Association of anti-ribosomal P protein antibodies with neuropsychiatric and other manifestations of systemic lupus erythematosus.
The objective of our study was to determine the prevalence of neuropsychiatric manifestations and anti-ribosomal P antibodies (aRP) in SLE and to examine the diagnostic utility and associations of aRP with neuropsychiatric and other disease manifestations. Thirty two consecutive SLE patients, diagnosed according to the updated 1997 ACR criteria, were studied. A full medical history, rheumatological, neurological, psychiatric examination, and psychometric evaluation, including a battery of tests for cognitive dysfunction and the Symptom Checklist-90-Revised depression and anxiety scales were administered to all patients. Disease activity was scored using the SLEDAI. Neuropsychiatric manifestations were diagnosed and categorized according to the 1999 ACR case definitions for 19 NPSLE syndromes. Laboratory and serologic tests including ANA, anti-ds DNA, anti-cardiolipin antibodies (aCL) and aRP (ELISA) were also carried out. Twenty six (81.2%) patients had one or more NP manifestations. Depression (59.4%), headache (46.9%) and cognitive dysfunction (37.5%) were the commonest NPSLE syndromes. Other less commonly detected manifestations included seizures, anxiety, acute confusional state, stroke, and psychosis. aRP was positive in seven (21.9%) patients, all of whom had one or more NPSLE syndromes. Patients with psychiatric manifestations in general and mood disorders in particular had significantly higher mean titers of aRP than patients without these disorders (p < 0.05). aRP were found to be significantly associated with a younger age at the onset of SLE, with more severe articular manifestations and with the presence but not the severity of depression. aRP were highly specific for NPSLE and depression, and they were highly sensitive for psychosis. Neuropsychiatric manifestations are found in 81.2% of unselected Egyptian SLE patients. The presence of aRP antibodies positively predicts patients with psychiatric manifestations in general and mood disorders in particular, for which aRP is specific, but not sensitive. However, aRP is sensitive for psychosis, so that its absence in patients with SLE may help exclude Lupus psychosis.


Changing characteristics of ecosystem and water storage under the background of warming and humidification in the Qilian Mountains, China.
The Qilian Mountains provide an ecological security barrier, and the region is an important river runoff area in China. Water resources play an essential role in the natural environment of Northwest China. This study used daily temperature and precipitation data from meteorological stations in the Qilian Mountains from 2003 to 2019, Gravity Recovery and Climate Experiment, and Moderate Resolution Imaging Spectroradiometer satellite data. Additionally, we used the Gravity Recovery and Climate Experiment satellite's monthly gravity field model data. Furthermore, we analyzed the characteristics of climate warming and humidification in the eastern, central, and western sections of the Qilian Mountains based on spatial precipitation interpolation and linear trend analysis. Finally, we examined the relationship between water storage changes and precipitation and its impact on vegetation ecology. The results revealed a significant warming and humidification trend in the western Qilian Mountains. The temperature increased significantly, and the increased precipitation rate in summer reached 1.5-3.1 mm/10a. Water storage in the Qilian Mountains displayed an increasing trend, with an increase of approximately 14.3 × 108 m3 over the 17 years study period, averaging an increase of 8.4 mm/year. The spatial distribution of water storage in the Qilian Mountains increased from north to south and east to west. There were noticeable seasonal differences, with the largest surplus occurring in the western Qilian Mountains (71.2 mm in summer). The fractional vegetation coverage in 95.2 % of the western Qilian Mountains and net primary productivity in 90.4 % of the area displayed an increasing trend, and vegetation ecology improved significantly. This study aims to investigate the characteristics of ecosystem and water storage changes in the Qilian Mountain area under the background of climate warming and humidification. The results obtained from this study provided an assessment of the vulnerability of alpine ecosystems and helped in making spatially explicit decisions for the rational utilization of water resources.


Fecal matters: Microbial signatures distinguish clinically relevant subtypes of precancerous colorectal polyps.
Colorectal cancer (CRC) can arise from adenomatous or serrated polyps, which differ in their detection rate and risk of cancer progression. In this issue, Lee et al. report that these polyp subtypes demonstrate distinct fecal microbial species composition and metabolic potential that associate with diet and medications.


Modelling the asymmetric effects of renewable and nonrenewable energy consumption and financial development on CO2 emissions in India: Empirical findings from the NARDL and Wavelet Coherence Approach.
A major challenge for humans in the twenty-first century is devising a way to minimize environmental pollution while fostering economic growth that will not deplete the planet's resources. Despite increased awareness of climate change and efforts to combat it, the amount of pollution emissions on the Earth continues to drop significantly. This study employs cutting-edge econometric methods to examine the long- and short-term asymmetric and causal impacts of renewable and non-renewable energy consumption and financial development on CO2 emissions in India at both aggregate and disaggregated levels. Thus, this work fills a significant gap in research. A time series from 1965 to 2020 was used for this study. Wavelet coherence was employed to investigate causal effects among the variables, while the NARDL model addressed long-run and short-run asymmetry effects. Our findings indicate that (i) REC, NREC, FD, and CO2 emissions are all interconnected in the long run, (ii) NREC and FD significantly trigger CO2 emissions in India in the long run, and (iii) the results of a wavelet coherence-based causality test support the long-term estimates of this study.


Development of a Visualization Deep Learning Model for Classifying Origins of Ventricular Arrhythmias.
Several algorithms have been proposed for differentiating the right and left outflow tracts (RVOT/LVOT) arrhythmia origins from 12-lead electrocardiograms (ECGs); however, the procedure is complicated. A deep learning (DL) model, a form of artificial intelligence, can directly use ECGs and depict the importance of the leads and waveforms. This study aimed to create a visualized DL model that could classify arrhythmia origins more accurately.Methods and Results: This study enrolled 80 patients who underwent catheter ablation. A convolutional neural network-based model that could classify arrhythmia origins with 12-lead ECGs and visualize the leads that contributed to the diagnosis using a gradient-weighted class activation mapping method was developed. The average prediction results of the origins by the DL model were 89.4% (88.2-90.6) for accuracy and 95.2% (94.3-96.2) for recall, which were significantly better than when a conventional algorithm is used. The ratio of the contribution to the prediction differed between RVOT and LVOT origins. Although leads V1 to V3 and the limb leads had a focused balance in the LVOT group, the contribution ratio of leads aVR, aVL, and aVF was higher in the RVOT group. This study diagnosed the arrhythmia origins more accurately than the conventional algorithm, and clarified which part of the 12-lead waveforms contributed to the diagnosis. The visualized DL model was convincing and may play a role in understanding the pathogenesis of arrhythmias.


On the possible specific role of acupuncture loci in therapeutics.
The case history of a patient with thoracic vertebra fracture and following pain syndrome of the inferior limbs is reported. As a result of acupuncture treatment the pain was significantly reduced, but it could be reinduced by stimulation of the B1-31-33 loci during treatment. On needling the connecting locus of the related meridian of the bladder (Ki-6) the pain disappeared; otherwise stimulation of other loci showed a failure to stop the pain induced by the stimulation of B1-31-33 loci. It is remarkable that both the bladder's and the Ki-6 loci belong to the lumbal 4 spinal segment. The problem of the specific role of the acupuncture loci also is discussed.


Effects of cooking fuel sources on the respiratory health of children: evidence from the Annual Health Survey, Uttar Pradesh, India.
India is predominantly a rural country, where more than two-thirds of the population live in rural areas. The majority of the rural population use crop residue, firewood, and dung cake as cooking fuel sources. Combustion of these fuels emits life-threatening pollutants that contaminate the household environment, which can have serious health consequences, especially for young children. This study examines the use of cooking fuel sources and their association with acute respiratory infections (ARIs) in children aged 0-59 months. This study used data from the second update of the Annual Health Survey (2012-13). The prevalence rate was measured in terms of the number of children per 1000 children suffering from ARIs. Bivariate analysis was used to analyze the use of different cooking fuels (in percentage) and the prevalence of ARIs in Uttar Pradesh. District-level variations in the cooking fuels used were assessed by simple bivariate analysis for all districts of Uttar Pradesh. A logistic regression was used to examine the association of household environment and pollutants with ARIs. In total, 89 per 1000 children suffered from ARIs in Uttar Pradesh. Infants (0-11 months) were significantly more likely to suffer from ARIs than older children (12-59 months). Households using dung cake for cooking and kerosene and other oils for lighting were found to have significantly higher odds for ARIs (odds ratio [OR]: 1.21; 95% confidence interval [CI]: 1.17-1.25 and OR: 1.07; 95% CI: 1.05-1.10, respectively). A considerable interdistrict difference was observed in the cooking fuel used and the prevalence of ARIs among children aged 0-59 months. The type of cooking fuel and lighting source used were found to be significant predictors of ARIs among children aged 0-59 months. These results highlight the need for targeted efforts for the provision of clean cooking fuels (liquid petroleum gas/biogas/electricity) and for the improvement in knowledge and awareness of ARIs and exposure to cooking and lighting pollution.


Hairy root cultures of Gynostemma pentaphyllum (Thunb.) Makino: a promising approach for the production of gypenosides as an alternative of ginseng saponins.
Hairy root cultures of Gynostemma pentaphyllum were established by infecting leaf discs with Agrobacterium rhizogenes. The dry biomass of hairy roots grown in MS medium for 49 days was 7.3 g l(-1) with a gypenoside content of 38 mg g(-1) dry wt.


Older people with depression - a three-year follow-up.
The prevalence of depression among older people amounts to 1-5 % at the diagnostic level. Depression in older people may be chronic and is associated with an increased risk of dementia. No longitudinal studies have been conducted of depression in older people in Norway. We have undertaken a multi-centre longitudinal observation study of 160 patients aged 60 years and above who had been treated for depression in departments of old-age psychiatry at specialist healthcare services in Norway. The patients were followed up on four occasions over a three-year period. Of the 131 patients who completed the study, 24 (18.3 %) were free from depression and depressive symptoms at the points of follow-up after discharge, while 55 (42.0 % showed depressive symptoms and 51 (38.9 %) had suffered at least one serious relapse or had remained continuously ill with a depressive condition. The proportion of persons with dementia increased from 14 out of 160 (8.8 %) at the start of the study period to 40 out of 131 (30.5 %) after three years. Older people with depression who have been treated in departments of old-age psychiatry in specialist healthcare services have an unfavourable prognosis regarding the course of their depression and development of dementia over a three-year period.


