The influence of drinking-water pollution with heavy metal on the expression of IL-4 and IFN-γ in mice by real-time polymerase chain reaction.
In recent years, water pollution has been converted to a challenging discussion in health area of human being. Heavy elements are one of the most important water pollutants and their negative adverse effects on body systems have been confirmed. In this study, investigation of effects of two heavy elements including lead (Pb) and copper (Cu) on expression of interlukin-4 (IL-4) and interferon-gamma (IFN-γ) as humoral and cellular immunity biomarkers, respectively, was aimed and PCR, real-time PCR and electrophoresis techniques were used. In this study, BALB/c mice were studied that had free access to drinking water which contained Cu or Pb salts. After 2 weeks, spleens of mice were removed, RNA extracted, and cDNA was prepared for RT-PCR. Then the expression of IL-4 and IFN-γ genes were assessed by real-time PCR. The expression of IFN-γ was up-regulated in both treated groups and the expression of IL-4 was only up-regulated in the group treated with Cu and down-regulated in the group treated with Pb. This study shows that the presence of heavy elements as drinking-water pollutants results in a disproportion of natural cytokines balances, and thus may result in a negative effect on immune system.


The effect of polyamine biosynthesis inhibition on growth and differentiation of the phytopathogenic fungus Sclerotinia sclerotiorum.
We studied the effects of several polyamine biosynthesis inhibitors on growth, differentiation, free polyamine levels and in vivo and in vitro activity of polyamine biosynthesis enzymes in Sclerotinia sclerotiorum. Alpha-Difluoromethylornithine (DFMO) and alpha-difluoromethylarginine (DFMA) were potent inhibitors of mycelial growth. The effect of DFMO was due to inhibition of ornithine decarboxylase (ODC). No evidence for the existence of an arginine decarboxylase (ADC) pathway was found. The effect of DFMA was partly due to inhibition of ODC, presumably after its conversion into DFMO by mycelial arginase, as suggested by the high activity of this enzyme detected both in intact mycelium and mycelial extracts. In addition, toxic effects of DFMA on cellular processes other than polyamine metabolism might have occurred. Cyclohexylamine (CHA) slightly inhibited mycelial growth and caused an important decrease of free spermidine associated with a drastic increase of free putrescine concentration. Methylglyoxal bis-[guanyl hydrazone] (MGBG) had no effect on mycelial growth. Excepting MGBG, all the inhibitors strongly decreased sclerotial formation. Results demonstrate that sclerotial development is much more sensitive to polyamine biosynthesis inhibition than mycelial growth. Our results suggest that mycelial growth can be supported either by spermidine or putrescine, while spermidine (or the putrescine/spermidine ratio) is important for sclerotial formation to occur. Ascospore germination was completely insensitive to the inhibitors.


Surgical left atrial appendage ligation is frequently incomplete: a transesophageal echocardiograhic study.
This study sought to determine the incidence of incomplete ligation of the left atrial appendage (LAA) during mitral valve surgery. Ligation of the LAA to prevent future thromboembolic events is commonly performed during mitral surgery. However, success in completely excluding the appendage from the circulation has never been systematically assessed. Using transesophageal Doppler echocardiography, we studied 50 patients who underwent mitral valve surgery and ligation of the LAA. Thirty patients were studied immediately postoperative, and 20 patients were studied 6 days to 13 years after surgery. Incomplete ligation was detected by demonstrating a color jet traversing the separation between the left atrial body and appendage. Transesophageal echocardiography detected incomplete LAA ligation in 18 of 50 (36%) patients. The incidence of incomplete ligation was not significantly different between patients studied immediately postoperative and patients studied at various times after surgery. Type of mitral surgery (repair vs. replacement), operative approach (sternotomy vs. port access), left atrial size or degree of mitral regurgitation did not significantly correlate with the incidence of incomplete appendage ligation. However, the power to detect a significant difference in left atrial size was only 64%. Spontaneous echo contrast or thrombus was identified within appendages in 9 of 18 (50%) patients with incomplete ligation, while 4 of these 18 (22%) patients had thromboembolic events. Surgical LAA ligation is frequently incomplete. The similar incidence of incomplete ligation detected immediately postoperative and at various times thereafter suggest that this results from an intraoperative phenomenon rather than from gradual dehiscence of sutures over years. The incidence of incomplete left atrial ligation was unrelated to type of surgery, surgical approach, left atrial size or degree of mitral regurgitation. Residual communication between the incompletely ligated appendage and the left atrial body may produce a milieu of stagnant blood flow within the appendage and be a potential mechanism for embolic events.


CRF receptor 1 antagonism and brain distribution of active components contribute to the ameliorative effect of rikkunshito on stress-induced anorexia.
Rikkunshito (RKT), a Kampo medicine, has been reported to show an ameliorative effect on sustained hypophagia after novelty stress exposure in aged mice through serotonin 2C receptor (5-HT2CR) antagonism. We aimed to determine (1) whether the activation of anorexigenic neurons, corticotropin-releasing factor (CRF), and pro-opiomelanocortin (POMC) neurons, is involved in the initiation of hypophagia induced by novelty stress in aged mice; (2) whether the ameliorative effect of RKT is associated with CRF and POMC neurons and downstream signal transduction; and (3) the plasma and brain distribution of the active components of RKT. The administration of RKT or 5-HT2CR, CRF receptor 1 (CRFR1), and melanocortin-4 receptor antagonists significantly restored the decreased food intake observed in aged male C57BL/6 mice in the early stage after novelty stress exposure. Seven components of RKT exhibited antagonistic activity against CRFR1. Hesperetin and isoliquiritigenin, which showed antagonistic effects against both CRFR1 and 5-HT2CR, were distributed in the plasma and brain of male Sprague-Dawley rats after a single oral administration of RKT. In conclusion, the ameliorative effect of RKT in this model is assumed to be at least partly due to brain-distributed active components possessing 5-HT2CR and CRFR1 antagonistic activities.


Anetoderma: evidence of the relationship with autoimmune disease and a possible role of macrophages in the etiopathogenesis.
Anetoderma is a benign condition characterized by round or oval macular lesions with focal loss of dermal elastic tissue resulting in localized areas of flaccid or herniated saclike skin. Often, the anetoderma is associated with immuno-mediated pathogenetic mechanism. In this article, we describe the association between anetoderma and autoimmune diseases, by underlining the role and the action of macrophages as a possible etiopathogenesis.


Bone mineral density of female athletes in different sports.
Anthropometry, training history, cardiorespiratory and muscular performance capacity, and bone mineral density (BMD) were studied in female orienteers (n = 30), cross-country skiers (n = 28), cyclists (n = 29), weight lifters (n = 18) and in a reference group (n = 25). BMD was measured at lumbar spine, femoral neck, distal femur, patella, proximal tibia, calcaneus and distal radius by dual energy X-ray absorptiometry. The weight lifters had significantly higher weight adjusted BMD (P < 0.001) than the referents at all sites (9-26%) except in femoral neck and calcaneus. Of the endurance athletes, the orienteers were the only group which had significantly higher BMD (P < 0.05) than referents, only at distal femur (5%) and proximal tibia (5%). BMD did not differ significantly at any skeletal site between subjects with different calcium intake. Weight training seems to provide more effective osteogenic stimulus than endurance training. The differences in BMD at different sites between the groups were consistent with specificity of the stimulus to the training of the studied sports.


A general kinetic analysis of transport. Tests of the carrier model based on predicted relations among experimental parameters.
The analysis of transport kinetics has lacked both a unified treatment in which general rate equations are written entirely in terms of experimental parameters, and a convention by which these parameters may be designated in a concise yet immediately recognizable manner. Such a treatment is presented here in an easily accessible form, and a simple system of nomenclature is proposed resembling that in use in enzyme kinetics. The treatment is independent of assumptions about rate-limiting steps in transport, and applies to both active and facilitated systems, including obligatory exchange. A single substrate is characterized by twelve different parameters, only five of which are required in theory to calculate the others. If a second substrate is present on the trans side of the membrane there are six more parameters. All eighteen parameters are linked by multiple relationships which provide a complete set of rejection criteria for the generalized form of the mobile carrier. Relationships among parameters are also defined that give information on the rate-limiting steps in transport. Equations governing any individual experiment, involving only experimental parameters, are easily written out from the general expressions, for example under conditions of zero trans and infinite trans flux, equilibrium exchange, or competitive inhibition.


Mammalian cell-based optimization of the biarsenical-binding tetracysteine motif for improved fluorescence and affinity.
Membrane-permeant biarsenical dyes such as FlAsH and ReAsH fluoresce upon binding to genetically encoded tetracysteine motifs expressed in living cells, yet spontaneous nonspecific background staining can prevent detection of weakly expressed or dilute proteins. If the affinity of the tetracysteine peptide could be increased, more stringent dithiol washes should increase the contrast between specific and nonspecific staining. Residues surrounding the tetracysteine motif were randomized and fused to GFP, retrovirally transduced into mammalian cells and iteratively sorted by fluorescence-activated cell sorting for high FRET from GFP to ReAsH in the presence of increasing concentrations of dithiol competitors. The selected sequences show higher fluorescence quantum yields and markedly improved dithiol resistance, culminating in a >20-fold increase in contrast. The selected tetracysteine sequences, HRWCCPGCCKTF and FLNCCPGCCMEP, maintain their enhanced properties as fusions to either terminus of GFP or directly to beta-actin. These improved biarsenical-tetracysteine motifs should enable detection of a much broader spectrum of cellular proteins.


Toxicity of nanosilver in intragastric studies: Biodistribution and metabolic effects.
The unique physicochemical properties of silver nanoparticles explain their extensive application in consumer goods, food, and medicinal products. However, the biological effects of nanosilver after peroral exposure of mammals are still debatable. This study describes the biodistribution and biological action of 12nm non-coated silver nanoparticles intragastrically administered to male rats after acute (single exposure) and sub-acute (multiple exposures over 30 days) toxicity experiments. The daily doses were 2000 and 250mg/kg of body weight for single and multiple administrations, respectively. Silver tissue detection was conducted by elemental analysis with the help of atomic absorption spectroscopy. An estimation of the state of exposed animals was made and the dynamics of hematological and biochemical parameters of rats was studied. It was demonstrated that single and multiple administrations resulted in silver accumulation in the liver, kidneys, spleen, stomach, and small intestine. After both one- and repeated-dose exposures, the highest Ag contents were detected in the liver (0.87±0.37μg/g of organ) and kidneys (0.24±0.02μg/g of organ). The concentrations of silver detected in tissues were far smaller than the administered doses (<99%), indicating its efficient excretion from the organism. Acute and sub-acute exposures caused no animal mortality or signs of toxicity, manifested as changes in outward appearance or notable deviations in behavior or locomotor activity. Postmortem study revealed no visible pathomorphological abnormalities of internal organs. Hematological indices and biochemical parameters of the treated rats did not differ from those of the vehicle control animals. Overall, it can be concluded that nanosilver is able to be absorbed from the gastrointestinal tract into the bloodstream and accumulate in the secondary organs of rats. It showed no distinct toxicity under the experimental conditions of this study.


