Challenges in physiotherapy of managing respiratory diseases in elderly population.
Lung function is a convincing prognosticator of longevity. With advancing age, there are many irreversible functional and anatomic changes in the body, making elderly susceptible to disease processes. As people age, the respiratory system experiences a number of anatomical, physiological, and immunological changes, predisposing risk of many chronic lung diseases (CLDs). Respiratory tract infections, TB, chronic obstructive pulmonary disease (COPD), and interstitial pulmonary disease are examples of common respiratory diseases (CRDs). The risk factors are mainly smoking, exposure to air pollution both indoors and outdoors, allergies, occupational exposure, poor diet, obesity, inactivity. Between 25 and 80 years the lung function and aerobic capacity each decline by ∼40% limiting physical function and promoting multimorbidity. In elderly, skeletal muscle dysfunction causes age-related multifactorial health disorders such sarcopenia and frailty, a recognised symptom of chronic respiratory disease. This perspective article highlights the importance of pulmonary physiotherapy in elderly with chronic lung disease and other chronic respiratory disorders. Common symptoms frequently experienced are dyspnoea, fatigue, decreased exercise tolerance, peripheral muscle dysfunction, and mental disturbances. An individual's symptoms, physical functioning, quality of life (QoL), hospitalisation, and morbidity goals are all addressed by a pulmonary rehabilitation programme (PRP). Pulmonary physiotherapy, an extensive patient-tailored intervention as exercise training, education, and life style modification is prescribed on the basis of a thorough personalised assessment. Through pulmonary physiotherapy, the goal is to restore the quality of life of elderly with chronic respiratory diseases and to encourage their long-term adherence to health-improving behaviour. The older patients learn to accept and overcome the reality of their illness rather than sticking to its limits. Multidisciplinary approach with a customized and comprehensive program makes the difference between living a fulfilling life and living a life with pulmonary disabilities.


Photodynamic therapy in the treatment of persistent central serous chorioretinopathy: a two-year follow-up.
The aim of this study was to assess during a follow-up period of two years the efficacy and safety of photodynamic therapy (PDT) in central serous chorioretinopathy (CSC) showing no spontaneous resolution four months after the onset of the symptoms. We present a prospective interventional non-comparative case series. The diagnosis of CSC was confirmed by fluorescein angiography (FA), and optical coherence tomography (OCT) in 46 eyes of 42 consecutive patients. PDT was performed according to the protocol used for treating choroidal neovascularization in age-related macular degeneration. The primary end point was to assess the anatomic re-attachment of the retina. The secondary end point was to record the visual function. A paired t-test and a linear regression and correlation test were used for the statistics. The leakage in FA and the detachment of the neurosensory retina in OCT were no longer present in 42 eyes six weeks after PDT and in the remaining four eyes three months after PDT. At the end of the follow-up, the best-corrected visual acuity measured with an ETDRS chart improved in 36 eyes, and remained stable in 10 eyes (mean improvement, 10.2 letters; p < 0.001). Two cases of recurrence were diagnosed. No treatment-related complications were noticed. PDT could be an effective and durable option for treating patients with persistent CSC.


The fate of long-standing intraperitoneal gallstone in the rat.
Gallstones are occasionally spilled into the peritoneal cavity during open and laparoscopic cholecystectomy. Using the rat model, we investigated the long term effect of such retained intraperitoneal gallstones. During a follow-up period of one year, no systemic deleterious outcome could be attributed to the presence of the implanted gallstones except for mild local effects. Based on the rat model we conclude that reasonable effort should be made in order to retrieve an escaped gallstone, but there is no justification whatsoever for a conversion of the laparoscopic procedure to an open laparotomy only for the purpose of retrieving a lost stone.


Efficacy of midtrimester short cervix interventions is conditional on intraamniotic inflammation.
Midtrimester ultrasound is a valuable method for identifying asymptomatic women at risk for spontaneous preterm delivery (PTD). However, response to various treatments (cerclage, progestogen) has been variable in the clinical setting. It remains unclear how other biomarkers may be used to guide intervention strategies. We applied an amniotic fluid inflammatory scoring system to determine if the degree of inflammation is associated with intervention efficacy in patients with midtrimester short cervix. Women carrying a singleton fetus between 16-24 weeks' gestation with a short cervix (≤25 mm) on transvaginal ultrasound underwent amniocentesis and were assigned to McDonald cerclage, no cerclage, or weekly 17-alpha hydroxyprogesterone caproate (17OHP-C). Our previously described inflammatory risk score (comprised of 14 inflammatory markers) was used to classify patients as high (score ≥8) or low (score <8) risk for inflammation. Gestational age at delivery was compared for each intervention and risk score status. Risk of delivering as a function of the remaining gestation was evaluated using modified Cox proportional hazards models with incorporation of methods to account for both left and right truncation bias. Ninety patients were included: 24 were in the nonintervention control group, 51 received cerclage, and 15 received 17OHP-C. Inflammation status at time of sampling influenced the efficacy of the treatment (P < .001). Compared to the nonintervention control group, in patients with low inflammation (score < 8), both cerclage (adjusted hazard ratio [HR], 2.86; 95% confidence interval [CI], 1.28-6.37) and 17OHP-C (HR, 3.11; 95% CI, 1.04-9.30) were associated with increased hazard of PTD. In contrast, in patients with high inflammation (score ≥8) both cerclage (HR, 0.22; 95% CI, 0.08-0.65) and 17OHP-C (HR, 0.20; 95% CI, 0.05-0.81) were associated with lower hazard of delivering preterm. Cerclage placement or administration of 17OHP-C therapy for midtrimester short cervix for PTD prevention appears beneficial only in the subset of patients with high inflammation. Knowledge of the amniotic fluid inflammatory status may aid in guiding the appropriate therapy for women presenting with midtrimester short cervix who are at increased risk of PTD.


Applications of bioluminescence- and fluorescence resonance energy transfer to drug discovery at G protein-coupled receptors.
Bioluminescence (BRET)- and fluorescence resonance energy transfer (FRET) techniques have become integral approaches in studies of protein-protein interactions in living cells. They rely on non-radiative transfer of energy between donor and acceptor species that can be appended to the proteins of interest. These techniques display exquisite dependence on distance and orientation between the energy transfer partners. This means they are well suited to measure both small conformational changes in response to ligand binding between partner proteins that remain within a complex or more extensive translocations of proteins between cellular compartments that occur in response to cellular challenge. Introduction of both energy donor and acceptor into a single polypeptide can also allow the detection of ligand-induced conformational switches in monomeric proteins in the millisecond time scale. Many of these approaches are amenable to high throughput screening and the drug discovery process. G protein-coupled receptors (GPCRs) represent a key drug target class. Specific applications of resonance energy transfer techniques to the identification of ligands for this class of protein are highlighted to illustrate general principles.


Management of traumatic hemipelvectomy through ERAS pathway: A case report.
Traumatic hemipelvectomy is a rare but life-threatening injury that involves separation of the pelvic ring from pubic symphysis usually results from high energy trauma and associated with other injuries. In this report, we describe a case of traumatic hemipelvectomy, who presented in hemorrhagic shock associated with other injuries such as: right groin injury with limitation of passive movement of right hip and knee joint, left pelvic visceral protruded out, and wrapped by peritoneum, all of the vulva and anal tear, lumbar vertebrae transverse process fracture. Traumatic hemipelvectomy. The patient was managed through enhanced recovery after surgery (ERAS) pathway with multidisciplinary coordination. Patient was able to walk with prosthesis or crutch, with associated injuries managed appropriately. The course was complicated with hemorrhagic shock and infection which were dealt promptly, with good recovery. In our case, the multimodal management through ERAS path has helped decrease stress level, decrease complication, decrease morbidity, decrease the length of stay in the hospital, and aid in faster recovery.


Potential impacts of ballast water regulations on international trade, shipping patterns, and the global economy: An integrated transportation and economic modeling assessment.
Global ballast water management regulations aiming to decrease aquatic species invasion require actions that can increase shipping costs. We employ an integrated shipping cost and global economic modeling approach to investigate the impacts of ballast water regulations on bilateral trade, national economies, and shipping patterns. Given the potential need for more stringent regulation at regional hotspots of species invasions, this work considers two ballast water treatment policy scenarios: implementation of current international regulations, and a possible stricter regional regulation that targets ships traveling to and from the United States while other vessels continue to face current standards. We find that ballast water management compliance costs under both scenarios lead to modest negative impacts on international trade and national economies overall. However, stricter regulations applied to U.S. ports are expected to have large negative impacts on bilateral trade of several specific commodities for a few countries. Trade diversion causes decreased U.S. imports of some products, leading to minor economic welfare losses.


Aflatoxin B1 in chilies from the Punjab region, Pakistan.
The occurrence of aflatoxin B1 (AFB1) in chilies from Pakistan was determined by using HPLC in work undertaken in Pakistan. Whole (n = 22) and powdered (n = 22) chilies were analyzed. Sixteen (73.0%) and 19 (86.4%) samples of whole and ground chilies, respectively, were contaminated. The mean concentration in powdered chilies (32.20 μg/kg) was higher statistically than in whole chilies (24.69 μg/kg). Concentrations ranged from 0.00 to 89.56 μg/kg for powdered chilies, compared with 0.00-96.3 μg/kg for whole chilies. The limits of detection and quantification were 0.05 μg/kg and 0.53 μg/kg, respectively. The concentrations were high in general and greater than the statutory limit set by the European Union. There is considerable scope for improvements in chili production in Pakistan.


A novel seasonal-spatial integrated model for improving the economic-environmental performance of crop production.
Excess agricultural nitrogen, mainly from manure and chemical fertilizers, is a primary source of nutrient pollution and presents serious environmental threats to natural ecosystems and human health. Improvements in nitrogen-use efficiency in crop production are critical for addressing the triple challenge of food insecurity, environmental degradation, and climate change. Approaches such as sustainable intensification that stress technological innovations have received the most attention. But science-based cropland use planning, a promising complementary approach, has so far been largely overlooked. Here we develop a spatially integrated economic-ecological modeling method to assess this previously unexplored potential for improving the economic-environmental performance of crop production by examining the seasonal and spatial implications of cropland and fertilizer use in Bangladesh. In doing so, we aim to make the modeling method accessible to researchers and practitioners interested in achieving the dual goal of food production and environmental sustainability for countries that are characterized by seasonal and spatial variations in crop mix and cropping practices.-The modeling method combines economic and ecological models to explore trade-offs between food security and environmental sustainability.-The modeling method considers both spatial and seasonal dimensions when measuring trade-offs.-The modeling method is highly suitable for adaptation to study topics concerning food security-ecosystem service trade-offs or to inform the design of related models.


