The effect of a stress and anxiety coping program on objective structured clinical examination performance among nursing students in shiraz, Iran.
Evaluation of the competence and practical skills of nursing students, using the objective structured clinical examination (OSCE), is an integral part of the nursing education program. However, their performance could be negatively influenced by a significant level of stress and anxiety prior to the test. The present study aimed to evaluate the effect of an anxiety coping program on the OSCE performance level of first-year nursing students in Shiraz, Iran. The present quasi-experimental study was conducted among 76 nursing students; control group (n = 35) and intervention group (n = 41). To attain the study purpose, the intervention group received a pre-exam anxiety coping program that included relaxation and soothing techniques, diaphragmatic breathing training, and progressive muscle relaxation training accompanied by light instrumental music, while the control group received no intervention before the exam. Data collection instruments included a demographic characteristics form and State-Trait Anxiety Inventory (STAI) questionnaire. Demographic characteristics of the participants indicated an overall homogeneity within the study population. The STAI questionnaire was filled in before and after the OSCE and the results were compared with those of the control group. The data were analysed using SPSS software (version 22.0). P < 0.05 was considered statistically significant. As a result of the anxiety coping program, a substantial reduction in the anxiety score (by 11.61 units) in the intervention group was observed. There was a significant difference in the pre- and post-exam anxiety scores between the control and intervention groups (P < 0.001). The anxiety coping program improved the examination results of nursing students in the final exam compared to the midterm results (an increase of 0.9487 units, P < 0.001). The anxiety coping program reduced the anxiety level among nursing students and improved their OSCE results. Our findings can be utilized to better evaluate clinical activities in different medical and paramedical groups. Moreover, educators can implement such coping programs prior to evaluations in order to effectively assess the knowledge, attitude, and performance of the students.


Robust, quick, and convenient intraoperative method to differentiate parathyroid tissue.
Identification of parathyroid tissue during surgery is necessary for its preservation in situ or for autotransplantation to avoid postoperative hypoparathyroidism. Frozen sections are the gold standard for distinguishing parathyroid tissue from other tissues during thyroidectomy. Although frozen sections are very accurate, they are costly and require pathologists and technical staff. Parathyroid tissue is rich in mitochondria, which harbor Krebs-cycle enzymes such as aspartate aminotransferase. In contrast, lactate dehydrogenase is expressed ubiquitously. These 2 enzymes are measured routinely as "leaked" enzymes. We hypothesized that the aspartate aminotransferase-to-lactate dehydrogenase ratio in suspended tissue could distinguish parathyroid tissue from other tissues. We analyzed 94 specimens (43 parathyroid, 19 thyroid cancers, 13 normal lymph nodes, 10 adipose, 6 thyroid, and 3 miscellaneous tissues) from 55 patients who underwent thyroid or parathyroid surgery between March 2018 and June 2019 in our institution. Trace amounts of remnant parathyroid tissue from autotransplantation specimens were suspended in 1 mL of normal saline and measured for aspartate aminotransferase and lactate dehydrogenase. Approximately 1 mm3 of apparently distinct tissue minced by scissors (eg, thyroid gland, metastatic lymph node, etc) or washouts of needles used for preoperative aspiration biopsy were also measured for comparison. The aspartate aminotransferase-to-lactate dehydrogenase ratios in suspended parathyroid tissue specimens were consistently greater than those of other tissues (P < .001, Mann-Whitney test); 0.27 was the optimal cutoff value with 100% sensitivity and specificity. This method distinguished parathyroid tissue quickly and conveniently from other tissues intraoperatively with minimum cost and without dedicated pathologic staff. This methodology may serve useful in decreasing the incidence of postoperative hypoparathyroidism, especially in settings with limited access to pathologists.


Evolution of milk composition, milk fat globule size, and free fatty acids during milking of dairy cows.
The objective of this study was to measure milk composition (fat, protein, and calcium contents; fatty acid profile), milk fat globule size, and free fatty acid content throughout milking. Composition was measured from milk samples collected every 1 min during morning milking in 2 previously published experiments. Experiments 1 and 2 used 9 and 6 dairy cows, respectively. From the beginning to end of milking in experiments 1 and 2, lactose content decreased (-0.45 percentage units), as did protein content (-0.28 and -0.17 percentage units, respectively). In contrast, fat content increased (+5.66 and +5.57 percentage units, respectively). Milk fat globule size increased (+1.51 and +0.43 µm, respectively), whereas free fatty acid content (measured after 24 h of storage at 4°C) decreased quickly during the first minutes (-0.45 mEq/100 g of fat from time point 1 to time point 4 in experiment 1, and -0.85 mEq/100 g of fat from time point 1 to time point 5 in experiment 2), and then largely stabilized, with a slight tendency to increase toward the end of milking period in experiment 2 (+0.32 mEq/100 g of fat). The evolution of milk fatty acid composition depended on the experiment. From the beginning to the end of milking, the concentration of C16:0 consistently increased (+3.4 wt/wt % in experiment 1 and +3.3 wt/wt % from time point 2 to time point 7 in experiment 2), whereas the C18:1/C16:0 ratio increased during the first minutes of milking and then slightly decreased (-0.050 in experiment 1 and -0.031 from time point 2 to time point 7 in experiment 2). Calcium content decreased in experiment 2 (-58 mg/kg). In conclusion, milk composition changed greatly during milking, suggesting that different mechanisms are involved in synthesis and excretion, depending on the type of milk component.


The muscular membrane and calcium activation of the contractile system of a lamellibranch smooth muscle (ABRM).
1. Thin bundles of fresh ABRM treated by EDTA solution or Triton x-100 0.1% can be brought like glycerol-extracted fibres through contraction-relaxation cycles by changing the free Ca2+ level of the bathing medium for 10-6 M to 10-9 M. The kinetics of isometric force development and relaxation has been studied in the two conditions i.e ionic strength 0.06 pH 6.5 and ionic strength 0.28, pH 7.0 which are known to induce the catch-state in glycerol extracted fibres. When the low Ca-2+ solution (10-9M) is substituted for the high Ca-2+ solution (10-6M) immediately after the maximal force has been developed, relaxation occurs at a higher rate at ionic strength 0928 and pH 6.5. In this last condition, no tension redevelops after a quick release applied during the slow relaxation. 2. During the plateau, in presence of Ca-2+ 10-6 M. a quick release applied at any time is followed by a large redevelopment of tension at ionic strength 0.06 and pH 6.5. At ionic strength 0.28 and pH 7.0, the tension redevelops only during the decreased from 10-6 to 10-9 M without any change in the time course of the tension maintained. 3. These results suggest that in EDTA and Triton X-100 treated fibres of Abrm, the catch-state is spontaneously induced after the activation of the contractile mechanism under the same conditions of ionic strengh and pH as in glycerol extracted fibres. However, in the EDTA and Triton treated fibres, the presence of a high free Ca-2+ level is not necessary to maintain the tension in the catch-state induced at ionic strength 0.28 and pH 7.0.


Gravitational effects on intracranial pressure and blood flow regulation in young men: a potential shunting role for the external carotid artery.
We sought to determine whether gravity-induced changes in intracranial pressure influence cerebral blood flow regulation. Accordingly, nine young healthy men were studied while supine (0°) and during mild changes in hydrostatic pressure induced by head-up tilt at +20° and +10° (HUT+20 and HUT+10) and head-down tilt at -20° and -10° (HDT-20, HDT-10). Blood flows were measured in the internal and external carotid and vertebral arteries (ICA, ECA, and VA). Intraocular pressure (IOP) was measured as an indicator of hydrostatic changes in intracranial pressure. A posture change from HUT+20 to HDT-20 increased IOP by +5.1 ± 1.9 mmHg (P < 0.001) and ECA blood flow (from 61.7 ± 26.1 to 87.6 ± 46.4 mL/min, P = 0.004) but did not affect ICA (P = 0.528) or VA (P = 0.101) blood flow. The increase in ECA flow correlated with the tilt angle and resultant changes in intracranial pressures (by IOP), thus indicating a passive hydrostatic gravitational dependence (r = 0.371, P = 0.012). On the contrary, ICA flow remained constant and thus well protected against moderate orthostatic stress. When ICA flow was corrected for the gravitational changes in intracranial pressures (by IOP), it demonstrated the same magnitude of gravitational dependence as ECA. These findings suggest that passive hydrostatic increases in intracranial pressure outbalance the concurrent increase in arterial feeding pressure to the brain and thus prevent cerebral hyperperfusion during HDT. The mechanism for maintaining constant cerebral flow was by increased ECA flow, thus supporting the role of these vascular beds as a shunting pathway.NEW & NOTEWORTHY We investigated whether gravity-induced changes in intracranial pressure influence cerebral blood flow regulation in young men. We recorded extra- and intracerebral blood flow during changes in posture, and data indicate that the external carotid artery may serve as an overflow pathway to prevent cerebral hyperperfusion during increases in cerebral arterial blood pressure.


Evidence of Resting-state Activity in Propofol-anesthetized Patients with Intracranial Tumors.
Resting-state (RS) networks, revealed by functional magnetic resonance imaging (fMRI) studies in healthy volunteers, have never been evaluated in anesthetized patients with brain tumors. Our purpose was to examine the presence of residual brain activity on the auditory network during propofol-induced loss of consciousness in patients with brain tumors. Twenty subjects with intracranial masses were prospectively studied by means of intraoperative RS-fMRI acquisitions before any craniectomy. After performing single-subject independent component analysis, spatial maps and time courses were assigned to an auditory RS network template from the literature and compared via spatial regression coefficients. All fMRI data were of sufficient quality for further postprocessing. In all but two patients, the RS functional activity of the auditory network could be successfully mapped. In almost all patients, contralateral activation of the auditory network was present. No significant difference was found between the mean distance of the RS activity clusters and the lesion periphery for tumors located in the temporal gyri vs. those in other brain regions. The spatial deviation between the activated cluster in our experiment and the template was significantly (P = 0.04) higher in patients with tumors located in the temporal gyri than in patients with tumors located in other regions. Propofol-induced anesthesia in patients with intracranial lesions does not alter the blood-oxygenation level-depended signal, and independent component analysis of intraoperative RS-fMRI may allow assessment of the auditory network in a clinical setting.


