Iridoidal glucosides from Gentiana rhodantha.
Six new iridoidal glucosides, 2'-O-(3''-hydroxybenzoyl)-8-epikingiside (1), 2'-O-(3''-hydroxybenzoyl)-kingiside (2), 6'-O-p-coumaroyl-8-epikingiside (3), loganic acid 11-O-beta-glucopyranosyl ester (4), 6'-O-beta-glucopyranosyl secologanoside (5), and 6'-O-beta-glucopyranosyl secologanol (6), together with seven known iridoidal glucosides, loganic acid (7), 6'-O-beta-d-glucopyranosyl loganic acid (8), 8-epikingiside (9), kingiside (10), secologanoside (11), secoxyloganin (12), and alpigenoside (13), were isolated from the whole plant of Gentiana rhodantha (Gentianaceae). Their structures were elucidated by detailed spectroscopic analysis and chemical methods.


Curcumin nanoparticles: physico-chemical fabrication and its in vitro efficacy against human pathogens.
Curcumin is one of the polyphenols, which has been known for its medicinal use since long time. Curcumin shows poor solubility and low absorption, and therefore, its use as nanoparticles is beneficial due to their greater solubility and absorption. The main aim of the present study was the formation of curcumin nanoparticles (Nano curcu), evaluation of their antibacterial activity against human pathogenic bacteria and formulation of Nano curcu-based cream. We synthesized Nano curcu by sonication method. The synthesis of Nano curcu was assessed for their solubility in water and by UV-visible spectrophotometry. Further, the nanoparticles were characterized by Fourier transform infrared spectroscopy, transmission electron microscopy, nanoparticle tracking and analysis, and zeta potential analysis. In vitro antibacterial activity of Nano curcu was evaluated against Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. The cream containing Nano curcu was found to be effective against human bacterial pathogens and hence can be used for treatment of bacterial diseases.


Chronic lung disease in the sleep apnea syndrome.
Several well controlled epidemiologic and hemodynamic studies suggest that about 20% of sleep apnea syndrome (SAS) patients will have chronic obstructive pulmonary disease (COPD), and the majority of these patients (with combined diseases) will have pulmonary hypertension. Indeed it has been suggested that only patients with underlying hypoxemia, such as that from COPD, will develop right heart failure in the OSA setting. Experience shows that apnea/COPD patients will have severe hypersomnolence associated with the OSA, cough and dyspnea with the airways disease, and edema and plethora related to chronic hypoxemia. Many patients present with respiratory failure and are diagnosed at the time of initial intubation and mechanical ventilation. Episodic nocturnal hypoxemia may be worsened by a steeper rate of desaturation due to lower alveolar and blood oxygen stores, and longer apneas perhaps contributed to by depressed chemosensitivity. Daytime hypoxemia may also add to the severe hemodynamic disturbances. Since COPD cannot be cured, aggressive treatment of SAS is critical. Past studies have shown that tracheostomy or nasal CPAP in this setting not only leads to resolution of episodic nocturnal desaturation but may lead to rapid improvement in daytime oxygenation in many patients. Pulmonary hypertension and other measures of cardiopulmonary function improve when apnea is cured. Elimination of the SAS may disclose nonapneic REM related desaturation that could require supplemental oxygen therapy in addition to tracheostomy or nasal CPAP. Pulmonary function testing in SAS patients with smoking histories, followed by aggressive treatment of SAS, is recommended.


Diphtheria in Pakistan post-COVID-19, a potential public health threat: an update.
Diphtheria, a vaccine-preventable disease, remains a concern in Pakistan as cases have risen post-COVID-19 pandemic causing more than 45 deaths in Pakistan in the year 2022. The respiratory variant of the disease is more common and can lead to serious complications, such as myocarditis and respiratory insufficiency. Diphtheria has caused havoc in the past killing millions of people worldwide before the development of its vaccine. Although the diphtheria toxoid vaccine is effective against toxigenic strains, there have been cases of treatment-resistant strains, particularly the non-toxigenic strains of C. diphtheriae. Pakistan's economic and health systems have suffered setbacks, which have been exacerbated by the COVID-19 pandemic. The pandemic has disrupted routine vaccination programs, and recent floods have contributed to an increase in diphtheria cases and rendered millions homeless. Poor immunization services, inadequate training of vaccination teams, and wealth inequality have all contributed to unequal vaccination coverage in Pakistan. The rising cases of diphtheria call for prompt action, including booster shots, updating vaccination records and administering immediate doses of the toxoid to close contacts.


Effect of moisture level on nitrogen immobilization as affected by wheat straw decomposition in soil.
Samples of a slightly degraded chernozem soil were amended with 2 per cent of wheat straw at three moisture levels (10, 20, and 30 per cent) and were provided with 160, 240, and 400 ppm of ammoniacal nitrogen. Amounts of total, ammonia, and nitrate were determined at different periods of incubation at 28 degrees C and immobilization of the total available nitrogen in the soil was calculated. Substantial amounts of the added nitrogen were immobilized in the soil as a result of the straw decomposition during the first month of incubation. The amount of inorganic nitrogen (NH4 + -N + NO3 - -N), bound within 75 days of incubation, was almost three times less than that immobilized within 30 days. Maximum quantity of nitrogen was immobilized at 30 and 20 per cent moisture levels at 30 and 75 days of incubation, respectively. Minimum immobilization was observed at 10 per cent moisture at almost all levels of nitrogen. The absolute amount of nitrogen immobilized increased in proportion to the quantity of nitrogen added, but the relative immobilization tended to decrease with the increased inorganic nitrogen the soil.


A versatile shear and compression apparatus for mechanical stimulation of tissue culture explants.
We have developed an incubator housed, biaxial-tissue-loading device capable of applying axial deformations as small as 1 microm and sinusoidal rotations as small as 0.01 degrees. Axial resolution is 50 nm for applying sinewaves as low as 10 microm (or 1% based on a 1 mm thickness) or as large as 100 microm. Rotational resolution is 0.0005 degrees. The machine is small enough (30 cm high x 25 cm x 20 cm) to be placed in a standard incubator for long-term tissue culture loading studies. In metabolic studies described here, application of sinusoidal macroscopic shear deformation to articular cartilage explants resulted in a significant increase in the synthesis of proteoglycan and proteins (uptake of (35)S-sulfate and (3)H-proline) over controls held at the same static offset compression.


The impacts of social interaction-based factors on household waste-related behaviors.
With the economy growing rapidly, as well as the increasing diversification of human material and cultural needs, waste management poses a pressing challenge for local authorities in China. The primary aim of the present study is to examine the determinants of household waste-related behaviors, especially focusing on the roles of two important social interaction-based factors, social norms and networks, and their combinations. Specifically, this paper adopted the method of principal component analysis to capture social interactions and leveraged ordered logit models to explore their influences on the behaviors involving waste sorting, bringing their own shopping bags and reusing plastic bags in other aspects. Using the data from the Chinese General Social Survey in 2013 (CGSS2013), the results reveal that both social norms and social networks exert a significant positive influence on pure altruistic waste sorting while only social norms are positively associated with bringing their own shopping bags to store and reusing bags in other aspects with the nature of impure altruism. Meanwhile, there is no convincing evidence for the interaction effect between social norms and social networks on waste sorting, yet the interaction item does work together negatively influencing bringing their own bags and reusing bags behaviors. Moreover, the results show that social norms have a much larger effect on waste-related behaviors in males than females while social networks lead to significant promotion in waste sorting only for females. For people with higher education levels, the impacts of social norms and social networks on waste sorting and bringing their own bags behaviors are insignificant, while the higher income groups are weakly affected by social networks as well, partly because of time constraints and opportunity cost. Lastly, this paper provides new insight into waste management from the perspective of social interaction.


Randomized trial of combined triple therapy comprising two types of peginterferon with simeprevir in patients with hepatitis C virus genotype 1b.
Simeprevir (SMV) is a potent, macrocyclic hepatitis C virus (HCV) non-structural 3/4 A protease inhibitor. This prospective study compared the efficacy and safety of SMV in combination with peginterferon α2a + ribavirin (P2aR) and with peginterferon α2b + ribavirin (P2bR) in Japanese patients with HCV genotype 1b infection. Hepatitis C virus genotype 1b patients were randomly assigned to receive SMV (100 mg QD) with P2aR for 12 weeks, then P2aR alone for 12 or 36 weeks; or SMV (100 mg QD) with P2bR for 12 weeks, then P2bR alone for 12 or 36 weeks. The primary endpoint was a sustained virologic response 24 weeks after completing treatment (SVR24). In total, 151 patients were randomly assigned to the P2aR (n = 76) or P2bR group (n = 75). Six patients dropped out. Sustained virologic response 24 weeks after completing treatment was achieved in 55 (75.3%) of 73 P2aR patients and 55 (76.4%) of 72 P2bR patients. There was no difference in the rate of SVR24 between the two groups (P = 0.88). No differences in the proportion of patients who became HCV RNA-negative were detected between the P2aR and P2bR groups. The two groups had comparable numbers of adverse events, which led to the discontinuation of treatment in 9.6% and 8.3% of participants in the P2aR and P2bR groups, respectively. Peginterferon α2a or α2b in combination with SMV + ribavirin therapy showed identical antiviral effects in patients with chronic hepatitis C. Also, the incidence of adverse events was identical for both regimens.


Mortality in patients with Cushing's disease more than 10 years after remission: a multicentre, multinational, retrospective cohort study.
No agreement has been reached on the long-term survival prospects for patients with Cushing's disease. We studied life expectancy in patients who had received curative treatment and whose hypercortisolism remained in remission for more than 10 years, and identified factors determining their survival. We did a multicentre, multinational, retrospective cohort study using individual case records from specialist referral centres in the UK, Denmark, the Netherlands, and New Zealand. Inclusion criteria for participants, who had all been in studies reported previously in peer-reviewed publications, were diagnosis and treatment of Cushing's disease, being cured of hypercortisolism for a minimum of 10 years at study entry, and continuing to be cured with no relapses until the database was frozen or death. We identified the number and type of treatments used to achieve cure, and used mortality as our primary endpoint. We compared mortality rates between patients with Cushing's disease and the general population, and expressed them as standardised mortality ratios (SMRs). We analysed survival data with multivariate analysis (Cox regression) with no corrections for multiple testing. The census dates on which the data were frozen ranged from Dec 31, 2009, to Dec 1, 2014. We obtained data for 320 patients with 3790 person-years of follow-up from 10 years after cure (female:male ratio of 3:1). The median patient follow-up was 11·8 years (IQR 17-26) from study entry and did not differ between countries. There were no significant differences in demographic characteristics, duration of follow-up, comorbidities, treatment number, or type of treatment between women and men, so we pooled data from both sexes for survival analysis. 51 (16%) of the cohort died during follow-up from study entry (10 years after cure). Median survival from study entry was similar for women (31 years; IQR 19-38) and men (28 years; 24-42), and about 40 years (IQR 30-48) from remission. The overall SMR for all-cause mortality was 1·61 (95% CI 1·23-2·12; p=0·0001). The SMR for circulatory disease was increased at 2·72 (1·88-3·95; p<0·0001), but deaths from cancer were not higher than expected (0·79, 0·41-1·51). Presence of diabetes, but not hypertension, was an independent risk factor for mortality (hazard ratio 2·82, 95% CI 1·29-6·17; p=0·0095). We noted a step-wise reduction in survival with increasing number of treatments. Patients cured by pituitary surgery alone had long-term survival similar to that of the general population (SMR 0·95, 95% CI 0·58-1·55) compared with those who were not (2·53, 1·82-3·53; p<0·0001). Patients with Cushing's disease who have been in remission for more than 10 years are at increased risk of overall mortality compared with the general population, particularly from circulatory disease. However, median survival from cure is excellent at about 40 years of remission. Treatment complexity and an increased number of treatments, reflecting disease that is more difficult to control, appears to negatively affect survival. Pituitary surgery alone is the preferred treatment to secure an optimum outcome, and should be done in a centre of surgical excellence. None.


