Development of a scale for attitude toward condom use for migrant workers in India.
The propaganda for the use of condoms remains one of the mainstay for prevention of human immunodeficiency virus (HIV) transmission. In spite of the proven efficacy of condom, some moral, social and psychological obstacles are still prevalent, hindering the use of condoms. The study tried to construct a short condom-attitude scale for use among the migrant workers, a major bridge population in India. The study was conducted among the male migrant workers who were 18-49 years old, sexually active and had heard about condoms and were engaged in nonformal jobs. We recruited 234 and 280 candidates for Phase 1 and Phase 2 respectively. Ten items from the original 40-item Brown's ATC (attitude towards condom) scale were selected in Phase 1. After analysis of Phase 1 results, using principal component analysis six items were found appropriate for measuring attitude towards condom use. These six items were then administered in another group in Phase 2. Utilizing Pearson's correlations, scale items were examined in terms of their mean response scores and the correlation matrix between items. Cornbach's alpha and construct validity were also assessed for the entire sample. Study subjects were categorized as condom users and nonusers. The scale structure was explored by analyzing response scores with respect to the items, using principal component analysis followed by varimax rotation analysis. Principal component analysis revealed that the first factor accounted for 71% of the variance, with eigenvalue greater than one. Eigenvalues of the second factor was less than one. Application of screen test suggests only one factor was dominant. Mean score of six items among condom users was 20.45 and that among nonusers was 16.67, which was statistically significant (P<0.01). Cornbach's alpha coefficient was 0.92. This tailor-made attitude-toward-condom-use scale, targeted for most vulnerable people in India, can be included in any rapid survey for assessing the existing beliefs and attitudes toward condoms and also for evaluating efficacy of an intervention program.


[Proliferation cycle changes of Epstein-Barr virus in nasopharyngeal carcinoma cell line CNE after infection].
The strategy of gene therapy on nasopharyngeal carcinoma (NPC) is determined by the characteristics of proliferation cycle of Epstein-Barr virus (EBV) in different histological types of NPC cells. This study was to investigate the characteristics of proliferation cycle of EBV in NPC cell line CNE2. CNE2 cells were co-cultivated with marmoset lymphocyte line B95-8, which was EBV-positive. Then B95-8 cells were removed by cytotoxic test of complement activation. The initial infection state of EBV in CNE2 cells was analyzed by reverse transcription-polymerase chain reaction (RT-PCR) and Southern hybridization. CNE2 cells were infected with EBV by cell-to-cell contacting. The transcription of BZLF1, the symbol gene for EBV lytic phase, maintained 12 days on average. The transcription of EBV-encoded small RNA (EBER), the symbol gene for EBV infectious phase, maintained 22 days on average. After invading CNE2 cells, most EBV initially might be at lytic phase, then switch to the relatively stable latent phase, and finally be lost due to cell culture and passage.


Treatment of ulcerative colitis with germinated barley foodstuff feeding: a pilot study.
Germinated barley foodstuff (GBF) has been shown to attenuate intestinal injury in animal models, largely by increasing luminal short-chain fatty acid production. To investigate the safety and efficacy of GBF in the treatment of ulcerative colitis (UC). Ten patients with active UC received 30 g of GBF daily for 4 weeks in an open-label treatment protocol while the baseline anti-inflammatory therapy was continued. The response to treatment was evaluated clinically and endoscopically. Pre- and post-treatment stool concentrations of short-chain fatty acids were measured by gas-liquid chromatography. Patients showed improvement in their clinical activity index scores, with a significant decrease in the score from 6.9+/-1.4 to 2.8+/-1.5 (mean+/-S.E.M., P < 0.05). The endoscopic index score fell from 6.1+/-2.3 to 3.8+/-2.3 (P < 0.0001). Patients showed an increase in stool butyrate concentrations after GBF treatment (P < 0.05). No side-effects were observed. Oral GBF therapy may have a place in management of ulcerative colitis, but controlled studies are needed to demonstrate its efficacy in the treatment of this disorder.


Retraction: Structural Basis of the Substrate Specificity and Enzyme Catalysis of a Papaver somniferum Tyrosine Decarboxylase.
[This retracts the article on p. 5 in vol. 4, PMID: 28232911.].


B2 SINE retrotransposon causes polymorphic expression of mouse 5-aminolevulinic acid synthase 1 gene.
5-Aminolevulinic acid synthase 1 (ALAS1) is the key enzyme in the homeostasis of nonerythroid heme and of fundamental importance in respiration, the metabolism of drugs, chemicals and steroids and cell signalling. The regulation of ALAS1 in response to stimuli occurs at transcriptional, translational and post-translational levels which could depend on inter-individual variation in basal expression. A genetic difference in hepatic ALAS1 mRNA levels between C57BL/6J and DBA/2 mice was detected by microarray and was >5-fold in whole liver or hepatocytes when estimated by qRT-PCR. Analysis of the ALAS1 promoter showed a 210 nt insert in the DBA/2 containing a B2 SINE retrotransposon causing a marked repression of expression by intracellular reporter systems. Deletions across the B2 SINE demonstrated that the full sequence was required for transcriptional inhibition. The findings show that a B2 SINE can contribute to the regulation of ALAS1 and SINEs in 5'-UTR regions contribute to inter-individual differences in gene expression.


The glomerular permeability factors in idiopathic nephrotic syndrome.
It is currently postulated that steroid-sensitive idiopathic nephrotic syndrome (SSNS) and steroid-resistant idiopathic nephrotic syndrome (SRNS), which are not related to the mutation of a gene coding for podocyte structures or for glomerular basement membrane proteins, result from a circulating factor affecting podocyte shape and function. T lymphocytes have for a long time been suspected to be involved in the pathophysiology of these diseases. The successful treatment of steroid-dependant nephrotic syndrome with rituximab suggests a potential role for B lymphocytes. Clinical and experimental data indicate roles for cytokines IL-13, TNFα, circulating cardiotrophin-like cytokine factor 1 (member of the IL-6 family), circulating hemopexin, radical oxygen species, and the soluble urokinase-type plasminogen activator receptor (suPAR) in the development of nephrotic syndrome. Podocyte metabolism modifications-leading to the overexpression of the podocyte B7-1antigen (CD 80), hypoactivity of the podocyte enzyme sphingomyelin phosphodiesterase acid-like 3 b (SMPDL3b), and to the podocyte production of a hyposialylated form of the angiopoietin-like 4 (Angptl4)-are mechanisms possibly involved in the changes in the podocyte cytoskeleton leading to SSNS and or SRNS. Different multifactorial pathophysiological mechanisms can be advocated for SSNS and SRNS. The present paper reviews the experimental and clinical data upon which the different hypotheses are based and reports their possible clinical applications.


The influence of cognitive load on transfer with error prevention training methods: a meta-analysis.
The objective was to conduct research synthesis for the U.S.Army on the effectiveness of two error prevention training strategies (training wheels and scaffolding) on the transfer of training. Motivated as part of an ongoing program of research on training effectiveness, the current work presents some of the program's research into the effects on transfer of error prevention strategies during training from a cognitive load perspective. Based on cognitive load theory, two training strategies were hypothesized to reduce intrinsic load by supporting learners early in acquisition during schema development. A transfer ratio and Hedges' g were used in the two meta-analyses conducted on transfer studies employing the two training strategies. Moderators relevant to cognitive load theory and specific to the implemented strategies were examined.The transfer ratio was the ratio of treatment transfer performance to control transfer. Hedges' g was used in comparing treatment and control group standardized mean differences. Both effect sizes were analyzed with versions of sample weighted fixed effect models. Analysis of the training wheels strategy suggests a transfer benefit. The observed benefit was strongest when the training wheels were a worked example coupled with a principle-based prompt. Analysis of the scaffolding data also suggests a transfer benefit for the strategy. Both training wheels and scaffolding demonstrated positive transfer as training strategies.As error prevention techniques, both support the intrinsic load--reducing implications of cognitive load theory. The findings are applicable to the development of instructional design guidelines in professional skill-based organizations such as the military.


[Isoelectric focusing of 3-hydroxy-3-methylglutaryl-CoA-reductase from the postmicrosomal fraction of rat liver].
Using isoelectrofocusing, the existence of multiple forms of 3-hydroxy-3-methylglutaryl-CoA reductase (EC 126.96.36.199) in the postmitochondrial fraction of rat liver has been demonstrated for the first time. The isoelectric points for the enzyme isoforms are 6.25, 7.5 and 8.25.


Toward quantitative metabarcoding.
Amplicon-sequence data from environmental DNA (eDNA) and microbiome studies provide important information for ecology, conservation, management, and health. At present, amplicon-sequencing studies-known also as metabarcoding studies, in which the primary data consist of targeted, amplified fragments of DNA sequenced from many taxa in a mixture-struggle to link genetic observations to the underlying biology in a quantitative way, but many applications require quantitative information about the taxa or systems under scrutiny. As metabarcoding studies proliferate in ecology, it becomes more important to develop ways to make them quantitative to ensure that their conclusions are adequately supported. Here we link previously disparate sets of techniques for making such data quantitative, showing that the underlying polymerase chain reaction mechanism explains the observed patterns of amplicon data in a general way. By modeling the process through which amplicon-sequence data arise, rather than transforming the data post hoc, we show how to estimate the starting DNA proportions from a mixture of many taxa. We illustrate how to calibrate the model using mock communities and apply the approach to simulated data and a series of empirical examples. Our approach opens the door to improve the use of metabarcoding data in a wide range of applications in ecology, public health, and related fields.


Radial Artery-to-Aorta Anastomoses Using Symmetry Aortic Connectors: Two Cases.
Abstract Symmetry aortic connectors (St. Jude Medical, Minneapolis, MN, USA) present a new alternative to hand-sewn proximal vein graft anastomoses. This report of 2 cases documents the feasibility of using these connectors for radial artery grafts as well.


Occult papillary carcinoma of the thyroid with pulmonary lymphangitic spread diagnosed by lung biopsy.
Distant metastases from occult papillary carcinoma of the thyroid, which is defined as a tumor less than 15 mm in diameter, are extremely rare. A 21-year-old patient with miliary micronodular densities in both lungs is described, in whom pulmonary lymphangitic spread of occult papillary thyroid carcinoma was diagnosed by transthoracic lung biopsy.


