The effect of variant interference on de novo assembly for viral deep sequencing.
Viruses have high mutation rates and generally exist as a mixture of variants in biological samples. Next-generation sequencing (NGS) approaches have surpassed Sanger for generating long viral sequences, yet how variants affect NGS de novo assembly remains largely unexplored. Our results from > 15,000 simulated experiments showed that presence of variants can turn an assembly of one genome into tens to thousands of contigs. This "variant interference" (VI) is highly consistent and reproducible by ten commonly-used de novo assemblers, and occurs over a range of genome length, read length, and GC content. The main driver of VI is pairwise identities between viral variants. These findings were further supported by in silico simulations, where selective removal of minor variant reads from clinical datasets allow the "rescue" of full viral genomes from fragmented contigs. These results call for careful interpretation of contigs and contig numbers from de novo assembly in viral deep sequencing.


Evaluation of the integrated hydrothermal carbonization-algal cultivation process for enhanced nitrogen utilization in Arthrospira platensis production.
Sustainable microalgal cultivation at commercial scale requires nitrogen recycling. This study applied hydrothermal carbonization to recover N of hot-water extracted Arthrospira platensis biomass residue into aqueous phase (AP) under different operation conditions and evaluated the N utilization, biomass yield and quality of A. platensis cultures using AP as the sole N source. With the increase of temperature at 190-210°C or reaction time of 2-3h, the N recovery rate decreased under nitrogen-repletion (+N) cultivation, while contrarily increased under nitrogen-limitation (-N) cultivation. Under +N biomass accumulation in the cultures with AP under 190°C was enhanced by 41-67% compared with that in NaNO3, and the highest protein content of 51.5%DW achieved under 200°C-2h was also 22% higher. Carbohydrate content of 71.4%DW under -N cultivation achieved under 210°C-3h was 14% higher than that in NaNO3. HTC-algal cultivation strategy under -N mode could save 60% of conventional N.


A prospective study on the endometrium properties and the pregnancy rate of infertile women with thin endometrium receiving Fructus ligustri lucidi used in traditional Chinese medicine.
To evaluate whether Zi Gui Nv Zhen capsules (ZGNZC) can increase the fertility rate of Chinese women with infertility due to thin endometrium. Prospective, randomized, open-labeled 3-monthly study; 104 patients (aged 20-40 years) receiving either ZGNZC (experimental group, n = 55) or not (control group, n = 49). Main outcomes: thickness/type of the endometrium during ovulation and pregnancy rate. Between-group analysis (A) compares the experimental vs. control group, and within-group analysis (B) compares data at baseline and after study in the experimental group. (A) Between-group-analysis: Patients with ZGNZC had a higher endometrium thickness (0.8 ± 0.27 vs. 0.68 ± 0.10; p < .05) and higher type A endometrium rates (34.2% vs. 13.2%; p < .05) than the control group. Pregnancy rates were higher in the experimental than in the control group (43.6% vs. 22.4%; p < .05). (B) Within-group-analysis: ZGNZC increased endometrium thickness (0.58 ± 0.13 vs. 0.87 ± 0.24 vs. 0.83 ± 0.26 vs. 0.80 ± 0.27), and type A endometrium rates (10.9% vs. 60.0% vs. 49.0% vs. 34.2%) (all p < .05). Univariate analysis of pregnancy with other study parameters showed positive and significant correlations between pregnancy and administration of ZGNZC (p < .05). All hepato-renal biomarkers remained within the norm. There were no adverse events. In infertile women with thin endometrium who wish to conceive, two months' application of ZGNZC can improve endometrial properties and proliferation, which is necessary for a healthy pregnancy, and increase the clinical pregnancy rate in our prospective randomized observational study.


Environmental Triggers of Hyperuricemia and Gout.
Gout is the most prevalent type of inflammatory arthritis worldwide and environmental factors contribute to hyperuricemia and risk for gout flare. Causes of hyperuricemia include increased purine consumption from meat, alcohol, and high fructose corn syrup as well as medications such as cyclosporine, low-dose aspirin, or diuretics. Triggers for gout flares include increased purine consumption and medication use such as urate lowering therapy and diuretics. Environmental exposures including lead exposure, particulate matter exposure, temperature fluctuations, and physiologic stress have been found to trigger flares. In the right clinical scenario, these factors should be considered when treating gout patients.


MicroRNA-195 inhibits proliferation, invasion and metastasis in breast cancer cells by targeting FASN, HMGCR, ACACA and CYP27B1.
De novo lipogenesis, a hallmark for cancers is required for cellular transformation. Further it is believed that resistance to apoptosis and epithelial-to-mesenchymal-transition(EMT) facilitates metastasis via over-expression of anti-apoptotic Bcl-2. Previously we demonstrated that hsa-miR-195 targets BCL2, induces apoptosis and augmented the effect of etoposide in breast cancer cells. However, the mechanism behind its function remains elusive. Herein gene expression profiling was done in presence/absence of hsa-miR-195 in Breast cancer cells. IPA revealed mitochondrial dysfunction, fatty acid metabolism and xenobiotic metabolism signalling among the top processes being affected. For the first time we herein identified ACACA, FASN (the key enzymes of de novo fatty acid synthesis), HMGCR (the key enzyme of de novo cholesterol synthesis) and CYP27B1 as direct targets of hsa-miR-195. We further showed that ectopic expression of hsa-miR-195 in MCF-7 and MDA-MB-231 cells not only altered cellular cholesterol and triglyceride levels significantly but also resulted in reduced proliferation, invasion and migration. We further demonstrated that over expression of hsa-miR-195 decreased the Mesenchymal markers expression and enhanced Epithelial markers. In conclusion we say that hsa-miR-195 targets the genes of de novo lipogenesis, inhibits cell proliferation, migration, and invasion which potentially opens new avenues for the treatment of breast cancer.


Social Support, Religiosity, Wisdom and Well-Being Among Older Adults in Indonesia.
As the population ages, it is critical to understand the elements that contribute to the well-being of older individuals. Prior research suggests that a better sense of mastery and purpose in life may explain at least some of the beneficial link between wisdom, religion, and subjective well-being. This current study seeks to identify a model of older persons' psychological well-being formation in a religious group. Whether psychosocial strengths such as religiosity, social support, and wisdom are directly related to psychological well-being. Self-acceptance, autonomy, positive interpersonal relationships, environmental mastery, personal growth, and a sense of life purpose are all components of psychological well-being. This cross-sectional study included 261 participants, 42 men and 219 women aged 60 and up with normal cognitive, hearing, and/or speech functions. Participants lived in The boarding house in South Tapanuli-North Sumatra, Indonesia, for over 6 months. A backward translated Likert scales is used for data collection. The data were analyzed using Structural Equation Model (SEM). The results indicate that social support and religiosity have an effect on psychological well-being through wisdom as a mediator. These findings emphasize the relevance of internal strengths for psychological well-being and give credence to the mediated path model's applicability to older adult communities in Indonesia.


A Comprehensive Study on the Dye Adsorption Behavior of Polyoxometalate-Complex Nano-Hybrids Containing Classic β-Octamolybdate and Biimidazole Units.
Six new hybrids based on β-[Mo₈O26]4- polyoxometalates, [Ni(H₂biim)₃]₂[β-Mo₈O26]•8DMF(1); (DMA)₂[M(H₂biim)₂(H₂O)₂][β-Mo₈O26]•4DMF (M = Ni (2), Co (3)), DMA = dimethyl-ammonium, H₂biim=2,2'-biimidazole); [M(H₂biim)(DMF)₃]₂[β-Mo₈O26]•2DMF (M = Zn (4), Cu (5)); [(DMA)₂[Cu(DMF)₄][β-Mo₈O26]•2DMF]n (6), have been successfully synthesized and characterized. Compounds 2⁻5 show favorable capacity to adsorb methylene blue (MB) at room temperature, and they can selectively capture MB molecules from binary-mixture solutions of MB/MO (MO = Methyl Orange), or MB/RhB (RhB = Rhodamine B). Compound 3 can uptake up to 521.7 mg g-1 MB cationic dyes rapidly, which perform the maximum adsorption in an hour among the reported materials as far as we know. The compounds are stable and still work very efficiently after three cycles. For compound 3, the preliminary adsorption mechanism studies indicated that the adsorption is an ion exchange process and the adsorption behavior of polyoxometalate-complex can be benefited from additional exchangeable protons in the complex cations.


[Laparoscopic Toupet - fundoplication].
The laparoscopic fundoplicatio is the "gold standard" among surgical therapy of gastrooesophageal reflux disease. In this context the Toupet fundoplicatio is an alternative indication to the Nissen fundoplicatio. The lesser dysphagia rate is specified as postoperative advantage. To avoid complications, a standardized procedure is relevant for a good postoperative outcome, even in more complex procedures. In this article, the indications and surgical methods are illustrated, as they are performed by the authors. The operation steps are demonstrated in addition to the text also in the attached video.


A Socio-Technical Regime Transitions Model for Gerontechnology Service Design: Privacy, Information Security and Cyber Security in Focus.
In this paper, we present on ongoing research to use a socio-technical privacy, information security and cybersecurity model to support the design, development and delivery processes of health care services for aging in place. The current research in gerontechnological services development is reviewed, and experiences from the use of serious games to evaluate the model are outlined.


'Peer review' for scientific manuscripts: Emerging issues, potential threats, and possible remedies.
Reviewers play a vital role in ensuring quality control of scientific manuscripts published in any journal. The traditional double blind peer review, although a time-tested method, has come under increasing criticism in the face of emerging trends in the review process with the primary concern being the delays in completion of the review process. Other issues are the inability to detect errors/fraud, lack of transparency, lack of reliability, potential for bias, potential for unethical practices, lack of objectivity, inconsistencies amongst reviewers, lack of recognition and motivation of reviewers. Alternative options to classical peer review being propagated are: open review, immediate self-publication using preprint servers, nonselective review focusing primarily on the scientific content, and post-publication review. These alternative review processes, however, may suffer from the inability to validate quality control. In addition, anecdotal instances of peer review frauds are being reported more often than earlier. Suggested means to ensure quality of peer review process includes:(a) each journal to have its own database of reviewers, (b) verification of email IDs of reviewers provided by authors along with details of their institutions, (c) ensure credibility of reviewers before requesting for review, (d) check for plagiarism at the editorial level, (e) editors to distinguish between a good review from a possible biased/bad review, and (f) give recognition for reviewers once in a year. To conclude, quickness of review and publication should not dictate the scientific publication process at the cost of quality of contents.


