WITHDRAWN: Vaccine hesitancy in Maltese family physicians and their trainees vis-à-vis influenza and novel COVID-19 vaccination.
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.


Rediscovery and redescription of the holotype of Liolaemus lemniscatus Gravenhorst, 1838 (Reptilia, Squamata, Liolaemidae).
The presumed lost holotype of Liolaemus lemniscatus Gravenhorst, 1838 has been found at the Museum of Natural History of the University of Wrocław and identified by the individual pattern of head scales which matches Gravenhorst's drawing. The first detailed description of this specimen is provided.


Supercritical fluids as a green technology for the pretreatment of lignocellulosic biomass.
One of the main drawbacks for using lignocellulosic biomass is related to its recalcitrance. The pretreatment of lignocellulosic biomass plays an important role for delignification and crystallinity reduction purposes. In this work rice husk (RH) was submitted to supercritical pretreatment at 80°C and 270 bar with the aim to determine the effect on lignin content, crystallinity as well as enzymatic digestibility. The yields obtained were compared with dilute sulfuric acid pretreatment as base case. Additionally a techno-economic and environmental comparison of the both pretreatment technologies was performed. The results show a lignin content reduction up to 90.6% for the sample with 75% moisture content using a water-ethanol mixture. The results for crystallinity and enzymatic digestibility demonstrated that no reductions were reached. Supercritical pretreatment presents the best economical and environmental performance considering the solvents and carbon dioxide recycling.


CHIPing away the progression potential of CHIP: A new reality in the making.
Over the past few years, we have gained a deeper understanding of clonal hematopoiesis of indeterminate potential (CHIP), especially with regard to the epidemiology, clinical sequelae, and mechanical aspects. However, interventional strategies to prevent or delay the potential negative consequences of CHIP remain underdeveloped. In this review, we highlight the latest updates on clonal hematopoiesis research, including molecular mechanisms and clinical implications, with a particular focus on the evolving strategies for the interventions that are being evaluated in ongoing observational and interventional trials. There remains an urgent need to formulate standardized and evidence-based recommendations and guidelines for evaluating and managing individuals with clonal hematopoiesis. In addition, patient-centric endpoints must be defined for clinical trials, which will enable us to continue the robust development of effective preventive strategies and improve clinical outcomes.


Social Determinants of Mental Health: Where We Are and Where We Need to Go.
The present review synthesizes recent literature on social determinants and mental health outcomes and provides recommendations for how to advance the field. We summarize current studies related to changes in the conceptualization of social determinants, how social determinants impact mental health, what we have learned from social determinant interventions, and new methods to collect, use, and analyze social determinant data. Recent research has increasingly focused on interactions between multiple social determinants, interventions to address upstream causes of mental health challenges, and use of simulation models to represent complex systems. However, methodological challenges and inconsistent findings prevent a definitive understanding of which social determinants should be addressed to improve mental health, and within what populations these interventions may be most effective. Recent advances in strategies to collect, evaluate, and analyze social determinants suggest the potential to better appraise their impact and to implement relevant interventions.


"It is still intense and not unambiguous." Nurses' experiences in the euthanasia care process 15 years after legalisation.
To explore how Flemish nurses working in hospitals and home care experience their involvement in the care of patients requesting euthanasia 15 years after the legalisation of euthanasia. Euthanasia was legalised in Belgium in 2002. Despite prior research that charted the experiences of nurses in euthanasia care before and right after legalisation in Belgium, it remains unclear how Flemish nurses currently, 15 years after the legalisation, experience their involvement. A grounded theory design, using semi-structured in-depth interviews. We interviewed 26 nurses working in hospitals or in home care, who had experience with caring for patients requesting euthanasia. Data were collected using a purposive sample and then a snowball sample. Data collection and data analysis were conducted simultaneously. Data were analysed by using the Qualitative Analysis Guide of Leuven. The study adhered to the COREQ guidelines. Caring for a patient requesting euthanasia continues to be an intense experience characterised by ambivalence. The nature of euthanasia itself contributes to the intensity of this care process. The nurses described euthanasia as something unnatural and planned that generated many questions and doubts. Nevertheless, most interviewees stated that they were able to contribute to a dignified end of life and make a difference, giving them a profound feeling of professional fulfilment. However, when nurses were not able to contribute to good euthanasia care, they struggled with strong negative feelings and frustrations. Although the results suggest some subtle shifts in nurses' experiences over time, they do not indicate perceptions of euthanasia as a normal practice by the nurses involved. The study reveals the need for more clarification of nurses' ethical responsibility in euthanasia care and their role as moral agents.


