Evaluation of the Accuracy of T-SPOT.TB for the Diagnosis of Ocular Tuberculosis in a BCG-vaccinated, Non-endemic Population.
To determine the performance of T-SPOT.TB, an interferon gamma release assay test, in patients with ocular tuberculosis (TB) in a BCG-vaccinated, non-endemic population. We employed a nested case-control design. In total, 45 subjects were enrolled (23 patients with ocular tuberculosis and 22 patients with other causes of uveitis). A blood sample was collected from each subject, and T-SPOT.TB was executed. Laboratory professionals were blinded to the disease status of each subject. Five patients were excluded because of indeterminate results. The calculated sensitivity and specificity were 0.80 and 0.85, respectively. The positive likelihood ratio was 5.33 and the negative likelihood ratio was 0.23. The overall accuracy of the test was 0.83. T-SPOT.TB adequately diagnosed ocular TB. This technique is particularly useful in populations where BCG vaccinations are still mandatory.


Efficacy of pattern feedback for the dissociation of heart rate and respiration rate.
The present study assessed the efficacy of pattern feedback for producing integrative and dissociative patterns of heart rate (HR) and respiration rate (RR). 60 uninformed subjects were assigned to six groups in which beat-by-beat feedback was contingent upon production of a specific pattern of increased ( ), decreased ( ), or unchanged (=) HR and RR during 11 feedback trials. Concomitant changes in respiratory volume and general activity (GA) were also recorded. Groups given feedback for HR and RR changes in the same directions (HR RR and HR RR ) ANd for changes in opposite directions (HR RR and HR RR ) were generally unable to produce the respective patterns, indicating that pattern feedback does not enable subjects to produce a wide range of HR-RR patterns. However, evidence of dissociation of HR and RR was obtained in the HR RR= and HR RR= groups in which HR changed significantly in the appropriate directions without significant changes in RR. These results are not consistent with the view that RR changes are necessary for HR control, although significant concomitant changes in respiratory volume and GA indicated that HR control was non-specific relative to these variables.


The possible protective effects of virgin olive oil and Nigella sativa seeds on the biochemical and histopathological changes in pancreas of hyperlipidaemic rats.
Hyperlipidaemia is a risk factor for the development and progression of atherosclerosis and is linked to various diseases. This study was done to evaluate the possible protective effects of virgin olive oil and Nigella sativa seeds on the biochemical and histopathological changes which occurred in the pancreas of the rats. The study lasted 8 weeks and included 24 albino rats that were divided into four groups (6 rats each); Group I - control group, fed with normal standard diet, Group II - fed with high fat diet (HFD), Group III - fed with HFD and virgin olive oil, Group IV - fed with HFD and Nigella sativa seeds powder. After finishing the experiment, blood samples were collected and assessed for the lipid profile, fasting blood glucose, pancreatic amylase and insulin levels. Then, the rats were sacrificed and the pancreata were extracted and slices of them were processed for histological examination using haematoxylin stain and Masson's trichrome stain. Small fragments from the tail of the pancreata were extracted and processed for electron microscopic examination. The statistical analysis of the data using the appropriate statistical tests was also conducted. In the present study, the serum lipid profile in hyperlipidaemic rats was ameliorated in rats fed on high fat diet with virgin olive oil or Nigella sativa seed powder, which was reflected by a significant decrease in total cholesterol, low-density lipoprotein-cholesterol and triglycerides. Moreover, Nigella sativa decreased high-density lipoprotein (HDL), while virgin olive oil significantly increased HDL. Also a significant decrease in the serum levels of blood glucose and amylase and a significant increase in insulin levels were present in these groups. The histological and ultrastructural results revealed regeneration of the exocrine and endocrine parts of the pancreatic tissues from the hyperlipidaemic rats fed with virgin olive oil or Nigella sativa seeds. In this study, the biochemical results were paralleled to the histological and ultrastructural results; therefore, it could be concluded that virgin olive oil and Nigella sativa seeds had antihyperlipidaemic and hypoglycaemic effects and they could protect the pancreas from hyperlipidaemia-induced injury. Daily consumption of virgin olive oil and Nigella sativa seeds in the diet is highly recommended.


The efficacy and safety of capecitabine plus bevacizumab combination as first-line treatment in elderly metastatic colorectal cancer patients.
The optimal treatment in older persons with metastatic colorectal cancer (mCRC) is complicated by a lack of general agreement. The aim of this study was to evaluate the activity of bevacizumab plus capecitabine combination in elderly mCRC patients who were not suitable for chemotherapy with irinotecan and oxaliplatin-containing regimens. Seventy years and older patients with metastatic colorectal carcinoma were included in this retrospective study. Bevacizumab was administered at a dose of 7.5 mg/kg on day 1 as an intravenous (IV) infusion over 30-90 min every 21 days, and capecitabine was prescribed at 1000 mg/m(2) twice daily on days 1-14 of the same 21-day schedule. Eighty-two consecutive patients (47 men, 35 women) were included in the study. The mean age was 75.5 (SD 3.9, range 70-87). Half of the patients were older than 75 years. There were 55 patients (67.1 %) with a good Eastern Cooperative Oncology Group (ECOG) performance status (PS: 0-1) and the remaining 27 patients (32.9 %) had a poor ECOG performance status (PS: 2). With a median follow-up period of 18.5 months, the median progression-free survival (PFS) was 10 months (95 % CI, 7.8-12.1) and the median OS was 25 months (95 % CI, 18.6-31.3). The main toxicities recorded were non-hematological. Thirty-one patients (37 %) experienced grade 3/4 adverse events, the most common being hand-foot syndrome (9.8 %). No fatal toxicity resulting from this regimen was recorded. Considering the toxicity profile and survival outcomes, the combination regimen of capecitabine and bevacizumab is a potentially feasible treatment option in elderly mCRC patients.


Feasibility of ketogenic diet therapy variants for refractory epilepsy in neonates to infants under 2 years old.
Ketogenic diet Therapy (KDT) has been reported as a possible beneficial management strategy for controlling seizures in infants aged <2 years, but the safety and efficacy of this therapy remain to be investigated. We investigated the achievability, tolerability, efficacy, and safety of KDT for patients under 2 years old. Infants younger than 2 years old with pharmacoresistant epilepsy were enrolled in this prospective study. We divided cases into three age groups: I) neonates; II) infants aged 1-12 months; III) infants aged 12-24 months. KDT initiation protocol were administration through parenteral route, enteral route or oral feeding. Seizure reduction rate, physical growth, and adverse effects were assessed at monthly visit. Thirteen patients who completed 6 months of KDT were recruited. There was one neonate in group I, 9 infants in group II, and 3 infants in group III. Eleven of them (11/13, 84.6%) were responders to KDT. All infants with underlying genetic etiology were seizure free after treating with KDT. The starting keto ratio was 1.1 mmol/L in group I, 2.3 mmol/L in group II, and 2.8 mmol/L in group III, which gradually approached 3:1-4:1 over 5-7 days. There were no symptomatic adverse effects or growth retardation in any of the study subjects. KDT is a promising alternative therapy with high feasibility, safety, and efficacy for pharmacoresistant epilepsy in infants under 2 years old, especially for those with genetic etiology. The starting keto ratio should be lower, and the keto ratio titration period should be longer than for children older than 2 years.


The effectiveness of collaborative models of care that facilitate rehabilitation from a traumatic injury: a systematic review.
Trauma is the most frequent cause of significant functional impairment that leads to the deterioration in health and often delayed functional and psychosocial recovery. Fundamentally, rehabilitation of those with traumatic injuries surpasses the acute management extending into the reintegration of patients to home life and the wider community. Consequently, rehabilitation from a traumatic injury is a multidisciplinary process that incorporates the continuum of care across different settings and organizations. Planning and maintaining effective rehabilitation across organizations and sectors is a significant challenge. Unmet rehabilitation needs can prolong discharge, limit the patient's activities, restrict participation, decrease quality of life and increase dependence on significant others. The objective of this systematic review was to identify and synthesize the best available evidence on the effectiveness of collaborative care models in relation to traumatic injury rehabilitation. What is the effectiveness of collaborative care models that facilitate rehabilitation from a traumatic injury? This review considered all studies that included adult patients above 18 years of age and of either gender with a traumatic physical injury requiring rehabilitation across different settings/organizations. Interventions of interest were models of collaborative care that facilitate those rehabilitating from a traumatic physical injury across different care types and settings. The comparator was usual care. TYPES OF STUDIES: This review aimed to identify randomized controlled trials; however, with the absence of any randomized controlled trials, other research designs were considered. This review considered studies that reported on participation, functionality, quality of life, pain, psychosocial outcomes and goals. The search strategy aimed to find both published and unpublished studies without language or publication date restrictions. A three-step search strategy was utilized in this review. The studies were independently assessed by two reviewers using standardized critical appraisal instruments from the Joanna Briggs Institute. No studies progressed to data extraction. Data synthesis was not undertaken as no study was identified of sufficient quality. This systematic review identified only one paper that met the inclusion criteria. It described the United States Veterans Affair's system of Veteran-centred, post-combat care rehabilitation programs that fundamentally relies on the collaborative care of social workers and nurses to support service members, veterans and their families proceed through the initial recovery, rehabilitation and re-integration into post-combat society and their home communities. Unfortunately, there was no formal evaluation provided that addressed the review's outcomes of interest and therefore the study was excluded. This review has highlighted the lack of research concerning collaborative models of care that facilitate rehabilitation from a traumatic injury. It found insufficient data to enable any conclusions to be made about the effectiveness of collaborative models of care that facilitate rehabilitation from a traumatic injury. IMPLICATIONS FOR CLINICAL PRACTICE AND RESEARCH: Further research investigating viable collaborative models of care that facilitate the rehabilitation journey across different healthcare sectors is required.


Morphine treatment and intravenous glucose tolerance tests in mice.
The effect of acute and chronic morphine treatment on i.v. glucose tolerance tests in mice was investigated. It was found that neither acute nor chronic morphine treatment affected the serum glucose disappearance with time after i.v. glucose loading, indicating that morphine has no significant effect on glucose tolerance. Analysis of hepatic glycogen and glucose levels in these mice revealed that morphine treatment might have some effects on glucose metabolism, but at the analgesic dose employed, did not impair the animal's physiological response to i.v. glucose loading.


