Metal carbonyls supported on iron oxide nanoparticles to trigger the CO-gasotransmitter release by magnetic heating.
Magnetic iron oxide, maghemite (Fe2O3) nanoparticles with covalent surface-bound CO-releasing molecules (CORMs) can be triggered to release CO through heating in an alternating magnetic field. In the proof-of-concept study the rate of CO-release from [RuCl(CO3)(μ-DOPA)]@maghemite nanoparticles was doubled upon exposure to an external alternating magnetic field (31.7 kAm(-1), 247 kHz, 25 °C, 39.9 mTesla, DOPA = dioxyphenyl-alaninato).


Sex differences and modifiable dementia risk factors synergistically influence memory over the adult lifespan.
More women than men develop Alzheimer's disease, yet women perform better and show less decline on episodic memory measures, a contradiction that may be accounted for by modifiable risk factors for dementia. Associations among age, sex, modifiable dementia risk factors, and cognition were measured in a cross-sectional online sample (n = 21,840, ages 18 to 89). Across four tests of associative memory and executive functions, only a Face-Name Association task revealed sex differences in associative memory that varied by age. Men had worse memory than women (the equivalent of performing similar to someone 4 years older) across ages. Men had larger age differences than women (ie, worse memory in older ages) among people with no to one risk factor, but not those with multiple risk factors. Because the relationship between dementia risk factors and age-related memory differences varies between men and women, sex-specific dementia prevention approaches are warranted.


Repeated measures correlation between functional capacity, pulmonary function and chest expansion in children undergoing open abdominal surgery: Secondary analysis from randomized clinical trial.
Six minute walk test (6MWT), Spirometry and chest expansion are used regularly to investigate the status of functional capacity and pulmonary function pre and post operatively. We assessed whether Functional capacity Ten meter walk test (10mWT), Nine stair climbing test (9SCT), pulmonary function [Spirometry parameters (FVC, FEV1, FEV1/FVC ratio and PEFR)] and chest expansion have correlation in children undergoing open abdominal surgery. Total 18 children aged 5-17 years old undergoing open abdominal surgery participated in the study. The study follows secondary analysis from randomized clinical trial. 6MWT, Spirometry parameters (FVC, FEV1, FEV1/FVC ratio and PEFR), 10mWT, 9SCT, and Chest expansion measures were taken before [Preoperative day (Pre-OP)] and after open abdominal surgery [postoperative day one (POD1) and postoperative day five (POD5)]. Bivariate analysis showed no correlation (rs <0.25; p>0.05) between Functional capacity and pulmonary function preoperatively, on POD1, and on POD5. 9SCT (Functional capacity) showed moderate to good correlation (rs= 0.742; p<0.05) with pulmonary function at the Pre-OP. Chest expansion parameters also showed moderate to good correlation (rs = 0.50-0.75; p<0.05) with the pulmonary function on Pre-OP, POD1, and POD5. There is moderate correlation exists between pulmonary function and chest expansion, but poor correlation of functional capacity with pulmonary function and chest expansion. Hence, all the outcome measures (6MWT, 10Mwt, 9SCT, Spirometry, and Chest expansion) are having individual importance.


[Osteoangiography in early diagnosis of acute hematogenic osteomyelitis of the long tubular bones in children].
33% cardiotrast of 70% verographin were used for the vessels contrasting. Osteoangiography was carried out in 61 cases suspected for acute hematogenic osteomyelitis (AHO). The age of patients ranged from 2 to 5 years. The diagnosis was proved in 53 cases. In 8 children osteoangiography permitted to cancel the diagnosis of AHO, which was proved later by subsequent clinical observations.


Microbial metabolic efficiency functions as a mediator to regulate rhizosphere priming effects.
Microbial metabolic efficiency (MME), a key physiological property that indicates the allocation of carbon (C) to microbial growth, is surely one potential pathway involved in the regulation of priming effect within soil systems. However, the function and mechanism concerning the regulation of the rhizosphere priming effects (RPE) by MME in plant-soil systems remain unclear. In this study, we performed a pot experiment that included two soil types (paddy soil and lou soil), two plant species (sorghum [Sorghum bicolor (L.) Moench] and maize [Zea mays L.]) and three stages of growth (big trumpet, blooming and mature stage) to investigate the MME mechanism of RPE. Both positive (up to 76% at the big trumpet stage) and negative (down to -11% at the mature stage) RPE were observed. A shift in related enzyme activities and microbial biomass indicated that the 'microbial activation' and 'microbial nitrogen (N) mining' hypotheses functioned together at first. The 'preferential substrate utilization' hypothesis then functioned at the latter two stages. After that, according to a correlation analysis method, the MME was introduced to regulate the RPE: the availability of soil C and N and the microbial biomass jointly shaped the microbial C: N imbalance (MIC:N), and the microbes then regulated their MME based on the MIC:N, thus, regulating the RPE. Specifically, the lower MME induced by a higher MIC:N was responsible for a greater RPE at the big trumpet stage across all the planted treatments, while a higher MME induced by a lower MIC:N was responsible for the lower or negative RPE at the blooming and mature stages. Overall, these findings demonstrate that the MME shaped by MIC:N functions as a mediator to regulate the RPE in planted soil.


Effect of topical pergolide on aqueous dynamics in normal and glaucomatous monkeys.
The effects of pergolide mesylate, an ergoline derivative, were studied on intraocular pressure (IOP), outflow facility, aqueous humor flow, and pupil size in monkeys. Unilateral topical administration of two 20-microliters drops of 0.1% pergolide significantly lowered IOP in the treated- and contralateral eye in both normal- and glaucomatous monkeys. In 12 normal monkeys, the baseline IOP of 18.3 +/- 0.4 mmHg [mean +/- S.E.(M.)] was maximally reduced to 14.4 +/- 0.7 mmHg in the treated eye (P less than 0.001) and 14.6 +/- 0.6 mmHg in the contralateral eye (P less than 0.001) at 2 hr after drug administration. In 10 monkeys made bilaterally glaucomatous by argon laser treatment of the trabecular meshwork, the baseline IOP of 33.9 +/- 3.0 mmHg [mean +/- S.E.(M.)] in the treated eyes and 31.7 +/- 3.3 mmHg in the untreated eyes maximally decreased to 23.9 +/- 2.2 mmHg (P less than 0.05) and 26.2 +/- 3.3 mmHg (P less than 0.005), respectively, at 5 hr. No significant change (P greater than 0.7) in outflow facility occurred in either eye of 11 normal monkeys 2 hr after unilateral 0.1% pergolide treatment. In six normal monkeys, the baseline aqueous humor flow of 1.58 +/- 0.20 microliter min-1 in treated eyes and 1.44 +/- 0.18 microliter min-1 in untreated eyes was reduced to 0.92 +/- 0.08 microliter min-1 (P less than 0.02) and 1.09 +/- 0.11 microliter min-1 (P greater than 0.10), respectively, from 0.5- to 3.5 hr after drug administration. A mydriatic response was observed in both eyes after unilateral treatment from 1- to 2 hr in eight normal monkeys. By the third day of treatment, bilateral twice a day 0.1% pergolide drops in eight glaucomatous monkey eyes no longer significantly (P greater than 0.05) decreased IOP.


Structural biology and inhibition of the Mtb cell wall glycoconjugates biosynthesis on the membrane.
Glycoconjugates are the dominant components of the Mycobacterium tuberculosis cell wall. These glycoconjugates are essential for the viability of Mtb and attribute to drug resistance and virulence during infection. The assembly and maturation of the cell wall largely relies on the Mtb plasma membrane. A significant number of membrane-bound glycosyltransferases (GTs) and transporters play pivotal roles in forming the complex glycoconjugates and are targeted by the first-line anti-TB drug and potent drug candidates. Here we summarize the latest structural biology of mycobacterial GTs and transporters, and describe the modes of action of drug and drug candidates that are of substantial clinical value in anti-TB chemotherapeutics.


Characterization of liposome suspensions by flow cytometry.
Novel approaches to drug delivery and induction of immune responses using liposomes have received much attention in recent years. Liposomes, however, are not a singular entity, but can be produced with a diverse group of phospholipids that form microspheres of different sizes, physical structure, electrochemical characteristics, and most importantly, physiologic properties. The purpose of this study was to establish the usefulness of flow cytometry as a convenient, rapid method for assessing the relative size and uniformity of liposomal preparations. Liposomes were made from phospholipid suspensions by sonication alone, or sonication followed by microemulsification. Forward laser light scatter (FSC) analysis of liposomal preparations by flow cytometry indicated that microemulsification produced homogeneous, small vesicles which were less than 1 micron in diameter, compared to the more heterogeneous sized liposomes generated by sonication alone. Transmission electron micrographs of the liposomal preparations were used to confirm the FSC results and showed that liposomes prepared by microemulsification were homogeneous, unilamellar vesicles which exhibited a mean diameter of 99.8 nm, whereas the sonicated-only preparation was more heterogeneous in size, exhibiting a mean diameter of 154.1 nm. Analysis of various liposome preparations by FSC during a 9 week storage period showed that small vesicles were relatively stable. We conclude that flow cytometry using FSC analysis provides a rapid, reproducible and convenient method to evaluate the relative size, uniformity and stability of liposomes.


Weaning from mechanical ventilation.
For the ventilator-dependent patient, weaning should be accomplished by withdrawing support safely, efficaciously, and efficiently. Success depends largely on physiologic determinants of respiratory system function, avoidance of ventilator-associated complications, and attention to patient readiness. Recent clinical trials, predictors of weaning, current techniques of weaning, the concept of reloading the respiratory pump, and determinants of ventilator dependency are all discussed.


[Endocarditis - an update].
Infective endocarditis remains a diagnostic and therapeutic challenge. This update focuses on recent developments in the diagnostic workup, therapeutic management and prophylaxis of infective endocarditis. Recommendations of the new guidelines of the European Society of Cardiology and the updated statement of the American Heart Association are compared and discussed. The new entity transcatheter aortic valve implantation (TAVI)-associated endocarditis is also highlighted.


Semisupine Positioning for Proximal Humerus ORIF Using Arthroscopic Shoulder Distractor.
Advances in implant technology have improved the orthopaedic surgeon's ability to successfully treat proximal humerus fractures. However, obtaining and maintaining anatomic reduction throughout surgery remains difficult. Failure to do so can compromise surgical outcomes leading to poor clinical results. Here, we describe a novel surgical method using upper-extremity traction that allows control and positioning of the operative extremity. This technique facilitates achieving and maintaining fracture reduction and decreases operative time.


