Symptomatic adrenal myelolipoma: therapeutic considerations.
Four cases of symptomatic myelolipoma of the adrenal gland are presented. Three were treated at laparotomy and one with a laparoscopic approach. On the basis of these four cases we discuss the aetiology, pathogenesis, clinical manifestations, diagnosis and treatment of this rare disease. We also report the follow-up of a patient with bilateral myelolipoma, who underwent monolateral excision. We conclude that myelolipoma, if correctly diagnosed, can be treated conservatively with careful follow-up, limiting surgery to symptomatic cases.


One-year prospective outcome analysis and complications following total replacement of the temporomandibular joint with the TMJ Concepts system.
Total replacement of the temporomandibular joint (TMJ) is increasingly accepted as the gold standard for reconstruction of irreparably damaged or ankylosed joints. The TMJ Concepts system (TMJ Concepts, Ventura, USA) has the longest follow-up of the 2 systems used in the UK. A total of 74 patients had placement of TMJ Concepts prostheses. The primary diagnoses were degenerative disease, multiple previous operations, injury, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and ankylosis. Of these, 12 were revisions of previous replacements (3 after multiple operations). Over the year there was a significant mean (SD) reduction in pain score (10 cm visual analogue scale) from 72 (2.5) to 8 (1.7) (p<0.0001), and mean (SD) improvements in mouth opening from 22.4 mm (9.4) to 33.7 mm (6.2) (p<0.0001), and dietary consistency (10 cm analogue liquid 0 to solid 100) from 38 (23) to 93 (16) (p<0.0001). No patient had worse symptoms postoperatively. Joints in 2 patients failed because of biofilm infections. Two patients required blood transfusion and one required ligation of the external carotid artery. Five had perioperative dislocation, which responded to elastic intermaxillary fixation for one week. A total of 31 patients had partial, and 2 had total weakness of the facial nerve. All resolved fully except weakness of the temporal branch in one patient, which required brow lift. Total TMJ replacement gives good early improvements in function and pain with few complications. Of the 74 patients, 71 were very pleased to have had the procedure. One was dissatisfied despite complete pain relief and improvement in mouth opening from 3 to 30 mm, and 2 were ambivalent (one had infection, revision, and permanent weakness of the temporal branch of the facial nerve).


Wearable device adherence among insufficiently-active young adults is independent of identity and motivation for physical activity.
Wearable devices are increasingly being integrated to improve prevention, chronic disease management and rehabilitation. Inferences about individual differences in device-measured physical activity depends on devices being worn long enough to obtain representative samples of behavior. Little is known about how psychological factors are associated with device wear time adherence. This study evaluated associations between identity, behavioral regulations, and device wear adherence during an ambulatory monitoring period. Young adults who reported insufficient physical activity (N = 271) were recruited for two studies before and after the SARS-COVID-19 pandemic declaration. Participants completed a baseline assessment and wore an Actigraph GT3X + accelerometer on their waist for seven consecutive days. Multiple linear regression indicated that wear time was positively associated with age, negatively associated with integrated regulation for physical activity, and greater after (versus before) the pandemic declaration. Overall, the model accounted for limited variance in device wear time. Exercise identity and exercise motivation were not associated with young adults' adherence to wearing the physical activity monitors. Researchers and clinicians can use wearable devices with young adults with minimal concern about systematic motivational biases impacting adherence to device wear.


Newborn screening for primary immunodeficiencies: beyond SCID and XLA.
Primary immunodeficiencies (PID) encompass more than 250 disease entities, including phagocytic disorders, complement deficiencies, T cell defects, and antibody deficiencies. While differing in clinical severity, early diagnosis and treatment is of considerable importance for all forms of PID to prevent organ damage and life-threatening infections. During the past few years, neonatal screening assays have been developed to detect diseases hallmarked by the absence of T or B lymphocytes, classically seen in severe combined immunodeficiencies (SCID) and X-linked agammaglobulinemia (XLA). As described in this review, a reduction or lack of T and B cells in newborns is also frequently found in several other forms of PID, requiring supplemental investigation and involving the development of additional technical platforms in order to help classify abnormal screening results.


Staging of Sinonasal and Ventral Skull Base Malignancies.
Tremendous pathologic diversity among sinonasal and ventral skull base malignancies complicates development of a uniform and prognostically relevant staging system. Because of the comparatively low incidence of these tumors, comprehensive evaluation and comparison of specific staging systems is difficult. The current American Joint Committee on Cancer TNM staging system for sinonasal malignancies is the most common and widely used system in current clinical practice. Alternative systems have been proposed for use with individual histopathologic subtypes. Many of these staging systems are of great utility and accurately predict patient survival. Further research and adjustment of these current staging systems remains an important area of research.


[Protective effects of astragali injection on tubular in patients with primary nephrotic syndrome].
To determine the effects of astragali injection on tubular and its possible mechanisms. Sixty patients with primary nephritic syndrome (PNS) were randomly divided into astragali group (n = 30) and control group (n = 30). The surm albumin (sALB) and urinary excretion of retinol-binding protein (RBP), N-Acety-P-beta-Glucosaminidase (NAG), beta2- Microglobulin (beta2MG) were measured before and after the treatment. After the one month treatment, sALB was significantly higher, and ubeta2MG, uNAG, uRBP, and 24 huP were significantly lower in astragali group (P <0.01, P < 0.05). Astragali injection on tubular plays a protective role in PNS.


Management of essential thrombocythemia during pregnancy with aspirin, interferon alpha-2a and no treatment. A comparative analysis of the literature.
It is advisable to treat essential thrombocythemia (ET) during pregnancy, because elevated platelet counts can lead to maternal and fetal complications. In order to establish which therapy is more favorable, we undertook a review of the literature. In addition to our own case, we found 27 reports which described 75 cases with 143 pregnancies. We discussed the complications of ET during pregnancy and postpartum, fetal outcome and the therapeutic strategies. Considering the clear risk of complications during pregnancy -- especially the occurrence of spontaneous abortion in the first trimester -- and the risk of intrauterine fetal death, we believe all patients should at least be treated with aspirin unless there is a contraindication. Platelet reduction with interferon-alpha (IFN-alpha) might be able to further reduce the complications of ET during pregnancy and to improve fetal outcome (data from 14 patients). After treatment with IFN-alpha, sufficient numbers of umbilical cord blood stem cells can be collected.


Chrysophyllum cainito leaves are effective against pre-clinical chronic pain models: Analysis of crude extract, fraction and isolated compounds in mice.
Chrysophyllum cainito L. (Sapotaceae), commonly known as caimito or star apple, is a neotropical tree valued for its ornamental quality and edible fruits. Besides its culinary use, the leaves are also popularly used to treat diabetes mellitus and several inflammatory diseases. This study aimed to complement previous data obtained about the anti-hypersensitivity effects of the crude methanol extract (CME), CHCl3 fraction and isolated compounds obtained from C. cainito. The CME, CHCl3 fraction and two isolated triterpenes identified as 3β-Lup-20(29)-en-3-yl acetate (1) and Lup-20(29)-en-3β-O-hexanoate (2) were evaluated regarding their effects using clinical pain models, such as post-operative, inflammatory and neuropathic pain. Acute inflammatory pain models induced by PGE2, epinephrine, LPS and CFA were also used to improve the knowledge about the mechanism of action. The animals treated with the CME and submitted to PGE2, epinephrine, LPS or CFA had the mechanical hypersensitivity significantly reduced. When repeatedly administered, the CME enhanced the mechanical withdrawal threshold of mice submitted to post-operative pain model, CFA-induced chronic inflammatory pain and two different models of neuropathic pain. In turn, the CHCl3 fraction presented anti-hypersensitivity effect against epinephrine- or LPS-induced hypersensitivity, with a more prominent activity in both the neuropathic pain models. The compound 1 seems to present the same profile of the CHCl3, whereas compound 2 exhibited activity similar to the CME. This data suggests that the CME effect involves interference in the production, release or action of some chemical mediators, such as PGE2, sympathetic amines, cytokines, etc. Part of these effects was observed with the CHCl3 fraction, emphasizing the prominent inhibition of neuropathic pain. The results also demonstrated that part of the CME effects are due to the presence of the triterpenes 1 and 2, but it is important to mention that we cannot discard the effects of countless other compounds presented in the crude extract, acting in a synergic way.


A novel method for determination of collagen orientation in cartilage by Fourier transform infrared imaging spectroscopy (FT-IRIS).
The orientation of collagen molecules is an important determinant of their functionality in connective tissues. The objective of the current study is to establish a method to determine the alignment of collagen molecules in histological sections of cartilage by polarized Fourier transform infrared imaging spectroscopy (FT-IRIS), a method based on molecular vibrations. Polarized FT-IRIS data obtained from highly oriented tendon collagen were utilized to calibrate the derived spectral parameters. The ratio of the integrated areas of the collagen amide I/II absorbances was used as an indicator of collagen orientation. These data were then applied to FT-IRIS analysis of the orientation of collagen molecules in equine articular cartilage, in equine repair cartilage after microfracture treatment, and in human osteoarthritic cartilage. Polarized light microscopy (PLM), the most frequently utilized technique to evaluate collagen fibril orientation in histological sections, was performed on picrosirius red-stained sections for comparison. Thicknesses of each zone of normal equine cartilage (calculated based on differences in collagen orientation) were equivalent as determined by PLM and FT-IRIS. Comparable outcomes were obtained from the PLM and FT-IRIS analyses of repair and osteoarthritis tissues, whereby similar zonal variations in collagen orientation were apparent for the two methods. However, the PLM images of human osteoarthritic cartilage showed less obvious zonal discrimination and orientation compared to the FT-IRIS images, possibly attributable to the FT-IRIS method detecting molecular orientation changes prior to their manifestation at the microscopic level.


Structural insights into the contactin 1 - neurofascin 155 adhesion complex.
Cell-surface expressed contactin 1 and neurofascin 155 control wiring of the nervous system and interact across cells to form and maintain paranodal myelin-axon junctions. The molecular mechanism of contactin 1 - neurofascin 155 adhesion complex formation is unresolved. Crystallographic structures of complexed and individual contactin 1 and neurofascin 155 binding regions presented here, provide a rich picture of how competing and complementary interfaces, post-translational glycosylation, splice differences and structural plasticity enable formation of diverse adhesion sites. Structural, biophysical, and cell-clustering analysis reveal how conserved Ig1-2 interfaces form competing heterophilic contactin 1 - neurofascin 155 and homophilic neurofascin 155 complexes whereas contactin 1 forms low-affinity clusters through interfaces on Ig3-6. The structures explain how the heterophilic Ig1-Ig4 horseshoe's in the contactin 1 - neurofascin 155 complex define the 7.4 nm paranodal spacing and how the remaining six domains enable bridging of distinct intercellular distances.