Mitochondrial thioredoxin-2 maintains HCN4 expression and prevents oxidative stress-mediated sick sinus syndrome.
Sick sinus syndrome (SSS) is associated with loss of HCN4 (hyperpolarization-activated cyclic nucleotide-gated potassium channel 4) function in the cardiac conduction system. The underlying mechanism for SSS remains elusive. This study is to investigate how mitochondrial oxidative stress induces HCN4 downregulation associated with in sick sinus syndrome. Trx2lox/lox mice were crossed with α-myosin heavy chain (α-Mhc)-Cre and Hcn4-CreERT2 deleter mice to generate Trx2 deletion mice in the whole heart (Trx2cKO) and in the conduction system (Trx2ccsKO), respectively. Echocardiography was applied to measure hemodynamics and heart rhythm. Histological analyses, gene profiling and chromatin immunoprecipitation were performed to define the mechanism by which thioredoxin-2 (Trx2) regulates HCN4 expression and cardiac function. Trx2cKO mice displayed dilated cardiomyopathy, low heart rate, and atrial ventricular block (AVB) phenotypes. Immunofluorescence revealed that HCN4 expression was specifically reduced within the sinoatrial node in Trx2cKO mice. Interestingly, Trx2ccsKO mice displayed low heart rate and AVB without dilated cardiomyopathy. Both mRNA and protein levels of HCN4 were reduced in the sinoatrial node, suggesting transcriptional HCN4 regulation upon Trx2 deletion. ChIP indicated that the binding of MEF2 to the HCN4 enhancer was not altered by Trx2 deletion; however, histone 3 acetylation at the MEF2 binding site was decreased, and expression of histone deacetylase 4 (HDAC4) was elevated following Trx2 deletion. Moreover, HDAC4 binding to the HCN4 enhancer was mediated by MEF2. Mitochondrial ROS were increased by Trx2 deletion and importantly, mitochondria-specific ROS scavenger MitoTEMPO suppressed HDAC4 elevation, HCN4 reduction, and sinus bradycardia in Trx2ccsKO mice. In the conduction system, Trx2 is critical for maintaining HCN4-mediated normal heart rate. Loss of Trx2 reduces HCN4 expression via a mitochondrial ROS-HDAC4-MEF2C pathway and subsequently induces sick sinus syndrome in mice.


Pedaling improves gait ability of hemiparetic patients with stiff-knee gait: fall prevention during gait.
Stiff-knee gait, which is a gait abnormality observed after stroke, is characterized by decreased knee flexion angles during the swing phase, and it contributes to a decline in gait ability. This study aimed to identify the immediate effects of pedaling exercises on stiff-knee gait from a kinesiophysiological perspective. Twenty-one patients with chronic post-stroke hemiparesis and stiff-knee gait were randomly assigned to a pedaling group and a walking group. An ergometer was set at a load of 5 Nm and rotation speed of 40 rpm, and gait was performed at a comfortable speed; both the groups performed the intervention for 10 min. Kinematic and electromyographical data while walking on flat surfaces were immediately measured before and after the intervention. In the pedaling group, activity of the rectus femoris significantly decreased from the pre-swing phase to the early swing phase during gait after the intervention. Flexion angles and flexion angular velocities of the knee and hip joints significantly increased during the same period. The pedaling group showed increased step length on the paralyzed side and gait velocity. Pedaling increases knee flexion during the swing phase in hemiparetic patients with stiff-knee gait and improves gait ability.


Renal infarction mimicking renal colic in patient with a prosthetic aortic valve.
A 31 year old man with prosthetic aortic valve replacement presented with sudden onset of colic right flank pain. Analysis of the urine revealed haematuria, and the international normalised ratio was suboptimal. The patient was misdiagnosed as having ureteral colic. On the second day, an ultrasound showed no signs of obstructive uropathy, and there was no evidence of absent function on intravenous pyelogram. Computed tomography with contrast agent was performed and revealed a right renal infarction. Renal angiography demonstrated total occlusion of the right renal artery. Fibrinolytic therapy and angioplasty were unsuccessful. To our knowledge, aortic prosthetic valve thrombus as a source of renal artery embolism mimicking renal colic has not been reported previously. This case underlines the importance of renal colic as a manifestation of renal infarction in patients with prosthetic valves and the need for a high index of suspicion of renal embolism.


[Percutaneous implantation of endoprosthesis for stenosis of branches of the pulmonary artery. Apropos of a case].
The authors report the case of a young man operated for tetralogy of Fallot and in whom surgical treatment of severe stenosis of the origins of the right and left pulmonary arteries had failed. Correction of these stenoses was obtained by implanting percutaneously an endoprosthesis in the right pulmonary artery with a good result: control angiography showed that the stenosis had disappeared and an increase in the right pulmonary artery diameter from: 5 to 11 mm, and the left pulmonary artery diameter from 7 to 14 mm. Perfusion pulmonary scintigraphy showed equal flow in the two lungs.


Role of hyperpolarization-activated cyclic nucleotide-gated ion channels in neuropathic pain: a proof-of-concept study of ivabradine in patients with chronic peripheral neuropathic pain.
Hyperpolarization-activated cyclic nucleotide-gated (HCN) ion channels mediate repetitive action potential firing in the heart and nervous system. The HCN2 isoform is expressed in nociceptors, and preclinical studies suggest a critical role in neuropathic pain. Ivabradine is a nonselective HCN blocker currently available for prescription for cardiac indications. Mouse data suggest that ivabradine in high concentrations is equianalgesic with gabapentin. We sought to translate these findings to patients with chronic peripheral neuropathic pain. We sought to translate these findings to patients with chronic peripheral neuropathic pain. We adopted an open-label design, administering increasing doses of ivabradine to target a heart rate of 50 to 60 BPM, up to a maximum of 7.5 mg twice daily. All participants scored their pain on an 11-point numerical rating scale (NRS). Seven (7) participants received the drug and completed the study. There was no significant treatment effect on the primary endpoint, the difference between the mean score at baseline and at maximum dosing (mean reduction = 0.878, 95% CI = -2.07 to 0.31, P = 0.1). Exploratory analysis using linear mixed models, however, revealed a highly significant correlation between ivabradine dose and pain scores (χ2(1) = 74.6, P < 0.001), with a reduction of 0.12 ± 0.01 (SEM) NRS points per milligram. The 2 participants with painful diabetic neuropathy responded particularly well. This suggests that ivabradine may be efficacious at higher doses, particularly in patients with diabetic neuropathic pain. Importantly, participants reported no adverse effects. These data suggest that ivabradine, a peripherally restricted drug (devoid of central nervous system side effects), is well tolerated in patients with chronic neuropathic pain. Ivabradine is now off-patent, and its analgesic potential merits further investigation in clinical trials.


Decreased clearance of Pseudomonas aeruginosa from airways of mice deficient in lysozyme M.
Lysozyme is a ubiquitous and abundant, cationic, antimicrobial polypeptide of leukocytes and epithelia, but its biological function in host defense is largely unexplored. To ascertain the role of lysozyme during bacterial infection of murine airways, we exposed the airways of lysozyme M-deficient (lys M-/-) mice to the pulmonary pathogen Pseudomonas aeruginosa and examined the host's response to infection. Despite partial compensation as a result of the appearance of lysozyme P in the infected airways of lys M-/- mice, these lys M-/- mice showed decreased clearance of P. aeruginosa compared with their lys M+/- or lys M+/+ littermates. Lysozyme contributes to optimal clearance of P. aeruginosa from the murine airways.


Human diploid fibroblast growth on polystyrene microcarriers in aggregates.
Polystyrene microcarriers were prepared in four size ranges (53-63 μm, 90-125 μm, 150-180 μm and 300-355 μm) and examined for ability to support attachment and growth of human diploid fibroblasts. Cells attached rapidly to the microcarriers and there was a direct relationship between cell attachment and microcarrier aggregation. Phasecontrast and scanning electron microscopic studies revealed that while aggregation was extensive, most of the aggregate consisted of void volume. Cell growth studies demonstrated that human diploid fibroblasts proliferated well in microcarrier aggregates, reaching densities of 2.5-3×10(6) cells per 2 ml dish after 6 days from an inoculum of 0.5×10(6) cells per dish. When cells were added to the microcarriers at higher density (up to 5×10(6) cells per 2-ml culture), there was little net growth but the cells remained viable over a 7-day period. In contrast, cells died when plated under the same conditions in monolayer culture. When the microcarriers were used in suspension culture, rapid cell attachment and rapid microcarrier aggregation also occurred. In 100-ml suspension culture, a cell density of 0.7×10(6) cells per ml was reached after 7 days from an inoculum of 0.1×10(6) cells. Based on these data, we conclude that microcarrier aggregation is not detrimental to fibroblast growth. These data also indicate that small microcarriers (53-63 μm) (previously thought to be too small to support the growth of diploid fibroblasts) can support fibroblast growth and this occurs primarily because microcarriers in this size range efficiently form aggregates with the cells.


[Factitious disorder--fever and delayed wound healing].
A 23-year-old woman was admitted to the department of rheumatology for detailed diagnostic tests for a suspected immune deficiency. Over the past 3 years, she has had repeated unexplained febrile episodes and impaired wound healing, which required permanent antibiotic treatment. Extensive tests initially showed no definitively diagnostic findings. Based on various clinical and inconsistencies in biochemic tests, the suspicion of a self-inflicted cause increased. In several interviews with a psychologist of the psychosomatic consultation service, the patient finally admitted manipulation by means of i. v. application of bacterially contaminated water. The self-inflicted injuries were interpreted as the consequence of a serious psychological trauma, as well as a self-healing attempt to prevent an emotional breakdown. The trust which the patient developed in her specialist carers after admitting the deception, made it possible to motivate her to continue psychotherapy. If a factitious disorder is suspected, the doctor should not be too precipitous in confronting the patient without expression of empathy, but rather respect the self-inflicted injury as a measure of self-preservation. Such non-confrontational behavior on the part of the carer enables the patient to accept the offer of psychotherapy without losing face.


'Unconventional' experiments in biology and medicine with optimized design based on quantum-like correlations.
In previous articles, a description of 'unconventional' experiments (e.g. in vitro or clinical studies based on high dilutions, 'memory of water' or homeopathy) using quantum-like probability was proposed. Because the mathematical formulations of quantum logic are frequently an obstacle for physicians and biologists, a modified modeling that rests on classical probability is described in the present article. This modeling is inspired from a relational interpretation of quantum physics that applies not only to microscopic objects, but also to macroscopic structures, including experimental devices and observers. In this framework, any outcome of an experiment is not an absolute property of the observed system as usually considered but is expressed relatively to an observer. A team of interacting observers is thus described from an external view point based on two principles: the outcomes of experiments are expressed relatively to each observer and the observers agree on outcomes when they interact with each other. If probability fluctuations are also taken into account, correlations between 'expected' and observed outcomes emerge. Moreover, quantum-like correlations are predicted in experiments with local blind design but not with centralized blind design. No assumption on 'memory' or other physical modification of water is necessary in the present description although such hypotheses cannot be formally discarded. In conclusion, a simple modeling of 'unconventional' experiments based on classical probability is now available and its predictions can be tested. The underlying concepts are sufficiently intuitive to be spread into the homeopathy community and beyond. It is hoped that this modeling will encourage new studies with optimized designs for in vitro experiments and clinical trials.


