Measurement of transferable chemical residue from nylon carpet using the California roller and a new mega-California roller.
Human chemical exposures resulting from transfer of surface deposition on indoor nylon carpets may be estimated by measuring transferable residues (mu g chemical/cm2 carpet). A weighted roller developed at California Department of Food and Agriculture (CDFA) has been extensively used to sample transferable residue for estimates of human exposure in risk characterization. A modified roller has been developed to evaluate the influence of pressure on transferable chemical residue since weight and force (or pressure, kg/m2) may vary person-to-person and activity-to-activity. A 30.5 cm diameter roller was used to apply 60 to 2100 kg/m2 to bracket pressures exerted by humans on a flat nylon-carpeted surface. Measurements of transferable cyfluthrin residues were made after 1, 7, and 21 days. Total Soxhlet extractable cyfluthrin residues were relatively constant during the test period. Residue transferability decreased during the study period. Modest increases in the transferability of surface residues were observed over the broad range of pressures applied by the modified roller.


Properties of an Escherichia coli cytotoxin.
Isoelectric focusing of a heat-labile cytotoxin of Escherichia coli H30 revealed the presence of two molecular variants, pI 7.2 and a comparatively small quantity of pI 6.8. Predominant component pI 7.2 had a molecular weight of 28,000, induced some fluid accumulation in rabbit ileal loops, and showed no morphological response in Y-1 cells but a strong cytotoxic effect on Vero cells.


Analgesia following major gynecological laparoscopic surgery--PCA versus intermittent intramuscular injection.
To compare the use of patient-controlled analgesia to intermittent intramuscular injections of morphine following major gynecological laparoscopic procedures in order to assess differences in level of pain, sedation, episodes of nausea and/or vomiting, hospitalization time and patient satisfaction with their postoperative analgesia. Seventy-two patients undergoing major gynecological laparoscopic surgery were randomized to receive either postoperative analgesia via intermittent intramuscular injection of morphine (Group 1) or patient controlled analgesia (PCA-Group 2). All patients received anesthesia via a standardized protocol. Postoperative pain levels were recorded via a 10 cm visual analogue scale, and sedation scores were recorded on a standard PCA form. Episodes of nausea and vomiting were also recorded on the same form. There were no statistically significant differences between intramuscular analgesia and PCA for any of the factors studied. Most significantly it was found that most patients ceased to require either form of parenteral analgesia within 24 hours of their procedure, regardless of the operating time. It is important for the surgeon to be aware of the effects of postoperative analgesia on his or her patients' level of satisfaction. We do not recommend the use of PCA analgesia following major laparoscopic gynecological surgery.


A Change from a Spinal Immobilization to a Spinal Motion Restriction Protocol was Not Associated with an Increase in Disabling Spinal Cord Injuries.
Over the past decade, Emergency Medical Service (EMS) systems decreased backboard use as they transition from spinal immobilization (SI) protocols to spinal motion restriction (SMR) protocols. Since this change, no study has examined its effect on the neurologic outcomes of patients with spine injuries. The object of this study is to determine if a state-wide protocol change from an SI to an SMR protocol had an effect on the incidence of disabling spinal cord injuries. This was a retrospective review of patients in a single Level I trauma center before and after a change in spinal injury protocols. A two-step review of the record was used to classify spinal cord injuries as disabling or not disabling. A binary logistic regression was used to determine the effects of protocol, gender, age, level of injury, and mechanism of injury (MOI) on the incidence of significant disability from a spinal cord injury. A total of 549 patients in the SI period and 623 patients in the SMR period were included in the analysis. In the logistic regression, the change from an SI protocol to an SMR protocol did not demonstrate a significant effect on the incidence of disabling spinal injuries (OR: 0.78; 95% CI, 0.44 - 1.36). This study did not demonstrate an increase in disabling spinal cord injuries after a shift from an SI protocol to an SMR protocol. This finding, in addition to existing literature, supports the introduction of SMR protocols and the decreased use of the backboard.


Gram-negative organisms predominate in Hickman line-related infections in non-neutropenic patients with hematological malignancies.
Catheter-related blood stream infections (CRBSI) cause significant morbidity and mortality in patients with hematological malignancies. Previous studies have identified a predominance of gram-positive organisms causing CRBSI but they included both neutropenic and non-neutropenic patients with solid organ and hematological malignancies. The aim of our study was to evaluate the incidence and microbiological profile of CRBSIs in a specific cohort of patients with hematological malignancies in their non-neutropenic phase of illness. A detailed retrospective review was done from January 2003 to December 2005 on all patients with hematological malignancies who had double-lumen non-antibiotic impregnated tunneled CVCs (Hickman catheters) inserted in our hospital to identify those fulfilling our criteria for CRBSI episodes. Amongst 273 evaluable patients, 61 developed CRBSI on 70 occasions. In contrast to previous studies, there was a predominance of gram-negative infections (68%). The majority (73%) of initial CRBSI episodes required catheter removal within 7 days of onset. Vancomycin and cefepime was the most common initial antibiotic regimen used. This study highlights the predominance of gram-negative infections in our cohort of non-neutropenic patients with underlying hematological malignancies who had Hickman catheters whose lines were not salvageable in the majority of cases. Empiric monotherapy with an antimicrobial agent with broad spectrum gram-negative cover needs to be given upfront pending results of the nature and sensitivity of organisms identified.


Sequence analysis of hepatitis B virus DNA in immunologically negative infection.
It was previously demonstrated that the serum of some patients without immunological evidence of HBV infection contains the virus. Here we demonstrated by sequence analysis that the serum of such a patient contained a mixed HBV population. In comparison with HBV genomes of different genotypes twenty-two nucleotide variations were found in all clones sequenced in parallel. One nucleotide variation was identified within the enhancer I. Twelve of the twenty-two nucleotide variations caused altogether fifteen changes of amino acid sequence in known or predicted viral proteins. The proteins of the P open reading frame, which are most important for viral replication, were affected by nine amino acid substitutions. Three amino acid substitutions concerned the product of the X gene, a transcriptional transactivator of various viral and cellular promoters. Three mutations were only observed in some of the clones. One point mutation affected the direct repeats of the enhancer II. It occurred together with an 8 bp-deletion involving the C promoter region and the X gene. The third mutation was a single insertion, causing a fusion of the X and C gene. One or several of the identified mutations could be responsible for the diminished rate of replication and consequently for the low-titred, immunologically negative HBV infection.


Effects of Transcranial Direct Current Stimulation on Attentional Bias to Methamphetamine Cues and Its Association With EEG-Derived Functional Brain Network Topology.
Although transcranial direct current stimulation (tDCS) has shown to potentially mitigate drug craving and attentional bias to drug-related stimuli, individual differences in such modulatory effects of tDCS are less understood. In this study, we aimed to investigate a source of the inter-subject variability in the tDCS effects that can be useful for tDCS-based treatments of individuals with methamphetamine (MA) use disorder (IMUD). Forty-two IMUD (all male) were randomly assigned to receive a single-session of either sham or real bilateral tDCS (anodal right/cathodal left) over the dorsolateral prefrontal cortex. The tDCS effect on MA craving and biased attention to drug stimuli were investigated by quantifying EEG-derived P3 (a measure of initial attentional bias) and late positive potential (LPP; a measure of sustained motivated attention) elicited by these stimuli. To assess the association of changes in P3 and LPP with brain connectivity network (BCN) topology, the correlation between topology metrics, specifically those related to the efficiency of information processing, and the tDCS effect was investigated. The P3 amplitude significantly decreased following the tDCS session, whereas the amplitudes increased in the sham group. The changes in P3 amplitudes were significantly correlated with communication efficiency measured by BCN topology metrics (r = -0.47, P = .03; r = -0.49, P = .02). There was no significant change in LPP amplitude due to the tDCS application. These findings validate that tDCS mitigates initial attentional bias, but not the sustained motivated attention, to MA stimuli. Importantly, however, results also show that the individual differences in the effects of tDCS may be underpinned by communication efficiency of the BCN topology, and therefore, these BCN topology metrics may have the potential to robustly predict the effectiveness of tDCS-based interventions on MA craving and attentional bias to MA stimuli among IMUD.


Determining dengue virus serostatus by indirect IgG ELISA compared with focus reduction neutralisation test in children in Cebu, Philippines: a prospective population-based study.
Detection of dengue virus antibodies is important for understanding future dengue virus risk and for prevaccination screening. We aimed to evaluate the performance of a dengue IgG indirect ELISA in determining dengue seroprevalence in a cohort of children in the Philippines, using a focus reduction neutralisation test (FRNT) as the reference test. In this prospective population-based cohort study, we enrolled healthy children residing in Bogo or Balamban, Cebu, Philippines, who were to be aged 9-14 years at the time of a mass dengue vaccination campaign. Sera were collected from participants and batch tested by indirect IgG ELISA and FRNT. The primary endpoint was dengue seroprevalence in the cohort, detected by ELISA, and validated by that detected by reference FRNT. This study is registered with ClinicalTrials.gov, NCT03465254. We collected 2996 serum samples between May 2, and June 2, 2017, and we tested each sample with IgG ELISA. Using 1961 samples (65·5%) that were tested with FRNT, and 1035 samples (34·5%) with imputed results, we found that 320 (10·7%) of 2996 children were dengue naive and 2676 (89·3%) were seropositive for previous dengue virus infection. Based on the 1961 non-imputed FRNT results classified as dengue seronegative or seropositive, the ELISA (with a 0·9 index value cutoff) showed 95·2% sensitivity, 93·4% specificity, 6·6% false positivity, and 4·8% false negativity. However, sensitivity of the ELISA was poor (77·1%) among children with immunity to just one dengue virus serotype. Of the 11 sera that were false positive with ELISA, seven samples (63·6%) were seropositive for Zika virus or Japanese encephalitis virus with FRNT. Most children (89·3%) assessed in our study and eligible to participate in the mass dengue vaccination campaign were seropositive for previous dengue virus infection. Compared with FRNT, ELISA had high sensitivity and specificity (>90%), but the false-negative and false-positive rates makes the test suboptimal for prevaccination screening. Individuals who are falsely identified as seropositive by dengue IgG ELISA and then vaccinated might be at risk of developing severe disease during a subsequent exposure to wild-type dengue virus. Those with a monotypic profile would benefit the most from vaccination, but the sensitivity of the IgG ELISA was much lower in this group than in those with a multitypic profile. Philippine Department of Health, Hanako Foundation, WHO, Swedish International Development Cooperation Agency through the International Vaccine Institute, and University of North Carolina, Chapel Hill, NC, USA.


