Normalization of binocular VERs after early onset visual deprivation in man.
Visually evoked responses (VERs) were elicited by a reversing checkerboard target from a patient who suffered early onset bilateral deprivation of form vision as a result of a high refractive error, large amplitude strabismus, and congenital nystagmus. Monocular and binocular steady-state VERs were abnormal in amplitude and wave form even when a correction for the patient's large refractive error (compound hyperopic astigmatism) was worn. Although monocular VERs could not be normalized, a normal wave form and amplitude were restored to the binocular VER by the addition of horizontal prisms to the patient's ophthalmic prescription. The initially degraded binocular VER gradually acquired a normal morphology and amplitude as the magnitude of compensating base-out prisms in the patient's habitual ophthalmic prescription was systematically increased. The relationship between the binocular VER amplitude and the correcting prisms derived by the method described in this paper was subsequently used to arrive at a practical clinical solution for the patient's unusual and debilitating visual symptoms. This electrophysiological evaluation of binocular function at the cortical level proved to be a very useful diagnostic procedure with prognostic value; standard clinic procedures were ineffective in elaborating the patient's sensory and oculomotor disorders. The theoretical and practical implications of managing patients with a history of early onset visual deprivation are discussed.


Microvolt QRS Alternans Without Microvolt T-Wave Alternans in Human Cardiomyopathy: A Novel Risk Marker of Late Ventricular Arrhythmias.
Background Action potential alternans can induce ventricular tachyarrhythmias and manifest on the surface ECG as T-wave alternans (TWA) and QRS alternans (QRSA). We sought to evaluate microvolt QRSA in cardiomyopathy patients in relation to TWA and ventricular tachyarrhythmia outcomes. Methods and Results Prospectively enrolled cardiomyopathy patients (n=100) with prophylactic defibrillators had 12-lead ECGs recorded during ventricular pacing from 100 to 120 beats/min. QRSA and TWA were quantified in moving 128-beat segments using the spectral method. Segments were categorized as QRSA positive (QRSA+) and/or TWA positive (TWA+) based on ≥2 precordial leads having alternans magnitude >0 and signal:noise >3. Patients were similarly categorized based on having ≥3 consecutive segments with alternans. TWA+ and QRSA+ occurred together in 31% of patients and alone in 18% and 14% of patients, respectively. Although TWA magnitude (1.4±0.4 versus 4.7±1.0 µV, P<0.01) and proportion of TWA+ studies (16% versus 46%, P<0.01) increased with rate, QRSA did not change. QRS duration was longer in QRSA+ than QRSA-negative patients (138±23 versus 113±26 ms, P<0.01). At 3.5 years follow-up, appropriate defibrillator therapy or sustained ventricular tachyarrhythmia was greater in QRSA+ than QRSA-negative patients (30% versus 8%, P=0.02) but similar in TWA+ and TWA-negative patients. Among QRSA+ patients, the event rate was greater in those without TWA (62% versus 21%, P=0.02). Multivariable Cox analysis revealed QRSA+ (hazard ratio [HR], 4.6; 95% CI, 1.5-14; P=0.009) and QRS duration >120 ms (HR, 4.1; 95% CI, 1.3-12; P=0.014) to predict events. Conclusions Microvolt QRSA is novel phenomenon in cardiomyopathy patients that can exist without TWA and is associated with QRS prolongation. QRSA increases the risk of ventricular tachyarrhythmia 4-fold, which merits further study as a risk stratifier.


A retrospective study on imported malaria in Jordan. 2. Malaria among non-military Jordanians.
Cases of imported malaria among civilian Jordanians returning from Asian and African countries from 1991-2011 are documented. A total of 511 cases of imported malaria were diagnosed among civilian Jordanians travelling abroad. Majority of cases were reported among adults over 21 year old accounting for or 87,67% of the total number of cases. Eighteen different categories of occupation were identified, where as students studying abroad showed the highest infection rate (33.2%), especially those returning from India (n=70). Infection among males was as high as 91.78%, compared to 8.22% in females. Females were mostly housewives accompanying their spouses. Cases were reported from 34 Asian and African countries.Most cases were reported among Jordanians returning from Pakistan (23.68%), Yemen (18.6%), India (18.4%) and Sudan (5.1%). The majority of infections were due to Plasmodium vivax (n=370, 72.4%), followed by Plasmodium falciparum (n=138, 27%). Only one case of Plasmodium malariae was observed. Few cases (n=3, 0.65%) of mixed infection with P. vivax and P. falciparum were reported. Sudan was the main source of P. falciparum (25.4%) followed by Yemen (20.3%), while Pakistan was the main source of P. vivax (28.9%) followed by India (22.7%). Most mixed infection cases were acquired in Sudan (66.7%).


An ultrasonic through-transmission technique for monitoring the setting of injectable calcium phosphate cement.
An ultrasound through-transmission method to monitor the setting process of injectable calcium phosphate bone cements in body fluids is presented. This method can be used to determine the acoustic properties of the bone cement as it sets, which are linked to its material properties and provide some information about changes occurring within the cement. The development of the methodology of ultrasonic testing and execution of velocity measurements of the longitudinal and transverse waves using the through-transmission method made it possible to determine the material constants of samples during the setting and hardening process of an injectable cement paste in physiological fluids (i.e. the Young's modulus (E), the Poisson ratio (ν) and the shear modulus (G)), and to determine the degree of anisotropy of wave velocity in the samples. A strong advantage of the proposed method is that it is non-destructive, and the same sample can be used to monitor the whole process of the cement setting. The testing was performed on premixed and injectable calcium phosphate (CPC)/chitosan blend, where glycerol was used as a liquid phase. Comparisons between ultrasonic velocity and empirical tests such as compressive strength, porosity measurement, FTIR, SEM and XRD analysis at different days of immersion in Ringer's solutions showed that the ultrasonic velocity can be very useful to provide in situ information about changes occurring within the cement.


mitoSomatic: a tool for accurate identification of mitochondrial DNA somatic mutations without paired controls.
Mitochondrial DNA (mtDNA) somatic mutations play important roles in the initiation and progression of cancer. Although next-generation sequencing (NGS) of paired tumor and control samples has become a common practice to identify tumor-specific mtDNA mutations, the unique nature of mtDNA and NGS-associated sequencing bias could cause false-positive/-negative somatic mutation calling. Additionally, there are clinical scenarios where matched control tissues are unavailable for comparison. Therefore, a novel approach for accurately identifying somatic mtDNA variants is greatly needed, particularly in the absence of matched controls. In this study, the ground truth mtDNA variants orthogonally validated by triple-paired tumor, adjacent nontumor, and blood samples were used to develop mitoSomatic, a random forest-based machine learning tool. We demonstrated that mitoSomatic achieved area under the curve (AUC) values over 0.99 for identifying somatic mtDNA variants without paired control in three tumor types. In addition, mitoSomatic was also applicable in nontumor tissues such as adjacent nontumor and blood samples, suggesting the flexibility of mitoSomatic's classification capability. Furthermore, analysis of triple-paired samples identified a small group of variants with uncertain somatic/germline origin, whereas application of mitoSomatic significantly facilitated the prediction of their possible source. Finally, a control-free evaluation of the public pan-cancer NGS dataset with mitoSomatic revealed a substantial number of variants that were probably misclassified by conventional tumor-control comparison, further emphasizing the usefulness of mitoSomatic in application. Taken together, our study demonstrates that mitoSomatic is valuable for accurately identifying somatic mtDNA variants in mtDNA NGS data without paired controls, applicable for both tumor and nontumor tissues.


Bispecific Monoclonal Antibodies in Multiple Myeloma: Data from ASH 2022: A Podcast.
The introduction of novel immunotherapies has transformed the treatment landscape in multiple myeloma (MM). The addition of these agents has significantly improved patient outcomes; however, MM remains largely incurable, with heavily pretreated patients suffering from shorter survival times. To address this unmet need, the focus has shifted toward novel mode of action therapies, such as bispecific antibodies (BsAb), which simultaneously bind to immune effector cells and myeloma cells. Currently, there are several T cell-redirecting BsAb being developed that target BCMA, GPRC5D, and FcRH5. These BsAb show impressive clinical activity for the relapsed/refractory population targeted and will likely become an essential part of MM treatment protocols in the future. In this podcast, the authors summarize and highlight some of the T cell-redirecting BsAb currently in development for the treatment of relapsed/refractory MM with a focus on the data reported at the oral session for BsAb at the American Society of Hematology's 2022 meeting from clinical phase 1 and 2 studies. The six presentations reported the latest safety and efficacy data for the BsAb: talquetamab, elranatamab, teclistamab, forimtamig, and alnuctamab.


Survival After Lobectomy vs. Sublobar Resection for Stage IA Large-Cell Neuroendocrine Carcinoma of the Lung: A Population-Based Study.
Due to the low incidence of pulmonary large cell neuroendocrine carcinoma (LCNEC), the survival analysis for comparing lobectomy and sublobar resection (SLR) for stage IA LCNEC remains scarce. Patients diagnosed with pathological stage IA LCNEC between 1998 and 2016 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The oncological outcomes were cancer-specific survival (CSS) and overall survival (OS). Kaplan-Meier analysis and Cox multivariate analysis were used to identify the independent prognostic factors for OS and CSS. Furthermore, propensity score matching (PSM) was performed between SLR and lobectomy to adjust the confounding factors. A total of 308 patients with stage IA LCNEC met the inclusion criteria: 229 patients (74.4%) received lobectomy and 79 patients (25.6%) received SLR. Patients who underwent SLR were older (P < 0.001), had smaller tumor size (P = 0.010), and less lymph nodes dissection (P < 0.001). The 5-year CSS and OS rates were 56.5 and 42.9% for SLR, and 67.8 and 55.7% for lobectomy, respectively (P = 0.037 and 0.019, respectively). However, multivariate analysis did not identify any differences between the SLR group and lobectomy group in CSS (P = 0.135) and OS (P = 0.285); and the PSM also supported these results. In addition, the age at diagnosis and laterality of tumor were identified as significant predictors for CSS and OS, whereas the number of lymph nodes dissection was a significant predictor for CSS. Although SLR is not inferior to lobectomy in terms of oncological outcomes for patients with stage IA LCNEC, more lymph nodes can be dissected or sampled during lobectomy. Lobectomy should still be considered as a standard procedure for patients with early-stage LCNEC who are able to withstand lobectomy.


