Extensions of Preventive Health in Addition to the Healthcare Provider.
This study aims to determine whether patients would use pharmacists with their healthcare providers to alert them to the need for adult vaccines and provide preventive and monitoring health services and information. A survey was sent to 310 participants to assess the willingness of patients to use pharmacists as adult vaccine and preventive health resources. Overall, the completed responses (305) to the survey show a willingness to use pharmacists as healthcare professionals for preventive health services. There was a significant difference (P = 0.001) by race regarding whether the respondents would use the pharmacist to receive a vaccine and whether they had received a vaccine from a pharmacist. There also was a significant difference (P = 0.01) by race, regarding using a pharmacist for health screenings and monitoring services. Most respondents know of and are willing to use some preventive services that a pharmacist can provide. A minority of respondents reported that they were less inclined to use these services. A targeted educational campaign using methods that previous research has shown to be effective could affect the minority. These methods include having a direct conversation with a pharmacist about preventive services and personalized direct mail targeting individuals who would use the range of preventive services that their community pharmacist can provide, such as adult vaccines. Pharmacy-based preventive health services could enable a more equitable delivery of preventive services for a broader range of patients.


Associations of alcohol consumption with breast tissue composition.
We investigated the associations of alcohol with percentage of epithelium, stroma, fibroglandular tissue (epithelium + stroma), and fat in benign breast biopsy samples. We included 857 cancer-free women with biopsy-confirmed benign breast disease within the Nurses' Health Study (NHS) and NHSII cohorts. Percentage of each tissue was measured on whole slide images using a deep-learning algorithm and then log-transformed. Alcohol consumption (recent and cumulative average) was assessed with semi-quantitative food frequency questionnaires. Regression estimates were adjusted for known breast cancer risk factors. All tests were 2-sided. Alcohol was inversely associated with % of stroma and fibroglandular tissue (recent ≥ 22 g/day vs. none: stroma: β = - 0.08, 95% Confidence Interval [CI] - 0.13; - 0.03; fibroglandular: β = - 0.08, 95% CI - 0.13; - 0.04; cumulative ≥ 22 g/day vs. none: stroma: β = - 0.08, 95% CI - 0.13; - 0.02; fibroglandular: β = - 0.09, 95% CI - 0.14; - 0.04) and positively associated with fat % (recent ≥ 22 g/day vs. none: β = 0.30, 95% CI 0.03; 0.57; cumulative ≥ 22 g/day vs. none: β = 0.32, 95% CI 0.04; 0.61). In stratified analysis, alcohol consumption was not associated with tissue measures in premenopausal women. In postmenopausal women, cumulative alcohol use was inversely associated with % of stroma and fibroglandular tissue and positively associated with fat % (≥ 22 g/day vs. none: stroma: β = - 0.16, 95% CI - 0.28; - 0.07; fibroglandular: β = - 0.18, 95% CI - 0.28; - 0.07; fat: β = 0.61, 95% CI 0.01; 1.22), with similar results for recent alcohol use. Our findings suggest that alcohol consumption is associated with smaller % of stroma and fibroglandular tissue and a greater % of fat in postmenopausal women. Future studies are warranted to confirm our findings and to elucidate the underlying biological mechanisms.


Strengths and weaknesses of FDA-approved/cleared diagnostic devices for the molecular detection of respiratory pathogens.
The rapid, sensitive, and specific identification of the microbial etiological characteristics of respiratory tract infections enhances the appropriate use of both antibiotics and antiviral agents and reduces the risk of nosocomial transmission. This article reviews the current nucleic acid amplification tests approved by the U.S. Food and Drug Administration (FDA) for the detection of respiratory pathogens. In addition, Emergency Use Authorization tests for the detection of 2009 influenza A H1N1 are discussed. The advantages and limitations of the current FDA-approved/cleared tests are reviewed.


Effect of 3D physiological loading and motion on elastohydrodynamic lubrication of metal-on-metal total hip replacements.
An elastohydrodynamic lubrication (EHL) simulation of a metal-on-metal (MOM) total hip implant was presented, considering both steady state and transient physiological loading and motion gait cycle in all three directions. The governing equations were solved numerically by the multi-grid method and fast Fourier transform in spherical coordinates, and full numerical solutions were presented included the pressure and film thickness distribution. Despite small variations in the magnitude of 3D resultant load, the horizontal anterior-posterior (AP) and medial-lateral (ML) load components were found to translate the contact area substantially in the corresponding direction and consequently to result in significant squeeze-film actions. For a cup positioned anatomically at 45 degrees , the variation of the resultant load was shown unlikely to cause the edge contact. The contact area was found within the cup dimensions of 70-130 degrees and 90-150 degrees in the AP and ML direction respectively even under the largest translations. Under walking conditions, the horizontal load components had a significant impact on the lubrication film due to the squeeze-film effect. The time-dependent film thickness was increased by the horizontal translation and decreased during the reverse of this translation caused by the multi-direction of the AP load during walking. The minimum film thickness of 12-20 nm was found at 0.4s and around the location at (95, 125) degrees. During the whole walking cycle both the average and centre film thickness were found obviously increased to a range of 40-65 nm, compared with the range of 25-55 nm under one load (vertical) and one motion (flexion-extension) condition, which suggested the lubrication in the current MOM hip implant was improved under 3D physiological loading and motion. This study suggested the lubrication performance especially the film thickness distribution should vary greatly under different operating conditions and the time and location that potential wear may occur was very sensitive to specific loading and motion conditions. This may provide some explanation to the large variations in wear from hip simulators and clinical studies, and also stress the importance of using more realistic loading and motion conditions in the tribological study of MOM hip prostheses.


Whitey crumbles.
Despite scientific evidence to the contrary, cultural notions that incorrectly aggrandize genetic differences between ethnicities persist. New work on the genetic makeup of Europeans now shows even more definitively how false those notions are.


Effect of GABA-administration on murine neuroblastoma cells in culture. I. Increased membrane dynamics and formation of specialized contacts.
(Gamma aminobutyric acid) GABA was applied to cultures of mouse neuroblastoma cells of different ages at concentrations ranging from 10(-4) to 10(-6) M. The cultures were exposed to GABA either in short term experiments for 2 h to 2 days or for longer periods by adding the substance twice within 10 days at 5-day intervals. The following effects were observed: (1) There was a strong proliferation of coated vesicles, appearing to derive from the Golgi complex and the rough endoplasmic reticulum (RER), and also showing all intermediate stages of fusion and pinching off from the plasma membranes. (2) In numerous areas, electron-dense material aggregated at the inner aspect of the plasma membrane and around small invaginations of the plasmalemma. (3) The number and area of specialized contacts increased between cells and their processes. (4) Similar to cultures free of GABA, varicosities and terminal swellings of the cells and their processes were filled with small round vesicle, 40--60 nm in diameter, or with smooth, very large, empty-appearing vesicular inclusions, or with flat pleiomorphic vesicles. In addition, mitochondria and some formations of the smooth endoplasmic reticulum (SER) appeared, and primitive contacts (symmetrical densities) were formed. (5) Dense-cored vesicles were found peripherally and linearly arranged, surrounded by an electron-dense substance. (6) Electron-dense material of unknown origin was seen between cells or their processes near the peripherally arranged dense-cored vesicles. Exogenous GABA may play a specific role in the early stages of synaptogenesis, since it showed a positive effect on the neuroblastoma cells, which in the absence of GABA are only capable of forming primitive or immature presynaptic elements. The significance of the peripheral accumulation of dense-cored vesicles, accompanied by an amorphous, electron-dense substance occurring both intra- and extracellularly is discussed.


Adaptive adversarial neural networks for the analysis of lossy and domain-shifted datasets of medical images.
In machine learning for image-based medical diagnostics, supervised convolutional neural networks are typically trained with large and expertly annotated datasets obtained using high-resolution imaging systems. Moreover, the network's performance can degrade substantially when applied to a dataset with a different distribution. Here, we show that adversarial learning can be used to develop high-performing networks trained on unannotated medical images of varying image quality. Specifically, we used low-quality images acquired using inexpensive portable optical systems to train networks for the evaluation of human embryos, the quantification of human sperm morphology and the diagnosis of malarial infections in the blood, and show that the networks performed well across different data distributions. We also show that adversarial learning can be used with unlabelled data from unseen domain-shifted datasets to adapt pretrained supervised networks to new distributions, even when data from the original distribution are not available. Adaptive adversarial networks may expand the use of validated neural-network models for the evaluation of data collected from multiple imaging systems of varying quality without compromising the knowledge stored in the network.


How rigid gas-permeable lenses supply more oxygen to the cornea than silicone hydrogels: a new model.
To show the superiority of hyper-Dk rigid gas-permeable (RGP) lenses to silicone hydrogels from the viewpoint of total oxygen supply to the entire cornea. The simple model of fitting the cornea with a contact lens was divided into 1-mm steps from the center to the limbus, and the area of concentric ring zones was calculated. Precorneal oxygen tension (PO2) for each zone was calculated using the Brennan oxygen calculator, and by taking into account the area uncovered by the RGP lens and the lens thickness, the average precorneal PO2 was mathematically compared for wear of silicone hydrogel and RGP lenses. The average precorneal PO2 of the RGP lens was superior to that of the silicone hydrogel lens under open- and closed-eye conditions because the precorneal PO2 in the uncovered areas of the cornea can supply large contributions. The PO2 of a silicone hydrogel lens with 125 x 10(-9) of oxygen transmissibility at center thickness (Dk/t(c)) was estimated as 45 mm Hg under closed-eye conditions. At the same value, the Dk/t(c) of an RGP lens with a diameter of 11.0 mm was estimated to be 90 x 10(-9). To minimize hypoxia in extended wear, clinicians should consider that an RGP lens with a Dk/t(c) value of only 90 x 10(-9) is equivalent to a silicone hydrogel lens with a Dk/t(c) value of 125 x 10(-9), and even high Dk/t(c) values for RGP lenses will provide more total oxygen to the entire cornea than their hybrid silicone hydrogel counterparts.


