Effect of smoking habit on age-related changes in serum lipids: a cross-sectional and longitudinal analysis in a large Japanese cohort.
To observe the effect of smoking habit on age-related serum lipid levels, we examined a large cohort of Japanese cross-sectionally and longitudinally. The participants included 103,648 Japanese men and women 17-94 years of age, who had received annual health examinations from 1989 to 2003. In cross-sectional analysis, total and LDL cholesterol levels of smokers were lower than those of nonsmokers up to an elderly age in men and up to middle age in women. Smoking was associated with decreased HDL cholesterol levels up to the 65-74 years age group in men and 55-64 years in women. The triglyceride levels were higher in smokers in both genders than those of nonsmokers below 55-64 years. In the longitudinal analysis, although smoking was associated with lower total and LDL cholesterol up to 60 years of age in women, beyond the sixties an inverted association was observed. The associations of smoking with lower LDL cholesterol levels in men and lower HDL cholesterol in both genders were fairly consistent at any given age. The increase of triglyceride levels in female smokers remained rather constant between 25 and 75 years, whereas the increase in triglyceride levels in male smokers was greater with older ages up to middle age. These results suggest that the effect of smoking on the serum lipid levels is dependent on age and gender.


Hemoglobin Denver [alpha 2 beta 2(41) (C7) Phe-->Ser]: a low-O2-affinity variant associated with chronic cyanosis and anemia.
To report a previously undescribed low-O2-affinity hemoglobin variant that is associated with chronic cyanosis. Pertinent laboratory and historical data for the index case (from Denver, Colorado) and certain family members were recorded, and the hemoglobin variant was characterized. Electrophoresis, high-performance liquid chromatography (HPLC), and isoelectric focusing were used to examine blood specimens for the presence of hemoglobin variants, and the O2 affinity of whole blood was determined. The abnormal peptide detected on reverse-phase HPLC of separated globin chains was analyzed for its amino acid composition and sequence. Although no abnormal hemoglobin band separated from hemoglobin A on electrophoresis, HPLC, and isoelectric focusing, a heat test showed hemoglobin instability, and O2 affinity studies disclosed an appreciably right-shifted dissociation curve. On chromatography, the new variant--hemoglobin Denver--was found to be due to a substitution of serine for phenylalanine at position 41 (C7) in the beta chain. In addition to substantial reduction in O2 affinity, hemoglobin Denver is accompanied by moderate reticulocytosis and mild anemia. Hemoglobin Denver causes no clinical symptoms other than cyanosis, which is attributable to the low O2 affinity.


S-aryl cysteine S,S-dioxides as inhibitors of mammalian kynureninase.
A series of 2-amino-S-aryl cysteine S,S-dioxides have been synthesised and shown to inhibit kynureninase an important enzyme in the biosynthesis of the known excitotoxic moiety quinolinic acid. The most potent of these, 2-amino-5-methyl-S-phenyl cysteine S,S-dioxide 6d, inhibits interferon-gamma induced synthesis of quinolinic acid in human macrophages.


GABAergic neurons in the entorhinal cortex project to the hippocampus.
Among the entorhinal neurons that give rise to the perforant path, a small population is sparsely spinous and displays either a multipolar or a horizontal-bipolar dendritic tree. By application of post-embedding immunocytochemistry to neurons of these types with previously identified projections to the hippocampus we found immunoreactivity for gamma-aminobutyric acid (GABA). Thus, it appears that the perforant path not only contains an excitatory but also a small inhibitory component.


NMR resonance assignments for the class II GTP binding RNA aptamer in complex with GTP.
The structures of RNA-aptamer-ligand complexes solved in the last two decades were instrumental in realizing the amazing potential of RNA for forming complex tertiary structures and for molecular recognition of small molecules. For GTP as ligand the sequences and secondary structures for multiple families of aptamers were reported which differ widely in their structural complexity, ligand affinity and ligand functional groups involved in RNA-binding. However, for only one of these families the structure of the GTP-RNA complex was solved. In order to gain further insights into the variability of ligand recognition modes we are currently determining the structure of another GTP-aptamer--the so-called class II aptamer--bound to GTP using NMR-spectroscopy in solution. As a prerequisite for a full structure determination, we report here (1)H, (13)C, (15)N and partial (31)P-NMR resonance assignments for the class II GTP-aptamer bound to GTP.


Lipid-lowering effects of a modified butter-fat: a controlled intervention trial in healthy men.
To investigate the lipid-lowering potential of a butter-fat modified through manipulations in bovine feeding to increase the unsaturated:saturated fatty acid ratio. Double-blind, randomised, cross-over intervention trial. University of Auckland Human Nutrition Unit, New Zealand. Twenty healthy, male subjects. A residential trial in which all foods and beverages were provided during two intervention periods, comprising 3 weeks of high unsaturated 'modified' vs. 3 weeks of saturated 'control' butter feeding separated by a 4 week washout. Diets were of typical composition of 39 percentage energy (en%) fat (20 en% butter-fat), 48 en% CHO, 13 en% protein. There was a significant decrease in both total (P<0.05, -7.9%) and LDL-cholesterol (P<0.01, -9.5%) during modified butter feeding. There was no significant effect of treatment on a range of other risk factors including HDL-cholesterol, triglyceride, apolipoprotein A or B, nonesterified fatty acids (NEFA), haemostatic clotting factor VII and fibrinogen or glucose (P>0.05). Subjects were maintained in energy balance and there was no significant change in body weight during intervention. Butter-fat composition alone differed between treatments. A significant improvement in cardiovascular risk can be achieved by moderate changes in dietary fatty acid profile, achieved through a common and well accepted food source, butter-fat.


Single-stage embolization with n-butyl cyanoacrylate and surgical resection of venous malformations.
Sclerotherapy or surgical resection is options for symptomatic venous malformations (VM). Sclerotherapy may require repetitive intervention and resection is often avoided due to operative morbidity. The purpose of this study was to report use of single-stage n-butyl cyanoacrylate glue embolization and surgical resection of focal VM. A review of patients with focal VM who underwent glue embolization followed by resection at a single tertiary care vascular malformations center was performed. All embolizations were performed with ultrasound and fluoroscopy under the same anesthetic as resection. Patient characteristics and outcomes were evaluated. Fifteen procedures were performed in 12 patients with a total of 20 VM addressed, as several patients had multiple VM. Mean age was 16 ± 9 years. Malformation locations included scalp, hip, gluteal, labial, toe, finger, face, lip, chest, and foot and size ranged from 1.0 to 10.5 cm. Median (range) of prior sclerotherapy treatments was 3 (0-5) and three patients previously underwent surgical resection. Median blood loss was zero (0-10) mL. Surgical complications occurred after five procedures (33%) including superficial wound dehiscence and cellulitis. No complications required readmission or reoperation. At a median follow up of 195 (103-266) days, no patients have required additional treatment. Glue embolization and resection of focal VM of variable size and location appears to have durable results and low surgical morbidity. This single-stage procedure, often performed as an outpatient, may be utilized as upfront treatment for symptomatic malformations or for VM refractory to other treatments.


[The lateral splitting of the knee joint capsule for treatment of chondropathia patellae (author's transl)].
This is a report on the results of the lateral splitting of the knee-joint capsule for treatment of chondropathia patellae. The operative procedure is described. Pains relative to the patella syndrome, chondropathia patellae, forms of dysplasia of the patella and lateral dislocation of the patella are regarded as indications. 50 knee-joints were post-examined. 26% were without complaints, 54% showed improvement, 10% no change, 10% deteriorated. These results are comparable to those of other, more intensive surgery. Representing a comparatively minor operation, the lateral splitting of the capsule is therefore particularly recommended for young patients.


Synthetic operon for (R,R)-2,3-butanediol production in Bacillus subtilis and Escherichia coli.
To reduce dependence on petroleum, an alternative route to production of the chemical feedstock 2,3-butanediol (2,3-BD) from renewable lignocellulosic sources is desirable. In this communication, the genes encoding the pathway from pyruvate to 2,3-BD (alsS, alsD, and bdhA encoding acetolactate synthase, acetolactate decarboxylase, and butanediol dehydrogenase, respectively) from Bacillus subtilis were engineered into a single tricistronic operon under control of the isopropyl β-D-1-thiogalactopyranoside (IPTG)-inducible Pspac promoter in a shuttle plasmid capable of replication and expression in either B. subtilis or Escherichia coli. We describe the construction and performance of a shuttle plasmid carrying the IPTG-inducible synthetic operon alsSDbdhA coding for 2,3-BD pathway capable of (i) expression in two important representative model microorganisms, the gram-positive B. subtilis and the gram-negative E. coli; (ii) increasing 2,3-BD production in B. subtilis; and (iii) successfully introducing the B. subtilis 2,3-BD pathway into E. coli. The synthetic alsSDbdhA operon constructed using B. subtilis native genes not only increased the 2,3-BD production in its native host but also efficiently expressed the pathway in the heterologous organism E. coli. Construction of an efficient shuttle plasmid will allow investigation of 2,3-BD production performance in related organisms with industrial potential for production of bio-based chemicals.


Conservation of hydrogenase and polyferredoxin structures in the hyperthermophilic archaebacterium Methanothermus fervidus.
A 3.3-kilobase-pair region of the Methanothermus fervidus genome encoding part of the small subunit and all of the large subunit of the methyl viologen-reducing hydrogenase and a polyferredoxin was cloned and sequenced. The sequence of this hyperthermophilic hydrogenase conforms to the consensus sequence established for procaryotic [NiFe] hydrogenases. Although the M. fervidus polyferredoxin is the same size as the Methanobacterium thermoautotrophicum ferredoxin, containing six tandemly arranged bacterial ferredoxinlike domains, these two proteins are predicted to be only 64% identical in their primary sequences.