Point-of-care ultrasonography: Downstream utilization of and diagnostic (dis)agreements with additional cross-sectional imaging.
Point-of-care ultrasonography (POCUS), defined as ultrasonography (US) performed and interpreted by the clinician, is increasingly performed. This study aimed to determine the frequency of and reasons why clinicians of the emergency department request cross-sectional imaging after POCUS and how often radiologists experience diagnostic (dis)agreements. This retrospective study included a consecutive series of 503 patients who underwent POCUS at the emergency department of a tertiary care center. Downstream cross-sectional imaging was performed in 77 (15.3%) of 503 POCUS examinations. Reasons for additional cross-sectional imaging were, in order of decreasing frequency: suspicion of pathology that was not assessed with POCUS in 46 cases (59.7%), confirmation of conclusive POCUS findings in 21 cases (27.3%), inconclusive POCUS (i.e. insufficient visualization of the structure of interest to make a diagnosis, despite an attempt of the POCUS operator) in 7 cases (9.6%), a combination of inconclusive POCUS and suspicion of pathology that was not assessed with POCUS in 2 cases (2.6%), and clarification of incidental findings on POCUS in 1 case (1.3%). In the 21 cases that underwent additional cross-sectional imaging to confirm POCUS findings, POCUS agreed with additional cross-sectional imaging in 19 (90.5%) and disagreed in 2 (9.5%) cases. The use of POCUS appears to not cause any considerable downstream overutilization of cross-sectional imaging. In addition, radiologists experience few diagnostic disagreements when asked to perform second opinion cross-sectional imaging. Future studies with more homogeneous datasets in terms of POCUS operators are required to confirm our results.


A model for predicting the site of paraxial retinal lesions secondary to "coaxial" operating microscope illumination systems.
We measured a 15 +/- 2-mm displacement of the illuminating element of the coaxial operating microscope from the true optical center of the microscope. We further calculated the displacement of the image of the illuminating element of the operating microscope on the retina of the simplified schematic eye and found that the "coaxial" operating microscope would focus the light between 1.3 and 1.8 mm superior to the fovea of the eye, depending on the theoretical refractive status of the simplified eye. Actual measurements on a simulated retina (35-mm camera) confirmed the calculated displacements. The deviation varied with eye tilt and microscope position. We also found that the maneuvers commonly used by anterior segment surgeons of tilting the microscope and rotating the eye downward tended to displace the image of the illuminating element closer to the fovea, increasing the chance for symptomatic retinal damage. A combination of such maneuvers may reduce the potential for clinically significant retinal phototoxicity by displacing the light further inferior to the fovea.


Foraminoplastic transfacet epidural endoscopic approach for removal of intraforaminal disc herniation at the L5-S1 level.
Transforaminal endoscopic disc removal in the L5-S1 motion segment of the lumbar spine creates a technical challenge due to anatomical reasons and individual variability. The majority of surgeons prefer a posterior classical or minimally invasive approach. There is only one foraminoplastic modification of the technique in the literature so far. In this paper we present a new technique with a foraminoplastic transfacet approach that may be suitable in older patients with advanced degenerative disease of the spine.


The epidemiology and management of adult poisonings admitted to the short-stay ward of a large Scottish emergency department.
The emergency department of Aberdeen Royal Infirmary receives around 68,000 new adult admissions annually. All poisoning cases are admitted to a 14-bedded short-stay ward, except those admitted to intensive care or immediately discharged. This study aimed to analyse epidemiological trends and management of short-stay ward admissions for poisonings. Adult (>13 years) poisoning presentations admitted to the emergency department short-stay ward of Aberdeen Royal Infirmary from 1 January-31 December 2009 were retrospectively reviewed using patient discharge summaries. During 2009, there were 1062 poisoning cases, of which repeat episodes were responsible for 15%. The mean age of presentation was 33.9 years (SD 14.4) and there was a female preponderance (62%). Almost half of poisonings were polypharmacy, alcohol was involved in 40% of cases and overdoses most commonly involved paracetamol (43%). Management involved basic observations only (66%), N-acetylcysteine (24%), naloxone (4%) and activated charcoal (1%). Liaison psychiatry reviewed 84% presentations and admitted 9% to the psychiatric unit. The short-stay ward is important for acute management of poisonings and the data gained from this study should help to direct patient services appropriately.


Diffuse alveolar hemorrhage in a patient with ANCA-associated vasculitis after thyroidectomy: A case report.
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is an autoimmune disease that mainly affects the lungs and kidneys. Limited reports of perioperative management of such patients were primarily concerned with airway stenosis. Here, we report a patient with AAV who developed diffuse alveolar hemorrhage (DAH) early after radical thyroidectomy. A 57-year-old female developed wheezing and dyspnea approximately 30 minutes after radical thyroidectomy, with hemoptysis occurring the following day. The patient had a history of AAV and DAH and was maintained with prednisone. A diagnosis of DAH was made on the basis of the history of AAV, dyspnea, hemoptysis, and chest computed tomography scan results that showed diffuse high-density shadows in the lungs. The patient was administered high-dose glucocorticoids and cyclophosphamide immunosuppressive therapy. Non-invasive ventilation was needed for 2 days postoperatively due to dysfunction of oxygenation. After high-dose glucocorticoids and cyclophosphamide immunosuppressive therapy, DAH improved approximately 2 weeks after the surgery, during which time kidney function was not significantly impaired. Patients with AAV may develop DAH in the early postoperative period and this may be confused with surgical complications and general anesthetic residues. Therefore, it needs to be identified in an appropriate timeframe.


Topical anesthetics for dermatologic procedures: a review.
Practitioners are increasingly using topical anesthetics to decrease the pain associated with superficial dermatologic, aesthetic, and laser procedures. Numerous lidocaine-containing products are available, but comprehensive reviews are lacking regarding their relative safety profiles and appropriate dermatologic uses. A literature review of currently available topical anesthetics, their safety profiles, and dermatologic uses was conducted. Factors that should be considered to reduce the risk of side effects associated with the use of topical anesthetics include the amount of product used, body location, size of the surface area, and duration of product application. Many case reports document adverse outcomes associated with the use of compounded products that the Food and Drug Administration has not approved that have inappropriately high anesthetic concentrations and from the use of topical anesthetics on excessively large skin surface areas during laser treatments. Lidocaine-containing products play an integral role in cutaneous anesthesia by providing patient comfort with minimal side effects. Careful attention must be paid to the particular anatomic location, the total surface area covered, and the duration of anesthetic skin contact.


Comparison of the ability of two continuous cardiac output monitors to detect stroke volume index: Estimated continuous cardiac output estimated by modified pulse wave transit time and measured by an arterial pulse contour-based cardiac output device.
Estimated continuous cardiac output (esCCO), a non-invasive technique for continuously measuring cardiac output (CO), is based on modified pulse wave transit time, which is determined by pulse oximetry and electrocardiography. We examined the ability of esCCO to detect stroke volume index (SVI) and changes in SVI compared with currently available arterial waveform analysis methods. We retrospectively reanalysed 15 of the cases from our previous study on esCCO measurement. SVI was calculated using an esCCO system, measured using the arterial pressure-based CO (APCO) method, and compared with a corresponding intermittent bolus thermodilution CO (ICO) method. Percentage error measurement and statistical methods, including concordance analysis and polar plot analysis, were performed. The difference in the SVI values between esCCO and ICO was -3.0 ± 8.8 ml (percentage error, 33.5%). The mean angular bias was 0.8 and the radial limits of agreement were ± 27.3. The difference in the SVI values between APCO and ICO was 0.9 ± 11.2 ml (percentage error, 42.6%). The mean angular bias was -6.8 and the radial limits of agreement were ± 44.1. This study demonstrated that the accuracy, precision, and dynamic trend of esCCO are better than those of APCO.


[Laboratory Diagnosis of Human Adenovirus for Surveillance in Japan in 2014].
This study sought to clarify how laboratory testing of human mastadenovirus (adenovirus) is conducted in local public health institutes (LPHI) as part of Japanese adenovirus surveillance. Questionnaires on adenovirus surveillance were distributed to LPHIs (n=77) between February and May, 2014. The participation response rate was 100%. During this period, adenoviral cultures were conducted at 65 institutes (84%) while 49 (64%) used neutralization testing. PCR diagnoses were conducted at 58 institutes (75%). The national adenovirus diagnosis manual (http://www.nih.go.jp/niid/ja/labo-manual.html), which includes methods of viral culture and PCR for penton, hexon, and fiber-coding regions, was used in 68% of the LPHIs. Ocular samples were diagnosed at 36 (47%) LPHIs. Most LPHIs conduct adenovirus surveillance in accordance with the national diagnosis manual. Both PCR and viral cultures were used for adenovirus surveillance in the majority of LPHIs during the surveyed period.


RNA-seq analysis of palatal transcriptome changes in all-trans retinoic acid-induced cleft palate of mice.
Cleft palate is a common congenital maxillofacial malformation in newborns. All-trans retinoic acid (atRA) is an ideal exogenous stimulus to construct a mouse cleft palate model. However, the precise pathogenic mechanism remains to be elucidated. In our study, to explore the toxicity of atRA on palatal shelves during different stages of palate development, a total of 100 mg/kg atRA was administered to C57BL/6 mice at embryonic day 10.5 (E10.5). Mouse embryonic palatal shelves at E13.5, E14.5, E15.5, and E16.5 were collected for RNA extraction and histological treatment. Changes in gene expression were tested through RNA-seq. Selected differentially expressed genes (DEGs) related to metabolic pathways, such as Ptgds, Ttr, Cyp2g1, Ugt2a1 and Mgst3, were validated and analyzed by Quantitative real-time PCR (qRT-PCR). In addition, Gene Oncology analysis showed that transcriptional changes of genes from extracellular matrix (ECM) components, such as Spp1, and crystallin family might play important role in palatal shelves elevation (E13.5-E14.5). Therefore, the protein expression level of Ttr and Spp1 from E13.5 to E16.5 were tested by immunohistochemistry (IHC). Besides, the mRNA level of Spp1, were down-regulated at E16.5 and the protein were down-regulated at E15.5 and E16.5 in all-trans retinoic acid group, suggesting that atRA may involve in palatal bone formation by regulating Spp1. Overall, gene transcriptional profiles were obviously different at each time point of palate development. Thus, this study summarized some pathways and genes that may be related to palatogenesis and cleft palate through RNA-seq, to provide a direction for subsequent studies on the mechanism and targeted therapy of cleft palate.


[Immunogenicity of H-antigen polymers obtained by different methods].
The authors studied the properties of two polymeres prepared from flagellin by various methods: precipitation with ammonium sulfate with the subsequent centrifugation or treatment with glutaric aldehyde in solution and subsequent gel-chromatography. Molecules of the former (P-I) and of the latter (P-II) were similar by shape, but the mol wt of P-I was greater. The preparations contained common H-antigen and were similar by serological activity. P-I had a very high "priming" activity for mice. P-II was highly immunogenic only within the narrow range of doses, was less immunogenic in comparison with P-II, and, in difference from P-I, induced formation of some amount of 7S-antibodies.


