A childhood immunization education program for parents delivered during late pregnancy and one-month postpartum: a randomized controlled trial.
Improved immunization rates have reduced the incidence of vaccine-preventable diseases (VPDs) in advanced nations. Japan's unique vaccination system classifies vaccines into routine vaccines ostensibly required under the Preventive Vaccination Law and recommended but optional vaccines, although all vaccines are in fact voluntary. In Japan, low immunization rates, particularly for optional vaccines, have resulted in high rates of sequelae and death. The decision as to whether a child will receive a vaccine depends on the parents, who must obtain information, make inquiries, and make the required payment, the last of which is a major barrier. This randomized, controlled trial was conducted to evaluate the effectiveness of an immunization education program designed to meet mothers' needs. This randomized controlled trial assigned pregnant women to intervention or control groups. The intervention was individual education sessions involving the children's fathers in shared decision-making on whether or not to immunize their child. A survey was conducted before and after the intervention. Data were analyzed using the intention-to-treat principle. Of 225 pregnant women, 175 (78%) participated and 171 replied to the post-survey. At age 3 months, intervention infants had higher self-reported immunization rates for hepatitis B virus vaccine (76% vs. 49%; P < 0.001) and rotavirus vaccine (84% vs. 68%; P = 0.019) than control group infants. The percentage of parents intending to vaccinate their infants was higher in the intervention group (77% vs. 52%; P < 0.01). Improvements in scores for basic knowledge (mean [SD]: 5.5 [3.6] vs. 3.0 [3.8], range: 10-30; P < 0.001), advanced knowledge (mean [SD]: 5.1 [2.4] vs. 2.8 [2.5], range: 5-15; P < 0.001), and health literacy regarding immunization (mean [SD]: 0.5 [0.8] vs. 0.2 [0.6], range: 1-5; P < 0.01) were higher in the intervention group. The rate of decision making by both parents (68% vs. 52%; P < 0.05) was higher in the intervention group. Our findings confirmed the program's effectiveness. The intervention improved immunization rates, the percentage of parents intending to vaccinate their infants and knowledge scores. Interventions which directly and indirectly involved fathers in shared decision-making on whether to immunize their child were effective, as were individualized interventions that provided parents with access to up-to-date information. UMIN000012575 . Registered 14 December 2013 (The study was prospectively registered).


Defining innovations of therapeutic interventions: a position paper by the Italian Society of Hospital Pharmacists.
Defining innovation in pharmacotherapy is complex because general definitions cannot be easily adapted to the specificity of different therapeutic areas. The Italian Society of Hospital Pharmacists has developed a position paper in which three criteria are used to recognise innovation to a new intervention: (1) clinical relevance of the trial's primary end-point; (2) evidence of superiority; (3) use of an adequate comparator in the controlled trial. Clinically relevant end-points should appear in predetermined lists by therapeutic area managed by our society; likewise, the third criterion must be documented by an authoritative therapeutic guideline recognised to be still valid. A preliminary attempt is presented to retrospectively apply these criteria, particularly the first one, to a series of 21 clinical trials; this initial experience has generated a first list of clinically relevant end-points. This approach of innovation assessment is proposed for application also in the field of medical devices.


Heat resistance of thermoduric enterococci isolated from milk.
Enterococci are reported to survive pasteurisation but the extent of their survival is unclear. Sixty-one thermoduric enterococci isolates were selected from laboratory pasteurised milk obtained from silos in six dairy factories. The isolates were screened to determine log(10) reductions incurred after pasteurisation (63°C/30 min) and ranked from highest to lowest log(10) reduction. Two isolates each of Enterococcus faecalis, Enterococcus faecium, Enterococcus durans and Enterococcus hirae, exhibiting the median and the greatest heat resistance, as well as E. faecalis ATCC 19433, were selected for further heat resistance determinations using an immersed coil apparatus. D values were calculated from survival curves plotted from viable counts obtained after heating isolates in Brain Heart Infusion Broth at 63, 69, 72, 75 and 78°C followed by rapid cooling. At 72°C, the temperature employed for High Temperature Short Time (HTST) pasteurisation (72°C/15s), the D values extended from 0.3 min to 5.1 min, depending on the isolate and species. These data were used to calculate z values, which ranged from 5.0 to 9.8°C. The most heat sensitive isolates were E. faecalis (z values 5.0, 5.7 and 7.5°C), while the most heat resistant isolates were E. durans (z values 8.7 and 8.8°C), E. faecium (z value 9.0°C) and E. hirae (z values 8.5 and 9.8°C). The data show that heat resistance in enterococci is highly variable.


Follicular flushing increases the number of oocytes retrieved: a randomized controlled trial.
Does follicular flushing increase the number of cumulus-oocyte complexes (COCs) retrieved compared to single aspiration? Follicular flushing significantly increases the number of COCs retrieved compared to single aspiration. On the basis of published meta-analyses, follicular flushing does not seem to increase the number of oocytes retrieved, the probability of clinical pregnancy, or that of live birth and has been associated with an increase in the duration of oocyte retrieval. It should be noted, however, that all the eligible randomized controlled trials (RCTs) in these meta-analyses have randomized patients into either single aspiration or follicular flushing. This study design might not allow the detection of the true effect of follicular flushing. Despite randomization, this might still be obscured, to an extent, by heterogeneity in patients, stimulation characteristics, and differences in the oocyte retrieval procedure. A prospective, single centre, RCT, including 105 patients was performed between July and December 2022. Eligible patients were those undergoing oocyte retrieval for ICSI, aged <43 years, with BMI 18-35 kg/m2. Patients with all types of ovarian response (low-normal-high), as assessed on the day of triggering final oocyte maturation, were included. Random allocation of the ovaries of each patient to either single aspiration or follicular flushing was performed on the day of oocyte retrieval, using a computer-generated randomization list. Patients could enter the study only once. All follicles from ovaries allocated to either follicular flushing or single aspiration, were aspirated by the same 16G double lumen needle, with a constant aspiration pressure of 190 mmHg, resulting in flow rate of 0.42 ml/s. In the ovaries allocated to the follicular flushing group, if a COC was not recovered in the initial aspirate of each follicle, follicular flushing was performed until a COC was retrieved, up to a maximum of five times. The primary outcome measure was the number of COCs retrieved. Secondary outcomes were oocyte recovery rate, oocyte maturation rate, fertilization rate, and rate of good quality embryos on Day 2. Values are expressed as a median (inter-quartile range). Significantly more COCs were retrieved in the follicular flushing as compared to the single aspiration group in all patients [5 (7) vs 2 (3), P < 0.001, respectively], as well as in patients with high [9 (3) vs 5 (4), P < 0.001, respectively], normal [5 (2) vs 2 (3), P < 0.001, respectively] and low [1 (1) vs 1 (1), P < 0.001, respectively] ovarian response. In patients with low ovarian response, no COCs were retrieved in 5.7% of the ovaries in the flushing group vs 42.8% of the ovaries in the single aspiration group (P < 0.001). The oocyte retrieval rate was significantly higher in the follicular flushing vs the single aspiration group, in all patients [88.9% (25.0) vs 45.5% (37.5), P < 0.001, respectively], as well as in patients with high [81.8% (15.9) vs 45.5% (22.2), P < 0.001, respectively], normal [85.7% (28.6) vs 40.0% (30.0), P < 0.001, respectively], and low [100% (0) vs 50.0% (100), P < 0.001, respectively] ovarian response. No significant difference was observed regarding maturation rate [85.2% (30.8) vs 100% (33.3), P = 0.78], fertilization rate [76.4% (50) vs 83.3% (50) P = 0.42], and the proportion of good quality embryos on Day 2 [83.3% (40) vs 100% (50), P = 0.62]. Similarly, no differences in the above variables were observed in patients with different types of ovarian response. Follicular flushing as compared to single aspiration was associated with a significant increase in the duration of oocyte retrieval in all patients [248 s (332) vs 135 s (164), respectively], as well as in patients with high [464 s (225) vs 237 s (89), P < 0.001, respectively], normal [248 s (108) vs 141 s (95), P < 0.001, respectively], and low [64 s (59) vs 48 s (10), P < 0.001, respectively] ovarian response. Although the current study design allows for a more accurate evaluation of the true effect of follicular flushing on the number of COCs retrieved, it does not permit the evaluation of its role on the probability of pregnancy. This is the first RCT to suggest that follicular flushing increases the number of COCs retrieved compared to single aspiration, independently of ovarian response. This implies that follicular flushing plays an important role in the optimization of oocyte retrieval. These results, however, need to be confirmed in future studies, in which an equal flow rate should be used during oocyte retrieval. No external funding was obtained for this study. There are no conflicts of interest to declare. NCT05473455. 15 July 2022. 27 July 2022.


FOXM1 cistrome predicts breast cancer metastatic outcome better than FOXM1 expression levels or tumor proliferation index.
FOXM1 is a key transcription factor regulating cell cycle progression, DNA damage response, and a host of other hallmark cancer features, but the role of the FOXM1 cistrome in driving estrogen receptor-positive (ER+) versus estrogen receptor-negative (ER-) breast cancer clinical outcomes remains undefined. Chromatin immunoprecipitation sequencing (ChIP-Seq) coupled with RNA sequencing (RNA-Seq) analyses was used to identify FOXM1 target genes in breast cancer cells (MCF-7) where FOXM1 expression was either induced by cell proliferation or repressed by p53 upregulation. The prognostic performance of these FOXM1 target genes was assessed relative to FOXM transcript levels and a 61-gene proliferation score (PS) for their ability to dichotomize a pooled cohort of 683 adjuvant chemotherapy-naïve, node-negative breast cancer cases (447 ER+, 236 ER-). Differences in distant metastasis-free survival (DMFS) between the dichotomized expression groups were determined by Cox proportional hazard modeling. Proliferation-associated FOXM1 upregulation induced a set of 145 differentially bound and expressed genes (direct targets), and these demonstrated minimal overlap with differentially bound and expressed genes following FOXM1 repression by p53 upregulation. This proliferation-associated FOXM1 cistrome was not only better at significantly predicting metastatic outcome of ER+ breast cancers (HR: 2.8 (2.0-3.8), p = 8.13E-10), but was the only parameter trending toward significance in predicting ER- metastatic outcome (HR: 1.6 (0.9-2.9), p = 0.087). Our findings demonstrate that FOXM1 target genes are highly dependent on the cellular context in which FOXM1 expression is modulated, and a newly identified proliferation-associated FOXM1 cistromic signature best predicts breast cancer metastatic outcome.


