The potential protective effect of melatonin and N-acetylcysteine alone and in combination on opioid-induced testicular dysfunction and degeneration in rat.
Methadone (Met) is the most common treatment for opioid addiction. Although Met is effective for treatment of opioid dependence, sexual dysfunctions and infertility have been reported as a major problem in patients under Met treatment. The present study aimed to evaluate the effect of melatonin and N-acetylcysteine (N) on morphine and Met-induced oxidative stress, apoptosis, suppression of blood sexual hormones, impairment in sperm parameters, and sexual dysfunction. Adult male Wistar rats (n = 66) were randomly divided into 11 equal groups (n = 6) as follows: control, sham, morphine, Met, Met+N, Met+ melatonin, Met+melatonin+N, morphine+ Met, morphine+Met+ melatonin, morphine+Met+N, and morphine+Met+ melatonin+N groups. On day 56 post-treatment, the blood was collected from the tail and the serum levels of sex hormones were evaluated, then the rats were sacrificed, and their bilateral testes and epididymis were retrieved for histological, immunohistochemical, molecular, testicular tissue stress oxidative status, and sperm parameters assays. Exposure to morphine, Met, and shift of morphine to Met resulted in testicular degeneration that can be attributed to generating the stress oxidative-induced- apoptotic testicular cell death and impairing spermatogenesis. Melatonin and N alone and particularly, in combination with each other improved testicular degeneration, sex hormone suppression, and testicular function mediated by increasing the testicular antioxidant capacity and inhibition of the apoptosis pathway. It's suggested that oral administration of antioxidants may be an effective treatment for attenuating some opioid-related testicular dysfunction and degeneration.


Genetic variation in liver X receptor alpha and risk of ischemic vascular disease in the general population.
Although animal studies indicate that liver X receptor alpha (LXRα) might influence risk of atherosclerosis, data in humans remain scarce. We tested the hypothesis that genetic variation in LXRα associates with risk of ischemic vascular disease and/or plasma lipid and lipoprotein levels in the general population. We studied 10,281 white persons of Danish ancestry from a general population cohort, including 1,986 in whom ischemic heart disease (IHD) developed, and 989 in whom ischemic cerebrovascular disease developed. We examined another 51,429 white persons of Danish ancestry from a general population study, including 3,789 with IHD. We genotyped 10 genetic variants identified by resequencing LXRα. Homozygosity for -840AA/-115AA(=2.7%) predicted hazard ratios of 1.3 (95% confidence interval, 1.0-1.7) for IHD, 1.6 (1.2-2.2) for myocardial infarction, and 1.7 (1.3-2.4) for ischemic cerebrovascular disease. The corresponding odds ratios in the second cohort were 1.1 (0.9-1.4) for IHD and 1.5 (1.1-2.0) for myocardial infarction. In the combined studies, odds ratios were 1.2 (1.0-1.4) for IHD and 1.5 (1.2-1.9) for myocardial infarction. Homozygosity for -840AA/-115AA did not associate with lipid or lipoprotein levels. LXRα -1830T>C (tagging the haplotype -1830C/-840A/-115A, all r(2)≥0.97) associated with 91% increased transcriptional activity. This study suggests that functional genetic variation in LXRα predicts risk of ischemic vascular disease in the general population.


Diagnostic accuracy evaluation of the ImmunoFlow HCV rapid immunochromatographic test for the detection of hepatitis C antibodies.
2% of the world's population lives with a hepatitis C virus (HCV) infection with highest rates in developing countries. The most common mode of transmission takes place via unsafe blood transfusions and unsafe therapeutic injections. Thus, screening potential blood donors for hepatitis C infection is a must to ensure safe blood transfusions. Rapid immunochromatographic tests are the best suitable test format to be used for screening for blood donors in resource-limited settings. The ImmunoFlow HCV from Core Diagnostics was evaluated at the Paul-Ehrlich-Institute, Germany for its test accuracy on three seropanels. Panel 1 consisted of 26 HCV positive and 55 negative samples, panel 2 of 193 HCV positive samples. Panel 3 contained 116 samples of 10 patients during seroconversion period. 39 of these 116 samples were characterized as HCV positive. The HCV ImmunoFlow had a sensitivity of 100% (95% CI: 93.5-100) and a specificity of 100% (95% CI: 86.8-100) when samples of panel 1 were tested. 191 samples of the 193 samples in panel 2 were correctly by the HCV Immunoflow, resulting in a sensitivity of 99.0%. 9 of 10 HCV infections were detected by the HCV ImmunoFlow when panel 3 was used. This evaluation revealed good sensitivity of the HCV ImmunoFlow test from and compares favorably with the results from the WHO evaluation and a systematic review conducted of field evaluations of Hepatitis C rapid diagnostic and other point of care tests.


Maternal postnatal high-fat diet, rather than gestational diet, affects morphology and mTOR pathway in skeletal muscle of weaning rat.
The positive regulation of insulin pathway in skeletal muscle results in increased activity of the mammalian target of rapamycin (mTOR), a positive effector of mRNA translation rate and protein synthesis. Studies that assess the activity of this protein in response to chronic high-fat diet (HFD) are scarce and controversial, and to date, there are no studies evaluating the mTOR pathway in infants exposed to gestational and postgestational HFD. This study investigated the effect of maternal HFD on skeletal muscle morphology and on phosphorylation of proteins that comprise the intracellular mTOR signaling pathway in soleus muscle of offspring at weaning. For this purpose, 10 days prior to conception, 39 female Wistar rats were randomly assigned to either control diet (CTL) or HFD. Later, rats were distributed into four groups according to gestational and postpregnancy diet: CTL/CTL (n=10), CTL/HF (n=11), HF/HF (n=10) and HF/CTL (n=8). After 21 days of lactation, pups were killed, and blood samples and soleus and gastrocnemius skeletal muscle were collected for analysis. We observed an influence of maternal postgestational diet, rather than gestational diet, in promoting an obese phenotype, characterized by body fat accumulation, insulin resistance and high serum leptin, glucose, triglycerides and cholesterol levels (P<.05). We have also detected alterations on skeletal muscle morphology--with reduced myofiber density--and impairment on S6 kinase 1 and 4E binding protein-1 phosphorylation (P<.05). These results emphasize the importance of maternal diet during lactation on muscle morphology and on physiological adaptations of infant rats.


A call to action: Temporal trends of COVID-19 deaths in the South African Muslim community.
Letter by Omar on letter by Jassat et al. (Jassat W, Brey Z, Parker S, et al. A call to action: Temporal trends of COVID-19 deaths in the South African Muslim community. S Afr Med J 2021;111(8):692-694. https://doi.org/10.7196/SAMJ.2021.v111i8.15878); and response by Jassat et al.


The versatility of the serratus anterior free flap in head and neck reconstruction.
Review the literature on the use of the serratus anterior free flap in the head and neck reconstruction and describe new applications of the serratus anterior free flap. Case series with retrospective chart review and literature review. A PubMed literature review was performed using the search terms "serratus free flap," "serratus skull base," "serratus scalp," and "serratus free tissue transfer." One hundred and seventy-six articles were identified, 22 of which included at least one head and neck reconstructive case utilizing the serratus free flap. Twenty-two articles were identified since 1982 that discussed the use of the serratus anterior free flap for reconstruction in the head and neck. However, most of these were harvested in conjunction with latissimus muscle. We present a case series of 15 patients in whom the serratus anterior muscle free flap was used alone for head and neck reconstruction. In seven of these patients, we used the serratus for coverage of the newly created pharynx after total laryngectomy, which has not previously been reported. The serratus anterior free muscle flap has great versatility in reconstruction of the head and neck. Because of its low donor site morbidity, thinness, and pliability, as well as its ease of harvest, it is ideal for reconstruction of the skull base and scalp. We have also found that it is ideal for muscle coverage of the newly reconstructed pharynx after total laryngectomy. 4. Laryngoscope, 127:568-573, 2017.


Clinical evaluation of a 1,450-nm diode laser as adjunctive treatment for refractory facial acne vulgaris.
Despite aggressive multitreatment medical acne regimens, many patients demonstrate modest benefit. The 1,450-nm diode laser has been shown to improve acne in a study setting. Herein we evaluate the use of this laser as an adjunctive tool in the management of refractory facial acne vulgaris. Thirteen patients were treated. Lesion counts, clinical evaluation, and digital photography were performed at baseline and at all follow-up visits. Patients received an average of three treatments. Acne severity index and patient satisfaction were assessed. Patients continued their medical acne regimen where applicable. RESULTS Mean total lesion and inflammatory lesion counts decreased from 66 +/- 14 and 23 +/- 5 at baseline to 34 +/- 12.9 and 14 +/- 7 after three treatments (p<.05). Side effects were mild, including erythema lasting up to 24 hours. The 1,450-nm diode laser provides moderate improvement of refractory acne vulgaris. Our findings support the use of this device as an adjunctive treatment for acne management.


Preliminary SAR and biological evaluation of potent HIV-1 protease inhibitors with pyrimidine bases as novel P2 ligands to enhance activity against DRV-resistant HIV-1 variants.
Introducing pyrimidine bases, the basic components of nucleic acid, to P2 ligands might enhance the potency of Human Immunodeficiency Virus-1 (HIV-1) protease inhibitors because of the carbonyl and amino groups promoting the formation of extensive hydrogen bonding interactions. In this work, we provide evidence that inhibitor 10e, with N-2-(2,4-Dioxo-3,4-dihydropyrimidin-1(2H)-yl) acetamide as the P2 ligand and a 4-methoxylphenylsulfonamide as the P2' ligand, displayed remarkable enzyme inhibitory and antiviral activity, with the IC50 2.53 nM in vitro and a promising inhibition ratio with 68% against wild-type HIV-1 in vivo, with low cytotoxicity. This inhibitor also exhibited appreciable antiviral activity against DRV-resistant HIV-1 variants, which was of great value for further study.


Exposure-response relationships between woodworking, smoking or passive smoking, and squamous cell neoplasms of the maxillary sinus.
A case-control study of squamous cell neoplasms of the maxillary sinus was performed in Hokkaido during 1982-86, with 169 cases and 338 controls matched for sex, age, and residence. The data were analyzed by a stepwise forward-selection method based on a conditional logistic-regression model without interaction terms, log-likelihood ratio tests, and chi-square tests for trend. Statistically significant linear trends were observed for associations between the risk of squamous-cell maxillary-sinus neoplasms and the duration of woodworking among men, the daily or lifetime amount of smoking among men, and the number of smokers in the household as an index of domestic exposure to cigarette smoke among women.