Childhood polymyositis/dermatomyositis.
Children with PM/DM differ in many respects from adults with PM/DM. The most characteristic and distinctive feature is the presence of a widespread vasculopathy. Although the pathogenesis is unknown, roles for both humoral and cell-mediated immunity have been proposed. Most intriguing is the evidence for a viral agent that is capable of precipitating an ongoing, immunologically mediated reaction damaging muscles and endothelial cells. Much remains to be discovered, however, regarding the pathogenesis of this disease.


An extracellular vesicle targeting ligand that binds to Arc proteins and facilitates Arc transport in vivo.
Communication between distant cells can be mediated by extracellular vesicles (EVs) that deliver proteins and RNAs to recipient cells. Little is known about how EVs are targeted to specific cell types. Here, we identify the Drosophila cell-surface protein Stranded at second (Sas) as a targeting ligand for EVs. Full-length Sas is present in EV preparations from transfected Drosophila Schneider 2 (S2) cells. Sas is a binding partner for the Ptp10D receptor tyrosine phosphatase, and Sas-bearing EVs preferentially target to cells expressing Ptp10D. We used co-immunoprecipitation and peptide binding to show that the cytoplasmic domain (ICD) of Sas binds to dArc1 and mammalian Arc. dArc1 and Arc are related to retrotransposon Gag proteins. They form virus-like capsids which encapsulate Arc and other mRNAs and are transported between cells via EVs. The Sas ICD contains a motif required for dArc1 binding that is shared by the mammalian and Drosophila amyloid precursor protein (APP) orthologs, and the APP ICD also binds to mammalian Arc. Sas facilitates delivery of dArc1 capsids bearing dArc1 mRNA into distant Ptp10D-expressing recipient cells in vivo.


Environmental Remediation of the difficult-to-return zone in Tomioka Town, Fukushima Prefecture.
Temporal variations in ambient dose rates in a restricted area designated as "difficult-to-return" for residents of Tomioka Town, Fukushima Prefecture were evaluated in a car-borne survey during 2018-2019. The median dose rates in the "Decontaminated area" in the difficult-to-return zone decreased rapidly from 1.0 μSv/h to 0.32 μSv/h; however, the median dose rates in the "Non-decontaminated area" and "Radioactive waste storage area" fluctuated between 1.1-1.4 μSv/h and 0.46-0.61 μSv/h, respectively. The detected rate of the cesium-137 (137Cs) (137Cs-detected points per all measuring points) in the "Decontaminated area" also decreased rapidly from 64% to 6.7%, accompany with decreasing in ambient dose rates. On the other hand, the detection of 137Cs in the "Radioactive waste storage area" and "Non-decontaminated area" decreased from 53% to 17% and 93% to 88%, respectively. We confirmed that the dose rates in the Decontaminated area dramatically decreased due to decontamination work aiming to help residents return home. Moreover, the estimated external exposure dose of workers during the present survey was 0.66 mSv/y in the Decontaminated area and 0.55 mSv/y in the Radioactive waste storage area, respectively. This case of Tomioka Town within the "difficult-to-return zone" may be the first reconstruction model for evaluating environmental contamination and radiation exposure dose rates due to artificial radionuclides derived from the nuclear disaster.


Colocalization of the gene for nephrogenic diabetes insipidus (DIR) and the vasopressin type 2 receptor gene (AVPR2) in the Xq28 region.
The gene for nephrogenic diabetes insipidus (DIR) and the vasopressin type 2 receptor gene (AVPR2) have both been localized in the Xqter region by genetic mapping and functional expression studies, respectively. In this paper genetic evidence that the DIR locus is localized distal to the DXS305 locus and that the functional gene for the V2 receptor is localized between the markers DXS269 and F8 is presented. These further refinements in the localization of both genes strengthen the assumption that both genes are identical and provide a rationale for cloning the gene by reversed genetics strategies.


Monitoring techniques for prevention of procedure-related ischemic damage in aneurysm surgery.
To describe the application of intraoperative monitoring techniques during aneurysm surgery and to discuss the advantages and limitations of these techniques in prevention of postoperative neurologic deficits. Articles found in the literature through PubMed for the time frame 1980-2011 and the authors' personal files were reviewed. Various techniques for detection of vascular insufficiency are available, including direct methods to measure cerebral blood flow and indirect methods to evaluate the integrity of neurologic pathways. The choice of monitoring modality should be governed by the vessel and by the vascular territory most at risk during the planned procedure with proper awareness of the potential limits related to each technique. Aneurysm surgery monitoring should help to address issues of continuity and provide a morphologic and functional assessment. Although the use of monitoring devices is still not routine in aneurysm surgery and no standards have been established, combining different monitoring techniques is crucial to optimize aneurysm surgery and avoid or minimize complications.


In situ chemical modification of peptide microarrays: characterization by desorption/ionization on silicon nanowires.
Peptide microarrays are useful devices for the high throughput study of biomolecular or peptide-cell interactions. Whereas the synthesis of unmodified peptide libraries is an easy task and can be performed at reasonable cost, the synthesis of libraries of modified peptides remains expensive and time consuming. This bottleneck led us to examine the possibility to produce modified peptide microspots by in situ chemical modification of unmodified peptide microspots. The great advantage would be the preparation of a series of complex microarrays (daughter microarrays) starting from an easy-to-make and cost-effective unmodified peptide microarray (parent microarray). One step toward this goal has been presented in the accompanying chapter dealing with the in situ methylation methodology for studying the specificity of antibodies directed toward methylated epitopes. Here we describe the development of a novel desorption/ionization on silicon nanowires mass spectrometry (DIOSiNWs-MS) technique for characterizing the in situ chemical modification of peptides.


Maternal investment of female mallards is influenced by male carotenoid-based coloration.
The differential allocation hypothesis predicts that females modify their investment in a breeding attempt according to its reproductive value. One prediction of this hypothesis is that females will increase reproductive investment when mated to high-quality males. In birds, it was shown that females can modulate pre-hatch reproductive investment by manipulating egg and clutch sizes and/or the concentrations of egg internal compounds according to paternal attractiveness. However, the differential allocation of immune factors has seldom been considered, particularly with an experimental approach. The carotenoid-based ornaments can function as reliable signals of quality, indicating better immunity or ability to resist parasites. Thus, numerous studies show that females use the expression of carotenoid-based colour when choosing mates; but the influence of this paternal coloration on maternal investment decisions has seldom been considered and has only been experimentally studied with artificial manipulation of male coloration. Here, we used dietary carotenoid provisioning to manipulate male mallard (Anas platyrhynchos) bill coloration, a sexually selected trait, and followed female investment. We show that an increase of male bill coloration positively influenced egg mass and albumen lysozyme concentration. By contrast, yolk carotenoid concentration was not affected by paternal ornamentation. Maternal decisions highlighted in this study may influence chick survival and compel males to maintain carotenoid-based coloration from the mate-choice period until egg-laying has been finished.


Bacterial Staining and Profiling for Glycan Interactions on Glycan Microarrays for t-Test Calculation.
The use of glycan microarrays to study carbohydrate interactions of bacterial cells is of great interest owing to the key roles these interactions play in bacterial colonization and infection of a host. In this chapter, the methods to fluorescently stain Gram-positive or Gram-negative bacteria and profiling them for glycan interactions using glycan microarrays are described in detail. The application of the Student's t-test to glycan microarray data using an example data set comparing glycan microarray binding of an Acinetobacter baumannii wild type and mutant strain is also described in step-by-step detail.


Enhancement of habitat heterogeneity and species richness on rocky shores inundated by sand.
Many rocky shores are subject to periodic inundation by sand, which is often thought to reduce species richness by eliminating organisms intolerant of sand scour or sand smothering. However, regular disturbance (e.g. inundation) should promote richness by preventing the development of low diversity climax communities. A study of faunal richness on 10 regularly inundated shores showed that inundation does promote richness, but by increasing habitat heterogeneity. Some species are excluded from parts of the shore by sand, but because of the patchiness of sand deposits they are rarely excluded from the entire shore. Other species are found only on rocks associated with sand, while typically sandy shore animals occur in the sand deposits themselves. Total richness (281 species) was greater than for local noninundated shores and sandy beaches combined.


Antiproliferative and cytostatic effects of the natural product eupatorin on MDA-MB-468 human breast cancer cells due to CYP1-mediated metabolism.
The natural product eupatorin has been reported to have antiproliferative activity in tumour cell lines, but the exact mechanism is unclear. The cytochromes P450 CYP1B1, CYP1A1, and CYP1A2 have been shown to participate in the activation of various xenobiotics, compounds derived from the diet as well as chemotherapeutic drugs. CYP1B1 and CYP1A1 have also been proposed as targets for cancer chemotherapy for their differential and selective overexpression in tumour cells. In this study, we aimed to identify a possible mechanism of action for the antiproliferative effect of eupatorin, which can be attributed to CYP1 family-mediated metabolism. The study focuses on the antiproliferative action of eupatorin on the human breast carcinoma cell line MDA-MB-468 and on a cell line derived from normal mammary tissue, MCF-10A. The cytotoxicity of the flavone, its effect on the cell cycle of the abovementioned cell lines, and its metabolism by CYP1 family enzymes were examined. Eupatorin showed a dose-dependent inhibitory effect of cell growth on MDA-MB-468 cells with a submicromolar median inhibition concentration (IC50) whereas the IC50 of this compound in MCF-10A cells was considerably higher. The antiproliferative effect, as measured by EROD (ethoxyresorufin-O-deethylase) assay and Western immunoblotting, was attributed mainly to CYP1A1 expression in MDA-MB-468 cells but not in MCF-10A cells. Moreover, CYP1 family enzymes were shown to metabolise eupatorin in vitro to the flavone cirsiliol and two other unidentified metabolites. Metabolism of eupatorin was also detected in MDA-MB-468 cell cultures, whereas metabolism by MCF-10A cells was negligible. Eupatorin was further shown to arrest the cell cycle of the CYP1-expressing cell line MDA-MB-468 in G2/M phase, whereas no effect was observed in MCF-10A cells, which do not express CYP1 enzymes. The effect of eupatorin on the MDA-MB-468 cell cycle could be reversed by co-application of the CYP1 inhibitor acacetin. The flavone eupatorin is selectively activated in breast cancer cells, but not in normal breast cells, due to CYP1 family metabolism. This provides a basis for selectivity which is desired against breast tumour cells. In this sense, eupatorin is shown by this study to be a very promising chemopreventative candidate that should be examined further in an in vivo study.


