[Nifedipine in hypertrophic obstructive cardiomyopathy].
The effects of nifedipine on left-ventricular dynamics were assessed in 6 patients with hypertrophic obstructive cardiomyopathy (HOCM). After intravenous infusion of 3 mg nifedipine the mean aortic pressure decreased from 100 +/- 14 to 85 +/- 8 mm Hg (P less than 0.001). Heart rate increased from 70 +/- 5 to 93 +/- 5 beats per minute (P less than 0.001). This led to an increase of cardiac index from 3.0 +/- 0.5 to 3.8 +/- 0.9 l/min . m2 (P less than 0.01), whereas the stroke volume index decreased from an average of 49 +/- 11 to 42 +/- 12 ml/m2 (P less than 0.05). A marked diminution of outflow obstruction was demonstrable in 3 patients with intraventricular pressure gradients. The left-ventricular enddiastolic pressure rose from 14 +/- 3 to 18 +/- 6 mm Hg (P less than 0.02) in all patients. This effect was accompanied by a clear-cut coronary dilatation, evidenced by an increase of oxygen saturation in the coronary sinus from 29 +/- 4 to 54 +/- 9% (P less than 0.001). Thus nifedipine leads to diminished outflow obstruction and concomitant increase of cardiac output in hypertrophic cardiomyopathy. Inhibition of contraction does not seem to be compensated by peripheral effects. Coronary dilatation demonstrable in HOCM patients permits protection against coronary spasms and thus an additional antianginous effects.


Treatment of Acute Abnormal Uterine Bleeding in Adolescents: What Are Providers Doing in Various Specialties?
The purpose of this study was to assess whether variability exists in the management of acute abnormal uterine bleeding (AUB) in adolescents between pediatric Emergency Department (ED) physicians, pediatric gynecologists, and adolescent medicine specialists. Retrospective chart review. Tertiary care medical center ED. We included girls aged 9-22 years who presented from July 2008 to June 2014 with the complaint of acute AUB. Patients were identified using the International Classification of Diseases, ninth revision codes for heavy menstrual bleeding, AUB, and irregular menses. Exclusion criteria included pregnancy and current use of hormonal therapy. One hundred fifty patients were included. Among those evaluated, 61% (n = 92) were prescribed hormonal medication to stop their bleeding by providers from the ED, Adolescent Medicine, or Pediatric Gynecology. ED physicians prescribed mostly single-dose and multidose taper combined oral contraceptive pills (85%; n = 24), compared with Adolescent Medicine (54%, n = 7), and Gynecology (28%, n = 13). Pediatric gynecologists were more likely than ED physicians to treat patients with norethindrone acetate, either alone or in combination with a single dose combined oral contraceptive pill (61%, n = 33 vs 7%, n = 2; P < .001). Variations in treatment strategies for adolescents who present with acute AUB exist among pediatric specialties, which reflects a lack of standardized care for adolescents. Prospective evaluation of the shortest interval to cessation of bleeding, side effects, and patient satisfaction are valuable next steps.


5-Fluorouracil for trabeculectomy in glaucoma.
The effect of 5-fluorouracil (5-FU) subconjunctival injection on the bleb formation and intraocular pressure (IOP) following trabeculectomy was studied in 18 glaucoma patients (20 eyes) with poor surgical prognosis. The results were analyzed by means of life tables and compared with those of 24 glaucoma eyes that had undergone trabeculectomy without postoperative administration of 5-FU after a previous repeat trabeculectomy that had failed. The surgical techniques and postoperative care were virtually identical between the eyes treated with 5-FU and eyes that had undergone repeat trabeculectomy, except that the latter group did not receive 5-FU postoperatively. At the end of 18-month follow-up, the success probability was 68.2% in the 5-FU treated eyes, and it was already as low as 10% in the nontreated eyes at the end of the 14-month follow-up. The difference was statistically highly significant (P less than 0.001). Postoperative, subconjunctival injection of 5-FU appears to improve the prognosis following trabeculectomy in patients with a poor surgical prognosis.


Use of uterine balloon tamponade for control of postpartum hemorrhage by community-based health providers in South Sudan.
To determine whether use of uterine balloon tamponade (UBT) for management of uncontrolled postpartum hemorrhage (PPH) by community-based providers in a resource-limited setting could be feasible, effective, and safe. In rural South Sudan, community providers were trained and equipped with a simple UBT device consisting of a catheter, condom, and syringe. Snowball sampling identified cases of UBT use since training. Semi-structured interviews were conducted among community providers, referral facility providers, patients, and patient family members. Interview transcripts were analyzed using qualitative methods. Thirteen cases were identified and 24 interviews related to community-based UBT use were conducted. Qualitative analysis revealed several major themes. Community providers applied UBT in appropriate clinical situations. UBT was effective for controlling PPH, even among severely ill patients. Referral was difficult and lengthy owing to the austere setting, but simple UBT appeared to mitigate these challenges. Communities had some initial fears, yet ultimately embraced UBT. Equipment and supplies were largely maintained. There was universal satisfaction with UBT among patients, family members, and providers. One death occurred among the 13 cases, although it was probably not attributable to PPH. Training and UBT device provision are simple, affordable, and effective for managing uncontrolled PPH in a resource-limited setting.


Discovery of benzothiazine derivatives as novel, orally-active anti-epileptic drug candidates with broad anticonvulsant effect.
In order to develop novel anti-epileptic drugs that are effective for both general and partial seizure, we conducted in vivo screening of our chemical library in the mice MES and sc-PTZ models and found the benzothiazine 1 as lead compound. Optimization of this compound led to the discovery of compound 7b, which showed potent anticonvulsant effect in the MES, scPTZ and rat amygdala kindling models. Since the chemical structure of 7b is different from that of any existing AED, it is suggested that 7b may have unique mechanism of action for relieving both partial and generalized epilepsy.


Screening for pre-eclampsia by using maternal serum inhibin A, activin A, human chorionic gonadotropin, unconjugated estriol, and alpha-fetoprotein levels and uterine artery Doppler in the second trimester of pregnancy.
To analyse the predictive power of maternal serum inhibin A, activin A, human chorionic gonadotropin (hCG), unconjugated estriol (uE(3)), alpha-fetoprotein (AFP) levels and uterine artery Doppler in the second trimester of pregnancy in screening for pre-eclampsia. Maternal serum inhibin A, activin A, hCG, uE(3), and AFP levels and uterine artery Doppler were determined in 178 healthy, pregnant women in the second trimester of pregnancy. Serum samples were collected between the 16th and 18th weeks of gestation, and Doppler investigation was performed between the 24th and 26th weeks of gestation. Receiver operating characteristic curves were created to analyse the predictive powers of the above parameters in screening for pre-eclampsia. Different combinations also were analysed. The rate of pre-eclampsia was 7.9% (14/178). Maternal serum inhibin A, activin A, hCG, AFP levels, the rate of presence of the prediastolic notch and uterine artery resistance index (RI) values in pre-eclamptic pregnancies were significantly higher than those in healthy pregnancies. Presence of the prediastolic notch, uterine artery RI, maternal serum activin A and inhibin A levels had high predictive efficacy, and each had a sensitivity between 70 and 93% and a specificity between 87% and 98%. The addition of inhibin A or activin A measurement to the Doppler velocimetry improved the specificity to 99-100%. Maternal serum inhibin A and activin A levels and uterine artery Doppler appear to be useful screening tests during the second trimester for pre-eclampsia. However, addition of these hormonal markers to Doppler velocimetry only slightly improves the predictive efficacy, which appears clinically insignificant.


Reduced DIDS-sensitive chloride conductance in Ae1-/- mouse erythrocytes.
The resting membrane potential of the human erythrocyte is largely determined by a constitutive Cl(-) conductance approximately 100-fold greater than the resting cation conductance. The 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS)-sensitive electroneutral Cl(-) transport mediated by the human erythroid Cl(-)/HCO(3)(-) exchanger, AE1 (SLC4A1, band 3) is >10,000-fold greater than can be accounted for by the Cl(-) conductance of the red cell. The molecular identities of conductive anion pathways across the red cell membrane remain poorly defined. We have examined red cell Cl(-) conductance in the Ae1(-/-) mouse as a genetic test of the hypothesis that Ae1 mediates DIDS-sensitive Cl(-) conductance in mouse red cells. We report here that wildtype mouse red cell membrane potential resembles that of human red cells in the predominance of its Cl(-) conductance. We show with four technical approaches that the DIDS-sensitive component of erythroid Cl(-) conductance is reduced or absent from Ae1(-/-) red cells. These results are consistent with the hypothesis that the Ae1 anion exchanger polypeptide can operate infrequently in a conductive mode. However, the fragile red cell membrane of the Ae1(-/-) mouse red cell exhibits reduced abundance or loss of multiple polypeptides. Thus, loss of one or more distinct, DIDS-sensitive anion channel polypeptide(s) from the Ae1(-/-) red cell membrane cannot be ruled out as an explanation for the reduced DIDS-sensitive anion conductance.


A simple and general strategy for the design of fluorescent cation sensor beads.
[Structure: see text] Chenodeoxycholic acid based PET sensors for alkali metal ions have been immobilized on Merrifield resin and on Tentagel. The fluorescence of the sensor beads is enhanced upon binding the cations. The modular nature of the sensor allows designing different sensors based on this concept.


Losing TREC with age.
In this issue of Immunity, den Braber et al. (2012) highlight differences in naive T cell lifespan between mice and humans. Their data suggest that mechanisms of naive T cell maintenance may differ between mice and men.


Expression of the cystic fibrosis transmembrane conductance regulator from a novel adeno-associated virus promoter.
Adeno-associated virus type 2 (AAV) vectors have been used for gene expression in respiratory epithelial cells and may be useful in gene therapy for diseases like cystic fibrosis (CF) which affect the airways. The AAV p5 promoter together with the AAV inverted terminal repeat (ITR) forms a 263-base pair cassette which mediated efficient expression in a CF bronchial epithelial cell line. We report here that the ITR itself can mediate gene expression. In stable transfection assays, AAV-CF vectors expressing the full-length cystic fibrosis transmembrane conductance regulator (CFTR) cDNA from either the p5 promoter or the ITR restored cAMP regulation of the chloride efflux characteristic of CFTR function. An AAV-ITR-CF vector deleted for the amino terminus of CFTR was also functional. This vector was packaged into AAV particles and used to transduce cells without selection. Transduced cells also exhibited cAMP-regulated Cl- efflux. The complemented cell lines showed increased levels of CFTR protein immunofluorescence, and the presence of intact AAV-CF vector sequence was confirmed by Southern blot analysis of rescued vector sequences. These studies provide novel insights into AAV gene expression, and this newly described promoter allows for the production of AAV vectors expressing CFTR in those differentiated cells affected in CF.


