To segment or not to segment: COVID-19 detection for chest X-rays.
Artificial intelligence (AI) has been integrated into most technologies we use. One of the most promising applications in AI is medical imaging. Research demonstrates that AI has improved the performance of most medical imaging analysis systems. Consequently, AI has become a fundamental element of the state of the art with improved outcomes across a variety of medical imaging applications. Moreover, it is believed that computer vision (CV) algorithms are highly effective for image analysis. Recent advances in CV facilitate the recognition of patterns in medical images. In this manner, we investigate CV segmentation techniques for COVID-19 analysis. We use different segmentation techniques, such as k-means, U-net, and flood fill, to extract the lung region from CXRs. Afterwards, we compare the effectiveness of these three segmentation approaches when applied to CXRs. Then, we use machine learning (ML) and deep learning (DL) models to identify COVID-19 lesion molecules in both healthy and pathological lung x-rays. We evaluate our ML and DL findings in the context of CV techniques. Our results indicate that the segmentation-related CV techniques do not exhibit comparable performance to DL and ML techniques. The most optimal AI algorithm yields an accuracy range of 0.92-0.94, whereas the addition of CV algorithms leads to a reduction in accuracy to approximately the range of 0.81-0.88. In addition, we test the performance of DL models under real-world noise, such as salt and pepper noise, which negatively impacts the overall performance.


The Na+-translocating ATPase in the plasma membrane of the marine microalga Tetraselmis viridis catalyzes Na+/H+ exchange.
Our previous investigations have established that Na+ translocation across the Tetraselmis viridis plasma membrane (PM) mediated by the primary ATP-driven Na+-pump, Na+-ATPase, is accompanied by H+ counter-transport [Y.V. Balnokin et al. (1999) FEBS Lett 462:402-406]. The hypothesis that the Na+-ATPase of T. viridis operates as an Na+/H+ exchanger is tested in the present work. The study of Na+ and H+ transport in PM vesicles isolated from T. viridis demonstrated that the membrane-permeant anion NO3- caused (i) an increase in ATP-driven Na+ uptake by the vesicles, (ii) an increase in (Na(+)+ATP)-dependent vesicle lumen alkalization resulting from H+ efflux out of the vesicles and (iii) dissipation of electrical potential, deltapsi, generated across the vesicle membrane by the Na+-ATPase. The (Na(+)+ATP)-dependent lumen alkalization was not significantly affected by valinomycin, addition of which in the presence of K+ abolished deltapsi at the vesicle membrane. The fact that the Na+-ATPase-mediated alkalization of the vesicle lumen is sustained in the absence of the transmembrane deltapsi is consistent with a primary role of the Na+-ATPase in driving H+ outside the vesicles. The findings allowed us to conclude that the Na+-ATPase of T. viridis directly performs an exchange of Na+ for H+. Since the Na+-ATPase generates electric potential across the vesicle membrane, the transport stoichiometry is mNa+/nH+, where m> n.


Antepartum testing for vasa previa: current standard of care.
Vasa previa is a rare accident in obstetrics with high fetal mortality. There are simple tests available to distinguish fetal from maternal blood. Recently it has been called into medicolegal question whether patients with third-trimester bleeding need to be tested for fetal bleeding. We surveyed 100 community hospitals and all the medical schools in the United States in an attempt to answer the question. It appears that the standard of care in the United States does not require such testing.


Missed care and support figures: Preliminary investigation in some surgical ward.
Missed Nursing care (MNC) is defined as planned care in the patients care process that is omitted or delayed. Despite their importance in Italy, there are just few studies that measure MNC's prevalence and causes. We are not aware of studies published in literature that have related MNC with the presence or absence of support staff. This study's objective, was to measure nurse's perception and reasons for missed care in surgical wards with or without Health Care Assistants (HCA), and, to assess whether there is a significant difference between the two groups of nurses. A Cross-sectional observational study was conducted through the administration of the "Missed Nursing Care Survey" in the Italian Version to nurses of the wards surveyed. Results have confirmed that the most frequent MNC are hygiene and mobilisation activities as reported in other Italian and foreign studies, with higher frequency in wards without HCAs. Also, the study confirmed other Italian and foreign study results recognising the most significant motivation for MNC's as the lack of staff and unexpected events. Without wishing to attribute a cause/effect relation, it is interesting to assess the results, which seem to show that the presence of HCAs contributes to reduce the prevalence of missed activities. The lack of staff has revealed higher average of MNC for both groups, which seems to direct our attention not only towards the presence of HCAs but in regards to their inclusion in care activities. It may be necessary to reflect on the priority that nurses give to certain activities.


Farmers' pesticide usage practices in the malaria endemic region of North-Western Tanzania: implications to the control of malaria vectors.
Pesticides remain the mainstay for the control of agricultural pests and disease vectors. However, their indiscriminate use in agriculture has led to development of resistance to both crop pests and disease vectors. This threatens to undermine the success gained through the implementation of chemical based vector control programs. We investigated the practices of farmers with regard to pesticide usage in the vegetable growing areas and their impact on susceptibility status of An. gambiae s.l. A stratified multistage sampling technique using the administrative structure of the Tanzanian districts as sampling frame was used. Wards, villages and then participants with farms where pesticides are applied were purposively recruited at different stages of the process, 100 participants were enrolled in the study. The same villages were used for mosquito larvae sampling from the farms and the surveys were complimented by the entomological study. Larvae were reared in the insectary and the emerging 2-3 days old female adults of Anopheles gambiae s.l were subjected to susceptibility test. Forty eight pesticides of different formulations were used for control of crop and Livestock pests. Pyrethroids were the mostly used class of pesticides (50%) while organophosphates and carbamates were of secondary importance. Over 80% of all farmers applied pesticides in mixed form. Susceptibility test results confirmed high phenotypic resistance among An. gambiae populations against DDT and the pyrethroids (Permethrin-0.75%, Cyfluthrin-0.15%, Deltametrin-0.05% and Lambdacyhalothrin-0.05%) with mortality rates 54, 61, 76 and 71%, respectively. Molecular analysis showed An. arabiensis as a dominant species (86%) while An. gambiae s.s constituted only 6%. The kdr genes were not detected in all of the specimens that survived insecticide exposures. The study found out that there is a common use of pyrethroids in farms, Livestocks as well as in public health. The study also reports high phenotypic resistance among An. gambiae s.l against most of the pyrethroids tested. The preponderance of pyrethroids in agriculture is of public health concern because this is the class of insecticides widely used in vector control programs and this calls for combined integrated pest and vector management (IPVM).


Comparison of cumulative viraemia following treatment initiation with different antiretroviral regimens: a real-life study in Brazil.
The relative efficacy of different antiretroviral (ART) regimens has been extensively evaluated in the context of clinical trials, using HIV viral load (VL) measurements at pre-specified timepoints after ART onset. However, data from real-life studies using combined longitudinal measurements of cumulative viraemia are scarce. This study aimed to address the independent effect of different ART regimens on HIV cumulative viraemia over the first 12 months after treatment initiation, using programmatic data from the Ministry of Health of Brazil. Retrospective cohort study analysing cumulative viraemia under the most frequently used ART regimens in Brazil (tenofovir, lamivudine and dolutegravir (regimen 1); tenofovir, lamivudine and efavirenz (regimen 2); tenofovir, lamivudine and ritonavir-boosted atazanavir (regimen 3)). We included 112,243 patients >12 years old who received their first ART prescription between January 2014 and August 2017. Univariate analysis indicated that cumulative viraemia was significantly lower in patients receiving regimen 1 as compared with those receiving regimens 2 or 3 (p<0.0001 for both pairwise comparisons). In a multivariable analysis adjusted for age, sex, baseline T CD4+ counts and baseline HIV VL, ART regimen persisted with statistically significant effect on 12-month cumulative viraemia. The model predicted a 45-unit increase in log10 copy-days/mL cumulative viraemia for regimen 2 as compared with regimen 1, and a 70-unit increase in log10 copy-days/mL cumulative viraemia for regimen 3 as compared with regimen 1 (95%CI 41 to 49 and 61 to 79 respectively; p<0.001 for both comparisons). In models restricted to youths (13 to 24 years old) and female patients, ART regimen had similar effects. ART regimen with dolutegravir in association with a tenofovir-lamivudine backbone was superior to regimens containing efavirenz or boosted atazanavir in reducing HIV VL, as shown by cumulative viraemia over the first 12 months after treatment initiation. The superiority persisted even after adjusting the analysis for potential confounders. Our findings could bring direct benefits to patients as suggested by lower viral replication during treatment, lower risk of HIV transmission, and a potential reduction in resistance mutations in the initial 12 months under ART.


Modification by GABA-ergic agents and clonidine of morphine-induced convulsions and toxicity in rats.
Intracerebroventricular (i.c.v.) administration of morphine produced dose-dependent behavioural changes in rats, the highest dose producing violent tonic convulsions. Naloxone (up to 10 mg/kg i.p., or 100 micrograms i.c.v.) failed to reverse morphine-induced toxicity. The conventional anticonvulsant drugs also failed to offer protection to morphine-induced seizures. GABA-ergic substances, GABA, piracetam and diazepam, on the other hand, protected the animals against morphine-induced convulsions and toxicity. Similarly, clonidine pretreatment also had a protective action against morphine-induced convulsions.


Multimodal imaging study of the 5-HT1A receptor biased agonist, NLX-112, in a model of L-DOPA-induced dyskinesia.
The leading treatment for motor signs of Parkinson's disease is L-DOPA, but, upon extended use, it can lead to levodopa-induced dyskinesia (LID). Serotonergic neurons are involved in LID etiology and previous pre-clinical studies have shown that NLX-112, a 5-HT1A biased agonist, has robust antidyskinetic effects. Here, we investigated its effects in hemiparkinsonian (HPK) rats with a unilateral nigrostriatal 6-OHDA lesion. We compared HPK rats with LID (i.e., sensitized to the dyskinetic effects of chronic L-DOPA) and without LID (HPK-non-LID), using [18F]FDG PET imaging and fMRI functional connectivity following systemic treatment with saline, L-DOPA, NLX-112 or L-DOPA + NLX-112. In HPK-non-LID rats, [18F]FDG PET experiments showed that L-DOPA led to hypermetabolism in motor areas (cerebellum, brainstem, and mesencephalic locomotor region) and to hypometabolism in cortical regions. L-DOPA effects were also observed in HPK-LID rats, with the additional emergence of hypermetabolism in raphe nuclei and hypometabolism in hippocampus and striatum. NLX-112 attenuated L-DOPA-induced raphe hypermetabolism and cingulate cortex hypometabolism in HPK-LID rats. Moreover, in fMRI experiments NLX-112 partially corrected the altered neural circuit connectivity profile in HPK-LID rats, through activity in regions rich in 5-HT1A receptors. This neuroimaging study sheds light for the first time on the brain activation patterns of HPK-LID rats. The 5-HT1A receptor agonist, NLX-112, prevents occurrence of LID, likely by activating pre-synaptic autoreceptors in the raphe nuclei, resulting in a partial restoration of brain metabolic and connectivity profiles. In addition, NLX-112 also rescues L-DOPA-induced deficits in cortical activation, suggesting potential benefit against non-motor symptoms of Parkinson's disease.


