Optimizing outcomes for patients with depression and chronic medical illnesses.
Depression and comorbid chronic medical conditions such as coronary heart disease, diabetes mellitus, and osteoarthritis are frequently seen in the primary care setting, and the interaction of these illnesses can complicate diagnostic and treatment efforts. Although the etiologies of these bidirectional associations are not well understood, a number of negative outcomes are apparent, and challenges exist at patient, provider, and healthcare system levels to better recognize and treat depression in patients with chronic medical comorbidity. Such patients are more likely to present with somatic complaints, engage in unhealthy behaviors, harbor unhealthy thoughts or cognitions, and are less likely to comply with therapeutic recommendations. Primary care encounters often represent the only opportunities for these patients to address these issues and obtain the professional attention their depression requires. For clinicians, forging empathetic partnerships with patients, prescribing appropriate treatments, and closely monitoring symptoms and therapeutic progress are invaluable for optimal management of both affective and medical disorders. Further opportunities to improve care also exist at the healthcare system level, such as developing, funding, and implementing multimodal collaborative care models in the primary care setting.


Comparative efficacy and safety of glycerol versus mannitol in patients with cerebral oedema and elevated intracranial pressure: A systematic review and meta-analysis.
Glycerol is thought to be superior to mannitol in the treatment of cerebral oedema and elevated intracranial pressure (ICP), particularly with safety concerns. However, the current evidence remains insufficient. Therefore, we aimed to compare the efficacy and safety of glycerol versus mannitol in this meta-analysis. PubMed, EMBASE, Web of Science, CENTRAL, China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP information, ClinicalTrials.gov, and the reference lists of relevant articles were searched for randomized controlled trials comparing glycerol and mannitol in patients with brain oedema and elevated ICP. Two investigators independently identified the articles, assessed the study quality and extracted data. Data analyses were performed using RevMan software. Thirty trials involving 3144 patients met our inclusion criteria. Pooled data indicated that glycerol and mannitol had comparable effectiveness in controlling cerebral oedema (RR, 1.00; 95% CI, 0.97 to 1.03; p = .97), but the risks of acute kidney injury and electrolyte disturbances were significantly lower with glycerol (RR, 0.21; 95% CI, 0.16 to 0.27 and RR, 0.23; 95% CI, 0.17 to 0.30, respectively) than mannitol. Moreover, there seemed to be a lower probability of rebound ICP after the withdrawal of glycerol. Neither haemolysis nor elevated blood glucose levels were observed in the glycerol group. Regarding the balance between efficacy and safety, glycerol could be an effective and more tolerable alternative therapy for cerebral oedema and elevated ICP than mannitol, especially for high-risk populations of renal failure.


Inter genotype differences in expression of genes involved in glucose metabolism in the establishment of hepatic steatosis in Muscovy, Pekin and mule ducks.
In waterfowls, overfeeding leads to a hepatic steatosis, also called "foie gras". Our main objectives were to determine what is the share of genes involvement of glucose metabolism in the establishment of fatty liver in three genotypes of waterfowls: Muscovy (Cairina moschata), Pekin ducks (Anas platyrhynchos) and their crossbreed, the mule duck. 288 male ducks of Pekin, Muscovy and mule genotypes were reared until weeks 12 and overfed between weeks 12 and 14. We analysed gene expression at the beginning, the middle and the end of the overfeeding period in different tissues. We have shown an upregulation of glucose transporters (GLUT) in peripheral tissues (pectoralis major or adipose tissue) in Pekin ducks. In addition, GLUT2 was not found in jejunal mucosa and another GLUT seems to replace it 3 h after the meal: GLUT3. Mule ducks upregulating GLUT3 earlier compared to Pekin ducks. However, these results need further investigations. In liver, globally, Pekin ducks exhibit the highest expression of GLUT or enzymes implicated in glycolysis. The few significant variations of gene expressions in glucose metabolism between these three genotypes and the momentary specific overexpression of GLUT do not allow us to detect a lot of specific genotype differences. To conclude, the differences in response to overfeeding of Pekin, Muscovy and mule ducks, for the establishment of hepatic steatosis, cannot be only explained by the glucose metabolism at transcriptomic level.


Advancing Oncology Nursing Practice Through the Adoption of Patient Monitoring Digital Tools.
The objective of this paper is to describe the use of oncology digital symptom monitoring and patient self-management coaching tools, how nurses and nurse practitioners (NPs) can optimize their use as an adjunct in improving oncology care and discuss issues and strategies needed for adoption within a variety of clinical settings. A review of the research literature regarding digital health in oncology symptom management in PubMed provided the foundation for this paper. Digital symptom monitoring technology provides a variety of opportunities for oncology nurses and NPs to efficiently extend and improve symptom management in multiple settings including cancer patients at home between clinic visits, at clinic visits, and during inpatient stays. Digital monitoring and patient engagement make possible frequent symptom assessments, just-in-time personalized self-management reinforcement, and judiciously alert nurses and NPs about key times for follow-up with patients supported with evidenced-based guidelines. Oncology nurses at all levels have the opportunity to be leaders in the adoption and expansion of digital tools to enhance their practice. Oncology nurses and NPs can lead practice changes that improve patient outcomes through understanding and shaping the use of digital tools.


Treatment with 8-OH-modified adenine (TLR7 ligand)-allergen conjugates decreases T helper type 2-oriented murine airway inflammation.
A strategy to improve allergen-specific immunotherapy is to employ new adjuvants stably linked to allergens. The study is addressed to evaluate the in vivo and in vitro effects of allergens [natural Dermatophagoides pteronyssinus 2 (nDer p 2) and ovalbumin (OVA)] chemically bound to an 8-OH-modified adenine. Humoral and cellular responses were analysed in allergen-sensitized and challenged mice by using conjugates (Conj) in a therapeutic setting. The in vitro activity of the conjugates on cytokine production induced by bone marrow dendritic cells and the co-culture system was also investigated. The nDer p 2-Conj treatment in nDer p 2-primed and challenged BALB/c mice reduced the numbers of eosinophils in bronchoalveolar lavage fluid and lung, airway allergen-driven interleukin-13 (IL-13) production in lung mononuclear cells and IgE, in comparison with nDer p 2-treated mice. The increase of IgG2a paralleled that of interferon-γ (IFN-γ) and IL-10 in allergen-stimulated spleen cells. Similar effects were elicited by treatment with OVA-Conj in an OVA-driven BALB/c model. The nDer p 2-Conj or OVA-Conj redirected memory T helper type 2 cells towards the production of IL-10 and IFN-γ also in C57BL/6 mice and when subcutaneously administered. Interleukin-10, IL-12 and IL-27 were produced in vitro by Conj-stimulated bone marrow dendritic cells, whereas IL-10 and IFN-γ were up-regulated in co-cultures of CD11c(+) and CD4(+) T cells from Conj-treated mice stimulated with allergen. Cytofluorometric analysis indicated that the Conj expanded IFN-γ- and IL-10- producing memory T cells. The Conj effects on IL-10(-/-) and IL-12(-/-) mice confirmed the role of IL-10 and IFN-γ in inducing a protective and balanced redirection the T helper type 2-mediated airway inflammation.


Determination of vitamin A and vitamin E esters in infant formulae and fortified milk powders by HPLC: Use of internal standardisation.
An HPLC method is described using normal phase conditions with an unbonded silica column to determine concentrations of supplementary vitamin A and vitamin E esters and β-carotene in infant formulae. The method utilises selective dual-channel fluoresence for vitamins A and E and visible absorbance for β-carotene. An attribute of the method is the use of retinol propionate, α-tocopheryl propionate and all-E-β-apo-8'-carotenoic acid ethyl ester internal standards to compensate for analytical variations associated with these labile vitamins. Extraction is performed without saponification, with the aid of protease to remove vitamin encaspsulation and facilitate vitamin partition into hydrocarbon solvent. Figures of merit indicate the method is suitable for its intended purpose in the highly regulated infant formula environment, including liquid formulations. The method is extendable to whole milk powders where total vitamin A content data can be calculated by summing the innate long-chain vitamin A esters with the added esters.


Alternatives to the baseline KUB for CTKUB-detected calculi: evaluation of CT scout and average and maximum intensity projection images.
A CT of the kidneys, ureters, and bladder (CTKUB) is the investigation of choice in suspected renal colic. Plain kidney, ureter, and bladder radiographs (KUB) can be used to monitor the progress of a stone if radiographically visible on a baseline KUB. This study aims to determine if a low-dose CT Scout, thick-slab average intensity projection (AIP), or maximum intensity projection (MIP) images are suitable as substitutes for a baseline KUB. A retrospective review of patients from a tertiary adult institute that had a positive CTKUB and a KUB within 4 h of the CT was performed. Two consultant radiologists independently reviewed the KUB, CT Scout, AIP, and MIP for stone visibility and their sensitivities and agreement values were compared. Stone characteristics (size, location, and peak Hounsfield units) and patient thickness were recorded and examined for any association with discordant results. 74 stones were evaluated for the study. KUB had a sensitivity of 66.2% (95% CI 54.3-76.8), CT Scout 47.3% (95% CI 35.6-59.3), AIP 55.4% (95% CI 43.4-67.0), and MIP 83.8% (95% CI 73.4-91.3). Fair agreement was found between the KUB and both CT Scout (κ=0.363, 95% CI 0.167-0.558) and AIP (κ=0.384, 95% CI 0.175-0.592). Moderate agreement was found between the KUB and MIP (κ=0.412, 95% CI 0.198-0.625). Neither any stone characteristic nor patient thickness had a significant association with discordant results. None of the possible substitutes for a baseline KUB showed strong agreement with the KUB. Low-dose CT Scouts have a similar sensitivity to the published literature for higher dose CT Scouts.


Native cytokines do not bind to uromodulin (Tamm-Horsfall glycoprotein).
Uromodulin bound with high affinity to human tumour necrosis factor (TNF) coated on microtitre plates. This interaction was not competitively inhibited by native TNF in solution. No interaction was observed between immobilized uromodulin and TNF in the liquid phase unless conditions were chosen which denatured the latter protein. Recombinant interleukin-1 alpha adsorbed on microtitre plates also interacted with uromodulin. However, gel filtration experiments demonstrated no interaction between the proteins in the liquid phase. These and additional results indicate that uromodulin interacts with denatured cytokines, but not with native, soluble cytokines.


