Impact of Variations in Kidney Function on Nonvitamin K Oral Anticoagulant Dosing in Patients With Atrial Fibrillation and Recent Acute Heart Failure.
Renal impairment and fluctuations in renal function are common in patients recently hospitalized for acute heart failure and in those with atrial fibrillation. The aim of the present study was to evaluate the hypothetical need for dosage adjustment (based on fluctuations in kidney function) of dabigatran, rivaroxaban and apixaban during the first 6 months after hospital discharge in patients with concomitant atrial fibrillation and heart failure. An observational study was conducted in 162 patients with nonvalvular atrial fibrillation after hospitalization for acute decompensated heart failure who underwent creatinine determinations during follow-up. The hypothetical recommended dosage of dabigatran, rivaroxaban and apixaban according to renal function was determined at discharge. Variations in serum creatinine and creatinine clearance and consequent changes in the recommended dosage of these drugs were identified during 6 months of follow-up. Among the overall study population, 44% of patients would have needed dabigatran dosage adjustment during follow-up, 35% would have needed rivaroxaban adjustment, and 29% would have needed apixaban dosage adjustment. A higher proportion of patients with creatinine clearance < 60 mL/min or with advanced age (≥ 75 years) would have needed dosage adjustment during follow-up. The need for dosage adjustment of nonvitamin K oral anticoagulants during follow-up is frequent in patients with atrial fibrillation after acute decompensated heart failure, especially among older patients and those with renal impairment. Further studies are needed to clarify the clinical importance of these needs for drug dosing adjustment and the ideal renal function monitoring regime in heart failure and other subgroups of patients with atrial fibrillation.


Canadian efforts to prevent and control hypertension.
Suboptimum blood pressure is estimated to be the leading risk factor for death worldwide and is associated with 13.5% of deaths globally. The clinical diagnosis of hypertension affects one in four adults globally and is expected to increase by 60% between 2000 and 2025. Clearly, global efforts to prevent and control hypertension are important health issues. While Canada had a prevalence of hypertension similar to that of the United States in the early 1990 s, the treatment and control rate was only 13% compared with 25% in the United States. A national strategic plan was developed, and a coalition of organizations and health care professional and scientist volunteers actively implemented parts of the strategy. Specific initiatives that have evolved include the development of hypertension knowledge translation programs for health professionals, the public and people with hypertension, an outcomes research program to assess the impact of hypertension and guide national-, regional- and community-based knowledge translation interventions, and a program to reduce the prevalence of hypertension by decreasing sodium additives in food. These initiatives have relied on the active involvement of health care professional volunteers, health care professional and scientific organizations and various government departments. There have been large increases in the diagnosis and treatment of hypertension, with corresponding reductions in cardiovascular disease and total mortality associated with the start of the hypertension initiatives. As a result, Canada is becoming recognized as a world leader in the prevention, treatment and control of hypertension.


A real-life overview of a hematopoietic cell transplant program throughout a four-year period, including prospective registry, exclusion causes and final donor selection.
Traceability of patients who are candidates for Hematopoietic cell transplant (HCT) is crucial to ensure HCT program quality. Continuous knowledge of both a detailed registry from a HCT program and final exclusion causes can contribute to promoting a real-life vision and optimizing patient and donor selection. We analyzed epidemiological data reported in a 4 year-monocentric prospective registry, which included all patients presented as candidates for autologous (Auto) and/or allogeneic (Allo) HCT. A total of 543 patients were considered for HCT: 252 (42.4%) for Allo and 291 (57.6%) for Auto. A total of 98 (38.9%) patients were excluded from AlloHCT due to basal disease progression more commonly (18.2%). Seventy-six (30.2%) patients had an HLA identical sibling, whereas 147 (58.3%) patients had only Haplo. UD research was performed in 106 (42%) cases, significantly more often in myeloid than lymphoid malignancies (57% vs 28.7%, p < 0.001) but 61.3% were finally canceled, due to donor or disease causes in 72.4%. With respect to Auto candidates, a total of 60 (20.6%) patients were finally excluded; progression was the most common cause (12%). Currently, Haplo is the most frequent donor type. The high cancellation rate of UD research should be revised to optimize further donor algorithms.


A new cleavage site for elastase within the complement component 3.
The lysosomal enzyme elastase was earlier shown to cleave the complement molecule C3. During some preliminary experiments on the interactions of certain pathogenic bacteria with the innate defence mechanisms, we observed C3 cleavage, in the presence of elastase, to fragments not previously described. To elucidate this proteolytic reaction, the present study was conducted. Degradation of C3 in mixtures with elastase or cathepsin G was detected by an immunoblot procedure using anti-C3c and anti-C3d antibodies after separating the proteins by SDS-PAGE. Certain C3 fragments were analysed for amino acid sequence. The results revealed the existence of a cleavage site for elastase at the position alanine1350/lysine1351 of the C3 molecule, which has not been previously described. The fragment resulted from this cleavage has a size of about 39 kDa and it contains a part or the whole of C3d. This cleavage was distinct from the one previously described at position 987/988, which gives a 34 kDa C3d-containing fragment.


Engineering an adenine base editor in human embryonic stem cells with minimal DNA and RNA off-target activities.
Genome editing in pluripotent stem cells (PSCs) using CRISPR technology holds great promise for therapeutic applications. Yet, it has been reported that Cas9-mediated cleavage could cause large deletions or rearrangements of DNA, and the selection of edited PSCs could acquire p53 mutations. Adenine base editors (ABEs) do not introduce DNA double-strand breaks and thus have been proposed as alternatives to circumvent those problems, but their off-target effects still limit their applications. Here, we tested different combinations of off-target reduction methods to further diminish off-target effects of ABEs without compromising their on-target editing efficiencies. We subsequently chose the best editor, CE-8e-dV, which contains V106W substitution, R153 deletion, and Cas-embedding strategy, to establish a single-cell-derived human embryonic stem cell (hESC) line expressing tetracycline-inducible CE-8e-dV. By performing RNA and whole-genome sequencing, we demonstrated that the expression of CE-8e-dV did not produce nearly any DNA or RNA off-target effects in hESCs. Our results provide stringent proof of the safety of ABEs in PSCs and suggest that CE-8e-dV could be suitable for related therapeutic strategies, such as generation of engineered stem cells in vitro and gene therapy in vivo.


Retrospective analysis of the risk of neoplasia associated with unilateral maxillary sinus opacification on computed tomography.
Unilateral maxillary sinus opacification on computed tomography may reflect an inflammatory or neoplastic process. The neoplasia risk is not clear in the literature. In this retrospective study, computed tomography sinus scans performed over 12 months were screened for unilateral maxillary sinus opacification, and the rates of inflammatory and neoplastic diagnoses were calculated. Of 641 computed tomography sinus scans, the rate of unilateral maxillary sinus opacification was 9 per cent. Fifty-two cases were analysed. The risk of neoplasia was 2 per cent (inverted papilloma, n = 1). No cases of unilateral maxillary sinus opacification represented malignancy, but one case of lymphoma had an incidental finding of unilateral maxillary sinus opacification on the contralateral side. Patients with an antrochoanal polyp (n = 3), fungal disease (n = 1), inverted papilloma and lymphoma all had a unilateral nasal mass. Our neoplasia rate of 2 per cent was lower than previously reported. A unilateral mass was predictive of pathology that required operative management. Clinical findings, rather than simple findings of opacification on computed tomography, should drive the decision to perform biopsy.


The Current Treatment Trends and Survival Patterns in Melanoma Patients with Positive Sentinel Lymph Node Biopsy (SLNB): A Multicenter Nationwide Study.
In melanoma treatment, an approach following positive sentinel lymph node biopsy (SLNB) has been recently deescalated from completion lymph node dissection (CLND) to active surveillance based on phase III trials data. In this study, we aim to evaluate treatment strategies in SLNB-positive melanoma patients in real-world practice. Five-hundred-fifty-seven melanoma SLNB-positive patients from seven comprehensive cancer centers treated between 2017 and 2021 were included. Kaplan-Meier methods and the Cox Proportional-Hazards Model were used for analysis. The median follow-up was 25 months. Between 2017 and 2021, the percentage of patients undergoing CLND decreased (88-41%), while the use of adjuvant treatment increased (11-51%). The 3-year OS and RFS rates were 77.9% and 59.6%, respectively. Adjuvant therapy prolonged RFS (HR:0.69, p = 0.036)), but CLND did not (HR:1.22, p = 0.272). There were no statistically significant differences in OS for either adjuvant systemic treatment or CLND. Lower progression risk was also found, and time-dependent hazard ratios estimation in patients treated with systemic adjuvant therapy was confirmed (HR:0.20, p = 0.002 for BRAF inhibitors and HR:0.50, p = 0.015 for anti-PD-1 inhibitors). Treatment of SLNB-positive melanoma patients is constantly evolving, and the role of surgery is currently rather limited. Whether CLND has been performed or not, in a group of SLNB-positive patients, adjuvant systemic treatment should be offered to all eligible patients.


Synthesis and SAR of a novel, potent and structurally simple LTD4 antagonist of the quinoline class.
The two geminal ethyl groups in the succinic acid moiety of CGP57698 (4-[3-(7-fluoro-2-quinolinyl-methoxy)phenyl-amino]-2,2-diethyl-4-oxo- butanoic acid) are responsible for the high in vitro and in vivo potency of this peptidoleukotriene antagonist of the quinoline type. The synthesis and structure activity relationships of CGP57698 and its analogs are described.


Mid-term structural change in the radial artery grafts after coronary artery bypass grafting.
Currently, excellent patency rates of radial artery grafts for coronary artery bypass grafting in the early period have been reported. However, the long-term result of radial artery grafts remains unclear. We investigated the midterm structural change in radial artery grafts using intravascular ultrasound imaging (IVUS). IVUS studies were performed on 15 radial artery grafts in the early phase and 11 in the midterm phase (20.3 +/- 13.7 days and 37.6 +/- 7.2 months after surgery, respectively). The radial artery grafts were observed throughout the entire length and 10 cross-sectional images were selected from each graft for measurement of the thickness of the intima (IN) and intima-plus-media (IN + MD). Grafts having palpable arteriosclerosis at the time of harvesting were excluded. IN and IN + MD were compared between the early and midterm phases using repeated measures analysis of variance. The coefficient of variation of IN and IN + MD was calculated as an index of irregularity and compared between the phases. IVUS revealed uniform and thin intima and media in the early and midterm groups and IVUS images were similar between the groups. There was no significant difference in both IN and IN + MD between the groups (IN, p = 0.83; IN + MD, p = 0.55). The median of coefficient of variation of IN and IN + MD was 8.5% and 8.1% in the early group and 8.7% and 9.3% in the midterm group. Again, there was no significant difference between the groups (IN, p = 0.87; IN + MD, p = 0.27). The present study suggested that structural changes rarely developed in radial artery grafts over several years after surgery.