The spinal antinociceptive actions of morphine metabolites morphine-6-glucuronide and normorphine in the rat.
The profound and prolonged effects of morphine in patients with renal dysfunction have been associated with high plasma levels of the opiate metabolites morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G) rather than an increased concentration of morphine. We present here electrophysiological evidence to suggest that potent spinal antinociception can be produced by both M6G and normorphine, another metabolite of morphine. Extracellular recordings of A beta- and C-fibre-evoked responses of convergent dorsal horn neurones were made in the halothane anaesthetised rat. M6G elicited dose-dependent, naloxone-reversible inhibitions of C-fibre-evoked responses which were completely suppressed (8% of control) by 2 micrograms M6G whereas A beta-fibre-evoked responses were only reduced to 57% of controls. The ED50 for the effects of M6G on C-fibre-evoked activity was calculated to be 0.53 micrograms. Systemic administration of M6G (2 mg/kg) also profoundly reduced noxious evoked neuronal activity. Intrathecal normorphine was less potent than M6G but complete selective inhibitions of C-fibre-evoked response could be elicited by 25 micrograms and the ED50 was calculated to be 2.68 micrograms. No such inhibitions were observed following administration of M3G. A comparison with intrathecal morphine in the same preparation reveals that normorphine is equipotent with morphine whereas M6G is 13-fold more potent. These results therefore confirm that M6G and normorphine might be significant contributers to opiate analgesia after administration of morphine.


Platelet count and associated morbidities in VLBW infants with pharmacologically treated patent ductus arteriosus.
Characterize the diagnosis of PDA and the distribution of pretreatment platelet count in pharmacologically managed PDA in infants ≤1500 g and assess the relationship of platelet count to serious morbidities. This is a retrospective, observational study. In 40 hospitals, data were collected on PDA, including pretreatment platelet count. Distribution of platelet count was examined. The association of platelet count and clinical outcomes of IVH, NEC and PDA closure prior to discharge were examined. Chi-square test was used to compare outcomes by platelet count groups. There were 311 patients treated with medically treated PDA. Pretreatment platelet counts were categorized as 0-119 K, 120-199 K, 200-299 K, >300 K. Incidence and grade of IVH were not significantly different by platelet group. Across all groups: No IVH 62-83%, Grades 1-2 IVH 13-25%, Grades 3-4 IVH 2-13%. NEC occurred in 0-11% of all patients studied. PDA closure rate was 33-45%. PDA closure was not significantly affected by platelet count. Platelet count was not a statistically significant factor for development of IVH and NEC in infants born <1500 g with pharmacologically treated PDA.


Syphilitic hepatitis: a case report and review of the literature.
Although recognized for more than 400 yr hepatic complications of syphilis are uncommon and frequently overlooked as explanations for acute liver dysfunction. We describe a case of acute hepatitis during the course of relapsing secondary syphilis, with additional confirmation of the diagnosis by lymph node biopsy demonstrating Treponema pallidum.


Reductive Radical Annulation Strategy toward Bicyclo[3.2.1]octanes: Synthesis of ent-Kaurane and Beyerane Diterpenoids.
Here we report a general [3 + 2] radical annulation that allows the facile construction of bicyclo[3.2.1]octane motifs in ent-kaurane- and beyerane-type diterpenoids. This radical annulation is difficult to control but was realized by harnessing an unprecedented and counterintuitive effect of TEMPO. Eleven natural products with a wide array of oxidation states are easily prepared, demonstrating the powerful utility of this straightforward synthetic strategy.


Hereditary Spastic Paraplegia: Clinical and Genetic Hallmarks.
Hereditary spastic paraplegia comprises a wide and heterogeneous group of inherited neurodegenerative and neurodevelopmental disorders resulting from primary retrograde dysfunction of the long descending fibers of the corticospinal tract. Although spastic paraparesis and urinary dysfunction represent the most common clinical presentation, a complex group of different neurological and systemic compromise has been recognized recently and a growing number of new genetic subtypes were described in the last decade. Clinical characterization of individual and familial history represents the main step during diagnostic workup; however, frequently, few and unspecific data allows a low rate of definite diagnosis based solely in clinical and neuroimaging basis. Likewise, a wide group of neurological acquired and inherited disorders should be included in the differential diagnosis and properly excluded after a complete laboratorial, neuroimaging, and genetic evaluation. The aim of this review article is to provide an extensive overview regarding the main clinical and genetic features of the classical and recently described subtypes of hereditary spastic paraplegia (HSP).


Alkaline phosphatase. 31P NMR probes of the mechanism.
31P NMR signals from substrates and products of alkaline phosphatase have been adapted to measure the rates and product ratios for the hydrolysis and phosphotransferase reactions from pH 6 to 10. Below pH 8, glycerol is a poorer acceptor than H2O (glycerol phosphates:Pi = 0.5). Tris is a more effective acceptor below pH 8, showing a maximum acceptor efficiency at pH 8 (Tris phosphate:Pi = 2). Phosphotransferase efficiencies are in the order expected for the pKaS of the alcohol groups, Tris less than glycerol Cl, C3 less than glycerol C2. Tris and glycerol induce chemical shifts in 113Cd(II) present at the A site but not the B or C sites of the metal triad present at each active center of Cd(II)6 alkaline phosphatase, suggesting that the alcoxides of the acceptors coordinate the A site metal and become the nucleophiles attacking the phosphoseryl residue (E-P) in the second step of the mechanism. The interaction is through the oxygen of Tris. The transferase activity of the amino alcohol shows a bell-shaped pH dependency. Aliphatic alcohol acceptors show small increases in acceptor activity between pH 6 and 8, with 5-fold increases from pH 8 to 10 (at pH 10, glycerol phosphates:Pi = 2.5). 31P NMR inversion transfer has been used to measure the koff for Pi dissociation from the noncovalent enzyme complex (E . P). For the Zn(II)4 alkaline phosphatase koff is essentially pH independent at approximately 35 s-1. For Cd(II) or Mg(II) at the B site in place of Zn(II), koff less than or equal to 1 s-1 X Cl-ion, which appears to coordinate the A site metal ion, enhances koff, suggesting that both Cl- and HPO2-4 can coordinate the A site metal ion in a 5-coordinate intermediate. pH control of the alkaline phosphatase mechanism appears to reside in the stability of E-P and not the dissociation of E . P, compatible with the hypothesis that the activity-linked pKa is that of a H2O molecule coordinated to the A site metal, which in the hydroxide form becomes the nucleophile attacking the phosphoseryl group (E-P).


The pharmacology of endorphin modulation of chick distress vocalization.
Intraventricular injections of beta-endorphin, gamma-endorphin and alpha-endorphin were demonstrated to reduce isolation-induced distress vocalization on 2-4 day old chicks in a dose response manner at doses as small as 12.5 picomoles (pmol). beta-Endorphin was more potent than the other peptides and morphine, while Met-enkephalin was without effect. However, the D-Ala2 substituted form of Met-enkephalin was as potent as morphine. None of the opioid peptides was effective when injected peripherally in doses of 400 pmol/g body weight. Extension of the interval between injection and behavioral observation from 4 minutes eliminated the ability of alpha- and gamma-endorphin to reduce the peeps. Specificity of the opioid effect was determined by testing intraventricular injections (200 pmol) of 9 other endogenously found peptides. Somatostatin, vasoactive intestinal peptide, and human pancreatic peptide reduced the vocalizations modestly, while alpha-MSH reliably increased them.


Persistence of SARS-CoV-2 in the environment and COVID-19 transmission risk from environmental matrices and surfaces.
The Coronavirus disease 2019 (COVID-19) is spreading around the world, representing a global pandemic, counting, as of June 5th, 2020, over 6,600,000 confirmed cases and more than 390,000 deaths, with exponentially increasing numbers. In the first half of 2020, because of the widespread of the COVID-19, researches were focused on the monitoring of SARS-CoV-2 in water, wastewater, sludge, air, and on surfaces, in order to assess the risk of contracting the viral infection from contaminated environments. So far, the survival of the novel Coronavirus out of the human body has been reported for short time periods (from hours to few days, in optimized in vitro conditions), mainly because of the need of an host organism which could consent the viral attack, and due to the weak external membrane of the virus. SARS-CoV-2 viral shedding strategies in the environment, either through animate and unanimate matrices, or exploiting the organic matter in water, wastewater, and waste in general, have been discussed in the present article. We concluded that, besides the high infectuousness of the novel Coronavirus, the transmission of the pathogen may be efficiently contained applying the adequate preventive measures (e.g., personal protection equipments, and disinfecting agents), indicated by national and international health authories.


Static lung compliance in chronic heart failure: relation with dyspnoea and exercise capacity.
The pathogenesis of dyspnoea in patients with chronic heart failure is poorly understood. Static lung compliance is reduced in chronic heart failure. The relation between static lung compliance and exercise capacity and dyspnoea in chronic heart failure has been investigated. Static lung compliance was calculated from expiratory pressure-volume curves in 18 patients with chronic heart failure (three women, mean age 62 years). Catheter mounted pressure transducers were used to measure changes in oesophageal pressure. Changes in lung volume were determined by integrating flow at the mouth, measured by a pneumotachograph. New York Heart Association (NYHA) class for dyspnoea was determined by a single observer. Patients underwent treadmill exercise to symptom limited maximum using staged and fixed rate protocols. Borg ratings for dyspnoea at submaximal exercise were measured. Static lung compliance, whether expressed as % total lung capacity (TLC)/cm H2O or % predicted TLC/cm H2O, was unrelated to NYHA class. Similarly, there was no relation between static lung compliance and exercise capacity with either protocol or with Borg ratings for dyspnoea at submaximal exercise, with the exception of that measured after 11 minutes of the staged protocol. Static lung compliance at rest has no relation with treadmill exercise capacity in chronic heart failure, and its relation with measures of dyspnoea is variable. No role for lung elasticity in determining the symptomatology of chronic heart failure was found.


A Cre recombinase transgene with mosaic, widespread tamoxifen-inducible action.
Cre-mediated site-specific recombination allows conditional transgene expression or gene knockouts in mice. Inducible Cre recombination systems have been developed to bypass initial embryonic lethal phenotypes and provide access to later embryonic or adult phenotypes. We have produced Cre transgenic mice in which excision is tamoxifen inducible and occurs in a widespread mosaic pattern. We utilized our Cre excision reporter system combined with an embryonic stem (ES) cell screen to identify ES cell clones with undetectable background Cre activity in the absence of tamoxifen but efficient excision upon addition of tamoxifen. The CreER transgenic mouse lines derived from the ES cells were tested using the Z/AP and Z/EG Cre reporter lines. Reporter gene expression indicated Cre excision was maximal in midgestation embryos by 2 days after tamoxifen administration, with an overall efficiency of 5-10% of cells with Cre excision. At 3 days after tamoxifen treatment most reporter gene expression marked groups of cells, suggesting an expansion of cells with Cre excision, and the proportion of cells with Cre excision was maintained. In adults, Cre excision was also observed with varying efficiencies in all tissues after tamoxifen treatment.


