In vivo Metabolic Profiles as Determined by 31P and short TE 1H MR-Spectroscopy : No Difference Between Patients with IDH Wildtype and IDH Mutant Gliomas.
Previous ex vivo spectroscopic data from tissue samples revealed differences in phospholipid metabolites between isocitrate dehydrogenase mutated (IDHmut) and IDH wildtype (IDHwt) gliomas. We investigated whether these changes can be found in vivo using 1H-decoupled 31P magnetic resonance spectroscopic imaging (MRSI) with 3D chemical shift imaging (CSI) at 3 T in patients with low and high-grade gliomas. The study included 33 prospectively enrolled, mostly untreated patients who met spectral quality criteria according to the World Health Organization (WHO II n = 7, WHO III n = 17, WHO IV n = 9; 25 patients IDHmut, 8 patients IDHwt). The MRSI protocol included 1H decoupled 31P MRSI with 3D CSI (3D 31P CSI), 2D 1H CSI and a 1H single voxel spectroscopy sequence (TE 30 ms) from the tumor area. For 1H MRS, absolute metabolite concentration values were calculated (phantom replacement method). For 31P MRS, metabolite intensity ratios were calculated for the choline (C) and ethanolamine (E)-containing metabolites. In our patient cohort we did not find significant differences for the ratio of phosphocholine (PC) and phosphoethanolamine (PE), PC/PE, (p = 0.24) for IDHmut compared to IDHwt gliomas. Furthermore, we found no elevated ratios of glycerophosphocholine (GPC) and glycerophosphoethanolamine (GPE), GPC/GPE, (p = 0.68) or GPC/PE (p = 0.12) for IDHmut gliomas. Even the ratio (PC+GPC)/(PE+GPE) showed no significant differences with respect to mutation status (p = 0.16). Nonetheless, changes related to tumor grade regarding intracellular pH (pHi) and phospholipid metabolism as well as absolute metabolite concentrations of co-registered 2D 1H CSI data for tumor and control tissue showed the anticipated results. Using 3D-CSI data acquisition, in vivo 31P MR spectroscopic measurement of phospholipid metabolites could not distinguish between IDHmut and IDHwt.


Social and structural determinants of emergency department use among Arab and Jewish patients in Jerusalem.
A growing body of research demonstrates that economic conditions and racial and ethnic disparities result in excessive overuse of emergency departments (EDs) by a small group of socioeconomically marginalized residents. Knowledge and understanding of these issues on the part of the healthcare team can promote equality by providing structurally competent care. This study aims to identify the major social and structural factors related to patterns of ED visits by Arab and Jewish patients in Israel, where access to health services is covered by universal national health insurance. A cross-sectional study was conducted using questionnaires of ED patients in a tertiary care medical center in Jerusalem. The hospital is the largest of the three EDs in Jerusalem with over 90,000 adult patient visits a year. The sample was stratified by ethnicity, including 257 Jewish patients and 170 Arab patients. The outcome variable was repeat visits for the same reason to the ED within 30 days. There were differences between Jewish and Arab patients' social and structural characteristics, including health status, socioeconomic status, feeling of safety, and social support. There were also significant differences in some of the characteristics of health service utilization patterns, including ED repeat visits, language barriers when seeking healthcare in the community, and seeking information about medical rights. The variables associated with repeat visits were different between the two groups: among the Arab patients, repeat visits to the ED were associated with concerns about personal safety, whereas among the Jewish patients, they were associated with poverty. The study illustrates the gaps that exist between the Arab and Jewish population in Israel. The findings demonstrated significant differences between populations in both health status and access to health services. In addition, an association was found in each ethnic group between different structural factors and repeat ED requests. This study supports previous theories and findings of the relationship between structural and social factors and patterns of health services utilization.


Variation in NAT2 acetylation phenotypes is associated with differences in food-producing subsistence modes and ecoregions in Africa.
Dietary changes associated to shifts in subsistence strategies during human evolution may have induced new selective pressures on phenotypes, as currently held for lactase persistence. Similar hypotheses exist for arylamine N-acetyltransferase 2 (NAT2) mediated acetylation capacity, a well-known pharmacogenetic trait with wide inter-individual variation explained by polymorphisms in the NAT2 gene. The environmental causative factor (if any) driving its evolution is as yet unknown, but significant differences in prevalence of acetylation phenotypes are found between hunter-gatherer and food-producing populations, both in sub-Saharan Africa and worldwide, and between agriculturalists and pastoralists in Central Asia. These two subsistence strategies also prevail among sympatric populations of the African Sahel, but knowledge on NAT2 variation among African pastoral nomads was up to now very scarce. Here we addressed the hypothesis of different selective pressures associated to the agriculturalist or pastoralist lifestyles having acted on the evolution of NAT2 by sequencing the gene in 287 individuals from five pastoralist and one agriculturalist Sahelian populations. We show that the significant NAT2 genetic structure of African populations is mainly due to frequency differences of three major haplotypes, two of which are categorized as decreased function alleles (NAT2*5B and NAT2*6A), particularly common in populations living in arid environments, and one fast allele (NAT2*12A), more frequently detected in populations living in tropical humid environments. This genetic structure does associate more strongly with a classification of populations according to ecoregions than to subsistence strategies, mainly because most Sahelian and East African populations display little to no genetic differentiation between them, although both regions hold nomadic or semi-nomadic pastoralist and sedentary agriculturalist communities. Furthermore, we found significantly higher predicted proportions of slow acetylators in pastoralists than in agriculturalists, but also among food-producing populations living in the Sahelian and dry savanna zones than in those living in humid environments, irrespective of their mode of subsistence. Our results suggest a possible independent influence of both the dietary habits associated with subsistence modes and the chemical environment associated with climatic zones and biomes on the evolution of NAT2 diversity in sub-Saharan African populations.


Lysis induction of Escherichia coli by the cloned lysis protein of the phage MS2 depends on the presence of osmoregulatory membrane-derived oligosaccharides.
Expression of the cloned lysis protein of phage MS2, which is sufficient to lyse wild type Escherichia coli, does not cause lysis of mutants lacking the osmoregulatory membrane-derived oligosaccharides (MDO). The lysis gene product normally found in the membrane fraction was not stably inserted into the membranes of a mdoA mutant; rather degradation and release from the membrane occurred. Gentle plasmolysis of the MDO-lacking mutant clearly showed an increased periplasmic space as compared to wild type cells. It is concluded that the MDOs play an important role in maintaining a proper arrangement of inner and outer membrane, a prerequisite for a functional insertion of the MS2 lysis protein.


Structural plasticity broadens the specificity of an engineered protease.
The substrate specificity of alpha-lytic protease has been changed dramatically, with a concomitant increase in activity, by replacing an active-site Met with Ala. The substrate specificity of both this mutant and another similar mutant are extraordinarily broad. X-ray crystallographic analysis shows that structural plasticity, a combination of alternate side-chain conformations and binding-site flexibility, allows both large and small substrates to be well accommodated.


Presence-absence cycles of the mother and not light-darkness are the zeitgeber for the circadian rhythm of newborn mice.
The relative roles of conflicting zeitgebers [presence/absence (PA) cycles versus light/dark (LD) cycles] on entrainment of circadian rhythm of locomotor activity were tested in pups of the night active mouse Mus booduga. During the early days of the pups' life the PA cycles of the mother acted as a zeitgeber and entrained their activity rhythm, even though the LD cycles were available. Entrainment by LD cycles took place only when the pups' eyes opened and probably became functional.


Discordance between data acquired by history and findings of physical examination: a phenomenal paradox.
History and physical examination are the basis of any diagnosis. The findings of the physical examination usually corroborate the thoughts generated by the medical history. However, it is not uncommon for the physician to note discrepancies between the history and the physical examination. Two physicians provided a list of diseases they have encountered in which there is occasionally discordance between the data retrieved from the patient's medical history and the findings of the physical examination. To verify the data from knowledge and experience, we resorted to two main medical textbooks and relevant articles from PubMed. We identified 25 diseases where a discordance between history and physical examination may frequently be observed. These diseases cover a wide spectrum of systems (i.e., neurological, cardiological, respiratory, and gastrointestinal). A variety of diseases are associated with a discordance between the findings one might expect based on the medical history and the actual findings of the physical examination. Physicians need to be aware of this paradox, as misdiagnosis can be detrimental in some of these diseases. We acknowledge that this is just a sample, and not an exhaustive list, of all diseases with such a discordance.


Individual augmentee deployment and newly reported mental health morbidity.
To investigate the association between US Navy individual augmentee (IA) deployers, who may lack the protective effects of unit cohesion and social support, and newly reported mental health. Responses from the Millennium Cohort Study questionnaires were examined for 2086 Navy deployers in this prospective exploratory study. Multivariable logistic regression was used to evaluate IA deployment and newly reported mental health symptoms. After adjusting for covariates, IA deployment was not significantly associated with newly reported posttraumatic stress disorder (odds ratio = 1.02; 95% confidence interval: 0.53-1.95) or mental health symptoms (odds ratio = 1.03; 95% confidence interval: 0.66-1.60) compared with non-IA deployment. IA deployment was not associated with increased risk for posttraumatic stress disorder or mental health symptoms following deployment. It is likely that social isolation was not highly influential among Navy IAs in this study.


Excellent response of intramedullary Erdheim-Chester disease to vemurafenib: a case report.
Erdheim-Chester disease is a rare histiocytosis characterized by multi-systemic organ involvement. Immune-modulating agents such as interferon-alpha have limited success and the disorder is progressive and causes high morbidity and mortality. Treatment with the BRAF-inhibitor vemurafenib has recently produced substantial improvement in three patients with Erdheim-Chester disease expressing the p. V600E BRAF mutation. The disorder commonly affects the central nervous system and it is not yet known whether vemurafenib can reverse intra-axial infiltration and the resulting neurological impairment. In this work, we report for the first time an excellent clinical response to vemurafenib in a Norwegian patient with debilitating progressive spastic paraparesis due to intra-axial infiltration of the thoracic spinal cord. The patient had been unresponsive to interferon-alpha. Low dose vemurafenib (720 mg daily) for a period of three months resulted in significant tumor shrinkage by >60% and regression of contrast enhancement and fluorodeoxyglucose uptake on positron-emission tomography. The patient's spastic paraparesis and gait function improved dramatically. She currently walks unaided and reports a substantially improved quality of life. Our findings show that vemurafenib therapy, even at low doses, can be effective for the treatment of intra-axial central nervous system involvement in BRAF-positive Erdheim-Chester disease.


