Psychometric properties of instruments used to measure the cultural competence of nurses: A systematic review.
Cultural competence is a key component of culturally congruent nursing care. In order to reduce healthcare inequalities and to identify potentials for improvement in nursing practice, researchers need to be able to assess cultural competence properly. Although many instruments for the assessment of cultural competence have been developed, their measurement properties have not yet been reviewed systematically. Such an overview of existing instruments, however, would allow researchers to identify the most valid and reliable instrument for nursing practice. The purpose of conducting this review is to identify and critically appraise the psychometric properties of instruments used to measure the cultural competence of nurses. A systematic literature search was performed in November 2019 in the following electronic databases: Cumulative Index of Nursing and Allied Health Literature, Embase, PsycINFO and PubMed. Studies that were conducted to assess any measurement property of instruments used to measure the cultural competence of nurses were included. Two reviewers independently screened the articles and assessed the risk of bias using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. The quality of included instruments was assessed on the basis of the updated criteria for good measurement properties, and the quality of the summarised results was graded based on the principles of Grading of Recommendations Assessment, Development and Evaluation. In total, 44 studies describing 21 instruments were included in this study. We found that most instruments were tested for at least some forms of validity, but seldom for reliability. The quality of the psychometric properties was evaluated using the criteria for good measurement properties for the following: content validity, structural validity, internal consistency, reliability, measurement error and construct validity. No studies were found in which cross-cultural validity, criterion validity, or the responsiveness of the included instruments were evaluated. The Transcultural Self-Efficacy Tool, the Cultural Competence Assessment, and the Cultural Competence Health Practitioner Assessment showed sufficient levels of quality for psychometric properties and can be recommended for the assessment of cultural competence in nurses. Given the broad availability of self-administered instruments to assess cultural competence, the development of new instrument is not recommended. A particular need was identified to conduct further psychometric evaluation studies on existing instruments and to adapt them accordingly, and especially on less frequently evaluated properties, such as reliability, measurement error and responsiveness.


Altered risk-related processing in substance users: imbalance of pain and gain.
Substance use disorders (SUDs) can be conceptualized as a form of risk-taking behavior with the potential for highly aversive outcomes such as health or legal problems. Risky decision-making likely draws upon several related brain processes involved in estimations of value and risk, executive control, and emotional processing. SUDs may result from a dysfunction in one or more of these cognitive processes. We performed a systematic literature review of functional neuroimaging studies examining risk-related decision making in individuals with SUDs. A quantitative meta-analysis tool (GingerALE) and qualitative approach was used to summarize the imaging results. Meta-analysis findings indicate that individuals with SUDs exhibit differences in neural activity relative to healthy controls during risk-taking in the anterior cingulate cortex, orbitofrontal cortex, dorsolateral prefrontal cortex, striatum, insula, and somatosensory cortex. In addition, a qualitative review of the literature suggests that individuals with SUDs may have altered function in the amygdala and ventromedial prefrontal cortex. The neuroimaging literature reveals that several neural substrates involved in the computation of risk may function suboptimally in SUDs. Future research is warranted to elucidate which computational processes are affected, whether dysfunctional risk-related processing recovers with sobriety, and whether different drugs of abuse have specific effects on risk-taking.


Separation of Glycosylated OmpA-Like Proteins from Porphyromonas gingivalis and Tannerella forsythia.
OmpA-like proteins located in the outer bacterial membrane are potential virulence factors from the major periodontal pathogens Porphyromonas gingivalis and Tannerella forsythia. Our previous studies have shown that OmpA-like proteins are glycosylated by O-linked N-acetylglucosamine (O-GlcNAc) and are strongly reactive to wheat germ agglutinin (WGA) lectin, which shows sugar specificity to GlcNAc. Utilizing this property, we have developed a separation method for OmpA-like proteins by affinity chromatography using WGA lectin-agarose. The purity of enriched native OmpA-like proteins were confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Coomassie Brilliant Blue (CBB) staining. More importantly, the purified OmpA-like proteins formed a unique trimeric structure keeping their bioactivity intact. In this chapter, we describe a detailed procedure to separate OmpA-like proteins, which may be used to further progress the biological studies of OmpA-like proteins.


Nucleolar changes in senescing WI-38 cells.
Changes in the area, dry mass and morphology of nucleoli were studied during in vitro aging of WI-38 cells. Interferometric methods were used for nucleolar dry mass determinations. The results show that there is (1) an increase in the fraction of cells with one large nucleolus per nucleus, 17% at population doubling 27.3 vs. 93% at population doubling 41.2, (2) an increase in mean nucleolar dry mass (583% at the last doubling), and (3) an increase in mean nucleolar area (236% at the last doubling) with in vitro senescence of WI-38 fibroblast cells. A strong correlation (r = 0.92) between nucleolar dry mass and nucleolar area was demonstrated.


Anomalies associated with dye exclusion as a measure of axolemmal repair in invertebrate axons.
After axonal injury, dye exclusion is often used as a measure of the re-establishment of a structural barrier. We now report that this use of dye exclusion is equivocal in two situations. (1) When a negatively-charged hydrophilic fluorescent dye (HFD) was placed in the physiological saline (PS) surrounding a crayfish medial giant axon (CMGA) before transection, this dye did not readily diffuse into the cut ends after transection whereas uncharged or neutralized dyes did do so. (2) When axoplasm flowed out of the cut ends of a transected squid giant axon (SGA), this outflow markedly slowed hydrophilic fluorescent dyes from diffusing into the cut ends. These anomalies suggest that dye exclusion by an injured axon does not always indicate that a structural barrier has formed. Therefore, dye assessments of axonal repair require control experiments that rule out anomalous exclusion due to dye interactions (biochemical and fluid dynamics) with components (axoplasm, axolemma, glial sheath, etc.) of the particular axon under study.


A comparative analysis of clinical and molecular factors with the stage of cervical cancer in a Brazilian cohort.
Cell cycle protein expression plays an important role in the pathophysiology of cervical cancer. However, few studies have attempted to correlate the use of these biomarkers with the clinical progression of the tumor. 1) To analyze the expression of Ki-67, p53 and p16(INK4a) in cervical cancer, 2) to correlate the relative expression of these proteins as well as clinical parameters with the stage of disease, and 3) to determine the HPV DNA prevalence and subtype distribution. Tissue Micro-Arrays (TMA) from patients with invasive cervical cancer (ICC) and controls were analyzed. HPV DNA detection was done by PCR and in situ hybridization. Ki-67, p53 and p16(INK4a) were analyzed by immunohistochemistry; clinical data was derived from the chart review. Advanced tumor stage (III and IV) was strongly associated (p<0.005) with advanced age (>55 years old), with more than four pregnancies and with the lack of formal education. HPV DNA was found in 94.3% of cases with the most prevalent types being HPV16 (67.5%), followed by HPV33 (12.0%) and HPV35 (3.6%). High expression of Ki-67 and p16 was more common in the advanced FIGO stages (p = 0.023). Women with HPV16 tended to be younger (50.9 years; SE 1.9) compared to women with other types (59.9 years; SE 2.8). We found that Ki-67 and p16 expression were independently associated with the tumor stage. We also noted that about 1/3 of the cervical cancers in this Brazilian cohort were not associated with HPV types directly targeted by the current HPV vaccines.


Life history patterns in lizards of the arid and semiarid zone of Australia.
Studies on the life histories and population dynamics of lizards in the semiarid/arid zone of Australia are reviewed to identify the influence of size (female mean snout-vent length), phylogeny (family effects) and ecological parameters on the evolution of life history traits of these species. Species producing more than one clutch per year are larger than single-clutched ones. In an ANCOVA, significant effects of size and phylogeny on clutch size and on age at sexual maturity were found. Microhabitat (arboreal, terrestrial, and subterranean life style) also had an effect on clutch size, but only mediated through a significant interaction with size. However, results of the ANCOVAs depend on the families and ecological parameters included in the analyses. Therefore, caution is necessary in interpreting or generalizing the results; in any case, size and phylogeny explain only a small percentage of the observed variation. Nevertheless, a direct comparison of a set of syntopic/paratopic desert lizards supports and extends the main conclusions of the ANCOVA. A significant but small phylogenetic effect was found, and arboreal microhabitat was associated with greater age at sexual maturity. Activity (diurnal versus nocturnal) influenced yearly mortalities and clutch frequencies. For both, microhabitat and activity, predation levels and size-dependent mortality were the likely selective factors causing these correlations. The demographic environment explains the paucity of duurnal lizard species with fixed clutch sizes in the semiarid/arid zone of Australia. Possible causes for the evolution of fixed clutch sizes are discussed.


Elastography in musculoskeletal imaging: A tool or a toy?
Elastography is a novel imaging technique based on ultrasound that evaluates the deformability of tissues to help characterize lesions. It is widely used and has been validated in many tissues (e.g., liver, breast, thyroid). It is also used in the study of musculoskeletal disease. Although the use of elastography in musculoskeletal radiology is limited by the variability and heterogeneity of tissues, it is a very promising technique. In this article, we aim to review the usefulness, possible indications, limitations, and future perspectives of this technique in musculoskeletal radiology.


How to conduct meta-analysis for studies with multiple intervention groups.
In this letter, we will introduce how to conduct a correct meta-analysis for studies with multiple intervention groups.


Theoretical and practical training improves knowledge of the examination guidelines of the International Standards for Neurological Classification of Spinal Cord Injury.
Prospective pre-post study. International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) represents the most frequently used assessment to determine the level and severity of a spinal cord injury (SCI). The guidelines for ISNCSCI are complex and challenging. Knowledge of its correct execution needs to be imparted precisely. The aim of this study was to investigate whether hands-on instructional courses can increase the knowledge of the ISNCSCI examination guidelines. European Multicenter Study about SCI. Before and after the instructional courses, participants were asked to complete questionnaires. The set of questions covered the most important aspects of the examination guidelines. Attendees were asked to self-rate their occupation and experience in ISNCSCI. The comparison of pretest and posttest results of 164 attendees from 2014 to 2018 revealed an improvement of knowledge reflected by an increase of correct answers from 66 ± 17% before to 89 ± 11% after the course (p < 0.01). The improvement was not associated with occupation (p > 0.1). However, the correctness of pretest results differed concerning both the period of experience with ISNCSCI (p < 0.05) and the course language (p < 0.01), while the frequency of execution resulted in differences in the posttest (p = 0.01). Instructional courses substantially improve knowledge of the ISNCSCI examination guidelines. Differences in knowledge present before the course leveled off after the course. Comprehensive theoretical training is strongly recommended to ensure reliability and validity of ISNCSCI examinations in clinical routine and research. Albeit being practiced in the instructional courses, the benefit of hands-on training still needs to be systematically evaluated in future studies.