Effect of High-Hydrostatic-Pressure Processing and Storage Temperature on Sliced Iberian Dry-Cured Sausage ("Salchichón") from Pigs Reared in Montanera System.
The top-quality "salchichón" (a fermented dry-cured sausage) is manufactured from Iberian pigs reared outdoors. This work aims to evaluate the effect of hydrostatic high pressure (HHP) and storage temperature on sliced vacuum-packaged top-quality Iberian "salchichón". Two types of "salchichón" (S1 and S2, manufactured at different companies) were processed at 600 MPa for 8 min and stored at 4 and 20 °C for 180 days. Microbiological, physicochemical, and sensory changes were evaluated. Microbiological counts were reduced by HHP treatment and also generally decreased during storage at both temperatures. Lightness and redness of slices decreased during storage at 20 °C, while yellowness values increased. Changes in color were also observed in sensory analysis of the dry-cured sausages. HHP increased lipid and protein oxidation values in S1, whereas protein oxidation increased at 20 °C in S2. S1 was more affected by HHP while S2 was more affected by the temperature of storage. Therefore, despite both products belonging to the same commercial category, slight differences in the composition of both products and/or differences in packaging determined a different behavior after HHP treatment and during storage at different temperatures.


In vitro sorption and desorption of basic fibroblast growth factor from biodegradable hydrogels.
In vitro interaction of basic fibroblast growth factor (bFGF) with biodegradable gelatin hydrogels was investigated, focusing on its sorption into the hydrogels and desorption from them. Basic bFGF was sorbed to the hydrogel of acidic gelatin with an isoelectric point (IEP) of 5.0 over time at 4 degrees C, in contrast to that of basic gelatin with an IEP of 9.0 and type I collagen. The bFGF sorption was almost independent of the sorption temperature except for 4 degrees C and the hydrogel water content. Fluorescent microscopic observation revealed that bFGF was sorbed into the interior of the acidic gelatin hydrogel. The binding molar ratio of bFGF to the acidic gelatin was around 1.0. The bFGF sorption to the acidic gelatin hydrogel increased when gelatin was further carboxylated. bFGF was sorbed into the acidic gelatin hydrogel more slowly than into the poly(acrylic acid) (PAAc) hydrogel, probably because of the lower density of negative charge of gelatin. The bFGF sorption decreased with an increase in solution ionic strength, indicating that an electrostatic interaction was the main driving force for bFGF sorption to the acidic gelatin hydrogel. However, even at higher ionic strengths of solution, the sorbed bFGF was not desorbed from the acidic gelatin hydrogel, in contrast to the PAAc hydrogel.


Precursors of glutamic acid nitrogen in primary neuronal cultures: studies with 15N.
We utilized gas chromatography-mass spectrometry to study the transfer of 15N from [2-15N]glutamine, [15N]leucine, [15N]alanine, or 15NH4Cl to [15N]glutamate and [15N]aspartate in cultured cerebrocortical GABA-ergic neurons from the mouse. Initial rates of 15N appearance (atom % excess) were somewhat higher with 2mM [2-15N]glutamine as a precursor than with 1mM [15N]leucine or 1mM [15N]alanine, but initial net formation (nmol [15N]glutamate/mg protein.min-1) was roughly comparable with all precursors. At steady-state 15N labeling was about two times greater with 2mM [2-15N]glutamine as precursor. The subsequent transfer of 15N from glutamate to aspartate was extremely rapid, the labelling pattern of these two amino acid pools being virtually indistinguishable. We observed little reductive amination of 2-oxo-glutarate to yield [15N]glutamate in the presence of 0.3mM 15NH4Cl. Reductive amination through glutamate dehydrogenase was much more prominent at a concentration of 3.0mM 15NH4Cl. Glutamate formation via reductive amination was unaffected by inclusion of 1mM 2-oxo-glutarate in the incubation medium. These results indicate that glutamate synthesis in cultured GABA-ergic neurons is derived not only from the glutaminase reaction, but also from transamination reactions in which both leucine and alanine are efficient N donors. Reductive amination of 2-oxo-glutarate in the glutamate dehydrogenase pathway plays a relatively minor role at lower concentrations of extracellular ammonia but becomes quite active at 3mM ammonia.


Coxsackievirus induced myocarditis in mice: cardiac myosin autoantibodies do not cross-react with the virus.
After infection with Coxsackievirus B3 (CB3), H-2 congenic strains of mice on an A-background develop an immunologically mediated myocarditis associated with autoantibodies directed mainly against cardiac myosin. We tested these autoantibodies for cross-reactivity with the virus. Using immunoblotting and virus neutralizing assays with affinity purified antibodies and absorbed sera, we found that the autoantibodies to heart myosin did not cross react with CB3. In addition, myosin autoantibodies induced by immunization with cardiac myosin did not react with the virus. Western immunoblotting revealed that the anti-CB3 antibodies in the infected mice are directed against the capsid protein VP 2. We conclude that CB3 antigens do not stimulate an immune response that cross-reacts with cardiac myosin.


Extracellular ATP and Macropinocytosis: Their Interactive and Mutually Supportive Roles in Cell Growth, Drug Resistance, and EMT in Cancer.
Macropinocytosis is one of the major mechanisms by which cancer cells uptake extracellular nutrients from tumor microenvironment (TME) and plays very important roles in various steps of tumorigenesis. We previously reported the unexpected finding that intratumoral and extracellular ATP (eATP), as one of the major drastically upregulated extracellular nutrients and messengers in tumors, is taken up by cancer cells through macropinocytosis in large quantities and significantly contributing to cancer cell growth, survival, and increased resistance to chemo and target drugs. Inhibition of macropinocytosis substantially reduced eATP uptake by cancer cells and slowed down tumor growth in vivo. More recently, we have found the eATP also plays a very important role in inducing epithelial-to-mesenchymal transition (EMT), and that macropinocytosis is an essential facilitator in the induction. Thus, macropinocytosis and eATP, working in coordination, appear to play some previously unrecognized but very important roles in EMT and metastasis. As a result, they are likely to be interactive and communicative with each other, regulating each other's activity for various needs of host tumor cells. They are also likely to be an integral part of the future new anticancer therapeutic strategies. Moreover, it is undoubted that we have not identified all the important activities coordinated by ATP and macropinocytosis. This review describes our findings in how eATP and macropinocytosis work together to promote cancer cell growth, resistance, and EMT. We also list scientific challenges facing eATP research and propose to target macropinocytosis and eATP to reduce drug resistance and slow down metastasis.


Electrochemical genosensor array for the simultaneous detection of multiple high-risk human papillomavirus sequences in clinical samples.
An electrochemical genosensor array for the simultaneous detection of three high-risk human papillomavirus (HPV) DNA sequences, HPV16, 18 and 45, exhibiting high sensitivity and selectivity is presented. The electrodes of a 4×4 array were modified via co-immobilization of a 1:100 (mol/mol) mixture of a thiolated probe and an oligoethyleneglycol-terminated bipodal thiol. Detection of synthetic and PCR products was carried out in a sandwich type format, with the target hybridized between a surface immobilized probe and a horseradish peroxidase-labelled secondary reporter probe. The detection limits obtained in the detection of each individual target were in the pM range, allowing the application of this sensor for the detection of samples obtained from PCR amplification of cervical scrape samples. The results obtained exhibited an excellent correlation with the HPV genotyping carried out within a hospital laboratory. Multiplexing and cross-reactivity studies demonstrated high selectivity over potential interfering sequences, facilitating application of the developed platform for the high-throughput screening of multiple high-risk DNA sequences.


Peculiarities of Cell Seeding on Electroformed Polycaprolactone Scaffolds Modified with Surface-Active Agents Triton X-100 and Polyvinylpyrrolidone.
We compared the capability of human fibroblasts to populate porous polycaprolactone (PCL) scaffolds modified during fabrication with surface-active agents Triton Х-100 (type 1 scaffold) and polyvinylpyrrolidone (type 2 scaffold). The mean fiber diameter in both scaffolds was almost the same: 3.90±2.19 and 2.46±2.15 μ, respectively. Type 1 scaffold had higher surface density and hydrophilicity, when type 2 scaffold was 1.6 times thicker. The cells were seeded on the scaffolds by the dynamic seeding technique and then cultured in Petri dishes with nutrient medium in a humid atmosphere. During 3-day culturing, no cell release from the matrix was noted. DAPI staining proved the presence of cells in both scaffolds. However, in type 1 scaffold the cells populated the whole thickness, while in type 2 scaffold, the cells were present only in the superficial layer. These findings suggest that PCL scaffolds modified with Triton Х-100 or polyvinylpyrrolidone are not cytotoxic, but the structure of the scaffold treated with Triton Х-100 is more favorable for population with cells.


Model based optimization of the intermittent aeration profile for SBRs under partial nitrification.
In this paper, a fast and accurate optimization framework is proposed to compute optimal aeration policies in SBR processes under partial nitrification. The optimization framework aims to determine an optimal intermittent aeration profile which minimizes both the operation time of the SBR cycle and the energy required for aeration. Special consideration is given to the fact that the results not only need to be accurate but also to converge within a short time. Moreover, methods to avoid nitrate formation are analyzed and implemented. It is demonstrated that the implementation of a nonlinear model "5-state" and the reduction of the optimization problem to three control variables are the keystones to an efficient solution strategy which achieves fast, robust, and accurate computation of the optimal intermittent aeration profile for any given conditions of the process. The optimization approach is so efficient that it can also be implemented with more complex models such as the ASM3 extended for a two-step nitrification-denitrification process.


