaller BMI and a lower body weight. This tendency was most pronounced in the function subscale which depicted significant differences in favour of a BMI smaller 30 kg/m2. No significant differences were observed in the other analysed factors. BMI greater than 30 kg/m2 as well as a higher body weight seem to negatively influence the function of revision TKA. However, all patients significantly improved after revision TKA and no differences were found according to the occurrence of complications. Therefore, revision TKA should not be refused to obese or heavy patients.


[Irinotecan plus temozolomide in refractory or relapsed pediatric solid tumors].
The prognosis of refractory or relapsed pediatric solid tumors is very poor, and there is no standard treatment for this condition. The combination of irinotecan and temozolomide has proved useful in adults as a second-line treatment of different solid tumors. In pediatric patients, this combination has been effective in Ewing's sarcoma, neuroblastoma, and relapsed or refractory rhabdomyosarcoma. A retrospective study was conducted on 32 pediatric patients with refractory or relapsed solid tumors, who were treated with irinotecan and temozolomide in the Oncology Department at Children's Hospital Niño Jesus from September 2005 to June 2012. The clinical characteristics, treatment performed, toxicity and outcome, were analyzed. Thirty-two patients received a total of 180 cycles. Of the 30 evaluable patients, 10 (33%) had a positive response (2 complete remission and 8 partial remission), and in 8 (27%) the disease remained stable. Almost all (94%) of the patients achieved a response in the first four cycles. Of the 180 cycles analyzed, only 50 (28%) had toxicity, and of these only 15 (8%) were grade iii-iv. The most common toxicity was diarrhea appearing in 18 patients. All patients received ambulatory treatment, except three of them who required hospitalization due to symptoms of their underlying disease. The combination of irinotecan and temozolomide is well tolerated and active against pediatric refractory or relapsed solid tumors.


Low-cost web-based Supervisory Control and Data Acquisition system for a microgrid testbed: A case study in design and implementation for academic and research applications.
This paper presents the design and implementation of a low-cost Supervisory Control and Data Acquisition system based on a Web interface to be applied to a Hybrid Renewable Energy System (HRES) microgrid. This development will provide a reliable and low-cost control and data acquisition systems for the Renewable Energy Laboratory at Universitat Politècnica de València (LabDER-UPV) in Spain, oriented to the research on microgrid stability and energy generation. The developed low-cost SCADA operates on a microgrid that incorporates a photovoltaic array, a wind turbine, a biomass gasification plant and a battery bank as an energy storage system. Sensors and power meters for electrical parameters, such as voltage, current, frequency, power factor, power generation, and energy consumption, were processed digitally and integrated into Arduino-based devices. A master device on a Raspberry-PI board was set up to send all this information to a local database (DB), and a MySQL Web-DB linked to a Web SCADA interface, programmed in HTML5. The communications protocols include TCP/IP, I2C, SPI, and Serial communication; Arduino-based slave devices communicate with the master Raspberry-PI using NRF24L01 wireless radio frequency transceivers. Finally, a comparison between a standard SCADA against the developed Web-based SCADA system is carried out. The results of the operative tests and the cost comparison of the own-designed developed Web-SCADA system prove its reliability and low-cost, on average an 86% cheaper than a standard brandmark solution, for controlling, monitoring and data logging information, as well as for local and remote operation system when applied to the HRES microgrid testbed.


[Not Available].
Extracts of spores of eight different mould strains were examined regarding their toxic potential. So three cytotoxicity tests were utilized. On one hand there are the MB-assay and the MTT-assay. Both were applied with the human lung cell carcinoma line A549. On the other hand there is the pollen tube growth test, a plantbased method. At first the sensitivities of the cytotoxicity tests against certain chosen mycotoxins were evaluated. This was followed by the toxicological examination of the extracts. Finally HPLC analysis was used for the determination in which degree mycotoxins are responsible for the cytotoxic effects of the spores.It was shown that each extract of the spores had inhibitory influence on the test approaches. But only in one of the extracts the content of mycotoxin was proved.


Integral photodynamic treatment of refractory superficial bladder cancer.
Cystectomy is indicated after unsuccessful transurethral resection and intravesical treatment of superficial bladder cancer. As an alternative, whole bladder photodynamic therapy was done. In 21 patients the bladder was irradiated with laser light at a wavelength of 630 nm. after intravenous injection of a synthetic porphyrin mixture. Of the 21 patients 12 attained complete remission with a mean disease-free interval of 18.0 months (range 3 to 42), 3 with partial remission were rendered disease-free with transurethral resection or neodymium:YAG laser coagulation and 6 underwent cystectomy. In patients with refractory superficial bladder cancer the bladder can be preserved by use of photodynamic therapy.


The inhibitory action of FR 34235 (a new Ca2+ entry blocker) as compared to nimodipine and nifedipine on the contractile response to norepinephrine, potassium and 5-hydroxytryptamine in rabbit basilar artery.
In isolated basilar arteries, FR 34235 (FR), a new Ca2+ entry blocker, inhibited the contractile response to potassium, norepinephrine and 5-hydroxytryptamine (5-HT) in a dose-dependent manner. The potency of the inhibitory action of FR was in the following order: potassium greater than 5-HT greater than norepinephrine. Nifedipine had a similar inhibitory action on the responses. Nimodipine had no inhibitory effect on the response to norepinephrine but suppressed the responses to potassium and 5-HT.


Exploring the phase diagram of the two-impurity Kondo problem.
A system of two exchange-coupled Kondo impurities in a magnetic field gives rise to a rich phase space hosting a multitude of correlated phenomena. Magnetic atoms on surfaces probed through scanning tunnelling microscopy provide an excellent platform to investigate coupled impurities, but typical high Kondo temperatures prevent field-dependent studies from being performed, rendering large parts of the phase space inaccessible. We present a study of pairs of Co atoms on insulating Cu2N/Cu(100), which each have a Kondo temperature of only 2.6 K. The pairs are designed to have interaction strengths similar to the Kondo temperature. By applying a sufficiently strong magnetic field, we are able to access a new phase in which the two coupled impurities are simultaneously screened. Comparison of differential conductance spectra taken on the atoms to simulated curves, calculated using a third-order transport model, allows us to independently determine the degree of Kondo screening in each phase.


Indices of ventricular contractile state: comparative sensitivity and specificity.
Twenty-four indices of ventricular contractile state were compared as to inotropic sensitivity using dobutamine infusion, as well as to preload and afterload independence using dextran and phenylephrine infusion. Experiments were done in 10 open-chest instrumented dogs and signal processing was done off-line by digital techniques. The indices studied, listed in order of decreasing sensitivity, are (1) power-averaged rate of generation of power density, (2) peak isovolumic rate of change of power, (3) ejection rate of change of power at peak tension, (4) peak second time derivative of ventricular pressure, (5) peak ejection rate of change of power, (6) peak isovolumic power, (7) energy-averaged power density, (8) mean aortic blood acceleration, (9) peak aortic blood acceleration, (10) peak first time derivative of ventricular pressure, (11) peak normalized fiber velocity, (12) peak fiber velocity, (13) peak aortic blood flow, (14) peak power, (15) extrapolated Vmax (total pressure), (16) mean normalized fiber velocity, (17) mean fiber velocity, (18) extrapolated Vmax (developed pressure), (19) mean aortic blood flow, (20) mean power, (21) stroke volume, (22) peak wall tension, (23) mean wall tension, (24) time-tension index. The most sensitive index which was statistically independent of preload and afterload manipulation was the ejection rate of change of power at peak tension.


Effect of estrogen on rabbit gallbladder prostaglandin biosynthesis.
Male and female gallbladder prostaglandin biosynthesis was compared by radiochromatographic analysis of microsomal membrane fractions. Normal female rabbit gallbladder total prostaglandin activity was 10-fold higher than the normal male rabbit gallbladder total prostaglandin activity. The normal male rabbit extracts produced PGF2 alpha and PGE2 as the major arachidonic acid metabolites. The normal female rabbit extracts synthesized PGI2 and PGE2 (20-fold higher activity than the normal male) as the major arachidonic acid metabolites present. The effect of estrogen was studied by comparing prostaglandin activity in ovariectomized female rabbits given high-dose estrogen, low-dose estrogen, and no estrogen. The zero estrogen group prostaglandin activity was 5-fold lower than the normal female group. Treatment with low- or high-dose estrogen restored the gallbladder prostaglandin activity to the level of the normal rabbit gallbladder prostaglandin activity.


Benign neoplasms of the skin.
Virtually all human beings have a number of benign cutaneous neoplasms. Many of these never come to medical attention. Patients who do show such lesions to a physician typically are concerned about the possibility that their growths may be skin cancer. With proper training and experience, the physician should be able to triage most such lesions with a clinical examination. In a medical setting increasingly influenced by managed care and dominated by cost consciousness, the primary care physician is expected to make these clinical judgments without recourse to consultation or histopathologic examination. Familiarity with these common cutaneous tumors, and in particular with their range of variability, is therefore required. This article reviews the clinical aspects of some of the common benign cutaneous lesions. Common clinical scenarios related to these growths are emphasized.


Totally endoscopic non-robotic excision of aortic valve fibroelastoma: a case report.
Papillary fibroelastomas (PFEs) are a rare subtype of benign primary cardiac tumours, which are most commonly found on the aortic valve. Although median sternotomy is still used frequently there has been different attempts to remove the aortic valve PFEs minimally invasively using robotic and Mini sternotomy approach. We report herein a case of totally endoscopic non robotic removal of PFE of aortic valve. The encouraging intra and post-operative outcomes and fast recovery using totally endoscopic approach for removal of PFE shows the potential benefits of this technique.


