High level of CTP synthase induces formation of cytoophidia in cortical neurons and impairs corticogenesis.
De novo synthesis of the nucleotide CTP is catalyzed by the essential pyrimidine biosynthesis enzyme CTP synthase (CTPs), which forms large-scale filamentous structures consisting of CTPs termed cytoophidia in prokaryotes and in eukaryotes. Recent studies have shown that cytoophidia are abundant in neuroepithelial stem cells in Drosophila optic lobes and that overexpression of CTPs impairs optic lobe development. Whether CTPs and cytoophidia also play a role in the development of the mammalian cortex remains elusive. Here, we show that overexpression of CTPs by in utero electroporation in the embryonic mouse brain induces formation of cytoophidia in developing cortical neurons and impairs neuronal migration. In addition, the increase of cytoophidia accelerates neuronal differentiation and inhibits neural progenitor cell proliferation by reducing their mitotic activity. Furthermore, we discovered that the cytoophidia diffused during the early G1-phase of the cell cycle. Together, our findings show, for the first time, that CTPs play a significant role in the development of the mammalian cortex.


Increased serum concentrations of signal peptide-Cub-Egf domain-containing protein-1 in patients with aneurysmal subarachnoid hemorrhage.
Signal peptide-Cub-Epidermal growth factor domain-containing protein 1 (SCUBE1), a marker for coagulation, is correlated with prognosis of some critical illnesses. The current study was designed to investigate the potential prognostic value of serum SCUBE1 concentrations in patients with aneurysmal subarachnoid hemorrhage (aSAH). Serum SCUBE1 concentrations of 125 patients and 125 controls were determined. Multivariate analyses were performed to identify independent risk factors for 6-month mortality, overall survival and unfavorable outcome (Glasgow Outcome Scale score of 1-3). Serum SCUBE1 concentrations were significantly higher in patients than in controls (17.7±7. vs. 1.2±0.4ng/ml, P<0.001) and were associated highly with World Federation of Neurological Surgeons (WFNS) scores (t=5.109, P<0.001) and modified Fisher scores (t=4.329, P<0.001). SCUBE1 emerged as an independent predictor for 6-month clinical outcomes. It had similar area under receiver operating characteristic curve (AUC) to WFNS scores and modified Fisher scores. Moreover, it could markedly improve the AUC of WFNS scores and modified Fisher scores to predict 6-month unfavorable outcome. Enhanced SCUBE1 concentrations are correlated with increasing severity and poor outcomes of aSAH patients, indicating SCUBE1 might have the potential to identify aSAH patients at risk of poor prognosis.


Abdominal Aortic Emergencies.
This article discusses abdominal aortic emergencies. There is a common thread of risk factors and causes of these diseases, including age, male gender, hypertension, dyslipidemia, and connective tissue disorders. The most common presenting symptom of these disorders is pain, usually in the chest, flank, abdomen, or back. Computed tomography scan is the gold standard for diagnosis of pathologic conditions of the aorta in the hemodynamically stable patient. Treatment consists of a combination of blood pressure and heart rate control and, in many cases, emergent surgical intervention.


Diet Quality in the United States Improved during the Great Recession and Deteriorated During Economic Recovery.
Macroeconomic changes are associated with population health outcomes, such as mortality, accidents, and alcohol use. Diet quality is a risk or protective factor that could be influenced by economic conditions. This study examined the trajectory of diet quality measured by the Healthy Eating Index 2015 before, during, and after the 2008-2009 Great Recession. Repeated cross-sectional survey data from the National Health and Nutrition Examination Survey were analyzed. The analytic sample included 48,679 adults who completed at least one dietary recall from National Health and Nutrition Examination Survey 1999-2018. Diet quality was assessed with a 24-hour dietary recall to calculate the Healthy Eating Index 2015 total scores, a measure of the conformance with the 2015-2020 Dietary Guidelines for Americans. Least squares regression was used to adjust for demographic changes across waves. Diet quality improved noticeably during the Great Recession and deteriorated as economic conditions improved. Deteriorating economic circumstances may constrain choices, but that does not necessarily imply a worsening of dietary quality. During the Great Recession, American diets became more consistent with Dietary Guidelines for Americans recommendations, possibly because of a shift toward food prepared at home instead of prepared food bought away from home.


Pain and Quality of Life in Patients Undergoing Lumbar Arthrodesis for Degenerative Spondylolisthesis: A Systematic Review.
Degenerative spondylolisthesis is a disease characterized by the displacement of a vertebra above the underlying vertebra. Lumbar arthrodesis is currently the most frequently performed surgical option for treatment due to the use of various approaches and techniques. The disease is characterized by low back pain, a clinical and public health problem, which in addition to having a socio-economic burden, severely affects functional status, quality of life (QoL), activity impairment, and health services. The study aims to investigate the benefits, in terms of pain, disability, andQoL, of lumbar arthrodesis surgery in patients with degenerative spondylolisthesis, at the latest follow-up. A systematic literature review registered in PROSPERO (ID: CRD42022379242), was conducted in the databases of: Cochrane Library, PubMed, Embase, Scopus, and Web of Science. The key words used were as follows: "spondylolisthesis", "arthrodesis", "degenerative", "quality of life", "pain", "patient reported outcome", and "disability". A total of 26 articles were included. Significant differences were found between the preoperative and postoperative evaluation of the outcomes considered, in particular: pain (MD = -6.74; SD = 2.83; 95% CI: -8.01 to -5.46), low back pain (MD = -3.35; SD = 3.27; 95% CI: -3.61 to -3.10), lower limb pain (MD = -3.81; SD = 3.80; 95% CI: -4.10 to -3.51), disability (MD = -23.75; SD = 19.68; 95% CI: -25.26 to -22.23) and QoL (MD = 0.21; SD = 0.24; 95% CI: 0.19 to 0.23). The results show significant improvement in all measured variables, demonstrating that there are different surgical treatments to cure degenerative spondylolisthesis. However, residual pain impacting the QoL remains, regardless of the technique used. Therefore, the development of personalized pain management for patients with residual chronic pain is indicated.


Construction of a bacterial artificial chromosome library for a myxobacterium of the genus Cystobacter and characterization of an antibiotic biosynthetic gene cluster.
A bacterial artificial chromosome (BAC) library was constructed to isolate the biosynthetic gene cluster for the polyketide/peptide hybrid-type antibiotic cystothiazole A from the myxobacterium Cystobacter fuscus strain AJ-13278. Sequence analysis of a 63.9 kb contiguous region that encompasses the biosynthetic gene cluster (cta) led to the identification of a polyketide synthase (PKS)/nonribosomal peptide synthetase (NRPS) hybrid gene cluster 32.1 kb in size, which consists of six open reading frames (ORFs), ctaB to ctaG, as well as downstream genes ctaJ and ctaK (1.0 and 0.9 kb, respectively) responsible for the final biosynthetic steps. The genes ctaB, ctaE, and ctaF encode PKSs, the genes ctaC and ctaG encode NRPSs, and ctaD encodes an NRPS-PKS hybrid enzyme. Disruption of ctaD impaired cystothiazole A production. Additionally, two downstream genes, ctaJ and ctaK, which encode a nitrilase and an O-methyltransferase, respectively, must be responsible for the final methyl ester formation in the cystothiazole A biosynthesis.


Primary total hip arthroplasty using an uncemented Wagner SL stem in elderly patients with Dorr type C femoral bone.
The purpose of this study was to review retrospectively the primary total hip arthroplasties operated upon with the cementless Wagner Self-Locking stem in patients with type C femoral bone. Twenty-eight total hip arthroplasties were performed in 25 patients aged ≥ 60 years using a cementless Wagner Self-Locking femoral component between 2006 and 2011. According to Dorr's criteria, all 28 femora were classified as type C bone. All patients were treated with THA using a cementless Wagner cone prosthesis. Clinical and radiologic evaluations were performed on all patients. Mean follow-up period was 125 ± 10.5 months (range 96 to 156 months). Average Harris hip score pre-operatively was 46 ± 9 (range 39 to 62) and at the last follow-up was 90 ± 9 (range 83 to 98). The stem to canal fill is calculated as percentages on the operative side at three distinct levels: just below the lesser trochanter, at midstem, and 1 cm above the tip of the component on anteroposterior radiograph. The mean proximal stem-to-canal fill percentages were 97% ± 2.1%, 95% ± 3.5%, and 88% ± 2.6%, respectively (anteroposterior view) and 92% ± 2.2%, 86% ± 1.9%, and 83% ± 2.5%, respectively (lateral view). Radiographic evaluation demonstrated good osteointegration of the implants in the follow-up. Based on the long-straight cylindrical tapered stem design, the cementless Wagner SL stem can achieve reliable stability by close apposition of the stem and wide stovepipe femoral canal from metaphysis to diaphysis in type C bone.


Cationic liposomes containing antioxidants reduces pulmonary injury in experimental model of sepsis: Liposomes antioxidants reduces pulmonary damage.
The intracellular redox state of alveolar cells is a determining factor for tolerance to oxidative and pro-inflammatory stresses. This study investigated the effects of intratracheal co-administration of antioxidants encapsulated in liposomes on the lungs of rats subjected to sepsis. For this, male rats subjected to sepsis induced by lipopolysaccharide from Escherichia coli or placebo operation were treated (intratracheally) with antibiotic, 0.9% saline and antioxidants encapsulated or non-encapsulated in liposomes. Experimental model of sepsis by cecal ligation and puncture (CLP) was performed in order to expose the cecum. The cecum was then gently squeezed to extrude a small amount of feces from the perforation site. As an index of oxidative damage, superoxide anions, lipid peroxidation, protein carbonyls, catalase activity, nitrates/nitrites, cell viability and mortality rate were measured. Infected animals treated with antibiotic plus antioxidants encapsulated in liposomes showed reduced levels of superoxide anion (54% or 7.650±1.263 nmol/min/mg protein), lipid peroxidation (33% or 0.117±0.041 nmol/mg protein), protein carbonyl (57% or 0.039 ± 0.022 nmol/mg protein) and mortality rate (3.3%), p value <0.001. This treatment also reduced the level of nitrite/nitrate and increased cell viability (90.7%) of alveolar macrophages. Taken togheter, theses results support that cationic liposomes containing antioxidants should be explored as coadjuvants in the treatment of pulmonary oxidative damage.