Fibrinolysis by urokinase endowed with magnetic property.
The activated magnetic modifier was synthesized from magnetite, alpha, omega-dicarboxymethylpoly(oxyethylene) and N-hydroxysuccinimide (Biochem. Biophys. Res. Commun., 145, 908-914, 1987). Urokinase was directly coupled with the activated magnetic modifier to obtain magnetic urokinase. The magnetic urokinase dispersed in saline and exerted high fibrinolytic activity (13.8 X 10(4) IU/mg protein), and was readily recovered from saline by magnetic force of 250 Oe. By applying magnetic force, the urokinase was attracted at our will and local fibrinolysis was achieved on fibrin gel in a petri dish.


Differences in clinical characteristics and liver injury between patients diagnosed with the Omicron subvariant BA.5.2 and the prototype of SARS-CoV-2: a single center retrospective study.
The purpose of this study was to investigate the differences between the clinical characteristics and the factors influencing liver injury in patients with the Omicron subvariant BA.5.2 (Omicron BA.5.2) and the prototype of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Between December 30, 2019 and November 30, 2022, 157 patients infected with the SARS-CoV-2 prototype and 199 patients infected with the Omicron BA.5.2 were included in this case-control, single-center, retrospective study. Differences in clinical characteristics and liver injury between the Omicron BA.5.2 patients and the prototype patients were subsequently analyzed. None of the Omicron BA.5.2 patients reached the critical state, and showed relatively milder symptoms including fever, cough, headache, muscle soreness, nausea or vomiting, diarrhea, anorexia and hypoxia. The Omicron BA.5.2 had a lower effect on body temperature (T), white blood cell (WBC) count, hematocrit (HCT), C-reactive protein (CRP) level, D-dimer, finger pulse oxygen saturation (SpO2) and lung lesions. The differences in liver injury between the two groups were related to the severity of the disease, T, blood oxygen levels, albumin (ALB), CRP, and medication usage. Gender, body mass index, and CRP levels influenced liver damage in the Omicron BA.5.2 patients. In particular, CRP was an independent risk factor for liver injury. Because the severity of liver function damage was considerably low, only a small number of Omicron BA.5.2 patients required liver-protective treatment. Liver injury is expected in the COVID-19 patients. The Omicron BA.5.2 patients showed milder symptoms of liver injury than the prototype patients. However, dynamic monitoring of liver function is warranted, especially for individuals presenting with elevated levels of CRP.


Haldane's rule in the placenta: Sex-biased misregulation of the Kcnq1 imprinting cluster in hybrid mice.
Hybrid phenotypes that contribute to postzygotic reproductive isolation often exhibit pronounced asymmetry, both between reciprocal crosses and between the sexes in accordance with Haldane's rule. Inviability in mammalian hybrids is associated with parent-of-origin placental growth abnormalities for which misregulation of imprinted gene (IGs) is the leading candidate mechanism. However, direct evidence for the involvement of IGs in hybrid growth dysplasia is limited. We used transcriptome and reduced representation bisulfite sequencing to conduct the first genome-scale assessment of the contribution of IGs to parent-of-origin placental growth dysplasia in the cross between the house mouse (Mus musculus domesticus) and the Algerian mouse (Mus spretus). IGs with transgressive expression and methylation were concentrated in the Kcnq1 cluster, which contains causal genes for prenatal growth abnormalities in mice and humans. Hypermethylation of the cluster's imprinting control region, and consequent misexpression of the genes Phlda2 and Ascl2, is a strong candidate mechanism for transgressive placental undergrowth. Transgressive placental and gene regulatory phenotypes, including expression and methylation in the Kcnq1 cluster, were more extreme in hybrid males. Although consistent with Haldane's rule, male-biased defects are unexpected in rodent placenta because the X-chromosome is effectively hemizygous in both sexes. In search of an explanation, we found evidence of leaky imprinted (paternal) X-chromosome inactivation in hybrid female placenta, an epigenetic disturbance that may buffer females from the effects of X-linked incompatibilities to which males are fully exposed. Sex differences in chromatin structure on the X and sex-biased maternal effects are nonmutually exclusive alternative explanations for adherence to Haldane's rule in hybrid placenta. The results of this study contribute to understanding the genetic basis of hybrid inviability in mammals, and the role of IGs in speciation.


Legionella pneumophila serogroup 4 isolated from joint tissue.
We report the isolation of Legionella pneumophila serogroup 4 from synovial tissue obtained from an 80-year-old female with chronic swelling of her right metacarpophalangeal joint. Synovial tissue infections caused by L. pneumophila are rare. Interestingly, this isolate was recovered from chocolate agar after 5 days of incubation.


Bacterial quorum sensing: a new target for anti-infective immunotherapy.
Cell-to-cell communication via exchange of small molecules, 'autoinducers', is a widespread phenomenon among Gram-negative and -positive bacteria. This intercellular signaling that synchronizes population-wide gene expression in a cell-density-dependent manner is termed 'quorum sensing' (QS). The discovery that Gram-negative bacteria employ non-peptide structures, N-acyl homoserine lactones, to globally regulate production of secondary metabolites and proteins, initiated a new area of research. Subsequently, other quorum-sensing systems and small signaling molecules were identified. With the emergence of antibiotic-resistant bacteria, most prominently methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa, new approaches for combating infections are needed. Inhibition of QS results in attenuation of virulence rather than direct killing of microbes. We highlight current trends in preventing bacterial infections using quorum-quenching strategies. We mainly focus on P. aeruginosa and S. aureus and their QS systems as targets for intervention. New research strongly suggests that QS systems represent attractive targets for discovery of novel anti-infective agents, including immunotherapeutic strategies.


C4 phenotypic variation suggests an unusual class III gene organization.
The class III gene markers, C4A, C4B, C2 and BF were determined in 26 HLA genotyped families. In 6 of these families the inheritance of the C4A electrophoretic phenotype, C4A 3, A 2 could not be explained assuming the genetic model that the C4A component is controlled by only one locus (C4A) and suggests that both C4A 3 and C4A 2 are encoded by the same chromosome. This apparently duplicated C4A locus haplotype is common in Northern Europeans occurring at a frequency of at least 6%. In 4 families the C4A 3, A 2 'variant' occurred together with HLA-Bw35 and in 2 together with HLA-Bw55. Furthermore, it was striking that in each family the C4A 3, A 2 'variant' was found exclusively with the complotype FC3/20 which encodes no phenotypically expressed C4B locus product.


Daily soluble aspirin and prevention of colorectal adenoma recurrence: one-year results of the APACC trial.
Epidemiologic and experimental studies have suggested that aspirin intake reduces the risk for colorectal carcinogenesis. However, the available data are not sufficient to serve as the basis for firm recommendations. We randomly assigned 272 patients with a history of colorectal adenomas (at least one more than 5 mm in diameter, or more than 3) to daily lysine acetylsalicylate (160 or 300 mg/day) or placebo for 4 years. The primary end points were adenoma recurrence after 1 and 4 years. These results are those of the year 1 colonoscopy. Among the 238 patients who completed the year 1 colonoscopy, at least one adenoma was observed in 38 patients of the 126 (30%) in the aspirin group and in 46 of the 112 (41%) in the placebo group; relative risk was 0.73 (95% confidence interval [CI]: 0.52-1.04; P = 0.08). At least one adenoma of more than 5 mm diameter was observed in 13 patients (10%) in the aspirin group and 26 (23%) in the placebo group (P = 0.01). The corresponding numbers for adenomas more than 10 mm in diameter were one (1%) and 7 (6%) (P = 0.05). Stepwise regression showed that independent factors associated with lower adenoma recurrence are aspirin treatment (adenoma >5 mm, P = 0.01), absence of personal history of adenoma before the entry colonoscopy (P = 0.01), and initial adenomatous polyp burden less than 10 mm (P = 0.001). Daily soluble aspirin is associated with a reduction in the risk for recurrent adenomas found at colonoscopy 1 year after starting treatment.


Implications for future humanitarian aid missions: Lessons from point-of injury and hospital care for Syrian refugees.
Warzone humanitarian medical aid missions are infrequent and applying lessons from these missions is vital to ensuring preparedness for future crises. Between 2013-2018, the Israel Defense Forces Medical Corps (IDF-MC) provided humanitarian medical aid to individuals injured in the Syrian Civil War who chose to seek medical assistance at the Israeli-Syrian border. Patients requiring care surgical or advanced care were transferred to civilian medical centers within Israel. This study aims to describe the injury characteristics and management of hospitalized Syrian Civil War trauma patients over a five-year period. Retrospective cohort analysis cross-referencing data from the IDF trauma registry, documenting prehospital care, and the Israel National Trauma Registry, documenting in-hospital care, between 2013 and 2018. Syrian trauma patients hospitalized in Israeli hospitals were cross-referenced between the two registries. Multivariable logistic regression was applied to identify independent factors associated with in-hospital mortality. Overall, 856 hospitalized trauma patients were included following definitive cross-matching. The median age was 23 years, and 93.3% were males. Blast (n = 532; 62.1%) and gunshot (n = 241; 28.2%) were the most common injury mechanisms. Injury Severity Score was ≥25 for 28.8% of patients and most common body regions with severe injury (Abbreviated Injury Scale≥3) were the head (30.7%) and thorax (25.0%). Intensive care unit admission was required for 40.1% of patients, and the median hospital stay was 13 days. In-hospital mortality was recorded for 73 (8.5%). Signs of shock upon emergency department admission and severe head injury were significantly associated with mortality in the adjusted model whereas age of <18 years was associated with decreased odds for in-hospital mortality. Trauma patients hospitalized in Israel following injuries sustained in the Syrian Civil War were characterized by a high prevalence of blast injuries with concomitant involvement of several body regions. Future missions should ensure preparedness for complex multi-trauma, often involving the head, and ensure high intensive care and surgical capacities.


Risk factors for transmission of carbapenem-resistant Enterobacterales to healthcare personnel gloves and gowns in the USA.
Hospitals are sources for acquisition of carbapenem-resistant Entero-bacterales (CRE), and it is believed that the contamination of healthcare personnel (HCP) hands and clothing play a major role in patient-to-patient transmission of antibiotic-resistant bacteria. The aim of this study was to determine which HCP types, HCP-patient interactions, and patient characteristics are associated with greater transmission of CRE to HCP gloves and gowns in the hospital. This was a prospective observational cohort study that enrolled patients with recent surveillance or clinical cultures positive for CRE at five hospitals in four states in the USA. HCP gloves and gown were cultured after patient care. Samples were also obtained from patients' stool, perianal area, and skin of the chest and arm to assess bacterial burden. Among 313 CRE-colonized patients and 3070 glove and gown cultures obtained after patient care, HCP gloves and gowns were found to be contaminated with CRE 7.9% and 4.3% of the time, respectively. Contamination of either gloves or gowns occurred in 10.0% of interactions. Contamination was highest (15.3%) among respiratory therapists (odds ratio: 3.79; 95% confidence interval: 1.61-8.94) and when any HCP touched the patient (1.52; 1.10-2.12). Associations were also found between CRE transmission to HCP gloves or gown and: being in the intensive care unit, having a positive clinical culture, and increasing bacterial burden on the patient. CRE transmission to HCP gloves and gown occurred frequently. These findings may inform evidence-based policies about what situations and for which patients contact precautions are most important.