Opinion paper: Exercise for healthy aging.
The physical demands of daily life in developed countries have decreased remarkably during the last two centuries. General leisure time has increased and the age at retirement has decreased. General health has improved and life expectancy has increased. Most people can expect to live 20-30 years after retirement. By 2050, one in four people in Europe and North America will be aged 65 or over. Furthermore, women live longer than men. Generally, the physical demands on older women will be low. Thus, their physical fitness will decline, which in turn will affect a variety of organ systems and functions, and so impact on mental health, quality of life and independent living. This opinion paper explores exercise strategies for healthy ageing.


Ring-shaped traveling wave ultrasonic motor for high-output power density with suspension stator.
A ring-shaped traveling wave ultrasonic motor with a suspension stator is proposed for improving output power density. Piezoelectric stacks working in d33 mode are involved in the stator, whereas piezoelectric plates employed in classic ring-shaped traveling wave motors often work in d31 mode. Spring-mass systems are used to suspend the stator from the base that supports the motor and provide preload force. The volume of piezoelectric material and the power density of the motor can be easily increased through the suspension structure. Large vibration amplitude of the stator can be generated on the coupling surface. Simulink analysis and finite element analysis are conducted to verify the theory and determine the optimum parameters of the suspension stator with four piezoelectric stacks. The maximum free vibration amplitude of 4.25 µm of the stator is observed, which is nearly 4.7 times of that without suspension. The prototype can work at a maximum no-load speed of 62 rpm and produce a stall torque of 49.5 mN m under a driving signal of 30 Vpp when the mass block is 0.30 g. Furthermore, the higher output power can be expected because more extra stacks can be added in this suspension structure.


Description of a new genus and three new species of Figitinae (Hymenoptera: Cynipoidea: Figitidae) from Colombia.
A new genus and three new species of Figitinae (Hymenoptera: Figitidae) are described from Colombia: Ferpereira Pujade-Villar n. gen., Ferpereira fiorellae Pujade-Villar n. sp., Neralsia levis Pujade-Villar & Petersen-Silva n. sp., and Figites colombiensis Pujade-Villar & Paretas-Martínez n. sp., which is the first species of Figites Latreille from Colombia and the second from South America. The diagnostic characters of these new taxa are illustrated.


[Application of pneumoperitoneum in collapse surgical procedures during tuberculosis outbreak].
Under conditions of tuberculosis epidemic resective methods come to be used more and more seldom, the causes of which fact being resistance of Koch's bacilli to antibacterial drugs, extension and duration of the process. Collapsosurgical interventions constitute an alternative to resecting methods but such operations are accompanied by complications in 11 to 22 percent of cases. The author suggests that pneumoperitoneum be used to prevent complications developing in thoracoplasty, substantiating his suggestion, validating it by submitting the relevant statistical material.


Improving outcomes in primary CNS lymphoma.
Primary central nervous system lymphoma (PCNSL) is an aggressive disease with previously poor prognosis. The advent of high-dose methotrexate-based induction regimens as well as use of consolidation therapy has greatly improved this prognosis in recent decades, but durable remission still eludes half of patients. In this review, we summarize the progress made in the treatment of PCNSL as well as the challenges that remain, with a focus on defining optimal induction and consolidation regimens, including the promise of developing biotherapies. Future studies will help delineate the best combination of existing and novel treatment strategies, with the goal of expanding the cohort of patients achieving a cure.


Carcinoma positive for Epstein-Barr virus staining. Mediastinal lymph node origination?
A 44-year-old man undergoing radical excision of metastatic carcinoma of the mediastinal lymph node with unknown primary sites remains alive and disease-free 14 years after surgery. His cancer cells were positive for the Epstein-Barr virus, which may have been related to the oncogenesis of this tumor. This case is unique in the patient's long, disease-free survival and its positive presence of the Epstein-Barr virus.


