Depression and anxiety disorders in patients with carpal tunnel syndrome after surgery - a case control study.
The aim of this study was to evaluate the frequency of depressive and anxiety disorders in patients with carpal tunnel syndrome (CTS) after surgery in comparison with normal individuals. This cross-sectional analytical case-control study conducted on patients who underwent surgery with a diagnosis of carpal tunnel syndrome. In the first group, 35 patients with CTS who underwent surgery were randomly selected and evaluated for anxiety and depression with two standard questionnaires - of CES-D (Center for Epidemiologic Studies Depression) and S-TAI (Spielberger State-Trait Anxiety Inventory). The second group of 35 normal people were randomly selected and examined after matching the age and sex. The data were compared and analyzed using SPSS V.22 software. The mean score of Spielberger state and trait anxiety and depression in the case group was higher than the control group (P < 0.001 and P = 0.003 respectively). In both age groups (< 40 and > 40 years) the level of state and trait anxiety and depression was significantly higher in case than the control group. In women, the level of state and trait anxiety and depression was significantly higher in the case group than in the control group, but in men, only trait anxiety was significant. The anxiety and depression disorders were more common in patients undergoing CTS than in normal individuals. Therefore, it is necessary to study the psychological status of these patients in the pre-discharge period and pay attention to its predictors in order to plan appropriate interventions.


Bulk flow of cerebrospinal fluid through a lumbo-omental pedicle graft in the dog.
Perfusion tests were performed in dogs with a pedicle graft of the greater omentum implanted in the lumbar subarachnoid space to measure its capacity to drain CSF. The CSF pressure was set at different levels in the range 0--50 mmHg and the outflow from a complete CSF space and then from the isolated dural sac was recorded in the same dog with an electronic drop recorder. It was shown that the omental graft could transport as much as 30% of the CSF normally carried by the physiological pathways. The spinal outflow in the controls was virtually non-existent. It is concluded that a bulk flow of CSF occurs through the graft. The results suggest that a lumbo-omental pedicle graft could possibly be used as a biological shunt in the treatment of hydrocephalus.


Gender and age differences in chief complaints of acute myocardial infarction (Worcester Heart Attack Study).
We examined gender and age differences for chief symptom complaints in a population-based sample of 881 women (43%) and 1,192 men (57%) hospitalized for acute myocardial infarction (AMI). Women, in particular older women, were less likely than men to have a chief complaint of chest pain associated with AMI. Overall, a large proportion of women and men whose AMI was ultimately diagnosed did not present with chest pain as their chief complaint.


Myostatin inhibition slows muscle atrophy in rodent models of amyotrophic lateral sclerosis.
Amyotrophic lateral sclerosis (ALS) is an incurable neurodegenerative disease leading to motor neuron cell death, but recent studies suggest that non-neuronal cells may contribute to the pathological mechanisms involved. Myostatin is a negative regulator of muscle growth whose function can be inhibited using neutralizing antibodies. In this study, we used transgenic mouse and rat models of ALS to test whether treatment with anti-myostatin antibody slows muscle atrophy, motor neuron loss, or disease onset and progression. Significant increases in muscle mass and strength were observed in myostatin-antibody-treated SOD1(G93A) mice and rats prior to disease onset and during early-stage disease. By late stage disease, only diaphragm muscle remained significantly different in treated animals in comparison to untreated controls. Myostatin inhibition did not delay disease onset nor extend survival in either the SOD1(G93A) mouse or rat. Together, these results indicate that inhibition of myostatin does not protect against the onset and progression of motor neuron degenerative disease. However, the preservation of skeletal muscle during early-stage disease and improved diaphragm morphology and function maintained through late stage disease suggest that anti-myostatin therapy may promote some improved muscle function in ALS.


Digital filtering of on-line evoked potentials.
Evoked potentials recorded automatically at frequent intervals are a useful adjunct for monitoring head injury patients; however, unaveraged residual noise due to patient movement and synchronization of th- stimulus to harmonics of the line frequency is sometimes present. A frequency analysis was performed on 23 records with varying degrees of unaveraged noise and the results were used to design a digital filter. The frequency content of the records analyzed was largely contained in a band from D.C. to 200 Hz. A zero phase shift lowpass digital filter with a cutoff frequency of 200 Hz eliminated the majority of noise. Despite the low frequency content, a wide-band amplifier is still required to avoid waveform distortion, particularly latencies. Digital filters can then be applied without causing distortion.


Comparative value of blood and skin samples for diagnosis of spotted fever group rickettsial infection in model animals.
The definitive diagnosis of spotted fever group (SFG) rickettsioses in humans is challenging due to the retrospective nature and cross reactivity of the serological methods and the absence of reliable and consistent samples for molecular diagnostics. Existing data indicate the transient character of bacteremia in experimentally infected animals. The ability of arthropod vectors to acquire rickettsial infection from the laboratory animals in the absence of systemic infection and known tropism of rickettsial agents to endothelial cells of peripheral blood vessels underline the importance of local infection and consequently the diagnostic potential of skin samples. In order to evaluate the diagnostic sensitivity of rickettsial DNA detection in blood and skin samples, we compared results of PCR testing in parallel samples collected from model laboratory animals infected with Rickettsia rickettsii, Rickettsia parkeri and Rickettsia slovaca-like agent at different time points after infection. Skin samples were collected from ears - away from the site of tick placement and without eschars. Overall, testing of skin samples resulted in a higher proportion of positive results than testing of blood samples. Presented data from model animals demonstrates that testing of skin samples from sites of rickettsial proliferation can provide definitive molecular diagnosis of up to 60-70% of tick-borne SFG rickettsial infections during the acute stage of illness. Detection of pathogen DNA in cutaneous samples is a valuable alternative to blood-PCR at least in model animals.


[Macrophage-fibroblast interaction and its possible role in regulating collagen metabolism during wound healing].
The role of macrophages in the resorption of denatured collagen in the wound tissue was demonstrated by transmission and scanning electron microscopy investigation. Tight cell contacts between the macrophages and fibroblasts in the granulation tissue preceded active collagen synthesis and fibrillogenesis. A hypothesis was suggested according to which these contacts played an important role in the transfer of specific signals for the initiation of collagen biosynthesis; collagen decomposition products were considered as the actual signals, thus connecting the collagen catabolism and biosynthesis. Such a feed-back mechanism probably served as an integral part of the general hemostasis regulating the growth of connective tissue.


Habitat modification destabilizes spatial associations and persistence of Neotropical carnivores.
Spatial relationships between sympatric species underpin biotic interactions, structure ecological communities, and maintain ecosystem health. However, the resilience of interspecific spatial associations to human habitat modification remains largely unknown, particularly in tropical regions where anthropogenic impacts are often greatest. We applied multi-state multi-species occurrence models to camera trap data across nine tropical landscapes in Colombia to understand how prominent threats to forest ecosystems influence Neotropical carnivore occurrence and interspecific spatial associations, with implications for biotic interactions. We show that carnivore occurrence represents a delicate balance between local environmental conditions and interspecific interactions that can be compromised in areas of extensive habitat modification. The stability of carnivore spatial associations depends on forest cover to mediate antagonistic encounters with apex predators and structurally intact forests to facilitate coexistence between competing mesocarnivores. Notably, we demonstrate that jaguars play an irreplaceable role in spatially structuring mesocarnivore communities, providing novel evidence on their role as keystone species. With increasing global change, conserving both the extent and quality of tropical forests is imperative to support carnivores and preserve the spatial associations that underpin ecosystem stability and resilience.


Electrical characteristics and chemical stability of non-oxidized, methyl-terminated silicon nanowires.
Silicon nanowires (Si NWs) modified by covalent Si-CH3 functionality, with no intervening oxide, show atmospheric stability, high conductance values, low surface defect levels, and allow for the formation of air-stable Si NW Field-Effect Transistors (FETs) having on-off ratios in excess of 105 over a relatively small gate voltage swing (+/-2 V).


A technique to visualize corneal incision and lamellar dissection depth during surgery.
To describe a surgical technique to visualize the depth of corneal incisions and lamellar stromal dissections during surgery. In porcine cadaver eyes, the aqueous was exchanged by air. Thus an air-to-endothelium interface (i.e., a useful optical surface) was created at the posterior corneal surface. The air-to-endothelium interface was used as a reference plane to visualize the corneal thickness and the relative depth of corneal incisions and dissections. Freehand peripheral corneal incisions, tangential keratotomy incisions, and lamellar stromal dissections were made at an intended corneal depth of 60, 80, and 99%. Light microscopy was used to measure the relative depth of the incisions and dissections. Achieved depth for peripheral corneal incisions averaged 65.2+/-5.3%, 78.8+/-5.1%, and 93.4+/-6.0%, respectively (p<0.05); and for tangential keratotomy incisions, 68.2+/-7.3%, 83.2+/-4.4%, and 95.8+/-3.6%, respectively (p<0.05). Achieved depth for lamellar stromal dissections averaged 58.3+/-9.4%, 81.1+/-3.4%, and 94.4+/-1.5%, respectively (p<0.05). Microperforations occurred with three incisions made at 99% intended depth. During surgery, the depth of incisions and lamellar dissections relative to the corneal thickness can be visualized by filling the anterior chamber with air (i.e., by creating an optical interface at the posterior corneal surface).


Incidence and predictors for chemotherapy modifications and their impact on the outcome of ovarian cancer patients.
Chemotherapy (CTX) is an important part of the treatment strategy of stage II-IV ovarian cancer. CTX modifications, such as delays, dose reductions or premature terminations might have a negative impact on overall survival (OS) and progression free survival (PFS). The goal of this study was to determine the incidence and predictors of CTX modifications and their influence on survival. An observational retrospective cohort analysis of 192 ovarian cancer patients who were treated at the Department of Obstetrics and Gynaecology, Technical University Munich, Germany, according to international guidelines was performed including from 2009 to 2013. A potential association between patient and disease characteristics and CTX modifications was tested with multivariate logistic regression. OS and PFS were estimated by Kaplan-Meier analysis. 44.8% (86/192) received a modification of CTX. 34 (17.7%) women discontinued CTX prematurely, 17 (8.9%) underwent a dose reduction, 16 (8.3%) experienced a CTX delay and 10 (5.2%) had both a delay and a dose modification. In nine (4.7%) patients, the dose needed to be divided. Leukopenia (p < 0.001) and anaemia (p = 0.003) were significantly more common in patients with CTX modifications. Significant predictors for CTX modifications were a history of thrombosis or embolism (p < 0.001) and residual tumour postoperatively (p = 0.003). Patients with CTX modifications showed a significantly lower OS as well as PFS (p < 0.001), even after adjustment for prognostic factors such as age, body-mass-index, residual tumour, histology, FIGO stage and grading (p = 0.005 for OS and p = 0.001 for PFS). CTX modifications have a negative impact on survival. Significant predictors for such modifications are a history of thrombosis or embolism and the presence of residual postoperative tumour. Further studies are needed to avoid CTX modifications and to improve survival of ovarian cancer patients.


