Regulation of hexose transport in respiration deficient hamster lung fibroblasts.
The transport of [3H]2-deoxy-D-glucose (2DG) and [3H]3-O-methyl-D-glucose (3-OMG) was elevated in a respiration deficient (NADH coenzyme Q [Co Q] reductase deficient) Chinese hamster lung fibroblast cell line (G14). This sugar transport increase was related to an increased Vmax for 2DG transport, 26.9 +/- 4.2 nmoles 2DG/mg protein/30 sec in the G14 cell line vs 9.5 +/- 0.6 nmoles 2DG/mg protein/30 sec in the parental V79 cell line. No differences were observed in their respective Km values for 2DG transport (3.9 +/- .6 vs. 3.0 +/- .13 mM). Factors which increase sugar transport (e.g., glucose deprivation, serum or insulin exposure) or decrease sugar transport (e.g., serum deprivation) in the parental V79 cell line had little effect on sugar transport in the G14 respiration deficient cell lines. Amino acid transport, specific 125I-insulin binding to cells, and insulin-stimulated DNA synthesis, however, were similar in both cell lines. Exposure of both cell lines to varying concentrations of cycloheximide (0.1-50 micrograms/ml) for 4 h resulted in differential effects on 2DG transport. In the parental cell line (V79) low cycloheximide concentrations resulted in decreased 2DG transport, while higher concentrations (greater than or equal to 1 microgram/ml) resulted in elevated 2DG transport. In the G14 cell line, 2DG transport decreased at all concentrations of cycloheximide (up to 50 micrograms/ml). The data indicate that the G14 mutant has been significantly and specifically affected in the expression of sugar transport activity and in the regulatory controls affecting sugar transport activity.


Thromboembolic disease in females and males aged 10 to 39 years in Germany.
We analysed differences in hospitalization rates for venous diseases such as pulmonary embolism (PE), deep vein thrombosis (DVT), sinus vein thrombosis (SVT), portal vein thrombosis (PVT), and Budd-Chiari syndrome (BCS) as well as for arterial diseases such as myocardial infarction (MI) and embolic stroke (ES) in females and males aged 10 to 39 years. Detailed lists of hospitalizations with the principal and additional diagnoses for PE (ICD-code I26.0 + I26.9), DVT (I80.0-I80.9), SVT (I67.6), PVT (I81), BCS (I82.0), MI (I21.0-I21.9), and ES (I63.1 + I63.4) in males and females aged 10 to 39 years in the years 2006 to 2015 were provided by the Federal Statistical Office in Germany. Considering the 10-year period there were more female than male cases hospitalized with the principal diagnoses for PE, DVT, SVT, and BCS. Looking at the principal diagnosis of the year 2015, one can see a steep increase in numbers of hospitalization for PE, DVT, and SVT in females ranging from the ages 12 to 13 and 14 to 15 years compared to males. The curves of PE and DVT meet again in the age group between 32 and 33 years, but not for SVT. The greatest differences are seen at the end of the second and at the beginning of the third decade of life. In contrast, MI was more frequent in young males beginning at the age of 18 to 19 years. The number of female and male cases with ES and PVT were almost similar in the different age groups. The presented data show higher hospitalization rates for females in the age group 10 to 39 years for different venous thrombosis but not for MI and ES.


Changes in serum proteomic patterns by presurgical alpha-tocopherol and L-selenomethionine supplementation in prostate cancer.
Evidence of the chemopreventive effects of the dietary antioxidants alpha-tocopherol (vitamin E) and l-selenomethionine (selenium) comes from secondary analysis of two phase III clinical trials that found treatment with these antioxidants reduced the incidence of prostate cancer. To determine the effects of selenium and vitamin E in blood and prostate tissue, we undertook a preoperative feasibility study complementary to the currently ongoing Selenium and Vitamin E Cancer Prevention Trial. Forty-eight patients with clinically localized prostate cancer enrolled on this 2 x 2 factorial design study were randomized to take selenium, vitamin E, both, or placebo for 3 to 6 weeks before prostatectomy. Sera were collected from patients before and after dietary supplementation. Thirty-nine patients were evaluable, and 29 age-matched disease-free men served as controls. Mass profiling of lipophilic serum proteins of lower molecular weight (2-13.5 kDa) was conducted, and mass spectra data were analyzed using custom-designed software. Weighted voting analyses showed a change in sera classification from cancerous to healthy for some patients with prostate cancer after dietary intervention. ANOVA analysis showed significantly different treatment effects on prediction strength changes among the four groups at a 95% confidence level. Eliminating an outlying value and performing post hoc analysis using Fisher's least significant difference method showed that effects in the group treated with the combination were significantly different from those of the other groups. In sera from patients with prostate cancer, selenium and vitamin E combined induced statistically significant proteomic pattern changes associated with prostate cancer-free status.


Role of class II histocompatibility antigens in Staphylococcus aureus protein A-induced activation of human T lymphocytes.
The capacity of peripheral blood monocytes and B lymphocytes to support staphylococcal protein A (SpA)-induced proliferation of autologous and allogeneic T cells, as well as the role of major histocompatibility complex (MHC) class I and II molecules in this activation process, were investigated. Highly purified peripheral T lymphocytes did not proliferate in response to SpA, but their response was reconstituted by both irradiated (or mitomycin C-treated) monocytes and B lymphocytes. The effect of B cells on the SpA-induced T-cell response could not be explained by a contamination of residual accessory cells because long-term continuous B-cell lines restored SpA-induced T-cell DNA synthesis as effectively as did monocytes. Support of SpA responsiveness by B cells could not be accounted for by polyclonal binding of SpA to cell surface immunoglobulins, since the ability of SpA-unreactive and SpA-reactive B cells was comparable. The cells from two human leukemic lines--K562 and Raji--showed the same ability in supporting the pokeweed mitogen-induced T-cell response, but the class II-positive Raji cells were much more effective than class II-negative K562 cells in restoring the T-cell responsiveness to SpA. Monoclonal antibodies specific for monomorphic determinants of MHC class II antigens, as well as their F(ab')2 fragments, consistently inhibited the SpA-induced proliferative response, whereas antibodies specific for MHC class I antigens were without effect. The antibodies specific for class II antigens appeared to act at the level of accessory cell, since pretreatment with these antibodies inhibited the ability of SpA-pulsed monocytes or Raji cells to present SpA to autologous or allogeneic T lymphocytes, respectively. These data indicate that either monocytes or normal and lymphoblastoid B cells can act as accessory cells for the proliferative response of human T cells to soluble SpA and that monomorphic determinants of MHC class II molecules play an important role in this activation process.


Surgical Outcomes for Obstructive Total Anomalous Pulmonary Venous Return of the Non-Infracardiac Type Compared with the Infracardiac Type.
Infracardiac obstructive total anomalous pulmonary venous return (TAPVR) has a poor outcome following surgical correction. We compared the surgical outcomes of obstructive TAPVR between non-infracardiac and infracardiac types. Among 51 patients who underwent surgical repair for obstructive TAPVR, 23 with infracardiac type and 28 with non-infracardiac type were included in this investigation. The study compared the immediate postoperative courses in the intensive care unit and long-term mortality and pulmonary vein stenosis. The risk factors for long-term survival in obstructive TAPVR also were investigated. The postoperative follow-up period was 79.8 ± 81.5 months. Immediate major operative complications were observed in 22 patients (43.1%); 10 patients (19.6%) died, and eight patients (15.7%) experienced pulmonary vein stenosis during the follow-up period. The Kaplan-Meier curve showed better cumulative survival in patients with infracardiac TAPVR (P = 0.308). The significant factors for survival after surgical repair of obstructive TAPVR did not include anatomical type but instead were postoperative course of ventilator care and lengths of intensive care unit and hospital stays. Patients with non-infracardiac TAPVR with obstruction had a longer postoperative course and experienced more complications. Their survival rate was poorer, and postoperative pulmonary vein stenosis was more frequent in those patients compared with infracardiac TAPVR patients. However, a large-scale study is mandatory to gather more data and confirm our findings.


Ginsenoside Rh2 sensitizes the anti-cancer effects of sunitinib by inducing cell cycle arrest in renal cell carcinoma.
Sunitinib, a VEGF blockade, is used to treat clear cell renal cell carcinoma (ccRCC). However, the anti-cancer treatment effects of sunitinib do not last long in ccRCC patients. Ginsenoside, a natural medicine extracted from ginseng, has been studied in cancer treatment and shown to have anti-tumor effects and low toxicity. We assessed cell viability and cell cycle analysis in ccRCC cell lines after treatment with ginsenoside and sunitinib. DNA damage was evaluated by measuring 8-OHdG levels and comet assay. ROS levels, reflecting the cause of oxidative stress, were also measured. Ginsenoside significantly enhanced the inhibition of cell viability by sunitinib, a result that was also confirmed in the xenograft model. In cell cycle analysis, combination treatment of ginsenoside and sunitinib enhanced G2M arrest in comparison with single-treatment groups. In addition, DNA damage was increased by ginsenoside and sunitinib according to the comet assay, and the level of 8-OHdG, which reflects oxidative DNA damage, also increased. We verified that ginsenoside enhances the efficacy of sunitinib to inhibit the proliferation of ccRCC cells via induction of oxidative DNA damage. The combination therapy of sunitinib and ginsenoside suggested the possibility of effectively treating ccRCC patients.


Elosulfase alfa enzyme replacement therapy attenuates disease progression in a non-ambulatory Japanese patient with Morquio A syndrome (case report).
Enzyme replacement therapy (ERT) with elosulfase alfa is the only approved therapy in Japan for patients with Morquio A syndrome, a lysosomal storage disorder inherited in an autosomal recessive fashion. The experience with ERT in severely affected, non-ambulatory patients has not been reported in previous studies. This case report describes clinical evidence for the 1-year efficacy and safety of ERT with elosulfase alfa in a severely affected, non-ambulatory, 47-year-old patient with Morquio A syndrome who needs intensive respiratory management. ERT with elosulfase alfa was well tolerated in this patient. Because of the possibility of potential hypersensitivity adverse events, special attention is needed when using ERT in patients with respiratory disorders. However, under the appropriate management of specialists, the patient in this case report showed significant respiratory improvement after starting ERT, and abdominal bloating was improved by gas evacuation. In addition, the patient was able to lift up her arms, reach behind her back, and move her legs slightly, and she recovered her grip strength. Her hearing loss improved and she could hear without a hearing aid. This report shows that ERT with elosulfase alfa can be used with appropriate respiratory care in patients with severe respiratory dysfunction.