Clinical Effects of Pleurotomy on Postoperative Outcomes of Patients Undergoing On-Pump Coronary Artery Bypass Grafting with Skeletonized Left Internal Thoracic Artery.
To evaluate the clinical impact of pleurotomy during skeletonized internal thoracic artery (ITA) harvesting in patients undergoing on-pump coronary artery bypass grafting (CABG). Consecutive patients (n = 758) who underwent CABG with skeletonized ITA were divided into 2 groups according to pleural integrity: open pleura (OP) and closed pleura (CP). Propensity score matching was performed after retrospective data extraction. The measured outcomes were postoperative pulmonary and hemorrhagic complications, 30-day mortality, and duration of hospital stay. Among 236 propensity score-matched pairs, there was no statistically significant difference between the 2 groups in terms of first 30-day mortality (OP, n = 7 [3%]; CP, n = 5 [2.5%]), blood product use (OP, 0.90 ± 0.71; CP, 0.74 ± 0.7), or median duration of hospital stay. The incidence of postoperative pleural effusion, thoracentesis, prolonged mechanical ventilation, respiratory failure, excessive drainage, cardiac tamponade, and reexploration and the number of patients requiring transfusion were similar in both groups. The clinical effect of pleural protection or pleurotomy on postoperative outcomes is limited in patients undergoing on-pump CABG with skeletonized ITA.


Doxorubicin toxicity and pharmacokinetics in old and young rats.
Doxorubicin (Dx) toxicity was compared in old (24 months) and young (6 weeks) Crl:CD(SD) BR male rats, and a clear age-related increase was found. The mortality of all animals receiving a single i.v. Dx dose was followed for 270 days. Old rats died after doses of 2.5 mg/kg, while young animals died after doses two times higher, 5 mg/kg. In old rats body weight loss started 10 to 15 days after Dx, compared to 50 to 80 days for young animals. In young and old rats pharmacokinetic and metabolic studies of Dx were conducted in vivo and in the liver perfusion model. Peak levels of Dx and areas under the time/concentration curves (AUC) in serum and in several tissues of old rats were 1.5 to 2 times higher than in young rats. Concentrations of Dx metabolites in serum and tissues (doxorubicinol, Dxol, and doxorubicinone, Dxone) in young and old rats were not noteworthy. However, higher percentages of Dxone than Dxol were found in both groups in vivo and in vitro. Old livers appeared to produce more Dxone as a percentage, particularly in the bile, which was higher. Urinary elimination of Dx markedly slowed with age; only small amounts of the metabolites were eliminated in urine. In vivo and in vitro availability of Dx and its metabolites is discussed in view of their possible role in the greater toxicity observed in 24-month-old rats.


Yeast adenylate cyclase catalytic domain is carboxy terminal.
Subcloning of DNA fragments from the gene coding for yeast adenylate cyclase has permitted, after complementation studies in S. cerevisiae cdc35 mutants as well as E. coli cya mutants, to identify the sequence coding for the catalytic domain of the protein. No homology is found between the yeast cyclase catalytic domain and the homologous domain found in E. coli adenylate cyclase. Analysis by Northern blotting of yeast polyA mRNA has shown the existence of multiple transcriptional products of the gene. A putative origin of a major transcript (3.5 kb) would allow synthesis of a ca. 100,000 dalton protein exhibiting cyclase activity in its carboxy terminal domain, and having 7 repeats of 17 amino acids at its amino terminal end. Several note-worthy features, including the possibility of transcriptional control by the general control of amino acids biosynthesis, are present at this putative origin. Data are presented suggesting that a much longer gene product might also be synthesized from the CDC35 gene. Neither the gene organization nor the amino acid sequence of the protein does display any homology with the adenylate cyclase gene and protein of Escherichia coli. This suggests a case of evolutionary convergence for the synthesis of cAMP in prokaryotes and eukaryotes.


Genome-wide identification and expression analyses of the pectate lyase (PEL) gene family in cotton (Gossypium hirsutum L.).
Pectin is a major component and structural polysaccharide of the primary cell walls and middle lamella of higher plants. Pectate lyase (PEL, EC 188.8.131.52), a cell wall modification enzyme, degrades de-esterified pectin for cell wall loosening, remodeling and rearrangement. Nevertheless, there have been few studies on PEL genes and no comprehensive analysis of the PEL gene family in cotton. We identified 53, 42 and 83 putative PEL genes in Gossypium raimondii (D5), Gossypium arboreum (A2), and Gossypium hirsutum (AD1), respectively. These PEL genes were classified into five subfamilies (I-V). Members from the same subfamilies showed relatively conserved gene structures, motifs and protein domains. An analysis of gene chromosomal locations and gene duplication revealed that segmental duplication likely contributed to the expansion of the GhPELs. The 2000 bp upstream sequences of all the GhPELs contained auxin response elements. A transcriptomic data analysis showed that 62 GhPELs were expressed in various tissues. Notably, most (29/32) GhPELs of subfamily IV were preferentially expressed in the stamen, and five GhPELs of subfamily V were prominently expressed at the fiber elongation stage. In addition, qRT-PCR analysis revealed the expression characteristics of 24 GhPELs in four pollen developmental stages and significantly different expression of some GhPELs between long- and short-fiber cultivars. Moreover, some members were responsive to IAA treatment. The results indicate that GhPELs play significant and functionally diverse roles in the development of different tissues. In this study, we comprehensively analyzed PELs in G. hirsutum, providing a foundation to better understand the functions of GhPELs in different tissues and pathways, especially in pollen, fiber and the auxin signaling pathway.


Adipose Tissue Mediates Associations of Birth Weight with Glucose Metabolism Disorders in Children.
This study aimed to examine the associations between low birth weight (LBW) versus high birth weight (HBW) and dysglycemia, including insulin resistance (IR) and impaired fasting glucose (IFG) in children, and aimed to explore the role of adipose tissue in these relationships. A total of 2,935 subjects aged 6 to 18 years were recruited to examine the relationship between birth weight and IR (defined as homeostasis model assessment of IR > 2.3) and IFG. Mediation analyses were conducted to examine the roles of various adipokines and anthropometrics in these relationships. Children with LBW had a nearly twofold increased risk of IR and IFG compared with children with normal birth weight, even after adjusting for BMI. Decreased circulating adiponectin levels contributed to 21.2% of the LBW-IR relationship, whereas none of the selected adipose markers mediated the LBW-IFG relationship. In contrast, after controlling for current BMI or waist circumference, HBW reduced the risk of IR by 34%, but it was not associated with IFG. The HBW-IR relationship was significantly mediated by reduced leptin levels (21.4%) and fat mass percentage (8.8%), after controlling for BMI. These findings suggest the potential role of adipose tissue dysfunction as an underlying mechanism for the birth weight-type 2 diabetes relationship.


Clinical and pathological features of Allen's type C classification of resected combined hepatocellular and cholangiocarcinoma: a comparative study with hepatocellular carcinoma and cholangiocellular carcinoma.
The clinical features of Allen's type C of combined hepatocellular and cholangiocarcinoma (cHCC-CC) are not well known. In this study, we aim to define the clinicopathologic features of cHCC-CC and to evaluate the preoperative diagnosis and surgical treatment results in comparison with those of hepatocellular carcinoma (HCC) and cholangiocellular carcinoma (CCC). We retrospectively analyzed 13 patients with cHCC-CC, 509 patients with HCC, and 41 patients with CCC treated in our hospital within past two decades. Viral hepatitis B or C backgrounds were more prominent in HCC and cHCC-CC groups than in the CCC group. Elevated serum alpha-fetoprotein (AFP) levels were found in 60.3% of HCC patients and in 46.2% of cHCC-CC patients. Only one patient of cHCC-CC was correctly diagnosed before surgery. The postoperative survival rates between the cHCC-CC and HCC or the CCC group were not significantly different. Both intrahepatic and extrahepatic postoperative recurrences were frequent in cHCC-CC patients, and CCC component recurrences were more frequently seen. In conclusion, the preoperative diagnosis is difficult; liver masses similar to those of HCC, together with moderately elevated serum AFP and CA19-9 levels, are reliable indicators of cHCC-CC. Surgical resection of this tumor yields results intermediate between those of HCC and CCC in character. More cases are needed to further define the characteristics of this tumor.


Cellulase recovery via membrane filtration.
A combined sedimentation and membrane filtration process was investigated for recycling cellulase enzymes in the biomass-to-ethanol process. In the first stage, lignocellulose particles longer than approx 50 microm were removed by means of sedimentation in an inclined settler. Microfiltration was then utilized to remove the remaining suspended solids. Finally, the soluble cellulase enzymes were recovered by ultrafiltration. The permeate fluxes obtained in microfiltration and ultrafiltration were approx 400 and 80 L/(m2 x h), respectively. A preliminary economic analysis shows that the cost benefit of enzyme recycling may be as much as 18 cents/gal of ethanol produced, provided that 75% of the enzyme is recycled in active form.


Calcinosis: pathophysiology and management.
This article reviews the most updated literature regarding the epidemiology, pathophysiology, diagnosis, and treatment of calcinosis cutis in patients with systemic sclerosis (SSc). Our review identified observational studies that describe the frequency of calcinosis in SSc and associated clinical features, genetic studies in animal models of heritable disorders leading to calcium deposition, and case series and case reports describing new diagnostic approaches and therapeutic interventions. Calcinosis cutis is the deposition of calcium in the skin and subcutaneous tissues. It affects almost one quarter of patients with SSc, and is associated with longer disease duration, digital ulcers, acroosteolysis, positive anticentromere antibody, and positive anti-PM/Scl antibody. Local trauma, chronic inflammation, and vascular hypoxia have been proposed as potential pathomechanisms. The development of mouse models that mimic heritable ectopic mineralization disorders are contributing to the understanding of the process of calcification. Diagnosis can be made clinically or with plain radiography. Experimental diagnostic studies include ultrasonography, multidetector computed tomography, and dual-energy computed tomography. Several pharmacologic therapies have been tried for calcinosis with variable results, but surgical excision of calcium deposits remains the mainstay of treatment.


A SMART design to optimize treatment strategies for patient and family caregiver outcomes.
Sequential multiple randomization trial (SMART) designs are experimental designs used to identify treatment strategies that maximize targeted health outcomes. SMART designs are receiving greater attention in nursing and other health disciplines to develop multicomponent interventions that are tailored to the patient's (or family caregiver's) needs and preferences. A SMART design resembles a traditional randomized controlled trial (RCT) design in that it scientifically examines intervention effects with randomization. However, the two designs address very different research inquiries. In this article, we compare traditional RCT designs and SMART designs, describe the adaptive treatment framework that underlies SMART designs and key features of SMART designs, and illustrate the application of a SMART design to develop an adaptive palliative care treatment to improve patient and caregiver outcomes.


