Human cardiac transplantation--evaluation of morphological changes in serial endomyocardial biopsies.
From May 1981 through July 1984 a total of 29 human allogenic orthotopic cardiac transplants were performed in Munich. The first two patients initially received conventional immunosuppressive treatment for 79 and 27 days, respectively; then treatment was continued with cyclosporine. All subsequent 27 patients received only cyclosporine treatment. Seventeen of the cardiac recipients are currently alive. Three of the recipients who died succumbed to immunological rejection. Twenty-five cardiac grafts were controlled by 355 sequential biopsy procedures, which yielded 1158 endomyocardial specimens for histological examination. The morphological findings and changes observed in the endomyocardium were analyzed. The interpretation of these findings and difficulties encountered in their interpretation are discussed. Special attention is attributed to findings possibly associated with the cyclosporine treatment.


Pure red-cell aplasia and antierythropoietin antibodies in patients treated with recombinant erythropoietin.
Within a period of three years, we identified 13 patients in whom pure red-cell aplasia developed during treatment with recombinant human erythropoietin (epoetin). We investigated whether there was an immunologic basis for the anemia in these patients. Serum samples from the 13 patients with pure red-cell aplasia were tested for neutralizing antibodies that could inhibit erythroid-colony formation by normal bone marrow cells in vitro. The presence of antierythropoietin antibodies was identified by means of binding assays with the use of radiolabeled intact, deglycosylated, or denatured epoetin. Serum from all 13 patients blocked the formation of erythroid colonies by normal bone marrow cells. The inhibition was reversed by epoetin. Antibodies from 12 of the 13 patients bound only conformational epitopes in the protein moiety of epoetin; serum from the remaining patient bound to both conformational and linear epitopes in erythropoietin. In all the patients, the antibody titer slowly decreased after the discontinuation of treatment with epoetin. Neutralizing antierythropoietin antibodies and pure red-cell aplasia can develop in patients with the anemia of chronic renal failure during treatment with epoetin.


Radiated Sound of a High-Speed Water-Jet-Propelled Transportation Vessel.
The radiated noise from a high-speed water-jet-propelled catamaran was measured for catamaran speeds of 12, 24, and 37 kn. The radiated noise increased with catamaran speed, although the shape of the noise spectrum was similar for all speeds and measuring hydrophone depth. The spectra peaked at ~200 Hz and dropped off continuously at higher frequencies. The radiated noise was 10-20 dB lower than noise from propeller-driven ships at comparable speeds. The combination of low radiated noise and high speed could be a factor in the detection and avoidance of water-jet-propelled ships by baleen whales.


Simultaneous bioelectricity generation and water desalination using Oscillatoria sp. as biocatalyst in photosynthetic microbial desalination cell.
Globally, the scarcity of drinking water has triggered the researchers towards the development of desalination techniques to turn up saline water into potable. Microbial Desalination Cell (MDC) is a novel green technology that shows potential approach for desalination along with electricity generation and wastewater treatment. However, the expensive catholyte/catalyst in the cathode side has limited the MDC for real time application. Hence, the main objective of this work was to investigate the electricity generation during dairy wastewater treatment and desalination efficiency using biocathode (Oscillatoria sp.) in the MDC. The results showed that the maximum open circuit voltage of 652 ± 10 mV, COD removal efficiency of 80.2 ± 0.5% and desalination efficiency of 65.8 ± 0.5%, were achieved respectively. The effect of saline water concentration was investigated and the performance of MDC was compared with real (sea) water. This study demonstrated that Oscillatoria sp. could be used as a potential biocatalyst in the cathode chamber for enhancing salinity removal along with electricity generation and wastewater treatment in the MDC.


Using Intravital Microscopy to Study the Role of MIF in Leukocyte Trafficking In Vivo.
In vivo visualization of the microvasculature of the mouse cremaster muscle has been fruitful in the evaluation of the role of macrophage migration inhibitory factor in promotion of leukocyte trafficking. Here we explain how to undertake this preparation, including details on mouse anesthesia, securing intravenous access, and cremaster muscle exteriorization. We also provide information on the various microscopy modalities now available for imaging microvascular preparations of this nature.


Combined effects of fasting and vinblastine treatment on serum insulin level, the size of autophagic-lysosomal compartment, protein content and lysosomal enzyme activities of liver and exocrine pancreatic cells of the mouse.
1. The volume fraction of autophagic vacuoles in liver parenchymal and exocrine pancreatic cells was smallest and the serum insulin level highest in the 24 hr prestarved mouse immediately after 3 hr feeding period. 2. The size of the autophagic vacuole and lysosome (dense body) compartments increased in both types of cells during 2-72 hr fasting parallel with decreasing serum insulin levels. 3. The protein content of the cells decreased and the DNA-based activity of acid phosphatase showed little change throughout fasting. The activity of cathepsin D increased during days 2 and 3 of food deprivation. 4. Vinblastine (50 mg/kg body wt) applied for the last 2 hr of different periods (2, 12, 24, 48 and 72 hr) of fasting decreased serum insulin level and increased the fractional cytoplasmic volume of autophagic vacuoles and dense bodies. This increase was smaller when the drug was applied shortly after feeding and much larger after prolonged fasting. The increase was more pronounced in the pancreatic than in the liver cells. 5. Our data show that the effect of vinblastine on the size of the autophagic-lysosomal compartment depends on the feeding status of the animals.


Panorama of biogenic nano-fertilizers: A road to sustainable agriculture.
The ever-increasing demand for food from the growing population has augmented the consumption of fertilizers in global agricultural practices. However, the excessive usage of chemical fertilizers with poor efficacy is drastically deteriorating ecosystem health through the degradation of soil fertility by diminishing soil microflora, environment contamination, and human health by inducing chemical remnants to the food chain. These challenges have been addressed by the integration of nanotechnological and biotechnological approaches resulting in nano-enabled biogenic fertilizers (NBF), which have revolutionized agriculture sector and food production. This review critically details the state-of-the-art NBF production, types, and mechanism involved in cultivating crop productivity/quality with insights into genetic, physiological, morphological, microbiological, and physiochemical attributes. Besides, it explores the associated challenges and future routes to promote the adoption of NBF for intelligent and sustainable agriculture. Furthermore, diverse applications of nanotechnology in precision agriculture including plant biosensors and its impact on agribusiness and environmental management are discussed.


Water extraction from SAR images based on improved geodesic active contour.
The rapid and accurate acquisition of water body information is of great significance to water resource investigation, flood disaster monitoring, ecological environment protection, and other fields. In this paper, the water boundary is optimized and extracted from single-polarization SAR images based on an improved geodesic active contour model (IMGAC). Firstly, the rough extraction results of the water body were obtained according to the adaptive threshold, and then a narrowband model was established, and the signed pressure force (SPF) function was introduced into the geodesic active contour (GAC) model. Finally, the optimal water boundary was obtained through continuous iteration. Compared with the active contour (AC) model without edge and the traditional GAC model, the results show that the IMGAC model proposed in this paper can reduce the calculation efficiency and improve the accuracy of water boundary detection. The F-measure index was used to evaluate the extraction accuracy of the three methods. IMGAC method had the highest extraction accuracy, which was 96.43%. The kappa coefficient reached 0.929. The F-measure index was 96.20%. Our study can provide a reference for water extraction and water boundary optimization.


Intensity of commonly-reported classroom-based physical activity opportunities in public schools.
The purpose of this study was to examine the intensity levels of PA opportunities offered in public school classrooms. Schools (N = 101) in school districts (N = 25) reported PA opportunities offered in classrooms using an online data collection tool over a two-year period (2014-2016). Using a randomized sampling technique, 20-30% of teachers in each school were selected each week to report PA in their classroom. These responses resulted in N = 18,210 usable responses. A researcher determined the intensity of PA opportunities using the 2011 Compendium of Physical Activities as a guideline; two additional researchers confirmed the coded categories. A descriptive analysis of PA opportunities was conducted to describe the proportion of opportunities whose intensity levels were light (LPA), moderate (MPA), vigorous (VPA), sedentary (SED), and those of unknown intensity. Chi-square analyses were utilized to examine differences between proportions of intensity levels offered by semester. Kruskal-Wallace tests were utilized to examine differences in proportion of physical activity opportunity intensity offered by grade level. Most PA opportunities were MPA (58.7%), followed by VPA (17.6%) and LPA (11.5%). Few responses were SED (0.5%), and 11.6% were of indeterminate intensity. A greater proportion of more physically intense activities reported during the fall versus spring semesters (p < 0.0001). Differences in the intensity levels of PA offered by grade also differed, with a trend of decreasing intensity as grade level increased (p < 0.0001). This study provides insight into the PA actually occurring in classrooms; a previously underexplored construct of school-based PA.


Is heart failure with midrange ejection fraction similar to preserved ejection fraction? For.
Basing heart failure (HF) classification on the echocardiographic values of left ventricular ejection fraction (LVEF) has been useful in defining two sub-types of HF: HF with reduced LVEF and HF with preserved LVEF. A new category has recently been defined: HF with midrange LVEF (40-49%). When current information is taken into account, this new category is more similar to HF with preserved LVEF than reduced LVEF.


Menin Maintains Cholesterol Content in Colorectal Cancer via Repression of LXR-Mediated Transcription.
Menin is a nuclear scaffold protein that regulates gene transcription in an oftentimes tissue-specific manner. Our previous work showed that menin is over-expressed in colorectal cancer (CRC); however, the full spectrum of menin function in colonic neoplasia remains unclear. Herein, we aimed to uncover novel menin-regulated pathways important for colorectal carcinogenesis. RNA-Seq analysis identified that menin regulates LXR-target gene expressions in CRC cell lines. Isolated colonic epithelium from Men1f/f;Vil1-Cre and Men1f/f mice was used to validate the results in vivo. Cholesterol content was quantified via an enzymatic assay. RNA-Seq analysis in the HT-29 CRC cell line identified that menin inhibition upregulated LXR-target genes, specifically ABCG1 and ABCA1, with protein products that promote cellular cholesterol efflux. Similar results were noted across other CRC cell lines and with different methods of menin inhibition. Consistent with ABCG1 and ABCA1 upregulation, and similarly to LXR agonists, menin inhibition reduced the total cellular cholesterol in both HT-29 and HCT-15 cells. To confirm the effects of menin inhibition in vivo, we assessed Men1f/f;Vil1-Cre mice lacking menin expression in the colonic epithelium. Men1f/f;Vil1-Cre mice were found to have no distinct baseline phenotype compared to control Men1f/f mice. However, similarly to CRC cell lines, Men1f/f;Vil1-Cre mice showed an upregulation of Abcg1 and a reduction in total cellular cholesterol. Promoting cholesterol efflux, either via menin inhibition or LXR activation, was found to synergistically suppress CRC cell growth under cholesterol-depleted conditions and when administered concomitantly with small molecule EGFR inhibitors. Menin represses the transcription of LXR-target genes, including ABCA1 and ABCG1 in the colonic epithelium and CRC. Menin inhibition conversely upregulates LXR-target genes and reduces total cellular cholesterol, demonstrating that menin inhibition may be an important mechanism for targeting cholesterol-dependent pathways in colorectal carcinogenesis.


