Cognitive Behavioral Therapy With Stabilization Exercises Affects Transverse Abdominis Muscle Thickness in Patients With Chronic Low Back Pain: A Double-Blinded Randomized Trial Study.
Nonspecific chronic low back pain (NCLBP) is a major public health and global socioeconomic burden with a variety of symptoms, such as fear-avoidance behaviors. This study aimed to evaluate the effect of cognitive behavioral therapy (CBT) associated with stabilization exercise (SE) on thickness of transverse abdominis (TrA) muscle in patients with NCLBP. Forty patients with NCLBP were randomly assigned into experimental CBT associated with SE (n = 20) and control groups without SE (n = 20). Transverse abdominis muscle thickness was assessed during abdominal drawing in maneuver (ADIM) and active straight leg raise (ASLR) of the right lower limb using ultrasound imaging. Fear-avoidance belief and disability were evaluated using a fear-avoidance belief questionnaire (FABQ) and a Roland-Morris disability questionnaire (RMDQ) before and after intervention. Mixed-model analysis of variance indicated that the effect of time was significant for the right and left TrA contraction thickness during ADIM and left TrA contraction thickness during ASLR (P < .05). However, the experimental group exhibited higher right and left TrA muscle thickness compared with the control group during ADIM (P = .001). Moreover, there were no significant differences between groups in the thickness of TrA muscle during ASLR (P > .05). The effect of time was significant for FABQ (P = .02) and RMDQ (P = .01); however, the effect of group was significant for the FABQ after intervention (P = .04). Stabilization exercise associated with CBT is more effective than SE alone in improving fear avoidance belief and in increasing the thickness of the TrA muscle during ADIM task.


Posterior reversible encephalopathy syndrome on computed tomography perfusion in a patient on "Triple H" therapy.
This article reports a case of posterior reversible encephalopathy syndrome on compyted tomography (CT) perfusion in a patient on "Triple H" (hypertension, hypervolemia, and hemodilution) therapy following aneurysmal rupture repair. "Triple H" therapy is used in the postoperative course for treatment of vasospasm to prevent stroke and hemorrhage by maintaining cerebral perfusion pressure. A potential complication includes vasogenic edema from dysfunction of cerebral blood vessel autoregulation. CT perfusion can detect alterations in cerebral blood flow and volume caused by these hemodynamic changes.


Widespread coding of navigational variables in prefrontal cortex.
To navigate effectively, we must represent information about our location in the environment. Traditional research highlights the role of the hippocampal complex in this process. Spurred by recent research highlighting the widespread cortical encoding of cognitive and motor variables previously thought to have localized function, we hypothesized that navigational variables would be likewise encoded widely, especially in the prefrontal cortex, which is associated with volitional behavior. We recorded neural activity from six prefrontal regions while macaques performed a foraging task in an open enclosure. In all regions, we found strong encoding of allocentric position, allocentric head direction, boundary distance, and linear and angular velocity. These encodings were not accounted for by distance, time to reward, or motor factors. The strength of coding of all variables increased along a ventral-to-dorsal gradient. Together, these results argue that encoding of navigational variables is not localized to the hippocampus and support the hypothesis that navigation is continuous with other forms of flexible cognition in the service of action.


Strength-duration time constant and rheobase measurements: Comparison of the threshold tracking method and a manual procedure.
To compare the strength-duration time constant (SDTC) and rheobase measurements obtained by the threshold tracking method (TT) and by a non-automated method (MM). The MM procedure involved measuring, using a routine electrodiagnostic device, the intensity required to evoke a motor response whose amplitude corresponds to 40% of the maximum amplitude for four stimulus duration (1.0, 0.7, 0.5, 0.2 ms), and studying the linear relationship between stimulus charge and stimulus duration (slope = rheobase, intercept on the x-axis = SDTC). Using TT and MM, 30 successive healthy subjects (mean age = 38 years old) underwent a prospective evaluation of SDTC and rheobase of the median nerve motor axons at the wrist. Nerve stimulation and bipolar recording of evoked motor responses were performed with disposable self-adhesive surface electrodes. The Spearman correlations between the two methods were 0.78 (p < 0.0001) for SDTC and 0.96 (p < 0.0001) for the rheobase. The Bland-Altman analysis did not reveal any systematic bias of MM compared to TT. The MM procedure was reliable for strength-duration relationship analysis. We encourage neurophysiologists, who do not have dedicated threshold tracking equipment, not to hesitate to use these simple tools to assess peripheral nerve excitability.


A leap towards changing gender dynamics in oncology leadership - An ESSO-EYSAC initiative.
Despite the importance of diversity for the success and survival of biological and social systems, women are underrepresented in leadership positions, particularly in the medical field. Data from seven internationally renowned academic associations in surgical, medical, and radiation oncology show that women's representation in leadership roles is only 11%, with no individual society exceeding 20%. Possible justifications for the underrepresentation of women include unconscious biases and societal norms. Fortunately, a notable development in the form of an increased number of women attaining leadership positions in many major professional societies has emerged over recent times, thereby reflecting a positive transformation in the direction of gender equality. The authors recommend organizational interventions such as mentorship, leadership development programs, and national-level initiatives with global collaboration. The oncology community must promote a culture of cooperation and gender equality to ensure equitable opportunities for women in all aspects of life, including professional hierarchy.


Endothelial Cell-Derived Interleukin-18 Released During Ischemia Reperfusion Injury Selectively Expands T Peripheral Helper Cells to Promote Alloantibody Production.
Ischemia reperfusion injury (IRI) predisposes to the formation of donor-specific antibodies, a factor contributing to chronic rejection and late allograft loss. We describe a mechanism underlying the correlative association between IRI and donor-specific antibodies by using humanized models and patient specimens. IRI induces immunoglobulin M-dependent complement activation on endothelial cells that assembles an NLRP3 (NOD-like receptor pyrin domain-containing protein 3) inflammasome via a Rab5-ZFYVE21-NIK axis and upregulates ICOS-L (inducible costimulator ligand) and PD-L2 (programmed death ligand 2). Endothelial cell-derived interleukin-18 (IL-18) selectively expands a T-cell population (CD4+CD45RO+PD-1hiICOS+CCR2+CXCR5-) displaying features of recently described T peripheral helper cells. This population highly expressed IL-18R1 and promoted donor-specific antibodies in response to IL-18 in vivo. In patients with delayed graft function, a clinical manifestation of IRI, these cells were Ki-67+IL-18R1+ and could be expanded ex vivo in response to IL-18. IRI promotes elaboration of IL-18 from endothelial cells to selectively expand alloreactive IL-18R1+ T peripheral helper cells in allograft tissues to promote donor-specific antibody formation.


Comparative evaluation of King Vision videolaryngoscope channeled and non-channeled blades with direct laryngoscope for intubation performance and skill retention by medical students: a randomized cross over two period study.
A videolaryngoscope(VL) with an intubation conduit like KingVision channeled(KVC) blade may provide an added advantage over a non-channeled VL like a KingVision non-channeled (KVNC) blade and direct laryngoscope (DL) for acquiring and retention of intubation skills, especially in novices. In this prospective two-period randomized crossover trial, one hundred medical students used three laryngoscopes KVC, KVNC and DL for intubation following standardized training with the study devices using a Laerdal Airway Management Trainer. After one month, all participants attempted intubation, in the same manner, using all devices. The duration of intubation, modified Cormack-Lehane (CL) grade, percentage of glottic opening (POGO) score, first-attempt success, number of attempts, ease of intubation and dental trauma was recorded. The retention of intubation skills after 1 month was also assessed on the same parameters. Median intubation times of KVC and DL were comparable and significantly better than KVNC (P < 0.001). The median POGO score was better with both videolaryngoscopes when compared with DL. The ease of intubation (P < 0.0012) and first-attempt success rate (P = 0.001) at the time '0' was significantly better with KVC compared to KVNC and DL. KVC fared better with respect to these intubation parameters during intubation after one month as well. KVC performed better in terms of time to intubation, success rate and ease of procedure as compared to KVNC and DL, both for acquisition and retention of skill. Hence, we advocate that KVC should be the preferred device over KVNC and DL for teaching intubation skills to novices.


[Influence of incision parameters on astigmatism during implantation of phakic-6-mm-iris-claw intraocular lenses].
The implantation of a phakic 6-mm-iris-claw intraocular lens requires a 6.1-6.2 mm incision. This induces a variable amount of corneal astigmatism depending on the location and the type of the incision used. The aim of the current study is to investigate the surgically induced astigmatism (SIA) of different incision types and locations. This should help to achieve nearly spherical postoperative refraction. 28 eyes of 16 patients with a 1-year follow-up after an implantation of a 6-mm-non-foldable iris-claw phakic IOL were studied. 5 different incision techniques were used. These were a superior corneal incision alone (8 eyes) or in combination with a 60 degrees limbal relaxing incision (LRI) at the same axis (8 eyes), a superior sclerocorneal tunnel incision (6 eyes) and the two-incisional approach either with a sclerocorneal (4 eyes) or a pure corneal (2 eyes) main temporal incision. The SIA was calculated for each incision used. The superior corneal incision had a mean SIA of 1.2 D cyl. This SIA was enhanced by an opposite LRI by another 1 D cyl. The sclerocorneal tunnel induced 0.75 D cyl, while the two-incisional techniques delivered nearly astigmatismus neutral results. A proper selection of an appropriate incision site and type allows to correct the preexisting astigmatism or to keep a spherical refraction after an implantation of a 6-mm-rigid phakic iris-claw IOL.


The response of plants to elevated CO2 : II. Competitive interactions among annual plants under varying light and nutrients.
Communities, consisting of six co-occurring, disturbed site annuals, were subjected to CO2 unenriched (300 ppm) and to CO2 enriched (450 and 600 ppm) atmospheres at different levels of light and nutrient availability. In general, total community production increased with CO2 enrichment to 450 ppm, but a further increase in CO2 to 600 ppm had little or no effect. The response of community production to CO2 level was not affected by nutrient availability but was affected by light level.Of the six species, four display C3 metabolism. The proportion of total community production contributed by these species increased as a result of CO2 enrichment, and was dependent upon both light and nutrient availability. The relative success of some species, particularly in terms of reproduction (total seed biomass), was significantly altered by CO2 concentration depending on the level of nutrients. There were not only changes in reproductive success (seed biomass) and shoot biomass but also changes in the proportion of biomass allocated to seed.These experiments demonstrate that CO2 enrichment does affect annual plant communities both in terms of productivity and species composition and that the affect of CO2 on such system may depend upon other resources such as light and nutrients.


