Screening and diagnostic tools for complex regional pain syndrome: a systematic review.
Complex regional pain syndrome (CRPS) is a severely painful condition that presents with a constellation of symptoms. The understanding of the pathophysiology of CRPS has evolved over time, as have the diagnostic criteria. Our primary objective was to identify screening and diagnostic tools for CRPS and summarize their feasibility, measurement properties, and study quality. A secondary objective was to identify screening and diagnostic tools used for CRPS in pediatric populations (0-21 years of age). A systematic review of English articles in electronic databases (PsycINFO, MEDLINE, Embase, CINAHL, CENTRAL, and Web of Science) was conducted with the aid of a librarian in November 2018 and updated in July 2020. Studies were included if the tool was a screening or diagnostic tool, the tool included self-report or physical examination, and the primary objective of the study was to evaluate the measurement properties or feasibility of use. For each study, data were extracted for quality indicators using the QUADAS-2 tool. No screening tools were identified. Four diagnostic tools were identified: the Veldman criteria, International Association for the Study of Pain criteria, Budapest Criteria, and Budapest Research Criteria. There are no diagnostic tools validated for use in pediatric CRPS. Because there are no extant screening tools for CRPS, all people with suspected disease should undergo rapid diagnostic assessment by a clinician. For adults, the Budapest Criteria are the preferred diagnostic tool. Future research is recommended to develop a diagnostic tool for pediatric populations and screening tools for both pediatric and adults.


Dementia-Parkinsonism syndrome with numerous Lewy bodies and senile plaques in cerebral cortex.
Five cases of age range 62-72 years with progressive dementia and muscular rigidity are reported and discussed from the clinicopathologic point of view. The neuropathology of these cases was characterized by the widespread occurrence of Lewy bodies (LB) in the CNS as well as the presence of senile changes. The presence of numerous LB in the cerebral cortex and basal ganglia was especially characteristic, although their distribution pattern in the diencephalon and brain stem was identical to that found in paralysis agitans. On the other hand, the presence of senile changes in the cerebral cortex was almost identical to the neuropathology of senile dementia or Alzheimer's disease. Nosologically, the present cases may represent either a combination of atypical paralysis agitans with senile dementia and Alzheimer's disease, or a new disease.


[Activating therapeutic care in geriatrics : Evaluation of a practice concept].
The special feature of the concept of activating therapeutic care in geriatrics (ATP-G) is based on the focus of nursing and therapeutic elements specifically related to the elderly. Further significance lies in the bottom-up development of this concept, which shows a close proximity to the nursing practice. The research project targeted the characteristics of ATP-G from a nursing point of view. Furthermore, the resulting elements of professional nursing care understanding for inpatient geriatric rehabilitation were used to build a scientific and theoretical foundation of the ATP-G concept. In this study 12 semi-structured interviews with professional caregivers were realized. The data collection was undertaken in three different facilities of inpatient geriatric (early) rehabilitation, chosen by lot. The data analysis was based on the methodology of qualitative content analysis according to Mayring. The research project showed that the basic elements described in the ATP-G concept are consistent with the view of nursing practitioners and therefore reflect the characteristic features of routine daily practice; nonetheless, some new aspects were found, primarily the importance of interdisciplinary teamwork in geriatric settings. There were also difficulties related to the ATP-G concept which were experienced as restraints by the questioned professionals. Further research should therefore investigate the structures for optimal implementation of the ATP-G concept into standard practice.


Sacroiliac joint dysfunction in patients with imaging-proven lumbar disc herniation.
A dysfunction of a joint is defined as a reversible functional restriction of motion presenting with hypomobility according to manual medicine terminology. The aim of our study was to evaluate the frequency and significance of sacroiliac joint (SIJ) dysfunction in patients with low back pain and sciatica and imaging-proven disc herniation. We examined the SIJs of 150 patients with low back pain and sciatica; all of these patients had herniated lumbar disks, but none of them had sensory or motor losses. Forty-six patients, hereinafter referred to as group A, were diagnosed with dysfunction of the SIJ. The remaining 104 patients, hereinafter referred to as group B, had no SIJ dysfunction. Dysfunctions were resolved with mobilizing and manipulative techniques of manual medicine. Regardless of SIJ findings, all patients received intensive physiotherapy throughout a 3-week hospitalisation. At the 3 weeks follow-up, 34 patients of group A (73.9%) reported an improvement of lumbar and ischiadic pain, 5 patients were pain free. Improvement was recorded in 57 of the group B patients (54.8%); however, nobody in group B was free of symptoms. We conclude that in the presence of lumbar and ischiadic symptoms our presented data suggest consideration of SIJ dysfunction, requiring manual medicine examination and, in the presence of SIJ dysfunction, appropriate therapy, regardless of intervertebral disc pathomorphology. This could avoid wrong indications for nucleotomy.


Risk factors for chronic undernutrition among children in India: Estimating relative importance, population attributable risk and fractions.
Nearly 40% of the world's stunted children live in India and the prevalence of undernutrition has been persistently high in recent decades. Given numerous available interventions for reducing undernutrition in children, it is not clear of the relative importance of each within a multifactorial framework. We assess the simultaneous contribution of 15 known risk factors for child chronic undernutrition in India. Data are from the 3rd Indian National Family Health Survey (NFHS-3), a nationally representative cross-sectional survey undertaken in 2005-2006. The study population consisted of children aged 6-59 months [n = 26,842 (stunting/low height-for-age), n = 27,483 (underweight/low weight-for-age)]. Risk factors examined for their association with undernutrition were: vitamin A supplementation, vaccination, use of iodized salt, household air quality, improved sanitary facilities, safe disposal of stools, improved drinking water, prevalence of infectious disease, initiation of breastfeeding, dietary diversity, age at marriage, maternal BMI, height, education, and household wealth. Age/sex-adjusted and multivariable adjusted effect sizes (odds ratios) were calculated for risk factors along with Population Attributable Risks (PAR) and Fractions (PAF) using logistic regression. In the mutually adjusted models, the five most important predictors of childhood stunting/underweight were short maternal stature, mother having no education, households in lowest wealth quintile, poor dietary diversity, and maternal underweight. These five factors had a combined PAR of 67.2% (95% CI: 63.3-70.7) and 69.7% (95% CI: 66.3-72.8) for stunting and underweight, respectively. The remaining factors were associated with a combined PAR of 11.7% (95% CI: 6.0-17.4) and 15.1% (95% CI: 8.9-21.3) for stunting and underweight, respectively. Implementing strategies focused on broader progress on social circumstances and infrastructural domains as well as investments in nutrition specific programs to promote dietary adequacy and diversity are required to ensure a long term trajectory of optimal child growth and development in India.


Iron deficiency: causes, consequences, and strategies to overcome this nutritional problem.
Iron deficiency and anemia affect a substantial portion of the world's population, provoking severe health problems to the people suffering these conditions, as well as important economic losses to the regions in which this nutritional deficiency is significant. In this work, the principal causes and consequences produced by this deficiency are discussed, as well as the different strategies that can be applied in order to prevent and solve this nutritional problem.


Calcium sensor Yellow Cameleon 3.6 as a tool to support the calcium hypothesis of Alzheimer's disease.
Alzheimer's disease (AD) is a neurodegenerative disease with increasing relevance as dementia cases rise. The etiology of AD is widely debated. The Calcium Hypothesis of Alzheimer's disease and brain aging states that the dysfunction of calcium signaling is the final common pathway leading to neurodegeneration. When the Calcium Hypothesis was originally coined, the technology did not exist to test it, but with the advent of Yellow Cameleon 3.6 (YC3.6) we are able to test its validity. Here we review use of YC3.6 in studying Alzheimer's disease using mouse models and discuss whether these studies support or refute the Calcium Hypothesis. YC3.6 studies showed that amyloidosis preceded dysfunction in neuronal calcium signaling and changes in synapse structure. This evidence supports the Calcium Hypothesis. In vivo YC3.6 studies point to calcium signaling as a promising therapeutic target; however, additional work is necessary to translate these findings to humans.


Pseudosarcomatous myofibroblastic proliferation of the appendix with an abdominal abscess due to diverticulum perforation: a case report.
Pseudosarcomatous myofibroblastic proliferation is a rare proliferative lesion of the submucosal stroma characterized by myofibroblast proliferation and inflammatory cell infiltration, and is mainly reported in the urinary system. We report a 65-year-old male who was referred to our emergency room with right-side iliac fossa pain. The pain gradually worsened for approximately 2 months, and rebound tenderness was positive. Blood examination showed severe inflammatory findings, and enhanced computed tomography revealed a heterogeneous contrast-enhancing mass lesion measured to be 55 × 50 mm in size at the lower right abdomen. Based on these results, the patient was diagnosed with appendicitis with an abdominal abscess. As the inflammation was severe, we drained the abscess before performing surgery. Approximately 1 month after the abscess diminished, interval appendectomy was performed. Macroscopic findings of the resected specimen showed a perforated diverticulum of the appendix and a small adjacent nodule measured to be 14 mm in size. Histopathological examination with hematoxylin and eosin staining revealed that the nodule consisted of fibroblast proliferation and inflammatory cell infiltration. Furthermore, immunohistochemical examination showed positive for smooth muscle actin and desmin and negative for S-100, c-kit, and anaplastic lymphoma kinase. Based on these histopathological results, we diagnosed the nodule as an unusual case of a pseudosarcomatous myofibroblastic proliferation associated with perforation of the diverticulum of the appendix. Herein, we report a rare case of a pseudosarcomatous myofibroblastic proliferation that occurred in the appendix with diverticulitis.


Rationale and design of the Study of Dietary Intervention Under 100 MMOL in Heart Failure (SODIUM-HF).
Patients with heart failure (HF) remain at high risk for future events despite medical and device therapy. Dietary sodium reduction is often recommended based on limited evidence. However, it is not known whether dietary sodium reduction reduces the morbidity or mortality associated with HF. The SODIUM study is a pragmatic, randomized, open-label trial assessing the efficacy of dietary sodium reduction to <1500 mg daily counseling compared to usual care for patients with chronic HF. The intervention is provided by trained personnel at the site and uses 3-day food records for directing counseling. The primary outcome is an intention-to-treat analysis on the time to first cardiovascular event or death measured at 12 months. Secondary end points include the change in quality of life (using the Kansas City Cardiomyopathy Questionnaire), change in New York Heart Association class, and change in 6-minute walk test. The first patient was enrolled in March 2014, and subsequently, 27 sites in 6 countries enrolled patients. The SODIUM-HF trial will provide a robust evaluation of the effects of dietary sodium reduction in patients with HF. Results are expected in 2020.