Auditory Effects of Multiple Impulses from a Seismic Air Gun on Bottlenose Dolphins (Tursiops truncatus).
Auditory thresholds were measured in three bottlenose dolphins before and after exposure to ten impulses from a seismic air gun. Thresholds were measured using behavioral and electrophysiological methods to determine the amount of temporary threshold shift induced. The results suggest that the potential for seismic surveys using air guns to cause auditory effects on dolphins may be lower than previously predicted; however, two of the three dolphins exhibited "anticipatory" behavioral changes at the highest exposure condition that suggested they were attempting to mitigate the effects of the exposures.


Immune checkpoint inhibitor therapy may increase the incidence of treatment-related necrosis after stereotactic radiosurgery for brain metastases: a systematic review and meta-analysis.
To compare the incidence of treatment-related necrosis between combination SRS+ICI therapy and SRS therapy alone in patients with brain metastases from melanoma and non-small cell lung cancer (NSCLC). A systematic literature search of Ovid-MEDLINE and EMBASE was performed up to August 10, 2020. The difference in the pooled incidence of treatment-related necrosis after SRS+ICI or SRS alone was evaluated. The cumulative incidence of treatment-related necrosis at the specific time point after the treatment was calculated and plotted. Subgroup and meta-regression analyses were additionally performed. Sixteen studies (14 on melanoma, 2 on NSCLC) were included. In NSCLC brain metastasis, the reported incidences of treatment-related necrosis in SRS+ICI and SRS alone ranged 2.9-3.4% and 0-2.9%, respectively. Meta-analysis was conducted including 14 studies on melanoma brain metastasis. The incidence of treatment-related necrosis was higher in SRS+ICI than SRS alone (16.0% vs. 6.5%; p = 0.065; OR, 2.35). The incidence showed rapid increase until 12 months after the SRS when combined with ICI therapy (14%; 95% CI, 8-22%) and its pace of increase slowed thereafter. Histopathologic diagnosis as the reference standard for treatment-related necrosis and inclusion of only symptomatic cases were the source of heterogeneity in SRS+ICI. Treatment-related necrosis tended to occur 2.4 times more frequently in the setting of combination SRS+ICI therapy compared with SRS alone in melanoma brain metastasis showing high cumulative incidence within the first year. Treatment-related necrosis should be considered when SRS+ICI combination therapy is used for melanoma brain metastasis, especially in the first year. • Treatment-related necrosis occurred 2.4 times more frequently in the setting of combination SRS+ICI therapy compared with SRS alone in melanoma brain metastasis. • Treatment-related necrosis more frequently occurred in brain metastases from melanoma than NSCLC. • Reference standard for treatment-related necrosis and inclusion of only symptomatic treatment-related necrosis were a significant source of heterogeneity, indicating varying definitions of treatment-related necrosis in the literature need to be unified.


Fully automatic computer-assisted pancreas imaging.
Good pancreas imaging is difficult to achieve even if a computer is applied. The special computer program proposed here was developed to optimize the results and to minimize the operator interaction with the data processing system.


Ultrastructural changes in the anterior horn synapses of rat spinal cord under different locomotor conditions.
Ultrastructural changes in axodendritic synapses of the spinal cord ventral horn are studied in rats subjected to different locomotor conditions: immobilization, control and physical loading. Enhanced motor activity results in a reduction of the number of synaptic vesicles in the axon terminal, as well as flattening and diminution of their size. Other changes correlated with the different motor regimes are likewise established in the number of terminal ending's mitochondria, in "active zones", in subjunctional dense bodies, and in the bouton area. Data are treated by means of variation analysis. The significance of differences is established by "T"-criterion.


Simple and rapid system for screening and identification of reducing sugars in urine.
As part of our screening programme for metabolic disorders we needed a rapid, simple, inexpensive means to detect reducing sugars in urine, with a simple but precise test for their identification. Our system comprises a bismuth reduction test for reducing sugars, with unidimensional thin layer chromatography on silica gel and color development with diphenylamine--aniline for definitive identification.


MUC1 expression in pulmonary metastatic tumors: a comparison of primary lung cancer.
MUC1 expression has been described as a predictor for tumor progression and worsening of prognosis in various human neoplasms. However, little is known about the role of MUC1 expression in pulmonary metastatic tumors. The aim of this study is to examine the clinicopathological significance of MUC1 expression in pulmonary metastatic tumors (PMT). One hundred forty-seven patients with PMT who underwent (18)F-FDG PET before metastasectomy were included in this study. Tumor sections were stained by immunohistochemistry for MUC1, glucose transporter 1 (Glut1), hypoxia-inducible-1α (HIF-1α) and vascular endothelial growth factor (VEGF). (18)F-FDG uptake and the expression of these biomarkers were correlated in primary lung cancer. MUC1 expression pattern was classified into high-grade polarized expression (HP), low-grade polarized expression (LP), or depolarized expression (DP) group. Of 147 patients, HP, LP and DP group were 9 (6%), 114 (78%) and 24 (16%), respectively. The expression of Glut1, HIF-1αand VEGF, and (18)F-FDG uptake were significantly higher in DP group than HP or LP groups. MUC1 expression with HP and DP pattern was significantly higher in primary lung cancer than in PMT, whereas, MUC1 expression with LP pattern yielded a significantly high positive rate in PMT. LP group was recognized in the majority of patients with pulmonary metastatic adenocarcinoma, especially colon cancer, whereas, HP group was significantly low in pulmonary metastatic adenocarcinoma as compared with primary adenocarcinoma. Polarized MUC1 has a different expression pattern between primary and metastatic tumors with adenocarcinoma, and depolarized MUC1 is closely associated with glucose metabolism and hypoxia.


Effect of penicillamine on the sensori-neural deafness of retinitis pigmentosa.
Four confirmed patients with retinitis pigmentosa and varying degrees of sensori-neural deafness were treated with penicillamine. The results indicated that the deafness improves with the therapy.


Stereoselective Synthesis of trans-Stilbenes through Silver-Catalyzed Self-Coupling of N-Triftosylhydrazones: An Experimental and Theoretical Study.
A silver-mediated homocoupling of N-triftosylhydrazones for the construction of trans-stilbenes has been presented. This protocol is characterized by its suitability for both inter- and intramolecular reactions, operational simplicity, high efficiency with excellent stereoselectivity, broad substrate scope, and good functional group tolerance. A plausible mechanism involving nucleophilic attack of in situ generated sulfonium ylides on silver carbene was proposed on the basis of experimental results and DFT calculations, which further indicates that π-π stacking interactions play a dominant role in stereoselectivity control.


Hepatitis A in urban Ireland.
To determine the prevalence of immunity to hepatitis A virus (HAV) infection in urban Ireland and to categorize the region into low, intermediate or high HAV endemicity, and to analyse the significance of certain commonly associated risk factors. Two hundred and thirty three volunteers were recruited from 6 general practices in Dublin, Ireland. There were 44 volunteers in the 10 to 19 yr age group, 40 in the 20 to 29, 42 in the 30 to 39, 43 in the 40 to 49 and 64 in the over 50 age groups. Each participant completed a detailed questionnaire and was tested for anti-HAV total antibody (primarily IgG) using a competitive ELISA assay. Urban Ireland was classified into the appropriate area of HAV endemicity according to the prevalence of immunity by age group. Risk factor differences were analysed for significance using the chi square test and Fisher's exact test. One hundred and fifty seven (67 per cent) volunteers were immune, of whom 20 (45 per cent) were in the 10 to 19 yr age group, 17 (43 per cent) in the 20 to 29, 30 (71 per cent) in the 30 to 39, 34 (79 per cent) in the 40 to 49 and 59 (92 per cent) in the over 50 age groups. Fifty-five per cent of the individuals studied below the age of 20 yr were non-immune. The immune rates over the age of 30 were significantly greater (p < 0.01) than those in the 10 to 29 age groups. Socioeconomic pattern in the total and 10 to 19 yr age group was a significant (p < 0.0002, p < 0.004 respectively) risk factor for infection. This study concludes that urban Ireland is an area of low HAV endemicity with age and socioeconomic status as the significant influences on seropositivity. This survey provides an insight into the changing epidemiology of HAV infection in Ireland and serves as a guide for immunisation of at risk population groups.


Towards Luminescent Vanadium(II) Complexes with Slow Magnetic Relaxation and Quantum Coherence.
Molecular entities with doublet or triplet ground states find increasing interest as potential molecular quantum bits (qubits). Complexes with higher multiplicity might even function as qudits and serve to encode further quantum bits. Vanadium(II) ions in octahedral ligand fields with quartet ground states and small zero-field splittings qualify as qubits with optical read out thanks to potentially luminescent spin-flip states. We identified two V2+ complexes [V(ddpd)2 ]2+ with the strong field ligand N,N'-dimethyl-N,N'-dipyridine-2-yl-pyridine-2,6-diamine (ddpd) in two isomeric forms (cis-fac and mer) as suitable candidates. The energy gaps between the two lowest Kramers doublets amount to 0.2 and 0.5 cm-1 allowing pulsed EPR experiments at conventional Q-band frequencies (35 GHz). Both isomers possess spin-lattice relaxation times T1 of around 300 μs and a phase memory time TM of around 1 μs at 5 K. Furthermore, the mer isomer displays slow magnetic relaxation in an applied field of 400 mT. While the vanadium(III) complexes [V(ddpd)2 ]3+ are emissive in the near-IR-II region, the [V(ddpd)2 ]2+ complexes are non-luminescent due to metal-to-ligand charge transfer admixture to the spin-flip states.