Chromosome analysis of bone marrow in mammals after treatment with isoniazid.
Cytogenetic investigations in bone marrow from animals treated with isoniazid (INH) were performed in seven different laboratories according to a standard protocol. The experiments were carried out in the Chinese hamster, the mouse, and the rat. In short-term studies INH was administered twice at an interval of 24 h in doses of 5, 25, and 125 mg/kg, and the animals were sacrificed 6, 12, 24, and 48 h after the second dose. In long-term studies doses of 25 and 125 mg/kg were administered thrice weekly for 12 weeks. As a rule, each group consisted of at least four animals, and 100 metaphases per animal were counted. Statistical analysis of the data showed that the incidence of chromosomal aberrations including gaps lay in the critical range for two groups in one laboratory and was significantly higher than in the control in three groups in another of the seven laboratories. From the results of both the short-term and the long-term studies in all laboratories, however, it may be concluded, that isoniazid does not induce gross chromosomal aberrations.


Axillary acne agminata (lupus miliaris disseminatus faciei).
Acne agminata is a papulo-pustular eruption typically affecting the face of young adults and characterized histologically by the presence of caseating granulomata in the dermis. We now describe two adults who developed the condition in the axillae.


Radionuclide assessment of Gaucher's disease.
Gaucher's disease involves multiple organs and may present with variable severity. The scintigraphic appearance of the reticuloendothelial system and bone are described in three patient's with Gaucher's disease. Scintigraphic abnormalities reflected the severity of organ involvement and correlated well with the patients' clinical status. Scintigraphy appears useful for the evaluation and followup of patients with Gaucher's disease.


Different vasodilator responses of human arms and legs.
Forearm vascular responses to intra-arterial infusions of endothelium-dependent and -independent vasodilators have been thoroughly characterized in humans. While the forearm is a well-established experimental model for studying human vascular function, it is of limited consequence to systemic cardiovascular control owing to its small muscle mass and blood flow requirements. In the present study we determined whether these responses could be generalized to the leg. Based upon blood pressure differences between the leg and arm during upright posture, we hypothesized that the responsiveness to endothelium-dependent vasodilators would be greater in the forearm than the leg. Brachial and femoral artery blood flow (Q, ultrasound Doppler) at rest and during intra-arterial infusions of endothelium-dependent (acetylcholine and substance P) and -independent (sodium nitroprusside) vasodilators were measured in eight healthy men (22-27 years old). Resting blood flows in the forearm before infusion of acetylcholine, substance P or sodium nitroprusside were 25 +/- 4, 30 +/- 7 and 29 +/- 5 ml min(-1), respectively, and in the leg were 370 +/- 32, 409 +/- 62 and 330 +/- 30 ml min(-1), respectively. At the highest infusion rate of acetylcholine (16 microg (100 ml tissue)(-1) min(-1)) there was a greater (P < 0.05) increase in Q to the forearm (1864 +/- 476%) than to the leg (569 +/- 86%). Similarly, at the highest infusion rate of substance P (125 pg (100 ml tissue)(-1) min(-1)) there was a greater (P < 0.05) increase in Q to the forearm (911 +/- 286%) than to the leg (243 +/- 58%). The responses to sodium nitroprusside (1 microg (100 ml tissue)(-1) min(-1)) were also greater (P < 0.05) in the forearm (925 +/- 164%) than in the leg (326 +/- 65%). These data indicate that vascular responses to both endothelium-dependent and -independent vasodilator agents are blunted in the leg compared to the forearm.


Influence of moderate alcohol intake on wakening plasma thiopental concentration.
In an earlier study, an inverse correlation between thiopental-induced sleeping time and alcohol intake in the preceding week was demonstrated in women undergoing termination of pregnancy. In order to investigate the mechanism behind the apparent cross-tolerance, the relationship between alcohol consumption in the week preceding thiopental/nitrous oxide/oxygen anesthesia and wakening plasma thiopental concentration on one hand and sleeping time on the other was examined in 68 women scheduled for termination of pregnancy and in 37 women scheduled for diagnostic uterine dilatation and curettage. In terms of pure alcohol, the weekly intake (mean +/- s.d.) was 1.17 +/- 2.07 ml . kg-1 in the former and 1.49 +/- 1.70 ml . kg-1 in the latter group. A positive correlation between alcohol consumption and wakening plasma thiopental concentration was found in both groups, reaching statistical significance (P less than 0.05) in the group undergoing termination of pregnancy, but not in the other. The inverse correlation found earlier between alcohol intake and sleeping time was not reproduced significantly in any of the groups. The results indicate that moderate alcohol intake may induce cerebral tolerance to thiopental.


Three-Component Friedel-Crafts Transformations: Synthesis of Alkyl and Alkenyl Trifluoromethyl Sulfides and Alkenyl Iodides.
Straightforward and mild hexafluoroisopropanol (HFIP)-mediated, metal-free, three-component Friedel-Crafts approaches are reported for the synthesis of alkenyl and alkyl trifluoromethyl sulfides from arenes, (PhSO2)2NSCF3, and alkynes or alkenes, respectively. The transformations proceed with high regio- and stereochemical control via the initial formation of cationic thiirenium and thiiranium intermediates, respectively, followed by Friedel-Crafts reactions with the arene. A mechanistically related three-component synthesis of alkenyl iodides from arenes, alkenes, and N-iodosuccinimide is also reported.


Polymer shell as a protective layer for the sandwiched gold nanoparticles and their recyclable catalytic property.
Poly(ethyleneglycol methacrylate) (PEGDMA) shell was used as a protective layer for the sandwiched gold nanoparticles, which were prepared through the in situ reduction in the HAuCl4 precursor in the presence of (aminopropyl)trimethoxysilane (APS) modified silica/PEGDMA core-shell microspheres. In this process, the silica/PEGDMA core-shell microspheres were afforded by the distillation-precipitation polymerization of the EGDMA monomer on the APS-modified silica particles with the aid of hydrogen-bonding interaction. The gold nanoparticles were formed at the interface between the silica core and the PEGDMA outer layer through the strong coordinate interaction between the gold nanoparticles and the amino groups on the surface of the silica during the reduction in HAuCl4. The sandwiched gold nanoparticles exhibited highly catalytic efficiency and facile recovery with good stability.


Spatial and temporal expression of folate-related transporters and metabolic enzymes during mouse placental development.
It is well understood that maternal folate deficiency can cause abnormal fetal development. However, the extent to which placental development and function are also dependent upon folate uptake and metabolism remains unclear. To understand which trophoblast cell types may be affected by folate deficiency or abnormal folate metabolism, we completed a comprehensive spatial and temporal protein expression analysis of folate receptor (Folr), folate transporters (proton-coupled folate receptor [Slc46a1 or PCFT] and reduced folate carrier-1 [Rfc1]) and folate metabolic enzymes (5,10-methylenetetrahydrofolate reductase [Mthfr] and methionine synthase [Mtr]) in histological sections of mouse placentas from early development (E8.5) until term (E18.5). We observed that the highest level of protein expression was during early development (E8.5-E10.5), prior to the formation of the three main layers of the mature placenta suggesting that folate uptake and metabolism may be required for placental development, itself. As expected, the labyrinth trophoblast cells, which are responsible for nutrient transport, expressed these proteins throughout pregnancy, including robust expression in the sinusoidal trophoblast giant cells that line the maternal blood spaces. Other trophoblast giant cell (TGC) subtypes (parietal-TGCs and canal-TGCs), whose function does not include nutrient transport, expressed folate transporters and enzymes from E8.5 onwards. Remarkably, these proteins were also detected in glycogen trophoblast cells from E12.5-E18.5 suggesting a new role in folate uptake and metabolism for these cells. Together, these data provide evidence that folate may be necessary for normal placental development and function, and perturbations in its availability or metabolism may lead to secondary effects on fetal development.


Incidence, characteristics, and outcomes of patients with bone and joint infections due to community-associated methicillin-resistant Staphylococcus aureus: a systematic review.
To summarize the published evidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) bone and joint infections. PubMed and Scopus electronic databases were searched. The annual incidence of invasive CA-MRSA infections ranged from 1.6 to 29.7 cases per 100,000, depending on the location of the population studied; bone and joint infections accounted for 2.8 to 43 % of invasive CA-MRSA infections. Surveillance studies showed that patients <2 years of age are mainly affected. Incidence rates were higher in blacks. Sixty-seven case reports and case series were identified; the majority of the patients included were children. Vancomycin and clindamycin were used effectively, in addition to surgical interventions. Seven patients out of 413 died (1.7 %) in total. Chronic osteomyelitis developed in 19 patients (data for 164 patients were available). The published evidence for CA-MRSA bone and joint infections refers mainly to children; their incidence depends on the location and race of the population. Vancomycin and clindamycin have been used effectively for their treatment.


Hijacking homeostasis: Regulation of the tumor microenvironment by apoptosis.
Cancers are genetically driven, rogue tissues which generate dysfunctional, obdurate organs by hijacking normal, homeostatic programs. Apoptosis is an evolutionarily conserved regulated cell death program and a profoundly important homeostatic mechanism that is common (alongside tumor cell proliferation) in actively growing cancers, as well as in tumors responding to cytotoxic anti-cancer therapies. Although well known for its cell-autonomous tumor-suppressive qualities, apoptosis harbors pro-oncogenic properties which are deployed through non-cell-autonomous mechanisms and which generally remain poorly defined. Here, the roles of apoptosis in tumor biology are reviewed, with particular focus on the secreted and fragmentation products of apoptotic tumor cells and their effects on tumor-associated macrophages, key supportive cells in the aberrant homeostasis of the tumor microenvironment. Historical aspects of cell loss in tumor growth kinetics are considered and the impact (and potential impact) on tumor growth of apoptotic-cell clearance (efferocytosis) as well as released soluble and extracellular vesicle-associated factors are discussed from the perspectives of inflammation, tissue repair, and regeneration programs. An "apoptosis-centric" view is proposed in which dying tumor cells provide an important platform for intricate intercellular communication networks in growing cancers. The perspective has implications for future research and for improving cancer diagnosis and therapy.


