Stem and Sheath Diseases and Yield Response of Irrigated Rice Rotation Systems with Different Intensification Levels.
Rice cultivation in South America is undergoing several intensification processes for economic reasons that cause more rice to be planted continuously on the same soils. This intensification makes the long-term biological and economic sustainability of systems questionable. Among the most common problems that threaten sustainability in intensified systems is pest and disease pressure. In this context, the primary rice diseases were studied during a 6-year period in a long-term experiment of rice rotations established in 2012 in Uruguay. The experiment consisted of six rice rotations with other crops with different duration and intensification levels. The main disease found was stem rot and, to a lesser extent, aggregate sheath spot and sheath spot of rice. These diseases are of importance in intensified rice systems because they produce sclerotia that accumulate in soils. Disease occurrence was variable among years and rotations. Stem rot incidence increased rapidly in the experiment, reaching values close to 85% in the third year, while the severity varied each year. Sheath spot incidence and severity were low and varied with the year. Continuous rice (CR) reached the highest occurrence values for stem rot, but other systems with short pastures in rotation did not differ. Aggregate sheath spot and sheath spot were of importance only in CR and in some years. When levels of intensification were compared, systems with less time (25 to 60%) occupied with rice showed lower disease severity and higher yields. Comparing CR with rice rotation with pastures of different lengths (1 to 3 years), disease occurrence was higher in 2 of the 4 years analyzed. However, yields were consistently lower, denoting that other factors are influencing productivity. Stem and sheath diseases appear not to be a limiting factor in the medium term in intensified rice systems. Also, there are several alternatives of rice intensification incorporating crops and pastures in the rotation.


Antimycin A-induced mitochondrial apoptotic cascade is mitigated by phenolic constituents of Phyllanthus amarus aqueous extract in Hep3B cells.
Antimycin A (AMA) treatment of cells blocks mitochondrial electron transport chain, and leads to elevated ROS generation, thereby causing damage to mtDNA, proteins and lipids, along with mitochondrial membrane depolarization, release of pro-apoptotic proteins into the cytoplasm, and induction of apoptosis. Prevention of such oxidative cellular damage by the aqueous extract of Phyllanthus amarus has been investigated in this study. The extract demonstrated significant potential in mitigating H(2)O(2)-induced membrane damage along with considerable recession in AMA-governed mitochondrial protein and lipid degradation in Hep3B cells. 8-OHdG analysis of mtDNA damage revealed substantial protective potential of the extract against mtDNA damage. SQ-PCR of selected mtDNA sequences confirmed the potential of the extract to alleviate levels of mtDNA damage. FACS analysis with JC-1 fluorescent dye established significant escalation of mitochondrial membrane potential by the extract in AMA-treated cells. Extract treatment resulted in a distinct decline in the degrees of AMA-induced release of cytochrome c and AIF into the cytoplasm along with consequent pacification of apoptosis. All protective efficiencies of the extract reported in this study were found to hold strong and significant (P<0.05) positive correlation to its total phenolic contents, thereby proving that polyphenolic constituents of P. amarus aqueous extract mitigate oxidative stress-induced cellular degeneration and aging.


RV size may predict death in unstable patients with PE.
Pulmonary emboli (PE) is a life threatening condition that discovered in many patients only "post mortem". Sub massive and massive PE that led to hemodynamic collapse characterized by right ventricular (RV) dysfunction, leading to a higher risk of death. To assess the ability to predict in hospital death of patients with acute PE, using a non-gated computed tomography pulmonary angiography (CTPA), based on the dimensions of the right ventricle. A retrospective study that analyzed CTPA images of patients admitted with acute PE during the years 2012-2017. The cohort study included 300 patients with documented acute PE, among them 255 hospitalized in medical (non-intensive care unit) wards, 45 were hospitalized in an intensive care unit (ICU). Among the 45 patients admitted to the ICU 8% died. Larger RV diameters predicted mortality (OR = 10.14, 95% CI [1.09-93.86]) as well as lower systolic and diastolic blood pressure measurements (p = 0.001 and 0.01). Among the 255 patients admitted to the Internal Medicine Ward 7% died. Older age (p = 0.028), sepsis and cancer (both p < 0.001), high WBCs count (p < 0.001), and renal failure (p < 0.001) predicted death. Lower blood pressure (systolic and diastolic) (p < 0.001, 0.008), older age (p < 0.007), sepsis (p < 0.001), cancer (p = 0.006), higher WBCs count (p < 0.001), and impaired renal function (p < 0.001) predicted death in patients admitted with acute PE. Clinical parameters and hematological parameters could predict death of patients admitted with acute PE. RV diameter, measured by the non-ECG gated CTPA, had an additive predictive value for patients who admitted to the ICU.


An epidemiologic retrospective study of maxillofacial traumatology in the elderly.
The elderly population, which is more active than before, is increasingly suffering from trauma (loss of reflexes and systemic pathologic conditions). Surgical management may be more controversial due to the potential consequences of general anesthesia and the sometimes negligible consequences of functional management. The main objective of this study was to analyze the causes and location of facial fractures in subjects older than 65 years. The secondary objective was to evaluate the management of these fractures (surgical or functional) according to comorbidities. In this retrospective study (over a five-year period), we analyzed the causes and management of facial fractures in patients aged over 65 years, and the medical history of each patient was investigated. One hundred and nineteen patients with 198 facial fractures were included. The main cause of fractures was a fall (50%). The zygomatic region (39.9%) and mandible (27.8%) were the sites of the most frequent fractures. Comorbidities were found in 84.9% of patients, the majority of which were cardiovascular diseases (82.3%). 75.8% of fractures were treated surgically and 4.8% of patients had complications. This work is a help to understanding the causes and consequences of facial trauma in the elderly population. The management of these facial fractures requires a multidisciplinary assessment, taking into account the patient's medical history and evaluating the risks and benefits of a surgical procedure with general anesthesia.


Improving quality of arterial spin labeling MR imaging at 3 Tesla with a 32-channel coil and parallel imaging.
To compare 12-channel and 32-channel phased-array coils and to determine the optimal parallel imaging (PI) technique and factor for brain perfusion imaging using Pulsed Arterial Spin labeling (PASL) at 3 Tesla (T). Twenty-seven healthy volunteers underwent 10 different PASL perfusion PICORE Q2TIPS scans at 3T using 12-channel and 32-channel coils without PI and with GRAPPA or mSENSE using factor 2. PI with factor 3 and 4 were used only with the 32-channel coil. Visual quality was assessed using four parameters. Quantitative analyses were performed using temporal noise, contrast-to-noise and signal-to-noise ratios (CNR, SNR). Compared with 12-channel acquisition, the scores for 32-channel acquisition were significantly higher for overall visual quality, lower for noise and higher for SNR and CNR. With the 32-channel coil, artifact compromise achieved the best score with PI factor 2. Noise increased, SNR and CNR decreased with PI factor. However mSENSE 2 scores were not always significantly different from acquisition without PI. For PASL at 3T, the 32-channel coil at 3T provided better quality than the 12-channel coil. With the 32-channel coil, mSENSE 2 seemed to offer the best compromise for decreasing artifacts without significantly reducing SNR, CNR.


Light and electron microscopy study of capillaries in normal and inflammatory human synovial membrane.
Synovium aspirated from the knee joint by trochar was studied by light and electron microscopy in 40 cases of inflammatory arthritis and in 10 controls. The morphology of synovial capillaries, extravascular plasma diffusion, interendothelial vascular gaps, extracapillary blood cell migration, vascular congestion, endothelial hyperplasia, and obliteration of the capillary lumen by endothelial cells were compared in normal and inflammatory synovia. Inflammatory synovitis was characterised by the number and diversity of blood cells migrating through the interendothelial pathway out of the capillary lumen. Polymorphonuclear leucocytes were the blood cells most often seen at interendothelial junctions. No other capillary changes that might be related to synovial inflammation were found.


Development of a method for the quantitative analysis of urinary stones, formed by a mixture of two components, using infrared spectroscopy.
The analysis of urinary stones is used for the diagnosis of the etiology of an episode of nephrolithiasis. The technique considered as standard for this purpose is infrared spectroscopy (IR). However, when the urinary stone is formed by a mixture of components, only semi-quantitative information can be achieved using IR. The objective of this work is the development of a quantitative method. Bands in the IR spectra of several mixtures were studied, in order to design a calibration model useful to determine the quantitative composition of the urinary stones. For mixtures of two components, four mathematical models were proposed. To assess the validity of these models, nine series of mixtures of two components were prepared, using the most frequently compounds found in urinary stones, for analyzing by ATR-FTIR spectroscopy (Attenuated Total Reflection Fourier Transformed Infrared). Nine series of nine mixtures of two components were prepared for this work. The IR spectrum was recorded for each mixture and the absorbance intensities at selected wave numbers were used to apply the proposed mathematical models. There were good linear correlations between the analytical signals (IR absorbances) and the analytical responses (weight fractions) using the calibration lines. The validity of the method was checked by the comparison between the weight fractions resulted from the calibration lines and the real weight fractions obtained by weighing, presenting good correlation parameters. The method developed in this work has been useful for the quantification of compounds which are commonly found in urinary stones. This method allows a total characterization of the urinary stones (qualitative and quantitative) by means of IR spectroscopy.


High-performance liquid chromatographic determination of tauro- and glyco-conjugated bile acids in human serum.
A method for the identification and individual determination of the ten tauro- and glyco-conjugated bile acids is described. It consists in a specific three-step extraction from small serum samples (500 microliters), high-performance liquid chromatographic separation and direct spectrophotometric detection at 119 nm. Extraction can be checked by the use of an internal standard. The reproducibility, recovery and separation of fractions were satisfactory.


Draft Genome Sequence of Cronobacter sakazakii GP1999, Sequence Type 145, an Epiphytic Isolate Obtained from the Tomato's Rhizoplane/Rhizosphere Continuum.
We present here the draft genome of Cronobacter sakazakii GP1999, a sequence type 145 strain isolated from the rhizosphere of tomato plants. Assembly and annotation of the genome resulted in a genome of 4,504,670 bp in size, with 4,148 coding sequences, and a GC content of 56.8%.


