Mayer-Rokitansky-Kuster-Hauser syndrome and stress urinary incontinence.
Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a disorder of development of the female genital tract, characterized by the absence of the upper portion of the vagina, an absent or hypoplastic uterus, and normal or hypoplastic fallopian tubes. Affected women may have associated urological or skeletal abnormalities. Case report. A 19-year-old female with MRKH syndrome, female genotype and phenotype, primary amenorrhoea and stress urinary incontinence was admitted to the outpatient department of the university hospital. The patient underwent tension free vaginal obturator tape (TVT-O) surgery for stress urinary incontinence. The patient's objective self-evaluation of the efficacy of treatment after 6 months was 60%.


Natural evolution of gastrointestinal nematodes in goats (Capra hircus) in the semi-arid ecosystem of the Paraíba backwoods, northeastern Brazil.
This study was conducted in Patos county, a semi-arid area with caatinga vegetation in Paraiba State, northeastern Brazil. Twenty-four male goats of mixed breeds were used. The animals were separated in age groups from 1-12 months, i. e., 1-2, 3-4, 5-6, 7-8, 9-10, 11-12 months, with four animals in each group. The animals were slaughtered and necropsied to recover and identify adult worms. The goats were exposed to nematode infection from the first month of life. The most prevalent nematodes in decreasing order were: Trichostrongylus colubriformis, Haemonchus contortus and Oesophagostomum columbianum. Age of the goats did not appear to be a factor in resistance to gastrointestinal nematode infection. Worm burdens of 11-12 month old animals were significantly (P<0.05) higher than in other age groups.


Emigration as a social and economic determinant of health in low-income urban Zimbabwe.
The negative consequences of medical professionals' emigration on the health systems of nations are well documented in the literature. However, there is a dearth of evidence on the impact of emigration in general, on sending households' welfare, health in particular. This study compared socio-economic characteristics, including health, of emigrants' households with those of non-emigrants' households in an urban setting in Harare, Zimbabwe. A cross-sectional survey and focus group discussions were used to collect quantitative and qualitative data, respectively. Concurrent and retrospective data were collected using an interviewer-administered questionnaire. The target population were households, both emigrants' households and non-emigrants' households, and the interviewees were de facto heads of the respective households. A sample of 279 households was determined; however, 268 heads of households, a response rate of 96%, were achieved. The majority of the respondents were females (52%). Emigrants' households were more likely to access private compared to government health care facilities, than non-emigrants' households [P = 0.001]. Emigrants' households were also more likely to report higher incomes than non-emigrants' households [P < 0.05] and were having more meals per day and better access to education. Emigrants' households were also more likely to report positive lifestyles than non-emigrants' households. Only 13.8% of emigrants' households reported a negative shift in lifestyle, compared to 25.2% non-emigrants' households. Emigration was found to have a positive relationship with health seeking, income, education, and number of meals a household had. It is clear from the findings that emigration during the hard economic times in Zimbabwe is beneficial; it cushions households from the ravages of poverty. Yet emigration robs the nation of its professional able-bodied people. It is, therefore, recommended that the government optimises the reported positive effects, whilst expeditiously working on improving the economy with the view of reversing the observed migration streams.


The pharmacokinetics and pharmacodynamics of PF-00734200, a DPP-IV inhibitor, in healthy Japanese subjects.
To evaluate the pharmacokinetics, pharmacodynamics, safety, and tolerability of PF-00734200, a potent dipeptidyl peptidase-IV (DPP-IV) inhibitor, in Japanese subjects, and compare the results with those in Western subjects. Eight healthy Japanese subjects received a single dose of PF-00734200 10 mg, 100 mg, or placebo. Another 8 subjects received PF-00734200 20 mg or placebo single dose once daily for 6 days. Serum and urine PK, plasma DPP-IV activity, and plasma glucagon-like peptide 1 (GLP-1) levels were measured. Linear pharmacokinetics was observed over the single dose range 10 - 100 mg. Following multiple-dose administration, 37.3 ± 4.33% of the unchanged PF-00734200 was excreted in the urine and renal clearance was calculated as 33.9 ± 6.56 ml/min. After the standardized meals, GLP- 1 levels increased ~ 2-fold compared with placebo, and no further increase in GLP-1 levels was observed at doses above 10 mg. The steady state DPP-IV inhibition at 24 h was ~ 75%. Pharmacokinetics of PF-00734200, inhibition of DPP-IV, and non-linear increases in GLP-1 were similar between healthy Japanese and Western subjects.


Significant nailfold capillary loss and late capillaroscopic pattern are associated with pulmonary arterial hypertension in systemic sclerosis.
To evaluate differences in nailfold videocapillaroscopy (NVC) findings between systemic sclerosis-SSc patients with and without a diagnosis of pulmonary arterial hypertension (PAH). 110 SSc patients were enrolled in this cross-sectional, case-control, multi-centre study. Patients were divided into cases (SSc-PAH confirmed by right hearth catheterization-RHC) and controls (SSc-nonPAH with low probability of PAH). NVC patterns (early, active, and late) and morphological parameters (microvascular density, non-specific abnormalities, giant capillaries, micro-haemorrhages, avascular areas) were considered using a semiquantitative scoring system. SSc-PAH patients showed higher frequencies of late pattern (p < 0.01), non-specific abnormalities (p < 0.01), lower capillary density (p < 0.01), higher avascular areas (p < 0.01), and a higher mean NVC score (p < 0.01). Contrarily, the early/active pattern (p < 0.01) and a higher rate of micro-haemorrhages (p = 0.04) were more frequent in non-PAH patients. By the multivariate analysis, SSc-PAH patients, compared to non-PAH, had more non-specific abnormalities (27/55, 49.1% vs 10/55, 18.2%, adjusted OR: 16.89, 95%CI: 3.06-93.16), a lower capillary density (grade 3, 20/55, 36.4% vs 5/55, 9.1%, adjusted OR: 38.33, 95%CI: 2.34-367.80), and avascular areas (18/55, 32.7% vs 10/55, 18.2%, adjusted OR: 16.90, 95%CI: 2.64-44.35). A correlation was found between the mean pulmonary arterial pressure-mPAP and avascular areas (p < 0.01), capillary density (p < 0.01), and non-specific abnormalities (p < 0.01). A clinical model including the NVC variables may be able to predict the diagnosis of PAH. Our results indicate that the distinctive peripheral microcirculatory injury of SSc, i.e capillary loss and morphological abnormalities, appear more severe and pronounced in patients with SSc-PAH.


Patient engagement in interprofessional team-based chronic disease management: A qualitative description of a Canadian program.
To explore how patients with chronic obstructive pulmonary disease (COPD) perceive their engagement and roles within an interdisciplinary team-based care model. A single intrinsic case study was used. Focus group participants were recruited from the Best Care COPD program across nine sites. Transcripts from patient focus groups were supplemented by healthcare provider focus group transcripts and thematically analysed. The majority of patients viewed themselves as having an inherent or central role on the team, which was corroborated by healthcare providers. Both positive (e.g., a desire to learn) and negative drivers (e.g., fear of inadequate care without self-advocacy) of active engagement were identified, for which patient-led communication was key. Components of the interdisciplinary team-based care model, including provider coordination and action planning, enabled positively driven active engagement and increased self-management. Although patients had heterogenous perspectives about engagement, most patients viewed themselves as, and were satisfied with, having a central role in their care. Active and passive engagement preferences were influenced by personal motivations and past experiences, amongst other factors. This study demonstrates how interdisciplinary chronic disease management programs can support patient engagement. Clarity of provider expectations, and communication about patients' roles and preferences, are recommended.


Effects of topical anesthetics on tympanic membrane structure.
Topical application of a local anesthetic agent can induce adequate insensibility to pain, and therefore can avoid the use of general anesthesia or invasive infiltration techniques for myringotomy or the insertion of a tympanostomy tube. A comparative study was conducted on a guinea pig animal model to determine the effects of three agents on the structure of the tympanic membrane: 5% tetracaine base dissolved in dimethylsulfoxide (DMSO), pure DMSO, and Bonain's solution. Survival times ranged from 1 day to 3 months. Following removal from the animals, membranes were embedded in Spurr and cut in semithin sections. Signs of mild or severe external otitis were frequent; to avoid non-specific results, infected specimens were not evaluated. Bonain's solution caused loss of the epidermis and mucosal epithelium within 1 day of treatment. The connective tissue layers of the drum were severely hyperplastic after a survival time of 1 month. Tetracaine base in DMSO caused a loss of epithelium and mucosal cells in 3 days. Regeneration started within 7 days and a restitution to integrity was seen after 3 months in drums treated with tetracaine base or DMSO alone.


Hsp90/Cdc37 assembly modulates TGFβ receptor-II to act as a profibrotic regulator of TGFβ signaling during cardiac hypertrophy.
Cardiac hypertrophy is accompanied by excessive collagen deposition in the heart. Despite painstaking research on this fatal disease, the precise role of molecular chaperones in myocardial fibrosis has not yet been elucidated. In this study, we have analyzed the mechanism by which Heat shock protein 90 (Hsp90)/Cell division cycle 37 (Cdc37) assembly modulates cardiac hypertrophy associated fibrosis. For the in vitro hypertrophy model, Angiotensin II (AngII) treated cultured adult cardiac fibroblasts were used, whereas the in vivo hypertrophy model was generated by renal artery ligation in adult male Wistar rats (Rattus norvegicus). Pretreatment with the Hsp90 inhibitor or the blocking of Hsp90-Cdc37 interactions during pressure overload hypertrophy resulted in ubiquitin-mediated proteasomal degradation of TGFβ receptor-II (TβR-II) leading to termination of TGFβ mediated signaling. In both cases significant reduction in collagen synthesis was observed revealing the Hsp90/Cdc37 complex as an integral profibrotic component of TGFβ signaling during cardiac hypertrophy.


Ultrasound contrast agent, Levovist microbubbles are phagocytosed by Kupffer cells-In vitro and in vivo studies.
Phase contrast microscopy showed that Levovist microbubbles were phagocytosed by cultured Kupffer cells and moved gradually toward the nucleus from the cell surface. They were diminished in size and disappeared within 30min by diffusion of the gas contained within the microbubbles. In an in vivo study, confocal laser scanning microscopy demonstrated that Levovist microbubbles were trapped and phagocytosed by Kupffer cells. No microbubbles were observed attached to the sinusoidal endothelium. Our findings suggest that liver-specific images obtained following intravenous injection of Levovist are composed of signals from microbubbles phagocytosed by Kupffer cells.


