99m-Technetium galactosyl human serum albumin scanning to evaluate liver function after stereotactic body radiotherapy for hepatocellular carcinoma: A case report.
The primary choice among treatment options for liver malignancies is surgery. However, if surgery cannot be performed, Stereotactic body radiotherapy (SBRT) may be effective. 99m-technetium galactosyl human serum albumin (GSA) single-photon emission computed tomography (SPECT) imaging is useful for the assessment of liver function before surgery. We report the case of a 77-year-old man who had undergone SBRT for hepatocellular carcinoma of the left lobe of the liver 2 years previously. Follow-up revealed a 15-mm hepatocellular carcinoma at the edge of the right lobe of the liver. 99m-technetium GSA SPECT was performed before SBRT to confirm that there was no accumulation in the left lobe and to ensure that there was good function of the right lobe. Three months after SBRT, the tumor had responded, and decreases in GSA accumulation were observed in line with the radiation beam. Because hepatocellular carcinoma often relapses, it is important to assess the anatomic site of liver dysfunction before and after radiation. This case demonstrates that 99m-technetium GSA SPECT is useful for this purpose.


The dorsomedial shell of the nucleus accumbens facilitates cocaine-induced locomotor activity during the induction of behavioral sensitization.
The mesolimbic dopamine system has been intensely studied as the neural circuit mediating the locomotor response to psychostimulants and behavioral sensitization. In particular, the dopaminergic innervation of the nucleus accumbens has been implicated as a site responsible for the manifestations of behavioral sensitization. Previous studies have demonstrated an augmented release of dopamine in the nucleus accumbens upon a systemic injection of a psychostimulant. In addition, alterations in the dopaminergic innervation patterns in this brain region have been demonstrated in animals that received repeated injections of cocaine. Furthermore, lesions of projection sites that have terminations in the nucleus accumbens have demonstrated alterations in psychostimulant induced locomotion, both acutely, as well as in sensitization paradigms. Since dopamine in the nucleus accumbens is believed to regulate several excitatory amino acid inputs, the present study examined the effects of a localized electrolytic lesion in the dorsomedial shell of the nucleus accumbens in order to better understand the functional role this brain region has in behavioral sensitization. All animals received bi-daily injections of 15 mg/kg i.p. cocaine. Only those demonstrating behavioral sensitization after a subsequent challenge dose were included in the analysis. Following acute exposure to cocaine, lesioned animals did not show any difference in their locomotor response when compared with sham controls. However, after repeated exposure to cocaine, sensitized animals demonstrated a significant attenuation in locomotor behavior when compared with sensitized sham controls. This decrease in horizontal locomotion persisted 2 days into withdrawal, yet dissipated in the sensitized animals that were challenged 2 weeks following their last injection. The data presented here demonstrate that the dorsomedial shell of the nucleus accumbens plays an important role in the initial stages of behavioral sensitization to cocaine.


Cap-assisted endoscopic mucosal resection as a salvage technique for challenging colorectal laterally spreading tumors.
Cap-assisted endoscopic mucosal resection (EMR-c) has emerged as a potential alternative to standard piecemeal wide-field EMR (WF-EMR) for the resection of laterally spreading tumors (LSTs). However, clear indications for this technique are still lacking. Our objective was to investigate the performance of salvage EMR-c after WF-EMR failure in the resection of large colorectal LSTs. The data of consecutive patients undergoing WF-EMR for large colorectal LSTs (2015-2021) were analyzed in this single-center, retrospective, observational study. In the event of a WF-EMR failure, the procedure was switched to EMR-c in the same session. The efficacy of the two techniques was evaluated in terms of complete endoscopic resection, R0 resection, and recurrence rate. Safety was also assessed. Overall, the data from 81 WF-EMRs were collected. Eighteen cases of WF-EMR failure were switched to EMR-c in the same session and complete endoscopic resection was achieved in 17/18 patients (94.4%). No statistically significant difference was observed between WF-EMR and salvage EMR-c in terms of macroscopic radicality (P = 0.40) and R0 resection (P = 0.12). However, recurrence was more common with EMR-c (44.4% vs. 23.5%; P = 0.05), as were adverse events, particularly intraprocedural bleeding (27.8% vs. 7.9%; P = 0.04). EMR-c is an effective salvage technique for challenging colorectal LSTs following WF-EMR failure. Due to the elevated risk of adverse events associated with this procedure, careful patient selection, endoscopic expertise, and close follow-up are strongly recommended.


Metabolic predictors of carbon monoxide poisoning.
In a retrospective study of 54 carbon monoxide (CO) levels greater than 10%, we looked for correlations with glucose, electrolytes and anion gap. Electrolytes and anion gap were not found to be significant. We did find, however, that 8 out of the 12 CO levels greater than 25 had glucose values greater than 110. We, therefore, conclude that if a patient presents with the appropriate history or signs of vague CNS symptoms and an increased blood glucose, a measurement of CO should be considered.


Current Concepts in Diabetes Mellitus and Chronic Liver Disease: Clinical Outcomes, Hepatitis C Virus Association, and Therapy.
Hereditary type 2 diabetes mellitus is a risk factor for chronic liver disease, and ~30 % of patients with liver cirrhosis develop diabetes. Diabetes mellitus has been associated with cirrhotic and non-cirrhotic hepatitis C virus liver infection, can aggravate the course the liver infection, and can induce a lower sustained response to antiviral treatment. Evidences that HCV may induce metabolic and autoimmune disturbances leading to hypobetalipoproteinemia, steatosis, insulin resistance, impaired glucose tolerance, thyroid disease, and gonadal dysfunction have been found. Prospective studies have demonstrated that diabetes increases the risk of liver complications and death in patients with cirrhosis. However, treatment of diabetes in these patients is complex, as antidiabetic drugs can promote hypoglycemia and lactic acidosis. There have been few therapeutic studies evaluating antidiabetic treatments in patients with liver cirrhosis published to date; thus, the optimal treatment for diabetes and the impact of treatment on morbidity and mortality are not clearly known. As numbers of patients with chronic liver disease and diabetes mellitus are increasing, largely because of the global epidemics of obesity and nonalcoholic fatty liver disease, evaluation of treatment options is becoming more important. This review discusses new concepts on hepatogenous diabetes, the diabetes mellitus–hepatitis C virus association, and clinical implications of diabetes mellitus in patients with chronic liver disease. In addition, the effectiveness and safety of old and new antidiabetic drugs, including incretin-based therapies, will be described.


The timing of the age at which natural menopause occurs.
The timing of natural menopause is a clinically important indicator of longevity and risk of morbidity and mortality. Demographic, menstrual, reproductive, familial, genetic, and lifestyle factors seem to be important in this timing. Smoking, lower parity and poor socioeconomic status are associated with earlier menopause. However, a number of relationships have been inconsistent; others remain largely unexplored. Much remains to be learned about factors that affect follicular atresia and the onset and duration of perimenopause and the timing of the natural menopause. Knowledge about these relationships offers women and their health care providers enhanced understanding and choices to deal with menopause.


From the Influence of Traumas to Therapeutic Letting Go: The Contribution of Hypnosis and EMDR.
The development of new psychotherapies such as Eye Movement Desensitization and Reprocessing (EDMR) has led to numerous fresh approaches to both the treatment of trauma and to the understanding of underlying psychopathology. A unified view appears to be slowly emerging in an attempt to corroborate clinical practice with neurobiological data. This article attempts to demonstrate links between alternate psychotherapies by highlighting what appears to be an invariant among these approaches, namely "letting go." This concept refers to a psycho-physical dynamic that combines psychological dissociation and reassociation, as well as the body's vagotonic mechanisms. Following an explanation of this process, it is demonstrated how letting go can manifest itself physiologically and why this may be significant in the study of trauma.


Role of eosinophils in the diagnosis and prognostic evaluation of COVID-19.
Severe acute respiratory syndrome coronavirus 2 is responsible for the coronavirus disease 2019 (COVID-19) epidemic, which has severely affected global public health security. However, the diagnosis and treatment of the disease need further exploration. Therefore, this retrospective analysis was conducted on multiple indicators of peripheral blood in patients with COVID-19 to determine the role of leukocytes, lymphocytes, and eosinophils in the diagnosis and prognostic evaluation of COVID-19. Baseline information and clinical records of 40 patients were collected, including demographic data, disease status, medication, and laboratory routine. The correlation between the inspection indicators and disease classification, as well as prognostic factors, was analyzed. Decreased eosinophils were detected in 33 out of 40 patients with COVID-19 on admission, while lymphocytes and eosinophils were inversely related to the severity of the disease, according to the Spearman's correlation coefficient. Thus, it could be deduced that eosinophils have better sensitivity for the diagnosis of COVID-19 and play a major role similar to lymphocytes in assessing the prognosis of patients.


Calcium-dependent regulation of protein synthesis at translational initiation in eukaryotic cells.
Evidence that Ca2+ may serve as a physiologic regulator of post-transcriptional protein synthesis was recently reported (Brostrom, C. O., Bocckino, S. B., Brostrom, M. A., and Galuska, E. M. (1986) Mol. Pharmacol. 29, 104-111). To evaluate further the role of Ca2+ in translation, the polysomal contents of Ca2+-depleted and -restored GH3 pituitary cells were compared. Ca2+ depletion of intact cells with 1 mM EGTA resulted in the disappearance of polysomes and an accumulation of 80 S monosomes and ribosomal subunits typical of slowed rates of initiation. Ca2+ repletion rapidly (minutes) restored cellular polysomal contents with an accompanying accumulation of 43 S preinitiation complex (40 S.eukaryotic initiation factor 2.Met-tRNAf.GTP). Comparable polysomal profiles were found for Ca2+-depleted and -restored cells exposed to cycloheximide which apparently slowed polypeptide chain elongation to rate-limiting values in the overall translation process. Ribosomal transit times for both Ca2+-depleted and -restored cells were identical, indicating that elongation is not directly affected by the cation. Transit times were extended in parallel as a function of increasing cycloheximide concentration. Lysates of GH3 cells exhibited incorporation that was proportional to the polysomal contents derived from the original intact cell preparations. Such lysates did not possess the ability to initiate new peptide synthesis and were not affected by Ca2+ or EGTA. Ca2+-depleted cells exposed to cycloheximide provided lysates with identical elongation activity to that of lysates prepared from either comparably treated or control Ca2+-restored cells. Ca2+ is proposed to regulate translation in intact cells through modulation of the rate of initiation rather than either polypeptide chain elongation or termination.


