Frequency, Associated Risk Factors, and Characteristics of COVID-19 Among Healthcare Personnel in a Spanish Health Department.
This study examines the frequency, associated factors, and characteristics of healthcare personnel coronavirus disease 2019 cases in a healthcare department that comprises a tertiary hospital and its associated 12 primary healthcare centers. This study included healthcare personnel that showed symptoms or were in contact with a coronavirus disease 2019 case patient from March 2, 2020 to April 19, 2020. Their evolution and characteristics (age, sex, professional category, type of contact) were recorded. Correlations between the different characteristics and risk of developing coronavirus disease 2019 and severe coronavirus disease 2019 were analyzed using chi-square tests. Their magnitudes were quantified with ORs, AORs, and their 95% CIs using a logistic regression model. Of the 3,900 healthcare professionals in the department, 1,791 (45.9%) showed symptoms or were part of a contact tracing study. The prevalence of those with symptoms was 20.1% (784/3,900; 95% CI=18.8, 21.4), with coronavirus disease 2019 was 4.0% (156/3,900; 95% CI=3.4, 4.6), and with severe coronavirus disease 2019 was 0.5% (18/3,900; 95% CI=0.2, 0.7). The frequency of coronavirus disease 2019 in symptomatic healthcare personnel with a nonprotected exposure was 22.8% (112/491) and 13.7% (40/293) in those with a protected exposure (AOR=2.2, 95% CI=1.2, 3.9). The service in which the healthcare personnel performed their activity was not significantly associated with being diagnosed with coronavirus disease 2019. A total of 26.3% (10/38) of male healthcare personnel with coronavirus disease 2019 required hospitalization, compared with 6.8% (8/118) among female healthcare personnel (OR=4.9, 95% CI=1.8, 13.6). A surveillance and monitoring program centred on healthcare personnel enables an understanding of the risk factors that lead to coronavirus disease 2019 among this population. This knowledge allows the refinement of the strategies for disease control and prevention in healthcare personnel during the coronavirus disease 2019 pandemic.


Coordination of pointing and stepping: do postural phenomena result from the juxtaposition of the dynamics of each task?
We questioned whether postural phenomena associated with the coordination of pointing and stepping resulted from the sole juxtaposition of the dynamics of each task during the overlapping time period ("juxtaposition hypothesis"). Nine subjects were involved in three experimental conditions: (1) "isolated stepping" (the stepping was performed alone), (2) "isolated pointing" (the pointing was performed alone), and (3) an "experimental sequence" (pointing and stepping were coordinated). Acceleration of centre of gravity (x''G) and displacement of centre of foot pressure (xP) were recorded using a force plate. Pointing acceleration was recorded using a wrist-strapped mono-axial accelerometer. The dynamics of a "theoretical sequence" were calculated by the linear summation of x''G and xP traces recorded in conditions (1) and (2). The juxtaposition hypothesis was tested by between-condition comparison of x''G and xP during the anticipatory postural adjustments of stepping, i.e., at time intervals when pointing was expected to most significantly influence stepping. Results showed that x''G and xP were higher (p<0.001 and 0.01, respectively) in the experimental than in the theoretical sequence. Also, when compared to isolated stepping, the experimental sequence was performed with a higher x''G (p<0.01) while xP remained unchanged (p>0.05). Altogether, our results suggest that the postural dynamics of pointing and stepping are not simply juxtaposed when both tasks are coordinated in a motor sequence. Conversely, the biomechanical consequences of the focal movement (pointing) on the mobility task (stepping) may be anticipated and integrated in the motor planning of quick stepping.


Cellular toxicity of yeast prion protein Rnq1 can be modulated by N-terminal wild type huntingtin.
Aggregation of the N-terminal human mutant huntingtin and the consequent toxicity in the yeast model of Huntington's disease (HD) requires the presence of Rnq1 protein (Rnq1p) in its prion conformation [RNQ1(+)]. The understanding of interaction of wild-type huntingtin (wt-Htt) with the amyloidogenic prion has some gaps. In this work, we show that N-terminal fragment of wt-Htt (N-wt-Htt) ameliorated the toxic effect of [RNQ1(+)] depending on expression levels of both proteins. When the expression of N-wt-Htt was high, it increased the expression and delayed the aggregation of [RNQ1(+)]. As the expression of N-wt-Htt was reduced, it formed high molecular weight aggregates along with the prion. Even when sequestered by [RNQ1(+)], the beneficial effect of N-wt-Htt on expression of Rnq1p and on cell survival was evident. Huntingtin protein ameliorated toxicity due to the prion protein [RNQ1(+)] in yeast cells in a dose-dependent manner, resulting in increase in cell survival, hinting at its probable role as a component of the proteostasis network of the cell. Taking into account the earlier reports of the beneficial effect of expression of N-wt-Htt on the aggregation of mutant huntingtin, the function of wild-type huntingtin as an inhibitor of protein aggregation in the cell needs to be explored.


Rat basophilic leukemia cells as model system for inositol 1,4,5-trisphosphate receptor IV, a receptor of the type II family: functional comparison and immunological detection.
This study concerns the detection and analysis of the highly homologous type II-like inositol 1,4,5-trisphosphate (InsP3) receptors (InsP3R-II, -IV and -V). We have particularly investigated RBL-2H3 cells, which at the mRNA level predominantly expressed InsP3R-IV [De Smedt H. Missiaen L. Parys JB. et al. (1994) Determination of relative amounts of inositol trisphosphate receptor mRNA isoforms by ratio polymerase chain reaction. J. Biol. Chem., 269, 21691-21698]. When measured in identical experimental conditions, microsomes from RBL-2H3 cells were characterized by a much higher InsP3 binding affinity (Kd 3.8 +/- 0.8 nM, Bmax 0.40 +/- 0.08 pmol/mg protein) than microsomes from A7r5 cells (Kd 65 +/- 7 nM, Bmax 0.65 +/- 0.08 pmol/mg protein) or from cerebellum (Kd 135 +/- 14 nM, Bmax 7.35 +/- 1.13 pmol/mg protein). An affinity-purified antibody against the C-terminus of type II-like InsP3Rs detected, after SDS-PAGE and immunoblotting, a 250 kD protein in RBL-2H3 and C3H10T1/2 cells, but not in other cell types. An isoform-specific antibody against the C-terminus of InsP3R-I was used to determine the presence of the various InsP3R-I splice isoforms at the protein level. The 273 kD (brain), 261 kD (peripheral tissues) and 256 kD (Xenopus oocytes) isoforms were recognized. Expression of InsP3R-I in RBL-2H3 cells was very low. Taken together, our results support the hypothesis that InsP3R isoforms may differ to a large extent in their affinity for InsP3 and suggest that RBL-2H3 cells are a useful model for the study of InsP3R-IV.


Retracted: Comprehensive Evaluation of BIM Calculation Quantity in Domestic Construction Engineering Based on Fuzzy Comprehensive Evaluation.
[This retracts the article DOI: 10.1155/2021/3292376.].


Continued increases in blood pressure over two decades in Samoa (1991-2013); around one-third of the increase explained by rising obesity levels.
To analyse trends over the period 1991-2013 in systolic blood pressure (SBP), diastolic blood pressure (DBP) and the prevalence of hypertension in adults aged 25-64 years in Samoa; and to assess the contribution of rising obesity levels to period trends. Unit record data from seven population-based surveys (n = 10,881) conducted between 1991 and 2013 were included for analysis. Surveys were adjusted to the nearest previous census to improve national representativeness. Hypertension was defined as SBP ≥140 mmHg and/or DBP ≥90 mmHg and/or on medication for hypertension. Obesity was measured by body mass index (BMI). Poisson, linear and meta-regression were used to assess period trends. Over 1991-2013 mean SBP and DBP (mmHg), and the prevalence of hypertension (%) increased in both sexes. Increases in hypertension were: from 18.3 to 33.9% (p < 0.001) in men (mean BP from 122/74 to 132/78); and from 14.3 to 26.4% (p < 0.001) in women (mean BP from 118/73 to 126/78). The estimate of the age-adjusted mean SBP and DBP over 1991-2013, and the relative risk for hypertension in 2013 compared to 1991, were attenuated after adjusting for BMI: by 22% (men) and 32% (women) for mean SBP; 37% (men) and 32% (women) for mean DBP; and 19% in both sexes for hypertension. Significant increases have occurred in SBP/DBP and hypertension prevalence in both sexes in Samoa during 1991-2013, which would contribute significantly to premature mortality from cardiovascular disease. Obesity accounts for around one-third of the rising trend in blood pressure in the Samoan population. Strengthening of population control of hypertension through reduction in obesity and salt intake, and case detection and treatment through primary care, is required to reduce premature mortality from cardiovascular disease in Samoa.


Axillary lipoblastoma--tumor recurrence in the right atrium.
This case report describes, for the first time, vascular invasion and recurrence of a lipoblastoma 6 months after the macroscopically complete excision of the initial cervico-axillary tumour. The importance of cytogenetics in the diagnosis of lipoblastoma is emphasized, as is the need to be wary of the diagnosis of lipoma in infancy.


Administration of granulocyte colony-stimulating factor induces immunomodulation, recruitment of T regulatory cells, reduction of myocarditis and decrease of parasite load in a mouse model of chronic Chagas disease cardiomyopathy.
Chagas disease, caused by Trypanosoma cruzi infection, is a leading cause of heart failure in Latin American countries. In a previous study, we showed beneficial effects of granulocyte colony-stimulating factor (G-CSF) administration in the heart function of mice with chronic T. cruzi infection. Presently, we investigated the mechanisms by which this cytokine exerts its beneficial effects. Mice chronically infected with T. cruzi were treated with human recombinant G-CSF (3 courses of 200 μg/kg/d for 5 d). Inflammation and fibrosis were reduced in the hearts of G-CSF-treated mice, compared with the hearts of vehicle-treated mice, which correlated with decreased syndecan-4, intercellular adhesion molecule-1, and galectin-3 expressions. Marked reductions in interferon-γ and tumor necrosis factor-α and increased interleukin-10 and transforming growth factor-β were found after G-CSF administration. Because the therapy did not induce a Th1 to Th2 immune response deviation, we investigated the role of regulatory T (Treg) cells. A significant increase in CD3(+)Foxp3(+) cells was observed in the hearts of G-CSF-treated mice. In addition, a reduction of parasitism was observed after G-CSF treatment. Our results indicate a role of Treg cells in the immunosuppression induced by G-CSF treatment and reinforces its potential therapeutic use for patients with Chagas disease.