Antidepressant resistance in adolescents with major depressive disorder: A nationwide longitudinal study.
Studies have suggested that psychiatric comorbidities have major effects on antidepressant resistance in adult patients with major depressive disorder (MDD). However, the association between psychiatric comorbidities and antidepressant resistance remains unclear in adolescents with MDD. A total of 10,624 adolescents with MDD were selected from the Taiwan National Health Insurance Research Database between 2001 and 2010 and followed for one year. Treatment-resistant depression (TRD) was defined as unresponsiveness to at least two antidepressants, and treatment resistant tendency was defined as unresponsiveness to the first antidepressant. Psychiatric comorbidities, such as anxiety disorders, substance use disorders, and attention deficit hyperactivity disorder (ADHD), were assessed as confounding factors. In our study, only 1.7% (n = 184) of adolescents with MDD met the TRD criteria but 23.3% (n = 2480) were classified as exhibiting treatment resistant tendency. Anxiety disorders (OR: 2.34, 95% CI: 1.73-3.16) and substance use disorders (OR: 2.41, 95% CI: 1.28-4.54) exhibited a correlation with TRD, and ADHD (OR: 1.34, 95% CI: 1.08-1.66) was associated with treatment resistant tendency. Approximately one-fourth of adolescents with MDD respond poorly to the first antidepressant treatment. The psychiatric comorbidities of anxiety disorders, substance use disorders, and ADHD may increase the risk of treatment resistance in adolescents with MDD.


Assessment of sediment quality in two important areas of mariculture in the Bohai Sea and the northern Yellow Sea based on acid-volatile sulfide and simultaneously extracted metal results.
The surface sediments from Laizhou Bay (LB) and the coastal sea around Zhangzi Island (ZI) were analyzed for acid-volatile sulfide (AVS) and simultaneously extracted metals (SEMs) to assess the sediment quality. These two areas, especially LB, are important mariculture bases in China and are significantly affected by the Yellow River. The concentrations of AVS ([AVS]) and SEM ([SEM]) varied in the ranges 0.71-11.03 and 0.10-0.74 μmol g(-1) dry weight, respectively. [AVS] was generally low in the river outlet area and increased in the seaward direction in LB. [AVS] was significantly and positively correlated with TOC. [SEM] was significantly and positively correlated with TOC, the water content of sediment and the fine sediment fraction and it was significantly and negatively correlated with coarse sediment fraction. The obtained results suggest that the surface sediments of LB and ZI were of high quality and not likely to cause negative effects on their ecosystems.


[Anxiety in times of COVID-19 and other health crises].
Epidemics and pandemics and the measures taken to contain their spread are accompanied by numerous stressors, which can lead in particular to severe anxiety. This article describes the components and determinants of these anxiety symptoms, potential resilience and risk factors and appropriate recommendations for action. The article presents an overview of research results regarding COVID-19 and previous epidemics and pandemics (e.g., HIV, SARS, MERS, Ebola and swine flu). Furthermore, official recommendations for action are presented. Anxiety symptoms frequently occur in epidemics and pandemics, especially in the early phase and usually decrease in the further course. Although other aspects of different infectious diseases vary, the associated fears are similar and include e.g. the fear of health-related, social and economic consequences. Resilience and risk factors in various epidemics and pandemics are comparable. Self-efficacy expectation, tolerance of uncertainty, normalization, routines, safety and social support usually have a protective effect. In contrast, excessive media consumption, female gender, work in a medical context, suppression, pre-existing diseases, unhealthy behavior and closer exposure to the virus are often accompanied by more severe anxiety. Fears should be observed and addressed in order to reduce pathological processes, especially in vulnerable groups. It is advisable to promote resilience factors and to counteract risk factors with preventive and therapeutic measures. For this purpose, the development and empirical testing of specific interventions as well as further longitudinal studies are needed.


The Yin-Yang personality from biopsychological perspective using revised Sasang Personality Questionnaire.
The biopsychological, pathological and physical characteristics of Yin-Yang (Eum-Yang in Korean) have been suggested using Sasang Personality Questionnaire (SPQ), however, the revision of SPQ is required for escalating its clinical use and multidimensional study on Yin-Yang. 274 university students were recruited to complete the SPQ, candidate items of revised SPQ (rSPQ) along with the Temperament and Character Inventory (TCI). After selecting rSPQ items using Item Analysis and Explorative Factor Analysis, its psychometric property was examined using Confirmatory Factor Analysis, Pearson's correlation and t-test. The biopsychological features of Yin and Yang personality groups based on rSPQ total score were illustrated with the TCI using ANOVA and Profile Analysis. The behavior, cognition and emotion subscales of 15-item rSPQ had robust psychometric construct and showed distinctive psychological characteristics of Yin-Yang. The rSPQ-total score was correlated positively with SPQ-total (r = 0.644, p < 0.01) and TCI Novelty-Seeking (r = 0.398, p < 0.01), and negatively with TCI Harm-Avoidance (r = -0.364, p < 0.01). And, the Yin personality group (34.45 ± 10.36 and 46.82 ± 12.27) has significantly different scores in Novelty-Seeking and Harm-Avoidance compared to Yang personality group (43.2 ± 9.1 and 36.53 ± 10.78). Yin and Yang personality groups showed distinctive TCI subscale profiles as shown in previous studies. The current study showed the organized subscale structure and clinical validity of rSPQ for Yin-Yang personality, and it would provide foundation for East-West cross-cultural psychology and integrative medicine.


Research on the effects of diesel engine exhaust transport distance on particulate microstructure.
This study aims to reveal the evolutionary process of particles during the diesel exhaust transport process and to further understand the effects of diesel exhaust transport distance (DET) on a particulate microstructure. Specifically, the micromorphological, particle size distribution, and aggregate characteristics of particles as well as the variation of the structural characteristics of elementary carbon particles (ECPs) as DET changed were examined using an engine exhaust particle size spectrometer, a high-resolution transmission electron microscopy system, and a small-angle X-ray scattering system. The results show the following: As DET increased, the chains gradually lengthened, the extent of accumulation and stacking increased, and a number of clusters gradually rose. The average particle diameter increased from 23.1 nm at 0 m to 92.7 nm at 3 m. In addition, as DET increased, the number of accumulation-mode particles, the number of folded, curved carbon layers in the inner core of carbon particles, and the disorderliness of carbon layers in the outer shell of carbon particles all increased. Moreover, the boundary between the inner core and the outer shell became increasingly obscure. As DET increased, there was a gradual decrease in the difference in electron density between particles, and the fractal dimensionality of the distribution, average cross-sectional size, radius of gyration, and axial length of pores were, respectively, 33.3%, 40%, 38.2%, and 50.3% less at 3 m than at 0 m. Besides that, the number of small (< 3 nm) pores gradually increased, and the number of large (> 10 nm) pores gradually decreased. Overall, as DET increased, pore size and number decreased. There was a gradual increase in the number of folded and curved carbon layers in the inner core of ECPs and an increase in the disorderliness of carbon layers in their outer shell as DET increased. Furthermore, the boundary between the inner core and the outer shell became increasingly obscure as DET increased. The crystallite size of ECPs decreased from 1.365 nm at 0 m to 1.098 nm at 3 m. This suggests that the number of continuously arranged carbon atoms decreased, the arrangement of carbon atoms was more disorderly, and the degree of graphitization decreased. As DET increased, there was a gradual increase in the interlayer spacing and curvature of ECPs. This suggests that increasing DET led to a more disorderly distribution of electron orbitals inside the carbon layers, less electron resonance stability in the carbon layers, greater oxidative activity of ECPs, and greater inherent oxidative capacity of particles.


Anisotropy of Transverse Spin Relaxation in H2O-D2O Liquid Entrapped in Nanocavities: Application to Studies of Connective Tissues.
The spin-spin relaxation in connective tissues is simulated using a model in which a connective tissue is represented by a set of nanocavities containing H2O-D2O liquid. Collagen fibrils in connective tissues form ordered hierarchical long structures of hydrated nano-cavities with characteristic diameter from 1 nm to several tens of nanometers and length of about 100 nm. We consider influence of the restricted Brownian motion of molecules inside a nano-cavity on spin-spin relaxation. The analytical expression for the transverse time T 2 for H2O-D2O liquid in contained a nanocavity was obtained. We show that the angular dependence of the transverse relaxation rate does not depend on the concentration of D2O. The theoretical results could explain the experimentally observed dependence of the degree of deuteration on the relaxation time T 2. Accounting the orientation distribution of the nanocavities well agreement with the experimental dependence of the relaxation for articular cartilage on the deuteration degree was obtained.


Vesicular Glutamate Transporter Expression Ensures High-Fidelity Synaptic Transmission at the Calyx of Held Synapses.
Recycling of synaptic vesicles (SVs) at presynaptic terminals is required for sustained neurotransmitter release. Although SV endocytosis is a rate-limiting step for synaptic transmission, it is unclear whether the rate of the subsequent SV refilling with neurotransmitter also influences synaptic transmission. By analyzing vesicular glutamate transporter 1 (VGLUT1)-deficient calyx of Held synapses, in which both VGLUT1 and VGLUT2 are co-expressed in wild-type situation, we found that VGLUT1 loss causes a drastic reduction in SV refilling rate down to ∼25% of wild-type values, with only subtle changes in basic synaptic parameters. Strikingly, VGLUT1-deficient synapses exhibited abnormal synaptic failures within a few seconds during high-frequency repetitive firing, which was recapitulated by manipulating presynaptic Cl- concentrations to retard SV refilling. Our data show that the speed of SV refilling can be rate limiting for synaptic transmission under certain conditions that entail reduced VGLUT levels during development as well as various neuropathological processes.


Is it safe for patients to drive after intra-articular knee injection?
Intra-articular knee injection is a central component in the current management of knee pain. While this is a routinely performed outpatient procedure, institutional policies for driving post injection differ. This study examines brake response times (BRTs) before and after intra-articular knee injection. Our hypothesis is that BRTs would not significantly differ and thus patients driving ability/safety is unaffected. Forty-five patients previously listed for right intra-articular knee injection were prospectively evaluated. Patients underwent baseline assessment of BRT prior to injection. All patients received 10 ml of fluid consisting of one milliliter of 10 mg/ml triamcinolone mixed with nine milliliters of 0.5% levobupivacaine. BRT was re-examined on the same day prior to discharge home. Pre- and post-injection BRTs were examined using the same machine and assessor. The mean age of the cohort was 64.0 ± 12.4 and compromised of 37.8% males. There was no significant difference in the mean pre- and post-injection braking time (0.83 ± 0.29 vs 0.78 ± 0.30 s, p = .42), or in the rate of failed braking time (11.1% vs 6.7%, p = .46). This study found that BRT did not significantly differ before and after the intra-articular injection, nor did it cause an increased number of patients failing their BRTs. These findings suggest patients should not be prevented from driving after intra-articular knee injection.