Five-component model validation of reference, laboratory and field methods of body composition assessment.
This study reports the validity of body fat percentage (BF%) estimates from several commonly employed techniques as compared with a five-component (5C) model criterion. Healthy adults (n 170) were assessed by dual-energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP), multiple bioimpedance techniques and optical scanning. Output was also used to produce a criterion 5C model, multiple variants of three- and four-component models (3C; 4C) and anthropometry-based BF% estimates. Linear regression, Bland-Altman analysis and equivalence testing were performed alongside evaluation of the constant error (CE), total error (TE), se of the estimate (SEE) and coefficient of determination (R2). The major findings were (1) differences between 5C, 4C and 3C models utilising the same body volume (BV) and total body water (TBW) estimates are negligible (CE ≤ 0·2 %; SEE < 0·5 %; TE ≤ 0·5 %; R2 1·00; 95 % limits of agreement (LOA) ≤ 0·9 %); (2) moderate errors from alternate TBW or BV estimates in multi-component models were observed (CE ≤ 1·3 %; SEE ≤ 2·1 %; TE ≤ 2·2 %; R2 ≥ 0·95; 95 % LOA ≤ 4·2 %); (3) small differences between alternate DXA (i.e. tissue v. region) and ADP (i.e. Siri v. Brozek equations) estimates were observed, and both techniques generally performed well (CE < 3·0 %; SEE ≤ 2·3 %; TE ≤ 3·6 %; R2 ≥ 0·88; 95 % LOA ≤ 4·8 %); (4) bioimpedance technologies performed well but exhibited larger individual-level errors (CE < 1·0 %; SEE ≤ 3·1 %; TE ≤ 3·3 %; R2 ≥ 0·94; 95 % LOA ≤ 6·2 %) and (5) anthropometric equations generally performed poorly (CE 0·6- 5·7 %; SEE ≤ 5·1 %; TE ≤ 7·4 %; R2 ≥ 0·67; 95 % LOA ≤ 10·6 %). Collectively, the data presented in this manuscript can aid researchers and clinicians in selecting an appropriate body composition assessment method and understanding the associated errors when compared with a reference multi-component model.


A comparison of two ambulatory blood pressure monitors worn at the same time.
There are limited data in the literature comparing two simultaneously worn ambulatory blood pressure (BP) monitoring (ABPM) devices. The authors compared BPs from two monitors (Mobil-O-Graph [I.E.M., Stolberg, Germany] and Spacelabs 90207 [Spacelabs Medical, Issequah, WA]). In the nonrandomized component of the study, simultaneous 8-hour BP and heart rate data were measured by Mobil-O-Graph, consistently applied to the nondominant arm, and Spacelabs to the dominant arm on 12 untreated adults. Simultaneous 8-hour BP and heart data were obtained by the same monitors randomly assigned to a dominant or nondominant arm on 12 other untreated adults. Oscillometric BP profiles were obtained in the dominant and nondominant arms of the above 24 patients using an Accutorr (Datascope, Mahwah, NJ) device. The Spacelabs monitor recorded a 10.2-mm Hg higher systolic pressure in the nonrandomized (P=.0016) and a 7.9-mm Hg higher systolic pressure in the randomized studies (P=.00008) compared with the Mobil-O-Graph. The mean arterial pressures were 1 mm Hg to 2 mm Hg different between monitors in the two studies, and heart rates were nearly identical. Our observations, if confirmed in larger cohorts, support the concern that ABPM device manufacturers consider developing normative databases for their devices.


Junb controls lymphatic vascular development in zebrafish via miR-182.
JUNB, a subunit of the AP-1 transcription factor complex, mediates gene regulation in response to a plethora of extracellular stimuli. Previously, JUNB was shown to act as a critical positive regulator of blood vessel development and homeostasis as well as a negative regulator of proliferation, inflammation and tumour growth. Here, we demonstrate that the oncogenic miR-182 is a novel JUNB target. Loss-of-function studies by morpholino-mediated knockdown and the CRISPR/Cas9 technology identify a novel function for both JUNB and its target miR-182 in lymphatic vascular development in zebrafish. Furthermore, we show that miR-182 attenuates foxo1 expression indicating that strictly balanced Foxo1 levels are required for proper lymphatic vascular development in zebrafish. In conclusion, our findings uncover with the Junb/miR-182/Foxo1 regulatory axis a novel key player in governing lymphatic vascular morphogenesis in zebrafish.


The Rousso stitch: a new everting skin closure technique.
The purpose of this article is to describe a new suturing technique that everts the skin and is a modification the horizontal mattress suture called the Rousso stitch. The technique is described step by step, along with reference pictures. The Rousso stitch technique was developed based on the well-documented theory behind everting the edges of thicker skin on closure of surgical incisions to allow for ideal coaptation and minimal scar formation. It is an easy technique to learn and appears to be a good time-saving option for the surgeon to use for the same applications of the typical horizontal mattress suture.


Contamination of freshly harvested maize kernels withFusarium mycotoxins on Bihar state, India.
Freshly harvested maize samples, collected from different fields of Bhagalpur during January-March, 1989, were analysed for the presence of Fusarium species and their toxins.F. moniliforme was most common followed byF. roseum,F. sporotrichioides,F. graminearum andF. equiseti. Different strains of these species produced zearalenone (11.2-28.2 μ/g), DON (0.3-2.9 μg/g) and T-2 (5.2-20.6 μg/g) toxins on mostrice medium. Fifteen per cent, out of 86 maize samples analysed, were found to be contaminated with various levels of above toxins, which occurred either alone or in groups. Toxin concentration in contaminated samples varied from 0.76-1.5 μg/g (ZEN), 0.41-202 μg/g (DON) and 0.55-2.92 μg/g (T-2).


Role of cytokines and reactive oxygen species in brain aging.
Aging is a complex process that produces profound effects on the brain. Although a number of external factors can promote the initiation and progression of brain aging, peripheral and central changes in the immune cells with time, also play an important role. Immunosenescence, which is an age-associated decline in immune function and Inflammaging, a low-grade inflammatory state in the aging brain contribute to an elevation in cytokine and reactive oxygen species production. In this review, we focus on the pro-inflammatory state that is established in the brain as a consequence of these two phenomena and the resulting detrimental changes in brain structure, function and repair that lead to a decline in central and neuroendocrine function.


Factor structure and psychometric properties of the TFEQ in morbid obese patients, candidates to bariatric surgery.
To analyze the factor structure and psychometric properties of the TFEQ in a morbid obese Spanish sample of bariatric surgery candidates. Multi-trait/ multi-item analyses and alpha coefficients were conducted to test the convergent /discriminant validity and the internal consistency reliability. Principal components analyses (varimax) were used to explore the factor structure. Sub-group factor analyses by gender, age and body mass index (BMI) were conducted to identify unstable items. The internal structure of the original TFEQ factors was unsatisfactory, especially the Disinhibition Scale. Most Disinhibition and Hunger items were grouped on one factor labeled "Dysregulation Eating". Cognitive Restraint was split into two factors. The first one, related to the behavioral component of Restraint, labeled "Restrained Behaviour" and the second one related to weight and eating concerns called "Predisposition to Restraint". The original factor structure of the TFEQ was not replicated. A revised 23-item instrument, representing the three new derived factors is offered as a valid screening instrument for severely obese patients.


[Percutaneous drainage of intra-abdominal collections. Conditions for success].
Technological advances currently allow safe percutaneous puncture of certain intra-abdominal collections, provided the indications and technical precision are imperatively respected. Our aim is to draw attention to success factors and the limits of this procedure.


Preferences for Enhanced Primary Care Services Among Older Individuals and Primary Care Physicians.
We aimed to identify the factors that are most important for community-dwelling older individuals (i.e., users) and primary care (PC) providers to enhance PC services. Discrete choice experiment surveys were administered to 747 individuals aged ≥ 60 years and 242 PC physicians in Singapore between December 2020 and August 2021. Participants were asked to choose between two hypothetical PC clinics and their current clinic. Latent class models were used to estimate the relative attribute importance (RAI) and to calculate the predicted uptake for enhanced PC services. Based on the attributes and levels used in this study, the out-of-pocket cost (RAI: 47%) and types of services offered (RAI: 25%) were the most important attributes for users while working hours (RAI: 28%) and patient load (RAI: 25%) were the most important for providers. For out-of-pocket visit costs ranging from Singapore dollars (S)$100 to S$5, users' predicted uptake for enhanced PC services ranged from 46 to 84%. For daily patient loads ranging from 60 to 20 patients, providers' predicted uptake ranged from 64 to 91%, assuming their income remains unchanged. Our study provides timely insights for the development of strategies to support the government's new health care initiative (HealthierSG), which places PC at the center of Singapore's healthcare system. The ability to choose their preferred clinic, low out-of-pocket costs and types of services offered (for users), and reasonable working conditions (for providers) were the key factors for users and providers to participate in enhanced PC services.