Early dorsomedial tissue interactions regulate gyrification of distal neocortex.
The extent of neocortical gyrification is an important determinant of a species' cognitive abilities, yet the mechanisms regulating cortical gyrification are poorly understood. We uncover long-range regulation of this process originating at the telencephalic dorsal midline, where levels of secreted Bmps are maintained by factors in both the neuroepithelium and the overlying mesenchyme. In the mouse, the combined loss of transcription factors Lmx1a and Lmx1b, selectively expressed in the midline neuroepithelium and the mesenchyme respectively, causes dorsal midline Bmp signaling to drop at early neural tube stages. This alters the spatial and temporal Wnt signaling profile of the dorsal midline cortical hem, which in turn causes gyrification of the distal neocortex. Our study uncovers early mesenchymal-neuroepithelial interactions that have long-range effects on neocortical gyrification and shows that lissencephaly in mice is actively maintained via redundant genetic regulation of dorsal midline development and signaling.


Do Misconceptions About Health-Related Quality of Life Affect General Population Valuations of Health States?
Healthcare resource allocation decisions are often informed by the expected gains in patients' quality-adjusted life-years. Misconceptions about ill-health's consequences for quality of life (QOL) may however affect evaluations of health states by the general population and hence affect resource allocation decisions informed by quality-adjusted life-years. We examine whether people selectively misestimate the QOL consequences of moderate anxiety or depression compared with other dimensions of health, and we test whether informing people of actual changes in QOL associated with health states changes appraisals of their relative undesirability. UK general population participants (N = 1259; in 2017) expressed preferences over moderate problems: anxiety or depression, self-care, and pain or discomfort. A randomized control trial design was used whereby a control group was given a functional description of each health state, and 2 intervention groups were additionally given information on the actual differences in either life satisfaction (LS) or day affect (DA) associated with experiencing each health state. The LS (DA) group reported a higher preference for avoiding living with moderate anxiety or depression, being 13.4% (13.9%) more likely to choose it as most undesirable. Informing people of the change in LS or DA associated with health states before they appraise them is a feasible way to obtain informed preferences.


The cerebral palsy transition clinic: administrative chore, clinical responsibility, or opportunity for audit and clinical research?
The majority of children with orthopaedic conditions in childhood survive to adult life, and there is a need for many of them to transition to adult services. This includes children with disorders such as club foot or developmental dislocation of the hip as well as those with complex syndromic conditions, bone dysplasias or neuromuscular disorders such as cerebral palsy and myelomeningocele. In many tertiary paediatric centres, transition has become a formal process in which clinicians document and communicate the status of patients who have been under their care to ensure a smooth transfer to adult services. The purpose of this report is to support the need for clear communication when children with cerebral palsy transition to adult services and to suggest that this transition represents a significant opportunity for audit and clinical research. Some of the factors to be considered in developing a minimum data sheet for the transfer or transition of children with cerebral palsy to adult services are described. Using the model of adolescents with cerebral palsy transitioning to adult services, orthopaedic surgeons can be encouraged to develop similar methodology and documentation for many other conditions for the purposes of communication, facilitation of transition, audit and clinical research.


Involvement of adenosine in the effect of fluoxetine on isolated guinea-pig atria.
The effect of fluoxetine (FL) a selective serotonin reuptake inhibitor antidepressant was studied on the rate and force of contractions of isolated guinea-pig atria. FL (2-16 microg/ml) caused a decrease in the rate (13-45%) and contractile force (41-53%) of isolated guinea-pig atria in a dose-dependent manner. These negative inotropic and chronotropic effect of FL (4 microg/ml) were not prevented by atropine (1 microg/ml) and 3,7-dimethyl-1-propargylxanthine (DMPX; 1.5 microg/ml), an adenosine A(2) receptor antagonist, but 1,3-dipropargyl-8-cyclopentylxanthine (DPCPX;12 microg/ml), a specific adenosine A(1) receptor antagonist significantly blocked these effects (P < 0.001) and theophylline (30 microg/ml) a non- selective adenosine A(1)/A(2A) receptor antagonist also prevented the inotropic and chronotropic effects of FL. These results suggest that the negative chronotropic and inotropic effect of FL on isolated guinea-pig atria is probably mediated through an inhibition of the reuptake of adenosine or the A(1) receptor mechanism.


[Method of preparing an otic insert in a case of narrowing of the external auditory meatus].
The authors present three cases of patients hard of hearing in whom narrowing of the external auditory meatus was found. The application of individually prepared insert with diameter greater than that of the meatus improved the hearing acuity without producing any side effects.


Is contrast as bad as we think? Renal function after angiographic embolization of injured patients.
Angiographic embolization (AE) is increasingly used to control bleeding after severe trauma. Serious concerns have been raised about the safety of high-volume i.v. contrast in hypotensive, hypovolemic patients. In a prospective cohort study, 100 consecutive trauma patients underwent AE for bleeding in the abdomen and pelvis. Serum creatinine (Cr) levels were measured before the procedure and up to 5 days after the procedure. Contrast nephropathy was defined as an increase in Cr levels after AE of more than 25% over the baseline measurement. An average of 248 +/- 59 mL of nonionic, low-osmolality contrast was used in all cases. Compared with the baseline, no increase in Cr levels after AE was observed among all patients (1.02 +/- 0.24 versus 0.94 +/- 0.26 mg/dL; p = 0.01) or among subgroups of patients who had any of the following risk factors for renal failure: older than 60 years, Injury Severity Score > or = 15, shock on arrival, renal injury, elevated Cr levels (> or = 1.5 mg/dL) before AE, or administration of a high volume of contrast (> 250 mL). Contrast nephropathy developed in five patients by means of mild Cr elevations. In all of these patients, Cr returned to baseline within 5 days of AE. Renal failure requiring hemodialysis developed at 41 and 55 days after AE in two patients with multiple organ failure who eventually died. Administration of nonionic contrast during AE causes mild and transient contrast nephropathy in 5% of severely injured patients. Our study adds additional support for the safety of AE for trauma.


Human-accelerated weathering increases salinization, major ions, and alkalinization in fresh water across land use.
Human-dominated land uses can increase transport of major ions in streams due to the combination of human-accelerated weathering and anthropogenic salts. Calcium, magnesium, sodium, alkalinity, and hardness significantly increased in the drinking water supply for Baltimore, Maryland over almost 50 years (p<0.05) coinciding with regional urbanization. Across a nearby land use gradient at the Baltimore Long-Term Ecological Research (LTER) site, there were significant increases in concentrations of dissolved inorganic carbon (DIC), Ca2+, Mg2+, Na+, and Si and pH with increasing impervious surfaces in 9 streams monitored bi-weekly over a 3-4 year period (p<0.05). Base cations in urban streams were up to 60 times greater than forest and agricultural streams, and elemental ratios suggested road salt and carbonate weathering from impervious surfaces as potential sources. Laboratory weathering experiments with concrete also indicated that impervious surfaces increased pH and DIC with potential to alkalinize urban waters. Ratios of Na+ and Cl- suggested that there was enhanced ion exchange in the watersheds from road salts, which could mobilize other base cations from soils to streams. There were significant relationships between Ca2+, Mg2+, Na+, and K+ concentrations and Cl-, SO42-, NO3- and DIC across land use (p<0.05), which suggested tight coupling of geochemical cycles. Finally, concentrations of Na+, Ca2+, Mg2+, and pH significantly increased with distance downstream (p<0.05) along a stream network draining 170 km2 of the Baltimore LTER site contributing to river alkalinization. Our results suggest that urbanization may dramatically increase major ions, ionic strength, and pH over decades from headwaters to coastal zones, which can impact integrity of aquatic life, infrastructure, drinking water, and coastal ocean alkalinization.


EMLA cream and nitrous oxide to alleviate pain induced by palivizumab (Synagis) intramuscular injections in infants and young children.
Palivizumab (Synagis [Abbot Laboratories, Kent, United Kingdom]) is recommended for the prevention of severe lower respiratory tract infections caused by respiratory syncytial virus in infants at high risk. These injections are very painful, and currently the use of analgesics is not systematic. The objective of this study was to compare the efficacy of EMLA with premixed 50% nitrous oxide/oxygen, used alone or combined with EMLA, for pain alleviation during palivizumab injections. This randomized, double-blind, multicenter study included children who were younger than 24 months. Each child randomly received during the first 3 monthly injections 3 different analgesic interventions: (1) EMLA: application of EMLA plus air inhalation; (2) nitrous oxide/oxygen: inhalation of 50/50 nitrous oxide/oxygen plus application of a placebo cream; and (3) nitrous oxide/oxygen plus EMLA: inhalation of 50/50 nitrous oxide/oxygen plus application of EMLA. Each child was his or her own control. Procedural pain was assessed through videotapes with the Modified Behavioral Pain Scale. The procedure itself was subdivided in 2 periods: (1) injection and (2) recovery (first 30 seconds after the removal of the needle). Modified Behavioral Pain Scale scores over time (injection and recovery periods) and among treatments were compared by repeated-measures analysis of variance. Fifty-five children were included. Mean +/- SD Modified Behavioral Pain Scale pain scores for EMLA, nitrous oxide/oxygen, and nitrous oxide/oxygen plus EMLA were, respectively, 9.3 +/- 1.0, 8.8 +/- 1.2, and 8.2 +/- 1.8 during the injection and 7.8 +/- 1.7, 7.4 +/- 1.9, and 6.9 +/- 2.4 during the recovery period. A significant time and treatment effect in favor of the combined nitrous oxide/oxygen plus EMLA was observed. The administration of 50/50 nitrous oxide/oxygen to infants and young children is effective in decreasing the pain associated with palivizumab intramuscular injections. The combined nitrous oxide/oxygen plus EMLA cream was more effective than either EMLA cream or nitrous oxide/oxygen alone.


