A study of the application of permeable pavements as a sustainable technique for the mitigation of soil sealing in cities: A case study in the south of Spain.
The use of 'Sustainable Urban Drainage Systems' (SuDS) has become a more sustainable alternative for managing stormwater, greatly reducing the effects of soil sealing. However, the lack of monitored projects is a barrier to their implementation, as the companies which manage sewer systems cannot quantify the impact and cost-efficiency of SuDS. This paper presents a project developed in the south of Spain, in which the hydrological performance of 3 types of permeable pavements has been analyzed. The efficiencies obtained (over 70%), are higher than or similar to the efficiencies of vegetated SuDS, demonstrating the capacity of these pavements for delaying catchment area response and slow flow velocities, reducing the operating costs of sewer systems and the flood risk, while also ensuring service conditions for cities and safety for pedestrian and vehicular circulation. This pilot site has generated results which are sufficiently consistent so as to be representative, and serve as a reference for other cities with a similar climate.


Ipsilateral ureteroureterostomy for single ureteral disease in patients with ureteral duplication: a review of 8 years of experience with 16 patients.
Ipsilateral ureteroureterostomy near the bladder (end-to-side anastomosis) for treatment of single ureteral disease in patients with complete ureteral duplication has been performed in 16 patients during the last 8 years. The operative technique, indications, results, followup and complications are presented. Reflux in the lower segment ureter was treated in 13 patients and upper segment ectopia or ureterocele was managed in 3 patients with this operative procedure. This operative technique is simpler and safer than reimplantation of both ureters into the bladder. Because no dissection of the bladder wall is needed there is less risk of injury to the pelvic viscera and vasculature. The chance of success in correcting reflux appears better than with reimplantation of both ureters into the bladder. Long-term followup has shown few complications and no repeat operations were needed in this series. The small stump of the diseased ureter left behind near the bladder caused no serious problems.


Arterial oxygen saturation during upper gastrointestinal endoscopy: influence of sedation and operator experience.
In order to compare the effects of Diazemuls and midazolam on arterial oxygen saturation during upper gastrointestinal endoscopy, 120 patients were randomly allocated to receive Diazemuls, midazolam, or normal saline. Endoscopy was performed by one consultant or one of four residents. Arterial oxygen saturation was monitored continuously during endoscopy by means of a Biox III pulse oximeter and ear probe. Oxygen saturation fell during endoscopy in all three groups, but no significant differences between the groups were detected at any stage of the procedure. When all groups were combined, there was significantly less desaturation when the consultant performed the endoscopy, and he was also significantly faster in carrying out endoscopy than the residents in each group. When an inexperienced resident was compared with one with at least 6 months of experience, there were significant differences in degree of desaturation, lowest value during endoscopy and tolerance score. It is suggested that the patient at risk of hypoxemia should, if possible, be endoscoped by an experienced endoscopist.


Thermoelectric performance enhancement of eco-friendly Cu2Se through incorporating CB4.
We have prepared Cu2Se + x wt% CB4 composites with x = 0, 0.1, 0.3, 0.5, and 0.7 by a hydrothermal method and hot-pressing technique. The structural and compositional analysis indicates that pure phase Cu2Se powders were synthesized and the densified layered bulk samples were obtained. Electrical properties testing showed that the sample with x = 0.5 has the high power factor of 0.886 mW m-1 K-2 due to its high Seebeck coefficient. Meanwhile, the thermal conductivity was suppressed to 0.6 W m-1 K-1 at 773 K. As a result, the final optimized ZT value of 1.46 at 773 K was achieved. These results suggest that CB4 could be an alternative inclusion to improve effectively the thermoelectric performance of Cu2Se.


The SDF-1 3'A genetic variation is correlated with elevated intra-tumor tissue and circulating concentration of CXCL12 in glial tumors: a study on Iranian anaplastic astrocytoma and glioblastoma multiforme patients.
Immunological factors are important in pathogenesis of various malignancies, including neural cancers. The CXC chemokine CXCL12 is involved in the immune responses. Therefore, the aim of the present study was to investigate the association between tumor tissue and circulating concentrations of CXCL12 as well as its genetic variation at position +801 known as(the SDF-1 3'A), in Iranian patients suffering from malignant glial tumors. In this study, stereotactic tumor biopsy specimens in parallel with peripheral blood samples were collected from 123 patients and 189 healthy controls. The serum level of CXCL12 was measured by ELISA and tumor tissues were subjected to Western blotting for intra-tumor CXCL12 detection; we also employed PCR-RFLP to detect the SDF-1 3'A polymorphism. Demographic data were collected by a researcher-designed questionnaire. These results demonstrated a significant difference between the A/A, A/G, and G/G genotype and A and G alleles of polymorphisms at position +801 of CXCL12. We also indicated elevated levels of CXCL12 in circulation and tumor tissue obtained from in patients suffering from malignant glial tumors. Based upon the results of this investigation, we propose that CXCL12 and its SDF-1 3'A polymorphism play a fundamental part in the pathogenesis of malignant glial tumors. It is also noteworthy that CXCL12 could probably be utilized as a beneficial biological marker in the diagnosis of these tumors.


Work, family, and personal characteristics explain occupational and gender differences in work-family conflict among Japanese civil servants.
A high level of work-family conflict (WFC) is an important risk factor for physical and mental health problems. Although individual work-related factors for WFC have been extensively studied, relatively little is known about whether occupation and gender affect WFC and how such effects might be generated. Cross-sectional study. This study surveyed 3053 civil servants aged 20-65 years working in a local government in the west coast of Japan in 2003. Logistic regression analyses were used to examine whether there are occupational and gender differences in WFC and to clarify the factors underlying these differences. WFC was higher in professional and technical workers compared with other occupations for both men and women, with age-adjusted odds ratios (ORs) for these workers of 1.29 in men and 2.58 in women. In men, occupational differences in WFC disappeared after adjusting for work and family characteristics (OR = 1.15). In women, significant occupational differences remained in the final model, but after adjusting for work characteristics the adjusted OR for professional and technical workers was reduced to 1.69. Women were more likely than men to experience high WFC (OR = 2.52). After controlling for work characteristics, the gender difference was considerably reduced (OR = 1.68). Work characteristics play a fundamental role in the difference in WFC between not only occupational but also gender differences. Stressful work characteristics among professional and technical workers and among women in all work roles should be addressed to reduce occupational and gender differences in WFC in Japan.


The microslicing method in the study of temporal bone changes in the perinatal period: an interim report.
The microslicing method was used to study the temporal bones of 49 perinatal deaths in the gross. X ray of the temporal bones was an important part of the investigation. The principle pathological changes were clearly observed. They were: acute otitis media in two cases; an anterior crural deformity of the stapes in four infants and haemorrhage of the apex of the fundus of the internal auditory meatus in 12. Primitive mesenchymal tissue was frequently seen in the infants of younger gestational age, but had largely disappeared by term.


GSTT1 null genotype contributes to hepatocellular carcinoma risk: a meta-analysis.
Studies investigating the association between genetic polymorphism of glutathione S-transferase T1 (GSTT1) and hepatocellular carcinoma (HCC) risk have reported conflicting results. Therefore, we conducted this meta-analysis to provide more precise evidence. Databases including PubMed, Embase, SCOPUS, ISI Web of Science, and Wangfang were searched for relevant studies. Potential sources of heterogeneity were also assessed by subgroup analysis. Funnel plots and Egger's linear regression were used to test publication bias among the articles. Finally, a total of 28 studies involving 3,897 HCC patients and 6,117 controls were included in this meta-analysis. In a combined analysis, the summary odds ratio for HCC of the GSTT1 null genotype was 1.43 (95% confidence interval (CI) 1.22–1.68, P < 10(−5)). In the subgroup analysis by ethnicity, significantly increased risks were found in East Asians for GSTT1 null polymorphism, while no significant associations were found among Caucasian, South Asian, and African populations. When stratified by a source of controls, both population- and hospital-based studies get consistent positive results. By pooling data from 10 studies (1,639 cases and 2,224 controls) that considered combinations of GSTT1 and GSTM1 genotypes, a statistically significant increased risk for HCC (odd ratio = 1.85, 95% CI 1.37–2.49) was detected for individuals with combined deletion mutations in both genes compared with positive genotypes. No evidence of publication bias was observed. Our result suggests that the GSTT1 null genotype contributes to an increased risk of HCC in East Asians and that interaction between unfavorable GSTs genotypes may exist.


Technical aspects: development, manufacture and installation of a cryo-cooled HTS coil system for high-resolution in-vivo imaging of the mouse at 1.5 T.
Signal-to-noise ratio improvement is of major importance to achieve microscopic spatial resolution in magnetic resonance experiments. Magnetic resonance imaging of small animals is particularly concerned since it typically requires voxels of less than (100 microm)(3) to observe the small anatomical structures having size reduction by a factor of more than 10 as compared to human being. The signal-to-noise ratio can be increased by working at high static magnetic field strengths, but the biomedical interest of such high-field systems may be limited due to field-dependent contrast mechanisms and severe technological difficulties. An alternative approach that allows working in clinical imaging system is to improve the sensitivity of the radio-frequency receiver coil. This can be done using small cryogenically operated coils made either of copper or high-temperature superconducting material. We report the technological development of cryo-cooled superconducting coils for high-resolution imaging in a whole-body magnetic resonance scanner operating at 1.5 T. The technological background supporting this development is first addressed, including HTS coil design, simulation tools, cryogenic mean description and electrical characterization procedure. To illustrate the performances of superconducting coils for magnetic resonance imaging at intermediate field strength, in-vivo mouse images of various anatomic sites acquired with a 12 mm diameter cryo-cooled superconducting coil are presented.


A 17-Year-Old Girl Diagnosed With STING-Associated Vasculopathy With Onset in Infancy (SAVI) After Lung Transplantation.
A 17-year-old girl received lung transplantation after chronic respiratory failure. She developed a fever (> 38 °C) once or twice weekly starting 2 months after surgery, and multiple papulopustules on the skin waxed and waned for 4 months. She then developed blood-tinged sputum. She had been treated with triple immunosuppressants, including prednisolone, tacrolimus, and mycophenolate mofetil after lung transplantation, and her symptoms appeared during prednisolone dose reduction.


