Long term performance of membranes in an anaerobic membrane bioreactor treating municipal wastewater.
The long term impact of SRT (100-40 days) and recovery cleaning on membrane performance of an AnMBR treating authentic municipal wastewater in a large pilot plant was assessed. Successful operation of the pilot plant at a flux of 17 LMH was maintained for a period of 536 days during which the longest period of operation without recovery cleaning or membrane replacement was 178 days. Lower SRT (40 days) reduced the fouling propensity of the mixed liquor in terms of TSS concentration and the dewaterability indicators including colloidal COD (cCOD) concentration and capillary suction time (CST). Critical fluxes ranged from 21 to 23 LMH to 25-27 LMH for SRTs of 70 and 40 days respectively and this was consistent with the reduced concentrations of TSS and improved dewaterability under the latter conditions. Recovery cleaning was found to result in substantial reduction of resistance as indicated by both pilot plant operation and clean water flux tests. The long-term fouling rate was observed to be higher with cleaned membranes as compared to virgin membranes. The lower membrane fouling with virgin membranes suggested that accumulation of foulants, which were resistant to cleaning, caused the higher fouling rates for the cleaned membranes.


Two layered strategy for cost effective production of pectinase: immobilization of yeast and utilization of crude substrate.
The wide scale application of pectinase is generally hindered by high cost of the enzyme production. In this work, a two dimensional strategy was adopted to reduce cost of pectinase production by Geotrichum candidum AA15. The strain was immobilized in alginate beads. The optimum concentration for bead formation was found to be 3.5% of sodium alginate (NA) with 4% calcium chloride (CaCl2). Such immobilized cells retained the ability to produce 0.115 IU mL-1 of pectinase for up to 6th production cycle in citrus pectin containing medium while free cells produced only 0.046 IU mL-1 of pectinase. For the cultivation of immobilized cells on orange peels (OP), a combination of 4.5% NA and 4% CaCl2 was found effective to prepare beads. Geotrichum candidum AA15 produced 0.220 IU mL-1 pectinase by fermenting OP as a substrate for up to 3rd production cycle. The results revealed that the process of immobilization can be used as a promising strategy in combination with the use of naturally available waste biomass.


The effects of non-functionalized polystyrene nanoparticles with different diameters on human erythrocyte membrane and morphology.
In this study, the potential toxicity of non-functionalized polystyrene nanoparticles (PS-NPs) in human erythrocytes has been assessed. The effect of PS-NPs with different diameters (∼30 nm, ∼45 nm, ∼70 nm) on fluidity of erythrocytes membrane, red blood cells shape, as well as haemolysis of these cells has been investigated. Erythrocytes were incubated for 24 h with non-functionalized PS-NPs in concentrations ranging from 0.001 to 200 μg/mL in order to study haemolysis and from 0.001 to 10 μg/mL to determine other parameters. Fluidity was estimated by electron paramagnetic resonance (EPR) and the fluorimetric method. It has been shown that PS-NPs induced haemolysis, caused changes in the fluidity of red blood cells membrane, and altered their shape. Non-functionalized PS-NPs increased the membrane stiffness in the hydrophobic region of hydrocarbon chains of fatty acids. The observed changes in haemolysis and morphology were dependent on the size of the nanoparticles. The smallest PS-NPs of ∼30 nm (with the smallest absolute value of the negative zeta potential -29.68 mV) induced the greatest haemolysis, while the largest PS-NPs of ∼70 nm (with the highest absolute value of the negative zeta potential -42.00 mV) caused the greatest changes in erythrocyte shape and stomatocytes formation.


[Epidemiology and prevention of respiratory allergies in children].
There appears to be a belief that asthma in children is increasing. Given the fact that the morbidity of asthma has not decreased despite many advances in pharmacologic treatment, it is clear that attempting at reduce exposure should come at an early stage of life. This is best accomplished through preventive measures such as dietary prophylaxis and sufficiently aggressive measures to reduce exposure to mites.


Enzymatic assay for UDP-GlcNAc and its application in the parallel assessment of substrate availability and protein O-GlcNAcylation.
O-linked N-acetylglucosaminylation (O-GlcNAcylation) is a ubiquitous and dynamic non-canonical glycosylation of intracellular proteins. Several branches of metabolism converge at the hexosamine biosynthetic pathway (HBP) to produce the substrate for protein O-GlcNAcylation, the uridine diphosphate N-acetylglucosamine (UDP-GlcNAc). Availability of UDP-GlcNAc is considered a key regulator of O-GlcNAcylation. Yet UDP-GlcNAc concentrations are rarely reported in studies exploring the HBP and O-GlcNAcylation, most likely because the methods to measure it are restricted to specialized chromatographic procedures. Here, we introduce an enzymatic method to quantify cellular and tissue UDP-GlcNAc. The method is based on O-GlcNAcylation of a substrate peptide by O-linked N-acetylglucosamine transferase (OGT) and subsequent immunodetection of the modification. The assay can be performed in dot-blot or microplate format. We apply it to quantify UDP-GlcNAc concentrations in several mouse tissues and cell lines. Furthermore, we show how changes in UDP-GlcNAc levels correlate with O-GlcNAcylation and the expression of OGT and O-GlcNAcase (OGA).


Labeling in cells of the nasal cavity of hamsters treated with tritiated N-nitrosodiethylamine.
Syrian golden hamsters were given a single dose of N-[3H]nitrosodiethylamine ([3H]DEN) by gavage. One hour later the animals were killed and their nasal cavities processed for high resolution light microscopic autoradiography for detection of bound radioactivity. The atrioturbinals, which are lined by squamous epithelium, were unlabeled. In the respiratory portion of the nose (nasal septum, naso- and maxilloturbinals) most bound radioactivity was concentrated in the mucous cells of the respiratory epithelium and the secretory cells of submucous glands). In the olfactory region (ecto and endoturbinals) most bound radioactivity was restricted to the secretory cells of submucous glands, while in the olfactory epithelium only the sustentacular cells were slightly labeled.


Transerythrocytic concentrations of urea and creatinine in normals and in azotemic patients.
Preliminary studies in our laboratory suggested alterations in the distribution of urea and creatinine between red cells and plasma in azotemic patients, as compared to normal controls. The present studies compare plasma erythrocyte concentrations of urea and creatinine in azotemic patients and in control subjects. Effects of adding exogenous urea and creatinine to the blood of control subjects were also studied. The findings suggest alterations of solute distribution patterns in azotemic blood. Specifically, the proportions of the solutes in cells appear reduced in azotemia.


FLNA p.V528M substitution is neither associated with bilateral periventricular nodular heterotopia nor with macrothrombocytopenia.
Filamin A is encoded by the FLNA gene on chromosome Xq28 and functions in cross-linking actin filaments into orthogonal networks in the cortical cytoplasm. FLNA p.V528M was initially detected in a female autopsy case of X-linked bilateral periventricular nodular heterotopia (BPNH), a neuronal migration disorder characterized by subependymal nodules of gray matter. During our mutation analysis of FLNA in a boy with apparent X-linked thrombocytopenia, we detected the p.V528M variant. The patient, mother and sister, who were heterozygous for the substitution, did not have BPNH. We observed an allele frequency of 4.8% in healthy control Japanese, but did not observe the variant in Caucasian subjects. Hemizygous controls had a normal platelet count and size. We suggest that p.V528M is neither associated with BPNH nor with thrombocytopenia and giant platelets, and represents a functional polymorphism.


[Effects of huannao yicong recipe extract on the learning and memory and related factors of Abeta generation in the brain of APP transgenic mice].
To study the effects of Huannao Yicong Recipe (HNYCR)extract on the learning and memory ability, and the expressions of amyloid precursor protein (APP), beta-site APP-cleaving enzyme 1 (BACE1), presenilin-1 (PS-1), and beta amyloid protein (Abeta)in hippocampus CA1 area of APP transgenic mice, and to explore its mechanisms for treating Alzheimer's disease (AD). Totally 3-month-old APP695V7171 transgenic mice were used to establish the AD model in this research. They were randomly divided into the model group, the Donepezil group, the large dose HNYCR extract group, the small dose HNYCR extract group, and the normal control group (C57BL/6J mice), 15 in each group. These animals were gavaged for 4 continuous months. Relevant indicators were detected: Morris water maze test was used to measure the spatial learning and memory ability. The immunohistochemical assay was used to detect the expressions of APP, BACE1, PS-1, and Abeta. The times of crossing the original platform and the swimming time and distance in the fourth quadrant of the 7-month-old APP transgenic mice were significantly reduced in Morris water maze test, when compared with the normal control group (P < 0.01). The times of crossing original platform and the swimming time and distance in the fourth quadrant of all treatment groups significantly increased in Morris water maze test, when compared with the model group (P < 0.05). The expressions of APP, BACE1, PS-1, and Abeta in hippocampus CA1 area of 7-month-old model mice increased significantly (P < 0.01), when compared with the normal control group. The expressions of APP, BACE1, PS-1, and Abeta in each 7-month-old intervention groups were significantly reduced, when compared with the model group (P < 0.01). Early application of HNYCR extract can obviously improve the learning and memory ability of APP transgenic mice that has declined, reduce the expressions of APP, BACE1, PS-1, and Abeta in the hippocampal CA1 area, reduce the production of Abeta, and slow down the pathological process of brains in APP transgenic mice.


Hydrodynamic flow in capillary-channel fiber columns for liquid chromatography.
The flow characteristics of capillary-channel polymer (C-CP) fiber liquid chromatographic (LC) columns have been investigated. The C-CP fibers are manufactured with eight longitudinal grooves (capillary channels) extending the length of the fibers. Three C-CP fiber examples were studied, with fiber dimensions ranging from approximately 35 microm to 65 microm, and capillary-channel dimensions ranging from approximately 6 microm to 35 microm. The influence of fiber packing density and column inner diameter on peak asymmetry, peak width, and run-to-run reproducibility have been studied for stainless steel LC columns packed with polyester (PET) and polypropylene (PP) C-CP fibers. The van Deemter A-term was evaluated as a function of fiber packing density (approximately 0.3 g/cm(3)-0.75 g/cm(3)) for columns of 4.6 mm inner diameter (i.d.) and at constant packing densities for 1.5 mm, 3.2 mm, 4.6 mm, and 7.7 mm i.d. columns. Although column diameter had little influence on the eluting peak widths, peak asymmetry increased with increasing column diameter. The A-terms for the C-CP fiber packed columns are somewhat larger than current commercial, microparticulate-packed columns, and means for improvement are discussed. Applications in the area of protein (macromolecule) separations appear the most promising at this stage of the system development.