Is coordination variability using vector coding different in overground and treadmill walking and running?
Coordination variability has been linked to overuse running injuries and has been studied both on a treadmill and over-ground. It is not clear, however, if the coordination variability data from over-ground locomotion can be compared with treadmill locomotion data. Therefore, the purpose of this study was to compare coordination variability of selected lower extremity couplings at different locomotor speeds during over-ground and treadmill walking and running. Nineteen (10 female, 9 male) healthy, recreational collegiate runners participated in this study. Each participant performed in two different conditions: over-ground and on a treadmill at three walking speeds (1.2, 1.6, and 2.0 m•s-1) and three running speeds (2.8, 3.2, and 3.6 m•s-1). A modified vector coding technique was used to calculate coordination variability for five selected coupled segment and joint angles. Each of the segmental couples was analyzed separately using a two-way repeated measures ANOVA (Condition Χ Speed) implemented with one-dimensional statistical parametric mapping. While no interaction effects were observed for condition X speed, we saw increased coordination variability in the sagittal couples during overground compared with treadmill locomotion, which predominantly occurred during the stance phase. There were mixed results for changes in coordination variability as a function of gait speed. However, for the sagital plane couplings, coordination variability decreased with speed, particularly during the stance phase. These results suggest that the controlled belt speed of the treadmill affects the intrinsic dynamics of human movement and this should be considered when making comparisons between treadmill and over-ground studies and in future study designs.


Vasopressin deficiency and circadian rhythms during food-restriction stress.
Vasopressin-containing, Long-Evans (LE) rats and vasopressin-deficient, Brattleboro (DI) rats were monitored for activity and core body temperature via telemetry. Rats were exposed to a 12-12 light-dark cycle and allowed to habituate with ad lib access to food and water. The habituation period was followed by an experimental period of 23 h of food-restriction stress in which a 1-h feeding period was provided during the light cycle. Although both strains of animals showed nocturnal activity and temperature rhythms during the habituation period, DI rats were more active than LE rats. The DI rats also had a lower body temperature in the dark. During the experimental period, both strains exhibited a phase shift of activity and body temperature correlating with the presentation of food. The DI rats developed a diurnal shift more rapidly than LE rats. The DI animals showed a dramatic increase in activity during the light phase and a marked decrease in body temperature during the dark phase. The LE animals showed a significant attenuation of activity, but maintained both nocturnal and diurnal temperature peaks throughout the food-restricted condition.


The Contribution of Pharmacogenetic Drug Interactions to 90-Day Hospital Readmissions: Preliminary Results from a Real-World Healthcare System.
Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines exist for many medications commonly prescribed prior to hospital discharge, yet there are limited data regarding the contribution of gene-x-drug interactions to hospital readmissions. The present study evaluated the relationship between prescription of CPIC medications prescribed within 30 days of hospital admission and 90-day hospital readmission from 2010 to 2020 in a study population (N = 10,104) who underwent sequencing with a 14-gene pharmacogenetic panel. The presence of at least one pharmacogenetic indicator for a medication prescribed within 30 days of hospital admission was considered a gene-x-drug interaction. Multivariable logistic regression analyzed the association between one or more gene-x-drug interactions with 90-day readmission. There were 2211/2354 (93.9%) admitted patients who were prescribed at least one CPIC medication. Univariate analyses indicated that the presence of at least one identified gene-x-drug interaction increased the risk of 90-day readmission by more than 40% (OR = 1.42, 95% confidence interval (CI) 1.09-1.84) (p = 0.01). A multivariable model adjusting for age, race, sex, employment status, body mass index, and medical conditions slightly attenuated the effect (OR = 1.32, 95% CI 1.02-1.73) (p = 0.04). Our results suggest that the presence of one or more CPIC gene-x-drug interactions increases the risk of 90-day hospital readmission, even after adjustment for demographic and clinical risk factors.


Front-of-pack nutrition labelling systems: a missed opportunity?
Both the US Institute of Medicine and the Canadian Standing Committee on Health have called for simple, standardized front-of-package (FOP) nutrition labelling systems on packaged foods. However, despite scientific evidence and expert consensus on the topic, Canada's Minister of Health has dismissed these recommendations, stating that Canadian consumers already have "the tools they need to make healthy food choices when they shop for groceries". This is relevant since existing evidence suggests that the current regulated nutrition labelling tools may not meet their intended objectives. Furthermore, Canada's current FOP labelling environment--characterized by a variety of FOP labels with varying criteria--does not support the objectives of good nutrition labelling defined by Health Canada. Evidence suggests that well-designed FOP systems are capable of positively influencing consumer purchases as well as product reformulations by manufacturers. The US Institute of Medicine suggests a standardized, simple, interpretive, and ordinal FOP symbol as the ideal FOP labelling system. Although additional research is required, such a system should be considered in Canada, as it may be capable of addressing the shortcomings of existing nutrition labelling tools found in the Canadian marketplace.


Childhood sexual abuse is associated with higher total ghrelin serum levels in adulthood: results from a large, population-based study.
Ghrelin is an orexigenic peptide hormone synthesized in times of stress and hunger and alterations of the ghrelin system following acute stressors could be repeatedly shown in humans. However, little data exists on long-term effects of trauma on the ghrelin system. We aimed to investigate the influence of childhood trauma on total ghrelin serum levels in a large, population-based study. Total serum ghrelin was measured in 1666 participants of a population-based cross-sectional study ('LIFE study'). The Childhood Trauma Screener (CTS) was used for the assessment of childhood trauma in the final sample (n = 1086; mean age: 57.10 ± 16.23 years; 632 males, 454 females). Multiple linear regression analyses and generalized linear models were chosen to examine the association between childhood trauma and total serum ghrelin concentrations. Childhood sexual abuse went along with significantly higher ghrelin serum levels in the total sample (β = 0.114, t = 3.958; p = 0.00008) and in women (β = 0.142, t = 3.115; p = 0.002), but not in men (β = 0.055; t = 1.388; p = 0.166). Women with severe emotional neglect in the childhood had higher ghrelin levels than those without (odds ratio = 1.204; p = 0.018). For the CTS Sum Score and other CTS sub-scale scores, no significant association with ghrelin serum levels was found. Our study is the first to show associations between childhood sexual trauma and total ghrelin levels in adults in a large, community-based sample. Our results should initiate further research of the role of ghrelin in human stress response in prospective study designs.


The effect of contrast media on CT measures of bone mineral density: a systematic review.
The aim was to systematically assess the literature on possible effect of administration of iodinated contrast media on CT-estimated bone mineral density (BMD). The Web of Science and PubMed databases were searched. Studies that used both CT principles of BMD measurement (volumetric quantitative BMD and CT attenuation in Hounsfield Units) were included. The baseline patient data, skeletal site, contrast medium data (if reported), and change in BMD on contrast-enhanced CT scans were collected. Sixteen studies met our review criteria, the majority of which was performed on lumbar spine, and the others on proximal femur. Almost all studies reported a significant increase in BMD values on the contrast-enhanced CT scans, ranging from 0.8 to 30.3%. The increase was most frequently reported to be about 10 to 15% for the spine and 5 to 10% for the femur. In addition to the difference in skeletal site, some authors found the contrast effect was age-, sex-, and contrast dose-dependent. BMD values in arterial phase were generally somewhat lower than in venous phase, and the effect of contrast in venous phase was more predictable. The review revealed significant changes in BMD values between unenhanced and contrast-enhanced CT. The change was more pronounced in lumbar spine than in proximal femur and appeared to depend on age, sex, contrast dose, and postcontrast imaging protocol. The review suggests the understanding of all mentioned factors during the interpretation of BMD measured on contrast-enhanced CT.


Precise Estimates of Persistence Time for SIS Infections in Heterogeneous Populations.
For a susceptible-infectious-susceptible infection model in a heterogeneous population, we derive simple and precise estimates of mean persistence time, from a quasi-stationary endemic state to extinction of infection. Heterogeneity may be in either individuals' levels of infectiousness or of susceptibility, as well as in individuals' infectious period distributions. Infectious periods are allowed to follow arbitrary non-negative distributions. We also obtain a new and accurate approximation to the quasi-stationary distribution of the process, as well as demonstrating the use of our estimates to investigate the effects of different forms of heterogeneity. Our model may alternatively be interpreted as describing an infection spreading through a heterogeneous directed network, under the annealed network approximation.


Novel design for a dynamic ankle foot orthosis with motion feedback used for training in patients with hemiplegic gait: a pilot study.
We designed a novel ankle foot orthosis (AFO), namely, ideal training AFO (IT-AFO), with motion feedback on the hemiparetic lower limb to improve ambulation in individuals with stroke-related hemiplegia. We, therefore sought to compare the kinematic parameters of gait between IT-AFO with and without dynamic control and conventional anterior-type AFO or no AFO. Gait parameters were measured using the RehaWatch® system in seven individuals with hemiplegia (mean 51.14 years). The parameters were compared across four conditions: no AFO, conventional anterior AFO, IT-AFO without dynamic control, and IT-AFO with dynamic control, with three trials of a 10-m walk test for each. The dorsiflexion angle increased during the swing phase when the IT-AFO was worn, and it was larger with dynamic control. These data can confirm drop foot improvement; however, the difference between the parameters with- and without-AFO control conditions was not significant in the swing phase. The IT-AFO with or without dynamic control enhanced the loading response to a greater extent between the hemiparetic and unaffected lower limbs than conventional AFO or no AFO. The duration of the stance phase on the hemiparetic lower limb was also longer when using IT-AFO with and without dynamic control than that when using conventional AFO, which improved asymmetry. User comfort and satisfaction was greater with IT-AFO than with the other conditions. The IT-AFO with dynamic control improved gait pattern and weight shifting to the hemiparetic lower limb, reducing gait asymmetry. The difference with and without dynamic control of IT-AFO is not statistically significant, and it is limited by sample size. However, this study shows the potential of IT-AFO in applying positive motion feedback with gait training. Taipei Medical University-Joint Institutional Review Board. N201510010 . Registered 12 February 2015. http://ohr.tmu.edu.tw/main.php .