Impact of simulated proximal interphalangeal arthrodeses of all fingers on hand function.
To evaluate the impact of simulated proximal interphalangeal (PIP) arthrodeses on hand performance and to assess the resulting compensatory metacarpophalangeal (MCP) joint motions in healthy subjects. Fifteen healthy subjects were tested under 2 conditions: (1) with unrestricted distal interphalangeal, PIP, and MCP joints and (2) with the PIP joint fixed at 40 degrees of flexion in all 4 fingers of 1 hand and unrestricted MCP and distal interphalangeal joints. Subjects performed the Jebsen hand function test and 13 activities of daily living. Perceived difficulty in performing tasks was assessed with a study-specific questionnaire. The motion of each finger was monitored using a motion analysis system. The average time to complete the Jebsen test did not increase significantly with simulated PIP arthrodesis, nor did subjects perceive the tasks to be more difficult. Activities of daily living tasks requiring power grasp did not show significant increases in MCP flexion or abduction. Precision handling tasks requiring greater PIP joint flexion did show increased MCP flexion and were associated with greater perceived difficulty. Our study showed a minimal overall impact from simulated arthrodeses of all 4 fingers at the PIP joints in 40 degrees of flexion when measured by selected lower-demand activities of daily living in healthy subjects. Precision handling tasks that normally use higher degrees of PIP joint flexion, however, were perceived to be more difficult to perform and required greater compensatory motion at the MCP joints. This study does not address directly the impairment that patients with generalized hand arthritis may experience after PIP joint arthrodesis. Prognostic, Level I.


Prevalence of giardiasis in patients with cystic fibrosis.
A group of 107 patients with cystic fibrosis and a control group of 64 normal members of households of patients with cystic fibrosis were surveyed for Giardia lamblia cysts and trophozoites by counterimmunoelectrophoresis of fecal samples. The patient group had a significantly higher rate of infestation than the control group (28.0% vs 6.3%, P = 0.0006), and the disparity between the two groups increased with age (P = 0.005). Aside from cystic fibrosis, all risk factors examined were without influence, except for the presence of household members less than or equal to 5 years of age. We conclude that our patients with cystic fibrosis have a previously unrecognized increased prevalence of giardiasis compared with that in a control population.


Hydration of inorganic phosphates in crystal lattices and in aqueous solution. An experimental and theoretical study.
B3LYP/6-31G* and 6-311++G** calculations have been carried out in order to study the hydration of phosphates in aqueous media. Optimized geometries and relative stabilities for PO4(-3), HPO(4)-2, H2PO4(-1) have been calculated considering the interaction with one, two, three, four and five discrete water molecules and taking into account the solvent effect by using the self-consistent reaction field theory (Onsager and PCM methods). The role of specific and bulk contributions of solvent effect on the observable properties of phosphate compounds is analysed. Good agreement between theoretical and available experimental results of harmonic vibration frequencies is found. Significant effects on the geometrical and vibrational frequencies are found for those studied phosphate anions. The results presented here provide a first step toward the understanding of the phosphate group as a hydration sensor in lipid bilayers.


Antioxidant and Anti-Inflammatory Properties of Plants Extract.
Inflammation is an adaptive response triggered by noxious stimuli and conditions such as infection and tissue injury [...].


Dynamic cardiac imaging using a focused, phased-array ultrasound system.
A two-dimensional ultrasound imaging system capable of producing high resolution, cross-sectional images of the heart in real-time has been developed. This system relies upon phased-array principles to rapidly steer and focus the ultrasound beam through the cardiac structures under investigation. A hand-held, linear array of 24 transducers is manipulated on the anterior chest wall to image various cardiac structures. Images of high line density are presented in selectable sector arcs to a maximum of 90 degrees. This imaging system has proved particularly useful for the detection of a variety of left ventricular and cardiac valvular disease.


The prevalence of human T-cell leukemia virus type I infection in patients with hematologic and nonhematologic diseases in an adult T-cell leukemia-endemic area of Japan.
In order to clarify the prevalence of human T-cell leukemia virus type I (HTLV-I) infection in the Kagoshima district, Japan, a highly endemic area for HTLV-I, antibodies for HTLV-I (anti-HTLV-I) were examined in the sera of 6167 from healthy residents and patients with various hematologic and nonhematologic diseases. In healthy residents, including blood donors, the prevalence of anti-HTLV-I was 11.9% (562/4741 persons). The prevalence increased with age, and was significantly higher in in females than in males (P less than 0.01). The prevalence of anti-HTLV-I in blood donors was 8.5%. In In hematologic diseases, the prevalence of anti-HTLV-I was 98.3% in ATL, 28.9% in lymphoproliferative disorders except ATL, and 10.6% in myeloproliferative disorders. In nonhematologic diseases, the prevalence of anti-HTLV-I was shown to be 29.5% in pulmonary tuberculosis, 25.8% in leprosy, 33.8% in chronic renal failure (CRF), 21.9% in autoimmune diseases, and 47.8% in strongyloidiasis. The various diseases except myeloproliferative disorders had significantly higher prevalence of anti-HTLV-I than healthy residents (P less than 0.01 or 0.05). For autoimmune diseases, the prevalence of anti-HTLV-I in patients with blood transfusion (55.6%) was higher than in those without blood transfusion (8.7%), and healthy residents. In hemodialysis patients with CRF who had received blood transfusions the prevalence of anti-HTLV-I increased with the number of blood transfusions. Therefore, HTLV-I transmission via blood transfusion would partially explain these high prevalence of anti-HTLV-I. However, the prevalence of anti-HTLV-I in hemodialysis patients with CRF was statistically higher than that in healthy residents, regardless of blood transfusion (P less than 0.01). Furthermore, hemodialysis patients showed significantly higher prevalence of anti-HTLV-I than healthy residents, even at a younger age. Patients with pulmonary tuberculosis and leprosy showed the same results as hemodialysis patients. These results suggest that possibility that HTLV-I infection has some relation not only to ATL but also to other diseases. Therefore, it seems very important to halt the spread of HTLV-I transmission as soon as possible.


Cryptochrome mediates circadian regulation of cAMP signaling and hepatic gluconeogenesis.
During fasting, mammals maintain normal glucose homeostasis by stimulating hepatic gluconeogenesis. Elevations in circulating glucagon and epinephrine, two hormones that activate hepatic gluconeogenesis, trigger the cAMP-mediated phosphorylation of cAMP response element-binding protein (Creb) and dephosphorylation of the Creb-regulated transcription coactivator-2 (Crtc2)--two key transcriptional regulators of this process. Although the underlying mechanism is unclear, hepatic gluconeogenesis is also regulated by the circadian clock, which coordinates glucose metabolism with changes in the external environment. Circadian control of gene expression is achieved by two transcriptional activators, Clock and Bmal1, which stimulate cryptochrome (Cry1 and Cry2) and Period (Per1, Per2 and Per3) repressors that feed back on Clock-Bmal1 activity. Here we show that Creb activity during fasting is modulated by Cry1 and Cry2, which are rhythmically expressed in the liver. Cry1 expression was elevated during the night-day transition, when it reduced fasting gluconeogenic gene expression by blocking glucagon-mediated increases in intracellular cAMP concentrations and in the protein kinase A-mediated phosphorylation of Creb. In biochemical reconstitution studies, we found that Cry1 inhibited accumulation of cAMP in response to G protein-coupled receptor (GPCR) activation but not to forskolin, a direct activator of adenyl cyclase. Cry proteins seemed to modulate GPCR activity directly through interaction with G(s)α. As hepatic overexpression of Cry1 lowered blood glucose concentrations and improved insulin sensitivity in insulin-resistant db/db mice, our results suggest that compounds that enhance cryptochrome activity may provide therapeutic benefit to individuals with type 2 diabetes.


Effect of stem cell treatment on burn wounds: A systemic review and a meta-analysis.
A meta-analysis was performed to evaluate the effect of stem cells treatment in managing burn wounds. A systematic literature search up to March 2022 incorporated 24 studies reported between 2013 and 2021 including 400 animals with burn wounds at the beginning of the study; 211 were using stem cells treatment, and 189 controlled. Statistical tools like the contentious method were used within a random or fixed-influence model to establish the mean difference (MD) with 95% confidence intervals (CIs) to evaluate the influence of stem cells treatment in managing burn wounds. Stem cells treatment had a significantly higher burn wound healing rate (MD, 15.18; 95% CI, 11.29-19.07, P < .001), higher blood vessel number (MD, 12.28; 95% CI, 10.06-14.51, P < .001), higher vascular endothelial growth factor (MD, 10.24; 95% CI, 7.19-13.29, P < .001), lower interleukin-1 level (MD, -98.48; 95% CI, -155.33 to -41.63, P < .001), and lower tumour necrosis factor α level (MD, -28.71; 95% CI, -46.65 to -10.76, P < .002) compared with control in animals' models with burn wounds. Stem cells treatment had a significantly higher burn wound healing rate, higher blood vessel number, higher vascular endothelial growth factor, lower interleukin-1 level, and lower tumour necrosis factor α level compared with control in animals' models with burn wounds. Further studies are required to validate these findings.


Relationships of Local Food and Physical Activity Environments With Overweight in 5- to 17-Year-Old Malaysian Children.
Evidence on the associations between built environment and overweight in children outside developed countries is scarce. We examined associations between access to local food and physical activity environments and overweight in 5- to 17-year-old Malaysians in two states with differing overweight levels. Information on children was measured in the National Health and Morbidity Survey 2015 and combined with Geographic Information System-derived data on local food and physical activity environments. Access to the built environment was measured by presence and distance from child's residence. Complete data were available for 880 children. Access to local food outlets and parks was higher and associated with higher occurrence of overweight in children living in the state with higher overweight prevalence. When adjusted for sociodemographic factors, higher presence of and shorter distance to convenience stores and parks were associated with overweight. Both built environment and children's sociodemographic backgrounds should be considered when planning interventions to curb the overweight epidemic in Malaysia.