Distinct phosphorylation sites in a prototypical GPCR differently orchestrate β-arrestin interaction, trafficking, and signaling.
Agonist-induced phosphorylation of G protein-coupled receptors (GPCRs) is a key determinant for their interaction with β-arrestins (βarrs) and subsequent functional responses. Therefore, it is important to decipher the contribution and interplay of different receptor phosphorylation sites in governing βarr interaction and functional outcomes. Here, we find that several phosphorylation sites in the human vasopressin receptor (V2R), positioned either individually or in clusters, differentially contribute to βarr recruitment, trafficking, and ERK1/2 activation. Even a single phosphorylation site in V2R, suitably positioned to cross-talk with a key residue in βarrs, has a decisive contribution in βarr recruitment, and its mutation results in strong G-protein bias. Molecular dynamics simulation provides mechanistic insights into the pivotal role of this key phosphorylation site in governing the stability of βarr interaction and regulating the interdomain rotation in βarrs. Our findings uncover important structural aspects to better understand the framework of GPCR-βarr interaction and biased signaling.


Undergraduate cardiac arrest team training.
Health profession students are traditionally educated within their discipline with little to no interaction with other health professionals, but are expected to function as integral members of the health care team after graduation. Health profession educators must bridge this disconnect by providing interprofessional learning experiences for students. We sought to evaluate the impact of interdisciplinary team-based (ITB) versus individual discipline-based (DB) learning with multiple health care disciplines during a simulated cardiac arrest. We performed a randomised trial with trainees from radiologic science (RS), physician assistant (PA) and nursing programmes (RN), taught by ITB and DB methods. Teams assessed a simulated patient experiencing a cardiac arrest before and after being educated using the First 5 Minutes(®) Curriculum (First-5). Knowledge and subjective evaluations were collected on each participant both before and after the educational intervention. The data were analysed using generalised estimating equations to account for correlated data. We enrolled 29 subjects: 15 ITB (4 PA, 5 RN, 6 RS) and 14 DB (3 PA, 5 RN, 6 RS). Knowledge improved more in the ITB group than in the DB group: with a median change of 2 (IQR 0-2) versus 1 (IQR 0-2), respectively (p = 0.014). Subjectively, participants overwhelmingly responded that working and learning with other disciplines was a valuable experience, and that more opportunities for interdisciplinary learning should be integrated into the curriculum. More opportunities for interdisciplinary learning should be integrated into the curriculum In our pilot study using a simulated model and the First-5, ITB education appears to improve trainees' knowledge over DB education, and was subjectively preferred by the learner.


Systematic review and meta-analysis of follow-up after hepatectomy for colorectal liver metastases.
The evidence surrounding optimal follow-up after liver resection for colorectal metastases remains unclear. A significant proportion of recurrences occur in the early postoperative period, and some groups advocate more intensive review at this time. A systematic review of literature published between January 2003 and May 2010 was performed. Studies that described potentially curative primary resection of colorectal liver metastases that involved a defined follow-up protocol and long-term survival data were included. For meta-analysis, studies were grouped into intensive (more frequent review in the first 5 years after resection) and uniform (same throughout) follow-up. Thirty-five studies were identified that met the inclusion criteria, involving 7330 patients. Only five specifically addressed follow-up. Patients undergoing intensive early follow-up had a median survival of 39·8 (95 per cent confidence interval 34·3 to 45·3) months with a 5-year overall survival rate of 41·9 (34·4 to 49·4) per cent. Patients undergoing routine follow-up had a median survival of 40·2 (33·4 to 47·0) months, with a 5-year overall survival rate of 38·4 (32·6 to 44·3) months. Evidence regarding follow-up after liver resection is poor. Meta-analysis failed to identify a survival advantage for intensive early follow-up.


Care pathways: have they a place in 'the new National Health Service'?
To discuss the use of Integrated Care Pathways (ICPs) as tools for ensuring cost-effectiveness and high quality patient-focused care. To examine how electronic pathways combining process, practice and audit might be effectively used by Primary Care Groups as a tool to integrate care within the 'New National Health Service'. It has been argued that for doctors pathways lead to 'cook book medicine' and for nurses they move practice away from patient-centred care back to a disease/task-based model. This article explores the origins of pathways, addresses the concerns of critics and goes on to describe a pathway strategy. Pathway development offers the potential to create a coherent plan of care and treatment (across primary/secondary care) which incorporates evidence-based practice and reduces fragmentation and duplication whilst aiding co-ordination and communication. The incorporation of clinical indicators and measurable goals ensures the audit process is embedded.


Review of NEDDylation inhibition activity detection methods.
NEDDylation is a post-translational modification of a protein, which transfers Ubiquitin like protein NEDD8 (Neuronal Precursor Cell-expressed Developmentally Down-regulated Protein 8) to the lysine residue of the product through a three-stage enzymatic reaction, and widely regulates many biological processes, such as cell cycle signal transduction and immune recognition. In the past ten years, we have witnessed tremendous progress in the study of protein ubiquitination modification, from modification mechanisms to drug development. Which suggests that inhibition of NEDDylation is an effective way to inhibit tumor. A variety of biological detection methods have been developed during the development of the inhibitor. In this review, we briefly introduced the modification process and substrates of NEDDylation, and discussed detection methods of NEDDylation activity in detail. This review will provide an up-to-date and comprehensive review of the methods for detecting NEDDylation activity that will contribute to NEDDylation inhibitor development.


Baseline and follow-up MRI of the internal auditory canal after suboccipital resection of acoustic schwannoma: appearances and clinical correlations.
Prospective baseline MRI was obtained on 31 patients who had "total" removal of acoustic schwannoma 6 months to 9 years previously. Follow-up MRI was performed after 1-2 years on patients with questionable abnormalities. We found four patterns (1) internal auditory canals (IAC) with nonenhancing soft-tissue strands, possibly scars or distorted residual nerves (8); (2) IAC with marginal enhancement-reactive dura mater (16); (3) IAC with contrast-enhancing globular tissues suggesting residual or recurrent tumour (5); (4) high-signal intensity in the IAC before contrast medium administration, probably related to graft with fat/fascia/muscle (2). Prospective 1-to 2-year follow-up studies were available in 8, 5, and 1 patients in groups 2, 3, and 4 respectively. In group 2, dural enhancement remained unchanged in 5 patients and decreased in 3. In group 3 follow-up showed 1 tumour recurrence (surgically confirmed) and 4 stable abnormalities. In group 4, follow-up in 1 of the 2 patients was stable. In groups 1 and 2, the MRI features correlate well with complete tumor removal. Whether follow-up in these groups is indicated needs to be determined. In group 3 residual or recurrent tumor cannot be excluded. In group 4, grafts may prevent adequate visualization of the IAC.


Comparison of large-scale deletions of the sperm mitochondrial DNA in normozoospermic and asthenoteratozoospermic men.
Mitochondria play a crucial role in energy metabolism for the survival and motility of sperm during fertilization. The aim of this study was to determine the association of large-scale mitochondrial DNA deletions with abnormal sperm motility and morphology in asthenoteratozoospermic patients. In this case-control study, 41 semen samples were collected from 18 normozoospermic healthy men and 23 asthenoteratozoospermic patients, according to the WHO guidelines. The swim-up technique was used for separation of spermatozoa on the basis of their motility. Long-range polymerase chain reaction (PCR) was used for screening of mitochondrial DNA (mtDNA) large-scale deletions, and primer shift PCR was used for confirmation of deletions. The mean sperm motility, normal morphology, and progressive motility in asthenoteratozoospermic patients were significantly lower than in the normozoospermic group (P < 0.0001). There was a positive significant correlation between motility and normal sperm morphology ( P < 0.0001, r = 0.741). The results of long-range PCR revealed the existence of 4866-bp deletion along with the two common 4977-bp and 7436-bp deleted mtDNA in both groups. However, the frequency of multiple mtDNA deletions in the asthenoteratozoospermic group (15/23, 65.22%) was significantly higher than that in the normozoospermic group (7/18, 38.89%). Direct sequencing of the 534-bp PCR product revealed that it was amplified from the mtDNA with a 4866-bp deletion flanked by a seven-nucleotide direct repeat (5'-ACCCCCT-3'). Our findings suggested that these large-scale deletions of mtDNA may be genetic risk factors for poor sperm quality in asthenoteratozoospermia-induced male infertility. Thus, it is necessary to understand the mechanisms behind the generation of these deletions.


Inhibition of endotoxin-induced hypothermia and serum TNF-alpha levels in CD-1 mice by various pharmacological agents.
Intraperitoneal injection of lipopolysaccharide (LPS) was used to elicit a sublethal, shock-like condition in mice. LPS, 2.5 mg/kg i.p., induced hypothermia, elevated serum TNF-alpha levels and lethality over a 48 h period in male CD-1 mice. The 5-lipoxygenase (LO) inhibitors, WY-50,295 tromethamine and zileuton (100 mg/kg p.o), significantly inhibited hypothermia at 4, 24 and 48 h after LPS. Interestingly, whereas cyclooxygenase (CO) inhibitors (ibuprofen, etodolac, naproxen and tenidap) at 40-80 mg/kg p.o. stimulated hypothermia at 4 h, they significantly reduced the later stages of hypothermia at 24-48 h. Rolipram (PDE-IV inhibitor) and dexamethasone significantly reduced hypothermia at 4-24 h and 1-24 h, respectively. All the anti-inflammatory agents significantly reduced elevated TNF-alpha levels at approximately 70 min post-LPS, except for ibuprofen. In conclusion, these anti-inflammatory standards indicate that LPS-induced shock involves multiple lipid mediators (PG's, LT's and possibly PAF) and secondary cytokine generation. This sublethal model of LPS-induced shock represents a sensitive model for estimating the efficacy of potential drug candidates for the treatment of endotoxic shock.


Use of twitch mouth pressure to assess diaphragm strength in patients with chronic obstructive pulmonary disease.
This study was undertaken to determine whether twitch mouth pressure (TwPmo) can reliably assess diaphragm strength in patients with chronic obstructive pulmonary disease (COPD) using fully automatic trigger techniques. Fifteen patients with COPD were recruited. TwPmo, twitch oesophageal pressure (TwPes) and twitch transdiaphragmtic pressure (TwPdi) were generated by phrenic nerve stimulation and were measured using an inspiratory flow trigger (40 ml/s, Experiment 1) using an inspiratory pressure trigger (-5 cmH2O, Experiment 2) and using no trigger at functional residual capacity (Experiment 3). The correlation between TwPmo and TwPes was as follows: r=0.832; P<0.0001 (Experiment 1), r=0.900; P<0.0001 (Experiment 2); there was no significant correlation in Experiment 3. A Bland-Altman plot of the difference between TwPmo and TwPes showed the limits of agreement in Experiment (1) bias (range) 0.18 cmH2O (-2.05 to 2.41) and Experiment (2) bias (range) 0.32 cmH2O (-1.69 to 2.32). Measuring TwPmo using a fully automatic technique is a simple and convenient method for assessing diaphragm strength.


