You read what you eat! Selective exposure effects as obstacles for environmental risk communication in the meat consumption debate.
The selective exposure effect describes people's tendency to prefer information that confirms rather than challenges existing beliefs. The present research replicates the selective exposure effect in the context of meat reduction as a proposed strategy to combat climate change. Additionally, we tested whether biased information selection can help explain polarization dynamics on the individual and group-level. We recruited a French crowd working sample (n = 351) to take part in an online study. Our research design included a selective exposure paradigm in which people could skip through a set of news headlines and decide for each headline whether to access an associated full text. The headlines either promoted or rejected meat reduction as effective environmental strategy. In accordance with the selective exposure effect, participants systematically preferred information in favor of their dietary habits. On a personal level, selective exposure indirectly accounted for attitudes towards meat reduction. On a social level, selective exposure indirectly accounted for indicators of group polarization. Overall, the findings demonstrate how psychological motives underlying information selection may hamper effective risk communication and could sharpen social divide in the climate change context. We discuss opportunities for future research and practical efforts to improve the efficacy of environmental risk communication.


Identification of a de novo fetal variant in osteogenesis imperfecta by targeted sequencing-based noninvasive prenatal testing.
Noninvasive prenatal testing (NIPT), which involves analysis of circulating cell-free fetal DNA (cffDNA) from maternal plasma, is highly effective for detecting feto-placental chromosome aneuploidy. However, recent studies suggested that coverage-based shallow-depth NIPT cannot accurately detect smaller single or multi-loci genetic variants. To assess the fetal genotype of any locus using maternal plasma, we developed a novel genotyping algorithm named pseudo tetraploid genotyping (PTG). We performed paired-end captured sequencing of the plasma cell-free DNA (cfDNA), in which case a phenotypically healthy woman is suspected to be carrying a fetus with genetic defect. After a series of independent filtering of 111,407 SNPs, we found one variant in COL1A1 graded with high pathogenic potential which might cause osteogenesis imperfecta (OI). Then, we verified this mutation by Sanger sequencing of fetal and parental blood cells. In addition, we evaluated the accuracy and detection rate of the PTG algorithm through direct sequencing of the genomic DNA from maternal and fetal blood cells. Collectively, our study developed an intuitive and cost-effective method for the noninvasive detection of pathogenic mutations, and successfully identified a de novo variant in COL1A1 (c.2596 G > A, p.Gly866Ser) in the fetus implicated in OI.


CLARITY with neuronal tracing and immunofluorescence to study the somatosensory system in rats.
The CLARITY technique enables researchers to visualize different neuronal connections along the nervous system including the somatosensory system. The present work describes the antero-lateral and dorsal column pathways until the thalamic and cortical stations, as well as descending oxytocinergic and vasopressinergic innervations by means of combined CLARITY, neuronal tracing, and immunofluorescence techniques. We used male Sprague-Dawley rats of 13, 30, and 60 days. The main results are as follows: A) CLARITY is a reliable technique that can be combined with fluorescent neuronal tracers and immunofluorescence techniques without major procedure modifications; B) at spinal level, some primary afferent fibers were labeled by CGRP, as well as the presence of neuronal populations that simultaneously project to the gracile and ventral posterolateral thalamic nuclei; C) corticothalamic connections were visible when retrograde tracers were injected at thalamic level; D) oxytocin receptors were expressed in the spinal dorsal horn by GABAergic-positive neurons, reinforcing previous outcomes about the possible mechanism for oxytocin blocking the primary afferent sensory input. The CLARITY technique lets us observe in a transparent way the entire processed tissue compared with classical histological methods. CLARITY is a potentially useful tool to describe neuroanatomical structures and their neurochemical stratus.


[Characteristics of the clinical course of Reiter's disease in relation to the causative agent].
Reiter's disease patients (RD, 83 per cent) were divided into five groups according to the causative agent. The clinical variants were compared. For the clinical picture of Chlamydia-associated RD follicular lesions of the cervical, rectal, and conjunctival mucosa are characteristic; latent forms prevail with initial joint syndrome and enteropathy. RD of Chlamydia-ureaplasma aetiology is characterised by extensive clinical manifestation with obligatory involvement of the sacro-iliac joint. Enterocolitis RD is epidemic, highly active, with pronounced fever syndrome and a more favourable prognosis.


Statistical efficiency for the detection of visual noise.
Visual detection thresholds were measured for one-dimensional static noise patterns centered at 2 c/deg on a logarithmic scale, for several widths and spatial frequency bandwidths in the presence and absence of a one-dimensional dynamic visual noise mask. Human performance was compared with the ideal observer's performance for the same task. The ideal's contrast thresholds increase with the fourth root of bandwidth. For thresholds measured in the presence and absence of noise, the fourth-root-law for bandwidth fitted the human observers' data from 1 to 6 octaves for a space constant of 2 degrees and from 2 to 6 octaves for a space constant of 0.25 degree. Detection efficiencies were quite high (30-60%) for patterns of 1- and 6-octave bandwidths. These results can be interpreted either in terms of a channel with an adjustable spatial frequency bandwidth or as very efficient combination of information between spatial frequency channels.


Bacteria adsorption on hydrophilic surfaces for the sensitive detection of pathogenic bacteria using a single tube chamber system.
Here, we developed a simple and effective bacterial isolation method that can be directly used for the detection of pathogenic bacteria. This approach only requires a single plastic tube chamber that can performing serial processes such as cell gathering, cell lysis, nucleic acid amplification, and signaling without the need to transfer samples from one chamber to another. A TEOS (tetraethoxysilane) surface was selected for this application because of its superior performance in the amplification process as well as the ability of bacteria to adsorb to its surface, which is necessary for all processes to be performed in single chamber. The optimal aquatic buffer conditions for bacteria adsorption on the hydrophilic surface were determined to be 1% polyethylene glycerol (PEG) and 10 mM MgCl(2) in 100 mM phosphate at pH 4 for the gram negative bacteria, Escherichia coli O157:H7 (E. coli O157:H7) and 10 mM Na(2)SO(4) in 100 mM phosphate in 100 mM phosphate at pH 4 for the gram positive bacteria, Bacillus cereus (B. cereus). When these divalent cation and anion (MgSO(4)) containing acidic solutions were used, 40% of both bacteria adsorbed onto the hydrophilic surface at a loading rate of 2 mL/min after introduction of low concentrations of bacteria. This method was directly employed to detect E. coli O157:H7 in beef using a single plastic tube chamber that was partially filled with nickel micro beads coated with TEOS. In this system, E. coli O157:H7 were lysed by induction heating of the nickel micro beads. The extracted mRNA was readily amplified and detected by adding an isothermal amplification mixture (NASBA, nucleic acid sequence based amplification) containing a hair-loop type reporting probe with FAM and DABCYL. As a result, this highly sensitive sensing tool could detect very low concentrations of E. coli [10(0) CFU/1 g of beef].


[Systemic candidiasis in patients after kidney and heart transplantation].
Nosocomial and other severe infections are able to cause life-threatening complications in organ transplant recipients. Unter such conditions the treatment will be successful only in early status of infection. Fluconazol (Diflucan) has been used in the treatment of candidosis in cardiac and renal transplant patients with good results, and lack of adverse effects.


Role of minor salivary glands in developing patient-rated xerostomia and sticky saliva during day and night.
The purpose of this prospective study was to investigate the relationship between xerostomia during the day (XERday) and night (XERnight) and sticky saliva during the day (STICday) and night (STICnight) and dose distributions in different major and minor salivary glands among head and neck cancer (HNC) patients treated with primary radiotherapy (RT) or chemoradiation (CHRT). The study population was composed of 201 consecutive HNC patients treated with intensity modulated radiotherapy (IMRT) or 3-dimensional conformal radiotherapy (3D-CRT). All patients were included in a standard follow up programme in which acute and late side effects and quality of life (QoL) were prospectively assessed, prior to, during and after treatment. The primary endpoints were XERday, XERnight, STICday, STICnight as assessed by the Groningen Radiotherapy Induced Xerostomia questionnaire (GRIX) six months after completion of treatment. Organs at risk (OARs) potentially involved in salivary function were delineated on planning-CT, including the parotid, submandibular and sublingual glands and the minor glands in the soft palate, buccal mucosa and lips. Patients with moderate-to-severe xerostomia or moderate-to-severe sticky saliva, respectively, at baseline were excluded. In order to determine which salivary glands were most important, a multivariate logistic regression analysis with an extended bootstrapping technique was used. In total, 29% and 19% of the cases suffered from XERday and XERnight, respectively. The multivariate analysis showed that baseline xerostomia and the mean parotid gland dose were the most important predictors for XERday and XERnight. At 6months after (CH)RT, 10% and 12% of the cases reported STICday and STICnight respectively. We were not able to identify prognostic factors related to dose distributions with regard to STICday. The mean submandibular gland dose was associated with STICnight. Baseline xerostomia and sticky saliva scores on the GRIX were associated with XERday, XERnight, STICday. Increasing age was correlated with both XERnight and STICnight. Organs at risk for XERday and STICday are similar to organs at risk for XERnight and STICnight.


Regional blood flow change in the lamb during the perinatal period.
Regional blood flow distribution was studied with a radioactive-labeled microsphere technique in 11 unanesthetized fetal sheep (139 to 143 days' gestation). After cesarean delivery each neonatal lamb was studied at 2 and 24 hours of age. Blood flow to the cerebral hemispheres and adrenal glands decreased progressively after birth and correlated inversely with the postnatal rise in arterial oxygen content (r = -0.77, p less than 0.001 and r = -0.52, p less than 0.01, respectively). Blood flow to the gastrointestinal tract and kidneys changed little despite the known increase in blood flow from the late fetal to the early neonatal period. Skeletal muscle and brown fat blood flow were both increased when measured at 2 hours after birth, with an even greater increase in their respective oxygen deliveries presumably reflecting their increased metabolic activity with thermogenesis at this time. Variable blood flow changes are thus evident over the immediate perinatal period. In some cases these changes reflect birth-related changes in either blood gases or functional activity whereas in others the changes simply reflect a continuum from the late fetal to the early neonatal period.