Clinicopathological feature of extrahepatic cholangiocarcinoma without jaundice: a single-center experience.
The prognosis remains unsatisfactory even if the patient undergoes extensive surgery, which is the only curative treatment for these tumors. Therefore, early detection and diagnosis are needed to improve long-term survival. To investigate the clinicopathological feature of extrahepatic cholangiocarcinoma in patients presenting without jaundice compared with the features of tumors in patients presenting with jaundice. This was a retrospective study of 50 patients resected for extrahepatic cholangiocarcinoma. There were 15 non-jaundiced (Group A) and 35 jaundiced patients (Group B). Data on demographic and clinical features, surgical procedures and pathological diagnoses were collected retrospectively. Preoperative mean serum levels of total bilirubin, aspartate aminotransferase, alanine aminotransaminase, alkaline phosphatase and gamma-glutamyltranspeptidase were statistically different between the groups. There was also a significant difference in the location of tumors. The distal tumors occurred in 9 non-jaundiced and 31 jaundiced patients (p=0.048). There were no significant differences between the characteristics and preoperative laboratory data of the patients with perihilar tumors and those with distal tumors. We believe that finding the disease in asymptomatic and non-jaundiced patients is very important for their prognosis. Further studies are needed and efforts should also continue to identify patients with suspicious findings.


Aquatic organotin pollution in Taiwan.
The current status of aquatic organotin pollution in Taiwan is reviewed. In freshwater sediments and biota, especially in rice-field related habitats, phenyltins (PTs) were dominant among the organotin pollutants, whereas butyltins (BTs) were usually predominant in marine environments. Among the marine habitats, contamination levels were found to be in the descending order of harbour and estuary>fish cultural site>coastal>offshore>coral reefs. Imposex snails were observed in all the sampling years (1990-2003). Meanwhile, organotin concentrations were greater in winter than those in summer, whereas proportions of PTs were much higher in summer than in winter. Due to the lack of continuous monitoring data, the effectiveness of the ban on TPT usage in agriculture in 1999 and the prohibition of TBT use on small boats in 2003 is still not known.


Helospectin I and II evoke vasodilation in the intact peripheral microcirculation.
Helospectin I and II, two closely related mammalian neuropeptides of the secretin/glucagons/vasoactive intestinal peptide (VIP) superfamily of peptides, are co-localized with VIP in nerve fibers surrounding vascular smooth muscle. However, the role if any, VIP receptors play in transducing the vasorelaxant effects of helospectin I and II in the intact peripheral microcirculation is uncertain. The purpose of this study was to determine whether helospectin I and II elicit vasodilation in the intact peripheral microcirculation and, if so, whether this response is mediated, in part, by VIP or pituitary adenylate cyclase activating peptide (PACAP) receptor engagement, and through local elaboration of cyclooxygenase products of arachidonic acid metabolism. Using intravital microscopy, we found that suffusion of helospectin I and II (each, 1.0 nmol) evoked potent vasodilation and of similar magnitude in the intact hamster cheek pouch microcirculation (P < 0.05). Suffusion of 0.1 nmol helospectin I and II had no significant effects on arteriolar diameter. Pretreatment with VIP(10-28), a VPAC1/VPAC2 receptor antagonist, or PACAP(6-38), a PAC1/VPAC2 receptor antagonist, had no significant effects on helospectin I- and II-induced responses. In addition, pretreatment with indomethacin had no significant effects on helospectin I- and II-induced vasodilation. Collectively, these data indicate that helospectin I and II evoke potent vasodilation in the intact peripheral microcirculation that is not transduced by VIP or PACAP receptors nor through cyclooxygenase products of arachidonic acid metabolism.


Processes to Create a Culture of Surgical Patient Safety.
This article discusses the processes, interventions, and methods by which health care systems can change the culture of their workplace to promote safety. The importance of this culture shift is discussed, as well as an organizational approach, highlighting the importance of investment of time and resources to the cause. Efforts must include an educational focus on patient safety where a culture of patient safety is emphasized. This attitude along with several specific key interventions, including, measurement, teamwork, briefings, checklists, and developmental infrastructure, are discussed.


New asymmetric approach to natural pyrrolizidines: synthesis of (+)-amphorogynine A, (+)-amphorogynine D, and (+)-retronecine.
Three natural pyrrolizidines, (+)-amphorogynines A and D and (+)-retronecine, have been prepared from a common lactam intermediate. This central compound, in turn, was synthesized in diastereomerically enriched form through a highly selective [2 + 2]-cycloaddition of dichloroketene with a chiral enol ether, followed by Beckmann ring expansion and reduction. Subsequent stereocenters were then cleanly introduced through internal induction.


Conventional vehicle display panels: the drivers' operative images and directions for their redesign.
The proliferation of new displays in modern vehicles sets the challenge to revisit the design of the conventional display units, toward more simplified appearance. The present study aims to evaluate the usefulness of the information provided to the drivers by the conventional vehicle display units, in order to trace directions that would lead to a simplification of the future display panels. Based on the concept of operative images, two working hypotheses were formulated: (i) the experienced drivers have developed an operative image-reference (OI-R) for the display panel of their own vehicle(s), reflecting the relative importance they attribute to the information emitted by the various displays of the panel, and (ii) the experienced drivers' drawings of the display panel of their own vehicle will be guided by their OI-R for it - providing therefore traces of the content of their OI-R, while the less experienced drivers' drawings will be closer to the actual display panel of their own vehicle. The method of drawing from memory was used to obtain traces of the operative images of both experienced and less experienced non-professional drivers. The obtained 335 drawings were compared to the actual display panels, as to their overall resemblance and to specific features. The results of the data analysis are in accordance to our working hypotheses. Considering the main features of the experienced drivers' OI-R, directions for the simplification of the appearance of conventional display units are proposed.


Selective Use of Neoadjuvant Targeted Therapy Is Associated with Greater Achievement of Partial Nephrectomy for High-complexity Renal Masses in a Solitary Kidney.
Partial nephrectomy (PN) is preferred for a renal mass in a solitary kidney (RMSK), although tumors with high complexity can be challenging. To evaluate the evolution of RMSK management with a focus on achievement of PN. Patients with nonmetastatic RMSK (n = 499) were retrospectively reviewed; 133 had high tumor complexity, including 80 in the pre-tyrosine kinase inhibitor (TKI) era (1999-2008) and 53 in the TKI era (2009-2022). After 2009, 23/53 patients received neoadjuvant TKI and 30/53 had immediate-surgery. Functional outcomes, adverse events and complications, dialysis-free survival, and recurrence-free survival (RFS) were the measures evaluated. Mann-Whitney and χ2 tests were used to compare cohorts, and the log-rank test was applied for survival analyses. Overall, the median RENAL score was 10 and the median tumor diameter was 5.2 cm. Demographic characteristics, tumor diameter, and RENAL scores were similar between the pre-TKI-era and TKI-era groups. In the TKI era, 23/53 patients (43%) with clear-cell histology were selected for neoadjuvant TKI. These 23 patients had a greater median tumor diameter (7.1 vs 4.4 cm; p = 0.02) and RENAL score (11 vs 10; p = 0.07). After TKI treatment, the median tumor diameter decreased to 5.6 cm and the RENAL score to 9, and tumor volume was reduced by 59% (all p < 0.05). PN was accomplished in 21/23 (91%) the TKI-treated cases and in 27/30 (90%) of the immediate-surgery cases (2009-2022). PN was only accomplished in 52/80 (65%) of the patients from the pre-TKI era (p < 0.01). The 5-yr dialysis-free survival rate was 59% in the pre-TKI-era group and 91% in the TKI-era group. The 5-yr RFS rate was lower in the TKI-era group (59% vs 74%; p = 0.21), which was mostly related to more aggressive tumor biology, as reflected by a predominance of systemic rather than local recurrences. Management of RMSK with high tumor complexity is challenging. Selective use of TKI therapy was associated with greater use of PN, although a randomized study is needed. RFS mostly reflected aggressive tumor biology rather than failure of local management. For complex kidney tumors in patients with a single kidney, management is challenging. Use of drugs called tyrosine kinase inhibitors before surgery was associated with reductions in tumor size and greater ability to achieve partial kidney removal for cancer control. Most recurrences were metastatic, which reflects aggressive tumor biology rather than failure of surgery.


EEG in neonatal herpes simplex encephalitis.
The EEGs of 21 newborns with herpes simplex encephalitis were analysed. The diagnosis was based on the demonstration of herpes simplex infection in association with neurological symptoms, other etiological factors being excluded. Sixteen of 21 babies (76%) showed in their EEGs electrical seizures, either focal or unilateral. These paroxysms consisted of sharp waves or slow waves repeating at pseudo-periodic intervals, usually of 0.5-2 sec. Individual paroxysms had a duration of 10-20 sec in 6 babies and 1-2 min in 10 patients. During the same period, 20 other babies displayed the same EEG finding. Of these, 11 had encephalitis of unknown etiology. In our series there appeared to exist a correlation between both the duration of the electrical seizures and the degree of EEG background abnormality and the clinical outcome. Babies with markedly abnormal background and long-lasting paroxysms tended to have a poor prognosis. It is concluded that in newborns with clinical signs of encephalitis who show in their EEGs paroxysms of the type described, the possibility of herpes simplex encephalitis should be considered.


[Corneal perforation associated with vitamin-A-deficiency].
Vitamin A has been identified as a substantial substrate for ocular surface integrity. Vitamin A deficiency, which can be caused by different etiologies, may lead to severe complications including corneal perforation. Case reports of three patients with vitamin A deficiency. The observed etiologies leading to vitamin A deficiency were: (1) primary biliary cirrhosis, (2) malnutrition induced by alcohol abuse, and (3) malabsorption syndrome caused by a graft-versus-host disease of the intestine after bone marrow transplantation. In all three cases vitamin A serum levels were below normal values. In two patients retinol binding protein was also reduced. Two of three had corneal perforation, which required penetrating keratoplasty (pKP). In one of these cases, pKP was performed three times on both eyes due to a rapid corneal stromal melting leading always to corneal perforation. The third case developed severe corneal thinning of both eyes with the formation of a descemetocele. Vitamin A substitution improved symptoms and ocular surface integrity. Vitamin A in combination with zinc is a crucial factor for maintaining conjunctival and corneal ocular surface integrity. Moreover, vitamin A regulates mucin production of the ocular surface epithelium, which is known to be an important part of the ocular surface defense. Several different primary diseases might cause vitamin A deficiency. Especially patients with rapid progressive corneal ulceration should be examined for vitamin A deficiency. Substitution of vitamin A should be initiated as early as possible to prevent serious disease progression.