Thermodynamic quantities of surface formation of aqueous electrolyte solutions VIII. Aqueous solutions of sulfates salts.
In this work the surface tension of the aqueous solutions of alkali metal sulfate, magnesium sulfate, and magnesium nitrate have been measured with an expectation that the effect of sulfate salts on the air/water surface differs from that of typical electrolyte because of their peculiar results of surface potential data. The results show that the slope of surface tension-concentration curves of sulfate salts depends to some extent upon cations while that of alkali metal nitrate gives almost the same magnitude. In order to make comparison with salts of different valence types, we used the ratio of surface excess density to bulk concentration of a salt as an index of surface activity of the salt. It was shown that the surface activity of a salt largely dependent upon its valence type as well as its specific property of anion.


Dexamathasone added to levobupivacaine improves postoperative analgesia in ultrasound guided interscalene brachial plexus blockade for arthroscopic shoulder surgery.
The purpose of this study was to evaluate the effect of the addition of 5 mg dexamethasone to 10 ml of 0.5% levobupivacaine on postoperative analgesic effects of ultrasound guided-interscalene brachial plexus block (ISBPB) in arthroscopic shoulder surgery under general anesthesia. In 60 patients scheduled for arthroscopic shoulder surgery that underwent general anesthesia, ISBPB was preoperatively performed with 10 ml of 0.5% levobupivacaine under the guidance of ultrasound and a nerve stimulator. Patients were randomly allocated to receive the same volume of normal saline (Group I), 5 mg of dexamethasone (Group II), or 1 : 400,000 epinephrine (Group III) as an adjuvant to the mixture. A blind observer recorded total analgesic consumption, sleep quality, complication, and patient satisfaction using a verbal numerical rating scale (VNRS) at 0, 1, 6, 12, 24, 48 h after the operation. All patients had successful ISBPB and excellent analgesic effects less than VNRS 4 up to discharge time. VNRS in Group II at 12 h and 48 h was statistically much lower than in Group I and III. There were no differences in total analgesic consumption, sleep quality, complications, and patient satisfaction. We conclude that the addition of 5 mg of dexamethasone to 10 ml of 0.5% levobupivacaine in ISBPB showed improvement of postoperative analgesia for arthroscopic shoulder operation without any specific complications.


Comparison of Long-Term Outcomes between the n-HA/PA66 Cage and the PEEK Cage Used in Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Disease: A Matched-Pair Case Control Study.
The nanohydroxyapatite/polyamide-66 (n-HA/PA66) cage is a novel bioactive nonmetal cage that is now used in some medical centers, while the polyetheretherketone (PEEK) cage is a typical device that has been widely used for decades with excellent clinical outcomes. This study was performed to compare the long-term radiographic and clinical outcomes of these two different cages used in transforaminal lumbar interbody fusion (TLIF). In this retrospective and matched-pair case control study, we included 200 patients who underwent TLIF from January 2010 to December 2014 with a minimum 7-year follow-up. One hundred patients who used n-HA/PA66 cages were matched with 100 patients who used PEEK cages for age, sex, diagnosis, and fusion level. The independent student's t-test and Pearson's chi-square test were used to compare the two groups regarding radiographic (fusion status, cage subsidence rate, segmental angle [SA], and interbody space height [IH]) and clinical (Oswestry Disability Index [ODI], and Visual Analog Scale [VAS] for back and leg) parameters preoperatively, postoperatively, and at the final follow-up. The n-HA/PA66 and PEEK groups had similar fusion rates of bone inside and outside the cage at the final follow-up (95.3% vs 91.8%, p = 0.181, 92.4% vs 90.1%, p = 0.435). The cage union ratios exposed to the upper and lower endplates of the n-HA/PA66 group were significantly larger than those of the PEEK group (p < 0.05). The respective cage subsidence rates in the n-HA/PA66 and PEEK groups were 10.5% and 17.5% (p = 0.059). There were no significant differences between the two groups in the SA, IH, ODI scores, or VAS scores at any time point. The n-HA/PA66 group showed high fusion and low subsidence rates during long-term follow-up. Both n-HA/PA66 and PEEK cages can achieve satisfactory long-term clinical and radiographic outcomes in TLIF. However, the n-HA/PA66 group showed significantly larger cage union ratios than the PEEK group. Therefore, the results indicated that the n-HA/PA66 cage is an ideal alternative material comparable to the PEEK cage in TLIF.


Adherence to nebulised antibiotics in cystic fibrosis.
To examine the adherence of patients with cystic fibrosis to nebulised antibiotics. A longitudinal design with adherence data collected over 12 weeks. 38 patients (mean age 24.6 years, S.D. 5.3) were recruited from an adult cystic fibrosis (CF) clinic. Adherence was electronically monitored using a Prodose adaptive aerosol delivery (AAD) device. Three indices of adherence were calculated: mean percentage of times the nebuliser was used as prescribed was 50.0% (S.D.=39.7, range 1.1, 155.6); mean percentage of days fully adhered was 31.6% (S.D.=29.4, range 0, 97.2); mean percentage of days nebuliser used at least once was 57.1% (S.D.=34.2, range 3.3, 100). Rates of adherence were generally low. Adherence was not associated with any variables apart from age. There were wide variations between individuals, and differences in rates of adherence depending on how this was defined, with potentially important health consequences for the patients. Technology that improves medication administration may still be associated with low rates of adherence. Health professionals need to be mindful of the pattern of non-adherence for each individual, and factors which may be influencing this.


Mitral annular motion as a surrogate for left ventricular function: correlation with brain natriuretic peptide levels.
Pulsed-wave (PW) Doppler tissue velocities of the mitral annulus correlate well with Left Ventricular (LV) diastolic(D) and systolic(S) functions. Brain natriuretic peptide (BNP) levels have been shown to be elevated in patients with symptomatic LV dysfunction (Dys) and correlate to the severity of symptoms and prognosis. To validate the accuracy of mitral annular motion (MAM) assessed by Doppler Tissue Imaging (DTI) & M-mode Echocardiography (MME) as a surrogate for determination of LV function in comparison with BNP. A series of 133 patients with a variety of cardiac pathologies referred for echocardiography and 20 healthy age & sex matched volunteers as a control group were included the study. Ejection fraction (EF) of LV, Doppler recordings of the mitral inflow, MME and PWDTI data (from each of 4 mitral annular sites, inferior, anterior, septum and lateral) were obtained. Mean peak (S) MAM velocity (Sm), mean annular early (D) velocity (Em) by PWDTI and mean mitral annular plane (S) excursion (MAPSE) by MME were calculated by averaging of values measured at each annular site. BNP levels were measured by a rapid immunoassay and blinded to cardiologist making the assessment of LV function. MAPSE < 12 mm determined by MME has 90% sensitivity, 88% specificity & 89% accuracy for detection of LVEF <50%, while these values were 94%, 93% & 94% respectively for (Sm) < 8 cm/s determined by PWDTI. BNP level>75 pg/ml has 98% sensitivity, 90% specificity & 97% accuracy for detection of LV Dys either (S,D, or both). BNP levels were significantly higher in patients with combined (S & D) Dys. Than those with only (S) Dys, the later group had significantly higher BNP levels than those with only (D) Dys. (1054.5 +/- 202.3 pg/ml vs. 500 +/- 39.9 pg/ml & 500 +/- 39.9 pg/ml vs. 215.3 +/- 100.9 pg/ml respectively, P < 0.001) & each were significantly higher than control group (12.3 +/- 5.7 pg/ml, P < 0.001). Significant correlations (P < 0.001 for all) were found between BNP levels and Em (r =-0.82), Sm (r=-0.7), early transmitral (E) to Em ratio (r=0.61), MAPSE (r=-0.54), LVEF(r=-0.64) & LV end D dimension (r=0.63). MME and PWDTI used for assessment of MAM are useful methods for evaluation of LV function but parameters measured by PWDTI correlate more strongly with plasma BNP levels than those measured by MME and provide a simple, sensitive, accurate and reproducible tool for early diagnosis of LV dysfunction.


A comparison of the impacts of different polysaccharides on the sono-physico-chemical consequences of ultrasonic-assisted modifications.
This study aimed to examine the sono-physico-chemical effects of ultrasound (UND) and its impact on the conjugate rates of morin (MOI) following the addition of polysaccharides in various conditions. In comparison to the control group, the incorporation of quaternary ammonium chitosan decreased the rate of MOI conjugation by 17.38%, but the addition of locust bean gum enhanced the grafting rate by 29.89%. Notably, the highest degree of myofibrillar protein (MRN) unfolding (fluorescence intensity: 114435.50), the most stable state (-44.98 mV), and the greatest specific surface area (393.06 cm2/cm3) were observed in the UMP/LBG group. The outcomes of atomic force microscopy and scanning electron microscopy revealed that the inclusion of locust bean gum led to a different microscopic morphology than the other two polysaccharides, which may be the primary cause of the strongest sono-physico-chemical effects of the system. This work demonstrated that acoustic settings can be tuned based on the characteristics of polysaccharides to maximize the advantages of sono-physico-chemical impacts in UND-assisted MOI processing.


In patients with mild hypertension, does exercise and a gradual rather than abrupt increase in fatty acid and salt intake cause less rise in cardiovascular risk factors?
In a randomised, single blind controlled trial, 58 patients with mild essential hypertension were administered either a normal diet with a gradual increase in salt and fatty acid consumption (Group A, 30 cases), or an abrupt increase (Group B, 28 cases) for a period of 24 weeks. Group A patients also did more physical activity from weeks 12-24 of the study. At entry to the study, age, sex, risk factors, previous drug therapy and nutrient intakes were comparable between the 2 groups. Adherence to nutrient intakes and exercise was assessed by questionnaires. After 12 weeks, a comparison of changes in mean blood pressure and blood lipids in groups A and B showed no significant difference. However, group B patients showed a significant increase in mean total cholesterol, diastolic pressure and heart rate compared to initial levels. There were no such changes in group A. After 24 weeks, while salt, fatty acids and cholesterol intakes were similar in both groups, there were significantly higher levels of mean total cholesterol, triglycerides, serum sodium, systolic and diastolic blood pressure, and heart rate in group B compared with group A. This may have been due to exercise or to a gradual rather than abrupt increase in salt and fatty acids consumption allowing the body to adapt. Increased physical activity appears to have a positive influence on adaptation leading to prevention of the adverse effects induced by fatty acids and salt loading.


