On the possible role of intestinal hormones as the diarrhoeagenic messenger in cholera.
Cholera enterotoxin introduced into the duodenum of young rabbits causes severe degranulation of the enterochromaffin (EC) cells as revealed by electron microscopy. In the mucosal epithelium fixed mainly 1 hr after toxin administration, many of the basal granules of the EC cells are swollen up and open to the basal and lateral cell surface. The EC cells of the rabbit, as it is the rule for intestinal endocrine cells in mammals, are open to the lumen with an apical process covered by microvilli. A hypothesis is proposed that cholera toxin stimulates this apical receptor of the EC cells and that the aminic (serotonin) and polypeptide (motilin?) products of the cells released by the stimulus may mediate the diarrhoeagenic action of cholera enterotoxin.


Elevation of serum creatine kinase in severe hypokalemic hyperaldosteronism.
The association between hypokalemia and increased serum creatine kinase has been investigated. Two patients were found who had severe hypokalemic hyperaldosteronism who had elevation of serum creatine kinase activity. The CPK activity returned to normal values after fluid and potassium replacement. In a prospective study of 129 patients with hypokalemia which did not include any patients with hyperaldosteronism, 12 were found to have increased CPK activity but each of these had some other severe disease process which could account for the increased CPK. Three other patients with K+ (2.2 MEq/1 did not have increased CPK. It is concluded that patients with severe hypokalemia such as that occurring in hyperaldosteronism with muscle weakness may have elevated CPK directly related to their hypokalemia. In other patients with hypokalemia, 10% may have increased CPK but this is related to other disease processes.


APCcdh1 activity in mouse oocytes prevents entry into the first meiotic division.
Fully grown mammalian oocytes maintain a prophase I germinal-vesicle stage arrest in the ovary for extended periods before a luteinizing hormone surge induces entry into the first meiotic division. Cdh1 is an activator of the anaphase-promoting complex (APC) and APCcdh1 is normally restricted to late M to early G1 phases of the cell cycle. Here, we find that APCcdh1 is active in mouse oocytes and is necessary to maintain prophase arrest.


Mammography and breast ultrasound analysis in male and female transgender persons using long-term gender affirming hormone therapy: a cross-sectional study in Brazil.
There is not much information about breast health in transgender (transexual) persons given the historical stigma that this population suffers. This research aimed to describe breast imaging patterns in transgender (trans) women and men that had been using gender affirmation hormone treatment for at least 3 years. In this observational, cross-sectional study, 67 transgender individuals (34 trans women and 33 trans men) had mammography and breast ultrasound performed. We also classified the findings by the American College of Radiology - Breast Imaging Reporting and Data System (ACR BI-RADS®). We found that there was a higher frequency of dense breasts in trans women (75.8%) and in trans men (66,6%) than expected for cisgender (cis) women. This study highlights the importance of a deeper understanding of the image patterns of transgender breasts because of hormonal effects that the gender transition entails so we can offer better health care and preventive services in the transgender (transexual) population.


Pneumocystis carinii pneumonia: advances in diagnosis and therapy.
As the AIDS epidemic has evolved, so have improvements been made in diagnosis and treatment of Pneumocystis carinii pneumonia, the most common opportunistic infection in AIDS. Advances, changes, and current research are discussed.


Co-composting solid swine manure with pine sawdust as organic substrate.
The main objectives of this work were to investigate the evolution of the principal physicochemical properties, i.e., bulk temperature, pH, electrical conductivity (EC), moisture content, total organic matter, total nitrogen and total phosphorus, in co-composting pine sawdust with increasing percentages of fresh solid swine manure, and thus to evaluate the most desirable manure proportion for producing organic substrates in consideration of the quality of the resulted compost. The composting was in four identical 100.5l lab vessels, using 5% each tea leaves and herb residues as conditioners. The swine manure was added in the trials at 20%, 30%, 40%, respectively, and was substituted in the control with 30% lake sludge corrected by 0.5% urea. The initial humidity of each treatment was 60+/-2%. While being aerated actively at approximately 0.3m(3)/min at intervals of 10 min/h, the mixture was composted for 29 days. The results indicated that N and P decomposition primarily occurred in the mesophilic phase, while organic carbon decomposed in the thermophilic phase and 30% swine manure with initial C/N ratio of about 40 was more desirable for composting organic substrates.


On the mechanism of water uptake by the developing eggs of Calotes versicolor.
Experiments show that osmotic gradient has a role in the absorption of water by the semi-cleidoic egg of Calotes versicolor. The observations also indicate that in nature the eggs need to be laid in water-saturated soil and can easily withstand flooding but not dryness.


Tubular Structures of Calcium Carbonate: Formation, Characterization, and Implications in Natural Mineral Environments.
Chemical gardens are self-assembled tubular precipitates formed by a combination of osmosis, buoyancy, and chemical reaction, and thought to be capable of catalyzing prebiotic condensation reactions. In many cases, the tube wall is a bilayer structure with the properties of a diaphragm and/or a membrane. The interest in silica gardens as microreactors for materials science has increased over the past decade because of their ability to create long-lasting electrochemical potential. In this study, we have grown single macroscopic tubes based on calcium carbonate and monitored their time-dependent behavior by in situ measurements of pH, ionic concentrations inside and outside the tubular membranes, and electrochemical potential differences. Furthermore, we have characterized the composition and structure of the tubular membranes by using ex situ X-ray diffraction, infrared and Raman spectroscopy, as well as scanning electron microscopy. Based on the collected data, we propose a physicochemical mechanism for the formation and ripening of these peculiar CaCO3 structures and compare the results to those of other chemical garden systems. We find that the wall of the macroscopic calcium carbonate tubes is a bilayer of texturally distinct but compositionally similar calcite showing high crystallinity. The resulting high density of the material prevents macroscopic calcium carbonate gardens from developing significant electrochemical potential differences. In the light of these observations, possible implications in materials science and prebiotic (geo)chemistry are discussed.


CaIPF14030 negatively modulates intracellular ATP levels during the development of azole resistance in Candida albicans.
Widespread and repeated use of azoles, particularly fluconazole, has led to the rapid development of azole resistance in Candida albicans. We investigated the role of CaIPF14030 during the development of azole resistance in C albicans. The expression of CaIPF14030 was measured by quantitative RT-PCR, and CaIPF14030 was disrupted by the hisG-URA3-hisG (URA-blaster) method. The sensitivity of C albicans to azoles was examined using a spot assay, and the intracellular ATP concentrations were measured by a luminometer. CaIPF14030 expression in C albicans was up-regulated by Ca(2+) in a calcineurin-dependent manner, and the protein was overexpressed during the stepwise acquisition of azole resistance. However, disruption or ectopic overexpression of CaIPF14030 did not affect the sensitivity of C albicans to azoles. Finally, we demonstrated that disruption of CaIPF14030 significantly increased intracellular ATP levels, and overexpression significantly decreased intracellular ATP levels in C albicans. CaIPF14030 may negatively modulate intracellular ATP levels during the development of azole resistance in C albicans.


Plasma interleukin-6 level is associated with NT-proBNP level and predicts short- and long-term mortality in patients with acute heart failure.
Interleukin 6 plays an important role in chronic heart failure (HF), but little is known about its involvement in acute decompensated heart failure (ADHF). The aim of our study is to evaluate the prognostic role of interleukin 6 (IL-6) in the patients with ADHF. Plasma levels of interleukin IL-6, N-terminal pro brain natriuretic peptide levels, and clinical covariates were measured in 92 patients with ADHF. Survival was followed up to 12 months, and prognostic factors were evaluated. Elevated plasma IL-6 levels were increased in nonsurvivors and were associated with 1-year mortality (p < 0.01). Plasma IL-6 levels were associated with plasma NT-proBNP levels. In multivariate analysis, increased plasma IL-6 and NT-proBNP levels remained strong independent predictors of 1-year mortality. Plasma IL-6 levels provide important prognostic information in the patients with ADHF. Measurement combining plasma IL-6 and NT-proBNP should serve as a powerful prognostic tool of multimarker strategy in patients with acute decompensated heart failure.


Increasing signal amplitude in electrical impedance tomography of neural activity using a parallel resistor inductor capacitor (RLC) circuit.
To increase the impedance signal amplitude produced during neural activity using a novel approach of implementing a parallel resistor inductor capacitor (RLC) circuit across the current source used in electrical impedance tomography (EIT) of peripheral nerve. The frequency response of the impedance signal was characterized in the range 4-18 kHz, then a frequency range with significant capacitive charge transfer was selected for experiment with the RLC circuit. Design of the RLC circuit was aided by in vitro impedance measurements on nerve and nerve cuff in the range 5 Hz to 50 kHz. The frequency response of the impedance signal across 4-18 kHz showed maximum amplitude at 6-8 kHz, and steady decline in amplitude between 8 and 18 kHz with -6 dB reduction at 14 kHz. The frequency range 17 ± 1 kHz was selected for the RLC experiment. The RLC experiment was performed on four subjects using an RLC circuit designed to produce a resonant frequency of 17 kHz with a bandwidth of 3.6 kHz, and containing a 22 mH inductive element and a 3.45 nF capacitive element with +0.8/- 3.45 nF manual tuning range. With the RLC circuit connected, relative increases in the impedance signal (±3σ noise) of 44% (±15%), 33% (±30%), 37% (±8.6%), and 16% (±19%) were produced. The increase in impedance signal amplitude at high frequencies, generated by the novel implementation of a parallel RLC circuit across the drive current, improves spatial resolution by increasing the number of parallel drive currents which can be implemented in a frequency division multiplexed (FDM) EIT system, and aids the long term goal of a real-time FDM EIT system by reducing the need for ensemble averaging.


Regulation of creatine phosphokinase expression during differentiation of BC3H1 cells.
The intracellular mechanisms involved in the regulation of creatine phosphokinase expression in the BC3H1 muscle-like cell line have been examined under conditions of enzyme induction and repression. In the presence of low serum concentrations, BC3H1 cells cease to grow and synthesize high levels of creatine phosphokinase. When differentiated BC3H1 cultures are exposed to media containing high serum concentrations, cell division is reinitiated and further induction of creatine phosphokinase is inhibited. Accumulation of creatine phosphokinase-mRNA appears to be intimately coupled to the state of growth of BC3H1 cells. Log phase cells do not contain detectable levels of translatable creatine phosphokinase-mRNA; however, following cessation of growth, creatine phosphokinase-mRNA accumulates in approximate proportion to the increase in creatine phosphokinase activity. Reinitiation of cell division in quiescent differentiated cultures results in the arrest of further accumulation of creatine phosphokinase-mRNA but does not inhibit the translation of pre-existing creatine phosphokinase-mRNA. Under conditions of enzyme repression, however, the newly synthesized creatine phosphokinase appears to be enzymatically inactive. These results indicate that the expression of the muscle phenotype in BC3H1 cells is regulated by components present in serum and that myogenic differentiation is at least partially reversible following re-entry of quiescent cells into the cell cycle.


