Implementing an education program for nurse-midwives focused on early essential care for breast milk expression among mothers of preterm infants.
Although breastfeeding guidelines for infants admitted to the neonatal intensive care unit (NICU) have been introduced in Japan, these guidelines have not been reflected in practice. To improve this situation, it is important for nurses and nurse-midwives to acquire knowledge of appropriate care. This study examined changes in nurse-midwives' knowledge, attitude, and implementation of appropriate care after implementing an education program focused on early essential care for breast milk expression among mothers of preterm infants. This pre- and post-intervention study using a single group was conducted from June 2018 to May 2019 and enrolled 36 nurse-midwives in one perinatal medical center. The education program content included nurses' roles in early essential care for milk expression and the necessary care to promoting breast milk production among mothers of preterm infants. The nurse-midwives' knowledge and attitude on care were investigated 3 months before (pre-1), just before (pre-2), just after (post-1), and 3 months after (post-2) the program. The nurse-midwives' care implementation was investigated at pre-1, pre-2, and post-2. During this time, 11 mothers (before: 7, after: 4) reported the status of milk expression for 10 days after birth. The mean knowledge scores of the nurse-midwives at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p < 0.001, post-2: p < 0.001). The attitude on care scores at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p < 0.001, post-2: p = 0.010). The care implementation score at post-2 was significantly higher than that at pre-2 in eight items (e.g., Q7 Explain about the effect of initiating milk expression early and assist mothers in it). However, the education program did not cause any changes in the mothers' initiation and frequency of milk expression, and breast milk volume after birth. The significant increases in the knowledge, attitude on care, and care implementation scores of the nurse-midwives suggest the beneficial effects of the education program. The small number of mothers in the survey on the practice of breast milk expression limited the full determination of the benefits of the education program for nurse-midwives.


Risk of herpes zoster among diabetics: a matched cohort study in a US insurance claim database before introduction of vaccination, 1997-2006.
To assess whether diabetes is a risk factor for herpes zoster (HZ). We conducted a retrospective cohort study using the Integrated Health Care Information Services database, during the period 1997-2006. A type I diabetes cohort, a type II diabetes cohort and two non-diabetic cohorts matched for date of enrolment and duration of follow-up were defined. HZ and diabetes were defined using a combination of ICD-9 and prescription drug codes. Individuals with immunosuppressive conditions or treatments were excluded. Cox Proportional Hazards regression analysis using a stepwise method with backward elimination was applied to estimate the hazard ratios (HR) of HZ, including age, gender and co-morbidities as covariates. The study population comprised 380,401 and 20,397 type II and type I diabetic subjects respectively, as well as 1,521,604 and 81,588 matched controls. The median ages were 55, 35, 33 and 29 years, respectively. HZ incidence was 4.59, 2.13, 1.97, and 1.82 per 1,000 person-years, respectively. There was no evidence of an impact of type I diabetes on the risk of HZ. Type II diabetes was associated with an increased risk for HZ in subjects ≥ 65 (HR 3.12; 95 % CI 2.77-3.52, adjusted for gender) and in subjects between 40 and 64 (HR 1.51; 95 % CI 1.42-1.61) years of age. Cardiac disease and chronic pulmonary disease were also risk factors (HR 1.92; 95 % CI 1.73-2.13 and HR 1.52; 95 % CI 1.38-1.67) in non-diabetic subjects. This study suggests that type II diabetes is associated with an increased risk of developing HZ, which was particularly high in adults 65 years and older and moderately increased in adults under 65 years of age.


Studies on blood serum beta-N-acetylglucosaminidases from several mammalian species--separation of different enzyme forms.
1. The beta-N-acetylglucosaminidases studied from peripheral blood sera have the following activities: 55.6 mU/ml in Bos taurus L. (bull, "Morucha" race), 31.3 mU/ml in Sus scropha var. domestica L. (pig) and 3.7 mU/ml in Capra hircus L. (goat). 2. The pH optima of the enzymes are 4.5 for Bos taurus L. and Sus scropha L., and 5.0 for Capra hircus L. 3. Two enzyme forms, A and B, have been separated from Bos taurus L. and Capra hircus L. sera by DEAE-cellulose chromatography; and three forms, A, B and S, from Sus scropha L. serum. 4. The B forms are more heat-stable than the A and the S forms. The S form has intermediate heat-stability between the A and the B forms.


Exploring primary breast cancer survivors' self-management of sustained cancer-related cognitive impairment in the workplace.
Work plays a central role in return to a more 'normal' life among women diagnosed with primary breast cancer. However, ongoing cancer-related cognitive impairment (CRCI) and cancer-related sequelae continue to detrimentally impact workability. Only a few studies have explored the long-term consequences of CRCI and self-management coping strategies applied in the workplace. This study explored women's experiences of sustained post-treatment CRCI and its impact on workability beyond the initial return-to-work (RTW), as well as experiences of self-management coping strategies. Forty employed women with a diagnosis of primary breast cancer who were between 6 and 60 months post-active treatment completed a semi-structured telephone interview. A 'framework' analysis approach was used. Two superordinate themes were identified: 'Sustained consequences of CRCI' and 'Self-management coping strategies to support work-related performance'. We found that the impact of CRCI extends beyond the initial RTW. The adopted self-management coping strategies could provoke mixed emotions, including emotional distress. Reduced workability was experienced up to 5-years post-active-treatment. Sustained CRCI induces negative emotions, fatigue and diminishes confidence reducing workability long into survivorship beyond RTW. The self-management coping strategies implemented to manage these sequelae generate mixed feelings, with some describing the strategies as problematic and of little benefit.


Differentiation between attention-deficit/hyperactivity disorder and autism spectrum disorder by the social communication questionnaire.
The differentiation of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) poses a clinical challenge. In children, overlap of psychopathological and cognitive findings has been found for both disorders. In addition, some children suffer from both disorders. The Social Communication Questionnaire (SCQ) is a screening instrument for ASD symptoms which indicates the presence of ASD in a rapid and economic way. However, validity to differentiate ASD and ADHD as differential or comorbid diagnoses has not been studied. Here, the differential validity was compared in groups of children with ASD, ADHD, ASD + ADHD, and typically developing (TD) children and IQ > 70. ROC analyses indicated an excellent differentiation between ASD and TD with ROC-AUC = .941 and between ASD + ADHD with ROC-AUC = .993. The optimal cutoff was below the originally recommended one of 15. The differentiation between children with ASD with (ROC-AUC = .982) or without ADHD (ROC-AUC = .864) and ADHD alone also showed acceptable differential validity, and here, the optimal cutoff corresponded to the recommended. Taken together, the SCQ can be recommended as a screening instrument for a first differentiation between children with ASD and typically developing children as well as children with ADHD.


Microsomal triglyceride transfer protein lipidation and control of CD1d on antigen-presenting cells.
Microsomal triglyceride transfer protein (MTP), an endoplasmic reticulum (ER) chaperone that loads lipids onto apolipoprotein B, also regulates CD1d presentation of glycolipid antigens in the liver and intestine. We show MTP RNA and protein in antigen-presenting cells (APCs) by reverse transcription-polymerase chain reaction and by immunoblotting of mouse liver mononuclear cells and mouse and human B cell lines. Functional MTP, demonstrated by specific triglyceride transfer activity, is present in both mouse splenocytes and a CD1d-positive mouse NKT hybridoma. In a novel in vitro transfer assay, purified MTP directly transfers phospholipids, but not triglycerides, to recombinant CD1d. Chemical inhibition of MTP lipid transfer does not affect major histocompatibility complex class II presentation of ovalbumin, but considerably reduces CD1d-mediated presentation of alpha-galactosylceramide (alpha-galcer) and endogenous antigens in mouse splenic and bone marrow-derived dendritic cells (DCs), as well as in human APC lines and monocyte-derived DCs. Silencing MTP expression in the human monocyte line U937 affects CD1d function, as shown by diminished presentation of alpha-galcer. We propose that MTP acts upstream of the saposins and functions as an ER chaperone by loading endogenous lipids onto nascent CD1d. Furthermore, our studies suggest that a small molecule inhibitor could be used to modulate the activity of NKT cells.


Development of high-throughput phosphorylation profiling method for identification of Ser/Thr kinase specificity.
Identification of substrate specificity of kinases is crucial to understand the roles of the kinases in cellular signal transduction pathways. Here, we present an approach applicable for the discovery of substrate specificity of Ser/Thr kinases. The method, which is named as the 'high-throughput phosphorylation profiling (HTPP)' method was developed on the basis of a fully randomized one-bead one-compound (OBOC) combinatorial ladder type peptide library and MALDI-TOF MS. The OBOC ladder peptide library was constructed by the 'split and pool' method on a HiCore resin. The peptide library sequence was Ac-Ala-X-X-X-Ser-X-X-Ala-BEBE-PLL resin. The substrate specificity of murine PKA (cAMP-dependent protein kinase A) and yeast Yak1 kinase was identified using this method. On the basis of the result, we identified Ifh1, which is a co-activator for the transcription of ribosomal protein genes, as a novel substrate of Yak1 kinase. The putative Yak1-dependent phosphorylation site of Ifh1 was verified by in vitro kinase assay.


[Application of coronal discharge to measure biophysical gas flow].
Studies and results on an ion beam produced at atmospheric pressure between a cathode point, a square diaphragm and a collector plane (anode) are presented. It is shown that the I(V) (characteristic at this device can become monotonous if a current feed back is applied to the diaphragm. Dimensions of beam impact are not affected by the electrostatical wind. The shape of the beam is given by calculation of electrostatical ion repulsion. This transducer allows gas flow measurement, this flow being a function of the current difference on the two half anodes. Theoretical calculations are in good agreement with the experiments.


The 1986 Walter Hubert lecture. Recent studies on a vaccine to prevent EB virus-associated cancers.
Epstein-Barr (EB) virus was discovered in 1964 (Epstein et al., 1964). In the decades since then an immense body of information has been accumulated on the virus and a great deal is now known about its general biological behaviour, its epidemiology, its molecular biology, the humoral and cellular immunological responses which it evokes, and about its relationship to human cancers. The fact that EB virus was thought from the outset to be a human tumour virus was no doubt responsible for the large number of laboratories in which it has been studied. Viruses causing tumours in animals have been known since early in the present century and affect frogs, fowl, rodents, rabbits, cats, cattle, monkeys and even fish (Klein, 1980). It was obvious that man could not be different in this respect and the finding of EB virus therefore promised to bring human tumours into line with those of other species.