Increased platelet sensitivity to ristocetin is predicted by the binding characteristics of a GPIb/IX determinant.
Platelets from patients with platelet-type von Willebrand disease (vWD) were used as immunogens for the production of murine monoclonal antibodies (MoAbs). One such MoAb, C-34, inhibited ristocetin-induced aggregation of patient or normal platelets, but not aggregation induced by other aggregating agents. As demonstrated by crossed-immunoelectrophoresis, C-34 recognized an epitope within the GPIb/IX complex. In indirect immunofluorescence studies on fresh platelets, the ratio of any of four different anti-GPIb MoAbs to one another was near unity (0.88-1.14) both for normals and for patients. In contrast, the ratio of the binding of C-34 to such a MoAb (AP-1) was 0.31 +/- 0.02 (means +/- SE) for normal platelets and significantly increased to 0.54 +/- 0.01 for patient platelets (P less than 0.001). In NP-40 lysates of 3H-labelled platelets, saturating concentrations of C-34 produced much fainter bands than did AS-2 or other anti-GPIb MoAbs in the GPIb and GPIX regions. In contrast to the other anti-GPIb MoAbs, C-34 did not bind to the purified 125I-labelled glycocalicin fragment of GPIb, to the glycocalicin derivative identified by crossed-immunoelectrophoresis, or to the amino-terminal approximately 40 kDa portion of GPIb alpha cleaved from 3H-labelled platelets by trypsin. C-34 appears to be the first MoAb that is quantitatively informative in identifying the abnormal platelets in platelet-type vWD. The observed differences between the patient and normal platelets may reflect an abnormality in the primary structure of the GPIb/IX complex. Alternatively, patient platelets may have an abnormality of other structures near this region that impose less of a steric hindrance upon binding of antibody to the C-34 epitope.


The effect of problem-based learning with cooperative-learning strategies in surgery clerkships.
Cooperative learning is used often as part of the problem-based learning (PBL) process. But PBL does not demand that students work together until all individuals master the material or share the rewards for their work together. A cooperative learning and assessment structure was introduced in a PBL course in 10-week surgery clerkship, and the difference was evaluated between this method and conventional PBL in an acute abdominal pain module. An experimental design was used. No significant differences in achievement were found between the study and control group. Both the study and control group students who scored low on the pretest made the greatest gains at the end of the education. Students in the cooperative learning group felt that cooperation helped them learn, it was fun to study and expressed satisfaction, but they complained about the amount of time the groups had to work together, difficulties of group work, and noise during the sessions. This study evaluated the impact of a cooperative learning technique (student team learning [STL]) in PBL and found no differences. The study confirms that a relationship exists between allocated study time and achievement, and student's satisfaction about using this technique.


Monoclonal antibody classification based on epitope-binding using differential antigen disruption.
Currently, classifying a population of specific antigen-reactive monoclonal antibodies (mAbs) according to their epitope-binding properties has been limited to competition assays. Such assays are time consuming, labor intensive and restricted to the number of mAbs in the experiment. To overcome this problem, a differential antigen disruption-based antibody profiling procedure was developed. This procedure rapidly classifies specific antigen-reactive mAbs into epitope-related groups by measuring the binding signal of the antibodies to a set of structurally disrupted antigens and then clustering the antibodies according to the similarity of their binding profiles. The clustering results generated by differential antigen disruption showed a significant concordance with those generated by competition experiments. Therefore, differential antigen disruption method opens an opportunity to assess the entire population of antigen-reactive mAbs according to their epitope-binding properties. In doing so, a set of representative antibodies can be drawn to describe the epitope complexity for systematically exploring their functions.


Renal prostaglandin E2 and the renin-angiotensin system in hypertensive disorders in man.
We studied renal vein concentrations of prostaglandin E2 (PGE2) and activity of the renin-angiotensin system in 9 normotensive young men (NT), 17 hypertensive patients with unilateral renal artery stenosis (URS), and 26 patients with essential hypertension (EH) of whom 12 had low renin essential hypertension (LRH). The PGE2 concentration, plasma renin activity (PRA), and angiotensin II (A II) were measured in the inferior vena cava and were compared with the mean concentration for both renal veins under basal conditions and without pharmacological interference. The renal vein PGE2 concentrations were higher in NT (p less than 0.01) and URS (p less than 0.05) than in LRH. However, there were no significant differences in A II concentrations between the groups, nor were there any correlations to PGE2 concentrations. The positive correlation between PRA and PGE2 (r = 0.29, p less than 0.02) indicates that PGE2 may contribute to the activation of the renin-angiotensin system or that there may be a common mechanism for stimulation of both hormonal systems. Our results are not compatible with the hypothesis that a reduction of PGE2 production is a specific feature of patients with EH.


Tracheal Inflammatory Myofibroblastic Tumour ALK+ as Cause of Dyspnea in a 10 Years Old Child.
Inflammatory myofibroblastic tumours are rare lesions that could occur in airways. We report a 10 years old male who complains about dyspnea after physical exercise. Making CT and RMI images and a biopsy, we make an accurate diagnosis of an inflammatory myofibroblastic tumour ALK+. After treatment with a subtotal resection and crizotinib as adjuvant, we achieve a complete remission. The online version contains supplementary material available at 10.1007/s12070-023-03775-5.


Comparative properties of purified cytochrome P-448 from beta-naphthoflavone treated rats and rainbow trout.
1. Cytochrome P-448 from beta-naphthoflavone treated rainbow trout (Salmo gairdnerii) liver was purified and compared to purified P-448 from beta-naphthoflavone treated rats (Rattus rattus) and purified P-450 from phenobarbital induced rats. 2. The two P-448 forms had similar spectral properties, substrate specificity, sensitivity to inhibitors and regioselectivity in the metabolism of benzo(a)pyrene and testosterone. 3. Rat and trout P-448 differed in apparent monomeric mol. wt (Mr) by at least 2000 daltons, and did not share identical antigenic determinants. Both rat and trout P-448 were shown to be quite different from rat P-450 using all of the above criteria for distinguishing multiple forms.


Corrigendum: Toward a possible trauma subtype of functional neurological disorder: impact on symptom severity and physical health.
[This corrects the article DOI: 10.3389/fpsyt.2022.1040911.].


Associations among two vitamin D receptor (VDR) gene polymorphisms (ApaI and TaqI) in acne vulgaris: A pilot susceptibility study.
Acne vulgaris (AV) pathogenesis is multifactorial. Vitamin D (VitD) plays an important role in sebocytes' differentiation and function. Most VitD functions are mediated by the nuclear VitD receptor (VDR) following binding of its biologically active form (1,25 dihydroxyvitamin D3). Genetic variations in VDR gene may cause significant receptor dysfunction and have been found to be associated with many inflammatory skin diseases. Two adjacent single nucleotide polymorphisms of VDR, ApaI (rs7975232) and TaqI (rs731236), were commonly studied. To evaluate the association between VDR ApaI and TaqI gene polymorphism and AV. This case control study included 30 Egyptian acne patients who attended Dermatology Outpatient Clinic of Al-Zahraa University and Misr University for Science and Technology Hospitals. Thirty age- and sex-matched healthy individuals participated as controls. VDR gene ApaI and TaqI polymorphisms were examined by polymerase chain reaction restriction fragment length polymorphism. Serum 25(OH)D was measured in all participants. Patients had significant decrease in ApaI A allele and AATT combined genotype (60%, 3.3%) than controls (78.3%, 20%), respectively, and significant increase in TaqI tt genotype and t allele (46.7%, 63.3%) than controls (13.3%, 41.7%), respectively. Patients showed significantly lower serum 25(OH)D3 concentration than controls. Polymorphisms of ApaI and TaqI may have a role in the pathogenesis of AV as A allele and AATT combined genotype could be considered protective against acne development and tt genotype and t allele may increase the risk of AV development. VitD deficiency can be considered as a risk factor for AV development.


[Interest of selective progesterone receptor modulators in endometriosis].
The SPRM (selective progesterone receptor modulators) are agonists and/or antagonists of progesterone receptor. They are responsible for anovulation, amenorrhea and a lower prostaglandin levels, which leads to an improvement in pain and regression of lesions in endometriosis. On the endometrium, a particular aspect, the progesterone receptor modulator-associated endometrial changes (PAEC), raises additional studies to verify its harmlessness. However, due to the lack of hypoestrogenism and metabolic effects with these drugs, it is very likely that the SPRM will in the near future an important place in the treatment of endometriosis.


Selenium and mercury in the hair of raccoons (Procyon lotor) and European wildcats (Felis s. silvestris) from Germany and Luxembourg.
This study examined the concentration of total mercury (THg) and selenium (Se), as well as the molar ratio of Se:THg in hair samples of terrestrial animals. THg and Se concentrations were measured from the hair of raccoons (Procyon lotor) and European wildcats (Felis s. silvestris) from Germany and Luxembourg. Median THg concentrations in hair from raccoons and wildcats were 0.369 and 0.273 mg kg-1 dry weight (dw), respectively. Se concentrations were higher in the hair of raccoons than of wildcats (0.851 and 0.641 mg kg-1 dw, respectively). Total mercury concentration in hair of raccoons from Luxembourg was almost 5× higher that found in hair of raccoons from Germany; however, Se concentration was similar. Thus, molar ratio of Se:THg was ~4× higher in the hair of raccoons from Germany than those from Luxembourg. Significant negative correlation was found between THg concentration and Se:THg molar ratio in both wildcats and raccoons.


The genetics of bipolar disorder: genome 'hot regions,' genes, new potential candidates and future directions.
Bipolar disorder (BP) is a complex disorder caused by a number of liability genes interacting with the environment. In recent years, a large number of linkage and association studies have been conducted producing an extremely large number of findings often not replicated or partially replicated. Further, results from linkage and association studies are not always easily comparable. Unfortunately, at present a comprehensive coverage of available evidence is still lacking. In the present paper, we summarized results obtained from both linkage and association studies in BP. Further, we indicated new potential interesting genes, located in genome 'hot regions' for BP and being expressed in the brain. We reviewed published studies on the subject till December 2007. We precisely localized regions where positive linkage has been found, by the NCBI Map viewer (http://www.ncbi.nlm.nih.gov/mapview/); further, we identified genes located in interesting areas and expressed in the brain, by the Entrez gene, Unigene databases (http://www.ncbi.nlm.nih.gov/entrez/) and Human Protein Reference Database (http://www.hprd.org); these genes could be of interest in future investigations. The review of association studies gave interesting results, as a number of genes seem to be definitively involved in BP, such as SLC6A4, TPH2, DRD4, SLC6A3, DAOA, DTNBP1, NRG1, DISC1 and BDNF. A number of promising genes, which received independent confirmations, and genes that have to be further investigated in BP, have been also systematically listed. In conclusion, the combination of linkage and association approaches provided a number of liability genes. Nevertheless, other approaches are required to disentangle conflicting findings, such as gene interaction analyses, interaction with psychosocial and environmental factors and, finally, endophenotype investigations.