Solid immersion microscopy images cells under cryogenic conditions with 12 nm resolution.
Super-resolution fluorescence microscopy plays a crucial role in our understanding of cell structure and function by reporting cellular ultrastructure with 20-30 nm resolution. However, this resolution is insufficient to image macro-molecular machinery at work. A path to improve resolution is to image under cryogenic conditions. This substantially increases the brightness of most fluorophores and preserves native ultrastructure much better than chemical fixation. Cryogenic conditions are, however, underutilised because of the lack of compatible high numerical aperture objectives. Here, using a low-cost super-hemispherical solid immersion lens (superSIL) and a basic set-up we achieve 12 nm resolution under cryogenic conditions, to our knowledge the best yet attained in cells using simple set-ups and/or commercial systems. By also allowing multicolour imaging, and by paving the way to total-internal-reflection fluorescence imaging of mammalian cells under cryogenic conditions, superSIL microscopy opens a straightforward route to achieve unmatched resolution on bacterial and mammalian cell samples.


Designing iron carbide embedded isolated boron (B) and nitrogen (N) atoms co-doped porous carbon fibers networks with tiny amount of BN bonds as high-efficiency oxygen reduction reaction catalysts.
In this paper, polyvinylpyrrolidone (PVP) and 4-hydroxybenzeneboronic acid (o-HPBA) are polarized in alkaline solution and then employed as boron (B) and nitrogen (N) sources. Fe(AC)2/o-HPBA/PVP/DMF(N,N-Dimethylformamide) slurries are first electrospunned into three-dimensional (3D) networks. Due to the electrostatic repulsion between negatively charged O- groups surrounding N and B atoms, N and B atoms can be kept far away from each other. Upon optimizing o-HPBA dosages, the maximum amount of isolated B and N atoms are successfully doped into the 3D porous iron carbide (Fe3C) embedded B and N co-doped carbon fibers (firstname.lastname@example.com) networks with tiny BN clusters. Electrochemical measure results demonstrate that email@example.com exhibit much better oxygen reduction reaction (ORR) activity than 20 wt% Pt/C in alkaline electrolyte. In acidic electrolyte, firstname.lastname@example.com also displays ORR activity comparable to Pt/C (its onset and half-wave potentials are just 40 and 50 mV more negative than those of Pt/C). Moreover, firstname.lastname@example.com show better stability and methanol tolerance ability than Pt/C for ORR in both alkaline and acidic solutions. This work opens new avenues for intentionally preventing the malignant combination of B and N atoms and boosting the electrocatalytic activity of B and N co-doped and Fe3C embedded carbon catalysts.


[Parametric identification of mathematical models of population genetics taking into account the geographical dispersion in finite samples].
A method for parameter identification of population genetics' mathematical models, taking account of geographical disperse at limited samples of experimental data on mutant frequency values has been developed. The existence of the MLS (method of the least squares) estimations of the models' parameters studied has been proved, zero approach of the looked for estimations found and the iterative procedure of making them precise shown. A means of building up the a posteriori function of probability density of the zero and following approximations of the models' parameters is pointed out. The possibility of application of the proposed method to find estimations of mathematical models' parameters of population genetics, taking account of geographical disperse, has been shown on the particular example.


The presence of Tetranychus urticae (Acari: Tetranychidae) and its predators on plants in the ground cover in commercially treated vineyards.
The presence of Tetranychus urticae and its predators on plants in the ground cover in commercially treated vineyards in the Hex River Valley, Western Cape Province, South Africa was investigated. Six Barlinka and six Dauphine vineyards were surveyed. Leaf samples from the plants on the vineyard floor were taken at monthly intervals and microscopically examined for spider mites and their predators. The coverage of the plants was determined using a co-ordinate sampling system. A wide variety of plant species was found on the vineyard floor. Most of the spider mites found on these plants were T. urticae. The phytoseiid mites on the plants were Euseius rubicolus, Neoseiulus californicus and an undescribed Typhlodromus species. The presence of these plants made it possible for T. urticae and phytoseiid mites to occur throughout the year, with a similar pattern in their seasonal activity on the vineyard floor and the vine leaves.


Reliability and construct validity of the Spanish version of the 6-item CTS symptoms scale for outcomes assessment in carpal tunnel syndrome.
The purpose of this study was to assess the reliability and construct validity of the Spanish version of the 6-item carpal tunnel syndrome (CTS) symptoms scale (CTS-6). In this cross-sectional study 40 patients diagnosed with CTS based on clinical and neurophysiologic criteria, completed the standard Spanish versions of the CTS-6 and the disabilities of the arm, shoulder and hand (QuickDASH) scales on two occasions with a 1-week interval. Internal-consistency reliability was assessed with the Cronbach alpha coefficient and test-retest reliability with the intraclass correlation coefficient, two way random effect model and absolute agreement definition (ICC2,1). Cross-sectional precision was analyzed with the Standard Error of the Measurement (SEM). Longitudinal precision for test-retest reliability coefficient was assessed with the Standard Error of the Measurement difference (SEMdiff) and the Minimal Detectable Change at 95 % confidence level (MDC95). For assessing construct validity it was hypothesized that the CTS-6 would have a strong positive correlation with the QuickDASH, analyzed with the Pearson correlation coefficient (r). The standard Spanish version of the CTS-6 presented a Cronbach alpha of 0.81 with a SEM of 0.3. Test-retest reliability showed an ICC of 0.85 with a SRMdiff of 0.36 and a MDC95 of 0.7. The correlation between CTS-6 and the QuickDASH was concordant with the a priori formulated construct hypothesis (r 0.69) CONCLUSIONS: The standard Spanish version of the 6-item CTS symptoms scale showed good internal consistency, test-retest reliability and construct validity for outcomes assessment in CTS. The CTS-6 will be useful to clinicians and researchers in Spanish speaking parts of the world. The use of standardized outcome measures across countries also will facilitate comparison of research results in carpal tunnel syndrome.


Midbrain reticular influences upon single neurons in lateral geniculate nucleus.
The effect of electrical stimulation of the midbrain reticular formation upon patterns of discharge of single lateral geniculate neurons was studied. Data were processed by means of a 256-channel scaler analyzer. The rate of spontaneous discharge of geniculate neurons was raised by electrical stimulation of the reticular formation and their ability to respond to intermittent light was enhanced.


Whole genome sequencing data for two individuals of Pakistani descent.
Here we report next-generation based whole genome sequencing of two individuals (H1 and H2) from a family of Pakistani descent. The genomic DNA was used to prepare paired-end libraries for whole-genome sequencing. Deep sequencing yielded 706.49 and 778.12 million mapped reads corresponding to 70.64 and 77.81 Gb sequence data and 23× and 25× average coverage for H1 and H2, respectively. Notably, a total of 448,544 and 470,683 novel variants, not present in the single nucleotide polymorphism database (dbSNP), were identified in H1 and H2, respectively. Comparative analysis identified 2,415,852 variants common in both genomes including 240,181 variants absent in the dbSNP. Principal component analysis linked the ancestry of both genomes with South Asian populations. In conclusion, we report whole genome sequences of two individuals from a family of Pakistani descent.


Ghrelin accelerates wound healing through GHS-R1a-mediated MAPK-NF-κB/GR signaling pathways in combined radiation and burn injury in rats.
The therapeutic effect of ghrelin on wound healing was assessed using a rat model of combined radiation and burn injury (CRBI). Rat ghrelin, anti-rat tumor necrosis factor (TNF) α polyclonal antibody (PcAb), or selective antagonists of p38 mitogen-activated protein kinase (MAPK), c-Jun N-terminal kinase (JNK), and growth hormone secretagogue receptor (GHS-R) 1a (SB203580, SP600125, and [D-Lys3]-GHRP-6, respectively), were administered for seven consecutive days. Levels of various signaling molecules were assessed in isolated rat peritoneal macrophages. The results showed that serum ghrelin levels and levels of macrophage glucocorticoid receptor (GR) decreased, while phosphorylation of p38MAPK, JNK, and p65 nuclear factor (NF) κB increased. Ghrelin inhibited the serum induction of proinflammatory mediators, especially TNF-α, and promoted wound healing in a dose-dependent manner. Ghrelin treatment decreased phosphorylation of p38MAPK, JNK, and p65NF-κB, and increased GR levels in the presence of GHS-R1a. SB203580 or co-administration of SB203580 and SP600125 decreased TNF-α level, which may have contributed to the inactivation of p65NF-κB and increase in GR expression, as confirmed by western blotting. In conclusion, ghrelin enhances wound recovery in CRBI rats, possibly by decreasing the induction of TNF-α or other proinflammatory mediators that are involved in the regulation of GHS-R1a-mediated MAPK-NF-κB/GR signaling pathways.


Device for obtaining multiple simultaneous samples of intestinal contents during perfusion studies in man.
A system is described for obtaining frequent simultaneous samples from three jejunal sites. It can be easily made from materials ordinarily available in any laboratory.


Synthesis of Cycloalkyl Substituted 7-Azaindoles via Photoredox Nickel Dual Catalytic Cross-Coupling in Batch and Continuous Flow.
An efficient photoredox/Ni dual catalytic Csp2-Csp3 cross-coupling protocol in a continuous-flow regime to synthesize a variety of regioisomeric cycloalkyl substituted 7-azaindoles has been developed. These transformations proceed efficiently under mild conditions (blue LED light irradiation at 30 °C over 40 min residence time in mixed solvent systems). Reactions are easy to perform and afford most of the desired 2-, 3-, 4-, 5-, and 6-cycloalkyl substituted 7-azaindoles in moderate-to-good yield.