TRF2-mediated telomere protection is dispensable in pluripotent stem cells.
In mammals, telomere protection is mediated by the essential protein TRF2, which binds chromosome ends and ensures genome integrity1,2. TRF2 depletion results in end-to-end chromosome fusions in all cell types that have been tested so far. Here we find that TRF2 is dispensable for the proliferation and survival of mouse embryonic stem (ES) cells. Trf2-/- (also known as Terf2) ES cells do not exhibit telomere fusions and can be expanded indefinitely. In response to the deletion of TRF2, ES cells exhibit a muted DNA damage response that is characterized by the recruitment of γH2AX-but not 53BP1-to telomeres. To define the mechanisms that control this unique DNA damage response in ES cells, we performed a CRISPR-Cas9-knockout screen. We found a strong dependency of TRF2-null ES cells on the telomere-associated protein POT1B and on the chromatin remodelling factor BRD2. Co-depletion of POT1B or BRD2 with TRF2 restores a canonical DNA damage response at telomeres, resulting in frequent telomere fusions. We found that TRF2 depletion in ES cells activates a totipotent-like two-cell-stage transcriptional program that includes high levels of ZSCAN4. We show that the upregulation of ZSCAN4 contributes to telomere protection in the absence of TRF2. Together, our results uncover a unique response to telomere deprotection during early development.


Exploring perceptions, attitudes and beliefs of Thai patients with type 2 diabetes mellitus as they relate to medication adherence at an out-patient primary care clinic in Chiang Mai, Thailand.
Within the sphere of diabetes self-management, much emphasis has been placed on medication adherence. There has been a shift in thinking about medication adherence, moving from "compliance" and historically paternalistic models of care, to seeking better ways of characterizing dynamic and complex relationships that determine medication adherence and diabetes control. This study sought to understand the relationship between patient's attitudes and medication adherence for oral anti-diabetics in Thailand. In-depth interviews of patients with type 2 diabetes mellitus, taking oral anti-diabetic drugs, at the out-patient clinic run by the Department of Family Medicine, Chiang Mai University between May and December 2016. Thematic analysis followed the WHO framework for medication adherence in chronic disease to explore patient's attitudes and their influence on medication compliance. Of 24 patients, 9 were men. The mean age was 62 years (SD 8.9 years). 67% had high compliance. Four themes were identified as important factors related to medication adherence: attitudes toward disease, attitudes toward treatment, attitudes toward family support and attitudes toward health care team. Specifically, symptoms at diagnosis, understanding and acceptance in taking medication, the presence of family support and the perception of concern by the doctor relate to improved medication compliance. Medication adherence in Thai patients with diabetes requires support from both the health care providers and the family. The patient's perception of the doctor's concern creates greater patient trust in the health care team. This trust, along with family support, helps deepen patients' understanding of the disease, accept the chronic nature of their disease, and engenders a positive attitude towards taking medication that can improve medication adherence.


Motivational Deficits in Schizophrenia and the Representation of Expected Value.
Motivational deficits (avolition and anhedonia) have historically been considered important negative symptoms of schizophrenia (SZ). Numerous studies have attempted to identify the neural substrates of avolition and anhedonia in schizophrenia , but these studies have not produced much agreement. Deficits in various aspects of reinforcement processing have been observed in individuals with schizophrenia, but it is not exactly clear which of these deficits actually engender motivational impairments in SZ. The purpose of this chapter is to examine how various reinforcement-related behavioral and neural signals could contribute to motivational impairments in both schizophrenia and psychiatric illness, in general. In particular, we describe different aspects of the concept of expected value (EV), such as the distinction between the EV of stimuli and the expected value of actions, the acquisition of value versus the estimation of value, and the discounting of value as a consequence of time or effort required. We conclude that avolition and anhedonia in SZ are most commonly tied to aberrant signals for expected value, in the context of learning. We discuss implications for further research on the neural substrates of motivational impairments in psychiatric illness.


7-Azidoactinomycin D: a novel probe for examining actinomycin D-DNA interactions.
The technique of photoaffinity labeling is applied to the actinomycin D system to provide a novel probe for the examination of the interactions of actinomycin D with nucleic acids. The capacity for covalent attachment of actinomycin D will aid greatly in the study of target-site specificities and the correlations of biological effects with biophysical DNA interactions. Through chemical modification of the parent actinomycin D molecule with a photoreactive azido substituent, a functional analog of the parent actinomycin D is generated having equilibrium binding properties identical to those of the parent molecule yet with the capacity to form a covalent attachment to DNA upon photolysis. The results presented here describe the noncovalent interactions of this photoreactive probe to DNA (absence of light) and compares the binding properties observed to those of the parent actinomycin D and 7-aminoactinomycin D analog. These studies demonstrate that the DNA binding properties (i.e. binding affinity, binding site size, and sequence specificity) retained by the 7-azidoactinomycin D, thus providing a suitable probe for examining actinomycin D-DNA interactions.


Disrespect and abuse of women during childbirth at health facilities in Eastern Africa: systematic review and meta-analysis.
Disrespectful and abusive maternity care is a sign of poor treatment that influences women's choice to deliver their babies in institutions. Such malpractices continue to go unreported and are rarely exposed in developing countries, despite their serious burden. Therefore, this meta-analysis study aimed to estimate disrespect and abuse of women during childbirth in East Africa. PubMed, Google Scholar, Scopus, and Science Direct databases were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Publication bias was checked by forest plot, Begg's rank test, and Egger's regression test. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by study region, sample size, and publication. The pooled odds ratio for associated factors was also computed. Out of 654 articles assessed, 18 met the criteria and were included in this study. There were a total of 12,434 study participants. The pooled prevalence of disrespect and abuse of women during childbirth in East Africa was 46.85% (95% CI: 45.26.72-66.98), I2 = 81.9%. It was lower in studies with sample size greater than 5000 (33%). The disrespect and abuse rates between community-based studies (44.96%) and institutional-based studies (47.35%) did not differ significantly, though. Instrumental delivery (AOR = 2.70; 95%CI: 1.79-4.08), presence of complications (AOR = 6.41; 95% CI: 1.36-30.14), receiving care at government hospitals (AOR = 3.66; 95% CI: 1.09-12.23), and poor wealth index (AOR = 2.16; 95% CI: 1.26-3.70) were associated factors. In East Africa, disrespect and abuse of women during childbirth was high. Instrumental delivery, presence of complications during childbirth, receiving care at government hospitals and poor wealth index were predictors of maternal disrespect and abuse. Safe delivery practice should be promoted. Training in compassionate and respectful maternity care, particularly in public hospitals, has also been recommended.


The effects of prostaglandins on cAMP levels in subpopulations of mouse lymphocytes.
The effects of prostaglandin E2 (PGE2) on cyclic AMP levels in various mouse lymphocyte populations were studied. It was found that spleen cells and thymocytes respond comparably to PGE2. Cortisone treatment abolished the responsiveness in thymocytes. Fractionation of splenic lymphocytes on glass wool columns into subpopulations of bone-marrow derived (B) cells or thymus-derived (T) cells showed that both B and T splenic lymphocytes can respond to PGE2. Lymphocytes or spleen cells cultured for varying periods (24--96 hrs) lose their sensitivity to PGE2 stimulation of cAMP. This "refractoriness" to PGE2 is only partially reversed by incubating lymphocytes with phosphodiesterase inhibitors.


Sol-gel synthesis of tantalum oxide and phosphonic acid-modified carbon nanotubes composite coatings on titanium surfaces.
Carbon nanotubes used as fillers in composite materials are more and more appreciated for the outstanding range of accessible properties and functionalities they generate in numerous domains of nanotechnologies. In the framework of biological and medical sciences, and particularly for orthopedic applications and devices (prostheses, implants, surgical instruments, …), titanium substrates covered by tantalum oxide/carbon nanotube composite coatings have proved to constitute interesting and successful platforms for the conception of solid and biocompatible biomaterials inducing the osseous regeneration processes (hydroxyapatite growth, osteoblasts attachment). This paper describes an original strategy for the conception of resistant and homogeneous tantalum oxide/carbon nanotubes layers on titanium through the introduction of carbon nanotubes functionalized by phosphonic acid moieties (-P(=O)(OH)2). Strong covalent C-P bonds are specifically inserted on their external sidewalls with a ratio of two phosphonic groups per anchoring point. Experimental results highlight the stronger "tantalum capture agent" effect of phosphonic-modified nanotubes during the sol-gel formation process of the deposits compared to nanotubes bearing oxidized functions (-OH, -C=O, -C(=O)OH). Particular attention is also paid to the relative impact of the rate of functionalization and the dispersion degree of the carbon nanotubes in the coatings, as well as their wrapping level by the tantalum oxide matrix material. The resulting effect on the in vitro growth of hydroxyapatite is also evaluated to confirm the primary osseous bioactivity of those materials. Chemical, structural and morphological features of the different composite deposits described herein are assessed by X-ray photoelectron spectroscopy (XPS), scanning (SEM) and transmission (TEM) electronic microscopies, energy dispersive X-rays analysis (EDX) and peeling tests.


A rationale for epidural analgesia in the treatment of multiple rib fractures.
Thoracic epidural analgesia (EA) is described as an alternative to controlled ventilation in patients presenting with multiple rib fractures. Lung mechanics were especially studied in 6 patients selected from a total of 49. The average ICU stay for this group was 4.5 days (2-11) and the mean age 55.7 years. The EA group was compared with 51 patients primarily ventilated who had an average stay in the ICU of 9.8 days and a mean age of 44.7 years. Mean number of rib fractures of the ventilated group at 6.5 was almost equal to the mean of 6.8 in the EA group. There was a difference in the number of associated fractures, 98 in the ventilated group compared to 35 in the EA group. Severe pulmonary and cerebral contusion were the two most important factors in enforcing the need to ventilate. The success of the method is evidenced by the increase in functional residual capacity (FRC), dynamic lung compliance (Cdyn), vital capacity (VC), the decrease of airway resistance (R) and a significantly increase of PaO2 (p less than 0,001) for the EA group with a balanced fluid therapy. All this accounts for the clinical observation of diminishing paradoxical movement of the flail segment.