Roles of mast cells and PMN leukocytes in cardiotoxin-induced rat paw edema.
Cardiotoxin, isolated from the venom of Naja naja atra, was found to cause rat hind-paw edema in a dose-dependent manner. This edematous response was significantly suppressed by pretreatment with diphenhydramine, methysergide or compound 48/80, which reduced the tissue histamine content. Polymorphonuclear (PMN) leukocyte infiltration appeared within 1 h and had accumulated markedly in the rat paw 3-6 h after subplantar injection of cardiotoxin. Methotrexate pretreatment significantly reduced not only the peripheral leukocyte count but also cardiotoxin-induced paw edema. Captopril, a kininase inhibitor, potentiated the edematous response caused by a low dose of cardiotoxin. The initial phase, occurring within 3 h, of paw edema induced by cardiotoxin was suppressed by trasylol, [Thi5,8,D-Phe7]bradykinin, or by cellulose sulfate pretreatment which greatly reduced plasma kininogen levels. Both mast cells and PMN leukocytes possess kinin-forming activities, but with different properties. The kinin-forming activity of mast cells but not of PMN leukocytes was inhibited by trasylol. In isolated mast cells, cardiotoxin caused a dose-dependent release of histamine, beta-glucuronidase, lactate dehydrogenase and kinin-forming activity. These observations suggest that mast cells and PMN leukocytes are involved in cardiotoxin-induced paw edema, and that inflammatory mediators such as histamine, serotonin and kinins were supplied directly or indirectly by mast cells, at least in the initial phase.


Influence of xenogeneic beta2-microglobulin on functional recognition of H-2Kb by the NK cell inhibitory receptor Ly49C.
NK cells maintain self-tolerance through expression of inhibitory receptors that bind MHC class I (MHC-I) molecules. MHC-I can exist on the cell surface in several different forms, including "peptide-receptive" or PR-MHC-I that can bind exogenous peptide. PR-MHC-I molecules are short lived and, for H-2K(b), comprise approximately 10% of total MHC-I. In the present study, we confirm that signaling through the mouse NK inhibitory receptor Ly49C requires the presence of PR-K(b) and that this signaling is prevented when PR-K(b) is ablated by pulsing with a peptide that can bind to it with high affinity. Although crystallographic data indicate that Ly49C can engage H-2K(b) loaded with high-affinity peptide, our data suggest that this interaction does not generate an inhibitory signal. We also show that no signaling occurs when the PR-K(b) complex has mouse beta(2)-microglobulin (beta(2)m) replaced with human beta(2)m, although replacement with bovine beta(2)m has no effect. Furthermore, we show that beta(2)m exchange occurs preferentially in the PR-K(b) component of total H-2K(b). These conclusions were reached in studies modulating the sensitivity to lysis of both NK-resistant syngeneic lymphoblasts and NK-sensitive RMA-S tumor cells. We also show, using an in vivo model of lymphocyte recirculation, that engrafted lymphocytes are unable to survive NK attack when otherwise syngeneic lymphocytes express human beta(2)m. These findings suggest a qualitative extension of the "missing self" hypothesis to include NK inhibitory receptors that are restricted to the recognition of unstable forms of MHC-I, thus enabling NK cells to respond more quickly to events that decrease MHC-I synthesis.


An immunohistochemical investigation of 18 cases of feline nasal lymphoma.
This report details clinical, histopathological and immunohistochemical findings in 18 cats with chronic nasal disease diagnosed as nasal lymphoma. Eight of the cats were female and 10 were male, with a median age of 10.5 years (range 7-14 years). Three of the cats were Siamese, one was Burmese, and the rest were non-pedigree. The duration of clinical signs before referral ranged from 30 to 540 days (median 88.5 days). The most common clinical signs were nasal discharge, stertor and sneezing. Nasal radiographs were abnormal in 14/16 cases examined. Abnormal masses were detected endoscopically in 13/18 cases. Nine cats received multi-agent chemotherapy or radiation therapy, or both, with survival times ranging from 14 to >541 days. Biopsy material from these 18 cats was examined by light microscopy, and serial sections were subjected to immunohistochemical labelling for the T lymphocyte marker CD3 and the B lymphocyte marker CD79a. In 13 tissues, expression of class II molecules of the major histocompatibility complex and the myelomonocytic antigen MAC387 was also determined. Twelve of the tumours were classified as diffuse large B-cell lymphomas, four as lymphoblastic B-cell lymphomas, and one as a follicular B-cell lymphoma. The tumour cells within these lesions all expressed CD79a, and (where tested) most also expressed MHC class II. One tumour was an anaplastic large cell neoplasm, in which the neoplastic cells expressed MHC class II alone in the absence of either lymphoid marker. There was a variable infiltration of reactive small T lymphocytes into these tumours, and zones of necrosis within the tumour tissue were sometimes heavily infiltrated by MAC387+ phagocytic cells.


Database analysis of a French type 2 diabetic population shows a specific age pattern of tooth extractions and correlates health care utilization.
To assess the relationship between type 2 diabetes and tooth loss and the predictive value of health behavior and routine dental care in regard to both dental and medical follow-ups. Cross-sectional study from a national database of a French population of railways transport workers was conducted with a descriptive analysis between registered diabetic patients and non-diabetic subjects. The relationship between oral health and diabetes was measured by tooth extraction prevalence in regard to the frequency of scaling-prophylaxis sessions and the number of medical and dental appointments. The prevalence of tooth extractions in the type 2 diabetic population is 1.88 higher than the non-diabetic population. Diabetic patients tend to undergo dental extractions earlier and more often than non-diabetic individuals. They also have more medical appointments and less dental check-ups and scaling sessions than the non-diabetic population. Measured by tooth loss, type 2 diabetic patients have a significantly earlier detrimental oral status when compared to the non-diabetic population. They exhibit a different pattern in health care utilization of outpatient medical resources. Oral health surveillance is not correctly addressed by the medical and dental coverage of these diabetic patients. Emphasis should be directed on specific dental care programs aimed at preventing tooth loss.


Remediation mechanism of endophytic fungus Phomopsis liquidambaris on phenanthrene in vivo.
Phenanthrene can easily be absorbed into the plant from the soil and cannot be effectively degraded in it. Thus, it is greatly hazardous for food safety and human health. In our study, the biodegradability and remediation mechanism of endophytic fungus Phomopsis liquidambaris on phenanthrene in vivo of rice (Oryza sativa L.) was detected. The results showed that the fungus could successfully establish a symbiotic relationship with rice, thus had the potential to degrade phenanthrene absorbed into the plant. Changes of phenanthrene-degrading genes of fungus in the combined system were consistent with the trends of their corresponding enzymatic activities, and the phenanthrene-degrading enzyme activities and gene expression levels in roots of rice were higher than those in the shoot. Moreover, the combined system can enhance bioremediation by increasing root viability, chlorophyll content, and energy supply. The combined system had also significantly increased the PPO activity and SOD activity in shoot compared with the control treatment, while decreased the content of MDA when remediation in vivo. The study on the degradation mechanism of the combined system will help us to increase the practical application potential of endophyte to effectively repair contamination absorbed into plant seedlings.


GABA-like immunoreactivity in the pedal ganglia of Mytilus galloprovincialis: light and electron microscopic study.
The distribution of gamma-aminobutyric acid (GABA)-like immunoreactivity was investigated in the pedal ganglia (PG) of Mytilus galloprovincialis (Mollusca, Bivalvia) with the aid of an antiserum raised against GABA coupled to bovine serum albumin. Examination of whole-mount preparations and serial vibratome and semithin sections showed the presence of different types of immunoreactive neurons. Small unipolar neurons were the most numerous, and were located mainly in the lateral ganglion cortex. A few bipolar and small multipolar neurons were scattered in the cortex, and, more rarely, in the neuropile. Furthermore, two large symmetrical multipolar neurons, the processes of which extended over large fields in the ipsilateral and contralateral neuropile, were consistently observed in each ganglion. Immunoreactive fibers formed networks in the neuropile and ran parallel in the commissure and in all nerves and connectives. The morphology and distribution of neurons and fibers immunostained by the anti-GABA serum were similar to those of GAD-like immunoreactive elements, which indicates that the neurotransmitter and its biosynthetic enzyme are present in the same neurons. Moreover, comparison of serial semithin sections alternatively incubated in postembedding with anti-GABA and antiserotonin sera revealed that immunoreactivity for these two substances was present in different neuronal populations. However, close association between serotoninlike and GABA-like immunoreactive elements was observed in a few PG areas. GABA-like immunoreactivity was demonstrated on ultrathin sections by using secondary antiserum coupled to colloidal gold particles. Labeling was found over somata, fibers, and varicosities containing a distinct type of small (63 nm), pleomorphic, dense-cored vesicle.


H4K44 Acetylation Facilitates Chromatin Accessibility during Meiosis.
Meiotic recombination hotspots are associated with histone post-translational modifications and open chromatin. However, it remains unclear how histone modifications and chromatin structure regulate meiotic recombination. Here, we identify acetylation of histone H4 at Lys44 (H4K44ac) occurring on the nucleosomal lateral surface. We show that H4K44 is acetylated at pre-meiosis and meiosis and displays genome-wide enrichment at recombination hotspots in meiosis. Acetylation at H4K44 is required for normal meiotic recombination, normal levels of double-strand breaks (DSBs) during meiosis, and optimal sporulation. Non-modifiable H4K44R results in increased nucleosomal occupancy around DSB hotspots. Our results indicate that H4K44ac functions to facilitate chromatin accessibility favorable for normal DSB formation and meiotic recombination.


[Reaction of vessels of the microcirculatory bed of subcutaneous tissue to exposure to an argon laser beam].
The effect of argon laser irradiation on the microvessels of the subcutaneous fat tissue of rabbit's ear placed into Clark's transparent chamber was studied. Capillaries and venules were found to be sensitive to argon laser irradiation; functional disturbances of microcirculation were most distinct. Following laser irradiation an active reconstruction of the microcirculatory bed with the redistribution of the blood stream took place along with destruction of the vascular wall and perivascular inflammation.


Critical moments in preschool obesity: the call for nurses and communities to assess and intervene.
Thirty years ago obesity was rarely seen in children but is now described as a world wide pandemic. Previous research has focused on school age children; however, researchers have now identified critical moments of development during uterine life and early infancy where negative factors or insults could cause permanent changes in the structure and function of tissues and lead to epigenetic changes. Obesity in preschool children can cause premature and long term chronic health problems; has been associated with academic and social difficulties in kindergarten children; difficulty with social relationships; increased feelings of sadness, loneliness and anxiety; and negative self image in children as young as 5 years of age. The importance of identifying children under the age of five with obesity and associated risks is important yet less than half of health professionals intervene in cases of preschool obesity. This paper explores the concerns around antenatal and preschool obesity and the challenges for nurses and midwives in assessing and providing appropriate interventions for children and families in community settings.