Stretching the wings further- susceptibility of Culex pipiens Linnaeus to bovine ephemeral fever virus infection under experimental conditions.
Bovine ephemeral fever (BEF) is a significant viral disease of cattle in the tropical, subtropical, and temperate climatic zones. This disease is also known as three-day sickness due to the spontaneous recovery of the cattle within a short period (usually 3-5 days). Despite its short duration, the disease may have a considerable impact. It can cause heavy economic losses, primarily due to decreased milk production, lowered fertility in bulls, and even fatality in severe cases. The virus is suspected to be transmitted by haematophagous insects (mainly mosquitoes and Culicoides biting midges); however, the identity of a competent vector for BEFV remains a mystery. Here, we investigated whether BEFV may replicate for a short duration in Culex pipiens Linnaeus, 1758, the most prevalent mosquito species in Israel and a potential vector of this virus to Israeli cattle. We applied nested- qPCR to test BEFV abundance in Cx. pipiens every 24 h for 14 consecutive days post-infection. Additionally, we collected eggs laid by BEFV-infected females and investigated BEFV abundance in the different developmental stages of F1 mosquitos. Our results suggest that Cx. pipiens mosquitoes have the potential to act as a vector of BEFV and also indicate that BEFV may be vertically transmitted from Cx. pipiens female parent to her female offspring.


Distribution of extravasated serum protein after cryoinjury in neonatal and adult rat brains.
The sequelae of cryoinjury to unilateral cerebral cortex were compared in neonatal and adult rats. In neonatal rats, immunostaining for autologous albumin disclosed a wide spread of extravasated albumin in both hemispheres on day 1 and rapid clearance from the tissue by day 7, whereas in adults rats, the distribution of albumin had progressively increased by day 7 and was then restricted to the injury site by day 14. Horseradish peroxidase tracing revealed a leakage of serum proteins by day 3 in neonates and by day 7 in adults. The rapid clearance of serum proteins from the neonatal brain tissue appeared to be promoted by vimentin-positive radial glia in the subpial and periventricular regions. A possible causal relationship between the rapid clearance of serum proteins and unique outcome of the cryoinjury in the neonatal brain is discussed.


Validating clinical reasoning: a question of perspective, but whose perspective?
This paper explores the notion of validity from different perspectives and addresses its integration with clinical reasoning. Whilst valuing the evidence-based practice (EBP) perspective in our quest for validation of practice, the authors posit that other perspectives may provide added value through their potential for offering validity in differing circumstances. The reality of the EBP aspiration is discussed and nuances within the evolved term 'research-enhanced practice' are shared. Validity theory applied through different perspectives may, it is argued help to get to grips with the balancing act of validating manual therapy practice.


Pyrrole, furan, and thiophene oxamates as potential antiallergy agents.
Nine heterocyclic oxamic acid derivatives were synthesized and tested in the rat passive cutaneous anaphylactic assay as potential antiallergy agents. Some compounds also were tested for their effects on cholesterol-lipoprotein levels and for diuretic, antidiabetic, and antifertility activities in rats.


The influence of environmental temperature on appetite-related hormonal responses.
Acute exercise in the heat has been shown to reduce appetite. However, the influence of exercise in the cold on appetite regulation remains unclear. The aim of this study was to compare exercise-induced appetite regulation under three different environmental temperatures. Eleven male participants completed three experimental trials on the following separate days: exercise in the heat (36 °C), exercise at neutral temperature (24 °C), and exercise in the cold (12 °C). The exercise trials consisted of pedaling exercises for 30 min at 65% of maximal oxygen uptake (VO2max). Blood samples were collected repeatedly to determine plasma ghrelin, peptide YY (PYY) and other hormonal concentrations. Subjective feelings of hunger and tympanic temperature were also monitored. Tympanic temperature was significantly higher in the 36 °C trial than that of the other two trials (P < 0.05). The subjective feelings of hunger in the 36 °C and 24 °C trials were significantly lower than those in the 12 °C trial (P < 0.05). Plasma ghrelin concentration decreased significantly with exercise in all conditions (P < 0.05), and the responses were not significantly different among the three conditions. Plasma PYY concentration increased significantly after the exercise in the 24 °C trial only (P < 0.05), with no significant difference among the three trials. These results suggest that exposure to hot or cold temperatures during exercise did not affect exercise-induced plasma ghrelin and PYY responses. However, the exercise-induced reduction of subjective hunger was significantly attenuated in a cold environment.


Genome-wide identification and characterization of long non-coding RNAs during differentiation of visceral preadipocytes in rabbit.
Emerging evidence suggests that long non-coding RNAs (lncRNAs) are critical regulators of diverse biological processes, including adipogenesis. Despite being considered an ideal animal model for studying adipogenesis, little is known about the roles of lncRNAs in the regulation of rabbit preadipocyte differentiation. In the present study, visceral preadipocytes isolated from newborn rabbits were cultured in vitro and induced for differentiation, and global lncRNA expression profiles of adipocytes collected at days 0, 3, and 9 of differentiation were analyzed by RNA-seq. A total of 2066 lncRNAs were identified from nine RNA-seq libraries. Compared to protein-coding transcripts, lncRNA transcripts exhibited characteristics of a longer length and lower expression level. Furthermore, 486 and 357 differentially expressed (DE) lncRNAs were identified when comparing day 3 vs. day 0 and day 9 vs. day 3, respectively. Target genes of DE lncRNAs were predicted by the cis-regulating approach. Prediction of functions revealed that DE lncRNAs when comparing day 3 vs. day 0 were involved in gene ontology (GO) terms of developmental growth, growth, developmental cell growth, and stem cell proliferation, and involved in Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of PI3K-Akt signaling pathway, fatty acid biosynthesis, and the insulin signaling pathway. The DE lncRNAs when comparing day 9 vs. day 3 were involved in GO terms that associated with epigenetic modification and were involved in the KEGG pathway of cAMP signaling pathway. This study provides further insight into the regulatory function of lncRNAs in rabbit visceral adipose and facilitates a better understanding of different stages of preadipocyte differentiation.


Association of attention deficit hyperactivity disorder-related psychopathology and personality traits with the serotonin transporter promoter region polymorphism.
The role of the genetic polymorphism within the promoter region of the serotonin transporter (5-HTT) gene is under discussion as a modulator for personality traits and a risk factor for several mental disorders including attention deficit hyperactivity disorder (ADHD). Here we report a significant association of this polymorphism with scores on the Wender Utah Rating Scale, which was used for the assessment of a history of ADHD-associated symptoms, indicating a higher frequency of the long variant allele in individuals with high scores. We found no association between the 5-HTT polymorphism and personality traits according to the Eysenck Impulsivity Questionnaire and the Freiburg Personality Inventory, respectively, except a significant association with social orientation. Thus, our study supports the recently reported finding of an association of the 5-HTT polymorphism with ADHD. However, since a dimensional assessment of ADHD-related symptomatology was used in our study instead of a diagnostic approach, we are now on the way in performing further studies regarding diagnostic discrimination and comorbidity.


Dimethyl sulfoxide interferes with in vitro differentiation of chick embryo endochondral chondrocytes.
Dedifferentiated chondrocytes derived from 6-day-old chick embryo tibiae when transferred on agarose, revert to the chondrocytic phenotype and mature to hypertrophic, type X collagen-producing chondrocytes (Castagnola et al. (1986). J. Cell Biol. 102, 2310-2317). The continuous presence of 180 mM dimethyl sulfoxide (DMSO) during the culture specifically inhibited synthesis of type X collagen and accumulation of its mRNA. The synthesis of the cartilage-specific type II collagen and the level of its mRNA were essentially unchanged in treated and control untreated cells.


Insectivore Nutrition - A Review of Current Knowledge.
Insectivores are represented in virtually all taxa, although more is known about mammalian and avian insectivore nutrition than for reptiles, amphibia and fish. Establishing nutrient requirements is challenging but recommendations should be based on data from similar taxa, similar GI tract physiology, and known nutritional concerns. In order to provide an appropriate diet for insectivores, consideration must be given to anatomy and method for procuring insects in free-ranging habitats, availability of feeder insects and the resulting dietary nutrient profiles, and complementing those profiles with appropriate diet items from various other categories including formulated feed, produce, animal matter, seeds or grains etc. Consideration of known nutritional concerns for a given species, and the variation in energy requirements in a captively managed situation are essential.


CD44 is functionally crucial for driving lung cancer stem cells metastasis through Wnt/β-catenin-FoxM1-Twist signaling.
A novel paradigm in tumor biology suggests that non-small cell lung cancer (NSCLC) metastasis is driven by lung cancer stem cell-like cells (LCSCs), but the underlying mechanisms remain unclear. Here, we aim to investigate biological function of CD44 in regulating metastatic trait of LCSCs and its underlying mechanisms. In this study, we found that CD133+ CD44+ cells which were derived from primary lung adenocarcinoma (LAC) possessed cancer stem cell-like features. Furthermore, CD44 was demonstrated functionally crucial to drive metastatic potential of CD133+ CD44+ LCSCs by in vitro and in vivo experiments. In patient cohorts, high level of CD44 predicted increased probability of metastasis. Significantly, microarray revealed that FoxM1 and key proteins of Wnt/β-catenin pathway were up-regulated in CD133+ CD44+ LCSCs compared with those in CD133+ CD44- cells. Then, we demonstrated that CD44 promoted metastatic activity in CD133+ CD44+ LCSCs through Wnt/β-catenin pathway and FoxM1 was the downstream target of Wnt/β-catenin pathway. Meanwhile, our findings indicated that FoxM1 promoted metastatic activity in CD133+ CD44+ LCSCs by inducing EMT and Twist was a direct transcriptional target of FoxM1. Collectively, CD44, both a functional biomarker and therapeutic target, promoted CD133+ CD44+ LCSCs metastasis by Wnt/β-catenin-FoxM1-Twist signaling. This study provided support for the missing link between EMT and CSCs surface-marker and supplied a promising approach for elimination of LCSCs by targeting CD44-Wnt/β-catenin-FoxM1-Twist signaling. © 2015 Wiley Periodicals, Inc.


Metabolic changes in the cells of the callus during fracture healing in the rat.
Unfixed, undecalcified sections from closed fractures of rat metatarsals have been studied by quantitative cytochemistry from the first week after fracture to late in the fracture-healing process. Alkaline phosphatase activity appeared to be related to calcification. Glucose 6-phosphate dehydrogenase activity was associated with proliferation and with calcification. Studies made with the critical electrolyte Alcian blue technique suggested that whether the ossification process is of the endochondral or membranous type might be predetermined in the relatively undifferentiated callus.


[Evaluation of various indicators of cellular immunity in persons exposed to work environment in the Masovian Refinery and Petrochemical Plants in Plock].
In 137 workers of the Mazovian Refining Petrochemical Plant cellular immunity parameters were examined. The following tests were performed: number of E rosette forming cells (T lymphocytes), TG and TM lymphocytes, EAC rosette forming cells (B lymphocytes), MIF generation and suppressor and cytotoxic activity of T lymphocytes. Workers of Asphalt Oxidation Division exhibited most pronounced deviations of the test parameters, as compared to controls.


