[Clinical study of acoustic densitometry technique in detecting atherosclerotic plaque].
To investigate the effect of Quyu Xiaoban Capsule (QYXB) on the regressive treatment of atherosclerosis (AS) with acoustic densitometry (AD) technique. Eighty patients with AS were randomly divided into two groups, trial group was treated with QYXB and conventional medicine, and control group was treated with conventional medicine alone. Normal arterial wall and different types of atherosclerotic plaques were detected with AD technique before treatment and 10 months later. The corrected averages in intimal echo intensity (AIIc%) were elevated in both groups but without significant difference, AIIc% of fatty plaques were increased in both groups and the value after treatment was significantly higher than that of pre-treatment in the trial group (68.12 +/- 5.54 vs 61.43 +/- 5.37, P < 0.05). The increment rate of AIIc% in trial group was significantly higher than that in control group (10.9 +/- 5.1% vs 2.5 +/- 5.5%, P < 0.05). QYXB can stabilize the atherosclerotic plaque by increasing its acoustic density. Acoustic densitometry technique can differentiate the different histological plaques and monitor the histological changes of plaques during treatment.


Local adenoviral delivery of soluble CD200R-Ig enhances antitumor immunity by inhibiting CD200-β-catenin-driven M2 macrophage.
CD200 is known as an immune checkpoint molecule that inhibits innate immune cell activation. Using a head and neck squamous cell carcinoma (HNSCC) model, we sought to determine whether localized delivery of adenovirus-expressing sCD200R1-Ig, the soluble extracellular domain of CD200R1, enhances antitumor immunity. Mouse-derived bone marrow cells and M1/M2-like macrophages were cocultured with tumor cells and analyzed for macrophage polarization. As an in vivo model, C57BL/6 mice were subcutaneously injected with MEER/CD200High cells, CD200-overexpressing mouse HNSCC cells. Adenovirus-expressing sCD200R1-Ig (Ad5sCD200R1) was designed, and its effect was tested. Components in the tumor-immune microenvironment (TIME) were quantified using flow cytometry. CD200 promoted tumor growth and induced the expression of immune-related genes, especially macrophage colony-stimulating factor (M-CSF). Interestingly, CD200 induced M2-like polarization both in vitro and in vivo. Consequently, CD200 recruited more regulatory T (Treg) cells and fewer CD8+ effector T cells. These effects were effectively abolished by local injection of Ad5sCD200R1. These protumor effects of CD200 were driven through the β-catenin/NF-κB/M-CSF axis. CD200 upregulated PD-L1, and the combined targeting of CD200 and PD-1 thus showed synergy. The immune checkpoint CD200 upregulated immune-related genes through β-catenin signaling, reprogrammed the TIME, and exerted protumor effects. Ad5sCD200R1 injection could be an effective targeted strategy to enhance antitumor immunoediting.


Recurrence dynamics after curative surgery in patients with invasive mucinous adenocarcinoma of the lung.
We investigated the patterns and timing of recurrence and death as well as prognostic factors based on clinicopathological and radiological factors in patients who underwent surgical treatment for invasive mucinous adenocarcinoma (IMA). We reviewed clinicopathological findings including spread through air spaces (STAS) and CT findings of IMA such as morphology, solidity, margin, well-defined heterogeneous ground-glass opacity, CT angiogram, and air bronchogram signs from 121 consecutive patients who underwent surgical resection. Prognostic factors for disease-free survival (DFS) and overall survival (OS) were identified. Hazard rate analyses were performed for the survival dynamics. T stage (hazard ratio [HR] = 4.102, p = 0.03), N stage (N2 vs. N0, HR = 7.653, p < 0.001), and consolidative CT morphology (HR = 3.556, p = 0.008) remained independent predictors for DFS. Age (HR = 1.110, p = 0.002), smoking (HR = 12.893, p < 0.001), T stage (HR = 13.005, p = 0.006), N stage (N2 vs. N0, HR = 7.653, p = 0.004), STAS (HR = 7.463, p = 0.008), and consolidative CT morphology (HR = 6.779, p = 0.007) remained independent predictors for OS. Consolidative morphology, higher T and N stage, and presence of STAS revealed initial sharp peaks after steep decline of the hazard rate curves for recurrence or death in follow-up period. Consolidative morphology, higher T and N stage, smoking, and STAS were indicators of significantly greater risk of early recurrence or death in patients with IMA. Thus, these findings could be incorporated into future surveillance strategies.


Effects of curing mode and moisture on nanoindentation mechanical properties and bonding of a self-adhesive resin cement to pulp chamber floor.
This study aimed to investigate the effect of dentin surface moisture and curing mode on microtensile bond strength (MTBS) and nanoindentation characteristics of a self-adhesive resin cement. Forty-four extracted human molars were distributed into four groups according to dentin surface moisture (dry or wet) and curing mode of the resin cement (light or chemical). Clearfil SA Cement (Kuraray Noritake Dental, Japan) was used for cementation of composite cores to the pulp chamber dentin. The specimens were sectioned into beams for MTBS test at the pulpal floor. Nanoindentation hardness and creep of the cement layer were measured under 100 mN load with 30s hold segment. Data were statistically analyzed using two-way ANOVA and Weibull distribution of MTBS (α=0.05). Moisture, curing mode or their interaction did not significantly affect mean MTBS values that ranged 17.6-22.6 MPa (p>0.05); however, the lowest characteristic strength was found in moist chemically cured group. Hardness ranged 437-512 MPa, and was not affected by the experimental factors (p>0.05). Nanoindentation creep ranged 9.3-10.9% with the chemically cured groups showing the highest values, indicating lower cross-linking and deformation resistance of their polymer network. Additional moisture on dentin surface did not contribute to adhesion of the anhydrous self-adhesive resin cement to dentin. Light-curing, despite attenuation through the composite core, was beneficial and improved nanoindentation creep resistance of the cement. The difference was not, however, reflected in the mean bond strength or hardness values.


Prolonged lidocaine metabolizing activity of primary hepatocytes with spheroid culture using polyurethane foam as a culture substratum.
Primary rat hepatocytes formed spheroids in the pores of polyurethane foam (PUF) used as a culture substratum. The hepatocytes in monolayer and spheroid stationary culture converted lidocaine to monoethylglycinexylidide (MEGX) which was N-deethylation of lidocaine. The metabolic activity of the hepatocytes/spheroid stationary culture system was 1.5∼2.0-fold higher than that of monolayer culture for 10 days. The activity of albumin production and cell survival of hepatocytes in monolayer and spheroid cultures decrease due to lidocaine treatment dependend on the lidocaine concentration, but the activity and cell survival in PUF/spheroid stationary culture were maintained at a higher level than that in monolayer culture under the lidocaine treatment. We developed a device for an in vitro liver model, drug metabolism simulator (DMS), using a PUF/spheroid packed-bed module including 4.00 ± 0.68 × 10(7) hepatocytes and analyzed pharmacokinetics of lidocaine in a one-compartment model. Lidocaine clearance and extraction ratio of hepatocytes in the DMS corresponded to 1.354 ± 0.318 ml/min/g-liver and 0.677 ± 0.0159/g-liver, respectively (N=4). These values were comparable with in vivo values, 1.930 ml/min g-liver and 0.965/g-liver reported by Nyberg (1977). Consequently, PUF/spheroid culture maintained high lidocaine metabolizing activity over a long term and seems to provide a promising culture system as a drug metabolism simulator which will be used for drug screening, cytotoxicity tests and prediction of pharmacokinetics.


Correlation of QT interval correction methods during atrial fibrillation and sinus rhythm.
The calculation of the corrected QT interval (QTc) is particularly problematic in patients during atrial fibrillation (AF). The aims of this study were to compare the QTc calculated using Bazett's formula in AF and sinus rhythm (SR) and determine whether alternative methods for QT correction were superior to Bazett's, in an effort to define the optimal method for QT correction in patients with AF. We evaluated consecutive patients with persistent AF admitted for initiation of dofetilide. The QT interval was corrected according to the following formulas: Bazett's, Fridericia, and Framingham. We compared the QTc interval on the last electrocardiogram in AF to the first electrocardiogram in SR. The cohort included 54 patients (age 60 ± 10 years, 80% men) with persistent AF for a median of 36 months. Bazett's overestimated QTc during AF compared with SR (464 ± 34 vs 445 ± 38 ms, p = 0.008); in contrast, Framingham underestimated it (385 ± 48 vs 431 ± 40 ms, p <0.001, respectively). However, there was no significant difference between the QTc interval in AF and SR when assessed by Fridericia (435 ± 33 vs 440 ± 35 ms, p = 0.46). There were 24 dofetilide dose reductions based on Bazett's QTc; this would have been avoided in 33% of patients had Fridericia been used. In conclusion, the commonly used Bazett's formula leads to an overestimation of the QTc during AF. This may result in unnecessary reduction in antiarrhythmic doses and thus drug efficacy. These data suggest that the Fridericia most closely approximates the QTc during AF to QTc during SR.


The effect of intravenous contrast on intensity-modulated radiation therapy dose calculations for head and neck cancer.
The objective of this study was to determine if the use of intravenous contrast results in clinically important errors in intensity-modulated radiation therapy (IMRT) dose calculations for head and neck radiotherapy treatment planning. Nonionic, iodinated intravenous contrast (Iohexol) was administered during the treatment planning computed tomography (CT) scan of 5 patients with head and neck cancer of varying disease sites. The potential effect of intravenous contrast was studied by changing the density of the contrast-enhanced vessels. An inverse IMRT plan was generated from an unmanipulated "normal contrast" planning scan. We then applied the same planning parameters to a "no contrast" planning scan. The effect of intravenous contrast was quantified by calculating the percent change of dose in a variety of target and normal structures. To evaluate a worst-case scenario situation, this comparison was repeated by assigning the vessels the maximum density in our planning system ("maximum contrast" density plan). Dose differences between a planning set of images using intravenous contrast and a set of images without contrast were less than 0.2% for all relevant target volumes and critical structures. A worst-case scenario in which normal contrast was overridden with "maximum contrast" led to small dose differences, generally less than 0.5%. Planning head and neck IMRT from CT scans that contain intravenous contrast does not result in clinically important errors in dose delivery.


Silk chemistry and biomedical material designs.
Silk fibroin has applications in different medical fields such as tissue engineering, regenerative medicine, drug delivery and medical devices. Advances in silk chemistry and biomaterial designs have yielded exciting tools for generating new silk-based materials and technologies. Selective chemistries can enhance or tune the features of silk, such as mechanics, biodegradability, processability and biological interactions, to address challenges in medically relevant materials (hydrogels, films, sponges and fibres). This Review details the design and utility of silk biomaterials for different applications, with particular focus on chemistry. This Review consists of three segments: silk protein fundamentals, silk chemistries and functionalization mechanisms. This is followed by a description of different crosslinking chemistries facilitating network formation, including the formation of composite biomaterials. Utility in the fields of tissue engineering, drug delivery, 3D printing, cell coatings, microfluidics and biosensors are highlighted. Looking to the future, we discuss silk biomaterial design strategies to continue to improve medical outcomes.