Digital Health Interventions for Weight Management in Children and Adolescents: Systematic Review and Meta-analysis.
Recent meta-analyses suggest the use of technology-based interventions as a treatment option for obesity in adulthood. Similar meta-analytic approaches for children are scarce. The aim of this meta-analysis is to examine the effect of technology-based interventions on overweight and obesity treatment in children and adolescents. A systematic literature search was performed using MEDLINE (PubMed), Scopus, and Cochrane Library for randomized clinical trials to identify interventional studies published between January 2000 and February 2021. In total, 9 manuscripts from 8 clinical trials of 582 children or adolescents were considered eligible. BMI, BMI z-score, and other BMI-related baseline metrics during and after intervention were considered as primary outcomes. In 7 of 8 studies, a technology-based intervention was applied in addition to conventional care. Of the 8 studies, 6 studies were conducted in the United States, 1 in Australia, and 1 in northwestern Europe. In total, 5 studies included adolescents, whereas the rest addressed children aged 9 to 12 years. Intervention duration ranged from 3 to 24 months. Significant differences between groups in BMI metric changes were reported by 5 of the 8 studies. Pooled analysis revealed an overall significant decrease in BMI metrics in the intervention group (standardized mean difference -0.61, 95% CI -1.10 to -0.13; P=.01). Subgroup analysis revealed that significance was lost in case of no parental involvement (standardized mean difference -0.36, 95% CI -0.83 to 0.11; P=.14). The small number of clinical trials found, the varying study quality, and the study heterogeneity are some limitations of this review. The studies reported herein describe functional and acceptable technology-based approaches, in addition to conventional treatments, to enhance weight loss in young populations.


Peripheral diabetic neuropathy or restless legs syndrome in persons with type 2 diabetes mellitus: Differentiating diagnosis in practice.
Restless legs syndrome (RLS) affects 8% of the population and is identified in 21% of individuals with type 2 diabetes (T2DM). Symptoms of RLS manifest as discomfort in the legs (e.g., numbness, tingling, electrical stimulations), usually occurring at night or at rest (sitting or lying), resulting in the need to move the legs. Peripheral diabetic neuropathy (PDN), which has symptoms similar to RLS, is a common consequence of T2DM. The purpose of this article is to provide nurse practitioners (NPs) with (a) an overview of RLS, (b) the association of RLS with T2DM, (c) the defining characteristics that differentiate PDN from RLS, and (d) implications to improve health outcomes of persons with T2DM. The literature was reviewed for the most current data on RLS and the defining characteristics of PDN. PDN is a common consequence of T2DM and is described as numbness, tingling, or discomfort in the lower extremities, symptoms that are similar to RLS. Differentiating the symptoms of PDN and RLS may be confusing and result in misdiagnoses, lack of treatment, and poor outcomes. It is essential that NPs are knowledgeable about the diagnostic and defining features of RLS as well as the characteristics of other conditions, specifically PDN, which mimics RLS.


Actions of human DNA glycosylases on uracil-containing DNA, methylated DNA and their reconstituted chromatins.
Extracts of human lymphoblastoid cells catalyzed complete release of uracil (Ura) from PBS1 DNA, which contains Ura instead of thymine as a normal component (Ura-DNA), and 3-methyladenine (3-MeAde) from DNA methylated with methyl methanesulfonate (Me-DNA). These two activities, Ura-DNA glycosylase and 3-MeAde-DNA glycosylase, differed in heat stability. Cell extracts released Ura more rapidly and 3-MeAde more slowly from alkali-denatured preparations of Ura- and Me-DNA, respectively, than from native DNA's. On incubation with reconstituted chromatins, prepared from Ura-DNA and Me-DNA, respectively, with calf thymus chromosomal protein by salt gradient dialysis, cell extracts released all the Ura but only about half of the 3-MeAde residues, although both these chromatins were degraded by micrococcal nuclease until about half of the nucleotides became acid soluble. The activities of Ura-DNA and 3-MeAde-DNA glycosylase of xeroderma pigmentosum cells were similar to those of normal cells.


A global survey on the attitudes of neurologists and psychiatrists about functional/psychogenic/dissociative/nonepileptic-seizures/attacks, in the search of its name.
We conducted an observational study to investigate the opinions of neurologists and psychiatrists all around the world who are taking care of patients with seizures [epilepsy and functional seizures (FS)]. Practicing neurologists and psychiatrists from around the world were invited to participate in an online survey. On 29th September 2022, an e-mail including a questionnaire was sent to the members of the International Research in Epilepsy (IR-Epil) Consortium. The study was closed on 1st March 2023. The survey, conducted in English, included questions about physicians' opinions about FS and anonymously collected data. In total, 1003 physicians from different regions of the world participated in the study. Both neurologists and psychiatrists identified "seizures" as their preferred term. Overall, the most preferred modifiers for "seizures" were "psychogenic" followed by "functional" by both groups. Most participants (57.9%) considered FS more difficult to treat compared to epilepsy. Both psychological and biological problems were considered as the underlying cause of FS by 61% of the respondents. Psychotherapy was considered the first treatment option for patients with FS (79.9%). Our study represents the first large-scale attempt of investigating physicianś attitudes and opinions about a condition that is both frequent and clinically important. It shows that there is a broad spectrum of terms used by physicians to refer to FS. It also suggests that the biopsychosocial model has gained its status as a widely used framework to interpret and inform clinical practice on the management of patients.


Double-blind comparison of the effectiveness of azathioprine and sulfasalazine in idiopathic proctocolitis. Preliminary report.
A double-blind therapeutic trial of azathioprine in 20 patients with acute proctocolitis was performed over a 3-month period. Azathioprine was compared with sulfasalazine in patients paired and treated in a sequential order. Clinical, laboratory, endoscopic, biopsy, and radiologic data were assessed by semiquantitative criteria. No significant difference in the effect of the drugs was observed. Both azathioprine and sulfasalazine produce significant improvement in clinical symptoms, some laboratory findings (ESR, serum iron), and endoscopic and biopsy findings (P smaller than 0.05). Radiologic improvement was less evident (P smaller than 0.10). On the overall final evaluation of the trial, 14 patients were improved, and 6 remained stationary or worsened (P smaller than 0.10). This short-term trial confirms previous uncontrolled experiences of one of the authors on larger series of patients.


Elective cholecystectomy increases plasma amino-acid clearance and hepatic capacity for urea synthesis for one week.
The importance of the liver in post-operative catabolism was studied in 6 cholecystectomy patients given a mixture of amino-acids as prime-continuous infusionś pre-operatively and on the 1st, 3rd, 6th and 12th post-operative day. The plasma clearance of total alpha-amino-nitrogen and of single amino-acids, the urea-nitrogen synthesis rate, and the functional hepatic nitrogen clearance were calculated. Surgery decreased fasting blood amino-nitrogen concentration by 15% (p < 0.01), and increased the plasma clearance of amino-nitrogen by 30% (P < 0.05) on the 1st, 3rd and 6th post-operative day. Surgery doubled the functional hepatic nitrogen clearance (p < 0.01) on the 1st, 3rd and 6th post-operative day. This indicates that post-operative stress catabolism is partly due to a hepatic condition by which the liver eliminates more amino-nitrogen despite lower amino-acid concentration in the blood, for one week post-operatively.


[Comparison and correlative analysis on characters of Rehmannia glutinosa Libosch. Varieties].
To compare the economical characters, yield characters and content of catalpol on Rehmannia glutinosa Libosch. varieties. To study characters by field randomized block test and analysis of variance. To analyse the content of catalpol by HPLC. The results by analysis of variance were that the F value in plant width was 15.4 (F0.01 = 5.54), the F value in length of leaves was 12.2, the F value in width of leaves was 13.35, the F value in yield of single plant was 55.7 and the F value in content of catalpol was 8.03. The results by correlative analysis were that the linear correlation coefficient of signal plant yield with length of leaves was 0.9639, with width of leaves was 0.9073, with amount of earthnuts was 0.7060 and with plant fresh weight was 0.9950. The linear correlation coefficient of content of catalpol with plant width was 0.9169, with length of leaves was 0.7046 and with width of leaves was 0.7159. There were significant differences in plant width, length of leaves width of leaves, and yield of single plant and content of catalpol of Rehmannia glutinosa Libnosch. varieties. There were significantly positive correlations in signal plant yield with plant fresh weight, length of leaves, width of leaves and amount of earthnuts. There were significantly positive correlations in content of catalpol with plant width, length of leaves and width of leaves.


Results of valve replacement with the Lillehei-Kaster disc prosthesis.
The results of valve replacement in 150 patients with Lillehei-Kaster aortic and mitral prostheses followed for 20 to 40 months are reviewed. Actuarial analysis showed 78 per cent cummulative thromboembolic-free rate three years following mitral valve replacement and 89 per cent following aortic valve replacement. Five patients had a total of six episodes of mitral valve thrombosis despite anticoagulant therapy. Early detection of mitral valve obstruction was difficult because a mid-diastolic murmur and absence of an opening sound was frequently encountered in normally functioning prostheses. Hemodynamic results assessed clinically in patients with nonthrombosed prostheses were satisfactory.


Part V--Sorption of pharmaceuticals and personal care products.
Pharmaceuticals and personal care products (PPCPs) including antibiotics, endocrine-disrupting chemicals, and veterinary pharmaceuticals are emerging pollutants, and their environmental risk was not emphasized until a decade ago. These compounds have been reported to cause adverse impacts on wildlife and human. However, compared to the studies on hydrophobic organic contaminants (HOCs) whose sorption characteristics is reviewed in Part IV of this review series, information on PPCPs is very limited. Thus, a summary of recent research progress on PPCP sorption in soils or sediments is necessary to clarify research requirements and directions. We reviewed the research progress on PPCP sorption in soils or sediments highlighting PPCP sorption different from that of HOCs. Special function of humic substances (HSs) on PPCP behavior is summarized according to several features of PPCP-soil or sediment interaction. In addition, we discussed the behavior of xenobiotic chemicals in a three-phase system (dissolved organic matter (DOM)-mineral-water). The complexity of three-phase systems was also discussed. Nonideal sorption of PPCPs in soils or sediments is generally reported, and PPCP sorption behavior is relatively a more complicated process compared to HOC sorption, such as the contribution of inorganic fractions, fast degradation and metabolite sorption, and species-specific sorption mechanism. Thus, mechanistic studies are urgently needed for a better understanding of their environmental risk and for pollution control. Recent research progress on nonideal sorption has not been incorporated into fate modeling of xenobiotic chemicals. A major reason is the complexity of the three-phase system. First of all, lack of knowledge in describing DOM fractionation after adsorption by mineral particles is one of the major restrictions for an accurate prediction of xenobiotic chemical behavior in the presence of DOM. Secondly, no explicit mathematical relationship between HS chemical-physical properties, and their sorption characteristics has been proposed. Last but not least, nonlinear interactions could exponentially increase the complexity and uncertainties of environmental fate models for xenobiotics. Discussion on proper simplification of fate modeling in the framework of nonlinear interactions is still unavailable. Although the methodologies and concepts for studying HOC environmental fate could be adopted for PPCP study, their differences should be highly understood. Prediction of PPCP environmental behavior needs to combine contributions from various fractions of soils or sediments and the sorption of their metabolites and different species. More detailed studies on PPCP sorption in separated soil or sediment fractions are needed in order to propose a model predicting PPCP sorption in soils or sediments based on soil or sediment properties. The information on sorption of PPCP metabolites and species and the competition between them is still not enough to be incorporated into any predictive models.