A comprehensive review of the neurobehavioral effects of bisphenol S and the mechanisms of action: New insights from in vitro and in vivo models.
The normal brain development and function are delicately driven by an ever-changing milieu of steroid hormones arising from fetal, placental, and maternal origins. This reliance on the neuroendocrine system sets the stage for the exquisite sensitivity of the central nervous system to the adverse effects of endocrine-disrupting chemicals (EDCs). Bisphenol A (BPA) is one of the most common EDCs which has been a particular focus of environmental concern for decades due to its widespread nature and formidable threat to human and animal health. The heightened regulatory actions and the scientific and public concern over the adverse health effects of BPA have led to its replacement with a suite of structurally similar but less known alternative chemicals. Bisphenol S (BPS) is the main substitute for BPA that is increasingly being used in a wide array of consumer and industrial products. Although it was considered to be a safe BPA alternative, mounting evidence points to the deleterious effects of BPS on a wide range of neuroendocrine functions in animals. In addition to its reproductive toxicity, recent experimental efforts indicate that BPS has a considerable potential to induce neurotoxicity and behavioral dysfunction. This review analyzes the current state of knowledge regarding the neurobehavioral effects of BPS and discusses its potential mode of actions on several aspects of the neuroendocrine system. We summarize the role of certain hormones and their signaling pathways in the regulation of brain and behavior and discuss how BPS induces neurotoxicity through interactions with these pathways. Finally, we review potential links between BPS exposure and aberrant neurobehavioral functions in animals and identify key knowledge gaps and hypotheses for future research.


Advancing Research on Psychosocial Stress and Aging with the Health and Retirement Study: Looking Back to Launch the Field Forward.
The Health and Retirement Study (HRS) was designed as an interdisciplinary study with a strong focus on health, retirement, and socioeconomic environment, to study their dynamic relationships over time in a sample of mid-life adults. The study includes validated self-report measures and individual items that capture the experiences of stressful events (stressor exposures) and subjective assessments of stress (perceived stress) within specific life domains. This article reviews and catalogs the peer-reviewed publications that have used the HRS to examine associations between psychosocial stress measures and psychological, physical health, and economic outcomes. We describe the research to date using HRS measures of the following stress types: traumatic and life events, childhood adversity, caregiving and other chronic stressors, discrimination, social strain and loneliness, work stress, and neighborhood disorder. We highlight how to take further advantage of the longitudinal study to test complex biopsychosocial models of healthy aging. The HRS provides one of the most comprehensive assessments of psychosocial stress in existing population-based studies and offers the potential for a deeper understanding of how psychosocial factors are related to healthy aging trajectories. The next generation of research examining stress and trajectories of aging in the HRS should test complex longitudinal and mediational relationships, include contextual factors in analyses, and include more collaboration between psychologists and population health researchers.


[Phototherapy in the "City of Light" Jena].
In 1801, ultraviolet (UV) radiation was first described in Jena (Germany). Over the course of the last 200 years, the city has developed into a university and industry center for glass production, optics and spectroscopy. How this development influenced dermatotherapy in Jena is the subject of this article. In the late 19th century, the developing glass and optic industry of Jena played a leading role in the production of electric lamps for therapeutic use. Although production in Jena did not become established for dermatotherapeutic lamps, Jena glassmakers remained a supplier of UV filters. The industry's fortunes were generously spent on development of the city and university and enabled the creation of a dermatology clinic in an independent building. A department of radio- and phototherapy was established and since then has been part of the dermatology clinic's therapeutic portfolio. Although the city of Jena faced heavy economic repression, the industry and the dermatology clinic's scientific activity expanded to fluorescence and protein diagnostics in the early 1960s. Investigations by Professor Heinz Langhof led to the description of erythropoietic protoporphyria (EPP) simultaneously, but independently from English colleagues, whose publication is considered EPP's first description. The first functioning laser in the former German Democratic Republic was built at the university, although the first laser beam was created by a research group in Berlin a short time before. Use of laser technology in the dermatology department proceeded only after political changes began. Despite economic hardships, excellent research was done in Jena through intense collaborations. The dermatology clinic has thus been able to offer modern phototherapy from the very beginning.


Author Correction: Deep-sea Sediment Resuspension by Internal Solitary Waves in the Northern South China Sea.
An amendment to this paper has been published and can be accessed via a link at the top of the paper.


Impacts of 1.5 °C and 2 °C global warming on Eucalyptus plantations in South America.
Even if the maximum global warming thresholds established by the Paris Agreement (1.5 and 2 °C relative to pre-industrial levels) are not exceeded, part of the climate system impacts resulting from this warming will be unavoidable. Forestry industries may be especially vulnerable, due to water shortages and the inability of growing certain forest species. An important part of the South American economy depends on the forestry sector (between 2 to ~7% of the Gross Domestic Product), mainly products derived from Eucalyptus, and so evaluating water availability considering the temperature thresholds established by the Paris Agreement will be fundamental. This study analyzed increased global average temperatures at 1.5 °C and 2 °C, and the impacts on water availability, using the Climatic Water Balance (CWB), and also studied possible impacts on Eucalyptus plantations in South America. Monthly temperature and precipitation data obtained from a set of simulations and projections of 26 General Circulation Models (GCMs) were used, in four Representative Concentration Pathway (RCP) scenarios. The CWB was calculated for three periods: i) the pre-industrial period (1861-1890), ii) the present period (1975-2005), and iii) the period when temperature projections are expected to reach global average increases of 1.5 °C and 2 °C. Due to changes in the CWB, with increases in actual evapotranspiration, water deficits, and a reduced water surplus, Eucalyptus plantations will be negatively affected and economically unfeasible for about 49.2% to 56.7% of all of South America, including a large part of the Amazon region, northern South America, midwestern and northeastern Brazil, western portions of Bolivia, Paraguay, central/northern Argentina, and northern Chile. Only some parts of South America, like the southern and southeastern regions of Brazil, Uruguay, southern Argentina and Chile, Andes Mountain Range, and northwestern South America, will not suffer water deficits, and Eucalyptus plantations will be less impacted in these regions. Large parts of South America will suffer from changes in water availability. The future of the forestry industry, and especially Eucalyptus plantations in these regions, will depend on urgent and effective adaptation measures.


Folate in maternal rheumatoid arthritis-filial autism spectrum disorder continuum.
Rheumatoid Arthritis (RA) is an inflammatory autoimmune disease that affects women three times more than men. Epidemiological studies found that the incidence of Autism Spectrum Disorder (ASD), a neurological and developmental disorder, in children born to mothers suffering from RA is higher compared with the control population. Considering that the pathogenesis of ASD could be traced back to pregnancy and in uterine conditions, and the evidence of reduced folate levels in the brain of ASD-affected children, we aimed to study the role of folate, as an important nutritional factor during pregnancy, in associating maternal RA to ASD development in the offspring. Folate balance during RA could be influenced twice, initially during the immune activation associated with disease onset, and later during the treatment with anti-folate drugs, with a potential consequence of folate deficiency. Maternal folate deficiency during pregnancy could increase homocysteine levels, oxidative stress, and global DNA hypomethylation, all known risk factors in ASD pathogenesis. These effects could be intensified by genetic polymorphisms in the folate system, which were also found as genetic risk factors for both RA and ASD. The available evidence suggests that folate level as an important factor during RA, pregnancy and ASD could have pathological and therapeutical significance and should be carefully monitored and investigated in the RA-pregnancy-ASD axis.


Autopsy findings 14 years after septation for single ventricle.
The autopsy findings of a patient who survived 14 years after ventricular septation for single ventricle are reported. Although the patient had been well for years, she suddenly died at 22 years of age. Her ventricular free walls had grown normally, but the ventricular septum did not. A crevice was found in the apex, and the ventricular septum consisted of only the Teflon patch. Microscopically, fibrosis was found only in the right atrium.


Mouse monoclonal anti-Ia antibodies recognize cross-reacting determinants expressed on distinct subsets of human Ia-like cell-surface molecules.
Human Ia-like cell-surface molecules from a homozygous HLA-DR (6/6) B lymphoblastoid cell line have been analyzed using five mouse anti-Ia m.Ab cross-reacting with HLA-DR antigens. The surface-iodinated molecules immunoprecipitated by these m.Ab were analyzed by SDS-PAGE under reducing conditions and by SDS-PAGE followed by isoelectrofocusing. As read from the different migration patterns, three distinct combinations of human Ia-like molecules were identified by these m.Ab. Three anti-I-E-reactive m.Ab immunoprecipitated two-chain molecules whose apparent mol. wt (32K, 29K) corresponded to those of the classical HLA-DR antigens. One m.Ab which on mouse cells recognized a determinant shared by the I-A and I-E molecules precipitated not only the 32-29K bands, but also a 26K band from human cell extracts. Finally, an I-A reactive m.Ab precipitated a complex set of polypeptides including in addition to the 32-29K bands, three additional chains of 30, 28 and 26K. Sequential immunoprecipitation demonstrated that removal of the classical 29-32K HLA-DR chains by an anti-I-E m.Ab did not affect the subsequent immunoprecipitation of the additional chains by the anti-I-A or the anti-I-A + I-E m.Abs. These patterns and those obtained by 2D-gels analysis which demonstrated the complexity of the 26K band are compatible with the coexpression of at least three different subsets of molecules: (1) Ia-like molecules of 29-32K, recognized by all the m.Ab used; (b) molecules of 28-30K recognized by the anti-I-A m.Ab and (c) molecules apparently constituted by 26K chains, precipitated by the anti-I-A m.Ab and by the anti-I-A + I-E m.Ab.


A Methylene Group on C-2 of 24,24-Difluoro-19-nor-1α,25-dihydroxyvitamin D3 Markedly Increases Bone Calcium Mobilization in Vivo.
Four side chain fluorinated analogues of 1α,25-dihydroxy-19-norvitamin D have been prepared in convergent syntheses using the Wittig-Horner reaction as a key step. Structures and absolute configurations of analogues 3 and 5 were confirmed by X-ray crystallography. All analogues showed high potency in HL-60 cell differentiation and vitamin D-24-hydroxylase (24-OHase) transcription as compared to 1α,25-dihydroxyvitamin D3 (1). Most important is that all of the 20S-configured derivatives (4 and 6) had high bone mobilizing activity in vivo. However, in the 20R series, a 2-methylene group was required for high bone mobilizing activity. A change in positioning of the 20R molecule in the vitamin D receptor when the 2-methylene group is present may provide new insight into the molecular basis of bone calcium mobilization induced by vitamin D.