Surgical aortic valve replacement in patients aged 50-69 years-insights from the German Aortic Valve Registry (GARY).
The aim of this study was to analyse the outcome of patients between 50 and 69 years of age undergoing biological or mechanical aortic valve replacement. Data were collected from the German Aortic Valve Registry. Data were analysed regarding baseline characteristics and outcome parameters such as 5-year survival, stroke and reintervention. In total. 3046 patients undergoing isolated surgical aortic valve replacement between 2011 and 2012 were investigated and a propensity score matching was performed. Within this period, 2239 patients received a biological prostheses, while 807 patients received a mechanical prosthesis. Mean age in the biological group was 63.07 (±5.11) and 57.34 (±4.67) in the mechanical group (standardized mean difference 1.172). In the overall cohort, there were more female patients in the biological group (32.7% vs 28.4%) and log EuroSCORE I was higher (5.41% vs 4.26%). After propensity matching (610 pairs), there was no difference in the mortality at 5-year follow-up (12.1% biological vs 9.2% mechanical P = 0.05) nor for reoperation/reintervention (2.5% biological vs 2.0% mechanical, P = 0.546). Patients undergoing mechanical aortic valve replacement suffered from a higher stroke rate 3.3% vs 1.5% (P = 0.04) at 5-year follow-up. Aortic valve replacement with biological or mechanical prostheses showed similar 5-year outcomes for survival and reoperation in a propensity-matched cohort, but significantly increased stroke rate after mechanical aortic valve replacement. This could influence the choice of a mechanical valve in younger patients.


UrsaPlex: An STR multiplex for forensic identification of North American black bear (Ursus americanus).
UrsaPlex is a forensic quality 5-dye multiplexed tetranucleotide STR and sex identification panel for individual genetic identification of North American black bears (Ursus americanus). The panel is validated for the identification of black bears involved in human-wildlife conflict events and poaching investigations. This is the first single multiplex panel composed solely of tetranucleotide STRs derived from black bear and bear-specific sex markers. UrsaPlex produces complete genetic profiles from as little as 78 pg of DNA template and has a probability of identity of 2.63 × 10-13. The panel has also been tested for utility in other ursids, and our results indicate with minor modifications, UrsaPlex should prove valuable in identification investigations involving these species as well.


Ookinete destruction within the mosquito midgut lumen explains Anopheles albimanus refractoriness to Plasmodium falciparum (3D7A) oocyst infection.
Previous studies have shown that the central American mosquito vector, Anopheles albimanus, is generally refractory to oocyst infection with allopatric isolates of the human malaria parasite Plasmodium falciparum. However, the reasons for the refractoriness of A. albimanus to infection with such isolates of P. falciparum are unknown. In the current study, we investigated the infectivity of the P. falciparum clone 3D7A to laboratory-reared A. albimanus and another natural vector of human malaria, Anopheles stephensi. Plasmodium falciparum gametocytes grown in vitro were simultaneously fed to both mosquito species and the progress of malaria infection compared. In 22 independent paired experimental feeds, no mature oocysts were observed on the midguts of A. albimanus 10days after bloodfeeding. In contrast, high levels of oocyst infection were found on the midguts of simultaneously fed A. stephensi. Direct immunofluorescence microscopy and light microscopical examination of Giemsa-stained histological sections were used to identify when the P. falciparum clone 3D7A failed to establish mature oocyst infections in A. albimanus. Similar densities of macrogametes/zygotes, and immature retort-form and mature ookinetes were found within the bloodmeals of both mosquito species. However, in A. albimanus, ookinetes were seldom associated with the peritrophic matrix, and were neither observed in the ectoperitrophic space nor the midgut epithelium. In contrast, ookinetes were frequently observed in these midgut compartments in A. stephensi. Additionally, young oocysts were observed on the midguts of A. stephensi but not A. albimanus 2days after bloodfeeding. Vital staining of the immature retort-form and mature ookinetes found within the luminal bloodmeal, demonstrated that a significantly greater proportion of these malaria parasite stages were non-viable in A. albimanus compared with A. stephensi. Overall, our observations indicate that ookinetes of the P. falciparum clone 3D7A are destroyed within the bloodmeal of A. albimanus and that the midgut lumen, rather than the midgut epithelium, is the site of mosquito refractoriness in this particular malaria parasite-mosquito vector combination.


Factors influencing adolescents' decision not to smoke.
Although adolescents ultimately make their own decisions to smoke or not to smoke, social, economic, and environmental circumstances shape their choices. Most research on prevention of youth tobacco use focuses on predictors of smoking initiation. In this study, we explored nonsmoking attitudes, beliefs, and norms from the perspective of 16-17-year-old nonsmokers. This qualitative study targeted nonsmoking youths because most social policy in the arena of tobacco prevention aims to support adolescents who are tobacco free. Participants were 39 nonsmokers recruited from youth organizations in an urban community and included 22 African Americans (12 females; 10 males) and 17 Caucasian Americans (10 females; 7 males). A health behavior framework guided the development of semistructured questions on attitudes, beliefs, and norms associated with nonsmoking, used in eight in-depth group interviews. Concerns for health and addiction, a positive self-image, and perceived confidence, emerged as factors affecting participants' decisions not to smoke. The approval of parents and friends, and personal beliefs further reinforced adolescents' nonsmoking decisions. There were more commonalities than differences in nonsmoking attitudes across gender and race. Future studies of youth tobacco prevention should employ multifaceted approaches targeting adolescents' attitudes, families, and peer networks.


Humoral and T-cell responses to SARS-CoV-2 vaccination in multiple sclerosis patients treated with ocrelizumab.
The COVID-19 epidemic raises important questions about the efficacy of vaccines for people treated with ocrelizumab, an anti-CD20 therapy. Ocrelizumab has been shown to reduce the humoral response to SARS-CoV-2 infection and vaccination, but the T-cell response to vaccination has not been fully characterized. We sought to provide data regarding B and T-cell mediated responses to SARS-CoV-2 vaccination in ocrelizumab-treated patients, and to determine what variables correlate with vaccine immunogenicity. We hypothesized that patients without a humoral response to SARS-CoV-2 vaccination would still have intact T-cell responses. We conducted a prospective, observational, single center cohort study of patients with MS treated with either ocrelizumab or natalizumab as a comparator between March 2, 2021, and July 1, 2021. Eligible patients were age 18 to 55 and had no known prior infection with, or vaccination against, SARS-CoV-2. Patients with prior use of immunosuppressive or chemotherapeutic agents, or treatment with any anti-CD20 therapy other than ocrelizumab within 12 months of enrollment, were excluded. The Roche Elecsys anti-SARS-CoV-2 S immunoassay was performed prior to and 3-4 weeks post vaccination to evaluate the antibody response to SARS-CoV-2 spike IgG. The Adaptive Biotechnologies T-Detect COVID Test was performed to evaluate the adaptive T-cell immune response to SARS-CoV-2 in OCR-treated patients with no detectable antibodies. Data were analyzed using descriptive statistics, Fisher's exact test, and Wilcoxon rank sum. Forty-eight patients were enrolled in the study, 69% treated with ocrelizumab and 31% treated with natalizumab. Eighteen percent of ocrelizumab and 100% of natalizumab patients had a positive antibody response. In ocrelizumab-treated patients, there was no correlation between age, sex, BMI, total number of infusions, immunoglobulin G, CD19, or absolute lymphocyte count and antibody response. There was a trend suggesting that a longer interval between the last infusion and vaccination increased the likelihood of producing antibodies (P = 0.062). All ocrelizumab patients with negative antibody responses had positive T-cell responses. Treatment with ocrelizumab substantially impaired the humoral response to SAR-CoV-2 vaccination but did not impair T-cell responses. Further research is needed to determine if the T-cell response to SARS-CoV-2 vaccination is sufficient to prevent infection or reduce severity of COVID in patients who did not produce antibodies.


Differences in heparan sulfate production in cervical fibroblast cultures from women undergoing term and preterm delivery.
An extensive remodeling of the human cervical connective tissue occurs throughout pregnancy, with a decrease in the total concentration of collagen and proteoglycans. We hypothesized that the profound changes in proteoglycan production in the cervix would be seen in corresponding cervical fibroblasts as well. Cervical biopsies were obtained from five non-pregnant women, five women undergoing elective Cesarean section, six women directly after spontaneous term parturition and four directly after spontaneous preterm parturition. By explant technique, fibroblasts were cultured from the biopsies. Subcultures of the primary fibroblasts were treated with antibodies to heparan sulfate proteoglycans and labeled with radioactive sulfate. The labeled proteoglycans were purified by ion-exchange chromatography and separated by gel electrophoresis. Proteoglycan production was reduced by 50% in fibroblasts obtained from term and preterm women. In comparison to equivalent control cultures from non-pregnant women, this decline was significant. Production of the proteoglycans biglycan and perlecan was similar in term partal and preterm partal cell cultures. Biglycan production was significantly reduced (by 40%) and perlecan production was significantly induced (by 60%) compared to control cultures. Fibroblast cultures established from women with preterm delivery had significantly higher production of heparan sulfate proteoglycans than those obtained from non-pregnant donors. Heparan sulfate proteoglycans were localized to cell membranes and intracellular compartments. The changes in proteoglycan production in the human pregnant cervix can also be seen in corresponding cervical fibroblasts. Term partal and preterm partal cells differed from their non-pregnant counterpart, which suggests a role for proteoglycans in cervical ripening.


Stabilization of oligomeric structure of α-crystallin by Zn+² through intersubunit bridging.
α-Crystallin, the major protein of mammalian eye lens, is a member of the small heat shock protein family and is a molecular chaperone. We previously reported that its molecular chaperone function as well as stability increased in presence of Zn+². Despite the effect of Zn+² on the structure and function of α-crystallin, evidence for direct interaction between them remained elusive. We now present the MALDI mass spectrometric data that shows direct evidence of Zn+² binding to recombinant αA- and αB-crystallin. The binding stoichiometry was over three Zn+² per subunit of α-crystallin at zinc/protein molar ratio of 20. Observation of multiple Zn+² binding is consistent with the large increase in thermodynamic stability. Sequence-based analysis of αA- and αB-crystallin predicted both proteins to be nonzinc binding proteins. Our dynamic light scattering data shows that Zn+² stabilizes the oligomeric structure of α-crystallin by bridging neighboring subunits in multiple centers. Despite the low affinity binding, the intersubunit bridging by multiple Zn+² makes the oligomer so stable that oligomer breakdown does not occur even at 6M urea. The subunit bridging has been supported by our FRET data that showed absence of subunit exchange in presence of zinc. MALDI data also showed that the interaction of α-crystallin with Zn+² is quite different from other bivalent metal ions. Bound Zn+² could be easily removed by dialysis of the complex. The relevance of such weak interaction on the stability of the oligomeric structure of α-crystallin and its function in the eye lens has been discussed.


