Laparoscopic management for prenatally diagnosed choledochal cysts.
The aim of this study was to validate our laparoscopic management strategy for asymptomatic and symptomatic patients with prenatally diagnosed choledochal cysts (CCs). Thirteen prenatally diagnosed CC patients from 1997 to 2015 were included. Seven patients (1997-2008) underwent open surgery (OS group), and 6 (2009-2015) underwent laparoscopic surgery (LS group). In the asymptomatic patients, LS was performed when the patients weighed over 5 kg. When the patient had clinical manifestations, early LS was performed irrespective of body weight. A retrospective comparison was conducted between the LS and OS groups in terms of the operative time, blood loss, postoperative fasting period, hospital stay, and intra- and postoperative complications. There was no difference between the demographics of both groups. The operative time was significantly longer (380 vs. 288 min) and blood loss was significantly lower (4 vs. 30 mL) in the LS group. Additionally, the postoperative fasting period (3 vs. 6 days) and hospital stay (11 vs. 20 days) were significantly shorter in the LS group. Intraoperative events and early postoperative complications were not encountered in either group. Small bowel obstruction requiring surgery occurred in two patients, 10 and 13 years after OS, respectively. LS is as safe and feasible as OS in small children with prenatally diagnosed CC, although sufficient pediatric laparoscopic expertise is mandatory.


Progesterone through progesterone receptors affects survival and metabolism of pig sperm.
Progesterone receptors (PR) through interaction with the specific ligand progesterone (PRG), play a central coordinate role in different reproductive events. In this study conventional PR were identified in boar spermatozoa by Western blotting. Immunofluorescence techniques indicate that PR are located at sperm acrosomal region, suggesting a possible role in the oocyte fertilization events. Treatment with 17-hydroxyprogesterone (17-OHP) enhanced viability and induced cholesterol efflux, serine and tyrosine phosphorylation, p-Bcl2, p-Akt that are known hallmarks of capacitation in sperm. The analysis of the triglyceride contents, lipase and acyl-CoA dehydrogenase activities, as well as the G6PDH activity, was conducted so as to address whether there was an increase in energy expenditure via 17-OHP through the PR. Taken together these results, particularly the 17-OHP action on boar sperm lipid and glucose metabolism, give emphasis to the role of PR in sperm physiology within the oviductal environment. Moreover the present study highlights, the effect of PRG via PR on boar sperm survival, renewing the role of this hormone in male reproduction as candidate for boar fertility. Thus the present research contributes to further elucidating the role of progesterone on the physiological regulation of the most relevant spermatozoa functions for a successful fertilization.


Surveillance following treatment for colorectal cancer in Australia. Has best practice been adopted by medical oncologists?
Intensive follow up after surgery for colorectal cancer is associated with a significant survival advantage and is endorsed by expert panels, but are physicians convinced of the benefit? A questionnaire was mailed to all members of the Medical Oncology Group of Australia, assessing surveillance practices after completion of adjuvant treatments. Responses were obtained from 141 (55%) medical oncologists of which 121 were considered evaluable. Thirteen per cent (n = 16) routinely did not carry out follow-up investigations. Of those carrying out surveillance, 47% (n = 51) nominated identifying potentially resectable metastatic disease as prime consideration. Many (44%) were motivated by patient reassurance and expectation. Carcinoembryonic antigen levels were commonly monitored 3 monthly in years 1 (77%, n = 85) and 2 (57%, n = 63) and 6 monthly thereafter (67%, n = 74). Eighty per cent (n = 88) carried out computed tomography (CT) surveillance 1 year after surgery, 69% (n = 76) at year 2 and 55% (n = 60) at year 3. Twenty-six per cent (n = 29) continued scanning annually up to 5 years. Inclusion of CT chest was routine for 33% (n = 36) and never carried out by 11% (n = 12). A significant minority (13%) of oncologists carry out no follow-up investigations, despite level I evidence of a survival advantage similar to standard adjuvant therapies. Further education and study of physician attitudes and reservations to routine surveillance are required.


Influence of docosahexaenoic acid on the interfacial behavior of cholesterol-containing lipid membranes: Interactions with small amphiphiles and hydration properties.
Cholesterol is known to significantly modify both the structural and the dynamical properties of lipid membranes. On one side, the presence of free cholesterol molecules has been determined to stiffen the membrane bilayer by stretching the hydrophobic tails. Additionally, recent experimental and computational findings have made evident the fact that cholesterol also alters the dynamics and the hydration properties of the polar head groups of DPPC model lipid membranes. In turn, we have recently shown that the Omega-3 fatty acid docosahexaenoic acid, DHA, counteracts the effect of cholesterol on DPPC membrane's mechanical properties by fluidizing the bilayer. However, such behavior represents in fact a global outcome dominated by the larger lipid hydrophobic tails that neither discriminates between the different parts of the membrane nor elucidates the effect on membrane hydration and binding properties. Thus, we now perform molecular dynamics simulations to scrutinize the influence of DHA on the interfacial behavior of cholesterol-containing lipid membranes by characterizing their hydration properties and their binding to amphiphiles. We find that while cholesterol destabilizes interactions with amphiphiles and slightly weakens the lipid's hydration layer, the incorporation of DHA practically restores the interfacial behavior of pure DPPC.


Acute spontaneous spinal epidural hematoma: an important differential diagnosis in patients under clopidogrel therapy.
Spontaneous spinal epidural hematoma (SSEH) is an infrequent spinal pathology. Although it is related to numerous risk factors, its etiology remains unclear. The aim of this article was to review the most important data in the literature about SSEH and to propose clopidogrel (Plavix) therapy as a risk factor. Case report. A 79-year-old woman was hospitalized in our unit with posterior thoracic pain and urinary retention of 72 hours duration. A clinical history was taken, and laboratory and imaging tests were performed. Urgent surgical decompression was performed, showing an epidural hematoma. Postoperative bacteriological cultures were negative, and microscopic analysis confirmed the diagnosis. For this patient, clopidogrel (Plavix) therapy was the only risk factor related to SSEH. In any patient under clopidogrel (Plavix): Sanofi-Synthelabo, Bristol-Myers Squibb/Sanofi Pharmaceuticals) therapy and with a typical clinical presentation, SSEH should be suspected and quickly diagnosed, regardless of hemostatic status or the absence of other major risk factors.


Application of three dimensional porous aerogels as adsorbent for removal of heavy metal ions from water/wastewater: A review study.
Nowadays, by rapid development of economies and industries, water contamination through the heavy metal ions (toxic, non-toxic and radioactive) is a great concern and an important environmental problem. Currently, numerous techniques such as chemical precipitation, coagulation, ion-exchange, filtration, reverse osmosis, biological treatment and physical adsorption are presented by researchers for removing and recycling heavy metal ions from wastewater. Among these methods, adsorption approach is one of the most efficient techniques for the elimination of heavy metal ions from aqueous solutions. There are a number of low cost absorbent such as agricultural and industrial solid waste such as lingo-cellulosic materials, wheat bran, peanut shell, moss peat, fly ash, bagasse, tree fern, gram husk, nanostructures (such as TiO2, SiO2, SnO2, ZnO, etc.), 3D porous structures (aerogels), etc. which have been developed and tested to efficient removal of heavy metal ions from wastewater. In this study, a critical review of the applications of aerogels in water and sewage purifications is performed. For this reason, different kinds of aerogel namely organic, inorganic and organic-inorganic hybrid aerogels are investigated. It is concluded that the most applicable aerogels used in these studies are graphene-based aerogels due to more porous structure as well as simplification of their modification. Also, in this review paper, for the first time we summarized and highlighted the recent literature information about heavy metal ions and theirs removal methods from aqueous pollutants and wastewater/water, adsorption kinetics, isotherms and thermodynamics models by different type of three dimensional (3D) porous structure. In additional, in this review article, the influence of various parameters such as pH solution, temperature, initial concentration of heavy metal ions, composition, contact time, coexisting ions and adsorbent dosage on the adsorption process of heavy metal ions were investigated.


The impact of culture and education on non-verbal neuropsychological measurements: a critical review.
Clinical neuropsychology has frequently considered visuospatial and non-verbal tests to be culturally and educationally fair or at least fairer than verbal tests. This paper reviews the cross-cultural differences in performance on visuoperceptual and visuoconstructional ability tasks and analyzes the impact of education and culture on non-verbal neuropsychological measurements. This paper compares: (1) non-verbal test performance among groups with different educational levels, and the same cultural background (inter-education intra-culture comparison); (2) the test performance among groups with the same educational level and different cultural backgrounds (intra-education inter-culture comparisons). Several studies have demonstrated a strong association between educational level and performance on common non-verbal neuropsychological tests. When neuropsychological test performance in different cultural groups is compared, significant differences are evident. Performance on non-verbal tests such as copying figures, drawing maps or listening to tones can be significantly influenced by the individual's culture. Arguments against the use of some current neuropsychological non-verbal instruments, procedures, and norms in the assessment of diverse educational and cultural groups are discussed and possible solutions to this problem are presented.


Coarctation in Taussig-Bing malformation of the heart. Surgical significance.
In a review of 126 heart specimens of simple complete transposition of the great arteries with ventricular septal defect (VSD), coarctation was noted in eight (6%). In 105 Taussig-Bing heart specimens, coarctation and/or aortic outflow tract obstruction was noted in 56 (53%) (p less than 10(-10). This was similar to our surgical experience in 26 patients with transposition and VSD or Taussig-Bing heart. Six of nine patients with Taussig-Bing heart also had coarctation of the aorta, whereas all 17 patients with transposition and VSD had a normal aorta. Four patients with Taussig-Bing heart underwent coarctation repair and pulmonary artery banding at 2 to 7 days of age. The remaining two patients with Taussig-Bing heart did not have a hemodynamically significant coarctation. Five of the six patients with Taussig-Bing heart and coarctation underwent a Senning procedure between the ages of 7 weeks and 3 1/2 years. In four (all less than 4 months of age) the VSD could not be closed through the tricuspid valve. A right ventriculotomy was done in two and contributed to their deaths. In the other two patients the VSD was left alone and the pulmonary artery banded. Both remain well. The fifth child, aged 3 1/2 years, had the VSD closed through the tricuspid valve but died in the postoperative period of renal failure. The sixth patient is awaiting further operation following coarctation repair and pulmonary artery banding. We conclude that the presence of coarctation strongly suggests that Taussig-Bing heart malformation exists rather than transposition and VSD. Pulmonary artery banding and coarctation repair are the initial procedures of choice in the management of these critically ill newborn infants. Increasing cyanosis and failure to thrive will necessitate further operation. Closure of the VSD through the tricuspid valve in these infants is difficult. Pulmonary artery banding in association with a Senning procedure is preferable to a right ventriculotomy. Closure of the VSD is then planned at a later stage.