Gene Editing with CRISPR/Cas Methodology and Thyroid Cancer: Where Are We?
Important advances on the role of genetic alterations in thyroid cancer have been achieved in the last two decades. One key reason is linked to the development of technical approaches that allowed for the mimicking of genetic alterations in vitro and in vivo and, more recently, the gene editing methodology. The CRISPR/Cas methodology has emerged as a tangible tool for editing virtually any DNA sequence in the genome. To induce a double-strand break and programmable gene editing, Cas9 endonuclease is guided by a single-guide RNA (sgRNA) that is complementary to the target sequence in DNA. The gene editing per se occurs as the cells repair the broken DNA and may erroneously change the original DNA sequence. In this review, we explore the principles of the CRISPR/Cas system to facilitate an understanding of the mainstream technique and its applications in gene editing. Furthermore, we explored new applications of CRISPR/Cas for gene modulation without changing the DNA sequence and provided a Dry Lab experience for those who are interested in starting "CRISPRing" any given gene. In the last section, we will discuss the progress in the knowledge of thyroid cancer biology fostered by the CRISPR/Cas gene editing tools.


BacterAI maps microbial metabolism without prior knowledge.
Training artificial intelligence (AI) systems to perform autonomous experiments would vastly increase the throughput of microbiology; however, few microbes have large enough datasets for training such a system. In the present study, we introduce BacterAI, an automated science platform that maps microbial metabolism but requires no prior knowledge. BacterAI learns by converting scientific questions into simple games that it plays with laboratory robots. The agent then distils its findings into logical rules that can be interpreted by human scientists. We use BacterAI to learn the amino acid requirements for two oral streptococci: Streptococcus gordonii and Streptococcus sanguinis. We then show how transfer learning can accelerate BacterAI when investigating new environments or larger media with up to 39 ingredients. Scientific gameplay and BacterAI enable the unbiased, autonomous study of organisms for which no training data exist.


Pathology-guided MR analysis of acute and chronic experimental allergic encephalomyelitis spinal cord lesions at 1.5T.
To directly correlate spinal cord pathology of guinea pigs with experimental allergic encephalomyelitis (EAE) to the MRI data obtained at 1.5T. Spinal cords from EAE animals were imaged in vivo with the following MRI sequences: T2-FSE, PD-FSE, fluid-attenuated inversion recovery (FLAIR)-FSE, T2-CSE, T1-CSE, T1-CSE + gadolinium-DTPA (Gd-DTPA), PD-CSE, and short-tau inversion recovery (STIR)-FSE. The spinal cords were removed and the lesions with specific pathological compositions were identified by histological analysis. Regions of interest (ROIs) were drawn on the corresponding MR images, and signal-to-noise ratios (SNRs) were measured for each MR sequence and compared with controls. The receiver operating characteristic (ROC) analysis of STIR-FSE and PD-CSE was able to differentiate tissue that contained cellular infiltrates with a high degree of accuracy. The SNRs of T2-FSE, STIR-FSE, T2-CSE, PD-CSE, and T1-CSE + Gd-DTPA were elevated in lesions that contained cellular infiltrates alone, whereas the SNRs of PD-CSE and T1-CSE + Gd-DTPA were reduced in demyelinated lesions that also contained inflammation. The SNR difference between the two lesion groups suggests that the combination of STIR-FSE, PD-CSE, and T1-CSE + Gd-DTPA sequences may be useful for differentiating inflammatory lesions containing demyelination from lesions with inflammation alone.


SPG2 mimicking multiple sclerosis in a family identified using next generation sequencing.
Several single gene disorders can potentially be overlooked in the differential diagnostic evaluation of patients with multiple sclerosis (MS). Pelizaeus-Merzbacher disease and spastic paraplegia type 2 are allelic X-linked disorders associated with defective myelination of the central nervous system and mutations in PLP1. Neurological symptoms are occasionally observed in female carriers of these mutations. Two women - the proposita (Pt1) and her mother (Pt2) - reported walking difficulties since adolescence and showed progressive cognitive decline. Their neurological examinations revealed spastic gait, pyramidal tract involvement and distal muscle atrophy in the legs. Peripheral neuropathy and diffuse white matter (WM) changes on brain MRI were also observed. Both patients had a preliminary diagnosis of primary progressive MS. Using a targeted method in next generation sequencing, the novel heterozygous c.210T>G/p.Y70* in PLP1 was identified in Pt2. The same mutation was also found in Pt1 but not in five healthy relatives. The mutation showed moderate-to-severe skewed X inactivation in tissues, and Western blotting revealed a significant reduction of PLP1 and DM20 in the sural nerve of Pt2. In conclusion a mother and daughter presented an X-linked dominant disorder with skewed X inactivation. The authors suggest that PLP1 testing might be considered in the evaluation of women with spastic paraparesis, cognitive decline and WM changes.


Unmet needs among patients with type 2 diabetes and secondary failure to oral anti-diabetic agents.
Secondary failure is defined as a deterioration of glucose control in patients with Type 2 diabetes on oral antidiabetic drugs (OAD), mainly due to the progressive decline in beta-cell function and reduction in insulin secretion. The consequent hyperglycemia is the most important determinant for the development of microvascular and macrovascular complications, so that an early recognition of this phenomenon can improve long-term outcomes. The recent lowering of target glycosylated hemoglobin (HbA1c) levels by international guidelines not only emphasises the importance of tight glycemic control, but also means that secondary failure to OAD will occur much sooner and is almost unavoidable. Accordingly, in the last years, new different therapeutic strategies were explored to improve the treatment of this condition. The aim of this review is to examine current approaches for treating patients with secondary failure, barriers to achieving and maintaining glycemic control, and recent evidence for emerging therapies which may represent a valid therapeutic option in subjects failing on oral hypoglycemic agents by acting mainly, but not only, at a beta-cell level. In particular, we will focus on the co-administration of OAD plus a novel drug class known as incretin mimetics (e.g. exenatide and liraglutide), which target insulin secretion, and on thiazolidinediones, which act on insulin resistance. Only incretin-mimetics have a lowering HbA1c action, due to the improvement in beta-cell function, which is coupled to significant weight loss. Even if these new options seem to improve the outcome of secondary failure, further investigation is needed to confirm positive results in the long term.


A three-dimensional kinematic and dynamic model of the lower limb.
A model describing the kinematics and dynamics of the lower limb is presented. The lower limb is modeled as a sequence of four rigid links connected by three universal rotary joints representing the hip, knee and ankle joints. Each joint is modeled as a sequence of three single axis rotational joints thus ascribing to the lower limb a total of 12 degrees of freedom. A method is described to measure the gait variables so that all nine angles can be computed based on the positions of nine markers placed on the subject during a gait study. The gait variables are then used in an iterative Newton-Euler formulation to compute the moments exerted about the axes of each joint during gait.


G protein controls stress readiness by modulating transcriptional and metabolic homeostasis in Arabidopsis thaliana and Marchantia polymorpha.
The core G protein signaling module, which consists of Gα and extra-large Gα (XLG) subunits coupled with the Gβγ dimer, is a master regulator of various stress responses. In this study, we compared the basal and salt stress-induced transcriptomic, metabolomic and phenotypic profiles in Gα, Gβ, and XLG-null mutants of two plant species, Arabidopsis thaliana and Marchantia polymorpha, and showed that G protein mediates the shift of transcriptional and metabolic homeostasis to stress readiness status. We demonstrated that such stress readiness serves as an intrinsic protection mechanism against further stressors through enhancing the phenylpropanoid pathway and abscisic acid responses. Furthermore, WRKY transcription factors were identified as key intermediates of G protein-mediated homeostatic shifts. Statistical and mathematical model comparisons between A. thaliana and M. polymorpha revealed evolutionary conservation of transcriptional and metabolic networks over land plant evolution, whereas divergence has occurred in the function of plant-specific atypical XLG subunit. Taken together, our results indicate that the shifts in transcriptional and metabolic homeostasis at least partially act as the mechanisms of G protein-coupled stress responses that are conserved between two distantly related plants.


Copy number variations in healthy subjects. Case study: iPSC line CSSi005-A (3544) production from an individual with variation in 15q13.3 chromosome duplicating gene CHRNA7.
CHRNA7, encoding the neuronal alpha7 nicotinic acetylcholine receptor (a7nAChR), is highly expressed in the brain, particularly in the hippocampus. It is situated in the 15q13.3 chromosome region, frequently associated with a Copy Number Variation (CNV), which causes its duplication or deletion. The clinical significance of CHRNA7 duplications is unknown so far, but there are several research data suggesting that they may be pathogenic, with reduced penetrance. We have produced an iPS cell line from a single healthy donor's fibroblasts carrying a 15q13.3 CNV, including CHRNA7 in order to study the exact role of this CNV during the neurodevelopment.


Synthesis of bridgehead hydroxy bicyclo[2.2.2]octane derivatives.
Two independent synthetic routes, starting from 1,3-cyclohexadione, toward the 4-hydroxy bicyclo[2.2.2]octane-2,6-dione derivative 3 are described.


Exploring the potential for age estimation using facial image sensing technology for postmortem investigation.
In this study, we examine the potential for using face imaging sensing technology in place of a human forensic practitioner to estimate the age of cadavers. We used the age estimation software FieldAnalyst for Signage Ver. 6.0 AW32. To validate the usefulness of its age estimation for living subjects, images of 28 subjects were taken at three angles (+30°, 0°, and -30°) with respect to the horizontal plane, with their eyes open and closed. The highest positive correlation between mean the estimated age and the actual age (y = 1.02x - 0.35, and Spearman's rank correlation coefficient of 0.78, P < 0.001) was obtained when the subjects had their eyes closed and the image was captured at an angle of 0°. The ages of 93% of the subjects were estimated within ±10 years of their actual ages. We then applied this procedure to 61 cadavers with their eyes closed. Facial images were taken at an angle of 0° with respect to the horizontal plane and used to estimate the ages of the cadavers. Although a positive correlation between the actual and mean estimated ages was obtained (y = 1.28x + 0.43, Pearson's correlation coefficient of 0.69, P < 0.001), the mean estimated ages of only 39.3% of the subjects were within ±10 years of their actual ages. It appears that this technology is not accurate enough to use to determine the age of a cadaver. Therefore, medical inspectors with adequate knowledge and experience are still required for postmortem examination.