Drug-mediated thrombocytopenia.
Thrombocytopenia due to drug-dependent antibodies most frequently occurs with quinine/quinidine and with heparin. Considerable evidence has accumulated about the mechanism of action of quinine/quinidine-induced antibodies but less is known about the effect of heparin. Although there is controversy, it is likely that the action of quinine/quinidine-induced antibodies follows a loose association between drug and platelet with antibodies acting independently of the Fc receptor. There is strong evidence that the complex of glycoprotein Ib and glycoprotein IX, absent in the Bernard-Soulier syndrome, provides the binding site for quinine/quinidine-dependent antibodies. It also appears that the two glycoproteins must be present in complex form for antibody binding to occur. There is some heterogeneity of quinine/quinidine-dependent antibodies since there are reports of a proportion of patient antibodies reacting with other membrane determinants or acting independently of the drug. Heparin-induced thrombocytopenia may be the consequence of a direct effect, or a more serious condition associated with thrombosis may occur when heparin-dependent antibodies are formed. The mode of action of these antibodies and the nature of their antigenic determinants remain unclear. Recognition of heparin-associated thrombocytopenia is important so that serious bleeding or thrombotic sequelae can be forestalled.


Carbohydrate-binding activity of the type-2 ribosome-inactivating protein SNA-I from elderberry (Sambucus nigra) is a determining factor for its insecticidal activity.
In recent years, different classes of proteins have been reported to promote toxic effects when ingested. Type-2 ribosome-inactivating proteins (RIPs) are a group of chimeric proteins built up of an A-chain with RNA N-glycosidase activity and a B-chain with lectin activity. These proteins are thought to play a role in plant protection. Sambucus nigra agglutinin I (SNA-I) is a type-2 RIP, isolated from the bark of elderberry (S. nigra L.). This study demonstrated the insecticidal potency of SNA-I on two Hemipteran insect species using two different methods. An artificial diet supplemented with different concentrations of the purified RIP reduced survival and fecundity of pea aphids Acyrthosiphon pisum. In addition, feeding of tobacco aphids, Myzus nicotianae, on leaves from transfected plants constitutively expressing SNA-I, resulted in a delayed development and reduced adult survival and also the fertility parameters of the surviving aphids were reduced, suggesting that a population of aphids would build up significantly slower on plants expressing SNA-I. Finally, a series of experiments with transgenic lines in which a mutant RIP was expressed, revealed that the carbohydrate-binding activity of SNA-I is necessary for its insecticidal activity. In a first set of mutants, the B-chain was mutated at one position (Asp231DeltaGlu), and in the second set both carbohydrate-binding sites were mutated (Asn48DeltaSer and Asp231DeltaGlu). Mutation of one carbohydrate-binding site strongly reduced the insecticidal activity of SNA-I, whereas mutation of both lectin sites (almost) completely abolished the SNA-I effect on tobacco aphids.


Current progress in artificial intelligence-assisted medical image analysis for chronic kidney disease: A literature review.
Chronic kidney disease (CKD) causes irreversible damage to kidney structure and function. Arising from various etiologies, risk factors for CKD include hypertension and diabetes. With a progressively increasing global prevalence, CKD is an important public health problem worldwide. Medical imaging has become an important diagnostic tool for CKD through the non-invasive identification of macroscopic renal structural abnormalities. Artificial intelligence (AI)-assisted medical imaging techniques aid clinicians in the analysis of characteristics that cannot be easily discriminated by the naked eye, providing valuable information for the identification and management of CKD. Recent studies have demonstrated the effectiveness of AI-assisted medical image analysis as a clinical support tool using radiomics- and deep learning-based AI algorithms for improving the early detection, pathological assessment, and prognostic evaluation of various forms of CKD, including autosomal dominant polycystic kidney disease. Herein, we provide an overview of the potential roles of AI-assisted medical image analysis for the diagnosis and management of CKD.


Mentha longifolia Alleviates Exogenous Serotonin-Induced Diabetic Hypoglycemia and Relieves Renal Toxicity via ROS Regulation.
Diabetic kidney disease is one of the most common microvascular complications of diabetes mellitus with consequences of diabetic nephropathy. Here we amined to evaluate the nephroprotective potential of methanolic Mentha longifolia (MML) against serotonin-induced hypoglycemia allied toxicity in the rat model of diabetes. Diabetes was induced in rats via alloxan administration and validated by blood glucose level measurement. After that, the animals were treated with serotonin and methanolic extract of Mentha longifolia. Surprisingly, serotonin treatment significantly reduced the glucose levels to hypoglycemic conditions, accompanied by impaired redox defense system, abnormal kidney histopathology, dyslipidemia, and altered level of liver toxicity markers. Interestingly these changes were rescued by the methanolic extract of M. longifolia. The present study suggests that impaired serotonin levels during diabetic conditions may accelerate hypoglycemic allied free radical-dependent abnormalities; however, medicinal plants like M. longifolia can reduce these deleterious effects by scavenging free radicals and their associated toxicity.


Bacterial infections in children after liver transplantation: A single-center surveillance study of 345 consecutive transplantations.
Infectious complications after pediatric liver transplantation frequently occur and are potentially serious. Data concerning strictly defined bacterial infections and their associated risk factors are lacking. For the pediatric liver transplant postoperative period, we analyzed data from the nosocomial infection surveillance (2006-2015). A total of 235 bacterial infections in 162 transplantations (47%) occurred, including 32 bacterial pneumonia cases, 104 surgical site infections, 27 urinary tract infections, and 40 bloodstream infections. Sepsis was diagnosed in 127 cases (54%), severe sepsis in 22 (9%) cases, and septic shock in 41 (17%) cases. Thirty patients (9%) died, and septic shock was the leading cause of death. The carrier status of multi-drug resistant bacteria and a tacrolimus level >20 ng/mL were independent risk factors for surgical site infections and the occurrence of severe sepsis or septic shock. The length of mechanical ventilation was an independent risk factor for pneumonia and surgical site infection. Bacterial infections in the early postoperative period after pediatric liver transplantation are associated with high morbidity and mortality. Physicians involved in the medical care of these patients should be aware of the specific risk factors, and further development of prevention programs is highly recommended.


Two dimensional echocardiographic recognition of the descending thoracic aorta.
Two dimensional echocardiography was used to identify the descending thoracic aorta in 106 subjects. In 12 of these subjects, contrast injection techniques were used to identify this structure as it descended posteriorly adjacent to the atrioventricular groove. The course of the descending thoracic aorta was mapped using both the long axis and transverse axis views. The normal descending thoracic aorta (26 subjects) measured 10 +/- 1.4 mm/m2 during diastole. Unusual M mode echocardiographic patterns of the descending aorta may be confused with other disease states; they are clarified with the two dimensional study. The size and appearance of the descending aorta in different types of cardiovascular disease, including aortic aneurysm, in 80 patients are described. It is anticipated that two dimensional echocardiography will prove to be a useful method of studying patients with aortic disease.


The impact of teleradiology on the inter-hospital transfer of neurosurgical patients and their outcome.
The impact of teleradiology technology used in the management of neurosurgical emergencies between district general hospitals and tertiary neurosurgical centres is reviewed. Its effect on clinical management such as diagnostic accuracy and the prevention of secondary insults has been shown to be favourable. Problems and possible future developments are also discussed.


The orbitofrontal cortex maps future navigational goals.
Accurate navigation to a desired goal requires consecutive estimates of spatial relationships between the current position and future destination throughout the journey. Although neurons in the hippocampal formation can represent the position of an animal as well as its nearby trajectories1-7, their role in determining the destination of the animal has been questioned8,9. It is, thus, unclear whether the brain can possess a precise estimate of target location during active environmental exploration. Here we describe neurons in the rat orbitofrontal cortex (OFC) that form spatial representations persistently pointing to the subsequent goal destination of an animal throughout navigation. This destination coding emerges before the onset of navigation, without direct sensory access to a distal goal, and even predicts the incorrect destination of an animal at the beginning of an error trial. Goal representations in the OFC are maintained by destination-specific neural ensemble dynamics, and their brief perturbation at the onset of a journey led to a navigational error. These findings suggest that the OFC is part of the internal goal map of the brain, enabling animals to navigate precisely to a chosen destination that is beyond the range of sensory perception.


A method for identifying the origin of chondroitin sulfate with near infrared spectroscopy.
The object of this study was to explore the feasibility of support vector machine (SVM) to identify the origin of chondroitin sulfate (CS) by near infrared spectroscopy. 96 batches CS from three different origins were collected in this research, 66 batches of which were chosen for training set by Kennard-Stone (KS) method and the rest were used for testing. Through the comparison of pretreatment methods of standard normal variate transformation (SNV), multiplicative scatter correction (MSC), Savitzky-Golay (SG) smoothing and derivative with SG smoothing, a SVM discrimination model was constructed, of which the prediction result is 100% accurate with the pretreatment of first derivative and SG smoothing with 15 points. The result indicated that it had great potential using SVM to identify the origin of CS.


Risk factors for exocrine pancreatic insufficiency after pancreatic surgery: a systematic review and meta-analysis.
Patients should be informed beforehand of the risk factors for exocrine pancreatic insufficiency (ExoPI) after pancreatic surgery; however, there are no clear identified risk factors for this condition. This study aimed to identify the preoperative, perioperative and postoperative risk factors for ExoPI after pancreatic surgery. We conducted a systematic search of PubMed, Scopus, SAGE, CINAHL Plus and Taylor & Francis from inception to Mar. 7, 2021, for full-text articles that included patients who had undergone pancreatic surgery. The primary outcome was the number of ExoPI events and any risk factors evaluated. We used the Newcastle-Ottawa Scale to assess study quality. Twenty studies involving 4131 patients (2312 [52.3%] male, mean age 60.12 [standard deviation 14.07] yr) were included. Of the 4131 patients, 1651 (40.0%) had postoperative ExoPI. Among the 11 factors evaluated, the significant risk factors were preoperative main pancreatic duct (MPD) diameter greater than 3 mm (odds ratio [OR] 4.50, 95% confidence interval [CI] 1.06-19.05), pancreaticoduodenectomy (PD) as the surgical treatment procedure (OR 3.31, 95% CI 1.92-5.68), pancreaticogastrostomy (PG) as the anastomotic procedure (OR 3.13, 95% CI 1.83-5.35), hard pancreatic texture (OR 2.93, 95% CI 1.99-4.32) and adjuvant chemotherapy (OR 2.50, 95% CI 1.54-4.04). Gender, history of diabetes mellitus or endocrine pancreatic insufficiency (EndoPI), underlying diseases, de novo diabetes or EndoPI, pylorus-preserving PD and postoperative pancreatic fistula were not risk factors for ExoPI after pancreatic surgery. Preoperative MPD diameter greater than 3 mm, PD, PG reconstruction, hard pancreatic texture and adjuvant chemotherapy were risk factors for the development of ExoPI after pancreatic surgery. The findings should provide useful information for patients to reduce postoperative dissatisfaction and improve quality of life.