Tea catechins and flavonoids from the leaves of Camellia sinensis inhibit yeast alcohol dehydrogenase.
Four new quercetin acylglycosides, designated camelliquercetisides A-D, quercetin 3-O-[α-L-arabinopyranosyl(1→3)][2-O″-(E)-p-coumaroyl][β-D-glucopyranosyl(1→3)-α-L-rhamnopyranosyl(1→6)]-β-D-glucoside (17), quercetin 3-O-[2-O″-(E)-p-coumaroyl][β-D-glucopyranosyl(1→3)-α-L-rhamnopyranosyl(1→6)]-β-D-glucoside (18), quercetin 3-O-[α-L-arabinopyranosyl(1→3)][2-O″-(E)-p-coumaroyl][α-L-rhamnopyranosyl(1→6)]-β-d-glucoside (19), and quercetin 3-O-[2-O″-(E)-p-coumaroyl][α-L-rhamnopyranosyl(1→6)]-β-D-glucoside (20), together with caffeine and known catechins, and flavonoids (1-16) were isolated from the leaves of Camellia sinensis. Their structures were determined by spectroscopic (1D and 2D NMR, IR, and HR-TOF-MS) and chemical methods. The catechins and flavonoidal glycosides exhibited yeast alcohol dehydrogenase (ADH) inhibitory activities in the range of IC(50) 8.0-70.3μM, and radical scavenging activities in the range of IC(50) 1.5-43.8 μM, measured by using the 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical.


Two mattress suture: A useful technique to prevent bleeding in tunneled catheter insertion.
The implant of tunneled catheters, may be associated with some complications such as bleeding after insertion. We aimed this study to present a modified method for catheter insertion to prevent bleeding after the procedure. The study included the analysis of retrospective results of 5339 tunneled catheter insertion procedures in our center, 5005 of which were performed using the standard method, and in 334 cases, the modified technique was applied. Applying a two-mattress suture was a safe and easy to apply and useful method for tunneled catheter insertion in our center. We reported only one bleeding around the catheter entry site with this modified technique of tunneled catheter removal. While the standard and routine technique was associated with 39 cases of bleeding. In our practice, the two-mattress suture procedure is the simplest and best method of central venous catheter insertion in hemodialysis patients and it is associated with less bleeding around the catheter entry site, so, it can be applied over the world.


Measuring the affinity of a radioligand with its receptor using a rotating cell dish with in situ reference area.
This report describes a semi-automated method for the measurement of affinity of radiolabeled ligands interacting with cell-surface receptors on intact cancer cells. The method saves labor time and reagents compared to common manual measurements. A complete affinity measurement can be performed in one cell dish by using a target cell area and a reference area and repeatedly measure the differential activity (i.e. target activity-reference activity). The affinities obtained for different ligand-receptor interactions agreed with affinities reported in the literature.


Phillygenin inhibits LPS-induced activation and inflammation of LX2 cells by TLR4/MyD88/NF-κB signaling pathway.
The traditional Chinese medicine Forsythiae Fructus is the dried fruit of Forsythia suspensa (Thunb.) Vahl. It is commonly used to clear heat and detoxify, reduce swelling and disperse knot, and evacuate wind and heat. Inflammation is involved in liver fibrosis. Phillygenin (PHI) is a kind of lignans extracted and separated from Forsythiae Fructus, which has been reported to have a good anti-inflammatory effect. Therefore, we aimed to explore whether PHI has a therapeutic effect on liver fibrosis caused by inflammation. Firstly, the induction of the LX2 cells inflammatory model and fibrosis model by LPS with different concentrations were studied. Then, high, medium and low doses PHI was given for intervention therapy. The secretion of IL-6, IL-1β and TNF-α inflammatory factors were detected by ELISA kit, and the expression of collagen I and α-SMA was detected by Western blot and RT-qPCR. The possible mechanism of PHI on TLR4/MyD88/NF-κB signal pathway was studied by computer-aided drug design software and the results were further verified by Western blot and RT-qPCR experiments. The results showed that LPS could promote the expression of IL-6, IL-1β and TNF-α and the expression of collagen I and α-SMA, indicating that LPS could induce inflammation and fibrosis in LX2 cells. PHI could inhibit LX2 cell activation and fibrotic cytokine expression by inhibiting LPS-induced pro-inflammatory reaction. Molecular docking results showed that PHI could successfully dock with TLR4, MyD88, IKKβ, p65, IκBα, and TAK1 proteins. Subsequently, Western blot and qPCR results further proved that PHI could inhibit the proteins expression in TLR4/MyD88/NF-κB signal pathway which were consistent with the molecular docking results. PHI can inhibit LPS-induced pro-inflammatory reaction and LX2 cell activation through TLR4/MyD88/NF-κB signaling pathway, thereby inhibiting liver fibrosis.


Gapped electron liquid state in the symmetric Anderson lattice, Kondo insulator state.
The Kondo insulator state (KIS) realized in the symmetric Anderson model at half filling is studied in the framework of a mean field approach. It is shown that the state of the Kondo insulator is realized in a lattice with a double cell and a gapped electron liquid behaves like a gapless Majorana spin liquid. The local moments of d-electrons form a static [Formula: see text]-field in which band electrons move. The gap value in the quasi-particle excitations spectrum decreases with increasing an external magnetic field and closes at its critical value. The behavior of an electron liquid is studied for an arbitrary dimension of the model. The proposed approach leads to the description of KIS without the need to resort to artificial symmetry breaking to alternative understanding of the physical nature of this phase state.


Bony ankylosis of hydroxyapatite prostheses in the middle ear.
Ossiculoplasty is a commonly performed middle ear procedure. Ossicular chain reconstruction (OCR) prostheses should be made of a biocompatible material; one such common material is hydroxyapatite (HA). 2 patients were identified who had HA OCR prostheses which had fused to the middle ear bony structures. One HA OCR had fused to the fallopian canal in the tympanic segment and represented a management dilemma. The other fused to the scutum. Bony ankylosis of a HA containing OCR prosthesis should be considered in the differential diagnosis of a failed ossiculoplasty. Depending on the location of the fusion, special measures may be needed to free the prosthesis from the underlying middle ear structures.


Ultrasonic calls of bank vole pups isolated and exposed to cold or to nest odor.
Bank vole pups produce ultrasounds when isolated from the nest, as other rodents do. The present study was intended to elucidate the possible interaction between the social stress of isolation from the mother and the physical stress of low ambient temperature during the nesting period. Although bank vole pups removed from nests and monitored at nest temperature vocalized at high frequency, the number and duration of signals increased at lower ambient temperature. In the tested voles it appears that exposure to cold was the most important stimulus of vocalization during the preweaning period. This effect can be enhanced by prolonged isolation from the mother, manifested as longer duration of calls. Moreover, vocalization was reduced not only by the odor from the home nest, but also by exposure to bedding of an alien lactating bank vole or even a lactating mouse fed the same diet. This suggests that the olfactory signals affecting the ultrasonic vocalization of bank vole pups probably are a mixture of volatile metabolites related to the physiological status and diet of rodent females. The reported experiments provide convincing evidence that the vocalization of bank vole pups is affected by isolation from the mother, by ambient temperature, and by olfactory signals released by lactating rodent females.


Investigations of peptide hydration using NMR and molecular dynamics simulations: A study of effects of water on the conformation and dynamics of antamanide.
The influence of water binding on the conformational dynamics of the cyclic decapeptide antamanide dissolved in the model lipophilic environment chloroform is investigated by NMR relaxation measurements. The water-peptide complex has a lifetime of 35 μs at 250 K, which is longer than typical lifetimes of water-peptide complexes reported in aqueous solution. In addition, there is a rapid intracomplex mobility that probably involves librational motions of the bound water or water molecules hopping between different binding sites. Water binding restricts the flexibility of antamanide. The experimental findings are compared with GROMOS molecular dynamics simulations of antamanide with up to eight bound water molecules. Within the simulation time of 600 ps, no water molecule leaves the complex. Additionally, the simulations show a reduced flexibility for the complex in comparison with uncomplexed antamanide. Thus, there is a qualitative agreement between the experimental NMR results and the computer simulations.


Toxicity of nitric oxide and peroxynitrite to Photobacterium damselae subsp. piscicida.
Virulent strains of Photobacterium damselae subsp. piscicida (Pdp) were grown in media with or without glucose supplementation (to enhance polysaccharide capsule formation) and the bactericidal action of nitric oxide (NO) and peroxynitrites was evaluated in a cell-free assay. Treatment with the NO-donor S-nitroso-acetyl-penicillamine (SNAP) induced a dose-and time-dependent decrease in Pdp survival. This effect was greater for strains grown without glucose supplementation (C forms) than for their counterparts grown with glucose supplementation (C(+) forms). Addition of superoxide anion (O2(-)) generating systems (Xanthine/Xanthine oxidase, glucose/glucose oxidase) to the culture media further enhanced the bactericidal effect of NO. A similar bactericidal effect, with the same pattern of sensitivity, was observed when C+ and C forms of the bacteria were treated with 3-morpholino-sydonimide hydrochloride (SIN-1), a compound which simultaneously generates NO and O2(-). Addition of superoxide dismutase (SOD) or SOD plus catalase (CAT) did not fully reverse the toxic action of SIN-1 and the bactericidal effect was similar for both C and C(+) forms suggesting that while NO alone is sufficient to cause damage in all strains of the pathogen tested, growth in glucose supplemented medium enhanced protection to reactive oxygen intermediates rather than NO.


Is a 40 % absorption of iron from a ferrous ascorbate reference dose appropriate to assess iron absorption independent of iron status?
Although a 40 % absorption of a standard reference dose corresponds to iron (Fe) absorption in borderline Fe-deficient subjects, this percentage is currently applied to all subjects independent of Fe status: (a) to assess the use of the 40 % of Fe absorption of the reference dose (FeRD%) for subjects with iron-depleted stores (IDS), normal Fe status (NIS), Fe deficiency without anemia (IDWA), and Fe deficiency anemia (IDA) and (b) to explore relationships between Fe status biomarkers and FeRD%. Six hundred forty-six participants (582 women and 64 men) were selected from multiple Fe bioavailability studies and classified into four groups based on Fe status: NIS, IDS, IDWA, and IDA. All men were classified as normal. The absorption from FeRD% was calculated in each group and correlated with Fe status biomarkers. (a) Women with IDS absorbed 40 (18.9-84.7) % of the reference dose; (b) for male subjects with NIS, the absorption of the reference dose was 19 (9.8-36.1) %, while for females, absorption was observed as to be 34 (16.7-68.6)%. In the case of subjects with IDWA, a 43 (19.7-92.5) % absorption was observed, while subjects with IDA demonstrated 67 (45.2-98.6) % absorption. Serum ferritin (SF) had the strongest inverse correlation with FeRD% (r = -0.41, p < 0.001). A transferrin saturation (TS) <15 % increases the probability that the FeRD% will be highly elevated (OR, 5.05; 95 % CI, 2.73, 9.31; p < 0.001). A 40 % absorption as reference dose is only appropriate to assess Fe absorption in subjects with IDS and IDWA. SF had an inverse correlation with FeRD%, and TS increases the probability that the FeRD% will be elevated by over fivefold.