A comprehensive assessment of the cross-training effect in ankle dorsiflexors of healthy subjects: A randomized controlled study.
To investigate the cross-training effect, induced on ankle dorsiflexors (AD) by unilateral strength-training of the contralateral muscles, as transfer of peak torque (PT) and muscle work (MW) and their relative contributions to muscle performance. Thirty healthy volunteers were randomly assigned to a training or control group. The trained group sustained a 4-week maximal isokinetic training of the stronger AD at 90 and 45°/s. At both angular velocities, PT, MW and MW/PT ratio were measured from both legs at baseline and after intervention (trained group) or no-intervention (controls). The familiarization/learning-effect was calculated and subtracted by PT and MW measures to obtain their net changes. Net PT increased in both legs (untrained: +27.5% at 90°/s and +17.9% at 45°/s; trained: +15% at 90°/s and +16.3% at 45°/s). Similarly, net MW increased in both the untrained (90°/s: +29.6%; 45°/s: +37%) and trained (90°/s: +23.4%; 45°/s: +18.3%) legs. PT and MW gains were larger in the untrained than trained AD (p<0.0005), with MW improving more than PT at 45°/s (p=0.04). The MW/PT ratio increased bilaterally only in the trained group (p<0.05), depending on the angular velocity. The cross-training effect occurred in AD muscles in terms of both PT and MW, with MW adding valuable information to PT-analysis in describing muscle performance. Moreover, the MW/PT ratio allowed estimating the contributions of these parameters to muscle capability and may represent a novel index in isokinetic testing. The greater improvements in the untrained than trained limb raises interesting clinical implications in asymmetric conditions.


New resolution technologies controlled by chiral discrimination mechanisms.
It is well known that optical resolution via crystallization is still a useful and practicalmethod for obtaining enantiomerically pure compounds for both laboratory experiment and industrial production,although it is a classical technique discovered nearly 160 years ago. In particular, diastereomericsalt formation using a resolving agent (diastereomer method) has been well applied in various fieldssuch as the pharmaceutical, agrochemical, and liquid crystal industries. Despite these affluent reportedand patented examples, unfortunately no concrete theory to determine an optimum resolution condition hasbeen devised, and only empirical procedures seem to provide a unique path in process development. Inthis chapter, three novel approaches for optical resolution via diastereomeric salt formation are presented:(1) chiral purity improvement by crystal habit modification with a tailored chiral additive; (2) a newapproach for finding a suitable resolving agent based on the space filler concept; and (3) chiralitycontrol by dielectrically controlled resolution.


Comparative genome analysis of novel Podoviruses lytic for hypermucoviscous Klebsiella pneumoniae of K1, K2, and K57 capsular types.
Hypermucoviscous (HV) strains of capsular types K1, K2 and K57 are the most virulent representatives of the Klebsiella pneumoniae species. Eight novel bacteriophages lytic for HV K. pneumoniae were isolated and characterized. Three bacteriophages, KpV41, KpV475, and KpV71 were found to have a lytic activity against mainly K. pneumoniae of capsular type K1. Two phages, KpV74, and KpV763 were lytic for K2 capsular type K. pneumoniae, and the phage KpV767 was specific to K57-type K. pneumoniae only. Two more phages, KpV766, and KpV48 had no capsular specificity. The phage genomes consist of a linear double-stranded DNA of 40,395-44,623bp including direct terminal repeats of 180-246 bp. The G + C contents are 52.3-54.2 % that is slightly lower than that of genomes of K. pneumoniae strains being used for phage propagation. According to the genome structures, sequence similarity and phylogenetic data, the phages are classified within the genus Kp32virus and Kp34virus of subfamily Autographivirinae, family Podoviridae. In the phage genomes, genes encoding proteins with putative motifs of polysaccharide depolymerase were identified. Depolymerase genes of phages KpV71 and KpV74 lytic for hypermucoviscous K. pneumoniae of K1 and K2 capsular type, respectively, were cloned and expressed in Escherichia coli, and the recombinant gene products were purified. The specificity and polysaccharide-degrading activity of the recombinant depolymerases were demonstrated.


Identification of potential new mosquito-associated viruses of adult Aedes aegypti mosquitoes from Tocantins state, Brazil.
Medically important arboviruses such as dengue virus (DENV), Zika virus (ZIKV), and chikungunya virus (CHIKV) are primarily transmitted by the globally distributed mosquito Aedes aegypti. Increasing evidence suggests that the transmission of some viruses can be influenced by mosquito-specific and mosquito-borne viruses. Advancements in high-throughput sequencing (HTS) and bioinformatics have expanded our knowledge on the richness of viruses harbored by mosquitoes. HTS was used to characterize the presence of virus sequences in wild-caught adult Ae. aegypti from Tocantins (TO) state, Brazil. Samples of mosquitoes were collected in four cities of Tocantins state and submitted to RNA isolation, followed by sequencing at an Illumina HiSeq platform. Our results showed initially by Krona the presence of 3% of the sequenced reads belonging to the viral database. After further analysis, the virus sequences were found to have homology to two viral families found in insects Phenuiviridae and Metaviridae. Three possible viral strains including putative new viruses were detected and named Phasi Charoen-like phasivirus isolate To-1 (PCLV To-1), Aedes aegypti To virus 1 (AAToV1), and Aedes aegypti To virus 2 (AAToV2). The results presented in this work contribute to the growing knowledge about the diversity of viruses in mosquitoes and might be useful for future studies on the interaction between insect-specific viruses and arboviruses.


Role of eicosanoids in relative oxygen tolerance of newborn rabbits.
Prolonged exposure to hyperoxia can result in significant lung injury, although newborn animals are more oxygen-tolerant than adults. Mechanisms affording tolerance to the newborn are incompletely understood. This study examined the hypothesis that eicosanoids play a significant role in newborn oxygen tolerance. One litter of term newborn albino rabbits and 15 adult rabbits were exposed to 65 hours of greater than 95% O2. An additional litter of newborns served as a normoxic control. Normoxic newborn rabbits had very high quantities of 6-keto-PGF1a and low TXB2 in bronchoalveolar lavage (BAL) fluid. Sixty-five hours of oxygen exposure in newborn rabbits produced no evidence of lung injury on light microscopy, 97% of BAL white cells were alveolar macrophages and BAL protein was low. An equal period of oxygen exposure produced significant lung injury in adult rabbits. BAL fluid from oxygen-injured adults contained a 17-fold greater percentage of PMN and 16-fold higher protein than oxygen-exposed newborns. Hyperoxic adults had significantly lower 6-keto-PGF1a, and significantly higher LTB4 and LTC4 in BAL compared to hyperoxic newborns. This study confirms the hypothesis of relative oxygen tolerance in newborn rabbits compared to adults, and suggests that this tolerance may have been afforded by higher pulmonary levels of the protective prostacyclin metabolite.


An ascending serotonergic pain modulation pathway from the dorsal raphe nucleus to the parafascicularis nucleus of the thalamus.
Three types of spontaneously active neurons were found in the parafascicularis (PF) nucleus of the thalamus of the rat: slow firing units (0.5-10 spikes/s), bursting units (2-5 spikes/burst in 10-20 ms, one burst every 1-2 s) and fast firing units (15-40 spikes/s). A similar population of neurons was found in the PF of rats treated with 5,7-dihydroxytryptamine (5,7-DHT), a serotonin neurotoxin. Noxious tail pinch (TP) caused 68% of the PF neurons to increase their firing rates to 242% of their initial baseline activity, while non-noxious touch stimulation failed to induce a response. In the 5,7-DHT-treated rats, TP caused 85% of the neurons in the PF to increase their firing rates to 581% of their initial baseline activity and 22% of the neurons increased their firing in response to touching the tail. Both the number of cells responding (P less than 0.05) and the percentage increase (P less than 0.001) were statistically greater in serotonin-depleted rats than in controls. This indicates that serotonin (5-HT) has a tonic inhibitory influence on responses to both noxious and non-noxious sensory stimuli. In control rats, electrical stimulation of the dorsal raphe nucleus (DR) decreased the firing rates of PF neurons. In contrast, the same DR stimulation induced an increase in PF firing rates during stimulation in serotonin-depleted rats and this increase in firing rates remained several seconds after cessation of stimulation. This indicates that the DR may use at least two different neurotransmitters in its projections to forebrain structures. In control rats, the TP stimulation induced an increase in firing rates of rates of PF neurons while DR stimulation attenuated the excitation induced by TP stimulation. In serotonin-depleted rats, DR stimulation and TP both caused an increase in firing rates. This effect was not additive indicating that there may be a serotonergic projection from the DR to the PF which modifies responses to somatosensory stimuli. The inhibitory effects elicited by electrical stimulation were limited to the immediate area of the DR. Stimulation of the adjacent reticular formation 1 mm lateral to the DR produced the opposite effect, an increase in firing rate often accompanied by driven spike activity in the PF.


Interferon-γ induces upregulation and activation of the interleukin-31 receptor in human dermal microvascular endothelial cells.
Interleukin-31 (IL-31), a recently discovered cytokine derived from T helper cells, is involved in chronic dermatitis and pruritus. This study demonstrates for the first time that the IL-31 receptor complex for IL-31 is substantially upregulated in human dermal microvascular endothelial cells after stimulation with interferon-γ (IFN-γ). Activation of the IL-31 receptor complex results in the induction of the intracellular ERK1/2 signaling pathway and downregulation of IFN-γ-induced monokine induced by IFN-γ expression. Inhibitor studies revealed that the IFN-γ-induced IL-31RA upregulation is processed via JNK and PI3 kinase activation. In sum, our study points toward an interaction between the T(H) 1-derived cytokine IFN-γ and the T(H) 2-derived cytokine IL-31 on endothelial cells.


Meta-analysis of prevalence: the psychological sequelae among COVID-19 survivors.
This meta-analysis aims to estimate the pooled prevalence of mental disorders among COVID-19 survivors. The databases Pubmed, Google Scholar, ScienceDirect, and medRxiv have been searched up to 1 August 2021 using COVID-19, survivors, mental disorders, and their related MeSH terms. The included studies were either cross-sectional, cohort, or case-control in design. Those studies included COVID-19 survivors after 14 or more days from their COVID-19 recovery and used validated questionnaires to assess their mental health outcomes. The random-effects model was used to pool the data from the incorporated studies. The heterogeneity was assessed using Cochran's Q heterogeneity test and I2 statistic. Twenty-seven studies were included in the data synthesis with a total sample size of 9605 COVID-19 survivors. The prevalence rates for Post-Traumatic Stress Disorder (PTSD), anxiety, psychological distress, depression, and sleeping disorders were 20% (95% CI = 16-24%), 22% (95% CI = 18-27%), 36% (95% CI = 22-51%), 21% (95% CI = 16-28%), and 35% (95% CI = 29-41%), respectively. Although we found high heterogeneity across the included studies, our meta-analysis provides evidence that there are psychological sequelae in COVID-19 survivors that require medical assiduity as well as further research on the matter.KEY POINTSIncreased prevalence of psychological sequelae among COVID-19 survivors.The prevalence of PTSD was 20% (95% CI = 16-24%) and of anxiety was 22% (95% CI = 18-27%) among COVID-19 survivors.The prevalence of psychological distress was 36% (95% CI = 22-51%), of depression was 21% (95% CI = 16-28%), and of sleep disorders was 35% (95% CI = 29-41%) among COVID-19 survivors.Future researches are recommended to search for effective and safe methods to mitigate the psychological sequelae in COVID-19 patients.