Expression of tumor necrosis factor-alpha stimulated gene-6 mRNA in cultured human uterine cervical fibroblasts.
Uterine cervical ripening process is an active biochemical process similar in part to inflammatory reaction. In this process, hyaluronan plays important roles including facilitation of tissue hydration, release of matrix metalloproteinases and migration of inflammatory cells. The activities of hyaluronan are mediated by the hyaluronan binding proteins, hyaladherins. In the present study, we investigated the mRNA expression of tumor necrosis factor-alpha stimulated gene-6 (TSG-6), a member of the hyaladherin family, in cultured human uterine fibroblasts and uterine cervical tissues. We developed one-step RT-PCR method for the quantification of TSG-6 mRNA and quantified the expression of TSG-6 mRNA in cultured human uterine fibroblasts, treated with or not proinflammatory cytokines, and TSG-6 mRNA in uterine cervical tissues. We clarified that [1] TSG-6 mRNA was expressed constitutively in cultured human uterine cervical fibroblasts, [2] expression of TSG-6 mRNA was upregulated in a dose dependent manner by proinflammatory cytokines, such as IL-1beta and TNF-alpha, which were key mediators in the cervical ripening process, [3] expression of TSG-6 mRNA in uterine cervices during parturition was significantly (P < 0.05) higher than that in a non-pregnant state. Our results suggest that TSG-6 might participate in the cervical ripening process.


Socioeconomic inequalities in cigarette smoking among men: evidence from the 2003 and 2008 Ghana demographic and health surveys.
Tobacco use is a public health burden in both developed and developing countries. However, there is still a dearth of nationally representative studies from Sub-Saharan Africa to inform interventions in the region. Socioeconomic trends and disparities in cigarette smoking were explored among Ghanaian men. A nationally representative sample of Ghanaian men 15-59 years was surveyed in the 2003 (N = 5015) and 2008 (N = 4568) Ghana Demographic and Health Surveys (N = 9583). Logistic regression analyses were conducted to investigate cigarette smoking by socioeconomic status (SES) and the changes over the two study periods. The results are presented as adjusted odds ratios (AOR) at 95% confidence intervals (CI). The prevalence decreased by 1.7% from 9% (95% CI 0.09-0.11) in 2003 to 7.3% (95% CI 0.07-0.09) in 2008. The prevalence of cigarette smoking was higher in the older age groups (25-34 year-olds and 35-59 year-olds) compared to 15-24 year-olds. Education (AOR = 2.2, 95% CI 1.4-3.4; no education vs higher education) and occupation (AOR = 4.2, 95% CI 2.3-7.6; not working vs managerial position) and being in labour force (AOR = 2.6, 95% CI 1.7-4.0) were related to cigarette smoking. Furthermore, religion, wealth (AOR = 3.1 95% CI 2.1-4.5; poorest compared to richest) and rural residence (AOR = 1.8, 95% CI 1.5-2.1) were associated with cigarette smoking. Over the period, cigarette smoking seems to have decreased among Ghanaian male at the population level but not among all groups by age, education, wealth and place of residence. Cigarette smoking interventions should be structured to reduce the menace among men. Such interventions must also particularly target lower socioeconomic groups in order to avert an increase in the inequalities in the behaviour and prervent a consequent increase in the socioeconomic gradient in tobacco-related diseases and deaths.


Improved Catalytic Performance toward Selective Oxidation of Benzyl Alcohols Originated from New Open-Framework Copper Molybdovanadate with a Unique V/Mo Ratio.
A new organic-inorganic hybrid open-framework molybdovanadate with mixed-valences of vanadium (V4+ /V5+ =4/3) and molybdenum (Mo5+ /Mo6+ =8/2) cations has been synthesized. The complex possesses the unique V/Mo ratio (7/10), fascinating 8-C topological network and 1D 4-MR channels (7.793 Å×6.699 Å). Importantly, its catalytic activities for the selective oxidation of benzyl alcohol to benzaldehyde (oxidant: H2 O2 , 30 wt %) have been well evaluated. The results indicated that it exhibited improved catalytic activities (conv.: 96.8 %) compared with the catalyst (Cpyr)5 PV2 Mo5 W5 O40 [conv.: 88.51 %, Cpyr=(C16 H32 C5 H4 N)+ )], high recyclability and structural stability. Moreover, the conversions and selectivities (conv.: 82.4-92.5 %; sele.: 91.5-95.7 %) of the substrates containing electron donating groups (-OH, -CH3 , -OCH3 and -Cl) were significantly higher than those of the substrate containing electron withdrawing group (-NO2 ) (conv. 67.4 %; sele.: 80.8 %). This is due to the fact that the -NO2 with a large Hammett substituent constant is not conducive to the generation of transition state products. The studies revealed the complex could act as a highly efficient heterogeneous catalyst in selective oxidation of benzyl alcohols.


Rethinking the birthing body: Cartesian dualism and perinatal nursing.
This paper highlights the pervasive influence of a Cartesian metaphysics on the medical paradigm and its profound impact on the practice of perinatal nursing in North America. Modern perinatal health care practices are founded on a Cartesian metaphysics that reduce birthing women to the status of object. Such practices deny the holistic aims of perinatal nursing. A philosophical inquiry informs the tenets of this metaphysical discussion regarding the foundations of perinatal nursing practices. Although perinatal health care is founded on a Cartesian metaphysics, an alternative paradigm of embodied practice is suggested as a way of viewing birthing women as embodied subjects. If the foundations of health care, which have been built on a Cartesian metaphysics, are not re-examined, perinatal nurses will be providing care that further reduce women to the status of object.


Isolation of the lignan secoisolariciresinol diglucoside from flaxseed (Linum usitatissimum L.) by high-speed counter-current chromatography.
High-speed counter-current chromatography was successfully used for the isolation and purification of secoisolariciresinol diglucoside, a bioactive lignan from flaxseed (Linum usitatissimum L.). The solvent system consisted of tert.-butylmethyl ether-n-butanol-acetonitrile-water (1:3:1:5). The purity and identity of the isolated compound was checked by high-performance liquid chromatography analysis in combination with mass spectrometry and NMR measurements.


Efficacy and safety of bicyclol for treating patients with idiosyncratic acute drug-induced liver injury: A multicenter, randomized, phase II trial.
Evidence for using bicyclol in drug-induced liver injury (DILI) is limited. This study aimed to explore the efficacy and safety of bicyclol in acute DILI. This was a multicenter, randomized, double-blinded, double-dummy, active-controlled, superiority and phase II trial. Patients with idiosyncratic acute DILI were randomized 1: 1:1 to low-dose bicyclol (25 mg times a day [TID]), high-dose bicyclol (50 mg TID) and polyene phosphatidylcholine (control) groups. The primary endpoint was the decrease from baseline in serum alanine aminotransferase (ALT) levels at post-treatment for 4 weeks. Overall, 241 patients were included in the full analysis set, with 81, 82 and 78 patients in the low-dose bicyclol, high-dose bicyclol, and control groups respectively. ALT levels decreased across groups (-249.2 ± 151.1, -273.6 ± 203.1, and -180.8 ± 218.2 U/L in the low-dose bicyclol, high-dose bicyclol and control groups, respectively; both p < .001, the bicyclol-dependent groups vs. control group). The ALT normalization rates at weeks 1, 2, 4, 6 and 8 were higher in the bicyclol-dependent groups than in the control group (p = .002 at week 1 and all p < .001 at weeks 2, 4, 6 and 8 respectively). The median times to ALT normalization in the low-dose bicyclol, high-dose bicyclol and control groups were 29, 16 and 43 days respectively. Adverse events, serious adverse events and adverse drug reactions were similar across groups. Bicyclol (25 and 50 mg TID) appeared efficacious and safe for treating idiosyncratic acute DILI, while bicyclol 50 mg TID showed higher efficacy. www. gov (registration no. NCT02944552).


After triage: lessons learned in Vietnam with military casualties.
There is no current training or experience that can closely parallel operating in the combat theater. However, the use of a structured and systematic approach to patient care such as Advanced Trauma Life Support would have given those thrust into trauma care a format to build upon.


A case of optic nerve oligodendroglioma associated with an orbital non-Hodgkin's lymphoma in adult. Case report.
The Authors report a case of optic nerve oligodendroglioma associated with an orbital non-Hodgkin's lymphoma. Its peculiar clinical aspects and neuroradiological appearance are discussed.


Photoelectric properties of a detector based on dried bacteriorhodopsin film.
The photoelectric response of a detector using dried bacteriorhodopsin (bR) film as the light sensing material is mathematically modeled and experimentally verified in this paper. The photocycle and proton transfer kinetics of dried bR film differ dramatically from the more commonly studied aqueous bR material because of the dehydration process. The photoelectric response of the dried film is generated by charge displacement and recombination instead of transferring a proton from the cytoplasmic side to the extracellular side of the cell membrane. In this work, the wild-type bR samples are electrophoretically deposited onto an indium tin oxide (ITO) electrode to construct a simple multiple layered photo-detector with high sensitivity to small changes in incident illumination. The light absorption characteristics of the thin bR film are mathematically represented using the kinetics of the bR photocycle and the charge displacement theorem. An electrically equivalent RC circuit is used to describe the intrinsic photoelectric properties of the film and external measurement circuitry to analyze the detector's response characteristics. Simulated studies and experimental results show that the resistance of the dried bR film is in the order of 10(11) Omega. When the input impedance of the measurement circuitry is one order of magnitude smaller than the dried film, the detector exhibits a strong differential response to the original time-varying light signal. An analytical solution of the equivalent circuit also reveals that the resistance and capacitance values exhibited by the dried bR film, in the absence of incident light, are almost twice as large as the values obtained while the material is under direct illumination. Experimental observations and a predictive model both support the notion that dried bR film can be used in simple highly sensitive photo-detector designs.


[Sonographically detectable changes in placental structures in pregnancy. 2. Statistical comparison of the frequency distribution of placenta stages 0-3 newborn infants with a birth weight of 2,500-3,999 grams].
1200 examinations of sonographical demonstrable placental ripeness were done in 552 pregnant women. The frequency of stages 0 to 3 as compared with aid of O. Bunke's confidence intervals. Stage 0 were found frequently until the 30. week of pregnancy, stage 1 between the 21. and 36. gestational week, stage 2 between the 33. and 38. week of pregnancy and stage 3 between the 35. and 40. week. The comparison of the areas of unsharpness several stages possibly may give informations about the period of pregnancy when the stages coincide.


The mammographic features of infiltrating epitheliosis.
The clinical, radiological and histological findings are described in nine cases of infiltrating epitheliosis. In seven cases the mammogram revealed 2.5-5.0 cm discoid radial scars which conformed with the histological features and there was no associated significant clinical abnormality. It can be difficult to differentiate the mammographic appearance of infiltrating epitheliosis from those of carcinoma with confidence but, taken in conjunction with the absence of clinical findings, the changes in the larger lesions are sufficiently distinctive to arouse considerable suspicion. The prevalence of the condition is estimated at 0.4/1000 women in the 45-65 years age range.


