[AP-2 expression and significance in the lung cancer tissues].
To determine the active protein-2 (AP-2) expression in non-small cell lung cancer (NSCLC) and the relationship between the expression and tumor biological characteristics. Fifty NSCLC tissues and 15 normal lung tissues were used to detect the expression of AP-2 transcription factor with the immunohistochemical method. The positive rate of AP-2 expression was zero in the normal lung tissues, but 32% in the NSCLC tissues. The AP-2 expression in the NSCLC tissues was significantly elevated (P < 0.05). The postive rate of AP-2 expression was significantly higher in the NSCLC tissues of pathological grade III (57.89%) than in those of grade I - II (16.13%) (P < 0.05), and higher in patients of clinical stage III - IV (44. 83%) than in those of stage I - II (14.29%) (P <0.01), and in the NSCLC patients with lymph node metastasis (40.54%) than in those without (7.7%) (P < 0.05). The up-regulation of AP-2 expression in the NSCLC tissues suggests that AP-2 may be involved in the NSCLC carcinogenesis. AP-2 may play an important role in the genesis and development of NSCLC.


The effectiveness of strength-based, solution-focused brief therapy in medical settings: a systematic review and meta-analysis of randomized controlled trials.
This meta-analysis synthesized randomized controlled trials of solution focused brief therapy (SFBT) in medical settings for patients' health-related psychosocial (e.g., depression, psychosocial adjustment to illness), behavioral (e.g., physical activity, nutrition score), and functional health (e.g., BMI, individual strength) outcomes. Medical setting is defined in this study as any healthcare setting that primarily focuses on patients' physical wellbeing. A comprehensive search strategy across five electronic databases, four academic journals, three professional websites, and reference lists of included articles resulted in a final sample of nine studies for meta-analytic synthesis. Combining outcomes indicated an overall significant effect of SFBT for health-related psychosocial outcomes (d = 0.34, p < .05.) and a nearly significant outcome for health-related behavioral outcomes (d = 0.28, p = .06), but not for functional health outcomes. Results indicated SFBT being an effective intervention for psychosocial outcomes and a promising approach for behavioral outcomes in medical settings.


Five new species of genus Kisaura Ross (Trichoptera: Philopotamidae) from Himachal Pradesh (India).
Five new species of Kisaura Ross are described and illustrated from the Indian Himalaya. Newly described species are Kisaura trailaensis sp. n., K. barotensis sp. n., K. monospinata sp. n., K. sachensis sp. n. and K. curvata sp. n. In addition, K. madhyamika Schmid is recorded from Himachal Pradesh and a catalogue of Indian species of Kisaura is provided.


Massive intraocular hemorrhage associated with anticoagulation and age-related macular degeneration.
The clinicopathologic correlation of three eyes with massive intraocular hemorrhage in patients receiving anticoagulant therapy is reported. All three patients were apparently predisposed because of antecedent disciform macular degeneration. The hemorrhage arose from the extrachoroidal neovascular vessels within the disciform lesions and caused rupture of the retinal pigment epithelium with massive intraocular hemorrhage. Because of the risk of vision-threatening intraocular hemorrhage, patients with exudative macular degeneration requiring anticoagulant therapy should be managed by both ophthalmologists and internists.


Effect of noise exposure on blood-labyrinth barrier in guinea pigs.
The influence of noise exposure on the endothelial transport system in the cochlea was investigated using cationic polyethyleneimine (PEI), since systemically administered PEI passes through the capillary endothelial cell and attaches to basal lamina (BL) anionic sites in the cochlea. Under general anesthesia, all guinea pigs were administered an intravenous injection of 0.5% PEI. Thirty minutes later, five animals were exposed to noise (10 kHz, broad band noise, 105 dB SPL) for 30 min, via speakers inserted into the external auditory canal. The remaining five animals (controls) were left without noise exposure for 1 h following PEI injection. All guinea pigs were then immediately sacrificed, and the bony labyrinths were removed. PEI distribution on the BL was assessed in the stria vascularis, spiral ligament, basilar membrane, spiral limbus and Reissner's membrane throughout the cochlea with transmission electron microscopy. Compared to control animals, PEI distribution in the noise-exposed animals was significantly increased in the strial vessels of the basal and second turns and in Reissner's membrane of all turns. In the spiral ligament, basilar membrane and spiral limbus, no significant difference in PEI distribution was observed between the control and noise-exposed animals. These findings indicate that noise exposure increases macromolecular transport in the stria vascularis but not in the spiral ligament, spiral limbus and basilar membrane and that systemically administered macromolecules are more readily transported to Reissner's membrane by noise exposure.


Expectant management and laser photocoagulation in isolated selective intra-uterine growth restriction: A single-center series.
The objective was to report on a consecutive series of monochorionic diamniotic pregnancies complicated by selective Intra-Uterine Growth Restriction (sIUGR) and to describe perinatal outcomes based on whether or not there were umbilical Doppler findings, and specifically to study those pregnancies treated by laser. This was a retrospective cohort study enrolling monochorionic diamniotic pregnancies presenting isolated sIUGR after 16 weeks' gestation (WG). Of the 25 cases of sIUGR, 16 were type I and 9 type II or III. Types II and III occurred earlier than type I (22.3 versus 24.3 WG), were more severe (discordance of 37% versus 23%), and delivered earlier (31.3 versus 33.9 WG). Survival was 12/18 (66.7%) for types II or III versus 32/32 (100%) for type I. Five laser photocoagulation procedures were attempted and allowed the survival of both twins in 2 cases. Overall survival after laser was 6/10 (60%). Isolated sIUGR is associated with high perinatal morbidity and mortality. Laser photocoagulation treatment is feasible and may enable survival of both twins in some cases, but may be technically difficult.


Disparities In County COVID-19 Vaccination Rates Linked To Disadvantage And Hesitancy.
We analyzed trends in adult COVID-19 vaccine coverage over time based on COVID-19 vaccine hesitancy and social vulnerability. We found that each of these variables carries an independent association with disparities across counties in COVID-19 vaccine coverage. Counties that score high on both hesitancy and vulnerability are especially likely to have lower COVID-19 vaccination rates compared with the rest of the country.


Motivation towards first trimester screening for preeclampsia among pregnant women in Denmark: A cross-sectional questionnaire study.
The aim of this cross-sectional questionnaire study was to investigate motivation to participate in a possible new screening for preeclampsia in the first trimester of pregnancy among Danish pregnant women through a questionnaire based on Theory of Planned Behavior developed for this specific purpose. The new screening combines maternal characteristics with mean arterial pressure, uterine artery pulsatility index and biochemical markers to predict the risk of preeclampsia, whereas the current Danish screening uses maternal characteristics alone. Participation was offered to a proportion of women attending a first or a second trimester screening scan at two University Hospitals in Copenhagen. The questionnaire was set up in REDCap® and answers were entered directly into the database, which was accessed via a QR-code. We invited 772 pregnant women to participate in the questionnaire survey between November 2021 and April 2022 at Copenhagen University Hospital Rigshospitalet (study site one) (n = 238) and Copenhagen University Hospital Hvidovre (study site two) (n = 534). The response rate was 71.8% (171/238) at study site one and 33.9% (181/534) at study site two. A total of 352 women were included in the study (total participation rate 45.6%). Most women had a positive attitude towards preeclampsia screening in pregnancy, and 99.4% said they would participate in a risk assessment for preeclampsia if given the opportunity. A total of 97.4% answered "yes" to whether a first trimester preeclampsia screening should be offered to all pregnant women in Denmark. Positive motivation to participate in preeclampsia screening was correlated with having a network with a positive attitude towards preeclampsia screening. The results of this study indicate that Danish pregnant women have a positive attitude towards participation in a first trimester screening for preeclampsia. This observation might be useful in relation to possible future implementation in Denmark.


[Experiences with B scan sonography as a diagnostic imaging procedure in the specialty of ENT].
Our experiences with more than 1200 cases submitted to high resolution ultrasound examination during a one year period are described. The findings on B-scan sonography are compared to those for radiology. The reliability of both methods was checked by reference to histological findings and the course of the disease. The indications, capabilities and limits of high resolution ultrasound are discussed.


Cost-effectiveness analysis of treatments for chronic disease: using R to incorporate time dependency of treatment response.
When constructing decision-analytic models to evaluate the cost-effectiveness of alternative treatments, we often need to extrapolate beyond the available experimental data, as these typically relate to a limited period starting from the initiation of a new treatment or the diagnosis of the current disease state. We may also be required to extrapolate beyond the available experimental evidence to compare potential treatment sequences. Markov models are often used for this extrapolation. These models have the defining assumption that future transition probabilities are independent of past transitions. This means that, in general, transition probabilities cannot be conditional of the time spent in a given state. Where data exist to show that the risks of transition are conditional on the time spent in the treatment state, the simplifying Markov assumption can result in a loss in the model's "face validity," and misleading results might be generated. Several methods are available to incorporate time dependency into transition probabilities based on standard methods and software. These include the inclusion of tunnel states in Markov models and patient-level simulation, where a series of individual patients are simulated. This article considers the features and limitations of these methods and also describes a novel approach to building time dependency into a Markov model by incorporating an additional time dimension resulting in a "semi-Markov" model. An example of the implementation of such a model, using the R statistical programming language, is illustrated using a cost-effectiveness model for new epilepsy therapies.


Familial type I hyperlipoproteinemia caused by apolipoprotein C-II deficiency.
A study was made on the clinical and biochemical features of siblings of patients with hyperchylomicronemia and its inherited relationship. It was not a case of the classical type of familial LPL deficiency, but of familial apolipoprotein C-II deficiency. The first patient with apolipoprotein C-II deficiency was reported by Breckenridge et al. and our patients provide the basis for the second report of this new disease. Our observations in this study strongly suggest that familial apolipoprotein C-II deficiency is transmitted by an autosomal recessive mode of inheritance and heterozygotes of this disorder have no abnormalities of plasma lipid and lipoproteins in spite of the reduced plasma apolipoprotein C-II.


