Fucose containing oligosaccharides from human milk. I. Separation and identification of new constituents.
Neutral oligosaccharides isolated from pooled human milk were subjected to fractionation on high-performance thin-layer chromatography (HPTLC) plates, Iatrobeads, and reverse-phase chromatography after borohydride reduction and peracetylation. By the combined HPLC and HPTLC separation a mixture of pooled human milk oligosaccharides was separated into 101 fractions. These fractions were characterized by field desorption or fast atom bombardment (FAB)-mass spectrometry. Each of the carbohydrate constituents, the peracetylated glucitol, the galactose, the glucosamine, and the fucose contribute specific mass increments to the molecular weight of the oligosaccharide. Therefore, the exact carbohydrate composition can be calculated from the molecular weight determined by mass spectrometry. Among the fractions obtained one trifucosyl-lacto-N-tetraose, five monofucosyl-, eleven difucosyl-, and nine trifucosyl-lacto-N-hexaoses, one monofucosyl-, eight difucosyl-, seven trifucosyl-, four tetrafucosyl-, and two pentafucosyl-lacto-N-octaoses, one trifucosyl-, and two difucosyl-lacto-N-decaoses could be identified. FAB spectra furnished additional data on structural features of the isolated oligosaccharides.


Endoscopic snare papillectomy: a possible radical treatment for a subgroup of T1 ampullary adenocarcinomas.
Pancreaticoduodenectomy is the standard care for invasive ampullary adenocarcinomas. However, endoscopic snare papillectomy (ESP) might play a curative role in very selected patients. We studied a series of 15 patients with T1 ampullary adenocarcinoma who were treated by ESP alone and followed up for a mean of 29.6 ± 21.9 months (range 8 - 81 months). ESP was curative for eight patients (57.1 %). No tumor-related death was observed in patients with a cancer infiltration depth of ≤ 4 mm. According to this preliminary experience, we suggest that this measurable variable threshold should be considered as a possible basis for future large-scale studies.


[Comparative analysis of the peroxidase activity of myoglobins in mammals].
Studies have been made on the peroxidase activity of metmyoglobins in animals from various ecological groups--the horse Equus caballus, cattle Bos taurus, beaver Castor fiber, otter Lutra lutra, mink Mustela vison and dog Canis familiaris. It was found that the level of this activity in diving animals depends on the duration of their diving, whereas in terrestrial species--on the strength of muscular contraction.


Targeted neonatal echocardiography (TnECHO) service in a Canadian neonatal intensive care unit: a 4-year experience.
To characterize the effect of a targeted neonatal echocardiography (TnECHO) program on decision making in a tertiary level unit. Retrospective cohort study of neonates, admitted between September 2007 and April 2011. Details of the TnECHO, and the clinical decisions within 6 h of the consultation were recorded. A total of 199 infants underwent 512 echocardiograms with a median (interquartile range) of 2 (1 to 3) TnECHO studies per infant. The indications included assessment for patent ductus arteriosus (PDA; n=261, 51%), post-PDA ligation assessment (n=101, 19%), pulmonary hemodynamics (n=81, 16%), myocardial performance and systemic blood flow (n=52, 10%), and central venous catheter tip position (n=6, 1%). TnECHO consultation was followed by a change in clinical management in 212 cases (41%) and avoidance of a planned intervention in 112 cases (22%). TnECHO may be a useful tool to guide clinical decisions in the neonatal intensive care unit setting. Well-planned prospective studies are needed to assess the impact of TnECHO on outcomes.


[Hospital morbidity and mortality in children with Down's syndrome: Experience in a university hospital in Chile].
Children with Down's syndrome (DS) have a higher risk of congenital malformations and acute diseases, with increased risk of hospital admissions compared with the general population. This study describes patterns of hospital admissions for children and adolescents with DS. A retrospective study of hospital admissions of children with DS, younger than 15 years old, and cared for by the Paediatric Department of the Hospital Clínico Pontificia Universidad Católica de Chile, between 2008 and 2011. There were 222 admissions of 161 patients with DS during the study period, of which 110 were girls. The median age was 8 months, and the median hospital stay was 6 days. Just over half (56.7%) of the hospital stays were in the Paediatric Critic Care Unit. Heart surgery was performed on 59.4%, and the principal congenital heart defect attended was atrioventricular canal. The principal diagnosis, other than heart surgery, was lower respiratory tract infection. In this series, 3 children died. Children with DS are a relevant group for inpatient care, because their high incidence in Chile, their respiratory and cardiovascular risk, prolonged hospitalizations, high frequency of critical care days and mortality risk. This group has special and complex needs during their hospitalizations and it is necessary to create a multidisciplinary team with competences to take care the particular characteristics of this vulnerable group.


Adrenocortical carcinoma extending into the inferior vena cava in a patient with right kidney agenesis: Surgical approach and review of literature.
Adrenocortical carcinoma (ACC) is a rare malignancy with a poor prognosis and the association with tumor thrombus into the inferior vena cava (IVC) is not common. The best treatment is represented by radical surgery. We describe a case of a large ACC of the left adrenal gland extending into the IVC through the left renal vein in a young patient with agenesis of the right kidney and signs of acute renal failure. A midline laparotomy was performed, subsequently extended by a left thoracophrenotomy through the 7th intercostal space in order to control the proximal surface of the mass and the thoracic aorta. The tumor was completely excised preserving the kidney, and thrombectomy was performed by a cavotomy with a temporary caval clamping, without cardiopulmonary by-pass (CPB). We discuss surgical approaches reported in literature in case of ACC with intracaval extension. The tumor must be completely resected and the thrombectomy can be performed by different approaches: cavotomy with direct suture, partial resection of caval wall without reconstruction, resection of vena cava with graft reconstruction. These procedures could require a CPB, with an increased mortality. In our case we preserved the kidney and a thrombectomy without CPB was performed. Intracaval extension of ACC does not represent a contraindication to surgery. The best treatment of intracaval thrombus should be the cavotomy with direct suture. The CPB is not always required. In presence of renal agenesis, the preservation of the kidney is mandatory.


[Pseudotumoral hepatic tuberculosis. Ultrasonics and x-ray computed tomography apropos of a case].
Results of CT scan and ultrasound exploration were discordant in a patient with the pseudotumoral form of hepatic tuberculosis. Although rare, this localization should not be unrecognized because of the curable nature of the affection. Tissular characterization of lesion was not possible by medical imaging alone and liver puncture-biopsy examination was necessary.


Case control analysis of LRRK2 Gly2385Arg in Alzheimer's disease.
Alzheimer's disease (AD) pathology has been described in Parkinson's disease (PD) patients with leucine-rich repeat kinase-2 (LRRK2) mutations. A common LRRK2 Gly2385Arg variant has been widely shown to be associated with a twofold increased risk of PD in various Asian populations. In a case control study, the frequency of the heterozygous Gly2385Arg genotype was demonstrated in 4.3% of AD compared to 4.5% in controls (odds ratio=0.94, 95% CI 0.37-2.42, p=1.0). The Gly2385Arg variant does not appear to modulate the risk of AD in our population.


Rapid identification of clinically relevant Nocardia species to genus level by 16S rRNA gene PCR.
Two regions of the gene coding for 16S rRNA in Nocardia species were selected as genus-specific primer sequences for a PCR assay. The PCR protocol was tested with 60 strains of clinically relevant Nocardia isolates and type strains. It gave positive results for all strains tested. Conversely, the PCR assay was negative for all tested species belonging to the most closely related genera, including Dietzia, Gordona, Mycobacterium, Rhodococcus, Streptomyces, and Tsukamurella. Besides, unlike the latter group of isolates, all Nocardia strains exhibited one MlnI recognition site but no SacI restriction site. This assay offers a specific and rapid alternative to chemotaxonomic methods for the identification of Nocardia spp. isolated from pathogenic samples.


Postpartum Posterior Reversible Encephalopathy Syndrome (PRES): Three Case Reports and Literature Review.
Posterior reversible encephalopathy syndrome is a rare complication generally associated with headache and acute changes in blood pressure. Delay in the diagnosis and treatment may result in death or in irreversible neurological sequelae. We present three cases of PRES occurring in young women during puerperium. We report a literature review ranged from January 1990 to June 2015 describing clinical features, diagnostic and medical approach, and maternal outcome.


The impact of clearance on mixing time for interface-added substrate.
This study was carried out to find the optimum clearance (impeller to bottom distance) for Rushton and pitch-blade turbine impellers in a stirred tank bioreactor for improved substrate mixing time added at interface, taking advantage of computational fluid dynamics. In this regard, the time needed for a thin layer of liquid, resembling substrate-rich or poor part, getting homogenously dispersed within the tank was calculated. The mixing time calculated in this way is called the surface aeration related mixing time (SARMT). SARMT was calculated using two approaches and was compared with each other. For the pitch-blade turbine impeller, a criterion which guarantees accurate mixing time by simulation was not satisfied, so the SARMT profile against clearance was not achieved. For the Rushton impeller, a general descending order of SARMT against impeller-bottom clearance was observed.


A method to estimate in vivo dynamic articular surface interaction.
This paper describes a method to calculate and visualize the proximity of subchondral bone surfaces during dynamic movement. This method combines high-speed biplane radiographic image data and three-dimensional (3D) bone surface information derived from computed tomography to determine subchondral bone motion during dynamic activities. Knowledge of in vivo subchondral bone motion may be useful in the study of osteoarthritis, in biomechanical modeling, and in identifying normal and pathological joint mechanics. This method can be used to identify the regions of close contact during dynamic motion, to calculate the surface area of subchondral bone within close contact, and to determine the changing position of the close contact area during dynamic activities. None of this informations can be obtained using other currently available 3D motion analysis techniques. Example applications showing dynamic in vivo tibio-femoral bone surface motion during canine gait and human one-legged hopping are presented.


Household catastrophic health expenditure related to pain in Korea.
The data related to pain and catastrophic health expenditure (CHE) needed to be further explored. This study aims to understand the relationship between pain and CHE. Using cross-sectional analysis of 4-year data (2015-2018) from the Korea Health Panel, the prevalence of CHE and adjusted odds ratio (AOR) by pain type were confirmed. Among participants (n = 46,597), the prevalence of pain and severe pain were 24.2% and 1.1%, respectively. The use of medical services in emergency rooms, hospitalizations, and outpatients increased in the order of pain-free, pain, and severe pain (P < 0.001). Prevalence of household CHE was 3.3% vs. 11.1% vs. 25.9%, (P < 0.001). The AOR of CHE was 1.5 (95% confidence interval [CI], 1.4-1.7) for pain and 3.1 (95% CI, 2.5-3.9) for severe pain. Household capacity to pay per year was lower and lower in the order of pain-free, pain, and severe pain ($25,094 vs. $17,965 vs. $14,056, P < 0.001). Also, the household out-of-pocket expenditure per year was higher and higher in the order of pain-free, pain, and severe pain ($1,649, $1,870, $2,331, P < 0.001). It can be inferred that pain is one of the mechanisms of poverty. Positivist healthcare policies for the prevention and management of pain should be sought.


