Physiological Variables Influenced by 'Candidatus Liberibacter asiaticus' Infection in Two Citrus Species.
'Candidatus Liberibacter asiaticus' is the bacterium associated with the citrus disease known as huanglongbing (HLB). This study evaluated the influence of 'Ca. L. asiaticus' infection on a number of key plant physiological variables concerning photosynthesis, cell integrity, reactive oxygen species scavengers' activity, and osmoregulation of two different species of citrus-the pomelo Citrus maxima and the mandarin C. reticulata 'Tankan'-relative to their measured 'Ca. L. asiaticus' infection load. Results indicated that all measured physiological variables except soluble sugar were affected by increased 'Ca. L. asiaticus' infection titers, wherein the variety C. maxima proved overall more resistant than C. reticulata. 'Ca. L. asiaticus' infection was linked in both plants to decrease in chlorophyll concentration, cell membrane permeability, and malondialdehyde, as well as increased free proline and starch contents. Chlorophyll fluorescence measurements taken 9 months after grafting the mandarin C. reticulata with 'Ca. L. asiaticus' scions revealed a significant decrease in the photosynthesis variables maximum photochemical quantum yield of photosystem II (PSII), effective photochemical quantum yield of PSII, and coefficient of photochemical fluorescence quenching assuming interconnected PSII antennae, whereas nonphotochemical fluorescence quenching increased significantly; C. maxima plants, on the other hand, did not show significant differences until the 12th month from infection exposure. The variables superoxide dismutase, catalase, peroxidase, and soluble protein initially increased and later decreased. In addition, progression of 'Ca. L. asiaticus' replication in both citrus species was accompanied by rapid changes in three reactive oxygen species scavenging enzymes in C. maxima, while the pattern was different in C. reticulata. We hypothesize that the observed interspecific differences in physiological change are related to their relative resistance against 'Ca. L. asiaticus' infection. These results provide a scaffold for better describing the pathogenesis, selecting the most resistant breeds, or even validating pertaining omics research; ultimately, these detailed observations can facilitate the diagnosis of 'Ca. L. asiaticus' infection.


Value of virtual bronchoscopic navigation and transbronchial ultrasound-guided sheath-guided exploration in diagnosis of peripheral lung cancer.
Peripheral lung cancer poses a substantial harm to human health, and it is easy to become exacerbated, potentially threatening the life and safety of patients. To assess the value of virtual bronchoscopic navigation (VBN) combined with transbronchial ultrasound-guided sheath-guided (EBUS-GS) exploration in the diagnosis of peripheral lung cancer. A total of 236 patients with peripheral lung cancer (nodule diameter range, 8-30 mm; diagnosed using high-resolution computed tomography) were selected from three centers between October 2018 and December 2019. Patients who underwent EBUS-GS exploration alone were included in a control group, and those who received VBN in combination with EBUS-GS exploration were included in an observation group. The diagnostic rate and total operating time of different subgroups of the two groups were compared, and the time needed to determine the lesion was recorded. There were no significant differences in diagnosis rate or total operation time between the two groups (P > 0.05), and the time needed to determine the lesion in the observation group was less than that of the control group (P < 0.05). The combined use of VBN and EBUS-GS exploration technology has little effect on the diagnosis rate and total operation time of peripheral lung cancer, but it significantly shortens the time needed to determine the lesion and is a valuable diagnostic method.


Isolation, expansion and functional assessment of CD4+CD25+FoxP3+ regulatory T cells and Tr1 cells from uremic patients awaiting kidney transplantation.
The immunosuppressive properties of regulatory T cells have emerged as an attractive tool for the development of immunotherapies in various disease contexts, e.g. to treat transplantation induced immune reactions. This paper focuses on the process of obtaining and functionally characterizing CD4+CD25+FoxP3+ regulatory T cells and Tr1 cells from uremic patients awaiting kidney transplantation. From October 2010 to March 2011 uremic patients awaiting living donor kidney transplantation, and their corresponding kidney donors, were enrolled in the study. A total of seven pairs were included. Isolation of CD4+CD25+FoxP3+ regulatory T cells was performed by magnetic activated cell sorting of peripheral blood mononuclear cells obtained from the uremic patients. Donor specific Tr1 cells were differentiated by repetitive stimulation of immature CD4+ T cells with immature dendritic cells, with the T cells coming from the future kidney recipients and the dendritic cells from the corresponding kidney donors. Cells were then expanded and functionally characterized by the one-way mixed leukocyte reaction and assessment of IL-10 production. Phenotypic analysis was performed by flow cytometry. The fraction of CD4+CD25+FoxP3+ regulatory T cells after expansion varied from 39.1 to 50.4% and the cells retained their ability to substantially suppress the mixed leukocyte reaction in all but one patient (3.8-19.2% of the baseline stimulated leukocyte activity, p<0.05). Tr1 cells were successfully differentiated from all but one patient and produced high levels of IL-10 when stimulated with immature dendritic cells (1,275-11,038% of the baseline IL-10 secretion, p<0.05). It is practically feasible to obtain and subsequently expand CD4+CD25+FoxP3+ regulatory T cells and Tr1 cells from uremic patients without loss of function as assessed by in vitro analyses. This forms a base for adoptive regulatory T cell therapy in the setting of living donor kidney transplantation.


London bombings July 2005: the immediate pre-hospital medical response.
On July 7th 2005 a series of terrorist bombs exploded in London. The transport system was targeted and at least 54 passengers were killed and around 700 injured. This paper describes the immediate pre-hospital medical response to the four scenes. From the perspective of the London Helicopter Emergency Medical Service the deployment, difficulties on scene and the initial lessons learned are discussed.


Glutathione Component of Antioxidant Status in Menopausal Women with Insomnia.
The study involved 138 women aged 45-60 years in perimenopause (n=55) and postmenopause (n=83) with insomnia (main groups) and without it (control). The levels of reduced (GSH) and oxidized (GSSG) glutathione and glutathione peroxidase activity were determined in erythrocytes; activities of glutathione S-transferase and glutathione reductase were measured in blood serum. The differences with the control groups were found only in perimenopause: higher glutathione reductase activity and reduced GSSG level and GSH/GSSG ratio in women with insomnia (p<0.05). The results of the comparative analysis between the main groups showed lower glutathione reductase activity, increased GSSG level, and a decrease the GSH/GSSG ratio in the postmenopausal period compared with the perimenopause (p<0.05). These results can be used in choosing the tactics for complex therapy of insomnia in menopausal women to correct free radical homeostasis and prevention of oxidative stress.


Specificity of arginine vasopressin and angiotensin II for microvessels in the hamster cheek pouch after the induction of renovascular hypertension.
The present study was undertaken to determine the specificity of the vasoconstrictor activity to angiotensin II (AII) and arginine vasopressin (AVP) on the microcirculation in normal and renovascular hypertensive states. Ten to fourteen days after the induction of hypertension, Syrian hamsters were anesthetized with pentobarbital sodium, the cheek pouch was exposed, and a plastic chamber was placed in situ so the membrane could be suffused with bicarbonate-buffered Ringer's solution (5% CO2, 95% N2, pH 7.4). Third order arterioles (30-45 micron) were identified for study and vessel diameter was measured using a shearing device. In one group of normotensive and hypertensive hamsters, AII was microapplied to the arteriole before and after adding an AVP antagonist to the suffusate. In a second group of similar hamsters, AVP was microapplied to the arteriole before and after adding an angiotensin II blocker, saralasin acetate, to the suffusate. AVP and AII receptor blockade was documented by observing whether the vasoconstrictor effect of either AVP or AII was abolished. Dose-response curves for either peptide were not altered in the presence of the antagonist to the other peptide; however, they were shifted to the left in the RHT hamsters. Neither AVP nor AII receptor blockade altered control resting arteriolar diameters. Thus, it can be concluded that the microvascular response to both AII and AVP are potentiated in RHT and there are no interactions between either AII or AVP with the receptors of the other peptide in these microvessels in normal or RHT hamsters, indicating a high specificity for each peptide to its vascular receptor.


Analytical and biological data of banked samples--a requirement to interpret accumulation and leaching of pollutants in biological specimens.
The accumulation of organic and inorganic pollutants in biological specimens depends, in many cases, not only on the atmospheric deposition or immission and contamination of the biotop, but also on the dynamic properties of the indicator. Thus the analytical data assume properties of process variables. In order to compare them in relation to space and time, it is often practical to refer them to defined conditions of the indicator (stationary phases, time cycles of low dynamics). If the accumulation varies consistently under identical conditions of contamination and if clear functional relations exist to the features of the indicator, for instance age, weight or ecological processes, it is necessary to normalize the analytical data, i.e. to refer them to a condition of the indicator which is defined meaningfully with regard to the ecology. Interactions with other inputs of substances may result in a differentiation of accumulation and leaching processes which is more or less specific for each element. Such knowledge is important for specifying the standard operation procedures and the evaluation as well as interpretation of analytic data, in particular, in the clarification of the ecotoxicological relations between the pollutant accumulation and the reaction of populations and ecosystems.


Trophism between C-type axon terminals and thoracic motoneurones in the cat.
1. Quantitative ultrastructural examinations of axon terminals synapsing with normal alpha-motoneurones in segment T9 of cat spinal cord provided estimates of their numbers, sizes and synaptic structure. One synapse, the C type, derived from short-axon propriospinal segmental interneurones, was studied in detail.2. The numbers, sizes and post-synaptic structure of normal C-type synapses at T9 were compared with similar estimates from material provided by cats subjected to partial central deafferentation by double spinal hemisection at T5 and T10 between 7 days and 2 years previously.3. The proportion of C-type synapses present progessively increased from 1% in normal cats to 8.8% 200 days following hemisection, and had still attained a level of 3.1% by 2 years; these increases imply that the absolute number of C-type synapses underwent increase.4. Mean sizes of C-type synapses increased from 4.0 mum (normal) to 5.8 mum (200 days) and retained their enlarged sizes up to 2 years (5.9 mum). Furthermore, while 84% of C-type synapses were under 6 mum in length in normal motoneurones, 48% were over 6 mum long 200 days post-operatively.5. The unique post-synaptic structure of C-type synapses also proliferated following partial central deafferentation of the motoneurones. The elongated cistern, increased numbers and individual lengths of lamellae of the associated underlying rough endoplasmic reticulum indicated a trophic interaction between the presynaptic C terminal and its post-synaptic motoneurone.6. Counts of ribosomes ;bound' to lamellae of the subsynaptic rough endoplasmic reticulum, and of the lamellae-associated polyribosomes interposed between individual lamellae for normal and 200 day post-operative C-type synapses indicated an over-all post-operative increase in capacity for local subsynaptic protein synthesis topographically directed towards this type of axon terminal.7. The observed greater increase in frequency of ribosomes ;bound' to the rough endoplasmic reticulum, together with an over-all proliferation of this structure, specificially indicated an increased capacity for synthesis of protein for utilization in sites remote from those of synthesis (e.g. a trans-synaptic passage of protein).8. A hypothesis is advanced on the basis of the above results relating both pre- and post-synaptic changes in structure to an increased functional activation of the segmental short-axon propriospinal interneurones forming the C-type synapses, as a compensatory response to partial central deafferentation of spinal motoneurones.


