Taking Stock: An Adaptable Research and Partnership Model for Developing Puberty Education in 10 Countries.
There is a growing global interest in puberty and early adolescence and the importance of ensuring young people have the information and support they need during this critical phase of transition in the life course. This article highlights an adaptable model being used to support the development of contextually appropriate puberty education, in the form of illustrated and often bilingual books, for early adolescent girls and boys in countries around the world. This youth-centered participatory research and design model, which relies on the generation of community and government partnerships, has been employed in 10 countries thus far. Valuable learning has been documented from various contexts, including the approach's flexibility in adapting to the inputs of government and community members, incorporating local buy-in as a key ingredient for sustainability, using in-country experts for social and cultural appropriateness of illustrations and translations, and ensuring that the authentic youth voices captured through the participatory data collection and field-testing shape the educational content. The continuous integration of insights and perceptions of adults who influence young people's lives into the development process is also essential to enabling the uptake of puberty content in each new country. Parents, educators, youth service providers, and government officials are often the gatekeepers to young adolescents receiving puberty content and are thus critical to the process. This review of more than a decade of experience using this model underscores the essentiality of 2 key components-local partnership and participatory data collection-and highlights the importance of flexible approaches that are adapted to the unique sociocultural and environmental conditions in each country context.


NASDA next generation Aquatic Habitat for Space Shuttle and ISS.
The National Space Development Agency of Japan (NASDA) has more than 20 years of experience developing aquatic animal experiment facilities. We are now studying the next-generation aquatic animal experiment facility or the Aquatic Habitat (AQH) for both Space Shuttle and International Space Station use. A prototype breeding system was designed and tested. Medaka adult fish were able to mate and spawn in this closed circulatory breeding system, and the larvae grew to adult fish and spawned on the 45th day after hatching. The water quality-control system using nitrifying bacteria worked well throughout the medaka breeding test. For amphibians, we also conducted the African clawed toad (Xenopus laevis) breeding test with the same specimen chambers, although a part of circulation loop was opened to air. Xenopus larvae grew and completed metamorphosis successfully in the small specimen chamber. The first metamorphic climax started on the 30th day and was completed on the 38th day.


Long-term follow-up of children and juveniles with arachnoid cysts.
In the vast literature on intracranial arachnoid cysts, communication of long-term follow-up is rare. Therefore, we studied the case histories of 60 children and juveniles operated on in our hospital since 1951. The most favorable cases were patients with temporal cysts: 93% recovered fully or with only slight deficits. In other locations (frontal, parietal, occipital, infratentorial), the percentages for a favorable course were lower. The reason cannot be attributed to the operation procedures. Independent of the surgical procedure, there were no postoperative deaths after 1969. Long-term follow-up revealed that, depending on the location of the arachnoid cyst, a high percentage (62%-93% of patients) had normal physical and social development with satisfactory quality of life.


The araBAD operon of Salmonella typhimurium LT2. III. Nucleotide sequence of araD and its flanking regions, and primary structure of its product, L-ribulose-5-phosphate 4-epimerase.
The araD gene of Salmonella typhimurium LT2 consists of 744 nucleotides and has an ORF coding for a protein of 248 amino acid residues with a calculated Mr of 27059. The product of araD, L-ribulose-5-phosphate 4-epimerase, was purified and the amino terminal sequence was determined. It is identical to that predicted by the ORF. A 143-bp intercistronic region was found between the araA and araD genes which can form stem-loop structures with calculated free energies of up to -76.7 kcal/mol. Three sets of sequences within this 143-bp region are comparable to a consensus sequence deduced from several known intercistronic regions. Approximately equimolar amounts of the araBAD operon products were present in L-arabinose-induced cells. Sequences similar to both rho-independent and rho-dependent transcription terminators are present after the araD gene.


The draft genome of the grass carp (Ctenopharyngodon idellus) provides insights into its evolution and vegetarian adaptation.
The grass carp is an important farmed fish, accounting for ∼16% of global freshwater aquaculture, and has a vegetarian diet. Here we report a 0.9-Gb draft genome of a gynogenetic female adult and a 1.07-Gb genome of a wild male adult. Genome annotation identified 27,263 protein-coding gene models in the female genome. A total of 114 scaffolds consisting of 573 Mb are anchored on 24 linkage groups. Divergence between grass carp and zebrafish is estimated to have occurred 49-54 million years ago. We identify a chromosome fusion in grass carp relative to zebrafish and report frequent crossovers between the grass carp X and Y chromosomes. We find that transcriptional activation of the mevalonate pathway and steroid biosynthesis in liver is associated with the grass carp's adaptation from a carnivorous to an herbivorous diet. We believe that the grass carp genome could serve as an initial platform for breeding better-quality fish using a genomic approach.


Sexually Transmitted Diseases: Diagnosis and Control.
Sexually transmitted diseases (STDs)-or sexually transmitted infections (STIs)-are generally acquired through sexual contact [...].


Analysis of postoperative complications after open scar hernia hernioplasty - a retrospective analysis of a patient cohort.
The aim of this study was to analyse complications associated with inicisional hernia repair surgery and to assess individual risk factors for surgical site infections occurring at the Department of Surgery of the University Hospital Kralovske Vinohrady in 2015. We analysed 138 patients with a focus on risk factors that potentially increase the risk of postoperative infectious complications such as mesh implantation, smoking, diabetes mellitus, ischemic heart disease, malignancies, immunosuppressive therapy and urgency of the procedure. Based on multivariate logistic regression analysis, acute surgery proved to be a risk factor for infection, and in the ad hoc Fisher test, the ratio was 2.73. Diabetes mellitus as a risk factor reached the limit of significance (p=0.071). No other variables were associated with an increased risk of surgical site infections. Acute surgery was assessed as a significant risk factor for postoperative wound infection. On the contrary, mesh repair was not associated with an increased risk of infection.


Evaluation of NR4A3 immunohistochemistry (IHC) and fluorescence in situ hybridization and comparison with DOG1 IHC for FNA diagnosis of acinic cell carcinoma.
Acinic cell carcinoma (AcCC) is diagnostically challenging on fine-needle aspiration because it can mimic several other neoplasms or even normal acinar tissue. Immunopositivity for DOG1, especially circumferential membranous staining, can support the diagnosis of AcCC but is not entirely specific, and it is prone to technical and interpretive challenges on small specimens. NR4A3 (nuclear receptor subfamily 4 group A member 3) translocation and nuclear NR4A3 overexpression were recently described in the majority of AcCCs. Here, the authors evaluate the performance of NR4A3 immunohistochemistry (IHC) and NR4A3 break-apart fluorescence in situ hybridization (FISH) on cell block preparations and compare them with DOG1 IHC in distinguishing AcCC from other entities in the differential diagnosis. The authors identified 34 cytology cell blocks with lesional cells, including 11 specimens of AcCC (2 of which derived from 1 patient and showed high-grade transformation) as well as 2 secretory carcinomas, 7 salivary duct carcinomas, 4 mucoepidermoid carcinomas, 3 oncocytomas, 3 renal cell carcinomas, and 6 specimens containing nonneoplastic salivary gland tissue. NR4A3 IHC, DOG1 IHC, and NR4A3 FISH were attempted for all cases. NR4A3 IHC had 81.8% sensitivity and 100% specificity for AcCC, whereas NR4A3 FISH had 36.4% sensitivity and 100% specificity, although 4 cases (3 mucoepidermoid carcinomas and 1 salivary gland tissue sample) could not be analyzed because of low cellularity. Notably, no normal acinar tissue specimens showed NR4A3 positivity by IHC or FISH. In addition, DOG1 IHC had 72.7% sensitivity and 92% specificity. NR4A3 IHC is highly specific for the diagnosis of AcCC and is more sensitive than DOG1 IHC and NR4A3 FISH. In addition, NR4A3 IHC performance is not improved by the inclusion of DOG1 IHC. Finally, NR4A3 positivity resolves the perennial problem of distinguishing AcCC from normal acinar tissue.


Transarterial Chemoembolization of Hepatocellular Carcinoma: Propensity Score Matching Study Comparing Survival and Complications in Patients with Nonalcoholic Steatohepatitis Versus Other Causes Cirrhosis.
To evaluate the oncologic outcomes and complication profile in nonalcoholic steatohepatitis (NASH)-induced cirrhosis leading to hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE). Two hundred and twenty patients who underwent treatment of 353 HCCs were retrospectively reviewed, including 30 NASH patients who received TACE for 46 HCCs. Patient charts were evaluated for time to progression (TTP), complications and overall survival (OS). The group was split into NASH and non-NASH cohorts for comparison and additional analyses were done using propensity score matching (PSM). Patients in the NASH cohort presented with significantly larger lesions (4.9 ± 5.8 cm vs 3.1 ± 2.4 cm, p = 0.05). There was no significant difference in TTP overall [Median NASH 396 days (95% CI 308-526 days) vs non-NASH cohort 307 days (95% CI 272-364), p = 0.25) or after PSM [259 days non-NASH (95% CI 215-490) vs 396 days NASH (95% CI (349-not reached), p = 0.43]. There was a non-significant increased OS in the non-NASH [median 1078 days (95% CI 668-1594)] as compared to the NASH cohort [median 706 days (95% CI 314-not reached)] (p = 0.08) which decreased following PSM [853 days (95% CI 526-1511) non-NASH vs 706 days (95% CI 314-not reached) NASH, p = 0.48]. The number of complications did not differ significantly between the two groups (p = 0.23). The oncologic outcomes and complication profile of TACE for HCC induced by NASH cirrhosis appear to be similar to that of other etiologies of cirrhosis. NASH patients presented with larger tumors emphasizing the need for early surveillance.


New benzoic acid derivatives from Cassia italica growing in Saudi Arabia and their antioxidant activity.
Two new benzoic acid derivatives: 1-p-hydroxy benzoyl-3-palmitoyl glycerol (1) and 6 -p-hydroxy benzoyl daucosterol (2), along with scutellarein-6-methyl ether (3), quercetin (4), and rutin (5) had been separated from Cassia italica (Fabaceae) aerial parts from EtOAc fraction. Their characterisation was accomplished by various spectroscopic techniques and by comparing with the published data. The Ethyl acetate (EtOAc) fraction and compounds 1-5 had been assessed for their antioxidant potential utilizing DPPH assay. They had significant antioxidant capacities with activity ranged from 19.7 to 95.8%, in comparison to butylated hydroxyanisole (BHA) (93.8%). These findings could provide a further evidence to support the traditional use of C. italica for the treatment of chronic or degenerative illnesses.