The evolution of environmental metalloproteomics over the last 15 years through bibliometric techniques.
Metalloproteomic studies in environmental scenarios are of significant value in elucidating metal uptake, trafficking, accumulation and metabolism linked to biomolecules in biological systems. The advent of this field occurred in the early 2000s, and it has since become an interesting and growing area of interdisciplinary research, although the number of publications in Environmental Metalloprotemics is still very low compared to other metallomic areas. In this context, the evolution of Environmental Metalloprotemics in the last decades was evaluated herein through the use of bibliometric techniques, identifying variables that may aid researchers in this area to form collaborative networks with established scientists in this regard, such as main authors, published articles, institutions, countries and established collaborations involved in academic research on this subject. Results indicate a growing trend of publications over time, reflecting the interest of the scientific community in Environmental Metalloprotemics, but also demonstrated that the research interactions in this field are still country- and organization-specific. Higher amounts of publications are observed from the late 2000's onwards, related to the increasing technological advances in the area, such as the development of techniques combining atomic spectroscopy and biochemical or proteomic techniques. The retrieved publications also indicate that the recent advances in genomic, proteomic and metallomic areas have allowed for extended applications of Environmental Metalloprotemics in non-model organisms. The results reported herein indicate that Environmental Metalloprotemics seems to now be reaching a more mature stage, in which analytical techniques are now well established and can be routinely applied in environmental scenarios, benefitting researchers and allowing for further insights into this fascinating field.


Total Artificial Heart Bridge to Transplantation for a Patient With Occult Intracardiac Malignancy: Case Report.
Malignancy is the leading cause of long-term morbidity and mortality after heart and other solid organ transplantation; therefore, great emphasis is placed on pre- and post-transplantation cancer screening. Even with meticulous screening during evaluation for heart transplant candidacy, an occult cancer may not be apparent. Here, we share the case of a 51-year-old man with refractory heart failure who underwent total artificial heart implantation as a bridge to transplantation with the surprise finding of an isolated deposit of metastatic carcinoid tumor nested within a left ventricular papillary muscle in his explanted heart. The primary ileal carcinoid tumor was identified and resected completely. After remaining cancer-free for 14 months, he was listed for heart transplantation and was transplanted 2 months later. He is currently 3.5 months out from heart transplantation and doing well, without evidence of recurring malignancy.


Fall algorithm development using kinematic parameters measured from simulated falls performed in a quasi-realistic environment using accelerometry.
This study aims to determine the optimal temporal, angular and acceleration parameters and thresholds for an accelerometer based, chest-worn, fall detection algorithm. In total, 10 healthy male subjects performed 14 different fall types, 3 times by each. The falls were performed onto in a quasi-realistic environment consisting of mats of a minimum thickness. Optimum parameters for; t(falling): time-to-fall, θ(max): max-angle, t(θmax) : max-angle-time, t(RTStanding) : Return-to-standing-time and t(lying) : lying-time were determined using a data set consisting of a total of 420 falls.


An infectious groove.... Despite attempts to eliminate hospital-acquired infections, new Leapfrog study finds 87% of hospitals still aren't up to snuff.
Everyone knows hospital-acquired infections pose a big threat. And it isn't going away. The latest Leapfrog Group study shows 87% of hospitals aren't following all recommended guidelines to solve the problem. Practitioners need to see results and know changes in their behavior will make a difference before the culture can shift. "You have to make it real to people," says Gregg Meyer, right, of Massachusetts General.


[Optimization of the "pharmaceutical consultation" practiced by pharmacists - Review, feedback and future proposals for development since the introduction of the initiative in 2013 focusing on the Calvados area].
In 2012, a National Agreement of Pharmacists was initiated in France and then amended in 2013 to introduce the "Pharmaceutical consultation". These consultations must be conducted by the pharmacist with the patient in a confidential area in pharmacy or patient residence. The objective is to decrease the frequency of negative side effects of the medical treatments (anti-vitamins k, direct oral anticoagulants and inhaled corticoid) and to improve the correct use of medication therefore assure the safety of the patient. This initiative also recognizes the expertise of the pharmacists who are remunerated with 50 euros per year and per patient from Social Security. This publication is based on a survey conducted in the whole Calvados area and it is based on several individual interviews. It gives a clear picture about how effective the practice has been so far. It shows that the "Pharmaceutical consultation" is currently only proposed to patients by 40% of pharmacists in this area, additionally the practice decreased by 85% in the pharmacies since 2013. However, 8 on 10 pharmacists recognized a real benefit for patients who subscribed for consultation. Independently, the number of non-subsidized conversation initiatives carried out by pharmacists (anti-tobacco, pregnancy, diabetes) are increasing. This finding leads to the investigation of the causes for not practicing the "Pharmaceutical consultation". The causes for not carrying out the consultations were identified, quantified, analysed and classified with a view to proposing short, medium and long time actions to optimize the "Pharmaceutical consultation" in a financially feasible manner. Nine practical proposals were identified and groups in three areas of improvement: communication, remuneration and organization.


Detection of high-grade dysplasia, carcinoma in situ and squamous cell carcinoma in the upper aerodigestive tract: Recommendations for optimal use and interpretation of narrow-band imaging.
The primary goal was to study the diagnostic potential of narrow-band imaging (NBI), and the secondary goal was to evaluate the most common mistakes when using and interpreting NBI. Retrospective study. University Medical Center Groningen, tertiary referral hospital, the Netherlands. Three hundred and seventy patients who underwent rigid endoscopy of the upper aerodigestive tract. Two observers assessed all lesions. Twelve observers assessed a selection of 100 lesions. All observers were provided with both white light imaging and NBI. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and reasons for insufficient photograph quality. When using NBI, the sensitivity, specificity, PPV, NPV and accuracy for detecting invasive carcinoma, carcinoma in situ or high-grade dysplasia were 92%, 68%, 61%, 94% and 77%, respectively. In multiple-observer analysis, values were 76%, 58%, 53%, 83% and 65% with the evaluation strictly based on type V patterns of Ni's classification, vs 83%, 68%, 64%, 85% and 74% when evaluation was also based on lesion-specific clinical characteristics. Lesions that caused misinterpretations were leukoplakia, papillomas and mucosal lesions after irradiation. In total, 185 photographs were assessed to be of suboptimal quality due to blurring (36%), bleeding (6%), insufficient zooming (15%) and/or insufficient lighting (17%). NBI is a relatively reliable screening method for detecting malignancy. Evaluation based on Ni's classification alone is not sufficient. To optimise NBI photograph quality, we recommend sufficient zooming and prevention of bleeding, blurring and inadequate lighting.


Assessing dosing errors in legacy and low dose tip ENFit® syringes.
To avoid misconnections between different medical devices, a unique standardized design of connectors (ENFit® ) for enteral medical devices has been developed. It was expected that the syringes with these connectors will replace the pre-existing syringes, henceforth referred to as legacy syringes. However, the changes in the connector's design led to concerns regarding dosing errors for low volume syringes (≤2 ml). Therefore, novel low dose tip (LDT) syringes were designed to address these concerns. These LDT syringes can connect with the standardized ENFit® male connectors. Only a few studies have investigated dosing errors, and findings have largely been mixed. The objective of this report was to calculate the contributions of unavoidable dosing errors for LDT syringes, compare with legacy syringes and to suggest strategies to optimize dose accuracy for enteral applications. Studies performed with a limited number of syringes to date may not reflect the actual diversity of dosing error that can occur across syringe orientations, batches, manufacturers, medications, etc. A computer-aided design software SolidWorks® was used to calculate the dosing errors in 0.5 and 1.0 ml legacy syringe connectors and were compared with dosing errors in LDT syringe connectors with the same nominal volume. Influence of orientation during delivery, spillage and flushing on dosing error was also investigated. For 0.5 and 1.0 ml LDT syringes, in absence of medication in the moat area, the maximum dosing error will be ±5% when delivering 100% of nominal volume, which is also equal to the dosing error in 0.5 and 1.0 ml slip tip legacy syringes. However, with medication present in moat area, and with syringe reused during flushing, the LDT dosing error can range from 1% to 18% and 28% to 35% for 1.0 and 0.5 ml syringes, respectively. The corresponding dosing error for legacy syringes would be when the same syringe is used for flushing or when syringe disengages pointing vertically up. The corresponding dosing errors for legacy syringes could range from -7 to 12% and -9% to 19% for 1.0 and 0.5 ml syringes, respectively. Dosing errors for legacy and LDT syringes increase as the nominal capacity of syringe reduces, or when the dose delivered is lower than the nominal capacity of the syringe. For LDT syringes, dosing errors can be reduced by clearing the moat area of the syringe and by using a new syringe for flushing post-delivery of medication. For legacy syringes, dosing errors can be minimized by ensuring the female connector points up during disengagement from the syringe post-medication administration, and by using a new syringe for flushing.


The low temperature magnetic circular dichroism spectra of iron-sulphur proteins. I. Oxidised rubredoxin.
Variable temperature magnetic circular dichroism spectra have been measured on oxidised Clostridium pasteurianum rubredoxin. Evidence has been obtained for the presence of two one-electron charge-transfer transitions, sulphur to ferric ion, in the region 15 000 to 28 000 cm-1. The first moment of the lower energy band is consistent with it being the orbital transition t1 non-bonding sulphur orbital, to the 2 e ferric d-orbital. The magnitude of the spin-orbit coupling constant in the lower excited state has been determined and shown to be small compared with the axial distortion. The splitting of the low energy band observed in the absorption spectrum can therefore be equated directly with the axial distortion of the lowest excited charge-transfer state. Finally, the potential utility of making saturation experiments at very low temperatures has been examined.


A method for combining Golgi impregnation procedures and light microscopic autoradiography.
The following is a description of a technique for directly combining Golgi impregnation of neurons with light microscopic autoradiography. Golgi impregnation procedures have been combined with [3H]thymidine labeling of dividing neurons. This method is useful to investigations that could combine Golgi impregnation of neurons with any permanent radioactive marker.