Intramural pregnancy with uterine rupture: a case report.
A case of intramural pregnancy is presented which mimicked early abruptio placentae and was associated with placenta percreta. The literature is briefly reviewed.


Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL): A challenging diagnosis and a rare multiple sclerosis mimic.
Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is an extremely rare hereditary cerebral small vessel disease caused by homozygous or compound heterozygous mutations in the gene coding for high-temperature requirement A serine peptidase 1 (HtrA1). Given the rare nature of the disease, delays in diagnosis and misdiagnosis are not uncommon. In this article, we reported the first case of CARASIL from Saudi Arabia with a novel homozygous variant c.1156C>T in exon 7 of the HTRA1 gene. The patient was initially misdiagnosed with primary progressive multiple sclerosis and treated with rituximab. CARASIL should be considered in the differential diagnosis of patients with suspected atypical progressive multiple sclerosis who have additional signs such as premature scalp alopecia and low back pain with diffuse white matter lesions in brain MRI. Genetic testing is important to confirm the diagnosis.


Local conduction delay causes R-wave amplitude increase in patients with effort angina.
Eighty-seven unipolar electrocardiograms distributed over the entire thorax were simulataneously recorded before and after treadmill exercise in 43 patients. Exercise-induced R-wave amplitude change (delta R) and peak R time (time from the onset of QRS to the peak of R wave), were calculated for each lead. The maximal delta R of 87 leads was designated as the max delta R. After exercise, regional delay of peak R time (greater than or equal to 10 msec) on the chest was observed in 13 patients. These patients had significantly higher max delta R than those without such regional peak R time delay (0.71 +/- 0.31mV vs. 0.33 +/- 0.20mV, p less than 0.01). In each case, the site of peak R time delay was almost the same as the site of max delta R. There was no significant difference in the peak heart rate, rise of the systolic blood pressure (delta BPs) during exercise or extent of ischemic ST depression between patients with and without peak R time delay. We concluded that ventricular condition delay plays an important role in the increase of R-wave amplitude after exercise in patients with effort angina pectoris.


Enrichment of N-terminal sulfonated peptides by a water-soluble fullerene derivative and its applications to highly efficient proteomics.
Recent studies have shown that N-terminal sulfonation of tryptic peptides by various sulfonating molecules greatly improves their post-source decay processes (e.g., in matrix-assisted laser desorption ionization) or the gas phase fragmentation processes (e.g., in tandem mass spectrometer), enhancing the ability to identify their sequences de novo. In the present work, we have demonstrated that incorporation of water-soluble C60-N,N-dimethylpyrrolidinium iodide selectively precipitates the 4-sulfophenyl isothiocyanate-modified peptide (SPITC-GGYR, SPITC-ASHLGLAR) by forming a noncovalent ion pair to the SO3- group of the SPITC, and thereby the C60 derivative can be utilized to enrich the modified peptide. Electrospray ionization (ESI) mass analyses show that the cationic SPITC-GGYR and SPITC-ASHLGLAR species are well separated from unmodified peptides and the modified peptides are subsequently detached from the C60 derivative upon using an acidic solution.


Electromagnetic reprogrammable coding-metasurface holograms.
Metasurfaces have enabled a plethora of emerging functions within an ultrathin dimension, paving way towards flat and highly integrated photonic devices. Despite the rapid progress in this area, simultaneous realization of reconfigurability, high efficiency, and full control over the phase and amplitude of scattered light is posing a great challenge. Here, we try to tackle this challenge by introducing the concept of a reprogrammable hologram based on 1-bit coding metasurfaces. The state of each unit cell of the coding metasurface can be switched between '1' and '0' by electrically controlling the loaded diodes. Our proof-of-concept experiments show that multiple desired holographic images can be realized in real time with only a single coding metasurface. The proposed reprogrammable hologram may be a key in enabling future intelligent devices with reconfigurable and programmable functionalities that may lead to advances in a variety of applications such as microscopy, display, security, data storage, and information processing.Realizing metasurfaces with reconfigurability, high efficiency, and control over phase and amplitude is a challenge. Here, Li et al. introduce a reprogrammable hologram based on a 1-bit coding metasurface, where the state of each unit cell of the coding metasurface can be switched electrically.


The Effect of Preoperative Administration of Antihistamine, Analgesic and Placebo on Postoperative Pain in Teeth with Symptomatic Apical Periodontitis: A Randomized Controlled Trial.
To compare the effect of preoperative administration of an antihistamine, an analgesic, or a placebo on postoperative pain in maxillary molar teeth with symptomatic apical periodontitis.Design: A randomized, controlled trial. Population: A total of 51 patients with moderate-to-severe maxillary molar tooth pain who have undergone a root canal treatment.Intervention: Preoperative administration of either an antihistamine or an analgesic.Control: Versus placeboOutcomes: Reduction in postoperative pain? The data were analyzed with chi-square, one-way analysis of variance (ANOVA) and least significant difference (LSD) post-hoc tests. At days 1 and 3, preoperative administration of the antihistamine and analgesic resulted in lower pain levels than the placebo. At days 5 and 7, however, while preoperative administration of the antihistamine still resulted in less pain than the placebo, there was no significant difference between the analgesic and placebo (P>0.05). Within the limitations of the present study, the preoperative administration of an antihistamine can be beneficial in reducing the postoperative pain of endodontic treatments.


Surgical treatment of the brow and upper eyelid.
Surgical management of the aging upper face has taken on a critical role in total facial rejuvenation, with a variety of techniques available. The hallmarks of the aging upper third of the face and periorbital region most commonly manifest as rhytids, brow descent, prolapse of periorbital fat, dermatochalasis, and volume loss and hollowing. The surrounding structures should be assessed individually and their relationships carefully analyzed to guide selection of the appropriate treatment. In this article, the authors explore the various approaches and techniques available for rejuvenation of the upper face, including the upper periorbital region.


Kinetic contributions to gating by interactions unique to N-methyl-D-aspartate (NMDA) receptors.
Among glutamate-gated channels, NMDA receptors produce currents that subside with unusually slow kinetics, and this feature is essential to the physiology of central excitatory synapses. Relative to the homologous AMPA and kainate receptors, NMDA receptors have additional intersubunit contacts in the ligand binding domain that occur at both conserved and non-conserved sites. We examined GluN1/GluN2A single-channel currents with kinetic analyses and modeling to probe these class-specific intersubunit interactions for their role in glutamate binding and receptor gating. We found that substitutions that eliminate such interactions at non-conserved sites reduced stationary gating, accelerated deactivation, and imparted sensitivity to aniracetam, an AMPA receptor-selective positive modulator. Abolishing unique contacts at conserved sites also reduced stationary gating and accelerated deactivation. These results show that contacts specific to NMDA receptors, which brace the heterodimer interface within the ligand binding domain, stabilize actively gating receptor conformations and result in longer bursts and slower deactivations. They support the view that the strength of the heterodimer interface modulates gating in both NMDA and non-NMDA receptors and that unique interactions at this interface are responsible in part for basic differences between the kinetics of NMDA and non-NMDA currents at glutamatergic synapses.


Individual differences in the effect of social defeat on anhedonia and histone acetylation in the rat hippocampus.
Major depression is a growing problem worldwide with variation in symptoms and response to treatment. Individual differences in response to stress may contribute to such observed individual variation in behavior and pathology. Therefore, we investigated depressive-like behavior following exposure to repeated social defeat in a rat model of individual differences in response to novelty. Rats are known to exhibit either high locomotor activity and sustained exploration (high responders, HR) or low activity with minimal exploration (low responders, LR) in a novel environment. We measured anhedonia using the sucrose preference test in HR and LR rats following exposure to social defeat stress or in basal, non-defeated conditions. We then compared histone acetylation in the hippocampus in HR and LR defeat and non-defeated rats and measured mRNA levels of histone deacetylases (HDAC) 3, 4, 5, and Creb binding protein (CBP). We found that basally, HR rats consumed more sucrose solution than LR rats, but reduced consumption after exposure to defeat. LR rats' preference was unaffected by social defeat. We found that HR rats had higher levels of histone acetylation on H3K14 and H2B than LR rats in non-stress conditions. Following defeat, this acetylation pattern changed differentially, with HR rats decreasing acetylation of H3K14 and H2B and LR's increasing acetylation of H3K14. Acetylation on histone H4 decreased following defeat with no individual variation. Basal differences in CBP expression levels may underlie the observed acetylation pattern; however we found no significant effects of defeat in levels of HDACs 3, 4, 5 in the hippocampus.


Investigating the background of a 1-cm(3) quartz gas proportional counter.
The background count rate of a 1-cm(3) quartz gas proportional counter (GPC) was investigated for measuring natural radioactivity levels of small samples. Using a new multiparameter digital counting system, spurious or afterpulses that contribute to background were identified by their pulse waveform and by a special event indicator defined by the time (<2000micros) between two successive pulses. With the GPC in coincidence with a low-background NaI(Tl) scintillation guard detector, the weighted mean and standard uncertainty anticoincidence counts per day (d(-1)) was 6.2+/-0.4d(-1).


A neuromorphic physiological signal processing system based on VO2 memristor for next-generation human-machine interface.
Physiological signal processing plays a key role in next-generation human-machine interfaces as physiological signals provide rich cognition- and health-related information. However, the explosion of physiological signal data presents challenges for traditional systems. Here, we propose a highly efficient neuromorphic physiological signal processing system based on VO2 memristors. The volatile and positive/negative symmetric threshold switching characteristics of VO2 memristors are leveraged to construct a sparse-spiking yet high-fidelity asynchronous spike encoder for physiological signals. Besides, the dynamical behavior of VO2 memristors is utilized in compact Leaky Integrate and Fire (LIF) and Adaptive-LIF (ALIF) neurons, which are incorporated into a decision-making Long short-term memory Spiking Neural Network. The system demonstrates superior computing capabilities, needing only small-sized LSNNs to attain high accuracies of 95.83% and 99.79% in arrhythmia classification and epileptic seizure detection, respectively. This work highlights the potential of memristors in constructing efficient neuromorphic physiological signal processing systems and promoting next-generation human-machine interfaces.


