The Caring Mission - Nursing Personnel's Inner Driving Force in End-of-Life Care.
Constantly facing human suffering and impending death can generate anxiety and insecurity in nursing personnel in end-of-life care. The aim of the study is to reveal nursing personnel's inner driving force in end-of-life care. A phenomenological hermeneutical method was used to search for meaning in the narrative data collected in this study. The structural analysis resulted in four themes: The appeal in the patient's vulnerability, The appeal in the patient's joy, Facing one's own existence in vulnerability, and Being at home with colleagues. Both vulnerability and joy motivated nursing personnel in caring. The care was often emotionally engaging and oscillated between grief and joy, which required a great deal from the nursing personnel both as professionals and fellow human beings. At the same time the emotionally engaging constituted an inner driving force, which gave them courage to do the best for the patients at the end of life.


Surgical management of ipsilateral breast tumor recurrence.
Approximately 10-15% of breast cancer patients treated by breast conserving surgery (BCS) and adjuvant radiotherapy (RT) will develop ipsilateral breast tumor recurrence (IBTR). International guidelines suggest total mastectomy as treatment of choice for IBTR following lumpectomy and RT. Nevertheless, there is evidence that second BCS might be equally sufficient. Patients with IBTR diagnosed between 1990 and 2014 after BCS and RT were included (n = 170). 34.1% women underwent secondary BCS, whereas 65.9% were treated by mastectomy. We determined predictive factors for time to local progression (TTP), disease free survival (DFS), and overall survival (OS) comparing these two groups. Median follow-up after primary IBTR was 49 months (59 months for patients still alive at time of analysis). Five-year IBTR-free rate after secondary BCS was 77.6% (SD ± 6.1%) and 75.0% (SD ± 4.5%) for patients after mastectomy. Five-year DFS was 57.3% (SD ± 8.2%), and 61.9% (SD ± 5.5%), five-year OS was 84.7% (SD ± 5.8%), and 72.6% (SD ± 5.1%), respectively. Prior adjuvant systemic therapy, muscular invasion, and skin infiltration were independent significant risk factors for a shorter TTP. Additionally, lymphovascular infiltration (LVI) in the IBTR increased the risk for a shorter DFS. LVI, muscular invasion, and skin infiltration were identified as independent significant risk factors for a shorter OS. No significant difference in local control, DFS, and OS was seen between IBTR patients treated either by secondary BCS or mastectomy. Our data suggest that secondary BCS for IBTR patients after initial BCS and RT is feasible in selected patients.


Raised platelet levels in diabetes mellitus complicated with nephropathy.
To study if elevated platelet levels are found in early and late diabetic nephropathy. A retrospective study was performed of platelet count in different subgroups of patients with insulin-dependent diabetes mellitus, including patients with long and short duration of diabetes and with early signs of nephropathy. Patients with severe renal failure subjected to renal transplantation were also included. The results suggest that raised platelet levels were associated with early signs of diabetic nephropathy and with female gender. Amongst diabetics progressing to uraemia leading to renal transplant, the platelet level was 50% higher than in non-diabetic uraemic patients. It is concluded that raised platelet levels are a common finding in patients with diabetes mellitus complicated by nephropathy.


Dose-dependent and time-dependent action of oxytocin on chick memory.
Experiments were conducted to investigate the dose-related and time-dependent effects of oxytocin on memory for a one-trial conditioned taste aversion task using two-day old chicks. Oxytocin was administered intracerebrally 1 min posttraining to 5 groups of chicks in dose levels differing by a factor of 10 and ranging from 5.0 pg to 50 ng. A second experiment tested the time-dependent nature of the neuropeptide's action. In this experiment the oxytocin (5.0 ng) was administered at either 1 min, 9 min or 59 min posttraining. In both experiments saline-injected control groups were included. The taste aversion training for all experiments consisted of presenting an attractive lure, coated with an aversive liquid (EtOH), to each chick for a 10-s training trial. Most chicks pecked 1 or 2 times at the lure before inhibiting any further response. The retention testing took place 24 h after the training and consisted of presenting the dry, uncoated lure to each chick for an additional 10 s. Chicks that avoided pecking at the lure were considered to have exhibited enhanced retention. The groups of chicks receiving 50 pg to 50 ng of oxytocin exhibited enhancement of retention, as did the 1 min group of the time-dependent experiment. These results are compared to the effects on memory consolidation in chicks induced by vasopressin and L-prolyl-L-leucyl-glycineamide. The apparent conflict between these results and those obtained in mammalian studies with oxytocin are discussed.


Susceptibility-guided sequential strategy versus empirical therapy for Helicobacter pylori infection: study protocol for a randomised controlled trial.
New treatment strategies are required against infections caused by Helicobacter pylori, which grows increasingly resistant to antibiotics. Polymerase chain reaction-based methods for antibiotic susceptibility testing are available for detecting H. pylori-specific mutations that confer resistance to clarithromycin and levofloxacin. Several meta-analyses have compared eradication rates for susceptibility-guided versus empirical therapy for H. pylori treatment; however, all have significant limitations and high heterogeneity, and the results are contradictory. The main objective of this trial is to assess whether a sequential strategy based on molecular susceptibility testing-guided therapy for H. pylori has a better eradication rate than empirical therapy. This trial is designed as a prospective, randomised, open-label, active-controlled and single-centre study. Men and women who are H. pylori-positive, naïve to treatment, and aged 18-65 years will be recruited. A total of 500 participants will be randomised to receive either empirical therapy or a susceptibility-guided sequential strategy. Bismuth quadruple therapy will be the empirical first-line therapy, and in case of failure, high-dose dual (proton-pump inhibitor + amoxicillin) treatment will be the rescue therapy. For the susceptibility-guided sequential strategy, regimen selection will be based on H. pylori susceptibility to clarithromycin (first-line) and levofloxacin (rescue). A first-line treatment of clarithromycin triple therapy will be selected for clarithromycin-sensitive strains. For clarithromycin resistance, a high-dose dual therapy will be selected. During the rescue treatment, a levofloxacin quadruple regimen will be selected for levofloxacin-sensitive strains, and a furazolidone quadruple regimen will be selected for others. The primary outcome is the first-line eradication rate in both groups, and the overall (including first and rescue therapies) H. pylori eradication rate in both groups is one of the secondary outcomes. The eradication rates of H. pylori will be analysed by intention-to-treat analysis, modified intention-to-treat analysis, and per-protocol analysis. This randomised controlled trial will provide objective and valid evidence about the value of polymerase chain reaction-based molecular methods for antibiotic susceptibility testing in guiding H. pylori eradication. Clinicaltrials.gov NCT05549115. Released on 18 September 2022. First posted on 22 September 2022. Enrolment of the first participant on 20 September 2022. The study is retrospectively registered.


Trends in Substance Use Among 6th- to 10th-Grade Students From 1998 to 2010: Findings From a National Probability Study.
Of the handful of national studies tracking trends in adolescent substance use in the United States, only the Health Behavior in School-Aged Children (HBSC) study collects data from 6th through 10th graders. The purpose of this study was to examine trends from 1998 to 2010 (four time points) in the prevalence of tobacco, alcohol, and marijuana use among 6th through 10th graders. Differences in trends by grade, gender, and race/ethnicity were examined for each substance use behavior, with a primary focus on trends for sixth and seventh graders. Overall, there were significant declines in tobacco, alcohol, and marijuana use from 1998 to 2010. The declines were largest for the younger grades, which suggest promise for future declines among high school students as these cohorts age into high school.


Diabetic ketoacidosis (DKA) in type 1 diabetes mellitus (T1DM) temporally related to COVID-19 vaccination.
SARS-CoV-2 pandemic has claimed millions of lives since its first identification in December 2019. Patients with diabetes are at a high risk of adverse outcomes after COVID-19 infection, whereas infection itself can be associated with severe hyperglycemia, including hyperglycemic emergencies. While the accelerated vaccine development and rollout have considerably decreased morbidity and mortality with reasonable safety, there are emerging reports of worsening of hyperglycemia in response to vaccination, with possible shared pathophysiology with COVID-19 infection-related hyperglycemia. We hereby report two young patients with type 1 diabetes (T1DM) who presented with severe diabetic ketoacidosis (DKA) after receiving second doses of COVISHIELD (ChAdOx1 nCoV-19) and COVAXIN (BBV152- inactivated whole virion) vaccines. Though a causal link cannot be established, post-vaccination immune response can potentially explain this transient worsening of hyperglycemia and hyperglycemic emergencies. We, hence report diabetic ketoacidosis (DKA) following COVID-19 vaccination in T1DM. We suggest that people with diabetes, particularly patients with T1DM with inadequate glycemic control should ideally be closely monitored for hyperglycemia and ketonemia for at least 2 weeks after receiving vaccination for COVID 19.


Noncommutativity of eye rotations and the half-angle rule.
In order to produce kinematically efficient behavior when dealing with the noncommutativity of rotations, the oculomotor system has developed strategies such as the half-angle rule. In this issue of Neuron, Ghasia and Angelaki demonstrate that during smooth pursuit eye movements the half-angle rule is implemented by the mechanical properties of the eye plant.


Correlation between tumour size, metastatic spread and galactosyl transferase activity in cyclophosphamide-treated mice bearing the Lewis lung carcinoma.
Galactosyl transferase activity was measured in tumour and normal tissues of mice receiving cyclophosphamide treatment for Lewis lung carcinoma. Animals which responded to cyclophosphamide therapy had significantly smaller tumours with fewer metastases than the untreated mice. The level of galactosyl transferase was significantly reduced in the tumours which were inhibited by the cyclophosphamide treatment.


A test of the tripartite model's prediction of anhedonia's specificity to depression: patients with major depression versus patients with schizophrenia.
The tripartite model of depression and anxiety suggests that anhedonia represents a relatively specific marker of depression. A strong version of this view is that anhedonic symptoms would particularly characterize depressed patients, even when compared to another diagnostic group-schizophrenic patients-for whom anhedonic symptoms represent a well-studied feature. This prediction was tested among 102 VA psychiatric inpatients (95 men), ages 21-72 (M=43.56; S.D.=8.47), all of whom received diagnoses of either major depression (n=50) or schizophrenia (n=52) based on structured diagnostic interviews. As predicted, patients with major depression scored significantly higher on the anhedonic symptoms scale of the Beck Depression Inventory (BDI) than did patients with schizophrenia. However, there was no difference between the two groups on the BDI total score or the BDI non-anhedonic symptoms score. Consistent with the tripartite model, anhedonic symptoms were more related to depressive vs. schizophrenic diagnostic status, whereas non-anhedonic depressive symptoms were not. Within the study's limitations, results were interpreted as relatively strong support for the validity and extension of the tripartite model.