Immunization with recombinant DcaP-like protein and AbOmpA revealed protections against sepsis infection of multi-drug resistant Acinetobacter baumannii ST2Pas in a C57BL/6 mouse model.
The prevalence of infections associated with multi-drug resistant (MDR) Acinetobacter baumannii is increasing worldwide. Therefore, the introduction of effective vaccines against this bacterium seems necessary. AbOmpA and DcaP-like protein were selected as promising and putative immunogenic candidates based on previous in silico studies. Three formulations including AbOmpA, DcaP-like protein, and AbOmpA + DcaP-like protein were injected into C57BL/6 mice three times with Alum adjuvant. The specific production of IgG antibodies (e.g. total IgG, IgG1 and IgG2c) and cytokines (e.g. IL-4, IL-6, and IL-17A), were evaluated. LD50% of MDR A. baumannii ST2Pas was measured using Probit's method. After the challenge with bacteria, a decrease in bacterial loads (DLs) in the lung and spleen of mice was measured. Then serum bactericidal assay was performed to determine the function of antibodies on day 42. In addition, histopathological examinations of the spleen and lung, the number of macrophage and neutrophil, as well as the rate of lymphocyte infiltration were assessed. The highest level of total IgG was reported in the group immunized with DcaP-like protein on day 42. The survival rate of mice was 80% in the AbOmpA immunized group and 100% for the rest of two groups. DLs in the spleen of mice immunized with AbOmpA, DcaP-like protein, and combination form were 3.5, 3, and 3.4 Log10 (CFU/g), respectively. While in the lung, the DLs were 7.5 Log10 (CFU/g) for the AbOmpA group and 5 for the rest of two groups. The levels of IL-6, IL-4, and IL-17A were significantly decreased in all immunized groups after the bacterial challenge (except for IL-17A in the group of AbOmpA). The bactericidal effect of antibodies against DcaP-like protein was more effective. No histopathological damage was observed in the combination immunized group. The DcaP-like protein was more effective in neutrophil and macrophage deployment and decreased lymphocyte infiltration. The results of immunization with AbOmpA + DcaP-like protein induced a protective reaction against the sepsis infection of MDR A. baumannii. It seems that in the future, these proteins can be considered as promising components in the development of the A. baumannii vaccine.


Preformed volatile nitrosamines in some Nigerian foodstuffs.
Some common Nigerian foodstuffs were assessed for their content of preformed volatile nitrosamine by chemiluminescence detection following gas chromatographic separation. Nitrosodimethylamine levels of between 0.4 and 4.6 ppb were detected in 75% of the samples analysed. The highest value was found in Brassica oleraceae, while Vernonia amygdalina contained the lowest detectable level. These data suggest that Nigerians may be exposed to chronic but very low levels of carcinogenic nitrosamines in their foods.


Repair of DNA damaged by mutagenic metabolites of benzo(a)pyrene in human cells.
The repair of human DNA after damage by known and potential metabolites of benzo(a)pyrene has been examined utilizing the bromodeoxyuridine photolysis assay. Repair was characterized as either ultraviolet ("long") or ionizing radiation type ("short") repair utilizing normal cells and cells deficient in ultraviolet-type repair endonuclease from a patient with xeroderma pigmentosum (XP). We have found that only (+/-)-7beta,8alpha-dihydroxy-9beta,-10beta-epoxy-7,8,9,10-tetrahydrobenzo(a)pyrene (BP diol epoxide 1) and its disastereomer, (+/-)-7beta,8alpha,-dihydroxy-9alpha,10alpha-epoxy-7,8,9,10-tetrahydrobenzo(a)pyrene (BP diol epoxide 2) elicit damage to DNA which is recognizable by the ultraviolet excision repair system in normal human cells. Benzo(a)pyrene 4,5-, 9,10-, 11,12-oxides do not elicit damage which is repairable by this repair system. The 1,2-diol-3,4-epoxides from naphthalene have no measurable activity in our assay. These results indicate that both the benzo(a)pyrene ring structure and the diol epoxide groups are important in causing the damage to DNA which is repairable by the ultraviolet excision repair system. These results parallel the reported high mutagenic activity of these compounds and support the concept that benzo(a)pyrene 7,8-diol-9,10-epoxides may be the ultimate, metabolically activated forms of benzo(a)pyrene.


Context improves comprehension of fronted objects.
Object-initial clauses (OCs) are associated with more processing difficulties than subject-initial clauses (SCs) in a number of languages (e.g. English, German and Finnish), but a supportive context can reduce or neutralize the difference between SCs and OCs with respect to reading times. Still, it is unresolved how context can affect the comprehension of OCs. In the present self-paced reading study of Danish, we therefore investigated both reading times, comprehension accuracy and response times for OCs and SCs. In line with previous studies on word order processing, OCs in an unsupportive context showed longer reading times than SCs, longer response times and a comprehension accuracy as poor as chance level. A manipulation of context showed no effect of reading time, but a supportive context had a stronger facilitating effect on comprehension (response accuracy and response time) for OCs than for SCs.


Arthroscopic Education in the 21st Century.
The Arthroscopy Association of North America (AANA), always with a mind to improving patient outcome, has revised it's educational course offerings to reflect changes in healthcare and education and technology. Arthroscopic and related surgeons would do well to attend the AANA Annual Meeting and Fall Course.


Working smarter, not harder: evaluating a population health approach to anticoagulation therapy management.
Inappropriate direct acting oral anti-coagulants (DOAC) prescribing increases the risk of adverse events. Population health management tools (PMTs) could help reduce adverse events through the early, efficient identification of questionable prescribing practices, but the impact of such a tool remains unknown. We evaluated the effect of PMT use on questionable DOAC dosing rates within 40 VHA medical centers and whether this effect differed by DOAC indication or agent. Medical centers were divided into PMT user or standard of care (SOC) groups based upon high or low tool access in the prior year. Questionable DOAC dosing rate was defined as the proportion of patients prescribed DOACs who were also flagged by the tool. Chi-square tests were used to determine if PMT user versus SOC groups differed with high (above 15.3%) versus low (below 15.3%) questionable dosing rates. T-tests were used to determine if mean questionable dosing rates significantly differed between the PMT user and SOC groups. DOAC PMT users were classified less frequently as being 'High" questionable dosage rate compared to SOCs (25% PMT vs. 75% SOC, respectively, p = 0.002). DOAC PMT utilization within the overall cohort was associated with a 4.3% absolute reduction in questionable DOAC dosing rates (13.2% PMT vs 17.5% SOC; p = 0.01). Tool use within the atrial fibrillation (AF) subgroup was associated with a 5.1% absolute reduction in questionable dosing rates (10.4% SOC vs. 5.3% PMT, p < 0.001). Tool use was also associated with lower questionable dosing rates in the apixaban (p < 0.001), dabigatran (p = 0.03) and AF plus venous thromboembolism (p < 0.001) subgroups. In our study, PMT use was associated with reduced questionable DOAC dosing, a difference most pronounced within AF patients. A population health approach has the potential to reduce adverse events among patients prescribed DOACs.


Impact of intravascular ultrasonography in the endovascular management of aortoiliac occlusive disease.
Intravascular ultrasonography (IVUS) is one of several new imaging technologies that have been applied in the treatment of arterial occlusive disease. Endovascular procedures are increasing annually, and arteriography, which is thought to be the "gold standard" for assessing adequacy of endovascular therapy, appears to have flaws. IVUS, a new imaging technique that expands the understanding of atherosclerotic lesions, images a vessel in a cross-sectional plane and provides information about the morphology of the lesion and the vessel wall. IVUS clearly visualizes the spatial relationship between a deployed stent and the vessel wall; this information is not usually obtainable with arteriography. We conducted 2 studies at our institution to evaluate the use of IVUS in the endovascular treatment of atherosclerotic aortoiliac occlusive disease. The first study showed that actual vessel size and lumen diameter were underestimated 62% of the time by arteriography and that 40% of stents (P < .01) placed in the iliac arterial system were underdeployed, which might be related to treatment failure. The second study showed that the use of IVUS had a positive effect on the long-term patency of angioplastied and stented iliac lesions--all of these reconstructions have remained patent to date. IVUS appears to be the best means of assessing morphology of the arterial occlusive lesions and the results of endovascular intervention. IVUS provides valuable information related to diagnosis and treatment that can alter the conduct of endovascular procedures.


Effects of ursodeoxycholate on maximal biliary secretion of bilirubin in the rat.
The effect of sodium ursodeoxycholate (0.5 and 1.0 mumol/min/100 g) on the maximal biliary secretion (Tm) of bilirubin and on the concentration of bilirubin in liver and plasma at the end of a bilirubin load was studied in Wistar rats. Administration of ursodeoxycholate at 0.5 mumol/min/100 g caused a 0.8-fold increase in bile flow and a significant increase in the bilirubin Tm (+24%). This was associated with a significant reduction of liver and plasma bilirubin concentrations (-16% and -17%, respectively). Bilirubin UDP-glucuronosyltransferase activity was not significantly enhanced. There was a significant increase in the biliary excretion of bilirubin conjugates (+30%) and in the diconjugates/monoconjugates ratio in bile (+31%). When ursodeoxycholate was given at 1.0 mumol/min/100 g, it produced a 1.7-fold increase in bile flow, but the bilirubin Tm was significantly reduced (-21%). Liver bilirubin concentrations were decreased (-20%) and there was a significant enhancement in total pigment concentration in plasma (+19%). Both the excretion of unconjugated bilirubin and that of bilirubin conjugates were significantly reduced (-60% and -18%, respectively). There was a significant decrease in the bilirubin-UDP glucuronosyltransferase activity and the diconjugates/monoconjugates ratio in bile (-27% and -27%, respectively). These results indicate that ursodeoxycholate is able to increase maximal bilirubin secretion only when administered at low doses and that infusion at higher rates can significantly interfere with different steps in the hepatobiliary transport of the pigment.


All-optical control of three-photon spectra and time asymmetry in a strongly coupled cavity polariton system.
Manipulating the nature of photons emission is one of the basic tasks in quantum optics and photonics. The ever growing list of quantum applications requires a robust means of controlling the strongly coupled coherent interaction of photons and matter. Here, we investigate three-photon transmission spectra in a strongly coupled cavity polariton system and show that the correlation functions and transmitted photon stream can be optically manipulated. The dynamics of single photons and photon pairs at the polariton resonances can be changed by light from a single external coupling laser. At the "dark-state polariton," three-photon transmission is a perfectly coherent field in contrast to the strong photon-bunching behavior of a typical cavity quantum electrodynamics system. When the detuned probe light is tuned to the "bright polariton," the light exhibits a dramatic photon antibunching effect. Remarkably, the Fano-resonant asymmetric three-photon transmission caused by the interference between the dressed states leads to a new quantum feature that is strongly nonclassical (the third-order correlation function g((3))(0, 0) ≪ 1) and has a wide and tunable bandwidth. The dependence of the intrinsic third-order correlation and time symmetry of the photon stream on the controlled parameters is also examined. Strongly nonclassical, all-optically controllable multi-photon dynamics are very important for future quantum devices and metrology.