First insights into species and genotypes of Echinococcus in South Africa.
Cystic echinococcosis is a serious and neglected parasitic zoonosis that is regarded as an emerging disease world-wide. Effective control of the disease is based on understanding the variability of Echinococcus granulosus (sensu lato), as genotypic characteristics may influence lifecycle patterns, development rate, and transmission. No molecular epidemiological research has previously been conducted to shed light on genotypes responsible for the disease in South Africa. To identify strains circulating in the country, parasite material was collected from patients between August 2010 and September 2012 and analyzed by PCR/RFLP methods. A total of 32 samples was characterized as E. granulosus sensu stricto (G1-G3) (81%), E. canadensis (G6/7) (16%) and E. ortleppi (G5) (3%). Furthermore, two co-amplifying G6/7 genotypes were confirmed as G7 by sequencing. This is the first report on genotyping of Echinococcus species in South Africa, and, to the best of our knowledge, the first report of the G5 and G7 genotypes from humans in Africa.


Decreased frequency of bone marrow NK progenitors in aplastic anaemia.
Twelve patients with aplastic anaemia were studied with regard to the frequency of NK progenitors in the bone marrow (BM) to investigate the mechanism of depressed NK activity and low NK cell count in the peripheral blood. NK cell (CD16+ cell) count and NK (K562) activity were significantly decreased (P less than 0.02 and P less than 0.001, respectively) in the patients as compared to eight healthy control subjects. Nylon wool non-adherent (NW-NA) BM mononuclear cells (MNC) of each patient and control were prepared. Mature T and NK cells were extensively depleted by sheep red cell rosette formation followed by a centrifugation on Ficoll-Hypaque and monoclonal antibody mediated complement dependent cytolysis. Those selected BM cells were cultured in the presence of recombinant interleukin 2 (rIL2). Generation of NK activity was significantly decreased (P less than 0.01) in the patients with aplastic anaemia. Frequency of NK progenitors in the selected BM cells assayed by the limiting dilution method was significantly decreased in those patients (P less than 0.05). The frequency of BM NK progenitors relative to NW-NA BM cells were related to NK cell count (P less than 0.01). Those results indicate that depressed NK activity in aplastic anaemia is closely related to decreased NK cell count which is probably due to decreased production of NK cells in the BM.


[Morphologico-functional study of the locomotor system of penguins as a principle of the general motor model of "underwater flight." III].
Based on some ideas about the evolution of the underwater flight of penguins (part I) and morphological data obtained by dissection of 26 individuals (part II), a survey is developed about the cooperation and interaction of the components of the muscle apparatus and some ethological peculiarities of Penguins are explained by their anatomical basis. The knowledge of the mechanics of the shoulder joint will be useful for comparative anatomical studies of specimens of recent and fossil birds.


Maternal report of young children's eating styles. Validation of the Children's Eating Behaviour Questionnaire in three ethnically diverse Australian samples.
The aim of this study was to validate the Children's Eating Behaviour Questionnaire (CEBQ) in three ethnically and culturally diverse samples of mothers in Australia. Confirmatory factor analysis utilising structural equation modelling examined whether the established 8-factor model of the CEBQ was supported in our three populations: (i) a community sample of first-time mothers allocated to the control group of the NOURISH trial (mean child age=24months [SD=1]; N=244); (ii) a sample of immigrant Indian mothers of children aged 1-5years (mean age=34months [SD=14]; N=203), and (iii) a sample of immigrant Chinese mothers of children aged 1-4years (mean age=36months [SD=14]; N=216). The original 8-factor model provided an acceptable fit to the data in the NOURISH sample with minor post hoc re-specifications (two error covariances on Satiety Responsiveness and an item-factor covariance to account for a cross-loading of an item (Fussiness) on Satiety Responsiveness). The re-specified model showed reasonable fit in both the Indian and Chinese samples. Cronbach's α estimates ranged from .73 to .91 in the Australian sample and .61-.88 in the immigrant samples. This study supports the appropriateness of the CEBQ in the multicultural Australian context.


Testosterone replacement therapy in male hypogonadism.
In human males 6-7 mg of testosterone are secreted by the testes in a circadian rhythm with a nocturnal rise in testosterone followed by a decline during the day. Testosterone is necessary to induce and maintain secondary sexual characteristics, lean muscle mass, bone density and for normal sexual behaviour and cognitive function in men. Replacement therapy has been shown to be beneficial in men with overt hypogonadism. Natural testosterone should be used and not modified molecules. Testosterone is currently available in oral, intramuscular, subcutaneous and transdermal preparations. Recent advances in testosterone replacement therapy include testosterone gels which provide flexibility in dosing and minimal skin irritation resulting in good compliance, and the development of longer acting intramuscular preparations which result in more stable testosterone levels with longer injection intervals. All patients receiving testosterone should be carefully monitored for changes in hematocrit, liver function, lipid parameters and prostate specific antigen (PSA).This article reviews the current experience with the use of various forms of testosterone for the treatment of male hypogonadism.


Combined surgical repair and venous sinus stenting for patients with skull base encephaloceles secondary to dural venous sinus stenosis.
Chronically elevated intracranial pressure (ICP) seen in idiopathic intracranial hypertension (IIH) can cause the development of skull base encephaloceles and cerebrospinal fluid (CSF) leaks. Surgical repair and ventriculoperitoneal shunt (VPS) placement are mainstays of treatment. Venous sinus stenting (VSS) is a newly accepted treatment modality. The goal of this study was thus to determine if VSS can be used to treat symptoms and prevent recurrence after surgical encephalocele repair. Retrospective chart review of patients that had surgical repair of encephaloceles followed by VSS for symptomatic stenosis with elevated pressure gradient. A total of 13 patients underwent a combined encephalocele repair and VSS. Seventy-two percent were female; 46% had headaches, 69% pulsatile tinnitus, and 92% CSF rhinorrhea or otorrhea. One had seizures. Mean lumbar opening pressure was 23.3 ± 2.6 cm H2O; the average sagittal-to-jugular pressure gradient was 12.7 ± 1.8 cmH2O and was elevated in all patients. Four patients had middle fossa craniotomy for repair of tegmen defect (one bilateral); one had a retrosigmoid craniotomy for repair of a sigmoid plate defect. Eight had an endoscopic endonasal repair for sphenoid or cribriform plate encephalocele. There were no VSS procedural complications or complications associated with dual antiplatelet therapy. One patient had meningitis after endoscopic repair that was treated with antibiotics. One patient had recurrence of both CSF leak and venous stenosis adjacent to the stent requiring repeat repair and VSS. There was no further recurrence. In patients with dural sinus stenosis and encephaloceles requiring repair, VSS can be performed safely within weeks of surgery for relief of symptoms, resolution of underlying pathology, and prevention of CSF leak recurrence.


Can we improve trauma mortality in a state with a voluntary trauma system.
Arizona has no organized statewide trauma system. We looked at the 1997 and the 1998 Uniform Hospital Discharge Data Set (UHDDS) for the State of Arizona, and examined the trauma mortality data at both trauma hospitals and nontrauma hospitals. All qualifying mortalities based on hospital data from 1997 through 1998 were reviewed for the State of Arizona. Trauma deaths from 32 nontrauma hospitals were examined and compared with that of 7 level 1 trauma centers within the state. In this time period, there were 375 qualified mortalities from nontrauma centers and 761 qualified mortalities from level 1 trauma facilities. Only 29 (8%) of nontrauma hospital deaths were found to be due to motor vehicle accidents. Only 8 (4%) mortalities at nontrauma centers were due to firearms. The data suggest that patients are arriving at the appropriate facility for definitive care despite the absence of a formal statewide trauma system.


Nursing students' perceptions of using smartphones in the community practicum: A qualitative study.
Smartphones have the potential to revolutionize the way in which nurses practice by facilitating access to evidence-based resources, however their integration in nursing practice remain variable. Millennials tend to be more comfortable with technology, yet find themselves limited in their ability to use smartphones within the context of clinical practice. Using a qualitative descriptive design, we explored nursing students' perceptions of using smartphones in the community practicum. Individual semi-structured interviews were conducted and verbatim transcripts were subjected to data analysis. The sample consisted of 8 undergraduate and graduate nursing students. Participants were recruited using a purposive sampling strategy. Students' narratives describe unclear expectations regarding the use of smartphones that force them to adopt individualized strategies to maintain their professional image and avoid negative consequences. A cultural shift will be required at the academic and organizational levels if we are to foster acceptance of smartphones in community practice going forward.


[Animal and human Cryptosporidiosis in rural zone in Vietnam (Cu Chi district, Ho-Chi-Minh-City)].
A pilot study was carried out in May-June 2003 to evaluate the epidemiological situation of cryptosporidiosis in the Cu Chi district, a rural zone of Ho-Chi-Minh City Vietnam. The modified acid-fast stain of the stools revealed that 10/202 (5%) cows, 1/29 (3.5%) cattle breeders, and 2/53 (3.8%) under five year- old children with diarrhoea were infected by this germ. Unconfined cattle had a significantly higher risk of infection than penned animals (odds ratio [OR]: 8.3; 95% confidence interval [CI]: 1.06-64.7; p: 0.025).


Spatiotemporal variability of PAHs and their derivatives in sediments of the Laizhou Bay in the eastern China: Occurrence, source, and ecological risk assessment.
To understand the pollution status and risk levels in the Laizhou Bay, the spatiotemporal distribution, source, and ecological risk of 16 polycyclic aromatic hydrocarbons (PAHs) and 20 substituted PAHs (SPAHs) were studied in surface sediments in 2022. The findings indicated significant seasonal differences in the concentrations of PAHs and SPAHs under the influences of precipitation, temperature, light, and human activities, with higher storage levels in summer than in spring, and there was also a spatial distribution trend of estuary > coast > offshore. 2-Nitrofluorene (2-NF) and 2-methylnaphthalene (2-MN) were the most abundant components of SPAHs in both spring and summer, with levels of 21.44 ng/g and 17.89 ng/g in spring, 43.22 ng/g and 25.51 ng/g in summer, respectively. The results of the diagnostic ratio and principal component analysis - multiple linear regression identified sources of PAHs and SPAHs as combustion sources, including petroleum, coal, and biomass. The risk level of PAHs was low-to-moderate according to the toxicity equivalent quotient (TEQ) and risk quotient. A novel calculation method based on TEQ was proposed to assess the ecological risk of SPAHs, and the results indicated that the risk level of SPAHs was moderate-to-high.