Antenatal care attendance, a surrogate for pregnancy outcome? The case of Kumasi, Ghana.
Antenatal care (ANC) has been shown to influence infant and maternal outcomes. WHO recommends 4 ANC visits for uncomplicated pregnancies. However, pregnant women in Ghana are required to attend 8-13 antenatal visits. We investigated the association of ANC attendance with adverse pregnancy outcomes (defined as low infant birth weight, stillbirth, preterm delivery or small for gestational age). A quantitative cross-sectional study was conducted on 629 women, age 19-48 years who presented for delivery at two selected public hospitals and 16 traditional birth attendants from July to November 2011. Socio-demographic and antenatal information were collected using a structured questionnaire. ANC attendance, medical and obstetric/gynecological history were abstracted from maternal antenatal records. Data were analyzed using Chi square and logistic regression. Twenty-two percent of the women experienced an adverse outcome. Eleven percent of the women attended <4 ANC visits. In an unadjusted model, these women had an increased likelihood of experiencing an adverse outcome (OR 2.27; 95% CI 1.30-3.94; p = 0.0038). High parity (>5 children) was also associated with adverse birth outcomes. Women screened for syphilis or use of insecticide-treated bed nets had a 40 and 36% (p = 0.0447 and p = 0.0293) reduced likelihood of experiencing an adverse pregnancy outcome respectively. After adjusting for confounders, attending <4 antenatal visits was associated with adverse pregnancy outcome compared with ≥4 ANC visits (Adjusted OR 2.55; 95% CI 1.16-5.63; p = 0.0202). Attending <4 antenatal visits and high parity were associated with adverse pregnancy outcomes for uncomplicated pregnancies.


Flash glucose monitoring in gestational diabetes mellitus (FLAMINGO): a randomised controlled trial.
Gestational diabetes mellitus (GDM) is the most common type of hyperglycaemia in pregnancy. GDM is a risk factor of adverse perinatal outcomes, with the incidence rate increasing proportionally to the level of maternal dysglycaemia. Therefore, glycaemic control plays an important role in management of GDM. The aim of this study was to assess the efficacy of flash glucose monitoring (FGM) in GDM. This was a non-blinded, randomised controlled trial, that recruited 100 pregnant women diagnosed with GDM between 24 and 28 weeks of gestation at the 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw. After meeting the inclusion criteria patients were randomly allocated to the study group (FGM, n = 50) or control group (self-monitoring of blood glucose-SMBG, n = 50). Clinical and laboratory results were assessed at four follow-up visits. The primary outcome was mean fasting and postprandial glycaemia. The secondary outcomes were perinatal outcomes. There was no significant difference in mean glycaemia between the groups (p = 0.437) Compared to the control group, the study group significantly reduced their fasting (p = 0.027) and postprandial glycaemia (p = 0.034) during the first 4 weeks following GDM diagnosis, with no significant difference in progression to insulin therapy (OR 1.09, 95% CI 0.47-2.57). Incidence of fetal macrosomia was significantly higher in SMBG as compared to FGM group (OR 5.63, 95% CI 1.16-27.22). Study results indicate that FGM has an impact on glycaemic control, dietary habits and incidence of fetal macrosomia in patients with GDM. Trial registration clinicaltrials.gov ID: NCT04422821.


Ionic liquid-based dispersive liquid-liquid microextraction for the determination of formaldehyde in wastewaters and detergents.
Spectrophotometry in combination with ionic liquid-based dispersive liquid-liquid microextraction (DLLME) was applied for the extraction and determination of formaldehyde in real samples. The method is based on the reaction of formaldehyde with methyl acetoacetate in the presence of ammonia. The variation in the absorbance of the reaction product was measured at 375 nm. An appropriate mixture of ethanol (disperser solvent) and ionic liquid, 1-hexyl-3-methylimidazoliumhexafluoro-phosphate [C(6)MIM][PF(6)] (extraction solvent) was rapidly injected into a water sample containing formaldehyde. After extraction, sedimented phase was analyzed by spectrophotometry. Under the optimum conditions, the calibration graph was linear in the range of 0.1-20 ng mL(-1) with the detection limit of 0.02 ng mL(-1) and limit of quantification of 0.08 ng mL(-1) for formaldehyde. The relative standard deviation (RSD%, n = 5) for the extraction and determination of 0.8 ng mL(-1) of formaldehyde in the aqueous samples was 2.5%. The results showed that DLLME is a very simple, rapid, sensitive, and efficient analytical method for the determination of trace amounts of formaldehyde in wastewaters and detergents, and suitable results were obtained.


Parental history of cardiovascular disease as an indication for screening for lipoprotein abnormalities in children.
We studied the relationship between parental history of cardiovascular disease and risk for adverse lipid and lipoprotein levels in a total community study of 3313 children (ages 4 to 17 years, 63% white, 37% black). Older white children (11 to 17 years) with a parental history of heart attack or diabetes were 4.3 and 5.6 times, respectively, more likely to have high levels (greater than or equal to 95th percentile) of serum total cholesterol than those without such a history (all p less than 0.05). White children with a parental history of heart attack or diabetes were twice as likely to have an elevated (greater than or equal to 95th percentile) low-density lipoprotein cholesterol (LDL-C) level than those without such a history (both p less than 0.05). In contrast, parental history of cardiovascular disease did not predict elevated levels of total cholesterol or LDL-C in black children. However, older black children with a parental history of heart attack, hypertension, or diabetes were 4 1/2 to 5 times more likely to have low levels (less than or equal to 5th percentile) of high-density lipoprotein cholesterol than those without such a history (all p less than 0.05). Only 40% of white children and 21% of black children with elevated LDL-C levels had a parental history of vascular disease. These findings raise questions about the current practice of screening only children with a family history of cardiovascular disease to identify those with elevated total cholesterol and LDL-C levels.


Importance of Preventing Inadvertent Perioperative Hypothermia During Liver Transplant.
Inadvertent perioperative hypothermia (IPH) leads to a series of deleterious effects that can be especially in complex procedures such as liver transplant. The implementation of a protocol is key to ensure the patient's normothermia. A cohort of 209 patients who underwent liver transplant in a tertiary hospital in a period between January 2016 and December 2018 was retrospectively analyzed. The patients were divided into 2 groups: group 1, patients with normothermia (core body temperature ≥ 36°C) and group 2, patients with hypothermia (core body temperature < 36°C). Mortality between both groups at 1 month, 1 year, and 3 years is compared. Postoperative morbidity is also compared. The incidence of IPH is 21.5%. Patients with normothermia present with statistical significance: a lower mortality at 1 year; a lower need for transfusion of platelets, plasma, fibrinogen consumption, or massive polytransfusion; and lower primary graft dysfunction, graft and surgical complications, rejection, hemodynamic complications, and metabolic and surgical reintervention. No significant differences were found in mortality at 1 month or 3 years in the need for prolonged mechanical ventilation; hospital readmission; length of stay in the intensive care unit or in hospital stay; rate of red blood cell transfusion; vascular, biliary, respiratory, or digestive complications; refractory ascites; or neurologic, kidney, hematological, endocrine, thrombotic, nutritional, or infectious issues. The incidence of IPH is relatively low in our patients, based on what is described in the literature, and in most cases it is mild. There is a reduction in complications fundamentally related to the consumption of blood products and the graft.


Bortezomib, paclitaxel, and carboplatin as a first-line regimen for patients with metastatic esophageal, gastric, and gastroesophageal cancer: phase II results from the North Central Cancer Treatment Group (N044B).
This study was undertaken to explore the response rate of a first-line, three-drug regimen that consisted of bortezomib, paclitaxel, and carboplatin in patients with metastatic adenocarcinoma of the esophagus, gastroesophageal junction, or gastric cardia. Patients with the above diagnosis and acceptable organ function were treated intravenously on a 21-day cycle with the following: bortezomib 1.2 mg/m on days 1, 4, and 8; paclitaxel 175 mg/m on day 2; and carboplatin with an area under the curve of 6 on day 2. Patients received indefinite treatment unless they manifested tumor progression or severe adverse events. All were monitored for tumor response as well as other clinical outcomes. The cohort included 35 eligible patients with a median age of 59 years (range, 36-78) and an Eastern Cooperative Oncology Group performance score of 0, 1, and 2 in 60%, 34%, and 6% of patients, respectively. Although this regimen was well tolerated, the tumor response rate was lower than that anticipated at 23% (95% confidence interval: 10%, 40%), thereby prompting premature study closure. There were no complete responses. The median survival for the cohort was 8.9 months (95% confidence interval: 5.9, 12.8). As prescribed in this trial and for this indication, this regimen does not merit further testing.


[Caries prevalence among schoolchildren in Zoetermeer. A study performed by primary health doctors].
In a study performed by primary health doctors among 10- and 11-year-olds in Zoetermeer (the Netherlands), 72% of the children were found to possess four healthy permanent first molars. The examination was exclusively based on visual inspection by means of mouth mirrors.


Contesting views on mobility restrictions in urban green spaces amid COVID-19-Insights from Twitter in Latin America and Spain.
Positive sentiments towards urban green spaces (UGS) unequivocally increased worldwide amid COVID-19. In contrast, this paper documents that views on mobility restrictions applicable to UGS are of a contested nature. That is, while residents unambiguously report positive sentiments towards UGS, they do not share views on how to administer access to UGS-which is a matter of public policy. These contesting views reflect opposite demands that managers of UGS had to balance during the pandemic as they faced the challenge of reducing risk of spread while providing services that support physical and mental health of residents. The empirical analysis in this paper relies on views inferred through a text classification algorithm implemented on Twitter messages posted from January to October 2020, by urban residents in three Latin American countries-Argentina, Colombia, and Mexico-and Spain. The focus on Latin America is motivated by the documented lack of compliance with mobility restrictions; Spain works as a comparison point to learn differences with respect to other regions. Understanding and following in real-time the evolution of contesting views amid a pandemic is useful for managers and city planners to inform adaptation measures-e.g. communication strategies can be tailored to residents with specific views.


