[Wavefront-guided laser in situ keratomileusis for myopia].
To compare the clinical results of wavefront-guided versus conventional LASIK surgery in the treatment of myopia. One hundred and thirteen eyes underwent wavefront-guided LASIK (Zyoptix) and 335 eyes were received conventional LASIK surgery (Planoscan). Besides visual acuity and refractions, the higher order aberrations and contrast sensitivity are also compared after surgery. The postoperative refractions were not significantly different between the Zyoptix group and Planoscan group. 33.6% of Zyoptix patient and 17.0% of Planoscan patient respectively, had postoperative uncorrected visual acuity than their preoperative best corrected visual acuity. At 6 mm pupil size, the higher order RMS was increased by 100% in the Planoscan group, while in the Zyoptix group, it was increased only by 35% postoperatively. Six months after operation, the contrast sensitivity of Planoscan patients returned to their preoperative baseline. However, the Zyoptix patients had slightly better contrast sensitivity than their preoperative level. Patients undergoing Zyoptix treatment have better quality of vision after surgery than Planoscan patients.


Instability of fasting blood glucose values in noninsulin-dependent diabetic patients with long-term insulin treatment.
We studied serum free C-peptide immunoreactivity (CPR) and the coefficient of variation (CV) of fasting blood glucose values (FBG) in 26 insulin-treated patients with non-insulin-dependent diabetes mellitus (NIDDM) in relation to the duration of insulin treatment. Serum free CPR responses during 100 g oral glucose tolerance test (OGTT) were significantly lower in patients with insulin treatment for five years or more than in those with insulin treatment for less than five years although their previous immunoreactive insulin (IRI) responses during OGTT before insulin treatment showed no significant difference. CV of FBG was found to be significantly higher at the time of this study (20.6 +/- 7.8%, mean +/- SD) than at the second year of insulin treatment (15.3 +/- 7.7%, P less than 0.05) in the patients with insulin treatment for five or more years but did not show any significant difference in patients with insulin treatment for less than five years at the corresponding times. Thus we measured CV of the FBG in NIDDM patients at various intervals during the long-term insulin or oral hypoglycemic agent treatment in another study. In 20 patients with insulin treatment, CV of FBG was found to be significantly different among the various intervals during insulin treatment (P less than 0.0025). It was significantly higher at the eight year (22.2 +/- 8.6%) and 12th year (21.9 +/- 9.1%) than at the second year (14.9 +/- 6.1%) and fifth year (15.0 +/- 6.7%) of insulin treatment (P less than 0.025, P less than 0.025; P less than 0.05, P less than 0.01, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)


SMARCE1-related meningiomas: A clear example of cancer predisposing syndrome.
We report the case of a 16-year-old girl presenting with spinal clear-cell multiple meningiomas (CCMs). In view of this presentation, we sequenced a bioinformatic panel of genes associated with susceptibility to meningioma, identifying a germline heterozygous variant in SMARCE1. Somatic DNA investigations in the CCM demonstrated the deletion of the wild-type allele (loss of heterozygosity, LOH), supporting the causative role of this variant. Family segregation study detected the SMARCE1 variant in the asymptomatic father and in the asymptomatic sister who, nevertheless, presents 2 spinal lesions. Germline heterozygous loss-of-function (LoF) variants in SMARCE1, encoding a protein of the chromatin-remodeling complex SWI/SNF, have been described in few familial cases of susceptibility to meningioma, in particular the CCM subtype. Our case confirms the role of NGS in investigating predisposing genes for meningiomas (multiple or recurrent), with specific regard to SMARCE1 in case of pediatric CCM. In addition to the age of onset, the presence of familial clustering or the coexistence of multiple synchronous meningiomas also supports the role of a genetic predisposition that deserves a molecular assessment. Additionally, given the incomplete penetrance, it is of great importance to follow a specific screening or follow-up program for symptomatic and asymptomatic carriers of pathogenic variants in SMARCE1.


Efficacy and Safety of E-Cigarette Use for Smoking Cessation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
People who smoke conventional cigarettes are increasingly turning to electronic cigarettes (e-cigarettes) as a pathway to quitting. However, the efficacy and safety of e-cigarettes for smoking cessation remains controversial. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), identified through a systematic search of the MEDLINE, EMBASE, and Cochrane CENTRAL databases. Inclusion was restricted to RCTs with a follow-up duration ≥6 months. The primary endpoint was the most rigorous criterion of biochemically validated abstinence at maximum follow-up, and the primary comparison was nicotine e-cigarettes versus any conventional (ie, non-e-cigarette) smoking cessation therapy. The Cochrane Risk of Bias Tool was used to assess bias. Count data were pooled across trials using random-effects models with inverse variance weighting to estimate relative risks (RRs) and corresponding 95% confidence intervals (CIs). We registered the study protocol with the Open Science Framework Registries (osf.io/26fkq). A total of 5 RCTs (n = 3253) were included. Compared with conventional smoking cessation therapies, the use of nicotine e-cigarettes was associated with an increase in abstinence, defined by the most rigorous criterion of abstinence reported (RR 1.77; 95% CI, 1.29-2.44). Nicotine e-cigarettes also increased abstinence (defined by the most rigorous criterion) compared with non-nicotine e-cigarettes (RR 1.56; 95% CI, 1.13-2.15). The incidence of death or serious adverse events was low across all trials at maximum follow-up. Among individuals attempting to quit smoking, nicotine e-cigarettes are more efficacious than conventional nicotine replacement or behavioral smoking cessation therapies, and may prove beneficial in reducing smoking-related health risks.


An incubation mixture of TDP-D-glucose and a purified enzyme extract from E. coli B containing TDP-D-glucose 4,6-hydro-lyase was treated with NaB(3)H(4). Hydrolysis of the separated sugar nucleotide fraction yielded D-galactose-4-(3)H but no 3H-labelled D-glucose. This indicates the presence of TDP-4-keto-D-glucose as an intermediate in the enzymatic conversion of TDP-D-glucose to TDP-L-rhamnose. The stereospecifity of the NaB(3)H(4) reduction can only be explained if TDP-4-keto-D-glucose exists as an enzyme bound complex.


Orientin relieves lipopolysaccharide-induced acute lung injury in mice: The involvement of its anti-inflammatory and anti-oxidant properties.
Oxidative stress and inflammatory responses are nearly involved in the pathogenesis of various diseases, including acute lung injury (ALI). Orientin (Ori), a flavonoid component extracted from natural plants, displayed anti-inflammatory and antioxidant properties in our previous studies. In the current study, we aimed to investigate the amelioration effect of Ori on lipopolysaccharide (LPS)-induced ALI, and we further explored the potential molecular mechanisms. The present results indicated that Ori effectively alleviated LPS-induced ALI by improving the histological changes of lung; decreasing the lung W/D ratio and protein levels, the release of inflammatory cells and cytokines into the bronchoalveolar lavage fluid (BALF); inhibiting nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2) and high mobility group box 1 (HMGB1) protein expression; reducing malondialdehyde (MDA) formation and reactive oxygen species (ROS) generation; and increasing the content of glutathione (GSH) and superoxide dismutase (SOD) contents. Moreover, Ori treatment not only significantly suppressed the LPS-induced nucleotide-binding domain (NOD)-like receptor protein 3 (NLRP3) inflammasome, and nuclear factor-kappa B (NF-κB) signaling pathway activation, but also obviously restored the expression of nuclear factor erythroid 2-related factor 2 (Nrf2), NAD (P) H: quinone oxidoreductase (NQO1), glutamate-cysteine ligase catalytic (GCLC), and heme oxygenase 1 (HO-1) expression in the lung; all of which are reduced by LPS. Taken together, these data suggested that Ori plays an important role in the protection against ALI by suppressing inflammation and oxidative stress which may be strongly related to the suppression of NLRP3 inflammasome and NF-κB activation, as well as the upregulation of the Nrf2 signaling pathway.


Prognostic impact of inferior mesenteric artery lymph node metastasis in colorectal cancer.
The aims of this study are to identify the natural course of inferior mesenteric artery (IMA) lymph node metastasis, and to evaluate the prognostic impact of IMA lymph node metastasis in the sigmoid colon and rectal cancer. From our prospectively collected database, a total of 625 patients who underwent resection with curative intent for stage III adenocarcinoma of the sigmoid colon and rectal cancer between June 1995 and June 2007 were selected. Patients were divided into the IMA-positive group (n = 33) and the IMA-negative group (n = 592) according to IMA lymph node metastasis status. Clinicopathological features, recurrence patterns, and 5-year disease-free survival rates were compared between the two groups. Following curative resection, 5-year disease-free survival rate was 31.9% in the IMA-positive group and 69.4% in the IMA-negative group (p < 0.001). Cox regression analysis revealed that rectal cancer, pathologic stage, and presence of IMA lymph node metastasis were independently associated with disease-free survival. Systemic recurrence rate was significantly higher in the IMA-positive group than in the IMA-negative group (48.5 vs. 20.8%, respectively, p = 0.001). Para-aortic nodal recurrence showed significant association with presence of IMA lymph node metastasis on multivariate analysis (hazard ratio 11.8; 95% confidence interval 2.7-52.2, p = 0.001). Presence of IMA lymph node metastasis should be considered as a predictive factor for high systemic recurrence, and should be treated and followed up with caution for para-aortic nodal recurrence.


Role of acid back-diffusion in the formation of mucosal ulceration and its treatment with drugs in diabetic rats.
We have studied the role of acid back-diffusion in the formation of gastric mucosal ulceration and its treatment with several drugs in streptozotocin-induced diabetic rats. After vagotomy, the stomach of 1-8 week-old diabetic rats and age-matched control rats were irrigated with acid solutions of graded concentrations (50-150 mm HCl) for 1 or 3 h. A marked increase in acid back-diffusion and in haemorrhagic ulceration was found in diabetic rats. The extent of acid back-diffusion and the severity of mucosal ulceration were dependent on the concentration and the time of contact of acid solutions with the gastric mucosa. A high correlation (r = 0.9227) between acid back-diffusion and mucosal ulceration was found in 3-h acid-irrigated diabetic rats. In the 2-week diabetic rat, intragastric cimetidine (300 mg kg-1) or NaHCO3 (52 mg kg-1) significantly (P < 0.05) reduced both acid back-diffusion and haemorrhagic ulcer formation, while atropine (1.0 mg kg-1) or bupivacaine (0.5%, 0.4 mL/rat) was ineffective. High blood glucose levels in diabetic rats were not influenced by these agents. Acid back-diffusion and ulceration in the diabetic rat were markedly reduced by daily administration but not single injection of insulin (50 units kg-1, s.c.). Taken together, in the early stage of diabetes development, chronic insulin deficiency rather than nerve degeneration or hyperglycaemia may be responsible for the disruption of mucosal barriers. It is concluded that acid back-diffusion played an important role in the formation of acute haemorrhagic ulceration that can be inhibited by intragastric cimetidine, NaHCO3 or daily injection of insulin.