Characteristics of clinical decision support alert overrides in an electronic prescribing system at a tertiary care paediatric hospital.
CONTEXT Electronic prescribing (EP) systems are advocated as a solution to minimise medication errors. Benefits in patient safety are often as a result of some clinical decision support (CDS) within the system. OBJECTIVE To study the characteristics of the CDS alerts generated within a commercially available EP system in use at a tertiary care paediatric hospital in the UK. METHODS Retrospective review and characterisation of CDS alerts recorded in the EP system over 1 year. RESULTS A total of 16 182 conflict alerts were recorded when ordering 26 836 items, of which 3507 (13 alerts per 100 prescription orders (95% confidence interval, 12.8 to 13.6)) were visible to the user. Eighty nine percent (3119/3507) of all visible alerts were overridden by the user at point of prescribing. Drug-allergy conflict alerts were the most accepted, and exact drug duplication alerts the least. CONCLUSION We found a high incidence of alert override, which is undesirable but consistent with that reported in the literature. The results suggest that the underlying algorithms for alert generation in many EP systems are not specific and need to be reviewed.


Training in Uniportal Video-Assisted Thoracic Surgery.
Interest in uniportal video-assisted thoracic surgery (VATS) is rapidly growing worldwide because it represents the surgical approach to the lung with the least possible trauma. Specific training in this surgical approach is crucial due to its technical implications, to perform it safely while upholding the required therapeutic radicality. Novel strategies, such as interactive learning technologies, simulators, high-volume preceptorships, and targeted proctorships, play important roles in the training for uniportal VATS which, ideally, should be standardized, governed, and credentialed by national and international surgical societies to ensure patient safety and academic responsibility.


Autopsy case of pure akinesia showing pallidonigro-luysian atrophy.
A 60-year-old man developed levodopa-resistant pure akinesia. The patient gradually became more akinetic without accompanying gaze palsies, nuchal dystonia, or other parkinsonian features such as rigidity or tremor. At the age of 71, he died of bronchopneumonia. Neuropathologically, bilateral marked neuronal loss and gliosis were restrictedly observed in the globus pallidus, substantia nigra and corpus luysii, whereas mild gliosis without neuronal loss was found in the brain stem. With Gallyas-Braak silver stain, numerous argyrophilic fibrous structures partly surrounding glial nuclei were observed in the three major affected regions. With Bodian stain, however, they were rarely recognized. The structures were partly positive for tau protein. Rare neurofibrillary tangles were found in the three areas and brain stem. They were relatively more numerous but still sparse in the hippocampus and the parahippocampus. The present case was diagnosed as having pallidonigro-luysian atrophy based on two characteristic findings: (i) the distribution of lesions showing neuronal loss with gliosis; and (ii) significant presence of tau-positive argyrophilic fibrous structures related to glia but with the absence of neurofibrillary tangles in the major affected regions and the brain stem. As our present case uniquely showed pure akinesia for the whole clinical course, it is noteworthy to report it here with a full neuropathological evaluation. In addition, a moderate number of diffuse plaques positive for beta-amyloid were distributed in the thalamus.


Bottlebrush inspired injectable hydrogel for rapid prevention of postoperative and recurrent adhesion.
Postsurgical adhesion is a common clinic disease induced by surgical trauma, accompanying serious subsequent complications. Current non-surgical approaches of drugs treatment and biomaterial barrier administration only show limited prevention effects and couldn't effectively promote peritoneum repair. Herein, inspired by bottlebrush, a novel self-fused, antifouling, and injectable hydrogel is fabricated by the free-radical polymerization in aqueous solution between the methacrylate hyaluronic acid (HA-GMA) and N-(2-hydroxypropyl) methacrylamide (HPMA) monomer without any chemical crosslinkers, termed as H-HPMA hydrogel. The H-HPMA hydrogel can be tuned to perform excellent self-fused properties and suitable abdominal metabolism time. Intriguingly, the introduction of the ultra-hydrophilic HPMA chains to the H-HPMA hydrogel affords an unprecedented antifouling capability. The HPMA chains establish a dense hydrated layer that rapidly prevents the postsurgical adhesions and recurrent adhesions after adhesiolysis in vivo. The H-HPMA hydrogel can repair the peritoneal wound of the rat model within 5 days. Furthermore, an underlying mechanism study reveals that the H-HPMA hydrogel significantly regulated the mesothelial-to-mesenchymal transition (MMT) process dominated by the TGF-β-Smad2/3 signal pathway. Thus, we developed a simple, effective, and available approach to rapidly promote peritoneum regeneration and prevent peritoneal adhesion and adhesion recurrence after adhesiolysis, offering novel design ideas for developing biomaterials to prevent peritoneal adhesion.


Use of Schizosaccharomyces strains for wine fermentation-Effect on the wine composition and food safety.
Schizosaccharomyces was initially considered as a spoilage yeast because of the production of undesirable metabolites such as acetic acid, hydrogen sulfide, or acetaldehyde, but it currently seems to be of great value in enology.o ced Nevertheless, Schizosaccharomyces can reduce all of the malic acid in must, leading to malolactic fermentation. Malolactic fermentation is a highly complicated process in enology and leads to a higher concentration of biogenic amines, so the use of Schizosaccharomyces pombe can be an excellent tool for assuring wine safety. Schizosaccharomyces also has much more potential than only reducing the malic acid content, such as increasing the level of pyruvic acid and thus the vinylphenolic pyranoanthocyanin content. Until now, few commercial strains have been available and little research on the selection of appropriate yeast strains with such potential has been conducted. In this study, selected and wild Sc. pombe strains were used along with a Saccharomyces cerevisiae strain to ferment red grape must. The results showed significant differences in several parameters including non-volatile and volatile compounds, anthocyanins, biogenic amines and sensory parameters.


A framework for transitioning patients from pediatric to adult health settings for patients with neurogenic bladder.
Adolescents with neurogenic bladder are a vulnerable population that severely lacks consistent transitional care from pediatric to adult urology settings. Our practice determined that 100 patients with spina bifida and other neurogenic bladder conditions were not appropriately transferred to the adult setting once reaching adulthood. We initiated a transitional program to establish a dedicated and formal process for adolescent patients to transition to adult urology. The REACH clinic implements a formalized staging framework to facilitate migration of adolescents and young adults to the adult health setting. A social worker was incorporated to act as a patient advocate, behavioral health consultant, and resource specialist. To date 45 patients have been enrolled in the transition program. We have identified and categorized according to the appropriate stage. The REACH clinic has appropriately outlined the goals and mission of the program and resources utilized are financially practical and feasible by conducting a monthly combined clinic. The program has been instrumental in improving tracking and monitoring of these patients through their transition period. Through the efforts of the pediatric and adult urology teams, the REACH program is a dedicated framework that provides structure for transition of the adolescent patient. The addition of a social worker has resulted in enriched rapport and will likely result in improved compliance. This program allows for surveillance and evaluation of patient outcome indicators in this patient population. We believe that early introduction and frequent encounters with the adult urologic team is crucial to successful transitions. Neurourol. Urodynam. 36:973-978, 2017. © 2016 Wiley Periodicals, Inc.


Peripheral Blood Leukocyte Telomere Length and Endometriosis.
Endometriosis is a common gynecologic disease defined by the presence of endometrial-like tissue outside the uterine cavity. While its etiology is largely unknown, accumulating evidence suggests that inflammation plays a major role. Our objective was to investigate the association between peripheral blood leukocyte telomere length (LTL) and endometriosis using data from two large population-based studies, the New England Case-Control Study (NEC; n = 877) and the National Health and Nutrition Examination Survey (NHANES; n = 2268). NEC control participants were identified through a combination of random digit dialing, drivers' license lists, and town resident lists. In NHANES, selection algorithms were used to identify a nationally representative sample. Blood samples and demographic, reproductive, and health-related information were available from both data sources. Endometriosis was defined as self-reported of physician-diagnosed endometriosis. LTL was measured using quantitative polymerase chain reaction. Multivariable logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for the association between LTL and endometriosis. Shorter LTL was associated with greater odds of history of endometriosis. In NEC, women with the shortest LTL tertile compared with the longest had a 2.5-fold greater odds of endometriosis (ORT3/T1 = 2.56, 95% CI = 1.16-5.63; p value, test for linear trend = 0.02). The association was stronger among women who usually experienced moderate or severe menstrual pain (OR T3/T1 = 3.50, 95% CI = 1.12-10.97). In NHANES, the data suggested a similar but attenuated association (ORT3/T1 = 1.29, 95% CI = 0.85-1.96). The observed associations in NEC suggest that shorter LTL may be associated with greater odds of endometriosis. A better understanding of how LTL influences endometriosis risk could elucidate novel disease pathophysiology.


The optimal timing of supporting patients in health-related behavior change after TIA or ischemic stroke: a prospective cohort study to determinants of health-related intention to change over time.
The optimal timing of an intervention to support health-related behavior after transient ischemic attack (TIA) or ischemic stroke is unknown. We aimed to assess determinants of patients' health-related intention to change over time. We prospectively studied 100 patients with TIA or minor ischemic stroke. Patients completed questionnaires on fear, response-efficacy (belief that lifestyle change reduces risk of recurrent stroke), and self-efficacy (patients' confidence to carry out lifestyle behavior) for behavior change, at baseline, 6 weeks and at 3 months after their TIA or ischemic stroke. We studied differences between these determinants at each visit by means of Wilcoxon signed-rank tests. Median self-efficacy score at baseline was 4.3 [interquartile range (IQ) 3.9-4.7], median fear 16 (IQ 7-21), and response-efficacy 10 (9-12). Fear was significantly higher at baseline than at 3 months (mean difference 2.0; 95% confidence interval: 0.78-3.9) and started to decrease after 6 weeks. No change in self-efficacy or response-efficacy was found. Since fear significantly decreased over time after TIA or ischemic stroke and self-efficacy and response-efficacy scores remained high, the optimal moment to start an intervention to support patients in health-related behavior change after TIA or ischemic stroke seems directly after the stroke or TIA.


Critical reflections on three popular computational linguistic approaches to examine Twitter discourses.
Although computational linguistic methods-such as topic modelling, sentiment analysis and emotion detection-can provide social media researchers with insights into online public discourses, it is not inherent as to how these methods should be used, with a lack of transparent instructions on how to apply them in a critical way. There is a growing body of work focusing on the strengths and shortcomings of these methods. Through applying best practices for using these methods within the literature, we focus on setting expectations, presenting trajectories, examining with context and critically reflecting on the diachronic Twitter discourse of two case studies: the longitudinal discourse of the NHS Covid-19 digital contact-tracing app and the snapshot discourse of the Ofqual A Level grade calculation algorithm, both related to the UK. We identified difficulties in interpretation and potential application in all three of the approaches. Other shortcomings, such the detection of negation and sarcasm, were also found. We discuss the need for further transparency of these methods for diachronic social media researchers, including the potential for combining these approaches with qualitative ones-such as corpus linguistics and critical discourse analysis-in a more formal framework.