Aggressive angiomyxoma of male genital region. Report of 4 cases with immunohistochemical evaluation including hormone receptor status.
Aggressive angiomyxoma (AA), first described by Steeper and Rosai (Am J SurgPathol. 1983;7:463-475), is a rare locally infiltrative tumor that usually arises in the pelvic and perineal soft tissues of young women. Approximately 150 cases have been reported in women. Aggressive angiomyxoma has a high rate of local recurrence because of its infiltrative growth and anatomical location making complete excision with wide margins difficult. To our knowledge, 39 cases of AA occurring in men have been reported in the literature. Sites frequently involved include the scrotum, spermatic cord, inguinal region, and perineum. The gross and microscopic appearances and clinical course are similar to those described in female cases. Immunohistochemistry evaluating estrogen and progesterone receptors (ER and PR, respectively), although frequently positive in the female cases, has rarely been studied in the male cases. We report the clinicopathologic features of 4 additional cases of AA in men with particular emphasis on hormone (ER/PR) receptor status. Hormone reactivity is significant in that AA may arise from specialized hormonally responsive stromal cells of the perineum and may potentially play a therapeutic role in unresectable tumors. From our small series, hormone positivity (1 case of ER+, 3 cases of PR+) does occur in the male cases of AA, and a large number of cases should be examined to determine the frequency at which these tumors express hormone receptors.


No Impact? Long-Term Effects of Applying the Best Possible Self Intervention in a Real-World Undergraduate Classroom Setting.
Positive psychology interventions (PPIs) improve students' well-being in laboratory settings. Best possible self (BPS) is one of the most widely used PPIs shown in the laboratory to effectively improve participants' well-being in both the short- and long-term, but limited research has been conducted in real-world contexts. This study applied BPS in an undergraduate classroom to examine its long-term effects. Students enrolled in an undergraduate education course were assigned to treatment and control groups. Three writing activities and four tests were integrated into the course as assignments in both groups. Data were analyzed using a 2 × 3 (group and time) mixed ANOVA. The results indicate that BPS did not significantly improve the participants' well-being over time compared with the control group. In fact, the control group performed better than treatment at one month after the intervention. This aligns with recent findings of well-being during COVID-19. Potential implications and areas for future research are discussed.


Effects of oral vitamin E on treatment of atopic dermatitis: A randomized controlled trial.
The pathogenesis of atopic dermatitis (AD) remains to be determined; recently a possible change in the immune system with production of immunoglobulins is proposed. As vitamin E is a potent antioxidant, with the ability to decrease the serum levels of immunoglobulin E (IgE) in atopic patients, we aimed to evaluate the effect of oral vitamin E on treatment of AD. This randomized, double-blind, placebo-controlled trial comprised seventy participants with mild-to-moderate AD, based on the Hanifin and Rajka diagnostic criteria. The patients were randomly selected from teaching skin clinics in Isfahan, Iran. They were randomly assigned to two groups of equal number, receiving vitamin E (400 IU/day) and placebo for four 4 months. Each month, the extent, severity, and subjective symptoms including itch and sleeplessness were measured by SCORAD index. Three months after the end of intervention, the recurrence rate was assessed. The improvement in all symptoms, except sleeplessness, was significantly higher in the group receiving vitamin E than in controls (-1.5 vs. 0.218 in itching, -10.85 vs. -3.54 in extent of lesion, and -11.12 vs. -3.89 in SCORAD index, respectively, P < 0.05). Three months after the end of intervention, the recurrence rate of AD was evaluated. Recurrence rate between all 42 individuals, who remained in the study, was 18.6%. Recurrence ratio of the group receiving vitamin E compared to the placebo group was 1.17, without significant differences between the two groups (P > 0.05). This study suggests that vitamin E can improve the symptoms and the quality of life in patients with AD. As vitamin E has no side effects with a dosage of 400 IU/day, it can be recommended for the treatment of AD.


Orbital Fracture: Significance of lateral wall.
The lateral orbital wall is the strongest among other orbital walls. However, it is commonly fractured in the setting of severe facial trauma. The fracture usually occurs at the sphenozygomatic suture line. In general, patients with lateral wall fractures are commonly young male who may present with mid facial swelling and some degree of deformity. In some cases, lateral orbital wall fracture may be associated with visual loss or change in mental status due to associated intracranial injury. Imaging studies with computed tomography is important in the proper diagnosis and planning of the surgical intervention. Management of intracranial or eye injuries should be undertaken on emergent basis. Thereafter, significantly displaced lateral wall fractures need to be repaired on timely basis. Proper realignment of the plane of the lateral orbital wall at the sphenozygomatic suture along with the other complex articulations of the zygomatic bone is necessary for proper functional and aesthetic outcome.


FMRI of ventral and dorsal processing streams in basic reading processes: insular sensitivity to phonology.
Most current models of the neurophysiology of basic reading processes agree on a system involving two cortical streams: a ventral stream (occipital-temporal) used when accessing familiar words encoded in lexical memory, and a dorsal stream (occipital-parietal-frontal) used when phonetically decoding words (i.e., mapping sublexical spelling onto sounds). The models diverge, however, on the issue of whether the insular cortex is involved. The present fMRI study required participants to read aloud exception words (e.g., 'one', which must be read via lexical memory) and pseudohomophones (e.g., 'wun', which must be read via sublexical spelling to sound translation) to examine the processing streams as well as the insular cortex, and their relationship to lexical and sublexical reading processes. The present study supports the notion of independent ventral-lexical and dorsal-sublexical streams, and further suggests the insular cortex to be sensitive to phonological processing (particularly sublexical spelling-sound translation). These latter findings illuminate the nature of insular activity during reading, which must be explored further in future studies, and accounted for in models of the neurophysiology of reading.


The Crusade against Mutant p53: Does the COMPASS Point to the Holy Grail?
Mutations in the TP53 gene not only inactivate its tumor suppressor function but also confer this transcription factor with gain-of-function oncogenic properties. A recent paper by Zhu and colleagues reveals a novel molecular pathway driven by mutant p53 and the COMPASS chromatin-modifying complex that is amenable to pharmacological inhibition.


Preparation of antibodies against xanthine oxidase from human milk.
1. Human xanthine oxidase [XO; EC 220.127.116.11.] was isolated by a non-proteolytic method from fresh human milk. Final purification of the protein was achieved by hydroxyapatite chromatography. Most (less than 95%) of the enzyme was released in the 0.40 M phosphate fraction at pH 6.8. 2. The specific activity of this preparation was found to be 0.047 microM min-1 mg-1 with xanthine as substrate. 3. Sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis (PAGE) separated two subunits, each with a mol. wt approximately 122 kDa. 4. On non-denaturing acrylamide gels both of these subunits exhibited oxidase-like activity with xanthine as substrate in the presence of nitroblue tetrazolium and molecular oxygen. 5. Immunoconjugates of XO were prepared by the keyhole limpet hemocyanin (KLH)- and glutaraldehyde-crosslinking techniques. 6. Polyclonal antibodies to XO were raised by i.m. injection of these conjugates into female New Zealand rabbits. 7. Western blot analysis using the semi-dry technique was employed to confirm the specificity of the antibody.


Corticosteroid withdrawal in simultaneous pancreas-kidney transplantation: a 3-year report.
Corticosteroids are an important element of immunosuppressive protocols, but their long-term use has detrimental effects on patient health, requiring eventual discontinuation. Herein, we present an evaluation of the safety and feasibility of corticosteroid withdrawal based on the findings of the Euro-SPK001 study. In this prospective, multicenter study, 205 simultaneous pancreas-kidney (SPK) transplant recipients were randomized to immunosuppressive treatment with either tacrolimus and mycophenolate mofetil (MMF) (n = 103) or cyclosporine microemulsion (CsA-ME) and MMF (n = 102). All patients received concomitant rATG induction therapy, MMF, and short-term corticosteroids. Corticosteroid withdrawal was successful in the majority of in-study patients: 66% tacrolimus and 73% cyclosporin-ME. In-study patients selected for corticosteroid withdrawal experienced fewer pancreatic or kidney graft losses and fewer episodes of acute rejection compared with out-of-study patients or those continuing corticosteroid therapy. Acute rejection episodes occurred after corticosteroid withdrawal in two patients who had a previous rejection and in five patients who were rejection free before corticosteroid withdrawal. No rejection episodes were associated with graft loss or immediate serious consequences. Overall, corticosteroid withdrawal was achieved with an increase in both MMF and tacrolimus dosage. Corticosteroid withdrawal was successful in the majority of in-study patients. A long-term survey of corticosteroid withdrawal in SPK transplantation with multifactorial analyses is necessary to confirm these early results and to evaluate possible positive effects on glucose metabolism and hypertension.


Nitrite decreases sickle hemoglobin polymerization in vitro independently of methemoglobin formation.
The root cause of sickle cell disease (SCD) is the polymerization of sickle hemoglobin (HbS) leading to sickling of red blood cells (RBC). Earlier studies showed that in patients with SCD, high-dose nitrite inhibited sickling, an effect originally attributed to HbS oxidation to methemoglobin-S even though the anti-sickling effect did not correlate with methemoglobin-S levels. Here, we examined the effects of nitrite on HbS polymerization and on methemoglobin formation in a SCD mouse model. In vitro, at concentrations higher than physiologic (>1 μM), nitrite increased the delay time for polymerization of deoxygenated HbS independently of methemoglobin-S formation, which only occurred at much higher concentrations (>300 μM). In vitro, higher nitrite concentrations oxidized 100% of normal hemoglobin A (HbA), but only 70% of HbS. Dimethyl adipimidate, an anti-polymerization agent, increased the fraction of HbS oxidized by nitrite to 82%, suggesting that polymerized HbS partially contributed to the oxidation-resistant fraction of HbS. At low concentrations (10 μM-1 mM), nitrite did not increase the formation of reactive oxygen species but at high concentrations (10 mM) it decreased sickle RBC viability. In SCD mice, 4-week administration of nitrite yielded no significant changes in methemoglobin or nitrite levels in plasma and RBC, however, it further increased leukocytosis. Overall, these data suggest that nitrite at supra-physiologic concentrations has anti-polymerization properties in vitro and that leukocytosis is a potential nitrite toxicity in vivo. Therefore, to determine whether the anti-polymerization effect of nitrite observed in vitro underlies the decreases in sickling observed in patients with SCD, administration of higher nitrite doses is required.