Syntenin increases the invasiveness of small cell lung cancer cells by activating p38, AKT, focal adhesion kinase and SP1.
Syntenin is a PDZ domain-containing adaptor protein that has been recently shown to regulate migration and invasion in several tumors. Small cell lung cancer (SCLC) is notorious for its invasiveness and strong potential for metastasis. We therefore studied the influence of syntenin on the invasiveness of SCLC. Immunohistochemistry in tumor tissues showed that syntenin was more frequently expressed in small cell carcinomas than other neuroendocrine tumors, such as carcinoids and neuroblastomas, suggesting that syntenin expression may be related to more aggressive forms of neuroendocrine tumors. In SCLC patients, syntenin overexpression in tumor cells was significantly associated with more extensive and advanced disease at the time of diagnosis (P=0.029). Overexpression of syntenin in SCLC cells that were intrinsically syntenin-low increased the invasiveness of cells and led to the induction of extracellular matrix (ECM)-degrading membrane type 1-matrix metalloproteinase (MT1-MMP) and matrix metalloproteinase 2 (MMP2). In contrast, suppression of syntenin in syntenin-high cells was associated with the downregulation of MT1-MMP. Contrary to the results of previous studies using malignant melanomas and breast carcinomas, signaling cascades were shown to be further transduced through p38 MAPK and PI3K/AKT, with activation of SP1 rather than NF-κB, under circumstances not involving ECM interaction. In addition, the upstream molecule focal adhesion kinase was induced by syntenin activation, in spite of the absence of ECM interaction. These results suggest that syntenin might contribute to the invasiveness of SCLC and could be utilized as a new therapeutic target for controlling invasion and metastasis in SCLC.


Variation in skin surface lipid composition among the Equidae.
Skin surface lipids from Equus caballus, E. przewalskii, E. asinus, E. grevyi, E. hemionus onager and a mule (E. asinus/E. caballus) were analyzed in detail. In all species the surface lipid mixtures consisted of giant-ring lactones, cholesterol, cholesteryl esters and minor amounts of wax diesters. In E. caballus, the lactone hydroxyacids were entirely branched chained, while in E. asinus and E. grevyi they were almost exclusively straight chained. In E. przewalskii, the onager and the mule there were both straight and branched chain hydroxyacid lactones. These results are in harmony with published interpretations of the evolutionary relationships among Equus species.


Intracellular distribution of endothelin-1 receptors in rat liver cells.
We studied the binding of (125I)-endothelin-1 as well as that of the vasopressin analogue (125I)-[8-phenylpropionyl]-LVP to purified plasma membranes, Golgi cisternae and cell nuclei from rat liver. Cell organelles were isolated by differential centrifugation and discontinuous sucrose gradients. Endothelin-1 exhibited specific binding to plasma membranes, Golgi cisternae and nuclei, while the binding of (125I)-[8-phenylpropionyl]-LVP was restricted to the plasma membranes. The number of receptors (Bmax) and the binding constants (Kd) were determined by Scatchard analysis of competition binding studies. In all cases only one class of Et-1 binding sites could be detected. The presence of Et-1 receptors on the Golgi complex either indicates that the receptor is glycosylated within the cisternae or alternatively, there exists a recycling pathway. The unexpected finding of Et-1 receptors on highly purified nuclei suggests that this peptide may exert part of its biological functions intracellularly via the nucleus.


Effect of grazing disturbance on floral display, pollen limitation and plant pollination efficiency in the desert steppe.
Grazing disturbance usually affects floral display and pollination efficiency in the desert steppe, which may cause pollen limitation in insect-pollinated plants. Effective pollination is essential for the reproductive success of insect-pollinated plants and insufficient pollen transfer may result in pollen limitation. Caragana microphylla Lam is an arid region shrub with ecological importance. Few studies have been conducted on how grazing disturbance influences pollen limitation and pollination efficiency of C. microphylla. Here, we quantify the effect of different grazing intensities on floral display, pollinator visitation frequency and seed production in the Urat desert steppe. In C. microphylla, supplemental hand pollination increased the seed set, and pollen limitation was the predominant limiting factor. As the heavy grazing significantly reduced the seed set in plants that underwent open-pollination, but there was no significant difference in the seed set between plants in the control plots and plants in the moderate grazing plots. Furthermore, there was a higher pollinator visitation frequency in plants in the control plots than in plants in the heavy grazing plots. We found that pollinator visitation frequency was significantly associated with the number of open flowers. Our findings also demonstrated that seed production is associated with pollinator visitation frequency, as indicated by increased seed production in flowers with higher pollinator visitation frequency. Therefore, this study provides insight into the effect of different grazing intensities on floral display that are important for influencing pollinator visitation frequency and pollination efficiency in desert steppes.


F-spondin regulates the differentiation of human cementoblast-like (HCEM) cells via BMP7 expression.
Cementum plays an important role in the attachment of connective tissue to the root surface. However, the detailed mechanism of cementum formation has not yet been clarified. We previously established human cementoblast-like cell lines (HCEM) and human periodontal ligament cell lines (HPL) by infection of hTERT gene. Using those cell lines, we compared the gene expression of them and identified F-spondin as a cementoblast specific gene. In this study, to clarify the role of F-spondin in the differentiation of periodontal ligament cells to cementoblasts, we compared the gene expression of F-spondin-overexpressed HPL (HPL-spondin) cells with HPL parent cells. We found that several genes expressed higher level in HPL-spondin cells than in HPL cells, such as heparin sulfate 6-sulfotranferase, calcitonin-related polypeptide beta, bone morphogenetic proteins 7 (BMP7), BMP2 and BMP8B. Among those genes, we focused on BMP7 and examined the interaction between F-spondin and BMP7, because BMP7 was reported to enhance cementoblast function. Moreover, we further examined the effect of BMP7 peptide on the expression of mineralization-associated genes in HCEM cells. RT-PCR and real-time PCR analyses showed that HPL-spondin expressed BMP7, but not HPL cells. And BMP7 and phospho-Smad1/5/8 protein production were detected in HPL-spondin by Western blot. siSPON1 inhibited expression of type I collagen, runt-related transcription factor 2 (RUNX2) and bone sialoprotein (BSP) mRNA in HCEM cells. And the mineralization tended to be decreased in siSPON1 treated cells by ALZ staining and the quantification analysis. Moreover, we examined the effect of BMP7 peptide on the gene expressions of HCEM cells by RT-PCR. Increase of the osteopontin and BSP mRNA was observed in BMP7 treated HCEM cells. These findings indicate that F-spondin regulates the differentiation of HCEM cells via BMP7 expression.


The development and healing of pressure sores related to the nutritional state.
The aims of the study were to investigate the relationship between nutritional state and the development of pressure sores and to test the hypothesis that supplementary nutritional support might prevent pressure sore development and improve healing. Newly admitted long-term care patients hospitalised for more than 3 weeks were included and randomised into an experimental and a control group. The nutritional state was evaluated using serum protein analyses, anthropometry and the delayed hypersensitivity skin test. Further, the patients' condition was assessed weekly using a modified Norton scale. The experimental group received extra nutritional support. Significantly more patients with protein-energy malnutrition had, or developed, pressure sores. Regression analyses indicated albumin, mobility, activity and food intake as predictors for pressure sores. Patients who received extra nutritional support tended to develop fewer pressure sores and to heal existing pressure sores to a greater extent than the control group, although this did not reach statistical significance.


Smartphone-based app for evaluating cardiothoracic residents: Feasibility and engagement.
Timely and high-quality feedback is important in cardiothoracic (CT) surgery education. Feedback on operative proficiency is an area for improvement in CT surgery programs. Traditional evaluations significantly lag behind operative interactions. We hypothesized that use of the System for Improving and Measuring Procedural Learning (SIMPL) app would improve operative feedback for trainees. Use of SIMPL was evaluated from December 2018 to January, 2021 within an academic CT surgery training program. Ratings include level of supervision, complexity of the operation, and trainee performance. Completion was limited to 72 h after the operation. Descriptive statistics of the users and ratings are presented. Over 28 months, 816 evaluations were completed, and of these, 495 had a rating from both the faculty and trainee. There were 19 trainees representing post-graduate years 1-8 and 19 faculty members who received or submitted at least one evaluation over the study period. The number of evaluations for each trainee ranged from 1 to 166 and from 1 to 81 for each of the faculty. The response rate for faculty ranged from 0% to 100%. "Active help" was the most common type of supervision (50.7% by the faculty, 60.4% from the trainees). Use of SIMPL within a CT surgery training program was feasible and engagement was observed from both trainees and faculty. SIMPL provided trainees with timely, concise feedback on operative performance. Further work will focus on correlating SIMPL ratings with pre-existing assessments of performance.


Strongyloides stercoralis daf-2 encodes a divergent ortholog of Caenorhabditis elegans DAF-2.
We hypothesise that developmental arrest in infectious larvae of parasitic nematodes is regulated by signalling pathways homologous to Caenorhabditis elegans DAF (dauer formation) pathways. Alignment of Strongyloides stercoralis (Ss) DAF-2 with DAF-2 of C. elegans and homologs of other species shows that most structural motifs in these insulin-like receptors are conserved. However, the catalytic domain of Ss-DAF-2 contains two substitutions (Q1242 and Q1256), that would result in constitutive dauer formation in C. elegans or diabetes in vertebrate animals. Ss-daf-2 also shows two alternately spliced isoforms, the constitutively expressed Ss-daf-2a, and Ss-daf-2b, which is only expressed in stages leading to parasitism.