Immobilization of Aspergillus oryzae β-galactosidase in cation functionalized agarose matrix and its application in the synthesis of lactulose.
Aspergillus oryzae β-galactosidase was immobilized in in-house quaternary ammonium agarose (QAA) and used for the first time in the synthesis of lactulose. A biocatalyst was obtained with a specific activity of 24,690 IUH∙g-1; protein immobilization yield of 97% and enzyme immobilization yield of 76% were obtained at 30 °C in 10 mM phosphate buffer pH 7 for standard size agarose at 100 mgprotein∙gsupport-1 which the maximum protein load of QAA. Highest yield and specific productivity of lactulose were 0.24 g∙g-1 and 9.78 g∙g-1 h-1 respectively, obtained at pH 6, 100 IUH∙g lactose-1 enzyme/lactose ratio and 12 lactose/fructose molar ratio. In repeated-batch operation with the immobilized enzyme, the cumulative mass of lactulose per unit mass of contacted protein and cumulative specific productivity were higher than obtained with the soluble enzyme since the first batch. After enzyme activity exhaustion, the enzyme was desorbed and QAA support was reused without alteration in its maximum enzyme load capacity and without detriment in yield, productivity and selectivity in the batch synthesis of lactulose with the resulting biocatalyst. This significantly decreases the economic impact of the support, presenting itself as a distinctive advantage of immobilization by ionic interaction.


Running Energy Reserve Index (RERI) as a new model for assessment and prediction of world, elite, sub-elite, and collegiate running performances.
The purpose of this study was to utilize the Running Energy Reserve Index (RERI) model and two-trial procedure to predict all-out athletic performances. Twenty-nine trained athletes tested for differences between RERIE and RERIspd (hypothesis 1). Six sprint trained (ST), six middle distance (MD), and six endurance trained (ET) athletes were selected to test for differences in the value of the constant. The prediction of all-out run performances using the RERI model (hypothesis 2) and two treadmill trials procedure (hypothesis 3) were tested on eighteen trained athletes. Lastly, three trained athletes were utilized to predict all-out running performances utilizing two track trials equation (hypothesis 3). RERIE and RERIspd were significantly different between ST, MD, and ET athletes. The RERIE model with a fixed cE value of 0.0185 s-1 predicted all-out running performances to within an average of 2.39 ± 2.04% (R2 = 0.99, nT = 252) for all athletes, with treadmill trials to within an average of 2.26 ± 1.89% (R2 = 0.99, nT = 203) and track trials to within an average of 2.95 ± 2.51% (R2 = 0.99, nT = 49). The two trials equations predicted all-out track performances to within errors of 2.43%. The RERI model may be accurate in determining running performances of 200 m and 5000 m, and treadmill performances ranging between 5 and 1340 s with a high level of accuracy. In addition, the two-trial procedure can be used to determine short and middle distance running performances of athletes and world-class runners.


Effects of RNA interference-mediated E-selectin gene silencing on cell adhesion molecule expression and cell-cell adhesion in vascular endothelial cells in mice with immunologic contact urticaria.
Contact urticaria is recognized as the wheal and flare reaction at a site from direct contact with a chemical or protein agent. Ongoing studies have proposed that gene silencing may have a promising future in finding optimal treatment of a variety of disease; hence, the aim of the study was to investigate the effect of RNA interference-mediated E-selectin ( SELE) gene silencing on cell adhesion molecule expression and on cell-cell adhesion in vascular endothelial cells (VECs) in a mouse model of immunologic contact urticaria (ICU). Following the successful establishment of mouse models of ICU induced by antidinitrophenol immunoglobulin E (IgE) combining 2,4-dinitrofluorobenzene challenge, enzyme-linked immunosorbent assay and immunohistochemistry were used to measure the levels of IgE, interleukin 4 (IL-4), interferon-γ (IFN-γ), and histamine as well as the positive expression rate of SELE, respectively. The siRNA- SELE vector was constructed and transfection efficiency was estimated prior to performing quantitative reverse-transcription polymerase chain reaction and Western blot assay to determine the relative expression of SELE, eosinophil cationic protein (ECP), intercellular adhesion molecule 1 (ICAM-1), L-selectin (CD62L), and the alpha chain of leukocyte function-associated antigen-1 (CD11a). Adhesion assay was then performed to assess the cell adhesion ability in VECs. Elevated levels of IgE, IL-4, IFN-γ, and histamine and increased positive expression rate of SELE were indicative of successful establishment of mouse models of ICU. Furthermore, the relative expression levels of SELE, ECP, ICAM-1, CD62L, and CD11a were highest in the OE- SELE group. Besides, cell adhesion ability of VECs was notably promoted. Collectively, the current study define the potential role of SELE silencing as an inhibitor to ICU development by inhibiting cell adhesion ability of VECs.


Quality Improvement for Rapid Development and Scale-Up of COVID-19-Related Screening Processes.
In March 2020, Ohio strongly recommended temperature and health screening for coronavirus disease 2019 symptoms in all businesses to reduce the spread of infection. We used multiple plan-do-study-act cycles and workplace efficiency techniques iteratively to develop 12 intervention components required to effectively screen employees and visitors across all locations. We used run and control charts to summarize our performance over time. Over the course of 20 days of rapid testing, we increased from 0% to 100% of locations successfully screening. The volume of people undergoing screening peaked during employee shift change. Employee positive screen results decreased by >50% after the first 7 days of screening, whereas family positive screen results remained stable throughout the study period. An empowered, multidepartmental steering team, disciplined use of rapid cycle quality improvement processes, and explicit, standardized training processes enabled rapid successful scale-up of standard screening and masking process for employees and patients during the coronavirus disease 2019 pandemic. This approach can assist hospitals in adapting screening processes to evolving evidence.


Preoperative left shoulder elevation > 1 cm is predictive of severe postoperative shoulder imbalance in early onset idiopathic scoliosis patients treated with growth-friendly instrumentation.
Prior research has demonstrated the influence of preoperative shoulder elevation (SE), proximal thoracic curve magnitude, and upper instrumented vertebra (UIV) on shoulder balance after PSF for AIS. Our purpose was to evaluate the impact of these factors on shoulder balance in early onset idiopathic scoliosis (EOIS) patients treated with growth-friendly instrumentation. This was a multicenter retrospective review. Children with EOIS treated with dual TGR, MCGR, or VEPTR and minimum 2-year follow-up were identified. Demographics and radiographic/surgical data were collected. 145 patients met inclusion criteria: 74 had right SE (RSE), 49 left SE (LSE), and 22 even shoulders (EVEN) preoperatively. Mean follow-up was 5.3 years (range, 2.0-13.1 years). The LSE group had a larger pre-index mean main thoracic curve (p = 0.021) but no difference was observed between groups at the post-index or most recent timepoints. RSE patients with UIV of T2 were more likely to have balanced shoulders post-index than patients with UIV of T3 or T4 (p = 0.011). Pre-index radiographic shoulder height (RSH) was predictive of post-index shoulder imbalance ≥ 2 cm in the LSE group (p = 0.007). A ROC curve showed a cut-off of 1.0 cm for RSH. 0/16 LSE patients with pre-index RSH < 1.0 cm had post-index shoulder imbalance ≥ 2 cm compared to 8/28 (29%) patients with pre-index RSH > 1.0 cm (p = 0.006). Preoperative LSE > 1.0 cm is predictive of shoulder imbalance ≥ 2 cm after insertion of TGR, MCGR, or VEPTR in children with EOIS. In patients with preoperative RSE, UIV of T2 resulted in a higher likelihood of balanced shoulders postoperatively.


Diagnosis of foregut duplication cysts by endoscopic ultrasonography.
Foregut duplication cysts are rare congenital anomalies of enteric origin found most commonly in children and rarely in adults. They are usually found in adults on routine radiological studies and represent a challenging diagnostic problem. Conventional imaging tests do not lead to a conclusive diagnosis. With endoscopic ultrasonography, it is possible to distinguish between cystic and solid masses and to accurately establish the location of the cyst in relation to the gastrointestinal wall and to the mediastinum. Seven patients who had endoscopic ultrasonography performed because of differentiation between a cystic or solid mass lesion in the chest or abdomen could not be made with conventional radiological methods are described. In all patients, a definite diagnosis was established by endoscopic ultrasonography. The diagnosis was confirmed in 2 patients after surgical excision. Surgery can be avoided in patients with asymptomatic enteric duplication cysts diagnosed by endoscopic ultrasonography.


Genomic insights and comparative analysis of Flavobacterium bizetiae HJ-32-4 isolated from soil.
In the late 1970s, Flavobacterium bizetiae was first isolated from diseased fish in Canada. After four decades of preservation, it was reported as a novel species in 2020. Here, we report the first complete genome sequence of HJ-32-4, a novel strain of F. bizetiae. Interestingly, HJ-32-4 was isolated from soil in Gangwon-do, Republic of Korea, unlike the other two previously reported F. bizetiae strains which were isolated from fish. We generated a single circular chromosome of HJ-32-4, comprising 5,745,280 bp with a GC content of 34.2%. The average nucleotide identity (ANI) value of 96.2% indicated that HJ-32-4 belongs to F. bizetiae CIP 105534T. The virulence factor was not detected in the genome. Comparative genomic analysis of F. bizetiae and major flavobacterial pathogens revealed that F. bizetiae had a larger genome size and the ratio of peptidases (PEP) and glycoside hydrolase (GH) genes of F. bizetiae were lower than those of the rest strains, implying that F. bizetiae exhibits similar characteristics with non-pathogenic strains from a genomic point of view. However, further experimental verification is required to ensure these in silico predictions. This study will provide insight into the overall characteristics of HJ-32-4 compared to other strains.


Preservation of residual hearing after cochlear implant surgery with slim modiolar electrode.
To evaluate the insertion results and hearing preservation of a novel slim modiolar electrode (SME) in patients with residual hearing. We retrospectively collected the data from the medical files of 17 patients (18 ears) implanted with a SME. All patients had functional low frequency hearing (PTA (0.125-0.5 kHz) ≤ 80 dB HL). The insertion results were re-examined from the postoperative cone-beam computed tomography scans. Postoperative thresholds were obtained at the time of switch-on of the sound processors (mean 43 days) and at latest follow-up (mean 582 days). The speech recognition in noise was measured with the Finnish matrix sentence test preoperatively and at follow-up. The mean insertion depth angle (IDA) was 395°. Neither scala dislocations nor tip fold over were detected. There were no total hearing losses. Functional low-frequency hearing was preserved in 15/18 (83%) ears at switch-on and in 14/17 (82%) ears at follow-up. According to HEARRING classification, 55% (10/18) had complete HP at switch-on and 41% (7/17) still at follow-up. Thirteen patients (14 ears) were initially fitted with electric-acoustic stimulation and seven patients (8 ears) continued to use it after follow-up. The preliminary hearing preservation results with the SME were more favorable than reported for other perimodiolar electrodes. The results show that the array may also be feasible for electro-acoustic stimulation; it is beneficial in that it provides adequate cochlear coverage for pure electrical stimulation in the event of postoperative or progressive hearing loss.