Cell proliferation on hydrogels.
The adhesion and proliferation of mammalian fibroblasts (Flow 7000) on the surface of hydrophilic (copolymer of N-vinyl-2-pyrrolidone and methyl methacrylate) and hydrophobic [polymethylmethacrylate (PMMA) stereocomplex] hydrogels with a wide range in water content were studied morphologically and quantitatively. It was demonstrated that cell proliferation on hydrogels by a static culture method decreased as the water content of the gels increased. However, it is remarkable that the cell proliferation on PMMA hydrogels with a high water content is equivalent to that on glass Petri dishes. The results obtained in the proliferation of cells on the surface of these hydrogels closely correspond to the state of cell adhesion. When fresh medium or air was perfused from the opposite side of the PMMA hydrogel membrane on which the cells were proliferating (perfusion method), the cells continued to grow into a higher density than with the conventional static culture method. In the case of fresh medium perfusion, the amount of proliferated cell was dependent on both the permeability of the membrane and the density of the membrane "scaffolding." Virus multiplication in the cultured cells increased in proportion to the cell density, whereas the cell function was similar in both culture methods.


Predictors of non-alcoholic fatty liver disease in children.
Abdominal obesity is strongly associated with the development of non-alcoholic fatty liver disease (NAFLD). Early identification and intervention may reduce the risk. We aim to improve pediatric NAFLD screening by comparing discriminative performance of six abdominal obesity indicators. We measured anthropometric indicators (waist circumference [WC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR]), body composition indicators (trunk fat index [TFI], visceral fat area [VFA]), and endocrine indicator (visceral adiposity index [VAI]) among 1350 Chinese children aged 6-8 years. Using Spearman correlation, receiver operating characteristic (ROC) curves, and Logistic regression, we validated their ability to predict NAFLD. All six indicators can predict NAFLD robustly, with area under the curve (AUC) values ranged from 0.69 to 0.96. TFI, WC, and VFA rank in the top three for the discriminative performance. TFI was the best predictor with AUC values of 0.94 (0.92-0.97) and 0.96 (0.92-0.99), corresponding to cut-off values of 1.83 and 2.31 kg/m2 for boys and girls, respectively. Boys with higher TFI (aOR = 13.8), VFA (aOR = 11.1), WHtR (aOR = 3.1), or VAI (aOR = 2.8), and girls with higher TFI (aOR = 21.0) or VFA (aOR = 17.5), were more likely to have NAFLD. User-friendly body composition indicators like TFI can identify NAFLD and help prevent the progress of liver disease. Chinese Clinical Trial Registry (ChiCTR) ( www.chictr.org.cn/enIndex.aspx , No. ChiCTR2100044027); retrospectively registered on 6 March 2021. Abdominal obesity increases the risk of pediatric non-alcoholic fatty liver disease (NAFLD). This study compared the discriminative performance of multiple abdominal obesity indicators measured by different methods in terms of accuracy and fastidious cut-off values through a population-based child cohort. Our results provided solid evidence of abdominal obesity indicators as an optimal screening tool for pediatric NAFLD, with area under the curve (AUC) values ranged from 0.69 to 0.96. User-friendly body composition indicators like TFI show a greater application potential in helping physicians perform easy, reliable, and interpretable weight management to prevent the progress of liver damage.


The serum fibroblast growth factor 21 is correlated with retinopathy in patients with type 2 diabetes mellitus.
despite advances in blood glucose control, the incidence of sight loss has not decreased in patients with diabetes. Several growth factors have been suggested as factors associated with diabetic retinopathy pathogenesis. In the current cross-sectional study, we examined the relationship between FGF21 and retinopathy as a microvascular complication of diabetes. Adult patients with type 2 diabetes mellitus (T2DM); were recruited and evaluated for retinopathy. Different clinical and biochemical factors, such as FGF21 were assessed and compared between groups. 91 T2DM patients with retinopathy, 93 T2DM patients without retinopathy, and 86 healthy control subjects were recruited. FGF21 was significantly different between the three groups (P<0.001). In the multivariate logistic regression model obesity, cholesterol, HbA1c, and FGF21 were associated with diabetic retinopathy. ROC curve analysis was used for establishing a cut-off FGF21 concentration to predict diabetic retinopathy. The area under the curve in this model was 0.992. The best cut-off point for predicting retinopathy based on FGF21 was greater than 312 pg/ml, with a sensitivity of 97.80% and specificity of 96.77%. FGF21 was associated with diabetic retinopathy and can be suggested as a surrogate diagnostic marker in the diagnosis of this state.


Relative effects of repetitive transcranial magnetic stimulation and electroconvulsive therapy on mood and memory: a neurocognitive risk-benefit analysis.
Two procedures for treating major depressive disorder were compared with regard to their respective effects on mood and cognition. Fourteen patients underwent treatment with electroconvulsive therapy and 14 underwent treatment with repetitive transcranial magnetic stimulation. Patients were tested on three occasions: before initiation of treatment, at the end of treatment, and 2 weeks after the end of treatment. Electroconvulsive therapy was applied unilaterally approximately three times per week for 2 to 4 weeks. Repetitive transcranial magnetic stimulation was applied in sessions of 1600 stimuli at 10 Hertz and 90% of motor threshold intensity to the left dorsolateral prefrontal cortex daily (Monday through Friday) for 2 consecutive weeks. Results indicate that electroconvulsive therapy had a more positive effect on mood than did a 2-week trial of repetitive transcranial magnetic stimulation. With regard to cognitive outcome measures, electroconvulsive therapy exerted a deleterious but transient effect on various components of memory that were no longer detected 2 weeks after the end of treatment; however, there was evidence of persistent retrograde amnesia after treatment with electroconvulsive therapy. As a group, repetitive transcranial magnetic stimulation patients experienced only a modest reduction in depression severity but there was no evidence of anterograde or retrograde memory deficits in the aftermath of treatment with repetitive transcranial magnetic stimulation. Findings suggest that electroconvulsive therapy is associated with transient negative cognitive side effects, most of which dissipate in the days after treatment. Deficits of this sort are not apparent after treatment with a 2-week course of repetitive transcranial magnetic stimulation.


Expression of AMPA receptor subunits in hippocampus after status convulsion.
The expression of 2-amino-3-(5-methyl-3-oxo-1, 2-oxazol-4-yl) propanoic acid receptor (AMPAR) subunits in the hippocampus of naive immature and adult rats (IRs, ARs) was investigated after status convulsion (SC). Seizures were induced in IRs and ARs with intraperitoneal injections of lithium and pilocarpine. Rats were killed at four time points (3 h, 1 day, 3 days, and 7 days) after SC. The proportion of apoptotic cells was quantified by Annexin V-FITC apoptosis detection. The location and type of apoptotic cells were assessed by using terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling staining. Immunoblotting techniques were used to demonstrate changes in AMPAR subunit expression. Severe seizures induced neuronal apoptosis in the hippocampus. The proportion of apoptotic cells in IRs was consistently lower than that in ARs after SC. The expressions of four AMPAR subunits in IRs were consistently lower than those in ARs before and after SC. SC for 1 h inhibited the expression of glutamate receptors (GluR1-4) in the hippocampus of IRs and ARs and altered the subunit composition of AMPARs. GluR2 was the predominant AMPAR subunit in the hippocampus of normal ARs, while the GluR2/3 subunits were predominantly expressed 7 days after SC. GluR3/4 subunits were mainly expressed in the hippocampus of normal IRs, which had the lowest levels of GluR2. Immature brain was more resistant to seizure-induced neural damage. The time course of reduction and recovery differed for each subunit and was dependent on developmental stage. The increased expression of GluR2 could confer early but transient protection in the immature brain after SC.


Generation of an induced pluripotent stem cell line from an individual with a heterozygous RECQL4 mutation.
The DNA helicase RECQL4 is known for its roles in DNA replication and repair. RECQL4 mutations cause several genetic disorders including Rothmund-Thomson syndrome (RTS), characterized by developmental defects and predisposition to osteosarcoma. Here we reprogrammed fibroblasts with a heterozygous RECQL4 mutation (c.1878 + 32_1878 + 55del24) to induced pluripotent stem cells (iPSCs). These iPSCs are pluripotent and are able to be differentiated into all three germ layers, providing a novel tool to further interrogate the role of RECQL4 DNA helicase in vitro.


Gastric emptying of solid food in normal man and after subtotal gastrectomy and truncal vagotomy with pyloroplasty.
Alterations in gastric emptying are considered contributory to many sequelae of peptic ulcer surgery. The application of a validated method of firmly tagging solid food has enabled the measurement of the rates and patterns of gastric emptying in normal subjects, subtotal gastrectomy, and vagotomy and pyloroplasty (V&P). Normal persons emptied with a linear pattern at a mean rate of 27.96% per hr. Subtotal gastrectomy patients showed up to three phases in their emptying pattern, which, over all, approximated an exponential pattern with a mean rate constant of 0.030 min-1 and calculated t1/2 of 23.3 min. V&P subjects divided into two groups: (1) slow emptying with a linear pattern and mean rate of 17.64% per hr; (2) rapid emptying with exponential pattern and mean rate constant of 0.039 min-1, t1/2 of 17.7 min. The slow gastric emptying rate and slow passage of chyme through the small intestine in one-half of the V&P group presumably allows greater efficiency of digestion and absorption and may account for the over-all less severe nutritional disturbances after V&P.


Uncertainty estimation approach in catalytic fast pyrolysis of rice husk: Thermal degradation, kinetic and thermodynamic parameters study.
The aim of this study was to understand the influence of catalyst in thermal degradation behavior of rice husk (RH) in catalytic fast pyrolysis (CFP) process. An iso-conversional Kissinger kinetic model was introduced into this study to understand the activation energy (EA), pre-exponential value (A), Enthalpy (ΔH), Entropy (ΔS) and Gibb's energy (ΔG) of non-catalytic fast pyrolysis (NCFP) and CFP of RH. The study revealed that the addition of natural zeolite catalyst enhanced the rate of devolatilization and decomposition of RH associated with lowest EA value (153.10 kJ/mol) compared to other NCFP and CFP using nickel catalyst. Lastly, an uncertainty estimation was applied on the best fit non-linear regression model (MNLR) to identify the explanatory variables. The finding showed that it had the highest probability to obtain 73.8-74.0% mass loss in CFP of rice husk using natural zeolite catalyst.


The evolving field of regenerative aesthetics.
Regenerative aesthetics (RA) is an emerging subfield based on many of the principles of regenerative medicine (RM). In order to ensure that the development of regenerative aesthetics is based on accepted regenerative concepts and to optimize treatment strategies, it is important to establish clear definitions, fundamental aims and consider the impact of the predominant RA tissue environment RM focuses on the regeneration of injured or diseased tissue, while RA aims to restore youthful properties to aging, senescent tissue. The distinction is key in understanding how best to develop treatments for these different goals. The current review suggests key concepts, definitions, and foundations of regenerative aesthetic approaches and examines current evidence supporting this. It considers the importance of the aging tissue environment, the essential regenerative goals of restored tissue structure and function and introduces the concept of regenerative scaffolds with a focus on CaHA. Current techniques in the field and promising future directions are also discussed. Regenerative aesthetics is an evolving subfield of regenerative medicine. Establishing clear definitions, identifying the challenges of the aging soft tissue environment and re-evaluating current evidence in light of regenerative goals are vital for the continuing evolution of this medical field.


