In Peru, reporting male sex partners imparts significant risk of incident HIV/sexually transmitted infection: all men Engaging in same-sex behavior need prevention services.
Detailed information on the sexual behavior of bisexual, non-gay-identified men and the relationship between same-sex behavior and HIV/sexually transmitted infection (STI) incidence is limited. This study provides information on the sexual behavior with male partners of non-gay-identified men in urban, coastal Peru and the relationship of this behavior with HIV/STI incidence. We analyzed data from 2146 non-gay-identified men with a baseline and then 2 years of annual follow-up, including detailed information on sexual behavior with up to 5 sex partners, to determine the characteristics associated with bisexual behavior. Discrete time proportional hazards models were used to determine the effect of self-reported sex with men on subsequent HIV/STI incidence. Over the 3 study visits, sex with a man was reported by 18.9% of men, 90% of whom also reported sex with a female partner. At baseline, reported bisexual behavior was associated with other sexual risk behaviors such as exchanging sex for money and increased risk of HIV, herpes simplex virus type 2, and gonorrhea. The number of study visits in which recent sex with men was reported was positively correlated with risk of other sexual risk behaviors and incident HIV, herpes simplex virus type 2, and gonorrhea. Recent sex with a man was associated with increased HIV/STI incidence (hazard ratio, 1.79; confidence interval, 1.19-2.70), after adjusting for sociodemographics and other sexual risk behaviors. Given the prevalence of recent sex with men and the relationship of this behavior with HIV/STI incidence, interventions with non-gay-identified men who have sex with men and their partners are warranted.


[A case of myonephropathic metabolic syndrome treated with limb washout using a roller pump and cell saver].
We operated on a 65 year old male for the saddle embolism presenting the signs of MNMS. Before the reperfusion of the ischemic limbs which were successfully embolectomized with the use of Fogarty catheter, we performed limb washout using roller pump and cell saver. The washout was done in the high flow and large volume by the roller pump. The red blood cells in the efflux were saved using cell saver and retransfused to the patient. The patient recovered without deterioration of MNMS. The limb washout was effective for the prevention of the deterioration of MNMS.


AlgiMatrix™-Based 3D Cell Culture System as an In Vitro Tumor Model: An Important Tool in Cancer Research.
Routinely used two-dimensional cell culture-based models often fail while translating the observations into in vivo models. This setback is more common in cancer research, due to several reasons. The extracellular matrix and cell-to-cell interactions are not present in two-dimensional (2D) cell culture models. Diffusion of drug molecules into cancer cells is hindered by barriers of extracellular components in in vivo conditions, these barriers are absent in 2D cell culture models. To better mimic or simulate the in vivo conditions present in tumors, the current study used the alginate based three-dimensional cell culture (AlgiMatrix™) model, which resembles close to the in vivo tumor models. The current study explains the detailed protocols involved in AlgiMatrix™ based in vitro non-small-cell lung cancer (NSCLC) models. The suitability of this model was studied by evaluating, cytotoxicity, apoptosis, and penetration of nanoparticles into the in vitro tumor spheroids. This study also demonstrated the effect of EphA2 receptor targeted docetaxel-loaded nanoparticles on MDA-MB-468 TNBC cell lines. The methods section is subdivided into three subsections such as (1) preparation of AlgiMatrix™-based 3D in vitro tumor models and cytotoxicity assays, (2) free drug and nanoparticle uptake into spheroid studies, and (3) western blot, IHC, and RT-PCR studies.


Production of interferon in human cell cultures by a new, potent viral inducer.
A new discovered double-stranded RNA inducer of interferon, bluetongue virus (BTV), stimulates the production of large amounts of interferon in animals as well as in many types of mammalian cell cultures, including human leukocytes, and continuous cell lines. The exceptional pH lability of BTV and its lack of pathogenicity for man further recommend its use as an interferon inducer. Among several human cell lines tested, the most efficient producer of interferon was a continuous cell line designated HT-1376, derived from a bladder carcinoma. With infectious BTV as the inducer, the HT-1376 line produced more interferon per cell than did leukocytes; interferon yields ranged from 10,000 to 60,000 units per ml of crude, unconcentrated supernatant fluid. Noninfectious BTV, inactivated by ultraviolet irradiation, was as effective as infectious virions. The interferon produced in HT-1376 cells has physicochemical and antigenic properties resembling those of fibroblast interferon produced in diploid cells.


The landscape of online news regarding genetically modified foods: A cross-sectional study.
There has been substantial debate surrounding the use of genetically modified foods (GMFs). The purpose of this study was to describe the content of news articles covering GMFs. A search was completed on Google News using the key words "genetically modified foods" and the resulting 100 English-language news articles were analyzed for content. Only 26% of the articles analyzed were from professional or government sources. Among all content categories, definition or explanation of GMFs with a featured product as an example had the highest coverage, being addressed in 74% of the sample. Identification of GMFs from food labels (p = .001), was significantly associated with the source of the article (p > .05). Opportunities exist for scientists, educators, and health experts to present evidence-based and science-based information, with a balanced emphasis on the risks and benefits of GMFs to help consumers to make well-informed choices.


Allowance for radial dilution in evaluating the concentration dependence of sedimentation coefficients for globular proteins.
The accuracy with which the concentration dependence of the sedimentation coefficient, s = s 0(1 - kc), can be quantified for globular proteins by commonly used procedures has been examined by subjecting simulated sedimentation velocity distributions for ovalbumin to c(s)‒s analysis. Because this procedure, as well as its g(s)‒s counterpart, is based on assumed constancy of s over the time course of sedimentation coefficient measurement in a given experiment, the best definition of the concentration coefficient k is obtained by associating the measured s with the mean of plateau concentrations for the initial and final distributions used for its determination. The return of a slightly underestimated k (by about 3%) is traced to minor mislocation of the air‒liquid meniscus position as the result of assuming time independence of s in a given experiment. Although more accurate quantification should result from later SEDFIT and SEDANAL programs incorporating the simultaneous evaluation of s 0 and k, the procedures based on assumed constancy of s suffice for determining the limiting sedimentation coefficient s 0-the objective of most s‒c dependence studies.


[History of breast cancer reconstruction treatment].
The authors summarize in those six pages of drawings the history of breast cancer reconstruction treatment. The focus is on the variety of techniques available for breast reconstruction and on the debates around different indications.


Persistent anthelmintic activity of topically administered ivermectin in red deer (Cervus elaphus L.) against lungworms (Dictyocaulus viviparus).
A controlled trial was conducted to evaluate the persistent anthelmintic effect of ivermectin as a topical treatment at 500 microg/kg against induced infection with lungworm (Dictyocaulus viviparus) in red deer (Cervus elaphus). The results showed a highly significant (p <0.01) anthelmintic activity for at least 28 days against a newly acquired infection with Dictyocaulus viviparus (>99% efficacy).


Association between Serum Uric Acid and Nonalcoholic Fatty Liver Disease in Nonobese Postmenopausal Women: A Cross-sectional Study.
This study aimed to determine the association between serum uric acid (sUA) and nonalcoholic fatty liver disease (NAFLD) in nonobese postmenopausal women. A total of 4323 female individuals over 18 years of age participated in this cross-sectional study. The subjects were divided into four groups according to menopause status and body mass index. sUA quartiles in this female population were categorized as follows: Q1 ≤ 230 mmol/L, Q2: 231-270 mmol/L, Q3: 271-310 mmol/L and Q4: ≥ 311 mmol/L. The presence or absence of NAFLD was assessed by abdominal ultrasonography. The prevalence of NAFLD was 38.8% in the general population, and the average age was 46.5 ± 11.3 years. Among nonobese and obese subjects, the prevalence of NAFLD was lower in nonmenopausal subjects than in postmenopausal subjects (nonobese: 20.74% vs 45.26%, respectively, P < 0.0001; obese: 70.51% vs 84.35%, respectively, P < 0.0001). After adjusting for age, current smoking status, current alcohol drinking status, diabetes, hypertension disease and triglyceride, the ORs (95% CIs) for NAFLD among individuals in Q2-Q4 were 1.518 (1.062-2.169), 1.431 (1.010-2.027) and 2.054 (1.442-2.927), respectively, P value for trend <0.0001. Higher sUA levels can be used as a predictive biomarker for NAFLD in nonobese postmenopausal women.


[Comparison of the results of computer tomography and isotope diagnostics in pathologic processes of the infratentorial range (author's transl)].
1. Computer tomography is much more clearly superior to cranial scintigraphy with regard to the identification and localization of pathologic infratentorial processes, than in the supratentorial range. 2. Computer tomography alone solves many diagnostic problems relating to the infratentorial range, but it cannot by any means solve all the problems. 3. The diagnosis identifying the kind of infratentorial growing and displacing tumors cannot be safely established either by computer tomography alone or by a combination of computer tomography and cranial scintigraphy. 4. Cranial scintigraphy and CSF scintigraphy can supply additional informations, support the diagnosis, or contribute towards establishing the final diagnosis, in cases where computer tomography alone supplies ambiguous, questionably positive or discrete answers. In such cases, the emphasis is on the etiologic grouping of unclear forms of hydrocephalos.


Continuous Versus Sequential Acquisition Head Computed Tomography: A Phantom and Clinical Image Quality Comparative Study.
Sequential computed tomography (CT) technique remains the most common protocol for CT evaluation of the head despite nearly universal adoption of continuous technique for all other body parts. This may be attributable to the belief by radiologists that this technique is superior to helical scanning uniquely for this indication. This study attempts to clarify the issue. A phantom evaluation and a prospective randomized clinical image quality trial were performed comparing sequential and helical technique using the most current generation 128-row detector CT scanner. Phantom evaluation demonstrated equivalence between the 2 techniques for low-contrast resolution and line pair spatial discrimination. Continuous scanning provided the highest contrast-to-noise ratio. There was no significant difference between the 2 techniques regarding image quality except for cortical visualization at the cerebral hemispheres, which was subtly but significantly superior for sequential technique. Head CT image quality for sequential and continuous techniques are virtually equivalent.