Numerical simulation for the control rod assembly drop time evaluation in a LFR.
During scram, the Control Rod Assembly (CRA) is quickly dropped into the core and as well, if any of the operating limits are exceeded, the CRA is dropped into the core within a stipulated time to shut down the reactor power as soon as possible. In this study, the Computational Fluid Dynamics (CFD) approach was used to investigate the CRA drop dynamics of a lead-based research reactor. To simulate the flow field around the CRA in the guide tube, a 3-dimensional model of the CRA in the LBE-filled guide tube was developed and discretized; and the averaged Navier-Stokes equations coupled with the dynamic mesh method were adopted. Considering the large mesh deformation in the LBE coolant domain while the CRA drops, the recently developed FSI method in the CFX code, namely the rigid body approach, was adopted, which falls under the monolithic method. In this method, the translational CRA wall, which is partially immersed in the LBE, was set as a rigid body. It has the advantage of updating and improving the mesh quality through the mesh and re-meshing technique during the process of computation. Compared with the results of the work done in the available literature, the CFD model proved to be applicable and reliable. From the results, the inherent high density among the LBE flow characteristics had the most influence on the drop time. The mass of the CRA impacts its driving force so that the drop time reduces when the CRA mass is increased. In conclusion, the method used in this study can be applied to compute and predict significant parameters which can serve as a reference for a suitable design of the CRA and its drive mechanism in the case of modification for safety.


Abortion in Nepal: perspectives of a cross-section of sexual and reproductive health and rights professionals.
Globally, women face many barriers in the attainment of sexual and reproductive health and rights (SRHR). Since 2002, the legalisation of abortion in Nepal has seen significant progress in the expansion of safe abortion and family planning services. This qualitative, exploratory study was conducted in 2014 and uses nine in-depth, open-ended interviews with a cross-section of SRHR professionals, to explore their perspectives on abortion in Nepal. The study was underpinned by the Assets Focused Rapid Participatory Appraisal (AFRPA) research methodology and used the health information pyramid conceptual framework. Thematic content analysis revealed emerging themes relating to barriers to access and uptake of skilled safe abortion services and post-abortion family planning. Findings also emphasised current practical and legal components relating to the provision of medical abortion through pharmacies and highlighted issues of sex-selective abortion within the predominantly patriarchal society. Effective and ongoing sector-wide monitoring and evaluation of safe abortion services and their staff is essential for women in Nepal to have adequate access to effective and efficient safe abortion services, access to contraception and sexual and reproductive health (SRH) information post-abortion and to ensure adherence to current Safe Abortion Policy. It is critical that the unsafe (less and least safe) provision of medical abortion through pharmacies and sex-selective abortion continues to be investigated and that innovative strategies are formulated to ensure the cultural, reproductive and sexual health and rights of Nepali women are realised.


Maximizing Solid Organ and Face Transplant Procurement Team Coordination: The Posterior Tibial Artery Flap as an Ideal Sentinel Flap.
Face transplantation became a reality with the first case performed in 2005. Facial tissue allograft procurement is technically complex and time-intensive. Brain-dead deceased donors are frequently, if not always, multiorgan donors. Every effort should be made during face allograft recovery to minimize any risk to the recovery of lifesaving solid organs. Some programs require the procurement of a myofascial vascularized skin graft to function as a sentinel flap allowing frequent monitoring for rejection without negatively impacting the esthetics of the face graft. Up till now, the flap used has been the radial forearm flap. Procuring the radial forearm flap places the procuring team in close proximity to the head and torso, where the face recovery and the solid organ recovery teams would require unhindered access. Here, we present the posterior tibial artery flap as an alternative flap that would provide benefits to the coordination of the multiple teams working to procure organs from a deceased donor.


Comprehensive investigation on the metabolism of emodin both in vivo and in vitro.
Emodin is a natural anthraquinone, which displays numerous pharmacological activities, including anti-tumor, anti-inflammation and immunosuppression. However, there was no comprehensive study on its absorption, metabolism, distribution, and excretion. In order to further evaluation on the possibility of drug development of emodin, both in vivo and in vitro experiments were fulfilled in this study. The results showed that the absolute bioavailability of emodin is approximately 3.2%. Furthermore, about 56% of emodin was unabsorbed and mainly excreted into feces as prototype. The absorb constituent could be rapidly metabolized as hydroxylated and glucuronidated metabolites. Both prototype and metabolites of emodin absorbed into the body circulation were predominantly distributed in kidney. Hydroxyed metabolites were predominantly excreted via urine and feces and glucuronidated metabolites were predominantly excreted via urine and bile. CYP1A2, CYP2E1, UGT1A1, UGT1A9, and UGT2B7 played a key role in the metabolism of emodin in liver microsomes of rats. To the best of our knowledge, this is the first comprehensive study on the absorption, metabolism, distribution, and excretion of emodin, and our results could help to understand both pharmaceutical and toxicological effects of emodin greatly.


Elicitor-mediated induction of tryptophan decarboxylase and strictosidine synthase activities in cell suspension cultures of Catharanthus roseus.
Treatment of one cell line (No. 615) of Catharanthus roseus c.v. Little Delicata with an elicitor preparation of autoclaved and homogenized Pythium aphanidermatum culture resulted in rapid accumulation of indole alkaloids. Alkaloid formation was preceded by rapid transient increases in the extractable activities of the enzymes tryptophan decarboxylase and strictosidine synthase. The induction of these two enzyme activities occurred when cells were transferred to alkaloid production medium or treatment with fungal elicitors. Treatment of this cell line with translational or transcriptional inhibitors prevented the Pythium-induced increases of enzyme activity as well as alkaloid accumulation. When cells were transferred to alkaloid production medium the induction of strictosidine synthase activity preceded that of tryptophan decarboxylase by many hours even when cells were also treated with Pythium elicitor. Results suggested that tryptophan decarboxylase induction proceeds only when endogenous tryptamine levels were decreased by two-third. The internal cellular level of tryptamine, therefore, could regulate expression of tryptophan decarboxylase, whereas induction of strictosidine synthase or of another enzyme in the biosynthetic pathway could control channeling of tryptamine into alkaloids. The results demonstrate that fungal elicitors can be used to facilitate studies of the factors which regulate expression of indole alkaloid pathway enzymes and their ultimate pathway products.


Arsenic inhibits neurofilament transport and induces perikaryal accumulation of phosphorylated neurofilaments: roles of JNK and GSK-3beta.
The environmental neurotoxin arsenic has recently been associated with altered neurofilament (NF) content in sciatic nerve. We examined herein the impact of sodium arsenite (the inorganic form of arsenic) on NF dynamics. Treatment of differentiated NB2/d1 cells and cultured dorsal root ganglion neurons decreased NF transport into axonal neurites and increased perikaryal phospho-NF immunoreactivity. Both of these effects were prevented by a pharmacological inhibitor (SP600125) of c-jun terminal kinase and by expression of a dominant-negative form of this kinase. Arsenic-induced inhibition of NF transport was prevented by treatment with lithium, a selective inhibitor of glycogen synthase kinase-3beta. Pharmacological inhibitors of cyclin-dependent kinase 5 and p38 mitogen-activated protein kinase did not attenuate the effects of arsenic on NF dynamics. These latter findings suggest that this environmental neurotoxin could contribute to peripheral neuropathy by perturbing NF dynamics.


Restoration of anthropometric, biochemical and histopathological alterations by Lactobacillus casei supplementation in Giardia intestinalis infected renourished BALB/c mice.
The present study describes the in vivo ameliorating effect of Lactobacillus casei supplementation in renourished Giardia intestinalis infected BALB/c mice. It was observed that daily administration of probiotic 7 days prior to Giardia-infection to renourished mice, efficiently reduced the excretion of Giardia cysts and trophozoite counts, along with significant increased fecal lactobacilli counts compared with Giardia-infected mice. It was also observed that oral feeding of probiotic to renourished-Giardia-infected mice abrogated all the anthropometric and biochemical anomalies. Histologically, morphological and cellular alteration of microvillus membrane integrity revealed that probiotic administration further ameliorated the mucosal damage in renourished-probiotic-Giardia-infected mice compared to severe microvillus atrophy, oedematous, vacuolated epithelial cells and ileitis in renourished-Giardia and Giardia-infected mice. Thus, it is suggested that probiotic used as the functional food helps in restoration of anthropometric, biochemical alterations and atrophied gut by enhancing the goblet cells and reducing the giardiasis.


Image-guided tumour biopsies in a prospective molecular triage study (MOSCATO-01): What are the real risks?
To evaluate efficacy, complications and preprocedural risk factors for percutaneous image-guided core needle biopsy of malignant tumours for genomic tumour analysis. Procedural data for core biopsies performed at a single centre for the MOSCATO-01 clinical trial were prospectively recorded between December 2011 and March 2016. Data assessed included patient demographics, tumour characteristics, procedural outcomes and complications. A total of 877 biopsies were performed under computed tomography (38.4%) or ultrasound guidance (61.6%) for tumours in the liver (n = 363), lungs (n = 229), lymph nodes (n = 138), bones (n = 15) and other miscellaneous sites (n = 124). Each biopsy harvested a mean 4.4 samples [1-15], with adequate tumour yield for genomic analysis in 95.3% of cases. Procedural complications occurred in 89 cases (10.1%), with minor grade I complications in 59 (66.3%); grade II in 16 (18%) and grade III in 14 (15.7%). No grade IV complications and no procedure-related death occurred. The most common complications were pneumothorax (51/89, 57.3%), haemorrhage (24/89, 27%) and pain (8/89, 8.9%). Predictive factors for complications by univariate analysis included biopsied organ (lung vs other), sample number, prone position, lesion size, lesion depth and biopsy approach. By multivariate analysis, only pulmonary biopsy was a significant risk factor (odds ratio = 27.23 [4.93-242.76], p < 0.01). Percutaneous image-guided core needle biopsy in cancer patients provides an effective method to obtain molecular screening samples, with an overall low complication rate. Lung mass biopsies present a higher risk of complication, although complications are manageable by minimally invasive techniques without prolonged sequelae.


Correction: Shi, H., et al. Arctigenin Attenuates Breast Cancer Progression through Decreasing GM-CSF/TSLP/STAT3/β-Catenin Signaling. Int. J. Mol. Sci. 2020, 21, 6357.
The authors wish to make the following correction to this paper [...].


Structure-guided design of C2-symmetric HIV-1 protease inhibitors based on a pyrrolidine scaffold.
Infections with the human immunodeficiency virus, which inevitably lead to the development of AIDS, are still among the most serious global health problems causing more than 2.5 million deaths per year. In the pathophysiological processes of this pandemic, HIV protease has proven to be an invaluable drug target because of its essential role in the virus' replication process. By use of pyrrolidine as core structure, symmetric 3,4-bis-N-alkylsulfonamides were designed and synthesized enantioselectively from D-(-)-tartaric acid as a new class of HIV protease inhibitors. Structure-guided design using the cocrystal structure of an initial lead as starting point resulted in a second series of inhibitors with improved affinity. The binding modes of four representatives were determined by X-ray crystallography to elucidate the underlying factors accounting for the SAR. With this information for further rational design, the combination of suitable side chains resulted in a final inhibitor showing a significantly improved affinity of K(i) = 74 nM.