Induction of LFA-1-mediated homotypic adhesions in promonocytic U-937 cells occurs independently of cell differentiation.
The differentiation of monocytes into macrophages occurs along with a marked increase in LFA-1-dependent intercellular adhesions. Similarly, the phorbol ester-induced differentiation of U-937 promonocytic cells into macrophage-like cells is morphologically characterized by an important increase in LFA-1/ICAM-1-dependent intercellular homotypic adhesions. Since an important functional role in activation of human T cells has been demonstrated for LFA-1-dependent adherence, we have analyzed whether the induction of LFA-1-dependent intercellular adhesion of human monocytic cells is necessarily accompanied by differentiation of these cells. We found that treatment of the promonocytic U-937 cells with the anti-LFA-1 mAb NKI-L16 induces formation of intercellular clusters, but does not induce cell differentiation as determined by several differentiation markers. These markers include the arrest of cell proliferation, production of reactive oxygen species, changes in the cell surface expression of differentiation-associated antigens such as the transferrin receptor, CD11b and CD11c and changes in the levels of several specific gene transcripts such as CD18 antigen, c-myc, ornithine decarboxylase and vimentin. These findings suggest that LFA-1-dependent adhesion and differentiation of monocytic cells are independent processes.


Biological phosphorus removal and its microbial community in a modified full-scale activated sludge system under dry and wet weather dynamics.
Enhanced biological phosphorus removal (EBPR) performance and microbial community dynamics during dry and wet-weather conditions of a full-scale treatment plant was evaluated by converting a section of activated sludge basins using low-cost operational modifications into an anoxic/anaerobic zone to promote EBPR. Two trains of the activated sludge system at the Des Moines, Iowa Metropolitan Wastewater Reclamation Facility were used for the study with one train modified for EBPR, and the other remained as nitrification-only for comparison. In addition to measuring the modification effectiveness for phosphorus removal, performance was compared during dry and wet weather conditions over the course of two summer seasons to improve understanding of wet and dry weather dynamics for EBPR. DNA sequencing and qPCR tests were conducted to develop an understanding of microbial population changes between control and modified basins and wet and dry weather conditions. Basin hydraulic retention times varied from 2.6 to 12.7 hours with an average of 8.9 hours. EBPR activity was successfully established in the modified basins with average phosphorus content of the return activated sludge 0.032 ± 0.002 compared to 0.016 ± 0.001 mg TP/mg TSS (95% confidence) in the control basins. Phosphorus removal was significantly decreased by prolonged wet weather conditions, particularly in year two of the study, however the modified basin maximum removal of 96% and average of 43.7 ± 5.3% remained significantly higher than the maximum of 46% and average 12.6 ± 2.4% removal in the control basins. DNA sequencing showed a significant increase in relative abundance of phyla Chloroflexi, Nitrospirae, and Verrucomicrobia in the modified basins, but no correlation to EBPR performance. qPCR indicated significant increase in relative quantity of Accumulibacter, but not for Actinetobacter-like phosphorus accumulating organisms (PAOs), which includes the PAO Tetrasphaera. Significant abundance of some Accumulibacter clades found within the modified basins was contrary to previous literature which focused on small-scale and batch studies. A higher than expected dominance of clade I and increased relative quantities of clades IIB and IIC during extended wet weather was observed which may have contributed to rapid recovery of phosphorus removal when dry weather resumed. The abundance of PAOs did not significantly correlate with changes in phosphorous removal performance, contrary to reports from previous small-scale and batch studies.


Synthesis and effect of CoCuFeNi high entropy alloy nanoparticles on seed germination, plant growth, and microorganisms inactivation activity.
Implementation of nanotechnology in agriculture is of interest primarily to improve the growth and productivity of crops, and to minimize the use of traditional expensive chemical fertilizers. This work presents a simple energy-conservative approach for the synthesis of CoCuFeNi high entropy alloy nanoparticles (HEA-NPs) capable of forming a stable suspension with a concentration of 0.3 g/L. The size, composition, and morphology of the nanoparticles were analyzed by XRD, SEM, TEM, and EDS. Obtained HEA-NPs were characterized by fine crystallinity with an average size of 25 nm. The investigated suspensions of HEA-NPs were tested for seeds germination and plants growth. The use of suspension of CoCuFeNi HEA-NPs for plant irrigating together with ordinary water showed positive results in plant biostimulation, which resulted in the plant height up to 12% for watercress and up to 50% for oil radish. CoCuFeNi HEA-NPs showed nice inactivation activity for Pseudomonas aeruginosa that was comparable for the use of Tetracycline.


Case report of a gallbladder agenesis, a diagnostic challenge.
Agenesis of the gallbladder is an underdiagnosed entity. It can be an asymptomatic pathology, usually diagnosed incidentally as a finding on imaging techniques or in necropsies. There are symptomatic cases presenting as biliary colic too, attributed to cholecystitis or cholangitis, leading to exploratory surgeries. We present a 14-year-old boy admitted to the outpatient Pediatric Gastroenterology Department with a history of daily abdominal pain for the past 2 months. Blood and fecal tests were normal. Coeliac disease, inflammatory intestinal diseases and Helicobacter pylori infection were ruled out. An abdominal US was informed of a hypodistensed gallbladder with no other findings. A CT scan was performed, which reported of an absent gallbladder. Upon these findings, a Magnetic Resonance Cholangiopancreatography (MRCP) was carried out, confirming the diagnosis of agenesis of the gallbladder. Its diagnosis still poses a challenge, as an absent gallbladder may not always be apparent by US, with the MRCP being the gold-standard test for examining the biliary tract. The prognosis is usually good, and the treatment of choice consists of antispasmodics when needed. There are few cases reported in literature, for this reason, our article discusses the most important aspects of agenesis of the gallbladder in order to suspect it, request the appropriate tests and saving unnecessary surgical interventions. Gallbladder agenesis is a rare entity that can lead to unnecessary diagnostic tests and interventions. The MRCP is the gold-standard test. Despite its benign nature, symptomatic treatment might be required in order to improve the patient's quality of life.


Status of hemodialysis adequacy in the United States: does it account for improved patient survival?
Certain analyses have suggested that the United States has lower patient survival than other comparable industrialized nations, but it remains to be determined whether this is due to the "adequacy" of dialysis in the United States. Substantial evidence exists that the doses of hemodialysis delivered in the United States have increased over the last 6 years. Databases from Fresenius Medical Care and the National Core Indicators Project from the Health Care Financing Administration (HCFA) have shown that as dialysis dose has increased, mortality has decreased. However, commensurate with this has been the introduction of other technologies and practices, such as anemia control and others. Discerning the relative role of these independent factors on outcome remains complicated. While awaiting the results of the National Institutes of Health HEMO study, this article discusses the merits and contributions of the increasing doses of dialysis on outcome.


Serratia marcescens strains implicated in adverse transfusion reactions form biofilms in platelet concentrates and demonstrate reduced detection by automated culture.
Serratia marcescens is a gram-negative bacterium that has been implicated in adverse transfusion reactions associated with contaminated platelet concentrates. The aim of this study was to investigate whether the ability of S. marcescens to form surface-attached aggregates (biofilms) could account for contaminated platelet units being missed during screening by the BacT/ALERT automated culture system. Seven S. marcescens strains, including biofilm-positive and biofilm-negative control strains and five isolates recovered from contaminated platelet concentrates, were grown in enriched Luria-Bertani medium and in platelets. Biofilm formation was examined by staining assay, dislodging experiments and scanning electron microscopy. Clinical strains were also analysed for their ability to evade detection by the BacT/ALERT system. All strains exhibited similar growth in medium and platelets. While only the biofilm-positive control strain formed biofilms in medium, this strain and three clinical isolates associated with transfusion reactions formed biofilms in platelet concentrates. The other two clinical strains, which had been captured during platelet screening by BacT/ALERT, failed to form biofilms in platelets. Biofilm-forming clinical isolates were approximately three times (P<0·05) more likely to be missed by BacT/ALERT screening than biofilm-negative strains. S. marcescens strains associated with transfusion reactions form biofilms under platelet storage conditions, and initial biofilm formation correlates with missed detection of contaminated platelet concentrates by the BacT/ALERT system.


An increased prevalence of self-reported allergic rhinitis in major Chinese cities from 2005 to 2011.
The prevalence of allergic rhinitis (AR) has increased worldwide in recent decades. This study was conducted to investigate the prevalence of self-reported AR and profiles of AR-related comorbidities in the adult population of China over time. This study surveyed residents of 18 major cities in mainland China. Telephone interviews were conducted with study participants after sampling target telephone numbers by random digit dialing. The questions asked during telephone interviews were based on those included in validated questionnaires and focused on topics regarding AR, nonallergic rhinitis (NAR), acute/chronic rhinosinusitis (ARS/CRS), asthma, and atopic dermatitis (AD). During 2011, a total of 47 216 telephone interviews were conducted, and the overall response rate was 77.5%. When compared with the AR prevalence in 11 cities surveyed in 2005, there was a significant increase in self-reported adult AR in eight of those cities (P < 0.01). In 2011, the standardized prevalence of self-reported adult AR in the 18 cities was 17.6%. The concentration of SO2 was positively correlated with the prevalence of AR (r = 0.504, P = 0.033). A multiple regression model showed that the absolute change in household yearly income was significantly associated with the change in the prevalence of AR (R(2) = 0.68), after adjusting for PM10 , SO2 , NO2, temperature, and humidity. The overall prevalences of NAR, ARS, CRS, asthma, and AD in the general population were 16.4%, 5.4%, 2.1%, 5.8%, and 14%, respectively. During a 6-year period, there was a significant increase in the prevalence of self-reported AR in the general Chinese adult population. The incidence of AR being accompanied by rhinosinusitis, asthma, or AD was significantly higher among individuals having self-reported AR compared with the general population.


miR-217 represses TGF-β1-induced airway smooth muscle cell proliferation and migration through targeting ZEB1.
Aberrant proliferation and migration of airway smooth muscle cells (ASMCs) contribute to the pathogenesis of airway remodeling during asthma development. Here, the potential function of microRNA-217 (miR-217) on the cell proliferation and migration of TGF-β1-induced ASMCs and the involved mechanisms were investigated in this study. We found that miR-217 expression was apparently downregulated in a time and dose dependent characteristic in ASMCs exposed to transforming growth factor-β (TGF-β1) stimulation. Overexpression of miR-217 significantly inhibited TGF-β1-induced proliferation, migration, extracellular matrix (ECM) deposition, but promoted apoptosis in ASMCs, whereas, miR-217 inhibitor showed an opposed effect. Bioinformatics analyses revealed that the 3'-untranslated region (UTR) of ZEB1 was a potential target for miR-217, which was further confirmed by luciferase activity, qRT-PCR and western blot assay. In addition, rescue experiment also displayed that restoration of ZEB1 expression partially abrogated the inhibitory effect of miR-217 on TGF-β1-induced proliferation and migration in ASMCs. By chromatin immunoprecipitation (ChIP) assay, we further confirmed that the binding of ZEB1 to the fibronectin promoter in TGF-β1-treated ASMCs was reduced by miR-217 overexpression. Therefore, our findings suggested the potential protective role of miR-217 on the attenuation of cell proliferation and migration was through targeting ZEB1 in TGF-β1-stimulated ASMCs.