Generation and periodontal differentiation of human gingival fibroblasts-derived integration-free induced pluripotent stem cells.
Induced pluripotent stem cells (iPSCs) have been recognized as a promising cell source for periodontal tissue regeneration. However, the conventional virus-based reprogramming approach is associated with a high risk of genetic mutation and limits their therapeutic utility. Here, we successfully generated iPSCs from readily accessible human gingival fibroblasts (hGFs) through an integration-free and feeder-free approach via delivery of reprogramming factors of Oct4, Sox2, Klf4, L-myc, Lin28 and TP53 shRNA with episomal plasmid vectors. The iPSCs presented similar morphology and proliferation characteristics as embryonic stem cells (ESCs), and expressed pluripotent markers including Oct4, Tra181, Nanog and SSEA-4. Additionally, these cells maintained a normal karyotype and showed decreased CpG methylation ratio in the promoter regions of Oct4 and Nanog. In vivo teratoma formation assay revealed the development of tissues representative of three germ layers, confirming the acquisition of pluripotency. Furthermore, treatment of the iPSCs in vitro with enamel matrix derivative (EMD) or growth/differentiation factor-5 (GDF-5) significantly up-regulated the expression of periodontal tissue markers associated with bone, periodontal ligament and cementum respectively. Taken together, our data demonstrate that hGFs are a valuable cell source for generating integration-free iPSCs, which could be sequentially induced toward periodontal cells under the treatment of EMD and GDF-5.


Musculoskeletal system neoplasia.
Tumors of the musculoskeletal system are rare in horses; however, they must be taken seriously. Diagnosis requires observation of clinical signs, radiographic findings, and histological examination. Veterinarians must realize prognosis is not favorable for most tumors; however, some of these tumors can be treated or at least ameliorated. Tumors discussed in this article include: osteoma and osteosarcoma; osteoblastoma; chondrosarcoma; fibroma and fibrosarcoma; plasma cell myeloma; synovioma; rhabdomyosarcoma and tumors metastatic to the musculoskeletal system.


Increment of hematopoietic progenitor cell count as an indicator of efficient autologs stem cell harvest in patients with multiple myeloma.
We previously showed that hematopoietic progenitor cell (HPC) count is a useful surrogate for the timing of autologs stem cell collection (ASCC). We investigated the role of HPC count increment in predicting the time for optimal ASCC in patients with multiple myeloma (MM). Between May 2002 and January 2011, 138 patients with MM who underwent ASCC after mobilization with cyclophosphamide (4 g/m(2)) and granulocyte-colony stimulating factor at Asan Medical Center. HPC monitoring was started on the 10th day of cyclophosphamide administration and ASCC was performed when HPC count reached at least 10/mm(3). Velocity of HPC increment (/mm(3) /day) was calculated as HPC count on the first day of ASCC/number of days from cyclophosphamide infusion to the first day of ASCC. A total of 422 leukapheresis were performed in 136 patients (median per patient: 3; range: 2-8). Of these patients, 131 (94.9%) successfully achieved optimal ASCC (≥5 × 106 CD34+ cells/kg). The median velocity of HPC increment was 2.17/mm(3) /day (range: 0.07-144.2/mm(3) /day). The mean ± standard error numbers of apheresis procedures in patients with velocity of HPC increment ≤2.0/mm(3) /day and >2.0/mm(3) /day were 3.43 ± 0.17 and 2.70 ± 0.11, respectively, and their median times to optimal ASCC were 15 and 13 days, respectively, with a hazard ratio of 0.47 (95% confidence interval, 0.32-0.68; P < 0.001) on multivariate analysis. Therefore, a slower increase of HPC of ≤2.0/mm(3) /day is associated with larger number of apheresis procedures for optimal ASCC.


Effect of respiratory motion on free-breathing 3D stack-of-radial liver R2∗ relaxometry and improved quantification accuracy using self-gating.
To develop an accurate free-breathing 3D liver R2∗ mapping approach and to evaluate it in vivo. A free-breathing multi-echo stack-of-radial sequence was applied in 5 normal subjects and 6 patients at 3 Tesla. Respiratory motion compensation was implemented using the inherent self-gating signal. A breath-hold Cartesian acquisition was the reference standard. Proton density fat fraction and R2∗ were measured and compared between radial and Cartesian methods using Bland-Altman plots. The normal subject results were fitted to a linear mixed model (P < .05 considered significant). Free-breathing stack-of-radial without self-gating exhibited signal attenuation in echo images and artifactually elevated apparent R2∗ values. In the Bland-Altman plots of normal subjects, compared to breath-hold Cartesian, free-breathing stack-of-radial acquisitions of 22, 30, 36, and 44 slices, had mean R2∗ differences of 27.4, 19.4, 10.9, and 14.7 s-1 with 800 radial views, and they had 18.4, 11.9, 9.7, and 27.7 s-1 with 404 views, which were reduced to 0.4, 0.9, -0.2, and -0.7 s-1 and to -1.7, -1.9, -2.1, and 0.5 s-1 with self-gating, respectively. No substantial proton density fat fraction differences were found. The linear mixed model showed free-breathing radial R2∗ results without self-gating were significantly biased by 17.2 s-1 averagely (P = .002), which was eliminated with self-gating (P = .930). Proton density fat fraction results were not different (P > .234). For patients, Bland-Altman plots exhibited mean R2∗ differences of 14.4 and 0.1 s-1 for free-breathing stack-of-radial without self-gating and with self-gating, respectively, but no substantial proton density fat fraction differences. The proposed self-gating method corrects the respiratory motion bias and enables accurate free-breathing stack-of-radial quantification of liver R2∗ .


Outcomes of extended transforaminal lumbar interbody fusion for lumbar spondylosis.
This study aims to assess the results of extended transforaminal lumbar interbody fusion (TLIF) for a two surgeon, single institution series. In total, extended TLIF with bilateral decompression was performed in 57 patients. Pain, American Spinal Injury Association scores, patient demographics, body mass index (BMI), perioperative indices and radiographic measurements were recorded and analysed. The surgeries were performed between February 2011 and January 2014 on 38 women and 19 men. The mean patient age was 62.86 years, and the mean BMI was 30.31 kg/m(2). In 49 patients, spondylolisthesis was the primary indication. The mean intraoperative time was 284.65 min, and this decreased as the series progressed. The median length of stay was 5 days (range: 2-9). The surgical complication rate was 19.3%. Two patients died from cardiopulmonary complications. Single level TLIF was performed in 78.9% of the cohort, with L4/5 the most commonly fused level. Significant pain reduction was achieved from a mean (± standard deviation) preoperative visual analogue scale (VAS) of 8.28 ± 1.39 to 1.50 ± 1.05 at 12 months postoperatively. No patients deteriorated neurologically. Spondylolisthesis was significantly corrected from a preoperative mean of 6.82 mm to 2.80 mm postoperatively. Although there is a learning curve associated with the procedure, extended TLIF with bilateral facet joint removal and decompression appeared to be a safe and effective alternative to other fusion techniques, and our results were comparable to other published case series. The stabilisation and correction of spinal deformity reduces pain, aids neurologic recovery and improves quality of life.


Synthetic RNAi triggers and their use in chronic hepatitis B therapies with curative intent.
Current therapies for chronic hepatitis B virus infection (CHB) - nucleos(t)ide analogue reverse transcriptase inhibitors and interferons - result in low rates of functional cure defined as sustained off-therapy seroclearance of hepatitis B surface antigen (HBsAg). One likely reason is the inability of these therapies to consistently and substantially reduce the levels of viral antigen production. Accumulated evidence suggests that high serum levels of HBsAg result in exhaustion of the host immune system, rendering it unable to mount the effective antiviral response required for HBsAg clearance. New mechanistic approaches are required to produce high rates of HBsAg seroclearance in order to greatly reduce off-treatment disease progression. Already shown to be a clinically viable means of reducing gene expression in a number of other diseases, therapies based on RNA interference (RNAi) can directly target hepatitis B virus transcripts with high specificity, profoundly reducing the production of viral proteins. The fact that the viral RNA transcripts contain overlapping sequences means that a single RNAi trigger can result in the degradation of all viral transcripts, including all messenger RNAs and pregenomic RNA. Advances in the design of RNAi triggers have increased resistance to degradation and reduced nonspecific innate immune stimulation. Additionally, new methods to effectively deliver the trigger to liver hepatocytes, and specifically to the cytoplasmic compartment, have resulted in increased efficacy and tolerability. An RNAi-based drug currently in clinical trials is ARC-520, a dynamic polyconjugate in which the RNAi trigger is conjugated to cholesterol, which is coinjected with a hepatocyte-targeted, membrane-active peptide. Phase 2a clinical trial results indicate that ARC-520 was well tolerated and resulted in significant, dose-dependent reduction in HBsAg for up to 57days in CHB patients. RNAi-based therapies may play an important role in future therapeutic regimes aimed at improving HBsAg seroclearance and eliminating the need for lifelong therapy. This paper forms part of a symposium in Antiviral Research on "An unfinished story: from the discovery of the Australia antigen to the development of new curative therapies for hepatitis B."


Analysis of the polypeptides synthesized in rinderpest virus-infected cells.
We have identified, by [35S]methionine labeling, eight major induced proteins and a number of minor proteins in rinderpest virus-infected bovine kidney cells. The polypeptides ranged in molecular weight from 212 to 21.5 kDa. The majority of these polypeptides are virus specific, as demonstrated by immunoprecipitation with rabbit hyperimmune serum against rinderpest. Infected cells radiolabeled with glucosamine contained a 75-kDa polypeptide and a broad band migrating at 80 kDa, both identified as virus specific by immunoprecipitation. Phosphorylated virus-specific proteins of 65 kDa and a complex of polypeptides at 92.5 kDa were also identified. Monospecific and monoclonal antibodies against measles virus and canine distemper virus hemagglutinin, fusion protein, nucleocapsid protein, and phosphoproteins confirmed the identity of the corresponding rinderpest virus-specific polypeptides.


An improved gas-chromatographic method for the determination of sulfated and unsulfated bile acids in serum.
This study has been aimed at improving some steps in the gas-liquid chromatographic determination of sulfated bile acids. The best conditions for the enzymatic hydrolysis with cholylglycine hydrolase of sulfolithocholylglycine and sulfolithocholyltaurine are described. Recoveries of more than 85% were obtained after prolonging the incubation to 12 h. A single-step procedure for solvolysis and methylation of bile acids was achieved by using, as a water scavenger, 2,2-dimethoxypropane added directly to the hydrolysis mixture. This procedure avoided the difficulty of the extraction of sulfated bile acids from aqueous solutions.