Genome size and ploidy level: new insights for elucidating relationships in Zygosaccharomyces species.
Ploidy is a fundamental genetic trait with important physiological and genomic implications. We applied complementary molecular tools to highlight differences in genome size and ploidy between Zygosaccharomyces rouxii strain CBS 732T and other related wild strains (ATCC 42981, ABT 301, and ABT 601). The cell cycle analysis by flow cytometry revealed a genome size of 12.7+/-0.2 Mb for strain CBS 732T, 21.9+/-0.2 Mb for ATCC 42981, 28.1+/-1.3 Mb for ABT 301, and 39.00+/-0.3 Mb for ABT 601. Moreover, karyotyping analysis showed a high variability, with wild strains having a higher number of chromosomal bands than CBS 732T. The ploidy level was assessed comparing genome size from flow cytometry with the average haploid size from electrophoretic karyotyping. Strain CBS 732T showed an haploid DNA content, whereas the wild strains a diploid DNA content. In addition gene probe-chromosome hybridization targeted to ZSOD genes showed that wild strains with a diploid DNA content have two ZSOD copies located on different chromosomes.


Single and double stereoselective fluorination of (E)-allylsilanes.
Acyclic allylic monofluorides were prepared by electrophilic fluorination of branched (E)-allylsilanes with Selectfluor. These reactions proceeded with efficient transfer of chirality from the silylated to the fluorinated stereocentre. Upon double fluorination, an unsymmetrical ethyl syn-2,5-difluoroalk-3-enoic ester was prepared, the silyl group acting as an anti stereodirecting group for the two C-F bond forming events.


[Optimization of information on the medication of polypharmacy patients in primary care].
As part of the protocol of the Health Service of the Principality of Asturias (Spain), primary care physicians periodically receive listings of the treatments of patients of any age taking 10 or more drugs/day for 6 months. Currently, the Health Service of the Principality of Asturias is developing a project that aims to assess the medications of polypharmacy patients. The aim is to identify: 1) the consumption of medicines of low therapeutic usefulness, 2) the consumption of potentially nephrotoxic drugs in patients with a low glomerular filtration rate, and 3) potentially inappropriate prescribing in patients aged 65 years or older. The project was started in Health Area II and the aim is to extend it to the remaining health areas. In our opinion, its automation and general implementation could be useful to optimize drug prescription.


Seeding in the walnut; Leptomeningeal spread of Breast Cancer.
Breast cancer is the most common etiology of leptomeningeal carcinomatosis (LC), with or without brain parenchymal involvement. However, only 5% of patients with breast cancer develop leptomeningeal metastasis even in late clinical course. It can rarely be detected on bone scintigraphy. MRI is the modality of choice.


Blunted cardiovascular and cortisol reactivity to acute psychological stress: a summary of results from the Dutch Famine Birth Cohort Study.
The Dutch Famine Birth Cohort Study is a large population based study of late middle aged, overall healthy men and women whose health has been followed from 50 to 65years of age. In a sample of 725 cohort members, an extensive psychological stress protocol was performed during which cardiovascular and cortisol responses were measured. In line with many previous studies, results showed that increased blood pressure responsiveness to the stress protocol was associated with an increased risk for hypertension 5years later. However, decreased cardiovascular and/or cortisol stress reactivity were associated with obesity and the risk of becoming obese, symptoms of depression and anxiety, a poor self-reported health, poor lung function, and poor cognitive function (all p for statistical tests<0.05). These associations generally survived adjustment for a range of potential confounders, including resting cardiovascular and cortisol activity, commitment to the stress tasks, sex, age, smoking and use of medication. Results from these studies agree with recent evidence that low biological reactivity to acute psychological stress may not always be beneficial for health but instead seems to be a marker for a range of negative health outcomes. Future studies have to point out whether low stress reactivity precedes or follows these negative health outcomes.


Steatocystoma simplex in penile foreskin: a case report.
Steatocystoma simplex is an uncommon skin lesion with a histological pattern that is identical to that of steatocystoma multiplex. We are reporting this case of steatocystoma simplex for its uncommon location in the penile foreskin, and its occurrence in a Wapishana man. A 56-year-old man of Wapishana ethnicity presented with complaints of referred penile discomfort and pain during sexual intercourse for 5 years. A physical examination revealed a mobile, compressible subcutaneous non-tender mass of 4 cm diameter located on the left-side of his penile foreskin. There were no signs of inflammation, no grip on the penile shaft, and no urethral discharge or enlargement of lymph nodes. We found no evidence of other cysts on cutaneous examination. We performed classical excision of the lesion under local anesthesia and confirmed the diagnosis of steatocystoma with the pathological report. As there were no complications, we discharged him the same day. Steatocystoma can be considered a differential diagnosis for cystic lesions on and around the penis.


The use of continuous-wear silicone contact lenses in the optical correction of aphakia.
Forty-two aphakic eyes of 37 patients were fitted with oxygen-permeable silicone rubber corneal contact lenses. Thirty-four eyes had the lens after two to 11 months of continuous use. Visual results, comfort, and patient acceptance were good, but the deposition of mucus on the lenses remains a problem.


Virtual screening approach of sirtuin inhibitors results in two new scaffolds.
Sirtuins (SIRT1-SIRT7) are NAD dependent deacetylases and intriguing drug targets in for example neurodegenerative diseases and cancer. Virtual screening has been shown to be a fast and efficient method of discovering new sirtuin inhibitors. In this study, a new putative binding site on the zinc binding domain of sirtuins was utilized to screen the ZINC database virtually in order to discover new sirtuin inhibiting scaffolds. Altogether 26 compounds were tested in vitro and initially 15 inhibitors displayed >30% SIRT3 inhibition. However, the evaluation of raw data from in vitro assay revealed that many of the compounds had intrinsic property to interfere with the fluorescence signal at the assay wavelengths resulting in false positives. All compounds with over 30% SIRT3 inhibition were studied more closely for their behavior in the assay and eventually, three compounds were identified as novel sirtuin inhibitors. They displayed 32-40% SIRT3 and 21-60% SIRT2 inhibition. The inhibitors display two new scaffolds, the smaller of which can be considered as a promising fragment, which offers a base for structural optimization.


MgO-La2O3 mixed metal oxides heterostructure catalysts for photodegradation of dyes pollutant: synthesis, characterization and artificial intelligence modelling.
In the present work, we prepared MgO-La2O3-mixed-metal oxides (MMO) as efficient photocatalysts for degradation of organic pollutants. First, a series of MgAl-%La-CO3-layered double hydroxide (LDH) precursors with different contents of La (5, 10, and 20 wt%) were synthesized by the co-precipitation process and then calcined at 600 °C. The prepared materials were characterized by XRD, SEM-EDX, FTIR, TGA, ICP, and UV-vis diffuse reflectance spectroscopy. XRD indicated that MgO, La2O3, and MgAl2O4 phases were found to coexist in the calcined materials. Also, XRD confirms the orthorhombic-tetragonal phases of MgO-La2O3. The samples exhibited a small band gap of 3.0-3.22 eV based on DRS. The photocatalytic activity of the catalysts was assessed for the degradation of two dyes, namely, tartrazine (TZ) and patent blue (PB) as model organic pollutants in aqueous mediums under UV-visible light. Detailed photocatalytic tests that focused on the impacts of dopant amount of La, catalyst dose, initial pH of the solution, irradiation time, dye concentration, and reuse were carried out and discussed in this research. The experimental findings reveal that the highest photocatalytic activity was achieved with the MgO-La2O3-10% MMO with photocatalysts with a degradation efficiency of 97.4% and 93.87% for TZ and PB, respectively, within 150 min of irradiation. The addition of La to the sample was responsible for its highest photocatalytic activity. Response surface methodology (RSM) and gradient boosting regressor (GBR), as artificial intelligence techniques, were employed to assess individual and interactive influences of initial dye concentration, catalyst dose, initial pH, and irradiation time on the degradation performance. The GBR technique predicts the degradation efficiency results with R2 = 0.98 for both TZ and PB. Moreover, ANOVA analysis employing CCD-RSM reveals a high agreement between the quadratic model predictions and the experimental results for TZ and PB (R2 = 0.9327 and Adj-R2 = 0.8699, R2 = 0.9574 and Adj-R2 = 0.8704, respectively). Optimization outcomes indicated that maximum degradation efficiency was attained under the following optimum conditions: catalyst dose 0.3 g/L, initial dye concentration 20 mg/L, pH 4, and reaction time 150 min. On the whole, this study confirms that the proposed artificial intelligence (AI) techniques constituted reliable and robust computer techniques for monitoring and modeling the photodegradation of organic pollutants from aqueous mediums by MgO-La2O3-MMO heterostructure catalysts.


Evaluation of SNPs associated with mammographic density in European women with mammographic density in Asian women from South-East Asia.
Mammographic density (MD), after accounting for age and body mass index (BMI), is a strong heritable risk factor for breast cancer. Genome-wide association studies (GWAS) have identified 64 SNPs in 55 independent loci associated with MD in women of European ancestry. Their associations with MD in Asian women, however, are largely unknown. Using linear regression adjusting for age, BMI, and ancestry-informative principal components, we evaluated the associations of previously reported MD-associated SNPs with MD in a multi-ethnic cohort of Asian ancestry. Area and volumetric mammographic densities were determined using STRATUS (N = 2450) and Volpara™ (N = 2257). We also assessed the associations of these SNPs with breast cancer risk in an Asian population of 14,570 cases and 80,870 controls. Of the 61 SNPs available in our data, 21 were associated with MD at a nominal threshold of P value < 0.05, all in consistent directions with those reported in European ancestry populations. Of the remaining 40 variants with a P-value of association > 0.05, 29 variants showed consistent directions of association as those previously reported. We found that nine of the 21 MD-associated SNPs in this study were also associated with breast cancer risk in Asian women (P < 0.05), seven of which showed a direction of associations that was consistent with that reported for MD. Our study confirms the associations of 21 SNPs (19/55 or 34.5% out of all known MD loci identified in women of European ancestry) with area and/or volumetric densities in Asian women, and further supports the evidence of a shared genetic basis through common genetic variants for MD and breast cancer risk.