Detrimental effects of prenatal exposure to filtered diesel exhaust on mouse spermatogenesis.
We recently showed that prenatal exposure to diesel exhaust (DE) disrupts spermatogenesis in mouse offspring. This study was undertaken to determine whether filtered DE in which 99.97% of diesel exhaust particles >0.3 microm in diameter were removed affects spermatogenesis in growing mice. After prenatal exposure to filtered DE for 2-16 days postcoitum, we examined daily sperm production (DSP), testicular histology, serum testosterone levels and mRNA expression of hormone synthesis process-related factors. In the filtered DE exposed group, DSP was markedly reduced at 12 weeks compared with the control group; clean air exposed group. Histological examination showed multinucleated giant cells and partial vacuolation in the seminiferous tubules of the exposed group. Testosterone was elevated significantly at 5 weeks. Moreover, luteinizing hormone receptor mRNA at 5 and 12 weeks, 17alpha-hydroxylase/C17-20-lyase and 17beta-hydroxysteroid dehydrogenase mRNAs at 12 weeks were significantly elevated. These results suggest that filtered DE retains its toxic effects on the male reproductive system following prenatal exposure.


ESI-FTICR mass spectrometry employing data-dependent external ion selection and accumulation.
Data-dependent external m/z selection and accumulation of ions is demonstrated in use with ESI-FTICR instrumentation, with two different methods for ion selection being explored. One method uses RF/DC quadrupole filtering and is described in use with an 11.5 tesla (T) FTICR instrument, while the second method employs RF-only resonance dipolar excitation selection and is described in use with a 3.5 T FTICR instrument. In both methods ions are data-dependently selected on the fly in a linear quadrupole ion guide, then accumulated in a second linear RF-only quadrupole trap that immediately follows. A major benefit of ion preselection prior to external accumulation is the enhancement of ion populations for low-level species. This development is expected to expand the dynamic range and sensitivity of FTICR for applications including analysis of complex polypeptide mixtures (e.g., proteomics).


Can the salivary urea and stimulated saliva concentration be a marker of periodontal diseases in opioid users? A case-control study.
& Aim: Microbial plaque is the primary cause of periodontal diseases, and smoking and opioid addiction can accelerate microbial plaque formation and disease progression. Adequate saliva flow and salivary urea concentration are important parameters for a healthy periodontium. In this study, the relationship between Periodontal Diseases and the History of opioid addiction was investigated by measuring the Salivary Urea and Stimulated Saliva Concentration. This case-control study was conducted on 240 patients (120 cases and 120 controls) in 2021 referred to addiction treatment centers and the dental clinic in Iran, Birjand. The control and case groups were matched in terms of age. Demographic, base data, and clinical examination results were collected by a checklist. Data were analyzed using SPSS 19 and one-way ANOVA and chi-square tests. P-value <0.05 was considered as the significance level. Periodontitis severity was significantly higher in the case group than in the control group (P-value = 0/000). Salivary urea concentration significantly increased in both case and control groups with an increase in periodontitis severity (P-value = 0/003 in the case group and P-value = 0/000 in the control group), but there was no significant relationship between the stimulated saliva flow rate and the severity of periodontitis in these two groups (P-value>0.05). Following the use of opioids, the flow of saliva decreases, and with the exacerbation of the periodontal disease, the concentration of urea in saliva increases. Therefore, it seems that the analysis of saliva parameters, including urea concentration, can be useful for the diagnosis of periodontal disease, and saliva urea concentration is not directly related to opioid use.


Localization of substance P-immunoreactive nerve fibers in the human digital skin.
Substance P-immunoreactive nerve endings were localized in human digital skin by the use of indirect immunohistochemical technique. It was found that substance P-like immunoreactivity was present in free nerve endings in the dermal papillae and in the epidermis. Some Meissner's corpuscles also contained substance P positive nerve endings. Furthermore, substance P-immunoreactive nerves were localized in close connection to sweat gland ducts and blood vessels. The functional significance of these findings was discussed with regard to pain mediation and inflammatory response.


Improving psychiatric consultation to nonpsychiatrist physicians.
Nonpsychiatrist physicians were surveyed regarding problems that they had experienced when seeking a psychiatric consultation or treatment referral. They gave three main reasons for not referring more patients to psychiatrists: a belief that other mental health professionals could do as well at less cost, that psychiatrists were less available to discuss patients, and that greater stigma was attached to seeing a psychiatrist than seeing other mental health professionals. Psychiatrists might improve their consultation and referral networks by addressing the misperceptions of their nonpsychiatrist physician colleagues.


Predicting metabolic cost of level walking.
Energy expenditure in walking is usually expressed as a function of walking speed. However, this relationship applies only to freely adopted step length-step rate patterns. Both the step length and the step rate must be used to preduct the energy expenditure for any combination of step length and step rate. Evidence on seven subjects indicates that the energy demand for such a combination can be determined by conducting two experiments. In the first, the subject is allowed to freely choose his own walking pattern to achieve a set of prescribed speeds. In the second, the speed is kept constant but the subject is forced to adopt a range of prescribed step rates. The results of the two experiments combined yield enough data to make possible the determination of the energy equation of the pattern, encompassing both "free" and "forced" gaits. Results show that the freely chosen step rate requires the least oxygen consumption at any given speed. Any other forced step rate at the same speed increases the oxygen cost over that required for the "free" step rate.


Irritable Bowel Syndrome and Microscopic Colitis: A Systematic Review and Meta-analysis.
Patients with microscopic colitis and patients with irritable bowel syndrome (IBS) present with similar symptoms. We examined the association between IBS and microscopic colitis in a systematic review and meta-analysis. We searched the medical literature to identify cross-sectional surveys or case-control studies reporting the association between microscopic colitis and IBS in 50 or more unselected adult patients. We recorded the prevalence of IBS symptoms in patients with histologically confirmed microscopic colitis, or the prevalence of histologically confirmed microscopic colitis in patients with IBS. Data were pooled using a random-effects model; the association between microscopic colitis and IBS was summarized using an odds ratio (OR) with a 95% confidence interval (CI). The search strategy identified 3926 citations, of which 10 were eligible for our analysis. The pooled prevalence of IBS in patients with microscopic colitis was 33.4% (95% CI, 31.5%-40.6%), but was not significantly higher in patients with microscopic colitis than in patients with diarrhea (OR, 1.39; 95% CI, 0.43-4.47). In 3 cross-sectional surveys, the pooled OR for microscopic colitis in participants with IBS, compared with other patients with diarrhea, was 0.68 (95% CI, 0.44-1.04). In 4 case-control studies the prevalence of IBS in patients with microscopic colitis was significantly higher than in asymptomatic controls (OR, 5.16; 95% CI, 1.32-20.2). Based on a meta-analysis, one third of patients with microscopic colitis reported symptoms compatible with IBS, but the prevalence of IBS was no higher than in other patients with diarrhea. The odds of microscopic colitis were no higher in patients with IBS compared with other patients with diarrhea. The value of routine colonoscopy and biopsy to exclude microscopic colitis in patients with typical IBS symptoms, unless other risk factors or alarm symptoms are present, remains uncertain.


Revealing the nature of hidden charm pentaquarks with machine learning.
We study the nature of the hidden charm pentaquarks, i.e., the Pc4312,Pc4440 and Pc(4457), with a neural network approach in pionless effective field theory. In this framework, the normal χ2 fitting approach cannot distinguish the quantum numbers of the Pc(4440) and Pc(4457). In contrast to that, the neural network-based approach can discriminate them, which still cannot be seen as a proof of the spin of the states since pion exchange is not considered in the approach. In addition, we also illustrate the role of each experimental data bin of the invariant J/ψp mass distribution on the underlying physics in both neural network and fitting methods. Their similarities and differences demonstrate that neural network methods can use data information more effectively and directly. This study provides more insights about how the neural network-based approach predicts the nature of exotic states from the mass spectrum.


Facile Synthesis of La- and Chitosan-Doped CaO Nanoparticles and Their Evaluation for Catalytic and Antimicrobial Potential with Molecular Docking Studies.
In the current study, a low-cost and straightforward coprecipitation technique was adopted to synthesize CaO and La-doped CS/CaO NPs. Different weight ratios (2 and 4) of La were doped into fixed amounts of CS and CaO. Synthesized samples exhibited outstanding catalytic performance by degrading methylene blue (MB) in a highly efficient manner. The X-ray diffraction technique detected the presence of a cubic phase of CaO and a decrease in crystallite size of the samples with the addition of La. Fourier transform infrared spectroscopy confirmed the presence of the dopant and the base material with functional groups at 712 cm-1. A decrease in the absorption intensity of doped CaO was observed with an increasing amount of dopants La and CS accompanied by a blueshift leading to an increase in the band gap energy from 4.17 to 4.42 eV, as recorded with an ultraviolet-visible spectrophotometer. The presence of dopants (La and CS) and the evaluation of the elemental constitution of Ca and O were supported with the energy-dispersive spectroscopy technique. In an acidic medium, the catalytic activity against the MB dye was reduced (93.8%) for 4% La-doped CS/CaO. For La-doped CS/CaO, vast inhibition domains ranged within 4.15-4.70 and 5.82-8.05 mm against Escherichia coli while 4.15-5.20 and 6.65-13.10 mm against Staphylococcus aureus (S. aureus) at the least and maximum concentrations, correspondingly. In silico molecular docking studies suggested these nanocomposites of chitosan as possible inhibitors against the enoyl-acyl carrier protein reductase (FabI) from S. aureus.


Low levels of circulating anti-ageing hormone Klotho predict the onset and progression of diabetic retinopathy.
Klotho is a circulating anti-ageing hormone that predicts progression of cardiovascular and renal disease. The role of Klotho in diabetic retinopathy is unknown. We performed a single-centre observational study of 81 people (males 62%) with type 2 diabetes followed for a median of 44 months. Circulating levels of Klotho and other markers, were measured from stored samples. The primary outcome was progression of retinopathy defined as new onset retinopathy or step change in retinopathy grading. During follow-up, 46 (57%) people reached the primary outcome. People with progression of retinopathy had lower levels of serum Klotho as compared to those without (median (interquartile range) 226.9 (171.1-394.0) vs 484.5 (221.8-709.9) pg/ml, p = 0.001). In multivariable logistic regression analyses, baseline Klotho level was the only variable independently associated with reduced risk of progression of retinopathy. Our results suggest that a halving of circulating Klotho levels increases the risk of retinopathy progression by 44%. In people with type 2 diabetes, lower circulating levels of the vascular protective hormone Klotho are associated with increased risk of progression of diabetic retinopathy. Klotho may be a novel biomarker and potential treatment target for diabetic eye disease.