Factors associated with recovery from early postoperative delirium.
Delirium occurs in 14% to 56% of postoperative, hospitalized elderly persons, making it one of the most common postoperative complications for the older patient. The aim of this study was to determine factors associated with recovery of delirium from postoperative day one (POD 1) to postoperative day two (POD 2). The hypothesis was that those with less pain are more likely to recover from delirium by POD 2. Patients aged 65 or older who were scheduled for noncardiac surgery, spoke English, and developed delirium on POD 1 as detected by the Confusion Assessment Method (CAM) were included (n = 176). Postoperative delirium on POD 2 was also measured with the CAM. Postoperative pain was assessed on PODs 1 and 2 using the Numeric Rating Scale (NRS). One hundred seventy-six patients developed delirium on POD 1, with 66 (38%) recovering from delirium by POD 2. The mean age of those patients who recovered from delirium was 72.5 ± 5.7 (n = 66), whereas the mean age of those patients who did not recover from delirium was 75.9 ± 6.5 (n = 110). Multivariate logistic regression revealed that patients less than age 75 were more likely to recover from delirium (OR = 2.31; 95% CI = 1.18-4.53; P = .015), as were patients who had pain scores of less than 5 on POD 2 (OR = 2.59; 95% CI = 1.26-5.35; P = .0098). Patients with lower pain levels (NRS ≤4) were also more likely to recover from delirium on POD 2. The type of postoperative pain therapy (the use or nonuse of patient-controlled analgesia) was not related to delirium recovery. The results suggest that aggressive pain management in the first 48 hours postoperatively may be important in promoting recovery from postoperative delirium.


pMAT: An open-source software suite for the analysis of fiber photometry data.
The combined development of new technologies for neuronal recordings and the development of novel sensors for recording both cellular activity and neurotransmitter binding has ushered in a new era for the field of neuroscience. Among these new technologies is fiber photometry, a technique wherein an implanted fiber optic is used to record signals from genetically encoded fluorescent sensors in bulk tissue. Fiber photometry has been widely adapted due to its cost-effectiveness, ability to examine the activity of neurons with specific anatomical or genetic identities, and the ability to use these highly modular systems to record from one or more sensors or brain sites in both superficial and deep-brain structures. Despite these many benefits, one major hurdle for laboratories adopting this technique is the steep learning curve associated with the analysis of fiber photometry data. This has been further complicated by a lack of standardization in analysis pipelines. In the present communication, we present pMAT, a 'photometry modular analysis tool' that allows users to accomplish common analysis routines through the use of a graphical user interface. This tool can be deployed in MATLAB and edited by more advanced users, but is also available as an independently deployable, open-source application.


Toward genetic transformation of mitochondria in mammalian cells using a recoded drug-resistant selection marker.
Due to technical difficulties, the genetic transformation of mitochondria in mammalian cells is still a challenge. In this report, we described our attempts to transform mammalian mitochondria with an engineered mitochondrial genome based on selection using a drug resistance gene. Because the standard drug-resistant neomycin phosphotransferase confers resistance to high concentrations of G418 when targeted to the mitochondria, we generated a recoded neomycin resistance gene that uses the mammalian mitochondrial genetic code to direct the synthesis of this protein in the mitochondria, but not in the nucleus (mitochondrial version). We also generated a universal version of the recoded neomycin resistance gene that allows synthesis of the drug-resistant proteins both in the mitochondria and nucleus. When we transfected these recoded neomycin resistance genes that were incorporated into the mouse mitochondrial genome clones into mouse tissue culture cells by electroporation, no DNA constructs were delivered into the mitochondria. We found that the universal version of the recoded neomycin resistance gene was expressed in the nucleus and thus conferred drug resistance to G418 selection, while the synthetic mitochondrial version of the gene produced no background drug-resistant cells from nuclear transformation. These recoded synthetic drug-resistant genes could be a useful tool for selecting mitochondrial genetic transformants as a precise technology for mitochondrial transformation is developed.


Morphologic analysis of alveolar bone in maxillary and mandibular incisors on sagittal views.
The aim of this study was to analyze the morphologic features of alveolus in relatively healthy maxillary and mandibular incisors using cone-beam-computed tomography (CBCT). CBCT images of 318 patients were retrospectively acquired. Alveolar bone in incisive area was divided into: type 1 (thick), type 2 (relatively thick with mono-plate concavity), type 3 (thin with double-plate concavities), and type 4 (vulnerably thin). Alveolus prevalence and widths were analyzed statistically relative to age, gender, and molar relationship. Prevalence of type 1 alveolus was 78.9% in maxillary central incisors, 15.1% in maxillary lateral incisors, 24.1% in mandibular central incisors, and 5.0% in mandibular lateral incisors. Type 2 alveolus was commonly observed in the maxillary lateral incisors (82.2%), mandibular central incisors (66.2%), and mandibular lateral incisors (87.9%). Prevalence of type 3 and 4 alveoli ranged from 0.0 to 9.4%. As for maxillary central incisors, type 1 was the widest both at the alveolar crest (7.77 ± 0.58 mm) and apical area (9.05 ± 1.86 mm), while type 3 had the lowest width at the apical region (4.08 ± 0.51 mm). Among maxillary central incisors, prevalence of type 1 tended to decrease with age. At all maxillary and mandibular incisor sites, alveolus widths were significantly thicker in males than in females. At maxillary lateral incisor and mandibular incisor sites, prevalence of alveolus type was significantly different among three molar relationships. A 4-type classification system was suggested for alveolus morphology in incisive region. Identification of alveolus type might aid in the corresponding treatment.


Evaluation of the levels of bFGF, VEGF, sICAM-1, and sVCAM-1 in serum of patients with thyroid cancer.
Tumour growth and development depend on a complex cascade of angiogenic factors. The aim of the study is evaluation of the level of growth factors VEGF and bFGF, and adhesion molecules sICAM-1, sVCAM-1 in the serum of patients with papillary thyroid cancer. The study comprised 35 patients aged 21-68 years (mean age 46+/-14) who had papillary thyroid cancer diagnosed on the basis of thin needle aspiration biopsy, and were qualified for operative treatment. This group comprised 28 women and seven men. The control group was 26 healthy individuals. Serum concentrations of bFGF, VEGF, sICAM-1, and sVCAM-1 were evaluated by the enzyme-linked immunosorbent assay (ELISA) method. We have observed significantly higher mean concentrations of bFGF, VEGF, and sICAM-1 in the serum of patients with thyroid cancer compared with the control group. There was no significant difference between the sVCAM-1 concentrations of the thyroid cancer group and the control group.


The Temperature Coefficients of Frequency of Surface Acoustic Wave Devices With SiOxNy Passivation Films on LiTaO3 Substrates.
This work assessed the possible correlation between the refractive index of a SiOxNy passivation film on a surface acoustic wave (SAW) device and the temperature coefficient of frequency (TCF) of the device itself. The data demonstrate that the refractive index does correlate with the TCF as well as the frequency of the one-port resonator. SiOxNy passivation films having an optimal refractive index can potentially suppress the frequency shifts caused by the deposition of such layers, and can change the TCF from that for a Si3N4 film to that for SiO2. The results also show that the coupling coefficient of the one-port resonator increases when using a SiOxNy film with a lower refractive index, which changes the TCF such that this value approaches that for a SiO2 film. Finite-element method spectral domain analyses established that the frequency responses of the one-port resonators were affected by the velocity and temperature coefficient of velocity of the dielectric films deposited on the interdigital transducer electrodes. Thus, adjusting the refractive index of the SiOxNy film can be used to control the properties of an SAW device, including the TCF.


Variation of T2 relaxation times in pediatric brain tumors and their effect on metabolite quantification.
Metabolite concentrations are fundamental biomarkers of disease and prognosis. Magnetic resonance spectroscopy (MRS) is a noninvasive method for measuring metabolite concentrations; however, quantitation is affected by T2 relaxation. To estimate T2 relaxation times in pediatric brain tumors and assess how variation in T2 relaxation affects metabolite quantification. Retrospective. Twenty-seven pediatric brain tumor patients (n = 17 pilocytic astrocytoma and n = 10 medulloblastoma) and 24 age-matched normal controls. Short- (30 msec) and long-echo (135 msec) single-voxel MRS acquired at 1.5T. T2 relaxation times were estimated by fitting signal amplitudes at two echo times to a monoexponential decay function and were used to correct metabolite concentration estimates for relaxation effects. One-way analysis of variance (ANOVA) on ranks were used to analyze the mean T2 relaxation times and metabolite concentrations for each tissue group and paired Mann-Whitney U-tests were performed. The mean T2 relaxation of water was measured as 181 msec, 123 msec, 90 msec, and 86 msec in pilocytic astrocytomas, medulloblastomas, basal ganglia, and white matter, respectively. The T2 of water was significantly longer in both tumor groups than normal brain (P < 0.001) and in pilocytic astrocytomas compared with medulloblastomas (P < 0.01). The choline T2 relaxation time was significantly longer in medulloblastomas compared with pilocytic astrocytomas (P < 0.05), while the T2 relaxation time of NAA was significantly shorter in pilocytic astrocytomas compared with normal brain (P < 0.001). Overall, the metabolite concentrations were underestimated by ∼22% when default T2 values were used compared with case-specific T2 values at short echo time. The difference was reduced to 4% when individually measured water T2 s were used. Differences exist in water and metabolite T2 relaxation times for pediatric brain tumors, which lead to significant underestimation of metabolite concentrations when using default water T2 relaxation times. 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:195-203.


A leucine-rich repeat-receptor-like kinase gene SbER2-1 from sorghum (Sorghum bicolor L.) confers drought tolerance in maize.
ERECTA (ER) is a leucine-rich repeat-receptor-like kinase gene (LRR-RLK) encoding a protein isolated from Arabidopsis. Although the regulatory functions of ER genes have been widely explored in plant development and disease resistance, their roles in drought stress responses remain to be clarified. In this study, we cloned and characterized two ER genes, SbER1-1 and SbER2-1, from the drought-tolerant model plant sorghum (Sorghum bicolor L.). Under drought stress, the two genes were expressed in the leaves and stems but not in the roots, and SbER2-1 transcript accumulation in the stem was increased. SbER2-1 was localized both on the plasma membrane and in the chloroplast. Moreover, SbER2-1 expression in Arabidopsis and maize conferred increased drought tolerance, especially in regard to water-use efficiency, increasing the net photosynthetic rate in maize under drought stress. Based on RNA-Seq analysis together with the physiological data, we conclude that the transgenic maize plants have upregulated phenylpropanoid metabolism and increased lignin accumulation under drought stress. Our results demonstrate that SbER2-1 plays an important role in response to drought stress. Furthermore, photosynthetic systems and phenylpropanoid metabolism are implicated in SbER2-1-mediated drought stress tolerance mechanisms. The use of genetic engineering to regulate SbER2-1 expression in plants and to breed new varieties tolerant to drought is a research field full of potential.