Assessing Invariance of Universal Ethnic-Racial Identity Measures Among Black Adolescents in the United States.
Black immigrants and their children represent a significant and growing share of the U.S. Black population; however, their experiences of their multifaceted identities are often collapsed into the experiences of multigenerational Black youth. The current study investigates whether generalized ethnic-racial identity measures are equivalent for Black youth with an immigrant parent and Black youth with only U.S.-born parents. Participants were 767 Black adolescents (16.6% immigrant-origin; Mage = 16.28, SD = 1.12) attending diverse high schools in two regions of the U.S. Participants completed the affirmation, exploration, and resolution subscales of the Ethnic Identity Scale-Brief (EIS-B), along with the centrality and public regard subscales of the Multidimensional Inventory of Black Identity-Teen (MIBI-T). The results indicated that, whereas the EIS-B demonstrated scalar invariance, the MIBI-T demonstrated partial scalar invariance. Accounting for measurement error, immigrant-origin youth reported lower affirmation than multigenerational U.S.-origin youth. Across groups, ethnic-racial identity exploration and resolution scores were positively associated with family ethnic socialization; ethnic-racial identity affirmation was positively associated with self-esteem; and ethnic-racial identity public regard was negatively associated with ethnic-racial discrimination, supporting convergent validity. Conversely, centrality was positively associated with discrimination among multigenerational U.S.-origin Black youth, but the relation was not significant among immigrant-origin Black youth. These results fill a methodological gap in the literature, providing researchers with empirical support for considering whether to pool immigrant-origin and multigenerational U.S.-origin Black youth in analyses regarding ethnic-racial identity.


Intramuscular 16-phenoxy PGE2 ester for pregnancy termination.
A new PGE2 derivative (16-phenoxy PGE2 methyl sulfonylamide sulprostone) was administered by the i.m. route to 48 women pregnancy in any of the three trimesters. The indications for pregnancy interruption were either serious medical problems in intact pregnancies (21 cases) or due to fetal death in utero (27 cases). Single doses of 500 micrograms were repeated every 4 hours in the former group or every 6 hours in the latter category for a maximum period of 24 hours. The treatment was successful in 81% of intact pregnancies and in 92.6% of fetal death cases with an overall mean induction interval of 12.9 hours. More than half the subjects did not experience any side effects apart from mild or moderate uterine colics. An overall mean of 1.4 episodes of vomiting or diarrhoea per induction trial was quite acceptable from the clinical point of view. The absence of serious complications in the group of critically sick women speaks in favor of the relative safety of the drug.


Synthesis and surface activity of photoresponsive hybrid surfactants containing both fluorocarbon and hydrocarbon chains.
Hybrid surfactants containing both alkyl and fluoroalkyl chains within the same molecule where modification of the azobenzene group will enable us to switch the superhydrophobic nature with an external light source, and the optical behavior will vary depending on the structure of the hydrophobic chains. Surface activity and its optically-induced variation of the azobenzene-modified hybrid surfactants were characterized using the surface tensiometry, UV-vis and NMR spectroscopy and theoretical calculation. The hybrid surfactants are superhydrophobic in nature reducing the surface tension of water to near 20 mN/m. Photo-isomerization of the azobenzene group induces a drastic surface tension variation (Δγ), and particularly the compositions containing the octyl-fluorocarbon chain exhibit remarkable Δγ as much as 30 mN/m which is even higher than that of the conventional surfactants (Δγ ≈ 14-20 mN/m). Theoretical calculation suggests significantly higher hydrophilicity of the cis isomer, causing the drastic switch in the surface activity. These results indicate the promise of the hybrid surfactants as efficient surface/interface manipulators.


Constitutive Modeling of Corneal Tissue: Influence of Three-Dimensional Collagen Fiber Microstructure.
The cornea, the transparent tissue in the front of the eye, along with the sclera, plays a vital role in protecting the inner structures of the eyeball. The precise shape and mechanical strength of this tissue are mostly determined by the unique microstructure of its extracellular matrix. A clear picture of the 3D arrangement of collagen fibrils within the corneal extracellular matrix has recently been obtained from the secondary harmonic generation images. However, this important information about the through-thickness distribution of collagen fibrils was seldom taken into account in the constitutive modeling of the corneal behavior. This work creates a generalized structure tensor (GST) model to investigate the mechanical influence of collagen fibril through-thickness distribution. It then uses numerical simulations of the corneal mechanical response in inflation experiments to assess the efficacy of the proposed model. A parametric study is also done to investigate the influence of model parameters on numerical predictions. Finally, a brief comparison between the performance of this new constitutive model and a recent angular integration (AI) model from the literature is given.


The efficacy of lidocaine administered via the LITA tracheal tube in attenuating the extubation response in beta-blocked patients following craniotomy.
The Laryngotracheal Instillation of Topical Anaesthetic (LITA) tracheal tube has an additional pilot tube through which local anaesthetic can be instilled into the larynx via 10 small holes above and below the cuff We studied 40 patients undergoing supratentorial craniotomy. They were premedicated with two oral doses of propranolol 1 mg.kg(-1). The anaesthetic consisted of infusions of remifentanil, propofol and vecuronium. On insertion of the first skin clip at the end of surgery, 5 ml of either saline or 2% lidocaine was injected into the appropriate lumen of the tracheal tube. There was no difference between the groups in the degree of coughing or the haemodynamic response to tracheal extubation.


[Skin exposure to carbon black and bladder tumors].
An epidemiological study on the dockworkers in the Genoa harbour, made after some occupational disease claims, showed an increase of bladder cancer probably caused by skin exposure to carbon black.


In what ways does maternity care in Australia align with the values and principles of the national maternity strategy? A scoping review.
Australia's national maternity strategy Woman-centred care: strategic directions for Australian maternity services (the Strategy) was released by the federal government in November 2019. It was developed to provide national guidance on the effective provision of woman-centred maternity care. The Strategy is structured around four values of safety, respect, choice, and access, and underpinned by twelve principles of woman-centred care. By examining previous research, this review aims to provide a baseline understanding of how maternity care provision is being met in relation to these core values. A systematic search of Australian literature was undertaken via four databases using the Strategy's values and 41 articles met the selection criteria. Include articles were predominantly published pre-2019, providing a baseline understanding of Australian maternity care provision prior to the Strategy's publication. Findings suggest that the four values align with those of women; however, women were not always receiving care in accordance with the values, particularly among women from priority populations. Women prioritised safety for themselves and their babies, articulated the need for respectful relationships with maternity care providers, wanted autonomy to make their own decisions, and desired access to appropriate, local, maternity services. Additionally, while pockets of appropriate care do exist, these are more likely to occur at a single-service level than more broadly at a population level. This implies the Strategy is needed, and its operationalisation must be prioritised through a coordinated national response to better meet the maternity care needs of Australian women. Further research is warranted to determine the Strategy's effectiveness.


Changes in morphology of long bone marrow tissue of rats submitted to cryotherapy with liquid nitrogen.
To study the main effects of local use of liquid nitrogen on bone marrow tissue in rats. The femoral diaphyses of 42 Wistar rats were exposed to three local and sequential applications of liquid nitrogen for one or two minutes, intercalated with periods of five minutes of passive thawing. The animals were sacrificed after one, two, four and 12 weeks and the specimens obtained were analyzed histomorphologically. In the second experimental week of one-minute protocol, histological degree of inflammation obtained a mean score of one (mild), ranging from 0 (absent or scarce) and two (moderate) (Kruskal-Wallis test p=0.01). In the second experimental week of two-minute protocol, degree of inflammation to the medullar tissue obtained an average score of two (Kruskal-Wallis test p=0.01). The degree of inflammation of the bone marrow tissue was higher in protocol of three applications of two minutes compared to protocol of three applications of one minute.


Impact of mild or moderate renal insufficiency on the intravascular ultrasonic analysis of chronic vascular response to paclitaxel-eluting and bare-metal stents (from the TAXUS IV, V, and VI trials).
The presence of even mild renal insufficiency is usually associated with an increased rate of cardiovascular events after coronary stenting. The aim of this study was to evaluate the impact of mild to moderate renal insufficiency on the chronic vascular responses to the implantation of paclitaxel-eluting stents (PES; Taxus) and bare-metal stents (BMS). In the TAXUS IV, TAXUS V, and TAXUS VI trials, patients with serum creatinine levels >2.0 mg/dl were excluded. In the present analysis, 816 patients with serum creatinine levels <or=2.0 mg/dl had intravascular ultrasound images acquired after the procedures and/or at 9-month follow-up (406 with PES, 410 with BMS). Patients were stratified by level of creatinine clearance (Ccr; group 1: Ccr <40; group 2: 40 <or=Ccr <60; group 3: 60 or/=Ccr <80; group 4: Ccr >or=80 ml/min/1.73 m(2)). For all levels of Ccr, patients with PES compared with those with BMS had less intimal hyperplasia area (group 1: 0.97 +/- 0.98 vs 2.94 +/- 1.89; group 2: 0.94 +/- 0.86 vs 2.30 +/- 1.21; group 3: 0.99 +/- 1.02 vs 2.53 +/- 1.29; group 4: 0.87 +/- 0.95 vs 2.12 +/- 1.29 mm(2), all p values <0.0001) and greater increases in peristent plaque and media area (group 1: 0.90 +/- 0.98 vs -0.02 +/- 0.98 mm(2), p = 0.03; group 2: 0.57 +/- 1.43 vs 0.20 +/- 1.14 mm(2), p = 0.11; group 3: 1.20 +/- 1.95 vs 0.02 +/- 1.17, p <0.0001; group 4: 0.35 +/- 1.44 vs -0.19 +/- 1.08 mm(2), p = 0.08). Neointimal growth and vessel remodeling were not affected by variations in Ccr after either BMS or PES implantation over the range studied. The incidence of incomplete stent apposition at follow-up was lowest in patients with the greatest renal impairment after BMS and PES implantation. In conclusion, neointimal proliferation was less prominent and expansive vessel remodeling was more prominent after PES than BMS implantation, independent of the severity of renal dysfunction.


Small molecule modulators of Keap1-Nrf2-ARE pathway as potential preventive and therapeutic agents.
Kelch-like ECH-associated protein 1 (Keap1)-nuclear factor erythroid 2-related factor 2 (Nrf2)-antioxidant response elements (ARE) pathway represents one of the most important cellular defense mechanisms against oxidative stress and xenobiotic damage. Activation of Nrf2 signaling induces the transcriptional regulation of ARE-dependent expression of various detoxifying and antioxidant defense enzymes and proteins. Keap1-Nrf2-ARE signaling has become an attractive target for the prevention and treatment of oxidative stress-related diseases and conditions including cancer, neurodegenerative, cardiovascular, metabolic, and inflammatory diseases. Over the last few decades, numerous Nrf2 inducers have been developed and some of them are currently undergoing clinical trials. Recently, overactivation of Nrf2 has been implicated in cancer progression as well as in drug resistance to cancer chemotherapy. Thus, Nrf2 inhibitors could potentially be used to improve the effectiveness of cancer therapy. Herein, we review the signaling mechanism of Keap1-Nrf2-ARE pathway, its disease relevance, and currently known classes of small molecule modulators. We also discuss several aspects of Keap1-Nrf2 interaction, Nrf2-based peptide inhibitor design, and the screening assays currently used for the discovery of direct inhibitors of Keap1-Nrf2 interaction.