Total anomalous pulmonary venous return with mixed drainage and double connection: a rare case report not previously described.
Total anomalous pulmonary venous return is a rare cyanotic congenital heart disease in which pulmonary veins connect to the systemic veins, right atrium, or coronary sinus. Given its variability, it is essential to define the pathway and drainage site. We describe a 3-day-old patient with total anomalous pulmonary venous return, in which the four pulmonary veins drained into a common vertical vein that had a double connection at the cardiac (coronary sinus) and infracardiac (portal vein) levels. The echocardiographic diagnosis was confirmed by computed tomography scan. At 1.5 months, she underwent surgery by anastomosis of the venous collector with the left atrium, unroof of the coronary sinus, and clousure of its communication with right atrium. The vertical vein was ligated. There were no complications after 1 year of follow-up. This is an unusual anatomy that has not been described in the literature. In this article, we discuss the embryological origin. Furthermore, we highlight the importance of an accurate diagnosis of the venous pathway and its impact on surgical planning and patient prognosis.


Synthesis of cuprous chloride and simultaneous recovery of Ag and Pd from waste printed circuit boards.
A benign and effective process for cuprous chloride synthesis and simultaneously recovery of Ag and Pd from waste printed circuit boards (PCBs) was developed in the present study. The main merit of the process is that neither corrosive acid nor strong oxidant was used. The PCBs were firstly pretreated by thermal shock process to obtain metallic particles (MPs), then cuprous chloride was synthesized by reacting MPs with cupric sulfate in the presence of sodium chloride. The optimum [Formula: see text] (mL/g) ratio, [Cu]/[Cu(2+)] mole ratio, treatment time and operation temperature were 6, 0.95, 30 min and 60°C, respectively. Approximately 98.5% of Cu could be recovered from the PCBs through two synthesis circles. During the synthesis process, Ag and Pd could be simultaneously recovered by forming a stable chloride complex since Cu(2+) played the role of oxidant in the system. The recovery percentages of Ag and Pd were 93.9% and 95.3%, respectively. Accordingly, it is believed that the process developed in the current study is benign and practical for copper and precious metal (Ag, Pd) recovery from waste PCBs.


DNA damage and oxidative stress in patients with mild preeclampsia and offspring.
Oxidative stress has been shown to play an important role in the pathogenesis of pre-eclampsia, and DNA damage frequently occurs in cells exposed to such stress. The aim of the present study was to investigate DNA damage and oxidative stress in mildly pre-eclamptic women and their offspring. We studied 25 mildly pre-eclamptic mothers, 20 healthy controls, and their infants. Mononuclear leukocyte DNA damage, total antioxidant status (TAS), and total oxidant status (TOS) were determined and the oxidative stress index (OSI) was calculated. DNA damage, and TOS and OSI levels were significantly increased, and TAS levels significantly decreased, in maternal and cord blood samples of the mildly pre-eclamptic group. A positive correlation between the extent of DNA damage and diastolic blood pressure was evident in pre-eclamptic mothers and there was a negative correlation between the extent of DNA damage and TOS. Both oxidative stress and DNA damage are elevated in mildly pre-eclamptic patients and their offspring. Increased oxidative stress may be important in inducing DNA damage in pre-eclamptic patients.


Phototransferred thermoluminescence characteristics of microcline (KAlSi3O8) under 470 nm blue- and 870 nm infrared-light illumination.
We report phototransferred thermoluminescence (PTTL) induced in microcline by 470 nm blue- and 870 nm infrared-light. A conventional thermoluminescence (TL) glow curve measured from a sample irradiated to 40 Gy produces five composite TL glow peaks P1, P2, P3, P4 and P5 at 90, 123, 166, 298 and 391 °C respectively. The sample produces PTTL peaks also identified as P1, P2, P3 and P4 following illumination by blue or infrared light after irradiation to 40 Gy and preheating to 400 °C. Step-annealing suggests the presence of deep electron traps associated with a signal beyond 500 °C. However, preheating to 500 °C and exposure to blue or infrared light does not produce significant PTTL peaks. For doses between 40 Gy and 100 Gy, the maximum PTTL is emitted within 60 and 150 s of blue light illumination. On the other hand, the same feature under the infrared light illumination occurs within 100-200 s of illumination. PTTL peaks P1, P2, P3 and P4 reproduced under blue light illumination have a linear dose response between 10 Gy and 100 Gy and those reproduced under infrared light illumination have a superlinear dose response between 10 and 100 Gy. In contrast, donor peak P5 in both cases follows sublinear dose response within the same dose range. Fading of PTTL peaks P1, P2, P3 and P4 as well as the donor peak P5 are negligibly small under blue light illumination compared to that of infrared light illumination. PTTL glow curves are also found to be properly reproducible.


Protective Effects of Silymarin Against Age-Related Hearing Loss in an Aging Rat Model.
Age-related hearing loss (ARHL) is one of the most common chronic degenerative disorders. Several studies have indicated that supplementation with some antioxidants can slow down the progression of ARHL. Despite several lines of evidence about the potent antioxidant and anti-aging effects of silymarin, its protective effect against ARHL has not evaluated yet. The aim of the current study was to investigate the effects of silymarin in prevention of ARHL in a d-Galactose-induced aging rat model for the first time. 45 male wistar rats aged 3-month old were divided into 5 groups: group 1, 2 and 3 received 500 mg/kg/day d-Gal plus 100, 200 and 300 mg/kg/day silymarin respectively for 8 weeks, placebo group received 500 mg/kg/day d-Gal plus propylene glycol as placebo, and control group received normal saline during this period of time. Auditory brainstem responses were measured at several frequencies (4, 6, 8, 12 and 16 kHz) before and after the intervention. Placebo group and group 3 showed significant ABR threshold increase across frequencies of 4, 6, 16 kHz compared with the other groups (P < 0.05). However, rats treated with silymarin 100 and 200 mg/kg/day plus d-Gal did not show any significant ABR threshold shifts. Similarly, ABR amplitude of P2 at 4, 8 kHz and P1, P4 at 4 kHz in the placebo group and group 3 were decreased significantly compared with other groups (P < 0.05). However, no significant differences are found in ABR absolute and inter-peak latencies between groups (P > 0.05). The findings indicates that silymarin with doses of 100 and 200 mg/kg/day has protective effect against ARHL and it can be supplemented into the diet of older people to slow down the progression of age-related hearing loss.


Osteoid osteoma of the rib: A report of an extremely rare condition.
Osteoid osteoma (OO) is a type of benign bone tumor that usually affects long bones of the lower extremities. In this case report, we describe a successful surgical resection of an OO located in the rib which is an extremely rare location. This is a 23-year-old man, referred to our thoracic surgery department for a very intense nocturnal right chest pain for over two months, the physical examination was normal without clinically palpable chest mass. The CT scan showed an osteocondensing lesion at the junction of the middle and posterior arches of the right 6th rib suggesting Ewing's sarcoma, a PET CT was then requested showed an appearance of a regular non-hypermetabolic inhomogeneous condensation at the junction of the middle and posterior arcs of the 6th right rib. After multidisciplinary concertation, a CT-guided biopsy of the lesion was performed, the histological examination of which revealed an osteoid osteoma, then a complete resection of the lesion was performed under posterolateral thoracotomy which histology confirmed a costal osteoid osteoma. The patient is currently in good health condition with complete disappearance of chest pain after one month of the operation and does not present any complications for the long-term follow-up. Osteoid osteoma (OO) is a benign primary bone tumor with unknown pathogenesis. That occurs in patients during the first two decades of life in about 60 to 75% of cases with a strong predilection for long bones, in 60 to 70% of cases. Flat bones, such as the skull, jawbones, innominate bones, and ribs are rarely described (McDermott et al., 1996 [1]). The standard treatment for OO is complete surgical excision, which is offered to the patient when the pain is chronic and not relieved by medical treatment (Osteoid osteoma: the results of surgical treatment [Internet] [2]). The osteoid osteoma of the rib is a very rare entity of bone neoplasms, this is the first case in our department that demonstrates that the OO of the rib must be suspected affront any painful rib and that complete surgical excision when it's possible, is a safe and effective treatment.


Long-term follow-up of non-calcified pulmonary nodules (<10 mm) identified during low-dose CT screening for lung cancer.
To assess the long-term stability of small (<10 mm) non-calcified pulmonary nodules (NCNs) in high-risk subjects initially screened for lung cancer using low-dose chest computed tomography (LDCCT). A total of 449 subjects initially underwent screening with serial LDCCT over a 2-year period. Participants identified as having NCNs ≥10 mm were referred for formal lung cancer workup. NCNs <10 mm diameter were followed in accordance with the study protocol. Seven years after baseline screening, subjects with previously documented NCNs <10 mm, which were unchanged in size after the 2-year follow-up period, were re-imaged using LDCCT to assess for interval nodule growth. Eighty-three subjects with previously documented stable NCNs <10 mm underwent LDCCT at 7 years. NCNs were unchanged in 78 subjects and had decreased in size in 4 subjects. There was interval growth of an NCN (from 6 mm to 9 mm) in one subject re-imaged at 7 years, but this nodule has remained stable in size over a further 2-year follow-up period. Non-calcified pulmonary nodules <10 mm in size that are unchanged in size or smaller after 2 years of follow-up with LDCCT are most likely benign.


Genome-wide identification and functional analysis of Cellulose synthase gene superfamily in Fragaria vesca.
The Cellulose synthase (CesA) and Cellulose synthase-like (Csl) gene superfamilies encode key enzymes involved in the synthesis of cellulose and hemicellulose, which are major components of plant cell walls, and play important roles in the regulation of fruit ripening. However, genome-wide identification and functional analysis of the CesA and Csl gene families in strawberry remain limited. In this study, eight CesA genes and 25 Csl genes were identified in the genome of diploid woodland strawberry (Fragaria vesca). The protein structures, evolutionary relationships, and cis-acting elements of the promoter for each gene were investigated. Transcriptome analysis and quantitative real-time PCR (qRT-PCR) results showed that the transcript levels of many FveCesA and FveCsl genes were significantly decreased during fruit ripening. Moreover, based on the transcriptome analysis, we found that the expression levels of many FveCesA/Csl genes were changed after nordihydroguaiaretic acid (NDGA) treatment. Transient overexpression of FveCesA4 in immature strawberry fruit increased fruit firmness and reduced fresh fruit weight, thereby delaying ripening. In contrast, transient expression of FveCesA4-RNAi resulted in the opposite phenotypes. These findings provide fundamental information on strawberry CesA and Csl genes and may contribute to the elucidation of the molecular mechanism by which FveCesA/Csl-mediated cell wall synthesis regulates fruit ripening. In addition, these results may be useful in strawberry breeding programs focused on the development of new cultivars with increased fruit shelf-life.