[Transient dysfunction of the retinal ganglion cells after laser in situ keratomileusis].
To evaluate the influence of high intraocular pressure(IOP) on the retinal ganglion cell function induced by suction during laser in situ keratomileusis(LASIK) using Frequency Doubling Technology(FDT). Twenty-seven eyes of 15 patients were studied. Threshold values of 19 targeted areas, mean deviation(MD), and pattern standard deviation (PSD) were measured before LASIK, and 2 hours, 1 day, and 1 week after LASIK. These parameters obtained by N-30 program of FDT were compared between before and after LASIK. Significant decrease of MD and threshold value in all areas was recognized at 2 hours, but MD and threshold value in 6 of the 19 areas showed significant increase at 24 hours. Significant increase of PSD value at 2 hours was recognized. After 7 days, there were no significant differences in any parameters between before and after LASIK. These results indicated that a transient dysfunction of the magnocellular pathway might be induced by high IOP during LASIK procedure.


Leaching of cell wall components caused by acid deposition on fir needles and trees.
Virgin fir forests have been declining since the 1960s at Mt. Oyama, which is located at the eastern edge of the Tanzawa Mountains and adjacent to the Kanto plain in Japan. An acid fog frequently occurs in the mountains. We collected throughfall and stemflow under fir trees and rainfall every week during January-December 2004 at Mt. Oyama to clarify the influence of acid fog on the decline of fir (Abies firma) needles. In relation to throughfall and stemflow, D-mannose, D-galactose, and D-glucose are the major neutral sugar components; only D-glucose is a major component of rainfall. The correlation coefficient between the total neutral sugars and uronic acid (as D-galacturonic acid), which is a key component of the cross-linking between pectic polysaccharides, was high except for rainfall. The leached amount of calcium ion, neutral sugars, uronic acid, and boron is related to the nitrate ion concentration in throughfall. Results of a laboratory exposure experiment using artificial fog water simulating the average composition of fog water observed at Mt. Oyama (simulated acid fog: SAF) on the fir seedling needles also shows a large leaching of these components from the cell walls of fir needles. The leaching amount increased concomitantly with decreasing pH of the SAF solution. We also observed that a dimeric rhamnogalacturonan II-borate complex (dRG-II-B) that exists in the cell wall as pectic polysaccharide was converted to monomeric RG-II (mRG-II) by the leaching of calcium ion and boron. Results not only of field observations but also those of laboratory experiments indicate a large effect of acid depositions on fir needles.


Craniosynostosis.
Craniosynostosis is the premature fusion of one or more of the cranial sutures. About 8% of the patients have familial or syndromic forms of synostosis, and in the remainder it occurs as a spontaneous isolated defect. Familial craniosynostosis syndromes are typically transmitted as an autosomal dominant trait resulting in disruption of the fibroblast growth factor receptor pathway. Familiarity with the characteristic head shapes resulting from craniosynostosis allows bedside diagnosis and differentiation from positional plagiocephaly. Because of the risks associated with untreated craniosynostosis, surgical treatment is usually undertaken soon after diagnosis. Current surgical methods include open calvarial reconstruction, minimally invasive strip craniectomy with use of postoperative molding helmet, minimally invasive strip craniectomy with spring implantation, and cranial distraction. Early referral to a pediatric craniofacial center allows all treatment options to be explored.


Evaluation of Carotenoids Protection Against Oxidative Stress in the Animal Model Caenorhabditis elegans.
The nematode Caenorhabditis elegans is a versatile and powerful model organism for animal experimental research and, despite being an invertebrate, displays remarkably similar molecular bases and conserved cellular pathways to those of humans. Oxidative stress is an etiological factor that influences numerous diseases, degenerative processes and aging. C. elegans has revealed as an opportune and feasible organism to investigate the antioxidant effects of different bioactives or complex food matrices, and a number of protocols have been developed by using different oxidative stressors. Carotenoids are recognized as quenchers and scavengers of reactive oxygen species, and many of their related health benefits attributed in the diet are tightly linked to their antioxidant properties. In this chapter, we report a simple and rapid assay to evaluate the protection capacity of pure carotenoids or complex carotenoid extracts against oxidative stress in the model system C. elegans. The protocol describes a representative feeding experiment by adding carotenoids to the nematode growth medium and after an incubation period, the C. elegans populations fed with carotenoids are exposed to an acute oxidative stress by using H2O2 as oxidative agent. The protection against oxidative stress is evaluated as the survival rate of the nematodes fed with the carotenoid prior to receiving oxidative treatment compared with the survival rate of control nematode population. In order to confirm the carotenoid intake by the nematodes during the feeding experiment a bioassimilation experiment is also reported.


Cross-sectional survey on genetic testing utilization and perceptions in Wisconsin Amish and Mennonite communities.
Amish and Mennonite (Plain) communities have increased prevalence of many recessively inherited disorders due to founder variants that can be identified using next-generation sequencing (NGS). We assessed newborn screening (NBS) utilization, prior genetic testing, and perceptions of genetic testing among Wisconsin Plain communities to guide implementation and utilization of a population-specific NGS gene panel testing. A mailed paper survey (N = 959) of demographics, NBS utilization, prior genetic testing, and preferences for categorical genetic disorder and defined clinical context testing was developed. Overall response rate was 39% (N = 378; 183 Amish, 193 Mennonite; 2 not Amish/Mennonite). Mennonites were more likely to respond in favor of carrier screening for metabolic disorders and other surgical conditions and less likely to respond in favor of asymptomatic testing for neurologic disorders and lethal disorders compared to Amish. Reported utilization of NBS was positively associated with stated interest in genetic testing for an asymptomatic child. Reported prior genetic testing was positively associated with stated interest in carrier screening and negatively associated with testing a symptomatic child. Although Plain community members share many common outward characteristics, our survey responses suggest diversity in their views of genetic testing and support laboratory methods that can be flexible to varied needs of individuals.


Glucocorticoids in a warming world: Do they help birds to cope with high environmental temperatures?
Climate change is threatening biodiversity world-wide. One of its most prominent manifestations are rising global temperatures and higher frequencies of heat waves. High environmental temperatures may be particularly challenging for endotherms, which expend considerable parts of their energy budget and water resources on thermoregulation. Thermoregulation involves phenotypic plasticity in behavioral and physiological traits. Information on causal mechanisms that support plastic thermoregulatory strategies is key to understand how environmental information is transmitted and whether they impose trade-offs or constraints that determine how endotherms cope with climate warming. In this review, we focus on glucocorticoids, metabolic hormones that orchestrate plastic responses to various environmental stimuli including temperature. To evaluate how they may mediate behavioral and physiological responses to high environmental temperatures, we 1) briefly review the major thermoregulatory strategies in birds; 2) summarize the functions of baseline and stress-induced glucocorticoid concentrations; 3) synthesize the current knowledge of the relationship between circulating glucocorticoids and high environmental temperatures in birds; 4) generate hypotheses for how glucocorticoids may support plastic thermoregulatory responses to high environmental temperatures that occur over different time-frames (i.e., acute, short- and longer-term); and 5) discuss open questions on how glucocorticoids, and their relationship with thermoregulation, may evolve. Throughout this review we highlight that our knowledge, particularly on free-living populations, is really limited and outline promising avenues for future research. As evolutionary endocrinologists we now need to step up and identify the costs, benefits, and evolution of glucocorticoid plasticity to elucidate how they may help birds cope with a warming world.


Contradictory renal function measured with mercaptoacetyltriglycine diuretic renography in unilateral hydronephrosis.
We studied apparently supranormal renal function in hydronephrotic kidneys, as measured by 99mtechnetium mercaptoacetyltriglycine renography. We retrospectively reviewed the clinical history, ultrasonography and renography of 29 children. Of the 29 children 7 had greater than 50% relative function in the hydronephrotic kidney. This finding was independent of patient age, gender, degree of hydronephrosis or obstructive pattern. Of these 7 cases 6 occurred on the right side (p < 0.05 versus a large registry). In most cases supranormal renal function is caused by a technical problem, likely the inadequate background subtraction of mercaptoacetyltriglycine in the liver.


111In-phenolphthalexon, a new chelate for extended cholescintigraphy: formulation and preclinical characterization.
The first 111In chelate exhibiting hepatobiliary excretion, a 111In-phenolphthalexon, has been formulated and tested in rats. The preparation of the chelate is simple, reflecting its inherently high stability. Its capability for extended cholescintigraphy allowed distinct visualization of the gallbladder and the bowel to the level of the rectosigmoid in dogs. No lethality or acute toxicity was induced by administration of the chelate.


Ultrasound-Guided Quadratus Lumborum Block at the Lateral Supra-Arcuate Ligament versus Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia Following Open Hepatectomy: A Randomized Controlled Trial.
Many studies confirmed that several approaches of quadratus lumborum block (QLB) were superior to transversus abdominis plane block (TAPB) in reducing opioid consumption during postoperative period. As a new QLB approach at the lateral supra-arcuate ligament (QLB-LSAL), the analgesic efficacy and safety in patients undergoing open hepatectomy are still unknown. This study aims to compare postoperative analgesia between the blocks in open hepatectomy. Sixty-two patients undergoing open hepatectomy were enrolled and randomly allocated into the QLB-LSAL group (group Q) and the subcostal TAPB group (group T). Preoperatively, patients received ultrasound-guided bilateral QLB-LSAL or subcostal TAPB with injection of 0.5% ropivacaine (a total volume of 40 mL). The primary outcome was cumulative total morphine equivalent consumption in the first postoperative 24 h. Other outcomes included numerical rating scale (NRS) scores at rest and coughing, cumulative total morphine equivalent consumption at 2, 6, 12, 48 h, Quality of Recovery-15 (QoR-15) scores, time to first patient-controlled intravenous analgesia (PCIA) request, time to first ambulation and adverse effects. The cumulative total morphine equivalent consumption in group Q was decreased significantly at all postoperative time points (P < 0.01). The postoperative NRS scores at rest and coughing in group Q were lower than those in group T at all postoperative time points except 48 h (P < 0.05). A significant increase was also observed in the QoR-15 scores among patients in group Q. Time to first PCIA request was significantly prolonged in group Q than in group T, and time to first ambulation was shortened. Adverse effects showed no statistical significance between the two groups. Compared with subcostal TAPB, preoperative bilateral QLB-LSAL provided superior analgesic properties and promoted early postoperative recovery quality in patients undergoing open hepatectomy. China Clinical Trials Registration Center (http://www.chictr.org.cn) ChiCTR2200063291, 3/9/2022.


