Subchorionic hematoma and risk of preterm delivery: a systematic review and meta-analysis.
This study aimed to investigate the association between early pregnancy with subchorionic hematoma and preterm delivery and other adverse pregnancy outcomes in singleton pregnancies. English studies published from 2000 to July 15, 2022 were retrieved from PubMed, Web of Science, and the Cochrane Library. The inclusion criteria were: singleton pregnancy, subchorionic hematoma, and perinatal outcomes. Studies including multiple pregnancy, basic molecular studies, case reports (series), and conference reviews were excluded. Data analysis was mainly conducted with Review Manager (RevMan) and Stata, and the results were represented with odds ratios and 95% confidence intervals. The methodological quality of the included studies was evaluated by the Cochrane risk assessment scale. In total, 370 studies were retrieved from the above databases. Our review included 16 studies and divided them into 2 subgroups: natural pregnancy (12 studies) and assisted reproductive pregnancy (4 studies). The relevant characteristics of each study were analyzed in detail. The primary outcome was preterm delivery. The secondary outcomes were miscarriage, fetal growth restriction, cesarean delivery, and preeclampsia. We found that subchorionic hematoma in the first trimester was not significantly associated with preterm delivery (odds ratio, 1.11; 95% confidence interval, 0.82-1.51) or other adverse outcomes in singleton pregnancy. Regression analysis found that the large heterogeneity of the included studies might be related to whether the included study population (early pregnancy with subchorionic hematoma) was complicated with threatened abortion (P<.05). However, no studies caused large heterogeneity according to sensitivity analysis. Finally, 15 studies related to preterm delivery did not have publication bias (Egger test: P=.26). However, subchorionic hematoma in the first trimester was associated with miscarriage in single pregnancies (natural pregnancy: odds ratio, 3.07; 95% confidence interval, 1.98-4.75; assisted reproductive pregnancy: odds ratio, 1.45; 95% confidence interval, 1.1-1.90). In singleton pregnancy, we found no association between subchorionic hematoma in the first trimester and preterm delivery. Although there was a correlation with miscarriage, the possible gestational age of miscarriage was not stated. More studies are needed to further address the herein posed research questions.


Natural occurrence of aflatoxins and ochratoxin a in corn and barley from mazandaran and golestan in north provinces of I. R. Iran.
Fourteen barley and nine corn samples, destined for animal feed, collected from Golestan and Mazandaran provinces in the north of Islamic Republic of Iran (I. R. Iran) were analysed for aflatoxins (AF) and ochratoxin A (OA) by high performance liquid chromatography. In corn samples, aflatoxin B1 (AFB1) and aflatoxin B2 (AFB2) were detected in 8 (88.8%) and 6 (66.6%) samples at a mean level of 15.83 and 2.99 ppb (median 1.72 and 1 ppb), respectively. None of the corn samples contained detectable amounts of aflatoxin G1 (AFG1) and aflatoxin G2 (AFG2). Only one of the AF-contaminated samples was co-contaminated with OA at a concentration of 0.35 ppb. This is the first report concerning natural occurrence of OA and co-occurrence with AF in corn samples of north of I. R. Iran.


Assessment of soil-gas radon concentration over lithologies: a case study from district Karak, Khyber Pakhtunkhwa, Pakistan.
The current study is aimed to determine the variation of soil-gas radon concentrations over different rock formations representing diverse lithologies in the district of Karak, Khyber Pakhtunkhwa, Pakistan. The stratigraphic units were grouped on the basis of lithological contents into four categories, i.e., limestone, evaporites, claystone/mudstone, and sandstone. The highest average soil-gas 222Rn concentration (544 Bq/L) was found in the uranium-bearing Dhok Pathan Formation of the Pliocene age, while the lowest radon levels (0.15 Bq/L) were observed in the salt-bearing strata of Bahadurkhel Salt of Eocene age showing the non-uraniferous nature of the salt. High radon potential associated with the Dhok Pathan Formation is likely to be related to the high degree of uranium mineralization which is contributing to the elevated soil-gas radon levels. The study revealed that the soil-gas radon concentration in all lithologies is varying in the order of RnSandstone > RnLimestone > RnClaystone/Mudstone > RnEvaporites with the highest radon levels in the sandstone unit of uranium-bearing Dhok Pathan Formation. High fluctuations of soil-gas radon levels observed in this study evidently show that lithology and uranium mineralization have strong control over the 222Rn concentrations.


Human periodontal ligament cell response to a newly developed calcium phosphate-based root canal sealer.
The aim of this study was to investigate the cellular effects of newly developed calcium phosphate-based sealers (CAPSEAL I and II) using cultured human periodontal ligament cells (HPDLCs) compared with epoxy resin sealer (AH26; Dentsply, DeTrey, Konstanz, Germany), zinc oxide eugenol [ZOE] sealer (extended working time [EWT]; Kerr Corporation, Orange, CA), and CPC sealer (Sankin apatite sealer; Sankin-kogyo, Tokyo, Japan). Cell viability by -(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazoliumbromide assay, cell attachment by scanning electron microscopy, osteoblastic differentiation and inflammatory mediators by reverse-transcriptase polymerase chain reaction, Western blotting, and alizarin red staining were evaluated. The cytotoxicities of CAPSEAL I and II were less than those of AH 26 and EWT after 1 and 14 days. Cells on CAPSEAL I and II were spread better as compared with those on other sealers. Mineralization after 14 days and the expression of osteoblastic differentiation markers such as alkaline phosphate and osteonectin messenger RNA increased in CAPSEAL I- and II-exposed HPDLCs after 1 and 3 days, whereas the production of inflammatory mediators, including cyclooxygenase-2, inducible nitric oxide synthetase, and reactive oxygen species (ROS), were lower than in other sealers. These results suggest that both CAPSEAL I and II show less cytotoxicity and inflammatory mediators compared with other sealers and have the potential to promote bone regeneration as root canal sealers.


The importance of the 2S albumins for allergenicity and cross-reactivity of peanuts, tree nuts, and sesame seeds.
Allergies to peanuts, tree nuts, and sesame seeds are among the most important food-related causes of anaphylaxis. Important clinical questions include: Why is there a variable occurrence of coallergy among these foods and Is this immunologically mediated? The clinical and immunologic data summarized here suggest an immunologic basis for these coallergies that is based on similarities among the 2S albumins. Data from component resolved diagnostics have highlighted the relationship between IgE binding to these allergens and the presence of IgE-mediated food allergy. Furthermore, in vitro and in vivo experiments provide strong evidence that the 2S albumins are the most important allergens in peanuts for inducing an allergic effector response. Although the 2S albumins are diverse, they have a common disulfide-linked core with similar physicochemical properties that make them prime candidates to explain much of the observed coallergy among peanuts, tree nuts, and sesame seeds. The well-established frequency of cashew and pistachio nut coallergy (64%-100%) highlights how the structural similarities among their 2S albumins may account for observed clinical cross-reactivity. A complete understanding of the physicochemical properties of the 2S albumins in peanuts, tree nuts, and sesame seeds will enhance our ability to diagnose, treat, and ultimately prevent these allergies.


Results and prognostic factors after resection of pulmonary metastases.
One hundred and fifty-nine thoracotomies were performed in 122 patients with pulmonary metastases. The patients' ages ranged from 2 to 76 years, and 13 patients were younger than 18 years. The primary tumour was carcinoma in 83 cases, sarcoma in 29 cases and melanoma in 10 cases. The primary tumour in children was osteogenic sarcoma (6 patients), Ewing's sarcoma (2 patients) and Wilms' tumour (2 patients). With a minimum follow-up of 2 years, an actuarial 5-year survival rate of 38% was observed for carcinoma and 28% for sarcoma. Four of the children survived disease-free for 3 years or more after pulmonary metastasectomy. The primary tumour in these cases was osteogenic sarcoma and Ewing's sarcoma. A statistically significant difference in survival was found between the groups of carcinoma and sarcoma, but the prognosis for melanoma patients was markedly worse. In carcinoma patients the main prognostic factor was the duration of the disease-free interval. The actuarial postthoracotomy survival in patients with osteogenic sarcomas was 31% at 5 years, and 18% at 5 years in soft-tissue sarcomas. The size of the lesions, activity and disease-free interval correlated with survival in the osteogenic sarcoma group, and the number of lesions in the soft-tissue sarcoma group. An aggressive surgical approach towards pulmonary metastatic disease thus appears to be justified.


Some competition experiments with alang-alang (Imperata cylindrica (L.) Beauv.) in replacement series.
The interaction between alang-alang (Imperata cylindrica) and maize or sorghum was studied in competition experiments according to the replacement principle. Dry matter yield of alang-alang in these experiments appeared hardly affected by the presence of maize or sorghum, while this yield of the latter two was strongly reduced by the presence of alang-alang. The relative yield total (RYT) reached unity except in one experiment in which a value of 0.6 was obtained.The results suggest that the allelopathic activity of alang-alang will find expression in an RYT deviating from one only if alang-alang is not able to utilize all available space.


Inverse Virtual Screening allows the discovery of the biological activity of natural compounds.
A small library of phenolic natural compounds belonging to different chemical classes was screened on a panel of targets involved in the genesis and progression of cancer. The re-investigation of their potential activity was achieved through the Inverse Virtual Screening approach. The normalization of the predicted binding energies permitted the selection of promising compounds on definite targets, avoiding the selection of false positive results. In vitro biological tests revealed the inhibitory activity of xanthohumol and isoxanthohumol on PDK1 and PKC protein kinases. This study validates the robustness of the Inverse Virtual Screening in silico approach as a useful tool for the identification of the specific biological activity of a given set of compounds.


Initial results of a randomized controlled trial comparing clinical and pathological downstaging of rectal cancer after preoperative short-course radiotherapy or long-term chemoradiotherapy, both with delayed surgery.
The aim of this study was to compare the downstaging achieved after long-course chemoradiotherapy (chRT) and short-term radiotherapy (sRT) followed by delayed surgery. A randomized controlled trial was carried out. Eighty-three patients with resectable stage II and III rectal adenocarcinoma were randomized to receive long-course chemoradiotherapy (46) and short-term radiotherapy (5×5 Gy) (37). Surgery was performed 6 weeks after preoperative treatment in both groups. The R0 resection rate was 91.3% in the chRT and 86.5% in the sRT group (P=0.734). Sphincter preservation rates were 69.6%vs 70.3% (P=0.342) and postoperative complication rates were 26.1%vs 40.5% (P=0.221). There were more patients with early pT stage [pT0 (complete pathological response) pT1] in the chRT group [21.8%vs 2.7% (P=0.03)] and more patients with pT3 disease in the sRT group [75.7%vs 52.2% (P=0.036)]. There were no differences in pN stage and lymphatic or vascular invasion in either group. Pathological downstaging (stage 0 and I) was observed in eight (21.6%) patients in the sRT group and in 18 (39.1%) in the chRT group (P=0.07). Tumours were smaller after preoperative ChRT (2.5 cm vs 3.3 cm; P=0.04). Long-course preoperative chemoradiation resulted in greater statistically significant tumour downsizing and downstaging compared with short-term radiation, but there was no difference in the R0 resection rates. Similar postoperative morbidity was observed in each group.