Extractive fermentation for enhanced production of thailandepsin A from Burkholderia thailandensis E264 using polyaromatic adsorbent resin Diaion HP-20.
Thailandepsin A is natural product of Burkholderia thailandensis E264 with potent histone deacetylase inhibitory activities and promising anticancer activities. The titer of thailandepsin A is very low (less than 10 mg/l) from limited empirical fermentation. To facilitate preclinical evaluations and potentially clinical development of thailandepsin A, systematic optimization and extractive fermentation of thailandepsin A from B. thailandensis E264 culture in flasks were investigated in this pilot study. The main fermentation parameters--28°C, pH 7.0, inoculum ratio 1% (v/v), incubation duration 60 h, medium volume 26%, shaking speed 170 rpm, and chloroform as extracting solvent--were determined by single factor experiments. Polyaromatic adsorbent resin Diaion HP-20, when added at a concentration of 4% (w/v), was most effective to reduce feedback inhibition of thailandepsin A and to significantly increase the titer of target product. Central composite design was used to further optimize the fermentation medium for B. thailandensis E264. The optimized medium contains glucose 17.89 g/l, tryptone 34.98 g/l, potassium phosphate 24.84 g/l, and sodium citrate 0.01 g/l, which resulted in a large increase of the titer of thailandepsin A to 236.7 mg/l. Finally kinetic models based on the modified logistic and Luedeking-Piret equations were developed, delivering a good description of temporal variations of biomass, product, and substrate in the fermentation process, which could be used as references for developing large-scale fermentation.


Ethnic differences in coronary atherosclerosis.
The study was done to evaluate whether ethnic differences exist in the prevalence of coronary artery calcification (CAC), and to determine whether differences in calcification correlate with the degree of coronary obstruction. Electron beam tomography (EBT) can be used to quantitate the amount of CAC and assist in prognostication of future cardiac events. It is unclear whether ethnic differences in coronary mortality are related to differences in the prevalence of coronary obstruction and CAC. A total of 782 symptomatic subjects underwent both EBT and angiography. A 50% luminal narrowing defined an angiographic obstruction. We observed substantial ethnic differences in prevalence of both CAC and angiographic stenosis. In whites (n = 453), prevalence of CAC (score >0) was 84%, and significant obstruction on angiogram was 71%. Compared with whites, blacks (n = 108) had a significantly lower prevalence of CAC (62%, p < 0.001) and angiographic disease (49%, p < 0.01). Hispanics (n = 177) also had a lower prevalence of CAC (71%, p < 0.001) and angiographic obstruction (58%, p < 0.01). Asians (n = 44) were not significantly different in regard to CAC (73%, p = 0.06) or angiographic stenosis (64%, p = 0.30). These ethnic differences remained after simultaneously controlling (by use of multiple logistic regression) for age, gender and cardiac risk factors. As compared with whites, blacks and Hispanics had significantly lower prevalence of CAC and obstructive coronary disease. Ethnic differences in risk-factor profiles do not explain these differences. This study demonstrated that whites have a higher atherosclerotic burden than blacks and Hispanics, independent of risk-factor differences among symptomatic patients referred for angiography.


Contribution of land use and cover change (LUCC) to the global terrestrial carbon uptake.
Terrestrial carbon uptake is critical to the removal of greenhouse gases and mitigation of global warming, which are closely related to land use and cover change (LUCC). However, understanding terrestrial carbon uptake and the LUCC contribution remains unclear because of complex interactions with other drivers (particularly climate change). By proposing an innovative approach of "trajectory analysis", this study aimed to isolate the LUCC contribution to terrestrial carbon uptake over different scales. Methodologically, global land was first divided into sub-regions of land transformations and stable land trajectories. Then, the carbon uptake change in the stable land trajectory was taken as a synthetic influence of climate change, which was used as a reference to isolate the carbon uptake alternation generated from the LUCC contribution in the land transformation trajectories. Finally, future LUCC and the terrestrial carbon uptake response were predicted under different development pathways. The results showed the global mean net ecosystem production (NEP) was 27.44 ± 36.51 g C m-2 yr-1 in the past two decades (2001-2019), generating 3.15 ± 0.88 Pg C yr-1 of the total terrestrial carbon uptake. Both the NEP and total carbon uptake showed significant increasing trends. Specifically, the mean NEP increased from 17.96 g C m-2 yr-1 in 2001 to 37.37 g C m-2 yr-1 in 2019, with the trend written as y = 1.20× + 15.20 (R2 = 0.62, p < 0.01). Meanwhile, the total carbon uptake increased from 2.35 Pg C yr-1 in 2001 to 4.13 Pg C yr-1 in 2019, which could be written as y = 0.12× + 1.93 (R2 = 0.56, p < 0.01). Climate change acted as the dominant factor for the trends at the global scale, which contributed 21.26 g C m-2 yr-1 and 1.59 Pg C yr-1 of the mean NEP and total carbon uptake changes in the stable land trajectories (94.30 million km2 that covered 63.29 % of the global land area), and the historical LUCC contributed -6.30 g C m-2 yr-1 (-40.85 %) and - 0.046 Pg C yr-1 (-57.50 %) of the mean NEP and the total carbon uptake change in the land transformation trajectories (6.64 million km2 that covered 4.46 % of the global land area), respectively. The maximum LUCC contribution (-61.85 g C m-2 yr-1) to the mean NEP occurred in the land transformations from evergreen needleleaf forests to woody savannas, while the maximum contribution (-0.034 Pg C y-1) to total carbon uptake was in the deforested regions from evergreen broadleaf forests to woody savannas. Eight SSP-RCP scenarios predictions demonstrated that future terrestrial carbon uptake would increase by an average of 0.015 Pg C yr-1 in 2100 due to global afforestation. SSP4-3.4 and SSP5-3.4 had the greatest potential for increasing carbon uptake, which is expected to reach a maximum increase (0.045 Pg C yr-1) in 2100. In contrast, the minimum terrestrial carbon uptake would occur in SSP5-8.5, which had the highest CO2 emissions. In conclusion, although relatively limited at the global scale, LUCC (particularly forest change) exerted an unneglectable role on terrestrial carbon uptake in land transformation regions. The results of this study will help to clarify terrestrial carbon uptake dynamics and provide a basis for carbon neutral and climatic adaptation.


[Some problems about incapability to work in direct connection to repression of people applied for relevant pension in accordance to the act from 24.01.1991].
In accordance to the act dated 24.01.1991 refeRring to combatants, victims of repression repressed in the years 1940-1956 apply for relevant pensions. There have been 6510 petitions for relevant pensions related to repression registered between 01.09.1997 to 31.12.2003 in the Social Insurance Department in Szczecin. It is very difficult to form an opinion of long lasting incapability to work related to repression ceasing over 50 years ago. During the medical examination most patents were 60 and over years old and have since retired. The actual system of relevant pensions in connection with repression made by Social Insurance Department is considered compensatory. It seems feasible to consider a new equal compensation system for all cases of repression.


Effects of pegylated interferon-α-2a monotherapy on growth in Japanese children with chronic hepatitis C.
The relationship between pegylated interferon (PEG IFN)-α-2a and growth of children with chronic hepatitis C (CHC) remains unclear. This study was to evaluate the effects of PEG IFN-α-2a on growth. From 2003-2012, we prospectively analyzed the data of children with CHC through mother-to-infant transmission. They were all treatment naive and were treated with PEG IFN-α-2a monotherapy. Among 31 children (19 boys, 12 girls; median age, 6 years) treated with monotherapy during the study period, 21 children (13 boys, eight girls; median age, 7 years) were statistically analyzed. The median treatment period of the 21 children was 48 weeks (range, 48-72). Z-scores of height and weight before treatment, at the end of treatment and 1 year after treatment were -0.05, -0.24 and -0.12 (height), and +0.11, -0.23 and -0.05 (weight). Both Z-scores were significantly decreased at the end of the treatment. One year after treatment, Z-scores of height and bodyweight were significantly improved compared with that of end of treatment but were still lower than those before treatment, with statistical significance. Z-scores of height growth velocity was significantly increased after the treatment (+0.71), compared with that during treatment (-2.25). PEG IFN-α-2a has an inhibitory effect on children's growth, and Z-scores of height and bodyweight were decreased at the end of treatment. Although Z-scores improved after the treatment, they had not returned to the baseline level 1 year after the treatment.


Insulin increases the synthesis of phospholipid and diacylglycerol and protein kinase C activity in rat hepatocytes.
The effects of insulin on phospholipid metabolism and generation of diacylglycerol (DAG) and on activation of protein kinase C in rat hepatocytes were compared to those of vasopressin and angiotension II. Insulin provoked increases in [3H]glycerol labeling of phosphatidic acid (PA), diacylglycerol (DAG), and other glycerolipids within 30 s of stimulation. Similar increases were also noted for vasopressin and angiotensin II. Corresponding rapid increases in DAG mass also occurred with all three hormones. As increases in [3H]DAG (and DAG mass) occurred within 30-60 s of the simultaneous addition of [3H]glycerol and hormone, it appeared that DAG was increased, at least partly, through the de novo synthesis of PA. That de novo synthesis of PA was increased is supported by the fact that [3H]glycerol labeling of total glycerolipids was increased by all three agents. Increases in [3H]glycerol labeling of lipids by insulin were not due to increased labeling of glycerol 3-phosphate, and were therefore probably due to activation of glycerol-3-phosphate acyltransferase. Unlike vasopressin, insulin did not increase the hydrolysis of inositol phospholipids. Insulin- and vasopressin-induced increases in DAG were accompanied by increases in cytosolic and membrane-associated protein kinase C activity. These findings suggest that insulin-induced increases in DAG may lead to increases in protein kinase C activity, and may explain some of the insulin-like effects of phorbol esters and vasopressin on hepatocyte metabolism.


Spread of carbapenem-resistant international clones of Acinetobacter baumannii in Turkey and Azerbaijan: a collaborative study.
Epidemic clones of Acinetobacter baumannii, described as European clones I, II, and III, are associated with hospital epidemics throughout the world. We aimed to determine the molecular characteristics and genetic diversity between European clones I, II, and III from Turkey and Azerbaijan. In this study, a total of 112 bloodstream isolates of carbapenem-resistant Acinetobacter spp. were collected from 11 hospitals across Turkey and Azerbaijan. The identification of Acinetobacter spp. using conventional and sensitivity tests was performed by standard criteria. Multiplex polymerase chain reaction (PCR) was used to detect OXA carbapenemase-encoding genes (bla OXA-23-like, bla OXA-24-like, bla OXA-51-like, and bla OXA-58-like). Pulsed-field gel electrophoresis (PFGE) typing was used to investigate genetic diversity. The bla OXA-51-like gene was present in all 112 isolates, 75 (67 %) carried bla OXA-23-like, 7 (6.2 %) carried bla OXA-58-like genes, and 5 (4.5 %) carried bla OXA-24-like genes. With a 90 % similarity cut-off value, 15 clones and eight unique isolates were identified. The largest clone was cluster D, with six subtypes. Isolates from clusters D and I were widely spread in seven different geographical regions throughout Turkey. However, F cluster was found in the northern and eastern regions of Turkey. EU clone I was grouped within J cluster with three isolates found in Antalya, Istanbul, and Erzurum. EU clone II was grouped in the U cluster with 15 isolates and found in Kayseri and Diyarbakır. The bla OXA-24-like gene in carbapenemases was identified rarely in Turkey and has been reported for the first time from Azerbaijan. Furthermore, this is the first multicenter study in Turkey and Azerbaijan to identify several major clusters belonging to European clones I and II of A. baumannii.