Estimation of rates of births, deaths, and immigration from mark-recapture data.
The analysis of mark-recapture data is undergoing a period of development and expansion. Here we contribute to that by presenting a model which includes both births and immigration, as well as the usual deaths. Data come from a long-term study of the willow tit (Parus montanus), where we can assume that all births are recorded, and hence immigrants can also be identified as birds captured as adults for the first time. We model the rates of immigration, birth rate per parent, and death rates of juveniles and adults. Using a hierarchical model allows us to incorporate annual variation in these parameters. The model is fitted to the data using Markov chain Monte Carlo, as a Bayesian analysis. In addition to the model fitting, we also check several aspects of the model fit, in particular whether survival varies with age or immigrant status, and whether capture probability is affected by previous capture history. The latter check is important, as independence of capture histories is a key assumption that simplifies the model considerably. Here we find that the capture probability depends strongly on whether the individual was captured in the previous year.


SUMOylation of IQGAP1 promotes the development of colorectal cancer.
IQGAP1 is a conserved multifunctional protein implicated in tumorigenesis. An aberrant expression of IQGAP1 widely exists in many cancers, but the SUMOylation modification of IQGAP1 in carcinogenesis is unknown by now. Here we first time explore biological functions of IQGAP1 SUMOylation in promoting colorectal cancer progression in vitro and in vivo. The expression of IQGAP1 and its SUMOylation level are both increased in human colorectal carcinoma (CRC) cells and tissues. IQGAP1 is mainly SUMOylated by SUMO1 at the K1445 residue, which could stabilize IQGAP1 by reducing protein ubiquitination. IQGAP1 SUMOylation improves CRC cell growth, cell migration and tumorigenesis in vivo through activating the phosphorylation of ERK, MEK and AKT. While the SUMOylation site mutation at K1445 of IQGAP1 greatly reduces CRC cell proliferation, migration ability and tumor growth of CRC-xenograft mice by suppressing phosphorylation of ERK, MEK and AKT. Our findings discover the IQGAP1 SUMOylation is a novel regulatory mechanism to enhance tumorigenesis and development of CRC in vitro and in vivo.


Temperature profoundly affects ataxin-3 fibrillogenesis.
Ataxin-3 (AT3) triggers spinocerebellar ataxia type 3 when it carries a polyglutamine stretch expanded beyond a critical threshold. By Fourier transform infrared spectroscopy and atomic force microscopy we previously showed that a normal (AT3Q24) and an expanded (AT3Q55) variant were capable of evolving into oligomers and protofibrils at 37 °C, whereas only the expanded form generated irreversibly aggregated fibrils that also were associated with a network of side-chain glutamine hydrogen bonding [Natalello et al. (2011) PLoS One. 6:e18789]. We report here that AT3Q24, when gradually heated up to 85 °C, undergoes aggregation similar to that observed at 37 °C; in contrast, AT3Q55 only generates large, amorphous aggregates. We propose a possible interpretation of the mechanism by which temperature affects the outcome of fibrillogenesis.


Evaluation of oversizing in association with conduction disorder after implantation of a rapid deployment valve.
Rapid deployment valve has expanded surgical indication for high-risk patients with aortic stenosis despite its accommodated risk for conduction disorder (CD). The purpose of this study was to evaluate the degree of oversizing in association with postoperative CD. During June 2019 to September 2021, 25 patients underwent aortic valve replacement with Edwards INTUITY. Device size selection was evaluated intraoperatively using provided sizers. Oversizing was evaluated retrospectively by measuring the difference of the dimension of the annulus and left ventricular outflow tract (LVOT) compared to the dimensions of the device used by preoperative-computed tomography. Although there was no incidence of pacemaker implantation, seven patients (28.0%) experienced CD after surgery. There was no difference in device area and annulus area (CD: - 37 ± 22.7 mm2 vs. no CD: - 56 ± 63.6 mm2, p = 0.47), and device circumference and annulus circumference (CD: - 4.4 ± 2.77 mm vs. no CD: - 6.9 ± 5.60 mm, p = 0.26) in patients with and without CD. However, there was a significant difference in area of the device skirt and sub-annular area at the LVOT (CD: 114 ± 28.4 mm2 vs. no CD: - 8 ± 80.0 mm2, p < 0.001), and circumference of device skirt and the LVOT (CD: 3.9 ± 2.08 mm vs. no CD: - 4.6 ± 5.24 mm, p < 0.001) between the two groups. Receiver operating characteristic curve analysis showed that an area difference of 77.7 mm2 and circumference difference of 0.91 mm at LVOT were associated with postoperative CD with specificities of 0.83, 0.78 and sensitivity of 1.0, 1.0, respectively. Preoperative measurement of the LVOT may be useful in evaluating the risk of postoperative CD in patients receiving rapid deployment valve.


Photochemical behavior of parathion in the presence of humic acids from different origins.
This paper reports the effect of ultraviolet radiation on the degradation of pesticide ethyl parathion in the presence of humic acids. Ethyl parathion was completely degraded in 300 min using an artificial lamp of 7.41 x 10(-10) einstein/s. Humic acid from peat did not influence the photochemical rate (k = 8.92 x 10(-3) min). However, in the presence of aquatic humic acid, the photochemical rate was higher (11.5 x 10(-3) min). The analytical determinations show the presence of p-nitrophenol and aminophenol in the reaction medium during the photochemical experiments. The kinetic of degradation in all experiments obeyed a first-order reaction pattern.


1-Palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol ameliorates chemoradiation-induced oral mucositis.
This study was designed to investigate whether necroptosis is involved in the pathogenesis of chemoradiation-induced oral mucositis in a murine model and whether 1-palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG) ameliorates this disorder. A chemoradiation-induced oral mucositis model was established by treating mice with concurrent 5-fluorouracil (100 mg/kg, i.p.) and head and neck X-irradiation (20 Gy). Phosphate-buffered saline or PLAG (100 mg/kg or 250 mg/kg, p.o.) was administered daily. Body weights were recorded daily, and mice were sacrificed on Day 9 for tongue tissue analysis. On Day 9, chemoradiotherapy-treated (ChemoRT) mice had tongue ulcerations and experienced significant weight loss (Day 0:26.18 ± 1.41 g; Day 9:19.44 ± 3.26 g). They also had elevated serum macrophage inhibitory protein 2 (MIP-2) (control: 5.57 ± 3.49 pg/ml; ChemoRT: 130.14 ± 114.54 pg/ml) and interleukin (IL)-6 (control: 198.25 ± 16.91 pg/ml; ChemoRT: 467.25 ± 108.12 pg/ml) levels. ChemoRT-treated mice who received PLAG exhibited no weight loss (Day 0:25.78 ± 1.04 g; Day 9:26.46 ± 1.68 g) and had lower serum MIP-2 (4.42 ± 4.04 pg/ml) and IL-6 (205.75 ± 30.41 pg/ml) levels than ChemoRT-treated mice who did not receive PLAG. Tongue tissues of mice who received PLAG also displayed lower phosphorylation levels of necroptotic signalling proteins. 1-Palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol mitigated chemoradiation-induced oral mucositis by modulating necroptosis.


Psychosocial correlates of substance use in adolescence: a cross-national study in six European countries.
To examine the psychosocial correlates of substance use among adolescents in six European countries. Cross-sectional school population survey (ESPAD) based on standardized methodological procedures. High schools in six European countries: Bulgaria, Croatia, Greece, Romania, Slovenia and UK. Representative samples of a total sample of 16,445 high school students whose 16th birthday fell in the year of data collection. Anonymous self-administered questionnaire. Self-reported substance use was measured by core items on tobacco, alcohol, marijuana and any illegal drug use. Psychosocial correlates included scales of self-esteem, depression, anomie and antisocial behavior, and items pertaining to family, school and peers. Logistic regression analyses for each potential correlate adjusted for country, taking into account the clustered sample, showed statistically significant associations with each substance use variable separately, in almost every case. Particularly strong associations were found between smoking and going out most evenings and having many friends who smoke, while cannabis and illegal drugs were strongly correlated with having friends or older siblings who used these substances. The self-esteem scale score was not correlated with substance use. Anomie and antisocial behavior were more strongly associated than depression with substance use. In the case of depression, anomie and most of the other items examined, associations were stronger for girls than for boys. The present cross-national study identified correlates of legal and illegal substance use which extend outside specific countries, providing grounds to believe that they can be generalized. They provide evidence for the need to address both the use of the gateway drugs and deviant behavior in conjunction with environmental risk factors when designing and implementing preventive interventions in schools.


Controlled Delivery of Chemopreventive Agents by Polymeric Implants.
The clinical development of cancer chemopreventive agents has been hampered by poor oral bioavailability issue. Several compounds have low aqueous solubility and undergo extensive first pass metabolism following oral dosing. To overcome this limitation, we developed polymeric implants from biodegradable ε-polycaprolactone (PCL) that can deliver both lipophilic as well as hydrophilic compounds. Implants furnish controlled release of compounds for long duration and provide dose-dependent release. The rate of release in vitro correlated well with the in vivo release. The polymeric implant technology thus overcomes the oral bioavailability issues, lowers the total required dose and minimizes or eliminates toxicity generally associated with high doses.


A method for the determination of acrylamide in a broad variety of processed foods by GC-MS using xanthydrol derivatization.
A novel GC-MS method was developed for the determination of acrylamide, which is applicable to a variety of processed foods, including potato snacks, corn snacks, biscuits, instant noodles, coffee, soy sauces and miso (fermented soy bean paste). The method involves the derivatization of acrylamide with xanthydrol instead of a bromine compound. Isotopically labelled acrylamide (d₃-acrylamide) was used as the internal standard. The aqueous extract from samples was purified using Sep-Pak™ C₁₈ and Sep-Pak™ AC-2 columns. For amino acid-rich samples, such as miso or soy sauce, an Extrelut™ column was used for purification or extraction. After reaction with xanthydrol, the resultant N-xanthyl acrylamide was determined by GC-MS. The method was validated for various food matrices and showed good linearity, precision and trueness. The limit of detection and limit of quantification ranged 0.5-5 and 5-20 µg kg⁻¹), respectively. The developed method was applied as an exploratory survey of acrylamide in Japanese foods and the method was shown to be applicable for all samples tested.


Trans-regulatory genes affect Slpa and Slpo expression and act in a tissue-specific manner.
The plasma protein C4 and its androgen-dependent homologue Slp are encoded by genes located in the mouse major histocompatibility complex, H-2. The C4 and Slp protein levels and liver mRNA levels are influenced by non-H-2-linked regulatory genes. The allele-specific regulation of C4 expression and the androgen regulation of Slp expression are manifest only in some of the tissues where these genes are expressed. Therefore, we studied tissues in which the effects of the non-H-2 regulatory genes are apparent. We show that these genes only affect the Slp expression in tissues where it is androgen-dependent. This indicates that the non-H-2 regulatory genes most likely act through interaction with the androgen regulation of Slp expression. We also show that liver cells of mice with the Slpo allele, which do not produce Slp protein, do express Slp mRNA; this expression is also androgen-induced and regulated by non-H-2 genes. Thus, both the Slpa and Slpo alleles appear to be regulated in the same way.