Investigation of Bacillus licheniformis in the biodegradation of Iranian heavy crude oil: A two-stage sequential approach containing factor-screening and optimization.
Oil pollution is a serious international concern due to its harmful effect on human health and the environment. This study aims to investigate the effective factors on the biodegradation of Iranian heavy crude oil by Bacillus licheniformis. For this purpose, oil removal from the artificial seawater was studied by response surface methodology (RSM). After the screening experiments, pH (4-10), NaCl concentration (0-10 g/L), and oil concentration (500-4500 ppm) were selected as influential factors. Moreover, to evaluate the bacterial capability in bioremediation of an actual polluted site, crude oil spill with a salinity of 35 g/L was experimentally simulated. The proposed model in this study clearly shows that both selected individual factors and their interactions are significantly effective on the crude oil biodegradation capacity. The results showed that Bacillus licheniformis was able to degrade crude oil at different concentrations of oil, especially at low concentrations, which are challenging in actual polluted sites. 15%-66% removal was achieved for 500-4500 ppm of crude oil after 14 days. Furthermore, according to the obtained results, this bacterium can tolerate the salinity up to 3.5%. At this salinity level, crude oil removal was 23.43 and 25.64% in neutral and alkaline conditions, respectively. Process factors were optimized, and 54.8% of crude oil was removed at optimum conditions i.e., 3500 ppm crude oil concentration, 2.5 g/L of NaCl and pH equal to 8.5. Finally, it can be concluded that the selected bacterium of this study can be more effective in harsh environments such as hypersaline and alkaline conditions.


Thermophilic anaerobic digester performance under different feed-loading frequency.
The effect of feed-loading frequency on digester performance was studied on a thermophilic anaerobic digester with a working volume of 27.43 m(3). The digester was fed 0.93 m(3) of chicken-litter slurry/d, containing 50.9 g/L chemical oxygen demand. The treatments were loading frequencies of 1, 2, 6, and 12 times/d. The hourly pH, biogas production, and methane percent of the biogas were less stable at lower feed frequencies. There was no statistical difference among treatments in methanogenic activity. The feed-loading frequency of six times per day treatment provided the greatest biogas production.


Study of the morphological, electrophysiological and behavioral effects of unilateral kainic acid injection into the cat's substantia nigra.
Morphological, electrophysiological and behavioral studies were carried out in cats after unilateral kainic acid injection in the substantia nigra. A forced contralateral head turning and compulsive circling was observed after surgery. Fifteen days after, when asymmetry disappeared, apomorphine induced an ipsilateral head and body turning, that was blocked by haloperidol. The percentage of turning, after electrical stimulation in the superior colliculus or pulvinar-lateralis posterior complex, was affected by substantia nigra lesion. This work demonstrates that the nigro-pulvinar-lateral posterior and the nigrotectal projection modulate the capability of electrical stimulation of the target structures to elicit turning, and after unilateral substantia nigra lesion, two opposite directions of asymmetry appear, which are time-dependent and modulated by different neurotransmitters.


[The presence of the Epstein-Barr virus in Waldeyer's lymphatic ring during the acute phase of infectious mononucleosis].
The aim of our research was to detect the existence of virus Epstein-Barr genome in the palatine- and the nasopharyngeal tonsil obtained from six patients during the acute phase of the infectious mononucleosis. The presence of EBV-DNA was demonstrated with the help of nucleic acid hybridization techniques (Southern-Blot and in situ hybridization) in the two components of the lymphoepithelial ring of the throat. The pathogenesis and the therapeutic implications of these findings are discussed.


Gigantism and the potential for interference competition in the rotifer genus Asplanchna.
Laboratory experiments showed that A. bright-welli could outreproduce, or coexist with, A. silvestrii only when the absence of dietary tocopherol prevented the latter from transforming to the giant cruciform and campanulate morphs. When tocopherol permitted polymorphic transformations, as often occurs in nature, the giant morphs of A. silvestrii ingested and rapidly excluded the much smaller, only slightly polymorphic A. brightwelli. Such interference (or encounter) competition from trimorphic Asplanchna species is known to occur in nature and must limit the distribution and abundance of monomorphic or only slightly polymorphic species. The ability to eat congeneric competitors may have provided some selective pressure for the evolution of gigantism in the genus.


Elevational and age gradients in hawaiian montane rainforest: foliar and soil nutrients.
Soils and plants were sampled along an elevational gradient from 265-1675 m on a 133-and a 3100-year-old lava flow on Mauna Loa, Hawai'i. Soil organic matter and nutrients accumulated more rapidly at low elevation on the young flow, but reached higher levels at higher elevation on the old flow. Foliar nitrogen and phosphorus concentrations were less and specific leaf weight greater for Metrosideros polymorpha leaves collected at high versus low elevations and on the young versus the old flow. Foliar δ13C was strongly correlated with specific leaf weight across the range of sites sampled.


Volume changes in soft tissue sarcomas during preoperative radiotherapy of extremities evaluated using cone-beam CT.
The objective of this study is to quantify volume changes in the gross target volume (GTV) during preoperative radiotherapy for extremity soft tissue sarcomas (ESTS). Twenty-seven patients with ESTS, treated with preoperative radiotherapy, were included in this study. Weekly cone-beam CT scans acquired for setup correction were used for GTV delineation in order to quantify volume changes over the course of treatment. Age, anatomical location, tumour type and tumour volume were evaluated as predictive factors for volume changes. Finally, the optimal time point for adaptive intervention was quantified. A GTV increase to a maximum of 28 % occurred in five patients. Thirteen patients showed no change and nine patients (all diagnosed with myxoid liposarcoma (MLS)) showed a GTV decrease to a maximum of 57 % of the GTV volume at start of treatment. In the multivariate analysis, only the relative volume change for tumour type was significant (p = 0.001). The optimal time point for adaptive intervention in non-MLS patients was the first week and for MLS patients the third week. Volume changes were quantified during preoperative RT of ESTS. Volume decrease was observed only in MLS patients. Individualised treatment resulting in plan adaptations could result in a clinically useful volume reduction for MLS patients.


Evaluation of the hearing loss associated with cis-platinum treatment by high-frequency audiometry.
The effect of cis-platinum treatment on the hearing of 23 ovarian cancer patients was evaluated using standard and high-frequency audiometry. Twenty-two percent of the patients developed a hearing loss of at least 15 db, 13% in the range 125-8000 Hz and 9% only in the high-frequency area above 8 kHz. However, due to the high-frequency hearing loss (presbyacusis) in older patients high-frequency audiometry was often unobtainable. Hearing screening using standard pure-tone audiometry is recommended for cis-platinum patients as a routine procedure.


CovidVisualized: Visualized compilation of international updated models' estimates of COVID-19 pandemic at global and country levels.
To identify international and periodically updated models of the COVID-19 epidemic, compile and visualize their estimation results at the global, regional, and country levels, and periodically update the compilations. This compilation can serve as an early warning mechanism for countries about future surges in cases and deaths. When one or more models predict an increase in daily cases or infections and deaths in the next one to three months, technical advisors to the national and subnational decision-makers can consider this early alarm for assessment and suggestion of augmentation of preventive measures and interventions. Five international and periodically updated models of the COVID-19 pandemic were identified, created by: (1) Massachusetts Institute of Technology, Cambridge, (2) Institute for Health Metrics and Evaluation, Seattle, (3) Imperial College, London, (4) Los Alamos National Laboratories, Los Alamos, and (5) University of Southern California, Los Angeles. Estimates of these five identified models were gathered, combined, and graphed at global and two country levels. Canada and Iran were chosen as countries with and without subnational estimates, respectively. Compilations of results are periodically updated. Three Github repositories were created that contain the codes and results, i.e., "CovidVisualizedGlobal" for the global and regional levels, "CovidVisualizedCountry" for a country with subnational estimates-Canada, and "covir2" for a country without subnational estimates-Iran.


Self-relevance effects and label choice: Strong variations in label-matching performance due to non-self-relevant factors.
Merely associating one's self with a stimulus may be enough to enhance performance in a label-matching paradigm (Sui, He, & Humphreys, 2012), implying prioritized processing of self-relevant stimuli. For instance, labeling a square as SELF and a circle as OTHER yields speeded performance when verifying square-SELF compared with circle-OTHER label matches. The precise causes of such effects are unclear. We propose that prioritized processing of label-matches can occur for reasons other than self-relevance. Here, we employ the label-matching paradigm to show similar benefits for non-self-relevant labels (SNAKE, FROG, and GREG) over a frequently employed, non-self-relevant control label (OTHER). These benefits suggest the possibility that self-relevance effects in the label-matching paradigm may be confounded with other properties of labels that lead to relative performance benefits, such as concreteness. The size of self-relevance effects may be overestimated in prior work employing the label-matching paradigm, which calls for greater care in the choice of control labels to determine the true magnitude of self-relevance effects. Our results additionally indicate the possibility of a powerful effect of concreteness (and related properties) on associative memory performance.