VAB-6 combination chemotherapy in resected stage II-B testis cancer.
Twenty-four patients with resected Stage II-B nonseminomatous germ cell tumors of the testis received adjuvant chemotherapy with the modified VAB-6 regimen for one year. Eighteen patients had nodal category N2B and six nodal category N3 (extranodal extension of tumor). Adjuvant VAB-6 started with two four day inductions at approximately four week intervals. Induction was cyclophosphamide 600 mg/m2 IV, vinblastine 4 mg/m2 IV, dactinomycin 1 mg/m2 IV, bleomycin 30 mg IV on day 1, then bleomycin 20 mg/m2/day by continuous 24 hour infusion for three days, and cis-platinum 120 mg/m2 IV on day 4. Maintenance was vinblastine 6 mg/m2 IV and dactinomycin 1 mg/m2 IV every three weeks. Six patients received a third induction but without bleomycin. All 24 patients remain free of disease with a median follow up of 24 months. Myelosuppression was the major toxicity. Four patients received antibiotics for fever during myelosuppression. In one patient, serum creatinine temporarily rose over 2 mg/dl after cis-platinum. VAB-6 is effective in the prevention of recurrences in resected Stage II-B nonseminomatous germ cell tumors. However, the optimal regimen remains to be defined.


Balancing the Risk-Benefit Ratio of Immune Checkpoint Inhibitor and Anti-VEGF Combination Therapy in Renal Cell Carcinoma: A Systematic Review and Meta-Analysis.
Although immune checkpoint inhibitors (ICIs) combined with vascular endothelial growth factor receptor (VEGFR)-targeted therapy and sunitinib monotherapy have been widely applied to metastatic renal cell carcinoma (mRCC), effectiveness and safety data are still lacking. To optimize clinical decision-making, we conducted a systematic review and meta-analysis of published randomized clinical trials to characterize the efficacy and the risk of adverse events (AEs) in patients treated with ICIs plus anti-VEGF therapy. We used PubMed, EMBASE, and the Cochrane Library to retrieve randomized controlled trials (RCTs) published before March 27, 2021. The efficacy outcomes were progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). The pooled risk ratio (RR) and 95% confidence intervals (CI) of AEs were calculated in the safety analysis. Six RCTs involving 4,227 patients were identified after a systematic search. For OS, ICI and anti-VEGF combination therapy decreased mortality approximately 30% in the intention-to-treat population (ITT) (hazard ratio (HR) = 0.70, 95% CI: 0.57-0.87), but there was no statistical difference in patients evaluated as "favorable" by the International Metastatic Renal-Cell Carcinoma Database Consortium (IMDC) criteria compared with monotherapy (HR = 0.90, 95% CI: 0.55-1.46, p = 0.66). In terms of PFS, the progression risk for all participants declined 35% (HR = 0.65, 95% CI: 0.50-0.83) and patients evaluated as "poor" by IMDC benefited further (HR = 0.46, 95% CI: 0.36-0.58). No evident divergence was found in age and sex subgroups. The RRs of all-grade hypertension, arthralgia, rash, proteinuria, high-grade (grades 3-5) arthralgia, and proteinuria developed after combination therapy were increased compared with sunitinib. The risk of high-grade hypertension and rash showed no statistical difference. However, the risk of hand-foot skin reaction (HFSR), stomatitis, and dysgeusia decreased in combination therapy groups. Compared with sunitinib, OS, PFS, and ORR were significantly improved in patients receiving ICI and anti-VEGF combination therapy at the expense of increased specific AEs. More attention should be paid to individualized application of these combination therapies to achieve the best benefit-risk ratio in the clinic. [https://inplasy.com/] INPLASY: 202130104.


Correction: The C-reactive protein/albumin ratio as an independent predictor of mortality in patients with severe sepsis or septic shock treated with early goal-directed therapy.
[This corrects the article DOI: 10.1371/journal.pone.0132109.].


Evaluating the prerequisites for adapting a paediatric nighttime telemedicine and medication delivery service to a setting with high malarial burden: A cross-sectional pre-implementation study.
We sought to evaluate the prerequisites (demand, interest, feasibility) for adapting a paediatric nighttime telemedicine and medication delivery service (TMDS) to Ghana. A cross-sectional survey of households and associated healthcare providers was conducted in urban and rural Ghana. Households were identified through randomised geospatial sampling; households with at least one child <10 years were enrolled. Household surveys collected information relating to demographics, household resources, standardised case scenarios, recent paediatric health events, satisfaction with healthcare access, and interest in TMDS intervention models. Providers were identified by households and enrolled. Provider surveys collected provider type, hours of operation, services, and opinions of a TMDS model. A total of 511 (263 urban, 248 rural) households and 18 providers (10 urban, 8 rural) were surveyed. A total of 262 health events involving children <10 years were reported, of which 47% occurred at night. Care was sought for >70% of health events presenting at night; however, care-seeking was delayed until morning or later for >75% of these events; 54% of households expressed dissatisfaction with their current access to paediatric care at night; 99% of households expressed that a nighttime TMDS service for children would be directly useful to their families. Correspondingly, 17 of 18 providers stated that a TMDS was needed in their community; >99% of households had access to a cellular phone. All households expressed willingness to use their phones to call a TMDS and allow a TMDS provider into their homes at night. Willingness to pay and provider-recommended price points varied by setting. Prerequisites for adapting a TMDS to Ghana were met. A nighttime paediatric TMDS service was found to be needed, appealing, and feasible in Ghana. These data motivate the adaptation of a TMDS to urban and rural Ghana.


Identifying cellular senescence associated genes involved in the progression of end-stage renal disease as new biomarkers.
Cellular senescence plays an essential role in the development and progression of end-stage renal disease (ESRD). However, the detailed mechanisms phenomenon remains unclear. The mRNA expression profiling dataset GSE37171 was taken from the Gene Expression Omnibus (GEO) database. The cell senescence-associated hub genes were selected by applying protein-protein interaction (PPI), followed by correlation analysis, gene interaction analysis, Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. We next explored the relationships of hub genes with miRNAs, TFs, and diseases. The absolute abundance of eight immune cells and two stromal cells were calculated by MCPcount and the correlation of hub genes with these ten cells was analyzed. Lasso was used to selecting for trait genes. ROC curves and DCA decision curves were used to assess the accuracy and predictive power of the trait genes. A total of 65 cellular senescence signature genes were identified among patients and controls. The PPI network screened out ten hub genes. GO and KEGG indicated that ten hub genes were associated with ESRD progression. Transcription factor gene interactions and common regulatory networks of miRNAs were also identified in the datasets. The hub genes were significantly correlated with immune cells and stromal cells. Then the lasso model was constructed to screen out the five most relevant signature genes (FOS, FOXO3, SIRT1, TP53, SMARCA4). The area under the ROC curve (AUC) showed that these five characteristic genes have good resolving power for the diagnostic model. Our findings suggested that cellular senescence-associated genes played an important role in the development of ESRD and immune regulation.


Targeting metabolic driving and minimization of by-products synthesis for high-yield production of D-pantothenate in Escherichia coli.
d-Pantothenate (DPA) is an important functional chemical that has been widely applied in healthcare, cosmetics, animal food, and feed industries. In this study, a high-yield DPA-producing strain was constructed by metabolic engineering strategies with targeting metabolic driving and by-products minimization. The metabolic driving force of push and pull was firstly obtained to improve the production of DPA via enrichment of precursor pool and synthetic pathway, accumulating 4.29 g L-1 DPA in shake flask fermentation. To eliminate the metabolic pressure on DPA production, an amino throttling system was proposed and successfully attenuated the synthesis of four competitive amino acids by a single-step regulation of gdhA. Further minimization of acetate was carried out by pta deletion, and utilization of β-alanine was improved via enhancing its uptake system with producing 5.78 g L-1 DPA. Finally, the engineered strain produced 66.39 g L-1 DPA with β-alanine addition in fermentor under fed-batch fermentation. This study paved a foundation for the industrial production of DPA.


A comparison of computed tomography and myelography in the diagnosis of lumbar disc herniation.
Ninety patients suspected to have a herniated lumbar disc were examined by myelography and computed tomography (CT). Of these, 37 were subjected to surgery. The surgical findings were in agreement in 21 patients (57%) with the myelograms and in 28 patients (76%) with the CT examinations. False-positive CT examinations were found in only one patient. CT is as reliable as myelography in the primary diagnosis of disc herniation.


Two-year prospective study of outcomes following total temporomandibular joint replacement.
The purpose of this 2-year prospective study was to investigate outcomes achieved with a stock temporomandibular joint (TMJ) replacement system in the management of end-stage TMJ disorders. Fifty-two patients requiring reconstruction (36 unilateral/16 bilateral) were operated on during the period 2006-2012; 68 total prostheses were implanted (Biomet Microfixation TMJ Replacement System). The mean age at surgery was 52.6±11.5 years. Changes in the values of inclusion diagnostic criteria at entry were assessed. These included persistent and significant TMJ pain, functional impairment after failure of other surgical therapies, and imaging evidence consistent with advanced TMJ disease of more than 1-year duration. Subjects were excluded if they presented insufficient quantity/quality of bone to support the TMJ replacement, severe hyperfunctional habits, active infectious disease, or an inability to follow postoperative instructions. Over the 2 years of postoperative follow-up, mean pain intensity was reduced from 6.4±1.4 to 1.6±1.2 (P<0.001), and jaw opening was improved from 2.7±0.9cm to 4.2±0.7cm (P<0.001). During the study period, three of 68 implants (4%) were explanted and new TMJ replacements fitted. The results of this study support the view that the surgical placement of stock TMJ prostheses provides significant long-term improvements in pain and function, with few complications.