A comprehensive review on recent advances toward sequestration of levofloxacin antibiotic from wastewater.
Among various classes of antibiotics, fluoroquinolones, especially Levofloxacin, are being administered on a large scale for numerous purposes. Being highly stable to be completely metabolized, residual quantities of Levofloxacin get accumulated into the food chain proving a great global threat for aquatic as well as terrestrial ecosystems. Various removal techniques including both conventional and advanced methods have been reported for this purpose. This review is a novel attempt to make a critical analysis of the recent advances made exclusively toward the sequestration of Levofloxacin from wastewater through an extensive literature survey (2015-2021). Adsorption and advanced oxidation processes especially photocatalytic degradation are the most tested techniques in which assorted nanomaterials play a significant role. Several photocatalysts exhibited up to 100% degradation of LEV which makes photocatalytic degradation the best method among other tested methods. However, the degraded products need to be further monitored in terms of their toxicity. Biological degradation may prove to be the most environment-friendly with the least toxicity, unfortunately, not much research is reported in the field. With these key findings and knowledge gaps, authors suggest the scope of hybrid techniques, which have been experimented on other antibiotics. These can potentially minimize the disadvantages of the individual techniques concurrently improving the efficiency of LEV removal. Besides, techniques like column adsorption, membrane treatment, and ozonation, being least reported, reserve good perspectives for future research. With these implications, the review will certainly serve as a breakthrough for researchers working in this field to aid their future findings.


Reverse transcriptase polymerase chain reaction on fine needle aspirates for rapid detection of translocations in synovial sarcoma.
To evaluate the utilization of fine needle aspiration (FNA) biopsy to obtain material for reverse-transcriptase polymerase chain reaction (RT-PCR) in the detection of the t(X;18)(p11.2;q11.2) translocation in synovial sarcomas. We applied RT-PCR to detection of synovial sarcoma fusion gene transcripts on fine needle aspirates. Five clinical samples were first analyzed: one was a tumor previously diagnosed as malignant hemangiopericytoma, one was a poorly defined tumor, and three were suspected synovial sarcomas. FNA material was transferred directly to the RT-PCR reaction tube without RNA extraction. The t(X;18) translocation could be detected on the limited amount of material that FNA provides. In each of the cases studied the representivity of the tumor samples was confirmed microscopically. Our protocol permits analysis directly on representative samples without extraction of RNA. The results imply that RT-PCR offers reliable detection of sarcoma fusion gene transcripts on fine needle aspirates. The procedure, apart from being applicable to outpatients, is rapid and sensitive.


Effect of American ginseng (Panax quinquefolius L.) on arterial stiffness in subjects with type-2 diabetes and concomitant hypertension.
Substantial pre-clinical and some clinical data are available showing that Asian ginseng (Panax ginseng C.A. Meyer) varieties or its particular ginsenosides exert a vasodilatating effect, thus may modulate vascular function. However, the clinical evidence for American ginseng (Panax quinquefolius L.) is scarce. Therefore, this study evaluates the effect of American ginseng (AG) on arterial stiffness, as measured by augmentation index (AI), and blood pressure (BP), in type 2 diabetes patients with concomitant hypertension. Using a double-blind, placebo-controlled, parallel design, each participant was randomized to either the selected AG extract or placebo at daily dose of 3g for 12 weeks as an adjunct to their usual antihypertensive and anti-diabetic therapy (diet and/or medications). AI and BP were measured by applanation tonometry at baseline and after 12 weeks of treatment. A total of 64 individuals with well-controlled essential hypertension and type 2 diabetes (gender: 22 M:42 F, age:63 ± 9.3 years, BP: 145 ± 10.8/84 ± 8.0 mmHg, HbA1c: 7.0 ± 1.3%, fasting blood glucose (FBG): 8.1 ± 2.3 mmol/L) completed the study. Compared to placebo, 3g of AG significantly lowered radial AI by 5.3% (P=0.041) and systolic BP by 11.7% (P<0.001) at 12 weeks. No effect was observed with diastolic BP. Addition of AG extract to conventional therapy in diabetes with concomitant hypertension improved arterial stiffness and attenuated systolic BP, thus warrants further investigation on long-term endothelial parameters before recommended as an adjunct treatment.


[Clinical studies of adjuvant systemic chemotherapy in breast cancer in The Netherlands assumes a greater number of patients than is available].
To determine whether the number of breast cancer patients in the Netherlands is sufficient for the current clinical investigations of adjuvant systemic chemotherapy. Descriptive. Nationwide. The number of current investigations of adjuvant therapy for breast cancer was obtained from the chairmen of the Comprehensive Cancer Centres and from the Protocol Review Committee of the Dutch Cancer Society (Koningin Wilhelmina Fonds). There were eight studies in progress. The current investigations of adjuvant therapy for breast cancer need 3612 patients (903 per year with a study duration of 4 years). The total number of relevant breast cancer patients per year in the Netherlands is 4993. Taking into account the necessary subgroups with respect to age and positive/negative axillary lymph nodes, and possible reluctance of patients and doctors to cooperate, it is not surprising that a number of studies are delayed. The number of breast cancer patients needed for clinical trials of adjuvant systemic chemotherapy in the Netherlands is a limiting factor for the progress of these studies.


Middle ear disease in samples from the general population. II. History of otitis and otorrhea in relation to tympanic membrane pathology. The study of men born in 1913 and 1923.
A study of 1371 men 20, 30, 50 and 60 years old and living in the city of Göteborg was performed to obtain information on otitis media infections in the general population. In addition to anamnestic data, a thorough examination of the ENT status was made by one observer. In this second report a sizable proportion of the men reported a history of otitis or otorrhea but had normal tympanic membranes. However, overall there was a close correlation between a positive history of otitis and otorrhea, and findings of pathological tympanic membranes in all the age groups, and the longer the duration of the otitis with or without otorrhea, the more frequent were the pathological findings. Men with a history of both otitis and otorrhea of long duration had generally more serious pathological findings than men with otitis but no longterm otorrhea.


Evolution of aortic hyperplasia after reversal of renovascular hypertension in the rat.
Unclipping of Goldblatt one-kidney, one clip hypertensive rats leads to a rapid correction of the high blood pressure. Simultaneously, the aortic smooth muscle cell proliferation wave is stopped. Any further proliferation is prevented but the proliferation changes previously established cannot be reversed. Thus, provided clip removal is performed at the earliest phase of hypertension, it can modify the time-course of the aortic proliferation changes. On the contrary, the heart hypertrophy is significantly improved regardless of the unclipping time. Accordingly, the response of the hypertensive cardiovascular modifications to an antihypertensive therapy cannot be regarded as a whole since it is dependent on the cardiovascular target as well as on the onset time of treatment.


Remote Ischaemic PrEconditioning of Human Myocardium (RIPE): study protocol for a double-blinded randomised controlled trial.
Remote preconditioning has been shown to be a potent protective phenomenon in many animals. Several studies aimed to demonstrate it was feasible in humans by trying to show its protective effect during cardiac surgery. Of these, some small studies and one larger trial were positive while two other bigger studies showed no effectiveness of remote preconditioning as assessed by levels of postoperatively released cardiac markers. Recently, two large clinical trials also failed to prove the benefit of remote preconditioning in cardiac surgery. No study showed that remote preconditioning actually increases resistance of human myocardium to standardised ischaemic and reperfusion stimulus in experimental settings. In animal studies, remote preconditioning was shown to improve mitochondrial function and structure, but such data on human myocardium are scarce. The aim of the study is to determine whether remote preconditioning protects human myocardium against ischaemia-reperfusion injury in both in vivo and in vitro conditions. The trial is designed as a single-centre, double-blinded, sham-controlled trial of 120 patients. We randomise (1:1) patients referred for coronary artery bypass grafting for stable coronary artery disease to remote preconditioning or "sham" intervention. The remote preconditioning is obtained by three cycles of 5 min inflation and 5 min deflation of a blood pressure cuff on the right arm. Postoperative course including myocardial enzymes profile will be analysed. Moreover, in the in-vitro arm the clinically preconditioned myocardium will be assessed for function, mitochondria structure, and mitochondria-dependent apoptosis. The informed consent of all patients is obtained before enrolment into the study by the investigator. The study conforms to the spirit and the letter of the declaration of Helsinki. In case the effect of remote preconditioning is not measurable in ex-vivo assessment, any future attempt at implementing this phenomenon in clinical practice may be futile and should not be continued until the effect can be confirmed in a controlled experimental setting. The study might therefore indicate future directions in trials of clinical implementation of remote preconditioning. Clinical Trials Register (Clinicaltrials.gov) identifier: NCT01994707. The study was approved by Institutional Review Board of the Medical University of Silesia (KNW/0022/KB1/160/12).


Subjective and physiological reactivity to chocolate images in high and low chocolate cravers.
Cue-reactivity to chocolate images was assessed using self-report and physiological measures. From a pre-screening sample of 454, young women were selected and assigned to high and low chocolate craving groups (N = 36/group). The experimental procedure consisted in the elicitation and measurement of the cardiac defense and startle reflexes while viewing chocolate and standard affective images selected from the International Affective Picture System. In response to chocolate images, high cravers reported more pleasure and arousal but less control than low cravers. In high cravers, viewing chocolate images inhibited the cardiac defense but potentiated the startle reflex, as compared to low cravers. The results confirmed at the physiological level that the motivational state that underlies the experience of chocolate craving include both appetitive (inhibition of the defense reflex) and aversive (potentiation of the startle response) components. The findings supported a motivational conflict theory of chocolate craving.


Improved low energy electron projection in-line holograms reconstruction: application to the holograms of a tungsten tip.
A modification of the classical calculation algorithm is presented which allows to minimize the effect of the long range oscillations created by the twin object in the reconstruction process of in-line holograms obtained by low energy electron projection microscopy. The reconstructed shapes of a tungsten tip, observed with different magnifications are shown.


Ingesting 500 ml of polyethylene glycol solution during capsule endoscopy improves the image quality and completion rate to the cecum.
The benefits of bowel preparation prior to capsule endoscopy (CE) are controversial. The aim of this study was to examine whether ingesting a small amount of polyethylene glycol (PEG) during, not before, the CE procedure improves the image quality and the cecal completion rate. A prospective single-blind controlled study was conducted including 59 patients. The initial 32 patients (group A) received no preparation, and the subsequent 27 patients (group B) ingested 500 ml of PEG starting 30 min after swallowing the capsule. The capsule reached the cecum in 65.6% of the patients in group A and 88.9% of the patients in group B (P = 0.038). The use of PEG during CE examination significantly improved the image quality, and this effect was more pronounced in the distal ileum. Ingesting a small amount of PEG during CE examination significantly improves both the CE image quality and the cecal completion rate.