Cabozantinib for the treatment of non-small cell lung cancer with KIF5B-RET fusion. An example of swift repositioning.
A new chimeric fusion transcript of KIF5B (the kinesin family 5B gene) and the RET (Rearranged during Transcription) oncogene, KIF5B-RET, was found in 1-2% of lung adenocarcinomas (LADCs) in 2012. Several related clinical trials for non-small cell lung cancer (NSCLC) with KIF5B-RET rearrangements using existing RET inhibitors, such as cabozantinib, lenvatinib, vandetanib, sunitinib, ponatinib, and AUY922, have been swiftly initiated by the discovery of the KIF5B-RET fusion gene. Anti-RET activity and the status of clinical development of cabozantinib for KIF5B-RET fusion-positive NSCLC are discussed.


The transmembrane helical segment but not the invariant lysine is required for the kinase activity of the large subunit of herpes simplex virus type 2 ribonucleotide reductase (ICP10).
The large subunit of herpes simplex virus type 2 ribonucleotide reductase (ICP10) is a chimera consisting, at the amino terminus, of a Ser/Thr protein kinase (PK) with features of a signal peptide and a transmembrane (TM) helical segment, and at the carboxy-terminus, of the ribonucleotide reductase (Chung et al., 1989, 1990). Membrane immunofluorescence of ICP10 transformed cells with antibodies to synthetic peptides located upstream or downstream of the TM indicates that ICP10 is a membrane-spanning protein. Site-directed and deletion mutants were used to further characterize ICP10-PK. Mutation of Gly106 in catalytic motif I or of the invariant Lys in catalytic motif II, and deletion of both motifs (amino acids 106-178) did not eliminate kinase activity. PK activity was retained by the invariant Lys mutant expressed in bacteria and following protein separation by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and transfer to membrane filters. Both ICP10 and the invariant Lys mutant bound 14C-labeled rho-fluorosulfonylbenzoyl 5'-adenosine, an ATP affinity analog. The deletion mutant had 4-fold lower kinase activity than ICP10-PK, and it was insensitive to Mn2+, suggesting that these motifs are involved in Mn2+ activation of kinase activity. PK activity was lost by deletion of the TM segment (amino acid residues 85-106).


Respiratory and calcium transport properties of spiny lobster hepatopancreas mitochondria.
Mitochondria were isolated from the hepatopancreas of the Florida spiny lobster Panulirus argus using a high osmolarity medium containing 600 mM mannitol, 83 mM sucrose, 5 mM 4-morpholinepropanesulfonic acid, pH 7.6, 0.5% bovine serum albumin (BSA), and 1 mM EDTA. O2 uptake and Ca2+ transport were measured by electrode methods in similar media (plus 4 mM KPi, 3.3 mM MgCl2, and 0.67 mg/ml BSA, with 80 mM KCl replacing a portion of the osmotic support). Substrate-supported respiration was observed to be coupled to phosphorylation of ADP or uptake of Ca2+ ions. State 3 rates (nanogram atoms O X minute-1 X milligram protein-1 +/- SEM (N)) were: 49.2 +/- 3.9 (19), succinate; 30.9 +/- 3.9 (6), DL-palmitoyl carnitine; 29.0 +/- 2.7(9), L-malate; 40.0 +/- 2.3(3), L-glutamate; 27.7 +/- 2.2(5), D-3-hydroxybutyrate; and 26.4 +/- 2.4 (18), L-proline +/- pyruvate. alpha-Glycerol phosphate was not oxidized. Ca2+ uptake driven by succinate oxidation proceeded with Ca:O ratios of 4.0 +/- 0.2 (SEM). Hepatopancreas mitochondria were not uncoupled by Ca2+ uptake in excess of 1100 ng atoms X mg protein-1. Ca2+ efflux could be induced by ruthenium red, indicating the presence of an active Ca2+ cycle. These mitochondria may provide a favorable model system in which to study regulation of the Ca2+ cycle.


[Castleman's disease in the rheumatological practice].
The term Castleman's disease encompasses a group of rare lymphoproliferative diseases that show histopathological similarities in lymph node biopsy. Diagnostic criteria and a specific ICD-10 code have been available for a few years. Case studies listed at the beginning illustrate that close cooperation between clinicians and pathologists is required to enable a reliable diagnosis. For an optimal histopathological assessment, the pathologist is also dependent on the removal of a complete lymph node. Before distinguishing a potentially fatal multicentric idiopathic Castleman's disease from the resectable unicentric form, which is important in terms of prognosis and treatment, early diagnosis presupposes that Castleman's disease is considered in the differential diagnosis. Various immune phenomena and overlaps with autoimmune diseases can increase the probability of misdiagnosis or undetected cases in the clinical routine of rheumatologists. The intention of the present overview is therefore to point out the similarities with autoimmune diseases that are relevant for differential diagnoses and to point out situations that justify a review of the previous diagnosis.


A PC-based on-line system for physiological in vivo and in vitro experiments.
A PC-based system for data acquisition, control of experiments and analysis of physiological signals has been developed. The system has a flexibility that makes it useful for many different types of study, e.g. hemodynamics, electrophysiology and in vitro studies of organ contractile functions. The experimental set-up is specified in a number of tables, which can be modified with a table editor. The specifications can be stored in file and used for other experiments with an identical experimental set-up. The recording of data can be done either intermittently or continuously, and the intermittent recordings are initiated automatically at predefined times, or manually. With a tape recorder utility, data can be recorded during an experiment and analyzed at a later time. The signal analysis module has a high degree of flexibility, achieved by parameters defining preprocessing, heartbeat detection, heartbeat selection and analysis. Data is presented on the display in three types of window, showing phasic signals, derived parameters in trend graphs and derived parameters in numerical form. Data is saved on disk in two types of file: sampled raw data or derived parameters (ASCII file). An Ethernet-based network is used to send data to a VAX cluster, where it is further processed in RS/1 or the BIOLAB analysis program. The source code has been written in Ada, and the compiler generated a 32-bit code, which facilitated the development of a large program with large data buffers.


Developing an application for the UK Pre-Doctoral Clinical and Practitioner Academic Fellowship (PCAF): the collective experience of a community of physiotherapists.
For physiotherapists and other healthcare professionals, developing capability and expertise in research can be challenging. However, involvement in research is beneficial at organisational and individual levels, both for clinicians and patients. One way to embark on research is to apply for a personal fellowship such as the National Institute for Health and Care Research (NIHR) Pre-Doctoral Clinical Academic Fellowship (PCAF). While the NIHR has guidance on how to complete the application form, it can be difficult to implement this guidance and understand what a competitive application looks like. As a group of physiotherapists and academic supervisors, who have applied for NIHR PCAFs, what follows is a supportive resource, to inform others who might be thinking of applying. CONTRIBUTION OF PAPER.


Generation of distortion product otoacoustic emissions in infants with a combined air and bone conduction stimulus.
Evaluation of Distortion Product Otoacoustic Emissions (DPOAEs) by combining Air Conduction (AC) and Bone Conduction (BC) stimuli in infants. Measurements were performed in 19 normal hearing infants, and in 23 adults serving as a control group. The stimulus consisted either of two AC tones, or of combined AC/BC tones. DPOAEs were measured for f2 at 0.7, 1, 2, 4 kHz, and a constant ratio of f2/f1 = 1.22. Sound pressure level of the primary stimulus L1 was held constant at 70 dB SPL, while the level of L2 was decreased in 10 dB steps from 70 to 40 dB SPL. A response was included for further analysis when DPOAEs reached a Signal to Noise Ratio (SNR) of ≥6 dB. Additional DPOAE responses of <6 dB SNR were included when visual inspection of the measurements indicated clear DPOAEs. DPOAEs could be elicited in infants at 2 and 4 kHz for the AC/BC stimulus. DPOAE amplitudes evoked by the AC/AC stimulus were larger than those by the AC/BC stimulus, with the exception of 1 kHz. The highest amplitudes of DPOAEs were registered for a stimulation level of L1 = L2 = 70 dB, with the exception of AC/AC at 1 kHz, where the highest amplitudes were with L1-L2 = 10 dB. We demonstrated that DPOAEs can be generated in infants by a combined AC/BC stimulus at 2 and 4 kHz. The high noise floor needs to be further reduced to achieve more valid measurements in frequencies <2 kHz.


Anxiety or Nervousness Disturbs the Progress of Birth Based on Human Behavioral Evolutionary Biology.
In general, anxiety or nervousness in pregnant women increases the risk of dystocia. Pregnant women are easily susceptible to anxiousness or nervousness. To support a safe and healthy birthing process, childbirth educators, other health-care professionals, and pregnant women require an in-depth understanding about the disruptive effects of anxiety or nervousness on birth progress. Anxiety and nervousness are difficult to quantify and may be influenced by culture. Therefore, reports comparing anxiety or nervousness with dystocia must include various biases. It is difficult to find this issue by medical research. Here, we discuss links between anxiety or nervousness and disturbance in the progress of birth based on the adaptive standpoint of human behavioral evolutionary biology.


A comparison between the effects of fentanyl, droperidol with fentanyl, and halothane anaesthesia on intra-ocular pressure in adults.
The effects of fentanyl 3.0 micrograms/kg (group 1), droperidol 0.1 mg/kg with fentanyl 3.0 micrograms/kg (group 2), and halothane 0.5% inspired concentration (group 3) on intra-ocular pressure were compared. In each group, a decrease in intra-ocular pressure was produced which was significantly lower than resting values (p greater than 0.01) and was independent of changes in arterial blood pressure. The recovery time in group 1 patients was significantly less than that of patients in group 3.