Modulation of cell surface iron transferrin receptors by cellular density and state of activation.
This report describes investigations of plasma membrane transferring receptors on a variety of lymphoid cell lines and normal peripheral blood lymphocytes during activation and cell growth cycles. Transformed lymphoid cell lines have as many as 1,000 times the number of receptors found on normal resting lymphocytes. The number of iron transferrin receptors on continuous cell lines as well as normal human fibroblasts is down-regulated during the transition from log-phase growth to stationary plateau growth. When normal lymphocytes are transformed by mixed lymphocyte culture or mitogens, they rapidly express a 50-fold increase in the number of transferrin binding sites. This appearance of iron transferrin receptors anticipates nuclear changes during cell activation and subsequent mitosis of normal cells.


Ultrasonic anatomy of the biliary system.
Real-time ultrasound has vastly improved the diagnosis of the diseases involving the tubular structures of the liver and biliary tract. Puncture of the bile duct and gallbladder can now be carried out under ultrasound visual guidance. An understanding of ultrasound anatomy is essential for taking full advantage of ultrasound in diagnosis.


Purification of rodent eosinophils on discontinuous metrizamide gradients.
Methods are described for the purification of rat and mouse eosinophils. Peritoneal exudate cells obtained from Schistosoma mansoni- or Trichinella spiralis-infected mice were plated on plastic dishes, and the nonadherent cells were centrifuged over discontinuous hypertonic metrizamide gradients. Approximately 41% of those eosinophils present in the original preparations were recovered from the interfaces between 20% and 22% metrizamide at an average of 88% purity. Peritoneal cells obtained from either uninfected or S. mansoni-infected rats were placed directly onto metrizamide gradients. After centrifugation, essentially all eosinophils present in the original preparations were recovered at the interface between 18.5% and 22.5% metrizamide, with an average of 80% purity. These methods for eosinophil purification have proven to be reproducible and to yield cells which are morphologically preserved and functional, as demonstrated by their ability to respond to a chemotactic stimulus.


A novel, highly sensitive method for assessing gap junctional coupling.
To assess gap junctional intercellular communication we have developed a tracer-based methodology which is both highly sensitive and potentially adaptable for in vivo measurements. We found that injection of serotonin revealed significantly more intercellular communication than that injection of the most permeant synthetic tracer currently in use, neurobiotin. Furthermore, mechanical tracer loading steps can be replaced by transfection with human serotonin transporter and the inclusion of serotonin in the medium. Tracer and transporter are detected using immunocytochemical techniques and the presence of cells that are tracer-positive but transporter-negative indicates junctional communication. Tracer loading in vivo using transgenesis, electroporation or viral transduction to direct expression of transporter should be more easily accomplished than with mechanical loading methods.


Automated vs. manual case investigation and contact tracing for pandemic surveillance: Evidence from a stepped wedge cluster randomized trial.
Case investigation and contact tracing (CICT) is an important tool for communicable disease control, both to proactively interrupt chains of transmission and to collect information for situational awareness. We run the first randomized trial of COVID-19 CICT to investigate the utility of manual (i.e., call-based) vs. automated (i.e., survey-based) CICT for pandemic surveillance. Between December 15, 2021 and February 5, 2022, a stepped wedge cluster randomized trial was run in which Santa Clara County ZIP Codes progressively transitioned from manual to automated CICT. Eleven individual-level data fields on demographics and disease dynamics were observed for non-response. The data contains 106,522 positive cases across 29 ZIP Codes. Automated CICT reduced overall collected information by 29 percentage points (SE = 0.08, p < 0.01), as well as the response rate for individual fields. However, we find no evidence of differences in information loss by race or ethnicity. Automated CICT can serve as a useful alternative to manual CICT, with no substantial evidence of skewing data along racial or ethnic lines, but manual CICT improves completeness of key data for monitoring epidemiologic patterns. This research was supported in part by the Stanford Office of Community Engagement and the Stanford Institute for Human-Centered Artificial Intelligence.


Differential expression of the putative Kex2 processed and secreted aspartic proteinase gene family of Cryphonectria parasitica.
Kex2-silenced strains of Cryphonectria parasitica, the ascomycete causal agent of chestnut blight, show a significant reduction in virulence, reduced sexual and asexual sporulation and reductions in mating and fertility. Due to this and the known involvement of Kex2 in the processing of important proproteins in other systems, we searched the whole C. parasitica genome for putative Kex2 substrates. Out of 1299 open reading frames (ORFs) predicted to be secreted, 222 ORFs were identified as potential Kex2 substrates by this screen. Within the putative substrates we identified cell wall modifying proteins, putative proteinases, lipases, esterases, and oxidoreductases. This in silico screen also uncovered a family of nine secreted aspartic proteinases (SAPs) of C. parasitica. Northern blot analyses of this gene family showed differential expression when exposed to chestnut wood and Cryphonectria hypovirus 1 (CHV1). Due to the reduction in fungal virulence known to be caused upon hypoviral infection of C. parasitica, the differential gene expression observed, and the known involvement of SAPs in virulence in other systems, we conducted deletion analyses of four of these proteinases, representing different expression patterns. Deletion of each of the four SAPs did not affect growth rates, sporulation or virulence, suggesting that none of the considered SAPs is essential for the full development or virulence of C. parasitica under the conditions tested.


[Rectal cancer treated at a county hospital. A prospective study of an 11-year period].
The results of rectal cancer surgery in a county hospital during an 11-year period from 1991 to 2002 are presented. Complications, local recurrence rate and survival were registered. One hundred patients operated by one surgeon were included in the study. Twelve were Dukes' type A, 36 B, 48 C, and four were D. Low anterior resection was performed in 68 patients (six with J-pouch), abdominoperineal resection in 29 and a Hartmann's procedure in three patients. The operation was radical in 80 patients. Until December 31, 1994 a conventional operation was performed in 34 patients. Thereafter total mesorectal excision was introduced with excision of the mesorectum for tumours below 10 cm from the anal verge and resection of the mesorectum 5 cm below tumour for higher tumours (46 patients). Thirty days mortality was 4%. The clinical leakage rate after resection was 10% and 6% ended up with a permanent stoma. There were no deaths among patients with leakage. As a consequence of the change in surgical technique from January 1, 1995 the 5-year local recurrence rate declined from 0.32 to 0.11 (p = 0.13) and the overall survival rate exhibited a slightly rising tendency from 0.62 to 0.70 (p = 0.47). Operations for rectal cancer can be performed in a county hospital with a satisfactory outcome as to complication rates and operative mortality provided the operations are concentrated on few hands. The local recurrence rate and the overall survival showed non-significant tendencies to improvement with the introduction of a more radical operation which is in accordance with results from international trials.


Andropause and psychopathology: minor symptoms rather than pathological ones.
This study examined the psychological symptomatology of men diagnosed with andropause and the association between calculated free testosterone (T) and depressed mood, anxiety and quality of life. Subjects were 153 men, aged 50-70 years, who participated in a screening of andropause. Total testosterone, FSH, LH and SHBG levels were measured. Depressed mood was assessed with the Carroll Rating Scale, anxiety with the "anxiety-insomnia" dimension of the General Health Questionnaire, and quality of life with the World Health Organisation Quality of Life questionnaire. The results showed that levels of free T decreased with age, whereas FSH and LH increased. Carroll Rating Scale scores were higher among hypogonadal subjects, but the mean score was low and not pathological. A negative correlation was observed between severity of depression as assessed by the Carroll Rating Scale and free T levels. However, subjects with a significant score on this scale did not exhibit different free T levels compared to subjects with a non-significant depressive score. Anxiety and quality of life did not differ between hypogonadal and eugonadal subjects. The present study therefore suggests that andropause is not characterised by specific psychological symptoms, but may be associated with "depressive symptoms" that are not considered as pathological.


The Application of Flow Cytometry for Simultaneous and Multi-parametric Analysis of Heterogenous Cell Populations in Basic and Clinical Research.
The use of flow cytometry allows simultaneous measurement and multiparametric analysis of single cells in a heterogenous solution. The purpose of flow cytometry can vary depending on the use of antibodies and dyes targeted for specific cell molecules. The method of immune-phenotyping with fluorescently conjugated antibodies to label cell proteins or DNA works in tandem with fluidic, optic, and electrical systems present in the flow cytometer. Some flow cytometers can detect numerous fluorescent molecules on a single cell, allowing the measurement of more than 30 parameters. This ability to detect, measure, and quantitate multiple fluorescent markers on a single cell makes the flow cytometer a useful tool for analyzing various aspects of cell phenotype and function. Here we describe a standardized protocol for surface and intracellular immune-phenotyping of murine lungs, beginning with the building of an optimal antibody panel and ending with data analysis and representation, including sample gating strategies for innate and adaptive immune responses.


Electronic monitoring with a digital smart spacer to support personalized inhaler use education in patients with asthma: The randomized controlled OUTERSPACE trial.
Poor adherence to inhaled medication has been associated with poor outcomes. Smart spacers can monitor inhaler use and technique, yet their feasibility in adults with asthma and their potential benefits are unknown. Assessing the feasibility of undertaking a definitive randomized controlled trial (RCT) of smart spacer-based inhaler education and explore potential clinical benefits in adults with asthma. Two-month randomized controlled feasibility OUtcomes following Tailored Education and Retraining: Studying Performance and AdherenCE (OUTERSPACE) trial comparing personalized smart spacer-based inhaler education versus usual care. Patients were recruited in four Dutch primary care centres. Outcomes were feasibility (inclusion speed, patient acceptance), medication adherence, inhaler technique, clinical effects (lung function, ACQ, FeNO) and usability (System Usability Scale [SUS]). 42 patients were randomized and all completed the study. The feasibility of performing a larger trial focusing on asthma patient education using a smart spacer was demonstrated with all patients included in four months and a participation rate of 86%. In the intervention group, inhalation errors per day decreased by 26.2% while in the usual care group inhalation errors increased by 14.6% (p = 0.021). Adherence decreased slightly in the intervention group as opposed to improvement in the control group (difference 12%, p = 0.028). No changes in lung function, ACQ or FeNO were observed. Usability was deemed high (SUS patients 71, nurses 89). This RCT showed that smart spacer-driven education in patients with asthma is feasible and in this short-term study reduced inhaler errors. Longer-term and larger studies are required to assess clinical effects.