Contribution of dynamic calibration to the measurement accuracy of a pressure plate system throughout the stance phase in sound horses.
The aim of this study was to evaluate the accuracy of the vertical force curve of a pressure plate (PP) using dynamic calibration with a force plate (FP) in six sound Warmblood horses. The animals were walked and trotted over a combined PP-FP system sampling at 250 Hz. Five valid measurements of each forelimb were collected. The recalibration factor (RF), the ratio between the calibrated and raw PP data, was evaluated in each timeframe throughout the stance phase. Following dynamic calibration, the vertical force curve of the PP demonstrated a characteristic biphasic pattern at the walk and typical spikes at the beginning and end of stance at the trot. Both at walk and trot, the RF was considerably higher and more variable in the first 5% of stance (i.e. the impact phase) and during the final 20% of stance (i.e. the breakover phase), whereas between these phases (i.e. in the support phase), the RF was lower and remained relatively constant. These findings were confirmed by plotting the RF as a function of the vertical force and the RF in the loading part of the vertical force curve was lower than in the unloading part of the curve. Without dynamic calibration with a FP, the accuracy of the PP appears suboptimal, especially at the impact and breakover phases. However, the accuracy of the PP was relatively high and constant during the support phase, and higher loading was not associated with increasing deviation. It is therefore essential to optimise PP calibration, as this may downsize systematic measuring errors. However, in a clinical setting, where a stand-alone PP is used to objectively quantify locomotor symmetry, these errors can be readily eliminated by evaluating left:right symmetry ratios.


Multilevel IRT models for the analysis of satisfaction for distance learning during the Covid-19 pandemic.
The Covid-19 pandemic played a relevant role in the diffusion of distance learning alternatives to "traditional" learning based on classroom activities, to allow university students to continue attending lessons during the most severe phases of the pandemic. In such a context, investigating the students' perspective on distance learning provides useful information to stakeholders to improve effective educational strategies, which could be useful also after the end of the emergency to favor the digital transformation in the higher educational setting. Here we focus on the satisfaction in distance learning for Italian university students. We rely on data comprising students enrolled in various Italian universities, which were inquired about several aspects related to learning distance. We explicitly take into account the hierarchical nature of data (i.e., students nested in universities) and the latent nature of the variable of interest (i.e., students' learning satisfaction) through a multilevel Item Response Theory model with students' and universities' covariates. As the main results of our study, we find out that distance learning satisfaction of students: (i) depends on the University where they study; (ii) is affected by some students' socio-demographic characteristics, among which psychological factors related to Covid-19; (iii) is affected by some observable university characteristics.


Understanding the Impact of Bromide on the Photovoltaic Performance of CH3 NH3 PbI3 Solar Cells.
An optimum amount of lead bromide (1%) can enhance the power conversion efficiency of CH3 NH3 PbI3-x Brx (where x ≈ 0) devices from 14.7% to 16.9% without altering the bandgap of the perovskite material.


Platform tying scissors.
A platform tying scissor incorporates the functional parts of a scissors and tying forceps in one design.


Preparation of capacitor's electrode from sunflower seed shell.
Series of nanoporous carbons are prepared from sunflower seed shell (SSS) by two different strategies and used as electrode material for electrochemical double-layer capacitor (EDLC). The surface area and pore-structure of the nanoporous carbons are characterized intensively using N2 adsorption technique. The results show that the pore-structure of the carbons is closely related to activation temperature and dosage of KOH. Electrochemical measurements show that the carbons made by impregnation-activation process have better capacitive behavior and higher capacitance retention ratio at high drain current than the carbons made by carbonization-activation process, which is due to that there are abundant macroscopic pores and less interior micropore surface in the texture of the former. More importantly, the capacitive performances of these carbons are much better than ordered mesoporous carbons and commercial wood-based active carbon, thus highlighting the success of preparing high performance electrode material for EDLC from SSS.


Host-tumor interactions in nasopharyngeal carcinomas.
Like other human solid tumors, nasopharyngeal carcinoma (NPC) is a tissue and a systemic disease as much as a cell disease. Tumor cell population in NPC is highly heterogeneous. Heavy infiltration by non-malignant leucocytes results at least in part from the production of abundant inflammatory cytokines by the malignant epithelial cells. There is indirect evidence that interactions between stromal and malignant cells contribute to tumor development. Peripheral blood samples collected from NPC patients contain multiple products derived from the tumor, including cytokines, non-cytokine tumor proteins, tumor exosomes and viral nucleic acids. These products represent a potential source of biomarkers for assessment of tumor aggressiveness, indirect exploration of cellular interactions and monitoring of tumor response to therapeutic agents. Most NPC patients are immunocompetent with evidence of active humoral and cellular immune responses against EBV-antigens at the systemic level. Tumor development is facilitated by local immunosuppressive factors which are not fully understood. Local accumulation of regulatory T-cells is probably one important factor. At least two NPC tumor products are suspected to contribute to their expansion, the cytokine CCL20 and the tumor exosomes carrying galectin 9. In the future, new therapeutic modalities will probably aim at breaking immune tolerance or at blocking cellular interactions critical for tumor growth.


Pre- and post-diagnostic blood profiles of perfluoroalkyl acids in type 2 diabetes mellitus cases and controls.
Studies exploring the associations between perfluoroalkyl acids (PFAAs) and type 2 diabetes mellitus (T2DM) are rather limited and have reported conflicting results. All studies to date, including prospective ones, have relied on a single blood sample to study this association. Similarly, studies investigating how T2DM status may influence the longitudinal changes in PFAA concentrations have not been previously performed. As PFAA concentrations in humans have changed considerably over the last two decades, and as individuals diagnosed with T2DM usually undergo lifestyle changes that could influence these concentrations, a single blood sample may not necessarily reflect the life-time exposure to PFAA concentrations. Hence, repeated measurements from the same individuals will extend our understanding of how PFAAs are associated with T2DM. The present study, therefore, aimed to explore associations between pre- and post-diagnostic PFAA blood profiles and T2DM and assess factors associated with longitudinal changes in PFAAs in T2DM cases and controls. Questionnaire data and blood samples from women participating in the Norwegian Women and Cancer study were used to conduct a nested case-control study among 46 T2DM cases matched to 85 non-diabetic controls. PFAAs were measured in blood samples collected prior to (2001/02) and after (2005/6) T2DM diagnosis. We investigated the association between PFAAs and incident and prevalent T2DM using conditional logistic regression. We assessed the longitudinal changes in PFAA concentrations within and between matched cases and controls using t-tests and linear regression models. We observed no significant associations between pre-diagnostic PFAA concentrations and T2DM incidence. Similar results were observed for the post-diagnostic PFAA concentrations and T2DM prevalence. Decrease over time in PFAA concentrations were observed for PFOA and ∑PFOS concentrations, whereas increase over time were observed for PFNA, PFDA and PFUnDA concentrations. Longitudinal trends in PFAA concentrations among T2DM cases were similar to the changes observed in controls. The study did not find evidence of association between PFAAs and incident or prevalent T2DM. The longitudinal changes in PFAAs concentrations were not influenced by T2DM status.


Opioid doses required for pain management in lung cancer patients with different cholesterol levels: negative correlation between opioid doses and cholesterol levels.
Pain management has been considered as significant contributor to broad quality-of-life improvement for cancer patients. Modulating serum cholesterol levels affects analgesia abilities of opioids, important pain killer for cancer patients, in mice system. Thus the correlation between opioids usages and cholesterol levels were investigated in human patients with lung cancer. Medical records of 282 patients were selected with following criteria, 1) signed inform consent, 2) full medical records on total serum cholesterol levels and opioid administration, 3) opioid-naïve, 4) not received/receiving cancer-related or cholesterol lowering treatment, 5) pain level at level 5-8. The patients were divided into different groups basing on their gender and cholesterol levels. Since different opioids, morphine, oxycodone, and fentanyl, were all administrated at fixed low dose initially and increased gradually only if pain was not controlled, the percentages of patients in each group who did not respond to the initial doses of opioids and required higher doses for pain management were determined and compared. Patients with relative low cholesterol levels have larger percentage (11 out of 28 in female and 31 out of 71 in male) to not respond to the initial dose of opioids than those with high cholesterol levels (0 out of 258 in female and 8 out of 74 in male). Similar differences were obtained when patients with different opioids were analyzed separately. After converting the doses of different opioids to equivalent doses of oxycodone, significant correlation between opioid usages and cholesterol levels was also observed. Therefore, more attention should be taken to those cancer patients with low cholesterol levels because they may require higher doses of opioids as pain killer.


Effects of gestational age at birth on health outcomes at 3 and 5 years of age: population based cohort study.
To investigate the burden of later disease associated with moderate/late preterm (32-36 weeks) and early term (37-38 weeks) birth. Secondary analysis of data from the Millennium Cohort Study (MCS). Longitudinal study of infants born in the United Kingdom between 2000 and 2002. 18,818 infants participated in the MCS. Effects of gestational age at birth on health outcomes at 3 (n = 14,273) and 5 years (n = 14,056) of age were analysed. Growth, hospital admissions, longstanding illness/disability, wheezing/asthma, use of prescribed drugs, and parental rating of their children's health. Measures of general health, hospital admissions, and longstanding illness showed a gradient of increasing risk of poorer outcome with decreasing gestation, suggesting a "dose-response" effect of prematurity. The greatest contribution to disease burden at 3 and 5 years was in children born late/moderate preterm or early term. Population attributable fractions for having at least three hospital admissions between 9 months and 5 years were 5.7% (95% confidence interval 2.0% to 10.0%) for birth at 32-36 weeks and 7.2% (1.4% to 13.6%) for birth at 37-38 weeks, compared with 3.8% (1.3% to 6.5%) for children born very preterm (<32 weeks). Similarly, 2.7% (1.1% to 4.3%), 5.4% (2.4% to 8.6%), and 5.4% (0.7% to 10.5%) of limiting longstanding illness at 5 years were attributed to very preterm birth, moderate/late preterm birth, and early term birth. These results suggest that health outcomes of moderate/late preterm and early term babies are worse than those of full term babies. Additional research should quantify how much of the effect is due to maternal/fetal complications rather than prematurity itself. Irrespective of the reason for preterm birth, large numbers of these babies present a greater burden on public health services than very preterm babies.