Modulation of X-ray-induced apoptosis in human keratinocytes (HaCaT) by 1,25-dihydroxyvitamin D3.
Possible effects of 1,25-dihydoxyvitamin D3 (vitamin D) on ionizing radiation-induced cell damage have been unknown until now. The task of the present study was to analyze, in a human keratinocyte cell line (HaCaT), the effects of a preincubation with vitamin D on the X-ray-induced mRNA expression of different genes related to apoptosis (gene array). The first results show that ionizing radiation leads to a down-regulation of various apoptosis-relevant genes in HaCaT cells pretreated with vitamin D. Therefore it can be speculated that vitamin D could prove to be a promising radioprotective substance.


Protective effect of melatonin on neural cells against the cytotoxicity of oxyradicals.
To investigate the exact mechanism of melatonin to prohibit the apoptosis of neural cells induced by various kinds of cytotoxic agents. We used the methods of phase contrast microscopy, MTT assay and hoechst dye staining to check this mechanism in SKNSH and U251 cell lines. Both 2 mmol/L H2O2 and 0.5 micromol/L amyloid beta-protein (Abeta) induce these two cell lines die via apoptosis. Either melatonin or glutathione can significantly protect both cell lines. The protective effect of 10 micromol/L melatonin is as same as that of 60 micromol/L glutathione. Melatonin can partly inhibit the cytotoxicity of H2O2 and Abeta through its role as a free radical scavenger.


Hospital Costs of Injection Drug Use in Florida.
People who inject drugs (PWID) experience significant injection-related infections (IRIs) at significant healthcare system cost. This study used and validated an algorithm based on the International Classification of Diseases, Tenth Revision, to estimate hospitalized PWID populations, assess the total statewide morbidity for IRIs among PWID, and calculate associated costs of care.


Use of ileum in reconstruction of the congenitally abnormal posterior urethra in two children.
The construction of a posterior urethra when a healthy anterior urethra is not available is surgically challenging. We describe two children in whom the posterior urethra was constructed from a segment of ileum. Both children had a satisfactory outcome; one has been followed up for 10 years and one for 1 year.


Effect of propranolol on monoamine metabolites in cerebrospinal fluid of patients with chronic schizophrenia.
Large doses (960 to 3200 mg/day) of propranolol were taken by eight patients with chronic schizophrenia in a double-blind therapeutic trial. To investigate the effects of such treatment on central monoaminergic processes, samples of cerebrospinal fluid (CSF) were drawn before starting the study and after 31 to 63 days (means = 49 days) on propranolol. Concentrations in CSF of 3-methoxy-4-hydroxyphenylglycol (MHPG), 5-hydroxyindoleacetic acid (5-HIAA), and homovanillic acid (HVA), the principal metabolites of norepinephrine, serotonin, and dopamine, were determined by HPLC with electrochemical detection. The level of HVA did not change. CSF 5-HIAA levels decreased an average of 34%, which indicates reduced turnover of serotonin in the central nervous system (CNS). There was a strong correlation between duration of treatment with propranolol and change in CSF 5-HIAA levels. The concentration of MHPG in CSF increased an average of 39%; this could have resulted from increased turnover of CNS norepinephrine as a consequence of the blockade of central beta-adrenoceptors or of altered metabolism and clearance of peripheral MHPG. Psychotic symptoms of the patients, as indicated by the 3-day average score on the Bunney-Hamburg scale, were not affected by treatment.


Letter to the editor regarding "Variant anatomy of the biliary system as a cause of pancreatic and peri-ampullary cancers."
We suggest two potential theories that could explain how low union of the cystic and common hepatic duct may be related to heightened risk for pancreatic ductal adenocarcinoma, as observed by the study by Muraki et al.


Relative impacts of mortality factors in field populations of the waterstrider Gerris buenoi Kirkaldy (Heteroptera: Gerridae).
Impacts of predators, food levels and cannibalism on population growth of G. buenoi were studied in two experiments using field exclosures. In the first experiment, experiments using field exclosures. In the first experiment, impacts of (1) predation by freshwater invertebrates and (2) food limitation on gerrid populations were considered in a 2 x 2 factorial design, using food supplements and elimination of predators as the experimental treatments. In the second experiment, the possible contribution of intraspecific predation to fitness of gerrid cannibals was assessed.Presence of invertebrate predators decreased egg-adult survivorship 2-3 fold and decreased the range of juvenile development times. The main predators noted in this study were fishing spiders (Dolomedes), backswimmers (Notonecta), larvae of predaceous diving beetles (Dytiscus), and dragonfly naiads (Aeshna). Food supplements, at 50-200% (by weight) of average natural surface fall, did not significantly effect survivorship but were associated with decreases in mean development time and with increases in whole body dry mass of teneral adults. Increases were greater for females than for males, suggesting that females are more likely to be protein limited under field conditions. Absence of predators was associated with smaller body size among teneral adults of G. buenoi, suggesting that screening out aquatic predators also had significant impact on food available to semi-aquatic bugs.Results of the second experiment demonstrate that the "food cache hypothesis" (Polis 1980) does not hold for G. buenoi. Neither survival to the adult stage nor dry mass of teneral males differed significantly between groups with or without access to early stages as potential prey. Dry mass of teneral females with access to younger stages during their own development was significantly less than for those without access to gerrid prey, suggesting that competition among stages for food was more important than cannibalism in, this experiment.


The Joint Role of Thyroid Function and Iodine Status on Risk of Preterm Birth and Small for Gestational Age: A Population-Based Nested Case-Control Study of Finnish Women.
Normal maternal thyroid function during pregnancy is essential for fetal development and depends upon an adequate supply of iodine. Little is known about how iodine status is associated with preterm birth and small for gestational age (SGA) in mildly iodine insufficient populations. Our objective was to evaluate associations of early pregnancy serum iodine, thyroglobulin (Tg), and thyroid-stimulating hormone (TSH) with odds of preterm birth and SGA in a prospective, population-based, nested case-control study from all births in Finland (2012-2013). Cases of preterm birth (n = 208) and SGA (n = 209) were randomly chosen from among all singleton births. Controls were randomly chosen from among singleton births that were not preterm (n = 242) or SGA (n = 241) infants during the same time period. Women provided blood samples at 10-14 weeks' gestation for serum iodide, Tg and TSH measurement. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for preterm birth and SGA. Each log-unit increase in serum iodide was associated with higher odds of preterm birth (adjusted OR = 1.19, 95% CI = 1.02-1.40), but was not associated with SGA (adjusted OR = 1.01, 95% CI = 0.86-1.18). Tg was not associated with preterm birth (OR per 1 log-unit increase = 0.87, 95% CI = 0.73-1.05), but was inversely associated with SGA (OR per log-unit increase = 0.78, 95% CI = 0.65-0.94). Neither high nor low TSH (versus normal) were associated with either outcome. These findings suggest that among Finnish women, iodine status is not related to SGA, but higher serum iodide may be positively associated with preterm birth.


Self-rated health in relation to age and gender: influence on mortality risk in the Malmö Preventive Project.
A study was undertaken to examine whether poor self-rated health (SRH) can independently predict all-cause mortality during 22-year follow-up in middle-aged men and women. Data are derived from a population-based study in Malmö, Sweden. This included baseline laboratory testing and a self-administered questionnaire. The question on global SRH was answered by 15,590 men (mean age 46.4 years) and 10,089 women (49.4 years). Social background characteristics (occupation, marital status) were based on data from national censuses. Mortality was retrieved from national registers. At screening 4,261 (27.3%) men and 3,085 (30.6%) women reported poor SRH. Among subjects rating their SRH as low, 1,022 (24.0%) men and 228 (7.4%) women died during follow-up. Corresponding figures for subjects rating their SRH as high were 1801 (15.9%) men and 376 (5.4%) women. An analysis of survival in subjects reporting poor SRH revealed an age-adjusted hazard risk ratio (HR, 95%CI) for men HR 1.5 (1.4-1.7), and for women HR 1.4 (1.2-1.6). The corresponding HR after adjusting for possible social confounders was for men HR 1.3 (1.1-1.4), and women HR 1.1 (0.9-1.4). When additional adjustment was made for biological risk factors the association for men was still significant, HR 1.2 (1.1-1.3). Poor SRH predicts increased long-term mortality in healthy, middle-aged subjects. For men the association is independent of both social background and selected biological variables. The adjustment for biological variables can be questioned as they might represent mediating mechanisms in a possible causal chain of events.


Abnormal cervicovaginal cytology with negative human papillomavirus testing.
Human papillomavirus (HPV) testing has become part of cervicovaginal diagnostics in many laboratories. False-negative HPV results, even if rare, are potentially relevant clinically, particularly when testing is used alone. In this study, the authors investigated the occurrence and causes of abnormal cervicovaginal cytologies with negative HPV testing. The study was performed on 4130 liquid-based cytology (LBC) specimens from 2918 women who had abnormal cervical cytology or colposcopy or a history of abnormal cervical smear. HPV testing with Hybrid Capture II was repeated in LBC specimens with obviously atypical cytology (squamous intraepithelial lesion or abnormal squamous cells, cannot exclude high-grade lesion) and initial negative test results. The results were compared with the follow-up results and with the cytologic features of the specimens. Of 4130 LBC specimens, 94 (2.28%) showed obviously abnormal cells despite negative HPV results, and 50 of those 94 samples (53.19%) were HPV-positive on a repeated testing of the same specimen. Histologic follow-up showed high-grade intraepithelial lesion or carcinoma in 10 specimens that initially were negative for HPV. Eight of those samples were HPV-positive on testing repetition. Both specimens that had persistently negative results had poor-quality cytologic samples at revision. High-grade lesions may be identified in the follow-up of HPV-negative specimens with abnormal cytology. Testing repetition in patients with discordant cytology may prevent most potentially clinically relevant false-negative HPV results.


The cell surface mucin MUC1 limits the severity of influenza A virus infection.
Cell surface mucin (cs-mucin) glycoproteins are constitutively expressed at the surface of respiratory epithelia where pathogens such as influenza A virus (IAV) gain entry into cells. Different members of the cs-mucin family each express a large and heavily glycosylated extracellular domain that towers above other receptors on the epithelial cell surface, a transmembrane domain that enables shedding of the extracellular domain, and a cytoplasmic tail capable of triggering signaling cascades. We hypothesized that IAV can interact with the terminal sialic acids presented on the extracellular domain of cs-mucins, resulting in modulation of infection efficiency. Utilizing human lung epithelial cells, we found that IAV associates with the cs-mucin MUC1 but not MUC13 or MUC16. Overexpression of MUC1 by epithelial cells or the addition of sialylated synthetic MUC1 constructs, reduced IAV infection in vitro. In addition, Muc1-/- mice infected with IAV exhibited enhanced morbidity and mortality, as well as greater inflammatory mediator responses compared to wild type mice. This study implicates the cs-mucin MUC1 as a critical and dynamic component of the innate host response that limits the severity of influenza and provides the foundation for exploration of MUC1 in resolving inflammatory disease.