Bile acids: Lipase-catalyzed synthesis of new hyodeoxycholic acid derivatives.
In this work we present an efficient, environmentally friendly approach to the synthesis of a series of hyodeoxycholic acid derivatives applying Biocatalysis. Fifteen acetyl and ester derivatives, twelve of them new, were obtained through an enzymatic strategy in a fully regioselective way and in very good to excellent yield. In order to find the optimal reaction conditions, the influence of several parameters such as enzyme source, alcohol or acylating agent:substrate ratio, enzyme:substrate ratio, temperature and reaction solvent was considered. The excellent results obtained made this procedure very efficient, particularly considering the low amount of enzyme required. In addition, this methodology uses mild reaction conditions and has reduced environmental impact, making biocatalysis a suitable way to obtaining these bile acids derivatives.


Influence of bone marrow-derived Ia-bearing cells on the selection of the T-cell repertoire.
We have presented the results of studies using chimeric animals to examine the role of distinct cell subsets in shaping the TCR repertoire. Examination of specificity and TCR expression in antigen-specific long-term T-cell lines derived from these chimeras suggests that bone marrow-derived APC play a role in the selection of T cells for MHC restriction during development, and also profoundly influence the expansion of the TCR repertoire following antigen priming. An understanding of the molecular mechanisms that govern TCR repertoire maturation may await the development of effective in vitro model systems of T-cell differentiation.


Effectiveness of elastic band-type ankle-foot orthoses on postural control in poststroke elderly patients as determined using combined measurement of the stability index and body weight-bearing ratio.
Poor recovery of postural stability poststroke is the primary cause of impairment in activities and social participation in elderly stroke survivors. The purpose of our study was to experimentally evaluate the effectiveness of our new elastic ankle-foot orthosis (AFO), compared to a traditional AFO fabricated with hard plastic, in improving postural stability in elderly chronic stroke survivors. Postural stability was evaluated in ten chronic stroke patients, 55.7±8.43 years old. Postural stability was evaluated using the standardized methods of the Biodex Balance System combined with a foot pressure system, under three experimental conditions, no AFO, rigid plastic AFO, and elastic AFO (E-AFO). The following dependent variables of postural stability were analyzed: plantar pressure under the paretic and nonparetic foot, area of the center of balance (COB) and % time spent in each location, distance traveled by the COB away from the body center, distance traveled by the center of pressure, and calculated index of overall stability, as well as indices anterior-posterior and medial-lateral stability. Both AFO designs improved all indices of postural stability. Compared to the rigid plastic AFO, the E-AFO produced additional positive effects in controlling anterior-posterior body sway, equalizing weight bearing through the paretic and nonparetic limbs, and restraining the displacement of the center of pressure and of the COB. Based on our outcomes, we recommend the prescription of E-AFOs as part of a physiotherapy rehabilitation program to promote recovery of postural stability poststroke. When possible, therapeutic outcomes should be documented using the Biodex Balance System and foot pressure system, as used in our study, to provide evidence needed to support the development of a larger controlled trial to generate high-quality evidence on the effectiveness of E-AFOs.


Spectroscopic investigation and comprehensive analysis of the polychrome clay sculpture of Hua Yan Temple of the Liao Dynasty.
This article shows the investigation results of the polychrome clay sculptures in Hua Yan Temple of the Liao Dynasty in Datong, China. The mineral pigments, adhesive and painting techniques used in these cultural relics were systematically analyzed in this project. Optical microscope (OM), Scanning electron microscope coupled with an energy-dispersive X-ray spectroscopy (SEM-EDS), micro-Raman, Fourier transform infrared spectrometer (FT-IR) and Pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS) analyses were selected as scientific micro-destructive analytical methods. The results show that the pigments in the polychrome clay sculptures include cinnabar, lead red, malachite, atacamite, azurite, orpiment and gold. Meanwhile, the presence of nitrogen-containing substances and glue-marker characteristic pyrolysis products clearly indicates that the adhesive used in most of the polychrome clay sculptures was glue-protein. Additionally, the combination of heat-bodied tung oil and glue-protein was also found in the golden areas.


A novel method for obtaining semi-thin cross sections of the Drosophila heart and their labeling with multiple antibodies.
The Drosophila heart has become an exciting model for elucidating the molecular basis for cardiac function in higher organisms. To complement the genetic approaches that have recently identified an array of genes essential for cardiac function, we developed a method to obtain optimal semi-thin cross sections of embryonic, larval, and adult fly hearts in a desired orientation. A procedure for fluorescent labeling of these sections with multiple markers has also been developed, allowing the detection of proteins at high subcellular resolution. Sections obtained by our method reveal changes in cell shape between embryonic heart and aorta cardioblasts and elucidate the morphology of the adult heart. Analysis of the adult heart reveals the precise cardiac tube morphology, differential distribution of the extracellular matrix protein Laminin within the cardiac tube, as well as individual hand-positive, and Held Out Wings (HOW)-positive luminal cells that might represent blood cells. In summary, our method enables visualization of cross sections of the embryonic and adult hearts at high resolution while maintaining the ability to co-label the sections with multiple markers, thereby facilitating the analysis of cardiac tube formation and maintenance at different developmental stages.


Direct operations for the management of life-threatening ischemic ventricular tachycardia.
Between June 1978 and 1986, 93 consecutive patients underwent electrophysiologically guided operations for life-threatening recurrent sustained ventricular tachycardia mostly associated with other surgical procedures, such as left ventricular resection (aneurysmectomy) and coronary artery bypass grafting. Eighty-seven percent of the surviving patients were free of spontaneous ventricular tachycardia return or sudden death 1 year after the operation and 77% at 5 years. The instantaneous risk of ventricular tachycardia return was highest immediately after operation, declined rapidly, and by 2 weeks postoperatively had merged with the constant hazard phase, which persisted as long as the patients were observed. Endocardial resection, rather than encircling endocardial myotomy, increased the risk of spontaneous ventricular tachycardia return/sudden death. Survival rates, including hospital deaths, were 95% at 30 days, 89% at 1 year, and 70% at 5 years after operation. The most prevalent mode of death was heart failure. The absence of anterolateral left ventricular aneurysms and the use of more extended encircling incisional techniques for ventricular tachycardia ablation increased the risk of early and late death. Survival was particularly poor in that subset of patients in whom recurrent sustained ventricular tachycardia returned after operation; the most prevalent mode of death in this group was also progressive left ventricular failure. Inferences: (1) Complete and partial encircling endocardial myotomy incisions are the most effective surgical techniques for malignant ventricular tachycardia ablation. (2) Because of their adverse effects on left ventricular structure and function, the arrhythmogenic tissues have to be localized as precisely as possible, and the encompassing incisions should be kept as limited as possible. (3) The late return of ventricular tachycardia may be more related to a progressive ischemic left ventricular cardiomyopathy than to an inadequate operation.


Diel variability of methane emissions from lakes.
Lakes are considered the second largest natural source of atmospheric methane (CH4). However, current estimates are still uncertain and do not account for diel variability of CH4 emissions. In this study, we performed high-resolution measurements of CH4 flux from several lakes, using an automated and sensor-based flux measurement approach (in total 4,580 measurements), and demonstrated a clear and consistent diel lake CH4 flux pattern during stratification and mixing periods. The maximum of CH4 flux were always noted between 10:00 and 16:00, whereas lower CH4 fluxes typically occurred during the nighttime (00:00-04:00). Regardless of the lake, CH4 emissions were on an average 2.4 higher during the day compared to the nighttime. Fluxes were higher during daytime on nearly 80% of the days. Accordingly, estimates and extrapolations based on daytime measurements only most likely result in overestimated fluxes, and consideration of diel variability is critical to properly assess the total lake CH4 flux, representing a key component of the global CH4 budget. Hence, based on a combination of our data and additional literature information considering diel variability across latitudes, we discuss ways to derive a diel variability correction factor for previous measurements made during daytime only.


Targeting microbiota to alleviate the harm caused by sleep deprivation.
Sleep deprivation has become a common health hazard, affecting 37-58% of the population and promoting the occurrence and development of many diseases. To date, effective treatment strategies are still elusive. Accumulating evidence indicates that modulating the intestinal microbiota harbors significant potential for alleviating the deleterious impacts of sleep deprivation. This paper first reviews the effects of sleep deprivation on gastrointestinal diseases, metabolic diseases, and neuropsychiatric diseases, discussing its specific mechanisms of influence. We then focus on summarizing existing interventions, including probiotics, melatonin, prebiotics, diet, and fecal microbiota transplantation (FMT). Finally, we have discussed the advantages and limitations of each strategy. Compared with other strategies, probiotics showed a high potential in alleviating sleep deprivation-related hazards due to their reduced risk and high security. We suggest that future research should focus on the specific mechanisms by which probiotics mitigate the harms of sleep deprivation, such insights may unveil novel pathways for treating diseases exacerbated by insufficient sleep.


Purulent lymphadenitis due to Halomonas hamiltonii: a case report.
Halomonas hamiltonii is a gram-negative rod bacterium isolated from highly saline environments. H. hamiltonii has rarely been reported as a human pathogen. Herein, we present the first case report of a purulent lymphadenitis caused by H. hamiltonii worldwide. The patient was a previously healthy girl aged 1 year who was referred to our hospital for left axillary lymphadenitis. Although oral amoxicillin was administered, lymphadenitis did not improve, and an abscess developed. After incision and drainage, the abscess was reduced. No recurrence of lymphadenitis was observed. The pus culture was negative. However, the 16S ribosomal DNA was amplified by the melting temperature mapping method. The amplified 16S ribosomal DNA sequence revealed 99.7% identity of H. hamiltonii. To the best of our knowledge, this is the first case of H. hamiltonii infection in a lymph node. This pathogen should be considered when diagnosing purulent lymphadenitis in healthy patients with lymphadenopathy of unknown origin.