Risk factors for ninety-day readmission following cervical surgery: a meta-analysis.
As an important evaluation index after cervical surgery, ninety-day readmission is gradually being valued. Our study collected the latest published relevant studies, analyzed the risk factors of ninety-day readmission after cervical surgery, and continuously improved the postoperative rehabilitation plan. This study focuses on two research hotspots: (1) What is the rate of ninety-day readmission after cervical surgery? (2) What are the risk factors affecting the ninety-day readmission? Based on the Cochrane Library, PubMed, Web of Science, and Embase databases, this study searched for studies about ninety-day readmission after cervical surgery, from the establishment of the database to August 1, 2022. The evaluation indicators are as follows: age, American Society of Anesthesiology physical status (ASA) class, diabetes, hypertension, chronic heart diseases, chronic lung diseases, income, and payments for hospitalization. The meta-analysis was performed using Review Manager 5.4. Seven studies with 222,490 participants were eligible for our meta-analysis. The analysis displayed that there were statistically significant differences in the age (MD = - 4.60, 95%CI - 4.89-4.31, p < 0.001), diabetes (OR = 0.60, 95%CI 0.56-0.64, p < 0.00001), hypertension (OR = 0.40, 95%CI 0.30-0.54, p < 0.00001), chronic heart diseases (OR = 0.05, 95%CI 0.01-0.19, p < 0.00001), chronic lung diseases (OR = 0.46, 95%CI 0.43-0.49, p < 0.00001), income (OR = 2.85, 95%CI 1.82-4.46, p < 0.00001), and payments for hospitalization (OR = 2.29, 95%CI 1.14-4.59, p = 0.02) between readmission and no readmission groups. In terms of the ASA, there was no difference on the ninety-day readmission (p = 0.78). Age, diabetes, hypertension, chronic heart diseases, chronic lung diseases, income, and payments for hospitalization are the risk factors of ninety-day readmission following cervical surgery.


[Chronic hepatic encephalopathy in cirrhotic patients and spontaneous portacaval anastomosis. Portal angiographic and manometric study].
Portal angiographic and manometric studies were prospectively carried out in 9 cirrhotic patients with spontaneous chronic portal-systemic encephalopathy. Hepatic encephalopathy presented as coma in 8 patients, and was the first manifestation of chronic liver disease in 6 cases. Hemodynamic studies showed a) a large single spontaneous portacaval anastomosis (gastrorenal, splenorenal, gradient (mean +/- SD = 16.3 +/- 5.4 mm Hg); c) a wedge hepatic venous pressure higher than portal pressure in 8 cases (difference: 1-11 mm Hg).


The development of the pediatric cardiac quality of life inventory: a quality of life measure for children and adolescents with heart disease.
Mortality after surgery for congenital heart disease (CHD) has decreased. Quality of life (QOL) assessment in survivors has become increasingly important. The purpose of this project was to create the Pediatric Cardiac Quality of Life Inventory (PCQLI). Items were generated through nominal groups of patients, parents, and providers. The pilot PCQLI was completed by children (age 8-12), adolescents (age 13-18), and their parents at three cardiology clinics. Item reduction was performed through analysis of items, principal components, internal consistency (IC), and patterns of correlation. A total of 655 patient-parent pairs completed the pilot PCQLI. Principal components identified included: impact of disease (ID); psychosocial impact (PI); and emotional environment (EE). After item reduction ID and PI had excellent IC (ID = 0.88-0.91; PI = 0.78-0.85) and correlated highly with each other (0.81-0.90) and with the total score (TS) (ID = 0.95-0.96; PI = 0.87-0.93). EE was not correlated with ID, PI, or TS and was removed from the final forms. Two-ventricle CHD patients had a higher TS than single-ventricle CHD patients across all forms (P < 0.001). The PCQLI has patient and parent-proxy forms, has wide age range, and discriminates between CHD subgroups. The ID and PI subscales of the PCQLI have excellent IC and correlate well with each other and the TS.


Updates in Cancer-Related Symptom Management of Anorexia and Cachexia Syndrome.
To provide current evidence and updates in cancer-related symptom management of cancer anorexia-cachexia syndrome (CACS). Textbooks, journal articles, and the internet. Nutrition and the treatment of CACS plays a pivotal role in multimodal cancer care. The pathophysiology of nutrition in patients with cancer is complex and requires active screening and interventions. Treatment of CACS should focus on antitumor treatment, nutrition intervention, supportive pharmacologic intervention and/or other interventions that improve clinical outcomes. Oncology nurses are in a pivotal position to provide proactive screening, assessment, clarify treatment options, and follow-up for patients with cancer and associated nutritional issues.


[Periodontal problems connected with orthodontic treatment of impacted teeth on high or vestibular eruption].
The authors report four cases of vestibular ectopia. The relevance of a sufficient gums adhesion to dental elements is outlined as a factor leading to an optimal reposition of the latter.


Diagnostic value of left ventricular outflow area in patients with hypertrophic cardiomyopathy: a real-time three-dimensional echocardiographic study.
Earlier studies demonstrated the ability of real-time 3-dimensional (3D) echocardiography (3DE) to measure left ventricular outflow tract (LVOT) area (A(LVOT)) in patients with hypertrophic cardiomyopathy (HCM). However, its clinical value is unknown. We sought to investigate the feasibility and accuracy of real-time 3DE-derived A(LVOT) to diagnose significant LVOT obstruction in a large number of patients with HCM. A total of 162 patients with HCM had 3DE by using a volumetric system. The smallest A(LVOT) during systole was determined by moving a 2-dimensional plane in 3D space. The pressure gradient across LVOT was assessed by continuous wave Doppler method. Provocation was performed in patients without significant LVOT obstruction (pressure gradient across LVOT < 50 mm Hg) at rest. Twenty (12%) patients with poor image quality of 3DE were excluded; 16 (28%) patients with a volumetric system, but only 4 (4%) patients with commercial equipment (P < .001). In the remaining 142 patients, A(LVOT) inversely correlated with pressure gradient across LVOT both at rest (r = 0.82, P < .001) and after provocation (r = 0.60, P < .001). The value of A(LVOT) less than 0.85 cm(2) and less than 2.0 cm(2) predicted resting and provokable LVOT obstruction with sensitivity of 87% and 81%, and specificity of 77% and 90%, respectively. Real-time 3DE measurement of A(LVOT) was successful in diagnosing and quantifying LVOT obstruction at rest and after provocation in a large number of patients with HCM.


Polymorphism of human plasma thyroxine binding prealbumin.
Amyloid fibrils from an individual with heredofamilial amyloidosis were found to be composed of plasma prealbumin. To study this protein a three step procedure to isolate prealbumin from plasma was developed. It entailed ion exchange chromatography on DEAE Sephadex, affinity chromatography on Affi-gel Blue and gel filtration on AcA-34. Trypsin Digests of prealbumin were separated by reverse phase HPLC and the pattern compared to that from the normal protein. Only one unexpected peptide was found and it represented the substitution of a methionine for a valine at position 30 in the molecule. This substitution accounts for about 1/3 of the isolated molecules and it represents the first point mutation identified in human plasma prealbumin.


Extracellular ATP opposes thrombin-induced myosin light chain phosphorylation and loss of barrier integrity in corneal endothelial cells.
Increased contractility of the actin cytoskeleton by phosphorylation of the regulatory myosin light chain (MLC) results in a loss of barrier integrity in corneal endothelial cells. This study has investigated the effect of extracellular ATP, which may influence both Ca2+ and cAMP signalling, on MLC phosphorylation and barrier integrity in cultured bovine corneal endothelial cells (BCEC) known to express A2B and P2Y purinergic receptors, and ecto-nucleotidases. Extracellular ATP (100 microM) promoted MLC dephosphorylation (pMLC=61.8% at 18 min; n=9). Pre-exposure to ARL-67156, an ecto-nucleotidase inhibitor, prevented ATP-induced dephosphorylation. Other P2Y agonists, UTP and ATPgammaS, also induced MLC dephosphorylation but to a lesser degree compared to ATP. Thrombin (2 U/ml), which activate Rho kinase through PAR-1 receptors in the endothelium, induced MLC phosphorylation (pMLC=129.2%; n=14). This phosphorylation was completely abolished by concomitant exposure to ATP. When cells were pretreated with adenosine (100 microM; A2B agonist) or forskolin (10 microM), thrombin-induced phosphorylation was suppressed. ATP also led to a significant increase in cAMP (> 3-fold compared to 10 microM adenosine). Thrombin-induced increase in trans-endothelial flux of horseradish peroxidase (44 kDa) and disruption of the cortical actin were suppressed by ATP. These findings indicate that in BCEC (1) ATP induces elevated cAMP through its metabolite adenosine leading to MLC dephosphorylation, (2) Stimulation of P2Y2 receptors also leads to activation of MLCP since UTP- and ATPgammaS caused MLC dephosphorylation, and (3) ATP is antagonistic to thrombin since the latter inhibits MLCP through increased activity of Rho kinase. These findings further emphasize the role of contractility of the actin cytoskeleton in regulating the barrier integrity of corneal endothelium.


Volume measurement of a pediatric ventricular phantom model using three-dimensional echocardiography.
Volume measurement of the ventricle is necessary to evaluate cardiac function. Accurate volume measurement of the ventricle by three-dimensional (3D) echocardiography will mark a new step in pediatric cardiovascular diagnosis and treatment. We studied volume measurement of a pediatric ventricular model using 3D echocardiography. The ultrasonic diagnostic setup used in this study comprised a Philips Sonos 7500 ultrasound system with an electronic sector probe of a ×4 matrix phased array transducer. The ventricular model was made from a latex surgical glove. The tip of the third finger of the glove was cut off and fixed to a manifold. The ventricular model was gently placed in a reservoir filled with water. Volumes of physiological saline solution ranging from 2 ml to 50 ml in 2-ml increments were injected into the ventricular model and examined. Twenty-five ultrasound images of the ventricular model were obtained using 4D Cardio View RT 1.2 software. There was excellent correlation and agreement between the injected volumes and the calculated volumes (Y = -0.539 + 1.005X, r = 0.997, four cut plane; Y = -0.191 + 1.006X, r = 0.997, eight cut plane). Thus, accurate volume measurement of the ventricular model by 3D echocardiography was confirmed. Our study demonstrated that 3D echocardiography is highly accurate for volume measurement in a pediatric ventricular model (for volumes of 2 to 50 ml) under static conditions.