History of the 'geste antagoniste' sign in cervical dystonia.
The geste antagoniste is a voluntary maneuver that temporarily reduces the severity of dystonic posture or movements. It is a classical feature of focal and particularly cervical dystonia. However, the precise historical aspects of geste antagoniste still remain obscure. The goals of this review were (1) to clarify the origin of the geste antagoniste sign; (2) to identify the factors that led to its diffusion in the international literature; (3) to follow the evolution of that term across the twentieth century. We used medical and neurological French, German and English literature of the late nineteenth and early twentieth centuries, and the PubMed database by entering the terms geste antagoniste, antagonistic gesture and sensory trick. The geste antagoniste sign is a legacy of the Paris Neurological School of the end of the nineteenth century. The term was introduced by Meige and Feindel in their 1902 book on tics, written in the vein of their master, Brissaud, who first described this sign in 1893. The almost immediate translations of this book by Giese into German and Kinnier Wilson into English contributed to the rapid spreading of the term geste antagoniste, which is still in use worldwide today. The term antagonistic gesture is the translation proposed by Kinnier Wilson, which also led to the use of the term geste antagonistique. The geste antagoniste sign has long been considered a solid argument for the psychogenic origins of dystonia until the 1980s when Marsden made strong arguments for its organic nature.


Estrogen- and antiestrogen-induced ornithine decarboxylase activity and uterine growth in the rat.
The estrogen antagonists tamoxifen and monohydroxytamoxifen are also classified as partial estrogen agonists. In infantile rats, estradiol induced a single peak of uterine ODC activity at 6h following injection regardless of the extent of induction by various estradiol doses. By contrast, the timing of the ODC activity peak induced by tamoxifen and monohydroxytamoxifen was highly dependent upon the dosing conditions and was delayed to 18 h at lower tamoxifen doses. In immature rats, tamoxifen and monohydroxytamoxifen induced two peaks of uterine ODC activity resembling those induced by estradiol. Both ODC activity peaks were delayed by 9 h, without decreases in peak heights, by a 50-fold tamoxifen dose reduction. In all experiments the initial appearance of antiestrogen- and estradiol-induced ODC activity corresponded to initial uterine wet weight gain regardless of dosing condition. Thus, when dose-related temporal shifts are taken into account, tamoxifen and monohydroxytamoxifen are complete agonists with respect to induction of uterine weight gain and ODC activity.


Ultrasound-assisted extraction of chromium from tanned leather shavings: A promising continuous flow technology for the treatment of solid waste.
In this work, a continuous flow extraction system assisted by ultrasound (US) was developed for the extraction of Cr(III) from residual tanned leather shavings. US energy was delivered into the system by a tubular applicator (clamp-on tube US applicator). The effect of the US energy was investigated at 20 kHz of frequency and electrical input power of 75, 150, 300 and 600 W. Residence time and temperature profile were also evaluated. It was observed that the internal temperature profile was affected by the presence of US and inverted in comparison with the conditions without US. In this way, the temperature profile generated by the US was reproduced by using electrical resistances in order to compare the obtained results. The US intensity was measured using a hydrophone connected to a sound pressure meter. The use of the US did not alter the dynamic behavior of the system but increased the extraction efficiency when compared to the silent condition. US power above 75 W did not lead to increased extraction efficiency, when the residence time was 30 min. However, when 60 min of residence time were employed, the optimized US power was 150 W, resulting in an extraction efficiency of 71.7 ± 0.7 %, about 28 % higher when compared to the silent condition in the same temperature and other conditions. The US energy allowed a reduction in processing time and operational temperature when compared to the silent condition with the same temperature profile. The overall energy consumption with US was similar or lower than that observed without US, showing the feasibility of the proposed extraction system.


How to Develop Statistical Predictive Risk Models in Oncology Nursing to Enhance Psychosocial and Supportive Care.
Predictive risk models are advocated in psychosocial oncology practice to provide timely and appropriate support to those likely to experience the emotional and psychological consequences of cancer and its treatments. New digital technologies mean that large scale and routine data collection are becoming part of everyday clinical practice. Using these data to try to identify those at greatest risk for late psychosocial effects of cancer is an attractive proposition in a climate of unmet need and limited resource. In this paper, we present a framework to support the development of high-quality predictive risk models in psychosocial and supportive oncology. The aim is to provide awareness and increase accessibility of best practice literature to support researchers in psychosocial and supportive care to undertake a structured evidence-based approach. Statistical prediction risk model publications. In statistical modeling and data science different approaches are needed if the goal is to predict rather than explain. The deployment of a poorly developed and tested predictive risk model has the potential to do great harm. Recommendations for best practice to develop predictive risk models have been developed but there appears to be little application within psychosocial and supportive oncology care. Use of best practice evidence will ensure the development and validation of predictive models that are robust as these are currently lacking. These models have the potential to enhance supportive oncology care through harnessing routine digital collection of patient-reported outcomes and the targeting of interventions according to risk characteristics.


Role of PPAR-beta in hydrogen peroxide-induced apoptosis in human umbilical vein endothelial cells.
Peroxisome proliferator-activated receptor beta (PPAR-beta) is a ligand activated transcription factor belonging to the nuclear receptor superfamily. Recent evidence suggests that PPAR-beta has clearly defined roles in skin wound healing, inflammation and cell proliferation. However, little is known about the role of PPAR-beta in oxidative stress-induced apoptosis in human umbilical vein endothelial cells (HUVECs). In this study, a specific PPAR-beta ligand, L-165041, and antisense phosphorothioate oligodeoxynucleotides (asODNs) against PPAR-beta were used to reveal the role of PPAR-beta in oxidative stress-induced apoptosis. The results showed that H(2)O(2) at 0.5mM resulted in a marked increase of apoptosis and a significant down-regulation of PPAR-beta expression and activation in HUVECs. Moreover, L-165041 significantly inhibited H(2)O(2)-induced apoptosis (P<0.05) and asODNs against PPAR-beta markedly inhibited the de novo synthesis of PPAR-beta, which was accompanied by enhanced apoptosis induced by H(2)O(2) (P<0.05). These data demonstrated that H(2)O(2) down-regulated the expression and activation of PPAR-beta, which played important roles in H(2)O(2)-induced apoptosis in HUVECs.


Magnetic resonance imaging of the elbow: update on current techniques and indications.
The utility of magnetic resonance imaging of the elbow has noticeably improved over the past decade. Advances in equipment and refinement of pulse sequences has allowed for superior visualization of many pathologic processes involving the elbow joint and its surrounding structures. At this time, magnetic resonance imaging is most valuable in detecting occult fractures, osteochondritis dissecans, collateral ligament tears, nonossified intra-articular loose bodies, and soft tissue masses. It may also aid in the diagnosis of tendinous injuries, compression neuropathies, and synovial disorders. This article serves as an educational update for hand surgeons and illustrates the features of normal anatomy and specific disorders of the elbow.


Selenium supplementation at low doses contributes to the decrease in heart damage in experimental Trypanosoma cruzi infection.
Chagasic patients with cardiomyopathy have low levels of selenium (Se), a fundamental trace element. We evaluated the effect of supplementing infected mice with Se (0.25-16 ppm). Supplementation with 0.25 or 1 ppm Se led to parasitaemia and survival curves similar to those of the control group. Mice treated with 4-16 ppm showed a dose-dependent decrease of parasitaemia, significant for the highest concentration. This was probably due to a direct effect on the parasites, which were lysed after in vitro incubation with Se. Survival rates did not change significantly; however, heart damage was reduced in infected mice supplemented with 4 ppm Se, as indicated by a lower cardiac isoform of creatine kinase levels. Our results imply that Se supplementation does not lead to a general protection during infection, but may help protect the heart from inflammatory damage. The effect of Se supplementation in the course of T. cruzi infection depends on the host-parasite pair employed.


Prevalence of non-calcified coronary plaque on 64-slice computed tomography in asymptomatic patients with zero and low coronary artery calcium.
To study the prevalence of noncalcified plaque in asymptomatic low-risk patients with no or mild coronary artery calcium (CAC). From 502 patients with coronary risk factors who underwent 64-slice computed tomography, 224 asymptomatic patients were identified with no CAC (n=117) or mild CAC (n=107; defined as patients with Agatston scores from 1 to 100). Patients with no CAC were younger and had diabetes less often. Medications and laboratory data were not significantly different between the two groups. The prevalence of noncalcified plaque was 11.1% in patients with no CAC and 23.4% in the mild CAC group (P=0.0142). Multiple plaques were detected in 2.6% of the group with no CAC and 3.7% of the group with mild CAC (P=0.5934). Significant coronary artery stenosis was found in one patient in the group with no CAC (0.9%) and three patients in the group with mild CAC (2.8%, P=0.3506). Significant percentages of noncalcified plaque were found in asymptomatic low-risk patients with no or mild coronary calcium.


Performance Promotion of Multipurpose Catalysts Using Increased Oxygen Vacancy Amounts by Charge-Mismatched Doping.
Modulating the oxygen vacancy (V0) in nanostructures has opened a new avenue for efficient catalyst design, facilitating biomass oxidation reactions and electrocatalytic properties. In this study, we have investigated the properties of NiO-based catalysts with varying degrees of V0 achieved through ion doping of the catalyst with cations of different oxidation states (TM3+) or the same valence state (TM2+) as Ni2+ in the NiO matrix. By introducing charge-mismatched dopants, we enhanced the concentration of V0 in the NiO catalyst, resulting in remarkable selectivity (∼50%) for the conversion of 2,5-hydroxymethylfurfural (HMF) to 2,5-furandicarboxylic acid (FDCA), as well as a lower overpotential in the oxygen evolution reaction (OER). We believe that charge-mismatched doping offers a novel avenue for optimizing defect engineering in oxide-based catalysts, which can enable more efficient biomass conversion and water splitting. These findings have made a significant contribution to the field of multipurpose catalysis and hold the potential to inspire new catalyst designs that would usher in a more sustainable future.


Effect of insulin and isoproterenol on lipid metabolism in porcine adipose tissue from different depots.
Significant differences were found in the rates of lipogenesis, glucose oxidation and lipolysis in porcine adipose tissue from four depots; outer subcutaneous (OSC), middle subcutaneous (MSC), perirenal (PR) and omental (OM). Lipogenesis was stimulated by insulin in all depots in the order PR > OM > MSC > OSC. Lipolysis was stimulated by isoproterenol in all depots in the order PR > OM > MSC > OSC. Differences in lipid metabolism by the different depots may have an important impact on lipid accretion in vivo.


