A Single-site Interventional Study on the Contemporary Relevance of Braun Enteroenterostomy After Pancreaticoduodenectomy.
Braun enteroenterostomy following pancreaticoduodenectomy is a standard procedure. It has been reported to decrease bile reflux and vomiting, prevent reflux gastritis and delay gastric emptying (DGE). However, some reports suggest that the incidence of DGE is unaffected with this procedure. Therefore, in this study, we aimed to investigate whether Braun enteroenterostomy was effective after pancreaticoduodenectomy. A total of 145 patients who underwent pancreaticoduodenectomy were enrolled and divided into 2 groups i.e., 51 patients with Braun enteroenterostomy (B group) and 94 patients without Braun enteroenterostomy (non-B group). We compared the perioperative data of the patients. Patients who reported postoperative symptoms underwent gastrointestinal endoscopic evaluation. The incidence of DGE was 7.4% (7/94) and 1.9% (1/51) in the non-B and B groups, respectively (p=0.36), with no significant difference between the groups. During follow-up, some patients reported symptoms including epigastralgia, nausea and melena. The incidence of these symptoms was 27.7% (26 patients; 26/94) and 23.5% (12 patients; 12/51) in non-B and B groups, respectively. Regarding gastrointestinal endoscopic findings, the incidence of anastomotic ulcer was 7.7% (2/26) and 16.7% (2/12) in non-B and B groups, respectively (p=0.40). Bile reflux incidence was 30.8% (8/26) and 0% (0/12) in non-B and B groups, respectively (p=0.03). Though Braun enteroenterostomy was related to bile reflux, it did not affect the incidence of anastomotic and gastric ulcers or DGE. Therefore, it may not be a necessary procedure after pancreaticoduodenectomy.


Anti-HTLV antibody profiling reveals an antibody signature for HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP).
HTLV-I is the causal agent of adult T cell leukemia (ATLL) and HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Biomarkers are needed to diagnose and/or predict patients who are at risk for HAM/TSP or ATLL. Therefore, we investigated using luciferase immunoprecipitation technology (LIPS) antibody responses to seven HTLV-I proteins in non-infected controls, asymptomatic HTLV-I-carriers, ATLL and HAM/TSP sera samples. Antibody profiles were correlated with viral load and examined in longitudinal samples. Anti-GAG antibody titers detected by LIPS differentiated HTLV-infected subjects from uninfected controls with 100% sensitivity and 100% specificity, but did not differ between HTLV-I infected subgroups. However, anti-Env antibody titers were over 4-fold higher in HAM/TSP compared to both asymptomatic HTLV-I (P < 0.0001) and ATLL patients (P < 0.0005). Anti-Env antibody titers above 100,000 LU had 75% positive predictive value and 79% negative predictive value for identifying the HAM/TSP sub-type. Anti-Tax antibody titers were also higher (P < 0.0005) in the HAM/TSP compared to the asymptomatic HTLV-I carriers. Proviral load correlated with anti-Env antibodies in asymptomatic carriers (R = 0.76), but not in HAM/TSP. These studies indicate that anti-HTLV-I antibody responses detected by LIPS are useful for diagnosis and suggest that elevated anti-Env antibodies are a common feature found in HAM/TSP patients.


Barrel index of bulky cervical tumours and intrauterine fluid determined by MRI as additional prognostic factors for survival.
to investigate whether morphologic characteristics determined by magnetic resonance imaging (MRI) can discriminate between bulky cervical tumours with a favourable or worse prognosis. MRI examinations were performed in 24 patients with cervical cancer Stage >or= 1B2. The ratio between tumour width and length (barrel index: BI) and the presence of intrauterine fluid retention were related to survival in a multivariate regression analysis. BI and intracavital fluid were predictors of survival, independent from tumour diameter and other known important factors for survival. A cut-off value of 1.40 for the BI proved to be the best prognostic factor with respect to recurrence and death: the hazard ratios of BI > 1.40 as compared to BI <or= 1.40 were 18.9 (95% CI 2.8 to 125.6) for recurrent disease and 16.4 (95% CI 2.9 to 93.9) for death by cervical cancer. The hazard ratios of intracavital fluid retention were 73.6 (95% CI 5.3 to 1,016.4) and 48.1 (95% CI 4.7 to 491.6) for recurrence and death, respectively. The morphologic characteristic BI and the presence or absence of intracavital fluid as determined by MRI might have predictive value for survival in patients with bulky cervical tumours.


[Upper and lower eyelid blepharoplasty : development of aesthetic periocular plastic surgery].
The article describes the indications and techniques for blepharoplasty of the upper and lower eyelids as well as combinations with other eyelid correction techniques. Upper eyelid blepharoplasty may include skin excision with orbital fat modulation as well as ptosis correction and definition of the superior sulcus palpebralis. The main goal of lower lid blepharoplasty is modulation of intraseptal fat and also often the treatment of a lower lid laxity by canthopexy. It is recommended to avoid excessive skin resection in the lower lid. Furthermore techniques to address an ectropium are reviewed and possible complications of blepharoplasty are presented.


Anti-oxidant and immunomodulatory properties of seabuckthorn (Hippophae rhamnoides)--an in vitro study.
This study was designed to determine the anti-oxidant and immunomodulatory properties of seabuckthorn (Hippophae rhamnoides) using lymphocytes as a model system. Chromium(VI) as potassium dichromate was used to induce oxidative damage. The production of free radicals by chromium and the ability of alcoholic leaf and fruit extracts of seabuckthorn to inhibit the oxidative damage induced by chromium was investigated. Addition of chromium (10 microg/ml) to the cells resulted in enhanced cytotoxicity, apoptosis, free radical production and decreased glutathione (reduced) levels. Chromium also caused a significant inhibition of lymphocyte proliferation induced by both lipopolysaccharide and concanavalin A. Alcoholic extracts of leaves and fruits of seabuckthorn at a concentration of 500 microg/ml were found to inhibit chromium-induced free radical production, apoptosis, DNA fragmentation and restored the anti-oxidant status to that of control cells. In addition, these extracts also were able to arrest the chromium-induced inhibition of lymphocyte proliferation. These observations suggest that the alcoholic extracts of leaves and fruits of seabuckthorn have marked cytoprotective properties, which could be attributed to the anti-oxidant activity.


Is cerebral palsy associated with successful ureteral access during the initial attempt at ureteroscopy for urolithiasis in children and young adults?
Ureteroscopy is a common treatment for urolithiasis, but initial ureteral access is not always possible, particularly in pediatrics. Clinical experience suggests that neuromuscular conditions such as cerebral palsy (CP) may facilitate access, thus avoiding the need for pre-stenting and staged procedures. We sought to determine if probability of successful ureteral access (SUA) during initial attempted ureteroscopy (IAU) is higher in pediatric patients with CP vs. without CP. We reviewed IAU cases for urolithiasis (2010-2021) at our center. Patients with pre-stenting, prior ureteroscopy, or urologic surgical history were excluded. CP was defined using ICD-10 codes. SUA was defined as scope access to urinary tract level sufficient to reach stone. Association of CP and other factors with SUA were evaluated. 230 patients (45.7% male, median age: 16 years [IQR: 12-18 y], 8.7% had CP) underwent IAU, with SUA in 183 (79.6%). SUA occurred in 90.0% of patients with CP vs. 78.6% of those without CP (p = 0.38). SUA was 81.7% in patients >12 years (vs. 73.8% in those <12), and the highest SUA was in those >12 years with CP (93.3%), but these differences were not statistically significant. Renal stone location was significantly associated with lower SUA (p = 0.007). Among patients with renal stone only, SUA in those with CP was 85.7% vs. 68.9% in those without CP (p = 0.33). SUA did not differ significantly by gender or BMI. CP may facilitate ureteral access during IAU in pediatric patients, but we were unable to show a statistically significant difference. Further study of larger cohorts may demonstrate whether CP or other patient factors are associated with successful initial access. Improved understanding of such factors would help preoperative counseling and surgical planning for children with urolithiasis.


Comparison of Shoulder-Arm Complex Pain, Function, and Scapular Dyskinesia in Women With and Without Unilateral Lymphedema After Breast Cancer Surgery.
Lymphedema is the most important complication seen after breast cancer surgery. The study aimed to evaluate pain, shoulder-arm complex function, and scapular function in women who developed lymphedema after breast cancer surgery and to compare these with women without lymphedema. Fifty women with lymphedema (age, 54.34 ± 9.08 years; body mass index, 30.10 ± 4.03 kg/cm2) and 57 women without lymphedema (age, 53.68 ± 9.41 years; body mass index, 29.0 ± 5.44 kg/cm2) after unilateral surgery for breast cancer were included. Clinical and demographic information was noted. The severity of lymphedema with perimeter measurements (Frustum model), level of heaviness discomfort sensation with a visual analog scale, pain threshold with a digital algometer, shoulder-arm complex functionality with the Disabilities of the Arm, Shoulder, Hand Problems Survey (DASH), and scapular function with observational scapular dyskinesia and lateral scapular sliding tests were assessed. The t test, χ2 test, and Mann-Whitney U test were used for analyses. The follow-up duration after the surgery was 4.24 ± 2.97 years and 3.19 ± 1.76 years, and the upper extremity volume was 2106.65 ± 510.82 cm3 and 1725.92 ± 342.49 cm³ in the lymphedema group and in the no-lymphedema group, respectively. In the lymphedema group, arm-heaviness discomfort, pain threshold levels in the trapezius and deltoid muscles, and DASH scores were worse (P < .05). The rate of scapular dyskinesia (70.0%) and type 2 scapula (32%) in the surgical side was higher in patients with lymphedema. The pain pressure threshold in the trapezius and deltoid muscles, heaviness sensation level, and inadequate upper extremity function are significantly higher in patients with lymphedema, and the scapular dyskinesia rate was higher.


Growth in young children with chronic renal failure.
Statural growth and its relation to growth potential, renal function, blood urea nitrogen (BUN), mineral metabolism hormones and dietary intake were studied in 17 prepubertal children (aged 1.6-9.3 years) on conservative treatment for chronic renal failure due to tubulo-interstitial nephropathy. Statural growth (height SDS) was related to the degree of renal failure, was more retarded than ossification, and was independent of the chronological age of the patients. We observed that the lower the glomerular filtration rate (GFR), the lower was the growth potential (increased bone age/statural age ratio). Growth velocity may be normal regardless of statural and bone maturation delay and the degree of renal insufficiency. Impaired growth rate correlated with parathyroid hormone levels, caloric intake and increased blood urea nitrogen during the year of observation. These data show that comprehensive monitoring and suitable treatment must be performed in order to prevent growth retardation at any GFR level.