Anticipatory Electrodermal Response as a Differentiating Somatic Marker Between Children with ADHD and Controls.
Six children with Attention Deficit Hyperactivity Disorder (ADHD) and five control children between the ages of 9 and 11 years were administered an adapted version of the Iowa Gambling Task while measuring anticipatory electrodermal response (EDR). Anticipatory EDR measures were compared between groups. Results indicate that the ADHD group exhibited significantly lower autonomic reactivity to anticipated consequences, evidencing a neuropsychological profile similar to patients with lesions in the ventromedial prefrontal cortex.


Anti-clastogenic effect of magnolol on benzo(a)pyrene-induced clastogenicity in mice.
It was previously reported that magnolol strongly inhibited the mutagenicity induced by the indirect mutagens [benzo(a)pyrene (B(a)P), 2-amino-3-methylimidazo[4,5-f]quinoline (IQ), 2-aminodipyrido[1,2-a:3',2'-d]imidazole (Glu-P-2), 2-aminoanthracene (2AA), and 7,12-dimethylbenz[a]anthracene (DMBA)] in Salmonella typhimurium TA98 and TA100 in the Ames test, and that the mechanism of this anti-mutagenic effect may involve the inhibition of the metabolic activation of indirect mutagen enzymes. In this study, the in vivo anti-clastogenic effect of magnolol against clastogenicity induced by B(a)P was evaluated using the micronucleus test in mice. Animals were treated with an oral administration of magnolol (1, 10, and 100 mg/kg) at -24, 0, 24, 48, 72, and 96 h before a single intraperitoneal injection of B(a)P. Peripheral blood specimens were prepared 48 h after administration of B(a)P, and analyzed by the acridine orange (AO) technique. The results indicated that magnolol inhibited clastogenicity induced by B(a)P at various administration times. In order to elucidate the mechanism behind this effect, we measured the activity of the detoxifying enzymes [UDP-glucuronosyltransferase (UGT) and glutathione-S-transferase (GST)] and antioxidative enzymes [superoxide dismutase (SOD) and catalase] in the liver when treated with an oral administration of magnolol at various administration times. Its effect on clastogenicity created by exposure to oxidative DNA damage-inducing X-ray irradiation was also evaluated using the micronucleus test in mice. Results showed that magnolol increased the activity of both UGT and SOD enzymes, and also inhibited the clastogenicity induced by X-ray irradiation. Magnolol had an anti-clastogenic effect on B(a)P in the micronucleus test as well as an anti-mutagenic effect on indirect mutagens in the Ames test. The anti-clastogenic effect of magnolol was also suggested by the increases in UGT and SOD enzyme activity, and by the attenuation of oxidative damage induced by X-ray irradiation.


Raffinose oligosaccharide concentrations measured in individual cell and tissue types in Cucumis melo L. leaves: implications for phloem loading.
Raffinose, stachyose, and galactinol are synthesized in intermediary cells (specialized companion cells) of the minor-vein phloem of cucurbits. To better understand the role of these carbohydrates and the regulation of their synthesis and transport, we measured the concentrations of each of the components of the raffinose oligosaccharide synthetic pathway in mesophyll and sieve element-intermediary cell complexes (SE-ICCs) in the leaves of melon (Cucumis melo L. cv. Hale's Best Jumbo). These concentrations are consistent with a polymer-trapping mechanism for phloem loading, with sucrose diffusing from mesophyll into intermediary cells and being made into raffinose and stachyose, which are too large to diffuse back to the mesophyll. To determine carbohydrate concentrations, we developed a method involving microdissected tissues. Blind endings of areoles, and mesophyll surrounding these veins, were separately removed from lyophilized leaf tissue. Carbohydrates were quantitated by high-performance liquid chromatography with pulsed amperometric detection. A small amount of mesophyll remained attached to the blind endings; the carbohydrate contribution of these cells to the vein sample was eliminated by subtraction, based on the amount of chlorophyll. Volumes of cells and subcellular compartments were calculated by morphometric analysis and were used to calculate carbohydrate concentrations. Assuming no subcellular compartmentation, the additive concentration of sugars in the SE-ICCs of minor veins is about 600 mM. Stachyose and raffinose concentrations are about 330 mM and 70 mM, respectively, in SE-ICCs; concentrations of these sugars are much lower in mesophyll (0.2 and 0.1 mM). This is consistent with the view that stachyose and raffinose are unable to pass through the plasmodesmata between intermediary cells and bundle-sheath cells. Sucrose levels appear to be higher in the SE-ICC (about 130mM) than in the mesophyll (about 10 mM), but if compartmentation is taken into account the gradient for sucrose is probably downhill from mesophyll to intermediary cells. Flux through plasmodesmata between the bundle sheath and intermediary cells was calculated and was found to be within the range of values of flux through plasmodesmata reported in the literature.


Naloxone treatment alters gene expression in the mesolimbic reward system in 'junk food' exposed offspring in a sex-specific manner but does not affect food preferences in adulthood.
We have previously reported that the opioid receptor blocker, naloxone, is less effective in reducing palatable food intake in offspring exposed to a maternal cafeteria diet during the perinatal period, implicating a desensitization of the central opioid pathway in the programming of food preferences. The present study aimed to investigate the effect of a maternal cafeteria diet and naloxone treatment on the development of the mesolimbic reward pathway and food choices in adulthood. We measured mRNA expression of key components of the reward pathway (mu-opioid receptor, proenkephalin, tyrosine hydroxylase, D1 and D2 receptors and the dopamine active transporter (DAT)) in the nucleus accumbens (NAc) and ventral tegmental area (VTA) of the offspring of control and cafeteria fed (JF) dams at weaning and after a 10-day naloxone treatment post-weaning and determined food preferences in adulthood in the remaining offspring. Naloxone treatment decreased the expression of DAT by 8.2 fold in female control offspring but increased it by 4.3 fold in female offspring of JF dams relative to the saline-injected reference groups. Proenkephalin mRNA expression was higher in the NAc of female JF offspring compared to controls, independent of naloxone treatment (P<0.05). There was no effect of naloxone treatment on food preferences in adulthood in either control or JF offspring. These data indicate that prenatal exposure to a cafeteria diet alters the impact of opioid signaling blockade in the early post-weaning period on gene expression in the central reward pathway in a sex specific manner, but that these changes in gene expression do not appear to have any persistent impact on food preferences in adulthood.


Duplex scanning for noninvasive assessment of both carotid luminal diameter and atheromatous plaque morphology.
The value of Duplex scanning in 50 consecutive patients with symptomatic carotid stenosis was evaluated. Compared with contrast arteriography, the sensitivity of Duplex scanning, for a greater than 50% internal carotid diameter reduction, was 90% (66/73) with a specificity of 96% (26/27). The overall agreement between Duplex and contrast arteriography as measured by the Kappa value was K = 0.561. One of the 13 arteries felt to be occluded on Duplex scanning was radiologically found to be patent. Excluding the six normal and 13 occluded arteries, 81 carotid plaques were defined as either heterogeneous, suggestive of intraplaque hemorrhage or as homogeneous. Twenty-four of the 32 asymptomatic cerebral hemispheres were associated with ipsilateral homogeneous plaques, while 30 of the 49 symptomatic hemispheres had heterogeneous plaques in the ipsilateral carotid, (p less than 0.001). This study confirms the accuracy of duplex scanning in detecting internal carotid stenosis as well as in identifying plaques which are morphologically heterogeneous and more likely to be associated with ipsilateral cerebral hemispheric symptoms.


Detection and Interpretation of Impossible and Improbable Coma Recovery Scale-Revised Scores.
To determine the frequency with which specific Coma Recovery Scale-Revised (CRS-R) subscale scores co-occur as a means of providing clinicians and researchers with an empirical method of assessing CRS-R data quality. We retrospectively analyzed CRS-R subscale scores in hospital inpatients diagnosed with disorders of consciousness (DOCs) to identify impossible and improbable subscore combinations as a means of detecting inaccurate and unusual scores. Impossible subscore combinations were based on violations of CRS-R scoring guidelines. To determine improbable subscore combinations, we relied on the Mahalanobis distance, which detects outliers within a distribution of scores. Subscore pairs that were not observed at all in the database (ie, frequency of occurrence=0%) were also considered improbable. Specialized DOC program and university hospital. Patients diagnosed with DOCs (N=1190; coma: n=76, vegetative state: n=464, minimally conscious state: n=586, emerged from minimally conscious state: n=64; 794 men; mean age, 43±20y; traumatic etiology: n=747; time postinjury, 162±568d). Not applicable. Impossible and improbable CRS-R subscore combinations. Of the 1190 CRS-R profiles analyzed, 4.7% were excluded because they met scoring criteria for impossible co-occurrence. Among the 1137 remaining profiles, 12.2% (41/336) of possible subscore combinations were classified as improbable. Clinicians and researchers should take steps to ensure the accuracy of CRS-R scores. To minimize the risk of diagnostic error and erroneous research findings, we have identified 9 impossible and 36 improbable CRS-R subscore combinations. The presence of any one of these subscore combinations should trigger additional data quality review.


Development of sex-linked markers for gender identification of Actinidia arguta.
The fruit of the dioecious plant Actinidia arguta has become a great attraction recently. It has long been difficult to distinguish the genders of hybrid seedlings before flowering, therefore increasing the expenditures of breeding. To produce reliable molecular marker for gender identification, this research utilized whole-genome re-sequencing of 15 males and 15 females from an 8-year-old cross population to develop gender specific markers. P51 and P11 were identified as sex-linked markers after verification. Both of these markers, according to the PCR results, only amplified a single band in male samples. These two markers were tested in 97 hybrids (52 females and 45 males) and 31 wild individuals (13 females and 18 males), with an accuracy of 96.88% and 96.09%, correspondingly. This research also verified the universalities of the two markers in Actinidia chinensis samples, and it could be inferred from the PCR results that neither marker was applicable to A. chinensis samples. The BLAST results of the two markers demonstrated that the two markers were closely aligned with different parts of the Y male-specific region of A. chinensis genome, thus they were likely to be useful for the research on the mechanism of sex determination of A. arguta. The two male-linked makers, P51 and P11, have already been used in sex-identification of A. arguta seedlings.


