Spectral and image analysis of hyperspectral data for internal and external quality assessment of peach fruit.
Hyperspectral imaging was attempted to evaluate the internal and external quality of 'Feicheng' peach by providing the spectral and spatial data simultaneously. Mask-image was created from hyperspectral image at 810 nm and used to segment the fruit region where the average spectrum, after area normalization, was obtained for soluble solids content (SSC) and firmness evaluation. Pixel size and area were used for diameter and weight estimation. Then effective wavelengths were selected by competitive adaptive reweighted sampling (CARS) and random frog (RF), and employed to develop multiple linear regression (MLR) models. The more effective prediction performances emerged from CARS-MLR model withRV2 = 0.841, RMSEV = 0.546, RPD = 2.51 for SSC andRV2 = 0.826, RMSEV = 1.008, RPD = 2.401 for firmness, followed by creating pixel-wise and object-wise visualization maps for quantifying SSC and firmness. Furthermore, peach diameter was estimated by calculating the minimum bounding rectangle with an average percentage error of 1.01 %, and the MLR model forweightpredictionachieveda good performance ofRV2 = 0.957, RMSEV = 9.203, and RPD = 4.819. The overall results showed that hyperspectral imaging could be used as an effective and non-destructive tool for evaluating the internal and external quality attributes of 'Feicheng' peach, and provided a holistic approach to develop online grading systems for quality tiers identification.


Tensile Bond Strength between Soft Liners and Two Chemically Different Denture Base Materials: Effect of Thermocycling.
The bond strength of soft denture liner to a recently introduced denture base resin after thermocycling has not been compared to traditional denture base materials. The objective of this study was to investigate the effects of thermocycling on the tensile bond strength of soft denture liners to two chemically different denture base resins, polymethyl methacrylate (PMMA) and urethane dimethacrylate (UDMA). A total of 48 PMMA and UDMA tensile test specimens were fabricated by attaching two different soft denture liners (Molloplast-B, Permaflex) according to the manufacturers' instructions and assigned to two groups. Half of the specimens for each group were stored in water for 1 week, and the other half were thermocycled (5000 cycles) between baths of 5°C and 55°C. Specimens were mounted on a universal testing machine with a 5 mm/min crosshead speed. The data were analyzed with three-way ANOVA and post hoc Tukey-Kramer multiple comparisons tests (α = 0.05). The highest bond strength was measured in the specimens from the UDMA/Molloplast groups, and the lowest was seen in the PMMA/Permaflex group. No significant difference in bond strength was detected in PMMA/Permaflex groups after thermocycling (p = 0.082), whereas other groups exhibited significant differences after thermocycling (p < 0.05). Thermocycling decreased the bond strength values in both the PMMA and UDMA groups. Regardless of types of soft liners, PMMA specimens presented lower bond strength values than UDMA specimens, both before and after thermocycling.


Long-term results of sacral neuromodulation with the tined lead procedure.
We present long-term followup data on the outcome of sacral neuromodulation using the tined lead procedure. We conducted a single center study including all patients who received an implantable neurostimulator between 2002 and 2005 using the tined lead technique. Treatment efficacy was evaluated by comparing the data of a 3-day voiding diary filled out in May 2009 to the data before the onset of sacral neuromodulation treatment (baseline). Clinical success was defined as more than 50% improvement in at least 1 of the relevant voiding diary parameters. A total of 64 patients underwent implantation with an implantable neurostimulator using the tined lead procedure. Mean followup was 53 months (range 35 to 77). Five patients died of causes unrelated to sacral neuromodulation and they were not included in analysis. The implantable neurostimulator was removed from 7 patients and 3 stopped using the neurostimulator. Voiding diary analysis showed that 38 of 59 patients (64%) were successfully treated. There were 21 patients (33%) who underwent a surgical revision due to an adverse event and 1 (1.6%) who underwent lead revision because of suspected lead migration. Sacral neuromodulation with the tined lead procedure is a safe and effective treatment for patients with overactive bladder symptoms or urinary retention.


Family factors in the development of disordered eating: integrating dynamic and behavioral explanations.
Previous studies exploring the dynamic (e.g., enmeshment, disengagement, rigidity, communication difficulties, overprotectiveness) and behavioral (e.g., parental modeling of eating behavior and attitudes toward weight, parental criticism and teasing, parental encouragement to diet) influences of the family on disordered eating behaviors have yielded mixed results. However, past research explored these different aspects of the family environment in isolation. The present study extended previous research by testing a prediction model in which the effects of family dynamics on the development of eating disorders operate through family food-related experiences. A total of 268 single college women completed the Eating Attitudes Test - Revised, Bulimia Test - Revised, Parental Bonding Instrument - II, Family Adaptability and Cohesion Scales - II, Parent Adolescent Communication Scale - Adolescent Form, Family Influence Scale, and Family Experiences Related to Food Questionnaire. Structural Equation Modeling revealed that both family dysfunction and negative family food-related experiences were associated with increased disordered eating. Results indicated that negative family food-related experiences mediated the relationship between family dysfunction and disordered eating. Discussion focuses on implications for the assessment and treatment of eating disorders.


Understanding the effect of workload on automation use for younger and older adults.
This study examined how individuals, younger and older, interacted with an imperfect automated system. The impact of workload on performance and automation use was also investigated. Automation is used in situations characterized by varying levels of workload. As automated systems spread to domains such as transportation and the home, a diverse population of users will interact with automation. Research is needed to understand how different segments of the population use automation. Workload was systematically manipulated to create three levels (low, moderate, high) in a dual-task scenario in which participants interacted with a 70% reliable automated aid. Two experiments were conducted to assess automation use for younger and older adults. Both younger and older adults relied on the automation more than they complied with it. Among younger adults, high workload led to poorer performance and higher compliance, even when that compliance was detrimental. Older adults' performance was negatively affected by workload, but their compliance and reliance were unaffected. Younger and older adults were both able to use and double-check an imperfect automated system. Workload affected how younger adults complied with automation, particularly with regard to detecting automation false alarms. Older adults tended to comply and rely at fairly high rates overall, and this did not change with increased workload. Training programs for imperfect automated systems should vary workload and provide feedback about error types, and strategies for identifying errors. The ability to identify automation errors varies across individuals, thereby necessitating training.


Phase I study of oxaliplatin in combination with capecitabine and radiotherapy as postoperative treatment for stage II and III rectal cancer.
A Phase I study was conducted to determine the maximal tolerated dose and the dose-limiting toxicity (DLT) of oxaliplatin (OXA) combined with capecitabine and radiotherapy as adjuvant treatment in patients with operable rectal cancer. A total of 21 patients with Stage II or III rectal adenocarcinoma after curative surgery were treated with radiotherapy to a total dose of 50 Gy in 5 weeks. OXA was administered at a dosage of 40 (n = 6), 50 (n = 3),60 (n = 3), 70 (n = 3), or 80 mg/m(2) (n = 6) once a week for 2 weeks (first cycle) followed by a second cycle after a 7-day break. Capecitabine at a fixed dose of 1,300 mg/m(2)/d was administered orally at the same schedule as for OXA. DLT was defined as Grade 3 or 4 hematologic and nonhematologic toxicity. Grade 1-3 leukopenia, diarrhea, and nausea/vomiting were the most common toxic side effects, and most were Grade 1-2. A DLT was first observed in 1 of 3 patients at 40 mg/m(2) (Grade 3 diarrhea) but was not observed in the next 3 patients at the same level or in patients who received a dose level of 50-70 mg/m(2). At 80 mg/m(2), DLT occurred in 3 of 6 patients (1 Grade 4 leukopenia and 2 Grade 3 diarrhea). OXA combined with a fixed dose of capecitabine at 625 mg/m(2) twice daily by mouth plus radiotherapy in the adjuvant setting was tolerable and clinically feasible. The maximal tolerated dose of OXA in this setting was 80 mg/m(2), comparable to the maximal tolerated dose of OXA in the neoadjuvant setting.


Intracranial aneurysm and hemorrhage following skull caliper traction. Review of skull traction complications.
Serious complications of caliper skull traction for fracture-dislocations of the cervical spine are so rare that they are not discussed in most standard textbooks. A fusiform intracranial aneurysm which followed the placement of skull tongs is reported. Subsequent aneurysmal rupture produced an intracerbral hematoma requiring drainage. The literature recording the complications of skull caliper traction is reviewed and the indications for skull traction and the need for scrupulous surgical technique are emphasized.


Transient structural MRI patterns correlate with the motor functions in preterm infants.
To explore the relationships between transient structural brain patterns on MRI at preterm and at term-equivalent age (TEA) as a predictor of general movements (GMs) and motor development at 1-year corrected age (CA) in very preterm infants. In this prospective study, 30 very preterm infants (median = 28wks; 16 males) had structural magnetic resonance imaging (MRI) at preterm (median = 31wks + 6d) and at TEA (median = 40wks) and neuromotor assessments. The quality of GMs was assessed by Prechtl's general movements assessment and a detailed analysis of the motor repertoire was performed by calculating a motor optimality score (MOS), both at term age and at 3 months post-term. Motor development at 1-year CA was evaluated with the Infant Motor Profile (IMP). Associations between qualitative MRI findings and neuromotor scores were investigated. Abnormal GMs and low motor performance at 1-year CA were associated with the poor visibility of transient structural pattern, that is with sagittal strata. Transient structural MRI pattern, sagittal strata, at preterm age is related to the quality of GMs and later motor development in preterm infants. This transient fetal brain compartment may be considered as a component of neurobiological basis for early neuromotor behavior, as expressed by GMs.


Recovery of two elite footballers from adductor strain with dry needling and eccentric strengthening: Two case studies.
Groin injuries are common in sports, almost 68% adductor strain among them, which generally more prone in football, soccer, hockey, and other games. The available literature well describes the rehabilitation phase of adductor strain but an application of dry needling on adductor injuries are not yet established. Two national-level younger football players were clinically diagnosed with the adductor strain. They had severe pain on medial aspect of the thigh, aggravated with kicking and functional activity (VAS- 8/10, LEFS 58/80, 69/80). The therapist assessed the patients and designed their rehabilitation protocol as per their findings of the examination. The lower extremity functional scale (LEFS), global rating scale, and VAS were used as outcome variables. The total intervention was given for 10-12 weeks, follow up had been taken for 4 months. The application of dry needling reduced the pain, improved and relieved the symptoms. The eccentric strengthening of the adductors and core stability improved the strength as well as functional activity of the lower limb. The case study is not generalized the effect of treatment. Thus, a randomized control trial is suggested for further study.


