Predictors for failure of endoscopic ureteric stenting in patients with malignant ureteric obstruction: systematic review and meta-analysis.
To determine the factors for failure of endoscopic ureteric stenting in patients with malignant ureteric obstruction. We performed a search strategy in the Medical Literature Analysis and Retrieval System Online (MEDLINE), the Excerpta Medica dataBASE (EMBASE), the Literatura Latino-Americana e do Caribe em Ciências da Saúde database (LILACS), and the Cochrane Central Register of Controlled Trials (CENTRAL) databases. We included patients with malignant ureteric obstruction, who had a JJ catheter insertion. The studies reported the percentage of failure and risk factors, e.g. bladder invasion or deformity of the trigone, hydronephrosis, renal failure, previous radiotherapy, age, obstruction aetiology, and patient's health status. We performed a meta-analysis using R software ('meta' and 'metafor' libraries). We included nine studies that met the inclusion criteria, with 761 patients and an average age of 60.5 years. The studies assessed the time to failure during the first 30 days. The reported failure rate was 32% (95% confidence interval [CI] 21-45%; I2 = 88%). Regarding risk factors for failure, bladder invasion or deformity of the trigone had a hazard ratio (HR) of 4.8 (95% CI 1.28-8.5; I2 = 97.4%); severe hydronephrosis had a HR of 3.92 (95% CI 0.32-7.52; I2 = 93.9%); and age <65 years had a HR of 0.93 (95% CI 0.8-0.9; I2 = 0%). We found a high probability of failure for endoscopic urinary decompression in patients with malignant ureteric obstruction. Factors such as bladder invasion or deformity of the trigone and age >65 years had an increased risk of failure.


Physical, Psychological, and Cognitive Profile of Post-COVID Conditions in Healthcare Workers, Quebec, Canada.
The prevalence of post-COVID conditions (PCC) and associated physical, psychological, and cognitive symptoms was assessed among Quebec healthcare workers (HCWs) with coronavirus disease 2019 (COVID-19). This case-control study compared 6061 symptomatic HCWs with polymerase chain reaction-confirmed COVID-19 between July 2020 and May 2021 with a random sample of 4390 symptomatic HCWs who were test-negative controls. The prevalence of physical symptoms lasting ≥4 weeks (PCC4w) or ≥12 weeks (PCC12w) was estimated among hospitalized and nonhospitalized cases. In multivariate models, sociodemographic and clinical characteristics, as well as vaccine history, were evaluated as potential risk factors. Prevalence ratios compared 4 aspects of self-reported cognitive dysfunction among PCC cases to controls, adjusting for psychological distress and fatigue. PCC4w and PCC12w prevalences of 46% (2746/5943) and 40% (653/1746), respectively, were observed among nonhospitalized cases and 76% (90/118) and 68% (27/37), respectively, among hospitalized cases. Hospitalization, female sex, and age were associated with higher PCC risk. A substantial proportion of nonhospitalized PCC4w cases often or very often reported cognitive dysfunction, including concentration (33%) or organizing (23%) difficulties, forgetfulness (20%), and loss of necessary items (10%). All 4 aspects of cognitive dysfunction were associated with PCC4w symptoms, psychological distress, and fatigue. PCC may be a frequent sequela of ambulatory COVID-19 in working-age adults, with important effects on cognition. With so many HCWs infected, the implications for quality healthcare delivery could be profound if cognitive dysfunction and other severe PCC symptoms persist in a professionally disabling way. Further evaluation of PCC prevalence and prognosis is warranted.


Bilateral psoas release for long standing hip-spine syndrome: surgical technique and case report.
Severe positive sagittal malalignment can potentially lead to shortening and contracture of the psoas and joint capsule in a flexed spinopelvic position. The utilization of bilateral psoas release to supplement sagittal spinal deformity correction in the same hospitalization was not reported in the literature. A 66-year-old patient presented with a 5-year history of severe global spinal deformity (sagittal vertical axis 220 mm, 60° spinopelvic mismatch) that did not improve on supine radiographs, and a modified Thomas test with more than 30° flexion contracture of bilateral hips. A 3-stage operation utilizing posterior spinal column osteotomies, anterior lumbar interbody fusion, and bilateral psoas releases was performed. Her postoperative alignment significantly improved and she was pleased with her new posture and the ability to stand up straight. This report is the first to demonstrate safe and substantial correction of severe spinal deformities associated with bilateral hip flexion contracture in 1 hospitalization.


Postoperative opioid use following head and neck endocrine surgery: A multi-center prospective study.
Opioid abuse is widespread in North America and the over-prescription of opioids are a contributing factor. The goal of this prospective study was to quantify over-prescription rates, evaluate postoperative experiences of pain, and understand the impact of peri-operative factors such as adequate pain counseling and use of non-opioid analgesia. Consecutive recruitment of patients undergoing head and neck endocrine surgery was undertaken from January 1st 2020 to December 31st 2021 at four Canadian hospitals in Ontario and Nova Scotia. Postoperative tracking of pain levels and analgesic requirements were employed. Chart review and preoperative and postoperative surveys provided information on counseling, use of local anesthesia, and disposal plans. A total of 125 adult patients were included in the final analysis. Total thyroidectomy was the most common procedure (40.8%). Median use of opioid tablets was 2 (IQR 0-4), with 79.5% of prescribed tablets unused. Patients who reported inadequate counseling (n = 35, 28.0%) were more likely to use opioids (57.2% vs. 37.8%, p < .05) and less likely to use non-opioid analgesia in the early postoperative course (42.9% vs. 63.3%, p < .05). Patients who received local anesthesia peri-operatively (46.4%, n = 58) reported less severe pain on average [2.86 (2.13) vs. 4.86 (2.19), p < .05] and used less analgesia on postoperative day one [0 MME (IQR 0-4) vs. 4 MME (IQR 0-8), p < .05]. Over-prescription of opioid analgesia following head and neck endocrine surgery is common. Patient counseling, use of non-opioid analgesia, and peri-operative local anesthesia were important factors in narcotic use reduction. Level 3.


A new concept for variance analysis of hyphenated chromatographic data avoiding signal warping.
Analysis of variance of chromatographic data is usually performed on the peak table or on entire chromatograms. These two data forms require signal pretreatment. Peak table requires peak detection, their standards and quantification, and the second form of data organization requires warping of the studied chromatograms to eliminate the observed peak shifts, which occurs due to minor variations in chromatographic conditions. In our study, a new form of data representation well suited for chromatographic data originating from multi-channel detection is proposed. It requires neither warping of chromatograms, nor peak detection. Its principles and performance are demonstrated for a real data set (being a part of a larger research project initiated to characterize the infusion of fermented rooibos herbal tea in terms of phenolic composition and antioxidant activity). As the method of choice for the analysis of data variation, the Multiple Analysis of Variance applied to the pairwise data representation was chosen.


Relationship between Escherichia coli AppA phytase's thermostability and salt bridges.
In order to study on the relationship between Escherichia coli AppA phytase's thermostability and salt bridges, and indicate an effective technical route of which factor to think about and where to modify at AppA for enhancing its thermostability, a salt bridge subtraction mutant E31Q and a salt bridge addition mutant Q307D were constructed by site-directed mutagenesis. The residual activities of the wild-type AppA phytase, E31Q and Q307D were 31.42%, 17.46%, and 40.57%, respectively, after being heated at 80°C for 10 min. The salt bridge subtraction mutant E31Q showed 13.96% thermostability decreasement, and the salt bridge addition mutant Q307D showed 9.15% thermostability enhancement than the wild-type both without the pH and temperature optimum changed. It proved salt bridges play a key role in E. coli AppA phytase's thermostability and the α/β-domain of AppA may be sensitive to heat. Salt bridges and the α/β-domain of AppA should have high priority to think about to enhance AppA's thermostability for commercial application. Besides, molecular dynamics simulation was used for salt bridges analysis.


ATP-regulated interactions between P1 ParA, ParB and non-specific DNA that are stabilized by the plasmid partition site, parS.
Localization of the P1 plasmid requires two proteins, ParA and ParB, which act on the plasmid partition site, parS. ParB is a site-specific DNA-binding protein and ParA is a Walker-type ATPase with non-specific DNA-binding activity. In vivo ParA binds the bacterial nucleoid and forms dynamic patterns that are governed by the ParB-parS partition complex on the plasmid. How these interactions drive plasmid movement and localization is not well understood. Here we have identified a large protein-DNA complex in vitro that requires ParA, ParB and ATP, and have characterized its assembly by sucrose gradient sedimentation and light scattering assays. ATP binding and hydrolysis mediated the assembly and disassembly of this complex, while ADP antagonized complex formation. The complex was not dependent on, but was stabilized by, parS. The properties indicate that ParA and ParB are binding and bridging multiple DNA molecules to create a large meshwork of protein-DNA molecules that involves both specific and non-specific DNA. We propose that this complex represents a dynamic adaptor complex between the plasmid and nucleoid, and further, that this interaction drives the redistribution of partition proteins and the plasmid over the nucleoid during partition.


A doctor's ability to assess the severity of childhood asthma by simple clinical features.
To ascertain whether the severity of childhood asthma can be reliably assessed by simple clinical features, 94 newly diagnosed, school-aged asthmatic children were investigated. The study included parental interviews, physical examination, skin prick tests, lung function studies, including a brief visual interpretation of the flow-volume curve, and a 6-min exercise challenge test on a treadmill, which was used as a reference. Baseline lung function studies showed a concave-shaped flow-volume curve in 40 (43%) patients, reduced maximal mid-expiratory flow (MMEF) in 25 (27%) and a reduced ratio of forced expiratory volume in 1 s to forced vital capacity (FEV(1)/FVC) in 14 (15%). The drop in peak expiratory flow (PEF) after exercise ranged from 0 to 79% of the baseline (mean 21.3%) and exceeded 12.5% in 52 (55%) patients. There was a small but significant correlation between the baseline FEV(1)/FVC and MMEF values and the response to exercise (r=-0.39 and -0.35; p=0.000, respectively), but when studied by linear regression analysis, the response to exercise was best predicted by the past symptom rate and a concave pattern in the pre-test maximal expiratory flow-volume curve. The values of traditional lung function tests or age, atopy, duration of symptoms or history of exercise-induced wheezing did not remain in the model. These results show that the severity of asthma in school-aged children can be predicted at the first visit based on the past rate of symptoms and a visual interpretation of the maximal expiratory flow-volume curve.