Human growth hormone radioiodination using different batches of 125I of various ages.
The reproducibility and the influence of the batch and decay level of Na125I on the radioiodination of human growth hormone (hGH) were examined by a polyacrylamide gel electrophoresis (PAGE) technique. The between-day coefficient of variation (CV) exhibited a value of 11.9% for labelling yields and 14.3% for antibody specific binding. The within-day variation for different shipments and isotope decay-levels was similar to that for the control experiment, carried out under the same conditions, using Na125I from a single lot. The results indicate that the decay-level and batch do not significantly influence either the yields or the immunological properties of the labelled product. The suitability of this PAGE technique as a control test for radioiodinated proteins is established by comparison with gel chromatography on Sephadex G-100.


Ischemia during rest intervals between sets prevents decreases in fatigue during the explosive squat exercise: a randomized, crossover study.
The study aimed to evaluate the impact of ischemia, used only before particular sets of a lower limb resistance exercise on power output. Ten healthy resistance-trained males (age = 26 ± 6 years; body mass = 90 ± 9 kg; training experience = 9 ± 7 years) performed two experimental sessions (with ischemia; control without ischemia) following a randomized crossover design. During the ischemic condition, the cuffs were inflated to 60% of arterial occlusion pressure. The cuffs were applied before each set for 4.5 min and released 30 s before the start of the set as the reperfusion (4.5 min ischemia + 0.5 min reperfusion). In the control condition, ischemia was not applied. During the experimental sessions, the subjects performed the Keiser machine squat exercise protocol which consisted of 5 sets of two repetitions, at a load of 60% of one-repetition maximum (1RM), with 5 min rest intervals between sets. The repetitions were performed with maximal velocity. The two-way repeated-measures ANOVA showed a statistically significant interaction effect for power output (p < 0.01; η2 = 0.26). There was also a statistically significant main effect of condition for power output (p = 0.02; η2 = 0.40). The post hoc analysis for interaction did not show significant differences between conditions in particular sets. The post hoc analysis for the main effect of the condition revealed that power output was significantly lower in the control group compared to the group where ischemic was used (p = 0.02). The t-test comparisons for particular sets showed a significant lower power output in set 3 (p = 0.03); set 4 (p < 0.01) and set 5 (p < 0.01) for the control condition when compared to the ischemic condition. The results indicate that ischemia applied before each set and released 30 s prior to the start of the squat exercise did not increase power output performance. However, we observed a significantly lower decline in power for the ischemic condition (4.5 min ischemia + 0.5 min reperfusion) in sets 3-5 compared to the control condition. Thus repeated ischemia with reperfusion used between sets can be an effective form of performance enhancement by preventing or at least diminishing fatigue during resistance exercise.


A Highly Diverse Portrait: Heterogeneity of Neuropsychological Profiles in cblC Defect.
Cobalamin C is a rare inborn disorder of metabolism that results in multisystemic abnormalities, including progressive visual deficits. Although the cellular pathophysiology of cblC is a field of active study, little attention has been dedicated to documenting the cognitive consequences of the defect. The neuropsychological assessment of nine individuals aged between 23 months and 24 years was conducted to establish cognitive profiles. Results reveal a marked heterogeneity, with intellectual functioning ranging from extremely low to average, and cognitive difficulties (e.g., attention) evidenced even in those who are not intellectually disabled. Central nervous system abnormalities and multisystem disease are likely to be major contributing factors to the observed cognitive impairments, with the presence of visual deficits constituting an additional impediment to normal cognitive development. This study underscores the importance of conducting in-depth neuropsychological assessments in individuals with cblC, the results of which may be particularly helpful for clinical management, guidance toward rehabilitation services, and educational/vocational planning.


Purification and characterization of (+)dihydroflavonol (3-hydroxyflavanone) 4-reductase from flowers of Dahlia variabilis.
Individual flowers from inflorescences of Dahlia variabilis (cv Scarlet Star) in young developmental stages contained relatively high activity of (+)-dihydroflavonol (DHF) 4-reductase. The DHF reductase was purified from such flowers to apparent homogeneity by a five-step procedure. This included affinity adsorption on Blue Sepharose and elution of the enzyme with NADP+. By gel filtration and by sodium dodecyl sulfate-polyacrylamide gel electrophoresis it was shown that DHF reductase contains only one polypeptide chain with a Mr of about 41,000. The reductase required NADPH as cofactor and catalyzed transfer of the pro-S hydrogen of NADPH to the substrate. Flavanones and dihydroflavonols (3-hydroxyflavanones) were substrates for DHF reductase with pH optima of about 6.0 for flavanones and of about 6.8 for dihydroflavonols. Flavanones were reduced to the corresponding flavan-4-ols and (+)-dihydroflavonols to flavan-3,4-cis-diols. Apparent Michaelis constants determined for (2S)-naringenin, (2S)-eriodicytol, (+)-dihydrokaempferol, (+)-dihydroquercetin, and NADPH were, respectively, 2.3, 2, 10, 15, and 42 microM. V/Km values were higher for dihydroflavonols than for flavanones. Conversion of dihydromyricetin to leucodelphinidin was also catalyzed by the enzyme at a low rate, whereas flavones and flavonols were not accepted as substrates. DHF reductase was not inhibited by metal chelators.


The use of low energy photon therapy (LEPT) in venous leg ulcers: a double-blind, placebo-controlled study.
Venous ulcers are estimated to be present in 0.2 to 0.4% of the population. Although new therapies have significant promise, nonhealing ulcers still represent a significant problem. To evaluate the efficacy of low energy photon therapy (LEPT) in the treatment of venous leg ulcers. A placebo-controlled, double-blind study using low energy photon therapy was performed in nine patients with 12 venous ulcers. Treatment was given three times a week for 10 weeks, using two monochromatic optical sources. One source provided a wavelength (lambda) of 660 nm (red) while the second source delivered a wavelength of 880 nm (infrared). Two optical probes were used, one consisted of an array of 22 monochromatic sources, operating at a wavelength of 660 nm and covering an area 6 x 10 cm2. The second probe had seven infrared sources, operating at a wavelength of 880 nm and covering an area of 4 cm2. The above configuration of optical probes was selected to cover the majority of the ulcer area being treated. The patients who were randomized to placebo treatment received sham therapy from an identical-appearing light source from the same delivery system. Nine patients with 12 venous ulcers were randomized to receive LEPT or placebo therapy. At the conclusion of the study, the percentage of the initial ulcer area remaining unhealed in the LEPT and placebo groups was 24.4% and 84.7%, respectively (P = 0.0008). The decrease in ulcer area (compared to baseline) observed in the LEPT and placebo groups was 193.0 mm2 and 14.7 mm2, respectively (P = 0.0002). One patient dropped out of the study, complaining of lack of treatment efficacy; he was found to be randomized to the placebo group. There were no adverse effects. In this placebo-controlled, double-blind study LEPT was an effective modality for the treatment of venous leg ulcers.


Hysterosalpingographic tubal abnormalities and HIV infection among black women with tubal infertility in sub-Saharan Africa.
Tubal factor remains a common cause of infertility. The association of HIV infection and tubal infertility is a cause for concern. To determine hysterosalpingographic tubal abnormalities and HIV infection among patients with tubal infertility. Over a 4-year period, 207 patients were analyzed. Of these, 174 (84.1%) presented with secondary infertility and 33 (15.9%) with primary infertility. The patients' age range was 21-48 years and mean age was 36.2 years. One hundred and two (49.3%) patients had a history of induced abortion. Concordant bilateral tubal occlusion was found in 139 (67.2%) patients while 68 (32.8%) had discordant bilateral tubal occlusion. Of the 414 fallopian tubes studied, proximal tubal occlusion was found in 66 (15.9%) cases and distal tubal occlusive pathology occurred in 348 (84.1%). An HIV positivity rate of 13.5% was recorded. Distal tubal occlusion with hydrosalpinx was more associated with HIV infection in this series. A high HIV positivity rate was recorded among the patients with tubal infertility compared to the general population. There is prepondence of distal tubal occlusion in infertile women with tubal factor.


Indium selenide/silver phosphate hollow microsphere S-scheme heterojunctions for photocatalytic hydrogen production with simultaneous degradation of tetracycline.
Designing heterojunction photocatalysts with strong interfacial interactions is an effective way to reduce the recombination of photogenerated charge carriers. Here, silver phosphate (Ag3PO4) nanoparticles are coupled with hollow flower-like indium selenide (In2Se3) microspheres by a facile Ostwald ripening and in-situ growth method, resulting in the construction of In2Se3/Ag3PO4 hollow microsphere step-scheme (S-scheme) heterojunction with a large contact interface. The flower-like In2Se3 with hollow and porous structure provides a large specific surface area and numerous active sites for photocatalytic reactions to take place. The photocatalytic activity was tested by measuring the hydrogen evolution from antibiotic wastewater, and the H2 evolution rate of In2Se3/Ag3PO4 reached 4206.4 µmol g-1h-1 under visible light, which is approximately 2.8 times greater than that of In2Se3. In addition, the amount of tetracycline (TC) degradation when it was used as a sacrificial agent is about 54.4% after 1 h. On the one hand, Se-P chemical bonds act as electron transfer channels in the S-scheme heterojunctions, which can facilitate the migration and separation of photogenerated charge carriers. On the other hand, the S-scheme heterojunctions can retain the useful holes and electrons with higher redox capacities, which is very favorable for the generation of more •OH radicals and the photocatalytic activity is greatly enhanced. This work provides an alternative design approach for photocatalysts toward hydrogen evolution in antibiotic wastewater.


Turn Around Time (TAT) as a Benchmark of Laboratory Performance.
Laboratory analytical turnaround time is a reliable indicator of laboratory effectiveness. Our study aimed to evaluate laboratory analytical turnaround time in our laboratory and appraise the contribution of the different phases of analysis towards the same. The turn around time (TAT) for all the samples (both routine and emergency) for the outpatient and hospitalized patients were evaluated for one year. TAT was calculated from sample reception to report dispatch. The average TAT for the clinical biochemistry samples was 5.5 h for routine inpatient samples while the TAT for the outpatient samples was 24 h. The turnaround time for stat samples was 1 h. Pre- and Post-analytical phases were found to contribute approximately 75% to the total TAT. The TAT demonstrates the need for improvement in the pre- and post-analytical periods. We need to tread the middle path to perform optimally according to clinician expectations.