Synergistic control of joint angle variability: influence of target shape.
Reaching movements are often used to study the effectiveness of motor control processes with respect to the final position of arm and hand. Empirical evidence shows that different targets can be grasped with similar final position accuracy. However, movements that achieve similar accuracy at their final position may nevertheless be controlled differently. In particular, control strategies may differ in the control of the abundant degrees of freedom with respect to the task-specific costs. The objective of the present study was to investigate whether the applied control strategy was influenced by the shape of the target to be grasped. It was investigated whether mechanical constraints, imposed on final hand orientation or final hand position by the shape of the targets, affected the synergistic coordination of the kinematic degrees of freedom of the arm. Subjects were asked to grasp either a cylindrical or a spherical target, which imposed different constraints on final hand orientation and position. Besides temporal movement aspects, variability of the joint angles of the arm, as well as variability of hand orientation and hand position was analyzed over the whole time course of movement execution, using the uncontrolled manifold method. Overall movement duration differed between cylindrical and spherical target condition, due to differences in deceleration duration. Reaching movements towards the cylindrical target, which was more constraint in final hand orientation and position, took longer than movements towards the spherical target. Analysis further revealed that the degrees of freedom of the arm were synergistically coordinated to stabilize both hand orientation and hand position, when grasping either the spherical or the cylindrical target. This suggests that the applied control strategy in natural reaching movements can simultaneously account for multiple task constraints. The analysis further revealed that stabilization of hand orientation was stronger when reaching towards a cylindrical target, which imposed more constraints on final hand orientation. In contrast, hand position was more strongly stabilized in the spherical target shape condition, where stronger constraints on final hand position were applied. This suggests that different target shapes do influence the control strategy of reaching movements even though variability at movement end was not affected.


Evaluation of silymarin in the treatment on asymptomatic Giardia infections in dogs.
We have reported previously the efficacy of antiprotozoal drugs against canine giardiasis (In press, Journal of Veterinary Clinic, the Korean Society of Veterinary Clinics). Fenbendazole was found to be the most efficacious for the treatment of canine giardiasis. There were no significant differences between the efficacy of albendazole and fenbendazole against canine giardiasis. On the other hand, the efficacy of metronidazole for the treatment of canine giardiasis, the efficacy was lower when compared to that of albendazole and fenbendazole. On the basis of these results, to evaluate clinical effect of silymarin, we evaluated the therapeutic efficacy of metronidazole alone, or combined with silymarin for 2 weeks for canine giardiasis. In addition, to observe effects on nutrition, we investigated the changes of body weight, the serum biochemical indicators for liver inflammation (GOT, GPT, NH3), the liver cell regeneration indicators (total protein, albumin) and the hematological changes during treatment (WBC, RBC, MCV, MCH and MCHC). The dogs were allocated to four groups; one group was treated with silymarin (3.5 mg/kg once a day, oral), another with metronidazole (50 mg/kg once a day, oral), and the other group with silymarin (3.5 mg/kg once a day, oral) plus metronidazole (50 mg/kg once a day, oral), while control group remained nontreated. The fecal samples from all the dogs were examined, using the ZSCT and giardia antigen test kit (SNAP(*) Giardia, IDEXX Laboratories), from each dog of each group for three times a week for 2 weeks. Dogs were considered to have giardiasis when one or more of the fecal samples had positive results for Giardia cysts. Seven days after treatment, the efficacy of silymarin plus metronidazole was found 79%, whereas that of metronidazole was 72%. Ten days post-treatment the efficacy of metronidazole plus silymarin (91%) was significantly different in comparison with that of metronidazole (75%). Two weeks post-treatment no cysts were detected in the fecal samples in the dogs of metronidazole or silymarin plus metronidazole-treated groups. Whereas, the fecal samples of all the dogs of the control and only silymarin-treated groups were giardia positive. Signs of side effects were not observed in silymarin plus metronidazole-treated dogs. But poor appetite and intermittent vomiting signs were observed in two dogs of the metronidazole-treated group that resolved when metronidazole administration was discontinued. The body weight of those treated with metronidazole was significantly decreased in comparison with those treated with silymarin and metronidazole plus silymarin. There were significant differences of body weight between the dogs treated with silymarin and metronidazole. Two weeks after metronidazole treatment, serum concentration of GOT, GPT and NH3 were significantly increased in comparison with those treated with silymarin. On the other hand, the serum concentration of GOT, GPT and NH3 were not significantly increased when treated with silymarin plus metronidazole compared to those treated with metronidazole. Serum total protein and albumin concentrations were decreased after metronidazole treatment as compared to those treated with silymarin and silymarin plus metronidazole. The concentrations of serum total protein and albumin decreased significantly in metronidazole-treated group as compared to that of treated with silymarin. The numbers of WBC and RBC did show significant differences in the dogs treated with metronidazole, while MCV, MCH were significant by different between silymarin and metronidazole-treated dogs. On the other hand, there were no significant differences in MCHC in any groups. These data suggest that silymarin, in supplement with antiprotozoal drugs, can influence the therapy of canine giardiasis.


Inflammation-induced Gro1 triggers senescence in neuronal progenitors: effects of estradiol.
Inflammation has been proposed to contribute to the decline in adult hippocampal neurogenesis. Proinflammatory cytokines activate transcription of chemokine growth-regulated oncogene α (Gro1) in human and murine hippocampal neuronal progenitor cells (NPC). The goal of this study was to investigate the effects of Gro1 on hippocampal neurogenesis in the presence of inflammation. Human hippocampal NPC were transfected with lentivirus expressing Gro1, and murine NPC and hippocampal neuronal HT-22 cells were treated with Gro1 protein. A plasmid expressing mGro1 was electroporated in the hippocampus of newborn mice that were sacrificed 10 days later. Adult male and female mice were injected with lipopolysaccharide (LPS; 1 mg/kg, i.p in five daily injections) or normal saline. Adult male mice were implanted with pellets releasing 17-β estradiol (E2; 2.5 mg/pellet, 41.666 μg/day release) or placebo for 6 weeks and challenged with LPS or normal saline as above. In both experiments, mice were sacrificed 3 h after the last injection. Hippocampal markers of neurogenesis were assessed in vitro and in vivo by Western blot, real-time PCR, and immunohisto/cytochemistry. Gro1 induced premature senescence in NPC and HT-22 cells, activating senescence-associated β-galactosidase and the cell cycle inhibitor p16 and suppressing neuroblast proliferation and expression of doublecortin (DCX) and neuron-specific class III beta-tubulin (Tuj-1), both neuroblast markers, while promoting proliferation of neural glial antigen 2 (Ng2)-positive oligodendrocytes. Gro1 overexpression in the hippocampus of newborn mice resulted in decreased neuroblast development, as evidenced by decreased DCX expression and increased expression of platelet-derived growth factor α receptor (PDGFαR), a marker of oligodendrocyte precursors. In adult mice, Gro1 was induced in response to LPS treatment in male but not in female hippocampus, with a subsequent decrease in neurogenesis and activation of oligodendrocyte progenitors. No changes in neurogenesis were observed in females. Treatment with E2 blunted LPS-induced Gro1 in the male hippocampus. Inflammation-induced Gro1 triggers neuroblast senescence, thus suppressing new neuron development in the hippocampus. Sex-dependent differences in Gro1 response are attributed to estradiol, which blunts these changes, protecting the female hippocampus from the deleterious effects of inflammation-induced Gro1 on neurogenesis.


The effects of experimenter status and cardiovascular reactivity on pain reports.
Existing evidence suggests that experimenter characteristics can influence research participants' pain reports. To examine the possibility that cardiovascular reactivity may serve as a potential mediating mechanism, blood pressure responses to stress were recorded in 117 healthy women during an arithmetic task and a subsequent cold pressor pain task. Laboratory sessions were conducted by two experimenters (i.e., a university professor and a graduate research assistant), who differed significantly on participant ratings of perceived social status. Participants tested by the university professor showed greater blood pressure responsivity to arithmetic and had higher pain tolerance and lower pain unpleasantness ratings compared to those tested by the research assistant. Further, hierarchical regression analyses indicated that blood pressure reactivity was a potential mediator of the association between experimenter status and both pain tolerance and unpleasantness, suggesting that perceived experimenter status may elicit physiological adaptations that can reduce sensitivity to painful laboratory stimuli.


Vertical gaze palsy induced by midbrain lesions and its structural imaging.
We experienced four cases of vertical gaze palsy induced by midbrain lesions. Lesions commonly covered the rostral midbrain, including the rostral interstitial nucleus, dorsomedial to the red nucleus. Two of the four cases resulted from vascular insult, in which a single, unpaired perforator is supposed to innervate the rostral midbrain and medial thalamus bilaterally. One case showed vertical gaze palsy accompanied by bilateral ptosis. The findings agree with recent experimental evidence that a neural substrate in eyelid control lies in the supraoculomotor area immediately dorsal to the oculomotor nucleus. The remaining two cases, a brain hemorrhage and an inflammatory tumor, showed unilateral lesions of the rostral midbrain. In these cases, vertical gazes were not abolished, but were limited in an incomplete way. This may be explained by partial damages of the descending fibers, some of which decussate through the posterior commissure before it reaches the oculomotor nucleus. Thus, clinical signs and symptoms were clarified based on anatomical and physiological points of view.


Sustained ventricular tachycardia associated with influenza syndrome in a young girl--a case report.
Ventricular arrhythmias in children with no demonstrable heart disease are rare. In a thirteen-year-old girl, a typical influenza syndrome was complicated by sustained ventricular tachycardia. Exercise tests, echocardiography, electrophysiological studies, and endomyocardial biopsy were negative. Viremia, fever, or medications may be responsible for this unusual complication.