Engineering of 3-ketosteroid-∆1-dehydrogenase based site-directed saturation mutagenesis for efficient biotransformation of steroidal substrates.
Biosynthesis of steroidal drugs is of great benefit in pharmaceutical manufacturing as the process involves efficient enzymatic catalysis at ambient temperature and atmospheric pressure compared to chemical synthesis. 3-ketosteroid-∆1-dehydrogenase from Arthrobacter simplex (KsdD3) catalyzes 1,2-desaturation of steroidal substrates with FAD as a cofactor. Recombinant KsdD3 exhibited organic solvent tolerance. W117, F296, W299, et al., which were located in substrate-binding cavity, were predicted to form hydrophobic interaction with the substrate. Structure-based site-directed saturation mutagenesis of KsdD3 was performed with W299 mutants, which resulted in improved catalytic activities toward various steroidal substrates. W299A showed the highest increase in catalytic efficiency (kcat/Km) compared with the wild-type enzyme. Homology modelling revealed that the mutants enlarged the active site cavity and relieved the steric interference facilitating recognition of C17 hydroxyl/carbonyl steroidal substrates. Steered molecular dynamics simulations revealed that W299A/G decreased the potential energy barrier of association of substrates and dissociation of the corresponding products. The biotransformation of AD with enzymatic catalysis and resting cells harbouring KsdD3 WT/mutants revealed that W299A catalyzed the maximum ADD yields of 71 and 95% by enzymatic catalysis and resting cell conversion respectively, compared with the wild type (38 and 75%, respectively). The successful rational design of functional KsdD3 greatly advanced our understanding of KsdD family enzymes. Structure-based site-directed saturation mutagenesis and biochemical data were used to design KsdD3 mutants with a higher catalytic activity and broader selectivity.


Initial Psychometric Evidence of Physical Inactivity Perceived Experience Scale (Pipes): COVID-19 Pandemic as a Pilot Study.
Our study aimed to develop a two-factor self-administered orthogonal questionnaire to assess the experience of perceived physical inactivity, to test its psychometric properties, to confirm its relationships with fear of COVID-19, and finally, with perceived stress during the pandemic. A total of 481 Tunisian subjects collected in several cities, aged from 16 to 67 years with a mean age = 32.48 ± 9.46, and of both sexes participate in our study with (male: 51.8%) and (female: 48.2%), divided according to the level of study into three categories. All subjects voluntarily answered the PIPES questionnaire, the IPAQ scale, the COVID-19 fear scale and the PSS-10 test. The results of the exploratory and confirmatory factor analysis supported the robustness of the tool measure. In addition, examination of configurational, metric, scalar, and strict invariance supported the equivalence of the structure by gender and educational level. Concurrent validity was established by the positive association of a negative perception of physical inactivity with scores measured by the IPAQ scale and a negative association with scores of COVID-19 fear and perceived stress. Whereas, a positive perception of physical inactivity from the COVID-19 scale was negatively associated with the IPAQ and positively associated with fear of COVID-19 and perceived stress. The PIPES-10 scale can be used to measure the perception of physical inactivity in different situations.


Control over MoSe2 formation with vacuum-assisted selenization of one-step electrodeposited Cu-In-Ga-Se precursor layers.
Cu(In,Ga)Se2 (CIGS) absorbers are prepared by direct current electrodeposition process followed by selenization of precursors. Selenization of electrodeposited layers is performed in a tubular furnace at 550 °C in elemental selenium atmosphere using Ar as carrier gas. The effect of evacuation of tube prior to the selenization on the formation of CIGS absorbers is studied. Characterization of CIGS absorbers reveals that the samples selenized without prior evacuation found to have excess MoSe2 formation at the CIGS/Mo interface leading to bulk cracks in underlying Mo back contact compared to their counterparts. Although the fabricated solar cells using the absorbers, prepared with and without evacuation, are observed to be photoactive, the cells from vacuum-based selenization showed improvement in performance compared to the cells from non-vacuum selenization. The process is further being improved to enhance the efficiency, which can pave way towards environmentally friendly low-cost solar cells.


Current biomarker-associated procedures of cancer modeling-a reference in the context of IDH1 mutant glioma.
Isocitrate dehydrogenases (IDH1/2) are central molecular markers for glioblastoma. Providing in vitro or in vivo models with mutated IDH1/2 can help prepare facilities to understand the biology of these mutated genes as glioma markers, as well as help, improve therapeutic strategies. In this review, we first summarize the biology principles of IDH and its mutations and outline the core primary findings in the clinical context of neuro-oncology. Given the extensive research interest and exciting developments in current stem cell biology and genome editing, the central part of the manuscript is dedicated to introducing various routes of disease modeling strategies of IDH mutation (IDHMut) glioma and comparing the scientific-technological findings from the field using different engineering methods. Lastly, by giving our perspective on the benefits and limitations of patient-derived and donor-derived disease modeling respectively, we aim to propose leading research questions to be answered in the context of IDH1 and glioma.


Tropical forest soils serve as substantial and persistent methane sinks.
Although tropical forest soils contributed substantially global soil methane uptake, observations on soil methane fluxes in tropical forests are still sparse, especially in Southeast Asia, leading to large uncertainty in the estimation of global soil methane uptake. Here, we conducted two-year (from Sep, 2016 to Sep, 2018) measurements of soil methane fluxes in a lowland tropical forest site in Hainan island, China. At this tropical forest site, soils were substantial methane sink, and average annual soil methane uptake was estimated at 2.00 kg CH4-C ha-1 yr-1. The seasonality of soil methane uptake showed strong methane uptake in the dry season (-1.00 nmol m-2 s-1) and almost neutral or weak soil methane uptake in the wet season (-0.24 nmol m-2 s-1). The peak soil methane uptake rate was observed as -1.43 nmol m-2 s-1 in February, 2018, the driest and coolest month during the past 24 months. Soil moisture was the dominant controller of methane fluxes, and could explain 94% seasonal variation of soil methane fluxes. Soil temperature could not enhance the explanation of seasonal variation of soil methane fluxes on the top of soil moisture. A positive relationship between soil methane uptake and soil respiration was also detected, which might indicate co-variation in activities of methanotroph and roots and/or microbes for soil heterotrophic respiration. Our study highlights that tropical forests in this region acted as a methane sink.


The effect of methylphenidate on urinary catecholamine excretion in hyperactivity: a partial replication.
Children with attention deficit disorder with hyperactivity were treated with methylphenidate HCl (0.74 +/- 0.2 mg/kg/day) for 2 weeks in an open trial to assess changes in the urinary excretion of catecholamines and behavior. The purpose of this study was to confirm earlier work that methylphenidate has a distinctly different effect on urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) excretion as compared to earlier studies with dextroamphetamine. Results confirmed the earlier finding that methylphenidate does not significantly change urinary MHPG excretion. No significant relationship was found between behavioral change and any of the urinary catecholamines or metabolites measured.


Phosphate-induced activation of VEGFR2 leads to caspase-9-mediated apoptosis of hypertrophic chondrocytes.
Low circulating phosphate (Pi) leads to rickets, characterized by expansion of the hypertrophic chondrocytes (HCs) in the growth plate due to impaired HC apoptosis. Studies in HCs demonstrate that Pi activates the Raf/MEK/ERK1/2 and mitochondrial apoptotic pathways. To determine how Pi activates these pathways, a small-molecule screen was undertaken to identify inhibitors of Pi-induced ERK1/2 phosphorylation in HCs. Vascular endothelial growth factor receptor 2 (VEGFR2) was identified as a target. In vitro studies in HCs demonstrate that VEGFR2 inhibitors block Pi-induced pERK1/2 and caspase-9 cleavage. Like Pi, rhVEGF activates ERK1/2 and caspase-9 in HCs and induces phosphorylation of VEGFR2, confirming that Pi activates this signaling pathway in HCs. Chondrocyte-specific depletion of VEGFR2 leads to an increase in HCs, impaired vascular invasion, and a decrease in HC apoptosis. Thus, these studies define a role for VEGFR2 in transducing Pi signals and mediating its effects on growth plate maturation.


Tumor blush with intracranial extensions of carcinoma of the paranasal sinuses.
Two malignant intracranial tumors that originated in the paranasal sinuses are described. The patients in both cases were investigated for neurological disorders and had no relevant history of sinus disease. Cerebral angiography demonstrated tumor vascularity identical to meningioma.


[Acetylcholine-angiotensin interaction on the electric activity of teniae coli].
It was tested on guinea-pig "Taenia-Coli" the interaction between ATN II and Ach in order to elucidate if there is an antagonism or an independence in the action of the two substances. It was concluded that there is no antagonism but a certain degree of interference.


Subconjunctival bevacizumab for vascularized rejected corneal grafts.
We describe 3 patients who experienced corneal neovascularization following keratoplasty and were treated with a single subconjunctival injection of 2.5 mg bevacizumab. Although there was immediate regression of the corneal vascularization and haze, as well as improvement in the anterior chamber reaction, the effects were short-lived and starting from the second week, the corneal vessels began to progress. All 3 cases ended in permanent graft failure. The series suggests a possible role for bevacizumab in the management of graft rejection with vascularization.


The essential role of infection-detection technologies for malaria elimination and eradication.
Recent emphasis on malaria elimination and eradication (E&E) goals is changing the way that experts evaluate malaria diagnostic tools and tactics. As prevalence declines, the focus of malaria management is pivoting toward low-density, subclinical infections and geographically and demographically concentrated reservoirs. These and other changes present challenges and opportunities for innovations in malaria diagnostics aimed at meeting the needs of malaria elimination programs. Developing such technologies requires a review of the operational approaches to detecting malaria infections in areas of declining prevalence. Here we review recent research on epidemiology and biology related to malaria elimination and operational factors that influence E&E strategies. We further propose use-scenarios and a target product profile framework to define and prioritize the required attributes of infection-detection technologies.