1-(Hex-5-en-1-yl)-4-{[3-methyl-2,3-di-hydro-1,3-benzo-thia-zol-2-yl-idene]meth-yl}quinolin-1-ium iodide monohydrate.
The title thia-zole orange derivative, bearing an alkene substituent, crystallized as a monohydrate of its iodide salt, namely, (Z)-1-(hex-5-en-1-yl)-4-{[3-methyl-2,3-di-hydro-1,3-benzo-thia-zol-2-yl-idene]meth-yl}quinolin-1-ium iodide monohydrate, C24H25N2S+·I-·H2O. The packing features aromatic π-stacking and van der Waals inter-actions. The water mol-ecule of crystallization inter-acts with the cation and anion via O-H⋯N and O-H⋯I hydrogen bonds, respectively.


Development of small-molecule inhibitors of sphingosine-1-phosphate signaling.
The pleiotropic sphingolipid mediator, sphingosine-1-phosphate, produced in cells by two sphingosine kinase isoenzymes, SphK1 and SphK2, regulates many cellular and physiological processes important for homeostasis and development and pathophysiology. Many of the actions of S1P are mediated by a family of five specific cell surface receptors that are ubiquitously and specifically expressed, although important direct intracellular targets of S1P have also recently been identified. S1P, SphK1, and or S1P receptors have been linked to onset and progression of numerous diseases, including many types of cancer, and especially inflammatory disorders, such as multiple sclerosis, asthma, rheumatoid arthritis, inflammatory bowel disease, and sepsis. S1P formation and signaling are attractive targets for development of new therapeutics. The effects of a number of inhibitors of SphKs and S1PRs have been examined in animal models of human diseases. The effectiveness of the immunosuppressant FTY720 (known as Fingolimod or Gilenya), recently approved for the treatment of multiple sclerosis, whose actions are mediated by downregulation of S1PR1, has become the gold standard for S1P-centric drugs. Here, we review S1P biology and signaling with an emphasis on potential therapeutic benefits of specific interventions and discuss recent development of small molecule antagonists and agonists that target specific subtypes of S1P receptors as well as inhibitors of SphKs.


CFVisual: an interactive desktop platform for drawing gene structure and protein architecture.
When researchers perform gene family analysis, they often analyze the structural characteristics of the gene, such as the distribution of introns and exons. At the same time, characteristic structural analysis of amino acid sequence is also essential, for example, motif and domain features. Researchers often integrate these analyses into one image to dig out more information, but the tools responsible for this integration are lacking. Here, we developed a tool (CFVisual) for drawing gene structure and protein architecture. CFVisual can draw the phylogenetic tree, gene structure, and protein architecture in one picture, and has rich interactive capabilities, which can meet the work needs of researchers. Furthermore, it also supports arbitrary stitching of the above analysis images. It has become a useful helper in gene family analysis. The CFVisual package was implemented in Python and is freely available from https://github.com/ChenHuilong1223/CFVisual/ . CFVisual has been used by some researchers and cited by some articles. In the future, CFVisual will continue to serve as a good helper for researchers in the study of gene structure and protein architecture.


Banana-peel-derived magnetic porous carbon as effective adsorbent for the enrichment of six bisphenols from beverage and water samples.
Functionalized magnetic nanoporous carbon derived from banana peel was synthesized through carbonization, porogenesis, carboxylation and magnetization using banana peel and was successfully used as a magnetic solid phase extraction (MSPE) material for the enrichment of six bisphenols (BPs) from beverage and water samples. After the optimization of MSPE process, the enrichment factors of six target analytes were in the range of 74-112 for water samples, and 15-22 for beverage samples. Then, high-performance liquid chromatography-quadrupole-Orbitrap high-resolution mass spectrometry (HPLC-Q Orbitrap-HRMS) was used for the separation and determination of the target analytes. Results showed that the extraction recoveries for 6 BPs were in the range of 71.9-108.4% with an RSD of 2.5-7.5% (n = 6). These results demonstrated that the as-prepared material could efficiently enrich some aromatic compounds and the proposed method is reliable and robust for the determination of BPs in water and beverage samples.


Indocyanine green potentiated paclitaxel nanoprodrugs for imaging and chemotherapy.
Self-assembled prodrug nanoparticles with tumor-responsive capacity have great potential in tumor visualization and treatment. However, the nanoparticle formulas usually contain multiple components, especially polymeric materials, which result in various potential issues. Herein, we report an indocyanine green (ICG)-driven assembly of paclitaxel prodrugs integrating near-infrared fluorescence imaging and tumor-specific chemotherapy. By feat of the hydrophilic merit of ICG, paclitaxel dimer could form more uniformly monodispersed nanoparticles. This two-in-one strategy reinforces the complementary advantages, resulting in superior assembly behavior, robust colloidal stability, enhanced tumor accumulation as well as desirable near-infrared imaging and in vivo feedback of chemotherapy. The in vivo experiments validated the prodrug activation at tumor sites as evidenced by enhanced fluorescence intensity, potent tumor growth suppression, and reduced systemic toxicity compared with commercial Taxol. The universality of ICG potentiated strategy toward photosensitizers and fluorescence dyes was confirmed. This presentation provides deep insight into the feasibility of constructing clinical-close alternatives for improving antitumor efficacy.


Use of microdebrider in glottic stenosis following airway stenting.
Stent placement may induce granulation tissue, occlude the stent lumen, and exacerbate respiratory symptoms. Microdebrider was designed to treat laryngeal papillomas and airway stenosis. However, little research exists on the management of airway stenosis following airway stenting with microdebrider. This study describes two cases of glottic stenosis caused by airway stenting successfully treated with mibrodebrider.


Inelastic scattering and stopping power of low-energy electrons (0.01-10 keV) in toluene.
In this study, the stopping power for electrons in toluene is reported for incident energies ranging from 10 to 10,000 eV. The present results have been obtained by combining the calculated inelastic electron scattering cross-sections with an experimental energy loss procedure. Calculations have been carried out by means of a quasifree absorption model whose reliability has been checked by comparison with empirical electron scattering total cross section data. Results have been compared with the high-energy stopping power data available in the literature. For energies below 1 keV these are the first results of the stopping power for electrons in toluene.


Displacement of a Total Ossicular Replacement Prosthesis Following Ossicular Chain Reconstruction.
Herein we describe the diagnosis and management of total ossicular replacement prosthesis (TORP) displacement following tympanoplasty with ossicular chain reconstruction (OCR). Case report with literature review. A 40-year-old male with otorrhea and tympanic membrane perforation underwent a right revision tympanoplasty with OCR using a TORP with a tragal chondroperichondrial graft. On postoperative day (POD) 4, he developed vertigo and profound right-sided hearing loss. Temporal bone computed tomography showed the prosthesis in the vestibule. After a steroid taper with mild improvement in symptoms, the TORP was removed two weeks later and the patient continued to improve. TORP displacement into the vestibule is a very rare complication following OCR. Conservative management with high dose steroids may improve symptoms, however further middle ear exploration and surgical management may be warranted depending on the depth of displacement into the inner ear as well as symptom severity.


Histone deacetylase inhibitor belinostat regulates metabolic reprogramming in killing KRAS-mutant human lung cancer cells.
Kirsten rat sarcoma virus (KRAS) oncogene, found in 20%-25% of lung cancer patients, potentially regulates metabolic reprogramming and redox status during tumorigenesis. Histone deacetylase (HDAC) inhibitors have been investigated for treating KRAS-mutant lung cancer. In the current study, we investigate the effect of HDAC inhibitor (HDACi) belinostat at clinically relevant concentration on nuclear factor erythroid 2-related factor 2 (NRF2) and mitochondrial metabolism for the treatment of KRAS-mutant human lung cancer. LC-MS metabolomic study of belinostat on mitochondrial metabolism was performed in G12C KRAS-mutant H358 non-small cell lung cancer cells. Furthermore, l-methionine (methyl-13 C) isotope tracer was used to explore the effect of belinostat on one-carbon metabolism. Bioinformatic analyses of metabolomic data were performed to identify the pattern of significantly regulated metabolites. To study the effect of belinostat on redox signaling ARE-NRF2 pathway, luciferase reporter activity assay was done in stably transfected HepG2-C8 cells (containing pARE-TI-luciferase construct), followed by qPCR analysis of NRF2 and its target gene in H358 cells, which was further confirmed in G12S KRAS-mutant A549 cells. Metabolomic study reveals significantly altered metabolites related to redox homeostasis, including tricarboxylic acid (TCA) cycle metabolites (citrate, aconitate, fumarate, malate, and α-ketoglutarate); urea cycle metabolites (Arginine, ornithine, argino-succinate, aspartate, and fumarate); and antioxidative glutathione metabolism pathway (GSH/GSSG and NAD/NADH ratio) after belinostat treatment. 13 C stable isotope labeling data indicates potential role of belinostat in creatine biosynthesis via methylation of guanidinoacetate. Moreover, belinostat downregulated the expression of NRF2 and its target gene NAD(P)H:quinone oxidoreductase 1 (NQO1), indicating anticancer effect of belinostat is mediated, potentially via Nrf2-regulated glutathione pathway. Another HDACi panobinostat also showed potential anticancer effect in both H358 and A549 cells via Nrf2 pathway. In summary, belinostat is effective in killing KRAS-mutant human lung cancer cells by regulating mitochondrial metabolism which could be used as biomarkers for preclinical and clinical studies.


Abdominal obesity is a more important causal risk factor for pancreatic cancer than overall obesity.
Obesity and type 2 diabetes (T2D) are associated with increased risk of pancreatic cancer. Here we assessed the relationship between pancreatic cancer and two distinct measures of obesity, namely total adiposity, using BMI, versus abdominal adiposity, using BMI adjusted waist-to-hip ratio (WHRadjBMI) by utilising polygenic scores (PGS) and Mendelian randomisation (MR) analyses. We constructed z-score weighted PGS for BMI and WHRadjBMI using publicly available data and tested for their association with pancreatic cancer defined in UK biobank (UKBB). Using publicly available summary statistics, we then performed bi-directional MR analyses between the two obesity traits and pancreatic cancer. PGSBMI was significantly (multiple testing-corrected) associated with pancreatic cancer (OR[95%CI] = 1.0804[1.025-1.14], P = 0.0037). The significance of association declined after T2D adjustment (OR[95%CI] = 1.073[1.018-1.13], P = 0.00904). PGSWHRadjBMI association with pancreatic cancer was at the margin of statistical significance (OR[95%CI] = 1.047[0.99-1.104], P = 0.086). T2D adjustment effectively lost any suggestive association of PGSWHRadjBMI with pancreatic cancer (OR[95%CI] = 1.039[0.99-1.097], P = 0.14). MR analyses showed a nominally significant causal effect of WHRadjBMI on pancreatic cancer (OR[95%CI] = 1.00095[1.00011-1.0018], P = 0.027) but not for BMI on pancreatic cancer. Overall, we show that abdominal adiposity measured using WHRadjBMI, may be a more important causal risk factor for pancreatic cancer compared to total adiposity, with T2D being a potential driver of this relationship.