BCI system with lower-limb robot improves rehabilitation in spinal cord injury patients through short-term training: a pilot study.
In the recent years, the increasing applications of brain-computer interface (BCI) in rehabilitation programs have enhanced the chances of functional recovery for patients with neurological disorders. We presented and validated a BCI system with a lower-limb robot for short-term training of patients with spinal cord injury (SCI). The cores of this system included: (1) electroencephalogram (EEG) features related to motor intention reported through experiments and used to drive the robot; (2) a decision tree to determine the training mode provided for patients with different degrees of injuries. Seven SCI patients (one American Spinal Injury Association Impairment Scale (AIS) A, three AIS B, and three AIS C) participated in the short-term training with this system. All patients could learn to use the system rapidly and maintained a high intensity during the training program. The strength of the lower limb key muscles of the patients was improved. Four AIS A/B patients were elevated to AIS C. The cumulative results indicate that clinical application of the BCI system with lower-limb robot is feasible and safe, and has potentially positive effects on SCI patients. The online version contains supplementary material available at 10.1007/s11571-022-09801-6.


Pharmacokinetic stability of macrocyclic peptide triazole HIV-1 inactivators alone and in liposomes.
Previously, we reported the discovery of macrocyclic peptide triazoles (cPTs) that bind to HIV-1 Env gp120, inhibit virus cell infection with nanomolar potencies, and cause irreversible virion inactivation. Given the appealing virus-killing activity of cPTs and resistance to protease cleavage observed in vitro, we here investigated in vivo pharmacokinetics of the cPT AAR029b. AAR029b was investigated both alone and encapsulated in a PEGylated liposome formulation that was designed to slowly release inhibitor. Pharmacokinetic analysis in rats showed that the half-life of FITC-AAR029b was substantial both alone and liposome-encapsulated, 2.92 and 8.87 hours, respectively. Importantly, liposome-encapsulated FITC-AAR029b exhibited a 15-fold reduced clearance rate from serum compared with the free FITC-cPT. This work thus demonstrated both the in vivo stability of cPT alone and the extent of pharmacokinetic enhancement via liposome encapsulation. The results obtained open the way to further develop cPTs as long-acting HIV-1 inactivators against HIV-1 infection.


Delivering 9-1-1 CPR Instructions to Limited English Proficient Callers: A Simulation Experiment.
Having 911 telecommunicators deliver CPR instructions increases cardiac arrest survival, but limited English proficiency (LEP) decreases the likelihood callers will perform CPR and increases time to first compression. The objective of our study was to assess which 9-1-1 CPR delivery modes could decrease time to first compression and improve CPR quality for LEP callers. 139 LEP Spanish and Chinese speakers were randomized into three arms: receiving CPR instructions from a 9-1-1 telecommunicator (1) with telephone interpretation, (2) using alternative, simple ways to rephrase, or (3) who strictly adhered to protocol language. Time interval from call onset to first compression, and CPR quality were the main outcomes. The CPR quality was poor across study arms. Connecting to interpreter services added almost 2 min to the time. CPR training in LEP communities, and regular CPR training for phone interpreters may be necessary to improve LEP bystander CPR quality.


Pharmacologic inhibition of NLRP3 reduces the levels of α-synuclein and protects dopaminergic neurons in a model of Parkinson's disease.
Parkinson's disease (PD) is characterized by a progressive degeneration of dopaminergic neurons, which leads to irreversible loss of peripheral motor functions. Death of dopaminergic neurons induces an inflammatory response in microglial cells, which further exacerbates neuronal loss. Reducing inflammation is expected to ameliorate neuronal loss and arrest motor dysfunctions. Because of the contribution of the NLRP3 inflammasome to the inflammatory response in PD, we targeted NLRP3 using the specific inhibitor OLT1177®. We evaluated the effectiveness of OLT1177® in reducing the inflammatory response in an MPTP neurotoxic model of PD. Using a combination of in vitro and in vivo studies, we analyzed the effects of NLRP3 inhibition on pro-inflammatory markers in the brain, α-synuclein aggregation, and dopaminergic neuron survival. We also determined the effects of OLT1177® on locomotor deficits associated with MPTP and brain penetrance. Treatment with OLT1177® prevented the loss of motor function, reduced the levels of α-synuclein, modulated pro-inflammatory markers in the nigrostriatal areas of the brain, and protected dopaminergic neurons from degeneration in the MPTP model of PD. We also demonstrated that OLT1177® crosses the blood-brain barrier and reaches therapeutic concentrations in the brain. These data suggest that targeting the NLRP3 inflammasome by OLT1177® may be a safe and novel therapeutic approach to arrest neuroinflammation and protect against neurological deficits of Parkinson's disease in humans.


Astigmatic decay following small incision, self-sealing cataract surgery.
A series of 22 consecutive patients had phacoemulsification using a small (3.5 to 4.0 mm), self-sealing incision. Preoperative keratometric analysis was performed using the EyeSys photokeratoscope. Results of this analysis were compared with keratometric data obtained at one week and at one month postoperatively. These comparisons were evaluated for surgery-induced cylinder and astigmatic decay at the 3, 5, and 7 mm corneal zones. At one week postoperatively, there was only mild against-the-rule change in cylinder at each corneal zone, and these changes showed minimal decay at the one month follow-up visit.


Association between gestational visit-to-visit blood pressure variability and adverse neonatal outcomes.
The authors aimed to explore the association between visit-to-visit blood pressure variability (BPV) in pregnant women and adverse neonatal outcomes. The study included 52 891 pregnant women. BPV was calculated as standard deviation (SD) and coefficient of variation (CV) of systolic blood pressure (SBP) or diastolic blood pressure (DBP). All participants were divided into four groups by the quartiles of BPV. When comparing the highest quartiles to the lowest quartiles of DBP SD in all participants, the fully adjusted ORs were 1.19 (95% CI 1.11-1.27, p for trend < .001) for fetal distress, 1.32 (95% CI 1.14-1.54, p for trend < .001) for small for gestational age, 1.32 (95% CI 1.06-1.63, p for trend = .003) for 1-min Apgar score ≤ 7. When comparing the highest quartiles to the lowest quartiles of DBP CV, ORs were 1.22 (95% CI 1.14-1.30, p for trend < .001) for fetal distress, 1.38 (95% CI 1.17-1.61, p for trend < .001) for small for gestational age, 1.43 (95% CI 1.14-1.79, p for trend < .001) for 1-min Apgar score ≤ 7. ORs for preterm birth and 5-min Apgar score ≤ 7 were not statistically significant. However, in participants with gestational hypertension or preeclampsia, ORs for preterm birth were 2.80 (95% CI 1.99-3.94, p for trend < .001) in DBP SD and 3.25 (95% CI 2.24-4.72, p for trend < .001) in DBP CV when extreme quartiles were compared. In conclusion, higher visit-to-visit BPV was associated with adverse neonatal outcomes.


[Roentgenologic phenotype in syndromes associated with congenital heart defects].
In a group of children with congenital heart disease in 10.7% concurrently skeletal anomalies were observed (1085 children) and in 10.5% anomalies of the upper urinary pathways (1807 children). The authors describe X-ray findings in syndromes of anomalies most frequently associated with congenital heart disease.


Expression of the gene for the retinal protein peripherin in the pineal gland of humans and Djungarian hamsters (Phodopus sungorus).
This study investigated whether the gene for peripherin, a protein previously considered to play only a role in the retina, may also be expressed in the pineal gland of both Djungarian hamsters (Phodopus sungorus) and humans. After extraction of mRNA from pooled pineal glands of hamsters and from one human pineal gland, mRNA was transcribed into cDNA followed by PCR amplification with specific primers. Clear signals were obtained at the expected sizes of the PCR products. An additional experiment in hamsters revealed that the peripherin gene is expressed throughout the entire 24-h period. Since peripherin is an important protein in the retina stabilizing the photoreceptor discs it is speculated that this protein might also play a structural role in the pineal gland.


[Sonographic diagnosis of a milk of calcium renal cyst].
Renal lime milk cysts are very rare. By ultrasound and computed tomography the diagnosis is easier than by normal X-rays. Presentation of a typical example.


An association between smoking habits and blood pressure in normotensive Japanese men.
We conducted a cross-sectional study to clarify the dose-effect relationship of smoking habits with blood pressure in Japanese men. The subjects were 2781 normotensive male steelworkers ranging in age from 40 to 54 years. They were classified into five categories according to their smoking habits: non-smokers, ex-smokers, light smokers, moderate smokers and heavy smokers. Age, body mass index, salt intake, physical activity, drinking habits, and levels of gamma-glutamyl transpeptidase, total serum cholesterol, uric acid, creatinine and plasma glucose were analysed as covariates. The association between smoking habits and blood pressure was evaluated using analysis of covariance. Our results showed that there was no significant difference in the adjusted systolic and diastolic blood pressure between non-smokers and ex-smokers. The adjusted systolic and diastolic blood pressures in light, moderate and heavy smokers were significantly lower than in non- and ex-smokers. However, among smokers, no significant difference was observed in correlation with smoking amount. In conclusion, blood pressure of smokers was lower than that of non- and ex-smokers. However, there were no significant dose-effect relationships between smoking amount and blood pressure when lifestyle and other confounding factors were considered.


Components of disability exclusion: Discrimination, avoidance and accessibility in later life.
To examine the prevalence and context of disability exclusion reported by people with disability, with and without communication and mobility problems. The 2015 Survey of Disability Ageing and Carers was used to measure the prevalence of reported exclusion. Tests of proportions were used to examine differences in prevalence rates. Proportional Venn diagrams were used to examine the intersection of measures of exclusion. Approximately 53% of those with a communication or mobility difficulty reported at least one measure of exclusion. Among this group, 7% reported an instance of discrimination, 44% reported avoidance, and 29% reported an accessibility problem. The levels of discrimination and avoidance for those without communication or mobility difficulties were approximately half this level (16% avoidance and 3% discrimination). Avoidance and discrimination reduced with age, but accessibility was age-invariant. Exclusion measures intersected and occurred in a variety of contexts. Despite protections provided in Australian law, disability exclusion persists and is high among those with communication and mobility difficulties.


Genome-scale methylation analysis of Parkinson's disease patients' brains reveals DNA hypomethylation and increased mRNA expression of cytochrome P450 2E1.
Multiple lines of evidence suggest a link between environmental toxins and Parkinson's disease (PD). Although numerous studies reported associations of genetic variants in de-toxifying enzymes, i.e. cytochrome genes, with PD. Epigenetic modifications of genes and subsequent altered expression may confer a yet unappreciated level of susceptibility. We present a genome-wide methylation analysis of PD with quantitative DNA methylation levels of 27.500 CpG sites representing 14.495 genes. We found decreased methylation of the cytochrome P450 2E1 gene and increased expression of CYP2E1 messenger RNA in PD patients' brains, suggesting that epigenetic variants of this cytochrome contribute to PD susceptibility.