The relationship between toxics release inventory discharges and mortality rates in rural and urban areas of the United States.
Potential environmental exposures from chemical manufacturing or industrial sites have not been well studied for rural populations. The current study examines whether chemical releases from facilities monitored through the Toxics Release Inventory (TRI) program are associated with population mortality rates for both rural and urban populations. We used the TRI database, Centers for Disease Control and Prevention age-adjusted mortality data, and additional county-level covariate data to conduct a national study at (N = 3,142) of the association between amounts of on-site TRI air and water releases for the years 1988-2006 and total age-adjusted mortality rates for the years 1999-2006, after controlling for the effects of other risk variables. Results of multiple linear regression analyses indicated significantly higher adjusted mortality rates associated with greater water and air releases in both rural and urban counties. The strongest associations between TRI releases and rural mortality rates were found when 8 or more prior years of TRI release data were used to study subsequent mortality. The results support the use of the TRI as a public reporting tool and a research tool, and demonstrate that greater amounts of air and water TRI releases are related to mortality outcomes for both rural and urban populations.


Similar alpha and beta diversity changes in tropical ant communities, comparing savannas and rainforests in Brazil and Indonesia.
Local biodiversity can be expected to be similar worldwide if environmental conditions are similar. Here, we hypothesize that tropical ant communities with different types of regional species pools but at similar habitat types in Brazil and Indonesia show similar diversity patterns at multiple spatial scales, when comparing (1) the relative contribution of alpha and beta diversity to gamma diversity; (2) the number of distinct communities (community differentiation); and (3) the drivers of β-diversity (species replacement or species loss/gain) at each spatial scale. In both countries, rainforests and savannas (biome scale) were represented by three landscapes (landscape scale), each with four transects (site scale) and each transect with 10 pitfall traps (local scale). At the local scale, α-diversity was higher and β-diversity lower than expected from null models. Hence, we observed a high coexistence of species across biomes. The replacement of species seemed the most important factor for β-diversity among sites and among landscapes across biomes. Species sorting, landscape-moderated species distribution and neutral drift are potential mechanisms for the high β-diversity among sites within landscapes. At the biome scale, different evolutionary histories produced great differences in ant community composition, so the replacement of species is, at this scale, the most important driver of beta diversity. According to these key findings, we conclude that distinct regional ant species pools from similar tropical habitat types are similarly constrained across several spatial scales, regardless of the continent considered.


Acute leucocytoclastic vasculitis and aquagenic pruritus long preceding polycythemia rubra vera.
We describe the unusual case of a 67-year-old woman with aquagenic pruritus, immediately following acute cutaneous leucocytoclastic vasculitis and preceding the development of polycythemia rubra vera by 3 years.


Tandemly repeated hexanucleotide at Tetrahymena rDNA free end is generated from a single copy during development.
The linear extrachromosomal ribosomal DNA of Tetrahymena is generated from a single integrated copy during macronuclear development. The free ends of this extrachromosomal gene contain 20-70 tandem repeats of the hexanucleotide CCCCAA. We have determined the nucleotide sequence at the same (3') end of the single, integrated micronuclear gene. In contrast to the extrachromosomal gene, only a single CCCCAA sequence was found at this position. The same result was obtained from two independently isolated DNA clones, and was therefore not likely an artifact of cloning. Comparisons of the genomic DNA with the cloned fragment by Southern hybridization also supported this argument. Thus the tandemly repetitive hexanucleotide at the free ends of the extrachromosomal rDNA is not an inherited feature, and must be generated during the development of the macronucleus.


Intrathecal injection of bombesin inhibits gastric acid secretion in the rat.
Bombesin (100-500 ng) injected intrathecally (T9-10) inhibited gastric acid secretion stimulated by pentagastrin and the GABAB agonist baclofen in urethane-anesthetized rats and basal gastric acid secretion in conscious, pylorus-ligated rats. Peptide action was dose-related, occurred within 30 min, and lasted for greater than 1 h. Bombesin-induced inhibition of pentagastrin-stimulated gastric acid secretion was not altered by cervical cord transection. Intravenous infusion of the monoclonal bombesin antibody 2A11 abolished intravenous bombesin (10 micrograms/kg.h)-induced 33% inhibition of gastric response to pentagastrin but did not alter intrathecal bombesin (200 ng)-induced 38% inhibition of gastric response to pentagastrin. The inhibitory effect of bombesin (200 ng) on pentagastrin-stimulated gastric secretion was reversed by bilateral adrenalectomy or removal of celiac and mesenteric ganglia. Intrathecal injections of rat calcitonin gene-related peptide, neuromedin B, neuromedin U, and the stable substance P analogue (pGlu5, MePhe8, MeGly9)-substance P(5-11) did not alter pentagastrin-stimulated gastric acid secretion. These results demonstrate that bombesin injected into the subarachnoid space of the spinal cord inhibits vagally stimulated and pentagastrin-stimulated gastric secretion in rats. Bombesin action is peptide specific, exerted at a spinal site, and expressed through the sympathetic nervous system.


Involvement of state transitions in the switch between linear and cyclic electron flow in Chlamydomonas reinhardtii.
The energetic metabolism of photosynthetic organisms is profoundly influenced by state transitions and cyclic electron flow around photosystem I. The former involve a reversible redistribution of the light-harvesting antenna between photosystem I and photosystem II and optimize light energy utilization in photosynthesis whereas the latter process modulates the photosynthetic yield. We have used the wild-type and three mutant strains of the green alga Chlamydomonas reinhardtii--locked in state I (stt7), lacking the photosystem II outer antennae (bf4) or accumulating low amounts of cytochrome b6f complex (A-AUU)--and measured electron flow though the cytochrome b6f complex, oxygen evolution rates and fluorescence emission during state transitions. The results demonstrate that the transition from state 1 to state 2 induces a switch from linear to cyclic electron flow in this alga and reveal a strict cause-effect relationship between the redistribution of antenna complexes during state transitions and the onset of cyclic electron flow.


Minimal Cerebrospinal Fluid Concentration of Miltefosine despite Therapeutic Plasma Levels during the Treatment of Amebic Encephalitis.
Miltefosine is an alkylphosphocholine compound that is used primarily for treatment of leishmaniasis and demonstrates in vitro and in vivo antiamebic activity against Acanthamoeba species. Recommendations for treatment of amebic encephalitis generally include miltefosine therapy. Data indicate that treatment with an amebicidal concentration of at least 16 μg/ml of miltefosine is required for most Acanthamoeba species. Although there is a high level of mortality associated with amebic encephalitis, a paucity of data regarding miltefosine levels in plasma and cerebrospinal fluid in vivo exists in the literature. We found that despite aggressive dosing (oral miltefosine 50 mg every 6 h) and therapeutic plasma levels, the miltefosine concentration in cerebrospinal fluid was negligible in a patient with AIDS and Acanthamoeba encephalitis.


Neuronostatin ameliorates sodium taurocholate-induced acute pancreatitis in rats.
Neuronostatin is encoded in the preprosomatostatin gene and exerts important physiological actions on neuronal and cardiovascular regulation and metabolism in diverse tissues. An intraperitoneal injection of neuronostatin can induce c-Jun expression in the periphery of pancreatic islets. Because of the relatively high amount of neuronostatin present in the pancreas, it is necessary to investigate the effects of neuronostatin on pancreas. Furthermore, little is known about the effect of neuronostatin on acute pancreatitis. Neuronostatin (30, 60, and 120 nmol) was injected in to the external jugular vein 30 min before retrograde infusion of 2 % sodium taurocholate into the pancreaticobiliary duct. After 6 h, histological damage of the pancreas was evaluated by pancreas weight and paraffin section. A blood sample was collected to determine the serum amylase and lipase activities. In our findings, neuronostatin groups had a reduction in interstitial edema, acinar cell vacuolization, and inflammatory infiltration of the pancreas compared with the model group. Biochemical data showed that serum amylase and lipase activities were significantly decreased in neuronostatin-pretreated groups by comparison with the model group. Histopathologic examination suggests that neuronostatin ameliorated the histological damage of sodium taurocholate-induced acute pancreatitis in rats. The biochemical analysis was consistent with that obtained from histopathologic examination, which was toward a trend of attenuating acute pancreatitis. In summary, neuronostatin might be potentially capable of ameliorating pancreatic damage in acute pancreatitis in rats.


Determinants of midterm outcome of partial left ventriculectomy in dilated cardiomyopathy.
Partial left ventriculectomy has been proposed for treatment of severe cardiomyopathies. This study reports midterm results of this procedure in 37 patients with dilated cardiomyopathy. All patients were in New York Heart Association class III (16) or IV (21). Partial ventriculectomy was associated with mitral annuloplasty in 27 patients and with mitral replacement in 2. There were seven operative deaths (18.9%). During a mean follow-up of 18.2+/-9.3 months, 9 more patients died. Actuarial survival was 56.7%+/-8.1% at 6 and 24 months. Analysis of factors influencing outcome showed that midterm survival was significantly affected only by myocardial cell diameter. Otherwise, functional class improved from 3.5+/-0.5 to 1.8+/-0.9 in the survivors (p < 0.001). Furthermore, left ventricular diastolic volume decreased from 523+/-207 to 380+/-148 mL (p < 0.001), and left ventricular ejection fraction increased from 17.1%+/-4.6% to 23%+/-8% (p < 0.001), whereas significant changes in cardiac index, stroke index, and pulmonary pressures were found at 1 month of follow-up. Although left ventricular diastolic volume tended to increase in the late postoperative period, left ventricular ejection fraction and hemodynamic variables did not change significantly. Partial ventriculectomy improves left ventricular function and congestive heart failure in patients with dilated cardiomyopathy for up to 24 months of follow-up. Nevertheless, this procedure's clinical application is limited by the high mortality observed in the first postoperative months. Otherwise, new perspectives may be advised by the identification that partial ventriculectomy results seem to be influenced by compromised myocardial cells.