Tumor cell formation by normal somatic cells fusing and cancer prevention prospects.
Malignant transformation might be ascribed to one of the rather widespread processes taking place in the organism daily and being genetically inherited in a normal somatic cell. In order that normal cells are transformed into malignant ones, they should undergo the following two stages: (1) initiation - the precancerous cell (first-stage synkarion) formation, and (2) promotion - the true tumor cell (second-stage synkaryon) formation. For promoting the tumor process, i.e. transformation into a true tumor synkaryon, first - stage synkaryon (precancerous cell) should go through the next stage/stages of development at the molecular and subcellular level. In a tumor synkaryon, in particular in its plasma membrane, most probably the antigenic mosaics of normal precursor cells is inherited and, therefore, such cells "escape" the effect of the immune forces of the body. In other words, antigenic determinants existing on the surface of normal initial (parent) precursor cells condition inaction of the so-called immune surveillance. The cancer prevention concept implies synchronous conversion of a tumor cell into the stage of nonviable polykaryocytes. In addition, for preventing this fatal disease the inhibition of the process of approaching and further adhesion of normal somatic cells would suffice. The expected outcome would be the creation in the body of the conditions when somatic cells are incapable of close contacts with each other (not injurious for organism). This will completely exclude the fusion of cells and then nuclei and reduce thus to a minimum the possibility of cancer cell development.


Anatomical measurement of the ossicles in patients with congenital aural atresia and stenosis.
Our aims were to measure and compare anatomical parameters of the ossicles in normal, congenital aural stenosis (CAS), and congenital aural atresia (CAA) ears. This retrospective study was performed using three-dimensional reconstructed images derived from computed tomography scans of 20 normal subjects, 20 CAS patients, and 20 CAA patients. The lengths of the malleus handle and long process of the incus were greater in normal ears than in CAS and CAA ears (all P < 0.05). The angles of the incudostapedial joint and between the short and long processes of the incus were smaller in normal ears than in CAS and CAA ears (all P < 0.05). There were no significant differences in the positions of the malleus head and incudomalleolar joint, the size of the malleus head, the length of the short process of the incus, or the angle of the incudomalleolar joint (P > 0.05). Anatomical parameters of the lower part, but not of the upper part, of the ossicular chain in CAS and CAA ears differed from those in normal ears. Different branchial arch origins of the upper and lower parts of the ossicular chain may explain these findings. Dysplasia of the second arch, which develops into the lower part of the ossicular chain, may contribute to ossicular malformation in CAA and CAS. Accurate radiographic measurement of malformed ossicles may be useful for reconstructive surgery of CAA and CAS using the patient's native ossicular chain and for choosing an appropriate place for active middle ear implants.


Indolyl-Pyridinyl-Propenone-Induced Methuosis through the Inhibition of PIKFYVE.
Methuosis is a form of nonapoptotic cell death characterized by the accumulation of macropinosome-derived vacuoles. Herein, we identify PIKFYVE, a class III phosphoinositide (PI) kinase, as the protein target responsible for the methuosis-inducing activity of indolyl-pyridinyl-propenones (3-(5-methoxy-2-methyl-1H-indol-3-yl)-1-(4-pyridinyl)-2-propen-1-one). We further characterize the effects of chemical substitutions at the 2- and 5-indolyl positions on cytoplasmic vacuolization and PIKFYVE binding and inhibitory activity. Our study provides a better understanding of the mechanism of methuosis-inducing indolyl-pyridinyl-propenones.


Light and nitrogen vacancy-intensified nonradical oxidation of organic contaminant with Mn (III) doped carbon nitride in peroxymonosulfate activation.
Recently, Mn-based materials have a great potential for selective removal of organic contaminants with the assistance of oxidants (PMS, H2O2) and the direct oxidation. However, the rapid oxidation of organic pollutants by Mn-based materials in PMS activation still presents a challenge due to the lower conversion of surface Mn (III)/Mn (IV) and higher reactive energy barrier for reactive intermediates. Here, we constructed Mn (III) and nitrogen vacancies (Nv) modified graphite carbon nitride (MNCN) to break these aforementioned limitations. Through analysis of in-situ spectra and various experiments, a novel mechanism of light-assistance non-radical reaction is clearly elucidated in MNCN/PMS-Light system. Adequate results indicate that Mn (III) only provide a few electrons to decompose Mn (III)-PMS* complex under light irradiation. Thus, the lacking electrons necessarily are supplied from BPA, resulting in its greater removal, then the decomposition of the Mn (III)-PMS* complex and light synergism form the surface Mn (IV) species. Above Mn-PMS complex and surface Mn (IV) species lead to the BPA oxidation in MNCN/PMS-Light system without the involvement of sulfate (SO4• ̶) and hydroxyl radicals (•OH). The study provides a new understanding for accelerating non-radical reaction in light/PMS system for the selective removal of contaminant.


The pathogenesis of Rift Valley fever virus in the mouse model.
Detailed studies describing the pathogenesis of Rift Valley fever (RVF) virus (RVFV) in the mouse model are lacking. A fully characterized small animal model of RVF is needed to evaluate potential vaccines and therapeutics. In this study, we characterized the pathogenesis of RVFV throughout the disease course in mice. Infection produced high-titer viremia and demonstrated RVFV tropism for a variety of tissue and individual cell types. Overwhelming infection of hepatocytes, accompanied by apoptosis, was a major consequence of infection. The majority of mice died or were euthanatized between days 3 and 6 postinfection with severe hepatitis. The remaining mice effectively cleared virus from the liver and blood, but exhibited neuroinvasion and developed panencephalitis. In addition, we characterized a number of other virological, clinicopathological, and histopathological features of RVFV infection in mice. The mouse model therefore mimics both the acute-onset hepatitis and delayed-onset encephalitis that are dominant features of severe human RVF.


How Institutional Evaluation Bridges Uncertainty and Happiness: A Study of Young Chinese People.
Uncertainty triggers negative psychological responses, while positive institutional evaluations elevate the sense of control in individuals and satisfy their need for structure and order. Data from the 2015 Chinese Social Survey (CSS) (N = 4,605) demonstrated that objective uncertainty negatively predicted the happiness of young people (aged 18-45 years). However, this negative relationship was attenuated among those who evaluated the institutional system (e.g., social security, local government effectiveness, and trust in government) positively; in other words, positive institutional evaluation may have protected people's happiness from the threat of uncertainty. In addition, participants from different age groups evaluated the institutional system differently. The first generation born after the Chinese economic reform, which includes young people born in the 1980s (aged 26-35 years), had unique experiences compared to the preceding (aged 36-45 years, born in the 1970s) and succeeding (aged 18-25 years, born in the 1990s) generations. Among the three age groups, young people born in the 1980s held the least positive evaluation of the institutional system. The institutional evaluation also showed the weakest moderating effect on this group's happiness.


[Acute pancreatitis: etiopathogenesis, physiopathology and clinical aspects].
Acute pancreatitis is a serious clinical problem. Many of the etiopathogenic mechanisms are not clear and its pathophysiology is very complex, with multisystemic implications. The outcome may be severe, and there is no general agreement on the therapeutic approach. In the present paper we review the newest etiopathogenic and physiopathologic concepts on acute pancreatitis as well as the diagnostic criteria on this condition.


Spermine cycling in mitochondria is mediated by adenine nucleotide translocase activity: mechanism and pathophysiological implications.
Spermine, besides to be transported in mitochondria by an energy dependent electrophoretic mechanism, can be also released by two different mechanisms. The first one is induced in deenergizing conditions by FCCP or antimycin A and it is mediated by an electroneutral exchange spermine protons. The second one takes place in energizing conditions during the activity of the adenine nucleotide translocase and is mediated by an electroneutral symport mechanism involving the efflux in co-transport of spermine and phosphate and the exchange of exogenous ADP with endogenous ATP. The triggering of this mechanism permits an alternating cycling of spermine across the mitochondrial membrane, that is spermine is transported or released by energized mitochondria in the absence or presence of ATP synthesis, respectively. The physiological implications of this cycling of spermine are related to the induction or prevention of mitochondrial permeability transition and, consequently, on apoptosis or its prevention.


MERCAT: Visualising molecular epidemiology data combining genetic markers and drug resistance profiles.
Molecular epidemiology uses genetic information from bacterial isolates to shed light on the population structure and dynamics of pathogens. Bacterial pathogens can now be studied by whole genome sequencing, but for some well-studied pathogens such as Mycobacterium tuberculosis a wealth of information is also available from other sources such as spoligotyping and multi-locus variable-number-tandem-repeats (VNTR). Isolates are also frequently tested for susceptibility to antibiotics. Methods of analysis are available for each type of data but it would be informative to combine multiple sources of information into a single analysis or visualisation. Here, we propose and implement a simple way to visualise genotypes along with drug resistance profiles for multiple drugs. We also present a way to combine information from different markers to aid in visualising relationships among isolates. These methods help to reveal the origins and spread of multi-drug resistant lineages of pathogens. We introduce a new computational package, MERCAT (Molecular Epidemiology Researcher's Collection of Analytical Tools), for analysing genotypic data from bacterial isolates. The software is available as an open source package in the statistical language R with a user-friendly interface using R Shiny. Although we focus on tuberculosis and the major molecular markers used to understand tuberculosis transmission - multilocus VNTR-typing (MLVA or MIRU) and spoligotyping - the methods and tools can be applied to other bacteria and can be easily tailored to other genetic markers such as SNP data from whole genome sequencing.


Rapid eye movements in the kitten.
The horizontal and vertical components of the rapid eye movements (REMs) of paradoxical sleep have been analysed in kittens of a few weeks of age and in adult cats. The following differences between young and adult animals have been found: (a) in kittens the horizontal and vertical components of the REMs are of saccadic type; in adult cats only the vertical components are saccades; (b) the peak velocity and the rate of velocity increase are surprisingly greater in kittens than in adult cats. These data might indicate that REM sleep plays a role in the maturation of neuronal organization of eye movements.