Electron transfer kinetics between Rhus vernicifera stellacyanin and cytochrome c (horse heart cytochrome c and Pseudomonas cytochrome c551).
The electron transfer reactions between Rhus vernicifera stellacyanin and either horse heart cytochrome c or Pseudomonas aeruginosa cytochrome c551 were investigated by rapid reaction techniques. The time course of electron transfer is monophasic under all conditions, and thus consistent with a simple formulation of the reaction. Both stopped-flow and temperature-jump experiments yield equilibrium constants in reasonable agreement with values calculated from the redox potentials. The differences in reaction rate between the two cytochromes and stellacyanin are discussed in terms of the Marcus theory.


A new, powerful player in lipoprotein metabolism: brown adipose tissue.
Important causes for modern epidemics such as obesity, diabetes, and cardiovascular disease are over- and malnutrition. Dietary as well as endogenous lipids are transported through the bloodstream in lipoproteins, and disturbances in lipoprotein metabolism are associated with atherosclerosis, heart disease, and diabetes. Recent findings reveal biological principles-how lipoproteins, in particular triglyceride-rich lipoproteins, are metabolized and what factors regulate their processing. The fate of triglycerides delivered by lipoproteins is quite simple: either they can be stored or they can be utilized for combustion or biosynthetic pathways. In the healthy state, fatty acids derived from triglycerides can be burned in the heart, muscle, and other organs for actual work load, or they can be stored in white adipose tissue. The combination of storage and combustion is realized in brown adipose tissue (BAT), a peripheral organ that was long thought to be only of relevance in small mammals: Recent data however prove that BAT plays an important role in human adults. Here, we will review recent insights on how BAT controls triglyceride clearance and the possible implications for the treatment of chronic diseases caused by lipid mishandling.


LacZ transgene expression as a cell marker to analyse rescue from the 2-cell block in mouse aggregation chimeras.
Embryos from certain mouse strains are arrested at the 2-cell stage in cell culture ('2-cell block'), whereas those from other strains develop to the blastocyst stage under the same conditions. It was previously shown that blocking embryos can be rescued in culture by aggregation with an excess of 2-cell stages of a non-blocking strain such as CBA x C57BL/6 F2. Here we have employed a LacZ transgene in a blocking strain (NMRI) to follow the fate of rescued blastomeres up to the blastocyst stage. We found that rescued blastomeres can participate in both inner cell mass and trophoblast formation, thus completely overcoming the 2-cell block.


Mapping PTBP2 binding in human brain identifies SYNGAP1 as a target for therapeutic splice switching.
Alternative splicing of neuronal genes is controlled partly by the coordinated action of polypyrimidine tract binding proteins (PTBPs). While PTBP1 is ubiquitously expressed, PTBP2 is predominantly neuronal. Here, we define the PTBP2 footprint in the human transcriptome using brain tissue and human induced pluripotent stem cell-derived neurons (iPSC-neurons). We map PTBP2 binding sites, characterize PTBP2-dependent alternative splicing events, and identify novel PTBP2 targets including SYNGAP1, a synaptic gene whose loss-of-function leads to a complex neurodevelopmental disorder. We find that PTBP2 binding to SYNGAP1 mRNA promotes alternative splicing and nonsense-mediated decay, and that antisense oligonucleotides (ASOs) that disrupt PTBP binding redirect splicing and increase SYNGAP1 mRNA and protein expression. In SYNGAP1 haploinsufficient iPSC-neurons generated from two patients, we show that PTBP2-targeting ASOs partially restore SYNGAP1 expression. Our data comprehensively map PTBP2-dependent alternative splicing in human neurons and cerebral cortex, guiding development of novel therapeutic tools to benefit neurodevelopmental disorders.


Burkholderia xenovorans LB400 possesses a functional polyhydroxyalkanoate anabolic pathway encoded by the pha genes and synthesizes poly(3-hydroxybutyrate) under nitrogen-limiting conditions.
Polyhydroxyalkanoates (PHAs) are biodegradable bioplastics that are synthesized by diverse bacteria. In this study, the synthesis of PHAs by the model aromatic-degrading strain Burkholderia xenovorans LB400 was analyzed. Twelve pha genes including three copies of phaC and five copies of the phasin-coding phaP genes are distributed among the three LB400 replicons. The phaC1ABR gene cluster that encodes the enzymes of the PHA anabolic pathway is located at chromosome 1 of strain LB400. During the growth of strain LB400 on glucose under nitrogen limitation, the expression of the phaC1, phaA, phaP1, phaR, and phaZ genes was induced. Under nitrogen limitation, PHA accumulation in LB400 cells was observed by fluorescence microscopy after Nile Red staining. GC-MS analyses revealed that the PHA accumulated under nitrogen limitation was poly(3-hydroxybutyrate) (PHB). LB400 cells grown on glucose as the sole carbon source under nitrogen limitation accumulated 40 ± 0.96% PHB of the cell dry weight, whereas no PHA was observed in cells grown in control medium. The functionality of the phaC1 gene from strain LB400 was further studied using heterologous expression in a Pseudomonas putida KT40C1ZC2 mutant strain derived from P. putida KT2440 that is unable to synthesize PHAs. Interestingly, KT40C1ZC2[pVNC1] cells that express the phaC1 gene from strain LB400 were able to synthesize PHB (33.5% dry weight). This study indicates that B. xenovorans LB400 possesses a functional PHA synthetic pathway that is encoded by the pha genes and is capable of synthesizing PHB.


Characterization of partitioning behavior of cephalosporins using microemulsion and micellar electrokinetic chromatography.
Electrokinetic chromatography (EKC) was introduced to determine the partitioning behavior of various cephalosporins (cefpim, cefpirom, cefaloridin, cefaclor, cephalexin, cefuroxim, cefotaxim) in microemulsions (ME) and micellar (MC) systems. The partitioning behavior of cephalosporins in microemulsions was characterized calculating the capacity factor. The required parameters for the determination of the capacity factor (micro(aq) and micro-me are the electrophoretic mobilities of the solutes in the aqueous phase and the microemulsion phase, micro(eff) is the effective mobility in the microemulsion solution) were measured by EKC using cationic and anionic microemulsion systems consisting of the surfactants/n-heptane/1-butanol/10 mM phosphate buffer solution, pH 7.0. Electrokinetic chromatography was shown to be a useful method to quantify the partitioning behavior of drugs in oil/water microemulsion. The logarithm of the capacity factor was correlated with the logarithm of the 1-octanol/water partitioning coefficients.


Adrenal gland-dependent augmentation of plasminogen activator inhibitor-1 expression in streptozotocin-induced diabetic mice.
Diabetes is associated with an excess risk of cardiac events, and one risk factor for infarction is an elevated level of plasminogen activator inhibitor-1 (PAI-1). To evaluate whether the glucocorticoid hormones are involved in the diabetes-induced PAI-1 production, we examined expression profiles of PAI-1 mRNA in adrenalectomized (ADX) mice with streptozotocin (STZ)-induced diabetes. The diabetes-induced augmentation of plasma PAI-1 levels and PAI-1 mRNA expression in the heart and lungs was completely normalized in diabetic ADX mice. The glucocorticoid receptor antagonist RU486 significantly, but only partly suppressed PAI-1 induction in STZ-induced diabetic mice, suggesting that factors other than glucocorticoids are also involved in PAI-1 induction provoked by diabetes. Our results suggested that the adrenal gland plays a critical role in the progression of thrombosis in diabetic patients by inducing expression of the PAI-1 gene.


Isolated lichen planus of the lip.
Oral lichen planus (LP) is a relatively common disorder of unknown aetiology. Oral LP occurs most often on the buccal mucosa, but the gingivae, tongue, floor of the mouth, retromalar pads and lips may also be affected. Usually, patients have multiple sites of involvement. We report a 44-year-old patient with a 3-year history of isolated swelling of the lower lip, erosions and crusting. Histology of a biopsy from the lip revealed features of LP. Oral treatment with acitretin and low-dose steroid led to complete resolution of the lesions within 10 weeks. This is the first well-documented case of isolated LP of the lip. Diagnostic difficulties and differential diagnosis are reviewed.


Outstanding supercapacitive properties of Mn-doped TiO2 micro/nanostructure porous film prepared by anodization method.
Mn-doped TiO2 micro/nanostructure porous film was prepared by anodizing a Ti-Mn alloy. The film annealed at 300 °C yields the highest areal capacitance of 1451.3 mF/cm(2) at a current density of 3 mA/cm(2) when used as a high-performance supercapacitor electrode. Areal capacitance retention is 63.7% when the current density increases from 3 to 20 mA/cm(2), and the capacitance retention is 88.1% after 5,000 cycles. The superior areal capacitance of the porous film is derived from the brush-like metal substrate, which could greatly increase the contact area, improve the charge transport ability at the oxide layer/metal substrate interface, and thereby significantly enhance the electrochemical activities toward high performance energy storage. Additionally, the effects of manganese content and specific surface area of the porous film on the supercapacitive performance were also investigated in this work.


Validating the caregiver self-efficacy in contribution to self-care scale Thai version for stroke: A psychometric evaluation.
To test the validity and reliability of the Caregiver Self-Efficacy in Contribution to Self-Care Scale Thai Version (CC-Self Efficacy Scale (Thai)) for Stroke. A cross-sectional study was undertaken from September to December 2022. Four hundred thirty-four caregivers of people with stroke were selected from the registry of stroke patients in primary care units or hospitals following inclusion criteria. The research assistants collected information when the caregiver took a patient for a doctor's appointment or visited the patient's and caregiver's home. The 434 caregivers had a mean age of 48 years, female 77.67%, 51.97% child or grandchild of patients, and 72.85% living with the patient. Ten items of the CC-Self Efficacy Scale (Thai) were normally distributed and appropriate for exploratory factor analysis (EFA). EFA suggested three-factor model. The confirmatory factor analysis (CFA) of the three-factor model was an unfit model, with the root mean square error of approximation (RMSEA) = 0.09. We regrouped items based on content to create six-factor model. CFA supported the six-factor model of CC-Self Efficacy Scale (Thai) questionnaire with the reliability judged by McDonald's omega being 0.87. The 434 sample size was enough for EFA and CFA. The CC-Self Efficacy Scale (Thai) with the six-factor model is appropriate for evaluating the caregiver confidence of people with stroke.


A long-time, high spatiotemporal resolution optical recording system for membrane potential activity via real-time writing to the hard disk.
Using real-time hard disk recording, we have developed an optical system for the long-duration detection of changes in membrane potential from 1,020 sites with a high temporal resolution. The signal-to-noise ratio was sufficient for analyzing the spreading pattern of excitatory waves in frog atria in a single sweep.