Blunted blood pressure response and elevated plasma adiponectin levels in female Sprague Dawley rats.
Premenopausal women have lower blood pressure (BP) levels than men of similar age. Adiponectin has been shown to play a role in the pathogenesis of hypertension. The aim of the present study was to compare the effect of various stress stimuli on BP and plasma adiponectin levels in male and female Sprague Dawley (SD) rats. In three experimental models of hypertension, fructose-enriched diet, high salt diet, or L-NAME, were administered for up to 4 weeks. BP, metabolic parameters, and plasma adiponectin were measured at baseline and during the studies. The fructose diet protocol was repeated in female rats for 2 weeks with the addition of testosterone injections or vehicle. Females, in contrast to males, did not develop fructose-induced hypertension. Total plasma triglycerides (TGs) were half in females at baseline (P < 0.001) and a third at 4 weeks (P < 0.05). Plasma insulin levels were 23% lower in females than in males at baseline (P < 0.05) and 42% lower after 4 weeks of fructose-enriched diet (P = 0.001). Plasma adiponectin levels were 65% higher in females than in males at baseline (P = 0.001) and 45% higher after 4 weeks of fructose-enriched diet (P < 0.05). Furthermore, female rats showed blunted BP response and elevated plasma adiponectin in the salt-induced and L-NAME-induced hypertension models. Testosterone injection to female rats reduced plasma adiponectin and reversed the blunted BP response. Elevated plasma adiponectin levels, perhaps due to lack of suppression by testosterone, are associated with a blunting of BP response in female compared to male SD rats.


A revised and dated phylogeny of cobweb spiders (Araneae, Araneoidea, Theridiidae): A predatory Cretaceous lineage diversifying in the era of the ants (Hymenoptera, Formicidae).
Cobweb spiders (Theridiidae) are highly diverse from the perspective of species richness, morphological diversity, variety of web architecture, and behavioral repertoires. The family includes over 50% of social spiders, a behavioral rarity among the order, and members of the family are furthermore the subject of research on venom, silk biomechanics, kleptoparasitism and web building, among other traits. Theridiidae is one of the most abundant groups of spiders, and thus key insect predators in many different ecosystems and is among relatively few spider families that show high degree of myrmecophagy. Modern comparative studies on all these fronts are best buttressed on a phylogenetic foundation. Our goal here is to offer a revised, dated, phylogenetic hypothesis for the family by summarizing previously published data from multiple molecular and morphological studies through data-mining, and adding novel data from several genera. We also test the hypothesis that the origin and diversification of cobweb spiders coincides with that of ants on which many species specialize as prey. The new phylogeny is largely congruent with prior studies and current taxonomy and should provide a useful tool for theridiid classification and for comparative analyses. Nevertheless, we also highlight the limitations of currently available data-the state of the art in Theridiidae phylogenetics-offering weak support for most of the deeper nodes in the phylogeny. Thus the need is clear for modern phylogenomic approaches to obtain a more solid understanding, especially of relationships among subfamilies. We recover the monophyly of currently recognized theridiid subfamilies with the exception of some enigmatic 'pholcommatines' (Styposis, Phoroncidia) and putative 'hadrotarsines' (Audifia, Tekellina) whose placement is uncertain in our analyses. Theridiidae dates back some 100 mya to the Cretaceous, a period of diversification in flowering plants and many groups of insects, including ants. The origin of cobweb spiders, and hence the cobweb-a speciallized trap for pedestrian prey-coincides with a major diversification shift in ants. The family becomes abundant in fossil record 50-40 mya as ants also diversify and reach dominance and contemporary patterns of abundances of theridiids and ants show the same trends, with increasing relative abundance towards the equator and at lower altitudes. We find that among orbiculariae, lineages that specialize on ant prey are non-randomly clustered within Theridiidae. Given these findings we hypothesize that the origin of the gumfoot web was a stepping stone that facilitated the capture of ants and resulted in specialized myrmecophagy in a number of 'basal' theridiids. We also document a subsequent loss in myrmecophagy, and associated increase in speciation rates, as 'recent' theridiid groups evolve diverse web forms and many return to the capture of aerial prey.


Characteristics of natural salt licks located in the Colombian Amazon foothills.
Salt licks are key places for the ecological dynamics of wildlife communities around the world and are locations where animals develop geophagical behaviours. Geophagy is a method for animals to supplement their diets or facilitate their digestive processes and is related to the health of individuals and populations. This study characterises a series of salt licks located in the Colombian Amazon foothills and describes their structural, mineralogical and physicochemical properties, as well as the fauna that visit these locations. The results are analysed in reference to the geological characteristics of the study area and in relation to the role of the salt lick in the nutritional ecology of the Amazonian fauna. Located in the study area are two types of salt licks that are significantly different in composition. These salt licks are located in an area where young geological materials have been exposed. The characteristics of the salt licks supports the hypothesis that they are used to solve nutritional problems that result from herbivorous diets. The clear importance of salt licks in the ecology of several Amazonian animal species emphasises the need to prioritise conservation areas by maximising the complementarities of salt lick sites.


Identification of two novel mutations in non-Jewish factor XI deficiency.
We have studied two heterozygous unrelated CRM- non-Jewish FXI-deficient patients. Neither of the patients carries a previously described mutation. Their FXI genes were screened by SSCP analysis following PCR amplification of each exon and the flanking intronic sequences. DNA fragments showing aberrant mobility were cloned and sequenced. The following mutations were identified: in case 1, a T to G transition in exon 12 results in the substitution of Phe-442 by Val (FXI-F442V); in case 2 a C to A transition in exon 5 results in the substitution of Cys-128 by a nonsense codon (FXI-C128X). The missense mutation results in a substitution within the protease domain of FXI. Molecular modelling locates this residue in a structurally conserved region of the protease domain and the amino acid substitution may therefore interfere with either chain folding and subsequent secretion or the stability of the protein in plasma. We conclude that the mutations which we have identified are responsible for the inherited abnormality in these patients.


Mesocortical dopaminergic neurons. 1. Electrophysiological properties and evidence for soma-dendritic autoreceptors.
Mesencephalic dopaminergic neurons were electrophysiologically identified by a variety of criteria, including antidromic activation from prefrontal or cingulate cortex, neostriatum, or nucleus accumbens in urethane-anesthetized rats. The mean firing rate of 98 mesocortical dopaminergic neurons was 2.9 +/- 0.3 spikes/sec and did not differ from the mean firing rate found for nigrostriatal or nucleus accumbens dopaminergic neurons. Spontaneously active mesocortical dopaminergic neurons were inhibited by intravenous administration of either apomorphine (6 micrograms/kg) or amphetamine (0.25 mg/kg). Whereas most antidromic responses of nigrostriatal and mesoaccumbens neurons consisted of the initial segment spike only, cortically-elicited antidromic responses typically consisted of a full initial segment-soma-dendritic spike. These findings are discussed with regard to the presence of soma-dendritic autoreceptors on mesocortical dopaminergic neurons.


Venous versus arterial actions of diethylamine/nitric oxide (DEA/NO) complex and S-nitroso-N-acetylpenicillamine (SNAP) in vivo.
We studied the effects of diethylamine/NO complex (DEA/NO) and S-nitroso-N-acetylpenicillamine (SNAP), relative to those of sodium nitroprusside (SNP) and nitroglycerin (NTG), on mean arterial pressure (MAP), mean circulatory filling pressure (MCFP), arterial resistance (Ra), venous resistance (Rv), heart rate (HR), cardiac output (CO) and stroke volume (SV) in groups of Inactin-anaesthetized rats pre-treated with i.v. mecamylamine (3.7 micromol kg(-1)) and noradrenaline (6.8 nmol kg(-1) min(-1)). Doses of each that reduced MAP by 30%, 80% and the lowest dose that maximally reduced MAP were examined to allow a comparison of the compounds' dilator actions at equivalent effective depressor doses. DEA/NO (4, 32 and 256 microg kg(-1) min(-1)), SNAP (4, 32 and 256 microg kg(-1) min(-1)) and SNP (8, 32 and 128 microg kg(-1) min(-1)) caused similar dose-dependent reductions in MAP and Ra, and increases in CO and SV. NTG (0.2, 0.8 and 6.4 microg kg(-1) min(-1)) dose-dependently reduced Ra, and increased CO and SV, but lowered MAP only at the highest dose. DEA/NO, SNAP and SNP but not NTG lowered MCFP with efficacy: DEA/NO > SNAP > SNP. All four drugs reduced Rv with efficacy: DEA/NO approximately equal to SNAP > SNP approximately equal to NTG. Therefore, all compounds lowered Ra and Rv. DEA/NO, SNAP and SNP but not NTG reduced MCFP. The pharmacological profiles of DEA/NO and SNAP resemble SNP more than NTG.


Smart Secure Homes: A Survey of Smart Home Technologies that Sense, Assess, and Respond to Security Threats.
Smart home design has undergone a metamorphosis in recent years. The field has evolved from designing theoretical smart home frameworks and performing scripted tasks in laboratories. Instead, we now find robust smart home technologies that are commonly used by large segments of the population in a variety of settings. Recent smart home applications are focused on activity recognition, health monitoring, and automation. In this paper, we take a look at another important role for smart homes: security. We first explore the numerous ways smart homes can and do provide protection for their residents. Next, we provide a comparative analysis of the alternative tools and research that has been developed for this purpose. We investigate not only existing commercial products that have been introduced but also discuss the numerous research that has been focused on detecting and identifying potential threats. Finally, we close with open challenges and ideas for future research that will keep individuals secure and healthy while in their own homes.


NHC-Stabilised Acetylene-How Far Can the Analogy Be Pushed?
Experimental studies suggest that the compound (NHCbz )2 C2 H2 can be considered as a complex of a distorted acetylene fragment which is stabilised by benzoannelated N-heterocyclic carbene ligands (NHCbz )→(C2 H2 )←(NHCbz ). A quantum chemical analysis of the electronic structures shows that the description with dative bonds is more favourable than with electron-sharing double bonds (NHCbz )=(C2 H2 )=(NHCbz ).


