Mediatorless solar energy conversion by covalently bonded thylakoid monolayer on the glassy carbon electrode.
Light reactions of photosynthesis that take place in thylakoid membranes found in plants or cyanobacteria are among the most effective ways of utilizing light. Unlike most researches that use photosystem I or photosystem II as conversion units for converting light to electricity, we have developed a simple method in which the thylakoid monolayer was covalently immobilized on the glassy carbon electrode surface. The activity of isolated thylakoid membrane was confirmed by measuring evolving oxygen under illumination. Glassy carbon surfaces were first modified with partial or full monolayers of carboxyphenyl groups by reductive C-C coupling using 4-aminobenzoic acid and aniline and then thylakoid membrane was bioconjugated through the peptide bond between amine residues of thylakoid and carboxyl groups on the surface. Surface properties of modified surfaces were characterized by cyclic voltammetry, contact angle measurements, and electrochemical impedance spectroscopy. Photocurrent of 230 nA cm(-2) was observed when the thylakoid monolayer was formed on the mixed monolayer of 4-carboxylpheny and benzene at applied potential of 0.4V vs. Ag/AgCl. A small photocurrent resulted when the 4-carboxyphenyl full monolayer was used. This work shows the possibility of solar energy conversion by directly employing the whole thylakoid membrane through simple surface modification.


Development of a selective solid phase extraction method for nitro musk compounds in environmental waters using a molecularly imprinted sorbent.
A powerful analytical method for the determination of the family of the nitro musk compounds at trace level in environmental waters-river, sea, and water from a treatment plant-is presented. The method is based on the use of molecularly imprinted silica (MIS) as sorbent for solid phase extraction (SPE) used for the clean-up and the concentration step of the target analytes previous to their determination by gas chromatography-mass spectrometry. The optimized extraction procedure allowed extraction recoveries between 61% and 87% using the MIS. The comparison with a non-imprinted silica (NIS) sorbent, for which extraction recoveries between 8% and 26% were obtained, showed the high selectivity of the MIS for the nitro musks. Moreover, high enrichment factors, ranging between 580 and 827, were achieved. The imprinted sorbent was compared to a conventional polymeric SPE sorbent for the extraction of the target compounds from environmental waters, showing high selectivity of the MIS and its clean-up potential. For the first time, the five nitro musk compounds were selectively extracted with an imprinted material.


Production of the dinoflagellate Amphidoma languida in a large scale photobioreactor and structure elucidation of its main metabolite AZA-39.
Shellfish contamination with azaspiracids (AZA) is a major and recurrent problem for the Irish shellfish industry. Amphidoma languida, a small thecate dinoflagellate of the family Amphidomataceae, is widely distributed in Irish coastal waters and is one of the identified source species of azaspiracids. Irish and North Sea strains of Am. languida have been found to produce as major metabolites AZA-38 and -39 whose structures have only been provisionally elucidated by mass spectrometry and their toxic potential is currently unknown. In order to provide pure AZA-38 and -39 for subsequent structural and toxicological analyses, we present the first successful large-scale culture of Am. languida. A 180 L in house prototype bioreactor was used for culture growth and harvesting in semi-continuous mode for two months. Two different runs of the photobiorector with different light and pH setting showed the highest toxin yield at higher light intensity and slightly higher pH. AZA-38 and -39 cell quota were measured throughout the complete growth cycle with AZA-39 cell quota increasing in proportion to AZA-38 at late stationary to senescence phase. Over two experiments a total of 700 L of culture was harvested yielding 0.45 mg of pure AZA-39. The structure of AZA-39 was elucidated through NMR data analyses, which led to a revision of the structure proposed previously by mass spectrometry. While the spirotetrahydrofuran/tetrahydrofuran of rings A and B has been confirmed by NMR for AZA-39, a methyl is still present in position C-14 and the carboxylic acid chain is different from the structure proposed initially.


Crystal structure and Hirshfeld surface analysis of (5aS,8aR)-3,5a-dimethyl-8-methyl-idene-2-oxododeca-hydro-oxireno[2',3':6,7]naphtho-[1,2-b]furan-6-yl (Z)-2-methyl-but-2-enoate extracted from Ferula persica.
In the title compound, C20H26O5, the two cyclo-hexane rings adopt boat and half-chair conformations. In the crystal, adjacent mol-ecules are connected by inter-molecular C-H⋯O hydrogen bonds, forming a three-dimensional network. According to a Hirshfeld surface study, H⋯H inter-actions are the most significant contributors to the crystal packing (63.0%).


Technological advances in probing 4D genome organization.
The last two decades of work on chromosome conformation in eukaryotic nuclei have revealed a complex and highly regulated hierarchy of architectural features, from self-associating domains and compartmental interactions to locus-specific loops. Recent findings have shown that these structures are dynamic and heterogeneous, with emerging insights into the factors that shape them and implications for the control of transcription and other nuclear processes. Here, we review the latest advances in the DNA sequencing- and microscopy-based technologies for probing these features in space and time (4D) and discuss how they have been combined with complementary approaches such as genetic perturbations, protein and RNA measurements, and modeling to gain mechanistic insights about genome regulation across space and time.


Hemispheric language lateralization in presurgical patients with temporal lobe epilepsy: Improving the retest reliability of functional transcranial Doppler sonography.
Since its introduction, functional transcranial Doppler sonography (fTCD) has been extensively applied in research and clinical settings and has now become part of the routine presurgical work-up of patients with epilepsy. Because of its importance in planning neurosurgical interventions and predicting possible cognitive risks, the reproducibility of fTCD in determining hemispheric language lateralization (HLL) has to be ensured. In the present study, fTCD was performed twice in 33 initially lateralized patients with temporal lobe epilepsy (TLE) as part of their presurgical work-up, using a standard word generation paradigm. Initially, the standard analysis, including only the statistical examination of fTCD data, was applied, and a rather poor retest reliability of r = 0.41 was obtained (p = 0.017). Because of doubts concerning appropriate task performance in some patients, subsequently, a two-step data analysis was introduced, including an additional qualitative evaluation of fTCD data regarding (1) instruction-compliant task performance, (2) sufficient quality of the baseline phase, and (3) adequate increase in cerebral blood flow velocity (CBFV) during the activation phase. Attributable to a more valid interpretation of fTCD data after the application of the qualitative step, the reproducibility of HLL significantly improved (p = 0.007) to a high retest reliability of r = 0.84 (p < 0.000). In clinical settings, psychological and situational factors seem to strongly influence the reproducibility of fTCD determining HLL. Accordingly, we highly recommend the complementation of the standard statistical examination of fTCD data by an additional qualitative evaluation (two-step data analysis), as this extra security is particularly desirable because of its direct implications for the further evaluation of neurosurgical interventions. This article is part of the Special Issue "Individualized Epilepsy Management: Medicines, Surgery and Beyond".


Imaging characteristics of delayed surface calcification in hydrophilic intraocular lens models.
We report two cases of opacified explanted intraocular lenses (IOL).The first lens was explanted from a cataract patient, then treated in vitro with trypsin/ethylene-diamine-tetra-acetic acid. The second hydrophilic acrylic IOL was explanted from a patient who had undergone sulphur hexafluoride (SF6) gas endotamponade surgery to repair a retinal detachment.


Estimation of genetic parameters for reproductive traits in Shall sheep.
The objective of this study was to estimate genetic parameters for reproductive traits in Shall sheep. Data included 1,316 records on reproductive performances of 395 Shall ewes from 41 sires and 136 dams which were collected from 2001 to 2007 in Shall breeding station in Qazvin province at the Northwest of Iran. Studied traits were litter size at birth (LSB), litter size at weaning (LSW), litter mean weight per lamb born (LMWLB), litter mean weight per lamb weaned (LMWLW), total litter weight at birth (TLWB), and total litter weight at weaning (TLWW). Test of significance to include fixed effects in the statistical model was performed using the general linear model procedure of SAS. The effects of lambing year and ewe age at lambing were significant (P<0.05). Genetic parameters were estimated using restricted maximum likelihood procedure, under repeatability animal models. Direct heritability estimates were 0.02, 0.01, 0.47, 0.40, 0.15, and 0.03 for LSB, LSW, LMWLB, LMWLW, TLWB, and TLWW, respectively, and corresponding repeatabilities were 0.02, 0.01, 0.73, 0.41, 0.27, and 0.03. Genetic correlation estimates between traits ranged from -0.99 for LSW-LMWLW to 0.99 for LSB-TLWB, LSW-TLWB, and LSW-TLWW. Phenotypic correlations ranged from -0.71 for LSB-LMWLW to 0.98 for LSB-TLWW and environmental correlations ranged from -0.89 for LSB-LMWLW to 0.99 for LSB-TLWW. Results showed that the highest heritability estimates were for LMWLB and LMWLW suggesting that direct selection based on these traits could be effective. Also, strong positive genetic correlations of LMWLB and LMWLW with other traits may improve meat production efficiency in Shall sheep.


Russian bank data: Birth and death, location, acquisitions, deposit insurance participation, state and foreign ownership.
For every Russian bank we hand collect information on its registration, license revocation, liquidation, location changes, acquisitions, entrance to and exit from the Deposit Insurance System as well as state and foreign ownership. The data come from various sources freely available online. Yet, some of these data are hard to find or require some tedious work to organize. This paper brings the information together and makes it publicly available. Combined with Russian bank financial statements (freely available on Bank of Russia's website) this dataset provides ample possibilities for empirical research: on bank failure prediction models; on how acquisitions affect competition; on how bank efficiency varies with ownership; on how a particular event, such as acquisition, change of location or ownership, or acceptance to deposit insurance, affects bank behavior and performance.