Lasers and endoscopic rhinologic surgery.
Lasers are playing a more important role in rhinologic surgery. A new laser, the KTP/532, provides flexible fibers that can be combined with nasal endoscopes to reach the recesses and spaces of the nasal cavity. It can deal effectively with turbinate dysfunction, bleeding disorders, polyps, and scarring. The author's experience with the use of this laser is described.


Multilevel CC2 and CCSD Methods with Correlated Natural Transition Orbitals.
In the multilevel coupled cluster approach, an active orbital space is treated at a higher level of coupled cluster theory than the remaining inactive orbitals. We introduce the multilevel CC2 method where CC2 is used for the active orbital space. Furthermore, we present a simplified formulation of the multilevel CCSD method where CCSD is used for the active space. The simplification lies in the evaluation of the CC2 amplitudes in the inactive space; these CC2 amplitudes have previously been determined iteratively. We use correlated natural transition orbitals to determine the active orbital spaces. The convergence of the multilevel CC2 and multilevel CCSD valence excitation energies is established with proof-of-concept calculations. The methods are also applied to two larger systems: p-nitroaniline in water and amoxicillin. The calculations on the p-nitroaniline-water system illustrate the usefulness of multilevel coupled cluster methods for molecules in solution and for charge transfer excitations.


Identification of differentially expressed genes in Budd‑Chiari syndrome by RNA‑sequencing.
Budd‑Chiari syndrome (BCS) is an uncommon disease characterized by the occlusion or obstruction of hepatic venous outflow. The mechanism of BCS is still unclear and there are no accurate and effective diagnostic or therapeutic tools. In the present study, blood samples from BCS patients and healthy controls were used for RNA‑sequencing. The differentially expressed genes (DEGs) in BCS patients compared with healthy controls were identified. Gene Ontology (GO) enrichment analysis, Kyoto Encyclopedia of Genes and Genomes pathway analysis and Protein‑Protein Interaction (PPI) networks construction were performed for DEGs. A total of 405 DEGs including 317 upregulated and 88 downregulated DEGs were identified. The cytosol was the most significantly enriched GO term and the proteasome was also identified as significant enriched pathway. According to the PPI network of 30 DEGs (18 upregulated and 12 downregulated DEGs), synuclein α, tubulin β‑2A class IIa and zinc finger protein Gfi‑1b (GFIIB) were the three most significant hub proteins. In conclusion, several DEGs including secreted protein acidic and cysteine rich, lipocalin‑2, GFI1B and proteasome‑associated DEGs may be associated with the pathological process of BCS. These results can provide novel clues for the pathogenesis and provide novel diagnostic and therapeutic strategies for BCS.


[Effect of the protein intake on the rhythm of assimilation in white rats with proportioned feeding].
Experimental data on the influence of separate protein feeding by giving milk cassein at different hours of the day and night, apart from the energy-supplying food, to young rats, showed that protein is best utilized by the organism when given durins the dark period of the day. The results obtained are discussed in relation to the coefficients of protein and caloric effectiveness in the different hours of the day and night, with regulation of the light and dark period for 24 hours.


Brain metabolism and diffusion in the rat cerebral cortex during pilocarpine-induced status epilepticus.
The real-time iontophoretic method using tetramethylammonium-selective microelectrodes and diffusion-weighted magnetic resonance imaging were used to measure the extracellular space volume fraction alpha, tortuosity lambda and apparent diffusion coefficient of water (ADC(W)) 240 min after the administration of pilocarpine in urethane-anaesthetized rats. The obtained data were correlated with extracellular lactate, glucose, and glutamate concentrations and the lactate/pyruvate-ratio, determined by intracerebral microdialysis. The control values of alpha and lambda were 0.19+/-0.004 and 1.58+/-0.01, respectively. Following pilocarpine application, alpha decreased to 0.134+/-0.012 100 min later. Thereafter alpha increased, reaching 0.176+/-0.009 140 min later. No significant changes in lambda were observed during the entire time course of the experiment. ADC(W) was significantly decreased 100 min after pilocarpine application (549+/-8 microm(2) s(-1)) compared to controls (603+/-11 microm(2) s(-1)); by the end of the experiments, ADC(W) had returned to control values. The basal cortical levels of lactate, the lactate/pyruvate ratio, glucose and glutamate were 0.61+/-0.05 mmol/l, 33.16+/-4.26, 2.42+/-0.13 mmol/l and 6.55+/-1.31 micromol/l. Pilocarpine application led to a rise in lactate, the lactate/pyruvate ratio and glutamate levels, reaching 2.92+/-0.60 mmol/l, 84.80+/-11.72 and 22.39+/-5.85 micromol/l within about 100 min, with a subsequent decrease to control values 140 min later. The time course of changes in glucose levels was different, with maximal levels of 3.49+/-0.24 mmol/l reached 40 min after pilocarpine injection and a subsequent decrease to 1.25+/-0.40 mmol/l observed 200 min later. Pathologically increased neuronal activity induced by pilocarpine causes cell swelling followed by a reduction in the ECS volume fraction, which can contribute to the accumulation of toxic metabolites and lead to the start of epileptic discharges.


[Cytoreductive surgery for malignant peritoneal tumors].
Cytoreductive surgery is an essential part of a multimodality treatment concept for peritoneal metastases. Indications are primary peritoneal tumors like peritoneal mesothelioma or secondaries from colorectal cancer or pseudomyxoma peritonei. Patients with gastric or ovarian carcinoma or abdominal sarcoma with peritoneal seedings can be treated within studies. Tumor entity, tumor load, and tumor distribution are the most critical issues for patient selection. Complete macroscopic cytoreduction is the strongest prognostic factor and can be achieved by parietal and visceral peritonectomy. The operation should be performed in a standardized manner. Due to possible tumor manifestation in all four quadrants of the abdomen and extensive extraperitoneal dissection, extensive surgical and oncological expertise is prerequisite. Treatment in specialized surgical oncology centers is recommended to minimize morbidity and mortality. The German Society for General and Visceral Surgery is certifying centers of competence for surgical treatment of peritoneal malignancies. Data of all patients are documented in the HIPEC register. The inclusion of patients in studies is recommended.


Breast cancer diagnostics using microfluidic multiplexed immunohistochemistry.
A quantitative, reproducible, fast and inexpensive multiplexed immunohistochemistry (IHC) system might play a locomotive role in drug screening and personalized medicine. Currently, fully automated IHC machines and sequential multiplexed IHC methods based upon multiple color reagents have been developed, with the evolution of such methods having revealed novel biological findings over the conventional IHC method, which is time consuming and labor intensive. We describe a novel parallel multiplexed IHC method using a microfluidic multiplexed immunohistochemistry (MMIHC) device for quantitative pathological diagnosis of breast cancer. The key factors for success of parallel multiplexed IHC are the fabrication of a robust microfluidic device, the interface between the device and a tissue slide, and an accurate fluidic control for multiple IHC reagents. In order to apply conventional thin-section tissues into on-chip systems without any additional modification process, a tissue slide-compatible assembler was developed for optimal compatibility of conventional IHC methods. With this approach, a perfect fluid control for various solutions was demonstrated without any leakage, bubble formation or cross-contamination. The results presented in this chapter indicate that the microfluidic IHC protocol developed can provide the possibility of tailored cancer treatments as well as precise histopathological diagnosis using numerous specific biomarkers.


Improved ethanol production from the slurry of pretreated brewers' spent grain through different co-fermentation strategies.
The aim of this work was to bioconvert all sugars in BSG into ethanol using a process scheme that includes the enzymatic hydrolysis of the whole slurry resulting from the pretreatment of BSG with phosphoric and sulfuric acid using previously optimised conditions, followed by the co-fermentation of the mixed sugars. More than 90% of the sugars in raw BSG were recovered in the pretreatment and the subsequent enzymatic hydrolysis of the whole slurry. The co-fermentation of the enzymatic hydrolysates with Escherichia coli was then compared with that the co-culture of Scheffersomyces stipitis and Saccharomyces cerevisiae, which resulted in lower ethanol production. The co-fermentation strategy with a single microorganism (E. coli) when BSG was pretreated with phosphoric acid resulted into the highest ethanol concentration, 39 g/L, which means that 222 L of ethanol can be obtained from a ton of BSG without detoxification requirements.


Medial Patellofemoral Reconstruction Techniques for Patellar Instability.
The medial patellofemoral complex (MPFC) is the term used to describe the primary soft tissue stabilizer of the patella, which consists of fibers that attach to the patella (medial patellofemoral ligament, or MPFL), and the quadriceps tendon (medial quadriceps tendon femoral ligament, or MQTFL). Despite the variability of its attachment on the extensor mechanism, the midpoint of this complex is consistently at the junction of the medial quadriceps tendon with the articular surface of the patella, indicating that either patellar or quadriceps tendon fixation can be used for anatomic reconstruction. Multiple techniques exist to reconstruct the MPFC, including graft fixation on the patella, quadriceps tendon, or both structures. Various techniques using several graft types and fixation devices have all reported good outcomes. Regardless of the location of fixation on the extensor mechanism, elements critical to the success of the procedure include anatomic femoral tunnel placement, avoiding placing undue tension on the graft, and addressing concurrent morphological risk factors when present. This infographic reviews the anatomy and techniques for the reconstruction of the MPFC, including graft configuration, type, and fixation, while addressing common pearls and pitfalls in the surgical treatment of patellar instability.


Biochemical genetic analysis of pyrimidine biosynthesis in mammalian cells. II. Isolation and characterization of a mutant of Chinese hamster ovary cells with defective dihydroorotate dehydrogenase (E.C. 22.214.171.124) activity.
A mutant (A204) of Chinese hamster ovary cells (CHO-K1), which is deficient in dihydroorotate (DHO) dehydrogenase (E.C. 1.3,3.1) activity, has been isolated by a replica plating procedure. The mutant does not show a requirement for exogenously added pyrimidines. Examination of intact cells shows that the mutant accumulates a large amount of carbamyl aspartate and is markedly but not totally deficient in biosynthesis of orotate from earlier precursors of pyrimidine biosynthesis, including aspartate and dihydroorotic acid, when compared to wild-type cells. Analysis of cell-free extracts of mutant and wild-type cells shows that the mutant is deficient in DHO dehydrogenase activity, possessing ca. 5% of the wild-type activity. this evidence leads to the conclusion that this mutant, A204, is in fact partially deficient in DHO dehydrogenase, and that in these cells it is this enzyme which carries out the fourth step of de novo pyrimidine biosynthesis.