Controlled trials of charcoal hemoperfusion and prognostic factors in fulminant hepatic failure.
One hundred thirty-seven patients with fulminant hepatic failure were entered into two controlled trials of charcoal hemoperfusion carried out concurrently. In trial A, 75 patients with grade 3 encephalopathy were randomized to receive 5 or 10 h of hemoperfusion daily. Overall survival rates for the two groups were similar (51.3% vs. 50.0%) as was the frequency of major complications including cerebral edema and renal failure. In trial B, in which 62 patients with established grade 4 encephalopathy on admission were randomized to a no-perfusion group or to have 10 h of hemoperfusion daily, overall survival rates for the two groups were again similar (39.3% and 34.5%, respectively). There was in both trials a significant relationship between survival and etiology quite independent of the use or duration of hemoperfusion. Thus, percentage survival for the acetaminophen-overdose cases was 52.9%, for hepatitis A 66.7%, for hepatitis B 38.9%, for presumed non-A, non-B hepatitis 20%, and for halothane or drug reaction 12.5%. Within the etiologic subgroups survival was also influenced by the three major complications that developed, being inversely related to their frequency and combination, except in the non-A, non-B hepatitis and halothane or drug reaction subgroups, which had a high mortality throughout. In the latter cases particularly, orthotopic liver transplantation merits early consideration and in the group with better "intrinsic" survival (acetaminophen, hepatitis A and B) intensive management of complications (rather than charcoal hemoperfusion) would appear to be of major importance.


MarLe: Markerless estimation of head pose for navigated transcranial magnetic stimulation.
Navigated transcranial magnetic stimulation (nTMS) is a valuable tool for non-invasive brain stimulation. Currently, nTMS requires fixing of markers on the patient's head. Head marker displacements lead to changes in coil placement and brain stimulation inaccuracy. A markerless neuronavigation method is needed to increase the reliability of nTMS and simplify the nTMS protocol. In this study, we introduce and release MarLe, a Python markerless head tracker neuronavigation software for TMS. This novel software uses computer-vision techniques combined with low-cost cameras to estimate the head pose for neuronavigation. A coregistration algorithm, based on a closed-form solution, was designed to track the patient's head and the TMS coil referenced to the individual's brain image. We show that MarLe can estimate head pose based on real-time video processing. An intuitive pipeline was developed to connect the MarLe and nTMS neuronavigation software. MarLe achieved acceptable accuracy and stability in a mockup nTMS experiment. MarLe allows real-time tracking of the patient's head without any markers. The combination of face detection and a coregistration algorithm can overcome nTMS head marker displacement concerns. MarLe can improve reliability, simplify, and reduce the protocol time of brain intervention techniques such as nTMS.


Comparison of a Stratified Group Intervention (STarT Back) With Usual Group Care in Patients With Low Back Pain: A Nonrandomized Controlled Trial.
A nonrandomized controlled trial. This study aims to explore the effectiveness of group-based stratified care in primary care. Stratified care based on psychosocial screening (STarT Back) has demonstrated greater clinical and cost-effectiveness in patients with low back pain. However, low back pain interventions are often delivered in groups and evaluating this system of care in a group setting is important. Patients were recruited from 60 general practices and linked physiotherapy services. A new group stratified intervention was compared with a historical nonstratified control group. Patients stratified as low, medium and high risk were offered risk-matched group care. Consenting participants completed self-report measures of functional disability (primary outcome measure), pain, psychological distress, and beliefs. The historical control received a generic group intervention. Analysis was by intention to treat. In total, 251 patients in the new stratified intervention and 332 in the historical control were included in the primary analysis at 12 weeks. The mean age of patients was 43 ± 10.98 years. Overall adjusted mean changes in the RMDQ scores were higher in the stratified intervention than in the control arm at 12-week follow-up (P = 0.028). Exploring the risk groups, individually the high-risk stratified group, demonstrated better outcome over the controls (P = 0.031). The medium-risk stratified intervention demonstrated equally good outcomes (P = 0.125), and low-risk stratified patients, despite less intervention, did as well as the historical controls (P = 0.993). Stratified care delivered in a group setting demonstrated superior outcomes in the high-risk patients, and equally good outcomes for the medium and low-risk groups. This model, embedded in primary care, provides an early and effective model of chronic disease management and adds another dimension to the utility of the STarT Back system of care. 2.


Enterobacter cloacae is an endophytic symbiont of corn.
The bacterium Enterobacter cloacae is presently used for biocontrol of postharvest diseases of fruits and vegetables and as a preplant seed treatment for suppression of damping-off. This bacterium has apparent affinities for several grass species, but it is not considered to be an endophyte. While screening corn for fungi and bacteria with potential for biocontrol of various corn diseases, the surface-sterilized kernels of one unknown Italian corn cultivar produced fungus-free corn seedlings with roots endophytically infected by E. cloacae. This paper describes the microscopic nature of E. cloacae RRC 101 with corn, and the in vitro control of Fusarium moniliforme and other fungi with this bacterium. Light and electron microscopy determined that this isolate of E. cloacae was biologically associated with corn seedling roots, where it was distributed intercellularly within the cortex and stele. This is a first report of a strain of this bacterium as an endophytic symbiont of roots. Following a topical application of E. cloacae to kernels, and upon germination this bacterium readily infected roots of two other corn cultivars. The bacterium was observed within the endosperm of germinating corn seedling, but germination was not affected. Further, the bacterium was isolated from leaves and stems of 3- to 6-week-old seedlings indicating that the above ground portions of corn were also colonized. There was no evidence of damage to cells of the root during a three to four week observation period. This bacterium was antagonistic to several isolates of the corn pathogen Fusarium moniliforme, and to two other species of fungi, all of which produce mycotoxins on corn.


Pixel-scale historical-baseline-based ecological quality: Measuring impacts from climate change and human activities from 2000 to 2018 in China.
Widespread concern about ecological degradation has prompted development of concepts and exploration of methods to quantify ecological quality with the aim of measuring ecosystem changes to contribute to future policy-making. This paper proposes a conceptual framework for ecological quality measurement based on current ecosystem functions and biodiverse habitat, compared with pixel-scale historical baselines. The framework was applied to evaluate the changes and driving factors of ecological quality for Chinese terrestrial ecosystems through remote sensing-based and ecosystem process modeled data at 1 km spatial resolution from 2000 to 2018. The results demonstrated the ecological quality index (EQI) had a very different spatial pattern based upon vegetation distribution. An upward trend in EQI was found over most areas, and variability of 46.95% in EQI can be explained well by change in climate, with an additional 10.64% explained by changing human activities, quantified by population density. This study demonstrated a practical and objective approach for quantifying and assessing ecological quality, which has application potential in ecosystem assessments on scales from local to region and nation, yet would provide a new scientific concept and paradigm for macro ecosystems management and decision-making by governments.


Identification of cholinergic centro-cingulate topography as main contributor to cognitive functioning in Parkinson's disease: Results from a data-driven approach.
Degeneration of the cholinergic system plays an important role in cognitive impairment in Parkinson's disease (PD). Positron emission tomography (PET) imaging using the presynaptic vesicular acetylcholine transporter (VAChT) tracer [18F]Fluoroethoxybenzovesamicol ([18F]FEOBV) allows for regional assessment of cholinergic innervation. The purpose of this study was to perform a data-driven analysis to identify co-varying cholinergic regions and to evaluate the relationship of these with cognitive functioning in PD. A total of 87 non-demented PD patients (77% male, mean age 67.9 ± 7.6 years, disease duration 5.8 ± 4.6 years) and 27 healthy control (HC) subjects underwent [18F]FEOBV brain PET imaging and neuropsychological assessment. A volume-of-interest based factor analysis was performed for both groups to identify cholinergic principal components (PCs). Seven main PCs were identified for the PD group: (1) bilateral posterior cortex, (2) bilateral subcortical, (3) bilateral centro-cingulate, (4) bilateral frontal, (5) right-sided fronto-temporal, (6) cerebellum, and (7) predominantly left sided temporal regions. A complementary principal component analysis (PCA) analysis in the control group showed substantially different cholinergic covarying patterns. A multivariate linear regression analyses demonstrated PC3, PC5, and PC7, together with motor impairment score, as significant predictors for cognitive functioning in PD. PC3 showed most robust correlations with cognitive functioning (p < 0.001). A data-driven approach identified covarying regions in the bilateral peri-central and cingulum cortex as a key determinant of cognitive impairment in PD. Cholinergic vulnerability of the centro-cingulate network appears to be disease-specific for PD rather than being age-related. The cholinergic system may be an important contributor to regional and large scale neural networks involved in cognitive functioning.


The expression and function of immunoglobulin-like transcript 4 in dendritic cells from patients with hepatocellular carcinoma.
Due to their easy availability and expansion in vitro, monocyte-derived dendritic cells (moDCs) are most frequently used for tumor vaccination. Immunoglobulin-like transcript 4 (ILT4), as inhibitory receptor, has been reported to be related to DC tolerance. However, the influence of ILT4 for DC tolerance in hepatocellular carcinoma (HCC) patients has not been illustrated. In this research, we explored the expression of ILT4 on moDCs from HCC patients and its effect on moDC function. We demonstrated that the expression of ILT4 on mature DCs (mDCs) was higher in the peripheral blood from HCC patients than in that from healthy donors. The levels of cytokines IL-1β and IL-6 secreted by mDCs from both HCC patients and healthy controls, stimulated by anti-ILT4 agonistic mAb, were decreased. In contrast, the levels of IL-10 and IL-23 were upregulated. In addition, ILT4, triggered by anti-ILT4 agonistic mAb, could reduce allogeneic T cell proliferation stimulated by the mDCs. Moreover, ILT4 triggered by anti-ILT4 agonistic mAb could also reduce the ability of the mDCs to stimulate tumor cell antigen-specific autologous CD4+ T cells (production of IFN-γ) and CD8+ T cells (production of IFN-γ and IL-2). Furthermore, ILT4 expression impaired the cytotoxicity of autologous T cells induced by the mDCs against the HCC tumor cell line SMMC-7721. Our data revealed that the high expression of ILT4 promoted the immune tolerance of DCs, resulting in an inefficiency of the T cell response, a process that is exacerbated in HCC patients.


