Cat blastocysts produced in vitro from oocytes vitrified using the cryoloop technique and cryopreserved electroejaculated semen.
Oocyte preservation is still a challenge in the cat. The aim of this study was to evaluate the efficiency of oocyte vitrification in cryoloop in the domestic cat and to assess the embryonic development after IVF with cryopreserved semen. In vitro matured cat oocytes were vitrified in cryoloop after exposure to 10% ethylene glycol (EG, 0.9 M) in hepes synthetic oviductal fluid (HSOF) for 1 min, 20% EG (1.8M) in HSOF for 1 min, and 40% EG (3.6M), 10mg/ml Ficoll 70 and 0.3M sucrose in HSOF for 20s. Warmed oocytes were fertilized in vitro with frozen-thawed semen collected by electroejaculation and presumptive zygote were cultured in vitro for 10 days. Results showed that percentage of degenerated oocytes was higher (P<0.01), while cleavage rate and morulae blastocysts rate on day 6 were significantly lower (P<0.01) for vitrified oocytes than control. Blastocyst rate on day 8 was higher (P<0.01) for control oocytes than vitrified counterparts, and also developmental ability was higher (P<0.05) for non-vitrified oocytes, while the hatched blastocyst rate on day 10 was higher (P<0.05) for vitrified oocytes than control. In conclusion cat oocytes can be vitrified in cryoloop with a fairly good survival rate, cleavage rate and embryo development until pre-implantation stage.


Effect of desire for pregnancy on decisions to escalate treatment in multiple sclerosis care: Differences between MS specialists and non-MS specialists.
Therapeutic inertia (TI) is a worldwide phenomenon that affects 60 to 90% of neurologists and up to 25% of daily treatment decisions during management of multiple sclerosis (MS) patients. A large volume of MS patients are women of childbearing age, and desire for pregnancy is a complex variable often affecting MS care. The objective of this study was to determine the effect of desire for pregnancy on decisions to escalate treatment during management of MS patients. 300 neurologists with expertise in MS from 20 countries were invited to participate in the study. Participants were presented with 12 pairs of simulated MS patient profiles reflective of case scenarios encountered in clinical practice. Participants were asked to select the ideal candidate for treatment escalation from modest to higher-efficacy therapies. Disaggregated discrete choice experiments were used to estimate the weight of factors and attributes affecting physicians' decisions when considering treatment selection. An excel calculator that provides estimates as the percentage of participants that would escalate treatment for a simulated case-scenario was constructed. 229 (76.3%) completed the study. The mean age (SD) of study participants was 44 (±10) years. The mean (SD) number of MS patients seen per month by each neurologist was 18 (±16). Non-MS specialists were significantly less likely to escalate treatment than MS specialists across mild, moderate, and severe patient cases. These differences were accentuated when case scenarios introduced a desire for pregnancy. The findings were consistent when MRI-lesions, severity of symptoms, and number of relapses were included. Desire for pregnancy differentially influences decisions to escalate treatment, suggesting knowledge-to-action gaps between MS and non-MS specialists. Our findings indicate the need for educational strategies to overcome these gaps and improve clinical outcomes for MS patients who desire pregnancy.


Melamine Recognition: Molecularly Imprinted Polymer for Selective and Sensitive Determination of Melamine in Food Samples.
In this study, a sensitive and selective sensor is constructed to measure the melamine (MEL) using molecular imprinting polymer (MIP) technique. Chemical and electrochemical techniques are used to construct the MIP and quantitative measurements. The constructed sensor was modified with GO-Fe3O4@SiO2 nanocomposite. Screening and optimization of factors are done using statistical methods, including Plackett-Burman design (PBD) and central composite design (CCD). Under the optimized conditions, an MIP sensor showed a linear range from 5.0 × 10-7 to 1.0 × 10-5 M MEL concentration with a correlation coefficient (R 2) of 0.9997. The limit of detection was obtained (0.028 µM) with a highly reproducible response (RSD 2.15%, n = 4). The electrochemical sensor showed good results for the determination of MEL in food samples.


Lung metastases after curative or noncurative irradiation of microscopic primary melanomas.
Melanomas growing in the feet of syngeneic C57BL/6 mice were treated with a single dose of X-irradiation. After doses of 0, 3.75, 7.5, 10, 20, or 30 Gy the tumor-bearing limb was amputated at tumor sizes 1, 2, 3, 4, or 5 mm. After doses of 40, 50, 62.5, or 72.5 Gy, progressive tumor growth did not occur, and amputation of tumor-bearing limbs was done when controls were 1, 2, 3, 4, or 5 mm in size. Eighteen days after amputation the mice were killed, and pulmonary metastases were documented at autopsy. None of the mice developed pulmonary metastases after curative irradiation of the primary foot tumor. After subcurative irradiation there was a significant increase (P less than .003) in pulmonary metastases. The size of the primary melanoma is important in the prediction of these metastases. In this model melanomas can be cured by an adequate dose of irradiation, but in those not cured the incidence of lung metastases is increased. The impact of this biologic phenomenon on survival is unclear.


Synthesis and antileukemic activity of new 3-(1-phenyl-3-methylpyrazol-5-yl)-2-styrylquinazolin-4(3H)-ones.
3-(1-Phenyl-3-methylpyrazol-5-yl)-2-styrylquinazolin-4(3H)-ones 14a-q and 15a-q were synthesized by refluxing in acetic acid the corresponding 2-methylquinazolinones 12 and 13 with the opportune benzoic aldehyde for 12 h. The synthesized styrylquinazolinones 14a-q and 15a-q were tested in vitro for their antileukemic activity against L1210 (murine leukemia), K562 (human chronic myelogenous leukemia) and HL60 (human leukemia) cell lines showing in some cases good activity.


Hormone-resistant prostate cancer with symptomatic pelvic tumours: patient survival and prognostic factors.
To determine the survival and investigate the prognostic significance of immunohistochemical variables and clinical factors in patients with hormone-resistant prostate cancer (HRPC) and symptomatic pelvic tumours, in whom preliminary observations indicated that survival exceeded the median 8-10 months of patients with HRPC and painful bone metastases. Seventy-five patients with HRPC referred for palliative pelvic radiotherapy between 1980 and 1996 were identified. For all patients at least two prostate biopsies had been obtained, one before primary hormone treatment and at least one after clinical progression despite androgen deprivation (HRPC biopsy). Bone scans at the time of referral were assessed. The medical records were reviewed for clinical variables of possible prognostic significance. Histological grade was recorded, and prostate-specific antigen (PSA), androgen receptors (ARs), Ki-67 and p53 determined immunohistochemically. In 18 HRPC specimens the degree of AR amplification was analysed. Positive staining for ARs was high in the HRPC biopsies, although there was no association with AR amplification. Ki-67 positivity increased after the development of HRPC. The median (range) survival was 14 (1-141) months; age < 65 years was associated with increased survival. In a multivariate analysis the following variables remained independent prognostic factors for survival from the time of the HRPC biopsy: bone metastases (0-10 vs > 10 lesions, P < 0.001), low Ki-67 score (0 vs 1-3, P = 0.006) and low p53 positivity score (0 vs 1-3, P = 0.014) in the HRPC biopsy. The median survival of patients with HRPC and pelvic tumours requiring palliation seems to exceed that of patients with HRPC and dominating painful bone metastases by at least 4-6 months. Simple clinical (bone metastases) and immunohistochemical variables (Ki-67, p53) enable patients with particularly long survival times to be identified, and in whom palliative treatment needs to be improved.


[Changes of interleukin-2 and soluble interleukin-2 receptor serum level and multiple organ dysfunction syndrome in severely traumatic patients].
To evaluate the role in the changes of interleukin-2 (IL-2) and soluble interleukin-2R (sIL-2R) serum level in the mechanism of post-traumatic multiple organ dysfunction syndrome (MODS). 59 severe traumatic patients were divided into MODS group (n = 24) and non-MODS group (n = 35) according to the occurrence of MODS after trauma. The changes in IL-2 and sIL-2R serum level were observed by enzyme linked immunoabsorbed assay (ELISA). Sera from 30 healthy individuals were used as normal controls. The serum level of sIL-2R was increased and that of IL-2 decreased in 59 traumatic patients. These changes were more marked in the MODS group than in non-MODS group (p < 0.05). The changes in IL-2 and sIL-2R serum level after trauma might participate in the mechanism of post-traumatic MODS.


How does reverse shoulder replacement change proprioception in patients with cuff tear arthropathy? A prospective optical 3D motion analysis study.
Reverse total shoulder arthroplasty (RSA) can improve function in cuff tear arthropathy (CTA) shoulders, but limited data are available on the effect of RSA on proprioception. The purpose of this study was the evaluation of the proprioception after RSA. This study included fifteen consecutive patients (n = 15) who received an RSA. We measured an active angle reproduction (AAR) by a novel 3D motion analysis using the Heidelberg upper extremity model (HUX). The overall proprioception didn't change significantly from 6.2° preoperatively to 6.2° postoperatively. We conclude that, the overall proprioception remained the same or deteriorated for different movements.


Isolated food intolerance after adjustable gastric banding: a major cause of long-term band removal.
Erosion, slippage, and esophageal dilatation have been acknowledged as typical long-term issues after lap banding. Yet it seems from our experience that isolated food intolerance has become a leading cause for band removal, although not reported as such in the literature. There were 1,450 patients who have been operated on over 12 years (May 1995-May 2007). Food intolerance occurred in 41 cases (2.9%), representing 1/3 of the causes of band removal. The average time for diagnosis was 58 months (16-110). Seventeen cases occurred before 5 years of follow-up, and 25 after. The postoperative course has been uneventful in all cases of simple removal. No patient had re-banding after removal, one had vertical banded gastroplasty in another center, two a gastric bypass, one a BPD, and four had a sleeve gastrectomy at the same operative time as band removal. Food intolerance is rarely reported in the literature, or often attributed to "poor compliance" or "poor results" after lap banding. The background and symptoms of this entity should be separated from other issues, i.e., esophageal dilatation and band slippage. Gastric bypass is a valuable option after band removal, but like others, we prefer sleeve gastrectomy as a second step procedure, given the weight loss that has already been achieved in many cases. Food intolerance after lap-banding is likely to represent the most common cause for band removal in the long run, although we do not know its future rate. From the literature and our experience, there is no clear cause to this complication in the majority of the cases; neither the type of band nor the type of procedure are sufficient explanations.