Peripheral nerve stimulation characteristics of an asymmetric head-only gradient coil compatible with a high-channel-count receiver array.
To characterize peripheral nerve stimulation (PNS) of an asymmetric head-only gradient coil that is compatible with a commercial high-channel-count receive-only array. Two prototypes of an asymmetric head-only gradient coil set with a 42-cm inner diameter were constructed for brain imaging at 3T with maximum performance specifications of up to 85 mT/m and 708 T/m/s. Tests were performed in 24 volunteers to measure PNS thresholds with the transverse (x = left-right; y = anterior-posterior [A/P]) gradient coils of both prototypes. Fourteen of these 24 volunteers were also tested for the z-gradient PNS in the second prototype and were scanned with high-slew-rate echo planar imaging (EPI) immediately after the PNS tests. For both prototypes, the y-gradient PNS threshold was markedly higher than the x-gradient threshold. The z-gradient threshold was intermediate between those for the x- and y-coils. Of the 24 volunteers, only two experienced y-gradient PNS at 80 mT/m and 500 T/m/s. All volunteers underwent the EPI scan without PNS when the readout direction was set to A/P. Measured PNS characteristics of asymmetric head-only gradient coil prototypes indicate that such coils, especially in the A/P direction, can be used for fast EPI readout in high-performance neuroimaging scans with substantially reduced PNS concerns compared with conventional whole body gradient coils. Magn Reson Med 76:1939-1950, 2016. © 2015 International Society for Magnetic Resonance in Medicine.


Hijiki and sodium arsenite stimulate growth of human colorectal adenocarcinoma cells through ERK1/2 activation.
Hijiki seaweed (Hijikia fusiformes) contains high levels of inorganic arsenic, a known carcinogen. However, scientific reports on carcinogenic risks associated with the consumption of this seaweed are limited. This study investigated the effects of seaweed extracts contaminated with arsenic on two colorectal cancer cell lines. Two seaweed extracts, including Hijiki and red seaweed, induced H508 but not HT29 cell proliferation. Growth induction of H508 cells after treatments with Hijiki and sodium arsenite at concentrations equivalent to arsenic found in Hijiki was observed by both MTT and BrdU assays. Hijiki and sodium arsenite induced epidermal growth factor receptor (EGFR) and ERK1/2 activations. AG1478, an EGFR inhibitor, decreased the activation of EGFR and ERK1/2 induced by Hijiki and sodium arsenite. U0126, an ERK1/2 upstream inhibitor, and atropine, a muscarinic acetylcholine receptor (mAChR) antagonist, but not AG1478 completely inhibited the proliferative effect of Hijiki. Altogether, the results suggest that the presence of arsenic in seaweed may partly contribute to the proliferation of colorectal cancer cells. EGFR-dependent, and -independent ERK1/2 signaling pathways, and mAChR may be involved in the growth stimulation by Hijiki. These results raise concern regarding the potential colorectal cancer risks from regular consumption of Hijiki containing high contents of inorganic arsenic.


Medical Record Documentation of Goals-of-Care Discussions Among Older Veterans With Incident Kidney Failure.
Elicitation and documentation of patient preferences is at the core of shared decision making and is particularly important among patients with high anticipated mortality. The extent to which older patients with incident kidney failure undertake such discussions with their providers is unknown and its characterization was the focus of this study. Retrospective cohort study. A random sample of veterans 67 years and older with incident kidney failure receiving care from the US Veterans Health Administration between 2005 and 2010. Demographic and facility characteristics, as well as predicted 6-month mortality risk after dialysis initiation and documentation of resuscitation preferences. Documented discussions of dialysis treatment and supportive care. We reviewed medical records over the 2 years before incident kidney failure and up to 1 year afterward to ascertain the frequency and timing of documented discussions about dialysis treatment, supportive care, and resuscitation. Logistic regression was used to identify factors associated with these documented discussions. The cohort of 821 veterans had a mean age of 80.9±7.2 years, and 37.2% had a predicted 6-month mortality risk>20% with dialysis. Documented discussions addressing dialysis treatment and resuscitation were present in 55.6% and 77.1% of patients, respectively. Those addressing supportive care were present in 32.4%. The frequency of documentation varied by mortality risk and whether the patient ultimately started dialysis. In adjusted analyses, the frequency and pattern of documentation were more strongly associated with geographic location and receipt of outpatient nephrology care than with patient demographic or clinical characteristics. Documentation may not fully reflect the quality and content of discussions, and generalizability to nonveteran patients is limited. Among older veterans with incident kidney failure, discussions of dialysis treatment are decoupled from other aspects of advance care planning and are suboptimally documented, even among patients at high risk for mortality.


PD-1 regulates leishmanicidal activity and IL-17 in dogs with leishmaniasis.
Leishmaniasis is an immunosuppressive disease caused by protozoa of the genus Leishmania, for which dogs are the domestic reservoir. The programmed cell death-1 molecule (PD-1) is highly expressed in leukocyte cells of dogs with leishmaniasis, and it promotes T lymphocyte exhaustion and suppression of cytokine secretion. Because PD-1 has a suppressive function regarding cell immunity, we evaluated the effect of PD-1 blocking antibodies on NO, ROS and interleukin 17 (IL-17) production and on parasite load in spleen leukocyte cultures from dogs with leishmaniasis. In vitro, PD-1 blocking promoted increased levels of intracellular NO and NO2 and reduced the levels of IL-17 in the culture supernatant, in addition to reducing the parasite load, but it did not change ROS levels. We conclude that PD-1 participates in the regulation of the immune response and that the blocking antibody is effective in restoring host microbicidal activity. This can be investigated in an immunotherapeutic study in the future.


Histidine-rich proteins (filaggrins): structural and functional heterogeneity during epidermal differentiation.
The urea-soluble protein profiles of guinea pig, rat, mouse and human epidermis have been compared by non-equilibrium pH gradient/sodium dodecyl sulphate two-dimensional gel electrophoresis. The histidine-rich proteins (filaggrins) were identified firstly by their characteristic specificity and kinetics of labelling with [3H]histidine and [32P]phosphate, and secondly by their ability in vitro to aggregate keratin filaments specifically into bundles. In all species the phosphorylated filaggrin precursor, profilaggrin, is resolved as a single or doublet band with an apparent molecular weight greater than 300,000 and a neutral or slightly acidic iso-electric point. In striking contrast, the strongly basic filaggrins produced from similar profilaggrins form molecular weight families that are clearly species specific. In rat and man there is a single, principal molecular weight form of filaggrin (Mr 45,000 and 38,000, respectively), while mouse and guinea pig have heterogeneous families, including high molecular weight variants (Mr greater than 200,000). Even filaggrins of a particular molecular weight are not homogeneous proteins, but consist of a number of iso-electric variants, some of which are considerably less basic than the bulk of the filaggrins. Incorporation studies using [3H]arginine and [32P]phosphate indicate that the iso-electric variance is not due to residual phosphate, following profilaggrin breakdown, but rather to a conversion of basic arginine residues into neutral citrulline residues. Filaggrins of all the molecular weights from all the species studied share the ability to aggregate keratin filaments into large, insoluble macrofibrils. However, the more acidic iso-electric variants have lower affinities for keratin, particularly in man and guinea pig where the most acidic filaggrins have completely lost the ability to aggregate keratins. We discuss the possibility that a loss of keratin binding ability, resulting in a loosening of the keratin fibre/filaggrin matrix is necessary before the normal complete proteolysis of the filaggrins can occur.


Ovarian function in the non-mosaic Turner syndrome; a case report.
A 19-year-old girl, with the 45,XO non-mosaic Turner syndrome, presented having spontaneous regular menstrual activity. Hormonal analysis showed normal ovulatory cycles; histology of the ovaries demonstrated primary follicles. Nevertheless, the karyotype of the ovary and of the peripheral lymphocytes was pure 45,XO. Comment on ovarian function in the 45,XO karyotype is given.


Distribution of cerebral blood flow in the caudate nucleus, lentiform nucleus and thalamus in patients with carotid artery stenosis.
To investigate the influence of internal carotid artery (ICA) stenosis on the distribution of blood flow to the caudate nucleus, lentiform nucleus, and thalamus. We studied 18 healthy control subjects, 20 patients with a unilateral asymptomatic ICA stenosis, and 15 patients with a recently symptomatic unilateral ICA stenosis. The contribution of the ICAs and the basilar artery to the perfusion of the deep brain structures was assessed by perfusion territory selective arterial spin labeling (ASL) MRI. Differences were tested with a two-tailed Fishers' exact test. The caudate nucleus was predominantly supplied with blood by the ipsilateral ICA in all groups. In 4 of the 15 (27%) the symptomatic patients, the caudate nucleus partially received blood from the contralateral ICA, compared to none of the 18 healthy control subjects (p = 0.03). The lentiform nucleus and the thalamus were predominantly supplied with blood by the ipsilateral ICA and basilar artery respectively in all groups. In patients with a symptomatic ICA stenosis, the caudate nucleus may be supplied with blood by the contralateral ICA more often than in healthy controls.


Rectal mucosal biopsy in aganglionosis and allied conditions.
Rectal mucosal biopsies were performed in 146 patients suspected of having Hirschsprung's disease. The biopsies were serially sectioned and screened for the presence of ganglion cells. In the 101 cases in which ganglion cells were found, the diagnosis of Hirschsprung's disease was ruled out. In 45 patients, histologic examination revealed the typical features of Hirschsprung's disease, i.e., the absence of ganglion cells and the presence of numerous hypertrophied nerve bundles. The varied morphologic features of Meissner's plexus in patients of different ages and the diagnostic pitfalls are described in detail. Serial frozen sections stained with hematoxylin-eosin were examined in eight cases of neonatal intestinal obstruction and enterocolitis. This method was found to be useful and reliable in emergencies. In three of these cases ganglion cells were found and major surgical procedures were avoided. In 73 cases, staining for acetylcholinesterase activity was performed. The results matched the microscopic findings in all but three false-positive cases.


C-HiC: A High-Resolution Method for Unbiased Chromatin Conformation Capture Targeting Small Locus.
Within the nucleus, precise DNA folding and organization is mandatory for a tight control of gene expression. In the past 20 years, a wealth of molecular approaches has unraveled the existence of DNA territories. With the emergence of affordable deep-sequencing approaches, "Cs" techniques such as 4C, 5C, and HiC, to name a few, are now routinely performed by the scientific community in a large number of model systems. We have modified the HiC approach to a capture probe-based version named C-HiC. This updated assay has resulted in an improved throughput analysis, reduced input material, and good repeatability. The protocol described below details our procedure and notes for a C-HiC approach, designed to target only specific portion of a given genome.


