Surgical treatment of abdominal aortic aneurysms associated with horseshoe kidney.
Abdominal aortic aneurysm surgery associated with a horseshoe kidney (HSK) is a serious technical challenge for the surgeon. We reviewed our experience with 127 patients electively operated on between 1990 and 2004 for abdominal aortic aneurysm. Pre- and perioperative medical, surgical, and radiologic data were retrospectively reviewed. Preoperative diagnosis was achieved with computed tomography with or without angiography or with additional conventional aortography. Seven patients were recognized to have had a HSK, with a mean age of 67.29 +/- 2.43 years. Preoperative serum creatinine levels were similar in patients with or without HSK (1.0 +/- 0.08 vs 0.9 +/- 0.12 mg/dL; not significant). In five of the patients with HSK, reimplantation of the anomalous renal artery was necessary. In all 127 patients, hospital mortality consisted of 5 patients, none of whom had an HSK. Dealing with HSK seemed to increase aortic clamp times (30.43 +/- 3.55 vs 27.04 +/- 3.92 minutes; p < .05) slightly. Patients with or without HSK were given similar amounts of intravenous fluid replacement (2,214.2 +/- 441.3 vs 1,923.3 +/- 433.6 mL/patient; not significant) and allogeneic blood transfusion (0.71 +/- 0.49 vs 0.9 +/- 0.4 U/patient; not significant) and had a similar intensive care unit stay. Abdominal aortic aneurysms associated with HSK have been managed without division of the isthmic tissue. The left retroperitoneal approach provided adequate exposure for all patients with HSK.


An improved probit method for assessment of domino effect to chemical process equipment caused by overpressure.
Overpressure is one important cause of domino effect in accidents of chemical process equipments. Damage probability and relative threshold value are two necessary parameters in QRA of this phenomenon. Some simple models had been proposed based on scarce data or oversimplified assumption. Hence, more data about damage to chemical process equipments were gathered and analyzed, a quantitative relationship between damage probability and damage degrees of equipment was built, and reliable probit models were developed associated to specific category of chemical process equipments. Finally, the improvements of present models were evidenced through comparison with other models in literatures, taking into account such parameters: consistency between models and data, depth of quantitativeness in QRA.


Transfer factors and effective half-lives of (134)Cs and (137)Cs in different environmental sample types obtained from Northern Finland: case Fukushima accident.
The Fukushima NPP accident caused a small but detectable cesium fallout in northern Finland, of the order of 1 Bq/m(2). This fallout transferred further to soil, water, flora and fauna. By using modern HPGe detector systems traces of (134)Cs from the Fukushima fallout were observed in various samples of biota. In northern Finland different types of environmental samples such as reindeer meat, berries, fish, lichens and wolf were collected during 2011-2013. The observed (134)Cs concentrations varied from 0.1 Bq/kg to a few Bq/kg. By using the known (134)Cs/(137)Cs ratio observed in Fukushima fallout the increase of the Fukushima accident to the (137)Cs concentrations was found to vary from 0.06 % to 6.9 % depending on the sample type. The aggregated transfer factors (Tag) and effective half-lives (Teff) for (134)Cs and (137)Cs were also determined and then compared with known values found from earlier studies which are calculated based on the fallout from the Chernobyl accident. Generally, the Tag and Teff values determined in this study were found to agree with the values found in the earlier studies. The Teff values were sample-type specific and were found to vary from 0.91 to 2.1 years for (134)Cs and the estimates for (137)Cs ranged between 1.6 and 19 years. Interestingly, the ground lichens had the longest Teff whereas the beard lichen had the shortest. In fauna, highest Tag values were determined for wolf meat ranging between 1.0 and 2.2 m(2)/kg. In flora, the highest Tag values were determined for beard lichens, ranging from 1.9 m(2)/kg to 3.5 m(2)/kg.


Early Onset Diabetes in Two Children due to Progeria, a Monogenic Disease of DNA Repair
Progeria syndrome is a rare disorder in childhood which causes accelerated systemic aging. Due to the accelerated aging process, disorders which normally occur only in old age will appear in these children at a much younger age. We report two children with progeria syndrome, in whom fulminant diabetes mellitus manifested at a very early age.


[Selective effect of decimeter waves on central brain structures].
Sensitivity of central cerebral structures to the action of the electromagnetic fields of decimetre waves (DMW) was studied with the aid of unit activity of comissural neurons. The greatest reactivity to DMW was found in neurons of hypothalamus and hippocampus. Neurons of the midbrain RF and of the specific thalamic nuclei displayed mainly an inhibitory response. The number of neurons responding to the DMW varied depending on the energetical density.


Fasting leptin and appetite responses induced by a 4-day 65%-energy-restricted diet.
Animal studies show that the leptin decline after acute severe caloric restriction is a peripheral signal to increase food intake. However, most human studies have failed to observe such a relationship. We studied the acute effects of severe caloric restriction on the association between serum leptin concentrations and subjective appetite. A total of 44 healthy adult men (aged: 43 +/- 5 years; BMI: 27.3 +/- 3.2 kg/m(2)). Fasting serum leptin concentrations and self-perceived appetite levels were measured during a 4-day diet containing 36% of the estimated energy requirements. Appetite levels were assessed with a 10-point Likert scale, reflecting hunger, fullness, desire to eat, prospective consumption and total appetite. After the 4-day energy deficit, fasting leptin concentrations decreased by 39.4% (95% CI: -43.6; -34.9%). This decline was associated with an increase in fasting hunger (r = -0.42; P < 0.01), desire to eat (r = -0.39; P < 0.05) and total appetite (r = -0.38; P < 0.05). Furthermore, the association between fasting leptin concentrations and fasting appetite levels became stronger during the energy restriction period (for total appetite: day 0 r = -0.15, P = 0.32; day 2 r = -0.31, P =< 0.05; day 4 r = -0.41, P < 0.01). The acute proportional reduction in fasting leptin after 4-day energy restriction is associated with an increase in self-perceived appetite. Additionally, the inverse association between proportional fasting leptin concentrations and self-perceived appetite response becomes stronger as energy restriction is prolonged. These findings suggest that leptin has an instrumental role in restoring energy balance in humans through the expression of appetite.


Ketoconazole high dose (H.D.) in the management of hormonally pretreated patients with progressive metastatic prostate cancer.
Ketoconazole high dose (H.D.) reduces effectively the testosterone production in both adrenals and testes. Its use in the management of (metastatic) prostate cancer has been advocated. Even in relapsing patients after previous hormonal therapy Ketoconazole H.D. could be of value. 28 Relapsing patients, of whom 15 were evaluable at 3 months, have been treated with Ketoconazole H.D. As could be expected, objective response was seen in only a small number of patients followed up till 9 months. Subjective improvement was however noticed in the majority of symptomatic patients. The side effects and toxicity of the therapy remains however a major limitation for the use of Ketoconazole, be it as first line treatment or as therapy for relapsing patients.


Visfatin in pregnancy: proposed mechanism of peptide delivery.
Visfatin is a newly identified 52 kD adipocytokine that appears to have insulinomimetic properties. We examined visfatin expression in visceral fat from lean and pregnant women. Visfatin gene expression was seven times higher in omental fat of pregnant women than in lean women. Both immunohistochemistry and immunoblot confirmed that visfatin protein was much higher in pregnant women than in nonpregnant women. However, serum visfatin was 20.8 +/- 7.7 ng/ml (n = 7) in lean women as compared to only a slight increase to 40.3 ng/ml in pregnant women (n = 4). We measured visfatin mRNA content of human placenta and found that placenta expresses high levels of visfatin mRNA and protein. At a concentration of 2 nM, visfatin and insulin produced nearly identical increase in glucose transport. The discrepancy between the elevated visfatin expression and tissue visfatin compared to only a small increase in serum visfatin is a matter of controversy. The data on serum visfatin concentrations are replete with contradictory data. Taken together, we suggest that visfatin is not a hormone. Instead, we propose that visfatin acts in either a paracrine or autocrine mode. This hypothesis would explain what various laboratories have found widely discrepant values for serum visfatin. Since visfatin potently and efficaciously induced glucose transport in a cell culture model, any hypothetical role for visfatin in pregnancy should include the possibility that it may play a role in maternal/fetal glucose metabolism or distribution and that it may do so by acting locally.


Pharmacogenetics and pharmacokinetics of tamoxifen in a Zimbabwean breast cancer cohort.
Tamoxifen is the most used hormonal therapy for oestrogen receptor-positive breast cancer. CYP2D6 is the main enzyme in the metabolic pathway of tamoxifen to endoxifen. Variations in endoxifen plasma concentrations are associated with CYP2D6 polymorphisms. This study aimed to determine the association between the CYP2D6 polymorphisms and endoxifen plasma concentrations in a cohort of Zimbabwean breast cancer patients (n = 40). TaqMan genotyping and copy number assays were done to determine CYP2D6 genotypes. Tamoxifen and metabolites were quantitated using LC-MS/MS. The population had high frequencies of the CYP2D6 reduced function alleles, *17 (15%) and *29 (18%). The median endoxifen concentration was 4.78 ng/mL, and in 55% of the patients, mostly intermediate metabolizers were below the endoxifen therapeutic threshold of 5.97 ng/mL. The CYP2D6 phenotypes and activity scores were significantly associated with endoxifen plasma concentrations (P = 0.0151) and with endoxifen to N-desmethyl-tamoxifen ratios (P = 0.0006).


[Laparoscopic appendectomy as routine operation for treatment of inflammatory diseases of the appendix. Analysis of 733 laparoscopic appendectomies 6/1992 to 8/1997 in the Reichenbach district hospital].
All laparoscopic appendectomies were analysed retrospectively during 6/1992 and 8/1997 in our hospital. Operation time was 33.6 +/- 12.9 min. In 9 patients the operation had to be converted. Complications occurred in 1.77% (13 patients). 7 complications could be treated laparoscopically and 6 required a laparotomy. The hospital time was 6.4 +/- 2.2 days. The patients needed 1.3 +/- 1.7 days oral analgetics. We believe the laparoscopic appendectomy a reliable operation to treat all inflammatory diseases of the appendix.


Characterization of interpolation effects in cine anatomic and phase-velocity images.
To compare actual and predicted frequency response of reconstruction algorithms applied to anatomic and phase-contrast velocity cine images. Anatomic and phase-contrast velocity segmented cine gradient echo images were collected from a stationary, doped-agarose phantom, using non-phase-contrast cine and phase-contrast cine with one to three directional encodings, one to 16 views per segment, and nearest-neighbor or linear interpolation. Temporal power spectra from object pixels were fit to linear transfer function models; nearest-neighbor interpolation by a sinc function and linear interpolation by a sinc(2) function. Simple linear transfer function models predicted >98% of the observed power spectral variation. Finite word effects produced small systematic differences at high temporal frequency. Temporal power spectra of cine images collected from stationary objects completely characterizes low pass filtration effects of interpolation.