Architecture and intrinsic connections of the prefrontal cortex in the rhesus monkey.
An investigation of the architectonic organization and intrinsic connections of the prefrontal cortex was conducted in rhesus monkeys. Cytoarchitectonic analysis indicates that in the prefrontal cortex there are two trends of gradual change in laminar characteristics that can be traced from limbic periallocortex towards isocortical areas. The stepwise change in laminar features is characterized by the emergence and gradual increase in the width of granular layer IV, by an increase in the size of pyramidal cells in layers III and V, and by a higher cell-packing density in the supragranular layers. Myeloarchitectonic analysis reveals that the limbic areas are poorly myelinated, adjacent areas have a diffuse myelin content confined to the deep layers, and in isocortices the myelinated fibers are distributed in organized horizontal bands (of Bail-larger) and a vertical plexus. Using the above architectonic criteria, we observed that one of the architectonic trends takes a radial basoventral course from the periallocortex in the caudal orbitofrontal region to the adjacent proisocortex and then to area 13. The next stage of architectonic regions includes orbital areas 12, 11, and 14, which is followed by area 10, lateral area 12, and the rostral part of ventral area 46. The last group includes the caudal part of ventral area 46 and ventral area 8. The other trend takes a mediodorsal course from the periallocortex around the rostral portion of the corpus callosum to the adjacent proisocortical areas 24, 25, and 32 and then to the medially situated isocortical areas 9, 10, and 14. The next stage includes lateral areas 10 and 9 and the rostral part of dorsal area 46. The last group includes the caudal part of dorsal area 46 and dorsal area 8. The interconnections of subdivisions of the basoventral and mediodorsal cortices were studied with the aid of anterograde and retrograde tracers. Within each trend a given area projects in two directions: to adjoining regions belonging to succeeding architectonic stages on the one hand, and to nearby regions from the preceding architectonic stage on the other. In each direction there is more than one region involved in this projection system, paralleling the radial nature of architectonic change. Periallo- and proisocortices have widespread intrinsic connections, whereas isocortices situated at a distance from limbic areas, such as area 8, have restricted connections. Most interconnections are limited to areas within the same architectonic trend. However, there are links between cortices from the two trends, and these seem to occur between areas that are at a similar stage of architectonic differentiation.(ABSTRACT TRUNCATED AT 400 WORDS)


Cross-sensitivity of patient-perceived adverse cognitive effects with antiepileptic drug use.
The extent to which adverse cognitive effects (ACEs) to a specific antiepileptic drug (AED) affect the chance of developing ACEs to other AEDs (i.e., cross-sensitivity) is unknown. We investigated the rates of cross-sensitivity of ACEs among AEDs and examined the association between clinical characteristics and occurrence of having ACEs to multiple AEDs in adults with epilepsy. The rates of cross-sensitivity of intolerable ACEs (IACEs; i.e., ACEs leading to dosage reduction or discontinuation) and the non-AED predictors of IACEs were investigated in 2269 patients who had taken at least two AEDs at a single center. We accounted for AED load and looked for specific cross-sensitivities between AEDs as well as cross-sensitivity based on the AED mechanism of action. Among the 2269 patients, the highest rates of IACEs were seen with TPM (26.3%), ZNS (9.8%), PHT (8.8%), and VPA (8.5%). Intolerable ACEs to two or more AEDs occurred in 100 patients (4.4%). History of psychiatric condition(s) and absence seizure type were independent predictors of IACEs to two or more AEDs. High rates of cross-sensitivity of IACEs were seen between phenytoin (PHT) and lamotrigine (LTG), valproate (VPA) and phenytoin, and valproate and zonisamide (ZNS). For example, of patients who had IACEs to VPA and were also prescribed ZNS, 46.2% had IACEs to ZNS (abbreviated as VPA→ZNS: 46.2%); of patients who had IACEs to ZNS and were also prescribed VPA, 37.5% had IACEs to VPA (abbreviated as ZNS→VPA: 37.5%). Other results are as follows: LTG→PHT: 28.6%, PHT→LTG: 20.0%, PHT→VPA: 42.9%, and VPA→PHT: 27.3%. No specific cross-sensitivities were found among AEDs sharing a similar mechanism of action. The probability of ACE intolerability to an AED can increase if a patient developed ACE intolerability to another AED. The cross-sensitivity rates for ACE intolerability between LTG and PHT, PHT and VPA, and VPA and ZNS were found to be particularly high. The cross-sensitivity rates provided here may be clinically useful for predicting ACE intolerability in patients taking certain AEDs and for AED selection in individual patients.


The relative effects of non-pharmaceutical interventions on wave one Covid-19 mortality: natural experiment in 130 countries.
Non-pharmaceutical interventions have been implemented around the world to control Covid-19 transmission. Their general effect on reducing virus transmission is proven, but they can also be negative to mental health and economies, and transmission behaviours can also change voluntarily, without mandated interventions. Their relative impact on Covid-19 attributed mortality, enabling policy selection for maximal benefit with minimal disruption, is not well established due to a lack of definitive methods. We examined variations in timing and strictness of nine non-pharmaceutical interventions implemented in 130 countries and recorded by the Oxford COVID-19 Government Response Tracker (OxCGRT): 1) School closing; 2) Workplace closing; 3) Cancelled public events; 4) Restrictions on gatherings; 5) Closing public transport; 6) Stay at home requirements ('Lockdown'); 7) Restrictions on internal movement; 8) International travel controls; 9) Public information campaigns. We used two time periods in the first wave of Covid-19, chosen to limit reverse causality, and fixed country policies to those implemented: i) prior to first Covid-19 death (when policymakers could not possibly be reacting to deaths in their own country); and, ii) 14-days-post first Covid-19 death (when deaths were still low, so reactive policymaking still likely to be minimal). We then examined associations with daily deaths per million in each subsequent 24-day period, which could only be affected by the intervention period, using linear and non-linear multivariable regression models. This method, therefore, exploited the known biological lag between virus transmission (which is what the policies can affect) and mortality for statistical inference. After adjusting, earlier and stricter school (- 1.23 daily deaths per million, 95% CI - 2.20 to - 0.27) and workplace closures (- 0.26, 95% CI - 0.46 to - 0.05) were associated with lower Covid-19 mortality rates. Other interventions were not significantly associated with differences in mortality rates across countries. Findings were robust across multiple statistical approaches. Focusing on 'compulsory', particularly school closing, not 'voluntary' reduction of social interactions with mandated interventions appears to have been the most effective strategy to mitigate early, wave one, Covid-19 mortality. Within 'compulsory' settings, such as schools and workplaces, less damaging interventions than closing might also be considered in future waves/epidemics.


Regulatory effect of heat shock transcription factor-1 gene on heat shock proteins and its transcriptional regulation analysis in small abalone Haliotis diversicolor.
The effects of diverse stresses ultimately alter the structures and functions of proteins. As molecular chaperones, heat shock proteins (HSPs) are a group of highly conserved proteins that help in the refolding of misfolded proteins and the elimination of irreversibly damaged proteins. They are mediated by a family of transcription factors called heat shock factors (HSFs). The small abalone Haliotis diversicolor is a species naturally distributed along the southern coast of China. In this study, the expression of HdHSF1 was inhibited by RNAi in hemocytes in order to further elucidate the regulatory roles of HdHSF1 on heat shock responsive genes in abalone. Meanwhile, to understand the transcriptional regulation of the HdHSF1 gene, the 5'-upstream regulatory region of HdHSF1 was characterized, and the relative promoter activity was examined by dual-luciferase reporter gene assay system in HEK293T cell lines. After the inhibition of the H. diversicolor HSF1 gene (HdHSF1) by dsRNA (double-stranded RNA), the expression of most heat shock related-genes was down-regulated (p < 0.05). It indicated the importance of HdHSF1 in the heat shock response of H. diversicolor. Meanwhile, 5'-flanking region sequence (2633 bp) of the HdHSF1 gene was cloned; it contained a putative core promoter region, TATA box, CAAT box, CpG island, and many transcription elements. In HEK293T cells, the 5'-flanking region sequence can drive expression of the enhanced green fluorescent protein (EGFP), proving its promoter function. Exposure of cells to the high-temperature (39 °C and 42 °C) resulted in the activation of HdHSF1 promoter activity, which may explain why the expression of the HdHSF1 gene participates in heat shock response. Luciferase activity of different recombinant plasmids, which contained different truncated promoter fragments of the HdHSF1 gene in HEK293T cells, revealed the possible active regions of the promoter. To further identify the binding site of the critical transcription factor in the region, an expression vector with the site-directed mutation was constructed. After being mutated on the GATA-1 binding site, we found that the luciferase activity was significantly increased, which suggested that the GATA-1 binding site has a certain weakening effect on the activity of the HdHSF1 promoter. These findings suggest that GATA-1 may be one of the transcription factors of HdHSF1, and a possible signaling pathway mediated by HdHSF1 may exist in H. diversicolor to counteract the adverse effects of heat shock stress.


Iron depletion alters surface-associated properties of Staphylococcus aureus and its association to human neutrophils in chemiluminescence.
Staphylococcus aureus NCTC 6571 was grown in iron-depleted tryptone soya broth (Fe-TSB) to approximate to in vivo conditions, and in iron-rich TSB (Fe + TSB). Low iron effected a crucial decrease in surface hydrophobicity (SH) and a lack of supernatant Protein A (PrA). Iron availability did not affect PrA detection in immunoblotting and it was identified as a 35.5 kDa antigen in this strain. Fe-phenotypes lacked 34, 48 and 52 kDa antigens. In chemiluminescence, Fe-phenotypes appeared least vulnerable to phagocytosis despite opsonisation.


The growth inhibitory effects of vitamins K and their actions on gene expression.
A characteristic defect occurs in rat and human hepatocellular carcinoma (HCC) resulting in a loss of function of the vitamin K-dependent enzyme gamma-glutamyl-carboxylase in the tumor but not in the underlying liver. This causes the secretion of elevated levels of the immature or des-gamma-carboxylated form of prothrombin, which is used as a marker of HCC. We investigated whether, using the defined conditions of growing HCC cell lines in tissue culture, addition of the naturally occurring vitamins K1 or K2 or the synthetic vitamin K3 could influence the secretion of immature prothrombin. We found that vitamins K1, K2 and K3 all suppressed the secretion of immature prothrombin into the tissue culture medium. Vitamins K2 and K3 were also found to inhibit growth of the HCC cell line, in an apparently nontoxic and reversible manner. The influence of the vitamins K on the expression of some genes related to vitamin K action was examined and compared with that of another growth inhibitor, TGF beta 1 protein. The vitamins K were found to increase the expression of prothrombin and carboxylase messenger RNA and c-myc messenger RNA, but had no effects on the expression of TGF beta 1 messenger RNA. By contrast, TGF beta 1 increased TGF beta 1 messenger RNA levels, but had no effects on the other genes, suggesting a different pathway. The previously studied vitamin K3-mediated inhibition of growth was antagonized by the addition of catalase to the culture medium, but the inhibitory effects of vitamin K2 were not antagonized.(ABSTRACT TRUNCATED AT 250 WORDS)