Sleep health and its related influencing factors in primary and middle school students in Fuzhou: A large multi-center cross-sectional study.
This current study set out to investigate the status of sleep health in 7-20-year-old students in Fuzhou and explore the related influencing factors of sleep health. A total of 38,467 children and adolescents in Fuzhou were included in the study through a random stratified cluster sampling. Data were collected from May to June 2019, in 18 primary schools and 18 middle schools from nine districts, Fuzhou. Children's parents and adolescents of sampled classes were invited to fill out a series of questionnaires about the performance of the last 6 months (sociodemographic characteristics, sleep-related lifestyle behaviors, and electronic-products usage). Multiple linear regression was carried out to analyze data. Of the total 40,888 questionnaires we released, 38,467 were valid and effective with the response rate was 94.08%. The age of the surveyed participants was 11.85 ± 3.1, including 20,013 boys and 18,454 girls. The multiple linear regression analysis identified factors associated with sleep health (p < 0.05): Boy (coef = 0.073, 95% CI: 0.030-0.115), age (coef = 1.797, 95% CI: 0.224-0.243), key school (coef = 2.069, 95% CI: 0.105-0.193), urban (coef = 0.096, 95% CI: 0.054-0.139), excessive daytime sleepiness (coef = 0.535, 95% CI: 0.432-0.639), unhealthy sleep habits (coef = 0.363, 95% CI: 0.307-0.419), eating before sleep (coef = 0.578, 95% CI: 0.527-0.630), using electronic products in bedroom (coef = 0.074, 95% CI: 0.028-0.121), screen time per day during school (coef = 0.260, 95% CI: 0.235-0.284), frequency of using electronics 30 min before bedtime (coef = 0.150, 95% CI: 0.134-0.166), strained relationship with parents (coef = 0.361, 95% CI: 0.270-0.452), strained relationship with peers (coef = 0.267, 95% CI: 0.171-0.363), excessive homework or learning (coef = 0.189, 95% CI: 0.141-0.237), time for doing homework (coef = 0.266, 95% CI: 0.245-0.287), and mood swings frequently (coef = 1.174, 95% CI: 1.127-1.221) negatively impact sleep health. Sleep alone (coef = -0.204, 95% CI: -0.262-0.147) were the risk factors for sleep health. Furthermore, frequent mood swings was considered the most influential factor on overall variables. Sleep health is associated with factors covered sociodemographic characteristics, family sleep habits, and routine activities before bedtime. Multiple measures should be taken to improve sleep quality in a targeted manner.


The effect of mood on food versus non-food interference among females who are high and low on emotional eating.
Emotional eating refers to overeating triggered by emotional experiences and may cause significant psychological distress and health problems. Thus, it is important to better understand its underlying mechanisms. The study examined if the ability to ignore task-irrelevant information, namely, interference control, is modulated by mood and exposure to food stimuli among females who are high and low on emotional eating. The study's sample included 80 women who were high (N = 40) or low (N = 40) on an emotional eating scale. Participants were divided to a negative or neutral mood induction group. Following the mood induction, they completed a food-flanker task that allowed assessing attentional interference caused by food and non-food stimuli separately. The low emotional eating group had significantly greater food compared to non-food interference, suggesting difficulty at ignoring food stimuli while attending a neutral target. In the high emotional eating group, there was no difference between food and non-food interference. However, higher levels of emotional eating predicted lower levels of food interference. The pattern of results suggests a food-avoidance attentional tendency among those with higher levels of emotional eating. The mood manipulation did not influence food-related interference in either group. The lack of an effect of mood on food-related interference questions the impact of negative emotions on basic attentional processes among individuals with emotional eating.


Glycemic control, atherosclerosis, and risk factors for cardiovascular disease in individuals with diabetes: the atherosclerosis risk in communities study.
Glycemic control (HbA(1c) [A1C]) is strongly associated with microvascular disease in individuals with diabetes, but its relation to macrovascular disease and atherosclerosis is less clear. This study examines the relationship between A1C, carotid intima-media thickness (IMT), and traditional cardiovascular risk factors in individuals with diabetes. A cross-sectional study of 2,060 people with diagnosed and undiagnosed (unrecognized) diabetes in the Atherosclerosis Risk in Communities study was performed. LDL and HDL cholesterol, plasma triglycerides, and waist-to-hip ratio were significantly associated with A1C after multivariable adjustment. African Americans with undiagnosed and diagnosed diabetes had significantly elevated A1C values compared with whites, even after adjustment for potentially confounding factors. There was a graded association between A1C and carotid IMT. In a fully adjusted model in individuals with undiagnosed diabetes, the odds ratio (OR) of being in the highest quartile of IMT versus the lowest was 2.46 (95% CI 1.16-5.03, comparing the highest quartile of A1C to the lowest). In people with diagnosed diabetes, the comparable OR was 2.62 (1.36-5.06). This study identified several important associations between A1C and known risk factors for cardiovascular disease and suggested that A1C is independently related to carotid IMT. Chronically elevated glucose levels may contribute to the development of atherosclerosis in people with diabetes, independent of other risk factors.


Can strict volume control be the key for treatment and prevention of posterior reversible encephalopathy syndrome in hemodialysis patients?
Posterior reversible encephalopathy syndrome (PRES) is a rare but if diagnosed late an irreversible disease. The majority of the patients present with severe hypertension, and effective blood pressure control is the mainstay of therapy. In this case report, we present three cases with PRES, treated successfully with strict volume control policy and propose that strict volume control policy may be a key element for the treatment of PRES.


Reaction of bone nanostructure to a biodegrading Magnesium WZ21 implant - A scanning small-angle X-ray scattering time study.
Understanding the implant-bone interaction is of prime interest for the development of novel biodegrading implants. Magnesium is a very promising material in the class of biodegrading metallic implants, owing to its mechanical properties and excellent immunologic response during healing. However, the influence of degrading Mg implants on the bone nanostructure is still an open question of crucial importance for the design of novel Mg implant alloys. This study investigates the changes in the nanostructure of bone following the application of a degrading WZ21 Mg implant (2wt% Y, 1wt% Zn, 0.25wt% Ca and 0.15wt% Mn) in a murine model system over the course of 15months by small angle X-ray scattering. Our investigations showed a direct response of the bone nanostructure after as little as 1month with a realignment of nano-sized bone mineral platelets along the bone-implant interface. The growth of new bone tissue after implant resorption is characterized by zones of lower mineral platelet thickness and slightly decreased order in the stacking of the platelets. The preferential orientation of the mineral platelets strongly deviates from the normal orientation along the shaft and still roughly follows the implant direction after 15months. We explain our findings by considering geometrical, mechanical and chemical factors during the process of implant resorption. The advancement of surgical techniques and the increased life expectancy have caused a growing demand for improved bone implants. Ideally, they should be bio-resorbable, support bone as long as necessary and then be replaced by healthy bone tissue. Magnesium is a promising candidate for this purpose. Various studies have demonstrated its excellent mechanical performance, degradation behaviour and immunologic properties. The structural response of bone, however, is not well known. On the nanometer scale, the arrangement of collagen fibers and calcium mineral platelets is an important indicator of structural integrity. The present study provides insight into nanostructural changes in rat bone at different times after implant placement and different implant degradation states. The results are useful for further improved magnesium alloys.


Factors correlated with adolescents' use of crack in public schools.
This study was undertaken to evaluate factors correlated with crack use by 479 adolescents in 1992 in Dade County, Florida public schools. Based upon self-reports, after application of the Bonferroni correction, only two variables were related to crack use, i.e., having friends who use crack and living alone.


Adult participation in youth sports. A developmental perspective.
Societal and familial forces of enormous emotional intensity have contributed to the growth of youth sports during the twentieth century, and continue to affect adult participation in children's athletics. This article addresses the historical evolution of youth sport programs, then identifies opportunities for adults to facilitate developmental progress and surmount emotional obstacles as they interact in sport activities with children ranging from preschool ages through adolescence. Youth sports are viewed as offering tremendous opportunities to teach not only physical skills and playing strategies, but also psychological skills and coping strategies that have applicability throughout life. A developmental rationale is provided to support recommendations for parents and coaches. Child and adolescent psychiatrists are faced with the challenge of collaborating with other professionals and making their knowledge base available to the volunteers who coach in and support youth sport programs.


Effect of intragranular porosity on compression behaviour of and drug release from reservoir pellets.
In this study, reservoir pellets were prepared and their compression behaviour as well as the importance of their porosity for compression-induced changes in drug release was investigated. Pellets of three different porosities, consisting of microcrystalline cellulose and salicylic acid, were prepared by extrusion-spheronisation and spray-coated with ethyl cellulose (ethanol solution). Lubricated reservoir pellets were compressed and retrieved by deaggregation of the tablets. The retrieved pellets were analysed regarding porosity, thickness, surface area, shape and drug release. It was found that the coating did not significantly affect their compression behaviour. Compaction of pellets of high original porosity considerably affected densification and degree of deformation, whereas the effect on drug release was minor. For low porosity pellets the influence of compaction on drug release was appreciable, but only slight regarding densification and degree of deformation. In conclusion, the porosity of pellets is a potential factor that the formulator can use to optimize drug release and one that can affect the robustness of a formulation during manufacture. Moreover, the coating may be able to adapt to the densification and deformation of the pellets.


"...those left behind." Biology and oncology of invasive glioma cells.
Although significant technical advances in surgical and radiation treatment for brain tumors have emerged in recent years, their impact on clinical outcome for patients has been disappointing. A fundamental source of the management challenge presented by glioma patients is the insidious propensity of the malignant cells to invade into adjacent normal brain. Invasive tumor cells escape surgical removal and geographically dodge lethal radiation exposure. Recent improved understanding of the biochemistry and molecular determinants of glioma cell invasion provide valuable insight to the underlying biological features of the disease, as well as illuminating possible new therapeutic targets. Heightened commitment to migrate and invade is accompanied by a glioma cell's reduced proliferative activity. The microenvironmental manipulations coincident to invasion and migration may also impact the glioma cell's response to cytotoxic treatments. These collateral aspects of the glioma cell invasive phenotype should be further explored and exploited as novel antiglioma therapies.


Characteristics of volatile organic compounds and secondary organic aerosol pollution in different functional areas of petrochemical industrial cities in Northwest China.
The aim of this study was to better understand the characteristics of volatile organic compounds (VOCs) and secondary organic aerosol (SOA) pollution in different functional areas of petrochemical industrial cities. In Lanzhou, a typical petrochemical industrial city in Northwest China, with the use of an Integrated Atmospheric Mobile Monitoring Vehicle (IAMMV), various real-time online monitoring instruments, including a VOC monitoring instrument (TH-300B) and single-particle aerosol mass spectrometer (SPAMS), were used in combination. These instruments were employed to determine PM2.5, VOCs and other factors at monitoring sites in Xigu (XG) and Chengguan (CG) districts in September 2020 and 2021, respectively. The results revealed that during the monitoring period, the average VOC concentrations at the XG and CG monitoring sites were 102.3 and 35.8 ppb, respectively. Benzene (45.58 %) and toluene (24.47 %) significantly contributed to the SOA formation potential at the XG site. M/P-xylene (27.88 %) and toluene (23.64 %) more notably contributed to the SOA formation potential at the CG site. The PM2.5 mass concentration at the XG site (24.1 μg·m-3) was similar to that at the CG site (21.2 μg·m-3), but the proportion of particulate matter components greatly differed. The proportion of organic carbon (OC) at the XG site (19.00 %) was higher than that at the CG site (9.97 %). The number of particles containing C2H3O+ (m/z = 43) accounted for 36.96 % and 15.41 % of the total particles at the XG and CG sites, respectively. The mixing ratios of OC and hybrid carbon (OCEC) with C2H3O+ (m/z = 43) were 0.81 and 0.53, respectively, at the XG site and reached only 0.48 and 0.25, respectively, at the CG site. The secondary ageing degree of particles in XG district was high. These results could provide a reference for ambient air quality improvement and the formulation of governance measures in different functional areas of petrochemical industrial cities.