Idarucizumab for Intravenous Thrombolysis and Endovascular Thrombectomy in Acute Stroke: A Case Report.
Non-vitamin K antagonist oral anticoagulants (NOACs), such as dabigatran, are widely used to prevent ischemic stroke in patients with nonvalvular atrial fibrillation. Nonetheless, stroke occurs in 1-2% of patients, and the use of NOACs may increase the bleeding risk for patients who are receiving acute treatment of intravenous thrombolysis (IVT) or endovascular thrombectomy (EVT). Idarucizumab, a monoclonal antibody developed to bind dabigatran, has been proven safe and effective for patients with uncontrolled bleeding or for patients planning to receive emergent procedures. It is now accepted that patients taking dabigatran with recurrent stroke may benefit from IVT after idarucizumab. However, there are limited data regarding idarucizumab use in patients planning to have EVT. We present the case of a male patient taking dabigatran who had a stroke and who was treated with idarucizumab followed by combined IVT and EVT. The patient had immediate recanalization of the occluded vessel and near total recovery of function after 3 months. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Our case report supports the evidence that patients presenting with acute ischemic stroke (AIS) despite being under dabigatran therapy should be evaluated for reversal by idarucizumab which can contribute to the eligibility for IVT as well as EVT. It has also been proved to provide better outcomes for patients with AIS. The availabilities of specific reversal agents for NOACs will probably alter the current management of patients with AIS.


Association of aldosterone excess and apnea-hypopnea index in patients with resistant hypertension.
The present study was to investigate the association of aldosterone excess and apnea-hypopnea index (AHI) in patients with resistant hypertension. Patients with resistant hypertension were enrolled and baseline characteristics including plasma aldosterone concentration (PAC) and 24 h-urine aldosterone levels were collected and compared between groups with different degrees of AHI as assessed by polysomnography. Association of key variables and AHI was then evaluated by univariate and multiple linear regression analysis. A total of 534 patients with resistant hypertension were enrolled and mean age was 57 ± 11 years. Overall, mean number of AHI was 21.7 ± 9.6 and nearly 92.3% of resistant hypertensive patients had obstructive sleep apnea (OSA). Mean PAC and 24 h-urine aldosterone level was 12.4 ± 6.3 ng/dL and 13.1 ± 6.8 ug, respectively. Compared with other groups, participants in the severe OSA group (AHI ≥ 30) had significantly higher PAC and 24 h-urine aldosterone level. Multiple linear regression analysis showed that PAC and 24 h-urine aldosterone levels were positively associated with AHI, while spironolactone was negatively associated with AHI, independent of age, gender, body mass index, smoking, plasma renin activity and diuretics. OSA is highly prevalent in patients with resistant hypertension and both PAC and 24 h-urine aldosterone level are significantly associated with AHI.


Hyperlipidemia Downregulate Brain Antioxidant Defense Enzymes and Neurotrophins in Rats: Assessment of the Modulatory Potential of EPA+DHA and Zerumbone.
Oxidative stress (OS) plays a vital role in the pathogenesis of cognitive disorders. In this study, brain antioxidant defense dysregulation as a consequence of hyperlipidemia, and the efficacy of eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA), and zerumbone (Z) in their modulation are assessed. Male Wistar rats are fed control, high-fat (HF), HF + fish oil (HF+F), HF + zerumbone (HF+Z), and HF + fish oil + zerumbone (HF+F+Z) diet for 60 days. Markers of OS, antioxidant enzymes, monoamine oxidase, nuclear factor (erythroid-derived 2)-like 2 (NRF-2), nitric oxide-2 (NOS-2), inter cellular adhesion molecule-1 (ICAM-1), and neurotrophins are measured. Hyperlipidemia increases OS, decreases antioxidant enzyme activity, increases monoamine oxidase activity, increases NOS-2 and ICAM-1 expression, decreases NRF-2 activation, decreases nerve growth factor (NGF), and brain-derived neurotrophic factor (BDNF) levels in the brain compared to control. While EPA+DHA and zerumbone significantly (p < 0.05) restores the perturbations induced by hyperlipidemia. It is concluded that hyperlipidemia cause OS by decreasing the activity of brain antioxidant enzymes via the downregulation of NRF-2. The reduced brain neurotrophins in hyperlipidemia indicate its potential risk on cognitive attributes. EPA+DHA, together with zerumbone, positively modulates hyperlipidemia induced brain dysfunction thereby offering promising therapeutic strategy.


The possible role of long non-coding RNAs in recurrent miscarriage.
Recurrent miscarriage (RM) is a complicated disease in reproductive medicine that impacts many families. Currently, the etiology of RM is thought to include chromosome abnormalities, reproductive tract malformations, autoimmune dysfunction, infection, and environmental factors. However, the underlying mechanisms of RM remain unknown. At present, research on long non-coding RNAs (lncRNAs) is rapidly emerging and becoming a hot research topic in epigenetic studies. Recent studies revealed that lncRNAs are strongly linked to RM and play a crucial role in epigenetic, cell cycle, cell differentiation regulation, and other life activities. This article mainly reviews the difference in lncRNA expression in patients with RM and regulation of susceptibility, endometrial receptivity, and the maternal-fetal interface. Meanwhile, the correlation between lncRNAs and RM is expounded, which provides new insights for the early diagnosis and treatment of RM.


Differences in personal care product use by race/ethnicity among women in California: implications for chemical exposures.
Personal care products may contain many chemicals, some of which are suspected endocrine disrupters. This is an important source of chemical exposure for women, but little is known about how chemical exposure differs among different races/ethnicities. This study examines differences in personal care product use among Black, Latina, Vietnamese, Mixed Race, and White women in California. We used a community-based participatory process to create and administer a personal care product usage survey to 321 Black, Latina, Vietnamese, Mixed Race, and White women. We used multivariate regression models with pairwise comparisons to examine the frequency of product use by race/ethnicity. We found distinct trends of personal care product use by race/ethnicity: Latina women typically used makeup most frequently; Black women used certain hair products or styles most frequently; and Vietnamese women were most likely to use facial cleansing products compared to other races/ethnicities. Latina and Vietnamese women were less likely to try to avoid certain ingredients in their products. These findings can help estimate disparities in chemical exposure from personal care product use and complement future research on health inequities due to chemical exposures in the larger environmental and social context.


Intraocular soluble intracellular adhesion molecule-1 correlates with subretinal fluid height of diabetic macular edema.
To investigate the correlations between aqueous concentrations of vascular endothelial growth factor (VEGF), monocyte chemoattractant protein-1 (MCP-1), soluble intracellular adhesion molecule-1 (sICAM-1) and diabetic macular edema (DME). VEGF, MCP-1 and sICAM-1 concentrations in aqueous humor samples of 22 patients with DME and 23 patients with cataract of a control group were measured with solid-phase chemiluminescence immunoassay. Aqueous VEGF (89.2 ± 58.5 pg/ml versus 48.5 ± 27.8 pg/ml, P = 0.006), MCP-1 (684.2 ± 423.4 pg/ml versus 432.4 ± 230.4 pg/ml, P = 0.019) and sICAM-1 (3213.8 ± 2581.6 pg/ml versus 260.2 ± 212.2 pg/ml, P < 0.001) all vary significantly between DME group and control group. Maximum height of submacular fluid measured by Optical coherence tomography (OCT) was significantly associated with aqueous sICAM-1 (r = -0.45, P = 0.034). The maximum height of macular thickness measured by OCT was not significantly associated with either VEGF (P = 0.300), MCP-1 (P = 0.320) or sICAM-1 (P = 0.285). Our results suggest that sICAM-1 may majorly contribute to the formation of subretinal fluid in DME patients and imply that MCP-1 and sICAM-1 may be the potential therapy targets, besides VEGF.


Presurgical cognitive status in patients with low-grade glioma and epilepsy: Testing the effects of seizures, antiseizure medications, and tumor localization.
Low-grade gliomas (LGGs) are frequently associated with epilepsy. There are few studies addressing the impact of seizures, antiseizure medications (ASMs), and lesion localization on presurgery cognitive functioning. We tested the relation between the above-mentioned variables in a continuous series of 73 young patients (mean age 38.3 years ± 11.7) affected by LGGs and epilepsy. The anatomical areas, involved in this sample, were the left insula with surrounding cortical and subcortical areas, the right precentral gyrus/rolandic operculum, and the white matter and cortical regions beneath. Patients' presurgery cognitive status was within the normal range, with borderline performance for some tasks. We tested whether lower scores were related with lesion or with epilepsy-related factors. Multiple regression identified variables that predict test scores. The Token test score was predicted by a model (p = .0078) containing the DT2T1 MRI, corrected for seizure features. Object naming performance was predicted by a model (p = .0113) containing the localization, the DT2T1 MRI, corrected for sex, EEG, and onset. Verbal fluency score was predicted by a model (p = .0056) containing the localization and the DT2T1 MRI, corrected for AEDs and EEG. Working memory score was predicted by a model (p = .0117) containing Engel class, the DT2T1 MRI, corrected for sex. Clock drawing score was predicted by a model (p < .0001) containing the Engel class, AEDs, and EEG. TMT A score was predicted by a model (p = .0022) containing localization, corrected for EEG. TMT B-A score was predicted by a model (p = .0373) containing localization. Voxel Lesion Symptom Mapping analyses carried out on patients' lesion volumes confirmed that patients' level of performance correlated with lesion-related variables. This preliminary study indicates that the presurgical level of performance for language tasks and for cognitive flexibility and shifting is mainly predicted by lesion-related variables, working memory by both lesion and epilepsy-related variables. Epilepsy clinical and instrumental characteristics predicted performance for visuospatial planning.


Prevention of pressure injuries in critically ill children: A preliminary evaluation.
To evaluate a prevention strategy implemented to reduce incidence and severity of positioning related pressure injuries affecting pediatric patients in a pediatric critical care unit. Secondary objective was to evaluate compliance with preventive recommendations. The skin in infants or children has important physiological and anatomical differences compared with adults. Further, factors such as the immaturity of the skin and limited activity and mobility in pediatric critical care unit, along with the pressure exerted by medical devices, increases the risk of pressure ulcers in infants and children. The most effective preventive measures specific to this intensive care population need to be evaluated. Quasi-experimental before-after study with consecutive sampling. The effectiveness of the care bundle implementation was evaluated based on the latest evidence (intervention group) versus the application of non-standardized care (control group). Pediatric patients up to 14 years old at risk of suffering from pressure injuries and who were admitted more than 48 h in a pediatric intensive care unit (level III) participated. For the collection of data, two computer programs and the hospital clinical records of each participant were consulted. The data collection period was 6 months per group (pre and post intervention). A sample of 110 patients was obtained (50 control group and 60 intervention group). The cumulative incidence in pediatric patients exposed to the risk of pressure injuries was reduced from 16% to 13.3%; and in the subgroup of patients with prolonged stay (≥28 days), the incidence was reduced from 55.55% to 20%. In the intervention group, category III and IV pressure ulcers were completely reduced. In addition, the total number of pressure injuries decreased by 21.43%. The care bandle recommendations with the highest level of adhesion recorded were: skin inspection, application of hyperoxygenated fatty acids and use of a special support surface. The main risk factor found during the study was the prone position (p < 0.05). The application of a care bundle for prevention can be an effective solution to reduce the number and severity of LPPs in an intensive care unit. The most vulnerable subgroup of patients may benefit from the application of these resources.