Home enteral nutrition in patients with Acquired Immunodeficiency Syndrome.
14 patients in advanced stages of HIV infection (1 ARC, 13 AIDS; sex: 1 female, 13 male; age 37.8 +/- 6.3 years; body mass index (BMI): 17.4 +/- 2.4 kg/m(2)) were followed prospectively while receiving home enteral nutrition (observation period: 62 +/- 75 days). Artificial nutrition was indicated because of severe weight loss (9-38 kg within 6-48 months, n = 7) or cerebral toxoplasmosis with eating and swallowing disorders (n = 7). In all patients a defined formula diet (175 +/- 17.7 kJ/kg body weight) was administered through an endoscopically placed gastrostomy tube (PEG). Home enteral nutrition was well tolerated by all patients and no significant PEG-related complications occurred. Enteral nutrition resulted in significant increases in body weight (p < 0.005), body cell mass (BCM, p < 0.05), total body fat (TBF, p < 0.005), serum albumin concentration (p < 0.05), and serum total iron-binding capacity (transferrin, p < 0.01). Home enteral nutrition via PEG is safe and well tolerated in patients with advanced HIV-related immunodeficiency and is capable of improving nutritional state including BCM.


Economic Evaluation of anti-epileptic Medicines for Autistic Children with Epilepsy.
We examine the cost-effectiveness of treating epilepsy with anti-epileptic medicines in autistic children, looking at impacts on healthcare providers (in England, Ireland, Italy and Spain) and children's families (in Ireland). We find carbamazepine to be the most cost-effective drug to try first in children with newly diagnosed focal seizures. For England and Spain, oxcarbazepine is the most cost-effective treatment when taken as additional treatment for those children whose response to monotherapy is suboptimal. In Ireland and Italy, gabapentin is the most cost-effective option. Our additional scenario analysis presents the aggregate cost to families with autistic children who are being treated for epilepsy: this cost is considerably higher than healthcare provider expenditure.


A Robust Phagocytosis Assay to Evaluate the Opsonic Activity of Antibodies against Plasmodium falciparum-Infected Erythrocytes.
Infection with Plasmodium falciparum parasites causes the majority of malaria-related morbidity and mortality. Constant exposure to the pathogen leads to the acquisition of antibodies and high levels of antibodies have been associated with clinical protection against malaria. A possible protective mechanism is the opsonization of parasites, or malaria-infected erythrocytes (IEs), for phagocytic clearance. Current assays use adherent or chemically differentiated THP-1 cells to evaluate opsonic antibodies in patients' samples, but these assays are often time consuming and damage the effector cells. We have developed a high throughput flow cytometry-based phagocytosis assay using undifferentiated THP-1 cells to quantify the opsonic activity against late stage P. falciparum-IEs. Opsonic antibodies bound to IEs promote their phagocytic uptake through Fcγ receptors found on THP-1 cells. Moreover, undifferentiated THP-1 cells do not express CD36, a surface scavenger receptor that promotes non-opsonic phagocytosis. This technical advance allows quantification of opsonic antibodies and is an important tool for the performance of large, population-based studies of malaria immunity, and to provide a significant increase in the statistical power for such studies.


Cooperative assembly confers regulatory specificity and long-term genetic circuit stability.
A ubiquitous feature of eukaryotic transcriptional regulation is cooperative self-assembly between transcription factors (TFs) and DNA cis-regulatory motifs. It is thought that this strategy enables specific regulatory connections to be formed in gene networks between otherwise weakly interacting, low-specificity molecular components. Here, using synthetic gene circuits constructed in yeast, we find that high regulatory specificity can emerge from cooperative, multivalent interactions among artificial zinc-finger-based TFs. We show that circuits "wired" using the strategy of cooperative TF assembly are effectively insulated from aberrant misregulation of the host cell genome. As we demonstrate in experiments and mathematical models, this mechanism is sufficient to rescue circuit-driven fitness defects, resulting in genetic and functional stability of circuits in long-term continuous culture. Our naturally inspired approach offers a simple, generalizable means for building high-fidelity, evolutionarily robust gene circuits that can be scaled to a wide range of host organisms and applications.


Cardiotocography in practice: a qualitative study to explore obstetrical care professionals' experiences with using cardiotocography information in Dutch practice.
This study aimed to explore obstetric care professionals' experiences with using cardiotocograph (CTG) information and how they employ this tool in their practice. Qualitative study, involving 30 semi-structured interviews and two focus group sessions. Conventional content analysis was used for data analysis. Amsterdam University Medical Centers in the Netherlands. In total, 43 care professionals participated. The respondents included obstetricians, residents in obstetrics and gynaecology, junior physicians, clinical midwives and nurses. Three main categories were identified that influenced the use of cardiotocography in practice; (1) individual characteristics involving knowledge, experience and personal beliefs; (2) teams involving collaboration in and between shifts and (3) work environment involving equipment, culture and continuing development. This study underlines the importance of teamwork when working with cardiotocography in practice. There is a particular need to create shared responsibility among team members for cardiotocography interpretation and appropriate management, which should be addressed in educational programmes and regular multidisciplinary meetings, to allow learning from colleagues' perspectives.


A kinetic study of the endogenous reduction of the oxidized sites in the primary cytochrome c peroxidase-hydrogen peroxide compound.
The primatry compound formed in the reaction between H2O2 and cytochrome c peroxidase is oxidized two equivalents above the native enzyme. The two oxidized sites are thought to be an Fe(IV) and an amino acid radical. In the absence of oxidizable substrate, the Fe(IV) and radical sites decay by apparent first-order processes but at different rates. It is likely that the decay involves both intra- and intermolecular electron-transfer reactions. The reduction of the Fe(IV) site depends upon the pH with a minimum reduction rate of 2.9-10(-5)s(-1) at pH 6. At pH 4 and 6, the reduction of the Fe(IV) site is facilitated by prior oxidation of amino acid residues in the protein.


MutS homologue hMSH4: interaction with eIF3f and a role in NHEJ-mediated DSB repair.
DNA mismatch repair proteins participate in diverse cellular functions including DNA damage response and repair. As a member of this protein family, the molecular mechanisms of hMSH4 in mitotic cells are poorly defined. It is known that hMSH4 is promiscuous, and among various interactions the hMSH4-hMSH5 interaction is involved in recognizing DNA intermediate structures arising from homologous recombination (HR). We identified a new hMSH4 interacting protein eIF3f--a protein that functions not only in translation but also in the regulation of apoptosis and tumorigenesis in humans. Our studies have demonstrated that hMSH4-eIF3f interaction is mediated through the N-terminal regions of both proteins. The interaction with eIF3f fosters hMSH4 protein stabilization, which in turn sustains γ-H2AX foci and compromises cell survival in response to ionizing radiation (IR)-induced DNA damage. These effects can be, at least partially, attributed to the down-regulation of NHEJ activity by hMSH4. Furthermore, the interplay between hMSH4 and eIF3f inhibits IR-induced AKT activation, and hMSH4 promotes eIF3f-mediated bypass of S phase arrest, and ultimately enhancing an early G2/M arrest in response to IR treatment. Our current study has revealed a role for hMSH4 in the maintenance of genomic stability by suppressing NHEJ-mediated DSB repair.


Simultaneous renal clear cell carcinoma and primary clear cell carcinoma of the liver: A case report.
Double primary clear cell carcinomas of the liver (PCCCL) and kidney are extremely rare; moreover, there have been no reported cases of adrenal metastasis from primary clear cell tumors of the liver. A 47-year-old male patient was admitted to our clinic with space-occupying lesions in the left kidney and liver during a regular medical examination. The tumors in the kidney and liver were diagnosed as primary clear cell carcinoma by histopathological examination. The patient subsequently underwent nephron-sparing surgery of the left kidney and radical partial excision of the right liver lobe by laparoscopic surgery. Transcatheter arterial chemoembolization (TACE) was performed for the patient 2 weeks after tumor resection. One month after the operation, the patient started adjuvant therapy with sorafenib (400 mg twice per day orally). However, follow-up CT imaging revealed a solid mass measuring 1.9 × 2.0 × 2.0 cm in the right adrenal gland at 2 months postoperatively, and then the patient underwent radiofrequency ablation (RFA) for the right adrenal tumor. The patient remained cancer free for 2 years following the diagnosis despite early right adrenal metastasis. Hepatocyte immunostaining is sufficient for the diagnosis of PCCCL.


Pleomorphic rhabdomyosarcoma with pulmonary metastasis in a stranded Steller (northern) sea lion (Eumetopias jubatus).
A Steller (northern) sea lion (SSL), stranded in northern California in July 2000 had an anaplastic pleomorphic rhabdomyosarcoma in the latissimus dorsi muscle, with pulmonary metastasis. Diagnosis was based on light and electron microscopy and immunohistochemistry. Death was attributed to multiple parasitic and bacterial lesions. The SSL is of special concern because, for unknown reasons, the global population has declined by 50% over the last decade. Published post-mortem data, however, are scarce. This case report highlights several disease conditions that affect this species and is the first report of a malignant neoplasm in a free-ranging SSL.


p-Phenylenediaminium iodide capping agent enabled self-healing perovskite solar cell.
In this study, p-Phenylenediaminium iodide (PDAI) is used to in-situ growth of 2D (PDA)2PbI4 perovskite layer between (FAPbI3)0.85(MAPbBr3)0.15 3D perovskite and CuSCN as a cheap hole transport layer. The results indicate that the incorporation of 5 mg mL-1 PDAI leads to enlarged grain sizes, compact grain boundaries, reduced trap density, efficient charge extraction, and enhanced stability of perovskite film. Passivation of perovskite film with the appropriate amount of PDAI helps in achieving efficient perovskite solar cell with a PCE as high as 16.10%, a JSC of 21.45 mA cm-2, a VOC of 1.09 V, and FF of 70.21%, with negligible hysteresis and excellent moisture stability which remains 99.01% of its initial PCE value after 5 h in high relative humidity of 90 ± 5% and shows unchanged PCE after 1440 h in low relative humidity of 15 ± 5%. Most strikingly, this ultra-thin 2D passivation layer by the use of PDA cations as a bulky spacer not only passivates the defects on the surface of perovskite film but also induces self-healing properties in PSCs which can be rapidly recovered after keeping away from water vapor exposure. This study introduces the cheap and extra stable perovskite solar cells with outstanding self-healing ability towards commercialization.


Methods for parameter identification in oscillatory networks and application to cortical and thalamic 600 Hz activity.
Directed information transfer in the human brain occurs presumably by oscillations. As of yet, most approaches for the analysis of these oscillations are based on time-frequency or coherence analysis. The present work concerns the modeling of cortical 600 Hz oscillations, localized within the Brodmann Areas 3b and 1 after stimulation of the nervus medianus, by means of coupled differential equations. This approach leads to the so-called parameter identification problem, where based on a given data set, a set of unknown parameters of a system of ordinary differential equations is determined by special optimization procedures. Some suitable algorithms for this task are presented in this paper. Finally an oscillatory network model is optimally fitted to the data taken from ten volunteers.