[Forensic-medical significance of determination of concentration of water, potassium and sodium ions in diagnostics of infliction of sequences of stab-and-cut wounds].
The results of analyses of content of water, potassium and sodium ions by Yu. A. Medvedev's method (1988) in muscular tissue from damage region in experiment, are represented. These analyses make possible to determine sequences of stab-and-cut wounds inflicted at short time before death.


[Effect of sodium butyrate on apoptosis and stromal interaction molecule and Orai1 activity in human colon cancer HCT-116 cells in vitro].
To investigate the mechanism underlying sodium butyrate (NaB)-induced apoptosis of a human colon cancer cell line HCT-116. The apoptosis of HCT-116 cells induced by NaB was confirmed by hoechst33342 staining and AnnexinV+ PI assay. The changes in the intracellular localization of stromal interaction molecule (STIM1) and Orai1 following NaB treatment were detected by immunofluorescence technique. Western blotting was used to investigate the protein expression levels of STIM1 and Orai1. NaB induced apoptosis and caused translocation and colocalization of STIM1 and Orai1 in HCT-116 cells. The apoptosis of human colon cancer cells induced by NaB is correlated to the redistribution of STIM1 and Orai1.


Diagnostic performance of a dual-chamber cardioverter defibrillator programmed with nominal settings: a European prospective study.
Despite technologic developments, accurate discrimination of ventricular tachyarrhythmia from rapid rhythms of nonventricular origin remains a challenge. We sought to examine the sensitivity and specificity of a dual-chamber arrhythmia detection algorithm, the PARAD algorithm, incorporated in a dual-chamber implantable cardioverter defibrillator, the Defender (ELA Medical). All detailed tachycardia episodes (i.e., with stored atrial and ventricular channel markers and electrograms) retrieved from the Holter memory of the device were analyzed from 95 patients (86 men and 9 women; age 62 +/- 12 years) implanted with the Defender with the algorithm programmed at nominal settings. Over a follow-up of 15 +/- 8 months, 559 detailed sustained tachycardia episodes detected in the tachycardia zone were gathered in 62 patients. Of the 300 ventricular tachycardia (VT) episodes, 298 were appropriately classified as VT by the algorithm. Of the 259 supraventricular tachycardia (SVT) episodes, 231 were appropriately classified as SVT. In 8 patients, 28 episodes of SVT were misclassified as VT: 25 atrial fibrillation episodes (6 patients), 2 sinus tachycardia (1 patient), and 1 atrial tachycardia. Calculated sensitivity and specificity were 99.3% and 89.2% on a per episode basis and 99.8% (95% confidence interval: 97.8 to 100) and 91.6% (95% confidence interval: 86.0 to 97.3) on a per patient basis, respectively. In this selected population of patients, the PARAD algorithm was safe and reliable for detection of a wide spectrum of tachyarrhythmias. Its specificity was high, particularly with respect to sinus tachycardia detection, but it must be improved with respect to detection of atrial fibrillation.


General route from simple methyl, alkyl, and cycloalkyl arenes to polycyclic cyclopentenyl aryl derivatives. The CpFe(+) group as an activator and tag.
[reaction: see text] The CpFe(+) group activates the perallylation of the benzylic groups of arenes using KOH and allylbromide under ambient conditions. This reaction can be followed by ruthenium-catalyzed RCM metathesis using Grubbs' catalyst at room temperature to give polycyclic aromatic derivatives in high yields, and these products are easily separated from the catalyst by extraction using ether. Alternatively, the RCM metathesis can be best carried out in ionic liquids at 80 degrees C, and extraction using ether is then facile.


Real-time observation of temperature-dependent protein-protein interactions using real-time dual-color detection system.
This study examined the ability of a real-time dual-color detection system to allow direct observations of the kinetics of temperature-dependent protein-protein interaction at a single-molecule level. The primary target protein was an Alexa Fluor 488-labeled actin conjugate, which had been pre-incubated with an unlabeled rabbit anti-actin antibody (IgG). The complementary fluorescent protein was Alexa Fluor 633-labeled goat anti-rabbit IgG antibody, which interacts with the rabbit anti-actin antibody (IgG) bound to the Alexa Fluor 488-labeled actin conjugate. The individual protein molecules labeled with different fluorescent dyes in solution were effectively focused, interacted with the other protein molecules at 500 aM, and detected directly in real-time using the dual-wavelength (lambda(ex)=488 and 635 nm) laser-induced fluorescence detection system. The kinetics of the protein-protein interactions were examined at different temperatures (12-32 degrees C). At concentrations in the aM range, the number of bound complex molecules through the protein-protein interaction decreased gradually with time at a given temperature, and increased with decreasing temperature at a set time. A high concentration (above 500 pM) of the protein sample caused aggregation and nonspecific binding of the protein molecules, even though the protein molecules were not an example of complementary binding. The results demonstrated that the real-time kinetics of a protein-protein interaction could be analyzed effectively at the single-molecule level without any time delay using the real-time dual-color detection system.


Cloning and localisation of an avermectin receptor-related subunit from Haemonchus contortus.
Ivermectin is believed to exert its anthelminthic effects by binding to glutamate-gated chloride channels (Glu-Cl) and several cDNAs encoding subunits of Glu-Cl have been cloned from Caenorhabditis elegans. We report the cloning of cDNAs encoding a putative Glu-Cl subunit (HG4) from the parasite Haemonchus contortus. The HG4 cDNAs were isolated using RT-PCR and the sequence of the predicted polypeptide has 82% amino-acid identity with the C. elegans Glu-Cl beta subunit. Individual HG4 cDNAs showed up to 4% sequence variation at the nucleotide level, but the vast majority of these polymorphisms were translationally silent. A synthetic peptide corresponding to sequence near the N-terminus of the mature polypeptide was used to raise an antiserum that recognised the N-terminal domain of HG4 expressed in E. coli. Affinity purified antibodies reacted with motor neuron commissures in immuno-localisation studies: these commissures were limited to the anterior portion of the worms, from a region level with the nerve ring to just anterior of the vulva. Some possible nerve cord staining was also observed, but no expression of HG4 on pharyngeal muscle could be detected.


Ultralow oxygen treatment for control of Latrodectus hesperus (Araneae: Theridiidae) on harvested table grapes.
The spider Latrodectus hesperus Chamberlin & Ivie (Araneae: Theridiidae) was subjected to low and ultralow oxygen (ULO) treatments at different temperatures. Complete control of the spiders was achieved in 24-h ULO treatments with 0.5% O2 or lower at 1 degrees C and in a 24-h low oxygen (2%) treatment at 15 degrees C. Oxygen level and temperature greatly affected spider mortality. At 1 degrees C, as oxygen level was decreased from 2 to 0.5%, spider mortality increased from 0 to 100%. At 2% O2, as temperature was increased from 1 to 15 degrees C, spider mortality increased from 0 to 100%. Grape clusters from two table grape (Vitis spp.) cultivars, 'Thompson Seedless' and 'Flame Seedless', were subjected to the 24-h ULO treatment with 0.5% O2 at 1 degrees C. The ULO treatment had no negative effects on grape quality. Because of the relatively short treatment time, effectiveness at low storage temperature and the easily attained oxygen level, we conclude that the ULO treatment have good potential to be implemented commercially for control of black widow spiders on harvested table grapes.


Effectiveness of cognitive, developmental, and behavioural interventions for Autism Spectrum Disorder in preschool-aged children: A systematic review and meta-analysis.
Autism spectrum disorder (ASD) is characterised by significant impairment in social communication and the presence of restrictive and repetitive behaviour or interest. Intervention during early childhood could decrease ASD symptoms. We aimed to identify the most effective intervention based on cognitive, developmental, and behavioural approaches and the factors that impact the effectiveness of the intervention. We performed a systematic review and meta-analysis of existing interventions for ASD in preschool-aged children. Electronic databases were searched for related articles with randomised controlled trial (RCT) designs published between 2001 to 2015. Outcome measures were communication, behavioural and cognitive skills, reported as standardised mean differences (SMD) compared to a control group. A Random-effects model was utilised to calculate the pooled estimate effect. Between-study variability was also assessed. The registering number of this study is CRD42017035354. Out of the initial 5174 studies that were identified, there were 14 RCTs (746 children) that were included in the final systematic review and meta-analysis. Pooled estimate effect provided by random-effects model was 0.23 (95% confidence interval, CI [0.08-0.37]) with no between-study heterogeneity (I2 = 0.00%, p = 0.0018). Three studies of music therapy interventions provided the greatest outcome effects with a shorter duration and lower intensity. SMD for music therapies ranged from 0.40 to 0.62 with 95% CI [0.22 to 1.85]. The quality of the health care provider, the duration, and the intensity of intervention played an important role in the effectiveness of the intervention. Music therapy appears to be an effective tool for improving social interaction in preschool-aged children with ASD. However, more evidence-based trials are required to further validate the effectiveness of music therapy in ASD.


Photonic coherence effects from dual-waveguide coupled pair of co-resonant microring resonators: erratum.
This erratum reports a correction of a typographical error in the theoretical study of coupled optical microring resonators [Opt. Express23, 12573-12587 (2015)]. The results and conclusions of the published work remain valid.


Enterocutaneous fistula formation after cardiac transplantation due to injury from LVAD driveline migration.
A man in his early 20s with heart failure with reduced ejection fraction secondary to non-compaction cardiomyopathy (Titin (TTN) gene mutation positive) was transitioned from left ventricular assist device (LVAD) mechanical support to heart transplantation. Transplantation was successful; however, LVAD explantation resulted in innumerable complications secondary to penetration of the driveline into the peritoneal cavity. He developed an enterocutaneous fistula which led to concurrent malnutrition, poor wound healing, systemic infection, and allograft rejection in a patient less than 1 month after heart transplantation on immunosuppression.