Supporting advancement of lab animal welfare and scientific integrity in developing countries: ACURET Cage Consortium (ACCON) Project.
Research involving animals remains an essential tool to increase our understanding of how human and animal bodies work; how diseases affect them and the safety assessment of chemicals, such as pesticides, for their possible effects on human health or the environment; and how diseases can be prevented or treated via developing and testing medicines and vaccines for humans or animals. To achieve high quality science based on animal manipulations and experimentations from developing countries, adequate welfare of the lab animals needs to become sine qua non for all concerned.ACURET.ORG is in the forefront of promoting humane animal care and use for scientific purposes in developing countries, with focus on Africa, seeking to aid and facilitate aspects of Institutional Lab Animal programmes in addition to its training and education programmes in the last 11 years since its inception and incorporation eight years ago. ACURET has embarked upon a project tagged 'ACURET Cage Consortium Project', the provision of re-usable 'open-top' cages for mice and rats in place of the many varied artificial housing materials being used to hold such animals in many facilities in Africa. ACURET is seeking old but functional cages and accessories, still 'fit for purpose'; other animal husbandry and research equipment, as donations from institutions and industry for distribution to institutions in Africa who require them to improve their lab animal welfare programme.With a phased funding support from Laboratory Animal Ltd., ACURET will be responsible for the collection of donated items from locations, re-package them for sea-shipping to NIMR in Lagos, from where they will be distributed to successful applying institutional animal facilities, on a 'first come, first served' basis.At the heart of the ACURET Cage Consortium Project is the enablement of researchers in Africa to engage in the essence of their research when the welfare of the laboratory animals they care for and use has been affirmed. Ultimately, we anticipate that the project will support raising the bar on Africans skilled in humane animal care and use for scientific purposes in developing countries.


Terrestrial insects as a promising source of chitosan and recent developments in its application for various industries.
Chitosan is a deacetylated form of chitin and increasingly important amino-polysaccharide used in many various sectors including agriculture, food, and biomedicine. However, chitosan from marine sources has several adverse effects, including allergenic components harmful to human health. Furthermore, marine resources are seasonal, and availability is limited due to dependency on environmental conditions and climate change. In addition, shell infection in crustaceans and environmental contamination make the harvesting of chitin and chitosan problematic. In recent years, chitosan from terrestrial insects has attracted considerable interest. The discoveries show insect chitosan is more advantageous compared to crustacean chitosan. In addition, we were unable to find any literature about the adverse effects of insect chitosan thus far. This review aims to reveal information regarding crustacean and terrestrial insect chitosan and recent advances in chitosan sources. Applications from specific insect orders and perspectives for further study will also be highlighted, including medical and sensing applications.


Matrix metalloproteinase-9 deletion is associated with decreased mid-term vein wall fibrosis in experimental stasis DVT.
Post thrombotic syndrome therapy is primarily palliative, and the associated vein wall inflammatory mechanisms are unclear. Vein wall fibrotic injury following deep venous thrombosis (VT) is associated with elevated matrix metalloproteinases (MMPs). Whether and by what mechanism MMP9 directly contributes to vein wall remodeling after VT is unknown. WT and MMP9 -/- mice underwent stasis VT by ligation of the inferior vena cava (IVC) and tissue was harvested at 2, 8, and 21days. Assessment of thrombus size, and gene, protein and structural vein wall determinations were done. VT resolution was increased in MMP9-/- mice as compared with controls at 21d only. The primary phenotypic fibrotic vein wall differences occurred at 8d post VT, with significantly less vein wall collagen content as assessed by Picosirius red staining in MMP9 -/- mice as compared with WT. Increased monocytic vein wall influx with less IL-1b and TGFb was found in MMP9 -/- vein walls as compared with WT. Corresponding levels of PAI-1 were increased in MMP9 -/- compared with WT, and no difference in FSP-1+cells as compared with controls. In stasis VT, MMP9 modulates midterm vein wall collagen content, with an altered local inflammatory and profibrotic environment, likely directed by monocytes. Thus, MMP9 plays a role in both vein wall responses as well as late thrombus resolution.


Propoxyphene use by community-dwelling and institutionalized elderly Medicare beneficiaries.
To provide the first comparable national prevalence estimates on use of propoxyphene, a potentially inappropriate drug, by elderly Medicare beneficiaries living in the community and institutions and to determine whether institutionalized beneficiaries are at a greater risk for receiving propoxyphene than community-dwelling beneficiaries. Cross-sectional study. U.S. representative sample of elderly using Medicare database. Nationally representative sample of community-dwelling (n = 9,851, weighted n = 32.5 million) and institutionalized (n = 1,099, weighted n = 2.3 million) Medicare beneficiaries aged 65 and older. National estimates on prevalence of propoxyphene use and the odds of receiving propoxyphene were the two main outcome measures. Annual prevalence of propoxyphene use in 1998 was 6.8% by all community-dwelling elderly beneficiaries and 15.5% by institutionalized elderly beneficiaries. Beneficiaries in long-term care facilities had almost 40% higher odds of receiving propoxyphene (odds ratio = 1.38, 95% confidence interval = 1.1-1.8) than beneficiaries in the community even after controlling for other factors in a logistic regression. Other risk factors include female, rural residence, poor health, and history of osteoporosis or hip fracture. Beneficiaries residing in regions in the midwest and south were more than twice as likely to receive propoxyphene as those in the mid-Atlantic area. These results show that propoxyphene use by U.S. community-dwelling seniors is high but is much higher in the institutionalized population. These findings suggest that prescribing for older adults with pain could be improved, especially for vulnerable long-term care residents.


Isradipine lowers human arterial low density lipoprotein retention in vivo.
During the recent past it has been discussed that calcium antagonists may exert antiatherosclerotic actions at the vessel wall. Apolipoprotein B containing lipoproteins were isolated by immunoaffinity chromatography and radiolabeled with 123-iodine. The effect of 2 x 2.5 mg isradipine on the low density lipoproteins (LDL) entry into the carotid and femoral arteries of 12 hypertensive patients with primary hyperlipoproteinemia (total cholesterol >6.5 mmol/l [250 mg/dL) was examined. Cholesterol -1.7% (P< 0.05 664), high density lipoprotein (HDL) cholesterol +4.5% (P< 0.01 123), and LDL cholesterol -1% (P< 0.01 563) did not change, nor did any of the safety parameters. The types of entry kinetics reflecting vascular surface lining did not change while the LDL retention 20 h after tracer application was depressed by up to 23.5%. The data were comparable in the carotid and femoral artery segments, the significance level ranging up to 0.0009. These results indicate a decreased LDL retention in the arterial wall of hypertensive patients induced by isradipine. The clinical implications of the findings ought to be pursued in properly designed clinical trials.


Heart and en-bloc thymus transplantation in miniature swine.
Donor-specific tolerance to organ allografts might be induced by cotransplantation of a sufficient amount of vascularized donor thymus. To facilitate donor thymus-induced cardiac allograft tolerance, we have developed a novel technique for heart and en-bloc thymus transplantation in swine. Donor heart and en-bloc thymus grafts were prepared by a technique that preserves the entire arterial supply and venous drainage of the right thymic lobe. En-bloc grafts (n = 4) were transplanted heterotopically into the abdomens of major histocompatibility complex-matched miniature swine. Recipients received 12 days of cyclosporine intravenously. Grafts were monitored by palpation, electrocardiographic monitoring, and periodic open biopsy. Engraftment of the donor thymus was demonstrated by measuring the proportion of recipient-type thymocytes in the donor thymus with flow cytometry. All of the heart and en-bloc thymus grafts had normal cardiac contractility and immediate perfusion of the thymus. All en-bloc grafts were accepted for more than 200 days without significant acute cellular rejection or cardiac allograft vasculopathy. Thymic tissue of en-bloc grafts displayed normal architecture and supported thymopoiesis of recipient-type cells. We have validated a new technique of donor thymus transplantation that could have utility in human heart transplantation.


K cell mediated lysis of cultured colon carcinoma and urinary bladder carcinoma cells induced by monospecific antisera against carcinoembryonic antigen (CEA) and two CEA-related normal glycoproteins.
Antibody dependent lymphocyte (K cell) mediated lysis of tumor cells in vitro was used to assay for cell surface associated carcinoembryonic antigen (CEA) and two CEA-related normal tissue components, "normal glycoprotein" (NGP) and biliary glycoprotein I (BGP I). Three tumor cell lines were used as target cells. These were HT-29, colon carcinoma, T-24, urinary bladder transitional cell carcinoma and Mel-1, malignant melanoma. To induce lysis we used the IgG-fraction of specific rabbit and monkey anti-CEA sera and of specific rabbit anti-NGP and anti-BGP I sera, respectively. Purified human lymphocytes were used as effector cells. HT-29 was efficiently killed by low concentrations of rabbit anti-CEA and less efficiently by monkey anti-CEA. T-24 and Mel-1 were not lysed by anti-CEA, HT-29 and T-24 were lysed by low concentrations of anti-BGP I. In contrast only HT-29 was lysed by anti-NGP. Only a fraction of the tumor cells was killed by the different antisera although kinetic studies showed that the lytic reaction was complete well before the end of the eighteen hour incubation period used in the assay. Anti-CEA and anti-BGP I gave 30-40% corrected lysis of HT-29. With anti-NGP the corresponding figure was 10-20%.


A Free-Standing α-MoO3/MXene Composite Anode for High-Performance Lithium Storage.
Replacing the commercial graphite anode in Li-ion batteries with pseudocapacitor materials is an effective way to obtain high-performance energy storage devices. α-MoO3 is an attractive pseudocapacitor electrode material due to its theoretical capacity of 1117 mAh g-1. Nevertheless, its low conductivity greatly limits its electrochemical performance. MXene is often used as a 2D conductive substrate and flexible framework for the development of a non-binder electrode because of its unparalleled electronic conductivity and excellent mechanical flexibility. Herein, a free-standing α-MoO3/MXene composite anode with a high specific capacity and an outstanding rate capability was prepared using a green and simple method. The resultant α-MoO3/MXene composite electrode combines the advantages of each of the two components and possesses improved Li+ diffusion kinetics. In particular, this α-MoO3/MXene free-standing electrode exhibited a high Li+ storage capacity (1008 mAh g-1 at 0.1 A g-1) and an outstanding rate capability (172 mAh g-1 at 10 A g-1), as well as a much extended cycling stability (500 cycles at 0.5 A g-1). Furthermore, a full cell was fabricated using commercial LiFePO4 as the cathode, which displayed a high Li+ storage capacity of 160 mAh g-1 with an outstanding rate performance (48 mAh g-1 at 1 A g-1). We believe that our research reveals new possibilities for the development of an advanced free-standing electrode from pseudocapacitive materials for high-performance Li-ion storage.