Damage of proliferating lymphoid cell deoxyribonucleic acid by methyl methanesulfonate and N-acetoxy-2-acetylaminofluorene.
Replicative synthesis of deoxyribonucleic acid by splenic lymphoid cells cultured from C57BL/6J strain mice and stimulated to proliferate with concanavalin A (Con A) was strongly suppressed by short exposure (10-60 min) of the cells to the direct-acting carcinogens methyl methanesulfonate or N-acetoxy-2-acetylaminofluorene. Carcinogen-treated lymphoid cells failed to recover stimulated levels of replicative synthesis after incubation for several hours in fresh medium without carcinogen. In contrast, spleen cells treated with hydroxyurea (a metabolic inhibitor of deoxyribonucleic acid replication) fully recovered stimulated rates of replicative synthesis upon incubation in medium without hydroxyurea. Furthermore, the inhibition of replicative synthesis by the carcinogens was accompanied by marked stimulation of deoxyribonucleic acid repair synthesis. Concomitant measurement of replicative and repair synthesis appears to be an effective approach for the in vitro study of carcinogen-induced damage in the deoxyribonucleic acid of proliferating lymphoid cells.


Hand-washing knowledge and practices among dentists and dental specialists.
Hand washing is the most important way to prevent the spread of infection. However, studies have shown that there is a lack of knowledge among physicians about proper hand hygiene. The purpose of this study was to determine the knowledge of general dentists and dental specialists regarding the correct agents to use and the appropriate times to wash hands. A questionnaire asking for demographic information and the answers to questions about proper hand hygiene practices and agents was sent via email to a list of general dentists and dental specialists. A total of 480 completed surveys were received (approximately 15% response). None of the respondents answered all the questions correctly. Six percent answered 4 questions correctly, 23% answered 3 questions correctly, and 47% answered only 2 questions correctly. There was no correlation between the number of correct answers and whether the respondent was a general dentist or a specialist. There is a lack of knowledge among dentists regarding proper hand hygiene. For the benefit of both the patient and the doctor, this situation must be remedied.


Is HRCT Temporal Bone Necessary in All Cases of Active Squamous Chronic Otitis Media?
To assess the usefulness of high resolution computed tomography (HRCT) temporal bones in cases of active squamous chronic otitis media (COM). Comparison of HRCT findings with operative findings. A prospective study of 104 clinically diagnosed patients with COM were included. Each patient was subjected to full clinical evaluation and HRCT temporal bone was done. Preoperative HRCT finding were correlated with surgical findings. The sensitivity of HRCT temporal bone in detecting cholesteatoma was 91.81%. However it could not differentiate cholesteatoma from other soft tissue density like granulation or hypertrophic mucosa or discharge, but soft tissue attenuation content with bone erosion was considered as hallmark of cholesteatoma. The sensitivity and specificity of HRCT for detecting malleus, incus and stapes erosion was 71.5 and 88.5%, 86.3 and 95% and 53.1 and 64.7% respectively. The sensitivity and specificity for detecting erosion of lateral semicircular canal (LSCC) was 77.78 and 98.2%. The sensitivity and specificity for facial canal was 80 and 100%. HRCT gives excellent details about the extent of cholesteatoma with reasonable accuracy in expert hands. It helps to warn the surgeon about anatomical variations preoperatively and detects complications if any. It effectively depicts integrity or erosion of dural plate, sinus plate, LSCC, facial nerve. Malleus and incus are seen reasonably well but status of stapes are not recorded effectively.


Lard-rich and canola oil-rich high-fat diets during pregnancy promote rats' offspring neurodevelopmental delay and behavioral disorders.
High-fat diets (HFDs) during pregnancy may damage the neural development and emotional behavior of rat offspring. Therefore, we investigated the neurobehavioral development of rat offspring who were fed a control diet (CD) or an HFD with lard (HFD-lard) or canola oil (HFD-canola oil), during pregnancy. Offspring's neurodevelopment (somatic growth, physical maturation, and ontogenesis reflex) was assessed while they were suckling. The rat's levels of depression, anxiety, and aggression were assessed through forced swimming, elevation plus a maze or open field test, and a foot-shock test on postnatal days 60, 80, and 110, respectively. Maternal HFDs with lard or canola oil promoted rats' offspring during suckling. They had reduced body weight and growth, physical maturation delay (auditory conduit and eyes opening to both groups HFDs-lard and canola oil; ear unfolding and incisor eruption only HFD-lard) and an ontogenesis reflex (palm grasp/vibrissa placing to both groups HFDs-lard and canola oil, and free-fall righting only in HFD-lard). Negative geotaxis resulted in the faster development of the HFD-lard offspring. Furthermore, in adulthood, the HDFs-offspring were more likely to be overweight, have shorter swimming times in the swim test, greater susceptibility to anxiety with an increased time spent in the closed arm in the elevated plus-maze while spending less time in the open arm, and having a decreased number of crossings and rearing in the open field. On the other hand, aggressive-like behavior was not affected. Therefore, these findings indicate that maternal HFDs enriched with lard or canola oil during pregnancy can impair the neurodevelopment of rat offspring and can perhaps be associated with possible changes to the emotional behavior of adult offspring.


The evolution of nonhuman primate social behavior.
A review of the recent literature concerning evolutionary mechanisms and possible genetic contributions to social behavior reveals a concentration on function rather than mechanism. Although functional consequences may influence future genetic changes in a population, they do not necessarily reflect evolutionary history. More important, genes cannot code for functions. Only when the anatomical structures and behavioral patterns of individuals are described can we study genetic contributions to social organization. Discussions of function in the abstract, without specification of mechanism, do not fall within the realm of scientific testing.


Prospective study of parental choice for aneuploidy screening in assisted conception versus spontaneously conceived twins.
The aim of this study was to evaluate and compare parental choice towards the use of aneuploidy screening and diagnostic techniques after assisted conception versus spontaneously conceived pregnancy. A total of 193 patients with consecutive twin pregnancies participated in the study, including 143 who spontaneously conceived and 50 who conceived following assisted reproduction treatment. Patients were investigated prospectively for their choice in the prenatal screening/diagnosis of aneuploidy. In the group of patients who conceived spontaneously, 111 (77.6%) opted initially for the non-invasive screening based on nuchal translucency measurements, whereas in the assisted conception group, 44 (88%) opted for the non-invasive screening. In the spontaneous conception group, 32 (22.4%) presented because they had a positive serum screening test or because they had opted for a chorionic villus sampling (CVS) or an amniocentesis for advanced maternal age. In the assisted conception group only six patients (12%) opted for amniocentesis. The difference in choice of noninvasive versus invasive screening between those with spontaneous and those with assisted conception was not significant, but those who had conceived spontaneously after the age of 37 years were significantly more likely (P < 0.05) to request an invasive diagnostic procedure through all maternal age groups. When needed, an amniocentesis was preferred to CVS. These data also indicate that the antenatal counselling needs to be adapted to couples presenting with an assisted conception twin pregnancy.


Correlative scanning-immunoelectromicroscopic analysis of neuropeptide localization and neuronal plasticity in the endocrine hypothalamus.
Thirty-two Sprague-Dawley rats were divided into four groups, eight rats per group. Animals were hypophysectomized with removal of both the pars distalis and the neural lobe of the neurohypophysis. Groups of eight rats were euthanized 1, 2, 4 and 8 weeks following hypophysectomy and prepared for routine scanning electron microscopy (SEM) and correlative immunoelectron microscopy employing antisera against arginine vasopressin (AVP). Eight normal rats served as controls. In experimental rats that survived one to eight weeks posthypophysectomy, remarkable neuroanatomical alterations were notable in the median eminence and adjacent third cerebral ventricular lumen. In contrast to normal control rats, large numbers of neurites were observed with SEM to insinuate from the lateral recess into the cerebral ventricular lumen and as early as one week following hypophysectomy they overgrew the apical surfaces of ependymal cells that constitute the lining of the cerebral ventricle. Immunoelectron microscopy revealed that a significant proportion of these neurites were magnocellular in origin in that they harbored AVP-positive neurosecretory vesicles. In addition to large numbers of invading magnocellular neurites, neuronal perikayria with apparent axosomatic synapses were observed to emerge upon the thick feltwork of invading axons, the latter of which appeared to freely terminate within the ventricular lumen. AVP-positive axon profiles were, in addition, seen to terminate upon the basal lamina of portal perivascular spaces in the zona externa of the median eminence. These data are consistent with the idea that following hypophysectomy (to include high stalk section of the neurohypophyseal system), that there is rapid, and dynamic sprouting and regrowth of AVP-positive axons into the adjacent third cerebral ventricular lumen and to the contact zone of the median eminence as well. This phenomenon may represent a compensatory physiological response to injury of the neurohypophyseal system characterized by a highly plastic neuroanatomical reorganization of magnocellular elements which appear to utilize the CSF of the third cerebral ventricle as a functional terminus for the neurocisternal secretion of AVP which ultimately enters the systemic circulation.


A Leading Role of Water Resources and Animal Husbandry in Environmental Sustainability: A Case Study of China.
Animal husbandry is an important emission source of greenhouse gas. In order to discover the real situation of carbon emission in China's animal husbandry scientifically, the paper measured and calculated carbon emission in China's animal husbandry from 1997 to 2017 on the basis of soil and water resources. In addition, analyzing its time-order characters, structural characters, driving factors and decoupling relationships are all done in this treatise. Major findings are as follows: (1) The carbon emission of China's animal husbandry in 2017 was 374.3528 million tons, an increase of 17.8066 million tons over 1997, with the average annual growth rate of 0.24% and the average annual carbon emission of 398.7817 million tons; (2) There was a decreasing trend in carbon emission of intestinal fermentation in China's animal husbandry while there was an increasing trend in carbon emission of manure emission in China's animal husbandry; (3) The carbon emission of China's animal husbandry peaked in 2006 and went through three phases of up-down-steady between 1997 and 2017; (4) The contribution of cattle, pig, sheep, other large livestock, poultry and rabbits to China's animal husbandry carbon emissions decreased in turn, and the average contribution of cattle, pigs and sheep to China's animal husbandry carbon emissions was as high as 98.15%. (5) Five factors reducing carbon emission of China's animal husbandry were carbon intensity, agricultural industrial structure, agricultural population-water resources matching degree, agricultural water-soil resources and per capita cultivated land area. Two factors increasing carbon emission of China's animal husbandry were population and economic benefits of agriculture per unit agricultural population; (6) There was a generally weak decoupling between carbon emission in China's animal husbandry and animal husbandry's economic growth from 1997 to 2017.