French version of the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) version 3.
Impairment of cognitive function, a common complaint in patients receiving chemotherapy, is usually measured through neuropsychological tests. Patient self-evaluation of cognitive difficulties is an important complement to those tests. The Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) is a self-report questionnaire with potential to be used in standard clinical practice as a tool for evaluating patient's cognitive function before, during, and after chemotherapy. The purpose of our study was to conduct linguistic validation of the French version of the FACT-Cog. Both qualitative and quantitative methods were used in this study. After undergoing a rigorous translation methodology, the French FACT-Cog version was pretested in France with 35 cancer patients undergoing chemotherapy treatment. Interviews were conducted with all patients to ascertain their understanding of each item. The validation of the final version was conducted among 63 cancer patients, and sociodemographic information was collected as well as brief measure of cognitive function and depression score. Patient comments obtained through the cognitive debriefing interviews indicated that patients understand the French FACT-Cog items as they are intended and that the measure is culturally appropriate. Internal consistency reliability of the subscales, evaluated using Cronbach's coefficient alpha, was high for all four subscales: Perceived Cognitive Impairments = 0.93, Impact On QOL = 0.85, Comments From Others = 0.70, and Perceived Cognitive Abilities = 0.89. All item-total correlations for each subscale were greater than 0.20, and most were greater than 0.50. Results from this study effectively demonstrate that the French FACT-Cog is a reliable instrument for the self-reporting of cognitive abilities in patients undergoing chemotherapy.


Cloning of a rat cDNA encoding a protein with high homology to mouse phospholipase A2-activating protein.
A complementary DNA (2510 bp) encoding a protein with high homology to mouse phospholipase A2-activating protein (PLAP) was cloned from rat hepatocytes by differential screening of a subtractive (normoxic minus hypoxic) lambda GEM-2 cDNA library. This cDNA clone, denoted as HCW9, encodes a 647-amino-acid (aa) protein with 96.1% identity in the N-terminal portion (255 aa) to mouse PLAP [Clark et al., Proc. Natl. Acad. Sci. USA 88 (1991) 5418-5422]. Four cDNA clones were further isolated by screening a primary normoxic lambda GEM-2 cDNA library with a fragment of the HCW9 clone as probe. Partial sequencing of these clones revealed that all of the four clones were identical to clone HCW9. Northern blotting analysis of total RNA extracted from normoxic or hypoxic rat hepatocytes, with two different fragments of clone HCW9 as probes, demonstrated a single band with a mobility corresponding to a size of 2.5 kb, whose level was significantly decreased during chemical hypoxia.


Structure, function, and intracellular localization of glycoprotein B of herpesvirus simian agent 8 expressed in insect and mammalian cells.
The cloned gene of glycoprotein B (gB) of herpesvirus simian agent 8 (SA 8) was expressed with a baculovirus system in insect cells. Expression of gB was easily detectable over the cellular background by Coomassie staining of electrophoretically separated proteins. Endoglycosidase digestion of immunoprecipitated gB revealed that the gene product is N-glycosylated, but only with unprocessed, endoglycosidase-H sensitive carbohydrates. The lack of terminal glycosylation of gB is consistent with the observation that gB expressed in insect cells has a molecular weight slightly lower than gB synthesized during an SA 8 infection in mammalian cells. The truncated carbohydrates of gB from insect cells have no measurable effect on the tertiary structure of gB. Immunofluorescence studies on mammalian cells expressing gB from a simian virus 40 based vector revealed that the glycoprotein is localized to cytoplasmic membranes, to the plasma membrane and to the nuclear envelope. Cells expressing gB were fused to polykaryons, which shows that gB has cell fusing activity in the absence of any other SA 8 gene product.


Optical anisotropy of toluidine blue-stained transformed cell nuclei.
Changes in chromatin order with cell transformation were studied in terms of optical anisotropy (birefringence) in toluidine blue-stained NIH 3T3 and Balb/3T3 cells. The transformed NIH 3T3 cell lines used were obtained by transfection with the T24 cell H-ras oncogene and the whole genomic DNA of MCF-7 human breast carcinoma cells. C2PO and PAP2 cell lines were used as representatives of Ha-ras-transformed NIH 3T3 cells with poor and high metastatic ability, respectively. The chromatin of all cells examined exhibited metachromasy and a birefringence of greenish-yellow interference color. The highest birefringence intensity was found in the chromatin granules of the most frequent nuclear phenotype of ras- and MCF-7 DNA-transformed cells, with the exception of the cells with high metastatic ability, in which a faint birefringence was observed. The differences in chromatin birefringence intensity are assumed to indicate differences in chromatin stereoarrangement with cell transformation. In the case of the highly tumorigenic and/or highly metastatic transformants the faint birefringence is assumed to be associated with the heterogeneous and complex physiological processes that may require a relatively less ordered arrangement of the chromatin.


Tyre and road wear particles - A calculation of generation, transport and release to water and soil with special regard to German roads.
Tyre and road wear is one of the main emission sources of particulate plastics (microplastics). In this study, the emissions of tyre wear particles (TWP) which are annually generated on the German road network were calculated. Emissions are calculated by applying two different data sets of emission factors and the annual mileage for distinct vehicles and road types (urban roads, rural roads, highways). Environmental entry paths of tyre and road wear particles (TRWP) were considered including releases to ambient air, soils and surface waters. Road runoff treatment was taken into account differentiated into sewage systems in urban areas and at non-urban roads. This study identifies the soundest data available concerning emission factors, data on traffic and road systems as well as comprehensive information on road runoff treatment in Germany. Applying this data and assuming that 5% of the total emissions are 'fine' air-borne particles, the emissions of coarse 'non-airborne' particles are 75,200-98,400 t/a; . the transport to road banks and soils near roads is 57,300-65,400 t/a (66-76%) including runoff and drift; 8700-19,800 t/a (12-20%) are released to surface waters. Due to lack of data, degradation in soils and surface waters was not considered. Besides soils, urban wastewater treatment plants are expected to be an important sink of TRWP assuming that most of the particles are incorporated in the sewage sludge. Due to the application of sewage sludge as a fertilizer, 1400-2800 t/a TWP are currently deposited on agricultural areas. No reliable data was available to estimate the masses of TWP which are transported from freshwaters into the marine environment. Existing mitigation measures should be improved according to the principle of precaution by installation of road runoff treatment systems and retrofitting of existing plants regarding optimum fine particle retention.


Is detection of asymptomatic recurrence after curative resection associated with improved survival in patients with gastric cancer?
It is not clear if more intense surveillance is associated with improved survival after curative resection for cancer. In the context of a followup program after curative gastrectomy, recurrence and survival were investigated for patients presenting with either symptomatic or asymptomatic recurrence. A prospectively maintained gastric cancer database was used to identify all patients who underwent a curative (R0) gastrectomy from July 1985 to June 2000. Survival curves were generated for patients with either symptomatic or asymptomatic recurrence, and the prognostic variables associated with outcomes were identified. Of 1,172 patients who underwent a curative (R0) gastrectomy, 561 patients (48%) had documented recurrence and 382 patients had complete data about symptoms. Median time to recurrence was 10.8months for asymptomatic patients and 12.4months for symptomatic patients (p = NS). Median postrecurrence survival was 13.5months for asymptomatic patients and 4.8months for symptomatic patients (p < 0.01). Median disease-specific survival was 29.4months for asymptomatic patients and 21.6months for symptomatic patients (p < 0.05). Variables predictive of poor postrecurrence survival included symptomatic recurrence, advanced stage (III/IV), poor differentiation, short disease-free interval (<12months), and multiple sites of recurrence. Followup did not identify asymptomatic recurrence earlier than symptomatic recurrence. Patients with symptomatic recurrence have more aggressive disease with a shorter postrecurrence survival. The impact of detecting asymptomatic recurrence in the course of followup after curative gastrectomy could not be distinguished from the effects of four powerful biologic variables that also interact to govern outcomes.


Unexpected Gastrointestinal Tract injury years following Laparoscopic Adjustable Gastric Banding.
Band migration is a late complication of Laparoscopic Adjustable Gastric Banding insertion, although rare it could be life threatening presenting as peritonitis secondary to gastro-intestinal tract injuries. A case of an unexpected extension of severe gastro-intestinal tract injuries secondary to intra-gastric migration and distal band dislocation is reported. A 53 years old male, with a history of laparoscopic gastric banding 15 years before and known erosion of the band into the gastric lumen was admitted for abdominal pain and raised serum amylase. Imaging revealed dislocation of the band down to the jejunum. Endoscopy and exploratory surgery showed severe decubitus pressure on the gastric antrum up to the duodenum as well as on the pancreas due to rod-like effect of the gastric band catheter and multiple sites of perforation on distal duodenum and small bowel proximal to the band, which migrated within the lumen until 90 cm distal to the Treitz ligament. Extended distal gastrectomy and resection of distal duodenum and small bowel extended to the proximal affected small bowel were necessary. Digestive tract was restored by a gastro-jejunostomy and duodeno-jejunostomy in a Roux-En-Y configuration with duodenal stump closure on tube duodenostomy. A post-operative leakage from the duodenal stump was treated conservatively and the patient was discharged on post-operative day 21. Erosion and migration of the band within the digestive lumen is one of the less frequent late complications occurring after LAGB, furthermore, the amount of extensive damage reported in this case presentation has yet to be reported in literature. Migration of the band should be considered in the differential diagnosis of abdominal complain in patients with adjustable gastric banding. Such a complication could be severe, and lesions may have unexpected extension requiring complex surgical approach.


Reliable and valid self-report outcome measures in sexual (dys)function: a systematic review.
This paper examines the published reliability and validity of non-disease specific, self-report measures of sexual function. Relevant papers were found in a search of the Embase electronic bibliographic database, for English language papers (published 1980-99) reporting on the psychometric testing of sexual function questionnaires. Existing published reviews or collections of such instruments were also searched, and the reference lists of all papers obtained were "back-searched" to identify other measures. Included measures were evaluated in a systematic manner using published standards concerning the validity, internal consistency, and reproducibility of health measurement scales and quality of life measures. Twenty-three self-report measures were identified for inclusion in this review. A further 2 measures were identified by reviewers of this paper after the main searches were undertaken. One measure was found not to be exclusively self-report. Eleven (46% of 24 included measures) did not meet minimum published standards for reliability, internal consistency, and validity. However one of these was reliable and valid in the female-version only. Of the 14 reliable and valid measures, or versions thereof (58% of 24), 2 (8% of 24) met "superior" psychometric standards. Many measures were developed for use with patients in sex or marital therapy, and are mainly suitable for administration to people with long-term sex partners. It is sensible to assume that instruments are only reliable and valid in the often specialized populations in which they were developed.