Assessing use of a printed lifestyle intervention tool by women with borderline gestational diabetes and their achievement of diet and exercise goals: a descriptive study.
The purpose of this study is to assess use of a booklet by pregnant women to record and assist dietary and lifestyle changes; to describe diet and exercise goals set during the initial lifestyle discussions; and to assess achievement of goals. Participants were women with borderline gestational diabetes who received a printed pregnancy record booklet, as part of a randomised trial, to record and set monthly goals for diet and exercise. Outcomes included women's use of the booklets and their achievement of dietary and exercise goals after 1 month. Fifty-six women returned their used pregnancy record booklets and were included in this study. These women set a total of 197 dietary goals and 65 exercise goals. In the first month, over 80% of dietary goals that targeted grains, dairy and overall diet were achieved, but only 20-30% of goals about vegetables, and foods high in fat, sugar and/or salt were achieved. After 1 month, women had achieved 86.4% of their exercise goals to maintain their current level of activity, but only 25.0 % exercise goals to increase walking during pregnancy. Women who used pregnancy record booklets reported good achievement rates for goals related to grains, fruits, dairy and overall diet, but they were less likely to be successful in achieving goals to increase intake of vegetables, and limit foods that high in fat, sugar and/or salt. Maintaining an active lifestyle during pregnancy was feasible for women although increases in physical activity were less often achieved. Using a pregnancy record booklet may be helpful in assisting and encouraging behavioural changes, although further investigations of long-term effects and in different populations are warranted.


The effects of dorso-lumbar motion restriction on energy use and center of mass movement during running.
The effects of restricting dorso-lumbar spine mobility on oxygen consumption in runners was investigated, as was vertical movement of the body's center of mass. Thermoplastic casting material was fashioned into a rigid orthosis and used to restrict spinal motion during running. Volunteers ran on a treadmill at 2.78 m/sec, under normal conditions and with spinal motion restricted. Oxygen consumption was assessed via a Douglas bag set-up. Separately, vertical movement of the center of mass was assessed with a Panasonic recorder. RESULTS: Casted running resulted in an increase in oxygen consumption (p < 0.01). Casted running resulted in less vertical movement of the body's center of mass (p < 0.01). CONCLUSIONS: Spinal mobility has statistically significant effects on the energy used during running and on the vertical movement of the center of mass. A running style that causes the body to use more energy is inefficient and can lead to earlier onset of fatigue. It can make the runner more prone to overuse injuries. We hypothesize that less movement of the center of mass vertically can affect stride length, lead to more strides being used to cover a specific distance and thus could contribute to earlier onset of fatigue and overuse injury. More research needs to be done on this topic.


Crosslinking of Electrospun Fibres from Unsaturated Polyesters by Bis-Triazolinediones (TAD).
Crosslinking of an unsaturated aliphatic polyester poly(globalide) (PGl) by bistriazolinediones (bisTADs) is reported. First, a monofunctional model compound, phenyl-TAD (PTAD), was tested for PGl functionalisation. 1H-NMR showed that PTAD-ene reaction was highly efficient with conversions up to 97%. Subsequently, hexamethylene bisTAD (HM-bisTAD) and methylene diphenyl bisTAD (MDP-bisTAD) were used to crosslink electrospun PGl fibres via one- and two-step approaches. In the one-step approach, PGl fibres were collected in a bisTAD solution for in situ crosslinking, which resulted in incomplete crosslinking. In the two-step approach, a light crosslinking of fibres was first achieved in a PGl non-solvent. Subsequent incubation in a fibre swelling bisTAD solution resulted in fully amorphous crosslinked fibres. SEM analysis revealed that the fibres' morphology was uncompromised by the crosslinking. A significant increase of tensile strength from 0.3 ± 0.08 MPa to 2.7 ± 0.8 MPa and 3.9 ± 0.5 MPa was observed when PGI fibres were crosslinked by HM-bisTAD and MDP-bisTAD, respectively. The reported methodology allows the design of electrospun fibres from biocompatible polyesters and the modulation of their mechanical and thermal properties. It also opens future opportunities for drug delivery applications by selected drug loading.


Preclinical and first clinical experience with the gastrin-releasing peptide receptor-antagonist [⁶⁸Ga]SB3 and PET/CT.
Gastrin-releasing peptide receptors (GRPR) represent attractive targets for tumor diagnosis and therapy because of their overexpression in major human cancers. Internalizing GRPR agonists were initially proposed for prolonged lesion retention, but a shift of paradigm to GRPR antagonists has recently been made. Surprisingly, radioantagonists, such as [(99m)Tc]DB1 ((99m)Tc-N4'-DPhe(6),Leu-NHEt(13)]BBN(6-13)), displayed better pharmacokinetics than radioagonists, in addition to their higher inherent biosafety. We introduce here [(68)Ga]SB3, a [(99m)Tc]DB1 mimic-carrying, instead of the (99m)Tc-binding tetraamine, the chelator DOTA for labeling with the PET radiometal (68)Ga. Competition binding assays of SB3 and [(nat)Ga]SB3 were conducted against [(125)I-Tyr(4)]BBN in PC-3 cell membranes. Blood samples collected 5 min postinjection (pi) of the [(67)Ga]SB3 surrogate in mice were analyzed using high-performance liquid chromatography (HPLC) for degradation products. Likewise, biodistribution was performed after injection of [(67)Ga]SB3 (37 kBq, 100 μL, 10 pmol peptide) in severe combined immunodeficiency (SCID) mice bearing PC-3 xenografts. Eventually, [(68)Ga]SB3 (283 ± 91 MBq, 23 ± 7 nmol) was injected into 17 patients with breast (8) and prostate (9) cancer. All patients had disseminated disease and had received previous therapies. PET/CT fusion images were acquired 60-115 min pi. SB3 and [(nat)Ga]SB3 bound to the human GRPR with high affinity (IC50: 4.6 ± 0.5 nM and 1.5 ± 0.3 nM, respectively). [(67)Ga]SB3 displayed good in vivo stability (>85 % intact at 5 min pi). [(67)Ga]SB3 showed high, GRPR-specific and prolonged retention in PC-3 xenografts (33.1 ± 3.9%ID/g at 1 h pi - 27.0 ± 0.9%ID/g at 24 h pi), but much faster clearance from the GRPR-rich pancreas (≈160%ID/g at 1 h pi to <17%ID/g at 24 h pi) in mice. In patients, [(68)Ga]SB3 elicited no adverse effects and clearly visualized cancer lesions. Thus, 4 out of 8 (50 %) breast cancer and 5 out of 9 (55 %) prostate cancer patients showed pathological uptake on PET/CT with [(68)Ga]SB3. [(67)Ga]SB3 showed excellent pharmacokinetics in PC-3 tumor-bearing mice, while [(68)Ga]SB3 PET/CT visualized lesions in about 50 % of patients with advanced and metastasized prostate and breast cancer. We expect imaging with [(68)Ga]SB3 to be superior in patients with primary breast or prostate cancer.


Iatrogenic cardiovocal syndrome caused by transcatheter coil closure of patent ductus arteriosus.
Two infants developed hoarseness unexpectedly the day after transcatheter coil closure of a slender patent ductus arteriosus (PDA). The pathogenesis of this complication appears to be similar to that of the classic cardiovocal syndrome. During the intervention, the inappropriately implanted coil might have distorted the slender PDA, thereby causing angulation of the pliable PDA itself and precipitating impingement on the left recurrent laryngeal nerve. Fortunately, both infants recovered spontaneously from the hoarseness within several weeks. At present, the definite underlying neuropathology of this complication is unknown as we have not yet confirmed recovery of the left vocal cord movement by follow-up fibreoptic bronchoscopy. Iatrogenic cardiovocal syndrome could occur in infants after transcatheter coil closure of a slender PDA, using the currently popular 0.038-inch coil. A coil with a smaller diameter might prevent the occurrence of this syndrome.


Developing the New Interventions for independence in Dementia Study (NIDUS) theoretical model for supporting people to live well with dementia at home for longer: a systematic review of theoretical models and Randomised Controlled Trial evidence.
To build an evidence-informed theoretical model describing how to support people with dementia to live well or for longer at home. We searched electronic databases to August 2018 for papers meeting predetermined inclusion criteria in two reviews that informed our model. We scoped literature for theoretical models of how to enable people with dementia to live at home independently, with good life quality or for longer. We systematically reviewed Randomised Controlled Trials (RCTs) reporting psychosocial intervention effects on time lived with dementia at home. Two researchers independently rated risk of bias. We developed our theoretical model through discussions with experts by personal, clinical and academic experiences, informed by this evidence base. Our scoping review included 52 studies. We divided models identified into: values and approaches (relational and recovery models; optimising environment and activities; family carer skills and support); care strategies (family carer-focused; needs and goal-based; self-management); and service models (case management; integrated; consumer-directed). The 11 RCTs included in our systematic review, all judged at low risk of bias, described only two interventions that increased time people with dementia lived in their own homes. These collectively encompassed all these components except for consumer-directed and integrated care. We developed and revised our model, using review evidence and expert consultation to define the final model. Our theoretical model describes values, care strategies and service models that can be used in the design of interventions to enable people with dementia to live well and for longer at home. PROSPERO 2018 registration number: CRD42018099693 (scoping review). PROSPERO 2018 registration number: CRD42018099200 (RCT systematic review).


Health systems and nutrition in the time of COVID-19.
As infection rates rise, job losses increase and workers leave cities to walk back home, and there is a silent hunger and nutrition crisis striking the country. Those who will bear the brunt of this are the already vulnerable-namely, children, adolescent girls, nursing and expectant mothers-now denied even basic calories. Among these are some who are also suffering huge weight losses because of the 15 days of high fever. This tragedy will play out in various horrifying ways in the future and must be addressed with urgency. Our stimulus package promises loans, which will take time to reach the poor, and a meager ration of cereals and pulses, while hunger and insufficient nutrition are immediate problems as Raghuram Rajan pointed out recently.


Revision of fossil species of Deinodryinus, with description of a new species (Hymenoptera, Dryinidae).
Deinodryinus veltenisp. n. is described from middle Eocene Baltic amber. The species differs from other fossil Palaearctic species of Deinodryinus Perkins owing to the shape of the antenna (clavate, with distal part very thickened), the large compound eyes, and the distal part of the stigmal vein much longer than the proximal part. A revision and a key to the fossil Palaearctic species of Deinodryinus Perkins, 1907 is presented.