Neonatal hydrothorax following migration of a central venous catheter.
The use of a central venous catheter may occasionally be associated with complications like sepsis, effusions and thrombosis. Migration of the central catheter is an unusual complication that often goes unrecognized. This case report is of a neonate who developed hydrothorax resulting from a migrating central line and highlights the need for a high level of clinical suspicion in diagnosing catheter related problems.


On the mechanism of action of amezinium methylsulphate on the dog saphenous vein.
Strips of dog saphenous vein were used to study the multiple effects of amezinium methylsulphate (AM) on adrenergic mechanisms. The ED50 of the contractile effect was 0.55 microM. After the maximal response to AM had been obtained, increasing the concentration of AM resulted in relaxation; a larger contraction occurred after washout. AM was not able to cause contraction of strips obtained from dogs pretreated with reserpine; phentolamine shifted the dose-response curve of AM to the right. AM 0.1 and 10 microM enhanced the sensitivity of the strips to noradrenaline (NA) about 3.5 and 11 times respectively. When the cocaine-like effect was excluded (by using cocaine itself, either alone or after pretreatment with reserpine) an alpha blocking effect of AM was demonstrated at a concentration of 100 to 150 microM. In homogenates from venous tissue, AM inhibited monoamine oxidase (MAO) activity. AM inhibited preferentially MAO type A, since the IC50 was 5 microM for MAO A and greater than 1 mM for MAO B. In the intact tissue, AM 0.01 microM reduced the formation of [3H]dihydroxyphenylglycol [3H ]DOPEG) without significantly altering the accumulation of [3H]NA or the formation of the other metabolites. AM 0.1 microM reduced the accumulation of NA, and AM 10 microM abolished the accumulation of [3H]NA, reduced the formation of deaminated metabolites and enhanced the formation of [3H]normetanephrine [3H ]NMN). In washout experiments of strips preloaded with [3H]NA, AM enhanced the efflux of [3H]NA and the effect began with 1 microM; washout of AM sustained the efflux of [3H]NA for at least 30 min. The deaminated metabolite [3H]DOPEG was significantly decreased.


Clinical Characterizations and Radiological Findings of COVID-19: A 4 Case Report.
Coronavirus disease 2019 (COVID-19, previously known as novel coronavirus [2019-nCoV]), first reported in China, has now been declared a global health emergency by World Health Organization. The clinical severity ranges from asymptomatic individuals to death. Here, we report clinical features and radiological changes of a cured family cluster infected with COVID-19. In this report, we enrolled a family of 4 members who were admitted to our hospital in January 2020. We performed a detailed analysis of each patient's records. All patients underwent chest computed tomography (CT) examination with 120 kilovolts peak and 150 kilovolt-ampere. Realtime polymerase chain reaction (RT-PCR) examinations for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid were done using nasopharyngeal swabs. In the family members infected with COVID-19 who were accompanied by other diseases or had low immunity, the pneumonia was prone to be aggravated.


[Physical activity in diabetes: an impossible mission or a motivational question?].
Pulling from self-determination theory (SDT) and motivational interviewing (MI), this article sought to present contemporary frameworks for understanding and promoting human motivation as useful tools for health professionals aiming to facilitate adoption and adherence to physical activity, presenting empirical evidence for its use. Practical strategies that may be used by a health professional to create an autonomy-supportive, well-structured, and interpersonally involved exercise counseling environment, more likely to support self-determined motivation, also are presented. Combining the strong theoretical underpinnings of SDT and the strong clinical base of MI should allow for much progress in developing the kind of motivation required to initiate and maintain exercise behaviors over the long term. These relatively simple and straightforward principles can be incorporated into existing approaches currently used by professionals who desire to improve their effectiveness, enhancing positive outcomes in terms of exercise adoption, adherence, and well-being;


Rate vs. rhythm characteristics of cluttering with data from a "syllable-timed" language.
Cluttering is a type of fluency disorder characterized by a speech rate which is perceived to be fast and/or irregular as well as by an abnormal speech rhythm. As far as we know, no research has been conducted as yet using objective measurements and acoustic phonetic description on the rhythm of cluttered speech. The aim of this study is to show by objective measurements whether there are any differences between the rhythm of cluttered and control speech, and which parameters point to such differences. For the analysis, recordings of spontaneous speech samples were taken from people who clutter (PWC) as well as from control speakers. Typical speech rhythm values and articulation rate were calculated in each speech sample. Results have confirmed that the rhythm of cluttering is slightly different from that of control speech in terms of various values, but the effect size is only small. It must be noted, however, that the difference between the two groups was not apparent in all analyzed values. The timing differences between cluttered and control speech are manifested primarily in the articulation rate while peculiarities in speech rhythm are almost negligible.


Persistent elevated bone marrow plasma levels of thrombopoietin in patients with aplastic anemia.
Acquired aplastic anemia (AA) is an immune-mediated bone marrow (BM) failure syndrome. Plasma thrombopoietin (TPO) levels are elevated in AA patients with reduced blood counts. However, whether elevated TPO can recover to normal level in AA patients in complete remission (CR) after efficient immunosuppressive therapy (IST) is unknown. We measured TPO levels of BM plasma in a large cohort of AA patients with focusing on patients in CR after IST. Our data showed that BM plasma TPO levels were still high in patients who had reached normal blood counts levels for a long time. We speculate that downregulated expression of MPL (TPO receptor) in HSPC (hematopoietic stem and progenitor cells) may be related to the upregulated TPO in AA.


Dynamics of phosphorus composition in suspended particulate matter from a turbid eutrophic shallow lake (Lake Chaohu, China): Implications for phosphorus cycling and management.
Particulate phosphorus (P) dominates the total P (TP) content in lacustrine water columns and is a primary source of dissolved P in turbid eutrophic shallow lakes. However, the spatiotemporal variability of P compositions in suspended particulate matter (SPM) remains poorly understood. In this study, we applied chemical extraction and solution 31P nuclear magnetic resonance (31P NMR) to assess the seasonal variations of SPM P compositions from a shallow turbid lake (Lake Chaohu, China) and its main river tributaries. P fractionation analysis indicated that mobile P (the sum of labile-P, iron-bound P, and organic P) accounted for >60% of the TP in SPM and showed high spatiotemporal variability throughout the year-long field investigation. In most seasons, riverine SPM (in urban rivers or rivers with high flow) contained a higher mobile P content than that of the lake and was therefore a dominant source of lacustrine mobile particulate P. Solution 31P NMR identified five types of P compounds in SPM, with highest contributions from orthophosphate. Organic P components and concentrations showed high seasonal variability, and elevated p values occurred during the summer algal bloom. The correlation analysis between organic and inorganic P fractions inferred the possible degradation of organic P into reactive inorganic components of SPM. Consequently, biological or chemical processes would further transform the labile inorganic P into soluble reactive phosphorus, which is readily utilized by lacustrine algae. Our results suggest that the labile forms of P in SPM were highly dynamic and significantly contributed to the eutrophication of the turbid shallow lake.


Preparation and characterization of pH- and temperature-responsive nanocomposite double network hydrogels.
A methodology is described for the preparation of pH- and temperature-responsive double network (DN) hydrogels with poly(N-isopropylacrylamide) (PNIPAM) as a tightly crosslinked 1st network, polyacrylic acid (PAA) as a loosely crosslinked 2nd network and graphene oxide (GO) as an additive. GO sheets were first prepared via an oxidation reaction and then dispersed in NIPAM aqueous solution via silanization. Free-radical polymerization of NIPAM was carried out at 20 °C in a water bath, and then subjected to UV light, leading to the formation of pH- and temperature-responsive PNIPAM/AA/GO DN hydrogels. The effects of GO sheets and AA contents on various physical properties were investigated. Results show that PNIPAM/AA/GO hydrogels undergo a large volumetric change in response to temperature. It also exhibits significantly fast swelling/deswelling compared with conventional PNIPAM hydrogel. Moreover, the PNIPAM/AA/GO hydrogels have a much better mechanical property than the conventional PNIPAM hydrogels.


Postoperative disruption of an internal prong-type caval filter--a case report.
A prong-type caval filter fractured and disintegrated within 4 months after its implantation in a 21-year-old woman. The fragments and the disrupted filter were removed surgically and the vena cava was plicated. Seven similar cases were found in the literature. Possible etiologic factors and measures to avoid this complication are discussed.


Single AAV-Mediated CRISPR-SaCas9 Inhibits HSV-1 Replication by Editing ICP4 in Trigeminal Ganglion Neurons.
Herpes simplex keratitis (HSK) is the most common cause of corneal blindness in developed nations, caused by primary or recurrent herpes simplex virus 1 (HSV-1) infection of the cornea. Latent infection of HSV-1, especially in the trigeminal ganglion (TG), causes recurrence of HSV-1 infection. As antiviral treatment is not effective on latent HSV-1, to test the possibility of inhibiting HSV-1 by SpCas9 (Streptococcus pyogenes Cas9) or SaCas9 (Staphylococcus aureus Cas9), ICP0 and ICP4, two important genes required for HSV-1 replication and reactivation, were chosen as targets. In Vero cells, SpCas9 and SaCas9 targeting ICP0 or ICP4 can effectively inhibit the proliferation of HSV-1 without affecting cell viability. No significant guide RNA (gRNA)-dependent off-targets were observed in the human genome by digenome sequencing and deep sequencing verification. Adeno-associated virus 1 (AAV1)-mediated delivery of SaCas9 inhibits HSV-1 replication by targeting ICP4 in mouse primary TG neuronal cells. SpCas9 and SaCas9 are able to inhibit HSV-1 infection in Vero cells and mouse TG neuronal cultures with high efficiency and good biosafety. AAV1-mediated delivery of SaCas9 shows great potential in treating HSK and inhibiting HSV-1 in TG neurons. Further investigations may be needed to test the inhibition of latent infections, which may result in the development of novel methods for treating viral diseases.


