Investigations into the biochemical basis of neuromodulation by 2-phenylethylamine: effect on microtubule protein.
In order to understand the role of 2-phenylethylamine (PE) on neuronal responses, membrane changes have been studied using ESR probes. We report that the anticipated change in lipid membrane fluidity generally implicated in signal transduction has not been observed when PE is added to synaptosomes. As cytoskeletal architecture of presynaptic terminals appears to be involved in synaptic transmission, we non-specifically labeled synaptosomal membrane proteins with the sulfhydryl spin probe N-(2,2,6,6-tetramethyl-piperidine-1-oxyl-4-yl) maleimide (4-MAL-TEMPO). The addition of 2-phenylethylamine was found to induce conformational changes, in decreasing the ratio of weakly to strongly immobilized spin label (W/S) to 65% of the control. Of the membrane proteins labeled, 70-90% of the 4-MAL-TEMPO is covalently incorporated into cytoskeletal proteins. In isolated synaptosomes, incorporated with spin-labeled tubulin, the addition of PE reduced the W/S ratio to 51.6% of that obtained for polymerized microtubules. In vitro, PE reduced tau R of polymerized microtubules by 37%. We propose that the PE interaction with tubulin changes microtubule dynamics which may lead to its neuromodulatory action. The state of microtubular assembly can modulate the responsiveness of second messengers in the cell to the effect of stimulatory agents. The nature and physiological significance of PE interaction with tubulin is currently under investigation.


Genetically tagging cholinergic diversity.
In this issue of Neuron, Li et al. (2022) identify and genetically target two sub-populations of cholinergic neurons in the basal forebrain. They show that these cholinergic subtypes have distinct projection patterns, electrophysiological phenotypes, and behavioral functions.


A word of caution: bilateral axillofemoral bypass could not provide sufficient blood flow in a patient who underwent aortic resection for aortoesophageal fistula: a case report.
An 81-year-old man was transferred to our hospital for a ruptured infected descending aortic aneurysm. An emergency thoracic endovascular aortic repair was performed, but a computed tomography scan 7 days later revealed an aortoesophageal fistula. The establishment of extracorporeal circulation using the femoral artery and utilization of the omentum was considered difficult. We performed bilateral axillofemoral bypass followed by descending aortic resection and esophagectomy. However, the patient's circulatory insufficiency worsened, and he died on the 18th postoperative day. In the treatment of aortoesophageal fistula, bilateral axillofemoral bypass is not recommended as an alternative to descending aortic replacement.


Evaluation of the Biken test to detect heat-labile (LT) enterotoxin produced by porcine and human Escherichia coli strains.
Fifty-seven strains of enterotoxigenic Escherichia coli isolated from humans and pigs and producing thermolabile (LT) enterotoxin were used to ascertain the efficiency of the Biken test compared to the passive immune haemolysis test (PIH), considered as very sensitive for detecting that enterotoxin. The two assays were carried out using anti-porcine (anti-LTp), anti-human (anti-LTh), anti-cholera toxin (anti-CT) and anti-choleragenoid (anti-Cg) antisera. Our results showed that the Biken test was very irregular, with many false-negative results. Positive results (ranging from 78.9 to 22.8) were dependent upon the antiserum used. Conversely, the PIH test was much more efficient in the detection of LT, since 100% of the LT+ strains were positive in this test whatever the antiserum used.


Spatial learning and memory function-related gene expression in the hippocampus of mouse exposed to nanoparticle-rich diesel exhaust.
Diesel exhaust particles are a major constituent of ambient particulate matter, and most particles emitted directly from diesel exhaust are smaller than 1microm in diameter. Recently, the toxicity of diesel engine-derived nanoparticles has come to be recognized as an emerging social issue. In the present study, we investigated spatial learning ability and memory function-related gene expressions in mouse hippocampus after the exposure of animals to nanoparticle-rich diesel exhaust (NRDE) with or without a bacterial cell wall component. Lipoteichoic acid (LTA), a cell wall component derived from Staphylococcus aureus, was used to induce systemic inflammation. Male BALB/c mice were exposed to clean air (particle concentration, 4.58microg/m(3)) or NRDE (148.86microg/m(3)) for 5h per day on 5 days of the week for 4 weeks in an exposure chamber, with or without the weekly intraperitoneal injection of LTA. On the day after the final day of exposure, we used a Morris water maze apparatus to examine the ability of the animals to perform a spatial learning task. After the completion of the test, the animals were sacrificed and the hippocampus was collected from each mouse; the expressions of NMDA receptor subunits (NR1, NR2A and NR2B), proinflammatory cytokines (IL-1beta and TNF-alpha) and the oxidative stress marker heme oxygenase 1 were then investigated using real-time RT-PCR. In the Morris water maze task, NRDE/LTA (+) group took a longer time to reach the hidden platform than clear air/LTA (-) group. However, NRDE exposure alone did not affect it. The relative mRNA levels of the NMDA receptor subunits and proinflammatory cytokines were higher in hippocampus of NRDE/LTA (+) group compared to clear air/LTA (-) group. These results indicate that co-exposure of NRDE and LTA could affect spatial learning and memory function-related gene expressions in mouse hippocampus.


2D Ti2C (MXene) as a novel highly efficient and selective agent for photothermal therapy.
Photothermal therapy (PTT) has shown significant potential for anti-cancer modality. In this report, according to our best knowledge, we explore for the first time Ti2C-based MXene as a novel, highly efficient and selective agent for photothermal therapy (PTT). Ti2C superficially modified with PEG was obtained from the layered, commercially available Ti2AlC MAX phase in the process of etching aluminum layers using concentrated HF, and characterized by scanning electron microscopy (SEM), high-resolution transmission electron microscopy (HREM) as well as X-ray photoelectron spectroscopy for chemical analysis (ESCA-XPS). The PEG-coated Ti2C flakes showed a satisfactory photothermal conversion efficacy (PTCE) and good biocompatibility in wide range of the tested concentrations. Through in vitro studies, the PEG-modified Ti2C demonstrated notable NIR-induced ability to cancerous cells' ablation with minimal impact on non-malignant cells up to the concentration of 37.5 μg mL-1. The applied doses of Ti2C_PEG in our work were even 24 times lower comparing other MXene-based photothermal agents. This work is expected to expand the utility of 2D MXenes to biomedical applications through the development of entirely novel agents for photothermal therapy. This work is expected to expand the utility of 2D MXenes to biomedical applications through the development of entirely novel agents for photothermal therapy.


Screening to Identify Postoperative Pain and Cross-Sectional Associations Between Factors Identified in This Process With Pain and Function, Three Months After Total Knee Replacement.
To describe the screening and recruitment process of a randomized trial and evaluate associations with knee pain and function 3 months after total knee replacement (TKR). In order to screen for a multicenter trial, a total of 5,036 patients were sent the Oxford Knee Score (OKS) questionnaire 10 weeks post-TKR. Patients who reported pain in their replaced knee (score of ≤14 on the OKS pain component) completed a second OKS questionnaire 12 weeks post-TKR. Those patients who were still experiencing pain 12 weeks post-TKR completed a detailed questionnaire 13 weeks post-TKR. These data were used to characterize pain in a cross-sectional analysis. Multivariable regression was performed in order to identify factors associated with pain and function at 13 weeks post-TKR. We received OKS questionnaires from 3,058 of 5,063 TKR patients (60%), and 907 of the 3,058 (30%) reported pain in their replaced knee 10 weeks post-TKR. By 12 weeks, 179 of 553 patients (32%) reported improved pain (score of >14 on the OKS pain component). At 13 weeks, 192 of 363 patients (53%) who completed a detailed questionnaire reported neuropathic pain, 94 of 362 (26%) reported depression symptoms, and 95 of 363 (26%) anxiety symptoms. More severe pain at 13 weeks postoperatively was associated with poorer general health, poorer physical health, more pain worry, and lower satisfaction with surgery outcome. More severe functional limitation was associated with higher levels of depression, more pain worry, lower satisfaction with surgery outcome, and higher pain acceptance. Screening after TKR identified individuals with pain. We identified several potential targets (physical and mental health outcomes, acceptance of pain, and quality of life) for tailored intervention to improve outcomes for patients. Future trials of multidisciplinary interventions warranted.


Dynamic structural order of a low-complexity domain facilitates assembly of intermediate filaments.
The coiled-coil domains of intermediate filament (IF) proteins are flanked by regions of low sequence complexity. Whereas IF coiled-coil domains assume dimeric and tetrameric conformations on their own, maturation of eight tetramers into cylindrical IFs is dependent on either "head" or "tail" domains of low sequence complexity. Here we confirm that the tail domain required for assembly of Drosophila Tm1-I/C IFs functions by forming labile cross-β interactions. These interactions are seen in polymers made from the tail domain alone, as well as in assembled IFs formed by the intact Tm1-I/C protein. The ability to visualize such interactions in situ within the context of a discrete cellular assembly lends support to the concept that equivalent interactions may be used in organizing other dynamic aspects of cell morphology.


A Primate Model for Viral Hemorrhagic Fever.
Lymphocytic choriomeningitis virus strain WE (LCMV-WE), a Risk Group 3 virus, causes a disease in rhesus monkeys that closely resembles human infection with Lassa fever virus, a Risk Group 4 agent. Three stages of disease progression have been defined and profiled in this model: pre-viremic, viremic, and terminal. The earliest or pre-viremic stage reveals changes in the blood profile predictive of the later stages of disease. In order to identify whether specific changes are pathognomonic, it was necessary to perform a parallel infection with an attenuated virus (LCMV-Armstrong). Here we review the use of nonhuman primates to model viral hemorrhagic fever and offer a step-by-step guide to using a rhesus macaque model for Lassa fever.


A practical method for N-alkylation of phosphinic (thio)amides with alcohols via transfer hydrogenation.
This manuscript describes a modular method for preparing N-alkyl phosphinic amides from primary or secondary alcohols and primary phosphinic amide (R1R2P=ONH2) nucleophiles via transfer hydrogenation. The transformation typically proceeds in excellent yields, employs conveniently available reagents, and produces water as the only byproduct.


Metabolic activity in cryopreserved and grafted ovarian tissue using high-resolution respirometry.
Cryopreservation of ovarian tissue followed by transplantation represents a strategy to restore ovarian function and fertility. Stress from cryopreservation-thawing processes can lead to alterations and/or damage to mitochondrial structure and functionality. High resolution respirometry and histological analysis were used to evaluate the effect of cryopreservation and transplantation on ovarian tissue. Four different conditions were performed: Fresh non-transplanted tissue, Fresh transplanted tissue, Cryopreserved non-transplanted tissue and Cryopreserved transplanted tissue. All groups were able to respond to the substrates-uncoupler-inhibitor protocol. We found a dramatic decrease in general oxygen consumption in hemi-ovaries submitted to cryopreservation and/or transplantation. The effect of cryopreservation on mitochondrial metabolism was less intense than effect of transplantation, since the transplantation affected all of the mitochondrial states. A total of 2644 follicles were analyzed. Of these, 2198 were classified as morphologically normal. The percentage of morphologically normal follicles was significantly lower in the Cryopreserved transplanted group when compared to the Cryopreserved non-transplanted group and the Fresh transplanted group (p-value < 0.05). Despite decreased follicular viability and mitochondrial activity, the cryopreservation followed by transplantation of ovarian tissue proved feasible for attempts to restore ovarian function.