Increasing severity of illness among patients undergoing phase 1 trials. Implications for nursing resources.
To determine whether the severity of illness of hospitalized patients participating in Phase 1 trials has changed, a modified APACHE II (MA II) index was used to evaluate retrospectively each Phase 1 patient admitted during September through December 1983 and the same 4-month span in 1987. During the 1983 period, 28 patients were enrolled in 13 Phase 1 protocols. Their average length of stay (LOS) was 12.6 days (+/- 12.3 SD) with a mean MA II of 3.44 (+/- 2.69 SD). During the same 4 months in 1987, there were 37 patients enrolled in 18 Phase 1 trials with a mean LOS of 13.5 days (+/- 13.4 SD) and a mean MA II of 6.08 (+/- 3.33). As indicated by MA II scores, 1987 hospitalized patients enrolled in Phase 1 trials had a higher severity of illness than did 1983 Phase 1 patients (p = 0.01). The implications of an oncology patient population with an increasing severity of illness are examined in relation to nursing staff forecasting, resource allocation, and productivity.


The HUSH complex controls brain architecture and protocadherin fidelity.
The HUSH (human silencing hub) complex contains the H3K9me3 binding protein M-phase phosphoprotein 8 (MPP8) and recruits the histone methyltransferase SETDB1 as well as Microrchidia CW-type zinc finger protein 2 (MORC2). Functional and mechanistic studies of the HUSH complex have hitherto been centered around SETDB1 while the in vivo functions of MPP8 and MORC2 remain elusive. Here, we show that genetic inactivation of Mphosph8 or Morc2a in the nervous system of mice leads to increased brain size, altered brain architecture, and behavioral changes. Mechanistically, in both mouse brains and human cerebral organoids, MPP8 and MORC2 suppress the repetitive-like protocadherin gene cluster in an H3K9me3-dependent manner. Our data identify MPP8 and MORC2, previously linked to silencing of repetitive elements via the HUSH complex, as key epigenetic regulators of protocadherin expression in the nervous system and thereby brain development and neuronal individuality in mice and humans.


[PROMISING OPTIONS FOR MEDICAL ROBOTICS APPLICATION IN SUPPORT OF CREW LIFE ACTIVITIES AND MITIGATION OF MEDICAL RISKS DURING SPACE FLIGHT].
Theme of the article is integration of robotics, medical robots that embody the bio-engineering technology specifically, into the spacecrew medical care system.


Vital signs changes during different dental procedures: A prospective longitudinal cross-over clinical trial.
The purpose of this study was to evaluate the magnitude of vital signs changes during 3 different dental treatments. A prospective longitudinal multiarm cross-over clinical trial was conducted. Three dental procedures were performed on each participant: supragingival scaling, dental restoration under local anesthesia (LA), and exodontia under LA. The following parameters were recorded for in each dental procedure: body temperature (BT), respiratory rate (RR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation (SpO2). Three repeated measurements of each parameter were recorded at 3 phases of each procedure. A total of 150 dental interventions were performed on 50 patients. Scaling caused a statistically significant rise in BT, RR, and SpO2, and a reduction in HR. Restorative treatment caused a statistically significant rise in SpO2 during LA. Exodontia caused a statistically significant rise in BT, RR, SBP (during the procedure), and SpO2 (during LA). Scaling and restorative treatment did not significantly impact heart rate. The respiratory rate may temporarily rise during LA injection and some dental procedures, especially exodontia. Increase in systolic blood pressure and heart rate during exodontia was tolerated by healthy patients.


Behavioral dissection of hunger states in Drosophila.
Hunger is a motivational drive that promotes feeding, and it can be generated by the physiological need to consume nutrients as well as the hedonic properties of food. Brain circuits and mechanisms that regulate feeding have been described, but which of these contribute to the generation of motive forces that drive feeding is unclear. Here, we describe our first efforts at behaviorally and neuronally distinguishing hedonic from homeostatic hunger states in Drosophila melanogaster and propose that this system can be used as a model to dissect the molecular mechanisms that underlie feeding motivation. We visually identify and quantify behaviors exhibited by hungry flies and find that increased feeding duration is a behavioral signature of hedonic feeding motivation. Using a genetically encoded marker of neuronal activity, we find that the mushroom body (MB) lobes are activated by hedonic food environments, and we use optogenetic inhibition to implicate a dopaminergic neuron cluster (protocerebral anterior medial [PAM]) to α'/β' MB circuit in hedonic feeding motivation. The identification of discrete hunger states in flies and the development of behavioral assays to measure them offers a framework to begin dissecting the molecular and circuit mechanisms that generate motivational states in the brain.


Explicit approach to rounds in an ICU improves communication and satisfaction of providers.
To evaluate an explicit approach to responsibilities and reporting during bedside rounds in the intensive care unit (ICU). Before-after comparison in the 15-bed medical-surgical ICU in a tertiary teaching hospital. All patients in the ICU during two 1-month periods: 2 months before and 16 months after the intervention. Explicit approach to clinical and educational responsibilities and to reporting assessments and plans during bedside rounds. Surveys of all ICU staff (attending physicians, residents, nurses, respiratory therapists, pharmacists, and medical students) were conducted during rounds on each patient. After the intervention, more respondents agreed that there was a long-term plan for each patient (74% vs. 53% before), that the long-term plan was clear (76% vs. 54% before), that there was structured teaching around each patient (46% vs. 30% before), that discussions other than structured teaching around each patient were useful (79% vs. 65% before), and that they were satisfied with the process and outcome of rounds (95% vs. 86% before). In contrast, slightly fewer respondents were aware of a problem list for the patients (96% vs. 99% before), and fewer residents and medical students had examined their patients before rounds (76% vs. 88% before). An explicit approach to bedside rounds in an ICU improves communication and satisfaction of health care providers.


The AngioGuard: a simplified snare?
We describe a case of successful retrieval of a lost intracoronary stent using the ANGIOGUARD XP emboli retraction guidewire system (Cordis Corporation) as a safe and innovative method for management of this critical issue in an 80-year old male patient.


Chinese (Mandarin) translation of the incremental shuttle walk test and its validity and reliability: A cross-sectional study.
To date, there are no published validated Chinese versions of the incremental shuttle walk test (ISWT) instructions despite its wide clinical applications. Translation of the Chinese ISWT instruction is done in an ad-hoc manner within the Chinese-speaking populations, affecting the test's reliability and validity since translation can differ significantly between individuals. This warrants the need for psychometric testing of such translation. To develop a Chinese (Mandarin) version of the ISWT instructions (ISWT-CHN) that is conceptually equivalent to the original English version (ISWT-ENG) and establish its reliability and validity. Forward and backward translations from the ISWT-ENG were done to generate the ISWT-CHN. Face and content validity was determined during the translation process. Intra-rater and inter-rater reliability of the ISWT-CHN, construct and criterion validity were established by analysing the ISWT and the gold standard cardiopulmonary exercise test results. The Item-Content validity index (I-CVI), Scale-level-Content validity index (S-CVI), and content validity ratio (CVR) of the ISWT-CHN were 1.0. Intra-class Correlation Coefficient (ICC) for inter-rater reliability between two raters were excellent (ICC=0.99, 95% CI 0.97-1.0, p<0.001; SEM=0.85 m, MDC=2.35 m). The intra-rater reliability of both Raters A (ICC=0.92, 95% CI 0.53-0.98, p=0.003; SEM=35 m, MDC=97 m) and B (ICC=0.90, 95% CI 0.76-0.96, p<0.001; SEM=32 m, MDC=88 m) were good. In a sample of 32 healthy participants, both ISWT-CHN and ISWT-ENG instruction results showed low-positive correlations with the VO2max determined from the cardiopulmonary exercise test (r = 0.439, p<0.001; r=0.448, p<0.001). There is a very high correlation between ISWT-ENG and ISWT-CHN results with no statistically significant differences (r=0.967, p<0.001). The construct and criterion validity of the ISWT-CHN were established. This study developed the ISWT-CHN and showed that it is a valid and reliable measure conceptually comparable to the ISWT-ENG. It will benefit the determination of functional exercise capacity in Chinese-speaking populations. •This study is aimed to develop a Chinese (Mandarin) version of the ISWT instructions.•The ISWT Chinese translation is valid and reliable that is conceptually comparable to the original English instruction.•The translated ISWT-Chinese instruction will enable the use of ISWT among the Chinese-speaking populations.


Pan-HER-targeted approach for cancer therapy: Mechanisms, recent advances and clinical prospect.
The Human Epidermal Growth Factor Receptor family is composed of 4 structurally related receptor tyrosine kinases that are involved in many human cancers. The efficacy and safety of HER inhibitors have been compared in a wide range of clinical trials, suggesting the superior inhibitory ability of multiple- HER-targeting blockade compared with single receptor antagonists. However, many patients are currently resistant to current therapeutic treatment and novel strategies are warranted to conquer the resistance. Thus, we performed a critical review to summarize the molecular involvement of HER family receptors in tumour progression, recent anti-HER drug development based on clinical trials, and the potential resistance mechanisms of anti-HER therapy.


Some studies on the enzyme lecithin-cholesterol acyl-transferase in rat plasma.
The results presented in this study, which include different physiological and pathological conditions, show: 1--In the rat subjected to bile duct occlusion there is a rapid decrease in the plasma LCAT activity which is followed by an increase in the activity to normal values at a later time. 2--In the rat subjected to interruption of the enterohepatic circulation of bile salts by means of a sequestering agent there is an increase in the plasma LCAT activity. 3--In the rat subjected to a 48 hour fast there is an increase in the plasma LCAT activity. 4--In the rat subjected to a small dietary cholesterol supplement there is an increase in the plasma LCAT activity.


Uncovering global lipid accumulation routes towards docosahexaenoic acid (DHA) production in Aurantiochytrium sp. SW1 using integrative proteomic analysis.
Aurantiochytrium sp., a marine thraustochytrid possesses a remarkable ability to produce lipid rich in polyunsaturated fatty acids (PUFAs), such as docosahexaenoic acid (DHA). Although gene regulation underlying lipid biosynthesis has been previously reported, proteomic analysis is still limited. In this study, high DHA accumulating strain Aurantiochytrium sp. SW1 has been used as a study model to elucidate the alteration in proteome profile under different cultivation phases i.e. growth, nitrogen-limitation and lipid accumulation. Of the total of 5146 identified proteins, 852 proteins were differentially expressed proteins (DEPs). The largest number of DEPs (488 proteins) was found to be uniquely expressed between lipid accumulating phase and growth phase. Interestingly, there were up-regulated proteins involved in glycolysis, glycerolipid, carotenoid and glutathione metabolism which were preferable metabolic routes towards lipid accumulation and DHA production as well as cellular oxidative defence. Integrated proteomic and transcriptomic data were also conducted to comprehend the gene and protein regulation underlying the lipid and DHA biosynthesis. A significant up-regulation of acetyl-CoA synthetase was observed which suggests alternative route of acetate metabolism for acetyl-CoA producer. This study presents the holistic routes underlying lipid accumulation and DHA production in Aurantiochytrium sp. SW1 and other relevant thraustochytrid.