Histochemistry as a tool in morphological analysis: a historical review.
Histochemistry has an interesting history, extending back to ancient times, in some ways. Man has long had a desire to understand the workings of the human body and the roles that various "humors" or chemicals have in those processes. This review traces the evolution of histochemistry as an investigative and diagnostic discipline, beginning with the efforts of medicinal chemists and extending through a period in which histology was increasingly paired with biochemistry. Those developments served as the underpinnings for an eventual marriage of microscopy, chemistry, immunology, and molecular biology, as realized in the current practice of anatomical pathology.


Reconstruction of shoulder and arm defects using the latissimus dorsi myocutaneous flap. A report of five cases.
Five patients with extensive traumatic shoulder and arm defects in whom successful repair with the latissimus dorsi island myocutaneous flap are presented. The ease and speed of elevation of the flap, its wide skin surface, large size, and long pedicle make it an ideal flap for reconstruction of such defects.


Sensory gating impairment in development of post-concussive symptoms in mild head injury.
Post-concussive symptoms reported by mild head injury (MHI) patients have been inadequately understood. Post-concussive symptoms reported by patients with MHI have so far been explained in terms of impairment in neurocognitive functions or deficits in modulation of flow of information. There are no studies that have looked into sensory gating impairment in MHI and its relation to post-concussive symptoms. The purpose of the present paper was to investigate the role of sensory gating impairment in post-concussive symptoms in mild head injury patients. Thirty MHI patients were evaluated for their neuropsychological functions, sensory gating deficits, and post-concussive symptoms. Neuropsychological functions were in the domain of attention, executive functions, and learning and memory. Sensory gating was assessed by Structured Interview for Assessing Perceptual Anomalies and post-concussive symptoms were assessed using the Neurobehavioral Rating Scale. Multiple regression method was used to identify predictors for post-concussive symptoms. Post-concussive symptoms were predicted by sensory gating deficits when sensory gating deficit was one of the predictors along with neuropsychological functions. Post-concussive symptoms were predicted by scores of Digit Vigilance and Digit Symbol Substitution Test, when predictors were restricted to neuropsychological functions. Sensory gating deficits were correlated with performance on Digit Symbol Substitution test. Post-concussive symptoms reported by MHI patients are the result of poor modulation of incoming sensory information.


Combined fractures of the scaphoid and distal radius: a revised treatment rationale using percutaneous and arthroscopic techniques.
Revision of the treatment rationale for combined fractures of the scaphoid and distal radius is based on evolution of treatment goals. The trend toward early recovery of hand function requires rigid fixation of both fractures before the start ofa hand therapy program. It is clear that prolonged immobilization of the scaphoid fracture jeopardizes early motion protocols for the distal radius. The fixation of unstable distal radius fractures with volar locking plates appears to offer the most stable construct to permit early motion. Evaluation, reduction, and fixation should be accomplished without disruption of the uninjured ligaments required for stable motion or the soft tissue envelope required for healing. Minimally invasive or percutaneous techniques are the meth-ods required. The tools needed are a clear understanding of anatomy, minifluoroscopic imaging units, and small-joint arthroscopy instruments. Many investigators advocate these techniques for scaphoid and distal radius fractures. It is only natural that these techniques should be used for these combined injuries. The key to success is a three-step process: (1)percutaneous reduction of the scaphoid fracture and provisional stabilization with a guide wire placed along its central axis, (2) percutaneous/arthroscopic reduction and rigid fixation of the distal radius fracture to permit early motion, and(3) fixation of the scaphoid fracture. This final step is accomplished by dorsal percutaneous implantation of a cannulated headless compression screw along the central scaphoid axis. Dorsal percutaneous fixation of scaphoid fractures with headless compression screws and rigid fixation of unstable distal radius fractures with a volar lock-ing plate system offer the most secure fixation. This small series suggests that the goals of early recovery of hand function can be accomplished using percutaneous/miniopen techniques for fracture reduction with rigid fixation and minimal risks.


Newborn hospitalization: a closer look.
To assess the safety of moderately early hospital discharge for normal newborn infants (mean +/- SD, 31 +/- 5 hours after delivery), we compared the incidence of hospital readmission within 6 weeks of birth with the incidence of readmission among a similar cohort of infants with extended hospitalization (mean +/- SD, 92 +/- 44 hours) as a result of maternal illness. The hospital charts for all infants admitted to the well-baby nursery between January 1 and December 31, 1985, were reviewed. Fifty-two (3.0%) of the 1714 infants who were discharged moderately early and 17 (2.7%) of the 622 infants who had an extended hospitalization were readmitted to the hospital by age 6 weeks (P = NS). Maternal age, financial status, and race each failed to predict infant readmission. Only four of the 52 readmission diagnoses among infants discharged moderately early could potentially have been identified (not prevented) before discharge with an extended newborn hospitalization. These data indicate that moderately early neonatal hospital discharge does not result in an increased incidence of rehospitalization within the first 6 weeks of life.


Matrix-filled microcavities in the emerging avian left-right organizer.
Hensen node of the amniote embryo plays a central role in multiple developmental processes, especially in induction and formation of axial organs. In the chick, it is asymmetrical in shape and has recently been considered to represent the left-right organizer. As mechanisms of breaking the initial left-right symmetry of the embryo are still ill-understood, analyzing the node's microarchitecture may provide insights into functional links between symmetry breaking and asymmetric morphology. In the course of a light- and electron-microscopic study addressing this issue we discovered novel intercellular matrix-filled cavities in the node of the chick during gastrulation and during early neurulation stages; measuring up to 45 μm, they are surrounded by densely packed cells and filled with nanoscale fibrils, which immunostaining suggests to consist of the basement membrane-related proteins fibronectin and perlecan. The cavities emerge immediately prior to node formation in the epiblast layer adjacent to the tip of the primitive streak and later, with emerging node asymmetry, they are predominantly located in the right part of the node. Almost identical morphological features of microcavities were found in the duck node. We address these cavities as "nodal microcavities" and propose their content to be involved in the function of the avian node by mediating morphogen signaling and storage.


Intermittent superior caval venous syndrome due to permanent transvenous electrode.
A 75-year-old man began suffering from intermittent episodes of superior caval venous syndrome, seven years after implantation of an endocardial pacemaker via the right cephalic vein. The obstruction of the superior caval vein was confirmed by venography and computed tomography of the chest. Changes of the intrathoracic pressure were considered to be the mechanism responsible for the intermittence of the syndrome.


Phytofiltration of chosen metals by aquarium liverwort (Monosoleum tenerum).
Aquatic bryophytes are widely used as indicators of water pollution with various substances, including metals. We present a first study concerning the feasibility of Monosoleum tenerum to remove potentially toxic metals Zn, Cu, Ni, Mn and Fe from water. The novel approach to study the bioaccumulation under controlled conditions and in vitro grown aquarium liverworts was applied. The plants were exposed to 1, 10 and 100 ppm multi-metal solution for 7 days and subsequently the metal content was determined in plant material and media to calculate the bioaccumulation factor (BAF). The study revealed various accumulation behavior (metal and dose dependent), which followed the order of Cu > Zn > Mn > Ni > Fe for 1 ppm; Zn > Cu > Mn > Fe > Ni for 10 ppm and Cu > Fe > Zn > Ni > Mn for 100 ppm solution. However, with increasing Cu, Mn and Ni concentration in the solution, BAF decreased. For Zn the highest BAF value (136) was obtained for the 10 ppm solution. Fe bioaccumulation increased with the increasing solution concentration. After 7 week exposure, the results indicated highest accumulation of Cu (3,25 mg) followed by Fe (1,8 mg) in the plant tissue for the 100 ppm solution. Overall, the bryophyte M. tenerum demonstrate high potential for the removal of toxic metals from the multi-metal solution via accumulation in plant tissue. The BAF values were proper to indicate the use of M. tenerum for phytofiltration of waste waters affected by Zn, Cu, Ni, Mn and Fe.


The natural history of epilepsy and nonepileptic seizures in Sturge-Weber syndrome: A retrospective case-note review.
Patients with Sturge-Weber Syndrome (SWS) experience varying degrees of neurological problems - including epilepsy, hemiparesis, learning disability (LD), and stroke-like episodes. While the range of clinical problems experienced by children with SWS is well recognized, the spectrum of clinical presentation and its treatment during adulthood has been relatively neglected in the literature to date. This study explored the natural history of epileptic and nonepileptic seizures into adulthood in patients with SWS, and their treatment, and investigated whether any clinical factors predict which symptoms a patient will experience during adulthood. A retrospective case-note review of a cohort of 26 adults with SWS at the National Hospital for Neurology and Neurosurgery (NHNN). Childhood data were also recorded, where available, to enable review of change/development of symptoms over time. The course of epilepsy showed some improvement in adulthood - seventeen adults continued to have seizures, while six patients gained seizure freedom, and no one had adult-onset seizures. However, seizures did worsen for some patients. Although no factors reached statistical significance regarding predicting continued epilepsy in adulthood, being male, more severe LD, having required epilepsy surgery, and bilateral cortical involvement may be important. Nonepileptic seizures (NES) also began during adulthood for four patients. By adulthood, there is some degree of improvement in epilepsy overall; while NES may occur for the first time. While the majority of the results did not survive adjustments for multiple comparisons, some interesting trends appeared, which require further investigation in a multicenter national audit. Patients with more neurologically severe presentations during childhood may continue to experience seizures. Careful monitoring and screening are needed during adulthood, to detect changes and newly developing symptoms such as NES, and target treatment promptly.