SEOM clinical guidelines for the systemic treatment of early breast cancer 2013.
The purpose of this article is to update our previous work on the treatment and follow-up in early breast cancer. In this new version we have classified a treatment by immunohistochemistry subtypes of breast cancer. Latest advances in the management of this disease have been compiled, either in the adjuvant and neoadjuvant setting or chemotherapy and hormonal treatment. This review is presented in an easy way for oncologist, fellows and for other specialties.


Comparative Study of Functional Changes in Heart Mitochondria in Two Modes of Epinephrine Exposure Modeling Myocardial Injury in Rats.
The parameters of coupled respiration and transport of calcium ions in mitochondria isolated from the heart of rats were studied in two modes of exposure to epinephrine for modelling myocardial damage. In 24 h after injection of 1.5 mg/kg epinephrine to rats, we observed a decrease in the efficiency of oxidative phosphorylation in heart mitochondria in the presence of both NADH- and FADH-dependent respiratory substrates. Increasing the epinephrine dose and exposure (2 mg/kg, 72 h) led to a more pronounced decrease in the ADP/O coefficient when succinate was used as a substrate, which indicated a predominant decrease in the activity of complex II of the respiratory chain. The injection of epinephrine in the two modes resulted in a decrease in the rate of calcium entry in rat heart mitochondria, but had no effect on mitochondrial calcium retention capacity, which reflects the resistance of the organelles to the induction of the Са2+-dependent pore. These findings suggest that both cardiomyopathy models in rats can be used to study the effectiveness of pharmacological therapy using mitochondria-targeted agents.


Synthesis and characterization of Co(II), Ni(II), Cu(II) and Zn(II) complexes of tridentate Schiff base derived from vanillin and DL-alpha-aminobutyric acid.
Co(II), Ni(II), Cu(II) and Zn(II) complexes of the Schiff base derived from vanillin and dl-alpha-aminobutyric acid were synthesized and characterized by elemental analysis, IR, electronic spectra, conductance measurements, magnetic measurements, powder XRD and biological activity. The analytical data show the composition of the metal complex to be [ML(H2O)], where L is the Schiff base ligand. The conductance data indicate that all the complexes are non-electrolytes. IR results demonstrate the tridentate binding of the Schiff base ligand involving azomethine nitrogen, phenolic oxygen and carboxylato oxygen atoms. The IR data also indicate the coordination of a water molecule with the metal ion in the complex. The electronic spectral measurements show that Co(II) and Ni(II) complexes have tetrahedral geometry, while Cu(II) complex has square planar geometry. The powder XRD studies indicate that Co(II) and Cu(II) complexes are amorphous, whereas Ni(II) and Zn(II) complexes are crystalline in nature. Magnetic measurements show that Co(II), Ni(II) and Cu(II) complexes have paramagnetic behaviour. Antibacterial results indicated that the metal complexes are more active than the ligand.


Innovative thermoplastic chitosan obtained by thermo-mechanical mixing with polyol plasticizers.
Chitosan shows a degradation temperature lower than its melting point, which prevents its development in several applications. One way to overcome this issue is the plasticization of the carbohydrate. In this work plasticized chitosan was prepared by a thermo-mechanical kneading approach. The effects of different non-volatile polyol plasticizers (glycerol, xylitol and sorbitol) were investigated. The microstructure and morphology were determined using FTIR, XRD, TEM and SEM in order to understand the plasticization mechanism. Sorbitol, which is the highest molecular weight polyol used, resulted in plasticized chitosan with the highest thermal, mechanical and rheological properties. On the other hand, the sample plasticized with glycerol, the lowest molecular weight polyol, had the most important amorphous phase content and the lowest thermal, mechanical and rheological properties. Also, when the polyol content increased in the formulation, the plasticized chitosan was more amorphous and consequently its processability easier, while its properties decreased.


Validation of chemometric models for the determination of deoxynivalenol on maize by mid-infrared spectroscopy.
Validation methods for chemometric models are presented, which are a necessity for the evaluation of model performance and prediction ability. Reference methods with known performance can be employed for comparison studies. Other validation methods include test set and cross validation, where some samples are set aside for testing purposes. The choice of the testing method mainly depends on the size of the original dataset. Test set validation is suitable for large datasets (>50), whereas cross validation is the best method for medium to small datasets (<50). In this study the K-nearest neighbour algorithm (KNN) was used as a reference method for the classification of contaminated and blank corn samples. A Partial least squares (PLS) regression model was evaluated using full cross validation. Mid-Infrared spectra were collected using the attenuated total reflection (ATR) technique and the fingerprint range (800-1800 cm(-1)) of 21 maize samples that were contaminated with 300 - 2600 µg/kg deoxynivalenol (DON) was investigated. Separation efficiency after principal component analysis/cluster analysis (PCA/CA) classification was 100%. Cross validation of the PLS model revealed a correlation coefficient of r=0.9926 with a root mean square error of calibration (RMSEC) of 95.01. Validation results gave an r=0.8111 and a root mean square error of cross validation (RMSECV) of 494.5 was calculated. No outliers were reported.


Ethnobotanical survey of food and medicinal plants of the Ilkisonko Maasai community in Kenya.
Pastoralist communities such as the Maasai are heavily reliant on traditional foods and medicines. This survey sought to identify traditional foods and/or medicinal plants of the Ilkisonko Maasai community living in Kenya. Ethnobotanical knowledge of traditional plants used as food and human/veterinary medicine was obtained using structured and semi-structured questionnaires administered through face to face interviews of key informants. A total of 30 species from 21 families and 25 genera were reportedly used as food and/or medicine by 48 respondents. The most commonly encountered genus was the Fabaceae. The growth forms encountered were tree (47%), shrub (33%) and herb (20%). Plants that were commonly mentioned by respondents were Salvadora persica (85%), Grewia villosa (52%), Ximenia americana (52%), Albizia anthelmintica (50%), Acacia robusta (46%) and Acacia nilotica (42%). The root/root bark was the most commonly used plant part (35%), followed by the stem/stem bark (30%), fruit (15%), leaves (11%) and whole plant (9%). Common ailments treated were stomach aches, constipation, back aches, joint aches, body pains and sexually transmitted infections. The plants were also used as tonics, digestives, and restoratives. It was evident that traditional medicine was the preferred health care system for the Ilkisonko Maasai community. It is important to document and use this knowledge in producing novel products that could improve nutrition and healthcare in rural communities.


Oral Fungal Infections: Diagnosis and Management.
Oral and maxillofacial fungal infections can appear in high-risk patients, including those immunocompromised. This article explores common oral manifestations of fungal infections in the oral cavity as primary lesions or as a result of disseminated disease. By far the most common oral fungal infection experienced in dentistry is oral candidiasis, which is reviewed in depth from simple oral infections to invasive candidiasis. The review aids the dental practitioner in understanding the full scope of Candida infections and other fungal infections. In addition to candidiasis, various other fungal infections are reviewed, including mucormycosis, aspergillosis, blastomycosis, histoplasmosis, cryptococcosis, and coccidioidomycosis.


Total Synthesis of Tetraketide and Cryptorigidifoliol I via a Sequential Allylation Strategy.
A unified and efficient synthetic route for both tetraketide (1) and cryptorigidifoliol I (2) has been devised successfully from commercially available starting materials in 11 and 17 steps, with 16% and 11% overall yields, respectively. Highlights of the syntheses involved sequential Lewis acid-catalyzed highly regio- and diastereoselective allylations and intramolecular Mitsunobu lactonization.


Triiodothyronine (T3) modifies cholinergic-induced hypothermia and tremor in rats.
Hypothermia and tremor responses of oxotremorine and eserine were studied in rats after several T3 treatment regimens. The T3 antagonized oxotremorine-induced hypothermia and failed to antagonize eserine hypothermic effect, but potentiated oxotremorine- and eserine-induced tremors. Acetylcholinesterase activity was not altered in T3 rats. The hypothetical mechanisms to explain changes of central cholinergic responses caused by T3 are discussed.


Adolescent girls' cardiovascular responses to peer rejection: exploring the impact of early life stress.
Detrimental effects of early life stress on cardiovascular health are evident in adolescence. Cardiovascular reactivity and recovery in response to interpersonal stress may be a mechanism. This study aimed to evaluate if adolescent girls with higher early life stress demonstrated greater cardiovascular reactivity and slower recovery to peer rejection. A sample of 92 adolescent girls (age: M = 13.24) self-reported early life stressors. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were continuously measured before, during, and after a laboratory peer rejection paradigm. Counter to hypotheses, adolescent girls with higher early life stress had lower, not higher, HR during the recovery period. Early life stress was not associated with SBP or DBP recovery. Additionally, early life stress was not associated with SBP, DBP, or HR reactivity. Future research is needed to assess if blunted cardiovascular reactivity to interpersonal rejection during adolescence is a mechanism linking early life stress and later cardiovascular disease risk in women.


The enzymic conversion of protoporphyrinogen IX to protoporphyrin IX. Protoporphyrinogen oxidase activity in mitochondrial extracts of Saccharomyces cerevisiae.
The oxidation of protoporphyrinogen IX to protoporphyrin IX in yeast cells is enzyme-dependent. The enzyme, protoporphyrinogen oxidase, associated with purified mitochondria isolated from Saccharomyces cerevisiae was solubilized by sonic treatment in the presence of detergent and partially purified. The molecular weight of the enzyme was 180,000 plus or minus 18,000. The purified preparation could be stored at -20 degrees in the presence of 20% glycerol for several months without loss of activity. Enzyme activity was destroyed by heating above 40 degrees and by proteolytic digestion and irreversible inactivation occurred outside the pH range of 4.0 to 9.5. The pH optimum of the enzymic reaction was 7.45 and the value of the Michaelis constant was approximately 4.8 muM. Protoporphyrinogen oxidase did not catalyse the oxidation of coproporphyrinogen I or III or uroporphyrinogen I or III and the rate of enzymic oxidation of mesoporphyrinogen IX was less than 20% of that observed with protoporphyrinogen IX. The presence of thiol groups in the enzyme system was indicated but no metal ion or other cofactor requirement was demonstrated. Enzyme activity was insensitive to cyanide, 2,4-dinitrophenol, and azide whereas it was inhibited in the presence of Cu-2+ or Co-2+ ions, high ionic strength, heme, or hemin.