Immunohistochemical Identification of Interneuronal Subpopulations in the Basolateral Amygdala of the Rhesus Monkey (Macaca mulatta).
Inhibitory circuits in the basolateral nuclear complex of the amygdala (BNC) critical for controlling the acquisition, expression, and extinction of emotional responses are mediated by GABAergic interneurons (INs). Studies in rodents have demonstrated that separate IN subpopulations, identified by their expression of calcium-binding proteins and neuropeptides, play discrete roles in the intrinsic circuitry of the BNC. Far less is known about IN subpopulations in primates. In order to fill in this gap in our understanding of primate INs, the present investigation used dual-labeling immunohistochemistry for IN markers to identify subpopulations expressing cholecystokinin (CCK), calbindin (CB), calretinin (CR), and somatostatin (SOM) in somata and axon terminals in the monkey BNC. In general, colocalization patterns seen in somata and axon terminals were similar. It was found that there was virtually no colocalization of CB and CR, the two calcium-binding proteins investigated. Three subtypes of CCK-immunoreactive (CCK+) INs were identified on the basis of their expression of CR or CB: (1) CCK+/CR+; (2) CCK+/CB+); and (3) CCK+/CR-/CB-. Almost no colocalization of CCK with SOM was observed, but there was extensive colocalization of SOM and CB. CCK+, CR+, and CCK+/CR+ double-labeled axon terminals were seen surrounding pyramidal cell somata in basket-like plexuses, as well as in the neuropil. CB+, SOM+, and CB+/SOM+ terminals did not form baskets, suggesting that these IN subpopulations are mainly dendrite-targeting neurons. In general, the IN subpopulations in the monkey are not dissimilar to those seen in rodents but, unlike rodents, CB+ INs in the monkey are not basket cells.


Palmitate differentially regulates the polarization of differentiating and differentiated macrophages.
The tissue accumulation of M1 macrophages in patients with metabolic diseases such as obesity and type 2 diabetes mellitus has been well-documented. Interestingly, it is an accumulation of M2 macrophages that is observed in the adipose, liver and lung tissues, as well as in the circulation, of patients who have had major traumas such as a burn injury or sepsis; however, the trigger for the M2 polarization observed in these patients has not yet been identified. In the current study, we explored the effects of chronic palmitate and high glucose treatment on macrophage differentiation and function in murine bone-marrow-derived macrophages. We found that chronic treatment with palmitate decreased phagocytosis and HLA-DR expression in addition to inhibiting the production of pro-inflammatory cytokines. Chronic palmitate treatment of bone marrows also led to M2 polarization, which correlated with the activation of the peroxisome proliferator-activated receptor-γ signalling pathway. Furthermore, we found that chronic palmitate treatment increased the expression of multiple endoplasmic reticulum (ER) stress markers, including binding immunoglobulin protein. Preconditioning with the universal ER stress inhibitor 4-phenylbutyrate attenuated ER stress signalling and neutralized the effect of palmitate, inducing a pro-inflammatory phenotype. We confirmed these results in differentiating human macrophages, showing an anti-inflammatory response to chronic palmitate exposure. Though alone it did not promote M2 polarization, hyperglycaemia exacerbated the effects of palmitate. These findings suggest that the dominant accumulation of M2 in adipose tissue and liver in patients with critical illness may be a result of hyperlipidaemia and hyperglycaemia, both components of the hypermetabolism observed in critically ill patients.


Specific left ventricular twist-untwist mechanics during exercise in children.
In adults, left ventricular (LV) systolic twist is an important factor that determines LV filling, both at rest and during exercise. In children, lower LV twist has been demonstrated at rest, but its adaptation during exercise and its functional consequences on LV filling are unknown. Using speckle-tracking echocardiography, LV twist-untwist mechanics were studied in 25 children (aged 10-12 years) and 20 young adults (aged 18-44 years) at rest and during three exercise workloads performed at 20%, 30%, and 40% of their maximal aerobic power. At rest, LV twist was lower in children, because of a higher temporal dispersion of peak rotation between base and apex. During exercise, the increase of basal rotation was blunted in children compared with adults (-6.7 ± 2.7° vs -9.0 ± 2.0° at 40% of maximal aerobic power, P < .05). Consequently, LV twist increased to a lesser extent (13.0 ± 5.0° vs 15.8 ± 4.5° at 40% of maximal aerobic power, P < .05). The increase in LV untwisting rates during exercise was also lower in children, leading to a lower percentage of untwisting during early diastole (8 ± 8% vs 29 ± 20% at 40% of maximal aerobic power, P < .001). Consequently, during early diastole, the normal timing of diastolic events observed in young adults, with untwist occurring before radial displacement, was blunted in children. Nevertheless, children exhibited normal LV filling due to higher diastolic radial and longitudinal strain rates. Twist-untwist mechanics may evolve with advancing age. In children, early diastolic LV untwisting appears to be less important than in adults. Their better LV intrinsic myocardial relaxation may ensure adequate LV filling during exercise without dependence on the additional effect of suction resulting from LV energy recoil.


Effect of linear charge density of polysaccharides on interactions with α-amylase: Self-Assembling behavior and application in enzyme immobilization.
The co-existence of polysaccharides and enzymes in the food matrix could form complexes that directly influence the catalytic efficacy of enzymes. This work investigated the self-assembly behaviors of α-amylase and charged polysaccharides and fabricated the α-amylase/polysaccharides complex coacervates. The results showed that the linear charge density of polysaccharides had a critical impact on the complex formation, structure, and enzyme protection under acidic conditions. At low pH, α-amylase formed compact and tight coacervates with the λ-carrageenan. However, α-amylase/pectin coacervates dissociated when the pH was lower than 3.0. The optimized binding ratio of α-amylase/λ-carrageenan was 12:1, and α-amylase/pectin was 4:1. Finally, the α-amylase/λ-carrageenan complex coacervates effectively immobilized the enzyme and almost 70% of enzyme activity remained in coacervates after exposure to pH3.0 for 1 h. This study demonstrates that the change in the linear charge density of polysaccharides could regulate the enzyme-catalyzed process in food processing by a simple and fine-controlled method.


Glyoxalase II promotes "in vitro" S-glutathionylation.
S-glutathionylation involves the reversible formation of a mix disulphide-bridge between specific cysteine and a molecule of glutathione, the major non-protein antioxidant compound in the cell. Mechanisms of protein S-glutathionylation are far to be completely understood and several reactions can promote it, either spontaneously or catalyzed. For the first time Glo II enzyme was studied as a new potential candidate to promote S-glutathionylation. To demonstrate its active involvement in protein glutathionylation were used actin, malate dehydrogenase and GAPDH purified proteins, which are known to be glutathionylated, for in vitro experiments..This work shows active involvement of cytosolic Glo II for in vitro protein S-glutathionylation. To confirm the role of Glo II, preliminary protein-protein docking studies was performed between Glo II and human actin. The data showed a high propensity to aggregate with other proteins through its catalytic site Further, in silico investigation of Glo II stability and behavior, conducted through full atom molecular dynamics simulations, showed an high folding stability together with a great affinity towards its own reaction product glutathione both protonated (GSH) and unprotonated (GS(-)). These studies, revealed that GloII, using its natural substrate SLG, allow a rapid and specific protein-SSG formation, leading enzymatic regulation of S-glutathionylation in proteins of different origin and cellular compartmentalization.


Altered glycan structures: the molecular basis of congenital disorders of glycosylation.
Congenital disorders of glycosylation (CDG) are a group of diseases that affect glycoprotein biogenesis. Eighteen different types of CDG have been defined genetically. They result from deficiencies in either the biosynthesis of oligosaccharide precursors or specific steps of N-glycan assembly, resulting in the absence or structural alteration of N-glycan chains. These diseases have a broad range of clinical phenotypes and affect nearly every organ system, with special emphasis on normal brain development and the multiple functions of the nervous, hepatic, gastrointestinal and immune systems. Although most of the deficiencies observed in CDG patients are only partial, the severity of the clinical manifestations signifies the relevance of protein N-glycosylation and shows the importance of defined glycan structures.


Factors affecting the outcome of foreskin reconstruction in hypospadias surgery.
Despite ongoing refinement of numerous techniques, the incidence of complications following hypospadias repair is still significant. The aim of this study is to evaluate the factors that affect the success in childhood of foreskin reconstruction with hypospadias repair. A retrospective study was carried out of all primary hypospadias repairs with foreskin reconstruction (n=408) over the last 23 years. The hypospadias was coronal in 160 (39%), glanular in 114 (28%), subcoronal in 78 (19%) and distal penile in 56 (14%) cases. Foreskin reconstruction was included in 362 cases suitable for a meatal advancement (191) or distal urethral tubularization (171), and 46 cases for a flip-flap procedure (37 Mathieu, nine Barcat). Outcome analysis was of foreskin-related complications post surgery. Foreskin repair was successful in 333 cases (92%) that underwent meatal advancement/distal urethral tubularization, and 33 (72%) that underwent a flip-flap operation. Complications related to the foreskin occurred in 10% of the whole group with a urethral fistula rate of 8%. The median age at surgery was 13 months (2-120 months), and the median follow-up period was 11 months (1-100 months). A good cosmetic and functional outcome can be achieved with foreskin reconstruction combined with a variety of hypospadias repairs. The outcome in this series was better in cases of distal hypospadias using interrupted polyglactin sutures.


Depressive symptoms and diabetes control in African Americans.
This study of African Americans with diabetes investigated: (1) the relationship between depressive symptoms and glycemic control; (2) the relationship between depressive symptoms and long-term diabetes complications; (3) the relationship between depressive symptoms and medication usage; and (4) the effects of demographic and diabetes variables on these relationships. One-hundred twenty five African American diabetic adults who were attending health fairs reported demographic and medical history and provided blood samples for A1c assessment of glycemic control. They also completed the Centers for Epidemiological Studies Depression questionnaire, and the Diabetes Self-Care Inventory. After controlling for confounders, higher depressive symptoms were associated with higher A1c, more long-term diabetes complications, and more diabetes medications. Diabetes self-care did not fully account for these relationships. The relationship between depression and poor diabetes control exists in African Americans as it does in Whites. Providers are encouraged to attend to depression in their African American patients with diabetes.


