Day treatment programs for the Spanish speaking: a response to underutilization.
This article describes how a hospital-based Community Mental Health Centre in California, United States, addressed the problem of underutilization by its Spanish-speaking population. The authors present a clinical program model which can be duplicated without hiring large numbers of bilingual professionals. The program offers a comprehensive range of psychiatric treatment services to a particular minority population, and can be readily adapted to deliver mental health care to any national minority or ethnic subpopulation. All of the services for the Spanish-speaking seek to promote community integration, and are designed to provide therapeutic experiences in a foreign environment while maintaining cultural ties.


Impact of prophylactic hydroxychloroquine on ultrastructural impairment and cellular SARS-CoV-2 infection in different cells of bronchoalveolar lavage fluids of COVID-19 patients.
Many drugs were recommended as antiviral agents for infection control and effective therapy to reduce the mortality rate for COVID-19 patients. Hydroxychloroquine (HCQ), an antimalarial drug, has been controversially recommended for prophylactic use in many countries, including India, to control SARS-CoV-2 infections. We have explored the effect of prophylactic HCQ from the cells of bronchoalveolar lavage fluids from COVID-19-induced acute respiratory distress syndrome patients to determine the level of infection and ultrastructural alterations in the ciliated epithelium, type II pneumocytes, alveolar macrophages, neutrophils, and enucleated granulocytes. Ultrastructural investigation of ciliated epithelium and type II pneumocytes showed lesser infections and cellular impairment in the prophylactic HCQ+ group than HCQ- group. However, macrophages and neutrophils displayed similar infection and ultrastructural alterations in both patient groups. The enucleated fragments of granulocytes showed phagocytosis of the matured virus in HCQ+ groups. The present report unveils the ultrastructural proof to complement the paradox regarding the role of prophylactic HCQ in COVID-19 patients.


Chemical constituents from aerial part of Curcuma wenyujin.
To investigate the chemical constituents from aerial part of Curcuma wenyujin. Compounds were isolated by repeated column chromatography on silica gel. Their structures were elucidated on the basis of spectral analysis and comparison with literature data. Six compounds were isolated and identified as codonolactone (1), voleneol (2), octacosanoic acid (3), beta-sitosterol (4), mangdesisterol (5), and daucosterol (6). Compounds 1, 2, and 5 were isolated from the plant for the first time.


The relationship between freezing tolerance and thermotropic leaf movement in five Rhododendron species.
Leaf movement kinetics in five species of Rhododendron were studied in response to leaf temperature, leaf freezing point, and leaf water deficit. There was a gradient in the degree of leaf curling among species in the following order from the greatest curling to the least curling: Rhododendron catawbiense, R. maximum, R. minus, R. macrophyllum, R. ponticum. Those species found to be tolerant of winter conditions had the most intense leaf movements (both curling and angle) while those species with minimal cold tolerance had limited or no leaf movements. Leaf curling occurred at leaf temperatures above the tissue freezing points in all species. Athough leaf angle was influenced by leaf turgor, general tissue desiccation was not the ultimate cause for thermotropic leaf curling in any species tested. Those species with the greatest leaf curling and angle movements had the highest osmotic potential, the lowest water deficit at the turgor loss point, and the lowest symplastic water fraction. These data suggest that there is a trade off in Rhododendron leaf physiology between cold tolerance (due to leaf movements) and water stress tolerance (due to turgor maintenance mechanisms).


Studies on digenetic trematodes of the genus Prosthodendrium Dollfus, 1931 from some Egyptian bats. 2. Trematodes of the subgenus Paralecithodendrium Odhner, 1911.
A review of the subgenus Paralecithodendrium Odhner, 1911 is presented. Prosthodendrium (Paralecithodendrium) glandulosum (Looss, 1896) is redescribed from some Egyptian bats. The present study indicated that this species is a very variable one. Moreover, a new species P. (Paralecithodendrium) aegyptiacum is described from two species of bats.


Role of Boron in Enhancing Electron Delocalization to Improve Catalytic Activity of Fe-Based Metallic Glasses for Persulfate-Based Advanced Oxidation.
Metallic glasses (MGs) with superior catalytic performance have recently been recognized as attractive candidates for wastewater treatment. However, further improving their performance will require knowledge of how to precisely regulate their electronic structures via compositional control. Here, two Fe-based MGs (Fe78Si9B13 and Fe80Si9B11) were prepared to compare how slightly altering boron content affected their electronic structure and catalytic performance. Density functional theory revealed that the Fe78Si9B13 MG with 2 atom % higher boron exhibits an attractive electron delocalization, a high persulfate adsorption energy, and a superb work function due to precise regulation of the electronic structure, leading to exceptional degradation performance for seven organic pollutants. Furthermore, it can be reused 23 times without significant deterioration of catalytic performance, amorphous structure, and surface morphology. This work provides a new paradigm for the fundamental theory explaining how electronic structure is controlled by composition, creating a solid foundation to explore novel catalysts for water treatment.


Dimensions of internalization relevant to the identity disruption model of body dissatisfaction.
The Identity Disruption Model posits that negative early life experiences are associated with disrupted personal identity, which in turn increases the risk of internalizing societal standards of attractiveness and body dissatisfaction. Although internalization plays a central role in this model, it is unclear which aspect(s) of internalization (awareness, endorsement, or internalization) are most relevant to the Identity Disruption Model. To address this issue, female participants (N = 278) completed measures of the following constructs: early adversity; self-concept clarity; awareness, endorsement, and internalization of societal standards of attractiveness; and body dissatisfaction. Self-concept clarity was negatively correlated with internalization (r = -.45, p < .001), but was not significantly correlated with awareness (r = -.05) or endorsement (r = -.11). Furthermore, structural equational modeling showed that there was a significant indirect path from early adversity to self-concept clarity to internalization to body dissatisfaction (unstandardized b = .015, SEboot = .004, p < .001). The indirect paths through awareness and endorsement were not significant. These findings help clarify the Identity Disruption Model by indicating that lower self-concept clarity is specifically associated with taking on societal standards as personally meaningful beliefs, rather than with mere awareness of, or agreement with, those standards.


Anticonvulsant and antioxidant effects of cyano-carvone and its action on acetylcholinesterase activity in mice hippocampus.
The anticonvulsant effect of cyano-carvone, a monoterpene monocyclic, was investigated in epilepsy model induced by pilocarpine. Cyano-carvone at doses of 25, 50 or 75 mg/kg promoted a reduction of 16.7, 33 and 66.7%, respectively, against pilocarpine-induced seizures, and it was efficacious in increasing both the latency to first seizures and the survival percentage, resulting in 33.3, 67 and 91.7% of protection against death induced by seizures, respectively (P < 0.05). The reference drug atropine (25 mg/kg) also produced a significant protection (100%). Its monoterpene, at 25, 50 and 75 mg/kg, was also capable to increase the latency for installation of status epilepticus induced by pilocarpine, and presented a significant protection against lipid peroxidation and nitrite formation in mice hippocampus (P < 0.05). In addition, it was observed that the cyano-carvone pretreatment increased the acetylcholinesterase activity in mice hippocampus after pilocarpine-induced seizures. The present results clearly indicate the anticonvulsant ability of cyano-carvone, which can be, at least in part, explained by the increased activity of the acetylcholinesterase enzyme. Our data suggest that the action mechanism can also be due to a direct activation of the antioxidant enzymes that could be associated with a reduction observed in oxidative stress in mice hippocampus, probably involving an inhibition of free radical production.


Necrotizing external otitis: diagnostic clues in the emergency department.
The assessment of necrotizing external otitis requires a high index of suspicion by the attending physician. The purpose of the study is to determine the accuracy of parameters available at the Emergency Department for the diagnosis of this pathology. Retrospective diagnostic accuracy study. Patients consulting at the Emergency Department for longstanding ear swelling, severe otalgia, and failure to respond to topical treatment were included. Otoscopy, physical examination, CT appearance, and analytical results were tested for the diagnosis of necrotizing external otitis, using nuclear imaging as gold standard. Sensitivity, specificity, likelihood ratios and ROC curves were calculated. 24 patients were included; 13 cases were necrotizing external otitis, and 11 cases were other external ear pathologies. Erythrocyte sedimentation rate and C-reactive protein levels were significantly associated with necrotizing external otitis (AUC 0.92 p < 0.001, and 0.8 p < 0.001). Positive likelihood ratios were 10.15 for values of erythrocyte sedimentation rate over 26 mm/h, and 8.25 for C-reactive protein levels over 10 mg/L. Negative likelihood ratios were 0.08 and 0.28, respectively. These results were significant. The rest of clinical and radiological parameters were less accurate. Erythrocyte sedimentation rate and C-reactive protein are useful parameters in the evaluation of a case of longstanding otitis with clinical suspicion of necrotizing external otitis. If any of them is elevated, the probability of suffering this condition is significantly increased. If they are within normal ranges, an alternative diagnosis should be sought.


Effects of salt type on the metabolites and microbial community in kimchi fermentation.
The taste of kimchi is greatly affected by the salt type used during fermentation. Here, we investigated the effects of salts with different mineral contents on the microbial community and metabolite profiles of fermented kimchi using multivariate statistical analysis. We evaluated different types of salt used to prepare kimchi, namely, solar salt aged for 1 year, solar salt aged for 3 years, dehydrated solar salt, and purified salt. The main microorganisms detected in kimchi were Weissella koreensis, Leuconostoc mesenteroides, and Latilactobacillus sakei. Leuconostoc and Weissella were mainly present in kimchi supplemented with solar salt. However, a high proportion of L. sakei was present in kimchi supplemented with purified salt and dehydrated salt. Additionally, using GC-MS-based metabolite analysis, we revealed that the content of free sugars, organic acids, and amino acids differed in kimchi fermented with different salt types. Therefore, we demonstrated that salt type had a pronounced effect on the resultant microbial community and the type and concentration of metabolites present in fermented kimchi.