Gastric myoelectrical activity in patients with cervical spinal cord injury.
Dyspeptic symptoms are common in patients with cervical spinal cord injury (SCI). The supraspinal control of sympathetic innervation to the stomach is interrupted in these patients. Gastric emptying has been reported to be delayed in some patients with cervical SCI. Gastric myoelectrical activity is known to regulate gastric motility and is correlated with gastric emptying. The change in gastric myoelectrical activity after cervical SCI is unknown; our aim was to investigate it. The study was performed in 12 cervical SCI patients and 14 healthy controls. Gastric myoelectrical activity was recorded using surface electrogastrography for 30 min in the fasting state and 1 h after a standard test meal. Spectral analysis was performed to compute the following parameters from the electrogastrogram; investigated were the percentage of 2-4 cycles/min (cpm) slow waves, the instability coefficient (IC) of the dominant frequency, the postprandial increment of dominant frequency (deltaF), and its power (deltaP). In both fasting and fed states, regular and stable gastric slow waves were observed in both the control group and patients with cervical SCI. The percentage of normal 2-4 cpm slow waves (preprandial, 80.7+/-3.6% vs 91.5+/-3.7%, p > 0.05; postprandial, 82.0+/-4.4% vs 87.2+/-4.2%, p > 0.05) and IC (preprandial, 0.19+/-0.04% vs 0.28+/-0.05%; postprandial, 0.24+/-0.04% vs 0.27+/-0.02%, p > 0.05) were not significantly different between the two groups. The dominant frequency and its power were also similar between the two groups, no matter whether in the fast (frequency, 2.92+/-0.3 vs 2.93+/-0.06 cpm; power, 30.05+/-1.29 vs 29.08+/-1.23 dB, p > 0.05) or fed (frequency, 3.17+/-0.07 vs 3.02+/-0.06 cpm; power, 32.55+/-0.90 vs 32.07+/-1.18 dB,p > 0.05) state. The postprandial response measured by deltaF (0.25+/-0.09 vs 0.09+/-0.07 cpm, p > 0.05) and deltaP (2.52+/-1.10 vs 2.24+/-1.20 dB, p > 0.05) were also similar between the two groups. Gastric myoelectrical activity was not altered after cervical SCI.


Use of Recorded Poetic Audios to Manage Levels of Anxiety and Sleep Disorders.
Anxiety and sleep disorders are highly prevalent affecting millions of people worldwide. Complementary therapies like art therapy, bibliotherapy, and music have been used to manage these problems. The objective of this study was to evaluate levels of anxiety and sleep disorder symptoms of participants before and after a 30-day intervention of listening to short poetic audios. Thirty-one participants listened to audio-taped messages, which associate music and literature for 30 days. Questionnaires were answered by participants prior to the start of the study (baseline collection) and after 30 days (final collection). Setting: the study was done in the city of Ribeirao Preto (Sao Paulo-Brazil). Participants were 31 adults with anxiety symptoms and sleep problems. The scores of the questionnaires were analyzed and compared by the t test for paired samples (α = 0.05), used to evaluate possible differences in anxiety and stress symptoms and sleep disturbances before and after the 30 days of intervention. Significantly lower levels of anxiety and sleep disorders were found after the 30-day intervention. This study reinforces the benefits of music and literature for improving the quality of life of people by reducing levels of anxiety and sleep disorder symptoms.


A novel way to validate UAS-based high-throughput phenotyping protocols using in silico experiments for plant breeding purposes.
It is possible to make inferences regarding the feasibility and applicability of plant high-throughput phenotyping via computer simulations. Protocol validation has been a key challenge to the establishment of high-throughput phenotyping (HTP) in breeding programs. We add to this matter by proposing an innovative way for designing and validating aerial imagery-based HTP approaches with in silico 3D experiments for plant breeding purposes. The algorithm is constructed following a pipeline composed of the simulation of phenotypic values, three-dimensional modeling of trials, and image rendering. Our tool is exemplified by testing a set of experimental setups that are of interest in the context of maize breeding using a comprehensive case study. We report on how the choice of (percentile of) points in dense clouds, the experimental repeatability (heritability), the treatment variance (genetic variability), and the flight altitude affect the accuracy of high-throughput plant height estimation based on conventional structure-from-motion (SfM) and multi-view stereo (MVS) pipelines. The evaluation of both the algorithm and the case study was driven by comparisons of the computer-simulated (ground truth) and the HTP-estimated values using correlations, regressions, and similarity indices. Our results showed that the 3D experiments can be adequately reconstructed, enabling inference-making. Moreover, it suggests that treatment variance, repeatability, and the choice of the percentile of points are highly influential over the accuracy of HTP. Conversely, flight altitude influenced the quality of reconstruction but not the accuracy of plant height estimation. Therefore, we believe that our tool can be of high value, enabling the promotion of new insights and further understanding of the events underlying the practice of high-throughput phenotyping.


Translocation (7;21) in a lipoma.
Cytogenetic analysis was performed on a solitary lipoma from the flank of a 38-year-old male. A translocation t(7;21)(p22;q11.2) was found as the sole clonal chromosomal abnormality. The results are discussed in relation to other cytogenetic abnormalities found in benign adipose tumors.


Electrophysiological and structural assessment of the central retina following intravitreal injection of bevacizumab for treatment of macular edema.
To evaluate with electrophysiological responses and Optical Coherence Tomography (OCT), the short term functional and structural effects at the macula following intravitreal injection of bevacizumab for macular edema. Prospective, non-randomized, interventional case study. In total, 17 eyes of 17 patients with macular edema due to vein occlusions and diabetic retinopathy received intravitreal bevacizumab. All Patients underwent complete ophthalmic examination including Snellen visual acuity testing, Multifocal Electroretinography (mfERG) and Full Field Electroretinography (FERG), OCT scanning at baseline at 1 week and 2 months after intravitreal bevacizumab. FERG did not show any change in waveform parameters following intravitreal injection of bevacizumab. Average mfERG macular responses within central 20 degrees showed increased P(1) amplitude (P < 0.05) at 2 months after treatment as compared to the baseline recordings in all subjects. No changes were seen in the implicit time. There was 22% improvement in central retinal thickness (CRT) at 2 months compared to the baseline (P < 001). Intravitreal injection bevacizumab resulted in reduction in the central retinal thickness and mild to moderate improvement in the mfERG amplitudes in this short-term study. The visual acuity changes did not directly correlate with the reduced central retinal thickness or improvement in mfERG. The short-term results showed no serious ocular adverse effects. Therefore on short-term follow up the off label drug showed improvement of macular edema secondary to vein occlusion and diabetic retinopathy with no demonstrable toxic effects.


Imaging Atomic Scale Dynamics on III-V Nanowire Surfaces During Electrical Operation.
As semiconductor electronics keep shrinking, functionality depends on individual atomic scale surface and interface features that may change as voltages are applied. In this work we demonstrate a novel device platform that allows scanning tunneling microscopy (STM) imaging with atomic scale resolution across a device simultaneously with full electrical operation. The platform presents a significant step forward as it allows STM to be performed everywhere on the device surface and high temperature processing in reactive gases of the complete device. We demonstrate the new method through proof of principle measurements on both InAs and GaAs nanowire devices with variable biases up to 4 V. On InAs nanowires we observe a surprising removal of atomic defects and smoothing of the surface morphology under applied bias, in contrast to the expected increase in defects and electromigration-related failure. As we use only standard fabrication and scanning instrumentation our concept is widely applicable and opens up the possibility of fundamental investigations of device surface reliability as well as new electronic functionality based on restructuring during operation.


The effect of technology-based interventions on child and parent outcomes in pediatric oncology: A systemic review of experimental evidence.
In recent years, childhood cancers have become an increasingly important health problem worldwide. Evidence shows that technology-based interventions in pediatric oncology are effective, feasible, and acceptable. However, studies in this field are limited. This systematic review was planned to examine the available evidence for the impact of technology-based interventions on children, adolescents with cancer patients, and their parents. In the systematic review, studies published between 2014 and 2023 from The Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus with Full Text, Cochrane Library, PsycINFO, ProQuest PubMed, Science Direct, Scopus, and Web of Science databases were identified using a search strategy. Six studies by the criteria were examined in terms of the technology-based intervention, the intervention's duration, the follow-up period, significant findings, and the theory used in the intervention. The Joanna Briggs Institute (JBI) critical appraisal tools were used to evaluate the quality of the studies. In this systematic review, preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. A total of six studies met the inclusion criteria: five randomized controlled trials and one quasi-experimental study. In studies for children with cancer, it was determined that the children were between the ages of 6 and 18. It has been determined that technology-based interventions mostly consist of electronic health interventions such as web-based interventions, virtual reality, and digital and mobile health interventions such as messaging, phone contact, and smartphone applications. In the studies, the intervention period ranged from 1 to 1.5 h and 10 weeks, and the follow-up periods ranged from 12 weeks to 6 months. In studies for parents, it was observed that the intervention durations ranged from 8 to 12 weeks, and the follow-up periods varied between 3 and 12 months. In most of the studies, technology-based applications have positive effects on the physical and psychological (symptom management, anxiety, stress, coping, and quality of life) problems of children and adolescents. Technology-based interventions affect parents' knowledge levels and coping skills, psychosocial symptoms (anxiety, post-traumatic stress disorder, depression, and caregiver burden), resilience, social support, and self-efficacy. Technology-based interventions have been effective in improving physical and psychological symptoms in children with cancer, and parents' coping and psychosocial symptoms. These results should be interpreted with caution due to the limited number of studies, small sample sizes, and high heterogeneity. Comprehensive and high-quality randomized controlled trials are needed to obtain the best evidence for the effectiveness of technology-based interventions in pediatric oncology. PROSPERO registration number was CRD42022297664.