Resident physician's knowledge and attitudes toward biostatistics and research methods concepts.
To assess the knowledge and attitudes of resident physicians toward biostatistics and research methodology concepts. We conducted a cross-sectional study between November 2014 and October 2014 at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. A self-administered questionnaire was distributed to all participants. The response rate was 90%. One hundred sixty-two resident completed the questionnaire. Most residents were well-informed in basic concepts, such as, "P" values, study power, and case control studies; more than half had confidence in interpreting the results of scientific papers. Conversely, more than 67% of the residents were not knowledgeable on more sophisticated terms in biostatistics. Residents with previous training in evidence-based medicine (EBM) (p=0.05) and non-specialist residents (p=0.003) were more likely to have better knowledge scores. Females (p=0.003), and those with previous training in biostatistics and epidemiology had positive attitude toward biostatistics (p less than 0.001 in both cases). Residents who read medical journals scored lower than those who never read journals (p=0.001). Prior courses in EBM, as well as male gender were associated with knowledge scores. Reinforcing training after graduation from medical school with special focus on integrating biostatistics with epidemiology and research methods is needed.


Health Extension Workers' Knowledge and Knowledge-Sharing Effectiveness of Optimal Infant and Young Child Feeding Are Associated With Mothers' Knowledge and Child Stunting in Rural Ethiopia.
Little is known about how the knowledge and the knowledge-sharing effectiveness (KSE) of health extension workers (HEWs) affect maternal knowledge of optimal infant and young child feeding (IYCF) and their child's nutritional status. The objective of this study was to evaluate mothers' and HEWs' knowledge of key IYCF practices and to investigate whether mothers' knowledge and HEWs' KSE are associated with stunting in young children (aged 12-23 months). This cross-sectional study used face-to-face interviews to assess the IYCF knowledge of HEWs (n = 96) and mothers of 12- to 23-month-old children (n = 122) in Mecha district, West Gojam, Ethiopia. The association between HEWs' KSE and children's length-for-age z scores (LAZ) was investigated. Stunting (50%), underweight (34%), and wasting (10%) were highly prevalent. Less than half (45%) of the mothers had access to nutrition education through the health extension program, but those who had, had better knowledge of IYCF practices and thus lower rates of stunting ( P < .001). However, key IYCF practices were not well understood by the HEWs and this affected their KSE. The gap in KSE was negatively associated with LAZ ( r = -.475, P < .001) and remained significant even after adjusting for maternal height, socioeconomic status, and maternal education ( r = -.423, P = .002). Health extension workers' KSE is associated with child stunting. Future training of HEWs would benefit from emphasis on not only the content of the IYCF messages but also the process of delivery while increasing their counseling skills.


Factors influencing maternal responsiveness in humans: usefulness of an animal model.
In this article we review some of the hormonal, sensory and experiential factors that regulate the onset and early maintenance of maternal responsiveness in rat and human mothers. We discuss data suggesting that, in humans, pregnancy is associated with changes in feelings and attitudes that may bear on adjustment to motherhood postpartum. Preliminary studies indicate that these changes are probably not hormonally mediated but are associated with a variety of psychosocial factors. Once women give birth, there is some suggestion that they undergo a period of elevated "responsiveness" which may be influenced by puerperal hormones and during which experiences with the newborn take on a special salience. Following the early postpartum period, a variety of factors influence maternal responsiveness, including the mother's affective state, her social relationships, and experiences caring for young. We discuss the relative contributions of psychological and physiological influences to maternal responsiveness at different stages of the maternity cycle.


Hybrid thermochemical/biological processing: putting the cart before the horse?
The conventional view of biorefineries is that lignocellulosic plant material will be fractionated into cellulose, hemicellulose, lignin, and terpenes before these components are biochemically converted into market products. Occasionally, these plants include a thermochemical step at the end of the process to convert recalcitrant plant components or mixed waste streams into heat to meet thermal energy demands elsewhere in the facility. However, another possibility for converting high-fiber plant materials is to start by thermochemically processing it into a uniform intermediate product that can be biologically converted into a bio-based product. This alternative route to bio-based products is known as hybrid thermochemical/biological processing. There are two distinct approaches to hybrid processing: (a) gasification followed by fermentation of the resulting gaseous mixture of carbon monoxide (CO), hydrogen (H(2)), and carbon dioxide (CO(2)) and (b) fast pyrolysis followed by hydrolysis and/or fermentation of the anhydrosugars found in the resulting bio-oil. This article explores this "cart before the horse" approach to biorefineries.


Development of polymorphic microsatellite markers for Cymbidium goeringii (Orchidaceae).
Microsatellite markers were developed in Cymbidium goeringii to investigate its genetic diversity and population genetic structure. From a microsatellite-enriched genomic library, 21 novel polymorphic microsatellites were isolated. The polymorphic patterns were verified in four populations (East Korea, West Korea, China, and Japan). The number of alleles per locus ranged from 11 to 29 with a mean of 20.29. The observed and expected heterozygosities varied from 0.272 to 0.799 and from 0.461 to 0.911, respectively. These microsatellite markers will be useful tools for understanding genetic variation and population ecogenetic structure in C. goeringii.


Ethnic identification, social disadvantage, and mental health in adolescence/young adulthood: results of a 25 year longitudinal study.
To examine the role of cultural identity and social disadvantage/childhood adversity in a birth cohort of 984 young people studied to the age of 25. Data were gathered on mental health, cultural identification, socioeconomic factors and childhood adversity as part of a longitudinal study of a New Zealand birth cohort (the Christchurch Health and Development Study). Those with sole Māori identity had rates of disorder that were 1.28-fold higher than those of non- Māori; those of Māori/other identity had rates of disorder that were 1.57-fold higher than non- Māori. Regression analyses suggested that the elevated rates of mental disorder among Māori were largely explained by their higher exposure to socioeconomic disadvantage and childhood adversity. But even after adjustment, being of sole Māori identity was a protective factor that reduced rates of mental disorder among Māori. Risk and protective factors associated with the mental health of young Māori involve an interplay between levels of exposure to social disadvantage/childhood adversity and cultural identity, with secure cultural identity being a factor that may mitigate the effects of exposure to adversity.


Erratum: Electronic cigarette use and its association with asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome among never cigarette smokers.
[This corrects the article DOI: 10.18332/tid/142579.].


Reduced GABAA receptor α6 expression in the trigeminal ganglion enhanced myofascial nociceptive response.
Activation of the GABAA receptor results in inhibition of neuronal activity. One subunit of this multi-subunit receptor termed alpha 6 (Gabrα6) contributed to inflammatory temporomandibular joint (TMJ) nociception but TMJ disorders often include myofascial pain. To address Gabrα6 role in myofascial pain we hypothesized that Gabrα6 has an inhibitory role in myofascial nociceptive responses similar to inflammatory TMJ arthritis. To test this hypothesis a, myofascial nociceptive response was induced by placing a ligature bilaterally on the tendon attachment of the anterior superficial part of a male rat's masseter muscle. Four days after ligature placement Gabrα6 expression was reduced by infusing the trigeminal ganglia (TG) with small interfering RNA (siRNA) having homology to either the Gabrα6 gene (Gabrα6 siRNA) or no known gene (control siRNA). After siRNA infusion nociceptive behavioral responses were measured, i.e., feeding behavior and head withdrawal after pressing upon the region above the ligature with von Frey filaments. Neuronal activity in the TG and trigeminal nucleus caudalis and upper cervical region (Vc-C1) was measured by quantitating the amount of phosphorylated extracellular signal-regulated kinase (p-ERK). Total Gabrα6 and GABAA receptor contents in the TG and Vc-C1 were determined. Gabrα6 siRNA infusion reduced Gabrα6 and GABAA receptor expression and significantly increased the nociceptive response in both nociceptive assays. Gabrα6 siRNA infusion also significantly increased TG p-ERK expression of the ligated rats. From these results we conclude GABAA receptors consisting of the Gabrα6 subunit inhibit TG nociceptive sensory afferents in the trigeminal pathway and have an important role in the regulation of myofascial nociception.


Cotransport and deposition of colloidal polystyrene microplastic particles and tetracycline in porous media: The impact of ionic strength and cationic types.
The cotransport behaviors of colloidal polystyrene microplastic particles (PSMPs) and tetracycline (TC) (20 mg/L) were investigated in saturated porous media in KCl and CaCl2 solutions of various ionic strengths (1, 10, 50, 100 mM). Furthermore, the effects of TC concentration (0, 1, 5, 10, 20 mg/L) on the cotransport behaviors of PSMPs and TC in 100 mM KCl solution were assessed. The cotransport behaviors were analyzed by comparing the individual transport behaviors of PSMPs or TC. When cotransported, the presence of TC (20 mg/L) slightly inhibited PSMPs mobility in K+ solutions (the C/C0 decreased in the range of 0-5.9%), but facilitated it in Ca2+ solutions (the C/C0 increased in the range of 6.7-42.6%). In KCl solutions, although the presence of TC (PSMPs) did not significantly affect the transport behaviors of PSMPs (TC), the attachment efficiencies of both PSMPs and TC showed a non-linear and non-monotonic change with increase in ionic strength. However, in CaCl2 solutions, the effects of TC (PSMPs) on the transport behaviors of PSMPs (TC) were remarkable and a non-linear non-monotonic change was observed. The adsorption of TC on PSMPs might play a critical role during the cotransport. Thus, the balance between the transport-inhibiting (e.g., the reduction in electrostatic repulsive force) and transport-facilitating effects (e.g., the effects on hydrophilicity/hydrophobicity of PSMPs due to TC adsorption) may be responsible for the observed changes. Overall, the results demonstrated that the cotransport behaviors of PSMPs and TC were more complicated than their individual transport behaviors in porous media, which might vary considerably with environmental conditions. This work could greatly improve our understanding of complex cotransport behaviors and environmental risk of PSMPs.