The association of Ala54Thr variant of intestinal fatty acid binding protein gene with general and regional adipose tissue depots.
To ascertain the relationship between the Ala54Thr variation of FABP2 gene and general as well as regional adipose tissue depots. 165 subjects, in which 86 were subjects with normal glucose tolerance (NGT) [age 54.45+/-9.80, male/female 1.05, body mass index (BMI) 26.48+/-4.01] and 79 were subjects with non-insulin-dependent diabetes mellitus (NIDDM) (age 55.86+/-10.00, male/female 1.08, BMI 26.75+/-3.30). An association study of FABP2-Ala54Thr variation detected by PCR/HhaI digestion with general and regional adipose tissue depots determined by BMI and magnetic resonance imaging [abdominal subcutaneous and visceral adipose tissue area (SA and VA) and femoral subcutaneous adipose tissue area (FA)]. The geneotype and allele frequencies of FABP2-Ala54Thr variation in Chinese were quite close to the frequencies in American Caucasians and Pima Indians reported in the literature. Significant difference in genotype frequency distribution was observed between FA subgroups comparisons (FA > or = 75 cm2 versus FA < 75 cm2) in NIDDM subjects (X2 = 11.460, P = 0.003), with significantly increased in Thr54-carrier [Thr54 (+)] genotype frequency and Thr54 allele frequency in NIDDM subject with FA < 75 cm2 (odd ratio for genotype was 4.62, X2 = 10.112, P = 0.001; and for allele = 2.36, X2 = 5.379, P = 0.020). The FA in NIDDM-Thr54 (+) subgroup was significantly lower than that in subjects with NIDDM-Thr54 (-) subgroup (61.19+/-21.51 cm2 versus 75.36+/-31.70 cm2, P = 0.021). Stepwise regression analysis revealed that FABP2-Thr54 genotype variation was an independent factor contributing to the variation of FA in NIDDM (P = 0.003). FABP2 is associated with regional adipose tissue depot. The decreased femoral subcutaneous adipose tissue depot in NIDDM subjects is related to FABP2-Thr54 variant.


Occupational asthma caused by automated salmon processing.
Within 3 months of the opening of a salmon-processing plant in the UK, some workers complained of symptoms suggestive of occupational asthma. A survey of all 291 employees identified 24 (8.2%) with occupational asthma. The employees worked near machines which generated respirable aerosols containing salmon-serum proteins. The IgE response to these proteins was associated with occupational asthma (p < 0.001), with increasing severity of symptoms (p < 0.001), and with working distance from the aerosol source (p = 0.037). The main factor which predisposed to IgE-antibody production and asthma was cigarette smoking (p < 0.001), whereas atopy and a previous allergic history did not. The affected employees were reallocated to a low-exposure worksite and factory ventilation was improved. Eleven showed significant clinical and pulmonary function improvement, and continued in employment. Thirteen who still had symptoms were advised to leave, thereafter becoming symptom-free, and regaining normal respiratory function. Early recognition of symptoms and prompt action to reduce aerosol exposure avoided the long-term reduction in pulmonary functions often associated with occupational asthma.


Temporal preparation facilitates perceptual identification of letters.
Recent evidence has suggested that perceptual processing of single stimulus features improves when participants are temporally prepared for the occurrence of the stimuli. This study was conducted to investigate whether the benefit of temporal preparation generalizes to perceptual identification of more complex stimuli, such as letters. In three experiments, participants discriminated masked letters under high- and low-temporal-preparation conditions. Visual discrimination performance in all experiments improved when the participants were temporally prepared. Therefore, the present results support the notion that perception benefits from temporal preparation not only at the feature level, but also at subsequent levels at which feature information is integrated.


Effects of median raphe nucleus lesions on hippocampal EEG in the freely moving rat.
The effects of median raphe lesions on the hippocampal EEG were examined in freely moving rats. First, median raphe lesions, including those restricted to the median raphe nucleus, unequivocally produced hippocampal low-frequency theta activity (5.8 Hz, SD = 0.47 Hz) during relaxed immobility which was not observed under normal conditions. This lesion-induced theta activity during immobiliy continued for at least 20 days, and was markedly suppressed by atropine sulfate (10 mg/kg, i.p.). On the other hand, reticular formation lesions had little effect on either hippocampal EEG patterns during immobility, movement or PS. Second, the mean frequency of theta activity was significantly reduced during movement and PS on the day following the median raphe lesion. These findings suggest a raphe-hippocampal pathway in which the median raphe mucleus plays a major role in hippocampal desynchronization (irregular pattern) by exerting an inhibitory influence on the hippocompal theta generating or facilitating mechanism. Thus the theta activity will be induced by the disinhibition following median raphe lesions.


Stepwise recycling of valuable metals from Ni-rich cathode material of spent lithium-ion batteries.
A novel and efficient approach for stepwise recycling of valuable metals from Ni-rich cathode material is developed. First, the spent cathode materials are leached by H2SO4 + H2O2 solution. The leaching efficiencies of lithium, nickel, manganese and cobalt reach almost 100%, 100%, 94% and 100%, respectively, under the conditions of 2 M sulfuric acid, 0.97 M hydrogen peroxide, 10 ml·g-1 liquid-solid ratio, 30 min and 80 °C. Then, manganese and cobalt are co-extracted from the leaching liquor with PC88A, while almost 99% nickel and 100% lithium remain in the raffinate followed by being separated from each other by solvent extraction with neodecanoic acid (Versatic 10). The results show that 98% manganese and over 90% cobalt are co-extracted at pH = 5, 30 vol% PC88A and volume ratio of oil to water (O:A) = 2:1, while 100% nickel is separated from lithium under the optimum extraction conditions of initial pH = 4, O:A = 1:3 and 30 vol% Versatic 10. Finally, cobalt and manganese in the strip liquor of co-extraction are separated by selective precipitation method. Over 90% manganese is separated from cobalt under the conditions of pH = 0.5, 0.076 M KMnO4, 80 °C and 60 min.


Annotation of structural variants with reported allele frequencies and related metrics from multiple datasets using SVAFotate.
Identification of deleterious genetic variants using DNA sequencing data relies on increasingly detailed filtering strategies to isolate the small subset of variants that are more likely to underlie a disease phenotype. Datasets reflecting population allele frequencies of different types of variants serve as powerful filtering tools, especially in the context of rare disease analysis. While such population-scale allele frequency datasets now exist for structural variants (SVs), it remains a challenge to match SV calls between multiple datasets, thereby complicating estimates of a putative SV's population allele frequency. We introduce SVAFotate, a software tool that enables the annotation of SVs with variant allele frequency and related information from existing SV datasets. As a result, VCF files annotated by SVAFotate offer a variety of metrics to aid in the stratification of SVs as common or rare in the broader human population. Here we demonstrate the use of SVAFotate in the classification of SVs with regards to their population frequency and illustrate how SVAFotate's annotations can be used to filter and prioritize SVs. Lastly, we detail how best to utilize these SV annotations in the analysis of genetic variation in studies of rare disease.


Milbemycins, a new family of macrolide antibiotics. Fermentation, isolation and physico-chemical properties of milbemycins D, E, F, G, and H.
Strain Au-3, a mutant of Streptomyces hygroscopicus subsp. aureolacrimosus, obtained with ultraviolet irradiation, was a high-yield strain of milbemycins D, E, F, G and H. Fermentation studies on the strains were conducted in shake flasks and 30-liter jar fermentors. Isolation of the metabolites was performed by adsorption on resinous adsorbent followed by elution with aqueous MeOH and separated by silica gel column chromatography. Milbemycin D was obtained as colorless needles after recrystallization and milbemycins E, F, G and H were purified to homogeneity by column chromatography. Physico-chemical characterization revealed that milbemycins D, E, F, G and H were new antibiotics possessing the 16-membered macrocyclic lactone with a 6,6-membered spiroketal ring system.


Oxidation catalysis via visible-light water activation of a [Ru(bpy)3](2+) chromophore BSA-metallocorrole couple.
Light induced enantioselective oxidation of an organic molecule with water as the oxygen atom source is demonstrated in a system where chirality is induced by a protein, oxygen atom transfer by a manganese corrole, and photocatalysis by ruthenium complexes.


Resolution of apparent growth hormone-dependent growth failure during puberty: a case report.
A prepubertal boy with apparent growth hormone (GH)-dependent growth failure displayed a marked increase in growth velocity, normal GH responses to arginine/insulin infusion and a fourfold increase in spontaneous 24-hour GH secretion following the onset of normal puberty. The case supports earlier observations of a transient form of GH insufficiency in some short prepubertal children, but represents the first evidence that puberty restores spontaneous as well as stimulated GH secretion in such patients.


Possibility to Apply Strontium Aluminate to Produce Light-Emitting Plants: Efficiency and Safety.
Light-emitting plants (LEPs) provides light in areas without electricity. The phosphorescent compound was used as a lighting material for LEP development. However, using the phosphorescent compound for LEPs development required optimization and phytotoxicity evaluation. Strontium aluminate (SrAl2 O4 ) is a phosphorescent compound that can glow for a long time and is easily recharged by visible light. In this study, using SrAl2 O4 to develop LEPs was evaluated. Additionally, plant stress under SrAl2 O4 was investigated. Metabolomic analysis can explain the possible mechanism of plants' stress under SrAl2 O4 . After, injecting 3 mL of 5 % (w/v) SrAl2 O4 products 1, 2, and 3 into the stem of Ipomoea aquatica, the result showed that SrAl2 O4 products 2 and 3 caused oxidative stress. The metabolomic analysis also indicated that I. aquatica responded to SrAl2 O4 product 1 by increasing pipecolic acid and salicylic acid, while I. aquatica injected with SrAl2 O4 products 2 and 3 showed a decrease in salicylic acid around 0.005 and 0.061-fold, respectively, compared to control plants. and an excess accumulation of MDA around 10.00-12.00 μmol g-1 FW. A 15 % concentration of SrAl2 O4 can be used for LEPs development, enabling photoemission 18-fold for 50 min. SrAl2 O4 product 1 has the potential to be a material for LEPs.