Seasonal and regional variations of asthma and association with osteoporosis: possible role of vitamin D in asthma.
Based on the evidence that vitamin D is involved in the development of immune system and vitamin D receptor gene is associated with asthma, we supposed that vitamin D is related to the development of asthma. Asthma patients were identified from the Swedish Hospital Discharge Register and the hospitalization rate was examined by different seasons and regions. Standardized incidence ratios (SIRs) for asthma were examined among patients hospitalized for osteoporosis compared with the general population. A total of 172,384 patients were hospitalized for asthma in Sweden during 1965-2007. More patients were hospitalized in winter and North Sweden than in summer and South Sweden. The risk of asthma after osteoporosis was significantly increased, giving an overall SIR of 2.93. The risk was higher in male patients when compared with female subjects. Patients hospitalized for osteoporosis at age younger than 55 showed a high risk. Reversing the analyses and examining the risk of osteoporosis after hospitalization of asthma, SIR was significantly increased (3.54). Our study suggests that vitamin D, as indicated by the high risk of asthma after osteoporosis and the seasonal and regional variations of hospitalization, could play an important role for the development of asthma.


Associations of plasma aprepitant and its N-dealkylated metabolite with cachexia status and clinical responses in head and neck cancer patients.
Oral aprepitant has a large interindividual variation in clinical responses in advanced cancer. This study aimed to characterize plasma aprepitant and its N-dealkylated metabolite (ND-AP) based on the cachexia status and clinical responses in head and neck cancer patients. Fifty-three head and neck cancer patients receiving cisplatin-based chemotherapy with oral aprepitant were enrolled. Plasma concentrations of total and free aprepitant and ND-AP were determined at 24 h after a 3-day aprepitant treatment. The clinical responses to aprepitant and degrees of cachexia status were assessed using a questionnaire and Glasgow Prognostic Score (GPS). Serum albumin level was negatively correlated with the plasma concentrations of total and free aprepitant but not ND-AP. The serum albumin level had a negative correlation with the metabolic ratio of aprepitant. The patients with GPS 1 or 2 had higher plasma concentrations of total and free aprepitant than those with GPS 0. No difference was observed in the plasma concentration of ND-AP between the GPS classifications. The plasma interleukin-6 level was higher in patients with GPS 1 or 2 than 0. The absolute plasma concentration of free ND-AP was higher in patients without the delayed nausea, and its concentration to determine the occurrence was 18.9 ng/mL. The occurrence of delayed nausea had no relation with absolute plasma aprepitant. Cancer patients with a lower serum albumin and progressive cachectic condition had a higher plasma aprepitant level. In contrast, plasma free ND-AP but not aprepitant was related to the antiemetic efficacy of oral aprepitant.


Synthetic amphipathic peptides resembling apolipoproteins stimulate the release of human placental lactogen.
Previous studies from our laboratory demonstrated native high density lipoproteins and apolipoproteins AI, AII, and CI, stimulate the release of human placental lactogen (hPL) from trophoblast cells in culture. To examine the mechanisms by which these apolipoproteins stimulate hPL release, we have studied hPL secretion in response to several synthetic peptide analogs of the amphipathic helical structure of the apolipoproteins. The magnitude of the stimulation of hPL release in response to the analog peptides correlated with the ability to displace apolipoproteins from high density lipoprotein and with other measures of phospholipid binding affinity such as the increase in alpha-helicity and the size of complexes formed between the peptide and phospholipid. The correlation of stimulatory ability and lipid affinity suggests that the action of the apolipoproteins on hPL release may be mediated through an interaction with plasma membrane phospholipids.


Primary amyloidosis of the external auditory canal: case report.
A case of primary amyloidosis of the external auditory canal is described. To the best of our knowledge this is the first case described in the literature.


Investing to maximize after-tax dollars.
There are many tax-saving options still available to the practicing physician. The material contained in this article is a brief introduction to some of these options. To fully utilize any tax-saving provision, a full understanding of that provision is essential. Therefore, it is important that doctors seek professional advice before implementing a tax-reduction plan, including those discussed in this article.


The "liver scan" appearance in cholescintigraphy. A sign of complete common bile duct obstruction.
One hundred consecutive Tc-99m IDA hepatobiliary scans were reviewed revealing 14 scans (14%), that showed nonvisualization of the common bile duct (CBD), gallbladder (GB), and small bowel (SB), but good hepatic uptake of Tc-99m IDA derivative, a pattern designated by us as "the liver scan appearance." In 11 of 14 cases (79%), the diagnosis of complete CBD obstruction was confirmed by surgery, percutaneous transhepatic cholangiogram (PTC), endoscopic retrograde cholangiopancreatography (ERCP), and/or percutaneous needle biopsy (PBx). Common bile duct obstruction was suspected but not proven in the other three cases. The cholescintigraphic, ultrasound, PTC, ERCP, intraoperative cholangiogram, clinical, laboratory, and surgical findings are presented and correlated. The "liver scan-appearance" by cholescintigraphy should suggest a diagnosis of complete common bile duct obstruction; however, it does not specifically differentiate between stone or tumor as the cause of obstruction.


Parents' decisional conflict, self-determination and emotional experiences in pediatric otolaryngology: A prospective descriptive-comparative study.
The aim of this study was to describe the level of decisional conflict experienced by parents considering surgery for their children and to determine if personal characteristics and emotional experiences vary as a function of whether or not parents experienced clinically significant levels of decisional conflict. Sixty consecutive parents of children who underwent surgical consultation for elective otolaryngological procedures were prospectively enrolled. Participants completed the Decisional Conflict Scale, Basic Needs Satisfaction Scale, and the Positive and Negative Affect Schedule-Revised. Eight participants (13.3%) scored over 25 on the Decisional Conflict Scale, a previously defined cut-off indicating clinically significant decisional conflict. Parents who experienced significant decisional conflict felt less autonomous and less related or connected to others as compared to those who did not report significant decisional conflict. In addition, parents who experienced significant decisional conflict reported more negative emotions and fewer positive emotions during the surgical consultation visit. However, parents who reported significant decisional conflict did not report feeling less competent. Parental decision-making on whether their child should undergo elective pediatric otolaryngological surgery is a personal and emotional process. Parents' characteristics and experiences should be acknowledged and supported during the surgical consultation. Future research should aim to normalize the decision-making experience for parents, and to allow surgeons to be aware of the importance of decisional needs.


An efficient synthesis of argifin: a natural product chitinase inhibitor with chemotherapeutic potential.
The first synthesis of the cyclopentapeptide family 18 chitinase inhibitor argifin has been achieved by a combination of solid phase and solution chemistry. Synthetic argifin is a nanomolar inhibitor of chitinase B1 from Aspergillus fumigatus and the high-resolution X-ray structure of the synthesized material in complex with the same enzyme is identical to that previously obtained for the natural product.


Meal box schemes a convenient way to avoid convenience food? Uses and understandings of meal box schemes among Danish consumers.
The term convenience food is subject to diversification, lack of clarity and moral ambiguity. In this paper we address these issues and critically discuss convenience food by using empirical findings from a Danish study that deals with practitioners' uses of meal box schemes. The methodological design consists of thirteen individual interviews, four focus groups and some observations of cooking practices. We combine the empirical findings with a particular definition of convenience food by Brunner et al. (2010) and selected practice theoretical concepts. This particular combination enables us to categorize meal box schemes as a new form of convenience food called convenient food. In addition, results suggest that meal box schemes reduce leftovers from dinner. Meal boxes also influence dinner related activities such as planning ahead in time and grocery shopping, which require less physical and mental effort.


Safety and efficacy of independent allied healthcare professionals in the assessment and management of plagiocephaly patients.
The incidence of positional plagiocephaly has increased significantly over the last two decades, which has caused a service delivery challenge for pediatric neurosurgeons. As a potential solution to the long waitlists for abnormal head shape, a plagiocephaly clinic was established at BC Children's Hospital (BCCH) in Vancouver, Canada. This clinic was supervised by an occupational therapist who had been trained by a neurosurgeon to independently assess and manage patients with a referring diagnosis of positional plagiocephaly. To determine the efficiency of the BCCH Plagiocephaly Clinic in the management of positional plagiocephaly patients and to investigate the clinic's ability to appropriately identify and refer patients with craniosynostosis to pediatric neurosurgeons for further assessment. A retrospective chart review was conducted to identify patients who were assessed and managed at the BCCH Plagiocephaly Clinic between 2008 and 2014. Data on patient demographics, head shape measurements, and treatment recommendations were collected, and the BC Children's neurosurgical database was cross-referenced to identify craniosynostosis cases missed by the Plagiocephaly Clinic. A descriptive analysis of the clinic's average wait times, severity of the patients' plagiocephaly, and recommended interventions was conducted. In addition, the sensitivity and specificity of the clinic's ability to appropriately refer craniosynostosis patients to pediatric neurosurgery were calculated. Of 1752 patients seen in the BC Children's Plagiocephaly Clinic between 2008 and 2014, 66% of patients received counseling about repositioning, 34% were referred for head banding, 19% were referred to physiotherapy for torticollis, and 1.4% were referred to the BC Children's Pediatric Neurosurgery Clinic for suspicion of craniosynostosis. The mean time from referral to first assessment by the Plagiocephaly Clinic was 41 days, and time from referral by the plagiocephaly clinic to diagnosis of craniosynostosis by a pediatric neurosurgeon was 8 days. Pediatric neurosurgeons requested imaging for 6 of the referred patients (25% ). The sensitivity and specificity of the plagiocephaly clinic for referral of craniosynostosis patients to the Pediatric Neurosurgery Clinic were 100 and 99%, respectively. The BC Children's Plagiocephaly Clinic is efficient and safe for the initial evaluation and treatment of patients with positional plagiocephaly. The clinic's model decreases wait times, appropriately manages patients with positional plagiocephaly, screens for craniosynostosis with high sensitivity and specificity, and takes pressure off outpatient neurosurgical clinics. This model for assessment of plagiocephaly could be considered in other medical centers.


Assessing Diversity in Hospital Library Collections.
Public libraries have conducted collection diversity audits, but this is the first known report of a diversity audit in the hospital library community. A two-part questionnaire was sent to hospital librarians to determine their use of diversity audits in collection management and to provide a tool for a preliminary assessment of their collections' diversity. Results of the questionnaire indicate that developing diversity within hospital library collections is important to these respondents. These librarians also support diversity in their library personnel, open access, researching critical gaps, and programming.