Drug-Induced Liver Injury from Statins.
The hydroxymethyglutaryl-coenzyme A reductase inhibitors (statins) are a commonly prescribed class of medication for the treatment of hyperlipidemia and coronary artery disease. This class of medication has several proven benefits, including reduction of mortality related to coronary artery disease. A major consideration when prescribing these drugs are the potential for adverse effects, mainly myalgias, myopathy, and hepatotoxicity. In this article, we summarize current data on statin-associated hepatotoxicity and highlight that the risk of clinically significant idiosyncratic drug-induced liver injury is actually quite small. We also review preclinical data suggesting potential hepatoprotective effects of statin therapy.


Overlapping rheumatoid meningitis with anti-N-methyl-D-aspartate receptor encephalitis: A case report.
A 66-year-old woman in treatment for rheumatoid meningitis was found to be positive for anti-N-methyl-D-aspartate receptor (NMDAR) antibodies in the cerebrospinal fluid, and intravenous immunoglobulin improved her psychiatric symptoms. The co-existence of NMDAR antibodies should be considered in cases of poor response to treatments or atypical symptoms in rheumatoid meningitis.


Regulation of glutamate level in rat brain through activation of glutamate dehydrogenase by Corydalis ternata.
When treated with protopine and alkalized extracts of the tuber of Corydalis ternata for one year, significant decrease in glutamate level and increase in glutamate dehydrogenase (GDH) activity was observed in rat brains. The expression of GDH between the two groups remained unchanged as determined by Western and Northern blot analysis, suggesting a post-translational regulation of GDH activity in alkalized extracts treated rat brains. The stimulatory effects of alkalized extracts and protopine on the GDH activity was further examined in vitro with two types of human GDH isozymes, hGDH1 (house-keeping GDH) and hGDH2 (nerve-specific GDH). Alkalized extracts and protopine activated the human GDH isozymes up to 4.8-fold. hGDH2 (nerve- specific GDH) was more sensitively affected by 1 mM ADP than hGDH1 (house-keeping GDH) on the activation by alkalized extracts. Studies with cassette mutagenesis at ADP-binding site showed that hGDH2 was more sensitively regulated by ADP than hGDH1 on the activation by Corydalis ternata. Our results suggest that prolonged exposure to Corydalis ternata may be one of the ways to regulate glutamate concentration in brain through the activation of GDH.


The impact of work-family conflict on product preferences: The role of self-control.
Despite the high incidence of work-family conflict, there has been a lack of research that investigates its impact on employee behavior, particularly concerning their consumption behavior, which has received inadequate attention. The present study draws on the strength model of self-control and investigates the influence of individuals' work-family conflict on their preferences for hedonic and utilitarian products via self-control, with frugality acting as a moderator of this relationship. This study gathered data from 502 full-time employees with families in China. Results from the moderated mediating model analysis conducted using the SPSS-PROCESS macro revealed that work-family conflict was positively associated with a preference for hedonic products and negatively associated with a preference for utilitarian products. Self-control was found to mediate the relationship between work-family conflict and product preferences, with a weaker mediating effect observed for individuals with higher levels of frugality in the case of utilitarian products. The findings of this study contribute to the literature on work-family conflict and have implications for organizations and merchants in understanding and addressing the impact of work-family conflict on employee consumption behavior. Specifically, this study provides insight into how organizations can better manage work-family conflict and how merchants can make more informed marketing decisions for hedonic and utilitarian products.


Modulatory effect of methylsulfonylmethane against BPA/γ-radiation induced neurodegenerative alterations in rats: Influence of TREM-2/DAP-12/Syk pathway.
Methylsulfonylmethane (MSM), is an organosulfur compound, has many health benefits. Bisphenol-A (BPA) and γ-radiation (R) are two risky environmental contaminants that human beings are exposed to in everyday life. This work aims at unveiling the modulatory role of MSM in combating BPA and R co-exposure induced neurodegenerative disorder (Alzheimer's (AD)-mimic neurotoxicity). Female rats were randomly divided into five groups. One group was normal control and the other four groups were subjected to subacute BPA intoxication and/or exposed to fractionated weekly doses of R for 4 weeks and either untreated or treated with MSM concomitantly. BPA and R co-exposure induced typical hallmarks of neurodegenerative disorders as revealed by tremendously elevated oxidative stress, extensive neuroinflammation (tumor necrosis factor -α and interleukin-1β), elevated AD markers (amyloid-beta (Aβ42), acetylcholinesterase (AchE) activity and tau-phosphorylation) in cortex and hippocampus as well as up-regulation of microglial pro-inflammatory triggering receptor expressed on myeloid cell-2(TREM-2)/DNAX-activating protein of 12 kDa (DAP-12)/spleen-tyrosine kinase (Syk) pathway and its downstream targets (PLC-γ/DAG/p38-MAPK) in hippocampus. Also, neurodegenerative lesions were revealed in histopathological examination of cortex and hippocampus coupled with marked Aβ deposition in hippocampus. Whereas, MSM treatment improved histopathological insults and ameliorated level of oxidative stress, neuroinflammation and AD markers as well as modulated TREM-2/DAP-12/Syk pathway. Our data suggest that MSM afforded neuroprotection against BPA and R; supporting its potential application in the associated neurodegenerative disorders.


Trace metal imbalance associated with oxidative stress and inflammatory status in anti-hepatitis C virus antibody positive subjects.
Toxic and essential trace metals, oxidative stress, and inflammatory status were evaluated in anti-hepatitis C virus (HCV) antibody-positive subjects. Blood biochemical parameters were determined in anti-HCV antibody-positive (n=17) and -negative controls (n=46). Compared with controls, anti-HCV antibody-positive individuals had significantly lower concentrations of plasma zinc (Zn); higher copper (Cu), iron (Fe), lead (Pb), cadmium (Cd), and aluminum (Al); and lower activities of erythrocyte antioxidant enzymes glutathione peroxidase and catalase, and elevated superoxide dismutase. Significantly increased lipid peroxidation malondialdehyde (MDA), and inflammatory markers such as alanine aminotransferase (ALT), high sensitivity C-reactive protein (hs-CRP), ferritin, and Cu/Zn ratios, as well as decreased albumin and high density lipoprotein (HDL) concentrations were observed. We have found significant interactions between toxic (e.g., Pb, Cd, and Al) and essential metals (e.g., Zn, Cu, Fe), which correlated with MDA. In conclusion, anti-HCV antibody-positive subjects had abnormal distributions of trace metals that may aggravate oxidative stress and inflammation, and exacerbate hepatic damage.


Sheep in Species-Rich Temperate Grassland: Combining Behavioral Observations with Vegetation Characterization.
Foraging behavior of livestock in species-rich, less intensively managed grassland communities will require different methodologies from those appropriate in floristically simple environments. In this pilot study on sheep in species-rich grassland in northern Estonia, foraging behavior and the plant species of the immediate area grazed by the sheep were registered by continually-recording Go-Pro cameras. From three days of observation of five sheep (706 animal-minutes), foraging behavior was documented. Five hundred and thirty-six still images were sampled, and a plant species list was compiled for each. Each plant species was assigned a score indicating its location, in the ecophysiological sense, on the main environmental gradient. The scores of the plant species present were averaged for each image. Thus, the fine structure of foraging behavior could be studied in parallel with the vegetation of the precise area being grazed. As expected, there was considerable individual variation, and we characterized foraging behavior by quantifying the patterns of interspersion of grazing and non-grazing behaviors. This combination of behavior recording and vegetation classification could enable a numerical analysis of the responses of grazing livestock to vegetation conditions.


African population history: an ancient DNA perspective.
The history of human populations in Africa is complex and includes various demographic events that influenced patterns of genetic variation across the continent. Through genetic studies of modern-day, and most recently, ancient African genetic variation, it became evident that deep African history is captured by the relationships among hunter-gatherers. Furthermore, it was shown that agriculture had a large influence on the distribution of current-day Africans. These later population movements changed the demographic face of the continent and descendants of farming groups today form the majority populations across Africa. Ancient DNA methods are continually evolving, and we see evidence of this in how research has advanced in the last decade. With the increased availability of full genomic data from diverse sets of modern-day and prehistoric Africans we now have more power to infer human demography. Future ancient DNA research promises to reveal more detailed stories of human prehistory in Africa.


Transcutaneous monitoring as trigger for therapy of hypoxemia during sleep.
Based on results on central chemosensitivity in cats, paired stimuli were applied for therapy to infants with central respiratory insufficiency of various degrees. An unspecific respiratory stimulus, e.g. light for 1 s, was followed by a jet of either O2 or 2% CO2 in O2 for 1.5 s. The unspecific and the chemical stimuli were interspaced by 0.5 s. The combined stimulation was repeated every 10 s. The program was triggered by using threshold values of transcutaneous pO2. In infants with intratrachial tubes or tracheostoma we used the end tidal pCO2 for triggering the stimulation. The method could prevent hypoxemia during sleep in non-ventilated subjects with sleep apnea syndromes or in infants with severe hypoxemia during sleep after being rescued from Sudden Infant Death Syndrome (SIDS). In patients with Ondine's Curse Syndrome (OCS) with its CO2 insensitivity, paired stimuli were used in order to condition the chemical function of the respiratory system. Polysomnograms from 310 clinically healthy infants including healthy siblings of SIDS victims revealed instability of arterial pO2 and low CO2 sensitivity during sleep within the second month and the fourth to ninth month of life, respectively. These data challenge the described method as a potential preventive or therapeutic measure to defeat SIDS and sleep apnea syndromes in conjunction with disturbed chemical regulation of respiration.


Diversity and functional annotation of microorganisms in French vertical flow constructed wetland treating greywater.
Constructed wetlands form a unique ecosystem having plants, soil, microbes in which microorganisms play a vital role in the transformation and degradation of pollutants from wastewater. In the present study, French type two-stage vertical flow constructed wetland (VFCW) was used for the treatment of single household greywater (GW). Pilot-scale VFCW having sand and gravel as the filter substrate was constructed with Canna indica plantation for treating GW. To understand the pollutant removal mechanism in VFCW, microbial diversity and functional annotation was carried out by metagenomics analysis of sequences obtained from illumina platform. Efficiency of VFCW was measured with respect to water quality parameters like COD, BOD5, Total Nitrogen, Nitrate, Nitrite, Ammoniacal-N, ortho-phosphate and TOC from inlet and outlet of system. The removal efficiency was 90%, 93%, 34%, 26%, 89%, 68%, 80%, and 80% for COD, BOD5, Total Nitrogen, Nitrate, Nitrite, Ammoniacal-N, ortho-phosphate and TOC respectively. Microbial diversity was much more diversified and unique in VFCW compared to GW. Metagenomes exhibited Proteobacteria and Bacteroidetes as major phyla in GW whereas Actinobacteria, Proteobacteria, Nitrospirae abundance in VFCW layers. Total of 809 and 695 genus were found in VFCW and GW respectively with minimum abundance of 10 hits. From functional annotation of sequences, VFCW microbes have the potential to transform various aromatic and xenobiotic compounds along with the removal of pollutants present in the form of Carbon, Nitrogen, and Phosphorus. These data reveal French type VFCW can efficiently treat GW and with its own unique, variable habitat VFCW harbours diverse community of microorganisms that transform and degrade the pollutants in GW.