Parainflammation associated with advanced glycation endproduct stimulation of RPE in vitro: implications for age-related degenerative diseases of the eye.
Age related macular degeneration (AMD) is one of the leading causes of blindness in Western society. A hallmark of early stage AMD are drusen, extracellular deposits that accumulate in the outer retina. Advanced glycation endproducts (AGE) accumulate with aging and are linked to several age-related diseases such as Alzheimer's disease, osteoarthritis, atherosclerosis and AMD. AGE deposits are found in drusen and in Bruch's membrane of the eye and several studies have suggested its role in promoting oxidative stress, apoptosis and lipofuscin accumulation. Recently, complement activation and chronic inflammation have been implicated in the pathogenesis of AMD. While AGEs have been shown to promote inflammation in other diseases, whether it plays a similar role in AMD is not known. This study investigates the effects of AGE stimulation on pro- and anti-inflammatory pathways in primary culture of human retinal pigment epithelial cells (RPE). Differential gene expression studies revealed a total of 41 up- and 18 down-regulated RPE genes in response to AGE stimulation. These genes fell into three categories as assessed by gene set enrichment analysis (GSEA). The main categories were inflammation (interferon-induced, immune response) and proteasome degradation, followed by caspase signaling. Using suspension array technology, protein levels of secreted cytokines and growth factors were also examined. Anti-inflammatory cytokines including IL10, IL1ra and IL9 were all overexpressed. Pro-inflammatory cytokines including IL4, IL15 and IFN-γ were overexpressed, while other pro-inflammatory cytokines including IL8, MCP1, IP10 were underexpressed after AGE stimulation, suggesting a para-inflammation state of the RPE under these conditions. Levels of mRNA of chemokine, CXCL11, and viperin, RSAD2, were up-regulated and may play a role in driving the inflammatory response via the NF-kB and JAK-STAT pathways. CXCL11 was strongly immunoreactive and associated with drusen in the AMD eye. The pathways and novel genes identified here highlight inflammation as a key response to AGE stimulation in primary culture of human RPE, and identify chemokine CXCL11 as putative novel agent associated with the pathogenesis of AMD.


Career Intentions and the Determining Factors among Health Science Students: A Systematic Review.
Health systemsneed adequate personnelin order to function; improvements in health-care services delivery, and coverage and the enjoyment of standard healthcare as a right, depend on the availability, mixture, quality, and accessibility of the health-care workforce. This review aimed to synthesize reliable evidence ondetermining factors among health science students' career choices to enhance policy advocacy for better health-care delivery. We sourced empirical studies from Scopus, PubMed, ScienceDirect and Google Scholar. From a total of 9,056 researcharticlesfrom 2010 to 2022, 27 studies with a total of 45,832 respondents met the inclusion criteria. The majority of the studies were of medical students; internal medicine was the commonest choice (64.3%), with psychiatry and public health receiving lesser attention. In the four available studies of nursing students, midwifery was not chosen at all. There is a paucity of studies on this all-important concept for nursing students. The determining factors of choice of specialty were in four themes: personal, socioeconomic, professional, and educational/policy. Among the barriers to choosing particular specialties were low prestige among colleagues, stigma, long working hours, and poor public recognition. The career choices of health science students do not reflect an adequate mix of health-care team members to meet the health-care needs of the world. Reforms of policy and educational training are needed.


The preoperative geriatric nutritional risk index predicts long-term prognosis in elderly locally advanced rectal cancer patients: a two-center retrospective cohort study.
The objective is to explore the value of preoperative geriatric nutritional risk index (GNRI) in evaluating long-term prognosis in elderly locally advanced rectal cancer (LARC) patients who accepted neoadjuvant chemoradiotherapy (NCRT) and to compare GNRI with established nutritional markers, including prognostic nutritional index (PNI) and controlling nutritional status (CONUT) score. Preoperative GNRI was retrospectively assessed in 172 LARC patients aged ≥ 60 years who underwent radical resection after NCRT at two centers. Optimal cutoff value of GNRI was determined by X-tile program. The association of GNRI with clinicopathological parameters and nutritional markers was analyzed. The survival ability of markers was evaluated using time-dependent receiver-operating characteristic (ROC) curve analysis. Finally, survival analysis was performed using Kaplan-Meier and Cox regression analysis. GNRI was highly correlated with nutritional markers. An optimal cutoff value for the GNRI was 96. In the time-dependent ROC curve, GNRI demonstrated a stable predictive ability for both disease-free survival (DFS) and overall survival (OS). Multivariate analysis showed that GNRI was the only nutritional marker that independently predicted DFS (HR 2.457, 95% CI 1.066-5.665, P = 0.035) and OS (HR 9.002, 95% CI 3.100-26.146, P < 0.001). As an additional benefit, GNRI was able to stratify survival in subgroups of ypTNM and tumor response. Preoperative GNRI is a promising predictor of long-term survival for elderly LARC patients undergoing NCRT, superior to the established nutritional markers.


Accessory and Expiratory Muscles Activation During Spontaneous Breathing Trial: A Physiological Study by Surface Electromyography.
The physiological and prognostical significance of accessory and expiratory muscles activation is unknown during a spontaneous breathing trial (SBT). We hypothesized that, in patients experiencing weaning failure, accessory and expiratory muscles are activated to cope with an increased respiratory workload. To describe accessory and expiratory muscle activation non-invasively by surface electromyography (sEMG) during an SBT and to assess differences in electrical activity (EA) of the inspiratory and expiratory muscles in successful vs. failing weaning patients. Intubated patients on mechanical ventilation for more than 48 h undergoing an SBT were enrolled in a medical and surgical third-level ICU of the University Teaching Hospital. Baseline characteristics and physiological variables were recorded in a crossover physiologic prospective clinical study. Of 37 critically ill mechanically ventilated patients, 29 (78%) patients successfully passed the SBT. Rapid shallow breathing index (RSBI) was higher in patients who failed SBT compared with the successfully weaned patients at baseline and over time (group-by-time interaction p < 0.001). EA of both the diaphragm (EAdisurf) and of accessory muscles (ACCsurf) was higher in failure patients compared with success (group-by-time interaction p = 0.0174 and p < 0.001, respectively). EA of expiratory muscles (ESPsurf) during SBT increased more in failure than in weaned patients (group-by-time interaction p < 0.0001). Non-invasive respiratory muscle monitoring by sEMG was feasible during SBT. Respiratory muscles EA increased during SBT, regardless of SBT outcome, and patients who failed the SBT had a higher increase of all the inspiratory muscles EA compared with the patients who passed the SBT. Recruitment of expiratory muscles-as quantified by sEMG-is associated with SBT failure.


Validation of the "CHIIDA" and application for PICU triage in children with complicated mild traumatic brain injury.
The Children's Intracranial Injury Decision Aid (CHIIDA) was developed to predict which patients with complicated mild traumatic brain injury (cmTBI; GCS ≥13 with depressed skull fracture or intracranial injury) would achieve the composite outcome of neurosurgical intervention, intubation >24 h, or death. The study also explored the CHIIDA as a triage tool to determine need for PICU care. The purpose of this study is to externally validate the CHIIDA and assess its effects on PICU triage. Retrospective cohort study (January 2016 to December 2017) to validate the CHIIDA to predict the composite outcome and assess its effects as a PICU triage tool at a level 1 pediatric trauma center. Of 345 patients with cmTBI, the composite outcome occurred in 16 patients (4.6%). At a cutoff score of 2, the CHIIDA predicted the composite outcome with a sensitivity of 94% (95% CI 67-99%) and specificity of 69% (95% CI 64-74%), similar to the original study. Using the same cutoff score for PICU triage resulted in 48 (71%) more patients admitted to PICU. In our cohort, the CHIIDA predicted the composite outcome well. If applied as a triage tool, it would have resulted in increased unnecessary PICU admissions. Level III, prognosis.


Temporal deep learning framework for retinopathy prediction in patients with type 1 diabetes.
The adoption of electronic health records in hospitals has ensured the availability of large datasets that can be used to predict medical complications. The trajectories of patients in real-world settings are highly variable, making longitudinal data modeling challenging. In recent years, significant progress has been made in the study of deep learning models applied to time series; however, the application of these models to irregular medical time series (IMTS) remains limited. To address this issue, we developed a generic deep-learning-based framework for modeling IMTS that facilitates the comparative studies of sequential neural networks (transformers and long short-term memory) and irregular time representation techniques. A validation study to predict retinopathy complications was conducted on 1207 patients with type 1 diabetes in a French database using their historical glycosylated hemoglobin measurements, without any data aggregation or imputation. The transformer-based model combined with the soft one-hot representation of time gaps achieved the highest score: an area under the receiver operating characteristic curve of 88.65%, specificity of 85.56%, sensitivity of 83.33% and an improvement of 11.7% over the same architecture without time information. This is the first attempt to predict retinopathy complications in patients with type 1 diabetes using deep learning and longitudinal data collected from patient visits. This study highlighted the significance of modeling time gaps between medical records to improve prediction performance and the utility of a generic framework for conducting extensive comparative studies.


Sustainable Afterglow Room-Temperature Phosphorescence Emission Materials Generated Using Natural Phenolics.
Long-lived afterglow room-temperature phosphorescence (RTP) from natural phenolics has seldom been reported yet this is essential for the development of sustainable afterglow RTP materials. With this research, we have prepared sustainable afterglow RTP materials (GA@SA) with a lifetime of up to ≈934.7 ms by embedding gallic acid (GA) within a Ca2+ -crosslinked sodium alginate (SA) matrix. Theoretical simulations indicate that the restricted carbonyl moieties of the GA and H-type aggregates of GA in a SA matrix promoted the spin orbit coupling (SOC) of GA and induced afterglow emission. Moreover, afterglow RTP emission could be produced by embedding different types of natural phenolics such as, tannic acid, caffeic acid and chlorogenic acid into Ca2+ -crosslinked networks of SA. As an illustration of potential applications, GA@SA was used to prepare anti-counterfeit afterglow clothing and paper. This work provides an innovative method for the activation of long-lived afterglow RTP from sustainable phenolics.