A search for EGF-elicited degradation products of the EGF receptor.
Epidermal growth factor (EGF) induces the degradation of EGF receptors in both human foreskin fibroblasts and A-431 cells. Similar degradation products of 125I-EGF covalently linked to its receptor appeared at the same times in both A-431 cells and fibroblasts when the cells were exposed to a concentration of 10 ng/ml EGF. Although the products between the two cell types differed in molecular weight, this was at least partly caused by an actual difference in the receptor proteins from the two cell types (as shown by partial proteolysis) rather than from different pathways of receptor degradation. However, when EGF receptors were biosynthetically labeled, no receptor degradation products could be observed, even when the receptor was labeled with radioactive mannose or phosphate, molecules which would predominantly label the outside or inside face of the receptor, respectively. At 20 degrees C, degradation of the receptor slowed and a 150,000-dalton degradation product was observed. This degradation product has previously been observed in cell homogenates produced in the presence of calcium, mediated by calpain. Thus, calpain may play a role in the intracellular degradation of the EGF receptor.


Hylocomium splendens (Hedw.) B.S.G. and Pleurozium schreberi (Brid.) Mitt. as trace element bioindicators: statistical comparison of bioaccumulative properties.
The principal objective of this study was to compare bioaccumulative properties of two terrestrial moss species Hylocomium splendens and Pleurozium schreberi from the Kielce area (south-central Poland), using various statistical techniques. Forty-six moss samples from 23 sampling sites located within the city limits were analyzed for 33 trace elements. The results indicated that 17 elements (Ba, Ce, Co, Cu, Eu, Fe, Gd, Hg, La, Mo, Nd, Ni, Pb, Pr, Sm, V, Y) dominated in H. splendens, whereas only three elements (Mn, Sr, Zn) occurred in excessive amounts in P. schreberi. No differences in the distribution pattern of Dy, Er, Ho, Sn, Tb, Th and Yb were observed. The element concentration ratio (PI/Hy) varied from 0.50 to 1.19. For 14 elements (Ce, Co, Cu, Fe, Gd, Hg, La, Mo, Nd, Ni, Pb, Sm, Th, V), PI/Hy < 1; for 4 elements (Cd, Mn, Sr, Zn), PI/Hy > 1; for 7 elements (Ba, Dy, Er, Eu, Pr, Y, Yb), PI/Hy = equalled 1. Czekanowski's method showed similarities in rare earth element concentrations for both moss species. The cluster analysis exhibited three significant clusters at D(link)/D(max) x 100 < 50 for both moss species. Strong positive Spearman correlations between both moss species were recorded for the following pairs: Ba-Ba, Co-Co, Er-Er, Eu-Eu, Gd Gd, Mn-Mn, Ni-Ni, Pb-Pb, Pr-Pr, Sm-Sm, Th-Th, Y-Y, and Yb-Yb. Nonparametric tests (Sign test, Wilcoxon tests) showed statistically significant differences only for Cd, Ce, Co, Cu, Hg, Mo, Ni, Pb and Sr. The scanning electron microscope study of H. splendens and P. schreberi revealed a different morphology of these species with no injuries.


[Esterase-6 activity in Drosophila melanogaster strains with varying male mating activity].
Analysis of the stocks of Drosophila melanogaster and of interstock hybrids with different male reproductive activity revealed positive connection between this index and the activity of esterase-6 in the reproductive system: ejaculatory duct, paragonies and ejaculatory bulb. X-chromosomes and chromosome 3 participate in genetic control of interstock differences of both sexual and esterase-6 activity.


Almost simultaneous onset of Vogt-Koyanagi-Harada syndrome in co-workers, friends, and neighbors.
To report almost simultaneous onset of Vogt-Koyanagi-Harada (VKH) syndrome in co-workers, friends, and neighbors. The onset of VKH syndrome in six patients was examined. Patient 1 and Patient 2 worked in the same room of an office and developed VKH syndrome 3 weeks apart from each other. Patient 3 and patient 4 were friends, lived in the same city, and developed VKH syndrome 1 month apart. Patient 5 and patient 6 lived in the same suburb and developed the syndrome 1 month apart. Almost simultaneous onset of VKH syndrome in co-workers, friends, and neighbors may suggest an exogenous factor such as viral infection in the pathogenesis.


Homozygous nonsense mutation in SGCA is a common cause of limb-girdle muscular dystrophy in Assiut, Egypt.
The genetic causes of limb-girdle muscular dystrophy (LGMD) have been studied in numerous countries, but such investigations have been limited in Egypt. A cohort of 30 families with suspected LGMD from Assiut, Egypt, was studied using immunohistochemistry, homozygosity mapping, Sanger sequencing, and whole exome sequencing. Six families were confirmed to have pathogenic mutations, 4 in SGCA and 2 in DMD. Of these, 3 families harbored a single nonsense mutation in SGCA, suggesting that this may be a common mutation in Assiut, Egypt, originating from a founder effect. The Assiut region in Egypt appears to share at least several of the common LGMD genes found in other parts of the world. It is notable that 4 of the 6 mutations were ascertained by means of whole exome sequencing, even though it was the last approach adopted. This illustrates the power of this technique for identifying causative mutations for muscular dystrophies. Muscle Nerve 54: 690-695, 2016.


Zinc: Roles in pancreatic physiology and disease.
Zinc is an essential trace element. Deficiencies are frequently seen with gastrointestinal diseases, including chronic pancreatitis, nutritional deficiency, and reduced intestinal absorption. Additionally, reduced zinc levels have been linked to cellular changes associated with acute pancreatitis such as enhanced inflammation with increased macrophage activation and production of inflammatory cytokines such as IL-1β, impaired autophagy, and modulation of calcium homeostasis. Preliminary data suggest that zinc deficiency may lead to pancreatic injury in animal models. The purpose of this review is to explore the biologic effects of zinc deficiency that could impact pancreatic disease. MESH KEYWORDS: Malnutrition, inflammation, trace element.


Renal artery aneurysm secondary to fibromuscular dysplasia in a young patient.
An 8-year-old male was found on routine physical examination to have a blood pressure of 220/110. Renal angiography demonstrated bilateral renal artery stenosis and an aneurysm of the distal left renal artery with branch involvement. At operation, the left renal artery stenosis and aneurysm was repaired by ex vivo arterial reconstruction and autotransplantation of the kidney. Pathologic evaluation of the resected aneurysm confirmed the diagnosis of fibromuscular dysplasia. Fibromuscular dysplasia is the most common cause of renal artery stenosis in children over 1 year of age and can in rare cases be associated with the development of renal artery aneurysms. In complex cases of renal artery stenosis with involvement of renal artery branches, ex vivo repair and orthotopic autotransplantation is an excellent approach for surgical management.


Ultralong UV/mechano-excited room temperature phosphorescence from purely organic cluster excitons.
Purely organic room temperature phosphorescence (RTP) has attracted wide attention recently due to its various application potentials. However, ultralong RTP (URTP) with high efficiency is still rarely achieved. Herein, by dissolving 1,8-naphthalic anhydride in certain organic solid hosts, URTP with a lifetime of over 600 ms and overall quantum yield of over 20% is realized. Meanwhile, the URTP can also be achieved by mechanical excitation when the host is mechanoluminescent. Femtosecond transient absorption studies reveal that intersystem crossing of the host is accelerated substantially in the presence of a trace amount of 1,8-naphthalic anhydride. Accordingly, we propose that a cluster exciton spanning the host and guest forms as a transient state before the guest acts as an energy trap for the RTP state. The cluster exciton model proposed here is expected to help expand the varieties of purely organic URTP materials based on an advanced understanding of guest/host combinations.


A case report of triple neural tube defect: revisiting the multisite closure theory.
Triple neural tube defects are rare. To the author's knowledge, there are only four reported cases available in the literature up to date. Controversies exist with regards to the development of neural tube defects. We revisit the multisite closure theory and try to explain the mechanism of neural tube defects in our case. We report a case of one-month-old baby boy who presented to us with three distinct neural tube defects. He had occipital and cervical encephaloceles along with thoracolumbar myelomeningocele accompanied by syrinx and mild hydrocephalus. All the three defects were surgically corrected with good neurological outcome. In the multisite model of human neural tube closure, there are only two fusion sites and two neuropores unlike in mouse. This can explain the origin of open neural tube defects including anencephaly and myelomeningocele (as in our case) but cannot account for the development of encephalocele, which appears to be a post neurulation defect.


Determinants of efficiency growth of county-level public hospitals-evidence from Chongqing, China.
The reform of county-level public hospitals is a breakthrough in the new era of healthcare reform in China and has attracted considerable attention since 2012. Continuous and efficient operations of hospital are primary concerns of this reform. To ensure the effectiveness of county-based intervention reform measures in Chongqing, it is significant to understand how hospital and county characteristics are associated with county-level public hospital efficiency due to significant development differences between counties. This study identifies the trajectory of hospital efficiency over time and determinants. It will also provide preliminary references for advancing reform. This study employs data from the Chongqing Regional Health Information Platform, Chongqing Health and Family Planning Statistical Yearbook, and Chongqing Statistical Yearbook for 2012-2016. A three-level growth model is used to estimate the efficiency growth trajectories within the contexts of hospitals and counties. The intra-hospital level factors that affect the initial efficiency include government financial assistance, daily charge per bed, total assets turnover, number of hospital healthcare technicians, and medical costs per 100-yuan medical income. Inter-hospital variance is explained by hospital type. Inter-county level factors affecting the growth rate include the number of healthcare technicians per 1000 people and population density of the county. The interaction effect of the number of hospital healthcare technicians, hospital type, and number of healthcare technicians per 1000 people on hospital efficiency growth is significant. This study identifies determinants that contribute to efficiency changes in public county-hospitals over time by using a three-level growth model. The differences in efficiency are associated with intra-hospital, inter-hospital, and inter-county characteristics in Chongqing, which provides useful insight into government decision-making and the progress of reform. The stability and reasonable increase in the number of healthcare technicians in a county are the key factors that improve the efficiency. Further reform should focus on maternal and child healthcare hospitals for increasing investment and implementing government compensation.


Pharmacological modulation of intracellular Ca(2+) channels at the single-channel level.
Synaptic signaling, memory formation, neuronal development, and neuronal pathology are strongly influenced by the properties of intracellular Ca2+ channels, ryanodine, and inositol 1, 4, 5 trisphosphate receptors. This review will focus on recently developed and discovered pharmacological tools to modulate these channel proteins at the single-channel level. It will allow the readers of Molecular Neurobiology to evaluate the current knowledge on the pharmacological modulation of intracellular Ca2+ channels and to direct future research efforts effectively using available experimental tools and concepts.


Metallic foreign body in the neck: case report.
Penetrating neck injuries constitute 5-10% of all trauma cases. Such injuries are dangerous because of the high risk of injury to the vital structures in the neck and hence demand an immediate surgical exploration. We present a case of a penetrating injury of the neck caused by the broken metallic fragment of a saw.