Transforming the Medication Regimen Review Process Using Telemedicine to Prevent Adverse Events.
Federally-mandated consultant pharmacist-conducted retrospective medication regimen reviews (MRRs) are designed to improve medication safety in nursing homes (NH). However, MRRs are potentially ineffective. A new model of care that improves access to and efficiency of consultant pharmacists is needed. The objective of this study was to determine the impact of pharmacist-led telemedicine services on reducing high-risk medication adverse drug events (ADEs) for NH residents using medication reconciliation and prospective MRR on admission plus ongoing clinical decision support alerts throughout the residents' stay. Quality improvement study using a stepped-wedge design comparing the novel service to usual care in a one-year evaluation from November 2016 to October 2017. Four NHs (two urban, two suburban) in Southwestern Pennsylvania. All residents in the four NHs were screened. There were 2,127 residents admitted having 652 alerts in the active period. Upon admission, pharmacists conducted medication reconciliation and prospective MRR for residents and also used telemedicine for communication with cognitively-intact residents. Post-admission, pharmacists received clinical decision support alerts to conduct targeted concurrent MRRs and telemedicine. Main outcome was incidence of high-risk medication, alert-specific ADEs. Secondary outcomes included all-cause hospitalization, 30-day readmission rates, and consultant pharmacists' recommendations. Consultant pharmacists provided 769 recommendations. The intervention group had a 92% lower incidence of alert-specific ADEs than usual care (9 vs 31; 0.14 vs 0.61/1,000-resident-days; adjusted incident rate ratio (AIRR) = 0.08 (95% confidence interval (CI) = 0.01-0.40]; P = .002). All-cause hospitalization was similar between groups (149 vs 138; 2.33 vs 2.70/1,000-resident-days; AIRR = 1.06 (95% CI = 0.72-1.58); P = .75), as were 30-day readmissions (110 vs 102; 1.72 vs 2.00/1,000-resident-days; AIRR = 1.21 (95% CI = 0.76-1.93); P = .42). This is the first evaluation of the impact of pharmacist-led patient-centered telemedicine services to manage high-risk medications during transitional care and throughout the resident's NH stay, supporting a new model of patient care.


Dynamics of medicinal plants knowledge and commerce in an urban ecosystem (Pernambuco, Northeast Brazil).
Given the importance of markets and fairs for the commerce of medicinal plants, an ethnobotanical study was undertaken at the Caruaru Fair (Pernambuco, northeastern Brazil) to compare the richness of species sold and their values of relative importance (RI) using two datasets collected with a 4-year interval. The seasonality of these plants' supplies was also analyzed. The Caruaru Fair is located in the 18 de Maio Park. It covers an area 40,000 m(2) and is used by merchants who sell several types of products, such as supplies, handicrafts, clay and aluminum utensils, shoes, clothes and medicinal plants. Semistructured interviews were carried out with the vendors who agreed to take part in the study in order to record which plants were sold and their respective indications. The plants were collected, and the species were determined. The information was analyzed with quantitative tools. A total of 169 plants were identified from both surveys, which were significantly different with regard to species richness (p < 0.05) but did not vary in relation to species' Relative Importance (p > 0.05). In relation to the seasonality of the plant supply, habit may explain the lack of some species during certain periods of the year, as most of the absent plants are herbaceous. In terms of the species most sold locally, it was found that spontaneous tree species are well known and extensively commercialized.


Impact of anti-tuberculosis treatment on hematological parameters in newly diagnosed tuberculosis patients at Jimma town: a longitudinal prospective study.
Tuberculosis (TB) is a significant public health problem affecting one-third of the world's population. In 2021, 1.6 million people died from TB. TB is the 13th leading cause of death and the second leading cause of infectious death after coronavirus disease 2019. Most anti-TB drugs affect hematological parameters in patients. This longitudinal prospective study was conducted from 03 January to 30 December 2019. Patients who completed a course of TB treatment were candidates for analysis. Sputum and blood samples were collected from each study participant and analyzed by the Gene X-pert machine and a HumaCount 30 hematology analyzer (Human GmbH). SPSS version 20 and R programming software version 4.2.3 were used for data analysis. Friedman's test was used to assess statistical significance. P-values less than 0.05 were considered statistically significant. A total of 148 patients who completed the course of TB treatment correctly were a candidate for final analysis. Ninety-one (61.5%) study participants were male; the median age was 27.6±9.8 years. Moreover, most of the study participants (84.4%) had pulmonary TB. Most of the hematological parameters had changed in the phases of TB treatment. After anti-TB treatment, there is a significant difference in hematological parameters in red blood cell count, hemoglobin concentration, hematocrit percentage, platelet count, and white blood cell count. Anemia and leucopenia are the most significant problems after TB treatment. Regular checking of these parameters is essential for the patient.


Morphological Retrospective Study of Peritoneal Biopsies from Patients with Encapsulating Peritoneal Sclerosis: Underestimated Role of Adipocytes as New Fibroblasts Lineage?
Background. Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication of peritoneal dialysis (PD). Besides the endothelial-to-mesenchymal transition (EMT), recently peritoneal adipocytes emerged as a potential source of fibrosis. We performed immunohistochemistry to approach EMT and to localize peritoneal adipocytes in peritoneal biopsies from PD-related EPS patients. Material and Methods. We investigated tissue expression of podoplanin, cytokeratin AE1/AE3 (mesothelium), calretinin (adipocytes), alpha-smooth muscle actin [α-SMA] (mesenchymal cells), interstitial mononuclear cell inflammation, and neoangiogenesis (CD3, CD4, CD8, CD20, CD68, and CD31 immunostainings, resp.). Results. Three patients (1 man/2 women; 17, 64, and 39 years old, resp.) developed EPS after 21, 90, and 164 months of PD therapy. In patients with EPS, we observed (1) loss of AE1/AE3 cytokeratin+ mesothelial cells without any evidence of migration into the interstitium, (2) disappearance of adipose tissue, (3) diffuse infiltration of calretinin+ cells in the areas of submesothelial fibrosis with a huge number of α-SMA and calretinin+ fusiform cells, and (4) increased vascular density. Conclusion. We report that the involvement of EMT in peritoneal fibrosis is difficult to demonstrate and that the calretinin+ adipocytes might be an underestimated component and a new source of myofibroblasts in peritoneal remodeling during PD-related EPS.


Preoperative chemotherapy for giant cell carcinoma of the thyroid.
Reported is the case of a 24-year-old white man with inoperable giant cell carcinoma of the thyroid who achieved tumor regression following therapy with bleomycin, Adriamycin and cisplatinum. After 2 courses of chemotherapy, the tumor was deemed operable, and the patient underwent total thyroidectomy followed by radiation to the neck and upper mediastinum without maintenance chemotherapy. Two-and-one-half years after the initial diagnosis, he developed pulmonary metastases which again responded to Adriamycin and cisplatinum therapy. The above approach suggests that inoperable thyroid carcinoma can be made operable by preoperative combination chemotherapy. This treatment program deserves further exploration for a greater number of patients.


The effects of crank power and cadence on muscle fascicle shortening velocity, muscle activation and joint-specific power during cycling.
Whilst people typically choose to locomote in the most economical fashion, during bicycling they will, unusually, chose cadences that are higher than metabolically optimal. Empirical measurements of the intrinsic contractile properties of the vastus lateralis (VL) muscle during submaximal cycling suggest that the cadences that people self-selected might allow for optimal muscle fascicle shortening velocity for the production of knee extensor muscle power. It remains unclear, however, whether this is consistent across different power outputs where the self-selected cadence (SSC) varies. We examined the effect of cadence and external power requirements on muscle neuromechanics and joint power during cycling. VL fascicle shortening velocity, muscle activation and joint-specific power were measured during cycling between 60 and 120 rpm (including SSC), while participants produced 10%, 30% and 50% of peak maximal power. VL shortening velocity increased as cadence increased but was similar across the different power outputs. Although no differences were found in the distribution of joint power across cadence conditions, the absolute knee joint power increased with increasing crank power output. Muscle fascicle shortening velocity increased in VL at the SSC as pedal power demands increased from submaximal towards maximal cycling. A secondary analysis of muscle activation patterns showed minimized activation of VL and other muscles near the SSC at the 10% and 30% power conditions. Minimization of activation with progressively increasing fascicle shortening velocities at the SSC may be consistent with the theory that the optimum shortening velocity for maximizing power increases with the intensity of exercise and recruitment of fast twitch fibers.


Study of blood pyruvic acid levels in pellagrins with and without neurological manifestations and response to nicotinic acid therapy.
In 25 cases of pellagra and 10 healthy controls, the blood pyruvic acid levels in the fasting stage and after 60 and 90 minutes of glucose load were estimated by the technique of Friedmann & Haugen (1943). The blood pyruvic acid levels after 60 and 90 minutes of glucose load were significantly higher in pellagrins as compared to controls. The following conclusions were drawn from this study: (i) that there is impairment of pyruvic acid metabolism in cases of pellagra, which is more marked in pellagrins with neurological manifestations than in those without; (ii) that after administration of nicotinic acid alone for 15 days the pyruvic acid levels returned to normal, thereby indicating that nicotinic acid deficiency is the cause of deranged pyruvate metabolism; (iii) that there is significant improvement in neurological status after nicotinic acid therapy.


Hepatic metastasectomy for soft-tissue sarcomas: is it justified?
Except for patients with gastrointestinal stromal tumors (GIST), systemic chemotherapy in patients with liver metastasis of soft-tissue sarcoma (STS) is not effective. Therefore, all patients with resectable liver metastases underwent surgical therapy. We present our experience with this approach during the last 13 years. All patients (n=45) with liver metastasis of STS undergoing surgical therapy were prospectively analyzed. Clinical and histopathological parameters as well as the postoperative course were recorded. Survival data were analyzed by using the Kaplan-Meier method and the log-rank test. Twenty-seven of 45 patients with liver metastasis underwent hepatic resection; 59% of these patients had a solitary metastasis, 22% had two metastases, and 18% had three or more metastatic nodules. The surgical perioperative mortality was 7%. The median survival was 44 (range, 1-123) months, and the 5-year survival was 49%. Repeated resection for recurrent tumor was performed in eight patients, which yielded a median survival of 76 months. Patients who have hepatic metastases that are functionally and technically resectable should be considered for surgery because this treatment offers the chance for long-term survival (>5 years).