Exploring reasons for variations in anxiety after testing positive for human papillomavirus with normal cytology: a comparative qualitative study.
To explore reasons for variations in anxiety in women testing positive for human papillomavirus (HPV) with normal cytology at routine HPV primary cervical cancer screening. In-depth interviews were conducted with 30 women who had tested HPV-positive with normal cytology, including 15 with low-to-normal anxiety and 15 with high anxiety. Data were analysed using Framework Analysis to compare themes between low and high anxiety groups. Several HPV-related themes were shared across anxiety groups, but only highly anxious women expressed fear and worry, fatalistic cognitions about cancer, fertility-related cognitions, adverse physiological responses and changes in health behaviour(s). In comparison to those with low anxiety, women with high anxiety more strongly voiced cognitions about the 12-month wait for follow-up screening, relationship infidelity, a lower internal locus of control and HPV-related symptom attributions. Receiving an HPV-positive with normal cytology result related to various emotional, cognitive, behavioural and physiological responses; some of which were specific to, or more pronounced in, women with high anxiety. If our observations are confirmed in hypothesis-driven quantitative studies, the identification of distinct themes relevant to women experiencing high anxiety can inform targeted patient communications and HPV primary screening implementation policy.


A single-centre study can improve our knowledge of a rare disease! As exemplified by studies in Langerhans' cell histiocytosis.
The main contribution of this clinical study of Langerhans' cell histiocytosis (LCH) is that it provides information on the adult outcome of patients diagnosed during childhood. The authors show that most patients, sometimes despite their sequelae, undertake higher education and live as independent adults. This study also offers evidence that some sequelae are due to radiotherapy, which should therefore be excluded from the treatment of LCH. The analysis of causes of death shows the important role of haematological dysfunction.


Quantitative composition and characterization of the proteins in membrane vesicles released from erythrocytes by dimyristoylphosphatidylcholine. A membrane system without cytoskeleton.
Membrane vesicles were prepared by incubation of human erythrocytes with dimyristoylphosphatidylcholine [3] and isolated by isopycnic centrifugation on Dextran density gradients. Protein analyses were carried out with crossed immunoelectrophoresis and dodecylsulfate polyacrylamide gel electrophoresis. The right-side-out-oriented membrane vesicles contained membrane and cytoplasmic proteins of the erythrocyte but lacked cytoskeletal components. Comparison of proteins in vesicles and erythrocyte membranes showed that acetylcholinesterase was enriched two to six times in the vesicles relative to both membrane-spanning proteins, band 3, and glycophorin. Two further, hitherto unidentified, sialic acid-containing membrane antigens were found in the vesicles. Both faced the outside of the membranes and were enriched two to seven times. Ankyrin was not present in the membrane vesicles and spectrin could not be detected by dodecylsulfate polyacrylamide gel electrophoresis. We suggest that the redistribution of proteins in the vesicles reflects differences in their interactions with other membrane components and their relative mobility within the erythrocyte membrane.


Tranexamic acid in pertrochanteric fractures: a retrospective analysis of perioperative outcomes after fixation with a proximal femoral nail.
Treatment of pertrochanteric femoral fractures is often associated with significant blood loss. It has already been demonstrated that the administration of tranexamic acid (TXA) for endoprosthetic procedures reduces blood losses and leads to a decreased frequency of postoperative complications. The aim of this study is to demonstrate whether the administration of TXA as part of osteosynthesis treatment for pertrochanteric fractures using a proximal femoral nail reduces perioperative blood losses and haemorrhage-related complications. In a two-centre retrospective cohort study, 1 g TXA i.v. was administered preoperatively to 294 patients who had suffered from pertrochanteric femoral fractures. The subjects were compared clinically to a historical control group who did not receive TXA (nonTXA). Outcomes were evaluated on the basis of perioperative blood loss, transfusion requirement, and occurrence of complications. The TXA group showed evidence of a reduction in blood loss (TXA = 0.97 ± 0.47 l; nonTXA = 1.06 ± 0.47 l; p = 0.004) and a lower frequency of transfusion (TXA = 20%; nonTXA = 31%; p = 0.032) as compared to the nonTXA group. However, evidence of this therapeutic effect could only be demonstrated at one of the centres on subgroup comparison between the two centres. At the second centre, the data did not show a significant difference. A trend could be seen towards a reduction in postoperative renal failure. No complications occurred resulting from the administration of tranexamic acid. Preoperative administration of TXA does not lead to an increased rate of thromboembolic complications when applied for treatment of pertrochanteric femoral fractures. Evidence of a positive effect could be seen in principle in relation to the reduction in perioperative blood loss and the frequency of transfusion. The difference in effect between the two centres remains to be clarified: for this reason, it is possible to assume that further factors influencing the efficacy of TXA administration are at play which were not taken into account in this study.


Human papillomavirus vaccine administration among women in the Eastern Mediterranean region of Turkey: prevalence and barriers.
Human papillomavirus (HPV) vaccines are very effective in preventing HPV infection and related diseases. This study aimed to determine the prevalence of the HPV vaccine administration and barriers to vaccination among women aged 15-49 years. This cross-sectional study was conducted on 401 women aged 15-49 years. The prevalence of women who received the HPV vaccine, their knowledge about HPV in general, HPV screening tests, HPV vaccine and the current HPV vaccination program were evaluated. Barriers to getting the HPV vaccine were questioned. The mean age of women who had received the HPV vaccine was 30.87±8.89 and the mean age at the first sexual intercourse was 22 years. 3.2% of women received HPV vaccine. The most important factor impeding the vaccination was unawareness of the HPV vaccine and the high cost of the vaccine. If the vaccine was free, most (81.2%) of the participants stated that they would vaccinate themselves and their children (72.8%). The highest lack of information was observed about the vaccination program and vaccinated women were more informed about HPV, HPV screening tests, HPV vaccine and the vaccination program. The increase in the knowledge about the HPV vaccination program increased the probability of getting vaccinated by an odds ratio (OR) of 4.43 times. The most important barriers to HPV vaccination were the lack of public funding for vaccines and the lack of information. We recommend increasing educational activities on the HPV vaccination program and public funding of vaccination.


Immunoglobulin G4-Related Lymphadenopathy.
Immunoglobulin G4-related lymphadenopathy (IgG4-RLAD) occurs in the setting of extranodal IgG4-related disease (IgG4-RD), an immune-mediated process described in many organ systems characterized by lymphoplasmacytic infiltrates with abundant IgG4-positive plasma cells and fibrosis. Although the morphologic features in the lymph node sometimes resemble those seen at the extranodal sites, 5 microscopic patterns have been described, most of which resemble reactive lymphoid hyperplasia. This morphologic variability leads to unique diagnostic challenges and a broad differential diagnosis. As IgG4-RD may be exquisitely responsive to steroids or other immunotherapy, histologic recognition and inclusion of IgG4-RLAD in the differential diagnosis is vital.


Combination of antimicrobials for non-specific isolated terminal ileal abnormalities - A randomized clinical trial.
Non-specific isolated terminal ileum abnormalities (NSITIA) namely erosions, ulcer and nodularity are frequent findings on ileal examination during colonoscopy. Their clinical significance and management are uncertain. A pilot randomized clinical trial comparing combination antimicrobial therapy (oral Rifaximin 550 mg twice daily for two weeks; Albendazole 400 mg orally as a single dose; Tinidazole 1 gm twice daily for three days i.e. Group A) with symptomatic treatment (Group B) was performed in patients with NSITIA, which was diagnosed on the basis of colonoscopy and histopathology features. The primary outcome measure was mucosal healing on follow-up ileocolonoscopy at three months of randomization. Additionally, clinical, endoscopic and histological findings were noted at baseline and after a follow-up of three months. Total 60 patients with NSITIA were randomized. The most prevalent symptoms were abdominal discomfort (n = 37, 61.6%), diarrhea (n = 25, 41.6%) and constipation (n = 24, 40%). The incidence of ulcers, nodularity and erosions were (n = 18, 62.1%), (n = 8, 27.6%) and (n = 3, 10.34%) in group A and (n = 18, 58%), (n = 9, 29%), (n = 4, 13%) in group B, respectively. After a mean follow-up duration of 3.36 ± 0.27 months, both groups showed comparable resolution in clinical symptoms (n = 24, 92.4% vs. n = 24, 88.8%, p = 0.954), ileocolonoscopic findings (n = 23, 88.5% vs. n = 22, 81.5%, p = 0.765) and histological characteristics (n = 20, 76.5% vs. n = 19, 70.4%, p = 0.806). The clinical, endoscopic and histopathological remission occurs in most patients with NSITIA. The use of antimicrobials including antibiotic, antiprotozoal and anthelminthic therapy did not have any impact on the rate of mucosal healing in these patients. Our study is a pilot study and has some limitations such as small sample size and lack of complete small bowel workup in all patients, which leaves a possibility of undetected ulcers proximal to the terminal ileum. This study has been registered in India's clinical trial registry under the registration number CTRI/2020/02/023459 ).


[Eclizumab in the treatment of myasthenia gravis crisis complicating invasive thymoma: a case study of efficacy].
A 40-year-old male patient was diagnosed with invasive thymoma and myasthenia gravis in 2015. In 2016 and 2017, he experienced myasthenic crises, with an increase in size of invasive thymoma. In 2018, he received chemotherapy for the invasive thymoma. After 2 months, his symptoms rapidly progressed to myasthenic crisis with severe bulbar and respiratory symptoms, despite the significant effect of chemotherapy for the thymoma. High-dose corticosteroid, multiple plasma exchanges, and intravenous immunoglobulin did not improve the symptoms. Thus, eculizumab was administered, resulting in an improvement in his conditions. To our knowledge, this is the first report showing that eculizumab may improve myasthenic crisis with invasive thymoma.


Role of 'angle of progression' in prediction of delivery mode.
The aim of this study was to investigate the role of the 'angle of progression' (AOP) in the prediction of vaginal delivery. In this prospective study, we followed 70 singleton pregnant women. AOP was measured at admission time and also at the beginning of the second stage immediately after digital examination. Digital and ultrasound examiners were unaware of each other's results. The digital examiner decided on the delivery mode based on clinical assessment. Sixty-five (92.9%) women had vaginal delivery. In the first stage of labor, the area under the curve was 87.5% (95% confidence interval [CI], 77.9-97.1; P = 0.005) for the AOP and 85.5% (95%CI, 75.2-95.6; P = 0.009) for digital examination and in the second stage of labor, the area under the curve was 90.2% (95%CI, 81-99.3; P = 0.003) for the AOP and 94.9% (95%CI, 89.1-100; P = 0.001) for digital examination. An AOP of ≥113° at the second stage was associated with a 90.8% probability of vaginal delivery. We found a significant relation between AOP and cervical dilatation during the first stage of labor. A larger angle at the beginning of the second stage was significantly associated with shorter time to delivery.