A skeleton of the human protein interactome.
In this issue of Cell, Wanker and colleagues (Stelzl et al., 2005) present a large-scale two-hybrid map of more than 3000 putative human protein-protein interactions. These new data will serve as an important source of information regarding individual protein partners and offer preliminary insight into the global molecular organization of human cells.


The role of Actinobacillus actinomycetemcomitans in periodontal disease.
The different forms of periodontitis are all associated with a distinct bacterial flora. However, a clear relationship is described between localized juvenile periodontitis (LJP) and Actinobacillus actinomycetemcomitans. Eleven LJP patients all harboured A. actinomycetemcomitans. The arrest of LJP is often impossible, due to the inability to eliminate A. actinomycetemcomitans. Therefore, antibiotic treatment was introduced in combination with the initial treatment. We studied the effect of periodontal treatment on the microflora and clinical status of periodontal disease patients using different therapies. Group 3 attained the best results (initial treatment and a combination metronidazole and amoxicillin), the group to eliminate A. actinomycetemcomitans effectively.


Effects of fenvalerate concentrations and its chiral isomers on bacterial community structure in the sediment environment of aquaculture ponds.
To investigate the effect of chiral pesticide fenvalerate (FV) on the micro-ecological environment of aquaculture pond sediment, we used an indoor static experiment to observe the effects of FV added at different concentrations with different chiral isomers on the changes in the sediment bacterial community. The 16S rDNA high-throughput sequencing technique was used to conduct sequencing and analysis of the bacterial community structure as well as changes in aquaculture pond sediments after 4 weeks of cultivation. The results showed that the microbial alpha diversity indices (Sobs and Shannon indices) of the treated groups were significantly lower than those of the control group after 4 weeks (P < 0.05), and the values in the high-concentration group were significantly lower than those of the low-concentration group (P < 0.05). In terms of bacterial group composition, the proportion of abundance of Proteobacteria and Acidobacteria in the treated groups were greater than in the control group after 4 weeks, while the proportion of abundance of Bacteroidetes and Verrucomicrobia were lower. In the high-concentration FV treatment group, the proportion of abundance of Bacteroidetes, Acidobacteria, Chloroflexi, Nitrospinae, unclassified_k_norank, Ignavibacteriae, and Nitrospirae were significantly different from those of the other groups (P < 0.05). Principal coordinate analysis (PCoA) and ANONISIM/Adonis analysis showed that the cis-enantiomer had a stronger effect on the bacterial community as the concentration of FV increased. In addition, the linear discriminant analysis effect size (LEfSe) and linear discriminant analysis (LDA) results revealed differences in the level of enrichment of bacterial groups caused by FV at different concentrations and isomer levels. Collectively, this study showed that FV residue has a pronounced effect on bacterial communities in sediment, which becomes more significant with increasing exposure concentration. The effects of the cis- and trans-enantiomers of FV on the sediment environment are different; the cis-enantiomer has a stronger effect on the bacterial community.


Polyethyleneimine-coating enhances adenoviral transduction of mesenchymal stem cells.
Mesenchymal stem cells (MSCs) are non-hematopoietic cells with multi-lineage potential, which makes them attractive targets for regenerative medicine applications. Efficient gene transfer into MSCs is essential for basic research in developmental biology and for therapeutic applications involving gene-modification in regenerative medicine. Adenovirus vectors (Advs) can efficiently and transiently introduce an exogenous gene into many cell types via their primary receptors, the coxsackievirus and adenovirus receptors (CARs), but not into MSCs, which lack CAR expression. To overcome this problem, an Adv coated with cationic polymer polyethyleneimine (PEI) was developed. In this study, we demonstrated that PEI coating with an optimal ratio can enhance adenoviral transduction of MSCs without cytotoxicity. We also investigated the physicochemical properties and internalization mechanisms of the PEI-coated Adv. These results could help to evaluate the potentiality of the PEI-coated Adv as a prototype vector for efficient and safe transduction into MSCs.


Slow coronary flow--a cause for angina with ST segment elevation and normal coronary arteries. A case report.
We report three cases of angina-like chest pain with documented ST segment elevation and slow coronary flow in the absence of any significant obstructive coronary artery disease and no evidence of any major epicardial coronary arterial spasm.


Carotid intima-media thickness in patients with slow coronary flow and its association with neutrophil-to-lymphocyte ratio: a preliminary report.
The slow coronary flow (SCF) is characterized by angiographically normal or near-normal coronary arteries with delayed progression of the contrast agent into distal vasculature. We aimed to investigate neutrophil-to-lymphocyte (N/L) ratio and the carotid intima-media thickness (CIMT) value in patients with SCF compared to patients with newly diagnosed coronary artery disease (CAD) and normal patients. We enrolled 60 consecutive patients with SCF, 68 patients with CAD, and 72 normal patients. The association between thrombolysis in myocardial infarction frame count, CIMT, and N/L ratio and other clinical and laboratory parameters were evaluated. The N/L ratio was significantly higher not only in patients with SCF but also in patients with CAD, compared to those of controls. The N/L ratio was positively and moderately correlated with CIMT in the whole study population. The NL ratio is significantly associated with reduced coronary blood flow, and elevated N/L ratio might be an independent predictor for the presence of SCF.


Haemophilia A in a litter of Siberian huskies.
To investigate haemorrhagic diathesis in several males in a litter of Siberian huskies. Activated partial thromboplastin time, prothrombin time, and Factor VIII and Factor IX concentrations were measured in citrated whole blood samples. Males in the litter had decreased Factor VIII concentrations. Haemophilia A was diagnosed as the cause of haemorrhagic diathesis in several males in a litter of Siberian huskies.


Conversion of CO2 into organic acids by engineered autotrophic yeast.
The increase of CO2 emissions due to human activity is one of the preeminent reasons for the present climate crisis. In addition, considering the increasing demand for renewable resources, the upcycling of CO2 as a feedstock gains an extensive importance to establish CO2-neutral or CO2-negative industrial processes independent of agricultural resources. Here we assess whether synthetic autotrophic Komagataella phaffii (Pichia pastoris) can be used as a platform for value-added chemicals using CO2 as a feedstock by integrating the heterologous genes for lactic and itaconic acid synthesis. 13C labeling experiments proved that the resulting strains are able to produce organic acids via the assimilation of CO2 as a sole carbon source. Further engineering attempts to prevent the lactic acid consumption increased the titers to 600 mg L-1, while balancing the expression of key genes and modifying screening conditions led to 2 g L-1 itaconic acid. Bioreactor cultivations suggest that a fine-tuning on CO2 uptake and oxygen demand of the cells is essential to reach a higher productivity. We believe that through further metabolic and process engineering, the resulting engineered strain can become a promising host for the production of value-added bulk chemicals by microbial assimilation of CO2, to support sustainability of industrial bioprocesses.


Direct AKT activation in tumor-infiltrating lymphocytes markedly increases interferon-γ (IFN-γ) for the regression of tumors resistant to PD-1 checkpoint blockade.
PD-1 immune checkpoint blockade against inhibitory receptors such as receptor programmed cell death-1 (PD-1), has revolutionized cancer treatment. Effective immune reactivity against tumour antigens requires the infiltration and activation of tumour-infiltrating T-cells (TILs). In this context, ligation of the antigen-receptor complex (TCR) in combination with the co-receptor CD28 activates the intracellular mediator AKT (or PKB, protein kinase B) and its downstream targets. PD-1 inhibits the activation of AKT/PKB. Given this, we assessed whether the direct activation of AKT might be effective in activating the immune system to limit the growth of tumors that are resistant to PD-1 checkpoint blockade. We found that the small molecule activator of AKT (SC79) limited growth of a B16 tumor and an EMT-6 syngeneic breast tumor model that are poorly responsive to PD-1 immunotherapy. In the case of B16 tumors, direct AKT activation induced (i) a reduction of suppressor regulatory (Treg) TILs and (ii) an increase in effector CD8+ TILs. SC79 in vivo therapy caused a major increase in the numbers of CD4+ and CD8+ TILs to express interferon-γ (IFN-γ). This effect on IFN-γ expression distinguished responsive from non-responsive anti-tumor responses and could be recapitulated ex vivo with human T-cells. In CD4+FoxP3+Treg TILs, AKT induced IFN-γ expression was accompanied by a loss of suppressor activity, the conversation to CD4+ helper Th1-like TILs and a marked reduction in phospho-SHP2. In CD8+ TILs, we observed an increase in the phospho-activation of PLC-γ. Further, the genetic deletion of the transcription factor T-bet (Tbx21) blocked the increased IFN-γ expression on all subsets while ablating the therapeutic benefits of SC79 on tumor growth. Our study shows that AKT activation therapy acts to induce IFN-γ on CD4 and CD8 TILs that is accompanied by the intra-tumoral conversation of suppressive Tregs into CD4+Th1-like T-cells and augmented CD8 responses.


Perceptions of "Natural" and "Additive-Free" Cigarettes and Intentions to Purchase.
In August 2015, the Food and Drug Administration (FDA) issued warning letters to cigarette manufacturers promoting brands as "natural" or "additive-free" because of concerns that such marketing claims might mislead consumers into believing that these brands are less dangerous to smoke than others. The current study examined consumer beliefs about the relative harms of "natural" cigarettes, and whether these beliefs influenced perceptions of advertising and purchase intentions when participants were shown an advertisement for American Spirit cigarettes. Data were collected using a web-based survey conducted in 2013 among 3,006 U.S.-based web panel members aged 15 to 65 years. Ratings of "natural" cigarette health risks (i.e., misperceptions) differed by sex, race, education, smoking status, and age. Controlling for perceived risks of other cigarette types, never smokers ( B = -0.31, p < .001) and ever/former smokers ( B = -0.15, p = .002) had significantly fewer misperceptions of "natural" cigarettes than current smokers. Current smoking (odds ratio [OR] = 17.8), believing the ad was truthful (OR = 1.18), and having more misperceptions about "natural" cigarette health risks (OR = 1.13) were independently associated with greater purchase intention. Consumers perceived cigarettes marketed as "natural" or "additive-free" as less harmful, and this influenced their perceptions of advertising claims and intention to purchase, controlling for other factors. These findings underscore Food and Drug Administration's recent warning letters.