Release of prostaglandin-like substance from inflamed synovial tissue of rat.
Influence of inflammation on the release of prostaglandin-like substance (PG) from synovial tissue of rat was studied. 1) In carrageenin inflammation, PG release was proportional to the increase in synovial tissue weight. 2) PG release was only increased in the later phase of dextran inflammation. 3) Aspirin suppressed PG release from both non-inflamed and inflamed synovial tissues, but hydrocortisone suppressed that only in inflamed tissue.


Perceived Future Outcomes of Unsuccessful Treatment and Their Association with Treatment Persistence Among Type-2 Diabetes Patients: A Cross-Sectional Content Analysis.
Despite the known strong association between patients' knowledge of outcomes of type 2 diabetes mellitus (T2DM) and treatment persistence, this knowledge in this patient population requires further clarification. The aim of our study was to reveal the perception of unsuccessful treatment outcomes among patients with T2DM and its association with treatment persistence by analysing answers to open-ended questions. In this cross-sectional study, 106 patients with T2DM who lived in Fukushima Prefecture, Japan, had a medical record in the Fukushima National Health Insurance Organisation database and had no cognitive problems were enrolled by purposive sampling. Treatment status was defined as "non-persistent" when a participant's treatment medical record was absent for a continuous period of ≥ 6 months; otherwise, it was referred to as "persistent". We asked about the possible future problems of untreated T2DM, inductively classified the open answers into 15 codes and then statistically examined the association between these codes and treatment persistence using logistic regression analysis adjusted for age and sex. Persistent treatment was prevalent among participants who mentioned the code "treatment", which encompasses the terms that indicated invasiveness, such as dialysis, insulin injection, and shots (odds ratio 4.339; 95% confidence interval 1.104-17.055). Persistent treatment was prevalent among patients with T2DM who mentioned the code "treatment", suggesting that these patients may anticipate a threat due to the invasiveness of diabetes and thus participate in persistent treatment to avoid this threat. Healthcare professionals should provide appropriate information and supportive conditions to achieve both a reduced feeling of threat and persistent treatment engagement.


Non-invasive in vivo characterization of breast tumors using photon migration spectroscopy.
Frequency-domain photon migration (FDPM) is a non-invasive optical technique that utilizes intensity-modulated, near-infrared (NIR) light to quantitatively measure optical properties in thick tissues. Optical properties (absorption, mu(a), and scattering, mu(s)', parameters) derived from FDPM measurements can be used to construct low-resolution (0.5 to 1 cm) functional images of tissue hemoglobin (total, oxy-, and deoxy-forms), oxygen saturation, blood volume fraction, water content, fat content and cellular structure. Unlike conventional NIR transillumination, FDPM enables quantitative analysis of tissue absorption and scattering parameters in a single non-invasive measurement. The unique functional information provided by FDPM makes it well-suited to characterizing tumors in thick tissues. In order to test the sensitivity of FDPM for cancer diagnosis, we have initiated clinical studies to quantitatively determine normal and malignant breast tissue optical and physiological properties in human subjects. Measurements are performed using a non-invasive, multi-wavelength, diode-laser FDPM device optimized for clinical studies. Results show that ductal carcinomas (invasive and in situ) and benign fibroadenomas exhibit 1.25 to 3-fold higher absorption than normal breast tissue. Within this group, absorption is greatest for measurements obtained from sites of invasive cancer. Optical scattering is approximately 20% greater in pre-menopausal versus post-menopausal subjects due to differences in gland/cell proliferation and collagen/fat content. Spatial variations in tissue scattering reveal the loss of differentiation associated with breast disease progression. Overall, the metabolic demands of hormonal stimulation and tumor growth are detectable using photon migration techniques. Measurements provide quantitative optical property values that reflect changes in tissue perfusion, oxygen consumption, and cell/matrix development.


Differential regulation of transcription factor T-bet induction during NK cell development and T helper-1 cell differentiation.
Adaptive CD4+ T helper cells and their innate counterparts, innate lymphoid cells, utilize an identical set of transcription factors (TFs) for their differentiation and functions. However, similarities and differences in the induction of these TFs in related lymphocytes are still elusive. Here, we show that T helper-1 (Th1) cells and natural killer (NK) cells displayed distinct epigenomes at the Tbx21 locus, which encodes T-bet, a critical TF for regulating type 1 immune responses. The initial induction of T-bet in NK precursors was dependent on the NK-specific DNase I hypersensitive site Tbx21-CNS-3, and the expression of the interleukin-18 (IL-18) receptor; IL-18 induced T-bet expression through the transcription factor RUNX3, which bound to Tbx21-CNS-3. By contrast, signal transducer and activator of transcription (STAT)-binding motifs within Tbx21-CNS-12 were critical for IL-12-induced T-bet expression during Th1 cell differentiation both in vitro and in vivo. Thus, type 1 innate and adaptive lymphocytes utilize distinct enhancer elements for their development and differentiation.


Unwrapping of nucleosomal DNA ends: a multiscale molecular dynamics study.
To permit access to DNA-binding proteins involved in the control and expression of the genome, the nucleosome undergoes structural remodeling including unwrapping of nucleosomal DNA segments from the nucleosome core. Here we examine the mechanism of DNA dissociation from the nucleosome using microsecond timescale coarse-grained molecular dynamics simulations. The simulations exhibit short-lived, reversible DNA detachments from the nucleosome and long-lived DNA detachments not reversible on the timescale of the simulation. During the short-lived DNA detachments, 9 bp dissociate at one extremity of the nucleosome core and the H3 tail occupies the space freed by the detached DNA. The long-lived DNA detachments are characterized by structural rearrangements of the H3 tail including the formation of a turn-like structure at the base of the tail that sterically impedes the rewrapping of DNA on the nucleosome surface. Removal of the H3 tails causes the long-lived detachments to disappear. The physical consistency of the CG long-lived open state was verified by mapping a CG structure representative of this state back to atomic resolution and performing molecular dynamics as well as by comparing conformation-dependent free energies. Our results suggest that the H3 tail may stabilize the nucleosome in the open state during the initial stages of the nucleosome remodeling process.


The impact of coronavirus disease 2019 (COVID-19) on provider use of electronic hand hygiene monitoring technology.
The use of an electronic hand hygiene monitoring system (EHHMS) decreased due to the coronavirus disease 2019 (COVID-19) pandemic. We analyzed dispenser use, hand hygiene (HH) badge use, and HH compliance to determine the effect of COVID-19 on EHHMS use and HH compliance. HH product shortages and other pandemic-induced challenges influenced EHHMS use.


Oral administration of antigen does not influence the proliferation and IFN-γ production of responsive CD8+ T cells but enables to establish T cell clones with different lymphokine production profile.
Feeding of a whole casein diet, which abolished the α(s1)-casein-specific proliferation and IFN-γ productivity of CD(4+) T cells, did not affect the proliferative response of CD8(+) T cells with regard to the antigen dose response, cell dose response, kinetics of the proliferation and epitope specificity, as well as IFN-γ production. To assess the characteristics of the CD8(+) T cells, we established α(s1)-casein-specific CD8(+) T cell clones from both casein-fed and control mice. The established clones produced different amount of IFN-γ and IL-10, and one clone derived from the casein-fed mice produced a remarkable amount of IL-10. The clones from casein-fed mice produced considerable amounts of TGF-β, while those from control mice produced only small amounts. The possible role of CD8(+) T cells in oral tolerance is discussed.


Age-dependent phenotypes of ovarian endometriomas.
To analyze the characteristics of the ovarian endometrioma (OE) across the life span of a woman. In the past, the OE has traditionally been viewed as a single, monolithic disease. Today, there are emerging data indicating that OE phenotypes differ according to the age of the woman. A narrative review of original articles on OE indexed by PubMed. When appearing in infancy and early adolescence, OE may be the consequence of endometrial cells retrogradely shed with neonatal uterine bleeding. The post-menarcheal variant, manifesting itself during full adolescence, is singularly frequent in the presence of vaginal or uterine outflow obstructive anomalies. The typical and most frequent adult phenotype is characterized by increasing fibrosis and a tendency to progress; its mere presence exerts a detrimental effect on the surrounding healthy ovarian tissue. In postmenopause, an old lesion may be reactivated in the presence of exogenous or endogenous estrogens, or even be produced ex novo; rarely, it can spread to a variety of organs and structures and even degenerate causing malignancies. Given the existence of these variants, it is important to agree on management guidelines that take into consideration these different phenotypes.


[Management of severe Budd-Chiari syndrome by spleen-internal jugular venous shunt].
To study the operative method for severe Budd-Chiari syndrome. 17 patients with severe Budd-Chiari syndrome were treated with splenectomy and spleen-internal jugular venous shunt. Follow up for 3 to 20 months 11 patients showed excellent results, 5 good results and 1 died. Spleen-internal jugular shunt is effective for the patients with severe Budd-Chiari syndrome.


FK506-binding protein of Neurospora crassa (NcFKBP) mediates sensitivity to the immunosuppressant FK506; resistant mutants identify two loci.
Growth of Neurospora crassa wild-type is inhibited by micromolar concentrations of the immunosuppressive macrolide FK506. Spontaneous and induced mutations that confer resistance to FK506 identified two loci, fkr-1 and fkr-2. They map on the right arm of linkage group V on either side of inl with fkr-1 being centromere proximal. Allele fb (fkr-2) lacks immunodetectable N. crassa FK506-binding protein (NcFKBP). This demonstrates that the sensitivity of N. crassa towards FK506 is mediated by NcFKBP. FK506-binding proteins have been shown to be highly conserved, i.e., found in all eukaryotic cells tested, and to exhibit peptidyl-prolyl cis-trans isomerase (PPIase) activity in vitro. Possible functions for the loci are discussed. Apart from the resistance to FK506 no other mutant phenotype was detected not even in double mutants that lacked NcFKBP as well as cyclophilin. Cyclophilin mediates the cytotoxic effect of the immunosuppressive drug Cyclosporin A and is also characterized by PPIase activity in vitro. Both FK506-resistant alleles studied exhibit incomplete dominance in forced heterokaryons. A mechanism is proposed to explain this dominance especially in view of the NcFKBP-deficient allele, fb.


Synthesis and biological activities of polyquinoline derivatives: new Bcl-2 family protein modulators.
The synthesis of quinoline derivatives, designed to interact with Bcl-x(L), and to inhibit its interaction with pro-apoptotic partners, is described and their biological effects investigated. We showed that 5 out of 28 synthetized compounds restored cell death of 3T3 cells overexpressing Bcl-x(L) following serum starvation. Active compounds were further characterized for their binding capacity to the anti-apoptotic member of the Bcl-2 family, Bcl-x(L) as well as Bcl-2, Bfl-1 and Mcl-1, and for their pro-apoptotic activities toward lymphoid tumor cells and peripheral blood mononuclear cells. Altogether our results indicate that dimeric, rather than trimeric quinoline derivatives, represent a new attractive class of BH3 mimetics for cancer therapy.