Inhibition of rabies virus infection by a soluble membrane fraction from the rat central nervous system.
This paper describes the inhibitory effect of a normal rat brain solubilized membrane preparation (RBSM-liposomes) on rabies virus infection. Rabies virus was incubated with RBSM-liposomes or their separated components (proteins, phospholipids, gangliosides) before infection of CER or neuroblastoma cells. In addition, both RBSM-liposomes and target cells were treated with enzymes prior to the infection step. All these experimental procedures showed that the active components were mainly lipids.


Targeting Ribosome Biogenesis in Cancer: Lessons Learned and Way Forward.
Rapid growth and unrestrained proliferation is a hallmark of many cancers. To accomplish this, cancer cells re-wire and increase their biosynthetic and metabolic activities, including ribosome biogenesis (RiBi), a complex, highly energy-consuming process. Several chemotherapeutic agents used in the clinic impair this process by interfering with the transcription of ribosomal RNA (rRNA) in the nucleolus through the blockade of RNA polymerase I or by limiting the nucleotide building blocks of RNA, thereby ultimately preventing the synthesis of new ribosomes. Perturbations in RiBi activate nucleolar stress response pathways, including those controlled by p53. While compounds such as actinomycin D and oxaliplatin effectively disrupt RiBi, there is an ongoing effort to improve the specificity further and find new potent RiBi-targeting compounds with improved pharmacological characteristics. A few recently identified inhibitors have also become popular as research tools, facilitating our advances in understanding RiBi. Here we provide a comprehensive overview of the various compounds targeting RiBi, their mechanism of action, and potential use in cancer therapy. We discuss screening strategies, drug repurposing, and common problems with compound specificity and mechanisms of action. Finally, emerging paths to discovery and avenues for the development of potential biomarkers predictive of therapeutic outcomes across cancer subtypes are also presented.


Mechanochemically Assisted Synthesis of a Ru Catalyst for Hydrogen Evolution with Performance Superior to Pt in Both Acidic and Alkaline Media.
Catalysts are at the heart of the hydrogen evolution reaction (HER) for the production of pure and clean hydrogen. For practical applications, the scalable synthesis of efficient HER catalysts, which work in both acidic and alkaline media, is highly desired. In this work, the mechanochemically assisted synthesis of a Ru catalyst with HER performance surpassing Pt in both acidic and alkaline media is reported. Mass production of this Ru catalyst can be achieved via a two-step procedure: the mechanochemical reaction between graphite and dry ice produces edge-carboxylic-acid-functionalized graphene nanoplatelets (CGnP); mixing a Ru precursor and the CGnP in an aqueous medium introduces Ru ions, which coordinate on the CGnP. Subsequent annealing results in uniform Ru nanoparticles (≈2 nm) anchored on the GnP matrix (Ru@GnP). The efficient Ru@GnP catalyst can be easily powered by a single silicon solar cell using a wireless integration device. The self-powered device exhibits robust hydrogen evolution under the irradiation of standard AM 1.5 solar light. This work provides a new opportunity for the low-cost mass production of efficient and stable catalysts for practical applications.


Properties of heat-treated calcium phosphate coatings deposited by high-velocity oxy-fuel (HVOF) spray.
The influence of crystallization, upon heat treatment, on the properties of high-velocity oxy-fuel (HVOF) sprayed hydroxyapatite (HA) coatings was investigated. The characterization of the HA coating was performed by X-ray diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FTIR). Differential Scanning Calorimeter (DSC) was employed to determine the crystallization temperature of the amorphous phase in an as-sprayed HA coating. The study demonstrated the effect of crystallization on the coating properties by considering the changes in materials chemistry, crystallinity level, and mechanical performance. Results showed that complete crystallization of the amorphous phase occurred at approximately 700 degrees C and the crystallization temperature was dependent on sample heating rate in the DSC test. The changes of ion groups were detected by FTIR, before and after the phase transformation. The crystallization of the coating after annealing at 750 degrees C resulted in a significant increase of the coatings' adhesive strength and shear strength, which attained maximum values 34 +/- 3 and 14.1 -/+ 0.8 MPa, respectively. Young's modulus increased from 21 +/- 1 to 25 +/- 2 GPa. Microhardness measurements confirmed the changes in coating properties. It is also found that the transformation from the amorphous phase has crystalline HA as the only resultant phase detected by XRD.


Biliary stones or ulcers at the choledochojejunal anastomotic site involving the jejunal mucosa at stent removal may be recurrent factors in patients with benign choledochojejunal anastomotic stenosis undergoing endoscopic biliary stenting using fully covered self-expandable metal stents.
Temporary fully covered self-expandable metal stent (FCSEMS) placement is performed for benign choledochojejunal anastomotic stenosis (bCJS). However, recurrence may develop after stricture resolution. We investigated endoscopic biliary stenting using FCSEMS for bCJS. Sixteen bCJS patients with FCSEMS placement were retrospectively analyzed. FCSEMS was removed endoscopically after 2 months. Technical success, stricture resolution, recurrence, and adverse events were evaluated. The technical success rate for FCSEMS placement was 94% (15/16). Biliary stones were detected and extracted in four patients. FCSEMS removal was successfully performed on 14 patients, excluding one with stent migration. At FCSEMS removal, stricture resolution was noted in 14 patients; however, four had anastomotic ulcers. The median follow-up was 319 days. Three patients with a history of repeated plastic stent placement had no recurrence. Four out of 15 patients (27%) had recurrence, and three had no recurrence after additional interventions. Biliary stones before first FCSEMS placement (P = .003) or anastomotic ulcers at FCSEMS removal (P = .018) were associated with recurrence. Although FCSEMS placement was useful for stricture resolution, recurrence was detected in patients with biliary stones before first FCSEMS placement or anastomotic ulcers at FCSEMS removal. Anastomotic ulcers are a risk factor for recurrence and only detected by endoscopy.


Peripheral T-cell lymphoma, not otherwise specified- Case report.
T-cell lymphomas are rare malignancies that are often found in older individuals. Here we present the case of a 63 year old female that presented with diffuse cervical, inguinal, and axillary lymphadenopathy with associated weight loss and night sweats. The patient underwent excisional lymph node biopsy which revealed a T-cell lymphoma with findings characteristic of peripheral T-cell lymphoma, not otherwise specified.


The red cell antigen JAL in the Swiss population: family studies showing that JAL is an Rh antigen (RH48).
The JAL antigen was found to have an overall frequency of 0.004% in the Swiss population and 0.06% in French-speaking Swiss. Family studies of 5 JAL+ individuals have shown that the JAL antigen is not part of the ABO, MNSs, Fy, Jk and Co blood group systems, or the Se system, nor is it X- or Y-linked. JAL is encoded by the RH locus or by a very closely linked locus. The number RH48 (4.48) has been assigned for JAL by the International Society of Blood Transfusion Working Party on Terminology for Red Cell Surface Antigens.


Klinefelter's syndrome: sexual development and activity.
Determination of plasma testosterone in 105 patients with Klinefelter's syndrome 16--45 years of age revealed that at each 5-year age interval values of male hormone were lower than in a control group of 25 normal adolescents and 85 fertile and potent men. Analysis of heterosexual development by means of the HTDM Questionnaire in 110 patients with Klinefelter's syndrome age 21--40 years, who were examined mainly for sterility and signs of imperfect somatosexual development, revealed a distinct retardation of sociosexual development compared to that of 325 normozoospermic men from sterile marriages. For eight out of 12 items on the HTDM Questionnaire the differences were statistically significant. Examination by means of the SAM Questionnaire in these two groups revealed that the sexual activity of examinees with Klinefelter's syndrome was significantly weaker than that of fertile and potent men. For 15 out of 18 items on the SAM Questionnaire the differences were statistically significant.


Synthesis and characterization of a new cutinase substrate, 4-nitrophenyl (16-methyl sulfone ester) hexadecanoate.
Phytopathogenic fungi penetrate plants by breaking down the cuticular barrier with cutinase. Cutinases are extracellular hydrolytic enzymes that degrade cutin, a polyester composed of hydroxy and epoxy fatty acids. Until now, cutinase has been recognized by its ability to release labeled cutin monomers or by a non-specific esterase assay based on the hydrolysis of p-nitrophenyl esters of short fatty acids. In this work, an insoluble p-nitrophenyl derivative was synthesized and purified, and its structure was determined to be 4-nitrophenyl (16-methyl sulfone ester) hexadecanoate (pNMSEH) by nuclear magnetic resonance (H+ NMR) analysis. pNMSEH was tested as a new cutinase substrate with Pseudomonas mandocino cutinase and porcine liver esterase. While a linear release over time of p-nitrophenol (pNP) was recorded in the presence of cutinase, no response was obtained with the esterase. The calculated kinetic parameters of pNMSEH hydrolysis by cutinase revealed a high specificity (Km=1.8mM), albeit a low catalytic rate (Vmax=10.5 micromol min(-l)l(-1)). This new synthetic substrate may be helpful for detecting and assaying cutinase activity in mixed solutions, such as crude fungal extracellular extracts.


Glycemic variability in type 2 diabetes mellitus and acute coronary syndrome: liraglutide compared with insulin glargine: a pilot study.
To explore the glucagon-like peptide-1 analogue liraglutide in the hospital setting in patients with type 2 diabetes mellitus (T2DM) and acute coronary syndrome and to evaluate the safety and efficacy and its impact on hospitalization and short-term glycemic variability (GV). A 12-week, open-label, prospective, randomized pilot clinical study with parallel groups that compared liraglutide (group 1) with glargine (group 2) and its impact on glycemic control and GV. Thirteen patients were included. During hospitalization, mean glucose was 164.75 mg/dL (standard deviation [SD] 19.94) in group 1 and 166.69 mg/dL (38.22) in group 2. GV determined by CV and SD was 20.98 (7.68) vs. 25.48 (7.19) and 34.37 (13.05) vs. 43.56 (19.53) in groups 1 and 2, respectively. Group 1 prandial insulin requirements during hospitalization were lower compared with group 2. Follow-up A1c in group 1 was 6.9% (-1.51%) and 6.5% in group 2 (-1.27). GV after discharge and hypoglycemia were lower in group 1 compared with group 2. Liraglutide seems to reduce GV in the acute phase of acute coronary syndrome, and patients achieved optimal control with a low incidence of hypoglycemia. These results support the need to explore liraglutide in a larger multicenter trial. Trial registration: The study was approved by the National Medical Ethics Committee of Spain. The study was registered at European Clinical Trials Database (EudraCT): 2014003298-40.