[Metabolic improvement of diabetes mellitus through pamphlets on the norms of self-monitoring control measures].
To assess whether giving a leaflet containing norms of self-control to diabetics receiving insulin treatment results in a metabolic improvement. The HbA1c was established prior and subsequent to giving out the leaflet. The written norms contained in the leaflet were highlighted from the wider range of instructions obtained from diabetes education. A longitudinal intervention study with no random allocation. Hospital care in a specialised Endocrinology clinic. 122 types 1 and 2 diabetics, treated with various insulin diets, who had received prior diabetes education and carried out blood self-controls. Cases of meta-diabetic syndrome, serious illnesses and those without apparent hypoglycaemia symptoms were excluded. Giving out of a leaflet with written norms of self-control. The averages, standard deviations and 95% confidence intervals of the basal HbA1c and of those at four-monthly check-ups were calculated. Basal 8.07 (CI 7.75 - 8.39); 4th month 6.88 (CI 6.74 - 7.17); 8th month 6.59 CI 6.29 - 6.90); 12th month 6.60 (CI 6.23 - 6.94); 16th month 6.06 (CI 5.63 - 6.49); 20th month 5.40 (CI 3.04 - 7.75). Averages were compared by the Student T test and all values had p < 0.005 against the basal. Following the written norms produced a clear metabolic improvement, represented by the significant fall of HbA1c. Therefore, though without ignoring the overall context of treatment and diabetes education, it is proposed that the relationship of the most practical features of insulin dosing to written norms of self-control should be emphasised.


Umbilical cord blood stearoyl-CoA desaturase index and lipoprotein lipase mass level in small-for-gestational age newborns.
We previously reported that triglyceride (TG) levels in small-for-gestational age (SGA) newborns were significantly higher than those in appropriate-for-gestational age (AGA) newborns. Stearoyl-CoA desaturase (SCD) activity is required for TG synthesis, while lipoprotein lipase mass (LPLm) facilitates TG clearance. The purpose of this study is to reveal whether SCD activity or LPLm is the cause of high TG levels in SGA newborns. Fifty-five newborns were classified as AGA (n = 42) and SGA (n = 13). Serum LPLm, TG and fatty acids in umbilical cord blood were analyzed. Then, [16:1 (n-7)]/ [16:0] and [18:1 (n-9)]/ [18:0] were calculated as SCD16 and SCD18 activities, respectively. The SGA group showed significantly higher TG levels and significantly lower LPLm levels than the AGA group. However, SCD16 and 18 activities were lower in SGA newborns than in AGA newborns. In conclusion, LPLm, rather than SCD activity may be involved in the increased TG levels in SGA newborns.


Recent advances in nanotherapeutics for the treatment and prevention of acute kidney injury.
Acute kidney injury (AKI) is a serious kidney disease without specific medications currently except for expensive dialysis treatment. Some potential drugs are limited due to their high hydrophobicity, poor in vivo stability, low bioavailability and possible adverse effects. Besides, kidney-targeted drugs are not common and small molecules are cleared too quickly to achieve effective drug concentrations in injured kidneys. These problems limit the development of pharmacological therapy for AKI. Nanotherapeutics based on nanotechnology have been proved to be an emerging and promising treatment strategy for AKI, which may solve the pharmacological therapy dilemma. More and more nanotherapeutics with different physicochemical properties are developed to efficiently deliver drugs, increase accumulation and control release of drugs in injury kidneys and also directly as effective antioxidants. Here, we discuss the recent nanotherapeutics applied in the treatment and prevention of AKI with improved effectiveness and few side effects.


Ultrasound-guided lung lavage for life-threatening bronchial obstruction due to meconium plug.
We present a case of life-threatening airway obstruction caused by meconium aspiration, a condition with significant neonatal mortality and morbidity. Lung ultrasound detected the obstruction and helped in the clinical management allowing to perform a quick and selective bronchoalveolar lavage with diluted surfactant.


[Change in the tissue spectrum of carboxylic ester esterases in the postnatal period in rats].
A comparative investigation of the composition of electrophoretic fractions of esterases of compound ethers of carbonic acids has been carried out in the rat tissues. Carboxyl, aryl, acetyl and choline esterases were identified by the sensitivity to inhibitors. Changes in the composition of these esterases during the postnatal period were followed.


Cytotoxicity of Mycoplasma mycoides subspecies mycoides for cultured endothelial cells.
Toxic effect of 5 SC- and 4 LC-type strains of Mycoplasma mycoides subspecies mycoides has been demonstrated in cultured endothelial cells. The SC strains are agents of contagious bovine pleuropneumonia and presumably specific for cattle although occasionally isolated from goats. The LC strains produce an acute septicemic disease in goats and a few strains have been reported in cattle. The tissue culture cytotoxic dose causing 75% cell death (TCCD75) was calculated for each strain. Cytotoxicity ranged from 0.9 X 10(9) to 12.0 X 10(9) when strains were tested in bovine endothelial cells with the SC strains being twice as cytotoxic as the LC strains on average. Strains G175/78 and D44 representing the most cytotoxic SC and LC strains respectively, were selected for comparative experiments using bovine, caprine and porcine endothelial cells, bovine embryonic lung fibroblast cells (BELF) and the bovine cell line Madin-Darby kidney cells (MDBK). Strain G175/78 was significantly more cytotoxic for bovine endothelial cells than caprine and porcine, suggesting that the cytotoxicity reflects specificity for the bovine species. This strain was also cytotoxic for BELF but not for MDBK cells indicating that not all bovine cells are susceptible. Conversely, cytotoxicity of strain D44 was not significantly different in any of the endothelial cells tested, although cytotoxicity for BELF was significantly different, the cytotoxicity of the LC strains seems to be of less specificity.


Rapid serodiagnosis of Staphylococcus aureus surgical site infection following median sternotomy.
To determine the sensitivity and specificity of a novel ELISA for the serodiagnosis of surgical site infection (SSI) due to staphylococci following median sternotomy. Twelve patients with a superficial sternal SSI and 19 with a deep sternal SSI due to Staphylococcus aureus were compared with 37 control patients who also underwent median sternotomy for cardiac surgery but exhibited no microbiological or clinical symptoms of infection. A further five patients with sternal SSI due to coagulase-negative (CoNS) staphylococci were studied. An ELISA incorporating a recently recognised exocellular short chain form of lipoteichoic acid (lipid S) recovered from CoNS, was used to determine serum levels of anti-lipid S IgG in all patient groups. Serum anti-lipid S IgG titres of patients with sternal SSI due to S. aureus were significantly higher than the control patients (P<0.0001). In addition, patients with deep sternal SSI had significantly higher serum anti-lipid S IgG titres than patients with superficial sternal SSI (P = 0.03). Serum anti-lipid S IgG titres of patients with sternal SSI due to CoNS were significantly higher than the control patients (P = 0.001). The lipid S ELISA may facilitate the diagnosis of sternal SSI due to S. aureus and could also be of value with infection due to CoNS.


Quality of life after conservative laryngeal surgery: a multidimensional method of evaluation.
Assessment of quality of life (QoL) and satisfaction with care are particularly important in the field of oncology. The definition of QoL and the requirements for its measurement are still a matter of debate, but it is generally accepted that QoL is a multidimensional concept involving three different domains: physical, psychological and social. The aim of this study was to test a simple, inexpensive, multidimensional method of QoL measurement, based both on patients' perception of clinical outcome and the quantitatively evaluated clinical outcome, equally weighted, in patients who underwent three different types of conservative laryngeal surgery: horizontal laryngectomy (HG), supraglottic laryngectomy (SL) and subtotal reconstructive laryngectomy (SRL). The following were carried out for each patient: subjective-objective evaluation of speech [computerized spectrographic analysis of fundamental frequency (FO), percentage of noise and intensity and logopedic evaluation of speech], evaluation of deglutition (videofluoroscopic parameters, and qualitative assessment) and evaluation of physical, social, emotional and functional well-being (Functional Assessment of Cancer Therapy, FACT-G, and modified University of Washington Quality of life Scale, UWQoL). Each assessment was given a score rating from one to three points. The overall evaluation of the qualitative and quantitative score for each field and for each type of laryngeal surgery shows that SL results in the best post-operative QoL. Although HG is less damaging and involves swifter functional recovery times, its slightly lower score is due to the poorer quality of speech. The analysis of the results obtained confirm the need to set up an evaluation protocol combining both the subjective perceptions of the patient, as well as the more objective evaluation of the functions that are impaired following surgery. The protocol described above, although limited by the low number of cases, was easy to carry out, inexpensive and applicable in relation to the various types of surgery that may compromise phonation and deglutition.


Mitotic orientation in three dimensions determined from multiple projections.
The three-dimensional orientation of mitoses in mouse small intestinal crypts of Lieberkuhn was determined from multiple projections of the mitotic figures in whole mounts of isolated intestinal crypts. We found evidence of a significant orientational bias for mitoses whose daughter cells would be added along the long axis of the crypt, and thus conform to the maintenance of the cylindrical shape of the intestinal crypt. However, we also observed many mitoses whose progeny must be rearranged if the simple cylindrical shape of the intestinal crypt is to be maintained. Our results indicate that the ultimate behavior of progeny cells and hence of local tissue form may not strictly depend on the orientation of mitosis. The methods presented may also be used in the study of mitotic orientation in other tissues.


Gallium-67 citrate in detecting recurrent rectal carcinoma after abdomino-perineal resection.
In a retrospective study we have found gallium-67 citrate imaging of the abdomen to be a value in detecting pelvic recurrence of carcinoma of the rectum after abdomino-perineal excision. In this context the technique proved to have an accuracy of 83%, sensitivity of 82% and specificity of 83%.


Reversal of cardiac dysfunction by selective ET-A receptor antagonism.
The effectiveness of a selective endothelin receptor-A (ET-A) antagonist, A-127722 (approximately 10 mg kg(-1) day(-1) as 200 mg kg(-1) powdered food), to reverse existing cardiac remodelling and prevent further remodelling was tested in deoxycorticosterone acetate (DOCA)-salt hypertensive rats. Uninephrectomised rats (UNX) administered DOCA (25 mg every fourth day s.c.) and 1% NaCl in drinking water for 28 days developed hypertension (systolic blood pressure (BP): UNX 128+/-6 mmHg, DOCA-salt 182+/-5* mmHg; *P<0.05 vs UNX), left ventricular hypertrophy (UNX 1.99+/-0.06 mg kg(-1) body wt, DOCA-salt 3.30+/-0.08* mg kg(-1) body wt), decreased left ventricular internal diameter (UNX 6.69+/-0.18 mm, DOCA-salt 5.51+/-0.37* mm), an increased left ventricular monocyte/macrophage infiltration together with an increased interstitial collagen from 2.7+/-0.3 to 11.7+/-1.3%, increased passive diastolic stiffness (UNX 21.1+/-0.5, DOCA-salt 30.1+/-1.3*), prolongation of the action potential duration at 20 and 90% of repolarisation (APD20-UNX 6.8+/-1.1, DOCA-salt 10.1+/-1.5* ms; APD90-UNX 34.4+/-3.5 ms, DOCA-salt 64.3+/-10.4* ms) and vascular dysfunctions (2.6-fold decrease in maximal contractile response to noradrenaline, 3.5-fold decrease in maximal relaxation response to acetylcholine). Administration of A-127722 for 14 days starting 14 days after surgery attenuated the increases in systolic BP (150+/-6** mmHg, **P<0.05 vs DOCA-salt), left ventricular wet weight (2.65+/-0.06** mg kg(-1) body wt) and internal diameter (6.39+/-0.31** mm), prevented left ventricular monocyte/macrophage accumulation, attenuated the increased left ventricular interstitial collagen (7.6+/-1.3%**), reversed the increased passive diastolic stiffness (22.1+/-1.2**), attenuated the action potential duration prolongation (APD20 - 7.6+/-1.4**, APD90 - 41.5+/-6.9** ms) and normalised changes in vascular function. ET-A receptor antagonism both reverses and prevents the cardiac and vascular remodelling in DOCA-salt hypertension and improves cardiovascular function.