Intranasal administration of regulatory dendritic cells is useful for the induction of nasal mucosal tolerance in a mice model of allergic rhinitis.
Intranasally administered dendritic cells (DCs) migrate into blood and thymus to induce immune responses. Regulatory dendritic cells (DCs) are also useful agents for allergy control. However, to the best of our knowledge, the effects of intranasal administration of regulatory DCs on allergy have not been reported until now. Therefore, we examined the effects of intranasal route of administration of CD40-silenced DCs on allergic responses and compared these with the effects of other administration routes, based on our previous findings on the inhibitory effects of CD40-silenced DCs on allergic responses. Mice with allergic rhinitis were treated intranasally, subcutaneously, intraperitoneally, or intravenously with CD40-silenced ovalbumin (OVA)-pulsed DCs that were transfected with CD40 siRNAs and pulsed with OVA antigen. The effects of these DCs on allergic reactions and symptoms were estimated. Intranasal, subcutaneous, intraperitoneal, or intravenous administration of OVA-pulsed CD40-silenced DCs inhibited allergic responses and symptoms in mice. Furthermore, intranasal administration of OVA-pulsed CD40-silenced DCs significantly reduced allergic symptoms and the number of eosinophils in the nasal mucosa compared with subcutaneous, intraperitoneal, or intravenous administration of these DCs. Intranasal administration of OVA-pulsed CD40-silenced DCs resulted in significantly up-regulated IL-10, IL-35, and Foxp3 expression, and enhanced the percentage of CD11c+CD40- and CD4+CD25+ cells within the cervical lymph nodes compared to subcutaneous, intraperitoneal, or intravenous routes of administration. We believe that this is the first report to demonstrate that regulatory DCs infiltrate into the cervical lymph nodes after intranasal administration of these cells and that intranasal administration of regulatory DCs is more effective for the induction of tolerance in the nasal mucosa than subcutaneous, intraperitoneal, or intravenous administration.


Healthcare payment reforms across western countries on three continents: lessons from stakeholder preferences when asked to rate the supportiveness for fulfilling patients' needs.
To test the hypothesis that care typology-being complex and highly unpredictable versus being clear-cut and highly predictable-guides healthcare payment preferences of physicians, policy makers, healthcare executives, and researchers. We collected survey data from 942 stakeholders across Canada, Europe, Oceania, and the United States. A total of 48 international societies invited their members to participate in our study. Cross-sectional analysis of stakeholder survey data linked to four scenarios of care typology: primary prevention, trial-and-error care, standard care and network care. We identified two "extremes": (1) dominant preferences of physicians, who embraced fee for service (FFS), even when this precludes the advantages of other payment systems associated with a minimal risk of harm (OR 1.85 for primary prevention; OR 1.89 for standard care, compared to non-physicians); and (2) the dominant preferences of healthcare executives and researchers, who supported quality bonus or adjustment (OR 1.92) and capitation (OR 2.05), respectively, even when these could cause harm. Based on exploratory findings, we can cautiously state that payment reform will prove to be difficult as long as physicians, healthcare executives, and researchers misalign payment systems with the nature of care. Replication studies are needed to (dis)confirm our findings within representative subsamples per area and stakeholder group.


Effect of undernutrition on cell generation in the adult rat brain.
Cell proliferation and cell death in the lateral ventricular subependymal layer were studied in acutely food-deprived and chronically undernourished 6-week-old rats. The length of the cell cycle was increased by 40-75%, while the DNA synthesis phase of the cycle was prolonged by 70-85%. The rate of cell acquisition was reduced to approximately half the control level, and the proportion of degenerating cells was significantly increased. The response to undernutrition of proliferating cells in the subependymal layer of adult rats differs from that in animals in the first two weeks of life, and resembles that seen in other tissues.


Characterizing the variation of particles in varied sizes from a container truck in a port area.
The transportation of container trucks in urban areas not only frequently causes traffic jams but also produces severe air pollution. With regard to this consideration, measurements of particle concentrations and traffic volume on different polluted days were carried out to discover the varied characteristics of particles from container truck transportation in the port area. Based on the original data, descriptive statistics were performed firstly to reveal the statistical characteristics of particle number concentrations (PNC). The Kolmogorov-Smirnov test as well as the Anderson-Darling test was adopted to identify the "best-fit" distributions on PNC data while the corresponding maximum likelihood estimation was conducted to estimate the parameters of the identified distribution. Additionally, the Pearson correlation analysis and principal component analysis were performed respectively to reveal the relationships between traffic volume and PNC. The results showed that on a hazy day, PNC levels in the morning were generally higher than those in the afternoon, while on a non-hazy day, the results were opposite. Particles in all sizes on a non-hazy day and larger than 0.5 μm on a hazy day were verified to fit the lognormal distribution. In contrast to the particles below 2 μm, the particles above 2 μm exhibited higher correlations with the traffic flow of a container truck in the morning on a hazy day. These results indicate the importance of reducing air pollution from a container truck and provide policymakers with a foundation for possible measures in a port city.


The relationship between personality, dysfunctional parenting in childhood, and lifetime depression in a sample of employed Japanese adults.
Few studies have explored the relationship between personality, dysfunctional parenting in childhood, and adult depression. Parental rearing styles and personality scores as measured by the Parental Bonding Instrument (PBI) and the Interpersonal Sensitivity Measure (IPSM) were compared in a group of employed Japanese adults with and without a lifetime history of depression. The diagnosis was provided by the Inventory to Diagnose Depression, Lifetime version (IDDL). To estimate the effects of the PBI and the IPSM scores on lifetime depression, a multiple logistic regression analysis was performed. Subjects with lifetime depression were seen to have significantly lower scores on the PBI 'care' and higher scores on the IPSM than the subjects without lifetime depression. Lower levels of maternal care and higher levels of 'interpersonal sensitivity' each independently increased the risk for lifetime depression. The findings of the present study may not be conclusive since the data were retrospectively obtained. Dysfunctional parenting and personality seem to be correlated by lifetime depression, but it is uncertain whether they are independent risk factors


Synthesis and in vitro cytotoxicity of cinnamaldehydes to human solid tumor cells.
Cinnamaldehydes and related compounds were synthesized from various cinnamic acids based on the 2'-hydroxycinnamaldehyde isolated from the bark of Cinnamomum cassia Blume. The cytotoxicity to human solid tumor cells such as A549, SK-OV-3, SK-MEL-2, XF498 and HCT15 were measured. Cinnamic acid, cinnamates and cinnamyl alcohols did not show any cytotoxicity against the human tumor cells. Cinnamaldehydes and related compounds were resistant to A549 cell line up to 15 micrograms/ml. In contrast, HCT15 and SK-MEL-2 cells were much sensitive to these cinnamaldehyde analogues which showed ED50 values 0.63-8.1 micrograms/ml. Cytotoxicity of the saturated aldehydes was much weak compared to their unsaturated aldehydes. From these studies, it was found that the key functional group of the cinnamaldehyde-related compounds in the antitumor activity is the propenal group.


Interstitial granulomatous lesions as part of the spectrum of presenting cutaneous signs in pediatric sarcoidosis.
Skin findings in childhood sarcoidosis vary greatly, but only a few occurrences have been published in which the histopathology has been characterized well. We describe a child with sarcoidosis in whom the cutaneous findings were atypical, resembling granuloma annulare. Histologic examination of these cutaneous lesions, however, revealed areas of sarcoid-like epithelioid cell granulomas, a palisading granulomatous process with features of granuloma annulare, as well as palisading neutrophilic and granulomatous dermatitis and interstitial granulomatous dermatitis. This underscores the variability of skin findings in childhood sarcoidosis--even within the same patient--and suggests that sarcoidosis should be considered in the differential diagnosis of children initially diagnosed with granulomatous skin lesions, such as granuloma annulare, palisading neutrophilic, and granulomatous dermatitis or interstitial granulomatous dermatitis, who demonstrate associated signs of systemic disease.


Effect of chronic endurance exercise on retention of dietary protein.
On two separate occasions, five well-trained endurance runners (VO2max = 71 +/- 5 ml/kg/min; means +/- SD) consumed a meat-free diet for 6 days. For one trial the subjects consumed the recommended dietary allowance (RDA) of protein (REC-PRO = 0.86 +/- 0.23 g/kg body wt/day). Protein intake for the other trial was 1.7 times higher (HI-PRO = 1.49 +/- 0.29 g/kg body wt/day). Each subject followed his regular training program (12-16 km running/day), and on day 5 of each diet completed a treadmill run at a similar intensity and duration (75 min at 72% VO2max). Seventy-two hour urinary urea N loss (days 4, 5, and 6 of each diet) and day 5 exercise sweat urea N excretion were measured. Serum urea N and creatinine increased significantly during the treadmill run under both dietary conditions (P less than 0.05). No significances between diet differences were observed in sweat or urinary urea N excretion; however, excretion of both tended to be higher on the REC-PRO diet than on the HI-PRO diet. The differences in protein intake combined with the nitrogen excretion measures resulted in significant differences in estimated whole-body nitrogen retention between the two treatments. Nitrogen retention (means +/- SE) remained positive during the HI-PRO trial (2.41 +/- 1.99 g/day) but was significantly (P less than 0.005) reduced to -5.29 +/- 2.58 g/day during the REC-PRO trial. These results suggest that the current protein RDA may be inadequate for athletes engaging in chronic high-intensity endurance exercise. Future studies are needed to confirm this observation.


Laryngeal chondritis induced by C3-4 osteophyte following supracricoid laryngectomy with cricohyoidoepiglottopexy: report of two cases.
We have performed supracricoid laryngectomy with cricohyoidoepiglottopexy or with cricohyoidopexy for tumour (T) stage T2 and T3 laryngeal cancer cases and some T4 cases. We report the clinical symptoms and management, using this technique to avoid complications. Among patients undergoing the procedure, two cases manifested laryngeal chondritis following laryngectomy with cricohyoidoepiglottopexy. This complication was caused by C3-4 cervical osteophytes physically contacting the cricoid cartilage. Laryngeal microlaryngoscopy was performed, which revealed white, necrotic tissue in the posterior wall of the pharynx and persistent oedema of the neoglottis. When encountering a patient with an excessive osteophyte formation at the level of C3-4, one needs to take extra precautions when undertaking laryngectomy with cricohyoidoepiglottopexy or with cricohyoidopexy.


The ultrasound appearance of the normal psoas muscle.
One hundred and forty-four psoas muscles in 72 subjects were scanned to study the normal ultrasound appearance. For the purpose of description the psoas was divided into three sections. Ten of the 432 sections could not be adequately seen on ultrasound. The psoas demonstrated hyperechoic striations on a hypoechoic background typical of muscle. In addition the upper section, from the origin of the muscle to the lower pole of the kidney, contained echogenic planes in 15 (10%) and the mid section, from the lower pole of kidney to iliac crest, demonstrated prominent echogenic planes and focal areas of increased and decreased echogenicity in 65 (46%). The lower section, from the iliac crest to fusion with the iliacus, demonstrated a single echogenic plane in 96 (70.5%) which was best seen running obliquely in the transverse plane and in 40 (29.5%) there were more complex echogenic planes or focal areas of increased or decreased echogenicity. The cause of the prominent echogenic plane in the lower section was not apparent in the anatomical literature and therefore cadaveric dissection of nine psoas muscles was performed which demonstrated that the echogenic plane was caused by intramuscular tendon fibres formed from the more cranial origins of the psoas. The psoas minor was not identified as a separate structure.