Anthropogenic disturbances on distribution and sources of pharmaceuticals and personal care products throughout the Jinsha River Basin, China.
Pharmaceuticals and personal care products (PPCPs) are recognized as a group of emerging contaminants closely related to anthropogenic activities, which capture increasing attention worldwide. To evaluate the anthropogenic disturbances on PPCP distribution and sources, this study investigated the distribution and sources of 50 PPCPs along the 2300 km long Jinsha River and revealed different anthropogenic disturbances on PPCPs. Results showed that 40 out of the 50 PPCPs were ubiquitously detected among these river water samples, with the concentrations varied from less than 1 ng/L to more than 500 ng/L. Although most PPCPs concentrations were much lower in the Jinsha River than in highly developed rivers, the prevalence of PPCPs suggested the widespread use and improper disposal of PPCPs in the Jinsha River. The risk assessment also revealed that some PPCPs posed risks to aquatic organisms in the Jinsha River. Anthropogenic activities including human habitation and dam construction had different influence on PPCPs. PPCP distribution varied significantly across the "Hu Huanyong line", indicating human habitation significantly influenced PPCP distribution. Dam construction was insignificant in altering PPCP distribution throughout the Jinsha River. Moreover, the land use index indicated degradation level of multiple lands related to anthropogenic activities and represented the major sources of PPCPs in the Jinsha River. Most PPCPs were correlated with anthropogenic lands, for example, antibiotics, analgesics, and endocrine disrupting chemicals mainly originated from artificial surfaces, whereas other PPCPs mainly originated from cultivated lands. Together, this study indicates the disturbances of multiple anthropogenic activities on PPCP distribution and sources along the Jinsha River, which contributes to PPCP management in rural areas.


[A case of visceral leishmaniasis with a difficult parasitological diagnosis and unexpected complications (author's transl)].
Report of a typical syndrome of which the leishmanial origin has been difficult to prove. The decrease of cellular immunity may be responsible for the pulmonary tuberculosis and Hbs hepatitis which occured after the successful treatment of the leishmaniasis with Glucantime and Lomidine.


The effects of error augmentation on learning to walk on a narrow balance beam.
Error augmentation during training has been proposed as a means to facilitate motor learning due to the human nervous system's reliance on performance errors to shape motor commands. We studied the effects of error augmentation on short-term learning of walking on a balance beam to determine whether it had beneficial effects on motor performance. Four groups of able-bodied subjects walked on a treadmill-mounted balance beam (2.5-cm wide) before and after 30 min of training. During training, two groups walked on the beam with a destabilization device that augmented error (Medium and High Destabilization groups). A third group walked on a narrower beam (1.27-cm) to augment error (Narrow). The fourth group practiced walking on the 2.5-cm balance beam (Wide). Subjects in the Wide group had significantly greater improvements after training than the error augmentation groups. The High Destabilization group had significantly less performance gains than the Narrow group in spite of similar failures per minute during training. In a follow-up experiment, a fifth group of subjects (Assisted) practiced with a device that greatly reduced catastrophic errors (i.e., stepping off the beam) but maintained similar pelvic movement variability. Performance gains were significantly greater in the Wide group than the Assisted group, indicating that catastrophic errors were important for short-term learning. We conclude that increasing errors during practice via destabilization and a narrower balance beam did not improve short-term learning of beam walking. In addition, the presence of qualitatively catastrophic errors seems to improve short-term learning of walking balance.


5As Team obesity intervention in primary care: development and evaluation of shared decision-making weight management tools.
Despite several clinical practice guidelines, there remains a considerable gap in prevention and management of obesity in primary care. To address the need for changing provider behaviour, a randomized controlled trial with convergent mixed method evaluation, the 5As Team (5AsT) study, was conducted. As part of the 5AsT intervention, the 5AsT tool kit was developed. This paper describes the development process and evaluation of these tools. Tools were co-developed by the multidisciplinary research team and the 5AsT, which included registered nurses/nurse practitioners (n = 15), mental health workers (n = 7) and registered dieticians (n = 7), who were previously randomized to the 5AsT intervention group at a primary care network in Edmonton, Alberta, Canada. The 5AsT tool development occurred through a practice/implementation-oriented, need-based, iterative process during learning collaborative sessions of the 5AsT intervention. Feedback during tool development was received through field notes and final provider evaluation was carried out through anonymous questionnaires. Twelve tools were co-developed with 5AsT. All tools were evaluated as either 'most useful' or 'moderately useful' in primary care practice by the 5AsT. Four key findings during 5AsT tool development were the need for: tools that were adaptive, tools to facilitate interdisciplinary practice, tools to help patients understand realistic expectations for weight loss and shared decision-making tools for goal setting and relapse prevention. The 5AsT tools are primary care tools which extend the utility of the 5As of obesity management framework in clinical practice.


Knowledge of the national emergency telephone number and prevalence and characteristics of those trained in CPR in Queensland: baseline information for targeted training interventions.
Members of the community contribute to survival from out-of-hospital cardiac arrest by contacting emergency medical services and performing cardiopulmonary resuscitation (CPR) prior to the arrival of an ambulance. In Australia there is a paucity of information of the extent that community members know the emergency telephone number and are trained in CPR. A survey of Queensland adults (n=4490) was conducted to ascertain current knowledge and training levels and to target CPR training. Although most respondents (88.3%) could state the Australian emergency telephone number correctly, significant age differences were apparent (P<0.001). One in five respondents aged 60 years and older could not state the emergency number correctly. While just over half the respondents (53.9%) had completed some form of CPR training, only 12.1% had recent training. Older people were more likely to have never had CPR training than young adults. Additional demographic and socio-economic differences were found between those never trained in CPR and those who were. The results emphasise the need to increase CPR training in those aged 40 and over, particularly females, and to increase the awareness of the emergency telephone number amongst older people.


Radiofrequency ablation does not induce apoptosis in the rat myocardium.
The mechanisms implicated in the genesis of delayed radiofrequency (RF) effects remain unclear, but may be related to extension of the lesion beyond the region of coagulative necrosis. The role of apoptosis in this process has not been previously reported. We assessed whether RF promotes apoptosis in the region surrounding acute ablation lesions in a rat model. Wistar rats (n=30; weight 300 g) were anesthesized, the chest was opened, and the heart was exposed. A modified unipolar RF ablation (custom catheter 4.5-mm-tip diameter, 12 Watts, 10 seconds) was undertaken on the left ventricular anterolateral epicardial surface and the chest was closed. After 2 hours, animals were killed for histological (hematoxylin and eosin, TdT-mediated dUTP Nick End-Labeling [TUNEL] assay) and immunohistochemical (anti-BAD and anti-caspase 3 antibodies) analysis (n=18). Additional animals (n=12) were sacrificed at 2 (n=3), 24 (n=3), 48 (n=3), and 72 hours (n=3) after ablation exclusively for anti-BAD Western Blotting analysis. Lesions were characterized by well-defined regions of coagulative necrosis. In 18/18 (100%) animals, TUNEL assay revealed positive luminescent reaction cells in the region surrounding the lesion, extending up to 2 mm from the border zone. However, microscopic evaluation of the nuclei and immunohistochemical and anti-BAD Western Blotting analysis were negative in all (100%) rats. Thus, positive TUNEL reaction in the periphery of the ablation lesion likely reflects nonspecific DNA damage. RF ablation does not promote apoptosis in the periphery of the myocardial lesion. This finding may have implications for the elucidation of late lesion extension following RF ablation.


Cardiovascular mortality in women with obstructive sleep apnea with or without continuous positive airway pressure treatment: a cohort study.
Obstructive sleep apnea (OSA) is a risk factor for cardiovascular death in men, but whether it is also a risk factor in women is unknown. To investigate whether OSA is a risk factor for cardiovascular death in women and assess whether continuous positive airway pressure (CPAP) treatment is associated with a change in risk. Prospective, observational cohort study. 2 sleep clinics in Spain. All women consecutively referred for suspected OSA between 1998 and 2007. Every woman had a diagnostic sleep study. Women with an apnea-hypopnea index (AHI) less than 10 were the control group. Obstructive sleep apnea was diagnosed when the AHI was 10 or higher (classified as mild to moderate [AHI of 10 to 29] or severe [AHI ≥30]). Patients with OSA were classified as CPAP-treated (adherence ≥4 hours per day) or untreated (adherence <4 hours per day or not prescribed). Participants were followed until December 2009. The end point was cardiovascular death. 1116 women were studied (median follow-up, 72 months [interquartile range, 52 to 88 months]). The control group had a lower cardiovascular mortality rate (0.28 per 100 person-years [95% CI, 0.10 to 0.91]) than the untreated groups with mild to moderate OSA (0.94 per 100 person-years [CI, 0.10 to 2.40]; P = 0.034) or severe OSA (3.71 per 100 person-years [CI, 0.09 to 7.50]; P < 0.001). Compared with the control group, the fully adjusted hazard ratios for cardiovascular mortality were 3.50 (CI, 1.23 to 9.98) for the untreated, severe OSA group; 0.55 (CI, 0.17 to 1.74) for the CPAP-treated, severe OSA group; 1.60 (CI, 0.52 to 4.90) for the untreated, mild to moderate OSA group; and 0.19 (CI, 0.02 to 1.67) for the CPAP-treated, mild to moderate OSA group. The study was observational and not randomized, and OSA was diagnosed by 2 different methods. Severe OSA is associated with cardiovascular death in women, and adequate CPAP treatment may reduce this risk. None.


Sequence analysis and docking performance of extracellular chitinase from Bacillus pumilus MCB-7, a novel mangrove isolate.
Bacterial chitinases has a major role in chitinaceous waste management, biological control of pests and phytopathogens. In the present study, exochitinase gene ChitA encoding extracellular chitinase from the mangrove bacteria Bacillus pumilus MCB-07 was genetically characterized. Oligonucleotide primers specific to chitinase gene of Bacillus pumilus were designed and amplified by PCR. The purified PCR product was successfully cloned in pGEM-T vector and transformed into Escherichia coli DH5-α competent cells. Nucleotide sequence alignment of the chitinase gene revealed 96 % similarity whereas 94 % of the catalytic domain of 598 amino acids is conserved with protein family GH18 chitinases, which is a novel report for Bacillus pumilus. The insert also showed a number of substitutions (mutations) with other sp. of Bacillus which demonstrated that chitinase of Bacillus pumilus MCB-07 is a novel gene. Multiple sequence alignment of chitinase gene sequences and its predicted amino acid sequences were also evaluated and the sequence was deposited in GenBank with accession number KT966736.1. Homology modeling of the chitinase depicted the typical (α/β) 8 TIM barrel structure. Molecular docking of the protein was performed by Autodock 4.2.6 and the docked pocket contained Val 113, Met 114, Gln 99, Ala 75 and Cys 98 as the key binding residues. The molecular docking of Bacillus pumilus chitinase, revealed the involvement of a phenylalanine of the catalytic domain in the catalytic process of chitin to mono and oligomers of NAG. The amino acid exhibited both hydrophobic and hydrogen bond interactions of chitin molecules with phenylalanine.