Hepatitis B and AIDS and the promise for their control by vaccines.
Human hepatitis B virus and human immunodeficiency virus (HIV), that causes AIDS, share attributes and possible evolutionary relationships. The specific requirements for inducing effective immunity against hepatitis B and HIV are discussed. Lessons learned in studies of hepatitis B and its vaccine may find application in creating a vaccine against HIV.


Use of the HemaClear™ elastic tourniquet reduces blood loss in operative treatment of humeral shaft fractures.
To determine if the use of a narrower elastic tourniquet compared to a standard pneumatic tourniquet reduces operative blood loss in the operative fixation of humeral shaft fractures. This retrospective cohort study was performed at a level I trauma center and included 134 patients, aged 18 to 90 years, with a humeral shaft fracture treated with open reduction internal fixation (ORIF) from January 2007 through June 2018. The primary variable of interest was the application of a HemaClear™ elastic tourniquet versus a standard pneumatic tourniquet during the fixation of a humeral shaft fracture. The primary outcome was estimated blood loss (EBL) during the humerus ORIF surgery as recorded in the operative record. The secondary outcomes were total tourniquet time and operative time. The primary purpose of the study was to compare the above outcomes between the two tourniquet types. Estimated blood loss was 42% lower (95% CI: 11% to 73%, p < 0.01) in the elastic tourniquet group when compared to the standard pneumatic tourniquet group. The use of the elastic tourniquet was also associated with a 67% increase (95% CI: 35% to 100%, p < 0.01) in tourniquet time compared to the standard pneumatic tourniquet. No difference in the total operative time between the two groups (difference, -3%; 95% CI: -21 to 14, p = 0.72) was observed. Elastic tourniquet use was associated with 42% less blood loss in the fixation of humeral shaft fractures compared to use of a traditional pneumatic tourniquet, although this may be of unclear clinical importance given the relatively low estimated blood loss in this cohort. The potential benefit of reduced blood loss associated with the narrower elastic tourniquet is likely caused by the increased tourniquet time, without a change in overall operative time.


Autosomal recessive polycystic kidney disease.
The clinical features of 55 cases of autosomal recessive polycystic kidney disease (ARPCKD) have been reviewed. Each had evidence of ARPCKD. The outcomes of 87% were known; 24 had died. Twenty-four of 31 were seen between 1980 and 1986; 7 could not be traced. Forty-five percent presented under 1 month; 38% between 1 month and 1 year; and 9 cases over 1 year. Hyponatraemia occurred in 15 out of 19 aged less than 3 months; hypertension occurred in 65%; splenomegaly in 47% of those surviving more than 3 months. Portocaval shunts were done in 5 aged 2-12 years. Thirteen died of renal failure, 6 under 1 year, and 7 between 1 year and 13 years. Life-table survival rates calculated from birth revealed that 86% were alive at 3 months, 79% at 1 year, 51% at 10 years, and 46% at 15 years. Calculations based on patients who survived to 1 year of age showed that 82% were alive at 10 years and 79% at 15 years. These results reveal an improved prognosis for a condition once assumed to be fatal.


Hepatocellular carcinoma bone metastasis in an 11-year-old boy.
Hepatocellular carcinoma (HCC) is the second most common primary hepatic malignant tumor in children older than 4 years. We describe a rare case of an 11-year-old boy with HCC who presented with HCC of the right liver lobe followed by multiple osseous metastases, confirmed by imaging and biopsy.


Tuberculous pericarditis: MRI features with contrast enhancement.
Tuberculous pericarditis has decreased in incidence, but early diagnosis and treatment are critical because constrictive pericarditis is a serious complication of this condition. The appearances of tuberculous pericarditis on gadolinium enhanced magnetic resonance imaging are described and the value of this modality in achieving an early diagnosis is emphasized.


Potential of trans fats policies to reduce socioeconomic inequalities in mortality from coronary heart disease in England: cost effectiveness modelling study.
To determine health and equity benefits and cost effectiveness of policies to reduce or eliminate trans fatty acids from processed foods, compared with consumption remaining at most recent levels in England. Epidemiological modelling study. Data from National Diet and Nutrition Survey, Low Income Diet and Nutrition Survey, Office of National Statistics, and health economic data from other published studies Adults aged ≥25, stratified by fifths of socioeconomic circumstance. Total ban on trans fatty acids in processed foods; improved labelling of trans fatty acids; bans on trans fatty acids in restaurants and takeaways. Deaths from coronary heart disease prevented or postponed; life years gained; quality adjusted life years gained. Policy costs to government and industry; policy savings from reductions in direct healthcare, informal care, and productivity loss. A total ban on trans fatty acids in processed foods might prevent or postpone about 7200 deaths (2.6%) from coronary heart disease from 2015-20 and reduce inequality in mortality from coronary heart disease by about 3000 deaths (15%). Policies to improve labelling or simply remove trans fatty acids from restaurants/fast food could save between 1800 (0.7%) and 3500 (1.3%) deaths from coronary heart disease and reduce inequalities by 600 (3%) to 1500 (7%) deaths, thus making them at best half as effective. A total ban would have the greatest net cost savings of about £265m (€361m, $415m) excluding reformulation costs, or £64m if substantial reformulation costs are incurred outside the normal cycle. A regulatory policy to eliminate trans fatty acids from processed foods in England would be the most effective and equitable policy option. Intermediate policies would also be beneficial. Simply continuing to rely on industry to voluntary reformulate products, however, could have negative health and economic outcomes.


Synthesis and characterization of ML and ML2 metal complexes with amino acid substituted bis(2-picolyl)amine ligands.
Metal complexes with ML or ML2 stoichiometry have been isolated in the reaction of Zn(NO3)2, ZnBr2 or M(NO3)2/NaBF4, M = Zn(ii), Co(ii) or Ni(ii), with either amino acid or amine substituted tridentate nitrogen ligands based on bis(2-picolyl)amine (bpa) or bis(2-quinaldyl)amine (bqa). The stoichiometry (M : L = 1 : 1 or 1 : 2) and stereochemistry (mer, trans-fac or cis-fac) of the products have been studied by NMR and IR spectroscopy, X-ray single crystal analysis and quantum-chemical calculations with an implicit SMD solvation model.


Acid and Hypoxia Tandem-Activatable Deep Near-Infrared Nanoprobe for Two-Step Signal Amplification and Early Detection of Cancer.
The early detection of cancers can significantly change outcomes even with existing treatments. However, ~50% of cancers still cannot be detected until they reach an advanced stage, highlighting the great challenges in the early detection. Here, an ultrasensitive deep near-infrared (dNIR) nanoprobe that is successively responsive to tumor acidity and hypoxia is reported. It is demonstrated that the new nanoprobe specifically detects tumor hypoxia microenvironment based on deep NIR imaging in ten different types of tumor models using cancer cell lines and patient-tissue derived xenograft tumors. By combining the acidity and hypoxia specific two-step signal amplification with a deep NIR detection, the reported nanoprobe enables the ultrasensitive visualization of hundreds of tumor cells or small tumors with a size of 260 µm in whole-body imaging or 115 µm metastatic lesions in lung imaging. As a result, it reveals that tumor hypoxia can occur as early as the lesions contain only several hundred cancer cells.


Subventricular zone volumetric and dosimetric changes during postoperative brain tumor irradiation and its impact on overall survival.
The aim of this retrospective study was to investigate the relationship between the dose to the subventricular zone (SVZ) and overall survival (OS) of 41 patients with glioblastoma multiforme (GBM), who were treated with an adaptive approach involving repeated topometric CT and replanning at two-thirds (40 Gy) of their course of postoperative radiotherapy for planning of a 20 Gy boost. We examined changes in the ipsilateral lateral ventricle (LV) and SVZ (iLV and iSVZ), as well as in the contralateral LV and SVZ (cLV and cSVZ). We evaluated the volumetric changes on both planning CT scans (primary CT1 and secondary CT2). The survival of the GBM patients was analyzed using the Kaplan-Meier method; the multivariate Cox regression was also performed. Median follow-up and OS were 34.5 months and 17.6 months, respectively. LV and SVZ structures exhibited significant volumetric changes on CT2, resulting in an increase of dose coverage. At a cut-off point of 58 Gy, a significant correlation was detected between the iSVZ2 mean dose and OS (27.8 vs 15.6 months, p = 0.048). In a multivariate analysis, GBM patients with a shorter time to postoperative chemoradiotherapy (<3.8 weeks), with good performance status (≥70%) and higher mean dose (≥58 Gy) to the iSVZ2 had significantly better OS. Significant anatomical and dose distribution changes to the brain structures were observed, which have a relevant impact on the dose-effect relationship for GBM; therefore, involving the iSVZ in the target volume should be considered and adapted to the changes.


Myoglobin's novel role in nitrite-induced hypoxic vasodilation.
Hypoxic vasodilation represents a key physiological response of the cardiovascular system to low tissue oxygen tension, adjusting local blood flow to meet the metabolic requirements in tissue. Vasodilation occurs by nitric oxide (NO) activation of the cyclic guanosine monophosphate (cGMP) signaling pathway in vascular smooth muscle cells. Under normoxia, NO is formed by the well-known endothelial NO synthase (eNOS) system while under hypoxia NO is generated from nitrite. We have unraveled the heme-protein myoglobin in vascular smooth muscle cells as a major source of NO generation by reduction of endogenous nitrite under hypoxia. This mediates hypoxic vasodilation under physiological conditions without direct involvement of eNOS and independently of effects on cardiac function.


Uridine as a non-toxic actinometer for UV-C treatment: influence of temperature and concentration.
UV-C treatment is an effective method to inactivate microorganisms and therefore gets increasingly more attention in food industry, especially for liquid products. To test and monitor different UV-C reactor designs, a photochemical actinometer is required that gives reliable UV-C dose values and is non-toxic allowing frequent control of the production chain. Here, a variable concentrated aqueous uridine solution is tested as a photochemical actinometer. Uridine reacts at 262 nm by photohydration to a single photoproduct not absorbing any light. A concentration dependent quantum yield (Ф) was quantified in the range of 0.2-3.0 mM uridine. Results show that uridine is as accurate as the commonly accepted iodide/iodate actinometry, but not as precise. Especially at higher concentrations a higher number of measurements becomes necessary. Further, a temperature correction is presented for 10 °C > ϑ > 30 °C. Taking these results into account, uridine can certainly be considered as a non-toxic dosimeter for UV-C systems.