Analysis of several BRCA1 and BRCA2 mutations in a hospital-based series of unselected breast cancer cases.
The distribution of BRCA mutations varies significantly between populations. The spectrum of BRCA1 and BRCA2 mutations in breast cancers in the Romanian population is incompletely known. The aim of the present study is to investigate the presence of nine BRCA mutations in patients with breast cancer identified in a surgical clinic from Bucharest. Unrelated women diagnosed with breast cancer from Coltea Hospital (n=114) and healthy controls (n = 150) were selected for this study. Seven mutations in BRCA1 (185delAG, 5382insC, 943ins10, E1250X, 1294del40, E1373X, R1443X) and two in BRCA2 (IVS16-2A4G and 6174delT) were tested using PCR based protocols. In addition, the presence of BRCA1 185delAG, BRCA1 5382insC, BRCA2 6174delT mutations were tested with a post amplification mutation detection system, based on the ELISA method. Two patients with sporadic breast cancer (2%) and one patient with family history of the disease (7.14%) have the BRCA1 5382insC mutation. No other mutation was detected in patient and control groups. The mutations were not present in the control lot. Our results indicate that BRCA1 5382insC is a common mutation in Romanian women with breast cancer (3 114).


The last 48 hours of life: a case study of symptom control for a patient taking a Buddhist approach to dying.
Caring for a patient dying of cancer can, at times, be extremely difficult. Sarah was 39 years old when she died, survived by her husband and two children aged 6 and 4 years. During the weeks leading up to her death, Sarah held extensive discussions with family and the multidisciplinary team. Her goal was to live the remainder of her last few hours as comfortable as possible and to die a "peaceful death". Terminal care is an important phase of life, one in which individuals have the right to expect quality of care to ensure that their death occurs with dignity. Sarah practised Buddhism on a daily basis. Issues of spirituality, serenity and peacefulness in dying were very important to her to ensure a good rebirth.


Declining brachytherapy utilization for high-risk prostate cancer-Can clinical pathways reverse the trend?
Although external beam radiation therapy (EBRT) plus a brachytherapy boost (BB) offers a 20% improvement in biochemical progression-free survival compared with dose-escalated EBRT alone for men with intermediate and high-risk prostate cancer, population studies show a concerning decline in BB utilization. We modified our clinical pathway (CP) in January 2016 to indicate EBRT with BB as first-choice modality for high-risk prostate cancer, based on preliminary findings of Androgen Suppression Combined with Elective Nodal and Dose-Escalated Radiation Therapy. A retrospective review was performed on 659 patients with high-risk prostate cancer treated with definitive intent EBRT ± BB within a network of 19 sites between December 2011 and July 2017. χ2 test was used to determine changes in practice pattern before vs. after CP modification. Before CP modification, 25.2% of patients were planned for BB, compared with 45.4% afterward (p < 0.001). Among 23 nonbrachytherapist physicians, utilization of BB increased from 3.4% to 14.8% (p < 0.001) after CP modification. Among nine brachytherapists, utilization increased from 46.4% to 55.6% (p = 0.120). Among patients treated by a nonbrachytherapist who did not receive BB, the reason was physician preference in 59.7%, patient preference in 19.9%, and other in 20.4%. Based on recent evidence suggesting improved biochemical progression-free survival with use of BB for high-risk prostate cancer, we modified our CP, after which we observed increased use of a BB across a network, especially among physicians who do not perform brachytherapy. However, physician preference remains the most significant factor in the nonutilization of BB. New mechanisms are needed to overcome this barrier.


Aryl hydrocarbon receptor (AhR) reveals evidence of antagonistic pleiotropy in the regulation of the aging process.
The antagonistic pleiotropy hypothesis is a well-known evolutionary theory to explain the aging process. It proposes that while a particular gene may possess beneficial effects during development, it can exert deleterious properties in the aging process. The aryl hydrocarbon receptor (AhR) has a significant role during embryogenesis, but later in life, it promotes several age-related degenerative processes. For instance, AhR factor (i) controls the pluripotency of stem cells and the stemness of cancer stem cells, (ii) it enhances the differentiation of embryonal stem cells, especially AhR signaling modulates the differentiation of hematopoietic stem cells and progenitor cells, (iii) it also stimulates the differentiation of immunosuppressive Tregs, Bregs, and M2 macrophages, and finally, (iv) AhR signaling participates in the differentiation of many peripheral tissues. On the other hand, AhR signaling is involved in many processes promoting cellular senescence and pathological processes, e.g., osteoporosis, vascular dysfunction, and the age-related remodeling of the immune system. Moreover, it inhibits autophagy and aggravates extracellular matrix degeneration. AhR signaling also stimulates oxidative stress, promotes excessive sphingolipid synthesis, and disturbs energy metabolism by catabolizing NAD+ degradation. The antagonistic pleiotropy of AhR signaling is based on the complex and diverse connections with major signaling pathways in a context-dependent manner. The major regulatory steps include, (i) a specific ligand-dependent activation, (ii) modulation of both genetic and non-genetic responses, (iii) a competition and crosstalk with several transcription factors, such as ARNT, HIF-1α, E2F1, and NF-κB, and (iv) the epigenetic regulation of target genes with binding partners. Thus, not only mTOR signaling but also the AhR factor demonstrates antagonistic pleiotropy in the regulation of the aging process.


[Combination of chromosome breaks during formation of complex rearrangements in Drosophila sperm].
A collection of rearrangements in the left and right arms of Drosophila autosome-2 was established with use of the "non-disjunction test". Rearrangements were induced by gamma-ray irradiation of mature sperm. The observed frequencies of rearrangement configurations for the 4-breaks rearrangements demonstrated that only spatially close breaks can reunite. Rearrangements configurations observed for the 3-breaks rearrangements support rather the classic hypothesis of rearrangement formation than the exchange hypothesis.


Strains and micromotions of press-fit femoral stem prostheses.
Average femoral geometry was determined from sections of 25 human femurs. A 'stem design program' was used to determine the largest femoral stem that could be introduced into the canal. The stem was fine tuned by observations of fit in Plexiglass models of the 25 femurs. This stem was called the 'Exact-Fit'. Type 1 stem was formed by grinding the anterior and posterior faces flat. Type 2 stem was formed by additionally grinding the medial and lateral faces flat. Four fresh femurs were used for the experiments. Strain gages were located on the proximal medial area and level with the distal lateral tip. Displacement transducers were mounted proximally to measure stem-bone micromotion. Vertical and anterior-posterior forces were applied to the femoral head and normal strain data obtained. The stems were then inserted in sequence and the strains and micromotions were measured. After the uncemented stems had been tested, a smaller size of 'exact-fit' stem was cemented and the tests repeated. The strains with the uncemented stems were closer to normal than with the cemented stems. For example, compressive calcar strains averaged 56% of normal uncemented compared with 30% cemented for the different loadings. The micromotion was higher uncemented, but was still at a low level. The 'exact-fit' stem gave less resultant micromotion than the type 1 and type 2 stems. The high variation of the strain results was attributed to variations in stem-bone contact and fit. The study provided information of direct application to press-fit stems in hip replacement surgery.


Examining predictors for 6-month mortality and healthcare utilization for patients admitted for heart failure in the acute care setting.
Acute heart failure (AHF) is a leading cause of mortality and hospitalization. Past studies reported increased healthcare spending in the last year of life in high-income countries, and this has been characterized as inappropriate healthcare resource utilization. The study aimed to examine potentially (in)appropriate healthcare utilization by comparing healthcare utilization patterns across predicted and observed 6-month mortality among patients admitted for HF. We conducted a retrospective cohort study among patients presenting at the emergency department (ED) of a tertiary hospital with HF as primary diagnosis and admitted after their ED discharge. We used LASSO Cox proportional hazards models to predict 6-month mortality, and estimated healthcare utilization patterns of predicted and observed mortality across inpatient healthcare services. 3946 patients were admitted into the emergency department with a primary diagnosis of HF. From 57 candidate variables, 17 were retained in the final 6- month mortality model (C-statistic 0.66). Patients who died within 6-months of ED admission had longer length of stay (LOS) and less inpatient surgeries than those who survived. Patients with a greater predicted mortality risk were admitted to the ICU more often and had a longer LOS than those with a lower predicted mortality risk. There were significant differences in healthcare resource utilization in patients admitted for AHF across predicted versus actual mortality. Lack of information on patients' preferences prevents the estimation of (in)appropriateness. Future studies should account for these considerations to estimate inappropriate healthcare utilization among these patients.


Efficacy of fosfomycin in preventing infection after endoscopic combined intrarenal surgery in periods of limited supply of first- and second-generation cephalosporins.
In March 2019, cefazolin was unavailable owing to difficulty in procuring the active ingredient. Furthermore, the supply of alternative drugs, such as cefotiam and cefmetazole, was limited. In the Department of Nephro-Urology, fosfomycin-based drugs are used as substitutes for cefazolin, which is a perioperative prophylactic antibacterial drug. Herein, we investigated the effectiveness of fosfomycin sodium and cefotiam in preventing infection after endoscopic combined intrarenal surgery as a retrospective preliminary study. A total of 200 patients who underwent endoscopic combined intrarenal surgery at our department between August 2017 and January 2021 were included. The patients were administered cefotiam (n = 95) or fosfomycin (n = 105) as perioperative antibacterial agents. There were no significant differences in the median age or surgery time between the cefotiam and fosfomycin groups. Propensity score matching was performed to match the preoperative urine bacterial counts of both groups. Sixty-eight patients were selected from each group. The median postoperative hospital stay duration was 4 days for the two groups. The median maximum postoperative temperatures were 37.5 and 37.4°C, respectively. There were no significant differences between the maximum postoperative temperatures in both groups. Furthermore, there were no differences between the groups regarding the white blood cell counts, C-reactive protein levels, and aspartate aminotransferase and alanine aminotransferase levels postoperatively, as well as in terms of postoperative fever requiring additional antibiotics. During a period of difficulty in acquiring cefazolin and cefotiam, the use of fosfomycin allowed us to continue with the procedure without increased clinical complications.