Intestinal perforation in ascariasis--case reports.
Two cases of intestinal perforation in association with ascariasis are described. In both cases adult ascarids were found either in the gut or lying free in the peritoneal cavity. Neither patient had typhoid fever, one had Hodgkin's lymphoma. The authors believe that the perforation were directly caused by the ascarids. Both patients died.


Statin use and the risk of developing diabetes: a network meta-analysis.
Randomized controlled trials have shown mixed findings regarding the association of statins and diabetes. This systematic literature review and network meta-analysis (NMA) was performed to update evidence on this association to possibly assist clinicians in making more informed treatment choices. We identified studies relevant to our NMA by performing study searches in databases like Embase, Cochrane, and PubMed, published between August 2010 and June 2014. Pre-2010 studies were identified from bibliography of previously published meta-analyses. Unpublished study data were found from clinicaltrial.gov. Data synthesis was performed by pairwise meta-analysis and NMA within a Frequentist framework. Twenty nine trials in which 1 63 039 participants had been randomized were included in this review; among these 1 41 863 were non-diabetic patients. The direct meta-analysis showed that statins, as a class, significantly increased the likelihood of developing diabetes by 12% (pooled OR 1.12; 95%CI 1.05-1.21; I2 36%; p = 0.002; 18 RCTs). In the NMA, atorvastatin 80 mg was associated with a highest risk of diabetes, with OR of 1.34 (95%CI 1.14-1.57) followed by rosuvastatin (OR: 1.17; 95%CI: 1.02-1.35). The ORs (95%CIs) for simvastatin 80 mg, simvastatin, atorvastatin, pravastatin, lovastatin and pitavastatin were 1.21 (0.99-1.49), 1.13 (0.99-1.29), 1.13 (0.94-1.34), 1.04 (0.93-1.16), 0.98 (0.69-1.38) and 0.74 (0.31-1.77), respectively. High-dose atorvastatin increased the odds of developing diabetes even when compared with pravastatin, simvastatin and low-dose atorvastatin in the NMA. Based on the results, statins, as a class, increased the risk of diabetes significantly in the pairwise meta-analysis. Overall, there appears to be a small increased risk of incident diabetes, particularly with more intensive statin therapy, although more data would be valuable to increase the robustness of this interpretation, given that the lower confidence intervals of our study analyses are close to, or just crossing one. Copyright © 2016 John Wiley & Sons, Ltd.


Microcomputer-based local area network system for controlling information on perinatal medicine.
We present an outline of our microcomputer-based Local Area Network (LAN) system designed to process information related to perinatal events. This system enables any of the medical personnel to use a microcomputer terminal installed at the bedside and also to process, in a real-time manner, new input-information together with past information, thereby correlating the processing of medical information to actual clinical care. In addition, using the utility subsystem, a more desired form of data-output can be substituted for conventional hand-prepared clinical charts. Over a 3-month test period for clinical use, it became evident that this could serve as a suitable prototype system capable of covering the entire scope of information required by perinatologists. This system also enables any form of statistical assessment to be made of events, such as calculating the perinatal mortality rate and the incidence of preeclampsia. Problems arising from the clinical application of this system are given immediate attention and appropriate steps taken.


Sucrose intake by rats affected by both intraperitoneal oxytocin administration and time of day.
Daily limited access to palatable food or drink at a fixed time is commonly used in rodent models of bingeing. Under these conditions, entrainment may modulate intake patterns. Oxytocin is involved in circadian patterns of intake and, when administered peripherally, reduces sucrose intake. However, oxytocin's effects on intake under limited-access conditions and its potential interaction with entrainment have not been explored. This study examined the role of entrainment on intake patterns, oxytocin's effects on sucrose intakes and locomotor activity and whether oxytocin's effects were mediated by its actions at the oxytocin receptor. Sated rats received daily 1-h access to 10% sucrose solution either at a fixed or varied time of day. Rats received intraperitoneal oxytocin (0 mg/kg, 0.3 mg/kg, 1 mg/kg, 3 mg/kg) prior to sucrose access, and spontaneous locomotor activity was assessed in an open-field test. Rats were then pre-treated with an oxytocin receptor antagonist, L368,899, prior to oxytocin before sucrose access. Intake patterns did not differ between fixed- or varied-time presentations; rats consumed more sucrose solution in the middle as opposed to the early-dark phase. Oxytocin dose-dependently reduced sucrose intakes, but also reduced locomotor activity. There was some evidence of partial blockade of oxytocin-induced sucrose intake reductions by L368,899, but the results were unclear. Time of day and oxytocin impact sucrose solution intake under daily limited access in rats and the sedative-like effects of oxytocin should be considered in future studies on oxytocin and food intake.


The interferon-induced protein BST-2 restricts HIV-1 release and is downregulated from the cell surface by the viral Vpu protein.
The HIV-1 accessory protein Vpu counteracts a host factor that restricts virion release from infected cells. Here we show that the interferon-induced cellular protein BST-2/HM1.24/CD317 is such a factor. BST-2 is downregulated from the cell surface by Vpu, and BST-2 is specifically expressed in cells that support the vpu phenotype. Exogenous expression of BST-2 inhibits HIV-1 virion release, while suppression of BST-2 relieves the requirement for Vpu. Downregulation of BST-2 requires both the transmembrane/ion channel domain and conserved serines in the cytoplasmic domain of Vpu. Endogenous BST-2 colocalizes with the HIV-1 structural protein Gag in endosomes and at the plasma membrane, suggesting that BST-2 traps virions within and on infected cells. The unusual structure of BST-2, which includes a transmembrane domain and a lumenal GPI anchor, may allow it to retain nascent enveloped virions on cellular membranes, providing a mechanism of viral restriction counteracted by a specific viral accessory protein.


[A field evaluation of the epidemiological efficacy of an attenuated live hepatitis A vaccine (H2 strain)].
To evaluate the epidemiological efficacy of an attenuated live hepatitis A vaccine (H2 strain). A randomized and controlled field trial was carried out in part of Zhengding County and the Jiaoqu District of Shijiazhuang city. There were about 37,000 children in these areas involved in the study and they were randomly divided into a vaccine group and a control group according to the months they were born. Children in the vaccine group were given a dose of 10(6.5) TCID50/ml attenuated live hepatitis A vaccine while those in the control group were given nothing. As soon as the children in the vaccine group had been vaccinated, all the subjects were carefully followed up for hepatitis A cases. In the 3.5 years of follow-up, there were 20 hepatitis A cases in the control group and the incidence rate was 136.4 per 100,000 population. There was only one hepatitis A case in the vaccine group and the incidence rate was 8.1 per 100,000 population. The difference of the incidence rates between the two groups was highly significant (P < 0.001) and the protective efficacy of the vaccine was 94.4% (95% CI: 67.1%-100%). The protective efficacy of the vaccine was excellent and the vaccine is suitable to be widely used.


Paraventricular hypothalamic influences on spinal nociceptive processing.
Oxytocin properties have been studied in different experimental models in order to obtain evidence for its analgesic properties. The analgesic effect of an oxytocinergic pathway descending from the hypothalamus reaching the dorsal horn of the spinal cord has been studied. In anesthetized rats, we recorded single units at the L4-L5 spinal dorsal horn level and stimulated the peripheral receptive field. The evoked responses were classified according to their latencies in A-beta, A-delta, C fibers, and postdischarge. We used these responses to evaluate the effects of electrical stimulation of the paraventricular nucleus (PV) of the hypothalamus. We observed a selective blockage of A-delta and C fibers related to the duration of the train stimulus duration. Similar effects were observed when oxytocin (OT) was applied directly on the spinal cord. The effects of OT and of PV electrical stimulation were reversed in a dose-dependent manner by application of the specific OT antagonist (OTA). These effects were observed in cells with reduced wind-up and cells displaying a clear wind-up response to peripheral stimulation. Superficial and deeper cells in the dorsal spinal cord were involved. The recorded cells were marked by pontamine blue iontophoretic injection after each cell recording, and their histological locations were specified. In order to obtain a behavioral correlation, we used rats with a loose ligature of the sciatic nerve and a chronic intrathecal catheter reaching the L4-L5 spinal cord level. We tested the hyperalgesia and allodynia of these animals using von Frey filaments and the application of acetone to the hind paws. Our results show a significant reduction in the mechanical and thermal test after the administration of 15 microl of 10(-6) M OT. Our electrophysiological, pharmacological, and behavioral results point out a clear OT antialgesic effect. The results are discussed on the basis of a previous work showing an OT blockage of glutamate activation. The paraventricular hypothalamic descending OT pathway is proposed as an interesting mechanism producing analgesia.


The stability of L-glutamine in total parenteral nutrition solutions.
An assessment was made over a period of 14 days of the rate of glutamine degradation in different intravenous solutions kept at 22-24 degrees C, 4 degrees C, -20 degrees C and -80 degrees C. At room temperature (22-24 degrees C) degradation rates in mixed parenteral nutrition solutions and aminoacid/dextrose solutions ranged from 0.7-0.9%/day, in Perifusin 0.6%/day, and in dextrose alone as low as 0.15%/day. At 4 degrees C, glutamine degradation was <0.1-0.2%/day in all solutions examined, at -20 degrees C it was minimal (<0.04%/day) and at -80 degrees C, it was undetectable. Glutamine degradation was found to be associated with the formation of equimolar quantities of ammonia. No glutamate formation was detected. It is concluded that it is possible to store glutamine in parenteral nutrition solutions kept at 4 degrees C, with about 2% loss over a period of 14 days. The degradation is sufficiently slow to consider the use of intravenous glutamine in nutritional therapy.