Disruptive 3D in vitro models for respiratory disease investigation: A state-of-the-art approach focused on SARS-CoV-2 infection.
COVID-19, along with most respiratory diseases in the medical field, demonstrates significant ability to take its toll on global population. There is a particular difficulty in studying these conditions, which stems especially from the short supply of in vitro models for detailed investigation, the specific therapeutic knowledge required for disease scrutinization and the occasional need of BSL-3 [Biosafety Level 3] laboratories for research. Based on this, the process of drug development is hampered to a great extent. In the scenario of COVID-19, this difficulty is even more substantial on account of the current undefinition regarding the exact role of the ACE2 [Angiotensin-converting enzyme 2] receptor upon SARS-CoV-2 kinetics in human cells and the great level of demand in the investigation process of ACE2, which usually requires the laborious and ethically complicated usage of transgenic animal models overexpressing the receptor. Moreover, the rapid progression of the aforementioned diseases, especially COVID-19, poses a crucial necessity for adequate therapeutic solutions emergence. In this context, the work herein presented introduces a groundbreaking set of 3D models, namely spheroids and MatriWell cell culture inserts, whose remarkable ability to mimic the in vivo environment makes them highly suitable for respiratory diseases investigation, particularly SARS-CoV-2 infection. Using MatriWells, we developed an innovative platform for COVID-19 research: a pulmonary air-liquid interface [ALI] associated with endothelial (HUVEC) cells. Infection studies revealed that pulmonary (BEAS-2B) cells in the ALI reached peak viral load at 24h and endothelial cells, at 48h, demonstrating lung viral replication and subsequent hematogenous dissemination, which provides us with a unique and realistic framework for studying COVID-19. Simultaneously, the spheroids were used to address the understudied ACE2 receptor, aiming at a pronounced process of COVID-19 investigation. ACE2 expression not only increased spheroid diameter by 20% (p<0.001) and volume by 60% (p≤0.0001) but also led to a remarkable 640-fold increase in intracellular viral load (p≤0.01). The previously mentioned finding supports ACE2 as a potential target for COVID-19 treatment. Lastly, we observed a higher viral load in the MatriWells compared to spheroids (150-fold, p<0.0001), suggesting the MatriWells as a more appropriate approach for COVID-19 investigation. By establishing an advanced method for respiratory tract conditions research, this work paves the way toward an efficacious process of drug development, contributing to a change in the course of respiratory diseases such as COVID-19.


Occurrence and risk levels of antibiotic pollution in the coastal waters of eastern China.
In order to preliminarily explore the distribution of antibiotic pollution in the coastal waters of eastern China, the concentrations of 13 antibiotics in 5 representative coastal rivers in Jiangsu and 21 sampling sites in the coastal waters of Jiangsu were analyzed. The total antibiotic concentrations in the 5 rivers ranged from 33.14 to 417.78 ng L-1, and the total antibiotic concentrations in the 21 sampling sites ranged from 0.90 to 86.33 ng L-1. Macrolides exhibited the highest total concentration and the maximum detection frequency in both coastal rivers and the coastal waters. The concentrations of antibiotics in a sampling site decreased as the distance of the sampling site from the coastline increased, indicating that river inputs are important sources of antibiotic pollution in the coastal waters of Jiangsu. The detection frequencies of roxithromycin, lincomycin, azithromycin, and sulfamethoxazole in the rivers and sampling sites were above 70%. Correlation analysis showed that the concentrations of antibiotics were positively correlated with the levels of chemical oxygen demand, total phosphorus, and total nitrogen. Risk assessments revealed that roxithromycin and ofloxacin posed medium ecological and resistance risks, respectively, to the most sensitive aquatic organisms in the coastal waters of Jiangsu. The results of this study highlight the significance of monitoring and controlling the concentrations of antibiotic contaminants in the coastal waters of Jiangsu.


Median Canaliform Dystrophy of Heller occurring on thumb and great toe nails.
Median Canaliform Dystrophy of Heller is a rare but morphologically striking habit tic deformity of thumb nails characterized by midline longitudinal furrow with multiple transverse parallel lines. The proposed etiopathogenesis is repetitive trauma to the nail plate and cuticle, however some case reports have suggested familial occurrence and use of oral retinoids in its causation. Treatment is often prolonged and unsatisfactory, though some topical agents have been used successfully. We report a case of a young male patient presenting with Median Dystrophy of Heller affecting both Great thumb and toe nails simultaneously.


AP lyase activity of the human ribosomal protein uS3: The DNA cleavage sequence specificity and the location of the enzyme active center.
The human protein uS3, a component of the small ribosomal subunit, has a long-known extra-ribosomal activity as an enzyme of base excision DNA repair displayed in its ability to cleave DNA at abasic (AP) sites. It has been found that the efficacy of DNA cleavage by uS3 in vitro depends on the DNA sequence. To clarify the issue on the sequence specificity of uS3 as an AP lyase in general, we applied a combinatorial approach based on the use of a model single-stranded circular DNA with an AP site flanked with random trinucleotides at both sides. The cleavage of this DNA by uS3 under conditions when only its minor portion undergoes the reaction resulted in the formation of the linear DNA with random triplets at the 5' and 3' termini. NGS sequencing of the DNA library derived from this DNA allowed identifying the contexts within which uS3 cleaves DNA the most and the least effectively. Given that the AP lyase reaction occurs via the formation of a covalent intermediate (Schiff base), we determined the region comprising the active center of the uS3 protein. By digesting of uS3 cross-linked to a radiolabeled AP site-containing model DNA with specific proteolytic agents followed by analysis of the resulting modified oligopeptides, the cross-link was mapped to the region 155-192 (likely, to R173/R178). Thus, our results clarified two previously unstudied features of the uS3 AP lyase activity, one related to the recognition of sequences in DNA surrounding the AP site, and the other to the protein region directly contacting this site.


Molybdenum-free nitrate reductases from vanadate-reducing bacteria.
Two catalytically distinct molybdenum-free dissimilatory nitrate reductases, a soluble periplasmic and a membrane-bound one, were isolated from the vanadate-reducing facultatively anaerobic bacterium Pseudomonas isachenkovii and purified to electrophoretic homogeneity. The enzymes did not contain molybdenum, the periplasmic enzyme contained vanadium, whereas the membrane-bound enzyme was vanadium-free. Both nitrate reductases lacked molybdenum cofactor. This fact was proved by reconstitution of the apoprotein of the nitrate reductase of Neurospora crassa nit-1 mutant. This is the first demonstration of molybdenum-free and molybdenum cofactor-free nitrate reductases.


Simultaneous Removal of Phenol and Dissolved Solids from Wastewater Using Multichambered Microbial Desalination Cell.
Microbial desalination cell (MDC) has great potential toward direct electricity generation from wastewater and concurrent desalination through potential difference developed due to microbial activity. Degradation of phenol by isolate Pseudomonas aeruginosa in anodic chamber and simultaneous desalination of water in middle desalination chamber of multichamber MDC is demonstrated in this study. Performance of the MDCs with different anodic inoculum conditions, namely pure culture of P. aeruginosa (MDC-1), 50 % v/v mixture of P. aeruginosa and anaerobic mixed consortia (MDC-2) and anaerobic mixed consortia (MDC-3), was evaluated to compare the phenol degradation in anodic chamber, bioelectricity generation, and simultaneous total dissolved solids (TDS) removal from saline water in desalination chamber. Synergistic effect between P. aeruginosa and mixed anaerobic consortia as inoculum was evident in MDC-2 demonstrating phenol degradation of 90 %, TDS removal of 75 % in 72 h of reaction time along with higher power generation of 27.5 mW/m(2) as compared to MDC-1 (95 %, 64 %, 12.8 mW/m(2), respectively) and MDC-3 (58 %, 52 %, 4.8 mW/m(2), respectively). The results illustrate that the multichamber MDC-2 is effective for simultaneous removal of phenol and dissolved solids contained in industrial wastewaters.


The versatility of the reverse superior labial artery flap.
The reverse superior labial artery flap was introduced in 2015 as a reconstructive option for medial cheek defects. Notably, this flap can be redesigned as a more effective repair tool for large facial defect reconstruction. In this study, we redesigned the reverse superior labial artery flap to include the vascular territories of the infraorbital and transverse facial arteries in larger sizes for the repair of large facial defects. A reverse superior labial artery flap was used to repair large facial defects in 17 patients with a mean age of 74 years. The defects were located in the orbital region and entirely nasal sidewall in patient two, buccal region in patient three, and in lower lip and malar areas in patient five. The flap sizes ranged from 3.5 × 10 to 7 × 15 cm. A sensory examination was performed on the flaps at 6 and 12 months postoperatively. The mean follow-up period was 12 months. All flaps survived without partial or total loss. In a small number of flaps minor complications such as venous congestion, epidermolysis, and dehiscence were seen. No functional disability was observed in the lower eyelid or lower lip, and the esthetic appearance was evaluated as satisfactory by the patients. In all the flaps, the protective sensation was recovered in the postoperative 12th month. The reverse superior labial artery flap has an extensive arc of rotation, a reliable vascular pedicle, and a large cutaneous paddle. Therefore, this flap may be a versatile surgical repair tool for large cheek defects.


Social adjustment and alcoholism among Chinese immigrants in New York City.
Based upon the patient files (N = 132) maintained by the Chinatown Alcoholism Services (CAS), interviews with CAS staff, and the clinical experience of the authors with Chinese alcoholics, this paper describes the social contexts of alcoholism among a group of working-class Chinese males in New York City. It focuses on the relationship between social adjustment and drinking behaviors, and analyzes the meaning of alcohol use and abuse within the ethnic community. The paper also examines the role of significant others in the alcoholics' drinking and help-seeking behaviors. Finally, treatment and research issues pertaining to alcoholism among the Chinese are discussed.


"This is most likely not the correct vaccine": Analyzing COVID-19's viral spread and vaccine anxieties in Ghana, Cameroon, and Malawi.
Following the successful development of vaccines for COVID-19, attention turned to the problem of vaccine access. However, in contexts where vaccines are available, hesitancy remains a major problem. Informed theoretically by the scholarship on vaccine anxiety, this paper uses a qualitative research approach that included 144 semi-structured interviews to investigate how social and political dynamics shaped people's perspectives in particular environments in Ghana, Cameroon, and Malawi about COVID-19's viral spread and COVID-19 vaccines. Vaccines and the viral spread of COVID-19 are related to political tensions and class-related fractures in particular contexts, and how the public interprets COVID-19's viral spread and engages with vaccination is based on people's social and political environment and their experience. Subjectivities are also rooted in coloniality. Vaccine confidence goes beyond clinical and regulatory authority approvals, and encompasses forces that are economic, social, and political in nature. Thus, an exclusive focus on technical prescriptions for enhancing vaccine uptake will not achieve significant positive results.