Cocaine and alcohol use preceding suicide in African American and white adolescents.
The goal of this investigation was to determine whether cocaine and ethanol use was a differentiating factor between African American and white teenage suicide victims. This is a retrospective analysis of medical examiner's records of all completed suicides in Fulton County, GA from 01/1989 to 12/2003, and included 1296 cases. There were 79 suicide victims aged 19 and younger during the study interval, and of this group, 49 (62%) were African American, 26 (33%) were white, and 4 (5%) other race, compared to adults (20 years) where 28.5% were African American, 68.6% white and 2.9% other race (chi(2)=42.678, d.f.=2, p<0.0001). Of the black teenaged victims, 82.2% had no cocaine or alcohol detected at autopsy, while 41.7% of the white victims were positive for one or both substance (chi(2)=4.633, d.f.=1, p=0.04). Only 8.9% of the black teenage suicide victims had used cocaine prior to death compared to 28% of the whites (chi(2)=4.432; d.f.=1; p<0.04). The suicide rate (suicide/100,000/year) for black teens was 5.48 compared to 4.16 for whites, but the rate of cocaine positive teen suicides was 1.12 for whites and 0.45 for blacks. The pattern of cocaine use changes dramatically in the adult group, with 27% of African American suicide victims compared to 7.7% of whites being positive (chi(2)=73.272; d.f.=1; p<0.001). Use of intoxicating substances does differentiate teenage suicide victims, as only a small proportion of black teenagers had used cocaine or alcohol prior to death compared to almost half of all whites.


Malignant fibrous histiocytoma arising from a hydronephrotic kidney: a case report and review of the literature.
Primary malignant fibrous histiocytoma (MFH) is extremely rare, and MFH arising from a hydronephrotic kidney has not been reported. When MFH originates from a long-standing hydronephrotic kidney, the imaging findings can include nearly invisible renal parenchyma and atrophy of the ureter and renal artery, in addition to the findings attributable to the MFH, and the MFH with hydronephrosis may be confused with a cystic renal cell carcinoma.


Multicenter Development and Validation of a Model for Predicting Retention in Care Among People with HIV.
Predictive analytics can be used to identify people with HIV currently retained in care who are at risk for future disengagement from care, allowing for prioritization of retention interventions. We utilized machine learning methods to develop predictive models of retention in care, defined as no more than a 12 month gap between HIV care appointments in the Center for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort. Data were split longitudinally into derivation and validation cohorts. We created logistic regression (LR), random forest (RF), and gradient boosted machine (XGB) models within a discrete-time survival analysis framework and compared their performance to a baseline model that included only demographics, viral suppression, and retention history. 21,267 Patients with 507,687 visits from 2007 to 2018 were included. The LR model outperformed the baseline model (AUC 0.68 [0.67-0.70] vs. 0.60 [0.59-0.62], P < 0.001). RF and XGB models had similar performance to the LR model. Top features in the LR model included retention history, age, and viral suppression.


Case report: successful interdisciplinary treatment of cerebrally disseminated invasive pulmonal aspergillosis in a child with acute myeloid leukemia.
Invasive pulmonary aspergillosis (IPA) is a life-threatening infection in immunocompromised patients. Mortality rates of cerebrally disseminated IPA approach 100%. We report on a case of a 9-year-old girl with acute myeloid leukemia, who acquired cerebrally disseminated IPA during chemotherapy-induced leukopenia. Longtime survival was achieved by left pneumonectomy and neurosurgical resection of the intracerebral lesion combined with systemic application of itraconazole and liposomal amphotericin B. A review of literature revealed 7 other cases of cerebrally disseminated IPA with survival of more than 12 months.


Androgen receptor immunoreactivity in specific neural regions in normal and hypogonadal male mice: effect of androgens.
This study examined the distribution and regulation of androgen receptor immunoreactivity (IR) in the brain of the hypogonadal (hpg) male mouse, genetically deficient in GnRH. Five groups of animals were studied: intact, castrated, or castrated and testosterone propionate (TP)-treated normal adult male mice, and intact or TP-treated hpg adult male mice. All groups were studied 1 week after treatment. Five regions of the brain with high concentrations of androgen receptors in normal animals were examined, including the medial preoptic area, the lateral ventral septum, the ventromedial hypothalamus, the bed nucleus of the stria terminalis and the medial amygdala. The results showed that the congenital absence of GnRH results in minimal expression of androgen receptor-IR in mice in all regions examined. However, treatment with exogenous testosterone for 1 week was sufficient to induce the numbers of neurons containing androgen receptors, as detected by immunocytochemistry, into the range seen in normal male mice in all the areas studied except the VMH. Similar plasticity was also observed in normal males after 1 week of castration and TP replacement.


UPLC-MS/MS assay for the simultaneous determination of ethinyl estradiol, norgestimate and 17-Desacetyl norgestimate at low pg/mL in human plasma.
Previously, because of the difficulty of measuring very low levels (pg/mL) of norgestimate (NGM) due to rapid metabolism to its active and major metabolite, 17-Desacetyl norgestimate (DNGM), only DNGM and the co-administered ethinyl estradiol (EE2) were required to be analyzed in bioequivalence (BE) studies for oral contraceptive NGM/EE2 tablets. Recently, with more sensitive assays available, health authorities have requested that bioequivalence of NGM be also demonstrated in addition to DNGM and EE2. Therefore, it was important to establish a 3-in-1 method for the quantitation of EE2, NGM and DNGM in human plasma. Here a UPLC-MS/MS method for the simultaneous quantitation of EE2, NGM and DNGM in human plasma at low pg/mL range is described. EE2, NGM, DNGM and their isotopic labeled internal standards (IS) EE2-d4, NGM-d6 and DNGM-d6 in 0.4mL of human plasma were extracted with hexane/ethyl acetate. The extracts were evaporated to dryness and derivatized with dansyl chloride, to enhance the mass spec response. The derivatives were reconstituted with methanol and analyzed by UPLC-MS/MS. In order to minimize the ex-vivo conversion of NGM to DNGM, sodium fluoride/potassium oxalate was used as anti-coagulant. To achieve desirable throughput for sample analysis, UPLC-MS/MS with a run time of 4.4min was utilized. The calibration curve ranges were 5-500pg/mL for EE2 and NGM, and 25-2500pg/mL for DNGM, respectively. The chromatographic separation was achieved on a Waters Acquity UPLC HSS T3 (100×2.1mm, 1.8μm) column with a gradient elution. Assay accuracy, precision, linearity, selectivity, sensitivity and analyte stability covering sample storage and analysis were established. This validated UPLC-MS/MS method has been applied to a BE study for the determination of EE2, NGM and DNGM concentrations in human plasma.


Bacterial endocarditis following COVID-19 infection: two case reports.
COVID-19, an emerging disease raised as a pandemic, urgently needed treatment choices. Some options have been confirmed as lifesaving treatments, but long-term complications must be clearly illustrated. Bacterial endocarditis is a less frequent disease among patients infected with SARS_COV_2 compared to other cardiac comorbidities in these patients. This case report discusses bacterial endocarditis as a potential adverse effect after administering tocilizumab, corticosteroids, and COVID-19 infection. In the first case, a 51-year-old Iranian female housewife was admitted to the hospital with fever, weakness, and monoarthritis symptoms. The second case is a 63-year-old Iranian woman who is a housewife admitted with weakness, shortness of breath, and extreme sweating. Both cases tested positive for Polymerase chain reaction (PCR) less than one month ago and were treated with tocilizumab and corticosteroid. Both patients were suspected of infective endocarditis. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in the blood cultures of both patients. The diagnosis of endocarditis is confirmed for both cases. Cases are subjected to open-heart surgery, a mechanical valve is placed, and they are treated with medication. In subsequent visits, their condition was reported to be improving. Adjacent to cardiovascular inclusion as COVID-19 disease complications, secondary infection taken after the organisation of immunocompromising specialists can result in basic maladies and conditions counting infective endocarditis.


Effects of adaptation and cross-adaptation to common ions on sourness intensity.
The effects of self and cross-adaptation of acetic acid and HCl solutions on the perception of sourness, were investigated using a filter paper method. In contrast to acetic acid and to pH-buffered acetic acid solutions, self-adaptation could not be obtained with HCl. In fact the sourness of the HCl test-stimulus after adaptation to HCl was increased compared to the sourness obtained with the unadapted tongue. Such a sourness potentiation was also observed with acetic acid and buffered acetic acid solutions after adaptation to distilled water. The results suggest that the reception process eliciting the sour taste of H+ ions and of undissociated acids are different and probably independent.


Early results of laparoscopic Heller myotomy do not necessarily predict long-term outcome.
We sought to evaluate how patients' symptoms evolve after laparoscopic Heller myotomy. Before and after laparoscopic Heller myotomy, 88 patients graded dysphagia and heartburn on a Likert scale (0 = none; 5 = severe). Patients graded outcomes as excellent, good, fair, or poor. Outcomes were compared in the same patients at 1 and 3 years of follow-up. At early follow-up (10.6 +/- 7.8 months) significant reductions were noted in dysphagia (11% versus 100%), dysphagia scores (0.6 +/- 1.1 versus 4.7 +/- 0.7), heartburn (31% versus 72%), and heartburn scores (1.2 +/- 1.6 versus 2.7 +/- 1.9). By late follow-up (37.6 months +/- 18.0) these values increased (47%, 1.9 +/- 1.7, 48%, 1.8 +/- 1.5, respectively) but remained significantly reduced compared with before operation. Excellent/good outcomes at early and late follow-up were 89% and 85%, respectively (P = not significant). Laparoscopic Heller myotomy is highly effective at palliating the symptoms of achalasia. With time, symptoms may recur owing to esophageal dysmotility, mandating continued surveillance.


Precision Oncology and Genomically Guided Radiation Therapy: A Report From the American Society for Radiation Oncology/American Association of Physicists in Medicine/National Cancer Institute Precision Medicine Conference.
To summarize important talking points from a 2016 symposium focusing on real-world challenges to advancing precision medicine in radiation oncology, and to help radiation oncologists navigate the practical challenges of precision, radiation oncology. The American Society for Radiation Oncology, American Association of Physicists in Medicine, and National Cancer Institute cosponsored a meeting on precision medicine in radiation oncology. In June 2016 numerous scientists, clinicians, and physicists convened at the National Institutes of Health to discuss challenges and future directions toward personalized radiation therapy. Various breakout sessions were held to discuss particular components and approaches to the implementation of personalized radiation oncology. This article summarizes the genomically guided radiation therapy breakout session. A summary of existing genomic data enabling personalized radiation therapy, ongoing clinical trials, current challenges, and future directions was collected. The group attempted to provide both a current overview of data that radiation oncologists could use to personalize therapy, along with data that are anticipated in the coming years. It seems apparent from the provided review that a considerable opportunity exists to truly bring genomically guided radiation therapy into clinical reality. Genomically guided radiation therapy is a necessity that must be embraced in the coming years. Incorporating these data into treatment recommendations will provide radiation oncologists with a substantial opportunity to improve outcomes for numerous cancer patients. More research focused on this topic is needed to bring genomic signatures into routine standard of care.