Studies on the anticoagulant action of Aspilia africana.
An anticoagulant activity was identified and isolated from the leaves of a West African plant, Aspilia africana by gel filtration on Sephadex G-100. The anticoagulant factor had an apparent molecular weight of approximately 60,000 d. Upon incubation with plasma, it prolonged the partial thromboplastin time, prothrombin time, thrombin and reptilase time. The factor decreased the fibrinogen content of plasma as well as the activity of coagulation factors V, VIII and IX but not factor VII, X or XI activities. After incubation with fibrinogen, the thrombin clotting time was prolonged and the quantity of clottable fibrinogen reduced. The action on fibrinogen was characterized by sequential lytic breakdown of the A-alpha-chain and B-beta-chain, the gamma-chain being lysed last, after prolonged incubation. Benzamidine, Epsilon aminocaproic acid or soybean trypsin inhibitor did not impede lysis.


Cocurricular Clinical Opportunity: Addressing Student Attitudes, Knowledge, and Skills With Disability Education.
Multiple organizations have urged inclusion of disability content in health care professional's education and training. Few nursing schools in the United States have adopted dedicated disability curricula nor studied its impact on attitudes, knowledge, and skills of disability education. Evidence suggests that inadequate education contributes to health care disparities and unmet needs of people with disabilities. A 2-hour cocurricular clinical experience was developed, using established competencies, and offered to senior nursing students. Students participated in multimodal experiences, with an emphasis on clinical exposure in various facilities serving children and adults with disabilities. Five cohorts of students (N = 34) participated in the fellowship. Data illustrate the strong need to continue and require the curricula. Faculty should develop disability education secondary to population prevalence and in accordance with the American Association of Colleges of Nursing's essential competencies. [J Nurs Educ. 2021;60(11):637-641.].


Irradiation leads to sensitization of hepatocytes to TNF-alpha-mediated apoptosis by upregulation of IkappaB expression.
This study aimed to reveal the pathophysiological signalling responsible for radiation-induced sensitization of hepatocytes to TNF-alpha-mediated apoptosis. IkappaB was upregulated in irradiated hepatocytes. Administration of IkappaB antisense oligonucleotides prior to irradiation inhibited occurrence of apoptosis after TNF-alpha administration. Caspases-8, -9 and -3 activities were increased in irradiated hepatocytes and downregulation of apoptosis by IkappaB antisense oligonucleotides was mediated by suppression of caspases-9 and -3 activation but not of caspase-8 activation, suggesting that radiation-induced sensitization of hepatocytes to TNF-alpha-mediated apoptosis additionally requires changes upstream of caspase-8 activation. Herein, upregulation of FLIP may play a crucial role. Cleavage of bid, upregulation of bax, downregulation of bcl-2 and release of cytochrome c after TNF-alpha-administration depend on radiation-induced upregulation of IkappaB, thus demonstrating an apoptosis permitting effect of IkappaB.


Health-related quality of life of children with vision impairment or blindness.
The aims of the study were to describe the functional ability, health status, and health-related quality of life (HRQL) of young children with a vision impairment or blindness (VI/BL) and to examine the effect of different types of ophthalmic condition and the presence of other impairments or systemic disorders. A cross-sectional community survey of children aged 3 to 8 years with VI/BL was conducted in four areas of England using the Health Utilities Index Mark 3 system. Seventy-nine children (47 males, 32 females; mean age 6 y 2 mo [SD 1 y 6 mo]) met the selection criteria: 43% had a visual pathway condition, 38% a condition of the eye, and 19% nystagmus alone; and 61% had additional impairments/disorders. Eighty per cent had functional limitations on at least two of the following attributes: vision, hearing, speech, cognition, ambulation, dexterity, emotion, and pain. Forty-four per cent had functional limitations on four or more attributes. Children with nystagmus alone had significantly higher mean HRQL utility scores (0.80 [SD 0.26]) than children with a condition of the eye (0.45 [SD 0.33]), who, in turn, had higher scores than children with a visual pathway condition (0.05 [SD 0.33], p=0.002). Children with an isolated VI/BL had significantly higher mean scores (0.73 [SD 0.21]) than those with additional impairments/disorders (0.09 [SD 0.34], p<0.001). These findings underline the need for a broad assessment of each child with VI/BL and a multidisciplinary approach to care.


Direct suppression of Stat1 function during adenoviral infection.
The action of adenoviral E1A oncoprotein on host immune-response genes has been attributed to interaction with p300/CBP-type transcriptional coactivators in competition with endogenous transcription factors such as signal transducer and activator of transcription (STAT) proteins. However, we show that mutant forms of E1A that no longer bind p300/CBP can still interact directly with Stat1 (via E1A N-terminal and Stat1 C-terminal residues) and block IFNgamma-driven, Stat1-dependent gene activation and consequent function during early-phase infection in the natural host cell. The results provide a distinct and more specific mechanism for E1A-mediated immune suppression and an alternative model of IFNgamma-driven enhanceosome formation that may allow for other adaptors (in addition to p300/CBP) to link Stat1 to the basal transcription complex.


Cloning and characterization of cell adhesion kinase beta, a novel protein-tyrosine kinase of the focal adhesion kinase subfamily.
A second protein-tyrosine kinase (PTK) of the focal adhesion kinase (FAK) subfamily, cell adhesion kinase beta (CAK beta), was identified by cDNA cloning. The rat CAK beta is a 115.7-kDa PTK that contains N- and C-terminal domains of 418 and 330 amino acid residues besides the central kinase domain. The rat CAK beta has a homology with mouse FAK over their entire lengths except for the extreme N-terminal 88 residues and shares 45% overall sequence identity (60% identical in the catalytic domain), which indicates that CAK beta is a protein structurally related to but different from FAK. The CAK beta gene is less evenly expressed in a variety of rat organs than the FAK gene. Anti-CAK beta antibody immunoprecipitated a 113-kDa protein from rat brain, 3Y1 fibroblasts, and COS-7 cells transfected with CAK beta cDNA. The tyrosine-phosphorylated state of CAK beta was not reduced on trypsinization, nor enhanced in response to plating 3Y1 cells onto fibronectin. CAK beta localized to sites of cell-to-cell contact in COS-7 transfected with CAK beta cDNA, in which FAK was found at the bottom of the cells. Thus, CAK beta is a PTK possibly participating in the signal transduction regulated by cell-to-cell contacts.


Rate of increase of lung-to-head ratio over the course of gestation is predictive of survival in left-sided congenital diaphragmatic hernia.
Congenital diaphragmatic hernia (CDH) is associated with high postnatal mortality because of pulmonary hypoplasia. The prognostic utility of serial lung-to-head circumference measurements as a marker of lung growth has not been described. Our objective was to examine the relationship between the rate of interval increase of LHR and postnatal survival in left-sided CDH. We retrospectively reviewed charts of all left-sided CDH patients from January 2004 to July 2014. All ultrasound studies performed at our institution (n=473) were reviewed. Categorical and continuous data were analyzed by chi-square and Mann-Whitney t-test, respectively, and slope analysis was performed by linear regression analysis (p<0.05). A total of 226 patients were studied, with 154 long-term survivors and 72 non-survivors. Established markers of CDH severity, including intrathoracic liver position and requirement for patch repair, were significantly increased in non-survivors (p<0.0001). The rate of LHR increase as measured by linear regression and slope analysis was significantly increased in long-term survivors (p=0.0175). Our findings indicate that the interval increase in LHR levels over the course of gestation correlate with survival in left-sided CDH patients. Regular ultrasonographic re-evaluation of LHR throughout gestation following diagnosis of CDH may provide prognostic insight and help guide patient management.


Gerstmann's Syndrome in a Patient Double-positive for Antibodies against the N-methyl-D-aspartate Receptor and NH2-terminal of α-enolase.
We herein report a case of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis concurrent with NH2-terminal of α-enolase (NAE) antibodies. A 36-year-old Japanese woman presented with Gerstmann's syndrome followed by jerky involuntary movements, seizure, autonomic instability, and consciousness disturbance. NAE antibodies were detected in the serum; however, NMDAR antibodies were identified in the cerebrospinal fluid with a cell-based assay, confirming the diagnosis of anti-NMDAR encephalitis. This case highlights the fact that Gerstmann's syndrome can be a manifestation of anti-NMDAR encephalitis and that NAE may be identified concurrently with NMDAR antibodies, suggesting that the diagnosis of Hashimoto encephalopathy requires the reasonable exclusion of alternative diagnoses, including anti-NMDAR encephalitis.


A rapid ELISA for the detection of matrix metallopeptidase 9 using a recombinant Fab-type antibody.
Matrix metalloproteinase 9 (MMP9) contributes to several aspects of inflammation and cancer pathology, including invasion, metastasis, and angiogenesis. In this study, we expressed a recombinant fragment antigen-binding (Fab)-type anti-MMP9 antibody in Escherichia coli with high purity within five days and confirmed the nanomolar order of antigen-binding efficiency of the recombinant Fab. Moreover, we optimized the experimental time for performing enzyme-linked immunosorbent assay (ELISA), and decreased the reaction time from the conventional 20.5 h to 3.5 h. The rapid and sensitive MMP9 detection system developed in this study can be applied to a range of applications, including the diagnosis of diseases with MMP9 overexpression including inflammatory and cancer-related diseases.


Alogliptin, a Dipeptidyl Peptidase 4 Inhibitor, Prevents the Progression of Carotid Atherosclerosis in Patients With Type 2 Diabetes: The Study of Preventive Effects of Alogliptin on Diabetic Atherosclerosis (SPEAD-A).
Recent experimental studies have shown that dipeptidyl peptidase 4 (DPP-4) inhibitors have antiatherosclerotic benefits in glucagon-like peptide 1-dependent and -independent manners. The current study investigated the effects of alogliptin, a DPP-4 inhibitor, on the progression of carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM). This prospective, randomized, open-label, blinded-end point, multicenter, parallel-group, comparative study included 341 patients with T2DM free of a history of apparent cardiovascular diseases recruited at 11 clinical units and randomly allocated to treatment with alogliptin (n = 172) or conventional treatment (n = 169). Primary outcomes were changes in mean common and maximum intima-media thickness (IMT) of the carotid artery measured by carotid arterial echography during a 24-month treatment period. Alogliptin treatment had a more potent glucose-lowering effect than the conventional treatment (-0.3 ± 0.7% vs. -0.1 ± 0.8%, P = 0.004) without an increase of hypoglycemia. Changes in the mean common and the right and left maximum IMT of the carotid arteries were significantly greater after alogliptin treatment than after conventional treatment (-0.026 mm [SE 0.009] vs. 0.005 mm [SE 0.009], P = 0.022; -0.045 mm [SE 0.018] vs. 0.011 mm [SE 0.017], P = 0.025, and -0.079 mm [SE 0.018] vs. -0.015 mm [SE 0.018], P = 0.013, respectively). Alogliptin treatment attenuated the progression of carotid IMT in patients with T2DM free of apparent cardiovascular disease compared with the conventional treatment.