Molecular analysis of testis biopsy and semen pellet as complementary methods with histopathological analysis of testis in non-obstructive azoospermia.
Non-obstructive azoospermia (NOA) is one the many causes of male infertility (10 %) resulting from testicular failure. Multiple testicular biopsies fail to find mature sperm in at least 50 % of cases Therefore; hunting for sensitive and specific biomarkers of spermatogenesis that could better determine the fertility status in NOA can lead to improved management of male infertility. Therefore, we evaluated sperm production through analyses of germ cell-specific transcripts (DAZ, TSPY1, SPTRX3 and SPTRX1) in semen and testicular biopsies of men with azoospermia. We collected semen (N=83) and testis biopsies (N=31) from men with non-obstructive azoospermia. We later extracted RNA and synthesized cDNA using washed semen precipitate and testicular tissues. We also performed semi-nested PCR with designed specific primers. Using H&E method, an expert pathologist performed the histopathological evaluation. Having categorized the patients into three groups based on histopathological results, we calculated the agreement between molecular results of semen and tissues with histopathological findings for each patient using Kappa statistical test. Molecular findings of precipitated semen and testicular tissues were in disagreement with histopathological results in most cases. Molecular analysis of testis biopsies showed significant difference (Kappa coefficient=0.009, P value=0.894) with histopathological results; TSPY1, DAZ, SPTRX3 and SPTRX1 were respectively detected in 94 %, 94 %, 17.6 % and 52.9 % of men diagnosed with germ cell aplasia. Molecular analysis of semen does not provide sufficient sensitivity and specificity to be used as a screening test at the present time, but it is a useful adjunct to histopathological methods in men with NOA. Spermatid/sperm specific transcripts indicated the possibility to find mature sperm following repeated multiple testicular sperm extraction (TESE) or microdisection TESE (mTESE).


Metachronous extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) and peripheral T-cell lymphoma unspecified: histologic, immunophenotypic, and molecular documentation.
Coexistence of B- and T-cell lymphoid malignancies has been reported sporadically. A 68-year-old woman developed a lymphoid neoplasm in the large intestine and a second lymphoid neoplasm in the esophagus, 24 months after the diagnosis of the first lymphoma. Immunophenotypic analyses were consistent with extranodal marginal zone B-cell mucosa-associated lymphoid tissue type (MALT type) and peripheral T-cell unspecified lymphomas in the large intestine and the esophagus, respectively. The molecular analysis confirmed the B-clonal genotype of the first lymphoma, and disclosed a biclonal genotype of the second one (composite T- and B-cell lymphoma). No evidence of Epstein-Barr virus (EBV) association was shown in either tumor. B- and T-cell neoplasms represent two distinct malignancies rather than progression of the same neoplastic clone.


Synthesis of 7'-[123I]iodo-D-luciferin for in vivo studies of firefly luciferase gene expression.
D-(-)-2-(6'-hydroxy-7'-[(123)I]iodobenzothiazolyl)-delta(2)-thiazoline-4-caroxylic acid (7'-[(123)I]iodo-D-luciferin) was synthesized as a novel reporter probe for in vivo studies of firefly luciferase gene expression. 7'-Iodo-D-luciferin, a nonradioactive standard, was synthesized and showed the binding property (K(M)=4.28 microM) similar to that of D-luciferin (2.53 microM) for firefly luciferase in luminescence assay.


Detection of ectosiallyltransferase activity using whole cells. Correction of misleading results due to the release of intracellular CMP-N-acetylneuraminic acid.
An inhibitory effect due to broken cells is observed when sialyltransferase (CMP-N-acetylneuraminate:D-galactosyl-glycoprotein N-acetylneuraminyltransferase, EC 18.104.22.168) is measured with mixture of intact and homogenized lymphocytes. This intracellular inhibitory factor ib purified and characterized as CMP-N-acetylneuraminic acid (CMP-NeuNAc) by its behavior in various chromatographic and electrophoretic systems and by its susceptibility to CMP-NeuNAc hydrolase. This endogenous CMP-NeuNAc leads to an isotopic dilution of the exogenous labelled CMP-NeuNAc explaining the apparently lower activity of homogenate when compared to whole cells. Consequently, the radioactivity bound to acceptors may not be related to a known number of sialyl residues transferred, calling into question the validity of comparing the incorporation of [14C]NeuNAc by homogenate and whole cells in order to assign sialyltransferase activity to ectoenzyme. A new approach is developed to detect ectoglycosyltransferases with whole cells, taking into account that both intracellular enzymes and endogenous precursor may be introduced by the small percentage of broken cells.


The impact of computerization of the nutrition support process on the nutrition support program in a tertiary care hospital in the Philippines: report for the years 2000-2003.
To improve hospital health care delivery by identifying malnutrition in all admitted patients and following up those identified to be malnourished and "at risk of developing malnutrition" a hospital nutrition support program based on the JCAHO system was initiated in 1999. Two major problems were encountered: first, the inability to perform a nutrition surveillance process due to failure by the staff to implement existing nutrition screening tools and second, the lack of awareness and support from the medical staff in this initiative. Two solutions were implemented in 2000: computerization of the nutrition screening and nutrition support process and synchronizing this with the whole nutrition support program. A computer program was developed which performs BMI-based nutrition screening, produces lists of all malnourished patients, and computes the different formulas for either nutritional requirement or parenteral and/or enteral formulation. It also generates patient status reports based on encoded data from the nutrition support team, which prioritized these patients for management based on the data output. From 2000 to 2003, improvement was seen in these areas: entry of height and weight in the patient record increased from 30% to 90%; nutrition surveillance shows nutritional status distribution to be: normal (58%), underweight (9%), overweight (25%), and obese (8%), referrals to the nutrition support team based on the screen notification increased from 37% to 100%, patient coverage by nutrition support services increased from 7374 (38.8%) in 2000 to 11,369 (83%) in 2003, and critical care patients seen increased from 10% in 2000 to 99% in 2003. More improvement is needed in physician response to nutrition support recommendations, which still remains low (11.2-24%). Computerization helps to improve nutrition support delivery in the hospital, but more cooperation and support from the medical staff is still needed for better results.


TRIB3 promotes pulmonary fibrosis through inhibiting SLUG degradation by physically interacting with MDM2.
Pulmonary fibrosis (PF) is the pathological structure of incurable fibroproliferative lung diseases that are attributed to the repeated lung injury-caused failure of lung alveolar regeneration (LAR). Here, we report that repetitive lung damage results in a progressive accumulation of the transcriptional repressor SLUG in alveolar epithelial type II cells (AEC2s). The abnormal increased SLUG inhibits AEC2s from self-renewal and differentiation into alveolar epithelial type I cells (AEC1s). We found that the elevated SLUG represses the expression of the phosphate transporter SLC34A2 in AEC2s, which reduces intracellular phosphate and represses the phosphorylation of JNK and P38 MAPK, two critical kinases supporting LAR, leading to LAR failure. TRIB3, a stress sensor, interacts with the E3 ligase MDM2 to suppress SLUG degradation in AEC2s by impeding MDM2-catalyzed SLUG ubiquitination. Targeting SLUG degradation by disturbing the TRIB3/MDM2 interaction using a new synthetic staple peptide restores LAR capacity and exhibits potent therapeutic efficacy against experimental PF. Our study reveals a mechanism of the TRIB3-MDM2-SLUG-SLC34A2 axis causing the LAR failure in PF, which confers a potential strategy for treating patients with fibroproliferative lung diseases.


Transcriptomic analysis of male and female Schistosoma mekongi adult worms.
Schistosoma mekongi is one of five major causative agents of human schistosomiasis and is endemic to communities along the Mekong River in southern Lao People's Democratic Republic (Laos) and northern Cambodia. Sporadic cases of schistosomiasis have been reported in travelers and immigrants who have visited endemic areas. Schistosoma mekongi biology and molecular biology is poorly understood, and few S. mekongi gene and transcript sequences are available in public databases. Transcriptome sequencing (RNA-Seq) of male and female S. mekongi adult worms (a total of three biological replicates for each sex) were analyzed and the results demonstrated that approximately 304.9 and 363.3 million high-quality clean reads with quality Q30 (> 90%) were obtained from male and female adult worms, respectively. A total of 119,604 contigs were assembled with an average length of 1273 nt and an N50 of 2017 nt. From the contigs, 20,798 annotated protein sequences and 48,256 annotated transcript sequences were obtained using BLASTP and BLASTX searches against the UniProt Trematoda database. A total of 4658 and 3509 transcripts were predominantly expressed in male and female worms, respectively. Male-biased transcripts were mostly involved in structural organization while female-biased transcripts were typically involved in cell differentiation and egg production. Interestingly, pathway enrichment analysis suggested that genes involved in the phosphatidylinositol signaling pathway may play important roles in the cellular processes and reproductive systems of S. mekongi worms. We present comparative transcriptomic analyses of male and female S. mekongi adult worms, which provide a global view of the S. mekongi transcriptome as well as insights into differentially-expressed genes associated with each sex. This work provides valuable information and sequence resources for future studies of gene function and for ongoing whole genome sequencing efforts in S. mekongi.


α-Synuclein disrupts the anti-inflammatory role of Drd2 via interfering β-arrestin2-TAB1 interaction in astrocytes.
α-Synuclein (α-Syn)-induced neuroinflammation plays a crucial role in the pathogenesis of Parkinson's disease (PD). Dopamine D2 receptor (Drd2) has been regarded as a potential anti-inflammatory target in the therapy of neurodegenerative diseases. However, the effect of astrocytic Drd2 in α-Syn-induced neuroinflammation remains unclear. The effect of Drd2 on neuroinflammation was examined in mouse primary astrocyte in vitro and A53T transgenic mice in vivo. The inflammatory responses of astrocyte were detected using immunofluorescence, ELISA, and qRT-PCR. The details of molecular mechanism were assessed using Western blotting and protein-protein interaction assays. We showed that the selective Drd2 agonist quinpirole suppressed inflammation in the midbrain of wild-type mice, but not in α-Syn-overexpressed mice. We also found that Drd2 agonists significantly alleviated LPS-induced inflammatory response in astrocytes, but failed to suppress α-Syn-induced inflammatory response. The anti-inflammation effect of Drd2 was dependent on β-arrestin2-mediated signaling, but not classical G protein pathway. α-Syn reduced the expression of β-arrestin2 in astrocytes. Increased the β-arrestin2 expression restored in the anti-inflammation of Drd2 in α-Syn-induced inflammation. Furthermore, we demonstrated that α-Syn disrupted the anti-inflammation of Drd2 via inhibiting the association of β-arrestin2 with transforming growth factor-beta-activated kinase 1 (TAK1)-binding protein 1 (TAB1) and promoting TAK1-TAB1 interaction in astrocytes. Our study illustrates that astrocytic Drd2 inhibits neuroinflammation through a β-arrestin2-dependent mechanism and provides a new strategy for treatment of PD. Our findings also reveal that α-Syn disrupts the function of β-arrestin2 and inflammatory pathways in the pathogenesis of PD.