Lidocaine and benzalkonium analysis and titration in drugs using new ISFET devices.
Two new ISFETs recently developed by us have now been applied to some pharmaceutical determinations in real matrices; the first device, responsive to cationic surfactants, was employed in the determination of benzalkonium chloride contained in two different disinfectant solutions and in three types of commercial collyrium; the second device, responsive to cocaine hydrochloride, showed an appreciable response also to lidocaine hydrochloride and was used in the determination of lidocaine hydrochloride contained in some injectable antibiotics. The repeatability and accuracy of measurements performed in the analysis of these pharmaceutical matrices using new solid state sensors were evaluated. A further aspect of the research involved the use of two sensors to record complete titration curves for the determination of benzalkonium chloride, cocaine hydrochloride and lidocaine hydrochloride, respectively. Applications to real matrices were also performed by analysing by titration pharmaceutical formulations containing benzalkonium chloride, or lidocaine hydrochloride and an illicit powder containing cocaine hydrochloride and sugars.


A quality of life assessment and the correlation between generic and disease-specific questionnaires scores in outpatients with chronic liver disease-pilot study.
Chronic liver diseases (CLD) are an important cause of morbidity and mortality in general population. The aim of this study was to analyze potential differences between patients with CLD and healthy control group, and to estimate the severity of CLD by using simple questionnaires: general health questionnaire (GHQ-12) and chronic liver disease questionnaire (CLDQ). A cross-sectional pilot study was performed in Zemun Clinical Hospital during years 2014 and 2015. Sixty participants were divided into 4 groups (15 per group): chronic alcoholic hepatitis, other chronic hepatitis, liver cirrhosis, and healthy control group. Entire study population chose one of four offered answers of structured questionnaires GHQ-12 and CLDQ, based on which mean model of end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) scores were calculated. Mean GHQ12 and CLDQ scores were 10.5 and 5.21 ± 1.11 respectively. Regarding certain CLDQ domain scores, a significant difference between alcoholic and non-alcoholic hepatitis groups in the worry domain was observed. Mean MELD score was 7.42 ± 2.89 and did not differ between chronic hepatitis groups, while mean CTP score was 5.73 ± 0.88. A statistically significant correlation was observed between GHQ12 and CLDQ scores (ρ = -0.404, p < 0.01), but not between subjective and objective scores. Mean GHQ12 and CLDQ scores pointed out to general psychological no-distress condition of the studied participants, as well as scarcely expressed CLD-specific complaints. Mean MELD and CTP scores indicated stable chronic liver diseases, with low three-month mortality rates in the cases of chronic hepatitis, as well as determination to Child A group in the case of liver cirrhosis.


Immunopathogenesis of the Canadian Delmarva (DMV/1639) infectious bronchitis virus (IBV): Impact on the reproductive tract in layers.
IBV infection may lead to reduced egg production and poor egg quality in layer flocks. The DMV/1639 strain was recently identified as one of the most dominant IBV variants isolated from Canadian layer flocks with egg production problems. The current study aimed to investigate the immunopathogenesis of the Canadian DMV/1639 strain in laying chickens. Specific-pathogen-free (SPF) layers were infected at the peak of lay (29 weeks; n = 10) with an uninfected control group (n = 10). Egg production in the infected group dropped to 40% by the fifth day post-infection (dpi). Five birds from the infected and the control groups were euthanized at 5 and 10 dpi. Ovarian regression and shortened oviduct with marked histopathological changes were observed in the infected group at 10 dpi. An increase in the IBV viral load in reproductive tissues was accompanied by a significant recruitment (p < 0.05) of KUL01+ macrophages and CD4+ and CD8+ T cell subsets at 10 dpi. Additionally, anti-IBV antibody response was detected in serum and locally in the reproductive tract washes of the infected group. Overall, our findings contribute to the understanding of the pathogenicity of the Canadian DMV/1639 strain and the subsequent host responses in the reproductive tract of chickens.


[Pulmonary crackles, what does the clinician hear?].
The overall duration of a pulmonary crackle is usually less than 20-30 ms but psychoacoustics demonstrates that an acoustical event with a duration of less than 20-40 ms cannot be estimated in terms of pitch and duration. We pose the hypothesis that the main resonant information is contained into the breath sounds following the crackle. Eight patients with COPD, viral pneumonia, bronchiectasis, congestive heart failure, hypoproteinemia and fibrosing alveolitis were recruited for this study. Thirty-six crackles were analyzed in time and frequency domains; 12 in each category of low, medium and high frequencies. The acoustic features of the crackles, their segments (initial deflection width, first cycle duration, two cycles duration, decay segment) and the breath sounds following the crackles were compared. The study confirms the differences between the three crackles categories in time and frequency domains. No statistical differences were found between the decay segments and breath sounds in each category. Breath sounds modified by lung tissue density could be the main resonators determining the fundamental transmission frequencies of crackle signals. Combined acoustic analysis of crackles and breath sounds could replace single analysis of isolated crackles.


Scintigraphic demonstration of accessory hepatic duct leak following liver transplantation.
Few noninvasive methods are available to diagnose complications following liver transplantation. Hepatobiliary scintigraphy can differentiate rejection from primary biliary complications such as obstruction or extravasation in patients with nonspecific clinical findings such as fever and rising liver function studies. In the following case report, an unexpected biliary leak from a recipient accessory hepatic duct was demonstrated by [99mTc] DISIDA scintigraphy following liver transplantation.


Patients with traumatic spinal cord injuries and their satisfaction with their general practitioner.
The objective of this study was to examine how satisfied patients with traumatic spinal cord injury (TSCI) are with their general practitioners (GP). The study included patients with TSCI, injured in the period 1982-2001 and living in western Norway. We performed a structured telephonic interview of the patients in the period 2004-2007. A total of 105 (59.3%) patients participated. Patients with TSCI were in general satisfied with their GP. Older patients were most satisfied, and patients with incomplete thoracic SCI were least satisfied. Patients with anxiety and/or depression reported low satisfaction with their GP on several parameters. Patients with incomplete SCI were least satisfied probably because their physicians do not acknowledge their complicated medical complaints and do not meet the patient's expectations. Patients with anxiety and/or depression were more likely to report low satisfaction with their GP.


Two-Stage Revision Protocol in Multidrug Resistant Periprosthetic Infection Following Total Hip Arthroplasty Using a Long Interval Between Stages.
We retrospectively reviewed the medical records of 31 patients with periprosthetic hip infections attempting to evaluate the outcome of a two-stage revision protocol characterized by prolonged interim period (mean=9.2 months, range 8-12 months) prior to the final re-implantation. In 3 cases (9.6%) the 1st stage was repeated after a mean period of 12.3 weeks due to relapse of infection. Five spacer dislocations occurred, not affecting the final clinical outcome after reimplantation, as evaluated by the Harris Hip Score. No protrusions or additional acetabular bone loss was noticed. Our proposed protocol is a simple, safe, efficient and reproducible treatment approach that may be successfully utilized predominantly when dealing with multidrug resistant pathogens.


Synergistic activity of purine metabolism inhibitors in cultured human tumor cells.
Cytotoxic effects of 3-deazaguanosine (3-DGUO) result from the inhibition of DNA synthesis and incorporation of the drug into DNA. Synergistic antiproliferative effects of a combination of 3-deazaguanosine and 2-beta-D-ribofuranosylthiazole-4-carboxamide, a potent inhibitor of inosine monophosphate dehydrogenase, was observed in human tumor cells. Inosine reversed the antiproliferative effects of the 3-deazaguanosine but not 2-beta-D-ribofuranosylthiazole-4-carboxamide. 3-Deazaguanosine monophosphate was shown to inhibit the activity of the de novo purine synthesis enzyme, 5'-phosphoribosyl-5-aminoimidazole-4-carboxamide transformylase. The data suggested a cytotoxic effect of 3-DGUO associated with the inhibition of de novo purine synthesis by drug nucleotides, an effect which may account for the synergistic action noted.


Stage Characterization and Marginal Bone Loss Evaluation Up to 96 Months of Crestal Sinus Augmentation With Sequential Drills: A Retrospective Study.
The 2-stage crestal approach to augment the maxillary sinus is a little-used technique. The aim of this retrospective study was to assess events characterizing stages of this technique after implant placement in the posterior maxilla with residual bone height less than 4 mm and evaluate the marginal bone loss (MBL) changes over time. Thirty-three patients underwent unilateral sinus augmentations using the trancrestal technique with mineralized allograft. Six-months (6 m) after first surgery, if skeletal subsidence prevented insertion of a 10-mm-length implant, additional grafting was performed during implant (n = 33) insertion. Radiographs were taken before grafting (baseline), immediately after and at 6 months; immediately after and 6 months after implant placement; and at follow-up (24-96 m). One implant was lost (ISR = 96.97%). Of the remaining 32 patients, 14 (A group) underwent standard implant placement, whereas 18 (B group) underwent additional grafting immediately before implant placement. Given that B-group patients initially obtained lower crestal bone height after first surgery, additional grafting procedures provided greater crestal height in the B group. A significant relationship between ending (eMBL) and 6mMBL was found in both groups, with greater values in the B group. However, in both groups, eMBL was always greater if 6mMBL was greater than 0.44 mm. Results suggest a high and low skeletal-reactivity patient categorization. In both patient categories, MBL greatly depends upon 6-month values. Investigations are necessary to relate sinus size with results obtained by this 2-stage crestal approach. The 2-stage crestal sinus lift procedure not only provides predictable results, but also allows low skeletal-reactivity patient recovery.


[Sexual and reproductive health among adolescents in high school in Guadalajara, México].
Some authors define adolescence as the period of transition between childhood and adulthood, a stage characterized by the succession of major physiological, psychological and social human beings. To determine the extent of information about preventing sexually transmitted diseases, knowledge and use of contraceptive methods, and to determine the percentage of high school teenagers who have initiated sex and age of onset. We have realized a transverse descriptive study in 754 students from public junior high school number 54 in the city of Guadalajara, during the 2005-2006 school year. We have applied a survey that included questions about sexual health, and aspects as knowledge and use of contraceptive methods and concepts on the prevention of sexually transmitted diseases. Data were captured in a database in Excel, and then analyzed using SPSS. It included 641 students who agreed to complete the questionnaire by signed consent. The source of information on sex education is the most important school. The 84.5% of students surveyed know at least one contraceptive method, of which the condom is the best known (73.3%). The 84% of teenagers know how to prevent sexually transmitted diseases. Of all students, only 46 (7.2%) have initiated sexual activity of which 100% of males used contraception while only 63.3% of women did. It is necessary to establish or strengthen information programs on sexual health for adolescents, not only in schools if not in the media.