Novel polyvinylidene fluoride nanofiltration membrane blended with functionalized halloysite nanotubes for dye and heavy metal ions removal.
Membrane separation is an effective method for the removal of hazardous materials from wastewater. Halloysite nanotubes (HNTs) were functionalized with 3-aminopropyltriethoxysilane (APTES), and novel polyvinylidene fluoride (PVDF) nanofiltration membranes were prepared by blending with various concentrations of APTES grafted HNTs (A-HNTs). The morphology structure of the membranes were characterized by scanning electron microscope (SEM) and atomic force microscopy (AFM). The contact angle (CA), pure water flux (PWF) and antifouling capacity of membranes were investigated in detail. In addition, the separation performance of membranes were reflected by the removal of dye and heavy metal ions in simulated wastewater. The results revealed that the hydrophilicity of A-HNTs blended PVDF membrane (A-HNTs@PVDF) was enhanced significantly. Owing to the electrostatic interaction between membrane surface and dye molecules, the dye rejection ratio of 3% A-HNTs@PVDF membrane reached 94.9%. The heavy metal ions rejection ratio and adsorption capacity of membrane were also improved with the addition of A-HNTs. More importantly, A-HNTs@PVDF membrane exhibited excellent rejection stability and reuse performances after several times fouling and washing tests. It can be expected that the present work will provide insight into a new method for membrane modification in the field of wastewater treatment.


Right ventricular performance in chronic congestive heart failure.
Right ventricular physiology is characterized by its close relationship with the pulmonary circuit. The right ventricle can accommodate significant changes in preload, but is highly sensitive to increases in afterload. Progressive dilatation and dysfunction can initiate a cycle of oxygen supply-demand mismatch that ultimately leads to right ventricular failure. Echocardiography and cardiac magnetic resonance imaging are the primary modalities used for non-invasive assessment of right ventricular function. The management of right ventricular failure centers on the optimization of preload, afterload and contractility. Few targeted therapies exist, although novel agents have shown promise in early studies.


Association of dysmorphic intratumoral vessel with high lung shunt fraction in patients with hepatocellular carcinoma.
To evaluate the role of dysmorphic intratumoral vessels as imaging marker for the prediction of high lung shunt fraction (LSF) in patients with hepatocellular carcinoma (HCC). This retrospective study included 403 patients with HCC who underwent a planning arteriography for transarterial radioembolization with administration of 99mTc-macroaggregated albumin to calculate LSF. The LSF was measured by using planar body scans. Two radiologists evaluated the pre-treatment contrast-enhanced CT findings, including tumor number, size, margin, distribution, tumor burden, portal and hepatic vein invasion, early hepatic vein enhancement, and dysmorphic intratumoral vessels. The logistic regression analysis was performed to determine significant predictors for high LSF > 20%. Using the identified predictors, diagnostic criteria for high LSF were proposed. Among 403 patients, 52 (13%) patients had high LSF > 20%, and dysmorphic tumor vessels were present in 115 (28.5%) patients. Predictors for LSF > 20% were tumor size > 11 cm, hepatic vein invasion, early hepatic vein enhancement, and dysmorphic intratumoral vessel. If the patient had three or more of the four predictors for LSF > 20% on imaging, the accuracy and specificity for diagnosing LSF > 20% were 88.8% and 96.3% respectively. Dysmorphic intratumoral vessel in HCC is an imaging marker suggesting a high LSF, which may be applicable to treatment modification or patient exclusion for radioembolization with combined interpretation of tumor size and hepatic vein abnormality.


LC-ESI-MS method for the monitoring of Abl 1 tyrosine kinase.
A liquid chromatography-electrospray ionization-mass spectrometric (LC-ESI-MS) method was developed and validated to study Abl 1 tyrosine kinase. An online desalting system was adopted, and a transformation of the ratio of product to substrate instead of a deuterated internal standard was introduced to calculate the concentration of product. In this study, the substrate used was Abltide (KKGEAIYAAPFA-NH₂). The detection was performed by selected ion monitoring (SIM) mode via positive ESI interface. Chromatographic separation was achieved on a C₁₈ column using an isocratic mobile phase system. The limit of quantification (LOQ) was 10nM for the product and 25 nM for the substrate. The simple ratios of product to substrate maintained a linear relationship (R²=0.9997) over the ratio of 0-50% product. Intra- and inter-day precision was less than 10% and accuracy was from -1.6 to +5.3%. The validated method was applied to the Abl 1 kinase kinetic study and the K(m) and V(max) constants obtained for Abltide were 34.78 μM and 5.563 μmol/mg/min and for adenosine triphosphate (ATP) were 43.61 μM and 5.906 μmol/mg/min. The enzymatic reaction of Abl 1 tyrosine kinase belongs to ternary-complex mechanism.


Trisomies 13 and 18: population prevalences, characteristics, and prenatal diagnosis, metropolitan Atlanta, 1994-2003.
In recent years, prenatal diagnosis and elective pregnancy termination have affected the reported birth prevalence of trisomies 13 and 18. We examined the prevalence and characteristics of these conditions using 1994-2003 data from a population-based surveillance system, the Metropolitan Atlanta Congenital Defects Program. Including fetal deaths and elective terminations increased the number of affected pregnancies by 58.7% for trisomy 13 and 72.2% for trisomy 18. Prenatal cytogenetic testing was reported in 70.8% of trisomy 13 cases and 76.1% of trisomy 18 cases. Among those with prenatal cytogenetic tests, 60.8% of trisomy 13 and 59.7% of trisomy 18 cases were electively terminated. Compared with non-Hispanic whites, non-Hispanic black race was associated with a decreased frequency of prenatal cytogenetic testing for both trisomy 13 and trisomy 18 (OR 0.24, 95% CI: 0.08-0.78 and OR 0.32, 95% CI: 0.14-0.69, respectively). The reported rates of prenatal cytogenetic testing remained stable throughout the period. As expected, maternal age > or =35 years was a risk factor for both conditions. However, while 67.1% (n = 55) of the trisomy 18 case mothers were > or =35 years, only 46.9% (n = 15) of the trisomy 13 case mothers were > or =35 years. Among live-born infants, the sex ratio among trisomy 18 infants showed an increased proportion of females: 60.4% female versus 39.6% male. However, the proportion was 48.3% female and 51.7% male among fetuses that were electively terminated in the second trimester. Inclusion of pregnancies that are prenatally diagnosed is critical for accurate surveillance and population-based analyses of these conditions.


[Polymorphism of a tumor cell population and selective processes. II. Change in the correlation of the numbers of 2 subpopulations of Ehrlich-Ich Ph ascites tumor cells in mice under the action of cell-free ascitic fluid and its fractions].
After repeated injections to mice of cell-free fluid the inhibition of growth of ascitic cell number was noticed already on the 5th day after transplantation of tumor. It was found that the inhibition of growth was due to the death of cells having 45 chromosomes, and containing A + B + 2C- and A + D + 2C-markers.


The Acute to Chronic Pain Transition: Can Chronic Pain Be Prevented?
Chronic postsurgical pain (CPSP) is a distressing disease process that can lead to long-term disability, reduced quality of life, and increased health care spending. Although the exact mechanism of development of CPSP is unknown, nerve injury and inflammation may lead to peripheral and central sensitization. Given the complexity of the disease process, no novel treatment has been identified. The preoperative use of multimodal analgesia has been shown to decrease acute postoperative pain, but it has no proven efficacy in preventing development of CPSP.


Chorioamnionitis with a fetal inflammatory response is associated with higher neonatal mortality, morbidity, and resource use than chorioamnionitis displaying a maternal inflammatory response only.
This study was undertaken to evaluate whether the proximity of infection of the chorion/amnion and fetal vessels affects neonatal outcomes. We examined all (n=2012) infants admitted to the British Columbia's Children's Hospital Neonatal Intensive Care Unit, from January 1996 to October 1997. We included infants with a placental examination (n=1296), and stratified those with histologic chorioamnionitis into cases displaying a maternal inflammatory response only and cases also displaying a fetal inflammatory response (funisitis and/or fetal surface vessel angiitis). Histologic evidence of chorioamnionitis was present in 31% of placentas. Of those, 38% exhibited maternal inflammation only, whereas 62% also exhibited fetal inflammation. Neonatal mortality (9.2% vs 7.2%), morbidity, and resource use were significantly (P < .05) higher when fetal inflammation was present compared with when only maternal inflammation was present. Chorioamnionitis with a fetal inflammatory response is associated with higher neonatal mortality, morbidity, and resource use than when only a maternal inflammatory response is present.


A rapid and reproducible method for the analysis of immune complexes using affinity chromatography and Western blotting.
A new procedure which couples different analytical techniques in a format permitting the rapid analysis of immune complex components is described. Complexes obtained from sera by polyethylene glycol (PEG) precipitation were resuspended and then added, using a batch method, to antibody coupled to Sepharose beads. Antibody directed against either human C1q or human C3c were used in the present study. Bound immune complexes were washed and then eluted from the Sepharose by sodium dodecyl sulphate (SDS) treatment and simultaneously reduced with dithiothreitol. Individual components were separated by SDS gradient polyacrylamide gel electrophoresis and then transferred to nitrocellulose by Western blotting. Individual strips of nitrocellulose were investigated using specific antisera and a radiolabelled probe. Immune complexes (IC) isolated from the sera of 7 rheumatoid arthritis (RA) patients were analysed using this method and the results obtained for both affinity adsorbents compared.


Oxidized low-density lipoprotein as a risk factor of thrombosis in antiphospholipid syndrome.
Beta2-Glycoprotein I (beta2-GPI) is a major antigen for anticardiolipin antibodies (aCL, Abs) present in patients with antiphospholipid syndrome (APS). We recently reported that oxidized LDL(oxLDL) is subsequently targeted by beta2-GPI and anti-beta2-GPI auto-Abs and that-carboxyl variants of 7-ketocholesteryl esters, such as 7-ketocholesteryl-9-carboxynonanoate (oxLig-1) and 7-ketocholesteryl-12-carboxy (keto) octadodecanoate (oxLig-2), are ligands for beta2-GPI (J Lipid Re 2001; 42: 697; J Lipid Res 2002; 43: 1486). These beta2-GPI ligands provide an electrostatic interaction between oxLDL and beta2-GPI followed by forming stable complexes (such as Schiff base adducts). The omega-carboxyl function in these ligand is responsible for beta2-GPI binding to oxLDL and the oxLDL-beta2-GPI complexes are anti-beta2-GPI auto-Ab-dependently taken up by macrophages (i.e., by phagocytosis). Our recent observations are consistent with the evidence that beta2-GPI co-localizes with lymphocytes and mononuclear cells in human athero-plaques. Thus, autoimmune thrombogenesis (atherogenesis) is linked to interaction of anti-beta2-GPI Abs with the beta2-GPI-oxLDL complexes. We propose an alternative idea, that an immune response against the beta2-GPI-oxLDL complexes may be involved in mechanisms in the development of atherosclerosis, which has been explained by the theory of 'the response to injury'.