Daphwazirin, biscoumarin glycopyranoside from Daphne oleoides.
Daphwazirin, a new biscoumarin glycoside (1), along with four known compounds (2), (3), (4) and (5) has been isolated from the roots of Daphne oleoides. Its chemical structure is established as 7-hydroxy-8-[2-oxo-2H-1-benzopyran-7'-(O-alpha-L-rhamnosyl)-6'-yl]-2H-1-benzopyran-2-one through spectroscopic techniques and chemical analysis.


Thymidine phosphorylase expression correlates with malignant potential and anti-tumor effect of doxifluridine on gastric cancer: multivariate analysis for adjuvant chemotherapy doxifluridine vs. 5-fluorouracil.
Doxifluridine (5'-DFUR) is an anticancer drug converted to 5-fluorouracil (5-FU) by thymidine phosphorylase (TP). TP is an angiogenetic and platelet-derived endothelial cell growth factor. We evaluated the relation between TP expression and chemotherapeutic efficacy and prognosis for gastric cancer. Advanced gastric cancer patients given oral adjuvant chemotherapeutics either 5'-DFUR; 163 patients or 5-FU; 162 patients were examined. TP expression was assessed with immunohistochemical staining. Multivariate analysis for influencing survival was done, employing variables such as gender, age, procedure, tumor size, location, Borrmann type, histologic factors [type, depth of invasion, lymph node metastasis (n), lymphatic invasion (ly), and venous invasion (v)], drug administered, and TP expression. In the patients with serosal invasion, 5'-DFUR in TP positive was an independent prognostic factor (risk ratio, 4.450; 95% confidence limit, 2.099-9.436), indicating significantly improved prognosis over the 5-FU group. In TP negative, n and ly were independent prognostic factors, but the survival curves of the two chemotherapeutic groups were not significantly different. TP expression was not prognostic factor in 5'-DFUR group, while, in 5-FU group, TP expression was an independent prognostic factor (2.834, 1.467-5.476). In conclusion, it was suggested that TP positive gastric cancer with serosal invasion increased malignant potential of the tumor and 5'-DFUR efficacy.


Correction: Synergistic Effect of Perineural Dexamethasone and Dexmedetomidine (Dex-Dex) Prolong Analgesic Effect of a Preoperative Interscalene Block.
[This corrects the article DOI: 10.7759/cureus.9473.].


Metabolism of the dimethyl ester of [2,3-(13)C]succinic acid in rat hepatocytes.
Hepatocytes prepared from overnight fasted rats were incubated for 120 min in the presence of the dimethyl ester of [2,3-(13)C]succinic acid (10 mM). The identification and quantification of 13C-enriched metabolites in the incubation medium were performed by a novel computational strategy for the deconvolution of NMR spectra with multiplet structures and constraints. The generation of 13C-labelled metabolites, including succinate, fumarate, malate, lactate, alanine, aspartate and glucose accounted for about half of the initial amount of the ester present in the incubation medium. A fair correlation was observed between the experimental abundance of each 13C-labelled glucose isotopomer and the corresponding values derived from a model for the metabolism of [2,3-(13)C]succinate. Newly formed glucose was more efficiently labelled in the carbon C5 than C2, as well as the carbon C6 than C1, supporting the concept that D-glyceraldehyde-3-phosphate may undergo enzyme-to-enzyme channelling between glyceraldehyde-3-phosphate dehydrogenase and phosphofructoaldolase.


Energy content of weight loss: kinetic features during voluntary caloric restriction.
The classic rule stating that restricting intake by 3500 kcal/wk will lead to a 1-lb/wk rate of weight loss has come under intense scrutiny. Generally not a component of most weight loss prediction models, the "early" rapid weight loss phase may represent a period during which the energy content of weight change (ΔEC/ΔW) is low and thus does not follow the classic "rule." The current study tested this hypothesis. Dynamic ΔEC/ΔW changes were examined in 23 Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy Study overweight men and women evaluated by dual-energy x-ray absorptiometry during weight loss at treatment weeks 4 to 24. Changes from baseline in body energy content were estimated from fat and fat-free mass. Repeated-measures analysis of variance was used to determine if ΔEC/ΔW changed significantly over time. The evaluation was expanded with addition of the Kiel 13-week weight loss study of 75 obese men and women to test with adequate power if there are sex differences in ΔEC/ΔW. The analysis of variance CALERIE time effect was significant (P < .001), with post hoc tests indicating that ΔEC/ΔW (kilocalories per kilogram) increased significantly from week 4 (X ± SEM; 4, 858 ± 388) to 6 (6, 041 ± 376, P < .01) and changed insignificantly thereafter; ΔEC/ΔW was significantly larger for Kiel women (6, 804 ± 226) vs men (6, 119 ± 240, P < .05). Sex-specific dynamic relative changes in body composition and related ΔEC/ΔW occur with weight loss initiation that extend for 1 month or more. These observations provide new information for developing energy balance models and further define limitations of the 3500-kcal energy deficit → 1-lb weight loss rule.


Pollution profiles and human health risk assessment of atmospheric organophosphorus esters in an e-waste dismantling park and its surrounding area.
Recycling e-waste has been recognized as an important emission source of organophosphate triesters (tri-OPEs) and organophosphate diesters (di-OPEs), but the presence of di-OPEs in atmosphere has not been studied. Herein, tri-OPEs and di-OPEs in atmosphere of an e-waste dismantling park and surrounding area in South China were monitored for three consecutive years. Thirteen tri-OPEs and seven di-OPEs were identified. In 2017, 2018, and 2019, tri-OPE concentrations in e-waste dismantling park were 1.30 × 108, 4.60 × 106, and 4.01 × 107 pg/m3, while di-OPE concentrations were 1.14 × 103, 1.10 × 103, and 0.35 × 103 pg/m3, respectively, which were much higher than the surrounding area. Tri-OPEs and di-OPEs generated during e-waste dismantling affected surrounding area through diffusion. Triphenyl phosphate (TPhP) and diphenyl phosphate (DPhP) were the predominant congeners of tri-OPEs and di-OPEs, respectively. Additionally, TPhP concentration was extremely higher than other tri-OPEs, so TPhP could be used as an indicator of e-waste dismantling. Spearman correlation analysis showed significant correlations between DPhP and TPhP (R2 = 0.53, p < 0.01), bis-(1-chloro-2-propyl) phosphate (BCIPP) and tris(2-chloropropyl) phosphate (TCIPP) (R2 = 0.49, p < 0.01), as well as dibutyl phosphate (DBP) and tributyl phosphate (TBP) (R2 = 0.53, p < 0.01), indicating that they had the same source. Further, non-carcinogenic risk of them to people via inhalation was acceptable and non-carcinogenic risk of tri-OPEs decreased year by year in surrounding area.


Interrater and Intrarater Reliability of the Tuck Jump Assessment by Health Professionals of Varied Educational Backgrounds.
Objective. The Tuck Jump Assessment (TJA), a clinical plyometric assessment, identifies 10 jumping and landing technique flaws. The study objective was to investigate TJA interrater and intrarater reliability with raters of different educational and clinical backgrounds. Methods. 40 participants were video recorded performing the TJA using published protocol and instructions. Five raters of varied educational and clinical backgrounds scored the TJA. Each score of the 10 technique flaws was summed for the total TJA score. Approximately one month later, 3 raters scored the videos again. Intraclass correlation coefficients determined interrater (5 and 3 raters for first and second session, resp.) and intrarater (3 raters) reliability. Results. Interrater reliability with 5 raters was poor (ICC = 0.47; 95% confidence intervals (CI) 0.33-0.62). Interrater reliability between 3 raters who completed 2 scoring sessions improved from 0.52 (95% CI 0.35-0.68) for session one to 0.69 (95% CI 0.55-0.81) for session two. Intrarater reliability was poor to moderate, ranging from 0.44 (95% CI 0.22-0.68) to 0.72 (95% CI 0.55-0.84). Conclusion. Published protocol and training of raters were insufficient to allow consistent TJA scoring. There may be a learned effect with the TJA since interrater reliability improved with repetition. TJA instructions and training should be modified and enhanced before clinical implementation.


Development of a novel UPLC-MS/MS method for the simultaneously quantification of polydatin and resveratrol in plasma: Application to a pharmacokinetic study in rats.
The purpose of this study is to develop a sensitive LC-MS-MS method to simultaneously quantify polydatin and its metabolite, resveratrol, for its application in a pharmacokinetic (PK) study and to determine polydatin hydrolysis by microflora. A Shimadzu UHPLC system coupled to an AB Sciex QTrap 4000 mass spectrometer was used for the analysis. Separation was achieved using an Acquity BEH C18 column (2.1 × 50 mm) with acetonitrile and 0.1% formic acid as the mobile phases. Analysis was performed under negative ionization mode using the multiple reaction monitoring (MRM) approach. The method was linear in the range of 9.77-1250 nM for both resveratrol and polydatin with correlation coefficient values >0.99. Themethodhas been shown to be reproducible, with intra- and inter-day accuracy and precision ±10.4% of nominal values, for both analytes. The average extraction recovery rates were 81.78-98.3% for polydatin and 86.4-103.2% for resveratrol, respectively. Matrix effect was in the acceptable range (<15%). The analytes in plasma were found to be stable under bench-top, freeze-thaw, and storage (-4 °C) conditions. The metabolic studies showed that polydatin can be rapidly hydrolyzed by rat fecal S9 fractions and PK studies showed that both polydatin and resveratrol were exposed in the plasma and variable tissues. This novel UPLC-MS-MS method can quantify the levels of both polydatin and its major metabolite resveratrol in biological samples.


Development of the mental, emotional, and bodily toughness inventory in collegiate athletes and nonathletes.
The assessment of an individual's mental toughness would assist clinicians in enhancing an individual's performance, improving compliance with the rehabilitation program, and improving the individual treatment program. However, no sound measure of mental toughness exists. To develop a new measure of mental toughness, the Mental, Emotional, and Bodily Toughness Inventory (MeBTough). Participants were invited to complete a 45-item questionnaire. University research laboratory. A total of 261 undergraduate students were recruited to complete the questionnaire. The Rasch-calibrated item difficulties, fit statistics, and persons' mental toughness ability estimates were examined for model-data fit of the MeBTough. Forty-three of the 45 items had good model-data fit with acceptable fit statistics. Results indicated that the distribution of items was fittingly targeted to the people and the collapsed rating scale functioned well. The item separation index (6.31) and separation reliability statistic (.98) provided evidence that the items had good variability with a high degree of confidence in replicating placement of the items from another sample. Results provided support for using the new measure of mental, emotional, and bodily toughness.