Misoprostol use for labor induction in developing countries: a prospective study in Guinea.
The purpose of this study was to assess the efficacy, side effects and cost of misoprostol regimens in various obstetrical situations frequently occurring in developing countries. One hundred and four parturient women with indications for labor induction received different regimens of misoprostol in the range of 50-800 microg according to their gestational age. Misoprostol was administered by the vaginal route, every 6h without exceeding four doses. All indications for labor induction concerned women with a gestational age of more than 30 weeks, except in the intrauterine death cases. The mean overall duration of labor was 7.8 h (+/-4.6 h). The mean amount of misoprostol used was 226 microg (+/-196 microg). The difference in the mean labor duration between the four indications for induction was statistically significant (P<0.01). It was also significant for the mean total dose of misoprostol used. Total dose of misoprostol and Bishop score were inversely proportional. Two caesarean deliveries and two uterine ruptures were recorded, but no maternal deaths. The mean Apgar score was 8.0 (+/-1) at 1 min and 9.5 (+/-0.8) at 5 min. In our series, four fetal deaths occurred. The mean cost of misoprostol for labor induction was around US$ 1, with a range of 0.05-4. The use of vaginal misoprostol appears to be relevant in developing countries in cases where labor induction is indicated. Nevertheless, the advantages of misoprostol (low cost, facility of storage) are counter-balanced by side-effects (C-section, uterine rupture) which can be harmful for the mother and also for the newborn.


Torsade de pointes induced by N-acetylprocainamide.
N-Acetylprocainamide (NAPA), a class III antiarrhythmic drug, caused torsade de pointes in a 72 year old woman who had this arrhythmia on two previous occasions while being treated with quinidine and disopyramide. Initial evaluation with an intravenous infusion of NAPA indicated a favorable antiarrhythmic response. The QTC interval was prolonged, but the 2.4 ms/microgram per ml incremental QTC interval lengthening caused by NAPA was not greater than usual. During subsequent oral therapy with NAPA, torsade de pointes developed at plasma levels of this drug that appeared to be well tolerated during the initial evaluation.


Electrical control of interlayer exciton dynamics in atomically thin heterostructures.
A van der Waals heterostructure built from atomically thin semiconducting transition metal dichalcogenides (TMDs) enables the formation of excitons from electrons and holes in distinct layers, producing interlayer excitons with large binding energy and a long lifetime. By employing heterostructures of monolayer TMDs, we realize optical and electrical generation of long-lived neutral and charged interlayer excitons. We demonstrate that neutral interlayer excitons can propagate across the entire sample and that their propagation can be controlled by excitation power and gate electrodes. We also use devices with ohmic contacts to facilitate the drift motion of charged interlayer excitons. The electrical generation and control of excitons provide a route for achieving quantum manipulation of bosonic composite particles with complete electrical tunability.


Biochemical impact of a soccer match - analysis of oxidative stress and muscle damage markers throughout recovery.
Exercise is a prone condition to enhanced oxidative stress and damage and the specific activity pattern of a soccer match may favour additional pro-oxidant redox alterations. To date, no studies have reported the impact of a soccer match on oxidative stress and muscle damage markers. To analyse the effect of a competitive soccer match on plasma levels of oxidative stress and muscle damage markers, and to relate these findings with lower limb functional data. Blood samples, leg muscle strength, sprint ability and delayed-onset muscle soreness (DOMS) were obtained in 16 soccer players before, at 30 min, 24, 48 and 72 h after a soccer match. Plasma creatine kinase (CK), myoglobin (Mb), malondialdehyde (MDA), sulfhydryl (-SH) groups, total antioxidant status (TAS), uric acid (UA) and blood leukocyte counts were determined. A soccer match elevated plasma Mb following 30 min and CK levels throughout the 72 h-recovery period. MDA increased throughout the recovery period and -SH decreased until 48 h post-match. TAS increased at 30 min and UA increased throughout the 72 h recovery. Blood neutrophils increased at 30 min whereas lymphocytes decreased and returned to baseline from 24 to 72 h. DOMS was higher than baseline until 72 h. Lower limb strength and sprint ability were lower than baseline until 72 h recovery. The present data suggest that a soccer match increases the levels of oxidative stress and muscle damage throughout the 72 h-recovery period. The extent to which the redox alterations are associated with the recovery of muscle function should be further analysed.


The inhibition of calcium signaling in T lymphocytes from old mice results from enhanced activation of the mitochondrial permeability transition pore.
Aging attenuates calcium signaling in T lymphocytes from old mice. Aging also attenuates the sustained elevation of cell free calcium by ionomycin, which is similar to the T cell receptor signal. In T lymphocytes from young mice, the ionomycin-induced elevation of cell free calcium was inhibited by collapsing the mitochondrial membrane potential by uncouplers and ionophores, and activation of the permeability transition. In T lymphocytes from old mice, the mitochondrial membrane potential was largely collapsed, but cyclosporin and N-methyl-val-4-cyclosporin, inhibitors of the permeability transition, restored the mitochondrial potential, as well as the ionomycin-induced elevation of cell free calcium. In addition, the generation of reactive oxygen species in the presence of mitochondrial electron transport inhibitors was relatively enhanced in T lymphocytes from old mice. The association between low rhodamine 123 fluorescence and attenuated calcium signaling in T lymphocytes from old mice is also shown to be a consequence of the collapsed mitochondrial potential. These results suggest that Ca2+ signaling is attenuated in T lymphocytes from old mice because of an enhanced activation of the permeability transition.


Rapid molecular diagnosis of ataxia-telangiectasia by optimised RT-PCR and direct sequencing analysis.
Ataxia-telangiectasia (A-T) is a severe autosomal recessive disorder involving cerebellar degeneration, immunodeficiency, chromosomal instability, radiosensitivity, and cancer predisposition. A-T results from mutations in a single gene (ataxia-telangiectasia mutated, ATM) on chromosome 11 that encodes a 3056 amino acid protein (ATM). The purpose of this study is the design of an easy and rapid method for the molecular diagnosis of A-T which could be applied to clinical diagnosis, genetic counselling, carrier prediction, and prenatal diagnosis. Sixteen primer pairs were designed for RT-PCR. The PCR conditions were optimised to obtain a unique profile for the amplification of the 16 PCR products. These fragments were purified, directly sequenced and interpreted. The mutations found in three Spanish A-T families were reconfirmed with the optimised PCR and direct sequencing analysis. Up to now more than 400 A-T associated mutations have been reported in the ATM gene that do not support the existence of one or several hotspots. The immense size (transcript with 9168 nucleotides) and the structure of this gene (66 exons) greatly complicate the process of screening for all sequence variations. Our simple method allows identification of mutations in the coding region of the ATM gene from cDNA and represents a very useful tool for early diagnosis and genetic counselling in families with A-T.


Association of Toll-like 4 receptor gene polymorphism (rs4986790, rs4986791) with the risk of urinary tract infection: A systematic review and meta-analysis.
Recently published studies had shown that there may be a potential link between the Single nucleotide polymorphism (SNP) of Toll-like receptor-4 (TLR4), and the risk of urinary tract infection (UTI); however, no consensus was reached. To further understand the relationship between TLR SNPs and urinary tract infections, we searched for related studies published in PubMed, EMBASE, and Web of Science before October 30, 2018, for further systematic review and meta-analysis. Our study accrued 10 case-control studies, which included 1476 urinary tract infection patients and 1449 healthy controls in TLR4(rs4986790, rs4986791). R3.4.2 and Stata 15.0 software were used for the analysis. In general, there was no statistically significant association between rs4986790 and urinary tract infection in the four genetic models. However, in the subgroup analysis, the Asian population showed significantly difference in the allelic model (G vs A: OR = 1.88 [95% CI:1.42-2.49], P = .03). In addition, there were also significant differences in the dominant model (GG + AG vs AA OR = 1.97 [95% CI:1.46-2.66], P = .01). Due to the small number of available literatures, no meaningful conclusion can be drawn regarding the relationship between TLR4 (rs4986791) and the risk of urinary tract infections in general. Nevertheless, our meta-analysis shows that in Asian populations, TLR4 (rs4986790) may be associated with risk of urinary tract infection.


Unique clonal relationship between T-cell acute lymphoblastic leukemia and subsequent Langerhans cell histiocytosis with TCR rearrangement and NOTCH1 mutation.
Acute lymphoblastic leukemia (ALL) occasionally develops before or after the onset of Langerhans cell histiocytosis (LCH). The mechanism of LCH developing after ALL remains unclear; thus the clonality of LCH developing during maintenance chemotherapy for T-cell ALL (T-ALL) was investigated. The T-ALL and LCH cells tested had the same T-cell receptor (TCR) gamma rearrangement. Mutation analysis of the NOTCH1 gene revealed 7213C>T (Q2405X) in exon 34 in T-ALL and LCH cells, but 5156T>C (I1719T) in exon 27 only in T-ALL. Polymerase chain reaction-restriction fragment length polymorphism analysis revealed three patterns of NOTCH1 mutations in T-ALL cells. The results suggest that the T-ALL and LCH cells were derived from a common precursor with TCR rearrangement and a single NOTCH1 mutation, rather than LCH cells developing from a minor clone of T-ALL with single NOTCH1 mutation.


The importance of ophthalmic artery hemodynamics in patients with atheromatous carotid artery disease.
The aim of this paper was to provide an insight on the role of the ophthalmic artery blood flow changes due to significant carotid stenosis and the effects of carotid revascularization on the eye and cerebral circulation. An electronic search (Medline) of the English literature was attempted. Measurements of Peak Systolic Velocity (PSV), end-diastolic velocity (EDV), mean velocity (Vmean), Resistance Index (RI) and flow direction, obtained in OA and its branches using transcranial Doppler, in to patients with significant stenosis >70% subjected to surgical or endovascular treatment, or in those with occlusion (unilateral or bilateral), symptomatic or not, in both eyes, prior to or/and after endarterectomy or stenting. As the degree of internal carotid artery (ICA) stenosis increases, the PSV in ophthalmic artery (OA) decreases. In severe stenoses the flow is not detectable or a reversed flow may be present. Following carotid endarterctomy or stenting, in almost all patients antegrade flow was detected, while in the patients with preoperative antegrade flow, an increase of the velocities was detected postoperatively. The reduced blood flow in the OA has consequences in the eye circulation. OA contributes to the collateral pathways in the perfusion of the brain but the importance of this collateral pathway has not been completely clarified.