Estimation of central pulse wave velocity from radial pulse wave analysis.
Arterial stiffness, commonly assessed by carotid-femoral pulse wave velocity (cfPWV), is an independent biomarker for cardiovascular disease. The measurement of cfPWV, however, has been considered impractical for routine clinical application. Pulse wave analysis using a single pulse wave measurement in the radial artery is a convenient alternative. This study aims to identify pulse wave features for a more accurate estimation of cfPWV from a single radial pulse wave measurement. From a dataset of 140 subjects, cfPWV was measured and the radial pulse waveform was recorded for 30 s twice in succession. Features were extracted from the waveforms in the time and frequency domains, as well as by wave separation analysis. All-possible regressions with bootstrapping, McHenry's select algorithm, and support vector regression were applied to compute models for cfPWV estimation. The correlation coefficients between the measured and estimated cfPWV were r = 0.81, r = 0.81, and r = 0.8 for all-possible regressions, McHenry's select algorithm, and support vector regression, respectively. The features selected by all-possible regressions are physiologically interpretable. In particular, the amplitude ratio of the diastolic peak to the notch of the radial pulse waveform (Rn,dr,P) is shown to be correlated with cfPWV. This correlation was further evaluated and found to be independent of wave reflections using a dataset (n = 3,325) of simulated pulse waves. The proposed method may serve as a convenient surrogate for the measurement of cfPWV. Rn,dr,P is associated with aortic pulse wave velocity and this association may not be dependent on wave reflection.


SEN virus infection among patients on maintenance hemodialysis in southern Taiwan.
The prevalence and clinical significance of two SEN virus (SENV) strains, SENV-D and SENV-H, was investigated among patients on maintenance hemodialysis in southern Taiwan. Sera from 99 uremic patients were tested for alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), and SENV-D and -H DNA. Sera from 120 healthy blood donors were tested as a control group. Of the 99 patients, 24.2 and 7.1% were positive for anti-HCV and HBsAg, respectively, and the prevalence of SENV-D and/or -H (SENV-D/H), SENV-D and SENV-H DNA was 61.6, 46.5 and 27.3%, which was significantly higher than for donors (23.3, 18.3, and 5.8%, respectively; all P<0.0001). Patients with SENV-D DNA had significantly higher mean age among both patients (P=0.019) and donors (P=0.015). Mean serum ALT levels were significantly higher among patients with anti-HCV (P=0.003) and patients with SENV-D and -H concurrent infection (P=0.034). By multivariate analyses, the presence of serum anti-HCV and concurrent SENV-D and -H infection were independent factors associated with increased ALT level. The prevalence of SENV-D/H infection is high among Taiwanese patients on maintenance hemodialysis with SENV-D more prevalent than SENV-H. The ALT level was associated with not only positive anti-HCV but also concomitant viremia of both SENV-D and SENV-H.


Acrylonitrile and cancer: a review of the epidemiology.
Several retrospective cohort epidemiology studies evaluated a number of health outcomes in workers exposed to acrylonitrile (AN). The epidemiology studies included in this review have been published since 1970 and were identified through Ovid and MEDLINE retrieval services using search words "acrylonitrile and cancer". We identified 26 studies which examined mortality and/or incidence rates among persons with AN exposure. Where cohorts have been updated the most recent data were relied upon but descriptions of the earlier publications are provided for background and rationale. Results are provided for all causes of death and all cancers. Detailed results and discussions are provided for the cancers which have received the most attention and for which some positive results have been reported. These include lung, bladder, prostate, and central nervous system cancers. In this review the four most informative cohort studies are evaluated and it is apparent that the results do not support a causal relationship between AN and all cancers or any specific type of cancer. IARC actually downgraded acrylonitrile from "probably carcinogenic" to "possibly carcinogenic to humans" finding that "the earlier indications of an increased risk among workers exposed to acrylonitrile were not confirmed by the recent, more informative studies". This was one of few downgrades of classification by IARC. Our review of the epidemiology data is consistent with the conclusions of the earlier IARC review which found no consistent findings of increased cancer risk across studies.


Hemoglobin enhancement of experimental infection of mice with Pasteurella haemolytica.
A 2% hemoglobin preparation injected into mice along with Pasteurella haemolytica culture was found to be as good an enhancer of virulence as a 7% swine gastric mucin preparation. The hemoglobin preparation was easier to prepare and was less toxic than mucin for mice when injected intraperitoneally.


In vitro multimodal-effect of Trichilia catigua A. Juss. (Meliaceae) bark aqueous extract in CNS targets.
The bark of Trichilia catigua A. Juss. (Meliaceae), popularly known as "big catuaba", is traditionally used in Brazilian folk medicine for its neuroactive potential as memory stimulant, and antinociceptive and antidepressant effects. To study the aqueous extract of T. catigua bark as dual inhibitor of monoamine oxidase A (MAO-A) and acetylcholinesterase (AChE). To explore its antioxidant potential through interaction with xanthine/xanthine oxidase (X/XO) pathway, and to attempt a relationship between its phenolic profile and effects displayed. Phenolic profiling was achieved by HPLC-DAD-ESI/MSn and UPLC-ESI-QTOF-MS analyses. The capacity to inhibit hMAO-A was assessed in vitro, as was that for AChE, evaluated in rat brain homogenates. The direct inhibition of the X/XO pathway and the scavenging of superoxide anion radical were the selected in vitro models to explore the antioxidant potential. The cytotoxic effects were assayed in the human neuronal SH-SY5Y cells by MTT reduction, after direct exposure (24h). Twenty-six compounds were identified and quantified (551.02 ± 37.61mg/g of lyophilized extract). The phenylpropanoid substituted flavan-3-ols were the most representative compounds (~81% of quantified mass). The extract inhibited hMAO activity in a concentration-dependent manner (IC50 = 121.06 ± 2.13μg/mL). A mixed model of inhibition of AChE activity was observed, reflected by the pronounced increase of Km values and a more discreet effect over the Vmax parameters, calculated from Michaelis-Menten fitted equations. In addition, it was demonstrated that the extract directly inhibits the X/XO pathway (IC50 = 121.06 ± 2.13μg/mL) and also imbalances the oxidative stress acting as superoxide anion radical scavenger (EC50 = 104.42 ± 10.67μg/mL), an oxidative by-product of this reaction. All these neuroprotective and neurotrophic effects were displayed within the non-toxic range of concentrations (0.063-0.500μg/mL) in SH-SY5Y cells. Our results validate the traditional use of T. catigua bark for its neuroactive and neuroprotective potential. A novel approach upon its application towards the management of neurodegenerative and related symptomatology was likewise demonstrated.


Image distortion and spatial resolution of a commercially available cone-beam computed tomography machine.
Our objective was to evaluate images produced by a commercially available cone-beam computed tomography (CBCT) machine (i-CAT model 9140-0035-000C, Imaging Sciences International, Hatfield, Pa) for measurement and spatial resolution (ie, the ability to separate 2 objects in close proximity in the image) for all settings and in all dimensions. A custom phantom containing 0.3 mm diameter chromium metal markers approximately 5 mm apart in 3 planes of space was developed for analyzing distortion and measurement accuracy. This phantom was scanned in the CBCT machine by using all 12 commercially available settings. The distance between the markers was measured 3 times on the 3-dimensional images by using a Digital Imaging and Communications in Medicine (DICOM) viewer and was also measured 3 times directly on the phantom with a fine-tipped digital caliper. A line-pair phantom was used to evaluate spatial resolution. Thirty evaluators analyzed images and assigned a resolution from 0.2 to 1.6 mm according to the separation of the line pairs. There were no statistically significant differences among the 3-dimensional images for any setting, in any dimension, or in images divided by thirds in terms of measurement accuracy. Comparison of the CBCT measurements to the direct digital caliper measurements showed a statistically significant difference (P <0.01). However, the absolute difference was <0.1 mm and is probably not clinically significant for most applications. The worst spatial resolution found was 0.86 mm. Spatial resolution was lower at faster scan times and larger voxel sizes. This CBCT machine has clinically accurate measurements and acceptable resolution.


Arrestin-like proteins mediate ubiquitination and endocytosis of the yeast metal transporter Smf1.
Many plasma membrane proteins in yeast are ubiquitinated and endocytosed, but how they are recognized for modification has remained unknown. Here, we show that the manganese transporter Smf1 is endocytosed when cells are exposed to cadmium ions, that this endocytosis depends on Rsp5-dependent ubiquitination of specific lysines and that it also requires phosphorylation at nearby sites. This phosphorylation is, however, constitutive rather than stress-induced. Efficient ubiquitination requires Ecm21 or Csr2, two members of a family of arrestin-like yeast proteins that contain several PY motifs and bind to Rsp5. Ecm21 also binds to phosphorylated Smf1, providing a link between Rsp5 and its substrate. PY motif-containing arrestin-like proteins are found in many species, including humans, and might have a general role as ubiquitin ligase adaptors.


Diagnosis of metachronous contralateral breast cancer.
The purpose of this study was to compare the characteristics of primary breast cancers (PBCs) and metachronous contralateral breast cancers (MCBCs). Between 1984 and 1996, 236 women treated with curative intent for PBC who developed a MCBC >6 months after initial diagnosis (without previous evidence of distant metastases) were retrospectively evaluated for clinical and pathologic characteristics and method of diagnosis of their tumors. There were more noninvasive cancers among the MCBCs than the PBCs (11.4% and 5.1%, respectively, p < 0.02). Among the invasive cancers, the mean size of the MCBCs was smaller than the PBCs (1.94 versus 2.55 cm, p < 0.001). MCBCs were more likely than PBCs to be mammographically detected (46.2% versus 19.9%, p < 0.001). Tumor size was correlated with the method of diagnosis. The mean tumor size was 1.39, 2.02, and 2.69 cm for mammogram-, physician-, and patient-detected tumors, respectively. Among patients having axillary lymph node dissections, mammogram- and physician-detected tumors were less likely to have lymph node metastases than patient-detected tumors (22.0% versus 41.2%, p < 0.005). Regular follow-up of breast cancer patients diagnoses MCBCs when they are smaller and less likely to have nodal metastases than PBCs mainly because of early mammographic detection.