Collection of Gender Identity in National Case Notifications of Chlamydia, Gonorrhea, and Primary and Secondary Syphilis, 2018.
In 2018, 21 (41%) jurisdictions had begun reporting gender identity for sexually transmitted disease case notifications sent to the Centers for Disease Control and Prevention. Among jurisdictions with ≥70% of cases with reported gender identity and sex, 1.0% of primary and secondary syphilis cases were identified as transgender and 71% of transgender women with syphilis were concurrently coded as being male sex.


A breath of not so fresh air….
Despite being widely used as a recreational drug, "poppers" lack a legal framework for their delivery. Their composition may vary largely. This report describes a case of severe bronchiolitis following amyl nitrite mixture inhalation. https://bit.ly/3p3S7LM.


Role of RIHP and renal tubular sodium transporters in volume retention of pregnant rats.
Normal pregnancy is characterized by sodium and water conservation and an increase in plasma volume that is required for an uncomplicated pregnancy. Renal interstitial hydrostatic pressure (RIHP) is significantly decreased in pregnant rats. This decrease in RIHP may play an important role in the sodium and water retention that characterizes normal pregnancy. Paradoxically this enhanced renal sodium and water reabsorption appear to conflict with the consistent findings of a general decrease in abundance of renal tubular sodium transporters during normal pregnancy. The objective of this review is to examine the apparent discrepancy between the increases in renal tubular sodium and water reabsorption, facilitated by decreases in RIHP, and the seemingly discordant decreases in abundance of renal tubular transporters during normal pregnancy in rats. Western blots and immunohistochemistry were used to evaluate abundance and localization of renal tubular transporters. RIHP was measured directly and continuously via a polyethylene (PE) matrix that was implanted in the left kidney of rats at the age of 11 to 16 weeks. Average basal RIHP and fractional excretion of sodium (FENa) were found to be significantly lower (P < .05) in midterm pregnant (MP; n = 18) and late-term pregnant (LP; n = 20) rats compared with nonpregnant (NP; n = 16) rats (3.5 +/- 0.3 mm Hg and 1.46 +/- 0.24% for MP; 3.3 +/- 0.1 mm Hg and 1.41 +/- 0.21% for LP; and 7.6 +/- 0.6 mm Hg and 3.67 +/- 0.24% for NP). Cortical Na+-K+-ATPase and Na-Pi2a cotransporter (Na-Pi) protein expression tend to decline with pregnancy. Also cortical Na+-H+ exchanger-1 (NHE-1) protein expression declines steadily during the course of pregnancy from MP to LP compared with that in NP rats, and cortical Na+-H+ exchanger-3 (NHE-3) protein expression is significantly lower in MP and LP compared with NP rats. We propose that during normal uncomplicated pregnancy, simultaneous decreases in RIHP and in net abundance of renal tubular sodium transporters occur. The effects of decreased RIHP exceed those of the reduction in net abundance, and presumably activity, of renal tubular transporters resulting in an enhanced net sodium and water retention during pregnancy.


Interventional spinal procedures guided and controlled by a 3D rotational angiographic unit.
The aim of this paper is to demonstrate the usefulness of 2D multiplanar reformatting images (MPR) obtained from rotational acquisitions with cone-beam computed tomography technology during percutaneous extra-vascular spinal procedures performed in the angiography suite. We used a 3D rotational angiographic unit with a flat panel detector. MPR images were obtained from a rotational acquisition of 8 s (240 images at 30 fps), tube rotation of 180° and after post-processing of 5 s by a local work-station. Multislice CT (MSCT) is the best guidance system for spinal approaches permitting direct tomographic visualization of each spinal structure. Many operators, however, are trained with fluoroscopy, it is less expensive, allows real-time guidance, and in many centers the angiography suite is more frequently available for percutaneous procedures. We present our 6-year experience in fluoroscopy-guided spinal procedures, which were performed under different conditions using MPR images. We illustrate cases of vertebroplasty, epidural injections, selective foraminal nerve root block, facet block, percutaneous treatment of disc herniation and spine biopsy, all performed with the help of MPR images for guidance and control in the event of difficult or anatomically complex access. The integrated use of "CT-like" MPR images allows the execution of spinal procedures under fluoroscopy guidance alone in all cases of dorso-lumbar access, with evident limitation of risks and complications, and without need for recourse to MSCT guidance, thus eliminating CT-room time (often bearing high diagnostic charges), and avoiding organizational problems for procedures that need, for example, combined use of a C-arm in the CT room.


Medial prefrontal cortex TRPV1 channels modulate the baroreflex cardiac activity in rats.
The ventral portion of the medial prefrontal cortex (vMPFC) comprises the infralimbic (IL), prelimbic (PL) and dorsopenducular (DP) cortices. The IL and PL regions facilitate the baroreceptor reflex arc. This facilitatory effect on the baroreflex is thought to be mediated by vMPFC glutamatergic transmission, through NMDA receptors. The glutamatergic transmission can be modulated by other neurotransmitters, such as the endocannabinoids, which are agonists of the TRPV1 receptor. TRPV1 channels facilitate glutamatergic transmission in the brain. Thus, we hypothesized that TRPV1 receptors in the vMPFC enhance the cardiac baroreflex response. Stainless steel guide cannulae were bilaterally implanted into the vMPFC of male Wistar rats. Afterwards, a catheter was inserted into the femoral artery, for recording MAP and HR, and into the femoral vein for assessing baroreflex activation. Microinjections of the TRPV1 receptor antagonists capsazepine and 6-iodo-nordihydrocapsaicin (6-IODO) into the vMPFC reduced the cardiac baroreflex activity in unanaesthetized rats. Capsaicin microinjected into the vMPFC increased the cardiac baroreflex activity in unanaesthetized rats. When an ineffective dose of the TRPV1 receptor antagonist 6-IODO was used, the capsaicin-induced increase in the cardiac baroreflex response was abolished. The higher doses of capsaicin administered into the vMPFC after the ineffective dose of 6-IODO displaced the dose-response curve of the baroreflex parameters to the right, with no alteration in the maximum effect of capsaicin. The results of the present study show that stimulation of the TRPV1 receptors in the vMPFC increases the cardiac baroreceptor reflex response.


Modified gluteus maximus V-Y advancement flaps.
A modified method is presented for the closure of wounds using gluteus maximus V-Y advancement flaps. Extra tissue is included in each flap by extending the corners of its advancing edge. The extra tissue is utilised to aid closure by using a combination of rotation and transposition in addition to advancement. This modification is illustrated and examples of its clinical use described.


Near-Infrared Mitochondria-Targetable Single-Molecule probe for Dual-Response of viscosity and sulfur dioxide in vivo.
Studies have demonstrated that the viscosity and SO2 in mitochondria are involved in various physiological processes, which are both important for maintaining the normal function of mitochondria. In this research, we rationally designed and synthesized a novel mitochondria-targetable fluorescent probe Mito-MG with near-infrared absorption and emission for dual-response of viscosity and SO2. Based on the TICT mechanism and Michael addition reaction, the probe Mito-MG responds to viscosity and SO2 with different near-infrared fluorescence signals. Importantly, Mito-MG presented outstanding mitochondrial targeting ability (Pearson's colocalization coefficient is 0.8602) and has been successfully applied to imaging of the cells, zebrafish and mice. We believe that Mito-MG could be applied as a powerful tool for a deep understanding of the connection of viscosity and SO2 in biological systems.


Peptide-like immunoreactivity in anuran optic nerve fibers.
Unilateral section, crush, or ligation of the optic nerve was performed in Rana pipiens. Following optic nerve disruption, Substance P (SP)-, leucine-enkephalin (LENK)-, cholecystokinin octapeptide (CCK8)-, and bombesin (BOM)-like immunoreactivities were analyzed in the retinae and optic nerves. Peptide-like immunoreactivity developed in the retinal stump of disrupted optic nerves within 1 hour after surgery and was retained until at least 30 days. Peptide-positive staining in the retinal stump of the optic nerves was abolished by preabsorption of each of the antibodies/antisera with the corresponding synthetic substances. No massive peptide-like immunoreactivity was observed in the cerebral stump of the ligated side, nor in the contralateral, nonoperated, optic nerve. No change in the pattern of peptide-like immunoreactivity was apparent in the retina ipsilateral or contralateral to the experimental procedure. The optic tectum contralateral to the surgical procedure displayed those changes in peptide-like immunoreactivity described previously following retinal deafferentation (Kuljis and Karten, '82a, '83a). Peptide-like immunoreactivity in the stump retinad to the surgical procedure occurred in the form of beaded and fibrillar elements often ending in an irregular expansion near the lesion site. Fluorescent double-label antibody methods demonstrated that SP-like immunoreactivity is present in different processes than those containing LENK, CCK8, or BOM. Electron microscopical immunocytochemistry revealed that peptide-like immunoreactivity is contained within unmyelinated and possibly also within myelinated axons in the stump retinad to the traumatic procedure. Radioimmunoassay studies of SP demonstrated a four- to sixfold increase in SP-like content in the retinal stump of ligated nerves, compared with both the cerebral stump and with the contralateral nonoperated optic nerves. These findings demonstrate the presence of peptide-like immunoreactivity in retinal ganglion cell processes, which is compatible with either a posttraumatic expression of previously repressed peptide-like phenotypes, or, most likely, with the existence of various classes of peptide-containing retinal ganglion cells. The latter prospect strongly suggests that peptide-specific subsets of retinal ganglion cells terminate in highly specific laminae in the optic tectum (Kuljis and Karten, '81, '82a-83a) and presumably differ in their physiological role in vision.(ABSTRACT TRUNCATED AT 400 WORDS)


Impact of Bovine Lipocalin-2 Gene on the Antioxidant Activity of Milk from Polish Holstein-Friesian Cows.
In the recent years, antioxidant properties of food products have become an important aspect for consumers. Milk is a very good source of easily absorbable proteins and minerals, as well as a valuable source of antioxidants. Lipocalin-2 (LCN2), given that, inter alia, it is produced in large quantities by various types of cells in response to oxidative stress caused by physical or chemical factors, it can be considered a protein that determines the total antioxidant capacity of milk. The main objective of this study was to analyze polymorphisms within the lipocalin-2 gene and to determine their impact on antioxidant activity of milk from Holstein-Friesian cows. The genotyping was carried out by sequencing of PCR products. To determine the antioxidant activity of milk, the Trolox equivalent antioxidant capacity (TEAC) method was used. A total of four polymorphic sites were identified in the examined segment of the bovine lipocalin-2 gene. It was shown that cows of the CC genotype at the locus g.98793763G>C produced milk of significantly higher antioxidant capacity. The antioxidant capacity of milk also varied according to the age of cows, their daily milk yield, and SCC in milk.