Proanthocyanidins inhibited colorectal cancer stem cell characteristics through Wnt/β-catenin signaling.
Cancer stem cells (CSCs) play a key role in tumor cell growth, drug resistance, recurrence, and metastasis. Proanthocyanidins (PC) is widely existed in plants and endowed with powerful antioxidant and anti-aging effects. Interestingly, recent studies have found that PC exhibits the inhibitory effect on tumor growth. However, the role of PC in CSCs of colorectal cancer (CRC) and molecular mechanism remain unclear. CCK-8, colony, and tumorsphere formation assay were used to evaluate cancer cell viability and stemness, respectively. Western blotting was used to detect the protein expression. Tumor xenograft experiments were employed to examine the tumorigenicity of CRC cells in nude mice. PC decreased the proliferation of CRC cells (HT29 and HCT-116), and improved the sensitivity of CRC cells to oxaliplatin (L-OHP), as well as inhibited tumor growth in nude mice. Further studies showed that PC also down-regulated CSCs surface molecular and stemness transcriptional factors, while suppressed the formations of tumorspheres and cell colony in CRC. In addition, PC-impaired proteins expressions of p-GSK3β, β-catenin and DVL1-3. LiCl, an activator of the Wnt/β-catenin signaling, rescued PC-induced downregulation of CSCs markers, and reduction of tumorspheres and cell colony formation abilities in CRC cells. Furthermore, the effects of PC on inhibiting cell proliferation and enhancing L-OHP sensitivity were impaired by LiCl. PC exerted an inhibitory effect on CSCs via Wnt/β-catenin in CRC, and may be a potential new class of natural drug for CRC treatment.


New aspect of anti-inflammatory action of lipo-prostaglandinE1 in the management of collagen diseases-related skin ulcer.
It is considered that the mechanism in intractable cutaneous ulcer is deeply associated with prolongation at the inflammatory phase. Having evaluated the effects of Lipo-prostaglandin E1 (Lipo-PGE1) with indicators such as the reduction ratio of the ulcer area and the values of the inflammatory markers after dividing them into two groups of collagen diseases and non-collagen diseases and giving them Lipo-PGE1, we managed to obtain the result that Lipo-PGE1 administration could influence various inflammatory markers such as C-reactive protein (CRP), IL-6, and VEGF in addition to reduction of the ulcer region. It also suggested that Lipo-PGE1 has the effect of maintaining an appropriate balance of induction of inflammation and angiogenesis. Additionally, it revealed that Lipo-PGE1 controls the production of cytokines, which are associated with the growth of collagen diseases. From these results, it can be expected that Lipo-PGE1 will act favorably on intractable collagen diseases.


How does risk-taking affect the green technology innovation of high-tech enterprises in China: the moderating role of financial mismatch.
As a core driver for the high-tech enterprises, green technology innovation is crucial, even with high financial risk. Against this background, this paper empirically examines the impact of risk-taking on green technology innovation of high-tech enterprises, taking Chinese A-share listed companies from 2007 to 2020 as the research sample and considering the moderating effect of financial mismatch. Findings show the following: First, the effect of risk-taking on green technology innovation of high-tech enterprises is insignificant in most cases, and the inhibitory effect of financial mismatch is partly supported. Second, financial mismatch only counter-regulates the inhibitory effect of systematic risk-taking on the number of invention patents granted in the eastern sample. Third, the effect of risk-taking on green technology innovation is significantly heterogeneous in terms of property rights and regional heterogeneity, regardless of considering the moderating effect of financial mismatch or not. Finally, the policy implementations point out that the government should create a favorable investment environment, financial institutions should adjust the way of capital allocation, while high-tech enterprises should broaden the financing channels to enhance their risk-taking ability, and promote green technological innovation to achieve high-quality economic development.


A simplified method for coliphage detection in natural waters.
The ARCAT (A Rapid Coliphage Analysis Technique) method for detecting coliphages in water has been modified. Modifications to the original method include media optimization, the use of frozen host cultures, the use of a single agar coliphage assay and optimized plaque resolution with 2, 3, 4-triphenyltetrazolium chloride. Detection of 5 coliphages per 100 ml of water sample is accomplished in 6 hours for rapid estimation of water quality.


Intravitreal triamcinolone acetonide in patients with macular oedema due to branch retinal vein occlusion: a pilot study.
To evaluate treatment of macular oedema due to branch retinal vein occlusion (BRVO) with intravitreal triamcinolone acetonide. In a prospective case series, nine patients with macular oedema due to BRVO received an intravitreal injection of 4 mg triamcinolone acetonide. Examination included best-corrected visual acuity (BCVA) for distance and reading, intraocular pressure (IOP) measurement, fluorescein angiography and high resolution imaging by optical coherence tomography, preoperatively and at 1 week, 1 month, 3 and 6 months postoperatively. Preoperative mean BCVAs were 1.3 +/- 0.8 for distance vision, and 1.1 +/- 0.3 for reading acuity, respectively. A significant improvement in reading acuity was observed until 1 month (0.7 +/- 0.4, p = 0.02). No significant reduction in mean macular thickness was observed. Intravitreal injection of triamcinolone acetonide led to a significant improvement in mean VA in patients with macular oedema due to BRVO. However, the significant effect was not permanent and persisted for only 1 month.


Budd-Chiari syndrome caused by undifferentiated small round cell tumor of the liver in an adult.
An undifferentiated small round cell tumor of the liver in a 60 year old black male is described. Although the light microscopic findings in this tumor were strongly suggestive of embryonal rhabdomyosarcoma, the ultrastructural study disclosed no myofibrils or other specific characteristics. Thus, we classify this tumor as an embryonic tumor or primitive mesenchymal tumor of the liver.


[The study of skeletal mechanics of anterior crossbite evaluated with SN length].
To study the stability of SN (anterior cranial base) length and the ability to evaluate upper lower jaws, and study the inner skeletal structure mechanism. Interrelated angles, SN length, maxillary and mandible length were measured, the ratios between SN and maxillary and mandible length were compared with normal standard data, the data between mixed and permanent dentition groups were compared. No significant difference was found on SN length between anterior crossbite patients and normal sample. Significant difference was found between crossbite and normal data on the ratio of SN and maxillary length and mandible length. Based on evaluation of SN length, the crossbite can be divided into three types of skeletal structures including normal maxilla and longer mandible, short maxilla and normal mandible, short maxilla and longer mandible, the longer mandible is a main factor. With the advantage of stability, SN can be used to evaluate maxilla and mandible, and decide the skeletal mechanics of crossbite individually and accurately.


Mobile app helps trainees manage emergencies at the bedside.
Although emergency departments (ED) have standardized guidelines for low-frequency, high-acuity diagnoses, they are not immediately accessible at the bedside, and this can cause anxiety in trainees and delay patient care. This problem is exacerbated during events like COVID-19 that require the rapid creation, iteration, and dissemination of new guidelines. Physician innovators used design thinking principles to develop EM Protocols (EMP), a mobile application that clinicians can use to immediately view guidelines, contact consultants (e.g., cath lab activation), and access code-running tools. The project became an institutional high priority, because it helps EM trainees and off-service rotators manage low-frequency, high-acuity emergencies at the point of care, and its COVID-19 guidelines can be rapidly updated and disseminated in real time. This intervention was deployed across two academic medical centers during the COVID-19 surge. Nearly 300 ED clinicians have downloaded EMP, and they have interacted with the app over 5,400 times. It continues to be used regularly, over 12 months after the initial surge. Since the app was received positively, there are efforts to build in additional adult and pediatric guidelines. Digital health tools like EMP can serve as invaluable adjuncts for managing acute, life-threatening emergencies at the point of care. They can benefit trainees during normal day-to-day operations as well as scenarios that cause large-scale operational disruptions, such as natural disasters, mass casualty events, and future pandemics.


Laparoscopic complete mesocolic excision with true central vascular ligation for right-sided colon cancer.
Complete mesocolic excision (CME) is known to be effective for colon cancer. However, in right-sided colon cancer, central vascular ligation (CVL) is not easy to perform. In particular, in patients in whom the superior mesenteric vein (SMV) runs on the ventral side of the superior mesenteric artery (SMA) (Type V/A), laparoscopic ligation of the artery at its root is extremely difficult compared with this procedure in patients in whom the SMA runs on the ventral side of the SMV (Type A/V). We started performing laparoscopic CME with true CVL for right-sided colon cancer using the SMA as a landmark in 2015, and by 2019, we had completed it for 60 patients. To start, the mesocolon is opened well to the caudal side of the ileocolic vessels. The mesentery is then fully detached from the retroperitoneal tissue, after which the ileocolic vessels are ligated at their roots. D3 lymph node dissection of the lymph nodes around the SMA and SMV on the resection side is also performed using the SMA as a landmark, and depending on the location of the tumor, the roots of the right and middle colic vessels are ligated and divided. This study was conducted with the approval of the Tokyo Medical University Ethics Committee. All patients provided informed consent. The tumor was located in the cecum in 21 cases, the ascending colon in 33, and the transverse colon in 6. The mean operating time was 229 min and the mean volume of hemorrhage was 67 ml. There was one Clavien-Dindo Grade 3 or worse postoperative complication (ileus). There were no surgery-related or in-hospital deaths. This procedure can be performed comparatively safely. However, since it requires some skill, we consider that it should only be performed in suitable cases by teams with sufficient experience.