Combined analysis of the proteome and metabolome provides insight into microRNA-1174 function in Aedes aegypti mosquitoes.
Pathogenic viruses can be transmitted by female Aedes aegypti (Ae. aegypti) mosquitoes during blood-meal acquisition from vertebrates. Silencing of mosquito- and midgut-specific microRNA (miRNA) 1174 (miR-1174) impairs blood intake and increases mortality. Determining the identity of the proteins and metabolites that respond to miR-1174 depletion will increase our understanding of the molecular mechanisms of this miRNA in controlling blood-feeding and nutrient metabolism of mosquitoes. Antisense oligonucleotides (antagomirs [Ant]) Ant-1174 and Ant-Ct were injected into female Ae. aegypti mosquitoes at 12-20 h posteclosion, and depletion of miR-1174 was confirmed by reverse transcription quantitative real-time PCR (RT-qPCR). Ant-1174-injected and control mosquitoes were collected before the blood meal at 72 h post-injection for tandem mass tag-based proteomic analysis and liquid chromatography-tandom mass spectrometry non-target metabolomic analysis to identify differentially expressed proteins and metabolites, respectively. RNA interference (RNAi) using double-stranded RNA (dsRNA) injection was applied to investigate the biological roles of these differentially expressed genes. The RNAi effect was verified by RT-qPCR and western blotting assays. Triglyceride content and ATP levels were measured using the appropriate assay kits, following the manufacturers' instructions. Statistical analyses were conducted with GraphPad7 software using the Student's t-test. Upon depletion of mosquito- and midgut-specific miR-1174, a total of 383 differentially expressed proteins (DEPs) were identified, among which 258 were upregulated and 125 were downregulated. Functional analysis of these DEPs using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment suggested that miR-1174 plays important regulatory roles in amino acid metabolism, nucleotide metabolism, fatty acid metabolism and sugar metabolism pathways. A total of 292 differential metabolites were identified, of which 141 were upregulated and 151 were downregulated. Integrative analysis showed that the associated differential proteins and metabolites were mainly enriched in a variety of metabolic pathways, including glycolysis, citrate cycle, oxidative phosphorylation and amino acid metabolism. Specifically, the gene of one upregulated protein in miR-1174-depleted mosquitoes, purine nucleoside phosphorylase (PNP; AAEL002269), was associated with the purine, pyrimidine and niacin-nicotinamide metabolism pathways. PNP knockdown seriously inhibited blood digestion and ovary development and increased adult mortality. Mechanically, PNP depletion led to a significant downregulation of the vitellogenin gene (Vg); in addition, some important genes in the ecdysone signaling and insulin-like peptide signaling pathways related to ovary development were affected. This study demonstrates differential accumulation of proteins and metabolites in miR-1174-depleted Ae. aegypti mosquitoes using proteomic and metabolomic techniques. The results provide functional evidence for the role of the upregulated gene PNP in gut physiological activities. Our findings highlight key molecular changes in miR-1174-depleted Ae. aegypti mosquitoes and thus provide a basis and novel insights for increased understanding of the molecular mechanism involved in a lineage-specific miRNA in mosquito vectors.


Sleep structure and nocturnal disordered breathing in familial dysautonomia.
In 13 patients with familial dysautonomia sleep recordings were obtained to investigate the possibility that autonomic nervous system dysfunction plays a role in disordered breathing during sleep. Sleep structure in some of our patients was abnormal, showing decreased amount of REM sleep and increased REM latencies. All patients showed breathing disorders in sleep. The average number of apneic spells was 73.4 per night; 77% of the patients had more than 50 apneic spells per night. Abnormal breathing patterns were not uniform and were independent of patient's primary complaints. Typically, even severe respiratory irregularities were not associated with the usual cardiac response, indicating that our patients had "cardiac dysautonomia".


Teaching hospitals and their influence on survival after valve replacement procedures: A retrospective cohort study using inverse probability of treatment weighting (IPTW).
The effect of teaching hospital status on cardiovascular surgery has been of common interest in recent decades, yet its magnitude on heart valve replacement is still a matter of debate. Given the ethical and practical unfeasibility of randomly assigning a patient to such an exposure, we use the inverse probability of treatment weighting (IPTW) to assess this marginal effect on the survival of Colombian patients who underwent a first heart valve replacement between 2016 and 2019. A retrospective cohort study was conducted based on administrative records. The time-to-death event and cumulative incidences of death, readmission, and reoperation are presented as outcomes. An artificial sample is configured through IPTW, adjusting for sociodemographic variables, comorbidities, technique, and intervention weight. Of a sample of 3,517 patients, 1,051 (29.9%) were operated on in a teaching hospital. The median age was 65.0 (18.1-91.5), 38.5% of patients were ≤60, and 6.9% were ≥80. The cumulative incidences of death at 30, 90 days, and one year were 5.9%, 8%, and 10.9%, respectively. Furthermore, 23.5% of the patients were readmitted within 90 days and 3.6% underwent reintervention within one year. The odds of 30-day mortality are lower for patients operated in a teaching hospital (OR 0.51; 95% CI 0.29-0.92); however, no effect on survival was identified in terms of time-to-event of death (HR 1.07; 95%CI 0.78-1.46). After IPTW, the odds of 30-day mortality are lower for patients operated in a teaching hospital. There was no effect on survival, 90-day or one-year mortality, 90-day readmission, or one-year reintervention. Together, we offer an opening for investigating an exposure that has yet to be explored in Latin America with potential value to understand teaching hospitals as the essential nature of reality of an academic-clinical synergy.