Time-series analysis of ambient PM2.5 and cardiorespiratory emergency room visits in Lima, Peru during 2010-2016.
There have been no time-series studies of air pollution in Peru. Here we evaluate the effect of ambient PM2.5 on emergency room (ER) visits in Lima. We estimated daily PM2.5 levels at a 1 km2 resolution during 2010-2016 using ground measurements, satellite data, and chemical transport model simulations. Population-weighted average daily PM2.5 levels were calculated for each district in Lima (n = 40), and assigned to patients based on residence. ER visits for respiratory and circulatory diseases were gathered from nine large public hospitals. Poisson regression was used to estimate the rate ratio for daily ER visits with change in daily PM2.5, controlling for meteorology, time trends, and district. For each interquartile range (IQR) increase in PM2.5, respiratory disease ER visits increased 4% (95% CI: 0-5%), stroke visits 10% (3-18%), and ischemic heart disease visits (adults, 18-64 years) 11% (-1, 24%). Districts with higher poverty showed significantly stronger associations of PM2.5 and respiratory disease ER visits than districts with lower poverty. Effects were diminished 24-42% using Lima-wide instead of district-specific PM2.5 levels. Short-term exposure to ambient PM2.5 is associated with increases in ER visits in Lima for respiratory diseases and stroke, and among middle-aged adults, ischemic heart disease.


Parental perspectives on gene therapy for children with haemophilia: The Exigency study.
Gene therapy is used in life-limiting conditions of childhood. While not a current therapeutic option for children with haemophilia, it may be considered in the future especially for those where access to treatment is limited. To assess the attitudes and opinions of parents of children with haemophilia about gene therapy as a potential future treatment, by understanding their awareness about gene therapy and what they need to know now and in the future; gauging levels of interest in gene therapy for their children; and exploring perceived current motivations and barriers. A mixed methods study with an online questionnaire and in-depth qualitative interviews in focus groups which were analysed using thematic analysis. One hundred and fifty-eight participants commenced the online survey; 63 were fully completed (39%). 60 had heard of gene therapy but few (17/60 [28.3%]) felt they had a good understanding. 38/60 (63.3%) respondents did not know that gene therapy is not available for children. However, most held positive views: 53/60 (88.3%) saying they would consider it for their child. In the interviews, participants (N = 10, all mothers) discussed their awareness and understanding of gene therapy and opinions about it for children, including how this should be communicated to the child and parents. A coherent, community-wide strategy for communicating information and news about gene therapy should now be provided for children and families living with haemophilia. This should come primarily from trusted haemophilia nursing teams, who can give tailored, age-appropriate, factual advice.


The value of objective measurements to select patients who are malnourished.
Several studies have attempted to define nutritional parameters that can be used to select malnourished hospitalised patients for nutritional support. A combination of objective nutritional parameters was evaluated in a group of 50 patients selected for total parenteral nutrition on clinical grounds only and compared with a control group. This control group consisted of 38 patients who were admitted for elective minor surgical procedures such as varicectomy and hernia repair. On a subset of 18 objective nutritional measurements, discriminant analysis was performed. In the evaluation it was shown that a combination of albumin (ALB), prealbumin (PALB), total lymphocyte count (TLC) and the percentage of ideal weight (PIW) was the most useful combination of nutritional tests in discriminating a chosen malnourished (M) group and a control group who were declared not malnourished (NM). With this combination the patients were correctly classified in 93% with a sensitivity of 93% and a specificity of 94%.


Effect of liquid-to-solid ratios on the properties of magnesium phosphate chemically bonded ceramics.
The temperature variation, setting time, phase compositions and compressive strength of magnesium phosphate chemically bonded ceramics were important for its application in biomedical field. Different amounts of liquid were added into the premixed acid phosphate and oxide powders in order to study the effect of liquid-to-solid ratios on the properties of magnesium phosphate chemically bonded ceramics. The results indicated that the setting time increased and the maximum temperature decreased as the liquid-to-solid ratio increases. The hydrated product was mainly composed of magnesium potassium phosphate hexahydrate, which was not affected by the liquid-to-solid ratios. Besides, magnesia was also found because it was an obvious excess of the hydrated reaction. The compressive strength decreased as the liquid-to-solid ratios increase possibly because of the higher porosity caused by the superfluous liquid. According to the performed study, results indicated that the properties of MPCBC could be adjusted by changing the liquid-to-solid ratios.


Cytological features of basal cell adenoma of salivary glands: Analysis of 19 cases emphasizing stromal spindle cells.
Basal cell adenoma (BCA) of the salivary gland is a relatively rare benign tumor. Although the presence of stromal spindle cells is a characteristic histopathological feature, this finding has not been the focus of much attention in the cytodiagnosis of BCA. Thus, we analyzed the cytological features of BCA, especially the presence of stromal spindle cells. Patients who were histopathologically diagnosed with BCA and underwent preoperative fine-needle aspiration cytological examination were enrolled in this study. The cytological characteristics including arrangement and shape of the neoplastic cells, nuclear and cytoplasmic features, and the presence of stromal spindle cells were reviewed. Nineteen patients were enrolled in the study. The cytological specimens were cellular and composed of small or large clusters or both. The neoplastic cells had scant cytoplasm and small round to oval nuclei. Basement membrane-like material was observed in 57.9%, and peripheral palisading was noted in 84.2%. Loose aggregates of stromal spindle cells were present in 63.2%, and the stromal spindle cells shown in the histological examination of 85.7% of cases were expressed in the cytological specimens. This study clearly demonstrated the relatively high frequency of stromal spindle cells in cytological specimens of BCA. This finding is characteristic of BCA, and therefore, the combination of cytological features, including packed clusters of neoplastic cells with scant cytoplasm and small nuclei, peripheral palisading, and basement membrane-like material, and the presence of stromal spindle cells could increase the diagnostic success of BCA.


The membrane-anchor of Paramecium temperature-specific surface antigens is a glycosylinositol phospholipid.
The temperature-specific G surface antigen of Paramecium primaurelia strain 156 was biosynthetically labeled by [3H]myristic acid in its membrane-bound form, but not in its soluble form. It could be cleaved by a phosphatidylinositol-specific phospholipase C from Trypanosoma brucei or from Bacillus cereus which released its soluble form with the unmasking of a particular glycosidic immunodeterminant called the crossreacting determinant. The Paramecium enzyme, capable of converting its membrane-bound form into the soluble one, was inhibited by a sulphydril reagent in the same way as the trypanosomal lipase. From this evidence we propose that the Paramecium temperature-specific surface antigens are anchored in the plasma membrane via a glycophospholipid, and that an endogenous phospholipase C may be involved in the antigenic variation process.


Coloboma of the lens, optic nerve hypoplasia, and orbital hemangioma--a possible developmental field defect.
To report the unusual association of a coloboma of the lens with ipsilateral optic nerve hypoplasia and orbital hemangioma. Descriptive case report. An eight-month-old girl had a gradually enlarging left orbital hemangioma. There was an ipsilateral temporal coloboma of the lens with a remnant of the pupillary membrane attached to the anterior lens capsule in the central region of the coloboma. The left optic nerve head was one half the size of the right one. The occurrence of intraocular malformations with an ipsilateral orbital vascular malformation may be the result of a developmental ocular and periocular field defect.


Preformed PAF-acether and lyso PAF-acether are bound to blood lipoproteins.
PAF-acether (PAF) is a newly formed mediator not normally present in circulating blood. A compound exhibiting all of its biological characteristics but coeluting with phosphatidylcholine (PC) in high-pressure liquid chromatography (HPLC) was unveiled ('peak X') in normal human plasma. A second HPLC run of peak X HPLC fractions revealed the presence of PAF itself with concomitant disappearance of peak X. Beside PAF, immunoreactive apolipoproteins A-I and E were found in peak X. Also lipoproteins (Ls) purified using either ultracentrifugation or immunoaffinity chromatography yielded peak X and, in a second HPLC run, authentic PAF. L-free plasma was devoid of peak X. Finally, after preincubation with plasma, labeled PAF was found associated with Ls. Thus in human blood preformed PAF is bound in high amounts to Ls, a result of interest given the role of Ls and platelets in vascular diseases and the present knowledge on PAF biosynthesis.


Laser-optics-based method to suppress Mikania micrantha growth.
Mikania micrantha is an exotic and aggressive species that can reproduce asexually and sexually through its germinative stem and its featherlike seeds. Present weeding methods cannot effectively or economically control the spread of Mikania micrantha. In this article, we propose a method to suppress the growth and spread of Mikania micrantha by applying a high-energy laser beam to penetrate its stem. The threshold penetrating optical intensity is 3.1 W/mm2. To optimize the damage to the inner tissue of the stem, which includes the vascular bundle and medulla for transporting organic nutrients, water, and inorganic salt, the absorption spectrum of the tissue and laser beam size are analyzed. According to the absorption spectrum of the tissue and growth mechanism of Mikania micrantha, a 455 nm blue laser is used as an irradiated light source. A single beam with two different beam sizes or two laser beams with the same beam size is used to optimize the stem damage. By the time the cumulative energy reaches 15 Joules for a single laser beam with dimensions of 0.81 mm × 0.74 mm, the inner tissue will be damaged 97.5%. We perform laser irradiation on the fresh Mikania micrantha grown hydroponically, with the result that all samples withered in 30 days. Therefore, using the method before the flowering season of Mikania micrantha can effectively inhibit its reproduction.


ZnO-ZnTe hierarchical superstructures as solar-light-activated photocatalysts for azo dye removal.
The excessive amount of textile effluents disposed into the water streams is a common source of contamination of the hydrosphere. To efficiently remove pollutants in water bodies, there is growing demand for highly efficient, cost effective, and green remediation techniques. In line with such demand, a heterostructured photocatalyst (ZnO-ZnTe) has been prepared through the assembly of zinc oxide (ZnO) and zinc telluride (ZnTe). A synergistic interaction between surface adsorption and photocatalysis was explored for the removal of azo dye using a hierarchical superstructure under solar-light irradiation. Methylene blue (MB) was bleached by about 91% under visible irradiation for 2 h to support the role of the prepared heterostructures as effective photocatalysts (QY is 3.16 × 10-7 molecules/photon). Moreover, the kinetic reaction rate of ZnO-ZnTe superstructures was 19.0 μmol g-1 h-1, which was 1.54 and 1.97 times higher than those of pristine ZnO and ZnTe, respectively. These results may be ascribed to the presence of a common cation that may have helped in the diffusion of photogenerated electrons between ZnO and ZnTe, while efficiently suppressing the recombination frequency of photogenerated electrons and holes.