Naloxone efficacy in bladder rehabilitation of spinal cord injury patients.
Naloxone has been reported to facilitate detrusor activity by blocking the inhibitory action of the enkephalins. We tested the urodynamic effects of intravenous naloxone (0.4 to 0.8 mg.) in 15 patients with spinal cord injury via rapid fill carbon dioxide cystometry and perineal electromyography. Fourteen patients had suprasacral lesions (3 complete), while 1 had an incomplete lower cord lesion. The average interval from injury was 4.2 months. Most of the patients were managed with intermittent catheterization and most had chronic bacteriuria. Initially, 10 patients had detrusor areflexia and 5 had detrusor hyperreflexia (2 with dyssynergia). Of the 15 patients 14 had no neuropathic condition as noted on baseline electromyography. After naloxone injection no significant cystometrographic changes occurred but 11 patients (73 per cent) had decreased electromyographic activity. The vesicourethral pattern of the 2 patients with dyssynergia did not change after naloxone, even though the electromyographic response decreased in both. The patients showed no other effects of the naloxone administration. Contrary to other studies, naloxone seemed to diminish pelvic floor (electromyographic) activity but it did not change bladder (cystometrographic) function during bladder rehabilitation of spinal cord injury patients.


Cell-cell interaction of macrophages and vascular smooth muscle cells in the synthesis of leukotriene b(4).
Biosynthesis of LTB(4) during cell-cell interaction between vascular smooth muscle cells (SMC) and alveolar macrophages (AM) has been investigated by use of both high-pressure Hquid chromatography (HPLC) and radtoimmunoassay (RIA). Both interleukin-beta (IL-beta) and tumour necrosis factor-alpha (TNFalpha) induced a time- and dose-dependent synthesis of 15-, and 5-hydroxyeicosatetraenoic acids (HETEs) from cultured SMC. However, neither TNFalpha nor IL-1beta induced a significant LTB(4) production in SMC alone or AM alone after 24 h of incubation. Addition of IL-1beta and TNFalpha simultaneously to SMC resulted in a dose-dependent synergistic increase of HETEs. Macrophages dose-dependently transformed extremely low concentrations of exogenous LTA(4) into LTB(4). Incubation of vascular SMC with various numbers of AM in the presence of IL-1beta (5 units/ml) and TNFalpha (10 units/ml) induced a great increase of LTB(4) synthesis in comparison with the detectable levels of LTB(4) produced by macrophages alone. Pretreatment of SMC with NDGA, cycloheximide, and actinomycin not only inhibited IL-1 and TNT induced HETEs synthesis but also abolished LTB(4) production when co-incubated with macrophages. These results suggest that LTB(4) in a mixture of SMC and macrophages could originate from a transcellular metabolism, i.e. macrophages transforming SMC-derived LTA(4) into LTB(4).


Synthesis and bioevaluation of hybrid 4-aminoquinoline triazines as a new class of antimalarial agents.
The emergence and rapid spread of chloroquine resistant strains of Plasmodium falciparum has dramatically reduced the chemotherapeutic options. Towards this goal, a series of new class of hybrid 4-aminoquinoline triazines were synthesized and screened against CQ sensitive strain 3D7 of P. falciparum in an in vitro model. Compounds 65 and 69 exhibited more than 99% suppression on day 4 and on day 6 post treatment, compound 69 showed impressive 99.11% suppression against CQ resistant strain N-67 of P. yoelii in an in vivo assay.


Aflatoxin M1 in milk, in Southern Italy.
A survey on the occurrence of aflatoxin M1 was carried out in the province of Bari (Italy) on a total of 106 samples of raw milk from local farms, commercially heattreated milk, and dried milk. About 72% of the samples were contaminated with aflatoxin M1 within the concentration range 4-280ng/Kg. The incidence of aflatoxin M1 was much higher in commercial milk (91%) than in farm milk (26%), and all the dried milk samples contained aflatoxin Ml (10 to 280ng per Kg of powder milk).


Posttraumatic elbow arthritis and arthroplasty.
Elbow contractures without significant articular injury can be treated with soft-tissue procedures, such as joint capsular releases, resection of heterotropic ossification, and joint debridement. Elbows with significant intra-articular injuries or posttraumatic arthritis require some form of joint reconstruction, such as a distraction arthroplasty, interposition arthroplasty, or implant replacement arthroplasty. With a better understanding of the surgical indications for elbow arthroplasty, improvements in surgical technique, improvements in elbow implants, and increased surgical experience, the results of implant arthroplasty for the posttraumatic elbow continue to improve.


Evaluation of Medium-Term Efficacy of Y90 Radiation Segmentectomy vs Percutaneous Microwave Ablation in Patients with Solitary Surgically Unresectable < 4 cm Hepatocellular Carcinoma: A Propensity Score Matched Study.
To evaluate the efficacy and safety of Y90 radiation segmentectomy (RS) vs. percutaneous microwave ablation (MWA) in patients with solitary HCC ≤ 4 cm. From 2014 to 2017, 68 consecutive treatment naïve patients were included (34 per treatment arm). Chi-square and t-test were used to evaluate differences in baseline demographics between groups. Objective response was evaluated using mRECIST and toxicity using CTCAE. Overall survival (OS) and progression free survival (PFS) in the targeted tumor and the remainder of liver from initial treatment was calculated using Kaplan-Meier estimation. Propensity score matching was then performed with n = 24 patients matched in each group. Similar outcome analysis was then pre-formed. In the overall study population, both groups had similar baseline characteristics with the exception of larger lesions in the RS group. There was no difference in toxicity, objective tumor response, OS and non-target liver PFS between the MWA and RS group (p's > 0.05). In the matched cohort, the objective tumor response was 82.6% in MWA vs. 90.9%% in RS (p = 0.548). The mean OS in the MWA group (44.3 months) vs RS (59.0 months; p = 0.203). The targeted tumor mean PFS for the MWA groups was 38.6 months vs. 57.8 months in RS group (p = 0.005). There was no difference overall PFS and toxicity between the 2 matched groups. Our data suggest Y90 RS achieves similar tumor response and OS with a similar safety compared to MWA in the management of HCC lesions ≤ 4 cm. Additionally, targeted tumor PFS appears to be prolonged in the RS group with similar non-target liver PFS between RS and MWA group.


Women's experiences of information, education and support when undergoing pelvic radiotherapy for gynaecological cancer: An exploratory qualitative study.
As cancer survival rates increase, so does the importance of preventing and alleviating the late effects of radiotherapy. The effect of long-term problems on patients' physical, social and psychological well-being must be addressed along with the importance of developing an understanding of the late effects of treatment to find ways of maximising the quality of life of cancer survivors. The aim of this service evaluation was to establish what support, information and education on post treatment changes women who have undergone pelvic radiotherapy for gynaecological cancer were provided with, and whether it met their needs. An interpretative phenomenological analysis was undertaken to explore the support, information and education on post treatment changes women who have undergone pelvic radiotherapy for gynaecological cancer are currently provided with and whether or not it meets their needs. Semi-structured interviews were conducted to gain insight into the experiences of participants. Researcher reflexivity was considered and ethics permissions granted. This paper reports the themes from analysis; communication and information provision, abandonment, service provision, and sexual health and intimacy. All patients experienced feelings of abandonment at the completion of treatment and those experiencing ongoing side effects needing greater support, particularly to manage side effects affecting the bowel and bladder. This study fills a gap in existing knowledge and identifies that patients with a gynaecological cancer require greater communication and support. The introduction of a therapeutic radiographer led late effects clinic and sexual care after radiotherapy clinic could provide the support and information that patients need to cope with the long-term side effects experienced due to pelvic radiotherapy. This service evaluation highlights the importance of including patient perspectives when designing and developing services.


Burnout levels and care behaviours in intensive care nurses: A cross-sectional, multicentre study.
To examine the relation between burnout levels and caring behaviours in intensive care nurses in Turkey, and the affecting factors. The research was conducted as a descriptive, cross-sectional and multi-centred study. In this study, an online questionnaire was applied in April and May 2021, using Google Form. A total of 460 intensive vare nurses responded to the questionnaire. Burnout was assessed with the Maslach Burnout Inventory, and care behaviours with the Caring Behaviours Inventory-24. The nurses reported a high level of emotional exhaustion (73.9%) and depersonalization (52.2%), and a medium level of personal accomplishment (40%). The nurses' levels of perception of care quality were high (5.4 ± 0.6). It was found that their highest score on the subdimensions was on knowledge and skills (5.6 ± 0.5), and the lowest was on connectedness (5.2 ± 0.7). There was a very weak, respectively weak correlation, between nurses' emotional exhaustion (r = -0.1), respectively depersonalization (r = -0.2), and poor care behaviours. There was a strong correlation between low personal accomplishment scores and poor care behaviours (r = 0.8). It was found that the mean scores of the nurses' exhaustion and care behaviours varied according to many descriptive characteristics, such as education, age, professional experience, the unit where they worked, communication difficulties, living conditions and whether they had chosen nursing willingly. It appears that the level of personal accomplishment, is the only subscale reflecting risk of burnout, that strongly correlates with care behaviour.


Effects of methylprednisolone on experimental pulmonary injury.
We studied the effects of methylprednisolone on pulmonary function of unanesthetized dogs with oleic acid induced pulmonary edema observed over a four day period. Methylprednisolone (30 mg/kg) was administered to 11 dogs three and 24 hours after pulmonary injury. Eleven animals were untreated after pulmonary injury and served as controls. There was no difference between the two groups until 72 hours after injury, when the venous admixture of the steroid treated animals was 11 +/- 3% (SD) compared to 22 +/- 8% (p less than 0.001) in the untreated with respective PaO2 values of 76 +/- 6 torr and 64 +/- 8 torr (p less than 0.001). Light microscopic examination of the lungs 96 hours after injury revealed a marked proliferation of Type II pneumocytes in the methylprednisolone treated animals. We conclude that, in the oleic acid or fat embolism model of pulmonary injury, methylprednisolone significantly increases resolution of the pulmonary injury presumably by stimulation of active proliferation and maturation of Type II pneumocytes.