Automatic virtual transducer locating system to assist in interpreting ultrasound imaging.
Bodymarkers are used to label the location and orientation of the transducer during ultrasound examination. We attempt to evaluate the usefulness of a new system that indicates transducer location over that of the conventional bodymarker. The proposed system uses an electromagnetic tracking device to track the three-dimensional (3-D) position and orientation of a small electromagnetic receiver attached to the ultrasound transducer relative to a transmitter placed under the bed. The new bodymarker is displayed as a 3-D graphic model. The physique of the examinee is calibrated by representing five locations on the body on the original bodymarker. To evaluate the accuracy of the system visually, we compared the transducer position indicated in the new bodymarker and the actual transducer position in four abdominal sections. Actual and displayed position and orientation closely agreed in all cases, and the transducer position indicator in the bodymarker display moved smoothly. Automatic transducer locator on the virtual 3-D bodymarker accurately indicated its position and orientation. This system is useful and convenient in clinical examinations.


Detection of Influenza in the Epidemic Season 2016/2017 Based on I-MOVE+ Project.
In the influenza season 2016/2017 in Europe, the predominant virus was A/H3N2/. In Poland, the percentage of people vaccinated against influenza was 3.33%. European I-MOVE+ project shows how important it is to monitor the effectiveness of influenza vaccine. The project demonstrates that a match between the circulating vaccine strains and those included in the vaccine for the Northern Hemisphere was low-to-moderate. In the present study, there were 379 patients and 296 control subjects examined in hospitals in Poland as part of I-MOVE+ project. The real-time reverse transcription polymerase chain reaction (qRT-PCR) method was used to detect the influenza virus in all subjects. We detected the influenza subtype A/H3N2/ in 59.1% and type B virus in 2.1%. There was one co-infection of subtype A/H3N2/ with subtype A/H1N1/ and eight co-infections of type B with subtype A/H3N2/. No influenza viruses were detected in the control group. Only 19 patients and 22 control subjects were vaccinated during the epidemic season in question. A proportion of people vaccinated against influenza in Poland remains dismally low compared to other European countries.


Effects of propofol target-controlled infusion on haemodynamic and respiratory changes with regard to safety.
We investigated the haemodynamic and respiratory effects of propofol target-controlled infusion (TCI) during spontaneous ventilation. We studied 20 patients scheduled for elective orthopaedic surgery who were classified as American Society of Anesthesiologists physical status I. During spontaneous ventilation, haemodynamic, respiratory and electroencephalographic variables were measured. Oxygen flow was maintained at 5 l/min using a semi-closed system and a close-fitting face mask. All measurements were obtained before the propofol TCI and at each propofol effect-site concentration (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5 and 4.0 micrograms/ml). Changes in Bispectral Index Score, systolic blood pressure, diastolic blood pressure, end tidal carbon dioxide tension and heart rate were negatively correlated with propofol effect-site concentrations. Despite maintaining oxygen saturation (> or = 99%), apnoea and blood pressure reductions were abruptly induced as the propofol effect-site concentration increased. We therefore recommend careful monitoring of haemodynamic and respiratory function during spontaneous ventilation using propofol TCI.


Relationship Between Laryngeal Electromyography and Video Laryngostroboscopy in Vocal Fold Paralysis.
The objective of this study was to better define the relationship of laryngeal electromyography and video laryngostroboscopy in the diagnosis of vocal fold paralysis. Retrospective diagnostic cohort study with cross-sectional data analysis METHODS: Data were obtained from 57 patients with unilateral vocal fold paralysis who attended a large tertiary voice referral center. Electromyographic findings were classified according to recurrent laryngeal nerve, superior laryngeal nerve, and high vagal/combined lesions. Video laryngostroboscopy recordings were classified according to the position of the immobile fold into median, paramedian, lateral, and a foreshortened/hooded vocal fold. The position of the paralyzed vocal fold was then analyzed according to the lesion as determined by electromyography. The recurrent laryngeal nerve was affected in the majority of cases with left-sided lesions more common than right. Vocal fold position differed between recurrent laryngeal and combined vagal lesions. Recurrent laryngeal nerve lesions were more commonly associated with a laterally displaced immobile fold. No fold position was suggestive of a combined vagal lesion. The inter-rater reliability for determining fold position was high. Laryngeal electromyography is useful in diagnosing neuromuscular dysfunction of the larynx and best practice recommends its continued implementation along with laryngostroboscopy. While recurrent laryngeal nerve lesions are more likely to present with a lateral vocal fold, this does not occur in all cases. Such findings indicate that further unknown mechanisms contribute to fold position in unilateral paralysis.


Iatrogenic catheter-induced ostial coronary artery dissections: Prevalence, management, and mortality from a cohort of 55,968 patients over 10 years.
We sought to describe the prevalence, management strategies and evaluate the prognosis of patients with iatrogenic catheter-induced ostial coronary artery dissection (ICOCAD). ICOCAD is a rare but potentially devastating complication of cardiac catheterisation. The clinical manifestations of ICOCAD vary from asymptomatic angiographic findings to abrupt vessel closure leading to myocardial infarction and death. 55,968 patients who underwent coronary angiography over a 10-year period were screened for ICOCAD as defined by the National Heart, Lung, and Blood Institute. The management and all-cause mortality were retrieved from local and national databases. The overall prevalence of ICOCAD was 0.09% (51/55,968 patients). Guide catheters accounted for 75% (n = 37) of cases. Half of the ICOCAD cases involved the right coronary artery while the remaining were related to left main stem (23/51; 45%) and left internal mammary artery (2/51; 4%). Two-thirds of ICOCAD were high grade (type D, E, and F). The majority of cases were type F dissections (n = 18; 66%), of which two third occurred in females in their 60s. The majority of ICOCAD patients (42/51; 82%) were treated with percutaneous coronary intervention while the remaining underwent coronary artery bypass grafting (3/51; 6%) or managed conservatively (6/51; 12%). Three deaths occurred during the index admission while 48/51 patients (94.1%) were safely discharged without further mortality over a median follow-up of 3.6 years. ICOCAD is a rare but life-threatening complication of coronary angiography. Timely recognition and prompt bailout PCI is a safe option for majority of patients with good clinical outcomes.


Serum 25-hydroxyvitamin D3 and the risk of pneumonia in an ageing general population.
Vitamin D has been suggested to have a role in infection defence and on the immune system. We therefore investigated the effect of serum 25-hydroxyvitamin D₃ (25(OH)D₃) on the risk of incident hospitalised pneumonia in an ageing general population in eastern Finland. The study population included 723 men and 698 women aged 53-73 years from the prospective population-based Kuopio Ischemic Heart Disease Risk Factor study who were free of pneumonia, other pulmonary diseases and cancer at baseline in 1998-2001. Incident pneumonia episodes leading to hospitalisation were collected by record linkage to the hospital discharge register. The serum vitamin D status was assayed as 25(OH)D₃ concentration. Cox proportional hazards regression models were used to analyse the effect of serum 25(OH)D₃ on the risk of incident pneumonia. The mean (SD) serum 25(OH)D₃ concentration of the study population was 43.5 (17.8) nmol/l. 73 subjects had at least one hospitalisation episode due to pneumonia during an average follow-up of 9.8 years. After multivariable adjustments, the subjects in the lowest serum 25(OH)D₃ tertile had a 2.6-fold (95% CI 1.4 to 5.0, p trend across tertiles=0.005) higher risk of developing pneumonia compared with the subjects in the highest tertile. This significant result remained even after adjustment for the determinants of serum 25-hydroxyvitamin D₃. These data suggest an inverse effect of serum 25(OH)D₃ concentration on the risk of incident pneumonia in the general ageing population.


Developing implantable neuroprosthetics: a new model in pig.
A new model has been established in the domestic pig for neural prosthetic device development and testing. To this end, we report on a complete neural prosthetic developmental system using a wireless sensor as the implant, a pig as the animal model, and a novel data acquisition paradigm for actuator control. A new type of stereotactic frame with clinically-inspired fixations pins that place the pig brain in standard surgical plane was developed and tested with success during the implantation of the microsystem. The microsystem implanted was an ultra-low power (12.5 mW) 16-channel intracortical/epicranial device transmitting broadband (40 kS/s) data over a wireless infrared telemetric link. Pigs were implanted and neural data was collected over a period of 5 weeks, clearly showing single unit spiking activity.


Risk of adenoma recurrence after polypectomy in patients younger than 50 years vs. 50 years old and over with diminutive or small adenomas.
Current studies have shown that polyp recurrence occurs after colonic adenomas polypectomy (AP), but the difference in recurrence risk between patients in patients older than 50 years and younger than 50 years has not been clearly studied. 490 patients after AP were enrolled in the study. The patients were classified according to age (<50 years old or ≥50 years old), and then further categorized according to the baseline adenoma characteristics: Group 1: 1-2 non-advanced adenomas (NAAs) 1-5 mm in size; Group 2: ≥3 NAAs, 1-5 mm; Group 3: 1-2 NAAs, 6-9 mm; Group 4: ≥3 NAAs, 6-9 mm; and Group 5: advanced adenomas. During a mean follow-up interval of 2.52 years (2.51 years for ≥50 years old and 2.55 years for patients <50 years old), NAA recurrence was detected in 147 patients (30.0%). Overall, the hazard ratio (HR) for NAA recurrence after AP was higher in patients ≥50 years old than that in patients <50 years old (HR, 1.774, P = 0.003). For patients <50 years old, HRs (Group 2-5 vs. G1, respectively) for NAA recurrence were 0.744 (P = 0.773), 3.885 (P = 0.007), 5.337 (P = 0.003), and 3.334 (P = 0.015). For patients ≥50 years old, HRs (Group 2-5 vs. G1, respectively) for NAA recurrence were 1.033 (P = 0.965), 1.250 (P = 0.405), 2.252 (P = 0.015), and 1.887 (P = 0.009). For G1, the risk of NAA recurrence was significantly higher in patients ≥50 years old (HR, 2.932, P = 0.011) than that in patients <50 years old; for G2-G5, the risk was similar in the two age groups (P > 0.05). For patients <50 years old with less than 3 NAAs that are 1-5 mm in size, the recurrence rate of NAA is less than that of patients ≥50 years old with the same index colonoscopy findings. When the adenomas are ≥5 mm, or their number exceeds 3, they have similar recurrence risk as that for patients ≥50 years old.