Configuration of Primary and Recurrent Aggressive Fibromatosis on Contrast-Enhanced MRI with an Evaluation of Potential Risk Factors for Recurrences in MRI Follow-Up.
To analyze the appearance of primary and recurrent aggressive fibromatosis (AF) on MRI with a focus on configuration and to determine potential risk factors for recurrences detected on MRI follow-up scans. From 79 consecutive patients with histologically proven diagnosis of AF, 39 patients underwent a minimum of four 1.5 T MRI follow-up scans after resection of primary AF between 2008 and 2018. The primary and recurrent tumors were radiographically examined for configuration, limitation and extent on MRI. Epidemiological data and loco-regional subcutaneous edema, muscle edema and post-operative seroma were included. The mean age of the patients was 39 ± 2.6 years. Primary and recurrent AF most often occurred in the thigh. The main appearance of primary AF was significantly most often fascicular (p = 0.001-0.01) with heterogeneous and marked contrast enhancement. 21 % (n = 8) of the patients developed recurrences of AF. A fascicular configuration with homogeneous/heterogeneous contrast enhancement was the main appearance of recurrent AF, but recurrent AF appeared nodular, polycyclic, ovoid or streaky/flat as well. Recurrent AF significantly most often occurred within the first 9 months after primary tumor resection (p = 0.009), especially in patients up to 25 years of age (RR = 6.1; 95 % CI: 1.8-20.9; p = 0.004). The cases of recurrent AF were altogether significantly smaller than the primary tumors (p = 0.001). Post-treatment subcutaneous and muscle edema were present in 77 % and 56 %, respectively. Patients with muscle edema after primary tumor resection had a significantly higher risk for AF recurrences (relative risk ratio (RR) = 1.8; 95 % CI: 1.16-2.8; p = 0.0096). There was no significant difference detected in patients with complete or incomplete resection of the primary tumor. Primary and recurrent aggressive fibromatosis has a mostly fascicular configuration, but may appear ovoid, nodular, streaky/flat or polycyclic as well. High risks for tumor recurrences are detected for patients up to 25 years of age, patients within the first 9 post-operative months and patients with muscle edema after primary tumor resection. · Primary aggressive fibromatosis mostly has a fascicular configuration with heterogeneous contrast enhancement. · Recurrent aggressive fibromatosis usually has a fascicular configuration with heterogeneous/homogeneous contrast enhancement. · Patients within the first 9 post-operative months and up to 25 years of age have a significantly higher risk for recurrences. · Muscle edema after resection of primary aggressive fibromatosis is associated with a significantly higher risk for recurrences. · Sedaghat S, Surov A, Krohn S et al. Configuration of Primary and Recurrent Aggressive Fibromatosis on Contrast-Enhanced MRI with an Evaluation of Potential Risk Factors for Recurrences in MRI Follow-Up. Fortschr Röntgenstr 2020; 192: 448 - 457.


Different Perfusion Patterns in a Patient with Acute Ischemic Stroke.
A 29-year-old male patient with aphasia and mild weakness of the right arm arrived at the emergency room 4 hours after symptom onset. The computed tomography perfusion showed a typical delay in the time-based maps in the left occipital lobe and another hyperperfused area in the left frontal lobe. The follow-up magnetic resonance imaging confirmed cortical ischemic lesions in both areas. This case shows that besides hypoperfusion, hyperperfusion can also be found in the first stages of acute stroke, and it is highly suggestive of established ischemic lesions.


2D Covalent Organic Frameworks: From Synthetic Strategies to Advanced Optical-Electrical-Magnetic Functionalities.
Covalent organic frameworks (COFs), an emerging class of organic crystalline polymers with highly oriented structures and permanent porosity, can adopt 2D or 3D architectures depending on the different topological diagrams of the monomers. Notably, 2D COFs have particularly gained much attention due to the extraordinary merits of their extended in-plane π-conjugation and topologically ordered columnar π-arrays. These properties together with high crystallinity, large surface area, and tunable porosity distinguish 2D COFs as an ideal candidate for the fabrication of functional materials. Herein, this review surveys the recent research advances in 2D COFs with special emphasis on the preparation of 2D COF powders, single crystals, and thin films, as well as their advanced optical, electrical, and magnetic functionalities. Some challenging issues and potential research outlook for 2D COFs are also provided for promoting their development in terms of structure, synthesis, and functionalities.


Motivation and job satisfaction of deans of schools of nursing.
Factors influencing the job satisfaction of deans of schools of nursing were analyzed using the motivational theory of expectancy. A questionnaire was sent to 595 deans/directors of baccalaureate and higher degree schools of nursing accredited by the National League for Nursing. The three part questionnaire consisted of (1) Demographic data, (2) Motivation and Reward Scales, and (3) The Job Description Index. Significant relationships were found within each job satisfaction variable (P less than or equal to .05). The most significant and numerous relationships were found within the variable of pay or salary. Deans who had long tenure in their administrative positions and were associated with large universities and schools of nursing were also found to be statistically significant (P less than or equal to .05). A direct relationship between the scores on the Motivation and Reward Scale and the scores on the Job Description Index was supported. The individual and collective facets of job satisfaction were positively and significantly correlated (P less than or equal to .05) with motivation, providing support for the theoretical framework that proposes an interdependent relationship. Additional findings from regression analyses suggested that motivation is a significant predictor of job satisfaction.


Trust and confidence: towards mutual acceptance of ethics committee approval of multicentre studies.
To compare issues raised by Human Research Ethics Committees (HREC) during the ethics review process and to determine the length of time taken to gain HREC approval for multicentre research studies. Review and analysis of HREC documentation and correspondence for all multicentre research studies were conducted through three HREC under the auspices of Cancer Trials Australia, Melbourne, Victoria, Australia, between November 1997 and March 2001 to determine the variance of documentation, correspondence and recommendations across the three HREC and the time taken for study approval. Thirty-one projects were submitted to any two of the HREC (16 studies) or all three HREC (15 studies). The median time for study approval at an individual HREC was 75 days, but it was 111 days for approval at all participating sites. There were 554 clarifications or comments made by the reviewing HREC, the majority of which had no significant bearing on the ethical or scientific calibre of the study. There was only one study in which a significant protocol change was requested by a HREC. Multicentre study approvals are delayed when submitted to multiple HREC. The three HREC raised similar issues without substantive differences in their recommendations. A process for the mutual acceptance of HREC recommendations could facilitate multicentre research.


Male breast cancer--an andrological disease: risk factors and diagnosis.
Gynaecomastia, the enlargement of the male breast, is considered as an andrological disease. To date, a review on male breast cancer (MBC) has not been published in an andrological journal. The papers underlying this review were published from authors of different institutions: Clinical Genetics, Dermatology, Gynaecology, Internal Medicine, Oncology, Pathology, Psychiatry, Radiology and Surgery. MBC accounts for approximately 1% of breast cancer patients. A total of 182 men died of breast cancer in 1999, in Germany. In the US, 1500 new cases per year occur. MBC accounts for <5% of surgically removed breast lumps. Diseases with increased oestrogen action increase the risk of MBC. Mutations of distinct genes are estimated to account for up to roughly 10% of MBC. BRCA1 and BRCA2 gene mutations are responsible for approximately 80% of the families with hereditary breast cancer. The diagnosis of MBC is not possible without histological examination. Different diagnostic procedures such as clinical diagnosis, sonography, mammography, fine-needle biopsy and core needle facilitate the decision whether a biopsy is necessary.


Spliced X-box binding protein 1 (XBP1s) protects spermatogonial stem cells (SSCs) from lipopolysaccharide (LPS)-induced damage by regulating the testicular microenvironment.
XBP1 is a transcription factor that plays a central role in controlling cellular responses to endoplasmic reticulum stress (ERS). Under stress conditions, the transcriptionally active form of XBP1 is generated by splicing of XBP1 mRNA by the ER-resident protein inositol-requiring enzyme-1α (IRE1α). This study aimed to investigate the role of XBP1 in male reproductive disorders. XBP1s-overexpressing goat spermatogonial stem cells (gSSCs) showed higher proliferative ability in vitro and in vivo. These cells also showed higher antioxidant capacity. In comparison, XBP1 knockdown significantly suppressed proliferation. Further analysis showed that XBP1 could stimulate the secretion of IL-6 from macrophages. Overall, the results indicate that XBP1s functions to enhance the proliferation ability and antioxidant capacity of gSSCs, potentially through a mechanism involving the regulation of gSSCs by macrophages.


Immunocytochemical analysis of glycogen phosphorylase isozymes in the developing and adult retina of the domestic chicken (Gallus domesticus).
Glycogen is the major energy reserve in neural tissues including the retina. A key-enzyme in glycogen metabolism is glycogen phosphorylase (GP) which exists in three differentially regulated isoforms. By applying isozyme-specific antibodies it could be demonstrated that the GP BB (brain), but not the GP MM (muscle) isoform is expressed in the chicken retina in neuronal and glial (Müller) cells. In the embryonic chicken retina, GP showed a development-dependent expression pattern. Double-labeling experiments with cell type-specific antibodies revealed that GP is expressed in various layers of the retina some of which, e.g., the photoreceptor inner segments, are known to be sites of high energy consumption. This suggests important roles of GP BB, and therefore glycogen, in early differentiation, spontaneous wave generation and in formation and stabilization of synapses.