The clinical development of paclitaxel and the paclitaxel/carboplatin combination.
Paclitaxel and carboplatin have nonoverlapping toxicities with a broad range of clinical activity. The combination of escalating dose paclitaxel and carboplatin dosed to a fixed area under the curve (AUC) was explored in a series of phase I studies. 76 patients were treated with paclitaxel over three hours followed by a 30 min carboplatin infusion, dosed by the Calvert formula to a target AUC of 4.0 or 4.5 mg/min/ml-1. The maximum tolerated dose of paclitaxel was 270 to 290 mg/m2, with a dose limiting toxicity of peripheral sensory neuropathy. Activity was seen in lung cancer, with a paclitaxel dose at or above 230 mg/m2. Neuropathy correlated with paclitaxel AUC due to nonlinear pharmacokinetics at higher doses. Ongoing studies include the use of amifostine as a neuroprotectant and phase II studies of the paclitaxel/carboplatin regimen in head and neck cancer, small cell lung cancer and sarcomas.


Demonstration of specific IgA in human feces after immunization with live Ty21a Salmonella typhi vaccine.
An enzyme-linked immunosorbent assay was applied to evaluate the appearance of specific IgA in fecal eluates of 11 normal subjects given oral live Salmonella typhi Ty21a vaccine. All subjects after immunization showed a detectable rise in levels of specific IgA to both lipopolysaccharide and flagellar antigens of S. typhi.


Effects of lead in the laboratory mouse. Development and social behaviour after lifelong exposure to 12 microM lead in drinking fluid.
The effects of chronic exposure to 12 microM lead, from conception onwards, on development and social behaviour were investigated in the laboratory mouse. Lead was administered as 0.25% solution of lead acetate in the drinking fluid. This level of exposure did not affect reproductive success, but caused decreased birthweight and retarded early development in offspring of treated dams. Mortality prior to weaning was significantly greater in pups treated with lead, and animals treated with lead had significantly reduced body weights throughout their lives. Levels of lead in tissues were greatly increased in all treated animals, with females showing significantly higher levels than males. Behaviour was assessed by ethological methods in paired encounters between unfamiliar animals in a novel environment. At age 3-4 weeks Exploratory Behaviour and Social Investigation were significantly increased and Immobility was significantly decreased in animals of both sexes treated with lead. Social Investigation was also increased at age 7-8 weeks but Exploratory Behaviour was decreased. At age 15-16 weeks Non-Social Activity was increased in males and decreased in females, although Social and Sexual Investigation was not affected in these male-female encounters. Lead-treated males, aged 17-18 weeks, showed significantly shorter latencies to aggression towards unfamiliar males than did controls.


Abuse of growth hormone among young athletes.
The underground abuse of growth hormone (GH) among young athletes presents a challenge to medical professionals. Health care professionals providing knowledgeable guidance regarding healthy ways to improve performance and appearance, as well as accurate information regarding substances' perceived benefits, risks, and unknown qualities, is invaluable to the young athlete. Further research focused on the profile and motivation of young people who use GH is essential to understanding and intervening better with those who use these substances.


Factors affecting professional ethics in nursing practice in Iran: a qualitative study.
Professional ethics refers to the use of logical and consistent communication, knowledge, clinical skills, emotions and values in nursing practice. This study aimed to explore and describe factors that affect professional ethics in nursing practice in Iran. This qualitative study was conducted using conventional content analysis approach. Thirty nurses with at least 5 years of experience participated in the study; they were selected using purposive sampling. Data were collected through semi-structured interviews and analyzed using thematic analysis. After encoding and classifying the data, five major categories were identified: individual character and responsibility, communication challenges, organizational preconditions, support systems, educational and cultural development. Awareness of professional ethics and its contributing factors could help nurses and healthcare professionals provide better services for patients. At the same time, such understanding would be valuable for educational administrators for effective planning and management.


Psychological and psychosocial determinants of musculoskeletal pain and associated disability.
Although much attention has been given to the physical determinants of common musculoskeletal complaints such as back and arm pain, research points to a stronger influence of psychological factors. Multiple studies have implicated poor mental health and somatisation (a tendency to worry about the common somatic symptoms) in the incidence and chronicity of musculoskeletal pain and associated disability. Also important are adverse beliefs about the prognosis of such disorders, and about the role of physical activity in their development and persistence. Differences in societal beliefs may have contributed to major variation in the prevalence of disabling musculoskeletal pain that has been observed between countries and in the same countries over time. Psychosocial aspects of work have also been linked with musculoskeletal pain, although relative risks have generally been smaller. There is a need to take account of psychological factors in the clinical management of patients with back, neck and arm pain.


Persistent decrease in proliferative potential of marrow CD34(+)cells exposed to early-acting growth factors after autologous bone marrow transplantation.
Post-graft hematopoiesis is characterized by long-term quantitative deficiency in marrow progenitor cells in both autologous and allogenic settings. In order to evaluate the function of post-graft progenitor cells, the proliferative capacity of marrow CD34(+) cells was evaluated in 10 patients 6 months after autologous bone marrow transplantation (ABMT) for non-Hodgkin's lymphoma and compared to that of 10 patients before ABMT and 10 normal controls. Immuno-selected CD34(+) cells were cultured for 7 days in liquid serum-free medium with a combination of early-acting GF consisting of stem cell factor, IL-3 and IL-1beta. Clonogenic efficiency of unselected cells for CFU-GM and BFU-E was decreased in post-graft patients compared to pre-graft and control patients. However, clonogenic efficiency of selected CD34(+) cells for CFU-GM was not different in post-graft, pre-graft and control patients but BFU-E values of post-graft patients remained lower than those of control patients. Decreased percentages of CD34(+) CD38(-) cells were observed in both post-graft and pre-graft patients while those of CD34(+) c-kit(+) cells were similar in all three patient groups. After 7-day liquid culture, expansion yields of total progenitor cells were significantly lower in post-graft patients (147 +/- 28%) than in pre-graft (255 +/- 27%) and control patients (246 +/- 23%). Post-graft deficiency in progenitor cell expansion was particularly marked for BFU-E (61 +/- 24%) compared to pre-graft patients (220 +/- 82%) and to controls (349 +/- 82%). These results indicate impaired proliferative potential of marrow CD34(+) cells several months after ABMT involving erythroid progenitor cells and/or commitment towards erythroid lineage from a more immature stage (pre-CFU).


Foraging behavior of cackling Canada Goose goslings: implications for the roles of food availability and processing rate.
Time spent foraging (and in other activities), rate of pecking at food items and length of foraging and nonforaging periods were studied in cackling Canada goose (Branta canadensis minima) goslings during brood-rearing on the Yukon-Kuskokwim Delta, Alaska in 1978 and 1979. Brood density on the study area was twice as high in 1978 (23 broods) as in 1979 (12 broods) owing in part to annual variation in nesting density and success. Peck-rates were lower in meadows during 1978 than in 1979. There was no between-year difference in time spent foraging prior to the adult molt (59% of daylight hours) but during molt, goslings spent more time feeding in 1978 (70%) than in 1979 (56%). Prior to the adult molt, 12.2 and 11.9 hours were spent feeding each day in 1978 and 1979 respectively, whereas goslings fed for 13.4 and 10.6 hours daily, in the two years during molting and fledging. Increased foraging time during the molt in 1978 completely compensated for lower peck rates so that total number of pecks per day during this period were similar in 1978 (62,800 pecks/d) and 1979 (57,900 pecks/d). Elsewhere, we reported that cackling geese significantly reduced the availability of their preferred food in 1979 and this food comprised a smaller proportion of the diet in 1978 than 1979. This variation in diet suggests that preferred foods were less available at higher brood densities, resulting in annual variation in foraging behavior. Lengths of foraging periods increased during brood-rearing in both years but were longer on average in 1978. There was no seasonal or between year variation in the length of nonforaging periods. The alternating pattern of foraging and nonforaging periods suggests that rate of processing limits rate of food intake because a relatively constant period of time was regularly required to empty the esophagus before foraging could be resumed. The restriction of food intake by digestive processes increased the importance of dietary nutrient concentrations because low nutrient concentrations could not be compensated for by higher rates of food intake.


Tumors arising in accessory parotid tissue.
A summary is presented of our experience with 23 patients who had accessory parotid tumors, comprising 1% of all primary parotid neoplasms seen during a 40 year period. Although more than half of the tumors proved malignant, adequate excision was usually curative. We prefer to approach these tumors through an extended cheek-flap incision. Once the lesion is exposed, either local excision or resection in conjunction with subtotal parotidectomy can be performed, depending on the clinical findings.


Upregulation of des-gamma-carboxy-prothrombin after portal vein embolization in a cirrhotic patient with hepatocellular carcinoma.
A 73-year-old female with hepatocellular carcinoma (HCC) received percutaneous transhepatic portal vein embolization (PTPE) before extensive right lobe hepatectomy. Serum levels of des-gamma-carboxy-prothrombin (DCP) were increased and remained at a high level until hepatectomy. Immunohistochemical examination revealed that an increased expression of DCP was demonstrated not only in HCC tissues, but also in the non-cancerous liver of the right lobe, where portal blood flow was blocked off as a result of PTPE. The serum level of DCP is known to be greatly increased in patients with HCC accompanied by portal vein invasion. We speculate that this increased DCP level is caused by both increased DCP production in HCC tissue and the surrounding non-cancerous liver, where portal flow is blocked off as a result of portal invasion by HCC.


Dry socket: a prospective study of prevalent risk factors in a Nigerian population.
To identify major risk factors for developing dry socket in some Nigerians, and to formulate a nonpharmacologic protocol for its effective prevention. Patients presenting with dry socket at the Oral Surgery Clinic of the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria, over an 18-month period were studied. Biographic data, preoperative diagnoses, teeth extracted, oral hygiene status, and history relevant to the extractions and presentations of dry socket were documented. Procedures were classified as traumatic or atraumatic. Data were analyzed using SPSS version 11.0 (SPSS Inc, Chicago, IL) with simple descriptive statistics and the chi(2) test, as appropriate. P <or= .05 was considered significant. Sixty-eight extraction sockets in 65 patients (46 females and 19 males) with a mean age of 33.48 (+/-SD 13.5) years were studied. All extracted teeth were posterior (17 maxillary, and 51 mandibular). Preoperative diagnoses were mainly of acute apical periodontitis secondary to carious lesion (30/68), chronic apical periodontitis (18/68), and chronic pulpitis (15/68). The use of an oral contraceptive was elicited in 25% of the females, and extractions were performed between days 1 and 22 of their menstrual cycle. Extraction was traumatic in 66.2% of cases. A ranking of the elicited risk factors suggests that a previously infected posterior tooth involves an equal risk in both genders. Poor oral hygiene and traumatic extraction in a mandibular tooth were prominent in males, whereas extractions performed between days 1 and 22 of the menstrual cycle were significant in females. Control of preoperative infection, insistence on good oral hygiene, avoidance of trauma, and avoidance of surgery on days 1 to 22 of the menstrual cycle in nonmenopausal women may reduce the incidence of dry socket in the study population.