Risk factors associated with venous thromboembolism in tuberculosis: A case control study.
Tuberculosis (TB) patients who develop venous thromboembolism (VTE) have poor clinical outcomes. This study aimed to explore the risk factors and the prognosis of TB patients with VTE. A total of 11 267 with TB patients from the Zhejiang University-affiliated Chest Hospital, China, were enrolled between January 2016 and January 2020. A total of 107 TB patients with VTE were selected as the VTE group. Patients in the control group were randomly screened in a 1:1 ratio between the VTE and control groups. Univariate and multivariate logistic regression analysis was used to evaluate the factors associated with VTE in TB patients. Of the 214 patients, 145 (60.17%) were male, 69 (32.2%) were female, with an average age of 62.21 ± 19.35. The incidence of VTE in TB patients was 0.95%. Using a univariate analysis, it was found that age, fever, dyspnea, lower limb edema, respiratory failure, malignant tumor, prothrombin time, activated partial thromboplastin time, D-dimer, and hemoglobin levels were different between the two groups (P < 0.05). Multivariate logistic regression analysis showed that higher D-dimer value, higher incidence of lower limb edema, and TB were risk factors for VTE; OR (95%CI) = 8.840 (2.383-32.794); OR (95%CI) = 4.957 (1.219-20.161); OR (95%CI) = 16.216 (4.779-55.025). However, the use of Rifamycin was found to be a protective factor against VTE [OR (95%CI) = 0.170(0.073-0.395)]. Receiver operating characteristic curve (ROC) curve of D-dimer (area under curve [AUC] = 0.831 ± 0.028 [95%CI: 0.776-0.886, P < 0.05]) and the cut-off value of 1855 μg/L was obtained according to the Youden index, with a sensitivity and a specificity rate of 82.2% and 74.3%, respectively. The risks of VTE seem higher in TB patients with fever, dyspnea, lower limb edema, and D-dimer levels of more than 1855 μg/L; therefore, it should be actively screened, and prophylactic anticoagulation given if necessary. Effective directly observed treatment plus short-course chemotherapy (DOTS) protocol anti-TB therapy helps reduce the probability of VTE in TB patients.


[Semen quality and fertility: the role of the environment and health].
Sperm quality appears to be degrading over the past 40 years. Nowadays, more than 35 % of causes of male infertility are still idiopathic. More and more studies have suggested an impact of environment on sperm quality, essentially through epigenetic and hormonal changes. Recent studies in men with impaired sperm quality, have demonstrated epigenetic variations in sperm DNA. These modifications are responsible for modifications of the expression of transmissible genes to theiroffspring. Those transgenerational effects have been particularly illustrated in drosophila and caenorhabditis elegans. In humans, consequences of the environment on fertility have been studied in obese men, who present hypogonadotropic as well as hypergonadotropic hypogonadisms. Interestingly, recent studies have suggested a correlation between sperm quality and longevity. In summary, those environmental factors are the source of new causes of infertility.


The future of endangered crayfish in light of protected areas and habitat fragmentation.
The long-term survival of a species requires, among other things, gene flow between populations. Approaches for the evaluation of fragmentation in the frame of freshwater habitats consider only a small amount of the information that combined demography and geography are currently able to provide. This study addresses two species of Austropotamobius crayfish in the light of population genetics, spatial ecology and protected areas of the Carpathians. Advancing the classical approaches, we defined ecological distances upon the rasterised river network as a surrogate of habitat resistance to migration, quantifying the deviations from the species´ suitability range for a set of relevant geospatial variables in each cell of the network. Molecular analyses revealed the populations of the two Austropotamobius crayfish species are clearly distinct, lacking hybridisation. Comparing pairs of populations, we found, in some cases, a strong disagreement regarding genetic and ecological distances, potentially due to human-mediated translocations or the geophysical phenomena of regressive erosion, which may have led to unexpected colonisation routes. Protected areas were found to offer appropriate local habitat conditions but failed to ensure connectivity. The methodology applied in this study allowed us to quantify the contribution of each geospatial (environmental) variable to the overall effect of fragmentation, and we found that water quality was the most important variable. A multilevel approach proved to reveal a better understanding of drivers behind the distribution patterns, which can lead to more adequate conservation measures.


Application of the GREAT-ER model for environmental risk assessment of nonylphenol and nonylphenol ethoxylates in China.
The environmental risk presented by "down-the-drain" chemicals to receiving rivers in large urban areas has received increasing attention in recent years. Geo-referenced Regional Environmental Assessment Tool for European Rivers (GREAT-ER) is a typical river catchment model that has been specifically developed for the risk assessment of these chemicals and applied in many European rivers. By utilizing the new version of the model, GREAT-ER 3.0, which is the first completely open source software for worldwide application, this study represents the first attempt to conduct an application of GREAT-ER in the Wenyu River of China. Aquatic exposure simulation and an environmental risk assessment of nonylphenol (NP) and its environmental precursor nonylphenol ethoxylates (NPEOs) were conducted effectively by GREAT-ER model, since NP is one of typical endocrine disrupting chemicals (EDCs) and its environmental precursor NPEOs as a "down-the-drain" chemical are extensively used in China. In the result, the predicted environmental concentrations (PECs) of NP and NPEOs in the water of Wenyu River were 538 and 4320 ng/L, respectively, at the regional scale, and 1210 and 8990 ng/L, respectively, at the local scale. From the results profile of the RCR, the combination of high emissions from large STPs with insufficient dilution of the river caused the high RCR. The PECs of NP in the sediment were in the range of 216.8-8218.3 ng/g (dry weight), which was consistent with the available monitoring data. The study showed the worldwide applicability and reliability of GREAT-ER as a river catchment model for the risk assessment of these chemicals and also revealed the general environmental risks presented by NP and NPEOs in the Wenyu River catchment in Beijing due to the extensive use of these chemicals. The results suggest that specific control or treatment measures are probably warranted for these chemicals to reduce their discharge in major cities.


Efficacy and speed of onset of pain relief of fast-dissolving paracetamol on postsurgical dental pain: two randomized, single-dose, double-blind, placebo-controlled clinical studies.
Paracetamol (APAP), also known as acetaminophen, is the most commonly used over-the-counter analgesic for the treatment of mild-to-moderate pain. However, the speed of onset of pain relief is limited mainly to the standard, immediate-release formulation. Efficacy and speed of onset of pain relief are critical in acute pain situations such as postsurgical dental pain, because reducing pain can improve clinical outcome and reduce the risk of transition from acute pain to more chronic pain. Efficacy and rapid onset also reduce the risk of excessive dosing with the analgesic. We sought to investigate the dose-response efficacy and speed of onset of pain relief of a fast-dissolving APAP formulation compared with lower doses of APAP and placebo in dental patients after impacted third molar extraction. Two single-center, single-dose, randomized, placebo-controlled, double-blind, double-dummy, parallel-group studies (Study I and Study II) were conducted to evaluate the efficacy and speed of onset of pain relief of different doses of a fast-dissolving APAP tablet (FD-APAP), standard APAP, and placebo in patients with postsurgical dental pain following third molar extraction. In Study I, a single dose of FD-APAP 1000 mg, FD-APAP 500 mg, or placebo was given to 300 patients; in Study II, a single dose of FD-APAP 1000 mg, standard APAP 650 mg, or placebo was given to 401 patients. All 701 patients from both studies were included in the analysis and safety assessment. FD-APAP 1000 mg demonstrated significantly greater effect compared with FD-APAP 500 mg, APAP 650 mg, and placebo for all efficacy measurements, including sum of pain relief and pain intensity difference, total pain relief, sum of pain intensity difference, pain intensity difference, and pain relief score during 6 hours after the dose. Onset of confirmed first perceptible relief in subjects treated with FD-APAP 1000 mg was 15 minutes, which was 32% and 25% significantly shorter than onset of pain relief of FD-APAP 500 mg (22 minutes) and standard APAP 650 mg (20 minutes), respectively. FD-APAP 500 mg and APAP 650 mg demonstrated efficacy over placebo for most of the measurements; however, their effects were significantly lower and lasted for a shorter period of time than for FD-APAP 1000 mg. All study treatments were well tolerated. FD-APAP 1000 mg tablets demonstrated efficacy over placebo. Also, FD-APAP 1000 mg had significantly superior effect, faster onset, and longer duration of pain relief compared with FD-APAP 500 mg and APAP 650 mg tablets.


The role of mucin in colon-cancer metastasis.
Mucinous colorectal cancer often presents at an advanced stage. We have previously observed that mucin production by human colon-cancer cells correlates with their ability to colonize the liver in experimental animal models. The present study was undertaken in order to further elucidate the mechanisms by which production of mucin by colon-cancer cells affects metastasis. Cell lines showing high mucin production (HMP) (HM 7, HM 3 and LS LiM 6) demonstrated increased adherence to basement membrane proteins and invaded a reconstituted basement membrane to a greater extent than their counter-part cell lines showing low mucin production (LMP) (LS174T and LM 12). Adherence of the LMP parental cell line LS174T to various matrix proteins was potentiated by the addition of purified human colon-cancer mucin in a dose-dependent fashion. HMP cell lines secreted more proteolytically active type-IV collagenase than LMP lines, and collagenase activity was further stimulated by purified mucin in a dose-dependent manner. Specific inhibition of mucin O-glycosylation by benzyl-alpha-N-acetylgalactosamine significantly affected each of the metastasis-related events, with the greatest effect on the HMP cell lines. The present data further indicate that mucin may play an important role in the metastatic process.


Major adverse cardiovascular events (MACE) in patients with severe COVID-19 registered in the ISARIC WHO clinical characterization protocol: A prospective, multinational, observational study.
To determine its cumulative incidence, identify the risk factors associated with Major Adverse Cardiovascular Events (MACE) development, and its impact clinical outcomes. This multinational, multicentre, prospective cohort study from the ISARIC database. We used bivariate and multivariate logistic regressions to explore the risk factors related to MACE development and determine its impact on 28-day and 90-day mortality. 49,479 patients were included. Most were male 63.5% (31,441/49,479) and from high-income countries (84.4% [42,774/49,479]); however, >6000 patients were registered in low-and-middle-income countries. MACE cumulative incidence during their hospital stay was 17.8% (8829/49,479). The main risk factors independently associated with the development of MACE were older age, chronic kidney disease or cardiovascular disease, smoking history, and requirement of vasopressors or invasive mechanical ventilation at admission. The overall 28-day and 90-day mortality were higher among patients who developed MACE than those who did not (63.1% [5573/8829] vs. 35.6% [14,487/40,650] p < 0.001; 69.9% [6169/8829] vs. 37.8% [15,372/40,650] p < 0.001, respectively). After adjusting for confounders, MACE remained independently associated with higher 28-day and 90-day mortality (Odds Ratio [95% CI], 1.36 [1.33-1.39];1.47 [1.43-1.50], respectively). Patients with severe COVID-19 frequently develop MACE, which is independently associated with worse clinical outcomes.