Comparing the preferences of health professionals and members of the public for setting health care priorities : experiences from Australia.
This article reports on a priority-setting exercise involving members of the general public and health professionals. The aim is to compare the healthcare priorities of these two groups, as well as their attitudes towards public involvement in priority setting. A convenience sample of 373 members of the public attending two central Sydney, Australia, medical clinics were asked to complete a structured, interviewer-administered questionnaire. Forty-four purposively sampled healthcare professionals working in central Sydney completed the same questionnaire. Both groups were asked whether the preferences of the public should inform priority-setting decisions. They then had to allocate an additional (but fixed) amount of healthcare resources across competing programmes, medical procedures and population groups and their preferences were compared. The health professionals and members of the public strongly supported using public preferences to inform priorities in healthcare. Both groups expressed a slightly stronger preference for using public preferences to inform priorities across healthcare programmes and population groups than for medical interventions. Considerable uniformity of preferences was revealed between the health professionals and the members of the public. However, it is argued that, even where the preferences of health professionals are consistent with and representative of those of the wider community, public involvement is important in terms of procedural justice, as it helps to legitimise both the process and the resultant priorities.


A Multicomponent Exercise Intervention that Reverses Frailty and Improves Cognition, Emotion, and Social Networking in the Community-Dwelling Frail Elderly: A Randomized Clinical Trial.
Frailty can be an important clinical target to reduce rates of disability. To ascertain if a supervised-facility multicomponent exercise program (MEP) when performed by frail older persons can reverse frailty and improve functionality; cognitive, emotional, and social networking; as well as biological biomarkers of frailty, when compared with a controlled population that received no training. This is an interventional, controlled, simple randomized study. Researchers responsible for data gathering were blinded for this study. Participants from 2 primary rural care centers (Sollana and Carcaixent) of the same health department in Spain were enrolled in the study between December 2013 and September 2014. We randomized a volunteer sample of 100 men and women who were sedentary, with a gait speed lower than 0.8 meters per second and frail (met at least 3 of the frailty phenotype criteria). Participants were randomized to a supervised-facility MEP (n = 51, age = 79.5, SD 3.9) that included proprioception, aerobic, strength, and stretching exercises for 65 minutes, 5 days per week, 24 weeks, or to a control group (n = 49, age = 80.3, SD 3.7). The intervention was performed by 8 experienced physiotherapists or nurses. Protein-calorie and vitamin D supplementation were controlled in both groups. Our MEP reverses frailty (number needed to treat to recover robustness in subjects with attendance to ≥50% of the training sessions was 3.2) and improves functional measurements: Barthel (trained group 91.6 SD 8.0 vs 82.0 SD 11.0 control group), Lawton and Brody (trained group 6.9 SD 0.9 vs 5.7 SD 2.0 control group), Tinetti (trained group 24.5 SD 4.4 vs 21.7 SD 4.5 control group), Short Physical Performance Battery (trained group 9.5 SD 1.8 vs 7.1 SD 2.8 control group), and physical performance test (trained group 23.5 SD 5.9 vs 16.5 SD 5.1 control group) as well as cognitive, emotional, and social networking determinations: Mini-Mental State Examination (trained group 28.9 SD 3.9 vs 25.9 SD 7.3 control group), geriatric depression scale from Yesavage (trained group 2.3 SD 2.2 vs 3.2 SD 2.0 control group), EuroQol quality-of-life scale (trained group 8.2 SD 1.6 vs 7.6 SD 1.3 control group), and Duke social support (trained group 48.5 SD 9.3 vs 41.2 SD 8.5 control group). This program is unique in that it leads to a decrease in the number of visits to primary care physician (trained group 1.3 SD 1.4 vs 2.4 SD 2.9 control group) and to a significant improvement in frailty biomarkers. We have designed a multicomponent exercise intervention that reverses frailty and improves cognition, emotional, and social networking in a controlled population of community-dwelling frail older adults. ClinicalTrials.gov. Identifier: NCT02331459.


Human immunodeficiency virus infection of cells arrested in the cell cycle.
Cell proliferation is necessary for proviral integration and productive infection of most retroviruses. Nevertheless, the human immunodeficiency virus (HIV) can infect non-dividing macrophages. This ability to grow in non-dividing cells is not specific to macrophages because, as we show here, CD4+ HeLa cells arrested at stage G2 of the cell cycle can be infected by HIV-1. Proliferation is necessary for these same cells to be infected by a murine retrovirus, MuLV. HIV-1 integrates into the arrested cell DNA and produces viral RNA and protein in a pattern similar to that in normal cells. In addition, our data suggest that the ability to infect non-dividing cells is due to one of the HIV-1 core virion proteins. HIV infection of non-dividing cells distinguishes lentiviruses from other retroviruses and is likely to be important in the natural history of HIV infection.


Water-maze learning and effects of cholinergic drugs in mouse strains with high and low hippocampal pyramidal cell counts.
Morphological differences have been found in inbred strains of mice in the number and volume of pyramidal cells in Ammon's horn of the hippocampus. Among the mouse strains surveyed, NZB/BINJ (NZB) and C57BL/10J (B10) are most divergent in both total volume and total number of neurons. These genetically derived differences were exploited to determine hippocampal involvement in the acquisition of a spatial water maze. Genetic differences in hippocampal cell number were related to the acquisition of this spatial task. Mice with small numbers of hippocampal pyramidal cells, the B10 strain, acquired a water-maze task more slowly than either NZB mice or (NZBxNZW) F1 (NZBWF) animals. In addition, strain differences in responsivity to cholinergic manipulations were found. B10 mice were more sensitive than NZB or NZBWF mice to both the disruptive effects of scopolamine and the facilitory effects of physostigmine on swim maze learning. Although other inherited differences undoubtedly exist between these strains as is apparent in other mouse lines, these data suggest a prominent role for the hippocampus in the learning of spatially oriented behavior. Furthermore, this behavior appears to be responsive to cholinergic manipulations.


The Significance of the Prognostic Nutritional Index in Patients with Completely Resected Non-Small Cell Lung Cancer.
Immunological parameters and nutritional status influence the outcome of patients with malignant tumors. A prognostic nutritional index, calculated using serum albumin levels and peripheral lymphocyte count, has been used to assess prognosis for various cancers. This study aimed to investigate whether this prognostic nutritional index affects overall survival and the incidence of postoperative complications in patients with completely resected non-small cell lung cancer. We retrospectively reviewed the medical records of 409 patients with non-small cell lung cancer who underwent complete resection between 2005 and 2007 at the Aichi Cancer Center. The 5-year survival rates of patients with high (≥50) and low (<50) prognostic nutritional indices were 84.4% and 70.7%, respectively (p = 0.0011). Univariate analysis showed that gender, histology, pathological stage, smoking history, serum carcinoembryonic antigen levels, and prognostic nutritional index were significant prognostic factors. Multivariate analysis identified pathological stage and the prognostic nutritional index as independent prognostic factors. The frequency of postoperative complications tended to be higher in patients with a low prognostic nutritional index. The prognostic nutritional index is an independent prognostic factor for survival of patients with completely resected non-small cell lung cancer.


Effect of various facial angles and measurements on the ideal position of the nasal tip in the Asian patient population.
Successful surgical correction of nasal tip position requires preoperative analysis. Perceived adequate nasal tip position depends on its relationship with other facial features. Nasal tip position can be affected by the subnasal contour, proportion of facial height, and relative facial size and shape. The relation of these factors to the nasolabial angle may not be as important as previously believed. To investigate and compare the factors affecting the ideal location of the tip of the nose in Asian patients using standard photographic measurements. We analyzed measurements of profile photographs and compared different factors that affect nasal tip location, including the nasofrontal, nasolabial, nasomental, and Legan angles and the ratios of the dorsal height to tip projection, the radix height to tip projection, the glabella to subnasale, and the subnasale to mentum. One hundred men, 100 women, 20 to 40 years old, seen for rhinoplasty at the Department of Otorhinolaryngology, Chosun University College of Medicine. Contribution of different facial measurements to the ideal nasal tip position. Nasolabial and nasomental angles exerted a statistically significant effect on ideal nasal tip position, whereas the Legane angle, the ratio of midface to lower face, and the ratio of nasal length to lower face did not show significant effects on nasal tip position. The nasolabial and nasomental angles have important effects on ideal nasal tip position and should be considered together during preoperative evaluation of the location of the nasal tip. Concurrent genioplasty should optimize rhinoplasty outcomes in appropriately selected patients. NA.


Aging profoundly delays functional recovery from gustatory nerve injury.
The peripheral taste system remains plastic during adulthood. Sectioning the chorda tympani (CT) nerve, which sends sensory information from the anterior tongue to the central nervous system, causes degeneration of distal fibers and target taste buds. However, taste function is restored after about 40 days in young adult rodents. We tested whether aging impacts the reappearance of neural responses after unilateral CT nerve injury. Taste bud regeneration was minimal at day 50-65 after denervation, and most aged animals died before functional recovery could be assessed. A subset (n=3/5) of old rats exhibited normal CT responses at day 85 postsectioning, suggesting the potential for efficient recovery. The aged taste system is fairly resilient to sensory receptor loss and major functional changes in normal aging. However, injury to the taste system reveals a surprising vulnerability in old rodents. The gustatory system provides an excellent model to study mechanisms underlying delayed recovery from peripheral nerve injury. Strategies to accelerate recovery and restore normal function will be of interest, as the elderly population continues to grow.