The efficacy of non-invasive brain stimulation in the treatment of children and adolescents with Anorexia Nervosa: study protocol of a randomized, double blind, placebo-controlled trial.
Current psychological and pharmacological treatments for Anorexia Nervosa (AN) provide only moderate effective support, and there is an urgent need for research to improve therapies, especially in developing age. Non-invasive brain stimulation has suggested to have the potential to reducing AN symptomatology, via targeting brain alterations, such as hyperactivity of right prefrontal cortex (PFC). We suppose that transcranial direct current stimulation (tDCS) to the PFC may be effective in children and adolescents with AN. We will conduct a randomized, double blind, add-on, placebo-controlled trial to investigate the efficacy of tDCS treatment on clinical improvement. We will also investigate brain mechanisms and biomarkers changes acting in AN after tDCS treatment. Eighty children or adolescent with AN (age range 10-18 years) will undergo treatment-as-usual including psychiatric, nutritional and psychological support, plus tDCS treatment (active or sham) to PFC (F3 anode/F4 cathode), for six weeks, delivered three times a week. Psychological, neurophysiological and physiological measures will be collected at baseline and at the end of treatment. Participants will be followed-up one, three, six months and one year after the end of treatment. Psychological measures will include parent- and self-report questionnaires on AN symptomatology and other psychopathological symptoms. Neurophysiological measures will include transcranial magnetic stimulation (TMS) with electroencephalography and paired pulse TMS and repetitive TMS to investigate changes in PFC connectivity, reactivity and plasticity after treatment. Physiological measures will include changes in the functioning of the endogenous stress response system, body mass index (BMI) and nutritional state. We expect that tDCS treatment to improve clinical outcome by reducing the symptoms of AN assessed as changes in Eating Disorder Risk composite score of the Eating Disorder Inventory-3. We also expect that at baseline there will be differences between the right and left hemisphere in some electrophysiological measures and that such differences will be reduced after tDCS treatment. Finally, we expect a reduction of endogenous stress response and an improvement in BMI and nutritional status after tDCS treatment. This project would provide scientific foundation for new treatment perspectives in AN in developmental age, as well as insight into brain mechanisms acting in AN and its recovery. Trial registration The study was registered at ClinicalTrials.gov (ID: NCT05674266) and ethical approval for the study was granted by the local research ethics committee (process number 763_OPBG_2014).


Restless legs syndrome in Egyptian medical students using a validated Arabic version of the Restless Legs Syndrome Rating Scale.
Restless legs syndrome (RLS) is a common movement disorder that has a variable prevalence and impact reported from different countries and specific populations. The current study validated an Arabic version of the International Restless Legs Syndrome Study Group (IRLSSG) rating scale (IRLS) and investigated the prevalence and impact of RLS in medical students at Ain Shams University in Cairo. Translation of IRLS was done according to standard recognized guidelines provided by the publisher. A total of 389 medical students (217 female and 172 male) participated in the study and answered four questions to detect RLS as proposed by the IRLSSG. Subjects who answered positively the first three questions were recruited for face-to-face interview to exclude RLS mimics and to answer the IRLS. A total of 46 subjects (11.8%; 27 female and 19 male) met the four criteria for RLS. Of these, 39 subjects (10%) had idiopathic RLS. Five subjects (1.3%) and two subjects (0.5%) reported association with history of anemia and diabetes mellitus respectively. Their mean total IRLS score was 16.33 ± 5.3, with moderate severity (11.62 ± 3.9) and low impact (3.1 ± 1.8). The prevalence of individuals who had two or more episodes of RLS of at least moderate severity per week was 5.9%. In this specific population of Egyptian medical students, a within-average prevalence of RLS was found with low impact on quality of life similar to worldwide reported populations. RLS sufferers were of high prevalence among this cohort. The Arabic version of IRLS is reliable and valid for further research in Arabic countries.


Myofibroblasts contribute to but are not necessary for wound contraction.
Wound contraction facilitates tissue repair. The correct balance between too little contraction, which leads to non-healing wounds, and too much contraction, which leads to contractures, is important for optimal healing. Thus, understanding which cells cause wound contraction is necessary to optimize repair. Wound contraction is hypothesized to develop from myofibroblast (cells which express alpha-smooth muscle actin; ACTA2) contractility, while the role of fibroblast contractility is unknown. In this study, we utilized ACTA2 null mice to determine what role fibroblasts play in wound contraction. Human scar contractures were immunostained for ACTA2, beta-cytoplasmic actin (ACTB), and gamma-cytoplasmic actin (ACTG1). Full-thickness cutaneous wounds were created on dorsum of ACTA2(+/+) mice and strain-matching ACTA2(+/-) and ACTA2(-/-) mice. Wound contraction was quantified. Tissue was harvested for histologic, immunohistochemical and protein analysis. Compared with surrounding unwounded skin, human scar tissue showed increased expression of ACTA2, ACTB, and ACTG1. ACTA2 was focally expressed in clusters. ACTB and ACTG1 were widely, highly expressed throughout scar tissue. Wound contraction was significantly retarded in ACTA2(-/-) mice, as compared to ACTA2(+/+) controls. Control mice had increased epithelialization, cell proliferation, and neovascularization. ACTA2(-/-) mice had lower levels of apoptosis, and fewer total numbers of cells. Smaller amount of collagen deposition and immature collagen organization in ACTA2(-/-) mice demonstrate that wounds were more immature. These data demonstrate that myofibroblasts contribute to but are not necessary for wound contraction. Mechanisms by which fibroblasts promote wound contraction may include activation of contractile signaling pathways, which promote interaction between non-muscle myosin II and ACTB and ACTG1.


Benign retropneumoperitoneum developed after endoscopic sphincterotomy and large balloon dilation of biliary sphincter for removal of large biliary stones: a case report.
Biliary endoscopic sphincterotomy (ES) followed by biliary orifice dilation (BOD) with large-diameter balloons (> 12 mm) is a relative new technique for extraction of large biliary stones. However, the safety and the potential complications of this combined technique are not known yet. We present a patient who developed benign retroperitoneum after ES plus BOD with large-diameter balloon for removal of a large biliary stone, which was successfully treated conservatively. To the best of our knowledge this is the first report of such a complication after introduction of this method to clinical practice.


Bisolvon and Actifed in the conservative management of glue ear.
Glue ear is a common condition in childhood. In this report treatment by Bisolvon and Actifed is described. In 60 patients, a success rate of 90% was recorded.


Somatosensory evoked potentials in Huntington's disease.
Scalp recorded somatosensory evoked potentials (SEPs) elicited by left and right median nerve stimulation were obtained in 21 patients with Huntington's disease (HD), 14 individuals at risk (AR) for HD, and 21 non-patient controls matched for age and sex. Although SEP abnormalities were not uniform in the HD group, no HD patient had SEPs that conformed fully to the normal configuration with respect to peak latencies, presence of all components and spatial distribution. The most common abnormality was non-specific in nature, consisting of amplitude reduction or virtual abscence of components after 100 msec. More specific deviations were noted in the early SEP events. In half of the HD patients, peak P30 seemed to occur at approximately 45 msec poststimulus; this peak could have been taken as the normal P45 had it not reversed in phase between the central and frontal leads. In these cases peak P45 prepared to be missing. Peak N20 latency values were longer in the HD group than in the non-patient controls, whereas the P15 latencies did not differ significantly. The conduction time between P15 and N20 was significantly longer in HD patients than the non-patient controls. SEPs of the majority of the ARs were similar to those of the non-patients controls in terms of overall configuration, although mean amplitudes were generally lower for ARs than non-patient controls and 4 ARs exhibited prolonged P15-N20 latency differences.


Chronic post amputation pain: pathophysiology and prevention options for a heterogenous phenomenon.
Chronic postamputation pain (cPAP) remains a clinical challenge, and current understanding places a high emphasis on prevention strategies. Unfortunately, there is still no evidence-based regimen to reliably prevent chronic pain after amputation. Risk factors for the development of phantom limb pain have been proposed. Analgesic preventive interventions are numerous and no silver bullet has been found. Novel techniques such as neuromodulation and cryoablation have been proposed. Surgical techniques focusing on reimplantation of the injured nerve might reduce the incidence of phantom limb pain after surgery. Phantom limb pain is a multifactorial process involving profound functional and structural changes in the peripheral and central nervous system. These changes interact with individual medical, psychosocial and genetic patient risk factors. The patient collective of amputees is very heterogeneous. Available evidence suggests that efforts should focus on prevention of phantom limb pain, since treatment is notoriously difficult. Questions as yet unanswered include the evidence-base of specific analgesic interventions, their optimal "window of opportunity" where they may be most effective, and whether patient stratification according to biopsychosocial risk factors can help guide preventive therapy.


Molecular structures, bond energies, and bonding analysis of group 11 cyanides TM(CN) and isocyanides TM(NC) (TM = Cu, Ag, Au).
We report on quantum chemical calculations at the DFT (BP86/TZP) and ab initio (CCSD(T)/III+) levels of the title compounds. The geometries, vibrational spectra, heats of formation, and homolytic and heterolytic bond dissociation energies are given. The calculated bond length of Cu-CN is in reasonable agreement with experiment. The theoretical geometries for CuNC and the other group 11 cyanides and isocyanides which have not been measured as isolated species provide a good estimate for the exact values. The theoretical bond dissociation energies and heats of formation should be accurate with an error limit of +/-5 kcal/mol. The calculation of the vibrational spectra shows that the C-N stretching mode of the cyanides, which lies between 2170 and 2180 cm(-)(1), is IR inactive. The omega(1)(C-N) vibrations of the isocyanides are shifted by approximately 100 cm(-)(1) to lower wavenumbers. They are predicted to have a very large IR intensity. The nature of the metal-ligand interactions was investigated with the help of an energy partitioning analysis in two different ways using the charged fragments TM(+) + CN(-) (TM = transition metal) and the neutral fragments TM(*) + CN(*) as bonding partners. The calculations suggest that covalent interactions are the driving force for the formation of the TM-CN and TM-NC bonds, but the finally formed bonds are better described in terms of interactions between TM(+) and CN(-), which have between 73% and 80% electrostatic character. The contribution of the pi bonding is rather small. The lower energy of the metal cyanides than that of the isocyanides comes from the stronger electrostatic interaction between the more diffuse electron density at the carbon atom of the cyano ligand and the positively charged nucleus of the metal.


2-Buten-4-olide (2-B4O) inhibits type II collagen-induced arthritis in Lewis rats.
2-Buten-4-olide (2-B4O) is an endogenous substance which suppresses appetite and/or food intake. We studied its effect on type II collagen-induced arthritis (CIA) in Lewis rats, an animal model for human rheumatoid arthritis. Bovine type II collagen with incomplete Freund's adjuvant was injected intradermally into Lewis rats to induce CIA. 2-B4O (50 or 100 mg/kg) significantly inhibited the expression of the clinical symptoms when administered i.p. daily from day 1 to 21 after immunization. Furthermore, administration of 2-B4O daily from day 15 to 21 significantly reduced the severity of symptoms in established CIA. In addition, the progression of soft tissue swelling and articular bone erosions were suppressed by daily administration of 2-B4O. 2-B4O also significantly suppressed the delayed-type hypersensitivity (DTH) response to type II collagen at doses of 50 and 100 mg/kg. Finally 2-B4O significantly inhibited the formation of anti-type II collagen antibody at a dose of 100 mg/kg, but not at 50 mg/kg. These results suggest that 2-B4O has the strong inhibitory effects and therapeutic usefulness effects on CIA through the suppression of immune responses to type II collagen.