Delayed light studies on photosynthetic energy conversion. VIII. Evidence from millisecond emission of chloroplasts for two adenylate binding sites on membrane-bound coupling factor, CF1.
Effects of adenylates on chloroplast delayed light emission, at millisecond dark times, are inverse to the previously characterized effects of adenylates on electron transport rates. Either ADP alone or ATP alone increase intensity of delayed light, while ADP plus Pi decrease it. ADP alone requires the presence of an electron acceptor to have this effect on delayed light, but ATP does not. All three adenylate effects are abolished by uncoupling with gramicidin, by partial removal of photophosphorylation coupling factor (CF1) with EDTA, and by antibody to CF1. Readdition of CF1 re-established the adenylate effects in EDTA-stripped membranes. The three adenylate effects are differentially sensitive to pH, and pH differentially affected their abolition by antibody to CF1. The two adenylate effects shown in the absence of Pi are exhibited at lower adenylate concentrations than the ADP plus Pi effect, and are also less sensitive to phloridzin. These results are discussed in terms of probable adenylate effects on membrane-bound chloroplast coupling factor, CF1. At least two ADP binding sites would differ with respect to adenylate concentration for half maximal binding; pH of optimal binding capacity; phloridzin sensitivity; and functional regulation of electron transport, proton uptake, and energy storage within the membrane as measured by delayed light emission. It remains unclear whether the high affinity ADP binding site is identical to a high affinity ATP binding site on CF1.


A pilot study comparing prosthetic to sound limb gait mechanics during a turning task in people with transtibial amputation.
Observational gait analysis is frequently used by clinicians to subjectively assess straight walking but is not often used to examine turning. Interlimb comparisons of phase- specific turning biomechanics in people with unilateral lower limb amputation has not previously been documented. A retrospective examination of gait kinematics and kinetics from five participants with unilateral transtibial amputation was performed. Data were collected during 90° step and spin turns capturing three distinct turning steps. Gait metrics of interest included: total turn time, stance time, peak knee flexion angle during Pre-Swing and Initial Swing gait phases, peak hip flexion and extension, ground reaction impulse, and whole body angular momentum. Statistical comparisons were made based on turn type between sound and prosthetic limbs. During the three turn steps (approach, apex, depart), participants spent significantly more time (P < 0.01) on their sound limb compared to their prosthetic limb regardless of turn type. Additionally, the prosthetic limb hip and knee exhibited more flexion (P < 0.05) during the apex step of turns, and whole body angular momentum was higher when the sound limb was used during the apex step of a turn (P < 0.05). This descriptive study offers the first phase-specific quantification of turning biomechanics in people with lower limb amputation. Results indicate that people with unilateral transtibial amputation spend more time on and experience higher impulses through their sound compared to their prosthetic limb during 90° turns, and that the prosthetic limb is performing differently than the sound limb, potentially increasing risks of injury or falls.


Detailed studies on the enantioselective synthesis and HPLC enantioseparation of N-protected 3-hydroxyglutarimides.
An analytical HPLC method using CHIREX (S)-LEU/(S)-alpha-NEA column was developed for the determination of the enantiomeric excesses of N-protected (S)-3-hydroxyglutarimides. Using this method, detailed studies on the base-promoted ring-expansion reaction of the amidolactones, derived from l-glutamic acid, were undertaken.


At the forefront of thought: the effect of media exposure on airplane typicality.
The terrorist attacks of September 11, 2001 provided a unique opportunity to investigate the causal status of frequency on typicality for one exemplar of a common conceptual category--namely, the typicality of airplane as a member of the category of vehicles. The extensive media coverage following the attacks included numerous references to the hijacked airplanes and to the consequences of suspending air travel to and from the United States for several days. The present study, involving 152 undergraduates, assessed airplane typicality at three time points ranging from 5 h to 1 month after the attacks and then again at 4.5 months after the attacks. Airplane was judged to be a more typical vehicle for 1 month following the attacks, relative to a baseline calculated from data collected yearly for 5 years preceding the attacks. By 4.5 months, however, typicality was back to baseline.


Binary Co-Crystals of Quercetin: Synthesis, Structure, and Spectroscopic Characterization.
A mechanochemical method was used to obtain four new quercetin (QUE) co-crystals. Three co-formers have the systems of the heterocyclic rings with the oxygen and nitrogen atoms and they form co-crystals at the stoichiometric ratio of 1 : 2. In contrast, the QUE : o-dianisidine co-crystal represents the 1 : 1 stoichiometry and the former molecule is the aniline derivative. The X-ray crystallography and FT-IR and FT-Raman spectra revealed formation of the intermolecular O-H…N or N-H…O hydrogen bonds. The dynamics of the hydrogen bonds was investigated using the XPS method. The N 1s XPS spectra showed no proton transfer in the QUE : FEN and QUE : O-DIA co-crystal systems. The QUE : BZFP and QUE : EBZFP show the two-site static disorder across the proton transfer pathway to the pyridine ring, with the occupancies (C=N : C=NH+ ) of 72 : 28 and 77 : 23, respectively.


Self-contacts in Asx and Glx residues of high-resolution protein structures: role of local environment and tertiary interactions.
In protein structures, side-chains of asparagine and aspartic acid (Asx) and glutamine and glutamic acid (Glx) can approach their own backbone nitrogen or carbonyl group. We have systematically analyzed intra-residue contacts in Asx and Glx residues and their secondary structure preferences in two different datasets consisting of 500 and 1506 high-resolution structures. Intra-residue contact in an Asx/Glx residue between the heavy atoms of side-chain and main-chain functional groups of the same residue was investigated irrespective of whether such contacts are due to hydrogen bonding or not. Our search yielded 563 and 1462 cases of self-contacting Asx and Glx residues from the two datasets. Two important observations have been made in this analysis. First, self-contacts involving side-chain oxygen and backbone nitrogen atoms in majority of Asx residues are not due to hydrogen bonds. In the second instance, surprisingly, side-chain and backbone carbonyl oxygens of a significant number of Asx and Glx residues approach each other. For a wide-range of accessible surface areas, self-contacting residues are surrounded by less number of polar groups compared to all other Asx/Glx residues. In buried and partially buried regions, side-chain and main-chain functional groups of these residues together participate in simultaneous interactions with the available polar groups or water molecules. Asx/Glx residues with self-contacts are rarely observed in the middle of an alpha-helix or a beta-strand. Asx/Glx side-chain having contact with its own backbone nitrogen shows different capping preferences compared to those having contact with its backbone oxygen. Examples of proteins with multiple self-contacting Asx/Glx residues are found. We speculate that mutation of a self-contacting residue in the buried or partially buried region of a protein will destabilize the structure. The results of this analysis will help in engineering protein structures and site-directed mutagenesis experiments.


Chemical composition, antimicrobial activity and cytotoxicity of Murraya paniculata (L.) Jack leaf essential oil from Assam, India: the effect of oil on cellular morphology of micro-organisms.
Murraya paniculata (L.) Jack is commonly cultivated as ornamental plant in Assam and has been used as spice and phytomedicine traditionally for many healthcare purposes. The therapeutic potential and chemical constituents of the essential oil of M. paniculata leaf was investigated against several pathogenic microbial species and human cancer cell lines. 29 chemical compounds were identified by GC-MS analysis from the essential oil representing 97.62% of the oil. The major compound identified was caryophyllene (20.93%). Leaf essential oil exhibited promising antibacterial activity against Mycobacterium smegmatis (MIC = 4 µg/mL) and Pseudomonas aeruginosa (MIC = 4 µg/mL). Best anticancer activity of the oil was observed for HeLa cells (IC50 = 6.28 μg/mL). Further, scanning electron microscopic studies revealed that the oil kills micro-organisms with the deformation of cellular morphology on treatment of the oil. Thus, the essential oil of M. paniculata leaf can be an excellent alternative for development of new antimicrobials and anticancer chemotherapeutic agents for the pharmaceutical industries.


Prospective implementation of a same-day discharge protocol for catheter ablation of paroxysmal atrial fibrillation.
Overnight stays associated with catheter ablation (CA) for paroxysmal atrial fibrillation (PAF) account for a significant proportion of treatment cost. Same-day discharge (SDD) after CA may be attractive to both patients and hospitals, especially in light of current restrictions on overnight stays due to COVID-19. This study reports on the selection criteria, protocol, and safety of SDD after CA of PAF. Patients undergoing CA for PAF were evaluated to assess the risk of groin, respiratory, cardiac, or bleeding complications. SDD eligibility criteria were stable anticoagulation with no bleeding history, systolic heart failure, respiratory conditions, or interventional procedures within 60 days, and recommended BMI < 35. Patient proximity to the hospital was also considered. Anesthesia with propofol was used, and ablations were performed with a contact force catheter. Patients rested for 6 h post-procedure and then ambulated over 1-2 h. Discharge followed if they were stable without evidence of complications. A nurse called all patients the following morning to elicit evidence of complications. Of 44 planned SDD procedures between April 2017 and June 2018, 41 resulted in SDD after 7.2 ± 1.0 h, 2 patients stayed overnight for observation, and one by choice. Average age was 59 ± 10 years with CHA2DS2-VASc of 1.6 ± 1.1. No SDD-related complications occurred, and no return visits resulted from the follow-up calls. Appropriate low-risk patients identified by well-defined clinical criteria can be safely discharged the same day after CA for PAF. Evaluation in a larger population across different centers is required for generalizability of this SDD protocol.


Rise of TRIM8: A Molecule of Duality.
The human tripartite motif containing protein 8 (TRIM8), a member of TRIM family proteins, is known to play a dual role as both tumor suppressor and oncogene, and to function at the crosstalk of cancer and innate immunity. In this review, in addition to accumulating recent corroborations that endorse this dual character of TRIM8, we appraise the game-changing capacity of TRIM8 under stress conditions against the backdrop of cell proliferation, apoptosis, and cancer, and also highlight the duality of TRIM8 in multiple contexts like cellular localization, stress-induced conditions, and E3 ubiquitin ligase activity. Finally, we discuss the emerging role of TRIM8 during bipolar spindle formation and mitotic progression, and its growing sphere of influence across multiple human cancers and pathologies, and suggest TRIM8-linked axes that can be modulated further for anti-cancer therapeutics development.