Determination of heavy metals by ICP-OES and F-AAS after preconcentration with 2,2'-bipyridyl and erythrosine.
The applicability of 2,2'-bipyridyl and erythrosine co-precipitation method for the separation and preconcentration of some heavy metals, such as Cd, Co, Cu, Ni, Pb and Zn in actual samples for their determination by ICP-OES and F-AAS was studied. Experimental conditions influencing the recovery of the investigated metals, such as pH, molar ratio of 2,2'-bipyridyl to erythrosine, the effect of time on co-precipitation were optimized. The analytical characteristics of the method (e.g. limit of detection, sensitivity, linear range and preconcentration factor) were obtained. The limits of detection LOD (ng mL(-1)) of the ICP-OES (F-AAS) method were: Cd: 4.0 (7.75), Co: 3.1 (57.2), Cu: 18 (10.3), Ni 21.3 (32.8), Pb: 35.9 (29.2) and Zn: 10.2 (6.90). The recovery of all the elements tested was more than 93%. The influence of inorganic matrix was examined. The proposed method was applied to determination of Cd, Co, Cu, Ni, Pb and Zn in vegetables and certified reference material (NCS ZC85006 Tomato).


[Rapidly destructive osteoarthritis of the hip: case presentation].
The rapidly destructive osteoarthritis of the hip is a variant of osteoarthritis that is characterized by hip pain during one to twelve months and rapid destruction of the femoral head, in absence of infectious, neurologic, metabolic or inflammatory disease. We present the case of a 66 year- old male with severe COPD that referred pain in both hips and was unable to walk. In the radiography of the pelvis complete destruction of both femoral heads was observed. The patient did not have abnormalities in blood tests that were related to infectious, neurologic or metabolic diseases. The patient underwent bilateral total hip replacement with prosthesis and physical therapy later. The patient functional status greatly improved with this treatment.


Altered acylcarnitine metabolism and inflexible mitochondrial fuel utilization characterize the loss of neonatal myocardial regeneration capacity.
Myocardial regeneration capacity declines during the first week after birth, and this decline is linked to adaptation to oxidative metabolism. Utilizing this regenerative window, we characterized the metabolic changes in myocardial injury in 1-day-old regeneration-competent and 7-day-old regeneration-compromised mice. The mice were either sham-operated or received left anterior descending coronary artery ligation to induce myocardial infarction (MI) and acute ischemic heart failure. Myocardial samples were collected 21 days after operations for metabolomic, transcriptomic and proteomic analyses. Phenotypic characterizations were carried out using echocardiography, histology and mitochondrial structural and functional assessments. In both groups, MI induced an early decline in cardiac function that persisted in the regeneration-compromised mice over time. By integrating the findings from metabolomic, transcriptomic and proteomic examinations, we linked regeneration failure to the accumulation of long-chain acylcarnitines and insufficient metabolic capacity for fatty acid beta-oxidation. Decreased expression of the redox-sensitive mitochondrial Slc25a20 carnitine-acylcarnitine translocase together with a decreased reduced:oxidized glutathione ratio in the myocardium in the regeneration-compromised mice pointed to a defect in the redox-sensitive acylcarnitine transport to the mitochondrial matrix. Rather than a forced shift from the preferred adult myocardial oxidative fuel source, our results suggest the facilitation of mitochondrial fatty acid transport and improvement of the beta-oxidation pathway as a means to overcome the metabolic barrier for repair and regeneration in adult mammals after MI and heart failure.


Differentiation of vertebral osteomyelitis and tuberculous spondylitis by magnetic resonance imaging.
Twenty patients with vertebral osteomyelitis and 18 with tuberculous spondylitis were investigated by magnetic resonance imaging to identify the distinguishing features. The number of vertebral bodies involved was less in vertebral osteomyelitis than in tuberculous spondylitis, and the paravertebral abscesses were smaller. The magnetic resonance intensity of the involved vertebral bodies was more homogeneous in vertebral osteomyelitis than in tuberculous spondylitis. Rim enhancement with Gadolinium-DTPA was less frequent in vertebral osteomyelitis. The differentiation of the two conditions by MRI was helpful in establishing the correct diagnosis of the infection.


Coronary stenting (Cordis) without anticoagulation.
We evaluated the effect of antithrombotic regimens on subacute thrombosis and short-term clinical courses after successful implantation of the Cordis coronary stent, which is a flexible, balloon expandable, radiopaque tantalum stent. Two hundred seventy-five consecutive patients with 290 lesions were treated with 356 Cordis stent implantations. According to poststent antithrombotic regimen, patients were divided into 3 groups; 165 patients with 175 lesions received aspirin 200 mg/day, ticlopidine 500 mg/day, and warfarin for 1 month (group 1), 66 patients with 69 lesions received aspirin and ticlopidine (group 2), and 44 patients with 46 lesions received aspirin alone (group 3) after successful Cordis stenting. The overall procedural success rates were 97.7% in group 1, 98.6% in group 2, and 100% in group 3. More than 65% of the patients were eligible for elective stenting. The overall rate of stent thrombosis was 1.8%: 1.2% in patients assigned to the treatment with aspirin, ticlopidine, and warfarin; 0% in patients with aspirin and ticlopidine; and 6.8% in patients assigned to the treatment with aspirin alone. In conclusion, the Cordis coronary stent is an effective endovascular stent in various clinical indications including unstable angina and acute myocardial infarction. Antiplatelet therapy using aspirin and ticlopidine after successful Cordis coronary stenting is a promising alternative to anticoagulation therapy to overcome the drawbacks of stenting. However, poststent antithrombotic therapy with aspirin alone is associated with a significant rate of stent thrombosis.


Defining the care delivery value chain and mapping the patient journey in rheumatoid arthritis.
Rheumatoid Arthritis (RA) is a chronic disease that impacts patients' quality of life. Sophisticated organization of care delivery drives quality improvement. Therefore, the study objective was establishing a validated process map of the care cycle for RA patients. Hence, increasing transparency and optimizing care delivery and identifying areas of improvement. To map the RA care cycle, the care delivery value chain (CDVC) approach was used as framework to document activities and resources systematically. A mixed method study was conducted where quantitative data on activities were collected from health records and unstructured interviews with medical staff were held. Consequently, the process map was separately validated in a consensus meeting with a delegation of the medical staff and patient advisory board. At the start of the care cycle, the focus is predominantly on defining the treat-to-target strategy and examining disease activity. Towards the monitoring phase, tapering medication and managing the disease through patient-reported outcome measures are becoming increasingly important. Although patient's functioning, quality of care and patient's evaluation of received care are monitored, reflection of CDVC and engaging patients in the evaluation process resulted in improvement actions on outcome and process level. Mapping the RA care cycle following a systematic approach, provides insight and transparency in delivered activities, involved resources and the engagement of patients and caregivers at multiple levels, contributing to a system facilitating value-based care delivery. The CDVC framework and applied methodology is recommended in other conditions. Future research will focus at assigning outcomes and costs to activities and evaluating interventions to explore patient value.


Is the effect of cognitive reserve in longitudinal outcomes in first-episode psychoses dependent on the use of cannabis?
Cognitive reserve (CR) is a protective factor against cognitive and functional impairment in first-episode psychosis (FEP). The aim of this study was to evaluate the differences in clinical presentation according to the use of cannabis (cannabis users vs non-users) among patients presenting a FEP (non-affective vs affective psychosis), to investigate the impact of CR and cannabis use on several outcomes and to explore the potentially mediatory role played by CR in the relationship between cognitive domains or clinical status and functionality, depending on the use of cannabis. Linear regression analysis models were carried out to assess the predictive value of CR on clinical, functional and cognitive variables at baseline and at two-year follow-up. The mediation analyzes were performed according to the principles of Baron and Kenny. CR was associated with better cognitive performance, regardless of cannabis consumption or diagnosis. In both diagnoses, CR was associated with better clinical and functional outcomes in those patients who did not use cannabis. In terms of mediation procedure, CR mediates the relationship between some cognitive domains and functioning at follow-up only in patients without cannabis use. The small sample size of the affective group. CR plays a differential role in the outcome of psychoses according to whether patients are cannabis users or not. Both in affective and non-affective groups CR exerted a greater effect in patients without cannabis use. Our results suggest that the deleterious effect of cannabis use on functioning in FEP surpasses the protective effect of CR.


Impact of a third-year post-graduation preparation elective course.
Background Limited literature is available evaluating retrospective student perceptions of the utility of a postgraduate preparation elective at graduation and career onset and its impact on residency match rates. This project sought to explore the perceived usefulness of a third-year elective course from 2016 to 2019 on post-graduation preparation and to compare the match rate of students enrolled vs. not enrolled in the elective. Impact The majority of students pursuing residency programs (94%) perceived the elective course as helpful in navigating the postgraduate training process. Of the students pursuing other employment, 77.8% found the elective to be helpful in navigating the employment process. The top five activities identified as most useful included: cover letters, letters of intent, and thank you cards overview; curriculum vitae workshop; interviewing tips; mock interviews; and overview of postgraduate training opportunities. The match rate was not statistically different between those who completed the elective (60.7%) vs. all school graduates (64.7%) (P =.70). Recommendations Consideration should be given to the topics to be included in this type of elective course depending on the targeted audience. Additionally, it may be more beneficial to introduce these types of topics and activities to students earlier in their didactic career and integrate them into different parts of the curriculum. Discussion The post-graduation preparation elective course was perceived positively by students in terms of preparing for their postgraduate plans. Limitations and confounders make it difficult to determine the true impact of this type of elective on successful residency match rates.


Two reactive behaviors of chondrocytes in an IL-1β-induced inflammatory environment revealed by the single-cell RNA sequencing.
To investigate the heterogeneous responses of in vitro expanded chondrocytes, which were cultured in an interleukin (IL)-1β -induced inflammatory environment. Human articular chondrocytes were expanded, in vitro, for 13 days and treated with IL-1β for 0, 24, and 48 h. Cells were collected and subjected to single-cell RNA sequencing. Multiple bioinformatics tools were used to determine the signatures that define chondrocyte physiology. Two major cell clusters with distinct expression patterns were identified at the initial phase and were with heterogeneous variation that coincides with inflammation progress. They transformed into two terminal cell clusters one of which exhibited OA-phenotype and proinflammatory characteristics through two paths, "response-to-inflammation" and "atypical response-to-inflammation", respectively. The involved cell clusters exhibited intrinsic relationship with cell types within native cartilage from OA patients. Genes controlling cell transformation to OA-phenotype were relating to the tumor necrosis factor (TNF) signaling pathway via NFKB, up-regulated KRAS signaling and the IL2/STAT5 signaling pathway and pathways relating to apoptosis and reactive oxygen species. The in vitro expanded chondrocytes under IL-1β-induced inflammatory progression behave heterogeneously. One of the initial cell clusters could transform into a proinflammatory subpopulation through a termed response-to-inflammation path, which may serve as the core target to alleviate OA progression.