A Novel Intra-aortic Device Designed for Coronary Blood Flow Amplification in Unrevascularizable Patients.
Patients with unrevascularizable coronary artery disease represent a substantial number of all patients with coronary disease. However, their therapeutic options are limited; they endure recurrent hospitalizations, a poor quality of life and prognosis. We aim to investigate a novel alternative approach to the treatment of this common medical condition by using a specialized intra-aortic device with coiling properties capable of enhancing diastolic coronary flow. Both a mathematical analysis and in vitro study presented in the current study have yielded enhanced coronary diastolic blood flow and energetic advantages. We suggest that this original approach might be implicated in severely symptomatic unrevascularizable patients.


Evaluating the presence of domestic cat hepadnavirus viraemia in cats with biochemical alterations suggestive of liver disease.
The association between domestic cat hepadnavirus (DCH) infection and feline chronic hepatitis and hepatocellular carcinoma has been suggested. However, studies focused on the association between DCH infection and clinicopathological changes consistent with liver disease in cats are not available. This retrospective investigation included sera obtained from 96 cats that had the serum activity of at least alanine aminotransferase or alkaline phosphatase measured during initial diagnostic work-up. Based on these haematobiochemical results, cats were categorised according to their likelihood of having liver disease (absent, low, intermediate or high). DCH DNA was detected using real-time PCR, nested PCR and sequencing. Overall, potential liver damage was observed in 44 cats, including cats with low (n = 14), intermediate (n = 10) and high (n = 20) likelihood of liver disease. Four cats (4.2%) were DCH-positive, with three positive cats belonging to the liver disease group (two with low and one with intermediate likelihood of liver disease). Although the pathogenic potential of DCH in cats still has to be clarified, these results suggest that DCH testing should not be based only on the presence of biochemical changes potentially consistent with liver disease.


Spinal narcotics and central nervous system depression.
A case of central nervous system depression which developed 7 hours after an intrathecal injection of 4 mg of morphine is described. The patient lapsed into coma with bradypnoea and "pin-point' pupils and there was no response to naloxone 0.4 mg. Treatment was continued for 3 hours. No postoperative analgesics were required for 126 hours. The problems associated with the use of intrathecal opiates are reviewed, delay in onset being the usual feature. Use of hyperbaric solutions of the narcotic and maintenance of a head-up posture may protect against respiratory depression.


Gender and science in Hiroshima's aftermath: a cross-cultural approach.
A comparative study of Japanese and Japanese-American survivors of the atomic bombs dropped on Hiroshima and Nagasaki in 1945 suggests that there is much to be gained by looking at the history of the Bomb as a cross-cultural history. Issues of science and gender in survivors' experiences and memories illuminate three key features of the trans-Pacific history: a Japanese female author's literary responses to the Bomb, the Japan-U.S. relationship after the war that shaped Japan's antinuclear movement, and Japanese-American survivors' effort to gain governmental recognition and medical care in the U.S. within the context of the Asian American movement. Using variety of sources--literature, popular political discourse, congressional hearings, and oral histories--this article shows the volatile diffusion of political and cultural ideas revealed by a trans-Pacific perspective.


Differential expression of amyloid precursor protein mRNAs in cases of Alzheimer's disease and in aged nonhuman primates.
Senile plaques are a characteristic feature in brains of individuals with Alzheimer's disease (AD) and aged monkeys. The principal component of amyloid in senile plaques is beta/A4, a peptide derived from a larger amyloid precursor protein (APP). To date, several alternatively spliced APP transcripts have been described. The relationship between levels of these APP mRNAs and amyloid deposition is unclear. In this study, we directly measured the relative levels of APP transcripts that lack the protease inhibitor domain (APP-695) and transcripts that encode the inhibitor sequences (APP-751/770). Our results indicate that the expression of APP mRNAs is not selectively altered in AD cortex. Moreover, the differential expression of APP transcripts is not correlated with the deposition of amyloid in cases of AD and aged monkeys. These findings suggest that other factors, not directly related to the relative expression of APP mRNAs, may contribute to amyloidogenesis in the brain.


Experimental atherosclerosis: effects of oestrogen and atherosclerosis on thromboxane and prostacyclin formation.
We evaluated the effect of oestrogen and experimental atherosclerosis on the in vivo formation of thromboxane and prostacyclin in rabbits. Twenty-four New Zealand White rabbits were divided into four groups. One group received control diet, one group received control diet and oestrogen, one group received control diet supplemented with 1% cholesterol and one group received cholesterol supplemented diet and oestrogen during 3 months. The in vivo formation of thromboxane and prostacyclin were measured as 2,3-dinor-TxB2 and 2,3-dinor-6-keto-PGF1 alpha in urine by gas chromatography/mass spectrometry. All rabbits on cholesterol diet became hypercholesterolaemic and developed atherosclerosis. As in previous experiments cholesterol and oestrogen-treated rabbits had only minor atherosclerosis compared to purely cholesterol-fed rabbits. The in vivo production of thromboxane in oestrogen-treated rabbits decreased from 1641 +/- 162 pg mg-1 creatinine pretreatment to 808 +/- 92 pg mg-1 creatine at 12 weeks (P = 0.0001). In contrast, the in vivo production of prostacyclin increased during oestrogen treatment (P = 0.0027). The in vivo production of prostacyclin decreased during pure cholesterol feeding without oestrogen 1384 +/- 219 pg mg-1 creatinine to 702 +/- 142 pg mg-1 creatinine (P = 0.0091). The ratio of in vivo prostacyclin to thromboxane formation increased 2-3-fold during oestrogen therapy (P = 0.0007).(ABSTRACT TRUNCATED AT 250 WORDS)


Drosophila Cu,Zn superoxide dismutase gene confers resistance to paraquat in Escherichia coli.
Superoxide dismutase (SOD) is known to protect organisms from reactive oxygen metabolites. We tested the hypothesis that the Drosophila Cu,Zn SOD is capable of protecting Escherichia coli from oxidative damage caused by the herbicide paraquat. The Cu,Zn Sod gene of Drosophila sechellia was subcloned into pET-20b(+) expression vector. Transformation of E. coli with the constructed vector resulted in an overexpression of this eukaryotic superoxide dismutase, as evidenced by dramatically increased levels of the Cu,Zn SOD polypeptide in bacterial cytosolic extracts. As well, the E. coli transformants showed resistance to paraquat-mediated inhibition of growth and survival. Paraquat is known to promote formation of the superoxide radical anion inside cells and thus the data have been interpreted as indicating that the cloned superoxide dismutase provides protection in E. coli against damage attributable to free radicals.


Comedonal, cornifying and hypertrophic Darier's disease in the same patient: a Darier combination.
Our 42-year-old patient had comedonal Darier's disease (DD) on the face, comedonal cornifying DD on the upper back, and hypertrophic DD on both legs. Biopsies taken from face, upper back and medial sides of the legs were found to be compatible with these clinical subtypes. The comedonal type was in the classical place, but the hypertrophic and cornifying types were not in the usual sites. In addition to the classic histopathology of DD, we noted multiple, warty dyskeratoma-like structures in the comedonal type, marked compact hyperkeratosis in the cornifying type, and marked papillomatosis in the hypertrophic type.


Integrated analyses delineate distinctive immunological pathways and diagnostic signatures for Behcet's disease by leveraging gene microarray data.
Behcet's disease (BD) is a chronic inflammatory vasculitis and clinically heterogeneous disorder caused by immunocyte aberrations. Comprehensive research on gene expression patterns in BD illuminating its aetiology is lacking. E-MTAB-2713 downloaded from ArrayExpress was analysed to screen differentially expressed genes (DEGs) using limma. Random forest (RF) and neural network (NN) classification models composed of gene signatures were established using the E-MTAB-2713 training set and subsequently verified using GSE17114. Single sample gene set enrichment analysis was used to assess immunocyte infiltration. After identifying DEGs in E-MTAB-2713, pathogen-triggered, lymphocyte-mediated and angiogenesis- and glycosylation-related inflammatory pathways were discovered to be predominant in BD episodes. Gene signatures from the RF and NN diagnostic models, together with genes enriched in angiogenesis and glycosylation pathways, well discriminated the clinical subtypes of BD manifesting as mucocutaneous, ocular and large vein thrombosis involvement in GSE17114. Moreover, a distinctive immunocyte profile revealed T, NK and dendritic cell activation in BD compared to the findings in healthy controls. Our findings suggested that EPHX1, PKP2, EIF4B and HORMAD1 expression in CD14+ monocytes and CSTF3 and TCEANC2 expression in CD16+ neutrophils could serve as combined gene signatures for BD phenotype differentiation. Pathway genes comprising ATP2B4, MYOF and NRP1 for angiogenesis and GXYLT1, ENG, CD69, GAA, SIGLEC7, SIGLEC9 and SIGLEC16 for glycosylation also might be applicable diagnostic markers for subtype identification.


Removal of perfluoroalkyl acids and common drinking water contaminants by weak-base anion exchange resins: Impacts of solution pH and resin properties.
The underlying chemistry of weak-base (WB) anion exchange resins (AERs) for contaminant removal from water is not well documented in the literature. To address this, batch adsorption experiments were conducted at pH 4, 7, and 10 using two representative WB-AERs (polyacrylic IRA67 and polystyrene IRA96) and two representative strong-base (SB) AERs (polyacrylic IRA458 and polystyrene A520E), of differing polymer composition, for the removal of nitrate, sulfate, 3-phenylpropionic acid (3-PPA) as surrogate for natural organic matter, and six perfluoroalkyl acids (PFAAs). Under acidic (pH 4) and neutral (pH 7) conditions, the selectivity of AERs for each contaminant was predominantly influenced by polymer composition followed by the size of the resin functional group. This result reflected the WB-AERs being fully protonated and functioning identical to SB-AERs. Isotherm model parameters revealed WB-AER had higher capacity than SB-AER with analogous polymer composition and porosity regardless of resin selectivity for each contaminant. Under basic conditions (≥ pH 10), contaminant removal by WB-AERs declined due to deprotonation of the tertiary amine functional groups. Removal of PFAAs by the more hydrophobic polystyrene WB-AER (IRA96) remained approximately constant with changing pH, which was possibly due to electrostatic interactions with remaining protonated amine functional groups on the resin.


Non-cooperative mechanism for bounded and ultrasensitive chromatin remodeling.
Chromatin remodeling is an essential form of gene regulation that is involved in a variety of biological processes. We develop a theoretical model that takes advantage of percolation effects at the level of nucleosome interactions, which allows for ultrasensitive chromatin expansion. This model is non-cooperative and readily provides spatial bounds to the expansion region, preventing uncontrolled remodeling events. We explore different chromatin architectures and the ultrasensitivity of the chromatin density as a function of transcription factor concentration. We also compare our model with experimental data involving an inhibitor of nucleosome acetylation. These results suggest a novel mechanism for spatially-bounded chromatin remodeling and they provide means for quantitative comparisons between proposed models of chromatin architecture.