Postnatal changes in sarcolemmal organization in the mdx mouse.
The tibialis anterior muscles of mdx mice degenerate between 3 and 4 weeks after birth and then partially recover. We show that the membrane cytoskeleton at the mdx sarcolemma is disorganized at 18-days postnatal, and becomes more disorganized at 4 weeks compared to earlier or later times. Mdx muscle at 18 days have few central nuclei, suggesting that it has not yet sustained significant damage. The variance of myofiber diameter confirms that the mdx pathology is greatest at 4 weeks, when the sarcolemma is most disorganized. Sarcolemmal disorganization in the mdx does not involve contractile structures, nor is it seen in age-matched controls. In revertant mdx fibers expressing dystrophin, sarcolemmal organization is similar to controls. Our results suggest that the absence of dystrophin results in the disorganization of the sarcolemma, even in 18-day-old mice, and that the extent of disorganization is greater when the myopathy is most severe.


Temporal Differences in Concussion Symptom Factors in Adolescents following Sports-Related Concussion.
To evaluate temporal differences in concussion symptoms up to 30 days following a sports-related concussion. Adolescent and young adult athletes (n = 782) were separated based on time since injury at presentation as Early (0-7 days; n = 321, age: 15.4 ± 1.9 years, 51.7% female), Middle (8-14 days; n = 281, age: 15.8 ± 2.2 years, 54.8% female), and Late (15-30 days; n = 180, age: 15.6 ± 1.8 years, 52.8% female). All participants completed the 22-item Post-Concussion Symptom Scale at first visit. A confirmatory factor analysis was completed separately for each time since injury cohort using a 4-component model reported previously. The confirmatory factor analysis model fit was acceptable for Early, Middle, and Late (using cognitive-migraine-fatigue, affective, sleep, and somatic factors). Both affective (change = 0.30; P = .01; Cohen d = 0.30) and sleep (change = 0.51; P ≤ .001; Cohen d = 0.47) factors were significantly greater in the Late group compared with the Early, but not Middle, groups. The previously reported 4-factor symptom model, including cognitive-migraine-fatigue, affective, somatic, and sleep factors, was appropriate for adolescents up to 30 days' postinjury. However, adolescents who presented between 15 and 30 days' postinjury reported greater affective and sleep symptoms than those who presented within 1 week. Clinicians should consider these temporal differences when evaluating concussion symptoms in adolescents, as greater affective and sleep symptoms can be predictive of prolonged recovery/persistent complications.


Autometallography: tissue metals demonstrated by a silver enhancement kit.
In biological tissue, minute accumulations of gold, silver, mercury and zinc can be visualized by a technique whereby metallic silver is precipitated on tiny accumulations of the two noble metals, or on selenites or sulphides of all four metals. In the present study a silver enhancement kit, primarily intended for the amplification of colloidal gold particles, has been used to demonstrate these catalytic tissue metals. Sections from animals exposed intravitally to aurothiomalatate, silver lactate, mercury chloride, sodium selenite or perfused with sodium sulphide were subjected to a commercial silver enhancement kit (IntenSE, Janssen Pharmaceutica). It was found that the kit performs adequately to the silver lactate gum arabic developer and to the photographic emulsion technique. The kit can be used as a silver enhancement medium for the demonstration of zinc by the Neo-Timm and selenium methods and for demonstration of gold, silver, and mercury in tissues from animals intravitally exposed to these metals. It can also be used for counterstaining silver treated osmium fixed tissues embedded in plastic.


Solitary spindle-cell xanthogranuloma of the eyelid.
To describe a rare presentation of a solitary spindle-cell xanthogranuloma in a 3-year-old boy with a 6-month history of a right upper lid soft tissue lesion. Interventional case report. An excisional full-thickness biopsy of the right upper lid was performed. Histologic examination and immunohistochemistry of the specimen were performed. Histopathologic evaluation revealed a well-demarcated nodule arising from the tarsus that contained a storiform array of spindle cells admixed with numerous multinucleated giant cells (some Touton type) and lymphocytes. The spindle cells labeled with antibodies to Factor XIIIa, CD68, lysozyme, Mac 387, and vimentin. The multinucleate giant cells labeled with CD68, lysozyme, and vimentin. Findings were consistent with the diagnosis of solitary spindle-cell xanthogranuloma. Spindle-cell xanthogranuloma resembles juvenile xanthogranuloma and fibrous histiocytoma (dermatofibroma) and should be considered in the differential diagnosis of spindle-cell tumors of the eyelid and periocular region. If similar lesions are noted elsewhere, the diagnosis of progressive nodular histiocytoma should be considered.


Cytotoxicity of 2D engineered nanomaterials in pulmonary and corneal epithelium.
Two-dimensional (2D) engineered nanomaterials are widely used in consumer and industrial goods due to their unique chemical and physical characteristics. Engineered nanomaterials are incredibly small and capable of being aerosolized during manufacturing, with the potential for biological interaction at first-contact sites such as the eye and lung. The unique properties of 2D nanomaterials that make them of interest to many industries may also cause toxicity towards epithelial cells. Using murine and human respiratory epithelial cell culture models, we tested the cytotoxicity of eight 2D engineered nanomaterials: graphene (110 nm), graphene oxide (2 um), graphene oxide (400 nm), reduced graphene oxide (2 um), reduced graphene oxide (400 nm), partially reduced graphene oxide (400 nm), molybdenum disulfide (400 nm), and hexagonal boron nitride (150 nm). Non-graphene nanomaterials were also tested in human corneal epithelial cells for ocular epithelial cytotoxicity. Hexagonal boron nitride was found to be cytotoxic in mouse tracheal, human alveolar, and human corneal epithelial cells. Hexagonal boron nitride was also tested for inhibition of wound healing in alveolar epithelial cells; no inhibition was seen at sub-cytotoxic doses. Nanomaterials should be considered with care before use, due to specific regional cytotoxicity that also varies by cell type. Supported by U01ES027288 and T32HL007013 and T32ES007059.


Survival outcome and prognostic factors in anaplastic oligodendroglioma: a single-institution study of 95 cases.
The aim of this study was to evaluate prognostic factors including surgical, radiographic, and histopathologic analyses in anaplastic oligodendroglioma (AO) patients. We reviewed the electronic records of 95 patients who underwent surgery and were diagnosed with AO for 20 years. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Univariate and multivariable analyses included clinical, histopathological, and radiographic prognostic factors. Subgroup analysis was performed in isocitrate dehydrogenase (IDH1/2)-mutant and 1p/19q-codeleted patients. The median PFS and OS were 24.7 months and 50.8 months, respectively. The 1-, 3-, 5-, and 10-year PFS were 75.8%, 42.9%, 32.4%, and 16.4%, respectively. Furthermore, the 1-, 3-, 5-, and 10-year OS were 98.9%, 76.9%, 42.9%, and 29.7%, respectively. The median PFS and OS of the IDH1/2-mutant and 1p/19q-codeleted patients were 54.2 and 57.8 months, respectively. In univariate analyses, young age, frontal lobe, weak enhancement, gross total resection (GTR), low Ki-67 index, 1p/19q codeletion, and IDH1/2 mutations were associated with a favorable outcome. In multivariable analyses, IDH1/2 mutation was related to better PFS and OS. In subgroup analysis, GTR was associated with favorable outcomes.


Impact of the scout view orientation on the radiation exposure and image quality in thoracic and abdominal CT.
To assess the impact of the scout view orientation on radiation exposure and image quality in thoracoabdominal CT, when automated tube voltage selection (ATVS) and automated tube current modulation (ATCM) are used in combination with scan planning on a single scout view. Fifty patients underwent two thoracoabdominal CT examinations, one planned on an anteroposterior scout view, one planned on a lateral scout view. Both examinations included contrast-enhanced imaging of chest (CH) and abdomen (AB) and non-contrast-enhanced imaging of the liver (LI). For all examinations the same imaging protocol was used on the same dual-source CT scanner. The radiation exposure was recorded and objective as well as visual image quality was assessed for all examinations. The median dose-length product was significantly lower in scans planned on a lateral scout view (CH: 179 vs. 218 mGy*cm, LI: 148 vs. 178 mGy*cm, AB: 324 vs. 370 mGy*cm, p < 0.0001). Objective image quality was marginal lower in scans planned on a lateral scout view, whereas the visual image quality was rated as equal. At the tested radiation doses, the orientation of the scout view has a significant impact on the radiation exposure but no clinically relevant impact on the image quality. • The scout view orientation has a significant impact on the radiation exposure. • The scout view orientation has no clinically relevant impact on image quality. • A lateral scout view should be preferred with regard to radiation exposure.


Successful pregnancy outcome in advanced chronic renal failure.
A 24 years female of advanced chronic renal failure due to lupus nephritis presented with pregnancy of eight weeks duration she continued the pregnancy against medical advice. At 29 weeks gestation further deterioration of renal function prompted weekly dialysis and hospitalisation for intensive maternal and fetal monitoring. At 35 weeks she was safely delivered by elective caesarian section. This is the first case of dialysis during pregnancy to be reported from India.


Amyloid: toward terminology clarification. Report from the Nomenclature Committee of the International Society of Amyloidosis.
The modern nomenclature of amyloidosis now includes 25 human and 8 animal fibril proteins. To be included in the list, the protein has to be a major fibril protein in extracellular deposits, which have the characteristics of amyloid, including affinity for Congo red with resulting green birefringence. Synthetic fibrils with amyloid properties are best named 'amyloid-like'. With increasing knowledge, however, the borders between different protein aggregates tend to become less sharp.