Effect-kinetic characterization of dimethindene maleate following oral administration (Fenistil, Tropfen).
Dimethindene maleate is a well known H1-receptor antagonist with strong affinity to the H1-receptor. In order to evaluate the time course of its activity, dimethindene maleate was investigated in a histamine provocation model in man. Eight healthy male volunteers were treated either with 4 mg dimethindene maleate using a commercially available solution (Fenistile, Tropfen) or an identically appearing placebo solution (po) following a double-blind, crossover study design. Intracutaneous histamine injections were administered at -1, 2, 5, 14, 17, 20, 23, 26 and 29 h following drug administration. Areas of flares and weals were measured 5, 10, 20, and 30 min following histamine provocation. A strong inhibition of the development of flares and weals was observed to be more pronounced in flares than in weals. Baseline adjusted areas under the curve differ statistically significantly following verum and placebo treatment conditions (P = 0.0028). According to the time schedule of the study maximal effects were observed at time point 5 h. The mean residence times of the inhibitory effects were calculated to be congruent to 13 h compared to the mean residence times of dimethindene blood levels of approximately 8 h indicating a non-linear relationship between blood level and effect.


High-Throughput Analysis of Amino Acids for Protein Quantification in Plant and Animal-Derived Samples Using High Resolution Mass Spectrometry.
Current methods for measuring the abundance of proteogenic amino acids in plants require derivatisation, extended run times, very sensitive pH adjustments of the protein hydrolysates, and the use of buffers in the chromatographic phases. Here, we describe a fast liquid chromatography-mass spectrometry (LC-MS) method for the determination of amino acids that requires only three steps: hydrolysis, neutralisation, and sample dilution with a borate buffer solution for pH and retention time stability. The method shows excellent repeatability (repeated consecutive injections) and reproducibility (repeated hydrolysis) in the amino acid content, peak area, and retention time for all the standard amino acids. The chromatographic run time is 20 min with a reproducibility and repeatability of <1% for the retention time and <11% for the peak area of the BSA and quality control (QC) lentil samples. The reproducibility of the total protein levels in the hydrolysis batches 1-4 was <12% for the BSA and the lentil samples. The level of detection on column was below 0.1 µM for most amino acids (mean 0.017 µM).


Hungry for blood vessels: linking metabolism and angiogenesis.
A new study by Arany et al. demonstrates that the metabolic master regulator peroxisome proliferator-activated receptor (PPARgamma) coactivator-1alpha (PGC-1alpha) can promote angiogenesis. These findings show that alterations in metabolic homeostasis are linked to angiogenesis, which raises exciting opportunities for novel proangiogenic and antiangiogenic therapies in various diseases.


One and done? Repair of recurrent hernias after prior Myofascial release.
Myofascial release (MFR) techniques, including retromuscular hernia repair, are often considered one-time repairs. We report recurrent ventral hernia repair (RVHR) in patients with prior MFR, focusing on redo-RM repair. Retrospective analysis of all patients undergoing RVHR after prior MFR. Primary outcomes were operative time, surgical site infection (SSI), surgical site occurrence (SSO), and 20-month recurrence. 111 RVHR were performed after MFR. For patients with prior external oblique release (EOR, n = 31), transversus abdominis release (TAR) was used for repair in 13. For patients with prior TAR/PCS (posterior component separation) (n = 22), EOR (n = 2) and redo-TAR (n = 3) were employed with comparable results. Prior retromuscular (RM) repair was performed in 92 patients. Redo-RM (n = 32) and intraperitoneal onlay mesh (IPOM; n = 38) were most common. Operative time was longer for redo-RM. SSI (12.5 vs 7.9%), SSO (40.1 vs 39.5%), and recurrence (18.8 vs 16.2%) were similar for redo-RM and IPOM repair. RVHR after prior MFR does not preclude additional MFR. Redo-RM VHR outcomes are similar to those repaired with other techniques.


Role of manganese oxides in the exposure of mute swans (Cygnus olor) to Pb and other elements in the Chesapeake Bay, USA.
The aims of this study are to estimate exposure of waterfowl to elements in contaminated sediments in the Chesapeake Bay and to consider the potential role of Mn in influencing bioavailability and exposure. Metal concentrations were measured in livers and digesta taken from mute swans living on the Aberdeen Proving Ground, whose sediment had elevated concentrations of Cu, S, Se, Zn, As, Co, Cr, Hg and Pb. Concentrations of only the first four of these elements were elevated in swan digesta. None of the concentrations detected in the digesta or livers of the swans was considered toxic, although the concentrations of Cu and Se were high compared to concentrations of these elements reported in other waterfowl. Lead was found to be scavenged by Mn and Fe oxides from the water and deposited on the surface of vegetation at a reference site. Under some environmental chemical conditions, this is an important route of exposure to Pb in waterfowl, not previously recognized.


Radiology report turnaround: expectations and solutions.
The ultimate work product of a radiology department is a finalized radiology report. Radiology stakeholders are now demanding faster report turnaround times (RTAT) and anything that delays delivery of the finalized report will undermine the value of a radiology department. Traditional reporting methods are inherently inefficient and the desire to deliver fast RTAT will always be challenged. It is only through the adoption of an integrated radiology information system (RIS)/picture archiving and communication system (PACS) and voice recognition (VR) system that RTAT can consistently meet stakeholder expectations. VR systems also offer the opportunity to create standardized, higher quality reports.


Soil phosphorus concentrations in Dane County, Wisconsin, USA: an evaluation of the urban-rural gradient paradigm.
Understanding the magnitude and location of soil phosphorus (P) accumulation in watersheds is a critical step toward managing runoff of this pollutant to aquatic ecosystems. Here, I examine the usefulness of urban-rural gradients, an emerging experimental design in urban ecology, for predicting extractable soil P concentrations across a rapidly urbanizing agricultural watershed in southern Wisconsin. I compare several measures of an urban-rural gradient to predictors of soil P such as soil type, slope, topography, land use, land cover, and fertilizer and manure use. Most of the factors that were expected to drive differences in soil P concentrations were found to be poor predictors of Bray-1 (extractable) soil P, which ranged from 4 to 660 ppm; while there were several significant relationships, most explained only a small proportion of the variation. A multiple linear regression model captured approximately 37% of the variation in the data using the urban-rural gradient, topography, land use, land cover, manure use, and soil type as predictors. There was a significant relationship between Bray-1 P concentration and each of the urban-rural gradients, but these relationships explained only between 2.6% and 3.3% of the variation in P concentrations. Extractable P concentration in soils, unlike some other ecosystem properties, is not well predicted by urban-rural gradients.


Epithelial differentiation in the mouse preimplantation embryo: making adhesive cell contacts for the first time.
The preimplantation embryo generates two distinct tissues, the trophectoderm, which is a transporting polarized epithelium, and the inner cell mass. Epithelial differentiation and tissue segregation, here examined in relation to the maturation of membrane adhesion and cell junction systems, are coordinated events regulated by a combination of the zygotic gene expression programme, kinase-mediated protein activation and cell-cell interactions.


Impact of baseline pool impedance on lesion metrics and steam pops in catheter ablation.
Little is known about the impact of blood-pool local impedance (LI) on lesion characteristics and the incidence of steam pops. Radiofrequency applications at a range of powers (30, 40, and 50 W), contact forces (CF) (5, 15, and 25 g), and durations (15, 30, 45, and 120 s) using perpendicular/parallel catheter orientation were performed in 40 excised porcine preparations, using a catheter capable of monitoring LI (StablePoint©, Boston Scientific). To simulate the variability in blood-pool impedance, the saline-pool LI was modulated by calibrating saline concentrations. Lesion characteristics were compared under three values of saline-pool LI: 120, 160, and 200 Ω. Of 648 lesions created, steam pops occurred in 175 (27.0%). When power, CF, time, and catheter orientation were adjusted, ablation at a saline-pool impedance of 160 or 200 Ω more than doubled the risk of steam pops compared with a saline-pool impedance of 120 Ω (Odds ratio = 2.31; p = .0002). Lesions in a saline-pool impedance of 120 Ω were significantly larger in surface area (50 [38-62], 45 [34-56], and 41 [34-60] mm2 for 120, 160, and 200 Ω, p < .05), but shallower in depth (4.0 [3-5], 4.4 [3.2-5.3], and 4.5 [3.8-5.5] mmfor 120, 160, and 200 Ω, respectively, p < .05) compared with the other two settings. The correlation between the absolute LI-drop and lesion size weakened as the saline-pool LI became higher (e.g., 120 Ω group (r2 = .30, r2 = .18, and r2 = .16, respectively for 120, 160, and 200 Ω), but the usage of %LI-drop (= absolute LI-drop/initial LI) instead of absolute LI-drop may minimize this effect. In an experimental model, baseline saline-pool impedance significantly affects the lesion metrics and the risk of steam pops.


Pathophysiology of the aortic regurgitation Doppler signal end-diastolic notching: "A-dip insight".
A 76-year-old man was admitted to the hospital with symptoms of severe decompensated heart failure. Initial echocardiogram showed normal left ventricular (LV) ejection fraction, grade II diastolic dysfunction, and mild-to-moderate aortic regurgitation. The aortic regurgitant Doppler signal exhibited an end-diastolic notching, called an A-dip. After intravenous diuretic therapy and 3 kg weight loss, a new echocardiogram was performed showing a grade I diastolic dysfunction and complete abolishment of the A-dip. Aortic A-dip is a rare finding denoting increased LV filling pressures. Conditions that favor its occurrence are increased LV stiffness, low diastolic blood pressure, and preserved left atrial contractility.


The power of analysis: statistical perspectives. Part 2.
A discussion of the importance of statistical power in research is presented accompanied by nomograms for determining sample size and statistical power for the Student's paired and unpaired t tests with a Type I error of 5%. A brief review of statistical inference is presented. Some findings from Part I are reviewed.


