Plum-blossom needle for coronavirus disease 2019-related headache: A protocol for systematic review and meta-analysis.
Assessing the effectiveness and safety of plum-blossom needle for (COVID-19) related headache is the main purpose of this systematic review protocol. We will search the following sources for the identification of trials: The Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database (CNKI), Chinese Science and Technique Journals Database (VIP), and the Wanfang Database. The searches were limited to articles published in 2020, but no language restrictions were imposed. Only include randomised controlled trials (RCTs), with or without blinding, and participant or observer reported outcomes, will be included.The primary outcome is the time and rate of appearance of headache induced by COVID-19. The secondary outcome is the length of hospital stay. Two independent reviewers will conduct the study selection, data extraction and assessment. Review Manager Software V.5.3 will be used for the assessment of risk of bias and data synthesis. The results will provide a high-quality synthesis of current evidence for researchers in this subject area. The conclusion of our study will provide an evidence to judge whether plum-blossom needle is effective and safe for COVID-19-related headache. This protocol will not evaluate individual patient information or affect patient rights and therefore does not require ethical approval. Results from this review will be disseminated through peer-reviewed journals and conference reports. CRD42020199508.


Current-less photoreactivity catalyzed by functionalized AFM tips.
A spatially confined photocatalytic oxidation of a thin film of synthetic textile azo dye (Procion Red MX-5B) using TiO2-functionalized AFM probes is described.


Accurate and Specific Measuring Grid for Otorhinolaryngological Surgeries.
Most of the ENT surgeries (tympanoplasty, rhinoplasty, ossiculoplasty, septoplasty) involve the reconstruction and the functional correction of the respective structures involved. Success of otorhinolaryngological surgeries depends on accurate measurements and precision in judgement. There is need to develop simple tools for measurements which are easy to procure, accurate and simple to handle. Every surgeon needs unique tools to accomplish such an outcome. In order to tackle this difficulty and to ease the learning process in ENT surgeries, we have developed an accurate specific measurement grid.


Brain knowledge and predictors of neuromyths among teachers in Morocco.
The objective of this study was to evaluate brain knowledge and the prevalence of neuromyths among teachers in Morocco. We aimed also predicting factors that may improve teachers' brain knowledge and widespread of neuromyths. An online questionnaire was sent to a large population of Moroccan teachers. The questionnaire contains 32 questions, 20 of them are designed to assess teachers' knowledge about the brain and the remaining 12 questions are neuromyths. The mean score of brain knowledge was (64.34% (SD = 27.9%)) and the mean score of neuromyths was (66.56% (SD= 25.73%)). Besides, 50% of teachers were unable to correctly answer seven out of the 20 brain knowledge questions. Moreover, half of the teachers believed in 9 out of the 12 neuromyths. Knowledge about the brain was the foremost predictor of neuromyths. The study disclosed a real lack of brain knowledge with a widespread of neuromyths among teachers in Morocco.


Risk factors of severe fever with thrombocytopenia syndrome combined with central neurological complications: A five-year retrospective case-control study.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with high mortality rate, especially SFTS combined with central neurological complications. The purpose of this study was to explore risk factors of central neurological complications in SFTS patients. In this retrospective study, SFTS patients admitted to the First Affiliated Hospital of Nanjing Medical University between January 2017 and December 2021 were enrolled. Based on the presence or absence of central neurological complications, SFTS patients were divided into case group and control group. The patients' laboratory parameters and clinical data were collected for statistical analysis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the prediction accuracy of independent risk factors in identifying SFTS patients with central neurological complications. In total, 198 hospitalized SFTS patients with complete medical records, clear etiological diagnosis and clinical outcomes were enrolled in this study. Of these, 74 (37.4%) cases were diagnosed with SFTS with central neurological complications, 29 (39.2%) cases died, and no death occurred in the control group. Multivariate logistic regression analysis revealed pulmonary rales, atrial fibrillation, and high serum SFTSV RNA, lactate dehydrogenase level during the fever stage as independent risk factors for the development of central neurological complications in SFTS patients. ROC curve analysis showed that the area under the ROC curve (AUC) of serum SFTSV RNA and lactate dehydrogenase levels were 0.748 (95%CI: 0.673-0.823, p < 0.001) and 0.864 (95%CI: 0.815-0.914, p < 0.001), respectively, in central neurological complications predicted in SFTS patients. Severe fever with thrombocytopenia syndrome (SFTS) combined with central neurological complications has high morbidity and mortality and diverse clinical manifestations. Early monitoring of lung signs, electrocardiogram, blood SFTSV RNA, and lactate dehydrogenase levels in SFTS patients may be useful in predicting the occurrence of central neurological complications.


The initial evaluation of the patient with multiple injuries.
The management of trauma patients requires organization and the cooperation of trained health personnel, beginning at the site of injury and continuing until the patient is discharged from the hospital. Treatment guidelines and priorities must be well outlined in advance to provide optimal care and minimize delay prior to definitive therapy. Resuscitation and treatment must begin immediately and simultaneously following well established principles. These guidelines and the general care of the patient with multiple trauma are discussed in this article.


Energy and economic dataset of the worldwide optimal photovoltaic-wind hybrid renewable energy systems.
The data describe supplementary materials supporting the research article entitled "Worldwide geographical mapping and optimization of stand-alone and grid-connected hybrid renewable system techno-economic performance across Köppen-Geiger climates" (Mazzeo et al., 2020). Hybrid renewable energy systems are increasingly adopted worldwide as technically and economically effective solutions to achieve energy decarbonization and greenhouse gas reduction targets. This data article includes the results of worldwide techno-economic optimization of stand-alone and grid-connected photovoltaic-wind hybrid renewable energy systems designed to meet the electrical energy needs of an office district. The technical simulations have been performed in TRNSYS 17 (Transient Energy System) environment. A total of 48 different locations around the world have been chosen across Köppen-Geiger climates with different latitudes and homogeneously distributed over the whole globe, considering very different climates. The analyses have been conducted for 343 different system power configurations, considering both stand-alone and grid-connected systems. A total of 16464 dynamic simulations were performed, summarized in yearly energy output from each component and in energy and economic indicators.


Mechanisms of multifocal breast cancer: an immunocytochemical study.
The issue of whether multifocal breast cancer represents intramammary spread from a single primary tumor or multiple synchronous tumors remains unresolved. We have used a series of immunocytochemical markers, B72.3, DF3, c-erbB-2, SP-1, CEA, and p53, to attempt to answer this question. Of 24 cases with separate discrete synchronous tumors in the same breast, 10 were histologically and immunocytochemically identical, five were histologically similar but immunocytochemically different, two were histologically different but immunocytochemically identical, and in seven cases the tumors were different both histologically and immunocytochemically. In seven of the 24 cases lymph nodes containing metastatic tumor were also available; in each instance, the immunoreactivity of the metastasis was similar to one or other of the tumors in the breast. This study indicates that multifocal breast cancer may result from either intramammary spread from a single primary tumor or multiple synchronous primary tumors.


Analysis of the guinea-pig estrogen-regulated gec1/GABARAPL1 gene promoter and identification of a functional ERE in the first exon.
The gec1/GABARAPL1 (GABA(A)-receptor-associated protein like-1) gene has been identified as an early estrogen-regulated gene in guinea-pig cultured endometrial glandular epithelial cells (GEC). Guinea-pig and human gec1/GABARAPL1 proteins share 87% identity with GABARAP, which acts as a protein linker between microtubules and the GABA(A) receptor. To investigate the molecular mechanisms regulating gec1/GABARAPL1 gene expression, the 1.5-kbp region upstream of the translation initiation codon of the guinea-pig gec1/GABARAPL1 gene was cloned. A 300-bp fragment encompassing a pyrimidine-rich initiator element (INR) and the transcription start site (+1) was sufficient to initiate transcription. Transfection and gel shift experiments showed that a sequence located at +36/+50 in the first exon permitted induction of expression of this gene by estradiol acting via ERalpha. This sequence (GGGTCAACGTGACGT) differs only by one base pair from the consensus estrogen response element ERE (GGGTCAACGTGACCT). It can be concluded that the ERE located in the first exon encoding the 5'-untranslated region is sufficient for E2 activation of gec1/GABARAPL1 transcription.


Immunological identification of soluble carbonyl reductase with testosterone 17 beta-dehydrogenase (NADP+) in guinea pig liver and kidney.
Antiserum was produced against one of two carbonyl reductases purified from guinea pig liver cytosol to identify the enzymes as testosterone 17 beta-dehydrogenase isozymes. Immunoelectrophoresis and immunoprecipitation with the antiserum indicated that the two reductases had common antigenic sites. The antiserum inhibited most of both carbonyl reductase and testosterone 17 beta-dehydrogenase activities in the purified reductases and in cytosols of liver and kidney.


3D Raman imaging of systemic endothelial dysfunction in the murine model of metastatic breast cancer.
It was recently reported in the murine model of metastatic breast cancer (4T1) that tumor progression and development of metastasis is associated with systemic endothelial dysfunction characterized by impaired nitric oxide (NO) production. Using Raman 3D confocal imaging with the analysis of the individual layers of the vascular wall combined with AFM endothelial surface imaging, we demonstrated that metastasis-induced systemic endothelial dysfunction resulted in distinct chemical changes in the endothelium of the aorta. These changes, manifested as a significant increase in the protein content (18%) and a slight decrease in the lipid content (4%), were limited to the endothelium and did not occur in the deeper layers of the vascular wall. The altered lipid to protein ratio in the endothelium, although more pronounced in the fixed vascular wall, was also observed in the freshly isolated unfixed vascular wall samples in the aqueous environment (12 and 7% change of protein and lipid content, respectively). Our results support the finding that the metastasis induces systemic endothelial dysfunction that may contribute to cancer progression.


Methotrexate for abortion at < or = 42 days gestation.
Methotrexate is cytotoxic to trophoblast and, in low doses, has minimal side effects. It is used to treat gestational trophoblastic neoplasia and ectopic pregnancy and has recently been shown to have similar effects on intrauterine trophoblast. A prior study suggested that methotrexate may successfully cause abortion of an early pregnancy without prostaglandin. To test this hypothesis, ten pregnant women at < or = 42 days gestation were treated with methotrexate 50 mg/m2 intramuscularly. Vaginal bleeding started 24 +/- 10 (mean +/- standard deviation) days after the injection and lasted 10 +/- 3 days. Methotrexate side effects occurred in 4 patients and were limited to the first 4 days after the injection. Methotrexate alone appears sufficient to abort a very early intrauterine pregnancy.