Influence of the selection of angiographic projections on the results of coronary angiographic follow-up trials. International Nifedipine Trial on Antiatherosclerotic Therapy Investigators.
In recent years follow-up trials on coronary artery disease with angiographic end points analyzed quantitatively have gained increasing relevance and popularity. There is no consensus, however, on the method of calculation of progression or regression from multiple angiographic projections. Therefore the influence of the selection of angiographic projections on the outcomes of such trials was investigated with the data of the International Nifedipine Trial on Antiatherosclerotic Therapy. In 348 patients with coronary artery disease, repeated coronary angiograms were compared in multiple identical angiographic projections. Changes in angiographic parameters were averaged over the 1063 stenoses analyzed. Five methods of evaluation of multiple projections in the individual stenoses were applied, resulting in different extents of overall progression, or even regression of coronary artery disease (p < 0.01). It is concluded that in quantitative coronary angiographic follow-up trials changes should be averaged over all angiographic projections available for a stenosis to avoid overestimation of progression or regression.


Scanning electron microscopic study of a Ciloxan bottle blocked by ciprofloxacin crystals.
To report blockage of a commercially available ciprofloxacin bottle by white crystalline deposits. This study evaluated the ultrastructural features of the ciprofloxacin crystals. A patient underwent intensive topical treatment of an infectious corneal ulcer with commercially available ciprofloxacin 0.3% ophthalmic solution. During treatment, the patient was unable to obtain medication from the ciprofloxacin bottle and required a new prescription. Examination of the bottle revealed that about 50% of the medication remained, but compression of the bottle with any amount of force failed to deliver any medication. On closer examination, a white material partially filled the nozzle track of the bottle and was on the outer bottle near the nozzle and the inner surface of the bottle cap. These white crystalline deposits were evaluated by scanning electron microscopy. Plate-like, needle, cable and spaghetti-like crystals were found. The needle crystals formed multiple petaloid patterns. This is the first report of blockage of a commercially available ciprofloxacin 0.3% bottle by ciprofloxacin crystals and the inability to deliver medication from the bottle. Ultrastructural study of the white crystalline deposits revealed four types of ciprofloxacin crystals.


Introducing Pediatric Reports: Only Another Pediatric Journal?
The purpose of this editorial is to introduce Pediatric Reports, a 10-year-old journal that is now at a turning point [...].


Depo-Provera and skeletal health: a survey of Florida obstetrics and gynecologist physicians.
In November of 2004, the US Food and Drug Administration (FDA) issued a black box warning regarding skeletal health concerns with depot medroxyprogesterone acetate (DMPA) contraception. This FDA labeling change has the potential to impact how this contraceptive is used. Our goal was to assess the impact of the FDA decision on how Florida obstetrician-gynecologists prescribe DMPA. A survey was conducted with questions and case scenarios regarding the use of DMPA before and after the black box warning. The survey was sent to all members of the Florida Obstetric and Gynecologic Society. Four hundred twenty-five surveys were mailed and 149 were returned - a 35% return rate. Forty-six percent of physicians surveyed indicated that they place a time limit on DMPA use, and 66% stated that this limit was based on the FDA black box warning. Sixty-five percent of respondents ordered bone mineral density (BMD) testing solely due to the use of DMPA, with 58% indicating that this decision was based on the black box warning. Eight (5.4%) of the respondents indicated they selectively prescribe bisphosphonates for patients based solely on the use of DMPA, while 33% of respondents state that they use estrogen supplementation. There was a trend towards fewer DMPA injections per week after the black box warning as compared to before; however, this trend was not statistically significant (p<.125). Respondents may be writing fewer prescriptions for DMPA, are likely to institute a time limit on said prescription and are likely to order BMD testing, using the black box warning as justification. Continued education is necessary to prevent inappropriate restrictions on DMPA use and the performance and/or prescription of inappropriate tests and medications.


A novel photoanode architecture of dye-sensitized solar cells based on TiO2 hollow sphere/nanorod array double-layer film.
A novel TiO(2) double-layer (DL) film consisting of TiO(2) hollow spheres (HSs) as overlayer and single-crystalline TiO(2) nanorod arrays (RAs) as underlayer was designed as the photoanode of dye-sensitized solar cells (DSSCs). This new-typed TiO(2) HS/RA DL film could significantly improve the efficiency of DSSCs owing to its synergic effects, i.e. the relatively large specific surface area of TiO(2) HSs for effective dye adsorption, enhanced light harvesting capability originated from TiO(2) RA film, and rapid interfacial electron transport in one-dimensional TiO(2) nanorod arrays. The overall energy-conversion efficiency of 4.57% was achieved by the formation of TiO(2) DL film, which is 16% higher than that formed by TiO(2) HS film and far larger than that formed by TiO(2) RA film (η=0.99%). The light absorption and interfacial electron transport, which play important roles in the efficiency of DSSCs, were investigated by UV-vis absorption spectra and electrochemical impedance spectra.


Antioxidant activities of novel resveratrol analogs in breast cancer.
The objective of the present study was to characterize the role of novel resveratrol (Res) analogs: 4-(E)-{(4-hydroxyphenylimino)-methylbenzene, 1, 2-diol} (HPIMBD) and 4-(E)-{(p-tolylimino)-methylbenzene-1,2-diol} (TIMBD) as potent antioxidants against breast cancer. Non-neoplastic breast epithelial cell lines MCF-10A and MCF-10F were treated with 17β-estradiol (E2), Res, HPIMBD, and TIMBD for up to 72 h. mRNA and protein levels of antioxidant genes, superoxide dismutase 3 (SOD3) and N-quinoneoxidoreductase-1 (NQO1) and transcription factors, nuclear factor erythroid 2-related factor (Nrf) 1, 2 and 3 were quantified after the above treatments. Generation of reactive oxygen species (ROS) was measured by CM-H2-DCFDA and oxidative-DNA damage was determined by measuring 8-hydroxy-2-deoxyguanosine (8-OHdG). HPIMBD and TIMBD scavenged cellular ROS production, attenuated oxidative DNA damage, increased mRNA and protein expression levels of SOD3 and NQO1 and activated Nrf signaling pathway. Our studies demonstrate that HPIMBD and TIMBD have the potential as novel antioxidants to prevent development of breast cancer.


The CAS Residents' Competition: a 25 year review.
The popularity of the Residents' Competition at the annual meeting of the Canadian Anaesthetists' Society inspired this 25 yr review of the competitors and their presentations. Data were collected from a questionnaire survey of all participants and all current Anaesthesia programme directors, review of the Canadian Anaesthetists' Society records, and a Medline data-base search. Over the 25 yr review period, 226 presentations have been given by 211 different participants, with the annual number of participants ranging from 6 to 13. The majority of participants have been male (85.3% vs 14.2% female, P < 0.001), and the majority of presentations have been clinical in nature (74% vs 26% laboratory, P < 0.01). Over half of all the presentations (53.1%) subsequently were published as scientific papers, and 71.7% of all participants practised anaesthesia in an academic environment at some point in their career. The Residents' Competition appears to have been successful in encouraging scientific excellence in physician's training in anaesthesia in Canada.


Modulatory influences of tamoxifen, tocopherol, retinyl acetate, aminoglutethimide, ergocryptine and selenium on DMBA-induced initiation of mammary carcinogenesis in rats.
Present study evaluates the chemopreventive actions of tamoxifen (10 mg/kg), retinyl acetate (50 mg/kg), tocopherol (200 mg/kg), aminoglutethimide (1 mg/kg), ergocryptine (5 mg/kg), and sodium selenite (1 mg/kg) when given singly/in combinations on the initiation of mammary carcinogenesis induced by 20 mg of DMBA in virgin female rats. DMBA was given when rats were 50 days old and the modulators were given in diet 10 days before and 10 days after carcinogen treatment and experiments were terminated 6 months later. DMBA alone yielded tumors in 62% rats. When modulators were given singly and in combinations of two, tumor incidences were not altered significantly. The range of tumor incidences was between 30% and 13% when the agents were given in combinations of 3, 4 and 5. Finally when all 6 modulators were given together the tumor incidence dropped down to 8.3%.


Epileptic encephalopathy with continuous spike-waves during slow-wave sleep including Landau-Kleffner syndrome.
Epileptic encephalopathy with continuous spike-waves during slow-wave sleep (CSWS) is a spectrum of epileptic conditions best defined by the association of cognitive or behavioral impairment acquired during childhood and not related to another factor other than the presence of abundant interictal epileptiform discharges (IED) during sleep, which tend to diffuse over the whole scalp. It is part of the childhood focal epileptic syndromes, some cases being idiopathic and overlapping with benign rolandic epilepsy, and others being symptomatic of a structural brain lesion. Landau-Kleffner syndrome (LKS) is a particular presentation where acquired aphasia is the core symptom. Clinical, neurophysiological, and cerebral glucose metabolism data support the hypothesis that IED play a prominent role in the cognitive deficits by interfering with the neuronal networks at the site of the epileptic foci but also at distant connected areas. Therefore, the treatment should aim to suppress IED. This may be achieved using conventional antiepileptic drugs, but corticosteroids seem to have more pronounced and sustained efficacy. Outcome for epilepsy is usually good, CSWS being an age-dependent EEG pattern, whereas outcome for cognition, language, and behavior is variable. Rehabilitation represents an important part of the treatment and visual forms of language should be encouraged in children with LKS.


Enhancement of in vivo supraspinatus tendon-to-bone healing with an alginate-chitin scaffold and rhBMP-2.
Rotator cuff disorders present a high retear rate despite advances in surgical treatment. Tissue engineering could therefore be interesting in order to try to enhance a more biological repair. RhBMP-2 is one of the most osteogenic growth factors and it also induces the formation of collagen type I. However, it has a short half-life and in order to get a more stable release over time it could be integrated in a more slowly degradable carrier, such as an alginate-chitin scaffold. The aim of this study was to investigate the role of the alginate-chitin scaffold alone and in combination with different concentrations of rhBMP-2 when applied on chronic rotator cuff lesions in a rat model. We performed an experimental study with 80 Sprague-Dawley rats, 8 months old, with a chronic rupture of the supraspinatus tendon that was repaired with a modified Mason Allen suture. A scaffold was applied over the suture and 4 groups were obtained; suture (S) only suture, double control (DC) alginate and chitin scaffold, single sample (SS) scaffold of alginate with rhBMP-2 (20 µg rhBMP-2) and chitin, double sample (DS) a scaffold containing alginate with rhBMP-2 and chitin with rhBMP-2 (40 µg rhBMP-2). Macroscopic, histological and biomechanical studies were performed at 4 months after reparation. The modified Åström and Rausing's histological scale (the higher the score the worse outcome, 0 points=native tendon) was applied: S got 52 points compared to DC 30 (p = 0,034), SS 22 (p = 0,009) and DS 16 (p = 0,010). Biomechanically the maximum load was highest in DC (63,05 N), followed by DS (61,60 N), SS (52,35 N) and S (51,08), p = 0,025 DS vs S. As to the elastic constant a higher value was obtained in DC (16,65), DS (12,55) and SS (12,20) compared to S (9,33), p = 0,009 DC vs S and 0,034 DS vs S. The alginate-chitin scaffold seems to promote a more biological response after the reparation of a chronic rotator cuff lesion. Its effect is further enhanced by the addition of rhBMP-2 since the osteotendinous junction is more native-like and has better biomechanical properties.