Changes in Care Delivery for Children With Sickle Cell Anemia During the COVID-19 Pandemic.
Specialty care for children with sickle cell disease (SCD) may be disrupted during the coronavirus (COVID-19) pandemic. Our DISPLACE consortium includes 28 pediatric SCD centers. In May 2020, we surveyed the consortium on the impact of COVID-19 on their practice focusing on transcranial Doppler ultrasound, chronic red cell transfusions, telehealth, and COVID-19 testing. Twenty-four DISPLACE providers completed the survey. Transcranial Doppler ultrasound screening decreased to 67% but chronic red cell transfusions remained at 96%. Most investigators (92%) used telehealth and 40% of providers had patients test positive for COVID-19. The COVID-19 pandemic has affected routine care and necessitated changes in practice in SCD.


Treatment of nasopharyngeal inlet stenosis following uvulopalatopharyngoplasty with the CO2 laser.
This report looks at outpatient treatment of nasopharyngeal inlet stenosis, a more commonly seen postoperative complication of uvulopalatopharyngoplasty (UPPP). It does not study the effectiveness of the UPPP for treatment of obstructive sleep apnea syndrome (OSAS). The authors evaluated six patients who had a UPPP for OSAS, all of whom developed stenosis in the nasopharyngeal inlet ranging from 14 mm to complete closure. Two patients had failed rotation flap repairs. The carbon dioxide laser was used to treat these patients in the office under a local anesthesia in a staged manner. We now have patients from 3 months to 12 months follow-up who have had stenosis treated successfully. We believe that the postoperative complication of nasopharyngeal inlet stenosis after UPPP can be treated in a safe and cost-effective manner in the office setting.


Postmortem computed tomography differentiation between intraperitoneal decomposition gas and pneumoperitoneum.
The aim of this study is to investigate the ability of postmortem computed tomography (PMCT) to distinguish intraperitoneal decomposition gas from pneumoperitoneum due to intestinal perforation. This retrospective study investigated the factors affecting intraperitoneal gas in two groups of 14 decedents as detected by postmortem CT performed in the Department of Legal Medicine of Hamburg University. The first group died with a cause of death associated with intestinal perforation, and the second group with other different natural causes of death. These factors include postmortem interval, gas volume, gas distribution, radiology alteration index (RAI), and pneumoperitoneum-associated pathology. The findings of this study showed the appearance of specific gas distribution patterns and a significant increase in gas volumes in the cases of intestinal perforation. Moreover, postmortem interval and the pneumoperitoneum-associated pathology could help distinguish postmortem-generated gas from pneumoperitoneum. Based on the findings of this study, we propose that these findings can improve the proper detection of intestinal perforation cases in the future.


Characterization of the hydrothermally synthesized nano-TiO2 crystallite and the photocatalytic degradation of Rhodamine B.
Pure anatase-TiO2 nanoparticles with 8 nm average crystallite size was synthesized hydrothermally at 200 degrees C in 2 h. The structural and physico-chemical properties of nano-TiO2 were determined by powder XRD, FT-IR, BET and SEM analyses. The behavior of anatase nano-TiO2 in catalytic degradation of Rhodamine B (RB) dye in transparent nano-TiO2 sol under UV-light was examined as a function of irradiation power of UV-light, irradiation time, amount of nano-TiO2 and initial RB concentration in the sol. Rhodamine B was fully degraded with the catalysis of the nano-TiO2 in a short time as low as 60 min. Photocatalytic activity of the nano-TiO2 for degradation of RB was compared with Degussa P-25 at optimum catalysis conditions determined for the nano-TiO2. It was found that, when compared to Degussa P-25, the nano-TiO2 could be repeatedly used with increasing photocatalytic activity. It was found that the photodegradation obeys the pseudo first-order reaction kinetics with the rate constant of 0.0658 min(-1), and the half period t1/2 was 10.53 min.


Angular dependence of dipole-dipole-Curie-spin cross-correlation effects in high-spin and low-spin paramagnetic myoglobin.
The (15)N-HSQC spectra of low-spin cyano-met-myoglobin and high-spin fluoro-met-myoglobin were assigned and dipole-dipole-Curie-spin cross-correlated relaxation rates measured. These cross-correlation rates originating from the dipolar (1)H-(15)N interaction and the dipolar interaction between the (1)H and the Curie spin of the paramagnetic center contain long-range angular information about the orientation of the (1)H-(15)N bond with respect to the iron-(1)H vector, with information measurable up to 11 A from the metal for the low-spin complex, and between 10 to 25 A for the high-spin complex. Comparison of the experimental data with predictions from crystal structure data showed that the anisotropy of the magnetic susceptibility tensor in low spin cyano-met-myoglobin significantly influences the cross-correlated dipole-dipole-Curie-spin relaxation rates.


Ecosystem functions of fruit woody species in an urban environment.
The objective of this work was to investigate the potential ecosystem services of 16 fruit trees to plan and manage more efficiently "Urban Forest," increasing also the resilience of cities to climate change. We evaluated the potential capacity of PM10 absorption, the storage of CO2 from the atmosphere, and the cooling of the environment through shading by the crown and through evapotranspiration. We observed that some species, such as Morus nigra, Juglans regia, Pyrus communis, and Cydonia oblonga, are able to store a higher quantity of CO2 than others over a period of 50 years, respectively, of 2.40 tons, 2.33 tons, 1.51 tons, and 0.96 tons. Ficus carica, Juglans regia, and Morus nigra were relevant for PM10 absorption, since they were able to absorb, referring to the year 2019, 146.4 gr/tree, 195.6 gr/tree, and 143.1 gr/tree, respectively. Results showed that these ecosystem functions depend principally on the morphological characteristics of the individuals: their height, DBH, expansion of their crowns, and characteristics of the foliage system.


The investigation of the interaction between NCP-EDA and bovine serum albumin by spectroscopic approaches.
The fluorescence and ultraviolet spectroscopies were explored to study the interaction between N-confused porphyrins-edaravone diad (NCP-EDA) and bovine serum albumin (BSA) under simulative physiological condition at different temperatures. The experimental results show that the fluorescence quenching mechanism between NCP-EDA and BSA is a combined quenching (dynamic and static quenching). The binding constants, binding sites and the corresponding thermodynamic parameters (ΔG, ΔH, and ΔS) of the interaction system were calculated at different temperatures. According to Förster non-radiation energy transfer theory, the binding distance between NCP-EDA and BSA was calculated to be 3.63 nm. In addition, the effect of NCP-EDA on the conformation of BSA was analyzed using synchronous fluorescence spectroscopy.


Home-based enzyme replacement therapy in children and adults with Pompe disease; a prospective study.
Pompe disease is a lysosomal storage disease treated with life-long enzyme replacement therapy (ERT). Home-based ERT has been provided in the Netherlands since 2008 because it diminishes the burden of treatment, increases patient flexibility and autonomy, and is thus a more patient-centred approach to ERT. All Dutch Pompe patients receiving alglucosidase alfa infusions at home were approached to participate in a questionnaire to validate the safety of home-based ERT. Prospective data on symptoms occurring during or within 48 h after infusion and retrospective data on infusion associated reactions (IARs) in the last three months were collected four times during one year. In total, 116 out of 120 eligible patients (17 classic infantile, 2 atypical infantile, 15 childhood onset and 82 adult) filled out 423 questionnaires (response rate: 88.1%). Symptoms during or after infusion were reported 27 times in 17 patients. Fatigue was the most commonly reported health complaint (in 9.5% of patients). Four health complaints were judged to be IARs and reported to the Erasmus MC University Medical Center. None of the IARs reported in this study warranted emergency clinical care. Our data demonstrate that home-based ERT in Pompe disease can be safely implemented as few, mostly mild, symptoms were reported during or after infusion. Insights from this study can be used as a base for implementing home-based ERT in other countries and to further optimize patient care, as unreported mild symptoms do not pose a health risk but may still be relevant to the patient.


[Analysis of MRI and CT manifestations of paranasal sinuses and orbitocranial disorders with secondary exophthalmos].
To study the MRI and CT manifestations of paranasal sinuses and orbitocranial disorders with secondary exophthalmos. MRI and CT scans of 51 patients were examined. MRI offers more information for evaluation of soft tissue lesions; the cavernous hemangioma and dermoid cyst were found to present rather characteristic images. Whereas in evaluation of lesions involving bony structures and calcifications, CT was superior to MRI. CT and MRI may evaluate the tumor location, extension into adjacent areas and are valuable in differential diagnosis of paranasal sinuses and orbitocranial disorder with secondary exophthalmos.


Parkinson-Related LRRK2 Mutation R1628P Enables Cdk5 Phosphorylation of LRRK2 and Upregulates Its Kinase Activity.
Recent studies have linked certain single nucleotide polymorphisms in the leucine-rich repeat kinase 2 (LRRK2) gene with Parkinson's disease (PD). Among the mutations, LRRK2 c.4883G>C (R1628P) variant was identified to have a significant association with the risk of PD in ethnic Han-Chinese populations. But the molecular pathological mechanisms of R1628P mutation in PD is still unknown. Unlike other LRRK2 mutants in the Roc-COR-Kinase domain, the R1628P mutation didn't alter the LRRK2 kinase activity and promote neuronal death directly. LRRK2 R1628P mutation increased the binding affinity of LRRK2 with Cyclin-dependent kinase 5 (Cdk5). Interestingly, R1628P mutation turned its adjacent amino acid residue S1627 on LRRK2 protein to a novel phosphorylation site of Cdk5, which could be defined as a typical type II (+) phosphorylation-related single nucleotide polymorphism. Importantly, we showed that the phosphorylation of S1627 by Cdk5 could activate the LRRK2 kinase, and neurons ectopically expressing R1628P displayed a higher sensitivity to 1-methyl-4-phenylpyridinium, a bioactive metabolite of environmental toxin MPTP, in a Cdk5-dependent manner. Our data indicate that Parkinson-related LRRK2 mutation R1628P leads to Cdk5 phosphorylation of LRRK2 at S1627, which would upregulate the kinase activity of LRRK2 and consequently cause neuronal death.