A survey of ethnomedicinal plants used to treat cancer by traditional medicine practitioners in Zimbabwe.
Traditional medicine plays an important role in health care provision in the developing world. A number of cancer patients have been found to be using traditional medicine as primary therapy and/or as complementary medicine. Cancer is one of the leading causes of morbidity and mortality globally among the non-communicable diseases. The aim of this study was to identify the plants used by traditional medicine practitioners (TMPs) in Zimbabwe to treat cancer. A structured questionnaire was used to interview consenting registered TMPs on ethnomedicinal plants they use to treat cancer. A review of published literature on the cited plants was also carried out. The practitioners were asked about the plants that they use to treat cancer, the plant parts used, type of cancer treated, other medicinal uses of the plants and preparation and administration of the plant parts. Twenty (20) TMPs took part in the study. A total of 18 medicinal plant species were cited. The commonly treated types of cancer were breast, prostate, colon, skin and blood cancers with most plants being used to treat skin, blood and breast cancers, respectively. Of the medicinal plants cited, 44.4% were used to treat all cancer types. The most used plant parts were the roots (72.2%) and leaves (72.2%) followed by the bark (38.9%). The medicinal plants were used for multiple ailments. The most common plant preparation methods were infusion (72.2%) and decoction (66.7%) and the oral route of administration, as extracts and powder put in tea and porridge, was the most used. The frequently used plant parts were leaves and roots. The traditional uses of the medicinal plants cited in this study resonate well with their reported uses from other ethnopharmacological studies done in other parts of the world. The plants used by TMPs to treat cancer in Zimbabwe, if adequately explored, can be instrumental in the discovery and development of cancer drugs.


Significant histological changes and satisfying antiviral efficacy in chronic hepatitis B virus infection patients with normal alanine aminotransferase. Antiviral therapy decision in chronic HBV patients with normal ALT.
A proportion of chronic hepatitis B virus (HBV) infection patients with normal alanine aminotransferase (ALT) should start antiviral therapy based on liver biopsy. We aim to evaluate the proportion of such patients, find noninvasive methods for identifying and then evaluate antiviral efficacy. 253 chronic HBV infection patients with normal ALT were analyzed at baseline and 57 patients with histological indication for antiviral therapy (Histology activity index ≥5 and/or Ishak fibrosis score ≥3) and 140 patients with elevated ALT received entecavir therapy and were followed-up to 78 weeks with a second liver biopsy in this multi-center study. 127 (50.2%) of 253 patients with normal ALT fulfilled histological indication for antiviral therapy. Aspartate aminotransferase (P=0.049), anti-hepatitis B virus core antibody (P=0.001) and liver stiffness measurement (P=0.000) were independent variables for identifying histological indication for antiviral therapy. A noninvasive model (AAF) performed best among independent variables and other noninvasive models with area under the operating characteristic curve of 0.887. Antiviral efficacy showed that 38 (66.7%) of 57 patients had undetectable HBV DNA. 12 (41.4%) of 29 patients who were hepatitis B e antigen (HBeAg)-positive at baseline achieved HBeAg loss and 3 (10.3%) achieved HBeAg seroconversion. 25 (43.9%) of 57 patients achieved histological response. Moreover, 57 patients with normal ALT had a similar antiviral therapy efficacy with 140 patients with elevated ALT (P>0.1) except proportion of inflammation improvement and histological response (P=0.005, P=0.049). Half of chronic HBV patients with normal ALT should start antiviral therapy based on liver biopsy. A noninvasive model could be used as a reliable tool for antiviral therapy decision. Patients with normal or elevated ALT had a similar antiviral efficacy.


Is systematic screening for thyroid disorders indicated in subfertile men?
Data on the prevalence of thyroid disorders in male subfertility remain scarce. To investigate the prevalence of thyroid dysfunction and thyroid autoimmunity in men with normal and abnormal semen characteristics. Tertiary referral center for reproductive medicine of the University Hospital AZ-VUB, Brussels, Belgium. Two hundred and ninety-two men were stratified according to the presence of normal (group 1; n = 39) or abnormal (group 2; n = 253) semen characteristics. Thyroid function was assessed by serum thyrotropin (TSH) and free thyroxine (FT4), and thyroid peroxidase antibodies (TPO-Ab) for thyroid autoimmunity (TAI or TPO-Ab > 34 kU/l); both were correlated with semen characteristics. Semen characteristics were determined by World Health Organisation criteria (rapid + slow motility > or = 50% and concentration > or = 20 x 10(6)) and Kruger criteria (morphology > or = 14% normal cells). In group 1, the mean (+/- s.d.) age was 33 +/- 4 years; serum TSH was 1.6 (0.3-29.6) mU/l (median (range)) and FT4 was 12.2 (8.8-15.6) ng/l. In group 2, the mean age was 33 +/- 5 years, serum TSH was 1.3 (0.3-5.2) mU/l and FT4 was 12.5 (8.4-17.5) ng/l; (compared with group 1 P = 0.008 for TSH and P = 0.037 for FT4). In both groups, one patient had increased TSH (2.6% and 0.4%; P = not significant (ns)). In group 1, one patient had TAI and in group 2 twelve patients had TAI (2.6% compared with 4.7%; P = ns). FT4 was an independent determinant for semen characteristics. The prevalence of thyroid dysfunction and autoimmunity is comparable between men with normal and abnormal semen characteristics. On the basis of these data, we do not advise systematic screening for thyroid disorders in subfertile men consulting a tertiary referral center for reproductive medicine.


The effect of prebiotic vaginal gel with adjuvant oral metronidazole tablets on treatment and recurrence of bacterial vaginosis: a triple-blind randomized controlled study.
Bacterial vaginosis is a change in the normal vaginal bacterial flora that leads to loss of hydrogen peroxide producing lactobacilli and overgrowth of predominantly anaerobic bacteria. The present study was conducted to compare the effects of prebiotic vaginal gel with oral metronidazole tablet and metronidazole tablet alone on treatment and recurrence of bacterial vaginosis. The present triple-blind randomized clinical trial was conducted in Sadatmandi Hospital in Robat-Karim town, where 100 patients were randomly divided into intervention (receiving a 5 mg prebiotic vaginal gel applicator plus three 250 mg metronidazole tablets per day for 7 days) and control (receiving a 5 mg placebo vaginal gel applicator and three 250 mg metronidazole tablets per day for 7 days) groups. Then, patients were assessed for bacterial vaginosis on 90 ± 3 day after treatment. Data collected were analyzed in SPSS-21 using Chi square, repeated measures, and student's t tests at a significance level of P < 0.05. The results obtained showed no significant difference between the two groups in terms of personal and social characteristics, clinical complaints, or laboratory markers. On the 10th day, healing rate based on Amsel and Nugent criteria was 76% in the intervention group and 30% in the control group [odds ratio (OR) 4.3; 95% confidence interval (CI) 2.7-9.4]. On the 90th day, healing rate was 84% in the intervention group and 62% in the control group (OR 3.7; 95% CI 1.3-8.9). Adjuvant treatment with prebiotic vaginal gel improves the efficacy of bacterial vaginosis treatment.


Results of a case-detection programme for alpha1-antitrypsin deficiency in COPD patients.
Alpha1-antitrypsin (alpha1-AT) deficiency is an underdiagnosed condition in patients with chronic obstructive pulmonary disease (COPD). The present authors have conducted a nationwide case detection programme of alpha1-AT deficiency in unselected patients with COPD using dried blood spots. The first phase analysed samples from 971 patients by determining alpha1-AT concentrations and identifying the deficient Z allele by genotyping using rapid real-time PCR. The second phase analysed 1,166 samples with alpha1-AT concentrations and identified both the S and the Z allele, but only in samples with low alpha1-AT concentrations. A total of eight (0.37%) individuals with the severe deficiency PiZZ were detected. In addition, three patients were identified with the PiSZ genotype in the second phase (0.3%). The global cost of the programme was 41,512, which represents 19.42 per sample and 5,189 per PiZZ detected. A sensitivity analysis demonstrated that performing Z genotype to all samples would have resulted in increased costs of 28 per sample and 7,479.5 per PiZZ case identified. In conclusion, a case detection programme of alpha1-antitrypsin deficiency in patients with chronic obstructive pulmonary disease using dried blood spots is feasible and at a reasonable cost per case detected. Diagnostic yield and costs depend largely on inclusion criteria and the protocol for processing of samples.


Release of slow reacting substance from the guinea-pig lung by phospholipases A2 of Vipera russelli snake venom.
Phospholipases A2 (PLA2) of Vipera russelli venom were isolated by column chromatography. The ability of PLA2 fractions to release slow reacting substance (SRS) was studied in the guinea-pig lung perfused with Krebs' solution. The relationship between the perfusion pressure change produced by PLA2 and SRS release was also studied. Two PLA2 fractions (II-5 and III-3; 3-100 micrograms), injected into the lung increased the perfusion pressure and released SRS. Pretreatment of the lung with indomethacin (10 micrograms) reduced the pressure response induced by the PLA2 fractions. The SRS released in the lung effluent by PLA2 was identified by bioassay as a mixture of thromboxane A2 (TXA2), prostacyclin (PGI2) and leukotrienes. TXA2 and PGI2 release was also quantitated by radioimmunoassay of the degradation products TXB2 and 6-keto-PGF1 alpha, respectively. There was a positive linear correlation between the pressure increases and the ratios of TXB2 to 6-keto-PGF1 alpha (r = 0.87). It appears that the relative amounts of TXA2 and PGI2 released determine the effects of PLA2 fractions on the guinea-pig lung. The release of arachidonic acid metabolites, prostaglandins and leukotrienes may account for part of the hypotensive action of PLA2.


Case 10: venous leg ulcer that was significantly impairing quality of life.
This heavily exuding, sloughy ulcer was so painful that the patient had difficulty tolerating any physical contact with it. After treatment, pain levels subsided, so that she was better able to tolerate dressing changes, could sleep in her own bed instead of a chair, and started compression therapy.


Histoplasmosis and subcutaneous nodules in a kidney transplant recipient: erythema nodosum versus fungal panniculitis.
Erythema nodosum (EN)-like lesions are a rare occurrence after solid organ transplantation. Differential diagnosis includes infective panniculitis, which can be a feature of progressive disseminated histoplasmosis (PDH), an uncommon but severe form affecting primarily immunocompromised hosts. We report on a fatal case of PDH, which presented as fungal panniculitis masquerading as EN in a renal allograft recipient 25 years after transplantation. We discuss the clinical, histopathological, and microbiological characteristics of this rare complication, with focus on its distinction from EN. This case emphasizes the central role of biopsy in transplant recipients presenting with cutaneous lesions, and the importance of clinicopathologic correlation and complementary microbiological investigations.