Cardiac MRI is superior to gated blood pool imaging in the assessment of left ventricular function in patients post-cardiac transplantation.
Gated Blood Pool Imaging (GBPI) has low inter-test variability compared to echocardiography, and is often used when accurate repeated measurements of left ventricular ejection fraction are required such as in the surveillance of post-transplant patients. The aim of this study was to determine if cardiac MRI (CMR) could replace Gated Blood Pool Imaging for annual assessment of left ventricular (LV) function in the surveillance of patients post-cardiac transplantation. Forty-nine patients at various stages of post-cardiac transplantation presenting for annual review underwent LV functional assessment with GBPI and CMR. LV ejection fractions (EF) obtained from the two methods were compared and limits of agreement determined. The mean EF (plus and minus two standard deviations) was 58.3+/-18% for GBPI and 57.6+/-18% for CMR. The two methods were found to provide clinically equivalent results. Assessment of LVEF with CMR offers comparable values to GBPI in post-heart transplant patients. However, CMR also allows quantitative volumetric analysis of ventricular volumes and assessment of wall motion and valvular function. As is now accepted in native heart assessment, CMR should be considered the "gold standard" for post-transplant volumetric and functional evaluation. CMR offers information over-and-above traditional imaging modalities.


The efferent connections of the feline nucleus cuneatus.
Nucleus cuneatus projections to nucleus ventralis posterolarteralis pars medialis (VPLm) and other thalamic as well as midbrain and medullary nuclei were studied in cats using the Fink-Heimer I silver technique. Single electrolytic lesions of very small size were made stereotaxically in different zones of nucleus cuneatus under electrophysiological control. All zones studied projected to contralateral VPLm in a pattern of discrete terminal arborizations or clusters, which were organized in onionskin-like dorso-ventral laminae. The clusters of degeneration varied in size and density according to their dorsoventral location within VPLm. Those in dorsal areas were smaller in diameter (50-125 mu) and contained less dense amounts of degeneration than clusters (150-300 mu) in more ventral regions. The clustered terminal arborizations mirrored the organization of the VPLm neuronal clusters, themselves. Terminations within VPLm were topographically organized, but were completely inverted, i.e. dorsal nucleus cuneatus projected to ventral VPLm and ventral to dorsal, lateral to medial, and medial to lateral VPLm. A ventral zone of nucleus cuneatus, which contained "deep" units, projected to a separate dorsal zone of VPLm. In addition to its classical connection with VPLm, nucleus cuneatus projected to the following contralateral brainstem or thalamic nuclei: medial and dorsal accessory olives, external nucleus of the inferior colliculus, ventrolateral part of the superior colliculus, nucleus ruber, medial geniculate nucleus pars magnocellularis, suprageniculatus, medial and lateral divisions of the posterior thalamic nuclear group, zona incerta, and Fields of Forel. Very sparse amounts of degeneration were also present within nuclei ventralis posteromedialis (caudal pole) and ventralis posterolateralis pars lateralis. The brain-stem and thalamic projections of the dorsocaudal part (cell nest region) of the cuneate nucleus were more restricted than those of its rostral and ventral regions. The clusters of both the VPLm neurons and cuneate terminations within VPLm provides an anatomical basis for the functional characteristics of synaptic security, fine grain somatotopia and modality specificity so prominent in the dorsal column nuclei-medial lemniscal system.


Potent stimuli for vasopressin release, hypertonic saline and hemorrhage, cause antipyresis in the rat.
Two potent stimuli for AVP release into the blood, hemorrhage and hypertonic saline, were evaluated for their antipyretic effects in the rat. Hemorrhage of 20% of estimated blood volume reduced brain temperature of febrile but not afebrile rats confirming earlier research in the sheep. Hypertonic saline was also antipyretic in the rat. Hypertonic urea was somewhat less antipyretic whereas hypertonic glucose had no effect on febrile temperatures. AVP release into the peripheral circulation showed the relationship saline greater than urea greater than glucose and parallelled the antipyretic effectiveness of these solutes. The antipyresis caused by hypertonic saline was not significantly different in rats passively immunized intravenously with AVP antiserum than in rats which received hypertonic saline alone. These results provide indirect evidence that endogenous AVP is released in the brain following hemorrhage or hypertonic challenge and that this endogenous AVP can affect central febrile pathways.


The pharmacokinetics of sumatriptan when administered with clarithromycin in healthy volunteers.
Macrolide antibiotics such as clarithromycin are potent inhibitors of the cytochrome P450 (CYP)3A4 isozyme and have the potential to attenuate the metabolism and increase blood concentrations of drugs metabolized by this pathway. In vitro studies have suggested that sumatriptan is metabolized primarily by the monoamine oxidase-A isozyme and not by CYP3A4. This study sought to determine the effect of coadministration of clarithromycin dosed to steady state on the pharmacokinetics of a single dose of sumatriptan. A secondary objective was to assess the safety and tolerability of combining these agents. This was an open-label, randomized, 2-way crossover study in healthy volunteers. During treatment period 1, subjects received either a single oral dose of sumatriptan 50 mg (sumatriptan alone) or clarithromycin 500 mg orally every 12 hours on days 1 to 3 and a single oral dose of sumatriptan 50 mg plus a single oral dose of clarithromycin 500 mg on the morning of day 4 (combination treatment). During treatment period 2, they received the alternative regimen. Equivalence between sumatriptan alone and combination treatment was concluded if the 90% CI for the ratio of reference to test means of loge-transformed data for area under the plasma concentration-time curve extrapolated to infinity (AUC(infinity)) and maximum plasma concentration (Cmax) fell within the interval from 0.8 to 1.25. In the 24 evaluable subjects (12 men, 12 women) included in the pharmacokinetic analysis, mean sumatriptan AUC(infinity) and Cmax values after administration of combination treatment were 9% and 14% higher, respectively, than the corresponding values after administration of sumatriptan alone. The 90% CI for the ratio of reference to test means for AUC(infinity) was 1.03 to 1.15. The 90% CI for the ratio of reference to test means for Cmax was 1.03 to 1.26, above the traditional bioequivalence criterion. All other pharmacokinetic parameters tested, including nonparametric analysis of the time to Cmax, met the criterion for equivalence between treatments. Both treatments were well tolerated in the 27 subjects (13 men, 14 women) included in the safety analysis. The extent of absorption of sumatriptan was similar after oral administration alone and in combination with clarithromycin dosed to steady state. These data are consistent with previous reports that sumatriptan is unaffected by coadministration with the potent CYP3A4 inhibitor clarithromycin, supporting concomitant administration of these agents without the need for dose adjustment of sumatriptan in the acute treatment of migraine.


Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae and urinary tract infections in pregnant/postpartum women: A systematic review and meta-analysis.
Urinary tract infections (UTI) and asymptomatic bacteriuria (AB) during pregnancy can result in considerable maternal and foetal adverse outcomes. Production of extended-spectrum beta-lactamase (ESBL) is a major antibiotic resistance mechanism by Enterobacteriaceae. To determine the global prevalence of ESBL-producing (ESBL-P) Enterobacteriaceae in symptomatic UTI/AB among pregnant/postpartum females. A systematic review of the PubMed, Embase, Scopus, WOS (Web of Science), ProQuest and the grey literature was conducted. Studies that reported the frequency of ESBL-P Enterobacteriaceae in pregnant/postpartum women with UTI and/or AB were eligible. First, the titles and abstracts of the retrieved articles were reviewed. Then, the full texts of the remained articles were reviewed. In order to estimate the pooled prevalence and the 95% confidence interval (95% CI), meta-analysis was performed using the random-effects model. Twenty-three studies (six from Africa, two from North America, one from South America, 12 from Asia and two European studies) that reported data on 20 033 Enterobacteriaceae strains were included. The pooled prevalence of ESBL-P Enterobacteriaceae was 25% (95% CI 18%, 32%); I2 = 98.8%. The estimated prevalence (95% CI) rates were 45% (22, 67%) in Africa, 33% (22, 44%) in India, 15% (6, 24%) in other Asian countries, 5% (2, 8%) in Europe, 4% (1, 11%) in South America and 3% (1, 5%) in North America (P < .001). This estimate was 21% (95% CI 11, 31%) in patients with symptomatic UTI and it was 28% (95% CI 15, 41%) in patients with AB (P = .40). The prevalence of ESBL-P Enterobacteriaceae among pregnant women with UTI/AB was significant and geographic region was a major source for heterogeneity. The findings could be taken into account by healthcare providers and programmers in the management and antibiotic selection of UTI/AB during pregnancy, especially in high prevalence areas.


No social distancing in the immune system.
Lymphocytes comprise two major subsets, T and B cells. Some T cells kill infected cells, while others help B cells produce antibodies. Deciphering the interactions between these cells and other cells is crucial to the development of therapeutics and vaccines.


Multi-conformation representation of Mpro identifies promising candidates for drug repurposing against COVID-19.
The COVID-19 main protease (Mpro), one of the conserved proteins of the novel coronavirus is crucial for its replication and so is a very lucrative drug target. Till now, there is no drug molecule that has been convincingly identified as the inhibitor of the function of this protein. The current pandemic situation demands a shortcut to quickly reach to a lead compound or a drug, which may not be the best but might serve as an interim solution at least. Following this notion, the present investigation uses virtual screening to find a molecule which is alraedy approved as a drug for some other disease but could be repurposed to inhibit Mpro. The potential of the present method of work to identify such a molecule, which otherwise would have been missed out, lies in the fact that instead of just using the crystallographically identified conformation of the receptor's ligand binding pocket, molecular dynamics generated ensemble of conformations has been used. It implicitly included the possibilities of "induced-fit" and/or "population shift" mechanisms of ligand fitting. As a result, the investigation has not only identified antiviral drugs like ribavirin, ritonavir, etc., but it has also captured a wide variety of drugs for various other diseases like amrubicin, cangrelor, desmopressin, diosmin, etc. as the potent possibilities. Some of these ligands are versatile to form stable interactions with various different conformations of the receptor and therefore have been statistically surfaced in the investigation. Overall the investigation offers a wide range of compounds for further testing to confirm their scopes of applications to combat the COVID-19 pandemic.


[CT diagnosis of the retrocaval ureter].
The article describes the value of CT in the diagnosis of the circumcaval ureter. The clinical symptoms of the rare anomaly are discussed.


[Influence of fatty-acid and glucose content of the perfusate on the energy metabolism of the preserved canine kidney].
Thirty-seven canine kidneys were preserved by hypothermic low flow perfusion for 24-120 h with solution I containing albumin, free fatty acids, and glucose, or with solution II containing Haemaccel without free fatty acids or glucose. Following 48 h preservation the renal ATP and SAN content was identical in both groups, irrespective of the availability of substrates from the perfusate.