Pharmacotherapy in the perinatal period--an exploratory study in midwifery.
To gather information on the adherence to the Dutch national neonatal vitamin K policy and on the administration of prescription medication during labor by community midwives. A telephone questionnaire under community midwives in the North of the Netherlands. In the main, the vitamin K practices follow the guidelines with respect to who receives the first dose and maintenance therapy. There is possibly underdosing. Midwives use their license to administer medicines during labor in moderation: 91% report to never use tocolytics, oxytocics or analgesics. In general, the national vitamin K policy is followed. Information gathered prospectively is needed on the use of pharmacotherapy by community midwives in the perinatal period.


NHP-immunome: A translational research-oriented database of non-human primate immune system proteins.
We are currently living the advent of a new age for medicine in which basic research is being quickly translated into marketable drugs, and the widespread access to genomics data is allowing the design and implementation of personalized solutions to medical conditions. Non-human primates (NHP) have gained an essential role in drug discovery and safety testing due to their close phylogenetic relationship to humans. In this study, a collection of well characterized genes of the human immune system was used to define the orthology-based immunome in four NHP species, with carefully curated annotations available based on multi-tissue RNA-seq datasets. A broad variation in the frequency of expressed protein isoforms was observed between species. Finally, this analysis also revealed the lack of expression of at least four different chemokines in new-world primates. In addition, transcripts corresponding to four genes including interleukin 12 subunit alpha were expressed in humans but no other primate species analyzed. Access to the non-human primate immunome is available in http://www.fidic.org.co:90/proyecto/.


Emotional behavior and arrhythmias induced in cats by hypothalamic stimulation.
As the relationship between emotional behavior and electrocardiographic (ECG) change induced by hypothalamic stimulation is poorly understood, eighty-four points in various areas within the hypothalamus in conscious cats were stimulated electrically through chronically implanted electrodes, the objective being to clarify the behavior accompanying ECG changes, in particular poststimulus arrhythmias. Forty-one of 84 points elicited behavioral patterns such as defense reaction, pseudo-rage and restlessness (classified as group A), and in twenty-one (51%) of these 41 points arrhythmias occurred after cessation of stimulation. Forty-three of 84 points elicited behavioral patterns including predatory, exploratory and other behavioral responses (classified as group B), and in three (7%) of 43 points, poststimulus arrhythmias followed. Under light anesthesia, stimulations of twofold current intensity were applied at these points, and the incidences of the arrhythmias did not change in either group. The arrhythmia-inducing area in the cases of group A was found to lie dorsal and caudal to the optic chiasma and to extend caudally in the fornix. Three points in the cases of group B were located in the outer area of the aforementioned area. These studies showed that arrhythmias and group A behavior were observed mainly from stimulation of the anterior hypothalamus, whereas stimulation of other areas of the hypothalamus, including the lateral and the posterolateral hypothalamus, produced group B behavior and no arrhythmias.


Risk factors and outcomes in pediatric blunt cardiac injuries.
Unlike adults, less is known of the etiology and risk factors for blunt cardiac injury (BCI) in children. Identifying risk factors for BCI in pediatric patients will allow for more specific screening practices following blunt trauma. A retrospective review was performed using the Trauma Quality Improvement Program (TQIP) database from 2017 to 2019. All patients ≤ 16 years injured following blunt trauma were included. Demographics, mechanism, associated injuries, injury severity, and outcomes were collected. Univariate and multivariate regression was used to determine specific risk factors for BCI. Of 266,045 pediatric patients included in the analysis, the incidence of BCI was less than 0.2%. The all-cause mortality seen in patients with BCI was 26%. Motor-vehicle collisions (MVCs) were the most common mechanism, although no association with seatbelt use was seen in adolescents (p = 0.158). The strongest independent risk factors for BCI were pulmonary contusions (OR 15.4, p < 0.001) and hemothorax (OR 8.9, p < 0.001). Following trauma, the presence of pulmonary contusions or hemothorax should trigger additional screening investigations specific for BCI in pediatric patients.


Geochemical fractionation, bioaccessibility and ecological risk of metallic elements in the weathering profiles of typical skarn-type copper tailings from Tongling, China.
Nonferrous metal tailings have long posed a significant threat to the surrounding environment and population. Previous studies have primarily focused on heavy metal pollution in the vicinity of sulfide tailings, while little attention was given to metal mobility and bioavailability within skarn-type tailings profile during weathering. Therefore, this study aimed to investigate the fractionation, bioaccessibility, and ecological risk associated with metallic elements (MEs, including Pb, Cd, Cr, Zn, and Cu) in two representative weathering copper-tailings profiles of Tongling mine (China). This was achieved through the use of mineralogical analyses, BCR extractions (F1: exchangeable, F2: reducible, F3: oxidizable, F4: residual fraction), in-vitro gastrointestinal simulation test (PBET) and risk assessment models. The mineral compositions of two weathering profiles were similar, with quartz and calcite being the dominant minerals, along with minor amounts of siderite, hematite and spangolite. The mean concentration in the tailings profile was approximately 0.31 (Cr), 1.8 (Pb), 12 (Zn), 33 (Cd) or 34 (Cu) times of the local background values (LBVs). The mean content of the bottom weakly-weathering layer in profile was about 0.36 (Cr), 0.91 (Pb), 1.91 (Cd), 2.73 (Zn) or 2.68 (Cu) times of the surface oxide layer, indicating a strong weathering-leaching effect. The average proportion of BCR-F1 fraction for Cd (30.94 %) was the highest among the five MEs, possibly due to its association with calcite. The PBET-extracted fractions for Cd, Zn and Cu were significantly positively correlated with the F1, F2 and F3 fractions of BCR, suggesting that these elements have higher bioavailability/bioaccessibility. The assessment results indicated that Cd posed a higher health risk, while the risk of Cu, Zn, and Pb is relatively low and Cr is safe. In conclusion, this study provides valuable insights into the environmental geochemical behavior and potential risks of MEs in skarn-type non-ferrous metal tailings ponds.


Action will boost awareness and training on domestic abuse.
Valid points on the need for nursing students to be able to competently detect and assess victims of intimate partner violence were made in Artur Dalfó Pibernat's letter in May's issue of Emergency Nurse magazine.


Is Mandibular Fossa Morphology and Articular Eminence Inclination Associated with Temporomandibular Dysfunction?
Finding a significant relationship between temporomandibular joint (TMJ) morphology and the incidence of temporomandibular dysfunction (TMD) may help early prediction and prevention of these problems. The purpose of the present study was to determine the morphology of mandibular fossa and the articular eminence inclination in patients with TMD and in control group using cone beam computed tomography (CBCT). The CBCT data of bilateral TMJs of 40 patients with TMD and 23 symptom-free cases were evaluated. The articular eminence inclination, as well as the glenoid fossa depth and width of the mandibular fossa were measured. The paired t-test was used to compare these values between two groups. The articular eminence inclination and glenoid fossa width and depth were significantly higher in patients with TMD than in the control group (p < 0.05). The articular eminence inclination was steeper in patients with TMD than in the control group. Glenoid fossa width and depth were higher in patients with TMD than that in the control group. This information may shed light on the relationship between TMJ morphology and the incidence of TMD.


A novel O2- (2,4-dinitrophenyl) diazeniumdiolate inhibits hepatocellular carcinoma migration, invasion, and EMT through the Wnt/β-catenin pathway.
Targeted Wnt/β-catenin pathway is considered to be a promising therapy for cancer metastasis. The novel O2 -(2,4-dinitrophenyl) diazeniumdiolate (JS-K) plays a potent inhibitory role in the proliferation of cancers. In this study, HepG2 and SMMC7721 were used to clarify the efficacy of JS-K inhibition of HCC metastasis. JS-K significantly inhibited cell motility through a wound-healing assay and restrained cell migration and invasion at noncytotoxic concentrations. However, the inhibitory effects of migration and invasion were abolished after the addition of NO scavenger, Carboxy-PTIO. In addition, JS-K inhibited the Wnt/β-catenin pathway by a decrease of p-GSK-3β at Ser9, cytosolic β-catenin, and nuclear β-catenin accumulation whereas an increase of p-β-catenin. Furthermore, the transcription regulators c-Myc, survivin, and Cyclin D1 were down-regulated after treating with JS-K. The inhibitory of the Wnt/β-catenin pathway was reversed after the addition of Carboxy-PTIO or LiCl. Meanwhile, JS-K also inhibited the epithelial-mesenchymal transition (EMT)-mediated cell migration and invasion. The characteristics of the inhibition were reflected by the upregulation of E-cadherin whereas the downregulation of Vimentin, Snail, and Slug. Taking together, these results demonstrated that JS-K inhibited HepG2 and SMMC7721 cells migration and invasion by reversing EMT via the Wnt/β-catenin pathway.


Use of a novobiocin-containing medium for isolation of Staphylococcus saprophyticus from urine.
The use of a novobiocin-containing medium provided little benefit over observable quantitative growth on blood agar in detecting Staphylococcus saprophyticus in urine cultures.


Perceived vs measured forces of interarch elastics.
Orthodontists depend on perceptions derived from education and clinical experience to judge the optimal forces in patient treatment. The purpose of this study was to survey practicing orthodontists to determine the interarch latex elastic forces they prescribe in different malocclusion scenarios. Thirty orthodontists were presented with 4 clinical scenarios on study models, including Class II and Class III malocclusions in edgewise and light wires. These orthodontists described the size and location of the elastics they would use. The forces produced by the prescribed elastics were measured and compared with actual dry forces measured on a testing machine. The orthodontists' force recommendations were a mean of 277 ± 89 g and a median of 256 g (range, 132-464 g) for a Class II malocclusion with edgewise wires; a mean of 183 ± 59 g and a median of 177 g (range, 59-284 g) for a Class II malocclusion with light wires; a mean of 290 ± 83 g and a median of 305 g (range, 151-562 g) for a Class III malocclusion with edgewise wires; and a mean of 216 ± 66 g and a median of 209 g (range, 119-344 g) for a Class III malocclusion with light wires. The force levels for light wires were statistically significantly lower than for edgewise wires. There were considerable variations in the forces selected for all cases. "Expert" recommendations fell within 1 SD of the mean of the orthodontists' recommendations except for the light-wire Class III scenario. Since latex elastic force decays significantly during a patient's use, elastics should be selected with initially higher forces than desired.