Relationship between the physicochemical properties of sludge-based carbons and the adsorption capacity of dissolved organic matter in advanced wastewater treatment: Effects of chemical conditioning.
Pyrolysis carbonisation is a promising technology to convert organic waste into valuable carbon-based materials. However, sludge is generally highly compressible and difficult to dewater because of its high concentrations of biopolymers; the bound water of sludge is trapped in a network composed of biopolymers. Therefore, chemical conditioning is an indispensable step for improving sludge dewaterability performance. In the present work, the effects of different chemical conditioning agents (polymeric aluminium chloride (PACl), iron(III) chloride (FeCl3), KMnO4-Fe(II) and Fenton's reagent) on the physicochemical properties of sludge-based carbons (SBCs) were systematically studied and the SBCs were further used in advanced wastewater treatment. The adsorption mechanisms of dissolved organic matters (DOMs) by different SBCs were also investigated. The results showed that conditioning with KMnO4-Fe(II) and Fenton's reagent improved the specific surface area of the SBCs, whereas inorganic salt flocculation conditioning reduced the porosity of the SBCs. In addition, we found that the Fenton-SBC and Mn/Fe-SBC performed better than the other investigated SBCs in the removal of organic compounds from secondary effluent and that the pseudo-second-order kinetic model could better describe the process of DOMs adsorption by all of the investigated SBCs. Moreover, three-dimensional fluorescence excitation-emission matrix spectroscopy in combination with an analysis of the physical and chemical fractionation of DOMs showed that all of the SBCs performed well in the adsorption of aromatic substances, hydrophobic acids and hydrophobic neutrals, whereas the Mn/Fe-SBC and Fenton-SBC performed better than the other SBCs in the removal of weakly hydrophobic acids.


#Nursing Now.
Nurses are the largest group in the global health workforce, but due to social, political, and gender inequality, traditionally their role has been undervalued. Nursing Now is a 3-year campaign which aims to empower nurses worldwide by building grassroots support to demand better investment in nursing and midwifery to tackle 21st-century health challenges.


Bioelectric responses of sea urchin eggs inseminated with oyster spermatozoa: a sperm evoked potential without egg activation.
Multiple oyster spermatozoa can enter sea urchin eggs with or often without fertilization membrane formation (Osanai and Kyozuka, 1982). In the present work, electrical responses of sea urchin (Temnopleurus hardwicki) eggs inseminated with oyster (Crassostrea gigas) sperm were examined and correlated to the failure of monospermy and egg activation. With diluted sperm, a transient depolarization of the membrane with a constant pattern appeared repeatedly and discretely, and the depolarizations (sperm evoked potentials, SEPs) were not associated with fertilization membrane elevation. With dense sperm, the SEPs occurred consecutively, and sometimes an assembled consecutive depolarization was followed by an activation potential associated with cortical granule discharge. When the membrane potential was artificially held at positive levels, the frequency of SEPs was strongly suppressed but not completely blocked. The present results indicate that an individual heterologous spermatozoon neither produces a depolarization sufficient to block additional sperm entry, nor stimulates egg activation, and that simultaneous entries of multiple heterologous spermatozoa, as possibly reflected by the assembled consecutive depolarizations, induce cortical granule discharge and egg activation.


End-to-end affine registration framework for histopathological images with weak annotations.
Histopathological image registration is an essential component in digital pathology and biomedical image analysis. Deep-learning-based algorithms have been proposed to achieve fast and accurate affine registration. Some previous studies assume that the pairs are free from sizeable initial position misalignment and large rotation angles before performing the affine transformation. However, large-rotation angles are often introduced into image pairs during the production process in real-world pathology images. Reliable initial alignment is important for registration performance. The existing deep-learning-based approaches often use a two-step affine registration pipeline because convolutional neural networks (CNNs) cannot correct large-angle rotations. In this manuscript, a general framework ARoNet is developed to achieve end-to-end affine registration for histopathological images. We use CNNs to extract global features of images and fuse them to construct correspondent information for affine transformation. In ARoNet, a rotation recognition network is implemented to eliminate great rotation misalignment. In addition, a self-supervised learning task is proposed to assist the learning of image representations in an unsupervised manner. We applied our model to four datasets, and the results indicate that ARoNet surpasses existing affine registration algorithms in alignment accuracy when large angular misalignments (e.g., 180 rotation) are present, providing accurate affine initialization for subsequent non-rigid alignments. Besides, ARoNet shows advantages in execution time (0.05 per pair), registration accuracy, and robustness. We believe that the proposed general framework promises to simplify and speed up the registration process and has the potential for clinical applications.


Influence of mating strategies on seminal material investment in crabs.
Reproduction involves high energetic costs which are related to behaviour and gamete production. In females energy allocation to gamete production has been well documented. However, estimations of male investment in seminal material are scarce. The present study aims to assess and compare male investment in four brachyuran species by determining biochemical substrates present in the vasa deferentia to subsequently estimate energetic investment during the reproductive cycle. We identified two groups with contrasting energy investments. Two species, Homalaspis plana and Romaleon setosum, showed high investment due to significant quantities of proteins and lipids. Both species are characterised by large and complex vasa deferentia, and the formation of a remarkably large sperm plug deposited to the female after copulation as a sperm competition avoidance strategy. In contrast, Metacarcinus edwardsii and Taliepus dentatus invested little energy in their smaller-sized and simpler vasa deferentia. Morpho-functional traits may play a key role in determining the investment, which may also be influenced by mechanisms (i.e. mating tactics) to prevent sperm competition and the intensity of polygyny. This study emphasises the high amount of energy males invest in seminal material and highlights the diversity of mating strategies in Brachyura, which are reflected even on the physiological level.


Metachronous early gastric adenocarcinoma presenting coinstantaneously with complete remission of stage IV gastric MALT lymphoma.
Adenocarcinoma and lymphoma represent the two most common malignant tumours of the stomach, with both neoplasms being associated with infection by Helicobacter pylori. However, the presence of lymphoma and adenocarcinoma in the same patient is a rare entity with synchronous neoplasms being more common than metachronous types. We report a case of stage IV gastric MALT lymphoma of the gastric angle with infiltration of the bone marrow successfully treated with chemotherapy and the occurrence of metachronous early gastric adenocarcinoma of the fundus presenting 1 year after the diagnosis of the lymphoma.


Successful treatment of ovarian pregnancy with laparoscopy-assisted local injection of etoposide.
To present a case of ovarian ectopic pregnancy successfully treated with laparoscopy-assisted local injection of etoposide. Case report. University-affiliated teaching hospital. A 33-year-old woman with the diagnosis of an ovarian pregnancy. Laparoscopically assisted local injection of etoposide. Successful treatment of the ovarian ectopic pregnancy, with preservation of the ovary. The patient was successfully treated, and she had normal menstruation after surgery. Treatment of ovarian ectopic pregnancy with a laparoscopy-assisted local injection of etoposide might be a less invasive choice that can circumvent the systemic side effects of the medication.


Alternative splicing within the I-II loop controls surface expression of T-type Ca(v)3.1 calcium channels.
Molecular diversity of T-type/Ca(v)3 Ca2+ channels is created by expression of three genes and alternative splicing of those genes. Prompted by the important role of the I-II linker in gating and surface expression of Ca(v)3 channels, we describe here the properties of a novel variant that partially deletes this loop. The variant is abundantly expressed in rat brain, even exceeding transcripts with the complete exon 8. Electrophysiological analysis of the Delta8b variant revealed enhanced current density compared to Ca(v)3.1a, but similar gating. Luminometry experiments revealed an increase in the expression of Delta8b channels at the plasma membrane. We conclude that alternative splicing of Ca(v)3 channels regulates surface expression and may underlie disease states in which T-channel current density is increased.


Immunocompetence of chimeric rabbits. III. Serial passage and persistence of B-lymphocyte memory.
In a model consisting of noninbred rabbits matched for major histocompatibility antigens and mismatched for immunoglobulin allotypes, using cell donors and recipients unrelated to each other, B-cell memory has been demonstrated to persist through three successive transfers for a period approaching 2 years. Memory cells from the original donor are shown to dominate specific antibody responses of the primary and secondary recipients. Vigorous antibody responses by donor-derived cells are obtained even when antigenic stimulation is delayed by several months. The data suggest that B memory cells may be particularly efficient in the colonization of recipients, and the potential significance of these findings for adoptive immunization of human bone marrow recipients is discussed.


Long-term survival following radiofrequency catheter ablation of atrioventricular junction for atrial fibrillation: clinical and ablation determinants of mortality.
For patients with drug-refractory atrial fibrillation, radiofrequency catheter ablation of the atrioventricular junction and pacemaker implantation is a nonpharmacologic option routinely used nowadays. Few data are available on the long-term survival following the procedure or on evaluation of the risk factors for death in a large study cohort. The patient population included 359 subjects undergoing atrioventricular junction ablation and pacemaker insertion. Fourteen clinical and 9 ablation variables were collected at baseline. During a mean following-up of 40.8 +/- 25.6 months, 46 patients died. Survival probability was estimated by the Kaplan-Meier methods. Multivariate Cox proportional hazards regression analysis was applied to define predictors of death. Mean age was 64.6 +/- 10.6 years with 203 male (57.7%). Actuarial survival probability for the total patients was 0.953 and 0.827 at 1 and 5 year. Four clinical variables, but no ablation variables, were found to be independent predictors of death: age > or =65 year (hazard ratio [HR], 1.92; 95% confidence interval [CI], 1.00-3.69), the presence of heart failure (HR, 3.83; 95% CI, 1.87-7.86), coexisting diabetes (HR, 2.91; 95% CI, 1.47-5.77), and the value of fractional shortening < or =20% (HR, 5.79, 95% CI, 3.00-11.18). There were 20 deaths in 28 patients with > or =3 risk factors and 4 deaths in 115 patients with no risk factor. The risk of death in patients undergoing ablation and pacing can be identified by readily available clinical variables. Patients with multiple risk factors are associated with an increasing mortality.


The Swedish Ankle Arthroplasty Register: An analysis of 531 arthroplasties between 1993 and 2005.
Whether or not ankles can be replaced with reasonable safety has been the subject of debate. We present the results of a nationwide series of total ankle arthroplasties. All Swedish hospitals that implant or have implanted modern three-component ankle prostheses reported demographic data and date of index and revision surgery to a central register. After the data had been introduced into a database, prosthetic survival rates with exchange or permanent extraction of components as endpoint were calculated. Of the 531 prostheses implanted, 101 had been revised by June 15, 2006. The overall survival rate at 5 years was 0.78 (95%CI: 0.74-0.82). For the three surgeons who had inserted the majority of the STAR ankles, the survival rates became significantly higher after the first 30 cases had been performed and was estimated to be 0.86 (0.80-0.93) at 5 years. Lower age at index surgery implied increased risk of revision whereas diagnosis or gender did not. Ankle replacement is a valuable alternative to arthrodesis. However, replacing an ankle is a demanding procedure and the survival is not comparable to that after hip or knee replacement. It is obvious that with increasing experience, the results -- including prosthetic survival -- will improve.