Interferon-alpha or -beta facilitates SARS-CoV-2 pulmonary vascular infection by inducing ACE2.
Severe viral pneumonia caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by a hyperinflammatory state typified by elevated circulating pro-inflammatory cytokines, frequently leading to potentially lethal vascular complications including thromboembolism, disseminated intracellular coagulopathy and vasculitis. Though endothelial infection and subsequent endothelial damage have been described in patients with fatal COVID-19, the mechanism by which this occurs remains elusive, particularly given that, under naïve conditions, pulmonary endothelial cells demonstrate minimal cell surface expression of the SARS-CoV-2 binding receptor ACE2. Herein we describe SARS-CoV-2 infection of the pulmonary endothelium in postmortem lung samples from individuals who died of COVID-19, demonstrating both heterogeneous ACE2 expression and endothelial damage. In primary endothelial cell cultures, we show that SARS-CoV-2 infection is dependent on the induction of ACE2 protein expression and that this process is facilitated by type 1 interferon-alpha (IFNα) or -beta(β)-two of the main anti-viral cytokines induced in severe SARS-CoV-2 infection-but not significantly by other cytokines (including interleukin 6 and interferon γ/λ). Our findings suggest that the stereotypical anti-viral interferon response may paradoxically facilitate the propagation of COVID-19 from the respiratory epithelium to the vasculature, raising concerns regarding the use of exogenous IFNα/β in the treatment of patients with COVID-19.


Influence of the light-scattering form factor on the Bragg diffraction patterns of arrays of metallic nanoparticles.
Accurate models for the light-scattering form factors of nanoparticles are of crucial importance to characterize the optical properties of the particles and to develop new photonic devices. Analytical or semi-empirical models exist for particles of spherical and cylindrical shape. The angular spectrum of scattering for particles of more complex shape is very complex and can only be obtained by numerical simulations. Moreover, the light scattering of metallic particles depends on many parameters as size, shape, optical constants, substrate and polarization of light. Experimental verification of the differential scattering cross-sections obtained from different calculation methods is always necessary. Measurements done on single nanoparticles are very sensitive to their local properties and the signal-to-noise ratio may be very poor. Arrays of identical particles illuminated by a planes waves produce Bragg diffraction and the resultant patterns depend on the averaged values of the form factors of the particles. In order to test the validity of models for the scattering form factor, we present an experimental setup capable of measuring Bragg diffraction patterns of arrays of nanoparticles in the visible and near-infrared regions of the spectrum. The approach is similar to that of X-ray diffraction of crystals.


PLANETARY CANDIDATES OBSERVED BY Kepler. VIII. A FULLY AUTOMATED CATALOG WITH MEASURED COMPLETENESS AND RELIABILITY BASED ON DATA RELEASE 25.
We present the Kepler Object of Interest (KOI) catalog of transiting exoplanets based on searching four years of Kepler time series photometry (Data Release 25, Q1-Q17). The catalog contains 8054 KOIs of which 4034 are planet candidates with periods between 0.25 and 632 days. Of these candidates, 219 are new in this catalog and include two new candidates in multi-planet systems (KOI-82.06 and KOI-2926.05), and ten new high-reliability, terrestrial-size, habitable zone candidates. This catalog was created using a tool called the Robovetter which automatically vets the DR25 Threshold Crossing Events (TCEs) found by the Kepler Pipeline (Twicken et al. 2016). Because of this automation, we were also able to vet simulated data sets and therefore measure how well the Robovetter separates those TCEs caused by noise from those caused by low signal-to-noise transits. Because of these measurements we fully expect that this catalog can be used to accurately calculate the frequency of planets out to Kepler's detection limit, which includes temperate, super-Earth size planets around GK dwarf stars in our Galaxy. This paper discusses the Robovetter and the metrics it uses to decide which TCEs are called planet candidates in the DR25 KOI catalog. We also discuss the simulated transits, simulated systematic noise, and simulated astrophysical false positives created in order to characterize the properties of the final catalog. For orbital periods less than 100 d the Robovetter completeness (the fraction of simulated transits that are determined to be planet candidates) across all observed stars is greater than 85%. For the same period range, the catalog reliability (the fraction of candidates that are not due to instrumental or stellar noise) is greater than 98%. However, for low signal-to-noise candidates found between 200 and 500 days, our measurements indicate that the Robovetter is 73.5% complete and 37.2% reliable across all searched stars (or 76.7% complete and 50.5% reliable when considering just the FGK dwarf stars). We describe how the measured completeness and reliability varies with period, signal-to-noise, number of transits, and stellar type. Also, we discuss a value called the disposition score which provides an easy way to select a more reliable, albeit less complete, sample of candidates. The entire KOI catalog, the transit fits using Markov chain Monte Carlo methods, and all of the simulated data used to characterize this catalog are available at the NASA Exoplanet Archive.


Comparative transcriptome analysis reveals immunotoxicology induced by three organic UV filters in Manila clam (Ruditapes philippinarum).
Benzophenone-3 (BP-3), 4-methyl-benzylidene camphor (4-MBC) and 2-ethyl-hexyl-4-trimethoxycinnamate (EHMC) are commonly used organic ultraviolet (UV) filters and are frequently detected in water environments. In the present study, we studied the potential adverse impacts of UV filter exposures in Ruditapes philippinarum by investigating transcriptomic profiles and non-specific immune enzyme activities. Transcriptome analysis showed that more genes were differentially regulated in EHMC-treated group, and down-regulated genes (2009) were significantly more than up-regulated ones (410) at day 7. Function annotation revealed that pathways "immune system", "cell growth and death" and "infectious diseases" were significantly enriched. Generally, combined qPCR and biochemical analyses demonstrated that short-term exposure to low dose of UV filters could activate immune responses, whereas the immune system would be restrained after prolonged exposure. Taken together, the present study firstly demonstrated the immunotoxicology induced by BP-3, 4-MBC and EHMC on R. philippinarum, indicating their potential threats to the survival of marine bivalves.


Repeated doses of tissue plasminogen activator for failed thrombolysis: case report and review of the literature.
This article reports the first case of a patient presenting with acute myocardial infarction in whom a repeated dose of tissue plasminogen activator (t-PA) was able to achieve successful thrombolysis after a first dose of t-PA itself failed to do so. This case report presents an alternative approach for the treatment of patients who fail thrombolysis after an initial dose of t-PA, an approach that might be particularly useful in hospitals that do not have immediate access to advanced interventional services.


Subclinical visual field defects in multiple sclerosis. Demonstration and quantification with automated perimetry, and comparison with visually evoked potentials.
Fourteen patients with definite but inactive multiple sclerosis (MS) and 17 normal controls were examined with the automated perimeter octopus. Most of the patients had subclinical visual field defects, typically consisting of patchy, shallow scotomata located mostly in an area of between 15 degrees and 30 degrees eccentricity. In 8 patients, more than 15% of the tested visual field of at least one eye was abnormal. The severity and extent of the defects was unrelated to a history of optic neuritis. When visually evoked potentials (VEPs) of these subjects were examined using a reversing pattern, no correlation was found in the MS patients between prolonged VEP latencies and the location, depth or extent of visual field defects. Since subclinical visual field defects may be found in MS patients with normal VEP latencies, automated perimetry can be helpful in diagnosing some cases.


Statins do not commonly cause muscle pain and stiffness.
The studyHerrett E, Williamson E, Brack K, et al. The effect of statins on muscle symptoms in primary care: the StatinWISE series of 200 N-of-1 RCTs. Health Technol Assess 2021;25:16.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/statins-not-likely-to-cause-muscle-pain-stiffness/.


Does single-dose cell resistance to the radio-mimetic zeocin correlate with a zeocin-induced adaptive response in Chlamydomonas reinhardtii strains?
This study aimed to test whether a correlation exists between single-dose resistance to zeocin and the ability to develop a zeocin-induced adaptive response (AR) in Chlamydomonas reinhardtii strains. Three genotypes were used: wild type (WT) strain 137C and two strains (H-3 and AK-9-9), which are highly resistant to radiation based on survival studies. Based on a micro-colony assay, the strains could be arranged according to their single-dose resistance to zeocin as follows: AK-9-9 > H-3 > 137C. However, zeocin induced a similar level of DSB in strains AK-9-9, H-3 and 137C. The radio- and zeocin-resistant strains AK-9-9 and H-3 showed higher DSB rejoining capacity than the WT strain 137C, suggesting that DSB rejoining can at least partly account for different cell survival. Both WT and radio-resistant strains develop zeocin-induced AR involving increased DSB rejoining. The radio- and zeocin-resistant strains AK-9-9 and H-3 again showed higher DSB rejoining capacity than the WT strain 137C. The higher resistance of strains H-3 and AK-9-9 did not abrogate their ability to adapt, albeit with a smaller magnitude as compared to the WT strain. The obtained results characterize new radio-resistant C. reinhardtii strains, which enrich the collection of resistant C. reinhardtii strains.


A report on drug-induced kerato-conjunctivitis sicca in dogs.
Kerato-conjunctivitis sicca is reported in beagle dogs treated with an antispasmodic compound for 26 weeks during a routine toxicity study. There was a deficiency of lachrymal secretion associated with keratitis and corneal vascularization. Histopathologically, the changes were characterized by vascularization, fibroblast proliferation and infiltration of inflammatory cells in the substantia propria. In some cases, the inflammation also occurred in corneal epithelium, ocular conjunctiva and corneal limbi.


[Indication and clinical value of vesiculodeferentography concerning urologic-andrologic diseases (author's transl)].
There are 29 cases of vesiculodeferentography (VDG) (1962-1975) presented. The very indication of VDG was the evaluation of azoospermia due to occlusion of the vas deferens, in addition to other urologic diseases. Especially from the andrologic point of view the various forms of occlusion-azoospermia are classified and analyzed. It is pointed out, that the rete testis region is not to be elucidated by VDG.


Immunohistochemical identification of actomyosin-containing (myoepithelial) cells in non-neoplastic and neoplastic tissues.
Actomyosin-containing cells in both non-neoplastic and neoplastic tissues of the salivary gland, lung, breast and some other organs were studied by immunofluorescent microscopy using antiactomyosin rabbit serum. In the breast, myoepithelial-like cells with positive immunofluorescence in the cytoplasm were observed not only in sclerosing adenosis and fibroadenoma but also in scirrhous and medullary-tubular duct carcinomas. No positive cells were observed in medullary carcinomas with lymphoid infiltration. The actomyosin positive cells were also seen at the outer layer of tubules of "mixed tumors" and of cell nests in adenoid cystic carcinoma and in myoepithelioma of the salivary gland, but not in the metaplastic squamous cells or in the cells of myxomatous and chondroid areas of "mixed tumor". In carcinoma of the lung, actomyosin-positive cells were observed in adenoid cystic carcinomas and adenocarcinoma of the bronchial gland type, but they were not seen in squamous cell carcinomas or papillary adenocarcinomas. It was concluded that the actomysoin-containing cells with structural appearances of myoepithelial cells in a variety of tumors were neoplastic myoepithelial cells.