Role of imaging in temporal bone and cerebellopontine-angle lesions. A surgeon's perspective.
In recent years, with the advances in imaging technology, the gold standard for diagnosis of lesions of the temporal bone and cerebellopontine angle has shifted from histologic identification of the lesion from surgical specimens or autopsy material to noninvasive identification, localization, and characterization of the tissue by imaging. The symptoms caused by such lesions usually provide clues as to their location and probable nature. Clinical tests such as the vestibular evaluation, audiometry, auditory brain stem response, and otoacoustic emissions further help with topodiagnosis of the lesion. If this information is covered to the neuroradiologist, the most diagnostically productive imaging study can be obtained, and the neuroradiologist will apply the most appropriate technical parameters necessary for any individual patient. An eclectic algorithm can be applied for each clinical situation, and illustrative examples are provided in the article. The algorithms will no doubt change with advances in diagnostic tests. Application of imaging studies without adequate clinical investigations often makes the task of interpreting the scans difficult for the neuroradiologist. Furthermore, the positive diagnostic yield from a widespread use of imaging technology is small and would be considered an inappropriate use of health care dollars.


Associations of parental and perinatal factors with subsequent risk of stress-related disorders: a nationwide cohort study with sibling comparison.
Little is known about the contribution of pregnancy-related parental and perinatal factors to the development of stress-related disorders. We aimed to investigate whether parental/perinatal adversities entail higher risks of stress-related disorders in the offspring, later in life, by accounting for genetic and early environmental factors. Based on the nationwide Swedish registers, we conducted a population-based cohort study of 3,435,747 singleton births (of which 2,554,235 were full siblings), born 1973-2008 and survived through the age of 5 years. Using both population- and sibling designs, we employed Cox regression to assess the association between parental and perinatal factors with subsequent risk of stress-related disorders. We identified 55,511 individuals diagnosed with stress-related disorders in the population analysis and 37,433 in the sibling analysis. In the population-based analysis we observed increased risks of stress-related disorders among offspring of maternal/paternal age <25, single mothers, parity ≥4, mothers with BMI ≥ 25 or maternal smoking in early pregnancy, gestational diabetes, and offspring born moderately preterm (GA 32-36 weeks), or small-for-gestational-age. These associations were significantly attenuated toward null in the sibling analysis. Cesarean-section was weakly associated with offspring stress-related disorders in population [hazard ratio (HR) 1.09, 95% confidence interval (CI) 1.06-1.12] and sibling analyses (HR 1.10, 95% CI 1.02-1.20). Our findings suggest that most of the observed associations between parental and perinatal factors and risk of stress-related disorders in the population analysis are driven by shared familial environment or genetics, and underscore the importance of family designs in epidemiological studies on the etiology of psychiatric disorders.


Beyond the exposure phase: Microplastic depuration and experimental implications.
Currently, most studies focus on the effect of microplastics (MPs) in the exposure phase, but pay limited attention to the depuration phase. Depuration is a promising practice to achieve safe aquaculture production, which is also helpful to understand the long-term impact of MPs. Therefore, investigating the post-exposure scenarios of MPs has great practical significance. In order to provide implications for future research, this work attempted to systematize the current findings and knowledge gaps regarding the depuration of MPs. More specifically, three methods, including direct fitting, one-compartment kinetic model and interval observation, for estimating the retention time of MPs to further determine the minimum depuration time were introduced, in which the one-compartment kinetic model could also be used to calculate the depuration rate constant and biological half-life of MPs. Moreover, the post-exposure effect of MPs generally presented three scenarios: incomplete reversal (legacy effect), return to control level (recovery) and stimulatory response (hormesis-like effect). In addition, the possible tissue translocation of MPs, the influence of food abundance and body shape on MPs egestion, and the potential interaction with environmental factors, have aroused great scientific concerns and need further exploration and clarification.


Alphavbeta3 and alphavbeta5 integrins control glioma cell response to ionising radiation through ILK and RhoB.
Integrins are extracellular matrix receptors involved in tumour invasion and angiogenesis. Although there is evidence that inhibiting integrins might enhance the efficiency of radiotherapy, little is known about the exact mechanisms involved in the integrin-dependent modulation of tumor radiosensitivity. The purpose of this study was to investigate the role of alphavbeta3 and alphavbeta5 integrins in glioblastoma cell radioresistance and overall to decipher the downstream biological pathways. We first demonstrated that silencing alphavbeta3 and alphavbeta5 integrins with specific siRNAs significantly reduced the survival after irradiation of 2 glioblastoma cell lines: U87 and SF763. We then showed that integrin activity and integrin signalling pathways controlled the glioma cell radiosensitivity. This regulation of glioma cell response to ionising radiation was mediated through the integrin-linked kinase, ILK, and the small GTPase, RhoB, by two mechanisms. The first one, independent of ILK, consists in the regulation of the intracellular level of RhoB by alphavbeta3 or alphavbeta5 integrin. The second pathway involved in cell radiosensitivity consists in RhoB activation by ionising radiation through ILK. Furthermore, we demonstrated that the alphavbeta3/alphavbeta5 integrins/ILK/RhoB pathway controlled the glioma cells radiosensitivity by regulating radiation-induced mitotic cell death. This work identifies a new biological pathway controlling glioblastoma cells radioresistance, activated from the membrane through alphavbeta3 and/or alphavbeta5 integrins via ILK and RhoB. Our results are clues that downstream effectors of alphavbeta3 and alphavbeta5 integrins as ILK and RhoB might also be promising candidate targets for improving the efficiency of radiotherapy and thus the clinical outcome of patients with glioblastoma.


Minimally invasive colectomies can be performed with similar outcomes to open counterparts for colorectal cancer emergencies: a propensity score matching analysis utilizing ACS-NSQIP.
The safety and feasibility of minimally invasive surgery (MIS) in the setting of colorectal cancer emergencies have been debated. We sought to compare postoperative outcomes of MIS with open techniques in the setting of colorectal cancer emergencies from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. We included patients undergoing colectomy for colorectal cancer emergency between 2012 and 2019 "2012-2019" from the ACS-NSQIP dataset. We compared short-term morbidity, mortality, short-term oncological outcomes, and secondary outcomes for MIS vs open colectomies using propensity score matching. We then evaluated the trends of MIS versus open colectomies using linear regression analysis. We examined a total of 5544 patients (open n = 4070; MIS n = 1474) and included 1352 patients for our postoperative outcome analyses after propensity score matching 1:1 (open n = 676; MIS n = 676). Within the matched cohort, mortality was significantly higher in the open group (open 6.95% vs MIS 3.99%, OR 1.8, p = 0.023). Anastomotic leak rates were comparable between the two groups (open 4.46% vs MIS 4.02%, OR 1.12, p = 0.787). Pulmonary complications were significantly higher after open surgery (open 10.06% vs MIS 4.73%, OR 2.25, p < 0.001). Rates of ileus were significantly higher amongst open patients (open 29.08% vs MIS 19.94%, p < 0.001). Patients stayed on average 1 day longer in the hospital after open surgery (p < 0.001). Rates of MIS for early tumors (N0 and T1/T2, n = 289) did not significantly change over 7 years (p = 0.597, rate = - 0.065%/year); however, utilization of MIS for late tumors (N1 or T3/T4, n = 4359) increased by 2.06% per year (p < 0.001). This study demonstrates that MIS was associated with superior postoperative outcomes compared to open surgery without compromising oncological outcomes in patients undergoing emergency colectomy for colon cancer. Within the matched cohort, MIS was associated with lower rates of mortality, pulmonary complications, ileus, and shorter postoperative length of stay.


Multiple odontogenic keratocysts in a patient with type II (mitis) Ehlers-Danlos syndrome.
Ehlers-Danlos syndrome (EDS) is now considered to be a heterogeneous collection of fundamentally distinct disorders. The many and varied sub-types of EDS have been distinguished using clinical, genetic and in some cases biochemical criteria and this has important implications as regards prognosis and the prediction of inheritance patterns. The major clinical features of EDS are reviewed, with particular emphasis placed on the possible complications encountered in the practice of oral surgery. A case of Type II mitis EDS is described, that presented with multiple odontogenic keratocysts.


Simulating future land use by coupling ecological security patterns and multiple scenarios.
A land use simulation model with coupling constraints of ecological security patterns (ESPs) and multiple scenarios (MSs) was developed using the PLUS model. The research scale was zoned with environmental functional regions, where land management policies were formulated. A case study in Anji County successfully demonstrated the application of the ESP-MS-PLUS model. First, we constructed three different levels of ESPs as ecological constraints by utilizing ecosystem services evaluation and circuit theory. Second, four scenarios of land use and land cover changes (LUCCs) in 2034 were assumed, namely business as usual (BAU), priority given to urban development (PUD), priority given to ecological protection (PEP), and balanced urban development and ecological protection (BUE). Then, the basic ecological constraints (ecological red line areas and waters) and three types of ESPs were coupled with the four scenarios. The results of the simulation and analysis of landscape metrics under each scenario showed that the PEP and BUE scenarios would effectively reduce the degree and speed of ecological destruction. In addition, there were three environmental functional areas that could be used as priority areas for urban construction to ensure economic development. This study provides a new mechanism for land use optimization in the context of ecological protection at scales conducive to practice.


Robotic NOTES (Natural Orifice Translumenal Endoscopic Surgery) in reconstructive urology: initial laboratory experience.
To present an initial experience with robotic natural orifice translumenal surgery (R-NOTES) in reconstructive urology using the da Vinci surgical system. In 10 female farm pigs (mean weight, 34.5 kg), 10 pyeloplasties (right 5, left 5), 10 partial nephrectomies (right 5, left 5), and 10 radical nephrectomies (right 5, left 5) were performed. The robot telescope and the first robotic arm were placed through a single 2-cm umbilical incision, and the second robotic arm was placed through the vagina. All 30 R-NOTES procedures were performed successfully without any addition of laparoscopic port or open conversion. Mean length of the umbilical incision was 2.6 cm. Mean operative time was 154 minutes, and mean estimated total blood loss was 72 mL. Mean warm ischemia time in the partial nephrectomy group was 25.4 minutes. There were no intraoperative complications. There were no robotic system failures during the entire experiment. We did not find any significant difference when comparing right-side and left-side procedures. When analyzing the learning curve, only robot preparation time reached a statistically significant inverse correlation with increasing number of cases (r = -0.72, P = .018). Robotic NOTES pyeloplasty, partial nephrectomy, and radical nephrectomy are feasible and safe in the porcine model. This approach has the potential for a less morbid and scarless outcome. Intracorporeal suturing is significantly enhanced using the robot, especially through the challenging translumenal natural orifice approach. Further development of robots adaptive to NOTES would boost efforts toward clinical NOTES applications.