In vitro evaluation of the hemostatic effectiveness of cryopreserved platelets.
Cryopreserved platelet (CPP) concentrates exhibit a variety of morphologic and functional alterations that may affect the action of CPP with accelerated platelet (PLT) response and clotting. The objective of this study was to compare the in vitro hemostatic effect of CPP with fresh whole blood (WB) and standard 5-day PLT concentrates (PCs). WB collected from eight healthy donors was used to prepare fresh WB, PLT-depleted WB (TPN), and PLT-restored TPN using CPP (TPN-CPP) or PC (TPN-PC). Clot properties were evaluated with thromboelastometry (ROTEM); adhesion and aggregate formation under high shear (Impact-R); and PLT adhesion, aggregate formation, fibrin formation, and prothrombin activation under medium shear in a perfusion system. TPN-CPP had faster clot initiation (ROTEM clot time--TPN-CPP 115 sec, WB 194 sec, TPN-PC 161 sec), and CPP contributes to a strong clot with PLT involvement (maximum clot firmness--TPN-CPP 32 mm, WB 62 mm, TPN-PC 59 mm). The Impact-R PLT-covered area with TPN-CPP was less than those of WB and PCs, but aggregate size was the same as WB. PLT coverage in perfusion studies was observed with TPN-CPP, although generally less than both WB and PC. Fibrin was deposited with CPP-restored samples, but did not exceed the level of WB. CPPs present a phenotype supporting a moderate increase in the rate of clot formation, form stable PLT clots, and do not present a hypercoagulable phenotype during in vitro functional tests.


Crystal structure of CD38 in complex with daratumumab, a first-in-class anti-CD38 antibody drug for treating multiple myeloma.
Multiple myeloma is a blood cancer characterized by the plasma cell malignancy in the bone marrow, resulting in the destruction of bone tissue. Recently, the US FDA approved two antibody drugs for the treatment of multiple myeloma, daratumumab and isatuximab, targeting CD38, a type II transmembrane glycoprotein highly expressed in plasma cells and multiple myeloma cells. Here, we report the crystal structure of CD38 in complex with the Fab fragment of daratumumab, providing its exact epitope on CD38 and the structural insights into the mechanism of action of the antibody drug. Daratumumab binds to a specific discontinuous region on CD38 that includes residues located opposite to the active site of CD38. All the six complementarity determining regions of daratumumab are involved in the CD38 interaction. The epitopes of daratumumab and isatuximab do not overlap at all and their bindings to CD38 induce different structural changes within the CD38 protein. This structural study can facilitate the design of improved biologics or effective combination therapies for the treatment of multiple myeloma.


Single strands induce recA protein to unwind duplex DNA for homologous pairing.
Single-stranded DNA, whether homologous or not, stimulates purified Escherichia coli recA protein to unwind duplex DNA. This helps to explain how recA promotes a search for homology in genetic recombination. As oligodeoxynucleotide also stimulate unwinding, a common mechanism may relate the function of recA protein in recombination to other functions (SOS) induced by oligonucleotides.


Visceral afferent participation in delayed satiation following NMDA receptor blockade.
We previously reported that rats increase their food intake, but not water intake, following intraperitoneal (i.p.) injection of MK-801, a noncompetitive antagonist of N-methyl-D-aspartate (NMDA)-activated ion channels. The drug appears to specifically interfere with signals that participate in satiation, thereby prolonging the meal and increasing its size. The mechanism by which delayed satiation occurs is not known. However, some well-studied satiety signals are carried by visceral sensory fibers that innervate the abdominal viscera. We hypothesized that MK-801 might increase food intake by interfering with satiety signals transmitted by visceral afferent neurons. To test this hypothesis, we examined MK-801's effect on food intake in rats systemically treated with capsaicin, a neurotoxin that destroys small unmyelinated visceral afferent neurons. Capsaicin treatment significantly attenuated increased sucrose intake following MK-801. We also investigated whether the effects of MK-801 on food intake would persist in rats treated with total subdiaphragmatic vagotomies. MK-801 increased the intake of 15% sucrose by sham-vagotomized rats, while vagotomized rats did not increase their intake following MK-801. Taken together, these results support the hypothesis that capsaicin-sensitive visceral sensory neurons are involved in increased food intake following systemic NMDA receptor blockade. This, in turn, suggests that NMDA receptor activation may be an important component of the neural circuitry involved in satiation.


Left coronary artery ostial stenosis from Takayasu's arteritis diagnosed using transthoracic color flow and pulsed Doppler echocardiography.
Coronary artery stenosis is seen in 10-45% of patients with Takayasu's arteritis (TA) and coronary ostia are most frequently involved. It may cause angina pectoris and sudden death during the early course of the disease. We describe a 14-year-old girl who first presented with exertional angina and syncope and was diagnosed as having left coronary artery ostial stenosis from TA by using transthoracic echocardiography. This is the first report showing the important role of color flow and pulsed Doppler echocardiography to detect coronary artery stenosis caused by TA.


Reconsidering the necessity of ipsilateral adrenalectomy during radical nephrectomy for renal cell carcinoma.
Ipsilateral adrenalectomy is traditionally advocated as part of radical nephrectomy performed for renal cell carcinoma. The current study addresses the controversy of whether ipsilateral adrenalectomy should be performed routinely during radical nephrectomy. A total of 225 patients were treated surgically for renal cell carcinoma over an 18-year period. Of these patients, 158 underwent nephrectomy and simultaneous ipsilateral adrenalectomy and the other 67 had sparing of the ipsilateral adrenal gland. A retrospective analysis of the medical records and assessment of the clinical and the pathologic data were performed. Rates of survival and progression were evaluated in a subgroup of 109 patients, further subdivided into 54 patients who underwent concomitant adrenalectomy and 55 patients with the ipsilateral adrenal preserved during surgery. Histopathologic abnormalities were detected in seven adrenal specimens (4.4%); however, only 3 patients (1.9%) had involvement of the adrenal by renal cell carcinoma. All cases of adrenal involvement were detected by the preoperative imaging modalities. Ipsilateral adrenalectomy did not improve the outcome in comparison to adrenal preservation. In view of the rarity of ipsilateral adrenal metastasis, the questionable prognostic merits of concomitant adrenalectomy, and the availability of accurate imaging modalities, we conclude that ipsilateral adrenalectomy is not necessary in the majority of the patients undergoing radical nephrectomy for renal cell carcinoma.


Current approaches, and challenges on identification, remediation and potential risks of emerging plastic contaminants: A review.
Plastics are widely employed in modern civilization because of their durability, mold ability, and light weight. In the recent decade, micro/nanoplastics research has steadily increased, highlighting its relevance. However, contaminating micro/nanoplastics in marine environments, terrestrial ecosystems, and biological organisms is considered a severe threat to the environmental system. Geographical distribution, migration patterns, etymologies of formation, and ecological ramifications of absorption are just a few topics covered in the scientific literature on environmental issues. Degradable solutions from material science and chemistry are needed to address the micro/nanoplastics problem, primarily to reduce the production of these pollutants and their potential effects. Removing micro/nanoplastics from their discharge points has been a central and effective way to mitigate the adverse pollution effects. In this review, we begin by discussing the hazardous effect on living beings and the identification-characterization of micro/nanoplastics. Then, we provide a summary of the existing degradation strategies, which include bio-degradation and advanced oxidation processes (AOPs), and a detailed discussion of their degradation mechanisms is also represented. Finally, a persuasive summary of the evaluated work and projections for the future of this topic is provided.


A lipid emulsion reduces mortality from clomipramine overdose in rats.
Tricyclic antidepressants are a common cause of self poisoning. Since these drugs are highly lipid soluble, we examined the interaction between imipramine and a lipid emulsion. Rats were given an iv dose of imipramine with either normal saline or a lipid emulsion as vehicle. The rats who received the lipid emulsion had a significantly lower mortality. The role of lipid emulsions poisoning therapy is reviewed.


Amelioration of aluminum phytotoxicity in Solanum lycopersicum by co-inoculation of plant growth promoting Kosakonia radicincitans strain CABV2 and Streptomyces corchorusii strain CASL5.
Aluminum (Al) toxicity is the main constraint for crop cultivation in acidic soils. In this study, Al-tolerant rhizobacteria Kosakonia radicincitans (CABV2) and actinobacteria Streptomyces corchorusii (CASL5) were isolated from Beta vulgaris rhizosphere in acidic soil. Both isolates displayed high tolerance to Al (10 mM), produce siderophores, indole-3-acetic acid, 1-aminocyclopropane-1-carboxylate and solubilize phosphate. Co-inoculation of CABV2 and CASL5 strains were significantly increased the root length (312.90%), shoot length (183.19%), fresh weight (224.82%), dry weight (309.25%) and photosynthetic pigments (chlorophyll a 279.69%, chlorophyll b 188.23% and carotenoids 158.20%) of Solanum lycopersicum plants under 300 mg Al kg-1 soil conditions as compared to uninoculated Al stressed plants. Similarly, the co-inoculation treated plants subjected to Al stress condition enhanced the uptake of essential nutrients (N 229%, P 252%, K 115%, Fe 185%, Mg 345% and Ca 202%) by plants as compared to Al stressed uninoculated plants. Under Al stress (300 mg Al kg-1 soil), co-inoculation significantly decreased malondialdehyde content (66%), and increased catalase (83%), superoxide dismutase (82%), peroxidase (89%) activities and root exudates (organic acids 6.44-12.36 fold) in S. lycopersicum as compared to uninoculated plants, indicating that the CABV2 and CASL5 strains were reduced Al-induced oxidative stress. Moreover, co-inoculation significantly reduced Al accumulation in the root (89%), stem (95%) and leaves (94%) of S. lycopersicum under Al stress at 300 mg Al kg-1 soil, compared to the uninoculated plants. This is the first report of K. radicincitans strain CABV2 and S. corchorusii strain CASL5 potentially reducing Al uptake in S. lycopersicum.


Dissociation and association rate constants changes following bilirubin binding affinity decreases.
The effect of sulfisoxazole, sodium salicylate, sodium cholate, urea and dimethyl sulfoxide on the kinetics of the bilirubin to human serum albumin at 24 degrees C and pH 7.40 was investigated. A marked decrease of the association constant was obtained. It was due mainly to that of the association rate constant, and might be an additional risk factor to the icteric newborn: when blood bilirubin increases, unbound bilirubin which cannot rapidly associate to albumin may reach a dangerous level, even when its equilibrium concentration is low.


Amino Azaxylylenes Photogenerated from o-Amido Imines: Photoassisted Access to Complex Spiro-Poly-Heterocycles.
Upon irradiation, cyclic imines containing o-amido groups are shown to produce reactive intermediates, amino azaxylylenes, which undergo intramolecular cycloadditions to tethered unsaturated pendants to yield complex N,O-heterocycles having an additional spiro-connected nitrogen heterocyclic moiety. Modular assembly of the photoprecursors allows expeditious increase of the complexity of the target poly-heterocyclic scaffolds with a minimal number of experimentally simple reaction steps. The photocyclization and subsequent postphotochemical transformations are accompanied by an increase of Lovering's fsp3 factor, thus producing unprecedented three-dimensional molecular architectures, and offering extended sampling of chemical space.