Biobased: Biostimulants and biogenic nanoparticles enter the scene.
Anthropogenic activities generally consume non-renewable resources and release polluting substances into the environment. Concerning agriculture, the cropping systems are almost based on exploiting non-renewable resources. In recent years, increasing interest has been devoted to reusing agricultural, food and other biomass wastes, considered relevant as they can be seen as resources rich in compounds that can find numerous applications. Biomass biorefining has been successfully applied and has opened up sustainable alternatives to the disposal of agricultural, agroindustrial and food wastes. In this area, an emerging, smart and environmentally friendly way to reduce the impact of waste on the environment is to obtain innovative materials for agriculture. Therefore, as part of biobased strategies, the use of waste biomass to obtain biostimulants and biogenic nanoparticles for crops has recently been proposed. Some research has shown that appropriate biostimulants and biobased nanomaterials have the potential to counteract some of the problems that plague agriculture. The above materials can improve crop performance, enhance crop tolerance to biotic and abiotic stresses, and improve plant nutrition. In light of the above, this review aspires, in the first part, to provide an overview of the ideas and central points that characterize the concept of bioeconomy and circular economy. In the second part, on the other hand, the most recent studies related to the valorization of various types of wastes leading to innovative biobased materials and their application in agriculture are presented. In particular, biostimulants and nanoparticles obtained through biogenic synthesis using agroindustrial and plant residues have been considered. In conclusion, the studies reported in this review show that the use of some biomasses to obtain the above materials represents a sustainable way of waste management and valorization, enabling innovative biobased materials for agriculture.


A rapid microtiter plate serum bactericidal assay method for determining serum complement-mediated killing of Mannheimia haemolytica.
In this study, we describe a rapid microtiter serum bactericidal assay (RMSBA) that can be used to measure the functionality of immune sera. It quantifies bactericidal activity of immune sera in the presence of complement against a homologous bacterium, M. haemolytica in this case. There is high correlation between data from RMSBA and standard complement-mediated bacterial killing assay (r=0.756; p<0.0001). The RMSBA activity of sera can be generated in less than 5 h instead of overnight incubation. RMSBA costs substantially less in terms of time, labor, and resources and is highly reproducible.


On-line prediction of beef quality traits using near infrared spectroscopy.
The aim of this study was to test the ability of visible-near infrared (Vis-NIR) reflectance spectroscopy to predict beef quality traits in the slaughterhouse by directly applying a fiber-optic probe on the carcass surface. Carcasses from 230 young bulls and heifers slaughtered in two commercial abattoirs were included in the experiment. Vis-NIR spectra were recorded on an exposed surface of M. gracilis in the abattoirs 4 to 6 and 14 to 16 h post mortem. Traits evaluated were pH, color indexes (L*, a*, b*, H, and SI), cooking loss, and Warner-Bratzler shear force. Prediction models were satisfactory for pH and color indexes, and promising for cooking loss but not for Warner-Bratzler shear force. Results of this work show that Vis-NIR spectroscopy may be a useful tool for on-line prediction of some physical beef quality traits when applied directly on the carcass surface.


Effects of some adrenergic and cholinergic drugs on isolated spleen strips from the cod, Gadus morhua.
The effects of drugs on isolated spleen strips from the cod, Gadus morhua, have been investigated. Affinities and intrinsic activities for various agonists were determined from cumulative dose-response curves. Contractions were produced by acetylcholine, methacholine or carbachol. The response to acetylcholine was considerably potentiated by the acetylcholinesterase inhibitor BW 284 C51. Methacholine-induced responses were competitively blocked by atropine (pA2 = 8.2), indicating the presence of muscarinic receptors. Nicotine did not contract the spleen strips. Adrenaline, noradrenaline or phenylephrine contracted the preparations and so did isoprenaline in high concentrations. Competitive blockade of the noradrenaline-induced contraction was obtained with yohimbine (pA2 = 6.1), phentolamine (pA2 = 6.0) and propranolol (pA2 = 3.4), and non-competitive blockade with phenoxybenzamine (pM50 = 7.0), indicating that alpha-adrenoceptors mediate the contractions produced by the adrenergic agonists. Isoprenaline caused a slight relaxation of preparations precontracted with methacholine. This effect was abolished by propranolol suggesting the presence of beta-adrenoceptors. Judged from the pA-values for the competitive antagonist, arterial and capsular/trabecular smooth muscles have slightly different alpha-adrenoceptor properties.


Sperm quality characteristics and fertilization capacity after cryopreservation of rooster semen in extender exposed to a magnetic field.
There has not been as much success in the effectiveness of avian semen cryopreservation as that of mammalian semen cryopreservation. This has been attributed to the unique characteristics of poultry sperm. In the area of mammalian semen, the use of magnetized extenders has enhanced the cryo-resistance of sperm in some species. The applicability of this strategy to avian semen has not yet been evaluated. The purpose of this study was to evaluate the effects on sperm quality and fertility after magnetization of extenders and use of these extenders for cryopreservation of rooster semen. Extenders were passed between two neodymium magnets that produced different magnetic induction values (0, 2000, 4000 and 6000 G). Physicochemical properties of the extenders were assessed and then semen samples were cryopreserved in the magnetized extenders. The smallest cluster sizes and zeta potentials in the extenders were observed in the extender magnetized at 2000 gauss (G). There were greater percentages of sperm total motility, viability and mitochondrial membrane potential in semen treated with the extender magnetized at 2000 G A greater percentage of sperm with enhanced membrane functionality was observed when sperm were stored in extenders magnetized with 2000 G and 4000 G. In a field trial, there were greater percentages of fertility and hatching rates of eggs using semen treated with extenders magnetized at 2000 G and 4000 G. Cryopreservation of rooster semen with magnetized extenders at 2000-4000 G resulted in enhanced quality indices of thawed sperm as well as the fertility capacity of the cryopreserved semen.


[Results of an epidemiologic analysis on the pathogenesis of chronic obstructive bronchitis in miners].
An epidemiological evaluation of chronic obstructive bronchitis in miners showed that smoking ranges in first place in the aetiopathogenesis. In addition, after prolonged underground exposure, the irritating nuisance of the respiratory tract must be considered as causal cofactor.


Evaluation of tubal patency by hysterosalpingo-contrast Sonography (HyCoSy): Controversies, dilemmas and considerations.
Evaluation of tubal patency is one of the vital steps in the process of female infertility management. Hysterosalpingo-contrast Sonography (HyCoSy) has become the first-line recommendation for evaluating tubal patency. However, there remain some controversies and dilemmas relevant to the evaluation of tubal patency by HyCosy, with no effective solution has been proposed or no consensus has been reached. Herein, combined with previous research and clinical experience, we conclude and analyze these controversies and dilemmas, aiming at offering our perspective on the opportunities and challenges which are faced by HyCosy.


HoxB8 in noradrenergic specification and differentiation of the autonomic nervous system.
Different prespecification of mesencephalic and trunk neural crest cells determines their response to environmental differentiation signals and contributes to the generation of different autonomic neuron subtypes, parasympathetic ciliary neurons in the head and trunk noradrenergic sympathetic neurons. The differentiation of ciliary and sympathetic neurons shares many features, including the initial BMP-induced expression of noradrenergic characteristics that is, however, subsequently lost in ciliary but maintained in sympathetic neurons. The molecular basis of specific prespecification and differentiation patterns has remained unclear. We show here that HoxB gene expression in trunk neural crest is maintained in sympathetic neurons. Ectopic expression of a single HoxB gene, HoxB8, in mesencephalic neural crest results in a strongly increased expression of sympathetic neuron characteristics like the transcription factor Hand2, tyrosine hydroxylase (TH) and dopamine-beta-hydroxylase (DBH) in ciliary neurons. Other subtype-specific properties like RGS4 and RCad are not induced. HoxB8 has only minor effects in postmitotic ciliary neurons and is unable to induce TH and DBH in the enteric nervous system. Thus, we conclude that HoxB8 acts by maintaining noradrenergic properties transiently expressed in ciliary neuron progenitors during normal development. HoxC8, HoxB9, HoxB1 and HoxD10 elicit either small and transient or no effects on noradrenergic differentiation, suggesting a selective effect of HoxB8. These results implicate that Hox genes contribute to the differential development of autonomic neuron precursors by maintaining noradrenergic properties in the trunk sympathetic neuron lineage.


Squamous Cell Carcinoma Arising in Discoid Lupus Erythematosus of the Nail Unit.
Discoid lupus erythematosus can affect periungual tissues leading to onychodystrophy. Squamous cell carcinoma can occur in persistent scars of discoid lupus; this rare occurrence has not yet been reported on the nail unit. Case presentation: we report a case of squamous cell carcinoma occurring on the distal phalanx of the thumb in a patient with longstanding periungual discoid lupus on several fingernails. Periungual discoid lupus erythematosus is rare. The scars caused by this disease can very rarely develop into squamous cell carcinoma. This is the first report of this occurrence at the periungual tissues.


A 1-year randomized controlled study of everolimus versus mycophenolate mofetil with reduced-dose cyclosporine in maintenance heart transplant recipients.
The aim of this study was to demonstrate noninferiority of everolimus with reduced cyclosporine (CsA) vs mycophenolate mofetil (MMF) with reduced CsA in improving renal function. In this 1-year randomized, open-label, noninferiority study in maintenance heart transplant recipients with impaired renal function 70 patients received everolimus (n = 36) or MMF (n = 34) in combination with reduced CsA. The planned sample size was not reached as the study was prematurely discontinued due to slow recruitment. Noninferiority of the everolimus regimen could not be shown: In the total population MMF seemed to be favorable on renal function assessed by serum creatinine and filtration rates, but not in the subset of patients who reached the intended reduced CsA level. Incidence rates of rejection episodes were significantly higher under MMF at month 6 (P = .0332). Overall, the results of this trial using reduced CsA in combination with either everolimus or MMF show that there is evidence to reduce the CsA level when everolimus is given concomitantly and that the benefit of MMF with reduced CsA levels is limited due to insufficient immunosuppression.