[Patient safety training and a safe teaching in primary care].
This narrative review manuscript aims to raise the difficulties and opportunities for patient safety in specialised healthcare training considering undergraduate, postgraduate, specialist and continuing education, even during the COVID-19 pandemic. It also suggests some proposals for carrying it out. It very briefly discusses this specific training and its current situation in primary care. Highlighting that patient safety is a need, an area of competence and a training opportunity for residents. It establishes the general framework of patient safety in primary care in the document "7 steps for Patient Safety in Primary Care", stating the need for a systemic approach. It highlights the elaboration and presentation of cases on clinical errors as the most frequent training strategy. The real-life clinical scenarios relate to difficult patients, critical incidents and bioethics issues in professional practice. These scenarios have as common characteristics, the fact to produce difficulties and suffering for all the actors involved. Several instruments for training in patient safety are also included. The medium-term goal is to consolidate clinical safety in specialised healthcare training. Finally, an analysis is made of the impact of the pandemic on patient safety training, particularly on specialised healthcare training and some proposals are recommended on how to carry out safe teaching in the times of the COVID-19 pandemic.


Associations between hepatocellular carcinoma risk and rs3212227 and rs568408 polymorphisms: a systematic review and meta-analysis.
Interleukin-12 (IL-12) is considered to be a risk factor for cancer; however, its role in hepatocellular carcinoma (HCC) remains unknown. This study aimed to explore the impacts of the IL-12 rs3212227 and rs568408 gene polymorphisms on HCC. We searched PubMed, Embase, Web of Science, and Chinese Knowledge Infrastructure databases for studies on the associations between HCC and IL-12 rs568408 and rs3212227 polymorphisms published prior to 1 May 2020. The effects of the polymorphisms on HCC susceptibility were presented as odds ratios (ORs) and associated 95% confidence intervals. Seven studies were ultimately included, including 2375 cases and 3445 controls. The rs3212227 polymorphism was significantly associated with the risk of HCC in both the dominant model (CC+AC vs. AA, OR=1.22) and the allele model (C vs. A, OR=1.12). Combined analysis of rs568408 yielded a significant relative risk for HCC in the dominant (AA+AG vs. GG, OR=1.13), recessive (AA vs. AG+GG, OR=1.72), allele (A vs. G, OR=1.29), heterozygote (AG vs. GG, OR=1.27), and homozygote models (AA vs. GG, OR 1.17). The IL-12 rs3212227 and rs568408 gene polymorphisms are associated with an increased risk of HCC.


Subtetanic neuromuscular electrical stimulation can maintain Wingate test performance but augment blood lactate accumulation.
Concentration- and time-dependent effect of lactate on physiological adaptation (i.e., glycolytic adaptation and mitochondrial biogenesis) have been reported. Subtetanic neuromuscular electrical stimulation (NMES) with voluntary exercise (VOLES) can increase blood lactate accumulation. However, whether this is also true that VOLES can enhance the blood lactate accumulation during sprint exercise is unknown. Thus, we investigated whether VOLES before the Wingate test can enhance blood lactate accumulation without compromising Wingate exercise performance. Fifteen healthy young males (mean [SD], age: 23 [4] years, body mass index: 22.0 [2.1] kg/m2) volunteered. After resting measurement, participants performed a 3-min intervention: VOLES (NMES with free-weight cycling) or voluntary cycling alone, which matched exercise intensity with VOLES (VOL, 43.6 [8.0] watt). Then, they performed the Wingate test with 30 min free-weight cycling recovery. The blood lactate concentration ([La]b) was assessed at the end of resting and intervention, and recovery at 1, 3, 5, 10, 20, and 30 min. [La]b during intervention was higher with VOLES than VOL (P = 0.011). The increase in [La]b after the Wingate test was maintained for longer with VOLES than VOL at 10- and 20-min recovery (P = 0.014 and 0.023, respectively). Based on the Wingate test, peak power, mean power, and the rate of decline were not significantly different between VOLES and VOL (P = 0.184, 0.201, and 0.483, respectively). The combination of subtetanic NMES with voluntary exercise before the Wingate test has the potential to enhance blood lactate accumulation. Importantly, this combined approach does not compromise Wingate exercise performance compared to voluntary exercise alone.


Low postnatal CRI values are associated with the need for ECMO in newborns with CDH.
Accurate, real-time technology is needed to predict which newborns with congenital diaphragmatic hernia (CDH) will require ECMO. The Compensatory Reserve Index (CRI) is a noninvasive monitoring technology that continuously trends an individual's capacity to compensate from normovolemia (CRI = 1) to decompensation (CRI = 0). We hypothesized that postnatal CRI values would be lower in CDH newborns that required ECMO than those who did not require ECMO. Newborns with a CDH were prospectively monitored with a CipherOx® CRI M1 device. We compared CRI values from delivery to ECMO (ECMO group) versus delivery to clinical stabilization (non-ECMO group). Postnatal CRI values were available from 26 newborns. Eight underwent ECMO within 33 h of delivery, and median CRI prior to ECMO was 0.068 (IQR: 0.057, 0.078). Eighteen did not require ECMO. Median CRI from birth to 48 h was 0.112 (IQR: 0.082, 0.15). CRI values were significantly lower in newborns that required ECMO versus those who did not (p = 0.0035). Postnatal CRI had the highest AUC (0.85) compared to other prenatal prognostic measures. Humans from newborns to adults share elemental features of the pulsatile waveform that are associated with progression to decompensation. CRI may be helpful when deciding when to initiate ECMO. Level III. Diagnostic test.


Detection of hypermethylated fibrillin-1 in the stool samples of colorectal cancer patients.
Prior studies have demonstrated that analysis of gene promoter methylation in stool samples may be a potential biomarker for noninvasive colorectal cancer detection. Aberrant methylation in gene promoter is common in various cancers, and epigenetic alterations can result in down-regulation or silence of gene expression. Recently, hypermethylation of fibrillin-1 (FBN1) was reported to be associated with colorectal cancer (CRC). In this study, we examined the methylation status of FBN1 in stool samples to test CRC. For the purpose of colorectal cancer detection, we investigated FBN1 hypermethylation in the tissue and stool samples of colorectal cancer patients using methylation-specific polymerase chain reaction. The result is that out of 75 patients with colorectal cancer, 59 (78.7%) exhibited hypermethylated FBN1 in their tumor tissue DNA. We next detected the methylation status of FBN1 in the stool DNA of these patients. The hypermethylated FBN1 occurred in 72% (54/75) of these patients in their stool samples and occurred in 6.7% (2/30) of healthy people (P < 0.001). The results indicated 72.0% sensitivity and 93.3% specificity of the test for detecting CRC by using stool samples. So, the study reveals that hypermethylation status in the promoter of FBN1 is a high specific and sensitive biomarker for colorectal cancer, and detecting hypermethylated FBNI in stool samples is a noninvasive and useful method for screening colorectal cancer.


Effect of heat treatment on viability of Taenia hydatigena eggs.
Effects of heat treatments on activation and infectivity of Taenia hydatigena eggs were assessed. Eggs containing oncospheres were used for in vitro and in vivo studies to determine the response to 5min of heat treatment, ranging from room temperature (22°C) to 60°C. The study demonstrated 99.47% and 100% reduction in oncosphere activation or infectivity after 5min of heat treatment at 60°C and 57.38°C under in vitro and in vivo conditions, respectively. Similar results between the two approaches indicted the appropriateness of the in vitro methods to identify oncosphericidal treatments of practical significance. Similar heat treatments may also be effective against Taenia saginata and help to reduce occurrence of beef cysticercosis.


Rehabilitation of the shoulder and elbow after arthroscopy.
Rehabilitation after arthroscopic shoulder and elbow surgery requires an emphasis on flexibility, strength, range of motion, and a return to activity program. Care must be taken to include fitness and conditioning programs for the entire athlete, not just the upper extremity. A thorough program will allow the athlete to return to competition in the best possible condition.


The histological appearance of oesophageal adenocarcinoma--an analysis based on 215 resection specimens.
The current study was performed to determine whether the histopathological appearance of oesophageal adenocarcinoma (AC) differs significantly from that of cardiac or gastric AC. Therefore, HE-stained slides of 215 primarily resected oesophageal AC, 108 cardiac and 184 gastric AC were classified according to a variety of clinico-pathologic parameters. According to Lauren's classification, oesophageal AC (1.4%) less frequently belonged to the diffuse type than cardiac (2.8%) and gastric AC (23.9%; p<0.0001). Tubular and papillary AC, as defined by the WHO classification, were more frequent among oesophageal (94.4%) than among cardiac (87.0%) and gastric AC (59.2%; p<0.0001). Solid carcinomas, according to Carneiro's classification, were less frequent among oesophageal (2.8%) than among cardiac (10.2%) and gastric AC (9.2%; p<0.0001). Oesophageal AC were graded more frequently G1/G2 (53.9%) than cardiac (30.6%) and gastric AC (27.7%; p<0.0001). Among oesophageal AC, Lauren's classification (p=0.0067), Carneiro's classification (p=0.0170), tumour grade (p=0.0005), lymphatic vessel invasion (p<0.0001) but not WHO classification were histological predictors of postoperative survival. In conclusion, oesophageal AC displays the same histological spectrum as cardiac and gastric AC. However, the relative proportion of differentiated, gland-forming carcinomas is significantly more frequent in the oesophagus than in the cardia and in the stomach.


Sequence specificity in the reaction of benzopyrene diol epoxide with DNA.
Benzopyrene diol epoxide (BPDE; (+)-7R,8S-dihydroxy-9S,10R-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene), the ultimate carcinogen derived from the polycyclic hydrocarbon benzo[a]pyrene, reacts principally with the guanine bases in DNA. Nineteen double stranded, self-complementary oligonucleotides, containing deoxyguanosine in various sequence contexts, were each treated with tritium labelled BPDE. The extent of reaction was determined by releasing the BPDE-guanine adduct with acid, isolating it by chromatography on a reverse-phase column, and estimating it by its radioactivity. Oligonucleotides containing an isolated guanine, such as AAGTACTT, were little affected by BPDE. Reactivity was increased where the guanine was flanked by another guanine on the same strand (e.g. TACCTAGGTA) or on the complementary strand (e.g. TATTCGAATA), and was highest in mixed G-C sequences such as ATCCGGAT. The results should help predict major sites of attack of BPDE on cellular proto-oncogenes.