Thrombin receptor ligation and activated Rac uncap actin filament barbed ends through phosphoinositide synthesis in permeabilized human platelets.
Cells respond to diverse external stimuli by polymerizing cytoplasmic actin, and recent evidence indicates that GTPases can specify where this polymerization takes place. Actin assembly in stimulated blood platelets occurs where sequestered monomers add onto the fast-growing (barbed) ends of actin filaments (F-actin), which are capped in the resting cells. We report that D3 and D4 polyphosphoinositides, Pl(4)P, Pl(4,5)P2, Pl(3,4)P2, and Pl(3,4,5)P3, uncap F-actin in resting permeabilized platelets. The thrombin receptor-activating peptide (TRAP), GTP, and GTP gamma S, but not GDP beta S, also uncap F-actin in permeabilized platelets. GDP beta S inhibits TRAP-induced F-actin uncapping, and Pl(4,5)P2 overcomes this inhibition. Constitutively active mutant Rac, but not Rho, activates uncapping of F-actin. Pl(4,5)P2-binding peptides derived from gelsolin inhibit F-actin uncapping by TRAP, Rac, and GTP gamma S. TRAP and Rac induce rapid Pl(4,5)P2 synthesis in permeabilized platelets. The findings establish a signaling pathway for actin assembly involving Rac in which the final message is phosphoinositide-mediated F-actin uncapping.


The effect of short duration streptozotocin-induced diabetes mellitus on the late phase and threshold of long-term potentiation induction in the rat.
Long-term potentiation (LTP) was examined in streptozotocin (STZ)-induced diabetic rats of 8 (DM8) and 20 (DM20) weeks duration of diabetes mellitus (DM). DM8 animals showed significant LTP induction, although the potentiation of the synapses was significantly lower than in the control animals. No significant potentiation of the synapses could be demonstrated in DM20 animals. The different aspects of LTP induction in the DM8 animals were studied. The threshold of LTP induction was measured by stimulating the slices with 100 Hz frequency trains of stimuli containing different number of impulses. The results showed increased threshold for LTP induction in the DM8 animals compared to the controls. The late LTP (L-LTP) phase induction was studied by applying 3 repeated HFSs to the afferent fibers. Diabetic animals (DM8) slices failed to maintain the synaptic potentiation induced by the high frequency stimulations (HFSs) for more than 1 h.


Genetic evidence for a Smoothened-Gα(i) signaling axis in mammals.
In this issue of Science Signaling, Villanueva et al. report on the identification of heterotrimeric guanine nucleotide-binding protein (G protein) Gαi2 as an essential effector of Smoothened-mediated mammary epithelial cell proliferation. Through a series of in vivo experiments, the authors delineate a Smoothened-regulated Gli-independent Gαi signal that provides direct genetic evidence connecting Smoothened with Gαi in mice.


Do we know enough to quantify the impact of urban green spaces on mortality? An analysis of the current knowledge.
The addition of green spaces (GS) in cities is perceived as an efficient solution to combat climate change and biodiversity loss while also improving human health. Quantitative health impact assessment (QHIA) is a powerful tool to assess the health benefits of GS and support policy-making decisions. In France, a preliminary analysis of the literature led to the decision of developing guidance for QHIA applied to GS and mortality. This paper focuses on the choice of exposure-response functions (ERF) for those QHIA. Literature review and analysis of the key steps of QHIA. Articles providing ERF for all-cause, cardiovascular and respiratory mortality in relation to GS were identified through a literature review and ranked based on a quality score. ERF from the articles with the highest scores was pooled in meta-analyses. In total, 13 ERF were selected for all-cause mortality, 10 for cardiovascular mortality and 5 for respiratory mortality. Meta-risk for a 0.1 increase in the normalised differential vegetation index were, 0.96 (95% confidence interval [CI] 0.94; 0.97), 0.98 (95% CI 0.96; 0.99) and 0.97 (95% CI 0.92; 1.02) for all-cause, cardiovascular and respiratory mortality, respectively. While current knowledge makes it possible to use QHIA on GS and mortality, interdisciplinary research is still needed to clarify the shape of the relationship and its temporality and to assess exposure in a meaningful way for decision-making.


Assessment of a 3050/3200 nm fiber laser system for ablative fractional laser treatments in dermatology.
Mid-infrared (IR) ablative fractional laser treatments are highly efficacious for improving the appearance of a variety of dermatological conditions such as photo-aged skin. However, articulated arms are necessary to transmit the mid-IR light to the skin, which restricts practicality and clinical use. Here, we have assessed and characterized a novel fiber laser-pumped difference frequency generation (DFG) system that generates ablative fractional lesions and compared it to clinically and commercially available thulium fiber, Erbium:YAG (Er:YAG), and CO2 lasers. An investigational 20 W, 3050/3200 nm fiber laser pumped DFG system with a focused spot size of 91 µm was used to generate microscopic ablation arrays in ex vivo human skin. Several pulse energies (10-70 mJ) and pulse durations (2-14 ms) were applied and lesion dimensions were assessed histologically using nitro-blue tetrazolium chloride stain. Ablation depths and coagulative thermal damage zones were analyzed across three additional laser systems. The investigational DFG system-generated deep (>2 mm depth) and narrow (<100 µm diameter) ablative lesions surrounded by thermal coagulative zones of at least 20 µm thickness compared to 13, 40, and 320 µm by the Er:YAG, CO2 , and Thulium laser, respectively. The DFG system is a small footprint device that offers a flexible fiber delivery system for ablative fractional laser treatments, thereby overcoming the requirement of an articulated arm in current commercially available ablative lasers. The depth and width of the ablated microcolumns and the extent of surrounding coagulation can be controlled; this concept can be used to design new treatment procedures for specific indications. Clinical improvements and safety are not the subject of this study and need to be explored with in vivo clinical studies.


A technique for transferring the contours of a functional impression to the polished surfaces of digitally fabricated removable complete dentures.
For the retention and stability of removable complete dentures, the denture base should be fabricated with appropriate borders and polished surfaces. A technique for transferring the contour of a functional impression for digitally fabricated removable complete dentures is described.


Assessment of heavy metal contents in the ambient air of the Coimbatore city, Tamilnadu, India.
Industrialization and urbanization are the two major causes of deteriorating air quality. To evaluate the ambient air quality of the Coimbatore city, suspended particulate matter (SPM) was collected at ten stations and analysed for the heavy metals content. The concentrations of seven heavy metals (Zn, Fe, Cu, Pb, Ni, Cr and Cd) were estimated. The level of SPM was found to be either at permissible or non-permissible limit depending upon the category of the sampling station. At majority of sampling stations, concentrations of Zn were found to be maximum than other heavy metals. The order of average concentrations of heavy metals in Coimbatore atmospheric air was Zn>Fe>Cu>Pb>Cr>Ni>Cd. The usage of Zn for protective coating on iron, steel etc. by the industries in Coimbatore city could be the major reason for the higher concentration of this heavy metal in this region.


Uterine perforation by a cystoperitoneal shunt, an unusual cause of recurrent vaginal discharge.
We describe the first reported case of uterine perforation by a cystoperitoneal shunt. The mechanism of this unusual complication is unclear. A 17-year-old patient had a cystoperitoneal shunt for a porencephalic cyst. She presented with recurrent watery vaginal discharge. A pelvic ultrasound examination showed that the uterus had been perforated by the distal tip of the shunt. The cystoperitoneal shunt was converted to a ventriculo-atrial shunt, and the vaginal discharge subsequently resolved. The appearance of light and clear vaginal discharge in a patient with a cystoperitoneal shunt raises the possibility of uterine perforation. This can be confirmed by ultrasound and analysis of the discharge. Removal of the shunt leads to spontaneous closure of the uterine defect.


Erratum to: Multicomponent, nonpharmacological delirium interventions for older inpatients : A scoping review.
Erratum to: the article "Multicomponent, nonpharmacological delirium interventions for older inpatients. A scoping review." Unfortunately, on 18.10.2019 a preliminary and incorrect version of the flowchart (Fig. 1) was published online. In the corrected and final version one additionally identified record is listed in the flowchart. The records after removal the duplicates are n = 4451 and the records that are excluded after title abstract screening are 4571. The studies included are n = 25. In addition, a further exclusion category is added after full text screening (Study not available: n = 1) and an existing exclusion category (Repeated data use of the original study) was corrected to n = 1, which can also be found in the corrected online supplement No. 2.Z Gerontol Geriat 2019 https://doi.org/10.1007/s00391-019-01627-y Please note the correct version of Fig. 1.The original article has been corrected.


Spectral analysis on fluctuation of heart period in paralyzed, vagotomized, and unanesthetized decerebrate cats.
Spectral analysis was performed on the heart period fluctuation in vagotomized, paralyzed, and unanesthetized decerebrate cats. The heart period was measured as the time interval between successive R waves of the electrocardiograms. When end-tidal PCO2 was set at the same level as that before immobilization, the power spectral density plot of the heart period fluctuation showed several distinct peaks: one peak corresponded to the frequency of the artificial ventilator and the others to its harmonics. In addition, the spectral density plot had another peak centered at the intrinsic respiratory frequency evaluated by recording efferent phrenic neural discharges. The amplitude of these spectral peaks tended to become greater when the end-tidal PCO2 was increased by adding CO2 to the input gas. Our results, therefore, provide evidence that the heart period is modulated not only by the artificial ventilation rhythm but also by the centrally generated respiratory rhythm, and suggested that the strength of such central interactions between cardiac and respiratory rhythms varies depending on the end-tidal PCO2 level.


[The proteolytic activity of the contents of the normal large intestine and in microecological disorders].
The proteolytic (caseinolytic) activity of fecal supernatants obtained from 52 practically healthy children and 220 children with the etiologically undetermined (unclear) diagnosis of gastrointestinal tract dysfunction has been studied. As revealed in this study, in cases of bacteriologically confirmed microecological disturbances in the intestine, accompanied by the activation of opportunistic microflora, the caseinolytic activity of fecal supernatants increases. The determination of the level of the caseinolytic activity of fecal supernatants on solid culture media as a rapid method, specially intended for the diagnosis of dysbiotic states of the gastrointestinal tract, is proposed.