Posttraining lesion of the superior colliculus interferes with feature-negative discrimination of fear-potentiated startle.
Though much is known about the neural circuits involved in the elicitation of fear, little is known about the neural circuits responsible for the reduction of fear. The present experiments investigated the contribution of the superior colliculus (SC) and the dorsal periacquaductal gray (dPAG) in the reduction of conditioned fear produced by an auditory feature trained in a feature-negative discrimination procedure. In this procedure, light plus foot shock training trials are interspersed with trials in which the light is preceded by a noise and this noise and light compound is not followed by foot shock. At the end of this feature-negative discrimination training, rats were given excitotoxic lesions of the SC or dPAG. Feature-negative discrimination of fear was assessed with the fear-potentiated startle effect in which conditioned fear is operationally defined as potentiated startle amplitude in the presence versus the absence of the light. Feature-negative discrimination of fear is evidenced by a reduction in fear-potentiated startle to the light when the noise feature accompanies the light. Lesions of the SC, but not the dPAG, interfered with feature-negative discrimination of fear-potentiated startle suggesting that the SC plays a role in feature-negative discrimination of fear. Both SC and dPAG lesions facilitated startle amplitude in the absence of the light suggesting that these structures may exert a tonic inhibition on the acoustic startle reflex. The SC receives polymodal sensory information and is known to project forebrain areas involved in the production of conditioned fear. Thus, the SC may be an important component of the feature-negative discrimination circuit.


Toxic effects of strychnine and strychnine N-oxide on zebrafish embryos.
The application of strychnine (S) is limited due to its toxicity; strychnine N-oxide (SNO) is a derivative of strychnine. The aim was to employ zebrafish embryos to investigate and compare the developmental toxicity induced by S and SNO. The toxicity of S and SNO was examined through the hatching rate and survival rate. Morphological changes of the zebrafish were observed with a dissecting microscope. Apoptosis was detected through acridine orange (AO) staining and flow cytometry. Apoptotic genes were measured by RT-PCR. Embryo malformation was observed in the embryos exposed to S at 200 μmol·L(-1). When SNO concentration was increased to 1 mmol·L(-1), scoliolosis, and pericardial edema could be seen in some embryos. Results from fluorescence microscopy and flow cytometry analysis showed that S at 200 μmol·L(-1) induced apoptosis, whereas the apoptotic rate in the SNO-treated group (200 μmol·L(-1)) was much lower than that in the S group. RT-PCR analysis showed that p53 mRNA expression and the ratio of Bax/Bcl-2 in the S group were significantly altered compared with the control group (*P < 0.05). Moreover, Bax mRNA expression in both S and SNO group were significantly different from that in the control group (**P < 0.01). These results lead to the conclusion that SNO has significantly lower toxicity than S in zebrafish embryos.


Timely orchiopexy by 18 months of age: Are we meeting the standards defined by the 2014 AUA guidelines?
Cryptorchidism is one of the most common reasons for pediatric urology referral and one of the few pediatric urologic conditions in which there are established AUA guidelines that recommend orchiopexy be performed before 18 months of age. While access to timely orchiopexy has been studied previously, there is no current study with data from a national clinical database evaluating timely orchiopexy after the AUA guidelines were published. Additionally, prior studies on delayed orchiopexy may have included patients with an ascended testis, which is a distinct population from those with true undescended testicles. To evaluate in a national, clinical database if timely orchiopexy improved after the AUA guidelines were published in 2014. In particular, we aim to evaluate a younger group of patients, 0-5 years of age, in an effort to account for potential ascending testes. Using Cerner Real-World Data™, a national, de-identified database of 153 million individuals, we analyzed pediatric patients undergoing orchiopexy in the United States from 2000 to 2021. We included males 0-18 years old and further focused on the subset 0-5 years. Primary outcome was timely orchiopexy, defined as age at orchiopexy less than 18 months. Predictor variables included race, ethnicity and insurance status. Statistical analyses were performed using logistic regression. Of the total 17,012 individuals identified as undergoing orchiopexy, 9274 were ages 0-5 at the time of surgery. Comparing time periods pre and post AUA guidelines (2000-2014 versus 2015-2021), we found a significant difference in the proportion of timely orchiopexy (51% versus 56%, respectively; p < 0.0001) (Figure). In multivariable analyses, Hispanic (OR = 0.65, p < 0.0001), African American (OR = 0.74, p < 0.0001), and Native American males (OR = 0.66, p = 0.008) were less likely to have timely orchiopexy compared to non-Hispanic White males. Individuals without insurance (OR = 0.81, p = 0.03) or with public insurance (OR = 0.88, p = 0.02) were less likely to have timely orchiopexy as compared to those with private insurance. Nearly a decade after publication of the AUA cryptorchidism guidelines, a large proportion of patients are still not undergoing orchiopexy by 18 months of age. This is the first study to show that timely orchiopexy has improved among patients 0-5 years, but the majority of patients are still not undergoing timely orchiopexy. Health disparities were apparent among Hispanic, African American, Native American, and uninsured males, highlighting the need for further progress in access to pediatric surgical care.


Relative biological effectiveness of 125I in the induction of micronuclei in human peripheral blood lymphocytes.
The RBE for 125I relative to 30 keV X-rays, 4 MeV X-rays and 137Cs gamma rays was determined using the induction of micronuclei in human lymphocytes as the biological test system. The 125I photons were as effective as the 30 keV X-rays. If a micronuclei count of 50 per 1500 cells is used as the endpoint, the RBE for 125I was found to be about 1.8 and 1.6 when 4 MeV X-rays and 137Cs gamma rays were used as the reference radiation, respectively.


Mapping the Transglycosylation Relevant Sites of Cold-Adapted β-d-Galactosidase from Arthrobacter sp. 32cB.
β-Galactosidase from Arthrobacter sp. 32cB (ArthβDG) is a cold-adapted enzyme able to catalyze hydrolysis of β-d-galactosides and transglycosylation reaction, where galactosyl moiety is being transferred onto an acceptor larger than a water molecule. Mutants of ArthβDG: D207A and E517Q were designed to determine the significance of specific residues and to enable formation of complexes with lactulose and sucrose and to shed light onto the structural basis of the transglycosylation reaction. The catalytic assays proved loss of function mutation E517 into glutamine and a significant drop of activity for mutation of D207 into alanine. Solving crystal structures of two new mutants, and new complex structures of previously presented mutant E441Q enables description of introduced changes within active site of enzyme and determining the importance of mutated residues for active site size and character. Furthermore, usage of mutants with diminished and abolished enzymatic activity enabled solving six complex structures with galactose, lactulose or sucrose bounds. As a result, not only the galactose binding sites were mapped on the enzyme's surface but also the mode of lactulose, product of transglycosylation reaction, and binding within the enzyme's active site were determined and the glucopyranose binding site in the distal of active site was discovered. The latter two especially show structural details of transglycosylation, providing valuable information that may be used for engineering of ArthβDG or other analogous galactosidases belonging to GH2 family.


Pediatric growth hormone treatment in Italy: A systematic review of epidemiology, quality of life, treatment adherence, and economic impact.
This systematic review aims to describe 1) the epidemiology of the diseases indicated for treatment with growth hormone (GH) in Italy; 2) the adherence to the GH treatment in Italy and factors associated with non-adherence; 3) the economic impact of GH treatment in Italy; 4) the quality of life of patients treated with GH and their caregivers in Italy. Systematic literature searches were performed in PubMed, Embase and Web of Science from January 2010 to March 2021. Literature selection process, data extraction and quality assessment were performed by two independent reviewers. Study protocol has been registered in PROSPERO (CRD42021240455). We included 25 studies in the qualitative synthesis. The estimated prevalence of growth hormone deficiency (GHD) was 1/4,000-10,000 in the general population of children; the prevalence of Short Stature HOmeoboX Containing gene deficiency (SHOX-D) was 1/1,000-2,000 in the general population of children; the birth prevalence of Turner syndrome was 1/2,500; the birth prevalence of Prader-Willi syndrome (PWS) was 1/15,000. Treatment adherence was suboptimal, with a range of non-adherent patients of 10-30%. The main reasons for suboptimal adherence were forgetfulness, being away from home, pain/discomfort caused by the injection. Economic studies reported a total cost for a complete multi-year course of GH treatment of almost 100,000 euros. A study showed that drug wastage can amount up to 15% of consumption, and that in some Italian regions there could be a considerable over- or under-prescribing. In general, patients and caregivers considered the GH treatment acceptable. There was a general satisfaction among patients with regard to social and school life and GH treatment outcomes, while there was a certain level of intolerance to GH treatment among adolescents. Studies on PWS patients and their caregivers showed a lower quality of life compared to the general population, and that social stigma persists. Growth failure conditions with approved GH treatment in Italy constitute a significant burden of disease in clinical, social, and economic terms. GH treatment is generally considered acceptable by patients and caregivers. The total cost of the GH treatment is considerable; there are margins for improving efficiency, by increasing adherence, reducing drug wastage and promoting prescriptive appropriateness.


Heterologous Expression and Catalytic Properties of Codon-Optimized Small-Sized Bromelain from MD2 Pineapple.
Bromelain is a unique enzyme-based bioactive complex containing a mixture of cysteine proteases specifically found in the stems and fruits of pineapple (Ananas comosus) with a wide range of applications. MD2 pineapple harbors a gene encoding a small bromelain cysteine protease with the size of about 19 kDa, which might possess unique properties compared to the other cysteine protease bromelain. This study aims to determine the expressibility and catalytic properties of small-sized (19 kDa) bromelain from MD2 pineapple (MD2-SBro). Accordingly, the gene encoding MD2-SBro was firstly optimized in its codon profile, synthesized, and inserted into the pGS-21a vector. The insolubly expressed MD2-SBro was then resolubilized and refolded using urea treatment, followed by purification by glutathione S-transferase (GST) affinity chromatography, yielding 14 mg of pure MD2-SBro from 1 L of culture. The specific activity and catalytic efficiency (kcat/Km) of MD2-SBro were 3.56 ± 0.08 U mg-1 and 4.75 ± 0.23 × 10-3 µM-1 s-1, respectively, where optimally active at 50 °C and pH 8.0, and modulated by divalent ions. The MD2-SBro also exhibited the ability to scavenge the 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) with an IC50 of 0.022 mg mL-1. Altogether, this study provides the production feasibility of active and functional MD2-Bro as a bioactive compound.