Renaturation effects of cis and trans platinum II and IV compounds on calf thymus deoxyribonucleic acid.
The effects of cis dichlorodiammine platinum [cis Pt(II)], trans dichlorodiammine platinum (trans Pt(II)], cis tetrachlorodiammine platinum [cis Pt(IV)], trans tetrachlorodiammine platinum [trans Pt(IV)], and ethylenediaminedichloride platinum [Pt(II)en] on the absorption spectra, and thermal hyper- and hypochromicity of calf thymus DNA were investigated. Platinum-induced renaturation was studied as one parameter of interstrand cross-linking. Based on a DNA cross-linking hypothesis, the tumor-inhibitory platinum compounds cis Pt(II), cis Pt(IV) and Pt(II)en would be expected to induce renaturation following thermal denaturation, whereas the ineffective drugs, trans Pt(II) and trans Pt(IV) would not. All five bind to DNA in such a way as to induce renaturation. However, cis Pt(IV) requires at least a 3- to 4-fold longer incubation time than is required by the other compounds to form the coordination bonds necessary for renaturation. Maximum renaturation with all compounds was observed at a molar Pt/base ratio of 0.05 except cis Pt(IV), with which it was 0.25. The rate of the formation of the platinum-coordinated cross-links by fresh cis Pt(II) suggests two reactions or types of reactions occur. The first is rapid and destabilizes the DNA helix, whereas the second is slow and responsible for renaturation following thermal denaturation. These results suggest that cis Pt(IV) may be activated cellularly and that cross-linking is not the primary mechanism of action of the tumor-inhibitory platinum compounds.


Attachment security in infants at-risk for autism spectrum disorders.
Little is known about attachment security and disorganization in children who are at genetic risk for an Autism Spectrum Disorder (ASD) prior to a possible diagnosis. The present study examined distributions of attachment security and disorganization at 15-months of age in a sample of infant siblings of older children with (ASD-sibs; n = 51) or without (COMP-sibs; n = 34) an ASD. ASD-sibs were not more or less likely to evince attachment insecurity or disorganization than COMP-sibs. However, relative to COMP-sibs, the rate of B1-B2 secure subclassifications was disproportionately larger in the ASD-sib group. Results suggest that ASD-sibs are not less likely to form secure affectional bonds with their caregivers than COMP-sibs, but may differ from COMP-sibs in their expression of attachment security.


Postural instability in Parkinson's disease.
Postural instability is one of the most disabling features of Parkinson's disease. Many factors contribute to balance impairment of Parkinson patients, including disturbed postural reflexes and poor control of voluntary movement. Additional factors which place Parkinson patients at risk for falls are side-effects of medication (dyskinesias), the poor response of postural instability to antiparkinsonian medication, orthostatic hypotension, gait abnormalities, muscular weakness in leg muscles and superimposed age-related changes such as reduced peripheral sensation. Future studies should not only investigate means of preventing falls in unstable patients, but should also be directed towards development of new treatment. Because accumulating evidence indicates that postural instability is at least partially related to non-dopaminergic lesions, these novel therapeutic approaches should be aimed at overcoming non-dopaminergic neurotransmitter deficiencies.


Ecological indicator values reveal missing predictors of species distributions.
The questions of how much abiotic environment contributes to explain species distributions, and which abiotic factors are the most influential, are key when projecting species realized niches in space and time. Here, we show that answers to these questions can be obtained by using species' ecological indicator values (EIVs). By calculating community averages of plant EIVs (397 plant species and 3988 vegetation plots), we found that substituting mapped environmental predictors with site EIVs led to a doubling of explained variation (22.5% to 44%). EIVs representing light and soil showed the highest model improvement, while EIVs representing temperature did not explain additional variance, suggesting that current temperature maps are already fairly accurate. Therefore, although temperature is frequently reported as having a dominant effect on species distributions over other factors, our results suggest that this might primarily result from limitations in our capacity to map other key environmental factors, such as light and soil properties, over large areas.


Deeper waters are changing less consistently than surface waters in a global analysis of 102 lakes.
Globally, lake surface water temperatures have warmed rapidly relative to air temperatures, but changes in deepwater temperatures and vertical thermal structure are still largely unknown. We have compiled the most comprehensive data set to date of long-term (1970-2009) summertime vertical temperature profiles in lakes across the world to examine trends and drivers of whole-lake vertical thermal structure. We found significant increases in surface water temperatures across lakes at an average rate of + 0.37 °C decade-1, comparable to changes reported previously for other lakes, and similarly consistent trends of increasing water column stability (+ 0.08 kg m-3 decade-1). In contrast, however, deepwater temperature trends showed little change on average (+ 0.06 °C decade-1), but had high variability across lakes, with trends in individual lakes ranging from - 0.68 °C decade-1 to + 0.65 °C decade-1. The variability in deepwater temperature trends was not explained by trends in either surface water temperatures or thermal stability within lakes, and only 8.4% was explained by lake thermal region or local lake characteristics in a random forest analysis. These findings suggest that external drivers beyond our tested lake characteristics are important in explaining long-term trends in thermal structure, such as local to regional climate patterns or additional external anthropogenic influences.


Sarcoplasmic body myopathy--a rare hereditary myopathy with characteristic inclusions.
To characterise a Swedish family with a rare hereditary myopathy with unique sarcoplasmic inclusion bodies in the muscle biopsy. Part of the pedigree was described in 1980. Nine new members of the included and the phenotype further characterised through clinical, neurophysiological and radiological investigations. Six of the nine subjects displayed clinical and/or laboratory evidence of myopathy with sarcoplasmic inclusions. Sarcoplasmic body myopathy is distinguished from other distal myopathies by a more malignant course and early involvement of thenar muscles and hand flexors. Five to ten years after onset the affected subjects develop distal, as well as proximal, weakness and atrophy and the majority require a wheelchair after ten to fifteen years of disease. The disorder is manifested through elevated creatine kinase levels and the presence of the pathognomonic sarcoplasmic inclusions prior to clinical signs and symptoms.


Exploring oxidative stress and endothelial dysfunction as a mechanism linking bisphenol S exposure to vascular disease in human umbilical vein endothelial cells and a mouse model of postnatal exposure.
Structural analogues used to replace bisphenol A (BPA) since the introduction of new regulatory restrictions are considered emerging environmental toxicants and remain understudied with respect to their biological actions and health effects. Studies reveal a link between BPA exposure and vascular disease in human populations, whereas the vascular effects of BPA substitutes remain largely unknown. To determine the effect of BPS, a commonly used BPA substitute, on redox balance, nitric oxide (NO) availability and microvascular NO-dependent dilation. In human umbilical vein endothelial cells (HUVEC), production of reactive oxygen species (ROS) and NO after exposure to BPS was measured using fluorescent probes for DCFDA and DAF-FM diacetate, respectively. The contribution of endothelial NO synthase (eNOS) uncoupling to ROS generation was determined by measuring ROS in the presence or absence of an eNOS inhibitor (L-NAME) or eNOS co-factor, BH4, while the contribution of mitochondria-derived ROS was determined by treating cells with mitochondria-specific antioxidants prior to BPS exposure. Bioenergetic profiles were assessed using Seahorse extracellular flux analysis and mitochondria membrane polarization was measured with TMRE and JC-1 assays. In a mouse model of low dose BPS exposure, NO-mediated endothelial function was assessed in pressurized microvessels by inducing endothelium-dependent dilation in the presence or absence of L-NAME. BPS exposure (≥25 nM) reduced NO and increased ROS production in HUVEC, the latter corrected by treating cells with L-NAME or BH4. BPS exposure led to a loss of mitochondria membrane potential but had no impact on bioenergetic parameters except for a decrease in the spare respiratory capacity. Treatment of HUVEC with mitochondria-specific antioxidants abolished the effect of BPS on NO and ROS. NO-mediated vasodilation was impaired in male mice exposed to BPS. Exposure to BPS may promote cardiovascular disease by perturbing NO-mediated vascular homeostasis through the induction of oxidative stress.


Recommendation to include a textile dye mix in the European baseline series.
Disperse dyes are common sensitizers, but are not currently included in the European baseline series. To justify the inclusion of a textile dye mix in the European baseline patch test series. A survey of the reported frequencies of contact allergy to textile dyes and textile dye mixes was performed by searching PubMed (http://www.ncbi.nlm.gov.ludwig.lub.lu.se/pubmed, last accessed 14 December 2014). The results from a multicentre study performed within the European Environmental Contact Dermatitis Research Group (EECDRG) and published in 2014 formed the final basis for the recommendation. The EECDRG study performed in Europe and the United States showed that 2.1-6.9% of consecutively tested dermatitis patients reacted to a 6.6% wt/wt textile dye mix consisting of eight disperse dyes. The clinical relevance was ascertained in >30% of the positive cases. A high frequency of simultaneous sensitivity to Disperse Orange 3 (DO 3) and p-phenylenediamine (PPD) was seen. Active sensitization to the mix was not noted. It is recommended to include a 6.6% textile dye mix consisting of eight disperse dyes in the European baseline series, even though one component, DO 3, may be superfluous, owing to its frequent cross-reactivity with PPD. Removal of DO 3 from the mix would need further study.


A MEMS-enabled portable gas chromatography injection system for trace analysis.
Growing concerns about environmental conditions, public health, and disease diagnostics have led to the rapid development of portable sampling techniques to characterize trace-level volatile organic compounds (VOCs) from various sources. A MEMS-based micropreconcentrator (μPC) is one such approach that drastically reduces the size, weight, and power constraints offering greater sampling flexibility in many applications. However, the adoption of μPCs on a commercial scale is hindered by a lack of thermal desorption units (TDUs) that easily integrate μPCs with gas chromatography (GC) systems equipped with a flame ionization detector (FID) or a mass spectrometer (MS). Here, we report a highly versatile μPC-based, single-stage autosampler-injection unit for traditional, portable, and micro-GCs. The system uses μPCs packaged in 3D-printed swappable cartridges and is based on a highly modular interfacing architecture that allows easy-to-remove, gas-tight fluidic, and detachable electrical connections (FEMI). This study describes the FEMI architecture and demonstrates the FEMI-Autosampler (FEMI-AS) prototype (9.5 cm × 10 cm x 20 cm, ≈500 gms). The system was integrated with GC-FID, and the performance was investigated using synthetic gas samples and ambient air. The results were contrasted with the sorbent tube sampling technique using TD-GC-MS. FEMI-AS could generate sharp injection plugs (≈240 ms) and detect analytes with concentrations <15 ppb within 20 s and <100 ppt within 20 min of sampling time. With more than 30 detected trace-level compounds from ambient air, the demonstrated FEMI-AS, and the FEMI architecture significantly accelerate the adoption of μPCs on a broader scale.