Stem cell Derived Extracellular Vesicles to Alleviate ischemia-reperfusion Injury of Transplantable Organs. A Systematic Review.
The possible beneficial effects of stem cell-derived EV on ischemia-reperfusion injury (IRI) in organ transplantation have been frequently investigated; however, the source of EV, as well as the methods of isolation and administration vary widely. We conducted a systematic review to summarize current pre-clinical evidence on stem cell-derived EV therapy for IRI of transplantable organs. PubMed, Embase and Web of Science were searched from inception until August 19th, 2022, for studies on stem cell-derived EV therapy for IRI after heart, kidney, liver, pancreas, lung and intestine transplantation. The Systematic Review Center for Laboratory animal Experiments (SYRCLE) guidelines were followed to assess potential risk of bias. The search yielded 4153 unique articles, of which 96 were retained. We identified 32 studies on cardiac IRI, 38 studies on renal IRI, 21 studies on liver IRI, four studies on lung IRI and one study on intestinal IRI. Most studies used rodent models of transient ischemic injury followed by in situ reperfusion. In all studies, EV therapy was associated with improved outcome albeit to a variable degree. EV-therapy reduced organ injury and improved function while displaying anti-inflammatory-, immunomodulatory- and pro-regenerative properties. A multitude of animal studies support the potential of stem cell-derived EV-therapy to alleviate IRI after solid organ transplantation but suffer from low reporting quality and wide methodological variability. Future studies should focus on determining optimal stem cell source, dosage, and timing of treatment, as well as long-term efficacy in transplant models.


Multi-scenario simulation of China's dynamic relationship between water-land resources allocation and cultivated land use based on shared socioeconomic pathways.
Rapid urban expansion, population growth, and limited cultivated land in China necessitate rethinking the path to sustainable management of cultivated land. Understanding the long-term dynamic relationship between water-land resource endowment and cultivated land use contributes to effective management and use of cultivated land. However, few studies have systematically documented this relationship, especially for future trends. Accordingly, we modified water-land resource matching (WLRM) using a more refined grid-scale and assessed cultivated land use efficiency (CLUE), then deployed spatial panel regression models to quantify historical changes. We subsequently simulated future trends under three Shared Socioeconomic Pathways scenarios. The results showed that the relationship assumed an N-shaped curve in nation, while the curve followed a down-up-down pattern in economically less developed regions, largely because of structural transformations of production factors. Under three development scenarios, the stage-specific characteristics of production factors were pronounced, and the dynamic relationship varied across regions.


MMP-9-positive neutrophil infiltration is associated to blood-brain barrier breakdown and basal lamina type IV collagen degradation during hemorrhagic transformation after human ischemic stroke.
An abnormal expression of some matrix metalloproteinases (MMPs) is related with hemorrhagic transformation events after stroke. Our aim was to investigate MMP-2 and MMP-9 in the ischemic brain and its relation with blood-brain barrier breakdown after hemorrhagic transformation in human stroke. We assessed 5 cases of fatal ischemic strokes with hemorrhagic complications; brain samples were obtained from infarct, hemorrhagic, and contralateral tissue. MMP-9 and MMP-2 content was analyzed by zymography and immunohistochemistry was performed to localize MMP-9 and to assess collagen IV integrity in the basal lamina. Laser capture microdissection was performed to isolate blood-brain barrier vessels to study these MMPs. Overall, MMP-9 levels were higher both in hemorrhagic and nonhemorrhagic infarcted tissue compared to contralateral areas (P<0.0001 and P<0.05). Moreover, levels of the cleaved MMP-9 85kDa-form were significantly elevated in the hemorrhagic compared to nonhemorrhagic and contralateral areas (P=0.033 and P<0.0001). No changes were found for MMP-2 content. Immunostaining revealed a strong MMP-9-positive neutrophil infiltration surrounding brain microvessels associated with severe basal lamina type IV collagen degradation and blood extravasation. Microdissection confirmed that content of MMP-9 was similarly high in microvessel endothelium from hemorrhagic and infarcted areas compared to contralateral hemisphere vessels (P<0.05), pointing to neutrophils surrounding dissected microvessels as the main source of MMP-9 in hemorrhagic areas. Our results show a strong neutrophil infiltration in the infarcted and hemorrhagic areas with local high MMP-9 content closely related to basal lamina collagen IV degradation and blood-brain barrier breakdown. Microvessel and inflammatory MMP-9 response are associated with hemorrhagic complications after stroke.


Puromycin reaction of the A-site bound peptidyl-tRNA.
AcPhe2-tRNA(Phe) which appears in ribosomes after consecutive binding of AcPhe-tRNA(Phe) at the P sites and EF-Tu-directed binding of Phe-tRNA(Phe) at the A sites is able to react quantitatively with puromycin in the absence of EF-G. One could readily explain this fact to be the consequence of spontaneous translocation. However, a detailed study of kinetics of puromycin reaction carried out with the use of viomycin (inhibitor of translocation) and the P-site test revealed that, apart from spontaneous translocation, this peptidyl-tRNA could react with puromycin being located at the A site. This leads to the conclusion that the transpeptidation reaction triggers conformational changes in the A-site ribosomal complex bringing the 3'-end of a newly synthesized peptidyl-tRNA nearer to the peptidyl site of peptidyltransferase center. This is detected functionally as a highly pronounced ability of such a peptidyl-tRNA to react with puromycin.


[Regional experience of a comprehensive dynamic assessment of the adolescents' health status with post-COVID-19 syndrome during aftercare in a sanatorium].
To determine the characteristics of sanatorium-resort therapy impact on children with post-COVID-19 syndrome of various severity, as well as to reveal association of its severity with family history data and genetic polymorphisms of alpha-1-antitrypsin-serpin-1 complex. This 2-week retrospective cohort study involved 42 adolescents after new coronavirus infection (COVID-19). The first group included 28 (67%) patients (mean age 13.1±0.8 years) after mild COVID-19 (without confirmed coronavirus pneumonia), the second group - 14 (33%) patients (mean age 14.5±0.1.2 years) after moderate or severe disease (with confirmed coronavirus pneumonia). A complex of procedures, according to the approved standard, was prescribed for all patients admitted after outpatient and hospital treatment to the pulmonology department of the state children's sanatorium in order to aftercare. The certain follow-up parameters were evaluated: symptoms severity, life quality, respiratory function and respiratory gases, as well as family medical history and alpha-1-antitrypsin-serpin-1 complex. Patients after moderate and severe COVID-19 had initially lower and less dynamic growth of integral life quality index, more torpid follow-up rates of spirometry, pulse oximetry and exhaled gases. Additionally, the higher incidence degree of adverse family medical history associated with respiratory illnesses was established in the group after new coronavirus infection. Moreover, relatively more deficient alpha-1-antitrypsin and more frequent heterozygous polymorphism type of serpin-1 were found in the group after severe new coronavirus infection. The revealed complex of epigenetic and genetic factors may indicate various risk and development phenotypes of both acute and chronic respiratory diseases.


Differential sensitivity of colorectal cancer cell lines to artesunate is associated with expression of beta-catenin and E-cadherin.
Artesunate, a remarkable antimalarial agent, also reveals profound cytotoxic activity. In the present investigation, we compared the anticancer effects of artesunate on three colorectal cancer cell lines and analyzed the relationship between drug sensitivity and malignant phenotype of the tumor cells. The findings are as follows: poorly-differentiated was colorectal cancer cell line CLY showing nuclear beta-catenin accumulation and loss of E-cadherin; moderately-differentiated were Lovo cells with cytoplasmic distribution of the two proteins; and well-differentiated were HT-29 cells with membranous localization of them. Also, both in vitro and in vivo, poorly- or moderately-differentiated CLY and Lovo were more susceptible to artesunate treatment than well-differentiated HT-29. Furthermore, the sensitive response of CLY and Lovo to artesunate was associated with membranous translocation of beta-catenin and increased expression of E-cadherin, which indicated the inhibition of hyperactive Wnt signaling pathway and the reversion of the epithelial to mesenchymal transition, respectively. Due to the vital roles of Wnt pathway and the epithelial to mesenchymal transition in tumor differentiation, we thought artesunate could promote the re-differentiation and apoptosis of colorectal cancer cells by inhibition of hyperactive Wnt pathway and reversion of the epithelial to mesenchymal transition.


Simultaneous leukaemic infiltrate and cholesteatoma in the same temporal bone.
Leukaemic relapse in the ear is very rare. We report a case of relapse of acute lymphoblastic leukaemia in the left ear. The patient presented with an aural polyp and ipsilateral facial palsy. The temporal bone showed simultaneous leukaemic infiltrate and cholesteatoma. To our knowledge, this is the first case reported with such pathology.


BrainS: Customized multi-core embedded multiple scale neuromorphic system.
Research on modeling and mechanisms of the brain remains the most urgent and challenging task. The customized embedded neuromorphic system is one of the most effective approaches for multi-scale simulations ranging from ion channel to network. This paper proposes BrainS, a scalable multi-core embedded neuromorphic system capable of accommodating massive and large-scale simulations. It is designed with rich external extension interfaces to support various types of input/output and communication requirements. The 3D mesh-based topology with an efficient memory access mechanism makes exploring the properties of neuronal networks possible. BrainS operates at 168 MHz and contains a model database ranging from ion channel to network scale within the Fundamental Computing Unit (FCU). At the ion channel scale, the Basic Community Unit (BCU) can perform real-time simulations of a Hodgkin-Huxley (HH) neuron with 16000 ion channels, using 125.54 KB of the SRAM. When the number of ion channels is within 64000, the HH neuron is simulated in real-time by 4 BCUs. At the network scale, the basal ganglia-thalamus (BG-TH) network consisting of 3200 Izhikevich neurons, providing a vital motor regulation function, is simulated in 4 BCUs with a power consumption of 364.8 mW. Overall, BrainS has an excellent performance in real-time and flexible configurability, providing an embedded application solution for multi-scale simulation.