Reproducibility studies and effects of bowel preparations on measurements of rectal epithelial proliferation.
Measurements of rectal epithelial proliferation (REP), using tritiated labelled thymidine, correlate with colonic epithelial proliferation, risk for cancer and response to therapies. There have been criticisms regarding its reproducibility and the possible deleterious effects of bowel preparations on this biomarker. We studied paired observations on 7 patients repeated without bowel preparation, 11 repeated after tap-water enema, and 8 repeated after PEG-electrolyte solution or extract of senna purgative and found no significant differences between paired observations. In addition, in a high-risk group for colorectal cancer, 31 persons received PEG or senna preparation and their REP was not significantly different from that of 23 examined without these preparations. Thus, REP is a reproducible biomarker and not affected by several commonly used bowel preparations.


[Happy feet, happy caregivers].
Healthcare professionals take care of their patients' feet. But how much attention do they pay to their own feet, which they use all day long? Perspectives on prevention and the connection between healthy feet and wellbeing.


Pancreatic panniculitis complicated by infection with Corynebacterium tuberculostearicum: A case report.
We present a case of pancreatic panniculitis in a patient with alcohol abuse where Corynebacterium tuberculostearicum was isolated from a pannicular nodule on the crus. The patient was started on linezolid treatment leading to regression of the patient's symptoms. Upon discontinuation of linezolid treatment progression of the skin symptoms progressed.


A New Hysteroscopic Risk Scoring System for Diagnosing Endometrial Hyperplasia and Adenocarcinoma.
To develop a new hysteroscopic morphologic scoring system that helps physicians, especially those who have less experience, to make a differential diagnosis among normal endometrium (NE), endometrial hyperplasia, and endometrial carcinoma. A retrospective study (Canadian Task Force Classification II). An office hysteroscopy service. A total of 435 endometrial biopsies were included in the study: 201 NE, 160 endometrial hyperplasia without atypia (EH), 30 atypical endometrial hyperplasia (AEH), and 44 endometrial cancer (EC). The authors retrospectively evaluated all videos of diagnostic hysteroscopies performed before endometrial biopsies to note endometrial morphologic parameters suggestive of pathology. Principal significant variables were selected by means of the chi-square test (p < .05) and integrated into an ordinal multivariate analysis. Through the estimate of the beta coefficient, a score was obtained to be appointed to each of the selected variables, and characteristic intervals of each of the endometrial lesions were created. The scoring system showed a sensitivity and specificity of 71.1% and 80%, 48.7% and 82.5%, 63.3% and 90.4%, and 95.4% and 98.2% regarding NE, EH, AEH, and EC, respectively. The positive predictive values and negative predictive values, respectively, were 76.8% and 80% for NE, 62% and 73.5% for EH, 32.7% and 97% for AEH, and 85.7% and 99.5% for EC. The proposed scoring system showed good diagnostic performance, especially in relation to endometrial cancer, and may represent a useful diagnostic tool, mainly for operators with less experience.


Cyclic nucleotide phosphodiesterase in silkworm. Developmental change of cyclic AMP and cyclic GMP phosphodiesterases.
Changes in theactivities of two cyclic AMP phosphodiesterases (II and III, EC 18.104.22.168) and cyclic GMP phosphodiesterase during development were studied in silkworm, Bombyx mori. The developmental patterns of the activities of the two cyclic AMP phosphodiesterases were similar to each other, but they differed distinctly from that of cyclic GMP phosphodiesterase. The ratios of cyclic GMP phosphodiesterase/cyclic AMP phosphodiesterase III were constant in larva, but changed greatly and rapidly before pupation.


[Experimental study on the stimulating effect and the tissue compatibility of a new type of implanted gastric electrical stimulator].
A new type of gastric electrical stimulator (GES) was introduced. After the stimulator was implanted in beagle dogs, its stimulating effects and the pathological changes at the implant site were observed to study the safety and efficacy of stimulator as well as the tissue compatibility of the materials used. The results showed that, this type of stimulator was safe and capable of inhibiting food intake of the dogs, and that the materials used had good tissue compatibility.


Two-Year Results of the Banded Versus Non-banded Re-sleeve Gastrectomy as a Secondary Weight Loss Procedure After the Failure of Primary Sleeve Gastrectomy: a Randomized Controlled Trial.
Insufficient weight loss or weight regain has been reported in up to 30% of patients after laparoscopic sleeve gastrectomy (LSG). Approximately 4.5% of patients who undergo LSG need revisional surgery for a dilated sleeve. This randomized controlled trial compared the outcomes between banded (BLSG) and non-banded re-LSG (NBLSG) after weight regain. Percentage excess body weight loss (%EWL), percentage total weight loss (%TWL), associated medical problems, gastric volume measurement, and endoscopy were measured preoperatively and 1 and 2 years postoperatively. Both groups (25 patients each) achieved similar % EWL and %TWL at six months, one year, and two years postoperatively (%EWL 46.9 vs. 43.6, 83.7 vs. 86.3, and 85.7 vs. 83.9) (p= > 0.151) (%TWL 23.9 vs. 21.8, 43.1 vs .43.3, 44.2 vs. 42.2) (p=>0.342), respectively. However, the body mass index was significantly lower with BLSG (24.9 vs. NBLSG, 26.9). Both groups showed a significant reduction in stomach volume after two years (BLSG -248.4 mL vs. NBLSG -215.8 mL). Food tolerance (FT) scores were significantly reduced in both groups, whereby BSLG had significantly lower FT with an average of -1.1 point. No significant differences were observed regarding improvement of the associated medical problems after the first and two years after revisional LSG or the postoperative complications between both groups. Laparoscopic re-LSG is feasible and safe with satisfactory outcomes in patients with weight regain after LSG who have gastric dilatation without reflux esophagitis. Both groups had comparable significant weight loss effects and improvement of associated medical problems. The BLSG tends to have a more stable weight loss after two years with a significantly lower BMI, lower stomach volume, and less weight regain. Food tolerance decreased in both groups but reduced more in the BLSG group. After a 2-year follow-up, we may regard both procedures are safe, with no significant differences in the occurrence of complications and nutritional deficits.


Pangenome guided pharmacophore modelling of enterohemorrhagic Escherichia coli sdiA.
Enterohemorrhagic Escherichia coli (EHEC) continues to be a significant public health risk. With the onset of next generation sequencing, whole genome sequences are a potential resource for predictive modelling of the different regulatory mechanism of pathogens, particularly quorum sensing. We used a pangenome approach to determine EHEC genome clustering, determine the synonymous and nonsynonymous mutations across the EHEC sdiA and modelled the associated amino acid changes. Across the EHEC population, nonsynonymous variants are notably absent in ligand binding site for quorum sensing, indicating that population wide conservation of sdiA ligand site can be targeted for potential prophylactic purposes. Applying pathotype-wide pangenomics as a guide for determining evolution of pharmacophore sites is a potential approach in drug discovery.


Paenibacillus frigoriresistens sp. nov., a novel psychrotroph isolated from a peat bog in Heilongjiang, Northern China.
A novel cold-resistant bacterium, designated YIM 016(T), was isolated from a peat bog sample collected from Mohe County, Heilongjiang Province, Northern China and its taxonomic position was investigated using a polyphasic approach. The strain was Gram-positive, aerobic, endospore-forming, motile and rod-shaped. Phylogenetic analyses based on the 16S rRNA gene sequence clearly revealed that strain YIM 016(T) is a member of the genus Paenibacillus. The strain is closely related to Paenibacillus alginolyticus DSM 5050(T), Paenibacillus chondroitinus DSM 5051(T) and Paenibacillus pocheonensis Gsoil 1138(T) with similarities of 99.0 %, 97.0 % and 96.3 %, respectively. Meanwhile, the low DNA-DNA relatedness levels between strain YIM 016(T) and its closely related phylogenetic neighbours demonstrated that this isolate represents a new genomic species in the genus Paenibacillus. Phenotypic and chemotaxonomic tests showed that growth of strain YIM 016(T) occurred at 4-37 °C, pH 6.0-8.0 and with a NaCl tolerance up to 0.5 % (w/v). The peptidoglycan contained meso-diaminopimelic acid, alanine and glutamic acid. The whole-cell hydrolysates mainly contained glucose, galactose and ribose. The predominant menaquinone was MK-7 and the major fatty acids were anteiso-C(15:0) and iso-C(16:0). The DNA G+C content of strain YIM 016(T) was 51.7 mol %. On the basis of phylogenetic, phenotypic and chemotaxonomic characteristics, strain YIM 016(T) could be clearly distinguished from other species of the genus Paenibacillus. It is therefore concluded that strain YIM 016(T) represents a novel species in the genus Paenibacillus, for which the name Paenibacillus frigoriresistens sp. nov. is proposed. The type strain is YIM 016(T) (= CCTCC AB 2011150(T) = JCM 18141(T)).


Use of decompressive craniectomy after severe head trauma.
Ten percent of head injuries quality as "severe," requiring prompt diagnosis and treatment. This level I trauma center uses an aggressive approach to treatment of severe head injuries and, when indicated, intervenes with decompressive craniectomy. This article explains decompressive craniectomy, including indications, procedures, and protocols. The case studies presented highlight two patients with profound head injuries. Additionally, cranioplasty replacement of autograft flap is explained and discussed.


The effects of three benzodiazepines and of meprobamate on the action of smooth muscle stimulants on the guinea-pig ileum.
The benzodiazepines chlorodiazepoxide, diazepam and flurazepam and meprobamate depress the response of the guinea-pig ileum to acetylcholine, histamine and 5-hydroxytryptamine. As compared to the benzodiazepines the action of meprobamate is very weak. Chlorodiazepoxide has a weaker anti-acetylcholine activity than diazepam and flurazepam. On the other hand chlorodiazepoxide possesses a realtively strong anti-histamine activity. The three benzodiazeptines tested are about equally effective in reducing the contraction of the guinea-pig ileum caused by 5-hydroxytryptamine. The potency of diazepam and flurazepam in blocking the effect of the three smooth muscle stimulants appears to be rather similar.