[Study on the relations between concentration of endotoxin in dwelling and atopic asthma in school-age children].
To explore the effect of endotoxin concentration in dwellings on the prevalence of atopic asthma in children. Standardized questionnaires of asthma were distributed to the parents of 2986 school children aged between 8 and 12 years and endotoxin content in children's mattress was measured by a kinetic limulus assay. A radioallergosorbent technique--fluorescence enzyme immunoassay (RAST-FEIA) was used to measure the level of specific IgE in serum. Complete data was available for 904 children with males more than females. There were both negative associations seen between endotoxin levels and both atopic asthma (OR = 0.48, 95% CI: 0.32-0.72, P < 0.05) and atopic sensitization (OR = 0.65, 95% CI: 0.49-0.94, P < 0.05) but not with non-atopic asthma and wheeze. Comparing with normal people, patients with atopic sensitization, atopic wheeze and atopic asthma had a higher levels of endotoxin (M-W U: 15 138.0, P < 0.01, M-W U: 4858.0, P < 0.01, M-W U: 4041.0, P < 0.01). Exposure to endotoxin in early lives of children might have a protective effect on atopic asthma and sensitization.


3D image texture analysis of simulated and real-world vascular trees.
A method is proposed for quantitative description of blood-vessel trees, which can be used for tree classification and/or physical parameters indirect monitoring. The method is based on texture analysis of 3D images of the trees. Several types of trees were defined, with distinct tree parameters (number of terminal branches, blood viscosity, input and output flow). A number of trees were computer-simulated for each type. 3D image was computed for each tree and its texture features were calculated. Best discriminating features were found and applied to 1-NN nearest neighbor classifier. It was demonstrated that (i) tree images can be correctly classified for realistic signal-to-noise ratio, (ii) some texture features are monotonously related to tree parameters, (iii) 2D texture analysis is not sufficient to represent the trees in the discussed sense. Moreover, applicability of texture model to quantitative description of vascularity images was also supported by unsupervised exploratory analysis. Eventually, the experimental confirmation was done, with the use of confocal microscopy images of rat brain vasculature. Several classes of brain tissue were clearly distinguished based on 3D texture numerical parameters, including control and different kinds of tumours - treated with NG2 proteoglycan to promote angiogenesis-dependent growth of the abnormal tissue. The method, applied to magnetic resonance imaging e.g. real neovasculature or retinal images can be used to support noninvasive medical diagnosis of vascular system diseases.


COVID-19: Automatic detection from X-ray images by utilizing deep learning methods.
In recent months, a novel virus named Coronavirus has emerged to become a pandemic. The virus is spreading not only humans, but it is also affecting animals. First ever case of Coronavirus was registered in city of Wuhan, Hubei province of China on 31st of December in 2019. Coronavirus infected patients display very similar symptoms like pneumonia, and it attacks the respiratory organs of the body, causing difficulty in breathing. The disease is diagnosed using a Real-Time Reverse Transcriptase Polymerase Chain reaction (RT-PCR) kit and requires time in the laboratory to confirm the presence of the virus. Due to insufficient availability of the kits, the suspected patients cannot be treated in time, which in turn increases the chance of spreading the disease. To overcome this solution, radiologists observed the changes appearing in the radiological images such as X-ray and CT scans. Using deep learning algorithms, the suspected patients' X-ray or Computed Tomography (CT) scan can differentiate between the healthy person and the patient affected by Coronavirus. In this paper, popular deep learning architectures are used to develop a Coronavirus diagnostic systems. The architectures used in this paper are VGG16, DenseNet121, Xception, NASNet, and EfficientNet. Multiclass classification is performed in this paper. The classes considered are COVID-19 positive patients, normal patients, and other class. In other class, chest X-ray images of pneumonia, influenza, and other illnesses related to the chest region are included. The accuracies obtained for VGG16, DenseNet121, Xception, NASNet, and EfficientNet are 79.01%, 89.96%, 88.03%, 85.03% and 93.48% respectively. The need for deep learning with radiologic images is necessary for this critical condition as this will provide a second opinion to the radiologists fast and accurately. These deep learning Coronavirus detection systems can also be useful in the regions where expert physicians and well-equipped clinics are not easily accessible.


Epidermal nevus superimposed by psoriatic plaque in a girl with proteous syndrome.
Proteus syndrome (PS) is a rare syndrome characterized by asymmetric limb overgrowth, vascular malformation, and hamartomas. In this study we report a case of PS in a 13-year-old girl with chief complaint of a new cutaneous lesion that was diagnosed and treated as leishmaniasis.


Characterization of surface modification on self-assembled monolayer-based piezoelectric crystal immunosensor for the quantification of serum α-fetoprotein.
Self-assembled monolayers (SAMs) on coinage metallic material can provide versatile modeling systems for studies of interfacial electron transfer, biological interactions, molecular recognition and other interfacial phenomena. Recently, a bio-sensing system has been produced by analysis of the attachment of antibody using alkanethiols, to form SAMs on the face of Au-quartz crystal microbalance (QCM) surfaces. In this study, the attachment of anti-α-fetoprotein monoclonal antibody to a SAMs surface of 11-mercaptoundecanoic acid was achieved using water-soluble N-ethyl-N'-(3-dimethylaminopropyl) carbodiimide hydrochloride and N-hydroxysuccinimide as coupling agents. Surface analyses were utilized by X-ray photoelectron spectroscopy and atomic force microscopy. The quantization of immobilized antibody was characterized by the frequency shift of QCM and the radioactivity change of ¹²⁵I labeled antibody. The limit of detection and linear range of the calibration curve of the QCM method were 15 ng/ml and 15-850 ng/ml. The correlation coefficients of α-fetoprotein concentration between QCM and radioimmunoassay were 0.9903 and 0.9750 for the standards and serum samples, respectively. This report illustrates an investigation of SAMs for the preparation of covalently immobilized antibody biosensors.


Equilibrium isotherm studies for the uptake of cadmium and lead ions onto sugar beet pulp.
The adsorption of Cd2+ and Pb2+ on sugar beet pulp (SBP), a low-cost material, has been studied. In the present work, the abilities of native (SBP) to remove cadmium (Cd2+) and lead (Pb2+) ions from aqueous solutions were compared. The (SBP) an industrial by product and solid waste of sugar industry were used for the removal of Cd2+ and Pb2+ ions from aqueous water. Batch adsorption studies were carried out to examine the influence of various parameters such as initial pH, adsorbent dose, initial metal ion concentration, and time on uptake. The sorption process was relatively fast and equilibrium was reached after about 70 min of contact. As much as 70-75% removal of Cd2+ and Pb2+ ions for (SBP) are possible in about 70 min, respectively, under the batch test conditions. Uptake of Cd2+ and Pb2+ ions on (SBP) showed a pH-dependent profile. The overall uptake for the (SBP) is at a maximum at pH 5.3 and gives up to 46.1 mg g(-1) for Cd2+ and at pH 5.0 and gives 43.5 mg g(-1) for Pb2+ for (SBP), which seems to be removed exclusively by ion exchange, physical sorption and chelation. A dose of 8 gL(-1) was sufficient for the optimum removal of both the metal ions. The Freundlich represented the sorption data for (SBP). In the presence of 0.1M NaNO3 the level of metal ion uptake was found to reach its maximum value very rapidly with the speed increasing both with the (SPB) concentration and with increasing initial pH of the suspension. The reversibility of the process was investigated. The desorption of Cd2+ and Pb2+ ions which were previously deposited on the (SBP) back into the deionised water was observed only in acidic pH values during one day study period and was generally rather low. The extent of adsorption for both metals increased along with an increase of the (SBP) dosage. (SBP), which is cheap and highly selective, therefore seems to be a promising substrate to entrap heavy metals in aqueous solutions.


When the safety net of treatment has been removed: patients' unmet needs at the completion of treatment for haematological malignancies.
To determine patients' information, emotional and support needs at the completion of treatment for a haematological malignancy. A self-report questionnaire was mailed to 113 adult patients. Sixty-six questionnaires were returned. The most frequently endorsed patient needs related to care co-ordination and help to manage the fear of recurrence. The most frequently endorsed unmet needs included managing the fear of recurrence, the need for a case-manager and the need for communication between treating doctors. Predictors of unmet needs included younger patients (p=0.01), marital status (p=0.03) and employment (p=0.03). Almost two-thirds of patients (59%) reported they would have found it helpful to talk with a health care professional about their experience of diagnosis and treatment at the completion of treatment and endorsed significantly more need in the arenas of Quality of Life (p=0.03) and Emotional and Relationships (p=0.04). This study provides valuable data on haematological cancer patients' needs in the first 12 months of finishing treatment. It appears that many needs emerge or remain unresolved at this time. An opportunity for patients to talk with a health professional about making the transition from active treatment to extended survivorship may be helpful.


Compact solid-state optical phased array beam scanners based on polymeric photonic integrated circuits.
Optical phased array (OPA) devices are being actively investigated to develop compact solid-state beam scanners, which are essential in fields such as LiDAR, free-space optical links, biophotonics, etc. Based on the unique nature of perfluorinated polymers, we propose a polymer waveguide OPA with the advantages of low driving power and high optical throughput. Unlike silicon photonic OPAs, the polymer OPAs enable sustainable phase distribution control during beam scanning, which reduces the burden of beamforming. Moreover, by incorporating a tunable wavelength laser comprising a polymer waveguide Bragg reflector, two-dimensional beam scanning is demonstrated, which facilitates the development of laser-integrated polymeric OPA beam scanners.


Relationship between coronary collateral growth in the dog and ischemic bed size.
Two models of gradual coronary occlusion (Ameroid method) were compared in this study: 3 months circumflex and 3 months right coronary occlusion. Following coronary occlusion, the collaterals developed in intact, normally active dogs. The collateral flows were assessed in an isolated heat preparation. The results indicated a pattern for collateral development. Collateral flow was directed primarily toward the left heart with circumflex occlusion, and toward the right heart with right occlusion. Although dominant collateralization was via epicardial collaterals, intramyocardial septal collaterals strongly participated in growth development of both models. Collateral growth to the circumflex with circumflex occlusion was 6.54 fold greater than collateral growth to the right coronary artery with right occlusion. The data suggest a relationship between collateral growth and ischemic bed size.