[Use of tissue adhesives and collagen membranes in clinical cases. Critical remarks].
On the base of his own 7 years clinical experience the author discusses with some critical remarks the possibilities and indications for applying tissue adhesive and adhesives together with collagen membranes in the treatment of injuries to the chest, abdomen and blood vessels.


Brain uptake of dihydroergotamine after intravenous and nasal administration in the rat.
This study was conducted to determine the uptake of dihydroergotamine (DHE) into the brain after intravenous and intranasal administration in rats. Eight anesthetized rats received either an intravenous (i.v.) or two successive intranasal (i.n.) doses of tritium labeled dihydroergotamine (3H-DHE) with 14C-inulin as a non-BBB (blood-brain barrier) permeable marker. Radioactivity concentrations in plasma were determined at designated times within 30 min postdose, and in blood and seven brain regions (olfactory bulb, frontal cortex, parietal cortex, occipital cortex, cerebellum, mid-brain areas, and brain stem) at 30 min. The plasma-to-brain permeability*area product (PeA) following an i.v. dose was calculated based on the 30-min brain tissue concentration and the area under the plasma concentration-time curve (AUC0-30 min, i.v.) assuming unidirectional transport from plasma to brain. Direct transport from nasal cavity to brain was assessed based on the amount of radioactivity in brain determined experimentally and predicted based on plasma AUC0-30 min, i.n. and PeA obtained from i.v. data. Following an i.v. dose, DHE distributed into the brain with a brain-to-plasma concentration ratio of approximately 5% at 30 min postdose. The PeA value of DHE ranged from 8.6 x 10(-4) to 37.5 x 10(-4) mL min(-1) g(-1) in different brain regions. Following i.n. doses the experimentally determined concentration in olfactory bulb was approximately 51 times, and in other regions three to seven times, greater than predicted values based only on PeA and plasma AUC, suggesting a direct transport pathway from the nasal cavity to the brain. As a result, the brain tissue concentrations at 30 min were similar to (0.31-1.04 times) those following an i.v. dose except for the olfactory bulb, in which the concentration was approximately four times greater than that following an i.v. dose. In conclusion, 3H-DHE penetrated the BBB following intravenous administration. Following i.n. doses, 3H-DHE was able to enter the brain directly from the nasal cavity, with the olfactory bulb being a part of the direct passage from nasal cavity to brain.


Effects and mechanism of gating modifier spider toxins on the hERG channel.
Jingzhaotoxin-I, -III, -IV, -XIII, and -35 (JZTX-I, -III, -IV, -XIII, and -35), gating modifier toxins isolated from the venom of the Chinese tarantula Chilobrachys Jingzhao, were reported to act on cardiac sodium channels and Kv channels. JZTX-I and JZTX-XIII inhibited the hERG channel with the IC50 value of 626.9 nM and 612.6 nM, respectively. JZTX-III, -IV, and -35 share high sequence similarity with JZTX-I and JZTX-XIII, but they showed much lower affinity on the hERG channel compared with JZTX-I and JZTX-XIII. The inhibitory potency of the above five toxins on the hERG channel was not in accordance with their affinity on the Nav1.5 and Kv2.1 channels, indicating that the bioactive surfaces of the five toxins interacting with hERG, Nav1.5 and Kv2.1 are at least in part different. Structure-function analysis of the gating modifier toxins suggested that the functional bioactive surface binding to the hERG channel consists of a conserved hydrophobic patch, surrounding acidic residues (Glu10 in JZTX-XIII, Glu11 in JZTX-I), and basic residues which may be different from residues binding to the Kv2.1 channel.


Further evidence for sublexical components in implicit memory for novel words.
This study provides further evidence for the notion, proposed by Dorfman (1994), that activation of sublexical components plays an important role in implicit memory for novel words. Priming in an identification task was observed consistently when nonwords were formed out of morphemes; weaker, more variable effects were observed when nonwords were composed of syllables or pseudosyllables. Priming was insensitive to changes in the surface features (type case) of the stimuli and was disrupted by rearrangement of the stimulus components. Results are interpreted in terms of the activation and integration of preexisting sublexical representations and as evidence against the role of newly established episodic or perceptual representations. It is concluded that findings of priming for novel information should not be taken as evidence against an activation view.


Effect of hypercapnia on changes in blood pH, plasma lactate and ammonia due to exercise.
The present study examined the effects of hypercapnia on changes in blood pH, plasma lactate and ammonia due to exhaustive exercise. Six male subjects underwent exercise of increasing intensity until exhaustion: (1) breathing air = MAX (maximal exercise), or (2) under hypercapnia (HC: 21% O(2), 6% CO(2)) that had been maintained from 60 min before to 30 min after exercise = HC; and (3) exercise of the same intensity as HC in air = SUB (submaximal exercise). Arterialized blood was drawn from a superficial vein. Blood pH in HC was significantly lower than in MAX or SUB at rest, at the end of exercise and throughout recovery (P<0.05). Plasma lactate and ammonia concentration in HC was significantly lower than in MAX (P<0.05), and similar to that in SUB at the end of exercise and throughout recovery. Respiratory acidosis resulting from hypercapnia shifted the linear lactate to blood pH relationship during exhaustive exercise below that at normocapnia (P<0.001). The reduced slope of linear blood pH to ammonia relationship under hypercapnia (P<0.001) is attributed to lactic acidosis that is less, due to the lesser work intensity at the end of exhaustion, than that of normocapnia. From these results we conclude that (1) hypercapnia-induced respiratory acidosis promoted the decrease in blood pH due to lactate production throughout recovery; (2) plasma lactate concentration at maximal exercise was lowered under hypercapnia; (3) plasma ammonia concentration at maximal exercise was reduced, probably due to a less intense lactic acidosis.


An educational intervention to enhance nurse practitioner role transition in the first year of practice.
Role transition is a natural process that occurs when the registered nurse pursues additional education to become a nurse practitioner (NP). Role transition generates feelings of anxiety and insecurity, leading to a longer and more tumultuous adjustment. This study investigated whether an evidence-based role transition webinar would support NP role transition during this critical period. This study was a nonrandomized, pretest-posttest, and single-group study using a convenience sample to address the research question: "Does completion of a role transition webinar enhance the perception of new NPs of their ability to perform well in their role?" The educational webinar was shown to have a positive influence on some aspects of the participant's reported perceptions of NP role transition. Having practical and assessable educational interventions to optimize NP role transition and determining factors that contribute to the success of these interventions would be prudent. This is the first quantitative study to investigate the positive association between an online educational intervention and NP role transition. A timelier and less tumultuous transition would allow NPs to perform more effectively in their new role.


Serum concentrations of A Proliferation-Inducing Ligand (APRIL) are elevated in sepsis and predict mortality in critically ill patients.
Inflammatory and autoimmune diseases have been associated with the tumor necrosis factor superfamily member "A PRoliferation Inducing Ligand" (APRIL). However, up to now, APRIL has not been investigated in critical illness or sepsis. We therefore analyzed APRIL serum concentrations in a large cohort of well-characterized intensive care unit patients. Serum concentrations of APRIL were measured in 246 critically ill patients, of which 157 fulfilled sepsis criteria in comparison with 81 healthy controls. Clinical data were recorded and correlated with APRIL serum levels. We detected strongly elevated serum levels of APRIL in critically ill patients compared with healthy controls. Levels of APRIL were further elevated in sepsis and significantly correlated with classical markers of inflammation, bacterial infection, or multiorgan failure. Consequently, high APRIL levels were associated with an unfavorable prognosis and predicted mortality with higher diagnostic accuracy than established prognostic scoring systems such as the Acute Physiology and Chronic Health Evaluation II score. Serum levels of APRIL were significantly elevated in intensive care unit patients, with the highest concentrations in septic patients, and associated with unfavorable outcome. Besides being used as a single marker, APRIL may be implemented into established scoring systems to further improve their sensitivity and specificity in predicting patient's prognosis.


Quantitative Clinical Cardiac Magnetic Resonance Imaging.
Cardiac magnetic resonance imaging (MRI) represents the established reference standard method for the assessment of cardiac function and non-invasive evaluation of myocardial tissue in a variety of clinical questions, wherein quantification of cardiac parameters gains growing diagnostic and differential-diagnostic importance. This review aims to summarize established and newly emerging quantitative parameters, which are assessed in routine cardiac MRI. Interrelations and interdependencies between metrics are explained, and common factors affecting quantitative results are discussed. The review is based on a PubMed literature research using the search terms "cardiac magnetic resonance" and "quantification", "recommendations", "quantitative evaluation/assessment", "reference method", "reference/normal values", "pitfalls" or "artifacts" published between 2000-2019. Quantitative functional, phase contrast, and perfusion imaging, as well as relaxation time mapping techniques give opportunity for assessment of a large number of quantitative cardiac MRI parameters in clinical routine. Application of these techniques allows for characterization of function, morphology and perfusion of the heart beyond visual analysis of images, either in primary evaluation and comparison to normal values or in patients' follow-up and treatment monitoring. However, with implementation of quantitative parameters in clinical routine, standardization is of particular importance as different acquisition and evaluation strategies and algorithms may substantially influence results, though not always immediately apparent. · Clinical cardiac MRI provides numerous functional and morphological quantitative parameters.. · Quantitative cardiac MRI enables assessment of diffuse and global myocardial alterations.. · Standardized data acquisition/evaluation is the prerequisite for diagnostic use of quantitative cardiac MRI parameters.. · Reiter U, Reiter C, Kräuter C et al. Quantitative Clinical Cardiac Magnetic Resonance Imaging. Fortschr Röntgenstr 2020; 192: 246 - 256.


Blood pressure, renin activity and heart rate changes during propranolol therapy of hypertension.
To investigate the importance of plasma renin activity in determining the antihypertensive action of propranolol and of heart rate in guiding propranolol therapy, the effect of a graded oral dose of propranolol on blood pressure, plasma renin and heart rate was studied in 24 men with essential hypertension and differing initial levels of renin activity. Although plasma renin decreased substantially in patients with normal and high renin levels tasking a small dose of propranolol (40 mg/day), blood pressure was unchanged in the normal renin group, and a small decrease in systolic pressure alone was noted in those with high plasma levels of renin. Patients with low renin levels had no reduction in blood pressure with small doses of propranolol, but as a group they responded well to a dose of 320 mg/day. Standing heart rate decreased maximally at plasma propranolol concentrations greater than 25 ng/ml, and did not exceed 72 beats/min with plasma concentrations above that level. Overall, the observed responses for plasma renin and heart were more pronounced at lower plasma propranolol concentrations than those for blood pressure.