Marital structure of the Italian community of Boston, Massachusetts, 1880-1920.
The marital structure of Italians living in Boston, Massachusetts, in the period 1880-1920 was studied in order to explore the integration process in the urban context. The study analyses endogamy and inbreeding, using data on 15,579 marriages from the parish books of the three Italian parishes of Boston. Endogamic rates are very high and increased in time, ranging from 93.9% to 97.3%. This correlated with the growth of the Italian community and the decline of the biased sex ratio. One parish, Our Lady of Pompeii in the South End, displays lower endogamic rates because of the reduced and scattered population attending it. The rate of consanguineous (2.33%) and isonymous (6.38%) marriages, and the coefficients of inbreeding, alpha (0.98 x 10(-3)) and Ft (0.0159), are similar to those of north Italian populations, and lower than those for south and insular Italy. The parish of Our Lady of Pompeii shows consistently higher values than the other two parishes. Marriages between first and second cousins are the main cause of the above values in each parish. Consanguineous marriages and inbreeding increased over time, from the 1890s, and this is in general agreement, although slightly delayed, with the Italian trend.


Partial laryngectomy in glottic cancer: complications and oncological results.
Most patients with laryngeal carcinoma present tumors in the glottis that can be treated by different treatment modalities. Some authors consider open partial laryngectomy as obsolete, while others still deem this as a viable and cost-efficient option. To compare the oncological and functional results of a series of patients undergoing partial laryngectomy vs. external radiotherapy for the treatment of glottic cancer. Historical cohort study with a series of glottic carcinoma patients undergoing partial laryngectomy or external radiotherapy during a period of ten years. Sixty-two patients with glottic carcinoma were included. Group A comprised those submitted to partial laryngectomy (n=30), and Group B, those who underwent radiotherapy (n=32). They were homogeneous in the comparison of mean age, 56.4 vs. 60.4 years (p=0.12) and distribution in pathological stage (p=0.91). With regard to oncological outcome, there were no differences in distant metastasis rates, or second primary tumor between groups (p=1.0), as well as in disease-free time, laryngeal rescue-free time, and overall five-year survival. Severe complication rates were also similar between groups. Open partial laryngectomy had complication rates and oncological results similar to those of radiotherapy for patients with glottic carcinomas and should still be considered among the main available therapeutic options.


Incidental Findings in Computed Tomography Examination of the Head in Rabbits and Guinea Pigs.
(1) Background: Rabbits and guinea pigs are popular pet animals and often undergo computed tomography (CT) examination for assessment of pathologies of the head. The goal of the study was to review CT examinations of the heads of rabbits and guinea pigs to identify and classify incidental findings. (2) Methods: 60 CT studies of the heads of rabbits and 65 of guinea pigs presented at 2 Institutions were reviewed and the indications for the study recorded. (3) Results: The presence of CT findings not directly related to the reason for the CT examination was present in 40/60 (66.7%) studies of rabbits and in 42/65 (64.4%) studies of guinea pigs. Most commonly, the incidental findings involved the ears, in 24/60 studies in rabbits and in 29/65 studies in guinea pigs. Incidental findings involved the nasal cavities, respectively, in 9 and 7 rabbits and guinea pigs. Soft tissue mineralization was present in 11 rabbits and 17 guinea pigs. (4) Conclusions: Based on the present study, incidental findings detected on CT studies are often present in rabbits and guinea pigs. Veterinarians should be aware of the possible clinical impact of these findings.


Species-related variations in lipoprotein metabolism: the impact of FER(HDL) on susceptibility to atherogenesis.
Several animal models have been used to investigate the mechanisms of atherogenesis. Each animal species has advantages and disadvantages with regard to similarity with human lipoprotein metabolism. In humans, fractional esterification rate in apolipoprotein B-depleted plasma (FER(HDL)) has been shown to correlate with the quality of high density lipoprotein particles. Increased values of FER(HDL) indicate an atherogenic lipoprotein profile. Such an association has not been defined in animal models. Thus, we have characterized plasma lipoprotein profile and FER(HDL) values in four animal species namely, cats, pigs, guinea pigs and rabbits. These animal species have been used in experimental dyslipidemia and atherosclerosis. Our data indicate a wide rage of variations among various animal species. High-density lipoprotein (HDL) particles contain approximately 40% of total plasma cholesterol concentrations in rabbits, pigs and cats <10% in guinea pigs. A negative association between FER(HDL) values and plasma HDL-cholesterol levels was observed in pigs, rabbits and guinea pigs. On the other hand, FER(HDL) values showed a positive association with plasma triglyceride levels in all animal species tested. These findings are in agreement with data reported in humans. More research is needed to identify the better animal models which closely resemble human lipoprotein metabolism.


Psychrophilic anaerobic dynamic membrane bioreactor for domestic wastewater treatment: Effects of organic loading and sludge recycling.
Two upflow anaerobic dynamic membrane bioreactors (AnDMBRs) with and without sludge recycling were operated in parallel at varied organic loadings and psychrophilic temperature for domestic wastewater treatment. A 75 μm nylon mesh, used as a supporting material, enabled quick and stable dynamic membrane formation. The AnDMBRs could operate continuously without relaxation at a high flux rate of 22.5 L/m2h; however, high organic loading accelerated the increasing rate of trans-membrane pressure (TMP). High chemical oxygen demand removal was achieved in both AnDMBRs with removal efficiencies of 70-90%. Sludge recycling enhanced the cross-flow velocity but negatively affected the effluent turbidity, sludge properties (particle size reduction and biopolymer release) and dynamic membrane filterability. Although increased organic loading enhanced biogas yield, the low biogas production was related to the dissolved methane loss in the effluent. Easy-operation, minimal maintenance and low-energy consumption makes the AnDMBR process cost-effective for practical wastewater treatment in temperate areas.


Improving quantitative synthesis to achieve generality in ecology.
Synthesis of primary ecological data is often assumed to achieve a notion of 'generality', through the quantification of overall effect sizes and consistency among studies, and has become a dominant research approach in ecology. Unfortunately, ecologists rarely define either the generality of their findings, their estimand (the target of estimation) or the population of interest. Given that generality is fundamental to science, and the urgent need for scientific understanding to curb global scale ecological breakdown, loose usage of the term 'generality' is problematic. In other disciplines, generality is defined as comprising both generalizability-extending an inference about an estimand from the sample to the population-and transferability-the validity of estimand predictions in a different sampling unit or population. We review current practice in ecological synthesis and demonstrate that, when researchers fail to define the assumptions underpinning generalizations and transfers of effect sizes, generality often misses its target. We provide guidance for communicating nuanced inferences and maximizing the impact of syntheses both within and beyond academia. We propose pathways to generality applicable to ecological syntheses, including the development of quantitative and qualitative criteria with which to license the transfer of estimands from both primary and synthetic studies.


Development of atherosclerosis in the diabetic BALB/c mice. Prevention with Vitamin E administration.
The aim of the present study was to determine in the BALB/c mice, a model of development of atherosclerosis when both hyperglycemia and hypercholesterolemia are present, whether the atherogenic effects of these parameters could be decreased with the administration of Vitamin E. BALB/c mice were made diabetic and divided in three groups: one fed the standard rodent chow diet (D); the other two fed an atherogenic diet (D+A); one of them supplemented with Vitamin E (D+A+E). Two groups of non diabetic animals were also performed, one fed the standard diet (C) and the other the atherogenic diet (C+A). After 16 weeks of treatment all the control animals survived, in contrast, a mortality rate of 12, 70 and 37% was observed, respectively, in the D, D+A and D+A+E groups. Neither fatty deposits nor macrophages were observed in the arterial wall of the animals fed the standard diet (D and C animals). In contrast, this finding was observed in 25% of the C+A, 71% of the D+A and 33% of the D+A+E. In conclusion, diabetic mice fed an atherogenic diet showed in the aorta a higher number of fatty deposits and macrophages than the control animals. These effects were partially reversed with the administration of Vitamin E, supporting in this model the role of oxidative stress in the development of atherosclerosis.


Lower levels of trust in one's physician is associated with more distress over time in more anxiously attached individuals with cancer.
In the present study, we investigated individual differences in the outcome of patient-physician trust when confronted with cancer from an attachment theoretical perspective. We expected that lower levels of trust are associated with more emotional distress and more physical limitations within the first 15 months after diagnosis, especially in those who score relatively high on attachment anxiety. No such association was expected for more avoidantly attached individuals. A group of 119 patients with different types of cancer (breast, cervical, intestinal and prostate) completed questionnaires concerning trust (short version of the Wake Forest Physician Trust Scale) and attachment (Experiences in Close Relationship scale Revised) at 3 months after diagnosis. Emotional distress (Hospital Anxiety and Depression Scale) and physical limitations (physical functioning subscales of the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire-C30) were assessed at 3, 9 and 15 months after diagnosis. To test the hypotheses, multiple hierarchical regression analyses were performed. Lower levels of trust were associated with more emotional distress and more physical limitations at 3, 9 and 15 months after diagnosis in more anxiously attached patients, but not in less anxiously attached patients. These results indicate an attachment-dependent effect of trust in one's physician. Explanations and clinical implications are discussed.


Physical Activity Behaviour in People with COPD Residing in Spain: A Cross-Sectional Analysis.
Chronic obstructive pulmonary disease (COPD) represents a major public health problem due to its high prevalence, morbidity and health cost. It has been demonstrated that physical activity (PA) is one of the most beneficial measures to prevent chronic diseases. The aim of this study was to examine PA levels of adults with COPD residing in Spain, and to analyse the differences by sex, age, education, marital status, cohabiting, tobacco consumption, alcohol consumption and body mass index. A total of 615 adults aged 15 to 69 years participated in this study. Data from the Spanish National Health Survey 2017 were used. This survey included the short version of IPAQ to measure PA levels. PA was expressed in total volume (MET·min/week), classified as low, moderate and high, and analysed according to sample characteristics. Statistical significance was set at p < 0.05 (CI = 95%). Level of PA was higher in men than in women (1808.8 vs. 1575.6 MET·min/week; p = 0.016), in those aged under 30 years than in those older than 60 years (2129.4 vs. 1381.4 MET·min/week; p = 0.047) and in those who drank alcohol than in those who did not drink (1912.8 vs. 1248.2 MET·min/week; p = 0.004). Also, underweight and obese participants participated in lower levels of PA than normal weight participants (p= 0.001). When classifying PA level, a total of 37.9% had a low level, 47.5% had a moderate level and only 14.6% had a high level of PA (p < 0.001). It is recommendable to implement programs to raise awareness of the importance and benefits of PA in the control of COPD, and these programs should focus on those with lower levels of PA.