Pearls, pitfalls, and surgical indications of the Intuity TM heart valve: A rapid deployment bioprosthesis. A systematic review of the literature.
To highlight short- and long-term clinical outcomes of the Intuity TM rapid deployment prosthesis for surgical aortic valve replacement. We reviewed on PubMed/MEDLINE, Embase, SciELO, LILACS, CCTR/CENTRAL, and Google Scholar for clinical trials, retrospective clinical studies, meta-analysis, and gray literature. Fourty-five clinical studies with 12.714 patients were included in the analysis. Thirty-day mortality ranged from 3.8% for Intuity and 3.9% for transcatheter aortic valve replacement (TAVR). The incidence of paravalvular leak (PVL) (Intuity 0% and TAVR 2.17%), permanent pacemaker implantation (Intuity 11.11% and TAVR 12.5%), stroke (Intuity 2.2% and TAVR 2.6%), myocardial infarction (MI) (Intuity 0% and TAVR 1%), were all higher in the TAVR group. Compared to other sutured bioprosthesis (SB), mortality ranged from 0% to 3.9% for Intuity and 0%-6.9% for SB. Long-term cardiac mortality ranged from 0.9% to 1.55% for Intuity and 1.4%-3.3% for the Perceval valve. The incidence of PVL (Intuity 0.24%-0.7% and Perceval 0%-1%), endocarditis (Intuity 0.2%-0.7% and Perceval 1.6%-6.6%), stroke (Intuity 0.36%-1.4% and Perceval 0%-0.8%), MI (Intuity 0.07%-0.26%), and SVD (Intuity 0.12%-0.7% and Perceval 0%) were comparable. Compared to standard full sternotomy (SFS), minimally invasive surgery (MINV) mortality ranged from 0% to 4.3% for MINV and 0%-2.1% for SFS. Hospital costs outcomes ranged from $37,187-$44,368 for the Intuity, $69,389 for TAVR, and $13,543 for SB. Intuity short-term mortality ranged between 0.9% and 12.4% while long-term mortality ranged between 2.6% and 20%. This manuscript provides a 360° overview of the current rapid deployments, sutureless, and TAVR prosthesis.


Bariatric tourists. Foreign bariatric patients treated in Poland - a survey based study.
Introduction: Bariatric procedures are becoming more popular worldwide. We present a current situation of foreign patients treated by high-volume bariatric surgeons in Poland in 2016.
Material and Methods: We sent an online survey to twenty high-volume bariatric surgeons. The questionnaire regarded the year 2016. We asked for number and types of bariatric procedures performed or supervised, number of foreign bariatric patients, their qualification process, country of origin, types of procedure, and post-op recommendations.
Results: We received 9 surveys (45%). Five surgeons performed or supervised from 100 to 300 bariatric procedures, 2 performed or supervised over 300 procedures, 2 performed or supervised from 50 to 100 procedures. All of the respondents performed laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LRYGB), four carried out mini gastric bypass, two - gastric banding (LAGB), one - SADI-S and duodenal switch (DS). Six surgeons operated on the total of 64 foreign patients, mainly performing LSG, LRYGB and mini gastric bypass. Most of the patients were qualified based on international criteria [body mass index (BMI) over 40 kg/m2 or BMI over 35 kg/m2 with comorbidities]. United Kingdom was the most popular country of origin, followed by Germany, USA, Ireland and Sweden. Qualification for surgery was based on a personal visit. After surgery, 83.3% (n = 5) of the respondents gave out discharge documents in English, recommending long-term bariatric follow-up in the country of origin. Every respondent carried out 3-month personal follow-up of every foreign patient.
Conclusions: Foreign bariatric patients travelling to Poland are qualified for surgery according to known international standards. Most of the patients receive post-op discharge documents in English, with a 3-month follow-up performed by their surgeon. Further bariatric supervision in the country of origin is routinely recommended.


Demographic correlates of variable egg survival for a tropical lizard.
Anolis limifrons is a small iguanid lizard that is found in lowland rainforest in Central America. Important life attributes include early maturity (3-4 mo), multiple clutches of a single egg per breeding season, and low survival. Population turnover is essentially annual as less than 5% adults live more than one year. My objectives were to resolve the following specific questions: 1) Where are eggs laid? 2) Does survival differ among different types of oviposition site? 3) How is the survival of eggs related to the density and age distribution of lizards at different areas? Most eggs are laid beneath litter on the ground. Eggs laid aboveground are placed in accumulations of soil and litter in stumps, crevices in buttressed trees and vines, holes in trees, and on the tops of logs. Eggs were found in aboveground sites in proportion to the abundance of those sites. The major cause of mortality was predation by Solenopsis ants. Judging by the ratio of eggs known to have hatched to those that were predated, survival did not differ among the various types of oviposition site. Study areas with high egg survival in the middle of the wet season had relatively more young (<4-6 mo old) lizards at the end of the wet season than areas with low egg survival. The strong correlation between the relative number of young individuals and egg survival is a consequence of the seasonal cycle of growth and reproduction. Most eggs are laid in the wet season (May-December). Hatchlings complete growth during the dry season (January-April) and become reproductive adults in their second wet season. However, because hatchlings can grow to reproductive size in approximately 3 months, individuals that hatch early in the wet season may themselves produce offspring that will be <4-6 mo old in the late wet season. The relative survival of juveniles (eggs) and adults is an important datum for many theories of life history evolution. For A. limifrons, survival of eggs was two to three times more variable than survival of lizards on both temporal and spatial scales. Comparative data for reptiles are not available to put this information into an evolutionary prespective.


Cloning and characterization of a glycosyltransferase from Catharanthus roseus for glycosylation of cardiotonic steroids and phenolic compounds.
To characterize a glycosyltransferase (UGT74AN3) from Catharanthus roseus and investigate its specificity toward cardiotonic steroids and phenolic compounds. UGT74AN3, a novel permissive GT from C. roseus, displayed average high conversion rate (> 90%) toward eight structurally different cardiotonic steroids. Among them, resibufogenin, digitoxigenin, and uzarigenin gave 100% yield. Based on LC-MS, 1H-NMR and 13C-NMR analysis, structure elucidation of eight glycosides was consistent with 3-O-β-D-glucosides. We further confirmed UGT74AN3 was permissive enough to glycosylate curcumin, resveratrol, and phloretin. The cDNA sequence of UGT74AN3 contained an ORF of 1,425 nucleotides encoding 474 amino acids. UGT74AN3 performed the maximum catalytic activity at 40 °C, pH 8.0, and was divalent cation-independent. Km values of UGT74AN3 toward resibufogenin, digitoxigenin, and uzarigenin were 7.0 µM, 12.3 µM, and 17.4 µM, respectively. UGT74AN3, a glycosyltransferase from a noncardenolide-producing plant, displayed catalytic efficiency toward cardiotonic steroids and phenolic compounds, which would make it feasible for glycosylation of bioactive molecules.


Differentiating human keratinocytes are deficient in p53 but retain global nucleotide excision repair following ultraviolet radiation.
Terminally differentiating keratinocytes constitute the predominant cell type within the skin epidermis and play an important role in the overall photobiology of human skin following ultraviolet radiation. However, the DNA repair capacity of differentiating keratinocytes is unclear, and little is known regarding how such repair activity is regulated in these cells. We systematically compared the global genomic nucleotide excision repair response of cultured undifferentiated human keratinocytes to those that were allowed to differentiate in 1.2 mM Ca(2+), in some cases supplemented with phorbol ester or Vitamin C. Differentiated cells ceased replication and expressed typical markers of differentiation. Following ultraviolet radiation, keratinocytes that were differentiated up to 12 days removed cyclobutane pyrimidine dimers and pyrimidine(6,4)pyrimidone photoproducts from the global genome as efficiently as undifferentiated cells. However, following the onset of calcium-induced differentiation, basal levels of p53 were nearly undetectable by 12 days of differentiation when global repair activity was unaffected. Following ultraviolet radiation, induction of p53 following ultraviolet radiation was abrogated by 6 days of calcium-induced differentiation. Basal levels of mRNA encoding the DNA damage recognition proteins, XPC and DDB2, were relatively insensitive to differentiation and p53 levels. However, following ultraviolet radiation, inductions of mRNA encoding the DNA damage recognition proteins, DDB2 and XPC, were differentially affected by differentiation. Rapid loss of DDB2 mRNA induction was associated with differentiation, while XPC mRNA induction diminished more slowly with differentiation. These results indicate that human keratinocytes preserve global nucleotide excision repair as well as expression of genes encoding key DNA damage recognition proteins well into the terminal differentiation process, perhaps using mechanisms other than p53.


Valorization of sugarcane bagasse by chemical pretreatment and enzyme mediated deconstruction.
After chemical pretreatment, improved amenability of agrowaste biomass for enzymatic saccharification needs an understanding of the effect exerted by pretreatments on biomass for enzymatic deconstruction. In present studies, NaOH, NH4OH and H2SO4 pretreatments effectively changed visible morphology imparting distinct fibrous appearance to sugarcane bagasse (SCB). Filtrate analysis after NaOH, NH4OH and H2SO4 pretreatments yielded release of soluble reducing sugars (SRS) in range of ~0.17-0.44%, ~0.38-0.75% and ~2.9-8.4% respectively. Gravimetric analysis of pretreated SCB (PSCB) biomass also revealed dry weight loss in range of ~25.8-44.8%, ~11.1-16.0% and ~28.3-38.0% by the three pretreatments in the same order. Release of soluble components other than SRS, majorly reported to be soluble lignins, were observed highest for NaOH followed by H2SO4 and NH4OH pretreatments. Decrease or absence of peaks attributed to lignin and loosened fibrous appearance of biomass during FTIR and SEM studies respectively further corroborated with our observations of lignin removal. Application of commercial cellulase increased raw SCB saccharification from 1.93% to 38.84%, 25.56% and 9.61% after NaOH, H2SO4 and NH4OH pretreatments. Structural changes brought by cell wall degrading enzymes were first time shown visually confirming the cell wall disintegration under brightfield, darkfield and fluorescence microscopy. The microscopic evidence and saccharification results proved that the chemical treatment valorized the SCB by making it amenable for enzymatic saccharification.


Dissemination activities: a critical new role for substance abuse treatment organizations.
The Affordable Care Act calls for integration of substance abuse treatment into medical care via medical homes and continuing specialty care. For this integration to occur in the substance abuse treatment field, substantial sharing and dissemination of information by treatment providers is required. This study explored the determinants of organizational activities directed at disseminating evidence-based practices (EBPs) undertaken by 193 community treatment programs who are members of the National Institute on Drug Abuse (NIDA) Clinical Trials Network. Using factor analysis, the research identified two generic categories reflecting different motivations for dissemination activities and explored both treatment center leadership and organizational characteristics as determinants of these different types of dissemination activities. Organizational characteristics predicting treatment center dissemination activities included size, previous involvement in research protocols, linkages with other providers, and having non-profit status. The treatment center leader's membership in professional organizations was also a significant determinant. Organization variables account for a larger portion of the variance in treatment center dissemination activities. The results suggest that the willingness of treatment providers to help disseminate EBPs within the industry may be heavily influenced through shared network connections with other treatment organizations.