Neuroimaging in the diagnosis and treatment of intracranial pressure disorders.
To review the clinical features, proposed pathophysiology, and the role of medical imaging in the diagnosis and treatment of idiopathic intracranial hypertension and spontaneous intracranial hypotension. The authors conducted a narrative review of the current literature on intracranial hypertension and hypotension syndromes, with a focus on imaging findings and role of neurointerventional radiology as a therapeutic option for these pathologies. Idiopathic intracranial hypertension commonly presents in obese women of childbearing age, being headache and papilledema the main clinical manifestations. Characteristic radiological findings consist of increased cerebrospinal fluid around the optic nerve, partially empty sella turcica and stenosis of the transverse sinuses. Transverse sinus stenting is a treatment alternative that has proven valuable utility in the recent years. Spontaneous intracranial hypotension in most of cases presents with orthostatic headache and has predilection for female population. The typical radiological features in the brain consist of subdural fluid collections, enhancement of the dura, engorgement of the venous structures, pituitary enlargement, and sagging of the brain. In this pathology, a cerebrospinal fluid leak in the spine associated with a defect in the dura, meningeal diverticulum, or a cerebrospinal fluid-venous leak must be actively ruled out. Neurologic complaints secondary to changes in intracranial pressure exhibit certain clinical features that in combination with fairly specific radiological patterns allow a highly accurate diagnosis. The diverse specialists in neurosciences should be aware of the multiple image modalities in the study of these syndromes as well as the treatment alternatives by neurointerventional radiology.


Race and ethnic disparities in cervical cancer screening in a safety-net system.
The three objectives of this research were: 1) to examine the use of Pap smear tests among low-income women, including minority and immigrant women who were patients in a safety-net healthcare system; 2) to identify policy relevant variables that could lead to changes in use of Pap smear screening services for these women; and 3) to contribute to the literature on use of Pap smear screening, especially among minorities and immigrants. The Behavioral Model for Vulnerable Populations was used as the theoretical framework. Pap smear screening predictors were examined using telephone interviews with a random sample of women aged 18-60, including 465 Non-Hispanic Whites, 285 African Americans, 164 Hispanic Americans, and 256 Hispanic immigrants, enrolled in a safety-net healthcare system in Texas in Fall 2000. Binary logistic regression analysis was used. The research revealed that Non-Hispanic Whites were most likely to have been screened ever and in the past 3 years, followed by African Americans, Hispanic immigrants, and Hispanic Americans. Among Hispanics, immigrants were most likely to have had Pap smear screening, supporting the "healthy immigrant hypothesis." Older women were most likely to have ever been screened, with younger women, most likely in the past year. Having a usual source of healthcare and a checkup for current pregnancy increased screening, while competing needs (food, clothing, housing) affected screening negatively. Culturally competent, community-based care for women is needed to increase Pap smear screening among minority groups, especially Hispanic immigrant and Hispanic American women.


Chemical and biological characterization of the DPP-IV inhibitory activity exerted by lupin (Lupinus angustifolius) peptides: From the bench to the bedside investigation.
Dipeptidyl peptidase IV (DPP-IV) is considered a key target for the diabetes treatment, since it is involved in glucose metabolism. Although lupin protein consumption shown hypoglycemic activity, there is no evidence of its effect on DPP-IV activity. This study demonstrates that a lupin protein hydrolysate (LPH), obtained by hydrolysis with Alcalase, exerts anti-diabetic activity by modulating DPP-IV activity. In fact, LPH decreased DPP-IV activity in a cell-free and cell-based system. Contextually, Caco-2 cells were employed to identify LPH peptides that can be intestinally trans-epithelial transported. Notably, 141 different intestinally transported LPH sequences were identified using nano- and ultra-chromatography coupled to mass spectrometry. Hence, it was demonstrated that LPH modulated the glycemic response and the glucose concentration in mice, by inhibiting the DPP-IV. Finally, a beverage containing 1 g of LPH decreased DPP-IV activity and glucose levels in humans.


The lipid profile in psoriasis: a controlled study.
Psoriasis is an inflammatory dermatosis that is characterized with hyperproliferation of keratinocytes and inflammatory infiltration in the epidermis and dermis. The high prevalence of atherosclerosis has been reported in psoriatic patients. High serum lipid level has been suggested in the pathogenesis of this phenomenon. In this study, our purpose was to compare the lipid profile in psoriatic patients with non-affected persons. This study was designed and conducted as a case-control assay with 50 cases in the patient and control groups, respectively. The lipid profile, including serum level of triglyceride, cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL), were assessed in both groups. The patient and control groups each consisted of 50 cases (39 male and 11 female). The serum triglyceride, cholesterol, and LDL was significantly higher in psoriatic patients (P < 0.05) but not for HDL (P = 0.29). This study, like previous assays, shows that high serum lipid level is significantly more common in psoriasis. This fact may be responsible for higher prevalence of cardiovascular accident in psoriatic patients. It may be useful to do early screening and treatment of hyperlipidaemia in psoriasis to prevent the atherosclerosis and its complications.


Extinction of Cocaine Memory Depends on a Feed-Forward Inhibition Circuit Within the Medial Prefrontal Cortex.
Cocaine-associated environments (i.e., contexts) evoke persistent memories of cocaine reward and thereby contribute to the maintenance of addictive behavior in cocaine users. From a therapeutic perspective, enhancing inhibitory control over cocaine-conditioned responses is of pivotal importance but requires a more detailed understanding of the neural circuitry that can suppress context-evoked cocaine memories, e.g., through extinction learning. The ventral medial prefrontal cortex (vmPFC) and dorsal medial prefrontal cortex (dmPFC) are thought to bidirectionally regulate responding to cocaine cues through their projections to other brain regions. However, whether these mPFC subregions interact to enable adaptive responding to cocaine-associated contextual stimuli has remained elusive. We used antero- and retrograde tracing combined with chemogenetic intervention to examine the role of vmPFC-to-dmPFC projections in extinction of cocaine-induced place preference in mice. In addition, electrophysiological recordings and optogenetics were used to determine whether parvalbumin-expressing inhibitory interneurons and pyramidal neurons in the dmPFC are innervated by vmPFC projections. We found that vmPFC-to-dmPFC projecting neurons are activated during unreinforced re-exposure to a cocaine-associated context, and selective suppression of these cells impairs extinction learning. Parvalbumin-expressing inhibitory interneurons in the dmPFC receive stronger monosynaptic excitatory input from vmPFC projections than local dmPFC pyramidal neurons, consequently resulting in disynaptic inhibition of pyramidal neurons. In line with this, we show that chemogenetic suppression of dmPFC parvalbumin-expressing inhibitory interneurons impairs extinction learning. Our data reveal that vmPFC projections mediate extinction of a cocaine-associated contextual memory through recruitment of feed-forward inhibition in the dmPFC, thereby providing a novel neuronal substrate that promotes extinction-induced inhibitory control.


Iatrogenic femoral vein pseudoaneurysm.
Femoral vein pseudoaneurysm is a rare complication during percutaneous interventions. We report the case of a patient with common femoral vein pseudoaneurysm caused by unsuccessful manual compression. A 68-year-old woman underwent catheter ablation for atrial fibrillation at another institution. Postoperatively, she experienced right groin pain and leg edema. Doppler ultrasound examination revealed a 2-cm venous pseudoaneurysm as a compressible and hypoechoic lesion. We successfully performed venous aneurysmectomy after failed ultrasound-guided compression therapy. Appropriate procedures must be selected for patients with femoral pseudoaneurysm. The efficacy of hemostatic techniques for preventing vascular complications after venous sheath removal should not be underestimated.


Outpatient surgery for prolapsed lumbar disc.
A selected series of 14 patients with lumbar disc prolapse causing sciatica have been operated successfully with outpatient (daycase) surgery. Postoperative pain has been much less than expected. This form of surgery has proved very acceptable to patients and to their family doctors.


Ultra-processed food consumption drives excessive free sugar intake among all age groups in Australia.
To analyze the contribution of ultra-processed foods to the intake of free sugars among different age groups in Australia. Dietary intakes of 12,153 participants from the National Nutrition and Physical Activity Survey (2011-12) aged 2+ years were evaluated. Food items collected through two 24-h recalls were classified according to the NOVA system. The contribution of each NOVA food group and their subgroups to total energy intake was determined by age group. Mean free sugar content in diet fractions made up exclusively of ultra-processed foods, or of processed foods, or of a combination of un/minimally processed foods and culinary ingredients (which includes table sugar and honey) were compared. Across quintiles of the energy contribution of ultra-processed foods, differences in the intake of free sugars, as well as in the prevalence of excessive free sugar intake (≥ 10% of total energy) were examined. Ultra-processed foods had the highest energy contribution among children, adolescents and adults in Australia, with older children and adolescents the highest consumers (53.1% and 54.3% of total energy, respectively). The diet fraction restricted to ultra-processed items contained significantly more free sugars than the two other diet fractions. Among all age groups, a positive and statistically significant linear association was found between quintiles of ultra-processed food consumption and both the average intake of free sugars and the prevalence of excessive free sugar intake. Ultra-processed food consumption drives excessive free sugar intake among all age groups in Australia.


Discrete molecular dynamics study of oligomer formation by N-terminally truncated amyloid β-protein.
In Alzheimer's disease (AD), amyloid β-protein (Aβ) self-assembles into toxic oligomers. Of the two predominant Aβ alloforms, Aβ1-40 and Aβ1-42, the latter is particularly strongly linked to AD. N-terminally truncated and pyroglutamated Aβ peptides were recently shown to seed Aβ aggregation and contribute significantly to Aβ-mediated toxicity, yet their folding and assembly were not explored computationally. Discrete molecular dynamics approach previously captured in vitro-derived distinct Aβ1-40 and Aβ1-42 oligomer size distributions and predicted that the more toxic Aβ1-42 oligomers had more flexible and solvent-exposed N-termini than Aβ1-40 oligomers. Here, we examined oligomer formation of Aβ3-40, Aβ3-42, Aβ11-40, and Aβ11-42 by the discrete molecular dynamics approach. The four N-terminally truncated peptides showed increased oligomerization propensity relative to the full-length peptides, consistent with in vitro findings. Conformations formed by Aβ3-40/42 had significantly more flexible and solvent-exposed N-termini than Aβ1-40/42 conformations. In contrast, in Aβ11-40/42 conformations, the N-termini formed more contacts and were less accessible to the solvent. The compactness of the Aβ11-40/42 conformations was in part facilitated by Val12. Two single amino acid substitutions that reduced and abolished hydrophobicity at position 12, respectively, resulted in a proportionally increased structural variability. Our results suggest that Aβ11-40 and Aβ11-42 oligomers might be less toxic than Aβ1-40 and Aβ1-42 oligomers and offer a plausible explanation for the experimentally observed increased toxicity of Aβ3-40 and Aβ3-42 and their pyroglutamated forms.