Innovative Approach to Unicondylar Proximal Phalangeal Fracture Fixation: Combining Antegrade Intramedullary Pinning With Flexion Proximal Interphalangeal Joint Transfixation.
Various surgical techniques have been described for the fixation of displaced unicondylar fractures of the proximal phalanx, with K-wire and interfragmentary screws being the most commonly used. Although open reduction with joint exposure can provide direct visualization and allow for anatomic reduction, its potential drawbacks, such as joint stiffness and loss of range of motion, are of significant concern. We introduced a novel fixation technique for displaced unicondylar fractures of the proximal phalanx using antegrade intramedullary pinning and transfixation of the proximal interphalangeal joint, which is simple, effective, and does not require open reduction.


Oral antioxidants counteract the negative effects of female aging on oocyte quantity and quality in the mouse.
This study aims to compare the effect of early and late onset administration of oral antioxidants on number and quality of oocytes retrieved from aged mice after exogenous ovarian stimulation. Control hybrid females were fed a standard diet supplemented or not supplemented with pharmacological doses of vitamins C and E either from the first day of weaning or from the age of 32 weeks until they were autopsied at the age 40-42, 50-52, or 57-62 weeks after exogenous ovarian stimulation. Analysis of chromosomal distribution, DNA organization and cellular morphology was performed in ovulated cumulus-enclosed and -free oocytes, ovarian non-germinal vesicle oocytes enclosed by or free of mucous cumulus cells and in vitro-matured ovarian germinal-vesicle oocytes. Both early and late onset administration of oral antioxidants counteracted the negative effects of female aging on number of ovarian oocytes and total percentage of oocytes retrieved from oviducts and ovaries exhibiting a normal distribution of chromosomes in the metaphase-II plate and/or morphological traits of apoptosis. Although both early and late onset administration of oral antioxidants can counteract the negative effects of female aging on number and quality of oocytes, transference of these results to human beings should be made with caution because of the potential side effects of high doses of vitamins on reproductive function as well as many other undesirable systemic disorders.


Four-year follow-up of effects of toluene diisocyanate exposure on the respiratory system in polyurethane foam manufacturing workers. II. Four-year changes in the effects on the respiratory system.
Fifty-seven polyurethane foam manufacturing workers (PF workers) and 24 reference workers were followed for 4 years to clarify the effects on pulmonary function of working in PF factories with exposure to toluene diisocyanate (TDI). No significant differences in the average annual losses (AALs) of pulmonary function for 4 years were observed among the 28PF workers whose TDI exposure levels were very low (mean = 0.1 ppb, group L), the remaining 29 PF workers with mean TDI exposure of 5.7 ppb (group H), and the reference workers. However, 15 PF workers in group H who had experienced peak exposure excursions to 30 ppb or above with a mean concentration of 8.2 ppb showed significantly larger AALs in percentage maximal mid-expiratory flow, forced expiratory volume in 1 s ratio to vital capacity (FVC), and forced expiratory flow at 25% of FVC than expected, and significantly larger AALs in some obstructive pulmonary function indices than those of the 14 remaining PF workers in group H whose peak exposure excursion levels were 3-14 ppb with a mean time-weighted average (TWA) of 1.7 ppb, group L, and the reference workers. These findings suggest that the peak exposure excursion level of TDI might be important in inducing obstructive pulmonary function changes in the PF workers rather than the TWA exposure levels, though further comparative studies of the AAL in those who are exposed to different peak exposure excursion levels but the same mean exposure levels are necessary. From the standpoint of prevention, the proposition that peak exposure excursion levels exceeding 20 ppb should be avoided is reasonable.


Unobstructive total anomalous pulmonary venous return: impact of early elective repair on the need for prolonged mechanical ventilatory support.
Optimal timing for elective repair of total anomalous pulmonary venous return (TAPVR) in the case of an unobstructed anomalous pathway is unclear. All infants with a diagnosis of TAPVR as an isolated lesion who underwent surgical repair at Children's Hospital of Wisconsin from 1991 to 2007 were reviewed to assess location of drainage, presence of obstruction, age at presentation, age at surgery, death, need for extracorporeal membrane oxygenation (ECMO), length of hospital stay, length of mechanical ventilation (MV), and late pulmonary venous obstruction. A total of 65 patients were identified: 38 (59%) with supracardiac drainage, 10 (15%) with cardiac drainage, 11 (17%) with infracardiac drainage, and 6 (9%) with mixed drainage. For 39 (60%) of the 65 patients, obstruction was identified preoperatively. Three early and five late deaths occurred after surgery (12%), all involving patients with preoperative obstruction. Most of the late deaths (80%) involved patients who experienced recurrent obstruction. Of the 65 patients, 26 (40%) had no obstruction preoperatively, and none died, required ECMO support, or experienced late obstruction. For the 26 patients without obstruction, the timing of surgery was elective at the discretion of the supervising cardiologist. Among these 26 patients, 15 had surgery less than 10 days after presentation (median age, 18 days), and 53% of these 15 patients (8/15) had MV less than 5 days. In contrast, all 11 patients who had elective surgery more than 10 days after presentation (median age, 56 days) required MV for more than 5 days (p = 0.007). Isolated TAPVR appears to be at the highest risk for death and late postoperative obstruction when obstruction is present preoperatively. Patients with unobstructive TAPVR do very well, but potential morbidity related to prolonged MV appears to be significantly reduced by early elective surgery.


Protein kinase C epsilon promotes de novo lipogenesis and tumor growth in prostate cancer cells by regulating the phosphorylation and nuclear translocation of pyruvate kinase isoform M2.
Protein kinase C epsilon (PKCε) belongs to a family of serine/threonine kinases that control cell proliferation, differentiation and survival. Aberrant PKCε activation and overexpression is a frequent feature of numerous cancers. However, its role in regulation of lipid metabolism in cancer cells remains elusive. Here we report a novel function of PKCε in regulating of prostate cancer cell proliferation by modulation of PKM2-mediated de novo lipogenesis. We show that PKCε promotes de novo lipogenesis and tumor cell proliferation via upregulation of lipogenic enzymes and lipid contents in prostate cancer cells. Mechanistically, PKCε interacts with NABD (1-388) domain of C-terminal deletion on pyruvate kinase isoform M2 (PKM2) and enhances the Tyr105 phosphorylation of PKM2, leading to its nuclear localization. Moreover, forced expression of mutant Tyr105 (Y105F) or PKM2 inhibition suppressed de novo lipogenesis and cell proliferation induced by overexpression of PKCε in prostate cancer cells. In a murine tumor model, inhibitor of PKM2 antagonizes lipogenic enzymes expression and prostate cancer growth induced by overexpression of PKCε in vivo. These data indicate that PKCε is a critical regulator of de novo lipogenesis, which may represent a potential therapeutic target for the treatment of prostate cancer.


Characterization of an Alkaline Family I.4 Lipase from Bacillus sp. W130-35 Isolated from a Tidal Mud Flat with Broad Substrate Specificity.
A gene encoding lipolytic enzyme, lip7-3, was isolated from Bacillus sp. W130-35 isolated from a tidal mud flat. The gene encoded a protein of 215 amino acids with a signal peptide composed of 34 amino acid residues. Lip7-3 belonged to the family I.4 lipase and showed its maximal activity at pH 9.0 and 60°C. Its activity increased in the presence of 30% methanol and, remarkably, increased as well to 154.6% in the presence of Ca(2+). Lip7-3 preferred pnitrophenyl octanoate (C8) as a substrate and exhibited broad specificity for short- to longchain fatty acid esters. Additionally, Lip7-3 showed a low degree of enantioselectivity for an S-enantiomer (e.g., (S)-methyl-3-hydroxy-2-methylpropionate). It efficiently hydrolyzed glyceryl tributyrate, but did not hydrolyze glyceryl trioleate, fish oil, or olive oil. Its substrate specificity and activation by the solvent might offer a merit to the biotechnological enzyme applications like transesterification in the production of biodiesel.


Preliminary crystallographic analysis of a plant pathogenic factor: pectate lyase.
Pectate lyase is a saccharide-binding enzyme that lyitically depolymerizes polypectate in higher plant cell walls, thus causing soft-rot diseases in food crops. A pectate lyase from Erwinia chrysanthemi, EC16 (PLe), crystallizes in the orthorhombic space group P2(1)2(1)2(1) with unit cell dimension of a = 39.0 A, b = 91.0 A and c = 103.4 A. The asymmetric unit consists of one molecule with a molecular mass of 38,118 daltons and the X-ray diffraction extends to a resolution of 1.8 A. The crystals reproducibly grow to large dimensions and are suitable for a high-resolution X-ray diffraction analysis.


Early cleaving embryos result in blastocysts with increased aspartate and glucose consumption, which exhibit different metabolic gene expression that persists in placental and fetal tissues.
Using time-lapse microscopy, previous research has shown that IVF mouse embryos that cleave earlier at the first division ('fast') develop into blastocysts with increased glucose consumption and lower likelihood of post-implantation loss as compared to slower cleaving embryos ('slow'). Further, metabolomics analysis employing LC-MS conducted on groups of 'fast' blastocysts revealed that more aspartate was consumed. With the worldwide adoption of single blastocyst transfer as the standard of care, the need for quantifiable biomarkers of viability, such as metabolism of specific nutrients, would greatly assist in embryo selection for transfer. Here we describe the development of a targeted enzymatic assay to quantitate aspartate uptake of single blastocysts. Results demonstrate that the rates of aspartate and glucose consumption were significantly higher in individual 'fast' blastocysts. Blastocysts, together with placental and fetal liver tissue collected following transfer, were analysed for the expression of genes involved in aspartate and carbohydrate metabolism. In 'fast' blastocysts, expressions of B3gnt5, Slc2a1, Slc2a3, Got1 and Pkm2 were found to be significantly higher. In placental tissue derived from 'fast' blastocysts, expression of Slc2a1, Got1 and Pkm2 were significantly higher, while levels of Got1 and Pkm2 were lower in fetal liver tissue compared to tissue from 'slow' blastocysts. Importantly, this study shows that genes regulating aspartate and glucose metabolism were increased in blastocysts that have higher viability, with differences maintained in resultant placentae and fetuses. Consequently, the analysis of aspartate uptake in combination with glucose represents biomarkers of development and may improve embryo selection efficacy and pregnancy rates.