DNA ploidy in oral cavity carcinomas, with special reference to prognosis.
Single-cell DNA cytofluorometry was performed on paraffin-embedded tissue of 140 patients with squamous cell carcinomas of the oral cavity. Half of the tumors (71 of 140) were DNA nondiploid. Well-differentiated carcinomas were more often DNA diploid than moderately well-differentiated ones (P less than 0.001; chi-square). The aneuploid tumors responded better to preoperative radiotherapy than did the DNA diploid (P less than 0.001) and polyploid tumors (P less than 0.05; chi-square). Using the multivariate Cox's regression analysis multiploid type tumor, age of the patients and presence of lymph node metastases were the only significant factors influencing survival. DNA diploid tumors in stages I and II had a better prognosis than DNA nondiploid (P less than 0.01; Kaplan-Meier). The reverse was true for stages III and IV, where DNA nondiploid tumors had a better prognosis (P less than 0.05; Kaplan-Meier). Tumor stages (P less than 0.001; Kaplan-Meier) and especially lymph node metastases (P less than 0.0005; Kaplan-Meier) were major prognostic factors. Tumor DNA ploidy may be a complement to clinical and morphologic parameters as a prognostic predictor in squamous cell carcinoma of the oral cavity.


Effect of exposure to antibiotics on the gut microbiome and biochemical indexes of pregnant women.
Exposure to antibiotics (ABX) during pregnancy can have a systematic effect on both fetal and maternal health. Although previous biomonitoring studies have indicated the effects on children of extensive exposure to ABX, studies on pregnant women remain scarce. To explore the effect on pregnant women of environmental exposure to ABX through accidental ingestion and identify potential health risks, the present study investigated 122 pregnant women in East China between 2019 and 2020. The presence of six categories of ABX (quinolones, sulfonamides, lincosamides, tetracyclines, amide alcohol ABX, and β-lactams) in plasma samples taken from the pregnant women was investigated using an ABX kit and a time-resolved fluorescence immunoassay. All six ABX were detected in the plasma, with a detection rate of 17.2%. It was discovered that the composition of intestinal flora in pregnant women exposed to ABX was different from that of pregnant women who had not been exposed to ABX. The intestinal flora of pregnant women exposed to ABX also changed at both the phylum and genus levels, and several genera almost disappeared. Furthermore, the metabolic levels of glucose and insulin and the alpha diversity of pregnant women exposed to ABX were higher than those of pregnant women not exposed to ABX. Pregnant women are potentially at higher risk of adverse microbial effects. Glucose metabolism and insulin levels were generally higher in pregnant women exposed to ABX than in unexposed women. Also, the composition and color of the gut microbiome changed.


Knowledge, Attitude, and Practices regarding Obesity among Population of Urban (Douala) and Rural (Manjo) Areas in Cameroon.
Knowledge, attitude, and practice (KAP) studies have recently been suggested as a useful tool to understand the specificity of the population related to a disease. However, in Cameroon, there is a lack of information based on KAP studies regarding obesity. This study has been designed to collect basic indicators on the KAP of the populations regarding overweight and obesity in urban and rural areas in Cameroon (Douala and Manjo). For this purpose, an epidemiological community-based cross-sectional descriptive study was conducted in these two areas using a well-structured questionnaire. Sociodemographic and medical characteristics and KAP information were assessed. For the quantification of KAP, a score varying from 0 (poor knowledge, attitude, or practices) to 100 (good knowledge, attitude, or practices) was attributed for each question. Correlations between knowledge, attitude, and practice were determined using inferential statistics tests which were χ2 test, independent Student t-test, ANOVA (followed by Tukey's post hoc test), and Pearson correlation coefficient. Results reveal that living in a rural area (Manjo), being overweight or obese, having complete secondary education, and being married increase the knowledge and the practice score. There is a strong and positive correlation between knowledge and practice score. However, there is no association between attitude and practice and between attitude and knowledge. Reducing the disparities between knowledge, attitude, and practices constitutes a serious track in a holistic strategy for the management of obesity in these areas.


Optimizing reconstruction of oncologic sternectomy defects based on surgical outcomes.
The optimal strategy for oncologic sternectomy reconstruction has not been well characterized. We hypothesized that the major factors driving the reconstructive strategy for oncologic sternectomy include the need for skin replacement, extent of the bony sternectomy defect, and status of the internal mammary vessels. We reviewed consecutive oncologic sternectomy reconstructions performed at The University of Texas MD Anderson Cancer Center during a 10-year period. Regression models analyzed associations between patient, defect, and treatment factors and outcomes to identify patient and treatment selection criteria. We developed a generalized management algorithm based on these data. Forty-nine consecutive patients underwent oncologic sternectomy reconstruction (mean follow-up 18 ± 23 months). More sternectomies were partial (74%) rather than total/subtotal (26%). Most defects (n = 40 [82%]) required skeletal reconstruction. Pectoralis muscle flaps were most commonly used for sternectomies with intact overlying skin (64%) and infrequently used when a presternal skin defect was present (36%; p = 0.06). Free flaps were more often used for total/subtotal vs partial sternectomy defects (75% vs 25%, respectively; p = 0.02). Complication rates for total/subtotal sternectomy and partial sternectomy were equivalent (46% vs 44%, respectively; p = 0.92). Despite more extensive sternal resections, total/subtotal sternectomies resulted in equivalent postoperative complications when combined with the appropriate soft-tissue reconstruction. Good surgical and oncologic outcomes can be achieved with defect-characteristic-matched reconstructive strategies for these complex oncologic sternectomy resections.


Is human papillomavirus associated with cervical neoplasia in the elderly?
There have been no studies in the United States of human papillomavirus (HPV) in elderly women. This paper presents cross-sectional data on HPV and cervical neoplasia among 232 women age 65 or more. HPV deoxyribonucleic acid (DNA) testing was performed using a modified dot-blot hybridization technique. The prevalence of HPV DNA positivity was 3.5% (95% confidence interval (CI) 0.9%, 6.0%). There were six cases of histologic cervical neoplasia. The crude odds ratio for cervical neoplasia among HPV DNA positives was 18.3 (95% CI 2.8, 120.3). The adjusted odds, controlling for age, prior screening history, current sexual activity, and past contraception use, were 12.2 (95% CI 1.2, 122.9). Ever having had a Papanicolaou smear was protective, and there was a trend for the odds of having neoplasia to increase with age. Additional studies with larger samples of elderly women are needed. If confirmed, the results suggest that, independent of past screening, HPV may increase the risk of having cervical neoplasia for elderly women.


Limited proteolysis of inactive tetrameric chloroplast NADP-malate dehydrogenase produces active dimers.
Carboxy-terminal amino acids of NADP-dependent malate dehydrogenase (EC 220.127.116.11) from pea chloroplasts were removed by treatment with carboxypeptidase Y. This results in the activation of the inactive oxidized enzyme, while activation by light in vivo is thought to occur via reduction of an intrasubunit disulfide bridge. After proteolytic activation the oxidized enzyme had a specific activity of 100 U/mg protein, which is 50% of the maximal activity of the control enzyme in the reduced state. When the truncated enzyme was reduced with dithiothreitol (DTT), the specific activity was further increased to 1200 U/mg. While the native enzyme is composed of four identical subunits of 38,900 Da, the truncated malate dehydrogenase forms dimers composed of two subunits of 38,000 Da. No further change of molecular mass or activity was noticed subsequent to prolonged incubation of native NADP-malate dehydrogenase with carboxypeptidase Y for several days. When the enzyme is denatured by 2 M guanidine-HCl, the proteolytic activation proceeds more rapidly, but only transiently. The truncated enzyme is less accessible to activation by reduced thioredoxin, but the stimulation of activity by DTT alone is more rapid than that of the native enzyme. These results indicate that only a small carboxy-terminal peptide of native NADP-malate dehydrogenase from pea chloroplasts is accessible to proteolytic degradation and that this peptide is involved in the regulation of activity, tetramer formation, and thioredoxin binding. While the pH optimum for catalytic activity of the intact reduced enzyme is at pH 8.0-8.5, it is shifted to more acidic values upon proteolysis of NADP-malate dehydrogenase. At pH values below 8 the reduced truncated enzyme exhibits substrate inhibition by oxaloacetate.


Preparation of heparin-immobilized PVA and its adsorption for low-density lipoprotein from hyperlipemia plasma.
In this study, heparin was covalently coupled by glutaraldehyde to Poly(vinyl alcohol) [PVA] in solid-liquid two-phase reaction system by two-step synthesis method to prepare a LDL-selective adsorbent. The parameters (the material ratio, reaction time and dosage of catalyzer) were investigated to evaluate their effect upon the immobilized amount of heparin onto the surface of PVA, IR was used to verify the covalent immobilization result and the heparin-modified PVA was also undergone the evaluation of its adsorption capability for low-density lipoprotein from hyperlipemia plasma, and its hemocompatibility was preliminarily evaluated by platelet adhesion test. Results showed: (1) under optimized reaction conditions the highest immobilization amount of heparin onto PVA surface within the experiments of this study has been obtained; (2) the optimized reaction conditions were: (i) at the refluxing temperature 78 degrees C; (ii) the material ratio of "PVA(g): 50% glutaraldehyde (ml)" was about "1:3"; (iii) the reaction time was about 5 h; and (iv) the amount of catalyzer (concentrated HCL) was about 1% of the 50% glutaraldehyde; (3) within the experiments of this study the highest immobilization amount would be up to 25 microg heparin on the surface of per g PVA granules; (4) the heparin-modified PVA granules showed significant adsorption for LDL under faintly alkaline environment (pH=7.2-9.5) ; (5) The result of platelet adhesion test showed no platelet adhered to its surface. Therefore, immobilization of heparin onto the surface of a support is one approach to prepare a kind of LDL adsorbent for blood purification.


Enzymes immobilized on amine-terminated ionic liquid-functionalized carbon nanotube for hydrogen peroxide determination.
We report on a new approach for the electrochemical detection of hydrogen peroxide (H2O2) based on Cytochrome C (Cyt c) immobilized ionic liquid (IL)-functionalized multi-walled carbon nanotubes (MWCNTs) modified glass carbon electrode (GCE). Functionalization of multi-walled carbon nanotube with amine-terminated ionic liquid materials was characterized using fourier transform infrared spectroscopy (FTIR), UV-vis spectra, and electrochemical impedance spectroscopy (EIS), and the results showed that the covalent modification of MWCNTs with ILs exhibited a high surface area for enzyme immobilization and provided a good microenvironment for Cyt c to retain its bioelectrocatalytic activity toward H2O2. Amperometry was used to evaluate the catalytic activity of the cyt c towards H2O2. The proposed biosensor exhibited a wide linear response range nearly 4 orders of magnitude of H2O2 (4.0 × 10(-8)M-1.0 × 10(-4)M) with a good linearity (0.9980) and a low detection limit of 1.3 × 10(-8)M (based on S/N=3). Furthermore, the biosensor also displays some other excellent characteristics such as high selectivity, good reproducibility and long-term stability. Thus, the biosensor constructed in this study has great potential for detecting H2O2 in the complex biosystems.