Testicular ultrasonography after chemotherapy for germ cell neoplasm: significance of highly hyperechoic lesions.
The sonographic appearance of the testis after administration of chemotherapy for metastatic germ cell neoplasm is not well known. Fifty-six patients (60 testes) who were previously treated with chemotherapy for metastatic germ cell neoplasm (originally diagnosed by removal of the contralateral testis or by biopsy of metastatic disease) underwent sonography followed by orchiectomy. The sonographic characteristics found to predict viable intratesticular tumor were: lesion size larger than 5 mm, fewer echoes than adjacent parenchyma (hypoechoic), inhomogeneous echo texture, poor margin definition, cystic areas, or highly hyperechoic foci within a hypoechoic lesion. Fibrosis was predicted by finding single or multiple small, highly hyperechoic lesions. These results suggest the potential for predicting the pathologic diagnosis in some patients after receiving chemotherapy for germ cell neoplasm.


Phycoremediation for carbon neutrality and circular economy: Potential, trends, and challenges.
Phycoremediation is gaining attention not only as a pollutant mitigation approach but also as one of the most cost-effective paths to achieve carbon neutrality. When compared to conventional treatment methods, phycoremediation is highly effective in removing noxious substances from wastewater and is inexpensive, eco-friendly, abundantly available, and has many other advantages. The process results in valuable bioproducts and bioenergy sources combined with pollutants capture, sequestration, and utilization. In this review, microalgae-based phycoremediation of various wastewaters for carbon neutrality and circular economy is analyzed scientometrically. Different mechanisms for pollutants removal and resource recovery from wastewaters are explained. Further, critical parameters that influence the engineering design and phycoremediation performance are described. A comprehensive knowledge map highlighting the microalgae potential to treat a variety of industrial effluents is also presented. Finally, challenges and future prospects for industrial implementation of phycoremediation towards carbon neutrality coupled with circular economy are discussed.


Transient neutropenia in a patient receiving cimetidine.
Transient neutropenia developed in a 62-year-old, white male on maintenance hemodialysis being treated with cimetidine for an in tractable duodenal ulcer. The probable mechanism was peripheral destruction of the granulocyte series, unlike the marrow depression reported with metiamide, another histamine H2 receptor antagonist.


Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients.
To test the clinical counterpart of the learned nonuse theory, 25 chronic hemiplegic stroke and head-injured patients with minimal to moderate upper extremity extensor muscle function were required to keep their uninvolved upper extremities within a hand-enclosed sling during waking hours over a 2-week interval. During this forced use period and for 1 year thereafter, changes in force or time-based measures among 21 functional tasks were compared to values at the sixth baseline session, a preintervention time when relearning had plateaued. Significant (P less than 0.05, Friedman's repeated measures followed by Tukey multiple comparison tests) changes were seen in 19 of the 21 tasks with most persisting at the 1-year follow-up. There were no apparent differences between right- and left-sided involvement or between stroke versus head injury clients (Mann-Whitney procedure). Ratings for quality of movement scored from videotapes presented in random order showed no change over time. These data suggest that learned nonuse does occur in select neurological patients and that this behavior can be reversed through application of a forced use paradigm.


Understanding cancer caregiver burden over time: Dyadic assessments of family cohesion, conflict and communication.
Previously we identified three distinct cancer communication concordance groups among cancer patient-caregiver dyads. This secondary analysis examined patient and caregiver reports of family functioning (cohesion and conflict) as associated with cancer communication concordance and assessed each as independent predictors of perceived caregiver burden among hematological cancer caregivers. A case series of hematological cancer patient-caregiver dyads (n = 171) were recruited from oncology clinics in Virginia and Pennsylvania and followed for 2 years. Using the previously identified communication groups this analysis prospectively examines patient and caregiver perceptions of family cohesion and conflict and the association with burden over time. Caregiver burden decreased over time. Caregiver, but not patient perceptions of family cohesion decreased over time; decreased cohesion and increased conflict was associated with greater cancer communication discordance. This work lends further support to the use of cancer communication congruence typologies for identifying potentially vulnerable dyads. Discordant cancer communication and declining caregiver perceptions of family cohesion may represent opportunities to intervene using family focused supportive services. Only caregiver perceptions of family functioning were associated with burden therefore identifying and supporting those caregivers with worsening communication and family function is important.


Vascular Complications of the Wrist: Prevention and Management.
Transradial access has increased in utilization and has been shown to be superior compared with transfemoral access. Although infrequent, several transradial access site-related complications occur. By understanding potential mechanisms related to these complications, several prevention and treatment strategies can be implemented to mitigate adverse outcomes.


Water requirements of terrestrial and epiphytic orchid seeds and seedlings, and evidence for water uptake by means of mycotrophy.
The use of endomycorrhizal fungi as an energy source (=mycotrophy) initiates seedling development and supplements or replaces photosynthesis in all orchids in nature. Fungus-infected and non-infected seeds of the monkey face orchid, Platanthera integrilabia, a US Federally-threatened terrestrial species, had a different set of water relations than seeds of the green fly orchid, Epidendrum conopseum, a subtropical epiphyte. Seeds of the terrestrial species had lower water loss rates, smaller activation energies for water loss and absorbed water from lower relative humidities. Thus, the epiphyte lacks the enhanced water retention capacity associated with the terrestrial species, implying that epiphytic orchids are capable of germinating quickly given an adequately moist substrate. After germination, water content of fungus-infected seeds was higher. These results provide first time fundamental information related to habitat preference by analyzing seed. Germination is considerably enhanced with mycorrhizal fungi that facilitate the absorption of free water by their orchid seed hosts.


Nitric oxide and noradrenaline contribute to the temperature threshold of the axon reflex response to gradual local heating in human skin.
The initial skin blood flow response to rapid local heating is an axon reflex, which may be mediated by calcitonin gene-related peptide and substance P released from C-fibres. We investigated the role of nitric oxide (NO) and noradrenaline on the temperature threshold for the axon reflex during gradual local heating. 36 subjects participated in two studies. Using microdialysis, we examined the following interventions: NO synthase inhibition (10 mM N(G)-nitro-L-arginine methyl ester, L-NAME); low-dose NO infusion (1.0 microM sodium nitroprusside, SNP); adrenergic blockade (10 mM bretylium tosylate); and low-dose (0.1 microM) noradrenaline infusion. Laser-Doppler flowmetry was used to measure red blood cell flux. Skin was heated at a rate of 0.1 degrees C min(-1) from 33 degrees C to 40 degrees C. Compared to control skin sites, the axon reflex response was shifted to a higher temperature in 4 subjects in the L-NAME sites (control, 37.0 +/- 0.3 degrees C, n = 16; L-NAME, 39.8 +/- 0.1 degrees C, n = 4; P < 0.001) and absent in 12 subjects. The response was also absent in L-NAME plus low-dose SNP sites and not altered by low-dose SNP infusion alone. Adrenergic blockade, with and without low-dose noradrenaline infusion, also abolished the axon reflex response in all subjects. Low-dose noradrenaline infusion alone shifted the axon reflex to a significantly lower temperature threshold compared to control sites (control, 38.2 +/- 0.5 degrees C; noradrenaline, 37.7 +/- 0.4 degrees C, P < 0.05, n = 5). These results suggest that endogenous NO and noradrenaline contribute to the temperature threshold of the axon reflex response during gradual local heating of the skin.


Preliminary validation of the Chinese version of the Pediatric Quality of Life Inventory.
The Pediatric Quality of Life Inventory (PedsQL) is a scale for assessing health-related quality of life of children and adolescents aged 2--18 years. Three reports of PedsQL for the age ranges 2--4 years and 5--7 years were translated into Chinese and their validities were examined. A total of 186 children and parents were involved in the study. Content validity, test-retest reliability, internal consistency reliability and construct validity were assessed. The correlation of parents' and children's reports was also examined. The results showed that the internal consistency is generally good, test-retest reliability ranged from moderate to good, differences between disabled and non-disabled individuals are significant in total scores and in all subscales except for the physical functioning subscale for the children's self-report for the age ranges of 2-4 years and 5-7 years and the correlation between the reports of the parents and children for the age range of 5-7 years is moderate to high. This suggests that the newly translated Chinese PedsQL for children aged 2-4 years and 5-7 years seems to be reliable and valid to be used as a measure of health-related quality of life in Chinese pediatric research and clinical applications.


Benefits of intervention in the Central Auditory Nervous System in individuals with Neurofibromatosis Type 1.
To verify the effectiveness of acoustically controlled auditory training in individuals with Neurofibromatosis Type 1. The sample consisted of individuals with Neurofibromatosis Type 1, randomly distributed into two groups, making up the intervention group: individuals undergoing formal auditory training; and the comparison group: individuals who were not submitted to the intervention. Behavioral assessment of central auditory processing and electrophysiological evaluation, composed by Brainstem Auditory Evoked Potential and Long Latency-P300 Auditory Evoked Potential, were evaluated in three moments of evaluations: initial evaluation, reevaluation and after four months of reevaluation and comparing the performance between the groups. Better performances in central auditory processing were observed after the formal auditory training in the intervention group with significant differences between the evaluations and performance maintenance four months after the end of the training. Significant differences were observed between the groups in the evaluations after the intervention. The electrophysiological evaluation shows unsystematic variation in the short latency potentials and changes in the long latency potentials with the appearance of the P3 wave after the intervention. The behavioral and electrophysiological evaluation in group that was not submitted to the intervention demonstrated that there is no improvement without the intervention, with deterioration of performance. Significant differences were observed in the behavioral and electrophysiological evaluations, in favor of the group submitted to formal auditory training. Formal auditory training is effective in rehabilitation in individuals with Neurofibromatosis Type 1. Neurofibromatosis 1; Hearing Disorders; Auditory Perceptual Disorders; Acoustic Stimulation; Evoked Potentials, Auditory.


Tie-2Cre mediated deletion of the vitamin D receptor gene leads to improved skeletal muscle insulin sensitivity and glucose tolerance.
A variety of studies have suggested that vitamin D may play a palliative role in improving insulin secretion and glucose tolerance. Endothelial cells of the microcirculation are thought to play an important role in regulating both insulin secretion and insulin sensitivity in target tissues. We have selectively deleted the vitamin D receptor (VDR) gene in endothelial cells of the murine vasculature. These mice demonstrate improved glucose tolerance, improved insulin sensitivity in skeletal muscle, but not in liver, and a reduction in expression and secretion of insulin in the pancreatic islets. Collectively, these data, taken within the context of recent publications in this field, suggest that the endothelial cell VDR plays a tonic inhibitory role in regulating glucose disposal and could prove to be a factor in controlling glucose homeostasis in the intact organism.