Adenocarcinoma of the bilateral fallopian tube occurring after tubal sterilization.
A case of bilateral tubal carcinoma occurring 22 years after tubal sterilization is presented. We believe that this is the first case report of bilateral tubal carcinoma that has arisen in ligated fallopian tubes. The possibility that tubal occlusion is one of the causative factors of tubal carcinoma is discussed.


[Skin, sun exposure and vitamin D: facts and controversies].
Vitamin D plays a clearly defined role in phosphorus, calcium and bone metabolism. In addition to its effects on cellular proliferation and differentiation, and on immunity, it appears to exert other action, poorly understood to date, on human physiology and disease. A number of epidemiological studies have demonstrated a protective role of sun exposure with regard to the incidence of certain immune diseases and cancer, and upon the related mortality rates. Furthermore, over the last 10 years, studies have purported to find levels judged "inadequate" in numerous populations, and, in the absence of any strict scientific arguments, a correlation was established by certain authors between supposedly "inadequate" levels, sun exposure and risk of cancer. However, analysis of the literature shows that there is in fact no precise and consensual definition of normal ranges and that the notion of inadequacy was created artificially using assay techniques lacking in sensitivity and reproducibility. Photosynthesis of vitamin D can in fact be considered perfectly adequate in the majority of populations. However, greater care is needed with elderly subjects and with subjects exposed very little to sunlight. Current studies show that the means of photoprotection used in everyday life do not adversely affect such photosynthesis. In the event of documented vitamin D deficiency, oral supplements should be given, and exposure to natural or artificial UV radiation should not be prescribed. Ultraviolet radiation has been shown to be carcinogenic and responsible for the onset of most skin cancers, and the population must be warned against misleading advertising from the tanning industry. Care should also be taken with regard to the potential harmful effects of inappropriate vitamin D supplementation.


Detection, quantification, and characterization of polystyrene microplastics and adsorbed bisphenol A contaminant using electroanalytical techniques.
The potential applications of electroanalytical techniques for the quantification and size characterization of nonelectroactive polystyrene microplastics is reported, in addition to characterizing the kinetics of adsorption of bisphenol A on these polystyrene microparticles. The individual adsorption events of very diluted polystyrene microparticles dispersions on glassy-carbon microelectrodes produce the blocking of the charge transfer of a mediator (ferrocene-methanol) thus decreasing the current of the recorded chronoamperogram in a stepwise manner. The magnitude of the current steps are in the order of pA values and can be related to the diameter of the plastic microparticles in the size range 0.1 to 10 µm. The frequency of the current steps in the domain time used (120 s) allows to quantify the number concentration of these microparticles in the range 0.005 to 0.500 pM. Electrochemical impedance spectroscopy confirms the adsorption of the polystyrene microplastics on carbon microelectrodes (and to a lesser extent on platinum microelectrodes) under the same experimental conditions as above. On the other hand, the adsorbed microplastics become concentrators of other pollutants found in the environment. The sensitive differential-pulse voltammetry determination of bisphenol A (linear range 0.80-15.00 µM; detection limit 0.24 µM) was used together with a simple separation procedure for studying the adsorption of bisphenol A on polystyrene microparticles. The adsorption capacity (mg of bisphenol A retained per g of the polystyrene microplastics) decreased from approximately 5.7 to 0.8 mg g-1 with increasing dosages of polystyrene microparticles from 0.2 to 1.6 g l-1. The adsorption isotherms were modeled resulting in a monolayer of bisphenol A adsorbed on the microplastics (i.e., best fitted to a Langmuir model).


Extension of Fisher's exact test to 2-by-k contingency tables: a computer program in BASIC.
A randomisation method of analysis for 2 X k contingency table data has been developed. This method, which is based on the fundamental principle of Fisher's exact probability test, gives a more accurate evaluation of the significance probability than does the chi-square test, especially when the sample size is small. A listing from the computer program in BASIC to carry out the 'exact probability test' for analysis of 2 X k contingency table data is available from the authors.


Rapid fabrication of the Au hexagonal cone arrays for SERS applications.
This study performed trace detection using surface-enhanced Raman scattering (SERS) on Au hexagonal cone arrays (Au-HCAs). Uniform porous anodized aluminum oxide (AAO) templates were used, and an Ag film with a cone cavity was prepared using a thermal deposition technique. Next, a series of homogeneous Au-HCAs were prepared controllably via electrodeposition growth technology. The prepared Au-HCAs were used as SERS substrates, and according to the experimental results, the optimal electrodeposition time is 600 s. At this time, Au-HCAs had the highest SERS activity. The detection limit of R6G was 10-9 M, exhibiting high reproducibility and high uniformity at 10-6 M, indicating that Au-HCAs had good stability. Moreover, a good linear correlation between the Raman intensity and the molecular concentration endowed Au-HCAs with good quantitative analysis ability. Therefore, the Au-HCAs exhibited great potential for qualitative and quantitative detection.


Global assessment of patients--a bedside study. I: The influence of physical findings on the global assessment.
Three physicians selected ten basic physical findings for a study of diagnostic decision making in the global assessment of patients. The physicians independently examined 201 hospital in-patients for the presence of each of the findings and concluded their assessment with a global evaluation of whether the patient appeared ill. Each of the ten findings were used by at least one of the physicians in his overall assessment of the patient. All the observers considered 'looking older than age', 'trouble with breathing', 'cyanosis', and 'anaemia' important, but disagreed in their use of the remaining findings (P less than 0.01). Agreement in the global clinical assessment is an essential prerequisite to uniformity in the approach to the patient.


The protective roles of autophagy in ischemic preconditioning.
Autophagy, a process for the degradation of protein aggregates and dysfunctional organelles, is required for cellular homeostasis and cell survival in response to stress and is implicated in endogenous protection. Ischemic preconditioning is a brief and nonlethal episode of ischemia, confers protection against subsequent ischemia-reperfusion through the up-regulation of endogenous protective mechanisms. Emerging evidence shows that autophagy is associated with the protective effect of ischemic preconditioning. This review summarizes recent progress in research on the functions and regulations of the autophagy pathway in preconditioning-induced protection and cellular survival.


Characterization of avian reoviruses isolated from the synovia and breast blister.
Reoviruses Texas, S 1133, UMI 203, and WVU 2937 induced swelling of the foot pad and inflammatory changes in the synovial membranes when inoculated in the foot pad of 2-week-old gnotobiotic chicks. From differences in virus neutralization as measured with geometric mean (R) value, all four viruses are subtypes of a single serotype. The cell-associated and cell-released virus growth curves were similar, with a lag phase of about 15 hours and a log phase of 15 to 21 hours. Viral RNA synthesis reached a peak in 5 hours and was active at 14 hours but not at 18 hours. In 90 minutes at 60 C the titer of each virus had decreased about 4 logs.


Highly chemoselective homologative assembly of the α-substituted methylsulfinamide motif from N-sulfinylamines.
α-Substituted methylsulfinamide are prepared through the homologation of electrophilic N-sulfinylamines with Li-CHXY reagents. The transformation takes place under full chemocontrol and exhibits good flexibility for preparing both N-aryl and N-alkyl analogues. Various sensitive functionalities can be accommodated on the starting materials, thus documenting a wide reaction scope.


The Impact of Palliative Care Team Consultation on Quality of Life of Patients with Advanced Cancer in Dutch Hospitals: An Observational Study.
Experimental studies have shown that palliative care team (PCT) involvement can improve quality of life (QoL) and symptom burden of patients with advanced cancer. It is unclear to what extent this effect is sustained in daily practice of hospital care. This observational study aims to investigate the effect of PCT consultation on QoL and symptom burden of hospitalized patients with advanced cancer in daily practice. After admission to 1 of 9 participating hospitals, patients with advanced cancer for whom the attending physician answered "no" to the Surprise Question were invited to complete a questionnaire, including the EORTC QLQ-C15-PAL, at 6 points in time, until 3 months after admission. Outcomes were compared between patients who received PCT consultation and patients who did not, taking into account differences in baseline characteristics. A total of 164 patients consented to participate, of whom 32 received PCT consultation. Of these patients, 108 were able to complete a questionnaire at day 14, of whom 19 after receiving PCT consultation. After adjusting for baseline differences, EORTC QLQ-C15-PAL scores for pain, appetite, and emotional functioning at day 14 were more favorable for patients who received a PCT consultation. PCT consultation decreased patients' symptom burden and tends to have a positive effect on QoL of hospitalized patients with advanced cancer, even if the PCT is consulted late in the patient's disease trajectory.


Ion exchange chromatography hyphenated with fluorescence detector as a sensitive alternative to UV detector: Applications in biopharmaceutical analysis.
Cation-exchange chromatography (CEX) is widely used for analysis of charge heterogeneity in monoclonal antibodies (mAbs) in the biopharmaceutical industry. Charge variant separation is typically achieved by either alteration of ionic strength or pH, and detection of the various species is performed using diode array detectors (DAD) at 280 nm. In this study, we investigate the suitability of fluorescence detector (FLD) as a sensitive alternative to traditional UV280 detection-based charge variant analysis. The objective of this work is to compare the performance of charge variants detection through cation exchange chromatography between FLD and DAD detectors. This was demonstrated for a mass spectroscopy compatible, pH based CEX method utilizing volatile ammonium acetate salt. The stability of FLD detection was tested as per method validation criteria set in the ICH Q2-(R1). LODFLD and LOQFLD were 59.07 and 59.64 times lower in comparison to LODUV and LOQUV, respectively (LODFLD: 0.13 µg, LOQFLD: 0.39 µg). The LinearityFLD was obtained in the range of 1-200 µg. Accuracy calculated as recovery value was between 93.38% and 103.35% and highest RSD value obtained for robustness was 2.54% (area under the curve). The application of FLD detection based CEX as a Process Analytical Technology (PAT) enabler in mAb biopharmaceutical analysis was demonstrated through direct charge variant profiling of CHO cell harvest supernatant (without pre purification through Pro-A). The method was also applied to and found suitable for biosimilarity assessment of drug products. While the present study is focused on analysis of trastuzumab biosimilars, the proposed method is expected to be applicable to any mAb product after suitable gradient modification.