Site-specific methylene blue delivery to pilosebaceous structures using highly porous nylon microspheres: an experimental evaluation.
This study aimed to evaluate the penetration of methylene blue (MB)-loaded microspheres into pilosebaceous structures of rats. MB was incorporated into 5 microm highly porous nylon microspheres. The microspheres were dispersed into fluid silicone. Male hairless rats were used to evaluate the penetration of MB into hair follicles. After formulation application, MB diffusion was induced and skin biopsies were realized immediately, 2 and 26 hours after MB loaded microspheres application. MB fluorescence was observed with a microscope expanded for fluorescence microscopy. Position of microspheres and MB diffusion was dependent on delay between microspheres application and harvest. Inside the skin, MB was seen exclusively in the hair follicle and the sebaceous glands. MB diffusion varied from 160+/-50 microm (2 hours after application) to 410+/-70 microm (26 hours after application). MB was also found in the sebaceous glands. This study confirms that 5 micro m microspheres are optimally deposited deep within the pilosebaceous structure. In agreement with the literature, when microspheres are topically applied on the skin, they penetrate via a "lipid-rich channel" coating the hair follicles. MB is exclusively distributed in the hair follicles and their accessories. This report presents evidence of MB pilosebaceous delivery through the use of microsphere formulation. This is obtained thanks to topical enhancement via the follicular route. This drug delivery system aims to transport MB into the pilosebaceous unit specifically and deeply. Various other applications could derive from this work. For example, such a method might be used to increase the therapeutic index of drugs directed at hair sebaceous gland disorders. Laser treatment of acne or laser hair removal could also benefit of this technique.


Preoperative chemotherapy of chemoradiotherapy for the treatment of adenocarcinoma of the pancreas and ampulla of Vater.
Much has been written about preoperative strategies in the treatment of pancreatic adenocarcinoma, yet there has been very little comment concerning other periampullary malignancies. This review discusses current issues relevant to the further development of preoperative adjuvant treatment of pancreatic adenocarcinoma. A small series of patients with ampullary adenocarcinomas treated with preoperative adjuvant chemoradiotherapy is also described.


Clinicopathologic and biological significance of kallikrein 6 overexpression in human gastric cancer.
Human kallikrein genes (KLK) have been reported to be involved in human malignancies and several KLKs are promising biomarkers of prostate, ovarian, testicular, and breast cancers. Herein, we investigated the clinicopathologic and biological significance of KLK6 gene expression in human gastric cancer. Using real-time reverse transcription-PCR, we analyzed the KLK6 expression status with respect to various clinicopathologic variables in 66 patients with gastric cancer. In addition, we established a KLK6 stably suppressed gastric cancer cell line (MKN28) using small interfering RNA-mediated gene silencing, and investigated its effects on the cell proliferation rate, cell cycle, and invasiveness. The KLK6 gene expression in cancerous tissue (0.37 +/- 0.53) was significantly (P < 0.000001) higher than that in noncancerous tissue (0.026 +/- 0.060). Elevated KLK6 expression was significantly associated with lymphatic invasion (P = 0.03). Furthermore, patients with a high KLK6 expression had a significantly poorer survival rate than those with a low KLK6 expression (P = 0.03). Therefore, we showed that KLK6 gene silencing with KLK6 small interfering RNA effectively suppressed the cell proliferation rate (P = 0.002), cell population in the S phase (P < 0.01), and invasiveness (P < 0.01) in comparison to mock-transfected cells. The KLK6 gene is markedly overexpressed in gastric cancer tissue and its expression status may be a powerful prognostic indicator for patients with gastric cancer. Our findings also suggest that KLK6 may possibly be a novel target for gastric cancer therapy by gene-silencing procedures.


Different contributions of insulin resistance and beta-cell dysfunction in overweight Israeli Arabs with IFG and IGT.
Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) are both intermediate stages that exist between normal glucose tolerance and overt type 2 diabetes. Epidemiological studies demonstrated that the two categories define distinct populations. In this study, we examined the contributions of insulin resistance and beta-cell dysfunction to both states in overweight subjects of Arab origin. Twelve subjects with isolated IFG, 10 with isolated IGT, and 20 with IFG and IGT (combined glucose in tolerance-CGT) were compared with 30 subjects with normal glucose tolerance (NGT) subjects; all were of Arab origin and were overweight or obese. Different indices for insulin resistance and beta-cell function were calculated from oral glucose tolerance (OGTT) values. Subjects with isolated IFG and CGT were more obese and had significantly higher values of insulin resistance than subjects with isolated IGT and NFG. There was no significant difference between the insulin resistance in subjects with isolated IGT and that in subjects with NGT. Indices of beta cell function were severely reduced among subjects with isolated IGT and CGT when compared with those with both isolated IFG and NGT, while subjects with isolated IFG had similar beta-cell indices to subjects with NGT. These data demonstrate that beta-cell dysfunction and insulin resistance contribute differently to the pathogenesis of IFG and IGT among overweight Arab subjects.


Toward Network Biology in E. coli Cell.
E. coli has been a critically important model research organism for more than 50 years, particularly in molecular biology. In 1997, the E. coli draft genome sequence was published. Post-genomic techniques and resources were then developed that allowed E. coli to become a model organism for systems biology. Progress made since publication of the E. coli genome sequence will be summarized.


Genomewide Association Studies in Pharmacogenomics: Meeting Report of the NIH Pharmacogenomics Research Network-RIKEN (PGRN-RIKEN) Collaboration.
Genomewide association studies (GWAS) have resulted in the identification of many heritable genetic factors that underlie risk for human disease or variation in physiologic traits. In contrast, there are fewer GWAS of drug response phenotypes, despite extensive unexplained interindividual variability. To address this urgent need, the NIH Pharmacogenomics Research Network (PGRN) and the Center for Integrative Medical Sciences (IMS) at RIKEN support a collaboration, PGRN-RIKEN, with the goal of accelerating GWAS of drug response phenotypes.


[Metastases of colorectal carcinoma].
Metastases of colorectal cancer represent an interdisciplinary therapeutic challenge. Evidence-based guidelines are supportive of treatment decisions in specific situations with the objective to improve the therapeutic outcome for patients. Interventional tumor therapies are increasingly applied therapeutic options in the treatment of colorectal metastases. The current literature indicates that thermoablation of colorectal liver metastasis can lead to an improved survival in selected patients. However, recommendation of thermoablation as a part of guidelines for the therapy of colorectal metastases is restricted due to a shortcoming of randomized controlled trials. Therefore, interventional tumor therapies have to be evaluated in comparison with standard therapies, particularly with regard to surgical resection and chemotherapy. Moreover, the interdisciplinary combination of tumor ablation, surgical resection, and chemotherapy is a promising approach for the optimization of oncological therapy strategies in the treatment of colorectal metastases.


Factors Associated with Early Mortality in HIV-Positive Men and Women Investigated for Tuberculosis at Ethiopian Health Centers.
Despite increasing access to antiretroviral treatment (ART) in low-income countries, HIV-related mortality is high, especially in the first months following ART initiation. We aimed to evaluate the impact of TB coinfection on early mortality and to assess gender-specific predictors of mortality in a cohort of Ethiopian adults subjected to intensified casefinding for active TB before starting ART. Prospectively recruited ART-eligible adults (n = 812, 58.6% female) at five Ethiopian health centers were followed for 6 months. At inclusion sputum culture, Xpert MTB/RIF, and smear microscopy were performed (158/812 [19.5%] had TB). Primary outcome was all-cause mortality. We used multivariate Cox models to identify predictors of mortality. In total, 37/812 (4.6%) participants died, 12 (32.4%) of whom had TB. Karnofsky performance score (KPS) and mid-upper arm circumference (MUAC) were associated with mortality in the whole population. However, the associations were different in men and women. In men, only MUAC remained associated with mortality (adjusted hazard ratio [aHR] 0.71 [95% CI 0.57-0.88]). In women, KPS <80% was associated with mortality (aHR 10.95 [95% CI 2.33-51.49]), as well as presence of cough (aHR 3.98 [95% CI 1.10-14.36]). Cough was also associated with mortality for TB cases (aHR 8.30 [95% CI 1.06-65.14]), but not for non-TB cases. In HIV-positive Ethiopian adults managed at health centers, mortality was associated with reduced performance score and malnutrition, with different distribution with regard to gender and TB coinfection. These robust variables could be used at clinic registration to identify persons at increased risk of early mortality.


Clinical features and predictive factors in psoriatic arthritis-related uveitis.
To analyze the clinical features of uveitis in psoriatic arthritis (PsA) and to investigate the factors predicting its appearance. Retrospective cohort study (1991-2000) of 71 patients diagnosed with PsA according to the criteria of Moll and Wright. All patients were studied according to a standard protocol. The group was divided into 3 articular categories: axial, oligoarticular, and polyarticular. Human leukocyte antigen (HLA)-Cw typing was performed by the polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSOP) method in 65 patients and in 177 healthy donors. HLA-DR typing was done by serologic methods in the 71 patients and in 82 healthy donors from the same racial and geographic origin. The HLA-B27 allele also was tested among the study population. All subjects with possible inflammatory ocular disease received a complete ophthalmologic examination at the Ophthalmology Department of our hospital. Only patients with uveitis were analyzed. Univariate and multivariate analyses were applied. Thirteen patients had uveitis (18% of this series), 4 (31%) had an insidious onset, and the remaining had acute-onset uveitis. Five cases (39%) had bilateral-simultaneous uveitis. Ten (77%) presented with anterior uveitis only, 2 with anterior and posterior pole involvement, and only 1 case with isolated posterior pole involvement. Four patients needed oral corticosteroids; 2 of them also used immunosuppresive drugs. None of our patients developed sequelae or complications. In univariate analysis, uveitis was associated with inflammatory back pain (P =.02), sacroiliac pain (P =.001), syndesmophytes (P =.001), bilateral sacroileitis (P =.0001), HLA-DR13 (P =.002), and HLA-B27 (P =.026). In multivariate analysis, the predictive factors for uveitis were bilateral sacroileitis (OR 17, 95% CI: 3.7-76, P =.0002), HLA-DR13 (OR 24, 95% CI: 3.78-150, P =.0056), and syndesmophytes (OR 9.7, 95% CI: 0.97-97, P =.05). Insidious onset, bilaterality, posterior pole involvement, and chronicity are common in PsA patients with uveitis. In this study, extensive axial involvement (bilateral sacroileitis and syndesmophytes), and the HLA-DR13 antigen were the best predictors for the appearance of uveitis.