Aptamer based probes for living cell intracellular molecules detection.
Biosensors have been employed for monitoring and imaging biological events and molecules. Sensitive detection of different biomolecules in vivo can reflect the changes of physiological conditions in real-time, which is of great significance for the diagnosis and treatment of diseases. The detection of intracellular molecules concentration change can indicate the occurrence and development of disease. But the analysis process of the existing detection methods, such as Western blot detection of intracellular protein, polymerase chain reaction (PCR) technique quantitative analysis of intracellular RNA and DNA, usually need to extract the cell lysis which is complex and time-consuming. Fluorescence bioimaging enables in situ monitoring of intracellular molecules in living cells. By combining the specificity of aptamer for intracellular molecules binding, and biocompatibility of fluorescent materials and nanomaterials, biosensors with different nanostructures have been developed to enter into living cells for analysis. This review summarizes the fluorescence detection methods based on aptamer for intracellular molecules detection. The principles, limit of detection, advantages, and disadvantages of different platforms for intracellular molecular fluorescent response are summarized and reviewed. Finally, the current challenges and future developments were discussed and proposed.


Flexible weighting of target features based on distractor context.
Models of attention posit that attentional priority is established by summing the saliency and relevancy signals from feature-selective maps. The dimension-weighting account further hypothesizes that information from each feature-selective map is weighted based on expectations of how informative each dimension will be. In the current studies, we investigated the question of whether attentional biases to the features of a conjunction target (color and orientation) differ when one dimension is expected to be more diagnostic of the target. In a series of color-orientation conjunction search tasks, observers saw an exact cue for the upcoming target, while the probability of distractors sharing a target feature in each dimension was manipulated. In one context, distractors were more likely to share the target color, and in another, distractors were more likely to share the target orientation. The results indicated that despite an overall bias toward color, attentional priority to each target feature was flexibly adjusted according to distractor context: RT and accuracy performance was better when the diagnostic feature was expected than unexpected. This occurred both when the distractor context was learned implicitly and explicitly. These results suggest that feature-based enhancement can occur selectively for the dimension expected to be most informative in distinguishing the target from distractors.


A case of pathophysiologic study in Kimura's disease: measurement of cytokines and surface analysis of eosinophils.
Kimura's disease is a rare but distinctive eosinophilic inflammatory disorder of unknown etiology; few reported case studies have focused on the immunopathologic background of this unique disease. To define better the immunopathogenetic features of Kimura's disease, we attempted to quantitatively analyze values of cytokines and soluble interleukin-2 receptor (sIL-2R) in peripheral blood (PB), as well as perform surface immunophenotypic analysis of eosinophils from a Japanese patient with chronic relapsing Kimura's disease. Granulocyte macrophage-colony stimulating factor (GM-CSF), tumor necrosis factor-alpha (TNF-alpha) and sIL-2R were elevated, and newly expressed antigens on eosinophils CD4, CD25, and HLA-DR were found to be involved in the pathophysiology of this disorder. Kimura's disease may be a disease in which activated lymphocytes release cytokines, and these released cytokines, such as GM-CSF and TNF-alpha cause eosinophil activation. These processes may be related to the pathogenesis of this disorder.


Structure-activity relationships of neoechinulin A analogues with cytoprotection against peroxynitrite-induced PC12 cell death.
Neoechinulin A, an alkaloid from Eurotium rubrum Hiji025, protected neuronal PC12 cells against cell death induced by peroxynitrite derived from SIN-1 (3-(4-morpholinyl)sydnonimine hydrochloride). In this study, we investigated the structure-activity relationships of neoechinulin A and a set of its analogues by using assays to measure anti-nitration and antioxidant activities and cytoprotection against SIN-1-induced PC12 cell death. The presence of the diketopiperazine ring was essential for both the antioxidant and anti-nitration activities of neoechinulin A derivatives. Nevertheless, a derivative lacking the diketopiperazine ring could still protect PC12 cells against SIN-1 cytotoxicity. An acyclic analogue completely lost the cytoprotective effect while retaining its antioxidant/anti-nitration activities. Pre-incubation of the cells with neoechinulin A for at least 12 hours was essential for the cells to gain SIN-1 resistance. These results suggest that neoechinulin A endows the cells with cytoprotection through a biological effect different from the apparent antioxidant/anti-nitration activities.


Risk involvement and risk perception among adolescents and young adults.
Adolescents as a group know about the connections between many risky behaviors and negative outcomes. However, it is unclear whether adolescents who engage in risky behavior differ in risk perceptions from those who do not. We proposed that risk differences between risk-involved and risk-uninvolved adolescents depend on how risk questions are framed. High school and college students estimated their risk of smoking and unprotected sex by replying to four different questions. The results revealed that, for both high school and college students, smokers saw their outcome risk (risk of negative outcomes) as higher than that of nonsmokers. A similar finding was obtained for sexual behavior, though only for high school students. No significant differences between risk groups were obtained when risk was measured by asking about behavior risk (general riskiness of the behavior). Overall, the data suggest that adolescents engaged in risky behavior do not have a complete appreciation of their exposure to harm. Programs intended to prevent or reduce risky behavior need to take a multifaceted approach to persuasion about risk.


Using system mapping to help plan and implement city-wide action to promote physical activity.
Background: There is growing interest in conceptualising public health problems such as physical inactivity as the outcome of multiple interacting factors within complex systems. A systems approach includes consideration of the indirect as well as direct impacts of interventions, the contexts within which they take place, the relations between the multiple factors at play, and the ways in which systems adapt in response to changes. This study involved working with stakeholders involved in a city-wide physical activity promotion programme in Derby, UK to investigate whether a conceptual map of the local physical activity system could be a useful tool to help improve the planning and implementation of the programme. Methods: We produced draft conceptual maps of the major modifiable drivers of physical activity in the city, based on the existing literature on determinants and correlates of physical activity, then refined them in a series of stakeholder meetings. The maps were used to explore ways in which the existing programme took a systems approach, and how it might be enhanced. Semistructured interviews were subsequently undertaken with stakeholders to assess their views on the contribution of the mapping approach. Results: Feedback from stakeholders described the mapping as valuable, especially in helping to identify the limitations of the original approach taken in the city. Conclusions: Even a very simple application of systems thinking can be a useful tool for disaggregating the key factors driving a system, helping to identify areas that merit greater attention, and supporting effective action.


Deconjugation of glycine-amidated bile salts does not occur in germfree rats.
After oral administration to germfree rats of cholyl-glycine-1-14C, deoxycholyl-glycine-1-14C and nor-ursocholyl-glycine-1-14C no significant amounts of 14CO2 are expired. This indicates that these bile salts are not significantly deamidated under physiological conditions in the rat organism outside the gastro-intestinal tract.


Vesicouterine fistula: a rare complication of cesarean section.
Vesicouterine fistula is a rare complication of cesarean section. Most patients present early postoperatively, while others are seen months later with urinary incontinence. Recurrent urinary infections, menstruation through the bladder (menouria), secondary infertility and amenorrhea are less common reasons for consultation. Although more than 100 such cases have been described, there have been few reports on fertility after surgical cure of the fistula. We report 4 cases of a vesicouterine fistula after cesarean section. The first patient was treated nonoperatively and the other 3 patients were treated surgically. Three patients had normal pregnancies after resolution of the problem. The clinical features, etiological factors and treatment modalities are discussed.


Long-term survival in stage I and stage II malignant melanoma of the limbs--a regional review.
A case is reported of survival in excess of 20 years in a patient presenting with Stage II cutaneous malignant melanoma. Long term survival is reviewed of patients with cutaneous malignant melanoma registered during the period 1957-1959. Prognosis is best in women with Stage I disease of the lower limb, but prolonged survival occurs in cases having regional lymph node involvement. Men with stage I disease of the upper limb have a relatively good prognosis.


Characteristics of 222Rn and 220Rn equilibrium factors in the indoor environments.
Humans receive a significant portion (˃50%) of the total dose attributed to all the natural radiation sources from indoor radon (222Rn), thoron (220Rn), and their progeny. While progeny contributes an overwhelming part to the dose, in most surveys, only radon gas is measured because of the simplicity of measurement. Progeny concentration is usually estimated by multiplying gas concentration with an assumed factor, called the equilibrium factor, and taken from literature. Recently, results of the measurements of equilibrium factors for 222Rn and 220Rn were reported from various parts of the globe. In India, many such studies have been conducted in the current decade. The studies show a wide variation of equilibrium factors which suggests that they depend on environmental factors and measurement conditions. Therefore, they should be determined site specifically if accurate site-specific dose estimation is targeted. This paper summarizes concepts, definitions, and methods to determine equilibrium factors and reviews literature about reported equilibrium factors worldwide, focusing on data reported from India.


Assessment of transpulmonary absorption of ethanol from alcohol-based hand rub.
Alcohol-based hand rubs (ABHRs) have been associated with a reduction of nosocomial infections. Despite the worldwide introduction of these products in health care settings, the aim of this study was to assess the transpulmonary absorption of ethanol contains in ABHRs used by health care workers (HCWs) in real conditions of work shift. Twenty-six HCWs of Nancy University Hospital were included. Research consisted in monitoring participants during 4 hours of work shift to assess their exposure to ethanol. The measurement of ethanol vapors in exhaled breath was performed using a class B ethylometer (Alco-Sensor FST). Ethanol concentration in inhaled breath was measured using Gilian pump LFS-113. Concentration of ethanol, acetaldehyde, and acetate in blood and urine samples were determined using gas chromatography with flame ionization detector. Participants were 12% male and 88% female. The mean age was 40 ± 8 years. None of the employees included in the study presented any traces of ethanol or its metabolites in the blood or urine. Ethanol (0.08 ± 0.07 mg/L) was detected in the breath of 10 HCWs at 1 to 2 minutes postexposure. The mean concentration of ethanol in the inhaled air was 46.2 mg/m. Absorption of ethanol vapor from ABHRs among HCWs during their care activities was not detected. Quantification of ethanol fumes inhaled during 4 hours of work shift was below the regulatory limitations of exposure to ethanol.