Graphene oxide as nanocarrier for sensitive electrochemical immunoassay of clenbuterol based on labeling amplification strategy.
A novel electrochemical immunosensor for sensitive detection of clenbuterol (CLB) is fabricated using glucose oxidase (GOD)-functionalized grahene oxide (GO) nanocomposites to label CLB. The immunosensor was constructed by layer-by-layer assembly colloidal prussian blue (PB), multiwalled carbon nanotubes (MWCNTs) and CLB antibodies (Abs) on a glassy carbon electrode (GCE). In this competitive immunoassay system, PB acts as the redox mediator to reduce H2O2 originated from the catalyst cycle of GOD. The high ratio of GOD to GO effectively amplified the signal for this competitive-type immunoassay. Under optimized conditions, the immunosensor shows a wide linear range from 0.5 to 1,000 ng/mL with a low detection limit of 0.25 ng/mL. The dual signal amplification of GOD-functionalized GO nanocomposites as a label is promising to be applied to design other sensitive immunosenseors.


[Idiopathic scoliosis and Scheuermann's kyphosis. Historical and current aspects of conservative treatment].
Although in practice since antiquity the nonoperative treatment of spinal deformities is still controversial. Giving preference to orthotic treatment and physiotherapy the historical development of nonoperative treatment will be demonstrated by the examples of idiopathic scoliosis and Scheuermann's kyphosis. It is surprising how early essential and still valuable principles of nonoperative treatment had been acquired and how many of the present-day concepts have remarkable forerunners in the 19th century. In the light of previous knowledge and personal experience the indication, practice and realistic capabilities of modern nonoperative treatment of idiopathic scoliosis and Scheuermann's kyphosis are pointed out.


The use of plasma androstenedione in monitoring therapy of patients with congenital adrenal hyperplasia.
Therapy of congenital adrenal hyperplasia tranditionally is monitored by the amount of urinary 17-KS. However, 24-hour urine collections are difficult to obtain and are often unreliable. Measurement of the plasma concentrations of androgens, such as delta or T, would therefore be a more convenient way to determine the efficacy of treatment. Over a period of 2 to 24 months, 23 patients were periodically assessed by clinical examination, bone age, and determinations of plasma delta, plasma T, and 24-hour urinary 17-KS. Plasma T concentration correlated well with clinical control in females and in preadolescent males, but not in infant and pubertal males. By contrast, plasma delta concentration correlated well with clinical control in either sex, regardless of stage of puberty. The present study suggests that monitoring plasma delta concentration is useful in the long-term management of patients with CAH.


Impact of age and sex on the long-term prognosis associated with early repolarization in the general population.
Early repolarization (ER) has been linked to the risk of sudden cardiac death (SCD) in the general population, although controversy remains regarding risks across various subgroups. The purpose of this study was to investigate whether age and sex influence the prognostic significance of ER. We evaluated the 12-lead electrocardiograms of 6631 Finnish general population subjects age ≥30 years (mean age 50.1 ± 13.9 years; 44.5% men) for the presence of ER (J-point elevation ≥0.1 mV in ≥2 inferior/lateral leads) and followed them for 24.4 ± 10.3 years. We analyzed the association between ER and the risk of SCD, cardiac death, and all-cause mortality in subgroups according to age (<50 or ≥50 years) and sex. ER was present in 367 of the 3305 subjects age <50 years and in 426 of 3326 subjects ≥50 years. ER was not associated with any of the endpoints in the entire study population. After adjusting for clinical factors, ER was associated with SCD (hazard ratio [HR] 1.88; 95% confidence interval [CI] 1.16-3.07) in subjects <50 but not in older subjects (interaction between ER and age group, P = .048). In the younger subgroup, women with ER had a high risk of SCD (HR 4.11; 95% CI 1.41-12.03), whereas among men ER was not associated with SCD. Finally, ER was not associated with cardiac mortality or all-cause mortality in either age group. ER is associated with SCD in subjects younger than 50 years, particularly in women, but not in subjects 50 years and older.


Effects of Fenugreek Seed Extract and Swimming Endurance Training on Plasma Glucose and Cardiac Antioxidant Enzymes Activity in Streptozotocin-induced Diabetic Rats.
Diabetes mellitus is a group of metabolic diseases characterized by chronic hyperglycemia condition resulting from defective insulin secretion or resistance insulin action, or both. The purpose of this study was to evaluate the effect of 6 weeks swimming training and Trigonella foenum-graecum seed (fenugreek) extract, alone and in combination, on plasma glucose and cardiac antioxidant enzyme activity of streptozotocin-induced diabetic rats. Fifty male Wistar rats were divided into five groups: diabetic control (DC, n = 8); healthy control (HC, n = 11); swimming training (S, n = 11); swimming training + fenugreek seed extract (1.74 g/kg body weight; SF1, n = 11); and swimming training + fenugreek seed extract (0.87 g/kg body weight; SF2, n = 9). Streptozotocin was used for the induction of diabetes. Results were analyzed using one-way analysis of variance followed by Tukey test. In comparison with the DC group, all groups exhibited a significant decrease in body weight (p < 0.05), except for the HC group. SF1 and HC groups showed significant decreases in plasma glucose levels compared with the DC group (p < 0.05). S, SF1, SF2, and HC groups showed significant elevations in cardiac antioxidant enzymes activity in comparison with the DC group. The results indicated that the combination of endurance swimming training and fenugreek seed extract can significantly reduce the plasma glucose levels and increase cardiac antioxidant enzymes activity in diabetic rats. Our findings suggest that this combination could be useful for the treatment of hyperglycemia and cardiac oxidative stress induced by diabetes mellitus.


COVID-19 and kidney transplantation.
The COVID-19 pandemic affects the transplant recipients since March 2020. Transplant centers quickly organized themselves to optimize the management of the immunocompromised patients and to progress in the knowledge of this new disease. To this end, a French Registry was created, which includes all solid organ transplant patients who have developed a SARS Cov2 infection. Numerous studies have been carried out using these data to describe this new disease in transplant patients, to characterize its clinical and biological risk factors and to define its prognosis. The 60 days-mortality of transplant patients hospitalized for COVID-19 was evaluated at 23% and renal failure plays a major role in the poor prognosis in addition to the classical risk factors described in the general population. The advent of vaccination has been a great relief but transplanted patients have shown a poor vaccine response keeping them at risk of severe disease even after an adapted vaccination scheme. Specific strategies was proposed in this particularly fragile population like increasing vaccine doses or using anti SARS Cov-2 monoclonal antibodies.


Prognosis and incidence of infections in chronic kidney disease patients with membranous nephropathy enrolled in a large Japanese clinical claims database.
The treatment of membranous nephropathy involves a combination of conservative approaches, steroids, and immunosuppressive agents. Infection is an adverse effect of these treatments and its incidence is a critical issue for patients with membranous nephropathy, as many of them are older adults. However, the incidence of infections remains unclear; hence, this study investigated this issue using data from a large Japanese clinical claims database. From a database of patients with chronic kidney disease (n = 924,238), those diagnosed with membranous nephropathy from April 2008 to August 2021 with a history of one or more prescriptions and undergoing medical care were included. Patients who had undergone kidney replacement therapy were excluded. Patients were divided into three groups based on their prescriptions after diagnosis: prednisolone(PSL), who received steroids; PSL + IS, who were prescribed steroids and immunosuppressive agents; and C, who were treated without steroid or immunosuppressive agent use. The primary outcome was death or the initiation of kidney replacement therapy. The secondary outcome was death or hospitalization due to infection. Infectious diseases such as sepsis, pneumonia, urinary tract infections, cellulitis, cytomegalovirus infection, colitis, or hepatitis were defined as infections. Hazard ratios were expressed using group C as a reference. Of 1,642 patients, the incidence of the primary outcome occurred in 62/460 individuals in the PSL group, 81/635 individuals in the PSL + IS group, and 47/547 individuals in the C group. The Kaplan-Meier survival curve showed no significant differences (P = 0.088). The incidence of secondary outcomes occurred in 80/460 individuals, 102/635 individuals, and 37/547 individuals in the PSL, PSL + IS, and C groups, respectively. The incidence of secondary outcomes was significantly higher in the PSL group (hazard ratio [HR] 2.43 [95% confidence interval [CI] 1.64-3.62, P < 0.01]) and PSL + IS group (HR 2.23 [95% CI 1.51-3.30, P < 0.01]). The outcome of membranous nephropathy was not completely satisfactory. Patients who use steroids and immunosuppressive agents have a high incidence of infection and may require close monitoring during the course of treatment.High-efficacy treatment with a low incidence of infections is desirable. The significance of this study lies in the fact that the impressions of membranous nephropathy, which have been recognized as tacit knowledge, were quantified using a clinical database.


Physical activity and screen time in children who survived cancer: A report from the Swiss Childhood Cancer Survivor Study.
Physical activity (PA) can reduce the risk of chronic adverse health conditions in childhood cancer survivors. We examined PA and sedentary screen time behavior in a nationwide study in Switzerland. The Swiss Childhood Cancer Survivor Study sent questionnaires to parents of all Swiss resident ≥5-year survivors diagnosed between 1995 and 2010. We assessed PA including compulsory school sport, recreational sport, commuting to school, and time spent with screen media in those aged 5-15 years, and compared results with international recommendations. We included 766 survivors with a median age at diagnosis of 2.8 (interquartile range 1.4-5.0) years and a median age at study of 12.5 (10.0-14.3) years. Median PA time was 7.3 (4.8-10.0) h/week and median screen time was 82 (45-120) min/day. Compulsory school sport hours and walking or cycling to school contributed significantly to total PA. Note that 55% of survivors met PA and 68% screen time recommendations. PA was lower for children living in regions of Switzerland speaking French or Italian compared to German, and for those who had a relapse or musculoskeletal/neurological conditions. Screen time was higher in males, children with lower parental education, and a migration background. PA and sedentary screen watching were associated with social factors, and PA also with clinical risk factors. Structural preventions that afford active commuting to school and sufficient school sport are essential, as is counseling vulnerable survivor groups such as those with musculoskeletal and neurological problems, and those who have had a relapse.


Total Kidney Volume as a Biomarker of Disease Progression in Autosomal Dominant Polycystic Kidney Disease.
Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder characterized by the formation of kidney cysts and kidney enlargement, which progresses to kidney failure by the fifth to seventh decade of life in a majority of patients. Disease progression is evaluated primarily through serum creatinine and estimated glomerular filtration rate (eGFR) measurements; however, it is known that serum creatinine and eGFR values typically do not change until the fourth or fifth decade of life. Until recently, therapy only existed to target complications of ADPKD. As therapeutic agents continue to be investigated for use in ADPKD, a suitable biomarker of disease progression in place of serum creatinine is needed. This review summarizes recent research regarding the use of total kidney volume as a biomarker in ADPKD, as presented at the Canadian Society of Nephrology symposium held in April 2015. Measurement of patients' total kidney volume made using ultrasound (US) or magnetic resonance imaging (MRI) has been shown by the Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease (CRISP) study to be directly correlated with both increases in cyst volume and change in glomerular filtration rate (GFR). Additional studies have shown total kidney volume to have an association with complications of ADPKD as well. Areas for further study continue to exist in comparison of methods of measuring total kidney volume. We believe that the evidence suggests that total kidney volume may be an appropriate surrogate marker for ADPKD disease progression.