[Postoperative compartment syndrome in a patient with acute aortic dissection (DeBakey type I)].
We report a case of compartment syndrome caused by femoral arterial cannulation during cardiopulmonary bypass. A 62-year-old man who had been diagnosed as acute aortic dissection (type I) received a operation of partial arch replacement with reconstruction of brachiocephalic and left carotid arteries. Compartment syndrome was noticed just after the operation, which was caused by long-term ischemia during femoral arterial cannulation combined with poor collateral circulation by the dissection of iliac arteries. The emergency fascitomy was performed, therefore, he could be discharged without any complications. It is concluded that in case of acute aorte aortic dissection, the back-flow of blood should be checked at the time of femoral arterial cannulation, and whenever the back-flow is poor, some procedures should be added to increase distal blood flow.


A simple measurement hammer for quantitative reflex studies.
A reflex hammer for measurement of the mechanical stimulus strength was designed. Combined with standard EMG equipment this instrument permits the study of both stimulus-response relations and latencies of myotatic reflexes. Some results in normal subjects are discussed.


Bronchoalveolar T lymphocytes and pulmonary sarcoidosis.
In recent years, our understanding of the pathogenesis of sarcoidosis has markedly changed. Originally, it was felt that sarcoidosis was a disease that was caused by a state of anergy. More recent studies suggest that sarcoidosis is not a disease of anergy but is mediated by a classic, heightened cellular immune process. It is hoped that additional studies utilizing inflammatory and immune effector cells obtained from sites of disease will further elucidate the pathogenic mechanisms leading to granuloma formation in patients with sarcoidosis.


An empirical basis for standardizing adherence measures derived from administrative claims data among diabetic patients.
To compare the predictive validity of 8 different adherence measures by studying the variability explained between each measure and 2 outcome measures: hospitalization episodes and total nonpharmacy cost among Medicaid eligible persons diagnosed with diabetes. This study was a retrospective analysis of the Arkansas Medicaid administrative claims data from January 2000 to December 2006. Diabetic (ICD-9-CM = 250.0 x - 250.9 x, where x = 0 or 2) patients were identified in the recruitment period July 2000 through April 2004. Patients had to be >or=18 years old and have at least 2 prescription fills in the index period for an oral antidiabetic drug. : Adherence rates to oral antidiabetic therapy were contrasted using the following 8 measures; including the medication possession ratio (MPR), proportion of days covered (PDC), refill compliance rate (RCR), compliance ratio (CR), medication possession ratio, modified (MPRm), continuous measure of medication gaps (CMG), and continuous multiple interval measure of oversupply (CMOS and continuous, single interval measure of medication acquisition (CSA). Multivariate and univariate linear and logistic regression models were used to prospectively predict nonpharmacy costs and hospitalizations in the follow-up year. A total of 4943 diabetic patients were studied. In predicting any cause hospitalization, univariate models with PDC and CMG had the highest predictive validity (C-statistic: 0.544). Multivariate models with MPR, PDC, CMG or continuous multiple interval measure of oversupply (CMOS) as adherence measures had the highest C-statistics of 0.701 in predicting diabetes specific hospitalizations. None of the adherence measures were significantly associated with nonpharmacy cost. MPR and PDC had the highest predictive validity for hospitalization episodes. These 2 measures should be considered first when selecting among adherence measures when using administrative prescription claims data.


Prognosis of Adults With Borderline Left Ventricular Ejection Fraction.
This study sought to examine the association of a borderline left ventricular ejection fraction (LVEF) of 50% to 55% with cardiovascular morbidity and mortality in a community-based cohort. Guidelines stipulate a LVEF >55% as normal, but the optimal threshold, if any, remains uncertain. The prognosis of a "borderline" LVEF, 50% to 55%, is unknown. This study evaluated Framingham Heart Study participants who underwent echocardiography between 1979 and 2008 (n = 10,270 person-observations, mean age 60 years, 57% women). Using pooled data with up to 12 years of follow-up and multivariable Cox regression, we evaluated the associations of borderline LVEF and continuous LVEF with the risk of developing a composite outcome (heart failure [HF] or death; primary outcome) and incident HF (secondary outcome). During follow-up (median 7.9 years), HF developed in 355 participants, and 1,070 died. Among participants with an LVEF of 50% to 55% (prevalence 3.5%), rates of the composite outcome and HF were 0.24 and 0.13 per 10 years of follow-up, respectively, versus 0.16 and 0.05 in participants having a normal LVEF. In multivariable-adjusted analyses, LVEF of 50% to 55% was associated with increased risk of the composite outcome (hazard ratio [HR]: 1.37; 95% confidence interval [CI]: 1.05 to 1.80) and HF (HR: 2.15; 95% CI: 1.41 to 3.28). There was a linear inverse relationship of continuous LVEF with the composite outcome (HR per 5 LVEF% decrement: 1.12; 95% CI: 1.07 to 1.16) and HF (HR per 5 LVEF% decrement: 1.23; 95% CI: 1.15 to 1.32). Persons with an LVEF of 50% to 55% in the community have greater risk for morbidity and mortality relative to persons with an LVEF >55%. Additional studies are warranted to elucidate the optimal management of these individuals.


Isolation of cytochalasins A and B fromAscochyta lathyri.
The possible presence of toxic metabolites in the culture extracts of 24Ascochyta strains, grown on autoclaved wheat, was ascertained by the use of the biological assay on brine shrimps (Artemia salina). Only in the culture extract ofA lathyri, that showed a very high toxicity, the presence of cytochalasins A and B was revealed by tlc,(1)H nmr and fab-mass spectra.SinceA heteromorpha, previously described as the firstAscochyta species to produce cytochalasins, has been reclassified asPhoma exigua varheteromorpha, this is therefore the first report on the cytochalasin production by a trueAscochyta species.


Evaluation of an Interferon Gamma Release Assay to Detect Tuberculosis Infection in Children in San Diego, California.
QuantiFERON-TB Gold In-Tube (QFT-GIT) and tuberculin skin test (TST) results are reported in 23 children with active tuberculosis due to Mycobacterium tuberculosis and Mycobacterium bovis. Overall QFT-GIT (96%) was more sensitive than TST (74%) for detecting tuberculosis infection in these patients.


Seasonality in circadian locomotor activity and serum testosterone level in the subtropical tree sparrow (Passer montanus).
Seasonality in daily locomotor activity pattern was investigated in the subtropical tree sparrow by exposing a group of birds to natural day lengths (NDL) for 30days and another group to 12L/12D for 14days followed by transfer to constant dim light (LLdim) for another 15days in four different seasons of the year. Serum testosterone levels were also measured during different seasons. Sparrows, under NDL, exhibited distinct circadian rhythmicity in their locomotor activity with almost similar general pattern in different seasons that restricted mainly to the light hours. However, they showed season-dependent differences in the characteristics of circadian locomotor activity rhythm. Birds, when exposed to 12L/12D, showed entrainment of their locomotor activity rhythm with the activity confined mainly during the light phase. Though, tau (τ) under free run conditions did not show any significant difference, the activity period varied significantly in different seasons. The highest level of testosterone was recorded in the spring season that corresponded with the maximum locomotor activity in spring months. The seasonality in daily locomotor activity correlates with the seasonal changes in testosterone levels suggesting the influence of gonadal steroids on endogenous circadian system which is indicative of adaptation of tree sparrow to local photoperiodic conditions.


Diffuse arterial narrowing as a result of intimal proliferation: a delayed complication of embolectomy with the Fogarty balloon catheter.
Most complications of embolectomy with the Fogarty balloon catheter are recognized early and have received ample attention in the surgical and radiologic literature. However, the delayed complication of diffuse arterial narrowing causing severe ischemia has received little emphasis, perhaps because follow-up arteriography is not always performed. This report describes five patients--women 43 to 62 years of age--with progressive leg ischemia discovered 2 to 4 months after embolectomy with the balloon catheter. Angiography showed a characteristic pattern of severe, smooth narrowing of that portion of the artery in which balloon embolectomy was performed. Pathologic examination of arterial specimens, available in two of the five patients, revealed marked intimal cellular proliferation, which narrowed the arteries severely without evidence of thrombosis, significant atheromatosis, or active arteritis. The cause appears to be intimal damage by the balloon. Embolectomy with the balloon catheter should be done especially carefully in relatively young women.


Prediction of gallstone composition: synthesis of CT and radiographic features in vitro.
To test a morphoradiographic algorithm designed to predict the composition of gallstones with use of computed tomography (CT) to define calcification patterns. Two reviewers retrospectively evaluated the radiographic features of 120 separate in vitro specimens (59 radiopaque and 61 radiolucent), then classified the stones into several categories of composition with the algorithm. The most useful features for prediction of cholesterol composition were, in order of decreasing importance, stone shape, absence of dense calcification on plain radiographs, overall CT attenuation not higher than that of water, presence of a second generation of smaller stones, and a peripheral cover of calcification detected on CT scans of aging cholesterol stones. The greatest error occurred in distinction between stones with mixed composition (50%-79% cholesterol) and older stones with higher cholesterol content (80%-95% cholesterol). The range of qualitative CT appearances advances the possibility of predicting gallstone composition and potential outcome of nonsurgical treatment.


Does provision of a higher Kt/V urea make a difference? A hemodialysis controversial issue.
Adequate dialysis cannot be ascertained on the sole base of a normal or even a high Kt/V(urea) so the impetus of this study was to use the neurophysiologic studies as a marker of the biologic status of the hemodialysis patients to assess the optimum level of Kt/V(urea). This study was carried out on 20 patients (15 men and 5 women) on maintenance hemodialysis; their ages ranged from 18 to 66 years. Initially, the patients were subjected to thorough clinical and laboratory investigations, and their dialysis adequacy was assessed by studying their urea kinetic modeling and neurophysiologic studies (Phase I). Dialysis was optimized to achieve a target Kt/V(urea) of 1.3 in Phase II and 1.5 in Phase III. The duration of each phase was six months at the end of which all patients were thoroughly reevaluated. Nutrition was not manipulated during the study. A neurophysiologic study showed a significant improvement of polyphasicity pattern of both proximal and distal muscles of the upper and lower limbs concomitant with improvement of quality of life on achieving a Kt/V(urea) of 1.5 (p < 0.001). There was no significant change of the duration and amplitude of all studied muscles, however. Achieving a Kt/V(urea) of 1.5 is a more suitable target for hemodialysis patients because it may be an avenue for improving the neuromuscular functions of these patients.