A Clerodane Diterpene from Callicarpa americana Resensitizes Methicillin-Resistant Staphylococcus aureus to β-Lactam Antibiotics.
The rise of antibiotic resistance presents a significant healthcare challenge and precludes the use of many otherwise valuable antibiotics. One potential solution to this problem is the use of antibiotics in combination with resistance-modifying agents, compounds that act synergistically with existing antibiotics to resensitize previously resistant bacteria. In this study, 12(S),16ξ-dihydroxycleroda-3,13-dien-15,16-olide, a clerodane diterpene isolated from the medicinal plant Callicarpa americana, was found to synergize with oxacillin against methicillin-resistant Staphylococcus aureus. This synergy was confirmed by checkerboard (fractional inhibitory concentration index (FICI) = 0.125) and time-kill assays, with a subinhibitory dose of 12(S),16ξ-dihydroxycleroda-3,13-dien-15,16-olide causing the effective concentration of oxacillin to fall below the susceptibility breakpoint for S. aureus, a >32-fold decrease in both cases.


Studies of the mechanisms involved in the fate of prostacyclin (PGI2) and 6-keto-PGF1alpha in the pulmonary circulation.
We have investigated the metabolism of [3]H-prostaglandin (PG)I2 and its non-enzymatic breakdown product [3]H-6-keto-PGF1alpha by rat pulmonary tissue and their possible uptake and metabolism upon passage through the isolated perfused rat lung. When incubated with rat lung homogenate in the presence of beta-NAD, [3]H-PGI2 was extensively degraded into at least one metabolite, while [3]H-6-keto-PGF1alpha was only minimally metabolized. However, on passage through isolated perfused rat lungs, neither [3]H-PGI2 nor [3]H-6-keto-PGF1alpha were removed from the circulation into the lung or degraded. This demonstration that PGI2 is not a substrate for the transport system for the removal of PGs from the circulation into the lung further illustrates that this system is a critical determinant for the pulmonary inactivation of circulating prostaglandins. The experimental findings are discussed in reference ot the structure-activity requirements necessary for pulmonary transport and subsequent metabolism.


N-hydroxysuccinimide-hippuran ester: application for radiolabeling of macro-molecules.
A method for synthesis of N-hydroxysuccinimide ester of radioactive hippuran is developed in order to label human serum albumin in a simple and efficient manner. Organ distribution in mice and rats for the labeled albumin preparation and the commercial radioiodinated serum albumin is similar. Hippuran metabolite released from the labeled preparation into the blood stream results in its rapid urinary clearance. The hippuran labeling method offers a mild and rapid protocol for radioiodine labeling of proteins and antibodies for application in diagnostic nuclear medicine procedures.


[Investigation on the impact of hot temperature methods of the tissue dissection and coagulation on parenchymatous organs in experiment].
There are adduced the results of experimental operations on mongrel rabbits with dissection and coagulation of the liver and the spleen, using highly temperature coagulation apparatuses of various kinds. There was established, that while application of various highly temperature technologies a typical process occurs, consisting of the heat spreading inside the organ. The temperature raising grade depends on the method and duration of the impact.


Effects of sulfur dioxide on the expressions of EGF, EGFR, and COX-2 in airway of asthmatic rats.
The pathogenesis of asthma involves a combination of genetic and environmental factors. The epidemiology studies have shown that SO(2)might play an important role in the initiation or exacerbation of the asthma disease. To investigate the asthmatic molecular mechanisms exposed to SO(2), male Wistar rats were divided randomly into four equal groups of six animals each: (1) SO(2) group, (2) ovalbumin (OVA) group (asthma group), (3) SO(2)plus OVA group, and (4) control group. The rats were challenged by ovalbumin (OVA) or SO(2) (5.6 mg/m(3)) inhalation alone or together. The mRNA and protein levels of asthma-related genes (EGF, EGFR, and COX-2) were analyzed in lungs and tracheas using real-time reverse transcription-polymerase chain reaction assay, radioimmunoassay method, and Western blot analysis, respectively. The results showed that inhaled SO(2) alone increased the mRNA and protein expressions of three tested genes in lung and trachea tissues, but only the mRNA levels of EGFR and COX-2 in tracheas were significantly increased compared with the control. However, OVA exposure significantly induced the mRNA and protein expressions of EGF, EGFR, and COX-2 compared with the control. Meanwhile, OVA plus SO(2) inhalation enhanced the mRNA and protein levels of these genes in rat airways, versus exposure to OVA alone. These results suggested that SO(2) could increase the expressions of EGF, EGFR, and COX-2 on the transcription and translation levels in the lungs and tracheas from asthmatic rats, which might be one of the possible mechanisms by which SO(2) pollution aggravates asthma disease.


Autonomous synchronization of the circadian KaiC phosphorylation rhythm.
The cyanobacterial circadian oscillator can be reconstituted in vitro by mixing three purified clock proteins, KaiA, KaiB and KaiC, with ATP. The KaiC phosphorylation rhythm persists for at least 10 days without damping. By mixing oscillatory samples that have different phases and analyzing the dynamics of their phase relationships, we found that the robustness of the KaiC phosphorylation rhythm arises from the rapid synchronization of the phosphorylation state and reaction direction (phosphorylation or dephosphorylation) of KaiC proteins. We further demonstrate that synchronization is tightly linked with KaiC dephosphorylation and is mediated by monomer exchange between KaiC hexamers during the early dephosphorylation phase. This autonomous synchronization mechanism is probably the basis for the resilience of the cyanobacterial circadian system against quantitative fluctuations in clock components during cellular events such as cell growth and division.


Forceps delivery is associated with increased risk of pelvic organ prolapse and muscle trauma: a cross-sectional study 16-24 years after first delivery.
To study possible associations between mode of delivery and pelvic organ prolapse (POP) and pelvic floor muscle trauma 16-24 years after first delivery and, in particular, to identify differences between forceps and vacuum delivery. This was a cross-sectional study including 608 women who delivered their first child in 1990-1997 and were examined with POP quantification (POP-Q) and pelvic floor ultrasound in 2013-2014. Outcome measures were POP ≥ Stage 2 or previous prolapse surgery, levator avulsion and levator hiatal area on Valsalva. Univariable and multivariable logistic regression analyses and ANCOVA were applied to identify outcome variables associated with mode of delivery. Comparing forceps to vacuum delivery, the adjusted odds ratios (aOR) were 1.72 (95% CI, 1.06-2.79; P = 0.03) for POP ≥ Stage 2 or previous prolapse surgery and 4.16 (95% CI, 2.28-7.59; P < 0.01) for levator avulsion. Hiatal area on Valsalva was larger, with adjusted mean difference (aMD) of 4.75 cm(2) (95% CI, 2.46-7.03; P < 0.01). Comparing forceps with normal vaginal delivery, the adjusted odds ratio (aOR) was 1.74 (95% CI, 1.12-2.68; P = 0.01) for POP ≥ Stage 2 or surgery and 4.35 (95% CI, 2.56-7.40; P < 0.01) for levator avulsion; hiatal area on Valsalva was larger, with an aMD of 3.84 cm(2) (95% CI, 1.78-5.90; P < 0.01). Comparing Cesarean delivery with normal vaginal delivery, aOR was 0.06 (95% CI, 0.02-0.14; P < 0.01) for POP ≥ Stage 2 or surgery and crude OR was 0.00 (95% CI, 0.00-0.30; P < 0.01) for levator avulsion; hiatal area on Valsalva was smaller, with an aMD of -8.35 cm(2) (95% CI, -10.87 to -5.84; P < 0.01). No differences were found between vacuum and normal vaginal delivery. We found that mode of delivery was associated with POP and pelvic floor muscle trauma in women from a general population, 16-24 years after their first delivery. Forceps was associated with significantly more POP, levator avulsion and larger hiatal areas than were vacuum and normal vaginal deliveries. There were no statistically significant differences between vacuum and normal vaginal deliveries. Cesarean delivery was associated with significantly less POP and pelvic floor muscle trauma than were normal or operative vaginal delivery.


Freestanding non-covalent thin films of the propeller-shaped polycyclic aromatic hydrocarbon decacyclene.
Molecularly thin, nanoporous thin films are of paramount importance in material sciences. Their use in a wide range of applications requires control over their chemical functionalities, which is difficult to achieve using current production methods. Here, the small polycyclic aromatic hydrocarbon decacyclene is used to form molecular thin films, without requiring covalent crosslinking of any kind. The 2.5 nm thin films are mechanically stable, able to be free-standing over micrometer distances, held together solely by supramolecular interactions. Using a combination of computational chemistry and microscopic imaging techniques, thin films are studied on both a molecular and microscopic scale. Their mechanical strength is quantified using AFM nanoindentation, showing their capability of withstanding a point load of 26 ± 9 nN, when freely spanning over a 1 μm aperture, with a corresponding Young's modulus of 6 ± 4 GPa. Our thin films constitute free-standing, non-covalent thin films based on a small PAH.


Abnormal origin of the ophthalmic artery from the anterior cerebral artery: neuroradiological and intraoperative findings.
A 7-year old male child with an abnormal ophthalmic artery arising from the A1 segment of the anterior cerebral artery is described. The patient suffered growth inhibition which was thought to be caused by a craniobasal cystic lesion affecting the hypothalamus. Preoperative angiograms revealed no vascular abnormalities. The right ophthalmic artery, however, could not be identified. During resection of a large arachnoid cyst the ophthalmic artery was found to arise from the A1 segment of the anterior cerebral artery. To the best of our knowledge, this exact anomaly has not previously been reported. The clinical, neuroradiological and intraoperative findings are presented.


Staphylococcus aureus peptidoglycan studied by electron microscopy of immunoperoxidase-treated sections of cell walls.
The immunoperoxidase technique in combination with electron microscopy was used for demonstration of antigenic determinants of Staphylococcus aureus peptidoglycan. Isolated antibodies against four synthetic peptides with amino-acid sequences similar to those found in native staphylococcal peptidoglycans were used. A homogeneous staining of the cell wall from the outer surface to the cell membrane was demonstrated.


Modification of sudden onset auditory ERP by involuntary attention to visual stimuli.
To investigate the cross-modal nature of the exogenous attention system, we studied how involuntary attention in the visual modality affects ERPs elicited by sudden onset of events in the auditory modality. Relatively loud auditory white noise bursts were presented to subjects with random and long inter-trial intervals. The noise bursts were either presented alone, or paired with a visual stimulus with a visual to auditory onset asynchrony of 120 ms. In a third condition, the visual stimuli were shown alone. All three conditions, auditory alone, visual alone, and paired visual/auditory, were randomly inter-mixed and presented with equal probabilities. Subjects were instructed to fixate on a point in front of them without task instructions concerning either the auditory or visual stimuli. ERPs were recorded from 28 scalp sites throughout every experimental session. Compared to ERPs in the auditory alone condition, pairing the auditory noise bursts with the visual stimulus reduced the amplitude of the auditory N100 component at Cz by 40% and the auditory P200/P300 component at Cz by 25%. No significant topographical change was observed in the scalp distributions of the N100 and P200/P300. Our results suggest that involuntary attention to visual stimuli suppresses early sensory (N100) as well as late cognitive (P200/P300) processing of sudden auditory events. The activation of the exogenous attention system by sudden auditory onset can be modified by involuntary visual attention in a cross-model, passive prepulse inhibition paradigm.