Circulatory and catecholamine changes during head-up tilt testing in neurocardiogenic (vasovagal) syncope.
Changes in heart rate, arterial pressure, norepinephrine and epinephrine levels were compared in 19 consecutive patients (10 men and 9 women, mean age 46 +/- 16 years) with neurocardiogenic syncope and 11 age- and sex-matched control subjects (5 men and 6 women, mean age 49 +/- 15 years) during head-up tilt testing. Norepinephrine and epinephrine levels were measured at the baseline supine position, in the initial upright position, every 90 seconds during the 70 degrees upright tilt, at the time of termination due to hypotension and syncope (or at 15 minutes in control subjects), and at 40 seconds and 1 minute and 40 seconds in the supine position after terminating the head-up tilt test. Baseline norepinephrine, epinephrine and heart rate were slightly higher in patients. Despite a significant decrease in mean arterial pressure during head-up tilt testing in patients (51 +/- 20 mm Hg; p < 0.001), norepinephrine levels in patients and control subjects at the time of terminating the head-up tilt test were comparable (459 +/- 204 vs 473 +/- 172 pg/ml). A fivefold increase in epinephrine levels (73 +/- 53 to 345 +/- 260 pg/ml; p < 0.01) were seen in patients, whereas control subjects had insignificant change (38 +/- 16 to 65 +/- 44 pg/ml). It is concluded that diminished neuronal sympathetic activity and enhanced adrenomedullary activity is demonstrated during head-up tilt testing in patients with neurocardiogenic syncope.


[Clinical Analysis of Pediatric Acute Myeloid Leukemia with CCLG-AML 2015 Regimen].
To analyze the clinical effects of CCLG-AML-2015 protocol on newly diagnosed children with acute myeloid leukemia (AML). The clinical data of 60 newly diagnosed AML children in the Department of Hematology and Oncology, Wuhan Children's Hospital from August 2015 to September 2019 were summarized, the effect of chemotherapy using the CCLG-AML-2015 regimen (hereinafter referred to as the 2015 regimen) were retrospectively analyzed. 42 children with AML treated by the AML-2006 regimen (hereinafter referred to as the 2006 regimen) from February 2010 to July 2015 were used as control group. There were no statistical differences between the 2015 regimen group and the 2006 regimen group in sex, age at first diagnosis, and risk stratification (P>0.05). The complete remission rate of bone marrow cytology after induction of 1 course of chemotherapy (84.7% vs 73.1%, P=0.155), and minimal residual disease detection (MRD) negative (42.3% vs 41.4%, P=0.928) in the 2015 regimen group were not statistically different than those in the 2006 regimen group. The bone marrow cytology CR (98.1% vs 80.6%, P=0.004) and MRD negative (83.3% vs 52.8%, P=0.002) in the 2015 regimen group after 2 courses of induction were higher than those in the 2006 regimen group. The 5-year overall survival (OS) rate in the 2015 regimen group (62.3%±6.4% vs 20.6%±6.4%, P=0.001), the 5-year disease-free survival (EFS) rate (61.0%±6.4% vs 21.0% ±6.4% , P=0.001) were better than those in the 2006 regimen group. The 5-year OS and EFS of high-risk transplant patients in the 2015 regimen group were significantly better than those of high-risk non-transplant patients (OS: 86.6%±9.0% vs 26.7%±11.4%, P=0.000; EFS: 86.6%±9% vs 26.7%±11.4%, P=0.000). The 2015 regimen can increase the CR rate after 2 courses of induction compared with the 2006 regimen. High-risk children receiving hematopoietic stem cell transplantation can significantly improve the prognosis.


Effects of idebenone on information processing in aged Long-Evans rats.
Idebenone (6-(10-hydroxydecyl)-2,3-dimethoxy-5-methyl-1,4-benzoquinone) is a benzoquinone that has been shown to improve cognitive function in animals subjected to cerebral ischemia and in rats with lesions of the basal forebrain cholinergic system. Because the cognitive deficits observed in aged rats have been associated with decreased cerebral blood flow and basal forebrain cholinergic dysfunction, it was hypothesized that IDE might improve cognition in aged animals. In the present study, the effects of idebenone on cognitive function in aged Long-Evans rats were assessed using a battery of tests that evaluated attention, habituation, and spatial learning. Selective attention was assessed using an overshadowing paradigm, where IDE (30 mg/kg, IP) was injected 30 min prior to compound cue exposure. IDE enhanced the overshadowing effect in aged rats. The Morris water maze was used to assess spatial learning, where IDE (3 mg/kg, IP) was injected daily throughout the course of training. IDE did not improve the impaired performance of aged rats in the Morris task. Habituation was tested by measuring recovery from gustatory neophobia. IDE (30 mg/kg, IP) was injected 30 min prior to the first exposure to the novel taste. IDE normalized habituation rate in aged rats. It was concluded that IDE improves some forms of acquisition in aged rats, and may do so by decreasing general reactivity to novel stimuli.


Molecular quantification, a new strategy for quality control of Chinese patent medicine containing animal-derived crude drug: Qi She in Jinlong capsule as an example.
Quality control for Chinese patent medicine (CPM) containing animal-derived crude drug(s) is rather difficult. The methods based on chemical composition analysis, which are commonly used in CPM consisted of plant-derived crude drugs, are often not applicable for CPM containing animal-derived crude drug, because the effective constituents of most animal-derived crude drugs remain unknown. Even if there are such methods, they are usually qualitative rather than quantitative, and the specificity is generally poor. Here we proposed a molecular quantification method for CPM containing animal-derived crude drug, based upon the hypothesis that the amount of remnant DNA fragments could reflect feeding quantity of the crude drugs and thus ensure the quality of the CPM. Take Jinlong capsule [a hepatocellular carcinoma-resisting Chinese patent medicine comprising of three fresh animal drugs, i.e. Shougong (Peking gecko, Gekko swinhonis), Qi She (sharp-snouted pitviper, Deinagkistrodon acutus), and Jinqian Baihua She (many-banded krait, Bungarus multicinctus)] as an example, we established a qPCR assay for Qi She in the capsule, which verified the feasibility of the quality control method based on molecular quantification. Species-specific primers and TaqMan probe for Qi She were designed, and the qPCR assay system was then established. The assay exhibited a good specificity; there's a good linearity between Ct values and logarithm of the target amplicon copy numbers within the range of 8.8 × 101 to 8.8 × 106 copies/μL, and the limit of detection was 88 copies/μL. The method was validated through reproducibility, stability assessment. Recovery of spiked samples was between 91.59% and 101.69%. It was verified that the copy numbers reflected the original feeding amount of an animal-derived crude drug by self-made Jinlong capsules. The assay was successfully applied in Qi She-specific amplicon determination in 20 batches of Jinlong capsule. The study was expected to provide a new strategy for quality control of CPM containing animal-derived crude drug.


Physical Contact Promotes the Development of Emotional Contagion Between Mice.
The establishment and maintenance of strong affiliative relationships is fundamental for group cohesion and crucial for overall individual well-being. Empathy is considered a critical process for promoting attachment and the long-term stability of social bonds. However, it is unclear how different modalities of social communication contribute to the development of empathy. Physical contact between individuals, such as gentle touching, is a highly salient form of social communication. Despite mounting evidence that touch may be crucial for promoting social bonds, the role of touch in the development of empathy is currently not well understood. Animal models have become a powerful tool for the experimental manipulation and examination of empathy related behaviors such as emotional contagion. Here, we use the Tube Co-Occupancy Test (TCOT) to promote voluntary physical contact between mice and examine whether social, physical contact promotes emotional contagion of pain between mice. We found that repeated exposure to TCOT promoted the development of emotional contagion between mice. However, preventing physical contact in the TCOT assay also prevented the development of emotional contagion of pain. These results demonstrate that voluntary physical contact is a critical component in the formation of social bonding and emotional contagion in mice.


Borrelia meningitis in Denmark.
We studied 23 patients with borrelia meningitis, a tick-borne spirochetosis increasingly recognized in Denmark. The disease showed a seasonal incidence from June to December. Twenty one patients experienced a painful sensory radiculitis, in 17 cases followed by a predominantly cranial mononeuritis multiplex mainly affecting the facial nerve (Bannwarth's syndrome). Three patients had focal CNS involvement in the form of a transverse myelitis, a focal encephalitis and a disseminated leucoencephalopathy, respectively. The CSF showed invariably lymphocytic pleocytosis and elevated spinal protein concentration. Measuring borrelia antibodies in the CSF seemed of higher diagnostic sensitivity than in serum. Penicillin therapy was effective even in cases with focal CNS lesions.


Environmental impacts of household appliances in Europe and scenarios for their impact reduction.
Assessing the environmental impact due to consumption of goods and services is a pivotal step towards achieving the sustainable development goal related to responsible production and consumption (i.e. SDG 12). Household appliances plays a crucial role and should be assessed in a systemic manner, namely considering all life cycle stages, technological efficiency, and affluence aspects. The present study assess the impact of such household appliances used in Europe, and tests scenarios of potential impact reduction at various scales. Life cycle assessment is applied to 14 different household appliances (ranging from dishwashers to television devices) selected to build a set of representative products, based on their economic value and diffusion in households in Europe. Related impacts are calculated with the Environmental Footprint method for calculating a Consumer Footprint "appliances" for the baseline year 2010. A number of scenarios encompassing eco-solutions on a technical level, changes in consumption pattern, behavioral changes, as well as the combination of all these aspects are run to estimate the Consumer Footprint related to household appliances for the year 2030, compared against this baseline scenario. The baseline Consumer Footprint is confirming the importance of the use phase in leading the impacts in almost all impact categories. Testing different scenarios concludes that there is a reduction of the impact for most of the categories (with up to 67% for the ozone depletion potential, and still around 35% for the global warming potential), while two of the here examined impact categories (i.e. land-use and mineral resource depletion) show an overall potential that is even negative - i.e. the results of all scenarios are higher than the ones of the 2010 baseline scenario. The increase in purchase and use of such appliances may offset energy efficiency benefits in some of the examined categories. Hence, the assessment of sustainability of appliances consumption should always include several scales, from the efficiency of the products (micro scale), to the improvement of the energy mix (meso scale), up to accounting for socio-economic drivers and patterns of consumption affecting the overall appliances stock (macro scale).


Cassava starch films for food packaging: Trends over the last decade and future research.
Cassava starch is one of the most available and cost-effective biopolymers. This work aimed to apply a bibliometric methodology to identify the most impactful scientific data on cassava starch and its residues for food packaging in the last ten years. As a result, an increasing interest in this subject has been observed, mainly in the past five years. Among the 85 selected scientific publications, Brazil and China have been leading the research on starch-based films, accounting for 39 % of the total. The International Journal of Biological Macromolecules was the main scientific source of information. Besides cassava starch, 41.18 % of these studies added other biopolymers, 5.88 % added synthetic polymers, and 4.71 % added a combination of both. Studies analyzed suggested that different modifications in starch can improve films' mechanical and barrier properties. In addition, 52.94 % of articles evaluated the film's bioactivity. Still, only 37.65 % assessed the performance of those films as food packaging, suggesting that more studies should be conducted on assessing the potential of these alternative packages. Future research should consider scale-up methods for film production, including cost analysis, assessment life cycle, and the impact on the safety and quality of a broader range of foods.