Electrospun cellulose acetate nanofiber incorporated with hydroxyapatite for removal of heavy metals.
Due to the negative impact of the heavy metal ions in water, the rejection of these toxic materials is one of the urgent requests for wastewater treatment. This work aims to facile fabrication and characterization of new organic/inorganic hybrid nanofiber membrane composites for removal of Fe (III) and Pb (II) ions using a batch technique. The manufacturing of pure cellulose acetate nanofibers (CA NFs) and its impregnated with hydroxyapatite (CA/HAp) nanocomposite fibers is explored by an electrospinning process. A production process of uniform and bead-free nanofiber is developed by adjusting various electrospinning conditions. The experiments prove that the slight changes in operating parameters may result in significant variations in the fiber morphology. The influence of various adsorption conditions and its effect on the removal efficiency is investigated. High separation efficiency of about 99.7 and 95.46% within 35 and 40 min. for adsorption Pb (II) and Fe (III) ions using hybrid nanofiber composite, respectively are obtained. The adsorption process was found to obey a pseudo-second-order and Freundlich models. The adsorption mechanism on the CA/HAp composite can be established via ion exchange and surface complexation.


Computational and experimental insight into antituberculosis agent, (E)-benzyl-2-(4-hydroxy-2-methoxybenzylidene) hydrazinecarbodithioate: ADME analysis.
A new Schiff base, (E)-benzyl-2-(4-hydroxy-2-methoxybenzylidene)hydrazinecarbodithioate (compound 1) has been synthesized and experimentally characterized by the IR, UV-Vis, 1H-NMR and mass spectroscopies. The theoretical study of the synthesized compound was evaluated using the density functional theory (DFT) at B3LYP/6-31G+(d,p) basis set. The electronic absorption spectrum of compound 1 was evaluated using time-dependent density functional theory. Besides, in silico studies were done for the prediction of absorption, distribution, metabolism and excretion profiles of compound 1. According to the result, the theoretical data were well fitted with the experimental values. The studied compound has low chemical reactivity and high kinetic stability. In the molecular electrostatic potential map, the negative and positive potential sites were found around electronegative atoms and hydrogen atoms of compound 1, respectively. The 97.75% Lewis and 2.25% non-Lewis structure were present in the studied molecule. The molecular docking results reveal that compound 1 can be used as antituberculosis agent as compare to ethambutol.


Changes in the activities of microsomal enzymes involved in hepatic steroid metabolism in the rat after administration of androgenic, estrogenic, progestational, anabolic and catatoxic steroids.
Several steroids (5 beta-dihydrotestosterone, 19-nortestosterone, methyltrienolone, norethisterone, medroxyprogesterone acetate, cyproterone acetate, chlormadinone acetate and 16 alpha-cyanopregnenolone) were tested for their ability to influence the activities of three sexually differentiated hepatic microsomal enzymes (3 alpha- and 3 beta-hydroxysteroid dehydrogenase and 5 alpha-reductase) in male and female gonadectomized and intact female rats. Of the steroids tested only 5 beta-dihydrotestosterone was completely ineffective. The other tested steroids elicited varying degrees of "masculinization" with a distinct gradation of effect according to the enzyme activity measured and animal model used. 5 alpha-Reductase was the most sensitive enzyme activity and 3 alpha-hydroxysteroid dehydrogenase the least. Male castrates responded better than female castrates, and these in turn better than intact females. The mechanism of action of three of the steroids (methyltrienolone, medroxyprogesterone acetate and norethisterone) was examined. Both flutamide and estradiol were able to block the action of methyltrienolone and medroxyprogesterone acetate, but not that of norethisterone. It is concluded that methyltrienolone and medroxyprogesterone acetate probably masculinize the enzyme activities by the same mechanisms as androgens, whereas the repression of 5 alpha-reductase activity elicited by norethisterone administration involves a different route.


The infection of human primary cells and cell lines by human cytomegalovirus: new tropism and new reservoirs for HCMV.
Human cytomegalovirus (HCMV) infection is asymptomatic in common persons and could reactive in immunosuppression groups. HCMV was considered as endothelial cells (EC) tropism and leukocyte tropism. We hypothesized that HCMV will infect other cell types from human which have not been reported yet. The HCMV released from human MRC-5 was inoculated into eight human primary cells and cell lines, including human dermal fibroblasts (HDF), human embryo-chondrocytes (HEC), human embryo-myoblasts (HEM), and human embryo-kidney endothelial cell (HEK-EC), human marrow stromal cell (HMSC). The cell lines were ECV304, Chung liver cell and L02. Several detection methods specific for HCMV, in which PCR for HCMV DNA sequences, immunofluorescence for pp65 antigen, Western-blot for gB protein, as well as cytopathic effect observation were conducted at different time post-infection. The results indicated that four cells in our experiment (HDF, HEM, HEC and HMSC) were HCMV-positive. The occurring time of cytopathic effect was different in these four cells. Our experiment found the new tropism and new reservoirs for HCMV.


Structure of microtubules with reduced hydration. Comparison of results from X-ray diffraction and electron microscopy.
A recent model for the structure of microtubules is used to interpret X-ray fiber diffraction patterns from microtubules, obtained under various conditions. The results suggest that tubulin may undergo conformational changes under conditions of reduced water-activity. Such changes could account for some of the differences in the structure of tubulin as determined by electron microscopy and X-ray diffraction.


Effect of glucocorticoid levels in vivo on growth hormone biosynthesis.
The rate of growth hormone (GH) biosynthesis in pituitary cells prepared from rats with different histories of glucocorticoid exposure was analyzed by a dual-labeling acrylamide-gel technique. Glucocorticoid deficiency, produced by adrenalectomy, reduces GH synthesis by approximately 50%. GH synthesis adrenalectomized rats treated with either natural or synthetic glucocorticoids, is restored to normal or above normal levels. Acute exposure (1 h) of cells to corticosterone in vitro does not produce a significant increase in GH synthesis. Adrenalectomized rats treated with steroid for one day show a small but detectable increase in GH synthesis, while treatment for 3--6 days results in progressively larger stimulatory effects. All of these results are similar to previous findings regarding glucocorticoid stimulation of GH synthesis in vitro.


Estimating the elastographic signal-to-noise ratio using correlation coefficients.
In conventional elastography, strain is estimated from the gradient of the displacement (time-delay) estimates. The displacement estimates involve estimating the peak location of the cross-correlation function between matching pre- and post-compression A-lines. Bias errors in estimating the peak location of the cross-correlation function, amplified by the gradient operation on the displacement estimates (needed for the computation of the strain), could result in values of elastographic signal-to-noise ratio (SNR(e)) that exceed the theoretical upper bounds, thereby hindering a consistent interpretation of this parameter. These algorithmic errors have not been accounted for by the theory. We propose the use of the measured correlation coefficients in the theoretical SNR(e) expressions to estimate the SNR(e), rather than computing them directly from the elastograms. This methodology results in values of SNR(e) that are lower than the theoretical upper bounds, thereby avoiding the problems associated with computing SNR(e) directly from the elastograms. Using simulated models of uniformly elastic phantoms, a proof of principle of such an SNR(e) measure is shown.


[Observation and analysis of microstructure of dentin caries lesions through 3D laser scanning microscope].
Microstructural changes in dentin carious lesions were investigated using a 3D laser scanning microscope, which has a morphological theoretical foundation in the further study of clinical caries disease prevention and treatments. Six fresh extracted caries molars were prepared into cross-section specimens. The sections were examined by 3D and laser measuring morphology. Zones were identified in the lesions on the basis of their optical appearance. Two zones were identified in the lesions on the basis of their laser appearance. The microstructure showed that the tubular was partly closed in transparent dentin; peritubular and intertubular dentin were reduced in the zone of demineralization; peritubular and intertubular dentin were damaged and fused; a beaded sample and oval lesions formed in the zone of bacterial invasion; and abnormal dentin structure was present in the zone of destruction on the basis of their laser appearance. Four zones were iden-tified in the lesions according to their colors, as determined from their 3D appearance. 3D laser scanning micros-cope may be a powerful, accessible, and non-destructive technique, as it identified the lesion and tubular zones, as well as peritubular and intertubular dentin in the four zones' lesions. The microstructure of dentin caries lesions may have significant merit in the evaluation of clinical prevention and treatment.


On the use of kernel machines for Mendelian randomization.
Properly adjusting for unmeasured confounders is critical for health studies in order to achieve valid testing and estimation of the exposure's causal effect on outcomes. The instrumental variable (IV) method has long been used in econometrics to estimate causal effects while accommodating the effect of unmeasured confounders. Mendelian randomization (MR), which uses genetic variants as the instrumental variables, is an application of the instrumental variable method to biomedical research fields, and has become popular in recent years. One often-used estimator of causal effects for instrumental variables and Mendelian randomization is the two-stage least square estimator (TSLS). The validity of TSLS relies on the accurate prediction of exposure based on IVs in its first stage. In this note, we propose to model the link between exposure and genetic IVs using the least-squares kernel machine (LSKM). Some simulation studies are used to evaluate the feasibility of LSKM in TSLS setting. Our results show that LSKM based on genotype score or genotype can be used effectively in TSLS. It may provide higher power when the association between exposure and genetic IVs is nonlinear.


Emergency physician-performed emergency bronchoscopy in cardiac arrest patient due to acute foreign body airway obstruction.
As foreign body airway obstruction (FBAO) can be life-threatening, it has to be promptly diagnosed and treated. We report a case series of three patients presenting to the emergency department with cardiac arrest due to FBAO. In each case, ventilation was difficult due to high airway resistance. As FBAO was suspected, the emergency physician did a prompt flexible bronchoscopy to confirm the diagnosis and retrieve the foreign body. Flexible bronchoscopy is an important diagnostic and therapeutic tool for emergency airway management, and is a relatively safe procedure if performed by a trained personnel. The life-saving benefits of bronchoscopy outweigh the small risks of complications such as bleeding, desaturation and pneumothorax. In the three cases, the removal of the obstructing material led to immediate improvements in oxygenation and ventilation. The patients had return of spontaneous circulation after cardiopulmonary resuscitation and definite airway control.


A sensitive, direct colorimetric assay of serum iron using the chromogen, nitro-PAPS.
A direct colorimetric method is presented for the determination of serum iron in 0.1-ml sized samples, using a new, water-soluble, reagent, 2-(5-Nitro-2-pyridylazo)-5-(N-propyl-N-sulfopropylamino)phenol Na salt (epsilon 585 nm = 9.4 X 10(4) l/mol per cm). Interference of copper and zinc in sera can be eliminated entirely by forming copper- and zinc-thioglycollate complexes immediately upon the dissociation of the protein-bound iron, copper and zinc by thioglycollate and sodium dodecyl sulfate. The serum blank was minimized by the use of sodium dodecyl sulfate as a protein denaturant. Within-run and between-run precision (CV) were in the range of 0.7-2.9% and 1.1-3.6%, respectively, depending on the serum iron content. A good correlation (r = 0.995) was obtained between this method and the reference method proposed by the International Committee for Standardization in Hematology.