Quantum annealing with special drivers for circuit fault diagnostics.
We present a very general construction for quantum annealing protocols to solve Combinational Circuit Fault Diagnosis problems that restricts the evolution to the space of valid diagnoses. This is accomplished by using special local drivers that induce a transition graph on the space of feasible configurations that is regular and instance independent for each given circuit topology. Analysis of small instances shows that the energy gap has a generic form, and that the minimum gap occurs in the last third of the evolution. We used these features to construct an improved annealing schedule and benchmarked its performance through closed system simulations. We found that degeneracy can help the performance of quantum annealing, especially for instances with a higher number of faults in their minimum fault diagnosis. This contrasts with the performance of classical approaches based on brute force search that are used in industry for large scale circuits.


Enhanced activation of persulfate by nitric acid/annealing modified multi-walled carbon nanotubes via non-radical process.
This study aim to explore an effective approach of persulfate (PS) activation based on multi-walled carbon nanotubes (CNTs) for the phenol degradation. The nitric acid/annealing modified CNTs were obtained by oxidation with concentrated nitric acid followed by annealing at various high temperatures (400-1000 °C). The modified CNTs catalysts were characterized and their catalytic degradation performances of phenol with PS were investigated. The results reveal that the modified CNTs can obviously enhance the phenol removal. The catalytic activity is improved by nitric acid modification and obviously influenced by the annealing temperature. PS concentration and solution pH could also affect the catalytic degradation of phenol. The mechanism of enhanced PS activation by the nitric acid/annealing modified CNTs was proposed that the nitric acid modification resulted in more defective edges and oxygen-containing groups, and subsequent annealing at high temperate facilitated the conversion of sp3 to sp2 carbon, then the catalytic activity for PS activation was enhanced by the active sites of CO group and sp2-hybridized carbon at the defective edges. In addition, a non-radical process of phenol degradation was demonstrated in terms of the radical quenching tests and electron paramagnetic resonance (EPR) spectra analyses. It is suggested that 1O2 is likely the main reactive specie generated in PS activation by the modified CNTs for the phenol removal.


Tactfully unveiling the effect of solvent polarity on the ESIPT mechanism and photophysical property of the 3-hydroxylflavone derivative.
In this contribution, the solvent effects on the excited-state intramolecular proton transfer (ESIPT) and photophysical properties of 2-(4-(diphenylamine)phenyl)-3-hydroxy-4H-chromen-4-one (3HF-OH, Dyes Pigm. 2021, 184, 108865) in the dimethylsulfoxide (DMSO), acetonitrile (ACN), dichloromethane (DCM) and cyclohexane (CYH) phases have been comprehensively explored by using the density functional theory (DFT) and time-dependent density functional theory (TD-DFT) methods. The obtained bond lengths, bond angles and infrared (IR) vibration analysis related to the intramolecular hydrogen bond (IHB) reveal that the IHB intensity of 3HF-OH is weakened as the solvent polarity increased. Besides, the ESIPT process changes from the endothermic to the exothermic with the enlargement of solvent polarity, and the reaction barrier increases gradually. It is worth noting that the molecular configuration torsion of 3HF-OH is gradually intensified with the decline of solvent polarity, which aggravates the twisted intramolecular charge transfer (TICT) state and thereby partially attenuates the short-wavelength fluorescence of 3HF-OH in the CYH solvent. In addition to these, the structural torsion has restrained the occurrence of the ESIPT behavior by means of elevating the energy barrier. This theoretical research would provide valuable guidance for regulating and controlling the photophysical behavior of compounds via the strategy of changing solvent polarity.


Detection of RET oncogene activation in human papillary thyroid carcinomas by in situ hybridisation.
We have recently reported the activation of a new oncogene in human papillary thyroid carcinomas. This oncogene, named PTC, is a novel rearranged version of the ret proto-oncogene. In fact PTC is the product of the fusion of the tyrosine kinase domain of the ret proto-oncogene with the 5'-terminal region of another gene that we have named H4. The ret proto-oncogene shows a pattern of expression restricted to neuroendocrine tissue. Its fusion with H4 allows the expression of the activated form in thyroid papillary carcinomas. Therefore the detection of ret transcripts is a tool to investigate ret activation in thyroid neoplasms. Here we show the detection by in situ hybridisation, of activated ret transcripts in human thyroid papillary neoplasms that were positive for PTC activation by Southern blot analysis. We did not find any ret transcripts in papillary carcinomas negative for PTC activation, nor in normal thyroid and in non-papillary thyroid neoplasias.


The quality of telemedicine consultations for sexually transmitted infections in China.
The burden of sexually transmitted infections (STIs) continues to increase in developing countries like China, but the access to STI care is often limited. The emergence of direct-to-consumer (DTC) telemedicine offers unique opportunities for patients to directly access health services when needed; However, the quality of STI care provided by telemedicine platforms remains unknown. After systemically identifying the universe of DTC telemedicine platforms providing on-demand consultations in China in 2019, we evaluated their quality using the method of unannounced standardized patients (SPs). SPs presented routine cases of syphilis and herpes. Of 110 SP visits conducted, physicians made a correct diagnosis in 44.5% (95% CI: 35.1% to 54.0%) of SP visits, and correctly managed 10.9% (95% CI: 5.0% to 16.8%). Low rates of correct management were primarily attributable to the failure of physicians to refer patients for STI testing. Controlling for other factors, videoconference (vs. SMS-based) consultation mode and the availability of public physician ratings were associated with higher-quality care. Our findings suggest a need for further research on the causal determinants of care quality on DTC telemedicine platforms and effective policy approaches to promote their potential to expand access to STI care in developing countries while limiting potential unintended consequences for patients.


Oviposition in Delia platura (Diptera, Anthomyiidae): the role of volatile and contact cues of bean.
The choice of a suitable oviposition site by female insects is essential for survival of their progeny. Both olfactory and contact cues of the oviposition site may mediate this choice. The polyphagous Delia platura (Diptera: Anthomyiidae), a severe agricultural pest of numerous crops, lays eggs in the soil close to germinating seeds. Maggots feed upon the cotyledons. Only little is known about the cues guiding oviposition behavior. In this study, the effects of both olfactory and contact cues of beans (Phaseolus vulgaris) on oviposition of D. platura females were tested. Egg deposition on germinated beans was preferred to egg deposition on ungerminated beans or on beans in different postgerminating developmental stages. Olfactory cues of germinating beans alone stimulated female flies to lay eggs. Additional contact cues of germinating beans seemed to enhance the response, but the difference was not significant. Surface extracts of germinating beans sprayed on surrogate beans showed that both polar and nonpolar substances stimulated oviposition of D. platura flies. Gas chromatography-electroantennographic detection recordings of head space samples of germinating beans showed positive response of females to different compounds. We conclude that olfaction plays a major role when D. platura females are searching for oviposition sites. Volatile compounds released from germinating beans such as 4-hydroxy-4-methyl-2-pentanone, 1-hepten-3-one, 1-octen-3-ol, and 3-octanone should be considered as key compounds that mediate oviposition behavior. The use of different sensory modalities by closely related species of Delia is discussed.


Diaphragmatic Hernia as a Prenatal Feature of Glycosylphosphatidylinositol Biosynthesis Defects and the Overlap With Fryns Syndrome - Literature Review.
Fryns syndrome is an autosomal recessive multiple congenital anomaly syndrome, with diaphragmatic defects and secondary lung hypoplasia as cardinal features. Despite it was reported first in 1979, its exact etiology has not been established to date. With this review, we would like to draw attention to the prenatal presentation of multiple congenital anomalies syndromes, resulting from defects in the synthesis of glycosylphosphatidylinositol anchors, to be considered in a prenatal assessment of fetuses with DH and Fryns-like phenotype.


CVTree: A Parallel Alignment-free Phylogeny and Taxonomy Tool Based on Composition Vectors of Genomes.
Composition Vector Tree (CVTree) is an alignment-free algorithm to infer phylogenetic relationships from genome sequences. It has been successfully applied to study phylogeny and taxonomy of viruses, prokaryotes, and fungi based on the whole genomes, as well as chloroplast genomes, mitochondrial genomes, and metagenomes. Here we presented the standalone software for the CVTree algorithm. In the software, an extensible parallel workflow for the CVTree algorithm was designed. Based on the workflow, new alignment-free methods were also implemented. And by examining the phylogeny and taxonomy of 13,903 prokaryotes based on 16S rRNA sequences, we showed that CVTree software is an efficient and effective tool for studying phylogeny and taxonomy based on genome sequences. The code of CVTree software can be available at https://github.com/ghzuo/cvtree.


Gender difference in the association and presentation of visual hallucinations in dementia with Lewy bodies: a cross-sectional study.
Visual hallucinations (VHs) are among the most striking features of dementia with Lewy bodies (DLB). We investigated gender differences in the association and presentation of VHs in DLB. A cross-sectional analysis of baseline data from a prospective, longitudinal study on dementia was performed. Cumulative frequency, 1-month frequency, and phenomenology of VHs were summarized and compared between female and male patients with DLB. Gender differences in the factors associated with VHs were investigated in patients with and without hallucinations. A total of 152 patients including 65 (42.8%) women and 87 (57.2%) men were analyzed. The cumulative and 1-month frequencies of VHs were 60% and 55.4%, respectively, in women and 44.8% and 41.4%, respectively, in men. Adjusting for age and disease severity resulted in the inclusion of more women in the VH group [odds ratio (OR) = 2.33, p = 0.028)] than in the non-VH group. In female participants, older age (OR = 9.16, p = 0.003) and higher neuropsychiatric inventory score (OR = 4.89, p = 0.009) were associated with VHs, whereas in male participants, more severe dementia stage (clinical dementia rating 2-3 versus clinical dementia rating 0.5, OR = 6.22, p = 0.008) and higher rates of using antipsychotics (OR = 9.64, p = 0.047) were associated with VHs. The frequencies of 1-month and cumulative VHs were high in DLB, which indicated a high prevalence as well as a high persistency of VHs in DLB. The patterns of factors associated with VHs differed between female and male patients. Copyright © 2017 John Wiley & Sons, Ltd.


Ring 14 chromosome with complex partial seizures: a case report.
A two-year-old girl was found to have a ring 14 chromosome: [46, XX, r(14) (P13 q32.3)]. Her development, including verbal ability, was retarded, her CT scan displayed a low density area anterior to the left temporal lobe, and she suffered from complex partial seizures. Focal central nervous system abnormalities may be present in patients with ring 14 chromosome, and their seizures are not exclusively of the primary generalized type. This is the first case with ring 14 chromosome and complex partial seizures.