Abdominal aortic wall motion of healthy and hypertensive subjects: evaluation of tissue Doppler velocity imaging.
To investigate the potential clinical application of tissue Doppler imaging (TDI) for motion measurement of the aortic wall in healthy and hypertensive adults. We used TDI to examine 53 hypertensive and 29 sex-matched healthy adults. Maximum velocity of the first and second systolic wall expansion peaks (S1, S2), maximum velocity of early (D) and end (E) diastolic retraction velocity peaks, pulse wave transmit time (PWTT), and stiffness index (beta) of the abdominal aorta were measured and compared as for factors influencing vascular compliance, including age, sex, and blood pressure. Compared with the healthy subjects, the wall motion waveform of hypertensive patients showed absent E, mixed S1 and S2 peaks, and blunted S1. S1 and D were lower in hypertensive than in healthy subjects. Shortened PWTT and increased indicated increased aortic stiffness in both male and female hypertensive subects when compared with controls. Age, diastolic blood pressure (DBP) and sex were the significant independent factors modulating S1, while DBP and age were the significant independent factors modulating D. PWTT was independently influenced by age and systolic blood pressure. This study provides evidence that abdominal aortic wall motion measurement with TDI could demonstrate qualitative and quantitative wall motion features differentiating hypertensive from healthy adults. Wall motion velocity and PWTT could reflect abdominal aortic compliance changes related to age, sex, and blood pressure.


Laser Raman spectra of calf thymus histones H1, H2A, and H2B.
Laser Raman spectra of the calf thymus histones H1, H2A, and H2B in aqueous solutions are presented. The amide III band in the spectrum of the very lysine-rich histone H1 in aqueous solution appears at 1245 cm-1, which is almost at the same frequency as the corresponding vibration of the ionized form of poly(L-lysine). Upon increasing the NaCl concentration to 1 M, the frequency of the amide III vibration shifts to 1250 cm-1 as a result of the formation of a more compact disordered structure of at least the N-terminal region of the protein. Changing the pH from 3 to 5 induces the same frequency shift. The amide III regions of the Raman spectra of the slightly lysine-rich histones H2A and H2B shows two bands at 1247 and 1265 cm-1 for H2A, and at 1254 and 1265 cm-1 for H2B. These doublets are attributed to vibrations involving the backbone of at least two structurally distinct parts of the histone molecules. The low frequency component is assigned to the random-coil regions of the proteins which appear to have similar conformations for H1 and H2A. The frequency of this component also suggest that the structure of the disordered regions of H2B are more compact and less extended. These conclusions confirm the conformation predictions based on the primary structures of these proteins. The high frequency component at 1265 cm-1 is assigned to the alpha-helical and rigid disordered structures of H2A and H2B, since this band increases in intensity upon addition of NaCl. The amide I' region of the histone spectra is also presented but appears to be much less sensitive to the conformation than the amide III region. The intensity of the bands due to the single bond C-C stretching modes, as well as the intensity ratio of the tyrosine Fermi doublet at 855 and 830 cm-1, are also discussed.


Cyclooxygenase products of metabolism of arachidonic acid in mouse macrophages exposed to N-phenyllinoleamide from toxic oil samples.
N-phenyllinoleamide (NPLA), one of the major extraneous constituents of Spanish toxic oil samples, appears to enhance the cyclooxygenase metabolic pathway of arachidonic acid by peritoneal mouse macrophages. Results reported herein show an increased biosynthesis of 6-oxo-PGF1 alpha and TXB2 by macrophages exposed to NPLA. However, light and electron microscopy failed to show cellular alterations in macrophages incubated with NPLA for two hours at 27 degrees C. These data suggest a possible involvement of cyclooxygenase arachidonic acid metabolism in the etiopathogenesis of the Spanish Toxic Oil Syndrome.


HIV-1 core proteins expressed from recombinant vaccinia viruses.
The sequences encoding the core proteins p55, p25, and p18 of the human immunodeficiency virus (HIV-1) have been inserted into the vaccinia virus genome. Infection of cultured cells with the live recombinant viruses led to the expression of proteins that were recognized by sera from HIV-seropositive individuals. Immunization of mice with the recombinant virus expressing the HIV p25 protein and the p55 precursor yielded high levels of antibodies directed against the corresponding HIV antigens. The data obtained are discussed in terms of the possible use of these live recombinant viruses in the development of a strategy toward an AIDS vaccine.


Predicting post-operative vault and optimal implantable collamer lens size using machine learning based on various ophthalmic device combinations.
Implantable Collamer Lens (ICL) surgery has been proven to be a safe, effective, and predictable method for correcting myopia and myopic astigmatism. However, predicting the vault and ideal ICL size remains technically challenging. Despite the growing use of artificial intelligence (AI) in ophthalmology, no AI studies have provided available choices of different instruments and combinations for further vault and size predictions. This study aimed to fill this gap and predict post-operative vault and appropriate ICL size utilizing the comparison of numerous AI algorithms, stacking ensemble learning, and data from various ophthalmic devices and combinations. This retrospective and cross-sectional study included 1941 eyes of 1941 patients from Zhongshan Ophthalmic Center. For both vault prediction and ICL size selection, the combination containing Pentacam, Sirius, and UBM demonstrated the best results in test sets [R2 = 0.499 (95% CI 0.470-0.528), mean absolute error = 130.655 (95% CI 128.949-132.111), accuracy = 0.895 (95% CI 0.883-0.907), AUC = 0.928 (95% CI 0.916-0.941)]. Sulcus-to-sulcus (STS), a parameter from UBM, ranked among the top five significant contributors to both post-operative vault and optimal ICL size prediction, consistently outperforming white-to-white (WTW). Moreover, dual-device combinations or single-device parameters could also effectively predict vault and ideal ICL size, and excellent ICL selection prediction was achievable using only UBM parameters. Strategies based on multiple machine learning algorithms for different ophthalmic devices and combinations are applicable for vault predicting and ICL sizing, potentially improving the safety of the ICL implantation. Moreover, our findings emphasize the crucial role of UBM in the perioperative period of ICL surgery, as it provides key STS measurements that outperformed WTW measurements in predicting post-operative vault and optimal ICL size, highlighting its potential to enhance ICL implantation safety and accuracy.


Attempts to label matrix synthesis of human root cementum in vitro.
The present study describes the dynamic process of both acellular extrinsic (AEFC) and acellular/cellular intrinsic fiber cementum (AIFC/CIFC) matrix production on growing human teeth. Selected erupting maxillary and mandibular premolars with roots grown to about 70%-95% of their final length were placed in organ culture immediately following extraction. Twelve teeth for short-time labeling were pulse-incubated for 15 min in medium containing 3H-proline and chased for various times in order to follow the migration and secretion of the tracer. Eight teeth for long-time incubation were labeled continuously for 5 h before being chased for 1-8 days in order to label cementum matrix accumulation. After decalcification in ethylene diaminetetraacetic acid (EDTA), their roots were subdivided into about 20 slices each. Epon-embedded sections were prepared for light- and electron-microscopic as well as autoradiographic examination. During CIFC-formation, cementoblasts revealed high intracytoplasmic silver grain concentrations within the first hour after 3H-proline administration. The release of the tracer occurred between 60 to 120 min after administration. After 2 h, cementoblasts and the cementum matrix appeared to be labeled about equally. After 5 h, most of the labeled proteins appeared to be localized in the cementoid. Silver grains increased in number over the cementum matrix from 5-24 h. Very high intracellular grain concentrations within very large cementoblasts corresponded to regions of rapid cementum formation. Tracer-halos around entrapped cells lend support to a multipolar mode of matrix production during CIFC-initiation. The fate of the tracer during the development of early AEFC-matrix was less clear. However, fibroblasts revealed dense intracytoplasmic grain accumulations within the first hour after 3H-proline administration. Thereafter, the tracer localization was vague. This indistinct grain localization reflected the particular mode of AEFC-matrix production characterized by addition of new fibril segments to pre-existing fibers of a collagenous fringe.


Foxp3⁺ Treg cells in the inflamed CNS are insensitive to IL-6-driven IL-17 production.
Foxp3(+) T regulatory (Treg) cells can be induced to produce interleukin (IL)-17 by in vitro exposure to proinflammatory cytokines, drawing into question their functional stability at sites of inflammation. Unlike their splenic counterparts, Treg cells from the inflamed central nervous system (CNS-Treg cells) during EAE resisted conversion to IL-17 production when exposed to IL-6. We show that the highly activated phenotype of CNS-Treg cells includes elevated expression of the Th1-associated molecules CXCR3 and T-bet, but reduced expression of the IL-6 receptor α chain (CD126) and the signaling chain gp130. We found a lack of IL-6 receptor on all CNS CD4(+) T cells, which was reflected by an absence of both classical and trans-IL-6 signaling in CNS CD4(+) cells, compared with their splenic counterparts. We propose that extinguished responsiveness to IL-6 (via down-regulation of CD126 and gp130) stabilizes the regulatory phenotype of activated Treg cells at sites of autoimmune inflammation.


Anaesthetic management of peripartum cardiomyopathy using "epidural volume extension" technique: a case series.
Peripartum cardiomyopathy is a rare cause of dilated cardiomyopathy in parturients, occurring in approximately one in 1000 deliveries, manifesting during the last few months or the first 5 months of the postpartum period. It can result in severe ventricular dysfunction during late puerperium. The major concern while managing these patients is to optimize fluid administration and avoid myocardial depression, while maintaining stable intraoperative hemodynamics. We present a case series of five parturients that were posted for elective cesarean section and managed successfully by the epidural volume extension technique.