Robotic-assisted radical prostatectomy is pushing the boundaries: a national survey of frailty using the national surgical quality improvement program.
Robotic-assisted radical prostatectomy (RARP) has been found to be comparable and, in some cases, favorable to open surgical approaches, while being used in a frailer population. We aimed to illustrate the trend in population frailty and compare morbidity and mortality postoperatively in patients who underwent RARP. The National Surgical Quality Improvement Program data set was used to select patients who underwent RARP between the years 2011-2019. Age, frailty indicators, surgical characteristics, and perioperative morbidity and mortality were compared between the years 2011-2019 using the chi-square test (χ2) for categorical variables and the one-way analysis of variance (ANOVA) for continuous variables. Our patient population consisted of 66,683 patients who underwent RARP. There was an increase in mean age and frailty indicated by an increase in 5-item frailty score ⩾2, metabolic syndrome index = 3, and American Society of Anesthesiologists' (ASA) class ⩾3 between the years 2011-2019 (p < 0.001). Whereas the rate of mortality and morbidity, indicated by postoperative Clavien-Dindo grade ⩾4 and major morbidity, remained the same over the same period (p > 0.264). Furthermore, operative time and length of stay decreased over the same period (p < 0.001). RARP is being performed on more frail patients, with no added morbidity or mortality.


10-Year Coronary Heart Disease Risk Prediction Using Coronary Artery Calcium and Traditional Risk Factors: Derivation in the MESA (Multi-Ethnic Study of Atherosclerosis) With Validation in the HNR (Heinz Nixdorf Recall) Study and the DHS (Dallas Heart Study).
Several studies have demonstrated the tremendous potential of using coronary artery calcium (CAC) in addition to traditional risk factors for coronary heart disease (CHD) risk prediction. However, to date, no risk score incorporating CAC has been developed. The goal of this study was to derive and validate a novel risk score to estimate 10-year CHD risk using CAC and traditional risk factors. Algorithm development was conducted in the MESA (Multi-Ethnic Study of Atherosclerosis), a prospective community-based cohort study of 6,814 participants age 45 to 84 years, who were free of clinical heart disease at baseline and followed for 10 years. MESA is sex balanced and included 39% non-Hispanic whites, 12% Chinese Americans, 28% African Americans, and 22% Hispanic Americans. External validation was conducted in the HNR (Heinz Nixdorf Recall Study) and the DHS (Dallas Heart Study). Inclusion of CAC in the MESA risk score offered significant improvements in risk prediction (C-statistic 0.80 vs. 0.75; p < 0.0001). External validation in both the HNR and DHS studies provided evidence of very good discrimination and calibration. Harrell's C-statistic was 0.779 in HNR and 0.816 in DHS. Additionally, the difference in estimated 10-year risk between events and nonevents was approximately 8% to 9%, indicating excellent discrimination. Mean calibration, or calibration-in-the-large, was excellent for both studies, with average predicted 10-year risk within one-half of a percent of the observed event rate. An accurate estimate of 10-year CHD risk can be obtained using traditional risk factors and CAC. The MESA risk score, which is available online on the MESA web site for easy use, can be used to aid clinicians when communicating risk to patients and when determining risk-based treatment strategies.


Contrast-enhanced ultrasound (CEUS) of the abdominal vasculature.
Vascular diseases account for a significant proportion of abdominal pathology and represent a common referral source for abdominal ultrasonographic examinations. B-mode, color Doppler, and spectral Doppler analyses are well-established in the evaluation of abdominal blood vessels although they may occasionally be limited by lower sensitivity for slow flow visualization or the deeper location of abdominal vascular structures. The introduction of microbubbles as ultrasonographic contrast agents has rendered contrast-enhanced ultrasound (CEUS), a valuable complementary ultrasonographic technique, which is capable of addressing clinically significant problems and guiding patient management. The purpose of this pictorial review is to analyze the use of CEUS in the evaluation of abdominal vascular pathology and illustrate such applications by presenting representative images. Pathology discussed includes abdominal aortic aneurysm, post-endovascular treatment aorta, portal vein thrombosis, abdominal vascular trauma, and organ transplantation along with its complications.


Endoscopic Image-guided treatment of Upper Gastrointestinal foreign body and nursing care of complications.
This study used phased array imaging algorithm to explore the epidemiological characteristics of endoscopic treatment of upper gastrointestinal foreign bodies to provide a basis for nursing intervention. We collected data on the age, sex, cause, type of foreign body, success rate of removal, retention location, time and complications of patients with foreign bodies in the upper gastrointestinal tract who were treated in the emergency department of the Digestive Endoscopy Center in our hospital. The study was conducted from January 2018 to December 2020 and we also performed statistical analysis. The high incidence of foreign bodies in the upper digestive tract was in 45 years old to 74 years old patients. The foreign body types were mostly food balls and sharp foreign bodies, accounting for 37.0% and 44.2%, respectively. The cause was misuse and the most accounted for 52.1%, followed by oesophageal pathological stenosis which accounted for 45.5%. The oesophagus in the retention site accounted for up to 80.0%, and the success rate of foreign body extraction was 96.4%. The complications of patients with foreign body retention within twenty four our retention were mainly esophageal scratches and traumatic esophagitis, accounting for 48.5%. 39.6%. There are high risks in the treatment of foreign bodies in the upper digestive tract. Targeted, prospective, and streamlined nursing interventions can provide patients with fast and professional medical care services and minimize patient pain.


ACE-inhibitors and atherosclerosis.
The involvement of the circulating and local renin-angiotensin system in atherosclerotic process has been hypothesized on the basis of experimental data showing presence and specific actions of the components of this system in the vascular wall. In particular, angiotensin II may participate in well known events in atherogenesis as the control of smooth muscle cell growth and proliferation. Recent studies have shown an effect of angiotensin converting enzyme (ACE) inhibition on the development of atherosclerosis in animal models. Captopril and cilazapril prevent myointimal proliferation after vascular injury in rat. Captopril reduces aortic cholesterol content and percentage intimal aortic surface covered by lesions in Watanabe heritable hyperlipidemic rabbits. Captopril also significantly reduces the progression of carotid and coronary lesions in monkeys fed a high cholesterol diet. In addition, a role for converting enzyme inhibitors in reducing aortic and microvascular growth either in hypertensive or normotensive rats has been demonstrated. It is possible that ACE-inhibitors prevent angiotensin II-induced vascular proliferation and thereby suppress the development of atherosclerosis in animals. It is also conceivable that the blood pressure effects of ACE-inhibitors could play a role in the antiatherosclerotic effect shown by these drugs, even though this explanation cannot be addressed by studies dealing with normotensive animals. Then, other mechanisms could be involved, including hypothesized effects of blockade of the renin-angiotensin system on sympathetic nervous system activity, regulation of vascular growth factors and insulin sensitivity. The clinical significance of these experimental findings is unknown.(ABSTRACT TRUNCATED AT 250 WORDS)


A trial of recombinant human superoxide dismutase in patients with Fanconi anaemia.
Fanconi anaemia (FA) is a rare genetic disorder that predisposes to the development of aplastic anaemia and neoplasia. The pathophysiologic hallmark of FA is increased susceptibility to chromosomal breakage. Superoxide metabolism has also been shown to be involved in the cellular pathophysiology of FA. Human SOD (rh-SOD), an enzyme which dismutates superoxide, has recently been cloned and expressed in yeast. We treated four FA patients with a 2-week infusion of rh-SOD (25 mg/kg d daily) to determine whether rh-SOD had any effect on haemopoietic progenitor cell growth or on the abnormal cellular phenotype. We found that lymphocyte chromosomal aberrations induced by diepoxybutane were decreased during rh-SOD treatment in two patients and that bone marrow progenitors were increased in one patient.


Two-photon nanoprobes based on bioorganic nanoarchitectonics with a photo-oxidation enhanced emission mechanism.
Two-photon absorption (TPA) fluorescence imaging holds great promise in diagnostics and biomedicine owing to its unparalleled spatiotemporal resolution. However, the adaptability and applicability of currently available TPA probes, which act as a critical element for determining the imaging contrast effect, is severely challenged by limited photo-luminescence in vivo. This is particularly a result of uncontrollable aggregation that causes fluorescence quenching, and inevitable photo-oxidation in harsh physiological milieu, which normally leads to bleaching of the dye. Herein, we describe the remarkably enhanced TPA fluorescence imaging capacity of self-assembling near-infrared (NIR) cyanine dye-based nanoprobes (NPs), which can be explained by a photo-oxidation enhanced emission mechanism. Singlet oxygen generated during photo-oxidation enables chromophore dimerization to form TPA intermediates responsible for enhanced TPA fluorescence emission. The resulting NPs possess uniform size distribution, excellent stability, more favorable TPA cross-section and anti-bleaching ability than a popular TPA probe rhodamine B (RhB). These properties of cyanine dye-based TPA NPs promote their applications in visualizing blood circulation and tumoral accumulation in real-time, even to cellular imaging in vivo. The photo-oxidation enhanced emission mechanism observed in these near-infrared cyanine dye-based nanoaggregates opens an avenue for design and development of more advanced TPA fluorescence probes.


Using NdSr isotopes in suspended sediments in the Abrolhos coral-reef (SW Atlantic, Brazil) to assess potential contamination from the 2015 Fundão dam collapse.
The Abrolhos bank is home of the richest coral reef system of the Southwestern Atlantic, where endemic coral species are found. It has been reported that Abrolhos' corals are under intense stress due to increasing of Marine Heat Waves during the last decades. Additionally, anthropic interventions along the adjacent coastal regions are a factor of concern since they contribute to the increase in the sediment load and to organic debris input in the reef domain. In November 2015, the collapse of the Fundão mining tailings dam resulted in the release of approximately 50 million m3 of iron oxide and quartz-rich slurry into the Doce River. Aiming at using a fingerprint of the tailings and to assess the presence of traces of the Fundão dam material from this event on the Abrolhos bank, this work presents new 87Sr/86Sr and 143Nd/144Nd isotope ratios of marine suspended sediment samples collected between 2016 and 2020 from a network of sediment traps throughout the reef and complementary suspended material at sea. In parallel, we monitored meteo-oceanographic parameters and modeled surface marine currents as an attempt to identify the sediment transport between the Doce River mouth and Abrolhos bank. The r isotopes were used as provenance proxies based on the fact that minerals and rocks tend to have specific isotopic signatures reflecting their own geological derivation. In this context, the isotopic ratios of various potential regional sources for the sedimentation in Abrolhos bank were evaluated. Our monitoring and isotopic measurements indicate that Doce River signatures are detected at Abrolhos bank, following the seasonal Doce River discharge at sea. Isotopic signature of Doce River at Abrolhos bank was also observed during the austral winter (July-August) when cold fronts migrate at the Brazilian coast with higher frequency and energy.