Falling for her psychiatrist: an unusual cause of falls in the elderly.
We describe the case of an elderly woman with auditory hallucinations of her psychiatrist commanding her to fall. The case highlights an unusual cause of falls in the elderly, not previously described in the falls literature.


"Just make sure you can get up and parent the next day": Understanding the contexts, risks, and rewards of alcohol consumption for parents.
Little is known about how parents make drinking decisions and weigh the risks and rewards of alcohol consumption in specific contexts. This qualitative study examined two questions: 1. What factors influence parental drinking decisions in different drinking contexts? 2. What do parents perceive as the risks and rewards of alcohol consumption in different drinking contexts? Purposive sampling was used to select sixty parents of children aged 10 or younger living in four mid-sized California cities. Data were collected via in-depth, semi-structured interviews. Many parents viewed drinking at family get-togethers or parties as protective of children, since the presence of multiple adults and children provide buffers when parents become intoxicated. In contrast, parents noted that drinking at home, and particularly drinking alone, transmitted potentially negative messages. Social pressures and contexts influence alcohol consumption among parents and could provide potential avenues for intervention against alcohol-related harms.


Improving PM2.5 predictions during COVID-19 lockdown by assimilating multi-source observations and adjusting emissions.
The Coronavirus Disease 2019 (COVID-19) outbreak caused a suspension of almost all non-essential human activities, leading to a significant reduction of anthropogenic emissions. However, the emission inventory of the chemistry transport model cannot be updated in time, resulting in large uncertainty in PM2.5 predictions. This study adopted a three-dimensional variational approach to assimilate multi-source PM2.5 data from satellite and ground observations and jointly adjusted emissions to improve PM2.5 predictions of the WRF-Chem model. Experiments were conducted to verify the method over Hubei Province, China, during the COVID-19 epidemic from Jan 21st to Mar 20th, 2020. The results showed that PM2.5 predictions were improved at almost all the validation sites, and the benefit of data assimilation (DA) can last for 48 h. However, the benefits of DA diminished quickly with the increase of the forecast time. By adjusting emissions, the PM2.5 predictions showed a much slower error accumulation along forecast time. At 48Z, the RMSE still has an 8.85 μg/m3 (19.49%) improvement, suggesting the effectiveness of emissions adjustment based on the improved initial conditions via DA.


Predictive utility of symptom measures in classifying anxiety and depression: A machine-learning approach.
Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are highly prevalent, co-occurring disorders with significant symptom overlap, posing challenges in accurately distinguishing and diagnosing these disorders. The tripartite model proposes that anxious arousal is specific to anxiety and anhedonia is specific to depression, though anxious apprehension may play a greater role in GAD than anxious arousal. The present study tested the efficacy of the Mood and Anxiety Symptom Questionnaire anhedonic depression (MASQ-AD) and anxious arousal (MASQ-AA) scales and the Penn State Worry Questionnaire (PSWQ) in identifying lifetime or current MDD, current major depressive episode (MDE), and GAD using binary support vector machine learning algorithms in an adult sample (n = 150). The PSWQ and MASQ-AD demonstrated predictive utility in screening for and identification of GAD and current MDE respectively, with the MASQ-AD eight-item subscale outperforming the MASQ-AD 14-item subscale. The MASQ-AA did not predict MDD, current MDE, or GAD, and the MASQ-AD did not predict current or lifetime MDD. The PSWQ and MASQ-AD are efficient and accurate screening tools for GAD and current MDE. Results support the tripartite model in that anhedonia is unique to depression, but inclusion of anxious apprehension as a separate dimension of anxiety is warranted.


Immunogenicity of Influenza Vaccination in Patients with Cancer Receiving Immune Checkpoint Inhibitors.
Among prospectively enrolled adult patients with cancer receiving immune checkpoint inhibitors (ICIs; n = 46) or cytotoxic agents (n = 90), seroprotection and seroconversion rates after seasonal quadrivalent influenza vaccinations were higher with ICI than with cytotoxic chemotherapy. These results support annual influenza vaccinations for cancer patients receiving ICIs. Clinical Trials Registration clinicaltrials.gov (NCT03590808).


Primary Care Physicians' Collection, Comfort, and Use of Race and Ethnicity in Clinical Practice in the United States.
The clinical utility of race and ethnicity has been debated. It is important to understand if and how race and ethnicity are communicated and collected in clinical settings. We investigated physicians' self-reported methods of collecting a patient's race and ethnicity in the clinical encounter, their comfort with collecting race and ethnicity, and associations with use of race in clinical decision-making. A national cross-sectional study of 787 clinically active general internists in the United States. Physicians' self-reported comfort with collecting patient race and ethnicity, their collection practices, and use of race in clinical care were assessed. Bivariate and multivariable regression analyses were conducted to examine associations between comfort, collection practices, and use of race. Most physicians asked patients to self-report their race or ethnicity (26.5%) on an intake form or collected this information directly from patients (26.2%). Most physicians were comfortable collecting patient race and ethnicity (84.3%). Physicians who were more comfortable collecting patient race and ethnicity (β= 1.65; [95% confidence interval; CI 0.03-3.28]) or who directly collected patients' race and ethnicity (β= 1.24 [95% CI 0.07-2.41]) were more likely to use race in clinical decision-making than physicians who were uncomfortable. This study documents variation in physician comfort level and practice patterns regarding patient race and ethnicity data collection. As the U.S. population becomes more diverse, future work should examine how physicians speak about race and ethnicity with patients and their use of race and ethnicity data impact patient-physician relationships, clinical decision-making, and patient outcomes.


Inducing cell growth arrest and apoptosis by silencing long non-coding RNA PCAT-1 in human bladder cancer.
Long non-coding RNAs (lncRNAs) are a class of non-coding RNAs that play important roles in cancer development and progression. Prostate cancer-associated transcript 1 (PCAT-1) is a novel lncRNA that promotes cell proliferation in prostate cancer. We hypothesized that PCAT-1 also have roles in bladder cancer. In this study, we found that PCAT-1 was up-regulated in bladder cancer compared to paired normal urothelium. Cell proliferation inhibition and apoptosis induction were also observed in PCAT-1 small hairpin RNA (shRNA)-transfected bladder cancer T24 and 5637 cells. Our data suggest that PCAT-1 plays oncogenic roles and can be used as a therapeutic target for treating human bladder cancer.


Vision: more than expected in the early visual system.
In the standard model of central visual processing, orientation tuned responses in cortex are built from untuned thalamic inputs. But recent studies in the mouse show orientation selectivity in thalamic neurons, and address their potential source and possible roles in cortical computation.


Dietary Branched-Chain Amino Acids (BCAAs) and Risk of Dyslipidemia in a Chinese Population.
This study aimed to explore the association between dietary BCAAs, blood lipid levels and risk of dyslipidemia. In this case−control study, a total of 9541 subjects with normal blood lipids were included as a control group, and 9792 patients with dyslipidemia were included as a case group. Dietary BCAA intake data were measured using 3-day 24 h meal recalls and household condiment weighing. All samples were from China Nutrition and Health Surveillance (2015). Generalized linear model, logistic regression, and restricted cubic spline (RCS) were used to evaluate the relationship between dietary BCAAs, blood lipids and dyslipidemia. After adjusting for confounding factors, dietary BCAAs were positively correlated with TC and LDL-C (p < 0.05). Higher dietary BCAAs were associated with higher OR for Hypercholesteremia (Q4 vs. Q1, OR = 1.29, 95% CI: 1.05−1.58, p-trend = 0.034). The ORs of Hyper-LDL-cholesterolemia showed inverted U-shaped with increasing dietary BCAAs (Q3 vs. Q1, OR = 1.20, 95% CI: 1.03−1.39; Q2 vs. Q1, OR = 1.05, 95% CI: 1.01−1.31). The relationship between dietary BCAAs and the risk of Hypercholesteremia and Hyper-LDL-cholesterolemia were both nonlinear (p nonlinearity = 0.0059, 0.0198). Our study reveals that dietary BCAAs are associated with specific types of lipids and risk of dyslipidemia, some of which may be non-linear.


Introducing water frogs--is there a risk for indigenous species in France?
The ecological success of introduced species in their new environments is difficult to predict. Recently, the water frog species Rana ridibunda has raised interest, as different genetic lineages were introduced to various European countries. The aim of the present study was to analyze the potential invasiveness of R. ridibunda and assess the risk of replacement for indigenous water frog species. The investigation of over 700 water frogs from 22 locations in southern France and four locations in Spain shows that the competition with indigenous species is mainly limited to a particular habitat type, characterized by high-oxygen and low-salinity freshwater. The competitive strength of R. ridibunda may be related to a higher growth rate and longevity as compared to the indigenous species R. grafi and R. perezi. Our data suggest that R. ridibunda is a risk to the diversity of indigenous water frog assemblages in France. Future monitoring needs to clarify the distribution of R. ridibunda, its ecological niche, and the risk status for indigenous water frog species.


Media use and organ donation willingness: A latent profile analysis from Chinese residents.
Previous studies have paid attention to media as an important channel for understanding organ donation knowledge and have not divided groups according to the degree of media use to study their differences in organ donation. Therefore, the purpose of this study is to explore the influence of media use on organ donation willingness and the influencing factors of organ donation willingness of people with different media use levels. A cross-sectional study of residents from 120 cities in China was conducted by questionnaire survey. Using Mplus 8.3 software, the latent profile analysis of seven media usage related items was made, and multiple linear regression was performed to analyze the influence of varying levels of media use on organ donation willingness of different population. All the interviewees were divided into three groups, namely, "Occluded media use" (9.7%), "Ordinary media use" (67.1%) and "High-frequency media use" (23.2%). Compared with ordinary media use, high-frequency media population (β = 0.06, P < 0.001) were positively correlated with their willingness to accept organ donation, residents who used media occlusion (β = -0.02, P < 0.001) were negatively correlated with their willingness to accept organ donation. The influencing factors of residents' accept willingness to organ donation were different among the types of occluded media use, ordinary media use and high-frequency media use. It is necessary to formulate personalized and targeted dissemination strategies of organ donation health information for different media users.