Reduction of the anticoagulant activity of glycosaminoglycans on the surface of the vascular endothelium by endotoxin and neutrophils: evaluation by an amidolytic assay.
The processes that underlie the coagulopathy observed in severe infection are not fully understood, but seem to be due to an imbalance in the antithrombotic, and prothrombotic properties of the vascular endothelium. Sulphated glycosaminoglycans (GAGs) present on the vessel wall represent an important component of the non-thrombogenic nature of the endothelium. We have modified an amidolytic assay to study the functional ability of GAGs on human umbilical vein endothelial cells (HUVECS), and investigate the effect of E. coli endotoxin and neutrophils on HUVEC surface anticoagulant activity (SAA). Neither endotoxin alone, nor separated neutrophils at lower concentrations (less than 10(6) neutrophils per ml), had major effects on endothelial SAA. When activated neutrophils were incubated with HUVECS pre-stimulated with endotoxin, a significant decrease in SAA was seen using either plasma (mean percentage of control 67.8% +/- sem 7.8; p < 0.02) or purified ATIII (mean percentage of control 69% +/- sem 4.6; p < 0.001). We suggest that alterations in endothelial surface GAGs may occur during sepsis and inflammation, and that this may have important consequences for vascular function. This system will allow the further study of the role of GAGs in the intravascular thrombosis of severe sepsis, and other inflammatory diseases.


Two-channel gastric pacing in patients with diabetic gastroparesis.
Our primary goals were to investigate the effects of two-channel gastric pacing on gastric myoelectrical activity, and energy consumption with the secondary intent to monitor gastric emptying and symptoms in patients with severe diabetic gastroparesis. Four pairs of temporary pacing wires were inserted on the serosa of the stomach at the time of laparotomy to place the Enterra™ System in 19 patients with severe gastroparesis not responding to standard medical therapies. Two of the pairs were for electrical stimulation and the other two for recording. Five days after surgery the optimal pacing parameters for the entrainment of gastric slow waves in each patient were identified by serosal recordings. Two-channel gastric pacing was then initiated for 6 weeks using a newly developed external multi-channel pulse generator. Electrogastrogram (EGG), Total Symptom Score (TSS), and a 4-h gastric emptying test were assessed at baseline and after 6 weeks of active gastric pacing. Enterra™ device was turned OFF during the duration of this study. Two-channel gastric pacing at 1.1 times the intrinsic frequency entrained gastric slow waves and normalized gastric dysrhythmia. After 6 weeks of gastric pacing, tachygastria was decreased from 15 ± 3 to 5 ± 1% in the fasting state and from 10 ± 2 to 5 ± 1% postprandially (P < 0.05), mean TSS was reduced from 21.3 ± 1.1 to 7.0 ± 1.5 (P < 0.05) and mean 4-h gastric retention improved from 42 to 28% (P = 0.05). Two-channel gastric pacing is a novel treatment approach which is able to normalize and enhance gastric slow wave activity as well as accelerate gastric emptying in patients with diabetic gastroparesis with a goal safety profile.


Crucial role of the influenza virus NS2 (NEP) C-terminal domain in M1 binding and nuclear export of vRNP.
The influenza virus genome replicates in the host cell nucleus, and the progeny viral ribonucleoproteins (vRNPs) are exported to the cytoplasm prior to maturation. The influenza virus NS2 protein has a nuclear export signal (NES) and binds to M1. It is therefore postulated that vRNP is exported from the nucleus by binding to NS2 through M1. However, the significance of the association between NS2 and M1 for the nuclear export of vRNP is still poorly understood. We herein demonstrate that the C-terminal domain of NS2 (residues 81-100) is essential for M1 binding and the nuclear export of progeny vRNPs.


Liver failure: basis of benefit of therapy with the molecular adsorbents recirculating system.
Accumulation of albumin-bound toxins is known to occur in liver failure, and to variable extents is responsible for the associated end-organ dysfunctions (kidney, circulation, brain). The toxin-binding and scavenging functions of albumin are exploited in albumin dialysis for removal of these toxins. The extracorporeal liver support device known as molecular adsorbents recirculating system (MARS) is based on dialysis across an albumin-impregnated membrane, using 20% albumin as dialysate. Charcoal and anion exchange resin columns in the circuit help cleanse and regenerate the dialysate. Clinical studies over the last few years have demonstrated proven reduction in hyperbilirubinaemia, along with an improvement in encephalopathy, systemic haemodynamics and renal function in liver failure patients, as well as apparent improvement in survival. The results of larger controlled clinical trials, as well as studies investigating the pathophysiological basis of its effect, are awaited.


TTBK2 mutations associated with spinocerebellar ataxia type 11 disrupt peroxisome dynamics and ciliary localization of SHH signaling proteins.
Frameshift mutations in Tau Tubulin Kinase 2 (TTBK2) cause spinocerebellar ataxia type 11 (SCA11), which is characterized by the progressive loss of Purkinje cells and cerebellar atrophy. Previous work showed that these TTBK2 variants generate truncated proteins that interfere with primary ciliary trafficking and with Sonic Hedgehog (SHH) signaling in mice. Nevertheless, the molecular mechanisms underlying the dominant interference of mutations remain unknown. Herein, we discover that SCA11-associated variants contain a bona fide peroxisomal targeting signal type 1. We find that their expression in RPE1 cells reduces peroxisome numbers within the cell and at the base of the cilia, disrupts peroxisome fission pathways, and impairs trafficking of ciliary SMO upon SHH signaling activation. This work uncovers a neomorphic function of SCA11-causing mutations and identifies requirements for both peroxisomes and cholesterol in trafficking of cilia-localized SHH signaling proteins. In addition, we postulate that molecular mechanisms underlying cellular dysfunction in SCA11 converge on the SHH signaling pathway.


Liquid chromatography-mass spectrometric determination of plasmalogens in human plasma.
A new liquid chromatography-mass spectrometry (LC/MS) method has been developed for the quantitative analysis of plasmalogens in human plasma using a nonendogenous plasmalogen (1-O-1'-(Z)-tricosenyl-2-oleoyl-rac-glycero-3-phosphocholine, PLS 23:0/18:1) as an internal standard. 1-O-1'-(Z)-Tricosenyl glyceryl ether was prepared by reacting lithioalkoxyallyl with 1-iodoeicosane as the key intermediate in the formation of PLS 23:0/18:1. In LC/MS analyses, PLS 23:0/18:1 generated significant fragment ions in positive and negative modes. In positive ion mode, the [M+H](+) of PLS 23:0/18:1 yielded unique fragments with cleavages at the sn-1 and sn-2 positions of the glycerol backbone. In negative ion mode, the [M+CH(3)COO](-) of PLS 23:0/18:1 resulted in characteristic fragmentation at the sn-2 and sn-3 positions. 1-O-1'-(Z)-Hexadecenyl-2-linoleoyl-rac-glycero-3-phosphocholine (PLS 16:0/18:2) and 2-arachidonoyl-O-1'-(Z)-hexadecenyl-rac-glycero-3-phosphocholine (PLS 16:0/20:4) were chemically synthesized as PLS 23:0/18:1. The calibration curves obtained for PLS 16:0/18:2 and PLS 16:0/20:4 were linear throughout the calibration range (0.04-1.60 pmol). The LOD (S/N = 5:1) was 0.008 pmol and the LOQ (S/N = 6:1) was 0.01 pmol for both PLS 16:0/18:2 and PLS 16:0/20:4. Plasma concentrations of PLS 16:0/18:2 and PLS 16:0/20:4 were 4.0 ± 1.3 μM and 3.5 ± 1.2 μM (mean ± SD), respectively, in five healthy volunteers.


Evolutionary game of environmental investment under national environmental regulation in China.
With the rapid development of social economy, the deterioration of environment has become more and more serious; it is urgent to find a balance between economic development and environmental protection. Therefore, enterprises are appealed to invest in environmental protection, and local municipalities are appealed to supervise the environmental behaviors of enterprises, while central government plays a role of regulation. In order to study the preconditions for a better environmental strategy combination of local municipalities and enterprises, an evolutionary game theory was first constructed in this paper, then the evolutionary stable strategy (ESS) of local municipalities and enterprises under different scenarios was examined, and finally a simulation was used to test the results of the analysis. The results indicate that central government's regulation has influence on the strategies chosen by local municipalities and enterprises, the larger the degree of central government's incentives are, the more possible local municipalities and enterprises would choose environment-friendly strategies; and the intensity of central government's regulation, the cost and benefits of local municipalities' supervision, and the cost and benefits of enterprises' environmental investment are the key influence factors.


VIIIth cranial nerve involvement in sarcoidosis.
Hearing loss and vertigo are uncommon but well-recognized complications of neurosarcoidosis. Until recently the site of the lesion has been debatable and the efficacy of steroids commonly prescribed for this type of hearing loss has been said to be doubtful. A case is presented of sarcoidosis-induced hearing loss in which bilateral VIIIth nerve lesions were demonstrable by MRI with gadolinium enhancement. Treatment with high-dose steroids and azathioprine produced a symptomatic improvement and virtual resolution of the lesions.


Using Flow Cytometry to Study Myc's Role in Shaping the Tumor Immune Microenvironment.
Myc is deregulated in most-if not all-cancers, and it not only promotes tumor progression by inducing cell proliferation but is also responsible for tumor immune evasion. In a nutshell, MYC promotes the development of tumor-associated macrophages, impairs the cellular response to interferons, induces the expression of immunosuppressive molecules, and excludes tumor infiltrating lymphocytes (TILs) from the tumor site. Based on the insights into the role of MYC in promoting and regulating immune evasion by cancer cells, it is of special interest to study the different immune cell populations infiltrating the tumors. MYC inhibition has emerged as a potential new strategy for the treatment of cancer, directly inhibiting tumor progression while also counteracting the immunosuppressive tumor microenvironment, allowing an optimal anti-tumor immune response. Hence, this chapter describes a flow cytometry-based method to study the different immune cell subsets infiltrating the tumor by combining surface, cytoplasmic, and nuclear multicolor protein stainings.


Autopsy findings in interstitial deletion 6q.
Autopsy findings from a child with interstitial deletion 6q [46,XX,del(6)(q13q21)] are reported. There was cervical scoliosis, an endocardial cushion defect, right ventricular hypertrophy, subependymal cysts, multicystic kidneys (Potter type IIB), and lung hypoplasia.


Blunt renal injuries of intermediate degree.
Our experience with 104 cases of blunt renal trauma included 20 injuries of intermediate degree. Of this group, urinary extravasation (60 per cent) and parenchymal laceration (100 per cent) were predominant features exhibited by conventional radiographic studies. Both findings do not require surgical intervention and spontaneous resolution can be anticipated. Nephrectomy (9 cases) and heminephrectomy (2 cases) were perhaps performed unnecessarily in this group since 9 similar patients managed either consevatively (7 cases) or subjected to minor operative procedures on the kidney (2 cases) responded with total functional and anatomic recovery. Arteriography is at times recommended since it can provide information that will give confidence in the conservative management of some cases.