Serum C-reactive protein at admission predicts in-hospital mortality in medical patients.
Previous studies have examined the role of inflammatory markers in patients with coronary heart disease, stroke, chronic renal failure and other selected patient populations. The aim of this study was to assess the clinical utility of serum C-reactive protein (CRP) at admission in predicting outcome in hospitalized medical patients. All patients admitted to our medical department were eligible to be included in the study. At the time of admission, demographic and clinical information was obtained. CPR was measured within 12 h of hospitalization. The results were analyzed using Cox proportional hazards multiple regression model. Three hundred eighty-two patients were included in the study (186 males and 196 females). Age (mean+/-standard deviation) was 70.8+/-15.7 years. Serum CRP [median (interquartile range) at admission was 29.7 mg/l (6.6-114.3). Serum CRP at admission was independently associated with in-hospital death. Levels above 120 mg/l increased the probability of fatal outcome three fold (hazard ratio=2.98, 95% confidence interval: 1.35-6.58). In patients older than 80 years, CRP at admission was a stronger predictor of in-hospital death (hazard ratio=5.41, 95% confidence interval: 1.38-21.26). Serum CRP at admission is an independent predictor of mortality in hospitalized patients, particularly in the elderly. Admission CRP higher than 120 mg/l was associated with increased probability of in-hospital death (three fold in the overall population and five fold in the elderly subgroup) compared with lower levels.


Anatomic Radial Head Arthroplasty: The Importance of Implant Angle.
Multifragmentary radial head and neck fractures not amenable to open reduction and internal fixation are usually treated with radial head arthroplasty (RHA). Although the optimal implant design is still subject to debate, anatomic designs are common. We hypothesized that positioning of the implant leading to increased radial stem angle (RSA) (angle of the RHA stem with respect to the proximal radius shaft, RSA) in anatomic RHA designs will contribute to failures. The aim of this study was to characterize the risk of RHA failure with respect to the stem angle in anatomic RHA design. A retrospective review of patients who underwent anatomic RHA for acute fractures between 2006 and 2019 at 2 academic centers was conducted. Initial postoperative elbow radiographs were reviewed to measure RSA on the anterior-posterior and lateral views. Radiolucency, stress shielding, and radiocapitellar arthritis were also evaluated. Implant failure was defined as prosthesis removal or revision. Implant failure was associated with significantly larger lateral RSA than that in intact implants. Increasing stem shaft angle on a lateral radiograph was associated with decreased implant survival. Radiolucency, stress shielding, and radiocapitellar arthritis were similar between the 2 groups. Anatomic radial head implants are commonly used; however, the importance of prosthesis positioning, specifically that of the stem within the proximal radius, remains understudied. Higher RSA is associated with the risk of implant failure and need for revision. Prognostic IV.


Development of masturbation in college women.
To elucidate a number of hypotheses about the development of sexual responsivity in women, a random sample of 100 undergraduate women was interviewed about their masturbation histories, techniques in masturbation, and the relationship of masturbation to intercourse. Masturbation had been practiced by 74%. It began most commonly as an accidental discovery. Learning the sexual nature of masturbation from peers and written sources seemed to result in methods more imitative of heterosexual activities and to increase the enjoyment and goal-directedness of the behavior. The view that experiencing sexual pleasure depends on social transmission of scripts was thus supported. Several techniques were related to orgasm ability in masturbation and intercourse. Women who were orgasmic in masturbation and who masturbated with that goal were more likely to continue the behavior than those with other goals. Frequency of masturbation and frequency of intercourse were not related, failing to support the notion of a unitary "sex drive". Nor was "clitoral fixation" documented by any relationship between reliance on clitoral stimulation in both masturbation and intercourse. Masturbating to orgasm was not related to orgasm ability in intercourse.


[Kinetics of Pseudomonas aeruginosa virulence gene expression during chronic lung infection in the murine model].
Pseudomonas aeruginosa is a Gram-negative bacillus frequently encountered in human diseases. P. aeruginosa produces a large number of secreted and cell associated virulence factors. Their production is coordinated by various systems of gene regulation. The correlation and sequential intervention of regulation systems during a pulmonary infection have not been determined yet. The aim of this study was to analyze the expression of three P. aeruginosa virulence genes (exoS, lasI, and algD) during the first seven days of chronic lung infection. To do so, mice were infected intratracheally with agarose beads containing P. aeruginosa. The results were a progressive decrease of exoS transcription and an increase of algD, and lasI transcription during infection. This dynamic evolution was consistent with the clinical observation, which demonstrated a progressive loss of type III secretion system function and an increase in the mucoid phenotype development in P. aeruginosa strains from cystic fibrosis patients. The development of a P. aeruginosa pulmonary chronic infection associates a decrease of gene expression related to a type III secretion system and an increase of alginate production.


Pilot Feasibility Study of an Educational Intervention in Women With Gestational Diabetes.
To pilot test the feasibility of an educational intervention, Start Understanding Gestational Diabetes and Risk of Developing Type 2 Diabetes (SUGAR), in women with gestational diabetes mellitus (GDM). A pretest-posttest, two-group study design. Three obstetrics and gynecology offices in the southeastern United States. Twenty-three women with a first-time diagnosis of GDM. Women diagnosed with GDM were recruited and placed in a control group or educational intervention group. Women completed six self-report, standardized questionnaires at baseline (third trimester) and posttest (6-8 weeks postpartum). Women in the intervention group (n = 18) received the SUGAR educational intervention after the baseline data collection with a booster session at 2 to 4 weeks postpartum. Women in the control group (n = 5) received an attention control treatment. Study participants had obesity, and most had a family history of type 2 diabetes mellitus. The attrition rate was low (n = 2; 8%). The educational intervention significantly increased diabetes mellitus knowledge for women in the SUGAR group. In addition, 39% of participants received the recommended postpartum glucose screening. Although the effect of the SUGAR intervention with a small sample was not expected to produce statistically significant changes, we add our pilot study to the limited research of diabetes mellitus preventative care for women with GDM and provide preliminary findings to develop meaningful education and support for women diagnosed with GDM. Future researchers need to focus on prevention programs that center on self-efficacy, postpartum glucose screening, and adoption of healthy lifestyle behaviors.


Athletic identity, compulsive exercise and eating psychopathology in long-distance runners.
Having a high athletic identity is thought to increase vulnerability for compulsive exercise and Eating Disorder (ED) psychopathology. This study examined whether there is an association between athletic identity and levels of compulsive exercise and ED psychopathology in long-distance runners. A sample of 501 long-distance runners completed the Athletic Identity Measurement Scale (AIMS), Compulsive Exercise Test (CET) and Eating Disorders Examination Questionnaire (EDEQ). There was a significant positive association between participants' AIMS and total CET scores (moderate effect size; r=0.34 for males and 0.33 for females). BMI did not influence the relationship between AIMS and CET scores in males. However, for females, AIMS scores were positively associated with levels of Weight Control Exercise when covarying for BMI (small to moderate effect size, r=0.22). No significant associations with EDEQ scores were found (negligible to small effect sizes; r=0.06 for males and r=0.14 for females). Following replication, coaches might need to be vigilant to the welfare of endurance runners that have a strong athletic identity, since this could be linked to them exercising compulsively. Future work should examine whether having a strong athletic identity predicts ED psychopathology when this identity is challenged (e.g., due to injury).


Proteomic study of benign and malignant pleural effusion.
Lung adenocarcinoma can easily cause malignant pleural effusion which was difficult to discriminate from benign pleural effusion. Now there was no biomarker with high sensitivity and specificity for the malignant pleural effusion. This study used proteomics technology to acquire and analyze the protein profiles of the benign and malignant pleural effusion, to seek useful protein biomarkers with diagnostic value and to establish the diagnostic model. We chose the weak cationic-exchanger magnetic bead (WCX-MB) to purify peptides in the pleural effusion, used matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) to obtain peptide expression profiles from the benign and malignant pleural effusion samples, established and validated the diagnostic model through a genetic algorithm (GA) and finally identified the most promising protein biomarker. A GA diagnostic model was established with spectra of 3930.9 and 2942.8 m/z in the training set including 25 malignant pleural effusion and 26 benign pleural effusion samples, yielding both 100 % sensitivity and 100 % specificity. The accuracy of diagnostic prediction was validated in the independent testing set with 58 malignant pleural effusion and 34 benign pleural effusion samples. Blind evaluation was as follows: the sensitivity was 89.6 %, specificity 88.2 %, PPV 92.8 %, NPV 83.3 % and accuracy 89.1 % in the independent testing set. The most promising peptide biomarker was identified successfully: Isoform 1 of caspase recruitment domain-containing protein 9 (CARD9), with 3930.9 m/z, was decreased in the malignant pleural effusion. This model is suitable to discriminate benign and malignant pleural effusion and CARD9 can be used as a new peptide biomarker.


Combining gut microbiota modulation and chemotherapy by capecitabine-loaded prebiotic nanoparticle improves colorectal cancer therapy.
Colorectal cancer (CRC) therapy efficiency can be influenced by the microbiota in the gastrointestinal tract. Compared with traditional intervention, prebiotics delivery into the gut is a more controllable method for gut microbiota modulatory therapy. Capecitabine (Cap), the first-line chemotherapeutic agent for CRC, lacks a carrier that can prolong its half-life. Here, we construct a Cap-loaded nanoparticle using the prebiotic xylan-stearic acid conjugate (SCXN). The oral administration of SCXN delays the drug clearance in the blood and increases the intra-tumoral Cap concentration in the CRC mouse model. SCXN also facilitates the probiotic proliferation and short chain fatty acid production. Compared with free Cap, SCXN enhances the anti-tumor immunity and increases the tumor inhibition rate from 5.29 to 71.78%. SCXN exhibits good biocompatibility and prolongs the median survival time of CRC mice from 14 to 33.5 d. This prebiotics-based nanoparticle provides a promising CRC treatment by combining gut microbiota modulation and chemotherapy.