Impact of a Coal-Fired Power Plant Shutdown Campaign on Heavy Metal Emissions in China.
Recently, China has committed to decommissioning the heavy metal (HM) intensive coal-fired power plants (CFPPs), small units especially, yet a quantitative assessment for the impact on HM emissions remains poorly understood. This study, for the first time, compiles a plant-specific inventory for six HMs (Hg, As, Se, Pb, Cd, and Cr) avoided by CFPPs decommissioned in China during the 12th Five Year Plan period. The reduced HM amounts to 271.58 t (9.19 t Hg, 45.84 t As, 60.76 t Se, 85.30 t Pb, 1.74 t Cd, and 68.75 t Cr), accounting for 12.71% of the total emissions from all China's CFPPs in 2010. Small units which have low boiler efficiency and lack air pollutant control devices are more than tenfold HM-intensive as the large units. The detailed HM emission factors for each CFPP decommissioned in each provincial region are also identified. HM content in the coal consumed is a key parameter to determine their corresponding emission factors, while the capacity of decommissioned coal plants plays a decisive role in the reduced emissions. The high-resolution inventory not only verifies China's progress in alleviating HM pollution, but also provides basis for further investigation into HM relevant environmental and human health impact.


Suppressive effects of QFGJS, a preparation from an anti-arthritic herbal formula, on rat experimental adjuvant-induced arthritis.
To analyze the anti-arthritic effects of QFGJS (a pharmaceutical preparation from herbs) on rheumatoid arthritis, adjuvant-induced arthritis (AIA) was established in male SD rats, and two administration protocols, i.e., oral treatment with different doses of QFGJS on the day of arthritis induction or on the day when visible clinical signs of arthritis occurred, were initiated and continued until day 30. Treatments with QFGJS using both administration protocols significantly suppressed the incidence and severity of arthritis in a dose-dependent manner, showing dramatic reduction of paw swelling and ESR throughout the disease progression of AIA. Radiological and histopathological examinations showed markedly decreased tissue and bone destruction of ankle joints in the QFGJS-treated rats. The serum levels of TNF-alpha, IL-1beta, and IL-6 were significantly decreased in the QFGJS-treated rats. QFGJS demonstrates pronounced anti-arthritic effects on AIA, indicating that this herbal preparation would be a potent candidate as a novel botanical drug for further investigation.


Morphological analysis of mandibular foramen through anatomical planes: implications for inferior alveolar nerve block.
Error in localization of mandibular foramen is attributed to a high failure rate of inferior alveolar nerve block in clinical dentistry. We hypothesized that a remodelled approach towards exploring the morphology of mandibular foramen would be useful. In the present study, the location of the mandibular foramen was analysed with respect to the anatomical planes across the ramus of the mandible and also with respect to the quadrants on the medial surface of ramus of mandible. The study was conducted on 50 dry human mandibles of unknown age and sex. The anatomical planes were defined and drawn on the mandibles. Measurements were made with digital Vernier callipers and findings were noted. It was observed that the most consistent position of the mandibular foramen was along the vertical plane, however, the foramen was most likely to be localized along the oblique plane. Morphological analysis of the foramen with respect to the anatomical planes as well as the quadrants on the medial surface of ramus led to the analysis that occlusion plane should be the preferred plane of approach. Moreover, a rectangular area on the medial surface of the ramus was identified posterior to the mid-point of occlusion plane (8 mm above mid-point, 6 mm below mid-point and 6 mm behind mid-point) where the incidence of location of the foramen was significantly high. The findings of this study may potentially reduce the failure rate of inferior alveolar nerve block and clinical complications thereof.


Venous and nerve invasion as prognostic factors in postoperative survival of patients with resectable cancer of the rectum.
The histopathologic and clinical findings in 682 patients with carcinoma of the rectum have been analyzed. Invasion of veins and nerves by primary growth was found in 38.9 and 34.9 per cent, respectively. The five-year survival rate for patients with resectable tumors was 49 per cent. The age, Dukes' staging, and presence and/or absence of liver metastases, of venous invasion, and of nerve invasion were found to be of statistically significant importance for the prognosis. Sex was found to be on the borderline of significance and Broders' grading was even less significant. Invasion of veins was found statistically significant more frequently than nerve invasion, but the present investigation revealed the importance of the invasion of veins as well as of nerves. When venous invasion was observed, liver metastases developed over three times as frequently in these patients as when metastases were not demonstrated. In contrast to Dukes' staging. Broders' grading can be applied to tumor biopsies preoperatively. The importance of venous and nerve invasion for the selection of patients for adjuvant therapy after termination of surgical treatment is discussed.


Pharmacokinetics of a single intramuscular injection of ceftiofur crystalline-free acid in American black ducks (Anas rubripes).
To determine the pharmacokinetic properties of 1 IM injection of ceftiofur crystalline-free acid (CCFA) in American black ducks (Anas rubripes). 20 adult American black ducks (6 in a preliminary experiment and 14 in a primary experiment). Dose and route of administration of CCFA for the primary experiment were determined in a preliminary experiment. In the primary experiment, CCFA (10 mg/kg, IM) was administered to ducks. Ducks were allocated into 2 groups, and blood samples were obtained 0.25, 0.5, 1, 2, 4, 8, 12, 48, 96, 144, 192, and 240 hours or 0.25, 0.5, 1, 2, 4, 8, 24, 72, 120, 168, and 216 hours after administration of CCFA. Plasma concentrations of ceftiofur free acid equivalents (CFAEs) were determined by use of high-performance liquid chromatography. Data were evaluated by use of a naive pooled-data approach. The area under the plasma concentration versus time curve from 0 hours to infinity was 783 h•μg/mL, maximum plasma concentration observed was 13.1 μg/mL, time to maximum plasma concentration observed was 24 hours, terminal phase half-life was 32.0 hours, time that concentrations of CFAEs were higher than the minimum inhibitory concentration (1.0 μg/mL) for many pathogens of birds was 123 hours, and time that concentrations of CFAEs were higher than the target plasma concentration (4.0 μg/mL) was 73.3 hours. On the basis of the time that CFAE concentrations were higher than the target plasma concentration, a dosing interval of 3 days can be recommended for future multidose CCFA studies.


A blueprint from nature: miRNome comparison of plasma cells and CHO cells to optimize therapeutic antibody production.
Chinese Hamster Ovary (CHO) cells are the most frequently used biopharmaceutical production hosts, although industry is presently suffering from their variable recombinant product quality, insufficient long-term stability and low productivity. Here, we present an effort to address overall cell line engineering by a novel bottom-up microRNA (miRNA) screening approach. miRNAs are small non-coding RNAs known to regulate global gene expression at the post-transcriptional level and have proved to serve as promising tools for cell line engineering for over a decade. Here the miRNome of plasma cells (PCs) has been analyzed as the natural blueprint for optimized production and secretion of antibodies. Performing comparative miRNome cross-species expression analysis of four murine/human PC-derived (PCD) and two CHO cell lines showed 147 conserved miRNAs to be differentially expressed between PCDs and CHOs. Conducting a targeted miRNA screen of this PC-specific miRNA subset revealed 14 miRNAs to improve bioprocess relevant parameters in CHO cells, among them the PC-characteristic miR-183 cluster. Finally, miRNA target prediction tools and transcriptome analysis were combined to elucidate differentially regulated lysine degradation and fatty acid metabolism pathways in monoclonal antibody (mAb) expressing CHO-DG44 and CHO-K1 cells, respectively. Thus, substantial new insights into molecular and cellular mechanisms of biopharmaceutical production cell lines can be gained by targeted bottom-up miRNA screenings.


Recovery of antithrombin III from milk by expanded bed chromatography.
In the present work, a new method of purification for antithrombin was developed using an expanded bed chromatography technique. Milk fat was removed by centrifugation and caseins were precipitated selectively by addition of zinc chloride. Crude skim milk was then directly fed to an expanded bed column containing the ion-exchange matrix. The use of a cation-exchanger (P-11) resulted in 100% adsorption and 13% recovery whereas the use of an anion-exchanger (DE-52) resulted in 100% adsorption and 84% recovery and up to five-fold purification of antithrombin. The buffer, 25 mM Tris-HCl pH 8.0; the eluting agent, 2 M (NH4)2SO4; and 100% expansion of settled bed were determined to be the optimum conditions for the purification of antithrombin by ion-exchange expanded bed chromatography. A comparison of column diameters revealed that the elution yields increase by two-fold while the column diameter increases from 1 to 2.5 cm. However, antithrombin III was concentrated to a higher degree by using the column with an internal diameter of 1 cm.


Presence of the eggshell sign in obstructive uropathy.
To analyze the relationship between hydronephrosis due to urinary tract obstruction and the presence of the sonographic eggshell sign, which is a recently described crescent of increased echogenicity at the caliceal/parenchymal interface and possibly an indicator of raised intrarenal pressure. All patients presenting between 1996 and 1999 for surgical management of pelviureteral junction obstruction or congenital posterior urethral obstruction had films reviewed for the presence of the eggshell sign. Of 94 patients, 40 presented postnatally and 54 had hydronephrosis detected on the antenatal ultrasound scan. Of the postnatal group, 16 (40%) had urethral obstruction, of whom 4 (25%) displayed the eggshell sign; in the 24 with pelviureteral junction obstruction, the echogenic pericaliceal crescent was seen in 5 (20.8%). Of the 54 in the prenatal group, 8 (15.4%) were found to have urethral obstruction, 5 (62.5%) of whom demonstrated the eggshell sign. Of the 46 prenatally diagnosed patients with pelviureteral junction obstruction, 31 (70.5%) displayed the eggshell sign before birth; we were unable to satisfactorily review 2 patients' ultrasound scans. Antenatally diagnosed hydronephrosis due to significant urinary tract obstruction seems to be related to the appearance of the eggshell sign on ultrasonography, particularly in those patients with pelviureteral junction obstruction. Those patients without significant caliceal distension and those with renal dysplasia or severe hydronephrosis with low-pressure kidneys were less likely to display the eggshell sign. Although the association with other causes of hydronephrosis is unknown, we believe these figures support the need for further investigation of the eggshell sign as a marker of raised intrarenal pressure to possibly provide another data point in the sonographic evaluation of congenital hydronephrosis.