An alternative polysaccharide uptake mechanism of marine bacteria.
Heterotrophic microbial communities process much of the carbon fixed by phytoplankton in the ocean, thus having a critical role in the global carbon cycle. A major fraction of the phytoplankton-derived substrates are high-molecular-weight (HMW) polysaccharides. For bacterial uptake, these substrates must initially be hydrolysed to smaller sizes by extracellular enzymes. We investigated polysaccharide hydrolysis by microbial communities during a transect of the Atlantic Ocean, and serendipitously discovered-using super-resolution structured illumination microscopy-that up to 26% of total cells showed uptake of fluorescently labelled polysaccharides (FLA-PS). Fluorescence in situ hybridisation identified these organisms as members of the bacterial phyla Bacteroidetes and Planctomycetes and the gammaproteobacterial genus Catenovulum. Simultaneous membrane staining with nile red indicated that the FLA-PS labelling occurred in the cell but not in the cytoplasm. The dynamics of FLA-PS staining was further investigated in pure culture experiments using Gramella forsetii, a marine member of Bacteroidetes. The staining patterns observed in environmental samples and pure culture tests are consistent with a 'selfish' uptake mechanisms of larger oligosaccharides (>600 Da), as demonstrated for gut Bacteroidetes. Ecologically, this alternative polysaccharide uptake mechanism secures substantial quantities of substrate in the periplasmic space, where further processing can occur without diffusive loss. Such a mechanism challenges the paradigm that hydrolysis of HMW substrates inevitably yields low-molecular-weight fragments that are available to the surrounding community and demonstrates the importance of an alternative mechanism of polysaccharide uptake in marine bacteria.


Ultrastructure of a new microtubule-neurofilament coupler in nerves.
A new structure associated with the surfaces of neuronal microtubules is described which connects microtubules to neurofilaments in the axonal processes of cultured chick sensory ganglia. These couplers consist of a spherical core particle (15 nm in diameter) from which radiate several thin filaments (4 nm in diameter). Connection of adjacent microtubules and neurofilaments is achieved by thin filaments radiating from core particles positioned between these cytoskeletal elements. Couplers are most conspicuous in regions of axonal processes containing widely separated microtubules and neurofilaments. The structure and distribution of these couplers suggests that they are directly involved in intra-axonal organelle movements, possibly by modulating the spatial separation of adjacent microtubules and neurofilaments, thereby allowing the passage of transported organelles.


Identification and characterization of small RNAs involved in RNA silencing.
Double-stranded RNA (dsRNA) is a potent trigger of sequence-specific gene silencing mechanisms known as RNA silencing or RNA interference. The recognition of the target sequences is mediated by ribonucleoprotein complexes that contain 21- to 28-nucleotide (nt) guide RNAs derived from processing of the trigger dsRNA. Here, we review the experimental and bioinformatic approaches that were used to identify and characterize these small RNAs isolated from cells and tissues. The identification and characterization of small RNAs and their expression patterns is important for elucidating gene regulatory networks.


CD26 expression on CD4+T cells in patients with cutaneous leishmaniasis.
Surrogate marker(s) of protection in human leishmaniasis is not well defined. In this study, T helper 1 (Th1) and Th2 cytokine profiles and CD26 expression on CD4(+) T cells in peripheral blood mononuclear cells of patients with healing or non-healing forms of cutaneous leishmaniasis (CL) stimulated with Leishmania antigens were assessed. The level of interferon (IFN)-gamma production was significantly higher in patients with healing or non-healing forms of CL than in healthy controls, but it was not significantly different between the two patient groups. The level of interleukin-5 production was significantly higher in patients with the non-healing form of CL than in the two other groups. There was a significant increase in the level of CD26 expression on CD4(+) T cells in patients with healing (P < 0.001) or non-healing (P = 0.025) forms of CL compared with the control group, but no significant difference was seen between the two patient groups. A weak positive correlation was seen between IFN-gamma production and CD26 expression on CD4(+) T cells of patients with the healing form of lesion (r = 0.54, P = 0.008), but this correlation was not observed in patients with the non-healing form of CL (r = 0.53, P = 0.078). Surface CD26 is not correlated with the clinical manifestation of CL or IFN-gamma production. Therefore, CD26 is not a surrogate marker for IFN-gamma production in CL.


Increasing HIV-1 subtype diversity in seven states, United States, 2006-2013.
The aim of the analysis was to explore HIV-1 subtype diversity in the United States and understand differences in prevalence of non-B subtypes and circulating recombinant forms (CRFs) between demographic/risk groups and over time. We included HIV-1 polymerase sequences reported to the National HIV Surveillance System for HIV infections diagnosed during 2006-2013 in seven states. We assigned subtype or CRF using the automated subtyping tool COMET, assessed subtype/CRF prevalence by demographic characteristics and country of birth, and determined changes in subtype/CRF by HIV diagnosis year. Of 32,968 sequences, 30,757 (93.3%) were subtype B. The most common non-B subtypes and CRFs were C (1.6%), CRF02_AG (1.4%), A (0.6%), CRF01_AE (0.5%), and G (0.3%). Elevated percentages of non-B infections occurred among persons aged <13 years at diagnosis (40.9%), Asians (32.1%), persons born outside the United States (22.6%), and persons with infection attributable to heterosexual contact (12.0%-15.0%). Prevalence of non-B infections increased from 5.9% in 2006 to 8.5% in 2013. Subtype B continues to predominate in the United States. However, the percentage of non-B infections has grown in recent years, and numerous demographic subgroups have much higher prevalence. Subgroups and areas with high prevalence of non-B infections might represent sub-epidemics meriting further investigation.


Regulation of squalene epoxidase activity by membrane fatty acid composition in yeast.
Depriving Saccharomyces cerevisiae strain GL7 of exogenous unsaturated fatty acid supplements causes this sterol biosynthetic mutant to accumulate squalene at the expense of squalene epoxide and squalene diepoxide. To further characterize the apparent relationship between squalene epoxidase activity and membrane fatty acid composition, a variety of unsaturated fatty acids differing in their chain lengths and in the positions and orientation (cis or trans) of their double bonds were tested for their ability to promote turnover of endogenous squalene in cells previously deprived of olefinic supplements. All of the unsaturated fatty acids tested were found to restore squalene epoxidase activity but there were marked differences in their efficacies that best were correlated with the extent to which they reduced the medium chain (C-10 + C-12) saturated fatty acid content of cellular phospholipids. Additional studies demonstrated that de novo protein synthesis was required for the restoration of squalene epoxidase activity in unsaturated fatty acid-deprived cells.


Metabolic profiles and screening tactics for MDMB-4en-PINACA in human urine and serum samples.
MDMB-4en-PINACA (Methyl 3,3-dimethyl-2-[1-(pent-4-en-1-yl)-1H-indazole-3-carboxamido] butanoate) is a potent agonist of the CB1 receptor. In 2021, it was one of the most common synthetic cannabinoid receptor agonists (SCRAs) seized by the Beijing Drug Control Agency. MDMB-4en-PINACA can be hard to detect in biological specimens because of ester hydrolysis. In this work, a highly sensitive liquid chromatography-high-resolution mass spectrometry (LC-HRMS) method was developed for the detection of MDMB-4en-PINACA metabolites in urine, serum, and hair samples. Metabolites from authentic samples were compared with those from human liver microsomes (HLMs) in vitro and in zebrafish in vivo. A total of 75 metabolites, including 44 previously unreported metabolites, were identified from urine samples. We found that 11 metabolic pathways were involved in MDMB-4en-PINACA metabolism, including acetylation, a novel metabolic pathway for SCRAs. Our results revealed that ester hydrolysis and hydroxylation were to the major metabolic pathways involved in MDMB-4en-PINACA metabolism. Using serum samples, we detected 9 metabolites along with the parent drug. Only the parent drug was detected using hair samples. The existence of ADB-4en-PINACA makes the currently used biomarkers for MDMB-4enPINACA not very specific for the intake of MDMB-4en-PINACA. Therefore, based on the identified metabolites and their structural features, we propose more sensitive screening tactics for MDMB-4en-PINACA using urine and serum samples.


Nonleukemic granulocytic sarcoma presenting as intussusception of small bowel.
Granulocytic sarcoma (GS) is defined as a localized tumor mass composed of myeloid blasts and/or immature myeloid cells in an extramedullary site. Usually, GS occurs concomitantly with or after acute myelogenous leukemia (AML), myeloproliferative disorder, or myelodysplastic syndrome. In rare cases, it occurs as a "preleukemic" condition and may precede the onset of AML, which occurs within several months if the patient is not treated with AML-type systemic chemotherapy. Recently, we discovered one case of nonleukemic GS in the small intestine incidentally when intussusception was suspected. The patient visited the emergency department, in October 2006, with symptoms of small-bowel obstruction. Intussusception due to a small-intestinal mass was suspected after evaluation, and small-intestine segmental resection was performed. The patient had no previous history of leukemia, and immunohistochemical staining was used to diagnose GS. Bone-marrow biopsy performed subsequently revealed no lesions that could be suspected as leukemia. The patient received three cycles of chemotherapy, applied as for AML (cytosine arabinoside and anthracycline), and is currently, as of October 29, 2007, showing no other marked indisposition; he has been disease-free for 12 months.


Mycobacteraemia among HIV-1-infected patients in São Paulo, Brazil: 1995 to 1998.
From July 1995 to August 1998, mycobacterial blood cultures were obtained from 1032 HIV-infected patients seen at the Centro de Referência e Treinamento de AIDS (CRTA), Hospital São Paulo (HSP), and Centro de Referência de AIDS de Santos (CRAS). Overall, 179 episodes of mycobacteraemia were detected: 111 (62.0%) at CRTA, 50 (27.9%) at HSP, and 18 (10.1%) at CRAS. The frequency of positive cultures declined sharply from 22.6% in 1995 to 6.9% in 1998, consistent with the decrease in opportunistic infections following the publicly funded distribution of highly active antiretroviral therapy. In 1995, mycobacteraemia was more frequently due to Mycobacterium avium complex (59.2%) than Mycobacterium tuberculosis (28.6%), whereas in 1998 the relative frequencies were reversed (28.6 vs. 64.3% respectively), probably justified by the increased virulence of M. tuberculosis and the greater risk of invasive infection in less-immunocompromised patients, including patients unaware they are infected with HIV.


Growth references for height, weight and body mass index of twins aged 0-2.5 years.
To determine the size of the growth deficit in Dutch monozygotic and dizygotic twins aged 0-2.5 years as compared to singletons and to construct reference growth charts for twins. Growth of twins was studied using longitudinal data on over 4000 twins aged 0-2.5 years of the Netherlands Twin Register. The LMS method was used to obtain growth references for length/height, weight, and body mass index (BMI) for twins. During the first 2.5 years of age, differences in length/height and weight between twins and singletons decrease but do not disappear. BMI of twins deviates less than that of singletons. Approximately half of the growth retardation from birth until 1.5 years of age was attributable to gestational age. Between 1.5 years and 2.5 years of age, this difference was reduced to one-third. Thus, a substantial part of the growth difference could not be explained by gestational age. During the first 2.5 years of life, there is a difference in growth between twins and singletons. Twins catch up in their body size, i.e. they grow faster after birth, but do not yet achieve the same height and weight till they reach 2.5 years of age. We recommend the use of the growth references for twins.