Response to Enhanced Cognitive Behavioural Therapy in an Adolescent with Anorexia Nervosa.
Few studies have examined the acceptability and usefulness of enhanced cognitive behavioural therapy (CBT-E) for adolescents with eating disorders (EDs). To investigate whether CBT-E was an acceptable and efficacious treatment for an adolescent presenting to a routine clinical service with an ED. Daily self-monitoring records were completed during a baseline (A) and intervention (B) phase in addition to routine outcome measures. There were reductions in both ED behaviours and "feeling fat", and increases in weight after 11 CBT-E sessions. Progress was only partially maintained at 8-month follow-up. CBT-E may be an acceptable and useful intervention for adolescents with EDs.


Ubiquitin and beta-amyloid-protein in inclusion body myositis (IBM), familial IBM-like disorder and oculopharyngeal muscular dystrophy: an immunocytochemical study.
We used immunocytochemistry to identify ubiquitin and beta-amyloid-protein in muscle biopsies from patients with three neuromuscular disorders characterized by the presence of rimmed vacuoles in muscle fibres: inclusion body myositis (IBM), familial IBM-like disorder and oculopharyngeal muscular dystrophy (OPMD). Labelling with anti-ubiquitin antibodies was observed in all three diseases, but it was frequent in IBM, less common in familial IBM-like disorder and rare in OPMD. This labelling is thought to correspond to the presence of IBM-type filaments (16-18 nm in external diameter) which are characteristic but not specific for IBM or familial IBM-like disorder, as they may also occur in other diseases including OPMD. Labelling with anti-beta-amyloid-protein antibody was seen in a few fibres in IBM but not in the other two conditions. The structures labelled with this antibody have yet to be determined. Labelling with anti-ubiquitin or anti-beta-amyloid-protein antibodies was not correlated with the presence of acid phosphatase activity.


Sequential cardiorespiratory patterns of anesthetic induction with ketamine in critically ill patients.
Hemodynamic and O2 transport effects of ketamine anesthesia were evaluated in 22 critically ill patients. After placement of radial and pulmonary artery catheters, simultaneous measurement were made of cardiac output, intravascular pressures, arterial and mixed venous gases, saturations, pH, and Hct; cardiorespiratory values then were calculated for a preinduction control period and sequentially at frequent intervals over a 15-min observation period. In general, there was an early progressive increase in HR, cardiac index (CI), arterial and venous pressures, stroke work, and O2 delivery (DO2); O2 consumption (VO2) and O2 extraction (O2 Ext) decreased. In general, ketamine produced an inotropic cardiac response, but these responses were not uniform; a relatively small percentage had reduced pressures, flow, and reduced myocardial performance that were related to hypovolemia and associated medical conditions.


Impact of a Novel Score to Predict Left Ventricular Diastolic Dysfunction After Catheter Ablation of Nonparoxysmal Atrial Fibrillation With Preserved Ejection Fraction.
The impact of catheter ablation of atrial fibrillation (AFCA) on left ventricular (LV) diastolic function is still unknown. This study aimed to develop a novel risk score to predict LV diastolic dysfunction (LVDD) 12 months after AFCA (12-month LVDD) and to evaluate whether the risk score was associated with cardiovascular events (cardiovascular death, transient ischemic attack/stroke, myocardial infarction, or heart failure hospitalization). We studied 397 patients with nonparoxysmal AF with preserved ejection fraction who underwent initial AFCA (age: 69 years, women: 32%). LVDD was diagnosed if more than 2 of 3 variables (average E/e' ratio >14, septal e' velocity <7 cm/s or lateral e' velocity <10 cm/s, and tricuspid valve regurgitation velocity >2.8 m/s) were present. The 12-month LVDD was observed in 89 patients (23%). A total of 4 preprocedural variables (woman, average E/e' ratio ≥9.6, age ≥74 years, and left atrial diameter ≥50 mm [WEAL]) were identified as predictors of 12-month LVDD on multivariable analysis. We developed a WEAL score. The prevalence of 12-month LVDD increased as WEAL scores increased (p <0.001). There was a statistically significant difference in cardiovascular events-free survival between those at high risk (WEAL score: 3 or 4) and those at low risk (WEAL score: 0, 1, or 2). (86.6% vs 97.2%, log-rank p = 0.009). The WEAL score before AFCA is useful to predict 12-month LVDD after AFCA in patients with nonparoxysmal AF with preserved ejection fraction and is associated with cardiovascular events after AFCA.


Genotyping of Streptococcus mutans by using arbitrarily primed polymerase chain reaction in children with Down Syndrome.
The aim of this study was to compare the caries prevalence between Down Syndrome (DS) and non-DS children and to investigate the difference between the genotypes of Streptococcus mutans (S. mutans) colonized in both DS and non-DS groups. Sixty children with DS and 64 non-DS children aged between 7 and 12 years old were included to this study. All erupted teeth were evaluated according to the criteria recommended by the World Health Organization. Unstimulated saliva samples were carried out from the children and cultivated on S. mutans selective Tryptone-yeast-cystine (TYC) agar with 0.2 U/ml bacitracin and 15% sucrose. Molecular typing of S. mutans strains was performed by using arbitrarily primed polymerase chain reaction (AP-PCR) with OPA-05 primer. All data were analysed by using SPSS (SPSS Inc., Chicago, IL, USA) 11.0 software program for windows. The caries index scores were found significantly lower in DS individuals than the non-DS group (p < 0.05). The salivary S. mutans levels between DS and non-DS groups did not show significant difference (p > 0.05). The difference between dental caries and salivary S. mutans levels also was not statistically significant (p > 0.05). According to the results of the AP-PCR typing, all profiles of S. mutans which colonized in DS group were different from the control group. The relationship between these different profiles and dental caries prevalence was statistically significant (p < 0.05). The profiles of S. mutans colonized in DS group might be a reason of low caries prevalence.


Low-Temperature Continuous Flow Synthesis of Metal Ammonium Phosphates.
The synthesis of the high performance inorganic materials essential to the quality of modern day life is hindered by traditionalist attitudes and reliance on outdated methods such as batch syntheses. While continuous flow methods have been extensively adopted in pharmaceutical circles, they remain largely unexplored for the preparation of inorganic compounds, despite higher efficiency, safety and versatility. In this publication, we demonstrate a step-change for the synthesis of metal ammonium phosphates through conversion of the extant batch process to a low-temperature continuous regime, exhibiting a tenfold increase in throughput combined with a significant decrease in particle size.


Virus replication begins in dendritic cells during the transmission of HIV-1 from mature dendritic cells to T cells.
To initiate immunity, dendritic cells (DCs) capture antigens or viruses at body surfaces, undergo maturation to express T-cell costimulatory molecules, and then migrate to lymphoid organs. DCs at body surfaces can capture human immunodeficiency virus 1 (HIV-1), but mature DCs do not support replication of the virus unless T cells are added. The initial site for HIV-1 replication remains unknown and it is unclear whether replication can take place in DCs or whether the virus must first be transmitted from DCs to T cells. We generated mature DCs from monocyte precursors. Upon infection with HIV-1, reverse transcription was completed only when T cells were added. When the reverse transcriptase inhibitor azidothymidine was added to the DCs during exposure to HIV-1, the DCs remained fully infectious, as long as the drug was removed just before culturing the DCs with T cells. HIV-1 variants that were engineered to undergo only one cycle of replication were able to infect DCs and replicate once in these cells. When T cells were added, newly produced HIV-1 Gag protein was exclusively localized to the DCs. With wild-type virus, subsequent rounds of replication took place in T cells. Soluble CD40 ligand (CD40L) and CD40L-transfected fibroblasts stimulated HIV-1 replication in purified mature DCs. Mature DCs provide a drug-resistant reservoir for HIV-1. This reservoir is activated within DCs by CD40L and upon interaction with T cells, and the virus then spreads rapidly to other T cells.


Identification and characteristic analysis of powder ejected from a lithium ion battery during thermal runaway at elevated temperatures.
The thermal runaway of a lithium ion battery under abusive conditions has become an urgent problem in recent years. The thermal runaway generates flammable and toxic gases and ejects a hazardous black solid powder. Although relevant research on gas vented from thermal runaway has been studied in recent works, the composition, hazardous characteristics and formation process of the ejected powder remain unclarified. To investigate the hazardous characteristics of the ejected powder products and further provide insights into the thermal runaway mechanisms of lithium ion battery in terms of the identified components, a series of instrumental tests were performed and analyzed in this work. The results show that the powder ejected from the thermal runaway of a lithium ion battery is composed of carbon, organic chemicals, carbonate, metal, metal oxides and other impurities. Different states of charge of the lithium ion battery, heating modes and environmental atmospheres have certain effects on the formation of the ejected powder. These effects include the production of slightly different components in the ejected powder and changes in the particle sizes. The ejected powder is produced via a complex formation process and is hazardous due to its organic components, metal and metal oxides.


Overexpression of the RAD2 gene of S. cerevisiae: identification and preliminary characterization of Rad2 protein.
The cloned RAD2 gene of S. cerevisiae was tailored into regulatable expression vectors for overexpression of Rad2 protein in E. coli and in yeast. In E. coli both Rad2/beta-galactosidase fusion protein and native Rad2 protein are insoluble, but are extractable with 1% Sarkosyl. In yeast some of the overexpressed native Rad2 protein is also insoluble; however, soluble protein is readily detected by immunoblotting with Rad2-specific antibodies. All forms of the protein detected in transformed or untransformed yeast cells and the insoluble species in E. coli migrate in denaturing polyacrylamide gels with an apparent molecular weight considerably larger than the size predicted from the sequence of the RAD2 coding region. This property is not the result of post-translational glycosylation detectable by binding of concanavalin A, or of phosphorylation of the protein. Overexpression of the RAD2 gene is toxic to yeast. Transformed yeast cells grow much more slowly than untransformed controls and when yeast transformants are serially propagated cultures show considerably colony heterogeneity and concomitant selection for rapidly growing variants which express less Rad2 protein. Antisera raised against Rad2/beta-galactosidase fusion protein expressed in E. coli do not cross-react with Rad1, Rad3 or Rad10 protein in crude extracts of yeast, nor with purified E. coli UvrA, UvrB or UvrC proteins.