Correlation between the CAG repeat size and electrophysiological findings in patients with spinal and bulbar muscular atrophy.
Spinal and bulbar muscular atrophy (SBMA) is caused by the expansion of a CAG repeat in the androgen receptor gene. The relationship between the CAG repeat size and electrophysiological findings is not completely understood. We retrospectively analyzed 62 SBMA patients to assess the correlation between their CAG repeat size and electrophysiological findings. In multiple regression analysis including age at examination and disease duration, we identified a negative correlation between the CAG repeat size and the compound muscle action potential (CMAP) amplitude. No significant correlation was found between the CAG repeat size and sensory nerve action potential (SNAP) amplitude. Contrary to previous reports of motor- and sensory-dominant phenotypes correlating with CAG repeat sizes, the CAG repeat size was negatively correlated only with CMAP amplitude, and not with SNAP amplitude. Muscle Nerve 57: 683-686, 2018.


Characterization of positional accuracy of a double-focused and double-stack multileaf collimator on an MR-guided radiotherapy (MRgRT) Linac using an IC-profiler array.
With advance magnetic resonance (MR)-guided online adaptive radiotherapy (MRgoART) relying on calculation-based intensity-modulated radiation therapy (IMRT) quality assurance (QA), accurate and sensitive QA of the multileaf collimator (MLC) becomes an increasingly essential component for routine machine QA. As such, it is important to assure compliance with the AAPM TG142 guidelines to supplement calculation-based QA methods for an online adaptive radiotherapy program. We have developed and implemented an efficient and highly sensitive QA procedure using an ionization chamber profiler (ICP) array to enable real-time characterization of the positional accuracy of a double-focused and double-stacked MLC on a clinical MR-guided radiotherapy (MRgRT) system and to supplement calculation-based QA for an MRgoART program. An in-house MR-compatible jig was used to position the ICP (detector resolution 5 mm on X/Y axis) at an extended SDD of 108.4 cm to enable each MLC leaf (8.3 mm leaf width at isocenter) to be uniquely determined by two neighboring ion chambers. The MRgRT linac system utilizes a novel jawless, double-focused, and double-stacked MLC design such that the upper bank (MLC1) and lower bank (MLC2) are offset by half a leaf width. Positional accuracy was characterized by three methods: single bank half-beam block (HBB) at central axis, forward slash diagonal (FSD), and backslash diagonal (BSD) at off-axis. Measurements were performed for each bank in which each leaf occludes half of a detector. A corresponding reference field with the MLC retracted from occlusion was measured. The sensitivities of HBB, FSD, and BSD were evaluated by introducing 0.5-2.5 mm of known errors in 0.5 mm increments, in both positive and negative directions. The relationship between detector response and MLC error was established. Over a 6-month longitudinal assessment, we have evaluated MLC performance with weekly QA of HBB among cardinal angles, and monthly QA of FSD and BSD. A strong correlation was found between detector response of percentage dose difference and MLC positional error introduced (N = 350 introduced errors) for both HBB and FSD/BSD with coefficient of determination of 0.999 and 0.977, respectively. The relationship between detector response to MLC positional change was found to be 20.65%/mm for HBB and 11.14%/mm for FSD and BSD. At baseline, the mean MLC positional accuracy averaged across all leaves was 0.06 ± 0.27 mm (HBB), 0.04 ± 0.52 mm (FSD), -0.06 ± 0.51 mm (BSD). The mean MLC positional accuracy relative to baseline over the 6-month assessment was found to be highly reproducible at 0.00 ± 0.12 mm (HBB; N = 28 weeks), -0.02 ± 0.19 mm (FSD; N = 6 months), -0.03 ± 0.19 mm (BSD; N = 6 months). Positional accuracy of a novel jawless, double-focused, double-stacked MLC has been characterized and monitored over 6 months with an efficient, highly sensitive, and robust method using an ICP array. This routine QA method supplements calculation-based IMRT QA for an online adaptive radiotherapy program. Longitudinal assessment demonstrated no-drift in the MLC calibration. A highly reproducible jig setup allowed the validation of MLC positional accuracy to be within TG142 criteria of ±1 mm for 99% of measurements (i.e., 100% HBB, 95% BSD, 95% FSD) over the 6-month assessment.


Effect of antipsychotic drugs on brain morphometry. A randomized controlled one-year follow-up study of haloperidol, risperidone and olanzapine.
The effect of antipsychotic drugs on brain morphology is under debate. Here we investigate the effects of risperidone, olanzapine and low doses of haloperidol on cortical and subcortical morphometry in first episode drug naïve patients with non-affective psychosis. Morphological variables were measured in three treatment groups (haloperidol=18; risperidone=16; olanzapine=18) and in healthy subjects (N=38) at baseline and after one year. The relationship between brain morphometric changes and changes in clinical scores was also assessed. At one year, the three antipsychotics had had an equal effect on the gray matter cortical structure, overall and lobes (all p's>0.121.). A significant time-by-group interaction was found in lateral ventricle volume (F2,47=5.65; p=0.006). Post-hoc comparisons revealed a significant increase in lateral ventricles in patients treated with risperidone (p=0.009). Patients exposed to atypicals (olanzapine and risperidone) exhibited a decrease in caudate nucleus volume (p=0.001). In general, brain changes did not account in any significant manner for clinical changes over time in any treatment group. We conclude that low doses of haloperidol, risperidone and olanzapine seem to have an equal effect on the gray matter cortical structure after 1 year of treatment. In contrast to typical antipsychotics, atypicals have differential effects on lateral ventricle and caudate nucleus volumes.


n-3 fatty acids and human health: defining strategies for public policy.
The last quarter of the 20th century was characterized by an increase in the consumer's interest in the nutritional aspects of health. As a result, governments began to develop dietary guidelines in addition to the traditional recommended dietary allowances, which have been superseded now by dietary reference intakes. In addition to governments, various scientific societies and nongovernmental organizations have issued their dietary advice to combat chronic diseases and obesity. Human beings evolved on a diet that was balanced in n-6 and n-3 essential fatty acid intake, whereas Western diets have a ratio of n-6/n-3 of 16.74. The scientific evidence is strong for decreasing the n-6 and increasing the n-3 intake to improve health throughout the life cycle. This paper discusses the reasons for this change and recommends the establishment of a Nutrition and Food Policy, instead of a Food and Nutrition Policy, because the latter subordinates the nutritional aspects to the food policy aspects. Nutrition and food planning comprise a tool of nutrition and food policy, whose objectives are the achievement of the adequate nutrition of the population as defined by nutritional science. The scientific basis for the development of a public policy to develop dietary recommendations for essential fatty acids, including a balanced n-6/n-3 ratio is robust. What is needed is a scientific consensus, education of professionals and the public, the establishment of an agency on nutrition and food policy at the national level, and willingness of governments to institute changes. Education of the public is essential to demand changes in the food supply.


Effect of prostaglandin analogue on progesterone-treated pony mares during early pregnancy.
Seven Welsh pony mares (9 pregnancies) received either 50 mg, 100 mg or 150 mg progesterone on alternate days, starting on day 21 of gestation. All but 2 pregnancies failed following prostaglandin administration on day 27. Although both mares were receiving the 150 mg progesterone dose rate, this treatment was not consistently successful in preventing pregnancy failure after prostaglandin administration.


Comparison of abortions induced by methotrexate or mifepristone followed by misoprostol.
To compare the effectiveness, side effects, and acceptability of medical abortions induced by methotrexate and misoprostol with abortions induced by mifepristone and misoprostol. This was a multicenter, randomized, nonblinded, controlled trial comparing 50 mg/m(2) of methotrexate followed 4-6 days later by 800 microgram of vaginal misoprostol with 600 mg of oral mifepristone followed 36-48 hours by 400 microgram of oral misoprostol. There were 518 women in the methotrexate group and 524 women in the mifepristone group. In the methotrexate group, 21 women required suction curretage, two for continuing pregnancy, eight because of physician request (usually for excessive bleeding), and 11 because of patient request. In the mifepristone group, 22 women needed surgical termination, 17 because of physician request, and five because of patient request. By day 8, only 386 (74.5%) in the methotrexate group had completed the abortion compared with 474 (90.5%) in the mifepristone group, and the mean number of days from beginning to completion was 7.1 for methotrexate and 3.3 for mifepristone (P </=.001). There were no differences in complications, and side effects were similar. Acceptance was slightly higher with mifepristone (88.0%) than with methotrexate (83.2%). Abortions induced with mifepristone completed faster than those induced with methotrexate, but the overall success rates, side effects, and complications were similar. Acceptance rates were slightly higher with mifepristone than methotrexate (P =.03).


Nuclear and chloroplast genetic structure indicate fine-scale spatial dynamics in a neotropical tree population.
Dicorynia guianensis is a canopy tree, endemic to the tropical rain forest of French Guiana. We compared generational and spatial genetic structure for maternally and biparentally inherited markers in two cohorts (adult and seedling) in order to infer processes shaping the distribution of genetic diversity. The study was conducted on a 40 ha study plot located at Paracou near Kourou, where 172 adults trees and 375 saplings were sampled. Aggregation of trees was therefore suggested at different distances, ranging from 100 to 400 m. There was a strong link between demographic and genetic spatial structures at small distances (less than 100 m) that is likely to be the consequence of restricted seed dispersal. Genetic differentiation was more pronounced between spatial aggregates than between cohorts. Despite the spatial differentiation, the species was able to maintain high levels of diversity for maternal genomes, suggesting rapid turnover of aggregates. Spatial autocorrelation was larger for chloroplast than nuclear markers indicating a strong asymmetry between pollen and seed flow. Fixation indices indicated a lower heterozygote deficiency for the adults, maybe because of gradual elimination of selfed trees. Genetic relatedness at lower distances was higher in adult trees than in saplings, as a result of generation overlapping in the adult cohort. Overall, our results confirm earlier biological knowledge about the dispersion mechanisms of the species, and lead to an enhanced role of spatial processes in the dynamics of genetic diversity of D. guianensis.