Exposure-response relationship in the hand-arm vibration syndrome: an overview of current epidemiology research.
The complex of vascular, neurologic, and osteoarticular disorders occurring in the upper limbs of vibration-exposed workers is called hand-arm vibration syndrome. There is epidemiologic evidence for an increased occurrence of peripheral sensorineural disorders in occupational groups working with vibrating tools. An excess risk for wrist osteoarthrosis and for elbow arthrosis and osteophytosis has been reported in workers exposed to shocks and low-frequency vibration of high magnitude from percussive tools. However, there are too few epidemiology data to enable reliable conclusions to be drawn about exposure-response relationships for both sensorineural disturbances and bone and joint disorders caused by hand-transmitted vibration. Cross-sectional and longitudinal epidemiology studies have shown that occupational exposure to hand-transmitted vibration from a great variety of hand-held tools is significantly associated with an increased occurrence of digital vasospastic disorders called vibration-induced white finger (VWF). The proposal of an exposure-response relationship for VWF has been included in an annex to the international standard ISO 5349. The findings of several epidemiology studies have shown a poor agreement between the risk for VWF observed in various occupational groups and that predicted by the ISO 5349 model. Both overestimation and underestimation of the occurrence of VWF have been reported by investigators. It has been argued that the current ISO frequency-weighting curve for hand-transmitted vibration may be inappropriate for the assessment of vibration-induced adverse vascular effects. Alternative exposure-response relationships for VWF have been suggested in recent epidemiology studies. The epidemiology data used to construct current exposure-response relationships for vibration-induced injuries are primarily derived from cross-sectional studies. Future epidemiology research should be based on prospective cohort studies because the design characteristics of such studies permit the study of cause-effect relationships and the formulation of etiologic hypotheses.


Controlled Synthesis of Ultrathin PtSe2 Nanosheets with Thickness-Tunable Electrical and Magnetoelectrical Properties.
Thickness-dependent chemical and physical properties have gained tremendous interest since the emergence of two-dimensional (2D) materials. Despite attractive prospects, the thickness-controlled synthesis of ultrathin nanosheets remains an outstanding challenge. Here, a chemical vapor deposition (CVD) route is reported to controllably synthesize high-quality PtSe2 nanosheets with tunable thickness and explore their thickness-dependent electronic and magnetotransport properties. Raman spectroscopic studies demonstrate all Eg , A1 g , A2 u , and Eu modes are red shift in thicker nanosheets. Electrical measurements demonstrate the 1.7 nm thick nanosheet is a semiconductor with room temperature field-effect mobility of 66 cm2 V-1 s-1 and on/off ratio of 106 . The 2.3-3.8 nm thick nanosheets show slightly gated modulation with high field-effect mobility up to 324 cm2 V-1 s-1 at room-temperature. When the thickness is over 3.8 nm, the nanosheets show metallic behavior with conductivity and breakdown current density up to 6.8 × 105 S m-1 and 6.9 × 107 A cm-2 , respectively. Interestingly, magnetoresistance (MR) studies reveal magnetic orders exist in this intrinsically non-magnetic material system, as manifested by the thickness-dependent Kondo effect, where both metal to insulator transition and negative MR appear upon cooling. Together, these studies suggest that PtSe2 is an intriguing system for both developing novel functional electronics and conducting fundamental 2D magnetism study.


Development of Chitosan-Based Nanoemulsion Gel Containing Microbial Secondary Metabolite with Effective Antifungal Activity: In vitro and in vivo Characterizations.
Microbial resistance to antibiotics is one of the most important public health concerns of the 21st century. We isolated, purified, and structurally elucidated antifungal secondary metabolites from red soil microbes and encapsulated them into chitosan (CS)-based nanoemulsion (NE) gel (NEG). Three compounds were isolated and purified of which only one compound (Pure 2) showed potent antifungal activity (MFC: 8-132 µg/mL), which was also significantly (P<0.05) more efficient than fluconazole (MFC: 32-132 µg/mL). Pure 2 was structurally elucidated using 1D- and 2D-NMR before its incorporation into NEG. The formulations were prepared by high-speed homogenization technique. Physicochemical and pharmacological characterizations of formulations (ie, droplet size, PDI, zeta potential, drug content, viscosity, SEM, FTIR, spreadability, in vitro drug release, ex vivo permeation, in vitro antifungal and in vivo antifungal activities) were assessed. NMR analyses identified the compound as a derivative of phthalic acid ester (PAE). The optimized formulations displayed a droplet size <100 nm, -ve zeta potential, and PDI <0.45. The drug content was within the official limit of pharmacopeia (ie, 100±10%). Insignificant changes (P>0.05) in the viscosity of the formulations stored were observed. The morphology of the formulations indicated mesh-like structure. The FTIR study indicated that there were no interactions between the drug and other ingredients of the formulations. Optimum spreadability was observed in all formulations. NEG released 75.3±1.12% of Pure 2 after 12 hrs while NE released 85.33±1.88% of the compound. The skin permeation of F2 (71.15±1.28%) was significantly different (P<0.05) from F3 (81.80±1.91%) in rabbits. Complete and apparently safe recovery from the fungal infection was achieved in rabbits treated topically with Pure 2-loaded NEGs. Hence, the NEG-loaded PAE isolated from Pseudomonas fluorescens represents a possible alternative for the treatment of fungal infections as compared to available therapies.


Differential pulse voltammetric determination of tin in the presence of noble metals.
A voltammetric method for the determination of tin is proposed to minimise interferences from noble metals that are commonly encountered with other analytical techniques. Strong distortions of voltammetric peaks are observed in the presence of platinum. On the basis of a full investigation, the formation of an intermediate Sn(II)-Pt mixed chloro-complex at the electrode surface is identified as being responsible for the platinum interference, as it competes with the normal Sn(IV)-->Sn(0)Hg reduction. The use of a higher scan rate prevents the relatively low reaction kinetics and thus gets rid of this interference. No problems are encountered with other noble metals such as Pd, Ir, Re, Rh and Ru when using the modified method, although a baseline subtraction is necessary for the latter one. The proposed method is validated with real Pt-Sn catalysts.


A Tin(IV) Chloride Promoted Tandem C-O Bond Cleavage/Nazarov Cyclization/Nucleophilic Addition Reaction of 1,1-Disubstituted Allylic Ethers toward the Synthesis of Multisubstituted Indenes.
A novel SnCl4-promoted tandem reaction toward multisubstituted indenes via a sequential C-O bond cleavage/Nazarov cyclization/nucleophilic addition reaction has been developed to afford a series of multisubstituted indenes with an all-carbon quaternary center in moderate to good yields.


Caffeine citrate in the NICU.
Administering caffeine citrate is a safe, noninvasive way to treat premature infants with persistent apnea. This drug decreases the frequency of apneic episodes, thus reducing the need for mechanical ventilation. It is given once a day, either orally or intravenously. Ideally, caffeine citrate can treat apnea of prematurity and prevent insults to the premature infant's neurological status.


Effect of atrial fibrillation on long-term survival in patients hospitalised for heart failure with preserved ejection fraction.
The prognostic importance of atrial fibrillation (AF) in heart failure (HF) is not clearly established. Studies conducted in systolic HF have led to discordant results. To evaluate the relation between AF and long-term survival in patients with heart failure and preserved ejection fraction (HFPEF). We prospectively included 368 consecutive patients hospitalised for a first episode of HFPEF during 2000 and compared the 5-year outcome of patients according to the presence or absence of AF on the baseline electrocardiogram. Propensity scores were used to reduce imbalance in baseline characteristics. Baseline AF was observed in 36% (n=132) of the study population. Patients with AF were older and more often had hypertensive heart disease. On univariate analysis, baseline AF was associated with an increased risk of 5-year overall mortality (HR=1.36; 95%CI 1.03-1.79; p=0.03). After adjustment for covariates, baseline AF was no longer a predictor of reduced survival. The risk of adjusted cardiovascular death in patients with and without AF was comparable. In the propensity-matched patients, AF was not related to a poorer outcome (HR=1.08; 95%CI 0.78-1.51; p=0.63). In patients hospitalised for HFPEF, AF is frequent and associated with an excess mortality mainly related to the advanced age of these patients. After adjustment for covariates, baseline AF is not an independent predictor of long-term mortality.


Differential segregation of nodaviral coat protein and RNA into progeny virions during mixed infection with FHV and NoV.
Nodaviruses are icosahedral viruses with a bipartite, positive-sense RNA genome. The two RNAs are packaged into a single virion by a poorly understood mechanism. We chose two distantly related nodaviruses, Flock House virus and Nodamura virus, to explore formation of viral reassortants as a means to further understand genome recognition and encapsidation. In mixed infections, the viruses were incompatible at the level of RNA replication and their coat proteins segregated into separate populations of progeny particles. RNA packaging, on the other hand, was indiscriminate as all four viral RNAs were detectable in each progeny population. Consistent with the trans-encapsidation phenotype, fluorescence in situ hybridization of viral RNA revealed that the genomes of the two viruses co-localized throughout the cytoplasm. Our results imply that nodaviral RNAs lack rigorously defined packaging signals and that co-encapsidation of the viral RNAs does not require a pair of cognate RNA1 and RNA2.


Uracil-DNA glycosylase (UNG) influences the melting temperature (T(m)) of herpes simplex virus (HSV) hybridization probes.
Prior to PCR amplification, uracil-DNA glycosylase (UNG) can be incorporated to prevent amplicon contamination. Melting temperature (T(m)) analysis of herpes simplex virus (HSV) hybridization probes was used to demonstrate a concentration-dependent decrease in T(m) values when heat stabile or heat labile UNG was added.