The Brain Trauma Foundation. The American Association of Neurological Surgeons. The Joint Section on Neurotrauma and Critical Care. Glasgow coma scale score.
When considering the use of the initial GCS for prognosis, the two most important problems are the reliability of the initial measurement, and its lack of precision for prediction of a good outcome if the initial GCS is low. If the initial GCS is reliably obtained and not tainted by prehospital medications or intubation, approximately 20% of the patients with the worst initial GCS will survive and 8-10% will have a functional survival (GOS 4-5).


Laparoscopic total mesorectal excision.
After total mesorectal excision for rectal cancer was introduced in 1982, local recurrence rates decreased to 5%. These results were found to be reproducible; therefore, the technique became standard for the treatment of rectal cancer. Laparoscopic surgery for curable colorectal malignancy is still considered investigational. Indeed, the United States National Cancer Institute (NCI) trial excludes rectal carcinoma. The application of laparoscopy to rectal carcinoma must compete with total mesorectal excision, which has obtained favorable results in the last decade. In this review, we assess the adequacy of laparoscopic total mesorectal excision, describe the techniques (both anterior resection and abdominoperineal resection), and discuss their potential advantages.


Development of delivery system based on marine chitosan: Encapsulationand release kinetic study of antioxidant peptides from chitosan microparticle.
The present work aims to encapsulate goby fish protein hydrolysate (GPH), endowed with antioxidant activity, through ionic gelation process using blue crab chitosan (CH) and tripolyphosphate anions and to evaluate the structural, thermal and antioxidant properties of the elaborated microparticles (MPs). The GPH-loaded MPs present spherical shape as seen by scanning electron microscopy (SEM) images and positive zeta potential. The increase of loaded GPH concentration led to the increase of encapsulation efficiency (EE) and to the reduction of the particle size. In fact, MPs, loaded with 2 and 5 mg/ml GPH, had EE values of 44 and 58% and mean particles size of 4.81 and 3.78 μm, respectively. Furthermore, thermogravimetric analysis (TGA) profiles revealed the enhanced thermal stability of encapsulated biopeptides compared to the free ones. Release kinetic data showed a Fickian diffusion behavior which follows swelling and a diffusion-controlled mechanism for peptides liberation. Finally, as opposed to unloaded MPs, an improvement of the antioxidant activity of the loaded MPs with biopeptides was observed.


High-Frequency Repetitive Magnetic Stimulation at the Sacrum Alleviates Chronic Constipation in Parkinson's Patients.
This study was to investigate the therapeutic effect of high-frequency repetitive magnetic stimulation (HF-rMS) at the sacrum for chronic constipation in Parkinson's patients (PD). Eventually 48 PD patients were enrolled from July 2019 to October 2020, and randomly divided into the HF-rMS group (the intervention group, n = 24) and the sham HF-rMS group (the control group, n = 24). The intervention group received HF-rMS at the sacrum, whereas the control group received ineffective magnetic stimulation. We performed clinical evaluation before and after HF-rMS treatment, including constipation score scale (KESS questionnaire), Unified Parkinson's Disease Rating Scale (UPDRS-III exercise examination), Hoehn-Yahr (H-Y) stage of motor function; simple mental status scale (MMSE), anxiety/depression table (HAD-A/HAD-D), the activity of daily living (ADL), and quality of life scale for patients with constipation (PAC-QOL) to evaluate symptoms and satisfaction of PD patients with chronic constipation. There was no significant difference in the clinical characteristics between the two groups. As compared to the control group, the HF-rMS group displayed a larger change (pre and posttreatment) in the KESS scores of PD patients with chronic constipation, suggesting a significant improvement. Moreover, HF-rMS significantly promoted the mood, activity of daily living, and quality of life of PD patients when comparing the alteration of HAD-A/HAD-D scores, ADL scores, and PAC-QOL scores between the two groups. Finally, there was no significant difference in the change of the UPDRS III score and the MMSE score between the two groups. HF-rMS at the sacrum can improve chronic constipation in PD patients.


Intercellular junctions in human tooth-pulp cells in culture in vitro revealed by freeze-fracture, lanthanum impregnation and filipin treatment.
Three kinds of intercellular junctions were detected between human dental pulp cells in explant culture with electron microscopy included filipin detection for cholesterol; desmosome-like junctions observed on ultrathin sections probably contribute to the cohesiveness between cells in culture. Gap junctions, responsible for intercellular communication, exhibited two morphologies on freeze-fracture replicas: a conventional arrangement of their intramembranous particles and a crystalline array corresponding to the formation stage of junctions. Primitive tight junctions were detected on freeze-fracture replicas but not on ultrathin sections. It is likely that they contribute to the cell-to-cell adhesion under culture conditions.


Mediation analysis of the relationship between sex, cardiovascular risk factors and mortality from coronary heart disease: Findings from the population-based VHM&PP cohort.
In Europe, annually about 77,000 women, but 253,000 men die prematurely from coronary heart disease (CHD) before the age of 65 years. This gap narrows with increasing age and disappears after the eighth life decade. However, little is known regarding the contribution of cardiovascular risk factors to this sex difference. We investigated to what extent men's higher risk of dying from CHD is explained through a different risk factor profile, as compared to women. Mediation analysis technique was used to assess the specific contributions of blood pressure, cholesterol, glucose, and smoking to the difference between men and women regarding CHD mortality in a large Austrian cohort consisting of 117,264 individuals younger than 50 years (as a proxy for pre-menopausal status) and 54,998 older ones, with 3892 deaths due to CHD during a median follow-up of 14.6 years. Adjusting for age and year of examination, we observed a male versus female CHD mortality hazard ratio (HR) of 4.7 (95% CI: 3.4-5.9) in individuals younger than 50 years, of which 40.9% (95% CI: 27.1%-54.7%) was explained through risk factor pathways, mainly through blood pressure. In older participants, there was a HR of 1.9 (95% CI: 1.8-2.0) of which 8.2% (95% CI: 4.6%-11.7%) was mediated through the risk factors. The extent to which major risk factors contribute to the sex difference regarding CHD mortality decreases with age. The female survival advantage was explained to a substantial part through the pathways of major risk factors only in younger individuals.


Response shift in self-rated health after serious health events in old age.
Although health generally deteriorates with advancing age, how older adults evaluate their health status (i.e., their self-rated health, SRH) remains rather positive. So far, however, little is known about how SRH in old age may change in the face of an abrupt health decline. Because change/stability in SRH may reflect not only change/stability in health but also changes in the meaning people assign to the concept of "health", response shift effects in SRH for people with and without a serious health event are investigated in the present study in the older general population. Longitudinal data from 1764 participants of the German Ageing Survey aged 65 + assessed at two occasions three years apart was used to investigate changes in SRH and three types of response shift: recalibration (change in standards for good health), reprioritization (change in the importance of different factors for health), and reconceptualization (omission/inclusion of new factors). The so-called "then-test" was used to examine recalibration response shift and path analyses, to examine reprioritization and reconceptualization response shift. SRH declined between the two measurement occasions. As expected, people who experienced a serious health event indicated stronger declines in SRH. The study found evidence of two types of response shift. Regardless of whether they experienced a serious health event or not, individuals on average retrospectively overestimated their baseline health relative to the concurrent rating (recalibration). Furthermore, the predictive importance of depressive symptoms and optimism for SRH increased for individuals who experienced a serious health event (reprioritization). The results indicate that older adults maintain stable SRH by using two types of response shift: recalibration and, when faced with a serious health event, reprioritization response shift.


Animal models of complex diseases: an initial strategy.
We speculated that the rise in atmospheric oxygen from 2 billion years ago was so integral for the evolution of biocomplexity that it must also associate strongly with complex diseases. As a remote test of this idea, we hypothesized that lines contrasting for disease and health would emerge from artificial selection for low and high aerobic treadmill running capacity. Eleven generations of selection in rats produced lines that differed by 347% in running capacity. The low line demonstrated health risk factors including higher visceral adiposity, blood pressure, insulin, and triglycerides. The high line was superior for VO2max, economy of running, heart function, and nitric oxide-induced vascular dilation.


Next-generation sequencing: the race is on.
The $1000 genome may still be years away, but with the arrival of next-generation sequencing (NGS) technologies that are much faster and cheaper than the traditional Sanger method, large-scale sequencing of hundreds or even thousands of human genomes is fast becoming reality.


Incidence, diagnosis, and management of sacral fractures following multilevel spinal arthrodesis.
Fractures of the sacrum are a rare complication following instrumented spinal fusion, with only 34 cases previously reported in the literature. Previous series have generally been limited to less than five cases. The purpose of this study is to determine the incidence of sacral fractures caudal to instrumented spinal fusion constructs, identify risk factors for fracture and for failure of conservative management, and describe strategies for surgical treatment of these fractures. This is a retrospective review. Patients undergoing instrumented posterior spinal arthrodesis between 2002 and 2011 were included in the sample. Clinical and radiographic data from hospital and surgeon records comprise outcome measures. Methods include a review of clinical and radiographic data from a prospectively collected patient database recording all adjacent segment fractures during the study period. Twenty-four patients developed sacral fractures caudal to instrumented spinal fusion constructs during the study period. The overall incidence was 6.1% and was significantly greater in fusions greater than four levels (14.5%). The mean time from index surgery to fracture was 4.3 months. Only one fracture was evident on plain radiography at the onset of symptoms. Computed tomography, magnetic resonance imaging, and nuclear scintigraphy can all be used to establish the diagnosis. Eight patients were successfully treated conservatively. The mean time to fracture union was 21 weeks. Anterolisthesis of the fracture greater than 2 mm and kyphotic angulation were significantly associated with failure of conservative management. Surgical intervention included posterior extension of the fusion construct to S2 and the iliac wings with sacroiliac joint fusion. In 10 cases, a combined anterior and posterior approach was used that consisted of either revision anterior lumbar interbody fusion or transsacral posterior lumbar interbody fusion. Sacral fractures following instrumented posterior spinal fusion are an uncommon complication; that is often unrecognized on plain radiographs. Risk factors include osteoporosis and long spinal fusions. Anterolisthesis and kyphosis of the fracture is associated with failure of conservative management.