Isolation and some characteristics of glutathione reductase from rabbit erythrocytes (38548).
Glutathione reductase from rabbit erythrocytes was pruified to homogeneity and found to be a monomer with a mol wt of 60,000. Both NADPH and HADH were capable of acting as cofactors for the reduction of GSSG and the following kinetic values were obtained: Km, GSSG = 120 muM; Km, NADPH = 37 muM; Vmax = 23 mumoles NADPH/min/mg protein, Km, NADH = 420 muM; Vmax = 3 mumoles NADH/min/mg protein. Rabbit erythrocyte GR exhibited substrate inhibition, and was susceptible to inhibition by p-hydroxymercuribenzoate under certain conditions.


Comparison of Ultrasound-Marked Versus Standard Lumbar Puncture Success in Infants.
The aim of this study was to compare ultrasound (US)-marked versus standard lumbar puncture success in infants. This was a prospective cohort study at an academic pediatric emergency department. Standard lumbar puncture success in a retrospective control was compared with success in a US-marked group. Spinal US was performed with infants in the sitting and lateral decubitus position to identify the interspinous space with the most cerebrospinal fluid. The optimal position was determined, and this space was marked. The proceduralist performed the lumbar puncture at the level of the markings. The primary outcome was a successful lumbar puncture by the first provider, defined as a collection of cerebrospinal fluid with less than 1000 red blood cells/mm3. Secondary outcomes were successful lumbar puncture after attempts by more than 1 provider and collection of any spinal fluid. Between June 2017 and April 2019, we enrolled 284 infants younger than 12 months, 210 in the retrospective standard group and 74 in the prospective US-marked group. Baseline characteristics of both groups were similar. The primary outcome showed no difference between US-marked group and control (38% vs 36%; difference: 1.6% [95% confidence interval (CI), -14.7 to 10.7]). Secondary outcomes showed no significant success differences by more than 1 provider (51% vs 39%; difference: 12.8% [95% CI, -25.7 to 0.3]) or in obtaining any spinal fluid (82% vs 79%; difference: 3.9% [95% CI -13.3 to 7.5]). There were no differences in success between US-marked and standard lumbar punctures in infants by different providers.


Mice lacking glutamate carboxypeptidase II are protected from peripheral neuropathy and ischemic brain injury.
Excessive glutamate release is associated with neuronal damage. A new strategy for the treatment of neuronal injury involves inhibition of the neuropeptidase glutamate carboxypeptidase II (GCP II), also known as N-acetylated alpha-linked acidic dipeptidase. GCP II is believed to mediate the hydrolysis of N-acetyl-aspartyl-glutamate (NAAG) to glutamate and N-acetyl-aspartate, and inhibition of NAAG peptidase activity (by GCP II and other peptidases) is neuroprotective. Mice were generated in which the Folh1 gene encoding GCP II was disrupted (Folh1-/- mice). No overt behavioral differences were apparent between Folh1-/- mice and wild-type littermates, with respect to their overall performance in locomotion, coordination, pain threshold, cognition and psychiatric behavioral paradigms. Morphological analysis of peripheral nerves, however, showed significantly smaller axons (reduced myelin sheaths and axon diameters) in sciatic nerves from Folh1-/- mice. Following sciatic nerve crush, Folh1-/- mice suffered less injury and recovered faster than wild-type littermates. In a model of ischemic injury, the Folh1-/- mice exhibited a significant reduction (p < 0.05) in infarct volume compared with their wild-type littermates when subjected to middle cerebral artery occlusion, a model of stroke. These findings support the hypothesis that GCP II inhibitors may represent a novel treatment for peripheral neuropathies as well as stroke.


The laryngeal mask airway for awake craniotomy in the pediatric patient: report of three cases.
The anesthetic management of three pediatric patients who underwent awake craniotomy with a combined, continuous intravenous infusion of propofol and alfentanil is described. The Laryngeal Mask Airway was effective in airway management during resection of epileptic foci with intraoperative cortical mapping and neuropsychological (speech) evaluation.


Postnatal maturation of the layer III pyramidal neurons in the human prefrontal cortex: a quantitative Golgi analysis.
In this study we examined the morphological maturation of the basal dendritic field of layer III pyramidal neurons located in the human dorsolateral prefrontal cortex in subjects ranging from 7.5 months after birth up to 27 years. The sections were stained with the Golgi-Cox method and the three-dimensional branching pattern was measured with a semi-automatic dendrite measuring system. Results show a rapid growth phase of the dendritic field from 7.5 months after birth up to one year. A marked increase in total dendritic length is observed, for which elongation of the terminal segments, longer intermediate segments and an increase in number of segments is an explanation. The dendritic length appears to have stabilized after one year, leading us to conclude that the postnatal morphological maturation of the layer III pyramidals does not continue well into childhood, but is completed at a much younger age. Additionally we analyzed the effect of varying section thickness on dendritic parameters and found no tendency for higher dendritic values with increasing section thickness for the range of thickness values of the histological sections used.


Uptake and depuration of three common antibiotics in benthic organisms: Sea cucumber (Holothuria tubulosa), snakelocks anemone (Anemonia sulcata) and beadlet anemone (Actinia equina).
Antibiotics are widely used drugs in human and veterinary medicine, which has attracted great attention in relation to the development of bacterial resistance, currently a problem of great concern for governments and states, as it is related to the resurgence of infectious diseases already eradicated. Understanding the bioaccumulation of antibiotics in aquatic organisms is an important key to understanding their risk assessment. The present study was designed to study the bioaccumulation of target antibiotics in relevant organisms inhabiting benthic marine environments. The uptake and elimination of ciprofloxacin (CIP), sulfamethoxazole (SMX) and trimethoprim (TMP) were investigated in sea cucumbers (Holothuria tubulosa), snakelock anemone (Anemonia sulcata) and beadlet anemone (Actinia equina) under controlled laboratory conditions. The results show that antibiotics have a particular trend over time during all periods of absorption and depuration. The tissue distribution of antibiotics in sea cucumber is strongly influenced by the structure of the compounds, while CIP is concentrated in the body wall; TMP is concentrated in the digestive tract. Two different approaches were used to estimate bioconcentration factors (BCFs) in different animal models, based on toxicokinetic data and measured steady-state concentrations. The BCF ranges were 456-2731 L/kg, 6-511 L/kg and 9-100 L/kg for TMP, CIP and SMX, respectively. The estimated BCF values obtained classify TMP as cumulative in A. equina and H. tubulosa, underlining the potential bioconcentration in these marine organisms. A correlation was observed between the BCFs of the target antibiotics and the octanol-water distribution coefficient (Dow) (r2 > 0.7). The animal-specific BCF followed the order of beadlet anemone > sea cucumber > snakelock anemone.


Factors influencing the outcome (GOS) in reconstructive cranioplasty.
After performing a decompressive craniectomy, a cranioplastic surgery is usually warranted. The complications of this reconstructive procedure may differ from the initial operation. The authors of this study report on their experience to define patient-specific and procedural risk factors for possible complications following cranioplasty influencing the outcome (Glasgow Outcome Scale (GOS)), mobility, shunt dependency, and seizures. A retrospective analysis of 263 patients of all ages and both sexes who had undergone cranioplasty after craniectomy for traumatic brain injury (including chronic subdural hematoma), subarachnoidal hemorrhage (including intracerebral hemorrhage), ischemic stroke, and tumor surgery in one single center in 12 years from January 2000 to March 2012 has been carried out. A multiple logistic regression analysis was performed to identify potential risk factors (age, gender, used cranioplasty material, initial diagnosis, clipped or coil-embolized subarachnoidal hemorrhage (SAH) patients, time interval, complications especially hydrocephalus and seizures, mobility) upon the prognosis described as a dichotomized Glasgow Outcome Scale. Two hundred forty-eight patients met the study criteria. The overall complication rate after cranioplastic surgery was 18.5% (46 patients). Complications included: surgical site infection, epidural hematoma, hydrocephalus with or without former SAH, and new-onset seizures. Logistic regression analysis identified significant correlation between a low GOS (2 or 3) and postoperative seizures (OR 2.37, CI 1.35-4.18, p < 0.05), shunt-depending hydrocephalus (OR 5.83, CI 3.06-11.11, p < 0.05), and age between 51 and 70 years (OR 2.4, 95% CI 1.09-5.29, p = 0.029). However, gender, time interval between craniectomy and cranioplasty, initial diagnosis, and used cranioplasty material had no significant influence on post-cranioplasty complications as surgical site infections, hematoma, wound healing disturbance, seizures, or hydrocephalus. Evaluation of treatment modality in aneurysmal SAH clip vs. coil showed no significant relation to postoperative complications either. Complications after cranioplastic surgery are a common problem, as prognostic factors could identify a shunt-depending hydrocephalus and epilepsia to develop a major deficit after cranioplastic surgery (GOS 2 or 3). We detected a significant extra risk of people between the age of 51 and 70 years to end up in GOS level 2 or 3.


Relapsed hepatoblastoma confined to the lung is effectively treated with pulmonary metastasectomy.
In children diagnosed with hepatoblastoma (HB), the lungs are the most common site of metastasis at both initial presentation and relapse. Previous studies have encouraged pulmonary metastasectomy to achieve a disease-free state after resection of the primary hepatic lesion. However, there is no consensus about how to manage recurrent pulmonary metastasis. A retrospective, multi-institutional review was performed from 2005 to 2014 to identify HB patients ≤18years of age who had disease recurrence associated with pulmonary metastases alone. Ten patients between the ages of 8 and 33months were identified. Pulmonary metastatic recurrence was detected by measuring alpha-fetoprotein (AFP) levels and/or with CT scans of the chest. All patients subsequently underwent pulmonary metastasectomy without post-operative complications. At last follow-up, 8 patients were alive and had normal AFP levels. The 8 survivors had a median follow-up from therapy completion of 18.5months. Two patients who presented with extrapulmonary recurrence subsequently died of treatment refractory disease. This review supports surgical resection as a safe and, in the context of multimodal therapy, efficacious approach to manage HB patients who present with isolated pulmonary relapse.


[A rare cumulation of vena cava catheter complications in the same patient (author's transl)].
Two complications that occurred in connection with the use of CVP catheters in the SVC and IVC in one patient are described: 1. Extravascular injection in the superior mediastinum and in the extrapleural space. 2. Massive thrombosis of the IVC. The differential diagnosis of a wedening of superior mediastinum is discussed. Recommendations are made to prevent these complications.