[Clinical Diagnosis and Prenatal Screening of Hb Lepore-BW Associated with IVS-II-654 Heterozygous Mutation].
To identify one case of rare Hb Lepore-BW associated with IVS-II-654 heterozygous mutation in Sichuan area. The blood routine examination and hemoglobin electrophoresis methods were used to analyze the blood routine parameters, HbA2 and HbF in the samples of peripheral blood in proband and his parents, as well as the cord blood of pregnant woman. The detection of thalassemia gene and Sanger sequencing methods were used to detect the hemoglobin mutations. The result showed that the Hb Lepore-BW heterozygous mutation was detected in the father of the proband, while a rare Hb Lepore-BW with IVS-II-654 heterozygous mutation was detected in the proband, as well as his mother and cord blood were both detected as IVS-II-654 heterozygous mutation. The study identified a rare Hb Lepore-BW with IVS-II-654 heterozygous mutation, which was characterized by intermediate β-thalassemia. It is necessary to hemoglobin electrophoresis combined with routine blood testing in prenatal screening.


Retinal axons to the medial terminal nucleus of the accessory optic system in old world monkeys.
Horseradish peroxidase (HRP) and HRP conjugated to wheat germ agglutinin (WGA-HRP) were used as anterograde tracers in the monkey visual pathways. In addition to known optic pathways, we observed labeled fibers which left the lateral terminal nucleus of the accessory optic system, traveled around the cerebral peduncle, and could be followed as far as the medial terminal nucleus.


Why Has It Taken So Long to Address the Problems Created by Uranium Mining in the Navajo Nation?
Following the start of uranium mining after World War II, progress toward addressing the hazards it created for workers and nearby communities was slow, taking many decades. This essay asks why it took so long and suggests several factors that might have contributed.


Effect-directed analysis in food by thin-layer chromatography assays.
Thin-layer chromatography (TLC) is widely used for food analysis and quality control. As an open chromatographic system, TLC is compatible with microbial-, biochemical-, and chemical-based derivatization methods. This compatibility makes it possible to run in situ bioassays directly on the plate to obtain activity-profile chromatograms, i.e., the effect-directed analysis of the sample. Many of the properties that can be currently measured using this assay format are related to either desired or undesired features for food related products. The TLC assays can detect compounds related to the stability of foods (antioxidant, antimicrobial, antibrowning, etc.), contaminants (antibiotics, pesticides, estrogenic compounds, etc.), and compounds that affect the absorption, metabolism or excretion of nutrients and metabolites or could improve the consumers health (enzyme inhibitors). In this article, different food related TLC-assays are reviewed. The different detection systems used, the way in which they are applied as well as selected examples are discussed.


Endovascular abdominal aortic aneurysm repair: 5-year follow-up results.
Endovascular aneurysm repair (EVAR) offers a minimally invasive alternative to open repair and has the benefits of reduced perioperative morbidity and mortality. There are potential complications specific to EVAR, including device failure, graft migration, and endoleak, which necessitate long-term follow-up. This remains a relatively novel technique, and therefore, little long-term data exist. This study reports 5-year EVAR outcome data from a single center. Five-year follow-up data for 58 patients at a single center who underwent EVAR using a variety of different commercial devices was reviewed. All patients were followed up with 6-monthly duplex ultrasound scanning and clinical assessment in a nurse-led clinic, in addition to yearly computed tomographic (CT) scans for those participating in the EVAR trial. All patients in this series were male, with a median age of 72 years (range 58-81). Mean preoperative aortic diameter was 5.95 cm, and this reduced following EVAR to 5.2 cm (mean diameter) at 5 years. Mean hospital stay was 7 days, and there were no perioperative deaths. There were 20 (34%) early and 15 (26%) late complications. There were 13 endoleaks confirmed on CT; four (31%) were type I and nine (69%) were type II. All-cause mortality was 26%. There were no late aneurysm-related deaths. EVAR has the advantages of shorter hospital stay and reduced perioperative morbidity and mortality. Long-term follow-up remains a priority following aortic stenting in order to detect late complications such as endoleak.


A case of adult onset Still's disease showing marked accumulation in the liver and spleen, on positron emission tomography-CT images.
A 35-year-old woman was admitted to our hospital because of high fever and skin rash, and subsequently diagnosed as having adult onset Still's disease (AOSD). Because of resistance to the steroid hormones, high levels of the serum-soluble form of the interleukin-2 receptor and splenomegaly, we suspected a possible diagnosis of malignant lymphoma and performed positron emission tomography (PET), which disclosed an intense accumulation of 2-deoxy-2 [F18] fluoro-D-glucose (FDG) in the liver and spleen. However, bone marrow aspiration and liver biopsy did not reveal any malignant cells. After the treatment of high-dose adrenocorticosteroids and plasma exchange, her symptoms and laboratory data, including PET findings, gradually improved. This is a rare case of severe AOSD in which an intense accumulation of FDG was detected by PET, and a differential diagnosis from malignant lymphoma may be difficult by FDG-PET alone, so that careful evaluation by techniques including histopathological examination may be necessary.


Effect of a Best-Practice Alert on the Rate of Smoking Cessation among Pregnant Women.
This study aimed to determine if a best-practice alert (BPA) implementation increases the rate of smoking cessation during pregnancy and affects pregnancy outcomes associated with smoking. This was a pretest-posttest study design where a BPA was added to electronic medical records (EMR) of pregnant persons who reported active smoking. The BPA provided the 5A's method to conduct counseling on smoking cessation. The rates of smoking cessation during pregnancy were compared 1.5 years before and after implementation of the BPA. Secondary outcomes examined whether counseling on smoking cessation was done, the number of the counseling sessions during pregnancy, and obstetric outcomes associated with maternal smoking. After implementation of the BPA, the rate of smoking cessation in pregnancy increased from 17.5% prior to BPA implementation to 54.9% after BPA implementation (p < 0.001). The rate of counseling on smoking cessation increased from 66.6% prior to BPA implementation to 95.6% after BPA implementation, with an increase noted also in the number of smoking cessation counseling sessions. In multivariate analyses, after controlling for maternal demographic and clinical factors, BPA implementation was significantly associated with higher rates of smoking cessation (adjusted odds ratio [aOR]: 3.44, 95% confidence interval [CI]: 2.17-5.51), higher rates of documented smoking cessation counseling in the EMR (aOR: 12.44, 95% CI: 6.06-25.64), and higher odds of conducting the counseling more than once (aOR: 6.90 95% CI: 4.45-10.88). The rate of smoking cessation and number of times pregnant persons were counseled increased after implementation of a BPA. The BPA could be a useful EMR tool to increase smoking cessation rates during pregnancy. · Smoking during pregnancy is a maternal and fetal concern.. · Prenatal care offers the chance to address smoking.. · BPA increases rates of smoking counseling and cessation..


Sudden infant death syndrome (SIDS) and child care centres (CCC).
Our aim was to review the risk of sudden infant death syndrome (SIDS) when infants are in child care (CC), to discuss factors potentially responsible for SIDS in this setting and to describe the impact of previous information campaigns on SIDS in CC. There is a remarkably increased risk of SIDS in CC settings. Special education focussing on a safe sleeping environment has resulted in a decrease of practices known to be associated with SIDS. However, despite a safe sleep environment SIDS prevalence remains disproportionately high. Efforts must continue to ensure safe sleeping practices in CC facilities. The possibility of other explanations for the increased prevalence of SIDS in CC settings, such as changes in infant care or stress, must be considered as well.


SB772077B (SB77) Alleviated the Aqueous Outflow Resistance Mediated by Cyclic Mechanical Stress in Perfused Human Cadaveric Eyes.
The intraocular pressure lowering property of a new rho kinase inhibitor, SB772077B (SB77) has been previously demonstrated in perfused human cadaveric eyes. In this study, the efficacy of SB77 in alleviating the aqueous outflow resistance mediated by cyclic mechanical stress in perfused human cadaveric eyes was investigated. A human anterior segment perfusion culture model was used to investigate the effect of cyclic intraocular pressure (IOP) on aqueous outflow facility in presence or absence of SB77. The status of RhoA activation and the downstream effector molecule myosin-light chain phosphorylation (p-MLC) was investigated by Western blot. Cyclic mechanical stress resulted in decrease in aqueous outflow facility (-19.79 ± 4.93%; p = 0.019) in perfused human eyes and treatment with SB77 (50 µM) significantly enhanced outflow facility by 15% (p = 0.05). The increase in outflow facility by SB77 was confirmed with the inactivation of RhoA/ROCK signaling and decreased expression of extracellular matrix markers. SB77 effectively reduced the outflow resistance mediated by cyclic IOP and thus may be a potential clinical candidate for the management of glaucoma.


Association of Sex and Race With Incident Peripheral Artery Disease Among Veterans With Normal Ankle-Brachial Indices.
Reported risk of incident peripheral artery disease (PAD) by sex and race varies significantly and has not been reported in national cohorts among individuals free of baseline PAD. To evaluate the association of sex and race, as well as prevalent cardiovascular risk factors, with limb outcomes in a national cohort of people with normal baseline ankle-brachial indices (ABIs). This cohort study was conducted using data from participants in the Veterans Affairs Birth Cohort Study (born 1945-1965), with follow-up data between January 1, 2000, and December 31, 2016. Baseline demographics were collected from 77 041 participants receiving care from the Veterans Health Administration with baseline ABIs of 0.90 to 1.40 and no history of PAD. Data were analyzed from October 2019 through September 2022. Sex, race, diabetes, and smoking status. Incident PAD, defined as subsequent ABI less than 0.90, surgical or percutaneous revascularization, or nontraumatic amputation. Of 77 041 participants with normal ABIs (73 822 [95.8%] men; mean [SD] age, 60.2 [5.9] years; 13 080 Black [18.2%] and 54 377 White [75.6%] among 71 911 participants with race and ethnicity data), there were 6692 incident PAD events over a median [IQR] of 3.9 [1.7-6.9] years. Incidence rates were lower for women than men (incidence rates [IRs] per 1000 person-years, 7.4 incidents [95% CI, 6.2-8.8 incidents] vs 19.2 incidents [95% CI, 18.7-19.6 incidents]), with a lower risk of incident PAD (adjusted hazard ratio [aHR], 0.49 [95% CI, 0.41-0.59]). IRs per 1000 person-years of incident PAD were similar for Black and White participants (18.9 incidents [95% CI, 17.9-20.1 incidents] vs 18.8 incidents [95% CI, 18.3-19.4]). Compared with White participants, Black participants had increased risk of total PAD (aHR, 1.09 [95% CI, 1.02-1.16]) and nontraumatic amputation (aHR, 1.20 [95% CI, 1.06-1.36]) but not surgical or percutaneous revascularization (aHR, 1.10 [95% CI, 0.98-1.23]) or subsequent ABI less than 0.90 (aHR, 1.04 [95% CI, 0.95-1.13]). Diabetes (aHR, 1.62 [95% CI, 1.53-1.72]) and smoking (eg, current vs never: aHR, 1.76 [95% CI, 1.64-1.89]) were associated with incident PAD. Incident PAD was rare among individuals without a history of smoking or diabetes (eg, among 632 women: IR per 1000 people-years, 2.1 incidents [95% CI, 1.0-4.5 incidents]) despite an otherwise-high-risk cardiovascular profile (eg, 527 women [83.4%] with hypertension). This study found that the risk of PAD was approximately 50% lower in women than men and less than 10% higher for Black vs White participants, while the risk of nontraumatic amputation was 20% higher among Black compared with White participants.