Risk factors for preeclampsia: a case-control study.
To explore the risk factors of preeclampsia and provide information for prevention of preeclampsia among obstetrical patients. A case-control study was designed to find the risk factors of preeclampsia among obstetrical patients by logistic regression analysis. The risk factors for pregnant women were older gestational age, increasing body mass index, living in the countryside or small towns, fewer antenatal visits, and cold seasons. Health education should be emphasized to encourage women to have children at a relatively younger age and control weight during pregnancy. Special measures should be taken to improve the living condition and prenatal care in the countryside and small towns.


The JANUS serum bank.
The on-going JANUS project was initiated by the Norwegian Cancer Society in 1973. The serum bank comprises close to 0.5 million serum samples collected from 170,000 donors. From 2-16 consecutive samples are available from each donor. The sera are stored at -25 degrees C. At regular intervals the JANUS-collection is matched against the files of the Norwegian Cancer Registry. From 1973 to 1991 almost 5000 of the donors have developed some form of cancer. Frozen serum samples collected from a few months to 18 years prior to clinical recognition of their disease are consequently available for research purposes. The aim of the JANUS-project is to search in these premorbid sera for chemical, biochemical, immunological or other changes that might be indicative of cancer development at early stages. Gas chromatography-mass spectrometry and two-dimensional protein electrophoresis have been used to evaluate the stability of the frozen sera. Some recent findings are: CA125 is elevated several months prior to diagnosis of ovarian cancer; serum thyroglobulin may be a preclinical tumour marker in subgroups of thyroid cancer; low level of selenium in serum reflects increased risk of thyroid cancer; and raised antibodies in serum against Epstein-Barr virus is a risk factor for development of Hodgkin's disease. On-going research includes trace elements and cancer, and studies on lipid-profiles, diet and cancer. The serum bank may in principle be used for other purposes, e.g. in environmental studies. Analysis of sequential sera may determine chemical substances in the sera that might reflect differences in exposure to environmental pollutants in the period 1973-1991.


Malaria among under-five children in rural communities of Al-Mahweet governorate, Yemen.
Malaria burden among under-five children living in endemic areas of Yemen is largely unknown due to the lack of community-based studies. Therefore, this study determined the prevalence and risk factors associated with falciparum malaria among under-five children in rural communities of Al-Mahweet governorate, Yemen. This community-based, cross-sectional study recruited 400 under-five children from two rural districts of Al-Mahweet governorate in December 2019. Demographic characteristics (gender, age, education and occupation of the child's parents, and household size) and risk factors associated with malaria were collected through interviews with children's caregivers using a structured questionnaire. Finger-prick blood was screened for Plasmodium falciparum and non-falciparum species using rapid diagnostic tests (RDTs), and duplicate Giemsa-stained thick and thin blood films were examined for malaria parasites. The density of asexual P. falciparum stages was also estimated. Data were then analysed, and the agreement between the results of thick-film microscopy and RDTs for diagnosing falciparum malaria was assessed using the kappa index. Statistical significance was set at a P-value of < 0.05. Plasmodium falciparum was prevalent among 9.8% (95% CI 7.0-13.1) of under-five children in the rural communities of Al-Mahweet, with a median asexual parasite density of 763 ± 2606 parasites/μl of blood (range: 132-4280) and low-to-moderate parasitaemia levels. Approximately one-third of microscopy-confirmed cases were gametocyte carriers. Multivariable logistic regression analysis confirmed that age of three years or older (AOR = 5.6, 95% CI 1.6-19.8; P = 0.007), not sleeping under a mosquito net the previous night of the survey (AOR = 8.0, 95% CI 2.4-27.4; P = 0.001), sleeping outdoors at night (AOR = 4.4, 95% CI 2.0-10.0; P < 0.001), and absence of indoor residual spraying (IRS) during the last year (AOR = 4.2, 95% CI 1.9-9.4; P < 0.001) were the independent predictors of falciparum malaria among under-five children in the rural communities of Al-Mahweet. The observed percentage agreement between thick-film microscopy and RDTs was 98.5%, with a very good agreement (k-index = 0.9) between the two methods for falciparum malaria diagnosis that was statistically significant. Approximately one in ten under-five children in rural communities of Al-Mahweet is infected with P. falciparum based on microscopy and RDTs. Age of three years or older, not sleeping under mosquito nets, sleeping outdoors at night and absence of IRS can independently predict falciparum malaria among them. The very good agreement between thick-film microscopy and RDTs for diagnosing falciparum malaria in children supports the usefulness of using RDTs in such resource-limited rural communities.


Advanced treatment of dye wastewater using a novel integrative Fenton-like/MnO2-filled upward flow biological filter bed system equipped with modified ceramsite.
The deposal of residual hydrogen peroxide (H2O2) in Fenton-like system and the requirement of oxygen in bioreactor are essential parts for the treatment of integrative Fenton-like/bioreactor. A novel low-cost integrative Fenton-like and MnO2-filled upward flow biological filter bed (Fenton-like/MBFB) equipped with the modified ceramsite was constructed to evaluate the main properties and catalytic activity of modified ceramsite, and the optimal conditions of integrative system and compare integrative and traditional systems. In this study, the Fenton-like reactor with modified ceramsite had higher catalytic ability whose Acid Orange 7 (AO7) degradation efficiency reached to 79.3% due to large surface area and high porosity, compared with that with raw ceramsite (44.3%). Furthermore, total utilization efficiency of H2O2 in integrative system (from 32.41% to 53.51%) and removal efficiencies of COD and AO7 were remarkably improved, which would effectively decrease the waste of H2O2 and the setting of regulation pool and aeration tank. Thus, the integrative system can save 0.51 CNY/m3 in construction cost and 0.21 CNY/m3 in operating cost. The average COD removal efficiency, AO7 degradation efficiency and effluent DO concentration were achieved to 64.8%, 79.5% and 9.3 mg/L respectively in integrative system were achieved in integrative system during sixty successive runs. Also, the potential degradation pathway of contaminants was also proposed according to the OH-enhanced at Fenton-like reactor due to catalyst and adsorption of modified ceramsite and the removal of microorganisms and modified ceramsite for contaminants at MBFB. This study demonstrated the feasibility of integrative Fenton-like/MBFB filled with modified ceramsite for simultaneously decreasing operational cost and complexity and enhancing removal efficiency, thus provided a one-step alternative for refractory dye wastewater.


Epitope-associated and specificity-focused features of EV71-neutralizing antibody repertoires from plasmablasts of infected children.
Protective antibody levels are critical for protection from severe enterovirus 71 infection. However, little is known about the specificities and functional properties of the enterovirus 71-specific antibodies induced by natural infection in humans. Here we characterize 191 plasmablast-derived monoclonal antibodies from three enterovirus 71-infected children, each of whom shows a distinct serological response. Of the 84 enterovirus 71-specific antibodies, neutralizing antibodies that target the rims and floor of the capsid canyon exhibit broad and potent activities at the nanogram level against viruses isolated in 1998-2016. We also find a subset of infected children whose enterovirus 71-specific antibodies are focused on the 3- and 2-fold plateau epitopes localized at the margin of pentamers, and this type of antibody response is associated with lower serum titers against recently circulating strains. Our data provide new insights into the enterovirus 71-specific antibodies induced by natural infection at the serological and clonal levels.Enterovirus 71 is a leading cause of hand-foot-and-mouth disease and herpangina. Here, the authors characterize a large panel of plasmablast-derived IgG mAbs that target the capsid of EV71 to identify neutralizing antibodies induced by natural infection.


Control of motor landing and processivity by the CAP-Gly domain in the KIF13B tail.
Microtubules are major components of the eukaryotic cytoskeleton. Posttranslational modifications (PTMs) of tubulin regulates interactions with microtubule-associated proteins (MAPs). One unique PTM is the cyclical removal and re-addition of the C-terminal tyrosine of α-tubulin and MAPs containing CAP-Gly domains specifically recognize tyrosinated microtubules. KIF13B, a long-distance transport kinesin, contains a conserved CAP-Gly domain, but the role of the CAP-Gly domain in KIF13B's motility along microtubules remains unknown. To address this, we investigate the interaction between KIF13B's CAP-Gly domain, and tyrosinated microtubules. We find that KIF13B's CAP-Gly domain influences the initial motor-microtubule interaction, as well as processive motility along microtubules. The effect of the CAP-Gly domain is enhanced when the motor domain is in the ADP state, suggesting an interplay between the N-terminal motor domain and C-terminal CAP-Gly domain. These results reveal that specialized kinesin tail domains play active roles in the initiation and continuation of motor movement.


Immunohistochemical study of epithelial cell proliferation in hyperplastic polyps, adenomas, and adenocarcinomas of the large bowel.
A monoclonal antibody to bromodeoxyuridine was used in tissue specimens previously incubated with bromodeoxyuridine to show S-phase cells by immunohistochemical technique. Biopsy specimens of normal mucosa (n = 10), hyperplastic polyps (n = 10), adenomas with low-grade dysplasia (n = 20), adenomas with high-grade dysplasia (n = 10), and invasive adenocarcinomas (n = 10) of the large bowel were studied. Labeling index and cell proliferative patterns were analyzed. No statistically significant difference was found in labeling index between normal mucosa and hyperplastic polyps or between adenomas with high-grade dysplasia and adenocarcinomas. The labeling index was significantly lower in normal mucosa and in hyperplastic polyps than in adenomas and adenocarcinomas (p less than 0.001). The difference in labeling index between adenomas with high-grade dysplasia and low-grade dysplasia was also statistically significant (0.01 less than p less than 0.05). In normal mucosa and in hyperplastic polyps the proliferative zone was confined to the lower two-thirds of the crypt; no kinetic activity was found in the upper portions of the crypt or in surface epithelium. In adenomas the labeled cells were either present in the upper third or scattered along the whole axis of the crypt and in the surface epithelium. Labeling patterns in invasive carcinomas were similar to those observed in adenomas with high-grade dysplasia. The difference in proliferative patterns between hyperplastic polyps and adenomas supports a different significance of the two polypoid lesions in the histogenesis of large bowel cancer; our results confirm the subsequent steps of the adenoma-carcinoma sequence. Immunohistochemical labeling patterns observed with monoclonal antibody to bromodeoxyuridine in polypoid and cancer lesions of the large bowel are similar to those described by autoradiographic studies.