Reproductive Hormones and Anthropometry: A Follow-Up of PCOS and Controls From Perimenopause to Older Than 80 Years.
There is a lack of knowledge about hormonal and anthropometric changes in women with polycystic ovary syndrome (PCOS) after the menopause. This work aimed to study reproductive hormones and anthropometry in women with PCOS older than 80 years. This prospective cohort study was conducted at a university hospital. A well-defined cohort of women with PCOS, previously examined in 1987 and 2008 (21 years) was reexamined in 2019 (11 years). Of the original cohort (n = 37), 22 women were still alive and 21 (age range, 72-91 years) participated. Comparisons were made with age-matched controls (n = 55) from the original control cohort (body mass index [BMI] similar to PCOS women). The results were compared with results from 1987 and 2008. Hormonal measurements and a physical examination were performed. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, sex hormone-binding globulin (SHBG), free androgen index (FAI), hirsutism score, BMI, and waist to hip ratio (WHR) were measured. At mean age 81 years, FSH levels were lower in women with PCOS (50 vs 70 IU/L) who were still more hirsute than controls (33% vs 4%). No differences were found in FAI, testosterone, SHBG or LH levels, BMI, or WHR. From perimenopausal age until the present age, levels of testosterone and FAI continued to decline in women with PCOS. SHBG levels continued to increase with age. FSH had not changed over time during the last 11 years. Women with PCOS at age 72 to 91 had lower FSH levels, remained clinically hyperandrogenic, and had similar FAI and body composition as controls.


Diagnostic performance on multiple parameters of real-time ultrasound shear wave elastography for evaluating nonalcoholic fatty liver disease: A rabbit model.
To study the diagnostic value of real-time ultrasound shear wave elastography (US-SWE) in evaluating the histological stages of nonalcoholic fatty liver disease (NAFLD) in a rabbit model. Twenty-one 8-week-old rabbits were fed a high-fat, high-cholesterol diet (experimental groups), and seven rabbits were fed a standard diet (control group). All rabbits underwent real-time US-SWE at various time points to document the histological stages of NAFLD. We categorized the histological stages as normal, NAFL, borderline nonalcoholic steatohepatitis (NASH), and NASH. We measured the elastic modulus of the liver parenchyma and analyzed the diagnostic efficacy of real-time US-SWE using the area under receiver operating characteristic curve (AUC) for the four histological stages. The mean, minimum, and maximum elastic modulus increase for NAFL, borderline NASH, and NASH. For the mean, minimum, and maximum elastic modulus, AUCs are 0.891 (95% confidence interval [CI]: 0.716-0.977), 0.867 (95% CI: 0.686-0.965), and 0.789 (95% CI:0.594-0.919) for differentiating normal liver from liver with NAFLD, respectively; AUCs are 0.846 (95% CI: 0.660-0.954), 0.818 (95% CI: 0.627-0.937), and 0.797 (95% CI:0.627-0.913) for differentiating normal liver or liver with NAFL from liver with borderline NASH or NASH, respectively; AUCs are 0.889 (95% CI: 0.713-0.976), 0.787 (95% CI: 0.591-0.918), and 0.895 (95% CI:0.720-0.978) for differentiating liver with NASH from liver with lower severity NAFLD or normal liver, respectively. Real-time US-SWE is an accurate, noninvasive technique for evaluating the histological stages of NAFLD by measuring liver stiffness. We recommend using the mean elastic modulus to differentiate the histological stages, with the minimum and maximum elastic modulus as valuable complements.


Assessment of the long-term safety and effectiveness of etanercept for the treatment of psoriasis in an adult population.
Etanercept is well tolerated and effective in moderate to severe plaque psoriasis. However, effectiveness and safety data beyond 2.5 years have not been reported. We sought to assess the effectiveness and safety profile of up to 4 years of etanercept therapy in psoriasis. We analyzed prospective data from previous trials and open-label extensions, including 506 patients who initiated etanercept therapy in either of two phase III trials. Patients received etanercept, 25 mg twice weekly, 50 mg weekly, or 50 mg twice weekly, depending on which trial therapy was started. Dosage adjustments were allowed in open-label extensions, but no patients exceeded 50 mg twice weekly. Outcomes included change from baseline for the static Physician Global Assessment and Dermatology Life Quality Index scores. Exposure-adjusted adverse event (AE) rates were calculated. In all, 75.9% (95% confidence interval 67.9-84.0) and 27.8% (95% confidence interval 19.3-36.2) maintained Dermatology Life Quality Index response (≥ 5-point improvement from baseline) and static Physician Global Assessment response (clear or almost clear) at 48 months, respectively. AE and serious AE rates were 243.5 and 7.8 events per 100 patient-years, respectively. No serious AE rates exceeded 1.0 event per 100 patient-years. Overall infection and serious infection rates were 96.9 and 0.9 events per 100 patient-years, respectively. No cases of tuberculosis or lymphoma were reported. Effectiveness data were limited to static Physician Global Assessment and Dermatology Life Quality Index scores. Analysis of AE rates was limited to available comparator databases. Etanercept demonstrated sustained effectiveness and a favorable safety profile with no cumulative toxicity for up to 4 years, representing, to our knowledge, the longest published study on etanercept use in psoriasis to date.


Effect of short-term organoid culture on the pharmaco-mechanical properties of rat extra- and intrapulmonary arteries.
1 Organoid cultured explants from differentiated tissues have gained renewed interest in the undertaking of physiological and pharmacological studies. In the work herein, we examined the pharmaco-mechanical properties of an in vitro model consisting of organoid cultured rings derived from rat extra- and intrapulmonary arteries, over a period of 4 days in culture. 2 Mechanical changes were quantified using isometric tension measurements on both fresh and cultured pulmonary arterial tissues, with experiments performed in the presence or absence of 10% foetal calf serum. Conventional histochemical and immunofluorescent stainings were also performed to assess tissue structure integrity and apoptosis. 3 The explants developed spontaneous rhythmic contractions (SRC) in approximately half of the vessels. SRC amplitude and time course were modified by conditions and agents acting on membrane potential (high-potassium solutions--levcromakalim, a potassium channel opener), while nitrendipine, an L-type calcium channel blocker, suppressed SRC. 4 Cultured explants also developed a hyper-reactivity to high potassium challenges (10-40 mM). Whereas contraction to serotonin (5-HT) was enhanced in intrapulmonary arteries, contraction to endothelin-1 remained unchanged after 4 days of culture. Serum did not alter contractile properties during the culture period. 5 Endothelial-dependent relaxation was maintained in response to A23187 500 microM, but was abolished in response to 10 microM carbamylcholine. 6 Histological and immuno-histological analyses revealed the absence of hypertrophied vascular wall or apoptosis. 7 In conclusion, the contractile phenotype as well as tissue structure integrity of organoid explants remain essentially intact during short-term culture, making this model suitable for pharmaco-genomic studies.


Risk factors associated with unsatisfactory hip function in children with late-diagnosed developmental dislocation of the hip treated by open reduction.
Open reduction with or without pelvic and femoral osteotomy is the accepted treatment option for children older than 18 months with developmental dislocation of the hip (DDH). However, few studies have investigated hip function in children with late DDH treated by open reduction. Therefore, we performed a retrospective study investigating the risk factors potentially associated with unsatisfactory hip function. We hypothesized that some risk factors can be associated with unsatisfactory hip function in patients with late DDH treated by open reduction. We retrospectively reviewed the clinical and radiographic data of 79 children (98 hips, mean age 39.7±18.6 months; range, 19-95.3) with late-detected DDH treated by open reduction. Acetabular index (AI), Tönnis grade, Center Edge Angle (CEA), avascular necrosis of the femoral epiphysis (AVN), and Severin radiographic grade were evaluated on radiographs. Hip function was rated according to modified Outcome Evaluation Standard for Congenital Dislocation of the Hip with a maximum score of 15. According to type of surgery, patients were divided into four groups: open reduction alone (Group A), open reduction in conjunction with pelvic osteotomy (Group B), and open reduction in conjunction with femoral osteotomy and Pemberton/Salter (Group C) or Bernese-type triple pelvic osteotomy (Group D). Analysis of variance (ANOVA), t-test, chi-square test, and multivariate regression analysis were used to evaluate the independent risk factors of unsatisfactory hip function. The mean hip function score was 10.8±2.8 (4.5-15); 61 hips (62.2%) had satisfactory function (23 [23.5%] excellent and 38 [38.8%] good), while 37 hips (37.8%) had unsatisfactory function (16 [16.3%] fair and 21 [21.4%] poor). Spearman correlation analysis indicated that age at surgery was negatively correlated with function score (r=-0.326, p=0.001). The age of patients with satisfactory hip function (34.5±14.2 months; range, 19.4-74.8) was significantly lower than those with unsatisfactory function (43.7±21 months; range, 20.6-95.3) (p=0.011). The hip function score in Group A (14.2±0.8; range, 12.8-15) was significantly higher than in the other three groups (p<0.001). Hip function score in patients with type III or IV AVN was significantly lower than those without AVN, or with type II AVN (p=0.001). Multivariate regression analysis confirmed age at surgery, type of surgery and AVN were negatively correlated with hip function score. Logistic regression analysis and chi-square test confirmed age and type of surgery, and AVN were independent risk factors of unsatisfactory hip function. Multivariate regression analysis found ability to squat and amount of hip flexion and abduction, significantly decreased with age at surgery; while presence of limping, amount of hip flexion, abduction, adduction and external rotation significantly decreased with type of surgery. Age at surgery, type of surgery and severe AVN are independent risk factors for unsatisfactory hip function in patients with late-detected DDH treated by open reduction. The ability to squat, the amount of hip flexion and abduction are the main functional parameters affected by age and surgery. IV, case series.