Growth and turnover of rat otoconia as revealed by labeling with tetracycline.
The formation process of otoconia remains controversial, and the turnover rate of mammalian otoconia has not been determined. Tetracycline was administered as a tracer for calcium, and the growth and turnover of rat otoconia were examined by fluorescence microscopy. Exposure of rats to tetracycline from 15.5 gestational day to 3-day postpartum resulted in incorporation of the drug into central portions of all otoconia, in both maculae sacculi and utriculi. When postnatal rats were injected subcutaneously with tetracycline, uptake of the drug into otoconia depended on the age of rats at injection. Apparent fluorescence was emitted from the periphery of all otoconia when tetracycline was injected into 7-day-old or younger rats. However, very little or no fluorescence was observed when this reagent was administered 10 days after birth. No fluorescence was detected when rats of 12 days of age or older were given this antibiotic. Otoconia that had been labeled with tetracycline during gestation were monitored during subsequent development, and it was found that all otoconia retained labeling in their central portions for at least 12 months. No otoconia that were not labeled with tetracycline were found. These findings indicate that: (1) all otoconia grow synchronously during late gestation and the neonatal period (up to about 10 days after birth) by accretion, (2) no new otoconia are formed subsequently, and (3) essentially no turnover of otoconia occurs and probably no turnover of calcium takes place under normal conditions once otoconia have formed.


Spider Web DNA: A New Spin on Noninvasive Genetics of Predator and Prey.
Noninvasive genetic sampling enables biomonitoring without the need to directly observe or disturb target organisms. This paper describes a novel and promising source of noninvasive spider and insect DNA from spider webs. Using black widow spiders (Latrodectus spp.) fed with house crickets (Acheta domesticus), we successfully extracted, amplified, and sequenced mitochondrial DNA from spider web samples that identified both spider and prey to species. Detectability of spider DNA did not differ between assays with amplicon sizes from 135 to 497 base pairs. Spider and prey DNA remained detectable at least 88 days after living organisms were no longer present on the web. Spider web DNA as a proof-of-concept may open doors to other practical applications in conservation research, pest management, biogeography studies, and biodiversity assessments.


3,3',4,4',5-Pentachlorobiphenyl (PCB 126) impacts hepatic lipid peroxidation, membrane fluidity and beta-adrenoceptor kinetics in chick embryos.
Polychlorinated biphenyls (PCB) and other aryl hydrocarbon receptor (AHR) agonists induce oxidative stress and alter membrane lipid peroxidation and fluidity. This study tested the hypothesis that PCB-induced changes in membrane properties impact membrane beta-adrenoceptor (beta-AR) affinity and capacity in chick embryo hepatocytes. Embryos were injected into the air cell with 1.6 microg 3,3',4,4',5-pentachlorobiphenyl (PCB 126)/kg egg at day 0, and incubated to day 19 when livers were removed. This dose resulted in hepatic PCB 126 levels of 0.67 ng/g liver or 10.2 ng/g liver lipid; levels in untreated embryos were non-detectable. Hepatic microsomal EROD activity was elevated by approximately 12-fold and embryo mortality was significantly increased compared with the untreated group. Hepatic lipid peroxidation increased and membrane order (steady-state fluorescence anisotropy values) decreased with in ovo PCB 126 exposure. Consistent with changes in membrane structure, hepatic beta-AR affinity for CGP 12177 significantly decreased (Kd increased) without changes in receptor numbers. This study demonstrates that in ovo exposure to PCB 126 in chick eggs significantly impacted embryo survival, and this was correlated with altered hepatic membrane structure and ultimately membrane function.


Estimation of increased hospital stay due to nosocomial infections in surgical patients: comparison of matched groups.
An investigation, using a prospective cohort study, was performed to estimate the prolongation of hospital stay caused by nosocomial infections in surgical patients. An evaluation of the one-to-one matching method, as a model for similar studies was also undertaken. Between 1992 and 1994, 225 of 1482 surgical patients (15%) developed infection. Of these, 223 evaluable patients were compared with 1256 uninfected cases, in an unmatched analysis. In a further analysis, 151 infected cases were matched one-to-one with uninfected controls, and other factors such as age, length of preoperative stay, presence of malignancy or diabetes and presence of foley catheters or drains, were evaluated. Patients with infection were hospitalized for 10.6 days longer than the matched controls. In the unmatched analysis, infected patients appear to remain in hospital for a further 17 days. The difference in the prolongation of stay between matched and unmatched groups indicates the importance of matching as an essential model for such studies. In cases where matching cannot be performed, the median can be a good alternative measure to the arithmetic mean.


Reducing the failure rate of hip resurfacing in dysplasia patients: a retrospective analysis of 363 cases.
Arthritis secondary to developmental hip dysplasia often mandates implant surgery at a relatively young age. Hip resurfacing arthroplasty (HRA), compared with standard stemmed total hip arthroplasty (THA), affords a more active lifestyle including extreme-motion activities but stimulates concerns pertaining to implant failure. We addressed the primary modes of failure through a series of interventions, including a new guideline for achieving proper implant alignment through intraoperative x-rays. We then compared two sequential cohorts in a single-surgeon practice: patients with developmental dysplasia who underwent HRA before (Group 1; 121 hips in 105 patients) and after (Group 2; 242 hips in 210 patients) June 2008, at which time the four interventions were all in place. Implants in Group 2 failed less frequently within two years (0.8 % vs. 6.6 %, p = 0.002) and were more likely to have projected seven-year Kaplan-Meier survivorship (99 % vs. 89 %, p < 0.0001 by log-rank test). Patients in Group 2 were more likely to have normal metal ion levels (77 % vs. 56 %, p = 0.0008) and optimum metal ion levels (99 % vs. 86 %, p = 0.0008). Patients in Group 2 also benefited from a 19-min decrease in mean operation time, a 45 % decrease in mean estimated blood loss, and a 0.9-day decrease in mean hospital stay (p < 0.0001 in each instance). We believe the interventions reported here, combined with sufficient surgeon experience and properly designed implants, afford patients with mild developmental dysplasia a more active lifestyle with favorable implant survival.


Cloning and characterization of Sel-1l, a murine homolog of the C. elegans sel-1 gene.
The Notch signaling pathway regulates specification and proliferation in a variety of cell lineages in invertebrates and vertebrates. We have cloned a murine homolog of SEL-1, a key negative regulator of the Notch pathway in Caenorhabditis elegans. Murine SEL-1L (mSEL-1L) protein exhibits a high degree of similarity to SEL-1, including a signal peptide and the C-terminal region required for SEL-1 function in C. elegans. This mammalian homolog of sel-1 is widely expressed in adult mouse and human tissues, with particularly high levels in the pancreas. RNA in situ analysis of developing mouse embryos indicates that mSEL-1L is moderately expressed throughout the neural tube and dorsal root ganglia, with particularly high levels in the floor plate of the neural tube beginning at E10.5 and increasing at E11.5. Expression is high at E14.5 and E17.5 in the acini of the pancreas, and moderate in the epithelial cells of the gut villi. We localized the SEL-1L protein to the cytosol, possibly in intracellular vesicles, in a beta-islet-derived tumor cell line (RinM).


Comparison of diagnostic potential of serological, molecular and cell culture methods for detection of Q fever in ruminants.
Q fever is an infectious disease caused by Coxiella burnetii. Diagnosis of Q fever based on clinical symptoms is unattainable; thus, different laboratory techniques are used to detect the infection. The aim of the study was to compare the diagnostic potential of ELISA, CFT, conventional PCR, real-time PCR and cell culture. The tests were carried out on 2251 serum samples from ruminants. Moreover, 668 placentas, 1277 vaginal swabs and 306 specimens of the internal organs of aborted foetuses were examined by PCR and cell culture. Pearson's chi-square test was used to compare the results obtained by ELISA, CFT, PCR, real-time PCR and isolation in cell culture. The χ(2) test confirmed that in most cases the results obtained by means of the different methods were correlated with each other (P<0.05). The highest correlation coefficients (r=0.76-0.87) were observed in the case of real-time PCR and conventional PCR. ELISA and CFT were moderately correlated (r=0.43-0.45). When the comparison was made between the results of tests run on samples from swabs and aborted foetuses, the r values between ELISA and CFT were lower than those between ELISA and PCRs. A negligible, or weak to moderate relationship was mostly observed when the method of cell culture isolation was compared with all the other analytical techniques investigated. The use of a combination of different laboratory methods, preferably ELISA for serology and polymerase chain reactions for the agent detection, is suggested to achieve the correct diagnosis of Q fever.


In vivo monitoring of amino acids by direct sampling of brain extracellular fluid at ultralow flow rates and capillary electrophoresis.
Extracellular levels of glutamate (GLU), aspartate (ASP), glycine (GLY), phosphoethanolamine (PEA), and gamma-aminobutyric acid (GABA) were measured in the striatum of anesthetized rats using a novel sampling approach in which extracellular fluid (ECF) was removed at 1-50 nl/min using a fused silica capillary tube with 18-40 microm inner diameter and a outer diameter of 90 microm. The samples of ECF were analyzed by capillary electrophoresis with laser-induced fluorescence detection. Basal levels for GABA, GLY, and GLU measured using direct sampling at 1 nl/min were 270 +/- 40, 4950 +/- 1100, and 1760 +/- 150 nM, respectively in good agreement with the values obtained using microdialysis sampling calibrated by the low-flow rate method. ASP levels were approximately four-fold higher in directly sampled fluid than in dialysate. At higher direct sampling flow rates (10-50 nl/min), detected levels of the amino acids were lower by 70-90% indicating depletion of analyte under these conditions. PEA, an indicator of membrane disruption, was 5.5-fold higher in dialysate than in directly sampled ECF indicating greater tissue damage associated with microdialysis. In addition to the basal measurements, the direct sampling technique was applied to monitoring concentration changes of GLU and ASP in the striatum with better than 90 s temporal resolution after perfusion of either 120 mM K(+) or 400 microM L-trans-pyrrolidine-2,4-dicarboxylic acid (PDC) through a microdialysis probe immediately adjacent to the direct sampling capillary. Levels of GLU and ASP increased 615 +/- 95 and 542 +/- 96%, respectively (n=4) upon addition of 120 mM K(+) to the perfusate and 622 +/- 234 and 672 +/- 218% (n=5) for PDC. It is concluded that direct sampling at low-flow rates allows determination of extracellular levels of the amino acids with spatial resolution that is at least 500-fold better than microdialysis.