Catastrophic failure of a titanium locking plate in a proximal humeral fracture: case report and literature review.
Angular stable locking plates have shown good clinical results in treating proximal humeral fractures, but complications are not uncommon. This study reported a rare case of catastrophic failure of a titanium locking plate. A retrieval analysis of the implants was performed using an optic microscope and a scanning electron microscope. A 69-year-old male reported a right proximal humeral fracture at the surgical neck and was treated by open reduction and internal fixation with a locking plate system. Ninety-six days after surgery, the patient came to clinic for acute local pain over the shoulder without any trauma. The radiographs showed a complete breakage of the implant accompanying displaced fracture. Revision surgery was performed to restabilize the fracture with a longer locking plate. The follow-up radiographs at 9 months showed complete union of the bone fracture. From the retrieval analysis, repetitive torsion loads on the vulnerable area of the implant are assumed to cause this catastrophic event. It is recommended that adequate activity restriction, such as reaching, be undertaken to avoid this rare complication. Current study also provides contributive information for the modification of plate design and pre-operative planning for device configuration to improve the success rate of locking plate fixation.


Acid phosphatase in eggs of the zebrafish, Brachydanio rerio.
2 isozymes of acid phosphatase have been identified by polyacrylamide disc gel electrophoresis in the ovary and mature, unfertilized eggs of B. rerio. Histochemically, the enzyme appears to be localized in preyolk bodies of previtellogenic oocytes and in yolk platelets of vitellogenic and postvitellogenic oocytes. The contents of the cortical granules at all stages of oocyte differentiation were acid phosphatase negative.


Endocrine tumours of the gastrointestinal tract. Somatostatin receptors as tools for diagnosis and therapy: molecular aspects.
Somatostatin is a neuropeptide that acts as an endogenous inhibitor of various cellular functions including endocrine and exocrine secretions and the proliferation of normal and tumour cells. Its action is mediated by a family of G-protein-coupled receptors (sst1-sst5) that are widely distributed in normal and tumour cells. Gastroenteropancreatic endocrine tumours express multiple somatostatin receptors, sst2 being clearly predominant. These receptors represent the molecular basis for the clinical use of somatostatin analogues in the treatment of endocrine tumours and their in vivo localisation. This review covers current knowledge in somatostatin receptor biology and signalling.


Retrospective 6 month-outcomes and prognostic factors following spontaneous angiogram-negative non-perimesencephalic subarachnoid hemorrhage.
Our objective was to analyze functional outcomes and prognostic factors in patients suffering from angiogram-negative non-perimesencephalic subarachnoid hemorrhage (non-PMH). In total, 1601 patients presenting with spontaneous SAH between January 2009 to December 2019 admitted to our institution were reviewed. Among them, 51 patients with angiogram negative non-perimesencephalic subarachnoid hemorrhage were analyzed. We divided patients into groups according to hemorrhage pattern and duration. Prognostic factors were assessed according to initial neurologic grade, early hydrocephalus, fisher grade, and duration of hemorrhage. Outcomes were assessed according to the modified Rankin Scale after 6 months. Overall, 41 patients (80.3%) with angiogram-negative non-PMH achieved a favorable outcome. In univariate analysis, good initial neurologic grade, absence of early hydrocephalus, non-Fisher-type 3 bleeding pattern, and short term hemorrhage (blood wash out <7 days after onset) duration were significantly associated with a favorable outcome. In multivariate analysis, a non-Fisher-type 3 hemorrhagic pattern (p < 0.05) and good initial neurologic state (p < 0.01) were independent predictors of favorable outcomes in angiogram-negative non-PMH patients. Patients with angiogram-negative non-PMH generally had favorable outcomes. A non-Fisher-type 3 hemorrhagic pattern and good initial neurologic state were prognostic factors of a favorable outcome in non-PMH. Furthermore, patients with long-term SAH were more likely to develop hydrocephalus. Evaluating the pattern and duration of subarachnoid hemorrhage may allow better prediction of outcomes in patients with angiogram negative and non-PMH.


Ultrasound characteristics of recurrent carotid disease: hypothesis explaining the low incidence of symptomatic recurrence.
The true incidence of recurrent disease after carotid endarterectomy (CENDX) is unknown, but noninvasive hemodynamic testing shows a paradox between the incidence of hemodynamically significant recurrent stenosis (RS) and the presence of symptomatic disease. We have shown that real-time B-mode ultrasound imaging can demonstrate the gross pathology of the arterial wall and plaque and their surface characteristics. Therefore we reviewed the clinical data and B-mode studies performed 6 months to 15 years after 276 carotid endarterectomies. Preoperative and perioperative risk factors and associated symptoms on follow-up were stored on computer. The patients were divided into three groups by the anatomy of their B-mode study. The majority of the studies were normal (203 [73.5%]), 42 (15.2%) showed mild disease, and 34 (12.3%) demonstrated significant RS. The RS group had a statistically significant increase in incidence of known lipid abnormalities (p less than 0.05), associated peripheral vascular disease, previous myocardial infarctions, and ulcerated plaque on the original carotid endarterectomy (p less than 0.01). The site of RS appeared related to the time of detection by B-mode ultrasound imaging. Internal carotid RS developed late (greater than 4 years), as did RS of the bifurcation. By contrast, stenosis at the common carotid level developed earlier. These findings suggest different pathogenic mechanisms--for the former, redevelopment of atherosclerosis; for the latter, accentuation of preexisting atherosclerosis perhaps by hemodynamic factors. Finally, in the 26 vessels with RS without occlusion, there was an 8% incidence of plaque ulcer or hemorrhage vs. a 62% incidence in 79 primary atherosclerotic plaques previously studied by both B-mode and pathologic examination. The low incidence of plaque characteristics associated with symptomatic disease may account for the low incidence of symptomatic disease associated with RS.


Late sequelae of foreign body inhalation. A multicentric scintigraphic study.
A multicentre European study on foreign body inhalation has been organized by the Pediatric Task Force covering both the SNME and the ENMS. Among the 100 cases which could be collected in a 2 year period, about 40% of scintigraphic abnormalities were found 6 months after relief of the foreign body. The frequency of these defects was clearly related to the time interval between aspiration and removal. Factors like the localization of the foreign body and the site of the early scintigraphic defects could be related to the further scintigraphic outcome, but this could not be proven statistically. Similarly, the absence of bronchial tree inspection after removal of the foreign body seemed to be associated with more permanent scintigraphic lesions. Finally, it is obvious that a large number of patients demonstrated scintigraphic alterations 6 months or more after removal of the foreign body, although the chest X-rays were considered normal.


Association between history of childhood sexual abuse and adult HIV-risk sexual behavior in Puerto Rican men who have sex with men.
This study explored whether homosexually active men who were sexually abused in childhood were more likely to engage in HIV-risk sexual behavior than men who were not sexually abused. Participants were 182 adult men of Puerto Rican ancestry living in New York City who had had sex with other men or with men and women. Quantitative and qualitative methods of exploration were used. Three groups were determined: (a) Abuse group (AB), formed by men who before age 13, had sex with a partner at least 4 years their senior and who felt hurt by the experience and/or were unwilling to participate in it; (b) Willing/not hurt group (W), consisting of men who had an older sexual partner before age 13 but did not feel hurt by the experience and were willing to participate; and (c) No-older-partner group (NOP). The results showed that men in the AB group were significantly more likely than men in the NOP group to engage in receptive anal sex and to do so without protection. Men in the W group were ranked between the other two groups in terms of their unsafe behavior. Age and education were cofactors both for receptive anal sex and for unprotected receptive anal sex. It is concluded that given the need to improve HIV prevention among Puerto Rican men who have sex with men, sexual abuse in childhood may constitute a marker to identify men at increased risk.


Influence diagnostics for two-component Poisson mixture regression models: applications in public health.
In many medical and health applications, Poisson mixture regression models are commonly used to analyse heterogeneous count data. Motivated by two data sets drawn from public health studies, influence diagnostics are proposed for assessing the sensitivity of the fitted two-component Poisson mixture regression models. Under various perturbations of the observed data or model assumptions, influence assessments based on the local influence approach are developed for detecting clusters and/or individual observations that impact on the estimation of model parameters. Results from studies on recurrent urinary tract infections and maternity length of stay illustrate the usefulness of the influence diagnostics.


Cold-inducible RNA-binding protein plays a central role in the pathogenesis of abdominal aortic aneurysm in a murine experimental model.
Cold-inducible RNA-binding protein (CIRP) is a recently identified proinflammatory cytokine. We hypothesize that CIRP is involved in the progression of abdominal aortic aneurysms (AAA) and that anti-CIRP treatment could inhibit this progression. We investigated CIRP expression in the sera and aneurysmal tissues of human AAA patients and elastase-induced AAA rats. To further examine the role of CIRP in the development of AAA, anti-CIRP antibody (1 mg/kg) or nonimmunized control immunoglobulin (Ig)G (1 mg/kg) was injected via the caudal vein in the experimental AAA model. To further investigate the underlying mechanisms, RAW 267.4 cells were stimulated with recombinant murine CIRP (rmCIRP). In human AAA tissue, CIRP exhibited a 5.6-fold and 93% increase in mRNA and protein expression, respectively. In a rat AAA model, CIRP was upregulated significantly in a time-dependent manner in the serum and AAA tissue. The anti-CIRP antibody treatment significantly suppressed the dilation of experimental AAA. Simultaneously, inhibition of CIRP significantly attenuated the expression of matrix metalloproteinase (MMP)-2, MMP-9, tumor necrosis factor-α, and monocyte chemoattractant protein-1, and the number of CD68-positive macrophages in the experimental AAA tissue. In vitro, rmCIRP significantly increased MMP-9 messenger RNA expression in a dose-dependent manner by 1.2-fold, 2.9-fold, and 5.5-fold, respectively. Simultaneously, rmCIRP promoted RAW 264.7 cell migration, with an approximately 2.7-fold increase in the number of migrated cells. Our findings demonstrate that CIRP mediates experimental AAA development by promoting the inflammatory response and inducing MMP-9 expression, demonstrating its potential as a novel target for inhibiting the progression of AAA.


COVID-19 and Pulmonary Emboli: A Case Series and Literature Review.
There is recent evidence that coronavirus disease 2019 (COVID-19) infection results in a prothrombotic state that may increase the risk of venous thromboembolism. Both COVID-19 infection and pulmonary emboli can present with dyspnoea, tachypnoea, hypoxaemia and an elevated D-dimer. Identifying a pulmonary embolus in a patient with COVID-19 and differentiating it from the typical clinical and biochemical features of COVID-19 is challenging. We report four cases, and reviewed two further cases in the literature, of a pulmonary embolus in patients who presented to the emergency department with COVID-19 and no other risk factor for a pulmonary embolus. We identified a series of atypical features that should raise suspicion for a pulmonary embolus: pleuritic chest pain; haemoptysis; atrial fibrillation; tachycardia; hypotension; late onset deterioration; evidence of right heart strain; or a disproportionally elevated D-dimer in comparison to ferritin.