Molecular characterization and phylogenetic relationship of HERV-W family in the Macaca fuscata.
A human endogenous retrovirus, HERV-W, has recently been identified on human chromosome 7 and contains a single complete open reading frame putatively encoding an envelope protein. Its env gene was expressed in various tissues, and mainly in human placenta. We investigated env gene of the HERV-W family in the Macaca fuscata (Japanese monkey). The env gene expression was detected in various tissues (testis, prostate, kidney, cerebellum, thymus, placenta, intestine, stomach, ovary) of the Japanese monkey by RT-PCR. Southern blot analysis indicated that the monkey genome contained at least 15 copies of the HERV-W family. Using the PCR approach with the monkey genome, thirteen env fragments of the HERV-W family were identified and analyzed. These env fragments from monkey showed a high degree of sequence similarity (91-94%) to that of human HERV-W (AF072506). Putative amino acid sequences of the env fragments indicated multiple frameshifts and termination codons by deletion/insertion or point mutation in all clones identified in this study. Phylogenetic analysis of the env fragments derived from the monkey genome with those of the human genome showed a random sister relationship.


Transuncovertebral joint screw placement: technical note.
Although a C2 pedicle screw and a C1-2 transarticular screw are the most rigid anchors, these screws cannot be used in cases with bilateral high-riding vertebral arteries. The authors describe their recent experience using a novel method of C2-3 transuncovertebral joint screw placement for occipitocervical fixation. A 67-year-old patient suffered myelopathy due to instability at C1-2. The patient had bilateral high-riding vertebral arteries that precluded the use of a C2 pedicle screw or a C1-2 transarticular screw. A C2-3 transuncovertebral joint screw was applied bilaterally under 3D navigation guidance. The patient's postoperative course was uneventful, and his neurological status improved after the surgery. Bony fusion was achieved after the surgery. This is the first report to describe the technique of transuncovertebral joint screw. Using a C2-3 transuncovertebral joint screw, a long screw could be used, and it provided an anchor at C3 and C2 from a posterior approach.


Improved syntheses of β-octabromo-meso-triarylcorrole derivatives.
In spite of significant applications as starting materials for a variety of metallocorrole derivatives, free-base β-octabromo-meso-triarylcorroles continue to be viewed as inaccessible. The reasons range from the need for tedious column-chromatographic purification to limitations of the reductive demetallation protocol for selected systems. Here we report that column chromatography may be entirely avoided for a number of β-octabromo-meso-tris(p-X-phenyl)corrole derivatives, where X=CF3, NO2, F, H, CH3, and OCH3; instead, analytically pure products may be obtained by recrystallization from chloroform/methanol. In addition, we have presented an optimized synthesis of the heretofore inaccessible, sterically hindered ligand β-octabromo-meso-tris(2,6-dichlorophenyl)corrole, H3[Br8TDCPC], via reductive demetallation of the corresponding Mn(III) complex. With our earlier report of β-octabromo-meso-tris(pentafluorophenyl)corrole, H3[Br8TPFPC], a comprehensive set of optimized synthetic protocols are thus in place for a good number of β-octabromo-meso-triarylcorrole ligands. Furthermore, we have illustrated the use of these ligands by synthesizing the iron complexes Fe[Br8TDCPC]Cl and Fe[Br8TDCPC](py)2, of which the latter lent itself to single-crystal X-ray structure determination.


The Mauna Loa environmental matrix: foliar and soil nutrients.
The accumulation of total carbon, nitrogen, and phosphorus in soils, available soil nutrients, and foliar nutrients in the native dominant Metrosideros polymorpha were determined across a wide elevational range on 9 lava flows on Mauna Loa, Hawai'i. The flows included a young (<140 y) and an old (>2800 y) áá (rough surface texture) and pāhoehoe (smooth) flow on the wet east and dry northwest side of the mountain. Soil element pools and nutrient availability increased with flow age independent of climate. The dry sites accumulated organic matter and nutrients more slowly than comparable wet sites, but relative nutrient availability to plants (as indicated by soil assays and foliar nutrients) was greater in the dry sites. Accumulation of soil organic matter and nutrients occurred most rapidly in lowerelevation sites on the young flows, but the largest accumulations occurred at higher elevations on old flows. The range of sites sampled represents a complete and largely independent matrix of major factors governing ecosystem structure and function.


Choroidal thickness in patients with alopecia areata: Is it a sign for poor prognosis?
Alopecia areata (AA) is an autoimmune disease which causes non-scarring type hair loss considered to target the pigmentary system. The hair follicle may not be the only site for involvement of the disease. Iris, the ciliary body, choroid and epithelium of the retinal pigment may also be affected. The aim of the present study was to compare retinal pigment epithelium (RPE) and choroidal thicknesses between patients with AA and healthy controls. The study included 44 patients with alopecia areata, and 44 healthy individuals with similar age and gender distribution. RPE and choroidal thickness measurements were performed through Spectral-domain optical coherence tomography (SD-OCT) (Heidelberg Spectralis® OCT). There was not any significant difference between patients with AA and healthy individuals for RPE and choroidal thickness (p = 0.751, p = 0.725, respectively). However, the choroidal thickness (422 ± 79 μm) was significantly thinner in patients with poor prognostic criteria than other patients (371 ± 75 μm; p = 0.039). Monitoring of choroidal thicknesses through optic coherence tomography (OCT) may provide an insight for the disease prognosis in patients with AA.


Neurogenic stimuli alter preoptic area and amygdala unit activity: central effects of olfactory projections on paraventricular nucleus units.
Unit responses were recorded in the preoptic area and amygdala of conscious male rats during exposure to stressful neurogenic stimuli. Olfactory stimulation elicited increases in preoptic area activity on all occasions and also increased activity in the intercalating, medial, and basomedial nuclei of the amygdala, but not in other regions. Acoustic stimulation had less specific effects, even inhibiting unit activity in the central amygdala. A separate series of experiments using urethane-anesthetized rats was carried out to examine the effects of electrical stimulation of the medial amygdala and olfactory tubercle on single-unit activity within the hypothalamic paraventricular nucleus. Inhibition was the predominant response following olfactory tubercle stimulation while excitatory responses predominated following stimulation of the medial amygdala. This was the case particularly for those paraventricular nucleus units identified as projecting to the median eminence (P less than 0.005 vs unidentified cells). The results obtained may be related to the neural regulation of adrenocortical activity as well as higher central nervous activity and have been discussed within these contexts.


Gender medicine teaching increases medical students' gender awareness: results of a quantitative survey.
Knowledge about gender implications of health is insufficiently integrated into university teaching in Germany. Gender awareness represents a key competence to integrate this knowledge into the medical practice. This study is the first survey of the gender awareness of medical students in a cross-sectional design in Germany. From April to July 2021, a quantitative cross-sectional survey in an online format using the "Nijmegen Gender Awareness in Medicine Scale" (2008) was conducted at four German universities (Charité Berlin, Friedrich-Schiller-University Jena, Ludwig-Maximilians-University Munich, and the University of Cologne) with a varied implementation of teaching gender medicine. Students indicated their agreement or disagreement with assumptions and knowledge about the influence of gender in everyday medical practice (gender sensitivity), as well as gender role stereotypes towards patients and physicians (gender role ideology). The 750 included participants showed relatively high gender sensitivity and low gender role stereotyping towards patients and physicians. The curricular implementation of gender medicine in the universities showed a significant influence on the students' gender sensitivity, as well as on their gender role stereotyping towards patients. Students who reported having taken classes in gender medicine or stated a definite interest in doing so showed significantly higher levels of gender sensitivity. Cis-males showed significantly lower gender sensitivity and significantly higher gender role stereotyping. Implementation of gender medicine in the medical curriculum, attending courses on gender education as well as one's gender and interest have a significant impact on medical students' gender competencies. These results support the need for structural integration of gender medicine in medical education and gender trainings at medical schools in Germany.


Unravelling the interaction between the DRD2 and DRD4 genes, personality traits and concussion risk.
Concussion occurs when biomechanical forces transmitted to the head result in neurological deficits. Personality may affect the balance between safe and dangerous play potentially influencing concussion risk. Dopamine receptor D2 (DRD2) and dopamine receptor D4 (DRD4) genetic polymorphisms were previously associated with personality traits. This case-control genetic association study investigated the associations of (1) DRD2 and DRD4 genotypes with concussion susceptibility and personality, (2) personality with concussion susceptibility and (3) the statistical model of genotype, personality and concussion susceptibility. In total, 138 non-concussed controls and 163 previously concussed cases were recruited from high school (n=135, junior), club and professional rugby teams (n=166, senior). Participants were genotyped for DRD2 rs12364283 (A>G), DRD2 rs1076560 (C>A) and DRD4 rs1800955 (T>C) genetic variants. Statistical analyses including structural equation modelling were performed using the R environment and STATA. The rs1800955 CC genotype (p=0.014) and inferred DRD2 (rs12364283-rs1076560)-DRD4 (rs1800955) A-C-C allele combination (p=0.019) were associated with decreased concussion susceptibility in juniors. The rs1800955 TT and CT genotypes were associated with low reward dependence in juniors (p<0.001) and seniors (p=0.010), respectively. High harm avoidance was associated with decreased concussion susceptibility in juniors (p=0.009) and increased susceptibility in seniors (p=0.001). The model showed that a genetic variant was associated with personality while personality was associated with concussion susceptibility. These findings highlight the linear relationship between genetics, personality and concussion susceptibility. Identifying a genetic profile of 'high risk' behaviour, together with the development of personalised behavioural training, can potentially reduce concussion risk.


Studies on the role of the sex-hormone-binding globulin (SHBG) in prostatic gland hypertrophy in men. II. In vitro research.
The effect of SHBG, stilbestrol and cyproterone acetate on the amount of 3H-DHT in the cell nuclei of hypertrophic prostatic glands was studied in vitro. It was found the SHBG lowers the DHT content, whereas stilbestrol and cyproterone acetate in the presence of SHBG tends to increase the amount of 3H-DHT in the nuclei.


Successful Correction of Postinfarction Interventricular Septum Rupture Diagnosed Online During the COVID-19 Pandemic (Clinical Case).
Postinfarction interventricular septum defect is a rare, but very serious and sometimes fatal, complication of acute myocardial infarction. This article describes a clinical case of online diagnosis of a late-stage myocardial infarction and the subsequent successful endovascular repair of a postinfarction ventricular septum defect with a Myval™ occluder.