Effect of vitamin D supplementation on assisted reproduction technology (ART) outcomes and underlying biological mechanisms: protocol of a randomized clinical controlled trial. The "supplementation of vitamin D and reproductive outcome" (SUNDRO) study.
Vitamin D plays an important role in human physiology and pathology. The receptor for vitamin D regulates 0.5-5% of the human genome. Accordingly, vitamin D insufficiency has been shown to increase the risk of several diseases. In recent years, based on growing evidence, on a role of vitamin D has been also postulated in reproductive health both in animals and humans, especially in female fertility female fertility. In vitro fertilization success was shown to be higher in women with appropriate reserves of vitamin D. However a causal relation has not been demonstrated and randomized controlled trials testing the effectiveness of vitamin D supplementation in IVF are warranted. This is a multicenter randomized double blinded placebo controlled study aimed at determining the benefits of vitamin D [25(OH)D] supplementation in improving clinical pregnancy rate in women undergoing IVF. Eligible women with a serum level of 25-hydroxyvitamin D [25(OH)D] < 30 ng/ml will be randomized. Recruited women will be given the drug (either 600,000 IU of 25(OH) D or placebo in a single oral administration) at the time of randomization. Two centres will participate and the sample size (700 women) is foreseen to be equally distributed between the two. Patients will be treated according to standard IVF protocols. The primary aim of the study is the cumulative clinical pregnancy rate per oocyte retrieval. Clinical pregnancy is defined as the presence of at least one intrauterine gestational sac with viable foetus at first ultrasound assessment (3 weeks after a positive human chorionic gonadotropin [hCG] assessment). Secondary outcomes include: 1) clinical and embryological variables; 2) oocyte and endometrium quality at a molecular level. To investigate this latter aspect, samples of cumulus cells, follicular and endometrial fluids will be obtained from a subgroup of 50 age-matched good-prognosis cases and controls. The protocol was included in EudraCT on 22nd September 2015 with the registration number assigned ' 2015-004233-27 '; it was submitted through the database of the Italian "Osservatorio Nazionale della Sperimentazione Clinica (OsSC)" - (National Monitoring Centre of Clinical Trials) to the National Competent Authority on 8th March 2016 and approved on 23rd June 2016.


The effects of a school-based psychosocial intervention on resilience and health outcomes among vulnerable children.
Responding to the psychosocial health needs of the vulnerable population has been considered as a significant public health issue that must be addressed through access to public health professionals. The study adopted a quasi-experimental design to evaluate the impact of a training program on nurses and teachers' knowledge of psychosocial health needs of vulnerable children and the impact this had on children's resilience and psychosocial health outcomes (self-esteem, social connection, anxiety, and depression). The result showed a significant increase in the knowledge mean scores of both nurses and teachers 6 weeks post intervention. Children's depression scores significantly reduced post intervention. Their resilience, self-esteem, and social connection were also significantly improved, while no significant reduction was found in their anxiety scores. The results of the pilot study suggest that a more rigorous study be conducted to further ascertain the effectiveness of the various interventions used in this study while taking into consideration the challenges raised by the authors.


Fecal Immunochemical Tests Combined With Other Stool Tests for Colorectal Cancer and Advanced Adenoma Detection: A Systematic Review.
Despite moderate to high detection rates of fecal immunochemical tests (FITs) of colorectal cancer (CRC), detection of adenomas remains limited. Further stool tests exist, which are not used in routine practice, such as DNA or RNA markers and protein markers. We aimed at systematically investigating and summarizing evidence for diagnostic performance of combinations of FIT with other stool tests compared with FIT alone in early detection of CRC and its precursors. We systematically reviewed studies that evaluated FITs in combination with other stool tests and compared measures of diagnostic accuracy with and without additional stool tests. PubMed and Web of Science were searched from inception to May 2015. Reference lists of eligible studies were also screened. Two reviewers extracted data independently. Some of the reports on DNA, RNA, or tissue tests, including tests based on DNA mutations, methylation, and integrity in selected genes as well as microRNA expression, showed some improvements of diagnostic test accuracy. In contrast, so far assessed stool protein markers did generally not lead to substantial improvements in performance of FIT when added to the latter. Many marker combinations were reported only in one study each, and few studies were conducted in a true screening setting. Several stool markers show potential to improve performance of FITs. However, the results require confirmation in further studies, which should also evaluate the costs and cost-effectiveness of combined screening strategies.


Comparison of safety, efficacy, and long-term follow-up between "one-step" and "step-up" approaches for infected pancreatic necrosis.
Although the "Step-up" strategy is the primary surgical treatment for infected pancreatic necrosis, it is not suitable for all such patients. The "One-step" strategy represents a novel treatment, but the safety, efficacy, and long-term follow-up have not yet been compared between these two approaches. To compare the safety, efficacy, and long-term follow-up of two surgical approaches to provide a reference for infected pancreatic necrosis treatment. This was a retrospective analysis of infectious pancreatic necrosis patients who underwent "One-step" or "Step-up" necrosectomy at Xuan Wu Hospital, Capital Medical University, from May 2014 to December 2020. The primary outcome was the composite endpoint of severe complications or death. Patients were followed up every 6 mo after discharge until death or June 30, 2021. Statistical analysis was performed using SPSS 21.0 and GraphPad Prism 8.0, and statistical significance was set at P < 0.05. One-hundred-and-fifty-eight patients were enrolled, of whom 61 patients underwent "One-step" necrosectomy and 97 patients underwent "Step-up" necrosectomy. During the long-term follow-up period, 40 patients in the "One-step" group and 63 patients in the "Step-up" group survived. The time from disease onset to hospital admission (53.69 ± 38.14 vs 32.20 ± 20.75, P < 0.001) and to initial surgical treatment was longer in the "Step-up" than in the "One-step" group (54.38 ± 10.46 vs 76.58 ± 17.03, P < 0.001). Patients who underwent "Step-up" necrosectomy had a longer hospitalization duration (65.41 ± 28.14 vs 52.76 ± 24.71, P = 0.02), and more interventions (4.26 ± 1.71 vs 3.18 ± 1.39, P < 0.001). Postoperative inflammatory indicator levels were significantly lower than preoperative levels in each group. Although the incisional hernia incidence was higher in the "One-step" group, no significant difference was found in the composite outcomes of severe complications or death, new-onset organ failure, postoperative complications, inflammatory indicators, long-term complications, quality of life, and medical costs between the groups (P > 0.05). Compared with the "Step-up" approach, the "One-step" approach is a safe and effective treatment method with better long-term quality of life and prognosis. It also provides an alternative surgical treatment strategy for patients with infected pancreatic necrosis.


[Interhospital transport with extracorporeal life support: results and perspectives after 5 years experience].
Describing the experience of a referral center for interhospital patients transport treated with extracorporeal circulatory or respiratory support (ECLS), the difficulties encountered and the results obtained. Retrospective and observational study. All patients with respiratory or circulatory failure accepted for extracorporeal assistance for which routine medical transport was life threatening. A descriptive analysis was performed (median and interquartile deviation). Comparison of biological data was performed using a non-parametric Wilcoxon test and 5 years overall survival was determined by a Kaplan-Meier analysis. Over a 55-month period, 29 patients were selected for transportation under ECMO or ECLS. Indication was respiratory failure in 38 % of cases, hemodynamic instability in 52 % of cases and combined symptoms in 10 % of cases. Average duration of transportation was 40 km (9-64 km). No complication related to transport was observed. Incidence of intrahospital death was 57 %. There was no correlation between death and indication of ECLS. Five-year survival was 55 % and 39 % for venovenous and arteriovenous ECLS, respectively. In our experience, interhospital transport of patients under ECMO is feasible in satisfactory conditions of safety with trained team and standard procedures.


The dysregulation of lncRNAs by epigenetic factors in human pathologies.
Dysregulation of long noncoding RNAs (lncRNAs) contributes to numerous human diseases, including cancers and autoimmune diseases (ADs). Given the importance of lncRNAs in disease initiation and progression, a deeper understanding of their complex regulatory network is required to facilitate their use as therapeutic targets for ADs. In this review, we summarize how lncRNAs are dysregulated in pathological states by epigenetic factors, including RNA-binding proteins, chemical modifications (N6-methyladenosine, 5-methylcytosine, 7-methylguanosine, adenosine-to-inosine editing, microRNA, alternative splicing, DNA methylation, and histone modification). Moreover, the roles of lncRNA epigenetic regulators in immune response and ADs are discussed, providing new insights into the complicated epigenetic factor-lncRNA network, thus, laying a theoretical foundation for future research and clinical application of lncRNAs.


Failure of body mass index or body weight to influence markedly the response to ovarian hyperstimulation in normal cycling women.
A retrospective analysis was performed of 368 normally cycling women treated with a single cycle of a standard ovarian hyperstimulation regime (CC 100 mg days 5 to 9 and hMG 150 IU days 6, 8, and 10) associated with either an IVF or GIFT program. Neither the peak serum E2 level attained nor the number of days of stimulation required bore a relationship to the BMI or the total body weight of these women. Whereas the mean number of oocytes aspirated from women with BMI less than 19.1 was higher (6.4 +/- 3.2) compared with obese women (BMI greater than 27.6, 4.8 +/- 2.6), the rate of fertilization was not different for both BMI extremes. It is concluded that factors other than BMI or total body weight have more important influences on the response to hyperstimulation in normal women.


Principal component analysis for the identification of pollution sources in mussel survey by trace metals.
Principal component analysis has been applied to analyze the correlation matrix obtained from a 8 X 43 data matrix. The 8 trace metals are Mn, Co, Ni, Cu, Zn, Cd, Hg, Pb, which are contained in the soft part of mussels (Mytilus galloprovincialis Lamarck). Mussels were sampled from two sites in the Gulf of Trieste. In both samples, 76-78% of the total variance is explained by the four principal components. The orthogonally rotated factor matrix indicates that Co and Ni are bonded to the first principal component and Cd and Pb to the first (site 2) or second principal component (site 1). The origin of trace metals in the soft part of mussels from the Gulf of Trieste is discussed.