Simplified laparoscopic parastomal hernia repair: the scroll technique.
Laparoscopic parastomal hernia repair can be technically challenging. We herein present a simplified technique of laparoscopic parastomal hernia repair. This technique entails fixation of the rolled mesh to the anterior abdominal wall before unfolding it, each side of the mesh is unfolded and fixed individually using transfascial sutures and tacks. This technique was used in 3 patients; The average time for mesh placement was about 30 minutes. The mean length of stay was 2 days. Apart from 1 patient who developed a transient postoperative seroma, there were no intraoperative or postoperative complications. This technique of mesh placement minimizes intracorporeal mesh manipulation, facilitates fixation of the mesh to the anterior abdominal wall, and provides adequate coverage to the hernia defect while hosting the colostomy without restriction.


Evaluating the effect of kidney function on brain volumes and dementia risk in the UK Biobank.
To investigate the association between kidney function with the risk of dementia and brain volumes. A total of 452,996 UK Biobank participants with calculated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) were included. We utilized Cox proportional hazards regression models and restricted cubic spline analyses to examine the relationships between kidney function and the risk of all-cause dementia (ACD), Alzheimer's disease (AD), and vascular dementia (VD). Additionally, we explored the correlations between kidney function and brain magnetic resonance indicators among 40,380 participants. During a median follow-up of 12 years, 5,258 incident ACD cases were identified. The deterioration of kidney function was associated with an increased risk of ACD. When compared to eGFR ≥ 90 ml/min/1.73 m², the highest risk increase was evident for eGFRcre < 30 ml/min/1.73 m² (adjusted HR = 2.372, 95% CI: 1.444-3.897, P < 0.001), with eGFRcys showing greater significance (adjusted HR = 3.045, 95% CI: 2.212-4.191, P < 0.001), especially in relation to AD. Compared to the ACR level in the range of 3-30 mg/mmol, the category of > 30 mg/mmol was associated with an increased risk of ACD (adjusted HR = 1.720, 95% CI: 1.350-2.190, P < 0.001). Moreover, the decline in kidney function was associated with the total brain volume atrophy and reduction in certain subcortical areas. Our study indicates that diminished kidney function, as evidenced by a drop in eGFR and aggravated proteinuria, elevates dementia risk. Associated brain structural changes further underpin this connection from a neuro-pathophysiological perspective.


Intestinal ultrasonography in infants with moderate or severe hypoxic-ischemic encephalopathy receiving hypothermia.
Infants with hypoxic-ischemic encephalopathy (HIE) may develop multiorgan dysfunction, but assessment of intestinal involvement is imprecise and based on nonspecific clinical signs that may occur several days later. Ultrasound imaging has been described as a helpful tool in assessing intestinal involvement in many gastrointestinal disorders. Describe abdominal ultrasonography findings in infants receiving therapeutic hypothermia and investigate its association with the severity of the hypoxic-ischemic insult and death. Studies were performed within the first 36 h of life to assess intestinal appearance (normal bowel, bowel wall echogenicity and thickness, and sloughed mucosa), free fluid, peristalsis and intramural perfusion. These findings were compared between infants with moderate and severe encephalopathy. Ultrasound findings were also categorized in three major groups and compared with markers of severity of the hypoxic-ischemic insult and with mortality. Nineteen infants with moderate and 9 with severe HIE at admission were studied (17.7 ± 9.5 h of life). Major ultrasonography findings were increased bowel wall echogenicity (78%), free fluid (75%), decreased or absent peristalsis (50%) and sloughing of the intestinal mucosa (21%). Abnormal intestinal findings such as increased bowel wall echogenicity in all quadrants and presence of sloughed mucosa were associated with more severe hypoxic-ischemic insult. All 12 patients with normal bowel appearance or increased bowel wall echogenicity restricted to only one quadrant survived, whereas 7/15 (47%) patients with increased bowel wall echogenicity in all four quadrants died during hospitalization. The presence of sloughed mucosa was associated with increased mortality (P < 0.001). In infants receiving therapeutic hypothermia, a high prevalence of intestinal involvement was noted by using ultrasonographic assessment. An association between intestinal findings and severity of hypoxic-ischemic insult was observed. The presence of sloughed mucosa is a potential ultrasonographic sign of severity.


Cost-minimization analysis of oral versus intravenous antibiotic treatment for Klebsiella pneumoniae liver abscess.
A cost-minimization analysis was conducted for Klebsiella pneumoniae liver abscess (KLA) patients enrolled in a randomized controlled trial which found oral ciprofloxacin to be non-inferior to intravenous (IV) ceftriaxone in terms of clinical outcomes. Healthcare service utilization and cost data were obtained from medical records and estimated from self-reported patient surveys in a non-inferiority trial of oral ciprofloxacin versus IV ceftriaxone administered to 152 hospitalized adults with KLA in Singapore between November 2013 and October 2017. Total costs were evaluated by category and payer, and compared between oral and IV antibiotic groups over the trial period of 12 weeks. Among the subset of 139 patients for whom cost data were collected, average total cost over 12 weeks was $16,378 (95% CI, $14,620-$18,136) for the oral ciprofloxacin group and $20,569 (95% CI, $18,296-$22,842) for the IV ceftriaxone group, largely driven by lower average outpatient costs, as the average number of outpatient visits was halved for the oral ciprofloxacin group. There were no other statistically significant differences, either in inpatient costs or in other informal healthcare costs. Oral ciprofloxacin is less costly than IV ceftriaxone in the treatment of Klebsiella liver abscess, largely driven by reduced outpatient service costs.Trial registration: ClinicalTrials.gov Identifier NCT01723150 (7/11/2012).


Variability of the electrophoretic mobility of low density lipoprotein. Comparison of interstitial fluid from human aortic intima and serum.
Interstitial fluid was collected from human aortic intima and the low density lipoprotein (LDL) was compared with serum LDL by two-dimensional immunoelectrophoresis. In half the samples derived from normal intima the migration rate was within +/- 10% of migration of LDL in serum, but in the remaining samples it was higher, indicating an increase in net negative charge on the molecule. By contrast, in most samples of interstitial fluid from gelatinous thickenings the migration rate of LDL was lower than in serum, indicating reduction in net negative charge. To test for the effect of different electrolyte concentrations in interstitial fluid and serum, migration of alpha 2-macroglobulin (alpha 2-M) was measured simultaneously in both. This showed no significant difference between interstitial fluid and serum, and varied by less than 2% between different serum samples. However, the mobility of LDL relative to alpha 2-M showed a remarkable variation, ranging from 80.9 to 127.1% of alpha 2-M mobility in interstitial fluid and from 58.6 to 115.9% in 23 serum samples. In serum, LDL relative mobility showed no correlation with general acid-base status, as indicated by serum bicarbonate levels, with fatty meals or diabetic keto-acidosis, or with extent of glycosylation of haemoglobin. This suggested that the variation in surface charge is intrinsic to the molecule and not a transient reflection of the plasma environment. Experimental alterations in the surface charge of LDL change its interaction with smooth muscle cells and macrophages in vitro, and its mitogenic properties. This raises the possibility that physiological variation in the surface charge of LDL in different subjects could alter its atherogenic potential.


Bioactive complement fragments in immunoregulation.
Several fragments derived from complement components have been identified as potent effector substances in in vitro assays that measure cell proliferation and antibody synthesis. The anaphylatoxin C3a suppresses the immune response but fails to influence T- or B-cell proliferation. The factor C5a augments both antibody production and antigen-induced, but not mitogen-induced, T-cell proliferation. C3a-mediated suppression occurs through the activation of a suppressor T-cell cascade with macrophage collaboration. C5a-mediated enhancement, depending upon the in vitro system studied, acts at the level of the helper T cell and/or macrophage. A fragment generated from treating iC3b with kallikrein (c3d-K) has aided in defining a structural region of the C3b molecule that can influence the level of circulating leukocytes. The factor C3d-K is also capable of suppressing both specific and non-specific T-cell proliferative responses and mitogen-induced B cell growth. The mechanism of C3d-K action is defined as a direct effect on "activated" T cells, even though IL-2 synthesis of treated cells is diminished. The effect of C3d-K is long lasting, non-reversible and requires only a short exposure to the target cell.


An automated procedure for correlation of q-sorts.
A set of computer programs which calculates correlations between Q-sort decks is described. These programs automatically process Q-sort decks in which the items are printed directly on IBM cards, thus enabling the rapid analysis of large volumes of Q-sort data. An application of this method to the assessment of family interaction is described.


Effect of Methyl Group Substitution on the Kinetics of Vinyl Radical + O2 Reaction.
The kinetics of (CH3)2CCH + O2 (1) and (CH3)2CCCH3 + O2 (2) reactions have been measured as a function of temperature (223-600 K) at low pressures (0.4-2 Torr) using a tubular laminar flow reactor coupled to a photoionization mass spectrometer (PIMS). These reactions are important for accurate modeling of unsaturated hydrocarbon combustion. Photolysis of a brominated precursor by a pulsed excimer laser radiation at 248 nm wavelength along the flow reactor axis was used for the production of radicals. The measured bimolecular rate coefficient of reaction 1 shows a negative temperature dependence over the temperature range 223-384 K and becomes temperature independent at higher temperatures. The bimolecular rate coefficient of reaction 2 exhibits a negative temperature dependence throughout the experimental temperature range. The bimolecular rate coefficients of reactions 1 and 2 are expected to be at the high-pressure limit under the current experimental conditions, and the following values are obtained at 298 K: k1(298 K) = (4.5 ± 0.5) × 10-12 cm3 s-1 and k2(298 K) = (8.9 ± 1.0) × 10-12 cm3 s-1. The observed products for reactions 1 and 2 were CH3COCH3 and CH3 + CH3COCH3, respectively. Substituting both β-hydrogens in the vinyl radical (CH2CH) with methyl groups decreases the rate coefficient of the CH2CH + O2 reaction by about 50%. However, the rate coefficient of the triply substituted (CH3)2CCCH3 radical reaction with O2 is almost identical to the CH2CH + O2 rate coefficient under the covered temperature range.


The use of focus groups in a study of attitudes to student nurse assessment.
This paper describes the use of focus groups in the first phase of a study to investigate the attitudes of teachers and clinical assessors to the assessment of student nurses. It offers a description of the methodology, with an analysis of its strengths and weaknesses.


[Identification and generalization of classes of public health laboratory detection activities].
To identify and generalize classes of public health laboratory detection activities and to discuss the method of identification and generalization of classes of Public Health Conceptual Information Model. At first, materials should be collected from consulting literatures and experts, referring to the existing system. Then, identification and generalization of classes are got for business process analysis, writing description documents, summing up important conceptions and activities, By use-case analysis, use-case diagram and tabulation of important conception and activities and reference to PHCDM, a structural diagram of classes is constructed. A structure diagram of classes of public health laboratory detection activity is given. This is a feasible method in identification and generalization of classes of public health laboratory detection activities.


Developing nursing research in a contract-driven arena: inequities and iniquities.
Despite the need for nursing to become more evidence-based, there are a number of problems regarding developing nursing research.