Determination of trace elements in calcium rich carbonate rocks by Wavelength Dispersive X-ray Fluorescence Spectrometry for environmental and geological studies.
A simple, rapid and non destructive Wavelength Dispersive X-ray Fluorescence Spectrometry (WDXRFS) was developed for the determination of trace elements such as V, Cr, Co, Ni, Cu, Zn, Pb, Ba, La, Ce, Nd, Rb, Sr, Y, Zr, and Nb in carbonate rocks with high calcium content. Samples of marble, limestone, fluorite ore and carbonatite-like rocks were chosen as objects under investigation. These samples have wide ranges of major and trace element contents, and high concentration of calcite (70-98%) in calcium rich carbonates. The sample mass required for infinite thickness was calculated for each element. In order to determine V, Cr, Co, Ni, Cu, Zn, Ba, La, Nd, Ce, sample weighting 1g was pressed with a pressure of 100kN. For the determination of Rb, Sr, Y, Zr, Nb, Pb, the sample mass was increased up to 5g. The calibration curves were constructed by employing the International Certified reference materials (ICRMs) and in-house standard reference materials (HSRMs) of various types of rocks and sediments, and the matrix effects were taken into account using the influence coefficients (α-correction equations). Analytical figures of merit have also been assessed. The calculated values of the instrumental limit of the detection were within the interval from 0.5 to 4.0mgkg-1. The repeatability and reproducibility were found to be satisfactory with the relative standard deviations lower than 5%. The accuracy was evaluated by the analysis of two reference materials and the comparison with the ICP-MS results. A good agreement was achieved between the reference and measured values with recoveries ranging from 85% to 115%. The relative disagreements between the XRF and ICP-MS results were less than 10%.


Topical capsaicin treatment of chronic postherpetic neuralgia.
Uncontrolled studies have indicated that topically applied capsaicin may be a safe and effective treatment for postherpetic neuralgia. In a double-blind study 32 elderly patients with chronic postherpetic neuralgia were treated with either capsaicin cream or its vehicle for a 6-week period. Response to treatment was evaluated by visual analogue scales of pain and of pain relief, together with changes in a categoric pain scale and in a physician's global evaluation. Significantly greater relief in the capsaicin-treated group compared with vehicle was observed for all efficacy variables. After 6 weeks almost 80% of capsaicin-treated patients experienced some relief from their pain. Because capsaicin avoids problems with drug interactions and systemic toxicity, we suggest that topical capsaicin be considered for initial management of postherpetic neuralgia.


Oligonucleotide probes containing pyrimidine analogs reveal diminished hydrogen bonding capacity of the DNA adduct O⁶-methyl-G in DNA duplexes.
Oligonucleotide hybridization probes containing nucleoside analogs offer a potential strategy for binding specific DNA sequences that bear pro-mutagenic O(6)-G alkylation adducts. To optimize O(6)-Me-G-targeting probes, an understanding of how base pairs with O(6)-Me-G are stabilized is needed. In this study, we compared the ability of O(6)-Me-G and G to hydrogen bond with three pyrimidine-like nucleobases (Z, 4-thio-U, and 3-deaza-C) bearing varied hydrogen bond donor and acceptor groups. We found that duplexes containing the pyrimidine analog nucleoside:G pairs were more thermodynamically stable than those containing pyrimidine analog nucleoside:O(6)-alkyl-G pairs. Thus, hydrogen bonding alone was not sufficient to impart selectivity to probes that target O(6)-G alkylation adducts in DNA.


In-chip microstructures and photonic devices fabricated by nonlinear laser lithography deep inside silicon.
Silicon is an excellent material for microelectronics and integrated photonics1-3 with untapped potential for mid-IR optics4. Despite broad recognition of the importance of the third dimension5,6, current lithography methods do not allow fabrication of photonic devices and functional microelements directly inside silicon chips. Even relatively simple curved geometries cannot be realised with techniques like reactive ion etching. Embedded optical elements, like in glass7, electronic devices, and better electronic-photonic integration are lacking8. Here, we demonstrate laser-based fabrication of complex 3D structures deep inside silicon using 1 µm-sized dots and rod-like structures of adjustable length as basic building blocks. The laser-modified Si has a different optical index than unmodified parts, which enables numerous photonic devices. Optionally, these parts are chemically etched to produce desired 3D shapes. We exemplify a plethora of subsurface, i.e., "in-chip" microstructures for microfluidic cooling of chips, vias, MEMS, photovoltaic applications and photonic devices that match or surpass the corresponding state-of-the-art device performances.


Personal space boundaries: clinical applications in psychiatric mental health nursing.
Theory of personal space boundaries (PSB) and its application to clinical psychiatric nursing. To provide a nursing perspective of interventions that incorporate the interactive effects of cognition, affect, behavior, and spirituality on human experience and behavior. Theory of PSB developed by the author. Understanding PSB allows for more effective nursing interventions.


The organization and function of the Golgi apparatus in dendrite development and neurological disorders.
Dendrites are specialized neuronal compartments that sense, integrate and transfer information in the neural network. Their development is tightly controlled and abnormal dendrite morphogenesis is strongly linked to neurological disorders. While dendritic morphology ranges from relatively simple to extremely complex for a specified neuron, either requires a functional secretory pathway to continually replenish proteins and lipids to meet dendritic growth demands. The Golgi apparatus occupies the center of the secretory pathway and is regulating posttranslational modifications, sorting, transport, and signal transduction, as well as acting as a non-centrosomal microtubule organization center. The neuronal Golgi apparatus shares common features with Golgi in other eukaryotic cell types but also forms distinct structures known as Golgi outposts that specifically localize in dendrites. However, the organization and function of Golgi in dendrite development and its impact on neurological disorders is just emerging and so far lacks a systematic summary. We describe the organization of the Golgi apparatus in neurons, review the current understanding of Golgi function in dendritic morphogenesis, and discuss the current challenges and future directions.


Laparoscopy-assisted resection of an undiagnosed liver tumor and ascending colon cancer via mini median laparotomy: report of a case.
We describe how we resected a hepatic angiomyolipoma and ascending colon cancer synchronously via laparoscopic left lateral segmentectomy and laparoscopic right colectomy, respectively. The patient was a 72-year-old man, admitted to our hospital after a liver tumor and ascending colon cancer were detected during a general health check. Computed tomography (CT) showed a hypervascular liver tumor mimicking hepatocellular carcinoma, 2 cm in diameter, in segment 3 of the liver. The ascending colon cancer was diagnosed as T2N0M0, Stage I. The left lateral liver and right colon were mobilized laparoscopically and hepatic transaction, followed by resection and anastomosis of the colon, were performed extracorporeally through the same 7-cm upper median incision. This type of laparoscopy-assisted combined resection is useful to obtain a pathological diagnosis of the liver tumor and to remove the entire tumor in a minimally invasive and cosmetic manner.


Head-to-head comparison of disaster triage methods in pediatric, adult, and geriatric patients.
A variety of methods have been proposed and used in disaster triage situations, but there is little more than expert opinion to support most of them. Anecdotal disaster experiences often report mediocre real-world triage accuracy. The study objective was to determine the accuracy of several disaster triage methods when predicting clinically important outcomes in a large cohort of trauma victims. Pediatric, adult, and geriatric trauma victims from the National Trauma Data Bank were assigned triage levels, using each of 6 disaster triage methods: simple triage and rapid treatment (START), Fire Department of New York (FDNY), CareFlight, Glasgow Coma Scale (GCS), Sacco Score, and Unadjusted Sacco Score. Methods for approximating triage systems were vetted by subject matter experts. Triage assignments were compared against patient mortality at hospital discharge with area under the receiver operator curve. Secondary outcomes included death in the emergency department, use of a ventilator, and lengths of stay. Subgroup analysis assessed triage accuracy in patients by age, trauma type, and sex. In this study, 530,695 records were included. The Sacco Score predicted mortality most accurately, with area under the receiver operator curve of 0.883 (95% confidence interval 0.880 to 0.885), and performed well in most subgroups. FDNY was more accurate than START for adults but less accurate for children. CareFlight was best for burn victims, with area under the receiver operator curve of 0.87 (95% confidence interval 0.85 to 0.89) but mistriaged more salvageable trauma patients to "dead/black" (41% survived) than did other disaster triage methods (≈10% survived). Among 6 disaster triage methods compared against actual outcomes in trauma registry patients, the Sacco Score predicted mortality most accurately. This analysis highlighted comparative strengths and weakness of START, FDNY, CareFlight, and Sacco, suggesting areas in which each might be improved. The GCS predicted outcomes similarly to dedicated disaster triage strategies.


Catalase, superoxide dismutase, glutathione reductase and thiobarbituric acid-reactive products in normal and dystrophic human muscle.
The level of thiobarbituric acid-reactive products and the specific activities of catalase and glutathione reductase were significantly higher in muscles from patients with major forms of muscular dystrophies over those of control subjects. Superoxide dismutase activity was not altered in dystrophic muscles. These findings indicate the occurrence in human dystrophic muscles of an increased level of lipid peroxidation and the possible activation of certain enzymes that could conceivably inhibit lipid peroxidation in vivo.


The 100 most cited articles investigating the radiological staging of oesophageal and junctional cancer: a bibliometric analysis.
Accurate staging of oesophageal cancer (OC) is vital. Bibliometric analysis highlights key topics and publications that have shaped understanding of a subject. The 100 most cited articles investigating radiological staging of OC are identified. The Thomas Reuters Web of Science database with search terms including "CT, PET, EUS, oesophageal and gastro-oesophageal junction cancer" was used to identify all English language, full-script articles. The 100 most cited articles were further analysed by topic, journal, author, year and institution. A total of 5,500 eligible papers were returned. The most cited paper was Flamen et al. (n = 306), investigating the utility of positron emission tomography (PET) for the staging of patients with potentially operable OC. The most common research topic was accuracy of staging investigations (n = 63). The article with the highest citation rate (38.00), defined as the number of citations divided by the number of complete years published, was Tixier et al. investigating PET texture analysis to predict treatment response to neo-adjuvant chemo-radiotherapy, cited 114 times since publication in 2011. This bibliometric analysis has identified key publications regarded as important in radiological OC staging. Articles with the highest citation rates all investigated PET imaging, suggesting this modality could be the focus of future research. • This study identifies key articles that investigate radiological staging of oesophageal cancer. • The most common topic was accuracy of staging investigations. • The article with the highest citation rate investigated the use of texture analysis in PET images.