The value of intraoperative MRI for resection of functional pituitary adenomas-a critical assessment of a consecutive single-center series of 114 cases.
This series sought to evaluate the role of intraoperative MRI (iMRI) for resection of functional pituitary adenomas (FPAs). We retrospectively reviewed clinical data of 114 consecutive FPAs with excessive hormone secretion treated with transsphenoidal surgery and iMRI during 01/2010-12/2017. We focused on iMRI findings, extend of resection and postoperative hormonal remission. Variables of incomplete resections and persistent hormone excess were evaluated by binary regression. Patients with FPAs presented with hypercortisolism (n = 23, 20%), acromegaly (n = 56, 49%), and as prolactinomas (n = 35, 31%) resistant to medical treatment. Preoperative MRI showed 81 macroadenomas (71%) and optic system involvement in 41 cases (36%). IMRI was suggestive for residual tumor in 51 cases (45%). Re-inspection of the cavity cleared equivocal findings in 16 cases (14%). Additional tumor was removed in 22 cases (19%). Complete resection was achieved in 95 cases (83%). Postoperative morbidity was low (1.7% revision surgeries, 0.8% permanent diabetes insipidus). Overall hormonal remission-rate was 59% (hypercortisolism 78%, acromegaly 52%, prolactinoma 57%). Supra- and parasellar invasion and preoperative visual impairment were significant predictors for incomplete resections despite use of iMRI. Risk for persistent hormone excess was increased sevenfold after incomplete resections. IMRI enabled reliable identification of tumor remnants during surgery and triggered further resection in a considerable proportion of cases. Nevertheless, tumor size and invasiveness set persistent boundaries to the completeness of resections. The low rate of surgical complications could point at a less invasive iMRI-guided surgical approach while achieving a complete tumor resection was a crucial determinant for hormonal outcome.


A longitudinal cross-sectional analysis of substance use treatment trends for individuals experiencing homelessness, criminal justice involvement, both, or neither - United States, 2006-2018.
Individuals experiencing homelessness or criminal justice involvement (CJI) have higher rates of substance use than the general public. Despite documented barriers to accessing treatment, few studies have compared substance use treatment patterns between these groups. This paper uses data from the Treatment Episode Dataset-Admissions between 2006 to 2018 to describe characteristics and trends in substance use treatment admissions indicating homelessness (n=2,524,413), CJI (4,764,750), both (509,902), or neither (8,950,797) in the United States. We used multivariable logistic regression to examine trends independent of demographic differences between groups. Between 2006 and 2018, the proportion of treatment admissions related to heroin increased across all groups. Methamphetamine-related admissions rose substantially for individuals experiencing homelessness, CJI, or both. By 2018, 27·8% (95% CI: 27·4-28·2%) of admissions for individuals experiencing both were methamphetamine-related and 16·7% (95% CI: 16·3-17·0%) were heroin-related. Conversely, among individuals experiencing neither, 7·5% (95% CI: 7·4-7·5%) of admissions were methamphetamine-related and 33·6% (95% CI: 33·4-33·7%) were heroin-related. Individuals experiencing both homelessness and CJI received lower rates of medications for opioid use disorder (OUD) (8·3%; 95% CI: 8·2-8·3%) compared to individuals experiencing neither (36·4%; 95% CI: 36·4-36·4%). Community treatment facilities should be supported to provide medications for OUD and accommodate rising rates of methamphetamine and polysubstance-related treatment admissions in populations experiencing complex social drivers of health such as homelessness, CJI, or both. National Institute of General Medical Sciences and National Institute of Diabetes and Digestive and Kidney Diseases.


Dietary soybean oil, canola oil and partially-hydrogenated soybean oil affect testicular tissue and steroid hormone levels differently in the miniature pig.
The present study was conducted to examine the influence of dietary canola oil (CAN) and partially-hydrogenated soybean oil (HSO) compared to soybean oil (SOY, control) on the morphology and function of testes using miniature pigs as the test subject. Male miniature pigs were fed a diet containing 10%SOY, 9%CAN+1%SOY, or 9%HSO+1%SOY for 18 months. The scheduled autopsies revealed no abnormalities in histopathological examination of the major organs, except the testes. Atrophy of the seminiferous tubules and hyperplasia in the Leydig cells were found in the SOY and CAN groups. DNA microarray analysis indicated downregulation in the CAN and the HSO groups of genes encoding for gonadotropins in the pituitary gland and of enzymes and proteins involved in steroid hormone metabolism in the testes, compared to the SOY group. Plasma levels of sex hormones in the CAN and HSO groups tended to be higher and testosterone and dihydrotestosteorne in the HSO group were significantly higher than in the SOY group. These results demonstrate that testes are morphologically and functionally affected by the dietary oils, while the plasma steroid hormone levels do not necessarily reflect the gene expression, probably owing to feedback regulation via the gonadal hormones in the hypothalamus-pituitary-gonadal axis.


Cloning of cDNA for newt WT1 and the differential expression during spermatogenesis of the Japanese newt, Cynops pyrrhogaster.
To investigate the function of Wilms' tumor 1 (WT1) during spermatogenesis, cDNA for newt WT1 homolog was cloned and the expression of WT1 in newt testes was examined. The cDNA is 2089 bp in length and encodes 426 amino acid (aa) residues. The deduced aa sequence shares 76 and 79% homology with human and Xenopus WT1, respectively. Northern blot analysis shows that WT1 mRNA, 3.2 and 4.5 kb in length, are expressed in the testis and kidney. Both WT1 mRNA species are detected in various stages of spermatogenesis, but the 3.2 kb mRNA is highly expressed in spermatogonia and mature sperm stages, while the amount of 4.5 kb mRNA is almost constant throughout spermatogenesis. In situ hybridization reveals that WT1 mRNA is localized in Sertoli cells. Moreover, immunohistochemical analysis shows that WT1 protein is highly expressed in the nuclei of Sertoli cells in early spermatogonia and mature sperm stages, but not in pericystic cells or germ cells. These results suggest that WT1 is involved in the regulation of gene expression in Sertoli cells, depending on the spermatogenic stage.


Limitations in response capacity of the newt, Notophthalmus viridescens, to soluble and particulate antigens.
We have investigated the cellular basis of the failure of primitive extant vertebrates, e.g. Notophthalmus viridescens, the American common newt, to respond to soluble thymus-dependent (TD) antigens, e.g. keyhole limpet hemocyanin (KLH). We have found that KLH can be used to prime for amplification of a response to hapten, 2,4,6-trinitrophenyl (TNP) when it is conjugated to KLH, only if both the unconjugated and conjugated KLH are adsorbed onto bentonite particles. The response is monitored in terms of antigen binding cells in the spleen. Moreover, prior injection of colloidal carbon, which is actively engulfed by phagocytes throughout the body, will prevent the response from taking place. Injection of colloidal carbon diminished responses to heterologous erythrocytes and to soluble or bentonite-coated 2,4-dinitrophenylated (DNP) dextran. Comparable colloidal carbon treatment did not reduce response levels to either soluble or bentonite adsorbed TNP-lipopolysaccharide (LPS) of E. coli. We suggest that the limitation in response capacity to soluble TD antigens may be associated with regulatory phagocytes. Moreover, the phagocytic cells of this primitive vertebrate appear to mediate responses to naturally particulate TD antigens and certain thymus-independent (TI) carriers, e.g. dextran, but not to LPS.


A randomized trial of ultraviolet-C (UV-C) light versus sodium hypochlorite delivered by an electrostatic sprayer for adjunctive decontamination of hospital rooms.
In a randomized trial, adjunctive ultraviolet-C light treatment with a room decontamination device and sodium hypochlorite delivered via an electrostatic sprayer were similarly effective in significantly reducing residual healthcare-associated pathogen contamination on floors and high-touch surfaces after manual cleaning and disinfection. Less time until the room was ready to be occupied by another patient was required for electrostatic spraying.


A case of hypogonadotropic hypogonadism caused by opioid treatment for nonmalignant chronic pain.
We report a case of 42-year-old male patient with hypogonadotropic hypogonadism. He suffered from general fatigue and erectile dysfunction after the treatment with transdermal fentanyl for chronic pain by traffic injury. Endocrine examinations and hormone stimulating tests showed that he had hypogonadotropic hypogonadism. Brain magnetic resonance imaging (MRI) showed no abnormal findings, and he had no past history of accounting for acquired hypogonadotropic hypogonadism. Therefore, his hypogonadism was diagnosed to be caused by opioid treatment. Although opioid-induced endocrine dysfunctions are not widely recognized, this case suggests that we should consider the possibility of endocrine dysfunctions in patients with opioid treatment.


Intra-articular versus intravenous administration of tranexamic acid in lower limb total arthroplasty: a systematic review and meta-analysis of randomised clinical trials.
The ideal route of tranexamic acid (TXA) administration in total hip arthroplasty (THA) or total knee arthroplasty (TKA) remains controversial. This study aims to identify the optima route of TXA administration in THA or TKA. PUBMED, EMBASE, MEDLINE and CENTRAL database were systematically searched until 4 August 2021 for randomised studies that compared intravenous (IV) or intra-articular (IA) administration of TXA in THA or TKA. Sixty-seven studies enrolling 8335 patients (IA: 4162; IV: 4173) were eligible for quantitative and qualitative analysis. Comparable results were demonstrated in the incidence of venous thromboembolisation (OR:0.96, p = 0.84), total blood loss (MD: - 9.05, p = 0.36), drain output (MD: - 7.36, p = 0.54), hidden blood loss (MD: - 6.85, p = 0.47), postoperative haemoglobin level (MD: 0.01, p = 0.91), haemoglobin drop (MD: - 0.10, p = 0.22), blood transfusion rate (OR: 0.99, p = 0.87), total adverse events (OR: 1.12, p = 0.28), postoperative range of motion (MD: 1.08, p = 0.36), postoperative VAS pain score (MD: 0.13, p = 0.24) and postoperative D-dimer level (MD: 0.61, p = 0.64). IV route of TXA administration was associated with significantly longer length of hospital stay compared to IA route of administration (MD: - 0.22, p = 0.01). In this meta-analysis, both IV and IA route of TXA administration were equally effective in managing blood loss and postoperative outcomes in lower limb joints arthroplasty. Level 1. PROSPERO Registration CRD42021271355.