Myocardial signal density levels and beam-hardening artifact attenuation using dual-energy computed tomography.
The assessment of myocardial perfusion using single-energy (SE) imaging is influenced by beam-hardening artifacts (BHA). We sought to explore the ability of dual-energy (DE) imaging to attenuate the presence of BHA. Myocardial signal density (SD) was evaluated in 2240 myocardial segments (112 for each energy level) and in 320 American Heart Association segments among the SE group. Compared to DE reconstructions at the best energy level, SE acquisitions showed no significant differences overall regarding myocardial SD or signal-to-noise ratio. The segments most commonly affected by BHA showed significantly lower myocardial SD at the lowest energy levels, progressively normalizing at higher energy levels.


An efficient strategy for unmodified nucleotide-mediated dispersion of magnetic nanoparticles, leading to a highly sensitive MRI-based mercury ion assay.
It is highly attractive to develop a detection system that is not only sensitive and selective but also simple, rapid, practical and cost-effective in operation. Here, we report an interesting observation that single-stranded oligonucleotide (ssDNA) can adsorb efficiently on carboxylic acid-functionalized magnetic nanoparticles (CAMNPs) and stabilize the nanoparticles against aggregation in weakly acidic solution. The adsorbing rate closely correlates with the pH of the solution, the temperature and the sequence length of ssDNA. On the basis of this observation, we have designed a highly sensitive, non-sandwich type magnetic relaxation-based detection system for quantitatively probing mercury ion. The assay is independent of the sample's optical properties, requires no covalent modification of the ssDNA or the CAMNPs surfaces, and can be used for high-throughput analysis. By varying the concentration of CAMNPs, four orders of dynamic response range and a detection limit of 0.3 nM for Hg(2+) are achieved. Moreover, we developed a multi-sample assay to detect Hg(2+) in real environmental samples with high sensitivity, selectivity and efficiency.


Placental abruption. Maternal risk factors and associated fetal conditions.
To investigate maternal risk factors and fetal conditions associated with abruption. Prospective cohort study of 30,681 singleton pregnancies at least 28 weeks' gestation. Data collected by patient questionnaire at the first prenatal visit and by medical record review. 307 women had abruption (1%). After adjustment, important maternal risk factors included age (in years; OR 1.03; 95% CL 1.00, 1.06; p = 0.04) and less than 12 years of education (OR 1.58; 95% CL 1.10, 2.25; p = 0.01). Each pack of cigarettes smoked per day increased the risk by approximately 40% (OR 1.39; 95% CL 1.09, 1.79; p = 0.009). If abruption occurred, the perinatal mortality rate was substantially higher in women who smoked at least one pack per day than in nonsmokers (RR 2.53; 95% CL 1.14, 5.61; p = 0.02). Abruption was also significantly associated with intrauterine growth retardation and fetal malformations. The increased malformation rate was due entirely to nearly a five-times increase in congenital heart defects (OR 4.63; 95% CL 2.49, 8.55; p = 0.00000014). Heavier smoking increases the risk both of abruption and of perinatal death when abruption occurs. If the association between abruption and congenital heart defects is confirmed, early evaluation could lead to more prompt treatment of these malformations in infants delivered after abruption.


Likelihood of left main coronary artery compression based on pulmonary trunk diameter in patients with pulmonary hypertension.
In patients with pulmonary hypertension, extrinsic compression of the left main coronary artery by a dilated pulmonary trunk may cause angina, left ventricular ischemia, and sudden death. We assessed coronary artery compression in relation to pulmonary trunk diameter and other demographic, echocardiographic, hemodynamic, and scintigraphic variables. Thirty-six patients (aged 15 to 86 years) with pulmonary hypertension, either idiopathic or associated with congenital heart disease, were enrolled. Left main coronary artery compression was defined angiographically as > or =50% obstruction associated with downward displacement of the vessel. Pulmonary trunk and aortic diameters were measured by transthoracic echocardiography. Twenty-six patients had angina, of whom 7 had left coronary artery compression. Compression was related to pulmonary trunk diameter (P = 0.002) and to the ratio of pulmonary trunk diameter to aortic diameter (P = 0.02). Compression was not seen at pulmonary artery diameters <40 mm; among 19 patients with values > or =40 mm, the rate was 37%. Similarly, compression did not occur at pulmonary trunk to aortic diameter ratios <1.21; among 27 patients with ratios > or =1.21, the rate was 26%. In pulmonary hypertension, noninvasive measurement of pulmonary trunk diameter may be helpful in determining the likelihood of left coronary artery compression and in selecting patients for diagnostic coronary angiography.


The strange tale of Martin van Butchell.
In the eighteenth century, a pedestrian strolling around Georgian London may have witnessed the bizarre sight of an ageing gentleman parading the streets on a painted horse and brandishing the jawbone of an ass. Not only was this man an eccentric, he was also a dentist. David Watkins here relates the remarkable story of Martin van Butchell, a dentist extraordinaire.


Novel arrangement of rRNA genes in Mycoplasma gallisepticum: separation of the 16S gene of one set from the 23S and 5S genes.
Large restriction fragments from the DNA of Mycoplasma gallisepticum S6 and PG31, which were prepared by digestion with BglI, BssHII, SmaI, or XhoI and which were separated by pulsed-field electrophoresis, were hybridized with probes containing most, or different parts, of an rRNA operon of Mycoplasma capricolum. The results showed that the genomes contained three widely separated rRNA loci. One locus contained genes for all three rRNA species and another contained 23S and probably 5S rRNA genes, whereas the third appeared to have only a 16S rRNA gene.


Triglyceridase and phospholipase A1 activities of rat-heart lipoprotein lipase. Influence of apolipoproteins C-II and C-III.
The influence of purified human apolipoprotein C-II on phospholipase A1 and triglyceridase activities of lipoprotein lipase were compared. Lipoprotein lipase was obtained from rat hearts by perfusion with a medium containing heparin and purified on a heparin Sepharose 4-B column. Using phosphatidyl-ethanolamine-coated triglyceride particles as substrate it was found that the phospholipase A1 and triglyceridase activities of lipoprotein lipase similarly depend on the presence of apolipoprotein C-II. Apolipoprotein C-III cannot replace apolipoprotein C-II. However, addition of apolipoprotein C-III in the presence of C-II affects both lipase activities. While strong inhibition of triglyceridase activity was observed under these conditions, phospholipase A1 activity was slightly stimulated. On the basis of these findings a model was constructed for the role of apolipoprotein C-II in lipoprotein lipase action.


A facile strategy for the preparation of ZnS nanoparticles deposited on montmorillonite and their higher catalytic activity for rapidly colorimetric detection of H2O2.
In this paper, ZnS nanoparticles deposited on montmorillonite (ZnS-MMT) were prepared by a facile method at room temperature and characterized by powder X-ray diffraction (XRD), Energy-dispersive X-ray Detector (EDX) and transmission electron microscope (TEM), respectively. Significantly, the as-prepared ZnS-MMT nanocomposites have been proven to possess intrinsic peroxidase-like activity that can rapidly catalyze the reaction of peroxidase substrate 3,3',5,5'-tetramethylbenzidine (TMB) in the presence of H2O2 and produce a blue color product in less than 30 seconds, which provides a sensitive colorimetric sensor to detect H2O2. Due to the synergistic effects between montmorillonite and ZnS nanoparticles, the obtained ZnS-MMT nanocomposites exhibit higher catalytic activity than that of MMT or ZnS alone. The catalytic behaviors of the ZnS-MMT nanocomposites showed a typical Michaelis-Menten kinetics. The catalytic activity and the catalytic mechanism were investigated using the procedures of steady-state kinetics and hydroxyl radical detection. ESR data revealed that the peroxidase-like activity of ZnS-MMT originated from the generation of OH radicals.


Human herpesvirus 8 serological markers and viral load in patients with AIDS-associated Kaposi's sarcoma in Central African Republic.
Epidemic Kaposi's sarcoma (KS) is one of the most frequent types of cancer in several African countries; however, very few data are available on human herpesvirus 8 (HHV-8) markers in KS patients from Central Africa. In a series of 36 AIDS-KS cases from Central African Republic, we showed, using a real-time PCR quantitative assay, the high frequency (82%) of detectable HHV-8 DNA in peripheral blood mononuclear cells (PBMCs). We also found that the level of antibodies directed against lytic or latent HHV-8 antigens is not correlated to the amount of HHV-8 viral load in the PBMCs, and finally, we demonstrated a much higher viral load in tumoral skin lesions (6.07 log copies/mug DNA) than in unaffected skin (2.93 log copies/mug DNA) or in PBMCs (2.55 log copies/mug DNA).


Superior Mesenteric Artery First Approach for Minimally Invasive Pancreaticoduodenectomy: A Step-By-Step Surgical Technique Video.
In the past decade, minimally invasive pancreaticoduodenectomy has been gaining interest. However, minimally invasive pancreaticoduodenectomy remains technically challenging and is associated with a steep learning curve. Additionally, the operating surgeon should be cognizant of replicating the same oncological steps as observed in the typical open approach. In view of this, there exist various maneuvers that are designed to achieve negative margins and a safer mesopancreatic dissection. One of these techniques is the superior mesenteric artery first approach, which is garnering interest among pancreatic surgeons. According to existing literature, there are several superior mesenteric artery dissections approaches. We describes 5 different minimally invasive approaches. This multimedia manuscript provide, for the first time in literature, a comprehensive step-by-step overview of the superior mesenteric artery first approach for minimally invasive pancreaticoduodenectomy by a team of expert surgeons from various international institutions. Through the tips and indications presented in this article, we aim to guide the choice of this approach according to tumor location, type of minimally invasive approach and the operating surgeon's experience and increase familiarity with such a complex procedure.