Management and behavior-modifying recommendation effects in childhood headache.
Headaches are common in childhood. Recently, there has been an increasing trend toward pharmacological treatment. Secondary causes were excluded first in patients who attended our clinic with headache. Those without a secondary cause were evaluated as primary headache and classified into subgroups. Behavior-modifying recommendations (adequate and regular sleep, adequate and regular nutrition, adequate fluid intake, and restriction of screen exposure) were given to all patients. Patients were re-evaluated at 1, 3, and 6 months. Pharmacologic treatment was started at the end of the first month with follow-up at the third and sixth months for those who did not benefit from the behavior-modifying recommendations. A total of 875 patients presented with headache complaints, of which 30.6% were evaluated as primary headache. Behavior-modifying recommendations were beneficial for 23.1% with migraine with aura; 20.3% with migraine without aura, and 36.8% with tension-type headache. Secondary causes should be excluded first in patients who present to the pediatric neurology clinic with headache. Behavioral modifications to change the lifestyle of patients diagnosed with primary headache should be tried before giving pharmacologic treatment.


Aneurysms of anterior cerebral artery: a review of a personal series.
In this paper we report a series of 9 patients with ACA aneurysms successfully operated on. Their incidence, anatomical location, clinical signs, surgical approach and results are reviewed.


Transcatheter Edge-to-Edge Repair for a Patient With Severe Mitral Regurgitation of Carpentier IIIa Classification.
Whether patients diagnosed with mitral regurgitation of Carpentier class IIIa (rheumatic origin) can possibly be treated with balloon mitral commissurotomy followed by transcatheter edge-to-edge repair remains unclear. Here, we report on such a case who was successfully treated with balloon mitral commissurotomy and then transcatheter edge-to-edge repair without aggravating mitral stenosis. (Level of Difficulty: Intermediate.).


[Comparative examination of endocrine ophthalmopathy by means of ultrasonography, computerized tomography and fish bioassay].
In 35 patients with Graves' ophthalmopathy (GO) thyroid function was tested by T3-RIA, T4-RIA, TBI, TRH-test, thyroid scanning, and determination of thyroid autoantibodies. Additional ultrasonography (A-scan), computed tomography (CT) of the orbit, and the determination of an exophthalmogenic serum activity in fish bioassay was performed. Typical alterations for GO were observed in 26 cases with ultrasonography. CT showed an enlargement of medial and/or lateral rectus muscles in 24 of 33 patients, and in 17 cases a region of high density in the apex of the muscle cone. The density of retrobulbar fat after i.v. injection of contrast medium did not differ significantly from that observed in normal men. Characteristic signs of GO were not detected in only 2 cases using both methods together. Exophthalmogenic serum activity was found in the IgG fraction of serum protein. The incidence rate was high (69%), but for diagnostic purpose the fish bioassay cannot be recommended.


Motivational Interviewing to Reduce Substance Use in Adolescents with Psychiatric Comorbidity.
Substance use among adolescents with one or more psychiatric disorders is a significant public health concern. In this study, 151 psychiatrically hospitalized adolescents, ages 13-17 with comorbid psychiatric and substance use disorders, were randomized to a two-session Motivational Interviewing intervention to reduce substance use plus treatment as usual (MI) vs. treatment as usual only (TAU). Results indicated that the MI group had a longer latency to first use of any substance following hospital discharge relative to TAU (36 days versus 11 days). Adolescents who received MI also reported less total use of substances and less use of marijuana during the first 6 months post-discharge, although this effect was not significant across 12 months. Finally, MI was associated with a significant reduction in rule-breaking behaviors at 6-month follow-up. Future directions are discussed, including means of extending effects beyond 6 months and dissemination of the intervention to community-based settings.


Diameter of the vial plays a crucial role in the amyloid fibril formation: Role of interface area between hydrophilic-hydrophobic surfaces.
Number of incurable diseases associated with neurodegenerative syndromes like Alzheimer's, and Parkinson's, are owing to protein aggregation which leads to amyloid fibril formation. In vitro, such fibrillation depends on concentration, temperature, pH, ionic strength, organic solvents, agitation, and stirring, which play a crucial role in understanding the mechanism of fibrillation as well as to identify potential inhibitors for fibrillation. Although these parameters were considered, the precise repeatability of amyloid fibrillation kinetics between laboratories remains challenging. Herein, we have demonstrated that another important parameter such as diameter of the vial in which protein undergoes fibrillation play a key role in the amyloid fibrillation. The various biophysical analyses indicated that the lag time, elongation, and the amount of fibril formation was significantly reduced with decreasing the diameter of the reaction vial from 24 to 15mm. Further, the minimum amount of protein required for fibrillation was determined by the diameter of the vial. The observed fibrillation difference in different vials is most likely due to the variation in the interface area between hydrophobic (air) and hydrophilic (water) surfaces as the diameter of the vial changes. The current results have a major role in the design of drug screening assays for amyloid inhibition.


Effect of chronic hypo and hypervitaminosis C on the brush border enzymes and the intestinal uptake of glucose and alanine.
Brush border sucrase and alkaline phosphatase activities are considerably enhanced in the intestine of ascorbic acid deficient guinea-pigs. Similar increase in the uptake of D-glucose and L-alanine also occurs in chronic vitamin C deficiency. However the permeability of D-glucose and L-alanine in the intestine of animals fed with large doses of vitamin C is severely depressed, with a reduction in the levels of sucrase and alkaline phosphatase activities.


Self-assembly patterning of ultrafine zirconia nanocrystal films fabricated on chemically patterned templates.
Ultra-thin zirconia (ZrO2) nanocrystal films were fabricated by using a controlled dip-coating process. ZrO2 nanocrystals possess a cubic crystalline phase and large surface-to-volume area. The film composite with only several layers of nanocrystals were obtained by controlling the withdrawal speed and mass concentration of the colloidal solution. The optical properties of ZrO2 nanocrystal films were accessed by UV-vis spectroscopy, which indicated the dense and uniform structure of the nanocrystal films. The high reflection index suggested that the films could be used in the reflection coating industry. Furthermore, a micro-pattern of self-assembled monolayers of silane molecular was used as a chemical mold for selective deposition of ZrO2 nanocrystals. As a result, a self-assembly patterning of ZrO2 nanocrystals with a neat edge was fabricated on silicon substrate. The low-cost fabricating method is compatible with conventional very-large-scale integration processes and can be extended to other kinds of nanocrystals.


One-third of term babies after perinatal hypoxia-ischaemia have transient hearing impairment: dynamic change in hearing threshold during the neonatal period.
To examine the process of change in hearing threshold during the neonatal period after perinatal hypoxia-ischaemia. The threshold of brainstem auditory evoked responses (BAER) was measured serially during the first month after birth in 92 term babies who suffered hypoxia-ischaemia. The mean BAER threshold in these babies was significantly increased on day 1 (ANOVA p < 0.001). The elevated threshold decreased progressively on days 3 and 5, but was still significantly higher than that in normal controls (p < 0.01). The elevation continuously decreased more slowly on days 10 and 15, and to a near normal level on day 30. Threshold elevation was seen in 31.7% of the babies on day 1, and 34.5% during the first three days. The rate of elevation decreased progressively thereafter. On day 30, 10.6% of the subjects still had increased thresholds. Moderate to severe elevation occurred mainly during the first week and severe elevation occurred predominately on day 1. Threshold elevation starting after days 3-5 is likely to be due to middle-ear disorders. As a whole, during the first month, 44.6% (41/92) of the babies studied had threshold elevation. BAER threshold was correlated weakly with the stage of hypoxic-ischaemic encephalopathy on days 1 and 3. The threshold was significantly higher in babies with severe encephalopathy than in those with mild or moderate encephalopathy during the first 3 d of life. Hearing threshold is elevated in about one-third of term babies after hypoxia-ischaemia. The elevated threshold decreases progressively after birth, and returns to normal by one month in most babies. The threshold correlates weakly with the severity of encephalopathy.


Heteroduplex formation and polarity during strand transfer promoted by Ustilago rec 1 protein.
Ustilago rec1 protein promotes formation of joint molecules between circular strands and linear duplex DNA in two stages. During the first stage--synapsis--ATP, or the nonhydrolyzable analog adenylyl-imidodiphosphate, is a necessary cofactor in the formation of complexes. During the second stage--strand exchange--transfer of the circular single strand to the duplex appears to require energy derived from ATP hydrolysis. Rec1-promoted strand exchange is driven in a unique direction. Circular plus strand pairs with the 5' end of its complement in the linear duplex molecule. The 3' end of the plus strand is displaced from the duplex as the circle rolls in.


"Retinoblastoma survival disparity": The expanding horizon in developing countries.
The patients' survival for the most common intraocular tumor in children, retinoblastoma, has a wide spectrum among the world countries. This study was conducted to provide an overview of the retinoblastoma survival disparity worldwide by discussing the trends of patients' survival, as well as recent advances in the management of retinoblastoma. The design of this study was literature review and commentary. Selected articles from PubMed (except one) including both developing and developed countries regarding the patients' survival in retinoblastoma were considered and reviewed critically. An analysis of 47 articles was performed. In conclusion, in spite of an obvious contrast of retinoblastoma survival disparity in the world, the expanding horizons in developing countries are promising and continuing on all fronts and results are hope-inspiring.


Assemblages, territories, contexts.
Human geographers have been at the forefront of efforts across the social sciences to develop "assemblage thinking", applying and extending this model in a series of highly original empirical studies. This commentary assesses some of the conceptual, methodological and procedural implications of this research for contemporary drug studies. I will argue that the most useful way of approaching assemblage thinking in the analysis of drug problems is to focus on the ways assemblages draw together social, affective and material forces and entities. I will briefly review these three nodes before indicating how their analysis may inspire novel empirical assessments of drug assemblages. I will conclude by exploring how the assemblage may replace the 'subject' and 'social context' as a discrete unit of analysis in drug studies.


Influence of intermittent water releases on groundwater chemistry at the lower reaches of the Tarim River, China.
Based on the data of the depths and the chemical properties of groundwater, salinity in the soil profile, and the basic information on each delivery of water collected from the years 2000 to 2006, the varied character of groundwater chemistry and related factors were studied. The results confirmed the three stages of the variations in groundwater chemistry influenced by the intermittent water deliveries. The factors that had close relations to the variations in groundwater chemistry were the distances of monitoring wells from the water channel, the depths of the groundwater, water flux in watercourse, and the salinities in soils. The relations between chemical variation and groundwater depths indicated that the water quality was the best with the groundwater varying from 5 to 6 m. In addition, the constructive species in the study area can survive well with the depth of groundwater varying from 5 to 6 m, so the rational depth of groundwater in the lower reaches of the Tarim River should be 5 m or so. The redistribution of salts in the soil profile and its relations to the chemical properties and depths of groundwater revealed the linear water delivery at present combining with surface water supply in proper sections would promote water quality optimized and speed up the pace of ecological restoration in the study area.