The Memory Function of the B Cell Antigen Receptor.
Activated B lymphocytes preserve their antigen experience by differentiating into long-lived pools of antibody-secreting plasma cells or various types of memory B cells (MBCs). The former population constantly produces serum immunoglobulins with sufficient specificity and affinity to thwart infections with recurrent pathogens. By contrast, memory B cell populations retain their antigen receptors on the cell surface and hence need pathogen-induced differentiation steps before they can actively contribute to host defense. The terminal differentiation of MBCs into antibody-secreting plasma cells is hallmarked by the absence of the lag phase characteristic for primary antibody responses. Moreover, secondary antibody responses are predominantly driven by MBCs that bear an antigen receptor of the IgG class on their surface although IgM-positive memory populations exist as well. These fundamental principles of B cell memory were enigmatic for decades. Only recently, we have begun to understand the underlying mechanisms. This review summarizes our current understanding of how different subpopulations of MBCs are generated during primary immune responses and how their functional heterogeneity on antigen recall is controlled by different signaling capabilities of B cell antigen receptor (BCR) isotypes and by the nature of the antigen.


Flocculating, emulsification and metal sorption properties of a partial characterized novel exopolysaccharide produced by Rhizobium tropici SRA1 isolated from Psophocarpus tetragonolobus (L) D.C.
A novel exopolysaccharide (EPS) was produced by a bacterium which was isolated from Psophocarpus tetragonolobus (L) D.C. and identified as 99% Rhizobium tropici SRA1 by 16S rDNA sequencing. The flocculating performances along with emulsifying activity began simultaneously with the growth and the production of EPS and reached its utmost at 28 h. EPS was purified via chilled ethanol precipitation followed by dialysis and lyophilization. The existence of hydroxyl, methoxyl, and carboxylic functional groups were confirmed by Fourier transform infrared (FT-IR) spectrum. EPS was found to be compose of 82.44% neutral sugar and 15.93% uronic acid. The average molecular weight of the exopolysaccharide was estimated as ~ 1.8 × 105. Gas-liquid chromatography indicated the presence of glucose and galactose at a molar ratio of 3:1 in EPS. In the pH range of 3-5 with EPS dosage of 15 mg/l at 30 °C, cation-independent flocculation greater than 90% was observed. Emulsification indices (E24) of EPS were observed as 86.66%, 83.33%, 76.66%, and 73.33% with olive oil, kerosene, toluene, and n-hexane respectively. Biosorption of Cu K [45.69 wt%], Cu L [05.67 wt%], Co K [15.58 wt%], and Co L [11.72 wt%] by EPS was confirmed by energy-dispersive X-ray spectroscopy (EDS). This report on the flocculating, emulsifying, and metal sorption properties of EPS produced by R. tropici SRA1 is unique in the literature.


Nutritional approach to preterm infants on noninvasive ventilation: An update.
Nutrition and pulmonary function in very-low-birth-weight infants (VLBWIs) are strictly related. Preterm infants on noninvasive ventilation may have respiratory instability that can interfere with feeding tolerance. Moreover, feeding may impair pulmonary function. These infants have nutritional requirements different from nonventilated infants. The main challenge of the nutritional support in such patients is to guarantee adequate caloric intake while avoiding episodes of feeding intolerance. The aim of this study was to review the issues and strategies of enteral feeding of preterm infants on noninvasive ventilation.


GSK-J4: An H3K27 histone demethylase inhibitor, as a potential anti-cancer agent.
Aberrant epigenetic modifications are emerging as potent drivers of tumor initiation and progression. The deregulation of H3K27me3 marks has shown to play an important role in cancer progression in several cancers. The H3K27me3 mark is associated with gene silencing. The reversible nature of these epigenetic aberrations makes them an important target for treating cancer. GSK-J4 is a histone demethylase inhibitor that inhibits the JMJD3/UTX enzyme, which results in the upregulation of H3K27me3 levels. In this review, the anti-cancer properties of GSK-J4 have been summarized, the various molecular pathways targeted, in-vivo studies, and drug combination studies in different cancer models. GSK-J4 targeted pathways like apoptosis, cell cycle, invasion, migration, DNA damage repair, metabolism, oxidative stress, stemness, etc. GSK-J4 is a promising candidate alone and in combination with other conventional anti-cancer drugs against different cancer types.


Associations between the use of a real-time benefit tool and measures related to prescription obtainment found in order type subgroups.
The use of real-time benefit tool (RTBT) may help increase transparency of patients' out-of-pocket (OOP) costs, thereby reducing patients' OOP spend and increasing prescription obtainment. We have previously reported on the potential benefit of RTBT in electronic health records at a large health system. We explore the benefit of RTBT by subgroups of prescriptions (i.e., order types). In a retrospective cohort, we reviewed orders generated with and without RTBT use. We compared the 2 groups on key metrics related to prescription obtainment (fill rate, modification rate, cancellation rate, time to ready, time to sold, abandonment rate, and cancellation and transfer rate). Subgroup analysis included orders without over-the-counter (OTC) medications, orders without specialty medications, and orders without OTC and specialty medications. Fill rate, cancellation rate, time to ready, time to sold, abandonment rate, and cancellation and transfer rate were statistically significantly different between the RTBT and non-RTBT groups, favoring the RTBT group (all, P < 0.01). Differences in modification rates were not statistically significant between the 2 groups. RTBTs have the potential to increase prescription obtainment. A consistent difference in key outcome measures between the RTBT and the non-RTBT groups was apparent among prescription orders regardless of whether OTC and specialty medications were included in the analysis.


"A change in perspective": Exploring the experiences of adolescents with hereditary tumor predisposition.
Hereditary tumor predisposition syndromes (HTPSs) are being recognized more frequently in the etiology of pediatric cancer. Previous research indicates that disclosure of tumor susceptibility is a significant event in adolescents' lives. Insight into adolescents' adjustment to knowledge of their syndromes can guide healthcare delivery, particularly genetic counseling. This study explored the experiences of adolescents with hereditary tumor predisposition and their perceptions of living at risk. Seven adolescents, ages 14 to 17, representing six different childhood-onset HTPSs, were purposively sampled and interviewed using a study-specific semistructured interview guide. We explored the disclosure process, support systems, and the perceived benefits and harms of knowledge of hereditary tumor susceptibility. Interview transcripts were analyzed via interpretive description. Three major themes emerged from the data: (1) The benefits of knowledge outweigh the harms; (2) context surrounding genetic testing must be recognized; and (3) self-concept is influenced but not defined by tumor risk. We conclude that adolescents recognize the challenges associated with awareness of tumor predisposition but may also identify positive aspects in their experiences, reflecting a changed life perspective. Results of this exploratory study suggest strategies that can guide pretest and posttest genetic counseling of adolescents for HTPSs, facilitating the adaptive incorporation of genetic information into an adolescent's self-concept.


Complication of Middle Cerebral Artery Aneurysm Surgery: An M2 Tear at the Neck, Managed with a Salvage M2-to-M2 In Situ Bypass.
An unexpected rupture at the aneurysm neck, with or without adjacent arterial injury or compromise of distal branches during microsurgical clipping, can be a challenging surgical problem to resolve. In this presented case of a neurologically intact 65-year-old woman, elective clipping of an unruptured right middle cerebral artery bifurcation aneurysm was complicated by an unexpected M2 tear at the neck, involving the origin of the frontal M2. Attempts to seal the tear directly, using various techniques, failed; therefore, it was ultimately managed with sacrifice of the vessel and a salvage side-to-side M2-to-M2 in situ bypass. Six months after surgery, the patient demonstrated moderate disability but was able to ambulate with a cane.


The resistance to reinfection of tracheal organ cultures from chickens previously infected with avian infections bronchitis virus.
Lower titres of avian infectious bronchitis (AIB) virus were found following the infection of tracheal organ cultures prepared from chickens that had been given AIB virus intranasally six weeks previously than were found following the infection of organ cultures prepared from untreated or from passively-immune chickens. No infectious virus was found in the tracheal organ cultures at the time they were prepared.


Study of the accumulation of tributyltin and triphenyltin compounds and their main metabolites in the sea bass, Dicentrachus labrax, under laboratory conditions.
Accumulation of two triorganotins, tributyltin (TBT) and triphenyltin (TPhT), has been studied by exposing the sea bass, Dicentrachus labrax, to different concentrations of both compounds, under controlled laboratory conditions. D. labrax juvenile fish were acclimatized in a laboratory and isolated to four groups. One group was used as control (first group), while the other three were exposed, during 28 days, in tanks with seawater containing simultaneously 2.5 microg/l TBT and 2.5 microg/l (second group), 5 microg/l TBT and 5 microg/l (third group) and 15 microg/l TBT and 15 microg/l (fourth group), respectively. The higher exposure dose caused mortality to all animals after 48 h. In the other two groups, quantitative analysis of TBT and TPhT was carried out, weekly, on the target organs (muscle and liver). Also, the main metabolites of TBT, monobutyltin (MBT) and dibutyltin (DBT), and TPhT, monophenyltin (MPhT) and diphenyltin (DPhT) were monitored. Gas chromatography (GC) coupled to mass spectrometry in tandem (MS/MS) mode was used for their identification. The results of analysis of TBT and TPhT showed that D. labrax accumulated the compounds from the first week, although the levels depended on medium concentration exposure. Liver was found to accumulate higher concentrations of TBT and TPhT than muscle.


Boosting Ultra-Fast Charge Battery Performance: Filling Porous nanoLi4Ti5O12 Particles with 3D Network of N-doped Carbons.
Lithium titanium oxide (Li4Ti5O12)-based cells are a promising technology for ultra-fast charge-discharge and long life-cycle batteries. However, the surface reactivity of Li4Ti5O12 and lack of electronic conductivity still remains problematic. One of the approaches toward mitigating these problems is the use of carbon-coated particles. In this study, we report the development of an economical, eco-friendly, and scalable method of making a homogenous 3D network coating of N-doped carbons. Our method makes it possible, for the first time, to fill the pores of secondary particles with carbons; we reveal that it is possible to cover each primary nanoparticle. This unique approach permits the creation of lithium-ion batteries with outstanding performances during ultra-fast charging (4C and 10C), and demonstrates an excellent ability to inhibit the degradation of cells over time at 1C and 45 °C. Furthermore, using this method, we can eliminate the addition of conductive carbons during electrode preparation, and significantly increase the energy density (by weight) of the anode.