[Prevalence of dental and mucosal lesions among the pediatric population who attended the emergency department of a general hospital].
The high prevalence of oral pathology in children encourages to gain further understanding on their manifestations and urgent nature, objective of the present study Methodology. Cross-sectional study that included patients aged <14 years of age who attended an emergency department over a one-year period. The relationship between the variables collected and oral pathology was analyzed. Fifty-five patients were included, 45.5% girls, mean age 4.11 years (10 days to 13 years). Overall, mucosal pathology (74.5%) prevailed over dental ones, and lesions of infectious origin (54.6%) over the traumatic ones (14.5%). Dental pathology (50% toothache and 35.7% infections) was significantly associated with being >6 years (66.7 vs 10%), pain (40.7 vs 10.7%) and absence of fever (37.9 vs 11.5%). Mucosal pathology (61% infections: 53.7% viral and 31.7% due to herpangina) was significantly associated with being =6 years (60 vs 6.7%) and having fever (76.9 vs 17.2%). Six traumatic lesions on the mucosa and two on the teeth were observed; significantly more patients attended the emergency room within 24 hours (median =1 hour) than in the case of infection (100 vs 51.7%). Being =6 years was significantly associated with fever, mucosal pathology, mucosal infection, and herpangina, and being >6 years was associated with pain, previous antibiotic treatment and at discharge, and previous NSAID regimen. The analyzed pediatric oral pathologies treated in the emergency department are of mucosal and infectious origin. Dental disease prevail in children >6 years of age and mucosal lesions in those =6 years; no sex differences are observed.


Geometric survey on magnetic resonance imaging of growth hormone producing pituitary adenoma.
Apart from the radiologic features regarding size and invasiveness, we had noticed some differences in morphology among types of pituitary adenomas. We conducted this study to verify the differences in radiologic morphology between growth hormone producing pituitary adenomas (GHoma) and nonfunctioning pituitary adenomas (NFoma). Pre-surgical magnetic resonance images (MRIs) were assessed in 50 cases of GHoma and 50 cases of NFoma. Geometric parameters on MRI were set in accordance with sellar anatomy. Intensity of T1-weighted image was not different between the two groups, but hypo-intensity of T2-weighted image was more frequently seen in GHoma. Predominant inferior extension of tumor was seen mostly in GHoma (88 vs. 38%). Extension of the tumor to the superior compartment of cavernous sinus was more frequent in NFoma. Pituitary gland was generally located superior to GHoma and postero-superior to NFoma. Growth characteristics of pituitary adenoma were confirmed to differ between GHoma and NFoma.


Possible involvement of inositol phosphoglycan-P in human parturition.
Preterm labour is a major cause of neonatal morbidity and mortality but the pathophysiology that underlies preterm labour is unknown. Inositolphosphoglycans (IPGs) comprise a ubiquitous family of putative carbohydrate second messengers and they have been linked to the pathogenesis of various conditions, including diabetes and pre-eclampsia. Studying IPG-P levels in normal and pre-eclamptic pregnancies, we noticed a constant rise of urinary IPG-P levels in all women at the time of delivery. A prospective pilot study of urinary IPG-P levels in 23 non-labouring and labouring women with uncomplicated pregnancies has, therefore, been performed. Levels of urinary IPG-P were significantly higher in labour than in the non-labouring group (P<0.0001). These higher levels have been found in both spontaneous and induced labour. The clinical significance of this observation with particular reference to the onset of labour itself is discussed.


Repeated transmission of SARS-CoV-2 in an overcrowded Irish emergency department elucidated by whole-genome sequencing.
To provide a detailed genomic-epidemiological description of a complex multi-ward SARS-CoV-2 outbreak, which originated in the crowded emergency department (ED) in our hospital during the third wave of the COVID-19 pandemic, and was elucidated promptly by local whole-genome sequencing (WGS). SARS-CoV-2 was detected by reverse transcriptase real-time polymerase chain reaction on viral RNA extracted from nasopharyngeal swabs. WGS was performed using an Oxford MinION Mk1C instrument following the ARTIC v3 sequencing protocol. High-quality consensus genomes were assembled with the artic-ncov2019 bioinformatics pipeline and viral phylogenetic trees were built, inferred by maximum-likelihood. Clusters were defined using a threshold of 0-1 single nucleotide polymorphisms (SNPs) between epidemiologically linked sequences. In April 2021, outbreaks of COVID-19 were declared on two wards at University Hospital Limerick after 4 healthcare-associated SARS-CoV-2 infections were detected by post-admission surveillance testing. Contact tracing identified 12 further connected cases; all with direct or indirect links to the ED 'COVID Zone'. All sequences were assigned to the Pangolin B.1.1.7 lineage by WGS, and SNP-level analysis revealed two distinct but simultaneous clusters of infections. Repeated transmission in the ED was demonstrated, involving patients accommodated on trolleys in crowded areas, resulting in multiple generations of infections across three inpatient hospital wards and subsequently to the local community. These findings informed mitigation efforts to prevent cross-transmission in the ED. Cross-transmission of SARS-CoV-2 occurred repeatedly in an overcrowded emergency department. Viral WGS elucidated complex viral transmission networks in our hospital and informed infection, prevention and control practice.


Bronchoalveolar lavage in rheumatoid arthritis and secondary Sjögren's syndrome.
Bronchoalveolar lavage (BAL) was performed to investigate pulmonary involvement in 39 patients with rheumatoid arthritis (RA) and in 7 patients with RA and secondary Sjögren's syndrome, and compared to 12 healthy controls. Lymphocytosis (more than 15%) was seen in 25, and more than 3% neutrophil granulocytes in 8 of 39 patients with RA. Lymphocytosis and/or neutrophil granulocytosis was seen in both seropositive and seronegative patients irrespective of clinical or radiologic findings. Patients with RA with or without secondary Sjögren's syndrome had increased DR+ lymphocytes in BAL compared with peripheral blood. In 7 patients with secondary Sjögren's syndrome an increased helper/suppressor cell index (OKT4+/OKT8+: 7.65 +/- 2.10) and increased natural killer cells (OKNK+: 27.3 +/- 5.5%) were found, as compared to 39 other patients with RA (OKT4+/OKT8+: 2.16 +/- 0.33, p less than 0.05; OKNK+: 14.5 +/- 2.3%, p less than 0.05). These BAL data are further evidence of frequent subclinical interstitial pulmonary involvement in RA with differences in the active autoimmune process from those in secondary Sjögren's syndrome.


Left atrium of the human adult heart contains a population of side population cells.
Cardiac "side population" (SP) cells have previously been found to differentiate into both endothelial cells and cardiomyocytes in mice and rats, but there are no data on SP cells in the human adult heart. Therefore, human cardiac atrial biopsies were dissociated, stained for SP cells and analyzed with FACS. Identified cell populations were analyzed for gene expression by quantitative real-time PCR and subjected to in vitro differentiation. Only biopsies from the left atrium contained a clearly distinguishable population of SP cells (0.22 ± 0.08%). The SP population was reduced by co-incubation with MDR1 inhibitor Verapamil, while the ABCG2 inhibitor FTC failed to decrease the number of SP cells. When the gene expression was analyzed, SP cells were found to express significantly more MDR1 than non-SP cells. For ABCG2, there was no detectable difference. SP cells also expressed more of the stem cell-associated markers C-KIT and OCT-4 than non-SP cells. On the other hand, no significant difference in the expression of endothelial and cardiac genes could be detected. SP cells were further subdivided based on CD45 expression. The CD45-SP population showed evidence of endothelial commitment at gene expression level. In conclusion, the results show that a SP population of cells is present also in the human adult heart.


Two novel begomoviruses belonging to different lineages infecting Rhynchosia minima.
Rhynchosia minima is a host for several begomoviruses, both in the Old World and the New World. In Cuba, a whitefly-transmitted disease causing yellow mosaic symptoms, suggested to be of viral origin, was described more than 30 years ago in R. minima, but no information about the nature of the viruses infecting this weed in this country is available to date. Here, we report the detection of isolates of two novel begomovirus species infecting R. minima in Cuba, which we proposed be named Rhynchosia golden mosaic Havana virus (RhGMHaV) and Rhynchosia rugose golden mosaic virus (RhRGMV). The highest nucleotide sequence identities of RhGMHaV and RhRGMV DNA-A were with isolates of Rhynchosia golden mosaic virus (78.7%) and Sida golden mosaic virus (87.5%), respectively. Phylogenetic analysis demonstrated that these novel viruses belong to two different lineages of New World begomoviruses.


The hydrolysis of cholesterol esters in plasma lipoproteins by hormone-sensitive cholesterol esterase from adipose tissue.
Adipose tissue contains a high level of neutral esterase active against emulsions of cholesteryl oleate. The present studies show that this enzyme can also effectively hydrolyze the cholesterol esters in native rat plasma high density lipoproteins (HDL) and low density lipoproteins (LDL). The hydrolysis of lipoprotein cholesterol esters by a pH 5.2 isoelectric precipitate fraction from the freshly prepared 100,000 X g supernatant of chicken adipose tissue was low, but increased more than 50-fold on activation with cyclic AMP-dependent protein kinase. Rat adipose tissue homogenates were also very active against lipoprotein cholesterol esters, hydrolyzing as much as 60% of the total labeled cholesterol ester in HDL or LDL in 1 h. Activity was optimal at pH 7 and very low at pH 4. No protease activity was detected at pH 7 and, since assays were done in 2 mM EDTA, phospholipase A activity was presumably negligible. The results show that hormone-sensitive cholesterol esterase of adipose tissue has ready access to the neutral lipid core of plasma lipoproteins, either because the enzyme penetrates the polar shell or because the cholesterol ester in the core is exposed, at least intermittently, to allow enzyme-substrate complex formation. Whether or not this enzyme activity plays a role in lipoprotein degradation by adipose tissue remains to be determined.


Bacteriological profiles and drug susceptibility of Streptococcus isolated from conjunctival sac of healthy children.
To investigate bacterial flora and antibiotics susceptibility of Streptococcus pneumoniae isolated from the conjunctival sac of heathy children. Bacteria were isolated from the secretions of conjunctival sac of healthy children between 2015 and 2018. Antimicrobial susceptibility of isolated S. pneumoniae strains were determined using microbroth dilution method. The sac secretions were collected from a total of 6440 children. 1409 samples presented bacterial growth, accounting for 21.8% of the samples. Among the 22 bacterial species isolated, 528 samples presented Gram-positive Staphylococcus spp. growth, accounting for 37.4% of the isolates, followed by Corynebacterium spp., counting for 30% of the isolates and Streptococcus pneumoniae, counting for 21.4% of the isolates. Antibiotics susceptibility tests showed that the majority of S. pneumoniae isolates were sensitive to most antibiotics tested. However, 72.8 and 81.2% of the isolates were resistant to erythromycin and tetracycline, respectively, and over 10% of them were resistant to gentamicin, tobramycin and rifampicin. The bacterial flora of healthy children is mainly consisted of Gram-positive bacteria belonging to Corynebacterium spp. and Streptococcus spp.; most of S. pneumoniae isolates were sensitive to antibiotics except erythromycin and tetracycline.