Isoproterenol instigates cardiomyocyte apoptosis and heart failure via AMPK inactivation-mediated endoplasmic reticulum stress.
A prolonged or excessive adrenergic activation leads to myocyte loss and heart dysfunction; however, how it contributes to heart failure remains poorly defined. Here we show that isoproterenol (ISO) induced aberrant endoplasmic reticulum (ER) stress and apoptotic cell death, which was inhibited by activating the AMP-activated protein kinase (AMPK) in vitro and in vivo. Persistent ISO stimulation suppressed the AMPK phosphorylation and function, resulting in enhanced ER stress and the subsequent cell apoptosis in cardiomyocytes in vitro and in vivo. AMPK activation decreased the aberrant ER stress, apoptosis, and brain natriuretic peptide (BNP) release in ISO-treated cardiomyocytes, which was blocked by AMPK inhibitor Compound C. Importantly, increased ER stress and apoptosis were observed in ISO-treated cardiomyocytes isolated from AMPKα2(-/-) mice. Inhibition of ER stress attenuated the apoptosis but failed to reverse AMPK inhibition in ISO-treated cardiomyocytes. Moreover, metformin administration activated AMPK and reduced both ER stress and apoptosis in ISO-induced rat heart failure in vivo. We conclude that ISO, via AMPK inactivation, causes aberrant ER stress, cardiomyocyte injury, BNP release, apoptosis, and hence heart failure in vivo, all of which are inhibited by AMPK activation.


SNAT7 regulates mTORC1 via macropinocytosis.
Mammalian target of rapamycin complex 1 (mTORC1) senses amino acids to control cell growth, metabolism, and autophagy. Some amino acids signal to mTORC1 through the Rag GTPase, whereas glutamine and asparagine activate mTORC1 through a Rag GTPase-independent pathway. Here, we show that the lysosomal glutamine and asparagine transporter SNAT7 activates mTORC1 after extracellular protein, such as albumin, is macropinocytosed. The N terminus of SNAT7 forms nutrient-sensitive interaction with mTORC1 and regulates mTORC1 activation independently of the Rag GTPases. Depletion of SNAT7 inhibits albumin-induced mTORC1 lysosomal localization and subsequent activation. Moreover, SNAT7 is essential to sustain KRAS-driven pancreatic cancer cell growth through mTORC1. Thus, SNAT7 links glutamine and asparagine signaling from extracellular protein to mTORC1 independently of the Rag GTPases and is required for macropinocytosis-mediated mTORC1 activation and pancreatic cancer cell growth.


Immune reconstitution in chronic lymphocytic leukemia.
Chronic lymphocytic leukemia (CLL) is associated with a profound immune defect, which results in increased susceptibility to recurrent infections as well as a failure to mount effective antitumor immune responses. Current chemotherapy-based regimens are not curative and often worsen this immune suppression, so their usefulness is limited, particularly in the frail and elderly. This article reviews the immune defect in CLL and discusses strategies aimed at repairing or circumventing this defect. In particular, it focuses on recent developments in the areas of CD40 ligand (CD40L/CD154) gene therapy, immunomodulatory agents such as lenalidomide, and adoptive transfer of T cells bearing chimeric antigen receptors.


Nitrogenase from Bacillus polymyxa. Purification and properties of the component proteins.
A purification procedure is described for the components of Bacillus polymyxa nitrogenase. The procedure requires the removal of interfering mucopolysaccharides before the two nitrogenase proteins can be purified by the methods used with other nitrogenase components. The highest specific activities obtained were 2750 nmol C2H4 formed . min-1 . mg-1 MoFe protein and 2521 nmol C2H4 formed . min-1 . mg-1 Fe protein. The MoFe protein has a molecular weight of 215 000 and contains 2 molybdenum atoms, 33 iron atoms and 21 atoms of acid-labile sulfur per protein molecule. The Fe protein contains 3.2 iron atoms and 3.6 acid-labile sulfur atoms per molecule of 55 500 molecular weight. Each Fe protein binds two ATP molecules. The EPR spectra are similar to those of other nitrogenase proteins. MgATP changes the EPR of the Fe protein from a rhombic to an axial-type signal.


Subacromial anatomy for the arthroscopist.
One of the most significant recent advances in arthroscopic surgery of the shoulder has been in the evaluation of the subacromial space and the anatomical structures within. Arthroscopic visualization of this area provides an unusual perspective of the anatomy that was not heretofore appreciated through open surgical techniques. This study was undertaken to attempt to define better the anatomy of the subacromial space as it pertains to arthroscopic surgery. Clinical arthroscopic evaluation of the subacromial space was correlated with gross anatomical dissections of 12 fresh cadaver shoulders and a review of the pertinent anatomical and surgical literature. By doing so, we have attempted to define better the boundaries of the subacromial space, the portions of the rotator cuff that are readily visualized arthroscopically, as well as those areas that are "blind" to arthroscopic evaluation. In addition, the anatomy of the coracoacromial ligament, the inferior surface of the acromion, and the acromioclavicular (AC) joint as viewed arthroscopically is presented with gross anatomical correlation. We feel that this information will help arthroscopists better understand the advantages as well as the limitation of arthroscopy of the subacromial space.


Seizure and cognitive outcomes of epilepsy surgery in infancy and early childhood.
To investigate seizure and developmental outcomes following epilepsy surgery in very young children and determine their predictive factors. We retrospectively reviewed the clinical data, surgical variables, and outcomes of 30 children under 3 years of age that underwent resection for refractory focal epilepsy in our institution in 2001-2011. Seizure onset was in the first year of life in 27 (90%) cases and mean age at surgery was 20 months (range 5-33.6). Pathology consisted of cortical malformations in 24 (80%) cases, glioneuronal tumour and infarction with or without cortical dysplasia in three (10%) cases each. Morbidity was comparable with older paediatric cohorts. At 1-11.6 year follow-up (mean 4.1) 21 of 30 (70%) children achieved seizure freedom (Engel I), six (20%) demonstrated worthwhile improvement (Engel II/III) and three (10%) did not benefit from surgery (Engel IV). Intralobar lesionectomy more often resulted in seizure freedom than multilobar or hemispheric surgery. The abundance of non-regional interictal and ictal EEG findings did not preclude seizure freedom. Presurgical developmental impairment was established in 25 of 28 (89%) children; its severity correlated with longer epilepsy duration and determined postoperative developmental outcome. Developmental progress was established in 26 out of 28 (93%) children following surgery, showing stabilized trajectories rather than catch-up. Resective surgery in very young children is safe and effective in terms of seizure control and developmental progress. Our findings underline the importance of early intervention in order to timely stop seizures and their deleterious effects on the developing brain.


Self-care actions for the maintenance of the arteriovenous fistula: An integrative review.
To identify self-care actions for the maintenance of arteriovenous fistula of renal patients. An integrative review study was conducted and literature were searched in Medline/PubMed, Scopus, CINAHL, LILACS, BDENF and SciELO Library databases using the descriptors chronic renal insufficiency, arteriovenous fistula, self-care, and knowledge. The inclusion criteria were that the documents be written in Portuguese, English, and Spanish, full text available, published in the last five years, and that they address the research question. Reflection articles, theses, dissertations, editorials of non-scientific journals, and research studies that did not follow the necessary methodological rigor were excluded. Data were analyzed with the IRAMUTEQ software. Fifteen articles were selected and comprised the final sample. Seven classes of self-care actions emerged from the text segments analysis and grouped into three categories: 1) Self-care actions that maintain the arteriovenous fistula; 2) Self-care actions for the prevention and the monitoring of complications with arteriovenous fistula; 3) Self-care actions directed at the perioperative period of arteriovenous fistula preparation. The results allowed us to identify important care for the maintenance of arteriovenous fistula functionality. The self-care actions identified in this study can guide a nursing care policy for implementation with protocols that help identify problems related to self-care actions and, thus, subsidize the development of actions aimed at the renal patient. However, more studies with high levels of evidence that identify self-care actions with arteriovenous fistula and the factors involved in its implementation are needed.


Efficacy of core exercises in patients with osteoarthritis of the knee: A randomized controlled clinical trial.
Randomized, evaluator blinded, controlled, parallel group. This trial was conducted between July 2011 and January 2015 at a public hospital in Argentina. Patients older than 40 years with a medical diagnosis of osteoarthritis (OA) were randomly assigned to the experimental group (EG) or control group (CG). Both groups performed conventional exercises 3 times a week for 12 weeks and core exercises were added to the EG intervention. The objective was to compare the efficacy of conventional treatment combined with core muscle strengthening exercises, with conventional treatment alone in terms of short- and medium-term pain reduction and physical function in patients with knee OA. The primary outcome was knee pain assessed using a visual analog scale and the secondary outcome was physical function assessed at baseline, week 8 and 12, and 2 follow-up visits held 1 month and 3 months after the end of treatment. 113 patients were randomized to a CG (n = 60) or EG (n = 53). 66 patients were eliminated and 25 patients in the EG and 22 in the CG were analyzed. Both pain reduction and improved physical function were observed throughout the intervention in both groups. At the end of the treatment, a statistically and clinically significant pain reduction was observed in the EG. No adverse effects were reported. The combination of core muscle activation exercises and conventional treatment was more effective in short-term pain reduction in patients with knee OA.


Nonsimultaneous primary choroidal and cutaneous melanomas. Report of a case.
The authors report a patient with nonsimultaneous choroidal and cutaneous melanomas. The patient did not display the dysplastic nevus syndrome phenotype, and there was a negative family history for cutaneous or uveal melanomas. This sporadic case might suggest a common etiologic factor in the pathogenesis of multicentric malignant melanomas.