[Comparison of cancer nursing interventions recorded in nursing notes with nursing interventions perceived by nurses of an oncology unit--patients with terminal cancer].
The purposes of this study were to determine the core nursing interventions in nursing notes and the practice which was perceived by nurses of an oncology unit with patients with terminal cancer. Also, comparing interventions in nursing notes with interventions in perceived practice was done. Subjects were 44 nursing records of patients with terminal cancer who had died from Jan. to Dec. 2002 at C University Hospital and 83 nurses who were working on an oncology unit for more than one year. Data was collected using a Nursing Interventions Classification and analyzed by means of mean and t-test. The most frequent nursing intervention was 'nausea management' in the nursing note and was 'medication administration: oral' in perceived practice. The frequency of nursing interventions in the nursing record was lower than in perceived practice. This study finds that nurses actually practice nursing care, but they may omit records. To correct for omitted nursing records, development of a systematic nursing record system, continuous education and feedback is recommended.


Demonstration of axonal branching of fibres from certain precerebellar nuclei to the cerebellar cortex and nuclei: a retrograde fluorescent double-labelling study in the cat.
The projections from certain brain stem precerebellar nuclei to the cerebellar cortex and nuclei have been examined in the cat by using the retrograde fluorescent double-labelling technique. Crystalline Fluoro-Gold was implanted into the left cerebellar nuclei from the contralateral side and rhodamine-B-isothiocyanate was injected into the overlying cerebellar cortex. The inferior olive, the lateral reticular nucleus, and the reticular tegmental pontine nucleus all contained double- as well as single-labelled neurons, and it was concluded that these nuclei have a high number of neurons whose axons branch to both the cerebellar cortex and nuclei. The neurons in the paramedian reticular nucleus and the pontine nuclei proper appear to project only to the cerebellar cortex.


Reduced-Dimension Modeling Approach for Simulating Recruitment/De-recruitment Dynamics in the Lung.
Acute respiratory distress syndrome is a pulmonary disease that requires the use of mechanical ventilation for patient recovery. However, this can lead to development of ventilator-induced lung injury caused by the over-distension of alveolar tissue and by the repetitive closure (de-recruitment) and reopening (recruitment) of airways. In this study, we developed a multi-scale model of the lung from a reduced-dimension approach to investigate the dynamics of ventilation in the lung during airway collapse and reopening. The model consisted of an asymmetric network geometry with 16 generations of liquid-lined airways with airflow driven by a variable pleural pressure. During the respiratory cycle changes in airway radii and film thickness yield the formation of liquid plugs that propagate and rupture throughout the airway network. Simulations were conducted with constant surface tension values [Formula: see text] dyn/cm. It was observed that the time onset of plug creation and rupture depended on the surface tension, as well as the plug aggregation/splitting behavior at bifurcations. Additionally, the plug propagation behavior was significantly influenced by presence of plugs in adjacent airways (i.e. parent and daughters) that affected the driving pressure distribution locally at bifurcations and resulted in complex aggregation and splitting behavior. This model provides an approach that has the ability to simulate normal and pathophysiological lung conditions with the potential to be used in personalized clinical medicine.


USP6-associated neoplasm as a tentative subset of postoperative spindle cell nodule.
Postoperative spindle cell nodule (PSCN) is a pseudosarcomatous proliferative lesion of unclear molecular genetic origins. We examined seven patients with PSCN, using routine haematoxylin-eosin (H&E) slide preparations and a series of immunostains. The latter targeted keratin, vimentin, α-smooth muscle actin (SMA), anaplastic lymphoma kinase (ALK [D5F3]), and other proteins. Ubiquitin-specific peptidase 6 (USP6) and anaplastic lymphoma kinase (ALK) gene rearrangements were also analysed by fluorescence in situ hybridization (FISH). There were histories of prior surgical intervention (n = 6) or trauma (n = 1) in all seven patients. All lesions were highly cellular and mitotically active spindle cell proliferations, with no cytologic atypia, nuclear pleomorphism, or aberrant mitoses. Immunohistochemical (IHC) staining disclosed focal, weak keratin positivity in two lesions, whereas vimentin (diffuse, strongly positive) and SMA (tram-track pattern) were present in each instance, and ALK (D5F3) was entirely negative. FISH analysis confirmed USP6 gene rearrangements in all seven cases, showing no ALK gene rearrangements. RNA sequencing results showed an MYH9::USP6 gene fusion in only one lesion (No. 6). A subset of PSCN is marked by USP6 gene rearrangements, a genetic feature of nodular fasciitis (NF). Given its similarity to NF, a designation as USP6-associated neoplasm (UAN) seems reasonable, signifying a transient clonal neoplastic lesion.


Retrospective Matched Case-Control Study on the Use of CO2 Laser for the Treatment of Nonhealing Diabetic Foot Ulcers: The DULCIS-2 (Diabetic ULcer, CO2 Laser, and Infections) Study.
Infection, which is one of the possible complications of diabetic foot ulcers (DFUs), makes the treatment of ulcers challenging because of its negative impact on healing processes and the high prevalence of multiresistant germs. This study is aimed at verifying the effect of a surgical CO2 laser (which reduces the bacterial load and allows a more accurate debridement), as compared with the traditional lancets, on the healing rate of DFU. The present case-control retrospective analysis was performed on patients with chronic (>6 months) DFU with Texas grade >1, treated with 80 W surgical CO2 laser (DEKA SmartXide2 C80, El.En. Group) and compared with a matched sample of patients with similar characteristics, who were treated with a traditional surgical approach. The debridement was performed trying to achieve the complete removal of nonviable tissues. The principal endpoint was the proportion of patients healed at 6 months. All analyses were carried out with SPSS 25.0. The study protocol was approved by the local ethical committee. This study included 118 patients (59 cases and 59 controls). At 6 months, the proportion of healing patients was 35% and 18% in cases and controls, respectively (P = .034). The corresponding figure at 1 year was 62% and 38% (P = .009), whereas no difference was observed at 1, 2, and 3 months. No serious adverse event was observed. In this article, we show for the first time that CO2 laser treatment, in comparison with traditional surgical approaches, can be associated with an increased healing rate in patients with DFU.


[Is supplemental ear acupuncture for surgical tooth removal with local anesthesia effective? : A pilot study].
The application of ear acupuncture can contribute to a reduction of acute pain. Data on the application of ear acupuncture following oral surgery in odontology is insufficient. This study investigated the effectiveness of ear acupuncture as an auxiliary analgesic treatment in addition to local anesthesia for operative tooth removal. In this prospective open non-randomized pilot study (in accordance with the CONSORT publication) 2 cohorts of 50 patients each with the indications for an operative tooth removal either with or without the application of ear acupuncture in addition to local anesthesia with articain were observed. Patients were allocated to the groups according to their preference. Pain intensity while resting and while chewing was recorded as the primary parameter for a period of 10 days. The secondary parameters were the subjective experience of anxiety and symptoms, such as headaches, dizziness and nausea. The two groups did not differ significantly with respect to demographic variables or the use of local anesthetics. At the various measurement intervals, pain intensity while resting or chewing differed significantly between the two groups (ANOVA, p = 0.004, p = 0.007, respectively). Furthermore, the experience of anxiety (ANOVA, p = 0.0001), the number of patients taking analgesics (χ2-test, p = 0.017) and the total postoperative consumption of analgesics (t-test, 0.001) revealed significant differences. In both groups the numerical rating scales (NRS) for postoperative headaches, dizziness and nausea were low. Despite a potential bias and methodological limitations of the study design, the results of this investigation suggest that ear acupuncture influences the experience of pain and anxiety in the postoperative period after tooth removal. As a treatment method with low adverse effects ear acupuncture can contribute to postoperative pain control, especially in patients with preoperative anxiety.


Responsive Direct Brain Stimulation for Epilepsy.
Closed-loop, responsive focal brain stimulation provides a new treatment option for patients with refractory partial onset seizures who are not good candidates for potentially curative epilepsy surgery. The first responsive brain neurostimulator (RNS® System, NeuroPace), provides stimulation directly to the seizure focus when abnormal electrocorticographic is detected. Seizure reductions of 44% at one year increase to 60 to 66% at years 3 to 6 of treatment. There is no negative impact on cognition and mood. Risks are similar to other implanted medical devices and therapeutic stimulation is not perceived.


Changing prevalence and antibiotic drug resistance pattern of pathogens seen in community-acquired pediatric urinary tract infections at a tertiary care hospital of North India.
The aim and objective of this study was to assess the temporal changes in the microbiological profiles and antimicrobial resistance patterns of uropathogens in pediatric community-acquired UTI. This is a retrospective analysis of data collected over a Scattered period of 5 years. The baseline data collected were from January to December 2009, and the second period considered for comparison was from January to December 2014. Urine specimens from children (<17 years) suspected of UTI were cultured by a semi-quantitative method on cysteine lactose electrolyte-deficient medium. Antibiotic sensitivity was put up by Kirby-Bauer disc diffusion method as per the Clinical and Laboratory Standard Institute guidelines. In the year 2009, 340 of 2104 (16.15%) urine specimens yielded significant colony count, whereas in 2014, it was 407 of 2212 (18.39%) (P = 0.051). Escherichia coli was the predominant pathogen and was significantly more prevalent in girls than in boys (P < 0.0001) during both periods. There was a significant overall increase in resistance to ampicillin (from 40.29% to 58.72%), amoxyclav (from 26.17% to 40.54%), nitrofurantoin (from 28.82% to 39.06%), and norfloxacin (from 30% to 41.42%). However, the maximum increase in the resistance was noted for co-trimoxazole from 35.58% in 2009 to 63.39% in 2014 (P = 0.0000058). The prevalence of extended-spectrum beta-lactamases (ESBLs) has also significantly increased from 21.7% to 33.16% (P = 0.0045). Although E. coli remains the prime pathogen in pediatric UTI, the prevalence of resistance has dramatically increased over the 5-year study period. Our study highlights the emergence of community-acquired ESBL-producing uropathogens in children proclaiming treatment challenges.