Fifteen years of imposex and tributyltin pollution monitoring along the Portuguese coast.
IMO's Anti-Fouling Systems convention banned the use of organotin-based antifouling systems in 2008 as the ultimate effort to stop tributyltin (TBT) inputs into the marine environment. One of the hazardous effects of TBT is imposex (the superimposition of male sexual characters onto gastropod females), a phenomenon that may cause female sterility and the gastropod populations decline. Despite previous European Union legislation had already been shown effective in reducing the imposex levels along the Portuguese coast, this study intends to confirm these decreasing trends after 2008 and describe the global evolution in the last 15 years. Imposex levels were assessed in two bioindicators - the dog-whelk Nucella lapillus and the netted-whelk Nassarius reticulatus (Gastropoda, Prosobranchia) - in 2011 and 2014, and the results were compared with previous years. Both species showed progressive decreasing trends in imposex levels over the last 15 years; median values of the vas deferens sequence index (VDSI) fell from 3.96 to 0.78 in N. lapillus and from 3.39 to 0.29 in N. reticulatus. The temporal/spatial evolution of imposex suggests an apparent shift of TBT hotspots, being now restricted to fishing ports and marinas in detriment of large commercial harbours where TBT levels fell rapidly. Butyltins were measured in the whole tissues of N. lapillus females collected in 2014: monobutyltin (MBT) varied from < DL (detection limit: 1 ng Sn/g) to 13 ng Sn/g dw, dibutyltin (DBT) from 2.2 to 27 ng Sn/g dw and TBT from 1.5 to 55 ng Sn/g dw. Although TBT body burden has declined over time, the butyltin degradation index ([MBT]+[DBT])/[TBT] exhibited values < 1 in c. a. 90% of the sites assessed, suggesting that recent TBT inputs are still widespread in the Portuguese coast eventually due to illegal use of TBT antifouling systems and TBT desorption from sediments.


Removal of RNase activity from DNase by affinity chromatography on agarose coupled aminophenylphosphoryl-uridine-2' (3')-phosphate.
Severe degradation of high molecular weight RNA was shown to occur during incubation with commercially purified DNase. Most of the RNase activity could be removed by passage of the DNase through a column of agarose-coupled amino phenylphosphoryl-uridine-2' (3')-phosphate. Incubation with the treated DNase caused only minimal alteration of the sedimentation pattern of high molecular weight nuclear RNA, determined under partially denturing conditions. No impairment of DNase activity was detected.


Ancrod enhances the thrombolytic effect of streptokinase and urokinase.
Since thrombi continue to incorporate fibrin during lysis we tested the effect of pretreatment with ancrod, a defibrinating agent from Malaysian pit viper venom, on thrombolysis with urokinase and streptokinase. Thrombi were induced by copper-coils in the carotid arteries of the dogs, weighed after 1 hour and inserted into the femoral arteries of the same animals. They were then exposed for 15 min to iv boluses of streptokinase 10,000 U/kg, urokinase 10,000 U/kg and urokinase 25,000 U/kg with or without pretreatment with ancrod. Ancrod depleted fibrinogen within 5 min and enhanced the lytic effect of streptokinase from 25 +/- 8% to 59 +/- 13% (p less than .05), urokinase 10,000 U/kg from 16 +/- 11% to 66 +/- 18% (p less than .01) and urokinase 25,000 U/kg from 27 +/- 17% to 85 +/- 8% (p less than .001) of the initial thrombus weight. Ancrod itself did not activate plasminogen to plasmin. We conclude that ancrod enhances thrombolysis probably by depleting fibrinogen and preventing new fibrin incorporation into the thrombus during lysis.


Males and females have different muscle activity patterns during gait after ACL injury and reconstruction.
Kinematic and kinetic changes following anterior cruciate ligament (ACL) rupture and reconstruction (ACLR) have been fundamental to the understanding of mechanical disrupted load as it contributes to the development of posttraumatic osteoarthritis. These analyses overlook the potential contribution of muscle activity as it relates to the joint loading environment. Males and females classified as non-copers present with unique knee kinematics and kinetics after ACL injury. The purpose of this study was to perform sex-specific analyses in these individuals to explore muscle activity timing during gait after ACL rupture. Thirty-nine participants (12 females, 27 males) were enrolled. Muscle activity during gait was evaluated before and after pre-operative physical therapy, and six months after ACLR. Surface electromyography data were evaluated to determine timing (e.g., the time the muscle activity begins ('On') and ends ('Off')) for seven muscles: vastus lateralis and medialis (VL, VM), lateral and medial hamstrings (LH, MH), lateral and medial gastrocnemius (LG, MG), and soleus (SOL). General linear models with generalized estimating equations detected the effects of limb and time for muscle activity timing. Males presented with more limb asymmetries before and after pre-operative PT in the VL On (p < 0.001) and Off (p = 0.007), VM On and Off (p < 0.001), and MH off (p < 0.001), but all limb differences resolved by six months post ACLR. Changes in muscle activity in males were pervasive over time in both limbs. Females presented with no interlimb differences pre-operatively, and only involved limb VL off (p = 0.027) and VM off (p = 0.003) and the LH off in both limbs (p < 0.038) changed over time. Our data indicate that inter-limb differences in muscle activity across time points and changes in muscle activity timing over the course of physical therapy were sex specific. Males presented with more inter-limb differences in muscle activity across time points, and females presented with fewer asymmetries before and after pre-operative physical therapy. These data support that sex-specific adaptations should be taken into consideration when assessing biomechanical changes after ACLR.


Computer network home care demonstration: a randomized trial in persons living with AIDS.
As Internet-based health care applications grow, it is important to determine their acceptability to ill persons and the likely outcomes resulting from their use. This randomized field investigation demonstrated the use and effects of a specialized computer network, the ComputerLink, among persons living with AIDS (PLWA). This study was designed to determine whether a home-based computer network designed for people with AIDS (PLWA) would be used and whether it would reduce social isolation and improve confidence and skill in decision making without causing differential decline in health status among PLWA. Wyse 30 terminals were placed in private homes, linked via a 1200 baud modem to a public access computer network. Services available to PLWA included an on-line electronic encyclopedia, public and private communication and a decision support system; all services were coordinated by a registered nurse. A six-month randomized trial involved 57 community-dwelling PLWA; 31 were in the experimental group. Mean age was 33, 93% were male, 61% white, 34% working, 13.5 mean years education. Six participants were lost to follow-up. 8449 accesses to the system were made during the study period. Mean number of access per participant was 192, the median, 129. Duration of access averaged 12 min. PLWA used two services during each session. First order hypotheses testing revealed no significant difference between experimental and control group participants. Post hoc exploration indicated that use of the system did reduce social isolation once participants levels of depression were controlled and that decision making confidence improved as a function of number of accesses. Computer networks provide feasible alternatives for the delivery of health services to home-bound individuals. Communication services were used more extensively than other services, suggesting that the primary mechanism of intervention is peer contact. Similar to other experiments, system use improves confidence, though not skill, in decision making. The Internet represents a promising pathway to reaching home-bound patients and providing them with information, communication and decision assistance.


Fine structure of the receptor-free epithelium in the vomeronasal organ of the rat.
The topography and distribution of the epithelia of the vomeronasal organ were investigated in the adult male rat. Special attention was given to the light and transmission electron microscopic structure of the area that is known to be free of receptor cells. In contrast to several brief descriptions in which many cell types have been reported, only one cell type is presently described in different functional phases. In the rat, this epithelium does not show the typical features of a respiratory or, in more general terms, non-sensory epithelium. The authors propose to call this epithelium as "receptor-free" rather than respiratory, non-sensory or ciliated. The importance of the vomeronasal organ in the maintenance of olfacto-endocrine mechanisms and reproductive behavior is discussed.


Effects ofFusarium-toxincontaminated wheat in ruminant nutrition.
An experiment was carried out to examine the effects of aFusarium-contaminated wheat grain as a component of the concentrate portion (10 mg deoxynivalenol and 0.76 mg zearalenone, ZON, per kg dry matter) on performance of growing bulls, and on carry over of ZON into tissues and body fluids. In a second study, rumen physiological parameters were investigated in wethers equipped with rumen fistulae. Moreover, the influences of a detoxifying agent (Mycofix®, MP, Biomin GmbH, Herzogenburg, Austria) were considered as an additional experimental factor beside the contamination of the wheat (uncontaminated control wheat,Fusarium-toxincontaminated wheat).The fattening experiment with bulls (n=14 per treatment) covered the live weight range between 244 kg and 460 kg. Daily dry matter intake and live weight gain (kg per animal and day) were 7.40, 7.52, 7.51 and 7.49 and 1.367, 1.296, 1.380 and 1.307 for bulls fed the unsupplemented control wheat, the supplemented control wheat, the unsupplemented andFusarium toxin contaminated wheat and the supplementedFusarium toxin contaminated wheat, respectively. Concentration of ZON and its metabolites in edible tissues were lower than the detection limits of the applied HPLC-method.The results of the rumen physiological investigations revealed that the molar ratios of short chained volatile fatty acids and ammonia concentration in rumen fluid remained unchanged in response to dietary treatments whereas the addition of MP to the diets buffered the postprandial decrease in rumen pH.


Spatial configuration of charge and hydrophobicity tune particle transport through mucus.
Mucus is a selectively permeable hydrogel that protects wet epithelia from pathogen invasion and poses a barrier to drug delivery. Determining the parameters of a particle that promote or prevent passage through mucus is critical, as it will enable predictions about the mucosal passage of pathogens and inform the design of therapeutics. The effect of particle net charge and size on mucosal transport has been characterized using simple model particles; however, predictions of mucosal passage remain challenging. Here, we utilize rationally designed peptides to examine the integrated contributions of charge, hydrophobicity, and spatial configuration on mucosal transport. We find that net charge does not entirely predict transport. Specifically, for cationic peptides, the inclusion of hydrophobic residues and the position of charged and hydrophobic residues within the peptide impact mucosal transport. We have developed a simple model of mucosal transport that predicts how previously unexplored amino acid sequences achieve slow versus fast passage through mucus. This model may be used as a basis to predict transport behavior of natural peptide-based particles, such as antimicrobial peptides or viruses, and assist in the engineering of synthetic sequences with desired transport properties.


The use of a control or baseline condition in electrophysiological studies of hemispheric specialization of function.
Asymmetries in event-related potential (ERP) measures between the two cerebral hemispheres in humans may not be apparent when the absolute values of left and right hemisphere recordings are only considered within the context of one experimental condition. ERP asymmetries may only emerge when results obtained during experimental conditions designed to differentially activate the two cerebral hemispheres are compared to a baseline or control condition involving low-level cognitive demands. Both theoretical and empirical considerations of such a baseline condition are discussed.


A scoping review of WeChat to facilitate professional healthcare education in Mainland China.
WeChat is the most popular social media platform in mainland China, with over 1 billion active users. Although social media is widely used in professional healthcare education in western countries, research on WeChat-based education in healthcare in mainland China is disparate and not systematic. The current study seeks to address this gap. A scoping review was conducted to systematically describe studies of WeChat use in professional healthcare education. A comprehensive search involving three international databases in English and Chinese literature was conducted in April 2019. Articles were retained in this study if they were original studies that used WeChat as a tool to facilitate healthcare education in mainland China. 25 studies met the inclusion criteria and the majority of studies were either experimental or quasi-experimental. WeChat was used in both university settings and hospital settings. Hybrid education-which integrates WeChat education and face-to-face education-was more common in university settings, whereas hospitals used a combination of hybrid and WeChat-only strategies. Significant heterogeneity was observed regarding the type of accounts and methods for delivering content and facilitating online conversations. A majority of studies found positive outcomes with WeChat education. This scoping review addressed a large gap in knowledge about the usage of WeChat in professional healthcare education. Of the existing studies identified, we observed considerable promise for future practice. We provide additional suggestions for conducting future research involving patients and other helping professionals in healthcare education to expand the usage of WeChat.