Association of hyperglycemia mediated increased advanced glycation and erythrocyte antioxidant enzyme activity in different stages of diabetic retinopathy.
This study aimed to evaluate whether hyperglycemia mediated increased formation of advanced glycation end products (AGEs) was associated with erythrocyte antioxidant enzyme activity in subjects with different stages of diabetic retinopathy (DR). Serum level of AGEs was determined by enzyme linked immunosorbent assay. Erythrocyte superoxide dismutase (SOD), glutathione reductase (GR) and catalase activity were estimated by enzymatic reaction based spectrophotometric assay in patients with type 2 diabetes with proliferative diabetic retinopathy (PDR), non-proliferative diabetic retinopathy (NPDR) and no retinopathy (DNR) and also in healthy non-diabetic controls (HC). Erythrocyte SOD and GR activity was significantly lower among NPDR (p=0.024, 0.0017, respectively) and PDR (p=0.0003, 0.0001, respectively) subjects compared with DNR individuals. A significant inverse correlation was observed between serum AGEs and erythrocyte SOD or GR activity in DNR (p=0.0019; r=-0.3033, p=0.0021; r=-0.3015, respectively), NPDR (p=0.0001; r=-0.4602, p=0.0003; r=-0.4161, respectively), and PDR (p<0.0001; r=-0.6753, p<0.0001; r=-0.5854, respectively) individuals. Poor glycemia may be the key factor enhancing AGE formation, which may be associated with lower erythrocyte SOD and GR activity along with increased catalase activity in DR.


The chronic kidney disease epidemiology collaboration equation combining creatinine and cystatin C accurately assesses renal function in patients with cirrhosis.
Accurate measurement of renal function in cirrhotic patients is still challenging. To find the best test for the determination of the true glomerular filtration rate (GFR) in cirrhotic patients this study prospectively compared measured (m)GFR, the gold standard, with estimated (e)GFR using equations based on serum levels of creatinine and cystatin C. GFR was measured by sinistrin clearance using the bolus method in 50 patients with cirrhosis (Child Turcotte Pugh score A, B and C) and 24 age-matched healthy subjects as controls. Measured (m)GFR was compared to eGFR using bias, accuracy 10 % and 30 %, as well as correlation coefficients. Creatinine-based equations generally overestimated GFR in patients with cirrhosis and showed a bias (average difference between mGFR and eGFR) of -40 (CG), -12 (MDRD) and -9 (CKD-EPI-Cr) ml/min/1.73 m(2). Cystatin C-based equations underestimated GFR, especially in patients with Child Turcotte Pugh score C (bias 17 ml/min/1.73 m(2)for CKD-EPI-CysC). Of these equations, the CKD-EPI equation that combines creatinine and cystatin C (CKD-EPI-Cr-CysC) showed a bias of 0.12 ml/min/1.73 m(2) as compared to measured GFR. The CKD-EPI equation that combines serum creatinine and cystatin C measurements shows the best performance for accurate estimation of GFR in cirrhosis, especially at advanced stages.


Impact Assessment of an Affirmative Action to Promote Diversity, Equity, Inclusion, and Respect in Brazilian Chemistry during the COVID-19 Pandemic.
In December 2019, the institutional affirmative action "Onde elas estão?" ("Where are they?") was launched for the mitigation of gender inequality in the STEM disciplines in Brazil, coincidentally in the same period which the first reports of the COVID-19 pandemic appeared in the city of Wuhan, China. Unfortunately, when evaluating the initiative through different approaches belonging to the Diversity, Equity, Inclusion, and Respect (DEIR) theories, the presence of implicit biases and the invisibility of underrepresented minorities was observed. Approximately 77.5% of the female scientists participating in the initiative were white and belonging to the wealthiest regions (75%) and with the greatest contribution to Brazil's Gross Domestic Product (GDP). On the other hand, Black, Indigenous, and Asian female chemists were not identified, nor were female chemists belonging to the North Region (Brazilian Amazon Region). The DEIR practice "Onde elas estão?" has an important role in the dissemination of highly qualified Brazilian female chemists and provides an important source of engagement and sense of community for future generations of female students to avoid abandoning STEM subjects. However, adjustments are needed that take into account greater Diversity, Inclusion, Equity, and Respect.


AIDS-associated central nervous system cryptococcosis: a Brazilian case study.
In recent years the effect of HAART in patients with AIDS has been great at decreasing the incidence of opportunistic infections. Nonetheless, patients with AIDS living in developing countries still present with severe central nervous system cryptococcosis, with high mortality rates. The study of the clinical-epidemiological-laboratory aspects of the patients treated before the HAART era might be useful in an assessment of the impact of these drugs in the prognosis of cases.


Long-term outcomes of cruciate marsupialization of intra-nasal cysts in patients with congenital dacryocele.
To evaluate the long-term outcomes of cruciate marsupialization of intranasal cysts associated with congenital dacryocele. This is a retrospective review of 15 patients of dacryoceles with intranasal cysts who underwent cruciate marsupialization of the medial wall of the cyst. Post-operative follow up for a minimum of 9 months was an inclusion criterion for analysis. Data analyzed include demographics, clinical presentations, previous interventions, associated systemic abnormalities, clinical course following marsupialization and recurrences. Primary outcome measures were resolution of the dacryocele and symptomatic relief from epiphora. The mean age at presentation was 1.6 months with a female preponderance (60%). History of prematurity (pre-term) was noted in 20% (3/15). Swelling in the lacrimal sac area (dacryocele) was the universal presentation. Five patients (33.3%) had a prior conservative treatment. Four patients (26.6%) had respiratory distress with feeding. Acute dacryocystitis was noted in 26.6% (4/15). At a mean follow up of 19.1 months, successful outcomes were achieved in 86.6%. Cruciate marsupialization of intranasal cysts achieves good results in patients with congenital dacryocele, which are maintained over a long period of time. Early diagnosis and management may prevent acute dacryocystitis in these patients.


Challenges in synergizing radiotherapy with immunotherapy to unlock the abscopal effect in metastatic NSCLC: A systematic review.
With the recent success of immunotherapy, there is a growing interest in combining radiation with immunotherapy to boost abscopal response rates. Several challenges exist in determining how to synergize these two modalities in the treatment of metastatic NSCLC. References for this review were identified through searches of MEDLINE/PubMed and Clinicaltrials.gov databases with the search terms "abscopal", "radiation OR radiotherapy," "NSCLC", and "lung" on the index date of July 2022 from 2000-2022. This systematic review focuses primarily on clinical papers. Early work combining radiotherapy with immunotherapy show promise in unlocking the abscopal effect. Preliminary evidence suggests that radiotherapy regimens with <5 fractions and smaller fields may be superior to regimens with 15 fractions and larger fields. There does not appear to be enough evidence to draw conclusions about the optimal timing of radiotherapy in relation to immunotherapy or the optimal anatomical location of radiation to induce the abscopal effect. Several studies suggest selecting patients with a higher absolute lymphocyte count (ALC) and lower neutrophil-to-lymphocyte ratio (NLR) may help to further boost abscopal response rates. Furthermore, selecting tumors with programmed death ligand-1 (PD-L1) expression, mismatch repair deficiency, and higher tumor mutational burden may similarly achieve this goal. Lastly, additional work is needed to minimize and predict for severe toxicity associated with combination therapy.


Cortical plasticity following nerve transfer in the upper extremity.
With increasing clinical experience, peripheral nerve surgeons have come to appreciate the important role that cortical plasticity and motor relearning play in functional recovery following a nerve transfer. Neurostimulation (transcranial magnetic stimulation), and neuroimaging (functional MRI, structural MRI, magnetoencephalography) measure different aspects of cortical physiology and when used together are powerful tools in the study of cortical plasticity. The mechanisms of cortical plasticity, according to current and widely accepted opinions, involve the unmasking of previously ineffective connections or the sprouting of intact afferents from adjacent cortical or subcortical territories. Although significant strides have been made in our understanding of cortical plasticity following nerve transfer and during motor relearning, a great deal remains that we do not understand. Cortical plasticity and its manipulation may one day become important contributors to improve functional outcome following nerve transfer.


Developmental expression of GD3 and polysialogangliosides in embryonic chicken nervous tissue reacting with monoclonal antiganglioside antibodies.
The appearance and developmental distribution of GD3 and polysialogangliosides was studied immunohistochemically by means of the monoclonal mouse antibodies AbR24 and Q211. Cryostat sections of chicken embryos from 1 to 5 days (E1-E5) of incubation (Hamburger and Hamilton, stages 9-26) were prepared. GD3, detected by AbR24, is expressed on E2 by proliferating neuroepithelial cells of all regions of the developing brain and spinal cord and by migrating neural crest cells. As development continues, GD3 drops to a much lower level in postmitotic neurons, but is still strongly expressed by cells of the mitotically active germinal zones. In non-neural tissues the antigen was found in much lower concentrations than in the neuroectoderm, with the exception of very early, heavily proliferating endodermal and mesodermal epithelia. In contrast, the antigen(s) of the monoclonal mouse antibody Q211, identified on TLC-plates in polysialoganglioside fractions, was found to be specific for central and peripheral derivatives of the neural ectoderm. In the CNS, these polysialogangliosides are absent in the proliferating neural epithelium and appear for the first time on cells of the developing peripheral mantle layers at E2.5 (stage 17). Sections from all brain areas, retina, optic stalk, spinal cord, and peripheral nerves and ganglia of later stages (E4-5) showed that the antigen(s) of Q211 is expressed by neuronal perikarya and cell processes. The data strongly suggest that the developmental appearance of these polysialogangliosides is synchronized with the withdrawal of proliferating precursor cells from the mitotic cycle and differentiation to neurons.