Investigation of the development of tolerance to the actions of zolpidem and midazolam.
It is well established that tolerance can develop very rapidly to the behaviour-suppressing effects of benzodiazepines. In previous studies, however, the depressant action of zolpidem, a novel hypnotic acting at the benzodiazepine receptor, on operant behaviour in rats was maintained after many injections. An experiment was carried out, therefore, to compare the effects of acute and chronic administration of zolpidem and midazolam. Rats were trained to press a lever in standard operant test chambers to obtain 45 mg food pellets on an FR 10 schedule. Dose-response curves were then established, before, immediately after and 4 weeks after the daily administration of midazolam (3.0 mg/kg s.c.) or zolpidem (1.0 mg/kg) for 10 days. In confirmation of previous work, marked tolerance developed to the response-rate-decreasing effect of midazolam, the dose-response curve being shifted to the right by a factor of 6 and also flattened. No significant dissipation of this tolerance occurred during a period of 4-6 weeks. In contrast, repeated administration of zolpidem produced only a small degree of tolerance, the dose-response curve being shifted by a factor of two. There was little evidence for cross tolerance between the two drugs, zolpidem-treated rats being sensitive to a dose of midazolam and midazolam-treated rats sensitive to a dose of zolpidem. Although the explanation for the development of tolerance to midazolam is unknown, these results suggest that the mechanisms of action of midazolam and zolpidem in reducing response rates are different.


Severe and benign Plasmodium vivax malaria in Emberá (Amerindian) children and adolescents from an endemic municipality in Western Colombia.
Malaria in children is still an important public health problem in endemic areas of South-East Asia and Latin America. Certain forms of the disease, such as Plasmodium vivax severe malaria, are still neglected. This descriptive study assessed the frequency of severe and benign P. vivax infection in Emberá children (<14 years of age) from an endemic municipality in Colombia in 2013, using the WHO criteria. During 2013, 270 Emberá children presented 349 episodes of malaria. From them, 22 (8.1%) presented at least one of the criteria for severe malaria. Some patients with P. vivax presented with severe malaria (severe anemia, renal dysfunction, respiratory distress and seizure). Mixed malaria cases presented more complications than those with monoinfection (OR=5.535; 95%CI 1.81-16.9). In Colombia, few data are available about severe P. vivax malaria in children, especially in the Amerindian ethnic groups. Mixed infections were associated with increased risk of severe malaria. At the same time, detailed and prospective studies are needed to measure the real impact of severe vivax malaria, as was evidenced in this paper.


Is gastroparesis that is often detected in patients with alcoholic chronic liver disease a manifestation of an autonomic dysfunction syndrome? A preliminary study.
the autonomic dysfunction defines the neuropathy of the autonomic nervous system. The prevalence of the gastric dysmotility and its relationship with the autonomic dysfunction in patients with alcohol chronic liver disease is not well known. thirty-six patients with alcohol chronic liver disease and 25 healthy controls were evaluated, in order to detect an autonomic dysfunction through different cardiovascular reflexes and gastric emptying tests. ninety-four per cent of the patients showed an impaired R index (variations in heart rate during six deep inspirations-expirations per minute) and/or S/S-HR (variations in heart rate when standing from a supine position). Seventy-five per cent of the patients showed gastroparesis (T1/2: gastric half-emptying time was delayed). There was a correlation between the R index and T1/2 (r = -0.49; p < 0.01). we suggest that gastroparesis detected in alcoholic chronic liver disease is another clinical manifestation of the autonomic parasympathetic dysfunction.


Transplantation algorithm for myelofibrosis in 2022 and beyond.
Myelofibrosis (MF) is a chronic myeloproliferative neoplasm with a very heterogenous clinical course. Median survival of patients with overt MF is close to 6 years, but with great individual variability. Allogeneic hematopoietic cell transplantation (allo-HCT) constitutes the only curative treatment, yet the advanced age of MF patients, together with significant transplant-related mortality, limit the applicability of this procedure in clinical practice to less than 10% of patients. In this article, we review the current indications for allo-HCT in MF and factors that should be considered when selecting candidates for the procedure. To this end, we describe the prognostic tools that have been developed to predict survival in MF patients managed with conventional pharmacological therapies and allo-HCT. We then summarize the main results of allo-HCT, review practical aspects of the procedure, and discuss optimal timing, particularly in relation to JAK inhibitor treatment.


Trends and Determinants of Non-Utilization of Modern Contraception in Ekiti State, Nigeria: A Ten-Year Review.
An increase in correct usage of modern contraception is vital in reducing the maternal mortality ratio and Under-5 mortality, leading towards the achievement of Sustainable Development Goal 3. Our study examined the trends and factors affecting non-utilization of modern contraceptives over a 10-year period in Ekiti State, Nigeria. This study used data from three consecutive National Demographic Health Surveys (NDHS) - 2008, 2013, and 2018 - with a weighted sample size of 1,357 women of reproductive age (15-49 years). Data on contraceptive use on these women, provided by the NDHS, were extracted and analysed using IBM SPSS version 25. The sample was weighted to adjust for disproportionate sampling and non-response. Pearson's chi-square and binary logistic regression were used to assess the factors associated with non-utilization of modern contraceptives. The mean age of the women was 30 years. Modern contraceptive use increased from 13.1% in 2008 to 23.0% in 2018, while unmet need for modern contraceptives decreased from 84.8% in 2008 to 75.4% in 2018. Identified predictors of non-utilization of modern contraceptive were age 20-24 years [aOR=0.33, 95%CI=0.19-0.59], 25-29 years [aOR=0.34, 95%CI=0.18-0.64], 30-34 years [aOR=0.46, 95%CI=0.22-0.94], 35-39 years [aOR=0.29, 95%CI=0.14-0.61] and 40-44 years [aOR=0.37, 95%CI=0.17-0.80] compared to age 15-19 years; living in urban areas [aOR=0.72, 95%CI=0.53-0.98] compared to in rural areas; higher level of education [aOR=0.46, 95%CI=0.21-0.98] compared to no education; and desire for more children [aOR=0.48, 95%CI=0.32-0.73] compared to not wanting more children. Although contraceptive usage increased over time, the factors associated with non-utilization were being an adolescent, living in a rural area, lower level of education, and desire for more children.


Nitrate reductase activity and chlorophyll content in sun leaves of subtropical Australian closed-forest (rainforest) and open-forest communities.
A study of the sun leaves of two closed-forest (rainforest) and eight open-forest communities in subtropical southeast Queensland, Australia, showed that a large number of pioneer woody species in closed-forests had high levels of nitrate reductase (EC 22.214.171.124), whereas only a few herbaceous species in the open-forests showed high levels. There was a continuously declining gradient in nitrate reductase activity from pioneer to mature-forest species in all communities, associated with a decrease in Leaf Specific Area. The level of nitrate reductase activity was lower in certain plant families (including sclerophyllous monocotyledons, small-leaved composites and legumes), but still showed the same general relationship with Leaf Specific Area. The decrease in Leaf Specific Area is associated with an increase in both the dry weight: fresh weight ratio and the chlorophyll a: chlorophyll b ratio of the leaves. Three groups of plants can be recognised by nitrate reductase activity plotted against water content (% fresh weight) of their leaves-(1) pioneer, (2) mature-forest and (3) semi-sclerophyllous species. As the proportion of cytoplasm to structural tissue (indicated by water content) in leaves increases, there is a continuous increase in (a) nitrate reductase activity (b) total chlorophyll (per unit dry weight) (c) the proportion of chlorophyll b to chlorophyll a and (b) chloroplastic isoform of glutamine synthetase. These attributes are associated with high nitrogen content in the leaves and high photosynthetic potentials, resulting in rapid growth rates of pioneer species.


Astrocyte arachidonate and palmitate uptake and metabolism is differentially modulated by dibutyryl-cAMP treatment.
Astrocytes play a vital role in brain lipid metabolism; however the impact of the phenotypic shift in astrocytes to a reactive state on arachidonic acid metabolism is unknown. Therefore, we determined the impact of dibutyryl-cAMP (dBcAMP) treatment on radiolabeled arachidonic acid ([1-(14)C]20:4n-6) and palmitic acid ([1-(14)C]16:0) uptake and metabolism in primary cultured murine cortical astrocytes. In dBcAMP treated astrocytes, total [1-(14)C]20:4n-6 uptake was increased 1.9-fold compared to control, while total [1-(14)C]16:0 uptake was unaffected. Gene expression of long-chain acyl-CoA synthetases (Acsl), acyl-CoA hydrolase (Acot7), fatty acid binding protein(s) (Fabp) and alpha-synuclein (Snca) were determined using qRT-PCR. dBcAMP treatment increased expression of Acsl3 (4.8-fold) and Acsl4 (1.3-fold), which preferentially use [1-(14)C]20:4n-6 and are highly expressed in astrocytes, consistent with the increase in [1-(14)C]20:4n-6 uptake. However, expression of Fabp5 and Fabp7 were significantly reduced by 25% and 45%, respectively. Acot7 (20%) was also reduced, suggesting dBcAMP treatment favors acyl-CoA formation. dBcAMP treatment enhanced [1-(14)C]20:4n-6 (2.2-fold) and [1-(14)C]16:0 (1.6-fold) esterification into total phospholipids, but the greater esterification of [1-(14)C]20:4n-6 is consistent with the observed uptake through increased Acsl, but not Fabp expression. Although total [1-(14)C]16:0 uptake was not affected, there was a dramatic decrease in [1-(14)C]16:0 in the free fatty acid pool as esterification into the phospholipid pool was increased, which is consistent with the increase in Acsl3 and Acsl4 expression. In summary, our data demonstrates that dBcAMP treatment increases [1-(14)C]20:4n-6 uptake in astrocytes and this increase appears to be due to increased expression of Acsl3 and Acsl4 coupled with a reduction in Acot7 expression.


Surgical Intervention for Masticatory Muscle Tendon-Aponeurosis Hyperplasia Based on the Diagnosis Using the Four-Dimensional Muscle Model.
The surgical target of Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is the masseter or temporal muscle. In our clinic, the 4-dimentional muscle model (4DMM) has been used to decide if we should approach to the masseter or temporal muscle. The aim of this study is validate the clinical usefulness of 4DMM on the basis of the surgical results. The 4DMM was constructed from the digital data of 3D-CT and 4-dimentional mandibular movements of the patients. It made us to able to visually observe the expansion rate of masticatory muscles at maximum mouth opening comparing to their length at closed mouth position. Fifteen patients were applied the 4DMM before the surgical treatment and 2 healthy volunteers were enrolled as control group. The expansion rate of temporal muscle at the maximum mouth opening in the patient group was significantly less than that in the control group (P < 0.05). On the other hand, the masseter muscles of all patients were expanded as same as the control group. Therefore the main cause of limitation of mouth-opening was suggested to be a contracture of the temporal muscle. Consequently, we performed successful bilateral coronoidectomy with no surgical intervention to the masseter muscles in all patients. The present 4DMM would be valuable modality to decide the target muscle of surgical treatment for patients with MMTAH. In this pathology, contracture of the temporal muscle seems to be main cause of limited mouth opening.