Determinants of Virologic Failure Among Adults on Second Line Antiretroviral Therapy in Wollo, Amhara Regional State, Northeast Ethiopia.
Treatment failure among the population on second line antiretroviral therapy is a major public health threat. In Ethiopia there has been limited research done on second line treatment failure. To identify determinants of virologic failure among adults on second line antiretroviral therapy in six public hospitals of Wollo, Amhara regional state, northeast Ethiopia. An institution-based unmatched case-control study was conducted from February 1, 2020 to April 30, 2020 on a total of 377 clients in six public hospitals of Wollo, Amhara regional state, northeast Ethiopia. Clients whose viral load result >1,000 copies/mL in two consecutive results at least 3 month apart were cases, while ≤1,000 copies/mL were controls. The sample size was calculated by using Epi-Info version 7. Cases (94) and controls (283) were selected using a simple random sampling method in a ratio of cases-to-controls of 1:3. The model fitted and binary logistic assumptions were fulfilled with 95% confidence level and P-values<0.05 were taken as statistically significant. Virologic failure was predicted by poor adherence (AOR=6.060, 95% CI=2.837-12.944), not disclosing their HIV status (AOR=4.178, 95% CI=1.431-12.198), OI (AOR=4.11, 95% CI=1.827-9.246), CD4 count <100 cells/mm3 (AOR=3.497, 95% CI=1.233-9.923) and 100-350 cells/mm3 (AOR=5.442, 95% CI=2.191-13.513), low BMI <16 kg/m2 (AOR=7.223, 95% CI=2.218-23.520), and young age 15-29 years (AOR=2.898, 95% CI=1.171-7.170). Determinants of second line ART virologic failure were patients who had poor adherence to ART, not disclosed, opportunistic infection, low CD4 counts <350 cell/mm3, low BMI (<16 kg/m2), and young age 15-29 year patients. Social support, disclosing their HIV status, and getting early treatment for any opportunistic infection is crucial to patients.


Economic evaluation of flap fixation techniques after mastectomy: Results of a double-blind randomized controlled trial (SAM-trial).
An economic evaluation was performed alongside an RCT investigating flap fixation in reducing seroma formation after mastectomy. The evaluation focused on the first year following mastectomy and assessed cost-effectiveness from a health care and societal perspective. The economic evaluation was conducted between 2014 and 2018 in four Dutch breast clinics. Patients with an indication for mastectomy or modified radical mastectomy were randomly assigned to: conventional closure (CON), flap fixation with sutures (FFS) or flap fixation with tissue glue (FFG). Health care costs, patient and family costs and costs due to productivity losses were assessed. Outcomes were expressed in incremental cost-effectiveness ratios (ICERs): the incremental cost per quality-adjusted life year (QALY). Bootstrapping techniques, sensitivity and secondary analyses were employed to address uncertainty. The FFS-group yielded most QALYs (0.810; 95%-CI 0.755-0.856), but also incurred the highest mean costs at twelve months (€10.416; 95%-CI 8.231-12.930). CON was the next best alternative with 0.794 QALYs (95%-CI 0.733-0.841) and mean annual costs of €10.051 (95%-CI 8.255-12.044). FFG incurred fewer QALYs and higher costs, when compared to the CON group. The ICER of FFS compared to CON was €22.813/QALY. Applying a willingness to pay threshold in the Netherlands of €20.000/QALY, the probability that FFS was cost-effective was 42%, compared to 37% and 21% for CON and FFG, respectively. The cost-effectiveness of FFS following mastectomy, versus CON and FFG, is uncertain from a societal perspective. Yet, from a health care and hospital perspective FFS is likely to be the most cost-effective intervention.


Organizational identification and commitment: correlates of sense of belonging and affective commitment.
The general purpose of this work is to analyze the overlap between organizational identification and commitment. Specifically, our study focuses on the analysis of the differences and similarities between sense of belonging (a dimension of organizational identification) and affective commitment (a dimension of organizational commitment). In order to do this, we analyzed their discriminant validity and raised their relationship with variables that previous research had showed like precedent and subsequent variables of them: value congruence, perceived support, organizational citizenship behavior, and intention to continue in the organization. A total of 292 people at one organization completed surveys measuring the variables previously described. The results showed that sense of belonging and affective commitment are different concepts and they have different relationships with relation to precedent and subsequent variables. Affective commitment seems to be more useful than sense of belonging to predict organizational citizenship behavior aimed at the organization and intention to continue. Some practical implications are described.


Outcome of second-line treatment after first-line chemotherapy with the GONO FOLFOXIRI regimen.
FOLFOXIRI demonstrated higher efficacy compared to 5-fluorouracil, leucovorin, irinotecan (FOLFIRI) as first-line treatment of metastatic colorectal cancer. We evaluated the outcome of second-line treatments among 196 patients treated with first-line FOLFOXIRI in three consecutive trials conducted by the Gruppo Oncologico Nord Ovest group. One hundred seventy-two of 196 patients so far progressed and 136 (79%) received second-line therapies: 32 (24%) were rechallenged with FOLFOXIRI, 52 (38%) were treated with irinotecan- or oxaliplatin-based doublets, and 52 (38%) received fluoropyrimidine plus mytomicin C or single-agent chemotherapy. Only 10 patients received bevacizumab (3) or cetuximab (7) with chemotherapy. Activity and efficacy data were collected and subgroup analyses were performed according to the regimen administered. Overall response rate (RR) was 23%; median progression-free survival (PFS) and overall survival (OS) were 5.9 and 13.2 months, respectively. At an exploratory subgroup analysis, retreatment with FOLFOXIRI was associated with longer PFS (8.2 versus 6.3 months; P = .003, hazard ratio [HR] = 0.61) and OS (19.3 versus 14.0 months; P = .02, HR = 0.57) compared with doublets; single-agent chemotherapy or fluoropyrimidine plus mytomicin C was significantly lower in terms of RR (8%), PFS (3.0 months), and OS (8.7 months) compared with FOLFOXIRI or doublets. First-line FOLFOXIRI does not impair the efficacy of second-line treatments. In some patients rechallenge with FOLFOXIRI may represent a valid option, although potential imbalances in prognostic factors due to better patient selection should be considered.


Delirium in the acute phase after stroke and the role of the apolipoprotein E gene.
To study the association between the epsilon 4 allele of apolipoprotein E (APOEε4) and delirium in a stroke population. 527 consecutive stroke patients were screened for delirium during the first week of admission with the confusion assessment method. In three hundred fifty-three patients genomic DNA isolation was available. The incidence of delirium after stroke in the 353 patients was 11.3%. There was no association between APOEε4 and delirium. Even after adjustment for IQCODE, stroke localization, stroke subtype, stroke severity, infection, and brain atrophy no association was found (odds ratio: 0.9; 95% confidence interval: 0.4-2.1). Delirium did not last longer in patients with an APOEε4 allele compared to patients without an APOEε4 allele (median: 5.6 days [range: 1-21] versus median: 4.6 days [range: 1-15], p = 0.5). There was no association between the presence of an APOEε4 allele and the occurrence of delirium in the acute phase after stroke.


Modeling the effect of light and salinity on viable but non-culturable (VBNC) Enterococcus.
Enterococci have been recommended as suitable bacteria indicators for assessing the microbial quality of recreational waters. However, recent studies have shown that bacteria, including enterococci, are able to enter a viable but non-culturable (VBNC) state under environmentally stressed conditions, where they may remain undetected if culture-based methods are employed. To appreciate the extent of transformation of these cells in surface waters, a model Enterococcus organism, E. faecalis, was examined in laboratory controlled microcosms under different light and salinity conditions. Cells were detected by both standard culture-based and PMA-qPCR (propidium monoazide quantitative PCR) methods so that the VBNC cells could be enumerated. The decay rates from the culture based method (kc) and PMA-qPCR method (kp) were established for the different conditions. In general, the kC values (ranging from 0.0088 hr(-1) to 0.9755 hr(-1)) were always higher than the kP values (0.0019 hr(-1) to 0.2373 hr(-1)), implying that cells were able to retain their viability for much longer periods than what is shown by the culture-based method. In both cases, the k values generally showed an increasing trend with an increase in light irradiation, implying greater die-off with light. For freshwater microcosms, the kp values were 3-6 times lower than the kc values for different irradiation conditions, whereas for seawater the difference was up to 12 times, showing that E. faecalis adapts well to seawater. The kinetic data were used to develop models to describe the dynamics of VBNC formation in natural waters. At low light intensities (less than about 20 Wm(-2)), the proportion of VBNC cells was found to steadily increase to as high as 50%, even after 4 days. However, at higher light levels, this proportion was achieved more quickly (less than 5 h) but also diminished more rapidly. Hence, at high light levels, the percentage of VBNC cells is expected to be significant only for a few hours, whereas at low light levels, the VBNC cells can be expected to be present for a long period of time. These results have implications on the interpretation of microbial water quality data that are based on culture based methods.


Outcome of combined stenotic and regurgitant aortic valve disease.
This study sought to describe the natural history of combined stenotic and regurgitant aortic valve disease. Data on outcome and prognostic factors in combined aortic valve disease are scarce. This study prospectively followed 71 consecutive asymptomatic patients (21 women, age 52 ± 17 years) with at least moderate aortic stenosis in combination with at least moderate aortic regurgitation and preserved left ventricular function (ejection fraction ≥55%). During a median potential follow-up of 8.9 years, 50 patients developed an indication for aortic valve replacement and no cardiac deaths were observed. Overall event rates were high with an event-free survival for the entire patient population of 82 ± 5%, 62 ± 6%, 49 ± 6%, 33 ± 6%, and 19 ± 5% at 1, 2, 3, 4, and 6 years, respectively. There was 1 operative and no post-operative deaths. Peak aortic jet velocity (AV-Vel) independently predicted event-free survival. Patients with an AV-Vel between 3 and 3.9 m/s had an event-free survival of 94 ± 4%, 88 ± 6%, 65 ± 9%, and 51 ± 9% after 1, 2, 4, and 6 years, respectively, compared with 92 ± 4%, 67 ± 7%, 38 ± 8%, and 12 ± 6% for patients with an AV-Vel between 4 and 4.9 m/s and 67 ± 8%, 39 ± 10%, 17 ± 9%, and 0% for patients with an AV-Vel ≥5 m/s (p < 0.0001). Asymptomatic patients with combined aortic valve disease can be safely followed until surgical criteria defined for aortic stenosis, aortic regurgitation, or the aorta are reached. However, high event rates can be expected even in younger patients and those with only moderate disease. AV-Vel, which reflects both stenosis and regurgitant severity, provides an objective and easily assessable predictive parameter.