Climate change effects on hatching success and embryonic development of fish: Assessing multiple stressor responses in a large-scale mesocosm study.
Climate change threatens freshwater fish species due to predicted changes in thermal, sedimentary and hydrological properties of stream ecosystems. Gravel-spawning fish are particularly sensitive to such alterations as warming, higher inputs of fine sediment and low-flow all have potentially negative effects on the functionality of their reproductive habitat, the hyporheic zone. Multiple stressors can interact in synergistic and antagonistic manners, causing surprise-effects that cannot be predicted from the additive consideration of individual stressors. For obtaining reliable, yet realistic data on the climate change stressor effects warming (+3-4 °C), fine sediment (increase in <0.85 mm by 22 %) and low-flow (eightfold discharge-reduction), we constructed a unique large-scale outdoor-mesocosm facility consisting of 24 flumes to study individual and combined stressor responses in a fully-crossed, 3-way-replicated design. To acquire representative results reflecting individual susceptibilities of gravel-spawning fish species due to taxonomic affiliation or spawning seasonality, we studied hatching success and embryonic development in the three fish species brown trout (Salmo trutta L.), common nase (Chondrostoma nasus L.) and Danube salmon (Hucho hucho L.). Fine sediment had the most significant single negative effect on both hatching rates and embryonic development (-80 % in brown trout, -50 % in nase, -60 % in Danube salmon). When fine sediment was combined with one or both of the other stressors, we observed strongly synergistic stressor responses, being distinctly stronger in the two salmonid species than in the cyprinid nase. Danube salmon was most susceptible to synergistic effects due to warmer spring water temperatures exacerbating the fine sediment-induced hypoxia, hence leading to complete mortality of fish eggs. This study highlights that individual and multiple-stressor effects depend strongly on life-history traits of respective species and that climate change stressors have to be assessed in combination to obtain representative results due to the high level of synergisms and antagonisms detected in this study.


A novel approach to the lung apex avoiding dissection of severe pleural adhesions.
A 70-year-old man was incidentally diagnosed with left pneumothorax. Primary surgery via the caudal thoracic cavity found severe pleural adhesions causing narrowing of the tunnel leading to the lung apex. The point of air leakage was located at the lung apex beyond the tunnel. To stop the air leakage, fibrin glue was injected to the apex via the tunnel; however, leakage reoccurred postoperatively. Considering the lung injury, a novel approach for lung apex without adhesion dissection was chosen for secondary surgery. An axillary skin incision was made at the 2nd intercostal space, and extrapleural dissection proceeded toward the apex. After the pleural space was confirmed by the movement of pleural effusion, the parietal pleura was incised, and a bulla was exposed and resected. The presented procedure to reach the apex of the lung without adhesion dissection could be an option in cases with dense and extensive pleural adhesions.


Poly(methylmethacrylate) and Topas capillary electrophoresis microchip performance with electrochemical detection.
A capillary electrophoresis (CE) microchip made of a new and promising polymeric material: Topas (thermoplastic olefin polymer of amorphous structure), a cyclic olefin copolymer with high chemical resistance, has been tested for the first time with analytical purposes, employing an electrochemical detection. A simple end-channel platinum amperometric detector has been designed, checked, and optimized in a poly-(methylmethacrylate) (PMMA) CE microchip. The end-channel design is based on a platinum wire manually aligned at the exit of the separation channel. This is a simple and durable detection in which the working electrode is not pretreated. H(2)O(2) was employed as model analyte to study the performance of the PMMA microchip and the detector. Factors influencing migration and detection processes were examined and optimized. Separation of H(2)O(2) and L-ascorbic acid (AsA) was developed in order to evaluate the efficiency of microchips using different buffer systems. This detection has been checked for the first time with a microchip made of Topas, obtaining a good linear relationship for mixtures of H(2)O(2) and AsA in different buffers.


Inhibition of histamine release from human basophils in vitro by calmodulin antagonists.
Calmodulin is a ubiquitous and versatile Ca2+-binding protein that plays a pivoting role in cellular metabolism. We have investigated the possibility that calmodulin plays a role in immediate hypersensitivity reactions by evaluating the effects of two agents, trifluoperazine dihydrochloride (TFP) and the sulfonamide derivative N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide (W-7) which selectively bind to calmodulin. TFP and W-7 cause a dose-dependent inhibition of histamine secretion from human basophils in vitro induced by several immunological (i.e., antigen and anti-IgE) and nonimmunological (i.e., formyl-methionine-containing peptide and the Ca2+ ionophore A23187) stimuli. These results indicating that two specific calmodulin antagonists are potent inhibitors of the secretory response of human basophils support the hypothesis that calmodulin may play a role in the control of the release of preformed mediators from human inflammatory cells.


The regulation of myo-inositol-1-phosphate-synthase activity from Neurospora crassa by pyrophosphate and some cations.
The effect of several cations on the inhibition by PPi of the enzyme myo-inositol-1-phosphate synthase (1L-myo-inositol-1-phosphate lyase (isomerizing) EC 220.127.116.11) from Neurospora crassa was studied. The study wastol biosynthesis can occur in the presence of an intracellular PPi concentration which exceeds the Ki for the enzyme by 350-fold. The inhibition of enzyme activity by PPi,at pH 7.7, was reversed, in decreasing order of effectiveness, by Mn-2, Fe-3


Receptors for IgM on human lymphocytes. I. Detection of receptors on freshly drawn lymphocytes and at physiological temperature.
Receptors for the Fc portion of IgM (RFcmu) have previously been found to be primarily associated with the T lymphocyte subpopulation in humans, and their detection has frequently required overnight incubation of the cells before assay. In the present study, using highly sensitized indicator cells (EAmu), lymphocytes with receptor for IgM (EAmu-RFC) were detected immediately after isolation from human peripheral blood. Identification of EAmu-RFC on freshly isolated lymphocytes was greatly facilitated by assay at room temperature (RT) or 37 degrees C, implying that analogous interactions between IgM-antigen complexes and lymphocytes with receptor for IgM normally occur in vivo. These results seem to indicate that some RFcmu on lymphocytes may be occupied by IgM and/or IgM-antigen complexes in vivo and that immediately after isolation many RFcmu are still occupied and unavailable for interaction with EAmu. It is suggested that the successful competition of IgM-antigen complexes for RFcmu on T lymphocytes is the signal for and/or mechanism of expression of help by the lymphocyte. The sensitivity of the assay for EAmu-RFC also permitted the identification of a small subpopulation of RFcmu+ lymphocytes in the non-T cell fraction of the peripheral blood of some individuals.


Circular permutation within the coenzyme binding domain of the tetrameric glyceraldehyde-3-phosphate dehydrogenase from Bacillus stearothermophilus.
A circularly permuted (cp) variant of the phosphorylating NAD-dependent glyceraldehyde-3-phosphate dehydrogenase (GAPDH) from Bacillus stearothermophilus has been constructed with N- and C-termini created within the coenzyme binding domain. The cp variant has a kcat value equal to 40% of the wild-type value, whereas Km and KD values for NAD show a threefold decrease compared to wild type. These results indicate that the folding process and the conformational changes that accompany NAD binding during the catalytic event occur efficiently in the permuted variant and that NAD binding is tighter. Reversible denaturation experiments show that the stability of the variant is only reduced by 0.7 kcal/mol compared to the wild-type enzyme. These experiments confirm and extend results obtained recently on other permuted proteins. For multimeric proteins, such as GAPDH, which harbor subunits with two structural domains, the natural location of the N- and C-termini is not a prerequisite for optimal folding and biological activity.


Bidirectional interaction of valproate and lamotrigine in healthy subjects.
To evaluate the steady-state pharmacokinetics of lamotrigine and valproate at three dosing levels of lamotrigine in normal volunteers receiving steady-state therapeutic doses of valproate. This was an open-label, randomized, three-way crossover study of 18 normal male volunteers. Subjects received oral valproate (500 mg Depakote twice a day) throughout the study. Each subject subsequently received three oral dosage regimens of lamotrigine (50, 100, or 150 mg/day) for 1 week each, with a 2-week washout period between lamotrigine treatment periods. Valproate and lamotrigine trough plasma samples were determined by a capillary gas chromatography method and immunofluorometric assay, respectively. Urine samples were assayed for 11 valproate metabolites by gas chromatography/mass spectrometry. When compared to other studies in which lamotrigine was administered with no concurrent antiepileptic drug, concomitant valproate markedly increased the half-life of lamotrigine and decreased lamotrigine clearance, without substantial alteration in the linear kinetics of the drug. The addition of lamotrigine was associated with a small but significant 25% decrease in steady-state valproate plasma concentration. Oral clearance of valproate was increased (from 7.2 +/- 1.1 ml/hr/kg before lamotrigine treatment to 9.0 +/- 2.0 ml/hr/kg on day 28; p < 0.05). The formation clearance of the hepatotoxic valproate metabolites, 2-n-propyl-4-pentenoic acid (4-ene-valproate) and 2-propyl-2,4-pentadienoic acid [2(E),4-diene-valproate], was unaffected by lamotrigine administration. As a consequence of the interaction between lamotrigine and sodium valproate, a dosage reduction of lamotrigine should be considered in patients taking a combination of valproate and lamotrigine.


The standardization of 33P by the TDCR efficiency calculation technique.
The activity of the pure beta-emitter phosphorus-33 (33P) has been directly determined by the triple-to-double coincidence ratio (TDCR) efficiency calculation technique, thus extending the number of radionuclides that have been standardized by this simple, non-extrapolation liquid scintillation (LS) method. The major advantage of inherently accounting for chemical quenching without the need for additional external measurements is demonstrated. The 33P solution activity concentration was verified by tracing with cobalt-60, utilizing 4pi(LS)beta-gamma coincidence counting. Agreement to within 1.2% confirmed the reliability of the TDCR measurements.


Ingestion of plastic debris by commercially important marine fish in southeast-south Brazil.
Rising concentrations of plastics in the oceans are leading to increasing negative interactions with marine biota, including ingestion by endangered and/or economically important seafood species such as fish. In this paper, we visually evaluated plastic debris ingestion by 965 specimens of eight commercially exploited fish species from different marine habitats off the southeast-south coast of Brazil. All species ingested plastics, with pelagic animals having higher amounts, frequency of occurrence, diversity and sizes of ingested items than demersal-pelagic and demersal animals. Highest frequency of occurrence (FO%) of plastic ingestion (25.8%) was observed for the pelagic skipjack tuna Katsuwonus pelamis (Scombridae), and lowest (5%) for the demersal bluewing searobin Prionotus punctatus (Triglidae). Microplastics predominated in all species, and fibers/lines and fragments were the main items found, possibly derived from fishing materials. The most abundant plastic colors were transparent, black and blue, and the most common polymers were polyamide and polyurethane. With the available data, no relationship between the size of the individuals and amount of ingested plastics was observed. Considering the negative impacts of plastic ingestion on marine fish, and potentially on human health due to their consumption, understanding ingestion patterns is critical for better evaluating their origin and possible causes, and consequently for helping define prevention strategies for this problem.