Improved description of terrestrial habitat types by including microbial communities as indicators.
Soils host diverse communities of microorganisms essential for ecosystem functions and soil health. Despite their importance, microorganisms are not covered by legislation protecting biodiversity or habitats, such as the Habitats Directive. Advances in molecular methods have caused breakthroughs in microbial community analysis, and recent studies have shown that parts of the communities are habitat-specific. If distinct microbial communities are present in the habitat types defined in the Habitats Directive, the Directive may be improved by including these communities. Thus, monitoring and reporting of biodiversity and conservation status of habitat types could be based not only on plant communities but also on microbial communities. In the present study, bacterial and plant communities were examined in six habitat types defined in the Habitats Directive by conducting botanical surveys and collecting soil samples for amplicon sequencing across 19 sites in Denmark. Furthermore, selected physico-chemical properties expected to differ between habitat types and explain variations in community composition of bacteria and vegetation were analysed (pH, electrical conductivity (EC), soil texture, soil water repellency, soil organic carbon content (OC), inorganic nitrogen, and in-situ water content (SWC)). Despite some variations within the same habitat type and overlaps between habitat types, habitat-specific communities were observed for both bacterial and plant communities, but no correlation was observed between the alpha diversity of vegetation and bacteria. PERMANOVA analysis was used to evaluate the variables best able to explain variation in the community composition of vegetation and bacteria. Habitat type alone could explain 46% and 47% of the variation in bacterial and plant communities, respectively. Excluding habitat type as a variable, the best model (pH, SWC, OC, fine silt, and Shannon's diversity index for vegetation) could explain 37% of the variation for bacteria. For vegetation, the best model (pH, EC, ammonium content and Shannon's diversity index for bacteria) could explain 25% of the variation. Based on these results, bacterial communities could be included in the Habitats Directive to improve the monitoring, as microorganisms are more sensitive to changes in the environment compared to vegetation, which the current monitoring is based on.


Late Feyerabend on materialism, mysticism, and religion.
Feyerabend's interests in religion and mysticism grew through his career. In his later writings, Feyerabend's numerous critiques of scientific materialism are often accompanied by purported advantages of religious orientations and temperaments. These recommendations do not simply follow from his tolerant theoretical pluralism; they are more positive attempts to articulate distinctive aspects of human life satisfied by religion, but not by scientific materialism. Elevating the human need for mystery, reverence, and love, he contrasts these goods with the deliverances of monistic conceptions of science and reason. I bring attention to some of the common themes in these remarks to argue that they were integral with other parts of his philosophical project and that they could serve as helpful rejoinders to contemporary exhortations to science-based secularism from philosophers of science.


Free radical scavenging activity, total phenolic content, total antioxidant status, and total oxidant status of endemic Thermopsis turcica.
Thermopsis turcica, endemic to Turkey, is in danger of extinction. Studies on this species are very few due to the fact that it was only discovered in 1983 and grows in a small circumscribed area in Turkey. In this study, free radical scavenging activity, total phenolic content, total oxidant status (TOS), and total antioxidant status (TAS) of methanol (TTM) and acetone (TTA) extracts of T. turcica were measured spectroscopically. Free radical scavenging activity was determined according to the elimination of DPPH radicals and total phenol content was determined by the Folin-Ciocalteu reaction. Total oxidant status (TOS) and total antioxidant status (TAS) were measured with commercially available kits. Methanol and acetone extracts of T. turcica were found to have a specific radical scavenging effect. This effect was found to be related to the total phenolic content of the extracts. Since the TTA had a higher phenolic content than the methanol extract, it had a stronger radical scavenging effect. In addition, the total antioxidant capacity of the methanol extract was observed to be higher than that of its acetone counterpart. As a result, due to its antioxidative properties, T. turcica is thought to be a natural source of antioxidants.


Phase I trial of a B7-1 (CD80) gene modified autologous tumor cell vaccine in combination with systemic interleukin-2 in patients with metastatic renal cell carcinoma.
A reason that the immune system may fail to reject tumors is that T cells encounter tumor antigen derived peptides on the surface of tumor cells in a tolerizing rather than activating context since tumor cells do not express T cell co-stimulatory molecules such as B7-1 (CD80). In preclinical models over expression of B7-1 on the surface of tumor cells has been shown to activate T cells which kill tumor cells. We conducted a phase I clinical trial testing this approach in patients with metastatic renal cell carcinoma. Resected tumors from 15 patients were disaggregated and adapted to tissue culture, transduced with the B7-1 gene and injected subcutaneously as a vaccine. The dose of the vaccine was escalated in 3 separate cohorts of patients, and systemic interleukin-2 (IL-2) was administered as an adjuvant designed to enhance the proliferation of the vaccine activated T cells. Of the 15 patients 9 had measurable disease, 2 had a partial response and 2 had stable disease. Perivascular T cell infiltrates at autologous tumor delayed type hypersensitivity skin test sites developed in 3 of the 4 patients with stable disease or partial response. Although the patients experienced the usual and expected toxicity from the IL-2, there was no significant toxicity observed with the vaccine. The B7-1 gene modified autologous tumor cell vaccine is safe and can be combined with systemic IL-2 with acceptable toxicity. Immunological and clinical responses were observed in some of the patients. A phase II trial is reasonable to determine the efficacy of this approach.


Malignant tumor is the greatest risk factor for pulmonary embolism in hospitalized patients: a single-center study.
This study aimed to investigate the background of patients who presented with pulmonary embolism (PE) on contrast-enhanced chest computed tomography (CT) and to explore the risk factors for PE. This study included a review of the medical records of all 50,621 patients who were admitted to one community hospital between January 1, 2013 and December 31, 2017. Data on sex, age, risk factors related to blood flow stagnation (obesity, long-term bed rest, cardiopulmonary disease, cast fixation, long-term sitting), risk factors related to vascular endothelial disorder (surgery, trauma/fracture, central venous catheterization, catheter tests/treatments, vasculitis, antiphospholipid antibody syndrome, history of venous thromboembolism (VTE)), and risk factors related to hypercoagulability (malignant tumor, use of oral contraceptives/low-dose estrogen progestin/steroids, infection, inflammatory enteric disease, polycythemia, protein C or protein S deficiency, dehydration) were evaluated. Of all inpatients, 179(0.35%) out of 50,621 were diagnosed with PE after contrast-enhanced chest CT examination, in which 74 patients were symptomatic and 105 patients had no symptom. Among asymptomatic 105 patients, 71 patients got CT scans for other reasons including cancer screening and searching infection focus, and 34 patients got CT scans for searching PE due to either apparent or suspicious DVT. The rate of discovering PE was significantly greater in women (0.46%, 90/19,409) than men (0.29%, 89/31,212) (P = 0.008). Of the 179 patients with PE, 164 (92%) had some type of risk factor. For both men and women, the most frequent risk factor was a malignant tumor, followed by obesity, long-term bed rest and infection for men and long-term bed rest, obesity and infection for women. The most common malignant tumor was lung cancer. Although taking antipsychotic agent is not advocated as a risk factor, there is a possibility of involvement. The risk factors for PE were identified in this single-center, retrospective study.


Plectin promotes migration and invasion of cancer cells and is a novel prognostic marker for head and neck squamous cell carcinoma.
Head and neck squamous cell carcinoma (HNSCC) is usually found at a late stage and distant metastasis occurs at high frequency; therefore, novel prognostic markers are needed. This study was aimed to identify novel tumor markers in HNSCC. We identified 65 proteins which were significantly increased or decreased in the tumors by 2D-DIGE using 12 HNSCC and adjacent non-cancer tissues. Western blotting and immunohistochemical analysis confirmed that the expression of plectin was significantly increased in most cancer tissues as compared with non-cancer tissues. Strikingly, the suppression of endogenous plectin using siRNA inhibited the proliferation, migration and invasion of HNSCC cells and down-regulated Erk 1/2 kinase. Furthermore, immunohistochemistry using paraffin-embedded tissues from 62 patients showed not only that the frequency of recurrence was correlated with the plectin expression but that the prognosis of patients with a high plectin was extremely poor. Moreover, the survival rate of patients with a high plectin was significantly lower than that of patients with low E-cadherin levels, which is known to correlate with the poor prognosis of HNSCC. Our findings suggest that plectin promotes the migration and invasion of HNSCC cells through activation of Erk 1/2 kinase and is a potential prognostic biomarker of HNSCC.


Deployment of Neurosurgeons at the Warfront Against Coronavirus Disease of 2019 (COVID-19).
The coronavirus disease 2019 (COVID-19) pandemic has taken the world by storm, especially the health care system. Medical practitioners of all specialties are being assigned to treat patients of COVID-19. In this article, two authors (T.V. and N.G.) from the Department of Neurosurgery who were deployed in the COVID-19 testing ward between April 25 and May 31, 2020 share their experience. A prospective observational study was conducted including all those who were admitted in this ward. The patients were studied according to their demographic profiles, diagnoses, admitting departments, travel history, and presence/absence of COVID-19-related symptoms. Relevant history regarding occupation, contact with patient with known COVID-19, and comorbid illness was noted. Those who tested positive for COVID-19 were studied further. The data from the institute's official record were updated until August 14, 2020. During the study period, there were 256 admissions in the ward, of whom 148 (92 male, 56 female) were patients and 108 were patients' attendants/relatives. Most patients were admitted under the departments of internal medicine (33, 22.3%) and general surgery (19, 12.8%). Of 148 patients, 46 (31.1%) were admitted as they were planned for a surgery/intervention. Among 148 patients, 29 (19.6%) had history of travel to or were residents of a red zone, 4 (2.7%) had history of contact with a confirmed case of COVID-19, whereas 6 (4.1%) were health care workers. One hundred four patients (70.2%) showed no COVID-19-related symptoms. Thirty-four patients (22.9%) had associated comorbid conditions. Eight patients (5 male, 3 female) with mean age of 37.6 years (range 4-69 years) tested positive for COVID-19. The authors share their experience and their institute's protocol in various facets during this war against COVID-19 pandemic. Preadmission and presurgical testing of patients is important in preventing the spread of the disease amongst health care workers.


UNC5A promotes neuronal apoptosis during spinal cord development independent of netrin-1.
In addition to their role as chemorepellent netrin-1 receptors, UNC5 proteins may mediate cell death because they induce apoptosis in cultured cells. To test this in vivo, we generated Unc5a (formerly Unc5h1) knockout mice and found that this deletion decreased apoptosis and increased the number of neurons in the spinal cord. In contrast, loss of netrin-1 (Ntn1) did not affect the amount of apoptosis, suggesting that NTN1 is not required for neuronal apoptosis in vivo.


Particle-scale understanding sorption of phenanthrene on sediment fractions amended with black carbon and humic acid.
Black carbon (BC) and humic acid (HA) have been proposed to dominate the sorption behavior of phenanthrene in sediment. Nevertheless, little is known about the sorption mechanism that related to particle-scale by spiking of BC and HA in sediment particle size fractions. In this study, sorption isotherms for phenanthrene were determined in four particle-size sediment fractions (<2 μm, 2-31 μm, 31-63 μm and >63 μm) that amended with BC and HA, or not. The fitting results by Freundlich model indicated that the sediment particle size fractions amended with BC increased the sorption capacity and affinity for phenanthrene. Sediment coarser size fractions (31-63 μm and >63 μm) by spiking of BC contributed higher to sorption capacity factor (KF) and nonlinearity factor (n) than the finer size fractions (2-31 μm and <2 μm). By contrast, the sediment particle size fractions amended with HA enhanced the sorption distribution coefficient (Kd), but reduced the sorption affinity for phenanthrene. All these phenomena are obviously affected by the distribution of heterogeneous organic matter that related to sediment particle-scale. Results of this work could help us better understand the impact of increased BC and HA content in sediments on the sorption of hydrophobic organic pollutants (HOCs) and predict the fate of HOCs in offshore sediments due to tidal action.