Misdiagnosis of Behçet's disease with unknown protracted fever and chill after surgical excision of cardiac tumor.
Behçet's disease involving the heart is extremely rare. Sometimes it is probable to misdiagnose as infective endocarditis when protracted fever and chill occurs. We report a case of protracted pyrexia of unknown origin after surgical excision of a cardiac tumour. Clinically and pathologically a diagnosis of infective endocarditis was probable but antibiotics had no effect. After case review the diagnosis of Behçet's disease was established and the patient was treated with glucocorticoids which resulted in resolution.


C=C Bond Oxidative Cleavage of BODIPY Photocages by Visible Light.
Photocages for protection and the controlled release of bioactive compounds have been widely investigated. However, the vast majority of these photocages employ the cleavage of single bonds and high-energy ultraviolet light. The construction of a photoactivation system that uses visible light to cleave unsaturated bonds still remains a challenge. Herein, we report a regioselective oxidative cleavage of C=C bonds from a boron-dipyrrolemethene (BODIPY)-based photocage by illumination at 630 nm, resulting in a free aldehyde and a thiol fluorescent probe. This strategy was demonstrated in live HeLa cells, and the generated α-formyl-BODIPY allowed real-time monitoring of aldehyde release in the cells. In particular, it is shown that a mannose-functionalized photocage can target HepG2 cells.


Temporary Cessation of Immunosuppression for Infection May Contribute to the Development of Graft-vs-Host Disease After ABO-Incompatible Living Donor Liver Transplantation: A Case Report.
Graft-vs-host disease (GVHD) after liver transplantation is a rare complication with a high mortality rate. A complex interplay between donor and recipient immunity plays a role in the development of GVHD. Infection following liver transplantation is one of the most common complications in a recipient of an organ transplant who is immunosuppressed. On clinical signs of infection, the immune reaction of the recipient can be reconstituted by withdrawal of immunosuppression in order to help combat infection. However, the discontinuation of immunosuppression could restore the donor's immune activity rather than that of the recipient. There is little information available as to whether the discontinuation of immunosuppression for severe infection could contribute to the development of GVHD in a patient who underwent ABO-incompatible (ABO-I) living donor liver transplantation (LDLT). Herein, we present a unique case of GVHD following ABO-I LDLT, for which the cessation of immunosuppression could be responsible.


An epigenetic switch controls an alternative NR2F2 isoform that unleashes a metastatic program in melanoma.
Metastatic melanoma develops once transformed melanocytic cells begin to de-differentiate into migratory and invasive melanoma cells with neural crest cell (NCC)-like and epithelial-to-mesenchymal transition (EMT)-like features. However, it is still unclear how transformed melanocytes assume a metastatic melanoma cell state. Here, we define DNA methylation changes that accompany metastatic progression in melanoma patients and discover Nuclear Receptor Subfamily 2 Group F, Member 2 - isoform 2 (NR2F2-Iso2) as an epigenetically regulated metastasis driver. NR2F2-Iso2 is transcribed from an alternative transcriptional start site (TSS) and it is truncated at the N-terminal end which encodes the NR2F2 DNA-binding domain. We find that NR2F2-Iso2 expression is turned off by DNA methylation when NCCs differentiate into melanocytes. Conversely, this process is reversed during metastatic melanoma progression, when NR2F2-Iso2 becomes increasingly hypomethylated and re-expressed. Our functional and molecular studies suggest that NR2F2-Iso2 drives metastatic melanoma progression by modulating the activity of full-length NR2F2 (Isoform 1) over EMT- and NCC-associated target genes. Our findings indicate that DNA methylation changes play a crucial role during metastatic melanoma progression, and their control of NR2F2 activity allows transformed melanocytes to acquire NCC-like and EMT-like features. This epigenetically regulated transcriptional plasticity facilitates cell state transitions and metastatic spread.


Polyphyllin I promotes cell death via suppressing UPR-mediated CHOP ubiquitination and degradation in non-small cell lung cancer.
Polyphyllin I (PPI) purified from Polyphyllarhizomes displays puissant cytotoxicity in many kinds of cancers. Several researches investigated its anti-cancer activity. But novel mechanisms are still worth investigation. This study aimed to explore PPI-induced endoplasmic reticulum (ER) stress as well as the underlying mechanism in non-small cell lung cancer (NSCLC). Cell viability or colony-forming was detected by MTT or crystal violet respectively. Cell cycle, apoptosis, reactive oxygen species (ROS) and mitochondrial membrane potential were assessed by flow cytometry. Gene and protein levels were evaluated by qRT-PCR and immunoblotting respectively. Protein interaction was determined by immunoprecipitation or immunofluorescence assay. Gene overexpression or silencing was carried out by transient transfection with plasmids or small interfering RNAs. The Cancer Genome Atlas (TCGA) database was used for Gene Set Enrichment Analysis (GSEA), survival analysis, gene expression statistics or pathway enrichment assay. PPI inhibited the propagation of NSCLC cells, increased non-viable apoptotic cells, arrested cell cycle at G2/M phase, induced ROS levels but failed to decrease mitochondrial membrane potential. High levels of GRP78 indicates poor prognosis in NSCLC patients. PPI selectively suppressed unfolded protein response (UPR)-induced GRP78 expression, subsequently protected CHOP from GRP78-mediated ubiquitination and degradation. We demonstrated that the natural product PPI, obtained from traditional herbal medicine, deserves for further study as a valuable candidate for lead compound in the chemotherapy of NSCLC.


From bumblebee to bioeconomy: Recent developments and perspectives for sophorolipid biosynthesis.
Sophorolipids are biobased compounds produced by the genera Starmerella and Pseudohyphozyma that gain exponential interest from academic and industrial stakeholders due to their mild and environmental friendly characteristics. Currently, industrially relevant sophorolipid volumetric productivities are reached up to 3.7 g∙L-1∙h-1 and sophorolipids are used in the personal care and cleaning industry at small scale. Moreover, applications in crop protection, food, biohydrometallurgy and medical fields are being extensively researched. The research and development of sophorolipids is at a crucial stage. Therefore, this work presents an overview of the state-of-the-art on sophorolipid research and their applications, while providing a critical assessment of scientific techniques and standardisation in reporting. In this review, the genuine sophorolipid producing organisms and the natural role of sophorolipids are discussed. Subsequently, an evaluation is made of innovations in production processes and the relevance of in-situ product recovery for process performance is discussed. Furthermore, a critical assessment of application research and its future perspectives are portrayed with a focus on the self-assembly of sophorolipid molecules. Following, genetic engineering strategies that affect the sophorolipid physiochemical properties are summarised. Finally, the impact of sophorolipids on the bioeconomy are uncovered, along with relevant future perspectives.


Piezo2 mediates visceral mechanosensation: A new therapeutic target for gut pain?
Mechanical distension/stretch in the colon provokes visceral hypersensitivity and pain. In this issue of Neuron, Xie et al. report that mechanosensitive Piezo2 channels, expressed by TRPV1-lineage nociceptors, are involved in visceral mechanical nociception and hypersensitivity.


Coordination of services for outpatients under concurrent medical and psychiatric care.
The proportion of outpatients with concurrent medical and psychiatric problems is high and is expected to increase, but coordination of services has not been satisfactory. The medical and psychiatric records of 28 patients under regular psychiatric and medical care were abstracted, for a total of 323 visits, to ascertain issues related to assessment and coordination of care. Results indicate that psychiatric therapists and primary-care providers do not perform satisfactorily in assessing medical and psychiatric problems, respectively, and in initiating coordination of their patients' health care. The implications of these findings for the training, education, and supervision of staff are discussed.


Investigating the Role of EPA and DHA on Cellular Oxidative Stress; Profiling Antidiabetic and Antihypertensive Potential.
Polyunsaturated fatty acids (PUFAs) remain part of the diet and are essential for growth and development. Furthermore, omega - 3 fatty acids boost various cardiovascular disease risk factors as well as lower blood pressure and cholesterol levels. The effects of PUFAs on glycemia in type 2 diabetes patients are unclear. In the present study, the anti-diabetic and anti-hypertensive potential of eicosapentenoic acid (EPA) and docosahexaenoic acid (DHA)-two polyunsaturated fatty acids-were examined. Using 3T3-L1 pre-adipocyte cells fed with PUFAs, the antioxidant capacity of EPA and DHA was assessed using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay/test. The DPPH activity of EPA and DHA was 49.72 and 50.51%, respectively, indicating a reduction in oxidative stress. The number, size, and total lipid content of adipocytes in adipose tissue were used to study the anti-diabetic effect of EPA and DHA. Both PUFAs were revealed to have a much lower capacity for cell lysis of 3T3-L1 pre-adipocytes when compared to propylene glycol monomethyl ether acetate (PMA). In 3T3-L1 pre-adipocyte cells that had been treated with EPA and DHA, the gene expression profiles for ATP synthase 6 were examined. The results demonstrated a similar trend of reducing total lipid content in 3T3-L1 pre-adipocyte cells treated with EPA and DHA. The amount of cell lysis was then examined for 3T3-L1 pre-adipocyte cells exposed to DHA and EPA, and the results showed 38.45% and 41.26%, respectively. In the 3T3-L1 pre-adipocyte cells, treatment with PUFAs, EPA, and DHA dramatically lowered total lipid content after 48 hours. The study also revealed that exposing 3T3-L1 pre-adipocyte cells to EPA at 90 g/ml for 48 hours reduced the total lipid content by a significant amount. According to the findings, EPA and DHA therapy reversed oxidative stress in mitochondria and upregulated the ATP synthase 6 gene. This discovery shows how EPA and DHA have anti-diabetic and hypertension properties.