Evaluation of common prescription analgesics and adjuvant analgesics as markers of suicide risk: a longitudinal population-based study in England.
Analgesics prescriptions may provide a marker for identifying individuals at higher risk of suicide. In particular, awareness of which analgesics are implicated may help clinicians assess and modify risk. A case-control study in England using the Clinical Practice Research Datalink (for primary care records) linked with hospital and national mortality electronic registries. We included patients aged ≥15 who died by suicide between 2001 and 2019 (N = 14,515), to whom we individually matched 580,159 controls by suicide date and general practice (N = 594,674). Odds ratios (ORs) for suicide, controlled for age and sex, were assessed using conditional logistic regression. Suicide risks were highest in those prescribed adjuvant analgesics (pregabalin, gabapentin and carbamazepine) (adjusted OR 4.07; 95% confidence intervals CI: 3.62-4.57), followed by those prescribed opioids (adjusted OR 2.01; 95% CI: 1.88-2.15) and those prescribed non-opioid analgesics (adjusted OR 1.48; 95% CI: 1.39-1.58) compared to those not prescribed these medications. By individual analgesic, the highest suicide risks were seen in patients prescribed oxycodone (adjusted OR 6.70; 95% CI: 4.49-9.37); pregabalin (adjusted OR 6.50; 95% CI: 5.41-7.81); morphine (adjusted OR 4.54; 95% CI: 3.73-5.52); and gabapentin (adjusted OR 3.12; 95% CI: 2.59-3.75). Suicide risk increased linearly with the number of analgesic prescriptions in the final year (p < 0.01 based on the likelihood ratio test), and the more different analgesics categories were prescribed in the final year (p < 0.01 based on the likelihood ratio test). Analgesic prescribing was associated with higher suicide risk. This is a particular issue with regard to adjuvant non-opiate analgesics. There was no funding for this study.


Prediction of N95 Respirator Fit from Fogging of Eyeglasses: A Pilot Study.
Fogging of eyeglasses while wearing N95 respirators is common. It is commonly held that the N95 respirator has a poor fit if there is fogging of eyeglasses. We conducted this prospective, pilot study to determine if fogging of eyeglasses predicts poor fit of N95 respirator. Seventy volunteer healthcare workers from a tertiary intensive care unit in Sydney, Australia participated. The participants donned one of the following N95 respirators: three-panel flat-fold respirator (3M 1870), cup-shaped respirator (3M 1860), or a duckbill respirator. After a satisfactory "user seal check" as recommended by the manufacturer, the participants donned eyeglasses and checked for fogging. A quantitative fit test (QnFT) of the respirator was then performed (using PortaCount Respirator Fit Tester 8048, TSI Inc., Minnesota, USA). A fit factor of <100 on quantitative fit testing indicates poor fit. The sensitivity and specificity for fogging of eyeglasses (index test) to predict the poor fit of N95 respirator was determined, compared to QnFT (gold standard test). Fogging of eyeglasses as a predictor of poor respirator fit (i.e., fit factor <100 on QnFT) had sensitivity of 71% (95% CI, 54-85%) and specificity 46% (95% CI, 29-63%). The odds ratio of fogging as a predictor for poor fit was 2.10 (95% CI, 0.78-5.67), with a two-tailed p-value of 0.22 (not significant). The receiver operating characteristic curve for fogging of eyeglasses as a diagnostic test had the area under the curve of 0.59. Fogging of eyeglasses is neither a sensitive nor a specific predictor for poor fit of N95 respirators. Kyaw S, Johns M, Lim R, Stewart WC, Rojas N, Thambiraj SR, et al. Prediction of N95 Respirator Fit from Fogging of Eyeglasses: A Pilot Study. Indian J Crit Care Med 2021;25(9):976-980.


Artifact-free holographic light shaping through moving acousto-optic holograms.
Holographic light modulation is the most efficient method to shape laser light into well-defined patterns and is therefore the means of choice for many intensity demanding applications. During the last two decades, spatial light modulators based on liquid crystals prevailed among several technologies and became the standard tool to shape light holographically. But in the near future, this status might be challenged by acousto-optic deflectors. These devices are well known for their excelling modulation rates and high optical power resilience. But only few scattered precedents exist that demonstrate their holographic capabilities, despite the many interesting properties that they provide. We implemented a holographic acousto-optic light modulation (HALM) system, that is based on displaying holograms on acousto-optic deflectors. We found that this system can eliminate the ubiquitous coherent artifacts that arise in holography through the inherent motion of acousto-optic holograms. That distinguishes our approach from any other holographic modulation technique and allows to reconstruct intensity patterns of the highest fidelity. A mathematical description of this effect is presented and experimentally confirmed by reconstructing images holographically with unprecedented quality. Our results suggest that HALM promotes acousto-optic deflectors from highly specialized devices to full-fledged spatial light modulators, that can compete in a multitude of applications with LC-SLMs. Especially applications that require large optical output powers, high modulation speeds or accurate gray-scale intensity patterns will profit from this technology. We foresee that HALM may play a major role in future laser projectors and displays, structured illumination microscopy, laser material processing and optical trapping.


Protection against cyclosporine-induced impairment of renal microcirculation by verapamil in mice.
Fluorescence microscopy was used to examine the effect of cyclosporine (CsA) infusion on renal subcapsular (cortical) blood flow in 53 living mice, using FITC-dextran (MW: 156,000) as a fluorescent marker. CsA (8-19 mg/kg body weight) given i.v. for 1 min induced complete inhibition of blood flow. A complete standstill of flow was also obtained during a continuous infusion with a rate of 0.8-2 mg/kg/min. With lower infusion rates (0.15-0.23 mg/kg/min), blood flow was partially impaired. In all experiments, the decrease in flow occurred after a 15-25 min delay, suggesting a CsA metabolite or exhaustion of a protective mechanism as the causative agent. Pretreatment with an alpha-blocking agent, phentolamine (1.0 mg/kg), did not prevent the CsA-induced inhibition of blood flow. In contrast, pretreatment with a calcium antagonist, verapamil (0.3-0.4 mg/kg), prevented the impairment of blood flow at low (0.15-0.23 mg/kg/min), and partially at higher (0.8-2.4 mg/kg/min) rates of CsA infusion. Clinical studies are warranted to explore the role of calcium antagonists in the prevention of posttransplant acute cyclosporine-induced nephrotoxicity.


A review and investigation of the effect of nanophotocatalytic ozonation process for phenolic compound removal from real effluent of pulp and paper industry.
Phenol and its derivatives are the major environmental pollutants discharged from paper and pulp industries into water bodies. All these compounds and chlorinated phenolic compounds in particular are very toxic to fauna and flora, even at relatively low concentration. This study aimed to investigate the removal rate of phenolic compounds from the effluent of pulp and paper industries using a combination of ozonation and photocatalytic processes. Firstly, a certain volume from the effluent of paper and pulp industries containing certain phenol concentrations was obtained and fed into a prefabricated reactor at laboratory scale. Then, the combined and separate effects of zinc oxide dosage (ZnO), ozone flow rate (O3), and pH under ultra violet radiation for 30 min were evaluated. The concentration of phenolic compounds and the produced ozone gas flow rate were measured by a spectrophotometry and iodometric method, respectively. The results showed that the phenolic removal rate increased at acidic PHs compared with alkaline PHs; it was also decreased with the increase in ZnO dosages. Furthermore, the highest phenolic compound's removal rate was 99% at the optimal condition (pH 5, ZnO dosage of 0.1 g L-1 at the 30 min with UV-C illumination of 125 W). Finally, Daphnia toxicity test showed that treated effluent was safe and met the standards to the extent that it can be discharged into the receiving waters. Graphical abstract .


Evaluating reproductive performance of three estrus synchronization protocols in Ghezel ewes.
Although estrus synchronization considered valuable management tools for improving reproductive performance of ewes, their high expenses and complicated usage prevent sheep farmers to apply these techniques. Therefore, the present study was designed to compare three protocols of estrus synchronization on reproductive performance of Ghezel ewes. For this reason, 27 Ghezel ewes were assigned to three estrus synchronization treatment groups based on a completely randomized design included: progestogen sponge for 12 days + 500 IU eCG at the time of sponge withdrawal (P4eCG group, expensive synchronization), two doses of 75 μg cloprostenol with 12 days interval (CLO group, economical synchronization), and CLO +500 IU eCG at day 12 (CLOeCG group, moderately priced synchronization). Four consecutive blood samples were also collected during the experiment to evaluate progesterone concentrations. The results of the present experiment showed that pregnancy and lambing rates of the first estrus as well as blood progesterone concentration were not affected by the treatments (P > 0.05), though total pregnancy and lambing rates were higher in both P4eCG and CLOeCG groups (P < 0.01). Accordingly, both P4eCG and CLOeCG protocols successfully improved reproductive traits of ewes, though CLOeCG protocol is an advisable technique for sheep farmers through its moderate price, simple application, and high reproductive performance.


50 MHz rectifier based on an organic diode.
A main focus of research on organic semiconductors is their potential application in passive organic radio-frequency identification (RF-ID) tags. First prototypes working at 125 kHz have been shown by industrial research groups. However, to be commercially viable, the organic RF-ID tag would need to be compatible with the base-carrier frequency of 13.56 MHz (ref. 2). High-frequency operation has been out of reach for devices based on organic semiconducting material, because of the intrinsically low mobility of those materials. Here, we report on a rectifier based on a pentacene diode that can rectify an incoming a.c. signal at 50 MHz. At 14 MHz, a rectified voltage of 11 V for an a.c. voltage with a peak-to-peak amplitude of 36 V has been achieved. On the basis of those results, we estimate the frequency limits of an organic diode showing that even the ultra-high-frequency band at around 800 MHz is within reach.


A quantitative assessment of the contribution of small standing water bodies to the European waterscapes - case of Estonia and France.
The abundance and properties of small standing water bodies (SSWB) is globally not well known for their ecological importance is undervalued and their detection suffers from technical limitations. In the current study, we used a combination of GIS-based methods (satellite, orthophoto, ground validation) to evaluate regional estimates of standing water body (SWB) inventories in two geographically different parts of Europe - France, and Estonia. In our study the SWBs surface area threshold limit was 0.00001 km2, exceeding the limits of previous studies (>0.002 km2). The total number of SWBs in Estonia is 111 552 (2.5 per km2) and in France 598 371 (1.1 per km2). Our estimates show that the median size of SWBs in Estonia and France is 0.0003 km2 and 0.0007 km2 respectively, meaning that most of the SSWBs are not included in the global inventories, and their number is therefore underestimated. SSWBs (area below 0.01 km2) form a significant share of the total shoreline length of SWBs, 70.3% in Estonia and 58.8% in France. As nearshore areas are often very productive with diverse habitats, the SSWBs hold a crucial role in maintaining biodiversity. Our results provide quantitative evidence that SSWBs are vital and abundant landscape elements, freshwater resources, and habitats that should not be ignored in global inventories.