Hearing impairment after childhood bacterial meningitis dependent on etiology in Luanda, Angola.
Childhood bacterial meningitis (BM) damages hearing, but the potential of different agents to cause impairment in developing countries is poorly understood. We compared the extent of hearing impairment in BM caused by Haemophilus influenzae type b (Hib), Streptococcus pneumoniae or Neisseria meningitidis among children aged 2 months to 13 years in Luanda, Angola. Hearing of 685 ears of 351 (78%) survivors among 723 enrolled patients was tested by brainstem-evoked response audiometry on day 7 of hospitalization. The causative agent was sought by cerebrospinal fluid culture, PCR or the latex-agglutination test. Altogether, 45 (12%) of the survivors were deaf (threshold >80 dB), and 20 (6%) had a threshold of 80 dB. The incidence of any kind of hearing loss, with ≥60 dB, was 34% with Hib, 30% with S. pneumoniae, 19% with N. meningitidis and 33% with other bacteria. Examining all ears combined and using the ≥60 dB threshold, the agents showed dissimilar harm (P=0.005), Hib being the most frequent and N. meningitidis the most infrequent cause. Compared to other agents, S. pneumoniae more often caused deafness (P=0.025) and hearing impairment at ≥60 dB (P=0.017) in infants, whereas this level of hearing loss in older survivors was most commonly caused by Hib (P=0.031). BM among children in Angola is often followed by hearing impairment, but the risk depends on the agent. S. pneumoniae is a major problem among infants, whereas Hib is mainly a risk beyond 12 months. N. meningitidis impairs hearing less frequently.


Intravital Imaging of Vascular Permeability by Two-Photon Microscopy.
The regulation of vascular permeability is critical in inflammation. It controls the distribution of water and plasma contents such as immunoglobulins in peripheral tissues. To regulate allergic diseases, it is important to study vascular biology especially in inflammation. Since the vascular permeability changes in minutes upon the exposure to proinflammatory mediators, intravital imaging system is a powerful technique to capture such dynamic responses. We here describe how to evaluate vascular permeability in vivo using multiphoton microscopy. We use various sizes of fluorescence-labeled dextran to visualize how leaky the blood vessels are in the steady state and in inflammation. Using this assay system, we can illustrate the dynamic kinetics of vascular permeability in vivo in real-time. This assay system provides a novel convenient way to study vascular biology that is beneficial in the assessment of various animal models of allergic disease.


Noninvasive Technique to Monitor the Pressure under a Cast: A Mobile Application-Friendly Bluetooth Pressure Sensor.
The purpose of this study was to design a sensor that could monitor the skin-cast contact surface pressure (SCCSP) of a limb under a cast and inform the user via a mobile application when the pressure increases. In this experimental study, an infant sphygmomanometer cuff was initially placed on the forearm of 10 volunteers. A pressure sensor with a Bluetooth chip was then placed on the volar aspect of the forearm. Short arm plaster was applied with synthetic cast material. The SCCSP under the plaster was measured by the sensor and the measured values were transmitted to a mobile application via a Bluetooth chip. The mobile application processed the data from the chip and converted it to mmHg. Intracompartmental pressure (ICP) values were categorized as 0, 10, 20, 30, 40, 50, 60, and 75 mmHg. The highest SCCSP was 75 mmHg CP, while the lowest was 0 mmHg CP. The correlation coefficient of the mean pressure values was 0.993 (p ≤ 0.001) (SD 0.002, range 0.989-0.997), and there was a significant relationship between ICP and SCCSP values (p ≤ 0.05). We can monitor SCCSP, detect limb swelling, and notify the user via a mobile application by using Bluetooth pressure sensors.


The transduction pattern of IL-12-encoding lentiviral vectors shapes the immunological outcome.
In situ modification of antigen-presenting cells garnered interest in cancer immunotherapy. Therefore, we developed APC-targeted lentiviral vectors (LVs). Unexpectedly, these LVs were inferior vaccines to broad tropism LVs. Since IL-12 is a potent mediator of antitumor immunity, we evaluated whether this proinflammatory cytokine could enhance antitumor immunity of an APC-targeted LV-based vaccine. Therefore, we compared subcutaneous administration of broad tropism LVs (VSV-G-LV) with APC-targeted LVs (DC2.1-LV)-encoding enhanced GFP and ovalbumin, or IL-12 and ovalbumin in mice. We show that codelivery of IL-12 by VSV-G-LVs or DC2.1-LVs augments CD4(+) or CD8(+) T-cell proliferation, respectively. Furthermore, we demonstrate that codelivery of IL-12 enhances the CD4(+) TH 1 profile irrespective of its delivery mode, while an increase in cytotoxic and therapeutic CD8(+) T cells was only induced upon VSV-G-LV injection. While codelivery of IL-12 by DC2.1-LVs did not enhance CD8(+) T-cell performance, it increased expression of inhibitory checkpoint markers Lag3, Tim3, and PD-1. Finally, the discrepancy between CD4(+) T-cell stimulation with and without functional CD8(+) T-cell stimulation by VSV-G- and DC2.1-LVs is partly explained by the observation that IL-12 relieves CD8(+) T cells from CD4(+) T-cell help, implying that a T(H)1 profile is of minor importance for antitumor immunotherapy if IL-12 is exogenously delivered.


Animating platelet production adds physiological context.
Animating complex biological processes contextualizes them within their underlying physiology, identifies gaps in our mechanistic understanding, affirms the importance of continued research, and provides a bridge between academic scientists and the general public. Here, two videos illustrate the clinical value of and translate state-of-the-art research in platelet production.


New insights into cholesterol efflux via ABCA1.
ABCA1 promotes the efflux of cholesterol from cells to HDL and has anti-atherogenic activities. Sun and Li present cryo-EM structures of ABCA1 in the ATP-free and ATP-bound states, which reveal bound cholesterol molecules and suggest a transmembrane cholesterol-transport mechanism.


Going for a stroll on lurasidone: Considerations on an atypical case of acute compartment syndrome of both legs.
Non-traumatic acute bilateral compartment syndrome is a rare condition that may lead to limb ischemia. We describe a case of this syndrome occurring after a five-kilometer walk in a young woman receiving chronic treatment with lurasidone, leading to a bilateral foot-drop and rhabdomyolysis of the anterolateral compartment of both legs. Due to her late presentation in the emergency department, we opted for a conservative approach, closely monitoring her renal function. We noticed a subsequent clinical and biochemical improvement over the following days, with the patient returning to her daily routine in a matter of weeks, despite a persisting bilateral foot drop. Since atypical antipsychotics are known to be associated with rhabdomyolysis, while possibly exerting a toxic effect on mitochondria, we hypothesize that a mild aerobic physical exertion might have triggered the event, in the context of an iatrogenic muscle susceptibility to oxidative distress.


Bioplex analysis of plasma cytokines in Alzheimer's disease and mild cognitive impairment.
Inflammatory mechanisms within the central nervous system contribute to cognitive impairment via cytokine-mediated interactions between neurons and glial cells. Sixty-nine subjects were consecutively recruited from October 2005 to February 2007. Fifteen individuals were excluded from the study and we ultimately enrolled 19 not cognitively impaired subjects, 25 mild cognitive impairment patients, and 10 Alzheimer's disease patients. To examine the inflammatory markers of mild cognitive impairment and Alzheimer's disease, we measured the plasma concentrations of 23 cytokines using a bioplex assay. The results showed that the macrophage migration inhibitory factor was higher in mild cognitive impairment and in Alzheimer's disease patients compared with the not cognitively impaired group; the results also showed that monokine induced by gamma interferon was higher in Alzheimer's disease patients than in not cognitively impaired subjects, as well as those of the mild cognitive impairment group [corrected].


Upconversion luminescence-based aptasensor for the detection of thyroid-stimulating hormone in serum.
Thyroid-stimulating hormone (TSH) plays a crucial physiological and pathological role in humans, and a timely and sensitive detection of TSH is critical for early diagnosis and prevention of thyroid-related diseases. Herein, we developed a simple wash-free biological aptasensor based on luminescence resonance energy transfer (LRET) between NaYF4:Yb,Er upconversion nanoparticles (UCNPs) and tetramethylrhodamine (TAMRA) for the detection of TSH with high sensitivity. In this LRET system, UCNPs as donors and TAMRA as receptors were modified with nucleic acid aptamers Apt-1 and Apt-2, respectively. When TSH was present, the two aptamer strands both specifically recognized TSH to form a hairpin-like structure, thereby shortening the space between UCNPs and TAMRA. The LRET occurred under radiation of 980-nm light. By detecting the change of upconversion luminescence (UCL) intensity (I545nm), the activity of TSH was quantified. The resulting detection dynamic range and the limit of detection were 0.1-5.0 mIU·L-1 and 0.065 mIU·L-1, respectively. The aptasensor using UCNPs as LRET donors was capable of effectively eliminating the background interference of a complicated biological environment, and showed good specificity because of the excellent recognition function of aptamers. Due to high sensitivity, easiness of fabrication, operational convenience, and selectivity, the UCL-based aptasensor is a promising candidate for clinical TSH determination. Based on nucleic acid aptamer and the mechanism of luminescence resonance energy transfer (LRET) between upconversion nanoparticles (UCNPs) donor and tetramethylrhodamine (TAMRA) receptor, an aptasensor was constructed for the quantitative analysis of TSH activity in serum by testing the change of I545nm.


Initial characterization of sheep T-cell growth factor and its species-restricted activity on human, rat, and mouse cells.
Sheep T-cell growth factor (TCGF) was prepared from concanavalin A-activated sheep peripheral blood cells and subsequently characterized by ammonium sulfate precipitation, gel exclusion chromatography, and isoelectric focussing. The TCGF was found in the 60-80% ammonium sulfate fraction and was shown to have an apparent molecular weight of 32,500 and an isoelectric point in the range pI 5.2-5.5. The ability of the sheep TCGF to promote proliferation of activated human, sheep, mouse, and rat cells was compared with that of human TCGF prepared by phytohemagglutinin stimulation of lymphocytes from multiple donors and TCGF prepared from concanavalin A-stimulated rat and mouse spleen cells. Human TCGF was found to act across all species barriers, rat TCGF supported the growth of cells of all species except human, and mouse only promoted the growth of activated mouse and rat cells. Sheep TCGF was unique in being unable to support the growth of any cells except autologous cells.


Thyroid surgery with the new harmonic scalpel: a prospective randomized study.
Despite their safety and effectiveness in thyroid surgery, the previous harmonic scalpel instruments are considered large and cumbersome by several surgeons. An innovative technical improvement of the device has been made available since 2008. The objective of this study was to compare the results of total thyroidectomy using the new harmonic scalpel (FOCUS) with that with the previously available device (HARMONIC ACE). A prospective randomized study of all total thyroidectomies between February and July 2008 was conducted. Patients (n = 90) were randomized to undergo total thyroidectomy with FOCUS (group A, n = 45) or HARMONIC ACE (group B, n = 45). No significant differences were identified between the 2 groups in terms of demographics, reoperative thyroid surgery, thyroid gland weight and diameter, pathologic diagnosis, preoperative and postoperative serum PTH and calcium levels, postoperative complications, duration of hospital stay, and final outcome. The mean operative time was less in group A than group B (63 ± 7 min vs 76 ± 8 min, P = .009). The new harmonic scalpel is a useful adjunct to the armamentarium of the thyroid surgeon. It is safe, effective, and hand friendly, offering great capabilities for delicate tissue grasping and dissection. Use of this device decreased operative time compared with the previously available instrument.