Predictors of Success When Implementing an Electromagnetic Navigational Bronchoscopy Program.
With the advent of lung cancer screening, lung nodules are being discovered at an increasing rate. With improvements in transbronchial biopsy technology, it is important for thoracic surgeons to be involved with diagnostic procedures. The aim of this project is to relate the thoracic surgeon experience in implementing an electromagnetic navigational bronchoscopy (ENB) program at our institution and describe the factors that led to successful navigation (the ability to position a biopsy instrument in range for biopsy) and diagnostic biopsy of nodules. The thoracic surgery ENB program was initiated in 2014. A retrospective analysis of patients referred to thoracic surgery from 2014 to 2019 for lung nodule evaluation was performed. Patients who underwent ENB and biopsy were included. Recursive partitioning (CART) and multivariable regression analyses were used to identify predictors of successful navigation and biopsy. There were 73 patients who underwent ENB evaluation of 91 nodules from 2014 to 2019. There was successful navigation in 75.8% of nodules, and on multivariable analysis, bronchus sign, lesion size, and pleural distance were significant predictors of successful navigation. Of the lesions that had successful navigation, 65.2% had a diagnostic biopsy. Based on CART analysis, positive bronchus sign and lesion size ≥ 1.3 cm were most predictive of obtaining a diagnostic biopsy with a probability of 0.75. Nodule size, distance to the pleura, and bronchus size are independent variables of successful navigation when using ENB. However, of the lesions that were successfully reached, combined lesion size >1.3 cm and a positive bronchus sign were most predictive of obtaining a diagnostic biopsy. These factors should be considered when implementing an ENB program in a thoracic surgery practice.


A plant indicator of air pollution and human health in Japanese rural communities.
An investigation of the effects of air pollution on vegetation and human health was conducted in a low-degree air-polluted Japanese rural area. The validity of the criteria, which were expressed as Bi-band ratios (R/B, R/G) in leaves of Japanese cedars based on infrared air photography, has been proved worthwhile for estimating the injury to the cedars. The degree of injury to the cedars by field survey showed a significant positive correlation with the concentration of sulfur oxide in the air for the last 3 years. The quantity of water-soluble sulfur in leaves of the cedar was less in the leaves of the less-injured cedars. In school children with positive skin reactions in the area, "subacute cough" (la and/or 3a by BMRC) and "phlegm" (6a and/or 8a by BMRC) had a significant positive correlation with the degree of injury to the cedars.


Imaging findings in human immunodeficiency virus-related pulmonary hypertension: report of five cases and review of the literature.
Five cases of human immunodeficiency virus-related pulmonary hypertension and their imaging manifestations are reported. The radiologic findings vary from mild enlargement of the pulmonary trunk or the central pulmonary arteries at early stages to marked dilatation of the central pulmonary arteries and massive cardiomegaly due to right ventricular and right atrial enlargement at later stages of the disease.


Endogenous synaptogenesis in the deafferented dentate gyrus does not exclude synapse formation by embryonic entorhinal transplants.
After partial deafferentation postsynaptic sites are reinnervated by local sprouting of remaining axons. We have investigated whether this process is sufficient to prevent new synapses being formed by transplanted embryonic tissue. We find that after unilateral entorhinal ablation endogenous sprouting by local axons is unable to reinnervate all the postsynaptic sites in the denervated outer dentate molecular layer. Axons from embryonic entorhinal tissue transplanted adjacent to the denervated area are able to reclaim a further proportion of the denervated postsynaptic sites. Thus, after a large lesion, endogenous sprouting is insufficient to preclude reinnervation by axons from embryonic transplants.


Comparison of immunofiltration assay of plasma D-dimer with diagnostic imaging in deep vein thrombosis.
This prospective study was designed to assess the diagnostic sensitivity, specificity and negative predictive value of the NycoCard D-dimer plasma immunofiltration assay in patients with suspected deep vein thrombosis (DVT) confirmed by ultrasonography/venography. 84 medical patients were recruited: 43 patients (51%) had proven venous thrombosis, 33 by venography and 10 by ultrasonography. The sensitivity of NycoCard D-dimer in patients with DVT was 95.3%, the specificity was 22.0% and the negative predictive value was 81.8%. An algorithm including the NycoCard D-dimer test for the acute management of DVT is proposed. This would enable low-risk patients to be discharged early from hospital, without imaging or anticoagulant therapy.


Probiotic sonicates selectively induce mucosal immune cells apoptosis through ceramide generation via neutral sphingomyelinase.
Probiotics appear to be beneficial in inflammatory bowel disease, but their mechanism of action is incompletely understood. We investigated whether probiotic-derived sphingomyelinase mediates this beneficial effect. Neutral sphingomyelinase (NSMase) activity was measured in sonicates of the probiotic L. brevis (LB) and S. thermophilus (ST) and the non-probiotic E. coli (EC) and E. faecalis (EF). Lamina propria mononuclear cells (LPMC) were obtained from patients with Crohn's disease (CD) and Ulcerative Colitis (UC), and peripheral blood mononuclear cells (PBMC) from healthy volunteers, analysing LPMC and PBMC apoptosis susceptibility, reactive oxygen species (ROS) generation and JNK activation. In some experiments, sonicates were preincubated with GSH or GW4869, a specific NSMase inhibitor. NSMase activity of LB and ST was 10-fold that of EC and EF sonicates. LB and ST sonicates induced significantly more apoptosis of CD and UC than control LPMC, whereas EC and EF sonicates failed to induce apoptosis. Pre-stimulation with anti-CD3/CD28 induced a significant and time-dependent increase in LB-induced apoptosis of LPMC and PBMC. Exposure to LB sonicates resulted in JNK activation and ROS production by LPMC. NSMase activity of LB sonicates was completely abrogated by GW4869, causing a dose-dependent reduction of LB-induced apoptosis. LB and ST selectively induced immune cell apoptosis, an effect dependent on the degree of cell activation and mediated by bacterial NSMase. These results suggest that induction of immune cell apoptosis is a mechanism of action of some probiotics, and that NSMase-mediated ceramide generation contributes to the therapeutic effects of probiotics.


[Ablation of hard biological tissue with the excimer laser].
Cutting and drilling of bone- and meniscus tissue were performed using a XeCl-excimer laser combined with a tapered fiber. Ablation speed on meniscus tissue is already sufficient, the thermal damage of the adjacent tissue is minimal. Increasing of energy transmission through special fibers promises higher ablation rates also on hard biological tissue and that promoted the interest in lasers again for accident surgeons.


Muscarinic receptor expression and receptor-mediated detrusor contraction: comparison of juvenile and adult porcine tissue.
Urinary bladder function is known to mature during fetal and postnatal development, including changes in neurotransmitter regulation of detrusor contraction. However, only few experimental data are available about muscarinic receptor antagonist function in the urinary bladder from young animals. In the present study, we compare the muscarinic receptor-mediated contractions in juvenile and adult porcine detrusor and the effects of antimuscarinic compounds. Urinary bladders from young (8-12 weeks; 12- to 35-kg body weight) and mature pigs (>40 weeks; >100 kg) were compared. Muscarinic receptor expression was assessed by real time polymerase chain reaction and radioligand binding. Muscle contraction was measured with a force transducer; L-type Ca2+ currents (ICa,L) of isolated detrusor myocytes were recorded with standard voltage clamp technique. Juvenile and adult detrusor expressed similar quantities of the messenger RNA of M2 and M3 receptors. The number of [3H]QNB-binding sites and their affinity for the radioligand were also similar between juvenile and adult detrusor. In contrast, maximum contractile responses to the muscarinic receptor agonist carbachol were slightly larger in juvenile than adult bladders. On the other hand, carbachol was slightly less potent in juvenile than in adult tissue. The M3 antagonist DAU 5884 and the spasmolytic drug propiverine inhibited contractile responses with comparable efficacies and potencies in juvenile and adult tissue. ICa,L was somewhat smaller in juvenile than in adult cells. Taken together, these data suggest that expression and function of M2 and M3 receptors are similar in the detrusor of juvenile and mature pigs. Therefore, similar responses to antimuscarinic compounds could be expected in young and adult patients.


[Is it possible to predict the length of knee flexor tendons by anthropometry?].
To compare the anthropometric data and the sportive way of life with the hamstring tendons dimensions, prospectively, in order to create a rule to predetermine its dimensions. General and anthropometric data were collected from 30 patients that were submitted to anterior cruciate ligament reconstruction. These data were correlated to the diameter and length of the hamstring tendons. The data collected were: height, weight, age, knee lesion side, body mass, sportive training level, femoral length, tibia length, thigh circumference, and knee circumference. The correlation was made by Pearson coefficient. Statistic significant correlation occurred only with height and tibia length versus the gracilis and semitendinous tendon length. Using linear regression the relations found could be expressed with the following formulas: semitendinous length = -2.276 + 0.177 x height; semitendinous length = 13.048 + 0.46 x tibia height; gracilis length = -9.413 + 0.207 x height; gracilis length = 7.036 + 0.583 x tibia height. It is possible to predetermine hamstring tendons length through linear regression formulas before surgical intervention.


Early activation of interferon-stimulated genes in human liver allografts: relationship with acute rejection and histological outcome.
Innate immunity mechanisms have been shown to play a paramount role in organ transplantation. Our aim was to investigate the hypothesis that activation of the interferon system may affect clinically relevant outcomes, such as acute rejection and/or early fibrosis progression, after liver transplantation. We studied 71 consecutive recipients (57 males; 25 with hepatitis C) who underwent two per protocol graft biopsies: the first, within 60 days after the transplant operation (median 24) and the second, after 1 year. The mRNA expression for five interferon-stimulated genes (Mx1, OAS2, PKR, IRF7A, IFI16) was measured on the first biopsy specimens. The main outcome measures were acute rejection during the first post-transplant year and fibrosis progression at the second biopsy. On multivariate analysis, the independent predictors of gene expression were hepatitis C (Mx1, OAS2, PKR and IFI16), donor age (IFI16) and recipient gender (IRF7A) (P < .05 for all). During the first post-transplant year, 19/71 patients (27%) had acute cellular rejection. At multivariate analysis, acute cellular rejection was independently predicted by high IRF7A mRNA expression. At the end of follow-up, 25 patients had some degree of fibrosis (F2 or higher in seven cases). On multivariate analysis, hepatitis C etiology, recipient age, and OAS2 overexpression were independent predictors of early fibrosis progression. In the early postoperative period of liver transplantation, interferon-stimulated gene activation is dependent on hepatitis C recurrence (the main factor responsible for early fibrosis progression) and donor age, and is related to the risk of acute cellular rejection.