MKC-231, a choline uptake enhancer: (3) Mode of action of MKC-231 in the enhancement of high-affinity choline uptake.
MKC-231, a putative cholinergic activity, is reported to improve learning and memory impaired in AF64A-treated animals. MKC-231 enhances high-affinity choline uptake (HACU) known as the rate-limiting step of acetylcholine (ACh) synthesis. We investigated the mode of action (MOA) of HACU enhancement by MKC-231. Intracerebroventricular (i.c.v.) injections of AF64A (3 nmol/brain) resulted in significant HACU reduction in hippocampal synaptosomes. Treatment with MKC-231 increased Vmax of HACU and Bmax of [3H]-HC-3 binding 1.6 and 1.7-fold, respectively. In studies of [3H]-MKC-231 binding and Biacore analysis, MKC-231 showed noticeable affinity for cloned high-affinity choline transporters (CHT1). The present study suggests that MKC-231 directly affects trafficking of CHT1 and increases the numbers of transporter, working for HACU, at the synaptic membrane.


[Electrical breakdown of erythrocyte membranes attributed to the diffusion potential difference].
A potential difference of a certain value can be obtained on the erythrocyte membranes if the cells are suspended in isotonic solution of low Cl- concentration. The potential value may be estimated by the pH changes in the medium without buffer. When the chloride membrane potential is high enough the electric breakdown, i.e. a sharp increase i of membrane ionic permeability, is observed.


Glycaemic control and antidiabetic therapy in patients with diabetes mellitus and chronic kidney disease - cross-sectional data from the German Chronic Kidney Disease (GCKD) cohort.
Diabetes mellitus (DM) is the leading cause of end-stage renal disease. Little is known about practice patterns of anti-diabetic therapy in the presence of chronic kidney disease (CKD) and correlates with glycaemic control. We therefore aimed to analyze current antidiabetic treatment and correlates of metabolic control in a large contemporary prospective cohort of patients with diabetes and CKD. The German Chronic Kidney Disease (GCKD) study enrolled 5217 patients aged 18-74 years with an estimated glomerular filtration rate (eGFR) between 30-60 mL/min/1.73 m(2) or proteinuria >0.5 g/d. The use of diet prescription, oral anti-diabetic medication, and insulin was assessed at baseline. HbA1c, measured centrally, was the main outcome measure. At baseline, DM was present in 1842 patients (35 %) and the median HbA1C was 7.0 % (25(th)-75(th) percentile: 6.8-7.9 %), equalling 53 mmol/mol (51, 63); 24.2 % of patients received dietary treatment only, 25.5 % oral antidiabetic drugs but not insulin, 8.4 % oral antidiabetic drugs with insulin, and 41.8 % insulin alone. Metformin was used by 18.8 %. Factors associated with an HbA1C level >7.0 % (53 mmol/mol) were higher BMI (OR = 1.04 per increase of 1 kg/m(2), 95 % CI 1.02-1.06), hemoglobin (OR = 1.11 per increase of 1 g/dL, 95 % CI 1.04-1.18), treatment with insulin alone (OR = 5.63, 95 % CI 4.26-7.45) or in combination with oral antidiabetic agents (OR = 4.23, 95 % CI 2.77-6.46) but not monotherapy with metformin, DPP-4 inhibitors, or glinides. Within the GCKD cohort of patients with CKD stage 3 or overt proteinuria, antidiabetic treatment patterns were highly variable with a remarkably high proportion of more than 50 % receiving insulin-based therapies. Metabolic control was overall satisfactory, but insulin use was associated with higher HbA1C levels.


Evaluation of the abbot Architect(™) epstein-barr virus viral capsid antigen IgM, viral capsid antigen IgG and nuclear antigen IgG assays in a pediatric and adult population.
The detection of antibodies against Epstein-Barr viral capsid (VCA) and nuclear (EBNA) antigens is routinely performed with different commercially available immunoassays. In this study, we evaluated the concordance and performance of the Architect(™) chemiluminescent microparticle immunoassays (CMIAs) using Captia(™) enzyme linked immunosorbent assays (ELISA) for VCA IgM, and standard immunofluorescence (IF) assays for VCA IgG and EBNA IgG as comparative techniques. Sera were selected from a heterogeneous population including pediatric and adult patients. Concordance between CMIAs and comparative assays was high with total agreement percentages of 84,1% (95% CI: 77.8-88.9) for VCA IgM, 90,6% (95% CI: 84.2-94.7) for EBNA IgG and 98,0% (95% CI: 93.9-99.6) for VCA IgG. Moreover, kappa statistic values showed good to excellent correlation with values of 0.68 (95% CI: 0.57-0.79) for VCA IgM, 0.73 (95% CI: 0.58-0.87) for EBNA IgG and 0.95 (95% CI: 0.89-1.00) for VCA IgG. A correlation was observed between positivity levels on CMIAs and semi-quantitative fluorescence intensity on IF for VCA IgG and EBNA IgG assays. With regard to an accepted gold standard IF assays, CMIA was 98,1% (95% CI: 93.3-99.8) sensitive and 97,4% (95% CI: 86.5-99.9) specific for the detection of VCA IgG. For the detection of EBNA IgG, it was 92,2% (95% CI: 85.1-96.6) sensitive and 84,6% (95% CI: 65.1-95.6) specific. In summary, we demonstrated that the CMIA EBV antibody detection panel has high performance and high concordance with other commercially available immunoassays.


Robotic Living Donor Right Hepatectomy: A Systematic Review and Meta-Analysis.
The introduction of robotics in living donor liver transplantation has been revolutionary. We aimed to examine the safety of robotic living donor right hepatectomy (RLDRH) compared to open (ODRH) and laparoscopic (LADRH) approaches. A systematic review was carried out in Medline and six additional databases following PRISMA guidelines. Data on morbidity, postoperative liver function, and pain in donors and recipients were extracted from studies comparing RLDRH, ODRH, and LADRH published up to September 2020; PROSPERO (CRD42020214313). Dichotomous variables were pooled as risk ratios and continuous variables as weighted mean differences. Four studies with a total of 517 patients were included. In living donors, the postoperative total bilirubin level (MD: −0.7 95%CI −1.0, −0.4), length of hospital stay (MD: −0.8 95%CI −1.4, −0.3), Clavien−Dindo complications I−II (RR: 0.5 95%CI 0.2, 0.9), and pain score at day > 3 (MD: −0.6 95%CI −1.6, 0.4) were lower following RLDRH compared to ODRH. Furthermore, the pain score at day > 3 (MD: −0.4 95%CI −0.8, −0.09) was lower after RLDRH when compared to LADRH. In recipients, the postoperative AST level was lower (MD: −0.5 95%CI −0.9, −0.1) following RLDRH compared to ODRH. Moreover, the length of stay (MD: −6.4 95%CI −11.3, −1.5) was lower after RLDRH when compared to LADRH. In summary, we identified low- to unclear-quality evidence that RLDRH seems to be safe and feasible for adult living donor liver transplantation compared to the conventional approaches. No postoperative deaths were reported.


[Objectivation of the rheologic and hemodynamic and metabolic effects of ultraviolet irradiation of autologous venous blood in Fontaine type II-IV peripheral arterial occlusive disorders].
72 patients with disturbances of the peripheral arterial blood supply of type II to IV after Fontaine showed characteristic clinical, haemodynamic (first flow, peak flow occlusion-plethysmographically reduced) metabolic (paO2 and pvO2 decreased), plasmatic (fibrinogen and alpha 2-macroglobulin levels increased) and--as far as investigated (37 patients)--haemorheological changes (much increased apparent whole blood viscosity). The latter was found out above all in shear rates occurring in the microcirculation. Ultraviolet irradiation of venous autologous blood (1 ml/kg) during three weeks (nine times) leads the haemorheological and plasmatic parameters to normal levels and decisively improves the metabolic and haemodynamic parameters. This effect is still to be proved after six months, but only in a small extent after one or two years. Because of the weaker therapeutic effects of the common conservative treatment this therapy must be recommended.


Transformation mechanism and fate of dissolved organic nitrogen (DON) in a full-scale drinking water treatment.
Dissolved organic nitrogen (DON) has attracted much attention in drinking water treatment due to its potential to produce nitrogenous disinfection by-products (N-DBPs). This work was designed to explore the transformation and fate of DON and dissolved inorganic nitrogen (DIN) in drinking water treatment. The changes of DON and formation of N-DBPs were evaluated along the water treatment route (i.e., pre-ozonation and biological-contact oxidation, delivery pipes' transportation, coagulation-sedimentation, sand filtration, post-ozonation, biological activated carbon, ultrafiltration and disinfection) of drinking water treatment plant (DWTP). The transformation mechanism of DON was comprehensively investigated by molecular weight fractionation, three-dimensional fluorescence, LC-OCD (Liquid Chromatography-Organic Carbon Detection), total free amino acids. A detailed comparison was made between concentrations and variations of DON and DIN affected by seasons in the drinking water treatment. Regardless of seasonal variation in raw water concentration, the DON removal trends between different treatment processes remain constant in the present study. Compared to other treatment processes, pre-ozonation and coagulation-sedimentation exhibited the dominant DON removal in different seasons, i.e., 11.13%-14.45% and 14.98%-22.49%, respectively. Contrary, biological-contact oxidation and biological activated carbon negatively impacted the DON removal, in which DON increased by 1.76%-6.49% in biological activated carbon. This may be due to the release of soluble microbial products (SMPs) from bacterial metabolism, which was further validated by the rise of biopolymers in LC-OCD.


A randomized clinical trial of lorazepam for the reduction of postoperative urinary retention.
To estimate whether lorazepam can decrease the incidence of postoperative urinary retention after ambulatory gynecologic surgeries. A randomized clinical trial at an urban academic medical center was performed. Lorazepam (1 mg) or a placebo was administered intravenously 1 hour after ambulatory gynecologic procedures. Ninety patients were randomized to receive lorazepam (n = 47) or a placebo (n = 43). A computer-generated random number table was used for group assignment. Concealment was maintained by the hospital pharmacy, which prepared and dispensed the medication. Physicians, nurses, and patients were blinded to the group assignment. The time of the first spontaneous void and other information about the surgery and recovery were then recorded. There was no difference in the overall mean time to void between the lorazepam (3.1 +/- 1.2 hours) and placebo (2.8 +/- 2.0 hours) groups (P =.5). The time to void did not correlate with intravenous fluid use, length of procedure, type of procedure, narcotic use, body mass index, age, type of catheterization, or estimated blood loss. Medium half-life benzodiazepines do not significantly reduce the incidence of postoperative urinary retention.