Ginsenoside compound K suppresses the abnormal activation of T lymphocytes in mice with collagen-induced arthritis.
To investigate the anti-arthritis and immunomodulatory activities of ginsenoside compound K (C-K) in mice with collagen-induced arthritis (CIA). DBA/1 mice with CIA were treated with C-K (28, 56 or 112 mg·kg(-1)·d(-1), ig) or the positive control methotrexate (2 mg/kg, ig, every 3 d) for 34 d. Splenic T and B lymphocytes were positively isolated using anti-CD3-coated magnetic beads or a pan B cell isolation kit. T lymphocyte subsets, and CD28, T cell receptor (TCR), cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) and programmed death-1 (PD-1) expression in purified splenic T lymphocytes were analyzed using flow cytometry, Western blotting and laser confocal microscopy. C-K treatment significantly ameliorated the pathologic manifestations of CIA mice, remarkably inhibited T lymphocyte proliferation, and marginally inhibited the proliferation of B lymphocytes. C-K treatment significantly suppressed TNF-α and anti-CII antibody levels, and increased IFN-γ level in the joints of CIA mice, but did not alter IL-4 production. Treatment of CIA mice with C-K significantly decreased the percentages of activated T cells, co-stimulatory molecule-expressing T cells and effector memory T cells, and increased the frequencies of naive T cells and regulatory T cells. Furthermore, C-K treatment significantly decreased the expression of CD28 and TCR, whereas it increased the expression of CTLA-4 and PD-1 on T lymphocytes of CIA mice. Methotrexate treatment exerted comparable effects in all these experiments. C-K suppresses the progression of CIA through regulating TCR, CD28, CTLA-4 and PD-1 expression, thus inhibiting the abnormal activation and differentiation of T lymphocytes.


[The general situation of the development of ophthalmology in recent five years in China].
The ophthalmology in China keeps the tendency of fast development since the new century. The clinic service in ophthalmology has obviously been improved. The actual strength of the ophthalmic organizations was enhanced. The whole level of eye doctors was advanced. The inland and international academic meetings were flourishing. The development in ophthalmology made progress.


[Technical instrumentation for tracheal endoprosthesis].
By applying the programme-oriented approach, a tracheal X-ray endoscopic prosthesis system has been worked out. Medical and technical evidence has been provided for the major parameters of the simplest cylindrical endoprosthesis of the trachea with the unique location of projections in a two-way spiral line. A concise programme has been proposed for calculating the above parameters by using the QBASIC language.


Operative treatment of pediatric obstructive hypertrophic cardiomyopathy: a 26-year experience.
We retrospectively reviewed the 26-year National Institutes of Health experience with operative treatment of obstructive hypertrophic cardiomyopathy in pediatric patients. Operative criteria were either severe obstructive symptoms (New York Heart Association functional class III or IV) or sudden death. Seventeen patients underwent 19 open procedures, of which the present study is comprised. Complete follow-up was available 10.1 +/- 1.4 years (mean +/- standard error; range, 0.8 to 26.2 years) after operation. The mean ages at diagnosis and operation were 11.9 +/- 1.3 years (range, 1 to 17 years) and 14.8 +/- 0.7 years (range, 9 to 17 years), respectively. The preoperative intraventricular septum mean dimension was 23.2 +/- 1.3 mm (range, 11 to 36 mm). The left ventricular outflow tract gradient was 74 +/- 9 mm Hg (range, 20 to 175 mm Hg) at rest and 94 +/- 7 mm Hg (range, 55 to 175 mm Hg) with provocation. Fifteen patients (88%) underwent left ventricular myotomy and myectomy, and 2 underwent mitral valve replacement. Two patients who initially received left ventricular myotomy and myectomy later underwent mitral valve replacement. There were one perioperative death (6%) and five late sudden deaths (31%) at 3.8, 8.7, 9.6, 14.1, and 21 years postoperatively. Kaplan-Meier survival was 86% +/- 8% at 5 years and 77% +/- 12% at 10 years. After operation, the left ventricular outflow tract gradient decreased almost 80% to 21 +/- 15 mm Hg (p = 0.0001). In 8 patients, the left ventricular outflow tract gradient completely resolved.(ABSTRACT TRUNCATED AT 250 WORDS)


A stepwise diagnostic approach for undiagnosed Anemia in children: A model for low-middle income country.
Reaching a precise diagnosis in rare inherited anemia is extremely difficult and challenging, especially in areas with limited use of genetic studies, which makes undiagnosed anemia a unique clinical entity in tertiary hematology centers. In this study, we aim at plotting a stepwise diagnostic approach in children with undiagnosed anemia while identifying indications for genetic testing. A one-year cross-sectional study involved 44 children and adolescents with undiagnosed anemia after undergoing an initial routine panel of investigations. They were classified based on mean corpuscular volume (MCV) into 3 groups: microcytic (n = 19), normocytic (n = 14) and macrocytic (n = 11). An algorithm that included four levels of investigations was devised for each category. After applying a systematic diagnostic approach, 33 patients (75 %) were diagnosed of whom 7 (15 %) had combined diagnoses, while 11 (25 %) patients remained undiagnosed. Based on the first, second, third and fourth levels of investigations, patients were diagnosed, respectively, as follows: of the 11 patients, 7 were microcytic, 3 normocytic and 1 macrocytic; of the 7 patients, 2 were microcytic, 2 normocytic, and 3 macrocytic; of 10 patients, 5 were microcytic, 4 normocytic and 1 macrocytic; finally, of the 16 patients, 8 were microcytic, 6 normocytic and 2 macrocytic. Numbers recorded appear higher than the actual number of the patients because some of them were diagnosed by more than one level of investigation. The diagnoses obtained in the microcytic group showed hemoglobinopathies, iron refractory iron deficiency anemia (IRIDA), membrane defects, sideroblastic anemia, hypo-transferrinemia, a combined diagnosis of sickle cell trait and pyropoikilocytosis. The diagnoses also showed a combined diagnosis of hereditary spherocytosis (HS) and alpha thalassemia minor, and a combined diagnosis of iron deficiency anemia and beta thalassemia minor, while 15 % remained undiagnosed. In the normocytic group, the diagnosis revealed autosomal recessive (AR) HS, vitamin B12 deficiency, pyruvate kinase deficiency (PKD), congenital dyserythropoietic anemia (CDA) type I, Diamond Blackfan anemia and beta thalassemia major. In addition, it showed a combined diagnosis of AR HS and CDA type II, a combined diagnosis of AR HS and PKD, and a combined diagnosis of dehydrated stomatocytosis (DHS) and G6PD carrier, meanwhile 20 % remained undiagnosed. Finally, the macrocytic group was diagnosed by vitamin B12 deficiency, sideroblastic anemia, PKD, a combined diagnosis of PKD and G6PD deficiency carrier, while 45 % remained undiagnosed. Conducting a stepwise approach with different levels of investigations may help reach the diagnosis of difficult anemia without having to resort to unnecessary investigations. Combined diagnosis is an important cause of undiagnosed anemia, especially in countries with high frequency of consanguinity. The remaining 25 % of the patients continued to be undiagnosed, requiring more sophisticated investigations.


Efficacy and safety of extended-release isosorbide mononitrate for stable effort angina pectoris.
The efficacy and safety of extended-release isosorbide mononitrate tablets were evaluated in patients with stable effort angina. In a double-blind study, 313 patients with stable effort-induced angina were randomized to receive placebo or extended-release isosorbide mononitrate: 30, 60, 120 or 240 mg once daily in the morning. Serial exercise testing was performed using the standard Bruce treadmill protocol on days 1, 7, 14, 28 and 42 immediately before morning drug administration, and 4 and 12 hours after administration. After initial dosing, all groups that received extended-release isosorbide mononitrate had significant (p < 0.01) increases in mean total exercise time of approximately 30 to 50 seconds in relation to placebo 4 and 12 hours after administration. On day 42, mean changes from baseline in total exercise time of patients who received 120 or 240 mg of extended-release isosorbide mononitrate exceeded placebo by approximately 50 to 60 seconds 4 hours after dosing (p < 0.01), and by 30 to 35 seconds 12 hours after dosing (p < or = 0.05). No significant difference was detected between responses to extended-release isosorbide mononitrate and placebo 24 hours after administration (i.e., immediately before the next dose). Thus, there was neither significant activity nor demonstrable rebound of effort-induced angina (zero-hour effect) at the end of the dosing interval. Transient headache was the most prevalent adverse experience. Extended-release isosorbide mononitrate (120 and 240 mg administered orally once daily) significantly prolonged exercise time to development of moderate effort-induced angina 4 and 12 hours after dosing during long-term therapy, without development of nitrate tolerance.(ABSTRACT TRUNCATED AT 250 WORDS)


Photocatalytic degradation of persistent organic pollutants by Co-Cl bond reinforced CoAl-LDH/Bi12O17Cl2 photocatalyst: mechanism and application prospect evaluation.
The widespread distribution of persistent organic pollutants (POPs) in natural waters has aroused global concern due to their potential threat to the aquatic environment. Photocatalysis represents a promising mean to remediate polluted waters with the simple assistance of solar energy. Herein, we fabricated a Co-Cl bond reinforced CoAl-LDH/Bi12O17Cl2 heterogeneous photocatalyst to investigate the feasibility of photocatalysis to treat POPs-polluted water under environmental conditions. The optimum CoAl-LDH/Bi12O17Cl2 (5-LB) composite photocatalyst exhibited excellent photocatalytic performance, which could degrade 92.47 % of ciprofloxacin (CIP) and 95 % of bisphenol A (BPA) with 2h of actual solar light irradiation in Changsha, China (N 28.12 °, E 112.59 °). In view of the synergistic influence of water constituents, various water matrices greatly affected the degradation rate of CIP (BPA), with the degradation efficiency of 82.17% (84.37%) in tap water, 69.67% (71.63%) in wastewater effluent, and 44.07% (67.7%) in wastewater inflow. The results of electron spin resonance, and chemical trapping experiment, HPLC-MS and density functional theory calculation reflected that the degradation of CIP was mainly attributed to h+ and 1O2 attacking the active atoms of CIP molecule with high Fukui index. Furthermore, the non-toxicity of both 5-LB photocatalyst and treated CIP solution was proved by E.coli and B.subtilis cultivation, which further demonstrated the feasibility of the 5-LB to treat POPs in real water under irradiation of solar light.