[Brachytherapy in France in 2020: State of the art and perspectives from the Groupe curiethérapie de la SFRO].
Because of its principle and its high proof level clinical results, brachytherapy represents a specific irradiation technique for the treatment of primary tumors as well as some local relapses in pre-irradiated area. After a glory period between the 80's and 90's, brachytherapy has progressively lost its attractiveness. In order to provide a practical solution to this deleterious situation, it is important that guardianships, health care payers, patient associations, specialist doctors and radiation oncologists understand the reasons leading to this harmful state as well as the risks concerned. A teaching judged insufficient, non-adapted value and an aging image of brachytherapy represent the three main reasons of this degradation and constitute the three most important challenges conditioning its maintain in the anticancer treatment arsenal. An adapted communication with radiation oncologists themselves but also with the other scientific societies remains crucial as well as with guardianship and patient associations. It is central that brachytherapy could be recognized in order to make it stronger and accessible for all the patients who could need it.


Anaesthetic requirement in spinal cord injured patients undergoing operation below the level of cord injury.
Anaesthesia in spinal cord injured (SCI) can be hazardous. In complete injuries above T6, the abnormal state of the respiratory and the cardiovascular systems pose special problems. The objective of this study therefore was to evaluate the anaesthetic requirements in patients with complete SCI undergoing operation below the level of the cord lesion. The medical records and the operation notes of all patients with complete SCI who underwent surgical operations between January 2001 and December 2005 were reviewed. Information about their demographics, level of injury, indications for operation, type of operation done and the type anaesthesia used were collated. The choice anaesthesia was guarded by the proximity of operation site to the level of cord transaction and by patient's preference. The pre-operative and intra-operative blood pressure, pulse rate and respiratory rate were used to monitor cardiovascular and respiratory responses. They were twenty-eight, all male except one. The age range was 13-67 years with an average of32 years. The level of cord lesion varied. The thoracic spine was most involved followed by the cervical spine. The most common indication for operation was pressure sore. The anesthetic requirement varied, and ranged from general anesthesia (GA) to no anaesthesia at all. Three broad groups were observed: no anaesthesia; sedation with diazepam; and general anaesthesia. There was no remarkable change in the blood pressure readings in the three groups. However, three patients who had GA and whose operation sites were in the twilight zone had remarkable changes in the pulse and respiratory rates. Even though spinal patients are insensate below the level of their injury, significant proportions that need operation below the level of cord lesion require anaesthesia.


Internet Searching About Disease Elicits a Positive Perception of Own Health When Severity of Illness Is High: A Longitudinal Questionnaire Study.
The Internet is one of the primary sources for health information. However, in research, the effects of Internet use on the perception of one's own health have not received much attention so far. This study tested how Internet use for acquiring health information and severity of illness influence patients with a chronic disease with regard to the perception of their own health. Negative psychological states are known to lead to preferential processing of positive information. In particular, the self-directed nature of Internet use provides room for such biases. Therefore, we predicted that patients experiencing negative health states more frequently, due to more frequent episodes of a chronic illness, will gain a more positive perception of their health if they use the Internet frequently to gain health information, but not if they use the Internet rarely. This effect was not expected for other sources of information. A longitudinal questionnaire study with two measurement points-with a 7-month time lag-tested the hypothesis in a sample of patients with chronic inflammatory bowel disease (n=208). This study assessed patients' frequency of Internet use, their participation in online social support groups, their use of other sources of health information, and several indicators of the participants' perceptions of their own health. A structure equation model (SEM) was used to test the predictions separately for Internet searches and other sources of information. Data analysis supported the prediction; the interaction between frequency of health-related information searches and frequency of episodes at the first measurement point (T1) was related to participants' positive perceptions of their own health at the second measurement point (T2) (B=.10, SE=.04, P=.02) above and beyond the perceptions of their own health at T1. When participants used the Internet relatively rarely (-1 SD), there was no relationship between frequency of episodes and positive perceptions of their own health (B=-.11, SE=.14, t203=-0.82, P=.41). In contrast, when participants used the Internet relatively often (+1 SD), the more frequently they had those episodes the more positive were the perceptions of their own health (B=.36, SE=.15, t203=2.43, P=.02). Additional SEM analyses revealed that this effect occurs exclusively when information is searched for on the Internet, but not when other sources of information are consulted, nor when online social support groups are joined. The results of this study suggest that patients might process information from the Internet selectively, in an unbalanced, biased fashion, with the formation of a self-serving (ie, positive) perception of own health. At the same time, this bias contributes to the ability of patients to cope psychologically with their disease.


[Metabolic characteristics of prolyl hydroxylase].
The turnover time of prolyl hydroxylase in the skin of one-day-old rats treated in vivo with L-[14C]leucine is 22--34 hrs. Theoretically this time interval comprises two processes: i. e. incorporation of [14C]-Leu into the inactive enzyme precursor and transformation of the inactive from into the active enzyme.


New insights into the FLPergic complements of parasitic nematodes: Informing deorphanisation approaches.
FMRFamide-like peptide (FLP) receptors are appealing as putative anthelmintic targets. To date, 31 flp-encoding genes have been identified in Caenorhabditis elegans and thirteen FLP-activated G-protein coupled receptors (FLP-GPCRs) have been reported. The lack of knowledge on FLPs and FLP-GPCRs in parasites impedes their functional characterisation and chemotherapeutic exploitation. Using homology-based BLAST searches and phylogenetic analyses this study describes the identification of putative flp and flp-GPCR gene homologues in 17 nematode parasites providing the first pan-phylum genome-based overview of the FLPergic complement. These data will facilitate FLP-receptor deorphanisation efforts in the quest for novel control targets for nematode parasites.


Short-term stimulation studies on neonatal pig pancreatic duct-derived cell monolayers.
Short-term stimulation with insulinotropic factors may induce morphologic and functional changes in primary ductal cell cultures as a potential source of stem cells. We sought to assess the capacity of hepatocyte growth factor (HGF) to induce expression and maturation of proteins--PDX-1 and GLUT-2--and the subsequent beta-cell secretory profiles. HGF, which is involved in pancreatic development, may induce islet beta-cell neogenesis. Primary ductal cell monolayers were cultured in Click's + FBS 10% at 37 degrees C until tissue confluence. The medium was enriched with HGF (10 ng/mL for different periods); controls were treated for similar times with normal culture medium. At the end of the study, three-dimensional islet-like cell aggregates were observed in both conditions. In all conditions immunostaining studies showed positivity for the major endocrine-phenotype cell markers: insulin, PDX-1, glucokinase, and GLUT-2. Furthermore, treatment with HGF for short periods induced the expression of a functionally active, phosphorylated isoform of PDX-1. Finally, we observed that under basal conditions the cells initially and progressively released proinsulin throughout 5 days in all settings. Thereafter proinsulin was gradually replaced by insulin in the culture medium, reflecting a maturation progress. This pattern of insulin maturation and release was more evident when the cells were continuously stimulated with HGF for 12 days. The employed stimuli seemed to differentiate the original ductal cell layers toward endocrine cell phenotypes that synthesize and release proinsulin and subsequently insulin. HGF seems to provide a more efficient differentiation.


Pharmacokinetics, pharmacodynamics, metabolism, toxicology and residues of phenylbutazone in humans and horses.
The presence of horse meat in food products destined for human consumption and labelled as beef has raised several concerns of public interest. This review deals solely with one aspect of these concerns; samples of equine tissue from horses destined for the human food chain have tested positive for the non-steroidal anti-inflammatory drug, phenylbutazone. The safety of some or all such foods for human consumers is a major concern, because it was shown many years ago that phenylbutazone therapy in humans can be associated with life threatening blood dyscrasias. As an initial basis for assessing the potential toxicity of foods containing phenylbutazone and its metabolites, this article reviews (1) the pharmacokinetic, pharmacodynamic, metabolic and toxicological profiles of phenylbutazone, with particular reference to horses and humans; (2) toxicity data in laboratory animals; (3) phenylbutazone residues in food producing species, and (4) as a preliminary assessment, the potential hazard associated with the consumption of horse meat containing phenylbutazone and its metabolites. Since phenylbutazone cannot be classified as a carcinogenic substance in humans, and noting that blood dyscrasias in humans are likely to be dose and treatment duration-dependent, the illegal and erratic presence of trace amount residues of phenylbutazone in horse meat is not a public health issue.


Designing the antimicrobial peptide with centrosymmetric and amphipathic characterizations for improving antimicrobial activity.
Antibiotic-resistant bacterial infections are becoming a serious health issue and will cause 10 million deaths per year by 2050. As a result, the development of new antimicrobial agents is urgently needed. Antimicrobial peptides (AMPs) are found in the innate immune systems of various organisms to effectively fend off invading pathogens. In this study, we designed a series of AMPs (THL-2-1 to THL-2-9) with centrosymmetric and amphipathic properties, through substituting different amino acids on the hydrophobic side and at the centrosymmetric position to improve their antimicrobial activity. The results showed that leucine as a residue on the hydrophobic side of the peptide could enhance its antimicrobial activity and that glutamic acid as a centrosymmetric residue could increase the salt resistance of the peptide. Thus, the THL-2-3 peptide (KRLLRELKRLL-NH2 ) showed the greatest antimicrobial activity (MIC90 of 16 μM) against Gram-negative bacteria and had the highest salt resistance and cell selectivity among all the designed peptides. In summary, the results of this study provide useful references for the design of AMPs to enhance antimicrobial activity.


Proliferative activity of rectal mucosa and soluble fecal bile acids in patients with normal colons and in patients with colonic polyps or cancer.
Rectal biopsies and fecal collections were obtained from a consecutive series of 34 outpatients prior to colonoscopy at a gastroenterology clinic. Subsequently, 14 were found to have no colonic pathology, 13 had adenomatous polyps, (3 of those had a previous history of colon cancer) and 7 were diagnosed with colon cancer. In confirmation of earlier studies the tritiated thymidine labelling index was higher in patients with tumors than in those without pathology (7.9% vs. 5.8% with P = 0.06). The patients with colonic tumors also had significantly higher levels of deoxycholic acid (P = 0.01) and lithocholic acid (P = 0.005) in the aqueous extract of their feces. This study shows that these biochemical measures may indicate colon cancer risk.