Effect of porosity on the structure, mechanical properties and cell viability of new bioceramics as potential bone graft substitutes.
Porous and alternative biografts for possible usages in orthopaedic applications were synthesized by the substitution of gelatin (G), cuttlefish backbone (C), meerschaum sepiolite (S) and hydroxyapatite (H). The effects of different proportions of the Gelatin substitutions on the mechanical properties and structure and cell viability properties of the fabricated biografts were investigated. Throughout the structure and mechanical evaluations, it was found that Gelatin substitution in the fabricated biografts increased the total porosity fraction, particularly for C13G75 and S13G75 biografts. Scanning Electron Microscope (SEM), X-ray diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FTIR) were used for characterization of the synthesized biografts. Furthermore, the cell viability tests for the synthesized biografts were carried out by using the osteoblast cell culture. Throughout the analysis, the synthesized C13G75 and S13G75 biografts generated the highest porosity and better correlation between mechanical properties and structural results contributing with highest cell viability rates.


Co-occurrence between hereditary angioedema and multiple sclerosis: Therapeutic management of both diseases with fingolimod.
Hereditary angioedema (HAE) related to C1 esterase-inhibitor deficiency activates the classic complement pathway and results to edematous crises. Although HAE is usually associated with multiple immunoregulatory disorders, neurologic manifestations are rare. We report on the case study of a 33-year-old man diagnosed with HAE (SERPIN1G gene mutation) and multiple sclerosis (MS), followed up for at least 6 years. After a first clinical attack of HEA with scrotal edema, MS disease exacerbation was observed. Treatment with glatiramer acetate could not prevent either MS or HAE clinical attacks with recurrent exacerbations been observed. Remission of MS and significant amelioration of HAE attacks were achieved under fingolimod treatment. Herein we provide long term evaluation of an extremely rare case of concomitant existence of HAE and MS and present the effects of MS current disease-modifying therapies in HAE attacks. Our case highlights the possible effect of fingolimod in immunoregulatory-mechanisms implicated in both diseases.


Role of cognitive ability in the association between functional health literacy and mortality in the Lothian Birth Cohort 1936: a prospective cohort study.
We investigated the role that childhood and old age cognitive ability play in the association between functional health literacy and mortality. Prospective cohort study. This study used data from the Lothian Birth Cohort 1936 (LBC1936) study, which recruited participants living in the Lothian region of Scotland when aged 70 years, most of whom had completed an intelligence test at age 11 years. 795 members of the LBC1936 with scores on tests of functional health literacy and cognitive ability in childhood and older adulthood. Participants were followed up for 8 years to determine mortality. Time to death in days was used as the primary outcome measure. Using Cox regression, higher functional health literacy was associated with lower risk of mortality adjusting for age and sex, using the Shortened Test of Functional Health Literacy in Adults (HR 0.95, 95% CI 0.92 to 0.98), the Newest Vital Sign (HR 0.88, 95% CI 0.80 to 0.97) and a functional health literacy composite measure (HR 0.77, 95% CI 0.65 to 0.92), but not the Rapid Estimate of Adult Literacy in Medicine (HR 0.95, 95% CI 0.90 to 1.01). Adjusting for childhood intelligence did not change these associations. When additionally adjusting for fluid-type cognitive ability in older age, associations between functional health literacy and mortality were attenuated and non-significant. Current fluid ability, but not childhood intelligence, attenuated the association between functional health literacy and mortality. Functional health literacy measures may, in part, assess fluid-type cognitive abilities, and this may account for the association between functional health literacy and mortality.


Somatic copy number alterations are associated with EGFR amplification and shortened survival in patients with primary glioblastoma.
Glioblastoma (GBM) is the most common malignant primary tumor of the central nervous system. With no effective therapy, the prognosis for patients is terrible poor. It is highly heterogeneous and EGFR amplification is its most frequent molecular alteration. In this light, we aimed to examine the genetic heterogeneity of GBM and to correlate it with the clinical characteristics of the patients. For that purpose, we analyzed the status of EGFR and the somatic copy number alterations (CNAs) of a set of tumor suppressor genes and oncogenes. Thus, we found GBMs with high level of EGFR amplification, low level and with no EGFR amplification. Highly amplified tumors showed histological features of aggressiveness. Interestingly, accumulation of CNAs, as a measure of tumor mutational burden, was frequent and significantly associated to shortened survival. EGFR-amplified GBMs displayed both a higher number of concrete CNAs and a higher global tumor mutational burden than their no EGFR-amplified counterparts. In addition to genetic changes previously described in GBM, we found PARK2 and LARGE1 CNAs associated to EGFR amplification. The set of genes analyzed allowed us to explore relevant signaling pathways on GBM. Both PARK2 and LARGE1 are related to receptor tyrosine kinase/PI3K/PTEN/AKT/mTOR-signaling pathway. Finally, we found an association between the molecular pathways altered, EGFR amplification and a poor outcome. Our results underline the potential interest of categorizing GBM according to their EGFR amplification level and the usefulness of assessing the tumor mutational burden. These approaches would open new knowledge possibilities related to GBM biology and therapy.


The Effects of Curl-Up and Straight Leg Raising Exercises in Different Hip Joint Positions on Abdominal Muscle Thickness.
The purpose of this study was to investigate the effect of combining 2 exercises at different angles of the hip joint on the thickness of the transverse abdominis and internal oblique muscles. Twenty-eight healthy adults (22.7 ± 2.5 years of age; 64.93 ±8.8 kg; body mass index: 22.2 ± 2 kg/m2) performed the curl-up exercise and straight leg raise with external rotation of the hip and dorsiflexion of the ankle simultaneously. The thicknesses of transverse abdominis and internal oblique muscles were measured from right and left sides while resting, in curl up, curl up with 10º flexion of hip, curl up with 15º flexion of hip, and curl up with 10º flexion and 15º abduction of the hip. The means of muscle thicknesses were compared using repeated-measures analysis of variance and post hoc Bonferroni tests in the 5 positions. The thicknesses of transverse abdominis (P < .001) and internal oblique (P < .001) muscles were significantly greater in curl up with 10º flexion and 15º abduction of hip compared with the other positions. There was no significant difference between abdominal muscle thicknesses in measuring from either side. Doing the curl-up exercise with 10º flexion and 15º abduction of the hip may be beneficial in strengthening deep abdominal muscles.


Ontogeny of the levels of serotonin in various parts of the brain in severely protein malnourished rats.
We have previously reported that irreversible central and peripheral chemical changes and irreversible changes in spontaneous activity of single neurons in the frontal cortex are seen in adult rats who were born to mothers fed an 8% isocaloric casein diet 5 weeks before mating and during gestation, who were cross-fostered at birth by control (25% casein diet fed) dams and who showed a normal growth curve. Thus, in the rat, a normal growth curve does not necessarily mean a normal development. We now report similar irreversible, albeit larger, changes in small-for-gestational-age (SGA) rats born to mothers fed a 6% isocaloric diet, nursed by 6% casein fed dams and who showed an abnormal growth curve. The regional ontogeny of serotonin, tryptophan and 5-HIAA in the brain and plasma levels of tryptophan, protein, albumin and NEFA are reported. Thus, similar changes were observed in animals with a normal growth curve and in animals with a very markedly decreased growth curve resembling marasmus in humans.


Field studies of the leachability of aged brown coal ash.
The environmental management of ash produced from the brown coal power stations of the Latrobe Valley region of Australia has been studied. Current practice consists of slurrying fly and bottom ash, a short distance to an ash disposal pond. However, storage facilities are approaching capacity and alternative ash management strategies are required in the near future. Initially, the ash produced within the power stations is known to possess a large soluble mass, which can leach rapidly to generate a saline leachate with minor trace metal content. After slurrying and deposition within the ash pond, it has been demonstrated that the soluble mass is significantly lower and the ash can be considered as aged or "leached" ash - a more benign waste that meets the criteria for fill material. In order to assess the long-term behaviour of the leached ash and its suitability for co-disposal in engineered sites within overburden dumps, two field cells were constructed and monitored over a period of 1 year. Each cell was 5 x 5 m in area, 3-m deep and HDPE lined with a coarse drainage layer and leachate collection pipe. The first cell only collected natural rainfall and was known as the Dry Cell. The second cell had an external tank of 5000 l installed (200-mm rainfall equivalent) and water was spray-irrigated regularly to simulate higher rainfall and accelerate the leaching process. The cumulative inflow and outflow for each cell has been calculated using a linear relationship and the leachate quality was monitored over time. The results demonstrate that the ash behaves as an unsaturated porous material, with the effect of evaporation through the profile being dominant and controlling the production of leachate. The leachate quality was initially moderately saline in both cells, with the concentration dropping by nearly 95% in the Wet Cell by the end of the field study. The leachate chemistry has been analysed using the PHREEQC geochemical model. The log activity plots of various species suggest the mineralogical controls on these species in leachate. The full results from this study are presented.


The simple "Rectum Catcher" device is a useful tool for laparoscopic-assisted high and lower rectal surgery.
This report describes our experience in 13 patients with rectal cancer along with a general overview of the use of the simple "Rectum Catcher" device in high and lower rectal surgery. The Rectum Catcher is made of stainless steel (length 40 cm, caliber 7 mm), with a circle of diameter 6 mm punched out at a distance of 5 mm from the top and covered with a short-cut T-tube (length 1 cm, caliber 6 mm) (SILKOLATEX T-tube, 8 mm; Willy Rusch AG, Germany). A vessel tape (width 9 mm, length 120 cm; Kawano Seisakusho, Chiba, Japan) is inserted into the stainless steel and the short-cut T-tube. The Rectum Catcher is inserted into the abdominal cavity through the 12-mm trocar (Ethicon Endo Surgery) and a vessel tape is circled the rectum and pulled to catch it. Thirteen patients with rectal cancer were operated laparoscopically using the Rectum Catcher at our hospital. From January 2007 to the present, this study included 13 patients (5 men and 8 women) undergoing laparoscopic-assisted high anterior resection (Lap-HAR, five patients), low anterior resection (Lap-LAR: six patients), and abdominoperineal resection (Lap-APR: two patients) for rectal cancer, using the Rectum Catcher. Using the Rectum Catcher, easy maneuverability of the rectum and irrigation of rectal lumen can be easily performed to safely cut the bowel being occluded, in the narrow laparoscopic view of the pelvic cavity. In our experience, the simple Rectum Catcher device is safe and useful for performing laparoscopic assisted high and lower rectal surgery.


Lipase production from mutagenic strain of Fusarium Incarnatum KU377454 and its immobilization using Au@Ag core shells nanoparticles for application in waste cooking oil degradation.
In the present study, lipase production from mutated strain of Fusarium incarnatum KU377454 was optimized through central composite design (CCD) based response surface methodology (RSM). The maximum lipase production (4.01 IU/mL) was obtained within 4 days of incubation using 0.1% CaCl2 concentration and 8% wheat bran concentration. Further, salting out technique was applied for partial purification of lipase. The partially purified lipase was immobilized using Au@Ag bimetallic nanoshell. The characterization of immobilized lipase was carried out by transmission electron microscopy (TEM), field emission scanning electron microscopy (FE-SEM), Fourier transformed infrared (FTIR), energy dispersive X-ray (EDX), X-ray diffraction (XRD) and thermo gravimetric analysis (TGA). The immobilized lipase could retain its 95% of activity after 15 days of storage at 4 °C. Subsequently, Au@Ag immobilized lipase was used for the degradation of waste cooking oil (WCO), which showed higher WCO degradation (85%) compared to the free lipase mediated waste cooking oil degradation (71%). The immobilized lipase could be reused for five times without any loss of its activity.