A developmental and psychoeducational approach to reducing conflict and abuse in little league and youth sports. The sport psychiatrist's role.
To stress a point made earlier, whether backyard or Little League, the tone of the youth sports experience is greatly influenced by the player and team selection process. All possible steps should therefore be taken to ensure that the draft is held on high moral ground, and that the adult participants, even on the Major Little League level, behave cooperatively rather than competitively. If it is the community's hope that Little League will "build character, and not characters," it must embrace Shields and Bredemeier's work and flood the Draft Room with the four virtues of compassion, fairness, sportspersonship, and integrity. In one attempt to achieve fairness and balance, some leagues enter player evaluations into a data base and allow a properly programmed computer to project equal teams. It might be best, however, to borrow a page from backyard baseball, and make team selection a more cooperative venture. Wolff has proposed such a draft model. He recommends that each child's name be placed on a big blackboard at the beginning of the draft. All assembled give their assessment of each child's baseball ability, and a consensus skill-level number (one through five) is entered next to each player's name. If there are 72 names, and the league wishes to form six teams of 12 players each, dividing up the rated players so that the skill levels balance would assure everyone (coaches, parents, the league, and by extension, the community) that the teams were of relatively equal strength. No coach at this point would know to which team he or she was being assigned, so there would be no motive for "stacking" a given team. Each team would be designated by a letter of the alphabet, and the six letters would be thrown into a hat. The six coaches would then blindly pick a team from the hat. If a coach desired that his or her child play on his or her team, fair adjustments (trades) could be made subject to majority agreement. The three draft models can be summarized as follows: Draft Model 1 Public tryouts Previous year rating Coach makes selections Can be very competitive, lacking in "character" Can result in very unequal teams Draft Model 2 Player evaluations placed into a data base Properly programmed computer projects equal teams Draft Model 3 All names placed on a blackboard Relative merits of players discussed Equal team drawn up and placed into a hat Adjustments can be made for coach's child If practical, this author suggests that coaches not pick a name for the team until the first team meeting or practice, when that task can be given to the children. In a symbolic way, this returns some of the sport to them while encouraging social interaction among new teammates, and helping the coach detect who the leaders are. Names of professional teams in the major sports, especially baseball, are to be avoided, as they fuel longstanding unconscious associations and fantasies, and may subtly tilt all participants toward the professional "win at all costs" mentality. No one draft model is perfect for every town, and even the most ethical attempt to achieve balance among teams can be severely tested by parents who request that their athlete be placed on the same team as another child for social or car pool reasons. Such requests are not inviolate, however. For example, they do not usually dictate placement in school classes, and car pools are frequently disrupted when children, in individual sports such as Tae Kwan Do, reach different ability levels, and so attend practices at different times. Baseball is no longer the national pasttime and, as we approach the millennium, American children have too many other attractive, competing interests and time demands to spontaneously organize a pick-up game. One coach shared with the author that his saddest moment in CAP League came when he arrived at 6 PM at a field that had been "reserved" for his team, and found a group of boys who were playing a pick-up game. The coach's impulse was to set his boys fre


Systematic Review and Meta-analysis of the Role of Total Pancreatectomy as an Alternative to Pancreatoduodenectomy in Patients at High Risk for Postoperative Pancreatic Fistula: Is it a Justifiable Indication?
Examine the potential benefit of total pancreatectomy (TP) as an alternative to pancreatoduodenectomy (PD) in patients at high risk for postoperative pancreatic fistula (POPF). TP is mentioned as an alternative to PD in patients at high risk for POPF, but a systematic review is lacking. Systematic review and meta-analyses using Pubmed, Embase (Ovid), and Cochrane Library to identify studies published up to October 2022, comparing elective single-stage TP for any indication versus PD in patients at high risk for POPF. The primary endpoint was short-term mortality. Secondary endpoints were major morbidity (i.e., Clavien-Dindo grade ≥IIIa) on the short-term and quality of life. After screening 1212 unique records, five studies with 707 patients (334 TP and 373 high-risk PD) met the eligibility criteria, comprising one randomized controlled trial and four observational studies. The 90-day mortality after TP and PD did not differ (6.3% vs. 6.2%; RR=1.04 [95%CI 0.56-1.93]). Major morbidity rate was lower after TP compared to PD (26.7% vs. 38.3%; RR=0.65 [95%CI 0.48-0.89]), but no significance was seen in matched/randomized studies (29.0% vs. 36.9%; RR = 0.73 [95%CI 0.48-1.10]). Two studies investigated quality of life (EORTC QLQ-C30) at a median of 30-52 months, demonstrating comparable global health status after TP and PD (77% [±15] vs. 76% [±20]; P =0.857). This systematic review and meta-analysis found no reduction in short-term mortality and major morbidity after TP as compared to PD in patients at high risk for POPF. However, if TP is used as a bail-out procedure, the comparable long-term quality of life is reassuring.


Food addiction and dietary restraint in postpartum women: The role of childhood trauma exposure and postpartum depression.
The early postpartum period is a sensitive time for understanding women's high-risk eating (i.e., eating behavior associated with negative health outcomes) given potential long-term eating behavior implications for infants. Food addiction and dietary restraint are two high-risk eating phenotypes associated with long-term negative health outcomes that have been theoretically linked. Yet, no research has considered how much these constructs overlap during the early postpartum period. The present study sought to characterize these two high-risk eating phenotypes in postpartum women to examine whether these are distinct constructs with specific etiologies and to inform future targets of intervention. Women (N = 277) in the early postpartum period reported on high-risk eating, childhood trauma exposure, depression symptoms, and pre-pregnancy weight. Women's height was measured and pre-pregnancy BMI was calculated. We conducted bivariate correlations and path analysis to characterize the relationship between food addiction and dietary restraint, controlling for pre-pregnancy BMI. Results showed that food addiction and dietary restraint were not significantly associated and that women's childhood trauma exposure and postpartum depression were associated with food addiction but not dietary restraint. Sequential mediation revealed that higher levels of childhood trauma exposure were associated with worse postpartum depression and, in turn, greater food addiction during the early postpartum period. Findings suggest that food addiction and dietary restraint have distinct psychosocial predictors and etiological pathways, which suggests important construct validity differences between the two high-risk eating phenotypes. Interventions seeking to address food addiction in postpartum women and mitigate the impact of this high-risk eating phenotype on the next generation may benefit from treating postpartum depression, especially in women with histories of childhood trauma exposure.


Autoantibody to aldolase in acute and chronic hepatitis.
Sera from 82 patients with acute or chronic hepatitis and 40 chronic carriers of hepatitis B were examined by ELISA and immunoblotting for reactivity with the glycolytic enzyme aldolase. The results of the ELISA tests, expressed as a percentage of a positive control, were compared to those obtained with sera from 39 patients with rubella, 11 with cytomegalovirus infection and 74 healthy subjects. The ELISA reaction with sera, expressed as mean +/- standard deviation was, for 15 patients with hepatitis A, 58.3 +/- 20.5%; 15 with hepatitis B, 59.5 +/- 42.18; 23 with hepatitis non-A, non-B 51.1 +/- 34.4%; 11 with HBsAg positive chronic active hepatitis, 70.1 +/- 31.5%; and 17 with autoimmune chronic active hepatitis, 66.8 +/- 21.4%. All values were significantly (p less than 0.05-p - less than 0.001) higher than those obtained with sera from carriers of hepatitis B surface antigen, 25.6 +/- 27.2%; rubella, 21.1 +/- 20.0%; cytomegalovirus infection, 19.2 +/- 27.8%; or healthy subjects, 20.9 +/- 16.2%. In two randomly selected sera, reactivity with aldolase by ELISA was neutralized by absorption with the enzyme. Selected sera showing reactivity by ELISA reacted by immunoblotting with aldolase. The findings suggest that acute or chronic liver damage may provoke the production of autoantibodies to aldolase.


[Role of intravenous cholangio-cholecystography in the diagnosis of asymptomatic choledocholithiasis].
Standard diagnostic procedures (anamnesis, physical examination, laboratory analyses, ultrasound diagnosis), commonly used in diagnosis and preparation for surgical intervention of patients with cholelithiasis, are in most cases a reliable indicator for evaluation of the disease and conditions planned for surgery. In some cases by application of these narrow diagnostic models, some conditions, anatomic variations and biliary tract malformations remain unrecognized. Asymptomatic ("silent") choledocholithiasis (2.02%) represents a special diagnostic and therapeutic problem. Our extended diagnostic protocol includes routine intravenous cholangio-cholecystography as a standard diagnostic procedure for evaluation of cholecysto-choledocholithiasis prior planning cholecystectomy.


Cationic lipid guided short-hairpin RNA interference of annexin A2 attenuates tumor growth and metastasis in a mouse lung cancer stem cell model.
The role of side populations (SP) or cancer stem-like cells (CSC) in promoting the resistance phenotype presents a viable anticancer target. Human-derived H1650 SP cells over-express annexin A2 (AnxA2) and SOX2, and are resistant to conventional cytotoxic chemotherapeutics. AnxA2 and SOX2 bind to proto-oncogenes, c-Myc and c-Src, and AnxA2 forms a functional heterotetramer with S100A10 to promote tumor motility. However, the combined role of AnxA2, S100A10 and SOX2 in promoting the resistant phenotype of SP cells has not been investigated. In the current studies, we examined for the first time a possible role of AnxA2 in regulating SA100A10 and SOX2 in promoting a resistant phenotype of lung tumors derived from H1650 SP cells. The resistance of H1650 SP cells to chemotherapy compared to H1650 MP cells was investigated by cell viability studies. A short hairpin RNA targeting AnxA2 (shAnxA2) was formulated in a liposomal (cationic ligand-guided, CLG) carrier and characterized for size, charge and entrapment and loading efficiencies; CLG carrier uptake by H1650 SP cells was demonstrated by fluorescence microscopy, and knockdown of AnxA2 confirmed by qRT-PCR and Western blot. Targeting of xenograft and orthotopic lung tumors was demonstrated with fluorescent (DiR) CLG carriers in mice. The therapeutic efficacy of CLG-AnxA2, compared to that of placebo, was investigated after 2 weeks of treatment in terms of tumor weights and tumor burden in vivo. Compared to mixed population cells, H1650 SP cells showed exponential resistance to docetaxel (15-fold), cisplatin (13-fold), 5-fluorouracil (31-fold), camptothecin (7-fold), and gemcitabine (16-fold). CLG carriers were nanoparticulate (199nm) with a slight positive charge (21.82mV); CLG-shAnx2 was of similar size (217nm) with decreased charge (12.11mV), and entrapment and loading efficiencies of 97% and 6.13% respectively. Fluorescence microscopy showed high uptake of CLG-shAnxA2 in H1650 SP cells after 2h resulting in a 6-fold reduction in AnxA2 mRNA expression and 92% decreased protein expression. Fluorescence imaging confirmed targeting of tumors and lungs by DiR-CLG carriers with sustained localization up to 4h in mice. CLG-shAnxA2 treatment of mice significantly reduced the weights of lung tumors derived from H1650 SP cells and tumor burden was reduced to only 19% of controls. The loss in tumor weights in response to CLG-shAnxA2 was associated with a significant loss in the relative levels of AnxA2, SOX2, total β-catenin and S100A10, both at the RNA and protein levels. These results suggest the intriguing possibility that AnxA2 may directly or indirectly regulate relative levels of β-catenin, S100A10 and SOX2, and that the combination of these factors may contribute to the resistant phenotype of H1650 SP cells. Thus down-regulating AnxA2 using RNAi methods may provide a useful method for targeting cancer stem cells and help advance therapeutic efficacy against lung cancers.