Quercetin prevents ethanol-induced dyslipidemia and mitochondrial oxidative damage.
Lipid metabolism disorder and oxidative stress play an important role on the development and progression of alcoholic liver disease (ALD), and mitochondria compartment is presumed as the main source and susceptible target of intracellular ROS. The objective of this study was to evaluate the protective effect of quercetin, a naturally occurring flavonoids possessing both antioxidant and hypolipidemic effect, on ethanol-induced dyslipidemia and oxidative damage focused on mitochondria. Chronic alcohol administration for adult male rats (4.0 g/kg for 90 days) resulted in the leakage of alanine and especially aspartate aminotransferases, and morphological malformation mainly evidenced by sustained lipid infiltration and degenerative changes on mitochondria and rough endoplasmic reticulum, which was markedly alleviated by quercetin (100 mg/kg.bw.) pretreatment. Furthermore, quercetin prophylaxis evidently ameliorated ethanol-stimulated mitochondrial dysfunction manifested by decreased membrane potential and induced permeability transition though suppressing glutathione depletion, enzymatic inactivation of manganese superoxide dismutase and glutathione peroxidase, ROS over-generation, and lipid peroxidation in mitochondria. Quercetin, thus, may protect rat, especially hepatic mitochondria, from chronic ethanol toxicity through its hypolipidemic effect and antioxidative role, highlighting a promising preventive strategy for ALD by naturally occurring phytochemicals.


Early reduced bone formation following burn injury in rats is not inversely related to marrow adiposity.
The objective of the study was to determine whether postburn reduction of bone formation occurred earlier than 2-3 weeks after burn injury and whether that reduction was inversely related to marrow adiposity. Using a rat model of burn injury with sacrifice at 3 days postburn, we measured serum osteocalcin, a biomarker of bone formation, as well as a regulator of glucose metabolism, and counted tibial marrow adipocytes. Serum osteocalcin was reduced as early as 3 days postburn, coinciding with a trend toward decline in marrow adipocyte number rather than demonstrating an inverse relationship with adipocyte count. Factors that may be responsible for the dissociation include lack of circulating sclerostin, previously reported, increased energy demands following burn injury, increased sympathetic tone and perhaps oxidative stress. The relationship between bone formation and marrow adiposity is complex and subject to a variety of influences.


Job market in head and neck surgery: A survey and analysis of recent fellowship graduates.
Recent years have seen increase in individuals pursuing postgraduate fellowships in head and neck (HN) surgery. This has presented concerns about insufficient jobs where graduates can apply their scope of specialized training. Data was collected in two manners- a survey and a manual online search of American Head and Neck Society (AHNS) fellowship graduates. A 25-question survey was sent in 2021 to approximately 400 HN fellows who graduated between 2010 and 2020. The AHNS list of graduates from the same years were searched online to collect information including gender, graduation year, fellowship training, and current job practice. Of the 78 survey responses, 64.1 % were male and 34.6 % female. 96.2 % reported ablative, 84.6 % microvascular, and 82.1 % TORS training. Mean number of interviews was 4 with most interviewing during the 3rd quarter (January to March). Majority reported being in academic and university-based practices (79.6 %). Online search was done on 393 graduates. Since 2010 the number of graduates almost doubled. There was a statistically significant increase in females by year (p = 0.022). There was a significant decrease (p = 0.022) in graduates with additional fellowship training from that of their AHNS fellowship. There was also a statistically significant increase in graduates being in academic practices (p = 0.022). Despite growing numbers, there appears to be more graduates entering an academic practice, although the definition of an academic HN practice may be evolving. These results provide guidance on how to approach the job search in a select market. II.


Undocumented donors: how driver's licenses can help solve the U.S. organ shortage.
In 2013, Illinois enacted a new law (SB 957) to allow undocumented motorists to acquire Temporary Visitor Driver's Licenses (TVDLs). We explored the impact of this legislation on organ donor registration in the state. Using Freedom of Information Act requests, we obtained the Illinois TVDL and general adult driver's license applicant organ donation statistics for the last 3 years from the Illinois Secretary of State. We found that between 2017 and 2019, TVDLs directly resulted in 91,720 newly registered organ donors. This group registered as organ donors at rates significantly higher (p < 0.0001) than the general population. In the 3 years studied, only 7.3% of general driver's license registrants became new organ donor registrants, while TVDL drivers signed up at an average rate of 44.9%. TVDLs resulted in a significant increase in registered organ donors. Similar policies implemented nationwide could increase donor registrations substantially. In addition, this finding among a population largely of Latin American origin may suggest strategies for future organ donor registration efforts globally.


Atrophie blanche. An unusual ulcerative state of the lower limb.
A case of atrophie blanche, an unusual ulcerative state of the lower limb, is presented herein.


An infant with Costello syndrome complicated with fatal hypertrophic obstructive cardiomyopathy.
We report a 3-month-old girl with Costello syndrome complicating fatal hypertrophic obstructive cardiomyopathy. She had typical findings of this syndrome, slight dyspnea and persistent wheezing. Doppler echocardiography revealed asymmetric septal hypertrophy and systolic anterior movement of the anterior mitral leaflet. There was grade 1 mitral regurgitation. Although once her heart failure had been controlled medically, she died suddenly following deterioration of her heart condition. Costello syndrome can complicate fatal hypertrophic obstructive cardiomyopathy.


[High-dose ifosfamide and etoposide regimen as salvage and mobilization therapy for patients with lymphoma].
Several groups have used salvage chemotherapy in relapsed or refractory lymphomas to mobilize peripheral blood stem cells. The objective of this study was to evaluate the antilymphomatous efficacy, the ability of mobilization and the toxicity of a regimen containing high-dose ifosfamide, etoposide, methylprednisolone (IFOVM) and granulocyte colony-stimulating factor (G-CSF). Twenty-four patients with relapsed or refractory lymphoma received IFOVM and G-CSF. The median age was 45 years and 13 were males. The histologyc subtypes of lymphoma were: diffuse large B cell (DLBCL) (n = 15), Hodgkin (n = 2), Burkitt (n = 2), mantle cell (n = 2), anaplastic (n = 1), peripheral T-cell (n = 1) and follicular (n = 1). Two patients died of sepsis within the pancytopenia period. In 17 (77%) of the remaining patients more than 1.5 x 10(6) CD34+ cells/kg (median: 7.7 x 10(6) CD34+ cells/kg) were collected. The median time to peripheral blood stem cells harvest was 17 (range: 13-24) days and 4 patients required 2 procedures of apheresis. Sixteen patients (67%) developed neutropenic fever. The median time to achieve granulocyte cell count > 1 x 10(9)/l and platelet count > 20 x 10(9)/l was 15 and 16 days, respectively. The only factor predicting successful mobilization was the diagnosis of DLBCL (p = 0.04). Ten patients underwent peripheral blood stem cells transplantation. The regimen IFOVM and G-CSF allows an effective peripheral blood stem cells mobilization in patients with lymphoma, particularly in those with DLBCL, but it is associated with significant toxicity.


Organic matter and salinity modify cadmium soil (phyto)availability.
Although Cd availability depends on its total concentration in soil, it is ultimately defined by the processes which control its mobility, transformations and soil solution speciation. Cd mobility between different soil fractions can be significantly affected by certain pedovariables such as soil organic matter (SOM; over formation of metal-organic complexes) and/or soil salinity (over formation of metal-inorganic complexes). Phytoavailable Cd fraction may be described as the proportion of the available Cd in soil which is actually accessible by roots and available for plant uptake. Therefore, in a greenhouse pot experiment Cd availability was observed in the rhizosphere of faba bean exposed to different levels of SOM, NaCl salinity (50 and 100mM) and Cd contamination (5 and 10mgkg-1). Cd availability in soil does not linearly follow its total concentration. Still, increasing soil Cd concentration may lead to increased Cd phytoavailability if the proportion of Cd2+ pool in soil solution is enhanced. Reduced Cd (phyto)availability by raised SOM was found, along with increased proportion of Cd-DOC complexes in soil solution. Data suggest decreased Cd soil (phyto)availability with the application of salts. NaCl salinity affected Cd speciation in soil solution by promoting the formation of CdCln2-n complexes. Results possibly suggest that increased Cd mobility in soil does not result in its increased availability if soil adsorption capacity for Cd has not been exceeded. Accordingly, chloro-complex possibly operated just as a Cd carrier between different soil fractions and resulted only in transfer between solid phases and not in increased (phyto)availability.


[Characteristics of the development of acute toxic hepatitis in rats stimulated with prodigiozan].
Acute toxic hepatitis was induced in Wistar rats by means of a single injection of 40% CCl4 on a peach-kernell oil base (0.2 ml/100 g body weight). Under conditions of stimulation with the bacterial polysaccharide prodigiosan, the resistance of hepatocytes to CCl4 sharply increased, which was shown by diminished severity of hepatic parenchyma destruction.


Mobile care app development process: using the ADDIE model to manage symptoms after breast cancer surgery (step 1).
The use of mobile applications is widespread in patient monitoring or education today. This study aims to describe the design and development process of a mobile app that supports patient self-care after breast cancer surgery. We used the ADDIE model to develop and test the mobile app. ADDIE (Analysis, Design, Development, Implementation, Evaluation) is a systematic approach based on a standard instructional design model for creating training materials. The model consists of five phases, each with its own set of steps. Once the steps within each phase are completed, the model progresses to the next phase, ultimately resulting in a "usable" product. Different team collaborations were established within each phase, and support was obtained from multiple experts during the design process. Thanks to this model, the information that patients need was transformed into a technological product. This article, which explains the stages of the product design process for mobile applications, provides information that may be helpful to researchers working on similar products.