Aging and presbycusis: effects on 2-deoxy-D-glucose uptake in the mouse auditory brain stem in quiet.
Autoradiography was used to assess the incorporation of [2-14C]deoxy-D-glucose by the auditory brain stem of young and aging mice of the C57BL/6 strain (which demonstrates progressive chronic sensorineural hearing loss) and the CBA strain (which maintains good hearing until late in life). Animals were injected with labeled 2-deoxyglucose and placed in quiet for 45 min; brain stem sections were prepared for autoradiography. The amounts of 2-deoxyglucose incorporated into the anterior ventral cochlear nucleus (AVCN), inferior colliculus (IC), and trigeminal nerve (TN) were densitometrically analyzed. Within each subject, the densities of the three structures were statistically compared. In every mouse, inferior colliculus density was greater than that of the anterior ventral cochlear nucleus, which was greater than trigeminal nerve density. To compare subject groups, relative densities (inferior colliculus and anterior ventral cochlear nucleus re: trigeminal nerve) were used; no significant differences were found between groups. Thus, aging, with or without severe loss of hearing, is not associated with altered incorporation of 2-deoxyglucose (and presumably glucose) in quiet.


Recent advances in genetic code engineering in Escherichia coli.
The expansion of the genetic code is gradually becoming a core discipline in Synthetic Biology. It offers the best possible platform for the transfer of numerous chemical reactions and processes from the chemical synthetic laboratory into the biochemistry of living cells. The incorporation of biologically occurring or chemically synthesized non-canonical amino acids into recombinant proteins and even proteomes via reprogrammed protein translation is in the heart of these efforts. Orthogonal pairs consisting of aminoacyl-tRNA synthetase and its cognate tRNA proved to be a general tool for the assignment of certain codons of the genetic code with a maximum degree of chemical liberty. Here, we highlight recent developments that should provide a solid basis for the development of generalist tools enabling a controlled variation of chemical composition in proteins and even proteomes. This will take place in the frame of a greatly expanded genetic code with emancipated codons liberated from the current function or with totally new coding units.


Training Guidelines for Endovascular Ischemic Stroke Intervention: An International multi-society consensus document.
ContributorsAmerican Academy of Neurological Surgeons/ Congress of Neurological Surgeons (AANS/CNS): S.D. Lavine, K Cockroft, B Hoh, N Bambakidis, AA Khalessi, H Woo, H Riina. A. SiddiquiAmerican Society of Neuroradiology (ASNR): J. A. HirschAsian Australasian Federation of Interventional and Therapeutic Neuroradiology (AAFITN): W. ChongAustralian and New Zealand Society of Neuroradiology - Conjoint Committee for Recognition of Training in Interventional Neuroradiology (CCINR) representing the RANZCR (ANZSNR), ANZAN and NSA: H. Rice, J Wenderoth, P Mitchell, A Coulthard, TJ Signh, C Phatorous, M KhangureCanadian Interventional Neuro Group (CING): P. Klurfan, K. Terbrugge, D Iancu, T. GunnarssonEuropean Society of Neuroradiology (ESNR); O. Jansen, M. MutoEuropean Society of Minimally Invasive Neurologic Therapy (ESMINT): I. Szikora L. Pierot P. Brouwer J. Gralla, S. Renowden, T. Andersson, J. Fiehler, F. Turjman, P. White, AC Januel, L Spelle, Z Kulcsar, R Chapot, L Spelle, A Biondi, S Dima, C Taschner, M Szajner, A KrajinaJapanese Society for Neuroendovascular therapy (JSNET): N.Sakai, Y. Matsumaru, S. YoshimuraSociedad Ibero Latino Americana de Neuroradiologica (SILAN): O.Diaz, P.LylykSociety of NeuroInterventional Surgery (SNIS): M.V. Jayaraman, A. Patsalides, C. D. Gandhi, S.K.Lee, T. Abruzzo, B. Albani, S. A. Ansari, A.S. Arthur, B.W. Baxter, K.R.Bulsara, M. Chen, J.E.Delgado-Almandoz, J.F.Fraser, D.V. Heck, S.W. Hetts, M.S.Hussain, R.P. Klucznik, T.M. Leslie-Mawzi, W.J.Mack, R.A.McTaggart, P.M.Meyers, J. Mocco, C.J.Prestigiacomo, G.L.Pride, P.A.Rasmussen, R.M.Starke, P.J.Sunenshine, R.W.Tarr, D.F.FreiSociety of Vascular and Interventional Neurology (SVIN): M.Ribo, R.G.Nogeuira, O.O. Zaidat, T. Jovin, I. Linfante, D. Yavagal, D. Liebeskind, R. NovakovicWorld Federation of Interventional and Therapeutic Neuroradiology (WFITN): S. Pongpech, G Rodesch, M Soderman, K ter Brugge, A. Taylor, T Krings, D Orbach, A. Biondi, L Picard, D C Suh, M. Tanaka, HQ Zhang.


Determination of aspoxicillin (TA-058) by high-performance liquid chromatography. Stability at different temperatures.
A rapid and sensitive HPLC-method has been developed for the determination of serum concentrations of aspoxicillin (TA-058), a new semisynthetic beta-lactam antibiotic. Aspoxicillin was chromatographed with a phosphate buffer/methanol (92:8 v/v) mobile phase and a C-18 reversed phase column and was detected at a wavelength of 220 nm. The stability of aspoxicillin in serum and buffer at different temperatures was studied over a time period of 3 months. Furthermore, the degradation of aspoxicillin versus piperacillin was determined in serum and buffer at 37 degrees C. Aspoxicillin remains stable only at -70 degrees C whereas degradation has been observed at -20 degrees C and 4 degrees C. At 37 degrees C, 20% of aspoxicillin is degraded in serum within 24 h whereas piperacillin is completely degraded under the same conditions.


Interaction of hydralazine and hydrazone derivatives with contractile mechanisms in rabbit aortic smooth muscle.
The mechanism of action and relative potency of hydralazine (H) and tow hydrazone derivatives were investigated using isolated rabbit aortic strips. H, hydralazine acetone hydrazone (HA) and hydralazine butanone hydrazone (HBH) relaxed established K+ and norepinephrine (NE) contractures, and inhibited the development of contractures to these two agents on preincubation. H, HA and HBH increased the threshold to Ca++ and decreased the maximum tension responses during K+-Ca++-contractures (HA greater than H, P less than .05; HBH greater than H P less than .01). The Ca++-dependent and Ca++-independent components of NE contractures were both inhibited by H, HA and HBH. NE contractures were more sensitive to the effects of H than K+ contractures. These results are consistent with the conclusion that H and hydrazone derivatives produce effects on vascular muscle both by interactions with the fluxes of Ca++ from the extracellular space and effects on release from cell stores. However, other possibilities need to be assessed experimentally.


[Liability in desensitization accidents].
Deaths that occur during the course of desensitization treatment are regularly analyzed in penal or civil investigations. Abnormal activity of an allergenic extract may also be the cause of the incident, but it is difficult to prove. Today the burden of proof is being reversing in favor of the patient because the legal requirements for drug producers are more specific. Liability to injury and liability of the product are discussed with regard to the legal situation in the Federal Republic of Germany and in Austria. In any case, there is a considerable gray area regarding liability for incidents during desensitization treatment. Because safer medicines are required today, the author is proposing that the duty to notify be intensified by the requirement that mild systemic reactions also be reported to a central registry.


Monoamine oxidase A and B activities in embryonic chick hepatocytes: differential regulation by retinoic acid.
Monoamine oxidases (MAOs) A and B are two isoenzymes involved in the degradation of many biological amines in the nervous system and in peripheral organs. In the present work hepatocytes isolated from 14-day-old chick embryos were used as a model system to determine whether retinoic acid (RA) is capable of modulating the activity of the two MAO forms. RA is a retinoid that, by binding with nuclear receptors, interferes with the expression of specific genes in many differentiation processes. Enzymic activity was measured with a radiochemical method using serotonin and beta-phenylethylamine as preferential substrates for MAO A and MAO B, respectively. The specific activity of the two forms was measured in hepatocytes cultured for 24, 48 and 72 h in the presence and the absence of serum. RA stimulated MAO B but not MAO A activity, in a dose- and time-dependent way, and only in the presence of serum. Maximum stimulation (about 3.5-fold) was obtained after treatment with 5 microM RA for 72 h. Kinetic analysis of MAO B activity showed an increase in V(max) in treated hepatocytes (5 microM RA for 72 h) with no change in K(m). In conclusion, the present work shows that RA selectively elicits MAO B activity in cultured chick embryonic hepatocytes, this stimulation requires the presence of some factors present in the serum and is probably due to an increase in the number of enzyme molecules.


Vascular risk factors, white matter hyperintensities and hippocampal volume in normal elderly individuals.
Hippocampal atrophy has been identified as marker for the development of Alzheimer's dementia (AD). To what extent vascular risk factors and white matter hyperintensities (WMH) affect hippocampal volume (HV) in asymptomatic elderly subjects and thus may impact such a predictive capacity is controversial. We analysed 287 participants of the Austrian Stroke Prevention Study (mean age 66.6 ± 6.6 years) with a Mini Mental State Examination score ≥27 who were free of neuropsychiatric disease and had undergone MRI including coronal T(1)-weighted sequences allowing for semi-automatic assessment of HV. Global brain volume (BV) was measured using SIENAX. WMH were rated according to the Fazekas scale and segmented to obtain WMH volumes. Higher age was associated with lower absolute and normalized HV, a lower BV and higher WMH volume. None of the vascular risk factors had an impact on HV except for high-density lipoprotein. This effect disappeared after normalization of HV. WMH severity and volume did not affect HV either. Our data indicate HV loss in parallel with the whole brain and suggest no specific vulnerability towards vascular risk factors or age-related WMH in a cognitively intact normal elderly population. This also supports the utility of HV measurements to identify impending AD.