Aging enhances G(1) phase in the colonic mucosa of rats.
Although in Fischer-344 rats, aging has been shown to be associated with increased crypt cell production in the colonic mucosa, no information is available about the responsible intracellular mechanisms for the age-related rise in colonic mucosal cell proliferation. To determine whether cell cycling events are affected by aging, the present investigation examines the age-related changes in Cdk2 activity and the regulation of this process in the colonic mucosa. Colonic mucosae from 4-, 13- and 24-month-old Fischer-344 rats were assayed for Cdk2 activity and protein expression of Cdk2, cyclin D1 and E, as well as p21(Waf1/Cip1) (total and the fraction bound to Cdk2), p53 and phosphorylated Rb. Kinase activity and protein levels of Cdk2, as well as cyclin D1 concentration in the colonic mucosa, rose steadily with advancing age. However, the levels of cyclin E in the colonic mucosa were found to be higher in 24-month-old than 13-month-old rats, compared to their 4-month-old counterparts. On the other hand, levels of mucosal p21(Waf1/Cip1) (total and the fraction bound to Cdk2), one of the universal inhibitors of Cdks, were found to be lower in aged than in young rats. This was accompanied by a parallel decrease in mucosal p53, a tumor suppressor protein that is known to regulate p21(Waf1/Cip1). Additionally, we observed that the levels of phosphorylated Rb protein, a form which is involved in regulating progression of cells through the S phase, are increased in the colonic mucosa of 24-month-old rats, but not in 13-month-old animals, when compared with their 4-month-old counterparts. Our data suggest that, G(1) to S phase transition, as well as progression through the S phase of the cell cycle are accelerated in the colonic mucosa of aged rats.


Greek young men grow taller.
To examine whether a secular trend for greater height is still observed in young Greek men. Height and weight of 3982 Greek conscripts, aged 18-26 years, were measured and correlated with the level of education and place of residence. Our data were collected from May 2006 to May 2007 from pre-selected army camps all over Greece. The data were compared with those of a similar study performed in 1990. Mean height (+/-SD) of the conscripts was 178.06 (+/-7.05) cm. From 1990 until 2006, mean height increased from 175.7 cm to 178.06 cm (p < 0.001), corresponding to 1.47 cm/decade. Height was positively correlated with the place of residence (p = 0.007) and the level of education (p < 0.001) of the conscripts. Our data show a further increase in the stature of young Greek men in the last 16 years. It appears that the male Greek population has still not exhausted its growth potential.


Hypochlorous Acid as a Potential Postsurgical Antimicrobial Agent in Periodontitis: A Randomized, Controlled, Non-Inferiority Trial.
Hypochlorous acid (HOCl) is an antimicrobial agent with high affinity to Gram-negative bacteria of the subgingival biofilm. It could have an equivalent or no inferiority effect to chlorhexidine (CHX) to avoid recolonization of these microorganisms after the post-surgical period. The objective is to compare the reduction of plaque index (PI), gingival index (GI), pocket depth (PD), gain of clinical attachment level (CAL), and bacterial recolonization of periodontopathic microorganisms in subgingival biofilm at 7, 21, and 90 days after Open Flap Debridement (OFD) under two antimicrobial protocols: (A) HOCl 0.05% followed by HOCl 0.025% and (B) CHX 0.2%/CHX 0.12% used per 21 days without regular oral hygiene during the post-surgical period. A no-inferiority randomized controlled trial was carried out. Thirty-two patients were randomly divided to receive each antiplaque protocol after OFD in patients with periodontitis. Clinical indexes and bacterial recolonization were assessed using qPCR for up to 90 days. Data were analyzed using repeated measures ANOVA, mixed effects models adjusted for treatment, time, and the Chi-squared/Fisher test. A no-inferiority analysis was also performed using the Hodges-Lehmann hypothesis test for non-inferiority. HOCl was not inferior to CHX in reducing PI. Both groups showed a comparable reduction of recolonization for Porphyromonas gingivalis, Tannerella forsythia, and Eubacterium nodatum. However, the HOCl protocol was non-inferior to the CHX protocol for Treponema denticola and Aggregatibacter actinomicetemcomitans. HOCl improved periodontal healing. HOCl showed an impact in reducing the recolonization of periodontopathic bacteria in the postoperative period.


Assembly, characterization, and photoluminescence of hybrids containing europium(III) complexes covalently bonded to inorganic Si-O networks/organic polymers by modified beta-diketone.
1-(2-naphthoyl)-3,3,3-trifluoroacetonate (NTA) was grafted to the coupling agent 3-(triethoxysilyl)-propyl isocyanate (TEPIC) and used as the first kind of precursor, and other kinds of precursors (PVPD, PMAA, and PVPDMAA) were synthesized through the addition polymerization reactions of the monomer 4-vinylpyridine and methacrylic acid. Then, these precursors coordinated to rare earth ions, and the three kinds of hybrid polymeric materials were obtained after hydrolysis and copolycondensation with the tetraethoxysilane (TEOS) via a sol-gel process. FTIR, ultraviolet, ultraviolet-visible diffuse reflection and photoluminescent spectra, electronic microscopy diagraphs, room-temperature X-ray diffraction patterns, and TG plots were characterized, and the results reveal that the hybrid materials imbedded into the single polymer (PVPD and PMAA) showed more uniformity in the microstructure, more efficient intramolecular energy transfer between europium ions and the modified ligand NTA-Si and more excellent characteristic emission of europium ions under UV irradiation with higher (5)D(0) luminescence quantum efficiency and longer lifetime than the hybrid materials imbedded into the multipolymer (PVPDMAA).


Dental development after successful treatment of infantile osteopetrosis with bone marrow transplantation.
A 3-week-old boy was diagnosed with congenital osteopetrosis. He underwent a bone marrow transplant at 6 weeks of age. At 3 years of age the primary teeth had all erupted, but the canines and the first molars totally lacked root development. The teeth were smaller in size and had evidence of both enamel hypomineralization and hypoplasia. In the permanent dentition, multiple missing teeth were found. The incisors were conical and the mandibular laterals were extremely small. All permanent teeth had normal eruption. This case shows that dental development and eruption of teeth can be reconstituted in a child with congenital osteopetrosis. Bone marrow transplantation induces normalization of osteoclast function, which is a prerequisite for normal dental development and eruption of teeth.


Impact of matrix metalloproteinase-1 gene variations on risk of acute coronary syndrome.
This case-control study was conducted to investigate whether genetic variations in the matrix metalloproteinase-1 gene promoter were related to risk of acute coronary syndrome (ACS). 222 patients with ACS and 191 normal controls were examined by means of polymerase chain reaction (PCR) and restriction fragment length polymorphism. A significantly higher frequency of AA genotype of -519A/G polymorphism was observed in ACS patients than in the controls (P<0.001). The relative risk of ACS in patients carrying A allele of -519A/G polymorphism was 1.33 [P<0.001, 95% confidence interval (CI)=1.12-1.57]. Linkage disequilibrium test and haplotype analysis indicated that the AT haplotype significantly increased the risk of ACS (P=0.004, 95% CI=1.14-2.04, odds ratio=1.53). Compared with the AT haplotype, the GT haplotype was associated with a reduced occurrence of ACS (P<0.001, 95% CI=0.36-0.70, odds ratio=0.51). Our findings suggested that genetic variations in the matrix metalloproteinase-1 gene promoter may contribute to interindividual variability in risk of ACS, and help predict susceptible individuals.


Life-Threatening Cerebral Hematoma Owing to Aneurysm Rupture.
To refine the surgical indications of surgery for life-threatening cerebral hematomas caused by aneurysm rupture, through the analysis of possible outcome predictors. Forty-nine consecutive patients requiring prompt clot evacuation were retrospectively reviewed. In all cases, the hematoma was equal to or greater than 60 mL. The bleeding aneurysm was located on the middle cerebral artery in 26 cases, on the internal carotid artery in 10 cases, and on the anterior cerebral artery in 13 cases; four aneurysms were giant. Six patients underwent aneurysm coiling followed by clot removal, whereas 43 patients were managed by concomitant clot evacuation and aneurysm clipping. The main clinical and radiologic features, the management paths and the treatment modalities were correlated with the outcomes. A statistical analysis was conducted. Overall mortality was 32.6%, severe morbidity was 22.4% and 22 patients (44.8%) achieved favorable results. The short-term results were more significantly influenced by the radiological parameters than by the initial clinical conditions. The prognostic weight of the radiologic findings was partially lost for six-month results, whereby management factors gained in importance. The bleeding severity was strongly determinant for early mortality. However, if patients can survive the initial crucial phase, their chances of a favorable outcome are not negligible. Further improvement may be possible through better patient selection and the identification of nonsalvageable subjects.


The evolution of Anammox performance and granular sludge characteristics under the stress of phenol.
The short- and long-term effects of phenol on anaerobic ammonium oxidation (Anammox) were evaluated. The short-term impact of phenol on Anammox activity was determined by a batch test, and an IC50 value of 678.2 mg L(-1) was calculated. Anammox granular sludge was equally seeded into two identical upflow anaerobic sludge blanket reactors (R0 and R1); synthetic wastewater without phenol was fed to R0 while with varied phenol was fed to R1 to study the long-term effects. The performance of R0 was stable, with a steadily rising nitrogen removal rate of 10.5-21.3 kg N m(-3)d ay(-1). However, the performance of R1 was significantly suppressed by an influent phenol concentration of 50 mg L(-1), and was recovered and stabilized by applying one or more control strategies. The phenol-mediated inhibition depressed the Anammox activity and biomass, and caused a change of stoichiometric ratios and granule characteristics.


Jagged-1-mediated activation of notch signalling induces adipogenesis of adipose-derived stem cells.
Notch signalling plays an important role in many cell activities, involving proliferation, migration, differentiation and cell death. The aim of this study was to investigate effects of such signalling on adipogenesis of mouse adipose-derived stem cells (mASCs). Jagged1 (50 and 100 ng/ml) was added to mASCs to activate Notch signalling, 2 days before adipogenic induction. At 5 and 7 days after induction, oil red-O staining was performed to evaluate lipid accumulation. Then real-time PCR was performed to examine expression of Notch downstream genes (Notch-1, -2, Hes-1 and Hey-1) and adipogenic transcription factor (PPAR-γ). Expressions of Hes-1 and PPAR-γ at protein level were confirmed by immunofluorescence staining. Our data indicated that Jagged1 promoted adipogenic differentiation of mASCs. Moreover, Jagged1 also increased expression of Notch downstream genes and PPAR-γ. Expressions of Hes-1 and PPAR-γ were found to be enhanced in Jagged1 pre-treated mASCs when compared to controls. The results led to the conclusion that activation of Notch signalling had stimulated adipogenesis of mASCs in the presence of adipogenic medium by promoting expression of PPAR-γ.