A combined behavioural economics- and simulation-based medical education to promote effectiveness among medical residents in coping with workplace violence in Northern China: a quasi-experimental study.
Workplace violence is internationally recognised as a major concern for the workforce, which entails serious consequences, and research shows that medical residents are more likely than other doctors to experience violence in the workplace. This study first examines the effectiveness of simulation-based medical education, and then simulation-based medical education combined with behavioural economics as interventions in medical residents' perception of, attitude toward, and self-efficacy in coping with violence in the workplace. A quasi-experimental design was used, 190 participants were randomised into three study groups to respectively test the effect of simulation-based medical education only and simulation-based medical education plus behavioural economics interventions, compared with a control group. Data were obtained from structured questionnaires, including (1) a perception of aggression scale, a management of aggression and violence attitude scale, a general self-efficacy scale, and (2) socio-demographic characteristics. The results show that the scores attained by simulation-based medical education (SBME) and simulation-based medical education combined with behavioural economics (SBME + BE) interventions for perception, attitude, and self-efficacy were significantly higher than those in the control group (p < .01). The SBME + BE group recorded a greater improvement in perception, which could be ascribed to the behavioural economics effect. Furthermore, the higher perception of workplace violence is correlated with single residents and those with more work experience, prior experiences of violence in the workplace, and training related to workplace violence. A higher positive correlation of workplace violence was recorded by female and widowed residents,and a higher level of self-efficacy related to violence in the workplace correlated with male, widowed,and senior (third-year) residents. This study contributes important evidence regarding changes in the perception, attitude, and self-efficacy of subjects following both the SBME + BE and SBME interventions among medical residents in coping with workplace violence, the biggest perception change having been recorded after the SBME + BE intervention, which can be explained by the inclusion of behavioural economics.


In situ growth of UiO-66-NH2 in wood-derived cellulose for iodine adsorption.
The capture of radioactive iodine is an inevitable requirement in nuclear industry for environmental protection. Metal-organic frameworks (MOFs) are a new generation of sorbents that have wide applications for iodine adsorption and recovery. Although the loading of MOFs on wood can avoid the drawbacks of the powder form of MOFs in implementation, the dense structure of wood results in the lower loading, even after delignification, which limits the adsorption capacity. Herein, a hierarchically porous UiO-66-NH2 @WCA composite was fabricated by in-situ synthesis of UiO-66-NH2 in wood-derived cellulose aerogel (WCA) that was further removed hemicellulose from delignified wood. UiO-66-NH2 @WCA exhibited a high loading (36 wt%) of UiO-66-NH2 crystals and a high adsorption capacity of 704 mg/g for iodine vapor and 248 mg/g for iodine aqueous solution. The adsorption behavior in iodine aqueous solution was well predicted by the Freundlich isotherm and pseudo-second-order kinetic model. The adsorption capacity of UiO-66-NH2 @WCA was highest in solution when the pH was 6, while the ionic strength had little effect. The hydroxyl groups on the WCA matrix had a charge transfer effect with iodine, providing additional sites for iodine capture. Furthermore, a packed column system was applied to demonstrate the excellent recyclability and potential for practical application.


Calprotectin (S100A8/S100A9) detects inflammatory activity in rheumatoid arthritis patients receiving tocilizumab therapy.
Assessing serological inflammation is difficult in tocilizumab (TCZ)-treated rheumatoid arthritis (RA) patients, as standard inflammation parameters, like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), are influenced by interleukin-6-receptor inhibition. Calprotectin in the serum, also named S100A8/S100A9, might be a more useful inflammation parameter in TCZ-treated patients. Sixty-nine RA patients taking TCZ were included. Serum-calprotectin levels were assessed, as well as ESR, CRP, need for a change in disease-modifying anti-rheumatic drugs due to RA activity (= active RA), and the RA clinical disease activity score (CDAI). Forty-five RA patients taking tumor-necrosis factor-inhibitors (TNFi) were investigated for the same parameters. TCZ-treated patients with active RA had higher calprotectin values than not active RA patients (4155.5 [inter quartile range 1865.3-6068.3] vs 1040.0 [676.0-1638.0] ng/ml, P < 0.001). A calprotectin cut-off value of 1916.5 ng/ml resulted in a sensitivity and specificity of 80.0 %, respectively, for the detection of RA disease activity. Calprotectin values correlated with CDAI-scores (r = 0.228; P = 0.011). ESR and CRP were less suitable to detect RA activity in TCZ-treated patients. Also TNFi-treated patients with active RA had higher calprotectin values compared to not active RA (5422.0 [3749.0-8150.8] vs 1845.0 [832.0-2569.0] ng/ml, P < 0.001). The calprotectin value with the best sensitivity and specificity for detecting RA activity was 3690.5 ng/ml among TNFi-treated patients. Calprotectin in the serum can be a useful inflammation parameter despite TCZ-treatment.


The combination of phacoemulsification surgery and intravitreal triamcinolone injection in patients with cataract and diabetic macular edema.
To assess the safety and efficiency of combined phacoemulsification (PHACO) surgery and intravitreal triamcinolone (IVTA) injection with or without macular grid laser photocoagulation in patients with cataract and diabetic macular edema. This prospective study included 41 eyes of 36 diabetic patients with cataract and coexisting clinically significant macular edema (CSME). After PHACO and IVTA injection eyes were divided into two groups: the laser and IVTA group (Group 1) and only IVTA group (Group 2). Preoperative and postoperative best corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were recorded. Paired sample t-test was used to compare data in the groups and C square test for qualitative variables. Postoperative BCVA was significantly higher than the initial BCVA during the follow-up period in both groups (p < 0.01). The BCVA 6 months after surgery was significantly higher in group 1 than in group 2 (p < 0.01). There was no statistically significant difference in IOP between two groups preoperatively and postoperatively during the follow-up period (p > 0.05). There was no statistically significant difference between both groups in mean CMT preoperatively and 2nd week, 2nd month and 3rd month after surgery (p > 0.05). The mean CMT 6 months after surgery was statistically significantly lower in group 1 than in group 2 (p < 0.01). PHACO surgery combined with IVTA injection improves BCVA and provides a decrease in CMT in diabetic patients with CSME. Additional macular grid laser photocoagulation after surgery helps to preserve this improvement in BCVA and decrease in CMT.


Cutaneous Lymphoproliferative Disorders: What's New in the Revised 4th Edition of the World Health Organization (WHO) Classification of Lymphoid Neoplasms.
Cutaneous lymphoproliferative disorders remain a challenging aspect of dermatopathology, in part due to the rarity of the entities and extreme variability in clinical outcomes. Although many of the entities remain unchanged, the approach to some of them has changed in the new 2016 classification scheme of the World Health Organization. Chief among these are Epstein-Barr virus-associated lymphoproliferative disorders such as Epstein-Barr virus-associated mucocutaneous ulcer and hydroa vacciniforme-like lymphoproliferative disorder, primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma, primary cutaneous acral CD8+ T-cell lymphoma, primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder, and breast implant-associated anaplastic large cell lymphoma. In addition, translocations and gene rearrangements such as those involving the 6p25.3 locus have started to inform diagnosis and classification of anaplastic large cell lymphoma and lymphomatoid papulosis. In this review, we will examine what is new in the diagnostic toolbox of cutaneous lymphoproliferative disorders.


Enhanced recovery after elective caesarean: a rapid review of clinical protocols, and an umbrella review of systematic reviews.
The rate of elective Caesarean Section (CS) is rising in many countries. Many obstetric units in the UK have either introduced or are planning to introduce enhanced recovery (ER) as a means of reducing length of stay for planned CS. However, to date there has been very little evidence produced regarding the necessary components of ER for the obstetric population. We conducted a rapid review of the composition of published ER pathways for elective CS and undertook an umbrella review of systematic reviews evaluating ER components and pathways in any surgical setting. Pathways were identified using MEDLINE, EMBASE and the National Guideline Clearing House, appraised using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool and their components tabulated. Systematic reviews were identified using the Cochrane Library and Database of Abstracts of Reviews of Effects (DARE) and appraised using The Grading of Recommendations Assessment, Development and Evaluation (GRADE). Two reviewers aggregated summaries of findings for Length of Stay (LoS). Five clinical protocols were identified, involving a total of 25 clinical components; 3/25 components were common to all five pathways (early oral intake, mobilization and removal of urinary catheter). AGREE II scores were generally low. Systematic reviews of single components found that minimally invasive Joel-Cohen surgical technique, early catheter removal and post-operative antibiotic prophylaxis reduced LoS after CS most significantly by around half to 1 and a half days. Ten meta-analyses of multi-component Enhanced Recovery after Surgery (ERAS) packages demonstrated reductions in LoS of between 1 and 4 days. The quality of evidence was mostly low or moderate. Further research is needed to develop, using formal methods, and evaluate pathways for enhanced recovery in elective CS. Appropriate quality improvement packages are needed to optimise their implementation.


Postoperative hyperthermia is associated with cognitive dysfunction after coronary artery bypass graft surgery.
Temperature is a well-known modulator of experimental cerebral injury. We hypothesized that hyperthermia would be associated with a worsened cognitive outcome after coronary artery bypass graft surgery (CABG). Three hundred consenting patients undergoing cardiopulmonary bypass for CABG had hourly postoperative temperatures recorded. The degree of postoperative hyperthermia was determined by using the maximum temperature within the first 24 hours as well as by calculating the area under the curve for temperatures >37 degrees C. Patients underwent a battery of cognitive testing both before surgery and 6 weeks after surgery. By use of factor analysis, 4 cognitive domains (scores) were identified, and the mean of the 4 scores was used to calculate the cognitive index (CI). Cognitive change was calculated as the 6-week CI minus the baseline CI. Multivariable linear regression (controlling for age, baseline cognitive function, and temperature during cardiopulmonary bypass) was used to compare postoperative hyperthermia with the postoperative cognitive change. The maximum temperature within the first 24 hours after CABG ranged from 37.2 degrees C to 39.3 degrees C. There was no relationship between area under the curve for temperatures >37 degrees C and cognitive dysfunction (P=0.45). However, the maximum postoperative temperature was associated with a greater amount of cognitive dysfunction at 6 weeks (P=0.05). This is the first report relating postoperative hyperthermia to cognitive dysfunction after cardiac surgery. Whether the hyperthermia caused the worsened outcome or whether processes that resulted in the worsened cognitive outcome also produced hyperthermia requires further investigation. In addition, interventions to avoid postoperative hyperthermia may be warranted to improve cerebral outcome after cardiac surgery.


Urine nitrification robustness for application in space: Effect of high salinity and the response to extreme free ammonia concentrations.
Urine nitrification is one of the possibilities for the future recovery of water and elements for soilless crop production in space systems. The start-up of artificial urine nitrification was conducted for over 85 days in a sequencing batch reactor (SBR). Two free ammonia (FA) incidents occurred, which gave the opportunity to demonstrate the impressive ability of nitrifiers to resist temporary inhibition by FA without long lasting adverse effects. The failures led to very high FA concentrations of 280 and 84 gN-NH3/m3, respectively. Sludge was exposed to FA for 19 and 27 h. It was possible to restore nitrification with simple remedy actions (dilution and pH restoration). No inhibitory effects on the nitrification rate were seen after implementation of the remedy actions and the nitrification rate increased considerably (up to 300% of the pre-failure value) due to decrease in salinity. After a few days of normal operation and salt concentration, the nitrification rate returned to the pre-failure values in both cases.