An evaluation of the selection process of hospital information systems.
This research study evaluates the selection process of a Hospital Information System (HIS), focusing on the level of compromise required by healthcare professionals during said process and the level of satisfaction achieved with the system selected. How other variables, such as job title, length of experience in the healthcare, data processing, and information systems fields affect these measured levels are also evaluated. Results of this study indicate that a HIS is critical to the viability of a hospital's operation and the level of compromises made during the selection process have an impact upon the how satisfied the healthcare provider is with the HIS they select.


Menopause review: Emerging treatments for menopausal symptoms.
Vasomotor symptoms (VMS) affect 2 out of 3 women during menopause and are highly disruptive and intolerable. They exert a negative impact on a woman's physical and mental well-being and are considered a high clinical priority requiring effective treatment. Although hormone therapy remains the gold-standard treatment for hot flushes, it is associated with several side effects and contraindications. Furthermore, alternative treatments for VMS are currently less efficacious and have limited availability; therefore, a new medication to treat VMS would benefit millions of women worldwide. Neurokinin 3 receptor (NK3R) antagonists have recently been developed as novel therapeutic agents for the amelioration of VMS through their action on NK3 receptors within the hypothalamus and consequent regulation of the thermoregulatory centre. So far, three NK3R antagonists have been studied in menopausal women, which have demonstrated significant reductions in VMS frequency and severity and have shown their ability to transform patients' quality of life.


Performance assessment of a novel two-step multiple displacement amplification-PCR assay for detection of Mycobacterium tuberculosis complex in sputum specimens.
A novel two-step multiple displacement amplification-PCR (MDA-PCR) assay for tuberculosis detection in 200 sputum specimens was evaluated. The MDA-PCR assay indicated a significant increase in sensitivity and specificity compared with those of standard PCR alone.


Cervical myelography with metrizamide (Amipaque). A comparison between conventional and computer-assisted myelography with special reference to the upper cervical and foramen magnum region.
Cervical myelography with metrizamide was performed in a series of 30 patients. Minor modifications to the conventional technique made it possible to carry out measurements of the sagittal diameter of the cord and to improve the opacification of the upper cervical--foramen magnum region. Computer tomography was performed with a head scanner within 1 h after the conventional examination, and the spinal cord surrounded by contrast medium was shown from C-3 to the foramen magnum region. Measurements of the sagittal diameter of the spinal canal and the cord at corresponding levels using the two methods showed good correlation.


Chitosan thiamine nanoparticles intervene innate immunomodulation during Chickpea-Fusarium interaction.
The present study evaluated the effect of chitosan thiamine nanoparticles (TCNP) on the activation of defence responses in chickpea against stress caused by wilt pathogen, Fusarium oxysporum f. sp. ciceri (FOC), under greenhouse condition. A significant increase in enzymatic and non-enzymatic antioxidants was observed in the TCNP treated chickpea plants challenged with FOC compared to the untreated control. Histochemical staining showed high deposition of lignin in the vascular bundles of chickpea stem tissues in TCNP treated plants challenged with FOC. More than 90% protection against wilt pathogen was observed in TCNP treated chickpea plants challenged with FOC, under greenhouse condition. Higher accumulation of antioxidants and phenylpropanoids in TCNP treated challenged chickpea plants well correlates with resistance against wilt pathogen. These results suggest that the elicitation of stress response in TCNP treated chickpea during FOC interaction play a vital role in suppressing the wilt disease in chickpea.


Clinical significance of bone marrow hemophagocytosis in adult patients with malignancy and non-malignancy-induced hemophagocytic lymphohistiocytosis.
Bone marrow hemophagocytosis is a frequently observed but not mandatory finding for the diagnosis of hemophagocytic lymphohistiocytosis (HLH). However, the impact of bone marrow hemophagocytosis on the diagnosis of HLH is still not clear in adult patients. Thus, we retrospectively analyzed adult patients with bone marrow hemophagocytosis between 2000 and 2014 to determine its clinical significance. Among 264 patients with bone marrow hemophagocytosis, malignant disorders were the predominant underlying cause (n = 170, 64 %), especially T/NK-cell (n = 88) and B-cell (n = 45) lymphomas compared to infectious disease (48/264, 18 %). The data for HLH-2004 diagnostic criteria was available in 182 patients, and only 29 % (77/264) of patients with ≥ five positive criteria could be diagnosed with HLH. Among the criteria for the diagnosis of HLH, increased serum ferritin (89 %) was more common than hypofibrinogenemia, hypertriglyceridemia, and bicytopenia (<40 %). The median overall survival was worse in patients with malignancy (9.0 months, 95 % confidence interval [CI] 5.6-12.5) than in those with non-malignant disorders (71.8 months, 95 % CI 56.5-87.1, P < 0.001). In patients with malignancy, the overall survival of patients fulfilling the HLH-2004 criteria was significantly worse than patients who did not (P < 0.001). In conclusion, our results suggest that bone marrow hemophagocytosis might be an important finding in the diagnosis of HLH in adult patients. Considering the high incidence of malignancy as a predisposing disorder for HLH, immediate evaluation should be performed in adult patients with bone marrow hemophagocytosis.


Alpha-Aminoadipate aminotransferase and kynurenine aminotransferase. Purification, characterization, and further evidence for identity.
Alpha-Aminoadipate aminotransferase and kynurenine aminotransferase activities were co-purified from the rat kidney supernatant fraction. The resulting preparation was determined to be nearly homogenous by analytical disc gel electrophoresis at pH 8.9 and 7.5 isoelectric focusing on polyacrylamide gels, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis. A molecular weight of approximately 85,000 was determined on Sephadex G-200 chromatography and sucrose density gradient analysis. The enzyme was determined to be comprised of two subunits of approximately the same molecular weight (45,500 +/- 850) by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. An isoelectric pH of 6.56 +/- 0.06 was determined by focusing on polyacrylamide gels. Further evidence is provided to support the idea that the alpha-aminoadipate aminotransferase and kynureine aminotransferase activities are properties of a single protein: (a) co-purification of the two activities from the rat kidney supernatant fraction with the ratio of their specific activities remaining constant, (b) similar chromatographic behavior, (c) a similarity in their dependence on added pyridoxal-P for activity, and (d) a similar pattern of heat inactivation.


Diet composition, nutrient substitutions and circulating fatty acids in relation to ectopic and visceral fat depots.
Short-term randomized trials have demonstrated that replacing saturated fat (SFA) with polyunsaturated fat (PUFA) causes a reduction or prevention of liver fat accumulation, but population-based studies on diet and body fat distribution are limited. We investigated cross-sectional associations between diet, circulating fatty acids and liver fat, visceral adipose tissue (VAT), intermuscular adipose tissue (IMAT) and other fat depots using different energy-adjustment models. Sex-stratified analyses of n = 9119 (for serum fatty acids) to 13 849 (for nutrients) participants in UK Biobank were conducted. Fat depots were assessed by MRI, circulating fatty acids by NMR spectroscopy and diet by repeated 24-h recalls. Liver fat, VAT and IMAT were primary outcomes; total adipose tissue (TAT) and abdominal subcutaneous adipose tissue (ASAT) were secondary outcomes. Three a priori defined models were constructed: the all-components model, standard model and leave-one-out model (main model including specified nutrient substitutions). Imiomics (MRI-derived) was used to confirm and visualize associations. In women, substituting carbohydrates and free sugars with saturated fat (SFA) was positively associated with liver fat (β (95% CI) = 0.19 (0.02, 0.36) and β (95% CI) = 0.20 (0.05-0.35), respectively) and IMAT (β (95% CI) = 0.07 (0.00, 0.14) and β (95% CI) = 0.08 (0.02, 0.13), respectively), whereas substituting animal fat with plant fat was inversely associated with IMAT, ASAT and TAT. In the all-components and standard models, SFA and animal fat were positively associated with liver fat, IMAT and VAT whereas plant fat was inversely associated with IMAT in women. Few associations were observed in men. Circulating polyunsaturated fatty acids (PUFA) were inversely associated with liver fat, IMAT and VAT in both men and women, whereas SFA and monounsaturated fatty acids were positively associated. Type of dietary fat may be an important determinant of ectopic fat in humans consuming their habitual diet. Plant fat and PUFA should be preferred over animal fat and SFA. This is corroborated by circulating fatty acids and overall consistent through different energy adjustment models. In UK Biobank, intake of saturated- and animal fat were positively whereas biomarkers of polyunsaturated fat were inversely associated with liver-, visceral- and intermuscular fat. Type of dietary fat may be a determinant of ectopic fat, a risk factor for cardiometabolic disease.


Transgenerational transmission of small-for-gestational age.
To evaluate the transgenerational transmission of small-for-gestational age (SGA). This was a cohort study of a random sample of 2043 offspring delivered between 1975 and 1993 at Hospital Sant Joan de Déu in Barcelona. Exclusion criteria were multiple pregnancy, aneuploidy or genetic syndrome, major birth defects, severe mental disease and macrosomia. Eligible individuals were contacted and those with at least one offspring were included in the study. Participants were classified according to the presence of SGA (defined as birth weight < 10th percentile) at birth. Multiple regression analysis was used to determine the presence of SGA or placenta-mediated disease (defined as the presence of SGA, pre-eclampsia, gestational hypertension and/or placental abruption) in the following generation. Of 623 individuals who agreed to participate, 152 (72 born SGA and 80 born appropriate-for-gestational age (AGA)) were reported to have at least one child. Descendants of SGA individuals presented with a lower birth-weight percentile (median, 26 (interquartile range (IQR), 7-52) vs 43 (IQR, 19-75); P < 0.001) and a higher prevalence of SGA (40.3% vs 16.3%; P = 0.001) and placenta-mediated disease (43.1% vs 17.5%; P = 0.001) than did the offspring of AGA individuals. After adjustment for confounding variables, parental SGA background was associated with an almost three-fold increased risk of subsequent SGA or any placenta-mediated disease in the following generation. This association was stronger in SGA mothers than in SGA fathers. Our data provide evidence suggesting a transgenerational transmission of SGA, highlighting the importance of public health strategies for preventing intrauterine growth impairment. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.