Trends in US Outpatient Antibiotic Prescriptions During the Coronavirus Disease 2019 Pandemic.
The objective of our study was to describe trends in US outpatient antibiotic prescriptions from January through May 2020 and compare with trends in previous years (2017-2019). We used data from the IQVIA Total Patient Tracker to estimate the monthly number of patients dispensed antibiotic prescriptions from retail pharmacies from January 2017 through May 2020. We averaged estimates from 2017 through 2019 and defined expected seasonal change as the average percent change from January to May 2017-2019. We calculated percentage point and volume changes in the number of patients dispensed antibiotics from January to May 2020 exceeding expected seasonal changes. We also calculated average percent change in number of patients dispensed antibiotics per month in 2017-2019 versus 2020. Data were analyzed overall and by agent, class, patient age, state, and prescriber specialty. From January to May 2020, the number of patients dispensed antibiotic prescriptions decreased from 20.3 to 9.9 million, exceeding seasonally expected decreases by 33 percentage points and 6.6 million patients. The largest changes in 2017-2019 versus 2020 were observed in April (-39%) and May (-42%). The number of patients dispensed azithromycin increased from February to March 2020 then decreased. Overall, beyond-expected decreases were greatest among children (≤19 years) and agents used for respiratory infections, dentistry, and surgical prophylaxis. From January 2020 to May 2020, the number of outpatients with antibiotic prescriptions decreased substantially more than would be expected because of seasonal trends alone, possibly related to the coronavirus disease 2019 pandemic and associated mitigation measures.


Expression and prognostic value of lactoferrin mRNA isoforms in human breast cancer.
We investigated the expression levels of human lactoferrin (Lf), a steroid hormone-inducible gene product the expression of which is often altered during oncogenesis, and of Delta-lactoferrin (DeltaLf), its alternative isoform, which has been shown to be absent from tumor cell lines in commonly used human breast epithelial cell lines, using semiquantitative RT-PCR. Both mRNAs were detected but with levels of expression lower than those found in normal breast epithelial cells. This downregulation was much more visible for DeltaLf since its expression was either significantly diminished (BT-20, MCF-7 cell lines) or practically absent (MDA-MB-231, T-47D, HBL 100 cell lines). In order to determine whether Lf gene products are useful prognosic tools, we further analyzed their expression levels in 99 primary breast cancer biopsies. DeltaLf transcripts were found in all of the samples, whereas Lf transcripts were found in 88% of them. Lf and DeltaLf expression levels were positively correlated (p = 0.003). Lf expression was related to tumor type with a higher recovery in lobular-type tumors (p = 0.04). DeltaLf expression was related to the histoprognostic grading (p = 0.02). In univariate analyses, DeltaLf and Lf expressions were prognosis parameters, high concentrations being associated with a longer overall survival.


Neurocritical care nursing research priorities.
The science of nursing has long been discussed as a blending of the art and science of caring, and nursing research builds the evidence of support for nursing practice. Nurses and nursing care are key to successful neurocritical care research endeavors. Ideally nursing care should be evidence based and supported by solid research. The goal of nursing research is to expand the knowledge of caring for patients. Within the scope of nursing research, the priorities for research in neurocritical care should support this goal. In this manuscript, we discuss what we believe are the priorities of neurocritical care nursing research, the obstacles, and some possible solutions.


Dealing with transcription-blocking DNA damage: Repair mechanisms, RNA polymerase II processing and human disorders.
Transcription-blocking DNA lesions (TBLs) in genomic DNA are triggered by a wide variety of DNA-damaging agents. Such lesions cause stalling of elongating RNA polymerase II (RNA Pol II) enzymes and fully block transcription when unresolved. The toxic impact of DNA damage on transcription progression is commonly referred to as transcription stress. In response to RNA Pol II stalling, cells activate and employ transcription-coupled repair (TCR) machineries to repair cytotoxic TBLs and resume transcription. Increasing evidence indicates that the modification and processing of stalled RNA Pol II is an integral component of the cellular response to and the repair of TBLs. If TCR pathways fail, the prolonged stalling of RNA Pol II will impede global replication and transcription as well as block the access of other DNA repair pathways that may act upon the TBL. Consequently, such prolonged stalling will trigger profound genome instability and devastating clinical features. In this review, we will discuss the mechanisms by which various types of TBLs are repaired by distinct TCR pathways and how RNA Pol II processing is regulated during these processes. We will also discuss the clinical consequences of transcription stress and genotype-phenotype correlations of related TCR-deficiency disorders.


Using expansive grasses for monitoring heavy metal pollution in the vicinity of roads.
We propose a method for monitoring heavy metal deposition in the vicinity of roads using the leaf surfaces of two expansive grass species which are greatly abundant. A principle of the proposed procedure is to minimize the number of operations in collecting and preparing samples for analysis. The monitored elements are extracted from the leaf surfaces using dilute nitric acid directly in the sample-collection bottle. The ensuing steps, then, are only to filter the extraction solution and the elemental analysis itself. The verification results indicate that the selected grasses Calamagrostis epigejos and Arrhenatherum elatius are well suited to the proposed procedure. Selected heavy metals (Zn, Cu, Pb, Ni, Cr, and Cd) in concentrations appropriate for direct determination using methods of elemental analysis can be extracted from the surface of leaves of these species collected in the vicinity of roads with medium traffic loads. Comparing the two species showed that each had a different relationship between the amounts of deposited heavy metals and distance from the road. This disparity can be explained by specific morphological properties of the two species' leaf surfaces. Due to the abundant occurrence of the two species and the method's general simplicity and ready availability, we regard the proposed approach to constitute a broadly usable and repeatable one for producing reproducible results.


Nuclear localization and cytosolic overexpression of LASP-1 correlates with tumor size and nodal-positivity of human breast carcinoma.
LIM and SH3 protein 1 (LASP-1), initially identified from human breast cancer, is a specific focal adhesion protein involved in cell proliferation and migration, which was reported to be overexpressed in 8-12 % of human breast cancers and thought to be exclusively located in cytoplasm. In the present work we analyzed the cellular and histological expression pattern of LASP-1 and its involvement in biological behavior of human breast cancer through correlation with standard clinicopathological parameters and expression of c-erbB2 (HER-2/neu), estrogen- (ER) and progesterone-receptors (PR). For this purpose immunohistochemical staining intensity and percentage of stained cells were semi-quantitatively rated to define a LASP-1 immunoreactive score (LASP-1-IRS). LASP-1-IRS was determined in 83 cases of invasive ductal breast carcinomas, 25 ductal carcinomas in situ (DCIS) and 18 fibroadenomas. Cellular LASP-1 distribution and expression pattern was visualized by immunofluorescence and confocal microscopy and assessed through separate Western blots of nuclear and cytosol preparations of BT-20, MCF-7, MDA-MB231, and ZR-75/1 breast cancer cells. Statistical analysis revealed that the resulting LASP-1-IRS was significantly higher in invasive carcinomas compared to fibroadenomas (p = 0.0176). Strong cytoplasmatic expression of LASP-1 was detected in 55.4 % of the invasive carcinomas, which correlated significantly with nuclear LASP-1-positivity (p = 0.0014), increased tumor size (p = 0.0159) and rate of nodal-positivity (p = 0.0066). However, levels of LASP-1 expression did not correlate with average age at time point of diagnosis, histological tumor grading, c-erbB2-, ER- or PR-expression. Increased nuclear localization and cytosolic expression of LASP-1 was found in breast cancer with higher tumor stage as well as in rapidly proliferating epidermal basal cells. Confocal microscopy and separate Western blots of cytosolic and nuclear preparations confirmed nuclear localization of LASP-1. The current data provide evidence that LASP-1 is not exclusively a cytosolic protein, but is also detectable within the nucleus. Increased expression of LASP-1 in vivo is present in breast carcinomas with higher tumor stage and therefore may be related with worse prognosis concerning patients' overall survival.


Role of extracorporeal membrane oxygenation in COVID-19: A systematic review.
We aimed to examine the literature evidence behind using extracorporeal membrane oxygenation in COVID-19 patients in a systematic review manner. We conducted a systematic review using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A comprehensive literature search was conducted on Global Health Medline, EMBASE, and Cochrane databases using keywords and MeSH terms to identify articles pertaining to extracorporeal membrane oxygenation (ECMO) and Coronavirus disease 2019 (COVID-19). A narrative synthesis was then undertaken to identify the key themes. A total of 25 articles met the inclusion criteria of this systematic review. Three main themes were identified following the data extraction: (a) evidence against/inconclusive regarding ECMO for COVID-19, (b) evidence supporting ECMO for COVID-19, and finally (c) VV-ECMO and VA-ECMO. After combining the data, there were 3428 patients diagnosed with COVID-19 and 95 ECMO-associated deaths (19.83%). Our study highlights the paucity of evidence and the need for further data to consolidate the efficacy of ECMO in improving patient outcomes. Although ECMO has been shown to be beneficial in a selected group of patients, the recuperative effects of ECMO remain inconclusive. We must ensure that risk-benefit analysis for each candidate is conducted thoroughly so that patients that have increased probability of survival can benefit from this scarce resource.


Calmodulin antagonists modulate rabbit neutrophil degranulation, aggregation and stimulated oxygen consumption.
In an attempt to define further the sequence of events involved in the activation of rabbit peritoneal neutrophils, we have investigated the effects of trifluperazine and N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide (compound W7), two compounds with known anti-calmodulin activity, on these cells' ability to respond to several stimuli. Neutrophil granule enzyme release, aggregation and oxygen consumption were monitored. These functions were elicited by the addition of one of the following stimuli to cell suspensions: the chemotactic factor f Met-Leu-Phe, arachidonic acid and the divalent cation ionophore A23187. Aggregation, oxygen consumption and granule enzyme release stimulated by the above three stimuli are all profoundly affected by calmodulin inhibitors. Low concentrations of trifluperazine slightly potentiates aggregation and oxygen consumption. At higher, but below lytic concentrations, compound W7 and trifluperazine significantly depress all three functions examined. In conjunction with previous results and by analogy to studies in other cell types, it therefore appears likely that calmodulin-stimulated events play central roles in the activation of rabbit neutrophils.


[Surgical treatment of cancer of the vulva. Our experience apropos of 21 cases].
The authors report the anatomoclinical aspects and the treatment of 21 cases of cancer of vulva at the Danang General Hosptial from 1961 to 1974. The treatment is only surgical : total vulvectomy and bilateral femoral, inguinal and pelvic lymphadenectomies (radical vulvectomy). The 5 year survival is 63,3 p. 100. Stages I and II have a better survival rate. Metastasis in nodes determine a poor prognosis.