Greater infarct growth limiting effect of mechanical thrombectomy in stroke patients with poor collaterals.
Stroke patients with good collateral circulation achieve the best recovery after mechanical thrombectomy (MT) but strict imaging selection may result in untreated patients that could benefit from MT. We assessed whether the extent of collaterals had modifying effects on the amount of ischemic tissue saved from infarction with MT over best medical treatment (BMT). This was a single center cohort of consecutive patients (n=339) with proximal occlusions in the carotid territory. Patients were categorized according to a four point category scale on CT angiography as having good (scores 2-3) or poor (scores 0-1) collaterals. The primary outcome measure was the interaction between collaterals and MT on infarct growth. The secondary outcome assessed the treatment effect of MT over BMT on functional status in relation to collateral status. Safety outcomes were mortality and symptomatic intracranial hemorrhage. Collaterals had a modifying effect of MT on infarct growth (P=0.004), with a greater reduction in 96 patients with poor collaterals (38.8 mL) than in 243 patients with good collaterals (1.9 mL). There was also a significant (P<0.001) interaction between the effect of MT and functional outcome in relation to collateral status, with more benefits of MT in patients with poor collaterals. MT was associated with lower mortality than BMT in patients with poor collaterals only. Compared with BMT, the use of MT in the early time window in large vessel stroke results in a more substantial limitation of infarct growth in patients with poor collaterals.


A mapping process for identifying and enhancing public health education in required medical student clerkships.
This is one of six short papers that describe additional innovations to help integrate public health into medical education; these were featured in the "Patients and Populations: Public Health in Medical Education" conference. They represent relatively new endeavors or curricular components that had not been explored in prior publications. Although evaluation data are lacking, it was felt that sharing a description of the mapping process for linking public health competencies to clinical clerkship activities at the University of Wisconsin School of Medicine and Public Health would be of value to medical educators.


Purification of penicillin G acylase using immobilized metal affinity membranes.
The immobilized metal affinity membrane (IMAM) with modified regeneration cellulose was employed for purification of penicillin G acylase (PGA). For studying PGA adsorption capacity on the IMAM, factors such as chelator surface density, chelating metal, loading temperature, pH, NaCl concentration and elution solutions were investigated. The optimal loading conditions were found at 4 degrees C, 0.5 M NaCl, 32.04 micromol Cu(2+) per disk with 10 mM sodium phosphate buffer, pH 8.5, whereas elution conditions were: 1 M NH(4)Cl with 10 mM sodium phosphate buffer, pH 6.8. By applying these chromatographic conditions to the flow experiments in a cartridge, a 9.11-fold purification in specific activity with 90.25% recovery for PGA purification was obtained. Meanwhile, more than eight-times reusability of the membrane was achieved with the EDTA regeneration solutions.


Neurological Involvement in the Course of Scleromyxedema: A Case Report.
Scleromyxedema is a rare disease of unknown etiology primarily affecting the skin, characterized by generalized papular eruption, dermal fibroblast proliferation with mucin deposition, and a monoclonal gammopathy. Neurological impairment is a rare but sometimes fatal complication of scleromyxedema that should be rapidly identified to prevent significant morbidity and mortality. A 63-year-old Caucasian man had a 2-year history of scleromyxedema, and was under immunosuppressive treatment with ciclosporine and methotrexate. The patient came to our attention because of sudden neurological dysfunction with altered sensorium, confusion, and dysarthria. After a few hours since admission, the patient developed left hemiparesis, followed after 2 days by right hemiparesis. The brain computed tomography and cerebrospinal fluid examination results were normal. Brain magnetic resonance imaging (MRI) showed a bilateral cortical hyperintense signal on T2 sequences with leptomeningeal enhancement. Extensive serological and liquoral evaluations were performed without significant findings. After steroid initiation, a remarkable neurological improvement was noticed. The dramatic and immediate response of the patient's to steroid and MRI data strongly suggested a dysimmune etiology. Over the ensuing week, the patient's language, motor, and sensory functions continued to improve. Two weeks after admission, the patient was discharged to home without significant neurological sequelae.


Diastolic atrial compression: a sensitive echocardiographic sign of cardiac tamponade.
Nine patients with clinical and hemodynamic evidence of cardiac tamponade underwent M-mode and two-dimensional echocardiography. Pericardial effusion was documented in each patient. Four patients demonstrated respiratory variation in ventricular volumes in association with paradoxical pulse. Right ventricular compression was present in seven. In five patients, echocardiography demonstrated diastolic left atrial compression. In all nine patients, the apical four chamber view revealed diastolic right atrial compression. Drainage of 450 to 1,800 cc of pericardial fluid relieved the cardiac tamponade and eliminated the echocardiographic findings associated with this disorder. These observations suggest that the echocardiographic findings of atrial compression is a sensitive sign of cardiac tamponade.


Association of Type 1 diabetes with ulcerative colitis in BALB/c mice: Investigations on sex-specific differences.
Diabetes comorbidity in ulcerative colitis (UC) has relevant clinical and therapeutic implications. The link between hyperglycemia and intestinal barrier function with respect to infection and inflammation consequences exists in diabetes. The present study was designed to decipher the molecular mechanisms associated with Type 1 Diabetes mellitus and the UC in both male and female BALB/c mice. Dextran sulfate sodium (DSS; 2.5%w/v) dissolved in drinking water was given for three cycles (each cycle; 7 days) with 7 days recovery period in-between to both male and female BALB/c mice. At the first recovery period, Streptozotocin (40 mg/kg; i.p.) was administered for 5 consecutive days in the case of male BALB/c mice; whereas the same procedure was repeated at the beginning of each recovery period in female animals. In the DSS + DB group of male animals, disease activity index, myeloperoxidase activity, nitrite level, plasma lipopolysaccharides, interleukin-1β, histological score, % fibrotic area, % TUNEL positive cells were significantly increased. Furthermore, protein expression of phosphorylated nuclear factor kappa light chain enhancer of activated B cells (pNFκB65), proliferating cell nuclear antigen, interleukin-6, apoptosis-associated speck-like protein containing a caspase-recruitment domain, and cysteine-containing aspartate-specific proteases-1 (caspase-1) significantly increased in the DSS + DB group of male animals as compared to female. The present study findings proved that hyperglycemic conditions exacerbated the pathological conditions in UC of male animals; whereas milder conditions developed in females.


Patients with autoimmune hepatitis who have antimitochondrial antibodies need long-term follow-up to detect late development of primary biliary cirrhosis.
Patients with autoimmune hepatitis (AIH) who have antibodies against mitochondrial proteins (AMA positive) are believed to have an autoimmune syndrome that should be managed as AIH. Of patients with AMA-positive AIH, we report on 3 individuals to demonstrate how autoimmune liver disease can progress over time. Specific features of primary biliary cirrhosis (PBC) overlapped in time in these patients. Our observations indicate the importance of careful follow up of patients with AMA-positive AIH; health care professionals that treat such patients should therefore be aware of longitudinal clinical changes that might indicate development of PBC in this setting.


Pretapped and self-tapping screws in the human midface. Torque measurements and bone screw interface.
Better contact between AO miniscrews and the bone and greater resistance against torque are achieved in the human midface if the thread is not pretapped. This was demonstrated by 60 methacrylate fixed human midfacial bone sections and by 100 torque measurements. It is concluded that pretapping is not to be recommended in the thin bone of the midface.


An open-label, noncomparative study of miglustat in type I Gaucher disease: efficacy and tolerability over 24 months of treatment.
The substrate synthesis inhibitor miglustat (N-butyldeoxynojirimycin) is the first oral agent to receive regulatory approval for the treatment of type I Gaucher disease (GD). The aims of this study were to further assess previous observations of the effects of miglustat in adult patients with mild to moderate type I GD and to evaluate the tolerability and safety profile of this drug. This was a noncomparative, open-label study in adult patients with type I GD (confirmed by genotyping and glucocerebrosidase assay) who were unwilling or unable to receive enzyme replacement therapy (ERT) or who had discontinued ERT for at least 3 months. Patients received miglustat 100 mg TID for 12 months, with the option of continuing treatment for a further 12 months. The primary end point was the percentage change in liver volume. Secondary end points included the percentage change in spleen volume and changes in hematologic parameters (hemoglobin, platelets), chitotriosidase activity (a surrogate marker of disease burden), and bone assessments (dual-energy X-ray absorptiometry, magnetic resonance imaging, and radiography). Clinical safety was monitored, including assessment of neurologic status at baseline and throughout the study using a comprehensive battery of standardized neurologic tests (eg, Purdue Pegboard Test, Mini-Mental State Examination, nerve conduction studies) and neuropsychological tests. Of the 10 patients (7 men, 3 women) who received at least 1 dose of miglustat, 7 completed 24 months of treatment. Patients were aged between 32 and 62 years (mean, 46.3 years) and weighed between 55 and 88 kg (mean, 72.4 kg). All patients had at least 1 manifestation of GD, including 10 with splenomegaly (mean size, 8.1 times normal; range, 3.9-15.9 times normal), 9 with thrombocytopenia, and 8 with hepatomegaly (mean size, 1.5 times normal; range, 1.0-2.0 times normal). At baseline, hemoglobin concentrations ranged from 11.5 to 15.1 g/dL (mean, 13.2 g/dL), platelet counts from 55 to 161 x 10(9)/L (mean, 83.8 x 10(9)/L), and chitotriosidase activity from 526 to 29636 nmol/mL . h (mean, 8143.7 nmol/mL . h). In the 8 patients comprising the efficacy set, significant mean percentage changes from baseline in liver volume were seen at 6 months (-8.4%; P = 0.036; 95% CI, -16.1 to -0.7) and 18 months (-15.1%; P = 0.022; 95% CI, -27.1 to -3.0). Although not statistically significant, the 95% CIs for the percentage changes in liver volume at 12 months (-9.4%; 95% CI, -19.5 to 0.6) and 24 months (-5.6%; 95% CI, -12.1 to 1.0) were similar to those at 6 and 18 months, supporting a consistent clinical effect. Significant mean percentage reductions in spleen volume were observed at 6 months (-19.0%; P = 0.006; 95% CI, -30.4 to -7.6) and 18 months (-24.3%; P = 0.001; 95% CI, -33.6 to -15.1). Mean hemoglobin concentrations, which were normal at baseline, remained stable over the course of the study. There were no significant changes in bone status. There was a significant mean increase in absolute platelet count at 12 months (by 13.9 x 10(9)/L; P = 0.030; 95% CI, 1.8 to 26.0); at 24 months, the mean percentage increase from baseline (23.0%) was not statistically significant. The mean percentage reduction from baseline in chitotriosidase activity at 24 months was 25.3%. Treatment was well tolerated, and the incidence of most adverse events decreased with time. Gastrointestinal and central nervous system adverse events reported during 3-month periods at the beginning (0-3 months) and end (>21-24 months) of the study were flatulence (10 and 2 patients, respectively), diarrhea (9 and 0), abdominal pain (7 and 1), tremor (4 and 1), paresthesia (3 and 0), headache (2 and 3), and abdominal distention (2 and 0). No evidence of clinically significant adverse effects on neurologic or neuropsychological function was found during the study. In this small study in symptomatic adult patients with type I GD, miglustat treatment resulted in a significant decrease in liver and spleen volume at 6 and 18 months, with clinical improvement noted over 24 months. Bone involvement and platelet and hemoglobin values remained stable, with no significant changes noted during the observation period. The effects of treatment were consistent with those of earlier studies of miglustat in type I GD.