The electrophysiological effects of opioid receptor-selective antagonists on sheep Purkinje fibres.
The cardiac electrophysiological effects of 16-methylcyprenorphine (M8008), nor-binaltorphimine (NBT) and naltrexone, which are relatively specific opioid antagonists for delta, kappa and mu receptors, respectively, were studied in paced (1.5 Hz) sheep Purkinje fibres in vitro. M8008 (1 ng ml-1-10 micrograms ml-1) caused a concentration-dependent reduction in the maximum rate of depolarisation of phase 0 (MRD) and in the action potential duration measured at 50% repolarisation, APD50. Neither NBT (10 ng ml-1-10 micrograms ml-1) nor naltrexone (1 ng ml-1-10 micrograms ml-1) produced any significant effect on the cardiac action potential. In the presence of a physiological salt solution modified to mimic some of the changes that occur during myocardial ischaemia (i.e. hypoxia, acidosis, hyperkalaemia), M8008 caused a more marked reduction in MRD and prolonged rather than shortened APD50. These results suggest that the reported antiarrhythmic activity of M8008, but not NBT or naltrexone, may be, at least in part, explained by a direct cardiac electrophysiological action.


[Inpatient rehabilitation of chronic schizophrenic patients with a behavior therapy token reinforcement program].
The efficacy of a token economy system was assessed in a study involving 76 chronic schizophrenics who were inpatients during a treatment period of four years. The interrelations between therapeutic success on the one hand, and socio-economic as well as course of disease-related factors on the other were studied, including psychopathology and the efficacy of token economy.


In vivo imaging of invasive aspergillosis with 18F-fluorodeoxysorbitol positron emission tomography.
Invasive aspergillosis is a critical complication in immunocompromised patients with hematologic malignancies or with viral pneumonia caused by influenza virus or SARS‑CoV‑2. Although early and accurate diagnosis of invasive aspergillosis can maximize clinical outcomes, current diagnostic methods are time-consuming and poorly sensitive. Here, we assess the ability of 2-deoxy-2-18F-fluorosorbitol (18F-FDS) positron emission tomography (PET) to specifically and noninvasively detect Aspergillus infections. We show that 18F-FDS PET can be used to visualize Aspergillus fumigatus infection of the lungs, brain, and muscles in mouse models. In particular, 18F-FDS can distinguish pulmonary aspergillosis from Staphylococcus aureus infection, both of which induce pulmonary infiltrates in immunocompromised patients. Thus, our results indicate that the combination of 18F-FDS PET and appropriate clinical information may be useful in the differential diagnosis and localization of invasive aspergillosis.


Effects of Calliandra and Sesbania supplementation on weight gain in dairy calves on smallholder farms in Kenya.
The growth rate of female calves on dairy farms is one of the crucial factors which influence age at first calving, affecting lifetime lactation productivity of a dairy cow. Diets with adequate crude protein are necessary to support calf growth. The study objective was to determine the effects of nutritional advice and diet supplementation with Calliandra calothyrsus and Sesbania sesban on average daily weight gain in dairy calves on semi-commercial smallholder dairy farms in Kenya. This trial involved 155 calves from 73 smallholder dairy farms, in Kenya, randomly selected and allocated to either intervention or control groups. The intervention group received nutritional advice and seedlings of Calliandra calothyrsus and Sesbania sesban, while the control group did not receive these interventions. Every 1-2 months for 16 months, data on farm nutritional practices and management were collected in a questionnaire, and physical examinations were done to monitor weight and health status. Descriptive and univariable statistical analyses were conducted, and multivariable mixed linear regression models were used for identification of factors associated (P < 0.05) with the natural log transformation of weight gain of calves on a given farm, controlling for clustering of visits within calves. Feeding at least 0.2 kg/day (wet weight) of Calliandra or Sesbania to calves <6 months old resulted in 33.2% increase in daily weight gain, while controlling for confounding by breed and sex of the calf. For calves ≥6 months, there was a significant interaction between amount of hay fed and if calves were also fed on Calliandra or Sesbania. When no Calliandra or Sesbania supplementation was provided, the mean weight gain was low and relatively constant even with increasing amounts of hay. When Calliandra or Sesbania supplement was added to the diet, the mean weight gain increased from 0.17 kg to 0.48 kg when hay was fed at 1 and 5 kg, respectively, while controlling for confounding by amount of maize silage fed and the prevailing season. In conclusion, supplementation of calf diets with at least 0.2 kg/calf/day of Calliandra or Sesbania is beneficial for faster weight gains.


Biased signaling as allosteric probe dependence.
Signaling 'bias' is a phenomenon whereby the natural allosteric probe dependence of seven transmembrane receptors allows different receptor conformations (stabilized by different agonists) to activate some signaling pathways (coupled to pleiotropically coupled receptors) more than others at the expense of those other pathways. There are a number of relevant scenarios where such an activity could be therapeutically beneficial therefore there are practical reasons why this property of receptors should be exploited. This paper discusses recent ideas around attempts to harness this potentially useful idea and also the limitations around the current methods available to do so. Specifically, the determination of a quantitative value for the receptor bias of a given agonist that may translate to useful in vivo has been particularly elusive and studies need to be directed to solving this problem.


Opportunistic infections associated with Janus kinase inhibitor treatment for rheumatoid arthritis: A structured literature review.
The availability of Janus kinase (JAK) inhibitors has transformed the management of rheumatoid arthritis (RA), helping patients achieve clinical remission. However, the emergence of opportunistic infections (OIs) associated with the use of JAK inhibitors has been reported. This structured literature review was conducted to summarize reports of OIs associated with JAK inhibitor treatment for RA in clinical trials. Structured searches were performed in MEDLINE® and Embase® to identify relevant clinical trial data through March 2021. Bibliographic searches of recent reviews were also conducted, and gray literature searches were used to supplement key gap areas. Publications were screened, extracted, and quality assessed. Data were narratively synthesized. Following screening, 105 publications describing 62 unique clinical trials reporting the rates of OIs in RA patients treated with JAK inhibitors were included. Overall, the highest exposure-adjusted incidence rate was reported for herpes zoster (HZ) infection (any form), followed by OI (any) and tuberculosis based on limited data from clinical trials with approved doses of JAK inhibitors. Lack of head-to-head trials and differences in trial design preclude direct comparison across JAK inhibitors. Higher rates of OIs were noted in the Asian and Australian populations compared with the global population. Higher rates of OIs were also noted with increasing dose of JAK inhibitors in most clinical trial data. HZ was the most common OI reported among RA patients using all currently approved JAK inhibitors in clinical trials, although tuberculosis and other OIs were also reported. More long-term safety studies in the real-world setting are needed to compare the risk of OIs between various JAK inhibitors.


Problematic anger and economic difficulties: Findings from the Millennium Cohort Study.
The role of problematic anger in relation to economic difficulties is not well understood. This study examined the association of problematic anger with 4 elements of economic difficulties among service members and veterans. Study participants (n = 95,895) were from the Millennium Cohort Study, and included U.S. service members and veterans; analyses were restricted to a Reserve/National Guard and/or veteran sample as appropriate. Key measures included the Dimensions of Anger Reactions scale and self-reported economic variables (involuntary job loss, financial problems, unemployment and homelessness). Covariates included demographics, military characteristics, disabling injury or illness, problem drinking, posttraumatic stress disorder, and major depressive disorder. The study design was cross-sectional. Among all participants, 17.4% screened positive for problematic anger, 29.7% reported involuntary job loss, and 6.4% reported financial problems. After adjustment for covariates, problematic anger was associated with involuntary job loss (AOR=1.28; 95% CI: 1.22, 1.33) and financial problems (AOR=1.46; 95% CI: 1.36, 1.57). Among veterans, 12.1% reported being unemployed; among Reserve/National Guard and veterans, 2.3% reported homelessness. Problematic anger was associated with unemployment (AOR=1.28, 95% CI: 1.18, 1.37) and homelessness (AOR=1.33; 95% CI: 1.16, 1.52) after adjusting for covariates. The study relied on self-report data and directionality could not be established. Problematic anger was significantly associated with involuntary job loss, financial problems, unemployment and homelessness, even after adjusting for relevant covariates. These findings have clinical relevance in demonstrating the potential for targeting problematic anger in service members and veterans.


Retracted: Software Systems Security Vulnerabilities Management by Exploring the Capabilities of Language Models Using NLP.
[This retracts the article DOI: 10.1155/2021/8522839.].


The role of oral hygiene in dental caries prevention in children and adolescents.
The role of oral hygiene in prevention of caries and periodontal diseases has been presented based on the literature and own clinical experience.


Spontaneous spiral formation in two-dimensional oscillatory media.
Computational studies of pattern formation in a modified Oregonator model of the Belousov-Zhabotinsky reaction is described. Initially inactive two-dimensional reaction media with an immobilized catalyst is connected to a reservoir of fresh reactants through a set of discrete points distributed randomly over the interphase surface. It is shown that the diffusion of reactants combined with oscillatory reaction kinetics can give rise to spontaneous spiral formation and phase waves.


Photocatalytic Property of TiO2-Vermiculite Composite Nanofibers via Electrospinning.
Titanium dioxide (TiO2) is one of the most common photocatalysts. In this study, TiO2-vermiculite composite nanofibers with a mesh structure and a diameter of approximately 300 nm were prepared via sol-gel approach combined with electrospinning technique. The samples were characterized by X-ray diffraction, scanning electron microscopy, ultraviolet-visible spectroscopy, etc. The photocatalytic property was also evaluated. The TiO2-vermiculite composite nanofibers annealed at 550 °C for 3 h exhibited the best absorption and photo-degradation ability for the treatment of methylene blue. The results implied that the combination of mineral vermiculite powders with TiO2 enhanced the absorption-degradation performance of the as-prepared photocatalytic materials, consequently promoting the materials' ability to degrade methylene blue.


Effects of mercury and chromium upon longevity of Diplostomum sp. (Trematoda: Diplostomidae) cercariae.
Laboratory experiments were carried out to examine the impact of mercury and chromium upon survival of Diplostomum sp. cercariae. Freshly emerged cercariae were exposed to solutions of either mercury, at concentrations ranging between 0.1 and 100 microg/l, or chromium at concentrations from 2 microg/l to 2 mg/l. The mortality patterns and mean survival times (MSTs) of the exposed parasites were determined by the Kaplan-Meier estimator and were compared (log-rank test) with corresponding patterns and estimators of the unexposed controls. Mercury concentrations > or = 10 microg/l caused statistically significant changes in the mortality pattern of Diplostomum sp. cercariae and reduced MST by at least 9 h compared with the control group, in which MST was 42 h. Cercariae exposed to chromium solutions had statistically significant changes in mortality pattern only at a concentration of 2 mg/l and exhibited a reduction in MST of 8 h compared with the control (MST = 41 h). The results show for the first time that longevity of Diplostomum sp. cercariae can be reduced by direct exposure to heavy metals. Ecotoxicological effects of mercury are manifested at lower concentrations than those of chromium, and thus potentially have a higher impact on parasite populations and communities.