Limited proteolysis and active-site studies of the first multienzyme component of the erythromycin-producing polyketide synthase.
The domain structure of the 6-deoxyerythronolide B synthase 1 component of the erythromycin-producing polyketide synthase from Saccharopolyspora erythraea has been investigated using limited proteolysis and active-site labeling. Trypsin, elastase, endoproteinase Glu-C, and endoproteinase Arg-C were used to cleave the multienzyme, and the sizes of the resulting fragments were assessed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The location of fragments within the primary structure was established by N-terminal sequence analysis. The cleavage pattern followed domain boundaries previously predicted on the basis of sequence alignments, but many predicted interdomain regions were not cleaved, even under the harshest conditions used. Initial proteolysis generated three large fragments: an N-terminal fragment (about 60 kDa) housing an acyltransferase-acyl carrier protein di-domain; a central fragment (about 90 kDa) containing a ketosynthase-acyltransferase di-domain; and a C-terminal fragment (about 220 kDa) containing the remaining six domains of the multienzyme, including the third acyltransferase. The intact multienzyme behaves as a dimer of molecular mass 660 kDa on gel filtration; and the C-terminal fragment remains dimeric. However, the N-terminal and central fragments appear to be monomeric species. After proteolysis of the multienzyme, the N-terminal di-domain was found to be specifically labeled after incubation with [14C]propionyl-CoA, providing the first evidence for its proposed role as a "loading domain" for the propionate starter unit. In contrast, the other two fragments were specifically acylated by [14C]methylmalonyl-CoA, indicating that both the other two acyltransferases remain enzymatically active after proteolysis.


Association between decreased serum parathyroid hormone after total thyroidectomy and persistent hypoparathyroidism.
Postoperative hypocalcemia caused by hypoparathyroidism is one of the most common morbidities of total thyroidectomy. The aim of this study was to analyze the kinetics and factors affecting PTH levels after total thyroidectomy and central neck dissection (CND). We performed a retrospective study in 438 consecutive patients who underwent total thyroidectomy between January 2007 and December 2010. No patient had a history of thyroid or neck surgery. PTH and calcium levels were recorded 1 day before the operation, during the first 5 days, and during follow-up (2 weeks and 2, 6, and 12 months). PTH levels declined to 41.90% of its initial value on the first day after the operation. After surgery, PTH was correlated positively with calcium and inversely with phosphate levels from postoperative day 1 to 14. Based on clinical observation, using a PTH threshold of <7 ng/L on postoperative day 1 was predictive of persistent hypoparathyroidism, with sensitivity and negative predictive value 100%, but poor specificity (70.19%). CND increased the risk of transient hypoparathyroidism compared with total thyroidectomy alone. Patients with thyroiditis had an increased risk of permanent hypoparathyroidism compared with those without thyroiditis. Iatrogenic removal of the parathyroid glands increased the risk of permanent hypoparathyroidism compared with those without iatrogenic parathyroidectomy. PTH declined on the first day after thyroidectomy. PTH levels <7 ng/L on the first day after surgery might be associated with persistent hypoparathyroidism. CND, thyroiditis, and iatrogenic parathyroidectomy increased the risk of hypoparathyroidism.


Etiology and pathogenesis of acute pancreatitis.
Recent studies probing the pathogenesis of biliary pancreatitis using models in experimental animals are reviewed. These studies have suggested that the earliest changes in pancreatitis involve acinar cells. These changes result in intra-acinar cell activation of digestive enzyme zymogens. Synthesis of digestive enzyme zymogens is not altered during the early stages of pancreatitis but secretion from acinar cells is blocked and digestive enzyme zymogens become colocalized with lysosomal hydrolases within intracellular vacuoles. Presumably, those vacuoles are the site of zymogen activation--a process which may be mediated by lysosomal hydrolases. The relationship between biliary tract stone passage and the onset of pancreatitis is complex but the evidence presented suggests that pancreatic duct obstruction and not bile reflux into the pancreatic duct is sufficient to trigger acute pancreatitis.


Prosthetic heart valve thrombosis: pathogenesis, diagnosis and management.
Thrombosis of a prosthetic valve is one of the most severe complications of cardiac valve replacement. The incidence is 0.5% in the aortic and mitral positions and up to 20% in the tricuspid position. The presenting clinical picture ranges from the absence of symptoms to cardiogenic shock. The traditional treatment of this complication has been emergency surgery, but thrombolysis, which has been available for many years, is being considered as the first line of treatment more and more every day. The pathogenesis, diagnosis and treatment of thrombosis of prosthetic heart valves are reviewed here. Thrombolysis, which has an efficacy of over 80%, is emphasized in this review. Embolic complications associated with this therapeutic approach remain a great concern with rates of 3% to 10%, and some authors reporting rates up to 20%.


Lupron depot (leuprolide acetate for depot suspension) in the treatment of endometriosis: a randomized, placebo-controlled, double-blind study. Lupron Study Group.
The safety and efficacy of leuprolide acetate (LA) for depot suspension (Lupron depot; TAP Pharmaceuticals, North Chicago, IL), 3.75 mg versus placebo, in the treatment of pain associated with endometriosis was assessed in a randomized, double-blind, multicenter study involving 52 patients. Dysmenorrhea, pelvic pain, and pelvic tenderness all responded significantly to LA treatment in comparison with placebo. Menses were suppressed in all of the LA patients. Estradiol decreased significantly to menopausal levels in the LA group. There were small to moderate changes in a variety of laboratory parameters, but these were not clinically significant. The most common adverse event was vasodilatation, occurring significantly more frequently in the LA group. Lupron depot was shown to be safe and effective in inducing a hormonal and menstrual suppression in patients with endometriosis, resulting in alleviation of pain symptoms.


Can patients with psychological distress achieve comparable functional outcomes and satisfaction after hallux valgus surgery? A 2-year follow-up study.
This study assessed the influence of preoperative mental health on functional outcomes and satisfaction, and the change in mental health after hallux valgus surgery. 383 patients who underwent scarf osteotomy were analyzed. Visual analogue scale (VAS), American Orthopaedic Foot & Ankle Society score (AOFAS) and SF-36 were assessed at 6 months and 2 years. The cohort was stratified into patients with and without psychological distress (i.e. SF-36 Mental Component Summary [MCS] <50 vs ≥50). After adjusting for demographics and baseline scores, VAS and AOFAS were poorer in the distressed group at 6 months. However, there was no difference in scores at 2 years and a similar proportion of patients were satisfied. SF-36 MCS in distressed patients significantly improved, but remained lower compared to non-distressed patients at follow-up. Patients with psychological distress undergoing hallux valgus surgery had poorer short-term outcomes, but these differences resolved at 2 years.


Neural regeneration ability of Polypyrrole-Collagen-Quercetin composite in the spinal cord injury.
Spinal cord injury (SCI) is a major clinical problem in young patients. The major hurdle in SCI regeneration is the replacement of lost nerve communication signals due to injury. Here we have prepared a biocompatible electrical conductive composite such as Collagen-Polypyrrole combined with Quercetin (Col-PPy-Qur) composite. The prepared composites are characterized for their chemical functionality and morphology by the FTIR and SEM & TEM analysis, respectively. The Col-PPy-Qur composite observed electrical conductivity at 0.0653 s/cm due to the conductive Polypyrrole polymer present in the composite. The Col-PPy-Qur composite exhibits a mechanical strength of 0.1281 mPa, similar to the native human spinal cord's mechanical strength. In order to explore the regeneration potential, the viability of the composite has been tested with human astrocyte cells (HACs). The Tuj1 and GFAF marker expression was quantized by RT-PCR analysis. Increased Tuj1 and decreased GFAF expression by the Col-PPy-Qur composite indicated the potential differentiation ability of the HACs into neuron cells. The results indicated that the Col-PPy-Qur composite could have good regeneration and differentiation ability, better biocompatibility, and suitable mechanical and conductivity properties. It can act as an excellent strategy for spinal cord regeneration in the nearer future.


Test-Retest Reliability and Construct Validity of the Brief Dark Triad Measurements.
Despite the widespread use of the Dirty Dozen (DD) and Short Dark Triad (SD3) as inventories for antagonist personality constructs, appropriately powered studies on their test-retest reliability (rtt) are lacking. We report the 12-day rtt-s of the DD and SD3 scales. Leveraging the test-retest data, we also calculated their convergent and discriminant correlations while controlling for measurement error. Median rtt-s were .87 and .90 (N = 500) for the DD and SD3 scales, respectively, substantially higher than their internal consistencies. Convergent correlations were .77, .63 and .64 for Machiavellianism, Narcissism and Psychopathy, respectively. Discriminant correlations between the Machiavellianism and Psychopathy scales had a median of .65, pointing to their being effectively indistinguishable traits in the SD3 and DD. The DD and SD3 items had median rtt-s of .69 and .71, respectively. We emphasize the importance of the rtt for scale development and validation.


Detection of the human papilloma virus type 16 mRNA-transcripts in cytological abnormal scrapings.
The RNA-polymerase chain reaction (PCR) was carried out on cervical scrapings to detect and analyze transcripts from the E6-E7 open reading frames (ORF) of human papilloma virus type 16 (HPV16). The method, described previously for cervical squamous carcinomas and cervical intraepithelial neoplasias, was adapted to cervical scrapings. A primer set and two different probes specific for the E6-E7 ORFs were selected. One of the probes was able to detect the amplification products from the full length, the major, and the minor transcripts whereas the other was specific for the major transcript only. To check the quality of the mRNA in the cervical scrapings, a primer set and a probe specific for the human keratin mRNA were selected. A group of 17 abnormal cytological cervical scrapes, which were positive for HPV16 DNA, was analyzed. In this group the human papilloma virus was not always transcriptionally active, as HPV16 mRNA transcripts were detected only in about one-half (8/17) of the samples. These findings suggest that the RNA-PCR method on cervical scrapings may be very useful for epidemiological studies on the role of transcriptionally active/inactive HPV16 genes in the pathogenesis of an HPV16 infected lesion.


The mismatch repair gene hPMS1 (human postmeiotic segregation1) is down regulated in oral squamous cell carcinoma.
Genomic instability or microsatellite instability (MSI) was initially recognized in colonic carcinoma and subsequently in other tumors. MSI has been associated with mutations in genes that play a role in DNA replication and repair. In a previous study we detected MSI in 85% of young patients with OSCC and excluded the involvement of MMR genes hMLH1 and hMSH2. In the present study, we screened the mutation and expression status of the MMR genes hMSH3, hMSH6, hPMS1 and hPMS2 in OSCC and found expression of the hPMS1 protein to be down regulated. Genomic analysis of hPMS1 did not show any mutational changes in exonic or promoter regions. Expression of hPMS1 mRNA was not deregulated in either MSI positive or MSI negative tumor cell lines by Northern blot analysis. In contrast, analysis by Western blot showed that 100% of MSI positive tumor cell lines had decreased or no expression of hPMS1 while MSI negative cell lines had normal protein expression. Our data indicate that hPMS1 is most likely deregulated by post-transcriptional modification in OSCC while hMLH1 and hPMS2 has no detectable changes. Furthermore, our results are consistent with the hypothesis that hPMS1 is associated with MSI in OSCC.