Standards of external fixation in prolonged applications to allow safe conversion to definitive extremity surgery: the Aachen algorithm for acute ex fix conversion.
External fixation has become an important tool in orthopedic surgery. Technology has improved the design and material as well as the construct of the fixator. As most patients are converted from external fixation to definite stabilization during later clinical course, prevention of complications such as infection is of high importance. Based on the current literature, principles of temporary external fixation were summarized. We focused on minimizing the risk of infection and introduce a standardized algorithm how to proceed when converting from external to internal fixation, which also was examined for effectiveness.


Inhibitory effect of ZnCl(2) on glycolysis in human oral microbes.
Although the inhibition of bacterial glycolysis by zinc ions might be expected to moderate dental caries, there has not been a comparison of the effect of Zn on different organisms under both fixed pH and free-fall conditions. Here, the effect of ZnCl(2) on Streptococcus salivarius, Strep. mutans, Strep. sobrinus, Actinomyces naeslundii and Lactobacillus casei, as well as on mixtures of oral organisms outgrown from human dental plaque and saliva, was surveyed. pH-stat experiments were performed at pH 7, 6 or 5 in a solution containing 5% glucose and a suspension of the test organism; pH-fall experiments started at pH 7. In both cases, acid production was monitored for 60 min, when samples were taken for Zn and lactate determinations. Under pH-stat conditions, acid production was inhibited by Zn most strongly in Strep. sobrinus and Strep. salivarius. In terms of total acid production averted, however, the effect of Zn under both pH-stat and pH-fall conditions was clearly greatest with Strep. salivarius. A. naeslundii was inhibited the least strongly under pH-stat conditions. Cultured oral organism mixtures were more sensitive to moderate concentrations of zinc (0.2-0.3mM initial concentration) than were the single species to higher concentrations (1mM). Packed cell layers responded to Zn quite differently from suspensions, the pH often falling in the presence of 1mM Zn at a rate similar to the no Zn control. As streptococci had the highest acidogenesis rates in both pH-stat and pH-fall experiments, it seems likely that inhibition of acid production with these organisms would be of more value in moderating caries than the inhibition of less acidogenic organisms such as A. naeslundii.


Surgery of the upper respiratory system.
Surgery of the respiratory tract often is considered a last resort. However, these surgeries can be performed successfully, allowing for preservation of genetics and productivity. This article discusses surgery of the upper respiratory system. Aspects of physical, radiographic, endoscopic, and ultrasonographic examination are explored. Conditions of the nares, paranasal sinuses, nasopharynx, palate, nasolacrimal duct, pharynx, and larynx are covered.


Interleukin-17 cytokines: Effectors and targets in psoriasis-A breakthrough in understanding and treatment.
The IL-17 cytokine family comprising IL-17A to IL-17F and receptor subunits IL-17RA to IL-17RE represents a genetically ancient intercellular network regulating local tissue homeostasis. Its pivotal role in antifungal defense and its central position in the pathogenesis of inflammatory diseases including psoriasis were discovered only relatively late in the early 2000s. Since the connection of dysregulated IL-17 and psoriasis pathogenesis turned out to be particularly evident, a number of monoclonal antibodies targeting IL-17 pathways have been approved and are used as first line treatment of moderate-to-severe plaque psoriasis and psoriatic arthritis, and further agents are currently in clinical development.


Relationship between serum anti-Leishmania antibody levels and acute phase proteins in dogs with canine leishmaniosis.
This study examined the relationship between two serologic assays which quantify anti-Leishmania antibodies (a commercial enzyme-linked immunosorbent assay (ELISA) and a time-resolved immunofluorometric assay (TR-IFMA)) and selected acute phase proteins (APPs) and analytes related to protein concentration. Data were obtained from 205 canine serum samples from different veterinary clinics located in an area in which canine leishmaniosis (CanL) is endemic. The samples were submitted to the Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), University of Murcia, Spain, for analysis. The biochemical analytes evaluated were serum ferritin, C-reactive protein (CRP), haptoglobin, paraoxonase-1 (PON-1) and albumin as APPs and total proteins and globulins as indicative analytes of protein concentration. Samples were submitted for the initial diagnosis of CanL, or to monitor the response to treatment in patients with CanL. The evaluation of the biochemical analytes did not show differences between Leishmania-seronegative and Leishmania-seropositive dogs. However, dogs with high antibody titers showed more pronounced clinicopathological abnormalities. Both serological assays had correlations of different significance with the biochemical analytes, showing higher significant correlations with total proteins and globulins than with the rest of the analytes. When the samples submitted for diagnosis and treatment monitoring were analyzed separately, serological assays showed lower correlation in samples for treatment monitoring (r = 0.531, p < 0.0001) than in samples for diagnosis (r = 0.769, p < 0.0001). In addition, higher correlations were found between TR-IFMA and analytes such as serum ferritin and CRP in the treatment monitoring group than with the ELISA. These results may help to clarify the relationship between anti-Leishmania antibody levels and selected biochemical analytes related to inflammation and protein concentration in CanL.


The postnatal evolution of muscular twitches in the developing rat.
The reported study concerns the evolution of muscular twitches during the 21 postnatal days of the normal rat pups. The data indicate an age-dependent progression of these twitches in different body regions.


Impact of Τh1 and Τh2 cytokines in the progression of idiopathic nephrotic syndrome due to focal segmental glomerulosclerosis and minimal change disease.
Differential diagnosis between primary focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD) is sometimes difficult as nephrotic syndrome is the main clinical symptom in both diseases. This study has attempted to evaluate the urinary excretion of Th1 and Th2 cytokines as potential biomarkers in distinguishing the two types of nephrotic syndrome, and predicting outcome of renal function. Thirty-six patients with FSGS (M/F 22/14, Age; 41.9 ± 17 years, SCr=1.7 ± 0.8 mg/dL, UProt=4.7 ± 5.5 g/24 h), and 21 with MCD (M/F 5/16, Age; 41.4 ± 15 years, SCr = 1 ± 0.4 mg/dL, UProt = 7.9 ± 9.3 g/24 h) were included in the study. Τh1 (IL-2, IL-12, GM-CSF, INF-γ, TNF-α) and Th2 cytokines (IL-4, IL-5, IL-10, IL-13) were measured by multiple cytokine assay, Luminex technology, in first morning urinary samples collected at the day of renal biopsy. No significant differences in urinary excretion of all cytokines were found between FSGS and MCD patients. In FSGS however, IL-12 urinary levels were independent factor correlated with both global sclerosis (R = 0.5, P = 0.009) and interstitial fibrosis (R = 0.5, P = 0.02). Th1 cytokines (IL-2 and GM-CSF) were significantly increased in FSGS patients who did not respond to treatment (P = 0.03 and P = 0.007, respectively). Th2 cytokines (IL-4, IL-5, IL-10, IL-13) were significantly increased in MCD patients with frequent relapses (P = 0.05, P = 0.001, P = 0.01, P = 0.03). Urinary excretion of Th1 and Th2 cytokines cannot discriminate FSGS from MCD. Th1 cytokines, especially IL-12, IL-2 and GM-CSF, may be involved in pathology and progression of FSGS, while Th2 cytokines are implicated in frequent relapses of nephrotic syndrome in MCD.


Description of three new Boulenophrys species from eastern Guangdong, China, emphasizing the urgency of ecological conservation in this region (Anura, Megophryidae).
The hilly region in eastern Guangdong, China lacks comprehensive scientific investigations for decades, especially in terms of herpetofauna. In recent years, several highly threatened amphibians have been gradually discovered from this region. In this work, three new species of the genus Boulenophrys are described, which are endemic from only one or two known localities in eastern Guangdong. These discoveries enrich the diversity of Boulenophrys in eastern Guangdong. With the large number of threatened urodeles and anuran species occurring in this densely populated area, the unique herpetological diversity in eastern Guangdong is facing the impacts of habitat degradation and fragmentation, and conservation actions are urgently required.


Current status of cytology laboratories in anatomic pathology departments.
Details of cytology work in 103 US histology laboratories (histolabs) and in 200 from 18 other countries are presented. Data from 1345 additional US cytology practices surveyed from 1985 to 2004 are also included. The average annual workload in 130 histolabs from the United States and 12 other countries combined is 32 200 cases. The average annual workload in 173 histolabs from Spain and 5 Hispano-American countries is 20 000 cytology cases, a workload that is significantly lower (P < .0005) than that in US laboratories. Gynecologic cases, with an average of 1.2 slides each, represent 79% of all cytology accessions in all laboratories. The average annual workload per cytotechnologist (CT) is 6600 cases; this number is not significantly different between countries (P > .10 to P > .75) and is significantly correlated (P < .0008) with the laboratories' total workloads. In the United States, the average annual productivity per CT is 6700 cases with 1.8 slides each, for a daily screening of 55 to 60 slides. The annual benchmark is from 7900 to 8700 cases, equivalent to 14 300 to 15 000 slides per each full-time CT position. The benchmark per cytology aide is 17 000 to 20 000 cases. The number of CTs per histolab is significantly correlated (P < .0002) with its workload. In the United States, there is an average of 4 CTs and 2.7 cytology aides per laboratory, and the cytology tasks completed by the histology staff average 4.1 hours daily. The average turnaround time for cytology cases in the United States is approximately 6 calendar days, with 90% of all cases signed out between 7 and 8 calendar days. In addition to the productivity benchmarks, the pathology leadership must address the ergonomic conditions of the work when filling a new CT position because muscular discomfort caused by the microscopy work is a common occurrence.