Assessing quality of a diagnostic test evaluation.
To develop a standardized scale for assessing the quality of a diagnostic test evaluation. Fourteen participants with formal and practical experience in evaluating diagnostic tests formed a consensus panel. Panel members identified and weighted questions that should be addressed when assessing the quality of a diagnostic test evaluation. General internal medicine division at an academic medical center. A 19-item weighted scale was developed. It prioritizes and addresses issues such as description of the proposed purpose of the test; appropriate selection and description of the study population; appropriate performance and description of the diagnostic test; appropriate selection and performance of the reference standard; and adequate presentation of test characteristics. The scale is proposed as a useful instrument for readers, investigators, reviewers, and editors, because it represents an updated synthesis of important criteria to consider when evaluating diagnostic tests. It can also be used to rate quantitatively the quality of diagnostic test evaluations.


Superficial and functional imaging of the tricipital lymphatic pathway: a modern reintroduction.
The tricipital, or Caplan's, lymphatic pathway has been previously identified in cadavers and described as a potential compensatory pathway for lymphatic drainage of the upper extremity, as it may drain lymphatic fluid directly to the scapular lymph nodes, avoiding the axillary lymph node groups. The aim of this study was to map the anatomy of the tricipital pathway in vivo in patients without lymphatic disease. A retrospective review was performed to identify patients with unilateral breast cancer undergoing preoperative Indocyanine green (ICG) lymphography prior to axillary lymph node dissection from May 2021 through January 2022. Exclusion criteria were evidence or known history of upper extremity lymphedema or non-linear channels visualized on ICG. Demographic, oncologic, and ICG imaging data were extracted from a Lymphatic Surgery Database. The primary outcome of this study was the presence and absence of the tricipital pathway. The secondary outcome was major anatomical variations among those with a tricipital pathway. Thirty patients underwent preoperative ICG lymphography in the study period. The tricipital pathway was visualized in the posterior upper arm in 90% of patients. In 63% of patients, the pathway had a functional connection to the forearm (long bundle variant) and in 27%, the pathway was isolated to the upper arm without a connection to the forearm (short bundle variant). In those with a long bundle, the contribution was predominantly from the posterior ulnar lymphosome. Anatomic destinations of the tricipital pathway included the deltotricipital groove and the medial upper arm channel, which drains to the axilla. When present, the tricipital pathway coursed along the posterior upper arm with variability in its connections to the forearm distally, and the torso proximally. Long-term follow-up studies will help determine the significance of these anatomic variations in terms of individual risk of lymphedema after axillary nodal dissection.


Characterization and separation of preterm and term spontaneous, induced, and cesarean EHG records.
To improve the understanding of the underlying physiological processes that lead to preterm birth, and different term delivery modes, we quantitatively characterized and assessed the separability of the sets of early (23rd week) and later (31st week) recorded, preterm and term spontaneous, induced, cesarean, and induced-cesarean electrohysterogram (EHG) records using several of the most widely used non-linear features extracted from the EHG signals. Linearly modeled temporal trends of the means of the median frequencies (MFs), and of the means of the peak amplitudes (PAs) of the normalized power spectra of the EHG signals, along pregnancy (from early to later recorded records), derived from a variety of frequency bands, revealed that for the preterm group of records, in comparison to all other term delivery groups, the frequency spectrum of the frequency band B0L (0.08-0.3 Hz) shifts toward higher frequencies, and that the spectrum of the newly identified frequency band B0L' (0.125-0.575 Hz), which approximately matches the Fast Wave Low band, becomes stronger. The most promising features to separate between the later preterm group and all other later term delivery groups appear to be MF (p=1.1⋅10-5) in the band B0L of the horizontal signal S3, and PA (p=2.4⋅10-8) in the band B0L' (S3). Moreover, the PA in the band B0L' (S3) showed the highest power to individually separate between the later preterm group and any other later term delivery group. Furthermore, the results suggest that in preterm pregnancies the resting maternal heart rate decreases between the 23rd and 31st week of gestation.


Small bowel angioectasia-The clinical and cost impact of different management strategies.
The management of patients with recurrent anaemia and small bowel angioectasia (SBA) is costly and challenging. In this retrospective cohort study, we examined the clinical and cost implication of a combination therapy of Somatostatin analogues (SA) and endoscopic ablation, endoscopic therapy alone, and conservative management. Median number of bleeding episodes reduced from 3.5 (IQR 4) in the year before, to 1 (IQR 2) in the year after starting combination therapy with SA (p = 0.002). There were no differences in number of bed days (13.7 vs. 15.3, p = 0.66) and cost (£10,835 vs £11,653, p = 0.73) in the year before and after starting combination therapy. There was a trend towards a reduction in median number of blood transfusions episodes (17 vs 5, p = 0.07) and therapeutic endoscopies (1 vs. 0, p = 0.05) after starting SA. In patients suitable for endoscopic therapy alone, time spent in hospital was reduced (-3.5 days, p = 0.004), but bleeding episodes, transfusions and cost of treatment were not different. Patients requiring a combination therapy were significantly more co-morbid with a mean (± sd) Charlson comorbidity index (CCI) of 7.1 (± 2.7). Higher CCI (OR 2.1, 95% CI 1.1-3.9) and presence of chronic renal failure (OR 4.1, 95% CI 1.4-12.4) predicted escalation to combination therapy. SAs may be a useful adjunct to endoscopic therapy for transfusion dependent comorbid patients. In the first year they reduce bleeding episodes. Cost in the 1-year before and after adding on SA are no different suggesting additional clinical benefit can be gained without additional cost.


Needlescopic inguinal hernia repair in children.
The object of the present study was to assess the value and outcome of needlescopy in the treatment of inguinal hernia (IH) in 150 children operated upon in Al-Mishary Hospital, Riyadh, between October 1997 and October 1999. Their ages ranged between 6 and 96 months, (mean 61.6 +/- 28.32 months). There were 130 males and 20 females; 81 (54%) presented with a right-sided IH and among these patients a hidden contralateral hernia was diagnosed in 12 cases (8%). A left-sided IH was present in 30 (20%) bilateral IHs in 19 cases (12.66%), a recurrent hernia in 15 (10%), and an incarcerated hernia in 5 (3.33%). All patients were subjected to needlescopic herniotomy using a 2.7-mm telescope and two 2-mm needle holders to close the internal ring with a 4/0 PDS suture. The mean duration of surgery was 20.6 +/- 4.65 min for unilateral and 26.4 +/- 1.6 min for bilateral hernia repair. The mean hospital stay was 18 +/- 3.23 h. The study showed that laparoscopic closure of the internal ring in children is feasible, easy, and preferable to open surgery. The fact that laparoscopy can diagnose a hidden contralateral hernia is an additional advantage.


Effectiveness of the Antenatal Psychosocial Health Assessment (ALPHA) form in detecting psychosocial concerns: a randomized controlled trial.
A pregnant woman's psychological health is a significant predictor of postpartum outcomes. The Antenatal Psychosocial Health Assessment (ALPHA) form incorporates 15 risk factors associated with poor postpartum outcomes of woman abuse, child abuse, postpartum depression and couple dysfunction. We sought to determine whether health care providers using the ALPHA form detected more antenatal psychosocial concerns among pregnant women than providers practising usual prenatal care. A randomized controlled trial was conducted in 4 communities in Ontario. Family physicians, obstetricians and midwives who see at least 10 prenatal patients a year enrolled 5 eligible women each. Providers in the intervention group attended an educational workshop on using the ALPHA form and completed the form with enrolled women. The control group provided usual care. After the women delivered, both groups of providers identified concerns related to the 15 risk factors on the ALPHA form for each patient and rated the level of concern. The primary outcome was the number of psychosocial concerns identified. Results were controlled for clustering. There were 21 (44%) providers randomly assigned to the ALPHA group and 27 (56%) to the control group. A total of 227 patients participated: 98 (43%) in the ALPHA group and 129 (57%) in the control group. ALPHA group providers were more likely than control group providers to identify psychosocial concerns (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.1-3.0; p = 0.02) and to rate the level of concern as "high" (OR 4.8, 95% CI 1.1-20.2; p = 0.03). ALPHA group providers were also more likely to detect concerns related to family violence (OR 4.8, 95% CI 1.9-12.3; p = 0.001). Using the ALPHA form helped health care providers detect more psychosocial risk factors for poor postpartum outcomes, especially those related to family violence. It is a useful prenatal tool, identifying women who would benefit from additional support and interventions.


Lipid peroxidation is involved in calcium dependent upregulation of mitochondrial metabolism in skeletal muscle.
Skeletal muscle cells continuously generate reactive oxygen species (ROS). Excessive ROS can affect lipids resulting in lipid peroxidation (LPO). Here we investigated the effects of myotube intracellular calcium-induced signaling eliciting contractions on the LPO induction and the impact of LPO-product 4-hydroxynonenal (4-HNE) on physiology/pathology of myotubes using C2C12 myoblasts. C2C12 myoblasts were differentiated into myotubes, stimulated with caffeine and analyzed for the induction of LPO and formation of 4-HNE protein adducts. Further effects of 4-HNE on mitochondrial bioenergetics, NADH level, mitochondrial density and expression of mitochondrial metabolism genes were determined. Short and long-term caffeine stimulation of myotubes promoted superoxide production, LPO and formation of 4-HNE protein adducts. Furthermore, low 4-HNE concentrations had no effect on myotube viability and cellular redox homeostasis, while concentrations from 10 μM and above reduced myotube viability and significantly disrupted homeostasis. A time and dose-dependent 4-HNE effect on superoxide production and mitochondrial NADH-autofluorescence was observed. Finally, 4-HNE had strong impact on maximal respiration, spare respiratory capacity, ATP production, coupling efficiency of mitochondria and mitochondrial density. Data presented in this work make evident for the first time that pathological 4-HNE levels elicit damaging effects on skeletal muscle cells while acute exposure to physiological 4-HNE induces transient adaptation. This work suggests an important role of 4-HNE on the regulation of myotube's mitochondrial metabolism and cellular energy production. It further signifies the importance of skeletal muscle cells hormesis in response to acute stress in order to maintain essential biological functions.