Sex-specific relationship between visceral fat index and dyslipidemia in Chinese rural adults: The Henan Rural Cohort Study.
The study aimed to explore the relationship between visceral fat index (VFI) and dyslipidemia and evaluate the efficiency of VFI as a marker for identifying dyslipidemia in Chinese rural adults. The cross-sectional study recruited 35,832 aged 18-79 years eligible participants from The Henan Rural Cohort Study. VFI was measured by bioelectrical impendence methods and classified into sex-specific quartiles. Fasting blood samples were collected. Logistic regression models with VFI as a categorical variable and restricted cubic spline regression models with VFI as a continuous variable were performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Receiver-operating characteristic (ROC) curve was conducted to evaluate the identifying performance of VFI. The age-standardized prevalence of dyslipidemia was 29.80% and 26.01% in male and female, respectively. Increasing VFI quartiles were significantly positively related to the risk of dyslipidemia and its components (Pfor trend < 0.01). The adjusted ORs (95% CIs) for per 1-SD increase in VFI were 2.11 (2.02-2.20) and 1.52 (1.47-1.56) in male and female, respectively, and dose-response relationships were observed in both genders (Pfor nonlinearity < 0.01). In addition, area under the curves (AUCs) in male (0.697) was larger than in female (0.655) (P < 0.05). VFI was significantly positively related to the risk of dyslipidemia and its components, and the risk was shown to be more prominent in male. Meanwhile, dose-response relationships were observed in both genders. Furthermore, VFI might be a relatively effective marker for identifying dyslipidemia in male, but not in female.


[Impact of pelvic floor muscle training on prevention of perineal pain and dyspareunia in postpartum].
Assessing the impact of perineal rehabilitation and massage on perineal pain and dyspareunia in the postpartum period, between 15days and 12months after delivery. We conducted an exhaustive review of the literature concerning pelvic floor rehabilitation in the postpartum between 1987 and May 2015, grading data by levels of evidence (LOE) according to the methodology recommendations for clinical guidelines. Pelvic floor rehabilitation in the postpartum is not associated with a decreased prevalence of perineal pain and dyspareunia at 1year (LOE3). The practice of digital perineal massage during the third trimester of pregnancy is not associated with decreased prevalence at 3-month postpartum of perineal pain or dyspareunia (RR=0.64; 95% CI [0.39-1.08] and RR=0.96; 95% CI [0.84-1.08], respectively), except for women who have delivered vaginally (RR=0.45; 95% CI [0,24-0.87]) (LOE2). The practice of digital perineal massage or application of warm packs in the second stage of labor does not reduce perineal pain (RR=0.93; 95% CI [0.66-1.32]) or dyspareunia (RR=0.99; 95% CI [0.74-1.34]) at 3-month postpartum (LOE2). There is no evidence of long-term benefit of perineal rehabilitation and perineal massage on perineal pain and dyspareunia in the year following childbirth. Further studies are needed to accurately assess the impact of therapeutic strategies proposed in France.


Three new antimicrobial peptides from the scorpion Pandinus imperator.
Three novel cysteine-free venom peptides, which were referred to as Pantinin-1, Pantinin-2 and Pantinin-3, respectively, have been identified from the scorpion Pandinus imperator by cDNA cloning strategy. The precursor of each peptide consists of a signal peptide, a mature peptide with no disulfide bridges, and an acidic propeptide with a typical processing signal. Each of the three peptides is an α-helical, cationic and amphipathic molecule with 13 or 14 amino acid residues. Their amino acid sequences are homologous to those of some 13-mer antimicrobial peptides isolated from scorpions. Antimicrobial assay showed that all the three peptides possess relatively strong activities against Gram-positive bacteria and a fungus, but have very weak antimicrobial activities against Gram-negative bacteria. Toxicity assay showed that the three peptides exhibit very low or mild hemolytic activities against human red blood cells. It is interesting to see that Pantinin-3 is able to potently inhibit the growth of vancomycin-resistant Enterococcus (VRE) S13, a pathogen that can cause a number of human infections; this suggests that Pantinin-3 has great potential to be applied in the treatment of VRE infections. Our findings gain new insights into the structure/function relationships of the small linear cationic antimicrobial peptides from scorpions, and provide new templates for designing of antimicrobial agents targeting antibiotic-resistant pathogenic bacteria.


Loss of cytochrome P450 (CYP)1B1 mitigates hyperoxia response in adult mouse lung by reprogramming metabolism and translation.
Oxygen supplementation is life saving for premature infants and for COVID-19 patients but can induce long-term pulmonary injury by triggering inflammation, with xenobiotic-metabolizing CYP enzymes playing a critical role. Murine studies showed that CYP1B1 enhances, while CYP1A1 and CYP1A2 protect from, hyperoxic lung injury. In this study we tested the hypothesis that Cyp1b1-null mice would revert hyperoxia-induced transcriptomic changes observed in WT mice at the transcript and pathway level. Wild type (WT) C57BL/6J and Cyp1b1-null mice aged 8-10 weeks were maintained in room air (21% O2) or exposed to hyperoxia (>95% O2) for 48h. Transcriptomic profiling was conducted using the Illumina microarray platform. Hyperoxia exposure led to robust changes in gene expression and in the same direction in WT, Cyp1a1-, Cyp1a2-, and Cyp1b1-null mice, but to different extents for each mouse genotype. At the transcriptome level, all Cyp1-null murine models reversed hyperoxia effects. Gene Set Enrichment Analysis identified 118 hyperoxia-affected pathways mitigated only in Cyp1b1-null mice, including lipid, glutamate, and amino acid metabolism. Cell cycle genes Cdkn1a and Ccnd1 were induced by hyperoxia in both WT and Cyp1b1-null mice but mitigated in Cyp1b1-null O2 compared to WT O2 mice. Hyperoxia gene signatures associated positively with bronchopulmonary dysplasia (BPD), which occurs in premature infants (with supplemental oxygen being one of the risk factors), but only in the Cyp1b1-null mice did the gene profile after hyperoxia exposure show a partial rescue of BPD-associated transcriptome. Our study suggests that CYP1B1 plays a pro-oxidant role in hyperoxia-induced lung injury.


Formalin-preserved zooplankton are not reliable for historical reconstructions of methylmercury bioaccumulation.
Time-series measurements of methylmercury (MeHg) concentrations in short-lived planktic animals, such as copepods, could allow for an evaluation of mercury (Hg) inputs and transferability to organisms in marine environments. If reliable, MeHg measurements in formalin-preserved marine animals could offer insights into past environmental MeHg levels. In the present study, we examined whether the amount of MeHg changed over time in formalin-preserved copepods for two species, Acartia tonsa, and Temora longicornis. Over a 51 (A. tonsa) and 7 (T. longicornis) week incubation, we found significant changes in MeHg content in both copepods, while the timing of these changes differed between species. Furthermore, we investigated the mechanism behind these temporal changes through a separate incubation experiment of formalin spiked with two levels of organic matter (OM), and stable-isotope-enriched Hg tracers. We found that the methylation of an inorganic 199Hg tracer was significantly higher in OM-enriched solutions in comparison to a control seawater-formalin solution. Our results suggest that formalin-preserved copepods are not fit for studies of past trends due to ongoing and unpredictable abiotic transformations of Hg in chemically preserved animal tissue.


Covariate Adjustment in Chronic Pain Trials: An Oft-Missed Opportunity.
Self-reported pain intensity, frequently used as an outcome in randomized clinical trials (RCTs) of chronic pain, is often highly variable and could be associated with multiple baseline factors. Thus, the assay sensitivity of pain trials (ie, the ability of the trial to detect a true treatment effect) could be improved by including prespecified baseline factors in the primary statistical model. The objective of this focus article was to characterize the baseline factors included in statistical analyses of chronic pain RCTs. Seventy-three RCTs published between 2016 and 2021 that investigated interventions for chronic pain were included. The majority of trials identified a single primary analysis (72.6%; n = 53). Of these, 60.4% (n = 32) included one or more covariates in the primary statistical model, most commonly baseline value of the primary outcome, study site, sex, and age. Only one of the trials reported information regarding associations between covariates and outcomes (ie, information that could inform prioritization of covariates for prespecification in future analyses). These findings demonstrate inconsistent use of covariates in the statistical models in chronic pain clinical trials. Prespecified adjustments for baseline covariates that could increase precision and assay sensitivity should be considered in future clinical trials of chronic pain treatments. PERSPECTIVE: This review demonstrates inconsistent inclusion and potential underutilization of covariate adjustment in analyses of chronic pain RCTs. This article highlights areas for possible improvement in design and reporting related to covariate adjustment to improve efficiency in future RCTs.


Flow Cytometric Analysis and Sorting of Plant Chromosomes.
Flow cytometry offers a unique way of analyzing and manipulating plant chromosomes. During a rapid movement in a liquid stream, large populations can be classified in a short time according to their fluorescence and light scatter properties. Chromosomes whose optical properties differ from other chromosomes in a karyotype can be purified by flow sorting and used in a range of applications in cytogenetics, molecular biology, genomics, and proteomics. As the samples for flow cytometry must be liquid suspensions of single particles, intact chromosomes must be released from mitotic cells. This protocol describes a procedure for preparation of suspensions of mitotic metaphase chromosomes from meristem root tips and their flow cytometric analysis and sorting for various downstream applications.


Impact of the COVID-19 pandemic on the incidence of healthcare-associated Clostridioides difficile infection in a tertiary healthcare facility in the Republic of Ireland.
Clostridioides difficile is the foremost cause of nosocomial infectious diarrhoea and one of the most prevalent healthcare associated infections (HAIs). To investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the incidence of healthcare associated C. difficile infection (HA-CDI). A retrospective study was conducted from January 2019-December 2022 inclusive at a tertiary University Hospital in Dublin, Ireland. The study period was divided into COVID-19 and non-COVID-19 periods determined in tangent with the then national incidences of COVID-19 and number of hospitalized patients with COVID-19. Analyses looked at quantity of testing performed, incidence rates and antimicrobial consumption. An independent samples t-test was used to determine significance between groups. Between COVID-19 and non-COVID-19 periods, no statistically significant difference was observed among HA-CDI rates per 10,000 bed-days (2.1 cases vs 1.76 cases; P=0.34), consumption of defined daily doses per 100 bed-days of antimicrobials - all antimicrobials (83.36 vs 89.5; P=0.091), fluoroquinolones only (3.71 vs 4.46; P=0.067), third-generation cephalosporins only (4.17 vs 4.43; P=0.449), carbapenems only (3.28 vs 3.26; P=0.944) - or the number of C. difficile tests performed per 10,000 bed-days (321.81 tests vs 326.63 tests; P=0.696). There was no difference in the incidence rates of HA-CDI between COVID-19 and non-COVID-19 periods at our institution.


[The true error and the attributed error: analysis of the causes and remedies from specimen collection to response].
After a brief definition of accidental, systematic error and blunder, the AA. analyse the causes and remedies of the error, before and during the laboratory stage. During the latter they analyse the manual and automatic steps of the tests. The AA. conclude that the modern laboratory is a very efficient and sometimes resolving means in order to formulate a diagnosis. It's not the diagnosis.