Identification of vulnerable carotid plaque with CT-based radiomics nomogram.
To develop and validate a radiomics nomogram for identifying high-risk carotid plaques on computed tomography (CT) angiography (CTA). A total of 280 patients with symptomatic (n=131) and asymptomatic (n=139) carotid plaques were divided into a training set (n=135), validation set (n=58), and external test set (n=87). Radiomic features were extracted from CTA images. A radiomics model was constructed based on selected features and a radiomics score (rad-score) was calculated. A clinical factor model was constructed by demographics and CT findings. A radiomics nomogram combining independent clinical factors and the rad-score was constructed. The diagnostic performance of three models was evaluated and validated by region of characteristic curves. Calcification and maximum plaque thickness were the independent clinical factors. Twenty-four features were used to build the radiomics signature. In the validation set, the nomogram (area under the curve [AUC], 0.977; 95% CI, 0.899-0.999) performed better (p=0.017 and p=0.031) than the clinical factor model (AUC, 0.862; 95% CI, 0.746-0.938) and radiomics signature (AUC, 0.944; 95% CI, 0.850-0.987). In external test set, the nomogram (AUC, 0.952; 95% CI, 0.884-0.987) and radiomics signature (AUC, 0.932; 95% CI, 0.857-0.975) showed better discrimination capability (p=0.002 and p=0.037) than clinical factor model (AUC, 0.818; 95% CI, 0.721-0.892). The CT-based nomogram showed satisfactory performance in identification of high-risk plaques in carotid arteries, and it may serve as a potential non-invasive tool to identify carotid plaque vulnerability and risk stratification.


Maternal Outcomes of Eclampsia at the Lagos University Teaching Hospital: A Six-Year Retrospective Review.
Eclampsia is one of the leading causes of maternal morbidity and mortality. To determine the incidence as well as the maternal outcomes of eclampsia at the Lagos University Teaching Hospital (LUTH). This was a retrospective review. During the six-year review period, 4182 women gave birth at our facility, out of which 67 cases of eclampsia were diagnosed (16 per 1000 deliveries). Four women died constituting a case fatality rate of 5.9%. Fifteen women were admitted to the intensive care unit, 6 women had acute kidney injury while 5 had abruptio placentae. Further comparison of our data with previous studies from our institution decades ago showed a continuous decrease in total number of eclamptic cases presenting to our facility (572 eclamptics in 1977 - 1986, 299 ECLAMPTICS IN 1986 - 1995, 165 IN 1996-2005 AND 67 IN 2015-2020). The case fatality rate from eclampsia is still high in our hospital. Increased utilisation of antenatal care may play an important role in improving the maternal outcomes from this life-threatening obstetric condition. There is need for maternal education and increase awareness on the importance of antenatal care and early referral to tertiary level of care in order to reverse this trend.


Ectodermal influence on physiological cell death in the posterior necrotic zone of the chick wing bud.
The phenomenon of "programmed cell death" in the posterior necrotic zone (PNZ) of the chick wing bud was reexamined. Prospective PNZs (pPNZs) were excised from stage 18-21 donor wings and observed for signs of necrosis in vitro. Cell death was quantified by a chromium-51 release assay. Prospective PNZs from the youngest donors (stage 18) showed no signs of death above control levels, while necrosis increased in vitro with increasing donor age. Cell death in the PNZ at stage 24 could be inhibited by removing the overlying ridge at stage 20 or 21. These results suggest that cell death in the PNZ is not rigidly determined early in development as previous studies suggest, but remains responsive to the cellular environment until shortly before the cells die.


Novel bacterial gas sensor proteins with transition metal-containing prosthetic groups as active sites.
Gas molecules function as signaling molecules in many biological regulatory systems responsible for transcription, chemotaxis, and other complex physiological processes. Gas sensor proteins play a crucial role in regulating such biological systems in response to gas molecules. New sensor proteins that sense oxygen or nitric oxide have recently been found, and they have been characterized by X-ray crystallographic and/or spectroscopic analysis. It has become clear that the interaction between a prosthetic group and gas molecules triggers dynamic structural changes in the protein backbone when a gas sensor protein senses gas molecules. Gas sensor proteins employ novel mechanisms to trigger conformational changes in the presence of a gas. In gas sensor proteins that have iron-sulfur clusters as active sites, the iron-sulfur clusters undergo structural changes, which trigger a conformational change. Heme-based gas sensor proteins reconstruct hydrogen-bonding networks around the heme and heme-bound ligand. Gas sensor proteins have two functional states, on and off, which are active and inactive, respectively, for subsequent signal transduction in response to their physiological effector molecules. To fully understand the structure-function relationships of gas sensor proteins, it is vital to perform X-ray crystal structure analyses of full-length proteins in both the on and off states.


Therapeutic lateral neck dissection in well-differentiated thyroid cancer: Analysis on factors predicting distribution of positive nodes and prognosis.
Neck dissection is considered the treatment of choice in patients with lateral neck metastases from well-differentiated thyroid cancer. A multicenter, retrospective review of patients who underwent therapeutic lateral neck dissection for well-differentiated thyroid carcinoma was carried out. The study included a total of 405 lateral neck dissections performed in 352 patients; 197 women (56%) and 155 men (44%). When considering ipsilateral neck metastases, levels IIa, IIb, III, IV, Va, Vb, and V (not otherwise specified) were involved in 42%, 6%, 73%, 67%, 11%, 31%, and 35% of cases, respectively. Five-year and 10-year overall survival (OS) were 93% and 81%, respectively. Age >55 years, pathologic T (pT)4 category, tumor diameter >4 cm, aggressive variants of well-differentiated thyroid carcinoma, endovascular invasion, and number of positive nodes >5 turned out to be the most important prognostic factors. Neck dissection is a valid treatment option in the presence of neck metastasis from well-differentiated thyroid carcinoma. Levels IIa, III, IV, and Vb should always be removed.


[Theory and practice of sampling studies: exemplified by the MONICA survey].
In parallel with the systematic registration of myocardial infarction, the MONICA-Project attempts to investigate at three different times the prevalence of risk factors for cardiovascular disease in the population. This article presents the sampling plan of the first MONICA survey in the cantons of Vaud, Fribourg and Tessin. The sampling procedure was at two levels: first, a sample of communes stratified according to community size was chosen, and secondly, within these communities, individuals were selected from the population registries. The prerequisites for an efficient sampling plan are discussed on a theoretical level. In addition, the practical constraints (budget, organizational problems, population registry files) are presented. Finally, all steps of the sampling procedure are described including the difficulties encountered. The discussion attempts a critical evaluation of the whole MONICA sampling procedure whose results are largely satisfactory.


Nutritional, chemical and bioactive profiles of different parts of a Portuguese common fig (Ficus carica L.) variety.
This study aims to give an unprecedented contribution on the chemical composition and bioactivities of the most produced and appreciated Portuguese fig variety ("Pingo de Mel") with the view of expanding the knowledge on its potentialities. An advanced characterization of its peel and pulp parts was carried out. Four free sugars (glucose, fructose, trehalose and sucrose), 5 organic acids (oxalic, quinic, malic, citric, and succinic acids), tocopherols in all their 4 forms, besides 23 fatty acids were detected in the samples. Fifteen different phenolic components were found in the peel hydroethanolic extract; whereas 12 were detected in the pulp hydroethanolic extract. Quercetin-3-O-rutinoside (rutin) was the major constituent of the peel, accounting for 33.8% of its phenolic content, followed by 5-O-caffeoylquinic acid and vanillic acid malonyl di-deoxyhexoside. Caffeic acid derivatives, such as caffeic acid hexosides, were the major components of pulp, followed by vanillic acid derivatives and O-caffeoylquinic acid. Both extracts displayed promising antioxidant capacities in all methods used, namely the 2,2-diphenyl-1-picrylhydrazyl radical-scavenging, the reducing power, the inhibition of β-carotene bleaching assays, the thiobarbituric acid reactive substances assay and the oxidative haemolysis inhibition assay; however, the peel presented significantly lower IC50 values than pulp. The extracts showed practically identical antibacterial capacities, being effective against methicillin-sensitive Staphylococcus aureus (MICs = 2.5 mg/mL), besides methicillin-resistant S. aureus, Escherichia coli and Morganella morganii (MICs = 5 mg/mL). The obtained results evidence that the fig peel is superior to the corresponding pulp as it relates to nutritional and phenolic profiles as well as bioactivities, endorsing the urgency in valorising and exploiting this usually discarded industrial by-product.


Backbone resonance assignment of the HEAT1-domain of the human eukaryotic translation initiation factor 4GI.
Controlling translation during protein synthesis is crucial for cell proliferation and differentiation. Protein translation is orchestrated by an assembly of various protein components at the ribosomal subunits. The eukaryotic translation initiation factor 4G (eIF4G) plays an important role in the formation of the translation initiation complex eIF4F consisting of eIF4G, the ATP dependent RNA helicase eIF4A and the cap binding protein eIF4E. One of the functions of eIF4G is the enhancement of the activity of eIF4A facilitated mainly through binding to the HEAT1 domain of eIF4G. In order to understand the interaction of HEAT1 with eIF4A and other components during translation initiation backbone assignment is essential. Here we report the (1)H, (13)C and (15)N backbone assignment for the HEAT1 domain of human eIF4G isoform I (eIF4GI-HEAT1), the first of three HEAT domains of eIF4G (29 kDa) as a basis for the elucidation of its structure and interactions with its binding partners, necessary for understanding the mechanism of its biological function.


Measuring hope: psychometric properties of the children's Hope Scale among South Sudanese refugee children.
We investigated the psychometric properties of the Children's Hope Scale among a sample of 1,118 South Sudanese refugee children (570 girls, 548 boys) aged 9 to 14 years displaced in Uganda. We assessed the underlying factor structure and model fit through exploratory and confirmatory factor analyses and measurement invariance by sex and developmental stage. Confirmatory factor analysis revealed good fit for a one-factor model with the error terms of items 1 and 3 and items 4 and 6 allowed to covary. There was no evidence of differential item functioning by group. Evidence from this study supports the use of a unidimensional model of hopefulness across groups and signifies the importance of confirming these properties for measures used to evaluate humanitarian interventions.


Childbearing and the risk of bladder cancer: a nationwide population-based cohort study.
The incidence of bladder cancer (BCa) is substantially lower in women than in men, a difference that cannot be fully explained by established risk factors. Several studies suggest that hormonal and reproductive factors play a role in the development of BCa. To examine possible associations between patterns of childbearing and the risk of BCa. This cohort study encompassed >2 million women for whom information on reproductive history and BCa incidence was retrieved from Swedish population-based registers. Incidence rate ratios (IRRs) of BCa were estimated using Cox proportional hazards modelling. The exposures under investigation were parity and age at first birth, adjusted for education and history of chronic obstructive lung disease (COLD). Among 2 009 811 women in the cohort, 2860 incident cases of BCa were identified. Parous women had lower incidence of BCa compared with nulliparous women (adjusted IRR: 0.80; 95% confidence interval [CI], 0.72-0.89). Moreover, the incidence was 15% lower in women with two children and 24% lower in women with three or more children compared with uniparous women. Compared with women aged 20-24 at first childbirth, the incidence was elevated in women with a first birth before age 20 (adjusted IRR: 1.16; 95% CI, 1.05-1.29). The risk of BCa was elevated in women with low education and among women with a history of COLD. Absence of data on menstrual history, use of exogenous hormones, and smoking was a limitation of the study. The incidence of BCa decreased with increasing parity and older age at first birth. Although smoking habits may partly explain some of the associations, our findings provide support for yet-to-be-identified protective mechanisms associated with childbearing, possibly mediated by hormonal or structural changes following pregnancy.