The impact of birth settings on pregnancy outcomes in the United States.
In the United States, 98.3% of patients give birth in hospitals, 1.1% give birth at home, and 0.5% give birth in freestanding birth centers. This review investigated the impact of birth settings on birth outcomes in the United States. Presently, there are insufficient data to evaluate levels of maternal mortality and severe morbidity according to place of birth. Out-of-hospital births are associated with fewer interventions such as episiotomies, epidural anesthesia, operative deliveries, and cesarean deliveries. When compared with hospital births, there are increased rates of avoidable adverse perinatal outcomes in out-of-hospital births in the United States, both for those with and without risk factors. In one recent study, the neonatal mortality rates were significantly elevated for all planned home births: 13.66 per 10,000 live births (242/177,156; odds ratio, 4.19; 95% confidence interval, 3.62-4.84; P<.0001) vs 3.27 per 10,000 live births for in-hospital Certified Nurse-Midwife-attended births (745/2,280,044; odds ratio, 1). These differences increased further when patients were stratified by recognized risk factors such as breech presentation, multiple gestations, nulliparity, advanced maternal age, and postterm pregnancy. Causes of the increased perinatal morbidity and mortality include deliveries of patients with increased risks, absence of standardized criteria to exclude high-risk deliveries, and that most midwives attending out-of-hospital births in the United States do not meet the gold standard for midwifery regulation, the International Confederation of Midwives' Global Standards for Midwifery Education. As part of the informed consent process, pregnant patients interested in out-of-hospital births should be informed of its increased perinatal risks. Hospital births should be supported for all patients, especially those with increased risks.


The Silent Majority of Emergency General Surgery: An Assessment of Consult and Operative Volumes.
Defining the work performed by emergency general surgery (EGS) surgeons has relied on quantifying surgical interventions, failing to include nonsurgical management performed. The purpose of this study was to identify the extent of operative and nonoperative patient management provided by an EGS service line in response to consults from other hospital providers. This is a retrospective descriptive study of all adult patients with an EGS consult request placed from July 1, 2014 to June 30, 2016 at a 1000-bed tertiary referral center. Consult requests were classified by suspected diagnosis and linked to patient demographic and clinical information. Operative and nonoperative cases were compared. About 4998 EGS consults were requested during the 2-y period, of which 69.6% were placed on the first day of the patient encounter. Disposition outcomes after consultation included admission to the EGS service (27.6%) and discharge from the emergency department (25.3%). Small bowel obstruction, appendicitis, and cholecystitis decisively comprised the top three diagnoses for overall consults and those requiring admission to the EGS service. For every consult requiring an operation (n = 1400), 2.6 consults were managed without an operation (n = 3598). EGS surgeons are asked to evaluate and manage a variety of potentially surgical diagnoses. As most consults do not require surgical intervention, operative volume is a poor surrogate for quantifying EGS productivity. The role of this service is vital to patient triage and disposition, particularly in the emergency department setting. Institutions should consider the volume of their nonoperative consultations when evaluating EGS service line workload and in guiding staffing needs.


GLUTAMATE RECEPTOR-LIKE genes mediate leaf-to-leaf wound signalling.
Wounded leaves communicate their damage status to one another through a poorly understood process of long-distance signalling. This stimulates the distal production of jasmonates, potent regulators of defence responses. Using non-invasive electrodes we mapped surface potential changes in Arabidopsis thaliana after wounding leaf eight and found that membrane depolarizations correlated with jasmonate signalling domains in undamaged leaves. Furthermore, current injection elicited jasmonoyl-isoleucine accumulation, resulting in a transcriptome enriched in RNAs encoding key jasmonate signalling regulators. From among 34 screened membrane protein mutant lines, mutations in several clade 3 GLUTAMATE RECEPTOR-LIKE genes (GLRs 3.2, 3.3 and 3.6) attenuated wound-induced surface potential changes. Jasmonate-response gene expression in leaves distal to wounds was reduced in a glr3.3 glr3.6 double mutant. This work provides a genetic basis for investigating mechanisms of long-distance wound signalling in plants and indicates that plant genes related to those important for synaptic activity in animals function in organ-to-organ wound signalling.


Acceleration by stannous ion of the evoked release of transmitter from motor nerve endings in the frog.
Stannous ion (Sn2+, 30 microM) increased the amplitude of endplate potential (EEP) in the frog sartorius muscle, although the amplitude of miniature endplate potential (MEPP) or acetylcholine potential evoked by iontophoretic application of acetylcholine was unchanged. Sn2+ (10-100 microM) dose-dependently increased the quantal content of the EPP. MEPP frequency was not altered by 30 microM Sn2+. These findings indicate that Sn2+ may increase the EPP as a result of acceleration of the transmitter release evoked by nerve impulses.


Macromolecular structural transitions in Pf1 filamentous bacterial virus.
The filamentous bacterial virus Pf1 is a simple model for biological filaments. We have studied the structure of the virion and report here that the helix parameters of Pf1 change sharply with temperature at about 8 degrees C. Local interactions between protein subunits change by only a few tenths of an angstrom, but the changes are amplified between one end and the other of the virion to a rotation of 15 turns and a translation of 1,000 A. The limited nature of the phase transition is probably due to the constraints of 'knobs-into-holes' interaction between side chains of adjacent alpha-helical protein subunits. Treatment of the virion with ether causes a rearrangement of protein subunits into sheets, with the alpha-helices normal to the plane of the sheet. This phase transition suggests a model for virion assembly in the bacterial membrane.


Limitations of fibrosis grade as diagnostic criteria for post polycythemia vera and essential thrombocytosis myelofibrosis.
The clinical phenotype of patients with myeloproliferative neoplasms (MPNs) including primary myelofibrosis (PMF), polycythemia vera (PV), and essential thrombocytosis (ET) whom manifest WHO grade 1 marrow fibrosis is poorly defined. Current IWG-MRT criteria require 2+ marrow fibrosis for diagnosis of post PV/ET myelofibrosis (MF). In contrast, the 2008 WHO definition of PMF does not require a minimum fibrosis threshold. We retrospectively analyzed the clinical characteristics of 91 MPN patients with 1+ marrow fibrosis. We compared the clinical phenotype of sub threshold fibrosis PV/ET with that manifested by PMF. We applied the IWG-MRT criteria for post-PV/ET MF with the fibrosis component omitted and evaluated for percentage of criteria fulfillment. When IWG-MRT criteria were applied to the PV/ET group, 38/58 (66%) of patients fulfilled criteria for diagnosis of post-PV/ET myelofibrosis except for the 2+ fibrosis requirement. Comparison of sub threshold fibrotic PV/ET clinical phenotype to PMF revealed similar characteristics including heavy symptomatic burden (57% and 52%), presence of splenomegaly (43% and 55%), leukoerythroblastic blood smear (38% and 45%), and median hemoglobin (12.8g/dL and 11.1g/dL). MPN progression represents a biological spectrum and definitions of progression in ET/PV may benefit from criteria not restricted by degree of fibrosis.


c-Jun N-terminal kinase 1 negatively regulates osteoblastic differentiation induced by BMP2 via phosphorylation of Runx2 at Ser104.
Runx2 plays a crucial role in osteoblastic differentiation, which can be upregulated by bone morphogenetic proteins 2 (BMP2). Mitogen-activated protein kinase (MAPK) cascades, such as extracellular signal-regulated kinase (ERK) and p38, have been reported to be activated by BMP2 to increase Runx2 activity. The role of cjun-N-terminal kinase (JNK), the other kinase of MAPK, in osteoblastic differentiation has not been well elucidated. In this study, we first showed that JNK1 is activated by BMP2 in multipotent C2C12 and preosteoblastic MC3T3-E1 cell lines. We then showed that early and late osteoblastic differentiation, represented by ALP expression and mineralization, respectively, are significantly enhanced by JNK1 loss-of-function, such as treatment of JNK inhibitor, knockdown of JNK1 and ectopic expression of a dominant negative JNK1 (DN-JNK1). Consistently, BMP2-induced osteoblastic differentiation is reduced by JNK1 gain-of-function, such as enforced expression of a constitutively active JNK1 (CA-JNK1). Most importantly, we showed that Runx2 is required for JNK1-mediated inhibition of osteoblastic differentiation, and identified Ser104 of Runx2 is the site phosphorylated by JNK1 upon BMP2 stimulation. Finally, we found that overexpression of the mutant Runx2 (Ser104Ala) stimulates osteoblastic differentiation of C2C12 and MC3T3-E1 cells to the extent similar to that achieved by overexpression of wild-type (WT) Runx2 plus JNK inhibitor treatment. Taken together, these data indicate that JNK1 negatively regulates BMP2-induced osteoblastic differentiation through phosphorylation of Runx2 at Ser104. In addition, unraveling these mechanisms may help to develop new strategies in enhancing osteoblastic differentiation and bone formation.


Life cycle assessment of water supply alternatives in water-receiving areas of the South-to-North Water Diversion Project in China.
To alleviate the water shortage in northern China, the Chinese government launched the world's largest water diversion project, the South-to-North Water Diversion Project (SNWDP), which delivers water from water-sufficient southern China to water-deficient northern China. However, an up-to-date study has not been conducted to determine whether the project is a favorable option to augment the water supply from an environmental perspective. The life cycle assessment (LCA) methodology integrated with a freshwater withdrawal category (FWI) was adopted to compare water supply alternatives in the water-receiving areas of the SNWDP, i.e., water diversion, wastewater reclamation and seawater desalination. Beijing, Tianjin, Jinan and Qingdao were studied as representative cities because they are the primary water-receiving areas of the SNWDP. The results revealed that the operation phase played the dominant role in all but one of the life cycle impact categories considered and contributed to more than 70% of their scores. For Beijing and Tianjin, receiving water through the SNWDP is the most sustainable option to augment the water supply. The result can be drawn in all of the water-receiving areas of the middle route of the SNWDP. For Jinan and Qingdao, the most sustainable option is the wastewater reclamation system. The seawater desalination system obtains the highest score of the standard impact indicators in all of the study areas, whereas it is the most favorable water supply option when considering the freshwater withdrawal impact. Although the most sustainable water supply alternative was recommended through an LCA analysis, multi-water resources should be integrated into the region's water supply from the perspective of water sustainability. The results of this study provide a useful recommendation on the management of water resources for China.