First-principles study on incidence direction, individual site character, and atomic projection dependences of ELNES for perovskite compounds.
The incidence direction dependence, the individual site character dependence, and the atomic projection dependence of O-K near edge fine structure of the EEL spectrum (ELNES) from YBa2Cu3O7 (YBCO) and SrTiO3 were theoretically simulated using the first-principles band structure calculation. In order to calculate ELNES, a core-hole was introduced at the oxygen 1s orbital, and sufficiently large supercells composed of more than 100 atoms were employed. We found that the intensity of the first peak of O-K ELNES from YBCO strongly depends on the atomic projection direction, and disappears when the spectrum is measured with the other projection directions. The large projection dependence was also predicted in the O-K ELNES of SrTiO3. It was found that those spectral changes according to the position of the projection are caused by the unidirectional Ti-O-Ti bond in SrTiO3.


Calcium, magnesium and aluminium ions as decontaminating agents against dermal fluoride absorption following hydrofluoric acid exposure.
The fluoride ions of the industrially largely irreplaceable, locally corrosive hydrofluoric acid (HF) can scavenge cations in biological tissues, which explains their high toxic potential, and also leads to local acidification through proton release. The influence of three complexing agents, calcium (Ca2+) gluconate (as 2.5% Ca2+gel and individually (2.84%) or commercially (10%) formulated Ca2+solution), magnesium (Mg2+) gluconate (2.84%) solution and aluminium (Al3+) solution (Hexafluorine®, pure and diluted) on the absorption of fluoride following HF exposure (1-3 min, 100 μl, 30%/0.64 cm2) through human skin was investigated in an ex-vivo diffusion cell model. Fluoride absorption was assessed over 6-24 h and analysed with a fluoride electrode. Decreasing the contamination time reduced the fluoride absorption distinctly which was further reduced by the application of fluoride-binding decontamination agents (Ca2+, Mg2+, Al3+) or water alone without being significantly different. Ca2+ appeared slightly more effective than Mg2+ in reducing fluoride absorption. Moreover, the addition of pH adjusting buffer promoted the decontamination efficacy. Fluoride-binding agents can facilitate the decontamination of dermal HF exposure. However, prompt decontamination appeared to be the key to successful limitation of fluoride absorption and pushes the choice of decontamination agent almost into the background.


Role of the 2-week urgent referral pathway in childhood cancer.
To evaluate the role of the urgent 2-week referral pathway in facilitating the early diagnosis of childhood cancer. Retrospective case notes review of all children referred via the pathway and all children diagnosed as having cancer via other means over a period of 3½ years (January 2007-July 2010). District general hospital with a shared care oncology service. 82 children aged 0-15 years. Outcomes for children referred via the 2-week urgent referral pathway, including diagnosis, need for further investigations and need for further specialist input. 35 children were referred via the 2-week urgent referral pathway with suspected cancer. Only one of these children had a malignancy. 49% of children required no further investigations and 43% were discharged after the first appointment with no follow-up thought necessary. Over the same time period, 47 children were diagnosed as having cancer via other means. The pickup rate of cancer among children referred via the 2-week urgent referral pathway is extremely low and the vast majority of cancer is diagnosed via different routes.


[The treatment of prolonged erection after intracavernous injection of a vasoactive drug].
The intracavernous injection of a vaso-active drug may induce an erection lasting for over 3 hours. The physician must carry out a simple procedure: an evacuatory puncture, which results in immediate detumescence of the penis and spares the patient any complications.


Technical and clinical success after venous sinus stenting for treatment of idiopathic intracranial hypertension using a novel guide catheter for access: Case series and initial multi-center experience.
Venous sinus stenting is a well established alternative to cerebrospinal fluid diversion for the treatment of idiopathic intracranial hypertension (IIH) with associated venous sinus stenosis. During this procedure, distal guide catheter placement within the venous sinuses may be desirable to facilitate stent delivery. We report our initial experience using the TracStar LDP™ (Imperative Care, Campbell, USA, 0.088-inch inner diameter) as the guide catheter for intracranial access during venous sinus stenting. A multi-institutional retrospective chart review of a prospectively maintained IRB-approved database was performed. Consecutive patients who underwent venous sinus stenting from 1/1/2020-9/6/2021 for IIH were included. Patient characteristics, procedural details, TracStar distal reach, outcomes, and complications were collected and analyzed. Fifty-eight patients were included. The mean age was 33.8 years and 93.1% of patients were female. Visual changes prompted evaluation in 86.2% of patients. Stent placement was successful in all patients. The TracStar LDP catheter was advanced to the location of stent placement in 97.9% of cases in which it was attempted. The large 0.088-inch inner diameter lumen enabled compatibility with all desired stent sizes ranging from six to 10 millimeters. Gradient pressure across transverse sinus stenosis dropped from an average of 19.5 mmHg pre-procedure to 1.7 mmHg post-stent placement (p < 0.001). Clinical improvement was achieved in 87.9% (51/58) of patients. There were no catheter-related complications. The TracStar LDP is a safe and effective access platform for reaching treatment locations in patients who present with idiopathic intracranial hypertension and who are candidates for venous sinus stent placement.


Covid-19 in Egyptian hemodialysis and kidney transplant children: retrospective analysis of single center experience.
Chronic kidney disease stage 5 (CKD 5) populations have peculiar risk for severe Covid-19 infection. Moreover; pediatric data are sparse and lacking. The aim of this study is to report our experience in CKD 5 children treated by hemodialysis (CKD 5D) and CKD 5 children after kidney transplantation (KTR) during one year of Covid-19 pandemic. Retrospective analysis of 57 CKD 5 children with Covid-19 like symptoms during 1 year pandemic was performed. A cohort of 19 confirmed patients (13 CKD 5D and 6 KTR) was analyzed in details as regard clinical, laboratory, radiological criteria, management and their short term outcome. CONCLUSION: Pediatric patients on regular HD (CKD 5D) are at higher risk and worse outcome of Covid-19 infection than KT recipients (KTR). Pre-existing HTN and shorter duration after KT are potential risk factors. Reversible AGD after KT and CVC related infections in HD patients are additional presenting features of Covid-19 infection.


A cryo-TSEM with temperature cycling capability allows deep sublimation of ice to uncover fine structures in thick cells.
The scanning electron microscope (SEM) has been reassembled into a new type of cryo-electron microscope (cryo-TSEM) by installing a new cryo-transfer holder and anti-contamination trap, which allowed simultaneous acquisition of both transmission images (STEM images) and surface images (SEM images) in the frozen state. The ultimate temperatures of the holder and the trap reached - 190 °C and - 210 °C, respectively, by applying a liquid nitrogen slush. The STEM images at 30 kV were comparable to, or superior to, the images acquired with conventional transmission electron microscope (100 kV TEM) in contrast and sharpness. The unroofing method was used to observe membrane cytoskeletons instead of the frozen section and the FIB methods. Deep sublimation of ice surrounding unroofed cells by regulating temperature enabled to emerge intracellular fine structures in thick frozen cells. Hence, fine structures in the vicinity of the cell membrane such as the cytoskeleton, polyribosome chains and endoplasmic reticulum (ER) became visible. The ER was distributed as a wide, flat structure beneath the cell membrane, forming a large spatial network with tubular ER.


Adherence with pharmacotherapy for type 2 diabetes: a retrospective cohort study of adults with employer-sponsored health insurance.
Trials have shown that intensive therapy to control blood glucose levels results in lower rates of microvascular complications and myocardial infarction among patients with type 2 diabetes. They have also demonstrated the economic and quality-of-life benefits of improved glycemic control among this patient population. Glycemic control achievable in controlled settings, however, may differ from that observed in actual practice settings, in part due to the patient's autonomy in determining whether, or to what extent, adherence to the prescribed regimen is acceptable. The goal of this study was to determine adherence with pharmacotherapy for type 2 diabetes among newly treated working-aged adults (ie, those aged 18-64 years) who had employer-sponsored health insurance. Adherence was defined as the regular refilling of prescriptions as indicated, such that an appropriate supply of medication is available over time. A retrospective cohort study of newly treated patients (aged 18-64 years) was conducted using an administrative claims database with coverage from 1997 through 2000. Eligibility required at least 12 months of history before and after the index prescription date. Early nonpersistence (failure to fill a second prescription for the index drug or any other antihyperglycemic medication) and 12-month non-persistence rates were calculated, as was nonadherence based on a medication possession ratio (MPR) <80%. Survival and logistic regression models were used to examine adherence rates and behavior predictors. A total of 6090 patients (median age, 51.0 years; 3263 men, 2827 women) were included. After the first prescription, 10.5% of patients (95% CI, 9.8-11.3) failed to fill a second prescription for the initial or any other antihyperglycemic medication. At 12 months after the initial prescription date, 37.0% of patients (95% CI, 35.8-38.2) had discontinued pharmacotherapy. During the period of persistence (the time interval during which prescriptions were being filled), 46.2% of patients (95% CI, 44.7-47.7) were nonadherent according to the MPR-based analysis. After adjustment for covariates, younger age (ie, 18-24 years) and female gender were found to be risk factors for early nonpersistence (odds ratio [OR], 1.77 [95% CI, 1.07-2.94] and OR, 1.47 [95% CI, 1.25-1.73], respectively) and for discontinuation over time (hazard ratio [HR], 2.44 [95% CI, 1.89-3.15] and HR, 1.18 [95% CI, 1.09-1.28], respectively). Another risk factor for early nonpersistence and discontinuation over time was initial treatment using insulin (OR, 3.00 [95% CI, 2.30-3.91]; HR, 2.68 [95% CI, 2.31-3.10]) or an alpha-glucosidase inhibitor (OR, 2.07 [95% CI, 1.11-3.84]; HR, 1.57 [95% CI, 1.11-2.22]). Adherence with antihyperglycemic pharmacotherapy was poor among working-aged patients newly treated for type 2 diabetes. Patients prescribed insulin as initial pharmacotherapy were less likely to persist on medication than those initially prescribed oral agents.