In-situ Raman analysis of hydrogenation in well-defined ultrathin molybdenum diselenide deposits synthesized through vapor phase deposition.
We report on the synthesis, characterization and in-situ Raman spectroscopy analysis of hydrogenation in ultrathin crystalline MoSe2 deposits. We use a controllable vapor phase synthesis method using MoSe2 powder as the only precursor, to fabricate nano- to micro-size few layer thick MoSe2 deposits with tunable number densities on SiO2/Si substrates. We employ this controllable synthesis method to correlate characteristic Raman spectroscopy response of MoSe2 at ca. 242 cm-1 (A1g) and ca. 280 cm-1 (E2g1) with the thickness of the deposits acquired from atomic force microscopy (AFM). We also use this array of well-defined atomically thin MoSe2 deposits to study possible hydrogenation effects on select architectures using in-situ Raman spectroscopy. Interestingly, our analysis indicates that ultrathin MoSe2 deposits with exposed edges show a blue shift of 1-2 cm-1 when exposed to H2 flow at 150-250 sccm for 2-4 hours in a sealed reaction cell. Exposure to Ar flow under same condition reverses the observed shift in the A1g mode of the select MoSe2 deposits. Our measurements provide in-situ evidence for hydrogen adsorption on MoSe2 deposits at room temperature and insight into the possible active sites for hydrogen reactions on layered dichalcogenides at lower dimensions.


Laboratory and pilot scale pretreatment of sugarcane bagasse by acidified aqueous glycerol solutions.
Pretreatment of sugarcane bagasse with acidified aqueous glycerol solution was evaluated at both laboratory and pilot scales. Laboratory scale pretreatment (4.00 g dry mass in 40.00 g liquid) with glycerol solutions containing ≤ 20 wt.% water and 1.2 wt.% HCl at 130°C for 60 min resulted in biomass having glucan digestibilities of ≥ 88%. Comparable glucan enzymatic digestibility of 90% was achieved with bagasse pretreated at pilot scale (10 kg dry mass in 60 kg liquid) using a glycerol solution containing 0.4 wt.% HCl and 17 wt.% water at 130°C for 15 min. We attribute more efficient pretreatment at pilot scale (despite shorter reaction time and reduced acid content) to improved mixing and heat transfer in a horizontal reactor. Pretreatment of sugarcane bagasse with acid-catalysed glycerol solutions likely produces glycerol-glycosides, which together with hydrolysed lignin are potential substrates for the production of biopolymers.


Synthesis and assay of isoquinoline derivatives as HIV-1 Tat-TAR interaction inhibitors.
Four new isoquinoline derivatives bearing guanidinium group or amino group-terminated side chain were synthesized to target the HIV-1 TAR element. Their abilities to bind TAR RNA and inhibit Tat-TAR RNA interaction were determined by CE analysis, a Tat-dependent HIV-1 LTR-driven CAT assay and SIV-induced syncytium evaluation.


The computer programmed multi-image lecture.
Computer programmed multi-image presentations enhance considerably the visual content of an audiovisual presentation. A multi-image production provides ample opportunity to present the pre- and post-operative images simultaneously, enabling the audience to compare and comprehend the results with ease. With more than one image the natural sequence of dissection details can be shown, resulting in continuity of thought. The dissolve mechanism offsets any visual fatigue of the audience. The films contribute animation sequences which cannot be demonstrated well on slides. A presentation of all material provides the lecturer with maximum control with the minimum of effort, utilising one button. A computer programmed multi-image production is a complex medium of audiovisual presentation and needs a great deal of time and experience and is not to be lightly undertaken. With the increased number of slides, images and projectors the margin for error is small. Careful slide assembly and repeated rehearsals are the keys to success. At the moment, its use is recommended for special lectures only with adequate consideration being given for the increased expense of production.


Role of CFTR's intrinsic adenylate kinase activity in gating of the Cl(-) channel.
The cystic fibrosis transmembrane conductance regulator (CFTR) is a Cl(-)channel in the ATP-binding cassette (ABC) transporter protein family. CFTR features the modular design characteristic of ABC transporters, which includes two membrane-spanning domains forming the channel pore, and two ABC nucleotide-binding domains that interact with ATP and contain the enzymatic activity coupled to normal gating. Like other ABC transporters CFTR is an ATPase (ATP + H(2)O --> ADP + Pi). Recent work has shown that CFTR also possesses intrinsic adenylate kinase activity (ATP + AMP left arrow over right arrow ADP + ADP). This finding raises important questions: How does AMP influence CFTR gating? Why does ADP inhibit CFTR current? Which enzymatic activity gates CFTR in vivo? Are there implications for other ABC transporters? This minireview attempts to shed light on these questions by summarizing recent advances in our understanding of the role of the CFTR adenylate kinase activity for channel gating.


Ultrastructural localization of four different neuropeptides within separate populations of p-type nerves in the guinea pig colon.
The ultrastructural localization of four neuropeptides, substance P, vasoactive intestinal polypeptide, Met-enkephalin, and somatostatin, in the guinea pig colon was investigated using electron immunocytochemistry. Each peptide was localized to the large granular vesicles in separate subpopulations of p-type nerves. These nerves could often be distinguished by the size and appearance of their immunostained granular vesicle cores. Thus, vasoactive intestinal polypeptide- and somatostatin-immunoreactive vesicles contained cores that were significantly larger (p less than 0.005) than those of substance P- or Met-enkephalin-positive vesicles. In addition, vasoactive intestinal polypeptide-immunoreactive vesicle cores were less well defined and more variable in shape than those of somatostatin-positive vesicles. Substance P- and Met-enkephalin-immunoreactive vesicle cores, however, were very similar in size (p greater than 0.05) and appearance and could only be differentiated using immunocytochemistry. This study demonstrates that the four neuropeptides under investigation are present within separate, often ultrastructurally distinct, neuronal systems in the gut. The distribution of these nerves within the colon is also described.


Lanolin with reduced sensitizing potential. A preliminary note.
The allergens of lanolin appear to lie in the content of natural free fatty alcohols rather than in the total alcohols as hitherto supposed. The detectable incidence of allergy is increased by the simultaneous presence of detergent. Amongst selected lanolin-sensitive skin patients, removal of both free fatty alcohols and detergent from lanolin reduces the incidence of detectable hypersensitivity by 96%. Methods are described for determining free fatty alcohols and detergent in lanolin, and for removing them.


Author Correction: Liquid versus tissue biopsy for detecting acquired resistance and tumor heterogeneity in gastrointestinal cancers.
An amendment to this paper has been published and can be accessed via a link at the top of the paper.


Synthetic peptide inhibitors of complement serine proteases--I. Identification of functionally equivalent protease inhibitor sequences in serpins and inhibition of C1s and D.
Sequence homology comparisons between serum serine protease inhibitors led to the prediction that the C-terminal sequences are functionally equivalent and represent an essential protease binding domain. Inhibition of complement serine protease D cleavage of factor B and of C1s cleavage of C4 by synthetic peptides containing sequences from the C-termini of three serum serine protease inhibitors supports this prediction. These functionally equivalent peptides represent a new class of inhibitors of D and C1s as well as other serum serine proteases.


Atypical incus necrosis: a case report and literature review.
We report an atypical case of ossicular necrosis affecting the incus, in the absence of any history of chronic serous otitis media. We also discuss the current theories of incus necrosis. A male patient presented with a history of right unilateral hearing loss and tinnitus. Audiometry confirmed right conductive deafness; tympanometry was normal bilaterally. He underwent a right exploratory tympanotomy, which revealed atypical erosion of the proximal long process of the incus. Middle-ear examination was otherwise normal, with a mobile stapes footplate. The redundant long process of the incus was excised and a partial ossicular replacement prosthesis was inserted, resulting in improved hearing. Ossicular pathologies most commonly affect the incus. The commonest defect is an absent lenticular and distal long process of the incus, which is most commonly associated with chronic otitis media. This is the first reported case of ossicular necrosis, particularly of the proximal long process of the incus, in the absence of chronic middle-ear pathology.


Complex regional pain syndrome type I in children. Clinical description and quality of life.
Complex regional pain syndrome type 1 (CRPS I) in children differs from its adult counterpart and relevant literature is scarce. Our aim was to investigate potential risk factors and to assess midterm outcome and quality of life. Medical records of patients diagnosed with CRPS I between 2004 and 2012 were analyzed. Patients and parents were called for a phone interview including the PEDS Quality of Life 4-0 questionnaire. Results were compared to a control group matched for age, gender and socio-economic status. Seventy-three patients were included (64 girls, 9 boys). Mean age at diagnosis was 11.5 years and mean time to diagnosis was 14.2 months. The lower limb was affected in 89% of cases. Allodynia, coldness and cyanosis were noted in 95%, 81% and of 74% of cases, respectively. Forty-nine percent of patients reported a physical injury. Multivariate analysis showed a strong association with being anxious (OR = 44.9, 95% CI [7.4-273]), presence of an atopic background (OR = 25.0, 95% CI: [4.6-135]), being good to excellent school performers (OR = 8.4 95% CI [1.3-52.1]), and having trouble falling asleep (OR = 5.3, 95% CI [1.6-17.0]). At a mean 37 months' follow-up (12-102), PEDS QL 4-0 score was significantly lower in CRPS patients compared to controls. Fifty-seven percent of patients acknowledged healing and 55% had presented a relapse. Childhood onset CRPS I affects predominantly preadolescent girls at the ankle. The present study highlights the relatively poor outcome, especially its physical and emotional aspects and the large role of psychology. IV.


Effect of anti-CD4 monoclonal antibody administration on rat small bowel allograft survival and circulating leukocyte populations.
This study assessed the effect of an anti-rat CD4 monoclonal antibody (OX38) on heterotopic small bowel allograft rejection. Fully allogeneic small bowel transplants were performed in the PVG-to-DA-rat strain combination. Animals received either i) short course (days -1, 0 and 1) of 1 mg/kg per day OX38, ii) short course of 5 mg/kg per day or iii) extended course (days -2, -1, 0, 1, 2 and twice weekly thereafter) of 1 mg/kg per day. Both the high dose (13 days) and extended low-dose (12 days) courses prolonged graft survival compared to untreated control animals (7 days). The low-dose, short-course treatment had no effect. Similar regimens were given to animals that did not receive transplants and in which peripheral blood CD4+ cell counts fell to between 20 and 55 % of pretreatment levels and 20-30% of binding sites were blocked. In summary, anti-CD4 monoclonal antibody therapy delayed rejection of rat small bowel allografts; however, long-term survival was not achieved.