Expression analysis of bone morphogenetic protein 4 between fat and lean birds in adipose tissue and serum.
The objectives of the present study were to characterize the tissue expression of chicken (Gallus gallus) bone morphogenetic protein 4 (BMP4) and compare differences in its expression in abdominal fat tissue and serum between fat and lean birds and to determine a potential relationship between the expression of BMP4 and abdominal fat tissue growth and development. The results showed that chicken BMP4 messenger RNA (mRNA) and protein were expressed in various tissues, and the expression levels of BMP4 transcript and protein were relatively higher in adipose tissues. In addition, the mRNA and protein expression levels of BMP4 in abdominal fat tissue of fat males were lower than those of lean males at 1, 2, 5, and 7 wk of age (P < 0.05). Furthermore, the serum BMP4 content of fat males was lower than that of lean males at 7 wk of age (P < 0.05). BMP4 mRNA expression levels were significantly higher in preadipocytes than those in mature adipocytes (P < 0.05), and the expression level decreased during differentiation in vitro (P < 0.05). These results suggested that chicken BMP4 might affect abdominal fat deposition through differences in its expression level. The results of this study will provide basic molecular information for studying the role of BMP4 in the regulation of adipogenesis in avian species.


Study to estimate the average blood loss in different orthopedic procedures: A retrospective review.
In orthopedic surgery, bleeding is an inevitable side effect. The study's aim was to provide estimated blood loss values in various orthopedic procedures and take a step towards developing statistically reliable formulae. This can provide blood loss values in orthopedic surgery, which will be a very good tool for operative planning. We reviewed case notes of 282 patients in a UK based trauma center from December 2020 to March 2021,who had undergone a various orthopedic procedures. The results were analyzed using SPSS version 25. Most common fracture was neck of femur (37.5%)followed by intertrochanteric fractures(27.6%). Paired t-test was used, and there is good evidence (t281 = 14.957, p = 0.000) that intraoperative transfusions increased HB levels in patients (t281 = 14.957, p = 0.000) by an average of 1.331 points, with a 95% confidence interval of 1.156-1.506. As a result, the variation between the Pre-op and Post-op HB levels is statistically important but minimal. We can see that the mean blood loss is statistically different in different age groups (0.03) of patients and by the existence of co-morbids using analysis of variance (0.04). The average number of days spent in the hospital varies by surgical type (0.01) performed on patients. Orthopedic surgery can be associated with high levels of blood loss. There is a significant relation between fracture form and age groups, change of wound dressing (COD), use of a tourniquet, and drain insertion, no connection was noted between gender and fracture types.


Intermittent vibration protects aged muscle from mechanical and oxidative damage under prolonged compression.
Deep tissue pressure ulcers, a serious clinical challenge originating in the muscle layer, are hardly detectable at the beginning. The challenge apparently occurs in aged subjects more frequently. As the ulcer propagates to the skin surface, it becomes very difficult to manage and can lead to fatal complications. Preventive measures are thus highly desirable. Although the complex pathological mechanisms have not been fully understood, prolonged and excessive physical challenges and oxidative stress are believed to be involved in the ulcer development. Previous reports have demonstrated that oxidative stress could compromise the mechanical properties of muscle cells, making them easier to be damaged when physical challenges are introduced. In this study, we used senescence accelerated (SAMP8) mice and its control breed (SAMR1) to examine the protective effects of intermittent vibration on aged and control muscle tissues during prolonged epidermal compression under 100mmHg for 6h. Results showed that an application of 35Hz, 0.25g intermittent vibration during compression decreased the compression-induced muscle breakdown in SAMP8 mice, as indicated histologically in terms of number of interstitial nuclei. The fact that no significant difference in muscle damage could be established in the corresponding groups in SAMR1 mice suggests that SAMR1 mice could better accommodate the compression insult than SAMP8 mice. Compression-induced oxidative damage was successfully curbed using intermittent vibration in SAMP8 mice, as indicated by 8-OHdG. A possible explanation is that the anti-oxidative defense could be maintained with intermittent vibration during compression. This was supported by the expression level of PGC-1-alpha, catalase, Gpx-1 and SOD1. Our data suggested intermittent vibration could serve as a preventive measure for deep tissue ulcer, particularly in aged subjects.


Substitution of only two residues of human Hsp90alpha causes impeded dimerization of Hsp90beta.
Two isoforms of the 90-kDa heat-shock protein (Hsp90), i.e., Hsp90alpha and Hsp90beta, are expressed in the cytosol of mammalian cells. Although Hsp90 predominantly exists as a dimer, the dimer-forming potential of the beta isoform of human and mouse Hsp90 is less than that of the alpha isoform. The 16 amino acid substitutions located in the 561-685 amino acid region of the C-terminal dimerization domain should be responsible for this impeded dimerization of Hsp90beta (Nemoto T, Ohara-Nemoto Y, Ota M, Takagi T, Yokoyama K. Eur J Biochem 233: 1-8, 1995). The present study was performed to define the amino acid substitutions that cause the impeded dimerization of Hsp90beta. Bacterial two-hybrid analysis revealed that among the 16 amino acids, the conversion from Ala(558) of Hsp90beta to Thr(566) of Hsp90alpha and that from Met(621) of Hsp90beta to Ala(629) of Hsp90alpha most efficiently reversed the dimeric interaction, and that the inverse changes from those of Hsp90alpha to Hsp90beta primarily explained the impeded dimerization of Hsp90beta We conclude that taken together, the conversion of Thr(566) and Ala(629) of Hsp90alpha to Ala(558) and Met(621) is primarily responsible for impeded dimerization of Hsp90beta.


Causes and consequences of RNA polymerase II stalling during transcript elongation.
The journey of RNA polymerase II (Pol II) as it transcribes a gene is anything but a smooth ride. Transcript elongation is discontinuous and can be perturbed by intrinsic regulatory barriers, such as promoter-proximal pausing, nucleosomes, RNA secondary structures and the underlying DNA sequence. More substantial blocking of Pol II translocation can be caused by other physiological circumstances and extrinsic obstacles, including other transcribing polymerases, the replication machinery and several types of DNA damage, such as bulky lesions and DNA double-strand breaks. Although numerous different obstacles cause Pol II stalling or arrest, the cell somehow distinguishes between them and invokes different mechanisms to resolve each roadblock. Resolution of Pol II blocking can be as straightforward as temporary backtracking and transcription elongation factor S-II (TFIIS)-dependent RNA cleavage, or as drastic as premature transcription termination or degradation of polyubiquitylated Pol II and its associated nascent RNA. In this Review, we discuss the current knowledge of how these different Pol II stalling contexts are distinguished by the cell, how they overlap with each other, how they are resolved and how, when unresolved, they can cause genome instability.


Horseradish peroxidase immobilized through its carboxylic groups onto a polyacrylonitrile membrane: comparison of enzyme performances with inorganic beaded supports.
A hydrophilic polyacrylonitrile (PAN) flat sheet membrane was aminated (8.5 micromol of NH2/mg of dry support) for covalent binding of horseradish peroxidase (HRP), mediated by the soluble carbodiimide l-ethyl-3-(3- dimethylaminopropyl)carbodiimide (EDC). Silica microbeads derivatized by silanization, to yield an aminated support, and commercial aminated glass microbeads were also coupled to HRP with EDC or activated with glutaraldehyde. The immobilized enzyme activities were determined in a batch enzyme reactor with an external loop, the highest specific immobilized HRP activity being obtained on the glass support (55.8 U/mg of protein). Continuous operational stability studies showed that hydrophilic PAN membrane led to the highest retention of HRP activity after an overall period of 35 h, with a normalized productivity of 59.5 micromol of H2O2 reduced/(h x Uimmob HRP).


Temporary hemiepiphysiodesis for correcting idiopathic and pathologic deformities of the knee: A retrospective analysis of 355 cases.
Hemiepiphysiodesis is a well-established treatment option in cases of pathologic deformities and leg discrepancies during evolution. The aim of this study was to evaluate the postoperative angular measurement, correction correlated with age at operation time, and postoperative complication rate. A total of 355 patients were treated with 887 8-plates between April 2007 and January 2013. Their mean age was 12.18 years (range four to 16 years), and the mean time to axis correction was 17.32 months (range two to 62 months). We analysed the entire population and also performed subgroup analyses for idiopathic, pathologic, varus, valgus and leg length discrepancy. The mean durations (time from (hemi-) epiphysiodesis to implant removal) in the idiopathic and pathologic groups were 13.24 and 21.3 months, respectively. The time to implant removal was 18.39 months for idiopathic varus deformities and 11.07 months for idiopathic valgus deformities. For the pathologic deformity group it was 24.9 and 20 months in the varus and valgus subgroups, respectively. Hemiepiphysiodesis is a well-established treatment option to correct angular deformities. The rate of correction was slower and less successful in pathologic deformities and for leg length discrepancies. This suggests that earlier intervention is appropriate for these patients. A higher body mass index (BMI) was observed for valgus deformity, but no correlation was present between BMI and durability.


Role of nonprotein thiols in enzymatic reduction of 2-nitroimidazoles.
The role of nonprotein thiols (NPSH) in the enzymatic reduction of the nitro function in 2-nitroimidazoles (2-NI) has been investigated. The addition of NPSH has been shown previously to protect cells from the hypoxic cytotoxicity of 2-NI, whereas depletion of NPSH enhances the hypoxic cytotoxicity. In this report, we have investigated the effects of thiol depleting agents, N-ethylmaleimide (NEM) and diethyl maleate (DEM), on the enzymatic reduction of the nitro group. Cytosolic and microsomal fractions of rat hepatic tissue and xanthine oxidase were employed as sources of nitro reductases. Addition of NPSH caused an enhancement in the reduction of the nitro group of 2-NI; cysteine was significantly more effective than glutathione (GSH) in stimulating the enzymatic reduction. The reduction of the nitro function was decreased markedly in the presence of NEM or DEM. Addition of cysteine or GSH reversed the inhibition with NEM. Both NEM and DEM also attenuated the enhancement of reduction observed after the addition of NPSH. These results suggest that the addition of NPSH facilities the reduction of the nitro function to the reduced intermediates that may be inactivated by an excess of NPSH, whereas the depletion of NPSH allows the accumulation of the toxic nitro radicals causing increased cytotoxicity.


Central connections of the pineal organ in the three-spined stickleback, Gasterosteus aculeatus L. (teleostei).
Central connections of the pineal organ of the three-spined stickleback, Gasterosteus aculeatus L., were studied by the use of horseradish peroxidase (HRP) for anterograde tracing. The pineal tract terminates bilaterally in the habenular nuclei, area praetectalis, dorsal and ventral thalamic nuclei, periventricular hypothalamus, and dorsal tegmentum. Furthermore, fibers were traced into the rostral hypothalamus, tuberal nuclei and deep tegmentum. No pinealopetal connections were observed.