Effects of a structured dance program in Parkinson's disease. A Greek pilot study.
Dance for Parkinson's Disease® (DfPD®) is a structured dance program that has never been evaluated in Greek PD population. This study assesses for the first time the efficacy, safety and feasibility of DfPD® program in Greek PD patients. A total of 16 early-to-mid-stage PD patients (50% men, aged 56 ± 12) underwent a total of 16 60-min classes of adjusted to Greek music and dance culture DfPD®, twice weekly, over 8 weeks. Assessments were performed at baseline and at the end of the study period and included quality of life (PDQ-8), depressive symptoms (BDI-II), fatigue (PFS-16), cognitive functions (MoCA), balance (BBS) and body mass index (BMI). Safety (possible falls, injuries, muscle soreness or excessive fatigue) and feasibility (technical and financial parameters, willingness for participation and continuation, recruitment rates) were also assessed. Statistically significant improvements were found in quality of life (29 ± 47%, p = 0,020), depressive symptoms (26 ± 52%, p = 0,046), fatigue (13 ± 20%, p = 0,021), cognitive functions (17 ± 23%, p = 0,010), balance (5 ± 4%, p = 0,003) and BMI (2 ± 2%, p = 0,010). No adverse events, high adherence (93,75%) and low attrition (12,5%) rates were reported. A twice weekly 60-min DfPD® class for 8 weeks is a safe and feasible non-pharmacological complementary therapeutic intervention for Greek PD patients and may improve their quality of life, depressive symptoms, fatigue, cognitive functions, balance, and BMI. Further research on this intervention is warranted.


Evolution in the management of facial nerve schwannoma.
To design a treatment algorithm based on experience with facial nerve schwannomas (FNS) over a 30-year period. Retrospective chart review. Seventy-nine patients with facial nerve schwannomas seen from 1979 through 2009 at a tertiary referral private otologic practice were categorized by treatment modality. Interventions included surgical resection with grafting, bony decompression, observation, or stereotactic radiation. Outcome measures included House-Brackmann facial nerve grade before and after intervention as well as change in facial nerve grade, tumor size, involved segments of nerve, time to intervention. Thirty-seven patients (46.8%) ultimately underwent surgical excision with grafting or primary anastomosis, 21 (26.6%) underwent bony decompression alone, 15 (19.0%) were managed with observation only, and 6 (7.6%) had stereotactic radiation. Through 1995, 85% of cases had surgical resection and none had observation only. Of the 52 patients seen after 1995, 27% had surgical resection and grafting, 33% had bony decompression, 29% were managed with observation alone, and 11% had radiotherapy. Facial nerve grade was maintained or improved over the follow-up period (mean time = 3.9 years) in 78.9% of the decompression group and 100% of the observation and radiation groups compared to 54.8% of the resection group (P ≤ .012). Surgical resection and grafting, once widely accepted and practiced, has in many cases given way to observation, bony decompression, or stereotactic radiation. A wide armamentarium of options is available to the neurotologist treating facial nerve schwannomas with the ability to preserve facial function for a longer period of time.


Gestational age at birth and risk of gastric acid-related disorders in young adulthood.
Preterm birth is associated with gastric acid-related disorders in infancy, but no investigators have examined this association beyond early childhood. We used antisecretory medication data to explore whether preterm birth is associated with gastric acid-related disorders in young adulthood. We conducted a national cohort study of 626,811 individuals born in Sweden in 1973 to 1979, followed up for antisecretory (proton pump inhibitor and H2-receptor antagonist) medication prescriptions from all outpatient and inpatient pharmacies nationwide from 2005 to 2009 (ages 25.5-37.0 years). We excluded individuals with congenital anomalies, and examined potential confounding by other comorbidities identified on the basis of oral anti-inflammatory or corticosteroid medication prescription. Gestational age at birth was inversely associated with antisecretory medication prescription in young adulthood. Adjusted odds ratios for ≥1 antisecretory medication prescription/year were 3.38 (95% confidence interval [95% CI], 1.73-6.62) for individuals born at 22-27 weeks, 1.38 (95% CI, 1.19-1.60) for those born at 28-34 weeks, and 1.19 (95% CI, 1.06-1.32) for those born at 35-36 weeks, relative to those born full-term (37-42 weeks). Exclusion of individuals who were prescribed oral anti-inflammatory or corticosteroid medications (≥1/year) had little effect on these results. These findings suggest that low gestational age at birth may be independently associated with an increased risk of gastric acid-related disorders in young adulthood.


Synthesis, characterization and reactivity of trinuclear Cu(II) complexes derived from disalicylaldehyde malonoyldihydrazone.
Three new homotrinuclear copper(II) complexes [Cu3(slmh)(μ-Cl)2(CH3OH)3]⋅0.5CH3OH (1), [Cu3(slmh)(NO3)2(CH3OH)5]⋅1.5CH3OH (2) and [Cu3(slmh)(μ-ClO4)2(CH3OH)3]⋅2CH3OH (3) from disalicylaldehyde malonoyldihydrazone have been synthesized and characterized. The composition of the complexes has been established on the basis of data obtained from analytical and thermoanalytical data. The structure of the complexes has been discussed in the light of molar conductance, electronic, FT-IR and far-IR spectral data, magnetic moment and EPR spectral studies. The molar conductance values for the complexes in DMSO solution indicate that all of them are non-electrolyte. The magnetic moment values for the complexes suggest considerable metal-metal intramolecular interaction between metal ions in the structural unit of the complexes. The EPR spectral features reveal that at RT, the ground state for the complexes is a mixture of the quartet state (S=3/2) and doublet state (S=1/2). At lower temperature, the ground state for the complexes is dx(2)-y(2) with considerable contribution from dz(2) orbital. Dihydrazone ligand is present in enol form in all of the complexes. The complexes have distorted square pyramidal stereochemistry. The electron transfer reactions of the complexes have been investigated by cyclic voltammetry. Hydrogen peroxide mediated oxidation of benzyl alcohol catalyzed by complex 1 has been studied.


CSMD1 exhibits antitumor activity in A375 melanoma cells through activation of the Smad pathway.
In this work, we studied the effects of CUB and Sushi multiple domains 1 gene (CSMD1) expression in A375 melanoma cells in vivo and in vitro. CSDM1 expression decreased proliferation and migration, and increased apoptosis and G(1) arrest in A375 cells in vitro. Expression of CSDM1 in established xenografted tumors decreased tumor size and weight, and decreased the density of intratumor microvessels. The survival rate of mice with tumors expressing CSMD1 was significantly higher than mice with tumors that did not express CSDM1. These results confirm the role of CSDM1 as a tumor suppressor gene in melanoma cells. Furthermore, we found that CSMD1 can interact with Smad3, activate Smad1, Smad2, and Smad3, and increase the expression of Smad4. These results might prove helpful for the development of novel therapies for melanoma treatment.


Monitoring Responses to Basic Military Training with Heart Rate Variability.
Heart rate variability (HRV) has shown sensitivity to the acute stressors experienced by defense personnel. This study examines the suitability of overnight HRV as a repeated measure of allostatic load in defense personnel. Daily measures of sleep, cognitive load, and perceived exertion were reported for the 12-wk duration of basic military training (BMT) in 48 recruits. Physical activity, subjective well-being, and HRV were measured weekly. The natural log of the root mean square of successive differences of interbeat intervals (Ln RMSSD) and the Ln RMSSD to interbeat interval ratio (Ln RMSSD:RRi ratio) during predicted slow wave sleep were used for HRV. Physical performance was assessed via the 20-m shuttle run and maximal push-up test in weeks 2 and 8 of BMT with predicted V̇O 2 peak values calculated. Predicted V̇O 2 peak increased from 42.6 ± 4.5 to 48.0 ± 2.7 mL·kg -1 ·min -1 ( P < 0.001). Ln RMSSD was elevated in weeks 7 and 10, and the Ln RMSSD:RRi ratio was elevated in week 10 above all other weeks ( P < 0.05). An increase in perceived exertion ( F = 9.10, P = 0.003) and subjective fatigue ( F = 6.97, P = 0.009), as well as a reduction in V̇O 2 peak ( F = 7.95, P = 0.009), individually predicted an increase in Ln RMSSD. The best predictive model of Ln RMSSD included perceived exertion ( F = 8.16, P = 0.005), subjective fatigue ( F = 8.49, P = 0.004), the number of awakenings during sleep ( F = 7.79, P = 0.006), and the change in V̇O 2 peak ( F = 19.110, P < 0.001). HRV was predicted by subjective recruit responses to BMT workloads rather than objective measures of physical activity. Improvements in cardiorespiratory fitness depicted recruits who experienced enough stress to facilitate physiological adaptation, which was reflected by a reduction in HRV during BMT. Monitoring HRV and HRV in relation to interbeat interval length may provide a better tool for determining allostatic load than HRV alone.


Construction of phosphomannose isomerase (PMI) transformation vectors and evaluation of the effectiveness of vectors in tobacco (Nicotiana tabacum L).
Phosphomannose isomerase (pmi) gene isolated from Escherichia coli allows transgenic plants carrying it to convert mannose-6- phosphate (from mannose), a carbon source that could not be naturally utilized by plants into fructose-6-phosphate which can be utilized by plants as a carbon source. This conversion ability provides energy source to allow the transformed cells to survive on the medium containing mannose. In this study, four transformation vectors carrying the pmi gene alone or in combination with the β-glucuronidase (gusA) gene were constructed and driven by either the maize ubiquitin (Ubi1) or the cauliflower mosaic virus (CaMV35S) promoter. Restriction digestion, PCR amplification and sequencing were carried out to ensure sequence integrity and orientation. Tobacco was used as a model system to study the effectiveness of the constructs and selection system. PMI11G and pMI3G, which carry gusA gene, were used to study the gene transient expression in tobacco. PMI3 construct, which only carries the pmi gene driven by CaMV35S promoter, was stably transformed into tobacco using biolistics after selection on 30 g 1(-1) mannose without sucrose. Transgenic plants were verified using PCR analysis. PMI/pmi - Phosphomannose isomerase, Ubi1 - Maize ubiquitin promoter, CaMV35S - Cauliflower mosaic virus 35S promoter, gusA - β-glucuronidase GUS reporter gene.