Vaccine Hesitancy: Where We Are and Where We Are Going.
Vaccines represent one of the most important aspects of pediatric preventive care. However, parents are increasingly questioning the safety of and need for vaccines, and as a result, vaccination rates have fallen to dangerously low levels in certain communities. The effects of vaccine hesitancy are widespread. Community pediatricians who interact regularly with vaccine-hesitant parents report higher levels of burnout and lower levels of job satisfaction. Not surprisingly, vaccine hesitancy has also had direct influence on vaccination rates, which in turn are linked to increased emergency department use, morbidity, and mortality. Literature from 1999 to 2017 regarding vaccines and vaccine hesitancy was reviewed. Few evidence-based strategies exist to guide providers in their discussions with vaccines-hesitant parents. Recent research has shown a presumptive approach (ie, the provider uses language that presumes the caregiver will vaccinate his or her child) is associated with higher vaccination uptake. Motivational interviewing is a promising technique for more hesitant parents. At the community level, evidence-based communication strategies to address vaccine hesitancy are needed. The practice of dismissing families from pediatric practices who refuse to vaccinate is common, although widely criticized. Other controversial and rapidly evolving topics include statewide vaccination mandates and school exemption policies. Electronic interventions, such as text-messaging services and social media, have recently emerged as effective methods of communication and may become more important in coming years.


Extraction and Characterization of Novel Natural Hydroxyapatite Bioceramic by Thermal Decomposition of Waste Ostrich Bone.
A novel natural hydroxyapatite (HAp) bioceramic was extracted from the ostrich cortical bone by the thermal decomposition method. HAp was characterized by different analytical tools such as thermogravimetric analysis (TGA), Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) analysis, and scanning electron microscopy (SEM). Removal of organic impurities from the bone powder was confirmed by TGA analysis. FTIR spectra of HAp confirmed the presence of the major functional groups such as phosphate (PO4 3-), hydroxyl (OH-), and carbonate (CO3 2-) in the bioceramic. The XRD data revealed that the HAp was the crystalline phase obtained by calcination of the bone powder at 950°C, and the SEM analyses confirmed the typical plate-like texture of the nanosized HAp crystals.


Computed tomography perfusion study of hemodynamic changes and portal hyperperfusion in a rabbit model of small-for-size liver.
Portal hyperperfusion in the small-for-size (SFS) liver can threaten survival of rabbits. Therefore, it is important to understand the hemodynamic changes in the SFS liver. Twenty rabbits were divided into two groups: a control group and a modulation group. The control group underwent an extended hepatectomy. The modulation group underwent the same procedure plus splenectomy to reduce portal blood flow. CT perfusion examinations were performed on all rabbits before and after operation. Perfusion parameter values, especially portal vein perfusion (PVP), were analyzed. PVP in the modulation group was lower than in the control group after operation (P=0.002). In the control group, postoperative PVP increased by 193.7+/-55.1% compared with preoperative PVP. A weak correlation was found between the increased percentage of PVP and resected liver-to-body weight ratio (RLBWR) (r=0.465, P=0.033). In the modulation group, postoperative PVP increased by 101.4+/-32.5%. No correlation was found between the increased percentage of PVP and RLBWR (r=0.167, P=0.644). Correlations were found between PVP and serum alanine aminotransferase, aspartate aminotransferase, and total bilirubin after surgery (P<0.05). We successfully evaluated the characteristics of hemodynamic changes as well as the effects of splenectomy in the SFS liver in rabbits by the CT technique.


Buried intramedullary implants for paediatric forearm fractures. Does the refracture rate improve?
Unstable forearm fractures may require surgical management by reduction and osteosynthesis with intramedullary needles. This fixation should be removed early if it has been left exposed, but this could increase the risk of refracture in a bone in the period of remodelling. As an alternative we can keep the needles, buried subcutaneously, for a longer time, to protect the bone callus. To assess whether there are differences between using exposed needles with respect to burying them in paediatric patients with forearm fractures. Our hypothesis is that by burying the needles we keep them longer by reducing forearm refractures. We present a cohort of 75 paediatric patients with a forearm fracture between 2010 and 2016. Demographic data, surgical technique, complications and patient follow-up were collected. The implants were left exposed in 50 patients and 25 buried. The average time of removal of the exposed implants was 6.8weeks and 17.6weeks in the buried ones. No significant differences were found in terms of consolidation (P=.19) or immobilization time (P=.22). Regarding refractures, a greater number was observed in the exposed osteosynthesis group (4patients) compared to only one case with buried osteosynthesis, but there were no significant differences (P=.49). No postsurgical complications were detected and the functionality was excellent at the end of the follow-up in both groups. Leaving implants buried in relation to skin exposed does not cause a decrease in the number of refractures or other complications, with adequate patient functionality in both cases.


Simulation-based hypothesis testing of high dimensional means under covariance heterogeneity.
In this article, we study the problem of testing the mean vectors of high dimensional data in both one-sample and two-sample cases. The proposed testing procedures employ maximum-type statistics and the parametric bootstrap techniques to compute the critical values. Different from the existing tests that heavily rely on the structural conditions on the unknown covariance matrices, the proposed tests allow general covariance structures of the data and therefore enjoy wide scope of applicability in practice. To enhance powers of the tests against sparse alternatives, we further propose two-step procedures with a preliminary feature screening step. Theoretical properties of the proposed tests are investigated. Through extensive numerical experiments on synthetic data sets and an human acute lymphoblastic leukemia gene expression data set, we illustrate the performance of the new tests and how they may provide assistance on detecting disease-associated gene-sets. The proposed methods have been implemented in an R-package HDtest and are available on CRAN.


Inhibition of the hERG potassium channel by phenanthrene: a polycyclic aromatic hydrocarbon pollutant.
The lipophilic polycyclic aromatic hydrocarbon (PAH) phenanthrene is relatively abundant in polluted air and water and can access and accumulate in human tissue. Phenanthrene has been reported to interact with cardiac ion channels in several fish species. This study was undertaken to investigate the ability of phenanthrene to interact with hERG (human Ether-à-go-go-Related Gene) encoded Kv11.1 K+ channels, which play a central role in human ventricular repolarization. Pharmacological inhibition of hERG can be proarrhythmic. Whole-cell patch clamp recordings of hERG current (IhERG) were made from HEK293 cells expressing wild-type (WT) and mutant hERG channels. WT IhERG1a was inhibited by phenanthrene with an IC50 of 17.6 ± 1.7 µM, whilst IhERG1a/1b exhibited an IC50 of 1.8 ± 0.3 µM. WT IhERG block showed marked voltage and time dependence, indicative of dependence of inhibition on channel gating. The inhibitory effect of phenanthrene was markedly impaired by the attenuated inactivation N588K mutation. Remarkably, mutations of S6 domain aromatic amino acids (Y652, F656) in the canonical drug binding site did not impair the inhibitory action of phenanthrene; the Y652A mutation augmented IhERG block. In contrast, the F557L (S5) and M651A (S6) mutations impaired the ability of phenanthrene to inhibit IhERG, as did the S624A mutation below the selectivity filter region. Computational docking using a cryo-EM derived hERG structure supported the mutagenesis data. Thus, phenanthrene acts as an inhibitor of the hERG K+ channel by directly interacting with the channel, binding to a distinct site in the channel pore domain.


Effect of Niacin on Carotid Atherosclerosis in Patients at Low-Density Lipoprotein-Cholesterol Goal but High Lipoprotein (a) Level: a 2-Year Follow-Up Study.
To examine the effect of niacin on the progression of carotid intima-media thickness (IMT) in patients with high level of lipoprotein (Lp) (a). Patients at low-density lipoprotein-cholesterol goal but with Lp (a) >25 mg/dL and mean carotid IMT >0.75 mm were included. Eligible patients were randomized at a 1:2 ratio into one of two groups for 24 months: control or 1,500 mg extended release niacin. The primary study outcomes were the percentage changes in mean and maximal carotid IMT. The percentage change in lipid profiles including Lp (a) was analyzed as a secondary study outcome. Among 96 randomized patients, 31 completed the study (mean age: 65 years; male: 44%). At follow-up, the percentage change in mean carotid IMT was not significantly different between the two groups (-1.4%±15.5% and -1.1%±7.3% in the control and niacin groups, respectively, p=0.95). The percentage change in maximal carotid IMT was also similar in the two groups (0.7%±16.5% and -4.4%±11.6%, respectively, p=0.35). Elevation of high-density lipoprotein-cholesterol tended to be higher in the niacin group (p=0.07), and there was a significant difference in the percentage change in hemoglobin A1c between the two groups (-1.9%±2.2% and 3.3%±6.7%, respectively, p=0.02). Reduction of Lp (a) was greater in the niacin-treated group compared to placebo, but the difference was not statistically significant. Treatment with niacin for two years did not inhibit the progression of carotid intima-media thickening in patients with high Lp (a) level. However, this study may have been underpowered to evaluate the primary study outcome.


VDAC1 oligomerization may enhance DDP-induced hepatocyte apoptosis by exacerbating oxidative stress and mitochondrial DNA damage.
Cisplatin (DDP)-based chemotherapy is a preferred treatment for a broad spectrum of cancers, but the precise mechanisms of its hepatotoxicity are not yet clear. Recently, the role of voltage-dependent anion channel protein 1 (VDAC1) in mitochondrial activity and cell apoptosis has attracted much attention. Our aim was to investigate the effects of mitochondrial outer membrane protein VDAC1 oligomerization in DDP-induced hepatocyte apoptosis. L-02 hepatocytes were divided into 4 groups: (a) control group, (b) 4,4'diisothiocyanate-2,2'-disulfonic acid (DIDS; 40 μm) group, (c) DDP (5 μm) group, and (d) DDP and DIDS combination group. Cell apoptosis was tested by Annexin V/FITC assay, protein expression of caspase-3, γH2AX and NDUFB6 were observed by western blot assay, reactive oxygen species (ROS), and mitochondrial superoxide anion radical (O2•- ) were detected by DCFH-DA and MitoSOX probe, and DNA damage was assessed by comet assay. Moreover, the activity of mitochondrial respiratory chain complex I was determined by the colorimetry method. Compared with the control group, apoptosis rate and activated cleaved-caspase-3 protein, ROS and O2•- generation, DNA damage marker comet tail length, and γH2AX protein level increased in the DDP treatment group (P < 0.05). Activity of mitochondrial COXI decreased after DDP treatment (P < 0.05). DIDS, as a VDAC1 oligomerization inhibitor, antagonized DDP-induced apoptosis by diminishing oxidative stress and DNA damage and protecting mitochondrial complex protein. These results show that VDAC1 oligomerization may play an important role in DDP-induced hepatocyte apoptosis by increasing ROS and mtDNA leakage from VDAC1 pores, exacerbating oxidative stress and mtDNA damage.