Secretion of acid phosphatase from extraradical hyphae of the arbuscular mycorrhizal fungus Rhizophagus clarus is regulated in response to phosphate availability.
Arbuscular mycorrhizal (AM) fungi increase phosphate (P) uptake by plants. Organic phosphate comprises 30-80% of total P in most agricultural soils. Some plants can utilize organic phosphate by secreting acid phosphatase (ACP) from their roots, especially under low P conditions. Although secretion of ACP from extraradical hyphae of AM fungi has been reported, the specific factors that affect the secretion of ACP are unknown. The objective of the present study was to investigate whether secretion of ACP from extraradical hyphae is induced by low P conditions. First, specimens of Allium fistulosum were either inoculated with the AM fungus Rhizophagus clarus strain CK001 or remained uninoculated and were grown in soil with 0.5 g P2O5 kg-1 soil or without P fertilization using two-compartment pots. Soil solution was collected using mullite ceramic tubes 45 days after sowing. The soil solution was analyzed for ACP activity by using p-nitrophenylphosphate. Second, Ri T-DNA transformed roots (i.e., hairy roots) of Linum usitatissimum inoculated with R. clarus were grown on solid minimal media with two P levels applied (3 and 30 μM P) using two-compartment Petri dishes under in vitro conditions. Hyphal exudates, extraradical hyphae, and hairy roots were collected and analyzed for ACP activity. ACP activity in the soil solution of the hyphal compartment in the A. fistulosum inoculation treatment was higher without P fertilization than with P fertilization. AM colonization also was higher without P fertilization than with P fertilization. In the in vitro two-compartment culture, ACP activity of hyphal exudates and extraradical hyphae were higher under the 3-μM treatment than under the 30-μM treatment. These findings suggest that the secretion of ACP from the extraradical hyphae of R. clarus into the hyphosphere is promoted under low P conditions.


Genetic relatedness of Staphylococcus epidermidis from infected infants and staff in the neonatal intensive care unit.
The genetic relatedness of Staphylococcus epidermidis associated with infections in infants and cultured from the hands of nurses was assessed. From March 2001 to January 2002, infections caused by S. epidermidis were prospectively monitored. Participating nurses had hand cultures performed quarterly following hand hygiene. Pulsed-field gel electrophoresis was performed to determine genetic relatedness of strains from infants and nurses. During the study period, S. epidermidis caused 42 of 143 (29%) and 26 of 100 (26%) infant infections and was cultured from the clean hands of 51 of 61 (84%) and 53 of 58 (91%) nurses in neonatal intensive care unit (NICU)-1 and NICU-2, respectively. Fifty-eight clones of S. epidermidis were identified among 173 isolates typed: 38 of 173 isolates (22%) were unique clones detected in a single infant (n=10) or nurse (n=28); 42 of 173 (24%) isolates were defined as belonging to small cluster clones (n=15), ie, were detected in 2 to 4 nurses and/or infants; and 93 of 173 (54%) isolates belonged to large cluster clones (n=4), ie, detected in 7 to 64 nurses and/or infants. These data suggested that most S. epidermidis isolates were shared between infants and nurses. Hand hygiene alone is inadequate to prevent S. epidermidis infections, and additional strategies are needed to prevent cross transmission in NICU populations.


Advanced skills for general surgeons and carving out a niche: Endoscopic retrograde cholangiopancreatography in regional Australia.
The provision of high-quality healthcare in rural Australian hospitals has necessitated general surgeons to take up the challenge and expand their expertise to advanced endoscopy techniques including endoscopic retrograde cholangiopancreatography (ERCP). This study examines the utility of ERCP in a regional setting especially in decreasing patient transfers and associated costs while achieving exceptional safety by measuring key indicators of safety and efficacy. A single-centre retrospective cross-sectional cohort review in a rural Queensland hospital of patients who underwent ERCP (emergent and elective) from January 2019 until July 2022. Standardized international ERCP performance indicators were collected and compared to benchmark literature values including the rate of cannulation, stone extraction, successful stent placement, and post-ERCP pancreatitis. The majority of the ERCP performance indicator benchmarks were met. 100% of patients had an appropriate indication for the procedure and consent. 98.95% successful CBD cannulation with only 14.14% requiring multiple attempts. 92.22% successful stone retrieval with 100% stent placement, well above guideline targets. The post-procedural complication rate was 6.81% (2.09% pancreatitis; 1.05% pancreatitis; 1.05% duodenal perforation). Antibiotic prophylaxis adherence was identified to require improvement (12.57%). High-quality ERCP procedures can be performed in a regional hospital by general surgeons in a safe and cost-effective manner, significantly decreasing the costs associated with patient transfer. This study reflects strong evidence for consistently achieving international ERCP performance benchmarks and the provision of high-quality healthcare by a regional hospital and provides a strong argument for increasing access to ERCP in rural and remote hospitals.


Detection of glycated gastric inhibitory polypeptide within the intestines of diabetic obese (ob/ob) mice.
Gastric inhibitory polypeptide (GIP) is produced within endocrine cells of the small intestine and released into the circulation upon nutrient ingestion. This study has quantified the levels of this insulinotropic peptide in the intestines of lean and diabetic obese ob/ob mice and estimated the proportion that is glycated. The total intestinal GIP concentration and content of the diabetic mice were significantly greater (p < 0.01) than that of control animals. Affinity chromatographic separation and side-viewing GIP radioimmunoassay demonstrated that approx 20% of the GIP extracted from intestines of ob/ob mice was present in glycated form. Less than 2% of intestinal GIP was glycated in lean mice. In conclusion substantial quantities of glycated GIP exist within the intestines of diabetic ob/ob mice, suggesting that this may be a contributing factor to the physiological disarray of this syndrome.


Pathological changes in the lymphoreticular tissues of Swiss mice infected with Echinococcus granulosus cysts.
Swiss mice infected intraperitoneally with approximately 1,500 protoscolices of Echinococcus granulosus and sacrificed at three and 13 months post infection yielded both viable and degenerated hydatid cysts. The mean cyst weights in the three and 13 months post infected mice were 0.13 and 2.1 g, respectively. Sections of spleens and lymph nodes in the three months post infected mice showed hyperplastic follicles and blastoid cells in thymus dependent areas. At 13 months post infection T cells from paracortex and periarterial areas were replaced by plasma cells and confluent sheets of histiocytes; follicles had retained germinal centres and medullary areas showed intense plasmacytosis and sinus histiocytosis. Failure of mice to control the histogenesis of hydatid cyst with reference to numerical reduction in T cells is discussed.


The acceptance and awareness of healthcare providers towards doctor of pharmacy (Phram D) in the Palestinian health care system.
Clinical pharmacy (Pharm.D or MSc Clinical Pharmacy graduates) is a patient care oriented specialty. It aims to improve patient therapeutic outcomes and minimize medication errors. In Palestine, it is a new specialty taught at two universities. In order to implement this new specialty in healthcare settings, healthcare providers should have a high awareness about it, its role and importance in clinical settings. This study aimed to evaluate the awareness and acceptance levels among healthcare providers' about clinical pharmacy specialty. A cross sectional study carried out using a self-administered questionnaire that was developed and tested by a panel of experts for validity and reliability, then it was distributed and filled by the convenient sample of health care providers in the northern and middle of Palestine between January and March 2019. An awareness scale and acceptance scale were developed from the questions used to identify the healthcare providers' awareness and acceptance. Chi-square (X2) -testing was performed to check for the significant association. Data were analyzed using SPSS (version22). Among 309 respondents, 203(65.7%) were male, 67(21.7%) were working at Jerusalem, 229(74.1%) of them completed their first degree at Arab countries and 69(54.7%) completed higher education. Regarding their work, 169(54.7%) were physicians, followed by 85(27.5%) nurses and 55(17.8%) pharmacists. Results revealed that the majority of healthcare providers had a moderate 182(58.9%) and good 81(26.2%) awareness level toward the Clinical pharmacy specialty roles and 217 (70.2%) had a good acceptance level toward their implementation among the health worker team. Significant differences were found between healthcare providers' awareness level and their sex (P = 0.001), professions (P = 0.006) and job descriptions (P = 0.013). There were no significant differences between the health care providers' acceptance level and their age, sex, qualification, profession and job descriptions. Our results revealed the ability to collaborate in the integration of such specialty within the Palestinian healthcare system. Additional interest from the Ministry of Health is recommended to integrate clinical pharmacy workers among the health system and promote their relations with other disciplines.


Preclinical pharmacology of novel indolecarboxamide ML-970, an investigative anticancer agent.
ML-970 (AS-I-145; NSC 716970) is an indolecarboxamide synthesized as a less toxic analog of CC-1065 and duocarmycin, a natural product that binds the A-T-rich DNA minor groove and alkylates DNA. The NCI60 screening showed that ML-970 had potent cytotoxic activity, with an average GI(50) of 34 nM. The aim of this study is to define the pharmacological properties of this novel anticancer agent. We established an HPLC method for the compound, examined its stability, protein binding, and metabolism by S9 enzymes, and conducted pharmacokinetic studies of the compound in two strains of mice using two different formulations. ML-970 was relatively stable in plasma, being largely intact after an 8-h incubation in mouse plasma at 37°C. The compound was extensively bound to plasma proteins. ML-970 was only minimally metabolized by the enzymes present in S9 preparation and was not appreciably excreted in the urine or feces. The solution formulation provided higher C(max), AUC, F values, and greater bioavailability, although the suspension formulation resulted in a later T(max) and a slightly longer T(1/2). To determine the fate of the compound, we accomplished in-depth studies of tissue distribution; the results indicated that the compound undergoes extensive enterohepatic circulation. The results obtained from this study will be relevant to the further development of the compound and may explain the lower myelotoxicity of this analog compared to CC-1065.


Muscle adaptation in response to a high-intensity interval training in obese older adults: effect of daily protein intake distribution.
Aging is associated with declines in muscle mass, strength and quality, leading to physical impairments. An even protein distribution in daily meals has recently been proposed along with adequate total protein intake as important modulators of muscle mass. In addition, due to its short duration, high-intensity interval training (HIIT) has been highlighted as a promising intervention to prevent physical deterioration. However, the interaction between daily protein intake distribution and HIIT intervention in elderlies remain unknown. To investigate muscle adaptation following HIIT in older adults according to daily protein intake distribution. Thirty sedentary obese subjects who completed a 12-week elliptical HIIT program were matched [criteria: age (± 2 years), sex, BMI (± 2 kg/m2)] and divided a posteriori into 2 groups according to the amount of protein ingested at each meal: < 20 g in at least one meal (P20-, n = 15, 66.8 ± 3.7 years) and ≥ 20 g in each meal (P20+, n = 15, 68.1 ± 4.1 years). Body composition, functional capacity, muscle strength, muscle power, physical activity level, and nutritional intakes were measured pre- and post-intervention. A two way repeated ANOVA was used to determine the effect of the intervention (HIIT) and protein distribution (P20- vs P20+, p < 0.05). No difference was observed at baseline between groups. Following the HIIT intervention, we observed a significant decrease in waist and hip circumferences and improvements in functional capacities in both P20- and P20 + group (p < 0.05). However, no protein distribution effect was observed. A 12-week HIIT program is achievable and efficient to improve functional capacities as well as body composition in obese older adults. However, consuming at least 20 g of proteins in every meal does not further enhance muscle performance in response to a 12-week HIIT intervention.