Modified hepatoduodenal ligamentectomy for advanced carcinoma of the biliary tract: the importance of preservation of the replaced left hepatic artery.
Hepatoduodenal ligamentectomy (ligamentectomy) is the ultimate surgery for biliary tract carcinoma involving perioperative difficulties such as total hepatic ischemia during revascularization of the hepatic artery and the portal vein, patency of the reconstructed hepatic artery, and high incidence of related operative mortality. In the present study, modified ligamentectomies with extended right hepatic lobectomy, including resection of the caudate lobe, were performed on three patients with advanced biliary tract carcinoma in whom the left hepatic artery had been replaced and the original artery was preserved. In all patients, postoperative courses were uneventful: success of the resection was confirmed by histological examination. This procedure enabled en bloc resection of hepatoduodenal ligament with positive cancer invasion to take place. It was carried out safely without concern for the difficulties described above. In our view, ligamentectomy should be performed in all such cases.


Barnacle hypersensitivity.
the aim of the present study is to investigate the responsible mechanism of different adverse reactions suffered by five patients, aged between six and thirty years-old, after consumption of barnacle. The symptoms were angioedema, dyspnea, generalized urticaria, conjunctivitis and one of them suffered from anaphylactic reaction. Four patients had personal atopic history. the allergic study included prick by prick test with raw and boiled barnacle and prick-test with a standardized battery of shellfish and neumoallergens, specific-IgE determination to barnacle, crustacean and house-dust-mite and SDS-PAGE immunoblotting to barnacle. Even though an oral challenge was proposed to three of the patients, they were reluctant to do the test and eventually the challenges were not carried out. prick to prick tests were positive to barnacle for all of them. Specific-IgE was found in four patients. The western blotting results showed an IgE-binding band whose apparent molecular mass ranged between 58 and 68 kDa. barnacle could induce IgE-mediated adverse reaction. Our study has demonstrated the presence of an IgE-binding protein in barnacle extracts ranged between 58 and 68 kDa of molecular mass. It has not been previously described a crustacean allergen with the same molecular mass, so it could be a specific allergen from barnacle. We believe that further study will confirm this is the case.


Prevalence and Risk Factors for Symptomatic Dry Eye Disease Based on McMonnies Questionnaire Among Medical Students, Saudi Arabia; a Cross-Sectional Study.
Dry eye disease (DED) is a common ocular problem that worsens patients' quality of life. This study aimed to assess DED prevalence and risk factors among medical students at the University of Tabuk. This is an analytical, cross-sectional, survey-based study. An online questionnaire was distributed by email to all medical students at the University of Tabuk. A self-administered McMonnies questionnaire was used in the assessment. We included 247 medical students who completed the questionnaire. Most participants were females (71.3%) and were <25 years old (85.8%). DED prevalence rate was 18.2% (95% CI=13.61% to 23.61%). Furthermore, DED was found to be significantly associated with the presence of irritation of eyes when waking up from sleep (OR=19.315), sleeping with partially opened eyes (OR=19.105), redness and irritation of the eyes when swimming in chlorinated fresh water (OR=7.863), and having prescription eyedrops or other dry eye treatments (OR=3.083). Our study at the University of Tabuk found that 18.2% of medical students had dry eye disease and identified the associated risk factors. Early diagnosis and treatment are crucial to prevent complications due to the high prevalence of DED.


Decreased gene expression of insulin signaling genes in insulin sensitive tissues of obese cats.
Type 2 diabetes mellitus (DM) animal models have provided ample opportunity for investigating pathogenesis, as well as to evaluate novel treatment and prevention options for the disease. Because the domestic cat shares a similar environment with humans, it is also confronted with many similar risk factors for diabetes, such as physical inactivity and obesity. Obesity is a significant risk factor for diabetes in cats, and as such, the domestic cat may serve as an ideal model for investigating obesity induced insulin resistance. This study determined changes in insulin signaling genes within insulin sensitive tissues of obese felines. Quantitative RT-PCR was performed to determine mRNA levels of three important insulin signaling genes which have been implicated with insulin resistance: insulin receptor substrate (IRS)-1, IRS-2, and phosphatidylinositol 3'-kinase (PI3-K) p85alpha. Obese cats had significantly lower IRS-2 and PI3-K p85alpha mRNA levels in liver and skeletal muscle as compared to control cats. This down regulation of insulin signaling genes in obese cats mirrors that of obese humans and rodents suffering from insulin resistance. Interestingly, preprandial blood tests indicated that our obese cats were no different from control cats with regards to glucose tolerance and insulin resistance, thus indicating that the obese cats used in our study had a moderate level of obesity. Therefore, insulin signaling gene alterations were occurring in insulin sensitive tissues of moderately obese felines before glucose intolerance was clinically evident. As such, the monitoring of key insulin signaling genes may have some important diagnostic value to determine the risk level and degree of obesity induced insulin resistance.


Expression of adrenocortical steroidogenic acute regulatory (StAR) protein is influenced by chromaffin cells.
Cell-cell interactions are crucial role for the proper functioning of endocrine glands. We recently demonstrated that interactions of chromaffin and cortical cells are important for adrenocortical steroidogenesis. However, the molecular mechanisms have not been elucidated and it is unclear if this involves acute and/or chronic processes. By Northern analysis and the quantitative technique of TaqMan PCR we investigated whether chromaffin cells influence the regulation of StAR and the peripheral benzodiazepine receptor (PBR), both required for the rate-limiting step, the delivery of cholesterol to the inner mitochondrial membrane. StAR mRNA levels in bovine adrenocortical cells were increased by incubation with chromaffin cell-conditioned medium (CCM). Short-term treatment for 4 h resulted in a greater stimulation (229+/-29% of basal, mean+/-SEM) than did longer incubation times of 8 h and 5 days (159+/-13 and 177+/-24%). Neither short nor a long-term treatment affected PBR expression. Consistently, the major secretion of chromaffin cells, epinephrine dose-dependently stimulated StAR expression with no effect on PBR mRNA. In conclusion, adrenomedullary secretory products are not necessary for the maintenance of PBR expression but facilitate steroid biosynthesis by increasing StAR mRNA expression and therefore can account for an ACTH-independent regulation of the rate-limiting step in steroidogenesis.


[Inhibition of ER alpha-mannosidase expression causes reduction and shortening of microvilli on rat liver epithelial cell WB-F344].
To study the effect of N-glycosylation on the modification of microvilli on the surface of rat liver epithelial cell WB-F344 and the growth of the cells in culture. Recombinant adeno-associated virus (rAAV) expression vector pAGX (+) containing an antisense or a sense fragment of 6A8 cDNA encoding a human alpha-mannosidase was constructed. The recombinant vectors or the mock were transfected into WB-F344 cells by means of lipofectAmine. The transfected cells were selected in G418 medium and cloned by means of limiting dilution. Integration of the transfected DNA into host DNA was detected by neo PCR. Rat liver ER alpha-mannosidase activity in cell supernatant was measured by using P-nitrophenyl-alpha-D-mannopyranoside as a substrate. Microvilli on cell surface were observed upon a scan electron microscope. The growth curves of the cells in culture were drawn. The cell clones transfected with antisense 6A8 showed reduction of ER alpha-mannosidase activity with various degrees. Clone AS1 and AS2 cell showed a pronounced reduction of the enzymatic activity. In the study on AS1 cells, Con A binding to the cells was found to be enhanced, cell growth in culture became slow from day 5. The microvilli on the cells were reduced and blunted. Transfection with antisense 6A8 resulted in reduction and blunting of microvilli on the surface of growing WB-F344 cells, which might be related to N-glycosylation modification.


Haematopoietic stem cell transplantation for thalassaemia major in Hong Kong: prognostic factors and outcome.
From August 1992 to August 1999, 44 patients received allogeneic haematopoietic stem cell transplantation in a single institution. The donors were HLA-identical siblings except for one who was a phenotypically matched father. Thirty-eight patients received bone marrow stem cells and the others received peripheral blood stem cells or umbilical cord blood (UCB). The mean age at transplant was 10.7+/-5.1 years, ranging from 1.8 to 21 years. Patients received busulphan (16 mg/kg) and cyclophosphamide (150 to 200 mg/kg) as conditioning, and antithymocyte globulin was given to 42 patients to prevent graft rejection. All had engraftment except a patient who received a UCB transplant. Four patients died from early treatment-related mortality, and one died from interstitial pneumonitis 3 months after transplant. Two patients developed secondary graft rejection and both received a second transplant. Thirty-eight patients survived and all except one were transfusion independent. The 5-year overall and event-free survival rates were 86% and 82%, respectively. By multivariate stepwise Cox proportional hazard analyses, severe veno-occlusive disease (VOD) of liver and Pesaro class 3 features were the significant factors associated with survival. Patients aged more than 11 years were more inclined to develop VOD. In conclusion, haematopoietic stem cell transplantation should be performed early if an HLA identical sibling is available.


Revised phylogeny of Bacteroidetes and proposal of sixteen new taxa and two new combinations including Rhodothermaeota phyl. nov.
Members of the phylum Bacteroidetes, which was originally defined as a monophyletic branch encompassing the genera Cytophaga, Flavobacterium and Bacteroides (CFB), are widely studied due to their importance in environmental and gut microbiology. As a consequence, the number of species names with standing in nomenclature has doubled in the past five years. In this study, a revision of an earlier phylogeny of Bacteroidetes has been performed using the 16S rRNA gene as a backbone in combination with the 23S rRNA gene, as well as multilocus sequence analysis (MLSA) of 29 orthologous protein sequences, and indels in the sequences of the beta subunit of the F-type ATPase and the alanyl-tRNA synthetase. In addition, taxonomic data for Bacteroidetes has been updated by considering the orphan species list, signature nucleotides in the 16S rRNA sequence, the list of outlier species, and discrepancies with the current taxonomy at the genus rank level. As a result, seven new taxa are proposed within Bacteroidetes (Chitinophagia classis nov., Chitinophagales ord. nov., Crocinitomicaceae fam. nov., Odoribacteraceae fam. nov., Hymenobacteraceae fam. nov., Thermonemataceae fam. nov. and Persicobacteraceae fam. nov.), as well as one new phylum Rhodothermaeota phyl. nov. that contains two classes, two orders, four families and a new genus with two new combinations.