Evaluating gene x gene and gene x smoking interaction in rheumatoid arthritis using candidate genes in GAW15.
We examined the potential gene x gene interactions and gene x smoking interactions in rheumatoid arthritis (RA) using the candidate gene data sets provided by Genetic Analysis Workshop 15 Problem 2. The multifactor dimensionality reduction (MDR) method was used to test gene x gene interactions among candidate genes. The case-only sample was used to test gene x smoking interactions. The best predictive model was the single-locus model with single-nucleotide polymorphism (SNP) rs2476601 in gene PTPN22. However, no clear gene x gene interaction was identified. Substantial departure from multiplicativity was observed between smoking and SNPs in genes CTLA4, PADI4, MIF, and SNPs on chromosome 5 and one haplotype of PTPN22. The strongest evidence of association was identified between the PTPN22 gene and RA status, which was consistently detected in single SNP association, gene x gene interaction and gene x smoking interaction analyses.


[Status of the osteoclast-activating system in cosmonauts after long-duration missions to the International Space Station].
The results of studying the system of osteoprotegerin/ receptor activator of nuclear factor kappa-B ligand (OPG/RANKL) in 22 cosmonauts after long-duration (124 to 199 days) ISS missions are presented. Immediately on return to 1 g, changes were observed in OPG and RANKL serum levels and the ability to produce unstimulated and stimulated PGA of peripheral blood mononuclear cells in vitro. Individual variability of these changes was noticed. Our findings suggest that the cytokine OPG/RANKL-system is involved in bone remodeling in members of long-duration space missions.


Normal human endometrium in cell culture. II. A microspectrophotometric study of polyploid nuclei in short-term primary epithelial cultures.
The growth of short-term primary cultures of endometrial epithelium has been studied using Feulgen microspectrophotometry. A gradual increase in the number of polyploid nuclei up to 64C has been observed and is associated with a decline in the growth capacity of the cultures. The specific mechanism(s) of this polyploidization is not known.


Molecular cytogenetic monitoring from CD34+ peripheral blood cells in myelodysplastic syndromes: first results from a prospective multicenter German diagnostic study.
The gold standard of cytogenetic analysis in myelodysplastic syndromes (MDS) is conventional chromosome banding (CCB) analysis of bone marrow (BM) metaphases. Most aberrations can also be detected by fluorescence-in situ-hybridization (FISH). For this prospective multicenter German diagnostic study (www.clinicaltrials.gov: #NCT01355913) 360 patients, as yet, were followed up to 3 years by sequential FISH analyses of immunomagnetically enriched CD34+ peripheral blood (PB) cells using comprehensive FISH probe panels, resulting in a total number of 19,516 FISH analyses. We demonstrate that CD34+ PB FISH correlates significantly with CCB analysis and represents a feasible method for a reliable non-invasive cytogenetic monitoring from PB.


Drug therapy in intermittent claudication: an objective assessment of the effects of three drugs on patients with intermittent claudication.
It has been suggested that, by reducing the viscosity of blood, flow through capillaries is increased with consequent improvement in the symptoms of patients with peripheral vascular disease. We examined the effects of treatment with drugs purported to reduce blood viscosity to test the validity of this claim. Measurements of viscosity and the rate of blood flow to the leg were made in a group of patients before and after treatment with three different drugs--tetranicotinoylfructose (Bradilan), oxypentifylline (Trental) and cinnarizine (Stugeron). All patients had intermittent claudication in one leg and the distribution of arteriosclerosis was similar in each patient. After treatment there was little or no change in blood viscosity and no change in the rate of flow recorded in the symptomatic legs. We did not find any objective evidence to support the use of these drugs in patients with intermittent claudication.


The Effect of Treatment on Stereognosis in Children With Hemiplegic Cerebral Palsy.
To determine if rehabilitation alone or combined with surgery or botulinum toxin injection improved stereognosis in children with hemiplegic cerebral palsy. Inclusion criteria were children with spastic hemiplegic cerebral palsy who had stereognosis testing 2 separate times with documentation of intervening treatment. Sixty-three children were included, 30 girls and 33 boys at an average age of 9.1 years (range, 4.4-16.0 years). Twelve standardized objects were used for manual identification. Baseline and postintervention stereognosis results were recorded for the hemiplegic and the dominant limb of each patient. The patients were separated into 3 groups based on intervening treatment: surgery with rehabilitation (27 patients), botulinum toxin injection with rehabilitation (19 subjects), and rehabilitation alone (7 subjects). Results were also analyzed by patient age group. Baseline testing of the hemiplegic limb revealed that 27 patients (43%) exhibited severe stereognosis impairment (0-4 objects identified correctly), 18 (28%) were moderately impaired (5-8 objects), 13 (21%) were mildly impaired (9-11 objects), and 5 (8%) had intact stereognosis (12 objects). There was no statistically significant difference in change in stereognosis scores postintervention among the 3 different treatment groups or between patients who had surgery and those who did not have surgery. There was no statistically significant difference in stereognosis function or postintervention change based on patient age at time of testing. In this study, 92% of children with spastic hemiplegic cerebral palsy had stereognosis impairment with a wide spectrum of severity. After operative or nonoperative treatment interventions, stereognosis as a secondary outcome measure was not changed. Therapeutic III.


An inordinate fondness for Fusarium: phylogenetic diversity of fusaria cultivated by ambrosia beetles in the genus Euwallacea on avocado and other plant hosts.
Ambrosia beetle fungiculture represents one of the most ecologically and evolutionarily successful symbioses, as evidenced by the 11 independent origins and 3500 species of ambrosia beetles. Here we document the evolution of a clade within Fusarium associated with ambrosia beetles in the genus Euwallacea (Coleoptera: Scolytinae). Ambrosia Fusarium Clade (AFC) symbionts are unusual in that some are plant pathogens that cause significant damage in naïve natural and cultivated ecosystems, and currently threaten avocado production in the United States, Israel and Australia. Most AFC fusaria produce unusual clavate macroconidia that serve as a putative food source for their insect mutualists. AFC symbionts were abundant in the heads of four Euwallacea spp., which suggests that they are transported within and from the natal gallery in mandibular mycangia. In a four-locus phylogenetic analysis, the AFC was resolved in a strongly supported monophyletic group within the previously described Clade 3 of the Fusarium solani species complex (FSSC). Divergence-time estimates place the origin of the AFC in the early Miocene ∼21.2 Mya, which coincides with the hypothesized adaptive radiation of the Xyleborini. Two strongly supported clades within the AFC (Clades A and B) were identified that include nine species lineages associated with ambrosia beetles, eight with Euwallacea spp. and one reportedly with Xyleborus ferrugineus, and two lineages with no known beetle association. More derived lineages within the AFC showed fixation of the clavate (club-shaped) macroconidial trait, while basal lineages showed a mix of clavate and more typical fusiform macroconidia. AFC lineages consisted mostly of genetically identical individuals associated with specific insect hosts in defined geographic locations, with at least three interspecific hybridization events inferred based on discordant placement in individual gene genealogies and detection of recombinant loci. Overall, these data are consistent with a strong evolutionary trend toward obligate symbiosis coupled with secondary contact and interspecific hybridization.


Evidence linking neuronal cell death to autoimmunity in Alzheimer's disease.
The catastrophic loss of cerebral neurons in Alzheimer's disease (AD) is not fully understood. Since serum proteins are known to extravasate into the brain parenchyma in AD due to blood-brain barrier (BBB) dysfunction, this study was designed to explore the possibility that neuronal cell death may be the consequence of the anomalous presence of serum proteins in the brain. As compared to age-matched, non-demented 'control' brain tissues, highly significant increases of immunoglobulins (Igs) were detected in parenchyma, which were associated with vessels in the AD brain tissues. Also, there were dramatic increases of +Ig-neurons in areas with greater parenchymal Ig reactivity. The Ig labeling extended throughout the cell, which showed neurodegenerative apoptotic features that were not observed in -Ig-neurons. Thus, the presence of +Ig-neurons in AD brains implies a critical link between the faulty BBB and neuronal death through an autoimmune mechanism.


1,25(OH)2D3 and its analogue calcipotriol inhibit the migration of human synovial and mesenchymal stromal cells in a wound healing model - A comparison with glucocorticoids.
Vitamin D analogue calcipotriol is currently used in the local treatment of psoriasis. However, it also has antiproliferative and anti-inflammatory effects in the cells of the joint - suggesting a possible benefit in local treatment of arthritis. In this study, calcipotriol was studied in different in vitro methods to find out its effect on synovial and mesenchymal stromal cells. Primary human cell lines of osteoarthritis or rheumatoid arthritis patients (five mesenchymal stromal cells, MSC, and four synovial stromal cells, SSC) were cultured to study migration and proliferation of the cells in a wound healing model. The media was supplemented with calcipotriol, 1,25(OH)2D3, dexamethasone, betamethasone, methylprednisolone or control solution in 1-100 nM concentrations. To see possible toxic effects of calcipotriol, concentrations up to 10 µM in SSCs and MSCs were studied in apoptosis and necrosis assays in four cell lines. Calcipotriol and 1,25(OH)2D3, as well as the three glucocorticoids, reduced the migration of both SSCs and MSCs. In SSCs, the effect of calcipotriol and 1,25(OH)2D3 was at least as effective as with glucocorticoids, while with MSCs, the glucocorticoids were stronger inhibitors of migration. The antimigratory of calcipotriol and 1,25(OH)2D3 was consistently maintained in 10 µM and 1 µM. Calcipotriol was not toxic to MSCs and SSCs up to concentrations of 10 µM. Calcipotriol, as well as 1,25(OH)2D3, exerts antimigratory and antiproliferative effects on human SSCs and MSCs of the joint. These effects are not caused by apoptosis or necrosis. Both calcipotriol and 1,25(OH)2D3 have similar effects as glucocorticoids without apparent toxicity, suggesting that calcipotriol might be an eligible candidate to the local treatment of arthritis with a broad therapeutic window.