Comparison of respiratory event detection by a polyvinylidene fluoride film airflow sensor and a pneumotachograph in sleep apnea patients.
Compare the ability of a polyvinylidene fluoride (PVDF) thermal sensor and a pneumotachograph to detect respiratory events in patients with obstructive sleep apnea. Single night of monitoring, single blinded scorer. Veterans Affairs medical center. Ten male subjects with obstructive sleep apnea. Nasal-oral airflow was simultaneously detected by a PVDF thermal sensor attached to the upper lip and a pneumotachograph in a mask over the nose and mouth. Events were scored from display views showing only the airflow tracings of the sensor in question and the events scored from that sensor. The apnea-hypopnea index was computed using two definitions for hypopnea. Hypopnea-1 was defined as a 50% reduction in flow for > or = 10 s in duration. Hypopnea-2 was defined as any reduction in airflow for > or = 10 s associated with a 3% drop in the arterial oxygen saturation or followed by an arousal. The level of agreement (kappa) for the sensors was determined by comparing whether or not they identified candidate events determined by a second blinded scorer. For the apnea-hypopnea-1 index (mean +/- SD), the event rate for the pneumotachograph (26.0 +/- 27.9 events/h) was slightly greater than that for the PVDF sensor (20.1 +/- 27.1 events/h; p < 0.05). For the apnea-hypopnea-2 index, the event rate for the pneumotachograph (29.4 +/- 26.8 events/h) and for that of the PVDF sensor (26.4 +/- 25.9 events/h) were similar (difference not significant). The mean +/- 2 SD difference was 3.0 +/- 8.5 events/h. The level of agreement between the sensors was in the "good range," whereby kappa = 0.69. For 20 randomly selected breaths per patient, the maximum deflections of the PVDF sensor varied linearly with pneumotachograph airflow deflections. The PVDF sensor compared favorably with a "gold standard" method of detecting respiratory events during sleep in patients with obstructive sleep apnea.


Degradation of MTBE and TBA by a new isolate from MTBE-contaminated soil.
Methyl tert-butyl ether (MTBE), a gasoline additive, possesses serious problems to the environmental health. In the present study, a bacterial culture named A-3 which could effectively degrade MTBE was isolated from the MTBE contaminated soil. The isolate was identified as Chryseobacterium sp., a new species capable of degrading MTBE. In order to enhance its degradation ability, selected environment factors were investigated. The results showed that the optimal temperature was in the range of 25-30 degrees C, the pH was 7.0, the inoculum size was 2 x 10(8) CFU/ml and the optimal concentration of MTBE was from 50 to 100 mg/L. The maximum MTBE utilization rate (upsilon(max)) was 102 nmol MTBE/(mg cell protein x h). Furthermore, it was found that the isolate could also degrade tert-butyl alcohol (TBA). The degradation rates of TBA were much faster than those of MTBE. The additional TBA would lead to the decrease of the initial MTBE degradation rate and the inhibitory effect of TBA increased with the increase of TBA concentration. Similar protein profiles at least seven peptides were demonstrated after SDS-PAGE analysis of crude extracts obtained from the cells growing in MTBE and TBA culture.


Integrating gamification and instructional design to enhance usability of online learning.
The current study investigates the interaction of Gamification, and Instructional Design to enhance the Usability of e-Learning in higher education programs. The study also examines the mediating role of Instructional design. Data were collected from a self-structured questionnaire from the academicians and was analyzed through Structural Equation Modelling (SEM). The results of the study confirmed that gamification is a multi-dimensional construct significantly predicted by elements, game dynamics, motivation, and game mechanics. Further, Instructional design partially mediates the relationship between gamification and usability of e-learning. This research demonstrates that Gamification can enhance the learning environment for e-learning students. This study will also inspire educators and course developers to give due consideration to the instructional design and gamification of an online course. The research findings will motivate educators/instructors/course developers to give equal importance to instructional design and gamification as well as to the content.


Molecular epidemiology and antimicrobial susceptibility profiles of Campylobacter jejuni isolated from bloodstream infections and enteritis in Japan.
Campylobacter enteritis (En) is the most frequently diagnosed bacterial En worldwide, including in Japan. Campylobacter spp. can also cause bloodstream infection (BSI), reactive arthritis, and Guillain-Barré syndrome. The purpose of this study was to clarify the characteristics of Campylobacter jejuni strains that cause BSI in comparison with En-causing strains. BSI strains (n = 40) and En strains that caused food poisoning (n = 67) were collected in Japan. Our study revealed that ST-4526 was predominant in BSI strains, and the overall distribution of sequence types was similar in both BSI and En strains. Differences in CPS type distribution might be related to the pathogenesis of bacteremia. Quinolone resistance rates were higher than those reported in previous studies, and strains resistant to both quinolones and tetracyclines were more frequently observed in BSI strains. Finally, we report a case of mixed infection with different STs in BSI.


Uveal melanoma: molecular pattern, clinical features, and radiation response.
To characterize the clinical spectrum of class 1 and class 2 uveal melanomas and their relationship with intraocular proton radiation response. Masked retrospective case series of uveal melanoma patients with fine needle biopsy-based molecular profiles. A total of 197 uveal melanoma patients from a single institution were analyzed for pathology, clinical characteristics, and response to radiation therapy. A total of 126 patients (64%) had class 1 tumors and 71 (36%) had class 2 tumors. Patients with class 2 tumors had more advanced age (mean: 64 years vs 57 years; P = .001), had thicker initial mean ultrasound measurements (7.4 mm vs 5.9 mm; P = .0007), and were more likely to have epithelioid or mixed cells on cytopathology (66% vs 38%; P = .0004). Although mean pretreatment and posttreatment ultrasound thicknesses were significantly different between class 1 and class 2 tumors, there was no difference in the mean change in thickness 24 months after radiation therapy (mean difference: class 1 = -1.64 mm, class 2 = -1.47; P = .47) or in the overall rate of thickness change (slope: P = .64). Class 2 tumors were more likely to metastasize and cause death than class 1 tumors (DSS: P < .0001). At the time of radiation therapy, thicker tumors, epithelioid pathology, and older patient age are significantly related to class 2 tumors, and class 2 tumors result in higher tumor-related mortality. We found no definitive clinical marker for differentiating class 1 and class 2 tumors.


Spiroplasma apis, a new species from the honey-bee Apis mellifera.
Two spiroplasma strains (B31 and B39) recovered from diseased honey-bees (Apis mellifera) in southwestern France were similar in biochemical, serological and pathological properties. The organisms grew at 30 degrees C, required cholesterol for growth, fermented glucose, catabolized arginine and produced a film and spot reaction. The two spiroplasmas were serologically indistinguishable but were related to serogroup IV spiroplasmas, which had been previously isolated from flower surfaces and from insects. The isolates were distinct from the three previously established species of Spiroplasma and from other presently known serogroups. The G + C content of the DNA from strain B31 was 30 +/- 1 mol %. Both B31 and B39 strains were associated with a lethal infection ("May disease") of the honey-bee. On the basis of the characterization presented here, it is proposed that these spiroplasmal pathogens of bees and allied strains be classified as a new species, Spiroplasma apis, the type strain of which is B31 (ATCC 33834).


Ulinastatin improved cardiac dysfunction after cardiac arrest in New Zealand rabbits.
The present study was designed to evaluate the effects of ulinastatin (UTI) on cardiac dysfunction after cardiopulmonary resuscitation (CPR). A total of 48 healthy adult male New Zealand rabbits were untreated for 8 minutes after the induction of ventricular fibrillation (VF) by an external transthoracic alternating current and then treated by CPR. These rabbits were then randomly divided into the control and UTI groups after the return of spontaneous circulation (ROSC) and were observed for 8 hours after the ROSC. Before CPR and after ROSC at 2, 4, and 8 hours, blood samples were collected to determine the levels of tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), malondialdehyde (MDA), cardiac troponin I (cTnI), and N-terminal probrain natriuretic peptide (NT-proBNP), and the left ventricular ejection fraction (EF) was measured by echocardiography. Nineteen of 24 rabbits in the control group and 18 of 24 in the UTI group were successfully resuscitated. The plasma levels of TNF-α, IL-6, MDA, cTnI, and NT-proBNP were significantly increased, accompanying a deceased EF in the control group, but the cotreatment with UTI decreased the plasma levels of TNF-α, IL-6, MDA, cTnI, and NT-proBNP (P < .05), attenuating the myocardial injury and improving the EF in the UTI group. Only 9 of 19 animals in the control group but 14 of 18 animals in the UTI group survived longer than 8 hours (P = .011). The progression of proinflammatory responses, oxidative stress, and myocardial injury have been linked to the reduced EF after VF/CPR, and the administration of UTI at a cardioprotective dosage preserved the cardiac function after VF/CPR.


Deoxygenation of pyrolysis vapour derived from durian shell using catalysts prepared from industrial wastes rich in Ca, Fe, Si and Al.
Catalysts prepared from industrial wastes rich in Fe, Ca, Si, and Al were used in catalytic upgrading of pyrolysis vapour derived from durian shell and their effect on product yield and properties were compared. With same silica-to-alumina ratio, catalyst prepared from oil palm ash (AS-OPA) with lower Fe and Ca contents gave higher liquid yield (8.32 wt%) with alcohols (28.90%), hydrocarbons (46.00%), and nitrogen-containing compounds (21.46%) while catalyst prepared from electric arc furnace slag (AS-EAF) with higher Fe and Ca contents produced lower liquid yield (50.21 wt%) with high amount of esters (25.80%) and hydrocarbons (72.82%). The presence of AS-OPA and AS-EAF catalysts enhanced deoxygenation degree of bio-oil to 81.13% and 85.49%, respectively. The catalytic performance of AS-EAF at different temperatures (400-600 °C) and AS-EAF/durian shell ratios (1:30, 2:30, 3:30) was investigated. Increasing catalytic temperature enhanced production of bio-oil, reduced oxygenates and enhanced formation of esters. The liquid yield and yield of esters decreased with increasing catalyst loading. Hydrocarbons (mainly neopentane) were the major chemical compounds found in bio-oil produced over AS-EAF. Besides that, AS-EAF showed good deoxygenation performance with highest selectivity of hydrocarbons at 500 °C and AS-EAF/durian shell ratio of 2:30. Catalytic fast pyrolysis of durian shell using waste-derived catalysts is an effective waste management strategy as the bio-oil produced can be a potential alternative source of energy or chemical feedstocks.