Relaxin Attenuates Organ Fibrosis via an Angiotensin Type 2 Receptor Mechanism in Aged Hypertensive Female Rats.
The antifibrotic effects of recombinant human relaxin (RLX) in the kidney are dependent on an interaction between its cognate receptor (RXFP1) and the angiotensin type 2 receptor (AT2R) in male models of disease. Whether RLX has therapeutic effects, which are also mediated via AT2R, in hypertensive adult and aged/reproductively senescent females is unknown. Thus, we determined whether treatment with RLX provides cardiorenal protection via an AT2R-dependent mechanism in adult and aged female stroke-prone spontaneously hypertensive rats (SHRSPs). In 6-month-old (6MO) and 15-month-old ([15MO]; reproductively senescent) female SHRSP, systolic BP (SBP), GFR, and proteinuria were measured before and after 4 weeks of treatment with vehicle (Veh), RLX (0.5 mg/kg per day s.c.), or RLX+PD123319 (AT2R antagonist; 3 mg/kg per day s.c.). Aortic endothelium-dependent relaxation and fibrosis of the kidney, heart, and aorta were assessed. In 6MO SHRSP, RLX significantly enhanced GFR by approximately 25% (P=0.001) and reduced cardiac fibrosis (P=0.01) as compared with vehicle-treated counterparts. These effects were abolished or blunted by PD123319 coadministration. In 15MO females, RLX reduced interstitial renal (P=0.02) and aortic (P=0.003) fibrosis and lowered SBP (13±3 mm Hg; P=0.04) relative to controls. These effects were also blocked by PD123319 cotreatment (all P=0.05 versus RLX treatment alone). RLX also markedly improved vascular function by approximately 40% (P<0.001) in 15MO SHRSP, but this was not modulated by PD123319 cotreatment. The antifibrotic and organ-protective effects of RLX, when administered to a severe model of hypertension, conferred cardiorenal protection in adult and reproductively senescent female rats to a great extent via an AT2R-mediated mechanism.


Rhabdomyolysis and acute kidney injury: creatine kinase as a prognostic marker and validation of the McMahon Score in a 10-year cohort: A retrospective observational evaluation.
High-volume fluid resuscitation and the administration of sodium bicarbonate and diuretics have a theoretical renoprotective role in patients at high risk of acute kidney injury (AKI) following rhabdomyolysis. Abnormally elevated creatine kinase has previously been used as a biological marker for the identification of patients at high risk of AKI following rhabdomyolysis. To assess the sensitivity and specificity of plasma creatine kinase (admission and peak values) for the prediction of AKI requiring renal replacement therapy (RRT) or of death in patients with confirmed rhabdomyolysis. To compare the diagnostic performance of creatine kinase with the McMahon score. Retrospective observational study. Data collection included McMahon and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores; daily creatine kinase; daily creatinine and electrolytes; ICU length of stay and mortality. Neurosciences and Trauma Critical Care Unit (Cambridge, UK). In total, 232 adults with confirmed rhabdomyolysis (creatine kinase > 1000 Ul) admitted to Neurosciences and Trauma Critical Care Unit between 2002 and 2012. AKI, RRT and mortality. Forty-five (19%) patients developed AKI and 29 (12.5%) patients required RRT. Mortality was significantly higher in patients who developed AKI (62 vs. 18%, P < 0.001). Average creatine kinase on admission was 5009 (range 69-157 860) Ul. Creatine kinase peaked between the day of admission and day 3 in 91% of cases. PEAK creatine kinase of at least 5000 Ul is 55% specific and 83% sensitive for the prediction of AKI requiring RRT. A McMahon Score of at least 6 calculated on admission is 68% specific and 86% sensitive for RRT. Creatine kinase is not a specific or early predictor of AKI in patients with rhabdomyolysis. Although a PEAK creatine kinase of at least 5000 Ul has sensitivity acceptable for screening purposes, this is often a delayed finding. A McMahon score of at least 6 calculated on admission allows for a more sensitive, specific and timely identification of patients who may benefit from high-volume fluid resuscitation.


Role of comprehensive geriatric assessment in screening for mild cognitive disorders.
The role of comprehensive geriatric assessment (CGA) in screening for mild cognitive disorders was not known. To evaluate the role of CGA in screening for mild cognitive disorders. A total of 100 elderly people who underwent health examinations in our hospital and community between January 2020 and December 2021 were included for analysis. Using Petersen as the diagnostic gold standard, healthy individuals were included in the control group and patients with mild cognitive impairment were assigned to the study group. The correlation between the cognitive function of the patients and their baseline clinical profiles was analyzed. Patients' Montreal Cognitive Assessment (MoCA) and CGA screening results were compared, and the sensitivity and specificity were calculated to assess the screening role of CGA. CGA assessment yielded higher diagnostic accuracy than MoCA. The results of the multivariate regression analysis showed no correlation of gender, age, body mass index and literacy with cognitive function. Patients with mild cognitive impairment obtained significantly lower MoCA scores than healthy individuals (P < 0.05). In the CGA scale, patients with mild cognitive impairment showed significantly lower Mini-mental State Examination, Miniature Nutritional Assessment and Berg Balance Scale scores, and higher Activity of Daily Living, Instrumental Activities of Daily Living Scale and Frailty Screening Inventory scores than healthy individuals (P < 0.05), whereas the other assessment scales showed no significant differences (P > 0.05). The CGA provides higher diagnostic sensitivity and specificity than the MoCA (P < 0.05). CGA allows accurate identification of mild cognitive impairment with high sensitivity and specificity, facilitating timely and effective intervention, and is thus recommended for clinical use.


E-cadherin and fibronectin expressions have no prognostic role in stage II ductal breast cancer.
The aim of the study was to describe the expressions of E-cadherin (EC) and fibronectin (FN) and their prognostic value in radically-treated ductal breast cancer. Ninety-eight patients, aged 26-86 (median, 57) with stage II G2 or G3 tumors, were subjected to a retrospective analysis. No significant associations were observed between the levels of the proteins studied and patient or cancer features, with the exception of relationships between FN expression and the histological grade of the tumor or hormonal status of the subjects. None of the markers showed a correlation with survival in multivariate analysis. Consequently, the experiment revealed no prognostic value of EC or FN expression in a homogenous patient group with stage II G2 or G3 ductal breast carcinoma. Further studies, on other uniform populations, with tumor features different from those described here, are necessary in order to reveal the prognostic significance of the molecules discussed.


Sialendoscopy under conscious sedation versus general anesthesia. A comparative study.
Sialendoscopy is a minimally invasive emerging approach, the general surgical technique has been published but many essential questions still need to be addressed with the aim of improving outcomes. For instance, should we systematically perform sialendoscopy under conscious sedation (CS) or general anesthesia (GA)? What are the limitations of CS? The objective of this study is to compare these two modalities. A retrospective study of 70 patients who had undergone a sialendoscopy between 2014 and 2016 (34 under GA and 36 under CS). Comparisons were made between these two groups in term of operative time, stone size and location, tolerability, operative success and post-operative pain. The patients' mean age was 45.33 years. The operative success rate among the GA group was 79.4% vs. 88.9% in the CS group (P = 0.276), while complications for both groups were comparable. All patients considered the intervention under CS to be tolerable. Sialendoscopy under CS or GA demonstrated the ability to access large and distal stones among the different salivary glands with an excellent tolerability. Anesthesia type should be based on surgeon and patient preference Nevertheless, patient reassurance and surgeon experience are important to producing a good result with CS.


Biting time of Anopheles darlingi in the Bolivian Amazon and implications for control of malaria.
Malaria is a growing problem in the Bolivian Amazon where there has been a four-fold increase between 1991 and 1998, largely owing to forest clearance bringing human and vector into closer association. The principle vector in this region is Anopheles darlingi Root, the behaviour of which has been little studied in this part of South America. The peak time of biting of A. darlingi was studied over a series of nights in July 2003 during the dry season in the town of Riberalta in the Bolivian Amazon. Peak biting occurred between 19:00 and 21:00 hours, when 48% of the total night's biting took place. This early biting habit has implications regarding control of malaria via the use of insecticide-treated bed nets. Anopheles darlingi was the most prevalent vector in the study, although A. albitarsis s.l. and A. braziliensis were also present.


A novel electrochemical sensor based on electrode modified with gold nanoparticles and molecularly imprinted polymer for rapid determination of trazosin.
A novel molecularly imprinted polymer sensor for fast and direct determination of trazosine (TR) was studied. The voltammetric sensor based on molecularly imprinted polymer (MIP) with disposable gold nanoparticles modified screen printed carbon electrode (MIP/AuNPs/SPCE) is developed for the determination of TR. Under the optimum conditions, the peak current of the sensor and TR concentration showed a good linear relationship over the range from 2.0 to 250.0 μM, with a low detection limit (S/N = 3) of 0.3 μM. The modified electrode demonstrated good electrocatalytic properties toward the oxidation of TR. This sensor selectively detected TR even in the presence of high concentration of similar compounds and MIP/AuNPs/SPCE was also confirmed successfully for the determination of TR in the various real samples including human blood serum, urine and trazosin tablet.


Functional health literacy and the quality of physician-patient communication among diabetes patients.
While patients with poor functional health literacy (FHL) have difficulties reading and comprehending written medical instructions, it is not known whether these patients also experience problems with other modes of communication, such as face-to-face encounters with primary care physicians. We enrolled 408 English- and Spanish-speaking diabetes patients to examine whether patients with inadequate FHL report worse communication than patients with adequate FHL. We assessed patients' experiences of communication using sub-scales from the Interpersonal Processes of Care in Diverse Populations instrument. In multivariate models, patients with inadequate FHL, compared to patients with adequate FHL, were more likely to report worse communication in the domains of general clarity (adjusted odds ratio [AOR] 6.29, P<0.01), explanation of condition (AOR 4.85, P=0.03), and explanation of processes of care (AOR 2.70, p=0.03). Poor FHL appears to be a marker for oral communication problems, particularly in the technical, explanatory domains of clinician-patient dialogue. Research is needed to identify strategies to improve communication for this group of patients.