Identification of a novel collagen type І-binding protein from Streptococcus suis serotype 2.
Streptococcus suis, a major pathogen of pigs, is an emerging zoonotic agent that causes meningitis and septic shock. cbp40 is a putative virulent gene that has been identified using suppression subtractive hybridization performed on the virulent S. suis serotype 2 strain HA9801 and the avirulent S. suis serotype 2 strain T15. Based on predicted protein features showing a shared conserved domain with the collagen-binding protein Cna of Staphylococcus aureus, Cbp40 is likely to function as a direct mediator of collagen adhesion. Here, the cbp40 gene was cloned and the recombinant protein purified. Western blotting using swine convalescent sera confirmed its role as an immunogenic protein. Collagen binding activity could be detected by western affinity blot and ELISA. Conversely, deletion of the cbp40 gene reduced bacterial adhesion to HEp-2 cells, capacity for biofilm formation, and virulence in a zebrafish infection model. The response of the bEnd.3 cell line to infection with the S. suis serotype 2 strain ZY05719 and the cbp40-knockout strain was evaluated using gene expression arrays. The differentially expressed genes were involved in inflammatory and immune responses, leukocyte adhesion and heterophilic cell adhesion. Collectively, these data suggest that Cbp40 plays an important role as an extracellular matrix adhesion protein that interacts with host cells during infection.


Long-term outcomes after out-of-hospital cardiac arrest: A systematic review and meta-analysis.
Long term outcomes after out-of-hospital cardiac arrest (OHCA) are not well understood. This study aimed to evaluate the long-term (1-year and beyond) survival outcomes, including overall survival and survival with favorable neurological status and the quality-of-life (QOL) outcomes, among patients who survived the initial OHCA event (30 days or till hospital discharge). Embase, Medline and PubMed were searched for primary studies (randomized controlled trials, cohort and cross-sectional studies) which reported the long-term survival outcomes of OHCA patients. Data abstraction and quality assessment was conducted, and survival at predetermined timepoints were assessed via single-arm meta-analyses of proportions, using generalized linear mixed models. Comparative meta-analyses were conducted using the Mantel-Haenszel Risk Ratio (RR) estimates, using the DerSimonian and Laird model. 67 studies were included, and among patients that survived to hospital discharge or 30-days, 77.3% (CI = 71.2-82.4), 69.6% (CI = 54.5-70.3), 62.7% (CI = 54.5-70.3), 46.5% (CI = 32.0-61.6), and 20.8% (CI = 7.8-44.9) survived to 1-, 3-, 5-, 10- and 15-years respectively. Compared to Asia, the probability of 1-year survival was greater in Europe (RR = 2.1, CI = 1.8-2.3), North America (RR = 2.0, CI = 1.7-2.2) and Oceania (RR = 1.9, CI = 1.6-2.1). Males had a higher 1-year survival (RR:1.41, CI = 1.25-1.59), and patients with initial shockable rhythm had improved 1-year (RR = 3.07, CI = 1.78-5.30) and 3-year survival (RR = 1.45, CI = 1.19-1.77). OHCA occurring in residential locations had worse 1-year survival (RR = 0.42, CI = 0.25-0.73). Our study found that up to 20.8% of OHCA patients survived to 15-years, and survival was lower in Asia compared to the other regions. Further analysis on the differences in survival between the regions are needed to direct future long-term treatment of OHCA patients.


Machine learning method using position-specific mutation based classification outperforms one hot coding for disease severity prediction in haemophilia 'A'.
Haemophilia is an X-linked genetic disorder in which A and B types are the most common that occur due to absence or lack of protein factors VIII and IX, respectively. Severity of the disease depends on mutation. Available Machine Learning (ML) methods that predict the mutational severity by using traditional encoding approaches, generally have high time complexity and compromised accuracy. In this study, Haemophilia 'A' patient mutation dataset containing 7784 mutations was processed by the proposed Position-Specific Mutation (PSM) and One-Hot Encoding (OHE) technique to predict the disease severity. The dataset processed by PSM and OHE methods was analyzed and trained for classification of mutation severity level using various ML algorithms. Surprisingly, PSM outperformed OHE, both in terms of time efficiency and accuracy, with training and prediction time improvement in the range of approximately 91 to 98% and 80 to 99% respectively. The severity prediction accuracy also improved by using PSM with different ML algorithms.


High light intensity augments mercury toxicity in cyanobacterium Nostoc muscorum.
The present study is aimed at investigating the role of growth irradiance in determining the extent of mercury (Hg) toxicity on various physiological parameters viz. growth, pigment contents, photosynthesis, respiration, (14)CO(2) fixation, photosynthetic electron transport, photorespiration and enzyme activity of cyanobacterium Nostoc muscorum. A general decline was observed in all these parameters with increasing concentration of Hg except for carotenoids content and respiratory activity which exhibited significant enhancement. This effect was more pronounced in high light (130 μmol photon m(-2) s(-1)) exposed cells as compared to normal (70 μmol photon m(-2) s(-1)) and low (10 μmol photon m(-2) s(-1)) light exposed cells. Among the photosynthetic electron transport activities, whole chain was found to be more sensitive than photosystem II (PSII) and photosystem I (PSI). (14)CO(2) fixation was more affected as compared to O(2) evolution when exposed to Hg and different light intensities. Photorespiratory activity, which is an index of protecting organisms from light-induced damage, also showed a similar declining trend. Enzyme assay revealed that among the carboxylating enzymes, activity of RUBISCO was more severely inhibited than PEPCase. Thus, these results suggest that Hg itself was toxic at all tested concentrations and high light intensity augmented its toxicity in N. muscorum inhibiting the growth, pigment contents and photosynthetic activity of the organism.


Characterization of adenosine receptors evoking excitation of mesenteric afferents in the rat.
We examined the effects of adenosine receptor agonists and antagonists on the discharge of mesenteric afferent nerves supplying the jejunum in pentobarbitone sodium-anaesthetized rats. Adenosine (0.03-10 mg kg(-1), i.v.), NECA (0.3-300 microg kg(-1), i.v.) and the A1 receptor agonist, GR79236 (0.3-1000 microg kg(-1), i.v.), each induced dose-dependent increases in afferent nerve activity and intrajejunal pressure, hypotension and bradycardia. The A1 receptor antagonist, DPCPX (3 mg kg(-1), i.v.), antagonized all the effects of GR79236 but only the haemodynamic effects of adenosine and NECA. The A2A receptor antagonist, ZM241385 (3 mg kg(-1), i.v.), antagonized the hypotensive effect of NECA but none of the effects of GR79236. The A2A receptor agonist, CGS21680 (0.3-300 microg kg(-1), i.v.), and the A3 receptor agonist, IB-MECA (0.3-300 microg kg(-1), i.v.), each induced only a dose-dependent hypotension. Subsequent administration of adenosine (3 mg kg(-1), i.v.) induced increases in afferent nerve activity and intrajejunal pressure and bradycardia. ZM241385 (3 mg kg(-1), i.v.) antagonized the hypotensive effect of CGS21680 but not the effects of adenosine. Bethanechol (300 microg kg(-1), i.v.) evoked increases in afferent nerve activity and intrajejunal pressure, hypotension and bradycardia. However, adenosine (3 mg kg(-1), i.v.) evoked greater increases in afferent nerve activity than bethanechol despite inducing smaller increases in intrajejunal pressure. In summary, A1 and A2B and/or A2B-like receptors evoke adenosine-induced increases in mesenteric afferent nerve activity and intrajejunal pressure in the anaesthetized rat. Furthermore, elevations in intrajejunal pressure do not wholly account for adenosine-evoked excitation of mesenteric afferent nerves.


Patterns of myocardial endothelin-1 expression and outcome after cardiac transplantation.
Endothelin-1 (ET-1), a potent vasoconstrictor, is released in response to several inflammatory cytokines after heart transplantation. The present study correlated patterns of myocardial ET-1 expression in heart biopsies with acute rejection, post-transplantation ischemic injury, and subsequent development of coronary vasculopathy. Patterns of myocardial ET-1 expression were evaluated in 47 heart transplant recipients at 3 months after transplant. Transplant vasculopathy was documented by coronary angiography at 2 years after transplant. Expression of ET-1 was tabulated for both blood vessels and the interstitium. Vascular ET-1 expression was positive in 7/17 (41%) of patients with greater than grade 2 (International Society Heart Lung Transplant) rejection compared with 3/30 (10%) of patients with grade 0 and grade 1A rejection (P=0.02). Compared with patients with negative interstitial ET-1 expression (n=22), patients with positive interstitial ET-1 expression (n=25) had higher incidence of post-transplantation ischemic injury (52% versus 9%, P=0.002), lower mean episodes of acute rejection (> or = grade 2) during the first 3 months of transplant (1.09+/-0.66 versus 1.86+/-1.6, P=0.048), and more common vasculopathy at 2 years (50% versus 15%, P=0.02), and they tended to have worse survival (83.2% versus 100%, P=0.058). Vascular ET-1 expression is likely to be associated with acute rejection. Interstitial ET-1 expression, however, is more likely to be associated with post-transplantation ischemic injury and subsequent development of coronary vasculopathy.


Submaxillary sialadenitis with a calculus in infancy diagnosed by ultrasonography.
Ultrasonography of submandibular masses in infancy may be performed during the acute phase of the disease, rapidly providing information about the mass. Further steps in management follow as illustrated by our infant with submaxillary sialadenitis and a non-opaque calculus.


A deep-learning framework for spray pattern segmentation and estimation in agricultural spraying systems.
This work focuses on leveraging deep learning for agricultural applications, especially for spray pattern segmentation and spray cone angle estimation. These two characteristics are important to understanding the sprayer system such as nozzles used in agriculture. The core of this work includes three deep-learning convolution-based models. These models are trained and their performances are compared. After the best model is selected based on its performance, it is used for spray region segmentation and spray cone angle estimation. The output from the selected model provides a binary image representing the spray region. This binary image is further processed using image processing to estimate the spray cone angle. The validation process is designed to compare results obtained from this work with manual measurements.