Health ramifications of the obesity epidemic.
For the first time in human history, the numbers of overweight and underweight individuals are about the same, at 2.1 billion each. Along with the current worldwide obesity epidemic is the explosion of obesity- and overweight-related health problems, including diabetes and the metabolic syndrome, musculoskeletal disorders,cardiovascular disease, pulmonary disorders, and certain forms of cancer. Obesity and overweight account for a significant percentage of overall health care costs and contribute significantly to morbidity and mortality in the United States and around the world.


An electrochemical genosensor for Leishmania major detection based on dual effect of immobilization and electrocatalysis of cobalt-zinc ferrite quantum dots.
Identification of Leishmania parasites is important in diagnosis and clinical studies of leishmaniasis. Although epidemiological and clinical methods are available, they are not sufficient for identification of causative agents of leishmaniasis. In the present study, quantum dots of magnetic cobalt-zinc ferrite (Co0.5Zn0.5Fe2O4) were synthesized and characterized by physicochemical methods. The quantum dots were then employed as an electrode modifier to immobilize a 24-mer specific single stranded DNA probe, and fabrication of a label-free, PCR-free and signal-on electrochemical genosensor for the detection of Leishmania major. Hybridization of the complementary single stranded DNA sequence with the probe under the selected conditions was explored using methylene blue as a redox marker, utilizing the electrocatalytic effect of the quantum dots on the methylene blue electroreduction process. The genosensor could detect a synthetic single stranded DNA target in a range of 1.0×10(-11) to 1.0×10(-18)molL(-1) with a limit of detection of 2.0×10(-19)molL(-1), and genomic DNA in a range of 7.31×10(-14) to 7.31×10(-6)ngμL(-1) with a limit of detection of 1.80×10(-14)ngμL(-1) with a high selectivity and sensitivity.


Intravitreal triamcinolone injection for chronic diabetic macular oedema with severe hard exudates.
The purpose of the study was to determine the efficacy and safety of intravitreal triamcinolone acetonide (TA) in chronic diabetic macular oedema with severe hard exudates. This prospective, interventional consecutive case series study consisted of 33 eyes of 28 patients with chronic diabetic macular oedema and severe foveal hard exudates who received an intravitreal injection of 4 mg of TA. The patients were divided into two groups according to the type of foveal hard exudates: group I, plaque-like (17 eyes) and group II, dot-like scattered hard exudates (16 eyes). The results of both groups, evaluated by colour fundus photography and fluorescein angiography, were compared and complications were recorded. All patients completed at least 6 months of follow-up. In all eyes, the hard exudates were completely resolved (24% in group I and 50% in group II) or decreased (76% in group I and 50% in group II). In group I, the mean diameter of the exudates plaques significantly decreased from 5.5+/-3.8 mm(2) in the pre-treatment period to 2.2+/-2.7 mm(2) at the end of the follow-up period. There was no recurrence of the hard exudates in either of the groups. The mean +/- SD visual acuity (VA) improved from 0.07+/-2.5 at the baseline to a maximum of 0.09+/-2.1 lines in group I (P<0.01) and from 0.13+/-3.9 to a maximum of 0.27+/-2.7 lines in group II (P<0.01). The mean VA improvement in group II was better than group I (3.2+/-2.5 vs. 1.4+/-1.0 lines, P<0.05). Intraocular pressure exceeded 21 mmHg in 10 eyes (30%), which was then controlled by topical medication. Three eyes (9%) exhibited signs of subcapsular cataract progression. Intravitreal TA appears to be a valuable treatment in chronic diabetic macular oedema with severe foveal hard exudates. In all eyes in this study the hard exudates were completely resolved or decreased, and the mean VA improved significantly in both groups. However, the VA improvement was significantly worse in eyes with plaque-like exudates suggesting the possible value of earlier treatment. Further studies would enable the assessment of the universal effectiveness of this treatment.


Trends in parastomal hernia repair in the United States: a 14-y review.
Parastomal hernia is the most common complication after stoma creation. Parastomal hernias can create significant morbidity, including patient discomfort, small bowel obstruction, and need for emergency surgery. We examined national trends in parastomal hernia repair (PHR) including annual frequency of procedure, patient characteristics, and same-admission complications. The 1998-2011 Nationwide Inpatient Sample was used to identify patients who underwent a PHR (International Classification of Disease, Ninth Edition, Procedure Code [ICD-9 PR] 46.42). PHRs were classified as PHR with concurrent resiting (ICD-9 PR 46.43), PHR with concurrent ostomy reversal (ICD-9 PR 46.52 or 46.51), or primary PHR. Patient characteristics were collected. Complications, length of stay, cost and inpatient mortality were identified. The estimated number of annual PHRs increased from 4150 to 7623 (P ≤ 0.01) for a total of 73,393 repairs. Thirty percent underwent a concurrent stoma reversal and 10% underwent a resiting. There was an upward trend in number of patients with ≥3 Elixhauser comorbidities (17%-44%, P < 0.01). Length of stay remained steady, with a median of 6.3 d and in-hospital annual mortality ranged from 1.8% to 3.9%. Mortality and emergency admission status were highest for patients who underwent primary PHR. The incidence of PHR nationwide is increasing and more than half of patients undergo primary repair. Although the surgical focus has moved toward prevention, parastomal hernia is a persistent complication of stoma creation. Further exploration is warranted to determine contributing factors to the observed increase in PHR and changes in surgical technique.


Sequence variation in a newly identified HLA-B35-restricted epitope in the influenza A virus nucleoprotein associated with escape from cytotoxic T lymphocytes.
Here, we describe a new HLA-B*3501-restricted cytotoxic T lymphocyte (CTL) epitope in the influenza A virus (H3N2) nucleoprotein, which was found to exhibit a high degree of variation at nonanchor residues. The influenza virus variants emerged in chronological order, and CTLs directed against old variants failed to recognize more recent strains of influenza A virus, indicating an escape from CTL immunity.


Extended osteocartilaginous spreader graft for reconstruction of deviated nose.
Correction of a deviated nose is a challenging problem for which different approaches may be considered. This study was designed to introduce a new technique for correction of a deviated nose with a high success rate. The study was a prospective follow-up of 59 patients with deviated nose who had undergone corrective surgery. An extended osteocartilaginous spreader graft was harvested from the quadrangular septum and the perpendicular plate of the ethmoid. After a medial osteotomy that was performed on the concave side, the nasal bone was lateralized and an extended osteocartilaginous spreader graft was inserted between the nasal bone and the septum to prevent further retraction of the concave side due to fibrotic scar tissue. On the contralateral side, a low lateral osteotomy was done as routine. The operation was done on the 59 cases with deviated nose. The subjects were followed up during a period of 8 months to 4 years. According to physical examination, postoperative photography, and patients' satisfaction, the final results were categorized as excellent, fair, or poor. Forty-eight patients (81.3%) were categorized as having excellent results. Eight patients (13.6%) showed fair improvement, while the results of surgery in only 3 patients (5.1%) were classified as poor. An extended osteocartilaginous spreader graft, with medial osteotomy and lateralization of the nasal bone on the concave side, is a new technique with a high success rate for correction of deviated nose.


Cryopreserved human fetal pancreas: a source of insulin-producing tissue?
Human fetal pancreata (HFP) were obtained from dilatation and extraction aborted fetuses of 11-18 weeks' gestation. The pancreas was excised under sterile conditions and kept in culture medium at 4 degrees C, prior to stepwise digestion into 50- to 150-micron fragments. The fragmented pieces were allowed to sediment by gravity, then transferred to tissue culture for 24-48 h, and cryopreserved. The freeze-thaw protocol used stepwise equilibration with dimethyl sulfoxide, nucleation of the sample at -10 degrees C, and a slow cooling rate of 0.25 degrees C/min to -40 degrees C, followed by submersion in liquid nitrogen (-196 degrees C). Rapid thawing at 300 degrees C/min from -196 degrees C was employed. Both fresh and frozen-thawed HFP fragments appeared viable as judged by light and electron microscopy, and secreted insulin in a perifusion system upon stimulation with glucose (28 mM) and theophylline (10 mM) or glucose (2.8 mM) and theophylline (10 mM). Six patients with Type I insulin-dependent diabetes mellitus, already requiring immunosuppression for a kidney transplant, had intraportal injection of 20 cryopreserved-thawed and pooled HFP fragments. Up to the 1-year post-transplant follow-up, there has been no evidence of in vivo insulin or C-peptide production. The usefulness of cryopreserved human fetal pancreata as a source of insulin-producing tissue for diabetic patients, therefore, remains to be demonstrated.


Modulation of mutagenicity by phosphorylation of mutagen-metabolizing enzymes.
In this Minireview, we discuss our findings on phosphorylation of cytochromes P450 (CYP) and influence of this modification on metabolic toxification and/or detoxification of a variety of mutagens. We show that phosphorylation drastically interferes with the mutagenicity of several classes of compounds which are of high human relevance (cytostatic drugs of the cyclophosphamide type, aromatic amines/amides, and nitrosamines). We illustrate this by describing the consequences of the stimulation of protein kinase A (with the example of CYP2B1 and CYP2E1), stimulation of protein kinase C, and inhibition of protein phosphatases PP1 and PP2A (with the example of CYP1A1 and CYP1A2). We discuss a possible mechanism governing these phosphorylation events.


A systematic review of lifestyle counseling for diverse patients in primary care.
Prior research and systematic reviews have examined strategies related to weight management, less is known about lifestyle and behavioral counseling interventions optimally suited for implementation in primary care practices generally, and among racial and ethnic patient populations. Primary care practitioners may find it difficult to access and use available research findings on effective behavioral and lifestyle counseling strategies and to assess their effects on health behaviors among their patients. This systematic review compiled existing evidence from randomized trials to inform primary care providers about which lifestyle and behavioral change interventions are shown to be effective for changing patients' diet, physical activity and weight outcomes. Searches identified 444 abstracts from all sources (01/01/2004-05/15/2014). Duplicate abstracts were removed, selection criteria applied and dual abstractions conducted for 106 full text articles. As of June 12, 2015, 29 articles were retained for inclusion in the body of evidence. Randomized trials tested heterogeneous multi-component behavioral interventions for an equally wide array of outcomes in three population groups: diverse patient populations (23 studies), African American patients only (4 studies), and Hispanic/Mexican American/Latino patients only (2 studies). Significant and consistent findings among diverse populations showed that weight and physical activity related outcomes were more amenable to change via lifestyle and behavioral counseling interventions than those associated with diet modification. Evidence to support specific interventions for racial and ethnic minorities was promising, but insufficient based on the small number of studies.