Gd-25 DTPA-MAb, a potential NMR contrast agent for MRI in the xenografted nude mouse: preliminary studies.
Monoclonal antibodies (MAbs) 19-9 and 73-3 specific for human colon adenocarcinoma were labelled with a high number of gadolinium atoms. Twenty five DTPA were chelated per MAb, with only slight loss of immunoreactivity. The NMR contrast agent Gd-25 DTPA-MAb 19-9 or 73-3 ([Gd] 17 mumole/kg, [MAb] 60 microM) was injected into nude mice bearing human colon adenocarcinoma (SW948). Tumours were removed 24 hr after injection and T1 was measured in vitro. T1 relaxation time varied according to MAb specificity against tumour targets; T1 decreased 20% for MAb 19-9 and MAb 73-3 with SW948 tumour. Imaging was performed with this model. Very good contrast was obtained 24 hr after Gd-25 DTPA-MAb injection.


Bone marrow mesenchymal stem cells combined with Sox2 increase the functional recovery in rat with traumatic brain injury.
About 10 million individuals suffer from traumatic brain injury (TBI) each year in the world, which is one of the most serious neurological disorders. The morbidity of TBI is 55.5~6.1/100,000 in China, which takes more costing in the therapy, and the outcome of that is not well. Therefore, we expect to find new methods to treat TBI and improve the outcomes of TBI. In the previous studies reviewed, we found that stem cell transplantation may hold promising potential for modifying motor dysfunction induced by TBI. Twenty-six adult SD rats were involved in our study. Two adult SD rats were used as donors of bone marrow stem cells (BMSCs), and the other adult SD rats were divided into four groups randomly, which were used to establish the TBI models. BMSCs were transduced with lentivirous-Sox2, and we try to examine the effects of Sox2 on the differentiation of BMSCs. Rats were anesthetized using pentobarbital sodium (at a concentration of 1.5% and a dose of 40 mg/kg) and fixed under the stereotaxic device. A 1.0-cm craniotomy was performed lateral to the sagittal suture. The skullcap was carefully removed, and rats were then subjected to TBI using a controlled cortical injury instrument. A standardized parietal contusion was performed using a 20-mg steel rod with a diameter of 4 mm, which dropped from a height of 30 cm. After injury, the incision was sutured, and rats were carefully observed and nursed. Seven days after TBI, rats were divided into four groups and were transplanted with BMSC-Sox2, single BMSC, single Lentivirus-Sox2, and PBS into injured brain, respectively. The motor function was tested using the neurological severity score (NSS). We found that the ectopic expression of Sox2 enhanced BMSCs to differentiate into neurons. Seven days after TBI, the rats were treated with BMSC-Sox2, BMSC, Sox2, and PBS. Results showed that NSS were 3.352 ± 0.398 in the BMSC-Sox2 group, 4.013 ± 0.495 in the BMSC group, 4.968 ± 0.293 in the Sox2 group, and 6.257 ± 0.361 in the PBS group, suggesting that there were obvious improvements in the neurological function in BMSC-Sox2, BMSC, and Sox2 groups. In addition, the BMSC-Sox2 group had the lowest scores, p < 0.05. The ectopic expression of Sox2 could enhance BMSCs to differentiate into neurons, and intervention of BMSCs combined with Sox2 transplantation could promote recovery of motor function in rats with TBI.


Advantages and limitations of 18-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in the diagnosis of infective endocarditis.
The early diagnosis of infective endocarditis (IE) is a medical challenge and a multidisciplinary approach is essential to improve its frequently fatal prognosis. Our goal was to evaluate the usefulness of [18F]2-fluoro-2-deoxy-d-glucose positron emission tomography (18F-FDG PET) in the diagnosis of this disease. We prospectively assessed 43 patients (five female and 38 male) with clinical suspicion of IE between 2014 and 2017. All patients underwent transesophageal echocardiography (TEE) and an 18F-FDG PET scan, and the results were compared. A positive PET finding was defined as increased FDG uptake on cardiac valves or intracardiac devices. Out of 43 patients with suspected IE, the diagnosis was confirmed in 30 cases (79.7%). 18F-FDG PET was positive in 24 patients, with 19 showing FDG uptake on cardiac valves (two native and 17 prosthetic) and five on cardiac devices, being concordant with echocardiographic findings in 11 cases. 18F-FDG PET sensitivity was 80%, specificity 92%, positive predictive value (PPV) 96% and negative predictive value (NPV) 66%. Echocardiography presented sensitivity, specificity, PPV and NPV of 36%, 84%, 84% and 36%, respectively. 18F-FDG PET proved to be a sensitive technique with a high diagnostic value in patients with prosthetic valves and intracardiac devices and suspected IE. Its utility decreased dramatically in patients with suspected IE on native valves, in which TEE presented higher sensitivity and thus better diagnostic value.


Development of a modified immunoelectroosmophoresis method for Uukuniemi and Runde virus serology.
In search for a suitable method for sero-ecological screenings for arboviruses in Norway, efforts were undertaken to make the immunoelectroosmophoresis technique more sensitive than here to fare in detection of antibodies. The aim was to make it comparable to haemagglutination inhibition test in sensitivity, retaining the advantages in specificity, simplicity and capacity. This has been achieved by: 1. Using concentrated virus as antigen. 2. Performing electrophoresis in a gel consisting of an agar-agarose mixture in optimal concentrations. 3. "Sandwiching" the first specific electrophoretic run with an anti-species antiserum to the tested sample.


Oscillations, cessations, and circulation reversals of granular convection in a densely filled rotating container.
We study spontaneously forming convection in a container that is almost completely filled with a bidisperse granular mixture. The container with an aspect ratio close to 1 rotates slowly about a horizontal axis. In this geometry, single vortex rolls are observed in the cell plane, after a spontaneous symmetry breaking. The circulation of grains produces nonuniform segregation patterns of the mixture that in turn interact with the convective flow. We describe oscillatory modulations of the convection velocity, cessations and spontaneous reversals of the circulation. All these features are absent in multiroll granular convection.


Meningiomas of the jugular foramen.
Primary meningiomas of the jugular foramen are extremely rare. There is controversy regarding the management of these tumors. The objective of this article is to analyze the treatment and results in a series of ten cases. From a series of 107 patients that had been operated on for jugular foramen tumors between 1987 and 2005, ten had meningiomas. The clinical, histological and imaging findings, as well as the outcome of these cases, were reviewed. A high incidence of malignant or aggressive tumors (six cases) was found. Gross total resection (Simpson I and II) was achieved in five patients. Four patients with meningotheliomatous meningiomas are alive, with a mean follow-up time of 71.8 months (6.5 years). Two patients (one with anaplastic type and one with papillary type) died in the immediate postoperative period. Four patients (two with papillary type, one with microcystic type and one with anaplastic type) died because of disease progression, with a mean survival time of 35 months. Radical removal of benign jugular foramen meningiomas is possible. The incidence of postoperative deficit of cranial nerves is higher than in other benign tumors of the jugular foramen. A high incidence of aggressive (malignant) tumors was observed in this series.


A Brief look at antitumor effects of doxycycline in the treatment of colorectal cancer and combination therapies.
Colorectal cancer (CRC) is considered the second most frequent cancer globally and one of the deadliest malignancies in humans. On the other hand, over time and facing the challenges of cancer treatment, several therapeutic approaches, including surgery, radiotherapy, chemotherapy, and immunotherapy, are being developed. Evidence showed that combination therapies had given relatively satisfactory clinical outcomes in inhibiting tumor progression and increasing patient survival compared with monotherapy. Among the available compounds and drugs used in chemotherapy, doxycycline, an antimicrobial drug, has been suitable for treating several malignancies such as CRC. It has been revealed that doxycycline has anti-tumor properties and can help control tumor growth in various mechanisms, such as inhibiting anti-apoptotic and angiogenic proteins. In addition, studies have shown that combination therapy with doxycycline and other anti-tumor drugs, such as doxorubicin, anti-angiogenic factors, and anti-check-point blockers, can inhibit tumor progression. Therefore, this review summarized the anti-tumor mechanisms of doxycycline in CRC treatment and related combination therapies.


Sequential changes of noradrenaline content of vein grafts in rats: quantitative estimation by high-performance liquid chromatography using electrochemical detection.
Supradiaphragmatic inferior vena cava was transplanted end-to-end into the abdominal aorta of 11-week-old rats of the same inbred strain and same litter using microvascular technique. The grafts were removed 3 days, 4, 8, 16, and 35 weeks postoperatively, and their noradrenaline (NA) content was estimated by high-performance liquid chromatography using electrochemical detection. The amount of NA was significantly lower (P less than .001) in all vein grafts as compared to nontransplanted vena cava. The substantial decrease of NA in the vein grafts throughout the observation period indicates a persistent denervation of the transplant.


New Insights into the Synthesis and Biological Activity of the Pamamycin Macrodiolides.
After a brief account of the biological properties of pamamycins, this review highlights the latest developments on the total synthesis and the biosynthesis of these macrodiolides.


The impact of scars on health-related quality of life after breast surgery: a qualitative exploration.
The purpose of this research was to explore women's experiences after breast surgery with scar characteristics and symptoms, and its impact on their health-related quality of life (HRQOL). A qualitative study using semi-structured face-to-face interviews was conducted among women following prophylactic, oncologic, or reconstructive breast surgery in the Netherlands. A directed content analysis was performed using guiding themes. Themes were "physical and sensory symptoms," "impact of scar symptoms," "personal factors," "impact of scar interventions," and "change over time." The study population consisted of 26 women after breast surgery. Women experienced a wide range of symptoms like adherence, stiffness, pain, and uncomfortable sensations. Scar characteristics as visibility, location, texture, and size, influenced satisfaction with their appearance. The impact of scar symptoms is reflected in physical, social, emotional, and cognitive functioning, thereby affecting HRQOL. The experienced impact on HRQOL depended on several factors, like personal factors as the degree of acceptance and environmental factors like social support. Women can experience a diversity of scar characteristics and symptoms, which play a central role in the perceived impact on HRQOL. Since scarring can have a considerable impact on HRQOL, scarring after prophylactic, oncologic and reconstructive breast surgery should be given more attention in clinical practice and research. Considering scarring as a common late effect after breast surgery and understanding the variety of experiences, which could impact HRQOL of women, can be beneficial in sufficient information provision, expectation management, and informed decision making.