Effects of powder particle size and binder viscosity on intergranular and intragranular particle size heterogeneity during high shear granulation.
A study was performed in order to elucidate the effects of powder particle size and binder viscosity on intergranular and intragranular particle size heterogeneities. Granules were produced by melt granulation in a high shear mixer from each of four calcium carbonates having mean particle sizes in the range of 5.5-63.1 microm. Each of three polyethylene glycols (PEGs) having viscosities in the range of approximately 40-14,000 mPas were applied as meltable binders. The size distribution of the calcium carbonate particles in three granule size fractions (125-250, 355-500, and 800-1000 microm) was measured after disintegration of the granules. Intragranular particle size heterogeneities were evaluated qualitatively by means of scanning electron microscopy. A preferential growth of the smaller particles was found to give rise to a higher content of small particles in large granules when calcium carbonates with mean particle sizes of 11.7, 34.5, and 63.1 microm were granulated with a binder of low viscosity. The use of a binder of medium or high viscosity leads to a marked reduction of these heterogeneities. A preferential growth of larger particles was seen when calcium carbonates with mean particle sizes of 5.5 and 11.7 microm were granulated with a highly viscous binder. The use of a binder with low or medium viscosity resulted in an increased homogeneity. Intragranular particle size heterogeneities were primarily seen when 5.5 and 11.7 microm calcium carbonate particles were granulated with a highly viscous binder.


The development of a multimedia online language assessment tool for young children with autism.
This study aimed to provide early childhood special education professionals with a standardized and comprehensive language assessment tool for the early identification of language learning characteristics (e.g., hyperlexia) of young children with autism. In this study, we used computer technology to develop a multi-media online language assessment tool that presents auditory or visual stimuli. This online comprehensive language assessment consists of six subtests: decoding, homographs, auditory vocabulary comprehension, visual vocabulary comprehension, auditory sentence comprehension, and visual sentence comprehension. Three hundred typically developing children and 35 children with autism from Tao-Yuan County in Taiwan aged 4-6 participated in this study. The Cronbach α values of the six subtests ranged from .64 to .97. The variance explained by the six subtests ranged from 14% to 56%, the current validity of each subtest with the Peabody Picture Vocabulary Test-Revised ranged from .21 to .45, and the predictive validity of each subtest with WISC-III ranged from .47 to .75. This assessment tool was also found to be able to accurately differentiate children with autism up to 92%. These results indicate that this assessment tool has both adequate reliability and validity. Additionally, 35 children with autism have completed the entire assessment in this study without exhibiting any extremely troubling behaviors. However, future research is needed to increase the sample size of both typically developing children and young children with autism and to overcome the technical challenges associated with internet issues.


Trends of the leprosy control indicators in Benin from 2006 to 2018.
Leprosy, or Hansen's disease, is a chronic infectious disease caused by Mycobacterium leprae. The purpose of this study was to describe the epidemiological characteristics of leprosy in Benin from 2006 to 2018. This descriptive retrospective study included data from January 2006 to December 2018. The data of all patients treated in the leprosy treatment centres (LTCs) of the Republic of Benin were obtained from the LTC registers and analysed using Stata/SE 11.0 software. Quantum GIS (Geographic Information System) version 2.18.23 software was used for mapping. The main indicators of leprosy were calculated according to the World Health Organization (WHO) recommendations. During the study period, a total of 2785 (annual average of 214) new cases of leprosy were diagnosed. The median age of the patients was 38 years, with extremes ranging from 6 to 88 years. The sex ratio (males/females) was 1.18 (1509/1276). The departments of Plateau, Atacora, and Zou were the most endemic; their leprosy detection rate per 100,000 population during these thirteen years were 6.46 (479/7414297), 5.38 (534/9932880) and 5.19 (526/10134877), respectively. The leprosy detection rate declined from 3.8 to 1.32 per 100,000 inhabitants. The proportion of paediatric cases varied from 8.56 to 2.67% as the proportion of multibacillary forms increased from 72.95 to 90%. From 2006 to 2018, 622 leprosy patients detected had grade 2 disability (G2D) at screening, indicating an average rate of 5.06 (622/122877474) cases with G2D per million population. The proportion of grade 2 disabilities increased from 21.23 to 32% during the study period. The majority of new leprosy cases among foreign-born persons were Nigerian (85.71%). The completion of multidrug therapy (MDT) for paucibacillary (PB) and multibacillary (MB) leprosy cases ranged from 96.36 to 95.65% and from 90.53 to 94.12%, respectively. In Benin, leprosy remains a major health challenge; it is important to revitalize the epidemiological surveillance system to achieve its elimination by 2030.


Galectin-3 in cord blood of term and preterm infants.
In recent years galectin-3 has gained attention as a signalling molecule, mainly in inflammatory diseases. Data on galectin-3 expression in neonates, however, are limited, and expression of this lectin in cord blood has not yet been reported. The aim of this study was to determine galectin-3 levels in cord blood of term and preterm neonates as well as galectin-3 levels in cord blood of term neonates after stimulation with the prevalent pathogen Streptococcus agalactiae. Cord blood samples were incubated for 24 h and galectin-3 levels were assessed by enzyme-linked immunosorbent assay. There is a positive correlation between gestational age and galectin-3 levels in cord blood. Expression of galectin-3 is significantly higher in cord blood of small-for-gestational-age infants compared to appropriate-for-gestational-age infants. Stimulation with an invasive but not with a colonizing strain of S. agalactiae induced expression of galectin-3. Galectin-3 is expressed constitutively in cord blood of neonates and seems to play a role in the innate immunity of this population.


[Participation of temporomandibular joints in rheumatoid disease in persons of developmental age].
From the midst of 97 patients of developmental age with verified rheumatoid disease treated in the health resort in Cieplice-Zdrój in 21 patients, i.e. 21.6% of the total number of the patients under examinations joints coming within this process have been found. The authors explain causes of some symptoms in the aspect of musculo-articular system of masticatory organ existing in these persons. They also verify criteria accepted for estimation of the damage degree of the stomatognathic system.


Pyogenic liver abscess related to intrahepatic bile duct stones: Difficulties in infectious control and diagnosis of concomitant cholangiocarcinoma.
Cholangitis, bacteremia, and pyogenic liver abscess (PLA) can be often caused by intrahepatic bile ducts stone (IBDS), which is endemic to South-East Asia. The association between IBDS and cholangiocarcinoma has been well recognized. Concomitant cholangiocarcinoma in the PLA related to IBDS is often missed. A case-control study consisting of 64 patients with PLA related to IBDS and 256 control patients with PLA not related to IBDS was used to investigate clinical features of PLA and incidence of concomitant cholangiocarcinoma in patients with PLA related to IBDS. The main imaging manifestations of PLA related to IBDS was cystic-solid lesions and solid lesions. Of seven patients (10.9%) with pathology-proven cholangiocarcinoma in the same area of PLA related to IBDS among 64 patients, only two patients were initially diagnosed as having concomitant cholangiocarcinoma by biopsy, and other five patients diagnosed as acute inflammatory lesion. Within 60 days after onset, the infection-related death rate and recurrence rate in patients with PLA related to IBDS were 12.9% and 20.3%, respectively, whereas in patients with PLA not related to IBDS were 3.9% and 3.1%, respectively. Only 25% of patients with PLA related to IBDS underwent surgery after admission. The main pathogens in PLA patients related to IBDS were Escherichia coli and extended-spectrum beta-lactamase-producing Enterobacteriaceae. The imaging manifestations of PLA related to IBDS often present cystic-solid or solid lesions. PLA related to IBDS is characterized by high rate of recurrence and infection-related death, difficulty in diagnosis of concomitant cholangicarcinoma.


Synthesis and hydrophobic adsorption properties of microporous/mesoporous hybrid materials.
Hybrid materials of silicalite-1 (Sil-1)-coated SBA-15 particles (MSs) have been successfully synthesized by crystallization process under hydrothermal conditions. These MSs materials were characterized by X-ray diffraction, nitrogen adsorption/desorption and TEM techniques, which illustrated that the silicalite-1-coated SBA-15 particles were successfully prepared and had large pore volume and hierarchical pore size distribution. Further experimental studies indicated that longer crystallization time under basic condition caused the mesostructure of SBA-15 materials to collapse destructively and higher calcination temperature tended to disrupt the long-range mesoscopic order while they had little influence on the phase of microcrystalline silicalite-1 zeolite. The resultant MSs materials were investigated by estimating dynamic adsorption capacity under dry and wet conditions to evaluate their adsorptive and hydrophobic properties. The hydrophobicity index (HI) value followed the sequence of silicalite-1>MSs>SBA-15, which revealed that the SBA-15 particles coated with the silicalite-1 seeds enhanced the surface hydrophobicity, and also were consistent with FTIR results. Our studies show that MSs materials combined the advantages of the ordered mesoporous material (high adsorptive capacity, large pore volume) and silicalite-1 zeolite (super-hydrophobic property, high hydrothermal stability), and the presence of micropores directly led to an increase in the dynamic adsorption capacity of benzene under dry and wet conditions.


Iatrogenic causes of erectile dysfunction.
Normal penile erection is a complex event dependent upon the proper sequential function of the endocrine, nervous, and vascular systems. Medical or surgical therapy can influence those systems and so cause erectile dysfunction. Physicians must understand these iatrogenic causes of erectile dysfunction in order to prevent or reverse them.


Outcomes of revision neurolysis of the ulnar nerve and ulnar groove plasty for persistent and recurrent cubital tunnel syndrome-A retrospective study of 21 cases.
Patients undergoing revision surgical treatment of the ulnar nerve at the elbow for cubital tunnel syndrome (CuTS) will have worse results compared to patients successfully treated with primary surgery. The purpose of this study is to evaluated clinical outcomes of revision neurolysis and ulnar groove plasty for recurrent and persistent cubital tunnel syndrome after failed surgical treatment. This retrospective investigation included patients presented with recurrent and persistent CuTS who were treated surgically with combination of revision neurolysis and ulnar groove plasty at a single institution from May 2006 to Oct 2016 with postoperative follow-up more than 24 months. Demographic data of all patients including age, sex, months to revision surgery, presenting symptoms after index surgery, previous surgical procedure and intraoperative findings were all recorded and pre-operative and post-operative data were compared. McGowen grading was used to evaluated functional impairment before and after revision surgery. There were 28 patients were identified with recurrent and persistent CuTS after primary surgery and 21 patients (75%) were completed in this study with an average age was 56 years, mean duration of symptoms was 17.24 months, and mean postoperative follow-up was 35.38 months. 17 patients had McGowan stage III and 4 had stage II preoperatively. The most common cause of recurrent and persistent CuTS was perineural fibrosis with or without kink which accounts for 86.36% according to intraoperative findings. McGowan grading improved after revision neurolysis and ulnar groove plasty is 80.95%. Improvement of Visual Analogue Scale (VAS) and 2-point discrimination test were 81.25% and 85.71%, respectively. Patients satisfaction after revision neurolysis and ulnar groove plasty was 95.24%. The favorable results of this study demonstrated that revision neurolysis and ulnar groove plasty as the treatment of choice for recurrent or persistent cubital tunnel syndrome.