Regulation of Fc-induced IL-6 from human peripheral blood mononuclear cells.
Previous experiments demonstrated that aggregated immunoglobulin and the Fc fragment of human IgG can induce interleukin-6 (IL-6) secretion from peripheral blood monocytes. The data herein indicate that Fc-induced IL-6 is modulated by IL-1, IL-4 and interferon (IFN-gamma). When added with Fc fragments, IL-1 and IFN-gamma increased IL-6 production. IL-4 added with Fc fragment did not influence IL-6 production although IL-4 added with LPS was inhibitory to IL-6 production. However, when PBMC were pre-treated with IL-4, IL-4 downregulated Fc-induced IL-6 secretion. The inhibitory effect of IL-4 in the pre-treatment phase could be overcome with a high concentration of IFN-gamma added with the IL-4. Both IL-4 and IFN-gamma acted in a dose- and time-dependent manner. By dot blot analysis, IL-6 mRNA production appeared to be decreased in amount and duration by IL-4 whereas IFN-gamma increased the amount of IL-6 mRNA production. Hence, IL-4 and IFN-gamma appear to have opposing effects and may play a balancing role in the regulation of IL-6 production secondary to Fc exposure.


Fixation and durability of a bone-ingrowth component for glenoid bone loss.
Deficient glenoid bone is a reconstructive challenge in shoulder arthroplasty. One solution is an ingrowth anatomic glenoid with column and screw fixation, with or without supplemental bone graft. This study examines the outcome of patients managed in this manner. This type of glenoid component was used in 21 shoulder arthroplasties with central or peripheral glenoid bone deficiencies: 13 for bone loss due to arthritic wear and 8 for revision arthroplasty. Patients were monitored clinically for a mean of 11.1 years (range, 7.6-15.1 years) and by x-ray imaging for a mean of 9.1 years (range, 2.2-14.2 years). Revision procedures were needed for 7 shoulders at a mean of 10.4 years (range 5.5-14.3 years), 6 for polyethylene or metal wear leading to glenoid loosening in 4. In the 14 nonrevised shoulders, pain ratings (1 to 5 scale) decreased from a mean of 4.5 to 1.9 (P < .001). Mean active elevation increased from 100° to 125° (P = .02). Mean external rotation increased from 28° to 43° (P = .06). Results assessed by the Neer rating were excellent in 3, satisfactory in 10, and unsatisfactory in 1. In radiographic assessment of the unrevised shoulders, 4 were at risk for glenoid loosening, and 1 was at risk for humeral loosening. This method of reconstruction can offer pain relief and improved motion. However, the large number of revision procedures and additional adverse changes on x-ray imaging suggest other reconstructive options may be more successful and durable.


Tricky TRIC: A replication study using trophoblast retrieval and isolation from the cervix to study genetic birth defects.
Noninvasive Prenatal Diagnosis has recently been introduced for a limited number of monogenetic disorders. However, the majority of DNA diagnostics still require fetal material obtained using an invasive test. Recently, a novel technique, TRIC (Trophoblast Retrieval and Isolation from the Cervix), has been described, which collects fetal trophoblast cells by endocervical sampling. Since this technique has not been successfully replicated by other groups, we aimed to achieve this in the current study. Pregnant women referred for transvaginal chorionic villous sampling (CVS) were asked for an endocervical sample prior to CVS. The TRIC samples were processed to isolate trophoblast DNA. TRIC DNA was used in ForenSeq to determine the amount of maternal DNA contamination, and for Sanger sequencing in case of a monogenic disorder. 23%-44% of samples had a sufficiently high fetal DNA fraction to allow genetic testing, as calculated by Sanger sequencing and ForenSeq, respectively. We have been able to successfully replicate the TRIC protocol, although with a much lower success rate as described by the original study performing TRIC. As we obtained the samples in the actual clinical setting envisioned, the method in its current setup is not advisable for use in prenatal diagnostics.


Comparison of the safety and efficacy of a combination tablet of niacin extended release and simvastatin vs simvastatin monotherapy in patients with increased non-HDL cholesterol (from the SEACOAST I study).
The efficacy and safety of 2 regimens of a combination of a proprietary niacin extended release plus simvastatin (NER/S; 1,000/20 and 2,000/20 mg/day) were compared with simvastatin monotherapy (20 mg/day) for 24 weeks in 319 high-risk patients with predominantly mixed dyslipidemia who were already at National Cholesterol Education Program Adult Treatment Panel III risk-adjusted goals for low-density lipoprotein cholesterol. After a run-in on simvastatin 20 mg/day, both NER/S doses (1,000/20 and 2,000/20 mg/day) resulted in greater decreases in non-high-density lipoprotein (HDL) cholesterol vs simvastatin 20 mg/day (-13.9% and -22.5% vs -7.4%, respectively; p <0.01). Significant improvements in HDL cholesterol, triglycerides, apolipoprotein B, lipoprotein(a), and total/HDL cholesterol ratio were also observed. Patients with hypertriglyceridemia (triglycerides > or =200 mg/dl) typically had greater lipid responses to NER/S with the notable exception that HDL cholesterol responses to NER/S were similar in those with or without increased triglycerides. Treatment with both doses of NER/S was well tolerated; < or =60% of patients in any treatment group experienced flushing, >90% of flushing was mild or moderate in intensity, and only 7.5% of patients in both NER/S treatment groups discontinued because of flushing. The safety of NER/S was consistent with the safety profile of each individual component. In conclusion, this study showed that NER/S provided additional clinically relevant improvements in multiple lipid parameters and was safe and well tolerated.


Anthropogenic change decouples a freshwater predator's density feedback.
Intraspecific interactions within predator populations can affect predator-prey dynamics and community structure, highlighting the need to better understand how these interactions respond to anthropogenic change. To this end, we used a half-century (1969-2018) of abundance and size-at-age data from Lake Erie's walleye (Sander vitreus) population to determine how anthropogenic alterations have influenced intraspecific interactions. Before the 1980s, the length-at-age of younger walleye (ages 1 and 2) negatively correlated with older (age 3 +) walleye abundance, signaling a 'density feedback' in which intraspecific competition limited growth. However, after the early 1980s this signal of intraspecific competition disappeared. This decoupling of the density feedback was related to multiple anthropogenic changes, including a larger walleye population resulting from better fisheries management, planned nutrient reductions to improve water quality and transparency, warmer water temperatures, and the proliferation of a non-native fish with novel traits (white perch, Morone americana). We argue that these changes may have reduced competitive interactions by reducing the spatial overlap between older and younger walleye and by introducing novel prey. Our findings illustrate the potential for anthropogenic change to diminish density dependent intraspecific interactions within top predator populations, which has important ramifications for predicting predator dynamics and managing natural resources.


'I know what I should be feeding my child': foodways of primary caregivers of Child Support Grant recipients in South Africa.
Despite South Africa being an upper middle-income country producing enough food to sustain its population, and having an advanced social welfare system, it has high levels of food insecurity at the household-level. Food insecurity is linked to malnutrition and undernutrition in children. This manuscript addresses gaps in knowledge about food choices and practices of primary caregivers of children in receipt of South Africa's largest cash transfer programme, the Child Support Grant (CSG). The main objective of the study was to explore CSG caregivers' foodways and the choices they made about what food to buy, where to buy it and for what reasons, in Langa in the Western Cape and Mt Frere in the Eastern Cape. We conducted a total of 40 in-depth interviews and 5 focus group discussions with primary caregivers of Child Support Grant recipients younger than 5 years in the Eastern and Western Cape provinces. Caregivers' food choices were less influenced by cultural practices and personal preferences, than by financial and physical constraints in terms of what and where to access food. Constraints in food choices were chiefly a consequence of the small amount of the grant, as well as a food environment that only availed foods of a certain quality and type in these low-income communities. The foodways of recipients of social assistance can only be better aligned with nutrition messaging and policy if there are changes in the monetary value of cash transfers, and the food environments of low-income households which determine access to, availability and affordability of nutritious food. Local informal food enterprises play an important role in the food system of CSG recipients and need to be considered in any strategies that seek to reform the food system of low-income communities in South Africa and similar settings.


Intracellular pH in diluting segment of frog kidney.
Chronic exposure to high potassium (K+ adaptation) stimulates H+ net secretion in the diluting segment of the frog kidney. In order to investigate the cellular mechanism of the H+ secretory process intracellular pH (pHi) measurements were performed in cells of the diluting segment of the isolated doubly-perfused kidney of K+ adapted Rana esculenta. pHi changes were monitored by pH-sensitive microelectrodes while the tubule lumen was rapidly perfused with various solutions. With control solutions (extracellular pH = 7.80) pHi averaged 7.60 +/- 0.05. Luminal application of furosemide (5 X 10(-5) mol/l) or reduction of luminal Cl- (from 104 mmol/l to 9 mmol/l) hyperpolarized the cell membrane potentials but pHi was not altered. Reduction of luminal Na+ (from 98 mmol/l to 3 mmol/l) depolarized the cell membrane potentials but pHi remained constant. Complete removal of luminal Na+, however, led to a significant decrease of pHi from 7.61 +/- 0.08 to 7.18 +/- 0.08. Luminal application of amiloride (1 X 10(-3) mol/l) also decreased pHi significantly (delta pHi = 0.15 +/- 0.02). The results indicate that an amiloride-sensitive H+ extrusion mechanism exists in the luminal cell membrane of the K+ adapted frog diluting segment. The data are consistent with Na+/H+ exchange which maintains a constant pHi even at extreme experimental conditions.