Carbon dioxide retention associated with a humidifier defect.
A case is presented which describes a patient who developed hypercarbia resulting from a defective humidifier. A Puritan-Bennett Cascade I humidifier was incorporated into a circle system between the inspiratory dome one way valve and the patient. A screw which supports the thermal well to the head of the humidifier was missing, thereby allowing an intermittent leak to develop in the system. The leak was present when the system pressure dropped to ambient level; however, at positive system pressure the leak sealed. This allowed exhaled gases into the inspiratory limb of the circuit unchecked by the inspiratory valve yet when the breathing circuit was occluded at the patient end and submitted to pressures of 20 and 40 cm H2O, no leaks were detected. Intraoperatively, PaCO2 was noted to be as high as 68 mmHg just prior to removing the humidifier from the circuit and corrected to 38 mmHg within 15 minutes of removal of the humidifier.


The transcription factor Cdx2 regulates inflammasome activity through expression of the NLRP3 suppressor TRIM31 to maintain intestinal homeostasis.
The intestine-specific transcription factor Cdx2 is essential for intestinal homeostasis and has been implicated in the pathogenesis of disorders including inflammatory bowel disease. However, the mechanism by which Cdx2 influences intestinal disease is not clear. Here, we present evidence supporting a novel Cdx2-TRIM31-NLRP3 (NLR family, pyrin domain containing 3) signaling pathway, which may represent a mechanistic means by which Cdx2 impacts intestinal inflammation. We found that conditional loss of Cdx function resulted in an increase in proinflammatory cytokines, including tumor necrosis factor alpha, interleukin (IL)-1β, and IL-6, in the mouse colon. We further show that TRIM31, which encodes a suppressor of NLRP3 (a central component of the NLRP3 inflammasome complex) is a novel Cdx2 target gene and is attenuated in the colon of Cdx conditional mutants. Consistent with this, we found that attenuation of TRIM31 in Cdx mutant intestine occurs concomitant with elevated levels of NLRP3 and an increase in inflammasome products. We demonstrate that specific inhibition of NLRP3 activity significantly reduced IL-1β and IL-6 levels and extended the life span of Cdx conditional mutants, reflecting the therapeutic potential of targeting NLRP3. Tumor necrosis factor-alpha levels were also induced independent of NLRP3, potentially via elevated activity of the proinflammatory NF-κB signaling pathway in Cdx mutants. Finally, in silico analysis of ulcerative colitis patients revealed attenuation of CDX2 and TRIM31 expression coincident with enhanced expression of proinflammatory cytokines. We conclude that the novel Cdx2-TRIM31-NLRP3 signaling pathway promotes proinflammatory cytokine expression, and its inhibition may have therapeutic potential in human intestinal diseases.


Validation of a radioimmunoassay for the determination of human plasma concentrations of lamotrigine.
A precise and sensitive radioimmunoassay to determine human plasma lamotrigine (430C78), Lamictal) is described. The method is a direct double antibody procedure employing a rabbit polyclonal first antibody raised to a BSA conjugate of lamotrigine, and an iodinated tyrosine methyl ester of lamotrigine as the tracer. Both reagents are added simultaneously to samples containing lamotrigine prior to an overnight incubation at 4 degrees C. The method has a sensitivity of 20 ng ml-1, when plasma samples are initially diluted 1:20 with phosphate buffer and sample volumes of 20 microliters are used. The intra-assay precision at 40, 80 and 160 ng ml-1 was 6.2, 2.1 and 4.8%, respectively, and the inter-assay precision at 500, 2000, 5000 and 10,000 ng ml-1 was 4.6, 5.7, 4.6 and 5.9%, respectively. The method was specific and showed reasonable correlation with an HPLC method [1].


Help, my rating looks bad! Coding comorbidities in arthroplasty.
In medicine today, there is a trend toward increasing transparency. Higher quality and better value are being sought, and one of the methods being used is publicly reported health care outcomes. However, there is a problem that comes from our loss of anonymity. Physicians who are being individually watched have to choose between doing what is best for the patient and doing what would look good when it is publicly reported. Often this might mean choosing not to treat a particularly sick patient who is unlikely to have a good outcome. Adjusting outcomes to account for risk factors should be a way to prevent this effect, but these methods need to be studied more. The current performance measures being released are based on administrative claims data, and to date, much of that information is not properly risk adjusted. To ensure that the increasing transparency reveals an accurate picture, it is critical that the complexity of care provided by surgeons be carefully documented. Therefore, we propose accurate coding of patients' comorbidities during hospitalization for total knee arthroplasty and total hip arthroplasty, and we have included a chart detailing our recommendations of the specific diagnostic codes that are most important.


New Synthetic Route for the Growth of α-FeOOH/NH2-Mil-101 Films on Copper Foil for High Surface Area Electrodes.
A novel metal organic framework (MOF)-based composite was synthesized on a Cu substrate via a two-step route. An amorphous iron oxide/hydroxide layer was first deposited on a Cu foil through a sol-gel process; then, Fe-NH2-Mil-101 was grown using both the iron oxide/hydroxide matrix, which provided the Fe3+ centers needed for MOF formation, and 2-aminoterephthalic acid ethanol solution. This innovative synthetic strategy is a convenient approach to grow metal oxide/hydroxide and MOF composite films. Structural, chemical, and morphological characterizations suggest that the obtained composite is made up of both the α-FeOOH goethite and the NH2-Mil-101 phases featuring a hybrid heterostructure. The electrochemical features of the composite structure were investigated using electrochemical impedance spectroscopy. The impedance behavior of the α-FeOOH/NH2-Mil-101 films indicates that they can be used as efficient high surface area metal hydroxide/MOF-based electrodes for applications such as energy storage and sensing.


Callosal dysfunction in amyotrophic lateral sclerosis correlates with diffusion tensor imaging of the central motor system.
We investigated the frequency and functional relevance of corpus callosum degeneration in amyotrophic lateral sclerosis (ALS). A total of 22 ALS patients and 29 healthy controls performed the newly developed Contralateral Co-Movement Test as indicator of callosal dysfunction. Diffusion tensor imaging was applied to determine fractional anisotropy values in the callosal area containing the crossing motor fibers and in the pyramidal tracts in 13 subjects of each group. ALS patients had more than twice the amount of co-movements as compared to healthy subjects. Contralateral co-movements correlated with fractional anisotropy values of the corpus callosum motor region as did ALS Functional Rating Scale as measure of disease progression. In both groups, contralateral co-movements correlated with the central motor index (ratio of the mean of fractional anisotropy values of both pyramidal tracts and corpus callosum motor region). Neuropsychological test results failed to show correlations with functional or morphological parameters. Combining Contralateral Co-Movement Test and diffusion tensor imaging in ALS revealed the close relation between functional and morphological impairment in the degenerating central motor-neuronal network. The Contralateral Co-Movement Test delivers simple means of symptom quantification, independent of ALS Functional Rating Scale, for future neuroprotective trials.


Mutagenesis of glutamate 820 of the gastric H+,K+-ATPase alpha-subunit to aspartate decreases the apparent ATP affinity.
Mutagenesis of Glu820, present in the catalytic subunit of gastric H+,K+-ATPase, into an Asp hardly affects K+-stimulated ATPase and K+-stimulated dephosphorylation of the enzyme. The ATP phosphorylation rate of the E820D mutant, however, is rather low and the apparent affinity for ATP in the phosphorylation process of this mutant is 2-3 times lower than that of the wild type enzyme. The reduction in the ATP phosphorylation rate of the E820D mutant has only an effect on the ATPase activity at low temperature. These findings suggest that Glu820 might play a role in H+ stimulation of the phosphorylation process.


Comparison of the effects of etomidate and its fluoro analogue, R 8110, on plasma cortisol, 11 beta-deoxycortisol, 17 alpha-hydroxyprogesterone and testosterone concentrations in dogs.
R 8110, an imidazole derivative, was shown to be clinically superior to etomidate for induction and maintenance of anaesthesia in dogs. The present study compared the effects of intravenous (i.v.) R 8110, etomidate and Ringer solution on cortisol biosynthesis by the adrenal gland in seven male labradors. A tetracosactide challenge was carried out 30 min after the i.v. injection of 3 mg/kg of both drugs and after i.v. Ringer solution (1 ml/kg). Etomidate and R 8110 both suppressed the cortisol response to tetracosactide almost completely and increased the plasma 11 beta-deoxycortisol levels more than 20 fold. Maximal 11 beta-deoxycortisol values were reached 120 min after R 8110, and not less than 300 min after etomidate. Plasma 17 alpha-hydroxyprogesterone and testosterone concentrations did not differ between placebo and R 8110 treatment, but they decreased after etomidate. These results indicate that the effects of R 8110 on steroid biosynthesis in dogs are less pronounced than those of etomidate and are largely limited to a temporary inhibition of the 11 beta-hydroxylase in the adrenal gland.


National survey for bariatric procedures in adolescents: Long time follow-up.
The role of bariatric surgery and its role in adolescent is still under discussion worldwide. The aim of this study is to report an Italian survey for bariatric procedures in adolescents and the outcome with a medium and long-term follow-up. We retrospectively analyzed consecutive data added into the Italian register of the society for bariatric surgery(period 2000-2010). We evaluated all patients treated in a 10-year period with a mean follow-up of 3 years. Inclusion and exclusion criteria were created. All patients were aged between 13 and 18 years. We evaluated and compared clinical data. After reviewing medical charts, 173 patients were considered for the study; 85 patients were treated with adjustable gastric band (AGB), 47 with intragastric balloon (IB), 26 with sleeve gastrectomy (SG) and other 15 patients with malabsorptive techniques (MT). Among clinical data, there was a statistical difference in terms of %excess weight loss (%EWL) between techniques only after 1 year post-procedure; at 5 years, considering the percentage of patients studied, sleeve gastrectomy had the best %EWL respect to other non malabsorptive techniques (p<0.05); at 5 year more than 90% resolved their comorbidities especially hypertension, dyspnea, orthopedic problems and dyspnea. This study is the first reporting a national survey in adolescent; more than 80% of patients are followed until 5 years post-op but only few patients (less than 5%) until 10 years. Our results demonstrated that sleeve gastrectomy in adolescent is safe and had a better %EWL respect to other non-malabsorptive bariatric procedures. level III.


Studies on the action of nitroimidazole drugs. The products of nitroimidazole reduction.
The electron requirements for the electrolytic reduction of misonidazole, metronidazole and 4(5)-nitroimidazole have been measured using high-resolution coulometry. Eleven of the labelled final reduction products of metronidazole (a 5-nitroimidazole) have been separated by high-performance liquid chromatography and identified. These appear to be formed without the prior generation of a stable intermediate. In contrast, the reduction products of misonidazole (a 2-nitroimidazole) show little similarity to those of metronidazole but are likely to be formed via the four-electron hydroxylamine derivative. None of the final reduction products show toxicity towards Clostridium bifermentans or Escherichia coli suggesting that the short-lived cytotoxic agent of nitroimidazoles is a reduction product formed by the addition of not more than three electrons.