Variation in the precordial QRS transition zone in normal subjects.
From body surface potential map data for 51 normal young men (with QRS axis between 0 and 90 degrees) both the spatial QRS area vector and the isoarea map of the QRS were obtained. Acting on Grant's assumption that the transition zone defined a plane perpendicular to the spatial QRS vector, we determined the angular shift in altitude and azimuth required to move the spatial vector of each individual to the position of the group mean. We then shifted the precordial map of the transition zone of each individual with the same angular correction. These resulting transition zone boundaries clustered much closer to each other, but did not move into absolute coincidence. We interpreted the nearness-to-fit to be an estimate of the degree to which the precordial QRS configurations conformed to a common simple vector or dipolar pattern.


A novel nonmetallized tip for electrospray mass spectrometry at nanoliter flow rate.
We report the fabrication of a durable nonmetallized nanospray tip. This nanospray tip does not require complex preparation procedures such as chemical treatment, deposition of gold or SiOx vapor. It was fabricated by pulling a heated glass capillary of 1.1 mm internal diameter to produce a fine tip with an orifice of 10-15 microns in diameter. A 10 microns gold-plated tungsten wire was inserted through the capillary tip. This tungsten wire played a central role in the operation of this durable nanospray tip by providing electrical contact. This type of nanospray tip could withstand electrical discharges and sustained spraying of solution at nanoliter flow rate for more than 3 h. Using insulin (35 microM) and myoglobin (1 microM) solutions, useful mass spectrum could be acquired with low fmol sensitivity.


Quantitative heterogeneous immunoassays in protein modified polydimethylsiloxane microfluidic channels for rapid detection of disease biomarkers.
Conventional detection of disease biomarkers employs techniques such as lateral-flow assays or central laboratory-based enzyme-linked immunosorbent assays (ELISA). Miniaturization and performance improvement of such traditional immunoassays using microfluidic technologies has proved promising in producing rapid, sensitive and automated next-generation immunosensors for quantitative diagnoses in the point-of-care setting. In this article a poly(dimethylsiloxane) (PDMS)-based immunosensor is presented for rapid detection of C-reactive protein. PDMS is selected in part because of the vast popularity of using PDMS as a material for microfluidic devices and in part because of the challenge of obtaining a stable surface coating with PDMS for immunosensing applications. Practical procedures for fabrication, surface modification, and preservation of the microfluidic immuno-chips as well as detailed descriptions of performing the microfluidic heterogeneous assay are presented.


[Survey of the interpersonal attitudes using a computerized "homeostat" procedure].
A clear and easy-to-interpret format of displaying the results of group psychology studies as a summarized diagram of individual modes of handling the homeostatic tasks was used to makes conclusions about the social activity and ability of teamwork of each group member in two long-duration chamber experiments (SFINCCS'99 and EXEMSI'92).


Effects of aprepitant on cytochrome P450 3A4 activity using midazolam as a probe.
Aprepitant is a neurokinin(1) receptor antagonist that enhances prevention of chemotherapy-induced nausea and vomiting when added to conventional therapy with a corticosteroid and a 5-hydroxytryptamine(3) (5-HT(3)) antagonist. Because aprepitant may be used with a variety of chemotherapeutic agents and ancillary support drugs, which may be substrates of cytochrome P450 (CYP) 3A4, assessment of the potential of this drug to inhibit CYP3A4 activity in vivo is important. The effect of aprepitant on in vivo CYP3A4 activity in humans with oral midazolam used as a sensitive probe of CYP3A4 activity was evaluated in this study. In this open-label, randomized, single-period study, 16 healthy male subjects were enrolled. Subjects received one of two oral aprepitant regimens for 5 days (8 subjects per regimen): (1) 125 mg aprepitant on day 1 and then 80 mg/d on days 2 to 5 or (2) 40 mg aprepitant on day 1 and then 25 mg/d on days 2 to 5. All subjects also received a single oral dose of midazolam, 2 mg, at prestudy (3 to 7 days before aprepitant treatment) and on days 1 and 5 (1 hour after aprepitant administration). Coadministration of midazolam and 125/80 mg aprepitant increased the midazolam area under the plasma concentration-time curve by 2.3-fold on day 1 (P <.01) and by 3.3-fold on day 5 (P <.01), as compared with midazolam alone (prestudy). The 125/80-mg regimen of aprepitant also increased the midazolam maximum observed concentration by 1.5-fold on day 1 (P <.05) and by 1.9-fold on day 5 (P <.01). The midazolam half-life values increased from 1.7 hours (prestudy) to 3.3 hours on both day 1 and day 5. Coadministration of 40/25 mg aprepitant and midazolam did not result in significant changes in the midazolam area under the plasma concentration-time curve, maximum observed concentration, and half-life at either day 1 or day 5. The 5-day 125/80-mg regimen of aprepitant produced moderate inhibition of CYP3A4 activity in humans, as measured with the use of midazolam as a probe drug.


The effect of microorganisms on phytotoxicity of herbicides. III. Interaction of Bacillus sp. 72 with Venzar.
Interactions between Venzar and some metabolites of Bacillus ps. 72 were studied. This strain was found to produce flavonoids increasing the phytotoxicity of Venzar. Venzar action was also increased by NH4+ ions released aboundantly by the bacterial strain.


The effectiveness of compliance therapy on drug attitude among schizophrenic patients: a systematic review.
Schizophrenia is one of the most severe mental illnesses. Studies have found that 25% to 80% of all schizophrenic patients are non-compliant in medication-taking. Non-compliance of medication-taking is associated with higher readmission rates that result from relapses. Compliance therapy has been developed to modify negative beliefs toward medication and aims to improve drug attitude toward medication-taking. However, the effect of compliance therapy on drug attitude among schizophrenic patients is unclear. The objective of this review was to systematically review the available evidence with regards to the effect of compliance therapy on improving attitudes toward medication among schizophrenic patients. People diagnosed with schizophrenia, schizophrenia-form disorder, delusion disorder, schizo-affective disorder. TYPES OF INTERVENTION(S): The review considered studies that evaluated any form of compliance therapy. The comparator was standard care. TYPES OF STUDIES: The review considered randomized controlled trials. TYPES OF OUTCOMES: Drug attitude measured by the Drug Attitude Inventory. Database searches included MEDLINE, CINAHL, EMBASE, Science Direct, SocIndex, PsycINFO, ERIC, the Web of Science, the National Central Library and the Chinese Electronic Periodical Services databases. Searches were limited to English and Chinese. Search was limited to articles published from 1983 to 2013. Two reviewers independently appraised the studies using the standardized critical appraisal checklist for randomized control trial and pseudo-randomized trails designed by Joanna Briggs Institute. Disagreements were resolved through discussion. A standardized data extraction tool from the Joanna Briggs Institute was used. Data were extracted by two reviewers independently. Due to the concern of heterogeneity, meta-analysis was not considered as an appropriate approach to synthesize data in the current review. A narrative summary was therefore carried out. Three randomized controlled trials met the inclusion criteria. Two studies compared compliance therapy to standard care and both found compliance therapy to significantly improve drug attitude (Drug Attitude Inventory: 1 randomized controlled trial, n=28, mean difference between groups: 4.32, 'p'=0.001; 1 randomized controlled trial, n=47 mean difference between groups: 2.2, 'p<0.001').However, the other study reported that there was no statistically significant difference in the drug attitude score between the two groups (Drug Attitude Inventory: n=50, mean difference between groups: -2.1 'p=0.32'). The present review found that the majority of the included studies identified an effect of compliance therapy in improving drug attitude. However, the evidence is still weak as the outcome was from three small and heterogeneous studies. Standardization of the compliance therapy and well-designed study is needed to test the effect in the future. Only then, can the therapy be considered to improve attitude toward medication taking among schizophrenic patients.


Prevalence of Theileria in cattle in China: A systematic review and meta-analysis.
Theileria, one of the causative agents of blood protozoan, has brought a huge economic loss to the cattle industry worldwide. However, the epidemiology of Theileria in Chinese cattle has not been systematically investigated. This comprehensive review aimed at investigating the prevalence of Theileria infection in cattle in China. A total of 48 published papers on Theileria infection in cattle in China (including data from 21,366 animals) from inception to October 8, 2021 met the inclusion standard after searching in five databases (Technology Periodical Database, Wan Fang Database, China National Knowledge Infrastructure, PubMed, and ScienceDirect). The pooled prevalence of Theileria in cattle in China was 32.4% identified by using a random effects model. The prevalence in Northeastern China (45.3%) was higher than that in other regions. In the sex subgroup, the prevalence of Theileria was higher in females (48.9%) than that in males (45.8%). The prevalence of Theileria was higher in cattle of free range (34.4%) compared with that of intensive farming (22.3%). The prevalence prior to 2013 (36.1%) was higher than that after 2013 (33.6%). Among three cattle species, dairy cows had the lowest prevalence (21.5%). The prevalence of Theileria (T.) annulata (22.2%) and T. sergenti (26.2%) was higher than other species of Theileria (T. buffeli: 17.5%, T. luwenshuni: 0.9%, T. orientalis: 15.5%, T. ovis: 0.21%, T. sinensis: 20.2%, T. uilenbergi: 6.2%, Others: 0.9%). We also analyzed the impact of different geographic factor subgroups (longitude, latitude, precipitation, temperature, humidity, and altitude) on the prevalence of Theileria in cattle. Among them, climatic factors of longitude, latitude, precipitation, humidity, temperature were associated with the prevalence of Theileria. These analyses suggested that Theileria was common in cattle in China. Targeted prevention programs based on geographic and climatic conditions in different areas may play an important role in reducing Theileria infection among cattle.


Agrin and the organization of the neuromuscular junction.
Agrin is a component of the synaptic extracellular matrix and may regulate the organization of acetylcholine receptors and other synaptic molecules in both synapse regeneration and development. Analyses of cDNAs encoding agrin define a number of structural domains, including regions of homology to laminin, Kazal protease inhibitors, and epidermal growth factor repeats.