Spinocerebellar ataxia type 31 (SCA31).
Spinocerebellar ataxia type 31 (SCA31) is one of the most common forms of autosomal-dominant cerebellar ataxia in Japan. SCA31 has a strong founder effect, which is consistent with the fact that this disease is basically absent in other ethnicities. After searching the entire founder region of a 2-megabase (Mb), we finally identified a 2.5 to 3.8 kb-long complex penta-nucleotide repeat containing (TGGAA)n, (TAGAA)n, (TAAAA)n and (TAAAATAGAA)n as the only genetic change segregating SCA31 individuals from normal people. Furthermore, (TGGAA)n was isolated as the only repeat explaining the pathogenesis because other repeats were encountered in control Japanese. From the genomic point of view, the complex penta-nucleotide repeat lies in an intronic segment shared by two genes, BEAN1 (brain expressed, associated with Nedd4) and TK2 (thymidine kinase 2) transcribed in mutually opposite directions. While TK2 is ubiquitously expressed, BEAN1 is transcribed only in the brain. Thus, the complex repeat is bi-directionally transcribed exclusively in the brain, as two independent non-coding repeats. Furthermore, the complex repeat containing (UGGAA)n was found to form abnormal RNA structures, called RNA foci, in cerebellar Purkinje cell nuclei of SCA31 patients' brains. Subsequent investigation by over-expressing (UGGAA)n in Drosophila revealed that the RNA containing (UGGAA)n exerts toxicity in a length- and expression level-dependent manner, whereas its toxicity could be dampened by (UGGAA)n-binding proteins, TDP-43, FUS and hnRNP A2/B1. It seems rational to formulate a treatment strategy through enhancing the role of RNA-binding proteins against (UGGAA)n-toxicity in SCA31.


Differential rate constants of racemization of aspartyl and asparaginyl residues in human alpha A-crystallin mutants.
Asp58 and Asp151 in alpha A-crystallin of human eye lenses become highly inverted and isomerized to d-beta-Asp residues with age. Racemization was previously shown to proceed rapidly when the residue on the carboxyl side of the Asp residue is small. Asn was also demonstrated to be more susceptible to racemization than Asp in protein. In this study, the changes of rate constants for racemization at Asp58 and Asp151 and at Asn58 and Asn151 were investigated using D58N, S59T, D151N and A152V mutants obtained through site-directed mutagenesis. The rate constant of racemization at Asn151 in D151N was found to be 1.5 times more rapid than Asp151 in the wild-type. For A152V, the rate constant at Asp151 was 1/4 that of the wild-type. There were no significant differences in the rate constants of racemization for both Asp58 and Asn58 residues. The aggregate size of D58N, S59T and D151N mutants increased or increased in polydispersity and their chaperone activities decreased. The size and chaperone activity of A152V was unchanged. These results suggest that structures close to Asp58 and Asp151 residues in the protein affect the rate constant of Asp racemization and the size and chaperone function of alpha A-crystallin.


Risk factors for acute urinary retention requiring temporary intermittent catheterization after prostate brachytherapy: a prospective study.
We prospectively investigated prognostic factors for men undergoing transperineal radioactive seed implantation for prostate cancer at the University of Washington. Between February and April, 1998, 62 consecutive unselected patients were prospectively followed after brachytherapy for early-stage prostate adenocarcinoma. Pretreatment variables included age, American Urological Association (AUA) score, uroflowimetry, and prostate volume by ultrasound. Nonrandomized variables included hormonal therapy, seed type, and use of pelvic radiotherapy. Patients were contacted by phone at one week postoperatively and at one-month intervals thereafter. Follow-up continued until all patients provided the date of last catheterization. Urinary retention rate at one week was 34% (21 of 63 patients). At one month, 29%; at three months, 18%; and at six months, 10%. Preoperative flow rate and post-void residual did not predict for retention (p =.48 and p =.58). Use of alpha blockers, hormonal therapy, type of seed (103Pd or 1251), or external beam radiotherapy had no impact on risk of retention at any followup point. Preimplant volume and AUA score predicted for retention on univariate analysis, but on multivariate analysis only postimplant volume remained significant (p =.02) for predicting retention risk and duration. Patients with large prostate size (>36 g) and higher AUA score (>10) appear to be at greater risk of risk of retention as well as duration of retention as defined in our study. Further investigation will be needed to clarify the risk of urinary retention for men undergoing brachytherapy.


Confirmation of severe GH deficiency after final height in patients diagnosed as GH deficient during childhood.
Human GH treatment of patients with childhood-onset (CO) growth hormone deficiency (GHD) ceases when they reach final height; this provides an opportunity to retest GH status in all patients before determining whether GH therapy will be required in adult life. At present, the diagnostic approach to these patients is not fully standardized. This study aimed to characterize a large group of previously GH-treated CO GHD patients and establish their GH status. The multinational study included 167 patients diagnosed as GH deficient and treated with hGH to final height during childhood. Mean age was 19.2 years and mean height standard deviation score (SDS) was -1.08. Peak serum GH concentrations were determined in standard GH stimulation tests. IGF-I and IGFBP-3 concentrations were determined at a central laboratory and converted to SDS values by reference to a normal population. Using only a peak GH value of less than 3 microg/l (1 mg = 3 U) in stimulation tests as the cut-off, 133 (79.6%) patients would be classed as GH deficient. Using only an IGF-I value less than -2 SDS as the cut-off, 134 (80.2%) patients would be classed as GH deficient. However, by using both criteria there were 120 (71.9%) patients who were definitely severely GH deficient (group 1) and 20 (12.0%) who were not GH deficient (group 2), leaving 14 (8.4%) classed as GH deficient from IGF-I SDS only (group 3) and 13 (7.8%) classed as GH deficient from stimulation test only (group 4). There was no difference between the groups in height SDS or body mass index (BMI), but the GH-deficient patients tended to have been diagnosed at a younger age (group 1, 8.2 +/- 3.9; group 2, 10.0 +/- 4.0; P = 0.052). For patients classed as GH deficient compared with those not GH deficient, the percentage of males was lower (group 1, 64.2%; group 2, 90.0%; P = 0.022) and the percentage with multiple pituitary hormone deficiencies was higher (group 1, 81.7%; group 2, 20.0%; P < 0 .001), with the other two groups being intermediate in each case. Only the group classed as GH deficient by both criteria had a mean IGFBP-3 less than -2 SDS and both IGF-I SDS and IGFBP-3 SDS increased steadily across the four groups. A high percentage (71.9%) of these childhood-onset GH-deficient patients were still GH deficient in adult life and are likely to require further hGH treatment. While 12.0% could be classed as definitely no longer GH deficient, there are some patients who are intermediate (16.2%) and may be classed as GH deficient by one criterion but not the other. When GH stimulation test results and IGF-I concentration are discordant, the IGFBP-3 level does not establish diagnosis and the hGH treatment requirement of such patients remains a dilemma.


Synovial sarcoma: a case report.
Synovial sarcoma most commonly affects adults in the third to fifth decades of life, and is the most common sarcoma of the foot. The tumors are encapsulated and frequently in contact with bone. Because there are often few anatomical barriers, malignant spread to surrounding nerves and vasculature is common. This article discusses the case of a young patient who presented to the foot and ankle clinic with soft tissue swelling in the right foot, and the imaging protocol for such a patient. A literature review of synovial sarcoma is also presented.


Choanal bleeding due to nasopharyngitis.
Twenty-two patients with bleeding from the nasopharynx which due to secondary changes in acute nasopharyngitis were treated at the Fujisaki Hospital. The titers of IgG, IgM and IgA of the viral capsid antigen (VCA), IgG and IgA of the early antigen (EA), and EB nuclear antigen (EBNA) were measured. There was no correlation between season of coryza or changes in season and the onset of nasopharyngitis, except for a slightly greater occurrence during mid summer and mid winter. One of three patients with severe bleeding, underwent posterior nasal packing using a rolled 10 X 10 cm gauze sponge. The majority of cases of bleeding from the nasopharynx were most satisfactorily treated by administration of the ranitidine hydrochloride (Zantac) of a selective antagonist for the H2-receptor of histamine.


[Measurement for instantaneous acceleration of ventricular pressure and its significant].
The indices of the first and second derivatives of the left ventricular pressure were compared in terms of their inotropic sensitivity and preload, afterload and heart rate dependence in 14 rabbits. In comparison with (dp/dt)max, (d2p/dt2)max is more sensitive to inotropic stimulation. Both indices are increased with increasing preload, afterload and heart rate (HR), but the difference in their dependences on load and HR is not statistically significant. The results suggest that (d2p/dt2)max is a better index of ventricular performance than (dp/dt)max.


Lesions of the superior colliculus in the rat differentiate between nigrostriatal and mesolimbic dopamine systems.
Bilateral electrolytic lesions of the superior colliculus in rats increased spontaneous locomotor activity, enhanced amphetamine-induced hyperactivity and attenuated apomorphine-induced biting. These lesions were associated with an increased rate of turnover of dopamine in the nucleus accumbens, but not in the striatum. Similarly concentrations of the dopamine metabolites homovanillic acid and 3,4-dihydroxyphenylacetic acid were elevated in accumbens tissue but not in striatum in rats with bilateral collicular lesions. The results indicate that lesions of the superior colliculus cause differentiation between hyperactivity and stereotypy, and that this may be related to blockade of a nigrostriatal outflow, and relief of inhibition on mesolimbic systems.


Symptom management in the older adult: 2015 update.
This article updates the 2002 Jamie von Roenn article about "the palliation of commonly observed symptoms in older patients, including pain, neuropsychiatric, gastrointestinal, and respiratory symptoms." When palliative care was last covered in Clinics in Geriatric Medicine, President George W. Bush had just signed the No Child Left Behind Act, Homeland Security was being established, Michael Jackson won the Artist of the Century Award at the American Music Awards, and gas cost $1.61 a gallon. What has changed in the last decade and a half?


Investigation of a glycoprotein-protein mixture from urine of anemic patients by analytical isotachophoresis.
Nine glycoprotein-protein fractions prepared of erythropoietin-active crude urinary protein and separated by gel filtration on Sephadex G-50, ion exchange chromatography on Sephadex DEAE A-50, gel filtration on Sephacryl S-200 and Sepharose 6B were investigated by analytical isotachophoresis. 7 to 38 components could be separated of every chromatographic fraction investigated using chloride as leading and glycinate as terminating electrolyte. Improvement of resolution is possible by variation of buffer system conditions.