Analytical solution for the dynamics and optimization of fractional Klein-Gordon equation: an application to quantum particle.
Klein-Gordon equation characterizes spin-particles through neutral charge field within quantum particle. In this context, fractionalized Klein-Gordon equation is investigated for the comparative analysis of the newly presented fractional differential techniques with non-singularity among kernels. The non-singular and non-local kernels of fractional differentiations have been employed on Klein-Gordon equation for the development of governing equation. The analytical solutions of Klein-Gordon equation have been traced out by fractional techniques by means of Laplace transforms and expressed in terms of series form and gamma function. The data analysis of fractionalized Klein-Gordon equation is observed for Pearson's correlation coefficient, probable error and regression analysis. For the sake of comparative analysis of fractional techniques, 2D sketch, 3D pie chart, contour surface with projection and 3D bar sketch have been depicted on the basis of embedded parameters. Our results suggest that varying frequency has reversal trends for quantum wave and de Broglie wave.


Chronic exercise downregulates myocardial myoglobin and attenuates nitrite reductase capacity during ischemia-reperfusion.
The infarct sparing effects of exercise are evident following both long-term and short-term training regimens. Here we compared the infarct-lowering effects of nitrite therapy, voluntary exercise, and the combination of both following myocardial ischemia-reperfusion (MI/R) injury. We also compared the degree to which each strategy increased cardiac nitrite levels, as well as the effects of each strategy on the nitrite reductase activity of the heart. Mice subjected to voluntary wheel running (VE) for 4weeks displayed an 18% reduction in infarct size when compared to sedentary mice, whereas mice administered nitrite therapy (25mg/L in drinking water) showed a 53% decrease. However, the combination of VE and nitrite exhibited no further protection than VE alone. Although the VE and nitrite therapy mice showed similar nitrite levels in the heart, cardiac nitrite reductase activity was significantly reduced in the VE mice. Additionally, the cardiac protein expression of myoglobin, a known nitrite reductase, was also reduced after VE. Further studies revealed that cardiac NFAT activity was lower after VE due to a decrease in calcineurin activity and an increase in GSK3β activity. These data suggest that VE downregulates cardiac myoglobin levels by inhibiting calcineurin/NFAT signaling. Additionally, these results suggest that the modest infarct sparing effects of VE are the result of a decrease in the hearts ability to reduce nitrite to nitric oxide during MI/R.


Simple solutions for difficult problems: a beginner's guide to ring fixation.
Ring external fixation is a surgical method for leg lengthening and deformity correction. It allows limited surgical exposure and dissection and can be tolerated for prolonged periods as compared to threaded uniplanar or multiplanar constructs. Because of the complexity in application and adjustment of the frame constructs, most orthopedic surgeons avoid using these devices. Surgeons are advised to apply these techniques initially to less complicated clinical situations, expanding application with comfort and proficiency. This discussion introduces ring fixation and provides guidelines for simple applications. Experience with these simple applications allows surgeons to expand their spectrum of proficiency and provides alternatives for solving complex clinical problems.


G1 phase arrest of the cell cycle by a ginseng metabolite, compound K, in U937 human monocytic leukamia cells.
We recently reported that the ginseng saponin metabolite, compound K (20-O-beta-D-glucopyranosyl-20(S)-protopanaxadiol, IH901), inhibits the growth of U937 cells through caspase-dependent apoptosis pathway. In this study, we further characterized the effects of compound K on U937 cells and found that, in addition to apoptosis, compound K induced the arrest of the G1 phase. The compound K treated U937 cells showed increased p21 expression; an inhibitory protein of cyclin-cdk complex. The up-regulation of p21 was followed by the inactivation of cyclin D and the cdk4 protein, which act at the early G1 phase, and cyclin E, which acts at the late G1 phase. Furthermore, compound K induced the activation of JNK and the transcription factor AP-1, which is a downstream target of JNK. These findings suggest that the up-regulation of p21 and activation of JNK in the compound K treated cells contribute to the arrest of the G1 phase.


Radiation and the Pregnant IR: Myth versus Fact.
The article is part of the series of articles on radiation protection. You can find further articles in the special section of the CVIR issue. Radiation exposure during pregnancy is a source of concern for many women interventional radiologists. There are misconceptions about the actual risks and what is safe. This article will address the myths surrounding occupational radiation exposure and clarify the facts.


Electro-acupuncture promotes gut motility and alleviates functional constipation by regulating gut microbiota and increasing butyric acid generation in mice.
Abnormalities in the gut microbiota and intestinal short-chain fatty acid (SCFA) levels are implicated in the pathogenesis of functional constipation (FC). Electro-acupuncture (EA) has been shown to improve constipation-related symptoms and rebalance the gut microbiota. However, it is currently unknown whether the gut microbiota is a key mechanistic target for EA or how EA promotes gut motility by regulating the gut microbiota and SCFAs. Therefore, we assessed the effects of EA in FC mice and pseudo-germfree (PGF) mice to address these questions. Forty female Kunming mice were randomly separated into a normal control group (n = 8), an FC group (n = 8), an FC + EA group (n = 8), a PGF group (n = 8) and a PGF + EA group (n = 8). The FC group and FC + EA group were treated with diphenoxylate to establish the FC model; the PGF group and PGF + EA group were given an antibiotic cocktail to initiate the PGF model. After maintaining the model for 14 d, mice in the FC + EA and PGF + EA groups received EA stimulation at the ST25 and ST37 acupoints, once a day, 5 times per week, for 2 weeks. Fecal parameters and intestinal transit rate were calculated to assess the efficacy of EA on constipation and gastrointestinal motility. Colonic contents were used to quantify gut microbial diversity using 16S rRNA sequencing, and measure SCFA concentrations using gas chromatography-mass spectrometry. EA significantly shortened the first black stool defecation time (P < 0.05) and increased the intestinal transit rate (P < 0.01), and fecal pellet number (P < 0.05), wet weight (P < 0.05) and water content (P < 0.01) over 8 h, compared with the FC group, showing that EA promoted gut motility and alleviated constipation. However, EA treatment did not reverse slow-transit colonic motility in PGF mice (P > 0.05), demonstrating that the gut microbiota may play a mechanistic role in the EA treatment of constipation. In addition, EA treatment restored the Firmicutes to Bacteroidetes ratio and significantly increased butyric acid generation in FC mice (P < 0.05), most likely due to the upregulation of Staphylococcaceae microorganisms (P < 0.01). EA-mediated resolution of constipation occurs through rebalancing the gut microbiota and promoting butyric acid generation. Please cite this article as: Xu MM, Guo Y, Chen Y, Zhang W, Wang L, Li Y. Electro-acupuncture promotes gut motility and alleviates functional constipation by regulating gut microbiota and increasing butyric acid generation in mice. J Integr Med. 2023; Epub ahead of print.


Dietary exposure to dioxin-like compounds in three age groups: results from the Flemish environment and health study.
Lipophilic contaminants are present in the environment and bioaccumulate in the food chain. Therefore, their intake via animal fat of various sources was assessed for three age groups of the Flemish population, participating in a large biomonitoring program of the Flemish government. In total, 1636 adolescents (14-15 years), 1186 mothers (18-44 years), and 1586 adults (50-65 years) participated in the study and completed a semi quantitative food frequency questionnaire. Individual consumption data were combined, via a so-called simple distribution approach, with recent data on polychlorinated dibenzo-p-dioxins/furans and dioxin-like polychlorinated biphenyls, measured via the chemical-activated luciferase gene expression (CALUX) bio-assay in food items available on the Flemish market. The median (95th percentile) estimated intakes of dioxin-like contaminants were 2.24 (4.61), 2.09 (4.26), and 1.74 (3.53) pg CALUX-TEQ kg(-1) bw d(-1) for, respectively adolescents, mothers and adults. These data are in the same range as those found in other European studies. The CALUX-TEQ results of respectively 59.8%, 53.7% and 36.2% of the adolescent, mother and adult population exceed the tolerable weekly intake (TWI) of 14 pg WHO-TEQ kg(-1) bw w(-1), as derived by the Scientific Committee on Food [Scientific Committee on Food, 2001. Opinion of the Scientific Committee on Food on the Risk Assessment of Dioxins and Dioxin-like PCBs in Food, CS/CNTM/DIOXIN/20 final Brussels, Belgium]. The main contributors of dioxin-like substances are fish and seafood (25-43% of the total intake), added fats (22-25% of the total intake) and dairy products (17-20% of the total intake).


Sign codes and sign language: two orders of communication.
Deaf children, like all children, are born with a capacity for language; i.e. the symbolization and expression of cognitive functioning. Until the age at which hearing children are talking, deaf children communicate well with others, using their sight, touch, and other actions--the common gestures in the culture of their caretakers. The chief problem in communication arises when hearers reject the deaf child's gestural symbolization of his developing language knowledge. The problem is aggravated by insistence that the child use speech as do those who hear. Linguistic, cognitive, emotional, and behavioral problems may then follow, because of the attitude and actions of the hearing. All these problems can be resolved by early recognizing that the deaf person has a language and by honestly trying to learn and use it. This language is not a set of signs standing for spoken words but a complete language with its own rules for making sense in signed sentences.


Isorhamnetin protects zearalenone-induced damage via the PI3K/Akt signaling pathway in porcine ovarian granulosa cells.
Zearalenone (ZEA) is widely derived from moldy cereal grain, which has adverse effects on animal reproduction. In particular, pigs are more sensitive to ZEA-induced toxicity than other animals. Isorhamnetin has extensive pharmacological activity. However, the role of isorhamnetin in ZEA-induced cytotoxicity remains unclear. This study was designed to investigate the therapeutic effect of isorhamnetin on ZEA-induced damage in porcine ovarian granulosa cells and elucidate its molecular mechanism. Two experiments were conducted, where a minimum of 3 biological replicates were used for each treatment. In Exp. 1, ovarian granulosa cells were treated with different concentrations of isorhamnetin (1, 5, 10, 20 and 30 μmol/L) and ZEA (0, 10, 30, 60, 90 and 120 μmol/L) for 24 h. Our results indicated that 60 μmol/L ZEA (half-maximal inhibitory concentration value) and 20 μmol/L isorhamnetin (the most effective concentration against ZEA-induced cytotoxicity) were optimum concentrations. In Exp. 2, ovarian granulosa cells were treated with isorhamnetin (20 μmol/L) for 2 h, before treatment with ZEA (60 μmol/L) for 24 h. Apoptosis, endoplasmic reticulum stress, oxidative stress, proliferation and hormone secretion of ovarian granulosa cells were detected. Our findings showed that isorhamnetin suppressed (P < 0.05) ZEA-induced apoptosis by altering mitochondrial membrane potential and apoptosis-related proteins (B-cell lymphoma-2 [Bcl-2], Bcl2-associated x [Bax] and cleaved caspase-3 [C-Casp3]). Changes in intracellular Ca2+ levels and C/EBP homologous protein (CHOP), recombinant activating transcription factor 6 (ATF6), glucose regulated protein78 kD (GRP78) indicated that isorhamnetin rescued (P < 0.05) ZEA-induced endoplasmic reticulum stress. Furthermore, isorhamnetin prevented (P < 0.05) ZEA-induced oxidative stress via the mitogen-activated protein kinase (P38) signaling pathway. Mechanistically, isorhamnetin stimulated (P < 0.05) the expression of proliferating cell nuclear antigen (PCNA) and cyclin D, thereby increasing the ratio of S phase cells in response to ZEA-induced apoptosis via phosphatidylinositol 3 kinase/protein kinase B (PI3K/Akt) signaling pathway. Isorhamnetin also recovered (P < 0.05) ZEA-induced steroidogenesis disorder by regulating steroidogenic enzyme gene and proteins (follicle-stimulating hormone receptor [FSHR] and cytochrome P450 family 19 subfamily a member 1 [CYP19A1]). Collectively, these findings show that isorhamnetin protects ovarian granulosa cells from ZEA-induced damage, which promotes proliferation, alleviates apoptosis, endoplasmic reticulum stress, oxidative stress, and steroidogenesis disorder.