Small RNAs were involved in homozygous state-associated silencing of a marker gene (Neomycin phosphotransferase II: nptII) in transgenic tomato plants.
Homozygous state-associated co-suppression is not a very common phenomenon. In our experiments, two transgenic plants 3A29 and 1195A were constructed by being transformed with the constructs pBIN-353A and pBIN119A containing nptII gene as a marker respectively. The homozygous progeny from these two independent transgenic lines 3A29 and 1195A, displayed kanamycin-sensitivity and produced a short main root without any lateral roots as untransformed control (wild-type) seedlings when germinated on kanamycin media. For the seedlings derived from putative hemizygous plants, the percentage of the seedlings showing normal growth on kanamycin media was about 50% and lower than the expected percentage (75%). Southern analysis of the genomic DNA confirmed that the homozygous and hemizygous plants derived from the same lines contained the same multiple nptII transgenes, which were located on the same site of chromosome. Northern analysis suggested that the marker nptII gene was expressed in the primary and the hemizygous transformants, but it was silenced in the homozygous transgenic plants. Further Northern analysis indicated that antisense and sense small nptII-derived RNAs were present in the transgenic plants and the blotting signal of nptII-derived small RNA was much higher in the homozygous transgenic plants than that of hemizygous transgenic plants. Additionally, read-through transcripts from the TRAMP gene to the nptII gene were detected. These results suggest that the read-through transcripts may be involved in homozygous state-associated silencing of the nptII transgene in transgenic tomato plants and a certain threshold level of the nptII-derived small RNAs is required for the homozygous state-associated co-suppression of the nptII transgene.


Time to opioid administration after implementation of an intranasal fentanyl protocol.
Prompt and effective analgesia is a mainstay of emergency department (ED) medicine; however, it is often delayed in times of overcrowding and by the need to establish intravenous (IV) access. Thus, noninvasive analgesic administration by means of the intranasal route could potentially reduce time to analgesic administration by eliminating IV line insertion. This retrospective study evaluated time from physician entry into patient's room to opioid administration after implementation of an intranasal fentanyl protocol. Data were collected on pediatric patients who received intranasal fentanyl in the ED 225 days after protocol implementation. Time to opioid administration was then evaluated against historical controls given IV opioids in the same ED 90 days before protocol implementation. Seven patients were included in the intranasal fentanyl group and were evaluated against 47 patients given IV opioids. Time from physician entry into patient's room to opioid administration was significantly reduced for intranasal fentanyl (20.43 ± 11.54 minutes) vs IV opioids (42.04 ± 31.55 minutes; P = .002), and IV line insertion was avoided in all 7 intranasal fentanyl patients. No significant differences in adverse events were noted. This study provides evidence that administration of fentanyl via the intranasal route in the ED decreases time to administration of opioids in pediatric patients.


[Clinical value of preserving intercostal-brachial nerve during breast cancer operations].
To study the value of preserving intercostal-brachial nerve during axillary dissection for breast neoplasms. From June 1996 to December 1997, stage I, II breast cancer patients were divided into experimental group (n = 45) and control group (n = 60) respectively. The intercostal-brachial nerve was preserved in the experimental group and not in the control group. Both were followed up after operations. The postoperation morbidity of arm sensory disturbance was 7.1% in the experimental group, which was significantly different from that of the control group(63.3%, chi2 = 34.69, P < 0.01). No difference was noted in the recurrence rate between the two groups. Preserving intercostal-brachial nerve may significantly decrease the morbidity of postoperation arm sensory disturbance during axillary dissection for stage I, II breast cancer patients.


Percutaneous ultrasound-guided thrombin injection of a post-traumatic pancreatic pseudoaneurysm in a pediatric patient.
Non-operative management for blunt injuries to the proximal pancreas has become increasingly common. A bleeding pseudoaneurysm in the setting of a traumatic pancreatic pseudocyst presents a morbid operation. We present the case of a 15-year old with a grade V pancreatic injury that developed a bleeding pseudoaneurysm successfully treated with percutaneous ultrasound-guided thrombin injection.


Global misregulation of genes largely uncoupled to DNA methylome epimutations characterizes a congenital overgrowth syndrome.
Assisted reproductive therapies (ART) have become increasingly common worldwide and numerous retrospective studies have indicated that ART-conceived children are more likely to develop the overgrowth syndrome Beckwith-Wiedemann (BWS). In bovine, the use of ART can induce a similar overgrowth condition, which is referred to as large offspring syndrome (LOS). Both BWS and LOS involve misregulation of imprinted genes. However, it remains unknown whether molecular alterations at non-imprinted loci contribute to these syndromes. Here we examined the transcriptome of skeletal muscle, liver, kidney, and brain of control and LOS bovine fetuses and found that different tissues within LOS fetuses have perturbations of distinct gene pathways. Notably, in skeletal muscle, multiple pathways involved in myoblast proliferation and fusion into myotubes are misregulated in LOS fetuses. Further, characterization of the DNA methylome of skeletal muscle demonstrates numerous local methylation differences between LOS and controls; however, only a small percent of differentially expressed genes (DEGs), including the imprinted gene IGF2R, could be associated with the neighboring differentially methylated regions. In summary, we not only show that misregulation of non-imprinted genes and loss-of-imprinting characterize the ART-induced overgrowth syndrome but also demonstrate that most of the DEGs is not directly associated with DNA methylome epimutations.


Humanized murine model for HBV and HCV using human induced pluripotent stem cells.
Infection of hepatitis B virus (HBV) and hepatitis C virus (HCV) results in heterogeneous outcomes from acute asymptomatic infection to chronic infection leading to cirrhosis and hepatocellular carcinoma (HCC). In vitro models using animal hepatocytes, human HCC cell lines, or in vivo transgenic mouse models have contributed invaluably to understanding the pathogenesis of HBV and HCV. A humanized mouse model made by reconstitution of human primary hepatocytes in the liver of the immunodeficient mouse provides a novel experimental opportunity which mimics the in vivo growth of the human hepatocytes. The limited access to primary human hepatocytes necessitated the search for other cellular sources, such as pluripotent stem cells. Human embryonic stem cells (hESCs) have the features of self-renewal and pluripotency and differentiate into cells of all three germ layers, including hepatocytes. Humaninduced pluripotent stem cells (iPSCs) derived from the patient's or individual's own cells provide a novel opportunity to generate hepatocyte-like cells with the defined genetic composition. Here, we will review the current perspective of the models used for HBV and HCV study, and introduce the personalized mouse model using human iPSCs. This novel mouse model will facilitate the direct investigation of HBV and HCV in human hepatocytes as well as probing the genetic influence on the susceptibility of hepatocytes to HBV and HCV.


Factors affecting relapse following chemotherapy for Hodgkin's disease.
A study of the factors affecting relapse following combination chemotherapy has been undertaken in 64 previously untreated patients with Hodgkin's disease. All patients were investigated and treated according to protocols of the British National Lymphoma Investigation. Bulk disease was significantly more common in the treatment failure group, being present in 23 out of 37 patients who failed compared to eight out of 27 patients who remain relapse-free (P less than 0.025). Reduced drug dosage was associated with treatment failure in 19 out of 37 patients receiving suboptimal chemotherapy compared to only four of 27 patients in the relapse-free group (P less than 0.01). Patients over the age of 50 years were more likely to receive suboptimal drug dosages (P less than 0.05).


The relationship between social media usage by undergraduate nursing students and development of their professional identity: A correlational study.
How nursing students perceive themselves as potential nurses in the future is defined as their nursing professional identity. Many undergraduate nursing students present positive attitudes regarding the use of social media. However, the influence of social media usage by undergraduate nursing students on the development of their professional identity is yet to be determined. To determine the relationship between social media usage by undergraduate nursing students and the development of their professional identity. Descriptive, correlational, cross-sectional study. Two universities in western Saudi Arabia. Undergraduate nursing students who used social media. An online questionnaire was designed, and its contents were validated. It was then distributed via a Qualtrics link to students' email addresses and via social media between 4th September 2019 and 28th October 2019. Descriptive analysis including frequencies, percentages, medians, and interquartile ranges were reported. Additionally, a number of non-parametric tests were conducted to investigate the relationships in question. In total, 484 questionnaires were included in the analysis. The participants who used social media for educational (p = 0.004), or for professional purposes (p = 0.015) had high scores on the PI scale. The professional identity scores were also positively associated among the participants who followed nurses (p < 0.001), shared their nursing experiences (p < 0.001), and acted as societal educators about the nursing profession (p < 0.001) on social media platforms. Engagement with social media positively influenced undergraduate nursing students in the development of their professional identity. However, it is notable that the pedagogy of nursing education has been slow to adopt social media into nursing curricula. Nursing students require guidance in terms of how to use social media for their professional development.


The clinical anatomy of the crista terminalis, pectinate muscles and the teniae sagittalis.
The crista terminalis (CT) is an important anatomic landmark due its close association with the sinoatrial node artery and the origin of the pectinate muscles (PM). However, the gross anatomy of the PM in relation to the CT has not been well described. The aim of our study has been to investigate the location and the morphology of PM in relation to the CT. We examined 300 adult formalin-fixed human hearts. All PM originated from the CT and extended along the wall of the appendage toward the vestibule of the tricuspid valve. It was observed that the PM varied significantly with respect to arrangement and course of its fibers. We were able to classify the course of the PM, including the most prominent PM called the tenia sagittalis (TS), into 6 different patterns with 3 different TS types. In Type A (15%), the TS was absent. Type B (65%) demonstrated a single TS and Type C (20%) was characterized by the presence of multiple TS. Furthermore, the course of the PM was classified into 6 patterns: Type I (40%), the PM was oriented perpendicular to the CT with uniform spacing and lack of crossover (trabeculation); Type II (20%), non-uniform PM was organized in a haphazard, trabecular fashion with numerous crossovers; Type III (15%), the PM had uniform spacing with no trabeculation with fibers oriented parallel to the CT; Type IV (10%), had arborizing PM originating from a common muscular trunk (solitary trunk); Type V (10%), fibers were oriented both perpendicular and parallel to the CT, similar in architecture to Type III, but with more than one common muscular trunk; Type VI (5%), prominent muscular column with velamentous PM with potential implications in cardiac catheterization procedures. The exact morphology of PM and TS may be clinically important in right atrial catheterization procedures, as well as in the development of arrhythmias but further investigations are now necessary to prove this theory.


A yellow ring-shaped macular reflection.
To describe a yellow ring-shaped reflection in the macula of healthy subjects observed with a common indirect ophthalmoscope. Observational case series. Fundus photographs of the macula were acquired with a slit lamp and 90-diopter lens in 5 healthy subjects (age range, 23-50 years) at a perpendicular angle and at an oblique angle to the retina. The perpendicular fundus photographs showed a yellow ring-shaped reflection with a diameter of approximately 5 degrees. The oblique photographs had a dark red spot in the center. To our knowledge, this phenomenon has hitherto escaped attention in the literature. We conclude that the shape, size, and location of the yellow reflection are consistent with a cone origin. This observation may be used for diagnostic purposes.