Diagnostic Accuracy of Procalcitonin, Neutrophil-to-Lymphocyte Ratio, and C-Reactive Protein in Detection of Bacterial Infections and Prediction of Outcome in Nonneutropenic Febrile Patients with Lung Malignancy.
Procalcitonin (PCT), C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) have emerged as important markers of inflammation, and these markers, especially PCT and CRP, have been studied in patients with neutropenia. This study was designed to evaluate their value in differentiating infectious fever from tumor fever (TF) and to investigate their role in assessing outcomes in nonneutropenic lung cancer patients (NNLCPs). This retrospective clinical study included 588 febrile NNLCPs between January 2019 and December 2019. The levels of PCT, CRP, and conventional inflammatory markers, including white blood cells (WBC) and neutrophils (NEU), were measured. NLR was defined as the ratio of the absolute neutrophil count to the absolute lymphocyte count. Patients' clinical and bacteriological data were recorded. This study included 311 NNLCPs with bacterial infections and 277 with TF. Inflammatory markers such as PCT, CRP, WBC, and NEU levels and NLR were significantly higher in patients with bacterial infections than in those with TF (p < 0.0001). However, PCT level was the best predictor of bacterial infections, with an area under the curve (AUC) of 0.874, followed by CRP level (AUC = 0.855) and NLR (AUC = 0.792) (p < 0.0001). Additionally, PCT level was significantly elevated in patients with bacterial infections with progressive disease after radiotherapy and chemotherapy (p < 0.01). The present study demonstrated the superiority of PCT over CRP and NLR in the diagnosis of febrile patients with bacterial infections. Additionally, PCT can be used to assess the clinical outcomes and cancer progression in NNLCPs.


Variational gated autoencoder-based feature extraction model for inferring disease-miRNA associations based on multiview features.
MicroRNAs (miRNA) play critical roles in diverse biological processes of diseases. Inferring potential disease-miRNA associations enable us to better understand the development and diagnosis of complex human diseases via computational algorithms. The work presents a variational gated autoencoder-based feature extraction model to extract complex contextual features for inferring potential disease-miRNA associations. Specifically, our model fuses three different similarities of miRNAs into a comprehensive miRNA network and then combines two various similarities of diseases into a comprehensive disease network, respectively. Then, a novel graph autoencoder is designed to extract multilevel representations based on variational gate mechanisms from heterogeneous networks of miRNAs and diseases. Finally, a gate-based association predictor is devised to combine multiscale representations of miRNAs and diseases via a novel contrastive cross-entropy function, and then infer disease-miRNA associations. Experimental results indicate that our proposed model achieves remarkable association prediction performance, proving the efficacy of the variational gate mechanism and contrastive cross-entropy loss for inferring disease-miRNA associations.


Azole resistance among oral Candida species isolates from AIDS patients under ketoconazole exposure.
This is a prospective study designed to investigate species distribution and azole susceptibility profile among Candida spp. isolated from the oral cavities of AIDS patients. One hundred thirty-two AIDS patients sequentially admitted at a teaching tertiary care hospital were enrolled in this study. Samples were obtained by swabbing the oral cavities of the patients. Yeast isolates were identified by classical methods and the antifungal susceptibility profile was further determined according to the NCCLS microbroth assay. Among all patients with prescriptions of systemic antifungal drugs, ketoconazole had been elected to treat 56% of patients. We found 82% of oral yeast carriage, 22% of them harboring non-albicans species. Overall rates of susceptibility dose dependent/resistance to azoles was 16% for itraconazole, 13% for ketoconazole, and 10% for fluconazole with a high agreement rate among the susceptibility profiles of all isolates tested against the triazoles.


Comparative studies on the human glutamate-pyruvate transaminase phenotypes--GPT 1, GPT 2-1, GPT 2.
The quantitative differences between the activity of the 3 common phenotypes of human red cell GPT has been confirmed. In addition, the activity of red cell GPT 1 was found to be greater in young children than in adults. No such difference was found for the GPT 2 phenotype. The activity of the red cell GPT 1 was found to decrease with age, reaching the adult level at the age of 10 to 12 years. Red cell GPT of all the 3 common phenotypes in both adults and children was found to show a similar response to the addition of excess pyridoxal phosphate. A method has been devised for the partial purification of human GPT (cytoplasmic) from liver. GPT 1 and GPT 2 have been purified, and very few significant differences were found amongst the physical and kinetic parameters tested.


Ultrastructural characteristics of solid pseudopapillary tumors of the pancreas.
We carried out an electron microscopic study of solid pseudopapillary tumors of the pancreas (operation material) from 15 patients. Two cell types were distinguished. Type 1 cells had large oval nuclei, little changed mitochondria, and short fragments of the granular cytoplasmic reticulum. These cells formed mainly pseudopapillary structures around the vessels. Type 2 cells were characterized by pronounced nuclear polymorphism with specific "coffee bean" picture. The cytoplasm of these cells contained many large mitochondria with clarified matrix and often destroyed cristae; lipofuchsin granules were seen. The ultrastructural characteristics of the solid pseudopapillary tumor cells attest to their epithelial origin.


Investigation of the relationship between wearing glasses and deep cervical flexor endurance in patients with non-specific neck pain.
The aims of this study: 1) to determine postural changes according to wearing glasses and relationship between these changes and deep cervical flexor muscle group, 2) to investigate effectiveness of endurance training on postural changes and deep cervical flexor muscles. Seventy-three patients who had neck pain participated in this study and divided into two groups according to wearing glasses or not. Before and after endurance training for 6 weeks, postural angles of cervical region were counted, deep cervical flexor endurance test was performed and score of pain and disability index were noted of all subjects. Before treatment endurance levels were lower and scores of disability index were higher in experimental group (p< 0.05). After treatment endurance levels were improved, and scores of disability index were decreased more significantly in control group (p< 0.05). There were no significant differences between gaze, head and neck angles in both groups after treatment (p> 0.05). As a result it was seen that wearing glasses affected endurance of deep neck flexor muscles negatively, and it was not found relationship between postural angles and endurance of deep cervical flexor muscles. Also it was observed that endurance training for 6 weeks hadn't affected postural angles but enhanced performance of deep cervical flexor muscles significantly.


Freeze-fracture demonstration of communicating junctions between interstitial cells of the pulmonary interalveolar septa.
Interstitial cells in the interalveolar septa of lungs, which are considered to be myofibroblasts, are coupled by communicating junctions.


Abnormal subcellular distribution of beta-glucuronidase in mice with a genetic alteration in enzyme structure.
Liver beta-glucuronidase is structurally altered in inbred strain PAC so that a peptide subunit with a more basic isoelectric point, GUS-SN, is produced. This allele of beta-glucuronidase was transferred to strain C57BL/6J by 12 backcross matings to form the congenic line B6 X PAC-Gus(n). Liver beta-glucuronidase activity was halved in males of the congenic strain compared to normal males. The lowered activity was specifically accounted for by a decrease in the lysosomal component. There was no alteration in the concentration of microsomal activity. This alteration in the subcellular distribution of beta-glucuronidase in Gus(n)/Gus(n) mice was confirmed by two independent gel electrophoretic systems which separate microsomal and lysosomal components. beta-Glucuronidase activity was likewise approximately halved in mutant spleen, lung, and brain, organs which contain exclusively or predominantly lysosomal beta-glucuronidase. The loss of liver lysosomal beta-glucuronidase activity was shown by immunotitration to be due to a decrease in the number of beta-glucuronidase molecules in lysosomes of the congenic strain. The Gus(n) structural alteration likely causes the lowered lysosomal beta-glucuronidase activity since the two traits remain in congenic animals. Heterozygous Gus(n)/Gus(b) animals had intermediate levels of liver beta-glucuronidase. Also, the effect was specific, in that three other lysosomal enzymes were not reproducibly lower in Gus(n)/Gus(n) mice. Gus(n) is, therefore, an unusual example of a mutation which causes a change in the subcellular distribution of a two-site enzyme.


Spirometry and maximal respiratory pressure references from healthy Minnesota 65- to 85-year-old women and men.
To obtain spirometry and maximal respiratory pressure (MRP) reference values for elderly persons. Survey. General community. Four hundred seventy-one healthy ambulatory white women and men age 65+ years. A stringent spirometry quality assurance program exceeded American Thoracic Society recommendations. A "healthy" subgroup of 176 women and 112 men between the ages of 65- and 85 years were identified by excluding those with conditions that negatively influenced FEV1 in a multiple regression analysis. Reference equations and normal ranges for FEV1, FVC, FEF25-75%, peak flow, and maximal inspiratory and expiratory pressures (MRPs) were determined from the healthy group with good quality maneuvers. Less than 10% of the subjects were unable to perform three acceptable spirometry maneuvers and ten MRP maneuvers. When the age and height corrected FEV1s from this group were compared with other spirometry reference studies, mean values from the women were nearly identical to those from Morris, while these men had substantially lower FEV1 values (by 0.3- to 0.5L) than elderly men in Crapo's study. Mean peak flow was over 20% higher when compared with previous studies, suggesting greater initial expiratory effort by our subjects. The maximal inspiratory pressure (MIP) values were about 20% higher than those reported by the Cardiovascular Health Study, perhaps because five MIP maneuvers were always performed. Spirometry and MRP reference values used for elderly patients should come from population studies using similar techniques and with large numbers of subjects over age 65 years.


Analytical performance evaluation of different test systems on serum creatinine assay.
Serum creatinine (SCr) is a useful diagnostic marker for the assessment of renal function. Accurate quantitation of SCr is clinically important in calculation of glomerular filtration rate (GFR). To confirm whether there are differences in SCr between enzymatic kits of different manufacturers, the analytical performance of the matched and open test system in the measurement of SCr was evaluated. The analytical performance evaluation was conducted according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Precision, accuracy, linearity, dilution, lower limit of measurement and analytical interference were studied between the two test systems. The performance of SCr from the open test system was in compliance with the matched test system with good precision, accuracy, and linearity. In presence of most common interferents, both test systems could lead to accurate creatinine results except for the existence of specified drugs. For dobutamine, the open test system showed better anti-interference performance than the matched system. This study provides referable opinions for clinical laboratory selection on the test system and a framework for future analogous studies based on different test systems.