Dynamic light scattering measurements of the diffusion of probes in filamentous actin solutions.
The diffusion coefficients of monodisperse polystyrene latex spheres in solutions of polymerized actin were measured using dynamic light scattering. Four different probes with radii R, ranging from 50 to 500 nm, were separately used in actin solutions with concentrations c, ranging from 1.5 to 21 microM, which had been polymerized with either 1 mM MgCl2, 1 mM CaCl2, or 100 mM KCl. Under all conditions, and at four different scattering angles in the range of 30 degrees-90 degrees, the measured average diffusion coefficients D of the probes were systematically smaller for samples of increased actin concentration or of increased probe radius. Control experiments indicated that the probes did not bind to the actin. These data for Mg2+- and Ca2+-polymerized actin agree and were found to be quite well summarized by the scaling relation D/D0 = exp[-alpha R delta c nu], where D0 is the measured diffusion coefficient of the probes in water (and, as also measured, in the starting actin solutions prior to polymerization with added salt), with values of delta = 0.73 +/- 0.05, nu = 1.08 +/- 0.09, and alpha = (1.1 +/- 0.6) x 10(-3) (with c in microM and R in nm). Data for KCl-polymerized actin show much more restricted diffusivities of the probes at comparable actin concentrations. Inhomogeneities in the solution are reflected in the "effective polydispersity" of the probe diffusion coefficients, which depend on local microviscosity differences.


Thermodynamic and EPR characterization of mitochondrial succinate-cytochrome c reductase-phospholipid complexes.
Succinate-cytochrome c reductase can be easily solubilized in a phospholipid mixture (1:1, iysolecithin:lecithin) in the absence of detergents. The resulting solution contains two b cytochromes with half-reduction potentials of 95 plus or minus 10 mV (b561), and 0 plus or minus mV (566) and cytochrome c1 (Em7.2 equals +280 plus or minus 5 mV). The oxidation-reduction midpoint potentials obtained by optical potentiometric titrations are identical to those determined by the EPR titrations and are 40-60 mV higher than the corresponding midpoint potentials of these cytochromes in intact mitochondria. In contrast to detergent-suspended preparations, no CO-sensitive cytochrome b can be detected in the phospholipid-solubilized preparation or intact mitochondria. The half-reduction potential of cytochrome b566 is pH-dependent above pH 7.0 ( minus 60 mV/pH unit) while that of b561 is essentially pH-independent from pH 6.7-8.5, in contrast to its pH dependence in intact mitochondria. EPR characterizations show the presence of three oxidized low-spin heme-iron signals with g values of 3.78, 3.41 and 3.37. The identification of these signals with cytochromes b566(bT), b561 (bK) and c1 respectively is made on the basis of redox midpoint potentials. In addition, the preparation contains four distinct types of iron-sulfur centers: S1 and S2 (Em7.4 equals minus 260 mV and 0 mV), and two iron-sulfur proteins which are associated with the cytochrome b-c1 complex: Rieske's iron-sulfur protein (Em7.4 equals +280 mV) and Ohniski's Center 5 (Em7.4 equals +35 mV).


New Finnish growth references for children and adolescents aged 0 to 20 years: Length/height-for-age, weight-for-length/height, and body mass index-for-age.
Growth curves require regular updates due to secular trends in linear growth. We constructed contemporary growth curves, assessed secular trends in height, and defined body mass index (BMI) cut-off points for thinness, overweight, and obesity in Finnish children. Mixed cross-sectional/longitudinal data of 73,659 healthy subjects aged 0-20 years (born 1983-2008) were collected from providers in the primary health care setting. Growth references for length/height-for-age, weight-for-length/height, and BMI-for-age were fitted using generalized additive models for location, scale, and shape (GAMLSS). BMI percentile curves passing through BMIs 30, 25, 18.5, 17, and 16 kg/m(2) at the age of 18 years were calculated to define limits for obesity, overweight, and various grades of thinness. Increased length/height-for-age was seen in virtually all age-groups when compared to previous Finnish growth data from 1959 to 1971. Adult height was increased by 1.9 cm in girls and 1.8 cm in boys. The largest increases were seen during the peripubertal years: up to 2.8 cm in girls and 5.6 cm in boys. Median weight-for-length/height had not increased. New Finnish references for length/height-for-age, weight-for-length/height, and BMI-for-age were constructed and should be implemented to monitor growth of children in Finland.


New Loss-of-Function Mutations in PCSK9 Reduce Plasma LDL Cholesterol.
Lower plasma levels of LDL (low-density lipoprotein) cholesterol (LDL-C) can reduce the risk of atherosclerotic cardiovascular disease. The loss-of-function mutations in PCSK9 (proprotein convertase subtilisin/kexin type 9) have been known to associate with low LDL-C in many human populations. PCSK9 genetic variants in Chinese Uyghurs who are at high risk of atherosclerotic cardiovascular disease due to their dietary habits have not been reported. The study involved the whole-exome and target sequencing of college students from Uyghur and other ethnic groups in Xinjiang, China, for the association of PCSK9 loss-of-function mutations with low plasma levels of LDL-C. The mechanisms by which the identified mutations affect the function of PCSK9 were investigated in cultured cells using biochemical and cell assays. The causal effects of the identified PCSK9 mutations on LDL-C levels were verified in mice injected with adeno-associated virus expressing different forms of PCSK9 and fed a high-cholesterol diet. We identified 2 PCSK9 mutations-E144K and C378W-in Chinese Uyghurs with low plasma levels of LDL-C. The E144K and C378W mutations impaired the maturation and secretion of the PCSK9 protein, respectively. Adeno-associated virus-mediated expression of E144K and C378W mutants in Pcsk9 KO (knockout) mice fed a high-cholesterol diet also hampered PCSK9 secretion into the serum, resulting in elevated levels of LDL receptor in the liver and reduced levels of LDL-C in the serum. Our study shows that E144K and C378W are PCSK9 loss-of-function mutations causing low LDL-C levels in mice and probably in humans as well.


Differential effect of damp housing on respiratory health in women.
To investigate the effect of exposure to damp housing on respiratory symptoms in women and men. We examined sex differences in the relationship between damp housing and respiratory symptoms in a cross-sectional survey of 1988 adults, 18 to 74 years of age, using a self-administered questionnaire. We used chi (2) and t-tests to test associations between potential risk factors and respiratory symptoms in men and women. We used multiple logistic regression modelling to determine adjusted odds ratios for several possible symptoms and home dampness. All multivariate analyses were stratified by sex. Men had a significantly higher prevalence of chronic wheeze compared with women. The prevalence of chronic wheeze, wheeze with shortness of breath, and allergy were higher for women reporting damp housing compared with those not reporting damp housing. No significant associations between damp housing and respiratory symptoms were found in men. These data raise the possibility that women may be more susceptible to the effects of damp housing than men are.


Does it get better? A quasi-cohort analysis of sexual minority wage gaps.
With few exceptions, it has been found that gay men earn less and lesbians earn more than their heterosexual counterparts. Most of the current literature has used single cross-sectional datasets to test possible sources of these wage differentials. This study adds to this literature by presenting a theoretical framework, grounded in gender theory, to explore: (a) whether sexual minority wage gaps have attenuated over the last decade, (b) whether wage gaps vary by age group, and (c) if wage gaps vary with duration in the labor market. Using Canadian census and survey data, this study finds no evidence that wage gaps have attenuated for gay men and only small reductions for lesbians and heterosexual women, relative to heterosexual men. Wage gaps are larger for younger gay men than for older gay men, which may suggest a "coming out penalty". The lesbian wage premium, vis-á-vis heterosexual women, does not appear at initial labor market entry; rather it develops with duration in the labour market.


Single-nucleus chromatin accessibility identifies a critical role for TWIST1 in idiopathic pulmonary fibrosis myofibroblast activity.
In idiopathic pulmonary fibrosis (IPF), myofibroblasts are key effectors of fibrosis and architectural distortion by excessive deposition of extracellular matrix and their acquired contractile capacity. Single-cell RNA-sequencing (scRNA-seq) has precisely defined the IPF myofibroblast transcriptome, but identifying critical transcription factor activity by this approach is imprecise. We performed single-nucleus assay for transposase-accessible chromatin sequencing on explanted lungs from patients with IPF (n=3) and donor controls (n=2) and integrated this with a larger scRNA-seq dataset (10 IPF, eight controls) to identify differentially accessible chromatin regions and enriched transcription factor motifs within lung cell populations. We performed RNA-sequencing on pulmonary fibroblasts of bleomycin-injured Twist1-overexpressing COL1A2 Cre-ER mice to examine alterations in fibrosis-relevant pathways following Twist1 overexpression in collagen-producing cells. TWIST1, and other E-box transcription factor motifs, were significantly enriched in open chromatin of IPF myofibroblasts compared to both IPF nonmyogenic (log2 fold change (FC) 8.909, adjusted p-value 1.82×10-35) and control fibroblasts (log2FC 8.975, adjusted p-value 3.72×10-28). TWIST1 expression was selectively upregulated in IPF myofibroblasts (log2FC 3.136, adjusted p-value 1.41×10- 24), with two regions of TWIST1 having significantly increased accessibility in IPF myofibroblasts. Overexpression of Twist1 in COL1A2-expressing fibroblasts of bleomycin-injured mice resulted in increased collagen synthesis and upregulation of genes with enriched chromatin accessibility in IPF myofibroblasts. Our studies utilising human multiomic single-cell analyses combined with in vivo murine disease models confirm a critical regulatory function for TWIST1 in IPF myofibroblast activity in the fibrotic lung. Understanding the global process of opening TWIST1 and other E-box transcription factor motifs that govern myofibroblast differentiation may identify new therapeutic interventions for fibrotic pulmonary diseases.