[Use of Eductyl(®) suppository for rectal preparation before prostate biopsy: an observational survey].
Local preparation of rectum governs the possibly survenue of complications during transrectal ultrasound guided biopsies of prostate. To determine the efficacy and acceptability of rectal preparation (Eductyl(®) suppository) in patients undergoing a transrectal prostate biopsy. From May to August 2005, eight urologists (Bel-Air Urological Center, Bordeaux) included 137 patients (mean age 66.4 years) with an indication of prostate biopsies. All patients were administrated prophylactic antibiotic therapy. They used Eductyl(®) effervescent suppositories for local preparation, the day before and/or the morning of the exam. Rectal vacuity was satisfactory or very satisfactory for 99% of patients. Introduction of probe and tracking of prostate were easy or very easy in 99% of cases. Eight days after the exam, only 35% of patients had suffered anal or rectal pain during a mean of 2 days. Most of patients recovered bowel function without requiring treatment and without any difficulty or pain. The bowel function recovery occurred the day of prostate biopsy and the day after for 28.4% and 62.2% of patients, respectively. Urologists considered that the use of Eductyl(®) suppositories before prostate biopsies ensured a satisfactory rectal preparation and optimal conditions for the exam. Moreover, this preparation was well accepted by patients.


Correlation and causality between carbon and energy markets: a complexity perspective.
Global warming obliges humans to focus on the relationships between carbon and energy markets. This study considers the relationship between carbon and energy markets from a complexity perspective. Chinese carbon prices and four energy indexes are selected as empirical variables. First, the complexities of carbon and energy markets are measured by multi-scale fuzzy entropy. The critical time delay of the series is then obtained by maximizing the Pearson coefficients between these markets. Further, analysis of the detrended cross-correlation coefficient confirms the existence of time delay. Finally, transfer entropy is applied to investigate the causality pertaining to dynamic complexity. Results of fuzzy entropy analysis reveal that the carbon market has lower complexity than energy markets. Meanwhile, multi-scale results indicate greater complexity on the small time scales in all markets than on the large time scales. The critical time delay is found to be about 50, which maximizes the correlation coefficient. Finally, causality between carbon and energy markets varies. Expectations in the carbon market impact oil gas and coal markets; electricity and new energy affect the carbon market; and cross-causality exists in the relationship between coal and carbon markets. The participants should focus on the information transmission between carbon and energy markets.


Prediction of sustained virologic responses to combination therapy of pegylated interferon-α and ribavirin in patients with chronic hepatitis C infection.
Hepatitis C virus (HCV) infection is a major health problem worldwide. Genotype-4 is the most common genotype in Saudi Arabia. The response to treatment with pegylated interferon-α combined with ribavirin in chronic HCV infection varies. This study aimed at investigating the pre- and on-treatment predictors of sustained virologic response (SVR) in patients with chronic hepatitis C (CHC) infection. Clinical data of 48 patients with CHC treated with standard HCV antiviral combination therapy, between January 2005 and December 2010, at a Saudi University hospital, were retrospectively reviewed for age, sex, body mass index, liver enzymes, HCV-RNA viral load, liver biopsy, and response to treatment. The primary end point was SVR defined as undetectable HCV-RNA by polymerase chain reaction (PCR) 24 weeks after the end of treatment. Univariable logistic regression was used to explore the association between the different variables and SVR. These independent predictors of SVR were then analyzed with multivariable logistic regression analysis. Of the 48 treated patients, 25 (52%) were females and 27 (56%) were Saudi. The mean age was 43 years (43 ± 10 years). Twenty-four (50%) had genotype-4, and 26 (54%) had liver biopsy. The overall SVR rate was 75% (36/48) and was 83.3% (20/24) among genotype-4 patients. Baseline factors associated with SVR identified by univariate logistic regression were genotype-4 and early viral response (EVR), defined as a drop of ≥2 log in serum HCV viral load after 12 weeks of initiation of combination therapy (P = 0.001). However, in stepwise regression analysis, the independent factor associated with the effect of antiviral therapy was genotype-4. When on-treatment variables were included, EVR (P = 0.003) and low baseline viral load (P = 0.048) were highly predictive of SVR. Of our HCV-treated patients, 75% had SVR. HCV genotype-4, EVR, and low baseline viral load were predictive of SVR.


The age-specific differences in histopathological tumor characteristics and TNM classification of breast carcinomas in Quality assured mamma diagnostic (QuaMaDi) program in the state of Schleswig-Holstein in Germany.
We explored the hypothesis that high-quality standards in diagnostic mammography can lead to an early diagnosis of breast cancers and identifies at risk populations outside screening programs. The histopathological features and distribution of the TNM classification were examined in relation to patient age in a large group of women with breast cancers participating in the Quality Assured Mamma Diagnostic (QuaMaDi) program of the state of Schleswig-Holstein. Surgical pathological reports were studied for clinicopathological characteristics, receptor status, molecular subtype and tumor stage. The analysis was conducted by dividing the study population into three age groups: women under 50 years (pre-screening), 50-69 years (peri-screening) and over 70 years (post-screening). 7.111 biopsies and 2.887 resection specimens were included. Breast cancer was diagnosed in 4.241 (59.7%) cases, one fourth of them in women < 50 years. Elderly women (> 70 years) had more well-differentiated, estrogen receptor (ER)-positive and HER2-negative carcinomas, whereas younger women (< 50 years) tended to have more poorly differentiated, ER negative, and HER2-positive carcinomas. 47% of breast carcinoma were luminal B tumors and were most common regardless of age. 70.4% of resected specimen had pT1 stage. Nodal negative were 71.2%. In QuaMaDi breast cancer was diagnosed at an early and potentially curable stage of the disease due to high-quality standards in diagnostic mammography. In addition, regardless of age, an increased number of prognostically unfavorable molecular subtypes were detected. Thus, QuaMaDi helps to identify at risk populations. QuaMaDi significantly improves diagnostic mammography and complements mammography screening programs.


Selective attention in anxiety: distraction and enhancement in visual search.
According to cognitive models of anxiety, anxiety patients exhibit an attentional bias towards threat, manifested as greater distractibility by threat stimuli and enhanced detection of them. Both phenomena were studied in two experiments, using a modified visual search task, in which participants were asked to find single target words (GAD-related, speech-related, neutral, or positive) hidden in matrices made up of distractor words (also GAD-related, speech-related, neutral, or positive). Generalized anxiety disorder (GAD) patients, social phobia (SP) patients afraid of giving speeches, and healthy controls participated in the visual search task. GAD patients were slowed by GAD-related distractor words but did not show statistically reliable evidence of enhanced detection of GAD-related target words. SP patients showed neither distraction nor enhancement effects. These results extend previous findings of attentional biases observed with other experimental paradigms.


Evidence of surfactant deficiency in persistence of the fetal circulation.
The phospholipids of tracheal aspirates in persistence of the fetal circulation (PFC) were compared to those in the respiratory distress syndrome (RDS) and those in other severe diseases of the newborn. The infants with PFC were hypoxemic despite 80 to 100% inspiratory oxygen. There were small, if any, pulmonary parenchymal changes in radiographs. Echocardiograms demonstrated evidence of increased pulmonary arterial pressure. Mechanical ventilation increased arterial oxygen tension in each case. However, five of the eight patients required ventilation at a high frequency (57-65 min) and long inspiratory time (0.6--0.7 s). The phospholipids in tracheal aspirates in PFC were quite similar to those in RDS, namely there was a small amount, if any, phosphatidylglycerol (PG), and the lecithin/sphingomyelin (L/S) ratio was low. However, phosphatidylinositol was higher in PFC than in RDS. In the other diseases studied, the phospholipid composition resembled that of the normal newborn, namely PG was present and the L/S ratio was high. Surfactant deficiency seems to be important in the pathogenesis of some cases of PFC. The favorable effect of mechanical ventilation may be partly due to the stabilization of peripheral airways.


Comparison of clear corneal phacoemulsification combined with 25-gauge transconjunctival sutureless vitrectomy and standard 20-gauge vitrectomy for patients with cataract and vitreoretinal diseases.
To compare effectiveness and outcomes of clear corneal phacoemulsification combined with 25-gauge transconjunctival sutureless vitrectomy and standard 20-gauge vitrectomy system for patients with clinically significant cataract and vitreoretinal diseases. Department of Ophthalmology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China. Clear corneal phacoemulsification combined with 25-gauge transconjunctival sutureless vitrectomy was performed in the study group (15 eyes). Patients in the control group (15 eyes) had combined surgery with clear corneal phacoemulsification and the existing 20-gauge vitrectomy system, providing a comparison between 2 groups with regard to preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure, and intraoperative and postoperative complications. The additional outcome measurements in both groups were duration of the surgical procedures, time to return to preoperative corneal clarity, time to achieve stable vision, and subjective ocular irritation postoperatively. Postoperatively, BCVA improved in 12 eyes (80%) in the study group and in 11 eyes (73.3%) in the control group. Mean operative time for opening and closing the sclerotomy was significantly greater in the control group than in the study group. Time to return to preoperative corneal clarity and time to achieve stable vision showed no significant difference between the groups. Compared with the control group, postoperative ocular irritation in patients in the study group was considerably reduced. Combined sutureless surgery needed shorter setup time for sclerotomy and caused less postoperative ocular irritation than combined surgery with 20-gauge vitrectomy. Therefore, this type of procedure would be a good option for selected cases with cataract and vitreoretinal diseases.


Towards solving enigmas in electrical injury.
The paper by Park and colleagues in the previous issue of Critical Care highlights vascular changes in electrical injury and finds them to be relatively long-lasting and significant. This finding is consistent with long-lasting disability seen clinically in electrically injured patients. Furthermore, the authors report that the changes seen in the shocked part of the body are accompanied by similar changes that are measurable in other parts of the body but that are not involved with electric current. This latter finding is of significant importance. A psychological syndrome - consistent and predictable - exists following an electrical injury. The causation is enigmatic. Recent psychiatric research indicates the importance of circulating cortisol and brain-derived neurotrophic factor (BDNF), which causes loss of hippocampal volume, in the genesis of depression. This psychiatric research has stimulated a speculative theory of the genesis of the psychological effects of electric shock. The paper by Park and colleagues is circumstantial support for the possibility that such a process is real and available.