Enhanced solubilization of immunoreactive proteins from Brugia malayi adult parasites using cetyltrimethylammonium bromide.
To determine an optimal method for extracting immunoreactive proteins from filarial parasites, we have subjected Brugia malayi adult worms to a variety of solubilization regimens and compared the results. The parasites were extracted in one of seven detergents (including anionic, cationic, nonionic, and zwitterionic compounds) under varying conditions of pH, detergent concentrations, and incubation time. The individual antigen preparations were then compared both by one-dimensional SDS-PAGE and by immunoblotting analysis using a serum pool from individuals resident in an area endemic for lymphatic filariasis. The cationic detergent cetyltrimethylammonium bromide (CTAB) at 1.0% concentration, pH 7.2, consistently solubilized more proteins immunoreactive with the sera tested. Additionally, CTAB never failed to solubilize immunoreactive proteins solubilized by those other detergents or combinations of detergents studied.


Immunosuppression by Fc region-mismatched anti-T cell antibody treatment.
Formation of anti-antibodies (anti-Ab) is known to counteract immunotherapy with anti-T cell antibodies. Our previously described immunological approach prevented anti-Ab with the consequence of prolonged survival of fully mismatched skin grafts in C57BL/6 mice. These mice were treated with a single priming injection of a monoclonal anti-T cell Ab followed by repeated injections of anti-T cell mAb differing in species origin from the priming mAb. We now show prolonged tolerance to discordant xenogeneic, to bispecific, and even to polyclonal Ab, and demonstrate that the underlying immunosuppressive principle is due to a difference in heavy chain constant region between first and second antibodies, independent of whether or not they share the same idiotype. To examine this phenomenon, a panel of mAb was generated which share the same mouse anti-Thy-1.2 idiotype, but carry a human IgG1(T23), IgG3(T212C8), or mouse IgG2a(MmT1) constant heavy chain region. We found that sequential injection of MmT1 and T23 according to the above treatment schedule induced huIgG1 isotype-specific tolerance to T23, which was similar to that seen when using a primary mAb (MmT5) that was, instead, fully mismatched with T23 in both idiotype and constant region. Thus, differences of idiotype between primary and booster Ab were inconsequential for their ability to inhibit anti-Ab formation. This novel form of induced specific tolerance to anti-T cell Ig survived graft rejection and was still evident 230 days after termination of the T cell depletion protocol. Taken together, these results demonstrate that rechallenge with Fc region-mismatched Ab opens an immunological window that allows for induction of tolerance to immunogenic anti-T cell Ab and prolonged immunosuppression.


Medicinal plant inventory of Kuna Indians: Part 1.
Results of an ethnopharmacognostic survey of 90 plants used by the Kuna Indians of San Blas Islands, who live in Ailigandí, are listed. Results of a literature search are also reported, including medical uses, known constituents and pharmacological effects.


Assessment and modeling of E-waste generation based on growth rate from different telecom companies in the State of Kuwait.
The present work assesses the production rate of cell phone e-waste in Kuwait by comparing the number of clients in three telecommunication service providers like Zain, Ooredoo, and Viva in the state of Kuwait over a period of 7 years from 2008 to 2015. An online survey was conducted to evaluate the growth in the number of clients in three cell phone companies, and the data analysis was carried out using statistical package for the social sciences (SPSS) software. The prediction of the growth percentage of the number of clients in each telecommunication company was analyzed using analysis of variance (ANOVA) test and followed by the regression model. The study shows that there is an increase in the number of clients in all three companies (Zain, Ooredoo, and Viva) between year 2008 and 2015, and it was estimated that approximately 7.9 million cell phone users would be achieved in the first quarter of 2015. Based on this predicted number of cell phone users, the production of e-waste would be 3 kt per year with an average growth of 12.7%.


Metabolic tapetoretinal degenerations.
There are a number of metabolic diseases which cause tapetoretinal degeneration, suggesting that pure pigmentary retinopathy may also be metabolic in nature. On the other hand tapetoretinal degenerations may have various modes of inheritance, so we may conclude that the metabolic disorder at the basis of these diseases is not unique and that tapetoretinal degenerations are heterogenic. In this article, some 450 published reports on tapetoretinal degenerations are reviewed. Based on these reports, the clinical and ocular manifestations, laboratory and histopathological findings, inheritance patterns, and treatments of various syndromes characterized by tapetoretinal degenerations are described. It is hoped that the gathering together of this information in one source will acid in the future understanding of metabolically based eye disease.


Taper fretting corrosion with Stryker Anato stem after hip replacement.
We report a case of head-neck taper fretting corrosion in a patient who had a total hip replacement with a noncemented Stryker Anato femoral stem and a V40 metal head with a Stryker Tritanium hemispherical socket with a highly cross-linked polyethylene liner (metal on polyethylene) (Stryker, Mahwah, NJ, USA). A 57-year-old man presented with early-onset hip pain after right total hip arthroplasty. Workup was negative for infection. Metal artifact reduction sequence MRI revealed an encapsulated fluid mass. Metal ion cobalt level was elevated at 6 ppb. The patient underwent right revision total hip arthroplasty with excellent results at 1-year follow-up.


Gaps in Postnatal Support for Intended Parents.
To identify gaps in postnatal depression screening and support services for intended parents (parents who are intended to receive the baby from a gestational surrogacy pregnancy), also known as commissioned parents. This descriptive study used quantitative and free-text survey questions designed to assess postnatal depression screening and postnatal services available for all parents and, more specifically, for intended parents. The survey was sent to 2,000 randomly selected postpartum nurses in the United States who are members of the Association of Women's Health, Obstetric and Neonatal Nurses. Completion of the survey was offered to the 125 nurses who responded that they provided care for intended parents. Thirty-seven percent of respondents indicated that postpartum support services are available for both parents. Free-text responses describe a gap in postnatal services for intended parents. Although 85% of survey respondents reported that postpartum depression screening occurs in their setting, nurses reported neither fathers nor intended parents are screened for postnatal depression. This study expands the known gap in postnatal support services for intended parents, including postnatal depression screening. Recommendations for nurses working in the perinatal setting include providing consistent support for all parents as they transition to parenthood. Creating standardized policies and practices reflecting the diverse needs and cultures of intended parents can help direct all clinicians toward providing more significant support. Adapting current postnatal screening and support systems could provide a continuum of support for all families.


Growth factor activity in luminal fluids from the male reproductive tract of the ram, rat, tammar wallaby (Macropus eugenii) and Japanese quail (Coturnix coturnix japonica).
Growth factor activity in luminal fluids from the male reproductive tract was assayed by measuring the stimulation of [3H]thymidine incorporation into BALB/c 3T3 fibroblasts. The potency of fluids from the rete testis of the rat, ram, tammar wallaby and Japanese quail was much the same. However, about 90% of the activity in fluid from the rete testis of the rat and tammar was lost during its passage through the epididymis.


Author Correction: Non-invasive monitoring of chronic liver disease via near-infrared and shortwave-infrared imaging of endogenous lipofuscin.
A Correction to this paper has been published: https://doi.org/10.1038/s41551-020-0569-y.


Identification of novel CR1 subfamilies in an avian order with recently active elements.
Chicken repeat 1 (CR1) is a taxonomically widespread non-LTR retrotransposon. Recent CR1 retrotranspositions in waterfowl suggested that, unlike chicken at least one subfamily remains active. Based on sequence information from 143 CR1 loci, six distinct groups of CR1 within the waterfowl coscoroba each with unique 3' untranslated regions and distinct open reading frames are described. Through comparison to other previously described avian CR1 subfamilies, it is shown that five of the six coscoroba groups represent new subfamilies. At least one of these subfamilies is likely active and provides a target for future isolation of the first active member of this taxonomically widespread non-LTR family.


Dual-modality imaging of endothelial progenitor cells transplanted after ischaemic photothrombotic stroke.
Stroke is a refractory cerebral blood circulation disorder. Endothelial progenitor cells (EPCs) participate in the repair and regeneration of vascular injury through the combination of cell replacement and bystander effects. Here, we evaluated the biological function of EPCs in treating a mouse model of cerebral ischaemic stroke, using dual-mode bioluminescence and magnetic resonance imaging to trace EPCs in vivo. We constructed a viral vector with a luciferase-enhanced green fluorescent protein (Luc-eGFP) reporter gene for bioluminescence imaging (BLI) detection, and simultaneously synthesized the magnetic resonance imaging (MRI) contrast agent, nano-sized superparamagnetic iron oxide (USPIO), to co-label human umbilical cord blood-derived EPCs (hEPCs). The labelled hEPCs were transplanted into mice with stroke, and the biological behaviours of the cells in-vivo were studied using BLI and MRI, and methods of molecular biology and histology. Comparing the two cell transplantation routes by BLI confirmed that many cells transplanted via the left ventricular route homed to ischaemic brain tissue. The dual-modality-imaging showed the prognosis of in-vivo tracking cells after transplantation in ischaemic tissues at different time points. Histological staining and neurological function scores confirmed that EPC transplantation can improve the symptoms of nerve deficit in the mouse stroke model. Histological staining revealed that cell transplantation can lead to recovery of neurological function after stroke, via various processes. These include reduced blood brain barrier permeability, recovery of white matter and of myelin, and the enhancement of neuroneogenesis. Dual-modality imaging revealed EPCs as potential candidates for the treatment of ischaemic stroke.


Biogas production and microbial community shift through neutral pH control during the anaerobic digestion of pig manure.
Laboratory-scale reactors, in which the pH could be auto-adjusted, were employed to investigate the mesophilic methane fermentation with pig manure (7.8% total solids) at pH 6.0, 7.0, and 8.0. Results showed that the performance of anaerobic digestion was strongly dependent on pH value. Biogas production and methane content at neutral pH 7.0 were significantly higher (16,607mL, 51.81%) than those at pH 6.0 (6916mL, 42.9%) and 8.0 (9739mL, 35.6%). Denaturing gradient gel electrophoresis fingerprinting and Shannon's index indicated that the samples contained highly diverse microbial communities. The major genus at pH 7.0 was Methanocorpusculum, compared with that was Methanosarcina at both pH 6.0 and 8.0. Our research revealed that cultures maintained at pH 7.0 could support increased biogas production, which has significant implications for the scale-up biogas engineering.


Denonvilliers' Fascia: The Prostate Border to the Outside World.
The fascial structure around the prostate has been a controversial issue for several decades, but its role in radical prostatectomy is crucial to achieving successful nerve-sparing surgery. One of the fasciae surrounding the prostate is Denonvilliers' fascia, forming its posterior border with the rectum and enclosing along its layers several fibers of the neurovascular bundle. This review focuses on embryological and anatomical points of Denonvilliers' fascia, aiming to provide a summary for the operating general surgeons and urologists of this area.