A cross-linguistic study of real-word and non-word repetition as predictors of grammatical competence in children with typical language development.
Although relationships among non-word repetition, real-word repetition and grammatical ability have been documented, it is important to study whether the specific nature of these relationships is tied to the characteristics of a given language. The aim of this study is to explore the potential cross-linguistic differences (Italian and English) in the relationship among non-word repetition, real-word repetition, and grammatical ability in three-and four-year-old children with typical language development. To reach this goal, two repetition tasks (one real-word list and one non-word list for each language) were used. In Italian the grammatical categories were the third person plural inflection and the direct-object clitic pronouns, while in English they were the third person singular present tense inflection and the past tense in regular and irregular forms. A cross-linguistic comparison showed that in both Italian and English, non-word repetition was a significant predictor of grammatical ability. However, performance on real-word repetition explained children's grammatical ability in Italian but not in English. Abilities underlying non-word repetition performance (e.g., the processing and/or storage of phonological material) play an important role in the development of children's grammatical abilities in both languages. Lexical ability (indexed by real-word repetition) showed a close relationship to grammatical ability in Italian but not in English. Implications of the findings are discussed in terms of cross-linguistic differences, genetic research, clinical intervention and methodological issues.


Assessing Perceived Discrimination as Reported by Black and White Women Diagnosed with Breast Cancer.
Although a number of factors contribute to racial disparities in breast cancer outcomes, perceived discrimination in healthcare may be a key factor that hinders positive interactions and negatively impacts patient outcomes. The goals of our study were to (1) assess the prevalence of perceived discrimination as reported by breast cancer patients and (2) identify factors related to discrimination in women overall as well as by race. This study is a secondary analysis of a larger study, "Narrowing the Gaps in Adjuvant Therapy," where a convenience sample of 359 women completed one telephone survey assessing sociodemographics, and attitudes and beliefs concerning breast cancer treatments and care. Chi-square analysis was used to assess the relationship of categorical variables with perceived discrimination, while the F-test was employed for continuous variables. Logistic regression determined predictors of perceived discrimination, a dichotomous variable (none vs. any). A majority of women were Black (58%), privately insured (85%), and had at least a Bachelor's degree (48%). Discrimination was reported by 32.4% of women, with significantly more Black women reporting discrimination than White women. Insurance status, attitudes toward treatment, and distress factors were significantly related to perceived discrimination. In the logistic model, women who were less trusting of their providers (OR = 0.863 [0.751, 0.993], p = .021) and Black women (OR = 7.241 [0.751, 0.993], p = .039) were more likely to report incidences of discrimination. Our findings suggest a need to understand Black survivor's experiences with healthcare. Similarly, future work must focus on identifying ways to improve provider trust amongst breast cancer survivors.


Sources of Distress Experienced by Parents of Children with Chronic Kidney Disease on Dialysis: A Qualitative Systematic Review.
Parents of children with chronic kidney disease face tremendous burdens of care, having to adopt dual roles as parents and informal healthcare providers, delivering home-based clinical care, despite lacking proper qualification and training. A systematic review of qualitative studies was conducted to identify sources of distress among parents caring for children with chronic kidney disease undergoing dialysis, excluding children who have had renal transplants. Guided by PRISMA guidelines, six electronic databases (PubMed, Embase, PsycINFO, Scopus, Cochrane, Google Scholar) were searched for relevant articles published in English. A three-step inductive thematic synthesis method outlined by Thomas and Harden (2018) was used to form descriptive themes and the Critical Appraisal Skill Program (CASP) qualitative checklist was utilised to appraise the quality of included articles. A total of 23,129 title and abstracts were reviewed; 161 full texts were reviewed. Thirteen papers, with the experiences of 183 parents, met the inclusion criteria. Most included studies were conducted in Western countries, which may limit the applicability of this review to other countries. Five themes emerged: disease-related distress, personal struggles, family structure, lack of resources and unrealistic social expectations. Parents of children with chronic kidney disease undergoing dialysis experienced distress at multiple levels. Healthcare professionals caring for children with chronic kidney disease could screen parents early for distress, and refer them to relevant psychosocial and community services.


Oxygen transport by pyridoxylated polyhemoglobin solution.
Pyrodoxylated Polyhemoglobin (PolyHb-PPa) with physiological oxygen affinity (P50 27 mm Hg) was used in vitro and in vivo. The oxygen binding coefficient was 1.1 ml O2/dl/g Hb, the oxygen capacity of 8.5% PolyHb-PPa solution 9.3 ml O2/dl, Hill coefficient 1.7, Met-Hb content below 2%. Exchange transfusion of whole blood with PolyHb-PPa results in a significant, linear increase in total oxygen capacity, in contrast to exchange transfusion with asanguineous solutions. In vitro analysis of oxygen equilibrium curves of mixtures of whole blood with PolyHb-PPa, however, shows a nonlinear release of the additional blood oxygen capacity. Significant amounts of PolyHb-PPa-bound oxygen are made available only when hemodilution exceeds 25%; only at 75% hemodilution does oxygen delivery by PolyHb-PPa account for 50% of the unloaded oxygen. In vivo results after therapy for hemorrhagic shock in minipigs clearly shows the efficacy of oxygen transport by PolyHb-PPa. At 70% hemodilution, PolyHb-PPa bound oxygen was twice that of erythrocytic oxygen. Availability of this additional oxygen capacity was demonstrated by an oxygen extraction ratio of 0.40%. The utility of PolyHb-PPa solution with "normal" P50 in the therapy of moderate anemia, however, remains to be proved.


Biochemical markers of bone metabolism and calciuria with inhaled budesonide therapy.
We investigated the changes in renal excretion of calcium, sodium, and potassium in asthmatic children treated with inhaled budesonide, an inhaled glucocorticoid. Twenty-two asthmatic patients (7 female, 15 male, mean age 10.1+/-4.3 years) treated with 400-600 microg/day inhaled budesonide and 23 healthy children (6 female, 17 male, mean age 10.2+/-2.8 years) were enrolled in the study. The parameters recorded were serum sodium, potassium, calcium, phosphorus, alkaline phosphatase (ALP), type I collagen carboxyterminal telopeptide (ICTP), osteocalcin, intact parathyroid hormone (PTH) levels, first spot morning urine calcium/creatinine ratio, sodium/potassium ratio, and daily renal calcium excretion rate (UCa-ER). These parameters were measured in the control group and pre- and post-budesonide treatment in asthmatic children. Serum electrolytes, ALP, PTH, ICTP, and UCa-ER were in the normal ranges and were not significantly different between controls and asthmatic children. Serum levels of ICTP increased, while levels of osteocalcin decreased after budesonide therapy in the asthmatic group ( P=0.001, P=0.005). UCa-ER was decreased after budesonide therapy in asthmatics ( P=0.000). In conclusion, moderate doses of inhaled budesonide cause hypocalciuria and decreased bone turnover. These results may be attributed to a mechanism compensating for decreased absorption of calcium in the gut due to the topical effect of swallowed budesonide rather than the systemic effects of the drug. Increased bone metabolism and decreased turnover may have an important role in this compensatory mechanism.


Pregnancy outcomes before and after a diagnosis of systemic lupus erythematosus.
The purpose of this study was to evaluate pregnancy outcomes before and after diagnosis of lupus. Successive selection criterion applied to 148 lupus and 78,905 non-lupus pregnancies, generated 3 groups: lupus group, 84 pregnancies (not-yet-diagnosed group, 15 women; already-diagnosed group, 69 women), and control group, 51,000 pregnancies. Three-way analysis of variance and the chi-squared test were used for analyses. Stillbirth outcome was increased in the lupus group compared with the control group (odds ratio, 4.84 [95% CI, 1.72,11.08]); the not-yet-diagnosed group (odds ratio, 9.89 [95% CI, 1.09,42.63]), and the already-diagnosed group (odds ratio, 3.85 [95% CI, 1.02,10.31]). Considering >1 pregnancy per patient would have overestimated the stillbirth rate. Stillbirth risk was increased significantly in severe maternal disease that was marked by central nervous system involvement. The already-diagnosed group had more hypertensive complications (P = .001 and .0001). Both lupus groups showed a significantly greater proportion of preterm births (P = .03), growth restriction (P = .019), and infants in the very low birth weight category (P = .021) compared with the control group. Poor fetal outcomes are seen in pregnancies that are complicated by lupus, even before clinical appearance of disease, which supports a predisease state.


Real-life experience: sensitivity and specificity of nasal and saliva samples for COVID-19 diagnosis.
COVID-19 (coronavirus disease 2019) outbreak has spread rapidly around the world, continues to show its effect, and it is not clear how long it will continue. For the diagnosis of COVID-19, it is important to ensure the comfort of the patients and to protect the healthcare workers (HCWs) by reducing the use of protective equipment. To evaluate or assess whether the samples taken by the patient for COVID-19 testing during this pandemic period can be used in real-life experience. Three different samples (nasopharyngeal taken by the healthcare worker, nasopharyngeal, and saliva taken by the patient) from 132 patients were evaluated for the diagnosis of COVID-19. The sensitivity and specificity of the samples in the diagnosis of COVID-19 were compared with real-life experience. Paired analyzes were performed by comparing each sample taken by the healthcare worker with the sample taken by the patient. The sensitivity of the three samples (nasopharyngeal taken by the healthcare worker, nasopharyngeal, and saliva taken by the patient) in the diagnosis of the COVID-19 was (100%, 98.7%, and 96.1%, respectively) accepted to be accurate. The sample taken by the paramedic was compatible compared to the real-life experience for the samples taken by the patient in the COVID-19 pandemic period. During the pandemic that is unknown when it will end, this study demonstrated that taking the sample of the patient alone for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test is a beneficial approach to the protection of the healthcare worker, reducing the need for protective equipment, increasing the patient's comfort and rapid sampling.


[Complex pelvic trauma : A case report with special consideration of the accompanying urogenital injury].
The following case report shows a young male patient with a complex pelvic trauma due to a traffic accident. In addition to the pelvic ring fracture, he also suffered a severe accompanying injury to the efferent urinary tract in combination with extensive damage of the lumbosacral plexus. Multiple extensive operations were necessary to address the C3 fracture of the pelvic ring and the bladder injury. Due to an infection a wound healing disorder subsequently occurred, which necessitated a myocutaneous flap plasty. This case highlights the complexity of this injury and confirms the necessity for an interdisciplinary individualized treatment.