Asthma mortality rate in Swedish children and young adults 1973-88.
To investigate the asthma mortality rate in Sweden for the period 1973-88, we reviewed all death certificates for suspected death from asthma coded as 493 of the International Classification of Diseases (ICD)-8 and ICD-9 for the age group 1-24 years. Age-related mortality rates were calculated and compared with the results from a previous Swedish study of 1952-72. To identify factors contributing to death, we assessed hospital records. The mortality rate was 3.46 for the period 1973-88 and 3.31 for the earlier period, a net increase of 5%. This small overall increase includes a minor decrease in deaths for the age group 1-14 years and a rather pronounced increase for 15-24-year-old asthmatic patients. More deaths among "mild" asthmatic patients were found in the higher age group for 1986-8 than 1973-81. In younger children, asthma was more severe, and no difference was found between the two periods of the study. Asthma mortality is increasing in Sweden in adolescents and young adults, and there is a tendency to increasing mortality from less severe asthma not treated with anti-inflammatory drugs.


Correction: Wnt11 Is Required for Oriented Migration of Dermogenic Progenitor Cells from the Dorsomedial Lip of the Avian Dermomyotome.
[This corrects the article DOI: 10.1371/journal.pone.0092679.].


A tsunamigenic delta collapse and its associated tsunami deposits in and around Lake Sils, Switzerland.
Large lacustrine mass movements and delta collapses are increasingly being considered as potential tsunamigenic sources and therefore hazardous for the population and infrastructure along lakeshores. Although historical reports document tsunami events in several lakes in Switzerland, and although the propagation of lake tsunamis has been studied by numerical wave modeling, only little is known about on- and offshore lacustrine tsunami deposits. In Lake Sils, Switzerland, a large prehistoric mass-movement deposit originating from the Isola Delta with a minimum estimated volume of 6.5 × 106 m3 and a basinal thickness of > 6 m in the seismic record has been identified by previous studies and radiocarbon dated to around 700 Common Era. Here, we combine (i) comprehensive sedimentological investigation of sediment cores recovered from the on- and offshore settings, (ii) mineralogical fingerprinting of the inflows from key catchments to characterize sediment provenance, and (iii) numerical tsunami modeling, to test the hypothesis of a tsunamigenic delta collapse in Lake Sils. We observe a clastic event deposit consisting of coarse-grained, fining-upward sand overlying an organic-rich peat deposit in the shallow water. This layer thins and fines landward on the coastal plain. Toward the deeper water (20-40 m), the deposit transforms into a thicker and more heterogeneous sediment package with multiple sequences of fining-upward sand and a well-pronounced clay cap at the top. Radiocarbon dating of the peat underlying the event deposit yields a maximum age of 225-419 calibrated Common Era. The tsunami models, which indicate wave heights reaching up to 5 m, simulate areas of inundation that coincide with the location of event deposits. Based on our results, we propose that the historically undocumented Isola Delta collapse generated a basin-wide tsunami that inundated the lakeshore, transporting large amounts of unconsolidated sediment along the lakeshore toward the coastal plain and into the deeper lake basin. The online version of this article (10.1007/s11069-021-04533-y) contains supplementary material, which is available to authorized users.


Transcriptomic profiling of nitrogen fixation and the role of NifA in Methylomicrobium buryatense 5GB1.
Methanotrophs capable of converting C1-based substrates play an important role in the global carbon cycle. As one of the essential macronutrient components in the medium, the uptake of nitrogen sources severely regulates the cell's metabolism. Although the feasibility of utilizing nitrogen gas (N2) by methanotrophs has been predicted, the mechanism remains unclear. Herein, the regulation of nitrogen fixation by an essential nitrogen-fixing regulator (NifA) was explored based on transcriptomic analyses of Methylomicrobium buryatense 5GB1. A deletion mutant of the nitrogen global regulator NifA was constructed, and the growth of M. buryatense 5GB1ΔnifA exhibited significant growth inhibition compared with wild-type strain after the depletion of nitrate source in the medium. Our transcriptome analyses elucidated that 22.0% of the genome was affected in expression by NifA in M. buryatense 5GB1. Besides genes associated with nitrogen assimilation such as nitrogenase structural genes, genes related to cofactor biosynthesis, electron transport, and post-transcriptional modification were significantly upregulated in the presence of NifA to enhance N2 fixation; other genes related to carbon metabolism, energy metabolism, membrane transport, and cell motility were strongly modulated by NifA to facilitate cell metabolisms. This study not only lays a comprehensive understanding of the physiological characteristics and nitrogen metabolism of methanotrophs, but also provides a potentially efficient strategy to achieve carbon and nitrogen co-utilization.Key points• N2 fixation ability of M. buryatense 5GB1 was demonstrated for the first time in experiments by regulating the supply of N2.• NifA positively regulates nif-related genes to facilitate the uptake of N2 in M. buryatense 5GB1.• NifA regulates a broad range of cellular functions beyond nif genes in M. buryatense 5GB1.


Is the language of intentional psychology an efficient tool for evolutionists?
The language of intentional psychology is commonly used as a means of addressing issues concerning selection. This habit is generally considered an efficient shorthand, but oft-reported misunderstandings leave room for doubt. I stress the general point that efficiency of a mode of expression is an empirical matter, deserving the same treatment, theoretically and methodologically, as other such matters. Mistaken assumptions regarding the relevant cognitive capacities may make for inefficient communication, and discourse about human evolution is a plausible case in point.


Phosphatase-independent functions of SHP2 and its regulation by small molecule compounds.
SHP2 is a non-receptor protein tyrosine phosphatase encoded by the PTPN11 gene in human. Clinically, SHP2 has been identified as a causal factor of several diseases, such as Noonan syndrome, LEOPARD syndrome as well as myeloid malignancies. Interestingly, both loss-of-function and gain-of-function mutations occur in the PTPN11 gene. Analyses by biochemical and cell biological means as well as probing with small molecule compounds have demonstrated that SHP2 has both phosphatase-dependent and independent functions. In comparison with its phosphatase activity, the non-phosphatase-like function of SHP2 has not been well introduced or summarized. This review mainly focuses on the phosphatase-independent functions and its regulation by small molecule compounds as well as their use for disease therapy.


Microfluidic technologies in tumour metabolism.
The tumour microenvironment presents many challenges in the development and evaluation of new anti-cancer therapeutics. Enhanced understanding of the unique metabolic characteristics of cancer cells could provide valuable knowledge to develop broad-spectrum anti-neoplastic agents with reduced systemic toxicity. However, a major limitation is the lack of physiological relevance of many conventional in vitro models. Emerging microfluidic platform technologies, hold the potential of recapitulating the physiological and pathological features of the tumour microenvironment, thus increasing the relevance of pre-clinical experimental data. With precise manipulation of physical and chemical properties, the microfluidic based, tumour-on-chip authentically replicates the tumour growth environment, potentially helping accelerate the pre-clinical screening of novel anti-tumour drug combinations. Additionally, nanoscale vehicles produced using microfluidic technologies, offer an emerging solution to modulate the hydrophilicity and release kinetics of drugs that in the free state exhibit challenging pharmacokinetics. This article will review the current state-of-the-art in this space and outline important challenges that are yet to be overcome.


Advanced POEMS syndrome treated with high-dose melphalan followed by autologous blood stem cell transplantation: a single-center experience.
POEMS syndrome is a rare paraneoplastic syndrome associated with plasma cell dyscrasia. High-dose chemotherapy followed by autologous stem cell transplantation has shown encouraging efficacy in the treatment of patients with POEMS syndrome. However, there are minimal reports on clinical outcomes after autologous stem cell transplantation for patients with advanced disease and very poor performance status. We retrospectively evaluated 9 advanced POEMS syndrome patients, who had an Eastern Cooperative Oncology Group performance status score of 3 or 4, and were treated with high-dose melphalan therapy followed by autologous stem cell transplantation from 2004 to 2011. Eight patients achieved initial hematologic response, 4 of whom had complete responses. At a median follow-up of 44 months (range, 8-94 months), 7 patients were alive, with 3-year overall survival rate of 77.8%. There were no hematologic relapses in the survivors. One patient died of disease progression; the other died of pneumonia despite a hematologic response 3 months after autologous stem cell transplantation. All survivors achieved improvement in general performance status and in clinical response. High-dose melphalan followed by autologous stem cell transplantation can be considered a valid treatment option even for patients with advanced POEMS syndrome.


Protection of rats spinal cord ischemia-reperfusion injury by inhibition of MiR-497 on inflammation and apoptosis: Possible role in pediatrics.
MicroRNAs are extensively included in the pathogenesis and progression of many diseases by inhibiting target gene expression. Recently, studies have demonstrated that microRNA-497 (miR-497) may be implicated in human breast cancer that miR-497 predicts the prognosis of breast cancer patients from the posttranscriptional level. However, the specific function of miR-497 in spinal cord ischemia-reperfusion (IR) injury is far from clear nowadays. The present study was designed to determine the role of miR-497 in spinal cord IR injury and investigate the underlying spinal cord protective mechanism. The rat spinal cord IR injury model was performed by occluding the left anterior descending coronary artery for 30 min, which is then followed by 12h reperfusion. As predicted, miR-497 over-expression markedly decreased the expression of IL-1 receptor associated kinase (IRAK1) and Cyclic AMP response element binding protein (CREB). Moreover, Toll-like receptor 4 (TLR4), nuclear factor-kappa B (NF-κB) and Caspase-3, as miR-497 potential targets were significantly suppressed after miR-497 transfection, then preventing inflammatory cytokines and factors regulating apoptosis. We also found that tumor necrosis factor-a (TNF-α) and interleukin-1beta (IL-1β) activity, pro-apoptotic related genes, such as extracellular regulated protein kinases (ERK), Bcl-2 Associated X Protein (Bax), Bcl-2, Bcl-xL levels were all decreased associated with the down-regulation of IRAK1 and CREB. In conclusion, our data demonstrate that miR-497 could inhibit inflammation and apoptosis of spinal cord IR through its targets, IRAK1 of TLR4 and CREB signaling pathway. Thus, miR-497 may constitute a new therapeutic target for the prevention of spinal cord IR injury.