The roles of metals in insect-microbe interactions and immunity.
Metal ions play essential roles in diverse physiological processes in insects, including immunity and interactions with microbes. Some, like iron, are essential nutrients and therefore are the subject of a tug-of-war between insects and microbes. Recent findings showed that the hypoferremic response mediated by Transferrin 1 is an essential defense mechanism against pathogens in insects. Transferrin 1 and the overall iron metabolism were also implicated in mediating interactions between insects and beneficial microbes. Other metals, like copper and zinc, can interfere with insect immune effectors, and either enhance (antimicrobial peptides) or reduce (reactive oxygen species) their activity. By covering recent advances in the field, this review emphasizes the importance of metals as essential mediators of insect-microbe interactions.


Susceptibility to a parkinsonian toxin varies during primate development.
Symptoms of Parkinson's disease typically emerge later in life when loss of nigrostriatal dopamine neuron function exceeds the threshold of compensatory mechanisms in the basal ganglia. Although nigrostriatal dopamine neurons are lost during aging, in Parkinson's disease other detrimental factors must play a role to produce greater than normal loss of these neurons. Early development has been hypothesized to be a potentially vulnerable period when environmental or genetic abnormalities may compromise central dopamine neurons. This study uses a specific parkinsonian neurotoxin, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), to probe the relative vulnerability of nigrostriatal dopamine neurons at different stages of primate development. Measures of dopamine, homovanillic acid, 1-methyl-pyridinium concentrations and tyrosine hydroxylase immunoreactive neurons indicated that at mid-gestation dopamine neurons are relatively vulnerable to MPTP, whereas later in development or in the young primate these neurons are resistant to the neurotoxin. These studies highlight a potentially greater risk to the fetus of exposure during mid-gestation to environmental agents that cause oxidative stress. In addition, the data suggest that uncoupling protein-2 may be a target for retarding the progressive loss of nigrostriatal dopamine neurons that occurs in Parkinson's disease and aging.


Spike protein of SARS-CoV-2 variants: a brief review and practical implications.
The scientific community has been alarmed by the possible immunological evasion, higher infectivity, and severity of disease caused by the newest variants of SARS-CoV-2. The spike protein has an important role in the cellular invasion of viruses and is the target of several vaccines and therapeutic resources, such as monoclonal antibodies. In addition, some of the most relevant mutations in the different variants are on the spike (S) protein gene sequence that leads to structural alterations in the predicted protein, thus causing concern about the protection mediated by vaccines against these new strains. The present review highlights the most recent knowledge about COVID-19 and vaccines, emphasizing the different spike protein structures of SARS-CoV-2 and updating the reader about the emerging viral variants and their classifications, the more common viral mutations described and their distribution in Brazil. It also compiles a table with the most recent knowledge about all of the Omicron spike mutations.


The application of digital surgical diagnosis and treatment technology: a promising strategy for surgical reconstruction of craniomaxillofacial defect and deformity.
The craniomaxillofacial defect and deformity always leads to serious dysfunction in mastication and facial contour damage, significantly reducing patients' quality of life. However, surgical reconstruction of a craniomaxillofacial hard tissue defect or deformity is extremely complex and often does not result in desired facial morphology. Improving the result for patients with craniomaxillofacial defect and deformity remains a challenge for surgeons. Using digital technology for surgical diagnosis and treatment may help solve this problem. Computer-assisted surgical technology and surgical navigation technology are included in the accurate digital diagnosis and treatment system we propose. These technologies will increase the accuracy of the design of the operation plan. In addition, the intraoperative real-time navigating location system controlling the robotic arm or advanced intelligent robot will provide accurate, individualized surgical treatment for patients. Here we propose the hypothesis that a digital surgical diagnosis and treatment technology may provide a new approach for precise surgical reconstruction of complicated craniomaxillofacial defect and deformity. Our hypothesis involves modern digital surgery, a three-dimensional navigation surgery system and modern digital imaging technology, and our key aim is to establish a technological platform for customized digital surgical design and surgical navigation for craniomaxillofacial defect and deformity. If the hypothesis is proven practical, this novel therapeutic approach could improve the result of surgical reconstruction for craniomaxillofacial defect and deformity for many patients.


School based screening for tuberculosis infection in Norway: comparison of positive tuberculin skin test with interferon-gamma release assay.
In Norway, screening for tuberculosis infection by tuberculin skin test (TST) has been offered for several decades to all children in 9th grade of school, prior to BCG-vaccination. The incidence of tuberculosis in Norway is low and infection with M. tuberculosis is considered rare. QuantiFERONTB Gold (QFT) is a new and specific blood test for tuberculosis infection. So far, there have been few reports of QFT used in screening of predominantly unexposed, healthy, TST-positive children, including first and second generation immigrants. In order to evaluate the current TST screening and BCG-vaccination programme we aimed to (1) measure the prevalence of QFT positivity among TST positive children identified in the school based screening, and (2) measure the association between demographic and clinical risk factors for tuberculosis infection and QFT positivity. This cross-sectional multi-centre study was conducted during the school year 2005-6 and the TST positive children were recruited from seven public hospitals covering rural and urban areas in Norway. Participation included a QFT test and a questionnaire regarding demographic and clinical risk factors for latent infection. All positive QFT results were confirmed by re-analysis of the same plasma sample. If the confirmatory test was negative the result was reported as non-conclusive and the participant was offered a new test. Among 511 TST positive children only 9% (44) had a confirmed positive QFT result. QFT positivity was associated with larger TST induration, origin outside Western countries and known exposure to tuberculosis. Most children (79%) had TST reactions in the range of 6-14 mm; 5% of these were QFT positive. Discrepant results between the tests were common even for TST reactions above 15 mm, as only 22 % had a positive QFT. The results support the assumption that factors other than tuberculosis infection are widely contributing to positive TST results in this group and indicate the improved specificity of QFT for latent tuberculosis. Our study suggests a very low prevalence of latent tuberculosis infection among 9th grade school children in Norway. The result will inform the discussion in Norway of the usefulness of the current TST screening and BCG-policy.


Yarrowia lipolytica: more than an oleaginous workhorse.
Microbial production of fuels and chemicals offers a means by which sustainable product manufacture can be achieved. In this regard, Yarrowia lipolytica is a unique microorganism suitable for a diverse array of biotechnological applications. As a robust oleaginous yeast, it has been well studied for production of fuels and chemicals derived from fatty acids. However, thanks in part to newfound genetic tools and metabolic understanding, Y. lipolytica has been explored for high-level production of a variety of non-lipid products. This mini-review will discuss some of the recent research surrounding the ability of Y. lipolytica to support bio-based chemical production outside the realm of fatty acid metabolism including polyketides, terpenes, carotenoids, pentose phosphate-derived products, polymers, and nanoparticles.


Myo-inositol facilitates astaxanthin and lipid coproduction in Haematococcus pluvialis by regulating oxidative stress and ethylene signalling.
In the present study, exogenous myo-inositol (MI) was applied to induce natural astaxanthin and biolipid accumulation in Haematococcus pluvialis. Under 200 μM MI, algal cells exhibited 62.11 % and 34.67 % increases in astaxanthin and lipid content, respectively, compared to the control. The carotenogenesis and lipogenesis genes were upregulated by induction of MI. Interestingly, MI addition elevated the ethylene (ETH) content and activated antioxidant enzyme-associated gene levels, which could be involved in alleviating oxidative stress. Further data showed that the ETH signal played a positive function in stimulating astaxanthin biosynthesis under MI induction. Supplementation with ethephon plus MI boosted the astaxanthin content to 33.08 ± 0.03 mg g-1 by further upregulating astaxanthin biosynthesis genes and blocking reactive oxidative species (ROS) levels, and vice versa under ETH inhibition. This study provides a potential induction approach for natural astaxanthin production and explains the role of ethylene signalling in regulating astaxanthin synthesis by H. pluvialis.


Tricuspid Regurgitation and Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis.
The extent of cardiac damage associated with aortic stenosis has important prognostic implications after transcatheter aortic valve replacement (TAVR). However, the role of tricuspid regurgitation (TR) in this clinical setting is still unclear. To explore the association between TR and mortality in patients undergoing TAVR and assess changes in TR severity post TAVR and its relationship with short and mid-term mortality. Relevant databases were searched for articles published from inception until August 2020. Out of 414 screened studies, we selected 24 that reported the degree of TR pre or post TAVR. The primary outcome was all-cause mortality, and random effects meta-analysis models were conducted (at a significance level of 5%). Seventeen studies reported associations between pre-TAVR TR and all-cause mortality (> 45,000 participants) and thirteen accessed TR severity post TAVR (709 participants). Moderate/severe baseline TR was associated to higher all-cause mortality both at 30 days (HR 1.65; 95% CI, 1.20-2.29) and 1.2 years (HR 1.56; 95% CI, 1.31-1.84). After TAVR, 43% of patients presented a decrease of at least one grade in TR (30 days, 95% CI, 30-56%), sustained at 12.5 months in 44% of participants (95% CI, 35-52%). Persistence of significant TR was associated with a two-fold increase in all-cause mortality (HR 2.12; 95% CI, 1.53-2.92). Significant TR pre TAVR is associated with higher mortality. Although TR severity may improve, the persistence of significant TR post TAVR is strongly associated with increased mortality. Our findings highlight the importance of a detailed assessment of TR pre and post TAVR and might help identify patients who may benefit from more careful surveillance in this scenario.


Genetic programming of catalytic Pseudomonas putida biofilms for boosting biodegradation of haloalkanes.
Bacterial biofilms outperform planktonic counterparts in whole-cell biocatalysis. The transition between planktonic and biofilm lifestyles of the platform strain Pseudomonas putida KT2440 is ruled by a regulatory network controlling the levels of the trigger signal cyclic di-GMP (c-di-GMP). This circumstance was exploited for designing a genetic device that over-runs the synthesis or degradation of c-di-GMP--thus making P. putida to form biofilms at user's will. For this purpose, the transcription of either yedQ (diguanylate cyclase) or yhjH (c-di-GMP phoshodiesterase) from Escherichia coli was artificially placed under the tight control of a cyclohexanone-responsive expression system. The resulting strain was subsequently endowed with a synthetic operon and tested for 1-chlorobutane biodegradation. Upon addition of cyclohexanone to the culture medium, the thereby designed P. putida cells formed biofilms displaying high dehalogenase activity. These results show that the morphologies and physical forms of whole-cell biocatalysts can be genetically programmed while purposely designing their biochemical activity.