The characteristics of inhibition of histamine release from human lung fragments by sodium cromoglycate, salbutamol and chlorpromazine.
1 Three drugs have been tested for activity against antigen-induced histamine release from passively sensitized human lung fragments after increasing periods of pre-incubation before challenge.2 After 30 s pre-incubation, sodium cromoglycate inhibited histamine release in the concentration range 0.2-200 muM, producing a maximum inhibition of 33.0%. As the pretreatment period was extended, tolerance developed in a dose-related manner, resulting in a 48.3% and 82.8% loss of activity of the 200 muM dose after 60 min and 19 h pre-incubation, respectively. Tolerance was independent of extracellular calcium and was poorly reversible. Lung tissue desensitized to cromoglycate was cross-tolerant to the related drug, bufrolin, but not to salbutamol or chlorpromazine.3 In acute studies, salbutamol (0.03-3.0 muM) produced dose-related inhibition of histamine release, with a maximum inhibition of 72.2%. The effect was blocked stereoselectively by 1 muM propranolol, suggesting that it occurred through an interaction with lung beta-adrenoceptors. Increasing the pre-incubation time with salbutamol from 30 s to 19 h did not produce tolerance. Inhibition produced by incubation with salbutamol for 19 h was totally prevented when propranolol was added at the beginning of the pre-incubation period, indicating that it resulted from stimulation of beta-receptors and not from a non-specific or toxic effect. However, studies of reversibility of effect through washing or late addition of propranolol did indicate some change in the nature of salbutamol inhibition with time.4 Chlorpromazine was a weak inhibitor of immunological histamine release. A 100 muM concentration was ineffective after 30 s pre-incubation but its activity increased with time. Pre-incubation of lung fragments with this concentration for 1 h or longer, or with a 1 mM dose for a shorter period, provoked histamine release in the absence of antigen. Effects of chlorpromazine were not reversed by washing.5 The different characteristics shown by sodium cromoglycate, salbutamol and chlorpromazine indicate that these drugs inhibit histamine release by interfering with the secretory mechanisms in different ways.


Mechanistic insight into the generation of reactive oxygen species in sulfite activation with Fe(III) for contaminants degradation.
Since the reactive species during the sulfite activation by Fe(III) (Fe(III)/sulfite process) had not been directly determined and the role of in-situ generated Fe(II) was overlooked, this study evaluated the oxidation performance of the Fe(III)/sulfite process, identified the reactive species, and investigated the role of in-situ generated Fe(II) in this process. The results demonstrated that carbamazepine (CBZ) could be degraded at different sulfite concentrations. Compared to the single-dosing mode, sulfite applied with multiple-dosing mode was beneficial to CBZ removal in this process when the same amount of sulfite was dosed. Fe(II) was rapidly generated and then decayed in this process, which were consistent with the trends of CBZ degradation and sulfite consumption. Electron paramagnetic resonance and scavenging experiments showed that SO4- was a major oxidant, while HO also played a significant role in CBZ degradation in this process. The tert-butyl alcohol assay indicated that the generation and re-oxidation of Fe(II) was accompanied with the generation of reactive species. Besides sulfite dosage, CBZ degradation was also affected by initial pH, Fe(III) dosage, and CBZ concentration. Cl- showed little inhibition on CBZ degradation while humic acid inhibited CBZ degradation in this process. This study advances the application of this oxidation system.


Anatomically dependent anticonvulsant properties of temporally-coded electrical stimulation.
In the PTZ animal model of epilepsy, electrical stimulation applied to the amygdaloid complex may result in either pro-convulsive or anticonvulsant effect, depending on the temporal pattern used (i.e. periodic-PS and non-periodic-NPS electrical stimulation). Our hypothesis is that the anatomical target is a determinant factor for the differential effect of temporally-coded patterns on seizure outcome. The threshold dose of PTZ to elicit forelimb clonus and generalized tonic-clonic seizure behavior was measured. The effect of amygdaloid complex PS on forelimb clonus threshold showed a pro-convulsive effect while NPS was anticonvulsant. NPS also significantly increased generalized tonic-clonic threshold; while PS, although at lower threshold levels, did not present statistical significance. Thalamus stimulation did not affect forelimb clonus threshold and showed similar anticonvulsant profiles for both PS and NPS on generalized tonic-clonic threshold. In summary, the anatomical target is a determinant factor on whether temporally-coded ES differentially modulates seizure outcome.


Interactive effects of temperature and bisphenol A on phytoplankton growth and community structure.
Environmental contamination of bisphenol A (BPA) is a widespread and multifaceted issue with vast ecological, social and economic consequences. Thus, understanding how local environmental conditions, such as temperature, interact with BPA to affect populations and community dynamics remain important areas of research. Here, we conduct laboratory experiments aimed at understanding how environmental gradients of both temperature and BPA concentration influence freshwater phytoplankton population growth and community structure. We exposed phytoplankton assemblages comprised of three common species of green algae (Chlorella vulgaris, Ankistrodesmus braunii and Scenedesmus quadricauda) as well as isolates of each individual species to three BPA concentrations (0, 2, 13 mg/L BPA) and three temperatures (18, 23, 27°C) monitoring population growth and community structure (via biovolume). We observed antagonistic interactions between BPA and warmer temperatures, such that when warmer temperatures decreased growth (observed with A. braunii), high concentrations of BPA elevated growth at these warm temperatures; however, when warmer temperatures increased growth (C. vulgaris, S. quadricauda), high BPA concentrations diminished these gains. Although BPA exposure inhibited the growth of most C. vulgaris populations, growth was not reduced in A. braunii or S. quadricauda populations exposed to 2 mg/L BPA. Phytoplankton assemblage evenness (Pielou evenness index) decreased as BPA concentration increased and was consistently lowest under 27°C. Community composition was similar in assemblages cultured under 0 and 2 mg/L BPA under 18 and 23°C but was most similar between assemblages cultured under 2 and 13 mg/L BPA under 27°C. These results indicate that local environmental temperatures can mediate the consequences of BPA for freshwater phytoplankton growth rates and community structure and that BPA can diminish potential gains of increased growth rate for warm-adapted phytoplankton species at high environmental temperatures.


The familial risk of breast cancer in women with endometriosis from Yale series.
Few studies examining the association of endometriosis with the risk of breast cancer. Our goal was to investigate the familial risk of breast cancer in women with endometriosis. Retrospective study. University-based endometriosis referral center. Three hundred fifty-two women with endometriosis and 180 infertile women without endometriosis were studied using laparoscopy between August 1996 and February 2002. The endometriosis group was further subdivided into a group of women with 94 positive and 268 negative family histories of breast cancer. The overall risk of familial breast cancer among first- and second-degree relatives in patients with endometriosis and the association between potential risk factors was estimated by chi(2) and by crude adjusted odds ratios (95% CI). Positive family history of breast cancer was detected in (26.7%) 94/352 of endometriosis group and in (5%) 9/180 of controls. The relative risk of women with endometriosis and positive family history of breast cancer was (OR=6.9 (95% CI, 3.4-14.1), chi(2)=34.6, P<0.001). Endometriosis was associated with the risk of first-degree relatives of breast cancer (OR=5.69 (95% CI, 2.4-13.3), P<0.001). Moreover, endometriosis was significantly associated with the risk of breast cancer in mothers (OR=6.3 (95% CI, 2.2-17.8), P<0.001) and in maternal aunts (OR=5.9 (95% CI, 1.3-72.9), P<0.001). The two groups are similar in age, race height, main complaints, age of menarche, cycle length, days of flow, estimated blood loss, stage of endometriosis and the presence of endometrioma. This study found an elevated risk associated with family history of breast cancer among women with endometriosis. A familial clustering interaction with a familial history of breast cancer in women with endometriosis is possible, but should be investigated further.


The Role of Extreme Weather and Climate-Related Events on Asthma Outcomes.
Extreme weather and climate events are likely to increase in frequency and severity as a consequence of global climate change. These are events that can include flooding rains, prolonged heat waves, drought, wildfires, hurricanes, severe thunderstorms, tornadoes, storm surge, and coastal flooding. It is important to consider these events as they are not merely meteorologic occurrences but are linked to our health. We aim to address how these events are interconnected with asthma outcomes associated with thunderstorm asthma, pollen production, mold infestation from flooding events, and poor air quality during wildfires.


[Experimental study of using xenologous sclera as wrapping materials for hydroxy apatite(HA)].
Use xenologous sclera (pig sclera) as wrapping materials for hydroxyapatite (HA) ocular implants in enucleated New Zealand white rabbits. Ten rabbits were unilaterally enucleated and the sockets implanted with 10 mm HA spherical implants. All implants were wrapped with pig sclera. The rabbits were killed 4 weeks later and the sockets were examined clinically for inflammation and implant exposure. Exenterated specimens were assessed histopathologically for inflammation and vascularization. No clinical evidence of implant exposure or extrusion was detected in rabbits receiving pig sclera wrapped implants. Histopathologically the xenologous (pig) sclera displayed moderate inflammation, as well as maintain its lamellar arrangement without disruption. Fibrovascular ingrowth was complete in all implants. Xenologous (pig) sclera behaves similar clinically to homologous sclera as a wrapping material for spherical HA ocular implants in a rabbit model, and may represent a reasonable alternative to sclera in such procedures in humans.


Mutations at the C-terminus of CDC42 cause distinct hematopoietic and autoinflammatory disorders.
Pathogenic missense variants in cell division control protein 42 (CDC42) differentially affect protein function, causing a clinically wide phenotypic spectrum variably affecting neurodevelopment, hematopoiesis, and immune response. More recently, 3 variants at the C-terminus of CDC42 were proposed to similarly impact protein function and cause a novel autoinflammatory disorder. We sought to clinically and functionally classify these variants to improve patient management. Comparative analysis of the available clinical data and medical history of patients was performed. In vitro and in vivo studies were carried out to functionally characterize individual variants. Differently from what had previously been observed for the p.R186C change causing neonatal-onset cytopenia, autoinflammation, and recurrent hemophagocytic lymphohistiocytosis, p.C188Y and p.∗192Cext∗24 promoted accelerated protein degradation. Unprenylated CDC42C188Y did not behave as a membrane-bound protein, whereas the residual CDC42∗192Cext∗24 mutant replicated the CDC42R186C behavior, being targeted to the Golgi apparatus in a palmitoylation-dependent manner. Assessment of in vitro polarized migration and development in Caenorhabditis elegans documented a loss-of-function behavior of the p.C188Y and p.∗192Cext∗24 variants. Consistently, the 3 pathogenic variants were associated with different clinical presentations, with dysmorphisms, severity, and age of onset of cytopenia and extent of autoinflammation representing major differences. Pathogenic variants at the CDC42 C-terminus differently impact protein stability, localization, and function, and cause different diseases, with p.R186C specifically associated with neonatal-onset pancytopenia and severe autoinflammation/hemophagocytic lymphohistiocytosis requiring emapalumab and bone marrow transplantation, and p.C188Y and p.∗192Cext∗24 causing anakinra-sensitive autoinflammation.