Declining Resident Surgical Autonomy and Improving Surgical Outcomes: Correlation Does Not Equal Causality.
The volume of cases that residents perform independently have decreased leaving graduating chief residents less prepared for independent practice. Outcomes are not worse when residents are given autonomy with appropriate supervision, however it is unknown if outcomes are worsening with decreasing operative autonomy experience. We hypothesize that resident autonomous cases parallel the improving outcomes in surgical care over time, however, are less complex and on lower acuity patients. Retrospective study utilizing the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database. Operative cases performed on teaching services within the VASQIP database from July 1, 2004 to September 30, 2019, were included. All adult patients who underwent a surgical procedure from July 1, 2004, to September 30, 2019, at a VA hospital on a service that included residents were initially included. After inclusions and exclusions, there were 1,346,461 cases. Cases were divided into 3 sequential 5 year eras (ERA 1: 2004-2008 n = 415,614, ERA 2: 2009-2013 n = 478,528, and ERA 3: 2014-2019 n = 452,319). The main exposure of interest was level of resident supervision, coded at the time of procedure as: attending primary surgeon (AP); attending and resident (AR), or resident primary with the attending supervising but not scrubbed (RP). We compared 30 day all-cause mortality, composite morbidity, work relative value unit (wRVU), hospital length of stay, and operative time between each ERA for RP cases, as well as within each ERA for RP cases compared to AR and AP cases. There was a progressive decline in the rate of RP cases in each successive ERA (ERA 1: 58,249 (14.0%) vs ERA 2: 47,891 (10.0%) vs ERA 3: 35,352 (7.8%), p < 0.001). For RP cases, patients were progressively getting older (60 yrs [53-71] vs 63 yrs [54-69] vs 66 yrs [57-72], p < 0.001) and sicker (ASA 3 58.7% vs 62.5% vs 66.2% and ASA 4/5 8.4% vs 9.6% vs10.0%, p < 0.001). Odds of mortality decreased in each ERA compared to the previous (aOR 0.71 [0.62-0.80] ERA 2 vs ERA 1 and 0.82 [0.70-0.97] ERA 3 vs ERA 2) as did morbidity (0.77 [0.73-0.82] ERA 2 vs ERA 1 and 0.72 [0.68-0.77] ERA 3 vs ERA 2). Operative and length of stay also decreased while wRVU stayed unchanged. When comparing RP cases to AP and AR within each ERA, RP cases tended to be on younger and healthier patients with a lower wRVU, particularly compared to AR cases. Mortality and morbidity were no different or better in RP compared to AR and AP. Despite resident autonomy decreasing, outcomes in cases where they are afforded autonomy are improving over time. This despite RP cases being on sicker and older patients and performing roughly the same complexity of cases. They also continue to perform no worse than cases with higher levels of supervision. Efforts to increase surgical resident operative autonomy are still needed to improve readiness for independent practice.


Enhancing extracellular electron transfer through selective enrichment of Geobacter with Fe@CN-modified carbon-based anode in microbial fuel cells.
Microbial fuel cells (MFCs) have been demonstrated as a renewable energy strategy to efficiently recover chemical energy stored in wastewater into clean electricity, yet the limited power density limits their practical application. Here, Fe-doped carbon and nitrogen (Fe@CN) nanoparticles were synthesized by a direct pyrolysis process, which was further decorated to fabricate Fe@CN carbon paper anode. The modified Fe@CN anode with a higher electrochemically active surface area was not only benefit for the adhesion of electrochemically active microorganisms (EAMs) and extracellular electron transfer (EET) between the anode and EAMs but also selectively enriched Geobacter, a typical EAMs species. Accordingly, the MFCs with Fe@CN anode successfully achieved a highest voltage output of 792.76 mV and a prolonged stable voltage output of 300 h based on the mixed culture feeding with acetate. Most importantly, the electroactive biofilms on Fe@CN anode achieved more content ratio of proteins to polysaccharides (1.40) in extracellular polymeric substances for the balance between EET and cell protection under a harsh environment. This work demonstrated the feasibility of development on anode catalysts for the elaboration of the catalytic principle about interface modification, which may contribute to the practical application of MFC in energy generation and wastewater treatment.


Huang-Lian-Jie-Du extract ameliorates atopic dermatitis-like skin lesions induced by 2,4-dinitrobenzene in mice via suppression of MAPKs and NF-κB pathways.
Huang-Lian-Jie-Du Decoction (HLJDD), is a well-known traditional Chinese herbal formula first written in the Tang dynasty. In Chinese medicine practice, HLJDD is commonly prescribed to treat various inflammatory skin diseases, such as atopic dermatitis (AD) and psoriasis. The present study aimed at investigating the therapeutic effect of HLJDD extract (HLJDE) and to elucidate the underlying molecular mechanisms of action in the 1-chloro-2,4-dinitrobenzene (DNCB)-induced AD-like mice. Female Balb/c mice were sensitized with DNCB for three days. After sensitization, mice were challenged with DNCB every three days and orally administrated with HLJDE (150, 300 and 600 mg/kg) daily from day 14 to day 29 for consecutive 16 days. At the end of experiment, the clinical AD scores of the mice were calculated to evaluate the therapeutic effect of HLJDE, and serum, ears and dorsal skin of the mice were collected for unravelling molecular mechanisms. HLJDE significantly reduced the clinical symptoms in the AD-like mice by inhibiting eosinophil and mast cell infiltration, suppressing the production of Th2-associated cytokine (IL-4) and pro-inflammatory cytokines (TNF-α). In addition, HLJDE significantly suppressed the NF-κB and MAPKs pathways. Moreover, HLJDE was able to accentuate filaggrin expression in the skin lesion when compared to the sensitized mouse without treatment. HLJDE significantly improved the AD-like symptoms on the DNCB-sensitized mice through mitigating the production of inflammatory mediators via suppressing MAPKs and NF-κB pathways. Additionally, the elevated expression of filaggrin in the skin lesion by HLJDE contributes to the recovery of dysfunctional skin barrier on the DNCB-sensitized mice.


Efficacy and safety of direct peroral cholangioscopy using a new multibending ultra-slim endoscope for the management of biliary diseases.
Compared with currently available duodenoscopy-assisted systems, direct peroral cholangioscopy (DPOC) using an ultra-slim endoscope is limited by technical difficulties. The multibending (MB) ultra-slim endoscope was introduced as a dedicated cholangioscope for DPOC to challenge the technical problem. We retrospectively analyzed the clinical utility of DPOC using an MB endoscope with free-hand insertion into the bile duct in patients with biliary diseases. A total of 145 patients who underwent DPOC using an MB endoscope were analyzed. The primary outcome was the technical success rate of DPOC using the free-hand insertion of the MB endoscope. The secondary outcomes were the technical success rates of DPOC-guided diagnostic and therapeutic interventions, the diagnostic accuracy of DPOC-guided target biopsy, and adverse events related to DPOC. Free-hand biliary insertion of a MB endoscope for DPOC was technically successful in 133 patients (91.7%). DPOC-guided target biopsy was successful in 36 of 38 patients (94.7%) and had a diagnostic accuracy of 91.7% (95% confidence interval, 82.6-100). Sixty-nine therapeutic interventions were performed; technical success was achieved in 65 (94.2%). No severe adverse events were observed. The MB ultra-slim endoscope was technically effective to perform a DPOC including various diagnosis and therapeutic interventions without device assistance. MB endoscope is considered to contribute to expanding a role of DPOC in diagnosis and treatment of diverse biliary tract diseases.


Screening of positive inotropic agents in isolated cardiac preparations from different sources.
The present study was designed to elucidate whether or not the positive inotropic effects of isoprenaline, milrinone, and DPI 201-106 in myocardial tissue from various sources reveal reliable results for the failing human heart. Therefore, in vitro positive inotropic responses were studied in human papillary muscle strips from patients with moderate heart failure (NNYHA II-III), human atrial trabeculae (HAT), isolated papillary muscles from Wistar-Kyoto rats (WK), and from spontaneously hypertensive rats (SHR). Results were compared with the effects of the compounds in papillary muscle strips from patients with severe heart failure (NYHA IV). In NYHA IV, positive inotropic responses were smaller for isoprenaline and milrinone than in NYHA II-III. The response to DPI 201-106 was more pronounced. In HAT, the effects of isoprenaline and milrinone were greater than in NYHA IV. The positive inotropic effect of DPI 201-106 was similar. In SHR, only the positive inotropic effect of isoprenaline was smaller than in WK. The effects of DPI 201-106 and milrinone did not differ. These data show that inotropic responses in NYHA II-III, HAT, WK, and SHR differ from the severely failing myocardium. It is concluded that new positive inotropic agents should be screened in human myocardial tissue from patients with heart failure, as experimental results from other sources may be irrelevant in this respect.


Comparison of concentrations of amoxicillin and ampicillin in serum and middle ear fluid of children with chronic otitis media.
Twenty-eight children aged five to nine years with chronic serous otitis media received a single dose of either ampicillin or amoxicillin by the oral route 1-2 hr before the removal of middle ear fluid by ventilation tubes inserted through the tympanic membrane. At the time middle ear fluid was obtained, a sample of blood was drawn from the patient, and levels of antibiotic in both specimens were microbiologically assayed by a disk diffusion method. Levels of amoxicillin (mean+/-standard error [SE], 1.48+/-1.6 microng/ml) in middle ear fluid were consistently and significantly higher (P less than 0.05) than levels of ampicillin (mean+/-SE, 6.2+/-5.0 microng/ml).


Fine needle aspiration cytodiagnosis of anaplastic carcinoma and malignant haemangioendothelioma of the thyroid in an endemic goitre area.
Between 1970 and 1987, 20,028 fine needle aspirates (FNA) of the thyroid have been examined in the Department of Pathology of the University of Innsbruck, Austria. During this period 92 cases of anaplastic carcinoma and 16 cases of malignant haemangioendothelioma (MHE) of the thyroid were diagnosed. Forty-three out of these 108 highly malignant tumours of the thyroid underwent FNA pre-operatively (39.1%). Thirty-seven FNA contained numerous cells of a highly malignant tumour. Five specimens (11.8%) contained only necrotic material and inflammatory cells. In one case of an anaplastic carcinoma no malignant cells could be demonstrated in FNA. We conclude that pre-operative FNA of highly malignant thyroid tumours may contribute substantially to subsequent clinical management.


Investigating the adsorption of 2-mercaptothiazoline on activated carbon from aqueous systems.
2-Mercaptothiazoline (2-MT) is widely used as an organic corrosive as well as a diffusion inhibitor due to its high ability to form metal-chelate Schiff base complexes. This study investigated the elimination of 2-MT from aqueous systems with adsorption process to reach the goal of sustainable use of water resources. The Freundlich and Langmuir adsorption isotherms were adopted to examine the adsorption behavior of two types of 2-MT (i.e., 2-MT molecule and 2-MT complex) on activated carbon (AC) Chemviron Filtrasorb 400 (F 400) in three different solutions. The results of adsorption isotherm data showed that the adsorption ability of 2-MT molecule is much higher than that of 2-MT complex, whose ability may be reduced due to the electrostatic repulsion. The good applicability of Langmuir adsorption isotherm to experimental data indicated that the adsorption of 2-MT complexes on F 400 might be limited to a monolayer. Higher ionic strength and lower pH value of the solutions promoted the uptake of 2-MT onto F 400 from the solutions. In addition, not only 2-MT molecule and complex but also Cu(II) can be adsorbed on the surface of F 400, which was demonstrated by energy dispersive analysis of X-ray (EDAX). Effects of the two major interactions, chemical and physical interactions, on the adsorption of 2-MT on F 400 were compared as well in this study.