Toll-like receptor 2 mediates alveolar macrophage response to Pneumocystis murina.
The innate immune response to Pneumocystis infection is not well understood. In this study, normal C57BL/6 mouse alveolar macrophages were found to respond to Pneumocystis murina organisms through Toll-like receptor 2 (TLR2), leading to the nuclear translocation of NF-kappaB and the production of proinflammatory cytokine tumor necrosis factor alpha (TNF-alpha) and chemokine macrophage inflammatory protein 2 (MIP-2). P. murina stimulation of normal alveolar macrophages from C57BL/6 mice resulted in increased TLR2 transcription but not increased TLR4 transcription. In gain-of-function studies with HEK293 cells expressing TLR2 or TLR4, only TLR2 was found to stimulate an NF-kappaB response to P. murina. TNF-alpha and MIP-2 production in response to P. murina by mouse alveolar macrophages was inhibited by a monoclonal antibody that specifically blocked the ligand-binding ability of TLR2. Alveolar macrophages from TLR2 knockout (TLR2-/-) mice showed little increase in TNF-alpha and MIP-2 mRNA levels upon P. murina stimulation. An in vivo study showed that TLR2-/- mice challenged with P. murina had reduced cytokine responses. These results indicate that TLR2 plays a major role in the innate immune response to P. murina.


Synthesis and antibacterial activity of 2-alkoxy penems.
The phosphite mediated Oxalimide cyclization reaction was extended to 4-dithiocarbonates of N-oxalyl-2-azetidinones to synthesize 2-alkoxy penems 3. In general, the in vitro antibacterial potency of compounds 3 was weak compared to the highly potent 2-alkylthiopenems 2.


Climate Change and Extreme Weather Events in Australia: Impact on Allergic Diseases.
Several climate change-related predictions and observations have been documented for the Australian continent. Extreme weather events such as cycles of severe drought and damaging flooding are occurring with greater frequency and have a severe impact on human health. Two specific aspects of climate change affecting allergic and other respiratory disorders are outlined: firstly, the consequences of extreme weather events and secondly, the change in distribution of airborne allergens that results from various climate change factors.


Impact of storage temperature and filtration method on dissolved trace metal concentrations in coastal water samples.
Trace elements play a major role in biogeochemical cycles and oceanographic processes. To determine trace element concentrations, the dissolved and particulate phase are usually separated by filtration. However, the frequently used membrane filtration as well as sample storage can bias the dissolved elemental concentrations by adsorption or desorption/contamination. We present a comparison of two filtration methods for coastal and estuarine water samples (pressure filtration with Nuclepore™ polycarbonate filters, vacuum filtration with DigiFILTER™s) applied to aliquots of a large-volume coastal water sample that were stored at -18°C or 4°C for up to nine weeks. The filtrates were analyzed by seaFAST-ICP-MS for dissolved Cd, Ce, Co, Cu, Dy, Er, Eu, Fe, Ho, La, Mn, Mo, Nd, Pb, Pr, Sm, Tb, U, V, W, Y, and Zn. The filtration blanks of DigiFILTER™s (0.0006 ± 0.0010 ng L-1 for Ho to 110 ± 180 ng L-1 for Zn) were sufficiently low for quantification of all analyzed elements with good repeatability, enabling a fast and reliable filtration of large sample sets of coastal water. However, the findings also highlight the need to measure procedural blanks including the filtration instead of only the instrument blanks to validate results. Measured concentrations of both filtration methods did not differ significantly for Cd, Cu, Mo, U, V, W, Zn but for other investigated elements, the ratio between both methods was up to 1.8 for Ce and 4.1 for Fe. Within nine weeks of storage, the elemental concentrations decreased significantly, resulting in losses of 20% Mn in frozen samples and 63% Pb, 64% Co and 93% Mn in cooled samples. PRACTITIONER POINTS: Two fast and cheap filtration methods for coastal water samples were compared. Dissolved concentrations of 22 elements were measured by seaFAST-ICP-MS. The filtration method is important in addition to filter pore size. Filtration blanks need to be reported to maintain comparability between methods. Cool and frozen storage of water samples biases the dissolved metal concentration.


Hepatosplenic schistosomiasis in pregnancy: report of a case and review of the literature.
We present a report of a pregnancy complicated by chronic schistosomiasis. A.H. is a 22 year old G1 Filipina, referred at 34 weeks gestational age for evaluation of hypersplenism and progressive thrombocytopenia. Physical exam was remarkable for hepatosplenomegaly. Laboratory evaluation of hepatic, renal, hematologic, autoimmune, or infectious disease etiology or abnormality was negative. Ultrasound revealed a normal fetus, an enlarged spleen, dilated splenic and hepatic vasculature and an enlarged liver with periportal fibrosis. Abdominal computed tomography revealed subcapsular calcifications, dilated ducts, and periportal fibrosis. Esophagogastrojejeunoscopy showed no varices. The presumptive diagnosis of hypersplenism secondary to chronic hepatosplenic schistosomiasis was made. Based on pathophysiology and literature review conservative management was elected. Liver functions, clotting functions, and platelet counts were monitored closely. Intense antepartum fetal monitoring was performed. Platelet counts remained between 30 and 40K. The patient went into labor at 38 3/7 weeks and delivered a 3148 g female Apgars 8/9 by spontaneous vaginal delivery. Evaluation of the placenta was negative for ova. By 2 weeks postpartum platelet counts had increased to the 60-70 k range, and a rectal biopsy, positive for S. japonicum ova was performed. Treatment with three doses of Praziquantel 20 mg/kg q8h was completed prior to her return to the Philippines.


Effects of listener sophistication on judgements of tracheoesophageal talker intelligibility.
The purpose of this project was to provide preliminary data on comparative judgments of tracheoesophageal (TE) speech intelligibility by two groups of listeners who varied in their listening sophistication. Four highly proficient TE talkers produced the stimuli for the study. Stimuli represented all consonant manner classes in both pre- and postvocalic contexts. The two listener groups were composed of 10 naive listeners and 10 experienced speech pathologists. Data from each listener group was analyzed for overall intelligibility and intelligibility by pre- and postvocalic phonetic position. Scores were also quantified by phonetic manner class. Statistically significant differences were identified between judgments of the two listener groups for prevocalic stops and fricatives. Experienced listeners did, however, generally judge talkers to exhibit higher intelligibility compared to naive listeners. The potential clinical implications of these data are discussed.


Interactions between vasotocin and other corticotropic factors on the frog adrenal gland.
The adrenocortical cells of the amphibian interrenal (adrenal) gland are controlled by multiple factors including neuropeptides and classical neurotransmitters. In particular, it has recently been shown that vasotocin (AVT), the amphibian counterpart of vasopressin, is a potent stimulator of frog corticosteroidogenesis. In the present study, we have investigated the possible interactions between AVT and other regulatory factors on frog interrenal tissue. When AVT (10(-9) M) and serotonin (10(-6) M) were infused together, a strict addition of the individual effects was observed. Similar results were obtained with concomitant infusion of AVT and vasoactive intestinal peptide or AVT and ACTH. In contrast, when AVT (10(-9) M) and acetylcholine (5 x 10(-5) M) were added together, the increase in corticosteroid secretion was less than additive. Dopamine induced a significant reduction of AVT-evoked stimulation of corticosterone production. These results indicate that regulatory peptides or classical neurotransmitters which participate in the control of adrenal steroidogenesis may interact on their target cell to modulate the activity of their congeners.


Effect of zinc added to a daily small-quantity lipid-based nutrient supplement on diarrhoea, malaria, fever and respiratory infections in young children in rural Burkina Faso: a cluster-randomised trial.
Preventive zinc supplementation in the form of tablets or syrup reduces the incidence of diarrhoea and acute lower respiratory tract infections (RTI), but its effect on malaria is inconsistent. When zinc is administered with other micronutrients or foods, its effect is also uncertain. We assessed the effects of different amounts and sources of zinc on the frequency of diarrhoea, malaria, fever and RTI in young children. This community-based, double-blind, placebo-controlled, cluster-randomised trial of 2435 children 9 months of age was carried out between April 2010 and July 2012 in rural southwestern Burkina Faso. Participants were randomly assigned at the concession level to receive daily 1 of 4 interventions for 9 months: (1) 20 g small-quantity lipid-based nutrient supplement (SQ-LNS) without zinc and placebo tablet, (2) 20 g SQ-LNS with 5 mg zinc and placebo tablet, (3) 20 g SQ-LNS with 10 mg zinc and placebo tablet or (4) 20 g SQ-LNS without zinc and 5 mg zinc tablet. Participants were visited weekly in their homes for morbidity surveillance for 9 months, and those with uncomplicated diarrhoea and malaria received treatment from the study field workers in the community. Incidence and longitudinal prevalence of diarrhoea, malaria, fever, and lower and upper RTI by intervention group. The incidence of diarrhoea, malaria and fever was 1.10 (±1.03 SD), 0.61 (±0.66 SD) and 1.49 (±1.12 SD) episodes per 100 child-days at risk, respectively, and did not differ by intervention group (p=0.589, p=0.856 and p=0.830, respectively). The longitudinal prevalence of acute lower RTI (0.1%; 95% IC 0.1-0.2%) and of upper RTI (7.8%; 95% IC 7.1-8.4%) did not differ among groups (p=0.234 and p=0.501, respectively). Inclusion of 5 or 10 mg zinc in SQ-LNS and provision of 5 mg zinc dispersible tablet along with SQ-LNS had no impact on the incidence of diarrhoea, malaria and fever or the longitudinal prevalence of RTI compared with SQ-LNS without zinc in this population. NCT00944281.


Signaling mediated by the NF-κB sub-units NF-κB1, NF-κB2 and c-Rel differentially regulate Helicobacter felis-induced gastric carcinogenesis in C57BL/6 mice.
The classical nuclear factor-kappaB (NF-κB) signaling pathway has been shown to be important in a number of models of inflammation-associated cancer. In a mouse model of Helicobacter-induced gastric cancer, impairment of classical NF-κB signaling in the gastric epithelium led to the development of increased preneoplastic pathology, however the role of specific NF-κB proteins in Helicobacter-associated gastric cancer development remains poorly understood. To investigate this C57BL/6, Nfkb1(-/-), Nfkb2(-/-) and c-Rel(-/-) mice were infected with Helicobacter felis for 6 weeks or 12 months. Bacterial colonization, gastric atrophy and preneoplastic changes were assessed histologically and cytokine expression was assessed by qPCR. Nfkb1(-/-) mice developed spontaneous gastric atrophy when maintained for 12 months in conventional animal house conditions. They also developed more pronounced gastric atrophy after short-term H. felis colonization with a similar extent of preneoplasia to wild-type (WT) mice after 12 months. c-Rel(-/-) mice developed a similar degree of gastric atrophy to WT mice; 3 of 6 of these animals also developed lymphoproliferative lesions after 12 months of infection. Nfkb2(-/-) mice developed minimal gastric epithelial pathology even 12 months after H. felis infection. These findings demonstrate that NF-κB1- and NF-κB2-mediated signaling pathways differentially regulate the epithelial consequences of H. felis infection in the stomach, while c-Rel-mediated signaling also appears to modulate the risk of lymphomagenesis in gastric mucosa-associated lymphoid tissue.