Characterization of nicotine's ability to serve as a negative feature in a Pavlovian appetitive conditioning task in rats.
Pavlovian feature negative discriminations have been widely used to understand inhibitory conditioning processes using exteroceptive stimuli. Comparatively little is known about inhibitory conditioning processes using a drug state as a negative feature. A negative feature signals that presentation of a conditional stimulus (CS) will not be paired with an unconditioned stimulus. The present research examined whether nicotine served as a negative feature and started characterizing its properties. In acquisition, rats received intermixed saline and nicotine (0.4 mg/kg, base) sessions. On saline sessions, a 15-s light CS was paired with 4-s access to sucrose; the CS was presented on nicotine sessions, but sucrose was withheld. The discrimination was acquired with more goal tracking during the CS on saline sessions. Nicotine's inhibition of this conditioned response (CR) was sensitive to nicotine dose (ED50=0.225) and injection to testing interval (CR returned at 200 min). Mecamylamine pretreatment, but not hexamethonium, produced a loss of inhibitory control by nicotine suggesting a role for central nicotinic acetylcholine receptors. Amphetamine, bupropion, arecoline, and chlordiazepoxide, but not caffeine, substituted for the nicotine feature. However, in locomotor tests, amphetamine and bupropion increased activity; arecoline and chlordiazepoxide decreased activity. For this reason, the motor effects of these ligands could not be dissociated from substitution via shared stimulus properties. This feature negative task provides a preclinical model for studying how drug states inhibit responding, although identifying the process(es) mediating CR inhibition will require further research.


Thermal analysis of bacteria by differential scanning calorimetry: relationship of protein denaturation in situ to maximum growth temperature.
Differential scanning calorimetry (DSC) was used to analyze thermal transitions in two strains of the thermophile Bacillus stearothermophilus (ATCC 12016 and WAT), the mesophile Bacillus megaterium and the psychrotroph Bacillus psychrophilus. The observed transitions, representing lipid melting and DNA and protein unfolding, are compared to the maximum growth temperature (Tmax) in each species as a means of identifying critical, thermolabile targets responsible for heat-induced inhibition of growth. A low temperature, lipid transition was detected in B. stearothermophilus and B. megaterium which varied slightly with Tmax but whose high temperature end is always 22-33 degrees C below Tmax. The transition temperature (Tm) of the main melting of DNA varies from 88 to 92 degrees C, 23-32 degrees C above Tmax. The main part of the profile representing irreversible transitions is resolvable into at least three distinct peaks and is identified primarily with protein denaturation. The onset temperature for denaturation (Tl), i.e., minimum temperature of detectable denaturation, is somewhat dependent on growth temperature (Tg). Tmax for B. stearothermophilus ATCC and WAT is 69 and 56 degrees C, respectively. For cells grown between 4 and 20 degrees C below Tmax, Tl is 2-4 degrees C lower than Tmax, demonstrating that some denaturation can be tolerated before complete inhibition of growth and suggesting that inhibition of growth is due to the denaturation of a critical protein with a Tm a few degrees above Tl or to the accumulation of denatured protein to a critical level. A similar pattern holds for B. megaterium and B. psychrophilus, except that Tmax is 48 and 32.5 degrees C (Tl = 45-46 degrees C and 30 degrees C), respectively. Thus, there is an excellent correlation between the onset of protein denaturation and maximum growth temperature for these three species of the same genus. This study also demonstrates the applicability of DSC for resolving transitions in intact cells on the basis of thermostability of cellular constituents and for obtaining an overall view of macromolecular stability.


Niacin metabolism and indoleamine 2,3-dioxygenase activation in malnourished patients with flaky paint dermatosis.
Flaky paint dermatosis, characterized by extensive, often bilateral areas of flaking and pigmentation, mostly in sun unexposed areas is considered a feature of kwashiorkor in both children and adults, and must be differentiated from other dermatosis, including chapped and xerotica skin, and pellagra. In this case series we provide evidence that malnourished patients with flaky paint dermatosis and infection/inflammation shown laboratory data suggestive of indoleamine 2,3-dioxygenase (IDO) activation, besides decreased urinary excretion of N1-methylnicotinamide (N1 MN), a marker of pellagra. We study nine adult patients showing flaky paint dermatosis and clinical features of infection or inflammation, and increased serum C-reactive protein, characteristic of the presence of acute phase response syndrome. As a group, they had low or deficient urinary N1 MN excretion (0.52 ± 0.39 mg/g creatinine) compatible with pellagra. They also showed low serum tryptophan levels (<29 μmol/L) and a serum kynurenine/tryptophan ratio higher than 0.04, suggesting increased IDO expression and increase in the tryptophan oxidation. Findings suggest that some patients with flaky paint dermatosis showed laboratory data suggestive of IDO activation, besides decreased N1 MN urinary excretion. Taken together, the data support the idea that flaky paint dermatosis could be a skin manifestation of niacin deficiency.


Prognostic significance of T helper 1 and 2 and T cytotoxic 1 and 2 cells in patients with non-small cell lung cancer.
We report the prognostic significance of peripheral and tumor-infiltrating Th1, Th2, Tc1 and Tc2 cells in lung cancer patients. We evaluated the rates of interferon (IFN)-gamma+/CD4+ cells (Th1), interleukin (IL)-4+ /CD4+ cells (Th2), IFN-gamma+/CD8+ cells (Tc1), IL-4+ /CD8+ cells (Tc2), and the ratio of Th1 to Th2 and that of Tc1 to Tc2 among peripheral blood lymphocytes (PBL) and tumor-infiltrating lymphocytes (TIL), in 51 consecutive patients with non-small cell lung cancer, by detecting the intracellular cytokine production using three-color flow cytometry. Patients with a low Th1/Th2 ratio in peripheral blood lymphocytes had a significantly better prognosis than those with a high Th1/Th2 ratio (5-year survival rate: low: 74.7% vs. high: 50.3%; p=0.038). Patients with a low Th1/Th2 ratio in peripheral blood had a significantly better prognosis than those with a high Th1/Th2 ratio in pathological Stage II or III (5-year survival rate: low: 66.6% vs. high: 18.2%; p=0.018). A high Th1/Th2 ratio in peripheral blood is a negative prognostic factor, especially in pathological Stage II or III non-small cell lung cancer patients.


1,3,5-Tris(bromo-meth-yl)-2,4,6-trimeth-oxy-benzene.
There are three independent mol-ecules in the asymmetric unit of the title compound, C12H15Br3O3, two of which have approximate trigonal symmetry, the third being conformationally different as it adopts near mirror symmetry. The crystal structure features C-H⋯Br inter-actions, a weak C-H⋯O hydrogen bond, π-π inter-actions [minimum ring centroid separation = 3.4927 (18) Å] and a short Br⋯Br contact [3.5894 (5) Å], resulting in a three-dimensional supramolecular network.


Saturated fatty acids are not off the hook.
A recent meta-analysis by Chowdhury et al. (2014) has disclaimed the association between coronary artery diseases and either circulating blood levels or the intake of total saturated fatty acids (SFA). Scrutiny revealed that two of the eight studies included in the meta-analysis focused on the proportion of pentadecanoic acid (C15:0) and heptadecanoic acid (C17:0) and their impact on cardiovascular disease (CVD) risk. These odd-chain fatty acids are markers for milk or ruminant fat intake. Both studies indicated inverse associations between milk-fat intake and first-ever myocardial infarction. Neither of the two studies described the association between total circulating blood SFA on coronary outcomes. In contrast to the cardioprotective effects of dairy consumption, we expected that an elevated intake of palmitic acid (C16:0) and stearic acid (C18:0) de novo may raise CVD risk. Thus, it is of particular importance to differentiate the effects of individual circulating SFA on cardiovascular outcomes. Excluding the studies that evaluated the association of fatty acids from milk fat and cardiovascular outcomes revealed a positive association of total SFA blood levels and coronary outcome (RR 1.21, CI 1.04-1.40). Therefore, results obtained from studies of C15:0 and C17:0 cannot be mixed with results from studies of other SFA because of the opposite physiological effects of regular consumption of foods rich in C16:0 and C18:0 compared to high intake of milk or ruminant fat. In our opinion, it is vital to analyze the impact of individual SFA on CVD incidence in order to draw prudent conclusions.


Actinoplanes solisilvae sp. nov., Isolated from Birch Forest Soil.
A novel actinomycete, designated strain LAM7112T, was isolated from soil sample collected from a birch forest in Xinjiang Uygur Autonomous Region, China. The new isolate was found to be able to grow at 20-45 °C (optimum: 35 °C), pH 5.0-10.0 (optimum: 7.0) and in the presence of 0-10.0% (optimum: 3.0%) (w/v) NaCl. The isolate formed very scantily irregular sporangia containing motile spores on the substrate mycelium. Phylogenetic analysis of 16S rRNA gene sequences indicated that the new isolate was closely related to members of the family Micromonosporaceae, with highest similarites to Actinoplanes ferrugineus X-14695T (97.4%), Micromonospora zamorensis DSM 45600T (97.3%) and Micromonospora aurantiaca ATCC 27029T (97.3%). In the phylogenetic trees, strain LAM7112T formed a stable phylogenetic subclade within the genus Actinoplanes. The genomic DNA G + C content was 70.0 mol%. The major fatty acids (> 10%) were determined to be iso-C16:0, anteiso-C15:0 and anteiso-C17:0. The predominant menaquinones were identified as MK-9 (H2), MK-9 (H4) and MK-9 (H6). The major polar lipids were found to be diphosphatidylglycerol, phosphatidylinositol and phosphatidylethanolamine. The diagnostic amino acid of the cell wall peptidoglycan was determined to be meso-diaminopimelic acid. The diagnostic sugars in cell hydrolysates were determined to be glucose and ribose. On the basis of its phenotypic, phylogenetic and chemotaxonomic characteristics, strain LAM7112T (= CGMCC 4.7580T = JCM 32512T) is proposed to represent the type strain of a novel species of the genus Actinoplanes, for which the name Actinoplanes solisilvae is proposed.