Immunoquantification of the low abundance lysosomal enzyme N-acetylgalactosamine 4-sulphatase.
The low abundance lysosomal enzyme N-acetylgalactosamine 4-sulphatase (4-sulphatase) has been quantified using a microimmunopurification step and a monoclonal-based ELISA detection system. The assay is similar in principle to a two-site ELISA but uses a single monoclonal antibody against one epitope to bind 4-sulphatase in two separate assay steps. The sensitivity of this assay is sufficient to allow the quantification of 4-sulphatase in human cultured skin fibroblasts derived from normal controls and patients deficient in 4-sulphatase activity (mucopolysaccharidosis type VI or Maroteaux-Lamy syndrome). The results obtained suggest a range of mucopolysaccharidosis type VI or 4-sulphatase deficient mutants, from those expressing little or no quantifiable 4-sulphatase protein to those examples with quantifiable levels of 4-sulphatase protein which is enzymically inactive. Phenotypic variability in patients with a 4-sulphatase deficiency may therefore be partially attributed to a range of protein expressions. The method should allow the determination of 4-sulphatase specific activity in mucopolysaccharidosis type VI patients.


Development of wheezing disorders and asthma in preschool children.
Recent longitudinal studies have shed light on the pathogenesis and progression of asthma. The patterns of expression of childhood asthma that persist into adult life have been explored. Distinct asthma phenotypes (transient wheezing, nonatopic wheezing, and atopy-associated asthma) have been identified. Defining which children are at risk for persistent asthma could allow for better management and, potentially, for reduced morbidity and mortality.


The effect of bacillus Calmette-Guerin on the urinary system of pigs.
An experimental study was conducted to determine the changes in structure and function of the pig kidney and renal pelvis following intrarenal infusion of bacillus Calmette-Guerin (BCG). Bilateral nephrostomy tubes were inserted in six pigs through a subcostal (flank) retroperitoneal approach. One week later, antegrade pyelograms and renal scans with hippuran I-131 were obtained. The left kidney was then infused weekly for six weeks with two ampules of BCG (Tice strain) dissolved in 75 cc of saline. The right kidney, serving as a control, was infused concomitantly with 75 cc of saline. On week 7, bilateral antegrade pyelograms and renal scans were repeated. Two pigs were sacrificed at four, eight and 12 weeks after completion of BCG therapy. In all pigs, antegrade pyelograms of the left kidney before BCG instillation were identical to those obtained after completion of treatment and to those of the saline infused kidneys. The isotope renal scan in five pigs showed no significant change in image appearance or relative renal plasma flow in the pre-treatment and post-treatment images. In one pig, there was a decrease in the relative clearance of hippuran in the saline infused kidney. In this kidney, an upper pole abscess was found. Microscopic examination of the renal cortex, medulla, pelvis and ureter of the BCG infused kidneys was normal and identical to the saline infused kidneys. The urothelium was intact and no inflammatory changes were noted in the renal cortex or medulla. These results show that direct infusion of BCG into the renal collecting system has no adverse effect on the structure and function of pig kidneys when followed one to three months after treatment.


Variations in the NSP4 gene of the type 2 porcine reproductive and respiratory syndrome virus isolated in China from 1996 to 2021.
Porcine reproductive and respiratory syndrome virus (PRRSV) has continuously mutated since its first isolation in China in 1996, leading to difficulties in infection prevention and control. Infections caused by PRRSV-2 strains are the main epidemic strains in China, as determined by phylogenetic analysis. In this study, we focused on the prevalence and genetic variations of the non-structural protein 4 (NSP4) from PRRSV-2 over the past 20 years in China. The fundamental biological properties of the NSP4 were predicted, and an analysis and comparison of NSP4 homology at the nucleotide and amino acid levels was conducted using 123 PRRSV-2 strains. The predicted molecular weight of the NSP4 protein was determined to be 21.1 kDa, and it was predicted to be a stable hydrophobic protein that lacks a signal peptide. NSP4 from different strains exhibited a high degree of amino acid (85.8-100%) and nucleotide sequence homology (81.0-100%). Multiple amino acid substitutions were identified in NSP4 among 15 representative PRRSV-2 strains. Phylogenetic analysis showed that the lineage 8 and 1 strains, the most prevalent strains in China, were indifferent clades with a long genetic distance. This analysis will help fully elucidate the parameters of the PRRSV NSP4 epidemic in China to lay a foundation for adequate understanding of the function of NSP4. Genetic information results from the accumulation of conserved and non-conserved sequences. The high conservation of the NSP4 gene determines the most basic life traits and functions of PRRSV. Analyzing the spatial structure of NSP4 protein and studying the genetic evolution of NSP4 not only provide the theoretical basis for how NSP4 participates in the regulation of the innate response of the host but also provide a target for genetic manipulation and a reasonable target molecule and structure for new drug molecules.


Pituitary apoplexy associated with acute COVID-19 infection and pregnancy.
We report a case of a pregnant female presenting with pituitary apoplexy and simultaneous SARS-CoV-2 infection with a focus on management decisions. A 28-year-old G5P1 38w1d female presented with 4 days of blurry vision, left dilated pupil, and headache. She tested positive for SARS-CoV-2 on routine nasal swab testing but denied cough or fever. Endocrine testing demonstrated an elevated serum prolactin level, and central hypothyroidism. MRI showed a cystic-solid lesion with a fluid level in the pituitary fossa and expansion of the sella consistent with pituitary apoplexy. Her visual symptoms improved with corticosteroid administration and surgery was delayed to two weeks after her initial COVID-19 infection and to allow for safe delivery of the child. A vaginal delivery under epidural anesthetic occurred at 39 weeks. Two days later, transsphenoidal resection of the mass was performed under strict COVID-19 precautions including use of Powered Air Purifying Respirators (PAPRs) and limited OR personnel given high risk of infection during endonasal procedures. Pathology demonstrated a liquefied hemorrhagic mass suggestive of pituitary apoplexy. She made a full recovery and was discharged home two days after surgery. Here we demonstrate the first known case of successful elective induction of vaginal delivery and transsphenoidal intervention in a near full term gravid patient presenting with pituitary apoplexy and acute SARS-CoV-2 infection. Further reports may help determine if there is a causal relationship or if these events are unrelated. Close adherence to guidelines for caregivers can greatly reduce risk of infection.


[Mathematical modeling of the kinematics of a pilot's head while catapulting into an air stream].
The trajectories of head movements in the helmet and velocities of impact contact with the seat and anterior of the cockpit were calculated as applied to every stage of the catapulting process and mass-inertia parameters of helmets taken into account. Kinematic models were used to describe biomechanic parameters of the head-neck system. Special attention was given to the case of catapulting to the air flow. The effect upon the nod of aerodynamic forces acting on the human body and the catapult ejection seat at air flow velocities of 700-800 and 1300 km/hr was calculated.


Whole-Genome Sequence of Pseudomonas putida Strain UASWS0946, a Highly Ammonia-Tolerant Nitrifying Bacterium Isolated from Sewage Sludge Aerobic Granules.
We report here the genome of Pseudomonas putida strain UASWS0946, a highly ammonia-tolerant nitrifying strain isolated from sewage sludge aerobic granules, which displays adequate genetic equipment for soil depollution, sludge treatment, and biological fertilization in agriculture.


Reduction of catheter-associated bloodstream infections through procedures in newborn babies admitted in a university hospital intensive care unit in Brazil.
Catheter-associated bloodstream infection (CA-BSI) is the most common nosocomial infection in neonatal intensive care units. There is evidence that care bundles to reduce CA-BSI are effective in the adult literature. The aim of this study was to reduce CA-BSI in a Brazilian neonatal intensive care unit by means of a care bundle including few strategies or procedures of prevention and control of these infections. An intervention designed to reduce CA-BSI with five evidence-based procedures was conducted. A total of sixty-seven (26.7%) CA-BSIs were observed. There were 46 (32%) episodes of culture-proven sepsis in group preintervention (24.1 per 1,000 catheter days [CVC days]). Neonates in the group after implementation of the intervention had 21 (19.6%) episodes of CA-BSI (14.9 per 1,000 CVC days). The incidence of CA-BSI decreased significantly after the intervention from the group preintervention and postintervention (32% to 19.6%, 24.1 per 1,000 CVC days to 14.9 per 1,000 CVC days, p=0.04). In the multiple logistic regression analysis, the use of more than 3 antibiotics and length of stay >8 days were independent risk factors for BSI. A stepwise introduction of evidence-based intervention and intensive and continuous education of all healthcare workers are effective in reducing CA-BSI.


[Proliferating Brenner tumor: case report].
Brenner tumors account for only 1 to 2% of ovarian tumors. Proliferating Brenner tumors are characterized by an epithelial proliferation, resembling superficial well-differentiated urothelial carcinomas. A single 29-year-old patient was operated for an ovarian tumor. On gross examination, the tumor, which originated in the left ovary, was cystic multilocular and presented polyoid excrescences. Definitive histological exam showed a papillary proliferation lined by transitional cells without stroma infiltration. Mucinous cells lined some cavities. The diagnosis of proliferating Brenner tumor was made. Clinical and pathological characteristics of this rare entity will be discussed.