Synthetic strategies of supported atomic clusters for heterogeneous catalysis.
Supported atomic clusters with uniform metal sites and definite low-nuclearity are intermediate states between single-atom catalysts (SACs) and nanoparticles in size. Benefiting from the presence of metal-metal bonds, supported atomic clusters can trigger synergistic effects among every metal atom, which contributes to achieving unique catalytic properties different from SACs and nanoparticles. However, the scalable and precise synthesis and atomic-level insights into the structure-properties relationship of supported atomic clusters is a great challenge. This perspective presents the latest progress of the synthesis of supported atomic clusters, highlights how the structure affects catalytic properties, and discusses the limitations as well as prospects.


Tinnitus resulting from tandem lesions of the internal carotid artery: combined extracranial endarterectomy and intrapetrous primary stenting.
Lesions of the internal carotid artery involving the bifurcation and the intrapetrous portion represent a challenging therapeutic situation. We herein report the first case of a patient suffering from tinnitus which was treated by simultaneous carotid endarterectomy of the bifurcation and transluminal angioplasty and stenting of the intrapetrous portion with a good mid-term angiographic result.


The mediating role of resilience in the effects of physical exercise on college students' negative emotions during the COVID-19 epidemic.
Due to its suddenness and unpredictability, COVID-19 caused strife and effects on public mental health, resulting in a surge of negative emotions. The study explores the relationship between physical exercise and negative emotions in home-based college students during the COVID-19 epidemic, as well as the mediating role of resilience, thus providing a new basis for understanding the role of physical exercise in improving negative emotions in college students; A total of 1214 college students were investigated with the Physical Exercise Questionnaire, Negative Emotion Scale and Resilience Scale; Both physical exercise and resilience were significantly negatively correlated with negative emotions in college students (r = - 0.25, - 0.33, P < 0.001), and there was a significant positive correlation between physical exercise and resilience (r = 0.47, P < 0.001). Physical exercise had a direct effect on the negative emotions of college students (β = - 0.14, P < 0.001). Resilience had a partial mediating effect between physical exercise and the negative emotions of the college students, with a mediating effect value of 0.14 and a mediating effect contribution rate of 50.00%; The study found that physical exercise not only directly affected the negative emotions of college students but also improved their resilience by slowing down their negative emotions and promoting their mental health.


A 24-week intervention based on nutrition care process improves diet quality, body mass index, and motivation in children and adolescents with obesity.
Higher motivation could support to lead behavioral change for obese children and adolescents. This study aimed to evaluate the effects of a nutrition care process (NCP)-based intervention targeted on diet and weight status in moderate to severe obese children and adolescents in Korea. One hundred four subjects (mean age: 10.95 years, body mass index (BMI) ≥97th percentile of age-sex) participated in the present study. Subjects were divided into a usual care group (UG) and a nutrition group (NG). All participants underwent nutrition education 6 times. The NG received individual access and continuous monitoring and setting goals with respect to nutritional problems. Consumption of high-calorie, low-nutrient (HCLN) food was significantly decreased (P < .05) and the Diet Quality Index-International (DQI-I) score also increased with respect to sodium (P < .001). The total self-efficacy score was increased from 9.15 to 10.14 points (P < .01). After 24 weeks, the BMI-z-score decreased from 2.27 to 2.19 in the NG (P < .05); however, no group difference was found. BMI-z-score was negatively associated with self-efficacy (β = -0.03, P < .019). NCP-based intervention might be helpful to solve dietary problems by enhancing self-efficacy and lower BMI-z-score in moderately to severely obese children and adolescents.


[Ondansetron in the prophylaxis of acute emesis induced by supra-high single dose total body irradiation (TBI)].
One hundred sixteen cases of leukemia patients received supra-high single dose TBI for bone marrow transplantation (BMT) with total a radiation dosage of 700-770 Gy at about 5cGy/min. Seventy patients were given ondanstron (8mg) plus dexamethasone (DXM, 10mg) for prophylaxis of TBI-induced acute nausea and vomiting, 46 patients were given paspertin (10mg) plus dexamethasone (10mg) as controls. The clinical results showed that ondansetron plus DXM achieved complete or major control of vomiting in 59/70 (84%) of cases and there was little or no nausea in 61/70 (87%), while paspertin plus DXM achieved complete or major control of vomiting only in 9/46 (20%) of cases and little or no nausea in 5/46 (11%). It is concluded that ondansetron has significantly greater advantage over paspertin in the control of acute emesis induced by TBI.


Geostatistical risk estimation at waste disposal sites in the presence of hot spots.
The present paper aims to estimate risk by using geostatistics at the wider coal mining/waste disposal site of Belkovskaya, Tula region, in Russia. In this area the presence of hot spots causes a spatial trend in the mean value of the random field and a non-Gaussian data distribution. Prior to application of geostatistics, subtraction of trend and appropriate smoothing and transformation of the data into a Gaussian form were carried out; risk maps were then generated for the wider study area in order to assess the probability of exceeding risk thresholds. Finally, the present paper discusses the need for homogenization of soil risk thresholds regarding hazardous elements that will enhance reliability of risk estimation and enable application of appropriate rehabilitation actions in contaminated areas.


Assessment of compliance with a weekly contraceptive patch (Ortho Evra/Evra) among North American women.
To determine compliance with the contraceptive patch (Ortho Evra/Evra) overall and by age among women in North America and to compare rates of perfect use with those of an established oral contraceptive. Data were pooled for three contraceptive studies in which women participated for up to 13 cycles; the subset of centers in North America was used in this analysis. 76 North American centers. Healthy women 18-45 years of age. In all studies, the patch regimen was three consecutive 7-day patches (21 days) followed by 1 patch-free week per cycle. Perfect use for the patch or oral contraceptive, defined as 21 consecutive days of drug-taking followed by a 7-day drug-free period; for contraceptive patch users, no patch could be worn for more than 7 days. Oral contraceptives were used according to package labeling. For all contraceptive patch users in North America (n = 1,785), perfect use was consistent across age groups. The percentage of cycles with perfect use of the patch ranged within age groups from 88.1% to 91.0%. In the comparative study conducted only in North America, perfect use was also consistent across age groups for the patch (n = 812), but rates of perfect use for the oral contraceptive (n = 605) differed significantly by age. Age did not affect compliance with the patch among all North American women studied. In a comparative study of women at North American centers, compliance with the weekly contraceptive patch was significantly better than with an established oral contraceptive. The contraceptive patch is uniformly easy to use across all ages.


Foetal monitoring during general surgery: a case report.
A case is reported in which the foetal heart was monitored by a Doppler apparatus during and after an operation on the kidney in a patient who was 27 weeks pregnant. This monitoring proved useful in detecting alterations of foetal heart rate which occurred during positioning of the patient.


Haemodynamic effects of the beta-receptor blocking agents metoprolol and propranolol in the anesthetized dog.
The haemodynamic effects produced by intravenous infusions of the beta-blocking agents metoprolol and propranolol in doses of 0.3 and 1 mg/kg/10 min were compared in anaesthetized dogs. When administered in a dose of 0.3 mg/kg/10 min, metoprolol caused a longer-lasting increase in pulmonary-arterial pressure and total pulmonary resistance, a greater increase in pulmonary capillary pressure and a more marked decrease in O2 partial pressure in the arterial blood than propranolol. These differences are probably due to differences in the pharmacokinetics of the two drugs. The effects of the two beta-blockers in a dose of 1 mg/kg/10 min were similar. At neither of the dose-levels tested were the changes induced by the compounds in the various parameters studied clearly dose-related.


Activators generated electron transfer for atom transfer radical polymerization for immunosensing.
A novel and ultrasensitive immunosensing strategy based on activators generated electron transfer for atom transfer radical polymerization (AGET ATRP) in combination with flow injection chemiluminescent (CL) and electrochemical detection was proposed. The initiator-conjugated polyclone PSA antibodies (Ab2*), prepared by coupling of N-hydroxysuccinmidyl bromoisobutyrate (initiator) with polyclone PSA antibodies (Ab2), were immobilized on the substrate surface through sandwiched immunoreactions to trigger polymerization. AGET ATRP is used for local accumulation of glycidyl methacrylate (GMA) monomers. Horseradish peroxidase (HRP) was chosen as signal species for its well-characterized chemiluminescent and electrochemical behavior, strong enzyme activity, good solubility and ease in coupling. Growth of long chain polymeric materials provided excess epoxy groups for HRP coupling, which in turn significantly increased the loading of signal molecules and enhanced the chemiluminescent and electrochemical readouts. With the proposed strategy, a detection limit of 4.0 and 1.3 pg mL(-1) was obtained for flow injection chemiluminescent and electrocatalytic measurements, respectively. A more than 13- and 14-fold enhancement in the chemiluminescent intensity and electrocatalytic current was achieved comparing to the traditional sandwiched immunoassays using HRP-conjugated antibody directly. The proposed method exhibited an efficient amplification performance for immunosensing. This paved a new way for ultrasensitive detection of cancer biomarkers.


Bleeding Complications After PCI and the Role of Transradial Access.
Bleeding events are the most common complications following percutaneous coronary intervention (PCI) and are associated with increases in short- and long-term mortality, nonfatal myocardial infarction, stroke, hospital length of stay, and hospital cost. Over time, there has been a decrease in periprocedural bleeding, primarily due to improvements in antithrombotic therapy; however, transradial (TR) catheterization has been shown to be an important strategy to minimize access site bleeding and potentially improve outcomes among patients with ST-segment elevation myocardial infarction. The rate of TR catheterization has been increasing significantly over the past few years and now accounts for an increasing proportion of procedures performed in the United States. Results from the recently published RIVAL Trial have shown comparable efficacy between transradial and transfemoral (TF) approaches with significant reduction in vascular access complications in the TR group. TR access in the STEMI population was prospectively assessed in the RIFLE-STEACS Trial and demonstrated significant reduction in the primary outcome of composite death/MI/stroke/target vessel revascularization/non-CABG bleeding. More recent studies have also demonstrated cost savings with TR access, related primarily to decreased hospital length of stay. While previous studies have shown increased operator radiation exposure compared to a TF approach, the most recent data suggest no significant difference in radiation at higher volume centers.