Implementing Family-Centered Prevention in Rural African American Communities: a Randomized Effectiveness Trial of the Strong African American Families Program.
Efforts to disseminate evidence-based prevention programs are hampered by a lack of real-world effectiveness trials undertaken with community providers. The Strong African American Families (SAAF) program is an empirically validated intervention designed to prevent problem behavior among rural African American youth. To evaluate the effectiveness of SAAF and its implementation protocols when delivered by a community provider, we conducted a randomized, wait-list-controlled trial with outcome measurements assessed longitudinally at baseline and 6 months after baseline. A total of 465 African American youth and their parents were recruited randomly from public school lists of fifth- and sixth-grade students in eight rural counties in south Georgia. Youth and parents assessed targeted outcomes in their homes. The main outcome, problem behavior vulnerability, was operationalized as a latent construct comprising three indicators: tolerance for deviance, intentions to engage in risky behavior, and affiliations with risk-taking peers. SAAF was implemented with uniformly high levels of adherence (85.5%; SD = 10.8) and attendance (M = 4.1, SD = 2.9, range = 0-7). Intent-to-treat and complier average causal effect analyses revealed significant program effects on intervention-targeted parenting practices, youth self-regulatory processes, and problem behavior vulnerability. SAAF influenced problem behavior vulnerability indirectly via effects on targeted parenting and youth processes. This study supported the effectiveness of SAAF in a community setting when a systematic implementation model supports participant engagement and intervention adherence.


Repertoire of human natural anti-glycan immunoglobulins. Do we have auto-antibodies?
Profiling of donor's antibodies using glycan arrays demonstrated presence of antibodies capable of binding to >100 mammalian glycans or their fragments. For example, relatively high binding to Galα1-4Galβ1-4GlcNAc (P(1)), Galα1-4Galβ1-4Glc (P(k)), Galβ1-3GlcNAc (Le(c)), 4-O-SuGalβ1-4GlcNAc, and GalNAcα1-3GalNAc (Fs) was found in all tested individuals. Affinity isolation using hapten-specific chromatography in combination with epitope mapping revealed their glycotopes. Notably, a significant part of the antibodies was capable of recognizing a fragment of larger glycans, for example, -Galβ1-4Glc of glycolipids, or Fucα1-3GlcNAc motif of Le(X)/Le(Y) antigens. Their epitope specificity did not vary between different healthy individuals. Nominally, all the mentioned immunoglobulins could be classified as auto-antibodies. In this work we re-evaluated results published earlier and analyzed new data to address the question why autologous antibodies found in healthy individuals do not cause severe auto-immune reactions. In all cases the presumably "auto" antibodies were found to bind short fragments "subtracted" from larger glycans whereas recognition of the same fragment in the context of the whole natural chain was completely abolished. Thus, in spite of numerous formally positive signals observed on the printed glycan array, we are yet unable to identify in blood serum of healthy individuals true auto-antibodies capable of binding carbohydrate chains in their naturally occurring form. The identified natural anti-glycan antibodies were found to be specific, high-titer and population conservative immunoglobulins - all of this suggesting as yet unknown biological role(s) of the studied proteins. This article is part of a Special Issue entitled Glycoproteomics.


Effects of Schisandra chinensis Baillon (Schizandraceae) on lipopolysaccharide induced lung inflammation in mice.
Schisandra chinensis Baillon (Sc), an anti-inflammatory herb that has been used in traditional Chinese medicine for thousands of years, is frequently used to treat upper respiratory tract infections. This study was conducted to evaluate the ability of a water extract of Sc to prevent airway inflammation both in vitro and in vivo. Human lung alveolar epithelial-derived A549 cells were stimulated with to interleukin-1β, tumor necrosis factor-α, and interferon-γ (IL-1β, TNF-α, and INF-γ; cytokine mixture; CM) and treated with Sc extracts. They were then evaluated using nitric oxide (NO), IL-8 and monocyte chemotactic protein-1 (MCP-1) secretions. In the in vivo study, BALB/c mice were challenged with lipopolysaccharide (LPS) to induce acute airway inflammation. After this challenge, the mice were treated with Sc extracts (10, 50 and 100mg/kg) by oral administration, and inflammatory cells in the bronchoalveolar lavage (BAL) fluid were counted. IL-6 and TNF-α secretions were measured using an enzyme-linked immunosorbent assay. Lung tissues of the LPS treated mice were prepared and stained with hematoxylin and eosin (HE) for histological examination. In the A549 cells, Sc extracts dose-dependently and significantly inhibited CM-induced NO production and reduced IL-8 and MCP-1 secretions. Sc extracts efficiently suppressed neutrophil and macrophage infiltrations of lung tissues and increased IL-6 and TNF-α levels in BAL fluid in LPS-instilled BALB/c mice. In addition, Sc extracts treatment inhibited pathologic progress in the lung tissues, as confirmed by H&E staining. These findings indicate that Sc extracts could be potentially useful for the treatment of acute lung inflammation and acute lung injury.


Interobserver and intraobserver variations in radial head fracture classification-assessment of two classification systems.
The aim of this study was to evaluate the intra- and interobserver variation of two classification systems for radial head fractures (Mason and Charalambous classifications) using plain radiographs. Five observers classified 30 radial head fractures as per the two classifications using anteroposterior and lateral elbow radiographs. Assessments were done on two occasions, at least 6 weeks apart. The interobserver and intraobserver variation of the Mason classification showed fair (mean kappa = 0.33) and moderate agreement (mean kappa = 0.43) respectively. The interobserver and intraobserver variation of the Charalambous classification showed moderate agreement for both (mean kappa = 0.42 and 0.49 respectively). A greater proportion of radial head fractures could be classified using the Charalambous classification compared with the Mason classification (P < 0.001). With the Charalambous classification, the inter-observer variation was better when assessing fracture morphology (4 morphology groups) versus fracture displacement (2 displaced/un-displaced groups) (p = 0.010). The Mason and Charalambous classifications for radial head fractures confer similar reliability when using plain radiographs, but the latter allows a greater proportion of fractures to be classified. Raters may agree more on fracture morphology as compared to fracture displacement. Our findings also demonstrate the limitations of using plain radiographs in classifying radial head fractures for clinical or research purposes, and suggest that evaluation with more sensitive modalities such as Computed Tomography may be preferable.


Ultrafast Synthesis of Multifunctional Submicrometer Hollow Silica Spheres in Microfluidic Spiral Channels.
We demonstrate a facile and ultrafast approach for the synthesis of multifunctional submicrometer hollow silica spheres (smHSSs) using microfluidic spiral channels with enhanced mixing performance, introduced by the transverse Dean flows cross the channel as a result of centrifugal effects. Formation of smHSSs is initiated by the hydrolysis of tetraethyl orthosilicate (TEOS) at the interface of two laminar reactant flows. Complete mixing of the flows further facilitates the subsequent condensation of hydrolyzed TEOS, which builds up the shell layer of smHSSs. The average size of the as-synthesized smHSSs is 804.7 nm, and the thickness of the shell layer is ~20 nm. Multifunctional smHSSs integrated with proteins, fluorescent dyes, quantum dots, and magnetic nanoparticles can be further produced via this general platform. Their applications in cell imaging, organic dye adsorption, and drug delivery are examined.


High platelet content can increase storage lesion rates following Intercept pathogen inactivation primarily in platelet concentrates prepared by apheresis.
Pathogen inactivation methods for platelet concentrates are increasingly being used in blood banks worldwide. In vitro studies have demonstrated its effects on storage lesion, but little routine quality control data on blood banking outcomes have been reported. Swirling of distributed products was monitored before and after implementation of Intercept pathogen inactivation. Metabolic parameters pH, glucose and lactic acid were determined in a random cohort of expired pathogen-inactivated products. Storage lesion indicators in apheresis concentrates with premature low swirling were compared to concentrates with normal swirling. During validation for implementing Intercept pathogen inactivation, pH and glucose levels decreased faster in apheresis platelet concentrates with high platelet content than with low platelet content or than in pathogen-inactivated pooled buffy coat-derived products. In routine products, glucose exhaustion was more often found in apheresis compared to buffy coat-derived platelet concentrates despite 3-7% more plasma carryover in the former. Annual incidence of premature low swirling increased significantly by 50% following implementation of pathogen inactivation implementation for apheresis but not for pooled buffy coat platelet concentrates. In addition, apheresis concentrates with premature low swirling had a significantly higher median platelet count (5·0 × 1011 ) than unaffected products (3·5 × 1011 ). The risk of increased storage lesion rates following Intercept pathogen inactivation is higher for apheresis than for buffy coat-derived platelet concentrates, especially when platelet contents are higher than 5·0 × 1011 .


[Does the structure of medical services affect the proportion of death in hospitals? An ecological analysis in the mobility regions of Switzerland?].
With the discussion about measures to reduce over-capacities in the health services in mind, we examined the influence of medical supply structures and services on hospital utilisation directly before death. Based on the specification of the place of dying from the death certificates, we determined the proportions of deaths in hospitals in an ecological study. We analysed deaths of persons above age 65 in each of the 106 mobility regions of Switzerland in the years 1979 to 1980. The proportion of deaths occurring in hospitals varied between 27% and 81%. Despite missing data regarding stationary and ambulatory care services, more than half of the variance could be explained by means of a multivariate regression analysis. Our results imply an inverse relation between the proportion of deaths in the hospital and the number of consultations provided by primary care physicians, as well as the number of nursing home beds. Further, we observe a direct relation to the number of hospital beds in a region. All indicators are calculated per inhabitant. In health care supply planning, such systematic associations should be taken into account. We recommend to analyse regularly interregional differences in supply and outcome of medical performances with the best available data.


Health system preparedness in infectious diseases: perspective of Malaysia, a middle-income country, in the face of monkeypox outbreaks.
The World Health Organization declared monkeypox as a Public Health Emergency of International Concern on July 23, 2022. As of July 25th, 2022, there were 16,016 laboratory-confirmed cases reported worldwide with 5 deaths. Malaysia's Health Ministry has developed a five-point strategy to prepare for the impending threat of the infectious disease, encompassing early detection of monkeypox, consolidation of laboratory diagnostic facilities, case management and treatment, cluster management, and strengthening public awareness. Crisis and disaster preparedness within a nation's health system is paramount to preventing disease spread. Various strategies for developing resilience in the face of global infectious disease spread were discussed. The current disease preparedness and response framework and guidelines in Malaysia have established a health system that is proactive and responsive to any potential infectious disease outbreaks. Despite this, the future remains unpredictable, and ongoing fortification is required as events unfold.