Immunohistochemical detection of tankyrase 2 in human breast tumors and normal renal tissue.
Tankyrase, which functions at telomeres and other cellular compartments, is thought to be a positive regulator of telomerase; its isoenzyme tankyrase 2 has been cloned as a putative cancer antigen. This pilot immunohistochemical study was designed to examine whether tumors overexpress tankyrase 2. An antibody was generated by using synthetic peptide specific for tankyrase 2 and was tested by Western blot and immunocytochemically; no cross-reaction with isoenzyme 1 was revealed. Among tissue sections, two tumors of 18 specimens were positive for tankyrase 2. Others were negative or contained barely detectable protein. The surrounding normal tissues were negative. Tankyrase 2 was also revealed in epithelial cells of a limited number of normal renal tubules, whereas other renal tissues were negative. These data suggest that tankyrase 2 is not expressed ubiquitously in human tissues. To determine whether the up-regulation of tankyrase 2 is associated with tissue regeneration and cell proliferation, we compared the activity and concentration of the enzyme in a model human embryonic kidney cell line 293 arrested by serum deprivation and restimulated with serum. The serum-starved quiescent cell culture exhibited detectable protein as did the proliferating cells; enzyme activity dramatically increased in the latter. We conclude that pathologic overexpression of tankyrase 2 in some tumors may be a result of the cancer-related adaptation of the malignant cells dependent on tankyrase activity. Under normal conditions, the protein might be up-regulated during cell differentiation and also posttranslationally in proliferating cells.


Clinical and hemodynamic results of cardiac valve replacement with the Monostrut Björk-Shiley prosthesis.
Between May 1983 and April 1986, 318 patients underwent cardiac valve replacement with the Monostrut Björk-Shiley prosthesis. There were 136 aortic valve replacements, 128 mitral valve replacements, and 54 multiple replacements. A total of 373 valves were implanted. Associated procedures were done in 79 (25%) of the patients. Hospital (30-day) mortality rate was 5.6% (18 patients): 2.9% (n = 4) after aortic, 7.8% (n = 10) after mitrals and 7.4% (n = 4) after multiple valve replacement. Follow-up was obtained in all 300 operative survivors, for a total of 500 patient-years (mean 18 months). Actuarial survival rate, excluding operative deaths, at 4 years was 94.7% +/- 1.5% (mean +/- standard error of the mean). There were 16 thromboembolic episodes (3.2/100 patient-years). Freedom from all valve-related complications was 87% +/- 2.4% at 3 1/2 years. Neither valve thrombosis nor structural failure has been observed. Eighty percent of the patients are in New York Heart Association functional class I. Forty-two patients (26 with aortic and 16 with mitral valve replacement) underwent cardiac catheterization a mean of 6 1/2 months after the operation. In the aortic position, peak gradients were an average of 6.9 +/- 1.2 mm Hg. Mean systolic gradients were 12.4 +/- 6.3 mm Hg and did not increase with exercise. In the mitral position, end-diastolic gradients were an average of 2.1 +/- 2 mm Hg and mean gradients, 5.9 +/- 2 mm Hg. Discharge coefficient (estimated orifice area/geometric area) was 0.63 +/- 0.2 for the aortic and 0.53 +/- 0.2 for the mitral prostheses. Disc opening was maximal in most patients. These results indicate that the Monostrut prosthesis has a low rate of thromboembolic events, no structural failures or thrombotic obstructions and excellent hemodynamic performance, especially in the small aortic sizes (discharge coefficient for 19 and 21 mm valves, 0.77).


Lagging strand replication of rolling-circle plasmids in Streptomyces lividans: an RNA polymerase-independent primer synthesis.
The rolling circle (RC) mechanism of DNA replication generating single-stranded DNA (ssDNA) intermediates is common in various high-copy circular plasmids in Streptomyces, and the ssDNA released after leading strand synthesis is converted to its double-stranded form (dsDNA) by the host proteins. The in vivo and in vitro lagging strand syntheses from ssDNA replicative intermediates of RC plasmid pSN22 in Streptomyces lividans was characterized. The presence or absence of the single-strand origin (sso), the replication initiation site of lagging strand synthesis, did not significantly affect the copy numbers of pSN22 derivatives. In vivo lagging strand synthesis was not affected by the rifampicin inhibition of S. lividans RNA polymerase. Likewise, in vitro lagging strand synthesis using cell-free extracts revealed sso-independent, rifampicin-resistant lagging strand synthesis in S. lividans. Although all four dNTPs are usually required for the initiation of such synthesis, the presence of only one NTP was sufficient to carry outlagging strand synthesis in vitro. Interestingly, the cell-free extract of exponential-phase cells required less ATP than that of stationary-phase cells. These results reveal a predominant RNA polymerase-independent priming system in S. lividans that may be a result of the stabilization of RC plasmids lacking sso in S. lividans.


Immunofluorescent detection and localization of thyroxine in blood of Rana catesbeiana from early larval through metamorphic stages.
Indirect immunofluorescent staining was used to detect and localize thyroxine (T4) in blood smears from individual Rana catesbeiana tadpoles in almost every stage of larval development. Earlier radioimmunoassays revealed a surge of T4 in the blood plasma during metamorphic stages, but plasma T4 concentrations in earlier stages were either very low or below the minimal detectable limits of the assays. With the present immunofluorescent method, T4 was found in plasma of tadpoles throughout the entire larval period from early limb bud stages to the end of metamorphosis. Moreover, T4 was also found in association with cytoplasm and nuclei of red blood cells, particularly nuclei of the new population of adult red cells differentiating during metamorphic stages. In conclusion, thyroid hormone is present in both blood plasma and erythrocytes of R. catesbeiana from early through late stages of larval development.


Mortality of Little Brown Bats ( Myotis lucifugus carissima) Naturally Exposed to Microcystin-LR.
We describe a die-off of little brown bats ( Myotis lucifugus carissima) associated with acute intoxication with microcystin-LR in 2016 at Scofield Reservoir in Utah, US. High levels of this cyanotoxin in water from the reservoir and gastrointestinal content of bats supported this diagnosis.


Hikikomori Risk Inventory (HRI-24): A new instrument for evaluating Hikikomori in both Eastern and Western countries.
Hikikomori, a clinical condition widely studied in Japan, is receiving increasing attention in Western Countries. This study aimed to create a new instrument for evaluating the risk of Hikikomori in both Eastern and Western countries. Through two studies on Italian adolescents, youths, and adults (n = 1,285) and a study on Japanese youths and adults (n = 392), we analyzed the psychometric properties of the Hikikomori Risk Inventory (HRI-24). We found support, in both the Italian and Japanese samples, for the good and stable factor structure of the scale (CFI = 0.94, RMSEA = 0.057 for both the adult samples), as well as for its convergent and divergent validity. The HRI-24 might be used in future studies in both Western and Eastern countries to shed light on the features of this clinical disorder in different cultures. This will allow the development of culture-sensitive preventive and clinical interventions.


Mortality and use of angiotensin-converting enzyme inhibitors in COVID 19 disease: a systematic review.
Interest exists concerning the use of angiotensin-converting enzyme inhibitors (ACEis) in patients with COVID-19 disease. The aim of the study was to perform a systematic review on mortality associated to the use of ACEi in patients with COVID-19 disease. Search in Medline (PubMed), in ISI Web of Knowledge and in medRxiv database; use of other sources. A total of 33 articles were evaluated. Concerning the papers used to produce the meta-analyses, 7 studies were selected, 5 of which were used. These 5 studies involved a total number of 944 patients treated with ACEi and 5173 not treated with ACEi. Increased mortality was seen in association to the use of ACEi in the context of COVID-19 disease (ACEi users vs nonusers; odds ratio, 1.48; 95% confidence interval, 1.02-2.15; P = .04). When compared to mortality in patients treated with angiotensin receptor blockers, mortality of patients treated with ACEi was not significantly different (odds ratio, 0.96; 95% confidence interval, 0.76-1.21; P = .74). Concerning the remaining reports, different types of data adjustments were used by several authors, after which increased mortality was not seen in association to the use of ACEi in this context. ACEi use could act as a marker of increased mortality risk in some but not all COVID-19 disease settings. The data now presented do not prove a causal relation but argue in favor of carrying out clinical trials studying ACEi in COVID-19 patients, to establish the safety of ACEi use in this context.


Derivation of severity index for rheumatoid arthritis and its association with healthcare outcomes.
To develop a claims-based severity index for rheumatoid arthritis (RA) using the Veterans Health Administration (VHA) database. Adult patients with at least two RA diagnoses 2 months apart were identified between 10/1/2008-09/30/2009. Patients were required to have at least 12 months continuous health plan enrollment before and after the index date (first RA diagnosis date) for an overall study period of 10/1/2007-09/30/2010. A severity index for rheumatoid arthritis (SIFRA, a proprietary algorithm of SIMR, Inc. [STATinMED Research]) was developed by calculating a weighted sum of 34 RA-related indicators assessed by an expert Delphi panel of six rheumatologists, including laboratory, clinical, and functional status, extra-articular manifestations, surgical history, and medications, during a 1-year pre-index period. Separate SIFRA versions were derived for patients with and without laboratory information. Correlations between SIFRA and previously validated claims-based indexes for RA severity (CIRAS), and other traditional comorbidity indexes were calculated during the pre-index period. The relationship between SIFRA and follow-up healthcare outcomes was also examined using histograms. The Spearman's rank correlations between SIFRA and CIRAS were 0.525 for SIFRA without and 0.539 with laboratory data. The correlations between SIFRA and the Charlson Comorbidity Index (CCI) (0.1503 without, 0.1135 with laboratory data), Elixhauser Index (ELIX) (0.105 without, 0.079 with laboratory data), and Chronic Disease Score (CDS) (0.255 without, 0.239 with laboratory data) were low. Histograms showed that patients in the upper tercile of SIFRA incurred $9123 more all-cause and $1326 more RA-related healthcare costs during the 1-year post-index period than patients in the lower tercile. Using SIFRA in combination with CCI, CDS, or ELIX significantly increased the percentage of variation explained in outcomes measures. Patients in the VHA database may not represent typical RA patients since the database generally contains older, economically disadvantaged men with a high disease burden. Validity of the score is indirectly based on disease activity score 28 (DAS28), which measures disease activity rather than severity. SIFRA was found to have moderate correlations with the previously validated CIRAS score, and demonstrated evidence of being a significant determinant of total and RA-related healthcare costs for RA patients. This study suggests that SIFRA could be an important methodological tool to control for severity in RA-related outcomes research. The algorithm can be applied to any claims dataset.