Unexpected lower testosterone in faster growing farmed saltwater crocodile (Crocodylus porosus) hatchlings.
Agricultural production of the saltwater crocodile (Crocodylus porosus) is an emergent industry in northern Australia with many of the factors affecting production remaining unknown. In this study, we sought to expand upon our previous findings of reference corticosterone and immune function by reporting baseline sex hormone levels [testosterone (TEST) and estradiol (ESTR)] and their association with growth. This was achieved by sampling 253 hatchling crocodiles repeatedly at 3, 6, and 9months of age. Sampling age had a significant effect on both TEST (p<0.001) and ESTR (p<0.001) suggesting climatic/abiotic factors have an influence even in prepubescent crocodiles. Stress, as measured by plasma corticosterone, had no detectable effect on plasma ESTR or TEST levels. Unexpectedly however, TEST was higher in slower-growing crocodiles, which is contrary to what has been reported for the American alligator. ESTR was not associated with growth.


Interleukin-10 and the immune response against cancer: a counterpoint.
Although interleukin-10 (IL-10) is commonly regarded as an anti-inflammatory, immunosuppressive cytokine that favors tumor escape from immune surveillance, a wealth of evidence is accumulating that IL-10 also possesses some immunostimulating properties. In fact, IL-10 has the pleiotropic ability of influencing positively and negatively the function of innate and adaptive immunity in different experimental models, which makes it questionable to merely categorize this cytokine as a target of anti-immune escape therapeutic strategies or rather, as an immunological adjuvant in the fight against cancer. Here, we review available data about the immunostimulating anticancer properties of IL-10, and in particular, we focus on the hypothesis that in contrast to what occurs in secondary lymphoid organs, IL-10 overexpression within the tumor microenvironment may catalyze cancer immune rejection.


Synthesis and Study on Ionic Conductive (Bi1-x,Vx)O1.5-δ Materials with a Dual-Phase Microstructure.
Homogeneous Bi₂O₃-V₂O₅ powder mixtures with different amounts of V₂O₅ content (≤15 mol%) were prepared by colloidal dispersion and sintering to high density. The sintered and annealed samples were studied by thermal analysis, quantitative X-ray diffraction and scanning electron microscopy. The electrical and ionic conductivities of the conductors were also measured by a four-probe direct current (DC) method. The results of the samples prepared at 600-800 °C and annealed for as long as 100 h show that the sintered samples consisting of a pure γ phase or δ + γ binary phase perform differently in conductivity. The highly conductive δ phase in the composition of Bi0.92V0.08O1.5-δ enhances the electric conductivity 10-times better than that of the pure γ-sample (Bi0.94V0.06O1.5-δ) between 400 and 600 °C. The compatible regions of the γ phase with the α- or δ phase are also reported and discussed, so a part of the previously published Bi₂O₃-V₂O₅ phase diagram below 800 °C is revised.


Native and iron-saturated bovine lactoferrin differently hinder migration in a model of human glioblastoma by reverting epithelial-to-mesenchymal transition-like process and inhibiting interleukin-6/STAT3 axis.
Glioblastoma, the most lethal form of brain cancer, is characterized by fast growth, migration and invasion of the surrounding parenchyma, with epithelial-to-mesenchymal transition (EMT)-like process being mostly responsible for tumour spreading and dissemination. A number of actors, including cadherins, vimentin, transcriptional factors such as SNAIL, play critical roles in the EMT process. The interleukin (IL)-6/STAT3 axis has been related to enhanced glioblastoma's migration and invasion abilities as well. Here, we present data on the differential effects of native and iron-saturated bovine lactoferrin (bLf), an iron-chelating glycoprotein of the innate immune response, in inhibiting migration in a human glioblastoma cell line. Through a wound healing assay, we found that bLf was able to partially or completely hinder cell migration, depending on its iron saturation rate. At a molecular level, bLf down-regulated both SNAIL and vimentin expression, while inducing a notable increase in cadherins' levels and inhibiting IL-6/STAT3 axis. Again, these effects positively correlated to bLf iron-saturation state, with the Holo-form resulting more efficient than the native one. Overall, our data suggest that bLf could represent a novel and efficient adjuvant treatment for glioblastoma's standard therapeutic approaches.


GM-CSF and the role of myeloid regulatory cells in the pathogenesis and treatment of Crohn's disease.
Intestinal monocytes/macrophages sustain the intestinal immune homeostasis and might be an attractive therapeutic target for the management of inflammatory bowel disease (IBD). Granulocyte macrophage colony-stimulating factor (GM-CSF) exerts beneficial effects on intestinal inflammation and promotes signal transducer and activator of transcription 3 (STAT3)-mediated expansion of myeloid-derived suppressor cells (MDSCs). However, the full action mechanism of GM-CSF, and especially whether monocytes mediate its therapeutic effects in vivo, had not been previously elucidated. This review article summarizes recent developments in the immunology of mucosal diseases and describes new aspects of the role of myeloid regulatory cells in IBD and the function of GM-CSF in maintaining the intestinal immune homeostasis in Crohn's disease (CD). This review article highlights the exploration of stimulating in addition to suppressive therapies for patients with IBD and underpins that myeloid regulatory cells might become a promising novel cell-based therapeutic option.


Immediate effect of ACL kinesio taping technique on knee joint biomechanics during a drop vertical jump: a randomized crossover controlled trial.
The purpose of this study was to investigate the effect of an ACL Kinesio Taping technique (ACL-KT) on knee joint biomechanics during a drop vertical jump (DVJ). Twenty healthy male participants (age 21.1±0.3 years; mass 64.2±4.3 kg; height 174.2±5.5 cm) participated in this study. The participants performed a DVJ and landed onto 2 adjacent force platforms under both ACL-KT and placebo (PT) conditions. All data were collected with 3-D motion analysis and comparison peak knee joint angles and moments, and knee joint angle at initial contact (IC) between conditions analyzed using a paired sample t-test. Statistical parametric mapping (SPM) was selected to assess difference between groups for the entire three-component knee trajectory during the contact phase. ACL-KT had a significant effect on decreasing knee abduction angle at IC (1.43±2.12 deg.) compared with the PT (-1.24±2.42 deg.) (p=0.04). A significant difference in knee abduction angle between the taping conditions was found between 100 ms before IC, at IC and 100 ms after IC (p<0.05). There were no significant differences (p>0.05) found between conditions in any of the other variables. This result confirmed that the application of ACL-KT is useful to reduce knee abduction angle at IC during a DVJ in healthy participants. Therefore, ACL-KT may be an acceptable intervention to reduce ACL injury risk. Retrospective registered on 25 September 2018. Trial number: TCTR20180926005.


1,25-dihydroxyvitamin D3 signaling-induced decreases in IRX4 inhibits NANOG-mediated cancer stem-like properties and gefitinib resistance in NSCLC cells.
Recent studies have demonstrated that acquisition of cancer stem-like properties plays an essential role in promoting epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) resistance in non-small cell lung cancer (NSCLC); however, how to regulate cancer stem-like properties and EGFR-TKI resistance is largely unclear. In this study, we discovered that increased iroquois-class homeodomain protein 4 (IRX4) was related to gefitinib resistance in NSCLC cells. Knockdown of IRX4 inhibited cell proliferation, sphere formation, and the expression of CD133, ALDH1A1, NANOG, Sox2 and Notch1, and the transcriptional activity of NANOG promoter. IRX4 overexpression increased the protein level of NANOG and CD133 in PC-9 cells. Combination of knocking-down IRX4 with gefitinib increased cell apoptosis and decreased cell viability and the expression of p-EGFR and NANOG in PC-9/GR cells. IRX4 knockdown in a PC-9/GR xenograft tumor model inhibited tumor progression and the expression of NANOG and CD133 more effectively than single treatment alone. Knockdown of NANOG inhibited the expression of CD133 and restored gefitinib cytotoxicity, and NANOG overexpression-induced cancer stem-like properties and gefitinib resistance could be obviously reversed by knocking-down IRX4. Further, we found that 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) reduced obviously the expression of IRX4 and NANOG by inhibiting the activation of TGF-β1/Smad3 signaling pathway; moreover, combination of 1,25(OH)2D3 and gefitinib decreased cell viability and proliferation or tumor progression and the expression of IRX4 and NANOG compared with single treatment alone both in PC-9/GR cells and in a PC-9/GR xenograft tumor model. These results reveal that inhibition of IRX4-mediated cancer stem-like properties by regulating 1,25(OH)2D3 signaling may increase gefitinib cytotoxicity. Combination therapy of gefitinib and 1,25(OH)2D3 by targeting IRX4 and NANOG, could provide a promising strategy to improve gefitinib cytotoxicity.


Effect of amniotic fluid stem cell transplantation on the recovery of bladder dysfunction in spinal cord-injured rats.
The effects of human amniotic fluid stem cell (hAFSC) transplantation on bladder function and molecular changes in spinal cord-injured (SCI) rats were investigated. Four groups were studied: sham and SCI plus phosphate-buffered saline (SCI + PBS), human embryonic kidney 293 (HEK293) cells, and hAFSCs transplantation. In SCI + PBS rat bladders, cystometry showed increased peak voiding pressure, voiding volume, bladder capacity, residual volume, and number of non-voiding contractions, and the total elastin/collagen amount was increased but collagen concentration was decreased at days 7 and 28. Immunoreactivity and mRNA levels of IGF-1, TGF-β1, and β3-adrenoceptor were increased at days 7 and/or 28. M2 immunoreactivity and M3 mRNA levels of muscarinic receptor were increased at day 7. M2 immunoreactivity was increased, but M2/M3 mRNA and M3 immunoreactivity levels were decreased at day 28. Brain derived-neurotrophic factor mRNA was increased, but immunoreactivity was decreased at day 7. HEK293 cell transplantation caused no difference compared to SCI + PBS group. hAFSCs co-localized with neural cell markers and expressed BDNF, TGF-β1, GFAP, and IL-6. The present results showed that SCI bladders released IGF-1 and TGF-β1 to stimulate elastin and collagen for bladder wall remodelling, and hAFSC transplantation improved these changes, which involved the mechanisms of BDNF, muscarinic receptors, and β3-adrenoceptor expression.