Catabolism of D-fructose and D-ribose by Pseudomonas doudoroffii. II. Properties of 1-phosphofructokinase and 6-phosphofructokinase.
1. The 1-P-fructokinase (1-PFK) and 6-P-fructokinase (6-PFK) from Pseudmonas doudoroffii were partially purified by a combination of (NH4)2SO4 fractionation and DEAE-Sephadex column chromatography. The pH optima of these enzymes were 9.0 and 8.5, respectively. 2. When the concentrations of the substrates of the 1-PFK reaction were varied, Michaelis-Menten kinetics were observed. The Kms for D-fructose-1-P (F-1-P) and ATP were 3.03 X 10(-4) M and 3.39 X 10(-4) M, respectively. Variation of MgCl2 at fixed concentrations of F-1-P and ATP resulted in sigmoidal kinetics; about 10 mM MgCl2 was necessary for maximal activity. Activity of 1-PFK was inhibited when the ratio of ATP:Mg++ was higher than 0.5, suggesting that ATP:2Mg++ was the substrate and that free ATP was inhibitory. Although an absolute requirement for K+ or NH4+ could not be demonstrated, these cations stimulated the rate of the reaction. Activity of 1-PFK was not significantly affected by 3 mM AMP, cyclic-AMP, Pi, D-fructose-6-P (F-6-P), ADP, P-enolpyruvate (PEP), pyruvate, citrate, or L-gluamate. 3. Sigmoidal kinetics were observed for 6-PFK when the concentration of F-6-P was increased and the level of ATP was kept constant. Activity of 6-PFK was increased by ADP, inhibited by PEP, and unaffected by 3 mM AMP, cyclic-AMP, Pi, F-1-P, pyruvate, or citrate.


Voices - Jane Cummings believes her new strategy will help nurses lead NHS change.
After an extensive engagement process, last month I launched the new national framework for nursing, midwifery and care staff.


Ideal shear strength under compression and tension in C, Si, Ge, and cubic SiC: an ab initio density functional theory study.
Ideal shear strength under superimposed normal stress of cubic covalent crystals (C, Si, Ge, and SiC) is evaluated by ab initio density functional theory calculation. Shear directions in [112] and [110] on the (111) plane are examined. The critical shear stress along the former direction is lower than that along the latter in all the crystals unless the hydrostatic tension is extremely high. In both the [112]-shear and [110]-shear, critical shear stress is increased by compression in C but is decreased in the other crystals. The different response of the critical shear stress to normal stress is due to the strength of the bond-order term, i.e., dependence of the short-range interatomic attraction on the bond-angle.


Long-term follow-up of patients treated with percutaneous balloon compression for trigeminal neuralgia in Taiwan.
This study aimed to evaluate the outcomes and complication rates associated with percutaneous balloon compression (PBC) for trigeminal neuralgia for a 10-year follow-up period. A total of 185 patients with trigeminal neuralgia were treated with an initial PBC between July 2000 and December 2001 and were followed up until July 2010. PBC was performed under general anesthesia with endotracheal intubation. Meckel's cave was cannulated with a No. 4 Fogarty catheter, and the balloon was inflated for 70-90 seconds. Treatment and long-term follow-up was completed for 130 of the 185 patients. The mean length of the follow-up period was 8.9 years. Sixty-two patients (47.7%) were 65 years of age or older. Seventy-eight patients (60%) had pain involving the ophthalmic or multiple trigeminal divisions. One hundred twenty-two patients (93.8%) experienced immediate relief from neuralgia after the procedure. No pain recurred within 3 months. Seventeen patients (14%) had recurrent symptoms within 2 years. Twenty-three patients (18.9%) had recurrent symptoms within 3 years. Thirty-six patients (29.5%) had recurrent symptoms within 5 years. A total of 46 patients (37.7%) had recurrent symptoms during the entire study period. PBC is a technically simple, less painful procedure carried out under brief general anesthesia and is well tolerated by patients. The operation success rate is high, and the recurrence rate is similar to that of other reports. We also found that longer compression time resulted in longer symptom-free periods.


Supercoiling response of E. coli promoters with different spacer lengths.
The effect of negative supercoiling on a series of synthetic Escherichia coli promoters has been investigated. These promoters carry perfect consensus sequences at the -35 and -10 regions, but with different spacer lengths (Aoyama, T. et al. (1983) Nucleic Acids Res. 11, 5855-5864). Topoisomeric plasmids carrying these synthetic promoters were constructed, and their activities were compared by detecting in vitro transcripts with the probe-hybridization method. In the relaxed state, the one with 17 basepairs (bp) spacing showed the highest activity, and the activity steeply decreased both sides of the optimal spacing. Similar results have been observed by run-off transcription. By introducing negative superhelicity, the 17 bp spacing promoter showed a relatively little response to supercoiling. In contrast, the activities of those with 16 and 18 bp spacings were markedly stimulated by supercoiling, with the mean, negative superhelical density (-sigma) which gave the maximum activity being about the same for the 16-18 bp spacing promoters (-sigma = 0.03 to 0.04). The promoter with 19 bp spacing, which showed no activity in the relaxed state, exhibited a significant activity at higher superhelicities (-sigma = 0.06). Even the 20 bp spacing promoter showed some activity by increasing superhelicity, while the 15 bp spacing promoter did not. On the basis of these observations, possible mechanisms by which negative supercoiling of DNA stimulates the protomer activity are discussed.


Effect of helicopter transport on neurological outcomes in a mouse model of embolic stroke with reperfusion: AIR-MICE pilot study.
Patients often suffer a stroke at a significant distance from a center capable of delivering endovascular therapy, thus requiring rapid transport by helicopter emergency medical services while receiving a recombinant tissue plasminogen activator infusion that was initiated locally. But little is known about how a helicopter flight may impact the safety and efficacy of recombinant tissue plasminogen activator-induced reperfusion and patient outcomes. To establish a new animal method to address with fidelity the safety and overall effect of helicopter emergency medical services during thrombolysis. Prospective randomized open blinded end-point study of an actual helicopter flight exposure. Adult C57BL/6 male mice were treated with a 10 mg/kg recombinant tissue plasminogen activator infusion two-hours after an embolic middle cerebral artery occlusion. Mice were randomized in pairs to simultaneously receive the infusion during a local helicopter flight or in a ground hangar. Eighteen mice (nine pairs) were analyzed. The paired t-test analysis showed nonsignificant smaller infarction volumes in the helicopter-assigned animals (mean pair difference 33 mm(3) , P = 0·33). The amount of hemorrhagic transformation between the helicopter and ground groups was 4·08 vs. 4·56 μl, respectively (paired t-test, P = 0·45). This study shows that helicopter emergency medical services do not have an inherent adverse effect on outcome in a mouse model of ischemic stroke with reperfusion. These results endorse the safety of the practice of using helicopter emergency medical services in stroke patients. The observed potential synergistic effect of helicopter-induced factors, such as vibration and changes in altitude, with reperfusion merits further exploration in animal experimental models and in stroke patients.


Conceptual age and ultrasound measurements of gestational sac and crown-rump length in in vitro fertilization pregnancies.
The growth of the mean gestational sac diameter and the crown-rump length were evaluated from individual series and found to be linear in singletons, twins, and triplets from an in vitro fertilization program as well as in pregnancies with ovulation determined from serial ultrasound folliculograms. No difference in growth rate between the different groups was observed. The 95% confidence limits were 7.7 days before and 7.5 days after mean for the gestational sac diameter, and 5.2 days before and 5.6 days after mean for the crown-rump length. These limits, used together with new linear equations, create less anxiety and less unnecessary surgical intervention than current nonlinear standards when conceptual age is known and the gestational sac or the crown-rump length are too small to be measured.


Biodegradation of microcystin-RR by Bacillus flexus isolated from a Saudi freshwater lake.
A bacterium capable of degrading microcystin-RR (MC-RR) was isolated from a Saudi eutrophic lake which was previously reported to have microcystin-producing cyanobacteria. Based on the analysis of the 16S rRNA gene sequence, the isolated strain SSZ01, most likely belong to the genus Bacillus with a highest sequence similarity (99%) with Bacillus flexus strain EMGA5. It was found that B. flexus strain SSZ01, possesses an mlrA gene encoding the most important enzyme for MC degradation. This strain was capable of degrading MC-RR, at a concentration of 10 mg l(-1), in batch experiments under environmentally relevant conditions. The degradation of MC-RR was completely removed within 4 d. The degradation of MC-RR by this strain occurred in a rich medium nutrient broth (NB), indicating that this could likely occur along with other organic compounds found in the environment. Therefore, the coexistence of such bacteria with MCs in the same environment can contribute to the self-purification of the ecosystem from such potent toxins. This is the first study to report that B. flexus can degrade MCs.


Predictors of entrepreneurial intentions: The role of prior business experience, opportunity recognition, and entrepreneurial education.
Entrepreneurship and its influence on the development of the economy are significant in competitive global advancement. Entrepreneurs need entrepreneurial intentions to improve the commercial environment of the country. Therefore, studying entrepreneurial intentions' influencing predictors is vital for business development. We collected data from small and medium-sized enterprises (SMEs) employees of the developing country and used partial least square structured equation modeling to analyze the proposed relationships. The results assist the literature extension and practically contribute to developing entrepreneurs' intentions through education and opportunity recognition. The findings aid the institutions in improving course planning and establishing practical business setups. This study facilitates the government's ideas of commencing entrepreneurial businesses through proper resource provisions for the entrepreneurs.


Effects of capsaicin desensitization on the stimulatory effect of kinins, prostaglandins, biogenic amines and various drugs in guinea-pig isolated atria.
1. A simple desensitization protocol was set up using capsaicin and isolated, spontaneously beating atria of guinea-pigs to assess the possible participation of cardiac, capsaicin-sensitive, substance P (SP)- and calcitonin gene-related peptide (CGRP)-containing sensory nerve fibres, in the cardiac stimulatory effects of bradykinin (Bk), kallidin (Kd), 5-hydroxytryptamine (5-HT), histamine, prostaglandin E2 (PGE2), prostaglandin E1 (PGE1), prostaglandin F2 alpha, (PGF2 alpha), adrenaline (Ad), glucagon, nicotine and angiotensin II (AII). 2. The positive chronotropic and inotropic effects of Bk, Kd and 5-HT were markedly reduced in capsaicin-desensitized atria compared to control. The percentage inhibition of the chronotropic and inotropic responses to the three agonists seemed to be inversely related to the concentration of agonist used and to vary also with the type of cardiac effect produced by the drug (for Bk the percentage inhibition was: 36-81% (chronotropic effect) and 62-86% (inotropic effect); for Kd: 61-78% (chronotropic effect) and 53-77% (inotropic effect); for 5-HT: 25-66% (chronotropic effect) and 40-64% (inotropic effect]. 3. The positive chronotropic and inotropic effects of histamine, PGE1, PGE2, PGF2 alpha, glucagon and AII had similar amplitudes in capsaicin-desensitized and control atria. 4. The positive chronotropic and inotropic effects of Ad and nicotine were differentially affected by capsaicin desensitization. The inotropic effects of 7.5 x 10(-7) and 7.5 x 10(-6) M Ad were reduced by 41 and 27% respectively, in capsaicin-desensitized atria compared to control. The chronotropic effects of 1.54 x 10(-5) and 6.17 x 10(-5) M nicotine were inhibited by 57 and 26% respectively, by capsaicin desensitization. On the other hand, the chronotropic effect of Ad and the inotropic action of nicotine were of similar amplitude in capsaicin-desensitized and control atria. 5. These results were taken as an indication that a substantial part of the chronotropic and inotropic effects of Bk, Kd or 5-HT in guinea-pig atria, unlike those of histamine, PGE1, PGE2 PGF2 alpha, glucagon and AII, might be the result of stimulation of capsaicin-sensitive, SP- and CGRP- containing sensory nerve fibres. The slight, differential inhibition of the chronotropic and inotropic effects of Ad and nicotine by capsaicin desensitization suggests a minor contribution by cardiac, capsaicin-sensitive sensory nerve fibres to the effects of nicotine and Ad in guinea-pig atria.