Double origin of an occlusion after gastric bypass: Intestinal intussusception contained in a Petersen hernia.
Roux-en-Y gastric bypass (RYGB) is a surgical technique described in 1970 and performed laparoscopically since 1993. Occlusions are late complications that most often occur more than 6 months after surgery. Internal hernias and intussusception are the two clinical situations that can occur after RYGB. The presentation is that of an occlusion or chronic abdominal pain. Diagnosis can be made by imaging, including abdominal and pelvic CT scans, with ingestion and injection of contrast agents if possible. Treatment is based on surgical exploration.


Large language models and the emergence phenomena.
This perspective explores the potential of emergence phenomena in large language models (LLMs) to transform data management and analysis in radiology. We provide a concise explanation of LLMs, define the concept of emergence in machine learning, offer examples of potential applications within the radiology field, and discuss risks and limitations. Our goal is to encourage radiologists to recognize and prepare for the impact this technology may have on radiology and medicine in the near future.


Mitochondrial DNA evolution in the obscura species subgroup of Drosophila.
Mitochondrial DNA (mtDNA) restriction site maps for nine species of the Drosophila obscura subgroup and for Drosophila melanogaster were established. Taking into account all restriction enzymes (12) and strains (45) analyzed, a total of 105 different sites were detected, which corresponds to a sample of 3.49% of the mtDNA genome. Based on nucleotide divergences, two phylogenetic trees were constructed assuming either constant or variable rates of evolution. Both methods led to the same relationships. Five differentiated clusters were found for the obscura subgroup species, one Nearctic, represented by Drosophila pseudoobscura, and four Palearctic, two grouping the related triads of species Drosophila subobscura, Drosophila madeirensis, Drosophila obscura, Drosophila subsilvestris, and two more represented by one species each, Drosophila bifasciata, and Drosophila tristis. The different Palearctic clusters are as distant between themselves as with the Nearctic one. For the related species D. subobscura, D. madeirensis, and D. guanche, the pair D. subobscura-D. madeirensis is the closest one. The relationships found by nucleotide divergence were confirmed by differences in mitochondrial genome size, with related species sharing similar genome lengths and differing from the distant ones. The total mtDNA size range for the obscura subgroup species was from 15.5 kb for D. pseudoobscura to 17.1 for D. tristis.


HHV-8-unrelated primary effusion-like lymphoma associated with clonal loss of inherited chromosomally-integrated human herpesvirus-6A from the telomere of chromosome 19q.
Primary effusion lymphomas (PEL) are associated with human herpesvirus-8 (HHV-8) and usually occur in immunocompromised individuals. However, there are numerous reports of HHV-8-unrelated PEL-like lymphomas with unknown aetiology. Here we characterize an HHV-8-unrelated PEL-like lymphoma in an elderly woman who was negative for human immunodeficiency viruses 1 and 2, and hepatitis B and C. The woman was, however, a carrier of an inherited-chromosomally-integrated human herpesvirus-6A (iciHHV-6A) genome in one 19q telomere. The iciHHV-6A genome was complete in blood DNA, encoding a full set of protein-coding genes. Interestingly, the entire iciHHV-6A genome was absent from the HHV-8-unrelated-PEL-like lymphoma cells despite retention of both copies of chromosome 19. The somatic loss of the 19q-iciHHV-6A genome occurred very early during lymphoma development and we propose it occurred via telomere-loop formation and excision to release a circular viral genome that was subsequently lost. Whether release of the HHV-6A genome from the telomere contributed to lymphomagenesis, or was coincidental, remains unclear but this event may have deregulated the expression of HHV-6A or 19q genes or else disrupted telomere function. To establish the frequency and importance of iciHHV-6 loss from telomeres, the HHV-6 copy number should be assessed in tumours that arise in iciHHV-6 carriers.


Adductor canal block provides better performance after total knee arthroplasty compared with femoral nerve block: a systematic review and meta-analysis.
The methods for pain control after total knee arthroplasty (TKA) vary and have been extensively studied in recent years. Femoral nerve block (FNB) is used as the standard method due to its effective pain control following TKA, but it may weaken the quadriceps strength. Adductor canal block (ACB) is a newly developing analgesic protocol with fast functional recovery and good pain control after TKA. A meta-analysis was conducted to try to find out if ACB is better than FNB in pain treatment and joint functional recovery after TKA. The databases PubMed, Web of Science, Embase, and Cochrane Library were systematically searched. Of 66 records identified, eight randomised controlled trials (RCT) involving 434 patients (504 knees) were eligible for data extraction and meta-analysis according to criteria included. Meta-analysis showed that ACB can significantly decrease visual analogue scale (VAS) score at rest within eight hours (p < 0.001) and at 24 hours (p < 0.001) after operation compared to FNB after TKA, and improve quadriceps strength (p < 0.001) and mobilization ability (p < 0.001). However, the differences in VAS score at rest at 48 hours, VAS score with activity within two days after operation, opioid consumption, hip adductor strength, patient satisfaction, and tourniquet times were not significant between the two groups. ACB provide better ambulation ability, faster functional recovery and better pain control at rest after TKA compared to FNB. The use of ACB post TKA is worthy of being recommended to replace FNB as a standard analgesic protocol for pain treatment after TKA.


Assessing the effects of psychotherapy. I. Analysis and critique of present conventions of estimating change.
The use of the difference between pre- and posttherapy status as an estimate of change and of the regression transformation as an adjustment for initial status variation is discussed in reliability and scaling terms. Also, the quantitative view of psychotherapeutic change implied by difference scores is set in contrast to a qualitative view of change as inner (re)structuring. Further, it is argued that psychotherapeutic goals should be conceived in terms of metapsychology rather than as the acquisition of desirable surface traits. Finally, the therapeutic and research consequences of testing and interviewing are compared.


Effects and safety of high-frequency rTMS in acute intracerebral hemorrhage patients: A pilot study.
Although high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) in chronic intracerebral hemorrhage (ICH) is beneficial, it has been poorly investigated in rTMS for acute ICH. Our aim is to investigate the effects and safety of rTMS in acute spontaneous ICH. We prospectively performed HF-rTMS on consecutive patients with ICH within 24 h from onset between April 2019 and August 2021. The inclusion criterion was (1) persistent paralysis, with an NIHSS scale of 1 or higher for at least 3 days after onset. The exclusion criteria were (1) cortical, subcortical, and cerebellar ICH, (2) disturbance of consciousness, and (3) over 80 years of age. For the purpose of comparison, we used a conventional rehabilitation group whose patients met the same criteria between April 2016 and March 2019. We evaluated incidence of epilepsy and exacerbation of the NIHSS score in the rTMS group. We also compared the two groups regarding clinical background and outcome. Enrolled in the study were a total of 44 patients. Of the patients, 22 (50%) were in the rTMS group. The median (IQR) time from onset to the start of rTMS was 9 (6-12) days. There were no cases of epilepsy or exacerbation of NIHSS after the start of rTMS. Favorable outcome (modified Rankin Scale score of between 0 and 2) at 3 months was frequently observed in the rTMS group (73% vs 27%, p = 0.006). HF-rTMS was independently associated with favorable outcome at 3 months (OR = 11.5, 95% CI = 2.194-60.447, p = 0.004). HF-rTMS may be safe and effective in acute ICH patients.


Structure of mouse ADP-ribosylhydrolase 3 (mARH3).
ADP-ribosylation is a reversible and covalent post-translational modification in which the attachment of ADP-ribose is catalyzed by ADP-ribosyltransferases and the removal of ADP-ribose is catalyzed by ADP-ribosylhydrolases. ADP-ribosylhydrolase 3 from mouse, consisting of 347 amino-acid residues, has been cloned, purified and crystallized. The three-dimensional structure has been resolved at a resolution of 1.8 A. The structure constitutes a compact all-alpha-helical protein with two Mg(2+) ions located in the active-site crevice. A structural comparison of mouse ADP-ribosylhydrolase 3 with its human orthologue shows a high degree of structural similarity. Furthermore, four prokaryotic proteins deposited in the PDB could be identified as being structurally related.


Identifying pollution dynamics using discrete Fourier transform: From an urban-rural river, Central Mexico.
The quality of life and human survival is dependent on sustainable development and sanitation of water bodies in an environment. The present research focuses on cyclicity data of more than 750,000 records of parameters associated with the water quality from a rural-urban river monitoring stations in real-time from River Atoyac in Central Mexico. The events detected in the instrumental records correlated with 2528 laboratory and instrumental determinations. The 64 polluting compounds were grouped into inorganic compounds (metals and metalloids) and organic compounds (pesticides, herbicides, hydrocarbons). Metal associated compounds were grouped along mechanical, pharmaceutical and textile industries which associates itself with the entry of polluting components. The cyclicity of the events was detected through Discrete Fourier Transformation time series analysis identifying the predominant events in each station. These highlight the events at 23-26 h corresponding to a circadian pattern of the metabolism of the city. Likewise, pollution signals were detected at 3.3, 5.5, and 12-14 h, associated with discharges from economic activities. Multivariate statistical techniques were used to identify the circadian extremes of a regionalized cycle of polluting compounds in each of the stations. The results of this research allow pollution prevention using a mathematical analysis of time series of different quality parameters collected at monitoring stations in real-time as a tool for predicting polluting events. The DFT analysis makes it possible to prevent polluting events in different bodies of water, allowing to support the development of public policies based on the supervision and control of pollution.


Effects of aging on the various steps of protein synthesis: fragmentation of elongation factor 2.
The possible mechanism responsible for the in vivo protein synthesis decline during aging was studied. In order to determine the effect of aging on the various steps of protein synthesis, we determined the ribosomal state of aggregation and the time of assembly and release of polypeptide chains in the process of protein synthesis in rat liver. The results suggest that elongation is the most sensitive step to aging. A molecular study of the Elongation Factor 2 (EF-2), the main protein involved in the elongation step, shows that this protein has a higher content of carbonyl groups and is less active in old rats. In addition, the molecular mass analysis of EF-2 shows that this protein becomes fragmented in old rats. A similar pattern of fragmentation is found in 3-month-old rats suffering oxidative stress, in that the decline in protein synthesis is similar to that found in old rats. These data suggest that: i) oxidative stress seems to be involved in the modifications of EF-2 observed during aging, and ii) the observed modifications (oxidation and fragmentation) of EF-2 could account for the decline in protein synthesis in old animals.