Sedation for bronchoscopy in children: A prospective randomized double-blinded trial.
In pediatric patients, flexible bronchoscopy requires deep sedation. Different sedation regimes are common, but only some of them include opioids. Due to their antitussive effect, the use of short-acting opioids may be beneficial for this particular indication, but additional respiratory depression may lead to an increase in adverse events. Here, we systematically compared sedation regimes in children undergoing flexible bronchoscopy with either propofol alone, or a combination of propofol and remifentanil. The primary outcome parameter was the frequency of coughing episodes during the intervention. Secondary outcome parameters were frequency and types of complications, patient satisfaction, examiner satisfaction, and recovery time after finishing the sedation. Fifty children aged 1-17 years undergoing flexible bronchoscopy under deep sedation with propofol were randomly assigned to two groups: PR receiving propofol and remifentanil and PP receiving propofol only. Sedation depth was predefined as Comfort Score 10-13. We found significantly less coughing episodes ([med (IQR)] PR: 0.73 (0.28-2.45)/min; PP: 1.98 (1.26-3.12)/min; p = .010) and shorter recovery time in Group PR (PR: 13.5 (8-17.5) min; PP: 21.0 (14-27) min; p = .011). Examiner's satisfaction was higher in Group PR (PR: 10 (8-10); PP: 9 (7-9); p = .012). The number of adverse events, patient satisfaction, and required propofol dose during the intervention did not differ between groups. We suggest the combination of propofol with remifentanil instead of using propofol alone in pediatric procedural sedation for flexible bronchoscopy.


Association between the FAAH C385A variant (rs324420) and obesity-related traits: a systematic review.
Overweight and obesity are the consequence of a sustained positive energy balance. Twin studies show high heritability rates pointing to genetics as one of the principal risk factors. By 2022, genomic studies led to the identification of almost 300 obesity-associated variants that could help to fill the gap of the high heritability rates. The endocannabinoid system is a critical regulator of metabolism for its effects on the central nervous system and peripheral tissues. Fatty acid amide hydrolase (FAAH) is a key enzyme in the inactivation of one of the two endocannabinoids, anandamide, and of its congeners. The rs324420 variant within the FAAH gene is a nucleotide missense change at position 385 from cytosine to adenine, resulting in a non-synonymous amino acid substitution from proline to threonine in the FAAH enzyme. This change increases sensitivity to proteolytic degradation, leading to reduced FAAH levels and increased levels of anandamide, associated with obesity-related traits. However, association studies of this variant with metabolic parameters have found conflicting results. This work aims to perform a systematic review of the existing literature on the association of the rs324420 variant in the FAAH gene with obesity and its related traits. A literature search was conducted in PubMed, Web of Science, and Scopus. A total of 645 eligible studies were identified for the review. After the identification, duplicate elimination, title and abstract screening, and full-text evaluation, 28 studies were included, involving 28 183 individuals. We show some evidence of associations between the presence of the variant allele and higher body mass index, waist circumference, fat mass, and waist-to-hip ratio levels and alterations in glucose and lipid homeostasis. However, this evidence should be taken with caution, as many included studies did not report a significant difference between genotypes. These discordant results could be explained mainly by the pleiotropy of the endocannabinoid system, the increase of other anandamide-like mediators metabolized by FAAH, and the influence of gene-environment interactions. More research is necessary to study the endocannabinoidomic profiles and their association with metabolic diseases.


Body mass and sex, not local climate, drive differences in chill coma recovery times in common garden reared bumble bees.
The time required to recover from cold exposure (chill coma recovery time) may represent an important metric of performance and has been linked to geographic distributions of diverse species. Chill coma recovery time (CCRT) has rarely been measured in bumble bees (genus Bombus) but may provide insights regarding recent changes in their distributions. We measured CCRT of Bombus vosnesenskii workers reared in common garden laboratory conditions from queens collected across altitude and latitude in the Western United States. We also compared CCRTs of male and female bumble bees because males are often overlooked in studies of bumble bee ecology and physiology and may differ in their ability to respond to cold temperatures. We found no relationship between CCRT and local climate at the queen collection sites, but CCRT varied significantly with sex and body mass. Because differences in the ability to recover from cold temperatures have been shown in wild-caught Bombus, we predict that variability in CCRT may be strongly influenced by plasticity.


Exceptional Elasticity of Microscale Constrained MoS2 Domes.
The outstanding mechanical performances of two-dimensional (2D) materials make them appealing for the emerging fields of flextronics and straintronics. However, their manufacturing and integration in 2D crystal-based devices rely on a thorough knowledge of their hardness, elasticity, and interface mechanics. Here, we investigate the elasticity of highly strained monolayer-thick MoS2 membranes, in the shape of micrometer-sized domes, by atomic force microscopy (AFM)-based nanoindentation experiments. A dome's crushing procedure is performed to induce a local re-adhesion of the dome's membrane to the bulk substrate under the AFM tip's load. It is worth noting that no breakage, damage, or variation in size and shape are recorded in 95% of the crushed domes upon unloading. Furthermore, such a procedure paves the way to address quantitatively the extent of the van der Waals interlayer interaction and adhesion of MoS2 by studying pull-in instabilities and hysteresis of the loading-unloading cycles. The fundamental role and advantage of using a superimposed dome's constraint are also discussed.


[Delegation and the Efficient Use of Medical Personnel - Ideas During Times of Physician Shortage].
Patient care is a cost intensive process and an important fraction of these costs is the salary of medical staff. Efficient use, especially in times of physician shortage, should thus be of great importance to hospital management. We aim to calculate the costs and resulting saving potential from delegation of tasks, that are performed by medical personnel, but could in principle be delegated. The calculation is based on the survey "Nachwuchsumfrage" of the Berufsverband and German Society of Surgery (n = 708). Satisfaction, limiting factors and time spent on tasks that could be delegated were assessed. From the average physician's salary and the salary of personnel that could be delegated to costs and potential savings were calculated. The surveyed surgeons spent an average of 124 min per day on tasks that could in principle be delegated. In total, costs through unused delegation were calculated at over 16,000 € per year and staff member, with a saving potential of up to 7,000 € despite full delegation. Our simple calculation shows the saving potential through adequate task delegation. Apart from the monetary aspects, a positive effect on physician staff satisfaction can be assumed, as unused delegation potential was the leading cause for decreased satisfaction.


Curing atrial fibrillation: Two decades of progress.
Since the original description of the Cox-Maze procedure two decades ago, there has been considerable refinement and expansion of surgical techniques for atrial fibrillation (AF). During this same time, there has been a parallel evolution of catheter-based ablation techniques designed to cure AF. Recent guidelines have been developed to guide patient selection for pharmacologic and nonpharmacologic options for therapy of AF. Understanding the mechanisms of AF will lead to better management strategies and improved patient outcomes.


Development of vertical vestibulo-ocular reflex characteristics in intact and flocculectomized rabbits visually deprived from birth.
The vertical vestibulo-ocular reflex (VOR) was recorded in dark-reared rabbits 3 months of age submitted in the dark to lateral sinusoidal oscillations of different frequencies and fixed amplitude. While the phase of the response was perfectly adequate to ensure head movements compensation, the gain values recorded showed a clear reduction with respect to the values obtained in a normally raised control group of the same age. After exposure to light, the visually deprived animals showed a complete and rapid recovery of normal VOR gain values. Another group of animals was flocculectomized prior to light exposure. The bilateral ablation of flocculus and paraflocculus did not affect the VOR characteristics of the deprived animals. After exposure to light, in the flocculectomized animals, no recovery of the VOR gain values was observed. The present results confirm that visual experience in early life is necessary for a correct development of the VOR. If visual deprivation is limited to the first few months of life, the impairment of the reflex characteristics is completely reversible. Finally our data suggest that in the rabbit, the flocculus controls the early life development of the VOR.


Application of Amniotic Membrane in Skin Regeneration.
Amniotic membrane (AM) is an avascular structure composed of three different layers, which contain collagen, extracellular matrix, and biologically active cells (stem cells). Collagen, a naturally occurring matrix polymer, provides the structural matrix/strength of the amniotic membrane. Tissue remodeling is regulated by growth factors, cytokines, chemokines, and other regulatory molecules produced by endogenous cells within AM. Therefore, AM is considered an attractive skin-regenerating agent. This review discusses the application of AM in skin regeneration, including its preparation for application to the skin and its mechanisms of therapeutic healing in the skin. This review involved collecting research articles that have been published in several databases, including Google Scholar, PubMed, Science Direct, and Scopus. The search was conducted by using the keywords 'amniotic membrane skin', 'amniotic membrane wound healing', 'amniotic membrane burn', 'amniotic membrane urethral defects', 'amniotic membrane junctional epidermolysis bullosa', and 'amniotic membrane calciphylaxis'. Ultimately, 87 articles are discussed in this review. Overall, AM has various activities that help in the regeneration and repair of damaged skin.


The mediating role of green creativity and the moderating role of green mindfulness in the relationship among clean environment, clean production, and sustainable growth.
This study aims to focus on Pakistan's fertilizer industry and investigate the causal relationships among environmental consciousness (ECO), green creativity (GCR), green mindfulness (GMD), and energy efficiency (EE), which are all essential mechanisms as well as circumstances that control the situation in well-developed manners. This study consists of a sample regarding four hundred and four (404) employees from seven companies by using partial least squares (PLS) and structural equation modeling (SEM) approach. The results indicate that environmental consciousness significantly and positively affects employee energy efficiency directly and indirectly in the presence of green creativity as a mediator. Moreover, the moderating effect of green mindfulness persisted only in the association between energy efficiency and green creativity. In the appropriate literature, this empirical investigation is the first of its kind which does not only provide an organized way to examine the effects of environmental consciousness on energy efficiency but also recommend the most effective means for employees and associations to embrace the best policies. This study has important policy implications for promoting clean production, clean environment, and sustainable development for developed and developing economies.


Soft Tissue Reconstruction of Parotidectomy Defect.
This article provides a review of soft tissue reconstructive options for the parotidectomy defect, including skin incision, primary closure, acellular dermis, autologous fat transfer, local and regional flaps, and free tissue transfer. The authors discuss considerations for volume enhancement, skin coverage, prevention of Frey syndrome, tumor surveillance, and potential complications.