Targeting the PI3K Pathway in Gynecologic Malignancies.
This review explores the PI3K pathway aberrations common in gynecologic malignancies, the relevant therapeutic targets that have been explored to date particularly given their success in endometrial cancers, and predictive biomarkers of response to therapy. Landmark trials have been noted involving this pathway, particularly in endometrial cancers. One phase II trial of the potent orally bioavailable mTOR inhibitor, everolimus, in combination with letrozole demonstrated an unprecedented clinical benefit rate (CBR) of 40% and high objective response rate (RR) of 32% in hormone agnostic endometrial cancers. This was followed by GOG 3007 that compared everolimus and letrozole to hormonal therapy yielding similar response rates but double progression-free survival rates. The phosphoinositide 3-kinase (PI3K) signaling pathway is implicated in tumorigenesis given its regulation over cell growth, cellular trafficking, and angiogenesis. In gynecologic malignancies, alterations in PI3K signaling are common. Therefore, developing modulators of the PI3K pathway and identifying molecular markers to predict response are of great interest for these cancer types.


Inhibition of neurogenic vasodilation and plasma extravasation by substance P antagonists, somatostatin and [D-Met2, Pro5]enkephalinamide.
The substance P (SP) analogues [D-Pro2, D-Phe7, D-Trp9]SP and [D-Pro2, D-Trp7,9]SP, which have been reported to be SP antagonists, inhibited the vasodilation and plasma extravasation induced by antidromic stimulation of the saphenous nerve or by i.a. infusion of SP. Somatostatin inhibited the vasodilatation and plasma extravasation induced by saphenous nerve stimulation, but had no effect on the vascular responses to i.a. infused SP. The opiate agonist [D-Met2, Pro5]enkephalinamide inhibited the vasodilation evoked by antidromic nerve stimulation in a naloxone reversible manner, but did not change the effect of i.a. infusion of SP. Calcitonin and caerulein had no effect on neurogenic vasodilatation. These results further support the concepts that neurogenic vasodilatation and plasma extravasation are mediated by SP, and that somatostatin and opiates inhibit the release of SP from peripheral sensory nerve endings.


Comparison of the safety and efficacy of lomefloxacin and trimethoprim/sulfamethoxazole in the treatment of uncomplicated urinary tract infections: results from a multicenter study.
Lomefloxacin, a new difluorinated quinolone, and trimethoprim/sulfamethoxazole (TMP/SMX) were compared in the treatment of adults with uncomplicated urinary tract infections. The study was conducted as a multicenter, controlled, prospectively randomized, single-blind study in five countries (Argentina, Belgium, Brazil, Mexico, and Venezuela). A total of 254 patients were enrolled: 129 in the lomefloxacin group and 125 in the TMP/SMX group. Patients received either 400 mg lomefloxacin orally once daily or 160 mg/800 mg TMP/SMX orally twice daily for 7-10 days. Escherichia coli and Proteus mirabilis were the pathogens most frequently isolated. At 5-9 days post-therapy, satisfactory bacteriologic results were noted in 98.4% of patients treated with lomefloxacin and in 95.8% of patients in the TMP/SMX group (p = 0.2153). Clinical success 5-9 days post-therapy was noted in 99.2% of patients in the lomefloxacin group and in 98.3% of patients in the TMP/SMX group (p = 0.5138). Adverse events probably related to treatment occurred in 6% of those treated with lomefloxacin and in 7% of patients treated with TMP/SMX. Once-daily oral lomefloxacin is a well-tolerated and effective treatment of uncomplicated urinary tract infections caused by susceptible pathogens.


Intensity-modulated radiation therapy with simultaneous integrated boost for locally advanced breast cancer: a prospective study on toxicity and quality of life.
Radiotherapy after breast conserving surgery and mastectomy with node positive disease has been shown to reduce risk of recurrence and mortality in the treatment of breast cancer. Intensity-modulated radiation therapy (IMRT) after conservative surgery offers several advantages over conventional RT including improved acute and late toxicity and quality of life (QoL). We undertook this study to prospectively evaluate acute (≤90 days after last dose of radiotherapy) and long-term (>90 days) cutaneous, esophageal, and fibrosis toxicity and QoL in breast cancer patients treated by adjuvant IMRT after breast surgery. We included patients with complex volumes for which 3D RT does not allow a good coverage of target volumes and sparing organs at risk. We report here an interim analysis with a median follow-up of 13.1 months (range, 6.5-25.9 months). Most of the acute toxicity was cutaneous (95.9%) and oesophageal (59.6%), and mostly grade 1 and 2. Medium-term cutaneous toxicity rate was 25.6%, and mostly grade 1. Medium-term esophageal toxicity was rare (1.8%). In this series acute oesophageal toxicity was found to be associated with dosimetric factors. QoL was well preserved throughout the study, and aesthetic outcomes were good. Based on these data, tomotherapy may be a favorable alternative to other techniques in patients needing a complex irradiation of the breast and lymph node volumes.


Taking the path of least resistance now, but not later: Pushing cognitive effort into the future reduces effort discounting.
Effort discounting describes the devaluation of rewards that require effort to obtain. The present study investigated whether discounting of cognitive effort depends on how near the effort is in time. The present study also investigated whether effort discounting, and its modulation by temporal distance to the effort, might depend on need for cognition, a personality trait that describes how much one enjoys cognitively demanding tasks. Participants performed a validated effort discounting task that measured the extent to which they subjectively devalued a $20 reward when effort was required to receive it. Immediacy of the effort was manipulated by having participants imagine exerting varying levels of effort either immediately, in a day, or in a month. Results revealed linear increases in discounting of rewards as a function of both how much effort was involved and how imminent the effort was. The extent to which both these variables influenced discounting correlated with need for cognition. Individuals low in need for cognition exhibited more effort discounting overall and a linear increase in effort discounting as the effort grew imminent. Individuals high in need for cognition engaged in less effort discounting, which was not modulated by how imminent the effort was. These results indicate that people exhibit dynamic inconsistency in effort-related decisions, such that the degree to which they discount effort depends on how soon the effort is. Additionally, this tendency is linked with systematic individual differences in need for cognition. Lastly, this study demonstrates that these tendencies can be quantitatively operationalized.


Genes for two small cytoplasmic Ro RNAs are adjacent and appear to be single-copy in the human genome.
Anti-Ro autoantibodies precipitate several small cytoplasmic ribonucleoproteins from mammalian cells. The RNA components of these particles, designated hY1-hY5 in human cells and mY1 and mY2 in mouse cells, are about 100 nucleotides long. We have analyzed a genomic clone that appears to contain true RNA-coding regions for two of the human Ro RNAs, hY1 and hY3. These RNAs exhibit many sequence and secondary structure homologies, both with each other and with the recently sequenced hY5 RNA. The hY2 RNA is a slightly truncated form of hY1; several shorter versions of hY3 are also detected in cell extracts and immunoprecipitates. The human hY1 and hY3 genes cross-hybridize with the mouse Ro RNAs, mY1 and mY2, respectively; we show that the mouse Ro RNAs are exclusively contained in Ro particles. The genes for hY1 and hY3 are transcribed in vitro by RNA polymerase III. In contrast with all other mammalian class III genes described, they appear to be present as single copies in the human genome.


Percutaneous Stenting for Unprotected Left Main Chronic Total Occlusion.
PCI of a left main coronary artery chronic total occlusion followed by PCI of the right coronary artery was performed in a patient refusing CABG surgery.


Free energy determinants of binding the rRNA substrate and small ligands to ricin A-chain.
A continuum model is provided of the free energy terms that contribute to the molecular association of ricin A-chain (RTA) with the rRNA substrate and several small ligands. The model for RTA interactions with the RNA was taken from a previously proposed complex containing a 29-mer oligonucleotide hairpin (. Proteins 27:80-95), and models for the ligands were constructed from x-ray crystallographic structures. The calculated absolute free energies of complex formation for the RTA-RNA assembly and several single-residue substitutions are in good agreement with experimental data, given the approximations of evaluating the strain energy and conformational entropy. The free energy terms were found to resemble those of protein-protein complexes, with the net unfavorable electrostatic contribution offset by the favorable nonspecific hydrophobic effect. Decomposition of the RTA-RNA binding free energy into individual contributions revealed the electrostatic "hot" spots arising from charge-charge complementarity of the interfacial arginines with the RNA phosphate backbone. Base interactions of the GAGA loop structure dominate the hydrophobic complementarity. A linear-scaling model was parametrized for evaluating the binding of small ligands against the rRNA substrate and illustrates the free energy determinant required for designing specific RTA inhibitors.


Oral antibiotics decrease urinary isoflavonoid excretion in children after soy consumption.
How oral antibiotics (OABX) alter isoflavones (IFLs) in soy-consuming children is unknown. We evaluated OABX effects on urinary IFL excretion rates (UIERs) in 17 children, ages 4 to 17 yr, who provided 2 urine collections in pairs of a baseline urine and an overnight urine collection after consuming a body-weight-adjusted dose of soy nuts. The first collection was during OABX treatment for a bacterial infection and the second when healthy and off antibiotics. IFL food levels and UIERs were measured for nonmetabolites (NM), namely, daidzein, genistein (GE), and glycitein, and the metabolites (M) dihydrodaidzein, dihydrogenistein, equol, and O-desmethylangolensin (DMA), by liquid chromatography mass spectrometry. Urinary IFLs were hypothesized to change after OABX due to intestinal microflora alterations. A total of 11 children completed the study correctly. During OABX use, UIER (nmol/h/kg) for GE (6.4 +/- 1.0 vs. 10.1 +/- 1.6), all NM (27.5 +/- 4.8 vs. 36.2 +/- 4.7), and total IFLs (all NM + all M; 29.4 +/- 5.0 vs. 38.8 +/- 4.8) was reduced (P < 0.05) vs. when healthy. In contrast, a trend toward more DMA production during OABX was observed (1.2 +/- 0.6 vs. 0.4 +/- 0.3, P = 0.13). The reduction in urinary IFL appearance could be due to the changes of intestinal bacteria by OABX and/or due to processes related to the infection.


[Profiles of polycyclic aromatic hydrocarbons in suspended particles of different cities in the Western Federal Republic of Germany (author's transl)].
The relative proportion of eight polycyclic aromatic hydrocarbons (PAH) in suspended particles from several sampling stations with different level of air pollution (cities and rural districts) was investigated. The PAH-profiles of most samples collected in three winters (1974/75, 1975/76, 1976/77) and in one summer (1975) were very similar. On the other hand the PAH-profiles differ distinctly from those of several exhausts, especially regarding automobiles, coke and oil stoves. It can be presumed, that the mixture of the emissions in the atmosphere leeds to a rather uniform relative proportion of the eight PAH in the immission as much as the difference in stability of the PAH.