Zosteriform cutaneous metastases from squamous cell carcinoma of the stump of an amputated arm.
The clinical appearance of skin metastases varies over a wide morphologic spectrum, cutaneous metastases mimicking herpes zoster being rare. We now report the case of an 83-year-old male with zosteriform cutaneous metastases secondary to a squamous cell carcinoma (SCC) which developed in the stump of an amputated arm. The pathogenesis is speculative, but in this case, the zosteriform distribution might well be explained by perineural lymphatic invasion and spread.


Electrical storms in an ICD-recipient with 429 delivered appropriate shocks: therapeutic management with antiarrhythmic drug combination.
The case of a 65 year old man with ischemic cardiomyopathy, an ICD device and recurrent electrical storms is presented. The patient had been implanted with an ICD device due to aborted sudden death. The first electrical storm occurred 12 months later. It was terminated by the administration of intravenous amiodarone and the patient was discharged on maintenance dose amiodarone and b-blocker. After a period of 3 months during which the patient remained asymptomatic, a second arrhythmic clustering occurred and it was controlled by the addition of mexiletine. A total number of 429 appropriate shocks had been delivered by the device. Thereafter and for a seven month follow-up period, the patient remains asymptomatic under this combination of antiarrhythmic drugs.


Principled estimation and evaluation of treatment effect heterogeneity: A case study application to dabigatran for patients with atrial fibrillation.
To apply the latest guidance for estimating and evaluating heterogeneous treatment effects (HTEs) in an end-to-end case study of the Long-term Anticoagulation Therapy (RE-LY) trial, and summarize the main takeaways from applying state-of-the-art metalearners and novel evaluation metrics in-depth to inform their applications to personalized care in biomedical research. Based on the characteristics of the RE-LY data, we selected four metalearners (S-learner with Lasso, X-learner with Lasso, R-learner with random survival forest and Lasso, and causal survival forest) to estimate the HTEs of dabigatran. For the outcomes of (1) stroke or systemic embolism and (2) major bleeding, we compared dabigatran 150 mg, dabigatran 110 mg, and warfarin. We assessed the overestimation of treatment heterogeneity by the metalearners via a global null analysis and their discrimination and calibration ability using two novel metrics: rank-weighted average treatment effects (RATE) and estimated calibration error for treatment heterogeneity. Finally, we visualized the relationships between estimated treatment effects and baseline covariates using partial dependence plots. The RATE metric suggested that either the applied metalearners had poor performance of estimating HTEs or there was no treatment heterogeneity for either the stroke/SE or major bleeding outcome of any treatment comparison. Partial dependence plots revealed that several covariates had consistent relationships with the treatment effects estimated by multiple metalearners. The applied metalearners showed differential performance across outcomes and treatment comparisons, and the X- and R-learners yielded smaller calibration errors than the others. HTE estimation is difficult, and a principled estimation and evaluation process is necessary to provide reliable evidence and prevent false discoveries. We have demonstrated how to choose appropriate metalearners based on specific data properties, applied them using the off-the-shelf implementation tool survlearners, and evaluated their performance using recently defined formal metrics. We suggest that clinical implications should be drawn based on the common trends across the applied metalearners.


In non-specific low back pain, is an exercise program carried out through telerehabilitation as effective as one carried out in a physiotherapy center? A controlled randomized trial.
s:The effectiveness of telerehabilitation (TLRH) in patients with non-specific low back pain (NLBP) remains unknown. No study till date has investigated the efficacy of a mobile-based TLRH in patients with NLBP. To investigate if a TLRH program is as effective as a clinical exercise programme in improving disability, pain intensity, pain catastrophizing, and hip pain and strength in patients with NLBP. Single-blind, two-armed, randomized controlled study. A total of 71 individuals with NLBP were randomly allocated to either the TLRH home group (TLRH) or clinic group (CG). The TLRH followed exercise videos and read information on pain neurophysiology. The CG performed the same exercises and received on-site pain education. Both groups performed the exercises twice weekly for 8 weeks. Disability, pain intensity, pain catastrophizing, and hip pain and strength were assessed at baseline, at post-treatment, and at three months. Statistically significant differences for time-by-group interaction were detected in the strength of left hip flexors (supine [F = 8.356; p = .005]; sitting [F = 9.828; p = .003]), right hip extensors with extended knee [F = 7.461; p = .008], left hip extensors (extended knee [F = 13.175; p = .001]; flexed knee [F = 13.505; p < .001]), pain during flexion of the right [F = 5.133; p = .027] and left [F = 4.731; p = .033] hips in the supine position, disability [F = 4.557; p = .014], and pain catastrophizing [F = 14.132; p < .001]. A TLRH mobile-based is as effective as clinical treatment in improving disability, pain catastrophizing, and pain and strength of the hip structures in patients with NLBP.


Selective reduction and homologation of carbon monoxide by organometallic iron complexes.
Carbon monoxide is a key C1 feedstock for the industrial production of hydrocarbons, where it is used to make millions of tonnes of chemicals, fuels, and solvents per annum. Many transition metal complexes can coordinate CO, but the formation of new C-C bonds in well-defined compounds from the scission and subsequent coupling of two or more CO moieties at a transition metal centre remains a challenge. Herein, we report the use of low-coordinate iron(II) complexes for the selective scission and homologation of CO affording unusual squaraines and iron carboxylates at ambient temperature and pressure. A modification of the ligand framework allows for the isolation and structural characterisation of a proposed metallacyclic Fe(II) carbene intermediate. These results indicate that, with the appropriate choice of supporting ligands, it is possible to cleave and homologate carbon monoxide under mild conditions using an abundant and environmentally benign low-coordinate, first row transition metal.


Investigation of sequence homology in a group of type-II restriction/modification isoschizomers.
We have dissected the cloned PstI M and R genes to make DNA hybridization probes spanning most of the sequence. These subclones, and also the intact sequence, were used to search for nucleic acid homology by Southern blot in the DNA from twelve organisms which produce PstI isoschizomers. One of these probes, a 206-bp fragment from the N-terminal domain of the endonuclease, showed significant hybridisation in four strains (Escherichia coli strains RFL48, RFL49 and RFL83, and Streptomyces albus P). No significant hybridisation was detected with other parts of the PstI sequences. We have used computer similarity searches to look for homology between the PstI proteins and the known sequences of other type-II systems that recognise different sites. We postulate a possible recognition domain within the M.PstI methyltransferase based on similarity to the M.PaeR7 and M.TaqI methyltransferases.


A comparison of pancreatitis induced by high or low pressure injections of enzymes into the canine pancreatic duct.
Purified pancreatic enzymes produced a substantial inflammatory response in the canine pancreas when injected under low pressure (40-60 cm). When high pressures in the range of 140 mm Hg were employed, the severity of the inflammatory response was considerably increased, and systemic hypotension and portal hypertension were common findings. The latter circulatory changes appeared to be related to a large load of enzyme-rich fluid absorbed predominantly by the venous route, and, to a lesser degree, by the lymphatics draining the interstitium of the gland. High pressure infusion appears to introduce variables that increase the intensity of the pathologic changes in the pancreas and the portal and systemic circulations. Infusion pressures within the range of physiologic probability appear to result in a lesion with less injection artifact. Studies involving experimental pancreatitis should take these factors into account, particularly when hemodynamic changes are an important consideration.


Obstetrical outcomes following laparoscopy during pregnancy: a retrospective case-control study.
To evaluate pregnancy outcome of patients who undergo laparoscopy during pregnancy. A retrospective case-control study, conducted in a single university-affiliated tertiary care medical center, comparing pregnancy outcomes of women who underwent laparoscopy during pregnancy to women without operations during pregnancy. The study group (n = 232) included all pregnant women who underwent a single laparoscopic surgery during pregnancy (4-28 weeks of gestation) which culminated in delivery between 2006 and 2017; this study group was matched to a control group (n = 463) without surgical intervention during pregnancy, in a 2:1 ratio by maternal age, parity, and multiple gestation. The main pregnancy outcomes included preterm birth, cesarean section, small for gestational age (≤ 10 percentile), and Apgar score of less than 7 in 5 min. Laparoscopy during pregnancy was associated with an increased risk for cesarean section (32.3% vs. 24.6%, adjusted OR = 1.9, CI 1.2-3.1, p = 0.011). We found no difference between the groups with regard to other outcomes, including rates of preterm birth (12.1% vs. 10.4%, adjusted OR = 1.3, CI 0.64-2.72, p = 0.451). In a subgroup analysis of the study group, various perioperative parameters such as operation duration, hospitalization length, and others, did not correlate with adverse pregnancy outcome. Laparoscopy during pregnancy may be associated with an increased rate of cesarean section. We did not find an increase in any other pregnancy or neonatal complication. Different perioperative parameters did not appear to predict adverse pregnancy outcome.


Elevated serum triglyceride and low-density lipoprotein cholesterol promotes the formation of colorectal polyps.
Hyperlipidaemia may be a potential risk factor for the occurrence of intestinal polyps. This study aimed to evaluate correlation between lipidaemia and the formation of colorectal polyps. One hundred and fourteen patients with colorectal polyps and forty-eight healthy controls were included in this study. Colonoscopies were performed for all patients and controls within 1 week before blood samples were taken. The concentrations of serum lipids and lipoproteins were measured simultaneously using an automatic biochemical analyser. The colorectal lesions were classified based on pathological characteristics, and four types were identified in the study: hyperplastic polyp (HP), tubular adenoma (TA), tubulovillous adenoma (TVA) and adenoma with high-grade dysplasia (A-HGD). Advanced adenoma was classified according to the number, size and histological type of polyps. The value of low-density lipoprotein cholesterol (LDL-C) was significantly higher in the group with advanced adenoma than in the controls (p < 0.05). Moreover, the LDL-C values in the HP and TA groups were higher when compared to that of controls (p < 0.05). Obesity, age, and increased TG and LDL-C were independent risk factors for the formation of colorectal polyps. The cut-off values of triglyceride (TG) and LDL-C to distinguish polyp patients from healthy controls were 0.96 mmol/L (AUC = 0.604, p = 0.036) and 3.05 mmol/L (AUC = 0.654, p = 0.002). The combined use of increased LDL-C and TG levels to distinguish polyp patients was effective, with a sensitivity of 50.0% and a specificity of 89.6% (AUC = 0.733, p < 0.01). Colorectal polyps are more often found in obese and older patients. Increased LDL-C and TG were correlated with the occurrence of polyps. Combination of the two serum indicators was useful to assess risk of colorectal lesions, maybe more effective in screening hyperplastic polyp, tubular adenoma and advanced adenoma.