Endovascular repair of a ruptured descending thoracic aortic aneurysm in a patient with an ascending aortic aneurysm: hybrid open arch reconstruction with simultaneous thoracic stent-graft deployment within elephant trunk.
Endovascular repair of the thoracic aorta is now widely practiced. The extension of this technique to emergent settings is in evolution. Pathology of the ascending and transverse aortic arch may preclude thoracic aortic stent grafting due to the lack of a proximal seal zone. Several hybrid open/endovascular approaches have been described. We recently encountered the difficult case of a contained rupture of a 6.8 cm descending thoracic aortic aneurysm in a 60-year-old patient with aneurysmal degeneration of the ascending and transverse aortic arch. This patient was treated with a hybrid approach of open ascending and transverse arch reconstruction along with simultaneous stent-graft repair of the descending thoracic aorta. The open repair established an excellent proximal landing zone by use of the "elephant trunk" technique. This technique also allowed direct suture fixation of the stent graft to the arch graft to prevent stent-graft migration. This hybrid surgical approach was successful and avoided the cumulative morbidity that a left thoracoabdominal approach would have added to the sternotomy. Further creative uses of these hybrid techniques will undoubtedly serve a larger role in the treatment of thoracic aortic pathology.


Transcriptome analysis reveals a positive effect of brassinosteroids on the photosynthetic capacity of wucai under low temperature.
Brassinosteroids (BRs) have a positive effect on many processes during plant growth and development, and in response to various abiotic stressors. Low-temperature (LT) stress constricts the geographic distribution, growth, and development of wucai (Brassica campestris L. ssp. chinensis var. rosularis Tsen). However, there is little information on the global gene expression of BRs under LT stress in wucai. In this study, the molecular roles of 24-epibrassinolide (EBR) after exogenously application, were explored by RNA sequencing under LT conditions. According to the Gene Ontology (GO) term and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses, photosynthesis was significantly enriched after spraying EBR under LT. The transcripts encoding the photosystem II (PSII) oxygen-evolving enhancer protein, photosystem I (PSI) subunit, light-harvesting chlorophyll protein complexes I and II, and ferredoxin were up-regulated after the application of EBR. Transcripts encoding several key enzymes involved in chlorophyll biosynthesis were also up-regulated, accompanied by significant differences in the contents of 5-aminolevulinic acid (ALA), porphobilinogen (PBG), protoporphyrin IX (Proto IX), Mg-protoporphyrin IX (Mg-proto IX), protochlorophyllide (Pchl), and photosynthetic pigments. Notably, transcriptional and physiological analyses revealed that under LT stress, plant responses to EBR involved a major reorientation of photosynthesis, as well as porphyrin and chlorophyll metabolism. This study explored the role of EBR as an LT stress tolerance mechanism in wucai. At the transcription level, LT tolerance manifests as an enhancement of photosynthesis, and the amelioration of porphyrin and chlorophyll metabolism.


Widely targeted metabolomics analysis reveals the effect of fermentation on the chemical composition of bee pollen.
Microbial fermentation can break the bee pollen wall. However, the global profiling of bee pollen metabolites under fermentation remains unclear. This study aims to comprehensively elucidate the changes in the composition of bee pollen after microbial fermentation. Ultra-performance liquid chromatography-electron spray ionization-mass spectrometry (UPLC-ESI-MS) based on widely targeted metabolomics analysis was used to compare the chemical composition of unfermented bee pollen (UBP) and fermented bee pollen (FBP). Among the 890 metabolites detected, a total of 668 differential metabolites (classified into 17 categories) were identified between UBP and FBP. Fermentation significantly increased the contents of primary metabolites such as 74 amino acids and derivatives, 42 polyunsaturated fatty acids and 66 organic acids, as well as some secondary metabolites such as 38 phenolic acids, 80 flavone aglycones and 22 phenolamides. The results indicate that fermentation is a promising strategy to improve the nutritional value of bee pollen.


No foot, no horse.
As a recipient of the Worshipful Company of Farriers' equine veterinary studies award, Edinburgh vet student Karis Stevenson got the opportunity to learn firsthand what farriers do. She spent a week with Stephen Newman near Paisley. Here, she gives a snapshot of what she learnt.


Studies on Echinococcus granulosus using the scanning electron microscope. I. Preparations of the parasite for infection of the final host.
The development of the protoscoleces of Echinococcus granulosus was studied after chemical stimulation, which mimics that offered by the final host. This stimulation resulted in some morphological changes in the parasite and to its evagination. These changes prepare the parasite to infect the intestine of its final host. The external morphology of the protoscolex body and of the germinal layer of the cyst and brood capsule were studied using the scanning electron microscope (SEM). Findings were related to other studies using the transmission electron microscope (TEM). The morphology of the flame cell is described and four cases of teratogenesis are reported.


Prevention of sexually transmitted diseases. A model for overcoming barriers between managed care and public health. The IOM Workshop on the Role of Health Plans in STD Prevention.
The growth of managed care has spurred re-evaluation of the roles and responsibilities of public health agencies and private health plans for providing public health services. Although rates of curable sexually transmitted diseases (STDs) in the United States are the highest in the developed world, many clinicians and managed care organizations are not systematically providing high-quality, comprehensive STD-related services to their patients and the community. To examine issues around managed care and STD prevention as a model for overcoming barriers that impede managed care organizations from providing comprehensive public health services and collaborating with health agencies. Two-day invitational workshop. Representatives from 18 health plans, 10 public health agencies, 6 academic institutions, 1 purchasing coalition, and 5 other health organizations. Major obstacles include: turnover and heterogeneity in the health care system; deficiencies in clinical knowledge and skills; differences in organizational culture and language; low priority of STDs; inadequate public health surveillance data and performance measures; confidentiality concerns; and lack of coverage for sex partners. Potential approaches for addressing these barriers include: requiring that STD-related services be covered by Medicaid managed care programs; implementing performance measures; requiring collaborative activities; promoting education of and outreach to stakeholders; funding of pilot projects; and researching the cost-benefit and cost-effectiveness of STD-related services for various populations.


Extended pancreatoduodenectomy as defined by the International Study Group for Pancreatic Surgery is associated with worse survival but not with increased morbidity.
Recently, the International Study Group for Pancreatic Surgery presented a consensus statement on the definition of an extended pancreatoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC). Because extended resections are associated with increased morbidity and mortality, prognostic factors for outcome are mandatory to optimize patient selection. The aim of this study was to apply the new definition of an extended PD and to assess prognostic factors for short-term complications and survival in patients with PDAC. A retrospective analysis was performed on a prospectively collected database running from 2004 to 2014. Inclusion criteria were all PD resections with histopathology-proven PDAC. Clinical data, operative results, and short- and long-term outcomes were analyzed. We included 177 patients who underwent PD for PDAC in this study. Sixty-six patients (37%) underwent a standard PD and 111 (63%) underwent an extended PD. No differences were found in duration of postoperative stay (median, 13 days) or overall complication rate of 35% (n = 61). Severe complications occurred in 24 patients (13%). Male sex (odds ratio, 2.4; 95% CI, 0.9-6.6) was a prognostic factor for severe complications. There was no in-hospital or 90-day mortality in either group. Multivariate survival analysis showed that poor tumor differentiation (hazard ratio [HR], 2.0; 95% CI, 1.3-3.1), lymph node metastasis (HR, 2.3; 95% CI, 1.4-3.9), neural invasion (HR, 1.9; 95% CI, 1.2-3.1), were independent prognostic factors for worse survival. An extended resection was associated with worse survival, but was not an independent prognostic factor (HR, 1.5; 95% CI, 1.0-2.3). Extended PD is associated with worse survival but not with increased morbidity.


Carbonylative Self-Coupling of Aryl Boronic Acids Using a Confined Pd Catalyst within Melamine Dendron and Fibrous Nano-Silica: A CO Surrogate Approach.
Development of heterogeneous catalysts with tunable activity and selectivity has posed a persistent challenge. This study addresses this challenge by fabricating a hybrid environment through the combination of mesoporous silica and N-rich melamine dendron via covalent grafting, allowing for controllable growth and encapsulation of Pd NPs. This catalyst presented an excellent catalytic activity for the oxidative carbonylative self-coupling of aryl boronic acids to afford symmetric biaryl ketones using N-formyl saccharin as a sustainable solid CO source and Cu as a co-catalyst.


Prevalence and risk factors of pre-schoolers' fine motor delay within vulnerable Australian communities.
This study examined the prevalence and risk factors of fine motor delay in Australian pre-school children from low-income communities. Children from the Early Start Baseline Study completed the Ages and Stages Questionnaire (3rd edn.). Age, sex, executive function and family characteristics were assessed and associations with fine motor skills analysed. Data were available for 700 children (Mage 54.0 ± 8.6 months, 53.1% boys) of which 77.4% were typically developing, 12.1% at risk and 10.4% delayed for fine motor skill. Children had higher odds of being delayed if they were male (odds ratio (OR) 3.30, 95% confidence interval (CI) 2.22-4.90) or indigenous (OR 3.31, 95% CI 2.12-5.16) and had lower self-regulatory (OR 2.17, 95% CI 1.31-3.58). Higher vocabulary (OR 0.92, 95% CI 0.89-0.94), higher family income (OR 0.22, 95% CI 0.05-0.90) and family education (OR 0.25, 95% CI 0.08-0.74) were associated with lower odds of delay. Almost one in four children from vulnerable communities experience fine motor difficulties, highlighting the importance of early screening and targeting key child and environmental risk factors.


Transanal Endoscopic Microsurgery: Current and Future Perspectives.
Transanal endoscopic microsurgery is part of the colorectal surgeons' armamentarium for over 2 decades. Since its first implementation for the resection of benign and T1 malignant lesions in the rectum several new indications were developed and it carries additional promise for further extension in upcoming years. Herein we review the technique, its current indications, novel implications, and future perspectives.


Core elements of national cancer control plans: a tool to support plan development and review.
When developed and implemented effectively, national cancer control plans (NCCPs) improve cancer outcomes at the population level. However, many countries do not have a high-quality, operational NCCP, contributing to disparate cancer outcomes globally. Until now, a standard reference of NCCP core elements has not been available to guide development and evaluation across diverse countries and contexts. In this Policy Review, we describe the methods, process, and outcome of an initiative to develop an itemised and evidence-based comprehensive checklist of core elements for NCCP formulation. The final list provides a ready-to-use guide to support NCCP development and to facilitate internal and external critical appraisal of existing NCCPs for countries of all income levels and settings. Governments, policy makers, and stakeholders can utilise this checklist, while considering their own unique contexts and priorities, from the drafting through to the implementation of NCCPs.


Total and IgE antibody levels following booster immunization with aluminum absorbed and nonabsorbed tetanus toxoid in humans.
Total and IgE serum antibodies to tetanus toxoid were measured in 32 healthy adults, 3-4 weeks following booster immunization with either plain or aluminum hydroxide-absorbed tetanus toxoid. Whereas no difference in the total antibody values was observed, the level of anti-tetanus toxoid IgE antibodies was significantly higher in the group boostered with the adjuvanted vaccine.