Acquired paroxysmal movement disorders.
Acquired paroxysmal movement disorders are reported less frequently than the familial forms of paroxysmal dyskinesias. Three children, with the acquired form of the disorder which followed an early childhood encephalopathic event, are described. Three similarly affected children have been reported previously. Movement disorders developing after perinatal encephalopathy appear to be a distinct entity. Patients with this condition demonstrated clinical improvement following the initiation of antiepileptic medications.


Robot-assisted Radical Prostatectomy with the Novel Hugo Robotic System: Initial Experience and Optimal Surgical Set-up at a Tertiary Referral Robotic Center.
We describe the first five robot-assisted radical prostatectomies (RARPs) performed with the new Hugo RAS system (Medtronic, Minneapolis, MN, USA) in Europe. The five patients underwent RARP ± lymph node dissection at OLV Hospital (Aalst, Belgium). All procedures were completed, with no need for conversion or for placement of additional ports. No intraoperative complication or technical failure of the system was recorded. The median operative time was 170 min (interquartile range [IQR]: 140-180) and the median console time was 120 min (IQR: 110-150). Median length of stay was 3 d (IQR: 2-4). System start-up and docking of the robotic arms were straightforward and rapid processes for a properly trained surgical team. Awaiting future investigations in larger series, this study proves the safety and feasibility of RARP with the Hugo RAS system and provides relevant data that may be of help to early adopters of this surgical platform.


The Ising triangular-lattice antiferromagnet neodymium heptatantalate as a quantum spin liquid candidate.
Disordered magnetic states known as spin liquids are of paramount importance in both fundamental and applied science. A classical state of this kind was predicted for the Ising antiferromagnetic triangular model, while additional non-commuting exchange terms were proposed to induce its quantum version-a quantum spin liquid. However, these predictions have not yet been confirmed experimentally. Here, we report evidence for such a state in the triangular-lattice antiferromagnet NdTa7O19. We determine its magnetic ground state, which is characterized by effective spin-1/2 degrees of freedom with Ising-like nearest-neighbour correlations and gives rise to spin excitations persisting down to the lowest accessible temperature of 40 mK. Our study demonstrates the key role of strong spin-orbit coupling in stabilizing spin liquids that result from magnetic anisotropy and highlights the large family of rare-earth (RE) heptatantalates RETa7O19 as a framework for realization of these states, which represent a promising platform for quantum applications.


Nomogram Analysis Based on Clinical and Sonographic Characteristics for the Assessment of Postpartum Stress Urinary Incontinence.
We aimed to develop and validate a nomogram integrating clinical and sonographic characteristics for the individualized SUI risk evaluation in the early postpartum stage. This was a prospective cross-sectional study. From June 2020 to September 2022, singleton primiparas who underwent TPUS examination at 6-8 weeks postpartum were recruited. They were divided into the training and validation cohorts at a ratio of 8:2 according to the temporal split. All subjects were interviewed before TPUS examination. Univariate and multivariate logistic analyses were performed to develop three models: the clinical, sonographic, and combined models. The ROC curve was plotted to evaluate model discrimination ability. Finally, the combined model was selected to establish the nomogram. The nomogram's discrimination, calibration, and clinical usefulness were evaluated in the training and validation cohorts. The performance of the combined model was better than that of the clinical and sonographic models. Six predictors (BMI, delivery mode, lateral episiotomy, SUI during pregnancy, cystocele, and bladder neck funneling) remained in the combined model. The nomogram based on the combined model had good discrimination with AUCs of 0.848 (95% CI: 0.796-0.900) and 0.872 (95% CI: 0.789-0.955) in the training and validation cohorts, respectively, and the calibration curve showed good efficiency in assessing postpartum SUI. Decision curve analysis showed that the nomogram was clinically useful. The nomogram based on clinical and sonographic characteristics showed good efficiency in assessing postpartum SUI risk and can be a convenient and reliable tool for individual SUI risk assessment.


Postpartum pelvic arthropathy with unusual features.
Eleven patients seen in Malawi are described with a syndrome of postpartum pelvic arthropathy. They complained of severe pain mainly located in the symphysis pubis and all were unable to walk. The following unusual features were noted: the absence of obstetric trauma, a symptom-free interval between the delivery and the onset of the syndrome, the absence of gross widening of the symphysis pubis and the lack of abnormal mobility in the same joint. It is speculated that the syndrome described is not caused by rupture of the symphysis or softening under the influence of hormones but by swelling inside the intact fibrous confines of the joint.


The association of prenatal cocaine use and childhood trauma with psychological symptoms over 6 years.
The use of cocaine and other drugs during pregnancy may have serious public health consequences. The objective of this study was to determine if the use of cocaine prenatally identifies women for ongoing risk of psychological symptoms. Four hundred and two women (207 cocaine using [C], 195 non-cocaine using [NC]) were assessed for rates of clinically elevated psychological symptoms shortly after childbirth, 6.5 months and 1, 2, 4 and 6 years after using the Brief Symptom Inventory (BSI). Generalized estimating equation modeling (GEE) was used to compare psychological symptom severity, controlling for confounding factors including early childhood trauma. Results indicated that women identified as having used cocaine during pregnancy had clinically elevated psychological distress (OR = 1.76, 95%CI = 1.15-2.71, p = 0.01), psychoticism (OR = 1.97, 95%CI = 1.41-2.76, p = 0.001), interpersonal sensitivity (OR = 2.34; 95%CI = 1.65-3.34; p < 0.0001) and phobic anxiety (OR = 1.86; 95%CI = 1.24-2.79) across all assessments compared to NC women. Childhood emotional abuse was also independently associated with psychological distress. Women who use cocaine during pregnancy should be recognized as at very high risk of ongoing clinically elevated psychological symptoms and should receive early and regular assessments and intervention for mental health and substance use problems.


Malignant tumours in renal transplant recipients receiving cyclosporin: survey of 598 first-kidney transplantations.
We analysed our population of renal transplant recipients treated with cyclosporin (CsA) and prednisolone with respect to clinically evident de novo malignancies. Eighteen of 598 patients (mean age 35.6 (1-73) years receiving their first renal graft between 1 May 1981 and 31 December 1986 developed a malignancy at a mean interval of 33.5 months. Types of malignancy were squamous carcinoma of the skin (1), carcinoma of the tonsils (1), urothelioma (5), renal-cell carcinoma (2), adenocarcinoma of colon and liver (3), metastic adenocarcinoma of the lung (1), teratocarcinoma of the testis (1), breast cancer (1), Hodgkin's lymphoma in the renal allograft (1), carcinoma of the uterus (1), and carcinoma of the prostate (1). Six cases were observed in the age group 40-49 years (3%), but only three in age group 20-29 years, and nine cases in patients older than 50 years. No malignancy emerged in children (age group less than 19 years) and in patients with pretransplant malignancies. Five patients with analgesic abuse (n = 21 of 598 patients) developed malignant urotheliomas. It is concluded that de novo malignancies constitute a heterogeneous group with no obvious risk attributable to CsA treatment. As previously reported there is a special risk of malignant urotheliomas in patients with analgesic nephropathy. The risk in children seems to be low. We did not observe the high incidence of lymphomas and skin cancer reported by other groups.


Genome-wide analysis of differentially expressed miRNA in PLX4720-resistant and parental human thyroid cancer cell lines.
Investigating BRAF((V600E)) inhibitors (BRAFi) as a strategy to treat patients with aggressive thyroid tumors harboring the BRAF((V600E)) mutant currently is in progress, and drug resistance is expected to pose a challenge. MicroRNAs (miRNAs) are involved in development of resistance to a variety of drugs in different malignancies. miRNA expression profiles in the human anaplastic thyroid cancer cell line (8505c) were compared with its PLX4720-resistant counterpart (8505c-R) by the use of Illumina deep sequencing. We conducted a functional annotation and pathway analysis of the putative and experimentally validated target genes of the significantly altered miRNAs. We identified 61 known and 2 novel miRNAs whose expression was altered greatly in 8505c-R. Quantitative reverse-transcription polymerase chain reaction validated altered expression of 7 selected miRNAs in 8505c-R and BCPAP-R (PLX4720-resistant papillary thyroid cancer cell line). We found 14 and 25 miRNAs whose expression levels changed substantially in 8505c and 8505c-R, respectively, after treatment with BRAFi. The mitogen-activated protein kinase and phosphatidylinositol 3-kinase-AKT pathways were among the prominent targets of many of the deregulated miRNAs. We have identified a number of miRNAs that could be used as biomarkers of resistance to BRAFi in patients with thyroid cancer. In addition, these miRNAs can be explored as potential therapeutic targets in combination with BRAFi to overcome resistance.


Comparative Evaluation of Diagnostic Accuracy Between Google Bard and Physicians.
In this study, we evaluated the diagnostic accuracy of Google Bard, a generative artificial intelligence (AI) platform. We searched published case reports from our department for difficult or uncommon case descriptions and mock cases created by physicians for common case descriptions. We entered the case descriptions into the prompt of Google Bard to generate the top 10 differential-diagnosis lists. As in previous studies, other physicians created differential-diagnosis lists by reading the same clinical descriptions. A total of 82 clinical descriptions (52 case reports and 30 mock cases) were used. The accuracy rates of physicians were still higher than Google Bard in the top 10 (56.1% vs 82.9%, P < .001), the top 5 (53.7% vs 78.0%, P = .002), and the top differential diagnosis (40.2% vs 64.6%, P = .003). Even within the specific context of case reports, physicians consistently outperformed Google Bard. When it came to mock cases, the performances of the differential-diagnosis lists by Google Bard were no different from those of the physicians in the top 10 (80.0% vs 96.6%, P = .11) and the top 5 (76.7% vs 96.6%, P = .06), except for those in the top diagnoses (60.0% vs 90.0%, P = .02). While physicians excelled overall, and particularly with case reports, Google Bard displayed comparable diagnostic performance in common cases. This suggested that Google Bard possesses room for further improvement and refinement in its diagnostic capabilities. Generative AIs, including Google Bard, are anticipated to become increasingly beneficial in augmenting diagnostic accuracy.