Core conflictual relationship themes of men and women who are violent toward their partners.
The Core Conflictual Relationship Themes of men and women violent toward their partners and entering psychotherapy, students violent toward their partners, and nonviolent students (n = 84; n = 14 in each of the six groups) were compared. Men and women entering psychotherapy more often had negative Wish elements than others. The wish element was "to be loved" for 11 of the 14 student women violent toward their partners and 5 of the 14 nonviolent student women.


Bronchioloalveolar carcinoma and generalized amyloidosis complicating progressive systemic sclerosis.
We report a patient with progressive systemic sclerosis in whom an autopsy, performed 13 years after diagnosis, revealed the presence of bronchioloalveolar carcinoma and of generalized amyloidosis. Characterization of the amyloid fibril protein suggested an immunoglobulin light chain (AL) origin.


Impact of house dust mite in vitiligo skin: environmental contribution to increased cutaneous immunity and melanocyte detachment.
Vitiligo is an autoimmune skin disorder characterized by loss of melanocytes. Protease-mediated disruption of junctions between keratinocytes and/or keratinocyte intrinsic dysfunction may directly contribute to melanocyte loss. House dust mite (HDM), an environmental allergen with potent protease activity, contributes to respiratory and gut disease but also to atopic dermatitis and rosacea. To verify if HDM can contribute to melanocyte detachment in vitiligo and if so, by which mechanism(s). Using primary human keratinocytes, human skin biopsies from healthy donors and patients with vitiligo, and 3D reconstructed human epidermis, we studied the effect of HDM on cutaneous immunity, tight and adherent junction expression and melanocyte detachment. HDM increased keratinocyte production of vitiligo-associated cytokines and chemokines and increased expression of toll-like receptor (TLR)-4. This was associated with increased in situ matrix-metalloproteinase (MMP)-9 activity, reduced cutaneous expression of adherent protein E-cadherin, increased soluble E-cadherin in culture supernatant and significantly increased number of suprabasal melanocytes in the skin. This effect was dose-dependent and driven by cysteine protease Der p1 and MMP-9. Selective MMP-9 inhibitor, Ab142180, restored E-cadherin expression and inhibited HDM-induced melanocyte detachment. Keratinocytes from patients with vitiligo were more sensitive to HDM-induced changes than healthy keratinocytes. All results were confirmed in a 3D model of healthy skin and in human skin biopsies. Our results highlight that environmental mite may act as an external source of pathogen-associated molecular pattern molecules in vitiligo and topical MMP-9 inhibitors may be useful therapeutic targets. Whether HDM contributes to the onset of flares in vitiligo remains to be tested in carefully controlled trials.


Stenting for symptomatic intracranial vertebrobasilar artery stenosis: 30-day results in a high-volume stroke center.
Symptomatic intracranial vertebrobasilar artery stenosis (IVBS) carries a high annual risk of recurrent stroke. Endovascular therapy was a promising technique but recent trials suggest it may carry a risk of periprocedual complications especially in inexperienced hands. This prospective study was to evaluate the safety of endovascular therapy for severe symptomatic IVBS in a high volume stroke centre. Patients with symptomatic IVBS caused by 70-99% stenosis despite medical treatment of at least one antiplatelet agent and statin were enrolled. The patients were treated either with balloon-mounted stent or balloon pre-dilation plus self-expanding stent as determined by the operators following a guideline. The primary outcome was 30-day stroke, transient ischemic attack (TIA) and death after stenting. The secondary outcome was successful stent deployment. The baseline characteristics and outcomes of patients with basilar artery (BA) lesions and patients with vertebral artery V4 segment lesions (BA group vs V4 group) were compared. And the outcome of different Mori type lesions was also compared. From September 2013 to September 2014, 105 patients with stroke or TIA due to intracranial IVBS were screened and 97 patients were treated by stenting, including 52 patients with BA stenosis and 45 patients with V4 stenosis. The rate of 30-day stroke, TIA and death was 7.1%. All the three strokes happened in the BA group and were perforator strokes. The successful stent deployment rate was 100%. General anesthesia was more preferred in the BA group than in the V4 groups (96.2% vs 75.6%, p=0.005). The Apollo stent was used more for Mori A lesions (30.5% vs 7.9%, p=0.011) and had lower degree of residual stenosis (8.6% vs 12.6%, p=0.014) than Wingspan stent. Mori C lesions were more likely to have higher degree of residual stenosis than Mori A lesion (15.3% vs 7.4%, p=0.005). The short-term safety of endovascular stenting for patients with severe symptomatic IVBS in a high volume stroke centre was acceptable. Mori A lesions may have lower residual stenosis rate than the Mori C type lesions.


Hemoperitoneum and acute abdomen caused by the rupture of ovarian granulosa cell tumor: a case report.
Granulosa cell tumors (GCT) constitute 70% of all ovarian sex-cord stromal tumors, which account for less than five percent of all ovarian carcinoma. The authors herein report a rare case of a ruptured GCT of the ovary in a 43-year-old female who was admitted to the emergency department with signs of acute abdomen.


Body mass index, long-term weight change, and esophageal squamous cell carcinoma: is the inverse association modified by smoking status?
Observational studies suggest that body mass index (BMI) is inversely associated with esophageal squamous cell carcinoma (ESCC). However, questions remain regarding reverse causation and confounding, especially by smoking, as alternative explanations. The authors examined the association between BMI and measures of weight history and risk of ESCC in a population-based Australian case-control study (from 2002 to 2005) comprising 287 patients with ESCC (cases) and a control group of 1544 individuals who were sampled from a population registry. Stratified analyses were performed specifically to explore whether this association was influenced by smoking. Multivariable logistic regression models were used to derive odds ratios (ORs). After adjusting for smoking, significant inverse associations with ESCC for BMI and weight 1 year before diagnosis, maximum adult BMI, and weight gain since age 20 years were observed (all P(trend) < .001). The risk of ESCC was reduced by 35% (range, 23%-44%) per 5-unit increase in recent BMI. Participants who gained weight after age 20 years had a lower risk than those who maintained their weight during adult life (OR for gain of >20 kg, 0.51; 95% confidence interval [CI], 0.33-0.77). In stratified analyses, higher BMI was associated with a decreasing risk of ESCC both in never-smokers (OR, 0.32; 95% CI 0.13-0.76) and smokers (OR 0.22, 95%CI 0.07-0.67) comparing the highest versus the lowest BMI quintile. In this study, the inverse associations between BMI, long-term weight gain, and other body measures and ESCC appeared to be robust and could not be explained by smoking status or potential confounding factors.


Improved recombinant Api m 1- and Ves v 5-based IgE testing to dissect bee and yellow jacket allergy and their correlation with the severity of the sting reaction.
No study has assessed the diagnostic sensitivity of rApi m 1 and rVes v 5 on Immulite testing system. To compare the diagnostic sensitivity of commercially available venom recombinant allergens between the currently available immunoassays [ImmunoCAP (CAP) and Immulite (LITE)] and establish their correlation with the severity of the sting reaction. This study evaluated 95 bee venom and 110 yellow jacket venom-allergic subjects. We measured the levels of sIgE to rApi m 1, rVes v 5 (LITE and CAP), rApi m 2 (LITE), rVes v 1 (CAP) and total IgE (CAP). Forty-nine healthy subjects served as controls. The diagnostic sensitivity of rApi m 1 and rVes v 5 was significantly higher with the LITE than with the CAP system (71% vs. 88% and 82% vs. 93%). The specificity of both assays for both allergens was between 94% and 98%. Twenty-nine patients that tested negative for rApi m 1 or rVes v 5 with CAP were positive with LITE, but none of the patients that tested negative with LITE were positive with CAP. The positive values of rApi m 1 and rVes v 5 were on average 2.7 and 2.3 times higher, with the LITE than with the CAP system. The combination of rApi m 1 and rApi m 2 (LITE) and the combination of rVes v 5 (LITE) and rVes v 1 (CAP) almost matched the sensitivity of native venoms (95% and 97%, respectively), whereas the diagnostic sensitivity of the combination of rVes v 5 and rVes v 1 (CAP) did not reach the sensitivity of rVes v 5 (LITE) alone (90% vs. 93%). IgE levels to venom recombinants and total IgE did not correlate with the severity of sting reaction. The use of rApi m 1 and rVes v 5 with the LITE system significantly enhanced diagnostic utility of venom recombinants and should improve the dissection of bee and yellow jacket venom allergy.


Effects of localized bending on DNA supercoiling.
The DNA double helix is straight only in the idealized case. In reality, it bends, twists and stretches in response to local base sequence and to specific interactions with proteins and other bound ligands. Naturally occurring bends appear to promote the assembly of nucleosomes, and in some cases can effectively replace regulatory DNA-binding proteins in vivo. Recently, a computational method known as 'finite element analysis', which is used routinely by engineers to analyse the stability of buildings and bridges, has been applied to the quantitative assessment of natural curvature in supercoiled DNA structures, providing new insight into the relationship between local, sequence-dependent features and the overall topology of these chains.


Velocity of mist droplets and suspending gas imaged separately.
Nuclear Magnetic Resonance Images (MRIs) of the velocity of water droplets and velocity of the suspending gas, hexafluoroethane, are presented for a vertical and horizontal mist pipe flow. In the vertical flow, the upward velocity of the droplets is clearly slower than the upward velocity of the gas. The average droplet size calculated from the average falling velocity in the upward flow is larger than the average droplet size of mist drawn from the top of the pipe measured with a multi-stage aerosol impactor. Vertical flow concentrates larger particles because they have a longer transit time through the pipe. In the horizontal flow there is a gravity-driven circulation with high-velocity mist in the lower portion of the pipe and low-velocity gas in the upper portion. MRI has the advantages that it can image both phases and that it is unperturbed by optical opacity. A drawback is that the droplet phase of mist is difficult to image because of low average spin density and because the signal from water coalesced on the pipe walls is high. To our knowledge these are the first NMR images of mist.