Ambient air pollution exposure and depressive symptoms: Findings from the French CONSTANCES cohort.
Few studies have reported the association between air pollution exposure with different dimensions of depression. We aimed to explore this association across different dimensions of depressive symptoms in a large population. Data from the enrollment phase of the French CONSTANCES cohort (2012-2020) were analyzed cross-sectionally. Annual concentrations of particulate matter with a diameter < 2.5 µm (PM2.5), black carbon (BC), and nitrogen dioxide (NO2) from the land-use regression models were assigned to the residential addresses of participants. Total depressive symptoms and its four dimensions (depressed affect, disturbed interpersonal relations, low positive affect, somatic complaints) were measured using Centre of Epidemiologic Studies Depression questionnaire (CES-D). We reported results of negative binomial regression models (reported as Incidence Rate Ratio (IRR) and 95 % confidence interval (CI) for an interquartile range (IQR) increase in exposure), for each pollutant separately. Stratified analyses were performed by sex, income, family status, education, and neighborhood deprivation. The study included 123,754 participants (mean age, 46.50 ± 13.61 years; 52.4 % women). The mean concentration of PM2.5, BC and NO2 were 17.14 µg/m3 (IQR = 4.89), 1.82 10-5/m (IQR = 0.88) and 26.58 µg/m3 (IQR = 17.41) respectively. Exposures to PM2.5, BC and NO2 were significantly associated with a higher CES-D total (IRR = 1.022; 95 % CI = 1.002: 1.042, IRR = 1.027; 95 % CI = 1.013: 1.040, and IRR = 1.029; 95 % CI = 1.015: 1.042 respectively), and with depressed affect, and somatic complaints. For all pollutants, a higher estimate was observed for depressed affect. We found stronger adverse associations for men, lower-income participants, low and middle education groups, those living in highly deprived areas, and single participants. Our finding could assist the exploration of the etiological pathway of air pollution on depression and also considering primary prevention strategies in the areas with air pollution.


Accelerating Virtual High-Throughput Ligand Docking: current technology and case study on a petascale supercomputer.
In this paper we give the current state of high-throughput virtual screening. We describe a case study of using a task-parallel MPI (Message Passing Interface) version of Autodock4 [1], [2] to run a virtual high-throughput screen of one-million compounds on the Jaguar Cray XK6 Supercomputer at Oak Ridge National Laboratory. We include a description of scripts developed to increase the efficiency of the predocking file preparation and postdocking analysis. A detailed tutorial, scripts, and source code for this MPI version of Autodock4 are available online at http://www.bio.utk.edu/baudrylab/autodockmpi.htm.


Following the Path; A Grounded Theory Study Regarding Doctoral Roles.
Decades after the AACN (2004) position statement regarding the clinical doctorate, the DNP, shows ongoing dialogue without professional consensus regarding the two terminal degrees. The lack of understanding and confusion surrounding the two doctoral degrees in nursing subsequently projects a negative image about the profession; suggesting a lack of cohesiveness; promotes an environment of distrust, thereby creating confusion for the public about the nursing profession. The purpose of this qualitative research was to develop a substantive theory about the perceptions and the attitudes of doctoral nurses regarding their roles. An adapted approach of Strauss and Corbin's grounded theory methodology was used. Sampling was purposive, snowball, and theoretical. Theoretical sampling with an expert group validated concepts, themes, and categories. The main categories of advancing, collaborating, transforming, and stewarding emerged from the data. The basic social process of Following the Path identified and explained the meaning ascribed by DNP and PhD nurses about their doctoral roles. The theoretical framework provides information about the DNP and PhD nurse. The findings support evidence the nursing profession is moving forward towards self-definition. Acceptance and need for the doctoral roles were identified. Understanding the perspectives of the doctoral nurses in the profession has identified forward movement in practice and cohesion of the nursing discipline.


Unilateral hemispherectomy at adulthood asymmetrically affects motor performance of male Swiss mice.
Evidence exists indicating that cerebral lateralization is a fundamental feature of all vertebrates. In humans, a series of studies demonstrated that the left hemisphere plays a major role in controlling movement. No such asymmetries have been identified in rodents, in spite of the fact that these animals have been frequently used in studies assessing motor behavior. In this regard, here, we used unilateral hemispherectomy to study the relative importance of each hemisphere in controlling movement. Adult Swiss mice were submitted to right unilateral hemispherectomy (RH), left unilateral hemispherectomy (LH) or sham surgery. Fifteen days after surgery, motor performance was assessed in the accelerating rotarod test and in the foot-fault test (in which performance depends on skilled limb use) and in the elevated body swing test (in which performance depends on trunk movements). The surgical removal of the right hemisphere caused a more pronounced impairment in performance than the removal of the left hemisphere both in the rotarod and in the foot-fault tests. In the rotarod, the RH group presented smaller latencies to fall than both LH and sham groups. In the foot-fault test, while both the sham and the LH groups showed no differences between left and right hind limbs, the RH group showed significantly worse performance with the left hind limb than with the right one. The elevated body swing test revealed a similar impairment in the two hemispherectomized groups. Our data suggest a major role of the right hemisphere in controlling skilled limb movements in mice.


4-[(E)-3-(4-Methyl-phen-yl)-3-oxoprop-1-en-1-yl]benzo-nitrile.
In the title mol-ecule C17H13NO, the phenyl rings are inclined to one another by 48.04 (9)°. In the crystal, weak C-H⋯π(ring) inter-actions form a layered structure parallel to the ab plane.


Evidence for lectin-mediated adherence of S. saprophyticus and P. aeruginosa to polymers.
By hemagglutination tests surface lectins on S. saprophyticus strain S 1 with N-acetylgalactosamine (GalNac) and N-acetylglucosamine (GlcNac) specificity and on P. aeruginosa ATCC strain 27853 with N-acetylneuraminic acid (NANA) specificity could be demonstrated. To elucidate the role of bacterial surface lectins for the specific adhesion, polyether urethane discs were preincubated for 15 h at 4 degrees C in human serum or urine. Adhesion studies with S. saprophyticus S1 and P. aeruginosa ATCC 27853 onto precoated polymers revealed that microbial lectins may play a role in the colonization of prosthetic devices since lectin-blocking with competitive glycoconjugates significantly decreased bacterial adherence to the coated surfaces. Non-specific carbohydrates did not inhibit the adherence demonstrating specificity of this process.


Genomic insight into Aquimarina longa SW024 T: its ultra-oligotrophic adapting mechanisms and biogeochemical functions.
South Pacific Gyre (SPG) is the largest and clearest gyre in the world, where the concentration of surface chlorophyll a and primary production are extremely low. Aquimarina longa SW024(T) was isolated from surface water of the SPG center. To understand how this bacterium could survive in this ultra-oligotrophic oceanic environment and its function in biogeochemical cycle, we sequenced the genome of A. longa SW024(T) and performed extensive genomic analyses. Genomic DNA was extracted and sequenced using Illumina Hiseq 2000 and Miseq platform. Genome annotation, genomic comparison and phylogenetic analyses were performed with the use of multiple bioinformatics tools like: BLAST+ 2.2.24, Glimmer3.0, RAST server, Geneious 4.8.5, ClustalW2 and MEGA5. Physiological and morphological features were tested by bacterial culture, electron microscopy, fluorescence microscopy and exopolysaccharides extraction. Analysis of seven Aquimarina genomes and 30 other genomes of Flavobacteriaceae isolated from seawater showed that most of the strains had low DNA G + C contents, and Aquimarina had larger genomes than other strains. Genome comparison showed varying genomic properties among seven Aquimarina genomes, including genome sizes and gene contents, which may warrant their specific adaptive strategies. Genome of A. longa SW024(T) was further compared with the genomes of two other Aquimarina species which were also isolated from the SPG and A. longa SW024(T) appeared to have much more genes related to replication, recombination and repair. As a copiotroph, A. longa SW024(T) is long in length, and possesses large genome size and diverse transporters. However, it has also evolved many properties to survive in the oligotrophic marine environment. This bacterium grew better on solid medium than in liquid medium, suggesting it may be liable to attach to particle surfaces in order to survive in the nutrient-limiting environment. Gliding motility and the capacity to degrade various polymers possibly allow the bacterium to grow on detritus particles and use polymeric substances as carbon and energy sources. Moreover, genes related to carbon, nitrogen, and sulfur metabolisms were identified, which showed that A. longa SW024(T) might be involved in various elemental cycles. Genomic comparison of Aquimarina genus exhibits comprehensive capabilities of the strains to adapt to diverse marine environments. The genomic characteristics of A. longa SW024(T) reveal that it evolves various strategies to cope with both copiotrophic and ultra-oligotrophic marine environment, which provides a better understanding of the survival abilities of bacteria in prevalent and even extreme oceanic environments. Furthermore, carbon, nitrogen and sulfur utilization of A. longa SW024(T) may represent its potential functions in the global biogeochemical cycle.


CA1 pyramidal cell diversity is rooted in the time of neurogenesis.
Cellular diversity supports the computational capacity and flexibility of cortical circuits. Accordingly, principal neurons at the CA1 output node of the murine hippocampus are increasingly recognized as a heterogeneous population. Their genes, molecular content, intrinsic morpho-physiology, connectivity, and function seem to segregate along the main anatomical axes of the hippocampus. Since these axes reflect the temporal order of principal cell neurogenesis, we directly examined the relationship between birthdate and CA1 pyramidal neuron diversity, focusing on the ventral hippocampus. We used a genetic fate-mapping approach that allowed tagging three groups of age-matched principal neurons: pioneer, early-, and late-born. Using a combination of neuroanatomy, slice physiology, connectivity tracing, and cFos staining in mice, we show that birthdate is a strong predictor of CA1 principal cell diversity. We unravel a subpopulation of pioneer neurons recruited in familiar environments with remarkable positioning, morpho-physiological features, and connectivity. Therefore, despite the expected plasticity of hippocampal circuits, given their role in learning and memory, the diversity of their main components is also partly determined at the earliest steps of development.


Intraocular cysticercosis.
We observed and photographed intraocular cysticercosis in a 50-year-old woman. The subretinal cysticercus in the macular area produced a macular break during its passage from the subretinal space into the vitreous cavity. The parasite was removed by closed vitrectomy, but the macular break was left untreated because there was no vitreous traction to the macula. The patient ultimately developed a subretinal scar in the macular area, and visual acuity improved from hand movements to counting fingers.


Air drying optimization of Saccharomyces cerevisiae through its water-glycerol dehydration properties.
This study describes the different stages of optimization in an original drying process for yeasts, which allows the retrieval of dried samples of Saccharomyces cerevisiae CBS 1171 with maximum viability. The process involves the addition of wheat flour to yeast pellets, followed by mixing and then air-drying in a fluidized bed dryer. The sensitivity to the osmotic stress was first studied in a water-glycerol solution and the observed results were then applied to the drying process. This study have shown that the yeast was quite resistant to osmotic stress and pointed out the existence of zones of sensitivity where viability dramatically decrease as function of final osmotic pressure and temperature of the treatment. Thus, for dehydration until low osmotic pressure (133 MPa, i.e. a(w) = 0.38) results have shown that viability was better when temperature of the treatment was less than 8 degrees C or higher than 25 degrees C. Moreover, kinetic of dehydration was found to greatly influence cells recovery. These observations allowed the choice of parameters of dehydration of yeasts with an original drying process which involve the mix of the yeasts with wheat flour and then drying in a fluidized bed. This process dried rapidly the yeasts to less than 220 MPa (aw < or = 0.2) with whole cell recovery and good fermentative capabilities.