Impact of dextran sulfate in culture media on titration of vesicular stomatitis virus.
Viral vectors derived from vesicular stomatitis virus (VSV) are important vectors for the development of vaccines and for the treatment of cancer. The efficiency of therapy based on VSV is dependent on the dose of virus used. Therefore it is essential to measure accurately and reproducibly the amount of functional vectors in the samples to be tested. Two common methods used to measure the titer of VSV are TCID50% and plaque assay. In the current study, we compared these two titration methods by using a recombinant VSV expressing the green fluorescent protein (VSV-GFP) as a model virus. Some culture media developed for suspension mammalian cells contain dextran sulfate. We observed that plaque assay, but not TCID50%, can underestimate the virus titer up to 10 fold when VSV-GFP was produced in culture media containing dextran sulfate. Dextran sulfate is commonly used in serum-free culture media to reduce cell aggregation in suspension culture. The inhibitory effect of dextran sulfate on the titration of VSV-GFP was confirmed by supplementing the culture medium with this compound during virus production. Our results also demonstrated that extending the incubation time during plaque assay and TCID50% increases virus titer.


Combined therapeutic strategy using erythropoietin and mesenchymal stem cells potentiates neurogenesis after transient focal cerebral ischemia in rats.
Many studies showed beneficial effects of either erythropoietin (EPO) or mesenchymal stem cells (MSCs) treatment in cerebral ischemia. In addition to a neuroprotective role, not only EPO but also MSC favors neurogenesis and functional recovery. In an attempt to further improve postischemic tissue repair, we investigated the effect of a systemic administration of MSC, in the presence or not of EPO, on neurogenesis and functional recovery in a transient focal cerebral ischemia model in the adult rat. Twenty-four hours after ischemia, the rats were divided into four groups, namely vehicle, MSC, EPO, and MSC+EPO, and received a single intravenous injection of MSC (2 x 10(6) cells) and/or a repeated intraperitoneal administration of EPO (1,000 UI/kg) for 3 days. The lesion volume, the MSC outcome, neurogenesis, and functional recovery were assessed 51 days after ischemia. The results showed that cellular proliferation and neurogenesis were increased along the lateral ventricle wall in the MSC+EPO group, whereas no significant effect was observed in groups receiving MSC or EPO alone. This effect was accompanied by an improvement of mnesic performances. Mesenchymal stem cells expressing neuronal or glial markers were detected in the ischemic hemisphere. These results suggest that EPO could act in a synergistic way with MSC to potentiate the postischemic neurogenesis.


Primary structure of human alpha 2-macroglobulin. II. Primary structure of eight CNBr fragments located in the NH2-terminal half of alpha 2-macroglobulin, accounting for 603 amino acid residues.
The amino acid sequence has been determined for eight medium-sized CNBr fragments from the NH2-terminal part of human alpha 2-macroglobulin. The fragments are: CB2 (10-78), CB5 (129-223), CB6 (224-295), CB7 (296-392), CB8 (393-441), CB11 (498-584), CB12 (585-643), and CB17 (691-775). These fragments account for 603 of the 1451 residues of the subunits of alpha 2-macroglobulin. CB2 contains two glucosamine-based carbohydrate groups attached to Asn-23 and Asn-38, and one internal disulfide bridge connecting Cys-16 with Cys-54. CB6 contains one glucosamine-based carbohydrate group attached to Asn-1 and two internal disulfide bridges (Cys-5 bound to Cys-53 and Cys-23 bound to Cys-41, respectively); Cys-32 is bound to Cys-16 in CB8. CB7 contains two glucosamine-based carbohydrate groups attached to Asn-78 and Asn-92, CB8 contains 1 Cys residue (Cys-16), bridged to Cys-32 of CB6. CB11 contains 1 Cys residue (Cys-75), bridged to Cys-58 of CB17. CB12 contains 1 Cys residue (Cys-35), bridged to Cys-1 of CB15. CB17 contains 1 Cys residue (Cys-58), bound to Cys-75 of CB11.


Vascular effects of dietary L-arginine supplementation.
The vascular endothelium is acknowledged to play an important role in vascular physiology. Attention has focused on endothelial production of nitric oxide as a key element in many of the processes associated with the development of atherosclerosis. L-arginine is the substrate for the enzyme nitric oxide synthase (NOS), which is responsible for the endothelial production of nitric oxide. Therefore, many investigators have been interested in whether dietary L-arginine supplementation can augment nitric oxide production and thereby improve vascular health. The effects of oral L-arginine on vascular health and disease have been examined both in human beings and in various animal models. In this review, we summarize the results of studies of oral L-arginine supplementation on atherosclerotic lesion formation, as well as markers of endothelial function (e.g. macrophage function, platelet aggregation and adhesion, and in vitro vascular ring studies). Although results of oral L-arginine supplementation in hypercholesterolemic animals have generally shown beneficial effects, the data in humans are varied, possibly because of small sample sizes and brief periods of study. Long-term randomized clinical trials are needed to more definitively address whether oral L-arginine supplementation could be advantageous for vascular health.


Adhesion design maps for fibrillar adhesives: the effect of shape.
The biomimetic reproduction of adhesion organs, as found in flies, beetles and geckoes, has become a topic of intense research over the past years. Successes, however, have so far been limited. This is due to the vast range of parameters involved, including fibril size, elastic modulus, contact shape, surface roughness and ambient humidity. In previous studies, design and materials selection charts to determine the optimum materials and design combination for dry adhesive systems have been established. The effect of shape on the adhesive properties of single fibers and fiber arrays has also been a research focus. In this paper both approaches are combined to provide more advanced guidelines for the design of optimal adhesive structures.


Diagnostic accuracy of urinary antigen tests for legionellosis: A systematic review and meta-analysis.
Urinary antigen tests (UATs) have been used for the early detection of legionellosis and have demonstrated moderate sensitivity and high specificity. However, the most recent systematic review and meta-analysis published in 2009 evaluated the accuracy of UATs; since then, UAT accuracy may have changed owing to advances and developments in UAT technology and epidemiological changes in the frequency of Legionella species that cause legionellosis. Therefore, this systematic review and meta-analysis aimed to update the accuracy of UATs for legionellosis among patients with suspected pneumonia. Overall, 1326 studies were screened, 21 of which fulfilled the eligibility criteria for quality assessment and meta-analysis. Data from 5772 patients, including 1368 (23.7%) with the target condition (i.e., suspected legionellosis), were included in the analysis. The overall quality of the included studies, which was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, was unclear. The calculated pooled sensitivity and specificity were 0.79 (95% confidence interval [CI], 0.71-0.85) and 1.00 (95% CI, 0.99-1.00), respectively. Subpopulation analysis revealed that the accuracy of UATs for sensitivity and specificity for Legionella pneumophilia serogroup 1 was 0.86 (95% CI, 0.78-0.91) and 1.00 (95% CI, 0.99-1.00), respectively. This study demonstrated that the sensitivity and specificity of UATs were moderate and high, respectively, which is comparable to the results reported in 2009. Therefore, UATs may be a useful method for the early detection of legionellosis caused by Legionella pneumophila serogroup 1. The review protocol was prospectively registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000041080).


Relationship between sexual orientation and psychotic experiences in the general population in England.
Non-heterosexual individuals are at high risk for a variety of factors associated with the emergence of psychotic experiences (PEs) (e.g. common mental disorders, substance use, and stress). However, there is a scarcity of data on the association between sexual orientation and PEs. Therefore, the aim of this study was to examine the sexual orientation-PE relationship, and to identify potential mediators in this relationship. This study used nationally representative cross-sectional data from the 2007 Adult Psychiatric Morbidity Survey. Sexual orientation was dichotomized into heterosexual and non-heterosexual. Past 12-month PE was assessed with the Psychosis Screening Questionnaire. Regression and mediation analyses were conducted to analyze the association between sexual orientation and PEs, and to identify potential mediators involved in this relationship. The final sample consisted of 7275 individuals aged ⩾16 years. The prevalence of non-heterosexual orientation and any PE was 7.1% and 5.5%, respectively. After adjusting for sex, age, and ethnicity, non-heterosexual orientation was positively associated with any PE (odds ratio 1.99, 95% confidence interval 1.34-2.93). The strongest mediators involved in this relationship were borderline personality disorder (BPD) traits (mediated percentage = 33.5%), loneliness (29.1%), and stressful life events (25.4%). These findings suggest that there is a positive relationship between sexual orientation and PEs in the general population in England, and that underlying mechanisms may involve BPD traits, loneliness, and stressful life events. Future studies with a longitudinal design are warranted to shed more light on how these factors are implicated in the association between sexual orientation and PEs.


[Analysis of function of the glutamatergic and GABAergic mediator systems in the olfactory cortex of spontaneously hipertensive rats in vitro].
The effect of persistent hypertension on neuronal activity and synaptic transmission has been studied on olfactory cortex slices of SHR rats. The profilies of focal potentials in hypertensive rats demonstrated a short duration of the 2-amino-3-(5-methyl-3-hydroxyisoxazol-4-yl)-propanoic acid (AMPA) component of excitatory postsynaptic potential (EPSP), a small amplitude and long duration of the N-methyl D-aspartate (NMDA) component of EPSP, and a large amplitude of the GABAB-dependent slow inhibitory postsynaptic potentials. The sensitivity of glutamate receptors responsible for the generation of AMPA- and NMDA-mediated EPSPs was low after the exposure to 1 mM L-glutamate. The amplitudes of the AMPA- and NMDA-mediated EPSPs decreased. Tetanization of slices from hypertensive rats induced a short-term potentiation followed by a depression. The data obtained indicate that persistent hypertension has depressive effects on the basic glutamatergic and GABAergic parameters of synaptic activity of neurons as well as on learning and memory. Apparently, these processes were evoked by glutamate excitotoxicity in the brain of hypertensive rats.


Topoisomerase 2 alpha: a real predictor of anthracycline efficacy?
Anthracyclines are frequently used in the adjuvant setting for breast cancer treatment since it is considered that anthracycline-based chemotherapy treatment benefits breast cancer patients. Nonetheless, these drugs are associated with severe side effects and predictive factors, for sensitivity to anthracyclines, are warranted in clinical practice. Topoisomerase 2 alpha (TOP2A) is considered to be the molecular target of these drugs. The potential predictive value of TOP2A amplification and overexpression has been extensively studied in breast cancer patients treated with anthracyclines. However, results are not conclusive. In this paper, we review some of the published studies addressing the predictive value of TOP2A as well as the cellular functions of this enzyme and its status in breast cancer tissue.