Atypical glandular cells of undetermined significance in conventional cervical/vaginal smears and thin-layer preparations.
Biopsy follow-up of a cervical/vaginal smear interpretation of atypical glandular cells of undetermined significance (AGUS) most often reveals either a benign reactive process or a squamous cervical intraepithelial neoplasia (CIN) rather than a glandular one. The ThinPrep Papanicolaou test (TP) has been shown to increase diagnostic sensitivity for CIN. To the authors' knowledge there are few studies examining its effectiveness in diagnosing uterine glandular lesions, either endocervical or endometrial. The authors compared outcomes after AGUS interpreted in TP specimens and conventional smear preparations (CPs). Follow-up was sought in all cases that were interpreted as AGUS during a 3-year period in which practice groups converted from CPs to TPs. A tissue diagnosis of adenocarcinoma in situ, CIN of Grade 2 or 3, or invasive carcinoma was considered to be a positive follow-up result. Either a benign biopsy finding with a subsequent benign cytologic result or two consecutive benign cytologic results were considered to be negative follow-up results. AGUS was reported in 116 of 75,002 TPs (0.15%) and 151 of 79,322 CPs (0.19%). Follow-up information was available in 91 (78%) and 130 (86%) cases, respectively. The predictive value of AGUS for a positive follow-up result was 22% in the TP group and 15% in the CP group. An AGUS interpretation with a positive follow-up result was found in 0.027% of all cases using TPs and in 0.025% of all cases using CPs. The use of TPs may increase the diagnostic specificity of AGUS for a high-grade precursor lesion or carcinoma.


Dual effect of adrenalin on sugar transport in rat diaphragm muscle.
The effect of adrenalin on the membrane transport of the non-metabolized sugar, 3-methylglucose, was studied in isolated "intact" rat hemidiaphragms and related to simultaneously occurring changes in the internal levels of Na+, ATP, glucose-6-P, glycerol formation and 45Ca uptake and loss. Basal sugar transport was inhibited by low (10-8-10-5 M) concentrations of adrenalin; this was antagonized by propranolol and practolol. High concentrations (10-4-10-3 M) stimulated sugar transport, and this was blocked by propranolol and butoxamine and was dependent on external Ca2+. These results suggest interaction with two different classes of adrenergic receptors, possibly of beta 1 and beta 2 types. Both low and high concentrations increases Na+ and K+ gradients by a practolol-sensitive effect. Isoproterenol behaved identically but phenylephrine had only the two practolol-sensitive effects on sugar and ion transport. Insulin did not interfere with inhibition of sugar transport and decrease in internal Na+ but prevented stimulation of sugar transport. Under anoxia adrenalin had no effect on sugar transport but led to greater Na+ gain by tissue. Addition of 3.0 mM palmitate decreased inhibition of sugar transport without changing receptor specificity. ATP was decreased and lipolysis enchanged by high adrenalin but glucose-6-P was increased by the low concentration as well. Influx of 45 Ca was decreased by low and increased by high adrenalin; 45Ca efflux was also differentially affected. The results indicate that inhibition and stimulation of sugar transport depend on different receptors and that the latter response may override the former. The data are consistent with the earlier postulated regulatory role of sarcoplasmic Ca2+ on sugar transport in muscle, with adrenalin affecting Ca2+ fluxes and distribution both directly and indirectly.


Infant born preterm have delayed development of adaptive postural control in the first 5 months of life.
Infants born preterm are at increased risk of developmental disabilities, that may be attributed to their early experiences and ability to learn. The purpose of this paper was to evaluate the ability of infants born preterm to adapt their postural control to changing task demands. This study included 18 infants born at 32 weeks of gestation or less whose posture was compared in supine under 2 conditions, with and without a visual stimulus presented. The postural variability, measured with root mean squared displacement of the center of pressure, and postural complexity, measured with the approximate entropy of the center of pressure displacement were measured longitudinally from 2.5 to 5 months of age. The infants looked at the toys in midline for several months prior to adapting their postural variability in a manner similar to full term infants. Only after postural variability was reduced in both the caudal cephalic and medial lateral direction in the toy condition did the infants learn to reach for the toy. Postural complexity did not vary between conditions. These findings suggest that infants used a variety of strategies to control their posture. In contrast to research with infants born full term, the infants born preterm in this study did not identify the successful strategy of reducing movement of the center of pressure until months after showing interest in the toy. This delayed adaptation may impact the infants ability to learn over time.


Histochemical examination of the effects of high-dose 1,25(OH)2D3 on bone remodeling in young growing rats.
Vitamin D has an anabolic effect on bone developmental processes and is involved in maintaining skeletal integrity. In recent years, pediatric cases of vitamin D intoxication have attracted attention. Therefore, the aim of this study was to investigate the influence of long-term administration of physiologically-high-dose calcitriol (1,25(OH)2D3) on bone remodeling in young developing rats. Neonatal rats received once-daily subcutaneous injection of calcitriol (250 ng/kg body weight), or PBS only as a control, for 3 weeks. At 1, 2 and 4 weeks' post-administration, rats were sacrificed and fixed by transcardial perfusion with 4 % paraformaldehyde, following which tibiae were extracted for histochemical analysis. Compared with the control group, the number of tartrate-resistant acid phosphatase- and Cathepsin K-positive osteoclasts were significantly increased, and the expression of alkaline phosphatase in osteoblasts was decreased in trabecular bone of rats administered high-dose 1,25(OH)2D3, leading to decreased trabecular bone volume. In addition, the expression of receptor activator of nuclear factor kappa-B ligand (RANKL) was increased, while that of osteoprotegerin was weaker in osteoblasts in the experimental group compared with the control group. Moreover, there was weaker immunoreactivity for EphrinB2 in osteoclasts and EphB4 in osteoblasts of trabecular bone in the experimental group compared with the control group. These findings suggest that long-term use of physiologically-high dose calcitriol may result in bone loss through RANKL/RANK/osteoprotegerin and EphrinB2-EphB4 signaling pathways, and that these negative effects could continue after drug withdrawal. Therefore, optimal limits for vitamin D administration need to be established for children and adolescents.


Maltose binding protein facilitates high-level expression and functional purification of the chemokines RANTES and SDF-1alpha from Escherichia coli.
The chemokines RANTES (regulated on activation, normal T cell expressed and secreted) and SDF-1alpha (stromal cell-derived factor-1alpha) are important regulators of leukocyte trafficking and homing. Chemokines form insoluble inclusion bodies when expressed in Escherichia coli (E. coli), resulting in low yields of soluble protein. We have developed a novel chemokine expression system that generates a high amount of soluble protein and uses a simple purification scheme. We cloned different types of RANTES and SDF-1alpha fused to either maltose binding protein (MBP) or glutathione-S-transferase (GST) and expressed the fusion proteins in E. coli under various conditions. We found that the yield of soluble chemokine is influenced by the type of fusion partner. Fusion to MBP resulted in a higher yield of total and soluble chemokine compared to GST. Under optimized conditions, the yield of soluble MBP-RANTES and MBP-SDF-1alpha was 2.5- and 4.5-fold higher than that of the corresponding GST-fusion protein, respectively. Recombinant chemokine fusion proteins exhibited specific binding activity to chemokine receptors. These results demonstrate that the use of MBP-fusion proteins may provide an approach to generating high yields of soluble and functional chemokines, such as RANTES and SDF-1alpha.


RETRACTED: Glycemic control outcomes of adults using the MiniMed™ 670G hybrid closed-loop (HCL) system: A single-center study.
This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the Editor-in-Chief. A number of individuals who fulfilled authorship requirements for the article were omitted by the sole author. Secondly, the conclusions drawn are statistically incorrect. The scientific inaccuracies include: incorrect use of available analysis sets, insufficient definition of statistical methodology (including in measurement of HbA1c), incorrect methodology, lack of statistical significance for correlations made, and data errors.


Does Preceptorship improve confidence and competence in Newly Qualified Nurses: A systematic literature review.
A systematic literature review to assess whether preceptorship improves confidence and competence in Newly Qualified Nurses. Preceptorship was introduced into nursing in the United Kingdom in 1991 with the original aim to improve competence and confidence. This systematic review was undertaken to review the evidence of the impact of preceptorship on confidence and competence of nurses in their first year post qualifying. A comprehensive search of The British Nursing Index, CINAHL, Embase, Medline, PsycInfo, PyscArticles, Campbell Collaboration; Cochrane, HMIC, ERIC, ASSIA, Web of Science, Scopus, Scopus Conference, Web of Science Conferences; NHS Evidence, OpenGrey, National Technical, NINR, Opendoar, SSRN, Kings College London and the RCN was conducted. A PRISMA structured systematic review was carried out, 14 papers 4 mixed methods, 8 qualitative, 1 scoping review and 1 service development, published between 1996 and 2013 were critically reviewed, and data extracted using thematic analysis. Four themes were identified from a thematic analysis: measurement, knowledge and experience, support, and structure. While one-to-one preceptorship does influence confidence and competence, Preceptorship Programmes has greater impact than the individual preceptor. Due to limited empirical research there is no concrete evidence that Preceptorship has a direct impact on confidence or competence. Further research into team preceptorship/choice of preceptors and what impacts on Newly Qualified Nurses confidence and competence is required.


Spectrophotometric intracutaneous analysis: a new technique for imaging pigmented skin lesions.
Spectrophotometric intracutaneous analysis (SIA) is a new technique for imaging pigmented skin lesions and for diagnosing melanoma. The SIAscope produces eight narrow-band spectrally filtered images of the skin over an area of 24 x 24 mm with radiation ranging from 400 to 1000 nm. To present the early results of a clinical trial with SIA. Spectrophotometric inputs from the skin were analysed using complex algorithms to return high-resolution information regarding total melanin content of the epidermis and papillary dermis, collagen and haemoglobin content as well as the presence of melanin in the papillary dermis. Simple, highly reproducible and reliable features were identified, e.g. the presence of dermal melanin, collagen holes and 'erythematous blush' with blood displacement. These simple features were found to be highly specific (80.1%) and sensitive (82.7%) for melanoma in a dataset of 348 pigmented lesions (52 melanomas) and compared very favourably with dermatoscopy when analysed using receiver-operator characteristic curves. This first clinical trial with SIAscopy has yielded very promising results and delivers new, useful information to the clinician diagnosing pigmented skin lesions.


On the osmoregulation in Atriplex hymenelytra (Torr.) Wats. (Chenopodiaceae).
Aspects of osmoregulation were studied in leaves of irrigated and nonirrigated plants of Atriplex hymenelytra (Torr.) Wats. (Chenopodiaceae) from their natural habitat in Death Valley, California. Using a set of several data concentrations of inorganic electrolytes (Na+, K+, Cl-) and of oxalate in the mesophyll of this salt secreting species were calculated. The osmotic potential resulting from these solutes (under consideration of an empirically estimated osmotic coefficient) is in good agreement with field measurements of the overall osmotic potential in the leaf mesophyll as determined by pressure-volume curves. This indicates that these 4 electrolytes are the main osmotically active solutes. Oxalate is present in comparably high concentrations and is used to achieve ion balance.Organic solutes analyzed include soluble carbohydrates (mono-, di- and oligosaccharides), amino- and organic acids as well as glycinebetaine. Of these, organic- and amino acids (including proline) contribute only little to osmoregulation. Soluble carbohydrates and especially glycinebetaine exhibit concentrations high enough for generating considerable osmotic potentials, at least if these compounds are regarded to be restricted to the cytoplasm acting as compatible solutes.