Why anticoagulant studies on sepsis fail frequently --- start with SCARLET.
The Sepsis Coagulopathy Asahi Recombinant LE Thrombomodulin (SCARLET) trial has many defects, and thus cannot be the terminator of recombinant thrombomodulin (rTM). On the contrary, it provides sufficient evidence for further research. Based on analysis focusing on the failure of SCARLET and several previous anticoagulant studies, it is most important for new studies to grasp the following two points: (1) The enrolled cases should have sufficient disease severity and a clear standard for disseminated intravascular coagulation; (2) Heparin should not be used in combination with the investigated drugs. Multiple post-hoc analyses show that no combination of heparin will not increase the risk of thromboembolism. In fact, the combination of heparin can mask the true efficacy of the investigated drug. Due to the complexity of sepsis treatment and the limitations of clinical studies, the results of all treatment studies should be repeatedly verified, rather than be determined at one stroke. Some research conclusions contrary to disease physiology, pharmacology and clinical practice may be deceptive, and should be cautious rather than be simply accepted. On the other hand, the dissenting voices in the "consensus" scene are often well discussed by the authors and should be highly valued.


[Problems of photo-documentation in microsurgery].
Photomicrography through the operating microscope requires considerable attention to detail. All the details which are essential for obtaining good photomicrographs for documentation and publication are described.


Anaerobic digestion of whole stillage from dry-grind corn ethanol plant under mesophilic and thermophilic conditions.
Anaerobic digestion of whole stillage from a dry-grind corn-based ethanol plant was evaluated by batch and continuous-flow digesters under thermophilic and mesophilic conditions. At whole corn stillage concentrations of 6348 to 50,786 mg total chemical oxygen demand (TCOD)/L, at standard temperature (0 °C) and pressure (1 atm), preliminary biochemical methane potential assays produced 88±8 L (49±5 L CH4) and 96±19 L (65±14 L CH4) biogas per L stillage from mesophilic and thermophilic digesters, respectively. Continuous-flow studies for the full-strength stillage (TCOD=254 g/L) at organic loadings of 4.25, 6.30 and 9.05 g TCOD/L days indicated unstable performance for the thermophilic digester. Among the sludge retention times (SRTs) of 60, 45 and 30 days tested, the mesophilic digestion was successful only at 60 days-SRT which does not represent a practical operation time for a large scale bioethanol plant. Future laboratory studies will focus on different reactor configurations to reduce the SRT needed in the digesters.


Obg-like ATPase 1 inhibited oral carcinoma cell metastasis through TGFβ/SMAD2 axis in vitro.
The human Obg-like ATPase 1 (OLA1) protein has been reported to play an important role in cancer cell proliferation. The molecular mechanism underlying OLA1 regulated oral metastasis is still unknown. We investigated in this study the regulatory role of OLA1 playing in oral squamous cell metastasis. A series of in vitro assays were performed in the cells with RNAi-mediated knockdown or overexpression to expound the regulatory function of OLA1 in oral cancer. We found that the endogenous level of OLA1 in a highly metastatic oral squamous cell line was significantly lower than that in low metastatic oral cells as well as in normal oral cells. Escalated expression of OLA1 resulted in a reduced ability of metastasis in highly metastatic cells, and enhanced its sensitivity to the paclitaxel treatment. Further analysis of the EMT markers showed that Snail, Slug, N-cadherin were up-expressed significantly. Meanwhile, E-cadherin was significantly down-regulated in the oral cancer cells with OLA1-knocked down, suggesting that OLA1 inactivated EMT process. Furthermore, we found that OLA1 suppressed oral squamous cell metastasis by suppressing the activity of a TGFβ/SMAD2/EMT pathway. Our data suggests that OLA1 may be developed as a potential target for the treatment of oral cancer metastasis.


Financial Impact of a Culturally Sensitive Hispanic Kidney Transplant Program on Increasing Living Donation.
In the United States, Hispanic/Latinx patients receive disproportionately fewer living donor kidney transplants (LDKTs) than non-Hispanic White patients. Northwestern Medicine's culturally targeted Hispanic Kidney Transplant Program (HKTP) was found to increase LDKTs in Hispanic patients at 1 of 2 transplant programs with greater implementation fidelity. We conducted a budget impact analysis to evaluate HKTP's impact on program financial profiles from changes in volume of LDKTs and deceased donor kidney transplants (DDKTs) in 2017 to 2019. We estimated HKTP programmatic costs, and kidney transplant (KT) program costs and revenues. We forecasted transplant volumes, HKTP programmatic costs, and KT program costs and revenues for 2022-2024. At both programs, HKTP programmatic costs had <1% impact on total KT program costs, and HKTP programmatic costs comprised <1% of total KT program revenues in 2017-2019. In particular, the total volume of Hispanic KTs and HKTP LDKTs increased at both sites. Annual KT program revenues of HKTP LDKTs and DDKTs increased by 226.9% at site A and by 1042.9% at site B when comparing 2019-2017. Forecasted HKTP LDKT volume showed an increase of 36.4% (site A) and 33.3% (site B) with a subsequent increase in KT program revenues of 42.3% (site A) and 44.3% (site B) among HKTP LDKTs and DDKTs. HKTP programmatic costs and KT evaluation costs are potentially recoverable by reimbursement of organ acquisition costs and offset by increases in total KT program revenues of LDKTs; transplant programs may find implementation of the HKTP financially manageable.


Pancreatic spasmolytic polypeptide (PSP): II. Radioimmunological determination of PSP in porcine tissues, plasma and pancreatic juice.
A radioimmunoassay (RIA) for the determination of porcine Pancreatic Spasmolytic Polypeptide (PSP) has been developed. The antisera raised in rabbits were sensitive to 5 pgequiv. of PSP in a volume of 100 microliter. Immunoreactive PSP (IR-PSP) has been determined in extracts from 22 porcine organs. Pancreas was found to be the only organ containing substantial amounts of IR-PSP (0.1 mgequiv. IR-PSP/g wet weight). The fasting porcine plasma level of IR-PSP was about 10 ngequiv./ml, corresponding to 850 pM. The concentration of IR-PSP in porcine pancreatic juice varied from 0.2 mugequiv./ml in the fasting state to 46-116 mugequiv./ml after stimulation with pancreozymin or secretin. A linear correlation was found between the exocrine secretion of IR-PSP and total protein.


Laser treatment for neovascular formation.
Neovascular formation or matting [Davis and Duffy, J Dermatol Surg Oncol 1990; 16:327; Folkman and Klagsbrun, Science 1987;235:442; Weiss et al., Lasers Surg Med 1996;8:40-41] is a complex problems for doctors to treat. It was done by two different kinds of lasers, 532 nm [Silver and Livshots, Cosmetic Dermatol 1996;9:61; Adrian, Dermatol Surg 1998; 24:19] and 1,064 nm [Weiss and Weiss, Dermatol Surg 1999; 12:399-402] Nd:Yag laser. This study was carried out to discover which had better results on the treatment of this pathology. Thirty-six patients underwent a monthly treatment, two sessions for neovascular formation by the 532 nm diode laser and the 1,064 nm [Weiss and Weiss, Dermatol Surg 1999;12:399-402] Nd:Yag laser. A comparative study was done by digital photography pre and post laser, 1 month after the second treatment by the two methods of evaluation, clinical percent clearance and by mathematically counting the number of vessels. There was a significant reduction of the number of capillaries in the affected areas treated by both lasers, mainly in the 1,064 Nd:Yag group. The association of 3 and 10 mm spot size of the 1,064 nm laser group had better results compared with the 532 nm laser for matting treatment.


Three-year experience with alendronate treatment in postmenopausal osteoporotic Japanese women with or without renal dysfunction: a retrospective study.
Chronic kidney disease is associated with an increased risk of fragility fractures. A retrospective study was conducted to compare outcomes after 3 years of alendronate treatment in postmenopausal osteoporotic Japanese women with or without renal dysfunction (RD). One hundred and thirty-five postmenopausal osteoporotic Japanese women (mean age at baseline: 68 years) who had been treated with alendronate in our outpatient clinic for more than 3 years were analysed. The lumbar spine bone mineral density (BMD) of patients was measured using dual energy x-ray absorptiometry, and urinary levels of cross-linked N-terminal telopeptides of type I collagen (NTX) and serum levels of alkaline phosphatase (ALP) were monitored during the 3-year treatment period. The incidence of osteoporotic fractures was also assessed. Twenty-six women had RD with an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. The urinary NTX and serum ALP levels significantly decreased and the lumbar spine BMD significantly increased, compared with the baseline values, in a manner that was similar among women with or without RD. However, the incidence of non-vertebral fractures, but not that of vertebral fractures, was significantly higher among women with RD than among women without RD. Alendronate treatment appeared to have a similar effect on surrogate markers in postmenopausal osteoporotic Japanese women with or without RD. However, further studies are needed to confirm that RD may increase the risk of non-vertebral fractures in patients treated with alendronate.


Correlation of MKI67 with prognosis, immune infiltration, and T cell exhaustion in hepatocellular carcinoma.
MKI67 plays a vital role in the tumour microenvironment (TME) and congenital immunity. The present work focuses on exploring the prognosis prediction performance of MKI67 and its associations with T cell activity and immune infiltration within numerous cancers, especially hepatocellular liver carcinoma (LIHC). Oncomine, GEPIA2, and HPA were adopted to analyse MKI67 levels in different types of cancers. The prognostic prediction performance of MKI67 was evaluated through the TCGA portal, GEPIA2, LOGpc, and Kaplan-Meier Plotter databases. The associations of MKI67 with related gene marker sets and immune infiltration were inspected through TISIDB, GEPIA2, and TIMER. We chose MKI67 to analyse biological processes (BPs) and KEGG pathways related to the coexpressed genes. Furthermore, the gene-miRNA interaction network for MKI67 in liver cancer was also examined based on the miRWalk database. MKI67 expression decreased in many cancers related to the dismal prognostic outcome of LIHC. We found that MKI67 significantly affected the prognosis of LIHC in terms of histology and grade. Increased MKI67 levels were directly proportional to the increased immune infiltration degrees of numerous immune cells and functional T cells, such as exhausted T cells. In addition, several critical genes related to exhausted T cells, including TIM-3, TIGIT, PD-1, LAG3, and CXCL13, were strongly related to MKI67. Further analyses showed that MKI67 was associated with adaptive immunity, cell adhesion molecules (CAMs), and chemokine/immune response signal transduction pathways. MKI67 acts as a prognostic prediction biomarker in several cancers, particularly LIHC. Upregulation of MKI67 elevates the degree of immune infiltration of many immune cell subtypes, including functional T cells, CD4+ T cells, and CD8+ T cells. Furthermore, MKI67 shows a close correlation with T cell exhaustion, which plays a vital role in promoting T cell exhaustion within LIHC. Detection of the MKI67 level contributes to prognosis prediction and MKI67 modulation within exhausted T cells, thus providing a new method to optimize the efficacy of anti-LIHC immunotherapy.