The efficacy and safety of pyrotinib in treating HER2-positive breast cancer patients with brain metastasis: A multicenter study.
To investigate the efficacy and safety of pyrotinib in treating patients with human epidermal growth factor receptor type 2 (HER2)-positive breast cancers with brain metastasis. This is a multicenter retrospective study, and the HER2-positive breast cancer patients with brain metastasis were studied. The enrolled patients were given pyrotinib 400 mg orally once per day for 21 days as one cycle, and evaluated every two cycles. All relevant data were detected for final assessments including medical history, clinical examination, histopathology, immunohistochemistry, radiographic imaging, treatment outcome, and adverse events. Forty-two female patients in total were enrolled in this study. The objective response rate (ORR) and disease control rate (DCR) of central nervous system (CNS), were found in 20 of 42 (47.6%) and in 39 of 42 (92.8%), respectively, while for extra-CNS, the respective ORR and DCR were in 9 of 38 (23.6%) and in 36 of 38 (94.7%), respectively. The compounded ORR and DCR were seen in 17 of 42 (40.4%) and in 39 of 42 (92.8%), respectively. The improvement rate of craniocerebral symptoms after treatment was (19/19) 100% and the median duration was 15 months. The median effective time of brain metastases and other metastases was 43 and 50 days. The median follow-up time was 22 months (interquartile range, 16.0-24.3 months). The median time for progression in brain metastasis was 16.6 months. The median time to progress for our group patients was 11.1 months. Sixteen patients (36%) with adverse reactions were recorded in the study. Pyrotinib combined with chemotherapy/radiotherapy or alone showed significantly greater local control rates and progression free survival (PFS), with manageable toxicity for patients with HER2-positive breast cancer with brain metastases, and further follow-up will provide an overall survival (OS) data.


Effect of dietary butylated hydroxyanisole on methylazoxymethanol acetate-induced toxicity in mice.
Administration of butylated hydroxyanisole (BHA), a widely used food additive, has been found to inhibit the carcinogenic and toxic effects of various chemicals in animal models. To study the relationship of dietary BHA to the acute toxicity of methylazoxymethanol (MAM) acetate, a colon-specific carcinogenic compound, groups of female CF1 mice were fed NIN-07 diet containing 0, 300, 1000, 3000 or 6000 ppm BHA or a semipurified diet containing 0 or 6000 ppm BHA for 4 wk, and were injected ip with MAM acetate (20 mg/kg body weight) at the end of the first 2 wk and again 4 days later. At levels of 300-6000 ppm, BHA was found to protect against death caused by MAM acetate. The mortality rates in MAM-treated mice were 80 and 92% in those fed the diets with no BHA and 0 and 1% in those fed 6000 ppm BHA, and were inversely related to the amount of BHA in the diet. The protection was associated with increased levels of hepatic cytochrome P-450 and b5 and with a reduction in necrotic changes in the liver.


[Medical engineering technologies of diagnosis and correction of higher mental functions in children and adolescents].
This is an introductory article for this issue of the journal prepared on the basis of the proceedings of the Scientific-and-Practical Conference on Problems in Instrumental Evaluation of Higher Mental Functions and Dysfunctions in Children and Adolescents by using computer-aided test systems (medical engineering technologies developed at the turn of millennia). The paper deals with the analysis of the themes of the conference, its composition, and issues examined.


The T-axial membrane system in striated muscles of the horseshoe crab.
Cardiac muscle and skeletal muscles powering walking leg, tailspine and gill movements in Limulus polyphemus were studied by transmission electron microscopy. All muscles examined had extensive invaginations of the sarcolemma at the Z disc and at the lateral margins of the A band. Invaginations at the Z disc were often branched in the transverse and longitudinal planes, but branching was not observed at other locations within a sarcomere. Dyads, and occasional triads, were observed at the A band in all muscles examined.


Substance P in the human brainstem. Preliminary results of its immunohistochemical localization.
The localization of substance P in the human post-mortem brainstem is studied by the indirect immunofluorescence technique. Positive neuronal cell bodies, nerve fibers and terminals are unevenly present over both sensory and effector areas and nuclei. The pattern of distribution of substance P in the human brainstem, similar to that seen in the laboratory animals, supports the hypothesis of a neurotransmitter role of this compound in man.


The role of CS-US contingency in human evaluative conditioning.
Recent studies suggest that in Pavlovian conditioning, two different processes may be operative: signal learning and evaluative learning, resulting in two qualitatively different associative structures. Signal-learning is hypothesized to be responsible for providing us with genuine predictors (CS) for significant events (US). This proposition logically entails that the statistical-correlational relation, i.e. the contingency between CS and US should be a crucial determinant of signal learning. Evaluative conditioning, on the other hand, refers to the observation that the mere pairing of neutral with (dis)liked stimuli changes the valence of the originally neutral stimuli in a (negative) positive direction. As argued elsewhere, evaluative conditioning is probably based on the CS acquiring a mere referential value to the US, without any genuine CS-US expectancy being involved. From this, it was hypothesized that evaluative conditioning might not be dependent on CS-US contingency. Using the standard evaluative conditioning paradigm, four different levels of CS-US contingency were created on a between-subject base. The overall effect of evaluative conditioning was strongly significant, and was not mediated by awareness of the CS-US relation. Of crucial importance, this conditioning effect did not interact with the level of contingency, supporting the hypothesis that CS-US contingency is not a crucial determinant of evaluative conditioning. Moreover, this effect was obtained in a situation in which Ss simultaneously evidence to have consciously registered quite accurately the different levels of CS-US contingency.


Use of second-look laparotomy in the management of patients with ovarian epithelial malignancies.
Between June 1976 and January 1986, 94 evaluable patients with stage I-IV disease underwent second-look laparotomy as part of their treatment for ovarian epithelial carcinomas. Stage and residual tumor size after initial debulking surgery demonstrated a significant association with absence of disease at reexploration. Forty-nine patients (52%) had no evidence of disease at second-look laparotomy. Thirty patients (32%) had macroscopic residual tumor, and 15 patients (16%) had microscopic disease at reexploration. Patients with a negative second-look laparotomy had an excellent prognosis; uncorrected 2- and 5-year survival rates exceed 90%. None of the patients with stage I or II disease developed recurrent tumor after a negative second-look laparotomy. However, 7 of the 25 (28%) patients with stage III disease and a negative second-look have demonstrated recurrent carcinomas. Recurrences were documented from 15.4 to 51.7 months after second-look laparotomy and were located within the abdominal cavity. Life table methods demonstrated improved survival for patients with microscopic disease as compared to those with gross tumor at second-look survey. Both groups had similar mean patient ages and tumor stage distributions. Patients with microscopic residual disease had uncorrected 2- and 5-year survival rates of 76 and 64%. The 2-year uncorrected survival rate for patients with gross tumor at second-look laparotomy was 25%. Thirty patients with macroscopic disease at second-look laparotomy underwent a repeat attempt at tumor debulking. Seventeen patients completed second-look surgery with residual disease less than 1 cm in maximum dimensions. Life table methods demonstrated improved survival when residual disease was less than 1 cm. Regardless of residual tumor size after reexploration, patients with gross tumor had a worse survival than those with microscopic disease.


Effects of salinity on hard clam (Mercenaria mercenaria) defense parameters and QPX disease dynamics.
QPX (Quahog Parasite Unknown) is a protistan parasite affecting hard clams (Mercenaria mercenaria) along the Northeast coast of the United States. The fact that QPX disease epizootics are usually observed in field sites with high salinities led to the general assumption that salinity represents an important factor for disease distribution. This study was designed to investigate the effect of salinity on QPX disease development as well as constitutive and QPX-induced defense factors in M. mercenaria. Naïve and QPX-infected (both experimentally and naturally) clams were submitted to 17 and 30 psu for 4 months. Standard and QPX-specific cellular and humoral defense parameters were assessed after 2 and 4 months. These included total and differential hemocyte counts, reactive oxygen species production, phagocytic activity of hemocytes, lysozyme concentration in plasma, anti-QPX activity in plasma and resistance of hemocytes to cytotoxic QPX extracellular products. Results demonstrated higher QPX-associated mortality in naturally infected clams maintained at high salinity compared to those held at 17 psu. Our findings also showed an increase in mortality following experimental challenge with QPX in clams submitted to 30 psu but not in those held at 17 psu. Constitutive clam defense factors and the response to QPX challenge were also affected by salinity. QPX challenge caused significant but transitory changes in hemolymph parameters that were obvious at 2 months but disappeared at 4 months. Overall, our results show that salinity modulates clam immunity and the progress of QPX disease although its impact appears secondary as compared to findings we reported earlier for temperature.


Is online objective structured clinical examination teaching an acceptable replacement in post-COVID-19 medical education in the United Kingdom?: a descriptive study
Coronavirus disease 2019 (COVID-19) restrictions resulted in an increased emphasis on virtual communication in medical education. This study assessed the acceptability of virtual teaching in an online objective structured clinical examination (OSCE) series and its role in future education. Six surgical OSCE stations were designed, covering common surgical topics, with specific tasks testing data interpretation, clinical knowledge, and communication skills. These were delivered via Zoom to students who participated in student/patient/examiner role-play. Feedback was collected by asking students to compare online teaching with previous experiences of in-person teaching. Descriptive statistics were used for Likert response data, and thematic analysis for free-text items. Sixty-two students provided feedback, with 81% of respondents finding online instructions preferable to paper equivalents. Furthermore, 65% and 68% found online teaching more efficient and accessible, respectively, than in-person teaching. Only 34% found communication with each other easier online; Forty percent preferred online OSCE teaching to in-person teaching. Students also expressed feedback in positive and negative free-text comments. The data suggested that generally students were unwilling for online teaching to completely replace in-person teaching. The success of online teaching was dependent on the clinical skill being addressed; some were less amenable to a virtual setting. However, online OSCE teaching could play a role alongside in-person teaching.


Cone beam computed tomography with oral contrast for accurate diagnosis and surgical planning of pharyngeal leakage and fistula: a case series.
Pharyngocutaneous fistula is one of the severe complications related to head and neck surgeries. Detecting the accurate three-dimensional location of both the fistula and leakage is essential for surgical treatment. Videofluoroscopy is usually used for locating these; however, its imaging is two-dimensional. We evaluated pharyngeal leakage and fistulae using Cone Beam Computed Tomography (CBCT), known for its three-dimensional high spatial resolution imaging, taken in a sitting position, with oral contrast (contrast CBCT). Pharyngeal leakage and fistulae were evaluated in a total of 31 subjects by sequentially performing videofluoroscopy and contrast CBCT. The detection accuracy of videofluoroscopy and contrast CBCT for leakage and fistula, as well as the ability to determine the extent and depth for surgical planning, were investigated and compared. Videofluoroscopy and contrast CBCT showed suspicious leakage and/or fistula in six and three of the 31 subjects, respectively. Surgical findings revealed the presence of leakage and/or fistula in three of the 31 subjects. The positive predictive values of videofluoroscopy and contrast CBCT were 50% (3/6) and 100% (3/3), respectively. Contrast CBCT provided more precise images, showing the extent and depth of leakage and fistula in three-dimensions. The present study's results indicate the usefulness of contrast CBCT in terms of accurate diagnosis of leakage and fistula, due to its three-dimensional imaging being performed with the patient in a sitting position.