Resuscitation skills amongst anaesthetists.
Resuscitation skills were assessed in a group of 24 anaesthetists of varying experience using 3 pre-determined scenarios. Seventy-nine percent of participants were found to be competent at resuscitation following the guidelines suggested by the Resuscitation Council (UK) in 1989. No one grade of anaesthetist was found to be consistently poor at resuscitation. Anaesthetists by the nature of their jobs may maintain the skills and knowledge of cardiopulmonary resuscitation as well as other groups in the hospital.


Quercetin Ameliorates CFA-Induced Chronic Inflammatory Hyperalgesia via Modulation of ROS-Mediated ERK1/2 Signaling and Inhibition of Spinal Glial Activation In Vivo.
Impact of reactive oxygen species (ROS) in development of hyperalgesia has recently motivated scientists to focus on ROS as novel target of anti-hyperalgesic interventions. Studies have indicated the usefulness of ROS scavengers and exogenous antioxidants as anti-nociceptive agents in animal models of neuropathic and inflammatory hyperalgesia. In present study, we suggest the anti-hyperalgesic potential of the dietary antioxidant quercetin on chronic inflammatory hyperalgesia induced by Complete Freund's Adjuvant (CFA). Three doses of quercetin (25, 50 and 75 mg/kg body weight) for consecutive 7 days were used for the study. Thermal hyperalgesia was assessed by paw withdrawal latency (PWL) test and inflammation was checked in terms of changes in paw edema. The insight of molecular signaling during chronic hyperalgesia was analyzed by TNF-α-TNFR1-ERK1/2 pathway in relation to change in ROS level in DRG and spinal cord. CFA-induced hyperalgesia was confirmed by decreased PWL and increased c-Fos activity in dorsal horn of spinal cord, determined by immunohistochemical analysis. It was characterized with elevated level of ROS and TNF-α estimated by ELISA. The activation of ERK1/2 and NF-κB in DRG and spinal cord and over-expression of TNFR1 in DRG were analyzed by Western blotting. Up-regulation of Iba1 and GFAP indicates glial activation in spinal cord. Expression of GFAP and its co-localization with NF-κB were examined by immunofluorescence. All the molecular modulators of hyperalgesia were brought towards normal after quercetin treatment showing its anti-hyperalgesic activity, indicating that repeated quercetin treatment is able to alleviate chronic inflammatory hyperalgesia by attenuating TNF-α-TNFR1-ERK1/2 signaling pathway via modulation of ROS and by suppression of central sensitization via inhibition of spinal glial activation.


Geriatric risk in the surgical management of infectious spondylitis.
The purpose of the present study was to evaluate and compare clinical outcomes in patients aged >65 years and <65 years who have undergone surgery for infectious spondylitis, and to identify any prognostic factors. We reviewed 60 consecutive patients treated surgically for infectious spondylitis. We reviewed patients' medical records especially focusing on comorbidities, preoperative serum albumin levels, postoperative complications and control of infection on follow up. Statistical analysis was carried out to determine whether these various factors affected clinical outcomes. Postoperative complication rates (P = 0.764) and infection control rates (P = 0.275) were not significantly different between the two groups. Univariate analysis did not show a correlation between age and clinical outcome, whereas body mass index (BMI; P = 0.04), Charlson Comorbidity Index (CCI; P = 0.017), American Society of Anesthesiologists (ASA) grade (P = 0.006) and serum albumin (P = 0.003) were associated with overall postoperative complications. BMI (P = 0.002) and CCI (P = 0.000) were also associated with postoperative fatalities. The χ2 -test for trend also showed that CCI (P = 0.018), ASA grade (P = 0.007) and low serum albumin (<3.5 mg/dL; P = 0.004) were associated with postoperative complications. Logistic regression analysis showed that ASA grade (P = 0.034) and BMI (P = 0.044) were related to overall postoperative complications. Receiver operating characteristic curve analysis using ASA grade and BMI to predict major postoperative complications and fatality showed an area under the curve value of 0.793 (P = 0.001) and 0.942 (p=0.002), respectively. BMI, ASA grade, CCI scores and serum albumin levels, rather than age, might be useful in predicting clinical outcome in surgery for infectious spondylitis in elderly patients. Geriatr Gerontol Int 2017; 17: 984-990.


Disorders of phosphate metabolism in chronic renal disease.
Hyperphosphatemia directly or indirectly contributes to the progression of chronic renal disease and is an important factor in the development of secondary hyperparathyroidism and uremic bone disease. New therapeutic advances include the development of calcium-free intestinal phosphate binders, calcimimetics to control parathyroid hormone secretion and non-calcemic vitamin D analogs.


Deferoxamine treatment during pregnancy: is it harmful?
The use of the iron chelator, Deferoxamine (DFO), in pregnant thalassemia women with iron overload has been generally avoided due to fear of its potential teratogenicity. We describe a case of a pregnant thalassemia major patient with iron overload, who received DFO throughout her second and third trimesters and gave birth to a healthy infant, who had no findings of DFO toxicity at birth and at a later follow-up. Review of the literature discloses over 40 other cases in which DFO was given in various periods of gestation without evidence of teratogenic effect. Sufficient documentation exists, therefore, to suggest that DFO can be considered for use in cases of pregnant women who need iron chelation treatment.


Seroma formation after modified Blalock-Taussig shunt which caused shock due to pulmonary vein compression.
Seroma formation is a relatively rare complication seen after a modified Blalock-Taussig shunt. Herein, we report a rare case of seroma formation on the posterior aspect of the left atrium without it touching the graft, and presenting with shock, due to pulmonary vein compression.


Integrated system for population dose calculation and decision making on protection measures in case of an accident with air emissions in a nuclear power plant.
The accidents in Chernobyl and Fukushima remind us that nuclear power plants should continuously invest resources in improving safety and in risk management. This paper presents the methodology for developing a measuring and modelling system with a high degree of automation, which enables predicting the effects of the spreading of radionuclides from the nuclear power plant to the atmosphere. The end result is the calculated population doses in the event of an accidental release, which is an essential piece of information needed by first responders to take proper action. The key challenge addressed by this methodology is how to build a system so that its operation is maximally automated, ongoing and in real time. Moreover, in a way that "fresh", normalized results for the hypothetically most probable types of emissions are always available to operators. The principle that normalized, fresh results are always automatically available to operators is the only real assurance that they will almost surely be available in the event of an accident and panic. This way, we can avoid performing complex model calculations at the operator's request when the accident is already taking place. The methodology divides the building of the system into key modules, which are substantiated and described. The theoretical section is followed by a description of implementation on the example of the Measuring and Modelling System at the Krško Nuclear Power Plant (in Slovenia). The system has been tested in regular nuclear emergency exercises and rated excellent by IAEA inspections; it has been operating automatically, continuously and in real time for many years. The availability of automatic results is counted for the last two years. Measurements and diagnostic modelling results were available for more than 96% and forecasts were available in more than 91% of all half-hour intervals.


Guidance of children and adolescents with cystic fibrosis.
Cystic fibrosis is the most common serious genetic disorder in people of European descent. Treatment of these patients is ongoing throughout life and until now has been aimed at the consequences and is still not curative. Over the past 10-20 years, there has been a dramatic improvement of mortality rates for cystic fibrosis, due in large part to advances in medical care. The average age of survival for young people with cystic fibrosis is pushing well into the 20s with one third living into their 30s. Consequently, education plays a major role in management of patients with cystic fibrosis, and starts directly after being sure of the diagnosis. Growing up, these patients experience a lot of problems, and these are especially marked in the adolescent. A special problem, for many cystic fibrosis patients is becoming an adult. Continuity in care for these patients from the pediatric to the adult department is not always guaranteed. It is concluded that patients with cystic fibrosis should be treated in specialized centers, and such treatment cannot be carried out sufficiently by one person, but has to be embedded in a team of caregivers.


Endogenous bursting due to altered sodium channel function in rat hippocampal CA1 neurons.
Intracellular recordings were obtained from pyramidal neurons in the rat hippocampal CA1 area in order to investigate membrane mechanisms involved in veratridine-induced epileptiform activity. Veratridine (0.03-0.2 microM) caused no changes in the passive membrane parameters including the resting potential, input resistance, and time constant. In the presence of small doses (0.03-0.1 microM) of veratridine, a single stimulus caused a relatively slow, large, synaptic-independent potential called the slow depolarizing after-potential (SDAP). When the hippocampal slice was treated with higher doses of veratridine (over 0.1 microM), bursting, or seizure-like activity (SLA) occurred in response to a brief super threshold intracellular stimulation. The duration of SLA bursting could be as long as ten seconds depending on the amplitude of SDAP, and was independent of the stimulus strength or duration. The frequency and configuration of SLA were sensitive to changes in membrane potential caused by applied DC current. At 0.3 microM or higher, veratridine induced spontaneous rhythmic bursting that was also sensitive to membrane potential changes. The evoked or spontaneous bursting is characterized by being: (1) independent of synaptic transmission in that it persisted after complete blockade of evoked synaptic potential with kynurenic acid (0.5 mM), (2) sensitive to selective inhibition by low doses of the specific sodium channel blockers tetrodotoxin (TTX) or cocaine with no apparent influence on the evoked action potential. These results indicate that endogenous SLA bursting can be induced in hippocampal CA1 pyramidal neurons when certain properties of sodium channels are altered by veratridine.


Preliminary characterization of hereditary cerebellar ataxia in rats.
A spontaneous model of Purkinje cell degeneration in rats is described. Breeding data indicate that the condition is hereditary and not sex linked. The breeding colony has remained free of common murine pathogens, including parvovirus. In older rats with pronounced ataxia, the major lesions consisted of greatly reduced numbers or complete absence of Purkinje cells (PCs), particularly in the anterior lobe of the cerebellum. There was a decreased thickness and increased cellular density of the molecular layer and degeneration of the inferior olivary nuclei. Morphometric analysis indicated that the anterior lobes of affected rats were 52% smaller than those of normal rats. In young rats, before severe signs of ataxia had developed, microscopic changes were minimal. The preliminary findings are discussed in relationship to human cerebellar ataxias and mouse models of Purkinje cell degeneration.