Central sensitization associated with low fetal hemoglobin levels in adults with sickle cell anemia.
Pain is the hallmark of sickle cell anemia (SCA), presenting as recurrent acute events or chronic pain. Central sensitization, or enhanced excitability of the central nervous system, alters pain processing and contributes to the maintenance of chronic pain. Individuals with SCA demonstrate enhanced sensitivity to painful stimuli however central mechanisms of pain have not been fully explored. We hypothesized that adults with SCA would show evidence of central sensitization as observed in other diseases of chronic pain. We conducted a prospective study of static and dynamic quantitative sensory tests in 30 adults with SCA and 30 matched controls. Static thermal testing using cold stimuli showed lower pain thresholds (p=0.04) and tolerance (p=0.04) in sickle cell subjects, but not for heat. However, SCA subjects reported higher pain ratings with random heat pulses (p<0.0001) and change in scores with temporal summation at the heat pain threshold (p=0.002). Similarly, with the use of pressure pain stimuli, sickle cell subjects reported higher pain ratings (p=0.04), but not higher pressure pain tolerance/thresholds or allodynia to light tactile stimuli. Temporal summation pain score changes using 2 pinprick probes (256 and 512mN) were significantly greater (p=0.004 and p=0.008) with sickle cell, and delayed recovery was associated with lower fetal hemoglobin (p=0.002 and 0.003). Exaggerated temporal summation responses provide evidence of central sensitization in SCA. The association with fetal hemoglobin suggests this known SCA modifier may have a therapeutic role in modulating central sensitization.


Involvement of Rho and tyrosine kinase in angiotensin II-induced actin reorganization in mesothelial cells.
We investigated the role of angiotensin II type 1 (AT(1)) receptors in angiotensin II-induced actin reorganization and the signaling pathways of the response in pleural mesothelial cells. The effects of angiotensin II on actin reorganization in pleural mesothelial cells were evaluated by dual fluorescence labeling of filamentous (F) and monomeric (G) actin with fluorescein isothiocyanate (FITC)-labeled phalloidin and Texas Red-labeled DNase I, respectively. Angiotensin II (10 microM) induced actin reorganization in the presence and the absence of extracellular Ca(2+). An angiotensin AT(1) receptor antagonist ([Sar(1),Ile(8)]angiotensin II) inhibited angiotensin II-induced actin reorganization. Pretreatment with C3 exoenzyme or tyrosine kinase inhibitors significantly reduced angiotensin II-induced actin reorganization. However, pertussis toxin, phosphatidylinositol-3-kinase and protein kinase C inhibitors had no effect on these responses. These results suggest that angiotensin II-induced actin reorganization in pleural mesothelial cells is extremely dependent on the angiotensin AT(1) receptor coupled with pertussis toxin-insensitive heterotrimeric G proteins, Rho GTPases and tyrosine phosphorylation pathways.


Visual outcomes and subjective experience after bilateral implantation of a new diffractive trifocal intraocular lens.
To assess clinical outcomes and subjective experience after bilateral implantation of a diffractive trifocal intraocular lens (IOL). Midland Eye Institute, Solihull, United Kingdom. Cohort study. Patients had bilateral implantation of Finevision trifocal IOLs. Uncorrected distance visual acuity, corrected distance visual acuity (CDVA), and manifest refraction were measured 2 months postoperatively. Defocus curves were assessed under photopic and mesopic conditions over a range of +1.50 to -4.00 diopters (D) in 0.50 D steps. Contrast sensitivity function was assessed under photopic conditions. Halometry was used to measure the angular size of monocular and binocular photopic scotomas arising from a glare source. Patient satisfaction with uncorrected near vision was assessed using the Near Activity Visual Questionnaire (NAVQ). The mean monocular CDVA was 0.08 logMAR ± 0.08 (SD) and the mean binocular CDVA, 0.06 ± 0.08 logMAR. Defocus curve testing showed an extended range of clear vision from +1.00 to -2.50 D defocus, with a significant difference in acuity between photopic conditions and mesopic conditions at -1.50 D defocus only. Photopic contrast sensitivity was significantly better binocularly than monocularly at all spatial frequencies. Halometry showed a glare scotoma of a mean size similar to that in previous studies of multifocal and accommodating IOLs; there were no subjective complaints of dysphotopsia. The mean NAVQ Rasch score for satisfaction with near vision was 15.9 ± 10.7 logits. The trifocal IOL implanted binocularly produced good distance visual acuity and near and intermediate visual function. Patients were very satisfied with their uncorrected near vision.


Drinking water management strategies for distribution networks: An integrated performance assessment framework.
Due to rapid population growth, urbanization, water contamination, and climate change, global water resources are under increasing pressure. Water utilities apply drinking water management strategies (DWMS) to ensure that water is safe for drinking. However, in recent years, due to increased inclination towards climate change, environmental emissions, and sustainable development goals; the environmental and economic performance of DWMSs is getting attention. An integrated framework combining life cycle thinking and water quality assessment techniques was developed in this study to evaluate the DWMSs' performance in terms of water quality, environment, and economics. Six DWMSs were assessed using the integrated framework as a case study. The environmental impacts in terms of human health, ecosystem, and resource use ranged from 1.46E-06 to 4.01E-06 DALY, 9.35E-10 to 3.80E-09 species.yr, and 0.0025-0.0071 USD-$, respectively. Pollution water index (PWI) and cost-benefit analysis (CBA) were used as decision-making techniques to assess the overall performance and suitability of DWMSs under given settings. The DWMSs with surface water as a source or ones providing relatively more degree of treatment have a relatively high PWI score (i.e., ≈0.31), reflective of high environmental impacts and water pollution compared to other alternatives. The CBA scores of selected alternatives ranged between 0.22 and 1.0. Furthermore, it was identified that DWMSs applied on relatively bigger water distribution systems can outweigh their costs (i.e., environmental and economic impacts). The proposed framework and approaches are flexible as they can incorporate different criteria in evaluating the performance and applicability of DWMSs.


Mechanical and metabolic power in accelerated running-Part II: team sports.
This manuscript is devoted to discuss the interplay between velocity and acceleration in setting metabolic and mechanical power in team sports. To this aim, an essential step is to assess the individual Acceleration-Speed Profile (ASP) by appropriately analysing training sessions or matches. This allows one to estimate maximal mechanical and metabolic power, including that for running at constant speed, and hence to determine individual thresholds thereof. Several approaches are described and the results, as obtained from 38 official matches of one team (Italian Serie B, season 2020-2021), are reported and discussed. The number of events in which the external mechanical power exceeded 80% of that estimated from the subject's ASP ([Formula: see text]) was 1.61 times larger than the number of accelerations above 2.5 m s-2 ([Formula: see text]). The difference was largest for midfielders and smallest for attackers (2.30 and 1.36 times, respectively) due to (i) a higher starting velocity for midfielders and (ii) a higher external peak power for attackers in performing [Formula: see text]. From the energetic perspective, the duration and the corresponding metabolic power of high-demanding phases ([Formula: see text]) were essentially constant (6 s and 22 W kg-1, respectively) from the beginning to the end of the match, even if their number decreased from 28 in the first to 21 in the last 15-min period, as a consequence of the increased recovery time between [Formula: see text] from 26 s in the first to 37 s in the last 15-min period. These data underline the flaws of acceleration counting above fixed thresholds.


[Impact of physical activity on the autonomy and the quality of life of patients with spinal cord injury].
To assess the effect of regular physical activity on the autonomy and the quality of life of Tunisian patients with spinal cord injury. The study relates to 25 paraplegic divided into two groups: 10 paraplegic sportsmen and 15 sedentary paraplegics among whom we assess the degree of the autonomy with the Functional Independence Measure and the quality of life with the quality of life questionnaire SF36 in its Arabic version. The result analysis shows a significant difference of the total score of the Functional Independence Measure between the two groups, the sporting paraplegic having developed a better autonomy on the daily activities than the nonsporting paraplegics with a total average score of 115.10 against 93.87 (p<0.001). A significant difference is noted, mainly in the headings "personal care" and ',"mobility". Concerning the shutter "quality of life", the scores of various dimensions of scale SF36 were higher in the sporting paraplegic with significant difference in the headings bodily pain (p<0.01), vitality (p<0.04) and global physical score (p<0.008). This study enabled us to show that the regular physical activity as well had a positive effect on optimization of the functional capacities of paraplegic as on the improvement of its quality of life, thus, supporting a better socioprofessional reintegration.


The effect of short time periods of pre-operative warming in the prevention of peri-operative hypothermia.
The aim of our study was to evaluate the performance of different durations of active pre-operative skin-surface warming (pre-warming) to prevent peri-operative hypothermia and postoperative shivering. We randomly assigned 200 patients, scheduled for surgery of 30-90 min under general anaesthesia, to receive passive insulation or forced-air skin surface warming for 10, 20 or 30 min. Body temperature was measured at the tympanic membrane. Shivering was graded by visual inspection. There were significant differences in changes of core temperature between the non-pre-warmed group and all the pre-warmed groups (p < 0.00001), but none between the three pre-warmed groups (p = 0.54). Without pre-warming, 38/55 (69%) patients became hypothermic (< 36 °C) at the end of anaesthesia, whereas only 7/52 (13%), 3/43 (7%) and 3/50 (6%) patients following 10, 20 or 30 min pre-warming, respectively, became hypothermic (p < 0.001 vs no pre-warming). Shivering was observed in 10 patients without, and in three, three and one patients with pre-warming in the respective groups (p = 0.02). Pre-warming of patients for only 10 or 20 min before general anaesthesia mostly prevents hypothermia and reduces shivering.