Biometals as conformational modulators of α-synuclein photochemical crosslinking.
Metal dyshomeostasis has long been linked to Parkinson's disease (PD), and the amyloidogenic protein α-synuclein (αS) is universally recognized as a key player in PD pathology. Structural consequences upon coordination of copper and iron to αS have gained attention due to significant dyshomeostasis of both metals in the PD brain. Protein-metal association can navigate protein folding in distinctive pathways based on the identity of the bio-metal in question. In this work, we employed photo-chemical crosslinking of unmodified proteins (PICUP) to evaluate these potential metal ion-induced structural alterations in the folding dynamics of N-terminally acetylated αS (NAcαS) following metal coordination. Through fluorescence analysis and immunoblotting analyses following photoirradiation, we discovered that coordination of iron obstructs copper-promoted crosslinking. The absence of intra-molecular crosslinking upon iron association further supports its C-terminal coordination site and suggests a potential role for iron in mitigating nearby post-translational modification of tyrosine residues. Decreased fluorescence emission upon synergistic coordination of both copper and iron highlighted that although copper acts as a conformational promotor of NAcαS crosslinking, iron inhibits analogous conformational changes within the protein. The metal coordination preferences of NAcαS suggest that both competitive binding sites as well as dual metal coordination contribute to the changes in folding dynamics, unveiling unique structural orientations for NAcαS that have a direct and measureable influence on photoinitiated dityrosine crosslinks. Moreover, our findings have physiological implications in that iron overload, as is associated with PD-insulted brain tissue, may serve as a conformational block of copper-promoted protein oxidation.


Double Trouble-COVID-19 and the Widespread Use of Corticosteroids: Are We Staring at an Osteonecrosis Epidemic?
A combination of immune-mediated vascular damage and routine use of systemic corticosteroid (CS) therapy in COVID-19 may significantly increase the risk and burden of osteonecrosis (ON) after COVID-19. This narrative review explores the pathogenesis, risk factors, and possible preventive and early treatment measures for ON in COVID-19. For this narrative review, an extensive literature search was performed using the PubMed, Medline, and Science Direct databases from January 2000 to August 2021 for relevant articles on etiopathogenesis, epidemiology, clinical manifestations, and treatment of severe acute respiratory syndrome coronavirus (SARS-CoV) infection and steroid-induced ON (SION). Pathogenesis of COVID-19, utility of corticosteroids in the treatment of COVID-19, pathogenesis of SION vis-a-vis SARS-CoV infection, associated risk factors, and early diagnosis and treatment of ON following CS therapy of SARS-CoV infection were discussed. Preliminary data of COVID-19 and similar trends from the SARS 2003 epidemic indicate that the "angiocentric" pathogenesis of SARS-CoV-2 and treatment with high-dose CS may increase the risk of ON in COVID-19 patients. Risk stratification based on CS intake during COVID-19 treatment can help identify subjects at moderate to high-risk for ON where early preventive and follow-up plans can be initiated.


Do microplastics affect sulfamethoxazole sorption in soil? Experiments on polymers, ionic strength and fulvic acid.
Microplastics (MPs) and sulfamethoxazole (SMX) are emerging contaminants that are ubiquitous in the soil environment. In this study, we investigated MPs polymer type and soil environmental factor effects on SMX adsorption behavior in the soil system. Our results showed that MPs dosage affected the soil particles' SMX adsorption rate and capacity (Qe). Adding 1 % polystyrene (PS) increased the SMX adsorption rate significantly. The value of K1, which represented the adsorption rate, increased from 0.569 h-1 to 1.019 h-1. However, the addition of MPs reduced the soil's SMX equilibrium adsorption capacity slightly. Moreover, increasing salinity strength enhanced SMX adsorption capacity by MPs significantly. However, increasing calcium ions concentration decreased SMX adsorption in the MPs amended soil due to multivalent cationic bridging and competitive adsorption mechanisms. In addition, we observed that fulvic acid addition inhibited SMX adsorption. This study suggests that the addition of MPs reduced the adsorption of SMX in the soil slightly due to dilution effect. Meanwhile, changes in environmental factors also affected the adsorption behavior of SMX in soil amended with MPs.


Bioactive silicon nitride: A new therapeutic material for osteoarthropathy.
While the reciprocity between bioceramics and living cells is complex, it is principally governed by the implant's surface chemistry. Consequently, a deeper understanding of the chemical interactions of bioceramics with living tissue could ultimately lead to new therapeutic strategies. However, the physical and chemical principles that govern these interactions remain unclear. The intricacies of this biological synergy are explored within this paper by examining the peculiar surface chemistry of a relatively new bioceramic, silicon nitride (Si3N4). Building upon prior research, this paper aims at obtaining new insights into the biological interactions between Si3N4 and living cells, as a consequence of the off-stoichiometric chemical nature of its surface at the nanometer scale. We show here yet unveiled details of surface chemistry and, based on these new data, formulate a model on how, ultimately, Si3N4 influences cellular signal transduction functions and differentiation mechanisms. In other words, we interpret its reciprocity with living cells in chemical terms. These new findings suggest that Si3N4 might provide unique new medicinal therapies and effective remedies for various bone or joint maladies and diseases.


The role of sialic acid in 5-HT binding to synaptic membranes.
The high affinity binding of [14C]5-HT to nerve ending membranes isolated from rat brain is not affected by neuraminidase treatment. The specificity of ligand receptor interaction was demonstrated by displacement studies with tryptamine derivatives, noradrenaline, and acetylcholine.


A comprehensive review of rFVIIa use in a tertiary care pediatric center.
Recombinant activated factor VII (rFVIIa) is a hemostatic agent developed for the treatment of bleeds in patients with hemophilia and inhibitors. Case reports/series document its growing use in patients without hemophilia. Such reports however do not accurately describe the proportion of rFVIIa used for various indications. We sought to document the complete use of rFVIIa at our institution over a 6-year period (2000-2005). Using a computerized registry documenting all rFVIIa use in our institution a complete list of patients receiving rFVIIa was generated. Clinical data on these patients was obtained through chart review. 111 patients received 7,016,400 microg of rFVIIa over the 6 years: 23 patients had congenital bleeding disorders (10 patients with hemophilia and inhibitors; 7 with congenital FVII deficiency; 6 with platelet function disorders). These 23 patients (21% of all patients receiving rFVIIa) accounted for 79.9% of all rFVIIa used; patients with hemophilia alone accounted for 68.6%. The 88 patients without a congenital bleeding disorder (79% of all patients using rFVIIa) accounted for 20.1% of rFVIIa used. However their annual use of rFVIIa increased 10-fold during the 6 years. Patients with hemophilia use massive amounts of rFVIIa repeatedly while patients without hemophilia use rFVIIa infrequently and at smaller doses. The use of rFVIIa in patients without congenital bleeding disorders (all "off-label" use) is rapidly growing in both number of patients and in total use and has likely significant clinical and economic ramifications.


Substance Use Disorders in the Elderly.
The population of elderly in the United States with substance use disorders (SUDs) is growing appreciably. SUDs among the elderly are often associated with poor outcomes and are frequently underdiagnosed. The current diagnostic criteria are less sensitive in identifying SUDs among the elderly. Routine screening with validated screening tools may improve the diagnosis of SUDs among the elderly. There is a dearth of data from controlled studies on SUDs among the elderly and the use of pharmacologic agents for treatment, although data indicate that older adults with SUDs respond well to treatments that are specifically designed for this age group.


Malignant Transformation and Spine Metastasis of an Intracranial Grade I Meningioma: In Situ Immunofluorescence Analysis of Cancer Stem Cells Case Report and Literature Review.
Malignant meningiomas are rare neoplasms of the central nervous system that occur de novo or rarely as a result of transformation. They have a higher rate of recurrence and metastasis accompanied by a significantly shorter survivorship compared with benign variants. Meningioma cancer stem cells (CSCs) have been previously shown to be associated with resistance and aggressiveness. However, the role they play in meningioma progression is still being investigated. We report a 29-year-old man who underwent a resection of a grade I meningioma in 2011. The patient had multiple local recurrences of the tumor that showed an aggressive change in behavior and transformation to grade III meningioma, and developed extracranial metastasis to the cervical spine. He underwent multiple operations and received radiotherapy. Analysis of the tissues indicated the presence of CSC markers before metastasis, and showed increased expressions of associated markers in the metastasized tissue. In addition, similar to the patient's profile, the pharmacological testing of a primary cell line retrieved from the metastasized tissues showed a high level of drug tolerance and a diminished ability to initiate apoptosis. Malignant progression of grade I meningioma can occur, and its eventuality may be anticipated by detecting CSCs. We performed a comprehensive literature review of relevant cases and discussed the clinical, diagnostic, and management characteristics of the reported cases.


Treatment of high-strength phenolic wastewater by a new two-step method.
Treatment of high-strength phenolic wastewater by a novel two-step method was investigated in the present study. The two-step treatment method consisted of chemical coagulation of the wastewater by metal chloride followed by further phenol reduction by resin adsorption. The present combined treatment was found to be highly efficient in removing the phenol concentration from the aqueous solution and was proved capable of lowering the initial phenol concentration from over 10,000 mg/l to below direct discharge level (1mg/l). In the experimental tests, appropriate conditions were identified for optimum treatment operation. Theoretical investigations were also performed for batch equilibrium adsorption and column adsorption of phenol by macroreticular resin. The empirical Freundlich isotherm was found to represent well the equilibrium phenol adsorption. The column model with appropriately identified model parameters could accurately predict the breakthrough times.


A Multi-Functional Implant Induces Bone Formation in a Diabetic Model.
Patients with diabetes mellitus (DM) have defective healing of bone fractures. It was previously shown that nonviral gene delivery of plasmid DNA (pDNA) that independently encodes bone morphogenetic protein-2 (BMP-2) and fibroblast growth factor-2 (FGF-2), acts synergistically to promote bone regeneration in a DM animal model. Additionally, both insulin (INS) and the hormonally active form of vitamin D3, 1α,25-dihydroxyvitamin D3 (1α,25(OH)2 D3 ) (VD3) have independently been shown to play key roles in regulating bone fracture healing in DM patients. However, these individual therapies fail to adequately stimulate bone regeneration, illustrating a need for novel treatment of bone fractures in diabetic patients. Here, the ability of local delivery of INS and VD3 along with BMP-2 and FGF-2 genes is investigated to promote bone formation ectopically in Type-2 diabetic rats. A composite consisting of VD3 and INS is developed that contains poly(lactic-co-glycolic acid) microparticles (MPs) embedded in a fibrin gel surrounded by a collagen matrix that is permeated with polyethylenimine (PEI)-(pBMP-2+pFGF-2) nanoplexes. Using a submuscular osteoinduction model, it is demonstrated that local delivery of INS, VD3, and PEI-(pBMP-2+pFGF-2) significantly improves bone generation compared to other treatments, thusimplicating this approach as a method to promote bone regeneration in DM patients with bone fractures.


Genetic linkage in the Norway rat.
The present status of research on genetic linkage is reviewed. Where possible, the data are statistically combined to give consolidated estimates of the recombination value. Ten groups of linked genes have been determined. The first assignments of linkage groups to specific chromosomes have been facilitated by inter-species cell hybridisation.