Impact of prior coronary artery bypass grafting on periprocedural and short-term outcomes of patients undergoing transcatheter aortic valve replacement: a systematic review and meta-analysis.
The effect of prior coronary artery bypass graft (CABG) on the outcomes of transcatheter aortic valve replacement (TAVR) remains incompletely characterized. In this meta-analysis, we investigated the impact of prior CABG on TAVR outcomes. A systematic search was conducted in PubMed, Google Scholar, and Cochrane databases from inception to 24 July 2022, using the search terms 'TAVR', 'CABG', 'peri-procedural complications', and 'mortality'. The major outcomes were peri-procedural complications, intraprocedural mortality, 30-day mortality, and 30-day cardiac mortality. We used random-effects models to aggregate data and to calculate pooled incidence and risk ratios with 95% confidence intervals (CIs). Among 116 results from the systematic search, a total of 8 studies (5952 patients) were included. Compared to patients without previous CABG, patients with prior CABG undergoing TAVR were younger, predominantly male sex, had more comorbidities, higher rates of peri-procedural myocardial infarction (MI) [relative risk (RR) 1.93; 95% CI, 1.09-3.43; P = 0.03], but lower rates of stroke (RR 0.71; 95% CI, 0.51-0.99; P = 0.04), major vascular complications (RR 0.70; 95% CI, 0.51-0.95; P = 0.02), and major bleeding (RR 0.70; 95% CI, 0.56-0.88; P = 0.002). There were no significant differences between the two cohorts in rates of pacemaker implantation, cardiac tamponade, acute kidney injury, intra-procedural mortality, 30-day mortality, and 30-day cardiac mortality. Among patients undergoing TAVR, a history of prior CABG was not associated with an increased risk of periprocedural complications (except for acute MI) or short-term mortality compared to those without CABG.


Ruptured ectopic pregnancies following methotrexate treatment: clinical course and predictors for improving patient counseling.
To determine the predictors for tubal rupture among women treated with methotrexate (MTX) for ectopic pregnancy. We performed a retrospective cohort analysis in a tertiary university-affiliated medical center. Medical records of 401 women who were diagnosed with ectopic pregnancy and were treated with MTX between January 2001 and June 2017 were reviewed. Forty-one women were diagnosed with ruptured ectopic pregnancy (study group) and 360 women with non-ruptured ectopic pregnancy (control group). Descriptive data and predictive variables for rupture ectopic pregnancy following MTX treatment were reviewed. Out of 122 women who failed MTX treatment, forty-one women had tubal rupture (33.6%). The median time interval from MTX treatment to tubal rupture was 6 days (1-25). β-hCG percentage change in the 48 h preceding MTX treatment and β-hCG level at day 0 were independent predictors for tubal rupture (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 1.04-1.12, p < 0.001 for every percent change in β-hCG; OR = 1.001, 95% CI = 1.0003-1.002 for every unit change in β-hCG, respectively). In a decision tree analysis model, in women with β-hCG percentage increment >69% in the 48 h preceding methotrexate the probability for tubal rupture was 85%. Risk assessment for tubal rupture should be made before methotrexate treatment according to β-hCG dynamics and level. The absolute risk for tubal rupture in women with β-hCG increment<20% is low.


The Deep Learning Generative Adversarial Random Neural Network in data marketplaces: The digital creative.
Generative Adversarial Networks (GANs) have been proposed as a method to generate multiple replicas from an original version combining a Discriminator and a Generator. The main applications of GANs have been the casual generation of audio and video content. GANs, as a neural method that generates populations of individuals, have emulated genetic algorithms based on biologically inspired operators such as mutation, crossover and selection. This article presents the Deep Learning Generative Adversarial Random Neural Network (RNN) with the same features and functionality as a GAN. Furthermore, the presented algorithm is proposed for an application, the Digital Creative, that generates tradeable replicas in a Data Marketplace, such as 1D functions or audio, 2D and 3D images and video content. The RNN Generator creates individuals mapped from a latent space while the GAN Discriminator evaluates them based on the true data distribution. The performance of the Deep Learning Generative Adversarial RNN has been assessed against several input vectors with different dimensions, in addition to 1D functions and 2D images. The presented results are successful: the learning objective of the RNN Generator creates tradeable replicas at low error, whereas the RNN Discriminator learning target identifies unfit individuals.


[Renal Cell Carcinoma metastases in the maxillofacial area: Case series.]
Renal cell carcinoma is an unpredictable malignancy. Sometimes, metastases are the disease debut. On the other hand, metastases could present years after treatment of the primary tumor. Four clinical cases of atypical metastases in the head and neck location are presented: parotid gland, mandibular bone, attached molar gingiva and masticator space. Physiopathology, clinics, histology and management of metastatic renal cell carcinoma at those anatomical regions are reviewed.


Splenic amyloidosis: a case report of spontaneous splenic rupture with a review of the pertinent literature.
A case of spontaneous rupture of the spleen as a complication and presenting factors of systemic amyloidosis is reported with a review of the pertinent literature. the sequelae of amyloid involvement of the spleen is discussed with emphasis on possible mechanisms involved in the causation of spontaneous rupture of this organ.


The range of therapeutic efficacy of atypical antipsychotics: a critical evaluation.
Atypical antipsychotics (AA) have revolutionized the treatment of schizophrenia, now being the treatment of choice for patients with this disorder. The positive therapeutic experience with the AA in the treatment of these disorders and their favourable adverse-effect profiles, has encouraged clinicians to extend their usage beyond their initial regulatory approval in several conditions and patient groups. It is noticeable that the positive results with AA in the treatment of aggression, depressive and manic syndromes tend to be overestimated and generalised, slowly creating the idea that these agents are omnipotent in the treatment of two big groups of psychiatric disorders: schizophrenia and affective disorders. The aim of this study is to summarize the clinical experiences in the treatment of these two groups of disorders, with the intention of taking the first step towards a clearer definition of their field of therapeutic usage and effectiveness.


Combined effects of nitric oxide synthase 3 genetic variant and childhood emotional abuse on earlier onset of suicidal behaviours.
Marked heterogeneity in suicide attempters has been observed, with earlier onset being linked to stronger heritability, more childhood maltreatment. Nitric oxide signalling system might be implicated in this relationship through its role in the stress response/adaptation. This study examined how NOS genetic variants and childhood maltreatment were associated with age at first suicide attempt (SA). Adult patients with SA history (N = 414) filled in the Childhood Trauma Questionnaire, and six functionally relevant NOS2 and NOS3 polymorphisms were genotyped. Analyses included χ2, Mann-Whitney U tests, Kendall's regression, multivariate linear and Cox survival regressions, and a moderation analysis. The NOS3 promotor 27-bp variable number tandem repeat (VNTR) bb homozygous state and childhood emotional abuse were independently associated with earlier age at first SA, which was robust after controlling for confounders [regression coefficient - 3.975, 95% CI -6.980 - (-0.970), p = 0.010, and - 1.088, 95% CI -2.172 - (-0.004), p = 0.049]. No interaction was observed. In the Cox proportional hazards model for age at first SA, the hazard ratio for patients with childhood emotional abuse and NOS3 27-bp VNTR bb was 0.533 (95% CI 0.394-0.720, p < 0.001) compared to patients without. Intermediate scores were observed with either only the risk genotype or only childhood emotional abuse. A graded relationship was also observed for repeated SA, family history of SA, and severe SA history. These results are preliminary due to a low statistical power and call for replication and further characterization of the role of nitric oxide system in the susceptibility to early-onset SB.


Serum prostatic antigen measurement in localized prostatic cancer: correlation with clinical course.
Serial serum prostatic antigen measurements were performed on patients treated for localized prostatic carcinoma. There was good correlation of mean serum prostatic antigen levels and the surgical stage of the disease. Among patients treated by radical prostatectomy there was good correlation of an elevated serum prostatic antigen and the development of metastatic disease. It appears that serum prostatic antigen is a good indicator and predictor of the development of distant metastasis in this group of patients.


Excess risk of SARS-CoV-2 infection among in-person nonhealthcare workers in six states, September 2020-June 2021.
While the occupational risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection for healthcare personnel in the United States has been relatively well characterized, less information is available on the occupational risk for workers employed in other settings. Even fewer studies have attempted to compare risks across occupations and industries. Using differential proportionate distribution as an approximation, we evaluated excess risk of SARS-CoV-2 infection by occupation and industry among non-healthcare workers in six states. We analyzed data on occupation and industry of employment from a six-state callback survey of adult non-healthcare workers with confirmed SARS-CoV-2 infection and population-based reference data on employment patterns, adjusted for the effect of telework, from the U.S. Bureau of Labor Statistics. We estimated the differential proportionate distribution of SARS-CoV-2 infection by occupation and industry using the proportionate morbidity ratio (PMR). Among a sample of 1111 workers with confirmed SARS-CoV-2 infection, significantly higher-than-expected proportions of workers were employed in service occupations (PMR 1.3, 99% confidence interval [CI] 1.1-1.5) and in the transportation and utilities (PMR 1.4, 99% CI 1.1-1.8) and leisure and hospitality industries (PMR 1.5, 99% CI 1.2-1.9). We found evidence of significant differences in the proportionate distribution of SARS-CoV-2 infection by occupation and industry among respondents in a multistate, population-based survey, highlighting the excess risk of SARS-CoV-2 infection borne by some worker populations, particularly those whose jobs require frequent or prolonged close contact with other people.


[Fungal involvement of the intestinal tract in HIV-positive males].
In a retrospective study on 21 HIV-positive patients (aged between 18 and 28) in stage WR 1 CDC II and WR 2 CDC III, we looked for yeast in tongue swabs and stool samples. About 2/3 of the cultures of stage WR 1 CDC II and nearly all cultures of stage WR CDC III revealed infection with yeasts.