Cryptococcus neoformans osteomyelitis of the tibia: a case report and review of the literature.
Osteomyelitis is a bone inflammation that can be related to various infectious agents. As with any other type of inflammation, the prevailing symptoms and signs may include redness, swelling, pain, and heat. Fungal osteomyelitis is rare and usually found in immune-compromised patients. A non-human immunodeficiency virus immunocompromised Greek female patient, 82 years old, visited the emergency department due to a 3 day pain located mainly over the left tibia's anterior surface, accompanied by swelling and redness. There was also a subcutaneous lesion of her left breast. Medical history revealed that the patient had an unmasked close contact with pigeons, a main host of the disease. Initial x-ray imaging showed an osteolytic area in the upper third of the tibial diaphysis. The patient was admitted and underwent a computed tomography-guided biopsy. The specimen revealed a Cryptococcus neoformans infection of the bone and the breast. She was treated with 400 mg fluconazole twice a day for 3 weeks while in hospital and 200 mg twice a day upon discharge for 9 months. After that, she underwent surgical debridement because of lasting local irritation. She was closely monitored in our outpatient office, and in her last visit, 1 year after the initial admission, inflammatory signs had regressed vastly. To our knowledge, this is the ninth cryptococcal osteomyelitis of the tibia to be recorded since 1974, and the most unusual finding was the bifocal nature of the infection, affecting both the tibia and the breast.


Tachycardia-termination algorithm: a valuable feature for interruption of pacemaker-mediated tachycardia.
A 45-year-old man who had been implanted with a VVI pacemaker for sinus arrest complained of syncope, dizziness and throbbing in the neck. His pacemaker function was normal, but during ventricular pacing, retrograde V-A conduction was observed. This pacer was replaced by a DVI unit which caused periodic abdominal muscular contractions. We replaced this unit with an Intermedics Cosmos DDD-M pacemaker. This type of pacemaker in a patient with V-A conduction may cause pacemaker-mediated tachycardia (PMT). However, the Cosmos has a tachycardia-termination algorithm which detects continued pacing at the ventricular tracking rate, allows it to proceed for 15 consecutive pace events, and inhibits the 16th ventricular output pulse, thus breaking the reentry loop. The Cosmos pacer has a number of features to prevent initiation of PMT, and is also able to terminate the tachycardia when it occurs because of the tachycardia-termination algorithm. This feature is valuable in DDD-M pacemakers implanted in patients with V-A conduction. Whether this algorithm will be effective in all cases remains to be determined.


COX2-related multicentric mixed-type Castleman's disease in a young man.
A 34-year-old male presented with a 5-month history of fatigue, anorexia, low fever, night sweats, and oliguria with edema of the eyelid, exacerbated by abdominal distension and mild diarrhea of 3 weeks duration. Physical examination showed positive signs of ascites, palpable spleen, slight abdominal tenderness and mild rebound tenderness in the lower abdomen, and edema of the lower limbs. Initial laboratory tests revealed abnormal liver biochemistry and increased protein concentration in the urine. Chest X-ray showed minimal pleural effusion in both sides of the thoracic cavity, and ultrasound detected moderate ascites, several small lymph nodes in the retroperitoneum, and mild splenomegaly with widening of the splenic vein. A lymph node biopsy established the diagnosis, and cytokine analysis in the serum revealed COX2 as the possible mediator. Abdominal paracentesis, chest X-ray, abdominal ultrasound, thoracic and abdominal CT scans, gastroscopy, colonoscopy, biopsies of the liver, bone marrow and lymph nodes, immunophenotype staining for lymphocytes, cytokine analysis. COX2-related multicentric mixed-type Castleman's disease. Chemotherapy and COX2 inhibitors.


The dependence of micellar rate effects upon reaction mechanism.
In the pseudophase treatment of reactivities in aqueous surfactants, water and the micelles are treated as discrete reaction media. Provided that transport of reactants between water and micelles is faster than the chemical reactions the overall reaction rate depends on local concentration(s) in water and micelles and rate constants in each medium. Only substrate binding has to be considered for spontaneous reactions, and observed first-order rate constants are interpreted in terms of reaction mechanism on the assumption that the micellar interfacial reaction region is less polar than water and has (for ionic micelles) a high electrolyte content. Rate effects on bimolecular reactions depend on second-order rate constants and concentrations of both reactants in the aqueous and micellar pseudophases. Second-order rate constants in the micellar pseudophase, relative to those in water, are also as expected for a reaction region that is less polar than water. For reactions of anionic nucleophiles and bases in cationic micelles local second-order rate constants are generally not very different from those in water, but are much lower for oxygen transfers from anionic oxidants. These rate effects are understandable in terms of properties of the interfacial region, reaction mechanism and consequent charge redistributions in formation of the transition state.


Effect of weathering on environmental behavior of microplastics: Properties, sorption and potential risks.
Microplastic (MP) pollution is a raising global concern in recent years due to its wide distribution. Additionally, most of the MPs have undergone extensive weathering in the environment, and weathered MPs may exhibit different physicochemical properties from pristine ones. The review reveals the change in physicochemical properties (e.g. size, color, crystallinity, mechanical property and oxygen-containing groups) and the release of additives and MP-derived intermediates (i.e. oligomers and oxygenated compounds) during weathering processes. Weathering further affects the sorption behavior of MPs for environmental pollutants because of the changed crystallinity, specific surface area and oxygen functional groups. The interaction mechanisms of pristine and weathered MPs with pollutants are summarized, and how weathering processes affect sorption behavior is critically revealed. Because of the changed size, color and surface charges, weathered MPs might be ingested by aquatic organisms in different ways from the pristine ones. The detailed effects of weathering on the ingestion of MPs are discussed, and the potential toxicity of leachates from weathering processes is evaluated. In addition, the environmental components (e.g. natural organic matter and salinity) and biofilm correlated to the sorption behavior of MPs are reviewed. As for the knowledge gap, further studies should focus on the long-term weathering of MPs and the relationships between weathering properties and sorption capacities toward pollutants. The potential risks of weathered MPs and leachates on organisms should be explored.


A new biologically active triterpenoid saponin from the leaves of Lepidagathis hyalina Nees.
A new biologically active triterpenoid saponin m.f. C42H68O13, m.p. 315 degrees-317 degrees C was isolated from the ethyl acetate soluble fraction of the methanolic extract of the leaves of Lepidagathis hyalina. Its structure was characterized as 3-beta-O-[alpha-L-rhamnopyranosyl(1-->4)O-beta-D-glucopyranosyl]16-alpha-hydroxy-olean-12-en(13)-28-oic acid by several spectral and chemical analysis. This new triterpenoid saponin showed antimicrobial activity against various plants pathogenic bacteria and fungi.


Diet impacts mortality from cancer: results from the multiethnic cohort study.
Cancer is the second leading cause of death in the United States and mortality varies by ethnicity. The objective of this study was to examine the association between cancer mortality and dietary intake among a large multiethnic population. A prospective cohort design was used to examine cancer mortality among 146,389 participants. Multiethnic cohort study participants represent five ethnic groups: African American, Native Hawaiian, Japanese American, Latino, and Caucasian. Hazard ratios for cancer mortality by intake levels of five food groups and discretionary fat were calculated using Cox proportional hazards models stratified by sex and ethnicity. There were a total of 2,028 male and 1,464 female fatal cancer cases at the end of follow-up. Among Japanese American men only, there was a significant protective effect seen in those reporting a high grain intake (HR = 0.49, 95 % CI 0.35-0.69); there was no effect of grain consumption in any other ethnic-sex group. There was no evidence that ethnicity modified associations between fruit, vegetable, meat, dairy, or discretionary fat intake and cancer mortality among men. Associations between food group consumption and risk for cancer mortality among women were similar across ethnic groups. The considerable reduction in cancer risk associated with high grain consumption among a specific ethnic-sex group, Japanese American men, warrants further investigation. Additional research is needed to validate this observation and determine whether this was a chance finding, or possibly due to differential intake of specific grain subtypes, and/or related to a sex-specific cancer type.


Pulmonary function in asthmatic patients in remission.
Thirty-five asthmatic patients (average age 28 years) who attended a pulmonary function laboratory when their mean ratio of forced expiratory volume in one second: forced vital capacity was 81 per cent (within the normal range for their age group) had arterial hypoxaemia and hypocapnia. These were probably secondary to lung hyperinflation and pulmonary ventilation/perfusion imbalance. The pulmonary abnormalities of bronchial asthma are not always detected by simple spirometric tests and the results of such tests should be interpreted cautiously.


High-energy and durable lithium metal batteries using garnet-type solid electrolytes with tailored lithium-metal compatibility.
Lithium metal batteries using solid electrolytes are considered to be the next-generation lithium batteries due to their enhanced energy density and safety. However, interfacial instabilities between Li-metal and solid electrolytes limit their implementation in practical batteries. Herein, Li-metal batteries using tailored garnet-type Li7-xLa3-aZr2-bO12 (LLZO) solid electrolytes is reported, which shows remarkable stability and energy density, meeting the lifespan requirements of commercial applications. We demonstrate that the compatibility between LLZO and lithium metal is crucial for long-term stability, which is accomplished by bulk dopant regulating and dopant-specific interfacial treatment using protonation/etching. An all-solid-state with 5 mAh cm-2 cathode delivers a cumulative capacity of over 4000 mAh cm-2 at 3 mA cm-2, which to the best of our knowledge, is the highest cycling parameter reported for Li-metal batteries with LLZOs. These findings are expected to promote the development of solid-state Li-metal batteries by highlighting the efficacy of the coupled bulk and interface doping of solid electrolytes.


A simple entry into nido-C2B10 clusters: HCl promoted cleavage of the C-C bond in ortho-carboranyl diphosphines.
Treatment of the diphosphines ortho-B10H10C(P(t)Bu2)C(PR2) (R = Et, Cy, Ph) with HCl gives the zwitterionic, nido-12-vertex species B10H10C(PH(t)Bu2)C(PClR2); these reactions are reversed by the addition of NEt3.


Prevalence and genomic characterization of Group A Streptococcus dysgalactiae subsp. equisimilis isolated from patients with invasive infections in Toyama prefecture, Japan.
Streptococcus dysgalactiae subsp. equisimilis (SDSE) causes severe invasive streptococcal infections, especially in elderly people. Between 2013 and 2018, 88 streptococci were isolated from clinical blood culture in a hospital in Toyama prefecture, Japan. The collection included six Group A SDSE (ASD) strains, which are rarely isolated. Multilocus sequence typing categorized five of the six strains into ST128 and the remaining strain into a new type. Maximum-likelihood phylogenetic analysis revealed that the six ASD strains had highly similar genome sequences. Bayesian analysis indicated that the most recent common ancestor of the strains appeared 39 years ago. The ASD strains possessed carbohydrate synthase genes that are conserved in Streptococcus pyogenes strains, whereas one strain featured a different arrangement of the gene cluster. The carbohydrate synthase genes varied by Lancefield type (A, C, and G).