Effect of endotoxin administration in pregnant camels.
Intravenous administration of Escherichia coli endotoxin at a dose of 0.05 μg/kg bodyweight to pregnant camels resulted in abortion. The injection of endotoxin caused significant increases in the plasma concentration of 13,14-dihydro-15-prostaglandin F2α, the metabolite of prostaglandin F2α (PG F2α) and cortisol and a significant decrease in the concentration of progesterone. It is suggested that endotoxin caused abortion in camels was a consequence of endotoxin induced PG F2α secretion resulting in luteal regression and decreased progesterone concentration.


Pulpal involvement-roots-sepsis index: a new method for describing the clinical consequences of untreated dental caries.
To describe a modification of the index of clinical consequences of untreated dental caries [pulpal involvement, ulceration, fistula and abscess (PUFA/pufa) index] to pulpal involvement-roots-sepsis (PRS/prs) and to compare the two indices using the example of caries in primary molar teeth in children aged 6-8 years. The study sample included 542 children aged 6-8 years, from five randomly selected schools in the Bialystok District, Poland. The occurrence of clinical consequences of untreated caries in deciduous molars using the pufa and prs indices was evaluated. Data were analysed to express the prevalence, the experience and the distribution of particular pufa and prs codes in the sample population. The differences in layout of the pufa and prs components were expressed. The response rate was 77.6%. The prevalence of the clinical consequences of untreated caries was 40.77%, mean pufa and prs were the same (0.85 ± 1.33). According to the pufa index, the following mean values were obtained: p = 0.79, u = 0.01, f = 0.04 and a = 0.01. For the prs index, the mean values were as follows: p = 0.45, r = 0.35 and s = 0.05. The proposed prs index was a useful epidemiological instrument for the evaluation of the clinical consequences of untreated caries in the surveyed population. The PRS instrument could be a good alternative to the PUFA index.


Psychosocial Interventions in Reducing Cannabis Use in Early Phase Psychosis: A Canadian Survey of Treatments Offered.
Cannabis use in people with early phase psychosis (EPP) can have a significant impact on long-term outcomes. The purpose of this investigation was to describe current cannabis use treatment practices in English-speaking early intervention services (EISs) in Canada and determine if their services are informed by available evidence. Thirty-five Canadian English-speaking EISs for psychosis were approached to complete a survey through email, facsimile, or online in order to collect information regarding their current cannabis use treatment practices. Data were acquired from 27 of the 35 (78%) programs approached. Only 12% of EISs offered formal services that targeted cannabis use, whereas the majority (63%) of EISs offered informal services for all substance use, not specifically cannabis. In programs with informal services, individual patient psychoeducation (86%) was slightly more common than individual motivational interviewing (MI) (76%) followed by group patient psychoeducation (52%) and information handouts (52%). Thirty-seven percent of EISs offered formal services for substance use, and compared to programs with informal services, more MI, cognitive-behavioural therapy, and family services were offered, with individual treatment modalities more common than groups. No EISs used contingency management, even though it has some preliminary evidence in chronic populations. Evidence-based service implementation barriers included appropriate training and administrative support. While most English-speaking Canadian EIS programs offer individual MI and psychoeducation, which is in line with the available literature, there is room for improvement in cannabis treatment services based on current evidence for both people with EPP and their families.


Experience with human growth hormone in Great Britain: the report of the MRC Working Party.
The Working Party on human growth hormone (hGH) has during the past decade developed a system for the evaluation and treatment of patients suffering from hGH lack. Today there are nineteen measurement centres in the United Kingdom at which patients are assessed and where the effects of therapy are monitored. The current supply of hGH, which is prepared from pituitary glands collected by pathologists in the National Health Service, is just enough to meet demand, but research conducted on behalf of the Working Party suggests that hGH deficiency is more common than has been thought and that the prevalence may be as high as one in 10 000. If, as is hoped, patients are diagnosed younger and more patients with partial deficiency are recognized, demand may soon outstrip supply. Work is in progress to define better methods of hGH production and optimal dose regimens, both of which will help to minimize the problem of supply and demand. A few children have anti-hGH antibodies, which block growth as a result of treatment. Improved hGH production techniques may result in a less antigenic product and the resolution of this problem. Many of the Working Party's activities began as research and have evolved into service. Because of this shift in emphasis, and although much research is still to be done, responsibility for provision of treatment with hGH transferred from the Medical Research Council to the Department of Health and Social Security in July 1977.


Social Media in Pediatric Surgery: Patient Perceptions and Utilization.
Social media is fast becoming the preferred source of information for many individuals. There is no information on the utilization of social media by patients or parents in the field of pediatric surgery. The aim of this study is to first identify parents' utilization of social media as a source of information in pediatric surgery. Secondly, we sought to identify the patient family perception towards the role of the pediatric surgeon on social media. A voluntary electronic survey was designed to assess participants' usage of social media platforms. We included parents of children with ages between 0 and 14 years presenting to our outpatient clinics. Data on demographics, social media usage among parents, and their attitude toward pediatric surgery in social media was collected. 227 responses were obtained. Half of our respondents were female and the rest were male, 114 (50.2%) and 113 (49.8%) respectively. The majority of respondents, 190 (83.4%) were millennials between the ages of 25-44 years. 205 of the respondents (90.3%) used multiple social media platforms. Half of the respondents 115 (50.7%) have used social media to search for information pertaining to their child's medical condition and 192 (85.58%) would like pediatric surgeons to be active on social media platforms. Social media plays a major role in healthcare. This study has clearly identified that parents are going to social media for information on their child's surgical condition. Pediatric surgeons should consider establishing an online presence to educate and inform patients and parents. IV.


Use of Multiple Ultrasonographic Parameters in Confirmation of Carpal Tunnel Syndrome.
Ultrasonography (US) of the median nerve has been increasingly studied and used for confirmation of carpal tunnel syndrome (CTS). However, a consensus on the choice of parameters to be evaluated is still not established. The aim of this diagnostic accuracy study was to assess the diagnostic value of multiple parameters individually, as well as in different combinations of variable complexity, and to find an optimal approach for US-based confirmation of a CTS diagnosis. All participants completed clinical and electrophysiologic evaluations, and their hands were scanned with a 5-13-MHz linear US transducer. Eighty-six patients with CTS (135 symptomatic hands) and 50 control participants (93 asymptomatic hands) were analyzed. The median nerve was recorded transversely at the forearm, at the carpal tunnel inlet, in the mid tunnel, and at the carpal tunnel outlet. For determining the parameters' diagnostic value, sensitivities, specificities, and area under the curve (AUC) values were calculated. The inlet cross-sectional area, inlet circumference, and outlet cross-sectional area of the median nerve had the highest AUCs (0.962, 0.920, and 0.913, respectively), sensitivities (87.4%, 80.0%, and 74.1%), and specificities (94.6%, 91.4%, and 92.5%) among single-measurement parameters. An analysis of 2-level parameters (wrist-to-forearm-ratio, inlet-to-outlet-ratio, outlet-to-forearm-ratio, and inlet-outlet mean) yielded the highest AUC (0.974) for the mean cross-sectional area of the median nerve [(inlet + outlet cross-sectional area)/2], with high sensitivity (93.5%) and specificity (91.1%). A compound regression-based index yielded a marginally higher AUC (0.989) than the previously mentioned parameters. Results of the study show that the mean cross-sectional area and inlet cross-sectional area may be valid and easy-to-acquire parameters for routine clinical use in confirming CTS.


The importance and provision of oral hygiene in surgical patients.
The provision of mouth care on the general surgical ward and intensive care setting has recently gained momentum as an important aspect of patient care. Oropharyngeal morbidity can cause pain and disordered swallowing leading to reluctance in commencing or maintaining an adequate dietary intake. On the intensive care unit, aside from patient discomfort and general well-being, oral hygiene is integral to the prevention of ventilator-associated pneumonia. Chlorhexidine (0.2%) is widely used to decrease oral bacterial loading, dental bacterial plaque and gingivitis. Pineapple juice has gained favour as a salivary stimulant in those with a dry mouth or coated tongue. Tooth brushing is the ideal method of promoting oral hygiene. Brushing is feasible in the vast majority, although access is problematic in ventilated patients. Surgical patients undergoing palliative treatment are particularly prone to oral morbidity that may require specific but simple remedies. Neglect of basic aspects of patient care, typified by poor oral hygiene, can be detrimental to surgical outcome.


A comparative study of thin-layer cross-sectional anatomic morphology and CT images of the basal cistern and its application in acute craniocerebral traumas.
To compare the cross-sectional morphologic features of successive thin-layers and CT images of the basal cistern and its application in the diagnosis and management of acute craniocerebral traumas. Successive thin-layer cross-sectional images of the basal cistern were retrieved from the second Chinese visible human (CVH) data set and observed. A total of 40 healthy volunteers were subjected to 64-slice spiral CT scan of the head, and CT images of the basal cistern were compared with CVH images. A total of 413 patients with acute craniocerebral traumas were subjected to 64-slice spiral CT scan of the head, CT image changes of the basal cistern were observed. Thin-layer cross-sectional images retrieved from the CVH data set clearly displayed the sectional anatomic morphology, morphologic change pattern and important adjacent structures of the basal cistern. The quadrigeminal cistern was pateriform or sellaeform; the suprasellar cistern was hexagonal or pentagonal star-shaped; the ambient cistern encircled both sides of the brainstem like an arc band. CT images of the quadrigeminal and ambient cisterns were similar with their CVH images; however, the morphology of the suprasellar cistern changed substantially. In 413 patients with acute craniocerebral traumas, the basal cistern may be normal, or presented with narrowing, obliteration, shift, hematocele, and pneumatosis. Narrowing or obliteration of the basal cistern occurred mostly at the side of dominant intracranial lesions, and frequently occurred in patients with diffuse axonal injury or combination of SDH + CONT + ICH. Thin-layer cross-sectional images of the basal cistern retrieved from the CVH data set correspond satisfactorily to CT images of the basal cistern. Comparison of the two types of images can provide a sectional anatomic basis for the image identification of acute craniocerebral traumas. A careful observation on the initial CT images of the basal cistern for anatomic morphologic changes will help diagnose acute craniocerebral traumas early, improve the management, and appropriately predict the prognosis of the condition.