Association of placental pathology and gross morphology with autism spectrum disorders.
This study evaluated the association between placental pathology and gross morphology and the risk of autism spectrum disorders (ASD). We conducted a matched case-control study of children with confirmed ASD who were born between 2000 and 2017 at one of three university-affiliated hospitals in Montreal, Quebec. Cases, who were identified through the Montreal Children's Hospital Autism Spectrum Disorders Program, were matched to babies (1:5) born at the same hospital and on the same day. Multi-fetal births were excluded. Maternal demographics, pregnancy characteristics and placental pathologies were collected from hospital charts by abstractors blind to autism diagnoses. This current study consisted of data from a single-site that had pathology reports available. Pearson chi-square and Wilcoxon rank-sum tests were used to estimate p-values. Our study consisted of 107 ASD cases and 526 matched controls. Mothers of cases and controls were similar in terms of parity, gravidity, smoking status, BMI, rates of clinical chorioamnionitis, chronic hypertension, and gestational diabetes. Age at delivery of <25 years was more common among mothers of controls. Compared with controls, cases were more likely born male, <32 weeks of gestation, and weighing <1500 g. Cases and controls had similar rates of placental inflammation, vasculitis, and other placental pathologies. There were no differences in placental weight, placental thickness, umbilical cord length, and umbilical cord insertion between the two groups. In conclusion, placental pathology and gross morphology do not appear to be associated with ASD, suggesting that any perinatal determinants of autism are not likely to be mediated through placental pathology. LAY SUMMARY: Data from a matched case-control study consisting of neonates born between 2000 and 2017 at one of three McGill-affiliated hospitals were used to examine the relationship between placental pathology and morphology and the development of autism. No differences in placental pathology and gross morphology were found between those with and without autism, which suggests that placental abnormalities are unlikely to either cause or mediate the development of autism.


Lesions of the caruncle: a description of 42 cases and a review of the literature.
Lesions of the caruncle are uncommon. On account of the histological composition of the caruncle, which includes, in addition to conjunctiva, hair follicles, sebaceous glands, sweat glands, and accessory lacrimal tissue, the caruncle may develop lesions that may be similar to those found in the skin, conjunctiva, or lacrimal gland. Clinical preoperative diagnosis is very difficult and reached only in about half of the cases. The vast majority of lesions of the caruncle are benign, mainly nevi. Reported malignant lesions are very rare but can be potentially fatal. Although malignancy is clinically overestimated, any suspected malignant lesion should be excised and examined histopathologically by an experienced pathologist. This study presents the clinical and histological data of 42 consecutive caruncular lesions processed at our laboratory and reviews previously reported cases of caruncular lesions.


Comparison of the Characteristics of Cytokine Storm and Immune Response Induced by SARS-CoV, MERS-CoV, and SARS-CoV-2 Infections.
Cytokine storm (CS) is a significant cause of death in patients with severe coronavirus pneumonia. Excessive immune-inflammatory reaction, many inflammatory cell infiltration, and extreme increase of proinflammatory cytokines and chemokines lead to acute lung injury and acute respiratory distress syndrome (ARDS). This review compares the characters of cytokine storms and immune responses caused by three highly pathogenic and infectious coronaviruses (HCoVs), including severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome-coronavirus (MERS-CoV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and analyzes the possible mechanisms to guide clinical treatment in the future.


Volume-outcome effects for children undergoing resection of renal malignancies.
Adults undergoing oncologic resections at low-volume centers experience increased perioperative morbidity and mortality. The volume-outcome effect has not been extensively studied in pediatric oncologic resections. To clarify volume-outcome effects in pediatric oncologic resections, we analyzed resection of renal malignancies in children less than 15 y of age. We conducted a cross-sectional analysis of hospital discharges included in the health care utilization project kids' inpatient database from 1997 to 2009, examining in-hospital operative complications, length of stay (LOS), and inflation-adjusted hospital charges. Hospital volume was expressed as low (n = 1-2), medium (n = 3-4), and high (n > 4) annual volume of resections. One thousand five hundred thirty-eight patients underwent renal malignancy resection. Of these, 527 patients had resection in low-, 422 in medium-, and 589 in high-volume hospitals. Relative to low-volume hospitals, those resected in medium-volume hospitals had an odds ratio of 0.62 (95% confidence interval 0.39-0.99, P = 0.046) for operative complication and those in high-volume hospitals had an odds ratio of 1.02 (95% confidence interval 0.63-1.65, P = 0.95). There was no detectable association with LOS (P = 0.113) or inflation-adjusted charges (P = 0.331). The number of complications, total charges, and LOS attributable to resection of a childhood renal malignancy did not differ among high-, medium-, or low-operative volume hospitals, although oncologic outcomes could not be determined because of the limited nature of this administrative database.


Acoustic method to quantitatively assess the position and patency of infant endotracheal tubes: preliminary results in rabbits.
In this preliminary laboratory study, an acoustical method was evaluated to quantitatively assess the position and patency of an infant-size endotracheal tube (ETT) by in vivo and in vitro measurements. The method consists of emitting an audible sound pulse into the ETT and the airways, and deriving position and patency information from the timing and characteristics of the returning echoes. The method's capacity to measure ETT changes of position in the tracheae of five anesthetized New Zealand white rabbits (weight, 4.3-4.9 kg; age, 1.5-3 years) was found to be accurate to 0.7 +/- 3.6 mm (mean +/- 95% CI) over a distance of 5 cm. The method was also shown to reliably differentiate between tracheal, bronchial, and esophageal intubations by means of an acoustically inferred diameter of the passageway just beyond the ETT tip. To assess the accuracy of estimating lumen obstruction, in vitro acoustical measurements were performed in different size ETTs (2.5, 3.0, 3.5, and 4.0 mm inner diameter), with obstructions ranging from 5-100% reduction in cross-sectional area. The system identified the sizes of these obstructions to within +/-7%. This technology has the potential for continuous, computer-based monitoring of breathing-tube function through instantaneous detection of ETT malposition or obstruction before it leads to a serious medical condition.


Complex resistivity signatures of ethanol in sand-clay mixtures.
We performed complex resistivity (CR) measurements on laboratory columns to investigate changes in electrical properties as a result of varying ethanol (EtOH) concentration (0% to 30% v/v) in a sand-clay (bentonite) matrix. We applied Debye decomposition, a phenomenological model commonly used to fit CR data, to determine model parameters (time constant: τ, chargeability: m, and normalized chargeability: mn). The CR data showed a significant (P≤0.001) time-dependent variation in the clay driven polarization response (~12 mrad) for 0% EtOH concentration. This temporal variation probably results from the clay-water reaction kinetics trending towards equilibrium in the sand-clay-water system. The clay polarization is significantly suppressed (P≤0.001) for both measured phase (ϕ) and imaginary conductivity (σ″) with increasing EtOH concentration. Normalized chargeability consistently decreases (by up to a factor of ~2) as EtOH concentration increases from 0% to 10% and 10 to 20%, respectively. We propose that such suppression effects are associated with alterations in the electrical double layer (EDL) at the clay-fluid interface due to (a) strong EtOH adsorption on clay, and (b) complex intermolecular EtOH-water interactions and subsequent changes in ionic mobility on the surface in the EDL. Changes in the CR data following a change of the saturating fluid from EtOH 20% to plain water indicate strong hysteresis effects in the electrical response, which we attribute to persistent EtOH adsorption on clay. Our results demonstrate high sensitivity of CR measurements to clay-EtOH interactions in porous media, indicating the potential application of this technique for characterization and monitoring of ethanol contamination in sediments containing clays.


Mild maternal sleep-disordered breathing during pregnancy and offspring growth and adiposity in the first 3 years of life.
Sleep-disordered breathing (SDB) during pregnancy has been linked to adverse fetal outcomes. Since the intrauterine milieu plays a critical role in childhood growth, we explored the interactions between maternal SDB and offspring growth and adiposity patterns during infancy. Fifty-eight healthy women with uncomplicated pregnancies underwent an objective sleep study and laboratory evaluation during the third trimester, their offspring underwent a 3-year growth surveillance. The 14 (24.1%) women with SDB had a higher body mass index (BMI) (P = 0.003), elevated C-reactive protein levels (P = 0.003), and decreased HDL-cholesterol levels (P = 0.009) than the women without SDB. A general linear model evaluated the interactions between maternal SDB and offspring growth and adiposity measurements after controlling for gestational age and maternal and paternal BMIs. The offspring of mothers with SDB had a significantly smaller head circumference at birth (P = 0.004), with a distinctive pattern of catchup growth by the end of the first year of life (P = 0.018). Their growth pattern was distinguished by compromised birth weight-to-length, rapid catch-up growth, and an increase in both weight-to-length and triceps thickness by the age of three (P < 0.001 and P = 0.001, respectively). Our findings suggest that maternal SDB during pregnancy affects head circumference growth and adiposity acquisition from birth through infancy.


Accelerated decline of snow cover in China from 1979 to 2018 observed from space.
Snow cover is an important indicator of climate change. Variations of snow integrate the competing effect of increasing temperature and precipitation. In this study, based on Theil-Sen Median (TSM) and Mann-Kendall (M-K) methods, observational evidence from space was used to investigate the variation of snow parameters in China from 1979 to 2018, and some meaningful conclusions were found. (1) The downward trend of snow depth (SD) with a median of -0.02 cm/year was generally found in the high altitude mountains, and the upward trend of SD with a median of 0.01 cm/year occurs in the plains. A widespread and accelerated decrease of SD was observed in the latest period (2009-2018) in NC and NX. (2) The mean annual areas with snow cover days (SCDs) greater than 150 days (d) accounted for 17.8%, 24.73% and 38.14% in NC, NX and QTP. SCDs in NC and Northern QTP were widely reduced, but the longest snow season with more than eight months is still maintained on QTP. (3) The downward trend of snow storage (SS) was found in all three snow areas. The difference of snow phenology is reflected in the slowest accumulation and melting rate of SS on QTP; the largest peak value of SS and the shortest snow season in NC; the slow accumulation and rapid melting of snow in the NX, and the peak value is achieved at the latest. The trend of maximum temperature was judged as the most important factor affecting the change of SD, while longitude and latitude are closely related to the change of SCD.


Expression, regulation, and mode of action of the AbiG abortive infection system of lactococcus lactis subsp. cremoris UC653
The abortive infection system AbiG is encoded by the lactococcal plasmid pCI750. The abiG locus (consisting of two genes, abiGi and abiGii) was examined by Northern blot analysis, revealing two transcripts of approximately 2.8 and 1.5 kb which were homologous to the two gene-specific probes. A transcriptional start site was mapped upstream of abiGi, and it appeared that the two genes were cotranscribed, resulting in the 2.8-kb transcript. The smaller transcript may be the result of independent transcription of abiGii within abiGi or of the presence of a weak terminator within abiGii. The locus was shown to be constitutively expressed. Evidence is presented for the possible existence of a second Abi mechanism on pCI750. Examination of phage sk1 RNA synthesis demonstrated that both the subcloned AbiG and, to a greater extent, pCI750 inhibited this process. pCI750 also severely inhibited synthesis of both early and late phage c2 transcripts, while the presence of the subclone resulted in a reduction in late transcript synthesis only.