Generation of genetically modified mice by oocyte injection of androgenetic haploid embryonic stem cells.
Haploid cells are amenable for genetic analysis. Recent success in the derivation of mouse haploid embryonic stem cells (haESCs) via parthenogenesis has enabled genetic screening in mammalian cells. However, successful generation of live animals from these haESCs, which is needed to extend the genetic analysis to the organism level, has not been achieved. Here, we report the derivation of haESCs from androgenetic blastocysts. These cells, designated as AG-haESCs, partially maintain paternal imprints, express classical ESC pluripotency markers, and contribute to various tissues, including the germline, upon injection into diploid blastocysts. Strikingly, live mice can be obtained upon injection of AG-haESCs into MII oocytes, and these mice bear haESC-carried genetic traits and develop into fertile adults. Furthermore, gene targeting via homologous recombination is feasible in the AG-haESCs. Our results demonstrate that AG-haESCs can be used as a genetically tractable fertilization agent for the production of live animals via injection into oocytes.


Measuring Enzyme Kinetics of Glycoside Hydrolases Using the 3,5-Dinitrosalicylic Acid Assay.
Use of the 3,5-dinitrosalicylic acid reagent allows the simple, rapid quantification of reducing sugars. The method can be used for analysis of biological samples or in characterization of enzyme reactions, as new reducing ends are generated when a polysaccharide substrate undergoes hydrolytic cleavage. Presented here is an application of the method in measuring the kinetics of a glycoside hydrolase reaction, including the optimization of the DNSA reagent, and the production of a standard curve of absorbance versus sugar concentration.


Endothelial function in patients with sickle cell anemia during and after sickle cell crises.
Prior studies have demonstrated increased adherence of sickle cell erythrocytes to vascular endothelial cells. While decreased production of nitric oxide and increased production of adhesion molecules have been implicated in this pathophysiology, the relative contribution of these mechanisms during acute sickle cell crises as compared to steady state conditions have not been elucidated. We studied 10 consecutive young adult patients presenting with a sickle cell crisis. Endothelial function was evaluated by a non-invasive brachial artery shear stress method. Serum levels of adhesion molecules were obtained during the crisis. Both brachial artery responsiveness and serum levels of adhesion molecules were then repeated at steady state. Ten age and gender matched volunteers served as a control group. Impaired endothelial function and impaired endothelium-independent vasodilatation were observed in all sickle cell patients during both steady state and during crisis. Flow mediated dilation (FMD)% was 3.25+/- 2.76% during crisis, 4.57+/- 4.11 at steady state, compared with the control group FMD of 11.64+/- 7.69% (p< 0.001). Flow independent dilation was 10.35+/- 11.3% during crisis, 10.03+/- 6.52% at steady state, compared with control group FID of 24.17+/- 11.87% (p< 0.001). Levels of cell adhesion molecules and markers of inflammation were increased in sickle cell crisis patients compared with the control group: sCD40 ligand levels during the acute crisis were over twice the level of normal matched volunteers (p=0.02), and similarly significant increases were seen for E-selectin (p=0.008), ICAM-1 (p=0.037) and VCAM-1 levels (p=0.01). The levels of each of these biomarkers was not significantly increased during acute crises as compared to patients' recovery state. Sickle cell anemia patients have severe systemic endothelial dysfunction as demonstrated by both brachial artery assessment and increased serum levels of adhesion molecules. These abnormalities characterize not only the sickle cell crisis but also the steady state pathophysiology of sickle cell anemia.


Endoscopic resections of glottic and supraglottic carcinomas with the CO2 laser.
Clinical experiences with transoral CO2 laser resections of glottic and supraglottic carcinomas are presented. 47 patients with variously sized supraglottic tumors and 114 patients with early glottic cancers were treated at the University of Kiel from 1979 to 1993. Although 10 patients with glottic tumors developed recurrences, curative treatment was possible with either repeat laser surgery (3 cases), irradiation (3 cases) or salvage laryngectomy (3 cases). One patient refused further treatment. Among the 30 patients with supraglottic lesions treated for cure 18 are currently alive and free of disease. 6 patients died with no evidence of disease, 2 patients died from secondary malignancies and 3 patients succumbed to their tumors. Present findings justify routine use of laser resections of laryngeal neoplasms, although patients must still be carefully selected for treatment.


Educating families and caretakers of traumatically brain injured patients in the new health care environment: a three phase model and bibliography.
Shorter inpatient stays for traumatically brain injured patients frequently allow less time for comprehensive education of families and caretakers. What is needed to compensate for the shortened duration of brain injury rehabilitation in many settings is a family educational programme that (1) satisfies the family's acute information needs as they arise, and (2) standardizes the delivery of information so that certain knowledge criteria are met. The following article proposes a three phase model of family and caretaker education with an accompanying bibliographical index.


Gunshots through laminated glass: expelled compounded fragments as a function of bullet type.
In the frame of an experimental setting, the formation of round-shaped compounded glass fragments on the exit site after gunshots through a windshield was examined. For that purpose, a 9 × 19 mm pistol (HK P30) and two different cartridges containing (a) a full metal jacketed round-nosed projectile and (b) a deformation projectile were used. On the basis of 52 gunshots, the morphology, impact angles and terminal ballistics of occurring compounded glass fragments were examined. The results showed that the compounded glass fragments' morphology allowed for the differentiation of two used projectiles. Fragments were able to cause round-shaped defects in a single cotton layer (T-shirt) with subsequent penetration of up to 2.4 cm into ballistic gelatin (10%, 4 °C). As a function of the projectile type, the compounded glass fragments showed different reproducible impact angles that differed notably from the known conical pattern of expelled glass fragments after bullet penetration. These findings might help to explain the atypical morphology of gunshot wounds with laminated glass as an intermediate target and prevent possible misinterpretations when reconstructing the sequence of events.


[Trendy inline skating sports. Pattern of injuries and groups at risk].
One hundred and eighty-two patients presented with 200 inline-skating injuries over a 30-month period. Of these, 14% were admitted to hospital, 10% required operative treatment. Fractures (49%), contusions/lacerations (27%) and capsular/ligamentuous injuries (16%) were the most prevalent types of injury. Children had an even higher risk of sustaining fractures (62%). Falling on the extended arm caused 44% of all injuries. Thirteen percent resulted from torque mechanisms of the leg, whereas direct trauma to elbow or knee (5% each) were uncommon injury mechanisms. Injuries of the elbow, forearm, wrist and hand accounted for 55.5% of all cases and 71% of all fractures. Head (13%), knee (9.5%) and ankle (9%) were other regions frequently involved. Protective equipment was often used only for uninjured regions, whereas the injured regions had most often been left unprotected.


White blood cell-reactive antibodies are undetectable in solvent/detergent plasma.
Transfusion-related acute lung injury (TRALI) is a life-threatening complication of transfusion. Although all types of blood products have been associated with TRALI, fresh-frozen plasma (FFP) is the most commonly implicated component. It has been postulated that TRALI is an immune-mediated event, because white blood cell (WBC)-reactive antibodies in the donor's plasma are frequently associated with the syndrome. In contrast to single donor-derived FFP, solvent/detergent (S/D) plasma is produced from multiple donations, leading to an at least 500-fold dilution of a single plasma unit. It was hypothesized that WBC-reactive antibodies are undetectable in S/D FFP. Twenty batches of S/D FFP (5 of each ABH group) were analyzed with well-established routine techniques to detect WBC antibodies. All samples tested negative for granulocyte-specific as well as HLA Class I and Class II antibodies. Different strategies to reduce the risk of TRALI are currently discussed. These include screening of all potentially immunized donors for WBC-reactive antibodies and exclusion of multiparous or all women from donating FFP. Here, it is demonstrated that neither granulocyte- nor lymphocyte-reactive antibodies are detectable in S/D FFP. Thus, S/D FFP may represent a potential alternative to reduce the risk of TRALI associated with the transfusion of FFP.


Results of surgical treatment for thymoma based on 66 patients.
Sixty-six patients with thymoma have undergone surgical treatment since 1965 and have been assessed from the viewpoint of clinical manifestations and prognosis. Thirty-one patients with encapsulated thymoma were treated with total surgical resection alone, and they had no postoperative tumor recurrence. With the exception of one patient who died of respiratory insufficiency on the fourth day after the operation, 34 patients with invasive thymoma were evaluated on the basis of their postoperative prognosis. Fifteen patients with invasive thymoma died from 1 1/2 months to 10 years, 1 month postoperatively; 9 died of local or metastatic tumor and 6 died of other diseases. Associated autoimmune diseases, as well as the invasive tendency of the tumors, apparently affected the prognosis. Ten-year survival rates of the patients who underwent surgical treatment were as follows: 61.6% for the total group, 74.3% for those with encapsulated thymoma, and 49.4% for those with invasive thymoma. In the surgical treatment for invasive thymomas, one should aim to resect the tumor totally, even though adjacent tissues are resected simultaneously. Even for the patient with total resection of invasive tumor, postoperative radiation should be required. Finally, if residual tumor must be left during the operation, postoperative radiation as well as anticancer chemotherapy should be aggressively scheduled, because postoperative distant metastasis may appear in these patients with residual thymoma.


Cofractionation of HeLa cell replication proteins with ors-binding activity.
Ors (origin enriched sequence) 8 is a mammalian autonomously replicating DNA sequence previously isolated by extrusion of nascent monkey (CV-1) DNA in early S phase. A 186 bp fragment of ors 8 has been identified as the minimal sequence required for origin function, since upon its deletion the in vivo and in vitro replication activity of this ors is abolished. We have fractionated total HeLa cell extracts on a DEAE-Sephadex and then on a Affi-Gel Heparin column and identified a protein fraction that interacts with the 186 bp fragment of ors 8 in a specific manner. The same fraction is able to support the in vitro replication of ors 8 plasmid. The ors binding activity (OBA) present in this fraction sediments at approximately 150 kDa in a glycerol gradient. Band-shift elution experiments of the specific protein-DNA complex detect by silver-staining predominantly two protein bands with molecular weights of 146 kDa and 154 kDa, respectively. The fraction containing the OBA is also enriched for polymerases alpha and delta, topoisomerase II, and replication protein A, (RP-A).