Evaluation of kapok (Ceiba pentandra (L.) Gaertn.) as a natural hollow hydrophobic-oleophilic fibrous sorbent for oil spill cleanup.
Oil sorption capacity and hydrophobic-oleophilic characteristics of an agricultural product, kapok (Ceiba pentandra), was thoroughly examined. The kapok fiber has a hollow structure with large lumen. Its performance was compared with that of a polypropylene (PP), a widely used commercial oil sorbent for oil spill cleanup. The oils investigated were diesel, hydraulic oil (AWS46), and engine oil (HD40). Reusability of the kapok after application to various oils was also evaluated. Both loose (at its natural state) and densely packed kapok assemblies were examined. Sorption capacities of the packed kapok assemblies were very much dependent on their packing densities. At 0.02gcm(-3), its oil sorption capacities were 36, 43 and 45gg(-1) for diesel, ASW46 and HD40, respectively. The values decreased to 7.9, 8.1 and 8.6gg(-1) at 0.09gcm(-3). Its sorption capacities for the three oils were significantly higher than those of PP. When the oil-saturated kapok assemblies were allowed to drain, they exhibited high oil retention ability, with less than 8% of the absorbed diesel and HD40, and 12% of the absorbed AWS46 lost even after 1h of dripping. When applied on oil-over-water baths, the kapok exhibited high selectivity for the oils over the water; almost all oils spilled could be removed with the kapok, leaving an invisible oil slick on water. After the 4th cycle of reuse, the reused kapok assembly only lost 30% of its virgin sorption capacity if packed at 0.02gcm(-3), and the loss in sorption capacity was much less at higher packing densities. The hydrophobic-oleophilic characteristics of the kapok fiber could be attributed to its waxy surface, while its large lumen contributed to its excellent oil absorbency and retention capacity.


Interventional radiology in appendicular skeletal trauma.
Embolotherapy for extremity vascular injuries is a relatively new, effective, and safe treatment modality in selected patients. The resultant hemostasis decreases the morbidity or even mortality that can result from uncontrolled hemorrhage. In addition, surgery may be postponed until the patient is stabilized, or avoided altogether. Prompt diagnosis of vascular injury and embolization when indicated also contributes to the proper management of associated osseous and soft tissue injuries.


Evidence of niche differentiation for two sympatric vulture species in the Southeastern United States.
As obligate scavengers utilizing similar habitats, interspecific competition undoubtedly occurs between resident black (Coragyps atratus) and turkey (Cathartes aura) vultures. In the interest of exploring how sympatric species coexist through habitat segregation, we examined resource selection of resident black and turkey vultures in the southeastern United States (US) for evidence of niche differentiation. Using fine-scale movement data, we assessed interspecific seasonal differences in monthly roost reuse frequency and roost site fidelity, as well as monthly flight, roost, and diurnal rest site resource selection based on > 2.8 million locations of 9 black vultures and 9 turkey vultures tracked from September 2013 to August 2015 using Groupe Spécial Mobile/Global Positioning System (GSM/GPS) transmitters. Black vultures generally exhibited greater roost fidelity as well as a greater maximum number of nights spent at a single roost than turkey vultures. Patterns of flight, roost, and resting habitat selection within the home range varied monthly as well as between species, providing evidence for habitat segregation and niche differentiation by sympatric vultures. In particular, our results indicate the importance of wooded wetlands for resting and roosting locations for both species, and revealed clear differences in the use of forested habitats between species during flight, resting, and roosting behavioral states. By examining differences in resource selection and spatial ecology of black and turkey vultures across a range of behaviors, this study demonstrates mechanisms of niche differentiation in these ecologically similar species, and enhances potential for conservation and informed management of this important group of birds.


Comparison of tramadol and lornoxicam for the prevention of postoperative catheter-related bladder discomfort: a randomized controlled trial.
Catheter-related bladder discomfort (CRBD is a painful complication of intraoperative urinary catheterization after anaesthesia. We conducted this study to compare the effect of tramadol and lornoxicam for the prevention of postoperative CRBD. One-hundred twenty patients (aged 18-60 years, ASA physical status 1-2, undergoing elective uterine surgery requiring intraoperative urinary catheterization were randomly divided into three groups with 40 patients in each group. Group T received 1.5 mg/kg tramadol, group L received 8-mg lornoxicam, and group C received normal saline. The study drugs were administered intravenously at the end of the surgery. The incidence and severity of CRBD were reported at 0, 1, 2, and 6 h after arrival at the postanaesthesia care unit (PACU). The incidence of CRBD was significantly lower in groups T and L than in group C at 1, 2, and 6 h after surgery. The incidence of moderate to severe CRBD was also significantly lower in groups T and L than in group C at 0, 1, and 2 h after surgery. The severity of CRBD reported as mild, moderate, and severe was reduced in groups T and L compared with group C at most times after surgery. Group T had a higher incidence of nausea than group C, and there were no differences in dizziness, drowsiness, or vomit among the three groups. Tramadol and lornoxicam administered intravenously at the end of the surgery were both effective in preventing the incidence and severity of CRBD after uterine surgery. However, tramadol increased the incidence of nausea compared with saline, but there was no difference between tramadol and lornoxicam. ChiCTR2100052003. Registered on 12/10/2021.


The assay of pyruvate kinase activity in gastric mucosa.
Pyruvate kinase activity in gastric mucosal supernatant preparations shows large responses to exogenous effectors. At pH 7.5, fructose 1,6-diphosphate can cause large stimulations in activity. Alanine inhibits the reaction but this effect is partially reversed by fructose 1,6-diphosphate. In the absence of these compounds, 4.0-5.0 mM phosphoenolpyruvate (PEP) is required to generate maximal activity in the assay system used. Electrophoresis reveals an isoenzyme pattern containing only one form of pyruvate kinase, an M isoenzyme, in both fundic and antral mucosa. The pyruvate kinase of gastric mucosa thus resembles the M-type enzymes of leucocytes and liver. Measurements of activity at both 1.0 mM PEP and 4.0--5.0 mM PEP, with and without additions of fructose 1,6-diphosphate, are recommended for the reliable estimation of pyruvate kinase activity in this tissue.


Chromatin reconstitution on small DNA rings. IV. DNA supercoiling and nucleosome sequence preference.
Nucleosome formation on inverted repeats or on some alternations of purines and pyrimidines can be inhibited in vitro by DNA supercoiling through their supercoiling-induced structural transitions to cruciforms or Z-form DNA, respectively. We report here, as a result of study of single nucleosome reconstitutions on a DNA minicircle, that a physiological level of DNA supercoiling can also enhance nucleosome sequence preference. The 357 base-pair minicircle was composed of a promoter of phage SP6 RNA polymerase joined to a 256 base-pair fragment containing a sea urchin 5 S RNA gene. Nucleosome formation on the promoter was found to be enhanced on a topoisomer with in vivo superhelix density when compared to topoisomers of lower or higher superhelical densities, to the nicked circle, or to the linear DNA. In contrast, nucleosomes at other positions appeared to be insensitive to supercoiling. This observation relied on a novel procedure for the investigation of nucleosome positioning. The reconstituted circular chromatin was first linearized using a restriction endonuclease, and the linear chromatin so obtained was electrophoresed as nucleoprotein in a polyacrylamide gel. The gel showed well-fractionated bands whose mobilities were a V-like function of nucleosome positions, with the nucleosome near the middle migrating less. This behavior is similar to that previously observed for complexes of sequence-specific DNA-bending proteins with circularly permuted DNA fragments, and presumably reflects the change in the direction of the DNA axis between the entrance and the exit of the particle. Possible mechanisms for such supercoiling-induced modulation of nucleosome formation are discussed in the light of the supercoiling-dependent susceptibility to cleavage of the naked minicircle with S1 and Bal31 nucleases; and a comparison between DNase I cleavage patterns of the modulated nucleosome and of another, non-modulated, overlapping nucleosome.


Histologic features of secondary syphilis: A multicenter retrospective review.
Secondary syphilis has a wide spectrum of clinical and histologic manifestations. We sought to determine the frequency of histopathological features characterizing secondary syphilis, and which are most common in specimens displaying few diagnostic findings. In a multicenter, retrospective analysis of biopsy-proven secondary syphilis, cases were subcategorized by the number of histologic characteristics present. The 106 cases mostly had 5 to 7 of the features studied. Many features were scarcer in cases with 5 or fewer features, including endothelial swelling (87.7% overall vs 72.4% ≤5 features), plasma cells (69.8% vs 48.3%), and elongated rete ridges (75.5% vs 27.6%). Specimens with 5 or fewer features were more likely to be truncal (61.1% vs 34.4% overall), demonstrate rete ridge effacement (44.8% vs 19.8%), and have pityriasis rosea (33.3% vs 17.2%) or drug eruption (33.3% vs 10.9%) in the clinical differential. An interstitial inflammatory pattern was the most common characteristic of specimens with 5 or fewer features (75.9%). This was a retrospective review. The independent value of many histologic features of syphilis may be overestimated. Combinations of endothelial swelling, interstitial inflammation, irregular acanthosis, and elongated rete ridges should raise the possibility of syphilis, along with the presence of vacuolar interface dermatitis with a lymphocyte in nearly every vacuole and lymphocytes with visible cytoplasm.


Sulfatase-2 promotes the growth and metastasis of colorectal cancer by activating Akt and Erk1/2 pathways.
The molecular mechanisms underlying the growth and metastasis of colorectal cancer (CRC) remain largely unknown. Sulfatase-2 (SULF2) was found to play critical roles in human cancers. Recent study reported that SULF1/2 overexpression resulted in increased viability and proliferation, and augmented cell migration in CRC cells. However, the expression of SULF2 and its underlying molecular mechanisms in CRC remain unknown. In this study, we found that the expressions of SULF2 in CRC tissues and cell lines were significantly increased compared to control groups. Increased expression of SULF2 was associated with malignant clinical features and poor prognosis of CRC patients. Loss of SULF2 significantly prohibited the proliferation, cell cycle progression, migration and invasion of HT29 cells, while restoration of SULF2 significantly promoted these cellular functions of SW480 cells. In vivo tumorigenicity and liver metastasis assays confirmed that SULF2 knockdown significantly reduced the growth and metastatic abilities of HT29 cells in nude mice. Furthermore, SULF2 knockdown reduced the levels of p-Akt and p-Erk1/2 in HT29 cells, while SULF2 overexpression showed opposite effects on the expressions of these proteins in SW480 cells. In all, SULF2 promotes the growth and metastasis of CRC probably by activating Akt and Erk1/2 pathways. SULF2 potentially serves as a promising biomarker and therapeutic target in CRC.