Identification of novel gyrase B inhibitors as potential anti-TB drugs: homology modelling, hybrid virtual screening and molecular dynamics simulations.
Using an integrated computational approach involving homology modelling, pharmacophore/structure-based virtual screening, molecular dynamics simulations and per-residue energy contribution, 10 compounds were proposed as potential TB inhibitors. Via validated docking calculations, binding free energy calculations showed that the proposed compounds presented better binding affinity with DNA gyrase B when compared to novobiocin. The compiled in silico approach employed in this study may serve as a useful tool in the process of the design and development of drugs, not only against TB, but also for a wide range of biological systems.


Anticipation in familial cavernous angioma: ascertainment bias or genetic cause.
Anticipation has been linked to unstable trinucleotide repeats in many neurological disorders. We examined the hypothesis of genetic anticipation in familial cavernous angioma (FCA) of the central nervous system. The mean ASO of affected individuals was compared between successive generations in 55 families. Intergenerational pair-wise comparisons were employed to avoid several ascertainment biases. Regarding severity of disease both type of manifestation and number of cavernous angiomas were compared between generations. The mean ASO decreased significantly both from the first to the second generation (31.6 vs 17.8 years; P = 0.000) and from the second to the third generation (17.8 vs 6.7 years; P = 0.002). The pair-wise comparisons also showed significantly earlier ASO. No clear evidence for anticipation with regard to severity of disease was found. Molecular genetic studies will determine whether trinucleotide repeats are the underlying mechanism for our observation of anticipation in FCA.


Chronic Lymphocytic Thyroiditis May Limit the Utility of Molecular Testing in AUS/FLUS Thyroid Nodules.
Chronic lymphocytic thyroiditis (CLT) may increase the likelihood of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) results in thyroid nodules by fine needle aspiration (FNA). Gene expression classifier (GEC) and Thyroid Sequencing (ThyroSeq) may better stratify rate of malignancy (ROM) of AUS/FLUS thyroid nodules. This study compares the utility of molecular tests in determining malignancy in surgical patients with concomitant AUS/FLUS thyroid nodules and CLT. A retrospective review of 1648 patients with index thyroid nodules who underwent FNA and thyroidectomy at a single institution was performed. Patients with concomitant AUS/FLUS thyroid nodules and CLT were subdivided into three diagnostic groups: FNA only, FNA with GEC, and FNA with ThyroSeq. Patients with AUS/FLUS thyroid nodules without CLT were subdivided into similar groups. Final histopathology of the cohorts was further stratified into benignity and malignancy and analyzed using Chi-squared statistics. Of 463 study patients, 86 had concomitant AUS/FLUS thyroid nodules and CLT with a 52% ROM, and the difference of ROM among FNA only (48%), suspicious GEC (50%), or positive ThyroSeq (69%) was not significant. In 377 patients with AUS/FLUS thyroid nodules without CL, ROM was 59%. ROM among these patients was significantly higher when molecular testing was used (FNA only 51%, suspicious GEC 65%, and positive ThyroSeq 68%; P < 0.05). Molecular tests may have limited value in predicting malignancy in surgical patients with concomitant AUS/FLUS thyroid nodules and CLT.


Parkinson's disease and functional decline in older Mexican Americans.
The purpose of this study was to establish prevalence and five-year incidence, and explore functional decline among older Mexican Americans with Parkinson's disease (PD). Using data from the Hispanic EPESE, baseline characteristics were compared across PD response profiles. Weighted generalized estimating equations (GEE) modeled the association between PD and outcomes. Prevalence was 1.30%; incidence at wave 4 was 1.18%. Those with prevalent PD had worse function than those without PD at each wave. Progressive functional decline across time was observed among those with PD. Older Mexican Americans with PD often live in the community, and those who provide care for them may be overburdened.


Pharmacological difference between degrader and inhibitor against oncogenic BCR-ABL kinase.
Chronic myelogenous leukemia (CML) is characterized by the oncogenic fusion protein, BCR-ABL protein kinase, against which clinically useful inhibitors have been developed. An alternative approach to treat CML is to degrade the BCR-ABL protein. Recently, potent degraders against BCR-ABL have been developed by conjugating dasatinib to ligands for E3 ubiquitin ligases. Since the degraders contain the dasatinib moiety, they also inhibit BCR-ABL kinase activity, which complicates our understanding of the impact of BCR-ABL degradation by degraders in CML growth inhibition. To address this issue, we chose DAS-IAP, as a potent BCR-ABL degrader, and developed a structurally related inactive degrader, DAS-meIAP, which inhibits kinase activity but does not degrade the BCR-ABL protein. DAS-IAP showed slightly weaker activity than DAS-meIAP in inhibiting cell growth when CML cells were treated for 48 h. However, DAS-IAP showed sustained growth inhibition even when the drug was removed after short-term treatment, whereas CML cell growth rapidly resumed following removal of DAS-meIAP and dasatinib. Consistently, suppression of BCR-ABL levels and downstream kinase signaling were maintained after DAS-IAP removal, whereas kinase signaling rapidly recovered following removal of DAS-meIAP and dasatinib. These results indicate that BCR-ABL degrader shows more sustained inhibition of CML cell growth than ABL kinase inhibitor.


Sources and seasonal variation of coliform bacteria abundance in groundwater around the slopes of Mount Meru, Arusha, Tanzania.
The quality of the groundwater along the slopes of Mount Meru, Tanzania, is poorly understood. Water access and sanitation practices may pose health risks to communities. This study was undertaken to assess the sources, abundance and seasonal variation of coliform bacteria in groundwater and factors contributing to such variations along slopes of Mount Meru, Tanzania. Water samples collected from 67 randomly selected water sources (springs, shallow wells which ranged from 4 to 35 m deep and Boreholes above 40 m deep) during dry and wet seasons were analysed for total coliform (TC), faecal coliform (FC), Escherichia coli (E. coli) and faecal streptococci (FS), using the membrane filtration method. The fraction of springs and shallow wells contaminated was generally higher compared to the fraction of boreholes. The highest TC, FC, E. coli and FS counts were significantly higher (p < 0.05) during the wet than the dry season owing to rising of water table and leaching during rainy season. Water sources that were located within 10 m of pit latrines had the highest coliform counts relative to those located beyond 10 m. Similarly, the highest coliform counts were observed in all shallow wells that (i) had low well head above the ground, (ii) were not covered, (iii) had casing materials which were not concrete and (iv) utilised traditional pumping (bucket/pulley) systems. This was due to contaminated storm water access, inoculation of microbes by exposed buckets and inefficiency of the casing material. Furthermore, the counts decreased with depths of boreholes and shallow wells during the two seasons probably due to retention and die-off. It is recommended that groundwater in this area be treated against coliform contamination prior to utilisation as portable water.


cAMP-induced changes of intracellular free Mg2+ levels in human erythrocytes.
To examine the role of cAMP in the regulation of intracellular free magnesium concentration ([Mg2+]i), we measured [Mg2+]i in human erythrocytes by 31P-NMR spectroscopy. (-)-Isoproterenol, forskolin, Bt2cAMP and 8-bromo-cAMP decreased [Mg2+]i in human erythrocytes. Bt2cAMP did not increase the efflux rate of Mg2+ from erythrocytes. HA1004, a potent inhibitor of cAMP-dependent kinases, markedly increased the [Mg2+]i in a Mg(2+)-free buffer solution. Addition of 8-bromo-cGMP or 12-O-tetradecanoylphorbol 13-acetate (TPA) did not affect the [Mg2+]i. These results suggest that beta-adrenergic stimulation and cAMP play an important role in the regulation of [Mg2+]i in human erythrocytes.


A sciatic nerve with three roots and its perforation by the enlarged ischiadic artery.
Knowledge about the variations of the sciatic nerve (SN) is important for many medical science disciplines. Its compression, entrapment or injury of any kind can result in loss of sensation, pain or motor disabilities in the lower limbs. We observed concurrent neurovascular variations in the gluteal region of an adult female cadaver. The SN had three roots as it emerged out of the greater sciatic foramen. The upper root passed above the piriformis; the middle and lower roots passed below the piriformis. The three roots joined to form the SN in the gluteal region. The inferior gluteal artery (IGA) was large, and it passed below the piriformis, between the middle and lower root of the SN. After a tortuous course, this artery continued down as the sciatic/ischiadic artery. The ischiadic artery (IA) was large in size and pierced the SN in the thigh. After piercing the nerve, it terminated by dividing into muscular branches. The inferior gluteal nerve emerged out from the pelvis through the greater sciatic foramen, above the level of the piriformis. The SN in this case was highly predisposed to compression by the piriformis, IGA or IA, which in turn may lead to altered cutaneous sensation or weakness of the muscles.


Cysteine-rich protein 61 (CCN1) domain-specific stimulation of matrix metalloproteinase-1 expression through αVβ3 integrin in human skin fibroblasts.
Human skin largely comprises collagenous extracellular matrix. The hallmark of skin aging is fragmentation of collagen fibrils. Matrix metalloproteinases (MMPs) are largely responsible for collagen degradation. MMP-1, principally derived from dermal fibroblasts, is the major protease capable of initiating degradation of native fibrillar collagens. Presently, we report that CCN1, a secreted and extracellular matrix-associated protein, is elevated in aged human skin dermal fibroblasts in vivo and stimulates MMP-1 expression through functional interaction with αVβ3 integrin in human dermal fibroblasts. CCN1 contains four conserved structural domains. Our results indicate that the three N-terminal domains (IGFBP, VWC, and TSP1), but not the C-terminal CT domain, are required for CCN1 to stimulate MMP-1 expression. This stimulation is dependent on interaction between the active structural domains and αVβ3 integrin. The interaction of VWC domain with integrin αVβ3 is necessary and requires functional cooperation with adjacent IGFBP and TSP1 domains to stimulate MMP-1 expression. Finally, induction of MMP-1 expression in dermal fibroblasts by CCN1 N-terminal domains resulted in fragmentation of type I collagen fibrils in a three-dimensional collagen lattice model. These data suggest that domain-specific interactions of CCN1 with αVβ3 integrin contribute to human skin aging by stimulating MMP-1-mediated collagen fibril fragmentation.