[Unilateral congenital absence of the carpal scaphoid associated with dysplasia of the capitate. Presentation of a case].
We report on a case of aplasia or unilateral congenital absence of the carpal scaphoid associated with dysplasia of the capitate. Congenital absence of the carpal scaphoid is a rare but well-documented condition. As far as we know, the present case is the seventh one reported in the medical literature. Imaging studies (X-ray and MRI) confirmed the absence of the carpal scaphoid associated with a dysplasia of the capitate and malformation of the radial styloid process. Congenital absence of the scaphoid when other congenital abnormalities (such as hypoplasia or aplasia of either forearm bones or thenar eminence, malformations of the skeletal elements of the thumb, absence of sesamoid bones or abnormal development of the forearm bones) do not exist is probably the main feature of the present case report.


Studies on aorta during development. I. Fetal rabbit aorta under ex vivo and in vitro conditions: rapid changes in smooth muscle cell phenotype, cell proliferation and cholesterol content with organ culture.
The structural development of the already well defined fetal rabbit aortic wall from 22 to 31 days of gestation in vivo consists of increasing aortic wall thickness, elastic lamina continuities, extracellular matrix deposition, and maturing of the fine structure of the medial smooth muscle cells. In vivo at term (31 days), the mature aortic smooth muscle cells demonstrated the characteristic thin, thick and intermediate filaments, dense plaques, endoplasmic reticulum, golgi, plasmalemma vesicles and an incomplete basal lamina. The fetal aorta rapidly responded to organ culture with various changes. Fetal smooth muscle cells modified their phenotype to the synthetic state when cultured in both serum-supplemented and serum-free media. This smooth muscle cell modification occurred after 3 days of culture in fetal explants. The synthetic type smooth muscle cells (fetal) began to proliferate after 6 days of culture. This proliferation resulted in a peripheral outgrowth after 9 days of 10-20 layers in fetal cultures from serum-supplemented media and of 2-4 layers in serum-free media. The orderly arrangement of the internal elastic lamina and alternating medial layers of smooth muscle cells and elastic lamina seen in vivo was disrupted along with increased matrix after 9 days of fetal explant culture. Significant numbers of 'modified' synthetic phenotype smooth muscle cells were not observed in adult aortic explants until after 15 days in culture in serum supplemented media. The mature contractile phenotype smooth muscle cell predominated in adult explants cultured in serum-free media. Significant synthetic phenotype smooth muscle cell proliferation only occurred in adult explants after 15 days culture in serum-supplemented media. When compared to aorta in vivo evidence for increases in cholesterol esterification were observed in both fetal (9 days) and adult (15 days) explants cultured in both serum-supplemented and serum-free media. The fetal aorta in organ culture appeared to be more susceptible than the adult aorta to (a) phenotypic modulation of smooth muscle cells to the synthetic state, (b) smooth muscle cell proliferation, and (c) early cholesteryl ester accumulation.


Erythrocyte-rich thrombus aspirated from patients with ST-elevation myocardial infarction: association with oxidative stress and its impact on myocardial reperfusion.
Recent studies have demonstrated that erythrocytes are a potential component in atheromatous lesions and thrombus formation in patients with ST-elevation myocardial infarction (STEMI). The purpose of this study was to determine the associations of red blood cell (RBC) component of coronary thrombi with oxidative stress and myocardial reperfusion. Aspirated thrombi from 178 STEMI patients within 12 h of symptom onset were investigated immunohistochemically using antibodies against platelets, RBCs, fibrin, macrophages, and neutrophils [myeloperoxidase (MPO)]. The thrombi were divided into tertiles according to the percentage of glycophorin-A-positive area: low (glycophorin-A-positive area <33%; n = 60), intermediate (<54 to 33%; n = 59), and high group (≥54%; n = 59). We also measured plasma MPO levels on admission. In the thrombi, the number of MPO-positive cells in the high-RBC group was significantly greater than that in the low-RBC group (high, 927 ± 385; intermediate, 765 ± 406; low, 279 ± 220 cells/mm(2); P< 0.0001). Plasma MPO levels were significantly higher in the high-RBC group than that in the low-RBC group [low 43.1 (25.0-71.6); intermediate 71.0 (32.9-111.2); high 74.3 (31.1-126.4)ng/mL; P< 0.005]. Distal embolization occurred more frequently in the high-RBC group (P= 0.0009). Moreover, the signs of impaired myocardial reperfusion, as indicated by incomplete ST-segment resolution (STR) and lower myocardial blush grades (MBG), and progression of left ventricular remodelling at 6 months were frequently observed in the high-RBC group (high vs. low: STR, P= 0.056; MBG, P< 0.01; remodelling, P< 0.01). The present study demonstrated that erythrocyte-rich thrombi contain more inflammatory cells and reflect high thrombus burden, leading to impaired myocardial reperfusion in STEMI patients.


The value of dynamic MRI in cervical spondylotic myelopathy: About 24 cases.
Dynamic magnetic resonance imaging (MRI) of the cervical spine is extremely useful in assessing pathological changes at the spinal cord, vertebrae, discs, ligaments and facet joints. We attempted to document the radiological changes that the cervical spine undergoes during dynamic maneuvers and the effects of Dynamic MRI in management of cervical myelopathy, emphasizing on the changes in treatment protocol effected by the new findings discovered. Our work is based on 24 consecutive patients with cervical spondylotic myelopathy had cervical MR imaging in neutral position, in flexion and extension of the cervical spine between January 2021 and December 2021. The result found the mean age was 57.9 years (range 26-85 years). Among these 24 patients, there were 11 males and 13 females. Total number of levels of compression were 47 and the additional levels of involvement were 17. Additional levels of compression were noted in 12 patients, among these 17 new levels, 7 were in the posterior and 10 in the anterior. The most affected level was C5C6 with 16 cases. All additional levels of compression were noted in extension; Reduction of the cervical canal was observed in 20 patients only in extension. In the bending sequences we have noticed an increase of the canal diameter in 3 patients. The location of the compression is in 15 cases anterior, 2 cases posterior and 5 cases are mixed anterior and posterior Surgery was considered in 17 patients. Anterior procedures were 11 (ACDF/corpectomy and fusion) and Posterior surgeries were 6 (laminoplasty/laminectomy), and. The rest of the patients did not require surgery and was conservatively treated. A change of the signal was found in 3 patients during the acquisition in extension position a. Most studies have shown a reduction of the root canal with an increase of the compression level, which was the case in our study. MRI is a useful tool for diagnosis of CM, it does not give an exact idea as to which is the offending level in a multilevel compression that requires surgery. Even the approach and procedure cannot be decided on a static examination and hence are subject to significant interpractitioner the role of extension MRI in determining cervical compression levels. Thus, dynamic cervical spine MRI should be an important investigation before we decide to write off surgical treatment in patients with cervical myelopathy and cord signal changes without definitive compression on static MRI. Flexion and extension MRI is an important tool for decision making and planning appropriate management in cervical compressive myelopathy.


Association between CYP17A1 rs3824755 and rs743572 gene polymorphisms and Alzheimer's disease in the Chinese Han population.
The CYP17A1 gene encodes cytochrome P450c17α, an enzyme that catalyzes the formation of sex hormones, which have been linked to the pathogenesis of Alzheimer's disease (AD). An association between the CYP17A1 rs743572 single nucleotide polymorphism (SNP) and AD has been reported; however, the findings are controversial. In the present study, we investigated the association between rs743572 and another SNP, rs3824755, and AD risk in a Chinese Han population (n=207 patients and 239 controls), and their interaction with the apolipoprotein E (APOE) e4 allele. We found that the C allele and GC+CC genotypes of rs3824755 conferred protection against AD only in APOE e4 carriers. Both rs3824755 and rs743572 polymorphisms showed interactions with APOE e4. The C allele and GC+CC genotypes of rs3824755 acted as protective factors that decreased the risk of APOE e4 in AD. The CYP17A1 rs743572G allele and AG+GG genotypes were found to be potential risk factors that act synergetically with APOE e4. Moreover, the CA and GG haplotypes were protective and conferred a slight risk, respectively, in APOE e4 carriers. These results indicate that CYP17A1 rs3824755 and rs743572 are associated with AD in the Chinese Han population and act in combination with APOE e4.


Quality of provider-participant relationships and enhancement of adolescent social skills.
This study adds to the limited research on the potential importance of the quality of the relationship between adult prevention service providers and youth participants in enhancing social skills and strengthening prevention outcomes. Study subjects were drawn from seven prevention programs funded under a Youth Mentoring Initiative by the Center for Substance Abuse Prevention in the Substance Abuse and Mental Health Services Administration. These programs maintain a relationship-based service focus but use a variety of one-on-one, group, volunteer, and paid staff service formats. Study results showed that youth who perceived a higher level of trust, mutuality and empathy in their relationship with providers experienced significantly greater improvements in social skills (i.e., cooperation, self-control, assertiveness, and empathy) than program participants who perceived a lower quality relationship with adult providers. These findings underscore the importance of recruitment, training and supervisory practices that promote staff and volunteer skills in achieving high quality relationships with youth participants regardless of the specific intervention strategy. Editors' Strategic Implications: Practitioners and policymakers should review the authors' findings about the importance of individual adult skills in building protective mentoring relationships. The impact of relationship quality, rather than setting, suggests that the scope of effective prevention practice can be broadened beyond the confines of formal prevention programming to any place in which caring and skilled adults interact with youth.