Extraordinary Case: Unique Presentation of an Aggressive Epstein-Barr Virus-Positive Mucocutaneous Ulcer.
Epstein-Barr virus-positive mucocutaneous ulcer is a recent and unusual type of lymphoproliferation, mostly associated with various forms of immunosuppression. In most cases, they regress spontaneously, but an increasing number of reports describe a spectral behavior of the lesion, which ranges from a simple ulcer with eosinophilia to aggressive ulcers. In these cases, Epstein-Barr virus-related lymphomas are the main differential diagnosis. We report a unique observation of this rare disease with mandibular involvement. Due to bone erosion, the patient was treated with 6 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) with complete healing of the ulcer on clinical examination and PET-scan control.


Bio-inspired layered chitosan/graphene oxide nanocomposite hydrogels with high strength and pH-driven shape memory effect.
The layered nanocomposite hydrogel films containing chitosan (CS) and graphene oxide (GO) have been prepared by water evaporation induced self-assembly and subsequent physical cross-linking in alkaline solution. The layered CS/GO hydrogel films obtained have a nacre-like brick-and-mortar microstructure, which contributes to their excellent mechanical properties. The tensile strength and elongation at break of the hydrogel films with 5wt% GO are 5.35MPa and 193.5%, respectively, which are comparable to natural costal cartilage. Furthermore, the CS/GO hydrogel films exhibited pH-driven shape memory effect, and this unique phenomenon is mainly attributed to the reversible transition of partial physically cross-linking corresponding to hydrogen bondings and hydrophobic interactions between CS polymer chains due to pH changing.


Lack of weight gain of sheep following iodine supplementation in inland regions of the South Island.
Weight gain response to iodine supplementation was investigated in five groups of sheep in different seasons. In only one spring period in one trial was a significant response obtained.


Islet cell transplantation in children.
This paper aims to provide an overview of islet cell transplantation in children, with specific attention to pediatric total pancreatectomy with islet autotransplantation (TPIAT). We will summarize the definition and causes of chronic pancreatitis in children, the TPIAT procedure and potential complications, the process of islet cell isolation and autotransplantation, and long-term results after TPIAT. Lastly, we will briefly discuss islet cell allotransplantation in the adult population and its potential role in treating children.


Advances in Osteosarcoma.
This article gives a brief overview of the most recent developments in osteosarcoma treatment, including targeting of signaling pathways, immune checkpoint inhibitors, drug delivery strategies as single or combined approaches, and the identification of new therapeutic targets to face this highly heterogeneous disease. Osteosarcoma is one of the most common primary malignant bone tumors in children and young adults, with a high risk of bone and lung metastases and a 5-year survival rate around 70% in the absence of metastases and 30% if metastases are detected at the time of diagnosis. Despite the novel advances in neoadjuvant chemotherapy, the effective treatment for osteosarcoma has not improved in the last 4 decades. The emergence of immunotherapy has transformed the paradigm of treatment, focusing therapeutic strategies on the potential of immune checkpoint inhibitors. However, the most recent clinical trials show a slight improvement over the conventional polychemotherapy scheme. The tumor microenvironment plays a crucial role in the pathogenesis of osteosarcoma by controlling the tumor growth, the metastatic process and the drug resistance and paved the way of new therapeutic options that must be validated by accurate pre-clinical studies and clinical trials.


Yueju volatile oil plays an integral role in the antidepressant effect by up-regulating ERK/AKT-mediated GLT-1 expression to clear glutamate.
Phytochemical investigation of the volatile oil of Yueju (YJVO) and its constituent herbs induced the detection of 52 compounds in YJVO, mainly monoterpenes and sesquiterpenes as well as a small amount of aromatic and aliphatic compounds. 5 of these compounds were found only in the YJVO instead of the volatile oil of its constituent herbs. The anti-depressant effect of YJVO was proved by behavioral tests in chronic unpredictable mild stress (CUMS) mice. An acute oral toxicity evaluation determined the LD50 of YJVO was 5.780 mL/kg. Doppler ultrasound and laser speckle imaging have detected that the YJVO could improve depression-related cerebral blood flow. In addition, related neurotransmitters and proteins were analyzed through targeted metabolomics and immunofluorescence. The potential antidepressant mechanisms of YJVO related to significantly decreasing Glu in CUMS mice by up-regulating the ERK/AKT-mediated expression of GLT-1.


Office space planning and design for medical practices: Part 2, Remodel or build new.
The decision to build anew or remodel/add-on to your existing facility can be a tough one. Your practice could possibly have multiple levels of ownership, equity, or lack of equity in the existing facility, emotional ties to the current location or building, etc. This article will deal with just how a practice makes that decision.


Effects of the organophosphate fenthion for control of the red-billed quelea Quelea quelea on cholinesterase and haemoglobin concentrations in the blood of target and non-target birds.
The red-billed quelea bird Quelea quelea is one of sub-Saharan Africa's most damaging pests, attacking small-grain crops throughout semi-arid zones. It is routinely controlled by spraying its breeding colonies and roosts with organophosphate pesticides, actions often associated with detrimental effects on non-target organisms. Attributions of mortality and morbidity of non-targets to the sprays are difficult to confirm unequivocally but can be achieved by assessing depressions in cholinesterase activities since these are reduced by exposure to organophosphates. Here we report on surveys of birds caught before and after sprays that were examined for their blood cholinesterase activities to assess the extent to which these became depressed. Blood samples from birds were taken before and after sprays with fenthion against red-billed quelea in colonies or roosts, and at other unsprayed sites, in Botswana and Tanzania and analysed for levels of haemoglobin (Hb) and activities of whole blood acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). Background activities of AChE, BChE and Hb concentrations varied with bird species, subspecies, mass, age and gender. Contrary to expectation, since avian erythrocytes are often reported to lack cholinesterases, acetylcholinesterase activities in pre-spray samples of adult birds were positively correlated with Hb concentrations. When these factors were taken into account there were highly significant declines (P < 0.0001) in AChE and BChE and increases in Hb after contact with fenthion in both target and non-target birds. BChE generally declined further (up to 87 % depression) from baseline levels than AChE (up to 83 % depression) but did so at a slower rate in a sample of quelea nestlings. Baseline activities of AChE and BChE and levels of Hb were higher in the East African subspecies of the red-billed quelea Q. q. aethiopica than in the southern African subspecies Q. q. lathamii, with the exception of BChE activities for adult males which were equivalent.


Untangling therapeutic ingredients of a personalized intervention for patients with depression and severe COPD.
We developed a personalized intervention for depressed patients with COPD (PID-C) aimed to mobilize patients to participate in the care of both conditions. We showed that PID-C reduced depressive symptoms and dyspnea-related disability more than usual care over 28 weeks. This study focused on untangling key therapeutic ingredients of PID-C. Randomized controlled trial. Community. 138 patients who received the diagnoses of COPD and major depression after screening 898 consecutive admissions for acute inpatient pulmonary rehabilitation. Nine sessions of PID-C compared with usual care over 28 weeks. Primary outcome measures were the 17-item Hamilton Depression Rating Scale and the Pulmonary Functional Status and Dyspnea Questionnaire-Modified. Other measures were adherence to rehabilitation exercise (≥2 hours per week) and adherence to adequate antidepressant prescriptions. Low severity of dyspnea-related disability and adherence to antidepressants predicted subsequent improvement of depression. Exercise and low depression severity predicted improvement of dyspnea-related disability. PID-C led to an interacting spiral of improvement in both depression and disability in a gravely medically ill population with a 17% mortality rate over 28 weeks and an expected deterioration in disability. The interrelationship of the course of depression and dyspnea-related disability underscores the need to target adherence to both antidepressants and chronic obstructive pulmonary disease rehabilitation. PID-C may serve as a care management model for depressed persons suffering from medical illnesses with a deteriorating course.


Direct anterior versus posterolateral approaches for clinical outcomes after total hip arthroplasty: a systematic review and meta-analysis.
The main objective of our study was to compare the intraoperative and postoperative outcomes of direct anterior approach (DAA) with posterolateral approaches (PLA). We searched Cochrane library, Web of Science, and PubMed for literatures comparing DAA with PLA. On the basis of inclusion and exclusion criteria, relevant literatures were selected. Two members independently screened qualified literatures, evaluated the literature quality, and extracted data information. Eighteen randomized controlled trials (RCTs) and non-RCTs totaling 34,873 patients (DAA = 9636, PLA = 25237) were contained in this systematic review and meta-analysis. The results showed that DAA were reduced in terms of length of hospital stay (weighted mean difference (WMD) = -0.43, 95% confidence interval (CI) -0.78 to -0.09, P = 0.01), LLD (WMD = -2.00, 95% CI -2.75 to -1.25, P < 0.00001), PE/DVT (WMD = 0.36, 95% CI 0.15 to 0.85, P = 0.02), dislocation (WMD = 0.42, 95% CI 0.30 to 0.59, P < 0.00001) and visual analog scale (VAS) (WMD = -0.57, 95% CI -0.91 to -0.23, P = 0.0009) compared with PLA; however, DAA compared with the PLA was increasing in terms of operative time (WMD = 14.81, 95% CI 7.18 to 22.44, P = 0.0001), intraoperative blood loss (WMD = 105.13, 95% CI 25.35 to 184.90, P = 0.01), fracture (WMD = 1.46, 95% CI 1.00 to 2.11, P = 0.05), and Harris hip score (HHS) (WMD = 1.19, 95% CI 0.77 to 1.61, P < 0.00001). DAA was preferable effectiveness to PLA in early pain relief and functional recovery; however, PLA has a shorter operation time, intraoperative less blood loss and fracture. Registration ID, CRD42020151208.


A Perspective to Control Laser-Induced Periodic Surface Structure Formation at Glancing-Incident Femtosecond Laser-Processed Surfaces.
The favorable combination of high material removal rate and low influence on the material beneath the ultra-short pulsed laser-processed surface are of particular advantage for sample preparation. This is especially true at the micrometer scale or for the pre-preparation for a subsequent focused ion beam milling process. Specific surface features, the laser-induced periodic surface structures, are generated on femtosecond laser-irradiated surfaces in most cases, which pose an issue for surface-sensitive mechanical testing or microstructural investigations. This work strives for an approach to enhance the surface quality of glancing-incident laser-processed surfaces on the model material copper with two distinctly different grain sizes. A new generalized perspective is presented, in which optimized parameter selection serves to counteract the formation of the laser-induced periodic surface structures, enabling, for example, grain orientation mapping directly on femtosecond laser processed surfaces. The online version contains supplementary material available at 10.1007/s11837-021-04963-w.