Implementation of physiological functional spinal units in a rigid-body model of the thoracolumbar spine.
Most of the current rigid-body models of the complete thoracolumbar spine do not properly model the intervertebral joint as the highly nonlinear stiffness is not incorporated comprehensively and the effects of compressive load on stiffness is commonly being neglected. Based on published in vitro data of individual intervertebral joint flexibility, multi-level six degree-of-freedom nonlinear stiffness of functional spinal units was modelled and incorporated in a rigid-body model of the thoracolumbar spine. To estimate physiological in vivo conditions of the entire spine, stiffening effects caused by directly applied compressive loads, and contributions to mono-segmental stiffness from the rib cage as well as multi-segmental interactions in the thoracic spine were analysed and implemented. Forward dynamic simulations were performed to simulate in vitro tests that measured the load-displacement response of the spine under various loading conditions. The predicted kinematic responses of the model were in agreement with in vitro measurements, with correlations between simulated and measured segmental displacements varying between 0.66 and 0.97 (p < 0.05) and average deviations below 1.6°. Coupling relationships were found between lateral bending and axial rotation. Under compressive loads, the model behaved stiffer and showed a decreased range of motion: The flexion/extension response of the full thoracolumbar spine under compressive loads up to 800 N was found to strongly correlate with the literature (r = 0.99, p < 0.0001). The implementation of physiological functional spinal units with nonlinear stiffness properties into rigid-body models can enhance accuracy of biomechanical simulations, and enable detailed analysis of spinal kinematics under complex loading conditions seen in vivo.


Hypovolaemia: pathophysiology and management options.
The pathophysiology of hypovolaemia is described. Elements of patient assessment are outlined. Therapeutic support and current controversies are discussed.


Control factors in the release of gastrin by direct electrical stimulation of the vagus.
The release of gastrin by direct electrical stimulation of the vagus was studied together with the relative effects on the response of antral and duodenal acidification. As expected, gastrin levels increased to three times the normal simulated response following antral neutralization. In contrast, duodenal acidification failed to influence the vagal release of gastrin when the antrum was neutralized although it had a minor effect when the antrum was acidified. Thus the antral pH dominates over duodenal pH as a factor in controlling gastrin release. Surprisingly, atropine in doses which blocked acid release and produced marked cardiac effects failed to inhibit the release of gastrin from the antrum on vagal stimulation. This suggests that, using this model, vagal release of gastrin, if cholinergic, is highly resistant to atropine.


Organosolv pretreatment for biorefineries: Current status, perspectives, and challenges.
Biorefineries integrate processes for the sustainable conversion of biomass into chemicals, materials, and bioenergy so that resources are optimized and effluents are minimized. Despite the vast potential of lignocellulosic biorefineries, their success depends heavily on effective, economically viable, and sustainable biomass fractionation. Although efficient, organosolv pretreatment still faces challenges that must be overcome for its widespread utilization, mainly related to solvent type and recycling, robustness regarding biomass type and integration of hemicellulose recovery and use. This review shows the recent advances and state-of-the-art of organosolv pretreatment, discussing the advances, such as the use of biobased solvents, whilst also shedding light on the perspectives of using the streams - cellulose, hemicellulose, and lignin - to produce biofuels and products of high added value. In addition, it presents an overview of the existing industrial implementations of organosolv processes and, lastly, shows the main scientific and industrial challenges and opportunities for this process.


Common occurrence of Theileria annulata and the first report of T. ovis in dairy cattle from Southern Xinjiang, China.
Bovine theileriosis is a common tick-born disease infected by Theileria spp. causing loss of beef and dairy cattle worldwide, therefore, the aim of this study was to determine the prevalence and genetic diversity of Theileria spp. in Southern Xinjiang Uyghur Autonomous Region, China. We screened 493 dairy cattle blood samples from Southern Xinjiang to detect Theileria spp. by PCR. The overall prevalence of Theileria spp. was 23.5% (116/493). The most frequent Theileria sp. was Theileria annulata 22.5% (111/493), followed by T. orientalis (0.6%, 3/493) and T. ovis (0.2%, 1/493). Additionally, one sample was co-infected with T. annulata and T. orientalis. Phylogenetic analysis showed that the 11 T. annulata Tams1 sequences grouped into three sequence clusters that belonged to group 2 (Asia group) and shared 96.4% to 99.9% identity with to each other. Furthermore, our results revealed the presence of several T. orientalis MPSP genotypes (types 1, 2, and 5) in this region. In this study, T. annulata was found to be the most prevalent Theileria species in dairy cattle from Southern Xinjiang. Theileria ovis was detected in one DNA sample of a free-grazing dairy cow from China for the first time.


Lack of synchrony between feeding activity and pulsatile growth hormone secretion in rats.
Plasma growth hormone (GH) was determined in blood sampled at 15 minute intervals in undisturbed chronically cannulated adult male rats while continuously monitoring feeding activity. Ten animals were studied; five were optic nerve sectioned from 24 days of age and five were intact. The sampling time was from 15:00 hours to 21:00 hours, which included 5 hours of light and the first hour of dark. Both GH secretion and feeding activity exhibited a pulsatile pattern. There was no consistent coordination of bursts of feeding activity and GH secretion. We conclude that feeding activity and GH secretion may be controlled by central timing mechanisms; however, it appears that these mechanisms are separate and are not synchronized.


Reflections and perspectives.
Complex patients who have biopsychosocial comorbidities represent a major challenge for the current health care system. Unlike standard medical situations for which medical care can be based on an evidence-based approach, complex patients require a broader concept of care. As demonstrated throughout this issue, such an integrated approach that takes into account the concepts of case- and care complexity is not only possible, it is cost-effective. Integrated care, however, needs assessment tools and a communications-based approach that fosters exchange and collaboration between different medical disciplines and professions and patients.


Three Ds for diagnosing necrotizing fasciitis by front-line clinicians.
Necrotizing fasciitis (NF) is a life-threatening infection and a surgical emergency. Not all clinicians have the experience or resources to detect NF in its early stages. To develop a diagnostic algorithm for primary care and emergency physicians to identify patients with possible NF, including an initial approach to triaging such individuals. Medline was searched to identify studies of validated algorithms for NF diagnosis and/or cohort or case series providing clinical and diagnostic features of NF. Candidate algorithms were validated via application to 3 published cases of initially misdiagnosed NF. We retrospectively reviewed NF cases between 2011 and 2022 at our center to validate our algorithm. The search yielded 540 articles; 109 were included following a review of abstracts. No published validated diagnostic algorithm was identified. Using the reported clinical and diagnostic features of NF, we generated an algorithm of the "3Ds" of NF: Disproportionate pain, Dermatological findings, and Disorganized physiology. A larger number of Ds indicated a greater level of suspicion for NF and prioritization for urgent surgical consultation. In 3 published cases of missed NF, the 3Ds algorithm successfully identified all as having possible NF. On reviewing our cases, we identified 56 patients with NF during an 11 year period. 66% of whom had the 3Ds at their initial presentation. The 3Ds algorithm, a simple and easy-to-remember tool can be easily applied in a primary or emergency care setting, and may improve the early diagnosis of NF. Retrospective analysis of NF cases allows for validation of this algorithm. However, this algorithm requires prospective validation.


Compassion protects against vital exhaustion and negative emotionality.
We investigated (i) the predictive relationships of compassion with negative emotionality (a marker of susceptibility to stress) and vital exhaustion (a marker of chronic stress response) and (ii) the effect of compassion on the developmental courses of negative emotionality and vital exhaustion over a follow-up from early adulthood to middle age. We used the prospective Young Finns data (n = 1031-1495, aged 20-50). Compassion was evaluated in 1997, 2001, and 2012; and vital exhaustion and negative emotionality in 2001, 2007, and 2012. The predictive paths from compassion to vital exhaustion and negative emotionality were stronger than vice versa: high compassion predicted lower vital exhaustion and lower negative emotionality. The effect of high compassion on lower vital exhaustion and lower negative emotionality was evident from early adulthood to middle age. Overall, high compassion appears to protect against dimensions of stress from early adulthood to middle age, whereas this study found no evidence that dimensions of stress could reduce disposition to feel compassion for others' distress over a long-term follow-up. The online version contains supplementary material available at 10.1007/s11031-021-09878-2.


Clinical evaluation of thyroxine-binding globulin (TBG) as a marker of liver tumors.
This investigation was undertaken to evaluate thyroxine-binding globulin (TBG) as a marker of liver tumors, in conjunction with the liver scintigram. Of 30 patients with primary hepatocellular carcinoma (PHC), 22 (73.3%) showed significantly higher TBG concentrations. Eight patients (26.7%) showed normal TBG concentrations. In the case of 27 out of 30 patients with definite liver tumors, defects were apparent on the scintigrams. But seven of them had normal TBG concentrations in spite of the defects on the scintigrams. Out of 33 postoperative patients with liver metastasis, 28 (84.8%) had a raised TBG concentration. Only five (15.2%) had a normal TBG level. In 31 patients (93.9%) out of 33 with liver metastasis, a definite diagnosis was made on the basis of the liver scintigram. In 28 (90.3%) of these 31 people, the TBG concentration was higher than normal. Among 63 patients with liver tumors, both primary and metastatic, the test sensitivity for liver tumors was 92.1% (58/63) based on the accuracy of the liver scintigram. It was 79.4% (50/63) based on the TBG measurement. Why TBG increases to such an extent in spite of the euthyroid state remains unexplained. But it may be concluded that elevated TBG with positive liver scintigram furnishes a sensitive, fairly reliable, nonspecific tumor marker to determine liver tumors, especially in the case of liver metastasis.


Rectal cancer radiotherapy.
We present the updated recommendations of the French society of oncological radiotherapy for rectal cancer radiotherapy. The standard treatment for locally advanced rectal cancer consists in chemoradiotherapy followed by radical surgery with total mesorectal resection and adjuvant chemotherapy according to nodal status. Although this strategy efficiently reduced local recurrences rates below 5% in expert centres, functional sequelae could not be avoided resulting in 20 to 30% morbidity rates. The early introduction of neoadjuvant chemotherapy has proven beneficial in recent trials, in terms of recurrence free and metastasis free survivals. Complete pathological responses were obtained in 15% of tumours treated by chemoradiation, even reaching up to 30% of tumours when neoadjuvant chemotherapy is associated to chemoradiotherapy. These good results question the relevance of systematic radical surgery in good responders. Personalized therapeutic strategies are now possible by improved imaging modalities with circumferential margin assessed by magnetic resonance imaging, by intensity modulated radiotherapy and by refining surgical techniques, and contribute to morbidity reduction. Keeping the same objectives, ongoing trials are now evaluating therapeutic de-escalation strategies, in particular rectal preservation for good responders after neoadjuvant treatment, or radiotherapy omission in selected cases (Greccar 12, Opera, Norad).