Adhesion GPCR Latrophilin 3 regulates synaptic function of cone photoreceptors in a trans-synaptic manner.
Cone photoreceptors mediate daylight vision in vertebrates. Changes in neurotransmitter release at cone synapses encode visual information and is subject to precise control by negative feedback from enigmatic horizontal cells. However, the mechanisms that orchestrate this modulation are poorly understood due to a virtually unknown landscape of molecular players. Here, we report a molecular player operating selectively at cone synapses that modulates effects of horizontal cells on synaptic release. Using an unbiased proteomic screen, we identified an adhesion GPCR Latrophilin3 (LPHN3) in horizontal cell dendrites that engages in transsynaptic control of cones. We detected and characterized a prominent splice isoform of LPHN3 that excludes a element with inhibitory influence on transsynaptic interactions. A gain-of-function mouse model specifically routing LPHN3 splicing to this isoform but not knockout of LPHN3 diminished CaV1.4 calcium channel activity profoundly disrupted synaptic release by cones and resulted in synaptic transmission deficits. These findings offer molecular insight into horizontal cell modulation on cone synaptic function and more broadly demonstrate the importance of alternative splicing in adhesion GPCRs for their physiological function.


LncRNA LINC00969 promotes acquired gefitinib resistance by epigenetically suppressing of NLRP3 at transcriptional and posttranscriptional levels to inhibit pyroptosis in lung cancer.
Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment prolongs the survival of lung cancer patients harbouring activating EGFR mutations. However, resistance to EGFR-TKIs is inevitable after long-term treatment. Molecular mechanistic research is of great importance in combatting resistance. A comprehensive investigation of the molecular mechanisms underlying resistance has important implications for overcoming resistance. An accumulating body of evidence shows that lncRNAs can contribute to tumorigenesis and treatment resistance. By bioinformatics analysis, we found that LINC00969 expression was elevated in lung cancer cells with acquired gefitinib resistance. LINC00969 regulated resistance to gefitinib in vitro and in vivo. Mechanistically, gain of H3K4me1 and H3K27Ac led to the activation of LINC00969 expression. LINC00969 interacts with EZH2 and METTL3, transcriptionally regulates the level of H3K27me3 in the NLRP3 promoter region, and posttranscriptionally modifies the m6A level of NLRP3 in an m6A-YTHDF2-dependent manner, thus epigenetically repressing NLRP3 expression to suppress the activation of the NLRP3/caspase-1/GSDMD-related classical pyroptosis signalling pathways, thereby endowing an antipyroptotic phenotype and promoting TKI resistance in lung cancer. Our findings provide a new mechanism for lncRNA-mediated TKI resistance from the new perspective of pyroptosis via simultaneous regulation of histone methylation and RNA methylation. The pivotal role of LINC00969 gives it the potential to be a novel biomarker and therapeutic target for overcoming EGFR-TKI resistance in lung cancer.


Hydrogels in endovascular embolization. III. Radiopaque spherical particles, their preparation and properties.
The synthesis and properties of spherical radiopaque hydrogel particles designed for endovascular occlusion are reported. These particles were prepared by the hydroxyl acylation of low crosslinked poly (2-hydroxyethyl methacrylate) beads with a nontoxic radiopaque compound based on triiodobenzoic acid, without affecting their properties which are advantages in medical practice. The effect of the iodine content on the size of dry and swollen particles is discussed. It has been found that an iodine content of about 25-30 wt% is desirable in order to obtain an easily recognizable X-ray image. These particles make the immediate control of embolus application easy and enable periodical inspection of the polymer to check the successful blockage of the vessel. They also open up the method of endovascular occlusion to further improvement.


A novel low molecular weight phospholipase D from Streptomyces sp. CS684.
With the aim of isolating economically viable enzymes from a microbial source, a novel phospholipase D (PLD) was purified from Streptomyces sp. CS684 (PLD(684)). PLD(684) had molecular weight of 29 kDa, which makes it the second smallest PLD reported so far. The enzyme activity was optimum at pH 6 and 45 degrees C, and enhanced by various detergents. It was stable from pH 7 to 9 and at or below 45 degrees C when assayed after 40 h and 2h, respectively. The K(m) and V(max) values for phosphatidylcholine were 1.16 mM and 1453.74 micromol min(-1)mg(-1), respectively. It catalyzed the transphosphatidylation of glycerol, but not that of l-serine, myo-inositol or ethanolamine. Low molecular weight PLD(684) with transphosphatidylation activity may be utilized in the industrial production of rare and commercially important phospholipids.


[Protective macrophages : New insights into the role of synovial macrophages in inflammatory joint diseases].
Macrophages are among the phylogenetically oldest cells of the immune system and are found in all tissues and organs. In addition to playing an important role in immune response against pathogenic microorganisms, these cells were previously described to play a vital role in chronic inflammatory diseases such as rheumatoid arthritis. Using novel techniques such as single-cell sequencing and advanced microscopy techniques it has now been shown that macrophages are far more versatile. Thus, these cells contribute considerably to tissue homeostasis and tissue regeneration. As each tissue has to fulfill special requirements, macrophages vary in their phenotype and function between organs. New data have now identified a specialised population of epithelioid macrophages that exert a protective and anti-inflammatory function in synovial tissue and prevent the initial onset as well as episodes of joint inflammation in rheumatoid arthritis.


[Possibilities of radiation-dose reduction in the treatment of Hodgkin's disease. I. Exclusion of the mediastinum from the radiation field in primary high-cervical or infradiaphragmatic involvement and stage I or II (author's transl)].
A retrospective analysis on 482 patients with localised Hodgkin's disease revealed that none of those with primary high-cervical or primary infradiaphragmatic involvement had any infiltration of the mediastinum, either at the time or later. As a result, prophylactic mediastinal radiation was not practised if high-cervical or infradiaphragmatic lymph-nodes had been affected first. None of these patients had any mediastinal recurrence after at least seven years.


Open comparison of mefloquine, mefloquine/sulfadoxine/pyrimethamine and chloroquine in acute uncomplicated falciparum malaria in children.
The susceptibility in vivo of Plasmodium falciparum to mefloquine, mefloquine/sulfadoxine/pyrimethamine and chloroquine was investigated in 115 children with acute uncomplicated falciparum malaria. Susceptibility of P. falciparum isolates to mefloquine and chloroquine in vitro was also investigated. Mefloquine alone and mefloquine/sulfadoxine/pyrimethamine showed similar response rates and both reduced parasitaemia and fever more rapidly than chloroquine. Mefloquine also promptly reduced parasitaemia and fever within 48 h in all chloroquine treatment failures. In vitro, 10% of isolates showed reduced susceptibility to mefloquine and 18% were resistant to chloroquine. These results suggest that the addition of sulfadoxine/pyrimethamine does not have a significant therapeutic advantage over mefloquine alone in the treatment of acute uncomplicated falciparum malaria in children from this endemic area.


Increased cortisol bioavailability, abdominal obesity, and the metabolic syndrome in obese women.
This study was conducted to obtain a detailed profile of hypothalamo-pituitary-adrenal (HPA) axis activity and reactivity and its differential relationships with body fat distribution and total fat mass in premenopausal obese women. Cortisol responses to stimulation (awakening, food intake, exercise) and suppression (0.25 mg dexamethasone), cortisol metabolism, and tissue sensitivity to glucocorticoids were studied in 53 premenopausal obese women grouped according to their waist-to hip ratio: women with abdominal body fat distribution (A-BFD; n = 31) and women with peripheral fat distribution (P-BFD; n = 22). Comparatively, A-BFD women had 1) lower awakening salivary cortisol levels; 2) increased salivary responsiveness to a standardized lunch; 3) similar pituitary sensitivity to dexamethasone but decreased sensitivity of monocytes to dexamethasone; 4) similar 24-hour urinary free cortisol but increased 24-hour urinary ratio of cortisone-to-cortisol; and 5) no difference in corticosteroid binding protein parameters. Although abdominal obesity is not very different from generalized obesity in terms of HPA function, subtle variations in HPA axis activity and reactivity are evidenced in A-BFD premenopausal obese women.


Evaluating the meteorological normalized PM2.5 trend (2014-2019) in the "2+26" region of China using an ensemble learning technique.
In recent years, implementation of aggressive and strict clean air policies has resulted in significant decline in observed PM2.5 concentration in the Beijing-Tianjin-Hebei (BTH) region and its surrounding areas (i.e., the "2 + 26" region). To eliminate the effects of interannual and seasonal meteorological variation, and to evaluate the effectiveness of emission abatement policies, we applied a boosted regression tree model to remove confounding meteorological factors. Results showed that the annual average PM2.5 concentration normalized by meteorology for the "2 + 26" region declined by 38% during 2014-2019 (i.e., from 96 to 60 μg/m3); however, the BTH region exhibited the most remarkable decrease in PM2.5 concentration (i.e., a 60% reduction). Certain seasonal trend in normalized PM2.5 level remained for four target subregions owing to the effects of anthropogenic emissions in autumn and winter. Although strong interannual variations of meteorological conditions were unfavorable for pollutant dispersion during the heating seasons of 2016-2018, the aggressive abatement policies were estimated to have contributed to reductions in normalized PM2.5 concentration of 19%, 10%, 19%, and 17% in the BTH, Henan, Shandong, and Shanxi subregions, respectively. Our study eliminated the meteorological contribution to concentration variation and confirmed the effectiveness of the implemented clean air policies.


The role of the blood glucose level in determining voluntary ethanol consumption in the LACG and diabetogenic C57BL strains of mice.
The influence of the blood glucose level (BGL) on the voluntary consumption of ethanol by two strains of mice has been investigated. LACG mice show an aversion towards ethanol whereas C57BL mice which are mildly hyperglycaemic show a preference for ethanol. Chronic compulsory ethanol drinking produced hypoglycaemia only in C57BL mice. The oral antidiabetic drugs phenformin and glibenclamide lowered the BGL of C57BL mice which then showed an aversion to ethanol. Raising the BGL of LACG mice by acute alloxan or streptozotocin treatment did not reduce ethanol aversion significantly, but alloxan significantly increased total fluid intake. Diazoxide chronically increased the BGL and slightly increased ethanol consumption in LACG mice. It is concluded that the BGL in C57BL mice may be a factor in determining their innate preference for alcohol. The relationship between alcoholism and diabetes is discussed.