[Composition and analysis of fatty acids in freshwater products in Hunan Province in 2014].
To investigate the nutritional composition of fatty acids in freshwater products in Hunan Province. The edible parts of freshwater products were detected by gas chromatography, and fatty acid fingerprints were obtained by statistical analysis. A total of 18 freshwater products were monitored and 14-26 fatty acids were detected in each freshwater product. Among them, 12 were saturated fatty acids(SFA), ranging from 0. 74 to 3143 mg/100 g, 9 were monounsaturated fatty acids(MUFA), ranging from 1. 23 to 2790 mg/100 g, and 10 were polyunsaturated fatty acids(PUFA), ranging from 1. 75 to 2832 mg/100 g. The ratio of n-6 to n-3 in polyunsaturated fatty acids ranged from 0. 24∶1 to 15. 7∶1. The composition of fatty acids in freshwater products in Hunan Province is mainly unsaturated fatty acids. Most freshwater products are rich in n-3 PUFA, and the ratio of n-6 PUFA to n-3 PUFA is less than 6, which is beneficial to the nutritional balance. The composition and content of fatty acids have ideal nutritional value.


Comparison between endoscopic submucosal resection and surgery for the curative resection of undifferentiated-type early gastric cancer within expanded indications: a nationwide multi-center study.
Endoscopic submucosal dissection (ESD) for undifferentiated early gastric cancer (UD EGC) has debate due to the risk of lymph node metastasis. We investigated the outcomes of ESD compared to those of surgery for the UD EGC within expanded indication. We reviewed 971 UD EGC patients performed ESD across 18 hospitals in Korea and 1812 patients who underwent surgical resection in two hospitals between February 2005 and May 2015. Of these cases, we enrolled a curative resected ESD group of 328 patients and surgery group of 383 cases within an expanded indication. Overall outcomes and one-to-one propensity score-matched (218 ESD group vs 218 surgery group cases) outcomes for these two groups were analyzed. Over the 75.6 month median follow-up period for the 711 enrolled cases, recurrences occurred in 22 patients (6.7%) in the ESD group but not in the surgery group. Overall survival (OS) was higher in the surgery group (p = 0.0316) in all cases, but there was no significant difference after propensity score matching (p = 0.069). According to the histologic type in propensity score matching, the OS of signet ring cell carcinoma and poorly differentiated carcinoma patients did not differ between the ESD and surgery groups (p = 0.1189 and p = 0.3087, respectively). In the surgery group involving expanded criteria, lymph node metastasis was found in six cases (1.56%). Although ESD shows comparable outcomes to surgery for the UD EGC within expanded indications, appropriate patient selection is needed for the ESD due to the possibility of lymph node metastasis.


Postnatal state transition of cardiomyocyte as a primary step in heart maturation.
Postnatal heart maturation is the basis of normal cardiac function and provides critical insights into heart repair and regenerative medicine. While static snapshots of the maturing heart have provided much insight into its molecular signatures, few key events during postnatal cardiomyocyte maturation have been uncovered. Here, we report that cardiomyocytes (CMs) experience epigenetic and transcriptional decline of cardiac gene expression immediately after birth, leading to a transition state of CMs at postnatal day 7 (P7) that was essential for CM subtype specification during heart maturation. Large-scale single-cell analysis and genetic lineage tracing confirm the presence of transition state CMs at P7 bridging immature state and mature states. Silencing of key transcription factor JUN in P1-hearts significantly repressed CM transition, resulting in perturbed CM subtype proportions and reduced cardiac function in mature hearts. In addition, transplantation of P7-CMs into infarcted hearts exhibited cardiac repair potential superior to P1-CMs. Collectively, our data uncover CM state transition as a key event in postnatal heart maturation, which not only provides insights into molecular foundations of heart maturation, but also opens an avenue for manipulation of cardiomyocyte fate in disease and regenerative medicine.


Hydrogen production from food wastes and gas post-treatment by CO2 adsorption.
The production of H(2) by biological means, although still far from being a commercially viable proposition, offers great promise for the future. Purification of the biogas obtained may lead to the production of highly concentrated H(2) streams appropriate for industrial application. This research work evaluates the dark fermentation of food wastes and assesses the possibility of adsorbing CO(2) from the gas stream by means of a low cost biomass-based adsorbent. The reactor used was a completely stirred tank reactor run at different hydraulic retention times (HRTs) while the concentration of solids of the feeding stream was kept constant. The results obtained demonstrate that the H(2) yields from the fermentation of food wastes were affected by modifications in the hydraulic retention time (HRT) due to incomplete hydrolysis. The decrease in the duration of fermentation had a negative effect on the conversion of the substrate into soluble products. This resulted in a lower amount of soluble substrate being available for metabolisation by H(2) producing microflora leading to a reduction in specific H(2) production. Adsorption of CO(2) from a gas stream generated from the dark fermentation process was successfully carried out. The data obtained demonstrate that the column filled with biomass-derived activated carbon resulted in a high degree of hydrogen purification. Co-adsorption of H(2)S onto the activated carbon also took place, there being no evidence of H(2)S present in the bio-H(2) exiting the column. Nevertheless, the concentration of H(2)S was very low, and this co-adsorption did not affect the CO(2) capture capacity of the activated carbon.


No correlation between patient outcome and abnormal lumbar MRI findings 21 years after posterior or posterolateral fusion for isthmic spondylolisthesis in children and adolescents.
Between 1977 and 1987, posterior (n=29) or posterolateral (n=73) fusion was performed for mild to moderate (slip <50%) isthmic spondylolisthesis on 102 patients (46 females, 56 males). The patients' average age at the time of operation was 15.9 (range, 8.1-19.8) years. Clinical (physical examination and Oswestry disability index (ODI)) and radiological (MRI and plain radiographs) examinations were performed on these patients after an average follow-up time of 21.0 (range, 26.2-15.1) years. In the radiographs, the mean slip preoperatively was 27% (range, 5-50%) and at the last follow-up visit 26% (range, 5-78%). Inside the fusion, there were a total of 148 intervertebral discs, 121 (82%) of them had decreased signal intensity in T2-weighted MR images and 113 (76%) were narrowed. Above the fusion level, 27 (27%) discs were speckled and 27 (27%) were black; 21 (21%) intervertebral disc spaces were narrowed. Two levels above the fusion level the numbers were 8 (8%), 16 (16%) and 16 (16%), respectively. Six (6%) patients had a prolapse. Degenerative facet joint hypertrophy above fusion was seen at 80 (79%) of the levels studied. When compared to healthy subjects higher frequency of disc and facet joint degeneration was found. In MR images, none of the patients had lumbar spinal stenosis inside or above the fusion. Narrowing of one or both of the neural foramina at the level of the L5-S1 interververtebral disc was noted in 32 (31%) patients. Seventeen (17%) of the patients had, usually mild, muscular atrophy of the psoas and 33 (32%) of the paraspinal muscles. There was no difference in frequency of abnormal MRI findings between patients (n=93) with ODI 20 or less compared with patients (n=9) with ODI more than 20. In situ fusion due to isthmic spondylolsthesis at adolescence is associated with moderate degenerative changes in the lumbar spine during a 20-year follow-up. Changes were most commonly found at the level of the spondylolisthesis and above fusion level. Neural foramina stenosis seems to be associated with spondylolisthesis and its severity to severity of the slip. Muscle atrophy tended to be mild. However, there was no correlation between patient outcome (ODI) and abnormal lumbar MRI findings.


Protons as second messenger regulators of G protein signaling.
In response to environmental stress, cells often generate pH signals that serve to protect vital cellular components and reprogram gene expression for survival. A major barrier to our understanding of this process has been the identification of signaling proteins that detect changes in intracellular pH. To identify candidate pH sensors, we developed a computer algorithm that searches proteins for networks of proton-binding sidechains. This analysis indicates that Gα subunits, the principal transducers of G protein-coupled receptor (GPCR) signals, are pH sensors. Our structure-based calculations and biophysical investigations reveal that Gα subunits contain networks of pH-sensing sidechains buried between their Ras and helical domains. Further, we show that proton binding induces changes in conformation that promote Gα phosphorylation and suppress receptor-initiated signaling. Together, our computational, biophysical, and cellular analyses reveal an unexpected function for G proteins as mediators of stress-response signaling.


Mobile students, remote education, free-fall economics: campus life in 2020: The pandemic-triggered economic crisis will have an unprecedented impact on higher education globally.
Between decreased income and increasing expenses to move classes online, colleges and universities need to adapt to a pandemic-triggered severe and global recession.


[RARE-MR urography: a fast nontomographic imaging procedure for demonstrating the efferent urinary pathways using nuclear magnetic resonance].
RARE-MR-Urography is a new fast data acquisition technique for magnetic resonance imaging. As a non-tomographic approach to the morphology of the urinary system, image information is similar to intravenous X-ray urography. As the sequence results in a heavily T2-weighted image displaying aqueous fluids, application of contrast agents is not necessary. Image quality is demonstrated by an exemplary case. Basic technical details and possible indications are discussed.


Men's experiences of pregnancy and childbirth in Sierra Leone: Reexamining definitions of "male partner involvement".
In recent decades, global health researchers and policy makers have advocated for men's increased involvement in pregnancy and childbirth with the goal of improving maternal health outcomes. By "involvement," these actors generally refer to narrow-largely Western-definitions of participation: accompanying women to antenatal and postpartum care visits, engaging in childbirth education, or being present during delivery. However, such approaches often fail to account for the culturally valid and gendered ways in which men already are involved in supporting women's reproductive health. This study is based on participant observation, semi-structured interviews, and life histories conducted among 106 fathers in eastern Sierra Leone over the course of 2013-2016. Findings demonstrate that in Sierra Leone, where pregnancy and childbirth are considered to belong to the domain of women, men's primary role is to supply the material resources for a safe and healthy birth: a nutritious diet, transportation to healthcare facilities, medicines and supplies in the case of emergency, and the items to wash and dress the baby. While evidence suggests that gender norms are shifting to include other forms of intimate and emotional involvement, it is important to recognize existing forms of material support as valuable and essential forms of care. By restricting male involvement to biomedical notions of care, global health programs and policies risk discounting other types of socially meaningful support. Rather than disparaging young, African men for falling short of what Western organizations and researchers perceive to be "correct" behaviors, this paper attempts to highlight men's own understandings of involvement, so as to provide a more complete picture of the gendered nature of reproductive health in this context.


Foundation course for the Open University.
The Open University will take its first batch of students next January. In this article Dr Stannard discusses the thinking that has gone into the foundation course in science, and outlines some of the problems involved in adapting teaching techniques to make the best use of television, radio and correspondence courses.