Stromelysin in tumor progression and metastasis.
There are several characteristics of stromelysin that suggest that expression of this enzyme may play an important role in tumor invasion and metastasis; the stromelysin gene is expressed in response to stimulation by oncogenes and tumor promoters, and the protein product of this gene is a metalloproteinase capable of degrading multiple components of the extracellular matrix. Experimental evidence to support this hypothesis has been derived from several animal model systems, in which a positive correlation has been observed between stromelysin expression and tumor progression and metastasis. In addition, in vivo experiments in which the levels of TIMP, the tissue inhibitor of metalloproteinases, were altered also strongly suggest a causal role for metalloproteinases in tumor metastases. The expression of active stromelysin in tumor cells requires the fulfillment of several criteria, and this multistep process is reminiscent of the molecular events that are currently understood to contribute to tumor progression and carcinogenesis. Expression of stromelysin mRNA requires both a stimulus, a step which may correspond to the activation of an oncogene in multistep carcinogenesis, as well as the lifting of transcriptional repression, which may correspond to the loss of tumor suppressor function. Both positive and negative modulation of stromelysin transcription appear to utilize pathways that involve the protooncogenes c-fos and/or c-jun. The expression of active stromelysin enzyme also requires conversion of the proenzyme to an active form, and a proper balance between the expression of inhibitors and the levels of active enzyme. The multiple levels of stromelysin regulation support the concept of multistep carcinogenesis and may provide a tool for further understanding of the molecular nature of the events that lead to tumor progression, invasion, and metastasis.


Lithium chloride induces partial responsiveness to LPS in nonresponder B cells.
The lipopolysaccharide (LPS)-nonresponder mouse strains C3H/HeJ, C57BL/10ScCR and C57BL/10ScN do not respond to LPS acting as a polyclonal B-cell activator, a mitogen, or an adjuvant. The genetic basis for the defective LPS response has been extensive studied in C3H/HeJ and C57BL/10ScCR mice, in which it was demonstrated that a single gene locus on chromosome 4 was responsible for LPS unresponsiveness. Lithium chloride, a potent inhibitor of adenylate cyclase, not only improved lymphocyte activity in a patient with adenosine deaminase deficiency but also enhanced the phytohaemagglutinin (PHA)-induced responses of normal human lymphocytes. Therefore, we investigated whether LiCl could restore LPS responsiveness in spleen cells of C3H/HeJ mice. We show here that LPS, in the presence of LiCl, induced polyclonal IgM and IgG antibody formation and DNA synthesis in C3H/HeJ mouse spleen cells in vitro. Moreover, LiCl (10 mM), which by itself is non-mitogenic, increased RNA synthesis in spleen cells from both LPS-nonresponder and high responders strains; in contrast, LPS failed to increase RNA synthesis in cells from such LPS-nonresponder strains as C3H/HeJ and B10ScCr mice.


Pruritus in Kidney Disease.
Pruritus is a common and distressing symptom in patients with chronic kidney disease. The most recent epidemiologic data have suggested that approximately 40% of patients with end-stage renal disease experience moderate to severe pruritus and that uremic pruritus (UP) has a major clinical impact, being associated strongly with poor quality of life, impaired sleep, depression, and increased mortality. The pathogenesis of UP remains largely unclear, although several theories on etiologic or contributing factors have been proposed including increased systemic inflammation; abnormal serum parathyroid hormone, calcium, and phosphorus levels; an imbalance in opiate receptors; and a neuropathic process. UP can present somewhat variably, although it tends to affect large, discontinuous, but symmetric, areas of skin and to be most symptomatic at night. A variety of alternative systemic or dermatologic conditions should be considered, especially in patients with asymmetric pruritus or other atypical features. Treatment initially should focus on aggressive skin hydration, patient education on minimizing scratching, and optimization of the aspects of chronic kidney disease care that are most relevant to pruritus, including dialysis adequacy and serum parathyroid hormone, calcium, and phosphorus management. Data for therapy specifically for UP remain limited, although topical therapies, gabapentin, type B ultraviolet light phototherapy, acupuncture, and opioid-receptor modulators all may play a role.


Self-poisoning as a cause of admission in a medical intensive care unit and a question of misuse of prescription medications.
Self-poisoning accounts for between 3 and 17% of intensive care unit (ICU) admissions. To display the misused substances, intention, and outcome of patients admitted to the ICU due to self-poisoning. A retrospective review of ICU admissions using an electronic patient database was performed. A total of 149 patients were admitted, accounting for 4.6% of ICU admissions. Self-poisoning with self-harm was more frequent than without self-harm intent (62.4% vs. 37.6%). 64.4% of ingested substances were misused prescribed drugs. Females used antipsychotics (X2 = 15, p< 0.05) and benzodiazepines (X2 =11.52, p< 0.05), and males ingested antipsychotics (X2 = 12, p< 0.05) with a self-harm intent. Antipsychotics were always used with a self-harm intent. Illicit drugs (X2 =9.14, p< 0.05) and ethanol (X2 =7.34, p< 0.05) were mostly used without self-harm intent. 102 patients (68.5%) continued treatment in a psychiatric clinic, more often women (X2 (1,N = 145)=7.94, p< 0.005). The readmission rate was low. Mortality was 2.6%. Self-poisoning is an infrequent cause of ICU admission. Prescribed psychotropic medications, including benzodiazepines, antipsychotics, and antidepressants were the most frequently misused substances. Psychiatric consultation before the ICU discharge and subsequent psychiatric treatment might lower the repetition and readmission rate.


A new species of Epicaerus Pascoe, 1881 (Coleoptera: Curculionidae: Entiminae: Geonemini) associated with potato cultivars in Tierras Altas de Chiriqu, <br>Panama.
Epicaerus panamensis Girn de Medeiros, a new species of broad-nosed weevil in the tribe Geonemini (Coleoptera: Curculionidae: Entiminae) is described. Specimens have been collected on or around potato cultivars in Tierras Altas de Chiriqu, Panama. Field and habitus images, images of the male and female genitalia, an image of the feeding damage caused by the weevils on potato leaves, and a locality map are provided. The species is compared to the closely related Epicaerus inaequalis (Sharp, 1891), including a brief discussion regarding their morphological affinities and current taxonomic placement.


Exploring reproduction (or is it procreation?) over language boundaries: the challenges and hidden opportunities of translation.
This article addresses the challenges and benefits derived from having to present social science research in another language than one's usual working language. As objects of study are, in part, moulded by language, translation becomes an invaluable opportunity for critical reflection on our epistemic choices. The article thus proposes a brief inquiry into the words we use, in French and in English, to describe and discuss issues in assisted reproductive technology, or medically assisted procreation as one would say in French. The article first explores similarities and differences in the generic terms used in each language to refer to this area, and discusses the verbs used to describe different facets of the reproductive process. It then proposes a short discussion of two terms often used interchangeably in both languages, 'reproduction' and 'procreation', and introduces a third term, engendrement ('engendering') that has recently emerged in France as an alternative concept. The conclusion points to the impact that technology may have on the issues considered worthy of attention, and on the meaning of certain words, as reproductive acts are displaced from the body to the laboratory. It also urges greater attention to how language affects the way we conceptualize reproductive practices and issues, and to how we deal with these differences in international encounters.


An unexpected disproportional reaction of 2H-azirines giving (1E,3Z)-2-aza-1,3-dienes and aromatic nitriles in the presence of nickel catalysts.
An unprecedented nickel-catalysed disproportional reaction of 2,3-diaryl-2H-azirines forming azabutadienes and aromatic nitriles was discovered. This reaction involves the cleavage of two bonds of the 2H-azirine framework, which provides a novel type of transformation of 2H-azirines.


Covert Brain Infarction in Emergency Department Patients: Prevalence, Clinical Correlates, and Treatment Opportunities.
Covert brain infarctions are focal lesions detected on brain imaging consistent with ischemia in the absence of a history of overt stroke or neurologic dysfunction. Covert brain infarctions are associated with an increased risk of future stroke. We evaluated the prevalence of covert brain infarctions in patients undergoing computed tomography (CT) in the emergency department (ED), as well as clinician response to the findings. Patients aged more than 50 years who underwent CT of the head and were seen and discharged from our ED from January to September 2018 were identified. Patients with a history of stroke, or prior brain imaging with ischemia, were excluded. Patient data and clinician response (patient notification, neurology referral, and risk factor modification) were collected. We included 832 patients, with an average age of 62 years, and 50% of the patients were women. Covert brain infarctions were present in 11% of patients (n=95). Only 9% of patients with covert brain infarctions were clearly made aware of the finding. Of the patients with covert brain infarctions, 27% were already on aspirin and 28% on a statin. Aspirin was added for 2 patients, and statin medication was not started on any patient. The blood pressure medication was added or adjusted for 2 patients with covert brain infarctions. The neurology department was consulted for 9% of the patients with covert brain infarctions. The prevalence of covert brain infarctions in patients older than 50 years presenting to the ED who underwent CT of the head and were subsequently discharged from the ED was 11%. Only 9% of these patients were made aware of the finding, with minimal intervention for stroke prevention at the time of their visit. Interventions targeting this population should be considered.


Non-equilibrium approach for binding free energies in cyclodextrins in SAMPL7: force fields and software.
In the current work we report on our participation in the SAMPL7 challenge calculating absolute free energies of the host-guest systems, where 2 guest molecules were probed against 9 hosts-cyclodextrin and its derivatives. Our submission was based on the non-equilibrium free energy calculation protocol utilizing an averaged consensus result from two force fields (GAFF and CGenFF). The submitted prediction achieved accuracy of [Formula: see text] in terms of the unsigned error averaged over the whole dataset. Subsequently, we further report on the underlying reasons for discrepancies between our calculations and another submission to the SAMPL7 challenge which employed a similar methodology, but disparate ligand and water force fields. As a result we have uncovered a number of issues in the dihedral parameter definition of the GAFF 2 force field. In addition, we identified particular cases in the molecular topologies where different software packages had a different interpretation of the same force field. This latter observation might be of particular relevance for systematic comparisons of molecular simulation software packages. The aforementioned factors have an influence on the final free energy estimates and need to be considered when performing alchemical calculations.