Classification of Osteoporotic Thoracolumbar Spine Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU).
Expert opinion. Osteoporotic vertebral fractures are of increasing medical importance. For an adequate treatment strategy, an easy and reliable classification is needed. The working group "Osteoporotic Fractures" of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) has developed a classification system (OF classification) for osteoporotic thoracolumbar fractures. The consensus decision followed an established pathway including review of the current literature. The OF classification consists of 5 groups: OF 1, no vertebral deformation (vertebral edema); OF 2, deformation with no or minor (<1/5) involvement of the posterior wall; OF 3, deformation with distinct involvement (>1/5) of the posterior wall; OF 4, loss of integrity of the vertebral frame or vertebral body collapse or pincer-type fracture; OF 5, injuries with distraction or rotation. The interobserver reliability was substantial (κ = .63). The proposed OF classification is easy to use and provides superior clinical differentiation of the typical osteoporotic fracture morphologies.


Risk Factors of Low Back Pain Aggravation After Tubular Microdiscectomy of Lumbar Disc Herniation.
Although lumbar disc herniation (LDH) patients' sciatic symptoms such as leg pain can be improved by decompressive surgery, some patients report postoperative aggravated low back pain (LBP). However, the exact reason for this phenomenon remained unknown. We retrospectively analyzed the prospectively collected LDH data of patients who underwent tubular microdiscectomy between December 2015 and December 2020. The patients were divided into aggravated and non-aggravated group according to whether the postoperative LBP visual analogue scale (VAS) score was higher than the preoperative score. We analyzed the relationship of the clinical and radiologic parameters with aggravated LBP. Postoperative aggravated LBP cases accounted for 14.1% (57 of 404) of this series. Of the 57 patients, 88% (50 of 57) had mild postoperative LBP aggravation (1-2), and 12% (7 of 57) had severe LBP aggravation (>2). The preoperative LBP VAS score of the aggravated group was significantly lower than that of the non-aggravated group (P < 0.001), while the LBP VAS score and Oswestry Disability Index at final follow-up was significantly higher in the aggravated group (P < 0.05). Additionally, the proportion of preoperative moderate-to-severe multifidus fatty atrophy (MFA) and lumbar facet joint degeneration (LFJD) was significantly higher in the aggravated group. A multiple stepwise logistic regression analysis indicated that the preoperative LBP VAS score (P < 0.001, odds ratio 0.266, 95% CI 0.161-0.439) and MFA (P < 0.001, odds ratio 4.491, 95% CI 2.092-9.640) were the risk factors for postoperative aggravated LBP. A preoperative lower LBP VAS score and moderate-to-severe MFA were associated with postoperative aggravated LBP. This will provide important guidance for patient's preoperative assessment and education.


[Apparently supernatural healing forces from a prepared shoe].
Authors report on results of the examination of a specially prepared shoe, therapeutically used by a faith-healer. The patients felt unexpected sensations caused by an electrical circuit built in the shoe and released by the doctors big toe. The faith-healer justified his method to be a special kind of "electrophysiological therapy". The public prosecutor withdrew the impeachment on trickery.


A systematic review on metal contamination due to mining activities in the Amazon basin and associated environmental hazards.
Metal contamination associated with mining activities has been considered one of the main environmental pollution problems in the Amazon region. Understanding the levels of metal contamination from mining activities requires a good understanding of background metal concentrations, which may vary notably according to the geology/lithology characteristics of the region, soil type, and predominant biogeochemical processes. This review assessed 50 papers and reports published between 1989 and 2020 describing environmental concentrations of different metals and metalloids (As, Hg, Mn, Fe, Cd, Cu, Cr, Pb, Ni, and Zn) in water and sediments of mining and non-mining areas in five geographic regions of the Amazon basin. Metal enrichment caused by mining activities was calculated and exposure concentrations were compared with sediment and water quality standards set for the protection of aquatic life. Significant enrichments of Cd, Cu, Cr, Fe, Hg, Mn, Ni and Zn were observed in mining areas in both sediment and water. Regarding background levels in the different geographic regions, the highest prevalence of metal enrichment (i.e., concentrations 10 to 100-fold higher than mean background values) in sediment samples was found for Fe (100% of samples), Ni (90%), and Mn (69%). For water, high prevalence of metal enrichment occurred for Zn, Mn, and Fe (100% of samples), and for Hg (86%). Hg, Fe, Pb, Cu, Cd, Ni and Zn exceeded water and/or sediment quality standards in a significant number of samples in the proximity of mining areas. This study indicates that mining activities significantly contribute to water and sediment contamination across the Amazon basin, posing hazards for freshwater ecosystems and potentially having human health implications.


Predicting carcinogenicity of petroleum distillation fractions using a modified Salmonella mutagenicity assay.
The Ames Salmonella/microsomal activation mutagenesis assay has been modified to improve sensitivity and reproducibility to complex mixtures derived from the refining and processing of petroleum. Oil samples were dissolved in cyclohexane and subsequently extracted with dimethyl sulfoxide to produce aqueous compatible solutions which readily interact with tester bacteria. Also, the liver homogenate (S-9) and NADP cofactor concentrations were increased and hamster rather than rat liver S-9 was used. The initial slope of the dose response curve relating mutagenicity (revertants per plate) to the dose of extract added was used as an index of mutagenic activity; this slope was obtained through a computerized curve fitting procedure. The modified assay was used to rank 18 oil samples for mutagenic activity; this ranking correlates highly (r = 0.92) with potency rankings of the same samples previously determined from dermal carcinogenicity bioassays. Sensitivity and reproducibility of the assay are sufficient to permit routine use for detecting potential carcinogenic activity of individual refinery streams and blends which contain components boiling above 500 degrees F.


Echocardiography and vascular ultrasound: new developments and future directions.
There have been major technological advances in echocardiography over the past decade. New and robust measures of myocardial function, both systolic and diastolic, have been identified and extensively evaluated. Some of the new measures such as annular velocities by tissue Doppler imaging have become an integral part of the echocardiographic examination, and other measures such as strain and strain rate have yet to be widely adopted. Three-dimensional (3D) echocardiography has evolved greatly since its introduction in the 1980s. Currently, its main clinical application is the perioperative assessment of the mitral valve. Though 3D echocardiography provides superior quantification of cardiac chamber size, its adoption has been limited by the lack of robust automated data analysis software with smooth integration of analysis packages into clinical workstations and suboptimal temporal and spatial resolution. With advancement in electronics and miniaturization, these limitations can be overcome. The history of contrast echocardiography is long and arduous. Use of a microbubble contrast for left ventricular opacification has become commonplace in most echocardiographic laboratories, but the routine use of microbubble contrast for myocardial perfusion will require standardization of the procedure and/or development of new contrast agents. The applications of 3D and microbubble contrast are also under active evaluation in vascular ultrasound. This review summarizes the current and future applications of these exciting developments in echocardiography and vascular ultrasound.


Heterotransplantation into nude mice of pancreatic carcinoma induced by N-bis(2-hydroxypropyl)nitrosamine in hamsters.
Heterotransplantation into nude mice by the subcutaneous (s.c.) and intraperitoneal (i.p.) routes of hamster pancreatic ductal cell carcinomas induced by N-bis(2-hydroxypropyl)nitrosamine (DHPN) was studied. By s.c. transplantation, tumors occurred in 1 of 4 mice at the first trial, and the tumor incidence was 100% for shorter periods by serial transfer. By i.p. transplantation, the malignant potential of hamster pancreatic ductal cell carcinoma was expressed as intra-abdominal invasive tumors with bloody ascites (carcinomatous peritonitis). Tumors in nude mice basically retained the histology of the original hamster pancreatic ductal cell carcinoma.


Isolated distal pisiform dislocation: Case Report.
Isolated pisiform dislocation is a rare lesion with few cases described in the literature. This type of lesion is typically observed in young males and can be easily overlooked at first assessment. Isolated proximal dislocation is more common due to the action of the flexor carpi ulnaris (FCU) muscle. We present the case of a 19-year-old male patient with isolated distal pisiform dislocation after wrist trauma. He underwent open reduction and internal fixation with Kirschner wires with excellent functional outcomes. Although there is no consensual therapeutic method, closed reduction is a first-line treatment for acute presentations. Pisiform open reduction or excision may be performed alternatively or after a failed closed reduction.


The treatment of patients with symptomatic common bile duct stenosis secondary to chronic pancreatitis using partially covered metal stents: a pilot study.
Although surgery remains the gold standard for the treatment of symptomatic common bile duct stenosis associated with chronic pancreatitis, plastic and self-expandable open-mesh stents have been proposed as alternative treatments. These may dysfunction, however, mainly due to stent occlusion by clogging or by hyperplasia of inflammatory tissue. The aim of this study was to evaluate the safety and long-term results of using partially covered metal stents in this setting. A total of 14 patients (12 men, 2 women; mean age 50 +/- 3 years) underwent partially covered metal stent insertion for common bile duct stenosis secondary to chronic pancreatitis (12 alcohol-related, two idiopathic). They had all been treated previously with plastic prostheses. Either a 40-mm (n = 13) or a 60-mm (n = 1) partially covered metal stent was placed, depending on the length of the common bile duct stenosis and the level of the cystic duct bifurcation. Stent placement was successful, with resolution of cholangitis and improvement in cholestasis, in all patients. During the median follow-up period of 22 months (range 12 - 33 months) seven patients developed dysfunction of the stent and required re-treatment. At 12, 24, and 30 months, the stent patency rates were 100 %, 40 %, and 37.5 % respectively. While partially covered metal stenting is safe and effective for the initial treatment of chronic pancreatitis-associated common bile duct stenosis and shows promising short-term results, long-term data show that dysfunction occurs in 50 % of cases. In light of the continued interest in nonsurgical treatment of this condition, further research is warranted to investigate new stent designs with improved long-term patency.


Studies on luciferase from Photobacterium phosphoreum. X. Heat of formation of the intermediate in the bioluminescent reaction studied by stopped-flow calorimetry.
The heat production in the reaction of luciferase-FMNH2 complex with O2 in the absence of aldehyde was measured by stopped-flow calorimetry. deltaH of the reaction, luciferase-FMNH2+ O2 leads to intermediate X1, is -1.3 X 10(2) kJ.mol-1 and the calculated deltaS for the reaction is -180 J.mol-1.K-1 at 20 degrees C. The heat production in the bioluminescent reaction was also measured in the presence of a saturating concentration of aldehyde, and it was estimated that 43 and 79% of the C10 and C13 aldehydes, respectively, bound with the intermediate X1 are converted to carboxylic acid yielding energy for photon emission.