Isolated Hepatic Chronic Ductopenic Rejection Requiring Liver Retransplant in the Absence of Kidney Graft Rejection After Combined Liver-Kidney Transplant: A Case Report.
The liver is considered the most immunotolerant organ among all solid-organ transplants. Liver transplant recipients have a lower incidence of rejection and better outcomes after episodes of rejection, with spontaneous operational tolerance developing in up to 20%. In multiorgan transplants, a protective effect of the liver allograft on simultaneously transplanted organs from the same donor has been demonstrated. We describe an unusual case of isolated liver allograft rejection in a patient with polycystic liver and kidney disease who received a combined liver-kidney transplant from the same donor. After initial discharge from the hospital, our patient had 2 episodes of biopsy-proven late acute cellular rejections, despite higher levels of immunosuppression required for her kidney allograft, which were addressed with pulsed steroid therapy. She had no evidence of ischemic cholangiopathy on imaging. Later, a subsequent liver biopsy demonstrated features consistent with chronic ductopenic rejection. She was eventually listed for liver retransplant and has recently received a second liver transplant while continuing to have no concerns with her kidney allograft function. Examination of the explanted liver confirmed graft loss from chronic ductopenic rejection. The exact reasons why our patient developed acute graft rejection progressing to chronic end-stage rejection of the liver allograft despite not developing graft rejection in the kidney allograft from the same donor remains elusive. Our experience demonstrates that graft tolerance in multiorgan transplant recipients can be organ specific and despite the belief of "immunologic privilege," isolated liver allograft rejection can occur in multiorgan transplant, resulting in graft loss.


Sensitized spleen B-cells in tolerance-resisting SJL mice.
A subpopulation of B-cells becomes sensitized in the 15-week-old SJL mouse, exposed to aggregate-freed rabbit gamma-globulin, which is highly tolerogenic when given to younger animals. This state of activation can only be expressed in collaboration with sensitized T-cells. The sensitized B-cell does not play an important role in the response of the intact 15-week-old SJL mouse, since there are no sensitized T-cells in the sRGG-treated animals.


Probability of arrest while driving under the influence of alcohol.
The probability of arrest while driving at a blood alcohol level over 0.10% was .0058 (about 1 in 200).


COMT inhibitors and metabolism of fluorodopa enantiomers in aggregating cell cultures.
Organotypic primary cell cultures of fetal rat brain were used as a model system to study the effect of COMT inhibitors on the cerebral metabolic conversions of fluoro-DOPA enantiomers. The selective COMT inhibitors OR 486 and CGP 28014 were used in conjunction with 5F-L-DOPA, 6F-L-DOPA and 6F-D-DOPA as substrates. Methylation can be clearly reduced by application of OR 486 at nanomolar level, without inhibition of AADC and MAO. The uptake of the substrate is unchanged. CGP 28014, already known to be active only in vivo, has no influence on the metabolic conversion rates of the fluoro-DOPA isomers. These results show that use of this culture system allows statement concerning the in vitro activity of COMT inhibitors. It has not been possible to show an increase of absolute levels of decarboxylation products due to inhibition of COMT, however, but the reduction in levels of methylated product itself may have significance for PET studies of the human brain.


Assessment of immunovirological features in HIV related non-Hodgkin lymphoma patients and their impact on outcome.
Despite the era of highly active antiretroviral therapy, non-Hodgkin lymphoma (NHL) remains one of the main causes of death in HIV-infected patients, with a wide variation on the outcome. We investigated immunological status and EBV, HHV8, HIV viral load in a group of HIV-infected patients at diagnosis of NHL to evaluate their prognostic significance. Eighty-one consecutive HIV+ NHL patients were studied. CD4 and CD8 cell counts, HHV8 DNA, EBV DNA, HIV RNA and HIV DNA were assessed at diagnosis and at 3 months after chemotherapy initiation. Hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of disease free survival (DFS) and overall survival (OS) were computed according to CD4 and CD8 cell counts, EBV DNA, HIV RNA and HIV DNA. HRs were, thereafter, computed also for continuous variation of CD4, CD8 cell counts and EBV DNA. In the multivariate analysis, CD4<160 and CD8<590 cell/μl and EBV DNA≥300 c/ml were independently associated to DFS (HR=2.98; 95%CI: 1.26-7.03; HR=2.65, 95%CI: 1.13-6.19; HR=4.01; 95%CI: 1.81-8.91) and OS (HR=3.32; 95%CI: 1.41-7.83; HR=4.62, 95%CI: 1.91-11.19; HR=3.11, 95%CI: 1.42-6.80). HRs for DFS and OS decreased continuously with increasing CD4 and CD8 cell counts, while they increased continuously with increasing EBV DNA levels. The association with survival of low CD4 and CD8 cell counts and detectable EBV viremia, measured at lymphoma's diagnosis, identified three independent prognostic biomarkers that might help in the management of NHL HIV+ patients, offering complementary information in the ascertainment of their outcome.


Taking care of patients and caring for patients are not the same.
THERE IS A SIGNIFICANT difference between taking care of patients and caring for patients. TAKING CARE OF PATIENTS emphasizes objective, professional care, such as the medical and psychological aspects of nursing. CARING FOR PATIENTS, on the other hand, is a humanistic way of interacting with patients that demonstrates sincere care and concern for patients simply because they are human beings.


Molecular modeling of [VO(L1-4)(R)] complexes (R = bipyridine, phenanthroline): DFT study of antioxidant activity, DNA binding and evaluation of electron-donating and -withdrawing substituent groups.
A DFT (density functional theory) study was conducted with eight oxovanadium complexes (C1 - C8) of general formula [VO(L1-4)(R)] (R = bipyridine, phenanthroline; L1-4 = group of ligands derived from dithiocarbamate). The obtained geometries showed a good correlation with the experimental structures. Molecular orbital analysis revealed that the contribution of the L-ligand in the SOMO (single-occupied molecular orbital) of the complexes correlated with the experimental antioxidant activity (IC50), while the contribution of the R-ligand to the LUMO (lowest unoccupied molecular orbital) of the complexes correlated with the experimental complex-DNA interaction (Kb). It has been identified that the presence of an electron-donating substituent group (such as -NH2) in the C5 - C6 structures should enhance these complexes' antioxidant and DNA interaction activities.


HPLC-MS method for the simultaneous quantification of the new HIV protease inhibitor darunavir, and 11 other antiretroviral agents in plasma of HIV-infected patients.
A new method using high performance liquid chromatography coupled with electrospray mass spectrometry (HPLC-MS) was developed and validated, for the quantification of plasma concentration of the new protease inhibitors darunavir (DRV) and other 11 antiretroviral agents (ritonavir, amprenavir, atazanavir, lopinavir, saquinavir, indinavir, nelfinavir and its metabolite M-8, nevirapine, efavirenz and tipranavir). A simple protein precipitation extraction procedure was applied on 50 microl of plasma aliquots and chromatographic separation of drugs and Internal Standard (quinoxaline) was achieved with a gradient (acetonitrile and water with formic acid 0.05%) on an C-18 reverse phase analytical column with 25 min of analytical run. Calibration curves were optimised according to expected ranges of drug concentrations in patients, and correlation coefficient (r2) was higher than 0.998 for all analytes. Mean intra- and inter-day precision (relative standard deviation %) for all compounds were 8.4 and 8.3%, respectively, and mean accuracy (% of deviation from nominal level) was 3.9%. Extraction recovery ranged within 93 and 105% for all drugs analysed. This novel HPLC-MS methodology allows a specific, sensitive and reliable determination of DRV and 11 other antiretrovirals. In our hand, it was used to measure DRV and ritonavir plasma concentration in HIV-positive patients, and it is now successfully applied for routine therapeutic drug monitoring and pharmacokinetics studies.


Highly sensitive detection of GG mismatched DNA by surfaces immobilized naphthyridine dimer through poly(ethylene oxide) linkers.
Naphthyridine dimer is a unique molecule that strongly, and selectively, binds to the guanine-guanine mismatch in duplex DNA. We have synthesized naphthyridine dimers possessing a different length of poly(ethylene oxide) (PEO) linker, and immobilized them to CM5 sensor chip to carry out a surface plasmon resonance (SPR) assay of DNA duplexes containing a single base mismatch. The sensitivity of the sensor remarkably increased with increasing numbers of PEO units incorporated into the linker. With the sensor surface immobilized naphthyridine dimer for 1.5 x 10(3) response unit (RU) through three PEO units, the distinct SPR signal was observed at a concentration of 1 nM of the 27-mer G-G mismatch.


Electrospun Flexible Coaxial Nanoribbons Endowed With Tuned and Simultaneous Fluorescent Color-Electricity-Magnetism Trifunctionality.
In order to develop new-typed multifunctional nanocomposites, fluorescent-electrical-magnetic trifunctional coaxial nanoribbons with tunable fluorescent color, including white-light emission, have been successfully fabricated via coaxial electrospinning technology. Each stripe of coaxial nanoribbon is composed of a Fe3O4/PMMA core and a [Eu(BA)3phen+Dy(BA)3phen]/PANI/PMMA (PMMA = polymethyl methacrylate, BA = benzoic acid, phen = phenanthroline, polyaniline = PANI) shell. X-ray diffractometry (XRD), field emission scanning electron microscopy (FE-SEM), biological microscopy (BM), vibrating sample magnetometry (VSM), energy dispersive spectrometry (EDS), Hall effect measurement system and photoluminescence (PL) spectroscopy were employed to characterize the coaxial nanoribbons. Emitting color of the coaxial nanoribbons can be tuned by adjusting the contents of Dy(BA)3phen, Eu(BA)3phen, PANI and Fe3O4 in a wide color range of blue-white-orange under the excitation of 273-nm single-wavelength ultraviolet light. The coaxial nanoribbons simultaneously possess excellent luminescent performance, electrical conduction and magnetism compared with the counterpart composite nanoribbons. Furthermore, the electrical and magnetic performances of the coaxial nanoribbons also can be tunable by adding different quantities of PANI and Fe3O4 nanoparticles, respectively. The obtained coaxial nanoribbons have promising applications in many areas, such as electromagnetic interference shielding, microwave absorption, molecular electronics, biomedicine, future nanomechanics and display fields.