Gaps in maternal influenza vaccine uptake in Northern Territory: A need for a year-round influenza vaccination campaign.
Maternal influenza vaccination was introduced in 2010 due to the high morbidity and mortality associated with influenza in pregnancy. The aim of this study was to assess the maternal influenza vaccination uptake in Northern Territory public hospitals and identify gaps to improve uptake. Birth data from Northern Territory (NT) public hospitals obtained from the Perinatal Register for deliveries in 2016 were merged with vaccination records from the NT immunisation register. There were 3,392 viable pregnancies in NT public hospitals in 2016 with 45.6% vaccination coverage against influenza. There was a statistically significant difference in coverage with 68.5% in Indigenous vs 31.7% in non-Indigenous deliveries (p < 0.001), yielding an odds ratio of 4.67 (95% CI 4.02, 5.42) for maternal influenza vaccination across Indigenous status. Influenza vaccination coverage for preterm births (< 37 weeks) was low especially in non-Indigenous mothers at 27.2% vs 65.05% in Indigenous mothers (p < 0.001). A distinct immunisation administration pattern was noted for 2016 with 58.9% of vaccinations occurring between April and June regardless of Indigenous status and maternal gestational age. This correlated with the annual influenza immunisation campaign by the NT and Commonwealth. A year-round maternal influenza vaccination campaign is crucial to avoid missed opportunities and increase vaccination protection for mother and baby. Antenatal influenza vaccination campaign with health care workers education and increasing patient awareness should continue throughout the year.


Oxidation of organophosphorus pesticides for the sensitive detection by a cholinesterase-based biosensor.
A potentiometric flow injection-type biosensor developed in our laboratory was used for the determination of organophosphorus pesticides (OPs). The principle of the biosensor is that the degree of inhibition of a sensor enzyme by an OP is dependent on the concentration of the pesticide. The sensor system consisted of a reactor with acetylcholinesterase (AChE) immobilized on a controlled pore glass and a detector with a tubular H(+)-selective membrane electrode. In order to examine the possibility of enhancing the sensitivity of the sensor by converting OPs to oxidized forms (stronger inhibitors), a comparison of the degree of enzyme inhibition by OPs at 10(-6) M before and after their oxidation was made. All of the ten pesticides tested exhibited greater inhibitory power toward the sensor enzyme following oxidation. All of the oxidized pesticides at 10(-6) M inhibited the sensor enzyme to a considerable degree, demonstrating the utility of the developed method for the class-specific determination of OPs. A calibration curve for diazinon, over the concentration range of 10(-11)-10(-4) M, was obtained. The lower detection limit was 2 x 10(-10) M. Treatment of the inhibited enzyme with pyridine-2-aldoxime restored the enzyme to near full activity, allowing repeated use of the sensor.


Applications of antibody array platforms.
Antibody arrays are valuable for the parallel analysis of multiple proteins in small sample volumes. The earliest and most widely used application of antibody arrays has been to measure multiple protein abundances, using sandwich assays and label-based assays, for biomarker discovery and biological studies. Modifications to these assays have led to studies profiling specific protein post-translational modifications. Additional novel uses include profiling enzyme activities and protein cell-surface expression. Finally, array-based antibody platforms are being used to assist the development and characterization of antibodies. Continued progress in the technology will surely lead to extensions of these applications and the development of new ways of using the methods.


Fluorine-18 Fluorodeoxyglucose Uptake in Hepatocellular Carcinoma: Correlation with Glucose Transporters and p53 Expression.
Hepatocellular Carcinoma (HCC) is one of most lethal cancers worldwide. The prognosis is very poor and therapeutic options are limited. The aim of this study was to determine the correlation of the [(18)F]FDG uptake profile of three HCC cell lines with p53 and glucose transporters (GLUTs) 1, 2, 3, 5 and 12 expression and with the glucose level present in the cell culture medium. Cell lines used are HepG2 (wp53), HuH7 (overexpress p53) and Hep3B2.1-7 (p53null). An immunocytochemical analysis was performed to evaluate p53 expression. Through uptake studies were analyzed the [(18)F]FDG uptake profiles of all cell lines under study. The expression of GLUTs were quantified by flow cytometry. The [(18)F]FDG uptake studies GLUTs expression analysis were performed on cells that grew in a high and low glucose medium in order to determine the effect of glucose concentration on GLUTs expression and on [(18)F]FDG uptake. Immunocytochemical analysis confirmed the p53 expression profiles of all cell lines. It was found out that for all cell lines, [(18)F]FDG uptake is higher when cells grow in low glucose medium, however, the glucose level doesn't affect mostly the GLUTs expression. The Hep3B2.1-7 (p53null) is always the one that have higher [(18)F]FDG uptake. It was found that not always GLUT1 and GLUT3 are the most expressed by these cell lines. Our results shown that the p53 expression influences [(18)F]FDG uptake. This suggests that [(18)F]FDG may be used in HCC diagnosis, and may even provide some information about the genetic profile of the tumor.


Influence of urine on "in vitro" crystallization rate of calcium oxalate: determination of inhibitory activity by a [14C]oxalate technique.
A simple radiochemical method is proposed for the in vitro assay of the inhibitory activity of urine with respect to calcium oxalate crystal growth using [14C]oxalate as a tracer. The method shows an improved sensitivity over existing methods and indicates that citrate, pyrophosphate and chondroitin sulphate are active inhibitors of calcium oxalate crystal growth down to concentrations of 10(-5), 10(-7) and 10(-10) mol/l respectively. The inhibitory activity in the urines of 12 recurrent calcium stone-formers was significantly lower than in the urines of matched control subjects (P less than 0.01), confirming the clinical usefulness of the test.


Eradication of scabies with a single treatment schedule.
A single application (16 to 20 hours) of 1% gamma benzene hexachloride (GBH) lotion, when applied to a total island population of 178 persons in which seventy-four clinically had scabies, resulted in a cure rate of over 98%. Re-examination of the population at 10 and 21 weeks revealed only one remaining individual still having scabies. On a neighboring island, only those with clinical evidence of scabies were treated (140 persons). Applications of 1% GBH lotion were applied with the same methods used on the first island. When the population was re-examined at 10 weeks, the prevalence of scabies was reduced by only 50%. Successful eradication of scabies from a population should include treatment of all contacts, whether clinically infected or not. Treatment of the entire population at risk at one time is preferable. Coexistent pyoderma should be treated, and a second treatment for scabies may be needed when the pyoderma has cleared.


Fatal intoxication with synthetic cannabinoid MDMB-CHMICA.
MDMB-CHMICA is a synthetic cannabinoid that appeared on the European drug market in September 2014. This substance was found in Poland in the herbal mixture "Mocarz" ("Strongman"), which caused a large outbreak of intoxications at the beginning of July 2015. This paper describes the circumstances of death and toxicological findings in a fatal intoxication with MDMB-CHMICA (in combination with alcohol). Loss of consciousness and asystole occurred a few minutes after smoking the 'legal high'. The man died after 4 days of hospitalisation. The cause of death accepted by the medical examiner was multiple organ failure. MDMB-CHMICA was detected and quantified in blood (ante- and postmortem) and internal organs tissues. The samples were analysed using liquid chromatography with mass spectrometry (LC-MS/MS). The concentration of MDMB-CHMICA in antemortem blood was 5.6 ng/mL. Although the death occurred after 4 days from administration a relatively high concentration (2.6 ng/g) was estimated in the brain. Traces of this compound were also found in other postmortem materials (blood, stomach, liver, bile, and kidney). The presented case shows the health risks associated with MDMB-CHMICA use. The administration of this substance can lead to the number of organ failures, cardiac arrest and consequently death.


Paramagnetic NMR Shielding Tensors and Ring Currents: Efficient Implementation and Application to Heavy Element Compounds.
We present an efficient implementation of paramagnetic NMR shielding tensors and shifts in a nonrelativistic and scalar-relativistic density functional theory framework. For the latter, we make use of the scalar exact two-component Hamiltonian in its local approximation, and generally we apply the well established (multipole-accelerated) resolution of the identity approximation and the seminumerical exchange approximation. The perturbed density matrix of a paramagnetic NMR shielding calculation is further used to study the magnetically induced current density and ring currents of open-shell systems as illustrated for [U@Bi12]3-. [U@Bi12]3- features delocalized highest occupied molecular orbitals and sustains a net diatropic ring current of ca. 18 nA/T through the Bi12 torus similar to the all-metal aromatic heavy-element cluster [Th@Bi12]4-.


Early complications in type 1 diabetes: central nervous system alterations preceded kidney abnormalities.
Abnormalities of the central nervous system (CNS), as discerned by neuroelectrophysiological studies, and an impaired, charge-related, differential filtration of protein at kidney level as evaluated by selective protein clearance, have recently been shown in diabetes of short duration and without any apparent complication. In order to explore the time of appearance and possible correlations, CNS and kidney abnormalities have been evaluated in parallel both in short-term and long-standing type 1 diabetic subjects. Two groups of patients were studied: Group 1 (no. 15), with no previously known clinical sign of complications and less than 5 years from diagnosis; Group 2 (no. 15) with more than 10 years of disease and with or without clinical signs of diabetic complications. Twenty age and sex comparable normal subjects were included in the study (Group 3). Short-latency multimodal evoked potentials (visual-VEP, brainstem auditory-BAEP, median and tibial somatosensory m- and t-SEP) and charge and/or size selective protein clearances (albumin, anionic immunoglobulins, neutral/cationic immunoglobulins) were evaluated. In Group 1, 27% of patients showed neurophysiological abnormalities (P < 0.05 vs. Group 3) while one showed proteinuria. In Group 2, 60% of patients showed electrophysiological changes (P < 0.0001 vs. Group 3) while 67% showed abnormal charge or size selective proteinuria (P < 0.0001 vs. controls) with a significant association between the abnormalities of CNS and of charge selective proteinuria (P < 0.05). Thus, CNS abnormalities may be detected even in patients with diabetes of short duration and are later associated with subclinical kidney abnormalities. These findings stress the value of the multimodal evoked potential evaluation as a sensitive and early diagnostic approach to the study of diabetic complications.


Early ischemia identification employing 2D speckle tracking selective layers analysis during dobutamine stress echocardiography.
Two-dimensional (2D) strain derived from speckle tracking proved to be feasible and accurate in the quantitative evaluation of myocardial ischemia during stress echocardiography. We compared the accuracy in detecting myocardial ischemia of the transmural segmental analysis with an endocardial specific evaluation in 20 patients undergoing dobutamine stress echocardiography (DSE) and coronary angiography. Peak systolic global strain (G-ε) and at the subendocardial level (Endo-ε) were measured off-line at rest, a low dose, and peak stress; then, we compared the results with wall-motion analysis and significant coronary artery disease (CAD > 70% diameter stenosis). Endocardial strain variation from basal to low and peak dose was computed both for global or subendocardial analysis. The utilization of the ROC curve allowed us to derive optimal cutoffs, sensibility and specificity for ischemic segments. The subendocardial analysis at high dose showed to be able to increase significantly the accuracy of the test to detect the ischemic segments (sens 90.2% vs 85.4%; spec 93.1% vs 92.2%). Moreover, at the low dose, the subendocardial analysis showed to be able to increase significantly, mostly the specificity of the test (sens 69.6% vs 68.3%; spec 92.2% vs 86.2%). Notably, the strain subendocardial analysis at low dose showed to reach a high specificity, similar to the peak dose transmural analysis. Measurement of subendocardial strain during DSE is feasible and can increase the accuracy of the test. Moreover, the subendocardial strain during DSE can reach a high specificity, even limiting the test at a low dose infusion.