Allergen immunotherapy in the current COVID-19 pandemic: A position paper of AeDA, ARIA, EAACI, DGAKI and GPA: Position paper of the German ARIA GroupA in cooperation with the Austrian ARIA GroupB, the Swiss ARIA GroupC, German Society for Applied Allergology (AEDA)D, German Society for Allergology and Clinical Immunology (DGAKI)E, Society for Pediatric Allergology (GPA)F in cooperation with AG Clinical Immunology, Allergology and Environmental Medicine of the DGHNO-KHCG and the European Academy of Allergy and Clinical Immunology (EAACI)H.
No abstract available.


Solitary fibrous tumor of the urinary bladder: An unusual case report with literature review.
Solitary fibrous tumor is neoplasm of mesenchymal origin commonly involving visceral pleura however we are presenting an unusual case with involvement of urinary bladder. It is generally indolent in nature therefore proper diagnosis is required for complete characterization to avoid unnecessary extensive surgical resection. Our patient was a 64-year-old female who presented with lower abdominal fullness with change in her bowel movement pattern. On imaging partially necrotic mass with heterogenous enhancement was found which was later biopsied and resected with clean surgical margin. Solitary fibrous tumor is overall a benign tumor with satisfactory outcome. Physicians should keep it in a differential of pelvic masses and with the risk recurrence, 6 monthly follow up imaging are usually required after resection.


Facilitation of drug entry into brain by osmotic opening of the blood-brain barrier.
1. After osmotic opening, the blood-brain barrier (BBB) has been shown to reclose more rapidly to large than to small neutral, water-soluble molecules. Quantitative analysis of these data supports the creation of interendothelial pores with radii of about 200 A through which such molecules pass by both restricted diffusion and bulk flow (with solute drag) from blood to brain. 2. The major reduction in BBB permeability from 6 to 35 min following osmotic opening seems to be due to a reduction in bulk flow by a factor of about 10, rather than marked decreases in pore densities or effective pore size. On this basis, quantitative predictions of brain uptake of neutral, water soluble substances are made for various times after osmotic opening of the BBB, as a function of molecular size. 3. Implications of these results are discussed for enhancement of uptake of drugs, including enzymes and certain anti-cancer agents, by the brain. 4. The idea of a 'therapeutic window' as the period of time, following reversible osmotic opening, during which the permeability of the BBB is enhanced significantly for a particular compound, is introduced. Since the BBB is normally highly impermeable to plasma proteins, the effect of BBB opening on the uptake of highly protein-bound drugs is discussed briefly. 5. The effect of molecular charge on the passage of molecules through interendothelial pores into the brain is also discussed.


Mixed actions of hemicholinium at autonomic receptor sites of the rat vas deferens.
1. The effects of hemicholinium (HC-3) on several autonomic agents in the isolated rat vas deferens were investigated. 2. HC-3 reduced slightly the effects of NE and DA. 3. The responses by cholinergic agents on the M1-ACh receptors were not modified, however HC-3 reduced, significantly, the responses on the M2-ACh receptors. 4. These results suggest that HC-3 besides its anticholinergic properties possesses ability to interact with adrenoceptors in the isolated rat vas deferens.


A case-control study of tackle based head impact event (HIE) risk factors from the first three seasons of the National Rugby League Women's competition.
The tackle is the most injurious event in rugby league and carries the greatest risk of concussion. This study aims to replicate previous research conducted in professional men's rugby league by examining the association between selected tackle characteristics and head impact events (HIEs) in women's professional rugby league. We reviewed and coded 83 tackles resulting in an HIE and every tackle (6,318 tackles) that did not result in an HIE for three seasons (2018-2020) of the National Rugby League Women's (NRLW) competition. Tackle height, body position of the tackler and ball carrier, as well as the location of head contact with the other player's body were evaluated. Propensity of each situation that caused an HIE was calculated as HIEs per 1,000 tackles. The propensity for tacklers to sustain an HIE was 6.60 per 1,000 tackles (95% CI: 4.87-8.92), similar to that of the ball carrier (6.13 per 1,000 tackles, 95% CI: 4.48-8.38). The greatest risk of an HIE to either the tackler or ball carrier occurred when head proximity was above the sternum (21.66 per 1,000 tackles, 95% CI: 16.55-28.35). HIEs were most common following impacts between two heads (287.23 HIEs per 1,000 tackles, 95% CI: 196.98-418.84). The lowest propensity for both tackler (2.65 per 1,000 tackles, 95% CI: 0.85-8.20) and ball carrier HIEs (1.77 per 1,000 tackles, 95% CI: 0.44-7.06) occurred when the head was in proximity to the opponent's shoulder and arm. No body position (upright, bent or unbalanced/off feet) was associated with an increased propensity of HIE to either tackler or ball carrier. In the NRLW competition, tacklers and ball carriers have a similar risk of sustaining an HIE during a tackle, differing from men's NRL players, where tacklers have a higher risk of HIEs. Further studies involving larger samples need to validate these findings. However, our results indicate that injury prevention initiatives in women's rugby league should focus on how the ball carrier engages in contact during the tackle as well as how the tackler executes the tackle.


Milk fat globule epidermal growth factor-8 limits tissue damage through inflammasome modulation during renal injury.
Mediators released by apoptotic renal resident cells play a crucial role in modification of the inflammatory microenvironment. We have demonstrated that milk fat globule epidermal growth factor 8 (MFG-E8) is released by apoptotic cells, which results in reduced proinflammatory cytokine production by macrophages. The present study was designed to study the role of MFG-E8 on the modulation of tissue damage and macrophage phenotype in a renal inflammatory model, unilateral ureteral obstruction (UUO). C57BL/6 WT or MFG-E8 KO mice underwent ureteral ligation for 3, 7, and 14 d to evaluate renal injury. MFG-E8 (30 µg/kg) or vehicle was also administered i.p. MFG-E8 administration reduced kidney damage and fibrosis compared with control, whereas its absence in MFG-E8 KO mice was associated with more severe disease. Moreover, MFG-E8 administration was associated with decreased inflammasome activation in the kidney. Furthermore, adoptive transfer of MFG-E8-stimulated macrophages reduced activation of inflammasome and tissue damage. In all cases, both the systemic administration of MFG-E8 and MFG-E8-treated macrophages promoted accumulation of anti-inflammatory CD206+ macrophages. We propose that the protective role of MFG-E8 is mediated through anti-inflammatory macrophage reprogramming which results in decreased inflammasome activation, preventing severe tissue damage. These data provide valuable insight for identification of MFG-E8 as a novel target in modulation of inflammatory diseases.


EspA is a novel fusion partner for expression of foreign proteins in Escherichia coli.
Escherichia coli secreted protein A (EspA) is a component of the type 3 secretion system (T3SS). The high level of expression when self-stimulated suggests that EspA may be used as a fusion partner. In the present study, EspA was used as a "fusion partner" to construct a fusion expression system, pEspA, in order to improve the expression and solubility of proteins from prokaryotes and eukaryotes. Target proteins were linked to the C-terminus of EspA by a linker containing a YAPQDP sequence, multiple cloning sites and an enterkinase cleavage site. Six proteins, IL-24, Stx2A1, Stx2B, S1, IntiminC300 and GFP, were expressed as EspA-fusion proteins using this vector. The expression level of each protein was enhanced by EspA and the majority of them (Stx2B, IntiminC300, GFP, Stx2A1, IL-24) were expressed in soluble form. EspA-fusion proteins can be purified by affinity chromatography (Sepharose chelated with EspA-specific monoclonal antibody) and by Ni(2+) affinity chromatography for they contain a 6× His tag at their C-terminus. In addition, IL-24 remains soluble and demonstrates certain anti-tumor activity after the removal of EspA by enterkinase. The EspA fusion expression system was efficient in enhancing expression levels and the solubility of target proteins.


Predictors of a change in patient willingness to have Total knee arthroplasty: Insights from the osteoarthritis initiative.
While many factors have been shown to influence patient willingness to have total joint arthroplasty, factors associated with changes in patient willingness to have arthroplasty have not been studied. The objective of this research is to identify predictors of change in patient willingness to have total knee arthroplasty (TKA). Patient willingness to have TKA as well as questionnaire, clinical, and radiographic data, were obtained from the Osteoarthritis Initiative (OAI) for individuals with, or at high risk for developing knee OA. Mixed effects ordinal logistic regressions were employed to assess the relationships between 40 predictors and change in willingness to have surgery. Predictors significant in univariate models were included in a multivariable analysis. Three thousand three hundred and ninety-four OAI patients were included in our analysis. Between baseline and follow-up, 462 (13.6%) became more willing and 533 (15.7%) became less willing to have TKA. After controlling for demographic factors in multivariable analysis, patients with higher income and expected difficulty with postoperative walking were more likely to increase their willingness to have TKA. General health, race, and knee injections within the past six months approached significance with regard to increasing willingness to have TKA over time. Income and expectations of difficulty walking postoperatively were significantly associated with changes in patient willingness to have TKA independent of age, sex, health coverage, employment, marriage status, and knee pain. Understanding factors influencing patient willingness to have surgery may be instrumental in counseling and addressing the mismatch of OA disease burden to surgical utilization.


Ultrastructural identification and clinical significance of light microscopic giant mitochondria in alcoholic liver injuries.
The identification and clinical significance of light microscopic giant mitochondria (GM) were investigated in liver biopsy specimens of 60 alcoholics. By light microscopic examinations using the same section and neighboring sections, we suggest that light microscopic GM correspond to the crystalloid bodies (CB) detected on ultrastructural observation. The reasons are as follows: (1) difference in stainability between eosinophilic light microscopic GM and acidbasophilic mitochondria; (2) similarity in morphological features and density of the round- and cigar-shaped types at the light microscopic level to those of CB at the electron microscopic level; (3) similarity of the area occupied in the hepatic cytoplasm at both light and electron microscopic levels; (4) the crystalline structure of CB in compatible with the subtype of Mallory body (MB); (5) a description of CB has been made at the electron microscopic level, although not yet at the light microscopic level. Moreover, we clinically observed that light microscopic GM seldom appeared either in early fatty liver of cases aged 35 or less or the late macronodular liver cirrhosis stage of alcoholic liver injuries while they were frequently recognized during the acute aggravation phase of the chronic stage (GPT: p less than 0.05). Furthermore, if one was to assume that MB is a change accompanying necrosis of the liver cells, the light microscopic GM might be a change accompanying degeneration of the cytoplasmic organelles.