The development and use of a test to identify resistance to the anticoagulant difenacoum in the Norway rat (Rattus norvegicus).
Feeding tests were carried out in the laboratory to obtain basic data on the susceptibility of wild Norway rats to difenacoum. The results were used to derive a standard test procedure for the identification of difenacoum resistance in warfarin-susceptible and resistant rats. Details are given of tests on rats from suspected difenacoum-resistant infestations on farms.


Progress and challenges for malaria vaccines.
Malaria causes much physical and economic hardship in tropical regions, particularly in communities where medical care is rudimentary. Should a vaccine be developed, it is the residents of these areas that stand to benefit the most. But the vaccine, which has been promised to be 'just round the corner' for many years, remains elusive. It is important to ask why this is so, when effective vaccines exist for many other infectious diseases. What are the reasons for the slow rate of progress, and what has been learned from the first clinical trials of candidate malaria vaccines? What are the remaining challenges, and what strategies can be pursued to address them?


Detection of carotid artery stenosis using histological specimens: a comparison of CT angiography, magnetic resonance angiography, digital subtraction angiography and Doppler ultrasonography.
Carotid endarterectomy (CEA) is accepted as a primary modality to treat carotid stenosis. The accuracy of measuring carotid stenosis is important for indication of the CEA procedure. Different diagnostic tools have been developed and used in the past 2 decades for the diagnosis of carotid stenosis. Only a few studies, however, have focused on the comparison of different diagnostic tools to histological findings of carotid plaque. Patients with internal carotid artery (ICA) stenosis were investigated primarily by computed tomography angiography (CTA). Digital subtraction angiography (DSA), Doppler ultrasonography (DUS) and magnetic resonance angiography (MRA) were performed as well. Atherosclerotic plaque specimens were transversally cut into smaller segments and histologically processed. The slides were scanned and specimens showing maximal stenosis were determined; the minimal diameter and the diameter of the whole plaque were measured. High quality histological specimen and histological measurement was considered to be the prerequisite for inclusion into the analysis. The preoperative findings were compared with histological measurement. CTA and histological measurements were obtained from 152 patients. DSA measurements were available in 138 of these cases, MRA in 107 and DUS in 88. A comparison between preoperative and histological findings was performed. In addition, correlation coefficients were computed and tested. A significant correlation was found for each of the diagnostic procedures. The strongest correlation coefficient and the best allocation of stenosis into clinical significant groups (<50 %, 50-69 %, ≥70 %) was observed for CTA. Mean differences in the whole cohort between preoperative and histological measurements were as follows: CTA underestimated histological measurement by 2.4 % (based on European Carotid Surgery Trial [ECST] methodology) and 11.9 % (based on North American Symptomatic Carotid Endarterectomy Trial [NASCET] methodology). DSA underestimated the histological measurement by 7 % (ECST) and 12.2 % (NASCET). MRA overestimated the histological measurement by 2.6 % (ECST) and underestimated by 0.6 % (NASCET). DUS overestimated the stenosis by 1.8 %. CTA yields the best accuracy in detection of carotid stenosis, provided that all axial slices of the stenosis are checked and carefully analysed. DSA underestimates moderate and mild ICA stenosis, whereas DUS overestimates high-grade ICA stenosis. For MRA, a relatively low correlation coefficient was observed with histological findings. We conclude that CTA-ecst technique is the most reliable technique for carotid stenosis measurement.


Neuromonitoring in neurological critical care.
In this article, we review technologies available for direct monitoring of cerebral oxygenation and metabolic status, including jugular venous oxygen saturation, brain tissue oxygen tension, transcranial cerebral oximetry with near-infrared spectroscopy, Positron emission tomography oxidative metabolism, single-photon emission computed tomography/computed tomography perfusion and functional imaging, and cerebral metabolite measurement using microdialysis. We also introduce a novel method of monitoring cerebral perfusion that may substitute for direct monitoring of oxygenation in the future.


The long-term effects of antiepileptic drugs on the visual system in rats: electrophysiological and histopathological studies.
We quantified the long-term effects of antiepileptic drugs (AEDs) on the visual system of rats using electroretinograms (ERGs) and visual evoked potentials (VEPs). Twenty adult Sprague-Dawley rats were divided into 4 groups (n=5). Each animal was treated by monotherapy of phenytoin (PHT), valproic acid (VPA), zonisamide (ZNS) or physiological saline as control. The AEDs were injected intraperitoneally daily for 180 days. ERGs and VEPs were recorded before the medication and on Days 30 and 180. There were no significant changes in the 4 groups on Day 30. On Day 180, the amplitudes of a- and b-waves of dark-adapted (DA) ERGs were reduced in the PHT group compared with those of the control group. In the VPA group, the amplitudes of the DA ERG a- and b-waves, light-adapted ERG b-wave and the DA VEP were reduced. No significant changes were observed in the ZNS group. There were no histopathological changes of the retina and visual cortex in all groups. Our results indicate that neurons along the visual pathways have different sensitivity to each AED. This may result from the differential pharmacological actions of each AED on visual neurons. Our findings suggest that epileptic patients on long-term use of AEDs might have subclinical influences to the visual systems.


A pilot study investigating of the nature of point-of-sale alcohol promotions in bottle shops in a large Australian regional city.
The promotion of alcohol by retailers and media can contribute to a culture of excessive alcohol consumption, but the effect of non-advertising alcohol promotions has largely been neglected. This study sought to gather initial data on this important area. An observational study of alcohol point-of-sale promotions in the Wollongong CBD area, conducted in July-August 2005. We identified 17 different promotions in three categories: gift with purchase; competitions; and buy some, get some free. Given previous research demonstrating the relationship between increased alcohol consumption and both ownership of alcohol-related merchandise and reduced per unit price, it appears that point-of-sale promotions may have the potential to further increase alcohol consumption among young people. Only when the extent and impact of such promotions is demonstrated will we be in a position to effectively advocate for appropriate regulations to ensure young people are not exposed to marketing strategies that further increase their exposure to alcohol-related harms.


Neuromuscular electrical stimulation but not photobiomodulation therapy improves cardiovascular parameters of rats with heart failure.
The aim of the present study was to analyze the effect of neuromuscular electrical stimulation (NMES) and photobiomodulation (PBMT) on the cardiovascular parameters, hemodynamic function, arterial baroreflex sensitivity (BRS), and autonomic balance (ANS) of rats with heart failure (HF). Male Wistar rats (220-290 g) were organized into five groups: Sham (n = 6), Control-HF (n = 5), NMES-HF (n = 6), PBMT-HF (n = 6), and NMES + PBMT-HF (n = 6). Myocardial infarction (MI) was induced by left coronary artery ligation. Animals were subjected to an eight-week NMES and PBMT protocol. Statistical analysis included the General Linear Model (GLM) followed by a Bonferroni post-hoc test. Rats of the NMES-HF group showed a higher MI area than the Control-HF (P = 0.003), PBMT-HF (P = 0.002), and NMES + PBMT-HF (P = 0.012) groups. NMES-HF and NMES + PBMT-HF showed higher pulmonary congestion (P = 0.004 and P = 0.02) and lower systolic pressure (P = 0.019 and P = 0.002) than the Sham group. NMES + PBMT-HF showed lower mean arterial pressure (P = 0.02) than the Sham group. Control-HF showed a higher heart rate than the NMES-HF and NMES + PBMT-HF (P = 0.017 and P = 0.013) groups. There was no difference in the BRS and ANS variables between groups. In conclusion, eight-week NMES isolated or associated with PBMT protocol reduced basal heart rate, systolic and mean arterial pressure, without influence on baroreflex sensibility and autonomic control, and no effect of PBMT was seen in rats with HF.


Repair of the injured spinal cord by transplantation of neural stem cells in a hyaluronan-based hydrogel.
Traumatic injury to the spinal cord causes cell death, demyelination, axonal degeneration, and cavitation resulting in functional motor and sensory loss. Stem cell therapy is a promising approach for spinal cord injury (SCI); however, this strategy is currently limited by the poor survival and uncontrolled differentiation of transplanted stem cells. In an attempt to achieve greater survival and integration with the host tissue, we examined the survival and efficacy of adult brain-derived neural stem/progenitor cells (NSPCs) injected within a hydrogel blend of hyaluronan and methyl cellulose (HAMC) into a subacute, clinically relevant model of rat SCI. Prior to use, HAMC was covalently modified with recombinant rat platelet-derived growth factor-A (rPDGF-A) to promote oligodendrocytic differentiation. SCI rats transplanted with NSPCs in HAMC-rPDGF-A showed improved behavioral recovery compared to rats transplanted with NSPCs in media. Rats with NSPC/HAMC-rPDGF-A transplants had a significant reduction in cavitation, improved graft survival, increased oligodendrocytic differentiation, and sparing of perilesional host oligodendrocytes and neurons. These data suggest that HAMC-rPDGF-A is a promising vehicle for cell delivery to the injured spinal cord.


Cloning and sequence analysis of the genes encoding the nonstructural proteins of Langat virus and comparative analysis with other flaviviruses.
Langat virus, a member of the family Flaviviridae is antigenically very similar to highly pathogenic tick-borne encephalitis viruses. We cloned and sequenced the complete nonstructural gene-coding region of Langat virus (strain TP21) and compared the deduced amino acid sequences of each nonstructural protein to those of other flaviviruses. By alignment with the reported amino acid sequences of the nonstructural proteins of several flaviviruses, we were able to predict proteolytic cleavage sites and identify sequence motifs, which are highly conserved among flaviviruses. Sequence similarity calculations revealed that the NS3 and NS5 proteins are the most highly conserved of the flavivirus nonstructural proteins. The NS3 and NS5 proteins of Langat virus contained specific peptide sequences that have been demonstrated to be associated with helicase or polymerase activities, respectively. The NS1 protein of Langat virus displayed complete homology of potential N-linked glycosylation sites and cysteine residues with the NS1 proteins of other tick-borne flaviviruses, suggesting a highly conserved NS1 protein structure. The data presented in this report serve to complete the entire sequence of the Langat virus-coding region and provide the basis for comparison of this naturally attenuated virus to the other highly virulent tick-borne flaviviruses.