Malignant eccrine spiradenoma: a case report with pulmonary metastasis.
Malignant eccrine spiradenoma is an extremely rare sweat gland tumor. It may develop de novo or arise in pre-existing benign eccrine spiradenoma. However, most tumors are presented in the latter mode. The case of a 50-year-old man with malignant transformation from previously existing benign eccrine spiradenoma over his right lateral thigh is reported. Evidence for this diagnosis includes two distinct morphological components. One is the well demarcated, small round to oval benign eccrine spiradenoma and the other is the malignant element with sarcomatoid differentiation. Some foci of transition between the benign eccrine spiradenoma and the sarcomatoid part are evident and represents that the latter may arise from the former. Whether different morphological patterns influence the patients' outcome is still doubtful. However, the malignant eccrine spiradenoma is thought to have the capacity of metastasis and lethal potentiality.


Determining family relations through drawing: Family relations in images drawn by immigrant children.
The aim of the study was to evaluate family relations of immigrant children with the drawing method. The sample, which was carried out using the visual phenomenology method, consisted of 60 immigrant children between the ages of 4-14. The data were collected by face-to-face interviews with the children and family, using the Family Information Form and the Family Drawing Test. The data obtained from the drawings were analyzed with the MAXQDA 2022 program. The pictures drawn by the children were examined and 3 themes (Chaos, Necessity, Development) and 9 sub-themes (Interpersonal Relations, Thoughts about Future, Violence, Authority, Emotional State, Communication, Needs and Desires, Role Modeling, Personality) were formed. It was determined that the family relations of immigrant children were adversely affected, children had conflicts with family members, were exposed to violence, felt many emotions, such as fear, anxiety, loneliness, anger, longing, exclusion, and needed communication, attention, and support. It is thought that nurses could use the picture analysis method to understand the feelings and thoughts of children.


To what extent do bond length and angle govern the 13C and 1H NMR response to weak CH⋯O hydrogen bonds? A case study of caffeine and theophylline cocrystals.
Weak hydrogen bonds are important structure-directing elements in supramolecular chemistry and biochemistry. We consider here weak CH⋯O hydrogen bonds in a series of cocrystals of theophylline and caffeine and assess to what extent the CH⋯O distance and angle govern the observed 13C and 1H isotropic chemical shifts. Gauge-including projector-augmented wave density functional theory (GIPAW DFT) calculations consistently predict a decrease in the 13C and 1H magnetic shielding constants upon hydrogen bond formation on the order of 2-5 ppm (13C) and 1-2 ppm (1H). These trends are reproduced using the machine-learning approach implemented in ShiftML. Experimental 13C and 1H chemical shifts obtained for powdered samples using one-dimensional NMR spectroscopy as well as heteronuclear correlation (HETCOR) spectroscopy correlate well with the GIPAW DFT results. However, the experimental 13C NMR response only correlates moderately well with the hydrogen bond length and angle, while the experimental 1H chemical shifts only show very weak correlations to these local structural elements. DFT computations on isolated imidazole-formaldehyde models show that the 13C and 1H chemical shifts generally decrease with the C⋯O distance but show no clear dependence on the CH⋯O angle. These results demonstrate that the 13C and 1H response to weak CH⋯O hydrogen bonding is influenced significantly by additional weak contacts within cocrystal heterodimeric units.


Synaptic interrelationships between the optic tectum and the ipsilateral nucleus isthmi in Rana pipiens.
The nucleus isthmi is reciprocally connected to the ipsilateral optic tectum. Ablation of the nucleus isthmi compromises visually guided behavior that is mediated by the tectum. In this paper, horseradish peroxidase (HRP) histochemistry and electron microscopy were used to explore the synaptic interrelationships between the optic tectum and the ipsilateral nucleus isthmi. After localized injections of HRP into the optic tectum, there are retrogradely labeled isthmotectal neurons and orthogradely labeled fibers and terminals in the ipsilateral nucleus isthmi. These terminals contain round, clear vesicles of medium diameter (40-52 nm). These terminals make synaptic contact with dendrites of nucleus isthmi cells. Almost half of these postsynaptic dendrites are retrogradely labeled, indicating that there are monosynaptic tectoisthmotectal connections. Localized HRP injection into the nucleus isthmi labels terminals primarily in tectal layers B, E, F, and 8. The terminals contain medium-sized clear vesicles and they form synaptic contacts with tectal dendrites. There are no instances of labeled isthmotectal terminals contacting labeled dendrites. Retrogradely labeled tectoisthmal neurons are contacted by unlabeled terminals containing medium-sized and small clear vesicles. Fifty-four percent of the labeled fibers connecting the nucleus isthmi and ipsilateral tectum are myelinated fibers (average diameter approximately 0.6 microns). The remainder are unmyelinated fibers (average diameter approximately 0.4 microns).


Differential response of salt stress on Brassica juncea: photosynthetic performance, pigment, proline, D1 and antioxidant enzymes.
To investigate the ability of sensitive and tolerant variety of Brassica juncea to adapt to a saline environment in a field, we examined the activities of antioxidant enzymes in relation to photosystem II, chlorophyll a fluorescence, photosynthetic pigment concentration, protein (D1) and proline in plants exposed to salt stress. We observed a greater decline in the photosynthetic rate (∆F/Fm') and electron transport rate (ETRsat) and saturating photosynthetically active photo flux density (PPFDsat) under salt stress in var. Urvashi (sensitive variety) than in var. Bio902 (tolerant variety). Var. Urvashi was found to be more sensitive to high salinity. In var. Bio902, chlorophyll a, chlorophyll b and total chlorophyll concentrations were higher than in the sensitive variety. Proline and protein contents were also higher in var. Bio902 as compared to their lower accumulation in var. Urvashi. The improved performance of the var. Bio902 under high salinity was accompanied by an increase in ascorbate peroxidase (APX, EC 22.214.171.124) and catalase (CAT, EC 22.214.171.124), though no salt-dependent increase in the activity of superoxide dismutase (SOD, EC 18.104.22.168) was observed. However, no such increase in APX and CAT was observed in var. Urvashi, though there was significant increase in SOD activity. These results suggest that var. Bio902 is potentially more tolerant to salt damage and is associated with better adaptive responses found in var. Bio902 than var. Urvashi. Increased photoinhibition in var. Urvashi as observed by its reduced thylakoid membrane protein, D1 probably results from the greater photosynthetic damage caused by salt stress than var. Bio902.


The life-cycle of Toxoplasma gondii reviewed using animations.
Toxoplasma gondii is a protozoan parasite that is the causative agent of toxoplasmosis, an infection with high prevalence worldwide. Most of the infected individuals are either asymptomatic or have mild symptoms, but T. gondii can cause severe neurologic damage and even death of the fetus when acquired during pregnancy. It is also a serious condition in immunodeficient patients. The life-cycle of T. gondii is complex, with more than one infective form and several transmission pathways. In two animated videos, we describe the main aspects of this cycle, raising questions about poorly or unknown issues of T. gondii biology. Original plates, based on electron microscope observations, are also available for teachers, students and researchers. The main goal of this review is to provide a source of learning on the fundamental aspects of T. gondii biology to students and teachers contributing for better knowledge and control on this important parasite, and unique cell model. In addition, drawings and videos point to still unclear aspects of T. gondii lytic cycle that may stimulate further studies.


Spin Crossover in Anionic Cobalt-Bridged Fullerene (Bu4N+){Co(Ph3P)}2(μ2-Cl-)(μ2-η2,η2-C60)2 Dimers.
A spin crossover phenomena is observed in an anionic (Bu4N+){Co(Ph3P)}2(μ2-Cl-)(μ2-η2,η2-C60)2·2C6H14 (1) complex in which two cobalt atoms bridge two fullerene molecules to form a dimer. The dimer has a triplet ground state with two weakly coupling Co0 atoms (S = 1/2). The spin transition realized above 150 K is accompanied by a cobalt-to-fullerene charge transfer that forms a quintet excited state with a high spin CoI (S = 1) and C60•- (S = 1/2).


National survey of nursing program options designed for the second degree student.
There is a current trend for schools of nursing to begin second degree options. Given the current economic situation, this is a win/win situation that benefits the second degree student, schools of nursing, the profession, and the community in general.


Intraoperative massive transfusion decreases survival after liver transplantation.
Patients undergoing liver transplantation often experience coagulopathy and massive intraoperative blood loss that can lead to morbidity and reduced survival. The aim of this study was to verify the survival rate and discover predictive factors for death among liver transplant patients who received massive intraoperative blood transfusions. This cohort study was based on prospective data collected retrospectively from January 2004 to July 2006. The 232 patients were distributed according to their blood requirements, (namely, more or less than 6 units), including red blood cell saver. The statistical analyses were performed using Student t test, Cox hazard regression, and the Kaplan-Meier method (log-rank test). The massively transfused cohort displayed higher Child-Pugh classifications (10.2 vs 9.6; P = .03); model for end-stage liver disease (MELD) scores (19 vs 17; P = .02); recipient weights (75.4 vs 71 kg; P = .03); as well as warm ischemia times (70.7 vs 56.4 minutes; P < .001) and surgery times (584.6 vs 503.4 minutes; P < .05). The proportional hazard (Cox) regression analysis showed that the risk of death increased 2.1% for each unit of donor sodium and 1.6% for each additional year of donors age over 50. The survival rates at 6, 12, 60, and 120 months for > or = 6 vs <6 U of blood transfusion of 63.8% vs 83.3%; 53.9% vs 76.3%; 40% vs 60%; 34.5% vs 49.2%. In conclusion, we observed that patients receiving over 6 red blood cell units intraoperatively displayed reduced survival. Predictive factors for this risk factor were high donor level of sodium and of age.


Temporal dissociation between category-based and item-based processes in rejecting distractors.
Presenting a target-like distractor in an RSVP task deteriorates the detection of a trailing target, because the visual system has difficulties in rejecting the erroneously accepted distractor. We investigated whether the rejection process is influenced by observers' knowledge regarding possible distractors. Observers identified a letter (target) embedded in a stream of line patterns, rejecting a preceding distractor (digit). We informed the observers about either the category of distractors ("digit") or the identity of the distractor (e.g., "5"). The distractors with certain distractor-target lags increased identification errors, indicating that the distractor rejection process temporarily interfered with the target identification. When the observers knew the distractor identity, the rejection process started later than when they knew only the distractor category. These results suggest that the rejection process may operate at either the category or the individual-item level; however, the setting of the rejection level is not under the observers' control.