Clinical course of acute hemorrhagic infarction of a thyroid nodule.
A 27-year-old woman patient with acute hemorrhagic infarction of a thyroid nodule had experienced abrupt painful swelling of the thyroid gland soon after being involved in an automobile accident. We diagnosed her thyroid mass, based on clinical symptoms and laboratory findings, as acute hemorrhagic infarction of a thyroid nodule. The mass diameter gradually decreased from 4.4 cm to 1.9 cm over the following 12 months but did not change thereafter. The serum thyroglobulin level rapidly decreased from 312.4 ng/ml to 14.2 ng/ml during the first 3 months and presented no change during the next 21 months. Fine-needle aspiration biopsy was repeated during the 24th month, when preexistence of a benign neoplasm had become clear. The clinical course of acute hemorrhagic infarction of the thyroid nodule was made apparent by ultrasonography, which readily identified the thyroid mass and accurately measured its dimensions at any time.


High-pass resolution targets in peripheral vision.
Visual acuity was measured at 10 degree intervals on the horizontal meridian in two normal subjects, using high-pass spatial frequency filtered test targets in a computer graphics display. The close similarity between detection and recognition thresholds resulted in quick and reliable measurements. Peripheral acuity was proportional to local retinal ganglion cell separation. High-pass targets appear to be nearly ideal for clinical perimetry because of the easy test task and the possibility of interpreting results in terms of numbers of functional neuroretinal channels. The major limitation appears to be a somewhat fuzzy definition of small, circumscribed defects.


The distribution of esterases in the skin of the minipig.
Skin esterases serve an important pharmacological function as they can be utilised for activation of topically applied ester prodrugs. Understanding the nature of these enzymes, with respect to their role and local activity, is essential to defining the efficacy of ester prodrugs. Minipigs are used as models to study the kinetics of absorption of topically applied drugs. Their skin has structural properties very similar to human skin. However, regional distribution differences in esterase activity from site-to-site could influence cross-species extrapolation. Investigation of the regional site variation of minipig skin esterase activity will facilitate standardization of topically applied drug studies. Furthermore, the characterization of regional skin variation, will aid in translation of minipig results to better predictions of human esterase activity. Here we report the variation in rates of hydrolysis by minipig skin taken from different regional sites, using the esterase-selective substrates: phenyl valerate (carboxylesterase), phenyl acetate (arylesterase) and p-nitrophenyl acetate (general esterase). Skin from ears and back of male minipig showed higher activity than female. Skin from minipig ears and the back showed the highest level of esterase activity and was similar to human breast skin used in vitro absorption studies. These results suggest that skin from the minipig back is an appropriate model for preclinical human skin studies, particularly breast skin. This study supports the use of the minipig, with topical application to the back, as a model for the investigation of pharmacokinetics and metabolism of ester prodrugs.


Effect of faecal stream diversion on recurrence of Crohn's disease in the neoterminal ileum.
Aphthous lesions recur in the neoterminal ileum within the first few months after curative resection of the distal ileum in patients with Crohn's disease. These lesions do not originate from microscopic disease that is already present at the time of surgery. To investigate the importance of faecal stream in the pathogenesis of recurrent Crohn's lesions, we have studied 5 patients with Crohn's disease who had ileal resection. After curative resection and ileocolonic anastomosis, a diverting terminal ileostomy was constructed 25-35 cm proximal to the anastomosis thereby excluding the neoterminal ileum, the anastomosis, and the colon from intestinal transit. After six months of exclusion, endoscopy of the ileocolon was undertaken and biopsy specimens were taken. Transit was then restored. Six months after reanastomosis further biopsy specimens were taken. These patients were compared with a control group of 75 patients with Crohn's disease who underwent a one-step ileal resection and ileocolonic anastomosis. None of the 5 patients had endoscopic lesions in the neoterminal ileum after six months of exclusion and biopsies did not show inflammatory changes characteristic of Crohn's disease. By contrast, 53 of 75 patients with one-step surgery had endoscopic recurrence in the neoterminal ileum within six months of surgery. All 5 patients had an important recurrence of disease, both endoscopically and histologically, at ileocolonoscopy six months after reanastomosis. Our findings strongly support the view that recurrence of Crohn's disease in the neoterminal ileum after curative ileal resection is dependent on faecal stream.


Photoelectrochemical measurements of a heterosupramolecular system under visible light irradiation.
A photochemical system utilising a modular approach characterised through interpretation of photoelectrochemical measurements is discussed. A photoanode was prepared by the chemisorption of a photosensitiser, cis-bis-(2,2'-bipyridine)-(4,4'-bis-(methyl)phosphonato-2,2'-bipyridine)ruthenium(II) dichloride (RuL2L'2+), to a mixed nanoporous nanocrystalline RuO2:TiO2 thin film, calcined on a fluorine doped SnO2 conducting glass substrate. Similarly, an electron relay molecule, 1-ethyl-1'-(2-phosphonoethyl)-4,4'-bipyridinium dichloride (EVP), was covalently bound to a platinum electroplated nanoporous nanocrystalline TiO2 thin film, and the electrodes connected in a photoelectrocatalytic cell (PCC). Irradiation with lamda > 420 nm gave a measurable photocurrent. Interpretation of the photocurrents obtained from this assembly provides a means for understanding photochemical reactions under low light intensities. Optimised conditions of the electrolyte solution were determined to be pH = 5 and illumination yielded eta = 0.0036% with an apparent quantum yield (AQY)= 1.6%.


Guideline use: a survey of dietitians working with adult kidney transplant recipients.
To establish current service provision as well as barriers and enablers to guideline implementation in the Nutritional Management of Adult Kidney Transplant Recipients (KTR). Fifteen primary renal transplant centres (15/17; 88% response rate) and 21 secondary renal transplant centres (21/24; 88% response rate) responded to an online survey addressing key questions investigating their current practice in the nutritional management of adult KTR. Referral from primary to secondary sites was limited with only two sites (9%) routinely receiving referrals. Allocated funding for KTR at secondary sites was low (n = 4, 14%). Many primary sites received nil or <0.5 full-time equivalent (FTE) funding for inpatient (n = 8, 53%); and nil or ≤0.2 FTE funding for outpatient services (n = 9, 60%). In sites reporting FTE hours, the average dietitian-to-patient ratio was 1 FTE dietitian for every 383 (range 50-1280) annually transplanted patients. Major barriers identified in delivering nutrition services at primary sites included time/lack of resources and limitations with systems to identify or track transplant recipients. Dietitian-to-patient ratios in the management of KTR at primary sites are inconsistent and likely to be inadequate at secondary transplant sites to implement guideline recommendations, especially for weight management. Investigations into the effectiveness of innovative interventions such as groups or telehealth are warranted, which may assist practitioners to achieve guideline recommendations in an environment of limited resources.


Effect of Fenoterol on PAF-induced lung edema in isolated and perfused rabbit lungs.
We have studied the effects of fenoterol on PAF-induced response in pulmonary circulation. We used 28 isolated and perfused rabbit lungs preparations: eight control preparations (CP), four vehicles preparations (VP), eight PAF preparations (PP) with two doses of PAF, one called low dose (LD = 0.5 microg/kg of weight) and the other high dose (HD = 1 microg/kg of weight) and eight Fenoterol preparations (FP) which we administered 0.05 mg of Fenoterol for 15 min, followed by a LD and HD of PAF. FP prevented elevation of pulmonary artery pressure (Ppa) as compared to PP, at LD of PAF: 12.615 (CI 95%: 8.57-20.885) versus 83.705 (CI 95%: 50.55-114.3) cm of water; and at HD of PAF: 19.38 (CI 95%: 11.235-28.94) versus 205.1 (CI 95%: 141.3-271) cm of water respectively. FP prevented the increase in fluid filtration rate (FFR) observed in PP at both doses of PAF LD: 0.765 (CI 95%: 0.07-3.385) versus 0.01 (CI 95%: -0.05-0.005) g/min; HD: 5.515 (CI 95%: 2.425-8.865) versus 0.03 (CI 95%: 0-0.33) g/min. Our results suggest that PAF has a vasoconstrictor effect that produces lung edema and this effect is inhibited by fenoterol.


[Influence of angiotensin-(1-7) on angiotensin II induced rat's tubular epithelial-myofibroblast transdifferentiation].
To explore the influence of angiotensin-(1-7)[Ang-(1-7)] on angiotension II(Ang II) induced rat's tubular epithelial-myofibroblast transdifferentiation and the secretion of extracellular matrix. The NRK52E were maintained and sub-cultured treated with Ang-(1-7) (10(-6); mmol/L) and Ang II(10(-6); mmol/L) for 24, 48, 72, 96 hours, we detect the protein expressions of E-cadherin and α-SMA by immunocytochemistry method; The content of Col I and FN in the cultured supernatant were measured by ELISA; The mRNA expression of E-cadherin, α-SMA, Col I and FN was detected by real-time PCR. Treat with ang II 96 h, the protein and mRNA expression of E-cadherin decreased significantly (P<0.05), but the protein and mRNA expression α-SMA, col I and FN increased significantly (P<0.05); treat with Ang II and Ang-(1-7), the protein and mRNA expression of E-cadherin increased significantly (P<0.05), but the protein and mRNA expression α-SMA, col I and FN decreased significantly (P<0.05). Ang-(1-7) can inhibits Ang II-induced rat's tubular epithelial myofibroblast transdifferentiation and decrease the secretion of FN and Col I.


Calcium-lowering medications in patients with primary hyperparathyroidism: intraoperative findings and postoperative hypocalcemia.
We analyzed how calcium-lowering medications (CLMs) influenced surgical findings in patients with primary hyperparathyroidism. A retrospective review was conducted of 281 patients undergoing surgery for primary hyperparathyroidism. Logistic regression evaluated the relationship between CLM and surgical findings. A mixed-effects model determined the influence of CLMs on these curves. We found that CLM (P = .018) and a higher serum calcium level (P = .018) were variables making 4-gland hyperplasia less likely. Analysis of intraoperative parathyroid hormone (IOPTH) plots revealed that CLMs altered the kinetics (P = .043). However, the 2 groups did not differ in the number of measurements necessary for a 50% decrease in IOPTH levels. Multivariate logistic regression also revealed that patients taking more than one CLM had an increased association with postoperative hypocalcemia (P = .018). Although CLM contributed to differences in IOPTH curves, their use does not require changing standard IOPTH protocol but should alert the surgeon to the risk of postoperative hypocalcemia.