The anal continence plug: a disposable device for patients with anorectal incontinence.
Anorectal incontinence is most commonly found in the elderly, but colorectal surgeons now see an increasing number of younger patients with this condition. Although medical and surgical treatments are available, a proportion of patients remain refractory to therapy. We investigated the efficacy of three designs of anal continence plug. 8 women and 2 men (mean age, 52 years) who were incontinent to both liquid and solid stool tested each plug for three consecutive weeks. 1 patients withdrew from the study. The median weartime for the optimum plug design was 12 h, and there were no episodes of incontinence in 82% of the periods during which the plug was in place. Patients required a median of eleven plugs per week, and in 82% of cases insertion was as easy as with a suppository. Plugs may have a place in the management of patients with anorectal incontinence.


Epidemiology and outcomes in patients with atrial fibrillation in the United States.
Nonrheumatic atrial fibrillation (AF) is a common cause of embolic stroke. Warfarin therapy can reduce stroke risk by two-thirds in patients with AF, but therapy may not always be used or always be used optimally. This study sought to document the patterns of anticoagulant use and the determinants and incidence of stroke, intracranial hemorrhage, and arterial thromboembolism in US patients with AF. Using health insurance claims and laboratory results, we examined events per unit of person-time and used Poisson regression to quantify the association of AF outcomes with the international normalized ratio (INR) and other covariates. In 116,969 patients age > or =40 years with an insurance claim for AF or atrial flutter between 1999 and 2005, warfarin was prescribed to 45%, and 48% had no claim for any anticoagulant or antiplatelet agent. Subtherapeutic INR levels (<2.0) raised the incidence of stroke (relative risk [RR]: 2.39, 95% confidence interval [CI]: 1.68 to 3.41) and arterial thromboembolism (RR: 5.68, 95% CI: 1.88 to 17.10) compared with therapeutic INR levels, whereas supratherapeutic INR levels (>3.0) doubled the incidence of intracranial hemorrhage (RR: 2.11, 95% CI: 1.16 to 3.84). Further covariate adjustment had little effect on these estimates. Warfarin remains underused within the outpatient setting. Nontherapeutic INR levels are associated with increased risk of stroke, bleeding, and thromboembolism compared with therapeutic INR levels.


Ablation as First-Line Therapy for Atrial Fibrillation: Yes.
This article addresses the use of catheter ablation (CA) as first-line therapy for atrial fibrillation (AF). CA increases long-term freedom from AF, reduces hospitalizations, and improves quality of life compared with antiarrhythmic drug (AAD) therapy in patients with symptomatic AF who have already failed one AAD. The role of CA as first-line therapy for AF, however, is still controversial. Evidence from randomized controlled trials shows that CA is definitely superior to AADs as first-line therapy for relatively young patients with paroxysmal AF, with comparable complication rates and results consistently reproducible across different institutions, operators, and types of ablation approaches.


Dendritic cell subsets generated from CD34+ hematopoietic progenitors can be transfected with mRNA and induce antigen-specific cytotoxic T cell responses.
Human dendritic cells (DCs) generated in culture from either monocytes or CD34+ hematopoietic progenitor cells (CD34-HPCs) have been used in cancer immunotherapy protocols with encouraging results. Yet an optimal strategy for the delivery of antigen(s) to DCs still remains to be established. Recent studies demonstrated the feasibility of mRNA transfection to load monocyte-derived DCs. It is not known, however, whether DCs derived by culturing CD34-HPC with GM-CSF and TNF-alpha for 9 days (CD34-DCs) can be efficiently transduced with mRNA. Here we show that clinical-grade CD34-DCs generated after 8 days of culture can be transfected with mRNA without significant alteration of cell viability. About 90% of cells transfected with GFP-RNA express GFP 24 h post-transfection. Remarkably, transfected CD34-DCs retain high levels of GFP expression for at least 14 days. CD34-DCs transfected with Flu-MP RNA were highly efficient in inducing the proliferation of Flu-MP-specific CD8+ T cells as measured by tetramer staining. Furthermore, the stimulated CD8+ T cells produced IFN-gamma upon antigenic stimulation and were able to kill targets pulsed with Flu-MP peptide. Both DC subsets in CD34-DCs, CD1a+-DC (Langerhans cells) and CD14+-DC (interstitial DC), were equally transfected with GFP-RNA, and yielded Flu-specific cytotoxic T cells upon transfection with Flu-MP RNA. Thus, RNA can be used to deliver antigens to two distinct myeloid DC subsets in CD34-DC cultures.


Poly-prescription drug misuse across the life course: Prevalence and correlates across different adult age cohorts in the U.S.
Most research on prescription drug misuse (PDM) focuses on the misuse of specific classes of psychoactive prescription drugs among adolescents or young adults. The current research addressed important gaps in the literature by assessing poly-prescription drug misuse (poly-PDM), the misuse of more than one class of psychoactive prescription drug, across different adult age cohorts. We used the 2015-2018 National Survey on Drug Use and Health to examine the prevalence of past-year poly-PDM and specific combinations of PDM. Multinomial logistic regression was used to identify demographic, health-related factors, and substance use behaviors that were significantly associated with poly-PDM. The prevalence of poly-PDM decreases with age and is common among individuals who engage in PDM. Slightly more than one in four respondents in age cohorts 18-25 (31.66%, 95% CI = 30.35, 33.00) and 26-34 (29.92%, 95% CI = 25.82, 30.12) who engage in PDM, misused more than one class of prescription drug. Additionally, poly-PDM was identified as a high-risk type of PDM as roughly 60% of adults younger than 65 who endorse poly-PDM reported having a substance use disorder (SUD). While certain characteristics (i.e., race/ethnicity, marital status, depression, suicidal ideation, illegal drug use, and SUD) were consistently associated with poly-PDM across age cohorts, other characteristics (i.e., sexual identity, income, and justice involvement) varied across age cohorts. Finally, a comparison of poly-PDM to single PDM showed, in all age cohorts, that having an SUD was associated with an increased likelihood of poly-PDM, while Black adults were less likely than whites to report poly-PDM. By identifying prevalence and correlates of poly-PDM across adult age cohorts, the current research has significant implications. Understanding stability and heterogeneity in the characteristics associated with poly-PDM should inform interventions, identify at-risk groups, and shape public health approaches to dealing with high-risk substance use behavior.


[Vagus nerve stimulation therapy in patients with drug-resistant epilepsy and previous corpus callosotomy].
To analyse the results of vagus nerve stimulation in patients with drug-resistant epilepsy and previous corpus callosotomy. We prospectively reviewed data from patients with drug-resistant epilepsy who showed persistence of disabling seizures after undergoing corpus callosotomy, in whom it was not possible to identify an epileptogenic focus and who were subsequently treated with vagus nerve stimulation. Variables analysed included: age, gender, aetiology of epilepsy, frequency and characteristics of the crises and Engel scale classification, before and after vagal stimulator implant. Furthermore, the percentage differences in seizure frequency changes were also calculated. Four patients were identified: two male and two female. The total seizure frequency had decreased between 20% and 81% after corpus callosotomy in three patients and one of them did not show any favourable response (Engel IVB). Following implantation of the stimulator they became reduced to between 57% and 100% after a mean follow-up period of 8.3 months (range: 3 to 12 months). Generalised seizures decreased between 71.4% and 100%, and focal seizures between 57.7% and 100%. Vagus nerve stimulation therapy proved to be an alternative for the reduction of seizure frequency in patients with drug-resistant epilepsy who suffered disabling seizures despite undergoing corpus callosotomy as primary surgery.


A preliminary deep learning study on automatic segmentation of contrast-enhanced bolus in videofluorography of swallowing.
Although videofluorography (VFG) is an effective tool for evaluating swallowing functions, its accurate evaluation requires considerable time and effort. This study aimed to create a deep learning model for automated bolus segmentation on VFG images of patients with healthy swallowing and dysphagia using the artificial intelligence deep learning segmentation method, and to assess the performance of the method. VFG images of 72 swallowing of 12 patients were continuously converted into 15 static images per second. In total, 3910 images were arbitrarily assigned to the training, validation, test 1, and test 2 datasets. In the training and validation datasets, images of colored bolus areas were prepared, along with original images. Using a U-Net neural network, a trained model was created after 500 epochs of training. The test datasets were applied to the trained model, and the performances of automatic segmentation (Jaccard index, Sørensen-Dice coefficient, and sensitivity) were calculated. All performance values for the segmentation of the test 1 and 2 datasets were high, exceeding 0.9. Using an artificial intelligence deep learning segmentation method, we automatically segmented the bolus areas on VFG images; our method exhibited high performance. This model also allowed assessment of aspiration and laryngeal invasion.


A novel sacral neuromodulation protocol is associated with reduction in removal for device infection.
Sacral neuromodulation (SNM) has been established as an effective third-line therapy for non-obstructive urinary retention and urinary urgency-frequency syndrome. Device infection, ranging from 2-10%, is a severe complication usually necessitating device explanation. This study sought to demonstrate an infection protocol founded upon established device implantation risk factors and novel approaches to reduce the incidence of device infection, while maintaining good antibiotic stewardship following best practice statements. A single-surgeon protocol was enacted from 2013 to 2022. Preoperatively, nasal swabs were cultured from each patient. If positive for methicillin-resistant Staphylococcus aureus or methicillin-sensitive Staphylococcus aureus, preoperative treatment with intranasal mupirocin was employed. Preoperative cefazolin was administered in patients with negative cultures or MSSA-positive. All protocol patients were given chlorhexidine wipes before surgery and prepped with a chlorhexidine scrub followed by alcohol/iodine paint. Post-procedural antibiotics were not given. Pre-protocol patients from 2011 to 2013 served as controls. Pre-protocol (n = 87) patients had a significantly higher rate of device infection compared to protocol patients (n = 444) in both the percentage of patients experiencing device infection (4.6% vs 0.9%, p = 0.01) and percentage of procedures associated with device infection (2.9% vs 0.5%, p < 0.05). A successful culture of the nares was achieved in 91.4% of protocol patients, with 11.6% MRSA-positive. Risk ratio for infection of pre-protocol/protocol patients was 0.19 (0.05-0.77) with odds ratio 5.1 (1.3-20.0). Utilization of a novel SNM infection protocol tailored to a patient's preoperative MRSA colonization is associated with a reduction in the overall incidence of explant for device infection while avoiding prolonged postoperative antibiotic regimens. The study was initiated prior to January 18, 2017 and does not meet the definition of an applicable clinical trial (ACT) as defined in section 402 (J) of the US PHS Act.