Intermolecular vibrational mode of the benzoic acid dimer in solution observed by terahertz time-domain spectroscopy.
The low-frequency modes of the benzoic acid (BA) dimer and its analogues in carbon tetrachloride (CCl(4)) have been investigated by terahertz time-domain spectroscopy. The solute spectrum is obtained by subtracting the solvent contribution from that of the solution. The difference spectrum of BA in CCl(4) has a broad band with a peak at 68 cm(-1). To assign the observed band, the spectrum is compared with spectra of other aromatic molecules, such as benzene and phenol in addition to p-methyl BA and deuterated BA species (BA-d(OH) and BA-d(5)) in CCl(4). The band at 68 cm(-1) is assigned to the cogwheel mode of the BA dimer. Density functional theory calculations also support this assignment. Finally, spectral lineshape analysis based on the multimode Brownian oscillator model is applied to the THz spectra for all the samples.


Cardioprotective stimuli mediate phosphoinositide 3-kinase and phosphoinositide dependent kinase 1 nuclear accumulation in cardiomyocytes.
The phosphoinositide 3-kinase (PI3K)/phosphoinositide dependent kinase 1 (PDK1) signaling pathway exerts cardioprotective effects in the myocardium through activation of key proteins including Akt. Activated Akt accumulates in nuclei of cardiomyocytes suggesting that biologically relevant targets are located in that subcellular compartment. Nuclear Akt activity could be potentiated in both intensity and duration by the presence of a nuclear-associated PI3K/PDK1 signaling cascade as has been described in other non-myocyte cell types. PI3K/PDK1 distribution was determined in vitro and in vivo by immunostaining and nuclear extraction of cultured rat neonatal cardiomyocytes or transgenic mouse hearts. Results show that PI3K and PDK1 are present at a basal level in cardiomyocytes nuclei and that cardioprotective stimulation with atrial natriuretic peptide (ANP) increases their nuclear localization. In comparison, overexpression of nuclear-targeted Akt does not mediate increased translocation of either PI3K or PDK1 indicating that accumulation of Akt does not drive PI3K or PDK1 into the nuclear compartment. Furthermore, PI3K and phospho-Akt(473) show parallel temporal accumulation in the nucleus following (MI) infarction challenge. These findings demonstrate the presence of a dynamically regulated nuclear-associated signaling cascade involving PI3K and PDK that presumably influences nuclear Akt activation.


Functional characterization of plantar pressure patterns in gait of typically developing children using dynamic pedobarography.
Abnormal foot posture is a common complaint presented in pediatric and pediatric orthopedic clinics. Functional, objective assessment of foot posture, with the potential for early identification of pathologic foot deformities, has, however, been lacking to date. While quantifying functional and regional impulses via dynamic pedobarography can improve the clinical assessment of children's feet, normative values have not yet been reported or characterized. The objectives of this study were to: (1) quantify and characterize the pattern and spectrum of foot impulses in walking-aged, typically developing children; and (2) compare these to impulses from non-disabled adults. Foot impulses of 102 participants (52 female) in five pre-determined age groups (2-3, 4-6, 7-10, 11-14, 15-17 years) were examined using dynamic pedobarography. Each pressure map (3 per foot per child) was divided according to anatomical foot regions: the hallux, heel, medial forefoot, lateral forefoot, lesser toes (D2 to D5), and midfoot. The impulse was calculated for each region and used to generate regional percent impulses and impulse ratios to assess anteroposterior and mediolateral balance within the foot. The impulse through the midfoot was highest in the youngest age group, with a corresponding lower impulse through the medial forefoot. As age advanced, the midfoot impulse decreased (p = 0.001), and the forefoot balance shifted slightly more medially (%Medial Forefoot: p = 0.004; Medial-Lateral Forefoot Balance: p = 0.019). When compared to adults, there were no significant differences between 15-17 year old children and adults in any of the regional percent impulses and impulse ratios. This indicates that skeletal maturity of the foot by late adolescence results in functional characteristics seen in adults. The age-standardized norms of functional and regional impulse measures in children reported in this study can be used as a comparative benchmark in the clinical assessment of children presenting with various foot deformities.


Gastrointestinal bioaccessibility and fiber mitigation of tropane alkaloids assessed on tea and cookies by in vitro digestion.
Tropane alkaloids (TAs) are toxic compounds with a high anticholinergic effect. They have been widely analyzed in food samples, but their fate in the gastrointestinal tract has not been evaluated yet. In this study, static in vitro digestion was performed to assess gastrointestinal bioaccessibility of the most common TAs on tea and home-made cookies. Cookies enriched with dietary fiber (pectin, arabinogalactan, and κ-carrageenan) were also tested to evaluate their influence on TA bioaccessibility. Two extraction methods and a liquid chromatography-mass spectrometry method were optimized and validated. Bioaccessibility for tea (60-105%) was higher than for cookies (39-93%) (P = 0.001-0.002), which indicates TAs could be more easily absorbed when they are contaminating tea. Digestion of cookies enriched with 50 g kg-1 of different fibers showed that, although no significant changes were observed in the gastric phase (P = 0.084-0.920), duodenal bioaccessibility was significantly reduced (P = 0.008-0.039). Pectin was the fiber with a better mitigation effect for all the compounds. TAs bioaccessibility was determined after in vitro digestion of contaminated tea and cookies. Dietary fiber seems to be a promising mitigation strategy, significantly reducing TA bioaccessibility percentages. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.


Uterine transplantation. First viable case in Southern Europe.
To describe the development and characteristics living donor uterine transplantation program of the Hospital Clínic (Barcelona, Spain) and to report the first successful procedure in Southern Europe. A 31-year-old female suffering of Rokitansky Syndrome underwent uterus transplant from her living sister, as a part of our research protocol. Before the transplant, the patient underwent an in vitro fertilization procedure and twelve embryos were obtained and cryopreserved. The uterus obtention procedure was performed entirely by robotic surgery and lasted 10h, being the main objective to obtain arterial and venous pedicles of good quality in order to ensure the vitality of the graft. The surgical procedure in the recipient was performed by laparotomy and the vascular anastomoses were performed in a terminolateral fashion, with polypropylene 8-0, the vaginal cuff of the graft was sutured to the recipient vaginal vault and the round and utero-sacral ligaments were fixed to the remaining recipient ligaments. Immunosuppressive treatment was prescribed following the protocols from other groups modified according to the solid organ transplantation protocols from our center. The donor and recipient were discharged without any major complications. The recipient ultrasound scan showed a normal flow in both uterine arteries and veins. A grade II rejection was treated with high dose corticoids with subsequent normal biopsies and a vaginal stricture was treated with the placement of an esophageal stent for 4 weeks. The patient had her first menstrual period 47 days after the surgery. The case reported here open new options in Spain for a wide group of patients that had no medical solution for a disease that deeply impairs their quality of life.


The presence of an endogenous lectin in early embryos ofXenopus laevis.
Xenopus laevis embryos were examined for the presence of endogenous carbohydrate binding proteins. Soluble extracts of cleavage, gastrula and neurula embryos are able to agglutinate trypsinized rabbit erythrocytes. Unlike other embryonic lectins this agglutination activity requires the presence of calcium ions but not of sulphydryl reducing agents. It is specifically inhibited by galactose and galactose containing derivatives. Thiodigalactoside is the most potent disaccharide inhibitor followed by lactose and melibiose respectively. Methyl α-D-galactopyranoside is a more effective inhibitor than its β anomer. N-acetyl-D-galactosamine, N-acetyl-D-glucosamine, methyl α-D-mannopyranoside andL-fucose do not inhibit activity at concentrations at or above 25 mM. EDTA and EGTA are also strong inhibitors of this activity. β-D-galactoside binding lectins present in the early chick embryo have been implicated in cell to cell and cell to substrate adhesiveness of extraembryonic chick endoderm cells. Since cells of the blastula inXenopus laevis possess surface receptors bearing terminal β-D-galactoside groups it is possible that this β-D-galactoside binding lectin may play a role in the control of cell surface mediated events during development.


Comparative arterial antithrombotic activity of clopidogrel and acetyl salicylic acid in the pig.
We investigated the comparative antithrombotic properties of clopidogrel, an analogue of ticlopidine, and aspirin, using the Folts' model on femoral arteries in 22 pigs. On each animal, clopidogrel or aspirin were used to treat the thrombotic process on the left femoral artery and to prevent this process on the right femoral artery. Sequentially: an injury and stenosis were carried out on the left femoral artery; the thrombotic process was monitored with a Doppler during a 30-min observation period for cyclic flow reductions or permanent cessation of flow; after the first cyclic flow reduction occurred, clopidogrel (5 mg kg-1) or aspirin (2.5, 5, 100 mg kg-1) were injected intravenously; if cyclic flow reductions were abolished, epinephrine (0.4 micrograms kg-1 min-1) was injected to try to restore cyclic flow reductions and/or permanent cessation of flow; then injury and stenosis were applied on the right femoral artery. Before and after injection of clopidogrel or aspirin, ear immersion bleeding times and ex-vivo platelet aggregation were performed. Clopidogrel (n = 7) abolished cyclic flow reductions were efficiently prevented, even for two injuries. Basal bleeding time (5 min 28) was lengthened (> 15 min, 30 min after clopidogrel and remained prolonged even after 24 h). ADP-induced platelet aggregation was inhibited (more than 78%). Comparatively, aspirin had a moderate and no dose-dependent effect. Aspirin 2.5 mg kg-1 (n = 6) abolished cyclic flow reductions in 2 animals, CFR reoccurred spontaneously in one animal and epinephrine restored it in a second animal.(ABSTRACT TRUNCATED AT 250 WORDS)


Spirituality for Coping with the Trauma of a Loved One's Death During the COVID-19 Pandemic: An Italian Qualitative Study.
Spirituality may be a key factor in reducing the negative psychological effects of traumatic events and a means by which the experience of grief can be processed. The objective of the present research is to assess whether and how spirituality provided concrete support in those who lost a loved one during the COVID-19 pandemic. The participants are 8 people from the most affected cities in northern Italy. They were interviewed in depth, the interviews were transcribed and the texts were analyzed through Interpretive Phenomenological Analysis. The results show that spirituality has been found to be a protective factor with regard to the processing of grief in crisis situations such as the COVID-19 pandemic, in particular with regard to the belief that the deceased loved one is now in an otherworldly dimension. In addition, the celebration of a funeral rite offers support to the grieving person in the early stages of mourning thus laying the foundation for a healthy grieving process. It is therefore important to support individual spirituality, which can be a useful tool for processing the traumatic experience, especially in difficult times such as the COVID-19 pandemic.