Effect of simultaneous treatment with low doses of perphenazine on plasma and urine concentrations of nortriptyline and 10-hydroxynortriptyline.
Plasma levels of nortriptyline and perphenazine were measured in six patients on continuous nortriptyline treatment before, during and after oral administration of perphenazine 4 mg t.i.d. In four patients the plasma levels of the conjugated and unconjugated principal metabolite 10-hydroxynortriptyline were also measured. Urinary excretion of conjugated and unconjugated 10-hydroxynortriptyline and plasma levels of perphenazine were determined in all six patients. During treatment with perphenazine two patients showed a slight increase in the plasma level of nortriptyline. The changes in metabolite excretion rate were inconclusive. Thus, there did not appear to be any important pharmacokinetic interaction between the two drugs at the doses used, which were normal therapeutic doses. The previously reported inhibitory effect of perphenazine on the metabolism of nortriptyline probably depended therefore, either on administration of a higher dose of perphenazine, or on treatment in the reverse sequence--a single dose of nortriptyline was given to patients already receiving perphenazine.


"We Will All Go, But What We All Seek Is Good Death": Cultural Notions of Good Death And Related Mortuary Rituals Among the Akan of Ghana.
Thanatologists who have researched mortuary beliefs and practices from around the world posit that many societies differentiate between good and bad deaths. The current study utilized in-depth interviews with 30 Akan culture experts to investigate what the Akan ethnic group of Ghana considers to be good death. The results show that Akan good death is natural harmonious death that occurs at advanced age. The deceased would also have experienced a meaningful life devoid of immorality or turpitude. While the bodies of decedents of Akan bad deaths are interred without much ceremony, good deaths are associated with elaborate burial rites and funerary obsequies that serve to honor the decedent. Findings show that Akans generally aspire to achieve a good death, be granted solemn burial rites, and to receive a fitting funerary celebration that would launch them on a journey to join ancestral kin in the hereafter.


Targeting Myocardial Substrate Metabolism in the Failing Heart: Ready for Prime Time?
We review the clinical benefits of altering myocardial substrate metabolism in heart failure. Modulation of cardiac substrates (fatty acid, glucose, or ketone metabolism) offers a wide range of therapeutic possibilities which may be applicable to heart failure. Augmenting ketone oxidation seems to offer great promise as a new therapeutic modality in heart failure. The heart has long been recognized as metabolic omnivore, meaning it can utilize a variety of energy substrates to maintain adequate ATP production. The adult heart uses fatty acid as a major fuel source, but it can also derive energy from other substrates including glucose and ketone, and to some extent pyruvate, lactate, and amino acids. However, cardiomyocytes of the failing heart endure remarkable metabolic remodeling including a shift in substrate utilization and reduced ATP production, which account for cardiac remodeling and dysfunction. Research to understand the implication of myocardial metabolic perturbation in heart failure has grown in recent years, and this has raised interest in targeting myocardial substrate metabolism for heart failure therapy. Due to the interdependency between different pathways, the main therapeutic metabolic approaches include inhibiting fatty acid uptake/fatty acid oxidation, reducing circulating fatty acid levels, increasing glucose oxidation, and augmenting ketone oxidation.


No increase in reaction-time after lesion of the dorsal noradrenergic bundle.
In this study we examined whether lesions of rats' dorsal noradrenergic bundles affect their reaction times to temporally unpredictable stimuli. Injection of 6-hydroxydopamine into rats' dorsal bundles drastically reduced the noradrenaline content of their cerebral cortex. Nevertheless, 6OHDA treated rats could still react as quickly as controls. Moreover, the treatment did not affect the efficiency with which rats performed the task, even when they were forced to respond very quickly.


SARS-CoV-2 infection prevalence in healthcare workers and administrative and support staff: The first-wave experience at three academic hospitals in the Tshwane district of Gauteng Province, South Africa.
The availability of well and functional healthcare workers (HCWs) and support staff is pivotal to a country's ability to manage the COVID-19 pandemic effectively. While HCWs have been identified as being at increased risk for acquisition of SARS-CoV-2 infection, there is a paucity of data pertaining to South African (SA) HCW-related infection rates. Global and provincial disparities in these numbers necessitate local data in order to mitigate risks. To ascertain the overall SARS-CoV-2 infection rates and outcomes among all hospital staff at three hospitals in the Tshwane district of Gauteng Province, SA, and further determine associations with the development of severe COVID-19 disease. This retrospective audit was conducted across three academic hospitals in the Tshwane district for the period 1 June - 31 August 2020. Deidentified data from occupational health and safety departments at each hospital were used to calculate infection rates. A more detailed analysis at one of the three hospitals included evaluation of demographics, work description, possible source of SARS-CoV-2 exposure (community or hospital), comorbidities and outcomes. The period prevalence of SARS-CoV-2 infections ranged from 6.1% to 15.4% between the three hospitals, with the average period prevalence being 11.1%. The highest incidence of SARS-CoV-2 infections was observed among administrative staff (2.8 cases per 1 000 staff days), followed by nursing staff (2.7 cases per 1 000 staff days). Medical doctors had the lowest incidence of 1.1 cases per 1 000 staff days. SARS-CoV-2 infections were categorised as either possibly community or possibly healthcare facility acquired for 26.6% and 73.4% of the infections, respectively. The administrative group had the highest proportion of possible community-acquired infections (41.8%), while doctors had the lowest (6.1%). The mean age of individuals with mild and severe disease was 41 years and 46.1 years, respectively (p=0.004). The presence of comorbidities was significantly associated with severity of disease (p=0.002). This study highlights that hospital staff, including administrative staff, are clearly at high risk for acquisition of SARS-CoV-2 infection during a surge.


Bioaccumulation and health risk assessment of trace metal contamination in the musculature of the trahira fish (Hoplias malabaricus) from two neotropical rivers in southeastern Brazil.
Fish are an important source of nutrition for humans. Artisanal fishing plays a fundamental role in Brazil fish production. In Brazil, the unrestrained increase, diffusion, and little importance for environmental causes of other economic activities, such as the agricultural industry, has caused irreparable damage, leading to the contamination of water bodies. Among the countless pollutants that reach water bodies, trace metals are extremely problematic. Here, we evaluated the bioaccumulation and health risk of trace metal contamination in the musculature of the trahira fish (Hoplias malabaricus), collected from two rivers in southeastern Brazil. During the period from May 2017 to November 2019, 90 fish were collected, 45 from each river. River water samples were also taken during the same collection periods. From fish, muscle tissue samples were taken, and together with river water samples, analyzed for the recovery of trace metals (Al, Cr, Mn, Fe, Ni, Cu, As, Cd, and Pb) through the technique of Inductively Coupled Plasma Mass Spectrometry (ICP-MS). In general, fish as well as the waters of the Jacaré-Guaçú River had higher concentrations of metals. The elements Al, Cr and Cd stood out from the others analyzed metals for having a hazard index (HQ) above 1 (Al), for being up to 10 times above the concentrations allowed by Brazilian legislation (Cr) and for having a high bioconcentration factor (Cd), indicating a biomagnification process through the food chain. In general, trace metal concentrations in the waters and fish of the Jacaré-Guaçú were higher than in the Jacaré-Pepira, which shows that the Jacaré-Guaçú is the one that suffers more anthropogenic action between the two rivers. In addition, some elements such as Al, Cr and Cd, due to its high concentrations, should receive some attention as they can pose risks to the health of fish, which can jeopardize the survival of their populations, and especially to humans who use these animals as a food source.


Compulsive pre-sleep behavior and apathy due to bilateral thalamic stroke: response to bromocriptine.
A 38-year-old women with bilateral thalamic infarctions had a severe memory disorder, severe apathy, and a compulsive tendency to assume a sleeping position. Bromocriptine improved the apathy and the disinhibited pre-sleep behavior.


Grafting of a peptide probe for Prostate-Specific Antigen detection using diazonium electroreduction and click chemistry.
The main objective of this work was to validate a label-free electrochemical method of protein detection using peptides as capture probes. As a proof-of-concept, we used a 7 amino acids sequence (HSSKLQL) specific for Prostate Specific Antigen. We investigated various electrografting conditions of two anilines (2-[(4-aminophenyl)sulfanyl]-8-hydroxy-1,4-naphthoquinone and 4-azidoaniline) further converted in situ into their corresponding diazonium salts on glassy carbon electrodes. It was demonstrated that the best method to obtain a mixed layer is the simultaneous electroreduction of the two diazonium salts. 4-azidoaniline was used to covalently immobilize the ethynyl-functionalized peptide probe by click coupling, and the hydroxynaphthoquinone derivative plays the role of electrochemical transducer of the peptide-protein recognition. The proteolytic activity of PSA towards a small peptide substrate carrying streptavidin at its distal end was also investigated to design an original sensing architecture leading to a reagentless, label free, and "signal-on" PSA sensor. Without optimization, the limit of quantification can be estimated in the nM to pM range.


Morphological and physiological properties of neurons after long-term axonal regeneration: observations on chronic and delayed sequelae of peripheral nerve injury.
Axonal regeneration has been the focus of extensive investigation of mechanisms which mediate structural and functional recovery after injury to mammalian peripheral nerves and has proven to be a valuable model for development and plasticity in the nervous system. Although details of the acute morphological and physiological responses to nerve injury are well-described, less information is available to nerve injury are well-described, less information is available about long-term alterations which persist or develop after regenerated axons have established connections with their targets. The present paper briefly discusses the mammalian neuron's initial response to peripheral nerve injury and subsequent events which occur during regeneration. Morphological and physiological alterations observed in neurons after long-term axonal regeneration are described and are considered in the context of their potential implications for clinical recovery after nerve injury, as well as their potential contribution to the appearance of delayed neurological dysfunction. Selective responses to neuronal injury during development and in different fiber populations are discussed.


Facades of suffering: clients' photo stories about mental illness.
In this article, photo stories are examined that were the result of working with photography as a therapeutic instrument dealing with suffering in mental health care settings. The purpose is to describe the role of facades in the process of suffering and acceptance. Clients took photographs, talked about them in group meetings, and exhibited them to a broader audience. Their photo stories were analyzed using a mixed-methods model. Data from two narrative approaches (semiotics and hermeneutics) were compared with information from other informants and official records to find discrepancies between the photo story and the real life context. Although facades are usually perceived as an obstacle for personal growth, the visual narratives revealed that facades can function as an alternative to common acceptance strategies, such as facing one's losses and reconciliation. Facades can create a distance between the person and the suffering. We conclude that visual narratives can reveal and foster agency in clients.


Case report: unsuspected pericarditis diagnosed with gallium67 scan.
Gallium67 scanning may be used to localize disease activity in pyrexia of unknown origin. In this patient the finding of unsuspected pericarditis also provided a pointer to the correct diagnosis.