Indication of a possible role in a demyelinating neuropathy for an antigen shared between myelin and NK cells.
In three patients with monoclonal IgM antibodies to myelin-associated glycoprotein and a demyelinating neuropathy, the human monoclonal antibodies and HNK1, a mouse monoclonal antibody against human natural killer cells, reacted with the same region of myelin-associated glycoprotein. In these three patients there was a pronounced decrease in the number of circulating HNK1-positive cells. Taken together, these findings provide evidence that a cross-reactive cell surface antigen may be involved in an autoimmune response directed simultaneously against the nervous system and the immune system.


Dental caries and associated factors among diabetic and nondiabetic adult patients attending Bichena Primary Hospital's Outpatient Department.
Dental caries is a significant public health issue affecting both the diabetic and nondiabetic populations. However, the problem and associated factors of dental caries among diabetics and nondiabetics patients are not well-known in Ethiopia. This study aims to compare the prevalence of dental caries and associated factors among diabetic and nondiabetic patients at the Outpatient Department of Bichena Primary Hospital in Northwest, Ethiopia. Institutional based, comparative cross-sectional study was conducted from October 7 to December 6, 2019, among 200 diabetes and 400 nondiabetic adult patients. A consecutive sampling technique was implemented to recruit study participants. Data were collected by a pretested structured questionnaire and analysis was performed in Statistical Package for Social Science version 20. Bivariable and multivariable logistic regressions were employed and variables with a p-value < 0.05 were declared statistically significant. A total of 582 patients were involved in the study with a response rate of 97.0%. The prevalence of dental caries was 67.9% [95% confidence interval (CI): 63.2%-72.8%] and 79.6% (95% CI: 74.0%-85.70%) in nondiabetic and diabetic group, respectively. Females gender [adjusted odds ratio (AOR) = 1.79, 95% CI: 1.15-2.77], poor oral hygiene (AOR = 2.95, 95% CI: 1.71-5.11), lack of regular teeth cleaning habits (AOR = 3.26, 95% CI: 2.13-4.97), feeling dry mouth (AOR = 2.31, 95% CI: 1.11-4.81), sugared tea drinking (AOR = 2.00, 95% CI: 1.18-3.38), inadequate oral health knowledge (AOR = 3.51, 95% CI: 2.19-5.62), and khat chewing (AOR = 2.14, 95% CI: 1.24-3.71) were significantly associated factors with high prevalence of dental caries. The prevalence of caries was significantly higher among diabetics than nondiabetics. Oral health education with preventive measures such as improving teeth cleaning practice, reducing sugary foods and drinks intake, and improving oral hygiene practice of patients should be mainstreamed along with diabetic follow-up care.


Feasibility and toxicity of concurrent chemoradiation for elderly patients with head and neck cancer.
Although concurrent chemoradiation is increasingly used for patients with locally advanced head and neck cancer, many elderly patients receive radiation alone due to toxicity concerns. We evaluate acute and late toxicity among patients age ≥ 65 who received concurrent chemoradiation for head and neck cancer. Retrospective review. Tertiary care center. Between 6/2003 and 8/2011, 40 consecutive patients age ≥ 65 underwent combined chemoradiation for head and neck cancer. Ten patients were treated in the postoperative setting and 30 underwent definitive chemoradiation. Twenty-eight patients received concurrent platinum-based chemotherapy and 12 received concurrent weekly paclitaxel. Treatment plans were designed to provide a dose of 66-72 Gy at 2-2.12 Gy/fraction to >95% of the gross tumor volume in the definitive setting or for positive margins and 60-66 Gy at 2 Gy/fraction post-operatively. Median follow-up was 23.2 months (range: 0-94.4 months). Acute skin and mucosal toxicity, unplanned treatment interruptions, and chronic treatment related toxicity including gastrostomy tube dependence as graded by the CTCAE v3.0. Eight patients (20%) required a radiation treatment break of ≥ 3 days. Thirteen (33%) required unplanned hospitalization during or immediately following treatment. No grade 4+ skin or mucosal toxicity was noted. Five patients remained PEG tube dependent at >1 year. One patient developed non-healing mandibular osteoradionecrosis >3 years following chemoradiation. The 2-year Kaplan-Meier estimate of overall survival was 55%. Higher-than-expected rates of in-patient hospitalization with significant acute toxicity were noted in this cohort with a correspondingly high rate of radiation treatment breaks. Late toxicity rates were similar to those observed in historical controls with younger patients. Careful patient selection criteria should be employed for elderly patients considering concurrent chemoradiation for head and neck cancer.


Coupling development and elution, a new thin-layer chromatography technique.
Three methods of coupling development and elution were studied in this paper. (1) A new mode of solvent supplementation and eluate collection was developed for descending development. By using a new distributor and collector in descending development, components can be separated and eluted continuously. (2) The same effect can be realized with a slope distributor [Su et al., J. Planar Chromatogr. 14 (2001) 203] and a collector by horizontal development. (3) In-situ elution can be used to treat a developed silica plate, which can elute the separated components to the receptor without scraping them off. These three methods can be used individually, and the in-situ elution can be used with other modes of development.


Serpin inhibitors of urokinase and thrombin in normal rat brain and the 9L brain tumor: evidence for elevated expression of protease nexin I-like inhibitor and a novel sodium dodecyl sulfate-activated tumor antithrombin.
Increasing attention is being paid to alterations of the hemostatic balance in tumors, in general, and brain tumors, in particular. Apparently divergent results, showing excess fibrinolysis (i.e., increased plasminogen activator activity) or its inhibition (i.e., increased inhibitor activity), have been reported. The 9L rat brain tumor is a gliosarcoma and a model used to study treatment paradigms for human gliomas. To study the roles of fibrin and fibrinolysis in this brain tumor model, we used these features to investigate the nature of the plasminogen activator (PA) and thrombin inhibitors in normal rat brain and in the 9L rat brain tumor, growing both in vitro and in vivo in rat brain. The results indicate that cells cultured from the tumor in vitro express PA inhibitory activity which is both of the protease nexin I and PA inhibitor 1 types. However, the serpin PA inhibitory activity in extracts of both the normal brain and tumor is of the protease nexin I/PA inhibitor 3 type. This activity is higher in the tumor than in the surrounding "normal" tissue. In addition, we present evidence for a novel thrombin inhibitor which (a) is present only in the tumor growing in rat brain and undetectable either in the normal brain tissue or in vitro, (b) is in a latent, but sodium dodecyl sulfate-activatable, state, and (c) does not bind urokinase. In current studies, investigators are exploring the roles of these molecules and the target serine proteases they inhibit in the pathogenesis of gliomas.


Intravenous IGF-I receptor antisense reduces IGF-IR expression and diminishes pressor responses to angiotensin II in conscious normotensive rats.
Given the variety of cardiovascular effects of insulin-like growth factor-I (IGF-I), we investigated the effects of a functional deficit in IGF-I signalling in the conscious rat cardiovascular system using intravenous IGF-I receptor antisense (AS, 0.5 nmol) treatment.Insulin-like growth factor-I receptor (IGF-IR) immunoreactivity was reduced in IGF-IR AS-treated tail arteries. Western immunoblot analysis demonstrated a decrease in cardiac IGF-IR in IGF-IR AS-treated rats; treatment reduced the expression of IGF-IR to 83+/-6% of that in samples from vehicle-treated rats, compared to 99+/-3% for a control, full-mismatch oligonucleotide (MM-18) or 100% (vehicle).IGF-IR AS treatment had no effect on resting blood pressure during the 14-day treatment period. Pressor responses (as measured by increase in systolic arterial pressure) to angiotensin II (AngII) gradually decreased over 2 weeks treatment with IGF-IR AS (5 x 0.5 nmol per intravenous injection, 2 weeks), and were significantly reduced at treatment day 14 compared to day 7 (2.7-fold rightward shift). IGF-IR AS treatment caused a significant rightward shift in the angiotensin II (AngII) dose-response compared to both vehicle and full-mismatch treated rats (4.0-fold shift compared to vehicle, P<0.01, n=6-14). There was a significant decrease in cardiac angiotensin II type 1 receptor (AT(1)R) expression in AS-treated rats compared to vehicle-treated rats; cardiac AT(1)R was decreased to 80+/-6% in comparison to 100%. AT(1)R immunoreactivity was also reduced in IGF-IR AS-treated tail arteries.IGF-IR AS treatment resulted in structural changes in both the heart and aortae, with small but significant differences observed between left ventricle/bodyweight ratios of AS and both vehicle- and MM-18-treated rats (n=8, P<0.05). Aortic cross-sectional areas of AS-treated rats were significantly lower than MM-18- and vehicle-treated rats (27.4+/-5.7% reduction of vehicle-treated samples, n=8, P<0.01). The results of this study suggest that an induced loss of IGF-IR, while not affecting resting blood pressure, has a predominantly inhibitory effect on vascular response to vasoconstrictor agents including angiotensin II. This may occur through downstream effects on AT1R expression, via modulation of the expression of receptors for other vasoactive signalling molecules, or via changes in myocyte proliferation.


Testing 3 Digital Health Platforms to Improve Mental Health Outcomes in Adults With Type 1 Diabetes: A Pilot Trial.
Our aim in this study was to examine the potential impact of a 3-pronged digital health pilot intervention (TRIFECTA) on diabetes distress and depressive symptoms among adults with type 1 diabetes (T1D) in British Columbia. We recruited 60 adults with T1D (mean age 38.9±15.1 years, 75% female, 77% Caucasian) who participated in the 6-month pilot intervention involving 3 digital health platforms: monthly, provider-led, group-based sessions over Zoom (virtual huddles); a WhatsApp peer texting group; and a web-based "Ask-the-expert" portal. Assessments were conducted at baseline and 6 months and measured diabetes distress (T1D Diabetes Distress Scale), depressive symptoms (9-item Personal Health Questionnaire), and TRIFECTA engagement metrics. Participation in TRIFECTA was associated with significant reductions in Overall Distress (p=0.011) and 4 distress subscales: Powerlessness (p=0.006), Management Distress (p=0.001), Hypoglycemia Distress (p=0.029), and Eating Distress (p<0.001). A higher number of virtual huddles attended predicted lower Overall Distress (p=0.019) and Family/Friends Distress (p=0.023). A higher number of "Ask-the-expert" posts viewed predicted lower Overall Distress (p=0.046), whereas a higher number of WhatsApp messages posted predicted lower Management Distress (p=0.006). Furthermore, engagement in all 3 metrics were predictors for lower Negative Social Perceptions Distress (p<0.05). No associations were seen in other distress subscales or for depressive symptoms. Participation in TRIFECTA was linked to reduced diabetes distress levels, but not depressive symptoms, in a platform-dependent manner. This study provides promising pilot data for a subsequent large-scale and fully powered randomized controlled trial.