Stage conversion of Toxoplasma gondii in mouse brain during infection and immunodepression.
The kinetics and pattern of expression of bradyzoite-specific proteins were studied in mouse brain during infection with Toxoplasma gondii. Parasites found in the brain 6 days after ingestion of cysts were expressing only tachyzoite-specific proteins (anti-SAG1 antibodies being used as a marker). Bradyzoite-specific protein (Pb36) expression was first found after 9 days in vacuoles containing mixed parasites simultaneously expressing SAG1 and Pb36 or cysts containing parasites expressing only the bradyzoite marker. Reactivation of toxoplasmosis was studied in mouse brain using corticosteroids for immunosuppression. Parasites expressing SAG1 were first found 6 days after the beginning of treatment, but a very heterogeneous pattern was found throughout the study. We simultaneously found vacuoles containing parasites expressing only SAG1 or containing intermediate stages or cysts containing parasites expressing only bradyzoite proteins. A striking observation was the multiplication of cysts in foci, suggesting that the immune suppression triggered the release of parasites from preexisting cysts but that the factors inducing bradyzoite development remained fully effective in driving parasites into this pathway.


Developing targeted drug delivery carriers for breast cancer using glutathione-sensitive doxorubicin-coupled glycated bovine serum albumin nanoparticles.
Incorporation of the nano-based carriers into drug delivery provides a promising alternative to overcome the limitations of the conventional chemotherapy. Doxorubicin (DOXO) is an effective chemotherapeutic drug widely used in chemotherapy for breast cancer treatment. A globular protein bovine serum albumin (BSA) holds great potential as carriers in pharmaceutical applications. This work is aimed at developing the DOXO-coupled glycated BSA nanoparticles via desolvation method for improving the capability of targeting the GLUT5 transporters over-expressed on breast cancer cells. Fructosamine assay and Fourier transform infrared spectroscopy were employed to determine the content of fructosamine structure and structural changes on the surfaces of nanoparticles, respectively. Additionally, the synthesized BSA nanoparticles were further characterized by electron microscopy and dynamic light scattering. Results revealed that the DOXO-coupled glycated BSA nanoparticles were spherically shaped with a hydrodynamic diameter of ~60.74 nm and a ζ-potential of ~ - 42.20 mV. Moreover, the DOXO release behavior of as-synthesized DOXO-coupled glycated BSA nanoparticles was examined under different conditions. Finally, the DOXO-coupled glycated BSA nanoparticles were found to exhibit cytotoxicity toward both MCF-7 and MDA-MB-231 cells. Our findings evidently suggested that the drug-coupled glycated BSA nanoparticles serve as the potential candidates for targeted drug delivery platform used in breast cancer therapy.


The scheduling of repeat cesarean section operations: prospective management protocol experience.
There are benefits to patients and a busy obstetric service if repeat cesarean section operations are performed on a scheduled basis. Optimum management avoids prematurity and reduces the need for amniocentesis. Over a period of 20 months repeat cesarean sections were performed at Tripler Army Medical Center while a protocol with the following elements was used: (1) known last menstrual period; (2) landmarks: positive urine human chorionic gonadotropin test by 6 weeks, Doppler fetal heart tone by 12 weeks, date determination by examination before 10 weeks, fetoscope fetal heart tone by 20 weeks, and date determination by size before 30 weeks; (3) date determination by midtrimester sonogram(s); (4) normal third-trimester glucose screening; (5) biparietal diameter of 9.2 or 9.5 cm before scheduling. With two or more clinical landmarks and one date by sonogram or one landmark and date by two sonograms, elective repeat cesarean section was scheduled at 39 weeks if the biparietal diameter was greater than or equal to 9.2 cm (127). If dates by sonogram were less than dates by last menstrual period but greater than 1 week or if last menstrual period was unknown, dates by sonogram and landmarks corresponding to dates by sonogram were used to electively schedule, with biparietal diameters of 9.2 or 9.5 cm respectively required (28). If protocol criteria were not met or earlier delivery was indicated (e.g., vertical scar or diabetes), amniocentesis was performed (42), except when not possible, advisable, or refused when patients either elected labor (20) or were scheduled if three or more criteria for 40+ weeks were met (18). Of 225 patients (70.5%) scheduled by protocol (173), amniocentesis (34), or medical indication (18), 188 (58.9%) were delivered without labor. In the 147 patients (46.1%) delivered electively by protocol without labor or amniocentesis, there were no cases of respiratory distress syndrome and the mean birth weight was 3517 gm. With early care and better patient compliance nearly all repeat cesarean sections can be safely delivered electively with the use of this protocol.


Evaluating breast cancer predisposition genes in women of African ancestry.
Studies conducted primarily among European ancestry women reported 12 breast cancer predisposition genes. However, etiologic roles of these genes in breast cancer among African ancestry women have been less well-investigated. We conducted a case-control study in African American women, which included 1117 breast cancer cases and 2169 cancer-free controls, and a pooled analysis, which included 7096 cases and 8040 controls of African descent. Odds ratios of associations with breast cancer risk were estimated. Using sequence data, we identified 61 pathogenic variants in 12 breast cancer predisposition genes, including 11 pathogenic variants not yet reported in previous studies. Pooled analysis showed statistically significant associations of breast cancer risk with pathogenic variants in BRCA1, BRCA2, PALB2, ATM, CHEK2, TP53, NF1, RAD51C, and RAD51D (all P < .05). The associations with BRCA1, PALB2, and RAD51D were stronger for estrogen receptor (ER)-negative than for ER-positive breast cancer (P heterogeneity < .05), whereas the association with CHEK2 was stronger for ER-positive than for ER-negative breast cancer. Our study confirmed previously identified associations of breast cancer risk with BRCA1, BRCA2, PALB2, ATM, TP53, NF1, and CHEK2 and provided new evidence to extend the associations of breast cancer risk with RAD51C and RAD51D, which was identified previously in European ancestry populations, to African ancestry women.


Melatonin attenuates the decrement of dendritic protein MAP-2 immuno-staining in the hippocampal CA1 and CA3 fields of the aging male rat.
Neuronal death during brain aging results, at least in part, from the disruption of synaptic connectivity caused by oxidative stress. Synaptic elimination might be caused by increased instability of the neuronal processes. In vitro evidence shows that melatonin increases MAP-2 expression, a protein that improves the stability of the dendritic cytoskeleton, opening the possibility that melatonin could prevent synaptic elimination by increasing dendritic stability. One way to begin exploring this issue in vivo is to evaluate whether long-term melatonin treatment changes the intensity of MAP-2 immuno-staining in areas commonly afflicted by aging that are rich in dendritic processes. Accordingly, we evaluated the effects of administering melatonin for 6 or 12 months on the intensity of MAP-2 immuno-staining in the strata oriens and lucidum of the hippocampal CA1 and CA3 fields of aging male rats, through semi-quantitative densitometry. Melatonin treated rats showed a relative increment in the intensity of MAP-2 immuno-staining in both regions after 6 or 12 months of treatment, as compared with age matched control rats. Although melatonin untreated and treated rats showed a decrease of MAP-2 immuno-staining in the hippocampus with increasing age, such decrement was less pronounced following melatonin treatment. These findings were confirmed by qualitative Western blot analyses. The melatonin effect seems specific because MAP-2 staining in the primary somatosensory cortex was not affected by the treatment. Thus, chronic melatonin administration increases MAP-2 immuno-staining and attenuates its decay in the adult aging hippocampus. These results are compatible with the idea that melatonin could improve dendritic stability and thus diminish synaptic elimination in the aging brain.


Innate tumor killers in colorectal cancer.
Standard treatment of colorectal cancer (CRC) improves the prognosis of CRC patients, but it is still intractable to control the progression of metastatic CRC. Immune microenvironment and immunotherapies of CRC have received extensive attention in recent years, but present immunotherapies of CRC have mainly focused on T cells and therapeutic response is only observed in a small proportion of patients. Innate immune cells are the first-line of defense in the development of malignancies. Natural killer (NK) cells, NKT cells and γδT cells are three types of innate cells of lymphoid origin and show cytotoxicity against various tumor cells including CRC. Besides, in the development of CRC, they can also be inhibited or express regulatory type, promoting tumor progression. Researches about anti-tumorigenic and pro-tumorigenic mechanisms of these cells are ongoing and regulation of these cells is also being unearthed. Meanwhile, immunotherapies using these cells more or less have shown efficacy in animal models and some of them are under exploration in clinical trials. This review provides an overview of intrinsic properties of NK cell, NKT cell and γδT cell, and summarizes current related promising treatment strategies.


Current status of metabolic engineering of microorganisms for bioethanol production by effective utilization of pentose sugars of lignocellulosic biomass.
Lignocellulosic biomass, consisting of homo- and heteropolymeric sugars, acts as a substrate for the generation of valuable biochemicals and biomaterials. The readily available hexoses are easily utilized by microbes due to the presence of transporters and native metabolic pathways. But, utilization of pentose sugar viz., xylose and arabinose are still challenging due to several reasons including (i) the absence of the particular native pathways and transporters, (ii) the presence of inhibitors, and (iii) lower uptake of pentose sugars. These challenges can be overcome by manipulating metabolic pathways/glycosidic enzymes cascade by using genetic engineering tools involving inverse-metabolic engineering, ex-vivo isomerization, Adaptive Laboratory Evolution, Directed Metabolic Engineering, etc. Metabolic engineering of bacteria and fungi for the utilization of pentose sugars for bioethanol production is the focus area of research in the current decade. This review outlines current approaches to biofuel development and strategies involved in the metabolic engineering of different microbes that can uptake pentose for bioethanol production.


Stimulation of human endothelial cells by synthetic muramyl peptides: production of colony-stimulating activity (CSA).
The in vivo induction of colony-stimulating activity (CSA) by well-defined immunomodulatory synthetic muramyl peptides has been demonstrated recently in mice. In the present study, we tested the capacities of three muramyl peptides to induce CSA production in human endothelial cell (HEC) cultures. Two adjuvant-active peptides (MDP and Murabutide) induced CSA in the supernatant of cultured endothelial cells, whereas an adjuvant-inactive compound had no effect. This effect of MDP and Murabutide appeared to be time and concentration dependent and was not secondary to decreased production of inhibitors of colony formation. CSA secretion by stimulated HEC required de novo protein synthesis and did not result from the release of preformed active CSA. Maximal concentration appeared in the supernatant media within the first 24 h after addition of muramyl peptides, and a substantial second CSA secretion could be observed after a subsequent 24 h reexposure. This CAS was not dialyzable and promoted granulocyte-macrophage formation of nonadherent human marrow and unfractionated murine marrow. Our data demonstrate that the human endothelial cell is a target cell for MDP and Murabutide and suggest that in vivo endothelium might play an active role in muramyl peptide-induced modulation of hematopoiesis.