Cloning and biochemical characterization of an endo-1,4-β-mannanase from the coffee berry borer Hypothenemus hampei.
The study of coffee polysaccharides-degrading enzymes from the coffee berry borer Hypothenemus hampei, has become an important alternative in the identification for enzymatic inhibitors that can be used as an alternative control of this dangerous insect. We report the cloning, expression and biochemical characterization of a mannanase gene that was identified in the midgut of the coffee berry borer and is responsible for the degradation of the most abundant polysaccharide in the coffee bean. The amino acid sequence of HhMan was analyzed by multiple sequence alignment comparisons with BLAST (Basic Local Alignment Search Tool) and CLUSTALW. A Pichia pastoris expression system was used to express the recombinant form of the enzyme. The mannanase activity was quantified by the 3,5-dinitrosalicylic (DNS) and the hydrolitic properties were detected by TLC. An endo-1,4-β-mannanase from the digestive tract of the insect Hypothenemus hampei was cloned and expressed as a recombinant protein in the Pichia pastoris system. This enzyme is 56% identical to the sequence of an endo-β-mannanase from Bacillus circulans that belongs to the glycosyl hydrolase 5 (GH5) family. The purified recombinant protein (rHhMan) exhibited a single band (35.5 kDa) by SDS-PAGE, and its activity was confirmed by zymography. rHhMan displays optimal activity levels at pH 5.5 and 30°C and can hydrolyze galactomannans of varying mannose:galactose ratios, suggesting that the enzymatic activity is independent of the presence of side chains such as galactose residues. The enzyme cannot hydrolyze manno-oligosaccharides such as mannobiose and mannotriose; however, it can degrade mannotetraose, likely through a transglycosylation reaction. The K(m) and k(cat) values of this enzyme on guar gum were 2.074 mg ml(-1) and 50.87 s(-1), respectively, which is similar to other mannanases. This work is the first study of an endo-1,4-β-mannanase from an insect using this expression system. Due to this enzyme's importance in the digestive processes of the coffee berry borer, this study may enable the design of inhibitors against endo-1,4-β-mannanase to decrease the economic losses stemming from this insect.


Determination of the GABAergic antidepressant drug fengabine and some of its metabolites in plasma by capillary gas chromatography with electron-capture detection.
A sensitive capillary gas chromatographic method was developed for the determination of fengabine (a GABAergic antidepressant drug) and some of its metabolites in plasma samples. The method involves a single and rapid liquid-liquid extraction of the parent drug and metabolites from plasma buffered at pH 5, evaporation of the organic phase under nitrogen, derivatization to tert.-butyldimethylsilyl ethers and esters and automatic gas chromatography on a fused-silica, silicone-bonded capillary column coupled to an electron-capture detector. The detection limit for fengabine and other compounds is lower than 1 ng/ml in plasma; the method was successfully applied to pharmacokinetic and drug monitoring clinical studies and tested on more than 2000 biological samples and was found not to suffer from endogenous or exogenous interferences.


Corrigendum to "Machine Learning Based Prediction of COVID-19 Mortality Suggests Repositioning of Anticancer Drug for Treating Severe Cases"[Artificial Intelligence in Life Sciences] 1(2021), 100020.
[This corrects the article DOI: 10.1016/j.ailsci.2021.100020.].


Neonatal foal diarrhea.
Diarrhea is a significant cause of morbidity and mortality in the neonatal foal. Numerous noninfectious and infectious agents are responsible for enterocolitis and enteritis. This article provides an overview of the differential diagnoses for neonatal diarrhea and general and specific guidelines for therapy.


Time impact on non-activated and kaolin-activated blood samples in thromboelastography.
The correct methodology of thrombelastography might be influenced by elapsing time. In our study we investigated kaolin activated citrated samples together with non-activated citrated samples in relation to the elapsed times of 0, 15 and 30 minutes to compare both methods and to find out if there is an impact of time on results of thrombelastography. Blood samples obtained from 10 healthy volunteers were analyzed after 0, 15 and 30 minutes from sampling with kaolin activation and without activation. Then the results were analysed and compared between the non-activated and the kaolin-activated method. All blood samples became more hypercoagulable with the time elapsing, both in non-activated and kaolin-activated samples and differences between both groups were found statistically and clinically significant after only 0 minutes. The non-activated citrated method seems to be reliable and suitable for thrombelastography in non-emergency cases (planned surgical procedures) when we have time to wait 15-30 minutes to get results. In urgent situations a rapid thrombelastography test should be preferred. Although the kaolin-activated method can also be used, results must be interpreted with caution.


Cefuroxime-impregnated cement and systemic cefazolin for 1 week in primary total knee arthroplasty: an evaluation of 2700 knees.
Infection is one of the most devastating complications after primary total knee arthroplasty (TKA). Antibiotics-impregnated cement has been used and proven effective in preventing deep infection. This study was to evaluate the long-term results of using cefuroxime-impregnated cement and systemic cefazolin for one week to assess their efficacy in preventing infection of primary TKA. From 1999 to 2007, 2700 cases of primary TKA were performed with cemented fixation of all patellar, tibial, and femoral components. Cefuroxime-impregnated cement for fixation and systemic cefazolin for one week were selected in all cases. The average follow-up period was 89 months (range, 40-140). The effects of this selected regime in the periprosthetic infection were evaluated. A total of eight infections occurred after primary TKA, including five deep infections (0.19%) and three superficial infections (0.11%) in the 2700 knees. No loosening or osteolysis was noted. Comparable with other measurements, cefuroxime-impregnated cement, accompany by systemic cefazolin for 1 week was shown to control postoperative deep infection to 0.19% (after primary TKA was performed in an operative setting without lamina flow and body exhaust suit).


Fine-Tuning the Coordinatively Unsaturated Metal Sites of Metal-Organic Frameworks by Plasma Engraving for Enhanced Electrocatalytic Activity.
Metal-organic frameworks (MOFs) have recently emerged as promising electrocatalysts because of their atomically dispersed metal sites and porous structures. The active sites of MOF catalysts largely exist as coordinatively unsaturated metal sites (CUMSs). In this study, facile microwave-induced plasma engraving is applied to fine-tune the CUMSs of cobalt-based MOF (Co-MOF-74) without destroying its phase integrity by controlling the plasma-engraving species, intensity, and duration. The electrochemical activity of the engraved MOF is found to be quantitatively correlated to the coordination geometry of the metal centers corresponding to CUMSs. Specifically, the hydrogen plasma-engraved Co-MOF-74 shows an enhanced catalytic activity of oxygen evolution reaction, which exhibits a low overpotential (337 mV at 15 mA cm-2), high turnover frequency (0.0219 s-1), and large mass activity (54.3 A g-1). The developed CUMS control strategy and the revealed CUMSs activity correlation can inspire the further microstructure tuning of MOFs for various applications.


Oxygen treatment of cluster headache: a review.
Our aim was to review the existing literature to document oxygen's therapeutic effect on cluster headache. A PubMed search resulted in 28 hits, and from these and their references we found in total 11 relevant studies. We included six studies that investigated the efficacy of oxygen treatment. One study is observational and the remaining five are RCTs. Another five studies were on hyperbaric oxygen treatment hereof two case studies. Oxygen therapy can be administered at different flow rates. Three studies investigate the effect of low-flow oxygen, 6-7 l/min, and found a positive response in 56%, 75% and 82%, respectively, of the patients. One study investigates high-flow oxygen, 12 l/min, and found efficacy in 78% of attacks. The effect of hyperbaric oxygen therapy has been investigated in a few small studies and there is evidence only for an acute, but not a prophylactic effect. Despite the fact that only a few high-quality RCT studies are available, oxygen treatment is close to an ideal treatment because it is effective and safe. However, sufferers of cluster headache do not always have access to oxygen because of logistic and financial concerns.


Molecular insights into a dinoflagellate bloom.
In coastal waters worldwide, an increase in frequency and intensity of algal blooms has been attributed to eutrophication, with further increases predicted because of climate change. Yet, the cellular-level changes that occur in blooming algae remain largely unknown. Comparative metatranscriptomics was used to investigate the underlying molecular mechanisms associated with a dinoflagellate bloom in a eutrophied estuary. Here we show that under bloom conditions, there is increased expression of metabolic pathways indicative of rapidly growing cells, including energy production, carbon metabolism, transporters and synthesis of cellular membrane components. In addition, there is a prominence of highly expressed genes involved in the synthesis of membrane-associated molecules, including those for the production of glycosaminoglycans (GAGs), which may serve roles in nutrient acquisition and/or cell surface adhesion. Biotin and thiamine synthesis genes also increased expression along with several cobalamin biosynthesis-associated genes, suggesting processing of B12 intermediates by dinoflagellates. The patterns in gene expression observed are consistent with bloom-forming dinoflagellates eliciting a cellular response to elevated nutrient demands and to promote interactions with their surrounding bacterial consortia, possibly in an effort to cultivate for enhancement of vitamin and nutrient exchanges and/or direct consumption. Our findings provide potential molecular targets for bloom characterization and management efforts.


Intron creation and DNA repair.
The genesis of the exon-intron patterns of eukaryotic genes persists as one of the most enigmatic questions in molecular genetics. In particular, the origin and mechanisms responsible for creation of spliceosomal introns have remained controversial. Now the issue appears to have taken a turn. The formation of novel introns in eukaryotes, including some vertebrate lineages, is not as rare as commonly assumed. Moreover, introns appear to have been gained in parallel at closely spaced sites and even repeatedly at the same position. Based on these discoveries, novel hypotheses of intron creation have been developed. The new concepts posit that DNA repair processes are a major source of intron formation. Here, after summarizing the current views of intron gain mechanisms, I review findings in support of the DNA repair hypothesis that provides a global mechanistic scenario for intron creation. Some implications on our perception of the mosaic structure of eukaryotic genes are also discussed.


Hormone-refractory metastatic prostatic cancer treated with methotrexate, cyclophosphamide plus adriamycin, cis-platinum plus 5-fluorouracil plus cyclophosphamide. National Prostatic Cancer Project randomized trial.
From 1982 to 1985, the National Prostatic Cancer Treatment Group conducted a randomized prospective trial of single-agent or combination chemotherapy in 180 patients with metastatic prostatic disease refractory to hormonal therapy. All three of the treatment regimens, methotrexate, Adriamycin plus cyclophosphamide, cis-platinum plus 5-fluorouracil plus cyclophosphamide, showed similar survival and progression-free survival intervals. Future studies utilizing these or other agents, in similar or modified dosage schedules or delivery mechanisms, should note these results. Protocols designed to address subjective quality of life measures and other benefit ratios can be effectively employed considering this report.