Hypotension dilates pial arteries by KATP and kca channel activation.
Hypotension induced pial artery dilation is prostaglandin-dependent in the newborn pig. Prostaglandins, in turn, elicit vasodilation through cGMP and cAMP dependent mechanisms and K+ channel activation contributes to cyclic nucleotide induced vasodilation. The present study was designed to characterize the role of ATP sensitive (KATP) and calcium sensitive (Kca) channel activation in hypotension induced pial artery dilation in newborn pigs equipped with a closed cranial window. Glibenclamide and iberiotoxin, KATP and Kca channel antagonists, attenuated hypotension induced dilation (36+/-1 vs. 14+/-2% before and after iberiotoxin). Combined administration of these K+ channel antagonists eliminated the vascular response. Hypotension induced dilation was associated with elevated cerebrospinal fluid (CSF) cAMP but not cGMP concentration (1023+/-29 vs. 1566+/-39 fmol/ml for cAMP). L-NNA, a nitric oxide (NO) synthase inhibitor, and Rp 8-Br cGMPs, a protein kinase G inhibitor, had no effect but Rp 8-Br cAMPs, a protein kinase A inhibitor, attenuated hypotensive dilation (35+/-1 vs. 16+/-2% before and after Rp 8-Br cAMPs). Dilation by the cAMP analogue 8-Bromo cAMP (10(-8), 10(-6) M) was attenuated by glibenclamide and iberiotoxin (8+/-1 and 17+/-1 vs. 4+/-1 and 9+/-1% before and after glibenclamide). These data show that both KATP and Kca channel activation contribute to hypotension induced dilation. These data suggest that dilation during hypotension results from the sequential release of prostaglandins and cAMP, which, in turn, activates both the KATP and Kca channel.


RETRACTED: Synergistic effects of thymoquinone and curcumin on immune response and anti-viral activity against avian influenza virus (H9N2) in turkeys.
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). The authors retract the above paper due to: 1) conflict of interest among the authors; and 2) addition of coauthor Dr. Muhammad Younus without his knowledge or permission. The authors apologize for these two grave mistakes.


Gestational week-specific of uterine artery Doppler indices in predicting preeclampsia: a hospital-based retrospective cohort study.
Plenty of studies explored the relationship between uterine artery (UtA) Doppler indices and the onset of preeclampsia at different trimesters. However, few studies test the gestational week-specific predictive value of the UtA indices for subsequent preeclampsia and compare the difference of right or left UtA indices (e.g., pulsatility or resistance index [PI or RI]). Hospital-based retrospective cohort study of singleton pregnant women who received the Doppler test between 2012 and 2016 was conducted in 2018. The predictive performance of the UtA indices for preeclampsia and its variants, including early-onset preeclampsia (< 34 weeks) and preterm preeclampsia (< 37 weeks), was estimated. The UtA indices, with a cutoff value of 1.11 for the right and left UtA-PI, and 0.66 and 0.63 for the right and left UtA-RI, respectively, were effective predictors for subsequent preeclampsia. The prediction was satisfactory at the 9th week of the Doppler scan: areas under the curve ≥ 0.80, the Youden index ranging from 0.54 to 0.58, the sensitivity of 63.2 ~ 73.7%, and the specificity 84.2 ~ 91.3%, respectively. The UtA indices had comparable performance in screening for early-onset and preterm preeclampsia but showed lower predictive value for late-onset cases. Among these indices, the right UtA-RI had the highest specificity (all P < 0.01), while the left UtA-PI showed good authenticity (higher Youden index) in predicting the disorder. The second-trimester measured UtA indices had a satisfactory performance at the 9th week in predicting subsequent preeclampsia. The right UtA-RI was the first choice in ruling out preeclampsia, while the left UtA-PI showed the best authenticity of the prediction.


[Response of the locus coeruleus to asphyxia].
To ascertain the mechanisms of the locus coeruleus (LC) function the response of the locus coeruleus neurons to the experimental sharp asphyxia was investigated by the light and electron microscope techniques. Apart from the specific nervous effect (directly through the LC axons and through the stem reticular formation), LC produced humoral influence on the brain structures. There are two possible mechanisms by which catecholamines synthesized in the LC cells could reach the blood; 1) through the cell membrane and then through the basal membrane of the capillary bed and the cytoplasm of the endothelial cell; 2) by virtue of the glia cells.


Phase transitions in disordered mesoporous solids.
Fluids confined in mesoporous solids exhibit a wide range of physical behavior including rich phase equilibria. While a notable progress in their understanding has been achieved for fluids in materials with geometrically ordered pore systems, mesoporous solids with complex pore geometries still remain a topic of active research. In this work we study phase transitions occurring in statistically disordered linear chains of pores with different pore sizes. By considering, quite generally, two phase change mechanisms, nucleation and phase growth, occurring simultaneously we obtain the boundary transitions and the scanning curves resulting upon reversing the sign of the evolution of the chemical potential at different points along the main transition branches. The results obtained are found to reproduces the key experimental observations, including the emergence of hysteresis and the scanning behavior. By deriving the serial pore model isotherm we suggest a robust framework for reliable structural analysis of disordered mesoporous solids.


Responses of the human auditory cortex to changes in one versus two stimulus features.
Neuromagnetic responses were recorded with a 24-SQUID magnetometer in two "oddball" experiments to determine whether mismatch responses to changes in single stimulus features are additive. In experiment 1, the one-feature deviants differed from standards in interstimulus interval (ISI) or frequency, and the two-feature deviants in both ISI and frequency. In experiment 2, deviants differed in duration, frequency, or both. All deviants evoked a mismatch field (MMF) with sources close to each other in the supratemporal auditory cortex. Except for the ISI deviants, the MMF sources were about 1 cm anterior to the source of the 100-ms response, N100m, to the standards. In the two experiments, MMFs obtained in response to the two-feature deviants resembled closely the sum of MMFs in response to one-feature deviants. The results suggest that the standards leave a multiple neuronal representation in the human auditory cortex. The particular neuronal traces of the representation react independently to changes in different features of sound stimuli.


Comparisons of tibial accelerations when walking on a wood composite vs. a concrete mezzanine surface.
Mezzanine surfaces can be made from concrete, bar grate, or composite materials. Anecdotal data indicate that mezzanines in distribution centers made from composite materials, due to their increased compliance, may be a more comfortable working surface. Prior research suggested that a measure of tibial shock, peak tibial acceleration, could potentially discriminate the biomechanical differences between these surfaces. The objective of this study was to quantify differences in tibial accelerations as 27 people walked on mezzanines constructed from concrete and a wood composite material. Accelerometers were attached bilaterally to the shins of volunteers, and data were collected as they walked 30.5 m on each surface at their normal walking speed, a faster-than-normal walking speed, and a slower-than-normal walking speed. Peak acceleration values obtained from the leg with the highest values were compared. On average, the peak acceleration values were 5% higher on the concrete mezzanine as compared with the wood composite mezzanine (p = .036). These findings suggest that individuals working on mezzanines in distribution centers constructed from composite surfaces would potentially experience less discomfort associated with long exposure periods on these surfaces.


Single neuron morphology in vivo with confined primed conversion.
Unraveling the structural organization of neurons can provide fundamental insights into brain function. However, visualizing neurite morphology in vivo remains difficult due to the high density and complexity of neural packing in the nervous system. Detailed analysis of neural morphology requires distinction of closely neighboring, highly intricate cellular structures such as neurites with high contrast. Green-to-red photoconvertible fluorescent proteins have become powerful tools to optically highlight molecular and cellular structures for developmental and cell biological studies. Yet, selective labeling of single cells of interest in vivo has been precluded due to inefficient photoconversion when using high intensity, pulsed, near-infrared laser sources that are commonly applied for achieving axially confined two-photon (2P) fluorescence excitation. Here we describe a novel optical mechanism, "confined primed conversion," which employs continuous dual-wave illumination to achieve confined green-to-red photoconversion of single cells in live zebrafish embryos. Confined primed conversion exhibits wide applicability and this chapter specifically elaborates on employing this imaging modality to analyze neural morphology of optically targeted single neurons in the developing zebrafish brain.


Analysis of the risk factors of untransplantable recurrence after primary curative resection for patients with hepatocellular carcinoma.
To determine the prognostic factors that predict recurrence of hepatocellular carcinoma (HCC) exceeding the University of California at San Francisco (UCSF) criteria after primary resection. HCC patients who underwent curative liver resections between 2001 and 2007 and who were within the UCSF criteria (n = 716) were examined. Independent prognostic factors were examined by the Cox proportional hazard model. A total of 285 patients (39.8 %) developed recurrences. Of the patients who developed recurrences, 180 had HCC still within the UCSF criteria (63.2 %), and 105 developed HCC beyond this criteria (36.8 %). Among the population with primary transplantable HCC, patients with larger primary tumor sizes, serum α-fetoprotein (AFP) levels over 400 ng/mL, satellite nodules, vascular invasion, or undifferentiated HCC had a risk of untransplantable recurrence, as shown by univariate analysis. In multivariate analysis, undifferentiated HCC and vascular invasion were identified as the significant predictors with adjusted hazard ratios of 9.25 [95 % confidence interval (CI) 2.13-40.21] and 2.19 (95 % CI 1.34-3.58), respectively. When only preoperative factors were considered in multivariate analysis, primary tumor size and serum AFP levels over 400 ng/mL were identified as significant predictors with adjusted hazard ratios of 1.24 (95 % CI 1.07-1.45) and 1.72 (95 % CI 1.05-2.82), respectively. For primary HCC patients within the UCSF criteria, larger tumor sizes and AFP levels over 400 ng/mL were associated with postresection recurrence of HCC exceeding the UCSF criteria. Because these are clearly markers for aggressive tumor biology, whether early primary transplant will alter the aggressive tumor behaviors warrant further investigation.


Differential drawing size associated with unilateral brain damage.
Size of Greek Cross reproductions was compared using 35 persons having unilateral right (RHD), 35 having unilateral left (LHD) hemisphere damage and 38 non-neurologic controls. With right hand tapping speed statistically controlled, RHD drawings were significantly larger than LHD reproductions. Spatial Relations scores were significantly associated with drawing size in the RHD group only, following adjustment for right hand tapping speed. Aphasia Screening scores were unrelated to drawing size. These data demonstrate that LHD/RHD drawing size differences are independent of any basic motor impairment and that for RHD subjects, drawing size is positively correlated with visuospatial impairment.


Comment on "Structural, electrical, and multiferroic characteristics of lead-free multiferroic: Bi(Co0.5Ti0.5)O3-BiFeO3 solid solution" by N. Kumar, A. Shukla, N. Kumar, R. Choudhary and A. Kumar, RSC Adv., 2018, 8, 36939".
My comments concern the significant errors in the crystallographic part of the commented paper. It was found that the studied crystal is of the sillenite type and the correct formula should be Bi25FeO39 : Co,Ti instead of BiFeO3. Moreover, the type of unit cell is not correct. Due to the double doping the new type of unit cell, previously unknown, was proposed for such crystals. Furthermore, the authors did not find that the studied sample contains two slightly different phases, both of the sillenite type. The actual chemical composition of the studied crystals is not known.