The neurological morbidity of carotid revascularisation: using markers of cellular brain injury to compare CEA and CAS.
This comparative study attempts to evaluate the profile of S-100beta and Neuron-Specific Enolase (NSE), biomarkers of brain injury, in patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS) and to correlate this with haemodynamic and embolic events detected using trans-cranial Doppler (TCD). 52 patients with internal carotid artery stenosis requiring intervention were recruited. 24 patients underwent CAS, and 28 underwent CEA. TCD was performed peri-operatively to record mean Middle Cerebral Artery (MCA) velocity and number of High Intensity Transient Signals (HITS) in the MCA of the operated side. Serum was drawn pre-operatively and at six time points in a 48 hour post-operative period, and then assayed using automated commercial equipment. Within and between group variability in markers were assessed by Generalized Estimation Equations modelling. CAS caused more HITS (p=0.028) but less haemodynamic disturbance (p=0.0001) than CEA. Treatment modality (CAS versus CEA) had no direct effect on S-100 changes (p=0.467). NSE levels declined after revascularisation in the CAS group but not after CEA (p=0.002). S-100beta levels rose in patients who had higher numbers of HITS (p=0.002). S-100beta and NSE were not associated with changes in MCA velocity (p>0.5). S-100beta alone increased significantly at 24 hours in those patients with a post-operative neurological deficit (p=0.015). Trans-cranial Doppler findings suggest that the mechanisms of rise in S-100beta and NSE levels may differ and may be due to increased peri-operative micro-embolisation and cerebral hypoperfusion respectively. Further studies are required to assess the clinical significance of these observed changes.


Joint approximate diagonalization of eigenmatrices as a high-throughput approach for analysis of hyphenated and comprehensive two-dimensional gas chromatographic data.
The objective of the present work is development of joint approximate diagonalization of eigenmatrices (JADE) as a member of independent component analysis (ICA) family, for the analysis of gas chromatography-mass spectrometry (GC-MS) and comprehensive two-dimensional gas chromatography-mass spectrometry (GC×GC-MS) data to address incomplete separation problem occurred during the analysis of complex sample matrices. In this regard, simulated GC-MS and GC×GC-MS data sets with different number of components, different degree of overlap and noise were evaluated. In the case of simultaneous analysis of multiple samples, column-wise augmentation for GC-MS and column-wise super-augmentation for GC×GC-MS was used before JADE analysis. The performance of JADE was evaluated in terms of statistical parameters of lack of fit (LOF), mutual information (MI) and Amari index as well as analytical figures of merit (AFOMs) obtained from calibration curves. In addition, the area of feasible solutions (AFSs) was calculated by two different approaches of MCR-BANDs and polygon inflation algorithm (FACPACK). Furthermore, JADE performance was compared with multivariate curve resolution-alternating least squares (MCR-ALS) and other ICA algorithms of mean-field ICA (MFICA) and mutual information least dependent component analysis (MILCA). In all cases, JADE could successfully resolve the elution and spectral profiles in GC-MS and GC×GC-MS data with acceptable statistical and calibration parameters and their solutions were in AFSs. To check the applicability of JADE in real cases, JADE was used for resolution and quantification of phenanthrene and anthracene in aromatic fraction of heavy fuel oil (HFO) analyzed by GC×GC-MS. Surprisingly, pure elution and spectral profiles of target compounds were properly resolved in the presence of baseline and interferences using JADE. Once more, the performance of JADE was compared with MCR-ALS in real case. On this matter, the mutual information (MI) values were 1.01 and 1.13 for resolved profiles by JADE and MCR-ALS, respectively. In addition, LOD values (μg/mL) were respectively 1.36 and 1.24 for phenanthrene and 1.26 and 1.09 for anthracene using MCR-ALS and JADE which showed outperformance of JADE over MCR-ALS.


Surgical treatment of early-stage thymomas: robot-assisted thoracoscopic surgery versus transsternal thymectomy.
This study aimed to compare the perioperative outcomes for patients who underwent transsternal or robot-assisted thymectomy and to determine the feasibility of robot-assisted thymectomy for the treatment of Masaoka stages 1 and 2 thymomas. The study evaluated the short-term outcomes for 74 patients undergoing surgery for Masaoka stages 1 and 2 thymomas without myasthenia gravis between January 2009 and December 2012. Of these 74 patients, 23 underwent thymoma resection using unilateral robot-assisted thoracoscopic surgery (RATS group), and 51 underwent transsternal thymectomy (TST group). Duration of surgery, amount of intraoperative blood loss, duration of chest drainage, duration of postoperative hospital stay, and postoperative complications were evaluated. The intraoperative blood loss was significantly less in the RATS groups (61.3 ml) than in the TST group (466.1 ml) (p < 0.01). The postoperative hospital stay was significantly shorter in the RATS group (3.7 vs 11.6 days; p < 0.01). No patients in the RATS group underwent conversion to open surgery. No severe surgical complications (e.g., bleeding caused by injury to the left brachiocephalic vein) and only one case of pulmonary atelectasis (appearing in a male patient 2 days after surgery) were detected in this series. Robot-assisted thoracoscopic thymectomy for early-stage thymomas is technically feasible, safe, and less invasive for the patient.


The role of managed care pharmacy in coprescribing naloxone for patients with specific risk: recommendations from the AMCP Addiction Advisory Group.
Prescription opioid misuse remains a significant cause of morbidity and mortality associated with drug overdose. Researchers, government agencies, public health interests, and professional organizations support the benefits of naloxone coprescribing for patients on chronic opioid therapy to prevent deaths from opioid overdose. However, gaps remain in the provision of naloxone to patients at risk. Currently, less than 1% of patients who should be prescribed naloxone with their opioid medications obtain a prescription for naloxone, illustrating an opportunity for health care providers to conduct thorough risk assessments for patients taking opioids and coprescribing naloxone to those at risk. There are documented barriers to the provision of naloxone for primary care providers, pharmacists, and patients. Managed care organizations have also created barriers. To better understand and evaluate trends in treatment, coverage, policies, and needs associated with providing health services to patients with substance use disorders, the Academy of Managed Care Pharmacy (AMCP) Addiction Advisory Group conducted a survey in 2019. Eighty percent of the managed behavioral health organizations and 47% of AMCP payer members who responded to the survey encouraged naloxone coprescribing in patients at high risk of overdose; however, no organizations require coprescribing. Health plans, managed care organizations, prescribers, pharmacists, patients, and others have important roles in decreasing the morbidity and mortality associated with opioid overdose. In particular, managed care organizations can take specific and meaningful actions to implement payment policies that improve naloxone coprescribing for patients at risk. In this article, opportunities have been outlined for managed care leadership that actively support public health policies for naloxone coprescribing, and 7 recommendations are presented. DISCLOSURES: The AMCP Addiction Advisory Group and the development of this article were supported by Alkermes and Precision Toxicology. Sponsors participated in the advisory group, which provided guidance in the development of the manuscript. Dharbhamalla is employed by AMCP. Skelton is a paid consultant working with AMCP.


A method of determining heated ancient nephrite jades in China.
Ancient jade is one of the most significant cultural relics in China. Despite the increasingly important role of heated jades in ancient jade study, there are still few in-depth material studies on heated jades for the time being, which results in limitations on archaeological research and conservation. In order to evaluate the appearance change of nephrite jades, we employ the heating simulation experiment to present these change under different heating temperature ranging from 100 °C to 1300 °C. In this study, a nondestructive identification method proposed is to help determine whether the ancient jades were heated before and what the approximate heating temperature was from 100 °C to 1300 °C though phase transformation, structure change and colour variation with several advanced characterization methods such as the X-ray diffraction (XRD), the thermo-gravimetric analyser (TGA), the ultraviolet-visible spectrophotometer (UV-Vis), the Fourier transform infrared spectroscopy (FTIR) and the scanning electron microscope (SEM). The hierarchy of colour (from ~500 °C) and structure (from ~800 °C) on heated jades in the jade research field were first proposed and discuss here. This method is considered useful and valuable in the study and protection of Chinese ancient jades.


Children's Digital Art Ability Training System Based on AI-Assisted Learning: A Case Study of Drawing Color Perception.
This study proposed a children's digital art ability training system with artificial intelligence-assisted learning (AI-assisted learning), which was designed to achieve the goal of improving children's drawing ability. AI technology was introduced for outline recognition, hue color matching, and color ratio calculation to machine train students' cognition of chromatics, and smart glasses were used to view actual augmented reality paintings to enhance the effectiveness of improving elementary school students' imagination and painting performance through the diversified stimulation of colors. This study adopted the quasi-experimental research method and designs the pre-test and post-test for different groups. The research subjects are the Grade 4 students of an elementary school in Taitung City, Taiwan. The test tools included an imagination test and an evaluation of painting performance ability. The test results of a total of 30 students before and after the experiment included the experimental group that received the children's digital art ability training system with AI-assisted learning and 30 students in the control group that had not received the teaching were analyzed by covariance. These results were supplemented by the description and interpretation of student feedback, teachers' reflection notes, and other qualitative data to understand the performance of the students in the experimental group in terms of imagination and painting performance.