CHO(E)P-14 followed by alemtuzumab consolidation in untreated peripheral T cell lymphomas: final analysis of a prospective phase II trial.
The rate of long-term remissions after treatment of peripheral T cell lymphomas (PTCL) with standard CHOP-like protocols is unsatisfactory. A prospective multicenter phase II trial was initiated in untreated patients with PTCL of all International Prognostic Index-risk groups, evaluating alemtuzumab consolidation in patients with complete or good partial remission after CHO(E)P-14 induction. Twenty-nine (70.7 %) of the 41 enrolled patients received alemtuzumab consolidation (133 mg in total). The main grades 3-4 toxicities during alemtuzumab therapy were infections and neutropenia with one potentially treatment-related death. Complete responses were seen in 58.5 %, partial responses in 2.4 % and 29.3 % had progressive disease. After a median observation time of 46 months, 19 patients have died, 16 of them due to lymphoma and/or salvage therapy complications. Event-free and overall survival at 3 years in the whole intent to treat population are 32.3 and 62.5 %, respectively, and 42.4 and 75.1 % in the patients who received alemtuzumab. In conclusion, application of a short course of alemtuzumab after CHO(E)P-14 induction is feasible although complicated by severe infections. A current phase III trial, applying alemtuzumab as part of the initial chemotherapy protocol to avoid early progression, will further clarify its significance for the therapeutic outcome.


Comparison between F-Fluorodeoxyglucose Positron Emission Tomography and Sentinel Lymph Node Biopsy for Regional Lymph Nodal Staging in Patients with Melanoma: A Review of the Literature.
Aim. to compare (18)F-Fluorodeoxyglucose positron emission tomography (FDG-PET) to sentinel lymph node biopsy (SLNB) for regional lymph nodal staging in patients with melanoma. Methods. We performed a literature review discussing original articles which compared FDG-PET to SLNB for regional lymph nodal staging in patients with melanoma. Results and Conclusions. There is consensus in the literature that FDG-PET cannot replace SLNB for regional lymph nodal staging in patients with melanoma.


Temperature measurements in high thermal gradients: I. The effects of conduction.
Two temperature probes (a fluoroptic sensor and a metallic thermistor), which are both suitable for stereotaxic implantation, were used in comparative thermometry studies during interstitial microwave heating of the brain in vivo. Thermal distributions having large temperature gradients (5-10 degrees C/cm) were routinely observed. The temperature differentials (delta T) between the 2 probes were position dependent within the thermal field. The maximum difference in temperatures measured, using the 2 probes along identical tracks without a catheter, ranged between 0.5 degree C and 1.8 degree C. Near the brain/air surface, the thermistor measured lower temperatures than the optical probe; however, medial to the antenna, the thermistor temperatures were higher than the optic sensor. The measured temperature discrepancies are the result of smearing due to thermal conduction along the axial length of the metallic thermistor probe. These effects are significantly accentuated when the temperature probes are tracked in catheters. Experiments performed in a nonperfused phantom, heated with the interstitial microwave antenna, demonstrated similar conductive effects. Studies in a nonelectromagnetic environment (flow cell-thermal step gradient) additionally confirmed that thermal conductive artifacts were the major source of temperature error.


The synaptic membrane D2-protein in amniotic fluid from pregnancies with fetal neural tube defects.
The D2-protein is a neuronal membrane protein which has an immunochemically detectable soluble derivative in cerebrospinal fluid. We used rocket-on-line immunoelectrophoresis with an antiserum against rat synaptosomal membranes for demonstration of the human D2-protein in fetal cerebrospinal fluid and in amniotic fluids from pregnancies with fetal neural tube defects. D2 was neither found in normal amniotic fluids nor in cases of amniotic fluids from pregnancies with other malformations. Analysis of D2 in amniotic fluids may thus have a future role in the antenatal diagnosis of fetal neural tube defects.


Cranial Nerve Stimulation for Olfaction (Cranial Nerve 1).
Like sensory maps in other systems, the sense of smell has an organizational structure based on converging projections of olfactory receptor neurons containing unique odorant receptors onto the olfactory bulb in synaptic aggregations termed glomeruli. This organizational structure provides the potential for electrical stimulation and restoration of smell. Prior animal and human studies support the feasibility of an olfactory stimulation device, encouraging ongoing work in development of olfactory implants.


The development of a pediatric radiology sedation program.
An increase in the number of patients undergoing sedation for imaging procedures has led to many changes in practice over the past 10 years. The purpose of this study was to compare and evaluate sedation practice changes in a pediatric radiology department during the last 5 years. The radiology computer database and corresponding minutes of the Radiology Sedation Committee were reviewed to identify changes in sedation policy. Data from three blocks of time were analyzed to determine time to sedation, time to discharge, drug frequency, rates of adverse events, sedation failure, and paradoxical reaction. Specific practice changes undertaken over the 5-year period include: (1) increased speed of administration of IV pentobarbital, (2) alternating pentobarbital and fentanyl, (3) presedation with midazolam, and (4) administering oral pentobarbital to children under and (5) over 12 months of age. Based on data analysis, changes 1 and 4 were incorporated into the sedation policy, while changes 2, 3, and 5 were abandoned. Comparison of data from the three time segments revealed improvement in the time to sedation, sedation failure, adverse event, and paradoxical reaction rates. There is improvement in all aspects of patient outcomes with sedation, as a result of several changes in sedation practice.


Time-dependent changes in hypothalamic dopamine metabolism during feeding in the rat.
The accumulation of the dopamine metabolite dihydroxyphenylacetic acid (DOPAC), but not the serotonin metabolite 5-hydroxyindoleacetic acid, in the hypothalamus is increased in rats during the second, third and fourth hours of a four hour period of access to food following a 20 hour period of food deprivation. This metabolic change does not correlate with duration of access to food or with amount of food consumed. These results suggest that increased hypothalamic dopamine metabolism during feeding is not related in any simple way to either the onset or termination of feeding.


Novel strategy with potential to identify developmentally competent IVF blastocysts.
Currently there are no markers fully predictive of developmental competence of human IVF embryos. The present study investigated a novel strategy involving blastocyst biopsy and DNA fingerprinting to link developmental competence with gene expression patterns. Patient's blastocysts were biopsied to remove 8-20 trophectoderm (TE) cells for molecular analysis prior to transfer. Biopsy samples were amplified and gene expression was evaluated using microarrays. Sibling TE biopsies and cells from resulting offspring were subjected to DNA fingerprinting to identify which blastocyst(s) in the transfer cohort developed to term. Blastocyst biopsy did not appear to impair developmental competence. Comparative microarray analysis of cDNA from pooled 'viable' and 'non-viable' TE samples identified over 7000 transcripts expressed exclusively in 'viable' blastocysts. The most significant of these included transcripts involved in cell adhesion and cell communication, key processes that have been associated with mammalian implantation. DNA fingerprinting of three cohorts of sibling blastocysts identified those blastocyst(s) that produced term pregnancies. The combination of blastocyst biopsy, microarray gene expression profiling and DNA fingerprinting is a powerful tool to identify diagnostic markers of competence to develop to term. This strategy may be used to develop a rapid diagnostic assay or for refining existing criteria for the selection of the single most viable blastocyst among a cohort developing in vitro.


Dual wavelength scanning cytophotometry (Bicoscan).
A computer program has been developed for stage-scanning cytophotometry of double-stained microscopical specimens. The program permits the simultaneous measurement of absorbance values at two wavelengths in each measuring spot. To account for overlap in the absorbance spectra of the two stained endproducts, the program incorporates correction of the measured data to compensate for the contribution of each chromophore to the absorbance measured for the other. The program will compute the corrected local absorbance values at specified wavelengths for each chromophore at each measuring spot and integrate these values over the total object to give separate totals for each stain. It is also possible to have integrated the absorbance values of one chromophore for all those measuring spots where the local corrected absorbance value of the other chromophore exceeds a preset minimum value. When this other chromophore is a nuclear DNA stain, it is possible to obtain an approximate measure of the content of any compound in the nuclear area which can be stained with a chromophore having an absorbance spectrum different from the DNA stain. The validity of the program was investigated on model preparations consisting of two (differently) coloured films of which the absorbance values could be measured either individually or in combination, by partially overlaying one film on the other. The program's potential has been demonstrated by using the combination of either Naphthol Yellow S or dinitrofluorobenzene as protein stains with the Feulgen-pararosaniline(SO2) procedure for DNA in chicken erythrocytes and rat liver cells.


Antiparasitic properties of 4-nerolidylcatechol from Pothomorphe umbellata (L.) Miq. (Piperaceae) in vitro and in mice models with either prepatent or patent Schistosoma mansoni infections.
Roots of Pothomorphe umbellata (L.) Miq. are used in traditional medicine of Africa and South America for the treatment of malaria and helminthiasis. However, neither P. umbellata nor its isolated compounds have been evaluated against Schistosoma species. To investigate the antischistosomal effects of P. umbellata root extracts and the isolated compound 4-nerolidylcatechol (4-NC) against Schistosoma mansoni ex vivo and in murine models of schistosomiasis. The crude hydroalcoholic (PuE) and hexane (PuH) extracts of P. umbellata roots were prepared and initially submitted to an ex vivo phenotypic screening against adult S. mansoni. PuH was analyzed by HPLC-DAD, characterized by UHPLC-HRMS/MS, and submitted to chromatographic fractionation, leading to the isolation of 4-NC. The anthelmintic properties of 4-NC were assayed ex vivo against adult schistosomes and in murine models of schistosomiasis for both patent and prepatent S. mansoni infections. Praziquantel (PZQ) was used as a reference compound. PuE (EC50: 18.7 μg/mL) and PuH (EC50: 9.2 μg/mL) kill adult schistosomes ex vivo. The UHPLC-HRMS/MS analysis of PuH, the most active extract, revealed the presence of 4-NC, peltatol A, and peltatol B or C. After isolation from PuH, 4-NC presented remarkable in vitro schistosomicidal activity with EC50 of 2.9 μM (0.91 μg/mL) and a selectivity index higher than 68 against Vero mammalian cells, without affecting viability of nematode Caenorhabditis elegans. In patent S. mansoni infection, the oral treatment with 4-NC decreased worm burden and egg production in 52.1% and 52.3%, respectively, also reducing splenomegaly and hepatomegaly. 4-NC, unlike PZQ, showed in vivo efficacy against juvenile S. mansoni, decreasing worm burden in 52.4%. This study demonstrates that P. umbellata roots possess antischistosomal activity, giving support for the medicinal use of this plant against parasites. 4-NC was identified from P. umbellata roots as one of the effective in vitro and in vivo antischistosomal compound and as a potential lead for the development of novel anthelmintics.