Hypovitaminosis D and the endocrine phenotype of COVID-19.
Vitamin D and its deficiency have recently been suspected to be involved in increased susceptibility and negative outcomes of COVID-19. This assumption was based on the well known immunomodulatory actions of vitamin D and on the consistent finding of low levels of 25 hydroxyvitamin D (25OHD) in hospitalized patients with COVID-19. Moreover, several studies reported a correlation between 25OHD levels and different clinical outcomes of the disease. Aim of the current review was to approach the topic of vitamin D and COVID-19 from a different perspective summarizing the data which led to the evidence of the existence of an endocrine phenotype of COVID-19. This review analyzed in the light of the current knowledge the possibility that several endocrine manifestations of COVID-19 could be holistically interpreted in the context of an inadequate vitamin D status.


Reply to Inzitari et al. Comment on "Blancafort Alias et al. A Multi-Domain Group-Based Intervention to Promote Physical Activity, Healthy Nutrition, and Psychological Wellbeing in Older People with Losses in Intrinsic Capacity: AMICOPE Development Study. Int. J. Environ. Res. Public Health 2021, 18, 5979".
This is a reply to the comment by Inzitari et al [...].


Associations of dairy, meat, and fish intakes with risk of incident dementia and with cognitive performance: the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD).
To investigate if dairy, meat, and fish intakes associate with dementia and cognitive performance. We included 2497 dementia-free men from Eastern Finland, aged 42-60 years in 1984-1989 at the baseline examinations. Data on cognitive tests [Mini Mental State Exam (MMSE), trail making test (TMT), verbal fluency test (VFL), selective reminding test (SRT), and Russell's adaptation of the visual reproduction test (VRT)] at the 4-year re-examinations were available for 482 men and on the ApoE phenotype for 1259 men. Data on dementia events were obtained by linkage to national health registers. Diet was assessed with baseline 4-day food records. Cox regression and analysis of covariance were used for analyses. During a mean 22-year follow-up, 337 men had a dementia diagnosis. Among the foods, only cheese intake associated with dementia risk (hazard ratio in the highest vs. the lowest quartile = 0.72, 95% confidence interval = 0.52-0.99, P-trend = 0.05). In the cognitive tests, higher non-fermented dairy and milk intakes associated with worse verbal fluency (VFT). Higher processed red meat intake associated with worse verbal (SRT) and visual memory (VRT), whereas higher unprocessed red meat intake associated with better general cognitive functioning (MMSE) and processing speed and executive functioning (TMT). Higher fish intake associated with better verbal memory (SRT). Among APOE-ε4 carriers, especially non-fermented dairy intake associated with higher risk of dementia outcomes, and higher fish intake indicated better cognitive performance. Although higher intake of some food groups associated with cognitive performance, we found little evidence for associations with dementia risk.


How home anterior self-collected nasal swab simplifies SARS-CoV-2 testing: new surveillance horizons in public health and beyond.
The sample collection procedure for SARS-CoV-2 has a strong impact on diagnostic capability, contact tracing approach, ultimately affecting the infection containment performance. This study demonstrates that self-collected nasal-swab has shown to be a valid and well tolerated procedure to SARS-CoV-2 surveillance in a healthcare system. More significantly, no performance adequacy difference was detected in self-administered swabs between healthcare worker (HCW) and non-HCW which allows to speculate that this procedure could be successfully extended to the entire population for mass screening.


Thematic review series: patient-oriented research. What we have learned about VLDL and LDL metabolism from human kinetics studies.
Lipoprotein metabolism is the result of a complex network of many individual components. Abnormal lipoprotein concentrations can result from changes in the production, conversion, or catabolism of lipoprotein particles. Studies in hypolipoproteinemia and hyperlipoproteinemia have elucidated the processes that control VLDL secretion as well as VLDL and LDL catabolism. Here, we review the current knowledge regarding apolipoprotein B (apoB) metabolism, focusing on selected clinically relevant conditions. In hypobetalipoproteinemia attributable to truncations in apoB, the rate of secretion is closely linked to the length of apoB. On the other hand, in patients with the metabolic syndrome, it appears that substrate, in the form of free fatty acids, coupled to the state of insulin resistance can induce hypersecretion of VLDL-apoB. Studies in patients with familial hypercholesterolemia, familial defective apoB, and mutant forms of proprotein convertase subtilisin/kexin type 9 show that mutations in the LDL receptor, the ligand for the receptor, or an intracellular chaperone for the receptor are the most important determinants in regulating LDL catabolism. This review also demonstrates the variance of results within similar, or even the same, phenotypic conditions. This underscores the sensitivity of metabolic studies to methodological aspects and thus the importance of the inclusion of adequate controls in studies.


Table Tilt Versus Pelvic Tilt Position for Intrauterine Resuscitation during Spinal Anaesthesia for Caesarian Section.
This study was undertaken to compare the effects on intrauterine resuscitation by table tilt versus pelvic tilt position after spinal anaesthesia for Caesarian Section. PATIENTS #ENTITYSTARTX00026; FIFTY ASA I AND II PATIENTS WHO FULFILLED THE ELIGIBILITY CRITERIA WERE ENROLLED IN THE STUDY AND WERE DIVIDED INTO TWO GROUPS: group W (Pelvic tilt with wedge under right hip and group L- (15(0)left lateral table tilt) and received spinal anaesthesia. The following parameters were recorded. Heart rate (HR), mean arterial pressure (MAP) at baseline, 2mins, 5 min and then 5 min thereafter. Mean height of block, Total no. of segments blocked, Onset Time of sensory block (in Minutes), ephedrine doses, incidence of hypotension & bradycardia, APGAR score at 1& 5 Minutes. The decrease in MAP was much more in wedged position as compared to table tilt position also the incidence of hypotension was 40% in wedged position as compared to 12% in table tilt position. Mean height of block, Total no. of segments blocked, and boluses of inj. ephedrine used were more in the wedged position than in table tilt position. Wedge placement caused increased incidence of hypotension and higher blockade after spinal anaesthesia as compared to left lateral table tilt position, there was no adverse effects on foetus and patients tolerated wedge better than left lateral table tilt position. Also surgery was easier to perform after wedge placement.


Polyoxygenated 24,28-epoxyergosterols inhibiting the proliferation of glioma cells from sea anemone Anthopleura midori.
Eleven sterols (1-11) and one carotenoid (12) were isolated and identified from sea anemone Anthopleura midori. Compounds 1-6 are rare polyoxygenated ergosterols with a 24,28-epoxy moiety. The structures of these epoxyergosterols were determined by NMR and HRESIMS analyses as well as their chemical-physical properties. Epoxyergosterols 1 and 2 were found to be new natural products and 3-6 are new compounds. Bioactive assay showed that compounds 1, 2, 3, 5, 7, 8, 11, and 12 inhibited the proliferation of rat glioma C6 and human glioma U251 cells with IC50 in a range of 2.41-80.45 μM. Further investigation suggested that 1 and 3 induced apoptosis in glioma cells and 1 blocked U251 cells at the G0/G1 phase.


A case study of a graphical misrepresentation: drawing the wrong conclusions about the measles, mumps and rubella virus vaccine.
Graphs have been used in attempts to show a relationship between the measles, mumps and rubella virus (MMR) vaccine and autism. We examine the topic of graphical representation of data in general, and one of these graphs in particular: the one that appeared in a 1999 letter to The Lancet. That graph combined data from England and from California, USA. The author alleged that this graph illustrated a rise in autism rates linked to the use of the MMR vaccine. By examining the presentation closely, we are able to show how this graph misrepresented the data used. We give advice for both authors and publishers in the use of such graphical treatments of data.


Autoradiography ofCoelopa frigida (Diptera) embryos, after labeling with3H-uridine during various phases of oogenesis.
The distribution of tritiated (3H) uridine or its derivatives in embryos of the kelp flyCoelopa frigida is analyzed by autoradiography. The radioactive label is introduced into the growing oocyte, after injectio into females at different time periods post eclosion. The majority of the label remains in the cytoplasm for the entire embryonic development and is presumably incorporated into stable RNA. Only when the precursor is injected toward the final stages of oogenesis, can presence of label be detected in the nuclei, for a short time period during the blastodern stage. Since no preferential location in nucleoli is found, it appears possible that labeled cytidine could have been derived from the original precursor which would be available for incorporation into DNA.


Characterization and comparison of protein complexes initiated by the intracellular domain of individual Notch paralogs.
The Notch signaling pathway is essential for embryonic development, organogenesis, and tissue homeostasis. Aberrant Notch signaling is associated with several types of cancers. The active form of Notch receptor is its intracellular domain (NICD), which is released from the cell membrane by serial proteolytic cleavages following ligand binding. Dose-dependent effects of NICD on cellular phenotypes have been observed under several conditions although the underlying mechanisms have not been well studied. Moreover, there are four mammalian Notch paralogs that have redundant as well as unique functions. The molecular basis for this variability is also not well understood. In this study, we used size exclusion chromatography to examine the overall distribution of NICD among NICD-containing protein complexes under conditions of increasing NICD abundance. We found that the assembly of NICD protein complexes was dose-dependent and that the abundance of the canonical complex was limited by, MAML, one of the proteins involved in the formation of canonical NICD transactivation complex, which became saturated with increasing NICD abundance. In addition, N4ICD showed a unique elution profile among the four NICDs. These results help to explain the dose-dependent and paralog-specific activities of NICD. These results are informative for the development of new reagents to block Notch signaling for therapeutic benefit.