Comparison of the methylation patterns of the two rat insulin genes.
We have investigated whether DNA methylation is involved in regulating the expression of the rat insulin genes. We studied cytosine methylation in and near the two insulin genes to examine the correlation of site-specific methylation with expression in different tissues and to compare the demethylation patterns of the two genes. For both genes, we found certain sites undermethylated only in insulin-producing tissues. However, the overall patterns of the two genes in expressing tissues are quite different. The insulin I gene is significantly less methylated than the insulin II gene in a tumor that makes equal amounts of the two insulin RNAs. In another tumor and cell line that make 5-fold higher levels of insulin I RNA than insulin II RNA, the changes in the methylation levels of the two genes do not correlate with the increased expression of insulin I. In nonexpressing tissues, the insulin I gene is completely methylated, while the insulin II gene is demethylated at a number of sites. Thus, the general level of methylation of the insulin genes does not correlate with their differential expression. Furthermore, the methylation at specific sites does not correlate either; some CG dinucleotides that appear to be important for one gene are not present in the other. Our results suggest that there is no specific control by methylation of the expression of the insulin genes in the rat.


Prognostic and Clinicopathological Significance of the Aberrant Expression of β-Catenin in Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.
This systematic review and meta-analysis aims to evaluate the prognostic and clinicopathological significance of the aberrant expression of β-catenin (assessed through the immunohistochemical loss of membrane expression, cytoplasmic and nuclear expression) in oral squamous cell carcinoma (OSCC). We searched for primary-level studies published before October-2021 through PubMed, Embase, Web of Science, Scopus, and Google Scholar, with no limitation in regard to their publication date or language. We evaluated the methodological quality and risk of bias of the studies included using the QUIPS tool, carried out meta-analyses, explored heterogeneity and their sources across subgroups and meta-regression, and conducted sensitivity and small-study effects analyses. Forty-one studies (2746 patients) met inclusion criteria. The aberrant immunohistochemical expression of β-catenin was statistically associated with poor overall survival (HR = 1.77, 95% CI = 1.20-2.60, p = 0.004), disease-free survival (HR = 2.44, 95% CI = 1.10-5.50, p = 0.03), N+ status (OR = 2.39, 95% CI = 1.68-3.40, p < 0.001), higher clinical stage (OR = 2.40, 95% CI = 1.58-3.63, p < 0.001), higher tumour size (OR = 1.76, 95% CI = 1.23-2.53, p = 0.004), and moderately-poorly differentiated OSCC (OR = 1.57, 95% CI = 1.09-2.25, p = 0.02). The loss of β-catenin in the cell membrane showed the largest effect size in most of meta-analyses (singularly for poor overall survival [HR = 2.37, 95% CI = 1.55-3.62, p < 0.001], N+ status [OR = 3.44, 95% CI = 2.40-4.93, p < 0.001] and higher clinical stage [OR = 2.51, 95% CI = 1.17-5.35, p = 0.02]). In conclusion, our findings indicate that immunohistochemical assessment of the aberrant expression of β-catenin could be incorporated as an additional and complementary routine prognostic biomarker for the assessment of patients with OSCC.


Abnormal platelet 5-hydroxytryptamine uptake and imipramine binding in postnatal dysphoria.
Platelet 14C-5-hydroxytryptamine (14C-5-HT) uptake, 3H-imipramine binding and monoamine oxidase (MAO) activity were measured in women 5 days postpartum and compared with depression scores (Edinburgh Postnatal Depression Scale) at that time and 6 weeks later. Mean Km of 14C-5-HT uptake was significantly reduced in the group showing dysphoria at 5 days (p less than 0.01). Mean Kd of 3H-imipramine binding was significantly increased in the group who later went on to become depressed at 6 weeks postpartum (p less than 0.03). Vmax for 14C-5-HT uptake, Bmax for 3H-imipramine binding and MAO activity did not differ between depressed and non-depressed patients on either occasion. Although the observed changes manifested in a system known to be disturbed in other forms of depression, they were in affinity rather than Bmax or Vmax. Even though probably not of direct physiological significance, such results, if confirmed, together with other pointers in the literature, suggest biochemical abnormalities specific to the puerperal period.


Modified neck dissection in treatment of thyroid cancer: a safe procedure.
Differentiated carcinoma of the thyroid metastasizes early and frequently to cervical lymph nodes. Radical neck dissection performed electively or therapeutically results in high cure rates. Modified neck dissection consisting of a single transverse incision, resection of the jugular chain of nodes and those in the posterior triangle of the neck with preservation of the sternomastoid muscle, the spinal accessory nerve and the submandibular salivary gland provides a cosmetic, functional result with minimal morbidity. In a series of 313 neck dissections for thyroid carcinoma, only three patients with papillary or follicular carcinoma, which was resectable, treated by thyroidectomy and modified neck dissection died of disease.


Novel neuropeptides in the control of food intake: neuronostatin and nesfatin-1.
Food intake is a complex, multifaceted process that involves the integration of numerous nutritional signals and behavioral outputs. Dozens of centrally acting peptide hormones that contribute to the control of appetite and food intake have been identified. Two recently described peptide hormones, neuronostatin and nesfatin-1, both act in the brain to induce anorexia, albeit through potentially different mechanisms. In this chapter, the central circuits mediating the anorexigenic effect of these two hormones, their interaction with the central melanocortin and oxytocin systems, and the physiological relevance of these hormones in appetite control are described and an integrated model of hypothalamic control of energy intake is presented.


High Rates of Undiagnosed Psychological Distress Exist in a Referral Population for Spinal Cord Stimulation in the Management of Chronic Pain.
Neuropathic pain affects various dimensions of patient health including physical, psychological, and socioeconomic. The spectrum of psychological dysfunction that accompanies this pain phenotype is unknown, as well as differences based on the etiology of the pain among patients referred for spinal cord stimulation (SCS). We prospectively assessed SCS referral patients with neuropathic pain for features of psychological distress, either mood or anxiety. Demographic data included age, gender, diagnosis, marital status, and educational level. Screening tools were applied for neuropathic pain (Douleur Neuropathic Quatre and Leeds Assessment of Neuropathic Symptoms and Signs) and psychological distress (Beck Depression Inventory [BDI] and Beck Anxiety Inventory [BAI]). Descriptive statistics defined disease prevalence, compared by gender and diagnosis. Logistic regression correlated pain intensity with severity of psychopathology. Among 150 patients with suitable neuropathic pain diagnoses and no treatable structural pathology, 57% were women, median age was 54 years, and 35% and 42% admitted to routine smoking and alcohol use, respectively. The most common diagnoses were complex regional pain syndrome (46%) and failed back surgery syndrome (38%). Depression symptoms were screened positive by BDI in 63% of patients, and anxiety symptoms were screened positive by BAI in 23% of patients. Pain intensity correlated with BDI scores (p < 0.02) but not BAI scores (p = 0.43). The high frequency of depressive and anxiety symptoms screened by the Beck scores in this cohort is an order of magnitude higher than seen in the general population. That many of these cases are undiagnosed should motivate clinicians from primary care providers, comprehensive pain specialists, and surgeons to screen SCS patients for such psychopathology. This represents an opportunity to enhance overall pain management as well as success with invasive neuromodulation strategies.


Accidental injection of 2% chlorhexidine gluconate instead of an anesthetic agent: A case report.
We report a case where 2% chlorhexidine (CHX) gluconate was mistaken for an anesthetic solution and infiltrated into the buccal vestibule during routine root canal treatment. Accidentally, 2% CHX gluconate solution was injected in the right upper buccal vestibule (16) of a 23-year-old male during routine root canal treatment. The patient experienced pain and a burning sensation over the injected area shortly after injection. Swelling with mild extraoral redness over the right cheek area was observed clinically. The patient was immediately administered dexamethasone intramuscularly, and was prescribed antibiotics, analgesics, and antihistamines. The patient complained of a loss of sensation over the right cheek by the 15(th) day. The swelling reduced gradually over a period of 15 days. Reversal of sensation was attained after 35 days.


Eye movement desensitization and reprocessing (EMDR) therapy for posttraumatic stress disorder in adults with serious mental illness within forensic and rehabilitation services: a study protocol for a randomized controlled trial.
Eye movement desensitization and reprocessing (EMDR) is an evidenced-based treatment for posttraumatic stress disorder (PTSD). Forensic mental health services provide assessment and treatment of people with mental illness and a history of criminal offending, or those who are at risk of offending. Forensic mental health services include high, medium, and low-security inpatient settings as well as prison in-reach and community outpatient services. There is a high prevalence of PTSD in forensic settings and posttraumatic experiences can arise in people who violently offend in the context of serious mental illness (SMI). Successful treatment of PTSD may reduce the risk of relapse and improve clinical outcomes for this population. This study aims to assess the efficacy, risk of harm, and acceptability of EMDR within forensic and rehabilitation mental health services, as compared to treatment as usual (routine care). This is a single-blind, randomized controlled trial comparing EMDR therapy to the waiting list (routine care). Adult forensic mental health service users (n = 46) with SMI and meeting the criteria for PTSD will be included in the study. Participants will be randomized after baseline assessment to either treatment as usual plus waiting list for EMDR or to treatment as usual plus EMDR. The EMDR condition comprises nine sessions, around 60 min in length delivered weekly, the first of which is a case conceptualization session. The primary outcomes are clinician and participant-rated symptoms of PTSD, and adverse events. Secondary outcomes include psychotic symptoms, social functioning, level of disability, self-esteem, depressive symptoms, post-trauma cognitions, and broad domains of complex posttraumatic difficulties. A trained assessor blinded to the treatment condition will assess outcomes at baseline, 10 weeks, and 6 months. Additionally, grounded theory qualitative methods will be used to explore participant experience of EMDR for a subset of participants. This study will contribute to the currently limited evidence base for EMDR for PTSD in forensic settings. It is the first randomized clinical trial to assess the efficacy, risk of harm, and acceptability of EMDR for PTSD in people with SMI in either forensic, mental health inpatient, or custodial settings. Australia and New Zealand Clinical Trials Network, ACTRN12618000683235. Registered prospectively on 24 April 2018.