Pillar[6]MaxQ: A Potent Supramolecular Host for In Vivo Sequestration of Methamphetamine and Fentanyl.
Pillar[6]MaxQ (P6AS) functions as an in vivo sequestration agent for methamphetamine and fentanyl. We use 1H NMR, isothermal titration calorimetry, and molecular modelling to deduce the geometry and strength of the P6AS•drug complexes. P6AS forms tight complexes with fentanyl (Kd=9.8 nM), PCP (17.1 nM), MDMA (25.5 nM), mephedrone (52.4 nM), and methamphetamine (101 nM). P6AS has good in vitro biocompatibility according to MTS metabolic, Adenylate Kinase cell death, and hERG ion channel inhibition assays, and the Ames fluctuation test. The no observed adverse effect level for P6AS is 45 mg/kg. The hyperlocomotion of mice treated with methamphetamine (0.5 mg/kg) can be ameliorated by treatment with P6AS (35.7 mg/kg) 5-minutes later, whereas the hyperlocomotion of mice treated with fentanyl (0.1 mg/kg) can be controlled by treatment with P6AS (5 mg/kg) up to 15-minutes later. P6AS has significant potential for development as a broad spectrum in vivo sequestration agent.


Bismuth toxicity in patients treated with bismuth iodoform paraffin packs.
Bismuth is a heavy metal used in bismuth iodoform paraffin paste (BIPP) antiseptic dressings and in a number of other medical preparations. It can be absorbed systemically and cause toxicity. We report 2 cases of such neurotoxicity after it was used in operations on the jaws.


Antigenic variants of leptospiras detected in peritoneal cavity in early stage of infection in immunized guinea pigs.
Antigenic variants were detected firstly 7 h following intraperitoneal challenge with Leptospira interrogans serovar copenhageni Shibaura in the peritoneal cavity of guinea pigs which had been previously immunized with the homologous strain. The variants appeared at a rate of 63% of the leptospiras which survived in the peritoneal cavity, and the survivors' rate was 0.00005% of the inoculated organisms. The antigenicity of these variants reversed to that of the parent after 3-5 passages in liquid normal serum medium.


Detection of a tumor-associated glycoprotein antigen in serum and urine of melanoma patients by murine monoclonal antibody (AD1-40F4) in enzyme immunoassay.
The urine of 68% of melanoma patients contains a high molecular weight glycoprotein which is expressed by melanoma cells and reacts with autologous antibody. Since high levels of this antigen in urine correlate with disease recurrence in surgically treated melanoma patients, it has been termed urinary tumor-associated antigen (U-TAA). We report the development of a murine monoclonal IgM antibody (AD1-40F4), which is specific for U-TAA. AD1-40F4 showed the same pattern of reactivity as the allo-antibodies previously used for the detection of U-TAA. The antigen recognized by AD1-40F4 has a high molecular weight (590-620 kilodaltons [kd]) and is heat stable. The AD1-40F4-reactive epitope is a protein. When AD1-40F4 was applied in an enzyme immunoassay, it allowed for the detection of U-TAA in the serum of 64% (33/52) of melanoma patients as opposed to only 5% (1/20) of normal controls. Thus, the murine monoclonal antibody AD1-40F4, which has been specifically developed against an allogeneic antibody defined antigen, U-TAA, appears to be important for immuno-prognosis of human melanoma.


The GATA factor HANABA TARANU promotes runner formation by regulating axillary bud initiation and outgrowth in cultivated strawberry.
A runner, as an elongated branch, develops from the axillary bud (AXB) in the leaf axil and is crucial for the clonal propagation of cultivated strawberry (Fragaria × ananassa Duch.). Runner formation occurs in at least two steps: AXB initiation and AXB outgrowth. HANABA TARANU (HAN ) encodes a GATA transcription factor that affects AXB initiation in Arabidopsis and promotes branching in grass species, but the underlying mechanism is largely unknown. Here, the function of a strawberry HAN homolog FaHAN in runner formation was characterized. FaHAN transcripts can be detected in the leaf axils. Overexpression (OE) of FaHAN increased the number of runners, mainly by enhancing AXB outgrowth, in strawberry. The expression of the strawberry homolog of BRANCHED1 , a key inhibitor of AXB outgrowth in many plant species, was significantly downregulated in the AXBs of FaHAN -OE lines, whereas the expression of the strawberry homolog of SHOOT MERISTEMLESS, a marker gene for AXB initiation in Arabidopsis, was upregulated. Moreover, several genes of gibberellin biosynthesis and cytokinin signaling pathways were activated, whereas the auxin response pathway genes were repressed. Further assays indicated that FaHAN could be directly activated by FaNAC2, the overexpression of which in strawberry also increased the number of runners. The silencing of FaNAC2 or FaHAN inhibited AXB initiation and led to a higher proportion of dormant AXBs, confirming their roles in the control of runner formation. Taken together, our results revealed a FaNAC2-FaHAN pathway in the control of runner formation and have provided a means to enhance the vegetative propagation of cultivated strawberry.


First mitochondrial genomes of Capitellidae and Opheliidae (Annelida) and their phylogenetic placement.
The complete mitochondrial genomes of Notomastus sp. (15,776 bp) (Annelida: Capitellidae) and Armandia sp. (18,538 bp) (Annelida: Opheliidae) were assembled for the first time. A group II intron (303 bp) was found in cox1 of Notomastus sp. A phylogenetic analysis revealed that Notomastus sp. and Armandia sp. were monophyletic, and this clade was clustered with echiurans, although the possibility of the effect of long-branch attraction should be considered.


Nationwide trends in the epidemiology of diabetic foot complications and lower-extremity amputation over an 8-year period.
To study the prevalence and trends of lower extremity complications of diabetes over an 8-year period in a single nation. Nationwide data for people with type 2 diabetes (T2D) and diabetic foot complications (DFCs) were analyzed over an 8-year period (2007-2014) from National Health Insurance Research Database using the International Classification of Diseases, Ninth Revision disease coding. The DFCs were defined as ulcers, infections, gangrene, and hospitalization for peripheral arterial disease (PAD). Trends of patient characteristics, foot presentation, and the execution of major procedures were studied, including lower-extremity amputations (LEAs). Along with the T2D population increasing over time, the absolute number of people with DFCs increased by 33.4%, but retained a prevalence of around 2% per year. The annual incident of LEAs decreased from 2.85 to 2.06 per 1000 T2D population (p=0.001) with the major LEA proportion decreasing from 56.2% to 47.4% (p<0.001).The mean age of patients increased from 65.3 to 66.3 years and most of the associated comorbidities of diabetes were increased. For example, end-stage renal disease increased from 4.9% to 7.7% (p=0.008). The incidence of gangrene on presentation decreased from 14.7% to 11.3% (p<0.001) with a concomitant increase in vascular interventions (6.2% to 19.5%, p<0.001). DFCs remain a sustained major medical problem. These nationwide long-term data suggest trends toward older people with greater comorbidities such as PAD and renal disease. Nevertheless, promising trends of reducing gangrene on presentation paired with increases in vascular interventions support continued vigilance and rapid, coordinated interdisciplinary diabetic foot care.


The C-O stretch as an unprecedently large spectral marker for the electron transfer between Copper(II) and a phenolate anion.
An unprecedented red shift of more than 200 cm(-1) in the vibrational frequency of the C-O bond in the [Cu(PhO)Ln]+ complex (PhO = phenoxy), dependent on the number n of additional ligands L, is reported. Upon change of n from 1 to 2, the spin density is shifted from the aromatic ring to the oxygen and copper atoms, which is reflected in the bond order and thus vibrational frequency of the C-O bond.


Small fenestra stapedotomies with and without KTP laser: a comparison.
The results of 33 small fenestra stapedotomies performed using conventional techniques were compared with the results of 33 stapedotomies performed using the argon or KTP laser. The ossicular chain was reconstructed using a Teflon wire piston of 0.6 mm diameter, and follow-up was at least 1 year. Over-closure of the air-bone gap or closure to within 10 dB was accomplished in 91% of the laser-treated group versus 72% of the conventionally treated group (p less than 0.10). The hearing results were statistically better in the laser group (p less than 0.05). Transient delayed vestibular symptoms, lasting from 1 to 3 weeks, were present in 39% of the laser-treated group and in 12% of the patients treated by conventional techniques (p less than 0.05). The KTP laser stapedotomy, using a micromanipulator mounted on the microscope, is a safe, efficient technique that reduces some of the technical difficulties associated with conventional stapes surgery. The main advantage of the laser is that it enables the surgeon to make an atraumatic, bloodless opening in a fixed or mobile stapes footplate without mechanical manipulation of the stapes. Using a lower wattage to vaporize the footplate and waiting several seconds between laser bursts may decrease the incidence of postoperative vestibular symptoms. The use of the KTP laser in stapes surgery represents a major advance in surgery for otosclerosis.


Determination of eight constituents of hsiao-cheng-chi-tang by high-performance liquid chromatography.
A high-performance liquid chromatographic method for the simultaneous determination of eight constituents (gallic acid, sennoside B, sennoside A, naringin, hesperidin, honokiol, magnolol and emodin) of the Chinese herbal formula hsiao-cheng-chi-tang was established. Various samples of the formula were separated using a Cosmosil 5C18 column with a linear gradient elution system consisting of acetate buffer as mobile phase. Contents of these marker substances in an unpretreated hsiao-cheng-chi-tang extract could be easily determined within 60 min. The effects of pH, buffer concentration and column selectivity for this method are described.


Prevention Knowledge and Its Practice Towards COVID-19 Among General Population of Saudi Arabia: A Gender-based Perspective.
This study is an original contribution to the gender-based perspective of measuring knowledge and practice towards COVID-19 among the Saudi population. This study investigates the existing knowledge of COVID-19 among both genders and its likely use in practice to combat COVID-19. Cross-sectional study with an online survey and data collected from all the five regions of Saudi Arabia. A structured, self-reported validated questionnaire was developed based on the World Health Organization (WHO) general public advice towards COVID-19 prevention. This study has employed snow-ball sampling technique. 627 participants (Male n=343, 54.7%) and (Females n=284, 45.3%). This study has found that women not only carry better knowledge, but their practicing behavior is far better than the male respondents. Females practiced their knowledge of hands hygiene more in comparison to males (86% vs. 80 %, p >0.05). Female respondents were also practicing more about sneezing/coughing into their elbows as compared to males (79% vs. 71%, p < 0.05). Likewise, the practice of knowledge of staying at home to prevent infection (females 98.2% vs males 95.5%, p > 0.05), and (females 83.2% vs. males 81.5%, p > 0.05), respectively. This study shows that women were more compliant with the WHO public health COVID-19 prevention advice than men, which can decrease the chances of COVID-19 infection.