The stimulating effects of polyphenol and protein fractions from jelly fig (Ficus awkeotsang Makino) achenes against proliferation of leukemia cells.
This study aimed to investigate the direct and immune-stimulated antiproliferative activities of jelly fig achenes fractions including pectinesterase inhibitors, crude polyphenols extract, and purified polyphenols extract (PP). Beside the measurement of cell viability of U937, the quantity of cytokines in conditioned medium and morphologic changes in leukemia were observed. After surveying all fractions in jelly fig, the obtained fractions of polyphenol exhibited the highest stimulating effects and directly cytotoxic effects against leukemia with the lowest effect found in protein fractions. The leukemia treated by our PP fraction showed dose-dependent response between the concentration and G2/M cell numbers of the U937 cells. The PP fraction had more pronounced effect on immune-stimulated than direct antiproliferative activities. The finding was also supported by morphological analysis by showing the formation of apoptotic bodies and differentiation from immature U937 cells into mature monocytes/macrophages on cells cultured with PP-conditioned medium. In conclusion, polyphenol fraction of pectinesterase inhibitors from jelly fig showed the immune-stimulated antiproliferative activities against U937 cell.


Knowledge, perception about antiretroviral therapy (ART) and prevention of mother-to-child-transmission (PMTCT) and adherence to ART among HIV positive women in the Ashanti Region, Ghana: a cross-sectional study.
Mother-to-Child Transmission (MTCT) has been identified as the greatest means of HIV infection among children. Adherence to antiretroviral drugs is necessary to prevent drug resistance and MTCT of HIV among HIV positive women. However, there is a gap in clients' knowledge, attitudes and perceptions of antiretroviral therapy (ART) and Prevention of Mother-To-Child Transmission (PMTCT) which influence their decision to adhere to ART. The study was a descriptive cross-sectional employing both qualitative and quantitative methods. The study involved 229 HIV positive women in reproductive age (18 - 49 years) and had been on ART for at least six months. Fourteen health workers were also included in the qualitative study. Respondents were selected from three ART centers in the Kumasi Metropolis through systematic random sampling from August to November 2011. HIV positive women who had consistently missed two or more ART appointments within the previous two months were classified as defaulters. Data was analyzed with SPSS 19 and STATA 11. Logistic regression was run to assess the odds ratios at 95% confidence level. The ART defaulter rate was 27% and clients had good knowledge about ART and PMTCT. More than 90% of the HIV positive women had inadequate knowledge about ART and PMTCT and these women were more likely to default ART (OR = 3.5; 95% CI = 1.89, 6.21). The educational background of HIV positive women did not have significant influence on their knowledge of ART and PMTCT. Mothers, knowledge and understanding of ART and PMTCT could influence their adherence to ART. Educational interventions which target the understanding of both the literate and illiterate women in society are necessary to develop positive behaviors and enhance adherence to ART.


Ceramide kinase expression is altered during macrophage-like cell differentiation of the leukemia cell line HL-60.
Ceramide kinase (CerK) has important roles in leukocyte functions, including the role in degranulation of mast cells and the phagocytosis of polymorphonuclear leukocytes, so its expression levels should be strictly regulated. Here, we report that the mRNA expression and enzyme activity of CerK were decreased during macrophage-like cell differentiation of the leukemia cell line HL-60, yet neither was altered during granulocytic differentiation of the same cells. Our findings demonstrate that HL-60 cells are useful for studying CerK functions in leukocyte differentiation, and they also suggest that CerK might have an important role in such differentiation.


Acute myeloblastic leukaemia in a dog.
Morphological and cytochemical characteristics of both bone marrow and peripheral blood cells as well as an appreciation of the course of the disease, were found to be important in making the correct diagnosis in a dog with acute myeloblastic leukaemia similar to the M-2 type (FAB classification) of man. Busulfan treatment resulted in only a limited effect, mainly consisting in a reduction of the number of nucleated cells in the peripheral blood. Even under busulfan treatment, however, the relative blast count in marrow and peripheral blood increased, indicating that most blast cells were not susceptible to the action of busulfan. The total survival time of the dog was 94 days, including 24 days from hospitalization and diagnosis until euthanasia in a moribund state. Based on the assessment of morphological abnormalities in leukaemic cells and of mitotic indices in bone marrow smears, it is tentatively concluded that the acute myeloblastic leukaemia in this dog arose in the pluripotent haematopoietic stem cell compartment giving rise to the formation of erythrocytes, eosinophils, neutrophils and monocytes as well as megakaryocytes and that the proliferation rate of cells of the myeloblastic clone was decreased, although an increase in the size of the potentially dividing compartment might have occurred.


[Role of the occupational physician in the management of the emergency of SARS].
The recent epidemic event related to SARS has focused the attention on an important role that the occupational doctor should play in prevention, protection and information of the workers. We would like to introduce some advices to resolve some problems that could happen in every business activity.


Factors influencing basic vaccination coverage in Myanmar: secondary analysis of 2015 Myanmar demographic and health survey data.
Immunization is one of the most effective measures for preventing disease when vaccination coverage is sufficient. Although vaccination coverage is known to be influenced by social and cultural barriers, the determinants of childhood immunization in Myanmar remain poorly understood. This study analyzed factors that influenced complete vaccination status (one dose each for Bacillus Calmette-Guérin and measles and three doses each for diphtheria-pertussis and polio) using 2015 data from the Myanmar Demographic Health and Survey. Data from 12 to 23-month-old children and their mothers were extracted from the nationally representative survey results. Bivariate and multivariate analyses with survey-weighted logistic regression were performed to examine the relationships between vaccination status and various sociodemographic and medical factors. The independent variables for the analyses included area of residence, economic status, maternal age, marital status, education, literacy, employment status, antenatal care attendance, tetanus vaccination, place of delivery, postnatal evaluations, child's sex, number of children, previous child death, decision maker(s) regarding child's health, frequency of healthcare visits, paternal education, and paternal occupation. A representative sample of 904 cases were extracted for the analysis. The overall complete vaccination rate was 55.4%. In the multivariate analysis with backward step-wise selection, complete vaccination was independently associated with middle or high economic status (adjusted odds ratio [AOR]: 2.64, 95% confidence interval [CI]: 1.85-3.78), older maternal age (AOR: 2.87, 95% CI: 1.62-5.10), ≥4 antenatal care visits (AOR: 1.87, 95% CI: 1.28-2.73), and maternal tetanus vaccination before delivery (AOR: 3.26, 95% CI: 1.82-5.85). The first Demographic and Health Survey in Myanmar revealed that only approximately one-half of 12-23-year-old children had received complete vaccination, which was lower than the estimated rate from routine administrative coverage. Our results indicate that incomplete immunization status was associated with low economic status, younger maternal age, fewer antenatal care visits, and no maternal tetanus vaccination. These findings may help improve the targeting and strategic implementation of the Expanded Programme on Immunization.


Plasma concentration-response relationships for some cardiovascular effects of dihydropyridines in healthy subjects.
The pharmacokinetics and some hemodynamic effects of three dihydropyridine (DHP) calcium channel blockers were studied in healthy subjects. In a randomized order, each subject was given 24 micrograms/kg nifedipine, 40 micrograms/kg nitrendipine, or 10 micrograms/kg nisoldipine intravenously. The three DHPs differed as to their total clearance and volume of distribution (nifedipine less than nisoldipine less than nitrendipine) but showed similar values for elimination half-lives. All three drugs evoked increases in heart rate and forearm blood flow (FBF) and small decreases in blood pressure. Whereas the observed peak changes in heart rate were virtually identical for the three drugs (about 45% above baseline), the peak changes in FBF were more pronounced in response to nitrendipine and nisoldipine (greater than 200% above baseline) than in response to nifedipine (79% above baseline). The heart rate and FBF responses to the DHPs were related directly to the drug concentrations in plasma. The plasma level-response curves obeyed Hill's equation. They showed that the DHPs differ mainly in their potencies at dilating the forearm resistance vessels (nifedipine less than nitrendipine less than nisoldipine).


Association between phosphodiesterase type 5 inhibitors and prostate cancer: A systematic review.
We aim to assess the effect of phosphodiesterase type 5 inhibitors (PDE5I) on prostate cancer risk as well on biochemical recurrence after radical prostatectomy. We performed a research using the following keywords "Phosphodiesterase type 5 inhibitors" and "Prostate cancer". Only trials examining the effect of PDE5I on prostate cancer risk and recurrence after radical prostatectomy were included. Seventeen preclinical trials and seven clinical trials were included. Preclinical studies demonstrate a pivotal role for PDE5I as a modulator of apoptosis preventing prostate carcinogenesis. The clinical benefit of PDE5I was not demonstrated. PDE5I use was not associated with decreased prostate cancer diagnosis in two retrospective cohort studies. Biochemical recurrence after radical prostatectomy was not lower (nor higher) in patients taking PDE5I in three retrospective case match studies. Based on this review, a change in our practice regarding pharmacological reeducation after radical prostatectomy is not justified.


Platelets in the pathogenesis of flavivirus disease.
Research on the role of platelets in modulating innate and adaptive host immune responses has gaining importance in the last two decades. Since the virus can directly interact with platelet receptors and modulate the host immune response, understanding the role of platelets in viral pathogenesis would pave way for novel therapeutic means. The present review aims at presenting the important molecular aspects of platelet-flavivirus interactions and how it leads to platelet activation, thrombocytopenia, and vascular endothelial leakage. Besides, the role of some of the platelet-derived factors as biomarkers for the early prediction of disease outcome taking dengue infection as an example is reviewed.


The treatment of end-stage corneal disease: penetrating keratoplasty compared with Boston type 1 keratoprosthesis.
Penetrating keratoplasty (PKP) yields excellent results for restoring vision in end-stage corneal diseases. However, its success is limited to high-risk diseases such as aniridia, chemical burns, autoimmune corneal diseases, and herpetic eye disease. Boston type 1 keratoprosthesis (BKPro) offers another option to these patients. Since 1992, improvements in perioperative management and device construction have significantly increased the use of BKPro worldwide and challenged the therapeutic role of PKP in these patients. This review aims to evaluate BKPro's place in the treatment algorithm of these high-risk patients to assist surgeons' decision-making. PKP and BKPro are compared in three outcome categories: visual acuity, graft retention and failure, and complications profile. Special attention is given to comparing secondary BKPro versus repeated PKP as well as primary BKPro versus primary PKP. We conclude that secondary BKPro bears a better prognosis than repeated PKP in most high-risk patients. Similarly, primary BKPro likely confers improved outcomes over primary PKP in most high-risk recipients. However, current evidence is based on retrospective designs, and controlled prospective randomized trials are required to validate these conclusions.