Divergent connectomic organization delineates genetic evolutionary traits in the human brain.
The relationship between human brain connectomics and genetic evolutionary traits remains elusive due to the inherent challenges in combining complex associations within cerebral tissue. In this study, insights are provided about the relationship between connectomics, gene expression and divergent evolutionary pathways from non-human primates to humans. Using in vivo human brain resting-state data, we detected two co-existing idiosyncratic functional systems: the segregation network, in charge of module specialization, and the integration network, responsible for information flow. Their topology was approximated to whole-brain genetic expression (Allen Human Brain Atlas) and the co-localization patterns yielded that neuron communication functionalities-linked to Neuron Projection-were overrepresented cell traits. Homologue-orthologue comparisons using dN/dS-ratios bridged the gap between neurogenetic outcomes and biological data, summarizing the known evolutionary divergent pathways within the Homo Sapiens lineage. Evidence suggests that a crosstalk between functional specialization and information flow reflects putative biological qualities of brain architecture, such as neurite cellular functions like axonal or dendrite processes, hypothesized to have been selectively conserved in the species through positive selection. These findings expand our understanding of human brain function and unveil aspects of our cognitive trajectory in relation to our simian ancestors previously left unexplored.


The role of perfectionism in obsessive-compulsive symptoms: "not just right" experiences and checking compulsions.
Perfectionism has long been considered an important cognitive variable in obsessive-compulsive disorder (OCD). However, little research has examined the components of perfectionism and their role in specific OCD symptoms. The current study is the first to examine the role of maladaptive perfectionism in predicting checking compulsions and "not just right" (NJR) obsessions. Using an undergraduate sample, linear structural relations were applied to these constructs. A mediational model was tested, where trait anxiety was hypothesized to mediate the relationship between obsessive-compulsive symptoms, as assessed with the Vancouver Obsessive-Compulsive Inventory (VOCI) and maladaptive perfectionism, as measured by four subscales of the Frost Multidimensional Perfectionism Scale (FMPS). Trait anxiety was assessed with the Spielberger State-Trait Anxiety Inventory (STAI). The results support the fully mediated model for checking and NJR compulsions. These findings suggest that perfectionism plays a specific role in certain forms of obsessive-compulsive symptoms, and that the model of OCD requires adjustment to account for this specificity.


Decreased heat- and tumor necrosis factor-mediated hsp28 phosphorylation in thermotolerant HeLa cells.
Heat shock or tumor necrosis factor rapidly stimulated the phosphorylation of the mammalian low molecular weight stress protein hsp28. We have found that both phenomena are greatly decreased in cells which are made tolerant to heat. This observation correlated with a better survival of thermotolerant cells exposed to either heat or TNF treatment. The results suggest that the phosphorylation of hsp28 may be linked to the resistance of the cells to the deleterious effects induced by either heat or a mediator of inflammation such as TNF.


[Causes and indwelling times of multiple voice prosthesis replacements in patients after total laryngectomy--analysis of 184 replacements in 42 patients].
Implantation of the indwelling voice prosthesis has become the preferred method of voice rehabilitation after total laryngectomy. Frequent prosthesis dysfunction remains the major problem. Analysis of the indwelling time and indications for multiple voice prosthesis replacements. Forty two patients after total laryngectomy due to laryngeal cancer (6 women and 36 men, mean age 62.1 ± 6.7 years) were included. 184 voice prosthesis replacements were analyzed (1271 patient-months). Mean time between replacements was 260 ± 150 days. The indwelling time decreased from 267 days to the first replacement to 100-160 days at eighth and subsequent exchanges (p < 0.01). Most frequent indications for replacement were leakage of fluids through the prosthesis, phonation problems caused by mucosal overgrowth around the prosthesis, inaccurate sizing, deformation, and spontaneous extrusion. The lifetime of voice prostheses was positively correlated with patients' age. Mycological culture of the smear taken from tracheoesophageal fistula at first replacement was positive in 34/41 cases, at the second in 29/31 cases, the third in 29/31, and at the fourth and subsequent replacements in all specimens. Most patients indicated the following factors as possible causes of a shortened lifetime of the prosthesis: use of alcohol and coffee (34% of responders), inappropriate dietary habits (sweets and tough foodstuff - 17%), cleaning of voice prosthesis discordant with the recommendations of the manufacturer (14%). Although our results confirm common indications for voice prosthesis replacement we also showed that the time between exchanges is gradually getting shorter. This observation could have implications for the current reimbursement practices.


Markers of endothelial cell activation in elderly men at high risk for coronary heart disease.
Circulating cell adhesion molecules (CAMS) are regarded as inflammatory markers related to the process of atherosclerosis and cardiovascular disease (CVD). In the haemostatic system, elevated levels of thrombomodulin (TM), von Willebrand factor (vWF) and tissue-type plasminogen activator antigen (tPAag) have likewise been associated with atherothrombotic cardiovascular disease states. Levels of these circulating markers were investigated in a cross-sectional study including 563 men aged 70 (64-76) years characterized as hypercholesterolaemic in 1972, as related to the following clinical entities: cardiovascular morbidity (28%), diabetes (15%), hypertension (70%) and smoking habits (34%) after 24 years. In patients presenting with CVD, significantly higher levels of tPAag were encountered (12.9 versus 12.0 ng/ml, p = 0.02). In smokers, levels of sICAM-1 were significantly higher (331 versus 298 ng/ml, p < 0.001), whereas levels of sVCAM-1 and sTM were lower compared with those in non-smokers (543 versus 582 ng/ml, p = 0.01, 40.6 versus 44.5 ng/ml, p < 0.01, respectively). In diabetics, levels of sE-selectin and tPAag were significantly higher than those in non-diabetics (55.9 versus 45.7 ng/ml, p < 0.001, 13.6 versus 12.0, p = 0.001, respectively). In subjects with hypertension, levels of TM were elevated (44.0 versus 40.8 ng/ml, p = 0.03). In multivariate regression analyses, tPAag remained significantly associated with the presence of CVD (p = 0.03), sE-selectin with diabetes (p=0.004), sTM with hypertension (p = 0.02) and sVCAM-1, sICAM-1 and sTM with smoking, (p = 0.01, p < 0.001, p < 0.001, respectively). The present results may contribute to the understanding of the multitude of factors influencing these endothelial markers and their evaluation in various disease entities.


Attachment of the ciliate Epidinium Crawley to plant fragments in the sheep rumen.
High concentrations of the ciliate Epidinium Crawley are associated with damaged regions of fresh plant material undergoing digestion in the sheep rumen. This finding supports that postulate that sequestration in the rumen explains the low rate of passage of protozoa despite the high flow rate of liquid from the rumen. The maintenance of Epidinium in the rumen, despite their slow growth rate, is also explained.


Soldier presence suppresses presoldier differentiation through a rapid decrease of JH in the termite Reticulitermes speratus.
The regulation of caste differentiation is essential to insect eusociality. Termite soldiers are sterile and cannot eat by themselves because they have specialized mouth morphology. Almost all termite species have a soldier caste, and the soldier ratio per colony is maintained at a low level, probably by elaborate regulatory mechanisms. Although the soldier presence is considered to negatively affect soldier differentiation in all examined species, the detailed mechanism remains unclear. Presoldier differentiation can be induced artificially by juvenile hormone (JH) application to workers, showing that JH is a key factor underlying the regulation of soldier differentiation. In this study, to elucidate physiological changes in workers because of the soldier presence during the molt into presoldiers, JH III applications and JH titer quantifications were carried out in the rhinotermitid termite Reticulitermes speratus. Firstly, the effects of soldier presence before the molt into presoldiers induced by JH III application to workers were investigated. The rates of presoldier molt induced by the treatments with soldiers were significantly lower than those without soldiers. Secondly, worker JH titers in the presence or absence of soldiers were quantified by LC-MS on day 0, 5, 10, and 15 after JH application. Results indicated that the worker JH titers (endogenous+applied JH III) in the presence of soldiers were significantly lower than those without soldiers on day 5 after the JH treatment. On days 10 and 15, such soldier effects were not observed. Finally, the effective duration of soldier presence after the JH application was elucidated. A 4 day period of co-existence with soldiers suppressed presoldier differentiation, suggesting that the soldier presence rapidly decreased the JH titer in other colony members (i.e., workers), resulting in the inhibition of presoldier production.


A Study of 219Rn Outgassing and 211Pb Contamination from 223Ra In dry, Liquid, and Murine Tissue Samples.
A study of Pb contamination caused by the outgassing of Rn from Ra in dry, liquid, and murine tissues samples has been made to help design proper handling procedures for Ra in preclinical biodistribution work. Pb activity levels were measured from Ra in dry, liquid, and tissue samples using aspiration and autoradiography techniques. Using aspiration techniques on dry samples of Ra, an average Rn outgassing rate of 51% ± 21% was measured with one measurement reaching as high as 81%. 31% ± 4% Pb contamination was measured within a 4.3 cm radius of a dry Ra source placed inside a 10-cm-diameter petri dish where the lip of the petri dish contained the Rn dissemination. Without the containment of the petri dish, Rn can reach as far as 7.8 cm from the source with trace levels spreading further. Using aspiration techniques on liquid samples of Ra, outgassing rates of Rn were 0.9% ± 0.3%. The outgassing levels in harvested organs from a biodistribution were as high as 10.1% ± 0.4% for an intraperitoneally injected mouse and 0.204% ± 0.006% for an intravenously injected mouse. The outgassing of the intravenously injected mouse carcass was less than 0.1%. In dry form, the high levels of Rn outgassing from a Ra source necessitate the use of ventilated biohoods when handling or preparing dry Ra from source vials. The very low levels of Rn outgassing from Ra liquid sources reduces exposure to Rn by a factor of 50. Rn exposure from murine organ tissue reaches levels of 10% when handling organs from an intraperitoneal injection and less than 0.2% for an intravenous injection.


The Subtle Cavovarus Foot Deformity: The Nonneurologic Form of Cavus Foot Deformity.
Conditions of ankle instability, peroneal tendon tears, and stress fractures of the lateral metatarsals are commonly encountered in a clinical foot and ankle practice. Evaluation of the supporting foot structure is critical to prevent failure of index procedures. The prominence of the subtle cavus foot is now a recognized entity and must be properly diagnosed and addressed surgically.