Exposure Therapy and Its Mechanisms.
Exposure therapy is the gold-standard treatment approach for pathological anxiety. This therapeutic approach builds on principles of extinction training from traditional fear conditioning and extinction protocols. In this chapter, we discuss principles of exposure therapy in the clinic and the laboratory experimental results that guide our decisions in the therapy. We discuss emotional processing theory and inhibitory learning principles, with a focus on expectation violation. We conclude with future research directions needed to improve exposure therapy outcomes among patients with anxiety-related disorders.


Long coiled-coil proteins and membrane traffic.
Protein transport between organelles is mediated by vesicles which must accurately dock and fuse with appropriate compartments. Over the past several years a large number of long coiled-coil proteins have been identified on the Golgi and on endosomes, mostly as auto-antigens in autoimmune disorders. Based on their restricted intracellular distributions and their predicted rod-like structure, these proteins have been proposed to play a role in tethering vesicles to target organelles prior to fusion. However, such proteins may also play a structural role, for example as components of a Golgi matrix, or as scaffolds for the assembly of other factors important for fusion. This review will examine what is known about the function of these large coiled-coil proteins in membrane traffic.


Detection of bone marrow and extramedullary involvement in patients with non-Hodgkin's lymphoma by whole-body MRI: comparison with bone and 67Ga scintigraphies.
The aim of this study was to evaluate the diagnostic potential of whole-body MRI (WB-MRI) for the detection of bone marrow and extramedullary involvement in patients with non-Hodgkin's lymphoma. WB-MRI, which was performed on 34 patients, consisted of the recording of T1-weighted spin-echo images and a fast STIR sequence covering the entire skeleton. The WB-MRI findings for bone marrow and extramedullary involvement were compared with those from (67)Ga and bone scintigraphies and bone marrow biopsy results. Two MRI specialists reviewed the WB-MRI results and two expert radiologists in the field of nuclear medicine reviewed the bone and (67)Ga scintigraphy findings. Bone marrow and extramedullary involvement of non-Hodgkin's lymphoma were confirmed by follow-up radiographs and CT and/or a histological biopsy. The detection rate of WB-MRI was high. More bone marrow involvement was detected by biopsy, and more lesions were detected by scintigraphies. In total, 89 lesions were detected by WB-MRI, whereas 15 were found by biopsy, 5 by (67)Ga scintigraphy, and 14 by bone scintigraphy. WB-MRI could also detect more extramedullary lesions than (67)Ga scintigraphy; i.e., 72 lesions were detected by WB-MRI, whereas 54 were discovered by (67)Ga scintigraphy. WB-MRI is useful for evaluating the involvement of bone marrow and extramedullary lesions throughout the skeleton in patients with non-Hodgkin's lymphoma.


An ultra-stretchable glycerol-ionic hybrid hydrogel with reversible gelid adhesion.
Functional hydrogels have attracted enormous interest as wet adhesives for biomedical research and engineering applications. However, reversible hydrogel adhesives that can be used for gelid conditions were rarely reported. In this work, we have developed a freezing-tolerant (freezing temperature < -50 °C), ultra-stretchable (stretch strain > 30000% at 25 °C) glycerol-ionic hydrogel via the ultraviolet curing of acrylamide monomer and hyper-branched polyethylenimine polymer in CaCl2-water-glycerol solution. The fabricated hydrogel exhibited reversible gelid adhesion, rapid self-healing (recover in 3 s) and weight-retaining (>2 weeks) properties. The hydrogel allows two iron substrates to adhere together at -40 °C with the lap-shear adhesion strength as high as ~1 MPa. Such strong adhesion measured was reversible, specifically achieving ~100% of initial adhesion strength at 25 °C and ~36% at -40 °C. Additionally, decreasing the testing temperature significantly improved the tensile strength but decreased the fracture strain of the hydrogel. Interestingly, lap-shear adhesion tests suggested that the gelid adhesion strength was enhanced by 130 times as the testing temperature decreased from 25 °C to -40 °C, which was mainly attributed to the enhanced mechanical strength of the bulk hydrogel as well as the increased surface interaction at gel-substrate interfaces. More importantly, the adhesion failure gradually changed from cohesive failure to adhesive failure as the temperature decreased. This work provides new practical and fundamental insights into developing multifunctional freezing-tolerant hydrogel adhesive for gelid conditions.


Shedding Novel Photophysical Insights Toward Discriminative Detection of Three Toxic Heavy Metal Ions and a hazard class 1 nitro-explosive By Using a Simple AIEE Active Luminogen.
In this work, we introduced a simple aggregation-induced emission enhancement (AIEE) sensor (PHCS) which can selectively detect and discriminate three environmentally and biologically imperative heavy metal ions (Cu2+, Co2+ and Hg2+) and a hazard class 1 categorized nitro-explosive picric acid (PA) in differential media. By virtue of its weak fluorescence attributes in pure organic medium owing to the synergistic operation of multiple photophysical quenching mechanisms, the molecular probe showcased highly selective 'TURN ON' fluorogenic response towards hazardous Hg2+ with a limit of detection (LOD) as low as 97 nM. Comprehensive investigation of binding mechanism throws light on the cumulative effect of probe-metal complexation induced chelation enhanced fluorescence (CHEF) effect and subsequent AIEE activation within the formed probe-metal adducts. Noteworthily, the probe (PHCS) can be readily used in real water samples for the quantitative determination of Hg2+ in a wide concentration range. In addition, the probe displayed modest colorimetric recognition performances to selectively detect and discriminate two essential heavy metal ions (Cu2+ and Co2+) with a LOD of 96 nM and 65 nM for Cu2+ and Co2+ respectively, in semi-aqueous medium. Intriguingly, based on high photoluminescence efficiency, the AIEE active nano-aggregated PHCS displayed a remarkable propensity to be used as a selective and ultra-sensitive 'TURN-OFF' fluorogenic chemosensor towards PA with LOD of 34.4 ppb in aqueous medium. Finally, we specifically shed light on the interaction of PHCS hydrosol towards PA using some unprecedented techniques, which helped uncover new photophysical insights of probe-explosive molecule interaction. We shed light on novel photophysical insights toward unique multifunctional sensory aptitude of a simple aggregation-induced emission enhancement active organic functional molecule in differential media, enabling ultra-sensitive discriminative detection of toxic heavy metal ions and explosive molecule simultaneously.


Estrogen action: revitalization of the chick oviduct model.
Despite decades of investigation, the molecular pathways triggered by estrogen that lead to tissue-specific cell proliferation, differentiation and survival are only superficially understood. If we are to modulate the actions of estrogen selectively in these processes, continued investigation using biologically relevant models is essential. The chick oviduct emerged as an early model for investigating the mechanism of action of steroid hormones because of its exquisite responsiveness to them. Unfortunately, because of experimental limitations, this model has been neglected in the past decade. Reviving this model has become intellectually attractive and technically feasible.


Standardization of therapy machine interface for treatment monitoring.
Computerized monitoring of radiation treatments is an effective tool in detecting and preventing errors in treatment delivery. Most manufacturers now supply optional treatment monitoring (Record and Verify) systems. These differ significantly in their features and are, in general, incompatible with each other. Based on our examination of four different commercial systems, we believe that these commercial and individualized systems are not adequate and are difficult to use. In a radiation therapy facility with more than one treatment machine, it is highly desirable, for a variety of reasons, that such a system be implemented on a central computer which monitors all machines. A centralized record and verify system which allows the storage of all data on a long term basis in an on-line common data base permits much easier access to individual patient data as well as useful data analysis and reports. Every patient's demographic, prescription and treatment data are then available on all treatment machines. This is particularly useful for cases in which a patient may be transferred from one machine to the other. Such a system is also easier to operate. The development of such a treatment monitoring system requires that the protocol of communication between the therapy machine and the computer, and the data describing therapy machine settings transmitted to the computer be standardized. We propose that every manufacturer supply an optional interface meeting this standard. A description of the proposed standard evolved in four years of our work in this field is given.


Characterizing the interactions between copper ions and dissolved organic matter using fluorescence excitation-emission matrices with two-dimensional Savitzky-Golay second-order differentiation.
Monitoring dissolved organic matter (DOM) content in aquatic environments is crucial for not only understanding the dynamics of heavy metals but also predicting their bioavailability. Fluorescence spectroscopy is typically employed to characterise DOM. Here, the interaction between DOM and trace metals was investigated by combining excitation-emission matrix (EEM) quenching with two-dimensional Savitzky-Golay second-order differentiation (2D-SG-2nd-df) analysis. The 2D-SG-2nd-df analysis decomposed the EEM spectra of commercial humic acid (HA) samples into six separate fluorescence peaks, which agreed with the results obtained through conventional parallel factor (PARAFAC) analysis. Compared with PARAFAC modeling, the 2D-SG-2nd-df approach provided more valid and reliable results when the dataset contained distinct samples. Moreover, since the results obtained from 2D-SG-2nd-df for each sample are independent, shifts in the peak wavelength can be reproduced more efficiently using this method. Triplicate titration experiments showed clear differences in HA-copper interactions for samples with different HA composition and molecular weight. The binding strength between copper and low-molecular-weight DOM in water was weaker than that observed for high-molecular-weight DOM. The results obtained in this study will serve as a basis for applying 2D-SG-2nd-df not only to DOM but also to other samples studied using EEM measurements.


Association of venous volume and diameter of incompetent perforator veins in the lower limb--implications for perforator vein surgery.
To define the association between venous volume as measured with air-plethysmography and the duplex ultrasound measured diameter of incompetent perforator of the lower limb. Thirty-six patients with chronic venous disease were investigated with air-plethysmography and duplex ultrasound. Venous volume and venous filling time was measured. Venous filling index was calculated. The findings were correlated with the diameter of the largest incompetent perforator vein of the lower limb. Twenty-six patients with venous volume in the normal range (80-170 ml) had a median perforator diameter of 3.5 mm (IQR 3.2-4.3). Ten patients with venous volume above 170 ml had median perforator diameter of 5.5 mm (IQR 4.6-7.7). (p=0.001, Mann-Whitney). There was a correlation between the venous volume and diameter of the largest incompetent perforator vein. (Pearson correlation factor 0.69, p=0.01). Limb volume correlates to the diameter of the largest incompetent perforator of the calf. Increase in venous limb volume could be partly responsible for an increase in the size of calf perforators thereby promoting incompetence.