Trappings of femininity: A test of the "beauty as currency" hypothesis in shaping college women's gender activism.
This study investigated whether believing beauty is a primary currency for women operates as an antecedent force in the relation between self-objectification and gender activism. Ninety-four ethnically diverse women attending a small liberal arts college in the southeastern United States completed the study questionnaires online for course credit. Preliminary results demonstrated beauty as currency belief, self-objectification, and support for the gender status quo were negatively associated with gender activism. A serial mediation analysis revealed support for the proposed model: Beauty as currency belief was indirectly and inversely linked to gender activism through self-objectification and support for the gender status quo, offering initial evidence for our beauty as currency hypothesis. These findings suggest belief in the notion women will reap more benefits from their bodies than other attributes or pursuits may be an important legitimizing feature of feminine beauty ideology that works through self-objectification against gender social change.


The laxative effect of emodin is attributable to increased aquaporin 3 expression in the colon of mice and HT-29 cells.
Emodin (1,3,8-trihydroxy-6-methylanthraquinone) is a stimulant laxative and used to treat constipation. Aquaporin 3 (AQP3) plays an important role in regulating water transfer in the colon. In the study, we investigated whether the laxative effect of emodin is associated with the regulation of AQP3 in the colon. Our results showed that treatment with emodin increased the fecal water content in the colon of mice and evaluation index of defecation in a dose-dependent manner. More interestingly, emodin significantly increased the AQP3 protein and mRNA expression both in the colon of mice and in human intestinal epithelial cells (HT-29). Mechanistically, emodin obviously up-regulated the cyclic adenosine monophosphate (cAMP)-dependent protein kinase A catalytic subunits α (PKA C-α) and phosphorylated cAMP response element-binding protein (p-CREB Ser133) expression in HT-29 cells. These results suggest that the laxative effect of emodin is associated with the increased expression of AQP3 by up-regulating PKA/p-CREB signal pathway.


Internet integrated in the daily medical practice within an electronic patient record.
Healthcare enters the information age and professionals are finding an ever-growing role for computers in the daily practice of medicine. However, a number of problematic issues are associated with electronic publications, especially through Internet. Whilst access to any information has been improved, access to specific information has become more and more difficult [1], due to the lack of a general meta-knowledge allowing to structure Internet resources. Physicians have to learn and adapt themselves to computers and Internet, but Internet has to meet the specific requirements of Healthcare. Important issues must therefore be addressed to allow a real and daily use of Internet in the medical practice. The paper discusses most of these issues and proposes a solution developed at the University Hospital of Geneva that integrates an Electronic Patient Record with Internet, without compromises on security or on performances and that runs on standard PCs'.


Effects of cord clamping timing in at-term elective cesarean section on maternal and neonatal outcomes: a randomized trial.
This study aimed to compare the effects of early cord clamping (ECC), delayed cord clamping (DCC), and umbilical cord milking (MC) on maternal and neonatal outcomes in elective cesarean births. We analyzed 204 women with uncomplicated at-term singleton pregnancies, who underwent cesarean birth under regional anesthesia between March and July 2021. The women were randomized into three groups: DCC (clamped 60 s postpartum), ECC (clamped within 15 s postpartum), or MC (clamped after milking five times) group. The neonatal and maternal outcomes of the groups were evaluated. The duration of the operation was significantly lower (P < 0.001) in the MC group at 50 min (ECC, 60 min; DCC, 60 min), while intraoperative bleeding was significantly higher (P < 0.001) in the ECC group at 500 mL (DCC, 300 mL; MC, 225 mL). The rates of anemia and polycythemia significantly differed (P = 0.049) between the three groups. DCC and MC did not negatively affect maternal and neonatal outcomes compared with ECC. DCC and MC are superior to ECC in terms of short-term maternal and neonatal outcomes in cases of elective cesarean birth under regional anesthesia.


Utilization of desktop 3D printer-fabricated "Cost-Effective" 3D models in orthognathic surgery.
In daily practice, three-dimensional patient-specific jawbone models (3D models) are a useful tool in surgical planning and simulation, resident training, patient education, and communication between the physicians in charge. The progressive improvements of the hardware and software have made it easy to obtain 3D models. Recently, in the field of oral and maxillofacial surgery, there are many reports on the benefits of 3D models. We introduced a desktop 3D printer in our department, and after a prolonged struggle, we successfully constructed an environment for the "in-house" fabrication of the previously outsourced 3D models that were initially outsourced. Through various efforts, it is now possible to supply inexpensive 3D models stably, and thus ensure safety and precision in surgeries. We report the cases in which inexpensive 3D models were used for orthodontic surgical simulation and discuss the surgical outcomes. We explained the specific CT scanning considerations for 3D printing, 3D printing failures, and how to deal with them. We also used 3D models fabricated in our system to determine the contribution to the surgery. Based on the surgical outcomes of the two operators, we compared the operating time and the amount of bleeding for 25 patients who underwent surgery using a 3D model in preoperative simulations and 20 patients without using a 3D model. There was a statistically significant difference in the operating time between the two groups. In this article, we present, with surgical examples, our in-house practice of 3D simulation at low costs, the reality of 3D model fabrication, problems to be resolved, and some future prospects.


A stitch in time saves nine: suture technique does not affect intestinal growth in a young, growing animal model.
Although this issue remains unexamined, pediatric surgeons commonly use simple interrupted suture for bowel anastomosis, as it is thought to improve intestinal growth postoperatively compared to continuous running suture. However, effects on intestinal growth are unclear. We compared intestinal growth using different anastomotic techniques during the postoperative period in young rats. Young, growing rats underwent small bowel transection and anastomosis using either simple interrupted or continuous running technique. At 7-weeks postoperatively after a four-fold growth, the anastomotic site was resected. Diameters and burst pressures were measured. Thirteen rats underwent anastomosis with simple interrupted technique and sixteen with continuous running method. No differences were found in body weight at first (102.46 vs 109.75g) or second operations (413.85 vs 430.63g). Neither the diameters (0.69 vs 0.79cm) nor burst pressures were statistically different, although the calculated circumference was smaller in the simple interrupted group (2.18 vs 2.59cm; p=0.03). No ruptures occurred at the anastomotic line. This pilot study is the first to compare continuous running to simple interrupted intestinal anastomosis in a pediatric model and showed no difference in growth. Adopting continuous running techniques for bowel anastomosis in young children may lead to faster operative time without affecting intestinal growth.


Access to cancer preventive care and program considerations for people experiencing homelessness across four European countries: an exploratory qualitative study.
People experiencing homelessness (PEH) have a higher prevalence of adverse health outcomes and premature mortality compared to the non-homeless population. These include a higher burden of cancer and cancer-specific morbidity and mortality-outcomes that may be a consequence of significant barriers to accessing primary and secondary prevention and community health services. This study aimed to better comprehend the health needs and barriers to accessing preventive cancer care for PEH across four European countries as well as necessary considerations for developing interventions around cancer prevention for this population. In this exploratory qualitative study, 69 semi-structured interviews were conducted across Austria, Greece, Spain, and the UK, with a sample comprising 15 professionals working in homelessness support services, 19 health professionals, and 35 PEH. Interviews took place between August 1 and October 31, 2021, and data were analysed inductively and iteratively following a thematic approach. Findings were organised into two overarching themes: (1) Experiences and understanding of cancer prevention and treatment and (2) Considerations for program interventions. While cancer was a significant worry among PEH across all settings, they generally had minimal knowledge and understanding of cancer symptoms and prevention. Specific programs for cancer prevention for PEH were described as almost non-existent. Health professionals in some settings indicated that cancer in PEH was often missed in the early stages and instead diagnosed when the severity of symptoms intensified. Overall, our findings indicate many commonalities in the health needs of PEH and the barriers they face when they seek access to cancer-specific healthcare services in the European context. This study received funding from the European Union's Horizon 2020 Research and Innovation Programme under GA 965351.


Unusual cutaneous findings in primary systemic amyloidosis. Report of a case.
A case of primary, systemic amyloidosis is reported because of the unique location of cutaneous lesions. Amyloid deposits had occluded both external auditory canals. Both the cutaneous biopsies and postmortem examination established the diagnosis.


Phosphorylated high molecular weight neurofilament protein in lower motor neurons in amyotrophic lateral sclerosis and other neurodegenerative diseases involving ventral horn cells.
Lower motor neurons of the spinal cord of patients with amyotrophic lateral sclerosis (ALS), Werdnig-Hoffmann's disease (WH), X-linked recessive bulbospinal neuronopathy (X-BSNP) and multiple system atrophy (MSA), all of which were known to involve the lower motor neurons, were immunohistochemically examined by using a monoclonal antibody (Ta-51) specific to phosphorylated epitopes of high molecular weight subunits of neurofilaments. The incidence of Ta-51-positive neurons was significantly increased in ALS, WH and MSA, but not in X-BSNP. Ta-51-positive neurons showed a wide variety of morphological appearances, including neurons with normal appearance, central chromatolysis, simple atrophy and neurons containing massive neurofilamentous accumulation. In aged-control cases, similar Ta-51-positive neurons were observed, although to a much lesser extent. In ALS, spheroids and globules, which were strongly positive for Ta-51, were also significantly increased. Ta-51-positive motor neurons, spheroids and globules appeared in proportional to the number of remaining large motor neurons in ALS.


mRNA expression of cytokines and its impact on outcomes after infection with lethal and nonlethal Plasmodium vinckei parasites.
Cytokines play an important role in the defense against malaria and some have long been documented to influence the course of malaria infection in rodents and humans. The present study was conducted to determine the mRNA expression pattern of a few prominent cytokines at different time points during the course of infection with a nonlethal and lethal Plasmodium vinckei rodent malaria parasite, using highly sensitive real-time PCR. Analysis of mRNA expression of cytokines in spleen from infected mice revealed that the principal difference was an early depletion in pro-inflammatory cytokine's mRNA expression in mice infected with lethal P. vinckei (PvAS) parasites. In addition, an increase in anti-inflammatory cytokines particularly IL-10 mRNA expression levels was found in the same group of mice. In contrast, the significant rise in pro-inflammatory cytokine's mRNA expression levels was recorded at day 1 onwards after infection with nonlethal P. vinckei (PvAR). The maximum fold change was recorded for IFN-γ and IL-10, when compared to baseline value. TGF-β did not seem to play any major role in P. vinckei infection.