Maspin overexpression correlates with increased expression of vascular endothelial growth factors A, C, and D in human ovarian carcinoma.
The vascular endothelial growth factor (VEGF) family, including VEGFA, VEGFC, and VEGFD, plays an essential role in the angiogenesis of both pathologic and nonpathologic conditions. Maspin belongs to the serpin superfamily and has been identified as a tumor suppressor because it inhibits motility, invasion, and angiogenesis. Few studies have compared maspin with VEGF in ovarian carcinoma. Therefore, we investigated the expression and correlation of maspin, VEGFA, VEGFC, and VEGFD with the tumorigenesis of the ovary and clinicopathologic variables. Using immunohistochemistry, we examined maspin, VEGFA, VEGFC, and VEGFD expression in 60 ovarian carcinoma tissues (35 serous papillary carcinomas, 18 endometrioid carcinomas, and 7 primary ovarian mucinous carcinomas). Staining of cells was scored as +2 if more than 50% of the cells were positive, as +1 if less than 50% of the cells were positive, and as negative if none of the cells stained positive. Overexpression of maspin, VEGFC, and VEGFD was significantly associated with high tumor grade (P<.001, P=.004, P<.001, respectively), clinical stage (P=.002, .01, and .001, respectively), the presence of ascites (P<.001, P=.03, and P=.001, respectively), and the presence of metastatic lymph nodes (P=.002, P<.001, and P<.001, respectively). Maspin was correlated with VEGFA (P=.01), VEGFC (P<.001), and VEGFD (P<.001). The VEGFA score was positively correlated with high tumor grade (P=.04), lymphovascular space invasion (LVSI) (P<.001), International Federation of Gynecology and Obstetrics (FIGO) stage (P=.009), maspin, VEGFC (P=.003), and VEGFD (P=.003), but it was not correlated with the presence of ascites and metastatic lymph nodes. Maspin, VEGFC, and VEGFD are expressed in ovarian tumors with a poor prognostic parameters, and seem to play a role in ovarian cancer angiogenesis, progression, and lymph node metastases. Our results indicate that in contrast to most other carcinomas, maspin expression is directly associated with the biological aggressiveness of ovarian carcinoma. These results may offer new insights regarding the role of maspin in ovarian cancer and might also affect the diagnosis and treatment strategies.


Analysis by the reductive-cleavage method of linkage positions in a polysaccharide containing 4-linked D-glucopyranosyluronic residues.
The fate of 4-linked D-glucopyranosyluronic residues under reductive-cleavage conditions was investigated by using the Klebsiella aerogenes type 54 strain A3 capsular polysaccharide. Treatment of the fully methylated polysaccharide with triethylsilane and trimethylsilyl trifluoromethanesulfonate in dichloromethane, followed by in situ acetylation, yielded 1,5-anhydro-2,3,4,6-tetra-O-methyl-D-glucitol, 3,4-di-O-acetyl-1,5-anhydro-2,6-di-O-methyl-D-glucitol, and 3-O-acetyl-1,5-anhydro-2,4-di-O-methyl-L-fucitol, as expected, but the expected product of reductive cleavage of the 4-linked D-glucopyranosyluronic residue, namely, methyl 3-O-acetyl-2,6-anhydro-4,5-di-O-methyl-L-gulonate, was not observed. Instead, methyl 2-O-acetyl-3,6-anhydro-4,5-di-O-methyl-L-gulonate (6) was identified as the sole product of reductive cleavage of the 4-linked D-glucopyranosyluronic residue. That compound 6 arose as a result of rearrangement during reductive cleavage rather than by reductive cleavage of a 5-linked D-glucofuranosyluronic residue, was established by reductive cleavage of the fully methylated polysaccharide following reduction of its ester groups with either lithium aluminum hydride or lithium aluminum deuteride. The products of the latter reductive cleavage were the same as before, except for the absence of 6 and the presence of 4,6-di-O-acetyl-1,5-anhydro-2,3-di-O-methyl-D-glucitol, or its 6,6-dideuterio isomer. Although the reductive-cleavage technique is suitable for the direct analysis of polysaccharides containing 4-linked D-glucopyranosyluronic residues, it does not establish whether the uronic residue is a 4-linked pyranoside or a 5-linked furanoside. The expected product is, however, derived from the 4-linked D-glucopyranosyluronic residue after sequential methylation, reduction of its ester group and reductive cleavage.


[Liver lipid peroxidation in the ontogeny of rats during perinatal exposure to polychlorinated biphenyls].
We studied the activity of NADPH-cytochrome P-450 reductase, NADPH- and ascorbate-dependent systems of lipid peroxidation in liver microsomes, the activity of superoxide dismutase in the supernatant and the level of malonic acid dialdehyde in liver tissue of rats of various age. The activity of lipid peroxidation system and the malonic dialdehyde content in the early postnatal period increased to the adult level. The NADPH-cytochrome P-450 reductase activity increased during the first four months of animals life while that of superoxide dismutase increased until the animals were seven months old. A single administration of polychlorinated diphenyls at a dose of 500 mg/kg (1/10 LD50) to pregnant rats drastically stimulated and changed the pattern of the studied activities in their offspring. The role of lipid peroxidation in modification of microsomal membranes after the monooxygenase system induction by polychlorinated diphenyls in early ontogenesis is discussed.


Acute renal failure due to uric acid nephropathy in a patient with renal hypouricemia.
This report is about a 23-year-old man who required hemodialysis in connection with an acute renal failure resulting from uric acid nephropathy without hyperuricemia. After recovering renal function he showed extreme hypouricemia (0.1-0.3 mg/dl) and elevated uric acid clearance (100-300 ml/min). The fractional excretion of uric acid (Cua/Ccr) could be suppressed by oral pyrazinamide and enhanced by probenecid. As no other renal tubular or metabolic abnormalities were detected, it is suggested that a markedly increased renal tubular urate secretion was responsible for the hypouricemia and also for the rare side-effect of an uric acid nephropathy in this patient.


Deletion of chromosome 22q11.2 and outcome in patients with pulmonary atresia and ventricular septal defect.
The 22q11.2 deletion (del22q) is present in many patients with conotruncal abnormalities including pulmonary atresia with ventricular septal defect (PA/VSD). We sought to determine the impact of the del22q on outcome in subjects with PA/VSD. We reviewed the experience for all patients with PA/VSD who were born between January 1993 and April 2002 and presented to our institution. Patients with conotruncal defects were routinely evaluated for genetic disorders including del22q. Fluorescence in situ hybridization was used to test for del22q. There were 67 subjects with PA/VSD who presented during that time period; testing for del22q was performed in 58 of 67 (87%) and these 58 patients comprised the study population. The 22q11.2 deletion was present in 20 of 58 (34%) patients tested. Major aortopulmonary collaterals were defined by angiography and were present in 27 (47%). These collaterals were significantly more common among subjects with del22q (13 of 20, 65%; p = 0.04). The median cross sectional area of the pulmonary arteries, the Nakata index, was significantly less for patients with del22q (41 versus 142 mm(2)/m(2); p = 0.006). There were 3 subjects, all of whom had del22q, who did not undergo surgery owing to markedly hypoplastic pulmonary arteries. Of the remaining 55 patients, 53 had arteriopulmonary shunt with or without unifocalization as the initial procedure and 35 patients have undergone complete repair. There were 8 operative deaths and 1 nonoperative death. The 5-year survival was 36% for patients with del22q versus 90% for patients without del22q. The 22q11.2 deletion was a significant risk factor for death, even after adjusting for the presence of major aortopulmonary collaterals (p = 0.004). There was no significant difference between the two groups with respect to the incidence of serious viral, bacterial, or fungal infections in the perioperative period. Patients with del22q and PA/VSD are at increased risk for death owing to a variety of factors including less favorable pulmonary artery anatomy. A better understanding of del22q, pulmonary artery anatomy, and outcome is required.


Strength characterization and lifetime prediction of dental ceramic materials.
To determine the Weibull modulus m, the characteristic strength σ0,the subcritical crack growth (SCG) parameters (n &A*) as well as the lifetime durability of three dental ceramic materials in water: a polycrystalline yttria-stabilized zirconia (Zenostar MT O, YSZ, Ivoclar Vivadent/Wieland, Germany), a lithium disilicate glass ceramic (IPS e.max CAD, LD, Ivoclar Vivadent, Liechtenstein), and a zirconia-containing lithium silicate glass ceramic (Celtra Duo, ZLS, Dentsply Sirona Inc, USA). 30 specimens (Ø12 mm × 0.9 mm thickness) of each material were fabricated. The biaxial ring-on-ring bending tests at four stress rates σ˙ (100, 10, 1, 0.1 MPa/s) were performed in water for all three ceramics. The results were used to determine the Weibull and SCG parameters, and to plot the Strength-Probability-Time (SPT) diagram. YSZ showed the highest m (12.5) and highest σ0 (542 MPa), while the values for the glass ceramic materials were lower: for LD m = 4.7, σ0 = 407 MPa, and for ZLS m = 2.7, σ0 = 279 MPa. The n for YSZ, LD and ZLS in water were 31.1, 13.7 and 16.6, respectively. The strength of YSZ decreased by 50% within a simulated period of 10 years, and for the glass ceramic materials the decrease was up to 80%. Determining the Weibull and SCG parameters from the constant stress rate testing is an efficient methodology for ranking materials in terms of durability and longevity.


Growth factor receptor expression in human gastroenteropancreatic neuroendocrine tumours.
Human gastroenteropancreatic neuroendocrine tumours are functionally and biologically heterogeneous, but their exact growth factor receptor expression pattern, important for onco- and carcinogenesis, remains unknown. This study searched for the mRNA expression pattern of six tyrosine- and serine/threonine kinase receptors [hepatocyte growth factor (HGFR), fibroblast growth factor (FGFR), epidermal growth factor (EGFR), insulin-like growth factor (IGF)-1R, transforming growth factor (TGF)-betaR1, TGF-betaR2] together with the five somatostatin receptors in human gastroenteropancreatic neuroendocrine tumours (gastrinomas, insulinomas, tumours with carcinoid syndrome, functionally inactive neuroendocrine tumours) using reverse transcriptase-polymerase chain reaction (RT-PCR). EGF receptor was expressed almost exclusively in gastrinomas. Among the four tumour subtypes, expression frequencies of the somatostatin receptors 1 and 5, HGF-, IGF-1-, TGF-betaR1, TGF-betaR2 and the EGF-receptor varied significantly. In spite of the common cellular origin of these tumours, differences in growth factor receptor expression suggest the existence of different pathways during tumour subtype development.


Differential interaction of lectins with chemosensory receptors.
L-Alanine and L-arginine bind with similar affinity (Kd 10(-7)-10(-6) M) to receptors in both a sedimentable fraction (P2) from taste epithelium and isolated olfactory cilia from the channel catfish, Ictalurus punctatus. Lectins of differing carbohydrate specificity were used to determine the glycoprotein nature of the chemosensory plasma membranes and to differentially affect receptors for L-alanine and L-arginine. The peroxidase-conjugated lectins concanavalin A (Con A), wheat germ agglutinin (WGA), and peanut agglutinin (PNA) were used to identify the glycoprotein components of the chemosensory plasma membranes after polyacrylamide gel electrophoresis. In both chemosensory membranes, numerous protein components were labelled by Con A and WGA. In contrast, a single predominant component was labeled by PNA in olfactory cilia, whereas several proteins in taste membranes were labeled by this lectin. When unconjugated lectins were preincubated with olfactory cilia, 60-70% of binding to L-alanine and L-arginine receptors was inhibited by Con A and WGA. PNA inhibited L-alanine but not L-arginine binding to olfactory receptors. Inhibition of olfactory receptor binding by lectins was time- and dose-dependent. By contrast, no inhibition of either L-alanine or L-arginine receptor binding in taste membranes was observed with any of the lectins. The differential labeling of the chemosensory membranes and the differential inhibition of receptor binding by lectins suggest that, despite ligand similarity, the chemosensory receptors in these membranes are not identical molecular species.