[In memory of J. F. F. Theodor Langhans (1839-1915)].
On occasion of the sesquicentennial of the birth of J.F.F. Theodor Langhans, a tribute is made to his life and work.


Ultra-thin light-weight laser-induced-graphene (LIG) diffractive optics.
The realization of hybrid optics could be one of the best ways to fulfill the technological requirements of compact, light-weight, and multi-functional optical systems for modern industries. Planar diffractive lens (PDL) such as diffractive lenses, photonsieves, and metasurfaces can be patterned on ultra-thin flexible and stretchable substrates and be conformally attached on top of arbitrarily shaped surfaces. In this review, we introduce recent research works addressed to the design and manufacturing of ultra-thin graphene optics, which will open new markets in compact and light-weight optics for next-generation endoscopic brain imaging, space internet, real-time surface profilometry, and multi-functional mobile phones. To provide higher design flexibility, lower process complexity, and chemical-free process with reasonable investment cost, direct laser writing (DLW) of laser-induced-graphene (LIG) is actively being applied to the patterning of PDL. For realizing the best optical performances in DLW, photon-material interactions have been studied in detail with respect to different laser parameters; the resulting optical characteristics have been evaluated in terms of amplitude and phase. A series of exemplary laser-written 1D and 2D PDL structures have been actively demonstrated with different base materials, and then, the cases are being expanded to plasmonic and holographic structures. The combination of these ultra-thin and light-weight PDL with conventional bulk refractive or reflective optical elements could bring together the advantages of each optical element. By integrating these suggestions, we suggest a way to realize the hybrid PDL to be used in the future micro-electronics surface inspection, biomedical, outer space, and extended reality (XR) industries.


Angina: evolution of the role of nitrates.
In recent years, concern has been expressed over attenuation of therapeutic effect in patients receiving continuous nitroglycerin therapy for the treatment of angina. Studies have shown that exercise tolerance time does not improve with continuous nitroglycerin regimens, although the frequency of anginal attacks may decrease. Intermittent therapy, which incorporates a nitrate-free interval, improves both exercise time and clinical angina. The optimal duration of the nitrate-free interval has yet to be determined. Future research is likely to focus more on supply-side factors in angina. Of the available antianginal drugs, nitrates have been shown to be highly effective coronary vasodilators, particularly in areas of stenosis.


Herpes Zoster Risk in Immunocompromised Adults in the United States: A Systematic Review.
The primary reported risk factors for herpes zoster (HZ) include increasing age and immunodeficiency, yet estimates of HZ risk by immunocompromising condition have not been well characterized. We undertook a systematic literature review to estimate the HZ risk in immunocompromised patients. We systematically reviewed studies that examined the risk of HZ and associated complications in adult patients with hematopoietic cell transplants (HCT), cancer, human immunodeficiency virus (HIV), and solid organ transplant (SOT). We identified studies in PubMed, Embase, Medline, Cochrane, Scopus, and clinicaltrials.gov that presented original data from the United States and were published after 1992. We assessed the risk of bias with Cochrane or Grading of Recommendations Assessment, Development, and Evaluation methods. We identified and screened 3765 records and synthesized 34 studies with low or moderate risks of bias. Most studies that were included (32/34) reported at least 1 estimate of the HZ cumulative incidence (range, 0-41%). There were 12 studies that reported HZ incidences that varied widely within and between immunocompromised populations. Incidence estimates ranged from 9 to 92 HZ cases/1000 patient-years and were highest in HCT, followed by hematologic malignancies, SOT, and solid tumor malignancies, and were lowest in people living with HIV. Among 17 HCT studies, the absence of or use of antiviral prophylaxis at <1 year post-transplant was associated with a higher HZ incidence. HZ was common among all immunocompromised populations studied, exceeding the expected HZ incidence among immunocompetent adults aged ≥60 years. Better evidence of the incidence of HZ complications and their severity in immunocompromised populations is needed to inform economic and HZ vaccine policies.


Optimization of the Surface Structure on Black Silicon for Surface Passivation.
Black silicon shows excellent anti-reflection and thus is extremely useful for photovoltaic applications. However, its high surface recombination velocity limits the efficiency of solar cells. In this paper, the effective minority carrier lifetime of black silicon is improved by optimizing metal-catalyzed chemical etching (MCCE) method, using an Al2O3 thin film deposited by atomic layer deposition (ALD) as a passivation layer. Using the spray method to eliminate the impact on the rear side, single-side black silicon was obtained on n-type solar grade silicon wafers. Post-etch treatment with NH4OH/H2O2/H2O mixed solution not only smoothes the surface but also increases the effective minority lifetime from 161 μs of as-prepared wafer to 333 μs after cleaning. Moreover, adding illumination during the etching process results in an improvement in both the numerical value and the uniformity of the effective minority carrier lifetime.


Solubilization of sphingomyelin vesicles by addition of a bile salt.
The interactions of the bile salt sodium taurocholate (TC) in 50 mM Trizma-HCl buffer and 150 mM NaCl (pH 9) at 37 degrees C with membranes composed of sphingomyelin (SM) were studied by dynamic light scattering, cryogenic transmission electron microscopy (cryo-TEM) and turbidity measurements. Small unilamellar SM vesicles were prepared by extrusion. Below the CMC of TC, taurocholate addition leads to vesicle growth due to incorporation of the taurocholate molecules into the vesicle bilayer. At around half the CMC of the bile salt, the SM vesicles are transformed into SM/TC mixed worm-like micelles, which are visualized by cryo-TEM for the first time. Further increase in the taurocholate concentration leads to the rupture of these structures into small spherical micelles. Interestingly, large non-spherical micelles were also identified for pure taurocholate solutions. Similar threadlike structures have been reported earlier for the bile salt sodium taurodeoxycholate [Rich, A., Blow, D., 1958. Nature 182, 1777; Blow, D.M., Rich, A., 1960. J. Am. Chem. Soc. 82, 3566-3571; Galantini, L., Giglio, E., La Mesa, C., Viorel-Pavel, N., Punzo, F., 2002. Langmuir 18, 2812] and for mixtures of taurocholate and phosphatidylcholate [Ulmius, J., Lindblom, G., Wennerström, H., Johansson, L.B.-A., Fontel, K., Söderman, O., Ardvisson, G., 1982. Biochemistry 21, 1553; Hjelm, R.P., Thiyagarajan, P., Alkan-Onyuksel, H., 1992. J. Phys. Chem. 96, 8653] as determined by various scattering methods.


Commercial kefir products assessed for label accuracy of microbial composition and density.
Kefirs are fermented beverages containing yeast and bacteria produced by the fermentation of water or milk with kefir grains. Because microorganism density may influence a product's health benefits, label accuracy regarding viable bacterial density and taxonomy of fermented foods is important. In this study, the microbiota of 5 commercial kefir products were measured quantitatively using standard plating techniques and characterized using high-resolution, long-read 16S rRNA gene amplicon sequencing. To enumerate viable lactic acid bacteria, 2 lots of each product were plated on de Man, Rogosa and Sharpe agar upon opening and following 14 d and incubated under anaerobic and aerobic conditions. Results revealed that 66% of products with a guaranteed count of colony-forming units per gram overstated microorganism density by at least 1 log, with only product E exceeding 1 × 109 cfu/g. Sequencing results demonstrated moderate product label accuracy in regard to taxonomy, yet several products contained bacterial species above the minimum detectable threshold (0.001% relative abundance) that were not included on the labels (e.g., Streptococcus salivarius, Lactobacillus paracasei). Our results demonstrate a moderate level of labeling accuracy for commercial kefir products intended for human consumption. Regulatory agencies and consumers must continue to scrutinize these products and demand a higher level of accuracy and quality.


Reduced substance P-like immunoreactivity in hereditary sensory neuropathy of pointer dogs.
Two unrelated Pointer dogs, each from a breeding of normal parents which produced three affected pups in a litter of nine, began to bite their paws at 3 and 5 months of age. Insensitivity to painful stimuli was marked in the distal parts of the limbs and receded proximally. The affected dogs were euthanatized at 5 and 20 months because of acral mutilation and infection. Changes affecting the primary sensory neurons included: small spinal ganglia with reduced numbers of cell bodies, degeneration of unmyelinated and myelinated fibers in dorsal roots and peripheral nerves, and reduced fiber density in the dorsolateral fasciculus (dlf). Since nociceptive loss was the salient deficit in a neuropathy affecting primary sensory neurons, immunohistochemical studies focused on substance P, the undecapeptide imputed to mediate nociception at the first synapse in the spinal cord and brain. The localization and density of substance P-like (SPL) immunoreactivity was studied in three control dogs and the two Pointers by the indirect antibody peroxidase-antiperoxidase method. The spinal intumescences of the control dogs contained dense SPL-immunoreactivity in fibers of the dlf and the superficial laminae of the dorsal horn (i.e., laminae I, II, and the dorsal part of III). Immunoreactive fascicles on the lateral aspect of the dorsal horn and in the reticular process sent contributions medially to a plexiform fiber arrangement in lamina V. Medially, SPL-immunoreactive fibers were more loosely arranged in the internal third of laminae VI and VII and in lamina X.(ABSTRACT TRUNCATED AT 250 WORDS)


Localization of angiotensin II binding sites in the bovine adrenal medulla using a labelled specific antagonist.
Angiotensin II binding sites have been localized in sections of bovine adrenal glands and on living cultured bovine adrenal medullary cells using [125I]-[Sar1,Ile8]-angiotensin II and autoradiographic techniques. Binding sites were observed over both adrenaline and noradrenaline chromaffin cells. However, they were present in higher density over adrenaline cells, as determined by the distribution of phenylethanolamine N-methyltransferase mRNA by in situ hybridization histochemistry and of glyoxylic acid-induced fluorescence of noradrenaline. Binding sites were also observed in low density over nerve tracts within the bovine adrenal gland. Living cultured bovine adrenal medullary cells possessed angiotensin II binding sites. Not all cells were labelled. At least 73% of identified dispersed chromaffin cells in these cultures were labelled. Some chromaffin cells were not labelled with the ligand, and at least some non-chromaffin cells in the cultures did possess angiotensin II binding sites. The results provide direct anatomical support for the known ability of angiotensin II to elicit catecholamine secretion from perfused adrenal glands and from cultured adrenal chromaffin cells. They also suggest that some of the effects of angiotensin II on calcium fluxes and second messenger levels measured in cultured adrenal medullary cell preparations may be due to angiotensin II acting on non-chromaffin cells present in these cultures.