Target organ-specific inactivation of drug metabolizing enzymes in kidney of hamsters treated with estradiol.
Chronic treatment of hamsters with estradiol for several months has previously been shown to decrease the specific content of cytochrome P450 in the kidney, a target of hormonal carcinogenesis, but not in liver. The reason for this decrease in metabolic enzyme activity is unknown and has been examined in this investigation. We now report that the decrease in specific content of renal cytochrome P450 by 73% in response to estradiol was not affected by co-treatment with tamoxifen for 1 month. The subcutaneous infusion of 250 micrograms/day estradiol for 7 days lowered renal cytochrome P450 by 71% from control values and was therefore used for further mechanistic studies. This treatment decreased renal activities of estradiol 2- or 4-hydroxylase by 77 to 80%, of 7-ethoxycoumarin-O-deethylase by 66% of control values, respectively, and completely eliminated aryl hydrocarbon hydroxylase activities, whereas liver enzymes remained unaffected. After 7 days of infusion of estradiol, fluorescent products of lipid peroxidation were more than doubled in hamster kidney but remained unchanged in liver. The possibility of enzyme destruction by binding of estradiol 2,3-quinone to metabolizing enzymes was investigated in vitro. In the presence of 2-hydroxyestradiol, cumene hydroperoxide, and microsomes, conditions known to favor the oxidation of the steroid to quinone, the binding of catechol estrogen metabolite to microsomal protein increased 60 fold over control values in the absence of cofactor. Purified rat liver cytochrome P450c also oxidized 2-hydroxyestradiol to 2,3-estradiol quinone. The rate of oxidation was linear for the first 2-3 min, but thereafter decreased with time.(ABSTRACT TRUNCATED AT 250 WORDS)


Right-side congenital pericardial defect associated with ischemic heart disease.
We report an unusual right-side congenital pericardial defect with herniation of the right atrium to the right thoracic cavity found intraoperatively in a 73- year-old man undergoing coronary artery bypass grafting for triple-vessel coronary artery disease. The right atrial wall showed fibrous changes due to contact with the defect edge. We suspected that the right coronary artery was obstructed by chronic strangulation of the right atrium. We repaired the defect with a polytetrafluoroethylene patch to prevent it from compressing the bypass graft and coronary arteries.


A primitive neuroectodermal tumor with extension into the cranial vault in a dog.
This paper reports the clinical findings, cytology, diagnostic imaging, and necropsy of an unusual case of a peripheral nervous system neoplasm which, subsequent to a 6-month clinical history, extended into the cranial vault. Necropsy and histology confirmed the diagnosis of a peripheral primitive neuroectodermal tumor.


Cortical modification of an epileptogenic focus.
The influence of cerebral cortex on penicillin-induced spikes in striate cortex was studied with the technique of hypothermic block. Direct cooling of the involved or contralateral striate cortex markedly reduced seizure activity. Significant reduction in seizure activity was also seen with cooling of ipsilateral and contralateral visual association cortex. None of the other cortical areas tested had a reproducible effect on the frequency of seizures. These findings are discussed in term of local and remote factors influencing the epileptogenic focus.


Postoperative preservation of pulmonary function in patients with chronic empyema thoracis: a one-stage operation.
Twenty-two patients with chronic empyema thoracis underwent decortication. In 11 of them, simple decortication achieved sufficient reexpansion of the lung. In the other 11 patients, our new method was indicated because the pleural space was not closed completely by simple decortication. In our procedure, the parietal wall is collapsed, without rib resection, to contact the surface of the decorticated lung. All 11 patients had a one-stage cure. Two of these 11 patients had bronchopleural fistula. The preoperative and postoperative percentage of vital capacity, percentage of forced expiratory volume in 1 second, arterial oxygen tension, alveolar-arterial oxygen pressure difference, and xenon 133 radiospirometry revealed that pulmonary function was well preserved in patients treated by our method as well as in those undergoing simple decortication. The alveolar-arterial oxygen pressure difference during oxygen inhalation improved significantly (p less than 0.05) after operation compared with the preoperative values in both groups. From the pulmonary function studies, we conclude that our method achieves results comparable with those of simple decortication for the treatment of chronic empyema thoracis. Our procedure is indicated in patients for whom it is thought simple decortication will not lead to primary cure of empyema.


Indications and Outcomes of Osteoporosis and Bone Modulation Therapies.
Osteoporosis is a disorder of bone strength that leads to an increased risk of fractures. It is most commonly seen in patients aged 50 or older, although it can sometimes occur at a younger age if there are other comorbidities present. The most common cause of osteoporosis by far is menopause, although it also occurs in men, usually with higher morbidity rates than those seen in women. There are many treatment options available, such as anabolics and antiresorptives, with many more currently being developed. However, osteoporosis remains grossly unrecognized and untreated, resulting in a significant strain on the American economy.


CD147 augmented monocarboxylate transporter-1/4 expression through modulation of the Akt-FoxO3-NF-κB pathway promotes cholangiocarcinoma migration and invasion.
Cholangiocarcinoma (CCA) is an aggressive type of cancer. The major obstacles for treatment are its late presentation and the occurrence metastases. Targeting the metastatic process may serve as a treatment option. CD147 is a membrane protein that promotes CCA metastasis. High lactate levels in CCA are predicted to result from lactate dehydrogenase A expression and sensitivity to monocarboxylate transporter (MCT) inhibitors. An involvement of CD147 in MCT maturation has been reported, but the exact role of MCT in CCA is not clear. Here, we aimed to assess the mechanism of CD147-promoted CCA progression through MCT regulation. The expression levels of CD147 and MCT-1/4 in human CCA tissues were determined by immunohistochemistry. Two CD147 knockout (CD147 KO) CCA cell (KKU-213) clones were established using the CRISPR/Cas9 system. Cell migration and invasion were determined using a Boyden chamber assay. Temporal protein levels were modified by siRNA, specific inhibitors and/or activators. The expression of target proteins was determined using Western blot analyses. CD147 and MCT-1/4 were found to be overexpressed in CCA tissues compared to normal bile duct tissues. In addition, we found that CD147 knockdown significantly alleviated CCA cell migration and invasion, concomitant with decreased pAkt, pFoxO3, pNF-κB (pp65) and MCT-1/4 levels. Conversely, we found that FoxO3 knockdown led to recovered migration/invasion abilities and increased pp65 and MCT-1/4 expression levels. The involvement of Akt in the regulation of MCT-1/4 expression through CD147 was established by inhibition and activation of Akt phosphorylation. Our data indicate that CD147 promotes the malignant progression of CCA cells by activating the Akt-FoxO3-NF-κB-MCT-1/4 axis. As such, CD147 may serve as a possible target for advanced CCA treatment.


Additive bronchodilator effects of terbutaline and enprofylline in asthma.
Enprofylline is a novel xanthine derivative with negligible adenosine antagonizing ability. It is eliminated almost exclusively by renal clearance with a half-life of about 2 h. Three i.v. infusions of enprofylline (1 mg/kg body weight over 10 min) were given at hourly intervals to 16 patients with stable, reversible airway obstruction. The patients were pretreated at random with i.v. terbutaline (4 micrograms/kg body weight) or placebo according to a double blind cross-over design. Lung function and drug concentrations in plasma were followed. Enprofylline produced significant and concentration-dependent bronchodilation between plasma levels of 1.24 and 3.22 mg/l. The improvement in ventilatory function was significantly enhanced by terbutaline pretreatment. At the highest plasma levels of enprofylline nausea and headache were found as subjective side effects. The results suggest that enprofylline and terbutaline might best be used in a low dose combination in the treatment of bronchial asthma.


Reduction of the Vertebral Bone Mineral Density in Patients with Hodgkin Lymphoma Correlates with Their Age and the Treatment Regimen They Received.
Nowadays, Hodgkin lymphoma (HL) has become highly curable. The young age at diagnosis and long life expectancy emphasize the importance of preventing long-term treatment side effects, including bone mineral density (BMD) loss, in these patients. We aimed to evaluate the effects of first-line therapeutic modalities on BMD dynamics in HL patients, intending to identify individuals at risk for osteopenia. Demographics, HL risk factors, treatment, including cumulative steroid doses, and BMD of 213 newly-diagnosed HL patients (median age 29 years), treated at Rambam between 2008-2016, were analyzed. The main chemotherapy regimens applied were: ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) and escalated BEACOPP (EB; bleomycin, etoposide, adriamycin, cyclophosphamide, oncovin, procarbazine, prednisone). BMD was measured using PET/CT scans. BMD loss >15% was revealed in 48% of patients at therapy completion, with osteopenia prevalence of 4% and 14% at baseline and post-therapy, respectively. Cumulative hydrocortisone equivalent doses >3400 mg/m2 correlated with significant BMD reduction. Multivariate analysis at 6 months post-therapy identified age ≥30 years and EB-regimens as significant risk factors for BMD decrease >15%. Therapy-related BMD loss is common in HL patients. Its persistence is associated with age ≥30 years and EB treatment. Reduction of cumulative steroid doses and switch to non-gonadotoxic drugs should be considered.


The effect of increased intraocular pressure on visual acuity and corneal curvature after radial keratotomy.
To detect the effect of increased intraocular pressure on visual acuity and corneal curvature after radial keratotomy, we measured these variables in the sitting and inverted positions in 18 patients who underwent radial keratotomy (Group 1) and compared their results with those from the unoperated on eyes of seven patients (Group 2). We also compared the results before and after inversion within each group. Intraocular pressure increased to approximately two times normal in each group. Significant improvement in visual acuity and reduction in central keratometry were noted only in Group 1. By multiple regression analysis, visual improvement correlated with the number of incisions but not the time since surgery. Our study provides evidence that increased intraocular pressure may account for transient changes in vision and corneal curvature after radial keratotomy.


T2-SPACE imaging of the cauda equina for the assessment of leptomeningeal metastatic disease.
The diagnosis of leptomeningeal metastatic disease (LMD) is frequently challenging and MRI of the spine is an important part of the diagnostic paradigm. We sought to examine the value of adding 3-dimensional, heavily T2-weighted, Sampling Perfection with Application optimised Contrasts using different flip angle Evolution (T2-SPACE) imaging of the lumbar spine to the MRI protocol for patients with suspected LMD. MRI spine examinations including T2-SPACE imaging of the lumbar spine performed for suspected or known LMD were retrospectively reviewed by a neuroradiologist to determine the additional benefit of the T2-SPACE sequence. The accuracy of T2-SPACE was also compared to contrast-enhanced T1-weighted imaging (ceT1WI) and standard T2-weighted imaging (T2WI). 59 patients with T2-SPACE were identified over a 20-month period, 17 having abnormal appearances on ceT1WI, including 12 with appearances consistent with LMD. In eight of these 12 patients, nodules visible on T2-SPACE were visible on T2WI, though T2-SPACE improved the temporal comparison of slowly progressive cauda equina nodules in two cases. In three patients, T2-SPACE identified nodules which were not readily identifiable on T2WI, though were visible on ceT1WI. In one patient, LMD visible on ceT1WI was not appreciable on T2-SPACE or T2WI due to the lack of a nodular component. In six patients, T2WI showed equivocal nodularity, which could be confidently attributed to facet joint arthropathy or a tortuous vessel. In conclusion, T2-SPACE has high sensitivity and specificity for the detection of nodular lesions of the cauda equina and can confidently characterise equivocal findings on standard T2WI.