Cost analysis of biologic drugs in rheumatoid arthritis first line treatment after methotrexate failure according to patients' body weight.
The objective was to assess the influence of patients' weight in the cost of rheumatoid arthritis treatment with biologic drugs used in first line after non-adequate response to methotrexate. Pharmaceutical and administration costs were calculated in two scenarios: non-optimization and optimization of intravenous (IV) vials. The retrospective analysis of 66 patients from a Spanish 1,000 beds-hospital Rheumatology Clinic Service was used to obtain posology and weight data. The study time horizon was two years. Costs were expressed in 2013 euros. For an average 69kg-weighted patient the lowest cost corresponded to abatacept subcutaneous (SC ABA) (€21,028.09) in the scenario without IV vials optimization and infliximab (IFX) (€20,779.29) with optimization. Considering patients' weight in the scenario without IV vials optimization infliximab (IFX) was the least expensive drug in patients ranged 45-49kg, IV ABA in 50-59kg and SC ABA in patients over 60kg. With IV vials optimization IFX was the least expensive drug in patients under 69kg and SC ABA over 70kg. Assuming comparable effectiveness of biological drugs, patient's weight is a variable to consider, potentials savings could reach €20,000 in two years.


One-Year Health Care Utilization and Recurrence After Incisional Hernia Repair in the United States: A Population-Based Study Using the Nationwide Readmission Database.
Most data on health care utilization after incisional hernia (IH) repair are limited to 30-days and are not nationally representative. We sought to describe nationwide 1-year readmission burden after IH repair (IHR). Patients undergoing elective IHR discharged alive were identified using the 2010-2014 Nationwide Readmission Database. Transfers and incomplete follow-up were excluded. Descriptive statistics were used to describe rates of 1-year readmission, IH recurrence, and bowel obstruction. Cox regression allowed identification of factors associated with 1-year readmissions. Generalized linear models were used to estimate predicted mean difference in cumulative costs/year, which allowed estimation of IHR readmission costs/year nationwide. Of 15,935 identified patients, 19.35% were readmitted within 1 y. Patients who were readmitted differed by insurance, Charlson index, illness severity, smoking status, disposition, and surgical approach compared with those who were not (P < 0.05). Of readmitted patients, 39.3% returned within 30 d; 50.9% and 25.6% were due to any and infectious complications, respectively; 25.6% presented to a different hospital; 35.4% required reoperation; 5.4% experienced bowel obstruction; and 5% had IHR revision. Factors associated with readmissions included Medicare (hazard ratio [HR] 1.46 [95% confidence interval 1.19-1.8]; P < 0.01) or Medicaid (HR 1.42 [1.12-1.8], P < 0.01); chronic pulmonary disease (1.38 [1.17-1.64], P < 0.01), and anemia (1.36, [1.05-1.75], P = 0.02). Readmitted patients had higher 1-year cumulative costs (predicted mean difference $12,190 [95% CI: 10,941-13,438]; P < 0.01). Nationwide cost related to readmissions totaled $90,196,248/y. One-year readmissions after IHR are prevalent and most commonly due to postoperative complications, especially infections. One-third of readmitted patients require a subsequent operation, and 5% experience IH recurrence, intensifying the burden to patients and on the health care system.


Molecular diversity of endosymbiotic Nephroselmis (Nephroselmidophyceae) in Hatena arenicola (Katablepharidophycota).
Hatena arenicola (Katablepharidophycota) is a single-celled eukaryote that temporarily possesses a chlorophyte alga of the genus Nephroselmis as an intracellular symbiont. In the present study, we investigated the molecular diversity of the endosymbiont Nephroselmis in a natural population of the host H. arenicola. We sequenced the host's 18S rRNA gene and the endosymbiont's plastid-encoded 16S rRNA gene. The results indicated that almost identical strains of the host harbored at least three distinct strains of the algal endosymbiont affiliated to the clade Nephroselmis rotunda. This finding supports our previous hypothesis that H. arenicola and its symbiotic alga are in an early stage of secondary endosymbiosis.


Robotic Retrocaval Metastasectomy After an Ipsilateral Radical Nephrectomy.
Robotic management of a retrocaval metastasis can be challenging because of prior surgery leading to scarring and obscure surgical planes around vital structures. We present our robotic approach and technique to manage a large retrocaval, biopsy-proven, metastatic mass after previous laparoscopic right radical nephrectomy with concomitant adrenalectomy 10 years ago. We present a 62-year-old man who previously underwent a laparoscopic right radical nephrectomy for pT1bNxMx chromophobe renal cell carcinoma (RCC) in 2007. Surveillance imaging in November 2016 indicated a 5-cm retrocaval mass, and biopsy confirmed the metastasis. The patient was positioned in standard robotic positioning for right renal surgery. Meticulous dissection was required to free the duodenum and inferior vena cava from the mass, enabling the mass to be lifted anteriorly. Posteriorly, a labyrinth of vessels required hem-o-lok clips before excision, which allowed complete extraction of the mass. Operative time was 234 minutes and estimated blood loss was 40 cc. Final pathology revealed a right 5 cm × 3.1 cm metastatic RCC, chromophobe-type, lymph node. The surgical margins were negative for tumor. We present a successful surgical outcome of a robotic retrocaval metastasectomy for recurrent RCC, chromophobe type. At the time of publication, the patient continues to remain cancer free. Incorporating the da Vinci robotic platform allows for excellent visualization and access to difficult surgical locations while providing patients with the least invasive approach. A high degree of robotic experience is necessary before attempting this procedure, given the adherence of the mass to the inferior vena cava and duodenum.


Impact of preculture temperature on peracetic acid-induced inactivation and sublethal injury of L. monocytogenes and subsequent growth potential of single cells.
The disinfectant peracetic acid (PAA) that is used in the food industry can cause sublethal injury in L. monocytogenes. The effect of preculture temperature on the inactivation and sublethal injury of L. monocytogenes cells due to PAA was evaluated by plating on non-selective and selective agar medium supplemented with 5 % (w/v) NaCl. L. monocytogenes cells were precultured at 30 °C, 20 °C or 4 °C, and the former was used as reference temperature. Preculture of cells at 20 °C or 4 °C and subsequent exposure to PAA at the respective growth temperatures caused higher injury compared to cells grown at 30 °C and exposed to PAA 20 °C and PAA 4 °C, respectively. Survival was also affected by the preculture temperature; 20 °C-grown cultures resulted in lower survival at PAA 20 °C. Nevertheless, preculture at 4 °C resulted in a similar number of surviving cells when exposed to PAA 4 °C compared to cells precultured at 30 °C and exposed to PAA at 4 °C. Flow cytometry was subsequently used to quantify outgrowth capacity of stressed and sublethal damaged populations following sorting of single cells in nutrient rich medium (Tryptone soy broth supplemented with yeast extract [TSBY]). PAA treatment affected the outgrowth of L. monocytogenes at single-cell level resulting in increased outgrowth-times reflecting higher single cell heterogeneity. To conclude, the response of L. monocytogenes when exposed to PAA depended on the preculture conditions, and the highly heterogeneous outgrowth potential of PAA-injured cells may affect their detection accuracy and pose a food safety risk.


Optimization of microporous palm shell activated carbon production for flue gas desulphurization: experimental and statistical studies.
Optimizing the production of microporous activated carbon from waste palm shell was done by applying experimental design methodology. The product, palm shell activated carbon was tested for removal of SO2 gas from flue gas. The activated carbon production was mathematically described as a function of parameters such as flow rate, activation time and activation temperature of carbonization. These parameters were modeled using response surface methodology. The experiments were carried out as a central composite design consisting of 32 experiments. Quadratic models were developed for surface area, total pore volume, and microporosity in term of micropore fraction. The models were used to obtain the optimum process condition for the production of microporous palm shell activated carbon useful for SO2 removal. The optimized palm shell activated carbon with surface area of 973 m(2)/g, total pore volume of 0.78 cc/g and micropore fraction of 70.5% showed an excellent agreement with the amount predicted by the statistical analysis. Palm shell activated carbon with higher surface area and microporosity fraction showed good adsorption affinity for SO2 removal.


Metabolic engineering of microorganisms for production of aromatic compounds.
Metabolic engineering has been enabling development of high performance microbial strains for the efficient production of natural and non-natural compounds from renewable non-food biomass. Even though microbial production of various chemicals has successfully been conducted and commercialized, there are still numerous chemicals and materials that await their efficient bio-based production. Aromatic chemicals, which are typically derived from benzene, toluene and xylene in petroleum industry, have been used in large amounts in various industries. Over the last three decades, many metabolically engineered microorganisms have been developed for the bio-based production of aromatic chemicals, many of which are derived from aromatic amino acid pathways. This review highlights the latest metabolic engineering strategies and tools applied to the biosynthesis of aromatic chemicals, many derived from shikimate and aromatic amino acids, including L-phenylalanine, L-tyrosine and L-tryptophan. It is expected that more and more engineered microorganisms capable of efficiently producing aromatic chemicals will be developed toward their industrial-scale production from renewable biomass.


Progress in modelling of brain dynamics during anaesthesia and the role of sleep-wake circuitry.
General anaesthesia is used widely in surgery and during interventional medical procedures, but little is known about the exact neural mechanisms for how unconsciousness arises from administering an anaesthetic drug. Computational modelling of brain dynamics has already provided valuable insights into the neural circuitry involved in generating this state. Current theories for the origin of electroencephalographic (EEG) features in brain activity under GABAergic anaesthetic drugs have been proposed through modelling results. While much attention has been paid to describing alpha and delta oscillations, burst suppression, paradoxical excitation and the possibility of hysteresis during transitions to and from unconscious state, these models have focused only on the role of the thalamocortical system. Recent empirical findings suggest that anaesthetic drugs may act directly on the neural circuitry regulating sleep and wake states and circadian rhythms in the hypothalamus. Coupled with the common behavioural features found in physiological sleep and general anaesthesia, this evidence serves as a foundation for the 'shared circuits hypothesis' which proposes that anaesthetic-induced unconsciousness arises predominantly through modulation of the hypothalamic sleep-wake switch. This paper reviews the key findings from computational models describing brain states during the administration of anaesthetic drugs, with a focus on those enhancing GABAergic inhibition given their widespread use in practice and that almost all models of anaesthesia have focused on these drugs. We draw physiological and behavioural links between brain states during sleep and anaesthesia, and aim to highlight the importance of computational modelling in advancing our understanding of anaesthesia by considering sleep and circadian mechanisms in generating unconsciousness in future work.