Etiology Intervention Link Predicts Resolution of Nutrition Diagnosis: A Nutrition Care Process Outcomes Study from a Veterans' Health Care Facility.
In this article, we evaluate relationships between Nutrition Care Process (NCP) chain links and improvement or resolution of the nutrition diagnosis. We conducted a retrospective record review for 12 months in a single Veterans Health Administration health care system using the Veterans Health Administration-specific monitoring and evaluation terms, NCP terminology, and its etiology categories to evaluate outcomes. Logistic regression analysis revealed that the strongest predictor for diagnosis improvement was the etiology-intervention link. The odds of improving the nutrition diagnosis were 51.43 times higher when the etiology-intervention link was present. The odds of improving the nutrition diagnosis were 19.74 times higher when the evidence-diagnosis link was present and 9.46 times higher when the intervention-goal link was present. For every added nutrition visit by the registered dietitian nutritionist, the odds of improving the nutrition diagnosis increased by 32.5%. For every increased point on the NCP audit score, the odds of resolving or improving the nutrition diagnosis increased by 37.7%. When applying the NCP, the presence of the etiology-intervention link significantly improves the odds of resolving the nutrition diagnosis in a Veterans Health Administration population. For the first time, we show evidence that the NCP works as designed. Also, we demonstrate that the quality of NCP documentation impacts resolution of the diagnosis, and we describe the methodology for how to evaluate NCP outcomes. Registered dietitian nutritionists are encouraged to critically evaluate links of the NCP chain, assess NCP documentation for quality, and pursue follow-up visits to improve resolution of nutrition problems.


Propionibacterium acnes osteomyelitis occurring 23 years after craniotomy: case report and review of literature.
Propionibacterium acnes is an uncommon pathogen in delayed surgical site infection, and its indolent course can complicate diagnosis and treatment. We report the longest delay between neurosurgery and P acnes infection reported. Asymptomatic postoperative P acnes osteomyelitis and tumor recurrence occurring 23 years after initial craniotomy. Initial presentation was of tumor recurrence only, without signs or symptoms of infection. Calvarial osteomyelitis was unexpectedly discovered intraoperatively. Craniectomy and débridement were performed, and there was prolonged antibiotic therapy. The longest delay between neurosurgery and asymptomatic P acnes infection is reported. We review the literature for P acnes infection and discuss biofilm formation and its role in delayed surgical infection.


Reinforcing cultural competency concepts during introductory pharmacy practice experiences.
To incorporate cultural competency concepts into various introductory pharmacy practice experiences (IPPE) at the University of Missouri - Kansas City, School of Pharmacy. A 6-week series, titled "Becoming a Culturally Competent Provider" was developed to provide IPPE students with the opportunity to apply theory regarding cultural competency in a clinical context. Pre- and post-intervention attitude survey instruments were administered to 25 students in the spring semester of 2009. Several activities within the series were associated with reflection exercises. Student presentations were evaluated and formal feedback was provided by faculty members. A course evaluation was administered to evaluate the series and determine areas of improvement. A special series on cultural competency resulted in positive changes in students' attitudes, highlighting the importance of reinforcing cultural competency concepts during IPPEs.


[Scanning electron microscopy of different yeast strains and their protoplasts].
Scanning electron microscopy has been used to study the morphology of seven species of protoplasts from yeasts. In all species examined grooves and droplets were seen advancing with time but their interpretation still remains indefinite.


Derivation of acceptable concentrations for the protection of aquatic organisms.
Derivation of quality standards to protect aquatic ecosystems demands a minimum set of toxicity data to allow the risk assessor to take some account of: (1) variable responses to toxicants; (2) variable environmental characteristics; (3) interactions between duration of exposure and effects; and (4) ecological significance of impacts. Extrapolation from limited experimental data to predict a concentration protective in diverse ecosystems can employ either statistical models (consistent but rather rigid and may not protect all species) or empirical factors (more flexible and possibly more protective, but require expert judgment in their application). However derived, quality standards must be tailored to the specific conditions of release and environmental fate which influence a chemical's impact in aquatic ecosystems. It must also be recognised that protection of all individuals and even of all aquatic species may not be achievable or necessary to maintain a healthy ecosystem. Some possible future advances in the determination of water quality standards are suggested.


Trihalomethane species model for drinking water supply systems.
Despite the existence of significant knowedge on complex mechanisms of THM formation, a simple kinetic model to predict THM species concentration is not available, hindering application of knowlwdge for regulatory, monitoring and operational control. The parallel second order reaction (2R) model containing fast and slow reactants has been well established to describe the chlorine decay kinetics under distribution conditions. The proposed THM species model expands the 2R model by systematically incorporating the initial unproductive (not forming THM) chlorine consumption and assuming each THM species is formed at a fixed yield (µg-THM species/mg- productive chlorine consumption). The model concept is tested on 15 water samples that contain a wide range of dissolved organic carbon, specific UV absorbence, and bromide concentrations collected from Australia and US. In all samples, the model describes the THM species concentrations well (error < 3 µg/L in 84% of model estimates) as long as the chlorine profile is described accurately (R2 > 0.984). The model formulated from the minimum data (initial and two other data points of Cl2 and THM species) predicts the rest of concentrations of THM species from only chlorine measurements. To fully optimise the system or adopt in regulatory monitoring, the effect of changes due to bulk water quality, operational conditions and wall (and biofilm) effects on THM formation kinetics should be established. A similar concept could be extended to other DBP, but rigorous testing is needed.


The search for a politically reflective clinical-community approach.
The following paper explores how working in Venezuela, a country that has gone through 20 years of economic and political problems, has highlighted the gap between clinical and community approaches in dealing with the sufferings of our consultants. Our efforts to develop theoretical and practical tools that can address the historical and political dimensions of people's lives are reviewed. These efforts illustrate how the community paradigm can help expand clinical perspectives, thus allowing a practise which can address the needs of people who have neither the time nor the economic means to engage in a traditional therapeutic relationship. The shift in perspective, the revision of our "therapeutic" stance and the use of de-naturalisation and problematization are illustrated.


Comprehensive cloning of Schizosaccharomyces pombe genes encoding translation elongation factors.
In the course of the Schizosaccharomyces pombe cDNA project, we succeeded in cloning all the genes encoding translation elongation factors EF-1alpha, EF-1beta, EF-1gamma, EF-2 and EF-3. With the exception of the EF-1gamma gene, the nucleotide (nt) sequence of S. pombe elongation factors has not been previously reported. For EF-1alpha, we found three genes whose amino acid (aa) sequences are quite homologous each other (99.5%), but whose 3' untranslated regions (UTRs) are completely different. Southern blot indicated that those three EF-1alpha genes are located at different loci. Northern analysis indicated that one of three EF-1alpha genes was inducible with UV-irradiation, while the level of expression for another of three EF-1alpha genes was repressed by UV and heat-shock (HS) treatments. The aa sequence predicted from the nt sequence of the S. pombe EF-1beta cDNA clone covered almost all the coding sequence (CDS) of EF-1beta except the first methionine which has 55.4% identity with that of S. cerevisiae. We also identified two copies of S. pombe EF-2 genes. Their aa sequences deduced from nt sequences are identical (100%), but they have different 3' UTRs. The location of these two EF-2 genes in different loci was proved by Southern analysis. The S. pombe EF-3 cDNA clone encoded only a third of the CDS from the C-terminal and its deduced aa sequence has a 76% identity with those of other yeasts and fungi.


Tetrastigma hemsleyanum Diels et Gilg ameliorates lipopolysaccharide induced sepsis via repairing the intestinal mucosal barrier.
Sepsis causes excessive systemic inflammation and leads to multiple organ dysfunction syndrome (MODS). The intestine plays a key role in the occurrence and development of sepsis. Tetrastigma hemsleyanum Diels et Gilg (San ye qing, SYQ), a precious Chinese medicine, has been widely used for centuries due to its high traditional value, such as a remarkable anti-inflammatory effect. However, the role of SYQ in intestinal permeability during the development of sepsis needs to be discovered. Mice were intraperitoneally injected with lipopolysaccharide (LPS) to simulate intestinal mucosal barrier function damage in sepsis. Pathological section, inflammatory cytokines, tight junctions, cell apoptosis, and intestinal flora were detected to evaluate the protective effect of SYQ on intestinal mucosal barrier injury in LPS-induced septic mice. The results showed that SYQ treatment obviously attenuated LPS-induced intestinal injury and reduced the production of tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and interleukin 6 (IL-6). Besides, SYQ also up-regulated the expressions of tight junctions, including Zonula occludens 1 (ZO-1), Claudin-5, and Occludin along with a decreased in the levels of myosin light chain kinase (MLCK) and myosin light chain (MLC). In addition, SYQ down-regulated the expression of Bax/Bcl2 as well as that of cleaved caspase-3 to prevent the cells from undergoing apoptosis. Further, SYQ restored the diversity of the intestinal flora, increased the abundance of Firmicutes, and decreased the abundance of Bacteroidota. The study indicated that SYQ exerted its protective effect on intestinal mucosal barrier injury in LPS-induced septic mice by reducing inflammatory response, improving the tight junction protein expression, inhibiting cell apoptosis, and adjusting the intestinal flora structure.


Potential microRNA panel for the diagnosis and prediction of overall survival of hepatocellular carcinoma with hepatitis B virus infection.
In hepatocellular carcinoma (HCC), abnormal expression of multiple microRNAs (miRNAs) has been shown to be involved in the malignant biological behavior of liver cancer. The vast majority of liver cancer cases in China are closely related to hepatitis B virus (HBV) infection, but there are few studies on the changes of miRNA expression in the progression from HBV infection to hepatoma. To explore the role of miRNAs in the progression of HBV infection to cirrhosis and even to liver cancer. We screened differentially expressed miRNAs in 40 HBV cirrhosis, 40 normal and 15 HCC tissues by using a TaqMan Low Density Array and real time quantitative polymerase chain reaction. To evaluate the power of the selected miRNAs to predict disease, we calculated the area under the receiver-operating-characteristic curves. The overall survival of HBV cirrhosis patients was analyzed via Kaplan-Meier analysis. The levels of miR-375, miR-122 and miR-143 were significantly lower in HBV cirrhosis tissues, while miR-224 was significantly higher than in the controls (P < 0.0001). The area under the curves of the receiver-operating-characteristic curve for the 4-miRNA panel was 0.991 (95%CI: 0.974-1). Patients with a lower expression level of miR-224 or higher expression levels of miR-375, miR-122 and miR-143 had longer overall survival. The four miRNAs (miR-375, miR-122, miR-143 and miR-224) may be helpful for early diagnosis of HBV infection, HBV cirrhosis, and prediction of its overall survival.