Evaluation of Anti-diarrheal Potential of Hydro-alcoholic Extracts of Leaves of Murraya koenigii in Experimental Animals.
The indigenous medical system of India mentions the use of Murraya koenigii leaves for the treatment of different types of diarrheas over ages. To evaluate the anti-diarrheal activity of hydro-alcoholic extracts of leaves of Murraya koenigii and to check its effects on intestinal transits in experimental rat model. The hydro-alcoholic extract of Murraya koenigii leaves was obtained with Soxhlet extraction method. Animals were divided into four groups (n = 6) receiving daily for three consecutive days: vehicle, standard drug atropine (3mg/kg, i.p.), leaf extracts 200 & 400 mg/kg respectively in oral route. Effects of the drugs on normal defecation were noted and then castor oil induced diarrhea was used to measure the effects of leaf extract on stool frequency and consistency. Finally, charcoal meal test was used to evaluate the effect of the extract on intestinal transit. Statistical evaluation was done using SPSS version 17, one way ANOVA followed by Dunnett's t-test was done and P< 0.001 was considered as significant. Murraya koenigii leaf extracts in 200 and 400 mg/kg dose reduced stool frequency, increased stool consistency and increased small intestinal transit time. Hydro-alcoholic extract of Murraya koenigii leaves possesses significant anti-diarrheal activity due to its inhibitory effect on gastrointestinal motility, making it useful for a wide number of gastrointestinal diseases.


Tuberculosis at Farmer-Cattle Interface in the Rural Villages of South Gondar Zone of Northwest Ethiopia.
Tuberculosis (TB) has been an important public health concern in Ethiopia, particularly at areas of human-animal intersection. However, limited epidemiological information is available in this respect in the country. Therefore, the present study was conducted to investigate the transmission of TB at human-cattle interface, associated risk factors and public awareness about the disease at South Gondar Zone, northwest Ethiopia. A cross sectional study was conducted between March 2015 and April 2018 on 186 farmers and 476 cattle in South Gondar Zone, northwest Ethiopia. Bacteriological examination, region of difference (RD) 9-based polymerase chain reaction (PCR), single intradermal comparative tuberculin test (SICTT), and questionnaire were used for undertaking this study. Culture positivity in farmers was 59.7% (111/186) and all the culture positive isolates were M. tuberculosis. About 68% (74/111) of culture positive respondents did not know about the transmission of TB from cattle to human or vice versa. The animal and herd prevalence of bovine TB were 1.5% (7/476) and 7.4% (7/95), respectively. Although the result was not statistically significant, the odds of bovine TB in cattle owned by TB positive households was slightly higher than those owned by TB free households (adjusted odds ratio, AOR = 1.39; 95% CI: 0.31-7.10; p = 0.76). Although SIDCTT reactivity was slightly higher in cattle owned by TB positive households, all the human isolates were M. tuberculosis and no M. bovis was isolated from farmers, which could be due to the low prevalence of bovine TB in the area.


Surgical-office-based versus radiology-referral-based breast ultrasonography: a comparison of efficiency, cost, and patient satisfaction.
The differences in efficiency, cost of care, and patient satisfaction between surgical-office-based (SB) breast ultrasonography by the surgeon and radiology-referral-based (RB) ultrasonography by the radiologist in the workup of lumps and imaging abnormalities have not been computed. Charts of 61 consecutive patients requiring breast ultrasonography at the Comprehensive Breast Center from October through December 2005 were evaluated. The SB ultrasonography approach was compared with the RB approach. Matching variables were patient age, presenting complaint, Gail risk score, ultrasonography findings, interventional procedure, and histopathology reports. Outcomes variables were efficiency (time from presentation and establishment of diagnosis), cost of care, and patient satisfaction. Twenty-nine patients had RB and 32 had SB breast ultrasonography. The RB and SB groups were similar in age, Gail risk, and ultrasonography findings. Median time to establish diagnosis in the RB group was 23 days, versus 1 day in the SB group (p < 0.0001). Median cost of care in the RB versus SB group was $659.00 versus $369.50 (p = 0.253), and net revenue generated was $85.00 versus $195.00 (p = 0.005), respectively. Forty-nine of 61 (80.3%) patients responded to the satisfaction survey. Forty-seven of 49 (96%) patients expect the diagnosis to be established within 48 hours. Twenty-eight of 28 (100%) patients in the SB group regarded their imaging study to be efficient, versus 5 of 21 patients in the RB group (p = 0.005); 16 of 21 in the RB group versus 26 of 28 in the SB group thought they adequately understood the ultrasonography findings at the time of study (p = 0.051). Twenty-four (86%) SB patients versus 14 (67%) RB patients rated overall experience as excellent (p = 0.055). SB breast ultrasonography is an efficient, cost-effective, and patient-friendly approach to breast problems.


Portal pressure, presence of gastroesophageal varices and variceal bleeding.
This study was performed to examine the relationships between portal pressure measurements and the presence of esophagogastric varices, the size of varices and the occurrence of hemorrhage from varices in 93 patients with alcoholic cirrhosis, using standardized measurements of portal pressure by hepatic vein catheterization. The mean hepatic vein pressure gradient (HVPG) was significantly higher in 49 patients who had bled from varices than in 44 cirrhotic patients who had not (20.4 +/- 5.1 vs. 16.0 +/- 5.2; p less than 0.001). None of the 49 patients who had bled from varices had an HVPG less than 12 mm Hg. Among the 87 patients who had been examined by endoscopy for varices, all 72 with varices had an HVPG greater than 12 mm Hg. Six of 15 cirrhotic patients without varices had HVPG less than 12 mm Hg. The mean HVPG in the 15 patients without varices (15.1 +/- 6.8 mm Hg) was lower than the 72 patients with varices (19.3 +/- 4.8 mm Hg; p less than 0.01). Of the 72 patients with varices, 40 had large varices, 28 had small varices, and in four patients variceal size could not be assessed adequately. The mean HVPG was similar in the patients with large or small varices (19.8 +/- 4.8 vs. 18.3 +/- 5.0 mm Hg; p greater than 0.10). There was a positive relationship between the presence of large varices and the occurrence of bleeding from varices.(ABSTRACT TRUNCATED AT 250 WORDS)


Determination of chloroquine and its major metabolite in blood using perfluoroacylation followed by fused-silica capillary gas chromatography with nitrogen-sensitive detection.
Tandem fused-silica capillary gas chromatographic methods for the determination of chloroquine and its major metabolite, desethylchloroquine, are described. Method A employs a single extraction step and internal standardization to permit rapid, precise analyses for chloroquine in whole blood. Method B, employing derivatization with pentafluoropropionic anhydride, can then be applied to the extract to allow qualitative and quantitative confirmation of chloroquine and sensitive, precise quantification for desethylchloroquine. The detection limit for chloroquine in blood is 5 ng/ml by both methods; the limit for desethylchloroquine is 15 ng/ml. Excellent precision is achieved by the methodology, partly due to the use of separate internal standards for the two analytes, each internal standard being a close analogue of the corresponding analyte. Data are presented which demonstrate the increase over time of metabolite relative to unchanged chloroquine found in the blood of a volunteer undergoing a chemoprophylactic regimen of chloroquine.


Anticopper therapy against cancer and diseases of inflammation and fibrosis.
Anticopper drugs that have been developed to treat Wilson's disease, a disease of copper toxicity, include tetrathiomolybdate, zinc, penicillamine, and trientine. Lowering copper levels by a modest amount in non-Wilson's patients with tetrathiomolybdate inhibits angiogenesis, fibrosis and inflammation while avoiding clinical copper deficiency. Through this mechanism tetrathiomolybdate has proven effective in numerous animal models of cancer, retinopathy, fibrosis, and inflammation. Penicillamine has efficacy in rheumatoid arthritis and trientine has efficacy in diabetic neuropathy and diabetic heart disease. If clinical studies support the animal work, anticopper therapy holds promise for therapy of cancer, fibrotic disease and inflammatory and autoimmune diseases.


Optodynamers: expression of color and fluorescence at the interface between two films of different dynamic polymers.
Color and fluorescence changes were expressed at the interface between two different polyhydrazone polymer films, induced by hydrazone bond exchange and component recombination through the interface, resulting in an extension of conjugation.


Asymptomatic sacroiliitis detected by magnetic resonance enterography in patients with Crohn's disease: prevalence, association with clinical data, and reliability among radiologists in a multicenter study of adult and pediatric population.
Patients with Crohn's disease (CD) usually undergo magnetic resonance enterography (MRE) for evaluating small bowel involvement. Musculoskeletal symptoms are the most frequent extraintestinal manifestation in inflammatory bowel diseases, especially in CD, with sacroiliitis at imaging occurring in about 6-46% of patients and possibly correlating with axial spondyloarthritis. The primary study aim was to assess the prevalence of sacroiliitis in adult and pediatric patients with CD performing an MRE. We also evaluated the inter-rater agreement for MRE sacroiliitis and the association between sacroiliitis and patients' clinical data. We retrospectively identified 100 adult and 30 pediatric patients diagnosed with CD who performed an MRE between December 2012 and May 2020 in three inflammatory bowel disease centers. Two radiologists assessed the prevalence of sacroiliitis at MRE. We evaluated the inter-rater agreement for sacroiliitis with Cohen's kappa and intraclass correlation coefficient statistics and assessed the correlation between sacroiliitis and demographic, clinical, and endoscopic data (Chi-square and Fisher's tests). The prevalence of sacroiliitis at MRE was 20% in adults and 6.7% in pediatric patients. The inter-rater agreement for sacroiliitis was substantial (k = 0.62, p < 0.001) in the adults and moderate (k = 0.46, p = 0.011) in the pediatric cohort. Age ≥ 50 years and the time between CD diagnosis and MRE (≥ 86.5 months) were significantly associated with sacroiliitis in adult patients (p = 0.049 and p = 0.038, respectively). Sacroiliitis is a frequent and reliable abnormality at MRE in adult patients with CD, associated with the age of the patients ≥ 50 years and CD duration.


Inflammation in preterm and term labour and delivery.
Inflammation has been implicated in the mechanisms responsible for preterm and term parturition, as well as fetal injury. Out of all of the suspected causes of preterm labour and delivery, infection and/or inflammation is the only pathological process for which both a firm causal link with preterm birth has been established and a molecular pathophysiology defined. Inflammation has also been implicated in the mechanism of spontaneous parturition at term. Most cases of histopathological inflammation and histological chorioamnionitis, both in preterm and term labour, are sub-clinical in nature. The isolation of bacteria in the amniotic fluid, known as microbial invasion of the amniotic cavity, is a pathological finding; the frequency of which is dependent upon the clinical presentation and gestational age. There is a window of time during which it may be possible to detect a 'molecular signature of inflammation' by analysis of the transcriptome before histological evidence is observed. This article reviews the role of inflammation in preterm and term parturition. It is possible that modulation of inflammation using anti-inflammatory cytokines, corticoids, antioxidants and/or other factors may complement antibiotic therapy and limit fetal injury.