A specialized innervation of the tensor tympani muscle in Macaca fascicularis.
The innervation of the tensor tympani muscle of the middle ear in Macaca fascicularis (cynomolgus monkey) was studied using the horseradish peroxidase (HRP) neural tracing technique. A compact column of small trigeminal motoneurons was labeled ipsilaterally following intramuscular application of HRP to the tensor tympani muscle. This column is located ventral and lateral to the dorsolateral division of the trigeminal motor nucleus, and just medial to the descending trigeminal nerve rootlets. No labeled neurons were present in the trigeminal mesencephalic nucleus or any other brainstem nucleus. Results are compared with those previously reported in several non-primate mammalian species, and in detail with that of the cat. A possible differential role of the tensor tympani muscle in acoustic modulation/middle ear aeration between primate and non-primate mammals is discussed.


Particle Swarm Optimization aided PID gait controller design for a humanoid robot.
Gait planning for the humanoid robot is a very essential and basic requirement. The humanoid robot is balanced at two feet; therefore, special attention is required for gait analysis for the execution of assigned tasks. In this paper, the linear inverted pendulum (LIPM) model is considered to simplify the study and to obtain better gait planning of humanoid robot NAO. Center of mass (COM) and zero moment point (ZMP) criterion are applied with the LIPM model for a better understanding of selecting the step length and period. In addition, a PSO (particle swarm optimization) tuned PID (proportional-integral-derivative) controller has been implemented. Sensory data such as the location of obstacles and the target along with the desired trajectory aided inverse kinematics have been embedded to the conventional PID controller, which provides an interim angle to start the navigation. This interim angle has been carried forward to the PSO technique accompanied by the desired trajectory. It tunes the parameters of the conventional PID controller and provides an optimum turning angle, which avoids obstacles and increases the stabilization of the robot while crossing it. It reduces travel time and shortens travel length. PSO technique minimizes the computational complexity and number of iteration because it requires fewer tuning parameters. Simulations are executed on the simulated NAO robot for the conventional PID controller and the proposed controller. To ratify its findings, experiments are carried out on a real NAO robot in laboratory conditions for both the conventional PID controller and the proposed controller. Simulation and experimental results are presenting a good agreement among each other with deviation under 6%. Applying the PSO tuned PID controller provides a predictable gait and reduces the stabilization time and essentially eliminating the overshoot by 25%. A comparative study with various controllers is performed, and the credibility of the evaluated result has been examined using statistical analysis. The proposed controller has been compared with a previously developed technique to ensure its robustness.


Intestinal microvascular adaptation to chronic portal hypertension in the rat.
Microvascular pressures, diameters, and flow velocities were measured in the small intestine of rats with chronic stenosis of the portal vein. Ten days after portal vein stenosis, portal venous pressure increased (13.8 +/- 0.4 mmHg vs, 7.3 +/- 0.5 mmHg; p less than 0.05) whereas systemic arterial pressure decreased (94.2 +/- 2.0 mmHg vs. 106.5 +/- 1.6 mmHg; p less than 0.05). Red blood cell centerline velocity, measured in first-order arterioles, was significantly higher in portal hypertensive rats (24.3 +/- 1.2 mm/s vs. 19.6 +/- 1.3 mm/s), yet there was no significant change in the diameters of these vessels. Microvascular pressures and diameters of first- and second-order arterioles were not different between control and portal hypertensive rats. However, both pressure (34.3 +/- 2.7 mmHg vs. 28.0 +/- 1.8 mmHg) and diameter (30.4 +/- 0.6 microns vs. 21.4 +/- 2.1 microns) were significantly increased in the third-order arterioles of portal hypertensive rats. A consistent elevation in pressure was observed throughout the distal segments (capillaries to first-order venules) of the intestinal microcirculation of portal hypertensive rats. The results of these studies indicate that the increased intestinal vascular pressures associated with chronic portal hypertension result from a combination of reduced arteriolar resistance and venous congestion.


Speech disruption under delayed auditory feedback in multilingual speakers.
The present study investigated the language familiarity hypothesis formulated by Mackay [(1970). How does language familiarity influence stuttering under delayed auditory feedback? Perceptual and Motor Skills, 30, 655-669] that bilinguals speak faster and stutter less under delayed auditory feedback (DAF) when speaking their more familiar language than a less familiar language. Thirty normally fluent native speakers of Dutch (17 males and 13 females, aged between 18;1 and 26;4 years) who were also proficient in French and English read meaningful and nonsense text under DAF in their mother tongue and in the two later acquired languages. The existence of a language familiarity effect was confirmed. The participants required significantly more time and showed significantly more speech disruptions under DAF in the later acquired languages than in the mother tongue, and reading time and number of speech disruptions was significantly higher for the nonsense texts than for the meaningful text for each of the three languages. An additional question addressed was whether or not there were any gender differences in the susceptibility to DAF. Results did not reveal a clear gender difference. The reader will be able to: (1) summarize the importance of language familiarity for the degree of speech disruption experienced by normally fluent multilingual speakers under delayed auditory feedback; and (2) describe gender differences in the susceptibility to delayed auditory feedback.


Characteristics of major mutagenicity of instant coffee.
Detailed quantitative studies on the mutagenicity of methylglyoxal showed that its contribution to the total mutagenicity of instant coffee on S. typhimurium TA100 was minor although we reported previously (Kasai et al., 1982) that its contribution to the mutagenicity of freshly brewed coffee was about 50%. Cysteine suppressed the mutagenicity of methylglyoxal and of methylglyoxal when added to instant coffee, but did not affect the mutagenicity of coffee itself. Catalase suppressed most of the mutagenicity of coffee, but not that of methylglyoxal or of methylglyoxal added to coffee.


Identification of a Predictive Genomic Biomarker for Prostate-directed Therapy in Synchronous Low-volume Metastatic Castration-sensitive Prostate Cancer.
Standard of care management for synchronous metastatic castration-sensitive prostate cancer (mCSPC) includes androgen deprivation therapy with a second-generation antiandrogen therapy and/or docetaxel. Recently, randomized data have demonstrated that prostate-directed therapy (PDT) is associated with an improvement in overall survival (OS) among patients with low-volume metastatic disease. Tumor genomics represents an additional dimension to define the clinical trajectory of patients with mCSPC. To evaluate a high-risk (HiRi) genomic signature to predict the benefit from PDT. We performed a single-institution retrospective review of men with synchronous low-volume mCSPC who underwent DNA panel sequencing of their tumor. Patients were classified according to the presence of HiRi mutation including pathogenic mutations in TP53, ATM, BRCA1, BRCA2, or Rb1. The primary endpoint was to determine the effect of PDT on OS in patients with and without a HiRi mutation. A survival analysis was performed with the Kaplan-Meier method compared with log-rank test and multivariable Cox regression. The interaction between HiRi mutation and PDT was evaluated. A total of 101 patients with synchronous low-volume CSPC were included with a median follow-up of 44 mo. Approximately half of patients were found to have a HiRi pathogenic mutation (49%). Patients with HiRi mutations demonstrated median OS of 73 versus 66.8 mo (p = 0.3) for no PDT versus PDT. Conversely, patients without a HiRi mutation demonstrated a significant improvement in OS of 60 versus 105.3 mo (p < 0.001) for no PDT versus PDT. The p value for interaction for OS between PDT and HiRi mutation was statistically significant (p < 0.001). Limitations include the retrospective nature of the study. Here, we have identified a HiRi genomic biomarker that appears predictive for the lack of benefit from PDT in men with synchronous low-volume mCSPC. Further work validating these results is warranted. In this report, we evaluated a high-risk genomic biomarker to predict the benefit from prostate-directed therapy for men with synchronous low-volume metastatic castration-sensitive prostate cancer. We found that men without a high-risk mutation appear to experience a greater clinical benefit from prostate-directed therapy than those with a high-risk mutation.


Staphylococcus epidermidis biofilm quantification: effect of different solvents and dyes.
Staphylococcus epidermidis biofilm formed in the presence of the solvents DMSO, ethanol or methanol was quantified using safranin or crystal violet staining protocols. We found that biofilm quantification was the most accurate when safranin protocol was applied. Moreover, both DMSO and ethanol stimulated biofilm formation.


Limb and component alignment after total knee arthroplasty comparing 28 consecutive iAssist and 28 conventional TKAs: A prospective study.
The objective of this study was to assess limb and component alignment after total knee arthroplasty (TKA) on long leg X-rays and to compare the use of iAssist, an accelerometric based computer-assisted device (CAD), with conventional jigs. We prospectively recruited 56 consecutive patients undergoing primary unilateral TKA by a single surgeon into this study. In the first 28 patients iAssist navigation system was utilized and in the following 28 conventional jigs were used. The groups were comparable with regard to age, sex distribution, body mass index and preoperative hip-knee-ankle (HKA) angle. Our aim was to restore neutral coronal alignment and a five degree tibial slope. The mean postoperative mechanical axis was 179.4° in the CAD group and 180.1° in the conventional group (P = 0.187). There were five TKAs deviating more than three degrees from neutral (18.5%) in the conventional group and none in the CAD group (P = 0.051). The mean femoral mechanical-condyles-angle was significantly closer (P < 0.001) to our target of 90° in the conventional group but contained more outliers (P = 0.67). The sagittal tibial slope was closer (P = 0.047) to our target of 85° in CAD-navigated TKAs with fewer outliers (P < 0.0001). The Oxford Knee Score showed comparable (P = 0.271) and good clinical outcome in both groups. The mean operation time was significantly longer in the CAD group (P < 0.001). This study shows that the use of iAssist accelerometric CAD facilitates comparable good leg alignment after TKA in the frontal plane and more accurate tibial slope with fewer outliers in the sagittal plane compared with a conventional technique. Our operation time was longer with CAD.