Intratympanic steroid therapy for Bell's palsy with poor prognostic results.
In Bell's palsy, electrodiagnosis by electroneurography (ENoG) is widely used to predict a patient's prognosis. The therapeutic options for patients with poor prognostic results remain controversial. Here, we investigated whether early intervention with intratympanic steroid therapy (ITST) is an effective treatment for Bell's palsy patients with poor electrodiagnostic test results (≤ 10% electroneurography value). Patients in the concurrent ITST group (n = 8) received the standard systemic dose of prednisolone (410 mg total) and intratympanic dexamethasone (16.5 mg total) and those in the control group (n = 21) received systemic prednisolone at the standard dose or higher (average dose, 605 ± 27 mg). A year after onset, the recovery rate was higher in the ITST group than in the control group (88% vs 43%, P = 0.044). The average House-Brackmann grade was better in the concurrent ITST group (1.13 ± 0.13 vs 1.71 ± 0.16, P = 0.035). Concurrent ITST improves the facial nerve outcome in patients with poor electroneurography test results, regardless of whether equivalent or lower glucocorticoid doses were administered. This may be ascribed to a neuroprotective effect of ITST due to a higher dose of steroid reaching the lesion due to dexamethasone transfer in the facial nerve.


Non-radioactive coloured microsphere measurement of regional tissue blood flow for axial pattern flaps in rabbits.
We administered non-radioactive coloured microspheres (NRACM) to measure the regional tissue blood flow (RTBF) of eight axial pattern flaps and four kidneys in four rabbits using four repeated injections into each animal. As a control, we used radioactive microspheres (RAM) for six kidneys in three rabbits. There were no significant differences for RTBF values between NRACM and RAM, between the numbers of microspheres used (2 x 10(6) and 4 x 10(6)), or between the number of injections. These results showed that NRACM is a useful and safe laboratory method.


Acute scrotum in an infant: post-herniorrhaphy complication. Sonographic evaluation.
The complications of herniorrhaphy mainly involve hematoma and other fluid collections within the scrotum. Discussed here is a case of another post-herniorrhaphy complication, recurrent scrotal hernia, in an infant who presented with an acute scrotum and was evaluated sonographically.


Insulin effects on ouabain binding in A6 renal cells.
The effects of insulin on the Na+-K+-ATPase pump of the basolateral membrane of tight epithelia were evaluated by measuring transepithelial transport and [3H]ouabain binding in cultured A6 kidney cells. [3H]Ouabain binding in epithelia incubated in either K+-containing or K+-free solutions was measured. Insulin induced increases in transepithelial sodium transport, as measured by the short-circuit current (Isc), and in the initial rate of [3H]ouabain binding determined when the preparation was bathed in K+-containing solutions. However, when initial [3H]ouabain binding in tissues incubated in K+-free solutions was measured the stimulation of the initial rate of [3H]ouabain binding caused by insulin was markedly reduced. Incubating the apical side of the epithelium with either amiloride or Na+-free solutions also reduced or abolished the increase in the initial rate of [3H]ouabain binding caused by insulin. Equilibrium binding measurements showed that insulin did not increase the maximum number of [3H]ouabain-binding sites in tissues incubated with either normal K+ or K+-free solutions. These results indicate that the increase in the initial rate of [3H]ouabain binding under transporting conditions is due to an effect on the binding kinetics of ouabain, probably related to an increased rate of Na+ entry, rather than to an increase in the number of Na+-K+-ATPases in the basolateral membrane. Cycloheximide inhibited both the increase in Isc and the increase in the initial rate of [3H]ouabain binding caused by insulin in epithelia incubated in K+-containing solutions. However, cycloheximide was without effect on the initial rate of [3H]ouabain binding in insulin-treated tissues incubated in K+-free solution. This finding suggests that the cycloheximide-sensitive step of the action of insulin is related to Na+ delivery to the pump.


Graft survival in four common groups of patients undergoing penetrating keratoplasty.
Graft survival rates and causes of graft failure were evaluated for 1046 consecutive keratoplasties in four groups: keratoconus, Fuchs' dystrophy, pseudophakic bullous keratopathy with retained intraocular lenses (IOLs), and pseudophakic/aphakic bullous keratopathy with secondary lens implants. Patient follow-up averaged 23 months (range, 1-84 months). There was a significant difference in graft survival among the four groups, P less than 0.0001. The keratoconus and Fuchs' groups had the highest survival rates and pseudophakic bullous keratopathy with retained IOLs the lowest rate. Problems with the external surface of the graft caused the largest number of graft failures. Grafts for pseudophakic bullous keratopathy with retained posterior chamber lenses had a significantly higher failure rate from rejection and endothelial decompensation, 5.1%, compared with less than 1.0% in keratoconus, Fuchs' dystrophy, or bullous keratopathy with secondary implants (P less than 0.0005).


Fragile-like regulatory T cells modulate opioid withdrawal in humans and mice.
Opioid use alters peripheral immune functions via unknown mechanisms. In a recent issue of Cell, Zhu et al. report increased fragile-like regulatory T cells in patients with opioid use disorder and in morphine-treated mice. In mice, Treg cell-derived interferon-γ within the brain promotes withdrawal-associated alterations in synapses.


Detection of marine and freshwater bacterioplankton in immersed victims: Post-mortem bacterial invasion does not readily occur.
We previously applied our method of detecting marine or freshwater bacterioplankton (bacteria) in the blood of immersed victims as a marker of drowning. However, we did not confirm the absence of post-mortem bacterial invasion during immersion. Here we examined the nature of bacterioplankton in blood samples from 21 immersed and 4 non-immersed cadavers. We found only freshwater bacterioplankton in the blood of two victims that were retrieved from the sea or an estuary inhabited by marine bacterioplankton even though one victim was highly putrefied. The results of diatom testing suggested that these two victims had drowned in fresh or brackish water with low salinity and then flowed out to the estuary or the sea. Two others were submerged in water, but representative bacterioplankton were undetectable in their blood although one victim was highly putrefied. Autopsy findings and the results of diatom tests did not indicate that the cause of death was drowning. As in previous studies, we identified freshwater bacterioplankton in the blood of seven other victims that had drowned in freshwater, marine bacterioplankton in the blood of four victims that had drowned in seawater and none in four victims found on land that had died by means other than drowning. Bacterioplankton in the blood of drowned victims appears to reflect the type of water aspirated and blood does not become easily contaminated with bacteria post-mortem even in decomposed bodies.


Rational construction of Ni(OH)2 nanoparticles on covalent triazine-based framework for artificial CO2 reduction.
Artificial photoreduction of CO2 to chemical fuel is an intriguing and reliable strategy to tackle the issues of energy crisis and climate change simultaneously. In the present study, we rationally constructed a Ni(OH)2-modified covalent triazine-based framework (CTF-1) composites to serve as cocatalyst ensemble for superior photoreduction of CO2. In particular, the optimal Ni(OH)2-CTF-1 composites (loading ratio at 0.5 wt%) exhibited superior photocatalytic activity, which surpassed the bare CTF-1 by 33 times when irradiated by visible light. The mechanism for the enhancement was systematically investigated based on various instrumental analyses. The origin of the superior activity was attributable to the enhanced CO2 capture, more robust visible-light response, and improved charge carrier separation/transfer. This study offers an innovative pathway for the fabrication of noble-metal-free cocatalysts on CTF semiconductors and deepens the understanding of photocatalytic CO2 reduction.


Impact of essential workers in the context of social distancing for epidemic control.
New emerging infectious diseases are identified every year, a subset of which become global pandemics like COVID-19. In the case of COVID-19, many governments have responded to the ongoing pandemic by imposing social policies that restrict contacts outside of the home, resulting in a large fraction of the workforce either working from home or not working. To ensure essential services, however, a substantial number of workers are not subject to these limitations, and maintain many of their pre-intervention contacts. To explore how contacts among such "essential" workers, and between essential workers and the rest of the population, impact disease risk and the effectiveness of pandemic control, we evaluated several mathematical models of essential worker contacts within a standard epidemiology framework. The models were designed to correspond to key characteristics of cashiers, factory employees, and healthcare workers. We find in all three models that essential workers are at substantially elevated risk of infection compared to the rest of the population, as has been documented, and that increasing the numbers of essential workers necessitates the imposition of more stringent controls on contacts among the rest of the population to manage the pandemic. Importantly, however, different archetypes of essential workers differ in both their individual probability of infection and impact on the broader pandemic dynamics, highlighting the need to understand and target intervention for the specific risks faced by different groups of essential workers. These findings, especially in light of the massive human costs of the current COVID-19 pandemic, indicate that contingency plans for future epidemics should account for the impacts of essential workers on disease spread.


Regulation of expression of the galactose gene cluster in Saccharomyces cerevisiae. Isolation and characterization of the regulatory gene GAL4.
The GAL4 gene positively regulating the expression of the gene cluster GAL7-GAL10-GAL1 in the yeast Saccharomyces cerevisiae was isolated for its ability to suppress a recessive mutation in that gene. When the isolated gene was incorporated into a multi-copy plasmid, the GAL cluster genes in the host chromosome partially escaped the normal control; a yeast that harbors the plasmid bearing the GAL4 gene synthesized the galactose-metabolizing enzymes encoded by the GAL cluster genes at a low but significant level in the absence of galactose. If the GAL7 gene was amplified along with GAL4 on the multi-copy plasmid, the constitutive synthesis of Gal-1-P uridylyl transferase encoded by GAL7 was further pronounced and the enzyme activity reached the level of the fully induced wild-type yeast. Such an escape synthesis of the GAL enzymes was not detected if GAL4 or both GAL4 and GAL7 were carried by a single-copy plasmid. The results suggest that the escape synthesis of GAL enzymes observed in the GAL4-amplified yeast was a consequence of overproduction of the GAL4 protein. The GAL80 gene negatively regulating the GAL cluster genes was also isolated, and when amplified together with GAL4, no escape synthesis of the GAL enzymes was observed, suggesting that the balanced synthesis of two regulatory proteins was essential to maintain the repressed state of the GAL cluster genes.


Characterization of the circulating antigen of Toxoplasma gondii.
Circulating antigen of Toxoplasma gondii has been shown to be antigenically distinct from haemagglutinating or peritoneal exudate antigen. It is composed of two components that have molecular weights of approximately 150,000 and 324,000 daltons. Treatment of rats wih cyclophosphamide stopped both the production of circulating antigen and dye test-specific antibody without affecting the parasite yield. Immune lysis appears to be the major pathway for production of circulating antigen, although other possible mechanism of release are discussed.