A new strategy to simultaneous removal and recovery of nitrogen from wastewater without N2O emission by heterotrophic nitrogen-assimilating bacterium.
Biological assimilation that recovery the nitrogen from wastewater in the form of biomass offers a more environmentally friendly solution for the limitations of the conventional wastewater treatments. This study reported the simultaneous removal and recovery of nitrogen from wastewater without N2O emission by a heterotrophic nitrogen-assimilating Acinetobacter sp. DN1 strain. Nitrogen balance, biomass qualitative analysis, genome and enzyme studies have been performed to illustrate the mechanism of nitrogen conversion by strain DN1. Results showed that the ammonium removal followed one direct pathway (GOGAT/GDH) and three indirect pathways (NH4+ → NH2OH → NO → NO2- → NH4+ → GOGAT/GDH; NH4+ → NH2OH → NO → NO2- → NO3- → NO2- → NH4+ → GOGAT/GDH; NH4+ → NH2OH → NO → NO3- → NO2- → NH4+ → GOGAT/GDH). Nitrogen balance and biomass qualitative analysis showed that over 70 % of the ammonium in the wastewater was converted into intracellular nitrogen-containing compounds and stored in the cells of strain DN1. Traditional denitrification pathway was not detected and the ammonium was removed through assimilation, which makes it more energy-saving for nitrogen recovery when compared with Haber-Bosch process. This study provides a new direction for simultaneous nitrogen removal and recovery without N2O emission by the heterotrophic nitrogen-assimilating bacterium.


Purification of multiple pea ferredoxins by chromatography at high ionic strength on unsubstituted Sepharose 4B.
At high concentrations of ammonium sulfate (3--4 M) pea ferredoxin (which is soluble under these conditions) can be adsorbed to Sepharose 4B, either by column chromatography or by batchwise treatment. A reverse (3 M to 1 M) ammonium sulfate gradient results in the elution of three peaks of ferredoxin. The spectral ratio A420/A280 of 0.47--0.54 indicates that each peak of ferredoxin is highly purified by this single step. A further gel filtration removes residual high molecular weight contaminants from the ferredoxin. The spectrum of the purified pea ferredoxin is typical of other plant ferredoxins in having absorbance peaks at 276 nm, 330 nm, 422 nm and 465 nm. Other chromatographic matrices are capable of adsorbing ferredoxin. Sepharose and Sephacryl wee the best adsorbents while Sephadex and cellulose adsorbed ferredoxin less tenaciously. The polyacrylamide-based resins Biogel P-4 and P-200 did not adsorb ferredoxin at high ionic strength.


Chronic peripheral nerve section results in a rearrangement of the central axonal arborizations of axotomized A beta primary afferent neurons in the rat spinal cord.
In order to investigate the reorganization of the neuropil of the dorsal horn following peripheral nerve injury, the central terminal arborizations of 35 A beta primary afferent neurons, chronically injured by a cut and ligation of the sural nerve 6-12 weeks previously, were studied by the intra-axonal injection of horseradish peroxidase. Their morphology was compared to 13 intact sural nerve hair follicle afferents. Following axotomy, three kinds of morphological abnormalities were observed in the collateral arbors of the 26 afferents that were hair follicle-like. Atrophy with thin stem axons and reduced terminal branch patterns with few boutons was seen in 5 afferents. Sprouting of bouton-containing terminals into lamina I and IIo was found in 8 afferents. Finally, abnormal arborization patterns in the deeper laminae were observed in 29% of the collateral arbors. Changes included the loss in some arbors of a flame-shaped appearance, which is characteristic of hair follicle afferents, atypical branching patterns and ventrally directed axons producing wider and deeper arbors, compared to normal. Axotomy also caused a disruption of the normal somatotopic organization of sural nerve A beta afferents. This disruption manifested as a variability in the normally mediolaterally restricted terminal sheet, with a consequent loss of the strict somatotopic register in the rostrocaudal direction. Damage to the peripheral axon of A beta primary afferents induces a structural reorganization of their central terminals in the dorsal horn of the spinal cord, which may modify sensory input to the central nervous system.


Aesthetic Breast Surgery Under Cold Tumescent Anesthesia: Feasibility and Safety in Outpatient Clinic.
Throughout the last decade, aesthetic breast surgery has enormously spread in the outpatient clinic setting where plastic surgeons perform the vast majority of procedures under local anesthesia as day-case operations. The "tumescent anesthesia" is defined as the injection of a dilute solution of local anesthetic combined with epinephrine and sodium bicarbonate into subcutaneous tissue until it becomes firm and tense, which is "tumescent." The "cold tumescent anesthesia" (CTA) derives from Klein's solution with the introduction of a new concept, which is the low temperature (4°C) of the injected solution. This novelty adds further anesthetic and hemostatic power to the well-known benefits of tumescent anesthesia. The authors report their experience with CTA in the last 15 years in the setting of aesthetic breast surgery, describing in detail the anesthesia protocol, surgical outcomes, and patient satisfaction. A total of 1541 patients were operated on during the study period and were included in this retrospective analysis. The types of breast procedures were breast augmentation in 762 cases (49.4%), mastopexy with implants in 123 patients (8.0%), mastopexy without implants in 452 cases (29.3%), and breast reduction in 204 cases (13.3%). Patient mean age was 42.8 years (range, 18-67 years). The mean operating time was 37 ± 32 minutes for breast augmentation, 78 ± 24 minutes for mastopexy with implants, 58 ± 18 minutes for mastopexy without implants, and 95 ± 19 minutes for breast reduction. No major complications occurred, and no conversion to general anesthesia was required. The median recovery time was 150 minutes (range, 120-210 minutes), and all patients were discharged within 3 hours after surgery. Wound or implant infections occurred in 33 patients (2.1%), wound dehiscences in 21 (1.4%), and postoperative bleeding requiring return to theater in 2 cases (0.1%). Thirteen patients (0.8%) developed capsular contracture. Fifteen patients (1%) required reintervention due to implant rotation or rupture. The median visual analog scale score was 1.8 (interquartile range, 1-3) after discharge. Patient satisfaction was very high in 91.3% (n = 1407) of the cases. In experienced hands, CTA can shorten operating time with high patient satisfaction and a low complication rate. These preliminary data could be hypothesis generating for future multicenter prospective trials done to confirm the benefits of CTA in other surgical fields.


Effect of Dietary Lactose Supplementation on Growth Performance and Intestinal Epithelium Functions in Weaned Pigs Challenged by Rotavirus.
The purpose of this study was to investigate whether dietary lactose supplementation relieves rotavirus (RV)-induced diarrhea and gut dysfunction. Thirty-six crossbred weaned piglets were randomly allocated into three groups and fed diets containing 0, 4%, and 6% lactose for 20 days. On Day 15, half of the piglets in each group were orally infused with RV. RV infection impaired growth performance; induced severe diarrhea; decreased serum D-xylose concentration and morphology and sIgA level of jejunal mucosa; downregulated MUC1, MUC2, occludin, Bcl-2, IL-4, pBD3, pBD2, and pBD1 mRNA expression of jejunal mucosa and/or mesenteric lymph nodes; upregulated Bax, caspase-3, IL-2, IFN-γ, and IFN-β mRNA expression of jejunal mucosa and/or mesenteric lymph nodes; and damaged microbiota and metabolites of cecal digesta in weaned piglets (p < 0.05). Dietary lactose supplementation improved nutrient digestibility and growth performance and relieved the negative influence of RV challenge on intestinal barrier function, mRNA expression of cytokines, and host defense peptides of jejunal mucosa and/or mesenteric lymph nodes in weaned piglets (p < 0.05). Dietary administration of 6% lactose tended to relieve diarrhea (p = 0.07). These results suggest that lactose in feed increases growth performance and has a tendency to alleviate RV-induced diarrhea, derived from the improvement of nutrient utilization, gut barrier function, and immunity.


Emergency department management of sexually transmitted infections.
Patients seeking treatment for sexually transmitted infections (STIs) account for a large number of emergency department (ED) visits per year. Despite the large volume of patients, STIs are often missed or treated inappropriately. Due to the high prevalence and incidence of STIs in the United States, it is important that emergency practitioners recognize symptoms consistent with STIs, and treat presumptively. This practice leads to overtreatment of STIs; however, when weighed against the public health risk and complications of untreated disease, empiric treatment is recommended. This article provides an overview of STIs encountered in the ED and recommendations for their treatment.


Effect of subacute and prenatal DINCH plasticizer exposure on rat dams and male offspring hepatic function: The role of PPAR-α.
Plasticizers are compounds added to plastics to modify their physical proprieties. The most well-known class of plasticizers, the phthalates, has been shown to possess antiandrogenic and tumor promoting activities. 1,2-Cyclohexane dicarboxylic acid diisononyl ester (DINCH) was approved for use in food contact containers in 2006 and has been used as a replacement for phthalates in toys and children products. However, we reported previously that the DINCH metabolite MINCH acts on primary rat adipocytes through the peroxisome proliferator activated receptor (PPAR)-α pathway in a manner similar to phthalates. Evidence from our studies, as well as from the current bibliography on DINCH, suggests that the liver might be one of its target organs. In the present study, we collected tissues from dams exposed subacutely and progeny at postnatal day (PND) 3 and 60 exposed in utero to DINCH (1, 10 and 100 mg/kg bw/day). Exposure to DINCH drastically affected liver gene expression in all 3 age groups tested and in particular at the dose of 1 mg/kg bw/day. The PPAR-α pathway along with other metabolic and DNA replication pathways were affected by DINCH. Modifications in PPAR-α and superoxide dismutase (SOD)-1 protein levels were observed in dams at PND21, as well as male progeny at PND3 and 60. No sign of fibrosis or direct liver toxicity was observed after 8 days of stimulus with low doses of DINCH. This study provides evidence that DINCH is not a biologically inert molecule in the rat, and in the liver its actions are mediated, at least in part, by PPAR-α.


A newly designed paraffin@VO2 phase change material with the combination of high latent heat and large thermal conductivity.
The paraffin is the widely used solid-liquid phase change material (PCM) with large fusion latent heat in thermal management, and vanadium dioxide (VO2) is a promising reversible solid-solid PCM with a near-ambient phase transition temperature (Tc = ~68 °C). In the real applications, the paraffin is always wrapped with inorganic or organic shells to stabilize the shape during the fusion/solidification with compromising large amounts of latent heat. Herein, we proposed the paraffin@VO2 PCM structure for the first time, which combines the solid-liquid paraffin PCM core and the solid-solid VO2 PCM shell. The paraffin@VO2 PCM structure is synthesized via an emulsion method starting with the Te/W-codoped VO2 microparticles and the paraffin wax (C26H54). This developed PCM structure shows a suitable Tc = 58.2 °C (ΔTc = 5.5 °C), a decent fusion latent heat 163 J/g and a largely enhanced thermal conductivity 1.53 W/mK, which should be promising for the high-efficient thermal management applications.