A pilot study of the efficacy of topical ivermectin against lungworm in young red deer (Cervus elaphus).
Three groups of ten 4-month-old red deer (Cervus elaphus) calves naturally infected with lungworm (Dictyocaulus viviparus) were treated with either oral ivermectin (200 microg/kg), topical (pour-on) ivermectin (500 microg/kg) or oral oxfendazole (5 mg/kg). Faecal larval counts for lungworm were undetectable or very low for 14 days after treatment with oxfendazole, 28 days after treatment with oral ivermectin and for 49 days after treatment with topical ivermectin. This pilot study suggests that the topical formulation of ivermectin was very effective against lungworm and had a more persistent action than the oral ivermectin formulation in young red deer.


Lymph node ratio predictive of recurrence, distant metastasis, and survival in submandibular gland carcinoma patients.
Submandibular gland (SMG) carcinoma has an unfavorable clinical course and a low survival rate. Specific tumor and nodal findings might help predict posttreatment recurrence and survival in SMG carcinoma patients. This study evaluated factors predictive of posttreatment recurrence and survival in SMG carcinoma patients. This study enrolled 99 consecutive patients with previously untreated SMG carcinoma. All patients underwent tumor and metastatic lymph node resection along with or without radiation/chemo-radiation. The predictive clinical and pathological factors for disease-free survival (DFS), distant metastasis-free survival (DMFS), disease-specific survival (DSS), and overall survival (OS) were determined using univariate and multivariate Cox proportional hazards regression analyses. The median tumor size was 2.7 cm and 53 patients (53.5%) had high-grade tumors. The rates of initial nodal and distant metastasis at initial presentation or follow-up were 45.5% and 42.4%, respectively. The actuarial 5-year DFS, DMFS, DSS, and OS rates were 46.4%, 55.9%, 61.5%, and 59.7%, respectively. The independent factors associated with poor DFS, DMFS, DSS, and OS outcomes (all p < 0.05) were T3-T4 classification and lymph node ratio. A histological high-grade tumor was an independent prognostic factor predictive of poor DMFS, DSS, and OS outcomes (all p < 0.05). A high rate of distant site failure is associated with SMG carcinoma, resulting in a poor survival rate. Lymph node ratio might help predict recurrence, distant metastasis, and death due to SMG carcinoma.


Diterpene esters of aristolochic acids from Aristolochia pubescens.
From the acetone and ethanol extracts of the tubercula of Aristolochia pubescens, two diterpene esters of aristolochic acids were isolated, together with 23 known compounds. The structures of the compounds were determined on the basis of spectroscopic analysis.


Bronchogastric fistula, pulmonary sequestration, malrotation of the intestine, and Meckel's diverticulum--a new association.
Two female children, each who had a bronchogastric fistula and pulmonary sequestration (communicating bronchopulmonary foregut malformation, CBPFM) and associated malrotation of the intestine and Meckel's diverticulum are presented. Each child also presented with severe gastroesophageal reflux. The association of malrotation of the intestine and Meckel's diverticulum with a CBPFM never has been reported as a distinct entity. The concept of association of anomalies is discussed briefly.


Apheresis in treatment of acute inflammatory demyelinating disorders.
Therapeutic apheresis has reached an important value in the treatment of neurologic disorders. In the indication of acute relapses of inflammatory demyelinating conditions plasma exchange (PE) is currently mentioned in guidelines in adults and children. Immunoadsorption (IA) is a younger but more selective apheresis method. Compared to PE, data on IA in these indications are less substantiated. Hitherto existing studies indicate IA as effective and safe with similar response rates versus PE. Our own study of 140 adult patients treated with PE or IA in steroid refractory multiple sclerosis or neuromyelitis optica affirm previous findings showing no significant difference in efficacy and treatment safety. Analogue to adult patients, children seem to benefit from apheresis therapy in steroid resistant inflammatory demyelinating conditions but their treatment implies certain challenges concerning physiology, anatomy and psychological aspects necessitating a multidisciplinary therapeutic setting.


Development of computer-aided model to differentiate COVID-19 from pulmonary edema in lung CT scan: EDECOVID-net.
The efforts made to prevent the spread of COVID-19 face specific challenges in diagnosing COVID-19 patients and differentiating them from patients with pulmonary edema. Although systemically administered pulmonary vasodilators and acetazolamide are of great benefit for treating pulmonary edema, they should not be used to treat COVID-19 as they carry the risk of several adverse consequences, including worsening the matching of ventilation and perfusion, impaired carbon dioxide transport, systemic hypotension, and increased work of breathing. This study proposes a machine learning-based method (EDECOVID-net) that automatically differentiates the COVID-19 symptoms from pulmonary edema in lung CT scans using radiomic features. To the best of our knowledge, EDECOVID-net is the first method to differentiate COVID-19 from pulmonary edema and a helpful tool for diagnosing COVID-19 at early stages. The EDECOVID-net has been proposed as a new machine learning-based method with some advantages, such as having simple structure and few mathematical calculations. In total, 13 717 imaging patches, including 5759 COVID-19 and 7958 edema images, were extracted using a CT incision by a specialist radiologist. The EDECOVID-net can distinguish the patients with COVID-19 from those with pulmonary edema with an accuracy of 0.98. In addition, the accuracy of the EDECOVID-net algorithm is compared with other machine learning methods, such as VGG-16 (Acc = 0.94), VGG-19 (Acc = 0.96), Xception (Acc = 0.95), ResNet101 (Acc = 0.97), and DenseNet20l (Acc = 0.97).


[Diagnostic image (358). A neonate with splenomegaly and calcified adrenal glands].
A 10-day-old male neonate with feeding problems and splenomegaly had bilateral adrenal calcifications on plain abdominal X-ray caused by Wolman disease.


Effects of coronary artery occlusion and reperfusion on cardiac cycle-dependent variation of myocardial ultrasonic backscatter.
We have recently reported a systematic variation in integrated ultrasonic backscatter throughout the cardiac cycle in canine hearts. This study was performed to determine whether the pattern of such variation is modified systematically by ischemia. Measurements of integrated ultrasonic backscatter in selected regions of normal, ischemic, and reperfused hearts were compared in view of known differences in systolic function of myocardium in each of these regions. Integrated ultrasonic backscatter (3-7 MHz) gated to the first derivative of left ventricular pressure was measured at the apex, midwall, and base in 10 dogs and at the apex before and during transient ischemia and reperfusion in four dogs. Quantitative integrated ultrasonic backscatter was referenced to a steel reflector. Cyclic variation of integrated ultrasonic backscatter was greatest at the apex [peak to trough variation 5.5 +/- 0.9 dB (mean +/- SE)] with the maximum near end diastole (-52.9 +/- 0.9 dB) and minimum near end systole (-58.4 +/- 1.0 dB). Variation at the apex (5.5 +/- 0.9 dB) and the midwall (4.3 +/- 0.8 dB) was greater than at the base (0.5 +/- 1.0 dB) (P less than 0.01 for either region compared with base). Left anterior descending coronary occlusion for 10 minutes in four of 10 dogs reduced variation at the apex to 0.4 +/- 1.5 dB (P less than 0.02 compared with preocclusion). Reperfusion for 2 hours restored apical cyclic variation to 3.9 +/- 1.7 dB, i.e., to values not significantly different from those before occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)


Review of the genus Leucoma Hbner, 1822 (Lepidoptera: Erebidae: Lymantriinae) from China, with description of two new species.
The genus Leucoma Hbner from China is reviewed. Based on morphological characters and DNA barcode data, fourteen species belonging to this genus are recognized, with descriptions of two new species: L. nyingchiensis sp. nov. and L. sichuana sp. nov.. Illustrations of adults and their genitalia are provided along with a key to all currently known species of Leucoma in China.


A phase 2, randomized, double-blind, placebo-controlled trial of AMG 301, a pituitary adenylate cyclase-activating polypeptide PAC1 receptor monoclonal antibody for migraine prevention.
To assess the safety and efficacy of AMG 301, an inhibitor of the pituitary adenylate cyclase-activating polypeptide (PACAP)-1 (PAC1) receptor, for prevention of migraine. In a double-blind trial, patients were randomized 4:3:3 to placebo, AMG 301 210 mg every 4 weeks, or AMG 301 420 mg every 2 weeks for 12 weeks. Effect on monthly migraine days and other secondary measures were assessed over weeks 9-12. Safety and tolerability were assessed. Of 343 randomized patients (mean age, 41.8-42.5 years), the majority were women (85.4-90.4%), white (94.1-96.2%), and had episodic migraine (62.5-67.9%). A total of 305 patients completed treatment (placebo, n = 124; AMG 301 210 mg, n = 94; AMG 301 420 mg, n = 87). Least squares mean reduction at week 12 in monthly migraine days from baseline was -2.5 (0.4) days for placebo and -2.2 (0.5) days for both AMG 301 treatment groups. No difference between AMG 301 and placebo on any measure of efficacy was observed; mean (95% confidence interval) treatment difference versus placebo for monthly migraine days for AMG 301 210 mg, 0.3 (-0.9 to 1.4); AMG 301 420 mg, 0.3 (-0.9 to 1.4). The incidence of adverse events was similar across groups. AMG 301 offered no benefit over placebo for migraine prevention; further studies may be necessary to fully understand the role of PACAP isoforms and its receptors in migraine pathophysiology. ClinicalTrials.gov: NCT03238781.


[Motor cortical representation in patients with complex regional pain syndrome: a TMS study].
In a group of patients with short- and long-term (chronic) duration of complex regional pain syndrome type I (CRPS I) motor cortical representation was determined, using a transcranial magnetic stimulation (TMS) mapping method. This was done, starting with suprathreshold intensities at the location of the largest MEP amplitude, mapping systematically in all directions. Patients were compared to a group of healthy subjects. In both patient groups we found significantly larger motor cortical representation for the unaffected hand muscles compared to the affected side. This asymmetry was absent in healthy subjects. Such motor cortical representation asymmetry can be considered an effect of altered sensomotor cortical representation. On the other hand, one must also consider the increased use of the unaffected hand and the presence of pain as cortical influencing variables. The real cause must remain speculative at this time.