Hospital emergency department surveillance system: a data base for patient care, management, research and teaching.
The Johns Hopkins Health Services Research and Development Center and Emergency Department have developed a processing and feedback mechanism to provide a data base for management planning, allocating available resources, research strategies to evaluate the quality of care and teaching programs to train physicians in emergency medicine. A 10% sample of all emergency department visits is randomly selected each day, and data collected on patient age, sex, race, marital status, mode of arrival, method of payment, census tract of residence, complaint, diagnosis, disposition, date of visit, and times of entry and departure. In addition, process data on nursing care are collected. A sub-sample is selected for telephone or household follow-up aimed at gathering outcome data as part of the surveillance study. Turnaround time from the subject's emergency department visit to provider's feedback is one month. Thus, an ongoing, current description of usage is available. Retrieval of data for longer time periods provides valuable information on daily, monthly and seasonal usage patterns.


[Heated car seats--a potential burn risk for paraplegics].
The comfort of heated car seats has gained popularity worldwide. We present a rare case of severe second- and third-degree burn in the lower back and sacral region of a 42-year-old post-traumatic paraplegic patient while using a heated car seat. The patient was admitted to our burn unit and required several reconstructive surgery procedures. Inadvertent thermal injury is a constant potential hazard for individuals with impaired sensibility such as paraplegics and other neurologically impaired patients. Early education of patients, manufacturers, and health care personnel is of eminent importance to prevent severe burn injuries in this risk population.


Involvement of reactive oxygen species in the UV-B damage to the cyanobacterium Anabaena sp.
Reactive oxygen species (ROS) are involved the damage of living organisms under environmental stress including UV radiation. Cyanobacteria, photoautotrophic prokaryotic organisms, also suffer from increasing UV-B due to the depletion of the stratospheric ozone layer. The increased UV-B induces the production of ROS in vivo detected by using the ROS-sensitive probe 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA). Ascorbic acid and N-acetyl-L-cysteine (NAC) scavenged ROS effectively, while alpha-tocopherol acetate or pyrrolidine dithiocarbamate (PDTC) did not. The presence of rose bengal and hypocrellin A increased the ROS level by photodynamic action in the visible light. The presence of the herbicide, 3-(3,4-dichlorophenyl)-1,1-dimethyl urea (DCMU), increased ROS production slightly, and ROS formation was greatly enhanced by the addition of methyl viologen due to the fact that this redox system diverts electrons from PSI to oxygen and thus forms ROS. UV-B induces ROS generation by photodynamic action and inhibition of the electron transport by damaging the electron receptors or enzymes associated with the electron transport chain during photosynthesis.


Risk of ventricular arrhythmias after myocardial infarction with diabetes associated with sympathetic neural remodeling in rabbits.
Abnormal sympathetic innervation underlies both long-term hyperglycemia and myocardial infarction (MI). The incidence of ventricular arrhythmias (VAs) after MI is higher in diabetic than in nondiabetic patients. However, the exact mechanism remains unclear. In this study, we aimed to explore sympathetic neural remodeling after MI in diabetic rabbits and its relationship with VAs. Rabbits were randomly assigned to 4 groups: control, diabetes mellitus (DM), MI and diabetic myocardial infarction (DI). After electrophysiological experiments in vivo, immunohistochemistry and real-time RT-PCR were used to measure sympathetic innervations. To test the function of sympathetic nerve fibers, norepinephrine levels were measured by high-performance liquid chromatography. The corrected QT interval and QT dispersion were significantly more prolonged with DI than other conditions. The density of tyrosine hydroxylase-positive fibers and corresponding mRNA abundance was significantly higher with DI than with DM and under control conditions, but was lower than with the MI group. Moreover, the distribution and structure of regenerated nerve was heterogeneous in DI rabbits. Norepinephrine content was higher in the DI group, and accompanied by an increased quantity of tyrosine hydroxylase-positive fibers. MI results in sympathetic neural remodeling in diabetic rabbits, which may be responsible in part for the increased occurrence of VAs.


Residual Inferior Vena Cava Thrombus Detected by Transesophageal Echocardiography After Resection of a Malignant Adrenal Mass.
A 43-year-old woman with a history of the Cushing syndrome secondary to adrenocortical carcinoma presented to the operating room for right adrenalectomy, hepatectomy, nephrectomy, and inferior vena cava (IVC) thrombectomy. Initial intraoperative transesophageal echocardiogram (TEE) confirmed the presence of an IVC tumor below the hepatic veins. Total vascular exclusion of the liver was necessary to perform the operation. A repeat TEE showed a residual thrombus within the IVC prompting an additional cavotomy to successfully remove the entire mass. The remainder of the procedure finalized uneventfully. The case highlights the importance of TEE monitoring for noncardiac surgery with thrombotic involvement of the IVC.


Physicochemical characteristics and gel-forming properties of myofibrillar protein in an oxidative system affected by partial substitution of NaCl with KCl, MgCl2 or CaCl2.
Effects of partial substitution of NaCl with KCl, MgCl2 or CaCl2 on oxidative characteristics of myofibrillar protein (MP) in a hydroxyl radical generating system and their heat-induced gel properties were investigated. Results indicated that MP oxidation is dependent upon the different chloride salt types and substitution degree. MP at 0.60 M NaCl was beneficial to protein unfolding and gel quality in the oxidative system. Increased formation of disulfide bonds affected the MP conformation and resulted in a large particle size and an aggregatednetworkofgel at the 50% substitution degree of KCl. The presence of CaCl2 or MgCl2 substitutes contributed to protein polymerization and insolubility. MP aggregation restrained the formation of dense and continuous gel networks during heating, and thus resulted in a low-grade gel. Ca2+ had more serious impact on gel properties than Mg2+, dependent on different cation effects. Substitution of 25% NaCl by KCl gave acceptable gel quality in MP.


Mitral valve replacement after atrioventricular canal repair in adults: report of three cases.
Three cases of adults who required a mitral valve replacement (MVR) following repair of an atrioventricular (AV) canal are presented herein. In adult patients with an AV canal, the deformity of the mitral valve is sometimes too advanced for adequate repair, and therefore, residual mitral regurgitation frequently causes intractable cardiac failure despite appropriate medical management. Thus, for adults with an AV canal associated with severe valvular deformities, MVR should be considered from the initial operation to obtain a significantly better outcome.


Effect of pesticides inAlternaria alternata mycotoxins production.
The effect of pesticides onAlternaria mycotoxins was evaluated both in culture media and in sunflower seeds. Different behaviour was observed depending on whether insecticides or fungicides were considered. When Captan, Lindaphor and Dichlorvos were evaluated in sunflower seeds their effects were dependent on the toxin being evaluated (alternariol, alternariol monomethyl ether and tenuazonic acid). A full spectrum of effects was observed, ranging from no effect, stimulation, to inhibition.


Indications and pitfalls of immunohistochemistry in head and neck cancer.
Immunohistochemistry (IHC) has been employed in the differential diagnosis of tumors. To assess the use of IHC in cases of head and neck tumor. This is a retrospective study of the cases included in the Cancer Registry of the institution. IHC was used in 76 (11%) of 704 pathology tests. Most cases were carcinomas (85.80%), and 83.66% of them were squamous cell carcinomas. All tests were done with diagnostic purposes. The most frequently used antibodies were 34BE12 (37.18%), AE1/AE3 (35.9%), 35BH11 (28.21%), CD45 (25.64%), CD20 (24.36%), CD30 (24.36%), CK7 (23.08%) and CD3 (23.08%). IHC was used in 10.67% of the head and neck tumor cases submitted to pathology testing, mostly for carcinoma (5.26%). In the determination of squamous cell carcinoma, IHC accounted for 18.42% of all tumors.


A deep learning-based precision and automatic kidney segmentation system using efficient feature pyramid networks in computed tomography images.
This paper proposes an encoder-decoder architecture for kidney segmentation. A hyperparameter optimization process is implemented, including the development of a model architecture, selecting a windowing method and a loss function, and data augmentation. The model consists of EfficientNet-B5 as the encoder and a feature pyramid network as the decoder that yields the best performance with a Dice score of 0.969 on the 2019 Kidney and Kidney Tumor Segmentation Challenge dataset. The proposed model is tested with different voxel spacing, anatomical planes, and kidney and tumor volumes. Moreover, case studies are conducted to analyze segmentation outliers. Finally, five-fold cross-validation and the 3D-IRCAD-01 dataset are used to evaluate the developed model in terms of the following evaluation metrics: the Dice score, recall, precision, and the Intersection over Union score. A new development and application of artificial intelligence algorithms to solve image analysis and interpretation will be demonstrated in this paper. Overall, our experiment results show that the proposed kidney segmentation solutions in CT images can be significantly applied to clinical needs to assist surgeons in surgical planning. It enables the calculation of the total kidney volume for kidney function estimation in ADPKD and supports radiologists or doctors in disease diagnoses and disease progression.


Changes in the intestine barrier function of Litopenaeus vannamei in response to pH stress.
pH of water environment affects the survival of aquatic animals. Intestine barrier function influences the health of animals, which is related to its mucosa structure, immune components, and microbial communities. In this study, we investigated the histological structure, digestive and metabolic capacity, immune responses, and microbial composition in the intestine of Litopenaeus vanmei under three different conditions: control (pH 8.3), low pH stress (pH 6.9), and high pH stress (pH 9.7) for 72 h. The results showed both low and high pH stress disrupted the intestine morphological structure, and induced variations in the activities of digestive (AMS, LPS, Tryp, and Pep) and metabolic (HK, PK, CCO, and LDH) enzymes. Low and high pH stress also increased oxidative stress (MDA, LPO, PC, and ·O2- generation), and decreased the antioxidant enzyme activities (T-AOC, SOD, and GST); shrimp enhanced CAT activity and HSP70, Trx, MT and Fer gene transcripts as defense mechanism. Additionally, Immune confusion was also found in the shrimp intestine in response to low and high pH stress, including the antibacterial ability (T-NOS, PO, proPO, ALF, and Lys), pathogen recognition (TLR and Lec), apoptosis (Casp, IAP and p53), and mucus homeostasis (Muc-1, Muc-2, Muc-5AC, Muc-5B, and Muc-19). pH exposure also decreased the diversity of the intestine bacterial, disturbed the composition of microbiota, and decreased the microbial metabolite SCFA contents. Our results indicated that acute pH stress can impair the intestine barrier function of white shrimp, probably via destroying mucosa structure, confusing digestion and metabolism, inducing oxidative stress, disordering immunity, and disrupting the microbial composition.