Pyramidal assemblies of colloidal particles by micromolding underneath top-gathering pillar arrays.
Assemblies of colloidal particles are known to have special photonic and optical properties. Periodic pyramidal assemblies of SiO2 particles with diameters of 0.5 and 1 microm were fabricated using top-gathering pillar arrays as a new template. These top-gathering pillar arrays consisted of four pillars gathered at the top, and were fabricated by photolithography of an organic-inorganic hybrid material. The top-gathering units were obtained by controlling both the capillary and restoring forces. When a colloidal water suspension was spread on the template and the water was allowed to evaporate, the SiO2 particles were molded under the top-gathering pillars according to particle size, resulting in pyramidal assembly arrays of the particles. From in situ observation during the evaporation of water, it was found that the particles were molded underneath the top-gathering pillars by flux generated by the evaporation and by the capillary force among the particles.


BT595, a 10% Human Normal Immunoglobulin, for Replacement Therapy of Primary Immunodeficiency Disease: Results of a Subcohort Analysis in Children.
To assess the efficacy, pharmacokinetics, and safety of a new, highly purified 10% IVIg (BT595, Yimmugo®) administered in children with PID. This was an open-label, prospective, uncontrolled, multicenter Phase III pivotal trial. Among the 67 subjects in the trial were 18 pediatric patients aged 2 to 17 years with diagnosis of PID included in this analysis. They received doses between 0.2 and 0.8 g/kg body weight for approximately 12 months at intervals of either 3 or 4 weeks. Dosage and dosing interval were based on each patient's pre-trial infusion schedule. The rates of acute serious bacterial infections (SBI), secondary efficacy, safety, and pharmacokinetic outcomes were evaluated. No SBI occurred in the pediatric population. Two hundred sixty infusions were administered to the 18 pediatric patients. The mean (SD) IgG trough level was 8.55 (1.67) g/L at baseline and 8.84 (2.17) g/L at the follow-up visit after the last BT595 infusion. At the single infusions respectively, the average mean IgG trough levels ranged between 8.52 and 10.58 g/L. More than 85% of all infusions administered were not associated with any infusional AE (start during or within 72 h post-infusion). None of the severe or serious AEs were related to the investigational medicinal product (IMP). No premedication was used. Thirteen children reached a maximum infusion rate between > 2.0 and 8 mL/kg/h; no AE with an onset during the infusion occurred at these infusion rates. BT595 is effective, convenient, well tolerated, and safe for the treatment of children with PID. EudraCT: 2015-003652-52; NCT02810444, registered June 23, 2016.


Insights into the mode of action of anticandidal herbal monoterpenoid geraniol reveal disruption of multiple MDR mechanisms and virulence attributes in Candida albicans.
The anticandidal potential of Geraniol (Ger) against Candida albicans has already been established. The present study reveals deeper insights into the mechanisms of action of Ger. We observed that the repertoire of antifungal activity was not only limited to C. albicans and its clinical isolates but also against non-albicans species of Candida. The membrane tampering effect was visualized through transmission electron micrographs, depleted ergosterol levels and altered plasma membrane ATPase activity. Ger also affects cell wall as revealed by spot assays with cell wall-perturbing agents and scanning electron micrographs. Functional calcineurin pathway seems to be indispensable for the antifungal effect of Ger as calcineurin signaling mutant was hypersensitive to Ger while calcineurin overexpressing strain remained resistant. Ger also causes mitochondrial dysfunction, impaired iron homeostasis and genotoxicity. Furthermore, Ger inhibits both virulence attributes of hyphal morphogenesis and biofilm formation. Taken together, our results suggest that Ger is potential antifungal agent that warrants further investigation in clinical applications so that it could be competently employed in therapeutic strategies to treat Candida infections.


Translocation 1;7 in four cases of myeloid disorders.
A der(1)t(1;7)(p11;p11) was observed in bone marrow chromosome analyses of four patients with myeloproliferative disorders. Three patients had developed secondary leukemias or preleukemias following chemotherapeutic exposure, and one patient was diagnosed with M4 de novo.


Electrochemical-assisted photodegradation of Allura Red and textile effluent using a half-exposed rotating TiO(2)/Ti disc electrode.
In this work, a rotating photoelectrocatalytic (RPEC) reactor, using a half-exposed and half-immersed TiO(2)/Ti disc as photoanode was developed for the first time to degrade Allura Red (AR) and textile effluent. The TiO(2) film was characterised by X-ray reflection diffraction (XRD) spectra and field emission scanning electron microscope (FESEM). When AR solutions with concentrations ranging from 10 mg L(- 1) to 50 mg L(- 1)AR were treated by half-exposed disc PEC (EPEC) process for 1 hour, solution color and TOC were reduced by 36-54% and 19-33%, respectively, higher than reduction of 9-46% and 4-27% observed for the conventional PEC (CPEC) process with half TiO(2)/Ti disc immersed in solution. Similarly, solution color and TOC for textile effluent was reduced by 46% and 10% for EPEC process, respectively, higher than reduction of 26% and 2% for CPEC process. Effectiveness of the RPEC process was further demonstrated in the treatment of textile effluent and textile effluent containing 30 mgL(- 1) AR by determining change of solution color, total organic carbon (TOC), biochemical oxygen demand (BOD(5)), and chemical oxygen demand (COD). Furthermore, a long run experiment was carried out for the TiO(2)/Ti disc and almost stable photoactivity was found after 10 runs of RPEC oxidation of both AR and textile effluent. Our results indicate the proposed RPEC is effective in degrading textile wastewater, probably because the light can directly irradiate the exposed disc in air instead of through solution in the CPEC reactor.


Human placental chorionic renin: production, purification and characterization.
Native human renin, produced from the culture of human chorionic trophoblasts, has been purified to homogeneity on a milligram scale using a five-step purification scheme. The chorion cells secrete 50-200 milliGoldblatt Units of trypsin-activatable prorenin per ml into the medium. The pro-enzyme is partially purified by ammonium sulfate fractionation and chromatographies on QAE-Sephadex and cibracon blue-agarose. Following conversion of prorenin to the active enzyme by porcine trypsin, the renin is purified to homogeneity by affinity chromatography and gel filtration. Chorionic prorenin has a molecular weight of 43,000; the active enzyme 40,000. Both proteins exist as a single polypeptide chain as determined by SDS-polyacrylamide gel electrophoresis under reducing conditions. The average specific activity of six different preparations was found to be 1072 Goldblatt Units/mg. The amino acid composition and N-terminal sequence of the active enzyme has been determined and is identical to the human kidney enzyme. Microheterogeneity of chorionic renin was demonstrated by isoelectrofocusing analysis. The physical characterization of chorionic renin is compared with that reported for the human kidney enzyme.


[Study of multiregression analysis on NK activities and related clinical factors in patients with head and neck neoplasms].
NK activity in patients with head and neck neoplasms treated with radiation and chemotherapeutics was studied on the influence of 19 factors by using the method of multiregression analysis. Of these factors, BUN, WBC, the size of radiation portal, chemotherapy, radiation doses, total protein (T.P.), age and GOT were significantly influenced on the fluctuation of NK activity (p less than 0.05). In the studies of the size of radiation portal and its doses, NK activity showed a tendency to increase with radiation dose in small size of radiation portal and a tendency to reduce in large size of it.


Impact of periodic intensification of routine immunization within an armed conflict setting and COVID-19 outbreak in Cameroon in 2020.
Cameroon's Southwest Region (SW) has been hit by an armed conflict for over half a decade now, negatively affecting the region's routine immunization and disease surveillance activities. This negative effect was further acerbated by the COVID-19 pandemic, which alongside the conflict, caused thousands of children to miss out on life-saving vaccinations. Herein, we present the contribution of periodic intensification of routine immunization in improving immunization and surveillance activities amid crises. Periodic intensification of routine immunization (PIRI) and disease surveillance were carried out in three rounds per health district. Before the intervention, the security profile of each district involved was reviewed. Data for this study was extracted on vaccination and surveillance activities from the District Health Information Software and monthly regional reports for 2019 and 2020 from the SW delegation of health. 54,242 persons were vaccinated in the SW following these interventions. An increase in performance was observed in all 18 health districts in 2020 compared to 2019. Both DPT-HebB-Heb-3 vaccine and OPV-3 coverage rose by 28% points. Similarly, the proportion of health districts that investigated at least a case of acute flaccid paralysis increased by 83%, rising from just three districts in 2019 to all 18 in 2020. PIRI was a practical approach to improving vaccination coverage and surveillance indicators in this region amidst the ongoing armed conflict and COVID-19 pandemic.


Activating KRAS mutation is prognostic only among patients who receive preoperative chemotherapy before resection of colorectal liver metastases.
While the prognostic role of KRAS status after resection of CRLM has been previously explored, the importance of KRAS status relative to the receipt of preoperative chemotherapy remains largely unknown. A total of 430 patients who underwent curative-intent surgery for CRLM between 2000 and 2015 and who had available KRAS genotype data were identified. Data regarding KRAS mutation status, receipt of preoperative chemotherapy, and overall survival (OS) were assessed using univariable and multivariable analyses. Median patient age was 58 years (IQR, 50.4-66.4 years). A total of 258 patients (60.0%) received preoperative chemotherapy, while 172 (40.0%) had upfront surgery. Median and 5-year OS in the entire cohort was 65.1 months and 53.2%, respectively. KRAS mutation was associated with a worse 5-year OS compared with wild-type tumors (HR 1.41; P = 0.042). After stratifying by the receipt of preoperative chemotherapy, the prognostic value of KRAS mutation only persisted among patients who had received preoperative chemotherapy (HR 1.67; P = 0.012). In contrast, KRAS mutation status had no impact on OS among patients who had not received preoperative chemotherapy (P = 0.597). KRAS mutation status was an independent predictor of OS among patients undergoing liver resection of CRLM. However, after stratifying by receipt of preoperative chemotherapy, KRAS was informative relative to prognosis only among patients who received preoperative chemotherapy. J. Surg. Oncol. 2016;114:361-367. © 2016 Wiley Periodicals, Inc.