Social determinants of health on human immunodeficiency virus care quality in Indonesia.
The aim was to examine the social determinants of health on human immunodeficiency virus care quality for children in Indonesia. A qualitative design using constructivist grounded theory methods was utilized. Data were collected between 2019 and 2020 using in-depth- interviews and memo writing. In total, 23 semi-structured individual interviews with healthcare professionals, 12 with children with human immunodeficiency virus, and eight family members were conducted. Data were analysed with the two-step initial coding and focused coding, along with the constant comparative method, theoretical sensitivity and memo writing. Five themes were constructed from participants' perspectives on human immunodeficiency virus care for children: (1) living with a low-socioeconomic status, (2) lacking instrumental support, (3) experiencing complicated procedures for public health insurance, (4) limited Human Immunodeficiency Virus care services for children and (5) lacking care coordination, policies and practices. Children living with human immunodeficiency virus had poor health outcomes, due to having a low-socioeconomic status, reduced access to healthcare, coupled with a lack of social support services. This study demonstrated how the social determinants of health negatively impact the quality of care for Indonesian children with human immunodeficiency virus and their families. Understanding these determinants would benefit health professionals, in particular nurses, to consider these factors in their assessment to create a holistic care plan for children living with human immunodeficiency virus and their families. Addressing the social determinants of health would beneficially enhance outcomes and well-being of children living with human immunodeficiency virus health in Indonesia.


Influence of depressive symptoms on distress related to positive psychotic-like experiences in women.
The Community Assessment of Psychic Experiences (CAPE) is an effective instrument for detection of the presence of psychotic symptoms and associated distress in the general population. However, little research has studied distress associated with positive psychotic-like experiences (PLEs). Our aim is to study PLE-related distress using the CAPE. In this study we analysed factors associated with differences in PLE-related distress in a sample of 200 non-clinical participants recruited by snowball sampling. Presence of PLEs and related psychological distress was measured using the CAPE questionnaire. The influence of age, gender, educational level and drug use was studied. In univariate analysis we found that gender and CAPE positive, depressive and negative scores, were associated with CAPE positive distress. Using multiple linear regression, we found that only the effect of gender, and the interaction between frequency of depression and gender, remained statistically significant. In our sample interaction between gender and depressive symptoms is a determining factor in distress associated with positive PLEs. The results of this study may be useful for the implementation of prevention programs.


B-cell modulation with anti-CD79b antibodies ameliorates experimental autoimmune encephalitis in mice.
B cells play a major role in the pathogenesis of many autoimmune diseases like MS, rheumatoid arthritis, or systemic lupus erythematosus. Depletion of B cells with anti-CD20 antibodies is an established therapy for MS. However, total B-cell depletion will also affect regulatory B cells that are known to suppress autoimmune responses. In our studies, we describe an alternative approach based on targeting CD79b that induces only partial B-cell depletion and achieves therapeutic effects by B-cell modulation. Prophylactic and therapeutic treatment with an antibody against CD79b and also a deglycosylated variant of this antibody, lacking effector function like antibody-dependent cellular cytotoxicity or complement activation, significantly reduced the development and progression of EAE in mice. Our data show that modulation of B cells via CD79b is equally effective as almost complete B-cell depletion with anti-CD20 antibodies and may constitute an alternative approach to treat MS.


Risk Factors and Nomogram for Postoperative Pulmonary Infection in Patients with Cervical Spinal Cord Injury.
To identify the risk factors for developing postoperative pulmonary infection in patients with acute cervical spinal cord injury (CSCI), and to develop a nomogram prediction model. Patients with CSCI who were admitted to 3 different medical centers between July 2011 and July 2021 were included in this study. All patients underwent cervical spine surgery. Data for patients admitted to the first 2 centers were included in a training set to establish the nomogram prediction model, and data for patients admitted to the third center were included in a validation set to externally verify the efficacy of the prediction model. For the training set, patients were divided into an infected group and a noninfected group (control group). Independent risk factors for postoperative pulmonary infection in patients with CSCI were identified by univariate and multivariate logistic regression analyses. Additionally, a nomogram prediction model was developed and validated based on the risk factors. A total of 689 patients were enrolled, including 574 for the training set and 115 for the validation set. Of the patients included for the training set, 144 developed pulmonary infection, with an incidence of 25.09%; 40 patients included for the validation set developed pulmonary infection (34.78%). Multivariate logistic regression analysis showed that age, American Spinal Injury Association grade, steroid pulse, high-level injury, smoking, multistage surgery, and operation duration were risk factors for the development of postoperative pulmonary infection in patients with CSCI. The area under the curve of the receiver operating characteristic curve of the model built by the training set was 0.905, and that of the receiver operating characteristic curve of the verification set was 0.917. The decision curve indicated that the model was in the range 1%-100%, and the predicted net benefit value of the model was high. Age, American Spinal Injury Association grade, steroid pulse, CSCI site, smoking history, number of surgical levels, and surgical duration are correlated with the development of postoperative pulmonary infection in patients with CSCI. The risk prediction model of postoperative pulmonary infection has a good prediction efficiency and accuracy.


FK506 binding protein 12 differentially accelerates fibril formation of wild type alpha-synuclein and its clinical mutants A30P or A53T.
Aggregation of alpha-synuclein (alpha-SYN) plays a key role in Parkinson's disease. We have previously shown that aggregation of alpha-SYN in vitro is accelerated by addition of FK506 binding proteins (FKBP) and that this effect can be counteracted by FK506, a specific inhibitor of these enzymes. In this paper, we investigated in detail the effect of FKBP12 on early aggregation and on fibril formation of wild-type, A53T and A30P alpha-SYN. FKBP12 has a much smaller effect on the fibril formation of these two clinical mutants alpha-SYN. Using an inactive enzyme, we were able to discriminate between catalytic and non-catalytic effects that differentially influence the two processes. A model explaining non-linear concentration dependencies is proposed.


Enhancement of biomethane potential of brown sludge by pre-treatment using vortex based hydrodynamic cavitation.
Novel, non-thermal and economically benign pre-treatment process was developed for enhancing valorisation potential of brown sludge generated by dairy industry wastewater treatment plant (WWTP). Vortex-based hydrodynamic cavitation (HC) device was used to quantify influence of pretreatment by measuring biomethane potential (BMP) of untreated and treated brown sludge. Pre-treatment parameters, primarily, pressure drop and number of passes through the cavitation device were varied to quantify influence on BMP. BMP tests were performed at 39 °C containing 5% of total solids in each reactors using an automatic BMP measurement system containing 15 reactors with each volume of 500 mL fitted with overhead stirrer. HC treatment increased the soluble chemical oxygen demand (sCOD) by more than 25% which increased the BMP. HC treatment was able to push the BMP of treated sludge to more than 80% of the theoretical BMP. Volatile solids (VS) removal was more than 65%. Highest methane yield was 376 mL/g-VS of sludge. The methodology and results presented here show significant potential to valorise brown dairy sludge via vortex based hydrodynamic cavitation.


Development of an ultrasonically activated trocar system.
Although rare, visceral and vascular injuries related to the insertion of conventional laparoscopic trocars may have disastrous consequences. Most of these injuries are due to the high puncture force applied to the trocar. We present the results of an animal laboratory evaluation of a newly developed ultrasonically activated trocar. A total of 40 punctures were made in four pigs with an average weight of 53 kg. An 11-mmHg pneumoperitoneum was created through a Veress needle. A 10-mm diameter trocar was inserted in the midline for a laparoscope. A series of five trocars were then inserted on each lateral wall under laparoscopic control. Twenty punctures were made with a conventional reusable 11-mm trocar (CT) whose tip was sharp and conical. Twenty punctures were made with an 11-mm ultrasonically activated trocar (UT), whose fequency was 23.5 KHz and amplitude 150 mm. The cutaneous incision was made large enough so that the skin did not interfere with the trocar insertion. The force applied to the trocar was measured with a push-pull gauge connected to a computer. The following data were recorded: maximal force applied to the trocar to obtain insertion of the tip through the abdominal wall, maximum abdominal pressure increase during trocar insertion, and time for abdominal penetration. The average time needed for trocar penetration was 12.8 s with CT and 4.5 s with UT (p < 0.001). The average maximal force was 6.8 kgF with CT and 0.4 kgF with UT (p < 0.001). The average abdominal pressure increase was 7.6 mmHg with CT and 0.8 mmHg with UT (p < 0.001). At 30 days, no necrosis was found. Pathological findings were similar in both groups. Ultrasonically activated trocars required less time and much less force to be inserted. This may be a breakthrough in the safety of trocar insertion.


Using the Logic Model Framework to Standardize Quality and Rigor in the DNP Project.
Since the implementation of the DNP degree, there has been controversy, confusion, and inconsistency about the DNP project. To this day, the profession lacks a consensus of what the DNP project should be. Despite much in the literature regarding these issues, there is no systematic approach to the development of DNP project guidelines. Consequently, there is now an escalating interest in increasing the quality and rigor of DNP projects. Many issues related to the DNP project can be addressed using a logic model approach and incorporating current best practices. This article demonstrates how a logic model can be used for the development or improvement of DNP project processes, incorporating best practices and evaluation methods to ensure quality and rigor.


Comparison between three molecular methods for detection of blood melanoma tyrosinase mRNA. Correlation with melanoma stages and S100B, LDH, NSE biochemical markers.
The molecular monitoring of circulating tumor cells by reverse transcriptase-PCR (RT-PCR) for patients with melanoma, is still under debate. It may be affected by: a) pre-analytical variability, b) frequency of melanoma-associated gene transcripts and c) the reliability of the methods employed. Few commercial methods are available for the detection of tyrosinase mRNA in blood. Comparison between two RT-PCR-nested methods with a third one based on real-time methodology, for detection and quantitation of tyrosinase transcripts, respectively. Sixty-two melanoma patients with different AJCC stages and 20 healthy subjects were enrolled. All blood samples were extracted in duplicate with two different methods. Two nested-PCR methods (one commercial and one in house) plus a real time commercial kit were employed. The two nested PCR methods employed were overimposable, specific and sensitive, at least in the stage III, where there was a concordance between sentinel lymph nodes detection and blood tyrosinase positivity. The different extraction methods did not affect the quality of results, while the commercial real-time kit cannot be used. Tyrosinase mRNA detection may be therefore employed to monitor the melanoma patients over time in function of response to therapy.