Memy I: a novel murine model for uterine leiomyoma using adenovirus-enhanced human fibroid explants in severe combined immune deficiency mice.
This study was undertaken to develop a representative murine model for human leiomyoma. Human fibroid tumor tissues were cut into small pieces and treated with medium alone, adenoviral-beta-galactosidase, adenoviral-vascular endothelial growth factor-A, adenoviral-cyclooxygenase-2, or both adenoviral-vascular endothelial growth factor-A and adenoviral- cyclooxygenase-2. Tissue pieces were inserted subcutaneously in the flank of each severe combined immunodeficient mouse. The developed lesion was measured twice per week. Xenograft tissues were harvested after 30 days and analyzed. Tissue pieces transfected with both adenoviral-cyclooxygenase-2 and adenoviral-vascular endothelial growth factor-A continued to grow up to 30 days postimplantation. The number of proliferating and apoptotic cells, as well as the expression of smooth muscle actin, desmin, vimentin, estrogen receptors, and progesterone receptors was similar between retrieved grafts from that group and the original patient tissue. Furthermore, hematoxylin and eosin and Masson's Trichrome stains confirmed this similarity. Human uterine leiomyoma xenografts, pretreated with both adenoviral- cyclooxygenase-2 and adenoviral-vascular endothelial growth factor-A and implanted subcutaneously in severe combined immunodeficient mice, represent a novel model for human uterine leiomyoma.


Evaluation of scapular mobilization and comparison to pectoralis minor stretching in individuals with rounded shoulder posture: A randomized controlled trial.
Rounded shoulder posture (RSP) is a common postural condition which can alter scapular position. Although, there is no consensus on the relationship between posture and musculoskeletal dysfunction, some evidence suggests a significant relationship between RSP and shoulder dysfunction. Therefore, treatment of this postural condition is important. Various treatment methods are used to correct RSP. However, the effectiveness of scapular mobilization, (SM) as a method which can alter scapular kinematics, has not been investigated. To evaluate the effects of SM on scapular resting position in individuals with RSP, and to compare this technique to pectoralis minor self-stretching (PMS), and combined SM + PMS. 52 healthy students (18 men and 34 women; mean age 23.67 ± 6.73 years) with RSP were randomly assigned to four groups (SM, PMS, combined SM + PMS, control). The mobilization group received SM, the stretching group performed self-PMS, and the combined group received SM + PMS. The control group received no treatment. Kinematics data to measure scapular protraction (cm), anterior tilt (°), internal rotation (°), and downward rotation (°) were captured with a motion analysis system before and after 5 sessions of group intervention. All variables decreased significantly post-intervention compared to baseline values (P < 0.05). Internal rotation and downward rotation decreased significantly in the intervention groups compared to the control group (P < 0.05). No significant differences were observed between the intervention groups. SM appears to be an effective technique to change scapular resting position in individuals with RSP. However, this technique was not superior to PMS or a combination of SM + PMS.


Anterior ankle impingement after tendo-Achilles lengthening for long-standing equinus deformity in residual poliomyelitis.
This study was performed to investigate anterior ankle impingement after tendo-Achilles lengthening for long-standing equinus deformity in patients with residual poliomyelitis and to investigate whether the severity of preoperative equinus deformity affected the occurrence of symptomatic anterior impingement. Twenty-seven consecutive patients (mean age, 43.8 ± 9.4 years) with residual poliomyelitis who underwent tendo-Achilles lengthening for equinus foot deformity were included. On lateral foot-ankle weight-bearing radiographs, the tibiocalcaneal angle, plantigrade angle, and McDermott grade were measured and the presence of anterior blocking spur was evaluated. Eleven patients (40.7%) had anterior ankle impingement on radiographic findings preoperatively and 24 patients (88.9%) at latest follow-up. There was a significant difference in McDermott grade between preoperative and latest follow-up (P < .001). There were significant differences in tibiocalcaneal angle and plantigrade angle between the patients with anterior ankle pain and without anterior ankle pain (P = .006 and .011, respectively) and between the patients with anterior blocking spur and without anterior blocking spur (P = .005 and .010, respectively). Most patients with residual poliomyelitis had anterior ankle impingement after tendo-Achilles lengthening for long-standing equinus deformity, and the presence of symptomatic anterior ankle impingement was significantly associated with the severity of the equinus deformity. Therefore, for residual poliomyelitis patients with severe long-standing equinus deformity, surgeons should consider the possibility of a subsequent anterior procedure for anterior impingement after tendo-Achilles lengthening. Level IV, retrospective case series.


Priming of naive CD8+ T cells in the presence of IL-12 selectively enhances the survival of CD8+CD62Lhi cells and results in superior anti-tumor activity in a tolerogenic murine model.
During the antigen-dependant activation process several subsets CD8+ T cells appear with different phenotypic and functional characteristics. Recent studies indicate that the state of T cell differentiation radically affects their ability to effectively respond to tumor challenge, with early effector CD8+ T (CD62Lhigh) cells having better anti-tumor activity. Thus strategies aimed at optimizing the generation of such subpopulations could significantly enhance the effectiveness of adoptive cell therapy (ACT) for cancer. In this study, we show that priming of naïve CD8+ T cells in the presence of IL-12 selectively rescued early CD8+ CD62L(hi) from activation induced cell death and resulted in the increased accumulation of this subset of CD8+ T cells. Furthermore, we demonstrated that IL-12 directly modulated the expression of CD62L on activated CD8+ T cells. When used for ACT, naïve CD8+ T cells primed in vitro in the presence of IL-12 showed superior anti-tumor activity toward B16 melanoma. Importantly, using the Pmel-1 model, priming pmel-1 cells in vitro with IL-12 reduced the state of functional tolerance associated with the non-mutated "self" tumor antigen gp100, as demonstrated by significant tumor responses in the absence of vaccination. Together, our results suggest that in vitro conditioning of naïve CD8+ T cells with IL-12 prior to ACT could significantly enhance their anti-tumor activity.


Comparative properties of rat liver chromatin in situ and in vitro at early stages after partial hepatectomy.
The binding of acridine orange and ethidium bromide to rat liver chromatin increases by 30% one hour after partial hepatectomy, returns to the control level by the second hour and increases again by the sixth hour. The changes described were found in investigations carried out on whole cells, on isolated nuclei, and on chromatin preparation in vitro. Increased ligand binding disappears after the treatment of the one-hour chromatin with a 0.3 M NaCl solution, but such a treatment does not change the binding of ligands to chromatin obtained six hours after hepatectomy. The one-hour chromatin is characterized by elongation of distances between individual nucleosomes whereas the two-hour chromatin is the same as in control.


[Multislice computed tomography in the selection of candidates for transcatheter aortic valve implantation].
Transcatheter aortic valve implantation is an emerging treatment option for severe symptomatic aortic stenosis in patients considered unsuitable for surgical valve replacement. The authors review the use of multislice computed tomography in the selection of candidates for transcatheter aortic valve replacement, procedural support and post-interventional follow-up. A single-center experience of the role of this imaging technique is also described. Multislice computed tomography is an essential imaging tool in the selection and exclusion of candidates for transcatheter aortic valve implantation, providing evaluation of coronary anatomy and the relationship of the coronary ostia with the aortic valve structure, and accurate analysis of the valve annulus and aortic root, left ventricular outflow tract, aorta and peripheral vascular access routes. Multislice computed tomography is also central to the choice of appropriate prosthesis size. In addition, it guides arterial puncture by image fusion techniques and enables correct prosthesis apposition to be verified. This review aims to describe the role of computed tomography in this increasingly common interventional valve procedure, providing an overview of current knowledge and applications.


The influence of gait speed on the stability of walking among the elderly.
Walking speed is a basic factor to consider when walking exercises are prescribed as part of a training programme. Although associations between walking speed, step length and falling risk have been identified, the relationship between spontaneous walking pattern and falling risk remains unclear. The present study, therefore, examined the stability of spontaneous walking at normal, fast and slow speed among elderly (67.5±3.23) and young (21.4±1.31) individuals. In all, 55 participants undertook a test that involved walking on a plantar pressure platform. Foot-ground contact data were used to calculate walking speed, step length, pressure impulse along the plantar-impulse principal axis and pressure record of time series along the plantar-impulse principal axis. A forward dynamics method was used to calculate acceleration, velocity and displacement of the centre of mass in the vertical direction. The results showed that when the elderly walked at different speeds, their average step length was smaller than that observed among the young (p=0.000), whereas their anterior/posterior variability and lateral variability had no significant difference. When walking was performed at normal or slow speed, no significant between-group difference in cadence was found. When walking at a fast speed, the elderly increased their stride length moderately and their cadence greatly (p=0.012). In summary, the present study found no correlation between fast walking speed and instability among the elderly, which indicates that healthy elderly individuals might safely perform fast-speed walking exercises.


Delamination of plastic-coated waste paper by enzymes of the white rot fungus Dichomitus squalens.
Many paper products are coated with plastic to improve their quality and stability. However, this limits recycling and recovery options and the plastic-coated waste paper is mostly disposed in landfills. Such practices are uneconomical and contrary to sustainable waste management. In this work enzymes of the white rot fungus Dichomitus squalens were investigated for possible delamination of plastic-coated waste paper. Enzymes were found capable to release the polyethylene foil from plastic-coated paper which resulted in 88.6-91.5% mass loss. The delamination rate, however, was depended on the ratio between plastic-coated paper and volume of enzyme filtrate. Results of a consequent experiment showed that enzymes are also efficient when plastic-coated paper is treated in a sequencing batch reactor resulting in 88.2-90.6% mass loss. The system was fully functional up to the 5th cycle; afterwards, the delamination rate reduced due to high thickness of the waste paper sludge. The enzyme activity, however, was still very high; with the laccase activity at the end of the experiment above 900 U/L and manganese peroxidase above 250 U/L. Our results demonstrated, that plastic-coated waste paper has the potential to be efficiently recovered instead of being disposed in landfills.


Criticality of the measurement of corneal thickness in specular reflection by digital biomicroscope.
The aim was to evaluate the effects on corneal thickness (t) measurement, of asymmetry of the CCD position for a digital biomicroscope in specular reflection. t was deduced from the distance between reflexes from anterior and posterior corneal surfaces using a biomicroscope (Takagi SM70 N), with the illuminator either, (a) farther from sensor side (150 eyes) or, (b) closer to it (134 eyes). The distance between reflexes was also measured on a glass slide and a reference lens, with nominal thicknesses of 1580 and 520 μm, respectively. Corneal thickness (tPACH) was also measured by pachymeter (Canon TX-20 P). When biomicroscope asymmetry was ignored, t for the glass slide was (a) 1760 and (b) 1404 μm. Correcting for the asymmetry provided corresponding values of 1588 and 1591 μm. For the lens, t was (a) 696 and (b) 543 μm, or 642 and 497 μm, when using the approximation of parallel surfaces (APS). Correcting for the asymmetry gave 565 and 552 μm (578 and 564 μm, with APS). Mean corneal t was (a) 560 and (b) 467 μm, (564 and 468 μm, with APS). Correcting for asymmetry gave (a) 506 and (b) 529 μm (508 and 530 μm, with APS). Mean tPACH was 552 μm. Biomicroscope asymmetry critically affects corneal thickness measurement in specular reflection. Induced errors can be accounted for and corrected, however. While the correction to the curvature radius is clinically relevant, it plays a minor role compared to asymmetry.