An Approach to Monitor Exocytosis in White Adipocytes.
Exocytosis, the fusion of vesicles with the plasma membrane, can be measured with the patch-clamp technique as increases in membrane capacitance. Here we provide detailed information on how to monitor white adipocyte exocytosis using this method. We describe how to isolate the stromal vascular fraction of cells (SVF) within adipose tissue and how to differentiate SVF and cultured 3T3-L1 cells into adipocytes suitable for patch-clamp studies. We also give detailed protocols of how to record and analyze exocytosis in the differentiated cells.


Cancer immunosurveillance: role of patrolling monocytes.
Classical inflammatory monocytes and their derivative macrophages promote tumor metastasis whereas CD8(+) T and NK cells restrict tumor growth. In a recent paper published in Science, Hanna and colleagues demonstrate that another monocyte population, nonclassical patrolling monocytes, is enriched in the microvasculature of tumor-challenged lung and reduces tumor metastasis by recruiting NK cells.


Prevalence and factors associated with burnout among healthcare providers in Malaysia: a web-based cross-sectional study.
This study aimed to assess the determinants of burnout among healthcare providers in the primary care setting. A web-based cross-sectional study was conducted among 1280 healthcare providers aged 18 years and older from 30 primary care clinics in Selangor, Malaysia. In this study, the Copenhagen Burnout Inventory was used to assess burnout. The results were analyzed using multiple logistic regression. The prevalence of personal burnout was 41.7%, followed by work-related burnout (32.2%) and client-related burnout (14.5%). The determinants for personal burnout in this study were younger age, being a doctor, higher COVID-19 exposure risk, do not know where to seek help, inability to handle stress, poorer sleep quality score, higher total COVID-19 fear score, higher total stress score, and lower total BRS score. The determinants of work-related burnout were younger age, being a doctor, longer years of working, higher COVID-19 exposure risk, do not know where to seek help, lower altruistic score, poorer sleep quality score, higher total stress score, and lower total brief resilience score (BRS) score. The determinants of client-related burnout were doctor, single/divorced, more than one attachment site, and higher satisfaction toward the infection control, inability to handle stress, higher total depression score, and lower total BRS score. Every fourth out of ten suffered from personal burnout, one-third from work-related burnout, and one-seventh from client-related burnout among healthcare providers during the COVID-19 pandemic. Healthcare systems must take care of healthcare workers' physical and emotional depletion, reducing the risk of burnout.


Preventive Potential of Dipeptide Enterocin A/P on Rabbit Health and Its Effect on Growth, Microbiota, and Immune Response.
The present study investigated the effect of the dipeptide enterocin (Ent) A/P on growth, immune response, and intestinal microbiota in rabbits. Eighty-eight rabbits (aged five weeks, M91 meat line, both sexes) were divided into three experimental groups: E (Ent A/P; 50 µL/animal/day for 14 days; between 0-14 days); S (methicillin-resistant Staphylococcus epidermidis SE P3/Tr2a strain; 500 µL/animal/day for 7 days starting at day 14 to day 21); and E + S (Ent A/P between 0-14 days and SE P3/Tr2a strain between 14-21 days) groups, and the control group (C). The additives were administered in drinking water. Administration of Ent A/P lead to an increase in weight gain, reduction of feed conversion; phagocytic activity was stimulated and gut microbiota were optimized due to reduction of coliforms, total bacterial count, and methicillin-resistant staphylococci. Good health and increased weight gain also showed that methicillin-resistant S. epidermidis SE P3/Tr2a strain did not have any pathogenic effect on rabbits' health status.


Nursing students' perceptions of peer learning through cross-cultural student-led webinars: A qualitative study.
To explore nursing students' perception of peer learning during cross-cultural learning activities through student-led webinars. An exploratory qualitative study. Thematic analysis of data collected from reflective journals and focus-group interviews of participating nursing students across three international universities in Australia, Hong Kong, and Sweden during autumn 2017. Three themes were identified: peer learning as creation of friendship; peer learning from interactions that went beyond what was originally intended; and peer learning as empowered learning. Combining peer learning as an educational approach with cross-cultural and student-led webinars provided new perspectives. On-line learning across global boundaries, based on a sound educational model, creates new opportunities for internationalization without straining individual and institutional financial resources.


Dynamics of epigenetic control in plants via SET domain containing proteins: Structural and functional insights.
Plants control expression of their genes in a way that involves manipulating the chromatin structural dynamics in order to adapt to environmental changes and carry out developmental processes. Histone modifications like histone methylation are significant epigenetic marks which profoundly and globally modify chromatin, potentially affecting the expression of several genes. Methylation of histones is catalyzed by histone lysine methyltransferases (HKMTs), that features an evolutionary conserved domain known as SET [Su(var)3-9, E(Z), Trithorax]. This methylation is directed at particular lysine (K) residues on H3 or H4 histone. Plant SET domain group (SDG) proteins are categorized into different classes that have been conserved through evolution, and each class have specificity that influences how the chromatin structure operates. The domains discovered in plant SET domain proteins have typically been linked to protein-protein interactions, suggesting that majority of the SDGs function in complexes. Additionally, SDG-mediated histone mark deposition also affects alternative splicing events. In present review, we discussed the diversity of SDGs in plants including their structural properties. Additionally, we have provided comprehensive summary of the functions of the SDG-domain containing proteins in plant developmental processes and response to environmental stimuli have also been highlighted.


Estrogen receptor negative/progesterone receptor positive breast cancer is not a reproducible subtype.
Estrogen receptor (ER) and progesterone receptor (PR) testing are performed in the evaluation of breast cancer. While the clinical utility of ER as a predictive biomarker to identify patients likely to benefit from hormonal therapy is well-established, the added value of PR is less well-defined. The primary goals of our study were to assess the distribution, inter-assay reproducibility, and prognostic significance of breast cancer subtypes defined by patterns of ER and PR expression. We integrated gene expression microarray (GEM) and clinico-pathologic data from 20 published studies to determine the frequency (n = 4,111) and inter-assay reproducibility (n = 1,752) of ER/PR subtypes (ER+/PR+, ER+/PR-, ER-/PR-, ER-/PR+). To extend our findings, we utilized a cohort of patients from the Nurses' Health Study (NHS) with ER/PR data recorded in the medical record and assessed on tissue microarrays (n = 2,011). In both datasets, we assessed the association of ER and PR expression with survival. In a genome-wide analysis, progesterone receptor was among the least variable genes in ER- breast cancer. The ER-/PR+ subtype was rare (approximately 1 to 4%) and showed no significant reproducibility (Kappa = 0.02 and 0.06, in the GEM and NHS datasets, respectively). The vast majority of patients classified as ER-/PR+ in the medical record (97% and 94%, in the GEM and NHS datasets) were re-classified by a second method. In the GEM dataset (n = 2,731), progesterone receptor mRNA expression was associated with prognosis in ER+ breast cancer (adjusted P <0.001), but not in ER- breast cancer (adjusted P = 0.21). PR protein expression did not contribute significant prognostic information to multivariate models considering ER and other standard clinico-pathologic features in the GEM or NHS datasets. ER-/PR+ breast cancer is not a reproducible subtype. PR expression is not associated with prognosis in ER- breast cancer, and PR does not contribute significant independent prognostic information to multivariate models considering ER and other standard clinico-pathologic factors. Given that PR provides no clinically actionable information in ER+ breast cancer, these findings question the utility of routine PR testing in breast cancer.


Inflammatory pseudotumor of the lung in adults: radiographic and clinicopathological analysis.
Inflammatory pseudotumors of the lung are rare in adults. We treated 7 patients with such tumors and describe the histological evidence, radiographic findings, and surgical treatment. In 5 patients, lung cancer was suspected preoperatively on the basis of the radiographic findings. Intraoperatively, the gross appearance of the pleura resembled lung cancer in 6 patients; the parietal pleura was involved in 3, and pleural indentation was present in the other 3. Two patients underwent partial resection, as the frozen section revealed a benign tumor, and 5 patients underwent lobectomy for what appeared to be lung cancer or a large mass. All of the patients are doing well without other therapy. We believe the lesion should be differentiated from lung cancer at operation by frozen sections, even though this proved pertinent in only 2 of the 7 patients. Limited resection is recommended if the lesion is an inflammatory pseudotumor.


Ultrastructural study of rabbit sciatic nerve regeneration following experimental excisional transection and autograft reconstruction.
This experimental study presents the ultrastructure of regenerating sciatic nerve of the rabbit, after transection and immediate end to end anastomosis, using perineural fascicular nerve autograft, in a sterile environment. Twenty-four hours, 1, 2, and 6 weeks after the anastomosis, the treated sciatic nerves were exposed and three segments were excised and studied. The first at the region of the graft and the others from the proximal and distal stump of the nerve, in the vicinity of the graft suture. The sections taken from the proximal part showed that the nerve structure was identical with the control. Degeneration and regeneration of nerve fibres were observed on the sections taken from the region of the grafts and from the distal parts. Macrophagic activity appeared mainly one week after the operation. Fibroblastic invasion started 24 hours after operation. A moderate amount of collagen fibres was gradually formed. The fibres were disposed in parallel with the neuraxon. Schwann cells were slightly affected initially but consequently they fully recovered and showed signs of extra-activity of the cytoplasm organelles, e.g., enlargement of the granular endoplasmic reticulum cisternae. The present study showed that the bridging of experimental gaps of rabbit's sciatic nerve, by means of autograft and by use of perineural suturing, was successful. The regenerating nerve fibres were growing through the graft towards the distal part of the nerve. In this process Schwann cells and fibroblastic activity play a key role, which is most favourably influenced by using the technique described in this paper.


Palmitic-Acid-Based Hydrophobic Deep Eutectic Solvents for the Extraction of Lower Alcohols from Aqueous Media: Liquid-Liquid Equilibria Measurements, Validation and Process Economics.
A new, natural, hydrophobic deep eutectic solvent (NADES) based on DL-menthol and palmitic acid is adopted for the extraction of alcohols from aqueous phase. DL-menthol is used as a hydrogen bond acceptor and palmitic acid, being a natural organic acid, as a hydrogen bond donor. The synthesis is carried out by the addition of DL-menthol and palmitic acid in a defined molar ratio. Physical properties of NADES along with water stability are then measured. Liquid-liquid equilibria (LLE) of lower alcohols, namely, DES (1) + lower alcohols (ethanol/1-propanol/1-butanol) (2) + water (3) are carried out at p = 1 atm and T = 298.15 K. LLE results show type-I phase behavior, where alcohol is preferentially attracted toward DES. The tie lines are then regressed via nonrandom two liquid and universal quasichemical models, which give root mean square deviation (RMSD) in the range of 0.29-0.35% and 0.39-0.75%, respectively. Finally, the quantum-chemical-based conductor-like screening model-segment activity coefficient is used to predict the tie lines, which gives an RMSD of 2.1-5.2%. A hybrid extractive distillation flowsheet is then used for scale up, process economics, and solvent recovery aspects in ASPEN using DES as a "pseudocomponent."