Comparison of ionization chamber efficiencies for activity measurements.
The calibration of ionization chamber measuring systems in terms of activity is described. The energy-dependent efficiency curves of three chambers at the Bureau International des Poids et Mesures, the National Physical Laboratory and the Physikalisch-Technische Bundesanstalt are determined and compared using a fitting procedure for the experimental radionuclide efficiencies by the Microsoft (MS) EXCEL Solver program. An estimation of the uncertainty of the efficiency curves and the deviations of experimental and calculated radionuclide efficiencies are given. By this fitting method, discrepancies in the efficiency determination can be detected at a level of about one percent. Systematic deviations entering into the calculations either from emission probabilities per decay or from absolute activity standardization are discussed.


The management of severe adherence of mediastinal structures to the sternum during cardiac reoperations.
The author's method for sternal re-entry in cases of extremely dense mediastinal adhesions is described. The anterior lamina and the spongiosa of the sternum is cut with an osteotome and the posterior lamina is divided using the Lebsche knife so as to leave the densely adhered patch of the posterior lamina on the underlying soft tissue. These bone fragments may be left in loco or, if the course of the operation requires it, they may be gently raised and peeled off. Removal of such a portion or portions of the posterior lamina does not appreciably weaken the sternum and safe sternal closure may be accomplished without difficulty.


Factors Influencing the Diagnostic Accuracy of Identifying the Histologic Type of Non--Small-Lung Cancer With Small Samples.
The pathologic diagnosis has become a greater consideration in decision-making regarding the treatment options for lung cancer. Therefore, the accurate diagnosis of the tumor histologic type is essential, even when only small biopsy or cytology samples are available. However, the risk of a misdiagnosis with smaller biopsy samples is greater. The factors underlying the increased risk of a misdiagnosis in small samples are unknown. The aim of the present study was to identify the clinical and pathologic factors (other than immunohistochemical staining) that influence the pathologic diagnostic accuracy in small biopsy and cytological lung samples obtained by bronchoscopy. We performed transbronchial lung biopsy or brushing and lavage to determine the preoperative diagnosis of 126 of 299 surgically resected lung cancer specimens. We assessed the diagnostic accuracy of the preoperative transbronchoscopic examination findings against that of the surgically resected lung specimens. On univariate analysis, the mean pathologic tumor size in the noncorresponding cases was larger than that in corresponding cases. Vascular invasion was also more prevalent in the noncorresponding cases. The tumor differentiation grade in the noncorresponding cases was poorer than in the corresponding cases. The noncorresponding cases were at a more progressed stage. On multivariate analysis, the pathologic tumor size and tumor differentiation grade were associated with the noncorresponding cases. We found a larger tumor size and poor differentiation grade were indicative of lung cancer tissue with a greater content of heterogeneous cells. Therefore, a possibility exists of a false diagnosis using only these factors. Thus, treatment decisions should be made considering the pathologic diagnosis and other relevant factors.


Tactics, teaching and transitioning: Response to the COVID-19 pandemic in the nursing home sector.
From leadership to the front-line our skilled nursing organization leveraged the expertise of all professionals in our various disciplines. A cohesive aligned approach was implemented to provide support, create and standardize guidance, develop systems, education and policies to conquer challenges being posed by COVID-19 in our settings. In addition to keeping residents safe from the virus, we as operators needed to establish creative ways to respond to the delivery of quality care, caring for residents, families and staff all while adhering to regulatory compliance and the ongoing pandemic and new challenges posed as we venture into a post pandemic world.


Choanal atresia and associated anomalies.
The authors have studied 130 cases of choanal malformation. They found 53 bilateral atresias, 51 unilateral atresias and 26 cases of choanal stenosis. Fifty-seven of these cases were associated with other anomalies and 38 had at least two features of the CHARGE association (C, colobomas; H, heart defects; A, atresia choanae; R, retarded growth; G, genito-urinary defects; E, ear defects). The pathogenesis of choanal atresia in regard to the abnormal migration of neuroectodermal cells is discussed.


Efficient genome editing in cotton using the virus-mediated CRISPR/Cas9 and grafting system.
The extensive application of CRISPR in cotton was limited due to the labor-intensive transformation process. Thus, we here established a convenient method of CRISPR in cotton by CLCrV-mediated sgRNA delivery.


Predonated autologous blood use in elective cardiac surgery.
The risks of homologous blood transfusion are well documented and recently increased with the emergence of acquired immunodeficiency syndrome. Preoperative autologous donation has been suggested to reduce these risks. This is a report concerning 104 consecutive adult autologous donors (group 1) who had an elective cardiac operation. A similar group of 111 patients operated on during the same period but without autologous blood donation was used for comparison (group 2). Both groups contained similar numbers of patients with coronary artery disease, valvular disease, and mixed lesions, and both had several patients with atrial septal defects. Group 2 patients (mean age, 67.8 years) were significantly older than group 1 patients (mean age, 58.9 years) (p less than 0.05). The mean donation in group 1 was 4.1 units, but 12 (11.5%) had to discontinue donations. Increasing angina in 10 (12.2%) of the 82 patients with coronary artery disease was the most common complication, and necessitated hospitalization in two instances. In 77 (75.5%) of the 102 group 1 patients who had operation and 23 (21%) of the 110 group 2 patients, no homologous blood products were required. Group 1 patients used significantly less homologous fresh frozen plasma (0.1 unit versus 0.97 unit; p less than 0.005) and packed red blood cells (0.6 unit versus 2.1 units; p less than 0.001) than group 2 patients. Group 1 patients received 3.3 and 3.1 units of autologous packed cells and plasma, respectively. No complications of autologous transfusion were seen. Predonation of autologous blood is an effective, safe method of reducing homologous blood requirements in elective cardiac operations, but it does carry some risk, especially in patients with coronary artery disease.


Role of platelet factors and serum complement in growth of fibroblasts with high-affinity Clq complement receptors.
Cultures of human diploid fibroblasts are heterogeneous in that a subpopulation interacts via high-affinity receptors with the globular head regions of the Clq complement protein. Growth and synthetic properties of these cells are characteristic of cells residing in healing wounds and inflammatory lesions. At these sites, fibroblasts are exposed to regulatory molecules such as complement components and factors released from blood platelets. We assessed the effects of native complement proteins and platelet-derived factors on proportions and phenotypic stability of high-affinity and low-affinity receptor cells generated from explants of adult and embryonic connective tissue, using radioligand binding assays and immunofluorescence analysis by flow cytometry. Fibroblasts expressing high-affinity Clq receptors could be generated from explants only when factors from platelets were present in the medium; native complement proteins were not essential. High-affinity receptor cells could be generated only from tissue; they could not be generated by incubating cultures of the low-affinity receptor phenotype in medium containing platelet-derived factors. High-affinity receptor cells, once established from explants in the presence of platelet-derived factors, persisted through many replications in the absence of platelets. We obtained the same fibroblast phenotypes from embryonic skin as from adult gingiva, but the proportion of high-affinity receptor cells from skin was much greater. We conclude that factors derived from platelets are essential for generating cultures containing fibroblasts expressing high-affinity Clq receptors, but not for their maintenance. High-affinity receptor cells may comprise a rapidly dividing subpopulation giving rise only to like progeny or to other, more differentiated cells.


Solid-phase microextraction of triazine herbicides via cellulose paper coated with a metal-organic framework of type MIL-101(Cr), and their quantitation by HPLC-MS.
Cellulose paper was coated with the metal-organic framework MIL-101(Cr) in a chitosan matrix and utilized for thin-film microextraction (TFME). The coated paper possesses excellent extraction efficiency for the triazine herbicides atraton, desmetryn, secbumeton, prometon, ametryn, dipropetryn, and dimethametryn. High-performance liquid chromatography-tandem mass spectrometry was applied to quantify target analytes. The effects of mass ratio of MIL-101(Cr) to chitosan, sample pH value, time of adsorption and desorption, and type and volume of desorption solvent on extraction efficiency were optimized. Under the optimal conditions, the method has limits of detection between 1.5 and 22 ng·L-1. The recoveries of triazines from spiked tap water, drinking water, lake water and river water range from 77.0 to 125.3%, with relative standard deviations of <17.4%. Graphical abstract Cellulose paper was modified with metal-organic framework MIL-101(Cr)/chitosan by using a simple, efficient and environmentally friendly approach. The modified cellulose paper was then used as a novel extraction phase in thin-film microextraction (TFME).


Subclinical myopathic findings in patients affected by malignant tumours. An autopsy study.
Histoenzymologic studies on representative muscles and the peripheral microcirculation from selected autopsies of non cachectic patients dying of neoplasms, without signs of neuromuscular involvement, demonstrate a high incidence of neuromuscular and microcirculatory changes. A correlation between neuromuscular changes and the peripheral microcirculation particularly evident in myopathic cases is discussed.


The oxidation of methylglyoxal by mammalian pyruvate dehydrogenase.
Mammalian pyruvate dehydrogenase actively catalyzed the oxidation of methylglyoxal to acetyl-CoA. The reaction was fully enzymatic with an estimated Km of 1.89 mM. On the other hand, methylglyoxal was a competitive inhibitor of the enzyme for pyruvate, the Ki being in the 1 mM range. The reaction was inhibited in the presence of HgCl2. The reaction products were quantitatively identified as acetyl-CoA and formic acid. A mechanism for the reaction is proposed.


The behaviour of 2-methylene-3,3-dimethylcyclopentane-1-one towards Michael's addition.
The employment of malonic acid dimethylester as a blocking group of a dynamic and self isomerising alpha,beta-unsaturated cyclopentanone-exomethylene group is reported.


Pacifier Use and Early Life Weight Outcomes in the Intervention Nurses Start Infants Growing on Healthy Trajectories Study.
Although widely used by infants, little is known about the long-term effects of pacifiers. We investigated relationships between pacifier use in infancy and appetite, temperament, feeding, and weight outcomes through age 2 years using data from the Intervention Nurses Start Infants Growing on Healthy Trajectories study. Mother-newborn dyads were randomized to a responsive parenting intervention for obesity prevention or a control group. Infants with data on pacifier use (n = 250) were categorized as using a pacifier beyond early infancy (≥4 months of age) or not. Anthropometrics were measured at 6 months, 1, and 2 years with overweight defined as weight-for-length ≥95th percentile at 1 year and BMI ≥85th percentile at 2 years. Mothers completed questionnaires on temperament, appetite, and feeding. Infants who used a pacifier at 4 months or later (68%) had greater conditional weight gain from birth to 6 months (p = 0.01), weight-for-length z-score at 1 year (p < 0.001), and BMI z-score at 2 years (p < 0.001) than infants who did not. Infants using a pacifier at ≥4 months were more likely to be overweight at ages 1 year (11.7% vs. 1.3%, p = 0.03) and 2 years (20.1% vs. 7.9%, p = 0.03). Pacifier use was associated with shorter breastfeeding duration and less responsive parent feeding styles, but these variables did not mediate the relationship between pacifiers and weight. Parent-reported temperament and appetite were unrelated to pacifier use. Pacifier use beyond early infancy is associated with accelerated infant growth and toddler overweight, although the reasons for this relationship are unclear.