Clinical and biochemical stabilization of Nelson's syndrome with long-term low-dose cabergoline treatment.
We report the results of long-term (6-year) treatment of Nelson's syndrome with the long-acting dopamine agonist, cabergoline, in a 55-year-old woman. The disease presented 26 years after bilateral adrenalectomy and radiation treatment for Cushing's disease, followed by glucocorticoid and mineralocorticoid replacement therapy. Signs of Nelson's syndrome included skin and mucosal hyperpigmentation accompanied by elevated plasma levels of adrenocorticotropic hormone (ACTH) (984 pmol/l; normal, 2.0-11.5 pmol/l). Magnetic resonance imaging of the pituitary demonstrated sellar enlargement with a 15 mm macroadenoma. The patient was initially treated with bromocriptine (10 mg/d) which had no effect on either ACTH level or tumor mass. Because of visual loss, transsphenoidal surgery was performed, with partial excision of the adenoma and chiasmal decompression, followed by radiosurgery. However, ACTH levels improved only temporarily, and then increased to previous levels. Therefore, cabergoline treatment (1.5 mg/week) was initiated. ACTH levels decreased dramatically from 1050 to 132 pmol/l, accompanied by clinical improvement. Repeated imaging studies demonstrated a stable residual pituitary tumor. This case demonstrates that long-term cabergoline treatment may be efficient in patients with Nelson's syndrome.


Inverse transcriptional activities during complementary chromatic adaptation are controlled by the response regulator RcaC binding to red and green light-responsive promoters.
Complementary chromatic adaptation (CCA) provides cyanobacteria with the ability to shift between red and blue-green phenotypes that are optimized for absorption of different wavelengths of light. Controlled by the ratio of green to red light, this process results from differential expression of two groups of operons, many of which encode proteins involved in photosynthetic light harvesting antennae biogenesis. In the freshwater species Fremyella diplosiphon, the inverse regulation of these two classes is complex and occurs through different mechanisms. It also involves a two-component pathway that includes a phytochrome-class photoreceptor and the response regulator RcaC. Here we uncover the mechanism through which this system controls CCA by demonstrating that RcaC binds to the L Box within promoters of both classes of light-regulated operons. We provide functional evidence that complementary regulation of these operons occurs by RcaC's simultaneous activation and repression of transcription in red light. We identify rcaC and L Boxes in the genome of a marine cyanobacterium capable of CCA, suggesting widespread use of this control system. These results provide important insights into the long-standing enigma of CCA regulation and complete the first description of an entire two-component system controlled by a phytochrome-class photoreceptor.


Epidemiology of musculoskeletal disorders (complaints) and related disability in Canada.
Data on musculoskeletal disorders (complaints), collected as part of the Canada Health Survey were analyzed. Sixteen percent of those sampled reported having arthritis, rheumatism or back, limb or joint disorders with a greater prevalence among females and in the older population. In 21% this was associated with limitation of activity with an average of 11 disability days/person/year. Serious back disorders were reported in 4.4% of the population. While the majority of health consultations (53%) were with a physician, a substantial number (34%) were with chiropractors.


Patient Misidentification Events in the Veterans Health Administration: A Comprehensive Review in the Context of High-Reliability Health Care.
The Veterans Health Administration maintains national patient safety event reporting and root cause analysis (RCA) databases. These were reviewed to understand the prevalence of and provide insight into patient misidentification. The results were compared with a high-reliability health care framework. We reviewed patient safety reports and RCA reports to identify and categorize patient identification-related events from October 1, 2016, to September 30, 2018. We analyzed 3232 patient safety reports and 67 RCAs, aggregated the findings, and compared them against The Joint Commission's High Reliability Health Care Maturity Model. Patient misidentification occurred in both inpatient and outpatient settings, for which the ratio of adverse events to close calls was similar. The ratio of adverse events to close calls varied for specific care areas. The most common RCA event characteristic was Two identifiers not used (39%). The most common failure mode was Procedure performed on wrong patient (31%). Issues related to policy and processes accounted for 42% of the root causes. Actions taken were primarily related to policy, process, and staff training/education (56%); these actions were rated as effective by the reporting facilities. Patient misidentification is prevalent in both the inpatient and outpatient settings. However, specific care areas reported more close calls, an indicator of good safety culture. There were associations between policy and process issues, consistent use of 2 identifiers, and misidentification events. This review provides insight from the Veterans Health Administration national databases that health care institutions can use to improve their systems.


Visualizing in vivo liposomal drug delivery in real-time.
Liposomes have tremendous potential for efficient small molecule delivery. Previous studies, however, have been hampered by an inability to monitor their distribution and release of contents. Here, the authors demonstrate the real time monitoring of small molecule delivery using luciferin as a model. To monitor the release of luciferin in vivo, luciferin was packaged in thermosensitive liposomes and delivered into transgenic mice that constitutively express luciferase. Their experiments show the thermally induced release of the liposomal content in real time. In addition, the model provides evidence that the thermosensitive liposomes are stable over a long period of time ( approximately 3 weeks), and still release their content upon heating. These data present a strategy to monitor liposomal drug delivery in vivo with luciferin.


Determinants of information provided by anaesthesiologists to relatives of patients during surgical procedures.
Data and interventions are lacking for family-centred perioperative care in adults. Perioperative information given to relatives by nurses or surgeons is associated with improved satisfaction and fewer symptoms of anxiety for relatives and the patient themselves. However, the frequency of the provision of information by anaesthesiologists to patients' relatives during surgery has never been reported. A cross-sectional survey was sent to French anaesthesiologists in October 2020 to inquire how often they provided information to patients' family members during surgery and what factors led to them providing information frequently (i.e. in more than half of cases). Among 607 anaesthesiologists, 53% (319/607) were male, with median age 47 (36-60) yr and nearly half (43%, 260/607) reported more than 20 years of clinical experience; most responders (96%, 580/607) mainly treated adults. Forty-nine (8%) anaesthesiologists declared that they frequently provide information to relatives during surgery. After multivariate analysis, age >50 yr, female gender, and paediatric practice were associated with providing information more frequently. Reasons for not providing information included a lack of time and dedicated space to talk to relatives. Urgent surgery or surgery lasting >2 h were identified as factors associated with provision of information to relatives. Giving information to relatives during surgery is not a common practice among anaesthesiologists. It depends on individual anaesthesiologists' personal characteristics and practice. Information during surgery could be provided systematically in situations identified as being the most important by anaesthesiologists in our survey. By creating new pathways of information, we could reduce stress and anxiety of patients and relatives.


Spatial and temporal expression of N-ethylmaleimide-sensitive factor gene in the nervous system of the cotton bollworm, Helicoverpa armigera.
N-ethylmaleimide-sensitive factor (NSF) is a component required for vesicular transport and release of neurotransmitters or neurohormones in the constitutive secretory pathways. Here, the spatial and temporal expression of NSF gene was investigated in Helicoverpa armigera (Helar). Reverse transcription-polymerase chain reaction analysis reveals that Helar-NSF is transcribed preferentially in the nervous system of H. armigera. Using in situ hybridization, the Helar-NSF mRNA is further localized in the superficial layer or deep layer cells of the brain, subesophageal ganglion (SG) and other ganglia. The developmental profiles of Helar-NSF show that both mRNA and protein in pupal brain-SG complexes are significantly higher in nondiapause-destined individuals than in diapause-destined individuals. The expression patterns are consistent with those of two neurohormones, prothoracicotropic hormone (PTTH) and diapause hormone (DH). These data suggest a central function of Helar-NSF in developmental process through regulating neurohormone release.


[Conservative surgery for a mandibular condyle osteochondroma].
Osteochondroma is a rare benign bone tumor of the mandibular condyle (90 cases reported). The symptoms are similar to those of temporomandibular joint disorders: painful temporomandibular joint, joint sounds, and modification of dental occlusion. A 37-year-old female patient consulted for a wide left laterodeviation of the mandible. CT scan revealed a 27 mm long bony growth on the condyle. The condyle neck was osteotomized, then the tumor and condyle head were split, the condyle was then remodeled and osteosynthesized on the condyle neck. The functional and esthetic results were satisfactory at 12 months without any recurrence or relapse. The authors present a novel conservative technique, slightly different from those reported in the literature. There are several therapeutic alternatives. They can be classified in three groups: invasive, non-invasive, and conservative techniques. Nevertheless, osteochondroma is a benign tumor and its management should be as little invasive as possible.


Physical mapping of unique nucleotide sequences on identified rice chromosomes.
A physical mapping method for unique nucleotide sequences on specific chromosomal regions was developed combining objective chromosome identification and highly sensitive fluorescence in situ hybridisation (FISH). Four unique nucleotide sequences cloned from rice genomic DNAs, varying in size from 1.3 to 400 kb, were mapped on a rice chromosome map. A yeast artificial chromosome (YAC) clone with a 399 kb insert of rice genomic DNA was localised at the distal end of the long arm of rice chromosome (1q2.1) and a bacterial artificial chromosome (BAC) clone (180 kb) containing the rice leaf blast-resistant gene (Pi-b) was shown to occur at the distal end of the long arm of chromosome 2 (2q2.1). A cosmid (35 kb) with the resistance gene (Xa-21) against bacterial leaf blight was mapped on the interstitial region of the long arm on chromosome 11 (11q1.3). Furthermore a single RFLP marker, 1.29 kb in size, was mapped successfully to the distal region of the long arm of rice chromosome 4 (4q2.1). For precise localisation of the nucleotide sequences within the chromosome region, image analyses were effective. The BAC clone was localised to the specific region, 2q2.1:96.16, by image analysis. The result was compared with the known location of the BAC clone on the genetic map and the consistency was confirmed. The effectiveness and reliability in physically mapping nucleotide sequences on small plant chromosomes achieved by the FISH method using a variety of probes was unequivocally demonstrated.