Disgust and behavioral avoidance in colorectal cancer screening and treatment: a systematic review and research agenda.
The emotion of disgust appears to promote psychological and behavioral avoidance, a dynamic that has significant implications in physical and psychological outcomes in colorectal cancer (CRC). Patients, caregivers, and health professionals alike are all potentially susceptible to responding with disgust and the associated avoidance. This article aimed to review the early-stage literature related to disgust and CRC, consider the clinical implications, and suggest an appropriate research agenda. Given limited research in this area, a systematic review of the literature was broadened to include disgust and all cancers. MEDLINE, Web of Science, SCOPUS, and ProQuest Dissertations and Theses databases were searched, with additional works sourced by reviewing citation lists and/or by contacting the lead authors. Nine studies were identified relating to disgust and cancer screening, and 6 related to disgust and cancer treatment. Two broad findings emerged: (1) disgust appears to be promoting aversion to (and avoidance of) CRC screening, and (2) several known elicitors of disgust are widely apparent in CRC contexts. Disgust likely represents a key emotional substrate for avoidance among CRC patients, caregivers, and health professionals. Further research is required to identify disgust's elicitors and effects in CRC contexts, informing interventions that target early identification of persons at risk of maladaptive outcomes. Exposure therapies and mindfulness training may be well suited to treating disgust-generated avoidance. Disgust has significant implications in CRC contexts. Oncology nurses are uniquely positioned to guide clinical interventions and ultimately improve outcomes in this area.


Prostate Biopsy: Hyperbole and Misrepresentation Versus Scientific Evidence and Equipoise.
There are conflicting recommendations from the American Urological Association and the European Association of Urology guidelines regarding transrectal or transperineal prostate biopsy, driven by a lack of high-quality data. In the interest of evidence-based medicine, it is best to avoid passionate overstatement of facts or assign strong recommendations until comparative effectiveness data are available.


Frequency of and outcome of acute coronary syndromes in patients with human immunodeficiency virus infection.
Fifty-one patients with human immunodeficiency virus infection and acute coronary syndromes were identified. Nearly all patients (98%) had traditional coronary risk factors. Revascularization procedures were performed safely with low in-hospital mortality.


In vivo Architecture of the Polar Organizing Protein Z (PopZ) Meshwork in the Alphaproteobacteria Magnetospirillum gryphiswaldense and Caulobacter crescentus.
The polar organizing protein Z (PopZ) forms a polar microdomain that is inaccessible to larger macromolecules such as ribosomes, and selectively sequesters proteins crucial for cell cycle control and polar morphogenesis in various Alphaproteobacteria. However, the in vivo architecture of this microdomain has remained elusive. Here, we analyzed the three-dimensional ultrastructural organization of the PopZ network in Magnetospirillum gryphiswaldense and Caulobacter crescentus by Volta phase plate cryo-electron tomography, which provides high spatial resolution and improved image contrast. Our results suggest that PopZ forms a porous network of disordered short, flexible, and branching filaments.


Hepatobiliary scintigraphy after hepatic portoenterostomy.
Hepatobiliary scintigraphy with 99mTc-E-HIDA was carried out in 10 patients who had undergone hepatic portoenterostomy for "non-correctable" biliary atresia. In all the patients there was an active bile flow and disappearance of jaundice, post-operatively. Elimination of 99mTc-E-HIDA from the liver was slow during the first 3 post-operative months despite active bile flow and disappearance of jaundice. The elimination rate of the radioactive agent from the liver in most long-term survivors was comparable with findings in controls.


Dopamine D3 receptor knock-out mice display deficits in locomotor sensitization after chronic morphine administration.
Locomotor sensitization is the progressive and enduring enhancement of locomotion induced by stimulants such as drugs, which alter rodent locomotion in a long-standing manner. The dopamine D3 receptor has been reported to play a role in morphine addiction. The aim of the present study was to investigate the role of dopamine D3 receptor in the morphine induced locomotor sensitization using dopamine D3 receptor knock-out mice. The dopamine D3 receptor knock-out mice did not display an enhanced behavioral response to acute morphine administration or develop an increased rate of locomotor sensitization to intermittent morphine administration. When 2mg/kg naloxone was co-administered with 10mg/kg morphine, morphine-induced locomotion sensitization in wild-type mice was significantly blocked while the locomotion in the D3 receptor knock-out mice was decreased. Then the wild-type mice were administered with dopamine D3 antagonist nafadotride. It was found that co-administration of morphine with nafadotride could effectively suppress the level of morphine induced behavioral sensitization. It was concluded that a loss of the dopamine D3 receptor gene may inhibit acute morphine induced hyperlocomotor activity and chronic morphine induced behavioral sensitization.


Some reflections of a medical social worker in a spinal paralysis unit.
Seventeen years as the social worker to a spinal paralysis unit has clearly demonstrated the very great importance of treating the 'whole patient'.


The use of dexamethasone in primary lumbar disc surgery. A prospective, randomized, double-blind study.
Corticosteroids have been used by many spine surgeons in the postoperative management of lumbar disc surgery patients. The potential side effects of these medications are significant, and yet there is little information available either supporting or contraindicating their use in the postoperative setting. This prospective, randomized double-blind study was designed to assess the effectiveness of the corticosteroid dexamethasone in decreasing postoperative pain and hospital stay after primary lumbar disc surgery. The patients' pain status was assessed both preoperatively and postoperatively by a standard pain questionnaire and pain drawing. Each patient's response to the questionnaire and pain drawing, as well as his usage of narcotics and days of postoperative hospitalization, were recorded and analyzed. Dexamethasone was shown to have a significant and selective effect on reducing leg pain postoperatively, while also significantly reducing the usage of injectable narcotics and shortening the postoperative hospital stay.


Normative Values for Pinch Strength-Relationship With Joint Hypermobility as Measured With the Beighton Criteria.
This study aimed to determine normative ranges of static pinch strength as measured with a spring gauge in adults of working age and investigate whether pinch strength is associated with hand hypermobility. A secondary aim was to explore whether the Beighton criteria for hypermobility are associated with hypermobility in joints of the hand during forceful pinching. A convenience sample of healthy men and women aged 18-65 years were recruited for measurement of lateral pinch, 2-point pinch, 3-point pinch, and joint hypermobility according to the Beighton criteria. Regression analysis was used to determine the effect of age, sex, and hypermobility on pinch strength. Two hundred and fifty men and 270 women participated in this study. Men were stronger than women at all ages. Lateral and 3-point pinch were greatest for all participants and 2-point pinch was the least strong. There were no statistically significant differences between age groups, but a trend for the lowest pinch strength to occur before the mid-thirties was seen in both sexes. Thirty-eight percent of women and 19% of men were hypermobile; however, these participants statistically insignificant differ in pinch strength compared with other participants. The Beighton criteria corresponded strongly with hypermobility in other joints of the hand as observed and photographed during pinch. Hand dominance did not show clear relationships with pinch strength. Normative lateral, 2-point, and 3-point pinch strength data for adults of working age are presented with men having greatest pinch strength at all ages. The Beighton criteria for hypermobility are associated with hypermobility in other joints of the hand. Benign joint hypermobility is not related to pinch strength. Men have greater pinch strength at all ages than women.


[Interpretation of Rectal MRI after Neoadjuvant Treatment in Patients with Rectal Cancer].
MRI is currently the imaging modality of choice to evaluate rectal cancer after neoadjuvant treatment. The purposes of restaging MRI are to assess the resectability of rectal cancer and to decide whether organ preservation strategies can be applied in patients with a complete clinical response. This review article indicates the key MRI features needed to evaluate rectal cancer after neoadjuvant treatment using a systematic approach. Assessment of primary tumor response including MRI findings to predict a complete response is discussed. Additionally, MRI evaluation of the relationship between the primary tumor and adjacent structures, lymph node response, extramural venous invasion, and tumor deposits after neoadjuvant treatment is presented. Knowledge of these imaging features and their clinical relevance may help radiologists provide an accurate and clinically valuable interpretation of restaging rectal MRI.


Centrophenoxine increases the rates of total and mRNA synthesis in the brain cortex of old rats: an explanation of its action in terms of the membrane hypothesis of aging.
The rates of total and polyA+ RNA (mRNA) synthesis were measured by radioisotope technique in the brain cortex of female CFY rats. There was practically no significant difference between the young (1.5 months) and adult (13 months) rats; however, the old group (26 months) displayed a considerable decrease of the rates of synthesis of both classes of RNA studied. Centrophenoxine treatment (100 mg per kg body weight per day, for 2 months) reversed this tendency, and increased significantly the synthesis rates of old rats almost to the adult level. The results are interpreted in terms of the membrane hypothesis of aging, attributing a free-radical scavenger function of the dimethylamino-ethanol incorporated into the nerve cell membrane from the centrophenoxine.


Medium optimization based on statistical methodologies for pristinamycins production by Streptomyces pristinaespiralis.
The optimization of nutrient levels for the production of pristinamycins by Streptomyces pristinaespiralis CGMCC 0957 in submerged fermentation was carried out using the statistical methodologies based on the Plackett-Burman design, the steepest ascent method, and the central composite design (CCD). First, the Plackett-Burman design was applied to evaluate the influence of related nutrients in the medium. Soluble starch and MgSO4 x 7H2O were then identified as the most significant nutrients with a confidence level of 99%. Subsequently, the concentrations of the two nutrients were further optimized using response surface methodology of CCD, together with the steepest ascent method. Accordingly, a second-order polynomial regression model was finally fitted to the experimental data. By solving the regression equation from the model and analyzing the response surface, the optimal levels for soluble starch and MgSO4 x 7H2O were determined as 20.95 and 5.67g/L, respectively. Under the optimized medium, the yield of pristinamycins in the shake flask and 5-L bioreactor could reach 1.30 and 1.01 g/L, respectively, which is the highest yield reported in literature to date.


Large mechanical changes in the bullfrog olfactory bulb evoked by afferent fiber stimulation.
The isolated olfactory bulb of the bullfrog responds to olfactory nerve stimulation with large mechanical changes in the bulb. The sequence of these changes represents: (1) swelling of the bulb associated with action potential production in the secondary neurons; (2) shrinkage during powerful inhibition of the secondary neurons; and (3) swelling accompanied by repetitive firing of action potentials in the bulb. The effects of bicuculline and Cl-free Ringer on these mechanical changes were examined. The shrinkage of the bulb is closely related with the inhibitory postsynaptic potentials (IPSPs) in the mitral cells.


Different prognostic impact of glucose uptake in visceral adipose tissue according to sex in patients with colorectal cancer.
The purpose of this study was to investigate whether sex differences in visceral fat volume and glucose uptake measured by positron emission tomography/computed tomography (PET/CT) in abdominal visceral fat can stratify overall survival (OS) in patients with colorectal cancer (CRC). We retrospectively enrolled 293 patients diagnosed with CRC who underwent PET/CT before surgical resection. Fluorodeoxyglucose uptake of visceral adipose tissue (VAT-SUV) and subcutaneous adiposity tissue (SAT-SUV) were measured using PET/CT. The relative VAT (rVAT) was defined as the visceral fat volume normalized to the total volume of fat (VAT plus SAT). We defined sex-specific cutoff values for VAT-SUV, SAT-SUV, and rVAT. Univariate and multivariate analyses using Cox proportional hazard regression analysis were performed to identify the independent prognostic factors. The study population comprised 181 men and 112 women. The rVAT (0.40 vs. 0.29, p < 0.001) and VAT-SUV (0.55 vs. 0.48, p = 0.007) were significantly greater in men than in women. High rVAT (than low rVAT) and high VAT-SUV (than low VAT-SUV) showed a worse prognosis in male and female patients, respectively. Multivariate analysis indicated that the combination of rVAT and VAT-SUV was an independent prognostic factor for predicting OS in both male and female patients. The combination of rVAT and VAT-SUV could differentiate the patients with the best survival outcome from the other three individual groups in female patients, but not in males. Glucose uptake and relative volume of visceral fat may provide a new risk stratification for patients with CRC, especially female patients.