Extraosseous osteogenic sarcoma arising from the retroperitoneum: a case report.
A 44-year-old housewife with a mass in the left upper quadrant of the abdomen was admitted. The tentative diagnosis was cystadenocarcinoma arising from the pancreatic tail, as determined by CT and selective angiography. Excision of the mass with removal of the spleen, pancreatic tail, left renal capsule and surrounding lymphnodes was performed. Photomicroscopic sections revealed proliferation of malignant cells and malignant osteoids. The final diagnosis was osteogenic sarcoma arising from the retroperitoneum. Among the extraosseous osteogenic sarcoma arising from the somatic soft tissue, involvement of the retroperitoneum is rare. Only 12 cases including our own case have been reported as being of retroperitoneal origin. No patient survived for five years and in our patient, there are signs of recurrence one year after the surgery.


Immunoregulatory Effect of Preventive Supplementation of Omega-3 Fatty Acid in a Complex Regional Pain Syndrome Type I Model in Mice.
Complex regional pain syndrome (CRPS) is usually triggered by trauma or a surgical procedure, and it typically becomes an established one after an intense inflammatory process with chronic pain and edema as the main symptoms. Available treatments for CRPS have low efficacy. This study aimed to evaluate the clinical and immunoregulatory effects of omega-3 polyunsaturated fatty acid (PUFA) supplementation on paw edema and anti- and pro-inflammatory cytokines and macrophage phenotypes in the chronic post-ischemia pain (CPIP) preclinical model of CRPS-Type I. Female Swiss mice were supplemented with omega-3, corn oil, or saline and then submitted to the CPIP model of ischemia/reperfusion (I/R) injury. Supplementation was carried out for 30 days prior to and up to 2 or 15 days after the induction of CPIP, according to experimental protocols. The supplementation protocol included 1,500 mg/kg of omega-3 or corn oil through an intragastric route (gavage). Paw edema, interleukin- (IL-) 4, IL-10, transforming growth factor-β1 (TGF-β1), monocyte chemotactic protein-1 (MCP-1), and tumor necrosis factor (TNF) were then measured in the paw skin and muscle by enzyme-linked immunosorbent assay (ELISA), and macrophage phenotypes (M1 and M2) assessed in the paw muscle by Western blotting. The CPIP model induced an increase in paw thickness up to 72 h post-I/R. Mice supplemented with omega-3 compared to the saline group displayed reduced edema but neither altered skin IL-4 or skin and muscle TGF-β1, TNF, and MCP-1 concentrations, nor did they exhibit significantly altered muscle macrophage phenotype on the 2nd-day post-CPIP. However, omega-3 supplementation reversed the I/R-related reduction in IL-4 in the paw muscle compared to groups supplemented with saline and corn oil. Furthermore, omega-3 promoted the reduction of IL-10 levels in the paw skin, compared to animals with lesions supplemented with saline, until the 2nd-day post-CPIP. On the 15th day post-CPIP, IL-10 was significantly increased in the muscle of animals supplemented with omega-3 compared to the saline group. The results suggest that omega-3 PUFA supplementation has anti-inflammatory effects in the CPIP model of CRPS-Type I, significantly reducing paw edema and regulating concentrations of anti-inflammatory cytokines, including IL-4 and IL-10.


Human salivary sugar clearance after sugar rinses and intake of foodstuffs.
The aetiology of dental caries is in part related to the retention time of dietary carbohydrates in the oral cavity and their subsequent metabolism by the oral bacteria. Salivary clearance of fermentable carbohydrates from three different foodstuffs was examined in 5 subjects and analyses performed by high-performance anion-exchange chromatography with pulsed amperometric detection. The clearance of glucose, fructose, sucrose, maltose and sorbitol rinses was studied as well as that of chocolate bars, white bread and bananas. Of the sugar rinses studied, sucrose was removed from saliva most rapidly whilst appreciable levels of sorbitol remained even after 1 h. Clearance of residual carbohydrates from bananas and chocolate bars seemed marginally faster than in the case of bread, but sucrose levels still tended to fall more quickly than other carbohydrates studied. Surprisingly, carbohydrate residues from the three foods studied were still present in the mouth even 1 h after ingestion, which is longer than has hitherto been reported.


Effect of COVID-19 pandemic on blood transfusion service: an experience from a regional blood transfusion center.
The unforeseen and uncertain life-threatening situation of the COVID-19 pandemic dramatically affected all areas of the human daily work schedule. This study was designed to assess the impact of the COVID-19 pandemic on blood transfusion services and discuss the adopted confrontation measures for uninterrupted blood supply during the pandemic situation. The data on blood donation, blood component preparation, and issue from January 2019 to December 2022 were collected from the inventory registers of the RBTC, Delhi, India. Compared to the non-pandemic year 2019, during the year 2020, all variables decreased gradually. The observed maximum decrease in variables such as blood collection (-79.16%) in the month of October, blood issue (-71.61%) in the month of August, random donor platelets (RDP) preparation (-98.09%) in the month of October, RDP issue (-86.08%) in the month of September, fresh frozen plasma (FFP) preparation (-100%) in the month of October, and FFP issue (-96.08%) in the month of July with an annual decrease of -45.52%, -42.87%, -33.00%, -59.79%, -40.98%, and -54.48%, respectively, as compared to year 2019. Compared to year 2020, in year 2021, the annual increase in blood collection, blood issue, FFP preparation, FFP issue, RDP preparation, and RDP issue was +50.20%, +21.68%, +65.31%, +78.52%, +116.23%, and +213.30%, respectively. Our study results show that the COVID-19 pandemic has significantly affected blood transfusion services at our blood bank. The adopted coping strategies to maintain the safe and uninterrupted blood transfusion chain at our blood bank gave us lessons for future preparedness if faced with a similar situation.


Anti-angiogenic therapy in pediatric neuro-oncology.
In order to grow, tissues require additional nutrients and oxygen as well as removal of waste products. Tumors achieve this by up-regulating angiogenic cytokines and/or down-regulating natural inhibitory proteins that allow neovascularization to proceed. Brain tumors continue to account for significant morbidity and mortality, in spite of significant advances in neurosurgical and radiation techniques and new chemotherapy combinations. As such, there is a real and immediate need for novel biologic therapies that can target these tumors. A number of new drugs that target different aspects of the angiogenic cascade have been identified and are now in clinical trials in children with primary brain tumors. In many of these pre-clinical and clinical studies, anti-angiogenic therapy has been well tolerated, has lacked many of the traditional toxicities of radiation and chemotherapy, does not require blood-brain barrier penetration, and targets a critical pathway in central nervous system tumor development. This review will discuss what angiogenesis is, how pediatric brain tumors regulate angiogenesis to obtain a vascular supply, what types of inhibitors are available, how different classes of inhibitors work, the types of resistance possible, how rapidly these inhibitors may work, and what surrogate markers of activity are available to follow response.


Using a simplified human immunodeficiency virus type 1 p24 antigen assay to diagnose pediatric HIV-infection in Malawi.
There is a worldwide need for a pediatric HIV-1 diagnostic test that has a high diagnostic accuracy, is technically simple and cost efficient. The Up24 HIV-1 assay, which requires both the HIV-1 p24 ELISA and the ELAST signal amplification kit, has previously been shown to be a robust tool to diagnose pediatric HIV-1 from dried whole blood spots (DBS) (Cachafeiro et al., JCM 2009;47:459-62(13)). In order to make the assay more accessible to a resource-limited clinical setting, we eliminated the ELAST system, which simplified the Up24 assay, reduced its cost, and tested the accuracy of the modified assay in a rural Malawian hospital. In this proof of concept study, we tested the ability of a simplified Up24 antigen assay, without ELAST, to detect HIV-1 on DBS obtained via heel prick from 6-week-old Malawian infants. A case-control study of DBS collected from 113 HIV-infected and 109 HIV-negative infants, using the HIV-1 DNA PCR assay as the reference standard. The simplified HIV-1 Up24 assay had a sensitivity and specificity of 84% and 98%, respectively. When HIV-1 prevalence is 15%, the positive- and negative-predictive values are 89% and 97%, respectively. The simplified Up24 assay has a good positive- and a robust negative-predictive values, is easier to perform and has a reduced cost compared to both HIV DNA PCR and Up24 assays. With additional testing, the simplified Up24 assay has the potential to increase global access to pediatric HIV-1 diagnostics.


Identification of pemphigus-like antigens expressed by SCaBER cells.
Indirect immunofluorescence revealed the presence of pemphigus-like antigenic activity on SCaBER cell monolayers after incubation with sera from patients with pemphigus vulgaris. In contrast, no fluorescence was observed after incubation of the cells with sera from patients with bullous pemphigoid, systemic lupus erythematosus or healthy individuals. In order to identify this pemphigus-like antigen, the SCaBER cell membrane proteins were solubilized in non-ionic detergent, separated according to their molecular weight by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and electrophoretically transferred to nitrocellulose sheets. After incubation with pemphigus serum followed by 125I-radiolabelled goat anti-human IgG, autoradiography revealed pemphigus antibody binding activity in the 105 Kd region in electrophoretograms of the unreduced SCaBER cell membrane extracts. This pemphigus-like antigen was isolated by affinity chromatography on the Sepharose-linked IgG fraction of sera from patients with pemphigus vulgaris.


Enhanced antitumor and anti-metastasis by VEGFR2-targeted doxorubicin immunoliposome synergy with NK cell activation.
Liposomal doxorubicin exhibits stronger drug accumulation at the tumor site due to the Enhanced Permeability and Retention (EPR) effect. However, the prognosis for the patient is poor due to this drug's lack of targeting and tumor metastasis during treatment. Vascular epidermal growth factor receptor (VEGFR2) plays an important role in angiogenesis and cancer metastasis. To enhance antitumor efficacy of PEGylated liposomal doxorubicin, we constructed a VEGFR2-targeted and doxorubicin-loaded immunoliposome (Lipo-DOX-C00) by conjugating a VEGFR2-specific, single chain antibody fragment to DSPE-PEG2000-MAL, and then we inserted the antibody-conjugated polymer into liposomal doxorubicin (Lipo-DOX). The immunoliposome was formed uniformly with high affinity for VEGFR2. In vitro, Lipo-DOX-C00 enhanced doxorubicin internalization into LLC and 4T1 cells compared with non-conjugated, liposomal doxorubicin. In vivo, Lipo-DOX-C00 delivered DOX to tumor tissues effectively, which exhibited an improved antitumor and anti-metastasis efficacy in both LLC subcutaneous tumor models and 4T1 tumor models. In addition, the combined therapy of a VEGFR2-MICA bispecific antibody (JZC01) and Lipo-DOX-C00 achieved enhanced inhibition of cancer growth and metastasis due to activation of the immune system. Our study provides a promising approach to clinical application of liposomal doxorubicin.