Ephedrine alkaloids-free Ephedra Herb extract: a safer alternative to ephedra with comparable analgesic, anticancer, and anti-influenza activities.
It is generally accepted that the primary pharmacological activities and adverse effects of Ephedra Herb are caused by ephedrine alkaloids. Interestingly, our research shows that Ephedra Herb also has ephedrine alkaloid-independent pharmacological actions, such as c-MET inhibitory activity. This study describes the preparation of an ephedrine alkaloids-free Ephedra Herb extract (EFE) by ion-exchange column chromatography, as well as in vitro and in vivo evaluation of its pharmacological actions and toxicity. We confirmed that EFE suppressed hepatocyte growth factor (HGF)-induced cancer cell motility by preventing both HGF-induced phosphorylation of c-Met and its tyrosine kinase activity. We also investigated the analgesic effect of EFE. Although the analgesic effect of Ephedra Herb has traditionally been attributed to pseudoephedrine, oral administration of EFE reduced formalin-induced pain in a dose-dependent manner in mice. Furthermore, we confirmed the anti-influenza virus activity of EFE by showing inhibition of MDCK cell infection in a concentration-dependent manner. All assessments of toxicity, even after repeated oral administration, suggest that EFE would be a safer alternative to Ephedra Herb. The findings described here suggest that EFE has c-Met inhibitory action, analgesic effect, and anti-influenza activity, and that it is safer than Ephedra Herb extract itself. Therefore, EFE could be a useful pharmacological agent.


Effect of 2-dodecyl-6-methoxycyclohexa-2,5-diene-1,4-dione, isolated from Averrhoa carambola L. (Oxalidaceae) roots, on advanced glycation end-product-mediated renal injury in type 2 diabetic KKAy mice.
The roots of Averrhoa carambola L. (Oxalidaceae) have a long history of medical use in traditional Chinese medicine for treating diabetes and diabetic nephropathy. 2-Dodecyl-6-methoxycyclohexa-2,5-diene-1,4-dione (DMDD) was isolated from the tuberous roots of A. carambola L. The purpose of this study was to investigate the beneficial effect of DMDD on the advanced glycation end-product-mediated renal injury in type 2 diabetic KKAy mice with regard to prove its efficacy by local traditional practitioners in the treatment of kidney frailties in diabetics. KKAy mice were orally administrated DMDD (12.5, 25, 50mg/kg body weight/d) or aminoguanidine (200mg/kg body weight/d) for 8 weeks. Hyperglycemia, renal AGE formation, and the expression of related proteins, such as the AGE receptor, nuclear factor-κB, transforming growth factor-β1, and N(ε)-(carboxymethyl)lysine, were markedly decreased by DMDD. Diabetes-dependent alterations in proteinuria, serum creatinine, creatinine clearance, and serum urea-N and glomerular mesangial matrix expansion were attenuated after treatment with DMDD for 8 weeks. The activities of superoxide dismutase and glutathione peroxidase, which are reduced in the kidneys of KKAy mice, were enhanced by DMDD. These findings suggest that DMDD may inhibit the progression of diabetic nephropathy and may be a therapeutic agent for regulating several pharmacological targets to treat or prevent of diabetic nephropathy.


Blunt thoracic trauma: flail chest, pulmonary contusion, and blast injury.
Blunt thoracic trauma can result in significant morbidity in injured patients. Both chest wall and the intrathoracic visceral injuries can lead to life-threatening complications if not anticipated and treated. Pain control, aggressive pulmonary toilet, and mechanical ventilation when necessary are the mainstays of supportive treatment. The elderly with blunt chest trauma are especially at risk for pulmonary deterioration in the several days postinjury and should be monitored carefully regardless of their initial presentation. Blunt thoracic trauma is also a marker for associated injuries, including severe head and abdominal injuries.


Complement polymorphisms: geographical distribution and relevance to disease.
The evolution of man has been characterised by recurrent episodes of migration and settlement with infectious disease a constant threat. This long history of demographic change, together with the action of evolutionary forces such as natural selection and genetic drift, has shaped human genetic diversity. In particular, the interaction between humans, pathogens and the environment has played a crucial role in generating patterns of human genetic variation. The complement system plays a crucial role in the early protective immune response after exposure to a pathogen. Pathogens, over time, have developed mechanisms to circumvent the effects of complement which in turn has led to development of a more complex complement system. During the evolution of the complement system genes coding complement proteins have evolved polymorphisms, some of which have a functional effect, and this may reflect human-pathogen interaction and geographical origin. An example is the polymorphism Ile62Val (rs800292 (A>G)) in the complement regulator Factor H gene which alters the susceptibility to age-related macular degeneration (AMD), with the Ile62 polymorphism protecting against AMD. When sub-Saharan African and European populations are compared, the frequency of this polymorphism shows a very marked geographical distribution. Polymorphisms in other complement genes such as complement factor B show similar trends. This paper describes the geographical variation present in complement genes and discusses the implications of these observations. The analysis of genetic variation in complement genes is a promising tool to unravel mechanisms of host-pathogen interaction and can provide new insights into the evolution of the human immune system.


Nickel-Mediated Photoreductive Cross Coupling of Carboxylic Acid Derivatives for Ketone Synthesis.
A simple visible light photochemical, nickel-catalyzed synthesis of ketones from carboxylic acid-derived precursors is presented. Hantzsch ester (HE) functions as a cheap, green and strong photoreductant to facilitate radical generation and also engages in the Ni-catalytic cycle to restore the reactive species. With this dual role, HE allows for the coupling of a large variety of radicals (1°,2°, benzylic, α-oxy & α-amino) with aroyl and alkanoyl moieties, a new feature in reactions of this type. With both precursors deriving from abundant carboxylic acids, this protocol is a welcome addition to the organic chemistry toolbox. The reaction proceeds under mild conditions without the need for toxic metal reagents or bases and shows a wide scope, including pharmaceuticals and complex molecular architectures.


Complementarity of conserved sequence elements present in 28S ribosomal RNA and in ribosomal protein genes of Xenopus laevis and Xenopus tropicalis.
The sequence analysis of the L1 ribosomal protein (r-protein) gene of Xenopus laevis has revealed a strong homology in four out of the nine introns of the gene; this homology region spans 60 nucleotides (nt) with 80% homology [Loreni et al., EMBO J. 4 (1985) 3483-3488]. We have extended our analysis to X. tropicalis, a species which is closely related to X. laevis. Partial sequencing of the isolated L1 gene has revealed that these 60-nt homology regions are also present in at least two introns of the X. tropicalis L1 gene. Computer analysis has revealed that perfect nt sequence complementarity exists between 13 nt of this intron region and the 28S ribosomal RNA in a region which is conserved in all eukaryotes, suggesting a possible base-pairing interaction between these two sequences.


Evidence for Involvement of Nonclassical Pathways in the Protection From UV-Induced DNA Damage by Vitamin D-Related Compounds.
The vitamin D hormone, 1,25dihydroxyvitamin D3 (1,25(OH)2D3), and related compounds derived from vitamin D3 or lumisterol as a result of metabolism via the enzyme CYP11A1, have been shown, when applied 24 hours before or immediately after UV irradiation, to protect human skin cells and skin from DNA damage due to UV exposure, by reducing both cyclobutane pyrimidine dimers (CPD) and oxidative damage in the form of 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-OHdG). We now report that knockdown of either the vitamin D receptor or the endoplasmic reticulum protein ERp57 by small, interfering RNA (siRNA) abolished the reductions in UV-induced DNA damage with 20-hydroxyvitamin D3 or 24-hydroxylumisterol3, as previously shown for 1,25(OH)2D3. Treatment with 1,25(OH)2D3 reduced oxygen consumption rates in UV-exposed and sham-exposed human keratinocytes and reduced phosphorylation of cyclic AMP response binding element protein (CREB). Both these actions have been shown to inhibit skin carcinogenesis after chronic UV exposure, consistent with the anticarcinogenic activity of 1,25(OH)2D3. The requirement for a vitamin D receptor for the photoprotective actions of 1,25(OH)2D3 and of naturally occurring CYP11A1-derived vitamin D-related compounds may explain why mice lacking the vitamin D receptor in skin are more susceptible to UV-induced skin cancers, whereas mice lacking the 1α-hydroxylase and thus unable to make 1,25(OH)2D3 are not more susceptible. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.


Private speech amount positively predicts memory performance in young adults.
This study used a card-matching game that relies on visual-spatial working memory to investigate whether the amount one talks out loud to themselves (referred to as private speech) predicts cognitive performance in young adults (n = 118, mean age = 20.13 years). Each participant's performance was measured in two "Private Speech" trials, in which they were instructed to complete the game efficiently, while using private speech as much as they can. Using multilevel modeling, we found that participants performed significantly better on trials for which they produced more private speech. This relationship was not moderated by baseline competency on the task (measured in a condition where participants were not instructed to use, and rarely ever used, private speech). The study shows that the degree to which adults use private speech - when instructed to do so, is associated with cognitive performance, which may have important implications for educational/instructional settings.


Distinction Between Precapillary and Postcapillary Pulmonary Hypertension by the Atrial Volume Ratio on Transthoracic Echocardiography.
The differential diagnosis between precapillary and postcapillary pulmonary hypertension (PH) is important for deciding on the appropriate therapeutic strategy. The aim of this study was to assess whether the atrial volume ratio can differentiate precapillary and post-capillary PH. Seventy-seven patients with PH who underwent transthoracic echocardiography (TTE) and right heart catheterization were retrospectively studied. Pulmonary hypertension was defined as a mean pulmonary arterial pressure of 25 mm Hg or higher by right heart catheterization. Patients with a pulmonary capillary wedge pressure higher than 15 mm Hg were classified as having postcapillary PH, and patients with a pulmonary capillary wedge pressure of 15 mm Hg or lower were classified as having precapillary PH. The atrial volume ratio derived from TTE was defined as right atrial volume divided by left atrial volume. Forty-four (57%) of 77 patients had precapillary PH by the right heart catheterization classification. The atrial volume ratio was significantly higher in precapillary PH than in postcapillary PH (1.03 ± 0.69 versus 0.50 ± 0.19; P < .001). The area under the receiver operating characteristic curve of the atrial volume ratio for detecting postcapillary PH was 0.84 (95% confidence interval: 0.75-0.93). Adding the atrial volume ratio to the left ventricular ejection fraction yielded a high area under the curve of 0.90 (95% confidence interval, 0.83-0.96) for distinguishing precapillary and postcapillary PH. The atrial volume ratio assessed by TTE might be useful for differential diagnosis between precapillary and postcapillary PH.