The effects of kangaroo mother care on physiological parameters of premature neonates in neonatal intensive care unit: A systematic review.
The effects of Kangaroo mother care (KMC) on physiological parameters in preterm infants have been reported in the literature by experimental and quasi-experimental studies, and varying findings have been presented. The present study was conducted to determine the effects of KMC on the physiological parameters of premature newborns in the Neonatal Intensive Care Unit. The review was conducted according to the specified keywords by scanning the EBSCO-host, Cochrane Library, Medline, PubMed, ScienceDirect, Web of Science, and TR index databases using the keywords "kangaroo care AND preterm AND vital signs." The pool mean differences (MDs) were calculated, adopting a 95% confidence interval (CIs) using the Stata 16 software for the meta-analysis [PROSPERO: CRD42021283475]. Eleven studies for systematic review and nine studies for meta-analysis, including 634 participants, were found eligible for inclusion. It was determined that the "temperature" (z = 3.21; p = 0.000) and "oxygen saturation" (z = 2.49; p = 0.000) values created a positive effect in general in the kangaroo care group; however, there was no sufficient evidence to state that it affected the "heart rate" (z = -0.60; p = 0.55) and "respiratory rate" (z = -1.45; p = 0.15) values. In the present study, the duration of KMC application had statistically different effects on temperature and oxygen saturation (SpO2) (p < 0.05). One-hour or shorter applications of KMC had a higher effect on the temperature and oxygen saturation values (1.83; 1.62, respectively). Our results provided references for clinical implications, and the "temperature" and "oxygen saturation (SpO2)" values created a positive effect in general in the KMC group. However, there was no sufficient evidence to state that it affected the "heart rate" and "respiratory rate" values. The duration of KMC application had statistically different effects on temperature and oxygen saturation. One-hour or shorter applications of KMC had a higher effect on the temperature and SpO2 values. Longitudinal, randomized, controlled studies examining the effects of KMC on vital signs in premature newborns with vital parameters outside the normal reference range are recommended. The goal of the NICU nurse is to improve the infant's well-being. The application of KMC is a unique care for the nurse in maintaining the newborn's well-being. The vital signs of newborns hospitalized in the NICU with critical problems may be out of normal limits. KMC is an essential developmental care practice that ensures that the neonate's vital signs are kept within normal limits by relaxing the neonate, reducing stress, increasing comfort, and supporting interventions and treatments. KMC application is unique for each mother‑neonate pair. Depending on the tolerance of the mother and infant in terms of duration, it is recommended to perform KMC in the NICU under the supervision of a nurse. Neonatal nurses should support mothers in giving KMC in the NICU since KMC has ameliorative effects on the vital signs of premature neonates.


Detection of hepatitis B virus DNA in spermatozoa, urine, saliva and leucocytes, of chronic HBsAg carriers. A lack of relationship with serum markers of replication.
Urine, saliva and semen from 18 chronic HBsAg carriers, material that might be concerned in the transmission of hepatitis B virus infection, was examined for the presence of HBV-DNA using molecular hybridisation. HBV-DNA was detected in samples from 14 patients: semen was positive in all of these, saliva in 12 and urine in 10. Autoradiographic studies indicated that HBV-DNA was present in the free form in all cases and in 10, higher molecular weight bands were also observed. While the latter suggested integration of HBV-DNA into host chromosome, resolution to 3.2 Kb following digestion with Eco RI in every case was more consistent with the HBV-DNA being free. In a further group of patients peripheral blood leucocytes were also found to contain HBV-DNA and were the likely source of HBV-DNA in saliva and urine, while in semen both spermatozoa and mononuclear cells contained HBV-DNA. Moreover, free HBV-DNA was identified in the semen of patients without markers of viral replication in serum indicating that sexual transmission could still occur and this is of importance in relation to current vaccination policies.


Methylprednisolone pulse plus mizoribine in children with Henoch-Schoenlein purpura nephritis.
We evaluated whether methylprednisolone and urokinase pulse therapy combined with mizoribine (MUPM) was effective in children with severe Henoch-Schoenlein purpura nephritis (HSPN). We studied 12 patients who had been diagnosed with HSPN of at least ISKDC type III. All patients were treated with MUPM. Clinical features, pathological findings, and prognosis were prospectively investigated. Ten patients (responders; nine with ISKDC grade IIIb and one with grade IVb) were treated with MUPM, whereas MUPM was discontinued due to the lack of response in two patients (non-responders; two with grade IVb). Among responders, urinary protein excretion had decreased significantly from 99.7 ± 37.8 to 25.9 ± 33.4 mg/m(2) per hour after 3 months of therapy. The acute index and tubulointerstitial scores decreased significantly from 5.8 ± 1.5 and 3.8 ± 0.6 at the first biopsy to 2.3 ± 1.3 and 1.0 ± 0.8 at the second biopsy, respectively. At the most recent follow-up, eight of the responders had normal urine, and two had minor urinary abnormalities. Non-responders demonstrated continued high levels of urinary protein excretion after 3 months of therapy, and MUPM was discontinued. Our study suggests that MUPM is effective in ameliorating the proteinuria and the histological severity of HSPN in patients with <50% crescents but is not so effective for HSPN in patients with >50% crescents.


The effect of drugs stimulating central dopaminergic system on transformation of exogenous adenine into c-AMP.
We tested the effect of dopamine (DA), apomorphine (APM), amantadine (AMD), dimethylaminoadamantane (DMAD) or haloperidol (HP) on the in vitro formation of c-AMP from ATP labelled intracellularly with exogenous 14C-adenine or from endogenous ATP in the slices of rat striatum. DA stimulated the synthesis of c-AMP from endogenous and 14C-adenine labelled ATP. Nonspecific stimulants of the dopaminergic system, APM, AMD and DMAD, stimulated the c-AMP synthesis much weaker than DA did. After application of APM, ADM or DMAD, the utilization of ATP formed from 14C/U/adenine for synthesis of c-AMP was lower than after DA. The effects of combined treatment with DA together with APM, AMD or DMAD was additive. HP, 1 X 10(-3) M did not change the amount of radioactive and total c-AMP, but inhibited the stimulatory action of DA and, to a lesser degree, of APM, AMD and DMAD. The synthesis of c-AMP from endogenous ATP stimulated with APM, AMD and DMAD in striate body slices was inhibited by HP more strongly than the synthesis of c-AMP from ATP labelled with exogenous 14C-adenine. The results indicate that ATP synthesized from intracellular adenyl nucleotides is more effectively utilized for the synthesis of c-AMP stimulated by APM, AMD or DMAD in striate body slices, than ATP labelled with 14C-adenine.


Pain Levels of Women Diagnosed with Endometriosis: Is There a Difference in Younger Women?
Early diagnosis and treatment of endometriosis affecting adolescent women are important in preventing chronic pain. Our aim was to analyze the clinical characteristics and severity of symptoms in adolescent patients with endometriosis compared with older patients. This single-center retrospective cohort study in a tertiary referral hospital analyzed women whose first consultation at the certified endometriosis center of Bern University Hospital between January 2017 and December 2020 resulted in the clinical diagnosis of endometriosis. Patients, divided into 2 groups by age, reported visual analog scale (VAS) scores for noncyclic pelvic pain, dysmenorrhea, dyschezia, dysuria, and dyspareunia. The symptom types and severity in the 2 groups were compared. The young patients with endometriosis were analyzed in greater detail, comparing VAS scores and types of endometriosis. From a total of 826 patients, 144 (17.4%) patients 24 years old or younger and 682 (82.6%) patients over 24 years old were compared. The younger patients reported significantly higher pain scores for dysmenorrhea (VAS 7.3 vs 6.6; P = .015), dyspareunia (VAS 4.6 vs 3.4; P = .001), and noncyclic pelvic pain (VAS 4.3 vs 3.7; P = .032) compared with the older patient collective. Similar results were found when excluding patients with hormonal treatment. Young patients with clinically diagnosed endometriosis have significantly higher dysmenorrhea and dyspareunia pain levels than older patients. By acknowledging and understanding this, early diagnosis and adequate treatment can be promoted. Dyspareunia in adolescents in particular merits clinical attention.


Using the sac membrane to close the flap donor site in large meningomyeloceles.
If a large transposition flap with or without muscle is used for closure of a large meningomyelocele defect, then, a part of the donor site of the flap can be closed by split thickness skin graft, which produces an additional donor wound for the patient. We used the sac membrane instead of split thickness skin graft for closure of donor sites of fasciocutaneous flaps and latissimus dorsi musculocutaneous flaps employed to cover large meningomyelocele defects. This technique was used in three thoracolumbar and in two lumbosacral meningomyelocele patients. The sac membrane was prepared like a full thickness skin graft. Follow-up in five patients has ranged from 1 to 18 months, with a mean of 10.6 months. The donor sites that were closed by the sac membrane exhibited complete healing in all patients. We conclude that the sac membrane supplies a reserve of epithelialised tissue that can be used for repair of the meningomyelocele defects.


Labour-related eclampsia.
Twenty-four cases of eclampsia managed in a hospital in Hong Kong over a five-year period were reviewed. Four patients had antepartum eclampsia and one had postpartum eclampsia following elective caesarean section. Four of these five patients had severe pregnancy-induced hypertension (PIH) (greater than 160/100 mmHg). The other 19 patients had eclampsia occurring during labour or within six hours of delivery. This group included 10 patients with labour-onset PIH, none of whom developed severe hypertension before their convulsions. In the remaining nine patients, only five had severe hypertension before convulsion. The results suggest that labour-related eclampsia has become more common than antepartum eclampsia, and severe hypertension before convulsion is an infrequent finding and therefore an unreliable sign in these patients.


The frequency of IgA-deficiency in the Austrian population. A protocol for large-scale screening by ELISA and a study on 3056 blood donors.
A protocol for large scale screening of blood donors for IgA-deficiency with the help of an ELISA is described. The ELISA method proved to be fast and reliable, the obtained data can be managed by electronic data processing. Donors were regarded as IgA-deficient when their serum level was below 10 mg/dl (normal values 90 to 450 mg/dl). At this concentration ELISA shows acceptable reproducibility (within +/- 15% limits). We found 8 deficient donors, i.e. one in 382 or 0.26%. Seven of these donors were totally deficient by ELISA, 2 of them having a strong anti-IgA in their serum. We conclude that ELISA is a simple, reliable, and inexpensive method for screening blood donors for IgA-deficiency.