Shaping a librarian; the impact of Shane Godbolt as manager, mentor and more.
A personal appreciation of Shane Godbolt as a colleague and friend.


Impact of income inequality on CO2 emissions in G20 countries.
Over the past three decades, the G20 countries have experienced rapid economic growth but also a widening income disparity and deteriorating environment. We examined whether and how income distribution affects CO2 emissions during economic growth under the extended EKC framework. Using simultaneous quantile regression analysis, we show that, for developing countries, a more equal income distribution favors reductions to the CO2 emissions per capita, whereas, in most developed countries, income inequality hardly affects CO2 emissions. Meanwhile, the EKC hypothesis is valid in G20. Based on the empirical results, we particularly emphasize the importance of reducing income inequality in developing countries and that the entire G20 takes the path of sustainable development.


Stories as Gift: Patient Narratives and the Development of Empathy.
Critical thought and assessment of medical, emotional, and social problems faced by patients is central to genetic counselor training and development. However, primary emphasis on these critical problem-solving approaches can interfere with the development of empathic listening skills. Using a narrative medicine approach, I describe how learning to reframe one patient's story of healing as a gift allowed me to become a more open and empathic listener. Ultimately, the empathy and understanding that I learned from this patient's narrative added to what previous patients had taught me and helped me assist other patients (and myself) in identifying and nurturing healing narratives for people coping with illness and grief. The approach presented here emphasizes the importance of recognizing patients as valuable teachers in the development of higher-level empathy skills.


The relationship between organisational support for career development, organisational commitment, and turnover intentions among healthcare workers in township hospitals of Henan, China.
Township hospitals in China face the challenge of shortage and turnover of healthcare workers. This study aims to evaluate the relationship between organisational support for career development (OSCD), organisational commitment, and turnover intentions among healthcare workers in township hospitals. The data in this study were obtained from the Health Service Capacity Survey of Primary Health Institutions (2020), one of the special surveys of rural health poverty alleviation in Henan, China. The sample comprised 298 healthcare workers. Three standardised instruments were used: the turnover intention scale, OSCD scale, and organisational commitment scale. Descriptive statistics, One-way Analysis of Variance, Pearson correlation analysis, and the simple mediation model were used for data analysis. The results showed that the mean score of the healthcare workers' turnover intentions was 2.21 ± 0.77, which was low. The healthcare workers' turnover intentions had significant differences in gender, age, marital status, education, professional title, and organisational tenure. OSCD had no significant direct relationship with turnover intentions, while having a significant positive direct relationship with organisational commitment. Organisational commitment had a significant negative direct relationship with turnover intentions, and played a fully mediating role in the relationship between OSCD and turnover intentions. OSCD had an indirect negative effect on healthcare workers' turnover intentions in township hospitals through the full mediation of organisational commitment. The findings of this study suggest the importance of policymakers and organisation managers to improve OSCD practice and pay attention to 'humanistic management'. In addition, the formulation and implementation of talent retention policies should consider socio-demographic differences.


Reaction of 4',5'-epoxynucleosides with carbon nucleophiles: stereoselective synthesis of 4'-C-carbon-substituted nucleosides.
4',5'-Epoxythymidine (4) was obtained as a single diastereoisomer by oxidation of 3'-O-(t-butyldimethylsilyl)-4',5'-dehydrothymidine (3) with dimethyldioxirane. When the epoxide 4 was treated with allyltrimethylsilane in the presence of SnCl4, regio- (at the C4') and stereoselective (from the alpha-face) cleavage of the oxirane ring proceeded to afford a 4'-C-alpha-allylated derivative (5) as a sole product. In the reaction of 4 with trimethylaluminum, 4'-C-beta-methyl derivative (8) was obtained as a major product.


Escaping behavior and morphological correlates in two Liolaemus species of Central Chile (Lacertilia: Iguanidae).
Two central Chile lizards differ in their response to the approach of potential predators: Liolaemus lemniscatus escapes from rocky patches into grassy patches, and Liolaemus fuscus runs away from a rock onto another within the same rocky patch. These escaping responses are associated with concealing coloration and comparatively shorter legs in L. lemniscatus, as compared to L. fuscus. The adequacy of the behavior of L. lemniscatus is discussed.


Alzheimer's vaccine: a cure as dangerous as the disease?
Studies in transgenic mouse models of Alzheimer's disease suggested the potential for a vaccine development. However, some patients in the human clinical trials developed symptoms of brain inflammation, demonstrating the high risk of a deliberately induced auto-immune response.


Latent class analysis of bipolar disorder symptoms and suicidal ideation and behaviors.
Individuals with bipolar disorder are at increased risk of dying by suicide compared to healthy controls and those with unipolar depression. Previous studies show that depressive symptoms and mixed episodes of mania and depression are related to suicide. However, most of these studies adopt a variable-centered approach to understanding how specific symptoms relate to suicidal ideation, without addressing how these symptoms and symptom profiles relate to suicidal behaviors. Using latent class analysis, this study adopts a person-centered approach to examine whether subtypes of patients with bipolar disorder differ in their levels of suicidal ideation and behaviors. A total of 150 patients from a behavioral health outpatient clinic were recruited. Latent classes were generated based on self reports of their depressive and manic symptoms. Five classes of patients with bipolar disorder were identified, namely, a minimal symptom, mania, moderately depressed, severely depressed, and mixed depression-mania subtypes. Those in the severely depressed and mixed depression-mania groups reported significantly higher levels of suicidal ideation and behaviors compared to the other groups. Our findings provide further support for the strong relationship between depressive symptoms and suicidality. These findings are significant as they shed light on the different suicide risk profiles among a heterogenous group of patients with bipolar disorder. Name of clinical trial: Suicidal Behavior in Patients Diagnosed with Bipolar Disorder: The Roles of Biological and Childhood and Adult Environmental Risk Factors. ClinicalTrials.gov Identifier: NCT02604277.


Functional prognosis after treatment of spinal radiculomeningeal arteriovenous malformations.
We performed surgical treatment successfully in six patients with spinal radiculomeningeal arteriovenous malformation (AVM); however, only four patients showed improvement of gait function postoperatively. These experiences prompted us to review the clinical findings and their possible association with the functional outcome in 33 reported cases of radiculomeningeal AVM together with those in our six patients. Statistical analysis revealed that the duration from onset of symptoms until diagnosis, the age at the time of treatment, the condition of the deep tendon reflexes (DTR) in the lower extremities, as well as the severity of both gait and urinary disturbance before treatment were significantly correlated with the functional outcome. A patient under 70 years old, who is treated within 2 years 6 months after the onset, whose gait or urinary disturbance is slight or moderate, and without absence of DTR in the lower extremities, is expected to have a good functional prognosis after treatment.


Pulmonary segmentectomy: results and complications.
Segmentectomy is an anatomic pulmonary parenchymal-sparing resection performed for certain benign lesions and on selected patients with lung cancer. We reviewed our experience with segmentectomy in this highly select group of patients. We retrospectively reviewed the records of 61 patients (5% of all anatomic resections) undergoing 62 segmentectomies from 1991 to 2001. Wedge resections were excluded. The operative indications were suspected or known lung cancer (43), benign disease (12), and metastatic cancer to the lung (7). Median follow-up for patients with malignancy was 28 months (range 1 to 89 months). Actuarial survival was calculated using the Kaplan-Meier method. Segmentectomy was performed in 43 lung cancer patients with pathologic stages of Ia-22, Ib-14, IIa-2, IIb-1, IIIa/IIIb-2, and IV-2. All resection margins were negative for malignancy. Segmentectomy for benign diseases included granulomatous disease (5), pulmonary abscess (2), plasmacytoma (1), and others (4). Complications occurred in 39% (24/62) of patients, including atelectasis requiring bronchoscopy (10/62, 16%), pneumonia (9/62, 14%), air leak more than 7 days (5/62, 8%), and supraventricular dysrhythmias (6/62, 10%). In-hospital mortality was 3% (2 patients). Median length of hospital stay was 6 days (range 4 to 66 days). In the lung cancer patients the locoregional recurrence rate was 0% and the distant recurrence rate was 20%. The 4-year actuarial survival for patients with lung cancer was 72%. Pulmonary segmentectomy has acceptable morbidity and mortality in selected patients with both benign and malignant lung disease and remains a useful procedure in a thoracic surgeon's armamentarium. Distant, not locoregional recurrence, was responsible for the cancer deaths.


[Reliability of electrophysiologic examinations for cataract surgery in cases of suspected retinal detachment].
Justification for cataract surgery obviously depends on retinal efficiency. The study of light projections makes it sometimes possible to suspect a retinal detachment. We are, therefore, trying to check for retinal detachment by means of the various exploration processes now available. Results of echography, electroretinography, electro-oculography, and visual evoked potentials are discussed according to the exper-ence gained.


Halothane selectively inhibits bradykinin-induced synovial plasma extravasation.
In vitro studies demonstrate that halothane, but not isoflurane, inhibits bradykinin-induced calcium currents and prostacyclin release in cultured endothelial cells. Because bradykinin is an important endogenous mediator of inflammation, we assessed the effects of halothane, isoflurane, and pentobarbital on plasma extravasation, a component of tissue inflammation induced by bradykinin, in rats. We anesthetized 23 rats with halothane (0.8 or 1.3 minimum alveolar concentration [MAC]), isoflurane (1.3 MAC), or pentobarbital (total of 85 mg/kg intraperitoneally). Their tracheas were intubated and their lungs mechanically ventilated. After intravenous administration of Evans blue dye, we perfused normal saline followed by bradykinin or platelet-activating factor, another inflammatory mediator, intraarticularly via needles placed in the knee joint. We collected perfusate and estimated extravasation by measuring dye in the perfusate using spectrophotometry. Bradykinin increased plasma extravasation eight- to ninefold above baseline in both pentobarbital- and isoflurane-anesthetized rats. In contrast, bradykinin-induced plasma extravasation at 0.8 MAC and 1.3 MAC of halothane was approximately 40% (P < 0.01) and 15% (P < 0.001), respectively, of that in pentobarbital- and isoflurane-anesthetized rats. Baseline plasma extravasation was lower in rats anesthetized with either concentration of halothane compared with pentobarbital or isoflurane (all P < 0.001). Platelet-activating factor-induced plasma extravasation was similar for all anesthetics. Halothane, but not isoflurane or pentobarbital, inhibits both baseline and bradykinin-induced peripheral plasma extravasation, demonstrating that volatile anesthetics differentially modulate this important component of inflammation.