Differential regulation of acid sphingomyelinase in macrophages stimulated with oxidized low-density lipoprotein (LDL) and oxidized LDL immune complexes: role in phagocytosis and cytokine release.
Oxidized low-density lipoprotein (oxLDL) and oxLDL-containing immune complexes (oxLDL-IC) contribute to the formation of lipid-laden macrophages (foam cells). Fcγ receptors mediate uptake of oxLDL-IC, whereas scavenger receptors internalize oxLDL. We have previously reported that oxLDL-IC, but not free oxLDL, activate macrophages and prolong their survival. Sphingomyelin is a major constituent of cell membranes and lipoprotein particles and acid sphingomyelinase (ASMase) hydrolyses sphingomyelin to generate the bioactive lipid ceramide. ASMase exists in two forms: lysosomal (L-ASMase) and secretory (S-ASMase). In this study we examined whether oxLDL and oxLDL-IC regulate ASMase differently, and whether ASMase mediates monocyte/macrophage activation and cytokine release. The oxLDL-IC, but not oxLDL, induced early and consistent release of catalytically active S-ASMase. The oxLDL-IC also consistently stimulated L-ASMase activity, whereas oxLDL induced a rapid transient increase in L-ASMase activity before it steadily declined below baseline. Prolonged exposure to oxLDL increased L-ASMase activity; however, activity remained significantly lower than that induced by oxLDL-IC. Further studies were aimed at defining the function of the activated ASMase. In response to oxLDL-IC, heat-shock protein 70B' (HSP70B') was up-regulated and localized with redistributed ASMase in the endosomal compartment outside the lysosome. Treatment with oxLDL-IC induced the formation and release of HSP70-containing and IL-1β-containing exosomes via an ASMase-dependent mechanism. Taken together, the results suggest that oxLDL and oxLDL-IC differentially regulate ASMase activity, and the pro-inflammatory responses to oxLDL-IC are mediated by prolonged activation of ASMase. These findings may contribute to increased understanding of mechanisms mediating macrophage involvement in atherosclerosis.


Quality of life, sense of coherence and experiences with three different treatments in patients with psychological distress in primary care: a mixed-methods study.
Psychological distress is associated with impaired health-related quality of life (HRQL) and poor sense of coherence (SOC). In a previous study, we found that therapeutic acupuncture (TA) and an integrative treatment that combined TA with person-centred approach in a salutogenic dialogue (IT) alleviated anxiety and depression significantly more than conventional treatment (CT) in primary care patients. Here, we report on secondary analyses regarding the HRQL and SOC from that previous pragmatic randomised controlled trial (RCT). Quantitative and qualitative design. One hundred twenty patients were referred for psychological distress. Quantitative analyses were performed at baseline and after 8 weeks of treatment using the SF-36 mental component summary (MCS), physical component summary (PCS) and the Sense of Coherence-13 (SOC) questionnaires. Qualitative manifest content analyses were based on open-ended questions-"Have you experienced any changes since the start of the treatment? Will you describe these changes?" No baseline differences were found. At 8 weeks, both the IT and TA groups had statistically better scores and greater improvement from baseline on the MCS and SOC than the CT group. The effect sizes were large. No significant differences were found between the IT and TA groups or in relation to the PCS. SOC was highly correlated with the MCS but not with the PCS. Dropout rates were low. The experiences of the intervention resulted in four categories: Being heading back; Status quo; Feeling confirmed; and Feeling abandoned, with 13 related subcategories. IT and TA seem to improve sense of coherence and mental health status in primary care patients with psychological distress, whereas CT appears to be less beneficial. IT and TA appear to be well-accepted and may serve as useful adjunct treatment modalities to standard primary care. Our results are consistent with much of the previous research in highlighting a strong relationship between SOC and mental health status. The written qualitative data described feeling confirmed and feeling increased self-efficacy, self-care and faith in the future. Those in the CT group, however, described feeling abandoned, missing treatment and experiencing increased emotional and physical problems. More research is needed. ISRCTN trial number NCT01631500.


REM sleep and memory consolidation.
One proposal referring to a specific function of REM sleep has been that it is necessary for, or at least conductive to, the progress of memory consolidation. This hypothesis was tested by comparing the effects on story retention of REM deprivation against an S4 deprived control. It was found that recall accuracy following REM deprivation was significantly poorer than following S4 deprivation. Furthermore, the degree of deterioration in recall accuracy during REM recovery sleep was less than during S4 recovery sleep. These findings were interpreted as evidence for active REM facilitation of memory consolidation. However, alternative explanations based upon proactive influences need to be investigated.


Genetic organization of the hrp gene cluster in Acidovorax avenae strain N1141 and a novel effector protein that elicits immune responses in rice (Oryza sativa L.).
The immune system of plants consists of two main arms, pathogen-associated molecular pattern (PAMP)-triggered immunity (PTI) and effector-triggered immunity (ETI). The multiple effectors that trigger ETI are translocated into plant cells by the type III secretion system (T3SS) of pathogenic bacteria. The rice-avirulent N1141 strain of Acidovorax avenae causes ETI in rice, including hypersensitive response (HR) cell death. Sequence analysis indicated that the N1141 genome contains the hrp gene cluster (35.3 kb), including genes encoding the T3SS apparatus. The T3SS-defective N1141 mutant (NΔT3SS) did not cause HR cell death, suggesting that ETI is caused by translocation of effector proteins into rice cells via T3SS. Computational sequence analysis predicted that Lrp, HrpW, and HrpY are secreted by T3SS. The hrpY deletion mutant (NΔhrpY) did not cause ETI, suggesting that HrpY is an important effector of ETI in the interaction between A. avenae N1141 and rice.


Gas6 Promotes Microglia Efferocytosis and Suppresses Inflammation Through Activating Axl/Rac1 Signaling in Subarachnoid Hemorrhage Mice.
Early brain injury (EBI) following subarachnoid hemorrhage (SAH) is characterized by rapid development of neuron apoptosis and dysregulated inflammatory response. Microglia efferocytosis plays a critical role in the clearance of apoptotic cells, attenuation of inflammation, and minimizing brain injury in various pathological conditions. Here, using a mouse SAH model, we aim to investigate whether microglia efferocytosis is involved in post-SAH inflammation and to determine the underlying signaling pathway. We hypothesized that TAM receptors and their ligands regulate this process. To prove our hypothesis, the expression and cellular location of TAM (Tyro3, Axl, and Mertk) receptors and their ligands growth arrest-specific 6 (Gas6) and Protein S (ProS1) were examined by PCR, western blots, and fluorescence immunostaining. Thirty minutes after SAH, mice received an intraventricular injection of recombinant Gas6 (rGas6) or recombinant ProS1 (rPros1) and underwent evaluations of inflammatory mediator expression, neurological deficits, and blood-brain barrier integrity at 24 h. Microglia efferocytosis of apoptotic neurons was analyzed in vivo and in vitro. The potential mechanism was determined by inhibiting or knocking down TAM receptors and Rac1 by specific inhibitors or siRNA. SAH induced upregulation of Axl and its ligand Gas6. The administration of rGas6 but not rPros1 promoted microglia efferocytosis, alleviated inflammation, and ameliorated SAH-induced BBB breakdown and neurological deficits. The beneficial effects of rGas6 were arrogated by inhibiting or knocking down Axl and Rac1. We concluded that rGas6 attenuated the development of early brain injury in mice after SAH by facilitating microglia efferocytosis and preventing inflammatory response, which is partly dependent on activation of Axl and Rac1.


Attrition one year after starting antiretroviral therapy before and after the programmatic implementation of HIV "Treat All" in Sub-Saharan Africa: a systematic review and meta-analysis.
Evidence on the real-world effects of "Treat All" on attrition has not been systematically reviewed. We aimed to review existing literature to compare attrition 12 months after antiretroviral therapy (ART) initiation, before and after "Treat All" was implemented in Sub-Saharan Africa and describe predictors of attrition. We searched Embase, Google Scholar, PubMed, and Web of Science in July 2020 and created alerts up to the end of June 2023. We also searched for preprints and conference abstracts. Two co-authors screened and selected the articles. Risk of bias was assessed using the modified Newcastle-Ottawa Scale. We extracted and tabulated data on study characteristics, attrition 12 months after ART initiation, and predictors of attrition. We calculated a pooled risk ratio for attrition using random-effects meta-analysis. Eight articles and one conference abstract (nine studies) out of 8179 screened records were included in the meta-analysis. The random-effects adjusted pooled risk ratio (RR) comparing attrition before and after "Treat All" 12 months after ART initiation was not significant [RR = 1.07 (95% Confidence interval (CI): 0.91-1.24)], with 92% heterogeneity (I2). Being a pregnant or breastfeeding woman, starting ART with advanced HIV, and starting ART within the same week were reported as risk factors for attrition both before and after "Treat All". We found no significant difference in attrition before and after "Treat All" one year after ART initiation. While "Treat All" is being implemented widely, differentiated approaches to enhance retention should be prioritised for those subgroups at risk of attrition. CRD42020191582 .


Selective and Scalable Synthesis of Sugar Alcohols by Homogeneous Asymmetric Hydrogenation of Unprotected Ketoses.
Sugar alcohols are of great importance for the food industry and are promising building blocks for bio-based polymers. Industrially, they are produced by heterogeneous hydrogenation of sugars with H2 , usually with none to low stereoselectivities. Now, we present a homogeneous system based on commercially available components, which not only increases the overall yield, but also allows a wide range of unprotected ketoses to be diastereoselectively hydrogenated. Furthermore, the system is reliable on a multi-gram scale allowing sugar alcohols to be isolated in large quantities at high atom economy.


Heat transfer and the energetic cost of singing by canaries Serinus canaria.
Sexually selected displays, such as male passerine bird song, are predicted to be costly. However, most measurements calculated the rate of oxygen consumption during singing using respirometry have shown that bird song has a low energetic cost. Since birds are reluctant to sing when enclosed inside a respirometry chamber, the energetic cost of singing could differ from that under more normal circumstances. We used heat transfer modelling, based on thermal images, to estimate the energetic cost of singing by canaries (Serinus canaria) that were not enclosed in respirometry chambers. Metabolic rate calculated from heat transfer modelling was 0.70 +/- 0.02 W (N = 10 birds) during singing, which was 14+/-5% greater than during standing (0.62 +/- 0.02 W). The energetic cost of singing did not differ significantly from that measured previously using respirometry when we took into account that birds sang for a greater proportion of the time during the current experiments. These conclusions were not sensitive to potential errors in the heat transfer model. Heat transfer modelling would be especially useful to obtain measurements of the energetic cost of activities that animals do not perform readily inside respirometry chambers, such as singing in birds.