Effects of dietary supplementation of bovine lactoferrin on growth performance, immune function and intestinal health in weaning piglets.
Weaning is a crucial period in the pig's life cycle, which is frequently followed by gastrointestinal (GI) infections, diarrhea and even death. This study focused on the impact of bovine lactoferrin (bLF) supplementation on the intestinal health of weaning piglets. Weaning piglets (Duroc × Landrace × Yorkshire, 23 days) were randomly allocated into four groups, which included negative control group (CON): basic diet; positive control group (ANT): basic diet + 20 mg/kg flavomycin + 100 mg/kg aureomycin; treatment group bLF-A: basic diet + 1 g/kg bLF; treatment group bLF-B: basic diet + 3 g/kg bLF. The result showed that dietary supplementation of bLF can improve growth performance and reduce diarrhea, which exhibits dose-dependency (P < 0.05). Compared with CON group, supplementation with bLF significantly improved immunity, and increased villus height and ratio of villus height/crypt depth at the small intestinal mucosa (P < 0.05). The mRNA expression of claudin-1, occludin and ZO-1 was greatly increased in the ileum of bLF group on days 7 and 14 (P < 0.05). Furthermore, the supplementation of bLF increased the abundance of Lactobacillus and Bifidobacterium and decreased the abundance of Escherichia coli in the cecum on day 7 (P < 0.05). The dietary supplementation of bLF enhanced the growth performance, reduced diarrhea rate in weaning piglets by improving intestinal immunity, morphology and barrier function, balancing intestinal microbiota. And bLF can be a promising feed additive in relieving stress situation of weaning piglets.


Intracisternal IGF-1 gene therapy abrogates kainic acid-induced excitotoxic damage of the rat spinal cord.
Development of alternative therapies for treating functional deficits after different neurological damages is a challenge in neuroscience. Insulin-like growth factor-1 (IGF-1) is a potent neurotrophic factor exerting neuroprotective actions in brain and spinal cord. It is used to prevent or treat injuries of the central nervous system using different administration routes in different animal models. In this study, we evaluated whether intracisternal (IC) route for IGF-1 gene therapy may abrogate or at least reduce the structural and behavioral damages induced by the intraparenchymal injection of kainic acid (KA) into the rat spinal cord. Experimental (Rad-IGF-1) and control (Rad-DsRed-KA) rats were evaluated using a battery of motor and sensory tests before the injection of the recombinant adenovector (day -3), before KA injection (day 0) and at every post-injection (pi) time point (days 1, 2, 3 and 7 pi). Histopathological changes and neuronal and glial counting were assessed. Pretreatment using IC delivery of RAd-IGF-1 improved animal's general condition and motor and sensory functions as compared to Rad-DsRed-KA-injected rats. Besides, IC Rad-IGF-1 therapy abrogated later spinal cord damage and reduced the glial response induced by KA as observed in Rad-DsRed-KA rats. We conclude that the IC route for delivering RAd-IGF-1 prevents KA-induced excitotoxicity in the spinal cord.


Lower genital tract infections in young female juvenile idiopathic arthritis patients.
To evaluate human papillomavirus (HPV), Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections in juvenile idiopathic arthritis (JIA) patients. After exclusion, 33 female adolescent and young JIA patients (ILAR criteria) and 28 healthy controls were selected for this study. Demographic data, gynecological, sexual function, cervical cytology and histological abnormalities were evaluated. JIA clinical/laboratorial parameters and treatment were also assessed. HPV-DNA, CT-DNA and NG-DNA testing in cervical specimens were performed by Hybrid Capture 2 assays. The mean current age was similar in JIA patients and controls (23.3 ± 6.24 vs. 26.1 ± 6.03 years, p = 0.09). The frequencies of sexual intercourse (76% vs. 89%, p = 0.201) and abnormal cervical cytology (24% vs. 11%, p = 0.201) were similar in JIA compared to controls. The higher frequency of HPV infection in JIA patients than controls (30% vs. 11%, p = 0.155) did not reach statistical significance. CT (0% vs. 7%, p = 0.207) and NG infections (0% vs. 4%, p = 0.459) were also alike in both groups. Further evaluation of JIA patients with abnormal and normal cervical cytology showed that the former group had a higher frequency of HPV infection (87% vs. 12%, p = 0.0002) with a low frequency of HPV vaccination (0% vs. 8%, p = 1.0). No differences were evidenced between these two JIA groups regarding demographic data, sexual function and clinical/laboratorial parameters. The frequencies of methotrexate (p = 0.206) and biological agent use (p = 0.238) were similar in both JIA groups. To our knowledge, this was the first study to assess lower genital infections in JIA patients allowing the identification of HPV as main cause of cervical dysplasia. Methotrexate and biological agents do not seem to increase risk of lower genital tract infections in JIA patients.


Non-polio enterovirus disease in the United States, 1971--1975.
Reports to the Center for Disease Control on isolation of non-polio enteroviruses for the years 1971--1975 were analysed. During the 5 year period, enterovirus isolations were reported from 7 075 individuals. 90% of these occurred in the 7 month interval of May--November. Enteroviruses were isolated more frequently from males than females for all age groups in all 5 years. The incidence of reported isolations decreased with increasing age, and an inverse relationship between severity of disease and age was suggested. Clinical diagnoses associated with enteroviral isolations included aseptic meningitis, encephalitis, upper respiratory tract disease, non-specific febrile illness, gastroenteritis, pneumonia and lower respiratory tract disease, exanthem, and enanthem.


Fabrication of monodisperse poly (allyl glycidyl ether-co-divinyl benzene) microspheres and their application in anion-exchange stationary phase.
Micron-sized poly (allyl glycidyl ether-co-divinyl benzene) microspheres were prepared by a seed swelling and polymerization method and applied to prepare anion-exchange stationary phases by direct quaternization. The mono-dispersity, diameters, surface characteristics and porosity of microspheres were measured by scanning electron microscope and nitrogen adsorption-desorption measurements. The anion-exchange stationary phases were characterized by Fourier Transform Infrared Spectrum, Elemental Analysis, Breakthrough Curve, etc. The chromatographic properties of this self-fabricated anion-exchange column were investigated by separating conventional anions and organic weak acids. According to the results, poly (allyl glycidyl ether-co-divinyl benzene) microsphere possesses good compatibility in the whole pH range of 1-14; the presence of epoxy group guarantees the microsphere's superior reaction activity. The prepared poly (allyl glycidyl ether-co-divinyl benzene) microsphere is promising to replace poly (styrene-divinylbenzene) and poly (glycidylmethacrylate-divinylbenzene) and becomes a generation of support for the preparation of anion exchangers.


Labelling monoclonal antibodies with yttrium-90.
Using the cyclic DTPA derivatisation procedure developed by Hnatowich, conditions have been optimised for labelling three tumour-associated monoclonal antibodies with 90Y. High labelling efficiencies (greater than 95%) at modest specific activities (1 mCi/mg) could be routinely obtained. Radiochemical stability of the radiolabelled preparations in vitro was good, but radiolysis resulted in early losses of antibody immunoreactivity.


Pupillary responses as a measure of attitudes about alcoholic beverages.
Pupillary and verbal responses of 39 adult subjects were not significantly associated though mean pupillary responses while viewing slides of a seascape, an automobile accident, and a control slide were significantly different. There was a positive relation between stated dislike of the accident scene and pupillary constriction. Pupillary responses and Bell Alcohol Scale scores correlated--.42.


In vitro and in vivo assays for the activity of Drosha complex.
MicroRNA (miRNA) genes are transcribed into long primary transcripts (pri-miRNAs) that get processed into mature miRNAs of about 22 nt in length by two different ribonuclease (RNase) III enzymes, Drosha and Dicer. Various experimental protocols have been developed and modified for genetic and biochemical analyses for microRNA processing. Here we describe the methods for the analysis of pri-miRNA processing that is mediated by Drosha and its cofactor, DiGeorge Syndrome Critical Region Gene 8 (DGCR8).


Clofibrate retardation of naturally-occurring arteriosclerosis in repeatedly-bred male and female rats.
Repeatedly-bred, male and female Sprague-Dawley rats which develop hyperglycemia, hyperlipidemia, hypertension, and arteriosclerosis spontaneously were killed at sequential time intervals, i.e., when the females had completed 1, 2, 3 and 4 pregnancies. The control breeders received no treatment; the experimental animals were given 113 mg of clofibrate/100 g of b.w., subcutaneously, daily, 5 times per week. Clofibrate-treated breeders manifested reduction in blood pressure and in the incidence and severity of arterial disease characteristic of repeatedly-bred rats. The aortic lesions of the clofibrate-treated breeders showed attenuation of the usual severe ground substance alterations, the degenerative changes in connective tissue elements, e.g., fibrosis and elastosis, and absence of calcification and cartilaginous metaplasia. Clofibrate-treated breeders did not show any unusual elevation in serum enzymes, e.g., CPK, SGOT, SGPT and LDH, or significant reduction of their hyperlipidemia. They manifested a definite reduction in adrenocortical and medullary histopathology and their circulating corticosterone levels were subnormal compared to non-treated breeders. It is suggested that the protective effect of clofibrate was mediated through its ability to block normal adrenal steroidogenic pathways rather than through its antilipemic action.


The effect of pertussis toxin on beta-adrenoceptor responses in isolated cardiac myocytes from noradrenaline-treated guinea-pigs and patients with cardiac failure.
1. A decreased responsiveness to the positive inotropic effects of beta-adrenoceptor agonists is a characteristic of human heart failure. We have investigated the involvement of inhibitory guanine nucleotide binding proteins (G-proteins) in this process using pertussis toxin treatment of isolated cardiac myocytes. 2. Myocytes isolated from failing human myocardium had a reduced maximum contractile response to isoprenaline relative to that for maximally stimulating concentrations of calcium, giving an isoprenaline/calcium ratio of 0.71 +/- 0.06 (n = 7 patients). This was significantly lower than in myocytes from non-failing myocardium, where the isoprenaline/calcium ratio was 1.16 +/- 0.07 (n = 6, P less than 0.001). Responses to high calcium were unchanged. 3. Myocytes were treated with pertussis toxin for 3-5 h at 35 degrees C. Successful inactivation of inhibitory G-proteins by pertussis toxin treatment was indicated by a loss of responsiveness to 10 microM adenosine (in the presence of submaximal isoprenaline). 4. Following pertussis toxin treatment of the myocytes from failing human heart the isoprenaline/calcium ratio increased to 1.43 +/- 0.27 (n = 7, P less than 0.05). Pertussis toxin treatment had no effect upon the maximum calcium contraction. The isoprenaline/calcium ratio in myocytes from non-failing human ventricle was not affected by the toxin treatment (n = 3). These observations support the hypothesis that increased inhibitory G-protein levels or activities contribute to beta-adrenoceptor desensitization in human heart failure. 5. beta-Adrenoceptor desensitization in human heart failure is thought to be secondary to raised noradrenaline levels in these patients. Experiments were repeated on myocytes isolated from hearts of guinea-pigs which had been chronically infused with noradrenaline. The isoprenaline/calcium ratio of these myocytes was reduced below that of myocytes from sham-operated animals (0.65 0.04, n = 6 compared with 0.88 +/- 0.02, n = 7, P<0.001).6. Pertussis toxin treatment (2 h at 35 degrees C) increased the isoprenaline/calcium ratio to 1.02 0.02 (n = 6,P<0.01) in myocytes from noradrenaline-treated guinea-pigs. This effect of pertussis toxin treatment was not seen in myocytes from sham-operated guinea-pig hearts.7. Incubation at 35 degrees C for similar periods in the absence of pertussis toxin also restored the isoprenaline/calcium ratio towards normal in the myocytes from both failing human and noradrenaline-treated guinea-pig hearts, although the effect was significantly smaller than that produced by the toxin. Myocytes kept at room temperature (22 degrees C) showed no such evidence of resensitization over periods up to 6h.8. These observations are consistent with the hypothesis that raised catecholamine levels result in increased inhibitory G-protein levels and functional P-adrenoceptor desensitization in heart failure.