S phase fraction of human bladder tumor measured in situ with bromodeoxyuridine labeling.
A total of 18 patients with transitional cell bladder cancer was given a 0.5-hour intravenous infusion of bromodeoxyuridine at the time of endoscopic biopsy or transurethral resection to label tumor cells in the deoxyribonucleic acid synthesis phase (S phase). The tumor specimens were fixed with 70 per cent ethanol, embedded in paraffin, sectioned and stained by an indirect immunoperoxidase method with anti-bromodeoxyuridine monoclonal antibody as the first antibody. The bromodeoxyuridine labeling index, S phase fraction, was determined by counting the number of bromodeoxyuridine-labeled cells in the tissue sections. All grade 1 tumors had an S phase fraction of lower than 10 per cent. The average S phase fractions for noninvasive (11 cases) and invasive (7) tumors were 9.8 and 20.0 per cent, respectively. Two distant metastatic bladder tumors showed an average S phase fraction of 25.3 and 30.0 per cent. Thus, transitional cell bladder cancers with an S phase fraction of greater than 10 per cent appears to grow faster and be more invasive more often than those with an S phase fraction of less than 10 per cent. The higher S phase fraction may indicate greater biological malignancy. Our preliminary results suggest that measurement of the bromodeoxyuridine labeling index in bladder tumors may be a new objective and quantitative assay of biological potential of individual tumors.


Modeling of yield and environmental impact categories in tea processing units based on artificial neural networks.
In this study, an artificial neural network (ANN) model was developed for predicting the yield and life cycle environmental impacts based on energy inputs required in processing of black tea, green tea, and oolong tea in Guilan province of Iran. A life cycle assessment (LCA) approach was used to investigate the environmental impact categories of processed tea based on the cradle to gate approach, i.e., from production of input materials using raw materials to the gate of tea processing units, i.e., packaged tea. Thus, all the tea processing operations such as withering, rolling, fermentation, drying, and packaging were considered in the analysis. The initial data were obtained from tea processing units while the required data about the background system was extracted from the EcoInvent 2.2 database. LCA results indicated that diesel fuel and corrugated paper box used in drying and packaging operations, respectively, were the main hotspots. Black tea processing unit caused the highest pollution among the three processing units. Three feed-forward back-propagation ANN models based on Levenberg-Marquardt training algorithm with two hidden layers accompanied by sigmoid activation functions and a linear transfer function in output layer, were applied for three types of processed tea. The neural networks were developed based on energy equivalents of eight different input parameters (energy equivalents of fresh tea leaves, human labor, diesel fuel, electricity, adhesive, carton, corrugated paper box, and transportation) and 11 output parameters (yield, global warming, abiotic depletion, acidification, eutrophication, ozone layer depletion, human toxicity, freshwater aquatic ecotoxicity, marine aquatic ecotoxicity, terrestrial ecotoxicity, and photochemical oxidation). The results showed that the developed ANN models with R 2 values in the range of 0.878 to 0.990 had excellent performance in predicting all the output variables based on inputs. Energy consumption for processing of green tea, oolong tea, and black tea were calculated as 58,182, 60,947, and 66,301 MJ per ton of dry tea, respectively.


Treating the family with multiple sclerosis.
It is difficult to treat a family, particularly when clinicians only have the opportunity to see one or two members in the medical setting. Still, one can accomplish a great deal by viewing the patient within a family system. Advantages of this systemic approach are similar to those accrued when one views the individual patient's problems as being inter-connected. For example, we know that pain stemming from MS can exacerbate depression that, in turn, increases pain ... and so on. By the same token, if the clinician treats either pain or depression, it will likely reduce the other one. One doesn't need to treat all aspects of the family to show a fundamental improvement in the system. If the well partner attends a support group, his or her ability to care for the patient may increase, which could reduce his or her own depression. If children learn to explain the patient's MS to their friends, then they feel more comfortable with closeness to the parent. Treating the family helps it stay healthy, and it is the family who ultimately cares for the patient. To treat the family is to provide the patient with essential care.


A new technique for direct percutaneous jejunostomy tube placement.
We describe a case in which we employed a new method of using intraluminal balloon support for direct percutaneous placement of a jejunostomy tube. Standard interventional radiologic techniques and readily available equipment and materials were used.


Consensus guidelines for high dose rate remote brachytherapy in cervical, endometrial, and endobronchial tumors. Clinical Research Committee, American Endocurietherapy Society.
A large number of medical centers have recently instituted the use of High Dose-Rate Afterloading Brachytherapy (HDRAB). There is wide variation in treatment regimens, techniques, and dosimetry being used and there are no national standard protocols or guidelines for optimal therapy. The Clinical Research Committee (CRC) of the American Endocurietherapy Society (AES) met to formulate consensus guidelines for HDRAB in cervical, endometrial, and endobronchial tumors. Each center is encouraged to follow a consistent treatment policy in a controlled fashion with complete documentation of treatment parameters and outcome including efficacy and morbidity. Until further clinical data becomes available, the linear quadratic model can be used as a guideline to formulate a new HDR regimen exercising caution when changing from a Low Dose Rate (LDR) to a HDRAB regimen. The treatments should be fractionated as much as practical to minimize long term morbidity. As more clinical data becomes available, the guidelines will mature and be updated by the Clinical Research Committee of the AES.


Evaluation of a combined HIV-1/2 and HTLV-I/II assay for screening blood donors.
A combined immunoassay for the simultaneous detection of antibodies to HIV-1/2 and HTLV-I/II (Bioelisa, Launch Diagnostics) has been evaluated to determine its suitability for routine use in blood screening. 84,222 donations were tested from 76,452 donors. One HIV- and 1 HTLV-1-positive donor were identified. The specificity was 99.7%, and the sensitivity for anti-HIV-1, anti-HIV-2, and anti-HTLV-1 on 173 positive sera was 100%; 2 of 25 anti-HTLV-II-positive sera were non-reactive. Although the specificity of the assay is not as high as that of HIV-1/2 kits currently in UK transfusion use, the information gained about donor HTLV antibody status makes the test an attractive alternative to them.


Nonlinear cable equations for axons. II. Computations and experiments with external current electrodes.
We have investigated the steady-state potential and current distributions resulting from current injection into a close-fitting channel into which a squid axon is placed. Hybrid computer solutions of the cable equations, using the Hodgkin-Huxley equations to give the membrane current density, were in good agreement with experimental observations. A much better fit was obtained when the Hodgkin-Huxley leakage conductance was reduced fivefold.


Theoretical molecular biology: prospectives and perspectives.
I briefly discuss some aspects of theoretical molecular biology. Specifically, I include the issues of searches for homologies via string matchings, for patterns of specific nucleotide groupings and of sequence-structure relationship. The various approaches developed in order to achieve this end are described, attempting to convey some of the excitement in this quickly growing field.


Detection of λ-cyhalothrin by a core-shell spherical SiO2-based surface thin fluorescent molecularly imprinted polymer film.
A fluorescent core-shell molecularly imprinted polymer based on the surface of SiO2 beads was synthesized and its application in the fluorescence detection of ultra-trace λ-cyhalothrin (LC) was investigated. The shell was prepared by copolymerization of acrylamide with allyl fluorescein in the presence of LC to form recognition sites. The experimental results showed that the thin fluorescent molecularly imprinted polymer (FMIP) film exhibited better selective recognition ability than fluorescent molecularly non-imprinted polymer (FNIP). A new nonlinear relationship between quenching rate and concentration was found in this work. In addition, the nonlinear relationship allowed a lower concentration range of 0-5.0 nM to be described by the Stern-Volmer equation with a correlation coefficient of 0.9929. The experiment results revealed that the SiO2@FMIP was satisfactory as a recognition element for determination of LC in soda water samples. Therefore this study demonstrated the potential of MIP for the recognition and detection of LC in food.


Imaging Histamine H3 Receptors with Positron Emission Tomography.
Positron emission tomography (PET) provides a unique tool to study the biochemistry of the human brain in vivo. By using PET probes that are binding selectively to certain receptor subtypes, brain PET allows the quantification of receptor levels in various brain areas of human subjects. This approach has the potential to reveal abnormal receptor expressions that may contribute to the physiopathology of some psychiatric and neurological disorders. This approach also has the potential to assist in the drug development process by determining receptor occupancy in vivo allowing selection of proper drug dosage to produce therapeutic effects. Several PET tracers have been developed for histamine H3 receptors (H3R). However, despite the potential of PET to elucidate the role of H3R in vivo, only limited work has been conducted so far. This article reviews the work that has been done in this area. Notably, we will cover the limitations of the first-generation PET radioligand for H3R and present the advantages of novel radioligands that promise an explosion of clinical PET research on the role of H3R in vivo.


Morphological characteristics of the spermatogonial stem cells in man.
The present investigation is concerned with establishing morphological criteria of spermatogonial stem cells in man. Testicular biopsies from patients having undergone semicastration for malignant tumors and radio- and chemotherapy for one year following the operation were studied light and electron microscopically. Those spermatogonial types that survived the treatment were regarded as stem cells in view of the fact that the stem cells, in contrast to the more differentiated spermatogonia, are radiation resistant and less sensitive to various noxious agents. In 7 out of 28 cases examined, a small number of spermatogonia was found adjacent to the basement membrane. The majority of these cells show the characteristic features of pale type A spermatogonia, while a few cells may represent variants of this cell type. The dark type A spermatogonia are almost completely eliminated from the seminiferous tubules. A concept is proposed that the stem cells of the human testis may be derived from the pale type A spermatogonia or the variants of this cell type.


Wellness, burnout, and the dermatologist: Fundamentals for practice longevity.
Physician wellness is a critical component of any effective health care system, as physicians serve essential roles as diagnosticians, surgeons, and leaders in medical care. Physician burnout, defined as a combination of the presence of emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, is an increasingly recognized problem in the US health care system, as rates of burnout among physicians are on the rise, now exceeding 50%. To date, few studies have examined the impact of burnout on dermatologists specifically, but existing studies evaluating physicians collectively have shed light on the problem that exists in our specialty. This review focuses on the causes of physician dissatisfaction and burnout and provides an overview on interventions to mitigate them while emphasizing wellness; where applicable, special emphasis is placed on dermatologists.