Evaluation of Factors Relevant to Pain Control Among Patients After Surgical Treatment.
Opioids are often prescribed after elective surgical treatment despite the potential for misuse. Although various pain control regimens exist, patient preferences for acute postoperative pain management are unknown. To describe patient-reported key attributes of postoperative pain management. This decision analytical model used responses from a survey based on conjoint analysis to investigate the value patients placed on different aspects of postoperative pain management. Participants were patients aged 18 years or older who underwent elective hand surgical procedures between July 1, 2018, and July 23, 2019, at a single academic center. The survey was completed on a web-based platform and took place between November 2019 and January 2020. Data were analyzed from May through July 2021. Participants were presented with a series of discrete-choice tasks and asked to select between 2 postoperative medication options that changed from question to question and had varying characteristics. Attribute importance scores and part-worth utility values for the queried aspects of pain control were calculated. Of 710 individuals invited, 321 (45.2%) completed the survey; there were 212 (66.0%) women and 108 (33.6%) men, and the most common age category was 60 to 69 years (102 participants [31.8%]). Most patients reported previous opioid use (282 individuals [87.9%]). Factors in the decision-making process with the highest attribute importance scores (SDs) were risk of addiction (26.3% [13.0%]) and amount of pain relief (25.6% [14.6%]). Adverse effects 13.9% (7.2%), functional independence 11.8% (7.3%), and level of trust in the prescriber 11.4% (5.8%) had intermediate attribute importance scores (SDs). Cost 7.9% (4.4%) and stigma 3.1% (1.3%) had the lowest attribute importance scores (SDs) in patient decisions. These findings suggest that multimodal pain control regimens that are associated with optimized pain relief and minimized risk of addiction are preferable to treat acute postoperative pain. The results suggest that identifying procedures for which patients prioritize minimizing risk of addiction over pain relief and incorporating patient preferences into decision-making may be associated with decreased postoperative opioid prescribing.


Resource use data by patient report or hospital records: do they agree?
Economic evaluations alongside clinical trials are becoming increasingly common. Cost data are often collected through the use of postal questionnaires; however, the accuracy of this method is uncertain. We compared postal questionnaires with hospital records for collecting data on physiotherapy service use. As part of a randomised trial of orthopaedic medicine compared with orthopaedic surgery we collected physiotherapy use data on a group of patients from retrospective postal questionnaires and from hospital records. 315 patients were referred for physiotherapy. Hospital data on attendances was available for 30% (n = 96), compared with 48% (n = 150) of patients completing questionnaire data (95% Cl for difference = 10% to 24%); 19% (n = 59) had data available from both sources. The two methods produced an intraclass correlation coefficient of 0.54 (95% Cl 0.31 to 0.70). However, the two methods produced significantly different estimates of resource use with patient self report recalling a mean of 1.3 extra visits (95% Cl 0.4 to 2.2) compared with hospital records. Using questionnaires in this study produced data on a greater number of patients compared with examination of hospital records. However, the two data sources did differ in the quantity of physiotherapy used and this should be taken into account in any analysis.


Performance of equations for calculated LDL-C in hypertriglyceridaemia: Which one correlates best with directly measured LDL-C?
The gold standard for measuring LDL-C is impractical and direct measurements have numerous shortcomings. Older predictive equations are used only with triglycerides (TG's) below 4.52 mmol/L. We evaluated the newer equations validated for use in hypertriglyceridaemia by comparison with direct LDL-C. Datasets from two platforms (Abbott Architect and Roche Cobas) comprised of a large cohort of 64,765 individuals were used to compare the Sampson-National Institutes of Health 2 (S-NIH2) and Extended Martin-Hopkins (E-MH) equations for LDL-C with direct LDL-C (dLDL-C) assays. With TG's of 4.52-9.04 mmol/L the S-NIH2 equation tended to calculate lower values than measured by dLDL-C and the E-MH equation calculated higher values. Both equations correlated better with the dLDL-C measured on Abbott than Roche with the E-MH equation having more values falling within acceptable concordance levels on both platforms. The E-MH equation correlates better with dLDL-C than the S-NIH2 on both platforms with TG levels up to 9.04 mmol/L. With hypertriglyceridaemia, the E-MH equation is less likely than the S-NIH2 equation to underestimate LDL-C when compared to the dLDL-C and will be less likely to underdiagnose patients with LDL-C levels requiring treatment according to current guidelines.


New roles for elongation factors in RNA polymerase II ubiquitylation and degradation.
RNA polymerase II (RNAPII) encounters numerous impediments on its way to completing mRNA synthesis across a gene. Paused and arrested RNAPII are reactivated or rescued by elongation factors that travel with polymerase as it transcribes DNA. However, when RNAPII fails to resume transcription, such as when it encounters an unrepairable bulky DNA lesion, it is removed by the targeting of its largest subunit, Rpb1, for degradation by the ubiquitin-proteasome system (UPS). We are starting to understand this process better and how the UPS marks Rbp1 for degradation. This review will focus on the latest developments and describe new functions for elongation factors that were once thought to only promote elongation in unstressed conditions in the removal and degradation of RNAPII. I propose that in addition to changes in RNAPII structure, the composition and modification of elongation factors in the elongation complex determine whether to rescue or degrade RNAPII.


[Ductal carcinoma in situ treated with radiation therapy and additional boost].
Women with ductal carcinoma in situ are treated with breast-conserving surgery and radiation therapy. The impact of an additive boost radiation is under evaluation. All women treated for ductal carcinoma in situ with breast-conserving surgery and whole breast radiation therapy at a total dose of 45Gy with a boost radiation from 1990 to 2008 have been included in this retrospective monocentric retrospective study. We included 171 patients. Boost radiation to the surgical bed was delivered by brachytherapy in 66 patients (39%), by direct en-face electron beam in 86 patients (50%), and by tangential fields using photon beams in 19 patients (11%). Median follow-up was 95.1months. Eight local relapses (4.6%) have occurred. The 10-year local recurrence-free survival rate was 97%. The 10-year overall survival rate was 98%. On multivariable analysis, brachytherapy (P=0.05; HR=5.15; IC=1-26.3) was associated with a reduction risk of local recurrence-free survival. In our experience, women treated for a ductal carcinoma in situ with breast-conserving surgery and whole breast radiation therapy with a boost radiation have a high 10-year local recurrence-free survival rate.


Cytokine mediated tissue fibrosis.
Acute inflammation is a recognised part of normal wound healing. However, when inflammation fails to resolve and a chronic inflammatory response is established this process can become dysregulated resulting in pathological wound repair, accumulation of permanent fibrotic scar tissue at the site of injury and the failure to return the tissue to normal function. Fibrosis can affect any organ including the lung, skin, heart, kidney and liver and it is estimated that 45% of deaths in the western world can now be attributed to diseases where fibrosis plays a major aetiological role. In this review we examine the evidence that cytokines play a vital role in the acute and chronic inflammatory responses that drive fibrosis in injured tissues. This article is part of a Special Issue entitled: Fibrosis: Translation of basic research to human disease.


Linkage relationships between Retinoschisis, Xg, and a cloned DNA sequence from the distal short arm of the X chromosome.
A cloned DNA sequence, RC8, from the short arm of the X chromosome which is linked to the Duchenne muscular dystrophy (DMD) gene has been employed to study linkage relationships with the Xg-linked retinoschisis (RS) locus. Results of three point linkage analyses in two families suggest that the gene order on Xp is Xg-RS-RC8. Moreover, it can be inferred from these date that the genetic distance between Xg and DMD is approximately 55 cM.


Accuracy of Flash Glucose Monitoring During Postprandial Rest and Different Walking Conditions in Overweight or Obese Young Adults.
Aims: To investigate the accuracy of FreeStyle LibreTM flash glucose monitoring (FGM) relevant to plasma glucose (PG) measurements during postprandial rest and different walking conditions in overweight/obese young adults. Methods: Data of 40 overweight/obese participants from two randomized crossover studies were pooled into four trials: (1) sitting (SIT, n = 40); (2) walking continuously for 30 min initiated 20 min before individual postprandial glucose peak (PPGP) (20iP + CONT, n = 40); (3) walking continuously for 30 min initiated at PPGP (iP + CONT, n = 20); and (4) accumulated walking for 30 min initiated 20 min before PPGP (20iP + ACCU, n = 20). Paired FGM and PG were measured 4 h following breakfast. Results: The overall mean absolute relative difference (MARD) between PG and FGM readings was 16.4 ± 8.6% for SIT, 16.2 ± 4.7% for 20iP + CONT, 16.7 ± 12.2% for iP + CONT, and 19.1 ± 6.8% for 20iP + ACCU. The Bland-Altman analysis showed a bias of -1.03 mmol⋅L-1 in SIT, -0.89 mmol⋅L-1 in 20iP + CONT, -0.82 mmol⋅L-1 in iP + CONT, and -1.23 mmol⋅L-1 in 20iP + ACCU. The Clarke error grid analysis showed that 99.6-100% of the values in all trials fell within zones A and B. Conclusion: Although FGM readings underestimated PG, the FGM accuracy was overall clinically acceptable during postprandial rest and walking in overweight/obese young adults.


Imaging associated with percutaneous and intraoperative management of renal tumors.
As new minimally invasive treatment options for small renal tumors such as laparoscopic partial nephrectomy (LPN), radiofrequency ablation (RFA), and cryoablation(CA) have been developed, the reliance upon imaging technologies, both intraoperatively and postoperatively, has expanded greatly. CT, MRI, and ultrasonography (US)have proven themselves extremely useful in this regard, but their utility requires a thorough understanding of each modality's limitations, proper intraoperative use, and expected postoperative findings. This article discusses intraoperative use of US for LPN,RFA, and CA. The expected postoperative MRI and CT findings after CA and RFA also are covered, highlighting the different radiographic evolutionary patterns encountered after use of these technologies. Because the success of these new treatments for small re-nal tumors (especially RFA and CA) depends not only on the technology itself but also on the advantages and limitations of the associated radiographic techniques, urologists of the 21st century must be facile at interpreting and manipulating these imaging modalities to appropriately care for their renal tumor patients.