Context matters for attractiveness bias.
To fully understand the attractiveness bias, we propose that contextual factors or affordances should be integrated into the mating-based evolutionary account of Maestripieri et al. We review examples highlighting the role of contextual factors in the perception of attractiveness and in attractiveness bias. These suggest contextual factors differentially afford the development of preference for attractive others into observed habits of mind.


The performance of patients with Parkinson's disease on the Face-Name Associative Memory Examination.
In this study, we examined the performance of patients with Parkinson's disease (PD) with different cognitive profiles on the Face-Name Associative Memory Examination (FNAME). We evaluated 71 patients with a comprehensive neuropsychological battery. The results revealed that the group with executive and additional visuospatial deficits demonstrated significantly lower scores on FNAME. This finding indicates the possible clinical utility of FNAME for screening patients with PD with distinct cognitive profiles. Further longitudinal studies are needed to consider the prognostic adequacy of FNAME in detecting high-risk Parkinson's disease dementia (PDD).


Near-Silent and Distortion-Free Diffusion MRI in Pediatric Musculoskeletal Disorders: Comparison With Echo Planar Imaging Diffusion.
Diffusion-weighted imaging (DWI) is common for evaluating pediatric musculoskeletal lesions, but suffers from geometric distortion and intense acoustic noise. To investigate the performance of a near-silent and distortion-free DWI sequence (DW-SD) relative to standard echo-planar DWI (DW-EPI) in pediatric extremity MRI. Prospective validation study. Thirty-nine children referred for extremity MRI. DW-EPI and DW-SD, based on a rotating ultrafast sequence modified with sinusoidal diffusion preparation gradients, at 3T. DW-SD image quality (Sanat ) was assessed from 0 (nondiagnostic) to 5 (outstanding) and comparative image quality (Scomp ) (from -2 = DW-EPI more delineated to +2 = DW-SD more delineated, 0 = same). ADC measured by DW-SD and DW-EPI were compared in bone marrow, muscle, and lesions. Wilcoxon rank-sum test and confidence interval of proportions (CIOP) were calculated for Scomp , Student's t-test, coefficient of variation (COV), and Bland-Altman analysis for ADC values, and intraclass correlation coefficient (ICC) for interreader agreement. DW-SD and DW-EPI ADC values for bone marrow, muscle, and lesions were not significantly different (P = 0.3, P = 0.2, and P = 0.27, respectively) and had an overall ADC COV of 14.8% (95% confidence interval: 12.3%, 16.9%) and no significant proportional bias on Bland-Altman analysis. Sanat CIOP was rated diagnostic or better (score of 3, 4, or 5) in 72-98% of cases for bone marrow, muscle, and soft tissues. DW-SD was equivalent to or preferred over DW-EPI in muscles and soft tissues, with CIOP 86-93% and 93%, respectively. Lesions were equally visualized on DW-SD and DW-EPI in 40-51%, with DW-SD preferred in 44-56% of cases. DW-SD was rated significantly better than DW-EPI across all comparative variables that included bone marrow, muscle, soft tissue, cartilage, and lesions (P < 0.05). Readers had moderate to near-perfect (ICC range = 0.45-0.85). DW-SD of the extremities provided similar ADC values and improved image quality compared with conventional DW-EPI. Level of Evidence 2 Technical Efficacy Stage 2 J. MAGN. RESON. IMAGING 2021;53:504-513.


Phagosome neutrality in host defense.
Activation of proteases in the phagosomes of neutrophils occurs by neutralization of the phagosomal pH by NADPH oxidase. In this issue, Savina et al. (2006) show that dendritic cell phagosomes also recruit NADPH oxidase but with different results. Here, the neutralization of phagosomal pH reduces protease activity, which preserves antigens for crosspresentation on class I MHC molecules.


Prognostic impact of TP53 mutation in newly diagnosed diffuse large B-cell lymphoma patients treated in the FIL-DLCL04 trial.
The prognostic role of TP53 disruption has been established in diffuse large B-cell lymphoma (DLBCL). Aim of this analysis was to correlate TP53 mutations by Sanger sequencing, cell of origin (COO) profile by Lymph2Cx panel on the NanoString platform and MYC, BCL2 and BCL6 overexpression or re-arrangements by immunohistochemistry (IHC) and fluorescent in-situ hybridization (FISH), with outcome in DLBCL patients enrolled into the FIL-DLCL04 trial (NCT00499018). One hundred and twenty-five DLBCL patients with tumour block available were analyzed. TP53 was mutated in 11/125 (9%) cases; 60/125 patients received high-dose chemoimmunotherapy up-front, as for the randomization arm; COO was reported in 88 patients: 48 germinal centre B-cell like, 25 activated B-cell like and 17 unclassified; 26 patients were double expressors in IHC and 11 double hit in FISH. After a median follow-up of 72 months, five-year failure-free survival (FFS) for TP53 mutated versus wild-type was 24% and 72%, and five-year overall survival (OS) was 34% and 83%, respectively. Adjusted hazard ratio (HR) was 2·28 [95% confidence interval (CI) 0·89-5·86, p = 0·086] and 4·05 (95% CI 1·37-11·97, p = 0·011) for FFS and OS, respectively. In this series of young DLBCL patients, TP53 gene mutation identified a poor prognosis subgroup, regardless of treatment and other biological markers.


Rotator Cuff Anterior Cable Reconstruction With Long Head of Biceps Tendon Autograft.
Rotator cuff tears with anterior cable disruption show a more detrimental natural history than tears with an intact cable. Anterior cable reconstruction in the setting of such tears provides a potential avenue to improve tissue quality of the repaired construct and enhance repair longevity. Cadaveric studies investigating anterior cable reconstruction have shown biomechanical advantages. We present an arthroscopic surgical technique for rotator cuff anterior cable reconstruction using long head of the biceps tendon autograft in the setting of repairable large-to-massive rotator cuff tears with poor anterior cable tissue quality.


Assessing Syrian women's knowledge of breast cancer risk factors, warning signs, and barriers to preventive measures: A cross-sectional study.
This study aims to investigate the knowledge of Syrian women about breast cancer risk factors, warning signals, and barriers. Breast cancer is the most common cancer worldwide and the leading cause of cancer death among women. It develops when cells in the breast tissue grow uncontrollably, forming a tumor that can spread to other parts of the body. This survey was conducted online from September 3 to September 27, 2022, and focused on Syrian women over the age of 18. It was divided into two sections, one focusing on sociodemographic characteristics and the other on breast cancer risk factors, warning signals, and barriers. This study found that the majority of the 1305 participants had inadequate knowledge of breast cancer risk factors, warning signs, and barriers. Those with higher levels of education, such as Ph.D. students, had the highest overall scores. The sample was mostly made up of housewives, married women, and women with moderate monthly incomes. This research found that Syrian women have inadequate knowledge about breast cancer, including risk factors, warning signs, and barriers. To reduce mortality rates, increase survival rates, and improve early diagnosis, local health organizations should provide awareness courses to emphasize the importance of annual breast exams.


Temperature dependence of di-2-ethylhexyl phthalate (DEHP) pharmacokinetics in rainbow trout.
Rainbow trout (Salmo gairdneri) acclimated at 6, 12, or 18 degrees C received 400 micrograms [14C]DEHP/kg as an intraaortic bolus. DEHP disappeared rapidly from plasma, with an estimated 50% of the dose eliminated after 5 hr. Plasma concentration-time data were analyzed using a three-compartment model and by the statistical moment method; both analyses yielded similar parameter estimates. The apparent steady-state volume of distribution (Vss) and the apparent volume of the deep peripheral compartment (V3) increased exponentially with increasing temperature (log V proportional to temperature) while the volumes of the central (V1) and shallow peripheral (V2) compartments were not systematically affected. The total body clearance of DEHP increased linearly with increasing temperature, while the capacity to hold DEHP increased more rapidly, resulting in the biological persistence and potential for bioaccumulation of DEHP to increase with increased temperature. Both the terminal elimination half-life and the mean residence time increased exponentially with increasing temperature; the half-life increased from 79.5 to 130 hr between 6 and 18 degrees C. Simulations with the model indicated that the distribution of DEHP was temperature sensitive; this finding may have important implications for the temperature sensitivity of DEHP toxicity or carcinogenicity.


Hepatitis B virus infection in adolescents in a rural township--15 years subsequent to mass hepatitis B vaccination in Taiwan.
In Taiwan, decrease of both infection and carrier rates of hepatitis B virus (HBV) have been documented especially in metropolitan areas after universal HBV vaccination. This study investigated HBV infection status in a rural township 15 years after the program began. Three cross-sectional studies were conducted in 1999, 2000 and 2003, to recruit all the students of the only junior middle school, born from July 1984 to June 1991, in a township in central Taiwan. Serum samples were tested for HBsAg, anti-HBs and anti-HBc. Subjects identified to be neither positive for HBsAg nor anti-HBs were given a booster dose of HBV vaccine. Subjects lacking an anamnestic anti-HBs response were given a complete 3-dose vaccination. A total of 1454 (98.5%) students responded. The prevalence rate of HBsAg decreased 57% [from 12.5% in 1984 to 5.4% in 1991, P < 0.005 (chi2-test for linear trends)], and anti-HBc positive rate dropped 68% (from 31.9 to 10.2%, P < 0.001). An anamnestic anti-HBs response developed after a vaccine booster among 433 (72%) anti-HBs negative and 12 (66.7%) anti-HBc alone subjects. And 93 (94.9%) anti-HBs negative and 1 (16.7%) anti-HBc alone subject developed a primary anti-HBs response after catch-up vaccination. Viremia was detected for two anti-HBc alone subjects without anamnestic or primary response. The vaccination program has decreased the number of those infected and carrier rates in either urban or rural areas in Taiwan. However, the prevalence of HBsAg and anti-HBc in rural area were much higher than urban area.


Presentation of a double myelomeningocele in the upper thoracic and thoracolumbar spine: A case report.
Double myelomeningocele are rare pathologies, with multiple cases described in developing countries. Causative factors are multifactorial, with folate deficiency as a leading associated factor. We describe a case of double myelomeningocele in the upper thoracic and thoracolumbar spine associated with split cord malformation, with emphasis on imaging appearance of this case. This is a full-term newborn baby boy delivered through a cesarean section due to an antenatal diagnosis of multiple myelomeningoceles in the upper thoracic and thoracolumbar spine. The baby was operated 24 h after delivery to repair the defects and insert a ventriculoperitoneal (VP) shunt for associated hydrocephalus. The baby tolerated the operation well and is being followed and managed by a multi-disciplinary team. Antenatal screening for myelomeningocele is paramount for prompt management. Multiple myelomeningoceles are uncommon, yet their management remains similar to single myelomeningocele.