Antibody response following the fourth SARS-CoV-2 vaccine dose during the Omicron wave in Brazil.
We investigated the impact of the fourth dose with ChAdOx1 nCoV-19 (AstraZeneca) in the humoral immune response to SARS-CoV-2 during a 9-month follow-up period in which Omicron was the predominant variant in Brazil. IgG for the SARS-CoV-2 spike protein (S) and nucleocapsid (N) proteins were analyzed in samples collected before and after the fourth dose. All participants were tested monthly for SARS-CoV-2 infection by RT-qPCR. The antibody response induced by the fourth dose of the coronavirus disease 2019 vaccine was evaluated and compared with the response induced by the second and third doses. The additional antibody response to the viral S protein after the fourth dose was smaller than those after the third vaccine dose. In contrast, an increase in the N IgG levels could be observed after the fourth dose compared to other vaccine doses. In the comparison of the antibody response before and after the fourth dose, an increase in both S-and-N IgG was noted, mainly in the positive qPCR group. We did not observe a significant decline in IgG levels after the fourth dose, as observed after the second and third doses, therefore, a sustained humoral response to both S and N proteins seems to be achieved.


Perinatal psychosocial assessment of women of refugee background.
Women of refugee background may be particularly vulnerable to perinatal mental illness, possibly due to increased exposure to psychosocial stressors associated with their forced migration and post-resettlement adjustment. This study aimed to compare psychosocial risk factors reported by women of refugee background receiving maternity services at a public hospital, to those reported by Australian-born women in the same hospital. It further aimed to examine the referrals offered, and accepted, by the women of refugee background reporting psychosocial risk factors for perinatal mental illness. A retrospective hospital record review was conducted to compare the antenatal and postnatal psychosocial risk factors of 100 women of refugee background and 100 Australian-born women who gave birth at a public hospital in Victoria between 1 July 2015 and 30 April 2016, and who had completed the Maternity Psychosocial Needs Assessment. Women of refugee background were more likely than Australian-born women to report financial concerns and low social support at antenatal assessment, but were less likely to report prior mental health problems than Australian-born women at either assessment point. Both groups reported low rates of family violence compared to published prevalence rates. Of the women of refugee background assessed antenatally, 23% were offered referrals, with 52% take-up. Postnatally, 11.2% were offered referrals, with 93% take-up. This study showed elevated rates of psychosocial risk factors among women of refugee background, however, possible under-reporting of mental health problems and family violence raises questions regarding how to assess psychosocial risk factors with different cultural groups. Lower antenatal referral take-up suggests barriers to acceptance of referrals may exist during pregnancy.


Gynaecological cancer leads to long-term sick leave and permanently reduced working ability years after diagnosis.
The aim of the study was to investigate overall patterns in labour market affiliation, risk for permanently reduced work ability and prevalence of long-term sickness absence among women diagnosed with gynaecological cancer. We followed 8451 women diagnosed with ovarian, endometrial or cervical cancer, and 72,311 women with no history of cancer in nationwide registers for up to 19 years (mean 7.5 years). We computed hazards ratios for permanently reduced working ability and annual proportions of long-term sick leave. Patterns of labour market affiliation varied by cancer diagnosis and stage. The hazard of permanently reduced working ability was increased for survivors of all three cancers but most pronounced for women diagnosed with advanced ovarian cancer. The highest hazard ratios were found 2-5 years after diagnosis, and they persisted for years in all groups and throughout the follow-up period of 19 years in women diagnosed with advanced cervical cancer. In the subgroups of women who continued to be potentially active on the labour market, long-term sick leave was more prevalent among cancer survivors than women with no history of cancer up to 10 years after diagnosis. Women diagnosed with localised as well as advanced gynaecological cancer are at prolonged risk for permanently reduced working ability and long-term sick leave. Gynaecological cancer can have long-term as well as permanent consequences for working ability, and survivors who remain active on the labour market might have to take more sick leave even years after cancer diagnosis than other women at their age.


Gender-specific effects of intrauterine growth restriction on the adipose tissue of adult rats: a proteomic approach.
Intrauterine growth restriction (IUGR) may program metabolic alterations affecting physiological functions and lead to diseases in later life. The adipose tissue is an important organ influencing energy homeostasis. The present study was aimed at exploring the consequences of IUGR on the retroperitoneal adipose tissue of adult male and female rats, using a proteomic approach. Pregnant Wistar rats were fed with balanced chow, either ad libitum (control group) or restricted to 50 % of control intake (restricted group) during the whole gestation. The offspring were weaned to ad libitum chow and studied at 4 months of age. Retroperitoneal fat was analyzed by two-dimensional gel electrophoresis followed by mass spectrometry. Both male and female restricted groups had low body weight at birth and at weaning but normal body weight at adulthood. The restricted males had normal fat pads weight and serum glucose levels, with a trend to hyperinsulinemia. The restricted females had increased fat pads weight with normal glucose and insulin levels. The restricted males showed up-regulated levels of proteasome subunit α type 3, branched-chain-amino-acid aminotransferase, elongation 1- alpha 1, fatty acid synthase levels, cytosolic malate dehydrogenase and ATP synthase subunit alpha. These alterations point to increased proteolysis and lipogenesis rates and favoring of ATP generation. The restricted females showed down-regulated levels of L-lactate dehydrogenase perilipin-1, mitochondrial branched-chain alpha-keto acid dehydrogenase E1, and transketolase. These findings suggest impairment of glycemic control, stimulation of lipolysis and inhibition of proteolysis, pentose phosphate pathway and lipogenesis rates. In both genders, several proteins involved in oxidative stress and inflammation were affected, in a pattern compatible with impairment of these responses. The proteomic analysis of adipose tissue showed that, although IUGR affected pathways of substrate and energy metabolism in both males and females, important gender differences were evident. While IUGR males displayed alterations pointing to a predisposition to later development of obesity, the alterations observed in IUGR females pointed to a metabolic status of established obesity, in agreement with their increased fat pads mass.


With Probiotics, Resistance Is Not Always Futile.
Probiotics and other bacteriotherapies are actively being explored and applied as symptom- and disease-modifying agents. In a recent issue of Cell, two papers contribute to our understanding of how live bacterial therapies variably affect individuals and the short- and longer-term impact of these therapies on colonization and host response.


Decreased high density lipoprotein-cholesterol levels in male patients with transient ischemic attacks.
Plasma lipid and lipoproteins levels were determined in a continuous series of 50 patients (36 males and 14 females), mean age around 50 years, with a clinical diagnosis of transient ischemic attacks (TIAs). TIA was defined as a sudden episode of focal cerebrovascular insufficiency, with complete resolution of the symptoms within 24 h. TIAs are considered an important prognostic symptom for ischemic cerebrovascular diseases, being manifest in approximately 45% of the patients later undergoing a complete stroke. Plasma total cholesterol levels did not differ in these patients, when compared with a similar series of patients of the same age and sex, free of cerebrovascular lesions. A slight elevation of mean triglyceride levels was detected in the patients of both sexes, as well as higher incidence of type IV hyperlipoproteinemia. The most significant finding, however, observed only in male TIA patients, was that of significantly reduced high density lipoprotein (HDL)-cholesterol levels. This reduction (-19.7% compared to the control group) is similar to that recently reported for patients with clear-cut ischemic cerebrovascular disease. The detection of decreased HDL-cholesterol levels in male TIA patients may be of considerable significance for a prognostic evaluation of this biochemical parameter.


Dexmedetomidine-midazolam versus Sufentanil-midazolam for Awake Fiberoptic Nasotracheal Intubation: A Randomized Double-blind Study.
Awake fiberoptic intubation (AFOI) is usually performed in the management of the predicted difficult airway. The aim of this study was to evaluate the feasibility of dexmedetomidine with midazolam (DM) and sufentanil with midazolam (SM) for sedation for awake fiberoptic nasotracheal intubation. Fifty patients with limited mouth opening scheduled for AFOI were randomly assigned to two groups (n = 25 per group) by a computer-generated randomization schedule. All subjects received midazolam 0.02 mg/kg as premedication and airway topical anesthesia with a modified "spray-as-you-go" technique. Group DM received dexmedetomidine at a loading dose of 0.5 μg/kg over 10 min followed by a continuous infusion of 0.25 μg·kg-1·h-1, whereas Group SM received sufentanil at a loading dose of 0.2 μg/kg over 10 min followed by a continuous infusion of 0.1 μg·kg-1·h-1. As necessary, since the end of the administration of the loading dose of the study drug, an additional dose of midazolam 0.5 mg at 2-min intervals was given to achieve a modified Observers' Assessment of Alertness/Sedation of 2-3. The quality of intubation conditions and adverse events were observed. The scores of ease of the AFOI procedure, patient's reaction during AFOI, coughing severity, tolerance after intubation, recall of the procedure and discomfort during the procedure were comparable in both groups (z = 0.572, 0.664, 1.297, 0.467, 0.895, and 0.188, respectively, P > 0.05). Hypoxic episodes similarly occurred in the two groups, but the first partial pressure of end-tidal CO2after intubation was higher in Group SM than that in Group DM (45.2 ± 4.2 mmHg vs. 42.2 ± 4.3 mmHg, t = 2.495, P < 0.05). Both dexmedetomidine and sufentanil are effective as an adjuvant for AFOI under airway topical anesthesia combined with midazolam sedation, but respiratory depression is still a potential risk in the sufentanil regimen.


Improved sensitivity and specificity of sandwich, competitive and capture enzyme-linked immunosorbent assays for allergen-specific antibodies.
Indirect ELISA is widely used to detect specific antibodies but can suffer from high non-specific binding-particularly of IgG. The use of affinity-purified rabbit antibody-coated microtitre plates to bind antigen greatly increases sensitivity without a significant increase in non-specific binding of IgG. Capture, competitive and sandwich assay procedures gave comparable results for IgG antibodies; but only the sandwich assay was suitable for detection of IgE antibodies.