Recycling habits and environmental responses to fast-fashion consumption: Enhancing the theory of planned behavior to predict Generation Y consumers' purchase decisions.
Fast-fashion industry is characterized by short product life-cycles, high volatility, affordable prices, and consumers' high impulse purchase decisions, which result in massive levels of waste and greenhouse gas emissions. In this context, Generation Y, the largest consumer of fast-fashion products, is believed to make this situation even worse, since their attitudes/intentions do not usually translate into actual pro-environmental behavior and they are still reluctant to dispose of their clothes through sustainable methods. However, the attitude/intention-behavior gap among Generation Y's fast-fashion consumers remains poorly understood. The present study addresses this need by adopting the Theory of Planned Behavior to examine the link between attitudes, intentions, and behavior, taking into account consumers' participation in recycling as a moderating variable. Results from a two-steps cluster analysis and a multiple moderated mediation analysis on a sample of 943 Italian Generation Y's consumers of fast-fashion products show that the attitude/intention-behavior gap seems not to exist in the Generation Y's context, since the favorable appraisal of sustainable products and consumption actually leads to socially-responsible consumer behavior. However, participation in recycling is found to reinforce the intention-behavior link only for individuals with high environmental attitudes. The present paper contributes to both fashion consumption and solid waste management literature by drawing connections between socially-responsible consumer behavior and recycling habits within the Generation Y's cohort, thus deepening comprehension of this rather unexplored context. Moreover, this study reveals policy development areas that allow the fashion industry to meet customers' needs in new ways.


Inhibition of hepatitis C virus RNA replication by ISG15 does not require its conjugation to protein substrates by the HERC5 E3 ligase.
Chronic infection of the liver by hepatitis C virus (HCV) induces a range of host factors including IFN-stimulated genes such as ISG15. ISG15 functions as an antiviral factor that limits virus replication. Previous studies have suggested that ISG15 could influence HCV replication in both a positive and a negative manner. In this report, we determined the effect of ISG15 on HCV RNA replication in two independent cell lines that support viral genome synthesis by inhibiting ISG15 expression through small interfering RNA, short-hairpin RNA and CRISPR/Cas9 gene knockout approaches. Our results demonstrated that ISG15 impairs HCV RNA replication in both the presence and absence of IFN stimulation, consistent with an antiviral role for ISG15 during HCV infection. ISG15 conjugation to protein substrates typically requires the E3 ligase, HERC5. Our results showed that the inhibitory effect of ISG15 on HCV RNA replication does not require its conjugation to substrates by HERC5.


Peptides and transmitter enzymes in hypothalamic magnocellular neurons after administration of hyperosmotic stimuli: comparison between messenger RNA and peptide/protein levels.
In situ hybridization histochemistry and indirect immunofluorescence histochemistry were used to study changes in the expression of vasopressin (VP), oxytocin (OXY), tyrosine hydroxylase (TH), galanin (GAL), dynorphin (DYN) and cholecystokinin (CCK) in hypothalamic magnocellular neurons of the paraventricular (PVN) and supraoptic (SON) nuclei of rats. After prolonged administration of 2% sodium chloride as drinking water (salt-loading), the treatment increased the levels of VP, OXY, TH, GAL, DYN and CCK mRNA in the PVN and SON. The increase in CCK mRNA was, however, proportionally higher in the PVN than in the SON. Within cell bodies of the PVN and SON of salt-loaded rats, a depletion of VP- and OXY-like immunoreactivity (LI) and an increase in TH-LI were seen. In salt-loaded/colchicine-treated rats, a marked decrease in GAL- and DYN-LI, but no specific changes in CCK-LI were observed. Within nerve fibers of the posterior pituitary of salt-loaded rats, a marked depletion of VP-, GAL- and DYN-LI was found. Less pronounced depletion was observed in OXY- and CCK-LI, and no specific changes in TH-LI were seen. The results show that high plasma osmolality induces increased mRNA levels for VP, OXY, TH, GAL, DYN and CCK, presumably indicating increased synthesis, an increased export from cell somata of VP, OXY, GAL and DYN, and a decrease in levels of these peptides in the posterior pituitary, suggesting increased release. The catecholamine-synthesizing enzyme TH, however, which has a cytoplasmic localization and is not released from nerve endings, remains high in the cell bodies and nerve endings during this state of increased activity.


Recurrent nephrotic syndrome in renal allografts.
We describe the clinicopathologic course of two patients with recurrent focal segmental glomerular sclerosis (FSGS). In both patients, FSGS was initially demonstrated during the evaluation of proteinuria. After progressing to end-stage renal disease, each patient received a living-related renal transplant. Shortly after transplantation, proteinuria recurred in both patients, progressing to the nephrotic syndrome. Serial renal biopsies were obtained from each patient. These initially demonstrated focal segmental epithelial proliferation (the "cellular lesion"), but focal segmental scars were observed in subsequent biopsies. None of the biopsies demonstrated immunoglobulin, complement deposition, or diffuse epithelial cell foot process fusion. These findings suggest that the scarring lesion in recurrent FSGS may be the result of a primary process involving damage to a limited number of visceral epithelial cells.


Surface carbohydrate epitopes of Thy-1.1 and Thy-1.2 thymocytes are distinguished by a monoclonal antibody with a specificity common to peanut agglutinin.
NIMF4-31.7 is a monoclonal IgM antibody with affinity for terminal galactose residues of membrane glycoproteins, Sepharose and agarose. It is cytotoxic for a subpopulation of murine thymocytes and peripheral lymphocytes, corresponding to the peanut agglutinin-positive population, but reacts with a majority of cells after neuraminidase treatment. It has revealed a genetic linkage between the Thy-1 locus and quantitative expression of carbohydrate determinants on the thymocyte membrane.


The development and validation of a dementia behavior disturbance inventory.
To develop an instrument that measures observable problematic behaviors in patients with dementia. We used focus group interviews to identify the problematic behaviors of patients with dementia. Eighty-two behaviors grouped into 12 domains were generated from the data collected from five different focus groups. After conducting a content validation process, a 72-item Dementia Behavior Disturbance Inventory (DBDI) rated by a frequency and a disturbance scale was formed. The DBDI was administered to 200 institutionalized elderly patients with dementia by formal caregivers for psychometric evaluation. Inter-item correlation of items in each domain was performed for item reduction. Forty-eight items remained after this procedure. Exploratory factor analysis obtained nine factors that explained 59.2% and 59.6% of the total variance in the frequency and disturbance scales, respectively. Cronbach's alpha of the entire 48-item frequency and disturbance scales was 0.88 and 0.91, respectively. Most of the factors had acceptable internal consistency reliability. Test-re-test reliability coefficients of the frequency and disturbance scales were 0.78 and 0.64, respectively. The DBDI was weakly but positively related to functions of daily activities and ambulation. The DBDI demonstrates promising psychometrical properties as an instrument to assess problematic behaviors in elderly people with dementia.


Carbon balance in tussock tundra under ambient and elevated atmospheric CO2.
Whole ecosystem CO2 flux under ambient (340 μl/l) and elevated (680 μl/l) CO2 was measured in situ in Eriophorum tussock tundra on the North Slope of Alaska. Elevated CO2 resulted in greater carbon acquisition than control treatments and there was a net loss of CO2 under ambient conditions at this upland tundra site. These measurements indicate a current loss of carbon from upland tundra, possibly the result of recent climatic changes. Elevated CO2 for the duration of one growing season appeared to delay the onset of dormancy and resulted in approximately 10 additional days of positive ecosystem flux. Homeostatic adjustment of ecosystem CO2 flux (sum of species' response) was apparent by the third week of exposure to elevated CO2. Ecosystem dark respiration rates were not significantly higher at elevated CO2 levels. Rapid homeostatic adjustment to elevated CO2 may limit carbon uptake in upland tundra. Abiotic factors were evaluated as predictors of ecosystem CO2 flux. For chambers exposed to ambient and elevated CO2 levels for the duration of the growing season, seasonality (Julian day) was the best predictor of ecosystem CO2 flux at both ambient and elevated CO2 levels. Light (PAR), soil temperature, and air temperature were also predictive of seasonal ecosystem flux, but only at elevated CO2 levels. At any combination of physical conditions, flux of the elevated CO2 treatment was greater than that at ambient. In short-term manipulations of CO2, tundra exposed to elevated CO2 had threefold greater carbon gain, and had one half the ecosystem level, light compensation point when compared to ambient CO2 treatments. Elevated CO2-acclimated tundra had twofold greater carbon gain compared to ambient treatments, but there was no difference in ecosystem level, light compensation point between elevated and ambient CO2 treatments. The predicted future increases in cloudiness could substantially decrease the effect of elevated atmospheric CO2 on net ecosystem carbon budget. These analyses suggest little if any long-term stimulation of ecosystem carbon acquisition by increases in atmospheric CO2.


Artificial Intelligence in Gastroenterology-Walking into the Room of Little Miracles.
The surge of artificial intelligence (AI) in medicine stands on a lengthy, and frequently reticent, buildout [...].


A comparison of the effects of continuous ketamine infusion and halothane on oxygenation during one-lung anaesthesia in dogs.
It has been shown that a continuous infusion of ketamine during one-lung anaesthesia combined with a 50 per cent oxygen-curare anaesthetic technique will provide consistently lower shunt fraction and higher Pao2 compared with halothane under the same experimental conditions. Because no additional factor was observed which could account for these changes and because the responses of the animals to the two anaesthetic agents were similar--the only difference being a different initial set point--the experimental model may be considered adequate. In the authors' view the difference in shunt fractions may be attributed to a more stable hypoxic reflex during ketamine anaesthesia. Further experimentation will be necessary to fully exclude the possibility of sequence-related changes affecting some of these results and to determine whether or not certain groups of dogs respond in a qualitatively different fashion.