Investigation of cardiac glycoside levels in human post mortem blood and tissues determined by a special radioimmunoassay procedure.
Even after the introduction of radioimmunological methods the question of a cardiac glycoside causing or contributing to the death of a patient can not be answered satisfactorily. By means of a special radioimmunoassay procedure for digoxin as well as for the structurally related methyl- and acetylderivatives we measured the concentrations in human blood and post mortem tissues. We investigated the glycoside contents in the blood of intravenously digitalised (Novodigal) al) patients before and after death. At autopsy blood specimens were taken from the heart and the femoral vein. We found an increase of the glycoside level up to a highly toxic range (7--15 ng/ml) especially in the heart blood. Thus post mortem blood levels of digoxin and its derivatives are not suitable for a final decision in alleged cases of fatal poisonings. Measuring various concentrations in tussues and body fluids of the above cardiac glycosides mentioned revealed the kidney concentration to be of high value in confirming a digitalis poisoning. This organ and the heart show the highest tissue concentrations. Interpretations of fatal digitalis poisonings should be based on the additional knowlege of these concentrations. Individual cardiac glycosides may be analyzed by a combination of thin layer chromatography and radioimmunoassay.


Towards a self tuning sliding mass metastructure.
Passive vibration control systems are characterized by their simple practical design and independence of external power supplies. However, they are usually hindered by their narrow frequency band that cannot handle variable frequency disturbances. Recent research has demonstrated the capability of passive self-tuning resonators through the use of a sliding mass without the need for any external power sources. This work analytically and experimentally investigates the passive self-tuning of a metastructure consisting of a clamped-clamped beam with a sliding mass. The governing equations of motion show that the slider can be driven by Coriolis and centrifugal forces upon applying the excitation force on the structure. To improve the accuracy of our analytical simulations, we derive the exact instantaneous mode shapes and frequencies of the structure and feed them into an adaptive algorithm, which updates the spatial state of the system. Numerical simulations demonstrate that the proposed resonator can tune itself to the excitation frequency as the slider reaches the equilibrium position. This observation suggests that a significant vibration reduction can be obtained using the proposed resonator over a wide frequency band. Experiments are carried out to validate the analytical findings. The proposed structure can be used in different vibration control applications (i.e., aerospace, automotive, and machining), and its model can further be extended to self-adaptive periodic structures (metamaterials).


Association of Dietary Variety Status and Sarcopenia in Korean Elderly.
Sarcopenia is associated with a variety of factors including age, diseases, exercise, and heredity. In particular, diet is known to affect changes in muscle mass loss. The purpose of this study was to analyze the diversity of food intake according to the presence of sarcopenia in elderly people over 65 years old using the 2008 to 2011 Korea National Health and Nutrition Examination Survey. The differences in subjects' general characteristics, lifestyle, and intake of 15 food groups were compared, and the risk odds ratio (OR) for sarcopenia was calculated for each food intake by gender. The proportion of sarcopenia was 27.7% for males and 24.3% for females. The sarcopenia group had significantly lower intakes of nuts and seeds, meats, and milks than the non-sarcopenia group in males. The females had significantly lower intake of fruits, milks, and beverages in non-sarcopenia group. The dietary diversity score was significantly lower in females with sarcopenia than non-sarcopenia group. Regression analysis of the risk OR for sarcopenia according to food group intake showed that the subjects in the lowest tertile (<31.1 g) had a 1.83 times (95% confidence interval [CI], 1.13-2.42) risk for sarcopenia in males. In case of milks intake of females, the risk for sarcopenia increased 1.39 times (95% CI, 1.11-1.86) in subjects with the lowest tertile (<30.1 g). Dietary diversity status was the most vulnerable to female with sarcopenia. Sarcopenia was associated with meat intake in male and milk intake in female.


Validation of the first computerized indicator for orthopaedic surgical site infections in France: ISO-ORTHO.
The French national authority for health (HAS) develops in-hospital indicators for improving quality of care, safety and patient outcome. Since 2017, it has developed a measurement of surgical site infections (SSI) after total hip or knee arthroplasty (TH/KA) by using a computerized indicator, called ISO-ORTHO, based on a hospital discharge database (HDD) algorithm. The aim of the study was to assess the performance of this new indicator . The ISO-ORTHO performance was estimated via its positive predictive value (PPV) among adult patients having undergone a TH/KA between January 1st and September 30th 2018, based on the orthopaedic procedure codes. Patients at very high risk of SSI and/or with SSI not related to the in-hospital care were excluded. SSI were detected from the date of admission up to 90 days after the TH/KA using the ISO-ORTHO algorithm, based on 15 combinations of ICD-10 and procedure codes. Its PPV was estimated by a chart review in volunteer healthcare organisations (HCO). Over the study period, 777 HCO including 143,227 TH/KA stays were selected, providing 1,279 SSI according to the ISO-ORTHO indicator. The 90-day SSI rate was 0.89 per 100 TH/KA stays (0.98% for THA and 0.80% for TKA). Among the 448 HCO with at least 1 SSI, 250 HCO participated in reviewing 725 SSI charts; 665 were confirmed, giving a PPV of 90.3% [88.2-92.5%], 89.9% [87.1-92.8%] in THA and 90.9% [87.7-94.2%] in TKA. The PPV of ISO-ORTHO over 90% confirms its validity for any use according to the HAS method. ISO-ORTHO and detailed information were provided in 2020 to HCO and used for quality assessment and in-hospital risk management.


Reconstruction of Bacillus thuringiensis ssp. israelensis Cry11A endotoxin from fragments corresponding to its N- and C-moieties restores its original biological activity.
Subtilisin hydrolyzes Cry11A endotoxin (of 70 kD) produced by Bacillus thuringiensis ssp. israelensis to fragments of 33- and 36-kD, which correspond to N- and C-terminal halves of the endotoxin molecule. Thermitase (a serine protease from Thermoactinomyces vulgaris) and insect gut proteases from Diptera and Lepidoptera exhibit the same hydrolytic effect on Cry11A. Hydrolyzates maintain high toxicity with respect to larvae of Aedes aegypti, Anopheles stephensi, and Culex pipiens. The 33- and 36-kD Cry11A endotoxin components purified by ion-exchange chromatography from the subtilisin hydrolyzate were inactive; however, equimolar mixture of these proteins exhibited almost the same activity as the initial hydrolyzate.


DNA methylation age is not accelerated in brain or blood of subjects with schizophrenia.
Individuals with schizophrenia (SZ) exhibit multiple premature age-related phenotypes and die ~20years prematurely. The accelerated aging hypothesis of SZ has been advanced to explain these observations, it posits that SZ-associated factors accelerate the progressive biological changes associated with normal aging. Testing the hypothesis has been limited by the absence of robust, meaningful, and multi-tissue measures of biological age. Recently, a method was described in which DNA methylation (DNAm) levels at 353 genomic sites are used to produce "DNAm age", an estimate of biological age with advantages over existing measures. We used this method and 3 publicly-available DNAm datasets, 1 from brain and 2 from blood, to test the hypothesis. The brain dataset was composed of data from the dorsolateral prefrontal cortex of 232 non-psychiatric control (NPC) and 195 SZ subjects. Blood dataset #1 was composed of data from whole blood of 304 NPC and 332 SZ subjects, and blood dataset #2 was composed of data from whole blood of 405 NPC and 260 SZ subjects. DNAm age and chronological age correlated strongly (r=0.92-0.95, p<0.0001) in both NPC and SZ subjects in all 3 datasets. DNAm age acceleration did not differ between NPC and SZ subjects in the brain dataset (t=0.52, p=0.60), blood dataset #1 (t=1.51, p=0.13), or blood dataset #2 (t=0.93, p=0.35). Consistent with our previous findings from a smaller study of postmortem brains, our findings suggest there is no acceleration of brain or blood aging in SZ and, thus, do not support the accelerated aging hypothesis of SZ.


Vasoconstrictor responses are normal but prostanoid-mediated vasodilatation is enhanced in human cirrhotic mesenteric arteries.
The mechanisms responsible for mesenteric vasodilatation in cirrhosis have not been fully elucidated. The aim of the present study was to examine whether there is altered intrinsic vascular reactivity of human mesenteric vessels in cirrhosis, which might contribute to vasodilatation in vivo. Ten mesenteric arteries from six cirrhosis patients undergoing liver transplantation were compared with 11 arteries from six control patients. Vasoconstrictor responses to potassium, norepinephrine and methoxamine were determined. Endothelium-dependent vasodilatation responses to acetylcholine and substance P were determined both before and after inhibition of nitric oxide (NO) and prostanoid synthesis. Cirrhotic vessels responded normally to potassium depolarization and did not differ to control vessels with respect to sensitivity and maximal response to norepinephrine. In cirrhotic vessels, inhibition of NO synthesis had significantly less effect on substance P-induced vasorelaxation than in controls (% Relaxation: cirrhosis 70.3 +/- 9.6; control 34.9 +/- 9.5; P = 0.03). However, after inhibition of both NO and prostanoid synthesis, vasodilatory responses were eliminated in both groups. The findings of the present study indicate that intrinsic hyporesponsiveness to vasoconstrictors does not play a pathogenetic role in the mesenteric vasodilatation in human cirrhosis. Furthermore, vasodilator prostanoids might make a significant contribution in mediating enhanced endothelium-dependent vasorelaxation in the mesenteric circulation.


[Specific features of nesting bird populations in forest-meadow-field landscapes of Meshchovsk Opolye reflect the diversity of their biotope connections].
Studies on specific features of nesting bird populations in patchy landscapes were performed in Meshchovsk Opolye, Kaluga Region, from 1981 to 1990. Indices of similarity between the avifaunas of agricultural fields, lowland bogs, and small-leaved forests markedly differed from parameters of their population density in rank and value. In the series of biotopes differing in the relative amount of woodland, from central areas of small-leaved forests to forest margins and then to forest islands gradually decreasing in size, the birds segregated into two distinct groups, one characteristic of forest margins and large forest islands and the other characteristic of small and very small forest islands. Specific features of bird density distribution in forest-meadow-field landscapes of Meshchovsk Opolye reflected heterogeneity of their populations manifested in diverse connections with nesting biotopes.


Combined recordings of compound nerve action potentials and spinal cord evoked potentials in differential diagnosis of spinal root lesions.
Three cases are presented to demonstrate the diagnostic value of sensory neurography in combination with somatosensory evoked potentials in the diagnosis of proximally located neuropathy and its differentiation to centrally located demyelinating processes. Simultaneous recording of cortical and spinal evoked potentials, as well as peripheral nerve action potentials, revealed in two cases (herpes zoster, Guillain-Barré syndrome) a site of lesion at the spinal roots suggesting radiculitis and in one case (tick bite) a site of lesion central to the source of lumbar evoked potentials suggesting myelitis. In all cases almost complete recovery of sensory conduction velocities suggests a complete repair myelination not previously described.