[Feminization of urology and glass ceiling: Survey of women urologists in France].
Urology has long remained the least feminized specialty. The objective of this study was to assess the demographic characteristics of female urologists and their feelings in terms of discrimination. The survey consisted of a questionnaire of 12 questions, sent by mailing to all female urologists, a first time in May 2016 (n=84), then a second time in January 2020 (n=98). The anonymized answers were analyzed and compared in order to assess the evolution over the last 4 years. The participation rate was 46.4% in 2016 (n=39 respondents) and 50% in 2020 (n=49 respondents). The majority of women worked full time (73.5%), with a hospital (38.8%), liberal (46.9%) or mixed (14.3%) activity. Their main theme was women's urology (57.1%). In 2020, 59.2% of respondents had encountered difficulties related to their status as women during their career and 28.1% difficulties related to motherhood. Female urologists in private practice were significantly less concerned than their counterparts with hospital or mixed activity (43.5% versus 73.1%, P=0.035). Women felt that they were underrepresented in association committees at 95.9% (vs. 82.1% in 2016) and in university positions at 79.6% (vs. 89.7% in 2016). Finally, 91.8% were in favor of the creation of an association of women urologists (vs. 53.8% in 2016). Women urologists may encounter difficulties related to their status as women during their professional career. Between 2016 and 2020, there is an increase in the feeling of under-representation within association committees and an increase in the need to federate. III, étude rétrospective cas-témoins.


Triethylenemelamine induced dominant lethals in mice--comparisons of oral versus intraperitoneal injection.
We have compared the relative effectiveness of oral and i.p. injections of triethylenemelamine (TEM) in inducing dominant lethality in male mice. The standard dominant lethal protocol was used in these experiments. TEM, when injected i.p. resulted in significant increased in fetal mortality during the first three weeks post-treatment. Decreases in the number of implants per pregnant female were noted during this same period, with only minor decreases in fertility. In contrast, oral injections of TEM resulted in only fluctuations in the percent of fetal mortality. In addition, oral injections of TEM did not result in significant differences in either total implants or percent fertility. Possible causes of the observed differences between these two routes of administration are discussed.


Dexamethasone Protects Against Apoptotic Cell Death of Cisplatin-exposed Auditory Hair Cells In Vitro.
Dexamethasone (DXM) protects against cisplatin-induced auditory hair cell (HC) loss in rat organ of Corti (OC) explants in vitro by reducing levels of oxidative stress and NADPH-Oxidase-3 (NOX-3). Intratympanic DXM has demonstrated protective effects against cisplatin-induced hearing loss in a few animal studies and one clinical trial. However, levels of protection with intratympanic DXM vary significantly between studies, which may not be a result of the intrinsic properties of DXM but rather reflect the diffusion of DXM into the cochlea. The molecular mechanisms and degree of DXM protection against cisplatin ototoxicity are currently unknown. OC explants from 3-day-old rats were cultured with no treatment or various concentrations of cisplatin (2, 5, or 10 μM) and DXM (75, 150, or 300 μg/mL) in vitro. HC viability and TUNEL assay were performed after 72 hours in vitro and levels of oxidative stress and NOX-3 were evaluated with confocal microscopy after 48 hours in vitro. Analysis of variance with Tukey's post hoc testing was performed. Cisplatin initiated dose-dependent losses of outer HCs (OHCs) in the basal turns of exposed explants (p < 0.001). DXM protected against cisplatin (2 μM)-induced OHC loss in a dose-dependent manner with complete protection at 300 μg/mL of DXM (p < 0.001). DXM (150 μg/mL) significantly reduced levels of oxidative stress, NOX-3, and apoptosis in the basal turn of explants exposed to cisplatin (2 μM). DXM protects against cisplatin-induced loss of OHCs in the basal turn of rat OC explants as demonstrated by reductions in oxidative stress and NOX-3 production and decreased levels of apoptotic cell death.


Eating disorders in college men.
This study was designed to assess the characteristics of men with eating disorders in the community. The authors recruited 25 men meeting DSM-IV criteria for eating disorders and 25 comparison men through advertisements in college newspapers. A second comparison group comprised 33 women with bulimia nervosa who were recruited and interviewed with virtually identical methods. The men with eating disorders closely resembled the women with eating disorders but differed sharply from the comparison men in phenomenology of illness, rates of comorbid psychiatric disorders, and dissatisfaction with body image. Homosexuality did not appear to be a common feature of men with eating disorders in the community. Childhood physical and sexual abuse appeared slightly more common among the eating-disordered men than among the comparison men. Eating disorders, although less common in men than in women, appear to display strikingly similar features in affected individuals of the two genders.


Studies on the effect of dimecron on the digestive system of a fresh water fish, Channa punctatus.
The effect of exposure to a sublethal concentration (0.32 mg/L) of Dimecron for 20 days on the digestive system of a fresh water teleost fish, Channa punctatus has been studied. The most conspicuous pathological changes in the liver were vacuolation of the cytoplasm of hepatocytes, enlargement of nuclei, rupture of the cell membrane, liver cord disarray, damage of connective tissue, infiltration of phagocytes and necrosis. The mucosa of stomach was ruptured and the gastric glands were degenerated. The mucosal epithelium of intestine and pyloric caeca was also degenerated. The mucus secreting goblet cells showed hyperactivity and the intestinal lumen was filled with mucus. No conspicuous changes were noted in the rectum except for hypersecretion of mucus. Histochemical tests revealed that alkaline phosphatase and glucose-6-phosphatase were inhibited by Dimecron treatment. However, acid phosphatase showed slight increase in activity. Biochemical tests for enzyme activity confirmed the histochemical findings. Alkaline phosphatase activity was significantly inhibited in liver and intestine. There was a slight elevation in the activity of acid phosphatase in the liver and pyloric caeca of exposed fish, but this was not statistically significant. The glucose-6-phosphatase activity was significantly inhibited in the liver, intestine and pyloric caeca.


Electrochemical sensing of cortisol: a recent update.
Psychological stress caused by everyday lifestyle contributes to health disparities experienced by individuals. It affects many biomarkers, but cortisol - "a steroid hormone" - is known as a potential biomarker for psychological stress detection. Abnormal levels of cortisol are indicative of conditions such as Cushing's syndrome Addison's disease, adrenal insufficiencies and more recently post-traumatic stress disorder (PTSD). Chromatographic techniques, which are traditionally used to detect cortisol, are a complex system requiring multistep extraction/purification. This limits its application for point-of-care (POC) detection of cortisol. However, electrochemical immunosensing of cortisol is a recent advancement towards POC application. This review highlights simple, low-cost, and label-free electrochemical immunosensing platforms which have been developed recently for sensitive and selective detection of cortisol in bio-fluids. Electrochemical detection is utilized for the detection of cortisol using Anti-Cortisol antibodies (Anti-Cab) covalently immobilized on nanostructures, such as self-assembled monolayer (SAM) and polymer composite, for POC integration of sensors. The observed information can be used as a prototype to understand behavioral changes in humans such as farmers and firefighters. Keeping the future directions and challenges in mind, the focus of the BioMEMS and Microsystems Research Group at Florida International University is on development of POC devices for immunosensing, integration of these devices with microfluidics, cross validation with existing technologies, and analysis of real sample.


Second trimester prenatal screening for Down syndrome: the associations between the levels of serum markers in successive pregnancies.
To investigate the association of Down syndrome screening results in successive pregnancies, and assess the impacts of including previous screening results in the current risk estimation on screening performance. The study was based on 56,951 women who had triple marker screening in two or more singleton pregnancies in the Ontario Maternal Serum Screening (MSS) program between October 1993 and September 2000. The problem of recurrent false positive results was examined by comparing screening results from different pregnancies in the same individuals. Between-pregnancy associations in the levels of serum markers were estimated using correlation analysis. A published method was used to adjust current risk estimation for previous screening results. The effect of this adjustment was assessed by comparing screening performances prior and subsequent to the adjustment. The observed false positive rate (FPR) in subsequent pregnancies was 2.5 times higher than that expected (26.4% vs 10.7%) among women who screened positive in one previous pregnancy, and 3.9 times higher (47.4% vs 12.1%) among women who screened positive in two previous pregnancies. Adjusting for a previous screening result will significantly reduce the recurrent FPR without compromising detection. Risk estimation for Down syndrome may be adjusted using the screening result from a previous pregnancy.


gamma-interferon production in atopic dermatitis shows differential modification by phosphodiesterase and prostaglandin inhibition.
Interferon-gamma (IFN-gamma) production by peripheral blood mononuclear leucocytes (MNL) is reduced in atopic dermatitis (AD) patients. This may be related to abnormalities in second messenger systems, and increased prostaglandin E2 (PGE2) release from monocytes. We compared the effects of manipulating the second messenger activity using the phosphodiesterase (PDE) inhibitor Ro 20-1724, dibutyryl cyclic adenosine monophosphate (cAMP), and cyclooxygenase inhibition of PGE2, on IFN-gamma production by cultured MNL from AD patients (n = 9) and normal controls (n = 10). Ficoll-Hypaque-separated MNL were cultured for 48 h with OKT3 stimulation, and cAMP, Ro 20-1724, or indomethacin. Supernatants were analysed for IFN-gamma by ELISA. Basal IFN-gamma was lower in AD patients, and the increase in IFN-gamma production with OKT3 was 6.5-fold greater in control subjects than patients with AD. Culture with indomethacin significantly enhanced OKT3-stimulated IFN-gamma production in both groups, whereas OKT3-stimulated IFN-gamma production was abolished with dibutyryl cAMP. IFN-gamma production was significantly lower with Ro 20-1742 in AD than in normal controls. We have shown reduced IFN-gamma release from unstimulated and stimulated MNL in AD patients compared with normal controls. The addition of indomethacin increased IFN-gamma production in both groups, although the increase was less in AD patients, suggesting an intrinsic cellular defect. IFN-gamma release from AD MNL was more sensitive to the inhibitory effects of PDE, and this may be due to increased PDE activity, or the hyperdynamic cAMP system present in atopics.


Use of Empagliflozin in Recipients of Kidney Transplant: A Report of 8 Cases.
Transplant teams face increasing challenges to manage diabetes following kidney transplantation. There is an increasing number of diabetics undergoing transplantation and there is an increased incidence of posttransplant diabetes mellitus (PTDM) due to a higher prevalence of obesity, increased use of steroids and calcineurin inhibitors, and the acceptance of older patients as potential candidates. The options for treating diabetes in the general population are expanding. Sodium-glucose cotransporter 2 (SGLT-2) inhibitors is one of the new modalities of treatment. We report the cases of 8 patients who underwent kidney transplantation and were treated with the SGLT-2 inhibitor empagliflozin for their pre-existing diabetes or for the development of PTDM. They were followed for an average of 12 months. The average age of the patients was 42.5 years. All 8 patients were taking tacrolimus, mycophenolate, and prednisolone. Although creatinine increased slightly (from 88.5 mmol/L to 99.5 mmol/L) in the month after starting empagliflozin, it stabilized after that. Hemoglobin A1c decreased on average 0.85 g/dL. Urine protein decreased by 0.6 g per day and weight decreased on average 2.4 kg throughout the year. One patient discontinued the medication due to recurrent urinary tract infections.