Preterm birth among African American and white women: a multilevel analysis of socioeconomic characteristics and cigarette smoking.
Research shows that neighbourhood socioeconomic factors are associated with preterm delivery. This study examined whether cigarette smoking and individual socioeconomic factors modify the effects of neighbourhood factors on preterm delivery. Case-control study. Moffit Hospital in San Francisco, California. 417 African American and 1244 white women, including all preterm and a random selection of term deliveries 1980-1990, excluding non-singleton pregnancies, congenital anomolies, induced deliveries, and women transported for special care. US census data from 1980 and 1990 were used to characterise the women's neighbourhoods, defined as census tracts. Cigarette smoking increased the risk of preterm delivery among both African American (OR=1.77, 95% confidence intervals (CI) (1.12 to 2.79)) and white women (OR=1.25, 95% CI (1.01 to 1.55)). However, cigarette smoking did not attenuate or modify the association of neighbourhood factors with preterm delivery. Among African American women, having public insurance modified the relation between neighbourhood unemployment and preterm delivery; among women without public insurance, the risk of preterm delivery was low in areas with low unemployment and high in areas with high unemployment, while among women with public insurance the risk of preterm delivery was highest at low levels of neighbourhood unemployment. Cigarette smoking was associated with preterm delivery, especially among African Americans. Adverse neighbourhood conditions had an influence on preterm delivery beyond that of cigarette smoking. The effects of some neighbourhood characteristics were different depending on individual socioeconomic status. Examining socioeconomic and behavioural/biological risk factors together may increase understanding of the complex causes of preterm delivery.


Vitamin A and tumor immunity.
Intraperitoneal administration of vitamin A into the BALB/c mice inoculated with a syngeneic fibrosarcoma, Meth A, caused a remarkable augmentation of tumor rejection. A cell-depletion technique revealed that the primary effector cells responsible for the augmented rejection were Thy-1 positive, Lyt-1 negative, Lyt-2 positive lymphocytes, suggesting the involvement of cytotoxic lymphocytes.


New positron emission tomography derived parameters as predictive factors for recurrence in resected stage I non-small cell lung cancer.
The recurrence rate for stage I non-small cell lung cancer is high, with 20-40% of patients that relapse after surgery. The aim of this study was to evaluate new F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) derived parameters, such as standardized uptake value index (SUVindex), metabolic tumor volume (MTV) and total lesion glycolysis (TLG), as predictive factors for recurrence in resected stage I non-small cell lung cancer. We retrospectively reviewed 99 resected stage I non-small cell lung cancer patients that were grouped by SUVindex, TLG and MTV above or below their median value. Disease free survival was evaluated as primary end point. The 5-year overall survival and the 5-year disease free survival rates were 62% and 73%, respectively. The median SUVindex, MTL and TLG were 2.73, 2.95 and 9.61, respectively. Patients with low SUVindex, MTV and TLG were more likely to have smaller tumors (p ≤ 0.001). Univariate analysis demonstrated that SUVindex (p = 0.027), MTV (p = 0.014) and TLG (p = 0.006) were significantly related to recurrence showing a better predictive performance than SUVmax (p = 0.031). The 5-year disease free survival rates in patients with low and high SUVindex, MTV and TLG were 84% and 59%, 86% and 62% and 88% and 60%, respectively. The multivariate analysis showed that only TLG was an independent prognostic factor (p = 0.014) with a hazard ratio of 4.782. Of the three PET-derived parameters evaluated, TLG seems to be the most accurate in stratifying surgically treated stage I non-small cell lung cancer patients according to their risk of recurrence.


Human fibroblast growth factor receptor 1 is a co-receptor for infection by adeno-associated virus 2.
Adeno-associated virus 2 (AAV)-based vectors have gained attention as a potentially useful alternative to the more commonly used retroviral and adenoviral vectors for human gene therapy. Although AAV uses the ubiquitously expressed cell surface heparan sulfate proteoglycan (HSPG) as a receptor, the transduction efficiency of AAV vectors varies greatly in different cells and tissues in vitro and in vivo. We demonstrate here that cell surface expression of HSPG alone is insufficient for AAV infection, and that AAV also requires human fibroblast growth factor receptor 1 (FGFR1) as a co-receptor for successful viral entry into the host cell. We document that cells that do not express either HSPG or FGFR1 fail to bind AAV and, consequently, are resistant to infection by AAV. These non-permissive cells are successfully transduced by AAV vectors after stable transfections with cDNAs encoding the murine HSPG and the human FGFR1. Furthermore, AAV infection of permissive cells, known to express both FGFR1 and the epidermal growth factor receptor, is abrogated by treatment of cells with basic fibroblast growth factor, but not with epidermal growth factor. The identification of FGFR1 as a co-receptor for AAV should provide new insights not only into its role in the life cycle of AAV, but also in the optimal use of AAV vectors in human gene therapy.


Fibrogenesis in chronic murine colitis is independent of innate lymphoid cells.
Insight in the pathogenesis of intestinal fibrosis is an unmet medical need in inflammatory bowel diseases. Studies in murine models and human organ fibrosis point to a potential role of innate lymphoid cells (ILC) in chronic intestinal inflammation and fibrosis. Dextran sodium sulfate (DSS) in drinking water was used to induce chronic colitis and remodeling in C57Bl/6 wild type (WT), RAG-deficient, RAG-/- common γ chain deficient and anti-CD90.2 monoclonal antibody treated RAG-/- mice. Inflammation was scored by macroscopic and histological examination and fibrosis was evaluated by hydroxyproline quantification and histology. In RAG-/- mice (which have a normal ILC population but no adaptive immunity), chronic intestinal inflammation and fibrosis developed similarly as in WT mice, with a relative increase in ILC2 during repeated DSS exposure. Chronic colitis could also be induced in the absence of ILC (RAG-/- γc-/- or anti-CD90.2 treated RAG-/- mice) with no attenuation of fibrosis. Importantly, clinical recovery based on weight gain after stopping DSS exposure was impaired in ILC-deficient or ILC-depleted mice. These data argue against a profibrotic effect of ILC in chronic colitis, but rather suggest that ILC have a protective and recovery-enhancing effect after repeated intestinal injury.


Bile duct adenoma and small-sized small duct type intrahepatic cholangiocarcinoma show distinct differences in genetic alterations, expression of IMP3 and EZH2 and stromal and inflammatory components.
Given that bile duct adenoma was significantly more prevalent in the liver with small duct type intrahepatic cholangiocarcinoma (small duct iCCA), compared to other primary liver carcinomas, we examined the possibility of bile duct adenoma as a precursor of small duct iCCA by analysing genetic alterations and other features in bile duct adenomas. Subjects included 33 bile duct adenomas and 17 small-sized (up to 2 cm in diameter) small duct iCCAs. Genetic alterations were examined by direct sequencing for hot-spot regions and immunohistochemical staining. The expression of p16INK4a , EZH2 and IMP3 and stromal and inflammatory components were also examined. Genetic alterations examined including BRAF were not detected in bile duct adenomas, whereas genetic alterations of p53 (47%), ARID1A (41%), PBRM1 (12%), MTAP (12%), IDH1 (6%), KRAS (6%) and TERT promoter (6%) were detected in 16 small-sized small duct iCCA (94%) (P < 0.01). The expression of IMP3 and EZH2 was not detected in bile duct adenomas, whereas it was detected in most small duct iCCA (94%) (P < 0.01). Immature stroma and neutrophilic infiltration were significantly more prevalent in small duct iCCA, compared to bile duct adenoma (P < 0.01). Bile duct adenomas and small-sized small duct iCCAs show distinct differences in genetic alterations, expression of IMP3 and EZH2 and stromal and inflammatory components. There was no evidence suggesting that bile duct adenoma is a precursor of small duct iCCA. Immunohistochemical staining for IMP3, EZH2, p53, ARID1A and MTAP may be useful for differential diagnosis between bile duct adenomas and small duct iCCAs.


Glucose production and oxidation in preterm infants during total parenteral nutrition.
During total parenteral nutrition in preterm infants, glucose may be infused at high rates, but it is not known if the endogenous glucose production is fully suppressed under these circumstances. Eight preterm appropriate for gestational age (AGA) (birth wt: 1613 +/- 151 g, gestational age: 31.1 +/- 1.5 wk) and eight preterm small for gestational age (SGA) newborn infants (1185 +/- 241 g, 32.9 +/- 2.6 wk) receiving a glucose infusion rate of 7.55 +/- 0.56 and 8.16 +/- 0.65 mg/kg.min, respectively, were studied during continuous total parenteral nutrition at postnatal d 8. Glucose oxidation rate was determined with a primed constant infusion of [U-13C] glucose, measuring the 13CO2 production in breath gas by isotope ratio mass spectrometry and the glucose production rate in plasma by gas chromatography mass spectrometry. In breath gas of AGA and SGA infants, 60 and 65%, respectively, of the infused tracer appeared as 13CO2. The glucose production rates were 7.97 +/- 1.61 and 8.12 +/- 1.84 mg/kg.min in AGA and SGA infants, respectively, indicating that no significant endogenous glucose production occurred. The glucose oxidation calculated from the glucose production and 13CO2 production was 4.74 +/- 0.99 mg/kg.min in AGA infants and was significantly different from the carbohydrate oxidation rate of 6.62 +/- 1.23 mg/kg.min measured by simultaneous indirect calorimetry. In SGA infants, however, the glucose and carbohydrate oxidation rates were not significantly different at 5.33 +/- 1.56 and 6.16 +/- 2.45 mg/kg.min. It is concluded that 1-wk-old AGA or SGA preterm infants receiving total parenteral nutrition of 80 kcal/kg.d produce no endogenous glucose and their glucose oxidation rates are similar at 63-65% of the glucose infused. It is suggested that the significant difference between glucose and carbohydrate oxidation rates observed in AGA but not in SGA infants is due either to a higher rate of lipogenesis from carbohydrates, or, less likely, to a higher rate of glycogen oxidation.


Effect of UV-B irradiation on release of arachidonic acid from B-16 melanoma cells.
B-16 melanoma cells in culture were prelabeled with (3H)-arachidonate, and exposed to UV radiation. Immediately after irradiation the cells released labeled materials. This UV-stimulated release was inhibited by mepacrine (20 microM) and calmodulin inhibitor W7 (0.5 microM). To determine the influence of extracellular Ca2+ on the UV-stimulated release, experiments were made with media containing various concentrations of Ca2+. The release decreased significantly at lower Ca2+ concentrations. These results suggest that Ca2+-calmodulin-dependent phospholipase A2 was involved in UV-stimulated release of radiolabeled materials, possibly arachidonic acid and its metabolites, from the cells.