Dietary intake and nutritional indicators are transiently compromised during radiotherapy for rectal cancer.
Patients with rectal cancer receive curative radiotherapy towards the pelvis for 5 weeks. Little is known about the impact of radiotherapy on dietary intake and nutritional status. The objective was to examine whether curative radiotherapy for rectal cancer promoted altered intake of energy and nutrients, and change in nutritional indicators. Prospective study. Department of Oncology in a tertiary care hospital. A total of 31 consecutive patients receiving radiotherapy for rectal cancer (50 Gray). A 7-day food intake registration, body weight, upper arm circumference, and analyses of blood samples were performed at the start and the end of radiotherapy, and at follow-up 4-6 weeks and 1 year after the end of radiotherapy. At the end of 5 weeks of radiotherapy, the mean daily energy intake was reduced by 15% from 8.9 to 7.6 MJ as compared with baseline (P = 0.002), and the intake of several nutrients was reduced (P < 0.01). The percentages of energy derived from fat, protein, and carbohydrates did not change, nor did the nutrient density. A transient body weight reduction of < 1 kg was observed (P = 0.009). Serum concentrations of vitamin A and 25-OH vitamin D did not change during radiotherapy. The daily intake of energy and nutrients, and body weight, had increased towards pretreatment values 4-6 weeks after radiotherapy. Radiotherapy for rectal cancer caused a transient reduction in energy intake and nutritional indicators. The nutritional quality of the diet was unchanged during radiotherapy.


Impact of financial decentralization on energy poverty and energy demand tendencies in Chinese settings.
This study intends to test the connection between fiscal decentralization, energy demand dynamics, and energy poverty status from the context of China. The study has collected large datasets ranging from 2001 to 2019 to justify the empirical findings. The long-run analysis economic techniques were considered and applied for this. The results indicated that a 1% adverse change in energy demand dynamics causes 13% of energy poverty. Supportively, a 1% positive rise in energy supply to fulfill energy demand reduces energy poverty by 9.4% in the study context. Moreover, empirical findings show that a 7% rise in fiscal decentralization accelerates 19% fulfillment in energy demand and mitigates energy poverty up to 10.5%. We demonstrate that if enterprises can only alter their technology choices in the long run, the short-run reaction of energy demand must be less than the long-run response. Second, we demonstrate that the elasticity of demand approaches its long-run level exponentially at the rate defined by the capital depreciation rate and the economy's growth rate, using a putty-clay model with induced technical development. According to the model, it takes more than 8 years for half of the long-run impact of induced technological change on energy consumption to be realized in industrialized nations once the carbon price is implemented. This research document also gives multiple policy directions for policy developers.


Inhibitory effects of Pfaffia paniculata (Brazilian ginseng) on preneoplastic and neoplastic lesions in a mouse hepatocarcinogenesis model.
Studies have been demonstrating Pfaffia paniculata root (Brazilian ginseng) anticarcinogenic activities. We evaluated its chemopreventive effects on preneoplastic hepatic lesions. BALB/c aged-15 days received 10mug/g of diethylnitrosamine carcinogen, i.p. They were fed with the powdered root added to the diet: 0.5, 2 or 10% during 27 weeks. After being sacrificed, the macroscopic lesions in the livers were examined. Preneoplastic or neoplastic lesions were measured, quantified and classified morphologically. The treatment reduced the incidence, mean area and number of lesions, indicating an inhibitory effect of these roots on hepatocarcinogenesis promotion or progression steps.


Solid state NMR service across the world.
In 2013 the EPSRC published a report on the NMR equipment base serving the physical and life sciences community in the UK. Whilst this included both solution and solid state NMR, the report omitted equipment from industry or outside of the UK. This report originated as a means of benchmarking industrial solid state NMR facilities around the world. A survey of 24 SSNMR laboratories was conducted in the first half of 2019, primarily by face-to-face interviews or via telephone. Aggregated statistics relating to service throughput, equipment, and staff are presented, along with discussions about barriers to accessing SSNMR. We found that the hardware profile seen in the earlier UK-only report was representative of the worldwide view, and that the main barrier to access was a lack of knowledge about what SSNMR can do. Publishing this survey provides a strong benchmark for SSNMR laboratories, which will hopefully allow them to identify barriers that might be preventing them from performing to their optimal level in solving materials science problems.


Synaptic junctions in the sinus gland of the freshwater prawn Palaemon paucidens.
Two types of neurosecretory fibers, designated as Type 5 and Type 6 axons, in the sinus gland of the freshwater prawn, Palaemon, establish contact with other neurosecretory axons by means of synaptic junctions. This finding strongly supports the view that release of some neurohormones from the eyestalk may be regulated by neurosecretory neurons through synaptic transmission.


Rapid tubulin synthesis during ciliated cell differentiation.
Using pulse-chase conditions in culture we have investigated the incorporation of 3H-leucine into tubulin of isolated oviducts from 5 day-old mice. Label appears in soluble, particulate and axonemal fractions minutes after incubation. In the latter two fractions, but not in the soluble fraction, this label is rapidly diluted under chase conditions. The data do not fit a simple model of sequential transfer of radioactively labeled, newly synthesized tubulin from a soluble fraction through centriole precursors to assembled ciliary axonemes.


Monitoring and treating life-threatening ventricular dysrhythmias.
Dealing with cardiac emergencies resulting from the development of life-threatening dysrhythmias always presents some degree of stress to the practitioner, regardless of the amount of experience and exposure to cardiac arrests. Dealing effectively with these emergencies is threefold. First is prevention of the event. The astute practitioner utilizes knowledge of precipitating factors, data collection, assessment, and intervention to prevent a patient's condition from advancing to an emergency situation. Second, one must be prepared to deal with the emergency, by having a plan of action and knowing what to expect. Finally, one must deal with the emergency as effectively as possible, and then evaluate what has occurred, how the emergency was handled, and what actions would have improved the experience.


Failure to thrive.
Failure to thrive is poor physical growth that results when the nutritional demands of young children are not fulfilled. This diagnosis is made when, on serial growth monitoring, the child's anthropometric parameters such as weight for age and/or height are found to be significantly below the expected values. A detailed evaluation by the treating physician, taking into account physical and psychosocial factors affecting the child's health is essential for understanding the factors contributing to failure to thrive. The treatment of this entity requires a multidisciplinary approach, correcting the macro and micronutrient deficiency in the child as well as education of parents regarding age-appropriate feeding recommendation for children. In addition, parents need to be apprised of the possible implications of malnutrition on growth and neurodevelopment of the child. Early childhood being a crucial period for growth and development, an early diagnosis and treatment will result in better outcomes in children with failure to thrive.


Are young adults following the dietary guidelines for Americans?
An analysis of lifestyle choices of Midwestern young adults suggests that this sector does not heed evidence-based guidelines for reducing risk of chronic diseases, which are the most common, costly, and preventable of all health problems. Nurse practitioners who consistently promote the guidelines may improve long-term health in this subpopulation.


[Effect on cellular and tissue metabolism of induced electrical currents].
The authors give a review of literature about the effects of c.e.i. on the metabolism of the cell and tissue. Particularly are studied the mechanism of action of c.e.i. on the bone metabolism, especially the precipitation of hydroxyapatite and the effects on the vascular system.


Stereotactic body radiotherapy in combination with non-frontline PD-1 inhibitors and targeted agents in metastatic renal cell carcinoma.
Radiotherapy may work synergistically with immunotherapy and targeted agents. We aimed to assess the safety and outcomes of stereotactic body radiotherapy (SBRT) plus non-first-line programmed death-1 (PD-1) inhibitors and targeted agents (TA) in metastatic renal cell carcinoma (mRCC). We retrospectively reviewed 74 patients treated with non-first-line PD-1 inhibitors plus TA in non-first-line setting. Survival outcomes were calculated from the anti-PD-1 treatment using the Kaplan-Meier method. Univariate and multivariate analyses were performed by Cox proportional hazards models. Thirty-two (43.2%) patients received anti-PD-1/TA therapy alone (anti-PD-1/TA alone group), and 42 (56.8%) received SBRT in addition (anti-PD-1/TA + SBRT group). The median duration of first-line therapy was 8.6 months. Patients in the anti-PD-1/TA + SBRT group had significantly longer overall survival (OS) (38.5 vs 15.4 months; P = 0.022). On multivariate analysis, oligometastasis, ECOG performance status 0-1, anti-PD-1/TA + SBRT, and duration of first-line therapy ≥ 8.6 months were predictors for OS. The addition of SBRT was associated with improved OS in patients with clear-cell type (HR 0.19; 95% CI 0.07-0.55; P = 0.002) and duration of first-line therapy ≥ 8.6 months (HR 0.22; 95% CI 0.06-0.88; P = 0.032). Grade ≥ 3 toxicities occurred in 23 patients (54.8%) in the anti-PD-1/TA + SBRT group, and in 21 patients (65.6%) in the anti-PD-1/TA alone group. Incorporating SBRT into anti-PD-1/TA therapy is safe and tolerable. Further investigation is needed, particularly in patients with clear-cell histology and a longer duration of response to first-line antiangiogenic therapy.


Behavioural responses of Intensivists to stressors in Intensive Care.
The hospital intensive care unit (ICU) environment encompasses sick patients who present for care in health crisis. Healthcare in this setting is complex, often involving the co-ordination of multiple professional teams, all under significant time pressures. The sequelae for staff interacting in this dynamic and often volatile setting are variable, depending upon their coping skillset and their familiarity with the stressors. The primary aim of this study was to describe and in doing so, normalize the behavioural responses expressed by ICU doctors (Intensivists) in response to stressful workplace events. The secondary aim was to identify those responses that contributed to resilience. A prospective qualitative study of senior Intensivists using a semi-scripted iterative interview. Data were transcribed and thematically analysed with verbatim quotations selected to support coding choices. Nineteen experienced Intensivists from three sites in Australia and Israel participated. Clinicians described conscious, physiological and professional responses to stressors, including sense-making and taking time to process information with appropriate support. Two of the most important mitigation processes revealed were the use of reflective learning and preventative practice changes to prevent future errors. These were overlaid with the importance of disclosure and transparency in clinical work. Repeated exposure to stressful events potentiates burnout, wherein staff no longer experience satisfaction and enjoyment in what they do. This paper presents the behavioural responses that experienced Intensivists described in relation to stressful events in the ICU, including steps taken to mitigate the effects of these events on their personal well-being.


Quadriceps paresis in pediatric groin surgery.
A total of 2,624 groin operations were performed in 2,202 infants and children aged 6 months-14 years during the last 4.5 years. Preventive analgesia was used in all operations, and included ilioinguinal and iliohypogastric nerve block combined with inguinal canal infiltration. In 6 patients transient postoperative quadriceps muscle paresis (QMP) was noted. They required bed rest and monitoring for a few hours, and complete spontaneous recovery was noted in all cases. The aim of this study was to examine the incidence of transient QMP following regional nerve block and to discuss models of possible prevention.