Increased infarct size and lack of hyperphagic response after focal cerebral ischemia in peroxisome proliferator-activated receptor beta-deficient mice.
Peroxisome proliferator-activated receptors (PPARs) are involved in energy expenditure, regulation of inflammatory processes, and cellular protection in peripheral tissues. Among the different types of PPARs, PPARbeta is the only one to be widely expressed in cortical neurons. Using PPARbeta knockout (KO) mice, we report here a detailed investigation of the role of PPARbeta in cerebral ischemic damage, associated inflammatory and antioxidant processes as well as food intake regulation after middle cerebral artery occlusion (MCAO). The PPARbeta KO mice had a two-fold increase in infarct size compared with wild-type (WT) mice. Brain oxidative stress was dramatically enhanced in these KO mice, as documented by an increased content of malondialdehyde, decreased levels of glutathione and manganese superoxide dismutase, and no induction of uncoupling protein 2 (UCP2) mRNA. Unlike WT mice, PPARbeta KO mice showed a marked increase of prooxidant interferon-gamma but no induction of nerve growth factor and tumor necrosis factor alpha after MCAO. In WT mice, MCAO resulted in inflammation-specific transient hyperphagia from day 3 to day 5 after ischemia, which was associated with an increase in neuropeptide Y (NPY) mRNA. This hyperphagic phase and NPY mRNA induction were not observed in PPARbeta KO mice. Furthermore, our study also suggests for the first time that UCP2 is involved in MCAO food intake response. These data indicate that PPARbeta plays an important role in integrating and regulating central inflammation, antioxidant mechanisms, and food intake after MCAO, and suggest that the use of PPARbeta agonists may be of interest for the prevention of central ischemic damage.


Review of robotics in foregut and bariatric surgery.
In the last decade, the robotic platform has been used in different surgical fields. However, the field of foregut and bariatric surgery is still evolving. Most surgeons still prefer laparoscopic techniques because it has proven clinical benefits, does not require complex setups, and does not have high costs compared with that of robotics. The aim of this article is to review the outcomes of foregut and bariatric surgery and its potential clinical advantages. We performed a search on PUBMED for the most relevant articles published in the field of robotic bariatric and foregut surgery in the last 15 years. More than 40 articles were selected and included on this review. Several systematic reviews were also included. Very few randomized clinical trials are available. For the most part, robotic procedures were associated with better ergonomics for the surgeon, better visualization of the anatomy, easier fine dissection (i.e., lymphadenectomy) when required, and higher costs. In foregut surgery, the robotic system is associated with a significant lower rate of mucosal perforation in Heller myotomy compared to laparoscopy. In bariatric surgery, the clinical advantages have not been well documented yet; however, it seems robotics shortens the learning curve of Roux-en-Y gastric bypass (RYGB). Foregut and bariatric robotic surgery is a surgical field still in development. For the vast majority of the procedures in this area, the clinical outcomes of robotic surgery are the same of standard laparoscopy. However, the use of robots in selected cases may have specific advantages and may overcome the limitations of laparoscopic surgery. More research is needed, especially large and well-designed randomized clinical trials, to elucidate more accurate conclusions.


Hypocalciuric effects of hydrochlorothiazide in the rat during NaHCO3, NaCl and NH4Cl loading.
Hydrochlorothiazide (HCTZ) and NaHCO3 each lower urinary calcium excretion, while NaCl and NH4Cl each increase urinary calcium. This study examines the ability of HCTZ to lower urinary calcium during NaHCO3, NaCl and NH4Cl loading in the rat. We show that HCTZ lowers urinary calcium in rats treated with NaHCO3, NaCl and NH4Cl. We demonstrate that urinary calcium excretion is depressed to a greater degree by administering NaHCO3 and HCTZ in combination than by administering these agents separately.


Federico Delpino and the foundation of plant biology.
In 1867, Federico Delpino, with his seminal work "Pensieri sulla biologia vegetale" (Thoughts on plant biology) established plant biology by defining it not in the broad general sense, namely as the science of living beings, but as a branch of natural science dedicated to the study of plant life in relation to the environment. Today, the figure and achievements of this outstanding plant scientist it is almost unknown. In the following pages, I will concisely describe the main realizations of Federico Delpino and outline the significance of his work for modern plant science.


Influence of daily alcohol consumption on serum adiponectin levels in men.
The risk of cardiovascular diseases is lower among moderate alcohol drinkers than among both nondrinkers and heavy drinkers. However, factors that can account for the U-shaped or J-shaped relationship between daily alcohol consumption and incident cardiovascular diseases remain obscure. The present cross-sectional study investigated the relationship between alcohol consumption and serum adiponectin levels. Total adiponectin was measured in 527 males participating in health check-up programs (age range 40-86 years, mean 60.5 years). Based on questionnaire responses, alcohol intake was categorized into three groups: none or occasional (A1); <50 g/day and ≥3 days/week (A2); and ≥50 g/day and ≥3 days/week (A3). No significant differences in adiponectin levels were observed among the three alcohol consumption groups of subjects without the metabolic syndrome (MetS). In subjects with the MetS, the adiponectin level was significantly higher in the A2 (moderate drinker) group than in both the A1 and A3 groups. MetS subjects in group A2 had higher HDL-C levels than those in A1, but levels in group A3 were not significantly different from those in group A2. An increased adiponectin level in moderate alcohol drinkers who have MetS may contribute to the U-shaped relationship between alcohol consumption and risk of cardiovascular events, in addition to the involvement of HDL-C.


Childhood maltreatment type and severity predict depersonalization and derealization in treatment-seeking women with posttraumatic stress disorder.
The dissociative subtype of posttraumatic stress disorder (D-PTSD) is estimated to occur in approximately 14% of those with posttraumatic stress disorder (PTSD), and is characterized by clinically significant dissociative symptoms in addition to typical PTSD symptoms. Prior research has found childhood maltreatment contributes to dissociation and D-PTSD susceptibility, but more nuanced questions about the nature of childhood maltreatment remain unexplored. We investigated how childhood maltreatment type and severity are associated with the dissociative symptoms of D-PTSD among women with PTSD (N = 106) receiving psychiatric care at a program specializing in trauma-related disorders. Participants completed self-report surveys of psychiatric symptoms and prior trauma exposure including the PTSD Checklist for DSM-5, the Dissociative Subtype of PTSD Scale, and the Childhood Trauma Questionnaire. We used multivariate linear regression to model the association of childhood maltreatment types and dissociation. In our final model childhood emotional abuse and physical abuse significantly predicted the dissociative symptoms of D-PTSD. This suggests childhood maltreatment type and severity, in particular of emotional and physical abuse, are associated with the dissociative symptoms of D-PTSD. This work points toward potential etiological contributions to D-PTSD.


Mesenchymal stem versus stromal cells: International Society for Cell & Gene Therapy (ISCT®) Mesenchymal Stromal Cell committee position statement on nomenclature.
The International Society for Cell & Gene Therapy (ISCT®) Mesenchymal Stromal Cell (ISCT MSC) committee offers a position statement to clarify the nomenclature of mesenchymal stromal cells (MSCs). The ISCT MSC committee continues to support the use of the acronym "MSCs" but recommends this be (i) supplemented by tissue-source origin of the cells, which would highlight tissue-specific properties; (ii) intended as MSCs unless rigorous evidence for stemness exists that can be supported by both in vitro and in vivo data; and (iii) associated with robust matrix of functional assays to demonstrate MSC properties, which are not generically defined but informed by the intended therapeutic mode of actions.


A study of germinal mosaicism inDrosophila melanogaster.
Three-hundred and twenty fertile,pal-induced Y-chromosome mosaic males and females were obtained. Fractional analysis of the sons of 55 somatically mosaic flies that were also germinally mosaic tentatively suggests that the number of functional primordial germ cells inDrosophila melanogaster is variable and that it is seldom greater than 24. From the observed 0.17 frequency of germinal mosaicism it was estimated that the average number of pole cells at the end of blastoderm formation is 45. At present, the germ cells afford the only opportunity to compare genetic estimates of the number of blastoderm or primordial cells with available histological counts. The good agreement between them suggests that both the fractional and the mosaic frequency methods for estimating primordial or blastoderm cell numbers of various larval and imaginal anatomical structures provide reasonably close approximations of the actual values.


The hairlet follicle in the skin of the wild Norway rat (Rattus norvegicus Berkenhout, 1769). Its morphology and function.
The hairlet follicle of the wild Norway rat (Rattus norvegicus Berkenhout 1769) differs from the other follicles in position and in structural characteristics. As an element of the guard (tylotrich) hair follicle group the hairlet follicles are arranged at the margin of the hair disk. The hairlet follicle, which produces the finest hair fibre, is enclosed by an active unilobular sebaceous gland. The arrector pili muscle is absent, but the follicle does have a supply of lanceolate nerve endings and Ruffini endings. The axons of the lanceolate endings are enclosed sandwich-like by Schwann cells and contact the basal lamina of the outer epithelial root sheath. Ruffini endings run within the band of connective tissue fibres that girdle the follicle at the level of the sebaceous gland. The appropriate stimulus for excitation of the nerve fibres can not be achieved by bending the tiny hairlet fibre. Tissue compression, induced by bending the central guard (tylotrich) hair, which is transformed via the sebaceous gland and the slim outer epithelial root sheath, may exicite the nerves of the hairlet follicle. It can be assumed that the hairlet follicle functions as a mechanoreceptor.


Topographic Filtering of Tractograms as Vector Field Flows.
While diffusion MRI (dMRI) is currently the most widely used in vivo imaging tool for studying brain connectivity, the biological validity of the tractography techniques based on dMRI is often debated. The wide presence of topographic regularity in various brain circuits provides a unique opportunity to examine and improve the reliability of tractography results. In this work, we develop a novel framework for the analysis of the topographic regularity of brain connectivity generated by modern FOD-based tractography techniques. Our method is based on the consistency between the mathematical property of smooth vector field flows and topographically regular fiber tracts. The main idea of our method is that we compute a principal vector field (PVF) for a given tractogram from the FODs by solving a Markov Random Field problem. By quantifying the consistency between each tract and the PVF, we develop a Vector Flow Deviation (VFD) measure and apply it to filter out topographically irregular tracts. In our experiments, we successfully applied our method to remove irregular fiber tracts in two fiber bundles with known connectopy: the visual pathway and the colossal motor pathway, which were reconstructed from the multi-shell diffusion imaging data of the Human Connectome Project (HCP). We also performed quantitative evaluation based on a G2SD distance proposed in previous work to quantitatively demonstrate the effectiveness of our filtering method.