Treatment of ventricular assist device driveline infection with vacuum-assisted closure system.
Deep driveline infection is a serious complication after left ventricular assist device implantation. Current treatment strategies are associated with significant morbidity related to healing or relocation of the driveline tract. We present a case of deep driveline infection successfully treated with a vacuum-assisted closure system as a potentially improved alternative therapy.


Factors Influencing Quality of Life in Breast Cancer Patients Six Months after the Completion of Chemotherapy.
To assess breast cancer patients' quality of life six months after the completion of adjuvant chemotherapy, and to investigate factors affecting this. The study was conducted in one large hospital located in a major Greek city. A convenience sample of 61 breast cancer outpatients was recruited. A questionnaire, including the SF-36 scale and questions regarding demographic and clinical information, was used to collect data. The mean age of the patients was 51.52 ± 12.10. The effect of age on the physical role was significant (p = 0.003). Τhe effect of menopausal status on physical role was also found to be significant (p = 0.003); this might be explained by age. Regarding the treatment type, patients who received hormone therapy in addition to surgery and chemotherapy reported a significantly higher quality of life in terms of bodily pain (p = 0.04) and vitality (p = 0.04) than patients who underwent only surgery and chemotherapy. Quality of life is affected by factors such as age, menopausal status, and previous therapy. Health care professionals should be more aware of the factors that influence the quality of life domains (physical role, bodily pain, vitality) within this group of cancer patients in order to meet their needs following acute treatment.


Fearfulness: An important addition to the starter kit for distinctively human minds.
Grossmann's impressive article indicates that - along with attentional biases, expansion of domain-general processes of learning and memory, and other temperamental tweaks - heightened fearfulness is part of the genetic starter kit for distinctively human minds. The learned matching account of emotional contagion explains how heightened fearfulness could have promoted the development of caring and cooperation in our species.


Studies on the purification of chlamydial agents grown in yolk sacs of embryonated eggs using disulphide-linked immunosorbents and enzymes.
Immunosorbents were derived from avid and non-avid sera raised in rabbits to multiple or single injections of chlamydiae passaged once or three times in HeLa cells after routine passage in eggs. Egg-derived suspensions of chlamydiae required pretreatment before application to immunosorbent columns; this was most conveniently done by fractionation on Sepharose 4B. Immunosorbents derived from avid serum had greater capacity than those from non-avid sera. However, organisms were desorbed in low yield from an avid immunosorbent, but in higher yields from non-avid immunosorbents. Even under the best conditions, the immunosorbents yielded suspensions of organisms still contaminated with egg antigens. Partially purified suspensions of chlamydiae were also treated with phospholipase C to yield suspensions of high purity.


The localization of receptor binding sites in the substantia nigra and striatum of the rat.
Neurotransmitter receptor binding of 5 ligands was examined in the striatum, substantia nigra (SN) and frontal cortex of rats which had received either unilateral 6-hydroxydopamine (6-OHDA) lesions of the nigrostriatal pathway (NSP) or unilateral kainic acid lesions of the striatum. 6-OHDA lesions of the NSP significantly reduced [3H]dihydroalprenolol ([3H]DHA) and [3H]naloxone ([3H]Nal) binding by 31% and 28% respectively, in the denervated striatum compared to the contralateral side. Scatchard analysis revealed that the alteration in [3H]DHA binding was not due to a change in the affinity of the beta-adrenergic receptor for [3H]DHA. In marked contrast to these changes in the striatum, destruction of the NSP resulted in a significant increase in [3H]DHA and [3H]Nal binding by 44% and 26%, respectively, in the frontal cortex of the lesioned compared to the control side. 6-OHDA lesions in the NSP did not alter striatal receptor binding for [3H]quinuclidinyl benzilate ([3H]QNB), [3H]muscimol ([3H]Mus) or [3H]flunitrazepam ([3H]Flu). Similarily, intrastriatal kainic acid injections did not alter striatal receptor binding for [3H]Nal, [3H]Flu or [3H]Mus. Of the various receptor densities measured in the SN after the above lesions the only alteration observed was a 43% increase in [3H]Flu binding following 6-OHDA lesions of the NSP. Scatchard analysis indicated no change in the affinity of the benzodiazepine receptor for [3H]Flu. 6-OHDA lesions of the NSP did not alter [13H]QNB or [3H]Nal binding in the SN. Striatal kainic acid lesions did not alter nigral [3H]QNB or [3H]Flu binding. The results are discussed in terms of neurotransmitter localization and plasticity within the striatum, SN and frontal cortex.


Toxicological evaluation of three contaminants of emerging concern by use of the Allium cepa test.
Di(2-ethylhexyl)phthalate, triclosan and propylparaben are contaminants of emerging concern that have been subjected to extensive toxicological studies, but for which limited information is currently available concerning adverse effects on terrestrial plant systems. The Allium cepa test, which is considered one of the most efficient approaches to assess toxic effects of environmental chemicals, was selected to evaluate the potential risks of these ubiquitous pollutants. Our data demonstrate that all three compounds studied may in some way be considered toxic, but different effects were noted depending on the chemical and the end point analysed. Results derived from the analysis of macroscopic parameters used in testing for general toxicity, revealed that while di(2-ethylhexyl)phthalate had no apparent effects, the other two chemicals inhibited A. cepa root growth in a dose-dependent manner. On the other hand, although all three compounds caused alterations in the mitotic index of root-tip cells, propylparaben was the only one that did not show evidence of genotoxicity in assays for chromosome aberrations and micronuclei. The results of the present study clearly indicate that sensitive plant bioassays are useful and complementary tools to determine environmental impact of contaminants of emerging concern.


[Correlations between germ content and tumor incidence in laboratory animals].
SPF-Status and hysterectomy is of high importance with respect of the spectrum of spontaneous tumours in mice. Obviously, the germ content of the gastrointestinal tract plays a decisive role in the inducibility of tumours in certain organs caused by chemical noxes. The specific changes of susceptibility are presented and its possible reasons are discussed.


The use of factor analysis and abductive inference to explore students' and practitioners' perspectives of feedback: divergent or congruent understanding?
The importance of feedback in workplace-based settings cannot be underestimated. Approaches that evaluate feedback reflect either the sender's or receiver's viewpoint in isolation of each other. This study investigated prevailing student and practitioner views of feedback resulting from development and testing of a survey about feedback. This study used a cross-sectional design, incorporating use of expert consultation and factor analysis of surveys. Fifty-two items based on identified attributes for effective feedback from current research were developed and reviewed through expert consultation. Surveys developed from the items were completed by students (n = 209) and practitioners (n = 145). The juxtaposition of items based on students' and practitioners' responses to the surveys were examined through use of exploratory factor analysis. Separate student and practitioner surveys resulted. Each survey contained 23 items that clustered into factors. The item statements were different across practitioner and student groups Only nine items were shared across factors identified for both groups. The resulting factors represented different notions of feedback-namely, practitioners had a process-oriented focus in comparison with students' outcome focus. While students and practitioners view feedback differently this does not necessarily mean they are incongruous.


The development of ciliated and mucus cells from basal cells in hamster tracheal epithelial cell cultures.
Hamster tracheal epithelia consist of three cell types: ciliated, mucus and basal cells. Autoradiographic data from several studies suggest that either basal or non-ciliated columnar cells may serve as stem cells for regeneration of lost or damaged ciliated and mucus cells. The objective of the present study was to examine the role of basal cells in the formation of ciliated and mucus cells in hamster tracheal epithelial (HTE) cell cultures via tritiated thymidine ([3H]-TdR) autoradiography. When 3 day cultures were pulsed with [3H]-TdR for 6 hr and incubated for 2 additional days in non-radioactive media (5 day total) label was present in the nuclei of basal and columnar epithelial cells suggesting that the labeled columnar cells may be derived from basal cells. However, the morphological reorganization occurring during this 2 day interval may create difficulties in this interpretation. Since these morphological changes are minimal during the 6 day to 8 day in vitro period, 6 day HTE cultures were pulsed with [3H]-TdR for 6 hr and incubated for 2 additional days in non-radioactive media (8 day total), and examined to further study the fate of labeled basal cells during this period. Analysis of these 8 day cultures revealed that labeled nuclei were present in both basal cells and adjacent ciliated and mucus cells. These results do not exclude the possibility of non-basal cell origin of ciliated and mucus cells in other systems but suggest that, at least in HTE cultures, undifferentiated basal cells have the ability to develop into ciliated and mucus cells.


Metallodrug Profiling against SARS-CoV-2 Target Proteins Identifies Highly Potent Inhibitors of the S/ACE2 interaction and the Papain-like Protease PLpro.
The global spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has called for an urgent need for dedicated antiviral therapeutics. Metal complexes are commonly underrepresented in compound libraries that are used for screening in drug discovery campaigns, however, there is growing evidence for their role in medicinal chemistry. Based on previous results, we have selected more than 100 structurally diverse metal complexes for profiling as inhibitors of two relevant SARS-CoV-2 replication mechanisms, namely the interaction of the spike (S) protein with the ACE2 receptor and the papain-like protease PLpro . In addition to many well-established types of mononuclear experimental metallodrugs, the pool of compounds tested was extended to approved metal-based therapeutics such as silver sulfadiazine and thiomersal, as well as polyoxometalates (POMs). Among the mononuclear metal complexes, only a small number of active inhibitors of the S/ACE2 interaction was identified, with titanocene dichloride as the only strong inhibitor. However, among the gold and silver containing complexes many turned out to be very potent inhibitors of PLpro activity. Highly promising activity against both targets was noted for many POMs. Selected complexes were evaluated in antiviral SARS-CoV-2 assays confirming activity for gold complexes with N-heterocyclic carbene (NHC) or dithiocarbamato ligands, a silver NHC complex, titanocene dichloride as well as a POM compound. These studies might provide starting points for the design of metal-based SARS-CoV-2 antiviral agents.