Raman Microspectroscopy evidence of microplastics in human semen.
The presence of microplastics (MPs) in human fluids and organs is a great concern, since, as highlighted by recent studies on animal models, they could cause alterations of several physiological functions, including reproduction. In this study, semen samples collected from men living in a polluted area of the Campania Region (Southern Italy), were analyzed to assess the presence of MPs. N. 16 pigmented microplastic fragments (ranging from 2 to 6 μm in size) with spheric or irregular shapes were found in six out of ten samples. All the detected MPs were characterized in terms of morphology (size, colour, and shape) and chemical composition by Raman Microspectroscopy. Chemical composition showed the presence of polypropylene (PP), polyethylene (PE), polyethylene terephthalate (PET), polystyrene (PS), polyvinylchloride (PVC), polycarbonate (PC), polyoxymethylene (POM) and acrylic, suggesting ingestion and/or inhalation as a route of exposure to environmental MPs. In this work, we propose for the first time a mechanism by which MPs pass into the semen most likely through the epididymis and seminal vesicles, which are the most susceptible to inflammation.


Paramorphogenic and genotoxic activity of Triton X-100 and sodium dodecyl sulphate in Aspergillus nidulans.
The genotoxic activities of Triton X-100 and sodium dodecyl sulphate in Aspergillus nidulans were assessed in order to evaluate their relative merits as paramorphogenic agents. Triton X-100 was found to be ideally suited to this purpose due to its efficient paramorphogenic effect and lack of genotoxicity. Sodium dodecyl sulphate was considered unsuitable since it reduced viability and was inconsistent in its paramorphogenic action.


Predictive DNA-testing for Huntington's disease and reproductive decision making: a European collaborative study.
This European collaborative study addresses the question whether a predictive test result for Huntington's disease (HD) has an effect on subsequent reproduction by comparing carriers and non-carriers of the Huntington mutation. A unique characteristic of this study is that this evaluation is done in persons at reproductive age who had a predictive test after the identification of the Huntington gene and who were counselled in one of the participating centres. Data were collected for 180 carriers and 271 non-carriers who received a predictive test result in the period 1993-1998 in Aberdeen, Athens, Cardiff, Leiden, Leuven, Paris or Rome. The mean age of the total study group was 31.5 years and for about half of the group the follow-up interval was 3 years or more, with a maximum of 7 years. The collaborative study clearly revealed an overall impact of the predictive test result on subsequent reproduction: 14% of the carriers had one or more subsequent pregnancies vs 28% of the non-carriers. In the total carrier group a prenatal test was carried out in about two thirds of the pregnancies and one child was born after preimplantation genetic diagnosis; artificial insemination by donor, egg cell donation or adoption were not reported. A more refined analysis was performed in the subgroup with a follow-up interval of at least 3 years and who reported 'family planning' as a motive to apply for predictive testing in the pretest period. The complexity of this motive is discussed. In this subgroup with a desire for children in the pretest period the effect of the predictive test result was more pronounced: 69% of the non-carriers had subsequent pregnancies while only 39% of the carriers who mentioned 'family planning' as one of the major reasons to apply for predictive testing had a subsequent pregnancy. Of the carriers with one or more subsequent pregnancies the percentage using prenatal diagnosis was slightly higher than the percentage not using it, although there were clear differences from one centre to another. The latter group's decisions may seem more intriguing but may be partially understood based on stage theories of health behaviour. Last, but not least, whatever option is chosen by a couple at increased risk of transmitting the Huntington mutation, it is of the utmost importance that professionals fully respect this decision and support the couple.


Canine diabetes mellitus: can old dogs teach us new tricks?
Diabetes is common in dogs, with an estimated prevalence of 0.32% in the UK. Clinical signs, as in man, include polydipsia, polyuria and weight loss, associated with hyperglycaemia and glucosuria. Diabetes typically occurs in dogs between 5 and 12 years of age, and is uncommon under 3 years of age. Breeds predisposed to diabetes include the Samoyed, Tibetan Terrier and Cairn Terrier, while others such as the Boxer and German Shepherd Dog seem less susceptible. These breed differences suggest a genetic component, and at least one dog leucocyte antigen haplotype (DLA DRB1*009, DQA1*001, DQB1*008) appears to be associated with susceptibility to diabetes. Canine diabetes can be classified into insulin deficiency diabetes (IDD), resulting from a congenital deficiency or acquired loss of pancreatic beta cells, or insulin resistance diabetes resulting mainly from hormonal antagonism of insulin function. There is no evidence for a canine equivalent of human type 2 diabetes. Adult-onset IDD, requiring insulin therapy, is the most common form, with pancreatitis and/or immune-mediated beta cell destruction considered to be the major underlying causes of the disease. Autoantibodies to insulin, recombinant canine GAD65 and/or canine islet antigen-2 have been identified in a proportion of newly diagnosed diabetic dogs, suggesting that autoimmunity is involved in the pathogenesis of disease in some patients. The late onset and slow progression of beta cell dysfunction in canine diabetes resembles latent autoimmune diabetes of the adult in man.


Improved survival of hospitalized patients with cardiac arrest due to coronary heart disease after implementation of post-cardiac arrest care: A population-based study.
Post-cardiac arrest care was implemented in 2010 and has been shown to improve the survival of patients with coronary heart disease (CHD). However, the findings varied for different survival conditions.We conducted a retrospective longitudinal study of records from 2007 to 2013 in the National Health Insurance Research Database. We evaluated the differences in short-term (2-day and 7-day) and long-term (30-day and survival to discharge) survival after the implementation of post-cardiac arrest care and among age subgroups. We reviewed inpatient datasets in accordance with the International Classification of Disease Clinical Modification, 9th revision codes (ICD-9-CM). Eligible participants were identified as those with simultaneous diagnoses of cardiac arrest (ICD-9-CM codes: 427.41 or 427.5) and CHD (ICD-9-CM codes: 410-414). Multiple logistic regression was applied to establish the relationship between calendar year and survival outcomes.The odds of 2-day survival from 2011 to 2013 were higher than those from 2007 to 2010 (adjusted odds ratio [aOR]: 1.15; 95% confidence interval [CI]: 1.03-1.29). Similarly, the odds of 7-day survival from 2011 to 2013 were higher than those from 2007 to 2010 (aOR: 1.11; 95% CI: 1.01-1.22). Improvements in the odds of 2-day and 7-day survival were discovered only in patients <65 years old. Our data reinforce that short-term survival improved after implementation of post-cardiac arrest care. However, older age seemed to nullify the influence of post-cardiac arrest care on survival.


Profile and triage validity of trauma patients triaged green: a prospective cohort study from a secondary care hospital in India.
To evaluate the profile of non-urgent patients triaged 'green', as part of a triage trial in the emergency department (ED) of a secondary care hospital in India. The secondary aim was to validate the triage trial with the South African Triage Score (SATS). Prospective cohort study. A secondary care hospital in Mumbai, India. Patients aged 18 years and above with a history of trauma defined as having any of the external causes of morbidity and mortality listed in block V01-Y36, chapter XX of the International Classification of Disease version 10 codebook, triaged green between July 2016 and November 2019. Outcome measures were mortality within 24 hours, 30 days and mistriage. We included 4135 trauma patients triaged green. The mean age of patients was 32.8 (±13.1) years, and 77% were males. The median (IQR) length of stay of admitted patients was 3 (13) days. Half the patients had a mild Injury Severity Score (3-8), with the majority of injuries being blunt (98%). Of the patients triaged green by clinicians, three-quarters (74%) were undertriaged on validating with SATS. On telephonic follow-up, two patients were reported dead whereas one died while admitted in hospital. Our study highlights the need for implementation and evaluation of training in trauma triage systems that use physiological parameters, including pulse, systolic blood pressure and Glasgow Coma Scale, for the in-hospital first responders in the EDs.


Overview of techniques to manage shoulder dystocia during vaginal birth.
Shoulder dystocia is an obstetric emergency which is unpredictable and complicates approximately 0.5-1% of vaginal births. This article discusses the risk factors and the associated fetal and maternal complications, while it is also an overview of techniques and algorithms to handle shoulder dystocia.


Extracorporeal shockwave shows regression of osteoarthritis of the knee in rats.
This study investigated the effects of extracorporeal shockwave technology (ESWT) in osteoarthritis of the knee in rats. Thirty-six Sprague-Dawley rats were randomly divided into three groups with 12 rats in each group. Group I was the control group and received neither anterior cruciate ligament transection (ACLT) nor ESWT. In groups II and III, ACLT was performed in left knee and osteoarthritis (OA) was verified at 12 wk. Group II received no ESWT, and group III received ESWT at 12 wk after ACLT. Radiographs and bone mineral density (BMD) were obtained at 0, 12, and 24 wk. The animals were sacrificed at 24 wk. One half of the animals were subjected to bone strength test, and the other half for histomorphologic examination and immunohistochemical analysis. Radiographs of the left knee showed progressive OA changes at 12 and 24 wk in group II, whereas, very subtle OA changes were noted in group I and group III. BMD and bone strength were significantly lower in group II compared with groups I and III, but no difference was noted between group I and group III. The cartilage degradations were significantly higher in group II compared with groups I and III, but no difference was noted between group I and group III. The subchondral bone remodeling was significantly less pronounced in group II compared with groups I and III, but no difference was noted between group I and group III. Application of ESWT to the subchondral bone of the medial tibia condyle showed regression of osteoarthritis of the knees in rats.