Characteristics of landslide-debris flow accumulation in mountainous areas.
Landslide-debris flow is a sudden geological hazard in mountain areas, which is characterized with large scale, fast speed and wide impact range, and often causes disastrous accidents. In this study, an indoor sliding chute test was used to study the movement process of the landslide-debris flow and its accumulation pattern in the valley, taking into account the initiated gradient and particle size distribution. Besides, the model test was reproduced by PFC and the numerical models were constructed to fit the actual situation of landslide-debris flow. The results show that the collision of particles occurs during the movement of landslide-debris flow, and obvious sorting phenomena occur in the final deposit. Coarse particles distribute in the front and surface of the deposit while fine particles distribute in the back and bottom. The initiated angle has a certain effect on the morphology of the deposit: larger initiated angle makes the deposit closer to the opposite bank of the valley. Particle gradation has a significant impact on the form and distribution of deposit as well, with the increase of the proportion of coarse particles, the deposit of fine particles shrinks to the center of the rear edge, the profile of the deposit is more flat and uneven, the deposit is closer to the opposite bank of the valley, and the angle of the deposit profile increases significantly.


Cataract surgery in patients with history of uveitis.
Cataract surgery in patients with uveitis is not as simple as any senile cataract surgery. Recent evidence suggests that useful visual outcome can be achieved in most of the cases if they are handled meticulously. Key factors leading to improved visual outcome are absolute control of preoperative inflammation with diligent use of immunomodulatory drugs, meticulous surgery along with early detection and care of postoperative complications. Modern technologies in the intraocular lens designs and materials have contributed to the success. In this article, we review the literature on this subject with emphasis on the importance of the use of immunomodulatory drugs to control preoperative and postoperative intraocular inflammation and avoid complications.


Association between serum C-reactive protein and albumin levels and psychiatric comorbidities in liver transplant recipients.
Orthotopic liver transplantation (OLT) is the definitive treatment for patients with end-stage liver disease. Many post-OLT patients have psychiatric comorbidities. The relationship between psychiatric comorbidities and biological factors, such as C-reactive protein (CRP) and albumin levels, in OLT recipients has seldom been investigated. We analyzed medical charts of all patients aged over 18 who underwent orthotopic OLT at a tertiary medical center between September 2008 and July 2010 for serum CRP and albumin levels before and 1 month after OLT. Data for baseline characteristics, such as gender, age, and body mass index (BMI), were also collected. Patients who had a psychiatric consultation or took psychotropic medications during the hospitalization were categorized as "with psychiatric comorbidities." Psychiatric comorbidities existed in 51 (33.8%) of 151 OLT recipients. By analysis of covariance adjusted for age and BMI, post-OLT CRP levels in patients with psychiatric comorbidities were significantly higher than those without psychiatric comorbidities (P = .015). For patients with psychiatric comorbidities, the paired t test showed significantly increased CRP levels at 1 month after when compared to the pre-OLT baseline levels (P = .044). Patients without psychiatric comorbidities had significantly decreased CRP levels at 1 month after when compared with the pre-OLT baseline levels (P = .009). Elevated CRP levels may indicate activation of a systemic inflammatory process caused by psychiatric comorbidities in OLT recipients.


Spectrofluorimetric study of the interaction of copper(II) and bis-heterocyclictriazene reagent in the presence of beta-cyclodextrin.
A new reagent, 1,3-bis(2-benzothiazolyl-diazoamino)benzene (BBTAB), was first synthesized and characterized by elemental analysis, 1H NMR and IR spectra. The inclusion complex of BBTAB with beta-cyclodextrin (beta-CD) was formed. BBTAB in the inclusion complex or alone reacts with copper(II) to form chelate complex in a slight basic medium, which results in drastic or slight fluorescence enhancement, respectively. The spectrofluorimetric method of trace amount of copper(II) based on the enhancement of inclusion complex by binding with copper(II) was established. The excitation and emission wavelengths of the BBTAB/beta-CD/Cu system are 389 and 480 nm, respectively. Under optimal conditions, a linear response of BBTAB/beta-CD to copper(II) is obtained in the range of 3.0 x 10(-7) to 1.0 x 10(-5) mol L(-1), and the detection limit is determined to be 1.2 x10(-8) mol L(-1). The method is selective, sensitive and simple, and has been used for the determination of trace copper(II) in water samples with satisfactory results. The possible response mechanism of BBTAB/beta-CD or BBTAB to copper(II) and the role of beta-CD in the drastic enhancement of fluorescence of BBTAB/beta-CD/Cu system have been discussed.


Mupirocin-resistant Staphylococcus aureus after long-term treatment of patients with epidermolysis bullosa.
In a long-term, open study, 47 patients with epidermolysis bullosa were treated with topical 2% mupirocin (Bactroban) ointment to decrease bacterial infection and promote wound healing. This antibiotic is effective against gram-positive but not gram-negative organisms. No significant adverse effects were noted, although some patients have been treated for more than 4 years. We sought evidence in this patient population for the appearance of bacterial strains with decreased sensitivity to mupirocin. In five patients cultures from nonhealing wounds revealed Staphylococcus aureus resistance to mupirocin. Four of these patients were given oral antibiotics to which S. aureus was sensitive; they improved clinically, and cultures of their wounds became negative for pathogens.


Can increased expression of miR-Let-7c reduce the transition potential of high-grade urothelial carcinoma?
Bladder cancer is the leading transitional cell carcinoma affecting men and women with high morbidity and mortality rates, justifying the need to develop new molecular target therapies using microRNAs. This study aimed to evaluate the behavior of the T24 cell line after transfection with miR-Let-7c precursor mimic through invasion, migration, apoptosis, and cell cycle assays. METHODS AND RESULTS: T24 cell was transfected with the Let-7c mimic and its respective control and evaluated after 24 h. The expression levels of miR-Let-7c were analyzed by qPCR. We performed wound healing, Matrigel and flow cytometry, apoptosis, and cell cycle assays to determine its effect on cellular processes. Cells transfected with miR-Let-7c showed increased apoptosis rates (p = 0.019), decreased migration 24 h (p = 0.031) and 48 h (p = 0.0006), invasion potential (p = 0.0007), and cell proliferation (p = 0.002). Our results demonstrate that miR-Let-7c can act in different pathways of the carcinogenic cellular processes of muscle-invasive urothelial carcinoma cells, inhibiting cell proliferation and increasing apoptosis levels, consequently limiting their invasion potential. However, further studies should be carried out better to elucidate this microRNA's role in high-grade urothelial carcinomas and unveil which targets this microRNA may present, which are intrinsically related to the cancer survival pathways.


[Preventive intraoperative irrigation in wound management with Lavasept. Report of experiences with 1,610 cases].
During the years 1984-1989 in the Surgery department of the Bezirksspital Wattenwil all soft-tissue injuries, beside open articulations, were cleaned with the new antiseptic "Lavasept" in a prophylactic way during operation. We are documenting the astonishingly low incidence of infections as well as the good tolerance of the cleaning substance.


Gaseous emissions from wastewater facilities.
A review of the literature published in 2019 on topics relating to gaseous emissions from wastewater facilities is presented. This review is divided into the following sections: odorant emissions from Water Resource Recovery Facilities (WRRFs); greenhouse gas (GHG) emissions; gaseous emissions from wastewater collection systems; physiochemical odor/emissions control methods; biological odor/emissions control methods; odor/GHG characterization and monitoring; and odor impacts/risk assessments. © 2020 Water Environment Federation PRACTITIONER POINTS: Provide a quick reference list for readers who do not have time to go through the 2019 published articles. This prescreening of relevant literatures will save them time and effort. Utilities, engineers, and researchers can identify knowledge gaps, which help them to plan for future testing and R&D needs. Designers can make use of the lit review findings to support their design.


Surgical planning for a complex double-outlet right ventricle using 3D printing.
Rapid prototyping may be beneficial in properly selected cases of complex congenital heart disease, providing detailed anatomical understanding that helps to guide potential surgical and cardiac catheterization interventions. We present a case of double-outlet right ventricle, where the decision to obtain a three-dimensional printed model helped for better understanding of the anatomy, with the additional advantage of surgical simulation in planning the surgical approach and type of surgical repair.


[Eyelid necrosis after injection of lidocaine with epinephrine].
Four patients (two women aged 50 and 67 years, a 36-year-old man, and a 5-year-old child) presented with necrosis of the eyelid after local anesthesia using 2% lidocaine with epinephrine. In three cases, the anesthesia was administered prior to suturing an eyelid laceration, and the necrosis involved the upper lid; in one case, the anesthesia was administered prior to temporal artery biopsy. Surgical debridement of the necrotic tissue was performed in all cases. Three patients developed a bacterial superinfection treated with systemic antibiotics with good results. Necrosis of the eyelid is a rare complication occurring after local anesthesia using lidocaine with epinephrine. Most dermatologists refrain from use of epinephrine with local anesthetics for digital blocks. Necrosis is due to prolonged vasoconstriction of arteries. It is observed especially commonly in patients at increased risk (arteritis, Raynaud's phenomenon and severe microvascular diseases). In the eyelid, few cases have been reported.


Health effects of low-level irradiation during development: experimental design and prenatal and early neonatal mortality in beagles exposed to 60Co gamma rays.
As part of a long-term study of the effects of irradiation during development, prenatal and early neonatal mortality were evaluated for beagles exposed in utero at 8 days postcoitus (dpc), 28 dpc, 55 dpc, or 2 days postpartum. Mean doses used were 0,0.16, or 0.83 Gy. A decrease in whelping rates was observed for female breeders irradiated at 8 dpc. There was a significant decrease in litter sizes from female breeders irradiated at 8 and 28 dpc. Both of these findings are indicative of increased embryonic mortality. There was a significant decrease in the percentage of females born after exposures given at 28 dpc, indicating a differential radiosensitivity by sex. A significant increase in early neonatal mortality up to 14 days of age was observed for beagles exposed 8 or 28 dpc, again with an excess mortality in females.


Fractionation of Tomato Fruit Chromoplasts.
Chromoplast differentiation involves an active synthesis of carotenoids associated with the remodeling of the preexisting plastid membrane systems to form specialized structures involved in the sequestration and storage of the synthesized carotenoids. These subplastidial structures show remarkable morphological differences and seem to be adapted to the accumulation of particular carotenoids in some plant species and organs. At present, very little is known about chromoplast biogenesis and the role of the different suborganellar structures in the synthesis and storage of carotenoids. The combination of classical fractionation methods with the use of biochemical and -omics techniques represents an attractive approach to unravel novel aspects related with the biochemical and cellular mechanisms underlying the biogenesis of the structures involved in the biosynthesis and storage of carotenoids during chromoplast differentiation. Here we describe a combined protocol for the isolation, lysis and fractionation of tomato fruit chromoplast. The fractions obtained are suitable for metabolomics and proteomics analysis.