Radiation-induced gene expression in human subcutaneous fibroblasts is predictive of radiation-induced fibrosis.
Breast cancer patients show a large variation in normal tissue reactions after ionizing radiation (IR) therapy. One of the most common long-term adverse effects of ionizing radiotherapy is radiation-induced fibrosis (RIF), and several attempts have been made over the last years to develop predictive assays for RIF. Our aim was to identify basal and radiation-induced transcriptional profiles in fibroblasts from breast cancer patients that might be related to the individual risk of RIF in these patients. Fibroblast cell lines from 31 individuals with variable risk of RIF (grouped into five classes from low to high risk) were irradiated with two different schemes: 1 x 3.5 Gy with RNA isolated 2 and 24h after irradiation, and a fractionated scheme with 3 x 3.5 Gy in intervals of 24h with RNA isolated 2h after the last dose. RNA was also isolated from non-treated fibroblasts. Transcriptional differences in basal and radiation-induced gene expression profiles were investigated using 15K cDNA microarrays, and results analyzed by both SAM and PAM. Sixty differentially expressed genes were identified by applying SAM on 10 patients with the highest risk of RIF and the four patients with the lowest risk of RIF after the fractionated scheme. The genes were associated with known functions in processes like apoptosis, extracellular matrix remodelling/cell adhesion, proliferation and ROS scavenging. A minimum set of 18 genes were identified that could differentiate high risk from low risk-patients after the fractionated scheme. The classifier of 18 genes may provide basis for a predictive assay for normal tissue reactions after radiotherapy, and provide new insight into the molecular mechanisms of RIF.


CP-GEP (Merlin) gene expression profiling: can my melanoma patient forgo sentinel lymph node biopsy?
Melanoma risk stratification is crucial for both patients and physicians. Patients want to understand what to expect after diagnosis, and physicians need to decide on an appropriate treatment plan. Traditionally, risk stratification has been based on Breslow thickness and sentinel lymph node (SLN) status. However, the introduction of CP-GEP (Merlin) has provided a molecular test that can be performed on primary melanoma diagnostic biopsy tissue, offering additional risk stratification beyond established variables. In this review, we assess the utility of CP-GEP testing compared to clinicopathologic variables and SLN status and propose a multilayered approach to selecting patients for adjuvant therapy using CP-GEP technology.


[Milk ultrafiltrate as a promising source of angiogenin].
The use of membrane technologies in the production of soft cheese (children's food) is associated with the appearance of up to 80% of angiogenin in the ultrafiltrate. An electrophoretically homogeneous preparation of angiogenin (MW approximately 17 kDa) was obtained from milk ultrafiltrate by two-stage ion-exchange chromatography. The yield of the angiogenin was approximately 60%, which corresponds to a 586-fold purification of the raw material. The obtained preparation retained stability in the course of lyophilization and could be stored at 4 degrees C for a long time without decomposition.


Acute Formation of a Blunt Trauma-induced Vertebral Artery Arteriovenous Fistula Treated with Endovascular Occlusion of Vertebral Artery.
Fistulous cerebrovascular injuries can occur spontaneously, iatrogenically following surgical procedures, or can result as a consequence of penetrating trauma. To our knowledge, this is only the second reported case of blunt-trauma induced cervical vertebral artery arteriovenous fistula (AVF) formation in a 55-year-old male. This was successfully occluded with N-butyl cyanoacrylate (NBCA) embolization of the recipient vein and endovascular coil ligation of the vertebral artery.


Reconfigurable assembly of colloidal motors towards interactive soft materials and systems.
Due to the highly flexible reconfiguration of swarms, collective behaviors have provided various natural organisms with a powerful adaptivity to the complex environment. To mimic these natural systems and construct artificial intelligent soft materials, self-propelled colloidal motors that can convert diverse forms of energy into swimming-like movement in fluids afford an ideal model system at the micro-/nanoscales. Through the coupling of local gradient fields, colloidal motors driven by chemical reactions or externally physical fields can assembly into swarms with adaptivity. Here, we summarize the progress on reconfigurable assembly of colloidal motors which is driven and modulated by chemical reactions and external fields (e.g., light, ultrasonic, electric, and magnetic fields). The adaptive reconfiguration behaviors and the corresponding mechanisms are discussed in detail. The future directions and challenges are also addressed for developing colloidal motor-based interactive soft matter materials and systems with adaptation and interactive functions comparable to that of natural systems.


An updated analysis of turning point, duration and attack rate of COVID-19 outbreaks in major Western countries with data of daily new cases.
As coronavirus spreads around the world, the study of its effects is of great practical significance. We collated data on daily new cases of the COVID-19 outbreaks in the six Western countries of the Group of Seven and the dates of governments' interventions. We studied the periods before and after the dates of major governments' interventions integrally based on a segmented Poisson model. The relevant results are published in the paper of "Predicting turning point, duration and attack rate of COVID - 19 outbreaks in major Western countries" [1]. Our method can be used to update prediction daily as COVID-19 outbreaks evolve. In this article, we illustrate an updated analysis with our method to facilitate reproducibility. Both datasets used and updated are provided.


Stent placement in the ductus venosus of a neonate with total anomalous pulmonary venous return.
A newborn with right isomerism, infracardiac total anomalous pulmonary venous return (TAPVR), and obstruction of the ductus venosus underwent stent implantation in the ductus venosus at 4 h after birth. This procedure averted early pulmonary venous obstruction. Since gradual neointimal proliferation subsequently occurred within the stent, the patient underwent stent balloon dilatation at 35 days of age and underwent surgical repair of the TAPVR with a Blalock-Taussig shunt operation at 53 days of age. Finally, the patient was discharged without any complications. Transthoracic echocardiography is very useful to confirm subsequent minimal change within the stent.


Intact hippocampal gray matter in schizophrenia as revealed by automatized image analysis postmortem.
Implicated as a key structure in the pathophysiology of schizophrenia, the hippocampus is at the forefront of neuropathological and neuroimaging research. To elucidate the cellular basis of hippocampal pathology in schizophrenia, we studied the postmortem hippocampal sections of 16 patients suffering from schizophrenia and 16 controls applying the gray-level index (GLI) method. We determined the area-percentage covered by neuronal perikarya in relation to the total area of the pyramidal cell layer in the four subdivisions of the ammon's horn (cornu ammonis, CA1-4) bilaterally. Additionally, we determined the area size of the pyramidal cell layer (CA1-4) and dentate gyrus (DG) granule cell layer. Results showed no significant differences between diagnostic groups with respect to the dependent variables, supporting the view that there is no primary alteration of hippocampal gray matter in schizophrenia.


A bis(silylene)-stabilized diphosphorus compound and its reactivity as a monophosphorus anion transfer reagent.
In contrast to the well-established transition-metal-mediated activation of white phosphorus (P4), the metal-free direct functionalization of P4 has remained rare. The conversion of P4 into a reactive zero-valent diphosphorus compound (P2) has proven challenging to carry out without relying on metal reactivity. Herein, we describe the facile degradation of P4 mediated by two divalent silicon atoms in a bis(silylene) scaffold, resulting in a silylene-stabilized zero-valent P2 complex. The presence of two lone pairs of electrons on each P atom in the silylene-stabilized P2 complex enables a rich reactivity towards small molecules; reaction of the P2 species with CO2, water or a borane leads to the formation of P-C, P-H or P-B bonds, respectively. Notably, the P2 complex also serves as a single phosphorus anion (P-) transfer reagent towards metal carbonyls and a chlorogermylene compound, leading to the synthetically valuable phosphaketenide (PCO-) ligand and a phosphinidene germylene complex, respectively.


A simple apparatus for electrokinetic removal of sodium dodecyl sulfate from protein digests.
Sodium dodecyl sulfate (SDS) in proteomics samples needs to be removed and estimated prior to mass spectrometry (MS)-based analysis and to avoid MS ion-source contamination. Here, we describe an organic solvent free method to remove SDS using a simple apparatus that mainly consists of an agarose gel inside a 1 mL plastic micropipette tip and a voltage power supply with electrodes. A small volume of sample (e.g., 50 μL) is loaded on top of the gel and then voltage (cathode at the sample side) is applied with an acidic solution at the other end of the micropipette tip. Within 25 min, SDS was removed (e.g., ≥99% SDS in 3.5 mM SDS) and the peptides were retained in the sample solution. The strategy was compared to the commercially available and expensive Pierce spin column for the removal of SDS and recovery of peptides from a digested bovine serum albumin sample.


Combined Effects of Electroacupuncture and Behavioral Training on Learning-Memory Ability and Event-Related Potential P300 in Rats with Mid/Advanced Cerebral Infarction.
The effectiveness of the combination of electroacupuncture (EA) and behavioral training (BT) for mid/advanced cerebral infarction (M/ACI) and related mechanisms remains unclear. This study aimed to investigate the combined effects on the learning-memory ability and event-related potential P300 in rats with M/ACI. Eighty rats with M/ACI were divided into Group Model (M), Group EA, Group BT, and Group EA-BT (n = 20) according to the random number with five healthy rats in Group Control (CON). On the 6th week after modeling, EA, BT, and EA-BT were given to Group EA, Group BT, and Group EA-BT, respectively, whereas Group M and Group CON were not given any intervention. Y-maze test and P300 were recorded before and after the intervention. After intervention, the P300 latency was lower and the amplitude was higher in the Group EA-BT, Group EA, and Group BT than before (for latency, t = -7.638, -4.334, and -5.916; for amplitude, t = 8.125, 3.846, and 5.238; P < 0.01), with Group EA-BT superior to Group EA (for latency, t = -3.708; for amplitude, t = 3.653; P < 0.01) and Group BT (for latency, t = -2.067; for amplitude, t = 2.816; P < 0.05), with no significant difference between Group BT and EA (for latency, t = -1.439; for amplitude, t = 1.075; P > 0.05). While the performances of Y-maze tests in the Group EA-BT, Group EA, and Group BT were all better than before (t = 10.359, 4.520, and 7.791, P < 0.01), with Group EA-BT better than Group EA (t = 5.627, P < 0.01) and Group BT (t = 2.913, P < 0.01) respectively, and Group BT better than Group EA (t = 2.912, P < 0.01). EA or BT can affect P300 in rats with M/ACI, and the combination of these two methods can significantly improve the learning-memory ability.