Peritoneal dialysis catheter outcomes in infants initiating peritoneal dialysis for end-stage renal disease.
End-stage renal disease (ESRD) although rare among infants presents many management challenges. We sought to evaluate factors associated with PD catheter failure among infants initiated on chronic PD. A retrospective chart review of all children under two years of age who had PD catheters placed for initiation of chronic PD from 2002 to 2015. Data was extracted for catheter related events occurring within 12 months of catheter placement. Cox and Poisson regression models were used to delineate factors associated catheter complications. Twenty-five infants with median age 18 days had PD catheters placed for chronic dialysis. Common complications included leakage around the exit site (31%), blockage (26%), migration or malposition (23%), catheter-related infections (18%), and other complications (2%). Predictors of initial PD catheter failure were age less than one month at catheter placement (hazard ratio (HR) 7.77, 95% CI, 1.70-35.39, p = 0.008), use of catheter within three days of placement (HR 5.67, 95% CI, 1.39-23.10, p = 0.015) and presence of a hernia (HR 8.64, 95% CI, 1.19-62.36, p = 0.033). In an adjusted Poisson regression model, PD catheter use within three days of placement was the only predictor of any catheter complication over the12 months of follow up. Use of PD catheters within three days of placement was associated with catheter failure. We recommend that when possible, catheters should be allowed to heal for at least three days prior to use to reduce risk of complications and improve catheter survival.


Hyperhomocysteinemia: a risk factor for retinal vein occlusion.
The aim of the study was to investigate the plasma homocysteine levels in patients with retinal vein occlusion (RVO) in order to reveal whether hyperhomocysteinemia was a risk factor for RVO. Thirty-three consecutive patients diagnosed to have RVO of any type and 25 age- and sex-matched controls without RVO were included in this prospective case-control study. Data regarding age, sex, history of hypertension, diabetes mellitus, other vascular events, glaucoma, medications and smoking habits were obtained from all subjects. Several laboratory tests relating to vascular disease including cholesterol, triglyceride and hematocrit were checked. The plasma total homocysteine (tHcy) level was measured by high-performance liquid chromatography (normal range: 5-15 micromol/l). Plasma folate, vitamin B(12) and creatinine levels were also studied since these vitamins and impairment of renal function might affect plasma tHcy values. Patients with RVO had a significantly higher tHcy level (median: 11.7 micromol/l, range: 7.2-25 micromol/l) compared to controls (median: 10.3 micromol/l, range: 6.7-13.4 micromol/l; p = 0.005). Nine of 33 patients with RVO (27.3%) had an elevated plasma tHcy level, whereas none of the controls had an abnormal tHcy value (p = 0.004). Plasma folate, vitamin B(12) and creatinine levels were comparable between the two groups (p > 0.05). The present study suggests an association between hyperhomocysteinemia and RVO. Further controlled studies with a large number of cases are needed to investigate the exact role of hyperhomocysteinemia in RVO.


Application of Artificial Intelligence (AI) in a Cephalometric Analysis: A Narrative Review.
In recent years, the application of artificial intelligence (AI) has become more and more widespread in medicine and dentistry. It may contribute to improved quality of health care as diagnostic methods are getting more accurate and diagnostic errors are rarer in daily medical practice. The aim of this paper was to present data from the literature on the effectiveness of AI in orthodontic diagnostics based on the analysis of lateral cephalometric radiographs. A review of the literature from 2009 to 2023 has been performed using PubMed, Medline, Scopus and Dentistry & Oral Sciences Source databases. The accuracy of determining cephalometric landmarks using widely available commercial AI-based software and advanced AI algorithms was presented and discussed. Most AI algorithms used for the automated positioning of landmarks on cephalometric radiographs had relatively high accuracy. At the same time, the effectiveness of using AI in cephalometry varies depending on the algorithm or the application type, which has to be accounted for during the interpretation of the results. In conclusion, artificial intelligence is a promising tool that facilitates the identification of cephalometric landmarks in everyday clinical practice, may support orthodontic treatment planning for less experienced clinicians and shorten radiological examination in orthodontics. In the future, AI algorithms used for the automated localisation of cephalometric landmarks may be more accurate than manual analysis.


Review of the effects of peroxide on enamel and dentine properties.
To review the available literature investigating the effects of peroxide-based products and solutions on enamel and dentine properties. All original scientific full papers listed in ISI Web of Science and Medline were included in this review using the search terms peroxide AND (enamel OR dentin*) up to the end of 2006. The majority of studies indicate that peroxide containing products and solutions have no significant deleterious effects on enamel and dentine surface morphology and chemistry, surface microhardness, subsurface enamel and dentine microhardness or ultrastructure. In addition, in vitro studies indicate that they have no significant clinically relevant effects on subsequent enamel and dentine loss caused by acidic erosive challenges, toothpaste abrasion or caries lesion formation. The contrasting studies that do show an effect on some of the above properties, in general, have some limitations in the in vitro methods used which do not accurately reflect the in vivo situation or use products/solutions that have a particularly low pH where acidic erosive processes are likely to dominate and explain the observed changes in enamel and dentine.


Detection of carbonic anhydrase IX protein in the diagnosis of malignant pleural effusion by enzyme-linked immunosorbent assay and immunocytochemistry.
Carbonic anhydrase IX (CAIX) is a hallmark of metabolic change in cancer cells. The aim was to evaluate the utility of CAIX expression for the detection of malignant pleural effusions by enzyme-linked immunosorbent assay (ELISA) and immunocytochemistry. A total of 97 pleural effusions including 54 benign effusions, 10 atypical effusions, and 33 malignant effusions, classified based on cytological diagnosis and etiology, were subjected to ELISA to measure protein level and to immunocytochemistry in cell blocks to determine CAIX expression. CAIX levels were significantly higher in the malignant group compared with the benign group. Receiver operating characteristic curve analysis of benign and malignant pleural effusion for CAIX indicated an area under the curve of 0.82 with a value of 1882 pg/dL as the best threshold for distinguishing benign from malignant effusions, which yields a sensitivity, specificity, and accuracy of 63.6%, 94.4%, and 82.8%, respectively. None of the benign effusion expressed CAIX by immunocytochemistry. Malignant effusion cell blocks expressed CAIX in 63.6% of cases with 100% specificity. Upon combination of CAIX level and immunocytochemistry to detect malignant pleural effusions, the sensitivity and accuracy increased to 81.8% and 89.7%, respectively. The CAIX level determined by ELISA and the CAIX expression detected by immunocytochemistry were positively correlated. In atypical effusions, 5 cases (50%) exhibited CAIX levels higher than the cutoff value or were highlighted by CAIX immunocytochemistry. ELISA and immunocytochemistry methods for determination of CAIX protein are potential additional tests for detection of malignant pleural effusions.


Pharmacokinetics, metabolism, and renal excretion of articaine and its metabolite articainic acid in patients after epidural administration.
Articaine is metabolized into articainic acid. The half-lives of articaine are 0.54 +/- 0.05 and 2.44 +/- 0.30 h and that of its metabolite, 2.44 +/- 0.30 h. Of the administered dose approximately 2-5% is excreted unchanged, 40-70% is excreted as articainic acid, and 4-15% as articainic acid glucoronide. The percentage of the total dose recovered in the urine varies between 50% and 91%. Protein binding of articaine in patients varies between 50% and 70%, and that of articainic acid between 60% and 90%. Renal clearance of articaine varies between 12 and 28 ml min-1, while that of articainic acid is between 84 and 160 ml min-1.


Experimental transplantation gliomas in the adult cat brain. 3. Regional biochemistry.
Experimental brain tumours were produced in adult cats by stereotactic xenotransplantation of the rat glioma clone F98. Regional ATP, glucose and lactate were measured after 2-4 weeks on coronal cryostat sections by substrate-induced bioluminescence, potassium content was imaged by the histochemical sodium cobaltinitrite method, and regional pH by incubating cryostat sections with the fluorescent pH-indicator umbelliferone. The regional biochemical alterations were correlated with magnetic resonance imaging and tissue water content. Biochemical changes were heterogeneous in tumours but exhibited a rather uniform pattern in peritumoural oedema. ATP was consistently reduced, glucose and lactate were increased and pH was more alkaline than in normal white matter. The decrease of ATP matched the increase of water, indicating that ATP decline represents fractional dilution in the oedematous tissue rather than break-down of energy metabolism. The increased lactate levels, therefore, may originate from the tumour and not from a metabolic disturbance in the peritumoural oedematous tissue. The implications of this interpretation for the pathogenesis of peritumoural oedema are discussed.


Single base discrimination of CENP-B repeats on mouse and human Chromosomes with PNA-FISH.
The satellite repeat structure of the mammalian centromere contains the CENP-B protein binding site. Using the peptide nucleic acid-fluorescence in situ hybridization (PNA-FISH), we show by direct PNA-DNA binding that all detectable CENP-B sites in a mammalian genome might have the same sequence. Two species-specific PNA 17-mers, pMm and pMc, were identified from CENP-B binding sites of Mus musculus and M. caroli, respectively. Fluorescence in situ hybridization confirmed that pMc hybridized to M. caroli centromeres only; however, pMm cross-hybridized to M. musculus and human centromeres. By using a series of CENP-B PNA 17-mers containing 1, 2, 3, 5, and 7 base-pair mismatches to their DNA counterparts, we further demonstrate that PNA-FISH can discriminate between two CENP-B DNA sequences that differ by a single base-pair in mouse and human centromeres, suggesting the degree of conservation of CENP-B sequences throughout the genome. In comparison with DNA oligonucleotides, PNA oligomers demonstrate the higher sequence specificity, improved stability, reproducibility, and lower background. Therefore, PNA oligomers have significant advantages over DNA oligonucleotide probes in analyzing microsatellites in a genome.


[The buried penis : Indications, a new technique and the results].
The buried penis describes a bunch etiologies and clinical presentations of which the congenital form is rare. In the past different techniques had been described, using inner prepuce after mobilization to cover the penile shaft. This can lead to persistent edema of the skin. We developed a new technique to reduce the rate of postoperative edema.


A study of inpatient referral patterns to a general hospital psychiatry unit in India.
The pattern of inpatient referral to a general hospital psychiatry department was examined in the present study. The referral rate of 3.6% was higher than those reported by other investigators from India. The majority of the patients had concurrent physical illness. Neurotic depression and alcohol dependence were the most frequent diagnoses. A diagnosis of schizophrenia was relatively infrequent. Among the patients referred for consultation, there was a high percentage of cases of self-inflicted injury and poisoning. Psychiatric disturbances were of transient nature in about one third of the cases. In about 20% of the cases, no physical illness was detected and their somatic complaints were considered to be psychologically determined.