Occurrence of aflatoxins in layer feed and corn samples in Konya province, Turkey.
The natural occurrence of aflatoxin was investigated in layer feed and corn samples brought to Konya Veterinary Control and Research Institute Laboratory between 15 April and 15 December 2002. Seventy-eight samples (52 feeds, 26 corn samples) were analysed for total aflatoxin (B1 + B2 + G1 + G2) by an ELISA screening method. Aflatoxin contamination was deter-mined in 37 feed samples (71.1%) and 15 corn samples (57.7%), with a range of 1.5-133 microg kg(-1). However, a majority of the aflatoxin contamination was less than 5 microg kg(-1) (50% within the positive samples). Two feed samples and two corn samples exceeded the maximum tolerated levels in feed (20 microg kg(-1)) and feedstuffs (50 microg kg(-1)) for total flatoxin.


Molecular characterization of adult-colonizing Streptococcus agalactiae from an area-based surveillance study in Romania.
One hundred and forty-eight colonizing isolates from adult Romanian women were conventionally serotyped and screened for antibiotic resistance. Capsular type assignment by multiplex polymerase chain reaction (PCR) was performed for nonserotypeable isolates. Tetracycline and macrolide resistance genes (tetM, tetO, tetL, ermA, ermB, and mefA) including tetM gene association with conjugative elements of the Tn916 family were searched. Molecular typing included PCR screening for major surface protein antigen genes (bac, bca, alp1, alp2/3, alp4, and rib), mobile genetic elements (GBSi1 and IS1548), and rapid detection of hypervirulent clone ST-17. Genetic diversity was assessed by pulsed field gel electrophoresis (PFGE) analysis of SmaI macrorestriction patterns. Among the colonizing isolates studied, serotypes V and III predominated and high rates of tetracycline and macrolide resistance were observed. The tetM gene occurred in 140 tetracycline-resistant isolates and was associated with the int-Tn916 gene in 94 of them. Most of the isolates displayed a constitutive MLS(B) phenotype (38/46 isolates) and harbored the ermB gene. rib, alp2/3, and alp1 were the most common surface protein genes detected. Either IS1548 or GBSi1 intron were detected in almost half of the isolates and nine serotype III isolates belonged to clone ST-17. PFGE analysis of SmaI macrorestriction patterns, obtained from 118 isolates, revealed an apparent genetic diversity.


Preparation and characterization of chemically bonded argon-boroxol ring cation complexes.
The cation complexes [ArB3O4]+, [ArB3O5]+, [ArB4O6]+ and [ArB5O7]+ were prepared via a laser vaporization supersonic ion source in the gas phase. Their vibrational spectra were measured via mass-selected infrared photodissociation spectroscopy. Spectroscopy combined with quantum chemical calculations revealed that the [ArB3O5]+, [ArB4O6]+ and [ArB5O7]+ cation complexes have planar structures each involving an aromatic boroxol ring and an argon-boron covalent bond. In contrast, the [ArB3O4]+ cation is characterized to be a weakly bound complex with a B3O4+ chain structure.


Human dendritic cells and macrophages exhibit different intracellular processing pathways for soluble and liposome-encapsulated antigens.
The intracellular fates of soluble and liposomal antigens in human macrophages and dendritic cells are not well defined. Previous studies using murine macrophages have demonstrated that liposomal antigens can enter the MHC class I pathway. The Golgi complex is a major organelle in this pathway. Phagocytosis of the antigens is followed by translocation of antigen-derived peptides to the trans-Golgi where they can complex with MHC class I molecules. In contrast, soluble antigens are normally processed through the MHC class II pathway. Therefore, in the present study, ovalbumin and a synthetic Ebola peptide were used either in a soluble form or encapsulated in liposomes to investigate the intracellular trafficking and localization of these antigens to the Golgi complex in human macrophages and dendritic cells. While liposome-encapsulated antigens were transported to the trans-Golgi region in 59-78% of macrophages, soluble antigens remained diffuse throughout the cytoplasm with only 3-11% of the macrophages exhibiting trans-Golgi localization. The majority of dendritic cells localized both soluble (Ebola, 75%; ovalbumin, 84%) and liposomal antigens (58% and 65%), and irradiated Ebola virus to the trans-Golgi. These studies demonstrate that the intracellular fate of soluble and liposomal antigens can differ depending upon the antigen-presenting cell.


Application of comparative genomic hybridization, spectral karyotyping, and microarray analysis in the identification of subtype-specific patterns of genomic changes in rhabdomyosarcoma.
Rhabdomyosarcoma (RMS) in children occurs predominantly as two major histologically defined subtypes called embryonal RMS (RMS-E) and the prognostically less favorable alveolar RMS (RMS-A). Comparative genomic hybridization (CGH) was performed on 21 RMS and identified consistent gains affecting chromosomes 2 (8/10), 5 (5/10), 6 (3/10), 7 (7/10), 8 (9/10), 11 (6/ 10), and 12 (5/10) in RMS-E. Losses/deletions involved chromosomes 19 (2/10) and chromosomes 4, 9, 10, 17, 21 (1/10 each). High copy number amplification, involving the 2p24 region (5/11) and less frequently, the 12q13-21 (2/11), 9p22 (1/11), and 17q22-25 (1/11) regions, was detected in RMS-A. Gene amplification at band 2p24 was present in 6/12 alveolar tumors, and in each case, MYCN was amplified, together with the distally placed DDX1 gene. For these patients there was a shorter disease free interval and a higher mortality than patients with tumors without amplification. Detailed spectral karyotype analysis (SKY) was performed on two RMS cell lines (one of each subtype) and identified a surprisingly high level of structural change. Gene expression studies with the Atlas Human Cancer Array (588 genes) showed that 153 genes generated a signal of similar intensity in both cell lines, and 45 genes appeared to have subtype-specific expression. The chromosomal location of differentially expressed genes was compared to the pattern of genomic alteration in RMS as determined by CGH in this study and the literature.


Ligand binding channels reflected in the resonance Raman spectra of cryogenically trapped species of myoglobin.
Variations in the v2 region of the Raman spectra of cryogenically trapped photoproducts of different liganded myoglobins as a function of ligand (CO, O2, and n-butyl isocyanide) and species (whale, tuna, elephant) are reported. These variations are attributed to differences in the population of "open" (ligand accessible) and "closed" (ligand inaccessible) conformations of the distal heme pocket. Based on these findings and those derived from other spectroscopies including x-ray crystallography, NMR, IR spectra, and ESR, a working model is presented which accounts for how the conformation of the distal heme pocket, the geometry of the bound ligand, the identity of the ligand, and the dynamics of the dissociated ligand are all interconnected.


Microangiopathy in multiple myeloma: a case of carfilzomib-induced secondary thrombotic microangiopathy successfully treated with plasma exchange and complement inhibition.
Thrombotic microangiopathy (TMA) is a potentially organ and life-threatening condition affecting patients with multiple myeloma (MM). Cases of proteasome inhibitor-induced TMA and specifically carfilzomib-induced TMA have been rarely reported and standards for diagnostic workup and treatment are not available. We describe a case of a male MM patient under salvage therapy including proteasome inhibitor carfilzomib following chemotherapy and autologous stem cell transplantation. The patient then developed acute kidney injury with clinical and laboratory signs of TMA. Hemodialysis became necessary and treatment with plasma exchange was initiated followed by therapy with C5 complement inhibitor eculizumab which led to amelioration of kidney function and hemolysis parameters. We report a patient with suspected proteasome inhibitor-induced secondary thrombotic microangiopathy that has been successfully treated with plasma exchange and eculizumab, a monoclonal antibody targeting complement factor C5.


Combination of change in hematological parameters with exercise stress test to predict coronary artery disease.
Treadmill exercise stress testing for identifying patients with a higher likelihood of coronary artery disease (CAD) before elective coronary angiography is recommended in the current guidelines. In this study, we aimed to evaluate the changes in the hematological parameters before and after exercise stress test in relation with the presence of CAD. A total of 113 patients with chest pain who underwent treadmill exercise testing and coronary angiography were included in this study. Neutrophil count (4.38±0.99 vs 5.19±0.93, P<.001), and neutrophil to lymphocyte ratio (NLR) (2.04±0.63 vs 2.41±0.78, P<.001) were significantly elevated after treadmill exercise test in all the patients. Increase in the NLR after exercise test was significantly higher in patients with positive exercise test (n=68) than negative exercise test (n=45) (0.49±0.58 vs 0.19±0.44, P=.016). The sensitivity and specificity of treadmill exercise testing according to coronary angiography was 79% and 64%, respectively. A cut-off point of 0.2 for the change in the NLR in addition to positive treadmill exercise testing had 91% sensitivity and 92% specificity in predicting significant coronary artery stenosis (AUC:0.913, 95% CI: 0.805-1.000, P<.001). Neutrophil to lymphocyte ratio is an important inflammatory marker that can contribute to treadmill ECG testing in predicting CAD.


The function of NADH-semidehydroascorbate reductase and ascorbic acid in corticosteroid hydroxylation.
We have demonstrated in rat adrenal (Natarajan, R.D. and Harding, B.W. (1985) J. Biol. Chem. 260, 3902-3905) that NADH-semidehydroascorbate reductase and ascorbate participate in an electron transport pathway (ETP) supplying reducing equivalents from NADH to cytochrome P-450scc. Here, we demonstrate that this ascorbate dependent ETP also supplies reducing equivalents to cytochrome P-450(11 beta/18) in both rat adrenal and bovine adrenal cortex. The activity is dependent upon addition of catalase or upon 'cold shock' treatment of isolated mitochondria. Comparison of the rates of 11 beta- and 18-hydroxylation supported by this ETP and by the classical pathway supported by various TCA cycle intermediates suggests that in vivo the ascorbate dependent pathway may be essential for maximal flow of reducing equivalents to the mitochondrial hydroxylases. Partial reconstitution of the ascorbate dependent 11 beta/18-hydroxylase activity was achieved with purified bovine outer mitochondrial and inner mitochondrial membranes fortified with supernatant from sonified mitochondria all preincubated with phosphatidyl choline. These preparations no longer require catalase or 'cold shock' treatment. Ascorbate and NADH-semidehydroascorbate reductase are unable to support 17 alpha- or 21-hydroxylase activity in isolated bovine adrenal cortical microsomes whether incubated with purified outer mitochondrial membranes or not.