The therapeutic effect of exosomal lncRNA MSTRG.91634.7 on mitochondrial dysfunction during SiO2-induced lung fibrosis.
Long-term silica (SiO2) exposure led to irreversible lung fibrosis, in which epithelial-mesenchymal transition (EMT) played an essential role. A novel lncRNA MSTRG.91634.7 in the peripheral exosomes of silicosis patients was reported in our previous study, which could remold the pathological process of silicosis. However, whether its regulatory role on the development of silicosis was related to EMT process is unclear, and its mechanism remains to be further studied. In this study, up-regulating lncRNA MSTRG91634.7 restricted SiO2-activated EMT and restored mitochondrial homeostasis binding to PINK1 in vitro. Moreover, overexpressing PINK1 could inhibit SiO2-activated EMT in pulmonary inflammation and fibrosis in mice. Meanwhile, PINK1 contributed to restoring the SiO2-induced mitochondrial dysfunction in mice lung. Our results revealed that exosomal lncRNA MSTRG.91634.7 from macrophages could restore mitochondrial homeostasis to restrict the SiO2-activated EMT by binding to PINK1 during pulmonary inflammation and fibrosis due to SiO2 exposure.


The distribution of dietary plant sterols in serum lipoproteins and liver subcellular fractions of rats.
Rats were fed plant sterols containing campesterol and beta-sitosterol in the differerent proportions, and their distribution in serum lipoproteins and in liver subcellular fractions was determined. In serum lipoproteins, the percentage as well as the concentration of plant sterols increased with the increase in the density of lipoproteins. Thus, high density lipoprotein (HDL) contained the highest and very low density lipoprotein (VLDL), the lowest. Also, there were distinct differences in the ratio of campesterol to sitosterol among lipoproteins, it was the highest in VLDL and lowest in HDL. Quantitatively, more than 75% of campesterol and 80% of sitosterol were carried in HDL; the values were significantly different from those of cholesterol (ca. 70%) in relation to total cholesterol. The distribution of plant sterols in liver subcellular fractions was virtually the same with that of cholesterol. Both nuclei and microsomes contained approximately 40% of total plant sterols.


The effect of VNS on the rehabilitation of stroke: A meta-analysis of randomized controlled studies.
The efficacy of vagus nerve stimulation (VNS) for the rehabilitation of stroke remains controversial. We conduct a systematic review and meta-analysis to explore the influence of VNS on the rehabilitation of stroke. We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through March 2020 for randomized controlled trials (RCTs) assessing the effect of VNS on the rehabilitation of stroke. This meta-analysis is performed using the random-effect model. Three RCTs are included in the meta-analysis. Overall, compared with control group in stroke, VNS is associated with significantly improved FMA-UE (SMD = 3.86; 95% CI = 1.19 to 6.52; P = 0.005) and Motor Function Test (SMD = 0.33; 95% CI = 0.04 to 0.62; P = 0.03), but has no obvious impact on Box and Block Test (SMD = -0.31; 95% CI = -3.48 to 2.86; P = 0.85), Nine-Hole Peg Test (SMD = 8.35; 95% CI = -40.59 to 57.28; P = 0.74), atrial fibrillation (RR = 3.46; 95% CI = 0.39 to 30.57; P = 0.26) or adverse events (RR = 0.59; 95% CI = 0.21 to 1.61; P = 0.30). VNS may be beneficial to the rehabilitation of stroke.


A novel non-lens betagamma-crystallin and trefoil factor complex from amphibian skin and its functional implications.
In vertebrates, non-lens betagamma-crystallins are widely expressed in various tissues, but their functions are unknown. The molecular mechanisms of trefoil factors, initiators of mucosal healing and being greatly involved in tumorigenesis, have remained elusive. A naturally existing 72-kDa complex of non-lens betagamma-crystallin (alpha-subunit) and trefoil factor (beta-subunit), named betagamma-CAT, was identified from frog Bombina maxima skin secretions. Its alpha-subunit and beta-subunit (containing three trefoil factor domains), with a non-covalently linked form of alphabeta(2), show significant sequence homology to ep37 proteins, a group of non-lens betagamma-crystallins identified in newt Cynops pyrrhogaster and mammalian trefoil factors, respectively. betagamma-CAT showed potent hemolytic activity on mammalian erythrocytes. The specific antiserum against each subunit was able to neutralize its hemolytic activity, indicating that the two subunits are functionally associated. betagamma-CAT formed membrane pores with a functional diameter about 2.0 nm, leading to K(+) efflux and colloid-osmotic hemolysis. High molecular weight SDS-stable oligomers (>240-kDa) were detected by antibodies against the alpha-subunit with Western blotting. Furthermore, betagamma-CAT showed multiple cellular effects on human umbilical vein endothelial cells. Low dosages of betagamma-CAT (25-50 pM) were able to stimulate cell migration and wound healing. At high concentrations, it induced cell detachment (EC(50) 10 nM) and apoptosis. betagamma-CAT was rapidly endocytosed via intracellular vacuole formation. Under confocal microscope, some of the vacuoles were translocated to nucleus and partially fused with nuclear membrane. Bafilomycin A1 (a specific inhibitor of the vacuolar-type ATPase) and nocodazole (an agent of microtuble depolymerizing), while inhibited betagamma-CAT induced vacuole formation, significantly inhibited betagamma-CAT induced cell detachment, suggesting that betagamma-CAT endocytosis is important for its activities. These findings illustrate novel cellular functions of non-lens betagamma-cyrstallins and action mechanism via association with trefoil factors, serving as clues for investigating the possible occurrence of similar molecules and action mechanisms in mammals.


Preoperative evaluation of pelvic lateral lymph node of patients with lower rectal cancer: comparison study of MR imaging and CT in 53 patients.
Preoperative assessment of the lateral pelvic lymph nodes is important for treatment strategy to patients with lower rectal cancer. Fifty-three patients with primary lower rectal cancer were preoperatively assessed by spiral computed tomography (CT) and magnetic resonance imaging (MRI) at 1.5 T with a phased-array coil. Preoperative tumor and lymph node stages were compared with the final histological findings. The MRI tumor stage coincided with the histological stage in 36 of 53 patients (68%). The MRI and CT lymph node stage coincided with the histological stage in 33 (62%) and 26 (49%) of 53 patients, respectively. However the accuracy of MRI in detecting the lateral pelvic lymph node involvement was 83%, compared to 77% of CT (p<0.05). With the use of MRI, the lateral pelvic lymph node involvement can be predicted with high accuracy, allowing preoperative identification of patients who need radiotherapy or extensive surgery to escape recurrence.


Expression of receptor protein tyrosine phosphatase alpha mRNA in human prostate cancer cell lines.
Receptor protein tyrosine phosphatase alpha (RPTPalpha) is a transmembrane protein phosphatase, and has been proposed to be involved in the differentiation of the neuronal system. In the present study, we demonstrated the expression of RPTPalpha mRNA in several normal human tissues. We further investigated the regulation of expression of RPTPalpha mRNA in epithelial cells utilizing three commercially available human prostate cancer cell lines LNCaP, PC-3 and DU145. This is because these cells exhibit different levels of differentiation, defined by the expression of a tissue-specific differentiation antigen, prostatic acid phosphatase (PAcP), and their androgen sensitivity. LNCaP cells express PAcP and are androgen-sensitive cells, while PC-3 and DU145 cells do not express PAcP and are androgen-insensitive cells. Northern blot analyses revealed that, in LNCaP cells, fetal bovine serum (FBS) and 5alpha-dihydrotestosterone (DHT) down-regulates RPTPalpha mRNA expression, similar to the effect on PAcP. Contrarily, FBS up-regulated the RPTPalpha mRNA level in PC-3 and DU145 cells. In LNCaP cells, sodium butyrate inhibited cell growth and up-regulated RPTPalpha as well as PAcP mRNA expression. Although, sodium butyrate also inhibited the growth of PC-3 and DU145 cells, the level of RPTPalpha mRNA was decreased in PC-3, while increased in DU145 cells. Thus, data taken together indicate that the expression of RPTPalpha is apparently regulated by a similar mechanism to that of PAcP in LNCaP cells.


Neurological complications of sickle cell anemia in Nigerian Africans--a case-control study.
To determine the neurological complications associated with sickle cell anaemia (SCA) in Nigerians and evaluate the relative frequencies. Six-hundred-thirteen patients with SCA attending outpatient clinics of Lagos University Teaching Hospital and 616 control subjects were evaluated using a uniform structured questionnaire to determine the occurrence of neurological complications. The relative frequencies of neurological abnormalities in patients and controls were compared. Neurological abnormalities occurred in a significantly higher percentage of patients (76%) compared to controls (32.1%). Among children, these abnormalities included stroke, febrile seizures and headache. Among adolescents and adults, the abnormalities included paraplegia, epileptic seizures and localized sensory neuropathy. Headache occurred in a significantly higher percentage in children and adolescents compared to controls, but not in adults. We conclude that SCA is associated with neurological complications: stroke and febrile seizures in children, epileptic seizures, paraplegia and localized sensory neuropathy in adolescents and adults, headache in children and adolescents. Detailed studies of each of these complications would be required to provide further insight into their significance.


The Barriers and Facilitators of Self-Management Among Adults with Type 2 Diabetes Mellitus: A Trans Theoretical Model (TTM)-Based Mixed Method Study in Iran.
This study planned to determine:( 1) the behavioral intention or profile of patients with type 2 diabetes mellitus (T2DM) based on the stages of the change model, and( 2) to explore the perceived facilitators and barriers of self-management (SM) in a sample of Iranian patients with T2DM. This was a mixed method study, accomplished in two phases. In the quantitative phase, 246 subjects with T2DM participated. They were classified according to items such as regular use of blood-glucose-lowering drugs, having a healthy diet and performing physical activity to pre-action and action groups. Socio-demographic and anthropometric information were collected, and a phenomenological qualitative study was conducted, and data collection continued until saturation achieved by 10 subjects in pre-action and 12 subjects in action groups. Four focus group discussions in the field of SM were accomplished. Analysis of quantitative and qualitative data was conducted by the SPSS and MAXQDA software, respectively. The mean age and duration of illness among the subjects were 53.9±7.1 and 6.9±4.9 years, respectively. The barriers of SM in action and pre-action stages were as follows: lower socio-economic status, poor performance of treatment team, physical-intellectual factors and lack of planning to change. The facilitators stated in the pre-action and action stage in the field of SM were satisfaction from treatment, planning, belief in diabetes, treatment team's support, nutritional knowledge, and religious beliefs. This study indicated facilitator and barrier factors in SM based on TTM in action and pre-action groups. Healthcare professionals should consider these findings to improve the patients' outcomes.


[Energy potential of the cerebral cortex in the pre-agonal and post-resuscitation period after acute blood loss].
In experiments on dogs it was revealed that during the preagonal period, after a four-hour hypovolemic hypotension, the content of ATP was reduced in the gray matter of the brain by 38 percent, and of ADP and AMP increased by 121 percent and 875 percent, respectively. Reflecting these shifts the energy charge potential decreased from 0.931 to 0.733 (P less than 0.05). At the early and remote postrescucitation period the content of metabolites and of energy charge potential failed to differ from the initial level.