Single left superior vena cava: antenatal diagnosis, associated anomalies and outcomes.
To describe the associated cardiac and extracardiac findings and estimate the prevalence of single left superior vena cava (LSVC) among fetuses referred for fetal echocardiography. This was a retrospective case series of fetuses diagnosed with situs solitus and single LSVC at the Brompton Centre for Fetal Cardiology, London, UK, from October 2006 to December 2020. Prenatal and postnatal outcome data were collected. Prenatal diagnosis was based on abnormal vessel alignment at the three-vessel view and/or three-vessel-and-trachea view, showing a vessel to the left of the pulmonary artery (i.e. the LSVC) and absence of the usual vessel to the right of the ascending aorta (i.e. the right superior vena cava), and further visualization of the LSVC draining into the coronary sinus. Of 19 968 fetal echocardiograms performed during the study period, 34 cases of single LSVC were identified (a prevalence of 0.17%). Of these, 32 pregnancies had a live birth, one was lost to follow-up and one resulted in intrauterine demise. Single LSVC was isolated in 79.4% of cases. No major congenital heart disease was identified. One fetus showed mild isthmus hypoplasia, with no aortic coarctation postnatally. Two fetuses had umbilical vessel abnormalities. A genetic abnormality was found in one case (15q24.1-q24.2 deletion). Antenatal diagnosis of single LSVC in the setting of situs solitus is usually a benign isolated finding. Nevertheless, investigation of other cardiac, extracardiac and genetic disorders should be considered. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.


Biofeedback training of 40-Hz EEG in humans.
This study was a preliminary evaluation of biofeedback training of human subjects to control high-frequency EEG responses in the 35- to 45-Hz (40-Hz) and 21- to 31-Hz ranges. A total of 22 adult males divided into three groups were successfully trained for increases or suppression of 40-Hz EEG, or increases of 21- to 31-Hz EEG. Dissociation of rates of 40-Hz EEG recorded from scalp leads and 40-Hz EMG responses from prominent muscle contaminators, and partial dissociation of 40-Hz and 21- to 31-Hz EEG responses were noted. After biofeedback training, 8 subjects demonstrated increase and suppression of 40-Hz EEG without feedback. No consistent descriptors of subjective experiences accompanying EEG changes were reported by subjects in any of the groups. The study suggests the utility of biofeedback procedures in research on high-frequency EEG activity.


Effects of intubation on coronary blood flow and myocardial oxygenation.
Effects on haemodynamics and myocardial oxygenation of endotracheal intubation were examined in 17 patients after halothane induction and 12 after 1 mg X kg-1 of IV morphine. Six patients having each anaesthetic were pretreated with IV propranolol (0.1 mg X kg-1) 45 minutes earlier. Arterial and intracardiac pressures, cardiac output and total coronary sinus blood flow (CSBF), both by thermodilution, were determined plus arterial-coronary differences of oxygen, haemoglobin and lactate. Blood pressure (BP), heart rate and CSBF were recorded continuously during intubation. The subjects were candidates for coronary bypass grafts, but had good ventricular function (mean ejection fraction 0.68 +/- 0.13 SD). From their reduced levels after induction, BP, cardiac index and systemic vascular resistance increased to awake levels following intubation. Mean CSBF in nonbetablocked patients increased to awake level along with BP. More myocardial oxygen was extracted and consumed after intubation, but lactate extraction continued: these data are evidence of adequate oxygen supply. Induction with either halothane or morphine effectively prevented the hypertensive response to intubation. Acute beta blockade led to less increase in heart rate from intubation.


Secondary metabolites related to the resistance of Psidium spp. against the nematode Meloidogyneenterolobii.
The guava tree (Psidium guajava) is a tropical species native to South America and is recognized as the 11th most economically important fruit tree in Brazil. However, the presence of the nematode Meloidogyne enterolobii and the fungus Fusarium solani in the roots of guava plants leads to the development of root galls, causing significant damage. In contrast, the species P. guineense and P. cattleianum have been identified as resistant and immune to the nematode, respectively. In this study, the researchers aimed to compare the metabolomic profiles of infected and uninfected roots of P. guajava, P. cattleianum, and P. guineense using mass spectrometry coupled with liquid chromatography (LC-MS). The goal was to identify secondary metabolites that could potentially be utilized as biochemical resources for nematode control. The findings of the study demonstrated that the plant metabolism of all three species undergoes alterations in response to the phytopathogen inoculation. By employing molecular networks, the researchers identified that the secondary metabolites affected by the infection, whether produced or suppressed, are primarily of a polar chemical nature. Further analysis of the database confirmed the polar nature of the regulated substances after infection, specifically hydrolysable tannins and lignans in P. guineense and P. cattleianum. Interestingly, a group of non-polar substances belonging to the terpene class was also identified in the resistant and immune species. This suggests that these terpenes may act as inhibitors of M. enterolobii, working as repellents or as molecules that can reduce oxidative stress during the infection process, thus enhancing the guava resistance to the nematode. Overall, this study provides valuable insights into the metabolic alterations occurring in different Psidium spp. in response to M. enterolobii infection. The identification of specific secondary metabolites, particularly terpenes, opens up new possibilities for developing effective strategies to control the nematode and enhance guava resistance.


[The role of digital storage in radiological studies based on fluoroscopic technics].
In recording radiological images obtained by fluoroscopic techniques on permanent support, digital storage, when compared with other methods, shows several interesting features, especially in order to reduce the X-ray dose and to allow for using economical hard copies. In the paper a system is described, for which it is possible to predict competitive cost in the near future; such system is based on a 512 X 512 X 6 bits digital memory, continuosly refreshed and on a software package oriented to handle radiological images. Examples of images referring to typical body segments (stomach, skull, chest) are reported.


Dealing with Scabies in a Hospital Ward.
A case of scabies has been diagnosed in the Medical Ward where Sophie works, and the hospital is having to take appropriate measures. Scabies mites can spread quickly, and staff who are in contact with the infected patient risk catching the parasites and contaminating their own family in turn. One of the night nurses is probably infected.


FeCl3-Mediated Radical Tandem Reactions of 3-Benzyl-2-oxindoles with Styrene Derivatives for the Stereoselective Synthesis of Spirocyclohexene Oxindoles.
A novel FeCl3-mediated reaction of 3-benzyl-2-oxindoles with styrene derivatives was developed. The reaction provided spirocyclohexene oxindoles in good yields and excellent diastereoselectivities via a tandem radical addition/cyclization process.


In-Hospital and Mid-Term Outcomes of ECMO Support During Coronary, Structural, or Combined Percutaneous Cardiac Intervention in High-Risk Patients - A Single-Center Experience.
Evidence regarding the impact of prophylactic implantation of Extracorporeal Membrane Oxygenation (ECMO) during coronary or structural procedures is limited. The purpose of this paper is to evaluate the in-hospital and medium term outcomes of ECMO support in complex percutaneous coronary or structural intervention. The present is an observational prospective study including consecutive patients who underwent to prophylactic ECMO implantation for percutaneous coronary intervention (PCI), structural or combined interventions between July 2018 and July 2020 in Maria Pia Hospital GVM Care & Research, Turin, Italy. Primary endpoints were in-hospital and medium term all-cause death. Secondary endpoints were vascular complication, bleeding and procedural success. 27 patients were included with a mean age of 80 ± 6 years, 10 (37%) being diabetics and 19 (70%) with severe left ventricle dysfunction. Mean Logistic Euroscore was 28.7 ± 18.7. Seven patients (26%) underwent complex coronary revascularization, 7 (26%) combined PCI + TAVI, 5 (19%) combined PCI + Mitraclip, 5 (19%) TAVI alone and finally 3 (11%) combined TAVI + Mitraclip. The procedural success was 96%, with only one in-hospital death due to major vascular complication at the ECMO vascular access. At a mean follow-up of 11 ± 6.8 months 4 deaths were recorded (3 from not cardiovascular causes). Prophylactic use of ECMO may be beneficial for high risk patients undergoing complex combined coronary/structural percutaneous interventions with good in-hospital and mid-term outcomes in term of safety and procedural success.


Photocatalytic Properties of Tetraphenylporphyrins Immobilized on Calcium Alginate Aerogels.
We have prepared photocatalytic systems based on tetraphenylporphyrins (TPP) immobilized on calcium alginate solid gels in the conditions of thermal drying on air (xerogel), freeze drying in vacuum (cryogel) and supercritical drying in the supercritical carbon dioxide (scCO2) medium (aerogel). As a test reaction to measure the prepared systems' efficiency, we studied tryptophan photooxidation in the aqueous medium. We have demonstrated that the systems with aerogel as a carrier exhibited the highest photocatalytic efficiency. In that case, the rate constant for the test substrate (tryptophan) oxidation exceeds the corresponding rate constants of similar systems based on xerogel and cryogel by more than 5 times. Moreover, the aerogel-based photocatalytic systems demonstrated enhanced functional stability and a possibility of multiple use of such a catalyst in tryptophan oxidation. Based on the data of small-angle X-ray scattering and thermooxidative destruction, we have made a conclusion about the relationship between the high photocatalytic activity of aerogel-immobilized TPP and formation of a developed porous aerogel structure in the conditions of drying in the scCO2 medium, which is stabilized due to formation of additional complex bonds of calcium ions with fragments of glycoside rings.


The open abdomen. The Marlex mesh and zipper technique: a method of managing intraperitoneal infection.
In conclusion, a zipper technique has been outlined that allows effective continuing drainage of the septic abdomen, permits early diagnosis of organ damage, is rapid and cost effective, minimizes ventilator dependency and gastrointestinal complications, is well tolerated by the patients, and has produced a modest 65 per cent survival rate in the first 34 critically ill patients in whom it was used. Selection of patients is critical. It is a technique that must not be undertaken lightly but that appears to have life-saving potential.


Comparison of quality attributes of buffalo meat curry at different storage temperature.
The product quality of curry is determined by the food animal source, raw materials and the method of processing. Moreover the scientific information on processing and quality of traditional buffalo meat curry from different groups of buffaloes is not available. This study was undertaken to develop processed curry from different buffalo groups and to compare its quality during storage at ambient and refrigeration temperature. The meat samples were collected from the longissimus dorsi muscle of the carcasses from each group of buffaloes slaughtered according to the traditional halal method. Buffalo meat curry was prepared in a pressure cooker with the standardized formulation. This final product was subjected to evaluation of quality and shelf life. To evaluate the effect of different groups of meat samples on the quality of curry, product yield, pH, proximate composition, water activity (aw), thiobarbituric acid reactive substances (TBARS), calorific value, sensory attributes and microbiological assay were determined The energy of meat curry from young buffaloes was significantly lower than the meat curry from spent animal groups. The overall acceptability of curry decreased significantly during 3 days ambient storage compared to refrigeration storage. Scientific processing by adopting good manufacturing practices and suitable packaging helped greatly to improve the shelf life of the ambient temperature stored buffalo meat curry. Buffalo meat curry from young male group showed better product characteristics and overall acceptability scores than spent buffalo group.