A case of cardiac tamponade due to an isolated abscess in the ascending aorta of a pregnant woman with a history of intravenous substance abuse.
We describe the case of a 23-year-old white female, 10-12 weeks pregnant, with a history of intravenous drug use and a recently diagnosed pneumonia, who was found deceased in her bed after a night of sleep. Although postmortem serum toxicology tested positive for alprazolam, tetrahydrocannabinol, and morphine, the ultimate cause of death was determined to be cardiac tamponade secondary to an isolated abscess in the ascending aorta. The patient had several risk factors for aortic rupture and cardiac tamponade including intravenous drug use, pneumonia, and pregnancy. However, an autopsy of the patient showed an isolated abscess of the ascending aorta without evidence of infective endocarditis, coronary artery rupture, aortic aneurysm, or aortic dissection making this an unusual case of cardiac tamponade. The aim of this case report is to encourage providers to obtain a tissue culture of any aortic abscesses so that the organisms involved can be identified. The identification of such organisms may help guide antimicrobial treatment in similar presentations in the future.


Renal transporter OAT1 and PPAR-α pathway co-contribute to icaritin-induced nephrotoxicity.
This study aimed to investigate the potential nephrotoxicity of icaritin and the underlying mechanism by in vitro-in vivo experiment technology combined with proteomics technology. First, icaritin showed a significant cytotoxic effect on HK-2 cells, which was accompanied by increased LDH and TNF-α in the supernatant, decreased protein expressions of Bcl-2 and increased Bax and enhanced apoptosis of HK-2 cells as measured by TUNEL staining. Moreover, icaritin induced obvious tubular damage and up-regulation of BUN and CRE levels in plasma in mice. Second, intracellular uptake of icaritin was considerably higher in hOAT1-HEK293 cells than in mock-HEK293 cells, suggesting that icaritin might accumulate in renal cells via OAT1 uptake. Importantly, icaritin caused significant changes in the PPAR signaling pathway in HK2 cells through proteomic analysis. Then, in vitro and in vivo results verified that icaritin significantly downregulated the protein expression of PPAR-α as well as downregulated APOB, ACSL3, ACSL4, and upregulated 5/12/15-HETE, implying that a lipid metabolism disorder was involved in the icaritin-induced nephrotoxicity. Finally, icaritin was found to increase the accumulation of iron and LPO levels while reducing the activity of GPX4, suggesting that ferroptosis was involved in the nephrotoxicity induced by icaritin.


A simple freezing medium for serum-free cultured cells.
Methylcellulose was found to protect serum-free cultured cells from the deleterious effects of freezing and thawing. We have formulated a simple medium suitable for freezing serum-free cultured cells that consists of 0.1% methylcellulose, 10% dimethylsulfoxide, and MEM or any other serum-free culture medium.


Retrospective Analysis of Long-Term Survival in Very Elderly (age ≥80) Critically Ill Patients of a Medical Intensive Care Unit at a Tertiary Care Hospital in Korea.
The purpose of this study was to evaluate the long-term survival rates of very elderly (age ≥80) critically ill patients admitted to a medical intensive care unit (MICU) at a regional tertiary-care hospital in Korea. We retrospectively analyzed data from patients who survived after discharged from the MICU of our hospital. Survival rates at 90 days, 1 year, 2 years, and 3 years were assessed between patients age ≥80 and those age <80. Survival status was evaluated using the National Health Insurance Service data. A total of 468 patients were admitted, 286 (179 males, 97 females; mean age, 70.18±13.2) of whom survived and were discharged soon after their treatment. Among these patients, 69 (24.1%) were age ≥80 and 217 (75.9%) were age <80. The 90-day, 1-year, 2-year, and 3-year survival rates of patients age ≥80 were significantly lower than those in patients age <80 (50.7%, 31.9%, 15.9% and 14.5% vs. 68.3%, 54.4%, 45.6%, and 40.1%, respectively) (p<0.01). The Kaplan-Meier survival curves showed significantly lower survival rates in patients age ≥80 than in those age <80 (p=0.001). The poor rates of long-term survival in very elderly (age ≥80) and critically ill patients admitted to an ICU should be considered while managing and treating them.


A heritable point mutation in an extracellular domain of the TSH receptor involved in the interaction with Graves' immunoglobulins.
The TSH receptor (TSHR) is the central antigen in Graves' disease. Variant receptor proteins, arising from mutations in the TSHR gene, may play a role in the pathogenesis of the disease. Therefore, we analysed the TSHR from a 38-year-old patient affected with autoimmune hyperthyroidism, diffuse goitre and ophthalmopathy. Reverse transcription PCR and DNA amplification followed by DNA sequencing revealed a point mutation (C-->A) at cDNA position 253 in one of two alleles. This leads to the replacement of a proline (CCC) by threonine (ACC) at amino acid position 52 of the predicted receptor protein. Secondary structure predictions indicated a major change of protein structure as a result of the mutation. By using allele-specific PCR, we were able to show that this mutation is heritable. Screening of 50 random individuals revealed that four of them also carried this mutation in the heterozygous state. This study shows the presence of different forms of the TSHR gene in the population. The mutation, which is in a portion of the receptor apparently involved in binding of Graves' immunoglobulins, is discussed as to its possible pathophysiological role in autoimmune hyperthyroidism.


The role of oral rehydration solutions in the children of Europe: continuing controversies.
Controversy remains concerning ORS composition in Europe. This centres chiefly upon the sodium level. Solutions with a low sodium content continue to be widely used in Europe. ORS with Na 90 mmol/l when given correctly is safe and effective. However when this solution is prepared incorrectly there is a risk of hypernatraemia. In most of Europe mortality and morbidity from gastroenteritis is now very low. Therefore any change from current formulation must not carry any risk in this regard. The need for bicarbonate or indeed any base in ORS is also controversial. There is a clear need in Europe for controlled trials of ORS solutions of various composition to determine the ideal solution for the children of Europe who have acute diarrhoea.


Publisher Correction: The transcription factor c-Maf is essential for the commitment of IL-17-producing γδ T cells.
In the version of this article initially published, the top right plot in Figure 4a was aligned incorrectly. The error has been corrected in the HTML and PDF versions of the article. The original and corrected figures are provided in the accompanying Publisher Correction.


Structural characterization and antagonistic effect against P-selectin-mediated function of SFF-32, a fucoidan fraction from Sargassum fusiforme.
Sargassum fusiforme (Harvey) Setchell, or Haizao, has been used in traditional Chinese medicine (TCM) since at least the eighth century a.d. S. fusiforme is an essential component of several Chinese formulas, including Haizao Yuhu Decoction, used to treat goiter, and Neixiao Lei Li Wan used to treat scrofuloderma. The pharmacological efficacy of S. fusiforme may be related to its anti-inflammatory effect. To determine the structural characteristics of SFF-32, a fucoidan fraction from S. fusiforme, and its antagonistic effect against P-selectin mediated function. The primary structure of SFF-32 was determined using methylation/GC-MS and NMR analysis. Surface morphology and solution conformation of SFF-32 were determined by scanning electron microscopy (SEM), Congo red test, and circular dichroic (CD) chromatography, respectively. The inhibitory effects of SFF-32 against the binding of P-selectin to HL-60 cells were evaluated using flow cytometry, static adhesion assay, and parallel-plate flow chamber assay. Furthermore, the blocking effect of SFF-32 on the interaction between P-selectin and PSGL-1 was evaluated using an in vitro protein binding assay. The main linkage types of SFF-32 were proven to →[3)-α-l-Fucp-(1→3,4)-α-l-Fucp-(1]2→[4)-β-d-Manp-(1→3)-d-GlcAp-(1]2→4)-β-d-Manp-(1→3)-β-d-Glcp-(1→4)-β-d-Manp-(1→2,3)-β-d-Galp-(1→4)-β-d-Manp-(1→[4)-α-l-Rhap-(1]3→. The sulfated unit or terminal xylose residues were attached to the backbone through the C-3 of some fucose residues and terminal xylose residues were attached to C-3 of galactose residues. Moreover, SFF-32 disrupted P-selectin-mediated cell adhesion and rolling as well as blocked the interaction between P-selectin and its physiological ligand PSGL-1 in a dose-dependent manner. Blocking the binding between P-selectin and PSGL-1 is the possible underlying mechanism by which SFF-32 inhibits P-selectin-mediated function, which demonstrated that SFF-32 may be a potential anti-inflammatory lead compound.


Maturational influences on suppression of vocal cord function by anesthesia.
Vocal cord abduction is a complex action that occurs with inspiration and is controlled by the respiratory center in the brainstem. A study was conducted to evaluate the maturational influences on the effect of anesthesia on vocal cord movement. Rabbits aged 15, 30, 45, and 60 days were used to study this problem. The animals were equilibrated to varying concentrations of halothane, and vocal cord movements were documented. In all age groups the vocal cord motion increased with increasing concentration of halothane. The amount of vocal cord movement also increased with the increasing age of the animal. These effects, however, were independent of each other. There did not appear to be any interaction between the concentration of halothane and the age of the animal. These findings are discussed in light of the apparent absence of active vocal cord motion observed in some children under a general anesthetic.


Risk Factors for Horse Fatality in Thoroughbred Jumps Racing in New Zealand.
The aim of this study was to examine the race-, horse- and jockey-level risk factors for race day fatality in New Zealand Thoroughbred jumps racing using retrospective race day data from the 2011/12 to 2021/22 seasons (n = 8,970 starts). There were 51 race day fatalities resulting in an incidence rate of 5.7 per 1,000 starts (95% C.I. 4.3-7.5). The majority of fatalities were the result of fractures (44/51, 4.9 per 1,000 starts, 95% C.I. 3.7-6.6). Steeplechase and hurdle races had the same incidence of fatal fractures of 4.9 per 1,000 starts (95% C.I. 3.7-6.6, P > .05). Most (70.5%) of the fatal fractures were due to a horse falling during the race. In steeplechase races, horses running in races over 4,201 m were 5.0 times (95% C.I. 1.2-33.0) more likely to sustain a fatal fracture than horses in racing over shorter distances. In hurdle races, horses racing during spring were 2.2 times (95% C.I. 1.0-4.8) more likely to sustain a fatal fracture compared to winter. Due to the low number of suspected cardiac failures and fatal soft tissue injuries, risk factors for these fatalities could not be identified. These data provide a baseline to enable evidence-based regulatory changes and prospectively monitor the effectiveness of changes made.


Temporomandibular joint capsule prolapse: a technique of repair using autograft cartilage.
Loss of bony integrity of the temporomandibular joint may result in prolapse of the joint capsule into the external auditory canal. This in turn gives rise to arthralgia, trismus and earache and a risk of septic arthritis. We describe a technique of repair which is simple, uses autologous tissue and has an acceptable cosmetic and functional result.