Cellular localization of prolactin-releasing peptide receptors in the human pituitary.
The recently identified prolactin (PRL)-releasing peptide (PrRP) is the first hypothalamic peptide hormone found to operate as a ligand of an orphan receptor that specifically stimulates PRL production from the pituitary gland. However, its other biological functions remain unknown. Using immunohistochemistry, we examined the distribution of the PrRP receptor in various human tissues, as well as the precise localization of the PrRP receptor in the human normal pituitary. Among various tissues examined, PrRP receptor-immunopositive cells were detected only in the pituitary gland. A double immunohistochemical procedure was used to examine PrRP receptor-positive cells from ten normal human pituitary glands, and it was determined that numerous PrRP receptor-positive cells are also positive for adrenocorticotropic hormone (ACTH) but negative for PRL. Growth hormone-, beta-thyroid-stimulating hormone-, beta-follicle-stimulating hormone-, beta-luteinizing hormone- or alpha-subunit-positive cells did not test positive for the presence of PrRP receptors. Thus, we suggest that PrRP receptor and probably PrRP may play a regulatory role in ACTH secretion, rather than in the release of PRL from the human anterior pituitary. This is the first report to demonstrate colocalization of the PrRP receptor and ACTH by immunohistochemistry.


Escaping herbivory: ocean warming as a refuge for primary producers where consumer metabolism and consumption cannot pursue.
Ocean warming is anticipated to strengthen the persistence of turf-forming habitat, yet the concomitant elevation of grazer metabolic rates may accelerate per capita rates of consumption to counter turf predominance. Whilst this possibility of strong top-down control is supported by the metabolic theory of ecology (MTE), it assumes that consumer metabolism and consumption keep pace with increasing production. This assumption was tested by quantifying the metabolic rates of turfs and herbivorous gastropods under a series of elevated temperatures in which the ensuing production and consumption were observed. We discovered that as temperature increases towards near-future levels (year 2100), consumption rates of gastropods peak earlier than the rate of growth of producers. Hence, turfs have greater capacity to persist under near-future temperatures than the capacity for herbivores to counter their growth. These results suggest that whilst MTE predicts stronger top-down control, understanding whether consumer-producer responses are synchronous is key to assessing the future strength of top-down control.


Profiling of immune responses by lactate modulation in cervical cancer reveals key features driving clinical outcome.
Cervical cancer is still an important problem perplexing health management in developing countries. Previous studies have shown that cervical cancer cells show markers of aerobic glycolysis, suggesting that these tumors may secrete lactic acid. Through the biological characterization of lactate gene in tumor and its relationship with immune cells in tumor microenvironment, a lactate scoring system capable of evaluating cancer prognosis was constructed to explore the molecular mechanism of lactate metabolism disorder affecting prognosis. 29 hub genes in this study were differentially expressed in cervical cancer, including 24 genes related to lactate metabolism, LDHA in Lactate dehydrogenase (LDH) group, SLC16A3 in Monocarboxylate transporters (MCT) group and three Histone lactation modification related genes (EP300, ACAT1, ACACA). More importantly, we found that from an epigenetic point of view, histone lactation plays an important role in the pathogenesis and prognosis of cervical cancer. Mainly affect the prognosis of the disease through changes in the infiltration of plasmacytoid Dendritic Cell (pDC) and Central Memory T cell (Tcm) in the tumor immune microenvironment. Lactate inhibition may be a useful tool for anticancer therapy.


Potentiation of the uterus-relaxing effects of β-adrenergic agonists with nifedipine: studies on rats and the human myometrium.
We investigated how progesterone and salmeterol modify the effect of nifedipine in an in vivo preterm birth model in rats, and how terbutaline and nifedipine modify the contractions of the isolated human myometrium. Experimental animal and human myometrial studies. Twenty-four female Sprague-Dawley rats and 13 human uterine tissues sampled from cesarean section. Preterm birth was induced in Sprague-Dawley rats with a combination of mifepristone and prostaglandin-E(2). The animals were treated with nifedipine or its combination with salmeterol and progesterone. Additionally, isolated human myometrial strips from cesarean sections were stimulated with oxytocin, and the inhibitory effects of nifedipine and terbutaline were studied. Nifedipine delayed the preterm delivery in the rats, but its effect was tripled by the addition of β(2)-mimetics, or abolished after progesterone pretreatment. Synergism was observed in the relaxing effects of nifedipine and terbutaline on the isolated human myometrium. The action of nifedipine in delaying labor is impeded by progesterone. A combination of nifedipine and β(2)-agonists should be considered for the treatment or prevention of preterm birth.


The effectiveness and health-economic evaluation of "Partner in Balance," a blended self-management program for early-stage dementia caregivers: study protocol for a cluster-randomized controlled trial.
Informal caregivers of people with dementia are crucial in dementia care. However, they are insufficiently supported and report caregiver burdens, which urges the need for cost-effective interventions aimed at supporting caregivers. This paper presents the design of a study evaluating the effectiveness, cost-effectiveness, and cost-utility of a blended self-management program for early-stage dementia caregivers. A pragmatic, cluster randomized controlled trial with a shared control group will be conducted. Participants will be informal caregivers of people with early-stage dementia and will be recruited by local care professionals. Randomization will be carried out at the level of the care professional level in a ratio of 35% to 65% (control arm vs. intervention arm). Participants in the control arm will receive care as usual and the intervention arm will receive the blended care self-management program "Partner in Balance" within a usual care setting in the Netherlands. Data will be collected at baseline and at 3-, 6-, 12-, and 24-month follow-ups. The primary outcome for effectiveness (part 1) is care management self-efficacy. For the health-economic evaluation (part 2) total care costs and the quality of life for individuals with dementia (cost-effectiveness) and quality-adjusted life years (cost-utility) will be the base case analysis. Secondary outcomes (parts 1 and 2) will include depression, anxiety, perceived informal caregiving stress, service-use self-efficacy, quality of life, caregivers' gain, and perseverance time. A process evaluation (part 3) will investigate the internal and external validity of the intervention. In this trial, we plan to evaluate the effectiveness, cost-effectiveness, and cost-utility of "Partner in Balance" among informal caregivers of people with dementia. We expect to find a significant increase in care management self-efficacy, and the program to be cost-effective, and provide valuable insights to stakeholders of "Partner in Balance." ClinicalTrials.gov, NCT05450146. Registered on 4 November 2022.


Pancreatic amylase- and protein-concentrations associated with thioacetamide-induced cirrhosis of the liver in rats.
In cirrhosis of the liver induced in rats by administration of thioacetamide for 8 months, pancreatic amylase and protein concentration and the number of zymogen granules were found to exceed those of the controls. The finding is attributed to a deficient metabolism of enterohormones. The model seems to provide a suitable approach to the study of the hypersecretory state of the pancreas associated with cirrhosis of the liver.


Procalcitonin is useful whereas C-reactive protein is not, to predict complications following coronary artery bypass surgery.
The respective value of procalcitonin (PCT) and C-reactive protein (CRP) as markers of postoperative complications after coronary bypass surgery is unclear. Therefore, complications during one week after surgery were studied to evaluate the predictive role of PCT and CRP changes during the immediate postoperative period. Thirty-two patients, in whom an uneventful immediate postoperative course was anticipated, were prospectively enrolled and followed-up to the 7th postoperative day. At the end of the follow-up, patients were divided into two groups. Group A were patients with an uncomplicated postoperative course and Group B were patients with a complicated postoperative course. Serum samples were drawn for PCT and CRP determination after induction of anesthesia (baseline), at the end of surgery and daily until postoperative day 2. Baseline serum PCT concentrations were 0.11 +/- 0.09 and 0.20 +/- 0.21 ng/mL in Groups A and B, respectively (NS). Serum PCT concentration increased compared with baseline in both groups during the first two days after surgery. The increase in serum PCT concentration was significantly greater in Group B than A patients (p < 0.0002). Considering a perioperative abnormal cut-off value of >0.5 ng/mL, there were none in Group A versus 57% in Group B (p < 0.0001). Baseline serum CRP concentrations were 1.44 +/- 1.30 and 1.58 +/- 1.35 ng/mL in Groups A and B, respectively (NS). After surgery, CRP increased significantly compared with baseline in both groups. When changes in time-varying variables were included in a logistic model, complications were predicted by changes (between baseline and end of surgery values) of PCT (coefficient = 9.410; t = 2.18) and heart rate (coefficient = 0.075; t = 1.57), whereas changes of CRP, white blood cells, mean blood and central venous pressures did not contribute statistically. The model constant was -4.827 (t = -2.43) and the ROC curve area was 0.8971. Thus, absolute PCT changes of 0.20, 0.40 and 0.60 ng/mL carry an approximate risk of 5, 26 and 69%, respectively, of postoperative complications in the time frame of this study. A postoperative serum PCT concentration of >0.5 ng/mL is highly suggestive of a postoperative complication. CRP changes do not contribute to predictive information.


Epidemiology of HIV infection in central Brazil: data from voluntary counseling and testing centers.
Voluntary counseling and testing (VCT) is recommended to facilitate early identification of HIV infection. Data from VCT centers in Goiás and Federal District, Central Brazil, evaluated HIV prevalence and identified risk factors for HIV among individuals ages 13 years and older. Results indicated a 1.5% overall prevalence of HIV. Factors independently associated with HIV infection were: getting tested in a large city, being illiterate, having had a previous HIV test, living with an HIV-infected sexual partner, and being a noninjection illicit drug user. Being referred by friends was strongly associated with HIV infection. For men, being a health care worker, sex worker, man who has sex with men, or injection drug user were significant. In Central Brazil, HIV remains concentrated in males and subpopulations with known risk behaviors. Higher prevalence among individuals referred to VCT by friends highlights the importance of social network-based HIV prevention interventions in Brazil.


Investigations for anthelmintic resistance in gastrointestinal nematodes from goats.
Field results from a commercial goat herd, based on egg counts and larval differentiation, suggested that anthelmintic resistance was present to albendazole, fenbendazole, levamisole, morantel, naphthalophos and phenothiazine. When the isolate was tested in sheep, using levamisole or oxfendazole, a possible resistance was shown for Trichostrongylus sp but no resistance was demonstrated in Haemonchus or Ostertagia spp. Ivermectin at a dose rate of 100 micrograms/kg was more than 98 per cent efficient in removing the adults of each of the three species of nematode. The phenomenon relating to the influence of the host on anthelmintic resistance is discussed.