Self-removal of catheter after robot-assisted radical prostatectomy: a feasibility study.
Self-removal of urinary catheter as an option after robot-assisted radical prostatectomy (RARP) has never been explored in literature. We report the feasibility and outcome of the first study of this novel concept in our hospital. We conducted a prospective audit of self-TWOC (trial without catheter) in men who underwent consecutive RARP in our centre between April 2022 and September 2022. Men who had self-TWOC filled a questionnaire about the outcomes of self-TWOC. Carbon footprint and carbon offset for each hospital TWOC avoided were calculated. Of the 129 who underwent self-TWOC, 112 filled the questionnaire and were hence included in the final analysis. Self-TWOC was successful in all the 112 (100%) men in the study. 99.1% of men were satisfied with self-TWOC at home. We managed to avoid 79.6 ± 36.72 km of travel and 77 min of travel time for every self-TWOC. This also saved 85£/patient on clinic expenses and fuel cost savings of 9.87-15.99£ per patient depending on car engine size/type. The carbon footprint calculated was 20 kg CO2 assuming average engine sized diesel/petrol cars and 10 kg CO2 for an average UK petrol hybrid car. The calculated carbon offset per patient for diesel/petrol cars: 0.32£, petrol hybrid: 0.16£. Self-TWOC for 80-160 patients will save the carbon emissions equivalent to that of a passenger on a London-New York Trans-Atlantic flight. Self-TWOC is safe, affordable and is sustainable to the environment. Widespread acceptance of this practice change will be a small, but steady step towards greener health systems across the world.


Sketch Kernel Ridge Regression Using Circulant Matrix: Algorithm and Theory.
Kernel ridge regression (KRR) is a powerful method for nonparametric regression. The time and space complexity of computing the KRR estimate directly are O(n3) and O(n2) , respectively, which are prohibitive for large-scale data sets, where n is the number of data. In this article, we propose a novel random sketch technique based on the circulant matrix that achieves savings in storage space and accelerates the solution of the KRR approximation. The circulant matrix has the following advantages: It can save time complexity by using the fast Fourier transform (FFT) to compute the product of matrix and vector, its space complexity is linear, and the circulant matrix, whose entries in the first column are independent of each other and obey the Gaussian distribution, is almost as effective as the i.i.d. Gaussian random matrix for approximating KRR. Combining the characteristics of the circulant matrix and our careful design, theoretical analysis and experimental results demonstrate that our proposed sketch method, making the estimate kernel methods scalable and practical for large-scale data problems, outperforms the state-of-the-art KRR estimates in time complexity while retaining similar accuracies. Meanwhile, our sketch method provides the theoretical bound that keeps the optimal convergence rate for approximating KRR.


Periodontal status and the efficacy of the first-line treatment of major depressive disorder.
The efficacy of treatment of major depressive disorder (MDD) is not satisfactory. Systemic inflammation may play an important role in MDD pathogenesis and treatment outcomes. Periodontal disease is the systemic inflammatory condition. Its prevalence may be as high as 45%. We aimed to assess the association of periodontal status with the outcome of 3-month first-line treatment of MDD with selective serotonin reuptake inhibitors. We performed the prospective cohort study during 2018/2019 at Psychiatric Hospital "Sveti Ivan," Croatia, on a consecutive sample of 43 patients. The outcome was the MDD symptoms severity measured using the Hamilton Depression Rating Scale-17. The periodontal status was indicated by the clinical attachment loss (CAL). Baseline periodontal status had a nonlinear significant and clinically relevant association with the MDD treatment outcome (R2 change of the quadratic term = 0.12; p = 0.027). In patients with good baseline periodontal status the severity of MDD symptoms was significantly improved. When the value of CAL was ≥4.44 mm, indicating the worse periodontal status, further increase in baseline CAL was associated with the worsening of MDD treatment outcomes independently of the baseline depression severity and 14 sociodemographic and clinical predictors of treatment outcome. Periodontal healthcare is accessible, and should be utilize in an integrative, multidisciplinary approach not only for the sake of psychiatric patients' quality of life and prevention of periodontal disease, but for the sake of the outcomes of psychiatric treatment as well.


Going provincial: preceptoring and mentoring revisited in the health sciences. Part I.
This article describes the Preceptor & Mentor Initiative for Health Sciences in BC, a provincial strategy to facilitate preceptoring and mentoring. A web site was developed with a comprehensive preceptor/mentor framework and resources, based on best practices and applicable to all health sciences. Informal feedback indicates this Initiative is effective in supporting health sciences preceptoring and mentoring in BC. A formal evaluation will be conducted by March 2003 and reported in a future FORUM article.


The 8th International Conference on Counter-current Chromatography held at Brunel University, London, UK, July 23-25, 2014.
The 8th International Conference on Counter-current Chromatography (CCC2014) was held at Brunel University London from July 23rd to 25th, 2014. It has been 14 years since Brunel hosted the first International Conference on CCC (CCC2000) at the beginning of the millennium and therefore, it was a good opportunity to review the progress of this emerging technology and particularly the impact it is having with industry today.


Use of charge coupled device camera for imaging of intracellular phthalocyanines.
A highly sensitive charge-coupled device (CCD) camera, linked to a computerized image processor, has been used to obtain fluorescence images of chloro-aluminum sulfonated phthalocyanine (ClAlSPc), and its mono- to tetra-sulfonated constituents, in cells recovered from the peritoneal cavity of dye-treated mice. Immunofluorescence and cytochemistry showed that cells which preferentially took up ClAlSPc and its sulfonated species were predominantly of the monocyte-macrophage series. While this technique may be of use in determining the nature of those cells capable of taking up light sensitive dyes and, perhaps, the intracellular location of such agents, the possibility that photoinactivation by dye aggregation could reduce the sensitivity of this procedure is discussed.


Review and classification of AI-enabled COVID-19 CT imaging models based on computer vision tasks.
This article presents a systematic overview of artificial intelligence (AI) and computer vision strategies for diagnosing the coronavirus disease of 2019 (COVID-19) using computerized tomography (CT) medical images. We analyzed the previous review works and found that all of them ignored classifying and categorizing COVID-19 literature based on computer vision tasks, such as classification, segmentation, and detection. Most of the COVID-19 CT diagnosis methods comprehensively use segmentation and classification tasks. Moreover, most of the review articles are diverse and cover CT as well as X-ray images. Therefore, we focused on the COVID-19 diagnostic methods based on CT images. Well-known search engines and databases such as Google, Google Scholar, Kaggle, Baidu, IEEE Xplore, Web of Science, PubMed, ScienceDirect, and Scopus were utilized to collect relevant studies. After deep analysis, we collected 114 studies and reported highly enriched information for each selected research. According to our analysis, AI and computer vision have substantial potential for rapid COVID-19 diagnosis as they could significantly assist in automating the diagnosis process. Accurate and efficient models will have real-time clinical implications, though further research is still required. Categorization of literature based on computer vision tasks could be helpful for future research; therefore, this review article will provide a good foundation for conducting such research.


The generation time, lag time, and minimum temperature of growth of coliform organisms on meat, and the implications for codes of practice in abattoirs.
The growth of coliform organisms on meat tissue from sheep carcasses processed in a commercial abattoir was investigated. The results indicated that for practical purposes the minimum temperature of growth of these organisms on meat may be taken as 8 degrees C. Equations were derived relating the generation time and the lag time of coliform organisms in raw blended mutton to the temperature at which the meat is held. Estimates of growth obtained with these equations were found to agree closely with the experimental results, especially at temperatures above 10 degrees C, and allowed the generation times and the lag times for all temperatures up to 40 degrees C to be calculated. These times were also found to agree closely with the times determined using a strain of Escherichia coli inoculated into blended mutton tissue. A strain of Salmonella typhimurium inoculated in the same way into blended mutton tissue gave longer generation and lag times at temperatures below 15 degrees C. Therefore, it is believed that the calculated tables of lag and generation times included in this paper can be used to determine the length of time raw chilled meat may be held afterwards at temperatures above the minimum temperature of growth without an increase in the number of any salmonella organisms present, and these times include a safety margin at each temperature. The study indicates that the mandatory codes of practice presently applied in commercial abattoirs are too stringent. Maintaining the temperature of boning rooms at 10 degrees C or less does not appear to be necessary providing the meat is processed within the calculated time limits. A relaxation of the restrictions on boning room temperatures would decrease costs, increase worker comfort and safety and would not compromise the bacteriological safety of the meat produced.


Multiple Intracranial Aneurysms from Coccidioidal Meningitis: Case Report Featuring Aneurysm Formation and Spontaneous Thrombosis with Literature Review.
Coccidioidal meningitis can progress to vasculitis with aneurysm formation. Although aneurysmogenesis is rare, it carries exceptionally high mortality. Except in one instance, prior case reports have documented universally fatal consequences. A 26-year-old man developed disseminated coccidioidomycosis with formation of multiple aneurysms throughout the anterior intracranial vasculature bilaterally. This report is unique in that it chronicles the formation and subsequent spontaneous thrombosis of several aneurysms over a 4-week period. In total 10 aneurysms were documented in the same patient-the highest reported to date. The patient was eventually discharged from the hospital for what has heretofore been a universally fatal disease process. Neurologic examination and vascular imaging 1 month after discharge demonstrated stable findings. Coccidioidal aneurysms carry a high mortality. The mainstay of therapy remains lifelong triazole antifungal therapy with the addition of liposomal amphotericin in cases of treatment failure. Steroid use is controversial but should be considered whenever there is vascular involvement. Although watchful waiting is reasonable in light of the possibility of spontaneous thrombosis with medical management, dynamic changes in aneurysm size or configuration should prompt timely endovascular or operative interventions.


Transthoracic hernia after harvesting a costal and latissimus dorsi flap.
Ribs are one of the most widely used grafts in craniofacial surgery. Harvesting a costochondral graft is easy and safe. The main complications are related to pneumothorax and chest-wall deformity in children. A complication is described in a patient who underwent an orbito-zygomatic reconstruction with two contiguous ribs and a latissimus dorsi free flap, and who subsequently developed a transthoracic hernia that required reconstruction with polypropylene mesh.