Oil injection for cosmetic enhancement of the upper extremities: a case report and review of literature.
Here the authors report a case of complications occured after injection of a site enhancement oil in the upper extremity for cosmetic muscles' volume enhancement and a literature review on the topic. The medical and sports communities should be aware of the secondary effects of site enhancement oils use, which could bring to severe complications.


The effect of ambient ozone on glucose-homoeostasis: A prospective study of non-diabetic older adults in Beijing.
To investigate potential effects of short- and medium-term exposure to low levels of ozone (O3) on glucose-homeostasis in non-diabetic older adults. 166 non-diabetic, older participants in Beijing were deemed eligible to partake in this longitudinal population-based study. Observations were recorded on three separate occasions from November 2016 up until January 2018. Concentrations of outdoor O3 were monitored throughout the study period. Biomarkers indicative of glucose-homeostasis, including fasting blood glucose, insulin, HbAlc, glycated albumin percentage (glycated albumin/albumin), HOMA-IR and HOMA-B were measured at 3 sessions. A linear mixed effects model with random effects was adopted to quantify the effect of O3 across a comprehensive set of glucose-homeostasis markers. Short-term O3 exposure positively associated with increased fasting blood glucose, insulin, HOMA-IR and HOMA-B. The effect on glucose occurred at 3-, 5-, 6- and 7-days, although the largest effect manifested on 6-days (5.6%, 95% CI: 1.4, 9.9). Significant associations with both insulin and HOMA-IR were observed on the 3- and 4-days. For HOMA-B, positive associations were identified from 3- to 7-days with estimates ranging from 40.0% (95% CI: 2.3, 91.5) to 83.1% (95% CI: 25.3, 167.5). Stratification suggests that women may be more susceptible to short-term O3 exposure. There does not appear to be a significant association between O3 and glucose-homeostasis in medium-term exposures. In this study, we found that O3 exposure is at least partially associated with type II diabetes in older adults with no prior history of this condition. O3 therefore appears to be a potential risk factor, which is a particular concern when we consider the rise in global concentrations. Evidence also suggests that women may be more susceptible to short-term O3 exposure although we are not quite sure why. Future research may look to investigate this phenomenon further.


Spontaneously occurring tumors in different wild-derived strains of hydra.
Hydras are freshwater cnidarians widely used as a biological model to study different questions such as senescence or phenotypic plasticity but also tumoral development. The spontaneous tumors found in these organisms have been so far described in two female lab strains domesticated years ago (Hydra oligactis and Pelmatohydra robusta) and the extent to which these tumors can be representative of tumors within the diversity of wild hydras is completely unknown. In this study, we examined individuals isolated from recently sampled wild strains of different sex and geographical origin, which have developed outgrowths looking like tumors. These tumefactions have common features with the tumors previously described in lab strains: are composed of an accumulation of abnormal cells, resulting in a similar enlargement of the tissue layers. However, we also found diversity within these new types of tumors. Indeed, not only females, but also males seem prone to form these tumors. Finally, the microbiota associated to these tumors is different from the one involved in the previous lineages exhibiting tumors. We found that tumorous individuals hosted yet undescribed Chlamydiales vacuoles. This study brings new insights into the understanding of tumor susceptibility and diversity in brown hydras from different origins.


The efficacy of dispersal in relation to safe site density.
For plant species, the most immediate function of dispersal is the placement of propagules in safe sites where they can grow and survive. The efficacy of any mode of dispersal is measured by the number of propagules so placed, and depends on the distribution of distances traveled by propagules and by the density of safe sites. A graphical model is developed to describe the relationship between these two factors, and to provide a method for comparing the efficacy of dispersal in different species. When safe sites are rare, distributions of distances with long tails are most efficacious; when safe sites are more abundant, distributions with broader peaks are more suitable. This analysis is shown to apply in a qualitative fashion to a group of species inhabiting the eastern forests of North America.


Serotonin-transporter mediated efflux: a pharmacological analysis of amphetamines and non-amphetamines.
The physiological function of neurotransmitter transporter proteins like the serotonin transporter (SERT) is reuptake of neurotransmitter that terminates synaptic serotoninergic transmission. SERT can operate in reverse direction and be induced by SERT substrates including 5-HT, tyramine and the positively charged methyl-phenylpyridinium (MPP(+)), as well as the amphetamine derivatives para-chloroamphetamine (pCA) and methylene-dioxy-methamphetamine (MDMA). These substrates also induce inwardly directed sodium currents that are predominantly carried by sodium ions. Efflux via SERT depends on this sodium flux that is believed to be a prerequisite for outward transport. However, in recent studies, it has been suggested that substrates may be distinct in their properties to induce efflux. Therefore, the aim of the present study was a pharmacological characterization of different SERT substrates in uptake experiments, their abilities to induce transporter-mediated efflux and currents. In conclusion, the rank order of affinities in uptake and electrophysiological experiments correlate well, while the potencies of the amphetamine derivatives for the induction of efflux are clearly higher than those of the other substrates. These discrepancies can be only explained by mechanisms that can be induced by amphetamines. Therefore, based on our pharmacological observations, we conclude that amphetamines distinctly differ from non-amphetamine SERT substrates.


Isoorientin attenuates benzo[a]pyrene-induced colonic injury and gut microbiota disorders in mice.
Benzo[a]pyrene (BaP, most toxic polycyclic aromatic hydrocarbon) is a global food-borne pollutant, and is associated with many diseases and gut microbiota disorders. The present study was designed to investigate the protective effects of isoorientin (ISO), a flavonoid compound in the human diet, on BaP-induced colonic damage and gut microbial disorders in mice. ISO was administered orally to mice at doses of 20 mg/kg body weight before BaP challenge (oral administration, 50 mg/kg body weight). The results revealed that ISO suppressed the BaP-induced reduction of body weight in mice, and it also prevented colonic damage, as evidenced by the increase in colon total superoxide dismutase (T-SOD) and glutathione peroxidase (GSH-Px) activities, and the decrease in colon malonaldehyde (MDA) and hydrogen peroxide (H2O2) levels, compared to BaP-treated mice. Meanwhile, we used 16S rRNA gene sequencing to investigate the impact of BaP with or without ISO on the colon contents associated bacteria in mice. ISO could relieve the BaP-induced change in the abundance of gut microbiota, especially the genera of Feacalibaculum, Lactobacillus, Acinetobacter, Desulfovibrio and Alistipes. And ISO ameliorated BaP-induced microbiota metabolic disturbance, especially the metabolic pathways of LPS and sulphur compounds. In conclusion, our findings indicated that ISO could be of significant advantage in suppressing the colonic injury and the gut microbiota disorder induced by BaP.


COVID-19, staying at home, and domestic violence.
We analyze how staying at home during the COVID-19 pandemic affects the rates of domestic violence in the U.S. Using police dispatch and crime data from 36 police and sheriff's departments and mobile device tracking data, we find that reported incidents of domestic violence increase as more people stay at home. Specifically, we estimate that staying at home due to COVID-19 increased domestic violence by over 5% on average from March 13 to May 24, 2020. This is consistent with a theory of exposure reduction, where victims and abusers stuck at home are more likely to fight.


Risk of visual axis opacification in infants with and without primary IOL implantation after congenital cataract surgery performed during the first 4 months of age.
The study evaluates the rate of postoperative formation of a pupillary membrane (PM) and posterior visual axis opacification (PVAO) in infants with and without primary IOL implantation during the first 4 months of infancy. Medical records for 144 eyes (101 infants) operated between 2005 and 2014 were evaluated. A posterior capsulectomy and anterior vitrectomy were performed. Primary IOL implantation was performed in 68 eyes, while 76 eyes were left aphakic. There were 16 bilateral cases in the pseudophakic group and 27 in the aphakic group. The follow-up period was 54.3 ± 21.05 months and 49.1 ± 18.60 months, respectively. Fisher's exact test was used for statistical analysis. The two-sample t-test with equal variance was used to compare surgery age, follow-up period and time intervals of complications. The mean age of surgery was 2.1 ± 0.85 months in the pseudophakic and 2.2 ± 1.01 months in the aphakic group. PM was diagnosed in 40% pseudophakic and 7% aphakic eyes. A second surgery for PVAO was performed in 72% pseudophakic and 16% aphakic eyes. Both were significantly higher in the pseudophakic group. In the pseudophakic group, the number of PVAO was significantly higher in infants operated before 8 weeks of age compared to surgery age 9-16 weeks. The frequency of PM was not age-dependent. Although it remains feasible to implant an IOL during the primary surgery, even in very young infants, there should always be solid arguments for this decision since it puts the child at higher risk of repeated surgeries under general anaesthesia.


Post-treatment of molasses wastewater by electrocoagulation and process optimization through response surface analysis.
Molasses wastewater is a high strength effluent of food industry such as distilleries, sugar and yeast production plants etc. It is characterized by a dark brown color and exhibits a high content in substances of recalcitrant nature such as melanoidins. In this study, electrocoagulation (EC) was studied as a post treatment step for biologically treated molasses wastewater with high nitrogen content obtained from a baker's yeast industry. Iron and copper electrodes were used in various forms; the influence and interaction of current density, molasses wastewater dilution, and reaction time, on COD, color, ammonium and nitrate removal rates and operating cost were studied and optimized through Box Behnken's response surface analysis. Reaction time varied from 0.5 to 4 h, current density varied from 5 to 40 mA/cm(2) and dilution from 0 to 90% (v/v expressed as water concentration). pH, conductivity and temperature measurements were also carried out during each experiment. From preliminary experiments, it was concluded that the application of aeration and sample dilution, considerably influenced the kinetics of the process. The obtained results showed that COD removal varied between 10 and 54%, corresponding to an operation cost ranging from 0.2 to 33 euro/kg COD removed. Significant removal rates were obtained for nitrogen as nitrate and ammonium (i.e. 70% ammonium removal). A linear relation of COD and ammonium to the design parameters was observed, while operation cost and nitrate removal responded in a curvilinear function. A low ratio of electrode surface to treated volume was used, associated to a low investment cost; in addition, iron wastes could be utilized as low cost electrodes i.e. iron fillings from lathes, aiming to a low operation cost due to electrodes replacement. In general, electrocoagulation proved to be an effective and low cost process for biologically treated molasses-wastewater treatment for additional removal of COD and nitrogen content and color reduction. Treated effluent samples with good quality were produced by EC, with COD, NH4-N and NO3-N concentrations of 180, 52 and 2 mg/l respectively. Response surface analysis revealed that optimized conditions could be established under moderate molasses wastewater dilution, (e.g. 45%), at 3.5 h treatment time and 33 mA/cm(2) current density.