In vivo gene transfer into the ocular ciliary muscle mediated by ultrasound and microbubbles.
This study aimed to assess application of ultrasound (US) combined with microbubbles (MB) to transfect the ciliary muscle of rat eyes. Reporter DNA plasmids encoding for Gaussia luciferase, β-galactosidase or the green fluorescent protein (GFP), alone or mixed with 50% Artison MB, were injected into the ciliary muscle, with or without US exposure (US set at 1 MHz, 2 W/cm(2), 50% duty cycle for 2 min). Luciferase activity was measured in ocular fluids at 7 and 30 days after sonoporation. At 1 week, the US+MB treatment showed a significant increase in luminescence compared with control eyes, injected with plasmid only, with or without MB (×2.6), and, reporter proteins were localized in the ciliary muscle by histochemical analysis. At 1 month, a significant decrease in luciferase activity was observed in all groups. A rise in lens and ciliary muscle temperature was measured during the procedure but did not result in any observable or microscopic damages at 1 and 8 days. The feasibility to transfer gene into the ciliary muscle by US and MB suggests that sonoporation may allow intraocular production of proteins for the treatment of inflammatory, angiogenic and/or degenerative retinal diseases.


Linear and nonlinear modeling approaches for urban air quality prediction.
In this study, linear and nonlinear modeling was performed to predict the urban air quality of the Lucknow city (India). Partial least squares regression (PLSR), multivariate polynomial regression (MPR), and artificial neural network (ANN) approach-based models were constructed to predict the respirable suspended particulate matter (RSPM), SO(2), and NO(2) in the air using the meteorological (air temperature, relative humidity, wind speed) and air quality monitoring data (SPM, NO(2), SO(2)) of five years (2005-2009). Three different ANN models, viz. multilayer perceptron network (MLPN), radial-basis function network (RBFN), and generalized regression neural network (GRNN) were developed. All the five different models were compared for their generalization and prediction abilities using statistical criteria parameters, viz. correlation coefficient (R), standard error of prediction (SEP), mean absolute error (MAE), root mean squared error (RMSE), bias, accuracy factor (A(f)), and Nash-Sutcliffe coefficient of efficiency (E(f)). Nonlinear models (MPR, ANNs) performed relatively better than the linear PLSR models, whereas, performance of the ANN models was better than the low-order nonlinear MPR models. Although, performance of all the three ANN models were comparable, the GRNN over performed the other two variants. The optimal GRNN models for RSPM, NO(2), and SO(2) yielded high correlation (between measured and model predicted values) of 0.933, 0.893, and 0.885; 0.833, 0.602, and 0.596; and 0.932, 0.768 and 0.729, respectively for the training, validation and test sets. The sensitivity analysis performed to evaluate the importance of the input variables in optimal GRNN revealed that SO(2) was the most influencing parameter in RSPM model, whereas, SPM was the most important input variable in other two models. The ANN models may be useful tools in the air quality predictions.


Changes in leukotrienes and prostaglandins in the liver tissue of rats in the experimental massive hepatic cell necrosis model.
When heat-killed Propionibacterium acnes is intravenously injected into rats followed by an intravenous injection of a small amount of Gram-negative lipopolysaccharide (LPS) 7 days later, massive hepatic cell necrosis is induced and most of the rats die within 24 hours of LPS injection. Using this experimental model, we studied the changes in the levels of leukotrienes (LTs) and prostaglandins (PGs) in the liver tissue and bile of rats with experimentally-induced massive hepatic cell necrosis. Both the levels of LTs and PGs in the liver tissue and LTs in the bile increased before the microscopic appearance of hepatic cell necrosis. These results suggest that arachidonic acid metabolites may play an important role in the induction of liver cell injury.


[Possibilities of temporal bone CT in examination of patients after sanitation operation on the middle ear].
The author presents the analysis of 56 CT images of the temporal bone in 5 to 72 year old patients operated on the middle ear; characterizes CT possibilities in the study of the operated ear; shows that the operation outcomes may be different (complete epidermization of the postoperative cavity, the presence of the granulation tissue, cholesteatoma recurrence); presents CT changes in the temporal bone in various perioperative and postoperative complications: otoliquorrhea, paresis of the facial nerve, labyrinthitis, progressive hypoacusis and deafness.


Enhanced bone formation in rat critical-size tibia defect by a novel quercetin-containing alpha-calcium sulphate hemihydrate/nano-hydroxyapatite composite.
We developed an innovative method to include quercetin into alpha-calcium sulphate hemihydrate/nano-hydroxyapatite (α-CSH/n-HA), to prepare a novel quercetin-containing α-CSH/n-HA composite (Q-α-CSH/n-HA). The physicochemical properties, and ability of Q-α-CSH/n-HA to promote cell proliferation, migration, and osteogenic differentiation of bone marrow stem cells (BMSCs) in vitro were examined. Further, the potential of Q-α-CSH/n-HA to promote bone defect repair was studied using a Sprague-Dawley rat model of critical tibial defects. Imaging was conducted by radiography and micro-CT, and bone defect repairs were observed by histopathological staining. Addition of quercetin clearly increased the porosity of the degraded composite, which elevated the cell proliferation rate, migration ability, osteogenesis differentiation, and mineralisation of BMSCs. Further, quercetin-containing composite increased the expression levels of OSX, RUNX2, OCN, ALP, BMP-2, OPN, BSP, SMAD2, and TGF-β in BMSCs, while it downregulated TNF-α. X-ray and micro-CT imaging showed that the quercetin-containing composite significantly enhanced bone defect repair and new bone in formation. Haematoxylin and eosin, Goldner, and Safranin O staining also showed that quercetin significantly increased new bone generation and promoted composite degradation and absorption. Moreover, immunofluorescence assay revealed that quercetin significantly increased the number of RUNX2/OSX/OCN-positive cells. Overall, our data demonstrate that Q-α-CSH/n-HA has excellent biocompatibility, bone conductivity, and osteo-induction performance in vitro and mediates enhanced overall repair effects and bone reconstruction in vivo, indicating that it is a promising artificial bone graft to promote bone regeneration.


Glycosphingolipids: the putative receptor for Staphylococcus aureus enterotoxin-B in human kidney proximal tubular cells.
We have investigated the binding of 125I-staphylococcal enterotoxin-B (SEB) in cultured human proximal tubular cells. We found that the binding of 125I-SEB to PT cells was time and concentration dependent and competitively inhibited by antibody against SEB. Preincubation of cells with trypsin and neuraminidase or with fetuin did not significantly impair the binding of 125I-SEB to such cells. In contrast, treatment with endoglycoceramidase completely inhibited the binding of 125I-SEB to cells. Neutral glycosphingolipids exerted a concentration-dependent inhibition of 125I-SEB binding to such cells, maximum inhibition (96% compared to control) occurred upon incubation of PT cells with neutral glycosphingolipids. Taken together, our studies indicate that SEB specifically binds to a neutral glycosphingolipid in PT cells. In contrast, staphylococcal enterotoxin-A and toxic shock toxin (TST-1) are bound to a protein in such cells.


Streptomyces genus as a source of probiotics and its potential for its use in health.
The effect of a probiotic on gut microbiota depends not only on the species of microorganism but specifically on the strain. In human beings, as in other animals, specific probiotics have been associated with numerous beneficial properties, which include weight modulation (gain or loss), immune modulation, and prevention of many disorders such as lactose intolerance, cardiovascular diseases, and antibiotic-associated diarrhoea. Streptomyces are an essential group of soil bacteria in the Actinomycetes family. They are related to producing a wide range of secondary metabolites known for their beneficial effects on human health. However, according to the human microbiome analysis, a lower prevalence of Streptomyces genus exists than in other non-human microbiomes. This difference can be associated with current lifestyles. In this article, we review the benefits associated with different compounds produced by Streptomyces, with a particular focus on the production of exopolysaccharides, antibiotics, and other secondary metabolites and the potential innovative use of Streptomyces spp. as probiotics.


Monitoring in language perception: The effect of misspellings of words in highly constrained sentences.
We present evidence for a monitoring process in language perception at the word level, reflected by a P600. This P600 is triggered when a conflict evolves because the brain encounters an unexpected linguistic item when another item is highly expected. To resolve this conflict between representations, the brain monitors the input to check for possible processing errors. A P600 was hypothesized to occur after orthographic anomalies, like pseudohomophones, in particular when the word from which the pseudohomophone is derived is highly expected. This hypothesis was tested by recording ERPs while participants read high-cloze sentences ('In that library the pupils borrow books ....') and low-cloze sentences ('The pillows are stuffed with books ....'). In a pretest, the high-cloze sentences were produced by more than 90% of the subjects, while the low-cloze sentences were never produced. In half of the sentences, the critical word books was replaced by a pseudohomophone (e.g., bouks), which in the high-cloze sentences orthographically and phonologically resembles the highly expected word. Consistent with the monitoring hypothesis, only pseudohomophones in high-cloze sentences elicited a widely distributed P600 effect while pseudohomophones in low-cloze sentences did not. A standard N400 effect of cloze probability occurred both for words and pseudohomophones. The present ERP results support the view that there is a process of monitoring that takes place in language perception which is reflected by the P600. It occurs whenever a conflict between a strong tendency to accept and one to reject a word brings the cognitive system in state of indecision.


Trial of ibuprofen to prevent post-vasectomy complications.
Sperm granuloma and epididymitis remain 2 of the most common and incapacitating complications of vasectomy. A study was designed to evaluate the possibility of reducing these inflammatory complications with a prophylactic course of a nonsteroidal anti-inflammatory drug. Patients undergoing outpatient vasectomy were randomized into 2 groups. Group 1 received a prophylactic course of ibuprofen and group 2 received no medication. The ibuprofen was tolerated well and no adverse reactions were noted. There was no increase in postoperative bleeding or hematoma formation. There was no clinical benefit or decrease in complication rate in the ibuprofen-treated group.


New contributions to the relationship between sequential changes of ATP-related metabolites and post-mortem interval in rats.
In recent years, it has become a new research direction to post-mortem interval (PMI) estimation from the changes in metabolite content generated during the process of cadaver corruption, and lead to more and more attention has been paid to the biochemical changes of muscles after death. The ATP degradation process has long been accepted as a precise manner to estimate freshness of meat products in food science. ATP-related metabolites may also serve as an indicator for PMI estimation of corpses. The purpose of this study was to test this possibility. Firstly, this study optimized the detection method of ATP-related metabolites in skeletal muscles of rat. Moreover, in animal experiment, ATP-related metabolites (ATP, ADP, AMP, IMP, Ino, Hx) in lower hind limb skeletal muscles of sixty rats were measured by RP-HPLC at different PMI for 168 h at 20 °C ± 1 °C, the change of freshness indicators (K value, K1 value, K0 value, H value, P value, G value, IMP ratio) were carefully analyzed, and investigate the relationship between them and PMI. The overall results showed that IMP, AMP, Hx, Total metabolites, K value, K1 value, K0 value, H value, P value, G value, and IMP ratio in skeletal muscles changed significantly with PMI (R2 = 0.864-0.971, all P < 0.01) while ATP, ADP, Ino, IMP precursors and IMP degradants had minor changes during the same period (R2 = 0.171-0.706). Specifically, significant linear positive correlations between H value of skeletal muscles and PMI were found, and the coefficients of their regression functions were R2 = 0.971. The correlation between AMP and PMI was slightly lower (R2 = 0.864), but the scope of PMI estimation was the widest (168 h). It can be concluded that the determination of ATP-related metabolites in skeletal muscle may be a potential tool in the PMI estimation. However, more researches on its influencing factors are needed to facilitate its final use in practice.