Probing the antiamoebic and cytotoxicity potency of novel tetrazole and triazine derivatives.
A series of compounds bearing a Tetrazole and Triazine ring motif conjugated with a SO(2)NH function were synthesized and investigated for their antiamoebic potency. Cytotoxicity of the compounds was checked on human hepatocellular carcinoma cell line HepG2. Incorporation of Triazine ring in place of tetrazole resulted in a precipitous increase in the antiamoebic activity of the compounds. Antiamoebic activity of the investigated compounds was found to be position and substituent dependent. In vitro cytotoxicity results revealed noncytotoxic nature of all the tested compounds up to a concentration of 25 μM. Compound 5c and 5d were obtained as least cytotoxic (IC(50) > 100 μM) and excellent Entamoeba histolytica inhibitors with IC(50) values of 1.05 μM and 1.02 μM respectively.


Infundibuloneurohypophysitis presenting a large sellar-juxtasellar mass: case report.
Infundibuloneurohypophysitis (INH) is reported to be a self-limiting inflammatory disease involving neurohypophysis. The authors experienced a case of INH presenting a large mass compressing the brain stem. The patient exhibited polyuria followed by left hemiparesis and dysarthria lasting a year. Magnetic resonance imaging showed a large sellar mass extending into the right cavernous sinus and prepontine cistern and compressing pons. Endocrinologically, diabetes insipidus was diagnosed and anterior pituitary function was almost normal. Microscopic examination of the surgical specimen obtained by a transsphenoidal route demonstrated diffuse infiltration of lymphoid cells with predominance of B cells over T cells and the granulation tissue. The patient underwent 40 Gy local radiation because of initial misinterpretation of histologic findings as malignant lymphoma and short-term corticostertoid administration. The mass gradually shrank and the patient has become neurologically intact in 6 months. At this moment, 67 months after the onset, the patient is free from disease and has no other lesion. INH seems to be a clinical entity possessing a wide spectrum from infundibular tumorlet to an aggressive sellar mass trespassing on surrounding structures.


Improvement of natural fiber's properties and evaluation of its applicability as eco-friendly materials in noise pollution control.
The use of green and eco-natural fibers due to availability, biodegradability, reasonable cost, and non-toxic effects are known as potential acoustic materials in research. Nevertheless, in this area, the use of chemical treatment in natural fibers as an effective strategy to improve the overall properties and acoustic performance is faced with limitations. So that the current paper aims to investigate the effect of alkali treatment on the mechanical and acoustical properties of jute fibers and evaluation of its applicability in noise pollution control. To determine the effect of alkali treatment on the sound absorption behavior of jute fibers, a sufficient amount of both types of fibers (raw and treated) were used to the fabrication of acoustic samples with thicknesses of 30, 40 and 50 mm at a density of 200 kg/m3. The acoustic evaluation was measured by the Impedance tube system according to transfer function method using by the standard ISO 10534-2. The morphological and tensile properties of fibers were evaluated by the Scanning Electron Microscopy (SEM) and tensile test (ASTM C1557-14 standard). Moreover, Infrared Spectroscopy (FTIR) and X-ray diffraction (XRD) were used to study and compare the chemical properties of raw and treated fibers. The result showed that the mean tensile strength and crystallinity index (CI) of treated fibers comparing with raw fibers increased by 61.66% and 3.26% respectively. The use of Alkali treatment helped to improve sound absorption performance of jute fibers with different thicknesses. Furthermore, noise reduction rate (NRC) in treated acoustic samples compared to untreated with a thickness of 50 mm increased from 0.66 to 0.69. Finally, the alkali treatment has enhanced the properties of jute fibers and confirmed the applicability of these fibers in acoustic absorption. The online version contains supplementary material available at 10.1007/s40201-022-00799-x.


Evolution of sex: The costs and benefits of sex: new insights from old asexual lineages.
Discussions that are aimed at understanding the maintenance of sexual reproduction are in a bit of a quagmire owing to the many competing theories that have been proposed. Also, one of the central observations that asexual lineages are typically short lived still needs to be properly quantified. Exciting new results on ancient asexual organisms show that lineages can persist for many millions of generations without recombination. Understanding how they do so might well provide crucial new insights into the problem of sex.


Potential role of nitration and oxidation reactions in the effects of peroxynitrite on the function of beta-adrenoceptor sub-types in the rat.
This study examined the hemodynamic responses elicited by the beta-adrenoceptor agonist, isoproterenol (1 and 10 microg/kg, i.v.) before and after administration of (i) peroxynitrite (10 x 10 micromol/kg, i.v.), (ii) the thiol chelator, para-hydroxymercurobenzoic acid (pHMBA, 75 micromol/kg, i.v.), and (iii) the electron acceptor, nitroblue tetrazolium (NBT, 10 micromol/kg, i.v.) in pentobarbital-anesthetized rats. The tachycardia elicited by the lower dose of isoproterenol was diminished whereas the tachycardia elicited by the higher dose was not attenuated after administration of peroxynitrite. The falls in hindquarter and renal vascular resistances elicited by both doses of isoproterenol were substantially diminished whereas the isoproterenol-induced falls in mesenteric vascular resistance were not changed after administration of peroxynitrite. All of the isoproterenol-induced responses were markedly attenuated after administration of pHMBA or NBT. These findings suggest that the oxidation and/or nitration of beta-adrenoceptors impair the ability of isoproterenol to bind to and/or activate these G protein-coupled receptors. beta1-, beta2- and beta3-adrenoceptors contain extracellular cysteine residues susceptible to oxidation (i.e., disulfide-bridge formation) whereas only the beta1- and beta2-adrenoceptors contain extracellular tyrosine residues susceptible to nitration. These findings also suggest that sustained impairment of beta1- and beta2-adrenoceptor function by peroxynitrite is due to nitration of extracellular tyrosine residues in these receptors. By analogy, beta3-adrenoceptors may not be permanently affected by peroxynitrite because these receptors are devoid of extracellular tyrosine residues.


Sociodemographic disparities in child restraint selection and variation in child passenger safety information sources.
Marginalized and otherwise vulnerable groups remain at higher risk than their counterparts for not having all of their children appropriately restrained during vehicle trips. Little is known about potential sources of these disparities, however a commonly theorized factor has been where caregivers find or obtain information (i.e., their information sources). The objective of this study was to: (1) characterize caregivers' actual and preferred sources of information related to child passenger safety information, overall and within sociodemographic groups; and (2) determine if, and if so how, sources impact appropriate child restraint use (i.e., child/seat fit). We conducted an online, cross-sectional survey of US caregivers. Caregivers answered questions about themselves, their child(ren), their child(ren)'s restraint use during trips, and their information sources to learn which seat their child should be using. We used Fisher's exact and Pearson chi-square tests to compare used and preferred sources of information across caregiver demographics (age, education, race/ethnicity), as well as to determine whether information sources were associated with caregivers' appropriate child restraint use. A total of 1,302 caregivers from 36 states with 2,092 children completed the survey. The majority (91%) of children were appropriately restrained. More caregivers from marginalized and otherwise vulnerable groups had children inappropriately restrained when compared with their counterparts. We identified multiple differences in both used and preferred information sources by caregivers' age, race/ethnicity, and education level. In addition, we found a trend that caregivers from populations with higher rates of inappropriate use seemingly used fewer information sources. Ultimately, information sources were not associated with appropriate restraint use; however, within vulnerable populations, almost all caregivers had all of their children appropriately restrained if they had used a Child Passenger Safety Technician (CPST)/Inspection Station or their Pediatrician. Our findings reiterate calls for more tailored interventions and efforts to combat widening disparities in child restraint use and crash outcomes and suggest one promising method may be providing more access to child passenger safety experts. Future studies must untangle the likely complex relationship between information sources and appropriate/accurate child restraint use.


Extrusion of double J stent: a rare complication.
Ureteral double J stents are associated with complications such as malposition, migration, fragmentation, and "forgotten stent," and are known to migrate both proximally and distally. We present a case of a forgotten stent that had proximal migration leading to extrusion, so far an unreported complication.


Inhibitory effect of some selected nutraceutic herbs on LDL glycation induced by glucose and glyoxal.
Anti-LDL glycative agents were investigated using aqueous extracts of Psidium guajava L. (PE), Toona sinensis Roem. (TE), Momordica charantia L. (ME) and Graptopetalum paragugayene E. Walther (GE). Concentrations of extracts 0.01-0.625 mg/mL, low density lipoprotein (LDL; 100 microg protein/mL) and inducers glucose (400 mM) and glyoxal (2.5 mM) were incubated at 37 degrees C. Evaluation parameters involved the thiobarbituric acid reactive substances (TBARS), conjugated dienes (CD), relative electrophoretic mobility (REM), 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging capability and total polyphenolic content. Results for anti-TBARS efficiency (in%) were PE (75.77), TE (75.10), ME (68.81) and GE (19.81) at 0.5 mg/mL, respectively, when induced by glucose; 36.68, 35.60, 32.62 and inactive, respectively, by glyoxal. The lag times for CD formation (in min) were: 289 and 125 by PE and TE, respectively, comparing to the control (45). REM was 1.6 with respect to PE (0.1 mg/mL) compared to the control (4.2). PE at 0.01 mg/mL effectively inhibited with 63.45% efficiency on AGEs induced by glucose. We conclude that PE virtually is a potent antiglycative agent, which can be of great value in the preventive glycation-associated cardiovascular and neurodegenerative diseases.