A retrospective textual analysis of sexual and reproductive health counseling for adolescent and young adult people with epilepsy of gestational capacity.
Rationale The American Academy of Neurology (AAN) recommends annual sexual and reproductive health (SRH) counseling for all people with epilepsy of gestational capacity (PWEGC). Child neurologists report discussing SRH concerns infrequently with adolescents. Limited research exists regarding documentation of such counseling. We retrospectively studied clinical notes using natural language processing to investigate child neurologists' documentation of SRH counseling for adolescent and young adult PWEGC. We segmented notes into sentences and evaluated for references to menstruation, sexual activity, contraception, folic acid, teratogens, and pregnancy. We developed training sets in a labeling application and used machine learning to identify additional counseling instances. We repeated this iteratively until we identified no new relevant sentences. We validated results using external reviewers; after removing sentences reviewers disagreed on (n = 13/400), we calculated Cohen's kappa values between the model and reviewers (>0.98 for all categories). We evaluated labeled texts for each patient per calendar year with descriptive statistics and logistic regression, adjusting for race/ethnicity, age, and teratogen use. Data comprised 971 PWEGC age 13-21 years with 2277 patient-years and 3663 outpatient child neurology notes. Nearly half of patient-years lacked SRH counseling documentation (49.1%). Among all patients, 38.0% never had SRH counseling documented. Documentation was present regarding menstruation in 26.7% of patient-years, folic acid in 25.0%, contraception in 21.9%, pregnancy in 3.5%, teratogens in 3.0%, and sexual activity in 1.8%. Documentation regarding menstruation and contraception was associated with prescription of antiseizure medications that have a higher risk of teratogenic effects (OR = 1.27, p = 0.020, 95% CI = [1.04,1.54]; OR = 1.27, p = 0.027, 95% CI = [1.03,1.58]). Documentation regarding contraception, folic acid, and sexual activity was increased among older patients (OR = 1.28, p < 0.001, 95% CI = [1.21,1.35]; OR = 1.26, p < 0.001, 95% CI = [1.19,1.32]; OR = 1.26, p = 0.004, 95% CI = [1.08,1.47]). Documentation regarding sexual activity was decreased among patients identifying as White/Non-Hispanic (OR = 0.39, p = 0.007, 95% CI = [0.20,0.78]). Child neurologists counsel PWEGC on SRH less frequently than recommended by the AAN based on documentation.


Occupational therapist-guided cognitive interventions in critically ill patients: a feasibility randomized controlled trial.
Intensive care unit (ICU) delirium is a common complication of critical illness requiring a multimodal approach to management. We assessed the feasibility of a novel occupational therapist (OT)-guided cognitive intervention protocol, titrated according to sedation level, in critically ill patients. Patients aged ≥ 18 yr admitted to a medical/surgical ICU were randomized to the standard delirium prevention protocol or to the OT-guided cognitive intervention protocol in addition to standard of care. The target enrolment number was N = 112. Due to the COVID-19 pandemic, the study enrolment period was truncated. The primary outcome was feasibility of the intervention as measured by the proportion of eligible cognitive interventions delivered by the OT. Secondary outcomes included feasibility of goal session length (20 min), participant clinical outcomes (delirium prevalence and duration, cognitive status, functional status, quality of life, and ICU length of stay), and a description of methodological challenges and solutions for future research. Seventy patients were enrolled and 69 patients were included in the final analysis. The majority of OT-guided sessions (110/137; 80%) were completed. The mean (standard deviation [SD]) number of sessions per patient was 4.1 (3.8). The goal session length was achieved (mean [SD], 19.8 [3.1] min), with few sessions (8/110; 7%) terminated early per patient request. This novel OT-guided cognitive intervention protocol is feasible in medical/surgical ICU patients. A larger randomized controlled trial is required to determine the impact of such a protocol on delirium prevalence or duration. www. gov (NCT03604809); registered 18 June 2018.


Congruence between diagnosis of recurrent major depressive disorder and psychotropic treatment in the general population.
We explored in a sample representative of the French general population the congruence between lifetime use of psychotropic drugs and diagnosis of recurrent major depressive disorder (rMDD). A total of 2111 (5.6%) subjects with rMDD were identified in the sample of 36 785 subjects assessed in the Mental Health survey in the General Population. A treatment congruent with a diagnosis of rMDD was defined as lifetime use of antidepressants or mood stabilizers. Only one-third of subjects with rMDD reported having ever used a congruent treatment. Female gender, higher income and presence of anxiety disorder were associated with a higher probability of having used a congruent treatment. Although these findings indicate that a large proportion of subjects with rMMD do not benefit from adequate treatment, community surveys not primarily designed to assess utilization and adequacy of psychotropic treatment in the community may overestimate the frequency of unmet need for care.


Retracted: Analysis of Psychological Shaping Function of Music Education under the Background of Artificial Intelligence.
[This retracts the article DOI: 10.1155/2022/7162069.].


AP4 modulated by the PI3K/AKT pathway promotes prostate cancer proliferation and metastasis of prostate cancer via upregulating L-plastin.
The transition from androgen-dependent to metastatic castration-resistant prostate cancer (PCa) is a lethal event of uncertain molecular aetiology. Our previous studies demonstrated that L-plastin is involved in PCa invasion and metastasis and is upregulated by androgen and oestrogen in the hormone-dependent PCa cell line LNCaP. We recently found that L-plastin expression is consistently activated even after androgen deprivation, suggesting that androgen-independent transcription factors may regulate its expression. Herein, we performed sequential deletion and luciferase analysis of the L-plastin promoter and found that an androgen-independent regulatory factor prominently located in the region close to the transcription initiation site (-216 to +118) may facilitate L-plastin upregulation. AP4 was then identified as the relevant transcription activator that directly binds to the L-plastin promoter, as confirmed by EMSAs, supershift assays and CHIP-qPCR experiments. Moreover, we determined that the AP4/L-plastin axis is regulated by the phosphatidylinositol 3-kinase (PI3K)/AKT pathway, contributing to PCa metastasis and castration resistance. Furthermore, we found that AP4 promotes PCa metastasis by upregulating L-plastin expression in vitro and in vivo. We collected a total of 136 PCa tissues and corresponding adjacent normal tissues from patients who underwent prostatectomy at Sun Yat-Sen Memorial Hospital from 2005 to 2015 and measured AP4 and L-plastin protein levels by immunohistochemistry. The results showed that AP4 levels strongly correlated with those of its downstream target gene L-plastin, were significantly upregulated in PCa tissues, were positively correlated with lymph node metastasis and Gleason scores over 7, and were an independent prognostic factor for patient survival. In summary, these findings support a plausible mechanism by which the AP4/L-plastin axis is regulated by the PI3K/AKT pathway in human PCa and may represent a novel therapeutic target in PCa treatment.


Do unmanned aerial vehicles reduce the duration and costs in transporting sputum samples? A feasibility study conducted in Himachal Pradesh, India.
The feasibility of and advantages of using an unmanned aerial vehicle (UAV) for sputum transportation for TB in Chamba, Himachal Pradesh, India, were evaluated. We conducted a non-randomized interventional study and compared the advantages of sputum transport between UAVs and motorbikes (conventional). We completed 151 transportations. Transportation by UAV (7.1±0.8 min) was faster than by motorbike (22.7±4.6 min, p<0.001). Motorbikes covered a greater distance (12.09±1.6 km) than UAVs (2.89±0.35 km, p<0.001). The recurrent cost per transport using an UAV (US${\$}$0.68) was less than by motorbike (US${\$}$1.4). All 26 stakeholders agreed that UAVs would reduce the turnaround time for diagnosis of drug-resistant TB. Sputum transportation by UAVs was feasible, cheaper and an efficacious potential alternative to conventional modes of transportation.


Interaction between arginine vasopressin- and raised extracellular potassium-stimulated pathways in adrenocorticotropin secretion.
The intracellular regulation of adrenocorticotropin (ACTH) secretion from pituitary corticotroph cells was investigated by simultaneously exposing cultured ovine corticotrophs to arginine vasopressin (AVP) and raised extracellular K+ concentration ([K+]e). Both of these secretagogues activate L-type voltage-sensitive calcium channels (L-VSCC) as part of their respective ACTH secretory responses. When given together at high concentrations, AVP and raised [K+]e caused ACTH responses that were smaller in magnitude than the sum of the individual responses. However, at low agonist concentrations the simultaneous responses were greater in magnitude (i.e., synergistic). Further investigation suggested that activation of protein kinase C (PKC), which is part of the AVP-induced intracellular signalling pathway, is necessary and sufficient for the generation of the synergistic response, although it is not obligatory for AVP-induced ACTH release.


Evaluation of effective diffusion coefficient and intrinsic kinetic parameters on azo dye biodegradation using PVA-immobilized cell beads.
An immobilized mixed culture (Aeromonas hydrophila, Comamonas testosteroni, and Acinetobacter baumannii) was prepared by entrapment into phosphorylated polyvinyl alcohol (PVA) gel beads. The unsteady-state diffusion mechanism in a gel bead was applied to estimate the effective diffusion coefficients (D(e)) and the partition coefficients (K(p)) of azo dye. In addition, a simple method was developed to determine the intrinsic kinetic parameters of immobilized cells from observed reaction rates and the intrinsic kinetic parameters were then verified by fitting the experimental data into the reaction-diffusion model in a batch reactor running at a well-stirred state. The calculated effectiveness factor (eta(cal)) approached unity at Thiele modulus (Phi) < 0.3 (i.e., d(p) < 0.475 mm). The experimental effectiveness factor (eta(exp)) was in the range of 0.71-0.45 for a corresponding sphere diameter (d(p)) of 1.91 +/- 0.16 to 4.43 +/- 0.07 mm at an initial dye concentration of 200 mg/L. The results show that intraparticle diffusion resistance has a significant effect on the azo dye biodegradation rate.


Effect of Isabgol husk supplementation on trace minerals (Zn, Cu, Mn) levels in adolescent girls.
The study was conducted on eleven healthy non-anaemic adolescent girls of 16 to 18 years of age. Balance studies were conducted in two trials of three weeks each on low and high fibre diets. High fibre diet contained 25 g Isabgol husk in addition to low fibre diet. The mean diet and nutrient intakes of the subjects were approximately the same during both trials. Addition of Isabgol husk to low fibre diet significantly (P less than or equal to 0.05) increased faecal excretion of zinc, copper and manganese and lowered their apparent retention. The serum levels of these trace minerals decreased significantly (P less than or equal to 0.05). Thus the high level of Isabgol has undesirable effect on trace minerals.


Intrapelvic Loss of a Trial Femoral Head During Total Hip Arthroplasty: A Case Report.
We report a case of intraoperative femoral head trial dislocation, with intrapelvic migration treated only with close observation with over the 17-year follow-up. Total hip arthroplasty has been used as an effective means of treating debilitating arthritis of the hip. Common complications of hip arthroplasty have been discussed at length in the literature. Intraoperative dislocation of the femoral head trial with intrapelvic migration is a relatively uncommon complication with only several documented cases in the literature. Multiple treatment strategies are described for this complication including immediate surgical exploration, delayed surgical exploration, laparoscopic exploration, and observation.