Using venous blood gas analysis in the assessment of COPD exacerbations: a prospective cohort study.
Identifying acute hypercapnic respiratory failure is crucial in the initial management of acute exacerbations of COPD. Guidelines recommend obtaining arterial blood samples but these are more difficult to obtain than venous. We assessed whether blood gas values derived from venous blood could replace arterial at initial assessment. Patients requiring hospital treatment for an exacerbation of COPD had paired arterial and venous samples taken. Bland-Altman analyses were performed to assess agreement between arterial and venous pH, CO2 and HCO3-. The relationship between SpO2 and SaO2 was assessed. The number of attempts and pain scores for each sample were measured. 234 patients were studied. There was good agreement between arterial and venous measures of pH and HC)3- (mean difference 0.03 and -0.04, limits of agreement -0.05 to 0.11 and -2.90 to 2.82, respectively), and between SaO2 and SpO2 (in patients with an SpO2 of >80%). Arterial sampling required more attempts and was more painful than venous (mean pain score 4 (IQR 2-5) and 1 (IQR 0-2), respectively, p<0.001). Arterial sampling is more difficult and more painful than venous sampling. There is good agreement between pH and HCO3- values derived from venous and arterial blood, and between pulse oximetry and arterial blood gas oxygen saturations. These agreements could allow the initial assessment of COPD exacerbations to be based on venous blood gas analysis and pulse oximetry, simplifying the care pathway and improving the patient experience.


Nano-pesticide carrier O-Carboxymethyl chitosan is indigestible in Apis cerana cerana and affects intestinal flora.
O-Carboxymethyl chitosan nanoparticles (O-CMC-NPs), which are organic pesticide carriers, have excellent application potential. Exploring the effects of O-CMC-NPs on non-target organisms, such as Apis cerana cerana, is critical for their effective application; however, such studies are limited. This study investigated the stress response of A. cerana Fabricius after O-CMC-NPs ingestion. The administration of high O-CMC-NP concentrations enhanced the activities of antioxidant and detoxifying enzymes in A. cerana, with the activity of glutathione-S-transferase increasing by 54.43 %-64.33 % after one day. The transit of O-CMC-NPs into the A. cerana midgut resulted in their deposition and adherence to the intestinal wall, as they cluster and precipitate in acidic conditions. The population of Gillianella bacteria in the middle intestine was remarkably reduced after 6 d of administration of high O-CMC-NP concentrations. Contrastingly, the abundance of Bifidobacteria and Lactobacillus in the rectum significantly increased. These results indicate that the intake of high concentrations of O-CMC-NPs causes a stress response in A. cerana and affects the relative abundance of crucial intestinal flora, which may pose a potential risk to the colony. This implies that even nanomaterials with favorable biocompatibility should be applied reasonably within a specific range to avoid adverse effects on the environment and non-target organisms in the context of large-scale research and promotion of nanomaterials.


Atypical Teratoid/Rhabdoid Tumor in Taiwan: A Nationwide, Population-Based Study.
Atypical teratoid/rhabdoid tumor (AT/RT) is a rare, highly aggressive embryonal brain tumor most commonly presenting in young children. We performed a nationwide, population-based study of AT/RT (ICD-O-3 code: 9508/3) in Taiwan using the Taiwan Cancer Registry Database and the National Death Certificate Database. A total of 47 cases (male/female = 29:18; median age at diagnosis, 23.3 months (IQR: 12.5-87.9)) were diagnosed with AT/RT between 1999 and 2014. AT/RT had higher prevalence in males (61.70%), in children < 36 months (55.32%), and at infratentorial or spinal locations (46.81%). Survival analyses demonstrated that patients ≥ 3 years of age (n = 21 (45%)) had a 5y-OS of 41% (p < 0.0001), treatment with radiotherapy only (n = 5 (11%)) led to a 5y-OS of 60%, treatment with chemotherapy with or without radiotherapy (n = 27 (62%)) was associated with a 5y-OS of 45% (p < 0.0001), and patients with a supratentorial tumor (n = 11 (23%)) had a 5y-OS of 51.95%. Predictors of better survival on univariate Cox proportional hazard modeling and confirmed with multivariate analysis included older age (≥1 year), supratentorial sites, and the administration of radiotherapy, chemotherapy, or both. Gender had no effect on survival. Older age, supratentorial site, and treatment with radiotherapy, chemotherapy, or both significantly improves the survival of patients with AT/RT.


Changes in blood lymphocyte enzyme profile in patients with renal cancer after a course of interferon therapy.
Activities of NAD(P)-dependent dehydrogenases in blood lymphocytes of patients with renal cell cancer were studied. The enzyme profiles in patients were different before and after the course of immunotherapy. A relationship between changes in the enzyme status and in vitro cell sensitivity to IFN-α2a was detected.


Molecular neuropathology of Alzheimer's disease: in situ hybridization studies.
1. Abundant senile plaques and neurofibrillary tangles in certain brain regions constitute the major neuropathological characteristics of Alzheimer's disease. Recent work has established that the amyloid beta protein, which is derived from a large precursor, constitutes the major constituent of plaque amyloid, whereas the microtubule-associated protein tau is a component of the paired helical filament, the major constituent of neurofibrillary tangles. 2. Multiple isoforms of amyloid beta protein precursor and tau protein are produced from a single gene through alternative RNA splicing. By Northern blotting amyloid beta protein precursor transcripts are found throughout central and peripheral tissues, whereas tau protein transcripts are only found in the nervous system. 3. In the central nervous system the cellular localization of amyloid beta protein precursor and tau protein transcripts is neuronal. The cells affected in Alzheimer's disease patients produce both types of transcripts; however, the various transcripts are also found in cells not affected in the course of the disease. At present, there exists no evidence to suggest that an overproduction of amyloid beta protein precursor or tau protein is the reason for plaque and tangle formation. The formation of the latter probably results from posttranslational events.


A further study of dye batch variation in textile and carpet fibres.
Four sets of acrylic fibre samples were obtained from a company that dyes fabrics for the fashion industry. Between seven and ten different batches of fibres constituted each set. Comparison microscopy, visible and UV range microspectrophotometry and thin layer chromatography (TLC) were used to compare the dyes on each batch of fibres within the sets. Only one of the four sets exhibited variation within the batches. The differences were seen when both microscopical and analytical techniques were used. In addition, two further sets of samples had been obtained from a company that produces carpets for the car industry. The first set consisted of 26 batches of acid dyed orange nylon fibres. The second consisted of 21 batches of acid dyed mustard coloured nylon and direct dyed brown viscose fibres blended together. When the first set was viewed under UV light one batch had more pale orange fibres present and they fluoresced more brightly than the other fibres. This could be due to the blending with a different dye batch of fibre or due to poor dye uptake--the latter being more likely. When tested using visible and UV range microspectrophotometry and TLC, further dye batch variation was not detected. The second set was examined after separating the nylon and viscose fibres from each other. The nylon fibres were indistinguishable when a range of microscopical and analytical techniques were employed; however, the viscose fibres showed dye batch variation when TLC was used.


Prolonged oral hydroxyurea and concurrent 3d-conformal radiation in patients with progressive or recurrent meningioma: results of a pilot study.
Treatment of recurrent and progressive meningiomas remains a challenge in clinical neurooncology. This study was designed to evaluate the efficacy of the simultaneous application of 3d-conformal radiotherapy and chemotherapy with hydroxyurea (HU). Twenty-one patients with recurrent or progressive meningiomas (13 benign, 4 atypical and malignant, 4 with unproven histology) received treatment by fractionated 3d-conformal radiation (55.8-59.4 Gy) and concurrent HU, administered for a median time of three months with a daily dosage of 20 mg/kg. Response was evaluated using clinical and neuro-imaging data. Disease stabilization was achieved in 14/21 patients (pts). Three pts had significant improvement of tumor associated neurological symptoms with imaging criteria of minor response. Progression free survival rates 1 year and 2 years after the initiation of radio-chemotherapy were 84% and 77%, respectively. At the time of analysis a total of 6/21 pts presented with progressive disease with a median time to progression of 59 weeks. Documented radio- and chemotherapy associated toxicity was minimal; only one patient discontinued HU treatment due to gastrointestinal symptoms such as anorexia and weight loss. Results obtained in this study indicate that treatment with HU and simultaneous radiotherapy is safe and effective with disease stabilization in the majority of patients. Randomized trials comparing radiosurgery versus radiochemotherapy versus fractionated radiotherapy are warranted.


Report from an effort to prevent type 2 diabetes development in primary care.
In a clinical trial 2009-2012, individuals with prediabetes were randomised to a lifestyle intervention (LI) focused on physical activity or care as usual (CAU), with the aim of reducing development of type 2 diabetes (T2DM). At study termination after three years, there was a significantly less of an increase in insulin resistance in LI compared with the CAU group. The aim of this extended follow-up was to investigate whether positive results concerning metabolic variables remained five years after study termination. All participants from the original study were contacted for a new follow-up with an oral glucose tolerance test, anthropometric measurements, blood pressure and blood samples. Questionnaires about lifestyle were completed. A total of 69 of the original 123 participants were examined, and personal data for another five participants were collected from the medical charts (n = 74). The LI group showed a decrease in diastolic blood pressure (-4 mmHg, CI 95% 0.8-6.8, p = 0.014) and body weight (-3 kg, CI 95% 1.2-4.9, p = 0.002) since base-line. Weight loss in the LI group was significantly greater compared with weight loss in the CAU group (-3 kg, CI 0.1-5.9, p = 0.044). Insulin resistance markers and incident T2DM were similar among the groups. Although without modifying the incidence of diabetes or the level of insulin resistance, a physical activity intervention may be used to induce sustainable weight change in subjects with prediabetes at the primary care level.


Mapping patients' experiences from initial symptoms to gout diagnosis: a qualitative exploration.
To explore patients' experiences from initial symptoms to receiving a diagnosis of gout. Data from in-depth semistructured interviews were used to construct themes to describe key features of patients' experiences of gout diagnosis. A maximum variation sample of 43 UK patients with gout (29 men; 14 women; age range 32-87 years) were recruited from general practices, rheumatology clinics, gout support groups and through online advertising. Severe joint pain, combined with no obvious signs of physical trauma or knowledge of injury, caused confusion for patients attempting to interpret their symptoms. Reasons for delayed consultation included self-diagnosis and/or self-medication, reluctance to seek medical attention, and financial/work pressures. Factors potentially contributing to delayed diagnosis after consultation included reported misdiagnosis, attacks in joints other than the first metatarsophalangeal joint, and female gender. The limitations in using serum uric acid (SUA) levels for diagnostic purposes were not always communicated effectively to patients, and led to uncertainty and lack of confidence in the accuracy of the diagnosis. Resistance to the diagnosis occurred in response to patients' beliefs about the causes of gout and characteristics of the people likely to be affected. Diagnosis prompted actions, such as changes in diet, and evidence was found of self-monitoring of SUA levels. This study is the first to report data specifically about patients' pathways to initial consultation and subsequent experiences of gout diagnosis. A more targeted approach to information provision at diagnosis would improve patients' experiences.