Antiplatelet therapies are associated with hematoma enlargement and increased mortality in intracranial hemorrhage.
Antiplatelet therapy (AT) is increasingly used for treating or preventing vascular diseases, especially as a consequence of population aging. However, the risks may sometimes outweigh the benefits, mostly in relation to intracranial hemorrhage (ICH). Our aim was to determine whether AT is associated with hematoma enlargement and increased mortality in ICH. A prospective, observational cohort study. The Intensive Care Unit (ICU) of Arrixaca University Hospital (Murcia, Spain). We studied 156 patients admitted with non-traumatic ICH between January 2006 and August 2008. None. Demographic data, medical history and clinical and laboratory parameters were recorded, along with hematoma volume upon admission and after 24h, and mortality. A total of 37 patients (24%) received AT. These subjects were older (69 ± 11 vs. 60 ± 15 years, p=0.001) and more frequently diabetic (38% vs. 15%, p=0.003) than those without AT. We detected no difference in hematoma volume upon admission between the two groups, though the volume was significantly greater after 24h in the AT group (66.7 [IQR 42-110] vs. 27 [4.4-64.6]cm(3), p=0.03), irrespective of surgical intervention. Moreover, hematoma volume increased by more than a third in AT-users (69% vs. 33%, p=0.002), and AT was the only significant predictor of hematoma enlargement. Patients on AT also had higher mortality during their ICU stay (78% vs. 45%, p<0.001). In addition, of the patients with hematoma enlargement, over one-third had higher overall mortality (62.5 vs. 28.8%, p=0.001). Independent risk factors for death were the Glasgow Coma Scale score, blood glucose upon admission, and AT. Our results show an association between AT and subsequent hematoma enlargement, as well as increased mortality in patients presenting with ICH who were receiving AT.


A meta-analysis of the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia.
Mixed findings on the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia (ALL), without radiation, indicate the need for a comprehensive meta-analytic review. The purpose of the current study was to conduct a meta-analysis assessing neuropsychological and academic functioning differences between children with ALL treated solely with chemotherapy and comparison groups. Thirteen articles met inclusion criteria for the meta-analysis and were analyzed using a random effects model, weighted least squares methods. Mean effect sizes were significantly different from zero for multiple domains of intelligence and academic achievement; processing speed; verbal memory; and some aspects of executive functioning and fine motor skills, indicating worse functioning in ALL survivors. Effect sizes for visual-motor skills and visual memory were not significantly different from zero. Results support the presence of neuropsychological and academic sequelae for ALL survivors treated solely with chemotherapy and highlight the need for ongoing follow-up of children with ALL using a standardized neuropsychological test battery and research methodology.


Transluminal placement of a prosthetic graft-stent device for treatment of subclavian artery aneurysm.
A 78-year-old man was seen with an expanding 5 cm false aneurysm of the right subclavian artery. This was treated by an intraluminal graft-stent device introduced through the brachial artery via a 16 F sheath. The graft was constructed from two polytetrafluoroethylene patches of 0.4 mm thickness and anchored in the subclavian artery by an 8 mm stainless steel stent. The procedure was monitored by an image intensifier. Completion arteriography and postoperative duplex scanning confirmed normal flow through the subclavian artery with no communication between the lumen and the aneurysmal sac. The patient recovered without complication.


In Situ Differentiation of Multiplex Noncovalent Interactions Using SERS and Chemometrics.
Probing changes of noncovalent interactions is crucial to study the binding efficiencies and strengths of (bio)molecular complexes. While surface-enhanced Raman scattering (SERS) offers unique molecular fingerprints to examine such interactions in situ, current platforms are only able to recognize hydrogen bonds because of their reliance on manual spectral identification. Here, we differentiate multiple intermolecular interactions between two interacting species by synergizing plasmonic liquid marble-based SERS platforms, chemometrics, and density functional theory. We demonstrate that characteristic 3-mercaptobenzoic acid (probe) Raman signals have distinct peak shifts upon hydrogen bonding and ionic interactions with tert-butylamine, a model interacting species. Notably, we further quantify the contributions from each noncovalent interaction coexisting in different proportions. As a proof-of-concept, we detect and categorize biologically important nucleotide bases based on molecule-specific interactions. This will potentially be useful to study how subtle changes in biomolecular interactions affect their structural and binding properties.


Epitope-specific regulation. IV. In vitro studies with suppressor T cells induced by carrier/hapten-carrier immunization.
Sequential immunization with a carrier molecule and a new epitope (hapten) conjugated to the carrier (carrier/hapten-carrier immunization) induces specific suppression for IgG antibody production to the new epitope (hapten) on the carrier. Once induced, this "epitope-specific" suppression persists and specifically suppresses subsequent in vivo IgG antibody responses to the hapten presented on the same or on an unrelated carrier molecule. In vitro studies presented here characterize the surface markers and specificity of suppressor T cells generated in carrier/hapten-carrier-immunized animals. Thus we show (1) that spleen cells from these donors suppress in vitro IgG anti-hapten antibody production by cocultured hapten-primed spleen cells; (2) that some but not all of the suppressor cells carry surface Lyt-2; (3) that at least some of the suppressor cells have receptors for the inducing hapten (DNP); and (4) that, unlike the suppression obtained in vivo, the in vitro suppression extends to IgG responses to unrelated carrier protein epitopes presented in association with the inducing hapten.


Lateral musculature in the whitemouth croaker (Micropogonias furnieri): its characterization with respect to different gonadal conditions.
Histochemical and ultrastructural studies were performed on the lateral musculature from individual female whitemouth croaker, Micropogonias furnieri, at the anterior, medium and posterior regions. Based upon histochemical myosin-ATPase (m-ATPase) determination, diverse types of red, pink and white fibres were discerned. Red muscle had abundant mitochondria and stained intensely for aerobic enzymes, white muscle scarcely stained for the same enzymes and pink muscle responded in an intermediate manner. Both white and pink muscle had few mitochondria. The relative proportion of red muscle increased towards the caudal region; pink muscle diminished towards this region and white muscle modified its proportion only in the anterior region. m-ATPase activity showed differences in relation to the gonadal condition along the body, particularly in the white fibres at the anterior and medium regions.


Presenilin 1 and APP Gene Mutations in Early-Onset AD Families from a Southeast Region of China.
Early-Onset Familial Alzheimer's Disease (EOFAD) has been reported to be associated with Presenilin 1 (PSEN1), Presenilin 2 (PSEN2), and Amyloid Precursor Protein (APP) genes. The spectrum of mutations in Chinese patients with EOFAD was rarely investigated. To investigate the spectrum of mutations in patients with EOFAD in Chinese population. We performed whole-exome sequencing and described relevant clinical features in a total of 67 subjects from 3 families with EOFAD. A splice mutation (p.S290C) in PSEN1 and a missense mutation (p.V717I) in APP were identified. The variant p. S290C (c.869-2>G) in PSEN1 in Chinese EOAD family revealed different clinical phenotypes when compared with that of Europeans.


Studies on the allergic and nonallergic nasal inflammation.
Nasal lavage after antigenic and nonantigenic nasal stimulation has become an important tool for the study of inflammatory phenomena in the upper airway. Biochemical and cytologic information is relatively easily obtainable, and pharmacologic manipulations can be readily monitored. This article is of several studies aiming toward a more profound understanding of the mechanisms of allergic and nonallergic rhinitis by the use of laboratory-challenge procedures and nasal-lavage techniques. An early and a late reaction are detected clinically in the nose after antigen challenge of allergic individuals. In addition, the sensitivity to antigen significantly increases after the initial challenge, and this phenomenon is not obligatorily linked to the presence of a late-phase reaction (LPR). Inflammatory mediators, mostly mast cell- and/or basophil-derived, are detected in the nasal washes and correlate with the symptomatology in both the early and the late reactions. The allergen-induced LPR is marked by an early influx of eosinophils and, later, basophils and neutrophils. Elevation of major basic protein and histamine, but not prostaglandin D2, is detected during the LPR, giving evidence of active eosinophil and basophil participation. Systemic steroids can effectively suppress the clinical, biochemic, and cellular manifestations of antigen-induced LPR. Topical steroids have a similar effect but are also capable of suppressing the early reaction to antigen. A nonallergic form of rhinitis can be induced in the laboratory by nasal inhalation of dry air at freezing temperatures in individuals who report sensitivity to cold and windy environments.(ABSTRACT TRUNCATED AT 250 WORDS)


Age-Related Sleep Changes and its Implication in Neurodegenerative Diseases.
In the article authors discuss the current data on sleep changes with aging focusing on the influence of age-related degenerative changes in orexin-containing and pacemaker brain areas. Pathophysiological mechanisms of sleep disturbances in Parkinson's and Alzheimer's diseases have much in common with normal age neurophysiological changes. Maintenance of the sleep-promoting systems function could positively modify the course of these diseases.


Sensitivity and specificity of a lateral flow immunoassay (LFI) in serum samples for diagnosis of melioidosis.
Culture is the gold standard for the diagnosis of melioidosis, an infection caused by Burkholderia pseudomallei. Here we evaluate a lateral flow immunoassay (LFI) to detect B. pseudomallei capsular polysaccharide (CPS) in serum samples. Patients with culture from any clinical specimen positive for B. pseudomallei were selected as cases. Patients who were blood culture positive for Staphylococcus aureus, Escherichia coli or Klebsiella pneumoniae as well as those who were malaria or dengue polymerase chain reaction assay positive were selected as controls. The sensitivity of the LFI was 31.3% (60/192 case patients [95% confidence interval {CI} 24.8 to 38.3]) and the specificity was 98.8% (559/566 control patients [95% CI 97.4 to 99.5]) in serum samples. Although LFI may have limited sensitivity in serum, it can rapidly diagnose melioidosis in resource-limited settings.


Neck-shoulder loading in wordprocessor use. Effect of learning, gymnastics and armsupports.
The loading of wordprocessor workers was followed over a four month period of a re-education course with the aid of electromyography of the trapezius and frontalis muscles in order to study the effect of learning. Working with the word processor increased the electrical activities in both muscles. The increase did not diminish with the learning of the work. On the contrary the electrical activity increased significantly in the frontalis muscle. Intervening gymnastics during work decreased the electrical activities. The screen (on/off) did not affect the activity. Most effective in lowering the myoelectrical activity in both muscles were the armsupports. A significant positive linear correlation was observed in the electrical activities of the trapezius and frontalis muscles both at rest and during wordprocessor work.