Micromotion of conventionally cemented all-polyethylene tibial components in total knee replacements. A roentgen stereophotogrammetric analysis of migration and inducible displacement.
Micromotion of the tibial component in 27 knee arthroplasties for gonarthrosis, three of which were regarded as failures for reasons other than mechanical loosening, was studied using high-resolution roentgen stereophotogrammetric analysis (RSA). Migration over time was found in all cases, ranging from 0.2 to 2.1 mm. The majority of the cases showed migration during the first year only, while a minority migrated continuously during the period studied. The latter group showed more migration even after 1 year. All cases showed inducible displacement in response to external forces, ranging from 0.2 to 1.0 mm. The micromotion correlated with the age of the patient but not with other demographic parameters. Alignment or component position did not correlate with the micromotion. All cases but one had developed a radiolucent zone, and it was concluded that the micromotion occurred in the soft tissue interface between bone and cement. Such micromotion is a normal finding in cemented tibial components in knee arthroplasty.


An anatomical basis for the resistance and capacitance in series with excitable membrane of the squid giant axon.
To correlate periaxonal tissue layer resistance with Schwann cell layer anatomy, cross and longitudinal sections of giant axons of Loligo pealei were examined by transmission electron microscopy. Measurements were made of the width and frequency of mesaxonal clefts entering the Schwann cell layer from the periaxonal space and leaving the cell layer adjacent to the basal lamina. The average mesaxonal cleft width is 10.5 nm. One cm2 of the giant axon surface is enclosed by a single cell layer containing about 690 000 Schwann cells. One cm2 of axon surface has a sheath mesaxonal area of 0.002 cm2 at the periaxonal surface and 0.016 cm2 at the basal lamina, the mesaxons branching frequently as they cross the sheath. The volume of the Schwann cell layer extracellular space was estimated to be roughly 1% of the Schwann cell layer volume. Several models were used to predict the resistance R, across the Schwann cell layer. Assuming the mesaxonal clefts contain seawater, and can be lumped into volume conductors having simple geometries, then (normalized for one cm2 of axon surface) R was estimated to be between 0.4 and 0.9 omega cm2. This compares favourably with electrophysiological estimates of the periaxonal tissue resistance (current clamp value = 0.9 omega cm2 and the voltage clamp value = 1.4 omega cm2) as these electrically measured values include the resistance across the outer connective tissue layer as well as the Schwann cell layer. The value of the Schwann cell membrane capacity was estimated to be approximately 0.7 muF/cm2.


[Effects of epidermal growth factor on calciumion and cAMP in the ductal cells of submandibular glands].
To study the effects of EGF on Ca(2+) and cAMP in the ductal cells of rat SMG. Fluorometric technique and radioimmunological technique were used to investigate the dynamic changes of Ca(2+) and cAMP in the ductal cells. The data were analysed statistically by t test. After an momently latent period, intercellular calcium increased rapidly, then began to decline. This period could last 5 minutes. After 3 minutes, cAMP showed a rapid decrease, and then increased slowly. Its concentration could restore 90 minutes later. EGF may regulate intercellular calcium and cAMP, which results in the proliferation of the ductal cells.


[Reality of psychotherapeutic care with regard to outpatient psychotherapy of elderly people in Münsterland (Westfalia)].
The need for efficacy of geriatric psychotherapy as well specialized training in geriatric psychosomatics and psychotherapy is commonly recognized amongst professionals. Despite this, this knowledge is not reflected in everyday life. One consequence of this is that psychotherapy for elderly patients is still the exception. We conducted a study in which 478 practicing psychotherapists in Münsterland (Westfalia) were surveyed by mail questionnaire regarding the number and main diagnosis of their patients of greater than 50 years of age, as well as the elderly-specific therapies or future plans for such therapies they might have. The response rate was 65% (312 psychotherapists who answered the questionnaire). The results showed that patients older than 60 years of age were greatly underrepresented compared to younger patients. Moreover, specific therapies, such as age-specific psychotherapy in groups, were rare. To date, it seems that only a minority of elderly patients with psychiatric and psychosomatic diseases are treated adequately by psychotherapy in the outpatient sector. This was evident even in a region such as Münsterland, which has plentiful psychotherapeutic resources.


Cognitive Function Among Obstructive Sleep Apnea Patients in North East Malaysia.
Obstructive sleep apnea patients may develop deficits in the cognitive domains of attention, concentration, executive function, verbal and visuospatial memory, constructional abilities, and psychomotor functioning. As cognitive performance will improve with the treatment, early screening for cognitive dysfunction should be done to prevent further deterioration. We aim to evaluate the cognitive function of obstructive sleep apnea patients by using the 'Mini Mental State Examination'. This was a cross sectional study to evaluate the cognitive function of moderate and severe obstructive sleep apnea patients with age ranged from 18 to 60 old who attended our sleep clinic. These patients were confirmed to have moderate and severe obstructive sleep apnea by Type 1 polysomnography (attended full overnight study). The age, gender and ethnicity were noted and other relevant data such as weight, height, body mass index and apnea and hypopnoea index were recorded accordingly. The cognitive function was evaluated using validated Malay version of Mini Mental State Examination which measured 5 areas of cognitive functions comprising orientation, registration, attention and calculation, word recall and language abilities, and visuospatial. A total of 38 patients participated in this study. All 19 patients of moderate group and 14 patients of severe group had normal cognitive function while only 5 patients in severe group had mild cognitive function impairment. There was a statistically significant difference between the moderate group and severe group on cognitive performance (p value = 0.042). Severe obstructive sleep apnea patients may have impaired cognitive function. Mini Mental State Examination is useful in the screening of cognitive function of obstructive sleep apnea patients but in normal score, more sophisticated test batteries are required as it is unable to identify in 'very minimal' or 'extremely severe' cognitive dysfunction.


Effect of plant-self debris on nitrogen removal, transformation and microbial community in mesocosm constructed wetlands planted with Myriophyllum aquaticum.
Aquatic macrophytes debris decomposition could release pollutants and nutrients into the water of constructed wetlands (CWs), but their role in nitrogen removal and transformation remains poorly understood. The present study investigated the effects of plant-self debris on nitrogen removal and microbial communities in mesocosm CWs planted with Myriophyllum aquaticum. During the 68-day operation, the plant debris addition did not change the mean removal efficiency of ammonium (NH4+-N) and total nitrogen (TN) of CWs but showed significant differences over the operation time. The NH4+-N and organic nitrogen released from the plant debris decomposition affected the nitrogen removal. The plant debris decreased the effluent nitrate concentration and N2O emission fluxes of the CWs with the increased abundance of denitrifying bacterial genera, indicating that plant debris decomposition increased the denitrification activities via dissolved organic carbon release. High-throughput sequencing indicated that the plant debris altered the distribution and composition of the microbial community in the sediments. Proteobacteria was the dominant phylum (28-52%), and the relative abundance of denitrifying bacteria genera was significantly higher in the sediments with debris addition (37-40%) than in the non-addition (6.6-7.7%). The present study provided new insights into the role of macrophytes in pollutant removal and the plant management strategy of CWs.


Screening for pheochromocytomas and paragangliomas.
Pheochromocytomas and paragangliomas are highly heterogeneous neuroendocrine tumors that must be considered not only in patients with hypertension and other manifestations of catecholamine excess but also in patients with incidentalomas or mutations in one of the ten tumor susceptibility genes identified to date. To first think of the tumor remains the critical step for screening in patients with signs and symptoms. In these patients, biochemical testing is straightforward and should include measurements of plasma or urinary metanephrines, comprising separately measured normetanephrine and metanephrine. Tumors due to an underlying germline mutation are often found in the absence of hypertension or other signs or symptoms of the tumor. Screening for disease in these patients can benefit from an individualized approach according to the particular mutation. Additional measurements of methoxytyramine, the metabolite of dopamine, can be useful in patients with mutations of succinate dehydrogenase genes or patients who are at risk for malignancy.


Effect of autoimmune diseases on cognitive function.
The location of both autoimmune processes and other causes of brain inflammation is important in determining the impact of inflammation on brain function. This chapter focuses on autoimmune and infectious diseases leading to inflammatory brain disease resulting in cognitive defects with a special focus on systemic lupus erythematosus (SLE). Collectively called neuropsychiatric SLE (NPSLE), NPSLE occurs in 20-95% of pediatric patients with SLE (pSLE). The incidence of cognitive dysfunction is difficult to ascertain in pediatric patients as few studies have been performed. Using formal neurocognitive testing of unselected pediatric SLE patients, the rate of cognitive abnormalities was approximately 50% and impairment was associated with longer disease duration in one study. A second small study showed global depression on performance and academic scores while a larger study using a neuropsychiatric inventory showed a 55% rate of dysfunction. These diverging findings may result from the lack of a standardized cognitive assessment battery. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) group of pediatric rheumatologists proposed a 2 hour 40 minutes battery for assessment of cognitive testing of SLE patients from age 9 to 18 years. Further assessments using this battery should provide a better neurocognitive profile of pSLE.


Dissociation of function between the dorsal and the ventral hippocampus in spatial learning abilities of the rat: a within-subject, within-task comparison of reference and working spatial memory.
Lesions restricted to the dorsal, but not the ventral, hippocampus severely impair the formation of spatial memory. This dissociation was first demonstrated using the water maze task. The present study investigated whether the dorsal and the ventral hippocampus are involved differentially in spatial reference and spatial working memory using a four-baited/four-unbaited version of the eight-arm radial maze task. This test allows the concurrent evaluation of reference and working memory with respect to the same set of spatial cues, and thereby enables a within-subjects within-task comparison between the two forms of memory functions. Rats with N-methyl-d-aspartic acid-induced excitotoxic lesions of the dorsal hippocampus, ventral hippocampus or both were compared with sham and unoperated controls. We showed that dorsal lesions were as effective as complete lesions in severely disrupting both reference and working spatial memory, whereas rats with ventral lesions performed at a level comparable with controls. These results lend further support to the existence of a functional dissociation between the dorsal and the ventral hippocampus, with the former being preferentially involved in spatial learning.


[Partnership in the context of care dependency].
Partners are one of the largest groups of caring relatives in Germany and are therefore very important for the maintenance of the German care system. For this reason, this article deals with coping with care situations in partnerships as well as with resources and ambivalences. The background to this article is the project "Care in the neighborhood" (PiQ). This study investigated the question of how the various home care settings of older people are organized and what problems and needs become visible in the process. This article focuses on caregiving for partners. Based on a case contrastive evaluation of guideline-supported individual and couple interviews, strategies of the couples for coping with the care situation were reconstructed. In addition to the interviews the analysis of egocentric network cards showed the problem areas and resources of the couples RESULTS: The caring partners in this sample showed different strategies for maintaining the relationship. In addition, there were ambivalences with respect to assumed and often exclusively positively connoted resources of the support network. This article highlights the special situation of caring partners. Based on the findings implications for the practice and (local) care policy are derived for improving the situation of older caregiving partners and thus their respective living conditions.