Leg stiffness during running in highly cushioned shoes with a carbon-fiber plate and traditional shoes.
Nike ZoomX Vaporfly (NVF) improves running economy and performance. The biomechanical mechanisms of these shoes are not fully understood, although thicker midsoles and carbon fiber plates are considered to play an important role in the spring-like leg characteristics during running. Leg stiffness (kleg) in the spring-mass model has been commonly used to investigate spring-like running mechanics during running. Does kleg during running differ between NVF and traditional (TRAD) shoes? Eighteen male habitual forefoot and/or midfoot strike runners ran on a treadmill at 20 km/h with NVF and TRAD shoes, respectively. kleg, vertical oscillation of the center of mass (∆CoM), spatiotemporal parameters, and mechanical loading were determined. kleg was 4.8% lower in the NVF shoe condition than in the TRAD condition, although no significant difference was observed. ∆CoM was not significantly different between shoe conditions. Spatiotemporal parameters and mechanical loading were also not significantly different between shoe conditions. The NVF shoe is well known as improving the running economy and running performance for the cause by characteristics of better spring function. Contrary to expectation, kleg and other parameters were not significantly different during running in the NVF compared to TRAD shoe at 20 km/h. These findings indicate that well-trained runners' spring-like running mechanics would not alter even if wearing the NVF shoes.


Privately protected areas increase global protected area coverage and connectivity.
Privately protected areas (PPAs) are increasing in number and extent. Yet, we know little about their contribution to conservation and how this compares to other forms of protected area (PA). We address this gap by assessing the contribution of 17,561 PPAs to the coverage, complementarity and connectivity of existing PA networks in 15 countries across 5 continents. We find that PPAs (1) are three times more likely to be in biomes with <10% of their area protected than are other PA governance types and twice as likely to be in areas with the greatest human disturbance; (2) that they protect a further 1.2% of key biodiversity areas; (3) that they account for 3.4% of land under protection; and (4) that they increase PA network connectivity by 7.05%. Our results demonstrate the unique and significant contributions that PPAs can make to the conservation estate and that PPAs deserve more attention, recognition and resources for better design and implementation.


LSCF-WO3 semiconductor composite electrolytes for low-temperature solid oxide fuel cells.
The La0.6Sr0.4Co0.2Fe0.8O3-δ (LSCF)-WO3 semiconductor composite was applied as an electrolyte for low-temperature solid oxide fuel cells (LTSOFCs). The study results revealed that the fuel cell could output a maximum power density (P max) of 812 mW cm-2 when the weight ratio of LSCF to WO3 was 8 : 2 (8LSCF-2WO3), and its open-circuit voltage (OCV) was higher than 1.0 V. This indicated that there was no short circuit problem in this fuel cell device and 80 wt% LSCF existed in the electrolyte layer. This was mainly due to the suppressed electronic conductivity and increased ionic conductivity of the composite as compared with LSCF due to the introduction of the WO3 wide band semiconductor. The oxygen ionic conductivity of the 8LSCF-2WO3 electrolyte was 0.337 S cm-1, which is much higher than that of the pure LSCF material. According to the XPS analysis results, a higher oxygen vacancy content at the heterointerface between LSCF and WO3 contributed to the increased ionic conductivity.


Extracellular unit responses in the pulvinar-lateral posterior complex of the cat through electrical stimulation of substantia nigra reticulata and lateralis.
Extracellular single-unit responses of neurons in the ipsilateral pulvinar-lateral posterior complex were recorded in 10 encéphale isolé cats with stimulating electrodes implanted in the substantia nigra pars reticulata and pars lateralis. Fifteen percent of 101 pulvinar-lateral posterior complex thalamic neurons increased their spike discharges when the substantia nigra was stimulated and none decreased its activity. The excitatory effect of this stimulation is discussed in relation to the eventual excitatory or inhibitory character of the efferent projection from the substantia nigra pars reticulata and lateralis to the pulvinar-lateral posterior complex.


Hyaluronic acid and its derivatives in drug delivery and imaging: Recent advances and challenges.
Hyaluronic acid (HA) is a biodegradable, biocompatible, nontoxic, and non-immunogenic glycosaminoglycan used for various biomedical applications. The interaction of HA with the CD44 receptor, whose expression is elevated on the surface of many types of tumor cells, makes this polymer a promising candidate for intracellular delivery of imaging and anticancer agents exploiting a receptor-mediated active targeting strategy. Therefore, HA and its derivatives have been most investigated for the development of several carrier systems intended for cancer diagnosis and therapy. Nonetheless, different and important delivery applications of the polysaccharide have also been described, including gene and peptide/protein drugs delivery. The aim of this review was to provide an overview of the existing recent literature on the use of HA and its derivatives for drug delivery and imaging. Notable attention is given to nanotheranostic systems obtained after conjugation of HA to nanocarriers as quantum dots, carbon nanotubes and graphene. Meanwhile, attention is also paid to some challenging aspects that need to be addressed in order to allow translation of preclinical models based on HA and its derivatives for drug delivery and imaging purposes to clinical testing and further their development.


Agents affecting health of mother and child in a rural area of Kenya. XI. Antibodies against rotavirus in sera from children living in the Machakos District of Kenya.
207 sera from children under 5 years of age and living in the Machakos District in Kenya were tested in the Complement Fixation Test for antibodies against rotavirus. Two different antigens were used. The superiority of 'O' antigen over Nebraska calf diarrhoea virus antigen was confirmed. After a fall to 29 percent in the 6-8 months age group, the percentage of children with antibodies quickly rises with age to 80 percent at the age of 24 months and to practically 100 percent at the age of 30 months. This age-immunity curve suggests that the majority of children contract infections with rotavirus between 6 and 23 months of age. This is conform the pattern usually found in temperate climate countries.


Environmental impact of electric motorcycles: Evidence from traffic noise assessment by a building-based data mining technique.
This study provided new evidence on the potential adoption of electric motorcycle (EM) as a cleaner alternative to gasoline-powered motorcycle. The effects of EM on human exposure to traffic noise were assessed in different urban areas with different traffic scenarios. The assessment was carried out by a developed building-based model system that took into account the contribution of motorcycle traffic. The results indicated that the EM could be an appealing solution to reduce the risk of human exposure to excessive high traffic noise in a motorcycle city. Particularly, in a historical urban area in which the total traffic volume was lower and motorcycle traffic was dominant, the proportion of noise levels meeting the standard of 70 dB(A) increased significantly from 12.2% to 41.9% when 100% of gasoline motorcycles in the real traffic scenario were replaced by EMs. On the other hand, in a modern urban area in which the total traffic volume was higher and traffic noise levels at majority of sites were higher than 75 dB(A), the proportion of noise levels above 75 dB(A) decreased significantly from 82.6% to 59.9%. Nevertheless, the effect of EM on improving the traffic noise compliance rate in the modern urban area was not significant and other policies or measures need to be sought.


Kleine-Levin syndrome: report of a case with marked dysautonomic features.
Kleine-Levin syndrome is a rare neurologic disorder of unknown etiopathogenesis, characterized by abrupt onset and remission of attacks of hypersomnia and cognitive dysfunctions. Psychiatric symptoms are frequently present, ranging from disinhibited sexual behavior and eating disorders to hallucinations, anxiety, mood alterations, and derealization. A vast range of attack-related dysautonomic signs and symptoms are reported but remain poorly described. We describe a patient with Kleine-Levin syndrome with sleep attacks dominated by marked dysautonomic features. We briefly review similar clinical cases and suggest that the hypothalamus may play a central role in the genesis of autonomic dysfunction in Kleine-Levin syndrome. Fiamingo G, Esposto R, Dal Fabbro B, Terzaghi M. Kleine-Levin syndrome: report of a case with marked dysautonomic features. J Clin Sleep Med. 2022;18(9):2313-2316.


Extraskeletal Ewing's sarcoma of the head and neck region in pediatric patients: A case report and literature review.
Extraskeletal Ewing's sarcoma (EES) is a collection of malignant cells that appear small and round and occur mostly in pediatrics and adolescence. Head and neck EES tumors are considered rare and require multidisciplinary care to achieve ideal results in management. A 14-year-old boy who complained of a mass protruding from the back of his neck which gradually increased in size in the last few months prior to the diagnosis. He was referred to a pediatric otolaryngology clinic with a one-year history of chronic painless nape swelling. Ultrasound prior to the referral was done and the findings revealed a well-defined rounded hypoechoic lesion with internal vascularity. MRI was done and the impression was a large subcutaneous, well defined enhancing soft tissue lesion which raised the suspicion of sarcoma. The multidisciplinary team decision was to go for complete resection with a free margin followed by chemoradiation postoperatively. No evidence of recurrence was detected throughout the follow-up. The literature review included ages of the pediatric group from 4 months up to 18-year-old. Clinical features are highly dependable on the size and site of the lesion. Complete resection of the tumor plays an important role in the local control and prognosis. We present a rare case of extraskeletal Ewing's sarcoma of the nape. Computed tomography and magnetic resonance imaging are frequently used as imaging modalities in evaluating and diagnosing EES. Management commonly includes surgery with adjuvant chemotherapy to decrease recurrence and prolong the survival rate.


Assessing therapist adherence to recovery-focused cognitive behavioural therapy for psychosis delivered by telephone with support from a self-help guide: psychometric evaluations of a new fidelity scale.
Recent research has highlighted the importance of psychological interventions such as cognitive behavioural therapy (CBT) in improving outcomes and promoting recovery for people with experience of psychosis, although a lack of trained therapists means that availability of face-to-face CBT is low. Alternative modes of delivering CBT are being explored, such as telephone and self-help methods, although research to date on whether they can be implemented effectively is limited. The aims of the present study were to describe and evaluate a new therapy fidelity scale (ROSTA; Recovery Oriented Self-help and Telephone therapy Adherence). This scale was developed to assess fidelity to cognitive behaviour therapy for psychosis (CBTp) focused on improving recovery, with optional subscales for delivery over the telephone and alongside a self-help guide. Experienced CBT therapists rated recorded therapy sessions using the ROSTA scale. The scores were used to assess internal consistency and inter-rater reliability, before being compared to scores from an independent expert rater using an alternative fidelity scale for cognitive therapy in psychosis (the CTS-Psy), to investigate concurrent validity. The ROSTA scale demonstrated excellent internal consistency, inter-rater reliability and validity when evaluated as a whole, although findings were mixed in terms of the individual subscales and items. The ROSTA scale is, on the whole, a reliable and valid tool, which may be useful in training and supervision, a utility that would be further emphasized if the therapeutic intervention it assesses is deemed to be efficacious based on future work.