Reference intervals for fetal heart volume from 3-dimensional sonography using the extended imaging virtual organ computer-aided analysis method at gestational ages of 20 to 34 weeks.
The purpose of this study was to establish the reference range for fetal heart volume from 3-dimensional (3D) sonography using the extended imaging virtual organ computer-aided analysis method. The fetal heart volume was measured in 303 normal singleton pregnancies at gestational ages of 20 to 34 weeks using 3D sonography. The extended imaging virtual organ computer-aided analysis method was used to obtain a sequence of 10 parallel symmetric sections through the heart, according to examiner-determined limits (the apex at one extremity and the connection to the great vessels at the other). Heart contours were drawn manually in all sections to obtain the 3D volume measurement, which was provided automatically by the software. Normal z scores and percentile reference ranges for each gestational age were constructed. The fetal heart volume increased with gestational age. The mean values were 3.09 mL at 20 weeks, 9.18 mL at 26 weeks, and 24.89 mL at 34 weeks, according to the following formulas: fetal heart volume (mL) = 18.0076 - 2.1005 × gestational age + 0.0677 × gestational age2 (R(2) = 0.922); and SD (mL) = (4.5038 - 0.4281 × gestational age + 0.0114 × gestational age2) × √1.495808 (R(2) = 0.922). A reference range for fetal heart volume using the 3D sonographic extended imaging virtual organ computer-aided analysis method at gestational ages of 20 to 34 weeks was established.


Monocyte procoagulant activity in Whipple's disease.
We have studied the expression of procoagulant activity by the circulating mononuclear cells of four patients with Whipple's disease. There was a spontaneous expression of procoagulant activity in two patients with active untreated Whipple's disease. This activity was shown to originate in the monocyte fraction of the mononuclear cells and was demonstrated to cleave prothrombin directly. This prothrombinase activity was not Factor Xa, because it was not neutralized by anti-Factor X serum and was not inhibited by an established panel of Factor Xa inhibitors. The prothrombinase activity was not expressed by the monocytes of these patients following 8 weeks of antibiotic therapy, by which time the patients' symptoms resolved, and was not found in two patients previously treated for Whipple's disease who were in clinical remission or in normal subjects. Serial studies in one patient with active disease showed that monocytes failed to express increased prothrombinase within 2 weeks of antibiotic therapy. A second procoagulant activity was produced in response to endotoxin (LPS) by cells from controls and patients with Whipple's disease and was identified as thromboplastin. These observations suggest that circulating monocytes of patients with active Whipple's disease are endogenously stimulated to express prothrombinase activity, which may contribute, at least in part, to the pathophysiology of this condition.


Should We Genetically Select for the Beauty Norm of Fair Skin?
Fair skin is often regarded as a beauty ideal in many parts of the world. Genetic selection for non-disease traits may allow reproducers to select fair skin for the purposes of beauty, and may be justified under various procreative principles. In this paper I assess the ethics of genetic selection for fair skin as a beauty feature. In particular, I explore the discriminatory aspects and demands of such selection. Using race and colour hierarchies that many would find objectionable, I argue that selection for beauty that is underpinned by such hierarchies is not a trivial selection. Given this, I claim that we should not make such selections.


Robotic resection of ectopic mediastinal parathyroid adenoma in multiple endocrine neoplasia 1.
Hyperparathyroidism in patients with multiple endocrine neoplasia 1 is attributed to the excessive secretion of parathyroid hormone (PTH) from multiple parathyroid glands. This can be successfully treated through complete resection of the parathyroid glands; however, subsequent surgery is often required because of the presence of supernumerary or ectopic parathyroid glands. Therefore, identifying the locations of all functional glands is crucial for precise resection. Here, we report a case of ectopic mediastinal parathyroid adenoma that was successfully resected using robot-assisted thoracoscopic surgery. A 53-year-old woman underwent a total parathyroidectomy with autotransplantation for multiple endocrine neoplasia 1-associated primary hyperparathyroidism. The patient previously underwent laparoscopic distal pancreatectomy for a pancreatic neuroendocrine tumor. She also presented with a mediastinal tumor and nonfunctional pituitary adenoma that could be followed up. Blood tests before total parathyroidectomy showed high levels of intact PTH (183 pg/mL) and calcium (Ca; 10.3 mg/dL); however, postoperative blood tests still revealed high levels of intact PTH (103 pg/mL) and Ca (11.4 mg/dL). Computed tomography and magnetic resonance imaging revealed a 45-mm-sized mass in the right upper mediastinum as a well-defined solid and cystic lesion, whereas 99mTc-methoxyisobutylisonitrile scintigraphy indicated a strong accumulation of tracers, suggesting an ectopic lesion in the mediastinum. Persistent hyperparathyroidism after total parathyroidectomy via neck incision was attributed to an ectopic parathyroid tumor in the mediastinum. Thus, we decided to resect the tumor using robot-assisted thoracoscopic surgery to perform the procedure gently and carefully. During surgery, a mediastinal tumor was identified as it was detected radiographically. Because it did not invade the surrounding tissues, it could be completely resected without injuring the capsule. The patient was discharged without complications. Postoperatively, Ca and intact PTH levels decreased back to normal. The final pathological diagnosis confirmed that the mass was an ectopic mediastinal parathyroid adenoma. Minimally invasive surgical resection of a remnant ectopic lesion was successfully performed in a patient with multiple endocrine neoplasia 1 using robot-assisted thoracoscopic surgery.


Intra-arterial blood gas monitoring system: more accurate values can be obtained.
To compare values measured by a continuous intra-arterial blood gas monitoring system with those measured by conventional blood gas analyzer for the assessment of the clinical performance of a new device for measurement of PaO2, PaCO2, and arterial pH. Forty-six patients undergoing cardiopulmonary bypass were enrolled in this study. All patients had a continuous intra-arterial sensor (PB 3300) placed into the radial artery through a 20-gauge catheter. A total of 319 arterial blood gas and pH values were obtained for comparison with a conventional blood gas analyzer. The measurements were performed every 12 hrs after the initial in vitro calibration of the sensor for each patient. Measurements were made over a range of 12 to 192 hrs. The overall bias and precision determined by the two methods were 4.5 and 17.1 mmHg for PaO2; 4.5 and 6.2 mmHg for PaCO2; and 0.009 and 0.035 for pH, respectively. For the range of PO2 less than 150 mmHg, the bias and precision improved to 4.2 and 9.5 mmHg. The sensor-derived PCO2 value, PCO2 (IABG), increased significantly more than the conventional blood gas analysis value, PCO2(ABG), even within 72 hrs (2.8 and 4.1 mmHg). The relationship between the two measurements can be described as: PCO2(IABG)/PCO2(ABG) = 1 + 0.0026.t where t is the time period of use (in hours). By correcting the PCO2(IABG) value using this formula, the overall bias and precision of the values measured by two methods decreases to -0.4 and 3.6 mmHg. The PO2 and pH values derived from an intra-arterial blood gas monitoring system agreed well with the values measured by a conventional blood gas analyzer. However, the PCO2 value must be corrected due to an increase of drift, especially with extended use for more than 72 hours.


Public policy and dietary recommendations to reduce population levels of blood cholesterol.
Because atherosclerosis and its physiological/behavioral precursors are mass phenomena and because the scientific evidence supports the potential benefit, safety, and feasibility of a population wide approach to their prevention, changes in eating patterns are recommended to lower average blood cholesterol levels for the American public. This public health approach is complementary to needed research on mechanisms of diet response, lipoprotein regulation, atherosclerosis, and coronary disease, and to the identification and treatment of individuals with dyslipoproteinemia or other elevated risk characteristics.


PET-based estradiol challenge as a predictive biomarker of response to endocrine therapy in women with estrogen-receptor-positive breast cancer.
To determine if response to endocrine therapy of breast cancer can be predicted by either a metabolic "flare reaction" detected by positron emission tomography (PET) with 2-[(18)F]-fluoro-2-deoxyglucose (FDG), induced by an estradiol challenge, or by estrogen-receptor (ER) status, determined by PET with the estrogen analog 16alpha-[(18)F]fluoroestradiol-17beta (FES). Fifty-one post-menopausal women with advanced estrogen-receptor positive breast cancer were studied. Patients underwent FES-PET and FDG-PET at baseline and repeat FDG-PET after 30 mg estradiol. Tracer uptakes was measured as the standardized uptake value (SUV). Patients were subsequently treated with either an aromatase inhibitor or fulvestrant. A prospectively defined cut-off SUV >or= 2 for FES was considered positive for ER expression. A cutoff of >or=12% increase in SUV for FDG, determined by ROC analysis, represented metabolic flare. PET results were correlated with responsiveness to endocrine therapy. Seventeen patients responded and 34 patients did not respond to endocrine therapy. Four responders and one non-responder had a clinical flare reaction, while only the responders demonstrated metabolic flare. After estradiol challenge, a significantly higher mean (+/-SD) percent change in SUV for FDG was noted in responders (20.9 +/- 24.2) compared with non-responders (-4.3 +/- 11.0, P < 0.0001). On FES-PET, a higher tumor SUV was noted in responders (3.5 +/- 2.5) compared with non-responders (2.1 +/- 1.8, P = 0.0049). There was significantly longer overall survival in patients with metabolic flare than in those without flare regardless of type of endocrine therapy (P = 0.0062). Baseline tumor FES uptake and metabolic flare after an estradiol challenge are both predictive of responsiveness to endocrine therapy in ER+ breast cancer.