The study of COVID-19 infection following vaccination in patients with multiple sclerosis.
At this time vaccination against SARS-CoV2 is a global priority. Cases with multiple sclerosis (MS) were among the first vaccinated populations in Iran. We evaluated the change in the frequency of COVID-19 after vaccination and the associated factors with severe COVID-19 infection before and after full vaccination. A questionnaire was validated to investigate the basic characteristics (age, gender, education, body mass index, smoking status, and comorbidities), MS disease and treatment status (MS type, MS duration, The Expanded Disability Status Scale (EDSS), disease modifying treatments) and the information about COVID-19 infection and severity. 692 (91.9%) of participants have received both doses of vaccines, of which Sinopharm appeared to be the most common type. Significant difference of COVID-19 infection prevalence was seen before vaccination and after full vaccination (difference: 0.16, 95% CI: 0.12-0.20) (p value < 0.001). The difference was not significant for severe cases (those who were admitted in the ward or ICU) relative to the COVID-19 cases or the whole participants. Of all the basic and disease factors, only EDSS showed a significant association with severe COVID-19 before vaccination. Severe COVID-19 in fully vaccinated cases did not show any significant relation to any of basic or disease characteristics except with prior history of severe allergic reactions (OR: 17.1, p value: 0.001). The decreased frequency of infection with SARS-CoV2 was predictable but the insignificant difference in cases with the severe forms of the disease raise concern. The only significant predictor was found to be severe allergic reactions. As there are debates on antiCD20 s association with severe COVID-19 and vaccine efficacy, we could not find such significant relation. The other noticeable point about the found relation of EDSS and critical COVID-19 before vaccination is the absence of such relation after full vaccination.


Incidence and risk of delayed surgical site infection following instrumented lumbar spine fusion.
We reviewed a retrospective case series of patients with delayed infections after spinal fusion, and surveyed medical experts in Canada and the USA regarding their use of prophylactic antibiotics for patients undergoing invasive procedures following spine surgery. Infections after spinal fusion are a relatively common complication, which typically occur early in the postoperative period. Infections which occur more than 3months from the index procedure are rare and are often caused by atypical pathogens. The proportion of infections that required debridement and occurred 6 months after the index procedure was 4.3% (7/162). Over 85% of these infections were polymicrobial, with one third of those containing methicillin-resistant Staphylococcus aureus. The most common operative indications were either trauma or tumour, and most patients with a delayed infection had a distant chronic infection. The majority of spine experts do not routinely recommend prophylactic antibiotics for invasive procedures after spine fusion. In the multivariate analysis, experts were more likely to recommend antibiotics for patients undergoing a non-dental procedure, those who were diabetic, and those who were greater than 1year out from their procedure. In summary, the delayed presentation of infection after instrumented spinal fusion is a rare but serious complication. However, due to its infrequency, routine prophylaxis to prevent haematogenous seeding is likely unnecessary.


A new bioinformatics approach to natural protein collections: permutation structure contrasts of viral and cellular systems.
Biological cells and viruses operate by different replication and symmetry paradigms. Cells are able to replicate independently and express little spatial symmetry; viruses require cells for replication while manifesting high symmetry. The author inquired whether different paradigms were reflected in the permutations of amino acid sequences. The hypothesis was that the permutation structure level and symmetry within viral protein collections exceed that of living cells. The rationale was that one symmetry aspect generally accompanies and promotes others in a system. The inquiry was readily answered given abundant sequence archives for proteins. The analysis of collections from diverse viral and cellular sources lends strong support. Additional insights into protein primary structure, the design of collections, and the role of information are provided as well.


The effect of forage species and stage of harvest on the processes of digestion occurring in the rumen of cattle.
1. Pure swards of perennial ryegrass (Lolium perenne L. cv. Melle) or white clover (Trifolium repens L. cv. Blanca) were harvested daily as either primary growth (May-June) or mid- (July) and late- (August-September) season 4-week regrowths and offered to Friesian steers at two levels of feed allowance (18 and 24 g dry matter (DM)/kg live weight), to examine the effect of forage species and stage of harvest on nutrient digestion and supply. 2. The early- and mid-season grasses had low nitrogen (23 g/kg DM) and high water-soluble carbohydrate (169 g/kg) contents whilst the late-season grass had a higher N content (28 g/kg). All clover diets had high N (average 45 g/kg) and low water-soluble carbohydrate (89 g/kg) contents, and DM digestibility on all diets ranged from 0.77 to 0.83 (mean of two feeding levels). 3. Mean total rumen volatile fatty acid concentrations were significantly (P less than 0.001) higher on the clover diets, whilst on the grass diets molar proportions of propionate showed a slight but not significant decline with advancing season and tended to be higher than those on the clover diets. Mean rumen ammonia concentrations were significantly (P less than 0.001) lower on the early- and mid-season grasses (59 mg NH3-N/l) than the late-season grass (242 mg/l) and early-season clover (283 mg/l) which were all significantly (P less than 0.01) lower than the mid- and late-season clovers (372 and 590 mg/l) respectively. 4. Rates of organic matter (OM) and N digestion in the rumen were estimated using established nylon-bag techniques and found to be high on all diets, but significant effects due to forage species (clover greater than grass; P less than 0.001) were detected, whilst overall potential degradability in the rumen exceeded 0.89 for both OM and N on all diets. 5. Significantly (P less than 0.001) more OM entered the small intestine of calves fed on white clover (10.2 g/kg live weight) than those fed on ryegrass (8.33 g/kg) and similar effects due to level of feeding (g/kg; low 7.9, high 10.6; P less than 0.05) and stage of harvest (g/kg; early 8.3 v. mid 10.0, late 9.50; P less than 0.05) were also detected.(ABSTRACT TRUNCATED AT 400 WORDS)


Acute psychosis after anesthesia: the case for antibiomania.
We report the case of a teenager who developed a postanesthesia acute psychosis (delusions, paranoia, and hallucinations) caused by a reaction to antibiotic therapy (amoxicillin and clarithromycin), so called 'Hoigne's syndrome' or 'antibiomania.' The differential diagnosis and a review of literature are presented. Our patient illustrates the importance of adding antibiomania as part of the differential diagnosis when altered postanesthesia behavior is observed in pediatric patients.


Development of a quantitative method for determination of steroids in human plasma by gas chromatography-negative chemical ionization-tandem mass spectrometry.
Sex steroids are involved in biological functions that encompass from the complete sexual development of individuals up to the deregulation of metabolic pathways leading to some pathologies. Steroids are present in blood at low concentration levels from pg mL-1 to ng mL-1. For this reason, a high sensitive and selective method based on gas chromatography-negative chemical ionization-tandem mass spectrometry (GC-NCI-MS/MS) is here proposed to quantify either androgens (androstenedione, dehydroepiandrosterone, dihydrotestosterone and testosterone), estrogens (estrone and estradiol) and a progestogen (progesterone) in human plasma. The sample preparation steps, protein precipitation and solid phase extraction, were optimized to ensure the sample matrix removal and to extract steroids with high efficiency. The NCI-MS/MS detection approach was compared with that based on electron impact to evaluate the incidence of the ionization source in the determination of steroids. The quantification limits for determination of these analytes were in a range from 10 pg mL-1 to 5 ng mL-1, with a high sensitivity for estrogens, typically found at low concentrations. The proposed method was tested for the determination of steroids in male blood samples, in which 6 out of 7 steroids were detected and quantified to report concentration values in agreement with those described in the literature.


The effects of citrate and urine on calcium oxalate crystal aggregation.
The rate of crystal sedimentation in a suspension of calcium oxalate monohydrate (COM) crystals was determined spectrophotometrically in the presence and absence of dialysed urine and citrate. A reduced rate of crystal sedimentation after stirring was recorded in suspensions containing citrate in concentrations between 0.33 and 1.67 mmol/l. The sedimentation rate was reduced in the presence of a 0.3-3.3% concentration of dialysed urine, with increased inhibition of crystal sedimentation when the concentration of urine was increased. A comparison of the inhibition of COM crystal sedimentation in whole urine and in dialysed urine from normal subjects and stone-formers disclosed significantly higher values (P < 0.05) in the dialysed urine. The results support previous observations that physiological concentrations of citrate might efficiently inhibit the aggregation of COM crystals. Furthermore even low concentrations of both whole urine and dialysed urine are apparently very efficient inhibitors of COM crystal aggregation.


Do goldeneye and perch compete for food?
We tested Eriksson's (1979) hypothesis that goldeneye and perch compete for invertebrate prey. (1) Diet overlap was high on both prey type (71%) and prey size (80%). Ephemeroptera nymphs and Trichoptera larvae made up over 65% of the stomach contents of goldeneye and perch, and over 80% of the diets of both species were organisms in the 0-20 mm size range. (2) Goldeneye and perch co-occurred on all three study lakes but there was an inverse relationship between their abundances on nine study plots within those lakes. This reciprocal density trend was not due merely to differences in habitat use by perch and goldeneye. When variation in habitat structure was controlled via partial correlation techniques, the reciprocal density trend remained. (3) An alternative hypothesis that density dependent predation maintained habitat separation of perch and goldeneye was not supported. (4) Food resources were limited in at least some sites. (5) Sites which supported populations of both perch and goldeneye had a significantly greater diversity of resources and a tendency toward higher levels of food production than sites in which only one or neither species occurred. (6) We cannot reject Eriksson's (1979) hypothesis. Our results are in agreement with his studies in Sweden and suggest that interactions between goldeneye and Perca spp. may be comparable over large geographic areas.


The placement of the umbilical venous catheter in the newborn and its relationship to the anatomy of the umbilical vein, ductus venosus and portal venous system.
The importance of lateral as well as AP views for the correct placement of the umbilical venous catheter is stressed. The position of the catheter is related to the anatomy of the ductus venosus which is demonstrated by contrast injection. Air in the portal venous system is not always indicative of a serious process.