Resistant starch improves cardiometabolic disease outcomes: A narrative review of randomized trials.
Healthy dietary patterns with adequate fiber improve cardiometabolic (CM) outcomes and attenuate disease progression. Resistant starch (RS) is a fermentable fiber that affects CM outcomes; however, studies are heterogeneous and inconsistent. Thus, the purpose of this narrative review is to assess the impact of RS intake by type and amount on CM outcomes while considering subject characteristics and trial duration. Randomized crossover or parallel studies (n = 31) were selected and compared according to acute (1 day; n = 12), medium (>1-30 days; n = 8), or long (>30 days; n = 11) duration. Most acute trials in healthy adults showed improvements in postprandial glycemic outcomes irrespective of RS type or amount. However, a more pronounced reduction occurred when test meals did not match for available carbohydrate. Daily RS intake had a minimal effect on CM outcomes in medium duration trials, but insulin resistant adults had better glycemic control at 4 weeks. Several longer duration trials (8-12 weeks) showed favorable CM outcomes with daily RS intake in adults with type 2 diabetes (T2D), but not in those at risk for T2D. Furthermore, some studies reported improved lipids, inflammatory biomarkers, and heart rate. Future studies should consider matching for available carbohydrates between the RS and control groups to understand the gut microbiome's role. Furthermore, energy and fiber should be considered. Overall, the acute intake of RS improves glycemic outcomes, and consuming RS at for least 4 and up to 8 to 12 weeks in adults with prediabetes and T2D, respectively, appears to improve CM outcomes.


Benign brain tumors: sellar/parasellar tumors.
Neoplasms of the sellar region include pituitary adenomas, craniopharyngiomas, Rathke's cleft cysts, and, less commonly, meningiomas, germinomas, and hamartomas. Each of these entities has unique diagnostic and treatment considerations. Pituitary adenomas are the most common sellar mass found in adults, whereas craniopharyngiomas account for the majority of pediatric sellar masses. The diagnosis of sellar lesions involves a multidisciplinary effort; detailed endocrinologic, ophthalmologic, and neurologic tests are critical. The management of pituitary tumors varies. For most tumors, transsphenoidal resection remains the mainstay of treatment. Less invasive modalities, such as endoscopic transsphenoidal surgery, specific chemotherapeutic drugs, and stereotactic radiosurgery, show promise as adjuvant treatment modalities.


Association between the anthropometric measurements and dietary habits on telomere shortening in healthy older adults: A-cross-sectional study.
This study aimed to evaluate the effect of anthropometric measurements and dietary habits on telomere length in healthy older residents in rural and urban areas. This was a cross-sectional study. The study population included 81 healthy older individuals aged ≥80 years. A quantitative food frequency questionnaire was used to determine dietary habits. Anthropometric measurements were taken by researchers. The telomere length of individuals was determined from leukocytes using quantitative polymerase chain reaction. Urban women had longer telomeres than rural women (P < 0.05). Rural men had significantly higher hip circumference, middle-upper arm circumference and fat-free mass than urban men (P < 0.05). It was shown that while fresh vegetable consumption was higher in rural areas, carbonated drink consumption was higher in urban areas (P < 0.05). In women, homemade bread and sugar consumption were higher in rural areas, and honey consumption was higher in urban (P < 0.05). Red meat, milk-based dessert and pastry consumption explain telomere shortening by 22.5%, 24.8% and 17.9%, respectively. In addition, the model based on anthropometric measurements also contributes to explaining telomere shortening by 42.9%. Red meat, milk-based dessert and pastry consumption, and waist circumference, hip circumference, waist-to-hip ratio and waist-to-height ratio are associated with telomere length. Longer telomeres are associated with a healthy, balanced, adequate diet and maintaining a healthy body weight/proportion, and they are crucial for achieving healthy aging. Geriatr Gerontol Int 2023; 23: 565-572.


Occurrence of sarcoptic mange in free-ranging vicuñas (Vicugna vicugna) of the Andean high plateau region of Argentina.
Free-ranging vicuñas (Vicugna vicugna) are handled in some areas of the Andean high plateau region following an ancestral practice known as chaku, which consists in their transient capture and shearing of their fiber for commercialization. In this study, 807 vicuñas captured during 12 chaku events that took place in 2019 in the province of Jujuy, Argentina, were examined for typical mange skin lesions. Twenty-eight of the examined vicuñas presented alopecia with erythema, exudation, hyperkeratosis, and/or bleeding scarred lesions, mostly in the chest, rear and front legs, and inguinal zone. Most of the cases (82%) appeared in Laguna Cucho at 4900 masl, where 23% of the animals presented these skin reactions. Microscopic evaluation of skin scrapings revealed the presence of a great number of 0.1- to 0.4-mm-long mites of different life cycle stages, morphologically compatible with the species Sarcoptes scabiei. This etiological agent was confirmed by PCR amplification and sequencing of a cox-1 species-specific segment. Histopathological examination of skin biopsies showed extensive infiltration of the dermis with lymphocytes, neutrophils and eosinophils, hyperplasia at different stages, epidermis degeneration, and hyperkeratosis. This is the first characterization of sarcoptic mange in free-ranging vicuñas by clinical examination, mite morphology, histopathological studies, and molecular confirmation in the region. Mange hampers the welfare of vicuñas and the economy of the local communities that organize chaku events since infested vicuñas cannot be sheared. Its long-term effects are unknown but it might affect the fitness and survival of this iconic South American camelid.


Toll-like receptor gene variants and bacterial vaginosis among HIV-1 infected and uninfected African women.
Bacterial vaginosis (BV) is a common vaginal syndrome associated with altered microflora that increases the risk of preterm delivery and acquisition of sexually transmitted diseases. The cause of BV is unknown although toll-like receptors (TLRs), that are central to innate immune responses, may be important. We evaluated associations between TLR SNPs and BV among HIV-1 infected and uninfected African women. Logistic regression was used to assess associations between SNPs (N=99) in TLRs 2-4, 7-9 and BV (as classified by Nugent's criteria). Among HIV-1 uninfected women, TLR7 rs5743737 and TLR7 rs1634323 were associated with a decreased risk of BV, whereas TLR7 rs179012 was associated with an increased risk. TLR2 SNP rs3804099 was associated with a decreased risk of BV among HIV-1 infected women. Our findings indicate that there may be differences in TLR association with BV among HIV-1 infected and HIV-1 uninfected women.


Apical dissection during radical retropubic prostatectomy without ligature.
During radical retropubic prostatectomy, hemostasis of the venous vascular plexus is of the utmost importance for avoiding excessive blood loss and ensuring optimal preservation of urethral length, complete extirpation of all apical prostatic notches and careful preservation of the parasympathetic nerves ('neurovascular bundles'). We have developed a careful bipolar coagulation of the venous plexus that results in a significant reduction of intra-operative blood loss, and the consequent need for transfusion, compared to the standard approach. Furthermore, this coagulation approach results in improved visibility, allowing maximum preservation of urethral length, complete extirpation of all apical prostatic notches and improved application of the nerve sparing technique compared to the standard approach. Follow-up after a mean of 14 months suggests that postoperative continence and potency is at least comparable to the standard approach. However, long-term follow-up and multicenter studies will show if this modification results in equally effective cancer control and equivalent functional results compared to the standard approach.


Changes in fibrinolysis in the intensive care patient.
Critically ill patients have been described as having blood coagulation abnormalities that predispose to bleeding and thrombosis. We have studied plasminogen activators, alpha 2-antiplasmin, X-oligomers fibrin fragments, fibronectin, antithrombin III, fibrinogen, platelets, kaolin-cephalin clotting time and prothrombin time on admission to the intensive care unit and sequentially after 24 and 48 hours in 39 adult patients: ARDS (n = 6), trauma (n = 12), sepsis (n = 8) and a miscellanea (n = 13). A decrease in plasminogen activators associated with an increase in X-oligomers, the earliest form of cross linked fibrin degradation products, indicate that fibrin deposition and the consumption of components of fibrinolysis is a widespread condition in the ICU patients. Low fibronectin levels were related to prognosis. These findings suggest that critically ill patients must be evaluated in respect to fibrinolysis and supported when necessary with prophylactic treatment.


Erectile dysfunction after radical prostatectomy: hemodynamic profiles and their correlation with the recovery of erectile function.
Despite the advent of nerve sparing radical prostatectomy some men experience erectile dysfunction. Many of these men have vasculogenic erectile impairment in the form of arterial insufficiency or venous leakage. Recent data imply that early postoperative injection therapy may decrease the rate of erectile dysfunction. We defined hemodynamic patterns in patients who underwent bilateral nerve sparing radical prostatectomy to assess the chronology of venous leakage development and explore the correlation of hemodynamic profiles with the return of functional erection 12 months postoperatively. Patients with excellent preoperative erectile function who underwent bilateral nerve sparing surgery and had no pharmacological support for erectile dysfunction in the initial 12 months after surgery received vascular evaluation at presentation. Vascular evaluation involved cavernosometry or penile ultrasonography. Patients were then interviewed again at least 12 months postoperatively to assess the ability to achieve sexual intercourse. Our study group comprised 96 men with a mean age plus or minus standard deviation of 54 +/- 12 years who met all inclusion criteria. All patients had pathologically proved organ confined disease. Mean time to the initial postoperative presentation was 6 +/- 5 months. Patients were divided into 4 groups according to the time of vascular studies postoperatively, namely less than 4 to 8, 9 to 12 and greater than 12 months. Normal vascular status, arterial insufficiency and venous leakage were diagnosed in 35%, 59% and 26% of the group, respectively. No difference in the incidence of arterial insufficiency was noted in the 4 time groups. Time postoperatively was significantly associated with the incidence of venous leakage (14% at less than 4 months and 35% at between 9 and 12). In regard to the correlation of the vascular diagnosis with the return to functional erection 47% of the normal, 31% of the arteriogenic and 9% of the venous leakage group achieved sexual intercourse 12 months postoperatively. These data imply that the longer the duration of erectile dysfunction after radical prostatectomy, the greater the risk of venous leakage. Furthermore, it appears that the prognosis for the return of functional erection is worst when venous leakage is present.