Pseudorabies virus encephalitis in humans: a case series study.
Pseudorabies virus (PRV) is known to cause severe encephalitis in juvenile pigs and various non-native hosts; recent evidences suggest that PRV might cause encephalitis in humans. In a multicenter cohort study in China, next-generation sequencing of cerebrospinal fluid (CSF) was performed to detect pathogens in all patients with clinically suspected central nervous system infections. This study involved all the patients whose CSF samples were positive for PRV-DNA; their clinical features were evaluated, and species-specific PCR and serological tests were sequentially applied for validation. Among the 472 patients tested from June 1, 2016, to December 1, 2018, six were positive for PRV-DNA, which were partially validated by PCR and serological tests. Additionally, we retrospectively examined another case with similar clinical and neuroimaging appearance and detected the presence of PRV-DNA. These patients had similar clinical manifestations, including a rapid progression of panencephalitis, and similar neuroimaging features of symmetric lesions in the basal ganglia and bilateral hemispheres. Six of the patients were engaged in occupations connected with swine production. PRV infection should be suspected in patients with rapidly progressive panencephalitis and characteristic neuroimaging features, especially with exposure to swine.


Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil: data from the Brazilian Type 1 Diabetes Study Group.
In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North-Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities.


Endogenous hormonal and enzymatic responses of Catharanthus roseus with triadimefon application under water deficits.
The effect of triadimefon was investigated in a medicinal plant, Catharanthus roseus subjected to water deficit stress. The abscisic acid (ABA) level, DNA and RNA contents and activities of ATPase and protease were found varying in different parts of the plants under treatment. Drought treatment increased the ABA level more than twofold in all parts of the plants. TDM treatment to the drought stressed plants showed highest contents. In roots, stem and leaves, drought stress caused a decrease in the DNA and RNA contents when compared with control and other treatments. TDM treatment with drought increased the nucleic acid contents to the level of the control roots. The activity of ATPase and protease were increased under drought treatment and lowered due to TDM applications. This information could be useful in the field of soil water deficits reclamation efforts by using plant growth regulators.


Anatomic comparison of the deep-plane face-lift and the transtemporal midface-lift.
To identify whether the deep-plane face-lift or the extended transtemporal subperiosteal midface-lift is more effective in correcting midfacial ptosis. Five cadaveric dissections were performed with a unilateral transtemporal subperiosteal midface-lift followed by a deep-plane face-lift on the same hemihead. Three suspension sutures were evaluated-transtemporal midface-lift, zygomaticofacial and melolabial sutures, and a deep-plane face-lift suture-to determine the degree of elevation on the nasolabial fold. Statistical analysis was performed to compare their effectiveness. The melolabial suture elevates the nasolabial fold 43.2% more than the deep-plane suture (P = .03) and 29.2% more than the zygomaticofacial suture (P = .10). At no point did the deep-plane suture offer more elevation than either the zygomaticofacial or melolabial suture. Midface-lifting surgery is challenging owing to the difficulty of adequately releasing the soft tissues overlying the zygomaticomaxillary region and resuspending them effectively. A comparison of the extended transtemporal midface-lift and deep-plane face-lift demonstrates the statistically significant advantage of the transtemporal midface-lift on elevating the nasolabial fold, particularly the melolabial suspension suture.


Risk Factors for Postdischarge Major Thromboembolism and Mortality in Hospitalized Patients with COVID-19 with Cardiovascular Comorbidities: Insights from the CORE-19 Registry.
Coronavirus disease 2019 (COVID-19) is associated with venous and arterial thromboembolism (VTE and ATE) and all-cause mortality (ACM) in hospitalized patients. High-quality data are needed on postdischarge outcomes in patients with cardiovascular disease. To analyze outcomes and identify risk factors for ATE, VTE, and ACM in a high-risk subgroup of hospitalized COVID-19 patients with baseline cardiovascular disease. We investigated postdischarge rates and associated risk factors of ATE, VTE, and ACM in 608 hospitalized COVID-19 patients with coronary artery disease, carotid artery stenosis (CAS), peripheral arterial disease (PAD), or ischemic stroke. Through 90 days postdischarge, outcome rates were: ATE 27.3% (10.2% myocardial infarction, 10.1% ischemic stroke, 13.2% systemic embolism, 12.7% major adverse limb event); VTE 6.9% (4.1% deep vein thrombosis, 3.6% pulmonary embolism); composite of ATE, VTE, or ACM 35.2% (214/608). Multivariate analysis showed significant association between this composite endpoint and age >75 years (odds ratio [OR]: 1.90, 95% confidence interval [CI]: 1.22-2.94, p = 0.004), PAD (OR: 3.23, 95% CI: 1.80-5.81, p ≤ 0.0001), CAS (OR: 1.74, 95% CI: 1.11-2.75, p = 0.017), congestive heart failure (CHF) (OR: 1.84, 95% CI: 1.02-3.35, p = 0.044), previous VTE (OR: 3.08, 95% CI: 1.75-5.42, p < 0.0001), and intensive care unit (ICU) admission (OR: 2.93, 95% CI: 1.81-4.75, p < 0.0001). COVID-19 inpatients with cardiovascular disease experience high rates of ATE, VTE, or ACM through 90 days postdischarge. Age >75 years, PAD, CAS, CHF, previous VTE, and ICU admission are independent risk factors.


Expression pattern of Siaz gene during the zebrafish embryonic development.
Siah is a mammalian homolog of Drosophila seven in absentia (SINA). Here we report the identification of a new member of the SINA/Siah gene family. This new gene, designated Siaz, was found in zebrafish, and its product is predicted to share extensive amino acid sequence homology with Drosophila SINA. Siaz is maternally inherited, with zygotic expression in all blastomeres starting at the mid-blastula transition. After the 20-somite stage, Siaz expression occurs in a stage-specific manner in particular regions, including the brain, eye, cranial cavity, otic vesicle, optic chiasm and gut.


Career change: in quest of a controllable lifestyle.
Over the past decade, top medical students are selecting "controllable lifestyle" (CL) specialties at an increasing rate. CL specialties include anesthesiology, dermatology, emergency medicine, neurology, ophthalmology, pathology, psychiatry, and radiology. The choice of "noncontrollable lifestyle" (NCL) specialties such as family practice, internal medicine, obstetrics/gynecology, and pediatrics was negatively affected by this trend. The effect of CL on the selection of surgical training by top medical students was variable. The purpose of this study was to determine if CL is a factor in career change by young surgeons during and after residency. Graduates of the University of Kentucky College of Medicine from 1975 to 1983 (n = 796) were questioned regarding the specialty they entered after graduation and whether they remained in that specialty as of March, 1988. NCL and surgery specialties showed a net loss of practitioners during the study period (P less than 0.005) and CL showed a net gain (P less than 0.005). When physicians changed specialties, the direction of change occurred from NCL and surgery to CL (P less than 0.05). Change from CL to NCL and surgery occurred infrequently.


Final clinical practicum, transition experience and turnover intentions among newly graduated nurses: A cross sectional study.
The shortage of nurses is a global issue, and turnover rates are especially high for newly graduated nurses. The transition from student to nurse is often described as challenging, and the final clinical practicum before graduation is suggested to be important in preparing graduating students for the transition. However, little is known about the actual relationships between the final clinical practicum, transition and turnover intentions. To examine whether the final clinical practicum experience is associated with the transition experience and turnover intentions of newly graduated nurses, and whether the transition experience mediates the potential relationship between the practicum and turnover intentions. Cross-sectional survey study. The study was carried out in Finland (October-December 2018). Registered nurses graduated within the past two years (n = 712). A new survey instrument with five subscales was developed for measuring the final clinical practicum experience. Transition experience was measured on four scales that demonstrated the emotional, physical, socio-developmental and intellectual domains of the transition: Psychological distress, sleep quality, role conflict/ambiguity, perception of transition and educational preparation. Turnover intentions from job and profession were asked about with two questions. Structural equation modelling was used to explore the associations between the variables. The models were adjusted for multiple potential confounders. Final clinical practicum experience was associated with all domains of the transition experience and turnover intentions. The association between the practicum and turnover intentions was partly mediated by the emotional (psychological distress) and socio-developmental (role conflict and ambiguity) domains of the transition. Our findings provide new evidence about the associations between the specific final clinical practicum dimensions and turnover intentions and the specific mechanisms linking this association. These results highlight the importance of final clinical practicums and suggest targets for improving nurses' transition processes during their first years in practice.


HIV-1 A-rich RNA loop mimics the tRNA anticodon structure.
Interaction of HIV-1 genomic RNA and human tRNA(Lys)3 initiates viral reverse transcription. An adenosine-rich (A-rich) loop in HIV RNA mediates complex formation between tRNA and viral RNA. We have determined the structure of an A-rich loop oligonucleotide using nuclear magnetic resonance spectroscopy. The loop structure is stabilized by a noncanonical G-A pair and a U-turn motif, which leads to stacking of the conserved adenosines. The structure has similarity to the tRNA anticodon structure, and suggests possible mechanisms for its role in initiation of reverse transcription.


Comparative anatomy of mammalian conjunctival lymphoid tissue: a putative mucosal immune site.
Organized mucosa-associated lymphoid tissue (O-MALT) is defined by mucosal lymphoid follicles with unique overlying lymphoepithelia, and classically appears in tissues with a simple columnar epithelium. Within follicle-associated epithelium, goblet cells are characteristically absent, replaced by ultrastructurally distinct antigen-absorptive cells, termed M cells (or microfold cells) for the appearance of their apical cell membranes. To determine if mammalian conjunctiva, with its stratified squamous epithelium, can be considered as a site of O-MALT, we compared the light and electron microscopic anatomy of conjunctiva from fourteen species of non-human adult mammals, and the conjunctiva of human adults harvested at autopsy. Lymphoid follicles in the conjunctiva were demonstrated in all mammals studied except for mice and rats. In those mammals with conjunctival lymphoid follicles, the follicle-associated conjunctival epithelium was notable for an absence of goblet cells. Transmission electron microscopy demonstrated an intimate association of lymphocytes with surface epithelial cells, but epithelial cell morphology was uniform overlying the follicle, and other ultrastructural features of M cells were absent. Therefore, conjunctival lymphoid follicle-associated stratified squamous epithelium demonstrates some but not all features of O-MALT lymphoepithelia. Further studies are necessary to determine what role conjunctival lymphoid tissue may play in mucosal immunity.