Matrix metalloproteinase 2 (MMP2) and MMP9 are produced by kidney collecting duct principal cells but are differentially regulated by SV40 large-T, arginine vasopressin, and epidermal growth factor.
We analyzed the expression and regulation of matrix metalloproteinase 2 (MMP2) and MMP9 gelatinases in a rabbit kidney collecting duct principal cell line (RC.SVtsA58) (Prié, D., Ronco, P. M., Baudouin, B., Géniteau-Legendre, M., Antoine, M., Piedagnel, R., Estrade, S., Lelongt, B., Verroust, P. J., Cassingéna, R., and Vandewalle, A. (1991) J. Cell Biol. 113, 951-962) infected with the temperature-sensitive (ts) SV40 strain tsA58. At the permissive temperature (33 degreesC), cells produced only MMP2. Shifting cells to a nonpermissive temperature (39.5 degreesC) induced a marked increase in total gelatinolytic activity due to an increase of MMP2 and an induction of MMP9 synthesis. This effect was attributed to large-T inactivation at 39.5 degreesC because it was abolished by re-infecting the cells with wild-type SV40 strain LP. Run-on experiments showed that negative regulation of MMP2 and MMP9 by large-T was transcriptional and posttranscriptional, respectively. MMP2 and MMP9 were also produced by primary cultures of collecting duct cells. In rabbit kidney, both MMP2 and MMP9 were almost exclusively expressed in collecting duct cells, where an unexpected apical localization was observed. Arginine vasopressin and epidermal growth factor, which exert opposite hydroosmotic effects in the collecting duct, also exhibited contrasted effects on MMP9 synthesis. Epidermal growth factor increased but arginine vasopressin suppressed MMP9 at a posttranscriptional level, whereas MMP2 was not affected. These results suggest a specific physiological role of MMP2 and MMP9 in principal cells of renal collecting duct.


Thin Ideal Internalization Assessment (THIINA): Development and Psychometric Validation of a New Measure of Female Body Image.
Thin ideal internalization is widely implicated in women's body image and eating disturbances. A recently proposed multidimensional operationalization of internalization suggests the brevity and construct validity of existing questionnaires may limit the assessment of thin ideal internalization. Therefore, this research aimed to develop a new questionnaire (i.e., Thin Ideal Internalization Assessment; THIINA) to comprehensively assess thin ideal internalization. In Study 1, 301 female participants were administered the THIINA. Exploratory factor analyses revealed the 17-item THIINA had a stable 3-factor structure reflecting thin idealization, thin overvaluation, and thin behavioral drive. In Study 2, 337 female participants were administered the THIINA and validation measures. Confirmatory factor analysis confirmed stability of the 3-factor structure and findings supported convergent, discriminant, and incremental validity of the THIINA. Support for temporal stability was found within a sub-sample of participants (n = 132). The THIINA demonstrated strong psychometric properties, a stable three-factor structure representing theoretically-driven domains, and support for the creation of a composite score representing overall thin ideal internalization. These findings suggest the multidimensional operationalization and measurement of thin ideal internalization could improve theoretical and clinical understanding of the impact of thin ideal internalization on women's body image and eating.


An Increased Lateral Femoral Condyle Ratio in Addition to Increased Posterior Tibial Slope and Narrower Notch Index Is a Risk Factor for Female Anterior Cruciate Ligament Injury.
To investigate the relationship between the lateral femoral condyle ratio (LFCR) among osseous morphologic characteristics of the knee and anterior cruciate ligament (ACL) injury in female patients. Inclusion criteria were female patients (ACL group, n = 59) undergoing primary ACL reconstruction from 2012 to 2018. Control female patients (control group, n = 58) were matched by age, height, and body mass index to ACL group. They had no meniscal or ligament tear, and no trochlear dysplasia on magnetic resonance imaging. The LFCR, notch width index (NWI), and posterior tibial slope (PTS) were measured and compared between the ACL and control groups. For each risk factor, the receiver operating characteristic curve and the area under the curve and its 95% confidence interval (CI) was calculated to determine the cutoff for detecting increased risk of ACL injury. The LFCR was significantly larger in the knees in the ACL group than in the control group (P = .001). The NWI was significantly smaller and the PTS was significantly larger in the knees in the ACL group than in the control group (P = .000, P = .000, respectively). The NWI (odds ratio [OR] 1.41; P = .000) was the most significant factor, followed by the PTS (OR 1.29; P = .003) and the LFCR (OR 1.26; P = .001). The area under the curve (0.67, 95% CI 0.58-0.77) for the LFCR had a sensitivity of 66% and specificity of 66% to predict an ACL injury. The cutoff of 63.9 was associated with an increased risk for ACL injury (OR 3.71; 95% CI 1.73-7.95). An increased LFCR was associated with female ACL injury. The LFCR, NWI, and PTS are predictive risk factors for an ACL injury. These findings need to be considered for clinician in identifying female patients at risk for an ACL injury. III, retrospective comparative prognostic trial.


Muscarinic acetylcholine receptors of rat lymphocytes.
The muscarinic acetylcholine receptors on rat lymphocytes were determined by [3H]quinuclidinyl benzilate binding studies. Binding of [3H]quinuclidinyl benzilate is rapid (half saturation occurred within 120 s) and highly specific. Muscarinic receptors reveal high lability. The number of receptors on plasma membrane depends on time of incubation as well as on composition of incubation medium. Lymphocytes incubated in nutrient-deficient media lose their surface receptors; enrichment of the medium causes reappearance of the receptors. Appearance of [3H]quinuclidinyl benzilate-binding sites in the incubation medium was under conditions in which binding to lymphocytes was decreased. It is concluded that the number of plasma membrane receptors on rat lymphocytes represents the dynamic steady state in which newly synthesized and degraded receptors are balanced.


Analysis of antibiotics from liquid sample using electrospray ionization-ion mobility spectrometry.
The recent findings of antibiotic residues in aquatic environment at trace level have gained much concern for the detrimental effect on ecological and human health due to bacterial resistance. Here, the feasibility of using electrospray ionization ion mobility spectrometry (ESI-IMS) for analysis antibiotics in liquid sample is demonstrated. Reduced mobilities and collision cross sections of 18 antibiotics are experimentally measured and compared with theoretical values according to mass-mobility correlation. Gentamicin is used as an example to investigate the capability of ESI-IMS for multi-component analysis of antibiotics. Mixtures of antibiotics at different concentrations are analyzed. The estimated detection limit for amoxicillin is 0.7 mg L(-1) (70 pg) and the linear range of response maintains over two orders. This method will be a potential technique for the analysis of antibiotics in aquatic environment.


Biostimulation of estuarine microbiota on substrate coated agar slides: a novel approach to study diversity of autochthonous Bdellovibrio- and like organisms.
Characterization of Bdellovibrio- and like organisms (BALOs) from environmental samples involves growing them in the presence of Gram-negative prey bacteria and isolation of BALO plaques. This labor-intensive enrichment and isolation procedure may impede the detection and phylogenetic characterization of uncultivable BALOs. In this article, we describe a simple slide biofilm assay to improve detection and characterization of BALO microbiota. Agar spiked with biostimulants such as yeast extract (YE), casamino acids (CA), or concentrated cells of Vibrio parahaemolyticus P5 (most widely used prey bacteria for isolation of halophilic BALOs) was plated onto buffed glass slides and exposed to water samples collected from Apalachicola Bay, Florida. After incubating for a week, diversity of the biofilm bacterial community was studied by culture-dependent and culture-independent molecular methods. The results revealed that most probable numbers (MPNs) of BALOs and total culturable bacteria recovered from YE agar slide were significantly higher than the numbers on CA- or P5-spiked agar slides. Polymerase chain reaction-restriction fragment length polymorphism followed by 16S rDNA sequencing of clones from different biostimulants resulted in identification of a plethora of Gram-negative bacteria predominantly from the alpha, gamma, delta-proteobacteria, and the Cytophaga-Flavobacterium-Bacteroides group. Corresponding to the higher biomass on the YE agar slide, the BALO clone library from YE was most diverse, consisting of Bacteriovorax spp. and a novel clade representing Peredibacter spp. Microbiota from all three biostimulated biofilms were exclusively Gram-negative, and each bacterial guild represented potential prey for BALOs. We propose the use of this simple yet novel slide biofilm assay to study oligotrophic aquatic bacterial diversity which could also potentially be utilized to isolate marine bacteria with novel traits.


Substrate-based peptidomimetic inhibitors of the Murray Valley encephalitis virus NS2B/NS3 serine protease: a P1-P4 SAR study.
Murray Valley encephalitis is an infectious disease spread by a mosquito-borne virus endemic in Papua New Guinea and northern Australia. In the past decade, it has spread to various regions of Australia and there is currently no therapeutic treatment against this disease. An attractive drug target is the viral serine protease NS2B/NS3, a critical enzyme involved in viral replication. Herein, we report the inhibitory activities of 37 C-terminal agmatine peptidomimetic inhibitors which led to the design of a novel structurally-constrained competitive inhibitor 38 possessing a Ki of 2.5±0.5 μM. We believe our data provides crucial insights into the viral protease active site specificity which could be used to facilitate drug design against Murray Valley encephalitis viral infections.