Twenty-six years of experience with the modified eloesser flap.
Empyema thoracis is a common thoracic problem with a multitude of therapeutic options. The modified Eloesser flap (MEF) is one means of dealing with this problem in selected complicated patients. The purpose of this study is to report our 26-year experience with the MEF. A review of 78 patients who had a MEF from 1975 to 2001 was performed. There were 52 males (67%) and 26 females (33%). Mean age was 59 +/- 14 years. The overall length of stay was 26 +/- 27 days, while mean postoperative length of stay was 16 +/- 17 days. Microbiology of the empyema cavity revealed a predominance of gram-positive organisms. Before a modified Eloesser flap, all patients failed initial conservative interventions and 23 patients (29%) failed surgical interventions. Operative indications were as follows: parapneumonic effusions, 35 patients (45%); postresectional, 23 patients (29%); tuberculosis related, 7 patients (9%); malignant effusion, 4 patients (5%); esophageal fistulas, 4 patients (5%); abdominal sepsis, 3 patients (4%); and hemothorax secondary to trauma, 2 patients (3%). The inverted-U incision was performed in all patients. Average rib resection was 3 +/- 1 ribs. There were no intraoperative complications and adequate drainage was achieved in all patients. Thirty-day morbidity/mortality was 4 patients (5%): 3 died of sepsis and 1 died of metabolic encephalopathy; although long-term follow-up (mean: 109 +/- 141 months) revealed no additional morbidity related to the MEF. We demonstrate that MEF can be performed as a safe, definitive surgical procedure for the treatment of chronic empyema thoracis. The MEF remains an important option in the surgical treatment of chronic, complicated empyema thoracis.


Surface-bonded ionic liquid stationary phases in high-performance liquid chromatography--a review.
Ionic liquids (ILs) are a class of ionic, nonmolecular solvents which remain in liquid state at temperatures below 100°C. ILs possess a variety of properties including low to negligible vapor pressure, high thermal stability, miscibility with water or a variety of organic solvents, and variable viscosity. IL-modified silica as novel high-performance liquid chromatography (HPLC) stationary phases have attracted considerable attention for their differential behavior and low free-silanol activity. Indeed, around 21 surface-confined ionic liquids (SCIL) stationary phases have been developed in the last six years. Their chromatographic behavior has been studied, and, despite the presence of a positive charge on the stationary phase, they showed considerable promise for the separation of neutral solutes (not only basic analytes), when operated in reversed phase mode. This aspect points to the potential for truly multimodal stationary phases. This review attempts to summarize the state-of-the-art about SCIL phases including their preparation, chromatographic behavior, and analytical performance.


Rapid construction of a patient-specific torso model from 3D ultrasound for non-invasive imaging of cardiac electrophysiology.
One of the main limitations in using inverse methods for non-invasively imaging cardiac electrical activity in a clinical setting is the difficulty in readily obtaining high-quality data sets to reconstruct accurately a patient-specific geometric model of the heart and torso. This issue was addressed by investigation into the feasibility of using a pseudo-3D ultrasound system and a hand-held laser scanner to reconstruct such a model. This information was collected in under 20 min prior to a catheter ablation or pacemaker study in the electrophysiology laboratory. Using the models created from these data, different activation field maps were computed using several different inverse methods. These were independently validated by comparison of the earliest site of activation with the physical location of the pacing electrodes, as determined from orthogonal fluoroscopy images. With an estimated average geometric error of approximately 8 mm, it was also possible to reconstruct the site of initial activation to within 17.3 mm and obtain a quantitatively realistic activation sequence. The study demonstrates that it is possible rapidly to construct a geometric model that can then be used non-invasively to reconstruct an activation field map of the heart.


Little League Shoulder and Subsequent Proximal Humeral Fracture in the Setting of Human Growth Hormone Use: A Case Report.
A 16-year-old right-hand dominant male baseball player presented with little league shoulder in the setting of recombinant growth hormone utilization for growth hormone deficiency. After a prolonged treatment course, including physical therapy and throwing programs, the patient returned to baseball but suffered an ipsilateral proximal humerus fracture around the growth plate. The occurrence of such an injury in the context of human growth hormone treatment merits consideration in youth athletes undergoing similar treatment regimens. Clinically, we recommend screening pediatric patients with sports-related epiphysiolysis for current or previous growth hormone use because of the possible prognostic implications of such treatment.


Can intensity in strength training change caloric expenditure? Systematic review and meta-analysis.
Strength training (ST) is considered an important strategy for maintaining body weight, as it promotes an increase in total energy expenditure (EE). However, the combination and manipulation of variables (intensity and volume) allow for different training adaptations. However, it remains unclear as to what is the most important variable between volume or intensity for example number of sets, repetitions, or total load for maximizing EE during ST. Several studies have analyzed the EE response in ST, but still unclear the variable is able to increase EE in the ST. This review aimed to investigate the effect of ST on EE in adults using a systematic literature review and subsequent meta-analysis. The search was performed on the electronic databases using the following keywords: strength training (resistance training; strength training; strength training method) and energy expenditure (energy metabolism; energy expenditure; caloric expenditure, caloric cost) with 'AND' and 'OR' combination. Manual searches of references were also conducted for additional relevant studies. After evaluating the inclusion and exclusion criteria, the selected studies were analysed according to strength training methods and the training variables used to measure EE. We identified two ST methods from the literature review: circuit training (CT) and traditional training (TT). Meta-analysis showed a significant effect on EE increase, which favour TT when compared with CT [-0·99 (95%CI: -1·96, -0·02), P<0·01] with I2 of 89% (P<0·01). After adjusting for bias risk, no significant differences were found in EE associated with intensity [-0·40, 95% CI (0·98, 0·18), P = 0·18). The present review and meta-analysis indicated that the intensity of exercise does not seem to be associated with an increase of EE in ST.


Altered glycemia and brain-update and potential relevance to the aging brain.
Hyperglycemia characterizes diabetes mellitus and is linked to its chronic and acute complications. Cognitive dysfunction in diabetes occurs especially in longstanding disease and with poor glycemic control. Recent data in humans suggests that hyperglycemia causes acute cognitive dysfunction. The underlying mechanisms are unknown but deserve further research as diabetes is becoming epidemic and will likely contribute increasingly to premature cognitive decline. The primary side effect of diabetes treatment is hypoglycemia, particularly resulting from insulin treatment. CNS adaptations to acute and chronic hypoglycemia underlie the inability of some people to promptly recognize and defend against the risk of serious hypoglycemia. Data from human and animal models may help explain how altered glycemia affects brain function both acutely and chronically. Improved mechanistic understanding of altered glycemia's effects could prevent the adverse impact of diabetes upon the CNS and give new insights into effects that may exist in normal aging.


Prenatal exposure to koumine results in cognitive deficits and increased anxiety-like behavior in mice offspring.
Koumine (KM) is a major alkaloid monomer in the traditional Chinese medicine herb Gelsemium elegans Benth that has exhibited therapeutic potential in clinical applications. However, the pharmacological toxicological mechanism of this drug has not been fully explored. The purpose of this study was to evaluate the impacts of KM administration at a therapeutic dose in offspring. On gestational day 0, mice were injected with KM once daily for 4 consecutive days. Male and female offspring were subjected to behavioral tests and neuropathological analyses from postnatal day 60. Prenatal KM exposure resulted in cognitive and memory impairments in the Morris water maze, Y-maze test, and novel object recognition test. The open field test and elevated plus maze test indicated that prenatal KM exposure induced anxiety-like behavior in offspring. Electrophysiological experiments demonstrated that KM exposure inhibited hippocampal long-term potentiation. Immunostaining for neurogenesis markers DCX and BrdU demonstrated that KM suppressed adult neurogenesis in the subgranular zone of the dentate gyrus. In addition, prenatal KM exposure induced a significant reduction in dendritic spine density in hippocampal neurons. Synaptic formation-related proteins were decreased in the KM group based on western blot. No sex differences in the effects of KM were observed. Collectively, our results indicate that prenatal KA exposure has detrimental neural effects on offspring. This study provides a preliminary preclinical toxicological assessment of the safety of KM use during pregnancy.


Update of Prior Probabilities by Minimal Divergence.
The present paper investigates the update of an empirical probability distribution with the results of a new set of observations. The update reproduces the new observations and interpolates using prior information. The optimal update is obtained by minimizing either the Hellinger distance or the quadratic Bregman divergence. The results obtained by the two methods differ. Updates with information about conditional probabilities are considered as well.


[Comparative study of the RNA-polymerase activity of non-pathogenic and pathogenic influenza viruses A and B].
Activity of RNA polymerase was studied in original non-pathogenic for mice viruses of influenza A and B (A/seal/Massachusetts 1/80, A/USSR 05/81, A/Philippines 2/82 and B/Singapore 227/79) and of their pathogenic derivatives. All the non-pathogenic viruses studied exhibited the low rate of transcriptase activity. Pathogenic derivatives of these strains exhibited higher activity of RNA polymerase, which was 1.5-3-fold higher as compared with the original strain. During passage of influenza viruses A and B in mice organism selection of the population appears to occur, which had the highest transcriptase activity.


Translation and cross-cultural adaptation of the risk assessment instrument TilThermometer for a Swedish version - patient handling in the healthcare sector.
Work-related musculoskeletal disorders are common in the healthcare sector due to exposure of physical demanding work tasks. Risk assessment is necessary to prevent injuries and promote a safety culture. The TilThermometer has proved to be useful in the Netherlands for assessing healthcare workers' physical exposure to patient handling. The aim of this study was to translate the risk assessment instrument TilThermometer from Dutch to Swedish, perform cross-cultural adaptation, and evaluate its linguistic validity to a Swedish healthcare context. Translation and validation process was performed according to following eight steps: 1) Translation (two translators), 2) Synthesis, 3) Back-translation (two back-translators), 4) Synthesis, 5) Linguistic review (one bilingual reviewer), 6) fifteen experts in a panel review according to Delphi-method, 7) Semi-structured interviewing eleven informants, analyzed using qualitative content analysis and step 8) discussion and input from creators of the instrument. A new Swedish version, the TilThermometer, was provided through the translation process (steps 1-5). The linguistic validity and usefulness were confirmed thru step 6 and 7. Consensus was reached in the expert review after two rounds, comments were analyzed and grouped into five groups. The qualitative content analyses of the interviews emerged in to three categories: 1) "User-friendly and understandable instrument", 2) "Further development", and 3) "Important part of the systematic work-environment management". In this study, the cross-cultural adaption and translation performed of the Swedish version of TilThermometer assured linguistic validity. This is this first phase before further testing the psychometrics aspects, inter-rater reliability and feasibility of TilThermometer. In the second phase TilThermometer will be implemented and evaluated together with other measures in the Swedish healthcare sector.