Electrochemical treatment of electroplating wastewater using synthesized GO/TiO2 nanotube electrode.
The graphene oxide (GO) deposited TiO2 nanotube (GO/TiO2) electrode on a titania plate was prepared using a simple anodization method. The morphological and structural properties of TiO2 and GO/TiO2 electrodes have been studied using field emission scanning electron microscopy energy dispersive spectroscopy (FESEM-EDS), X-ray diffraction (XRD), UV-vis diffuse reflectance spectroscopy (UV-vis DRS), Raman spectroscopy, Fourier transform infrared spectra (FT-IR), and X-ray photoelectron spectroscopy (XPS). FESEM-EDS analysis confirmed that the 13.56% wt of GO nanoparticles was formed over the TiO2 substrate, with the thickness of the wall to be ∼300 nm. The crystallite size of GO/TiO2, i.e., 19.53 nm, was confirmed by XRD analysis. Analysis of the UV-DRS spectrum showed the bandgap of the synthesized GO/TIO2 nanotube electrode to be 3.052 eV. Box-Behnken design (BBD) under response surface methodology (RSM) was used to design the experiments. The effect of operating input parameters like pH, current (i), and degradation time (t) on % COD degradation (X1) and energy consumed (X2) were also examined. At optimum process parameters, the value of X1 and X2 were 57.61% and 15.00 kWh/m3, respectively. Possible intermediates were identified based on the GC-MS data analysis. Scavenger tests showed that •OH radical plays a major role in electroplating effluents degradation. Based on the results, the EO process using GO/TiO2 electrodes could be considered a promising technique for electroplating effluent degradation due to high degradation efficiency.


New therapy of pleural empyema by deoxyribonuclease.
Empyema is a severe complication of different diseases and traumas. Management of this complication is difficult and should comprise general and local procedures. The general procedure is mainly based on administering wide-spectrum antibiotics. Local management depends on patient general condition, but in all cases the essential procedure is to insert a drain into the pleural cavity and to evacuate the pus. Sometimes pus is very thick and its evacuation and following re-expansion of the lung is rather impossible. In these patients surgical intervention is needed. The use of intrapleural enzymes to support the drainage was first described in 1949 by Tillett and Sherry using a mixture of streptokinase and streptococcal deoxyribonuclease. Nowadays, purified streptokinase has come into widespread use, but recent studies reported no streptokinase effect on pus viscosity. On the other side, deoxyribonuclease reduces pus viscosity and may be more useful in treatment. We report two cases of intrapleural administration of Pulmozyme (alfa dornase - deoxyribonuclease (HOFFMANN-LA ROCHE AG) in dosage 2×2.5mg with a significant improvement caused by changes in pus viscosity.


Application of 3D-printed pulmonary segment specimens in experimental teaching of sectional anatomy.
Lung cross-section is one of the emphases and challenges in sectional anatomy. Identification of the complex arrangement of intrapulmonary tubes such as bronchi, arteries, and veins in the lungs requires the spatial imagination of students. Three-dimensional (3D) printing has become increasingly used in anatomy education. This study aimed to analyze the effectiveness of 3D-printed specimens used for the experimental teaching of sectional anatomy. A digital thoracic dataset was obtained and input into a 3D printer to print multicolor specimens of the pulmonary segment after software processing. As research subjects, 119 undergraduate students majoring in medical imaging from classes 5-8 in the second-year were chosen. In the lung cross-section experiment course, 59 students utilized 3D printed specimens in conjunction with traditional instruction as the study group, while 60 students received traditional teaching as the control group. Preclass and postclass tests, course grading, and questionnaire surveys were used to assess instructional efficacy. We obtained a set of pulmonary segment specimens for teaching. The students in the study group scored better in the postclass test than those in the control group (P < 0.05), and the students in the study group scored higher in satisfaction with the teaching content and spatial thinking for sectional anatomy than those in the control group (P < 0.05). The course grades and excellence rates in the study group exceeded those in the control group (P < 0.05). The application of high-precision multicolor 3D-printed specimens of lung segments in experimental teaching of sectional anatomy can improve teaching effectiveness and is worth adopting and promoting in sectional anatomy courses.


Genetic variability of diurnally sub-periodic Wuchereria bancrofti in Nicobarese tribe of Nicobar group of Islands, Andaman and Nicobar Islands, India.
Sub-periodic form of Wuchereria bancrofti occurs in several well-isolated islands of Nicobar group of islands of Andaman Nicobar archipelago, India, presenting an interesting situation to study the genetic variability of its population. Microfilariae collected from 40 microfilaria (mf) carriers residing in eight locations on five islands (five carriers from each locality) were studied for genetic variability by generating random-amplified polymorphic DNA profiles. Phylognetic analysis of the profiles revealed a considerable genetic variability among parasite populations of different islands. The Nei's gene diversity between populations of 40 individual mf carriers ranged from 0.0218 to 0.2400. It was highest (0.24) among the parasite populations of Car Nicobar island and lowest (0.0218) among those of Payuha area of Camorta island and Teressa island. The dendrogram constructed exhibited four distinct clusters, which are geographically localized, and the gene flow between them appears to be influenced by human migration pattern.


Orbital abscess with white eye in patients treated with oral antibiotics for orbital cellulitis.
To report a case series of seven patients with late presentation of orbital/subperiosteal abscess following oral treatment of orbital cellulitis. A retrospective case series of all patients presented with orbital abscess following oral treatment of orbital cellulitis from two tertiary-care eye centres in Riyadh, Saudi Arabia, was conducted. Demographic profiles, risk factors, initial clinical presentation, management regimens, and final outcome were analysed. Patients presented mainly with proptosis and limitation of extraocular motility without external ophthalmic inflammatory signs. Most patients needed surgical evacuation despite the appropriate initiation of intravenous antibiotics following presentation to our hospitals. Treating orbital cellulitis with oral antibiotics may lead to delayed presentation of orbital abscess without external ophthalmic inflammatory signs.


Overvalued allelopathy and overlooked effects of humic acid-like substances on Microcystis aeruginosa and Scenedesmus obliquus competition.
To form Microcystis blooms, Microcystis must be competitively dominant to other phytoplankton species to produce enough biomass. The aim of this study was to determine the competition mechanisms between Microcystis aeruginosa and Scenedesmus obliquus. M. aeruginosa and S. obliquus were separately cultured in the filtrate of mono and mixed cultures of M. aeruginosa and S. obliquus with varying treatments concerning N, P and iron availability. The inhibition rate for M. aeruginosa was 20-31% when cultured in mono and mixed culture filtrates enriched with N and P, but this rate was reduced to -15 to 19% when cultured in filtrates enriched with N, P and iron. The inhibition rate for M. aeruginosa decreased from 80 to 100% to 11-39% in dialytic filtrates. However, there were no differences in inhibition rate for S. obliquus, regardless of filtrate or dialytic filtrate treatments. The potential allelochemical, 2-butyl-octanol (0.144 mg L-1), was found to have little inhibitory effect to M. aeruginosa or S. obliquus. Thus, previously reported allelopathy to Microcystis would be overestimated. We also report a new mechanism in phytoplankton competition in this study. The phytoplankton secreted humic acid-like substances that can reduce the bioavailability of iron, resulting in the inhibition of other phytoplankton.


Relation between the stability of dental implants and two biological markers during the healing period: a prospective clinical study.
The purposes of this study were to examine the correlation between the stability of dental implants and bone formation markers during the healing period and to monitor the stability of dental implants using the resonance frequency analysis (RFA) method. The null hypothesis of the study is no correlation between the stability of dental implant and bone formation markers. The study is a prospective clinical study during the 3-month healing period of implant. At implant placement (PW Plus, Nakhon Pathom, Thailand) and after 1, 2, 3, 4, 6, 8, 10, and 12 weeks, RFA assessments were performed and gingival (GCF)/peri-implant crevicular fluids (PICF) were collected from ten patients. The level of osteocalcin (OC) was measured by using ELISA kits, and the level of alkaline phosphatase (ALP) activity was measured by colorimetric analysis. Repeated measures analysis of variance, the Friedman test, the Mann-Whitney U test, and the Pearson correlation were performed for data analysis. There was a statistical decrease in the mean implant stability quotient (ISQ) values between 1 and 3 weeks (P < 0.05). The ISQ values recovered to the initial values at 4 weeks. There was no statistical difference in the ALP level at each measurement, while there was a statistical increase in the OC level at 6, 8, 10, and 12 weeks when compared with 1 week (P < 0.05). There was a significant correlation between ALP levels and ISQ values (r = 0.226, P < 0.05). There was a statistically significant correlation between OC levels and ISQ values at 1-12 weeks (r = 0.245, P < 0.05). The ISQ values were weakly correlated with both ALP and OC. The three-thread-design implant showed a high stability through healing period.


Lumbar artery aneurysm with acute aortic occlusion resulting from chiropractic manipulation: a case report.
A 44-year-old man with an acute aortic occlusion after chiropractic manipulation was found to have a lumbar artery aneurysm. This article presents a previously undescribed entity, a lumbar artery aneurysm, which manifested as a unique cause of distal aortic occlusion in a patient with chronic back pain.


Solid-phase synthesis of an RNA nucleopeptide fragment from the nucleoprotein of poliovirus.
The naturally occurring RNA-nucleopeptide H-Ala-Tyr[5'-pUUAAAAC-3']-NH2 is prepared via a solid-phase phosphite triester approach using N-SiOMB/O-TBDMS-protected nucleosides. Preliminary 1H-NMR studies show that the peptidyl unit has a remarkable effect on the conformational behaviour of the RNA moiety in the nucleopeptide.


DHA-enriched fish oil reduces insulin resistance in overweight and obese adults.
Adipose tissue inflammation is major factor in the development of insulin resistance (IR). Long-chain omega-3 polyunsaturated fatty acids (LCn-3PUFA) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are anti-inflammatory bioactive lipids, thus may protect against type 2 diabetes (T2D) development. Previous research has demonstrated a sex-dependent association between LCn-3PUFA and T2D, and evidence suggests LCn-3PUFA may improve IR in a sex-dependent manner. This double-blind, randomized, parallel-arm placebo-controlled study aimed to determine whether DHA-enriched fish oil (FO) supplementation improves IR. Sex-dependent effects were assessed by testing for an interaction between sex and treatment in the multiple regression models. Men and women with abdominal obesity (waist circumference: males, ≥102 cm; females, ≥88 cm) and without diabetes were recruited from the community. Participants (age: 50.9 ± 12.7 years, female: 63.7%, BMI: 32.4 ± 6.6 kg/m2) were randomly allocated to either 2 g FO (860 mg DHA + 120 mg EPA) (intervention, n = 38) or 2 g corn oil (CO) /day (control, n = 35) for 12 weeks in a double-blind randomised controlled trial. A fasting blood sample was collected at 0 and 12 weeks for assessment of IR, glucose and blood lipid profile. Sixty-eight participants completed the intervention. Compared with CO (n = 32), FO (n = 36) significantly reduced fasting insulin by -1.62 μIU/L (95%CI: -2.99, -0.26,) (p = 0.021) and HOMA-IR by -0.40 units (95%CI: -0.78, -0.02, p = 0.038). Higher insulin and HOMA-IR at baseline were associated with greater reductions in the FO group (p < 0.001). There was no interaction between sex and treatment for the change in insulin (p-interactionsex*treatment = 0.816) or HOMA-IR (p-interactionsex*treatment = 0.825). DHA-enriched FO reduces IR in adults with abdominal obesity, however, sex-dependent differences were not evident in this study.