Analgesic Posture and Pelvic Morphology in Patients with Lumbar Disc Herniation.
Pelvic morphology is an important element in determination of spinal alignment. We retrospectively examined the correlation between spinal alignment, severity, and pelvic morphology in lumbar disc herniation (LDH) surgery. The study included 62 cases of paramedian LDH surgeries (L4-5: 19 cases; L5-S1: 43 cases). For all cases, we performed x-ray imaging of the whole spine in the standing position preoperatively and 1 week postoperatively and measured spinopelvic parameters. Comparing preoperative parameters of patients with 82 healthy subjects, we examined changes before and after surgery. We also examined the relationship between preoperative severity and parameters. Compared with healthy subjects, patients with LDH exhibited significantly decreased lumbar lordosis and sacral slope and increased pelvic tilt and sagittal vertical axis (P < 0.01). Japanese Orthopaedic Association score improved from 16.1 ± 4.6 preoperatively to 23.5 ± 3.2 1 week postoperatively (P < 0.01). Spinopelvic parameters observed preoperatively improved significantly 1 week postoperatively (P < 0.01). Correlation analysis did not confirm any correlation of severity with preoperative pelvic tilt, sagittal vertical axis, or pelvic incidence. However, cases with high pelvic tilt/pelvic incidence were significantly more likely to be severe cases (R2 = 0.08, P = 0.027). A significant decrease in pelvic tilt was observed in cases with a large improvement in postoperative Japanese Orthopaedic Association score (P = 0.031). For LDH cases, pelvic retroversion is important to avoid pain. The range of mobility for pelvic retroversion varies depending on pelvic morphology of individuals. In cases of LDH, ratio of pelvic tilt to pelvic incidence correlates strongly with severity.


Combined Liver-Kidney Transplantation in High Immunologic Risk Recipients: Kidney Graft Evolution.
Candidates for combined liver-kidney transplant frequently present pretransplant HLA sensitization in most cases related to elevated prior transfusion requirements. The urgency criterion and the evidence of the protective effect at the immunologic level of the liver graft open the possibility of carrying out the combined transplant in patients with an incompatible crossmatch. The single-center experience presented here describes the patient profile and kidney graft evolution observed in this highly sensitized group. Descriptive study of a series of 4 cases of patients with positive crossmatch results who received a simultaneous liver-kidney transplant at our center. Demographic characteristics and clinical information were collected and detailed. Before the transplant, 2 patients presented HLA class I antibodies and the other 2 showed both class I and II. The post-transplant crossmatch result was negative in 2 of the 4 patients. All received induction with Thymoglobulin. In the 2 patients in whom the crossmatch remained positive, treatment with plasmapheresis, intravenous immunoglobulins and rituximab was initiated, after which the crossmatch resulted negative. During follow-up, anti-HLA antibodies were monitored, with the presence of mainly class I antibodies with variable mean fluorescence intensity being detected in all but 1 patient. Renal graft function remained stable throughout the tracing without objectifying histologic signs of rejection during the first 6 months of evolution. In our experience, combined liver-kidney transplant in sensitized patients with an incompatible crossmatching test has presented satisfactory outcomes. Close clinical and analytical monitoring is essential.


Association of osteoprotegerin with impaired glucose regulation and microalbuminuria: the REACTION study.
High osteoprotegerin (OPG) has been reported in association with insulin resistance and type 2 diabetes. We aimed to evaluate the association of serum OPG with impaired glucose regulation (IGR) and microalbuminuria among middle-aged and older Chinese. Serum OPG was measured in 599 individuals with normal glucose regulation, 730 with impaired glucose regulation and 327 newly diagnosed patients with diabetes. Serum OPG was measured using ELISA methods and urine albumin/creatinine ratio was used to determine the urinary albumin excretion. Serum OPG levels were significantly higher in subjects with isolated impaired fasting glucose, isolated impaired glucose tolerance, combined impaired fasting glucose/impaired glucose tolerance and diabetes than in those with normal glucose regulation, whereas serum OPG levels were not different in the four groups with dysregulation of glucose metabolism. OPG was associated with a higher risk for IGR (OR 1.108 for each 0.1 μg/l increase in OPG, 95% CI 1.009-1.117, p = 0.01) after adjustment for gender, age, BMI, current smoking and alcohol intake, family history of diabetes, homeostasis model assessment of insulin resistance (HOMA-IR), lipid profile; the corresponding OR of combined impaired glucose regulation and type 2 diabetes was 1.121 (95% CI 1.101-1.141, p = 0.0005). OPG was associated with the risk of microalbuminuria (OR 1.025, 95% CI 1.006-1.044, p = 0.02) after adjustment for gender, age, current smoking, current alcohol intake, family history of diabetes, BMI, waist/hip ratio, HOMA-IR, eGFR and lipid profile. Serum OPG level is closely and independently associated with IGR and is an independent risk factor for microalbuminuria.


What Do Clinicians and Organizations Owe Patients With Recalled Implanted Devices or Materials?
Placement of prosthetic breast implants for augmentation or reconstruction is common. Two specific safety concerns are considered in this article: breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and complexes of symptoms known as breast implant illness. In response to a case involving a patient with concerns about BIA-ALCL, this commentary notes that triage, counseling, and treatment are guided in practice by available data in the literature. The commentary also discusses ethical considerations regarding breast implants and related illnesses.


[Infected cystic malformations of a seminal vesicle with ipsilateral uretero-renal agenesis. Description and discussion of the surgical approach].
The author reports a case of rare malformation affecting all of the elements derived from the Wolffian duct, the embryology of which is briefly reviewed. The clinical picture, as in the majority of previously published cases, was initially suggestive of acute prostatitis, but clinical, radiological and ultrasonographic examination revealed the malformation. The treatment is surgical and most authors prefer an intra-peritoneal transvesical approach.


Stable maintenance in chemostat-grown Escherichia coli of pBR322 and pACYC184 by disruption of the tetracycline resistance gene.
Plasmid stability was studied in antibiotic-free chemostat cultures. Disruption, either by deletion or insertion, of the tetracycline resistance gene in the EcoR1/EcoRV region of the cloning vector pBR322 or in the HindIII/BamH1 region of pACYC184 yields plasmids markedly more stable than the parent plasmids. Thus, at least for these two instances, cloning of a partitioning (par) locus is not prerequisite for plasmid maintenance.


Determination of Cell Membrane Capacitance and Conductance via Optically Induced Electrokinetics.
Cell membrane capacitance and conductance are key pieces of intrinsic information correlated with the cellular dielectric parameters and morphology of the plasma membrane; these parameters have been used as electrophysiological biomarkers to characterize cellular phenotype and state, and they have many associated clinical applications. Here, we present our work on the non-invasive determination of cell membrane capacitance and conductance by an optically activated microfluidics chip. The model for determining the cell membrane capacitance and conductance was established by a single layer of the shell-core polarization model. Three-dimensional finite-element analyses of the positive and negative optically induced dielectrophoresis forces generated by the projected light arrays of spots were performed, thus providing a theoretical validation of the feasibility of this approach. Then, the crossover frequency spectra for four typical types of cells (Raji cells, MCF-7 cells, HEK293 cells, and K562 cells) were experimentally investigated by using a micro-vision based motion-tracking technique. The different responses of these cells to the positive and negative ODEP forces were studied under four different liquid conductivities by automatic observation and tracking of the cellular trajectory and texture during the cells' translation. The cell membrane capacitance and conductance were determined from the curve-fitted spectra, which were 11.1 ± 0.9 mF/m2 and 782 ± 32 S/m2, respectively, for Raji cells, 11.5 ± 0.8 mF/m2 and 114 ± 28 S/m2 for MCF-7 cells, 9.0 ± 0.9 mF/m2 and 187 ± 22 S/m2 for HEK293 cells, and 10.2 ± 0.7 mF/m2 and 879 ± 24 S/m2 for K562 cells. Furthermore, as an application of this technique, the membrane capacitances of MCF-7 cells treated with four different concentrations of drugs were acquired. This technique introduces a determination of cell membrane capacitance and conductance that yields statistically significant data while allowing information from individual cells to be obtained in a non-invasive manner.


Expression of the polyubiquitin-encoding gene (ubq-1) in transgenic Caenorhabditis elegans.
The expression of the polyubiquitin-encoding gene (ubq-1) of Caenorhabditis elegans was analysed using transgenic nematode lines carrying translational ubq-1::lacZ fusions. Animals carrying a construct consisting of 938 bp of ubq-1 upstream sequences fused to lacZ (ubq938::lacZ) expressed beta Gal in embryos and in a tissue-general manner in 20% of L1 larvae. Somatic expression in later stages was usually confined to body muscle. Progressively larger deletions extending from the 5' end of ubq938::lacZ did not significantly alter the pattern of expression until 827 bp of sequence had been removed. Thus, sequences upstream from the transcription start point, including a G+C-rich block and a sequence resembling a TATA box (GAATAA), are not required to generate the expression pattern seen with ubq938::lacZ. Moreover, a basal level of expression was maintained in embryos when 903 bp were deleted. These results suggest that the promoter elements required for efficient expression of ubq-1 may reside within the transcribed region of the gene; alternatively, they must lie more than 1.7 kb upstream or 0.8 kb downstream from this region. Polymerase chain reaction analysis indicates that RNA molecules transcribed from the ubq938::lacZ and ubq delta 827::lacZ transgenes are trans-spliced to SL1, as is ubq-1 RNA.


Investigation of formation of well-known AGEs precursors in cookies using an in vitro simulated gastrointestinal digestive system.
The present study investigated the influence of in vitro stimulated digestion system on the content of glyoxal and methylglyoxal in commercial cookies. Glyoxal and methylglyoxal levels in different cookie samples were analyzed before and after in vitro digestion with High Performance Liquid Chromatography. Initial glyoxal and methylglyoxal values ranged between 42.9 and 126.6 µg/100 g, and between 22.9 and 507.3 µg/100 g, respectively. After in vitro digestion, formation of glyoxal and methylglyoxal values were increased up to 645% and 698%, respectively. The results revealed that in vitro stimulated digestion conditions strongly increased the amount of glyoxal and methylglyoxal in cookies. The amount of fructose was found to be more effective on the formation of both GO and MGO than those of glucose and sucrose. Further studies are needed to extensively investigate glyoxal and methylglyoxal formation under in vitro conditions in such foods.


Preparation of Adhesion Culture of Neural Stem/Progenitor Cells of the Olfactory Mucosa for the Treatment of Spinal Cord Injuries.
In this work, an optimal protocol was developed for obtaining adhesion culture of neural stem/progenitor cells (NSPC) of rat olfactory mucosa. During the development of the protocol, the conditions for cell culturing on adhesion substrates fibronectin and laminin in DMEM/F-12 and neurobasal media with the same culture additives were compared. Cell proliferation was maximum during culturing on both substrates in the neurobasal medium. Using the immunofluorescence method, we found that culturing on fibronectin in the neurobasal medium ensured maximum (52.22%) content of nestin-positive cells in comparison with other culturing conditions. The highest percentage of βIII-tubulin-positive cells was detected in cultures growing on fibronectin in the neurobasal medium and in DMEM/F-12 (79.11 and 83.52%, respectively). Culturing in adhesion cultures in the neurobasal medium on fibronectin allowed obtaining cultures enriched with NSPC and neurons differentiating from them in a quantity sufficient for further transplantation. The developed protocol can be recommended for obtaining NPSC from human olfactory mucosa for the treatment of spinal cord injuries.