Bleeding risk after acupuncture in patients taking anticoagulant drugs: A case control study based on real-world data.
Patients on anticoagulant medications may be at a higher risk of bleeding after acupuncture. This study aimed to assess the association between anticoagulant drug use and bleeding after acupuncture. Case control study SETTING: We analysed the diagnosis and treatment records (2000-2018) of a random sample of two million patients from the National Health Insurance Research Database in Taiwan. anticoagulant and antiplatelet drugs MAIN OUTCOME MEASURES: The incidence rates of major (visceral bleeding or ruptured blood vessels requiring transfusion) and minor (skin bleeding or contusion) bleeding after acupuncture RESULTS: We included the records of 13,447,563 acupuncture sessions in 821,946 participants and followed up the patients for 14 days after each session. The incidence of minor bleeding was 8.31 per 10,000 needles, whereas that of major bleeding was 4.26 per 100,000 needles. Anticoagulants significantly increased the risk of minor bleeding (adjusted OR = 1.15 (1.03-1.28)), but the risk of major bleeding did not reach statistical significance (adjusted OR = 1.18 (0.8 0-1.75)). Anticoagulants, such as warfarin (adjusted OR = 4.95 (2.55-7.64)), direct oral anticoagulants (adjusted OR = 3.07 (1.23-5.47)), and heparin (adjusted OR = 3.72 (2.18-6.34)) significantly increased the risk of bleeding. However, antiplatelet drug was not significantly associated with post-acupuncture bleeding. Comorbidities including liver cirrhosis, diabetes, and coagulation defects, were the risk factors for bleeding after acupuncture. Anticoagulant drugs may increase the risk of bleeding after acupuncture. We encourage physicians to ask patients in detail about their medical history and drug use prior to acupuncture treatment.


You only get one brain: adult reflections on coping and recovery after traumatic brain injury in adolescence.
TBI during adolescence can result in significant acute symptoms that can persist into adulthood. This research analyzed retrospective qualitative accounts of young adults who had sustained a TBI in adolescence to explore coping and recovery processes specific to this developmental stage. Thirteen adults (aged 20-25 years; mean 23 years) who sustained a mild (n = 12) or moderate (n = 1) TBI during adolescence (aged 13-17 years at injury), approximately 7.7 years (range = 6.7-8.0 years) prior, participated. Semi-structured individual interviews, analyzed using thematic analysis, explored participants' experiences following their TBIs. Thematic data analysis produced two key categories of themes relating to recovery processes: (1) Individual factors impacting coping, with themes of learning to cope with difficulties, seeking acceptance and balance, and finding meaning; and (2) Social factors impacting coping, which included themes of feeling included, relying on family, professionals didn't get it, and lacking someone who understands. Recovery following TBI sustained during adolescence could be maximized by facilitating greater understanding of specific impacts on young people among clinicians and family, longer term monitoring of symptoms including emotional reactions to symptoms, and the provision of emotional support.


High copper and low zinc serum levels in Iranian patients with multiple sclerosis: a case control study.
The purpose of this study was to evaluate the levels of zinc (Zn) and copper (Cu) in the serum of Iranian patients with multiple sclerosis (MS). The serum levels of zinc (Zn) and copper (Cu) were measured in sixty Iranian patients with MS and compared with sixty age-, gender- and socioeconomic status-matched healthy subjects without any neurological disorders as controls from the same geographical area. Significantly lower serum Zn and higher serum Cu levels were found in the MS patients compared with the controls (p < 0.0001 and p = 0.002, respectively). The serum Zn level of the secondary-progressive MS patients was significantly lower compared with the relapsing-remitting MS patients (p = 0.009). There was no significant difference between the serum Cu levels of the two subgroup of MS patients (p = 0.42). The results suggest significant deviations of the Iranian MS patients' serum Zn and Cu levels from the norm.


Parallel imaging improves the image quality and duct visibility of breathhold two-dimensional thick-slab MR cholangiopancreatography.
To evaluate the effect of parallel imaging (PI) with different acceleration factors on the image quality and duct visibility of breathhold two-dimensional (2D) thick-slab single-shot turbo spin-echo (SSTSE) MR cholangiopancreatography (MRCP) images. Breathhold 2D thick-slab SSTSE MRCP was performed three times, i.e., without PI, with PI factor 2, and with PI factor 3, at 1.5 Tesla (T) for each of 85 patients. Two, independent readers evaluated the image quality and the visibility of five duct segments and ranked their preference of the three MRCP sequences. The data were analyzed using the repeated-measures analysis of variance test, the Friedman test, and the linear-by-linear chi-square test. MRCP sequences with PI factor 2 or 3 generated better image quality (P < 0.001) and an improved duct visibility for all duct segments (P ≤ 0.01), while no significant difference was noted between the MRCP sequences with PI factor 2 and PI factor 3 (P > 0.05). Among the three sequences, both readers most often preferred the MRCP with PI factor 3, followed by the MRCP with PI factor 2 (P < 0.001). The application of PI improves the image quality and duct visibility in breathhold 2D thick-slab SSTSE MRCP.


The Incidence and Risk Factors of Medial and Inferior Orbital Wall Fractures in Korea: A Nationwide Cohort Study.
We aimed to investigate orbital wall fracture incidence and risk factors in the general Korean population. The Korea National Health Insurance Service-National Sample Cohort dataset was analyzed to find subjects with an orbital wall fracture between 2011 and 2015 (based on the diagnosis code) and to identify incident cases involving a preceding disease-free period of 8 years. The incidence of orbital wall fracture in the general population was estimated, and the type of orbital wall fracture was categorized. Sociodemographic risk factors were also examined using Cox regression analysis. Among 1,080,309 cohort subjects, 2415 individuals with newly diagnosed orbital wall fractures were identified. The overall incidence of orbital wall fractures was estimated as 46.19 (95% CI: 44.37-48.06) per 100,000 person-years. The incidence was high at 10-29 and 80+ years old and showed a male predominance with an average male-to-female ratio of 3.33. The most common type was isolated inferior orbital wall fracture (59.4%), followed by isolated medial orbital wall fracture (23.7%), combination fracture (15.0%), and naso-orbito-ethmoid fracture (1.5%). Of the fracture patients, 648 subjects (26.8%) underwent orbital wall fracture repair surgeries. Male sex, rural residence, and low income were associated with an increased risk of orbital wall fractures. The incidence of orbital wall fractures in Korea varied according to age groups and was positively associated with male sex, rural residency, and low economic income. The most common fracture type was an isolated inferior orbital wall fracture.


Preemptive Ladd Procedure in congenital diaphragmatic hernia and Abdominal Wall defects does not reduce the risk of future volvulus.
Patients with congenital diaphragmatic hernia (CDH), gastroschisis, and omphalocele are prone to abnormalities of intestinal rotation and thus future midgut volvulus. Controversy exists whether routine preemptive Ladd procedure in this subgroup of asymptomatic patients is of value to reduce future volvulus. The Pediatric Health Information System (PHIS) database was queried for neonates with CDH, gastroschisis, and omphalocele between January 2009 and September 2015. Standard univariate and multivariate analysis was completed to compare risk of volvulus between patients treated with a preemptive Ladd versus no Ladd (p<0.05). Seven thousand seven hundred forty-nine neonates with CDH (40%), gastroschisis (38%), omphalocele (14%), and abdominal wall malformation (NOS) (9%) were identified. Overall, 3.6% (n=279) had a preemptive. Thirty-two patients had subsequent volvulus. Ladd procedure did not reduce volvulus readmissions for any diagnosis and was associated with a significantly increased risk of volvulus for omphalocele patients (9.1% vs 0.1%, p<0.001). Overall, a Ladd procedure during the index admission was associated with a higher risk for volvulus (1.4% vs. 0.4%, p=0.021) and was associated with a 3.28 increased odds ratio of future volvulus (95% CI 1.12-9.68). Ladd procedure performed prophylactically in patients with CDH, gastroschisis, and omphalocele did not reduce subsequent volvulus. III, Retrospective Comparative Study.


Renewed endovascular repair for recurrent acute abdominal aortic aneurysm.
The aim of the study was to describe the successful endovascular management of a patient who was admitted urgently with a second episode of acute abdominal aortic aneurysm (AAA) 30 months after emergency endovascular abdominal aortic aneurysm repair (eEVAR) for a ruptured AAA. The patient, an 84 year-old male physician, presented with severe acute abdominal and back pain. Contrast-enhanced computer tomography scanning showed type III endoleak owing to complete disconnection of both graft limbs and the prosthetic main body. Treatment consisted of acute stent-grafting with two bridging stent-grafts to seal the endoleak and reline the graft. The patient is alive and well 6 months postoperatively. This case indicates the need for follow-up after eEVAR, but also that complications can be managed endovascularly.


Histopathological differences in the development of small intestinal metaplasia between antrum and body of stomach.
This study used mucin immunohistochemistry to investigate differences in the properties of intestinal metaplasia between the antrum and body of the stomach in 28 resected specimens. Intestinal metaplasia was classified as: (1) small intestinal metaplasia (SIM) with a tubule, including CD10-positive brush border on a background of MUC5AC-/ HGM-negative cells; or (2) goblet cell metaplasia (GCM) with MUC2-positive and CD10-negative cells. In the antrum, frequencies of SIM and GCM were nearly equal irrespective of metaplasia grade. Frequency and length of remnant pyloric gland for SIM were significantly greater in the antrum than in the body. In the proliferative zone, there existed a lower level in SIM than in non-intestinalized tubules. These findings suggest that the proliferative zone shifts from the neck zone toward the bottom of the tubule during the SIM process in the antrum. In the body, however, the grade of SIM grade was significantly higher than that of GCM. The proliferative zone was located higher in the fundic gland, pseudopyloric gland and SIM, in that order. Almost all remnant pyloric glands for SIM were negative for pepsinogen I. These facts indicate that SIM in the body originates in a proliferative zone that shifted downward to an area near the bottom of the tubule, with atrophic pyloric glands originating from pseudopyloric gland metaplasia.