[Development of pain resource nurses: towards a national cooperation protocol].
Improving access to specialized pain management centers for the 20% of French people suffering from chronic pain is a major challenge for our healthcare system. Less than 3% of these people receive appropriate care in one of the Chronic Pain Centers (SDC) in France. The current care offer is therefore not sufficient despite the constant increase in the number of SDC. Recognition of the expertise of Pain Resource Nurses (IRD) working in these structures and the delegation of protocolized activities would be one possible response to improve access to care and the quality of care for chronic pain patients by freeing up medical time for the care of new patients.


Rehabilitation programs for myocardial infarction patients: a national survey.
Considering the evidence in support of the importance of psychologic and social factors in the recovery of myocardial infarction (MI) patients, the authors studied the nationwide prevalence of psychosocial rehabilitation programs for MI patients. Findings from a survey of U. S. hospitals with coronary care units (n = 1628) included widespread involvement of patients and families in inpatient programs, approximately half as many continuing in outpatient programs, limited use of group counseling, and multidisciplinary staffing but counseling by nurses and social workers primarily. The clinical and economic benefits of group-oriented psychosocial rehabilitation programs are discussed. The authors encourage more psychologically informed intervention in the various parts of the patient's life-space and more use of groups.


The Acinetobacter baumannii website (Ab-web): a multidisciplinary knowledge hub, communication platform, and workspace.
Acinetobacter baumannii is a Gram-negative bacterium increasingly implicated in hospital-acquired infections and outbreaks. Effective prevention and control of such infections are commonly challenged by the frequent emergence of multidrug-resistant strains. Here we introduce Ab-web (https://www.acinetobacterbaumannii.no), the first online platform for sharing expertise on A. baumannii. Ab-web is a species-centric knowledge hub, initially with 10 articles organized into two main sections, 'Overview' and 'Topics', and three themes, 'epidemiology', 'antibiotic resistance', and 'virulence'. The 'workspace' section provides a spot for colleagues to collaborate, build, and manage joint projects. Ab-web is a community-driven initiative amenable to constructive feedback and new ideas.


High seroprevalence of antibodies against human respiratory syncytial virus and evidence of respiratory syncytial virus reinfection in young children in Thailand.
To investigate the seroprevalence of respiratory syncytial virus (RSV) infections in young children, the correlation between RSV antibody levels in maternal and cord serum, and to provide evidence of RSV reinfection in Thai children after primary infections. Serum samples were collected from 302 mothers and 291 children between 2015 and 2021. Maternal and cord blood were collected at birth. Serial serum samples of children were collected at the ages of 2, 7, 18, 19, 24, 36, 48, and 60 months and the presence of anti-RSV immunoglobulin G (IgG) was tested using an enzyme-linked immunosorbent assay. The cord: maternal serum antibody ratio was 1.09 (95% confidence interval 1.08-1.11). Although >90% of babies at birth were seropositive through transplacental transfer, antibody levels gradually declined, with the highest seronegative rate (91.9%) at 7 months of age. Subsequently, anti-RSV IgG levels increased with age, most likely due to natural infection. One-third of the children showed evidence of reinfection as determined by seroconversion of anti-RSV IgG or increased titers of at least 50 relative units/ml. Waning of RSV antibodies in infants is rapid, and RSV infection subsequently increases anti-RSV IgG titers. RSV vaccination in children before the age of 7 months should be recommended.


[Study on the distribution of hepatitis C virus genotypes in patients visiting one methadone maintenance clinic in Wuhan].
To study the prevalence of hepatitis C virus (HCV) infection and characteristics on molecular biology related to HCV among patients who were enrolled in a Methadone maintenance clinic in Wuhan. Serum samples from 332 injection drug users (IDUs) were obtained and anti-HCV IgG was detected by enzyme linked immunosorbrent assay(ELISA), together with 86 anti-HCV positive specimens genotyped. A reverse transcriptase-polymerase chain reaction (RT-nPCR) assay using conserved primers deduced from the core-envelopel (C-E1) region of the HCV genome was employed to amplify a 474 bp fragment. Phylogenetic analysis of the C-E1 sequences was conducted by direct sequencing of the RT-nPCR products and alignment with determined by nucleotide sequencing followed by composition of a phylogenetic tree. There were 313 cases (94.3%) appeared positive anti-HCV IgG in the 332 patients from a Methadone maintenance clinic in Wuhan. It was demonstrated that there were four different subtypes of HCV in that clinic in Wuhan, including 6a--71 cases (82.5%), 3b--7 cases (8.2%), 1a--5 cases (5.8%) and 1b--3 cases (3.5%). Infection of 6a genotype HCV was predominant in patients from the Methadone maintenance clinic in Wuhan, followed by HCV 3b, 1a and 1b.


Dynasplint Trismus System exercises for trismus secondary to head and neck cancer: a prospective explorative study.
The Dynasplint Trismus System (DTS) can be used to treat trismus secondary to head and neck cancer. We conducted a prospective study with the following aims: (1) to determine the effects of DTS exercises on changes in mouth opening, pain, mandibular function, quality of life (QoL), and symptomatology and (2) to analyze the patients' perception on DTS exercises, including user satisfaction, experiences, comfort, and compliance. The patients were instructed to exercise with the DTS for at least 16 weeks. Changes in mouth opening, pain, mandibular function, QoL, and symptomatology were evaluated, as well as the patients' perception of DTS exercises. Eighteen consecutive patients were included. Baseline mouth opening was 22.6 mm (sd 7.6). After the patients completed the DTS exercise program, mouth opening increased (7.1 mm, sd 4.7) and perceived difficulty of opening the mouth improved significantly (p < 0.05). No significant effects were found in mandibular function, QoL, and overall symptomatology. The patients' perception was diverse. They reported effectiveness and positive feelings of the results and would recommend DTS exercises to other patients. About half of them thought DTS exercises were burdensome. Mouth opening increased significantly after the DTS exercise program, relative to baseline. About one third of the gained increase was lost in the follow-up period. In general, the patients were satisfied about the effects and the DTS exercise program.


Correction to 'Wald's martingale and the conditional distributions of absorption time in the Moran process'.
[This corrects the article DOI: 10.1098/rspa.2020.0135.].


Metal concentrations in the liver and kidney of aquatic mammals and penguins.
We determined the hepatic and renal concentrations of Cd, Pb, Zn, Cu, and Fe in (1) marine mammals (three bottle-nosed dolphins, six California sea lions, and one sea otter), (2) freshwater and brackish-water mammals (one Oriental short-clawed otter and four European river otters), and (3) sea birds (three rock-hopper penguins, two king penguins, three Humboldt penguins, four Macaroni penguins, and four Magellanic penguins), all of which were kept in a zoo and an aquarium in Japan. We investigated the species-specificity of Cd accumulation in these aquatic animals. We also presented the basic data on metal concentrations. The concentrations of Cd in liver and kidney tended to be higher in marine mammals than in freshwater mammals. Many penguins, sea birds, showed high Cd concentrations. These results suggest that the habits of these animal species may be involved in accumulation of Cd. Pb concentrations were below the detection limit or low in both liver and kidney [not detected (ND) = 0.132 microg/g and ND = 0.183 microg/g, respectively]. The hepatic concentrations of Zn and Cu were high in young animals. In penguins, a positive correlation was found between the Zn and Cd concentrations in the liver and kidney and between the Cu and Cd concentrations in the liver. Individual variation was large in Fe concentration (48-3746 microg/g in the liver and 51-980 microg/g in the kidney).


[Spontaneous esophageal rupture after gastrointestinal examination using barium].
We experienced a case of spontaneous rupture of the esophagus after gastrointestinal examination using barium. A 48-year-old male experienced severe chest pain after vomiting following gastrointestinal examination. Chest X-ray revealed a right pneumothorax and pleural effusion by barium. We diagnosed spontaneous rupture of the esophagus and performed right thoracotomy 6 hours after onset of symptoms. At 10 cm above the diaphragm, there was a vertical perforation 3 cm in length. Following saline lavage, the ruptured esophageal wall was directly closed by the layer to layer method. The post operative course was uneventful and the patient was discharged 3 weeks after surgery. Cases of spontaneous rupture of the esophagus into the right thoracic cavity induced by gastrointestinal examination are extremely rare.


Cobalt-protoporphyrin, a synthetic heme analogue, feminizes hepatic androgen metabolism in the rat.
A single injection of cobalt-protoporphyrin (50 mumol/kg) produced marked changes in the metabolism of 14C-labeled testosterone and 4-androstenedione by male rat liver microsomes and this effect was maintained for at least 3 weeks. The rate of 3 beta- and 5 alpha-reduction was increased to levels observed in untreated adult female animals and cobalt-protoporphyrin altered the metabolic profile of testosterone towards that observed after infusion of growth hormone whereas hypophysectomy produced a more general inhibition of androgen metabolism. The reduction of testosterone or 4-androstenedione by liver microsomes was also increased when cobalt-protoporphyrin (10-30 microM) was added in vitro but a higher concentration (100 microM) led to inhibition of androgen metabolism. The identity of the main androgen metabolites was established by TLC, HPLC and mass spectrometry and the role of 5 alpha-reductase was demonstrated using a specific inhibitor of this enzyme. The possible sites of action of cobalt-protoporphyrin are discussed in relation to its in vivo effects on serum testosterone and LH concentrations.