[The work of local teachers of the deaf at danish audiological institutes (author's transl)].
In Denmark, the audio-paedagogical care of hearing-impaired adults is examplarily organised. A considerable role, within this rehabilitation system, is played by the local teachers of the deaf who, in co-operation with the national audiological institutes, do most of the audio-paedagogical work.


HOSVD-Based 3D Active Appearance Model: Segmentation of Lung Fields in CT Images.
An Active Appearance Model (AAM) is a computer vision model which can be used to effectively segment lung fields in CT images. However, the fitting result is often inadequate when the lungs are affected by high-density pathologies. To overcome this problem, we propose a Higher-order Singular Value Decomposition (HOSVD)-based Three-dimensional (3D) AAM. An evaluation was performed on 310 diseased lungs form the Lung Image Database Consortium Image Collection. Other contemporary AAMs operate directly on patterns represented by vectors, i.e., before applying the AAM to a 3D lung volume,it has to be vectorized first into a vector pattern by some technique like concatenation. However, some implicit structural or local contextual information may be lost in this transformation. According to the nature of the 3D lung volume, HOSVD is introduced to represent and process the lung in tensor space. Our method can not only directly operate on the original 3D tensor patterns, but also efficiently reduce the computer memory usage. The evaluation resulted in an average Dice coefficient of 97.0 % ± 0.59 %, a mean absolute surface distance error of 1.0403 ± 0.5716 mm, a mean border positioning errors of 0.9187 ± 0.5381 pixel, and a Hausdorff Distance of 20.4064 ± 4.3855, respectively. Experimental results showed that our methods delivered significant and better segmentation results, compared with the three other model-based lung segmentation approaches, namely 3D Snake, 3D ASM and 3D AAM.


A physico-chemical approach to the study of the binding interaction between S-adenosyl-L-methionine and polyanions: binding constants and nature of the interaction with sodium poly(styrene sulfonate).
The interaction between S-adenosyl-L-methionine (AdoMet) and sodium poly(styrene sulfonate) NaPSS) was studied by means of ultrafiltration and ultraviolet absorption spectroscopy at several pH values and sodium sulfate concentrations. The results obtained are interpreted mainly in terms of electrostatic interactions and permit the evaluation of the binding constants under different experimental conditions. Furthermore, ultraviolet absorption spectroscopy data show a specific short-range interaction between the aromatic electronic system of AdoMet and the NaPSS aromatic ring. The results indicate that the binding strength is greatly affected by the AdoMet positive charge on the adenine ring. The other positive charges on both the sulfonic pole and the amino acidic group of AdoMet contribute only weakly to the binding to the polyanionic matrix, thus assuring some stability of AdoMet even at physiological pH.


Utilization of oil palm decanter cake for valuable laccase and manganese peroxidase enzyme production from a novel white-rot fungus, Pseudolagarobasidium sp. PP17-33.
Oil palm decanter cake (OPDC) in the current study was converted to valuable products as laccase and manganese peroxidase (MnP) by an undescribed strain of the white-rot fungus, Pseudolagarobasidium sp. PP17-33. The optimization to enhance the production of enzymes through solid-state fermentation was performed using Plackett-Burman design and response surface methodology. The highest observed laccase was 5.841 U/gds and observed MnP was 5.156 U/gds, which enhanced yield by 2.59-fold and 1.94-fold from the non-optimization. The optimized medium (mg/g of OPDC) consisted of 0.852 mg CuSO4·5H2O, 13.512 mg glucose, 2 mg yeast extract, 0.2 mg KH2PO4, 1.5 mg MgSO4·7H2O, 0.01 mg FeSO4·7H2O, 0.15 mg MnSO4·H2O, 0.01 mg ZnSO4·7H2O and 0.3 mg Tween 80 (pH 5.0) when incubated at 30 °C for 7 days. The most significant variables of laccase and MnP productions were CuSO4·5H2O and glucose concentrations. This study is the first to report on the production of ligninolytic enzymes from OPDC waste using white-rot fungi. In addition, five different white-rot fungi, Coriolopsis aspera, C. retropicta, Dentipellis parmastoi, Nigroporus vinosus and Tyromyces xuchilensis, are newly observed producers of ligninolytic enzymes in Thailand. The results obtained from this study are significant not only for agro-industrial waste management but also for value-added enzyme production.


Reliability of isometric and isokinetic trunk flexor strength using a functional electromechanical dynamometer.
To determine the absolute and relative reliability of functional trunk tests, using a functional electromechanical dynamometer to evaluate the isokinetic strength of trunk flexors and to determine the most reliable assessment condition, in order to compare the absolute and relative reliability of mean force and peak force of trunk flexors and to determine which isokinetic condition of evaluation is best related to the maximum isometric. Test-retest of thirty-seven physically active male student volunteers who performed the different protocols, isometric contraction and the combination of three velocities (V1 = 015 m s-1 , V2 = 0.30 m s-1, V3 = 0.45 m s-1) and two range of movement (R1 = 25% cm ; R2 = 50% cm) protocols. All protocols to evaluate trunk flexors showed an absolute reliability provided a stable repeatability for isometric and dynamic protocols with a coefficient of variation (CV) being below 10% and a high or very high relative reliability (0.69 < intraclass correlation coefficient [ICC] > 0.86). The more reliable strength manifestation (CV = 6.82%) to evaluate the concentric contraction of trunk flexors was mean force, with 0.15 m s-1 and short range of movement (V1R1) condition. The most reliable strength manifestation to evaluate the eccentric contraction of trunk flexors was peak force, with 0.15 m s-1 and a large range of movement (V1R2; CV = 5.07%), and the most reliable way to evaluate isometric trunk flexors was by peak force (CV = 7.72%). The mean force of eccentric trunk flexor strength with 0.45 m s-1 and short range of movement (V3R1) condition (r = 0.73) was best related to the maximum isometric contraction. Functional electromechanical dynamometry is a reliable evaluation system for assessment of trunk flexor strength.


Phase II study of oral capecitabine in patients with hormone-refractory prostate cancer.
Currently available treatment for hormone refractory prostate cancer is limited in efficacy and associated with significant toxicity. This phase II study was performed to assess the efficacy of the oral fluoropyrimidine capecitabine in advanced prostate cancer. Patients who had a rising prostate-specific antigen (PSA) despite androgen withdrawal, but who remained free from cancer-related symptoms. In total, 14 patients received oral capecitabine 1250 mg/m2 twice daily for two weeks of a three-week cycle. Tumour response was assessed using serum PSA measurement at 3-weekly intervals and, where present, imaging of soft tissue metastases. One of 14 patients experienced a partial response as assessed by both PSA and imaging of liver metastases. In seven other patients (50%), treatment decreased the rate of PSA rise. The duration of PSA stabilisation was generally short, but in 5/14 patients (36%) was sustained beyond 18 weeks, and in one patient to 24 weeks. Toxicity was significant but manageable, the most common adverse events being nausea, mucositis and hand-foot syndrome, each occurring in 50% of patients. Other common side effects were diarrhoea and lymphopenia. All toxicities were grade 1 or 2, except for grade 3 hand-foot syndrome occurring in one patient, and no dose reduction was required because of toxicity. Capecitabine has limited activity as a single agent in prostate cancer, but appears to modulate tumour biology. Considering the added convenience of oral administration, these results support further evaluation of combinations containing capecitabine in hormone-refractory prostate cancer.


Pathogenic Homozygous Mutations in the DBT Gene (c.1174A>C) Result in Maple Syrup Urine Disease in a rs12021720 Carrier.
Maple syrup urine disease (MSUD; OMIM #248600) is an autosomal recessive metabolic disorder in the catabolism of branched-chain amino acids (leucine, isoleucine, and valine) and may be lethal if untreated in affected newborns. Single-nucleotide polymorphism haplotyping and Sanger sequencing of BCKDHA, BCKDHB, and DBT genes were performed in a cohort of 10 MSUD patients. We identified a 16.6 Mb homozygous region harboring the DBT gene in an Iranian girl presenting with MSUD. Sanger sequencing revealed a pathogenic homozygous variant (NM_001918.3: c.1174A > C) in the DBT gene. We further found a controversial variant (rs12021720: c.1150 A > G) in the DBT gene. This substitution (p.Ser384Gly) is highly debated in literature. Bioinformatics and cosegregation analysis, along with identifying the real pathogenic variants (c.1174 A > C), lead to terminate these various interpretations of c.1150 A > G variant. Our study introduced c.1150 A > G as a polymorphic variant, which is informative for variant databases and also helpful in molecular diagnosis.


Increase in gonorrhoea among very young adolescents, Catalonia, Spain, January 2012 to June 2013.
Between January 2012 and June 2013, 27 sexually transmitted infections were reported in adolescents aged 13-15 years in Catalonia, Spain. In the first half of 2013, there were nine cases of gonorrhoea, while in the same period of 2012, there was one. In June 2013, two gonorrhoea cases aged 13-14 years, linked to a common source through a social network, were reported. The public health response should be adapted to this vulnerable population.


Patients' perceptions of isotretinoin, depression and suicide--a qualitative study.
Isotretinoin is an effective acne medication. The evidence for it causing depression and suicide, although widely publicised, remains uncertain. Twenty-six semi-structured interviews with patients with acne were coded and subjected to thematic analysis. Isotretinoin was perceived to be effective but dangerous. The most well known adverse effects were depression and suicide. The overemphasis of serious psychological adverse events in patients might discourage the use of isotretinoin by those who might benefit from it.


Regional variation in the structure and function of parrotfishes on Arabian reefs.
Parrotfishes (f. Labridae) are a unique and ubiquitous group of herbivorous reef fishes. We compared the distribution and ecosystem function (grazing and erosion) of parrotfishes across 75 reefs in Arabia. Our results revealed marked regional differences in the abundance, and taxonomic and functional composition of parrotfishes between the Red Sea, Arabian Sea, and Arabian Gulf. High densities and diversity of parrotfishes, and high rates of grazing (210% year(-1)) and erosion (1.57 kgm(-2)year(-1)) characterised Red Sea reefs. Despite Arabian Sea and Red Sea reefs having broadly comparable abundances of parrotfishes, estimates of grazing (150% year(-1)) and erosion (0.43 kgm(-2)year(-1)) were markedly lower in the Arabian Sea. Parrotfishes were extremely rare within the southern Arabian Gulf, and as such rates of grazing and erosion were negligible. This regional variation in abundance and functional composition of parrotfishes appears to be related to local environmental conditions.