Sites of strong Rec12/Spo11 binding in the fission yeast genome are associated with meiotic recombination and with centromeres.
Meiotic recombination arises from Rec12/Spo11-dependent formation of DNA double-strand breaks (DSBs) and their subsequent repair. We identified Rec12-binding peaks across the Schizosaccharomyces pombe genome using chromatin immunoprecipitation after reversible formaldehyde cross-linking combined with whole-genome DNA microarrays. Strong Rec12 binding coincided with previously identified DSBs at the recombination hotspots ura4A, mbs1, and mbs2 and correlated with DSB formation at a new site. In addition, Rec12 binding corresponded to eight novel conversion hotspots and correlated with crossover density in segments of chromosome I. Notably, Rec12 binding inversely correlated with guanine-cytosine (GC) content, contrary to findings in Saccharomyces cerevisiae. Although both replication origins and Rec12-binding sites preferred AT-rich gene-free regions, they seemed to exclude each other. We also uncovered a connection between binding sites of Rec12 and meiotic cohesin Rec8. Rec12-binding peaks lay often within 2.5 kb of a Rec8-binding peak. Rec12 binding showed preference for large intergenic regions and was found to bind preferentially near to genes expressed strongly in meiosis. Surprisingly, Rec12 binding was also detected in centromeric core regions, which raises the intriguing possibility that Rec12 plays additional roles in meiotic chromosome dynamics.


Bacteriology of pediatric breast abscesses beyond the neonatal period.
Limited data exist regarding the presentation and bacteriology of nonneonatal pediatric breast abscess. To determine the bacteriology and characteristic presentation of pediatric breast abscesses in a tertiary care center. Cross-sectional study of patients age 1 month to 21 years admitted to a pediatric Emergency Department (ED) between 1996 and 2018 with a breast abscess. Patients with pre-existing conditions were excluded. Records were reviewed to determine demographics, history, physical exam findings, wound culture results, imaging and ED disposition. We used descriptive statistics to describe prevalence of different bacteria. We identified 210 patients who met study criteria. Median age was 13.6 years [IQR 6.6, 17.4], and 91% (191/210) were females. Ninety-two patients (43.8%) were 'pre-treated' with antibiotics prior to ED visit, and 33/210 (16%) were febrile. Ultrasound was obtained in 85 patients (40.5%), 69 patients had a single abscess and 16 had multiple abscesses. Most patients were treated with antibiotics and 100 had a surgical intervention, of these 89 had I&D and 11 a needle aspiration. Admission rate was 45%. Culture results were available for 75 (75%). Thirty-three (44%) had a negative culture, or grew non-aureus staphylococci or other skin flora. Culture were positive for MSSA 21 (28%), MRSA 13 (17%), Proteus mirabilis 2 (2.6%), Serratia 1 (1.3%). Other organisms include Gram-negative bacilli, group A Streptococcus and enterococcus. Non-neonatal pediatric breast abscess bacteriology is no different than data published on other skin abscesses. MRSA coverage should be considered based on local prevalence in skin infections.


Leukotriene C4 is an essential 5-lipoxygenase intermediate in A23187-induced macrophage cytostatic activity against P815 tumor cells.
Resident peritoneal macrophages incubated with 3.5 x 10(-7) M Calcium ionophore A23187 in tumor cell growth medium (TGM) release large amounts of leukotriene (LT)E4 and an unidentified 5-lipoxygenase product, whereas A23187-stimulated macrophages produce in serum free medium LTD4, predominately. LTC4 and 3H-LTC4 incubated for 20 min at 37 degree C in serum containing TGM, convert into LTE4 and 3H-LTE4, respectively. Thus, LTC4 released from A23187-stimulated macrophages is an intermediate in TGM which rapidly converts into LTE4, probably because of the presence of gamma-glutamyl transpeptidase and cystenylglycinase in TGM. Macrophages express antitumor cytostatic activity towards P815 cells (49-53%) in a cocultured ratio (macrophage: tumor cell) 2:1 when stimulated with 3.5 x 10(-7) M A23187 in TGM. The 5-lipoxygenase inhibitor AA861 reverses the cytostatic activity by 42-58% and it inhibits also the formation of A23187-induced 5-lipoxygenase products from macrophages. Restoration of 38% macrophage- antitumor cytostatic activity by exogenous LTC4 (10(-8) M) indicates that LTC4 is an essential 5-lipoxygenase intermediate in the pathway of required signals underlying A23187-induced macrophage antitumor cytostatic activity. Macrophages not stimulated by A23187 do not express cytostatic activity in the presence of LTC4. This implies that besides LTC4, increased cytosolic [Ca2+] is required for A23187 induction of macrophage cytostatic activity.


The TLR-4 agonist adjuvant, GLA-SE, improves magnitude and quality of immune responses elicited by the ID93 tuberculosis vaccine: first-in-human trial.
Tuberculosis (TB) is the leading cause of infectious death worldwide. Development of improved TB vaccines that boost or replace BCG is a major global health goal. ID93 + GLA-SE is a fusion protein TB vaccine candidate combined with the Toll-like Receptor 4 agonist adjuvant, GLA-SE. We conducted a phase 1, randomized, double-blind, dose-escalation clinical trial to evaluate two dose levels of the ID93 antigen, administered intramuscularly alone or in combination with two dose levels of the GLA-SE adjuvant, in 60 BCG-naive, QuantiFERON-negative, healthy adults in the US (ClinicalTrials.gov identifier: NCT01599897). When administered as 3 injections, 28 days apart, all dose levels of ID93 alone and ID93 + GLA-SE demonstrated an acceptable safety profile. All regimens elicited vaccine-specific humoral and cellular responses. Compared with ID93 alone, vaccination with ID93 + GLA-SE elicited higher titers of ID93-specific antibodies, a preferential increase in IgG1 and IgG3 subclasses, and a multifaceted Fc-mediated effector function response. The addition of GLA-SE also enhanced the magnitude and polyfunctional cytokine profile of CD4+ T cells. The data demonstrate an acceptable safety profile and indicate that the GLA-SE adjuvant drives a functional humoral and T-helper 1 type cellular response.


Crosslinked concanavalin A-O-(diethylaminoethyl)-cellulose--an affinity medium for concanavalin A-interacting glycoproteins.
When concanavalin A (Con A) is reacted with a low concentration of glutaraldehyde, the product formed strongly binds to DEAE-cellulose. Thus, the resultant material can be used as an affinity medium for those glycoproteins which interact with Con A. This affinity medium is easy to prepare, has a capacity comparable to that of similar commercially available affinity media, and is stable for up to at least 6 months.


Unenhanced CT and acute stroke physiology.
Unenhanced CT remains the most widely used imaging technique and is the standard of care for acute stroke evaluation. Early ischemic signs (EIS) within the first 3 to 6 hours of symptom onset (eg, parenchymal hypodensity, sulcal effacement, and dense vessel) have been advocated as a triage tool for thrombolytic therapy. Recent studies have challenged the relevance of these EIS within 3 hours of stroke onset, with advanced MR and CT methods increasingly competing with unenhanced CT as the primary imaging modality for acute ischemia. Nonetheless, the insights regarding acute stroke physiology provided by studying the CT evolution of early ischemic signs continue to be valuable for the informed interpretation of all stroke images. It is these insights that comprise the topic of this article.


Air-stable van der Waals PtTe2 conductors with high current-carrying capacity and strong spin-orbit interaction.
High-performance van der Waals (vdW) integrated electronics and spintronics require reliable current-carrying capacity. However, it is challenging to achieve high current density and air-stable performance using vdW metals owing to the fast electrical breakdown triggered by defects or oxidation. Here, we report that spin-orbit interacted synthetic PtTe2 layers exhibit significant electrical reliability and robustness in ambient air. The 4-nm-thick PtTe2 synthesized at a low temperature (∼400°C) shows intrinsic metallic transport behavior and a weak antilocalization effect attributed to the strong spin-orbit scattering. Remarkably, PtTe2 sustains a high current density approaching ≈31.5 MA cm-2, which is the highest value among electrical interconnect candidates under oxygen exposure. Electrical failure is caused by the Joule heating of PtTe2 rather than defect-induced electromigration, which was achievable by the native TeOx passivation. The high-quality growth of PtTe2 and the investigation of its transport behaviors lay out essential foundations for the development of emerging vdW spin-orbitronics.


Vasoactive intestinal polypeptide (VIP) as a mediator of the watery diarrhea syndrome.
Evidence that VIP is the principal humoral mediator of the watery diarrhea syndrome includes: (a) actions of VIP in experimental anaimals parallel the clinical manifestations of the syndrome; (b) infusions of VIP induce watery diarrhea in intestinal loops of dogs and a picture resembling the clinical syndrome in pigs, at circulating levels of the peptide similar to those observed in human disease; (c) most patients with the watery diarrhea syndrome and underlying tumors have elevated plasma levels of VIP; (d) in those patients in whom pre- and postoperative measurements were made, plasma VIP levels fell to the normal range with removal of the tumor and relief of the diarrhea; and (e) extracts of such tumors are rich in VIP-immunoreactivity and VIP-like biologic activity. A few patients with the syndrome have been reported to have normal plasma VIP levels, and it is possible that other humoral agents (such as pancreatic polypeptide, prostaglandins) may contribute to the production of the diarrhea.


Late ocular hypotony following intracapsular cataract extraction: probable relation to premature resorption of polyglactin 910 sutures.
We have recently had a series of seven patients who developed late ocular hypotony, flat anterior chambers, and choroidal detachments following cataract surgery. In each case, there was evidence of premature dissolution of the polyglactin 910 sutures that were used for closure. From this experience we propose steps that can be taken to minimize such problems.


Carbonic anhydrase is required for statoconia homeostasis in organ cultures of statocysts from Aplysia californica.
A novel organ culture system has been developed to study the regulation of statoconia production in the gravity sensing organ in Aplysia californica. Statocysts were cultured in Leibovitz (L15) medium supplemented with salts and Aplysia haemolymph for four days at 17 degrees C. The viability of the system was evaluated by examining four parameters: statocyst morphology, the activity of the mechanosensory cilia in the statocyst, production of new statoconia during culture and change in statoconia volume after culture. There were no morphological differences in statocysts before and after culture when ciliary beating was maintained. There was a 29% increase in the number of statoconia after four days in culture. Mean statocyst, statolith and statoconia volumes were not affected by culture conditions. The presence of carbonic anhydrase in the statocysts was shown using immunohistochemistry. When statocysts were cultured in the presence of 4.0 x 10(-4) M acetazolamide to inhibit the enzyme activity, there was a decrease in statoconia production and statoconia volume, indicating a role for this enzyme in statoconia homeostasis, potentially via pH regulation. These studies are the first to report a novel system for the culture of statocysts and show that carbonic anhydrase is involved in the regulation of statoconia volume and production.


Delayed onset seizures after inguinal herniotomy in a premature infant: a case report.
We report a case of a premature neonate born at 34 weeks and operated at 6 weeks of age developing unexplained seizures 10 hours after the end of surgery under single shot caudal epidural analgesia with bupivacaine and lidocaine combined with general anesthesia.