Effect of 2,3-butanedione monoxime on smooth-muscle contraction of guinea-pig portal vein.
Effects of 2,3-butanedione-2-monoxime (BDM) on the contraction of intact and skinned smooth muscles from guinea-pig portal vein were examined. In intact preparations loaded with fura-2, 5-10 mM BDM markedly suppressed Ca2+ transients and force developments induced by 154 mM potassium and by phenylephrine (0.1 mM). On the other hand, in Ca(2+)-free depolarizing solution, BDM did not suppress phenylephrine (0.1 mM)-induced Ca2+ transient and force development. In skinned preparations obtained with Staphylococcus aureus alpha-toxin treatment, BDM did not markedly affect active force development. The above results indicate that BDM suppresses contraction of the portal vein mainly by the inhibition of voltage-dependent cytosolic Ca2+ transients. An additional result suggests that BDM suppresses the force-enhancing effect of alpha 1-adrenergic agents on the contractile elements.


Effects of technology-supported exercise programs on the knee pain, physical function, and quality of life of individuals with knee osteoarthritis and/or chronic knee pain: A systematic review and meta-analysis of randomized controlled trials.
The study sought to examine the effects of technology-supported exercise programs on the knee pain, physical function, and quality of life of individuals with knee osteoarthritis and/or chronic knee pain by a systematic review and meta-analysis of randomized controlled trials. We searched MEDLINE, EMBASE, CINAHL Plus, and the Cochrane Library from database inception to August 2020. A meta-analysis and subgroup analyses, stratified by technology type and program feature, were conducted. Twelve randomized controlled trials were reviewed, all of which implemented the programs for 4 weeks to 6 months. Telephone, Web, mobile app, computer, and virtual reality were used to deliver the programs. The meta-analysis showed that these programs were associated with significant improvements in knee pain (standardized mean difference [SMD] = -0.29; 95% confidence interval [CI], -0.48 to -0.10; P = .003) and quality of life (SMD = 0.25; 95% CI, 0.04 to 0.46; P = .02) but not with significant improvement in physical function (SMD = 0.22; 95% CI, 0 to 0.43; P = .053). Subgroup analyses showed that some technology types and program features were suggestive of potential benefits. Using technology to deliver the exercise programs appears to offer benefits. The technology types and program features that were associated with health values have been identified, based on which suggestions are discussed for the further research and development of such programs.


Inhibition of Phytophthora species, agents of cocoa black pod disease, by secondary metabolites of Trichoderma species.
Cocoa production is affected by the black pod disease caused by several Phytophthora species that bring, about each year, an estimated loss of 44% of world production. Chemical control remains expensive and poses an enormous risk of poisoning for the users and the environment. Biocontrol by using antagonistic microorganisms has become an alternative to the integrated control strategy against this disease. Trichoderma viride T7, T. harzanium T40, and T. asperellum T54, which showed in vivo and in vitro antagonistic activity against P. palmivora, were cultured and mycelia extracted. Inhibition activity of crude extracts was determined, and then organic compounds were isolated and characterized. The in vitro effect of each compound on the conidia germination and mycelia growth of four P. palmivora, two P. megakaria, and one P. capsici was evaluated. T. viride that displayed best activities produced two active metabolites, viridin and gliovirin, against P. palmivora and P. megakaria strains. However, no activity against P. capsici was observed. Besides being active separately, these two compounds have a synergistic effect for both inhibitions, mycelia growth and conidia germination. These results provide the basis for the development of a low-impact pesticide based on a mixture of viridin and gliovirine.


Spatial distribution of radon contamination in hot springs water and its cancer and non-cancer risks in the Hunza-Nagar valley, Pakistan.
Radon (222Rn) is a ubiquitous radioactive gas and could threaten human life due to its potential for cancer and non-cancer risks. This study examined the measurement of 222Rn concentration and associated health risks in the hot springs of Hunza-Nagar valley. For this purpose, the hot springs water of Hunza and Nagar districts and the background sites were analyzed for 222Rn concentration using the RAD7 detector (Durridge Company, USA). The average concentrations of 222Rn were 46.1 ± 0.94, 65.3 ± 0.45, and 5.47 ± 0.25 Bq/L in the Hunza district, Nagar district, and background sites, respectively. Results showed that 222Rn concentrations of hot springs water were multifold higher than the background sites. 222Rn concentrations for hot springs water in Hunza-Nagar valley had surpassed the maximum contamination level set by the US environmental protection agency (USEPA). Humans' annual mean exposure dose rates of various age groups were calculated for the estimated lifetime cancer risk (ELCR) and non-cancer risks. The total annual mean exposure doses from 222Rn in water (EwTotal) values were (187 ± 3.80, 265 ± 1.84, and 22.2 ± 1.02 μSv/a) for infants (143 ± 2.92, 203 ± 1.40, and 17.0 ± 0.78 μSv/a) children, and (138 ± 2.80, 196 ± 1.35, and 16.4 ± 0.76 μSv/a) adults in the Hunza district, Nagar district, and background, respectively. Among the age groups of humans, infants showed a higher risk than others. Results showed that hot springs water consumption surpassed the world health organization threshold of 100 μSv/y for chronic or non-cancer and USEPA 0.1 × 10-3 for ELCR risks. The concentration of 222Rn showed a positive correlation (> 0.68) with hot springs' water temperature and pH suggesting a common origin.


Visual evoked potentials in acute occipital blindness. Diagnostic and prognostic value.
Pattern-evoked and flash-evoked responses were recorded from four patients with acute blindness due to occipital ischaemia. No responses could be obtained with pattern stimulation. Flash stimulation, however, yielded well-reproducible potentials in all four cases in spite of practically complete visual loss. In one patient vision recovered completely while the three others showed poor or minimal recovery in restricted visual field areas only. It is concluded that the flash method is not appropriate for differentiation of occipital blindness from psychogenic visual disorders. Furthermore, preserved flash-evoked potentials in the acute stage of occipital blindness cannot be taken as a reliable prognostic sign for visual recovery, as has been postulated by others. A possible extrastriate origin of these flash responses is discussed in view of recent theories on a second visual system.


Factors Associated With the Quality of Life of Nursing Home Residents During the COVID-19 Pandemic: A Cross-Sectional Study.
Quality of life (QoL) of nursing home (NH) residents is critical, yet understudied, particularly during the COVID-19 pandemic. Our objective was to examine whether COVID-19 outbreaks, lack of access to geriatric professionals, and care aide burnout were associated with NH residents' QoL. Cross-sectional study (July to December 2021). We purposefully selected 9 NHs in Alberta, Canada, based on their COVID-19 exposure (no or minor/short outbreaks vs repeated or extensive outbreaks). We included data for 689 residents from 18 care units. We used the DEMQOL-CH to assess resident QoL through video-based care aide interviews. Independent variables included a COVID-19 outbreak in the NH in the past 2 weeks (health authority records), care unit-levels of care aide burnout (9-item short-form Maslach Burnout Inventory), and resident access to geriatric professionals (validated facility survey). We ran mixed-effects regression models, adjusted for facility and care unit (validated surveys), and resident covariates (Resident Assessment Instrument-Minimum Data Set 2.0). Recent COVID-19 outbreaks (β = 0.189; 95% CI: 0.058-0.320), higher proportions of emotionally exhausted care aides on a care unit (β = 0.681; 95% CI: 0.246-1.115), and lack of access to geriatric professionals (β = 0.216; 95% CI: 0.003-0.428) were significantly associated with poorer resident QoL. Policies aimed at reducing infection outbreaks, better supporting staff, and increasing access to specialist providers may help to mitigate how COVID-19 has negatively affected NH resident QoL.


Phosphotriester formation by the haloethylnitrosoureas and repair of these lesions by E. coli BS21 extracts.
The alkylation of phosphates in DNA by therapeutically active haloethylnitrosoureas was studied by reacting N-chloroethyl-N-nitrosourea (CNU) with dTpdT, separating the products by HPLC, and identifying them by co-chromatography with authentic markers. Both hydroxyethyl and chloroethyl phosphotriesters of dTpdT were identified; a similar reaction between CNU and dTR yielded 3-hydroxyethyl and 3-chloroethyl dTR as the major products of ring alkylation. A DNA-like substrate for repair studies was synthesized by reacting 14C-labelled N-(2-chloroethyl)-N'-cyclohexyl-N-nitrosourea (14C-CCNU) with poly dT and annealing the product to poly dA. An extract of E. coli strain BS21 selectively transferred a chloroethyl group from one of the chloroethyl phosphotriester isomers in this substrate to the bacterial protein; chemical instability of the hydroxyethyl phosphotriesters precluded definite conclusions about the repair of this product.


Toward 'seeing' critically: a Bayesian analysis of the impacts of a critical pedagogy.
Critical reflection supports enactment of the social roles of care, like collaboration and advocacy. We require evidence that links critical teaching approaches to future critically reflective practice. We thus asked: does a theory-informed approach to teaching critical reflection influence what learners talk about (i.e. topics of discussion) and how they talk (i.e. whether they talk in critically reflective ways) during subsequent learning experiences? Pre-clinical students (n = 75) were randomized into control and intervention conditions (8 groups each, of up to 5 interprofessional students). Participants completed an online Social Determinants of Health (SDoH) module, followed by either: a SDoH discussion (control) or critically reflective dialogue (intervention). Participants then experienced a common learning session (homecare curriculum and debrief) as outcome assessment, and another similar session one-week later. Blinded coders coded transcripts for what (topics) was said and how (critically reflective or not). We constructed Bayesian regression models for the probability of meaning units (unique utterances) being coded as particular what codes and as critically reflective or not (how). Groups exposed to the intervention were more likely, in a subsequent learning experience, to talk in a critically reflective manner (how) (0.096 [0.04, 0.15]) about similar content (no meaningful differences in what was said). This difference waned at one-week follow up. We showed experimentally that a particular critical pedagogical approach can make learners' subsequent talk, ways of seeing, more critically reflective even when talking about similar topics. This study offers the field important new options for studying historically challenging-to-evaluate impacts and supports theoretical assertions about the potential of critical pedagogies.