A descriptive study exploring the principles of asepsis techniques among perioperative personnel during surgery.
Perioperative nurses are expected to demonstrate strict adherence with asepsis principles to prevent surgical site infections (SSIs) as breaching of these principles poses a serious risk of infection to surgical patients. A descriptive survey was conducted with a convenience sample of 87 perioperative personnel to describe self-reported compliance with the principles of asepsis during surgery. The purpose of this study was to examine the practices of perioperative scrub personnel with surgical asepsis. A sizable percentage of participants indicated that they never or rarely observe breaches in the sterile field during surgery with regards to open suction drain systems (46.6%; n = 41), closed suction drain systems (46.6%; n = 41), suture material (39.7%; n = 35), use of surgical instruments (37.5%; n = 33), and prosthetic implants (56.8%; n = 50). Perioperative scrub RNs were less likely to wear shoe covers during surgical procedures than ORTs (M = 3.42 and 4.17; mdn = 3.00 and 5.00 respectively; p = .026). The findings showed areas of compliance and noncompliance with the principles of asepsis. Given that the role of the perioperative nurse is paramount in maintaining surgical integrity, and enhancing positive patient outcomes, strict adherence to surgical asepsis is vital to prevent SSIs and other complications.


Effect of tetraethyl lead and restricted food intake on locomotor activity in the rat.
The effect of tetraethyl lead (TEL) and restricted food intake on spontaneous locomotor activity in male albino rats was investigated. Forty animals were injected intraperitoneally with 4, 7, 10 or 13 mg/kg body weight of TEL in peanut oil, or a peanut oil placebo. Forty additional animals were food yoked to lead treated animals as a control procedure to hold food intake constant between lead treated and lead free animals. A comparison of pre- and posttreatment measures revealed significant decreases in food intake and increases in activity levels at dosages of 7, 10 and 13 mg/kg of TEL. In addition, food intake and activity were significantly correlated in both lead treated and yoked groups. The issue of factors associated with reduced food intake playing a role in observed activity level increases was raised.


An experimental model of chronic renal failure in mice.
Chronic renal failure (CRF) was induced in CBA/J mice by a combination of surgery and diathermy to the right kidney followed 2 weeks later by complete removal of the left kidney. This procedure resulted in a progressive rise in blood urea nitrogen (BUN) levels accompanied by a fall in packed cell volume (PCV). In a typical group of mice BUN rose to 156.9 +/- 9.1 mg/100 ml and PCV fell to 36.4 +/- 1.9%, 8 weeks after removal of the left kidney, compared to 23.3 +/- 2.8 mg/100 ml and 51.6 +/- 2.1%, respectively, in normal mice. These changes were accompanied by other serum abnormalities in potassium, sodium, calcium, phosphate, chloride, and silicon levels. The surviving renal tissue showed histological changes, and skeletal changes were also evident on radiological examination. Mice in CRF had an increased mean survival time of tail skin allografts and a significant reduction in thymus weight, supporting the use of this model to investigate the well-documented phenomenon of immunosuppression in human patients with uremia.


Nonbridging external fixation of intra-articular distal radius fractures.
New solutions to difficult problems are always welcome, but nonbridging external fixation of intra-articular fractures is still in its infancy. Multicenter clinical trials are necessary to deter-mine whether the superior results obtained with nonbridging fixation of extra-articular fractures can be duplicated. With further study and new fixator designs, it is anticipated that nonbridging external fixation of intra-articular distal radius fractures will become another viable treatment option.


Pulmonary vascular reactivity to supplemental oxygen in Sherpa and lowlanders during gradual ascent to high altitude.
What is the central question of this study? How does hypoxic pulmonary vasoconstriction and the response to supplemental oxygen change over time at high altitude? What is the main finding and its importance? Lowlanders and partially de-acclimatized Sherpa both demonstrated pulmonary vascular responsiveness to supplemental oxygen that was maintained for 12 days' exposure to progressively increasing altitude. An additional 2 weeks' acclimatization at 5050 m altitude rendered the pulmonary vasculature minimally responsive to oxygen similar to the fully acclimatized non-ascent Sherpa. Additional hypoxic exposure at that time point did not augment hypoxic pulmonary vasoconstriction. Prolonged alveolar hypoxia leads to pulmonary vascular remodelling. We examined the time course at altitude, over which hypoxic pulmonary vasoconstriction goes from being acutely reversible to potentially irreversible. Study subjects were lowlanders (n = 20) and two Sherpa groups. All Sherpa were born and raised at altitude. One group (ascent Sherpa, n = 11) left altitude and after de-acclimatization in Kathmandu for ∼7 days re-ascended with the lowlanders over 8-10 days to 5050 m. The second Sherpa group (non-ascent Sherpa, n = 12) remained continuously at altitude. Pulmonary artery systolic pressure (PASP) and pulmonary vascular resistance (PVR) were measured while breathing ambient air and following supplemental oxygen. During ascent PASP and PVR increased in lowlanders and ascent Sherpa; however, with supplemental oxygen, lowlanders had significantly greater decrease in PASP (P = 0.02) and PVR (P = 0.02). After ∼14 days at 5050 m, PASP decreased with supplemental oxygen (mean decrease: 3.9 mmHg, 95% CI 2.1-5.7 mmHg, P < 0.001); however, PVR was unchanged (P = 0.49). In conclusion, PASP and PVR increased with gradual ascent to altitude and decreased via oxygen supplementation in both lowlanders and ascent Sherpa. Following ∼14 days at 5050 m altitude, there was no change in PVR to hypoxia or O2 supplementation in lowlanders or either Sherpa group. These data show that both duration of exposure and residential altitude influence the pulmonary vascular responses to hypoxia.


Pregnancy in Breast Cancer Survivors.
Safety of pregnancy occurring after breast cancer treatment has been studied largely, but it is still debatable. These studies have generally showed that overall and disease-free survival in breast cancer survivors with subsequent pregnancy is not less than those without future pregnancy . Also, breast cancer survivors treated with chemotherapy , radiation therapy, or both had no increased risk of congenital anomalies, single gene disorders, or chromosomal syndromes in their offspring. However, it appears that the incidence of preterm labor, low birth weight, and fetal anomalies is higher in these cases.These issues as well as safe time interval from breast cancer treatment to pregnancy , safe contraceptive method after breast cancer, counseling about pregnancy in survivors, and how to follow up the patient for breast cancer recurrence during pregnancy are discussed in this chapter.


Design, synthesis and biological evaluation of a novel series of 1,3,4-oxadiazole bearing N-methyl-4-(trifluoromethyl)phenyl pyrazole moiety as cytotoxic agents.
On account of the reported anticancer activity of pyrazoles and oxadiazoles, we have designed and synthesized a novel combinatorial library of S-substituted-1,3,4-oxadiazole bearing N-methyl-4-(trifluoromethyl)phenyl pyrazole moiety and tested for in-vitro cytotoxic activity by MTT assay. Amongst the tested compounds, the compound 5e was the most promising anticancer agent with IC(50) value of 15.54 μM in MCF-7 cells, compared to Doxorubicin as standard drug. The newly synthesized compounds were characterized by NOE, IR, (1)H NMR, (13)C NMR and LC-MS analysis.


Effectiveness of an expert assessment and individualised treatment compared with a minimal home-based exercise program in women with late-term shoulder impairments after primary breast cancer surgery: study protocol for a randomised controlled trial.
In breast cancer patients, late-term upper limb sequelae, such as shoulder pain and impaired shoulder function, remain common after primary breast cancer surgery. The aim of this trial is to evaluate whether an expert assessment of shoulder impairments, followed by an individualised treatment plan, is superior to a minimal physiotherapeutic rehabilitation program in reducing shoulder symptoms, among women with late-term shoulder impairments after primary breast cancer. The study is designed as a stratified, parallel-group, assessor-blinded, randomised, controlled trial conducted in Denmark; 130 participants with late-term shoulder impairments 3-7 years after primary surgery for breast cancer will be recruited. Participants will be randomised (allocation 1:1) to either an expert assessment of shoulder impairments followed by an individualised treatment plan or to follow a minimal physiotherapeutic rehabilitation program delivered in a pamphlet. The primary outcome will be a change in shoulder pain and function from baseline to 12 weeks after initiating the treatment, as measured by the patient-reported outcome Shoulder Pain and Disability Index (SPADI) questionnaire. There has been an insufficient focus in research and clinical practice on late-term shoulder impairment in women following surgery for breast cancer. This trial will focus on interventions towards late-term shoulder impairments and is expected to provide evidence-based knowledge to physiotherapists and women about the management of shoulder pain and impaired shoulder function. ClinicalTrials.gov NCT05277909. Registered on 11 March 2022.


Distinct T-cell receptor profiles associated with hepatitis B e antigen seroconversion during entecavir treatment.
T-cell receptor (TCR) repertoire is ambiguously changed in chronic hepatitis B (CHB) patients during antivirus therapy. We tried to assess TCR repertoire dynamics and its clinical significance upon HBeAg seroconversion in CHB patients. Twenty CHB patients undergoing 1-year entecavir (ETV) treatment were enrolled, including 10 complete response (CR) vs 10 non-complete response (NCR) patients based on HBeAg seroconversion at week 48. The TCRβ complementarity-determining region 3 (CDR3) of peripheral CD4+ and CD8+ T cells at weeks 0, 12 and 48 was analyzed by unbiased high-throughput sequencing. The TCR repertoire profiles and their correlations with serological parameters were analyzed. The diversity of TCRβ repertoires was decreasing in CR patients but increasing in NCR patients. The distribution pattern of TCR repertoires stratified according to clonotype frequencies changed in the opposite direction between CR and NCR patients. Narrow amounts of newly appearing clonotypes in CR patients experienced a more intensive and robust expansion and this phenomenon could occur as early as week 12 for the CD4+ subset but later at week 48 for the CD8+ subset. There existed some CR-exclusive clonotypes with a relatively low but increasing frequency at week 48. The number of unique TCRβ clonotypes was positively correlated with the ALT or HBV DNA level in CR patients but showed no or negative correlation in NCR patients. Distinct TCR profiles contribute to predicting HBeAg seroconversion in CHB patients during ETV treatment and certain TCRβ CDR3 motif may be utilized for CHB immunotherapy in the future.