Binding of lysozyme to brush border membranes of rat kidney.
The binding of 125I-labelled egg-white lysozyme to isolated brush border membranes of rat kidney cortex was investigated. The lysozyme binding was reversible and saturable. The Scatchard plot revealed a one-component binding type with a dissociation constant of 7.8 microM and 15.6 nmol/mg membrane protein for the number of binding sites. The binding of the basic lysozyme could be reduced by basic amino acids such as L-lysine, L-ornithine or L-arginine, while neutral amino acids such as L-citrulline or L-alanine had no effect. The inhibitory effect of lysine was competitive.


Xenopus oocytes can synthesise but do not secrete the Z variant of human alpha 1-antitrypsin.
Human liver mRNA was prepared from a patient homozygous for alpha 1-antitrypsin deficiency (PiZZ) and from a normal subject (PiMM). Both liver RNAs were microinjected into Xenopus oocytes and alpha 1-antitrypsin identified by immunoprecipitation. The normal M variant of alpha 1-antitrypsin is synthesised and secreted by Xenopus oocytes, the abnormal Z protein is not secreted and an intracellular form accumulates in the oocytes. In the presence of tunicamycin an unglycosylated form of M alpha 1-antitrypsin appears in the incubation medium but no corresponding unglycosylated version of the Z protein is secreted.


General Multiscenario Ultrasound Image Tumor Diagnosis Method Based on Unsupervised Domain Adaptation.
The utilization of computer-aided diagnosis (CAD) in breast ultrasound image classification has been limited by small sample sizes and domain shift. Current ultrasound classification methods perform inadequately when exposed to cross-domain scenarios, as they struggle with data sets from unobserved domains. In the medical field, there are situations in which all images must share the same networks as they capture the same symptom of the same participant, implying that they share identical structural content. Nevertheless, most domain adaptation methods are not suitable for medical images as they overlook the common features among the images. To overcome these challenges, we propose a novel diverse-domain 2-D feature selection network (FSN), which uses the similarities among medical images and extracts features with a reconstruction network with shared weights. Additionally, it penalizes the feature domain distance through two adversarial learning modules that align the feature space and select common features. Our experiments illustrate that the proposed method is robust and can be applied to ultrasound images of various diseases. Compared with the latest domain adaptive methods, 2-D FSN markedly enhances the accuracy of classification of breast, thyroid and endoscopic ultrasound images, achieving accuracies of 82.4%, 96.4% and 89.7%, respectively. Furthermore, the model was evaluated on an unsupervised domain adaptation task using ultrasound images from multiple sources and achieved an average accuracy of 77.3% across widely varying domains. In general, 2-D FSN improves the classification ability of the model on multidomain ultrasound data sets through the learning of common features and the combination of multimodule intelligence. The algorithm has good clinical guidance value.


An exploration of alternative methods for assessing return-to-work success following occupational injury.
To explore alternative methods for assessing return-to-work success. This exploratory study employed a prospective design. Participants (N = 150) were all vocational rehabilitation recipients who sustained a work-related injury that resulted in them being off work for at least 6 months, and were unable to return to their pre-injury position. At baseline (B), all were reported to have found post-injury employment. Qualitative features of the participants' post-injury employment were assessed at the time of initial interview (T1), which was conducted a mean of approximately one year following the participants' scheduled workplace re-entry (mean 344 days). Participants' T1 employment characteristics were then compared to their outcomes at the time of follow-up (T2), which was approximately 3 months later (mean 85 days). Findings indicate that 25% of participants were not in their baseline jobs at the time of last contact; some were in different jobs, however others were not working. At T1 many of those working reported experiencing difficulties. Comparisons revealed significant relationships between problem indicators at T1 and employment outcomes at T2, with significant problem indicators including worries that symptoms might interfere with their ability to continue in the job, difficulties with the job's physical demands and a strong desire to leave their current job. When problem indicators were used in combination, stronger relationships were observed and self-assessed performance contributed to the effect. Results add support to the contention that rather than a single event, RTW is an evolving, complex and sometimes nonlinear process. This should be kept in mind when assessing the success of an injured worker's RTW.


Soil type and integrated nitrogen nutrient-rice straw residue management techniques affect soil microbes, enzyme activities and yield of wheat crop.
Sporadic burning of rice straw and the particulate air pollution caused consequently have created a pressing need for identification of practical environmentally sound in situ rice residue management methods. However, the agronomic interventions associated with the agri-inputs particularly the type of nitrogen fertilizer source must be worked out for these interventions. In a two-year field study performed at two different locations representing sandy loam and clay loam soil types, zero tillage with application of nitrophosphate (applied as basal dose through drilling) in combination with urea (applied at 1st irrigation + 3 foliar sprays of urea at weekly interval) significantly enhanced the grain and straw yield of wheat. The soil microbial viable cell counts and dehydrogenase and urease enzyme activities were also recorded to be highest in this treatment indicating the occurrence of higher living microbial population. The treatment × response variable Principle component analysis (PCA) biplot depicted relative variation among the residue management treatments/Nitrogen fertilizer sub-treatments and the enzyme activities as response variables. A variation in the soil organic content components was recognized through Fourier transform infra-red spectroscopy (FT-IRS) studies. Irrespective of the soil types under study, the FT-IR spectra exhibited presence of the aromatic carbon functional groups in residue incorporated treatments as compared to the no residue incorporation treatment.


Modulation of Paraoxonase-1 and Apoptotic Gene Expression Involves in the Cardioprotective Role of Flaxseed Following Gestational Exposure to Diesel Exhaust Particles and/or Fenitrothion Insecticide.
The developmental exposure to a single chemical may elicit apoptosis in the different fetal organs, while the combined effects are restricted. We have examined the protective role of flaxseed (FS) against diesel exhaust particles (DEPs)- and/or fenitrothion (FNT)-induced fetal cardiac oxidative stress and apoptosis. A total of 48 timed pregnant rats were divided into eight groups (n = 6). The first group was saved as the control and the second fed on 20% FS diet. Animals in the third, fourth, and fifth groups were administered with DEPs (2.0 mg/kg), FNT (3.76 mg/kg), and their combination, respectively, while the sixth, seventh, and eighth groups were supplemented with 20% FS through intoxication with DEPs, FNT, and their combination, respectively. Our results revealed that DEPs and/or FNT significantly elevated the level of protein carbonyl and superoxide dismutase activity in the fetal cardiac tissues. However, the catalase activity and total thiol level were decreased; besides the histopathological alterations were remarked. Moreover, DEPs and/or FNT exhibited significant down-regulation in the anti-apoptotic (Bcl-2) and paraoxonase-1 gene expression, and up-regulation in the apoptotic (Bax and caspase-3) gene expression along with DNA fragmentation. Remarkably, FS supplementation significantly ameliorated the fetal cardiac oxidative injury, down-regulated the expression of the apoptotic genes, up-regulated the anti-apoptotic and paraoxonase-1 gene expression, reduced DNA fragmentation, and alleviated the myocardial cell architectures. These findings revealed that FS attenuates DEPs- and/or FNT-induced apoptotic cell death by repairing the disturbance in the anti-apoptotic/pro-apoptotic gene balance toward cell survival in the fetal myocardial cells.


Parents' knowledge and socio-demographic determinants toward child's restraint system use.
Lack of protection or improper protection, is one of the most important reasons of child passenger's death and injury in traffic crashes. Based on what we see on the roads, Iranian children are unrestrained inside the car. The aim of this study was to investigate children restrained system (CRS) use rate, its socio-demographic determinants and parents' knowledge toward CRS use among Iranian parents. Using multi-stage cluster sampling and direct in filed method of observation, the behavior of 700 children in cars was observed in the current cross-sectional study. Socio-demographic determinants and parents' knowledge, toward using the CRS were evaluated using questionnaires. The study was performed from July to August 2019 in Tabriz city, northwestern Iran. The rate of child safety seat (CSS) use was 15.1% CI 95%:(12.5%,18.0%), and the rate of booster use was 0.6%; CI 95%:(4.3%,8.0%). The majority of parents [e.g. 64.3%; CI 95%: (60.7%,67.9%)], had low knowledge about the use of CRS. The most important reasons for not using CRS was lack of laws and policies [e.g. 59.7%; CI 95%:(12.5%,18.0%)], lack of knowledge [e.g.59.6%; CI 95%:(57.9%, 63.3%)] and the high cost of CRS [e.g. 57.6%; CI 95%:(53.81%,61.2%)]. The most important predictors of not using CRS were the child's age, parental knowledge, and the socioeconomic status of the household (p < 0.05). Most children did not have CRS. The parents with higher education and those with higher socioeconomic status had higher rate of CRS use. Based on the low rate of CRS use and poor parental knowledge about it, education of parents toward boosters use and benefits of using CRS, enforcing mandatory laws and ploicies for CRS use in Iran, and allocation of government subsidies to low-income families for purchasing CRS are suggeted as essential strategies to increase CRS use.


What is the difference between irony and sarcasm? An fMRI study.
Verbal irony is a figure of speech that communicates the opposite of what is said, while sarcasm is a form of irony that is directed at a person, with the intent to criticise. The current study used functional magnetic resonance imaging (fMRI) with the aim of mapping the neural networks involved in the processing of sarcastic and non-sarcastic irony. Participants read short texts describing an interaction between two characters, which ended in either a literal, sarcastic, or non-sarcastic ironic comment. Results showed that the mentalising network (mPFC) and semantic network (IFG) were more activated for non-sarcastic irony than for literal controls. This would suggest that interpreting this kind of language involves understanding that the speaker does not mean what they literally say, as well as processes involved in conflict detection and resolution. Sarcastic irony recruited more of the semantic network, as well as areas associated with humour appreciation and subcortical structures, indicating that more complex neural mechanisms underlie the comprehension of sarcastic versus non-sarcastic irony.


Cognitive aspects of MELAS and CARASAL.
Monogenic diseases, although rare, should be always considered in the diagnostic work up of vascular dementia (VaD), particularly in patients with early onset and a familial history of dementia or cerebrovascular disease. They include, other than CADASIL, Fabry disease, Col4A1-A2 related disorders, which are well recognized causes of VaD, other heritable diseases such as mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) and cathepsin-A related arteriopathy strokes and leukoencephalopathy (CARASAL). MELAS, caused by mtDNA (80% of adult cases m.3243A>G mutations) and more rarely POLG1 mutations, has minimum prevalence of 3.5/100,000. CARASAL, which is caused by mutations in the CTSA gene, has been described in about 19 patients so far. In both these two disorders cognitive features have not been fully explored and are described only in case series or families. This review paper is aimed at providing an update on the clinical manifestations, with particular focus on cognitive aspects, but also neuroradiological and genetic features of these less frequent monogenic diseases associated with VaD.