Homocysteine at pathophysiologic concentrations activates human monocyte and induces cytokine expression and inhibits macrophage migration inhibitory factor expression.
Homocystinemia is an important independent risk factor for atherosclerosis. Inflammatory cytokines play key roles in the development of atherogenesis. This study investigated the effect of homocysteine on inflammatory cytokine expression. Human monocytes were treated in vitro with a variety of DL-homocysteine concentrations that ranged from physiologic concentration to higher than pathophysiologic concentration, and we analyzed their expressions of inflammatory cytokines, including tumor necrosis factor-alpha, interleukin-1beta, interleukin-6, interleukin-8, interleukin-12, and migration inhibitory factor. DL-homocysteine at a marginal physiologic concentration of 2 microg/mL (15 microM) activated monocytes. In addition, DL-homocysteine at the pathophysiologic dose of 25 microg/mL (185 microM) induced mRNA and protein expressions of inflammatory cytokines tumor necrosis factor-alpha, IL-1beta, interleukin-6, interleukin-8, and interleukin-12. Moreover, at the larger dose of 50 microg/mL (370 microM) DL-homocysteine decreased expression of migration inhibitory factor at the mRNA and protein levels. These findings suggest that homocysteine may contribute to the initiation and progression of vascular disease by activating monocytes, resulting in the secretion of cytokines that amplify the inflammatory response.


Modified conventional bioreactor for microalgae cultivation.
Microalgae, a renewable source for third generation biofuel production, have a great potential if cultivated in high concentration economically. Bottleneck lies with designing economical and efficient photobioreactor. In addition, proportional C and N inputs in the known media does not support high specific growth rate and high biomass build-up. Nitrates in fermentation media, f/2 for Nannochloropsis sp. and Zarrouk's for Arthrospira platensis, were modified. Aeration and agitation were altered in conventional bioreactor (BIOFLO 110) to reduce power consumption, increase mixing time and prevents settling. This was achieved by introducing four way flow regime supporting uniform nutrient and cell distribution in media. Volumetric cell productivity for Nannochloropsis sp. and A. platensis were achieved as 0.618 g/l/d and 0.774 g/l/d, respectively. This photobioreactor also supported the maximum specific CO2 sequestration rates to the level of 0.42 g/g/h and 0.39 g/g/h for Nannochloropsis sp. and A. platensis, respectively, confirming efficient and effective operation.


An RNA polymerase with reduced fidelity of RNA synthesis from an E. coli mutant suggests the existence of a correction system of non-complementary nucleotide incorporation during transcription.
An RNA polymerase mutant of E. coli B/r-rpoB402, with a pleiotropic effect on stability of the phenotype has recently been obtained (8-11). The present study is concerned with the fidelity of in vitro RNA synthesis carried out by highly purified RNA polymerase from the wild type strain and rpoB402 mutant. The data indicate that mutational alteration of RNA polymerase reduced the accuracy of the enzyme to a value lower than that required for the cell. The results suggest the existence of some correcting system during transcription.


Modulatory effect of green coffee bioactives on high-fat diet-induced obesity in C57BL6 mice model.
The aim of the present study was to determine the efficacy of green coffee bioactives in ameliorating the effects of high-fat diet (HFD)-induced obesity through in vitro and in vivo assessments. Green coffee extract (GCE) was obtained by implementing a novel green extraction technique. The efficacy of GCE to inhibit in vitro pancreatic amylase and lipase was evaluated. Further, in vivo studies were conducted using a C57BL6 mice model grouped as starch-fed diet control, HFD control, HFD + positive control, HFD + GCE (100 mg/kg body weight), and HFD + GCE (200 mg/kg body weight). Animal body weight, diet intake, and fecal fat excretion were measured during the feeding period. On completion of the experiment, blood serum was collected for biochemical analysis, and organs were harvested for assessing the obesity-related biomarkers. The obtained GCE was enriched with polyphenols and alkaloids. GCE led to significant (P < 0.05) in vitro inhibition of pancreatic amylase and lipase. GCE supplementation considerably prevented weight gain in treated groups post-consumption of HFD. It also led to increased fecal fat excretion and regulated the high-fat-mediated blood glucose levels. GCE effectively modulated the blood lipid profile, morphology of adipose and liver tissues, and liver antioxidant defense enzymes and resulted in hepatoprotective effects. It also downregulated the genes associated with lipid biosynthesis. GCE exhibits promising results in suppressing the consequences associated with HFD-induced obesity. It has the potential to be incorporated into food products benefiting consumer health and food industries.


A new bluetongue virus serotype isolated in Kenya.
An apparently new strain of bluetongue virus was first isolated in Kenya in 1965 and since, has been obtained on 7 further occasions from diseased sheep during clinical outbreaks of disease. It proved to be serologically different from the 16 bluetongue virus strains then held at this laboratory. The virus was modified by passage in embryonated hens eggs to produce a live virus strain suitable for inclusion in a polyvalent vaccine. Recent neutralisation tests, carried out with 24 guinea pig immune sera prepared at Pirbright against the currently known World serotypes, have confirmed the earlier results and show that it is different from any of the existing serotypes.


[Near-drowning associated Aeromonas pneumonia].
Aeromonas pneumonia associated with near-drowning, though uncommon, is serious and a major morbidity factor for patients. A healthy 30-year-old man nearly drowned in a pound. He was admitted to the medical intensive care unit and required intubation and mechanical ventilation. He was given antibiotic therapy in the form of amoxicillin/clavulanic acid. After a brief stable period post immersion, he rapidly developed fever and respiratory failure. The thoracic scan revealed bilateral alveolar infiltrates and led to a fibreoptic bronchoscopy. Aeromonas veroniiandPseudomonas aeruginosa were found on culture of the bronchial aspirate. A change of antibiotic therapy appropriate to these bacteria led to clinical improvement and allowed complete withdrawal of ventilation. Rapid respiratory deterioration following near-drowning should raise the suspicion of pulmonary infection with the bacteria usually found in the respiratory tract during ventilation but without overlooking the possibility of unusual organisms, particularly Aeromonas.It is usuallysensitive to third generation cephalosporins and fluoroquinolones. Ideally, Aeromonas should be sought in pulmonary aspirates and samples of the water where immersion occurred.


Deep anterior lamellar keratoplasty for pellucid marginal degeneration.
To present the surgical outcomes of deep anterior lamellar keratoplasty (DALK) for pellucid marginal degeneration (PMD). A retrospective review was performed in 16 eyes of 16 patients who underwent DALK at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia between January 1, 2006 and December 30, 2009. Baring of Descemet's membrane (DM) during DALK was achieved in 8 (50%) eyes; residual stroma was left intraoperatively in the remaining 8 (50%) eyes. The big bubble technique was performed in 10 (62.5%) eyes and manual dissection was performed in the remaining 6 (37.5%) eyes. Visual acuity (LogMAR notation), intraocular pressure, intraoperative complications and postoperative graft status were assessed. The mean follow up was 14.6 ± 8.2 months (range 6-35 months). The mean overall age was 31.4 ± 9.6 years (range, 19-50 years). Visual acuity increased statistically significantly from 0.9 ± 0.3 (range 0.5-1.6) preoperatively to 0.4 ± 0.2 (range 0.0-0.7) at last follow-up (p < 0.0001). There was a statistically significant improvement in postoperative sphere, cylinder, and spherical equivalent (p < 0.035, p < 0.001, and p < 0.02, respectively) compared to preoperative. Postoperative visual acuity was not statistically significantly related to gender, type of surgical technique, and baring or perforation of DM. The main graft-related complication was graft-host vascularization (2/16 eyes). DALK reduces severe corneal astigmatism and results in good visual and refractive outcomes and is an effective alternative for patients with PMD.


A short haptic diameter modified J-loop intraocular lens for improved capsular bag performance.
The laboratory and clinical characteristics of a modified J-loop intraocular lens (IOL) are presented. The lens features a 6 mm polymethylmethacrylate optic with uniplanar polypropylene loops of a 12 mm overall haptic diameter. The haptic design has a low resistance to compression at all diameters down to 9 mm. The relationship of the haptic configuration to the architecture of the capsular bag facilitates easy capsular bag implantation and consistent IOL centration in eyes with small and moderate capsular bag diameters. Three hundred fourteen lenses have been implanted over a one year period with no instance of asymmetric capsular bag-ciliary sulcus IOL placement, optic decentration, or pupillary capture.


Survival of patients with chronic lymphocytic leukemia before and after the introduction of chemoimmunotherapy in Germany.
Chronic lymphocytic leukemia (CLL) is the most common leukemia of adults in western countries. Therapy is indicated in symptomatic and advanced stages and has changed fundamentally since 2010 when rituximab, an anti-CD20 antibody, has been approved for treatment of CLL. Until then therapy had been based on chemotherapy drugs. This study investigates whether survival in CLL patients improved at the population level after the introduction of combined chemoimmunotherapy. Data from the cancer registry North-Rhine Westphalia was used to calculate relative survival (RS) by applying period analyses. Age-standardized 5-year RS increased from 79% in 1998-2002 (75% in 2003-2007) to 81% in the calendar period 2008-2012 and 88% in 2013-2016 for men and continuously from 71% in 1998-2002 to 92% in 2013-2016 for women. In CLL patients aged 15-69 years 5-year RS increased from 83% to 90% for men and from 82% to 94% for women after adding an anti-CD20-antibody to chemotherapy while in the older age group of 70-79-year-old CLL patients an increase by 20 percentage points was observed. These findings show marked improvements in the survival of CLL patients at the population level subsequently to the approval of anti-CD 20 antibodies like rituximab, ofatumumab or obinutuzumab for CLL treatment.


Post-infectious cough of different syndromes treated by traditional Chinese medicines: A review.
The application of traditional Chinese medicines (TCMs) has a history of more than 2000 years, which have the characteristics of multi-component, multi-target, and high safety. Post-infectious cough (PIC) is a respiratory disease with high incidence. It belongs to subacute cough and accounts for as much as 40%-50%. Cough is the main clinical manifestation of PIC. PIC seriously affects people's life quality because of complex etiology, long-term course of disease, treatment difficulties and other characteristics. Western medicines are based on the principle of symptomatic treatment, so they are often difficult to control PIC fundamentally. These factors could due to that PIC is prolonged and unable to heal repeatedly. TCMs have obvious advantages in treating PIC, with accurate curative effects, less side effects and adverse reactions and are effective in improving PIC-related symptoms and indicators, enhancing patients' life quality and reducing pain. TCMs, guided by holistic concept and syndrome differentiation, advocate determine treatment on the basis of pattern types, and have remarkable clinical treatment effects. As for TCMs etiology, pathogenesis and syndrome types of PIC, TCM scholars have not yet reached a unified standard. However, most of them think that wind pathogen can cause PIC alone, or it can be combined with other evils, which might be the main mechanism of PIC. This paper discusses the advantages and limitations of TCMs in PIC treatment from etiology, pathogenesis, distribution of syndrome types and treatment of TCMs. This article focuses on the treatment methods and pharmacodynamic material basis of wind pathogen, providing ideas in treating PIC of TCMs clinically and innovative drug development.