Correct approach in urticarial vasculitis made early diagnosis of lupus nephritis possible: a case report.
Urticarial vasculitis is a clinicopathologic entity defined by recurrent episodes of urticarial lesions that persist > 24 hours and demonstrate the histopathologic features of leukocytoclastic vasculitis. The most important prognostic feature is the presence of normo- or hypocomplementemia. In the latter, patients are much more likely to have systemic manifestations. Urticarial vasculitis is most often idiopathic, but it can arise in association with autoimmune connective diseases, cryoglobulinemia, infections, medications, and hematologic malignancies. We present the case of a 61-year-old Caucasian woman with a skin eruption that consisted of erythematous plaques on the trunk and limbs that lasted > 24 hours but were asymptomatic. The skin eruption had an acute onset and persisted for 3 months upon initial presentation in our dermatology department. A punch biopsy showed signs of a leukocytoclastic vasculitis in the superficial dermis. On laboratory examination, signs of activation of the complement system were found with low complement C3, C4, and C1q, and with a high anti-C1q antibody titer. The clinical, histological, and lab results fit the diagnosis of hypocomplementemic urticarial vasculitis. There was also a positive antinuclear factor with elevated U1 small nuclear ribonucleoprotein and high double-stranded DNA determined by Farr method. On urinalysis, marked proteinuria and massive hematuria were found. Kidney biopsy showed focal crescentic and focal mesangial type of glomerular damage with a full-blown positivity of immunoglobulin A, immunoglobulin G, and C1q, leading to lupus nephritis class III-A (according to the International Society of Nephrology/Renal Pathology Society 2003 classification of lupus nephritis). The patient was treated with hydroxychloroquine, corticosteroids, and low-dose intravenous cyclophosphamide (Euro-Lupus regimen) as remission-inducing agent, followed by azathioprine as remission-maintaining agent. This treatment regimen gave good results, with total clearance of the skin lesions and remission of the lupus nephritis. Clinicopathologic recognition of urticarial vasculitis with correct screening for extracutaneous disease can lead to early diagnosis of serious organ involvement and thereby improve prognosis for the patient.


Duration of Shedding and Secondary Household Transmission of Shiga Toxin-Producing Escherichia coli O26 During an Outbreak in a Childcare Center, Oregon, October-December 2010.
We assessed shedding duration and secondary household transmission of Shiga toxin 1-positive Escherichia coli O26 during a childcare-associated outbreak. No severe illness was noted. Shedding duration was 15-46 days (median, 29). No secondary transmission to household members was identified. Value of isolating asymptomatic infected children with this low-virulence infection remains uncertain.


Effect of ligation of variant hepatic arterial structures on the completeness of regional chemotherapy infusion.
Twenty-three patients with separate arterial supplies to both sides of the liver underwent unilateral arterial ligation and chemotherapy via the remaining artery. Radionuclide infusion studies revealed only 62 percent complete perfusion after left hepatic ligation and 90 percent after right hepatic artery ligation.


Influence of vasopressin and calcium on electrolyte transport across isolated colonic mucosa of the rat.
Vasopressin enhanced the absorption of water and Na+ across everted sacs of rat colon descendens but had no effect on absorption across the colon ascendens. The short-circuit current (Isc) and open-circuit potential difference (p.d.) across the colon descendens were dose-dependently decreased by vasopressin. Isc and p.d. across the colon ascendens were not altered by vasopressin. In the colon descendens the decrease in Isc and p.d. was significant at 1 microu. vasopressin/ml and reached a maximum at 1 mu./ml. Propranolol and phentolamine or naloxone did not alter the decrease in Isc and p.d. to a submaximal dose of vasopressin. Vasopressin increased the mucosal to serosal flux of Na+ and Cl- and decreased the serosal to mucosal flux of Cl- across short-circuited colon descendens. Consequently these changes increased the net flux of Na+ and Cl-. Adenylate cyclase activity in homogenates of the colon descendens was not altered by vasopressin. Omission of Ca2+ from the serosal bathing solution reversibly decreased Isc and p.d. and increased Na+ and Cl- absorption across the colon descendens in a similar way as did vasopressin. The results suggest that the effect of vasopressin on the colon descendens may be due to a decrease in intracellular Ca2+ activity.


Pancreas divisum, pancreatic pseudocyst, and choledochal cyst in an 8-year-old child.
An 8-year-old American Indian girl presented with acute pancreatitis. Ultrasonography and computerized tomography (CT) showed two large cystic masses near the head of the pancreas. During 4 weeks of complete bowel rest and total parenteral nutrition, she had multiple exacerbations of pancreatitis without resolution of the cysts. There were no symptoms of biliary ductal obstruction. Endoscopic cholangiopancreatography (ERCP) showed an 8-cm pancreatic pseudocyst, pancreas divisum, and a 10-cm choledochal cyst. The junction of the common bile duct and the pancreatic duct of Wirsung had a normal relationship. She underwent a Roux-en-Y pseudocyst-jejunostomy and an accessory sphincteroplasty. Three months later, a choledochal cyst excision was performed with biliary reconstruction. The patient is well and asymptomatic 1 year later. This case suggests that pancreatic juice reflux into the common bile duct may not be the only etiology of choledochal cyst formation.


Depression in Swedish women: relationship to factors at birth.
Depression is a common and serious disorder that may have developmental origins. Birth-related factors have been related to childhood and adult occurrence of somatic as well as psychiatric disorders, but studies on the relationship between birth-related factors and depression are few and show mixed results. In addition, varying methods have been used to assess depression. Standardized clinical criteria to diagnose depression, combined with birth data collected from midwife records have not been used in most studies. Participants in the Prospective Population Study of Women in Sweden (803 women), born 1914, 1918, 1922 and 1930, provide information on birth factors and depression. Women participated from 1968 at mid-life ages of 38-60 years, to 2000, when they were age 78-92 years. Original birth records containing birth weight, length, head circumference, and gestational time, as well as social factors were obtained. Lifetime depression was diagnosed via multiple information sources. Symptoms were assessed using the Comprehensive Psychopathological Rating Scale and diagnoses were based on DSM-III-R criteria. Over their lifetime, 44.6% of women in this sample experienced depression. Birth weights ≤ 3500 g [odds ratio (OR), age-adjusted = 1.72; 95% CI 1.29-2.28, P < 0.001] and shorter gestational time (OR, age-adjusted = 1.13; 95% CI 1.04-1.24, P = 0.005) were independently associated with a higher odds of lifetime depression in a logistic regression model adjusted for age. Lower than median birth weights and shorter gestational time were related to lifetime depression in women. Both neurodevelopmental and environmental contributions to lifetime depression may be considered.


Replacing canes with an elasticated orthotic-garment in chronic stroke patients - The influence on gait and balance. A series of N-of-1 trials.
To investigate the effect of replacing canes with an elasticated orthotic-garment on balance and gait-function in chronic stroke survivors. Experimental, N-of-1 series with a replicated, ABC design with randomised phase duration in a home setting. Four cane using chronic stroke survivors (P1-4). Phase A (9-12 weeks) cane-walking "as usual" to establish baseline values; Phase B (9-16 weeks) intervention: orthotic-garment worn throughout the day with maximal cane-use reduction; Phase C (9-10 weeks) participant-determined follow-up: either no walking-aid, orthotic-garment or cane. Primary: Functional-Gait-Assessment (FGA), Secondary: Trunk-sway during walking measured as Total-Angle-Area (TAA°2) in frontal and sagittal-planes, both measured weekly. Visual and statistical analysis of results showed significant improvements in FGA from phase A to B in all participants. Improvement continued in phase C in P2, stabilized in P1 and P4 and deteriorated in P3. A Minimal-Clinical-Important-Difference of 6 points-change was achieved in P2 & P4. Trunk-sway reduced during walking, indicating increased stability, in two participants from phase A to B and in three participants from A to C but no TAA changes were statistically significant. In phase C participant-selected walking-aids were: P1 cane-usage reduced by 25%, P2 independent-walking with no assistive-device, S3 usual cane-usage, P4 orthotic-garment with reduced cane-usage 2-3 days-a-week, usual cane-usage 4-5 days. Although walking ability is multifactorial these results indicate that the choice of walking-aids can have a specific and clinically relevant impact on gait following stroke. "Hands-free" assistive-devices may be more effective than canes in improving gait-function in some patients. CLINICALTRIALS. NCT03642444.


New stochastic devices for simultaneous analysis of mismatch repair proteins and KRAS in biological samples.
Two stochastic microsensors based on the immobilization of inulins: inutec and frutafit in a paste obtained from a graphene decorated with nitrogen (10.8 %), and boron (2.6 %), and paraffin oil (IR purity) were designed, characterized and validated for the molecular recognition and analysis of mismatch repair proteins like MLH1, MSH2, MSH6, PMS2, and of KRAS in biological samples such as: whole blood, urine, saliva, and tumoral tissues. The sensor based on inutec exhibited the largest working concentration range (10 decades of concentration) and the lowest limit of determination (0.32fg mL-1) when used for the assay of MLH1, and the wider working concentration range (8 decades of concentration), and the lowest limit of determination (2.30fg mL-1) when used for the assay of MSH6. The sensor based on frutafit exhibited the largest working concentration range (10 decades of concentration) when used for the determination of KRAS, and the wider working concentration range (5 decades of concentration), and the lowest limit of determination (1.00fg mL-1) when used for the assay of PMS2. No influence of the modifier (inutec and frutafit) was recorded on the linear concentration range (10 decades of concentration), and on the limit of determination (1.00 fg mL-1) for the assay of MSH2. The recoveries of MLH1, MSH2, MSH6, PMS2, and of KRAS in whole blood, urine, saliva, and tumoral tissues were higher than 98.00 with RSD (%) values lower than 0.10 %.


miR-452 promotes the development of gastric cancer via targeting EPB41L3.
Gastric cancer is the most common malignant tumor of the digestive system and it is beneficial to find a safer and more effective therapeutic target if we have a deep understanding of the molecular function mechanism during the development of gastric cancer. In recent years, through many researches, we found that miRNA functions as oncogene or cancer suppressor gene, and it plays an important role in the occurrence and development of tumors. Many researches also showed that miR-452 has different expression patterns and roles in different tumors. Its expression is significantly reduced in glioma, breast cancer, colorectal cancer and prostate cancer; however, the expression is significantly increased in liver cancer, renal clear cell carcinoma, esophageal cancer and urothelial carcinoma, etc. However, the role and mechanism of miR-452 in gastric cancer is still unclear. In this study, we found that miR-452 was highly expressed in both tumor tissue and gastric cancer cells, and could directly target the cancer suppressor gene EPB41L3 3'-UTR. miR-452 significantly promoted the proliferation, migration and the S-phase arrest of gastric cancer cells, but EPB41L3 as a downstream target gene of miR-452 reversed such promoting effect. While down-regulation of miR-452 expression significantly inhibited the malignant biological behavior of gastric cancer cells, but this inhibitory effect was reversed by EPB41L3 siRNA. In addition, miR-452 in the gastric cancer xenograft model in nude mice could down-regulated the expression level of EPB41L3 and promote the growth of transplanted tumor in nude mice. Taken together, this study reveals the role of miR-452 in gastric cancer via inhibiting the target gene EPB41L3, suggesting that miR-452 has the potential to become a new target for the diagnosis and treatment of gastric cancer.