Evaluation of a new wide-pore superficially porous material with carbon core and nanodiamond-polymer shell for the separation of proteins.
In this study, reversed phase liquid chromatographic columns packed with superficially porous material made of a carbon core and nanodiamond-polymer shell were evaluated for the analytical characterization of proteins. The emphasis was put on the impact of pore size on the kinetic performance when analyzing large molecules. Three different types of columns possessing an average pore size of 120, 180, and 250Å were thus evaluated. As expected, the peak capacities were improved with the 180 and above all the 250Å pore size, while the kinetic performance achieved with the 120Å were systematically lower. It was also shown that a trifluoroacetic acid (TFA) concentration of 0.3-0.5% was required when analyzing proteins, to achieve suitable peak shapes (limited broadening and tailing) with this material. Elevated temperature (>60°C) is mandatory when analyzing proteins with silica-based stationary phases, but this was not the case with this particular column made with a carbon core and nanodiamond-polymer shell, since the peak capacities were not improved at high temperature. However, there was a need to increase mobile phase temperature in the range 70-90°C when analyzing monoclonal antibodies (mAbs), to limit adsorption that often occur in RPLC with this specific class of biomolecules. Finally, the FLARE(®) wide-pore column was applied to real life samples of native, oxidative stressed and reduced therapeutic proteins as well as reduced, digested mAbs and antibody drug conjugates (ADCs), to highlight the possibilities offered by this column technology.


Multi-component synthesis and in vitro and in vivo anticancer activity of novel arylmethylene bis-isoxazolo[4,5-b]pyridine-N-oxides.
A three component one-pot protocol has been investigated for the synthesis of arylmethylene bis-isoxazolo[4,5-b]pyridine-N-oxides 1 from the commercially available materials. The title compounds 1 were also synthesized by a step-wise method and found to be identical with one-pot synthesis by spectral and analytical data. The newly synthesized compounds were evaluated for their in vitro anticancer activity against human cancer cell lines and in vivo anticancer activity on EAC-bearing mice. Compound 1a was found to be the most active both in in vitro and in vivo cytotoxic studies.


N-(2-Methyl-3-oxo-1,3-diphenyl-prop-yl)acetamide.
In the title compound, C18H19NO2, the dihedral angle between the benzene rings is 42.0 (1)°. In the crystal, mol-ecules are linked by N-H⋯O and C-H⋯π inter-actions.


Purification and characterization of a plasmid-encoded aminoglycoside-(3)-N-acetyltransferase IV from Escherichia coli.
Plasmid-encoded aminoglycoside-(3)-N-acetyltransferase IV, AAC(3)-IV, was purified to homogeneity by affinity chromatography from E. coli. The enzyme was shown to consist of a monomer, with the apparent Mr being in agreement with that calculated from the nucleotide sequence of the aacC4 gene (Mr 28 500). Determination of the sequence of the N-terminal 6 amino acids revealed that processing did not occur, indicating the cytoplasmic localization of the AAC(3)-IV enzyme. A correlation of antibiotic resistance with Km values of the purified enzyme for a corresponding set of aminoglycoside substrates is discussed with respect to the mechanism of resistance in vivo.


Postoperative Critical Care Admission Was Not Associated with Improved Postoperative Outcomes in Elective Colorectal Surgery: Secondary Analysis Of POWER Trial.
The efficacy of routine admission of high-risk patients to a critical care unit after surgery is not clear. The aim of our study was to investigate the association between critical care admission after scheduled colorectal surgery and postoperative complications, 30-day mortality, and length of stay in hospital. A pre-defined secondary substudy of POWER study was performed. POWER study was a prospective multicenter observational study of patients undergoing elective primary colorectal surgery during a single period of two months of recruitment between September and December 2017. A total of 2084 patients from 80 Spanish hospitals were included, of which 722 (34.6%) were admitted to critical care unit (CCU) after elective surgery. After adjusting for confounding factors in the multivariate analysis, postoperative CCU admission was independently associated with a higher incidence of moderate-to-severe postoperative complications (adjusted OR 1.951, 95% CI 1.570, 2.425; p < 0.001). Regarding secondary outcomes, postoperative critical care admission was independently associated with higher 30-day mortality (adjusted OR 6.736; 95% CI 2.507, 18.101; p < 0.001) and independently associated with an increased hospital length of stay (adjusted OR 1.143, 95% CI 1.112, 1.175; p < 0.001). Direct admission to CCU after scheduled colorectal surgery was not associated with a reduction in moderate-to-severe postoperative complications.


Proliferation of CD11b+ myeloid cells induced by TLR4 signaling promotes hepatitis B virus clearance.
Effective immune response plays a key role in the clearance of hepatitis B virus (HBV). However, the specific role of innate immune response in the clearance of virus is still unclear. Here we investigated the effect of TLR4 signaling on the proliferation and differentiation of CD11b+ myeloid cells, which contributes to virus clearance. C57BL/6 mice were pretreated with TLR4 ligand lipopolysaccharide by intraperitoneal injection. Hydrodynamic injection (HI) was performed to establish HBV-replicated mice. The viremia was monitored. The immune cells were isolated from liver and spleen of the mice. The proliferation and differentiation of CD11b+ myeloid cells were analyzed by flow cytometry. The changes of CD11b+ myeloid cells and its role in virus clearance during HBV infection after LPS stimulation were analyzed. LPS stimulation induced the proliferation of CD11b+ myeloid cells which differentiated into neutrophils and inflammatory mononuclear macrophages. The expression of F4/80 protein on the surface of mononuclear macrophages in the liver of LPS-stimulated mice was significantly lower than that of control. It indicated that intrahepatic Kupffer cells were significantly decreased in the LPS-stimulated mice, which promoted the clearance of virus. LPS stimulation induces the proliferation of CD11b+ myeloid cells that differentiate into inflammatory neutrophils and monocytes, which inhibits HBV replication. And the decrease of intrahepatic Kupffer cells also contributes to the clearance of HBV during HBV infection.


Appetitive and aversive olfactory learning induce similar generalization rates in the honey bee.
Appetitive and aversive learning drive an animal toward or away from stimuli predicting reinforcement, respectively. The specificity of these memories may vary due to differences in cost–benefit relationships associated with appetitive and aversive contexts. As a consequence, generalization performances may differ after appetitive and aversive training. Here, we determined whether honey bees show different rates of olfactory generalization following appetitive olfactory conditioning of the proboscis extension response, or aversive olfactory conditioning of the sting extension response. In both cases, we performed differential conditioning, which improves discrimination learning between a reinforced odor (CS?) and a non-reinforced odor (CS-) and evaluated generalization to two novel odors whose similarity to the CS? and the CS- was different. We show, given the same level of discriminatory performance, that rates of generalization are similar between the two conditioning protocols and discuss the possible causes for this phenomenon.


A New Perspective on Microbes Formerly Known as Nitrite-Oxidizing Bacteria.
Nitrite-oxidizing bacteria (NOB) catalyze the second step of nitrification, nitrite oxidation to nitrate, which is an important process of the biogeochemical nitrogen cycle. NOB were traditionally perceived as physiologically restricted organisms and were less intensively studied than other nitrogen-cycling microorganisms. This picture is in contrast to new discoveries of an unexpected high diversity of mostly uncultured NOB and a great physiological versatility, which includes complex microbe-microbe interactions and lifestyles outside the nitrogen cycle. Most surprisingly, close relatives to NOB perform complete nitrification (ammonia oxidation to nitrate) and this finding will have far-reaching implications for nitrification research. We review recent work that has changed our perspective on NOB and provides a new basis for future studies on these enigmatic organisms.


Beyond gender mainstreaming: transforming humanitarian action, organizations and culture.
The United Nations and major humanitarian organizations have made policy commitments to promote gender equality and empower women and girls. This study assesses the extent to which humanitarian responses have met these commitments based on reviews of gender mainstreaming, textual analysis of policy and program cycle documents, and interviews with humanitarian actors. The analysis reveals that while gender mainstreaming may raise awareness and make fixes at the margins, its focus has been limited to altering internal processes rather than emphasizing results for women and men and girls and boys. Our study also analyzes the cultural and institutional context in which gender mainstreaming takes place. The culture of humanitarian organizations has been characterized as hierarchical and driven by a short-term crisis response with a distinctly macho style of functioning, which is misaligned with gender mainstreaming. We propose replacing gender mainstreaming with a results-focused approach rooted in behavioral science that uses evidence of the conscious and non-conscious drivers of human behavior to address problems, alongside other efforts to change the internal culture of humanitarian organizations.


Effect of mouthwashes on the force decay of polymeric ligature chains used for dental purposes: a systematic review and meta-analysis.
External factors such as the daily use of antimicrobial mouthwashes to maintain oral hygiene and to reduce the microbial activity can contribute to alter the mechanical properties of the elastomeric chains used during orthodontic treatments, causing loss of effectiveness. This systematic review and a meta-analysis assessed the rate of force decay and degradation of the polymeric chains depending on the type of mouthwash. A systematic search of the literature were there was an exposure of orthodontic elastomeric chains to certain mouthwashes was conducted in the electronic databases of PubMed, Cochrane Library (CENTRAL), Scopus, EMBASE and Web of Science, as well as grey literature (Opengrey). No limit was placed on publication year and research was done up to June 2022. Based on inclusion/ exclusion criteria, data were extracted by two independent reviewers. For the quantitative analysis, studies were analysed with a mixed-effect (random effect) meta-regression model, with beta coefficients and R [2] values. I [2] index and Q and Egger tests were used to find heterogeneity among studies. A total of 178 potentially eligible studies were identified, of which 14 were eventually included in the qualitative analysis and 14 in the quantitative meta-analysis. The meta-analysis showed that all the mouthwashes were associated with a greater force decay than the control groups. After 7 days (p = 0.005) significant differences were found among the different mouthwashes, with those containing alcohol having significantly higher impact on the force decay than those containing chlorhexidine 0.2%, sodium fluoride or Persica. However, at 24 h (p = 0.200), 14 days (p = 0.076), 21 days (p = 0.120) and 28 days (p = 0.778) no statistically significant differences among the different mouthwashes were found, although those containing alcohol presented a strong tendency. Although mouthwashes tend to increase the speed of force decay of elastomeric chains, especially those containing alcohol, clorhexidine 0.2% can be a good alternative due to its low impact on the force decay and its ability to maintain low microbial activity. More in vitro and in vivo studies comparing different manufacturers and other agents should be performed.


Locking in stable states of gene expression: transcriptional control during Drosophila development.
Cell fate decisions can be maintained during long periods of developmental time by stable states of gene expression. The Polycomb group and trithorax group proteins of Drosophila are key transcriptional regulators that maintain stable expression states during development. Recent advances in knowledge about individual Polycomb group and trithorax group proteins, their mechanisms of action, and potential homologs in mice and humans are contributing to a greater understanding of their roles in gene expression and development.


Do the benefits of screening mammography outweigh the harms of overdiagnosis and unnecessary treatment?--yes.
Yes. Public health adviser David Roder and Cancer Council Australia CEO Ian Olver believe the reduction in breast cancer mortality in Australia reflects both treatment and screening effects.