Phase transformation and room temperature stabilization of various Bi2O3 nano-polymorphs: effect of oxygen-vacancy defects and reduced surface energy due to adsorbed carbon species.
We report the grain growth from the nanoscale to microscale and a transformation sequence from Bi →β-Bi2O3→γ-Bi2O3→α-Bi2O3 with the increase of annealing temperature. The room temperature (RT) stabilization of β-Bi2O3 nanoparticles (NPs) was attributed to the effect of reduced surface energy due to adsorbed carbon species, and oxygen vacancy defects may have played a significant role in the RT stabilization of γ-Bi2O3 NPs. An enhanced red emission band was evident from all the samples attributed to oxygen-vacancy defects formed during the growth process in contrast with the observed white emission band from the air annealed Bi ingots. Based on our experimental findings, the air annealing induced oxidation of Bi NPs and transformation mechanism within various Bi2O3 nano-polymorphs are presented. The outcome of this study suggests that oxygen vacancy defects at the nanoscale play a significant role in both structural stabilization and phase transformation within various Bi2O3 nano-polymorphs, which is significant from theoretical consideration.


A versatile, fast and unbiased method for estimation of gene-by-environment interaction effects on biobank-scale datasets.
Identification of gene-by-environment interactions (GxE) is crucial to understand the interplay of environmental effects on complex traits. However, current methods evaluating GxE on biobank-scale datasets have limitations. We introduce MonsterLM, a multiple linear regression method that does not rely on model specification and provides unbiased estimates of variance explained by GxE. We demonstrate robustness of MonsterLM through comprehensive genome-wide simulations using real genetic data from 325,989 individuals. We estimate GxE using waist-to-hip-ratio, smoking, and exercise as the environmental variables on 13 outcomes (N = 297,529-325,989) in the UK Biobank. GxE variance is significant for 8 environment-outcome pairs, ranging from 0.009 - 0.071. The majority of GxE variance involves SNPs without strong marginal or interaction associations. We observe modest improvements in polygenic score prediction when incorporating GxE. Our results imply a significant contribution of GxE to complex trait variance and we show MonsterLM to be well-purposed to handle this with biobank-scale data.


Nr4a1 plays a crucial modulatory role in Th1/Th17 cell responses and CNS autoimmunity.
Nuclear receptor4 group A1 (Nr4a1), an orphan nuclear receptor, is down-regulated in peripheral blood mononuclear cells (MNCs) of individuals with multiple sclerosis (MS), and Nr4a1 deficiency results in severe experimental autoimmune encephalomyelitis (EAE), an animal model of MS, caused by increased macrophage infiltration into the central nervous system (CNS). However, the role of Nr4a1 in macrophage phenotype and T cell responses remains poorly understood. In the present study we show that macrophages/microglia of Nr4a1-/- mice, which exhibited earlier onset and more severe clinical EAE, were polarized to an enhanced type 1 (M1) phenotype and produced higher levels of IL-12 and TNF-α than wild type mice. Significantly increased numbers of CD4+ T cells and frequency of CD4+IFN-γ+ and CD4+IL-17+ T cells were observed in the CNS and spleen of Nr4a1-/- mice, with decreased percentages of apoptosis in CD4+ T cells. The percentages of CD4+Foxp3+ Treg cells in the CNS of Nr4a1-/- mice were also reduced. Furthermore, purified CD4+ T cells from naïve Nr4a1-/- mice exhibited enhanced Th1 and Th17 differentiation capacity, and MOG-reactive Th17 cells from Nr4a1-/- mice adoptively transferred more severe EAE in recipient mice. Our results, for the first time, demonstrate that Nr4a1 not only induces Type 2 macrophages/microglia phenotype, but is also a critical inhibitory molecule for Th1/Th17 cell differentiation. This finding indicates that Nr4a1-related molecule(s) may have therapeutic potential in MS and likely other autoimmune disorders.


Antimicrobial-Resistant Bacteria Carriage in Rodents According to Habitat Anthropization.
It is increasingly suggested that the dynamics of antimicrobial-resistant bacteria in the wild are mostly anthropogenically driven, but the spatial and temporal scales at which these phenomena occur in landscapes are only partially understood. Here, we explore this topic by studying antimicrobial resistance in the commensal bacteria from micromammals sampled at 12 sites from a large heterogenous landscape (the Carmargue area, Rhone Delta) along a gradient of anthropization: natural reserves, rural areas, towns, and sewage-water treatment plants. There was a positive relationship between the frequency of antimicrobial-resistant bacteria and the level of habitat anthropization. Although low, antimicrobial resistance was also present in natural reserves, even in the oldest one, founded in 1954. This study is one of the first to support the idea that rodents in human-altered habitats are important components of the environmental pool of resistance to clinically relevant antimicrobials and also that a "One Health" approach is required to assess issues related to antimicrobial resistance dynamics in anthropized landscapes.


Adult-Onset Deletion of β-Catenin in (10kb)Dmp1-Expressing Cells Prevents Intermittent PTH-Induced Bone Gain.
β-Catenin (βcat) is a major downstream signaling node in canonical Wingless-related integration site (Wnt) signaling pathway, and its activity is crucial for canonical Wnt signal transduction. Wnt signaling has recently been implicated in the osteo-anabolic response to PTH, a potent calcium-regulating factor. We investigated whether βcat is essential for the anabolic action of intermittent PTH by generating male mice with adult-onset deletion of βcat in a subpopulation of bone cells (osteocytes and late-stage osteoblasts), treating them with an anabolic regimen of PTH, and measuring the skeletal responses. Male (10kb)Dmp1-CreERt2 transgenic mice that also harbored floxed loss-of-function βcat alleles (βcat(f/f)) were induced for Cre activity using tamoxifen, then injected daily with human PTH 1-34 (30 μg/kg) or vehicle for 5 weeks. Mice in which βcat was deleted showed either total lack of bone mineral density (BMD) gain, or BMD loss, and did not respond to PTH treatment. However, bone mass measurements in the trabecular compartment of the femur and spine revealed PTH-induced bone gain whether βcat was deleted or not. PTH-stimulated increases in periosteal and cancellous bone formation rates were not impaired by βcat deletion, but resorption markers and cortical porosity were significantly increased in induced mice, particularly induced mice treated with PTH. These results suggest that βcat is required for net-positive BMD effects of PTH therapy but that the anabolic effects per se of PTH treatment might not require osteocytic/osteoblastic βcat.


Airways and air pollution in childhood: state of the art.
Correlations between ambient pollutants and health effects, such as observed in SIDS, may in reality be to a larger extent the result of indoor sources. These distinctions between indoor and outdoor sources, while important, do not detract from the overall conclusion that pollution affects the airway in children directly and indirectly. Much still needs to be learned about the permanence of these effects, the mechanism by which the effect is mediated, and the conditions under which some of these effects are maximal. Two approaches seem particularly suited to shed further light on these issues. First, identification of biological markers for exposure to pollutants will yield both more accurate measures of exposure to pollutants and information about health consequences. Second, newer modeling techniques promise to predict health outcomes under a variety of environmental conditions. Shumway et al., for instance, describe a promising model predicting an increase in mortality due to ambient pollutants in the Los Angeles Basin with higher levels under extremes of temperature, especially during cold spells. Time series and factor analyses may further our knowledge as well. In the near future, large cohort studies should begin to reveal the cumulative effects of air pollution on the respiratory system, especially in relation to active smoking. Finally, studies in Black children are virtually unavailable. Given their high risk for respiratory illnesses, such studies are sorely needed.


Methylation of the miR-126 gene associated with glioma progression.
Gliomas are the most common and the most malignant brain tumors, accouting for 45-55% of all intracranial tumors. The incidence of glioma worldwide is about 6-12 per 100,000. Recently, several studies showed that the activation of the oncogenes and the inactivation and/or loss of the tumor suppressor genes, especially for miRNA-21, let-7 and so on, are the most primary molecule event in gliomas. MicroRNAs (miRNAs) are a class of endogenously expressed small noncoding RNAs which are usually 21-23 nucleotides long. miRNAs regulate gene expression and play important roles in a variety of physiological and pathological processes, such as cell proliferation, differentiation and apoptosis. To date, Growing evidence has shown that mi RNAs are frequently dysregulated in human cancers and can act as both tumor suppressors and oncogenes. Along with the discovery of micro RNA, more and more research focusing on its relationship with glioma was carried out to investigate the biological features of glioma and to provide experimental evidence for glioma mechanism. In the present study, we aimed to verify the miRNA-126 down-regulation which showed in the results of glioma tissue miRNAs chip and discuss the miRNA-126 methylation in patients with glioma. A total of 50 samples from patients with glioma and 20 control samples from patients with cerebral trauma were included in this study. The expression levels of the miR-126 gene were detected using quantitative polymerase chain reaction (PCR), and the methylation status of miR-126 was examined using methylation-specific PCR-denaturing high-performance liquid chromatography (MSP-DHPLC). The expression level of miRNA-126 was found to be significantly higher in the control group (0.6134 ± 0.1214) than in the glioma group (0.2771 ± 0.1529; P < 0.05). The expression was also significantly elevated in low-grade gliomas (0.3117 ± 0.1474) compared with high-grade gliomas (0.1582 ± 0.1345; P < 0.05). In addition, increased methylation of miR-126 was found in 40% of glioma patients in our study (20/50 cases), resulting in significantly decreased miR-126 expression (0.1715 ± 0.1376; P < 0.05). Our results indicate that we verified successfully the miRNA-126 down-regulation phenomenon in patients with glioma which showed in the results of glioma tissue miRNAs chip and the miRNA-126 down-regulation through methylation in patients with glioma. So we could say that epigenetic modification is a crucial mechanism for controlling the expression of miR-126 in glioma.


Author Correction: Inhibitory connectivity defines the realm of excitatory plasticity.
An amendment to this paper has been published and can be accessed via a link at the top of the paper.