Determinants of outpatient substance use disorder treatment length-of-stay and completion: the case of a treatment program in the southeast U.S.
Successful outcomes of outpatient substance use disorder treatment result from many factors for clients-including intersections between individual characteristics, choices made, and social determinants. However, prioritizing which of these and in what combination, to address and provide support for remains an open and complex question. Therefore, we ask: What factors are associated with outpatient substance use disorder clients remaining in treatment for > 90 days and successfully completing treatment? To answer this question, we apply a virtual twins machine learning (ML) model to de-identified data for a census of clients who received outpatient substance use disorder treatment services from 2018 to 2021 from one treatment program in the Southeast U.S. We find that primary predictors of outcome success are: (1) attending self-help groups while in treatment, and (2) setting goals for treatment. Secondary predictors are: (1) being linked to a primary care provider (PCP) during treatment, (2) being linked to supplemental nutrition assistance program (SNAP), and (3) attending 6 or more self-help group sessions during treatment. These findings can help treatment programs guide client choice making and help set priorities for social determinant support. Further, the ML method applied can explain intersections between individual and social predictors, as well as outcome heterogeneity associated with subgroup differences.


Mitochondrial branched chain aminotransferase gene expression in AS-30D hepatoma rat cells and during liver regeneration after partial hepatectomy in rat.
Branched chain aminotransferase (BCAT) is the first enzyme in the catabolism of branched chain amino acids (BCAA). Unlike other amino acid degrading enzymes present in liver, BCAT is only expressed in extrahepatic tissues, and is not regulated by dietary protein, glucagon or glucocorticoids. However, the mitochondrial (m) isoform of BCAT is highly expressed in the fetal liver and rapidly decays after birth. The purpose of the present work was to establish if liver cells under conditions of rapid cell proliferation such as in hepatoma AS30D cells or during liver regeneration after partial hepatectomy were associated with an increase in the activity and expression of BCATm. BCAT activity in mitochondria of AS30D cells was 18.6 mU/mg protein. Western, Northern blot, and immunohistochemical analysis revealed that AS30D hepatoma cells expressed only BCATm. The apparent Km of BCATm in isolated AS30D cells mitochondria for leucine, isoleucine and valine was 1.0+/-0.02, 1.3+/-0.1 and 2.1+/-0.1 mM, respectively. The regenerated liver showed BCAT activity from day 3 to day 6, and the maximal BCAT activity (7.0 mU/mg protein) was on day 5. By day 14 after partial hepatectomy BCAT activity and expression was almost undetectable. Interestingly, there was a relationship between BCAT activity and the Mr. of the immunoreactive band of BCATm. The presence of a 41 kDa band was associated with BCAT activity, whereas the 43 kDa band with undetectable activity. The results of this study indicate that BCATm activity is required in liver cells under conditions of rapid cell proliferation.


Different photochemical events of a genetically encoded phenyl azide define and modulate GFP fluorescence.
Expanding the genetic code opens new avenues to modulate protein function in real time. By genetically incorporating photoreactive phenyl azide, the fluorescent properties of green fluorescent protein (GFP) can be modulated by light. Depending on the residue in GFP programmed to incorporate the phenyl azide, different effects on function and photochemical pathways are observed.


The impact of body mass index in old age on cause-specific mortality.
To assess the association between Body Mass Index (BMI) and cause-specific mortality in older adults and to assess which BMI was associated with lowest mortality. Prospective study. European towns. 1,980 older adults, aged 70-75 years from the SENECA (Survey in Europe on Nutrition and the Elderly: a concerted action) study. BMI, examined in 1988/1989, and mortality rates and causes of death during 10 years of follow-up. Cox proportional hazards model including both BMI and BMI², accounting for sex, smoking status, educational level and age at baseline showed that BMI was associated with all-cause mortality (p<0.01), cardiovascular mortality (p<0.01) and mortality from other causes (p<0.01), but not with cancer or respiratory mortality (p>0.3). The lowest all-cause mortality risk was found at 27.1 (95%CI 24.1, 29.3) kg/m², and this risk was increased with statistical significance when higher than 31.4 kg/m² and lower than 21.1 kg/m². The lowest cardiovascular mortality risk was found at 25.6 (95%CI 17.1, 28.4) kg/m², and was increased with statistical significance when higher than 30.9 kg/m². In this study, BMI was associated with all-cause mortality risk in older people. This risk was mostly driven by an increased cardiovascular mortality risk, as no association was found for mortality risk from cancer or respiratory disease. Our results indicate that the WHO cut-off point of 25 kg/m² for overweight might be too low in old age, but more studies are needed to define specific cut-off points.


Results of laparoscopically assisted colon resection for carcinoma.
Surgical resection is the primary treatment for colorectal carcinoma. Laparoscopically assisted colon resection technically is feasible for both benign and malignant disease. However, the role of laparoscopically assisted colon resection for carcinoma is controversial. We prospectively studied our first 100 patients with colorectal carcinoma who successfully underwent laparoscopically assisted colon resection for the carcinoma. The pathologic stages were Dukes' categories A-16, B-52, C-25, and D-7. Operative mortality and morbidity were 2% and 22%, respectively. During a mean follow-up period of 40.3 months, recurrence by stage was zero patients with stage A disease, five patients with stage B disease, nine patients with stage C disease. Thirteen of these patients died as a result of their disease. At this writing, 60 patients are alive without evidence of disease, and 23 have completed the study disease free after more than 60 months. The 5-year survival probabilities by stage were 100% for stage A, 76.8% for stage B, and 51.7% for stage C. Laparoscopically assisted colectomy for cancer can be performed safely. The recurrence rate after laparoscopically assisted resection appears to be at least as good as after open resection. Results from ongoing prospective, randomized trials are needed to confirm these findings.


Interaction Between Parenting Styles and Adrenarcheal Timing Associated With Affective Brain Function in Late Childhood.
Parenting and pubertal timing have consistently been associated with internalizing and externalizing symptoms in childhood and adolescence, and there is some evidence that the interaction between these factors may be important in conferring risk. However, few studies have investigated whether neurobiological factors mediate these relationships. The current study examined whether interactions between adrenarcheal timing and parenting styles were associated with affective brain function and, in turn, mental health difficulties. Participants were 88 healthy children (46 female and 42 male, mean age 9.42 years, SD = 1.08 years), with 45 classified as relatively early and 43 as relatively late in adrenarcheal development based upon adrenal hormone levels. Participants completed an affective face functional magnetic resonance imaging task, and parents reported on 5 parenting styles and on child internalizing and externalizing symptoms. Negative parenting styles (corporal punishment and poor monitoring) were associated with brain hemodynamic response while viewing affective faces in several subcortical and lateral prefrontal regions, and adrenarcheal timing and/or sex moderated most of these relationships. Sex differences in associations between corporal punishment and brain activation to affective faces indicated that late females might show less adaptive affective neural function when more exposed to this parenting style. Findings suggest that the interaction between parenting styles and adrenarcheal timing is associated with affective brain function in late childhood, with marked sex differences. Further longitudinal research with larger samples is needed to corroborate and expand upon these findings.


Rapid characterization of microorganisms by mass spectrometry--what can be learned and how?
Strategies for the rapid and reliable analysis of microorganisms have been sought to meet national needs in defense, homeland security, space exploration, food and water safety, and clinical diagnosis. Mass spectrometry has long been a candidate technique because it is extremely rapid and can provide highly specific information. It has excellent sensitivity. Molecular and fragment ion masses provide detailed fingerprints, which can also be interpreted. Mass spectrometry is also a broad band method--everything has a mass--and it is automatable. Mass spectrometry is a physiochemical method that is orthogonal and complementary to biochemical and morphological methods used to characterize microorganisms.


A real-time fluorescent gp32 probe-based assay for monitoring single-stranded DNA-dependent DNA processing enzymes.
Single-stranded DNA (ssDNA) generated during DNA replication, recombination and damage repair reactions is an important intermediate and ssDNA-binding proteins that binds these intermediates coordinate various DNA metabolic processes. Mechanistic details of these ssDNA-dependent processes can be explored by monitoring the generation and consumption of ssDNA in real time. In this work, a fluorescein-labeled gp32-based sensor was employed to continuously monitor various aspects of ssDNA-dependent DNA replication and recombination processes in real time. The gp32 protein probe displayed high sensitivity and specificity to a variety of ssDNA-dependent processes of T4 phage. Several applications of the probe are illustrated here: the solution dynamics of ssDNA-binding protein, protein-protein and protein-DNA interactions involving gp32 protein and its mode of interaction, ssDNA translocation and protein displacement activities of helicases, primer extension activity of DNA polymerase holoenzyme and nucleoprotein filament formation during DNA recombination. The assay has identified new protein-protein interactions of gp32 during T4 replication and recombination. The fluorescent probe described here can thus be used as a universal probe for monitoring in real time various ssDNA-dependent processes, which is based on a well-characterized and easy-to-express bacteriophage T4 gene 32 protein, gp32.


Assessing the influence and distribution of shrimp pond effluent in a tidal mangrove creek in north-east Australia.
Effluent from a land based shrimp farm was detected in a receiving creek as changes in physical, chemical and biological parameters. The extent and severity of these changes depended on farm operations. This assessment was conducted at three different stages of shrimp-pond maturity, including (1) when the ponds were empty, (2) full and (3) being harvested. Methods for assessing farm effluent in receiving waters included physical/chemical analyses of the water column, phytoplankton bioassays and nitrogen isotope signatures of marine flora. Comparisons were made with an adjacent creek that served as the farms intake creek and did not directly receive effluent. Physical/chemical parameters identified distinct changes in the receiving creek with respect to farm operations. Elevated water column NH(4)(+) (18.5+/-8.0 microM) and chlorophyll a concentrations (5.5+/-1.9 microg/l) were measured when the farm was in operation, in contrast to when the farm was inactive (1.3+/-0.3 microM and 1.2+/-0.6 microg/l, respectively). At all times, physical/chemical parameters at the mouth of the effluent creek, were equivalent to control values, indicating effluent was contained within the effluent-receiving creek. However, elevated delta(15)N signatures of mangroves (up to approximately 8 per thousand) and macroalgae (up to approximately 5 per thousand ) indicated a broader influence of shrimp farm effluent, extending to the lower regions of the farms intake creek. Bioassays at upstream sites close to the location of farm effluent discharge indicated that phytoplankton at these sites did not respond to further nutrient additions, however downstream sites showed large growth responses. This suggested that further nutrient loading from the shrimp farm, resulting in greater nutrient dispersal, will increase the extent of phytoplankton blooms downstream from the site of effluent discharge. When shrimp ponds were empty water quality in the effluent and intake creeks was comparable. This indicated that observed elevated nutrient and phytoplankton concentrations were directly attributable to farm operations.