Clinical and histopathological responses to bee venom phonophoresis in treating venous and diabetic ulcers: a single-blind randomized controlled trial.
Chronic venous and diabetic ulcers are hard to treat that cause patients long time of suffering as well as significant healthcare and financial costs. The conducted study was to evaluate the efficacy of bee venom (BV) phonophoresis on the healing of chronic unhealed venous and/or diabetic foot ulcers Also, to compare the healing rate of diabetic and venous ulcers. The study included 100 patients (71 males and 29 females) with an age range of 40-60 years' old who had chronic unhealed venous leg ulcers of grade I, grade II, or diabetic foot ulcers with type II diabetes mellitus. They randomly assigned into four equal groups of 25: Group A (diabetic foot ulcer study group) and group C (venous ulcer study group) who both received conservative treatment of medical ulcer care and phonophoresis with BV gel, in addition to group B (diabetic foot ulcer control group) and group D (venous ulcer control group) who both received conservative treatment of medical ulcer care and received ultrasound sessions only without BV gel. Wound surface area (WSA) and ulcer volume measurement (UVM) were used to assess the ulcer healing pre-application (P0), post-6 weeks of treatment (P1), and after 12 weeks of treatment (P2). In addition to Ki-67 immunohistochemistry was used to evaluate the cell proliferative in the granulation tissue of ulcers pre-application (P0) and after 12 weeks of treatment (P2) for all groups. This research revealed a statistical significance improvement (p ≤ 0.0) in the WSA, and UVM with no significant difference between study groups after treatment. Regarding Ki-67 immunohistochemistry showed higher post treatment values in the venous ulcer group in comparison to the diabetic foot ulcer group. Bee venom (BV) provided by phonophoresis is effective adjuvant treatment in accelerating venous and diabetic foot ulcer healing with higher proliferative effect on venous ulcer. www.ClinicalTrials.gov, identifier: NCT05285930.


Alpha-methyltyrosine attenuates and reserpine increases methamphetamine-induced neuronal changes.
The repeated administration of methamphetamine to rats has been shown to cause a long-lasting depletion of dopamine in various brain regions. In the first study, the effects of pretreatment with alphamethyltyrosine (AMT) or reserpine on the long-lasting methamphetamine-induced dopamine depletion were examined. In the second study, the effects of AMT and reserpine on central dopamine levels were measured in rats previously treated with methamphetamine. Pretreatment with AMT attenuated the long-lasting dopamine depletion induced by methamphetamine, whereas, pretreatment with reserpine increased the depletion. The acute effects of AMT and reserpine on brain dopamine were not altered when administered two weeks after the last methamphetamine injection.


Effect of isoxsuprine on fetal lung surfactant in rabbits.
To examine the effect of beta adrenergic drugs on fetal lung development, we administered isoxsuprine to pregnant rabbits for 24 hr and measured indices of pulmonary surfactant synthesis, storage, and release in rabbit fetuses at 26 days gestation. Incorporation of radiolabeled choline into total and disaturated phosphatidylcholine was measured in vitro in fetal lung slices. There was a significant increase in the rate of choline incorporation into disaturated phosphatidylcholine in the isoxsuprine-treated group and a tendency toward an increased incorporation into total phosphatidylcholine as well. We also observed an increase in the pulmonary phospholipid reservoir as evidenced by a significant increase in total lung disaturated phosphatidylcholine and a trend toward higher total lung phosphatidylcholine in the isoxsuprine group. In addition, there was a significant increase in lung lavage L/S ratio in the treated fetuses and in lung deflation stability determined by pressure volume curve. We conclude that isoxsuprine increases synthesis, storage, and release of surfactant in rabbit fetuses at 26 days gestation.


Oomycete intracellular effectors: specialised weapons targeting strategic plant processes.
Oomycete phytopathogens have adapted to colonise plants using effectors as their molecular weapons. Intracellular effectors, mostly proteins but also small ribonucleic acids, are delivered by the pathogens into the host cell cytoplasm where they interfere with normal plant physiology. The diverse host processes emerging as 'victims' of these 'specialised bullets' include gene transcription and RNA-mediated silencing, cell death, protein stability, protein secretion and autophagy. Some effector targets are directly involved in defence execution, while others participate in fundamental metabolisms whose alteration collaterally affects defences. Other effector targets are susceptibility factors (SFs), that is host components that make plants vulnerable to pathogens. SFs are mostly negative regulators of immunity, but some seem necessary to sustain or promote pathogen colonisation.


Comparative Study Between Microscopic and Endoscopic Tympanoplasty Type I.
Tympanoplasty is surgical reconstruction of tympano-ossicular system and includes-Canalplasty, Meatoplasty, Myringoplasty and Ossiculoplasty. To analyse and compare the intraoperative and postoperative aspects and the outcomes of conventional postauricular microscopic tympanoplasty and permeatal endoscopic tympanoplasty this study was conducted on 50 patients undergoing type I tympanoplasty (25 patients divided into two groups; group A-microscopic tympanoplasty and group B-endoscopic tympanoplasty). Advantages, disadvantages and results were compared between the two groups. Success rates and hearing improvement were comparable in both groups while intraoperative ease, postoperative morbidity and operative time was seen superior in endoscopic group. Although, endoscopic technique being minimally invasive yet has disadvantages such as single handed difficult instrumentation, frequent cleaning of scope and thus a steep learning curve. In conclusion permeatal endoscopic tympanoplasty can be considered as a good alternative to the conventional microscopic tympanoplasty.


Functional connectivity change of brain default mode network in breast cancer patients after chemotherapy.
Complaint about attention disorders is common among breast cancer patients who have undergone chemotherapy, which may be associated with the default mode network (DMN). To validate this hypothesis, we investigated the DMN functional connectivity (FC) change and its relationship with the attention function in breast cancer patients (BC) using resting-state functional magnetic resonance imaging (rs-fMRI). Twenty-two BC treated with chemotherapy and 22 healthy controls (HC) were recruited into this study. The FC between the DMN's hubs and regions of the dorsal medial prefrontal cortex (dMPFC) and medial temporal lobe (MTL) subsystems was respectively calculated for each participant. The statistical result showed significantly lower connectivity in dMPFC and MTL subsystems in the BC group. In addition, the partial correlation analysis result indicated that the low connectivity of some brain regions in MTL subsystem was correlated with attention dysfunction following BC chemotherapy. These results suggest that the functional disconnection in MTL subsystem of the DMN may have association with attention function of BC after chemotherapy.


Impact of substrate digestibility on microbial community stability in methanogenic digestors: The mechanism and solution.
This study investigated the temporal dynamics of digestion efficiency and community stability in digesters fed with waste activated sludge (WAS), straw (STR-AD), food waste (FW-AD) and mixture of straw-and-food waste (STR-FW-AD). Results showed that carbon removals of recalcitrant substrates (i.e., 48.2 ± 3.9% in WAS-AD and 57.8 ± 4.9% in STR-AD) were lower than that of labile substrates (i.e., 70.7 ± 4.0% in FW-AD). Nonetheless, carbon removal of recalcitrant substrates was largely improved through co-digestion (70.3 ± 3.2% in STR-FW-AD). In contrast to monopoly communities (e.g., the highly enriched Paludibacter) fed with the labile substrates, recalcitrant substrates supported highly diverse communities. Accordingly, the medians of negative/positive cohesions of communities in WAS-AD, STR-AD, STR-FW-AD and FW-AD decreased from 0.86 to 0.63, suggesting their decreasing community stability. Microbial source tracking analyses showed the major contribution of the STR-AD community to the co-digestion community. This study provided unprecedented mechanistic insight into stability improvement of substrate co-digestion on the methanogenic digestion microbiome.


Does laughing with others lower the risk of functional disability among older Japanese adults? The JAGES prospective cohort study.
While laughter is evoked mainly in social contexts, the potential link between laughter in daily life and health benefits is unclear. This study aimed to examine the association between laughter in daily life and the onset of functional disability among older adults in Japan. Data were obtained from a 6-year follow-up cohort of 12,571 participants (46.1% male) in the Japan Gerontological Evaluation Study, aged ≥65 years, who could independently perform daily activities. We evaluated their laughter in daily life from three perspectives: the types of situations in which people laugh, the number of situations in which people laugh with others, and the persons with whom people laugh. Using the Cox proportional hazards model, the risk of functional disability was estimated. A total of 1420 functional disabilities were observed during follow-up. After adjusting for potential confounders, participants who laughed with others (e.g., during conversations with friends) were at a reduced risk of functional disability (hazard ratio, 0.77; 95% confidence interval, 0.65-0.92) than those who laughed alone (e.g., during watching television). Similarly, the number of situations to laugh with others was inversely associated with the risk of functional disability (Ptrend < 0.001). Laughing in a conversation with friends reduced the risk of functional disability by approximately 30% compared to laughing alone. Overall, laughing with others was associated with a reduced risk of functional disability. Having more situations to laugh with others or at least the situation to laugh with friends might contribute to reducing the risk of functional disability later in life.


Vitamin E. deficiency increases the synthesis of platelet-activating factor (PAF) in rat polymorphonuclear leucocytes.
Vitamin E deficiency was found to stimulate FMLP (N-formyl-L-methionyl-L-leucyl-L-phenylalanine)-induced biosynthesis of PAF (1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine) in polymorphonuclear leucocytes (PMN) from rat peritoneum. In three separate experiments each, the amounts of PAF synthesized during 6 min and 12 min incubation of PMN cells from control, vitamin E-supplemented, and vitamin E-deficient rats were 129-240, 131-227 and 248-354 pmol/10(6) cells, respectively. The activity of the acetyl-transferase, which transfers the acetyl moiety of [3H]acetyl-CoA to 2-lysoPAF (1-O-alkyl-sn-glycero-3-phosphocholine) to form [3H]PAF, was higher in PMN homogenates from vitamin E-deficient rats (2.28 +/- 0.07 nmol/min/mg protein) than in those from E-supplemented rats (1.06 +/- 0.10 nmol/min/mg protein). However, there was no difference between the two groups in the activity of acetylhydrolase (4.26 +/- 0.71 and 4.26 +/- 0.06 nmol/min/mg protein, respectively), measured as degradation of [3H]PAF to [3H]lysoPAF. In vitro addition of alpha-tocopherol did not inhibit the increased activity of acetyl-transferase in vitamin E-deficient rats, indicating that the enzyme in vitamin E-supplemented rats was not directly inhibited by alpha-tocopherol. The acetyl-transferases of the two groups showed similar Km values for acetyl-CoA, but different Vmax values (225 microM and 6.4 nmol/min/mg protein in vitamin E-deficient rats, and 216 microM and 3.6 nmol/min/mg protein in vitamin E-supplemented rats), suggesting that the enzyme was not activated but increased in amount in vitamin E deficiency.