Cryptogenic chronic liver disease and hepatitis C virus infection in children.
The clinical features of 'cryptogenic' chronic liver disease and the prevalence of antibody to hepatitis C virus (HCV) in serum have been investigated in 33 Italian children (mean age 5 years). The diagnosis was based on the persistence of increased alanineaminotransferase values for longer than 6 months after the exclusion of biliary diseases, of extra-hepatic causes of hypertransaminasemia, of infection with known hepatotropic viruses and of autoimmune or metabolic disorders. Five patients had been transfused early in life, three had undergone surgery and one girl's mother had had acute non-A, non-B hepatitis during pregnancy. The remaining patients had no history of overt parenteral exposure. At presentation only 11 patients were symptomatic, the others had been referred after a check-up for intercurrent diseases. Liver histology performed in 21 cases showed persistent or mild active hepatitis in 18 cases and severe hepatitis or cirrhosis in three cases. Anti-HCV antibodies were found in 48% of the cases, including 88% with obvious exposure and 33% of the remaining cases. During a mean follow-up period of 5 years (range 1-14 years) only 11% of the cases achieved sustained biochemical remission, although none developed signs of liver failure. There was no significant difference in the clinical features and outcome of the disease between anti-HCV-positive and -negative patients. The results of this study suggest that HCV is implicated in most cases of 'cryptogenic' chronic liver disease observed in Italian children with a history of parenteral exposure and in at least one-third of the cases without overt exposure.(ABSTRACT TRUNCATED AT 250 WORDS)


Sequencing and analysis of the complete mitochondrial genome in Anopheles sinensis (Diptera: Culicidae).
Anopheles sinensis (Diptera: Culicidae) is a primary vector of Plasmodium vivax and Brugia malayi in most regions of China. In addition, its phylogenetic relationship with the cryptic species of the Hyrcanus Group is complex and remains unresolved. Mitochondrial genome sequences are widely used as molecular markers for phylogenetic studies of mosquito species complexes, of which mitochondrial genome data of An. sinensis is not available. An. sinensis samples was collected from Shandong, China, and identified by molecular marker. Genomic DNA was extracted, followed by the Illumina sequencing. Two complete mitochondrial genomes were assembled and annotated using the mitochondrial genome of An. gambiae as reference. The mitochondrial genomes sequences of the 28 known Anopheles species were aligned and reconstructed phylogenetic tree by Maximum Likelihood (ML) method. The length of complete mitochondrial genomes of An. sinensis was 15,076 bp and 15,138 bp, consisting of 13 protein-coding genes, 22 transfer RNA (tRNA) genes, 2 ribosomal RNA (rRNA) genes, and an AT-rich control region. As in other insects, most mitochondrial genes are encoded on the J strand, except for ND5, ND4, ND4L, ND1, two rRNA and eight tRNA genes, which are encoded on the N strand. The bootstrap value was set as 1000 in ML analyses. The topologies restored phylogenetic affinity within subfamily Anophelinae. The ML tree showed four major clades, corresponding to the subgenera Cellia, Anopheles, Nyssorhynchus and Kerteszia of the genus Anopheles. The complete mitochondrial genomes of An. sinensis were obtained. The number, order and transcription direction of An. sinensis mitochondrial genes were the same as in other species of family Culicidae.


Cloning and characterization of rice HMGB1 gene.
We isolated a 918 bp long full-length rice HMGB1 cDNA, which has an open reading frame of 471 bp encoding 157 amino acids, with a central domain of high sequence similarity to the HMG-box domain of other plant HMGB1 proteins. RNA gel blot analysis indicated that rice HMGB1 gene is constitutively expressed in various tissues and organs. Southern hybridization and sequence analyses suggested that a single copy of the HMGB1 gene composed of seven exons and six introns exists in rice. We have also cloned a 1755 bp long 5' flanking region of the rice HMGB1 gene, which can be regarded as its promoter. 5' deletion analysis of this promoter indicated that positive cis-elements residing between -1400 and -1115 are important to enhance quantitative expression, whereas negative cis-elements between -1755 and -1400 and between -1115 and -351 inhibit expression.


Deciphering host-pathogen interaction during Streptomyces spp. infestation of potato.
Potato crop, currently, is the staple food crop of about 1.3 billion global population. Potato is attaining even more admiration globally day by day owing to its public acceptability. However, potato sustainable production is distinctly challenged by multiple factors like diseases, pests and climate change etc. Among diseases, common scab is one of the prime threats to potato crop due to its soil-borne nature and versatility in phytotoxins' secretion. Common scab is caused multiple number of phytopathogenic streptomyces strains. Despite extensive research programs, researchers are still unable to identify a significant solution to this threat that is proliferating exceptional rate across the globe. To develop feasible remedies, adequate information regarding host-pathogen interaction should be available. This review possesses insights on existing pathogenic species, the evolution of novel pathogenic streptomyces spp. and phytotoxins produced by the pathogenic strains. Furthermore, which type of physiological, biochemical and genetic activities occur during pathogen's infestation of the host are also canvassed.


Hip1 and Hippi participate in a novel cell death-signaling pathway.
Neuronal apoptosis is a cardinal feature of late-onset neurodegenerative disorders such as Alzheimer's and Huntington's disease. Biochemical and cell biological studies point to a role for Hip1 and Hippi in caspase-8 activation and the initiation of apoptosis during the pathogenesis of Huntington's disease.


Chemiluminescence enzyme immunoassay for monitoring hepatitis C virus core protein during interferon-alpha2b and ribavirin therapy in patients with genotype 1 and high viral loads.
This study evaluated an updated chemiluminescence enzyme immunoassay (CLEIA) for hepatitis C virus (HCV) core protein for monitoring viral kinetics during treatment with interferon (IFN)-alpha and ribavirin. Using the CLEIA, serum levels of HCV core protein were measured in 17 patients with genotype 1 and high baseline viral loads during the first 4 weeks of combination therapy. HCV RNA was measured by the Amplicor Monitor test for comparison. At the start of therapy, the median HCV level (interquartile range) was 700 (540-940) kIU/ml of viral RNA and 11,310 (5,528-14,238) fmol/L of core protein. HCV RNA was above the upper limit of the linear range of the Amplicor Monitor test in 13 of the 17 patients, while the core protein level was within the linear range of the CLEIA in all patients. During therapy, the proportion of patients with HCV levels below the cutoff values at each time point was less with the Amplicor Monitor test than with CLEIA. Serum HCV core protein level decreased rapidly during the first 24 hr of therapy and more slowly thereafter, with median exponential decays of 1.08 and 0.046 log10/day, respectively. In the second phase, between day 1 and 28, the median decrease in HCV core protein level was higher in four patients with sustained virologic response (0.13 log10/day) than in 13 patients with no response (0.028 log10/day, P = 0.042). The wide linear range of the HCV core protein assay is appropriate for measuring viral loads during therapy with IFN-alpha and ribavirin.


Effectiveness of multidisciplinary led self-management interventions on glycaemic control in people with type 1 diabetes: a systematic review protocol.
To synthesize evidence on the effectiveness of multidisciplinary self-management interventions for glycaemic control in people with type 1 diabetes. Type 1 diabetes is a chronic autoimmune disease. Self-management education led by a multidisciplinary team facilitates those with diabetes to acquire the necessary knowledge and skillset to improve their outcomes and quality of life. This review will consider studies on people aged 16 years and over with type 1 diabetes, investigating the effectiveness of multidisciplinary self-management interventions. The primary outcome of interest is glycemic control as measured by glycated hemoglobin levels. Secondary outcomes include quality of life as measured by validated screening tools and adverse outcomes, such as number of hypoglycemia, hyperglycemia and diabetic ketoacidosis events. This review will consider all quantitative study designs. Studies published in English since 2009 will be considered. MEDLINE (via PubMed), CINAHL (via EBSCO), Embase (via embase.com), PsycINFO (via EBSCO) and the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Register of Studies (via Cochrane Library) will be searched. Sources of unpublished studies and gray literature to be searched include ProQuest Dissertations and Theses and Google Scholar. Titles and abstracts will be screened by two independent reviewers, with disagreements resolved through discussion or with a third reviewer. Eligible studies will be critically appraised for methodological quality using standardized critical appraisal instruments from JBI. Data extraction and synthesis will follow methods outlined by JBI. PROSPERO CRD42020170205.


The physiology of nutritional assessment and therapy in protein-calorie malnutrition.
Protein-calorie malnutrition (PCM), in the purest sense, is the result of depleted body protein stores due to semistarvation. A review of the hormonal response to simple semistarvation illustrates the elegant adaptive ability of the body to respond to an inadequate diet. By contrast, the body's metabolic response to an injury or illness stimulus is a dynamic process orchestrated by monokines and hormones. Although the injury response, strictly speaking, is not synonymous with PCM, the resultant increased energy expenditure, anorexia, and potential for skeletal muscle breakdown can result in an even more rapid depletion of body protein stores. Ultimately, the need for nutritional support depends on the amount of recent weight loss, anticipated time of insufficient oral intake, and the degree of stress. A discussion of basic concepts of anthropometry precedes examples of advantages and disadvantages of a given anthropometric parameter for selected disease states. The effects of PCM on visceral structure and function are discussed in detail so that the reader can appreciate why the metabolic response to injury may have a very different impact on the nourished compared with the malnourished patient. Particular attention is paid to the adverse effects of PCM on immune function and its antithesis, the beneficial impact of nutritional repletion on the immune system. An approach to refeeding discusses indications for initiation of nutritional support, choice of route, design of a macronutrient and micronutrient regimen, and guidelines for monitoring. Familiarity with the metabolic alterations of refeeding is key to the mitigation of potentially life-threatening complications of sudden refeeding. Appreciation of the anticipated response to nutrition is important, as the response will vary with the degree of stress. A nearly optimal response can be expected with appropriate nutrition in the nonstressed semistarved patient, whereas inefficient repletion is to be expected in the severely stressed patient. The review concludes with a discussion of the role of nutrition as a modifier of the body's metabolic response to injury.