A new alkaline lipase obtained from the metagenome of marine sponge Ircinia sp.
Microorganisms associated with marine sponges are potential resources for marine enzymes. In this study, culture-independent metagenomic approach was used to isolate lipases from the complex microbiome of the sponge Ircinia sp. obtained from the South China Sea. A metagenomic library was constructed, containing 6568 clones, and functional screening on 1 % tributyrin agar resulted in the identification of a positive lipase clone (35F4). Following sequence analysis 35F4 clone was found to contain a putative lipase gene lipA. Sequence analysis of the predicted amino acid sequence of LipA revealed that it is a member of subfamily I.1 of lipases, with 63 % amino acid similarity to the lactonizing lipase from Aeromonas veronii (WP_021231793). Based on the predicted secondary structure, LipA was predicted to be an alkaline enzyme by sequence/structure analysis. Heterologous expression of lipA in E. coli BL21 (DE3) was performed and the characterization of the recombinant enzyme LipA showed that it is an alkaline enzyme with high tolerance to organic solvents. The isolated lipase LipA was active in the broad alkaline range, with the highest activity at pH 9.0, and had a high level of stability over a pH range of 7.0-12.0. The activity of LipA was increased in the presence of 5 mM Ca(2+) and some organic solvents, e.g. methanol, acetone and isopropanol. The optimum temperature for the activity of LipA is 40 °C and the molecular weight of LipA was determined to be ~30 kDa by SDS-PAGE. LipA is an alkaline lipase and shows good tolerance to some organic solvents, which make it of potential utility in the detergent industry and enzyme mediated organic synthesis. The result of this study has broadened the diversity of known lipolytic genes and demonstrated that marine sponges are an important source for new enzymes.


Technologies for the removal of phenol from fluid streams: a short review of recent developments.
The available technologies for the abatement of phenol from water and gaseous streams are briefly reviewed, and the recent advancements summarized. Separation technologies such as distillation, liquid-liquid extraction with different solvents, adsorption over activated carbons and polymeric and inorganic adsorbents, membrane pervaporation and membrane-solvent extraction, have been discussed. Destruction technologies such as non-catalytic, supercritical and catalytic wet air oxidation, ozonation, non-catalytic, catalytic and enzymatic peroxide wet oxidation, electrochemical and photocatalytic oxidation, supercritical wet gasification, destruction with electron discharges as well as biochemical treatments have been considered. As for the abatement of phenol from gases, condensation, absorption in liquids, adsorption on solids, membrane separation, thermal, catalytic, photocatalytic and biological oxidation have also been considered. The experimental conditions and the performances of the different techniques have been compared.


Arborinine, a potential LSD1 inhibitor, inhibits epithelial-mesenchymal transition of SGC-7901 cells and adriamycin-resistant gastric cancer SGC-7901/ADR cells.
Arborinine is a natural product isolated from G. parva leaf extracts, which displays potentially antiproliferative activity against human cervical cancer cells. In contrast, its anticancer effects against gastric cancer cells and drug-resistant gastric cancer cells remain unknown. In this work, arborinine was evaluated as a broad-spectrum antiproliferative agent, and it exhibited potently inhibitory activity against NCI-N87 (IC50 = 5.67 μM), BGC-823 (IC50 = 7.26 μM), MGC803 (IC50 = 4.75 μM), SGC-7901 (IC50 = 1.96 μM), HGC-27 (IC50 = 5.70 μM), SGC-7901/ADR (IC50 = 0.24 μM), SGC-7901/VCR (IC50 = 1.09 μM), and MGC803/PTX (IC50 = 1.32 μM) cell lines. Subsequent target verification experiments demonstrated that arborinine selectively and reversibly inhibited LSD1 in a time-dependent manner. Furthermore, it was found that arborinine suppressed the epithelial-mesenchymal transition of gastric cancer cell line SGC-7901 and adriamycin-resistant gastric cancer cell line SGC-7901/ADR in a dose-dependent manner. The in vivo antitumor study further indicated that arborinine can significantly reduce the growth of tumors both in SGC-7901 and SGC-7901/ADR xenograft mouse models. Overall, we demonstrated the potential of arborinine as an effective treatment for gastric cancer and adriamycin-resistant gastric cancer.


Laser coagulation of placental anastomoses with a 30 degrees fetoscope in severe mid-trimester twin-twin transfusion syndrome with anterior placenta.
To assess outcome after fetoscopic laser coagulation (FLC) of placental vascular anastomoses with the 30 degrees fetoscope in mid-trimester severe twin-to-twin transfusion syndrome (TTTS) with completely anterior placenta compared with the regular 0 degrees fetoscope in TTTS with other placental locations. This was a prospective study of 176 consecutive monochorionic twin pregnancies undergoing FLC for severe TTTS. Of these, 51 patients required use of the 30 degrees fetoscope (study group) and 125 placental locations permitted use of the 0 degrees fetoscope (controls). The two groups had very similar outcomes. The median gestational age at FLC in the study group vs. control group was 21.0 (range, 17.4-24.6) weeks vs. 20.6 (range, 15.9-24.6) weeks. Both fetuses survived in 58.8% (30/51) of study patients vs. 66.4% (83/125) of controls. At least one fetus survived in 84.3% (43/51) of study patients and 88.8% (111/125) of controls (P = 0.45). Study patients delivered at a median of 34.1 (range, 25.0-38.4) weeks and controls at 34.0 (range, 25.0-40.3) weeks' gestation. Use of a 30 degrees fetoscope for FLC in cases of technically challenging extensive anterior placentation is associated with an outcome that is very similar to that achieved when a 0 degrees fetoscope is used in cases of more favorable placental location.


On the origin of enzymatic species.
The diversity of enzyme catalytic function is remarkable, particularly when one considers that ancestral life forms must have started with a much smaller ensemble of proteins. In this article, we discuss the evolution of the mandelate pathway in pseudomonads as an example of how catalytic diversity may have evolved. We suggest that existing enzymes that catalyse the chemistry needed to accomplish a transformation were recruited, followed by the evolution of specific binding.


Brief assessment of subjective health complaints: Development, validation and population norms of a brief form of the Giessen Subjective Complaints List (GBB-8).
Although there is no causal relationship to medical morbidity, routine clinical assessment of somatic symptoms aids medical diagnosis and assessment of treatment effectiveness. Regardless of their causes, somatic symptoms indicate suffering, distress, and help-seeking behavior. The aim of the present study was to develop and validate a brief self-report questionnaire to assess somatic symptom strain. A brief form of the Giessen Subjective Complaints List (GBB-8) was developed and validated in a large population sample representative of the Federal Republic of Germany (N=2008). Psychometric analyses included confirmation of factor structure, classical item analysis, and measurement invariance tests. The sample furthermore served as a norm group. As indicators of construct validity, correlations with measures of anxiety, depression, alexithymia, and primary care contact were computed. Psychometric analyses yielded excellent scale properties regarding item characteristics, factor structure, and measurement invariance tests (Cronbach's alpha=0.88; CFI=0.980, TLI=0.965, RMSEA=0.049) for the second-order four-factor model; strict invariance was confirmed for gender, depression status, and physician contacts; strong invariance was confirmed regarding age and age×gender. The GBB-8 with its four subscales exhaustion, gastrointestinal complaints, musculoskeletal complaints, and cardiovascular complaints proves to be an economic measure of subjective symptom strain. Psychometric analyses deem it suitable for epidemiological research. The availability of norms makes it a potential everyday tool for general practitioners and psychosomatic clinics.


Effect of cisapride and metoclopramide on digoxin bioavailability.
Pharmacokinetics of digoxin were investigated in six healthy volunteers following one week of digoxin monotherapy 0.25 mg b.i.d., and during coadministration of metoclopramide 10 mg t.i.d. or cisapride 10 mg t.i.d.. Metoclopramide reduced the peak plasma concentration of digoxin from 1.5 +/- 0.2 ng/ml to 1.1 +/- 0.1 ng/ml (mean +/- SEM) (p = 0.05), cisapride lowered the peak concentration to 1.3 +/- 0.1 ng/ml (p = 0.14). Metoclopramide prolonged the time required to reach the peak concentration of digoxin from 2 hr to 2.7 hr (p = 0.17), cisapride did not. Digoxin AUC0-12 (743 +/- 79 ng/ml.min) was reduced by 12% on coadministration of cisapride (653 +/- 38 ng/ml.min, p = 0.22) and by 19% on coadministration of metoclopramide (605 +/- 34 ng/ml.min, p = 0.06). It is concluded that the gastrointestinal absorption of digoxin is reduced by both substances. Monitoring of the patient's clinical status should be recommended when metoclopramide and cisapride are coadministered.


Dialysis encephalopathy and aluminum exposure: an epidemiologic analysis.
We identified 55 patients with dialysis encephalopathy in six dialysis centers studied by means of a uniform clinical classification. Dialysis encephalopathy was the direct cause of death in most cases, and the disease appeared to significantly shorten survival. The overall attack rate of dialysis encephalopathy was 4% and varied among dialysis centers from 2.2% to 14.7%. In two centers with adequate data, the attack rate for dialysis encephalopathy rose significantly with increasing cumulative aluminum exposure via dialysate, and the mean cumulative aluminum exposure for patients with the disease was significantly higher than that for all other patients at risk. We further demonstrated that the cumulative level of aluminum tolerated by the patient before onset of symptoms was inversely related to the average aluminum concentration of dialysate water.


Effect of a biguanide (buformin) on carnitine palmitoyltransferase activity.
Buformin at a concentration of 1--2.5 mM stimulates solubilized carnitine palmitoyltransferase by reducing the inhibitory effect of palmitoyl-CoA. Neither buformin nor metformin inhibits the solubilized carnitine palmitoyltransferase.


Variability in intraosseous flush practices of emergency physicians.
Intramedullary pressure changes during intraosseous (IO) procedures have been implicated in the intravasation of bone marrow fat and with pain in conscious patients. The objective of this study was to demonstrate inter-provider variability in pressures generated during initial flush procedures. IO cannulas were inserted into the proximal tibiae and humeri by study personnel. A second cannula was placed in the mid diaphysis of each bone to record intramedullary pressures. Fifteen emergency physicians performed 60 flushes in random order in two cadavers while flush duration and IO pressure were continuously recorded. Providers were blinded to the flush pressures they generated and the flush techniques of others. The median IO pressure (IOP) generated by providers was 903 mm Hg (range, 83-2941 mm Hg) and the median flush duration was 5.2 seconds (range, 1.0-13.4 seconds). Significant differences were noted among providers in peak IOP generated (analysis of variance P<.001). Providers were consistent in the forces they generated relative to each other. An inverse, nonlinear relationship was observed between flush duration and the peak IOP generated. Significant differences were noted in intramedullary flush pressures at flush sites within cadavers (analysis of variance P: cadaver #1 P<.001; cadaver #2 P=.012). The IO compartment pressures generated by physicians demonstrated significant interoperator variability with greater than 35-fold difference in flush forces, and an inverse relationship between intraosseous pressure and flush duration. It may be prudent practice for providers to extend the flush over several seconds, thus limiting maximal pressures.