Lack of clinical or haemodynamic rebound after abrupt interruption of beta-blockers in patients with cirrhosis.
Beta-blockers may have to be interrupted in patients with cirrhosis. The concept of a rebound after interruption of beta-blockers is based on an animal study and on isolated case reports of variceal bleeding. To determine if a rebound occurs in patients with cirrhosis following abrupt interruption of beta-blockers. We prospectively included all consecutive patients with cirrhosis undergoing right heart and hepatic vein catheterisation. Four groups were defined: 'no beta-blockers' including patients not receiving beta-blockers; '≤1 day', '2-3 days' and '≥4 days' classified according to the time patients had interrupted beta-blockers before catheterisation. Results were expressed as median (interquartile range). A total of 150 patients were included. Among the 25 patients in the groups '2-3 days' and '≥4 days', median duration of beta-blockers interruption was 4 (3-6) days. No gastrointestinal bleeding occurred during that period, nor during the following month. Hepatic venous pressure gradient was not different among patients in usually treated with beta-blockers. After adjustment, beta-blockers interruption was not associated with hepatic venous pressure gradient. Cardiac index was higher in the '≥4 days' group [4.6 L/min/m(2) (3.5-5.1)] than in the '≤1 day' group [3.4 (2.6-4.0); P = 0.001] or in the '2-3 days' group [3.1 (2.7-3.7); P = 0.007], but not different from the 'no beta-blockers' group. Abrupt interruption of beta-blockers is associated neither with an apparent increase in the risk of variceal bleeding nor with a haemodynamic rebound. Thus, interruption of beta-blockers in patients with cirrhosis may not require particular dosing or surveillance.


Stress-induced changes in muscarinic and beta-adrenergic binding sites on rat thymocytes and lymphocytes.
This study examined the effect of immobilization stress on the expression of muscarinic and beta-adrenergic receptors on thymocytes and lymphocytes obtained from 5-month-old L-E male rats. After 2 h immobilization (acute stress) there was a significant increase in specific binding of [3H]-DHA to beta-adrenergic receptors on thymocytes and on lymphocytes from the blood but not from the spleen, whereas [3H]-QNB binding to muscarinic receptors in those cells was not altered in comparison with the undisturbed control. Chronic immobilization stress (5 days, for 2 h) decreased the [3H]-QNB binding to lymphocytes collected from the spleen and blood but not from thymus; it caused neither a significant change in the 3H-DHA binding to thymocytes nor lymphocytes obtained from the blood and spleen.


Parasitic infections in dairy cattle around Hanoi, northern Vietnam.
In northern Vietnam, dairy cattle are mainly managed in small-scale farms, where animals are kept confined and feeding occurs by cut and carry methods. In the present study the occurrence of parasitic infections was examined in five provinces around Hanoi. A total of 201 farms were visited, and 334 stool and 239 blood samples were collected from calves younger than 3 months, animals between 3 and 24 months and adult cows. Furthermore, 254 milk samples were collected from lactating animals. Coproscopical examination indicated a high prevalence of nematode eggs (Cooperia spp., Haemonchus and Oesophagostomum spp.) in animals (n=176) between 3 and 24 months (66%) and in adult cows (n=90; 54%). In these age groups the prevalence of Fasciola was 28% and 39%, respectively, and for Paramphistomum the prevalence was 78% and 82%, respectively. Fifty percent of the calves younger than 3 months (n=68) were positive for Giardia, and none for Cryptosporidium. Most Giardia isolates were identified as the non-zoonotic G. duodenalis assemblage E on the beta-giardin gene. The blood samples were examined with commercially available Svanovir((R))Elisa's for the presence of Anaplasma marginale and Babesia bigemina specific antibodies, and a prevalence of 28% and 54% was found, respectively. In the milk samples Neospora caninum specific antibodies (Svanovir((R))Elisa) were detected in 30% of the lactating animals. The present study demonstrates that parasitic infections occur frequently in dairy cattle around Hanoi although animals are mainly kept confined, and indicates that further research on the economic impact of these infections is needed.


Subspace learning using structure learning and non-convex regularization: Hybrid technique with mushroom reproduction optimization in gene selection.
Gene selection as a problem with high dimensions has drawn considerable attention in machine learning and computational biology over the past decade. In the field of gene selection in cancer datasets, different types of feature selection techniques in terms of strategy (filter, wrapper and embedded) and label information (supervised, unsupervised, and semi-supervised) have been developed. However, using hybrid feature selection can still improve the performance. In this paper, we propose a hybrid feature selection based on filter and wrapper strategies. In the filter-phase, we develop an unsupervised features selection based on non-convex regularized non-negative matrix factorization and structure learning, which we deem NCNMFSL. In the wrapper-phase, for the first time, mushroom reproduction optimization (MRO) is leveraged to obtain the most informative features subset. In this hybrid feature selection method, irrelevant features are filtered-out through NCNMFSL, and most discriminative features are selected by MRO. To show the effectiveness and proficiency of the proposed method, numerical experiments are conducted on Breast, Heart, Colon, Leukemia, Prostate, Tox-171 and GLI-85 benchmark datasets. SVM and decision tree classifiers are leveraged to analyze proposed technique and top accuracy are 0.97, 0.84, 0.98, 0.95, 0.98, 0.87 and 0.85 for Breast, Heart, Colon, Leukemia, Prostate, Tox-171 and GLI-85, respectively. The computational results show the effectiveness of the proposed method in comparison with state-of-art feature selection techniques.


The epidemiology of nonaccidental trauma in children.
Abuse of children is abhorrent in Western society and, yet, is not uncommon. Nonaccidental trauma (NAT) is the result of a complex sociopathology. Not all of the causative factors of NAT are known, many are incompletely described, not all function in each case, and many are secondary to preexisting pathology in other areas. We therefore addressed the following questions in this review: (1) what is the general incidence of NAT; (2) what factors are intrinsic to the abused child, family, and society; and (3) what orthopaedic injuries are common in NAT? We searched Medline, Medline In Process & Other Non-Indexed Citations, and Embase using OVID. Only one article fit our inclusion criteria; therefore, this is a descriptive generalized review of the epidemiology of NAT. The general incidence of NAT ranges from 0.47 per 100,000 to 2000 per 100,000. Younger children are at greater risk of NAT than older children. Parents are often the perpetrators of the abuse. Rib fractures are highly indicative of NAT in young children. It is important to consider child, family, and societal factors when confronted with suspicions of child abuse. Our review demonstrates the currently limited information on the true incidence of NAT. To determine a much more accurate incidence of NAT, there needs to be a population-based surveillance program conducted through primary care providers.


Characterization and Functional Analysis of Pyrabactin Resistance-Like Abscisic Acid Receptor Family in Rice.
Abscisic acid (ABA) plays crucial roles in regulating plant growth and development, especially in responding to abiotic stress. The pyrabactin resistance-like (PYL) abscisic acid receptor family has been identified and widely characterized in Arabidopsis. However, PYL families in rice were largely unknown. In the present study, 10 out of 13 PYL orthologs in rice (OsPYL) were isolated and investigated. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) analysis showed that expression of OsPYL genes is tissue-specific and display differential response to ABA treatment, implying their functional diversity. The interaction between 10 OsPYL members and 5 protein phosphatase 2C in rice (OsPP2C) members was investigated in yeast two-hybrid and tobacco transient expression assays, and an overall interaction map was generated, which was suggestive of the diversity and complexity of ABA-sensing signaling in rice. To study the biological function of OsPYLs, two OsPYL genes (OsPYL3 and OsPYL9) were overexpressed in rice. Phenotypic analysis of OsPYL3 and OsPYL9 transgenic rice showed that OsPYLs positively regulated the ABA response during the seed germination. More importantly, the overexpression of OsPYL3 and OsPYL9 substantially improved drought and cold stress tolerance in rice. Taken together, we comprehensively uncovered the properties of OsPYLs, which may be good candidates for the improvement of abiotic stress tolerance in rice.


Boosting the fermentable sugar yield and concentration of corn stover by magnesium oxide pretreatment for ethanol production.
MgO pretreatment was investigated to boost the fermentable sugars derived from corn stover with LHW pretreatment as control. Compared to LHW pretreatment, MgO pretreatment caused twice hemicellulose recovery (42 vs 21%). Double hemicellulose recovery not only didn't affect glucose yield but increased xylose yield by 13% and total sugar yield by 6% under the optimal conditions (pretreatment: 10% biomass loading, 0.1 mol/L MgO, 190 °C, and 40 min; hydrolysis: pretreated biomass loading of 10 g/100 mL, enzyme loading of 1 mL/g pretreated biomass, 50 °C, and 120 h). A total sugar concentration of 50 g/L was obtained under the above conditions. Besides, the enzyme component hydrolyzing xylan may be prone to deactivation by lignin residues in pretreated biomass. Both SEM and FTIR analyses indicate that MgO effectively disrupted the biomass structures and enlarged the exposed surface area of carbohydrates, thus boosting the enzymatic hydrolysis and fermentable sugars for ethanol production.


Prolonged neuromuscular blockade as a result of malnutrition-induced pseudocholinesterase deficiency.
Mivacurium is a short-acting neuromuscular blocking drug, ideal for short surgical procedures. The brief duration of action depends on rapid hydrolysis by plasma cholinesterase. An inherited or acquired deficiency of plasma cholinesterase can prolong the effect of mivacurium. We present an unusual case of unanticipated postoperative apnea following mivacurium administration, as a result of acquired plasma cholinesterase deficiency, in a patient with previous uneventful exposure to both mivacurium and suxamethonium (succinylcholine).


Inhibition of ovulation in the rat by a hCG antagonist.
Chemically deglycosylated preparations of hCG (DG-hCG) which have been shown to have hormonal antagonistic activity in vitro were able to compete with 125I-labeled hCG for binding sites in the ovary in pseudo-pregnant rats. DG-hCG at 100 micrograms dose inhibited ovulation by 73% in PMSG-treated rats. Administration of DG-hCG prior to and concurrent with 25 IU hCG reduced ovulation by 37% (P less than 0.05). In mature cycling rats, DG-hCG was capable of inhibiting ovulation when injected on the afternoon of proestrus. These results indicate that DG-hCG can exert its hormonal antagonistic activity in vivo in rats.


[18F]-N-Methylspiroperidol: the radioligand of choice for PETT studies of the dopamine receptor in human brain.
N-Methylspiroperidol, the amide N-methyl analogue of the neuroleptic spiroperidol, was radiolabeled with fluorine-18, and its distribution in the baboon brain was studied using positron emission transaxial tomography. Stereospecific binding was demonstrated in the striatum (but not in the cerebellum) by pretreatment with (-)- or (+)-butaclamol. The kinetic distribution was similar to that of [18F]spiroperidol, but the absolute striatal uptake (in percent of administered dose) was at least two-fold higher. Analysis of baboon blood at 10 min after injection indicated that less than half of the radioactivity in the plasma was due to unchanged radioligand. Analysis of the metabolic stability of [18F]-N-methylspiroperidol in rat brain for 4 hr indicated that, like [18F]spiroperidol, it is very stable to metabolic transformation in the rat central nervous system. Striatal uptake and retention in the rat was five-fold higher for [18F]-N-methylspiroperidol than for [18F]spiroperidol. These results suggest that [18F]-N-methylspiroperidol is an ideal choice for studies of the dopamine receptor in humans.