Decline in the contribution of microbial residues to soil organic carbon along a subtropical elevation gradient.
There has been an increasing interest in studying microbial necromasses and their contribution to soil organic carbon (SOC) accumulation. However, it remains unclear how the interaction among climate, plants, and soil influence the microbial anabolism and how microbial necromass contribute to SOC formation. Here, we assessed the relative contribution of microbial residues to SOC pool across a subtropical elevation gradient (ranged from 630 to 2130 m a.s.l.) representing a subtropical ecosystem on Wuyi Mountain in China, by using amino sugars as tracers. Analysis of topsoil (0-10 cm) amino sugars and the composition of microbial community across this gradient revealed that the soil total amino sugars accounting for 12.2-25.7% of the SOC pool, decreased with increasing elevation. Moreover, the linear reduction in the bacterial-derived carbon (C) and an increase in the ratio of fungal- to bacterial-derived C with increasing elevation suggested the reduction in the contribution of bacterial-derived C to SOC pool across this elevation gradient. The divergent changes in the contribution of the microbial residues to SOC infer a potential change in SOC composition and stability. The microbial-derived SOC formation and its climatic responses are influenced by the interaction of vegetation types and soil properties, with soil amorphous Fe being the determiner of soil amino sugar accrual. Our work highlights the importance of understanding ecosystem type and mineral composition in regulating microbial-mediated SOC formation and accumulation in responses to climate change in subtropical ecosystems.


An emergency physician's guide to prosthetic heart valves: identification and hemodynamic function.
We describe methods for identifying the type and size of seven commonly used prosthetic heart valves and how these features influence the hemodynamics of flow through the valve. The four mechanical heart valves reviewed are Starr-Edwards silicone rubber ball valves (Models 1200/1260 aortic and 6120 mitral valves), Bjork-Shiley tilting disc valves (60 degrees standard spherical model and the 60 degrees convexo-concave model), Medtronic-Hall (Hall-Kaster) tilting disc valve, and St Jude Medical bileaflet valve. The three bioprostheses reviewed are Hancock porcine valve, Carpentier-Edwards porcine valve, and Ionescu-Shiley bovine pericardial valve. These valves were chosen because of their past or present popularity and therefore are the ones most apt to be implanted in patients seen in the emergency department.


An empirical evaluation of multidimensional clinical outcome in chronic low back pain patients.
Individuals with persisting pain often present a constellation of symptoms that includes pain, health-related impairment and dysphoric mood. It is now widely accepted that comprehensive assessment must address each of these dimensions. Despite recognition of the value of multidimensional assessment, no empirical efforts have validated the construct of a multidimensional clinical outcome presentation based on the dimensions of pain, impairment and dysphoric mood. We employed cluster analytic procedures on standard measures of pain, impairment and depression in chronic low back pain (CLBP) patients (n = 96) attending a general orthopedic clinic in order to empirically characterize multidimensional clinical outcomes. Results indicated that 3 groups could be identified reliably: (1) 'Chronic Pain Syndrome' (n = 25; high levels of pain, impairment and depression), (2) 'Positive Adaptation to Pain' (n = 24; high levels of pain with low levels of impairment and depression) and (3) 'Good Pain Control' (n = 47; low levels of pain, impairment and depression). The reliability of this cluster solution was supported by several tests of internal consistency. Discriminability of the clusters was examined across both the outcome measures themselves and several additional independent variables. The cluster solution was then cross-validated in an independent sample of pain clinic CLBP patients (n = 180) to test its generalizability. Finally the stability of the cluster dimensions over time was tested by re-assessing 36 CLBP patients 6 months after they initially were characterized into 1 of the 3 outcome groups on the same measures. MANOVA results indicated that the outcome groups were differentiated statistically across assessments. The multiple outcome measures did not change significantly across time, nor did the outcome groups change differentially across time on these measures. We conclude that the outcome dimensions of pain, impairment and depression are relatively stable phenomena that differentially describe CLBP patients.


Systematic Review of Surgical Management of Spinal Intradural Arachnoid Cysts.
Spinal intradural arachnoid cysts (SIACs) are rare pathological lesions that can arise via outpouchings of the arachnoid layer in the spinal canal that can result in neurological deficits. We performed a systematic literature review regarding the current surgical techniques used in the management of SIACs and discussed the prevailing hypotheses surrounding the etiology of SIACs. A systematic search of the literature was performed in December 2020 using EMBASE and MEDLINE for reports regarding the surgical management of SIACs. Data were collected regarding the demographics of the patients, classification system used, presence or absence of syrinxes, preoperative imaging modality, surgical approach and extent of resection, and postoperative outcomes and follow-up. Our search yielded 19 reports for inclusion in the present study. The 19 studies included a total of 414 cases, with an overall male/female ratio of 0.93:1. The most common site for the SIACs was the thoracic spinal cord at 77.5%. The symptoms were very similar across the 19 studies. Of the 19 studies, 15 had used resection to manage the SIACs, 10 had used fenestration or marsupialization, and 4 had used cystoarachnoid or cystoperitoneal shunts. SIACs are rare and debilitating spinal pathological lesions, with the etiology of primary SIACs still not fully elucidated. Multiple surgical approaches have been effective, with the optimal operative strategy largely dependent on the individual patient and cyst factors on a case-by-case basis.


Meta-ecosystems and biological energy transport from ocean to coast: the ecological importance of herring migration.
Ecosystems are not closed, but receive resource subsidies from other ecosystems. Energy, material and organisms are moved between systems by physical vectors, but migrating animals also transport resources between systems. We report on large scale energy transport from ocean to coast by a migrating fish population, the Norwegian spring-spawning (NSS) herring Clupea harengus. We observe a rapid body mass increase during parts of the annual, oceanic feeding migration and we use a bioenergetics model to quantify energy consumption. The model predicts strong seasonal variation in food consumption with a marked peak in late May to July. The copepod Calanus finmarchicus is the most important prey and 23 x 10(6) tones (wet weight) of C. finmarchicus is consumed annually. The annual consumption-biomass ratio is 5.2. During the feeding migration 17% of consumed energy is converted to body mass. The biomass transported to the coast and left as reproductive output is estimated from gonad weight and is about 1.3 x 10(6) tones for the current population. This transport is to our knowledge the world's largest flux of energy caused by a single population. We demonstrate marked temporal variation in transport during the last century and discuss the effects of NSS herring in the ocean, as a major consumer, and at the coast, where eggs and larvae are important for coastal predators. In particular, we suggest that the rapid decline of lobster Homarus gammarus landings in Western Norway during the 1960s was related to the collapse of NSS herring. We also discuss spatial variation in energy transport caused by changed migration patterns. Both climate and fisheries probably triggered historical changes in the migration patterns of NSS herring. New migration routes emerge at the level of individuals, which in turn determines where resources are gathered and delivered, and therefore, how meta-ecosystems function.


Prediction of therapeutic response in acute treatment with antidepressants. Results of an empirical study involving 159 endogenous depressive inpatients.
A study was carried out involving 159 endogenous depressive inpatients treated with antidepressants. Using standardized rating instruments, a large set of potential predictor variables was tested. After cross-validation according to the split-half technique, only very few of these proved to be suitable as predictors for the main outcome criteria. These predictors included premorbid maladjustment, neurotic traits of premorbid personality, intensity of depressive-apathetic symptoms at admission, and the self-evaluated mood assessment score 3 weeks after commencement of treatment. This last criterion demonstrated the highest predictive value. Several predictors known from the literature could not be reproduced in this study.


EM visualization of nucleocytoplasmic transport processes.
The nuclear envelope is strategically located between the nucleoplasm and cytoplasm, and, as such, can play a major role in controlling cellular activity by regulating the exchange of macromolecules between these two compartments. The nuclear pore complexes, which are located within circular areas formed by fusion of the inner and outer membranes of the envelope, represent the primary, if not the exclusive, exchange sites. Individual pores are able to function in both protein import and RNA efflux from the nucleus. Translocation of macromolecules occurs by either passive diffusion or facilitated transport through central channels within the pores. The functional size of the diffusion channel is approximately 9 to over 12 nm in diameter depending on the cell type. The width of the transport channel varies as a function of the number and effectiveness of the specific nuclear targeting signals contained within the permeant molecule. The maximum diameter of the channel can be over 26 nm. Nucleocytoplasmic exchanges can be regulated either by (1) differences in the properties of the transported molecule (molecular size and signal content) or (2) changes in the properties of the pore complexes, which can effect both diffusion and transport.


Group A streptococcal bacteremia in intravenous drug abusers.
The clinical and microbiologic features of group A streptococcal bacteremia are described in 40 patients, all of whom were seen between January 1982 and June 1983 and all of whom were intravenous drug abusers. Eleven patients had endocarditis (two with left-sided and nine with right-sided), and 29 patients had bacteremia without endocardial involvement. Twenty-seven of the 29 patients without endocarditis had soft tissue infections, primarily groin abscesses. Constitutional symptoms were more severe in patients with endocarditis. The two patients with left-sided endocarditis died despite antimicrobial therapy; all nine patients with right-sided endocarditis and all 29 patients without endocarditis were cured of their infection. A predominant strain of group A streptococcus was identified by serologic typing, suggesting a common source for these cases.