Immunohistochemical localization of guanine nucleotide-binding proteins in rat olfactory epithelium during development.
It has recently been proposed that guanine nucleotide (GTP)-binding proteins (G-proteins) are involved in transducing stimuli in olfactory receptor neurons. If this is the case, G-proteins should be expressed when receptor cells first generate action potentials in response to odorants, i.e. in the rat fetus on the 16th embryonic day (E16). We have done an immunohistochemical study to determine when the alpha- and beta-subunits of the stimulatory G-protein (Gs), are expressed in developing rat olfactory epithelium. The 3 primary antisera used were monospecific polyclonal antibodies generated in rabbits by immunization with synthetic peptides, the amino acid sequences of which matched a portion of the alpha- or beta-subunits of stimulatory G-protein. Both subunits were present in olfactory axons at E15 and in olfactory receptor cell cilia at E16, the day when cilia first sprout in these cells. As development progressed and more cilia grew, most were immunoreactive with antisera to both subunits. Examination of specimens with electron microscopic immunocytochemistry confirmed the localization. Not all cilia on a given olfactory cell were stained, in either fetal or juvenile specimens. The observation that G-proteins are expressed in cilia when action potentials are first demonstrated supports the hypothesis that G-proteins are involved in signal transduction in olfactory receptor cells.


The regulation of platelet-activating factor production in endothelial cells. The role of calcium and protein kinase C.
Endothelial cells (EC) synthesize platelet-activating factor (PAF) when stimulated with agonists that bind to cell-surface receptors. We examined events that link receptor binding to synthesis of PAF by EC. Bovine EC stimulated with agonists that interact with specific cell-surface receptors accumulated PAF only in the presence of extracellular calcium. Hormonal stimulation of EC resulted in Ca2+ entry characteristic of that seen with receptor-operated calcium channels; Indo-1 measurements demonstrated that this inward flux of Ca2+ caused prolonged elevated levels of intracellular Ca2+. EC were exposed to melittin or theta toxin from Clostridium perfringens (pore-forming peptides that increase the permeability of the plasma membrane for small molecules) resulting in an inward flux of Ca2+ and accumulation of PAF. Ca2+ appears to be regulatory for PAF production at the level of phospholipase A2-mediated production of the PAF precursor 1-O-alkyl-2-lyso-sn-glycero-3-phosphocholine, as Ca2+ was required for the stimulated hydrolysis of 1-O-alkyl-2-acyl-sn-glycero-3-phosphocholine. PAF accumulation in EC is also regulated by protein kinase C. Pretreatment of EC with phorbol esters that activate protein kinase C or with dioctanoylglycerol, followed by stimulation, resulted in a 2-fold increase in stimulated PAF production. The regulatory effect of protein kinase C also appears to be at a phospholipase A2-mediated hydrolysis of 1-O-alkyl-2-acyl-sn-glycero-3-phosphocholine.


Expression of neuroectodermal antigens common to melanomas, gliomas, and neuroblastomas. I. Identification by monoclonal anti-melanoma and anti-glioma antibodies.
The reactivity spectrum of five different monoclonal anti-melanoma antibodies cross-reacting with gliomas and neuroblastomas and one monoclonal anti-glioma antibody cross-reacting with melanomas and neuroblastomas was investigated. Comparison of the binding activity of these monoclonal antibodies for 11 melanoma, seven glioma, and three neuroblastoma cell lines showed that each of these clones had a different pattern of cross-reactivity. The results indicated that the antigenic determinants detected by these antibodies were not associated with the same antigen and thus suggested the existence of at least six different antigens common to melanomas, gliomas, and neuroblastomas. Since all these tumors are known to derive from cells originating embryologically from the neural crest, it can be assumed that the antigens recognized by our monoclonal antibodies are neuroectodermal differentiation antigens. However, absorption with fetal brain homogenates abolished only the binding of monoclonal anti-glioma antibody, but did not modify the binding of monoclonal anti-melanoma antibodies.


Complications of endoscopic thoracic sympathectomy.
Endoscopic resection of the thoracic sympathetic trunk has been performed in various diseases of the upper limb. The success rates in endoscopic techniques and open surgical procedures are reportedly between 95% and 100%. However, the incidence of complications varied significantly depending on the technique used. We report our experience with complications after endoscopic resection of the thoracic sympathetic trunk. To evaluate the complications of endoscopic thoracic sympathectomy, we retrospectively investigated 412 patients operated on since 1965. In 412 patients 698 procedures had been performed: a bilateral trunk resection in 81.9%, right thoracic sympathectomy in 12.9%, and left sympathetic trunk resection in 5.2%. Complications demanding intervention were found in 2.7% of the procedures, and in 9.7% complications not indicating active therapy were seen. In all cases requiring intervention a pneumothorax that needed to be drained was found on postoperative x-ray film. An asymptomatic small apical pneumothorax was found in 4.4%, cutaneous emphysema in 2%, pleural effusion in 1.1%, and segmental atelectasis in 0.4% of the procedures. One case of bleeding from an intercostal vessel occurred (0.1%). A permanent Horner's ptosis was seen in 1.7% of the patients. The endoscopic resection of the thoracic sympathetic trunk is a safe and minimally invasive procedure with a low complication rate. We believe that endoscopic sympathectomy should be preferred to open surgical procedures.


A systematic study of neutrophil degranulation and respiratory burst in vitro by defined immune complexes.
Defined immune complexes (IC) were used to compare the effect of antibodies of different classes and subclasses on neutrophil respiratory burst and degranulation. IC were made from 5-iodo-4-hydroxy-3-nitrophenacetyl (NIP) conjugated to bovine serum albumin (BSA) and chimaeric mouse-human anti-NIP monoclonal antibodies including IgA2, IgE and all four IgG subclasses. The activation of neutrophils by IC depended on antibody class and subclass, on antigen epitope density, on antigen: antibody ratio and on the medium used. The ability to generate the respiratory burst showed a different pattern to the ability to give rise to degranulation. Compared with other IC, IgA2 IC provided the strongest stimulus for neutrophil activation. IgG1 IC, IgG2 IC and IgG4 IC activated neutrophils moderately or weakly IgG3 IC were unable to stimulate the respiratory burst, but could cause strong degranulation. IgE IC could hardly cause any neutrophil response. Neutrophil degranulation in response to IgG3 IC in serum-free medium or heat-inactivated serum was fast, and it quickly reached maximum. Degranulation caused by IgA IC was relatively slow, but gradually increased during incubation. The activity of IgG1 IC, IgG2 IC and IgG4 IC generated a respiratory burst increased with antibody excess and decreased with antigen excess. The activity of IgA2 IC, however, was not affected by change of antigen and antibody ratio. A specific role of serum, possibly due to complement, was found in enhancing degranulation, both temporally and quantitatively, by IgA2 IC.


Gene transcriptional expression of cortical thinning during childhood and adolescence.
The cognitive and behavioral development of children and adolescents is closely related to the maturation of brain morphology. Although the trajectory of brain development has been depicted in detail, the underlying biological mechanism of normal cortical morphological development in childhood and adolescence remains unclear. By combining the Allen Human Brain Atlas dataset with two single-site magnetic resonance imaging data including 427 and 733 subjects from China and the United States, respectively, we performed partial least squares regression and enrichment analysis to explore the relationship between the gene transcriptional expression and the development of cortical thickness in childhood and adolescence. We found that the spatial model of normal cortical thinning during childhood and adolescence is associated with genes expressed predominantly in astrocytes, microglia, excitatory and inhibitory neurons. Top cortical development-related genes are enriched for energy-related and DNA-related terms and are associated with psychological and cognitive disorders. Interestingly, there is a great deal of similarity between the findings derived from the two single-site datasets. This fills the gap between early cortical development and transcriptomes, which promotes an integrative understanding of the potential biological neural mechanisms.


The difference between metacognition and mindreading: Evidence from functional near-infrared spectroscopy.
The relationship between metacognition and mindreading was investigated by examining how well one can monitor their own learning (Self) compared to another person's learning (Other). Here, we used functional near-infrared spectroscopy (fNIRS) to systematically investigate the brain area activation during metacognition and mindreading. The evidence indicated that metacognition and mindreading are underpinned by distinct neural systems. Metacognition is associated with activation in brain regions important for memory retrieval, such as the fusiform gyrus, while mindreading is associated with activation in brain regions important for understanding and reasoning about others' intentions, such as the right temporoparietal junction (rTPJ).


Food Consumption and Weight Recurrence in Patients Undergoing Bariatric Surgery with a Minimum of 2 Years Post-surgery.
Eating habits are one of the factors that directly affect weight recurrence after bariatric surgery, and therefore, this study assessed the association between food consumption and weight recurrence in patients who underwent bariatric surgery a minimum of 2 years. A cross-sectional observational study was conducted with patients who underwent bariatric surgery a minimum of 2 years through SUS, in the city of Palmas, Tocantins. Food consumption was assessed through two 24-h dietary recalls (R24). The foods were classified into groups by degree of processing following the NOVA classification system. Also, macronutrients and fiber contents were quantified. Anthropometric variables were evaluated and weight recurrence (WR) was defined as 15%. Ninety-three (93) patients participated in the study, being 83.9% female, with mean age of 43.5 ± 9.13 years, mean post-surgery time of 4 years, and 58% present WR. A lower total energy consumption was found in patients without WR compared to those with WR (p = 0.05). Among the WR group, calories from processed foods (p = 0.00) and culinary ingredients (p = 0.05) were higher. However, carbohydrate consumption (percentage) was lower in the WR group (p = 0.04). A positive correlation was found between total energy (p = 0.03), processed foods (p = 0.03) and weight recurrence (p = 0.03). Weight recurrence is associated with total daily energy intake, carbohydrates and food groups classified according to NOVA.