Immune-mediated tubule atrophy promotes acute kidney injury to chronic kidney disease transition.
Incomplete repair after acute kidney injury can lead to development of chronic kidney disease. To define the mechanism of this response, we compared mice subjected to identical unilateral ischemia-reperfusion kidney injury with either contralateral nephrectomy (where tubule repair predominates) or contralateral kidney intact (where tubule atrophy predominates). By day 14, the kidneys undergoing atrophy had more macrophages with higher expression of chemokines, correlating with a second wave of proinflammatory neutrophil and T cell recruitment accompanied by increased expression of tubular injury genes and a decreased proportion of differentiated tubules. Depletion of neutrophils and T cells after day 5 reduced tubular cell loss and associated kidney atrophy. In kidney biopsies from patients with acute kidney injury, T cell and neutrophil numbers negatively correlated with recovery of estimated glomerular filtration rate. Together, our findings demonstrate that macrophage persistence after injury promotes a T cell- and neutrophil-mediated proinflammatory milieu and progressive tubule damage.


A dose-equivalent comparison of the effects of continuous subcutaneous glucagon-like peptide 2 (GLP-2) infusions versus meal related GLP-2 injections in the treatment of short bowel syndrome (SBS) patients.
Glucagon-like peptide 2 (GLP-2), secreted endogenously from L-cells in the distal bowel in relation to meals, modulates intestinal absorption by adjusting gastric emptying and secretion and intestinal growth. Short bowel syndrome (SBS) patients with distal intestinal resections have attenuated endogenous GLP-2 secretion, which may contribute to their rapid gastric emptying, gastric hypersecretion and poor intestinal adaptation, whereas SBS patients with preserved terminal ileum and colon, who have a constantly elevated GLP-2 secretion, seem to do better in these respects. This study compared effects of continuous, subcutaneous (s.c.), exogenous GLP-2 infusion (CONT-GLP-2) versus three daily s.c. GLP-2 injections (TID-GLP-2) on intestinal absorption in SBS patients. Eight SBS patients (5 F, 3 M; 60±7 years; remnant small bowel 111±62 cm; 1 with 50% colon) were studied. In an open-label, sequential study, the 72-hour baseline admission was followed by two dose-equivalent, 21-day, dosing regimens; CONT-GLP-2, providing 1.0mg/day by a MiniMed insulin pump and TID-GLP-2, providing 0.33 mg injections in relation to three meals, separated by a washout period of at least 3 weeks. During admissions, the intestinal absorption was evaluated by analysing a double portion of the diet, faecal and urinary excretions. Post-absorptive plasma citrulline, reflecting enterocyte mass, was measured by HPLC. Compared to baseline, both GLP-2 dosing regimens reduced diarrhoea (CONT-GLP-2: 749±815 g/d and TID-GLP-2: 877±1004 g/d, p=0.01) and increased wet weight absorption (CONT-GLP-2: 19±19% and TID-GLP-2: 25±21%, p=0.003). Significant increases in plasma citrulline (CONT-GLP-2: 7.5±7 μmol/L and TID-GLP-2, 12.7±8 μmol/L; p=0.001) suggesting intestinotrophic effects in relation to GLP-2 treatment, are followed by increases in relative absorption of energy, carbohydrate and fat. No significant difference was seen on any of the absorptive parameters measured between the two dosing regimens. Both GLP-2 regimens significantly reduced diarrhoea in SBS patients, but a significant difference between continuous GLP-2 administration and TID injections could not be detected in a study of this size.


[Ocular pharmacokinetics of pilocarpine micron emulsion in rabbits].
To compare the pharmacokinetics of pilocarpine micron emulsion with generic pilocarpine solution in the aqueous humor. 60 albino rabbits were used and were divided into 20 groups, each consisting of 3 animals. 10 groups received 2% generic pilocarpine 50 microl as controls; 10 groups received 50 microl of 2% pilocarpine micron emulsion in the conjunctival sac. The aqueous humor was withdrawn at 5, 10, 30, 40, 60, 90, 120, 180, 240 and 360 min. after instillation. The drug was extracted from aqueous humor with dichloromethane. The drug was analyzed by reversed phase high pressure liquid chromatography (HPLC). Pilocarpine micron emulsion therapy gave higher aqueous humor concentration of the drug than drops at all time periods tested except 5 min. time point (P = 0.0003 - 0.042). The area under curve of micron emulsion was 3 times as much as that of drops. There was a two-fold increase in ocular bioavailability of pilocarpine due to the therapy with micron emulsion. Measurable amounts of drug following 2% micron emulsion were still observed at 360 min. while drug levels at 180 min. following 2% drop therapy were nil. Our study results demonstrated significantly increase in ocular bioavailability of pilocarpine due to the therapy with micron emulsion. Our finding indicates that a novel topical preparation of pilocarpine incorporated in micron emulsion might serve as a long acting antiglaucoma agent, and less frequent applications are necessary with it than with conventional drops.


Role of 3D printing in the management of complex acetabular fractures: a comparative study.
The aim of this study is to assess the role of 3D printing of actual size pelvis in the management and outcome of acetabular fractures. Retrospective study with inclusion of acetabular fractures which were divided into two groups (traditional and 3D printing) was done over a 1 year period. The indices for comparison of both groups in this study were (a) operative time (from skin incision to suture), (b) intraoperative blood loss (noted from the anaesthetist notes), (c) times of intraoperative fluoroscopy, (d) postoperative complications, (e) quality of fracture reduction (good = < 2 mm displacement, fair = > 2 mm displacement) and (f) Harris hip score at final follow-up. 27 cases (traditional group = 15, 3D printing group = 12) meeting the study criteria were included in the study with a mean follow-up of 26.3 ± 11.2 months. There was a significant difference in the operative time, intraoperative blood loss and number of intraoperative fluoroscopy images. The mean operative time was shorter in the 3D printing group by 62 min. No difference was noted in the quality of reduction in either of the groups (p > 0.05). 3D imaging and printing helps in better understanding of the anatomy of acetabular fractures. It leads to reduced operative time, blood loss as well as exposure to radiation intraoperatively. There is no difference in functional outcome at final follow-up between 3D printing and traditional groups.


Can infection with Trypanosoma cruzi modify the toxicological response of Triatoma infestans susceptible and resistant to deltamethrin?
Chemical control plays a central role in interrupting the vector transmission of Chagas disease. In recent years, high levels of resistance to pyrethroids have been detected in the main vector Triatoma infestans, which were associated with less effectiveness in chemical control campaigns in different regions of Argentina and Bolivia. The presence of the parasite within its vector can modify a wide range of insect physiological processes, including toxicological susceptibility and the expression of resistance to insecticides. This study examined for the first time the possible effects of Trypanosoma cruzi infection on susceptibility and resistance to deltamethrin in T. infestans. Using WHO protocol resistance monitoring assays, we exposed resistant and susceptible strains of T. infestans, uninfected and infected with T. cruzi to different concentrations of deltamethrin in fourth-instar nymphs at days 10-20 post-emergence and monitored survival at 24, 48, and 72 h. Our findings suggest that the infection affected the toxicological susceptibility of the susceptible strain, showing higher mortality than uninfected susceptible insects when exposed to both deltamethrin and acetone. On the other hand, the infection did not affect the toxicological susceptibility of the resistant strain, infected and uninfected showed similar toxic responses and the resistance ratios was not modified. This is the first report of the effect of T. cruzi on the toxicological susceptibility of T. infestans and triatomines in general and, to our knowledge, one of the few on the effect of a parasite on the insecticide susceptibility of its insect vector.


Short term heart rate variability in healthy neonates: normative data and physiological observations.
The measurement of heart rate variability (HRV) reveals information on the functional state of the autonomic nervous system (ANS). Moreover, several diseases are known to be accompanied by a reduction in HRV. Currently, there are no data on HRV within larger samples of healthy neonates. This study was initiated to establish normative data of HRV parameters and to assess physiological observations in healthy newborn infants. We performed 10 min recordings of HRV in 80 healthy neonates. We computed time domain parameters. Furthermore power spectrum analysis was calculated by Fourier Transformation in 3 frequency bands. The total power as well as the peak frequencies was estimated for each band. The normative data of each HRV parameter for healthy newborns are presented as mean, standard deviation and the 5th and 95th percentiles. Increasing postnatal age is accompanied by a significant (p<0.05) elevation of HRV parameters. Baroreceptor loop fluctuations were delayed from 0.1 Hz (adults) to 0.07 Hz in healthy newborns. A respiratory peak according to respiratory sinus arrhythmia (RSA) as it is common in adults was not detectable. Normative data of HRV allows the interpretation of clinical data in neonatal diseases affecting the ANS. Moreover, we observed physiological deviations in healthy newborns in comparison to adults.


Improved content aware scene retargeting for retinitis pigmentosa patients.
In this paper we present a novel scene retargeting technique to reduce the visual scene while maintaining the size of the key features. The algorithm is scalable to implementation onto portable devices, and thus, has potential for augmented reality systems to provide visual support for those with tunnel vision. We therefore test the efficacy of our algorithm on shrinking the visual scene into the remaining field of view for those patients. Simple spatial compression of visual scenes makes objects appear further away. We have therefore developed an algorithm which removes low importance information, maintaining the size of the significant features. Previous approaches in this field have included seam carving, which removes low importance seams from the scene, and shrinkability which dynamically shrinks the scene according to a generated importance map. The former method causes significant artifacts and the latter is inefficient. In this work we have developed a new algorithm, combining the best aspects of both these two previous methods. In particular, our approach is to generate a shrinkability importance map using as seam based approach. We then use it to dynamically shrink the scene in similar fashion to the shrinkability method. Importantly, we have implemented it so that it can be used in real time without prior knowledge of future frames. We have evaluated and compared our algorithm to the seam carving and image shrinkability approaches from a content preservation perspective and a compression quality perspective. Also our technique has been evaluated and tested on a trial included 20 participants with simulated tunnel vision. Results show the robustness of our method at reducing scenes up to 50% with minimal distortion. We also demonstrate efficacy in its use for those with simulated tunnel vision of 22 degrees of field of view or less. Our approach allows us to perform content aware video resizing in real time using only information from previous frames to avoid jitter. Also our method has a great benefit over the ordinary resizing method and even over other image retargeting methods. We show that the benefit derived from this algorithm is significant to patients with fields of view 20° or less.