[Biomechanics of whiplash injury].
The article reports a new hypothesis of whiplash injury based on a series of experimental studies using isolated human cadaveric specimens. Although the clinical symptoms of whiplash are widely known, the understanding of the underlying injury mechanism is poor. The prevailing view of neck-hyper-extension as the essential injury mechanisms was not supported by recent experiments. In a series of experiments using eight human cadaveric specimens which underwent experimental stepwise whiplash acceleration from 2.5 to 10.5 g functional radiographs and flexibility tests were performed at the end of each acceleration step. Ligament strains, vertebral alignment and elongation of the vertebral artery were monitored during the whiplash trauma by highspeed cinematography and specially designed transducers. After the trauma CT- and MRI-scans were taken and specimens were sectioned using Cryomicrotomy. We found a distinct biphasic kinematic response of the cervical spine to whiplash trauma. In the first phase the spine formed an S-shaped curve with flexion at the upper levels and hyper-extension at the lower levels. This phase was found to be the vulnerable phase of whiplash trauma. The largest dynamic elongation of the capsular ligaments was observed at the C6-C7 level during this initial S-shaped phase of whiplash. The maximum elongation of the vertebral artery could be observed synchronously in the first S-shaped curve of the cervical spine. In the second phase of whiplash all levels of the cervical spine were extended, so that the head reached is maximum extension. No injuries were observed in the second phase. We propose, based on our experimental findings, that with low accelerations the anterior structures of the lower cervical spine are injured during the first phase of whiplash, when the cervical spine forms an S-shaped curve and before the neck is fully extended. At higher trauma accelerations there is also a tendency for the injuries to occur at upper levels of the cervical spine. Based on our findings the traditional view of whiplash as hyper-extension injury can be modified by a differentiated, time dependent, biphasic biomechanical model of the injury, thus allowing better and more effective injury prevention, diagnosis and therapy.


Male function for ensuring pollination and reproductive success in Berberis lycium Royle: A novel mechanism.
In Berberis lycium anthers on alternate stamens dehisce, thus prolonging the male function so that pollination is affected and reproduction is ensured. The large pollen sac of each bithecous anther after the appearance of longitudinal dehiscence slit moves away from the filament while remaining attached at the tip of the connective and then orients in such a way that pollen-laden surface faces the stigma. No pollen is available to receptive stigma as pollen grains remain stuck to the anther sac. They do not get dispersed even by wind. Pollination and consequently reproduction is ensured through the intervention of insect, which does not affect pollen transfer to the stigma directly but by touching the base of the staminal filament while foraging nectar secreted by nectaries at the base of corolla, thus leading to staminal movement. This makes the dehisced anthers stick to the stigma and deposit pollen there.


Fluorinated poly(p-triphenyl piperidine) anion exchange membranes with robust dimensional stability for fuel cells.
Anion exchange membrane fuel cells (AEMFCs), which are more economical than proton exchange membrane fuel cells (PEMFCs), stand out in the context of the rapid development of renewable energy. Superacid-catalyzed ether-free aromatic polymers have recently received a lot of attention due to their exceptional performance, but their development has been hampered by the trade-off between the dimensional stability and ionic conductivity of anion exchange membranes (AEMs). Here, we introduced fluoroketones containing different numbers of fluorinated groups (x = 0, 3 and 6) in the main chain of p-terphenyl piperidine because of the favorable hydrophobic properties of fluorinated groups. The results show that fluorinated AEMs can enhance OH- conductivity by building more aggregated hydrophilic channels while ensuring dimensional stability. The PTF6-QAPTP AEM with more fluorinated groups has the most excellent performance at 80 °C with an OH- conductivity of 142.7 mS cm-1 and a swelling ratio (SR) of only 4.55 %. Additionally, it exhibits good alkali durability, with the OH- conductivity and quaternary ammonium (QA) cation retaining at 93.45% and 92.6%, respectively, after immersion in a 2 M NaOH solution at 80 °C for 1200 h. In addition, the power density of the PTF6-QAPTP based single cell reaches 849 mW cm-2 when the current density is 1600 mA cm-2. The PTF6-QAPTP based cell has a voltage retention of 88% after 80 h of stability testing at a constant current density of 300 mA cm-2 at 80 °C.


SKN-1/Nrf2-dependent regulation of mitochondrial homeostasis modulates transgenerational toxicity induced by nanoplastics with different surface charges in Caenorhabditis elegans.
The toxic effects of nanoplastics on transgenerational toxicity in environmental organisms and the involved mechanisms remain poorly comprehended. This study aimed to identify the role of SKN-1/Nrf2-dependent regulation of mitochondrial homeostasis in response to transgenerational toxicity caused by changes in nanoplastic surface charges in Caenorhabditis elegans (C. elegans). Our results revealed that compared with the wild-type control and PS exposed groups, exposure to PS-NH2 or PS-SOOOH at environmentally relevant concentrations (ERC) of ≥ 1 μg/L caused transgenerational reproductive toxicity, inhibited mitochondrial unfolded protein responses (UPR) by downregulating the transcription levels of hsp-6, ubl-5, dve-1, atfs-1, haf-1, and clpp-1, membrane potential by downregulating phb-1 and phb-2, and promoted mitochondrial apoptosis by downregulating ced-4 and ced-3 and upregulating ced-9, DNA damage by upregulating hus-1, cep-1, egl-1, reactive oxygen species (ROS) by upregulating nduf-7 and nuo-6, ultimately resulting in mitochondrial homeostasis. Additionally, further study indicated that SKN-1/Nrf2 mediated antioxidant response to alleviate PS-induced toxicity in the P0 generation and dysregulated mitochondrial homeostasis to enhance PS-NH2 or PS-SOOOH-induced transgenerational toxicity. Our study highlights the momentous role of SKN-1/Nrf2 mediated mitochondrial homeostasis in the response to nanoplastics caused transgenerational toxicity in environmental organisms.


Pretreatment anemia is associated with poorer survival in patients with stage I and II gastric cancer.
A negative correlation between anemia and outcome has been demonstrated in various cancers treated with radiotherapy. However, it is rarely studied whether this correlation may exist in surgical setting. Our aim was to investigate the relationship between pretreatment anemia and survival in surgically treated patients with gastric cancer. A total of 1,688 patients who had undergone curative resection for gastric cancer between 1991 and 1995 were reviewed. Anemia was defined as a hemoglobin level <12.0 g/dl. The influence of anemia on patient overall survival was evaluated by univariate and multivariate analysis. Pretreatment anemia was present in 39.9% of the patients. The 10-year overall survival rate in anemic patients was 48.2% as compared with 62.6% in nonanemic patients (P < 0.001). In subgroup analysis according to the stage, the significant difference in 10-year overall survival rate between anemic and nonanemic patients was found in stage I and II gastric cancer (76.1% vs. 83.5% in stage I, P = 0.030; 55.1% vs. 67.2% in stage II, P = 0.043). On multivariate analysis, anemia was an independent prognostic predictor in patients with stage I and II disease (P = 0.007; RR, 1.466; 95% CI, 1.109-1.937). Pretreatment anemia was found to have an independent relationship to the long-term survival of patients with stage I and II gastric cancer.


[Cricothyrotomy : Data situation, guidelines and techniques for the definitive surgical airway].
Cricothyrotomy represents the final approach to secure the airway, in the course of which less invasive measures have failed. It can also primarily be carried out to establish a secure airway. This is essential to protect the patient from a significant hypoxia. This is a cannot ventilate-cannot oxygenate (CVCO) situation, which presumably all colleagues in emergency intensive care medicine and anesthesia have already been confronted with. Evidence-based algorithms for the management of a difficult airway and CVCO have been established. If oxygenation using an endotracheal tube, an extraglottic airway device or bag-valve mask ventilation all fail, the airway must be surgically secured, i.e. using cricothyrotomy. The prevalence of the CVCO situation in a prehospital setting is ca. 1%. No valid prospective randomized in vivo studies have been carried with respect to the question of the best method.


The Assessment of Blood Loss During Total Knee Arthroplasty When Comparing Intravenous vs Intracapsular Administration of Tranexamic Acid.
Administration of tranexamic acid topically and intravenously has demonstrated effectiveness in decreasing blood loss and transfusion rates. We randomized 131 patients undergoing primary total knee arthroplasty to receive either intracapsular (69) or intravenous tranexamic acid (62). Postoperative blood loss was calculated using the formula derived by Nadler et al. The number of units transfused was recorded, as well as length of hospital stay. We found no statistically significant difference on calculated blood loss (postoperative day [POD] 1: 624 ± 326 vs 644 ± 292; P = .71, POD 2: 806 ± 368 vs 835 ± 319; P = .64, and POD 3: 1076 ± 419 vs 978 ± 343; P = .55). There was no difference in number of blood transfusions, length of stay, or complications. Intracapsular tranexamic acid is not inferior to intravenous tranexamic acid in decreasing blood loss and blood transfusion rate in primary total knee arthroplasty.


Comparison of freshly cultured versus freshly thawed (cryopreserved) mesenchymal stem cells in preclinical in vivo models of inflammation: a protocol for a preclinical systematic review and meta-analysis.
Mesenchymal stem cells (MSCs) are multipotent cells that demonstrate therapeutic potential for the treatment of acute and chronic inflammatory-mediated conditions. Especially for acute conditions, it is critical to have a readily available freshly thawed (cryopreserved) MSC product for rapid administration. Although controversial, some studies suggest that MSCs may lose their functionality with cryopreservation which in turn could render them non-efficacious. In controlled preclinical in vivo models of inflammation, to determine if there are differences in surrogate measures of preclinical efficacy between freshly cultured and freshly thawed MSCs METHODS/DESIGN: A systematic search for pre-clinical in vivo inflammatory model studies will compare freshly cultured to freshly thawed MSCs from any source. The primary outcomes will include measures of in vivo preclinical efficacy; secondary outcomes will include measures of in vitro MSC potency. Electronic searches for MEDLINE and EMBASE will be constructed and reviewed by the Peer Review of Electronic Search Strategies (PRESS) process. If applicable, study outcomes will be meta-analyzed using a random effects model. Risk of bias will be assessed by the SYRCLE "Risk of Bias" assessment tool for preclinical in vivo studies. The results of this systematic review will provide translational scientists, clinical trialists, health regulators, and the clinical and public community with the current pre-clinical evidence base related to the efficacy and potency of freshly cultured versus freshly thawed MSCs, help identify evidence gaps, and guide future related research. Protocol is submitted to PROSPERO for registration (pending confirmation) and will be submitted to Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies (CAMARADES) for public posting.