Hydrogen peroxide bleaching of cotton in ultrasonic energy.
It is well known that, conventional hydrogen peroxide bleaching process is an important and a specific step for wet processors; however it has some problems such as long time, high energy consumption. On the other hand, using ultrasonic energy in bleaching is an alternative method for the conventional processes. In this work, 100% cotton materials of different forms such as raw fibre, ring-spun yarns and knitted fabrics produced from these cottons, were treated with hydrogen peroxide in two different concentrations (5 mL/L and 10 mL/L), at three different temperatures (20 degrees C, 30 degrees C, 40 degrees C) and times (20 min, 30 min, 60 min). Whiteness Index of the samples were then measured spectrophotometrically and the overall results were compared.


'Legal highs'--novel and emerging psychoactive drugs: a chemical overview for the toxicologist.
'Legal highs' are psychoactive chemicals which are sold from 'head shops', the internet and from street suppliers and may be possessed without legal restriction. An increase in the marketing of these materials has resulted in a corresponding increase in published reports of their adverse effects. However, a lack of primary literature pertaining to their chemistry, pharmacology and toxicology, makes an evaluation of their harm difficult. This review covers the basic chemistry of these novel psychoactive compounds and relates them to endogenous neurotransmitters and existing drugs of abuse. A survey of the internet was used to identify websites that are marketing 'legal highs' in the UK. Trivial and systematic chemical compound names, for example methoxetamine, 4-methoxyphencycline, 4-fluorotropacocaine and ethyl phenidate were entered into PubMed to retrieve data on these compounds. This search elicited no citations. Other search terms which were more fruitful included desoxypipradrol, diphenylprolinol, methylenedioxy-2-amino-indane and methylenedioxy-2-amino-tetralin, alpha-methyltryptamine and 5-methoxy-N,N-diallyl-tryptamine. 'Legal highs' from the phenylethylamine, cocaine, tryptamine and phencyclidine classes are increasingly being marketed and, in the majority of cases, little is cited in the literature on their true chemical identity, pharmacology or toxicology. 'Legal highs' are gaining in popularity and present clear challenges to toxicologists and society as a whole. Whilst improved use of existing legislation and development of new legislation can be used to reduce the supply of these materials, investment in better education for young people on the harms associated with 'legal highs' is needed.


Putting it into practice: strategizing a successful anemia management protocol in the long-term care setting.
To familiarize the consultant pharmacist with the new American Medical Directors Association (AMDA) guideline for the management of anemia in the long-term care setting and with the responsibilities of each member of the interdisciplinary care team in anemia management. Guidelines and recent articles focusing on anemia in geriatric patients or in the long-term care population. Key articles and guidelines were selected to provide background supporting the need for improved recognition and management of anemia in the long-term care setting and the role of the consultant pharmacist in meeting this need. This clinical review includes data relevant to the development of a clinical protocol for the diagnosis and management of anemia in the long-term care setting and the role of the consultant pharmacist in developing such protocols. The successful implementation of an anemia management protocol in the long-term care setting requires an interdisciplinary effort and familiarity with clinical practice guidelines and recommendations. Such protocols can optimize the quality of life and functional status of geriatric patients with anemia. The consultant pharmacist can fill a crucial role in improving the recognition and management of anemia in the long-term care setting. Familiarity with the recommendations put forth in the AMDA guideline can assist consultant pharmacists in developing protocols that can be followed by members of the interdisciplinary care team and can improve the quality of life of patients with anemia.


Seasonal associations between air pollutants and influenza in 10 cities of southern China.
Few studies have explored the associations between air pollutants and influenza across seasons, especially at large scales. This study aimed to evaluate seasons' modifying effects on associations between air pollutants and influenza from 10 cities of southern China. Through scientific evidence, it provides mitigation and adaptation strategies with practical guidelines to local health authorities and environmental protection agencies. Daily influenza incidence, meteorological, and air pollutants data from 2016 to 2019 were collected. Quasi-Poisson regression with a distributed lag nonlinear model was used to evaluate city-specific air pollutants and influenza associations. Meta-analysis was used to pool site-specific estimates. Attributable fractions (AFs) of influenza incidence due to pollutants were calculated. Stratified analyses were conducted by season, sex, and age. Overall, the cumulative relative risk (CRR) of influenza incidence for a 10-unit increase in PM2.5, PM10, SO2, NO2, and CO was 1.45 (95% CI: 1.25, 1.68), 1.53 (95% CI: 1.29, 1.81), 1.87 (95% CI: 1.40, 2.48), 1.74 (95% CI: 1.49, 2.03), and 1.19 (95% CI: 1.04, 1.36), respectively. Children aged 0-17 were more sensitive to air pollutants in spring and winter. PM10 had greater effect on influenza than PM2.5 in autumn, winter, and overall, lesser in spring. The overall AF due to PM2.5, PM10, SO2, NO2, and CO was 4.46% (95% eCI: 2.43%, 6.43%), 5.03% (95% eCI: 2.33%, 7.56%), 5.36% (95% eCI: 3.12%, 7.58%), 24.88% (95% eCI: 18.02%, 31.67%), and 23.22% (95% eCI: 17.56%, 28.61%), respectively. AF due to O3 was 10.00% (95% eCI: 4.76%, 14.95%) and 3.65% (95% eCI: 0.50%, 6.59%) in spring and summer, respectively. The seasonal variations in the associations between air pollutants and influenza in southern China would provide evidence to service providers for tailored intervention, especially for vulnerable populations.


Menstrual cycle influences grooming behavior and sexual activity in the Rhesus monkey.
The time spent by the female rhesus monkey in grooming the male fluctuates rhythmically and reaches a minimum at mid-cycle. At this time the male's grooming activity reaches a maximum. The rhythmic changes in male mounting behavior, together with the males' and females' grooming cycles, are abolished by ovariectomy and have a hormonal basis.


Establishing naming in typically developing two-year-old children as a function of multiple exemplar speaker and listener experiences.
Naming is a verbal developmental capability and cusp that allows children to acquire listener and speaker functions without direct instruction (e.g., incidental learning of words for objects). We screened 19 typically developing 2- and 3-year-old children for the presence of Naming for 3-dimensional objects. All 9 3-year-olds had Naming, and 8 of 10 2-year-olds lacked Naming. For the 2-year-old children who lacked Naming, we used multiple-probe designs (2 groups of 4 children) to test the effect of multiple exemplar instruction (MEI) across speaker and listener responses on the emergence of Naming. Prior to the MEI, the children could not emit untaught listener or speaker responses following match-to-sample instruction with novel stimuli, during which they had heard the experimenter tact the stimuli. After MEI with a different set of novel stimuli, the children emitted listener and speaker responses when probed with the original stimuli, in the absence of any further instruction with those stimuli. Seven of 8 children acquired the speaker and listener responses of Naming at 83% to 100% accuracy. We discuss the basic and applied science implications.


Green finance, the low-carbon energy transition, and environmental pollution: evidence from China.
With 2008-2020 China's provincial panel data as the research object, we use the entropy weight method to compute green finance and pollution, and we empirically study the scope of the spillover effects and threshold impacts of green finance on environmental pollution using the spatial Durbin model and threshold regression model. The findings are as follows: first, under different spatial weight matrices, green finance has a spatial spillover effect on pollution. And the effect boundary is approximately 500 km. Second, with the low-carbon energy transition, technological progress, and green finance as threshold variables, there are a single threshold, single threshold, and double threshold, respectively, that have significant threshold effects. Third, the spillover and threshold effects of green finance on pollution differ by region. The indirect effect is negative in the eastern region and positive in the central and western regions. There is a single threshold effect of low-carbon energy transition and green finance in the western region, a single threshold effect of green finance in the central region, and a single threshold effect of technological progress in the eastern region. On this basis, we put forward. specific policy recommendations.


Nasal route for vaccine and drug delivery: Features and current opportunities.
Mucosal administration, and specifically nasal route, constitutes an alternative and promising strategy for drug and vaccine delivery. Mucosal routes have several advantages supporting their selective use for different pathologies. Currently, many efforts are being made to develop effective drug formulations and novel devices for nasal delivery. This review described the structure and main characteristics of the nasal cavity. The advantages, achievements and challenges of the nasal route use for medical purposes are discussed, with particular focus on vaccine delivery. Compelling evidences support the potentialities and safety of the nasal delivery of vaccines and drugs. This alternative route could become a solution for many unmet medical issues and also may facilitate and cheapen massive immunization campaigns or long-lasting chronic treatments. Nowadays, in spite of certain remaining skepticism, the field of nasal delivery of drugs and vaccines is growing fast, bolstered by current developments in nanotechnology, imaging and administration devices. A notable increase in the number of approved drugs for nasal administration is envisaged.


En Bloc enucleation with early apical release technique using MOSES (En Bloc MoLEP) vs. classic En Bloc HoLEP: a single arm study comparing intra- and postoperative outcomes.
We aimed to describe the technique and outcomes of En-Bloc MOSES laser enucleation of the prostate (En-Bloc MoLEP) with early apical release comparing it to En-Bloc HoLEP (non-MOSES). This is a single-arm prospective study, using a historical control. n = 80 patients were enrolled to the En Bloc MoLEP group and compared to a retrospective group of n = 137 patients treated by En Bloc HoLEP (non-MOSES), in total n = 217 patients. En-Bloc MoLEP, showed to significantly improve the surgical time by 32% compared to non-MOSES HoLEP (32.16 ± 14.46 min, 47.58 ± 21.32, respectively; P = 0.003). Enucleation time, ablation rate and hemostasis time were also significantly improved (P < 0.001, for all three parameters). Enucleation time was 22.10 ± 9.27 min and 31.46 ± 14.85 min (P < 0.001), ablation rate 4.11 ± 2.41 and 2.54 ± 1.31 gr/min (P < 0.001), Hemostasis time 3.01 ± 2.50 and 8.35 ± 5.38 min (P < 0.001), for En Bloc MoLEP and En Bloc HoLEP, respectively. Q-max, PVR, PSA and IPSS showed significant improvement, however, at 12 months no significant differences were observed comparing both groups. En-Bloc MoLEP was significantly better than En-Bloc HoLEP in terms of surgical time, enucleation time, ablation rate and hemostasis time. However, large comparative RCT with long-term follow-up are needed.