The flavivirus dengue induces hypertrophy of white matter astrocytes.
Flaviviruses, including Zika and dengue (DENV), pose a serious global threat to human health. Of the 50+ million humans infected with DENV annually, approximately 1-3 % progress to severe disease manifestations, dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Several factors are suspected to mediate the course of infection and pathogenesis of DENV infection. DHF and DSS are associated with vascular leakage and neurological sequelae. Our hypothesis was that altered astrocyte activation and morphology would alter the dynamics of the extracellular space and hence, neuronal and vascular function. We investigated the mechanisms of neuropathogenesis DENV infection in rhesus macaques. There were decreased numbers of GFAP immunopositive astrocytes per unit area, although those that remained had increased arbor length and complexity. This was combined with structural hypertrophy of white matter astrocytes in the absence of increased vascular leakage. Combined, these studies show how even low-grade infection with DENV induces measurable changes within the parenchyma of infected individuals.


Realist inquiry: a new way to think about overcrowding interventions.
Physician-focused throughput initiatives are intended to mitigate the effects of emergency department (ED) overcrowding. Our tertiary care academic hospital recently piloted an emergency physician leader role intended to improve throughput. Although a separate experimental evaluation of this initiative was undertaken, it was expected that such an evaluation could not alone provide the necessary information to inform 'how' the emergency physician leader intervention worked. The objective of this study was to conduct a realist evaluation of the emergency physician leader. Realist inquiry utilizes Context Mechanism Outcome configurations to determine the impacts of interventions that are often missed by quantitative analysis. Using a realist perspective, this study aimed to evaluate the emergency physician leader initiative's effects on throughput with the goal of building transferable lessons to the implementation of future interventions. Semi-structured interviews with key stakeholders in the intervention were conducted and analyzed using thematic and template techniques specifically aimed at identifying Context Mechanism Outcomes. 13 interviews were conducted with physicians and nurses who identified contexts and mechanisms which promoted or impeded ED throughput. For example, in situations where there was a clear indication for imaging or management that could not be initiated within the scope of a nursing protocol, the emergency physician leader initiating these orders was felt to promote ED throughput. Conversely, in contexts where there was no nurse available to fulfill early orders, the emergency physician leader's initiation of orders was perceived to impede throughput. This evaluation provides insights into the reasoning and behaviour of individuals involved in the emergency physician leader initiative and provides a systematic approach to unraveling its complex causal pathway. Knowledge of context-mechanism-outcome relationships may help implementers design and measure the impact of future physician-focused throughput interventions.


Using Geographic Catchment Areas to Measure Population-based Access to Kidney Transplant in the United States.
Monitoring efforts to improve access to transplantation requires a definition of the population attributable to a transplant center. Previously, assessment of variation in transplant care has focused on differences between administrative units-such as states-rather than units derived from observed care patterns. We defined catchment areas (transplant referral regions [TRRs]) from transplant center care patterns for population-based assessment of transplant access. We used US adult transplant listings (2006-2016) and Dartmouth Atlas catchment areas to assess the optimal method of defining TRRs. We used US Renal Data System and Scientific Registry of Transplant Recipient data to compare waitlist- and population-based kidney transplant rates. We identified 110 kidney, 67 liver, 85 pancreas, 68 heart, and 43 lung TRRs. Most patients were listed in their assigned TRR (kidney: 76%; liver: 75%; pancreas: 75%; heart: 74%; lung: 72%), although the proportion varied by organ (interquartile range for kidney, 65.7%-82.5%; liver, 58.2%-78.8%; pancreas, 58.4%-81.1%; heart, 63.1%-80.9%; lung, 61.6%-76.3%). Patterns of population- and waitlist-based kidney transplant rates differed, most notably in the Northeast and Midwest. Patterns of TRR-based kidney transplant rates differ from waitlist-based rates, indicating that current metrics may not reflect transplant access in the broader population. TRRs define populations served by transplant centers and could enable future studies of how transplant centers can improve access for patients in their communities.


Adhesion of oral streptococci to all-ceramics dental restorative materials in vitro.
In recent years, patients have benefited from the development of better and more esthetic materials, including all-ceramics dental restorative materials. Dental plaque formation on teeth and restorative materials plays an important role in the pathogenesis of oral diseases. This study investigates initial adhesion of stationary phase streptococcal species to different all-ceramics dental restorative materials. The saliva-coated materials were incubated with the bacteria for 1 h in an in vitro flow chamber which mimics environmental conditions in the oral cavity. Number and vitality of adhering bacteria were determined microscopically after staining. Surface roughness and the composition of the materials had no distinctive influence on bacterial adhesion. However, S. mutans and S. sobrinus adhered about tenfold less numerous to all materials than the other streptococcal species. Further, there was a correlation between bacterial vitality and materials' glass content. The results showed that early plaque formation was influenced predominantly by the presence of the salivary pellicle rather than by material dependent parameters whereas the composition of the all-ceramics appeared to have influenced the percentage of viable cells during the adhesion process. This presented in vitro technique may provide a useful model to study the influence of different parameters on adherence of oral streptococcal species.


Association between mitral annular calcification and progression of mitral and aortic stenoses.
Mitral annular calcification (MAC) is a chronic degenerative process affecting the annular fibrosus of the mitral valve. We sought to examine the relationship between MAC and the progression of valve disease. The echocardiography database was searched for patients with MAC who had undergone at least two studies more than 1 year apart. The degree of MAC was quantified according to both extent and thickness. The degree of aortic stenosis (AS) and mitral stenosis (MS) was classified according to valve area and mean gradient, respectively. Of 125 patients, moderate or greater AS was present in 8 of 86 (9.3%) patients with mild, 12 of 29 (41.4%) patients with moderate, and 4 of 10 (40%) patients with severe MAC extent, P = .0002. The rate of progression of AS was highest in those with greatest MAC extent (0.21 cm2 /y) or greatest MAC thickness (0.28 cm2 /y) compared with those with least MAC extent (0.09 cm2 /y) or thickness (0.07 cm2 /y), P = .04 and <.0001, respectively. The rate of progression of mean mitral gradient was highest in those with greatest MAC extent (0.71 mm Hg/y) or greatest MAC thickness (0.17 mm Hg/y) compared with those with least MAC extent (0.07 mm Hg/y) or thickness (0.07 mm Hg/y), P = .0003 and P < .0001, respectively. Patients with greatest MAC extent had lower survival than those with lower MAC extent, P = .03. However, there was no difference in survival between patients with different MAC thickness, P = .43. Both the degree of MAC extent and thickness are associated with the rate of progression of aortic and mitral stenosis and may serve as a risk marker for future progression.


Conservative management of a pregnancy complicated by preeclampsia and postpartum spontaneous hepatic rupture: A case report and review of the literature.
Most spontaneous hepatic rupture cases are associated with a pregnancy-induced hypertensive disorder like preeclampsia and HELLP syndrome. Although it is a rare complication, it is still associated with high maternal and fetal morbidity and mortality rates. With this study, we aim to present a case report and review the available literature on hepatic rupture associated with hypertensive disorders of the pregnancy. We present a case report and a review of the literature of the last 20 years on hepatic rupture associated with pregnancy-induced hypertensive disorders. The selected cases were reviewed to collect information on maternal characteristics, clinical presentation, diagnostic studies, therapeutic modalities and maternal and fetal outcomes. Our review has found 57 publications describing a total of 93 cases of hepatic hemorrhage with capsule rupture associated with pregnancy-induced hypertensive disorders. Most of the patients were less than 35 years old and primiparous and the first symptoms of hepatic rupture included epigastric and right upper abdominal pain. Most of the diagnoses were made during surgery without previous diagnosis and, in the majority of cases, a surgical approach was necessary to achieve hemostasis. Perihepatic packing was the most used surgical method. Our clinical case and literature review reinforces the importance of closely monitoring all pregnancies complicated with hypertensive disorders, including in the postpartum period. Although hepatic rupture accounts for high maternal and fetal morbidity and mortality rates, it is possible to keep a conservative approach with good maternal and fetal outcomes, with a high index of suspicious, an early diagnosis and a multidisciplinary approach.


Revealing geometrically necessary dislocation density from electron backscatter patterns via multi-modal deep learning.
The characterization of geometrically necessary dislocation (GND) is central to understanding the plastic deformation in materials. Currently, fast and accurate determination of GND density via Electron Backscatter Diffraction (EBSD) remains a challenge. Here, a multi-modal deep learning approach is proposed to predict GND density in terms of electron backscatter patterns (EBSPs) and dislocation configurations. The proposed multi-modal architecture consists of two separated convolutional neural network (CNN) processing streams. One CNN stream aims at extracting pattern shifts from EBSPs, and the other CNN stream focuses on learning suitable representations of dislocation configurations. We also introduce a specific data augmentation strategy termed neighboring pairs generating strategy for the GND prediction task. Taking the GND density from dictionary indexing-based analysis as the target property, high accuracy is achieved on several aluminum samples. Also, our networks are robust to various forms of noise, and the prediction speed is as fast as modern EBSD scanning rates, enabling real-time GND density analysis possible.


Time course of the Bioelectrical Impedance Vector Analysis and muscular ultrasound in critically ill patients.
Several different tools have been developed to integrate the clinical and biochemical nutritional evaluations in critical care patients. Aims of this study were to evaluate the changes in the Bioelectrical Impedance Vector Analysis (BIVA) and ultrasonographic features of the diaphragm (DTee) and rectus femoris (RFCSA) during the first week of ICU stay. Ninety-six adult mechanically ventilated patients enrolled within 24 h after the admission to the ICU (T1). RFCSA and diaphragm end-expiratory thickness were measured, as well as BIVA parameters. Anthropometric data and biochemical parameters were collected. The measurements were repeated on the 3rd (T3) and 7th (T7) days of ICU stay. During the study period, the phase angle significantly decreased by 21%, reactance by 27%, and resistance by 11%. Both RFCSA and DTee significantly decreased, while neither were correlated to any BIVA parameter. DTee was considerably higher in survivors vs. non-survivors. Body composition is significantly modified after one week of ICU stay. BIVA may be useful in the definition of hydration state, while it does not seem to track muscle mass. Different temporal trends of specific BIVA and muscle ultrasound parameters were found in patients with high or low severity of illness.


Oral and maxillofacial dental care professionals in critical care during the COVID-19 pandemic.
At the peak of the COVID-19 pandemic there was a 'call to arms' across the oral and maxillofacial staff. This article reports on the extended role of the department's dental care professionals (DCPs) and the tremendous opportunity and value that temporary redeployment presented.