A clinical index to predict survival in acute renal failure patients requiring dialysis.
Recent advances in technology have not substantially changed the relatively low survival rate associated with acute renal failure (ARF). Several clinical prognostic variables and multivariate models have been reported to predict survival in individual patients, but these are either cumbersome to use or restrictive in their application. A straightforward clinical index has been developed to predict survival in ARF based on data obtained for all patients receiving dialysis for ARF at the University of Kansas Medical Center from November 1979 through October 1985. During this period, 126 patients received dialysis for ARF, with an overall survival of 25% (32/126). There were no significant differences between survivors and nonsurvivors in age, gender, or indication for dialysis. Eleven variables were statistically related to survival, and were reduced to five when clinically similar variables were combined or eliminated. A clinical survival index was based on these five easily determined variables that were significantly related to survival: systolic blood pressure less than or equal to 110 mm Hg, assisted ventilation, congestive heart failure, proven or suspected sepsis, and gastrointestinal (GI) dysfunction (bleeding, ileus, obstruction, or recent abdominal surgery). Survival was directly related to the number of factors present: zero, 62% (8/13); one, 44% (8/18); two, 30% (10/33); three, 19% (5/26); four, 0% (0/20); and five, 6% (1/16). This straightforward index, derived from easily obtained clinical data, is useful for judging survival prognosis in patients with ARF severe enough to warrant treatment with dialysis.


A feline case of multiple myeloma treated with bortezomib.
Multiple myeloma (MM) is an uncommon neoplasm in cats. There is no established standard of treatment due to the rare occurrence of this disease in cats. Bortezomib is a proteasome inhibitor that serves as the first-line drug for MM in humans, but its effectiveness currently is unknown in feline MM. We present here the case report of a feline MM that exhibited a favorable response to bortezomib. The case was an 11-year-old non-castrated male domestic cat with light-chain MM presenting with clinical symptoms (anorexia, fatigue, and vomiting), mild azotemia, and pancytopenia. The cat failed on melphalan with prednisolone (MP), so bortezomib (Velcade) was initiated on Day 88. A total of 6 cycles of the treatment was performed, with each treatment cycle consisting of twice-weekly subcutaneous administration for 2 weeks followed by a 1-week rest. The dose of bortezomib was 0.7 mg/m2 for first week and 1.0 mg/m2 for second week in the first cycle. A dose of 0.7 mg/m2 was used for subsequent cycles. Prednisolone was used concomitantly in the first 2 cycles. Following treatment with bortezomib, clinical symptoms disappeared and a decrease in serum globulin and recovery of pancytopenia were noted. A monoclonal gammopathy, overproduction of serum immunoglobulin light chain, and Bence-Jones proteinuria that existed at diagnosis were undetectable on Day 123. A monoclonal gammopathy also was not detectable at the end of the bortezomib treatment (Day 213). Anorexia, fatigue, and marked bone marrow toxicity were experienced when bortezomib was administrated at a dose of 1.0 mg/m2, while no recognizable toxicity was observed at a dose of 0.7 mg/m2 throughout the treatment period. The case was placed on follow-up and there was no evidence of relapse as of Day 243. Bortezomib was effective and durable for the treatment of this case of feline MM after failure with MP. Bortezomib was well-tolerated in this cat at a dose of 0.7 mg/m2, but not at 1.0 mg/m2. Bortezomib appears to be a drug worthy of further study for the treatment of feline MM.


Effectiveness of bis(phenylimidazoselenazolyl) diselenide on a mouse model of inflammatory nociception.
The injection of complete Freund's adjuvant (CFA) in the hindpaw of rodents induces tissue inflammation and nociceptive hypersensitivity. In addition, it has been reported that organoselenium compounds have antinociceptive properties in animal models. The purpose of this study was to investigate the potential antinociceptive effect of bis(phenylimidazoselenazolyl) diselenide (BPIS) in the inflammatory nociception model in mice and its possible mechanism of action. C57BL/6 mice received CFA intraplantar in right hindpaw and the inflammatory response was verified 24h after injection as well as the antinociceptive effect of BPIS. The CFA-induced mechanical allodynia was reversed by BPIS treatment (1mg/kg, p.o.) observed through the von Frey hair test. Additionally, L-arginine (600mg/kg; i.p.), administered before BPIS treatment, blocked its antinociceptive effect. Regarding myeloperoxidase activity, NOx and 3-nitrotyrosine levels, BPIS administration did not reverse alterations observed in the paw of animals injected with CFA. BPIS reversed the increase in spinal NOx content induced by CFA. In the spinal cord, it was also found that CFA induced an increase in malondialdehyde content and a decrease in glutamate uptake, and these alterations were reversed by BPIS. Moreover, BPIS treatment induced an increase in non-protein thiol levels in spinal cord of animals that received CFA injection. No alterations were found in glutathione peroxidase, reductase and S-transferase activities of experimental groups. The obtained data reinforce the relevance of BPIS as an antinociceptive agent as well as highlight the importance of the nitric oxide pathway in the spinal cord and its antioxidant potential for its mechanism of action.


Prognostic value of intraoperative MEP signal improvement during surgical treatment of cervical compressive myelopathy.
The purpose of the current study was to evaluate the prognostic value of intraoperative improved transcranial motor evoked potential (MEP) after cervical cord decompressive surgery for cervical compressive myelopathy (CCM). A consecutive series of 59 CCM patients who underwent cervical cord decompressive surgery were studied between December 2013 and April 2015 in this study. And all patients were divided into three subgroups: the patients with intraoperative improved MEP, without obvious MEP change and MEP degeneration. MEP and modified Japanese Orthopedic Association (mJOA) score were mainly utilized to assess intra-, pre- and post-operative neurologic function; all patients had reliable and stable MEP baseline. The early neurologic outcomes and the long-term mJOA improvement rate were evaluated after surgery. There were 21 patients with intraoperative monitoring improvement (MEP improved rate, 140 ± 76 %), 32 patients without obvious MEP change and six patients with MEP degeneration. The early motor or sensory outcome showed varying degrees of recovery in the MEP improvement group. The long-term mJOA improvement rate among the three groups was 59.5 ± 4.2, 48.9 ± 3.9 and 40.6 ± 7.4 %, respectively, after 6-month follow-up, and the improvement group was better than the other two groups with statistical significance (59.5 ± 4.2 vs. 48.9 ± 3.9 %, p < 0.05; 59.5 ± 4.2 vs. 40.6 ± 7.4, p < 0.05). Patients with intraoperative MEP improvement after cervical cord decompression have better prognosis in early and long-term neurologic recovery in CCM surgery.


Intraoperative radiation therapy first part: rationale and techniques.
Intraoperative radiotherapy (IORT) is a technique where a high, single-fraction radiation dose is delivered during a surgical procedure to macroscopic tumours or tumour beds with minimal exposure of surroundings tissues which are displaced and shielded during the procedure. In this paper, the rationale for and use of IORT, both with electron beams (IOERT) and high-dose-rate brachytherapy (HDR-IORT) are discussed. For most tumours, the likelihood of obtaining local control (LC) improves when increasing doses can be administered. In many clinical situations, however, the dose that can be delivered safely to the tumour target is limited by the risk of damaging normal tissues. Special consideration is therefore given on this paper to the relationship between dose, LC and possible complications. Criteria for patient's selection and evaluation and information on sequencing and techniques are presented as well as some considerations on the need for a proper programme on quality assurance and periodical reporting of data.


Molecular screening of cancer-derived exosomes by surface plasmon resonance spectroscopy.
We report on a generic method to detect and identify the molecular profile of exosomes either derived from cultured cell lines or isolated from biofluids. Exosomes are nanovesicles shed by cells into their microenvironment and carry the molecular identity of their mother cells. These vesicles are actively involved in intercellular communication under physiological conditions and ultimately in the spread of various diseases such as cancer. As they are accessible in most biofluids (e.g., blood, urine, or saliva), these biological entities are promising tools for cancer diagnostics, offering a non-invasive and remote access to the molecular state of the disease. The composition of exosomes derived from cancer cells depends on the sort and state of the tumor, requiring a screening of multiple antigens to fully characterize the disease. Here, we exploited the capacity of surface plasmon resonance biosensing to detect simultaneously multiple exosomal and cancer biomarkers on exosomes derived from breast cancer cells. We developed an immunosensor surface which provides efficient and specific capture of exosomes, together with their identification through their distinct molecular profiles. The successful analysis of blood samples demonstrated the suitability of our bioanalytical procedure for clinical use.


Reanalysis of historic elemental speciation filters to investigate the presence of fibrous mineral particles using microscopy techniques.
A case is presented for the value of archiving air quality filters to allow for retrospective analysis of emerging contaminants, that is filter constituents not considered to be harmful (and thus not identified or quantified specifically) at the time of collection but subsequently considered to be of interest. As an example, filters from a 20-year historical archive consisting of 16,000 filters from three sites across Auckland are re-examined for the presence of elongated mineral fibres known to be present in rock across the city. Originally collected for the purpose of the source apportionment of particulate matter, 10 filters from each of the three sites were chosen for reanalysis based on their high silica and aluminium content, and thus considered more likely to contain fibre-like particles (FLP). These filters were analysed using various microscopic methods, including phase contrast microscopy (PCM), scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS). The results show that although the commonly used fibrous polytetrafluoroethylene (PTFE) material of the filters may hamper the visual identification of any fibre-like particles under a certain length, their key components are able to be identified using a combination of PCM and SEM when they are of a suitable dimension and have settled in a certain orientation on the filter. In this case, the use of EDS confirmed the silicon content of the fibres and also revealed elemental spectra. Although the exact identification of the mineral fibre is uncertain, the EDS scan is consistent with hazardous zeolites such as erionite, known to be present in the rock found in Auckland. This study highlights the value in maintaining filter archives for the purpose of investigating the historical evolution of emerging atmospheric pollutants.


Prefrontal cortical activation in Internet Gaming Disorder Scale high scorers during actual real-time internet gaming: A preliminary study using fNIRS.
Observation of real-time neural characteristics during gameplay would provide distinct evidence for discriminating the currently controversial diagnosis of internet gaming disorder (IGD), and elucidate neural mechanisms that may be involved in addiction. We aimed to provide preliminary findings on possible neural features of IGD during real-time internet gaming using functional near-infrared spectroscopy (fNIRS). Prefrontal cortical activations accompanying positive and negative in-game events were investigated. Positive events: (1) participant's champion slays or assists in slaying an opponent without being slain. (2) the opposing team's nexus is destroyed. Negative events: (1) participant's champion is slain without slaying or assisting in slaying any opponent. (2) the team's nexus is destroyed. Collected data were compared between the IGD group and control group, each with 15 participants. The IGD group scored significantly higher than the CTRL group on the craving scale. Following positive events, the IGD group displayed significantly stronger activation in the DLPFC. Following negative events, the IGD group displayed significantly weaker activation in the lateral OFC. Individuals scoring high on the IGD scale may crave for more internet gaming after encountering desired events during the game. Such observations are supported by the correlation between the craving scale and DLPFC activation. The IGD group may also show diminished punishment sensitivity to negative in-game experiences rendering them to continue playing the game. The present study provides preliminary evidence that IGD may demonstrate neural characteristics observed in other addictive disorders and suggests the use of fNIRS in behavioral addiction studies.