Clinical features of neonatal seizures.
Identification of seizures in neonates is difficult. This study analyses the clinical features of seizures in a cohort of neonates. The clinical events of 41 neonates referred for investigation of suspected seizures were studied with prolonged video/electroencephalographic (EEG) telemetry. Sixteen neonates had no seizures recorded; 25 had confirmed seizures, 13 with clinical correlates. Each neonate with electroclinical seizures had paroxysms of abnormal movements in stereotyped patterns. These patterns were consistently found to have electrical correlates. Focal clonic movements were seen most frequently. Multiple clinical features characterized the seizure repertoire in six neonates. In five neonates the clinical features became less evident during monitoring and these seizures were difficult to recognize. This change was associated with anticonvulsant administration in three cases. Electroclinical seizures are characterized by abnormal paroxysmal stereotyped behaviour, often with multiple clinical features. Recommendations for the management of abnormal neonatal events are proposed.


Effect of freeze-thaw cycle aging and high-temperature oxidation aging on the sorption of atrazine by microplastics.
This study aims to better understand the aging characteristics of microplastics in the environment and the influence of aging microplastics on the migration and transformation of organic pollutants. In this study, polyvinyl chloride (PVC) and polyethylene (PE) were chosen as research objects, and the effects of two aging methods (freeze-thaw cycle aging and high-temperature oxidation aging) on their surface properties and atrazine (ATZ) sorption were investigated. The crystallinity of PE increased after freeze-thaw cycling and decreased after high-temperature oxidation. The freeze-thaw cycle destroys the amorphous region of PE, reducing the micropores on the PE surface and decreasing the ATZ adsorbed by PE. Although aging had no significant effect on the surface structure of PVC, it caused new oxygen-containing functional groups to be produced on the PVC surface, which reduced the ATZ adsorption capacity. These results show that the two aging modes change the surface properties of PVC and PE, thus affecting the sorption mechanism of ATZ, and provide a theoretical premise for the natural behavior and ecological chance assessment of ATZ in the presence of microplastics.


Predicting final results of brace treatment of adolescents with idiopathic scoliosis: first out-of-brace radiograph is better than in-brace radiograph-SOSORT 2020 award winner.
In-brace radiograph of adolescents with idiopathic scoliosis (AIS) has been shown to reflect brace efficacy and the possibility of achieving curve correction. Conversely, the first out-of-brace radiograph could demonstrate the patient's ability to maintain the correction. We aimed to determine which of the two radiographs is the best predictor of the Cobb angle at the end of treatment (final radiograph). Retrospective cohort study of a prospective dataset. The population was selected based on the following inclusion criteria: AIS, age 10-18 years; Risser score 0-2; Cobb angle 25-40°; brace treatment; availability of all radiographs. Pearson correlations provide a first exploration of data. The univariate and multivariate logistic regression model tested the predictors. Finally ROC curve provided a check of model accuracy. A total of 131 patients were included (mean age 13.0 ± 1.3, Cobb angle 33.2 ± 5.5°; 78% females). At the end of treatment, 56% had stabilised, 9% had progressed, and 44% had improved. The difference between the in-brace and final radiographs was 8.0 ± 6.0°, while the difference between the first out-of-brace and final radiographs was 1.8 ± 5.2°. The best predictor of final outcome was the first out-of-brace radiograph (0.80), compared to in-brace (0.68) and baseline (0.59) radiographs. The best cut-offs to predict avoidance of progression were 30% and 10% of the correction rates for the in-brace and first out-of-brace radiographs, respectively. The first out-of-brace radiograph predicts end results better than the in-brace radiograph. It offers an excellent clinical reference for clinicians and patients. The first out-of-brace radiograph should be considered an essential element of future predictive models. LEVEL OF EVIDENCE 1: Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.


Free amino acid composition of Opisthorchis pedicellata (Trematoda) from the gall-bladder of a fresh water fish, Rita rita (Ham.)
The paper chromatograms reveal the presence of 12 free amino acids, viz. leucine, isoleucine, valine, proline, tyrosine, phenyl-alanine, alanine, glycine, glutamic acid, serine, aspartic acid and lysine, in Opisthorchis pedicellata.


Usage of complementary and alternative medicine among patients with chronic kidney disease on maintenance hemodialysis.
To determine the prevalence and the type of complementary and alternative medicine (CAM) use among chronic kidney disease (CKD) patients on maintenance hemodialysis (MHD). The study was conducted in 200 CKD patients who were on MHD. The patients were subjected to a validated interviewer-administered questionnaire adopted from the National Health Interview Survey Adult CAM. The knowledge on CAM and its usage by the patients were assessed based on the responses given by the patients. Of the 200 patients, 52 (26%) patients were identified to be using CAM therapy. The most commonly used CAM modality by these patients was Ayurveda both alone (30.4%) and in combination with other CAM modalities (23.2%), followed by acupuncture in 17.3% patients. CAM usage was high in the age range of 50-64 years (67%). Of the CAM users, 21% of patients were from a rural area; 16.5% of patients were from upper middle class, and 24% were on dialysis for 1-4 years. There was a statistically significant association between CAM usage and age, gender, place of living, socioeconomic status, and duration of dialysis (P < 0.01). The present survey provides the data on the usage of CAM among dialysis patients and adds to the increasing evidence about CAM use. Because many products are at risk to either accumulate or cause interactions with medication, a better education on the risks and benefits of the CAM therapy by the health care providers to the end stage renal disease patients is needed.


Involvement of service user representatives on a healthcare organizational level at Norwegian Healthy Life Centres: A qualitative study exploring health professionals' experiences.
The involvement of service user representatives in planning, delivering, and evaluating health care services is regarded as essential in Healthy Life Centres (HLCs) to ensure high-quality services. However, information on how HLC-professionals involve service user representatives at a healthcare organizational level at HLCs remains sparse. To explore HLC professionals' experiences involving service user representatives in planning, delivering, and evaluating the HLC services. Five qualitative semi-structured focus group interviews with 27 health professionals from 27 Norwegian HLCs were conducted. Data were analysed using systematic text condensation. The involvement of service user representatives at the HLCs varied from well-integrated and systematized to the opposite. The professionals' primary rationale for involving service user representatives was to include the representatives' unique experiential knowledge to ensure the quality of the service. Experiential knowledge was seen as a 'different' competence, which came in addition to professional competence. The professionals' choice of service user representatives depended on the purpose behind the involvement initiative. The HLC professionals often hand-picked former service users according to their health problems, motivation, and the HLC's need. The professionals said they were responsible for initiating the facilitation to accomplish genuine involvement. Support from their leaders to prioritize these tasks was essential. To meet the demand for adequate service user representatives, the HLCs need access to different service user representatives, representing both diagnose-based and generic service user organisations and the public. To achieve genuine involvement, the rationale behind the involvement and the representatives' role must be clarified, both for the HLC professionals and service user representatives. This will require resources for continuous organizational preparation and facilitation.


[Copaiba oil effect on urea and creatinine serum levels in rats submitted to kidney ischemia and reperfusion syndrome].
To evaluate the copaiba oil effect on urea and creatinine levels in rats submitted to kidney ischemia and reperfusion syndrome. Eighteen Wistar rats (Rattus norvegicus albinus), aged between 90 and 120 days, weight between 200 g and 250 g, were allocated in 2 groups (n=9) and submitted to 50 minutes of renal ischemia and reperfusion and treated or not with copaiba oil (0.63 ml/kg daily seven days before ischemia). The nitrogen excrements were assessed at 24, 48 and 72 hours after ischemia period. The urea serum level was smaller (p d" 0,05) at 24 and 48 hours, and the creatinine serum level was smaller at 48 hours in animals treated with copaiba oil (GIRC) than the GIR. The copaiba oil decreased significantly the urea serum level at 24 and 48 hours and the creatinine level at 48 hours after kidney ischemia and reperfusion in rats.


Determinants and risk factors for central corneal thickness in Japanese persons: the Funagata Study.
To examine the association between glucose metabolism and central corneal thickness (CCT) in Japanese adults. A sub-sample of 322 Japanese adults participating in the Funagata Study was included in this analysis. CCT was measured using a specular microscope. Glucose metabolism was examined using 75-g oral glucose tolerance test. Mean differences in CCT (μm) and 95% confidence intervals were estimated with univariate, age-sex-adjusted and multivariate models using multiple linear regression. The mean (± standard deviation) age of the study sample was 63.7 ± 11.4 years and 44% were men. The mean fasting plasma glucose (FPG), 2-hour post-load plasma glucose (2hPG) and haemoglobin A1c (HbA1c) concentrations were 96.8 ± 12.6mg/dl, 123.6 ± 41.2mg/dl and 5.3 ± 0.4%, respectively. CCT was normally distributed in the study sample, and the mean CCT was 544.7 ± 34.6μm. After multivariate adjustment, characteristics associated with increased CCT were 2hPG and HbA1c concentrations, impaired glucose tolerance, diabetes, body weight or body mass index and current smoking. Impaired glucose tolerance, diabetes, obesity and current smoking are associated with increased CCT. Additional studies are required to examine whether interventions to affect these characteristics may reduce CCT.


Modification of ureteral motility and promotion of urine flow around an intraureteral obstruction by CL-316243, phenylephrine, and furosemide in dogs.
The aim of this study was to evaluate the effects of a beta3-adrenoceptor (AR) agonist (CL-316243), an alpha1-AR agonist (phenylephrine), and a loop diuretic (furosemide) on the spontaneous rhythmic contractions of the isolated canine ureter and on an acute ureteral obstruction produced by inflation of a balloon catheter in anesthetized dogs. In the isolated ureter, CL-316243 concentration dependently reduced both the amplitude and frequency of the rhythmic contractions (pD(2): 7.19 +/- 0.33), whereas phenylephrine significantly enhanced both variables (pD(2): 5.26 +/- 0.09) and furosemide reduced them only slightly. In the acute ureteral obstruction model, the intraureteral pressure (IUP) gradually rose to reach a plateau of 58.9 mm Hg after inflation of a balloon catheter within the lower ureter. Intravenous administration of CL-316243 (0.3 microg/kg) significantly reduced the elevated IUP and the resumed urine flow (UF), leading to a sustained reduction in the IUP. In contrast, the IUP continued to increase above the plateau level for 10 minutes after phenylephrine administration (10 microg/kg) and for 30 minutes after furosemide administration (1,000 microg/kg). In the phenylephrine group, the UF resumed when the IUP reached 75.8 mm Hg, and thereafter the IUP gradually decreased in parallel with the increase in the UF. From these results, we conclude that in dogs, CL-316243 reduces the IUP by allowing the UF to resume as a result of a relaxation of ureter at the obstruction site, whereas with phenylephrine, the reduction in the IUP is secondary to a resumption in the UF resulting from an induced contraction of ureter that causes an increase in hydrostatic pressure above the obstruction site.