Physical Activity Interventions for Colorectal Cancer Survivors: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Physical activity (PA) has been shown to improve total mortality and colorectal-specific mortality risk; however, colorectal cancer (CRC) survivors have lower rates of PA compared with survivors with other types of cancers. To examine the effect of PA interventions on CRC survivors. A systematic review and meta-analysis were conducted to identify randomized controlled trials that met the inclusion criteria, which included an intervention designed to increase PA and more than 1 outcome of interest. Random effects of the meta-analyses were performed using Review Manager 5.3. Eight publications representing 7 randomized controlled trials of 803 participants were identified. All studies used a combination of behavioral change methods. Physical activity interventions significantly improved disease-specific quality of life, PA level, and maximum amount of oxygen and did not show significant improvements for fatigue and body mass index among CRC survivors. We provided evidence that PA interventions were effective in improving disease-specific quality of life, PA level, and maximum amount of oxygen; however, they did not improve fatigue and body mass index. Further randomized controlled trials are needed to determine the optimal mode of delivering PA intervention for CRC survivors. As the survival rate of patients with CRC increases, survivors of CRC need to increase PA in a community setting after completing primary treatments. Effective and efficient modes of PA intervention delivery could improve health-related outcomes and address specific barriers for CRC survivors.


The ultrastructure of the uterine epithelium of the pig during the estrous cycle and early pregnancy.
The ultrastructure of the endometrial epithelium of the pig was studied during the estrous cycle and early pregnancy up to implantation. Special attention was given to the luminal epithelium and morphological indications of protein synthesis. Although the general morphology of the luminal and glandular epithelia is similar (both tissues consist of secretory cells and ciliated cells at all the stages studied), it appears that the two epithelia should be considered as two functionally different units in the pre-implantation period. Morphological evidence suggests the presence of at least three different secretory products within luminal epithelial cells; they are released at different times, i.e. at estrus, between day 8 and 10 and after day 11. The glandular epithelium shows release of secretory products from day 10-11. Increasing amounts of glycogen were found within epithelial cells, especially in pregnant gilts from day 12. The possible significance of secretory activity of the epithelium is discussed in relation to the development of the embryos.


Pulmonary Valve Replacement and Redo Pulmonary Valve Replacement via Ministernotomy.
Minimally invasive cardiac surgery is mainly dedicated to acquired left-sided valve diseases. Ministernotomy is widely used for aortic valve repair or replacement, whereas pulmonary valve repair via this approach has been reported only recently. This article aims to describe the use of ministernotomy for pulmonary valve replacement in adult congenital patients.


[Immunological responsiveness in C57BL/6 mice during the growth of a tumoural graft: the Lewis' lung carcinoma (author's transl)].
Using antibody and delayed type hypersensitivity responses to sheep red blood cells, immunological responsiveness was studied during the course of 3LL tumor growth. Acquired specific resistance to Listeria monocytogenes of tumor bearing mice was also investigated. Experimental results obtained, showed that the ability of 3LL bearing mice to establish a specific immune response is not markedly impaired.


Does the "delayed start" protocol with gonadotropin-releasing hormone antagonist improve the pregnancy outcome in Bologna poor responders? a randomized clinical trial.
Recently, a novel approach with delaying the start of controlled ovarian stimulation along with gonadotropin-releasing hormone (GnRH) antagonist pretreatment for 7 days after estrogen priming for further suppression of endogenous follicle stimulating hormone (FSH) during the early follicular phase, resulting in more FSH-responsive follicles and thus improving synchronous follicular development was introduced. Two clinical trials have examined this strategy and reported controversial results. This study aimed to compare the effect of delayed-start GnRH antagonist protocol and standard GnRH antagonist in patients with poor ovarian response (POR) undergoing in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI). This randomized clinical trial was conducted at infertility department of Royan Institute from January 2017 to June 2018. Poor ovarian response was defined according to the Bologna criteria. The eligible women were randomly allocated into an experimental and control groups. In experimental group, patients received delayed-start GnRH antagonist protocol with estrogen priming followed by early follicular-phase GnRH antagonist treatment for 7 days before ovarian stimulation with gonadotropin and in control group, patients treated with estrogen priming antagonist protocol. IVF/ICSI outcomes were compared between groups. Among all the 250 patients examined 156 women were eligible for study and finally 120 patients were allocated to intervention (n = 60) and control (n = 60) groups. Demographic characteristics and hormonal profiles of the patients did not differ between groups. The statistical analysis showed that there were significant differences between groups regarding the total dose of used gonadotropins (P < 0.001), stimulation duration (P < 0.001), number of retrieved oocytes (P = 0.01) and top quality embryo (P < 0.001) and also cancellation (P = 0.002) and fertilization rates (P = 0.002). On the basis of present results the delayed-start protocol in poor responders can improve the fertilization rate and quality of embryos and reduce the cycle cancellation but have no significant effect on clinical pregnancy rate; however, larger randomized clinical trials are required to compare it with other protocols. NCT, NCT03134690. Registered 1 May 2017 - Retrospectively registered, http://www.clinicaltrial.gov / NCT03134690.


Biogeochemical dynamics of particulate organic phosphorus and its potential environmental implication in a typical "algae-type" eutrophic lake.
Organic phosphorus (Po) plays a very important role in the process of lake eutrophication, but there is still a lack of knowledge about the internal cycle of Po in suspended particulate matter (SPM) dominated by algal debris. In this study, the characterization of bioavailable Po by sequential extraction and enzymatic hydrolysis showed that 45% of extracted TP was Po in SPM of Lake Dianchi, and 43-98% of total Po in H2O, NaHCO3 and NaOH fractions was enzymatically hydrolyzable Po (EHP, H2O-EHP: 31-53%). Importantly, labile monoester P was the main organic form (68%) of EHP, and its potential bioavailability was higher than that of diester P and phytate-like P. According to the estimation of P pools in SPM of the whole lake, the total load of Pi plus EHP in the H2O extract of SPM was 74.9 t and had great potential risk to enhance eutrophication in the lake water environment. Accordingly, reducing the amount of SPM in the water during the algal blooming period is likely to be a necessary measure that can successfully interfere with or block the continuous stress of unhealthy levels of P on the aquatic ecosystem.


General and Disease-Specific Health Indicator Changes Associated with Inpatient Rehabilitation.
Rehabilitation plays a vital role in the mitigation and improvement of functional limitations associated with aging and chronic conditions. Moderating factors such as sex, age, the medical diagnosis, and rehabilitation timing for admission status, as well as the expected change related to inpatient rehabilitation, are examined to provide a valid basis for the routine assessment of the quality of medical outcomes. An observational study was carried out, placing a focus on general and disease-specific health measurements, to assess representative results of multidisciplinary inpatient rehabilitation. Aspects that were possibly confounding and introduced bias were controlled based on data from a quasi-experimental (waiting) control group. Existing data or general health indicators were extracted from medical records. The indicators included blood pressure, resting heart rate, self-assessed health, and pain, as well as more disease-specific indicators of physical function and performance (eg, activities of daily living, walking tests, blood lipids). These are used to identify moderating factors related to health outcomes. A standardized collection of routine data from 16,966 patients [61.5 ± 12.5 years; 7871 (46%) women, 9095 (54%) men] with different medical diagnoses before and after rehabilitation were summarized using a descriptive evaluation in terms of a content and factor analysis. Without rehabilitation, general health indicators did not improve independently and remained stable at best [odds ratio (OR) = 0.74], whereas disease-specific indicators improved noticeably after surgery (OR = 3.20). Inpatient rehabilitation was shown to reduce the risk factors associated with certain lifestyles, optimize organ function, and improve well-being in most patients (>70%; cutoff: z-difference >0.20), with a standardized mean difference (SMD) seen in overall medical quality outcome of -0.48 ± 0.37 [pre- vs post-rehabilitation: ηp2 = 0.622; dCohen = -1.22; 95% confidence interval (95% CI) -1.24 to -1.19]. The baseline medical values obtained at the beginning of rehabilitation were influenced by indication, age, and sex (all P < .001); however, these factors have less significant effects on improvements in general health indicators (ηp2 < 0.01). According to the disease-specific results, the greatest improvements were found in older patients (SMD for patients >60 vs ≤60 years: 95% CI 0.08-0.11) and during the early rehabilitation stage (ηp2 = 0.063). Compared with those who received no inpatient rehabilitation, patients who received rehabilitation showed greater improvements in 2 independent areas, general and disease-specific health measures, regardless of their diagnosis, age, and sex. Due to the study design and the use of a nonrandomized waiting group, causal conclusions must be drawn with caution. However, the comparability and stability of the presented results strongly support the validity of the observed improvements associated with inpatient rehabilitation.


[Long-time survival after experimental lung homotransplantation (author's transl)].
Haemodynamic and respiratory function tests were carried out in a dog submitted to left-sided lung homotransplantation. It was observed that successful immunosuppressive therapy enabled the graft to maintain adequate function for the entire 28-month period of observation.


Emerging Role of Circular RNAs in Kidney Diseases in Nephrology.
Circular RNAs (circRNAs) have been identified to be involved in a variety of human diseases such as cancers, cardiovascular diseases, and autoimmune diseases. In recent years, the role of circRNAs in the development of kidney diseases in nephrology has been gradually recognized. We updated and described the current status of circRNAs in kidney diseases in nephrology. We particularly focused on the roles and mechanisms of circRNAs in systemic lupus erythematosus and lupus nephritis. We summarized recent reports published on PubMed, Web of Science, Scopus, Scielo databases using keywords circRNAs, kidney diseases or renal diseases, or systemic lupus erythematosus. Studies of circRNAs in certain kidney diseases, such as acute kidney injury, focal segmental glomerulosclerosis, idiopathic membranous nephropathy, IgA nephropathy, diabetic nephropathy, hypertensive renal damage, and particular lupus nephritis address the function and pathogenesis of circRNAs. Mechanisms of circRNAs in the above human kidney diseases so far have focused on the role of sponging microRNAs and regulating the expression of target genes. Moreover, circRNAs have been detected in blood, urine, and kidney tissue samples. These results suggest that circRNAs can serve as biomarkers for the diagnosis and monitoring of the progression of kidney diseases. CircRNAs play important roles in the pathogenesis, diagnosis, and treatment of kidney diseases emphasizing lupus nephritis in nephrology.


High-performance liquid chromatographic analysis of pulmonary metabolites of Leu- and Met-enkephalins in isolated perfused rat lung.
A high-performance liquid radiochromatographic analytical system has been developed which allows the determination of [3H]Leuenkephalin, [3H]Met-enkephalin and their potential metabolites [3H]TyrGlyGlyPhe, [3H]TyrGlyGly, [3H]TyrGly and [3H]tyrosine. Using this procedure, the biotransformation of each of the above enkephalins after 20 min of recirculating transit through isolated perfused rat lungs resulted in the formation of two major metabolites: tyrosine and TyrGlyGly in each case. The results indicate that significant metabolism of enkephalins may occur in the pulmonary circulation.