Coronary obstruction following transcatheter aortic valve implantation: a systematic review.
This study sought to evaluate, through a systematic review of the published data, the main baseline characteristics, management, and clinical outcomes of patients suffering coronary obstruction as a complication of transcatheter aortic valve implantation (TAVI). Very few data exist on coronary obstruction after TAVI. Studies published between 2002 and 2012, with regard to coronary obstruction as a complication of TAVI, were identified with a systematic electronic search. Only the studies reporting data on the main baseline and procedural characteristics, management of the complication, and clinical outcomes were analyzed. A total of 18 publications describing 24 patients were identified. Most (83%) patients were women, with a mean age of 83 ± 7 years and a mean logistic European System for Cardiac Operative Risk Evaluation score of 25.1 ± 12.0%. Mean left coronary artery (LCA) ostium height and aortic root width were 10.3 ± 1.6 mm and 27.8 ± 2.8 mm, respectively. Most patients (88%) had received a balloon-expandable valve, and coronary obstruction occurred more frequently in the LCA (88%). Percutaneous coronary intervention was attempted in 23 cases (95.8%) and was successful in all but 2 patients (91.3%). At 30-day follow-up, there were no cases of stent thrombosis or repeat revascularization, and the mortality rate was 8.3%. Reported cases of coronary obstruction after TAVI occurred more frequently in women, in patients receiving a balloon-expandable valve, and the LCA was the most commonly involved artery. Percutaneous coronary intervention was a feasible and successful treatment in most cases. Continuous efforts should be made to identify the factors associated with this life-threatening complication to implement the appropriate measures for its prevention.


The Still, Small Voice of Grief.
When caring for a grieving patient, professional chaplains may assess the patient's spiritual suffering, address questions of meaning and purpose, and identify sources of comfort, love, and strength. In the setting of a pandemic, with heightened precautions and limited visitation by loved ones, all members of the clinical team are called to utilize compassionate listening and communication skills to address the pervasive isolation and grief of those in their care. This article uses a chaplain's personal narrative to explore the challenges of facilitating grief support with a newly bereaved patient who cannot speak. It presents the Biblical concept of kol d'mama daka, the "still small voice," as an image of the power of silence and revelation that comes when clinicians employ deep listening and compassion.


Evaluation of a train-the-trainer program for stable coronary artery disease management in community settings: A pilot study.
To evaluate the feasibility and effectiveness of conducting a train-the-trainer (TTT) program for stable coronary artery disease (SCAD) management in community settings. The study involved two steps: (1) tutors trained community nurses as trainers and (2) the community nurses trained patients. 51 community nurses attended a 2-day TTT program and completed questionnaires assessing knowledge, self-efficacy, and satisfaction. By a feasibility and non-randomized control study, 120 SCAD patients were assigned either to intervention group (which received interventions from trained nurses) or control group (which received routine management). Pre- and post-intervention, patients' self-management behaviors and satisfaction were assessed to determine the program's overall impact. Community nurses' knowledge and self-efficacy improved (P<0.001), as did intervention group patients' self-management behaviors (P<0.001). The satisfaction of community nurses and patients was all very positive after training. The TTT program for SCAD management in community settings in China was generally feasible and effective, but many obstacles remain including patients' noncompliance, nurses' busy work schedules, and lack of policy supports. Finding ways to enhance the motivation of community nurses and patients with SCAD are important in implementing community-based TTT programs for SCAD management; further multicenter and randomized control trials are needed.


Acute retinal pigment epitheliitis.
Acute retinal pigment epitheliitis is an infrequently described macular disorder of unknown cause that affects healthy young adults. Acute symptoms include either reduced visual acuity or central scotoma. Ophthalmoscopy discloses discrete pigment clumps with surrounding hypopigmented halos in the center of the macula. Inflammatory signs are mild or absent. The hypopigmented areas show transmission hyperfluorescence without leakage on fluorescein angiography. Symptoms subside spontaneously although retinal pigment epithelial (RPE) changes are usually permanent. Central serous choroidopathy, macular edema, or permanently decreased vision have not developed in any of the eight patients we have followed for up to 8 years. Accurate identification of retinal pigment epitheliitis as a specific clinical entity is important because of the good prognosis without treatment.


Prion diseases.
The human prion diseases comprise Creutzfeldt-Jakob disease, variably protease-sensitive prionopathy, Gerstmann-Sträussler-Scheinker disease, fatal familial insomnia, and kuru. Each is a uniformly fatal rare neurodegenerative disease in which conformational changes in the prion protein are thought to be the central pathophysiologic event. The majority of cases of human prion diseases occur worldwide in the form of sporadic Creutzfeldt-Jakob disease and a minority of around 10-15% are associated with mutations of the prion protein gene, termed PRNP, in the forms of genetic Creutzfeldt-Jakob disease, Gerstmann-Sträussler-Scheinker disease, and fatal familial insomnia. Prion diseases are also transmissible and occur in iatrogenic and zoonotic forms (iatrogenic Creutzfeldt-Jakob disease and variant Creutzfeldt-Jakob disease respectively), adding a public health dimension to their management. Despite having a high public profile, human prion diseases are both rare and heterogeneous in their clinicopathologic phenotype, sometimes making a diagnosis challenging. A combined clinical, genetic, neuropathologic, and biochemical approach to diagnosis is therefore essential. The intensive study of these diseases continues to inform on neurodegenerative mechanisms and the role of protein misfolding in more common neurodegenerative diseases such as Parkinson disease and Alzheimer disease.


Temporal Trends in Fertility Rates: A Nationwide Registry Based Study from 1901 to 2014.
Increasing age at first childbirth has been suggested to increase the risk for infertility. Our objective is to determine whether women above thirty years of age historically have been able to sustain fertility rates above replacement level. A descriptive nationwide Danish study using birth registries from 1901-2014. Information on women's age at childbirth was obtained by using records from primary, secondary and tertiary institutions. Mothers to 8,024,969 live births. Mothers were stratified according to age at childbirth to determine total and age specific fertility rates. Total fertility rate (TFR) decreased from 4.1 to 1.8 children per woman and age specific fertility also decreased from 1901 to 2014. Women aged 30-34, 35-39 or 40-44 years in the first decade of the 20th century had higher fertility rates than the corresponding five year younger age groups (25-29, 30-34 and 35-39, respectively) have had for the last 65 years. On average, women gave birth to two children after the age of 30 and one or more child after 35 years of age in the beginning of the 1900s. Furthermore, women more than 40 years of age accounted for 10% of TFR in 1901 compared with 4% in 2014 despite usage of assisted reproduction. This nationwide study shows that women above 30 years of age historically have been able to sustain fertility rates above replacement level. This implies that other factors besides age are strong determinants of fertility in women above 30 years of age.


Possible generators of retrotrochanteric gluteal and thigh pain: the gemelli-obturator internus complex.
To investigate and correlate the anatomy of the gluteal region with the clinical findings of retrotrochanteric and posterior thigh pain, as seen in clinical chiropractic practice, and describe potential treatment options. A descriptive gross anatomic study is correlated to a case presentation of a patient with deep persistent aching pain in the retrotrochanteric region of the left hip and upper posterolateral thigh. The structures that are located in the same location as the retrotrochanteric pain described by the patient are the gemelli-obturator internus muscle complex and associated bursae. In patients with persistent gluteal and sciatica-like pain, especially when centered in the retrotrochanteric region, the gemelli-obturator internus muscle complex and associated bursae should be considered as a possible source of the pain.


Pretreatment with fosinopril or valsartan reduces myocardial no-reflow after acute myocardial infarction and reperfusion.
Both fosinopril and valsartan are effective in protecting endothelial function. We hypothesized that they may also reduce myocardial no-reflow. In addition, suppression of adenosine triphosphate-sensitive K (KATP) channel opening is an important mechanism for myocardial no-reflow. Therefore, this study sought to assess the effect of fosinopril and valsartan on myocardial no-reflow and explore the possible mechanism. Coronary ligation area and the area of no-reflow were determined with both myocardial contrast echocardiography in vivo and pathological means in 56 mini-swine randomized into seven study groups: eight in control, eight in fosinopril-pretreated (1 mg/kg/day) for 3 days, eight in fosinopril and glibenclamide (KATP channel blocker)-pretreated, eight in valsartan-pretreated (2 mg/kg/day) for 3 days, eight in valsartan and glibenclamide-pretreated, eight in glibenclamide-treated and eight in sham-operated. An acute myocardial infarction and reperfusion model was created with a 3-h occlusion of the coronary artery followed by a 2-h reperfusion. The levels of KATP channel proteins (SUR2, Kir6.1, and Kir6.2) in the reflow and no-reflow myocardium were quantified by Western blotting. Compared with the control group, both fosinopril and valsartan significantly improved ventricular function, decreased area of no-reflow (myocardial contrast echocardiography: from 78.5+/-4.5 to 24.5+/-2.7 and 24.3+/-3.6%, pathological means: from 82.3+/-1.9 to 25.2+/-3.2 and 24.9+/-4.4% of ligation area, respectively; all P<0.01), reduced necrosis size from 98.5+/-1.3 to 88.9+/-3.6 and 89.1+/-3.1% of ligation area, respectively (both P<0.05). They also increased the levels of SUR2 and Kir6.2 (P<0.01), but had no effect on the level of Kir6.1 (P>0.05). A combination of fosinopril or valsartan with glibenclamide significantly increased area of no-reflow (P<0.05) and decreased the levels of SUR2 and Kir6.2 (P<0.01). Pretreatment with fosinopril or valsartan can reduce myocardial no-reflow. This beneficial effect is due to activation of the KATP channel.


Rupture of the abdominal aorta artery due to self-inflicted injuries in a young man.
Intentional drug poisoning is the most common method of suicide in the population. Self-inflicted injuries are usually limited to parts of the body that are easily accessible with one's hand, such as the neck, thorax, or upper extremities. Penetrating aortic trauma has a high mortality rate, and open surgery is frequently required. We report a 19-year-old man who stabbed himself in the anterior abdomen with a kitchen knife after ingesting numerous benzodiazepine tablets, resulting in a rupture of intra-abdominal viscera, including the abdominal aorta artery. Aortic penetrating injuries have a high mortality rate. The retroperitoneal position of the abdominal aorta and the minor size of the rupture were associated with the formation of very large clots, which were essential in controlling bleeding and hemodynamic abnormalities. In any patient with drug poisoning following committing suicide, in case of acute abdominal symptoms and hemodynamic disturbance, after controlling the level of consciousness, respiratory, and hemodynamic correction of the patient, immediate consultation with the surgical service should be considered.


Asperger Syndrome and Schizophrenia: A Comparative Neuropsychological Study.
There has been an increasing interest in possible connections between autism spectrum disorder (ASD) and schizophrenia in the last decade. Neuropsychological comparison studies have, however, been few. The present study examined similarities and differences in intellectual and executive functioning between adults with Asperger syndrome (AS) and adults with schizophrenic psychosis (SP). A group with AS and a group with SP were assessed neuropsychologically with WAIS-III and D-KEFS. Similarities were found between groups, as displayed by an uneven cognitive profile, limitations in working memory, processing speed and some aspects of executive functioning. Full Scale IQ was higher in the AS group. These results add to the current research illuminating similarities and differences between ASD and schizophrenia on a cognitive level.