Spatiotemporal variation evaluation of water quality in middle and lower Han River, China.
As the water source for the middle route of the South-to-North Water Transfer Project, the Han River in China plays a role of the world's largest inter-basin water transfer project. However, this human-interfered area has suffered from over-standard pollution emission and water blooms in recent years, which necessitates urgent awareness at both national and provincial scales. To perform a comprehensive analysis of the water quality condition of this study area, we apply both the water quality index (WQI) and minimal WQI (WQImin) methods to investigate the spatiotemporal variation characteristics of water quality. The results show that 8 parameters consisting of permanganate index (PI), chemical oxygen demand (COD), total phosphorus (TP), fluoride (F-), arsenic (As), plumbum (Pb), copper (Cu), and zinc (Zn) have significant discrepancy in spatial scales, and the study basin also has a seasonal variation pattern with the lowest WQI values in summer and autumn. Moreover, compared to the traditional WQI, the WQImin model, with the assistance of stepwise linear regression analysis, could exhibit more accurate explanation with the coefficient of determination (R2) and percentage error (PE) values being 0.895 and 5.515%, respectively. The proposed framework is of great importance to improve the spatiotemporal recognition of water quality patterns and further helps develop efficient water management strategies at a reduced cost.


CT in homonymous hemianopia.
Computed tomography (CT) is useful for demonstrating a lesion of the optic pathway, because a slice of the brain almost parallel to the optic pathway can be viewed and the relationship between the optic pathway and the extent of the lesion can be demonstrated. We studied 53 cases of homonymous hemianopia by CT. In 85% of our cases, positive CT findings were obtained. When the lesion was in the occipital lobe, correlation between the size of the lesion and the type of visual field defect was observed.


High-Volume Billing and Reimbursement Trends for Endoscopic Swallowing Studies in the Medicare Population.
The aim of this study is to delineate the reimbursement trends in fiberoptic endoscopic evaluation of swallowing with sensory testing (FEESST) and without sensory testing (FEES) in relation to that of speech-language pathology's (SLP) portion of modified barium swallow studies (MBS), as well as to document the types of providers billing for these procedures. We performed descriptive analyses of the volume of FEES/FEESST and MBS, and total reimbursements data obtained from 2013-2018 Medicare Part B National Summary files. We also utilized the 2017 Medicare Provider Utilization and Payment Data to analyze the higher volume providers (> 10 procedures annually) of either FEES and/or FEESST. From 2003 to 2018, there has been an average, annual increase of approximately 318 FEES/FEESST performed within the Medicare fee-for-service population (R = 0.9505 [95% CI 0.860-0.983]; p < 0.001) covered under Part B (which is largely outpatient coverage). Similarly, there was an increase in Medicare-specific FEES/FEESST reimbursement from $302,840 in 2003 to $1.2 million in 2018 (R = 0.9721 [95% CI 0.920-0.990; p < 0.001]). Prior to 2010, FEESST was performed more frequently than FEES (maximum annual difference of 1174), though from 2010 onward, relatively more annual FEES was performed. From 2003-2018, the reimbursement per procedure increased by $16.79 and $35.36 for FEESST and FEES, respectively, and by $32.84 for the SLP portion of the MBS. Among high-volume FEES/FEESST billers, 65.4% were otolaryngologists and 32.3% were independently billing SLPs. From 2003 to 2018, there has been a significant rise in the number of performed and reimbursed FEES/FEESST. From 2014 onward, compared to SLP-involved MBS, there has been a relative increase in performance of FEES/FEESST.


Energy dissipation effects on imaging of soft materials by dynamic atomic force microscopy: a DNA-chip study.
Using amplitude-mode AFM (AM-AFM), we have obtained valuable information during these recent years through the study of amplitude and phase shift dependence on tip-sample separation, leading to a comprehensive understanding of the interaction processes. Two imaging regimes, attractive and repulsive, have been identified and a relationship between phase and dissipative energy was established, providing information on observed material properties. Most of the previous studies have concerned model systems: either hard or soft materials. In this paper, we present the analysis of a mixed system of soft structures on a hard substrate. This is a DNA chip for biological applications consisting of oligonucleotides covalently linked by a layer of silane to a silicon substrate. A detailed study of amplitude-phase curves as a function of the tip-sample separation allowed us to define the best experimental conditions to obtain specific information: we got reliable conditions to minimize noise during topographic imaging and an understanding of the processes of energy dissipation involved in the DNA breaking for DNA arrays. By calculating the energy dissipated as a function of the amplitude of oscillation, we have demonstrated a transition from an energy dissipation process governed by localized viscoelastic interactions (due to the soft layer) to a process governed by extended irreversible deformations (due to the hard substrate).


Diagnostic performance and predictive value of rheumatoid factor, anti-cyclic-citrullinated peptide antibodies and HLA-DRB1 locus genes in rheumatoid arthritis.
We evaluated the significance of the genes, defined as DRB1*04 or DRB1*01, in rheumatoid arthritis (RA) patients. We focused on the role of genetic and serologic markers to predict disease activity and destructive process of joints. Sixty patients with RA were examined. Radiographic changes were evaluated by (Larsen score) and disease activity was measured by disease activity score 28 (DAS28). The markers analyzed were: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptides (anti-CCP2) and HLA-DRB1 alleles typed by PCR. In this study, anti-CCP antibodies, CRP, RF and AKA were detected in 83.3%, 56.7%, 71.7% and 52% of patients respectively. HLA-DRB1*01 was found in 45% of patients and 35% of them had one or two HLA-DRB1*04 alleles. According to DRB1*04 subtypes, (DRB1* 0405) was present in of 80% them. For prediction of grade of activity, the independent predictors were anti-CCP (OR 19.6), and DRB1*04 positive allele (OR 5.1). The combination of DRB1*04 + anti-CCP antibodies gave increase in the specificity and positive predictive value to 92% and 90 respectively. As regards to the prediction of radiological joint damage, the independent predictors were HLA-DRB1*04, HLA-DRB1*01, RF, and CRP > 18 (OR 5.5, 4.5, 2.5, 2.0 respectively). Our findings suggest that anti-CCP2 is superior to RF for the detection of RA and provided predictive information on joint destruction and disease activity. The presence of RA associated antibodies (ACCP or RF) and/or the SE genes are indicative for a poorer radiological outcome and higher grade of activity.


Recent advances on host plants and expression cassettes' structure and function in plant molecular pharming.
Plant molecular pharming is a promising system to produce important recombinant proteins such as therapeutic antibodies, pharmaceuticals, enzymes, growth factors, and vaccines. The system provides an interesting alternative method to the direct extraction of proteins from inappropriate source material while offering the possibility to overcome problems related to product safety and source availability. Multiple factors including plant hosts, genes of interest, expression vector cassettes, and extraction and purification techniques play important roles in the plant molecular pharming. Plant species, as a biosynthesis platform, are a crucial factor in achieving high yields of recombinant protein in plant. The choice of recombinant gene and its expression strategy is also of great importance in ensuring a high amount of the recombinant proteins. Many studies have been conducted to improve expression, accumulation, and purification of the recombinant protein from molecular pharming systems. Re-engineered vectors and expression cassettes are also pivotal tools in enhancing gene expression at the transcription and translation level, and increasing protein accumulation, stability, retention and targeting of specific organelles. In this review, we report recent advances and strategies of plant molecular pharming while focusing on the choice of plant hosts and the role of some molecular pharming elements and approaches: promoters, codon optimization, signal sequences, and peptides used for upstream design, purification and downstream processing.


Role of amino acids as additives on sperm motility, plasma membrane integrity and lipid peroxidation levels at pre-freeze and post-thawed ram semen.
The possibility of including amino acids for cryopreservation of ram semen to improve the quality of frozen semen was explored in this study in sheep model. 24 samples were collected in triplicate from 8 rams of 2-3 year old Bannur cross bred rams maintained at the Institute Experimental Livestock Unit. Semen was diluted in tris-egg yolk glycerol diluent and made into 7 aliquots as follows: aliquot 1 served as control, "l-alanine" was added at 100 and 135mM in the aliquots 2 and 3, "l-glutamine" was added at 20 and 25mM in the aliquots 4 and 5 and "l-proline" was added at 25 and 50mM in the aliquots 6 and 7, respectively. Diluted semen was filled in 0.25ml French straws and frozen in LN2. Inclusion of "l-proline" and "l-glutamine" in the diluent increased the percent live sperm (P<0.001), total motility (P<0.05) and maintained higher functional membrane and acrosomal integrity (P<0.001) by decreasing lipid peroxidation (P<0.001) compared to the control group. In contrast, "l-alanine" decreased the percentage of total motility, fast progressive spermatozoa and increased (P<0.01) the percentage of immotile spermatozoa. It can be concluded that 20mM "l-glutamine" and 25mM "l-proline" can be used as semen additive to freeze ram semen as they prevented cryoinjuries to sperm and improved the pre-freeze and post-thaw semen characteristics.


Implementing a professional nursing practice philosophy and model: using affective methods to address resistance.
The desire of community hospitals to build more professionalism into nursing practice through the implementation of a practice philosophy and model can be driven by several factors, including practice needs, consistency, and/or a Magnet Recognition journey. The development team for this institution provided 30 2-hour sessions on professional practice to nurses on all shifts. This training was mandatory, with typical resistance for such programs. The rollout strategy wove cognitive and affective teaching methods that integrated head and heart, with very positive outcomes identified in postprogram evaluations.


The induced by an electromagnetic field coexistence of types I and II spectra in Weyl semimetals.
Due to their unique properties, Weyl semimetals (WSMs) are promising materials for the future electronics. Currently, the two types (I and II) of WSMs are discovered experimentally. These types of WSMs differ from each other in their topological properties. In this paper we showed that a coexistence of types I and II Weyls spectra is possible in some WSMs under crossed magnetic and electric fields. This is possible in systems with non-equivalent Weyl points (WPs). In particular, it is possible in strained WSMs. Such phase, controlled by electromagnetic field, is principally new for topological matter physics. It is obvious, that in this regime new features of electron transport will appear. We showed that this effect can also be considered as a mechanism of strain induced type-I-type-II transition.