Antagonism by propranolol of the ganglion stimulant action of 5-hydroxytryptamine.
The effects of racemic propranolol and its constituent isomers were studied on ganglionic stimulation produced in situ by close arterial injection of 5-HT and DMPP to the superior cervical ganglion. Ganglion stimulation was recorded in terms of the resultant contraction of the nictitating membrane. d,l-Propranolol caused a biphasic antagonism of the ganglion stimulant effect of 5-HT. At low doses, 0.5-10 mug, the antagonism was surmountable by increasing the amount of 5-HT. The l-isomer (0.2-4 mug) but not d-propranolol also caused antagonism. At higher doses, 0.1-5 mg, both d,l- and d-propranolol caused a second type of blockade of 5-HT which was not surmountable and resembled that seen with procaine. The ganglion stimulant effects of DMPP and acetylcholine were only antagonised by the higher doses of d- and d,l-propranolol. d,l-Propranolol did not reduce the direct stimulation by 5-HT on the muscle of the nictitating membrane.


Zygomatic arch deformation: an anatomic and clinical study.
Trauma to the zygomatic arch classically leads to 1 of 3 injury patterns: fracture with medial displacement, fracture with posterior telescoping, or explosive burst with lateral displacement. We identified an additional injury pattern whereby the arch undergoes significant bending in the axial plane without fracture. In the anatomical part of the study, computed tomography (CT) scans of patients with arch deformation without fracture were analyzed for location, degree, and type of arch bending. In the clinical part, patients were divided into "arch deformation without fracture" and "arch fracture" groups and their demographic characteristics compared. Three patients from each group, all treated with the Gillies' technique, underwent postoperative CT scanning to compare accuracy of zygoma repair. Bending occurred most commonly in the middle and posterior thirds of the zygomatic arch, with average deformation of 11 degrees . Post-Gillies' repair, average residual arch deformation was 2 degrees . Patients with arch deformation without fracture were significantly younger than those with arch fracture (24 yrs vs 42 yrs, P < .05). Unlike patients with arch fractures, all those with arch bending treated with the Gillies' maneuver had near anatomic zygoma realignment. Zygomatic arch deformation without fracture occurs in 19% of zygoma injuries in our group and is likely elastic in nature. We believe this injury pattern is important clinically as it may decrease the need for coronal exposure, facilitate anatomic repair, and provide stability without hardware fixation.


Disposition of fleroxacin, a new trifluoroquinolone, and its metabolites. Pharmacokinetics in renal failure and influence of haemodialysis.
The pharmacokinetics of fleroxacin and its metabolites following a single oral dose of fleroxacin 400mg were examined in 6 healthy subjects and 24 patients with various degrees of renal insufficiency. Plasma and urine samples, collected at various times after administration, were assayed by high performance liquid chromatography (HPLC). In healthy subjects, Cmax was 6.8 +/- 0.7 mg/L; tmax = about 1h, t1/2 = 14 +/- 2h, total clearance = 4.86 +/- 0.72 L/h and the percentage of unchanged fleroxacin excreted in urine in 48 hours was 48 +/- 4% (HPLC). Plasma concentrations of metabolites were very low and accounted for no more than 5% of the levels of unchanged fleroxacin. In uraemic patients Cmax did not change, whatever the degree of renal failure; tmax was increased in patients with a glomerular filtration rate below 0.6 L/h, and Vd/f was independent of the severity of renal failure. These data suggest that bioavailability of the drug is unchanged. In uraemic patients t1/2 was prolonged and AUC multiplied by a factor of 2 to 3. A linear relationship was found between total and renal clearances of fleroxacin and creatinine clearance. Accumulation of N-demethyl-fleroxacin and N-oxide-fleroxacin was very high in uraemic patients, due to slow formation of these metabolites and decreased urinary elimination. Dialysance of fleroxacin and of its metabolites was approximately 3.6 to 4.8 L/h. These findings suggest that fleroxacin dosage may need to be reduced in patients with severe renal disease; in haemodialysed patients, treated every 2 days, a single dose of fleroxacin 400mg is recommended at the end of each dialysis session.


Liposome-mediated insertion of intact DNA into isolated nuclei. Potential for a new in vitro transcription system.
DNA molecules sequestered within negatively charged liposomes became nuclei-associated following interaction between isolated mouse plasmacytoma nuclei and liposomes. Few if any liposomes appeared to adhere to washed nuclei following their interaction with liposomes, suggesting that DNA was internalized. Liposome-delivered, radioactive pBR322 DNA re-extracted from nuclei appeared intact, whereas DNA from nuclei incubated with naked DNA was degraded. Up to 2 X 10(10) D of DNA were inserted into each nucleus. DNA delivered into nuclei via liposome was transcribed as shown by the fact that about 1% of the RNA synthesized in nuclei injected with pBR322 or E. coli DNA hybridized with moderate excess of homologous DNA. pBR322-specific RNA synthesized in isolated nuclei consisted of large MW transcripts. Experiments in which SV40 DNA and pBR322 DNA were delivered simultaneously in equimolar amounts into nuclei indicated that SV40 DNA was transcribed as efficiently as pBR322 DNA.


Predictive genetic testing: high risk expectations in the face of low risk information.
The aims of this cross-sectional, questionnaire study were (1) to estimate the proportion of those receiving negative ("low risk") results following predictive genetic testing who expect to undergo clinically unnecessary future screening and (2) to examine the factors associated with this expectation. Of 127 adults receiving negative results following predictive genetic testing for familial adenomatous polyposis (FAP), 54 people (42%) were expected to attend for future bowel screening. The main predictor was doubt about the accuracy of genetic test results. Expecting to attend was also associated univariately with perceiving the chance of developing FAP as higher, being more worried about this, perceiving the test result to be more uncertain and threatening, and holding a behavioral model of the cause of FAP. Attendance for health screening may be influenced by people's perception of the accuracy of genetic tests that they have undergone. Future research should investigate test presentation and influences on test perception.


Postprocedural Troponin Elevation and Mortality After Transcatheter Aortic Valve Implantation.
Background This study sought to investigate the role of postprocedural troponin elevations in mortality prediction after transcatheter aortic valve implantation and to define the threshold at which clinically relevant postprocedure myocardial injury determines mortality. Methods and Results A total of 1333 consecutive patients with transcatheter aortic valve implantation with available postprocedural high-sensitivity cardiac troponin T measurements were included in the analysis. The threshold at which postprocedure myocardial injury determines long-term mortality was identified using restricted cubic spline analysis. A >18.3-fold increase of troponin above the upper reference limit was identified as threshold for relevant postprocedure myocardial injury. Associations remained significant in a landmark analysis between 30 days and 2 years (hazard ratio [HR], 1.61, [95% CI, 1.13-2.28]; P=0.01), after adjusting for known confounders (adjusted HR, 1.90 [95% CI, 1.40-2.57]; P<0001), and in subgroups of patients with coronary artery disease (adjusted HR, 2.17 [95% CI, 1.44-3.29]; P<0.001), renal dysfunction (adjusted HR, 1.88 [95% CI, 1.35-2.62]; P<0.001), and intermediate/high surgical risk (adjusted HR, 2.70 [95% CI, 1.40-5.22]; P=0.003). Conclusions This study determined a troponin threshold for the identification of patients at increased mortality risk after transcatheter aortic valve implantation. The proposed definition of postprocedure myocardial injury advances risk stratification in patients with transcatheter aortic valve implantation and may assist in postprocedural patient management.


Symmetrical interdigital keratoderma of the hands.
We report the case of a 26-year-old man affected by a symmetrical keratoderma localized to the interdigital spaces of the fingers. No occupational, traumatic, or irritant factors were discovered. Clinical and histological features were consistent with the diagnosis of symmetrical interdigital hyperkeratosis, a sporadic disorder described by Frei in 1926. We believe this condition to be less rate than the few cases reported in the literature would suggest.


Detecting functional neurotoxicity in the course of safety evaluations with laboratory animals.
In the course of routinely performed subchronic toxicity studies with laboratory rodents, functional neurotoxicity, i.e. behavioral changes are usually noted first during the daily cage side observations of all animals. Observation and subsequent neurologic examination of a few key animals provide a primary tentative diagnosis. Additional automated testing might include: motor activity, startle response, hurdle stepping and maze behavior. Automated testing provides further refinement of the diagnosis and serves to determine the no observable effect level under conditions of blind testing. Behavioral changes should be assessed as early as possible after initiation of testing, i.e. during acute tests for mortality and the following subchronic range-finding studies. Subsequent subchronic organ toxicity studies are then carried out by following a valid experimental protocol for implementation of automated testing procedures and appropriate neuropathologic evaluation.


[Study of quality control on Cuscuta chinensis and C. australia].
To study the estimate method of C. chinensis and C. australia. HPLC was used to determine the contents of four kinds of flavones of C. chinensis and C. australia growing on different hosts. C. chinensis and C. australia growing on different hosts both had hyperoside, quercetin, kaempferol and isorhamnetin. The content range of hyperoside was 2.790-6.502 mg/g and was higher than other flavones. The content ranges of quercetin, kaempferol and isorhamnetin were 0.025-0.176 mg/g, 0.001-0.213 mg/g and 0.001-0.077 mg/g, respectively. The contents of hyperoside and quercetin are higher in C. chineasis than in C. australia. The contents of kaempferol and isorhamnetin are lower in C. chinensis than in C. australia. The hosts influence flavones content of C. chinensis and C. australia.


Devolution of healthcare system in Kenya: progress and challenges.
The aim of the present study was to systematically review the progress and challenges on the devolved healthcare system in Kenya. A systematic review design was adopted for the present study. Literature search was on biomedical databases of the most recent available electronic data published in English, that is, between January 2012 and April 2020. The populations for eligible studies were stakeholders within the county governments, healthcare workers and community dwellers. The databases included PubMed, EMBASE and Google Scholar. The following were the key words used in the search: 'Devolution of Health' 'Health care system in Kenya' AND 'County Health Facilities' 'challenges' AND 'progress' AND 'Kenya'. Other literature sources were after screening of all the references of all the added articles. Before the development of search terms, we looked for appropriate Medical Subject Headings terms and applied with maximal truncations. The data were qualitatively analysed, and findings were presented by three thematic domains. The search generated 1109 articles, of which 23 articles met the inclusion criteria. Data were presented and organized under three thematic domains: (1) localised decision-making process, (2) improvement in structural development and (3) inadequate resources/funds/staff. This is a systematic review which, to the best of our knowledge, is the first study of its kind to present the available evidence on the progress and challenges on the devolved healthcare system in Kenya. The major findings of this review were as follows: there was improvement in the health structural development that was brought by devolution in the country. However, devolution is not free of challenges. The major challenges noted in the postdevolution era within the health sector include inadequate resources/funds from the national government and understaffed health facilities. The study recommends allocation of resources to counties commensurate with the devolved functions. The study calls out for further research on equity and equality of the devolved healthcare system in Kenya.