Readmission and inhospital death 1 year after COVID-19 hospitalization in South Africa.
Acute SARS-COVID-19 infection may increase readmission risk compared to other respiratory infections. We assessed the 1-year readmission and inhospital death rates of hospitalized SARS-COVID-19 patients compared to patients hospitalized with other types of pneumonia. We determined the 1-year readmission and inhospital death rate of adult patients initially hospitalized with a positive SARS-COVID-19 result, and subsequently discharged, between March 2020 and August 2021, at a Netcare private hospital in South Africa, and compared this to all hospitalized adult pneumonia patients in the 3 years prior to the COVID-19 pandemic (2017-2019). The 1-year readmission rate in COVID-19 patients was 6.6% (328/50,067) versus 8.5% in pneumonia patients (4699/55,439; p < 0.001), with an inhospital mortality rate of 7.7% (n = 251) and 9.7% (n = 454; p = 0.002) for COVID-19 and pneumonia patients, respectively.


Social Norms and the Consumption of Fruits and Vegetables across New York City Neighborhoods.
Consumption of fruits and vegetables is associated with a lower risk of developing many chronic health conditions such as diabetes and cardiovascular disease. While five or more servings of fruits and vegetables per day are recommended, only 50 % of New York City (NYC) residents consume two or more servings per day. In addition, there is wide variation in dietary behaviors across different neighborhoods in NYC. Using a validated agent-based model and data from 34 NYC neighborhoods, we simulate how a mass media and nutrition education campaign strengthening positive social norms about food consumption may potentially increase the proportion of the population who consume two or more servings of fruits and vegetables per day in NYC. We found that the proposed intervention results in substantial increases in daily fruit and vegetable consumption, but the campaign may be less effective in neighborhoods with relatively low education levels or a relatively high proportion of male residents. A well-designed, validated agent-based model has the potential to provide insights on the impact of an intervention targeting social norms before it is implemented and shed light on the important neighborhood factors that may affect the efficacy of the intervention.


Social Networks and Residential Status in Community-Dwelling Older Adults With Schizophrenia: Compensation by Reconfiguration?
To address the paucity of data on the structure and content of social networks of older adults with schizophrenia (OAS). The OAS group comprised 249 persons aged 55 and older with early-onset schizophrenia living in supportive housing (SS; n = 151), independently (SI; n = 70), or with family (SF; n = 28). The community comparison (CC) group comprised 113 individuals. Social network analysis was used. Multinomial logistic regression with p ≤0.001 and p ≤0.05 was used for overall and pairwise comparisons, respectively. Each OAS subgroup had more total, nonkin, and formal linkages than the CC group. The SS and SI subgroups had fewer kin linkages than the CC group. The CC group had more confidants than the SS subgroup, more reliable linkages than the SS and SI subgroups, and more sustenance linkages than each of the OAS subgroups. Nearly everyone in the CC, SI, and SF subgroups had a confidant, a reliable contact, and a sustenance linkage; 33% of the SS subgroup had no confidants. The SS subgroup displayed more psychiatric symptoms than the SI and SF subgroups. There were no differences in loneliness or relationship satisfaction between the CC and the schizophrenia subgroups. Networks were expressed differentially across residential arrangements and differences may reflect dissimilarities in psychiatric functioning. OAS generally had ample levels of companionship and emotional and instrumental support, often comparable to their age peers. Whereas social networks typically decline at illness onset and may be predominantly family-focused, later life may be a time of network reconfiguration and reconstitution.


Nicotinic cholinergic receptors in brain synaptosomes.
In order to elucidate pharmacological characteristics of nicotinic receptors in the brain, competitive binding of nicotine analogues or cholinergic agents to brain particles was studied utilizing [3H]nicotine. The binding of [3H]nicotine to brain crude nitochondrial or synaptosomal fraction was progressively inhibited by the addition of increasing amounts of native nicotine or nornicotine, but cotinine had little effect. Of the myelin, synaptosomal and mitochondrial subfractions of the crude mitochondrial fraction, [3H]nicotine binding was almost exclusively confined to synaptosomes. In this binding, the affinity constant was 1.97 X 10(9)/M and the maximum binding capacity was 7.30 X 40(-8) M/g of protein. This binding was reduced by 50% in the presence of 4 X 10(-7) M D-tubocurarine and 10(-6) M carbamylcholine, while atropine was the least effective of the drugs tested. These findings suggest the possible existence of nicotinic cholinergic receptors in the synaptic region. A study of regional differences in nicotinic cholinergic receptors showed that higher specific bindings of nicotine to synaptosomes occurred in the hypothalamus, hippocampus and thalamus. These findings suggest that the nicotinic cholinergic mechanism plays an important role in these regions of the central nervous system.


Histopathological and postoperative behavioral comparison of rodent oral tongue resection: fiber-enabled CO2 laser versus electrocautery.
To compare operative time and hemostasis of fiber-enabled CO(2) laser (FECL) energy to that of the electrocautery (EC) technique for oral tongue resection, to compare return to oral intake and preoperative weight after FECL and EC resection, and to compare histologic changes in adjacent tissue after FECL and EC resection. Prospective animal study. Research laboratory. The CO(2) laser fiber and the Bovie cautery were each used to resect the anterior tongue in 15 adult rats. Fixative perfusion and killing were performed on postoperative day 0 (n = 10), 3 (n = 10), or 7 (n = 10). Body weight, food intake, and water intake were recorded daily for 3- and 7-day survival rats. After preparation for histologic analysis, the tongue tissue was graded with a mucosal wound-healing scale (MWHS). A higher incidence of intraoperative bleeding and shorter operative times were noted in the EC group. No statistically significant difference in postoperative food or water intake between the EC and FECL groups was noted. The FECL group returned to baseline weight by postoperative day 6. MWHS scores were lower in the EC group by postoperative day 3 and lower in the FECL group by postoperative day 7. Both EC and FECL are effective for resection of the tongue in rats. EC has the advantage of shorter operative time and lower MWHS scores by postoperative day 3; FECL has the advantages of less intraoperative bleeding, faster return to baseline body weight, and lower MWHS score by postoperative day 7.


[Sinonasal hemangiopericytomas].
The aim of this study was to report on the clinical, radiological and histological characteristics of hemangiopericytomas, and to discuss our experience with their treatment. The authors reexamined two recent cases of patients presenting with sinonasal hemangiopericytomas (semiology, CT and MRI results, treatment and follow-up). There was substantial variability of hemangiopericytoma presentation depending on location. Hemangiopericytomas of the nose and paranasal sinuses are considered a distinct entity with a good prognosis. Treatment is based on endoscopic sinus surgery. The histological approach requires the use of immunohistochemistry. Recurrences vary in the literature depending on the initial resection quality. Metastases are rare.


Undergraduate teaching of occupational medicine in European schools of medicine.
General practitioners play or should play a role in occupational medicine (OM), either in diagnosing occupational diseases or in counseling on return to work. Nevertheless, their training has been reported to be insufficient in most single country studies. The objectives of this study were to analyze the content and extent of undergraduate teaching of OM in European medical schools. An e-mail questionnaire survey of the teaching of OM to undergraduates was undertaken from December 2010 to April 2011 in all medical schools and medical faculties listed in 27 European countries (n = 305). Among the 305 universities identified, 135 answered to the questionnaire, giving a response rate of 44%. The mean number of hours given to formal instruction in occupational medicine to medical undergraduates was 25.5 h. Nevertheless, this number of hours varied widely between countries, but also within countries. Overall, 27% of medical schools gave their students 10 h of teaching or less, 52% 20 h or less and 69% 30 h or less. Whereas occupational diseases and principles of prevention were covered in most schools, disability and return to work were very poorly represented among the topics that were taught to students. Dedicated undergraduate teaching on occupational health or OM in European medical schools is present in most medical schools, usually at a low level, but is very variable between and within countries. Medical schools across Europe are very unequal to provide qualifying doctors education on the topics they will frequently come across in their working lives.


Determination of antimicrobial activity of Cefaclor on common respiratory tract pathogens in Pakistan.
To determine the antimicrobial activity of Cefaclor against common respiratory tract pathogens isolated from patients in Pakistan. Department of Microbiology, Liaquat National Postgraduate Medical Centre, Karachi. A laboratory analysis was done on 466 isolates of respiratory tract pathogens collected from 13 laboratories from all over Pakistan. Antibiotic sensitivity test was done by Kirby Bauer disc diffusion method and MIC of Cefaclor was determined by 'E' test. Of the 163 Streptococcus pneumoniae, 87 Moraxella catarrhalis and 216 Haemophilus influenzae > 95% isolates were susceptible to Cefaclor. The MIC 90 of all these pathogens were < 2 ug. Resistance of respiratory tract pathogens to the 2nd generation Cephalosporin, Cefaclor is very low. MIC 90 of Cefaclor against all three common respiratory tract pathogens is < 2 ug, which indicates that Cefaclor would be effective in more than 90% of cases infected with these bacteria.


Changes in red cell density and related indices in response to distance running.
The red cell population in peripheral venous blood was characterised in 7 young males before and up to 16 days after a 21.1 km road race. There was a 1.9 +/- 2.4% (mean +/- SD) reduction in plasma volume immediately post race (p less than 0.05), an increase in serum osmolality from 277 +/- 4 mOsm.kg-1 to 291 +/- 14 mOsm.kg-1 (p less than 0.05) and a reduction in red cell water (64.4 +/- 0.3% to 63.4 +/- 0.4%, p less than 0.001). The latter was consistent with alterations in the manually derived MCV and MCHC values although the same Coulter derived values were unaltered. A concomitant increase in median red cell density in whole blood (1.1045 +/- 0.0009 g.ml-1 pre race to 1.1057 +/- 0.012 g.ml-1 immediate post race, p less than 0.05) was recorded by centrifugation through phthalate esters of different density. The changes in creatine content of the red cells suggested that during the race younger cells were released into the circulation but that 24 h to 72 h after the race the mean red cell age had increased. Similarly, fractionation of the red cells on discontinuous Percoll density gradients indicated that the cell population was significantly denser in all post race samples up to 72 h but had normalized by a 16 day sample; the osmotic fragility was similarly affected.(ABSTRACT TRUNCATED AT 250 WORDS)