Diet-induced obesity alters myeloid cell populations in naïve and injured lung.
There are pulmonary consequences to obesity, including increased prevalence of asthma, greater susceptibility to influenza, and possibly reduced susceptibility to lung injury. Although it is well established that obesity is associated with alterations to the immune system, little is known about obesity-associated changes to pulmonary immune cells. We hypothesized that obesity would alter the inflammatory milieu in the unchallenged lung and circulation; thereby contributing to altered susceptibility to lung injury. We used a murine model of diet-induced obesity and evaluated bone marrow and blood leukocytes at 3 months, and pulmonary leukocytes at 3 and 6 months for changes in their adhesion and chemokine receptors, markers of activation states, and cell numbers. We also evaluated the inflammatory response to LPS in obese mice. In the lung, diet-induced obesity was associated with increased leukocyte numbers over-time. Adhesion receptors were increased in a cell- and site-specific fashion, and there was an evolution of macrophage and neutrophil polarization toward M1 and N1, respectively. After LPS-challenge, obesity was associated with increased neutrophil recruitment to the lung with impaired migration into the alveolar space. Associated with these changes, obesity increased LFA-1 and ICAM-1 neutrophil expression and altered CXCL1 gradients. Our results highlight the effects of diet-induced obesity on the murine blood and lung leukocyte populations, including increases in adhesion receptor expression that may contribute to altered recruitment or retention within the lung. Translation of these findings to people with obesity will be critical for determining the basic inflammatory underpinnings of pulmonary disease susceptibility.


Ezrin is highly expressed and a druggable target in chronic lymphocytic leukemia.
Despite the development of therapeutic strategies for chronic lymphocytic leukemia (CLL), most patients remain incurable, relapse, or refractory to current treatments, indicating the need to expand the antineoplastic repertoire for this disease. Ezrin (EZR) is a known oncogene in solid tumors and plays a key role in cell survival and BCR-mediated signaling activation in B-cell lymphomas. However, its role in hematological neoplasms remains poorly explored. The present study assessed EZR expression in samples from CLL patients and healthy donors and evaluated the cellular and molecular effects of a pharmacological EZR inhibitor, NSC305787, in CLL cellular models. EZR was highly expressed and positively associated with relevant signaling pathways related to CLL development and progression, including TP53, PI3K/AKT/mTOR, NF-κB, and MAPK. NSC305787 reduced viability, clonogenicity, and cell cycle progression and induced apoptosis in CLL cells. Pharmacological EZR inhibition also attenuated ERK, S6RP, and NF-κB activation, indicating that EZR not only associates with but also activates these signaling pathways in CLL. Ex vivo assays revealed that the EZR inhibition-induced cell viability reduction was independent of molecular risk and the Binet stage. Our study provides insights into EZR as a pharmacological target in CLL, shedding light on a novel strategy for treating this disease.


Identification of the distinctive type i/XhoI+ strain of Epstein-Barr virus in gastric carcinoma in Peru.
To clarify the reason for the low frequency of Epstein-Barr virus-associated gastric carcinoma (EBVaGC) in Peru, despite the high frequency reported in neighboring countries, the distribution of the distinctive EBV (type i/XhoI+) strain in EBVaGC and a healthy population was examined. EBV polymorphisms in BamHI W1/I1 and XhoI restriction site of the latent membrane protein 1 gene (LMP1) were examined among 11 EBVaGCs and 172 healthy controls from Peru, and these frequencies were compared with those in a previous study of Chile and Colombia (n=303). The frequency of the distinctive EBV strain in EBVaGCs (55%) was significantly higher than that in controls (7%). Furthermore, the frequency of this EBV type in Peruvian controls was significantly lower than that in controls from Chile and Colombia (27%, p<0.001). The low frequency of the distinctive EBV strain among the Peruvian population might be a reason for the lower incidence of EBVaGC in Peru, as compared with neighboring countries.


Retrospective Analysis of Subsolid Nodules' Frequency Using Chest Computed Tomography Detection in an Outpatient Population.
The study was designed to evaluate the frequency of detection and the characteristics of subsolid nodules (SSNs) in outpatients' chest computed tomography (CT) scans from a private hospital in Southern Brazil. A retrospective analysis of all chest CT scans was performed in adult patients from ambulatory care (non-lung cancer screening population) over a thirty-day period. Inclusion criteria were age > 18 years and lung-scanning protocols, including standard-dose high-resolution chest CT (HRCT), enhanced CT, CT angiography, and low-dose chest CT (LDCT). SSNs main features collected were mean diameter, number, density (pure or heterogenous ground glass nodules and part-solid), and localization. TheLungRADS system and the updated Fleischner Society's pulmonary nodules recommendations were used for categorization only for study purposes, although not specifically fitting the population. The presence of emphysema, as well as calcified and solid nodules were also addressed. Statistical analysis was performed using R software, categorial variables are shown as absolute or relative frequencies, and continuous variables as mean and interquartile ranges. Chest computed tomography were performed in 756 patients during the study period (September 2019), and 650 met the inclusion criteria. The IQR for age was 53/73 years; most participants were female (58.3%) and 10.6% had subsolid nodules detected. The frequency of SSNs detection in patients in daily clinical practice, not related to screening populations, is not negligible. Regardless of the final etiology, follow-up is often indicated, given the likelihood of malignancy for persistent lesions.


Comparison of endothelin receptors in normal versus cirrhotic human liver and in the liver from endothelial cell-specific ETB knockout mice.
Endothelin (ET) antagonists show promise in animal models of cirrhosis and portal hypertension. The aim was to pharmacologically characterise the expression of endothelin receptors in human liver, hepatic artery and portal vein. Immunofluorescence staining, receptor autoradiography and competition binding assays were used to localise and quantify ET receptors on hepatic parenchyma, hepatic artery and portal vein in human cirrhotic or normal liver. Additional experiments were performed to determine the affinity and selectivity of ET antagonists for liver ET endothelin receptors. An endothelial cell ET(B) knockout murine model was used to examine the function of sinusoid endothelial ET(B) receptors. ET(B) receptors predominated in normal human liver and displayed the highest ratio (ET(B):ET(A) 63:47) compared with other peripheral tissues. In two patients examined, liver ET(B) expression was up-regulated in cirrhosis (ET(B):ET(A) 83:17). Both sub-types localised to the media of normal portal vein but ET(B) receptors were downregulated fivefold in the media of cirrhotic portal vein. Sinusoid diameter was fourfold smaller in endothelial cell ET(B) knockout mice. The liver morphology of ET(B) knockout mice was markedly different to normal murine liver, with loss of the wide spread sinusoidal pattern. In the knockout mice, sinusoids were reduced in both number and absolute diameter, while large intrahepatic veins were congested with red blood cells. These data support a role for the ET system in cirrhosis of the liver and suggest that endothelial ET(B) blockade may cause sinusoidal constriction which may contribute to hepatotoxicity associated with some endothelin antagonists.


Magnetic resonance imaging at 3.0-T in postmenopausal osteoporosis: a prospective study and review of the literature.
To promote advanced research using magnetic resonance imaging (MRI) in the diagnosis of and screening for osteoporosis by looking for correlations among the T-scores measured by dual-energy X-ray absorptiometry (DEXA), the apparent diffusion coefficient (ADC) values on diffusion-weighted imaging (DWI), and the T1-weighted signal intensity values. This was a prospective study of postmenopausal women with no contraindications to MRI and no history of cancer who underwent DEXA within 30 days before or after the MRI examination. A 3.0-T scanner was used in order to acquire sagittal sequences targeting the lumbar spine. Thirteen women underwent DEXA and MRI. In two cases, the MRI was discontinued early. Therefore, the final sample comprised 11 patients. The ADC values and T1-weighted signal intensity were found to be higher in patients with osteoporosis. However, among the patients > 60 years of age with osteoporosis, ADC values were lower and T1-weighted signal intensity was even higher. It is unlikely that MRI will soon replace DEXA for the diagnostic workup of osteoporosis. Although DWI and ADC mapping are useful for understanding the pathophysiology of osteoporosis, we believe that T1-weighted sequences are more sensitive than is DWI as a means of performing a qualitative analysis of vertebral alterations.


[Effects of a network program for preventing obesity of patients taking antipsychotics or antidepressants].
This study was designed to investigate the effects of a network program to prevent obesity and improve dietary habits for patients taking antipsychotics or antidepressants. Thirty-seven patients in two hospitals were assigned to a control group (21 patients) or an intervention group (16 patients). The intervention group was evaluated to analyze the effect of the network program for six weeks after the program. There was a difference in the rate of increased body weight between the control group and the intervention group. Notably, the body weight of both groups before the intervention was significantly increased. However, after the intervention the body weight of the intervention group rarely increased, whereas, the body weight of the control group was significantly increased as expected. There was an observed difference in diet between the control group and the intervention group. After the intervention, caloric intake per day of the intervention group decreased. Also, the duration of the meal of the intervention group after the intervention was longer than before. The network program for preventing obesity and improving dietary habits of patients taking antipsychotics or antidepressants was effective. The study shows that a network program can be an important part of a nursing intervention in clinical practice.


Nitrogen utilization during postoperative, low nitrogen, high caloric parenteral nutrition.
Twenty elderly patients having undergone colonic resection were randomized into two regimens of postoperative parenteral nutrition. Fructoglucose satisfied the basal caloric needs of the patients. Amino acids were given as a mixture that provided 0.11 (0.09-0.14; mean and range) g/kg/day of nitrogen only. In half of the patients the energy intake was doubled with fat emulsion. The mean nitrogen-energy ratios in grams of nitrogen/kcal/day were 1:201 and 1:336 in the two groups, respectively. Both regimens were given for three days, starting from the first postoperative day. On the first day, the mean nitrogen balance was negative in both groups. On the third day, the mean balance was slightly positive in the amino acid, fructoglucose plus fat emulsion group, but negative in amino acid plus fructoglucose group. Amino acid concentrations in plasma and urine were markedly elevated in both groups, but relative concentrations in plasma remained rather normal. Apparently, a positive postoperative nitrogen balance can be obtained with restricted amino acid supply, if energy is provided in abundance.