Ointment Fistulography: Introducing a Novel Technique for Single or Multiple Urethrocutaneous Fistula Diagnosis After Hypospadias Surgery.
Hypospadias is a common congenital malformation of the male genital tract. The most frequent complication after hypospadias repair is urethrocutaneous fistula.1 Its incidence has been reported up to 35% worldwide.2 The diagnosis of these fistulas is sometimes challenging particularly with tiny and multiple fistulas. Usually, parents complain of urinary spraying, sprinkling, or passing a single stream of urine from the undersurface of the penis after the surgery. Urethrocutaneous fistulas are not always visible on physical examination. Locating the fistula and status of the surrounding skin is very important in order to choose the surgical repair technique.3 The patency and anatomy of the distal urethra should also be determined before the repair surgery.4 That is why urologists usually use retrograde urethrography or cystoscopy to find the location of fistula. However, these modalities have their own risk for children and are not always helpful. Sometimes the contrast media inserted can clog some fistulas especially near the glans and preclude the diagnosis. We present an easy technique to screen for urethrocutaneous fistulas after hypospadias surgery. In this technique (Video 1), an antibiotic ointment is inserted through the meatus while the base of the penis is held; the ointment is then gently pushed through the meatus. As shown in the video, the ointment will protrude through the fistulas anywhere along the shaft. This technique can also be performed reversely as the ointment inserted from the fistulas will protrude from the meatus. For younger children under the age of 3, we exclusively perform this technique under anesthesia on the repair surgery day, whereas in toddlers we perform this technique in the office and once again under anesthesia right before the repair surgery. This technique shows even tiny and multiple fistulas not detectable on physical examinations. We have used this technique in our clinic and have not missed any fistulas. The diameter of the protruded ointment in reverse fistulography is an indicator of the distal urethral diameter. Therefore, in case of narrow ointment diameter, distal urethral strictures should be suspected as correction of distal obstruction is an important determinant in the success rate of fistula repair surgery.5 CONCLUSION: We suggest this diagnostic technique as a safe, inexpensive, easy, office-based, feasible, and reproducible method. Negative urine culture is not required for this examination. Also, there is no need to insert contrast media as in retrograde urethrography or induce anesthesia as in cystoscopy. We believe this simple technique help urologists around the world to diagnose this common complication of hypospadias surgery without the need for special equipment.


Update on adult attention-deficit/hyperactivity disorder.
Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent and highly morbid neurobehavioral disorder afflicting children, adolescents, and adults throughout the world. This article discusses the clinical assessment of adult ADHD, reviews the results of recent adult ADHD treatment studies with an emphasis on medications currently approved by the US Food and Drug Administration, and discusses the clinical management and monitoring of ADHD pharmacotherapy.


Sex differences in the effects of haloperidol, morphine, and their combination on colonic temperature in rats.
Previously it was found that during the loss of postural support induced by combined administration of haloperidol and morphine, rats became markedly hypothermic. The present work was a more detailed study of this hypothermia. Morphine alone (20 mg/kg) produced a slight hyperthermia (1 degrees C) in female rats and no effect in males. Haloperidol alone (5 mg/kg) elicited a hypothermia of about 3 degrees C in females and no effect in males. The combination of both elicited a greater decrease of temperature (about 5 degrees C) in female rats and, unexpectedly, a decrease of 3 degrees C in males. According to these data, increased endorphinic activity with a concomitant decrease in dopamine in some unidentified regions of the central nervous system causes hypothermia.


Computerized Assessment of Motor Imitation as a Scalable Method for Distinguishing Children With Autism.
Imitation deficits are prevalent in autism spectrum conditions (ASCs) and are associated with core autistic traits. Imitating others' actions is central to the development of social skills in typically developing populations, as it facilitates social learning and bond formation. We present a Computerized Assessment of Motor Imitation (CAMI) using a brief (1-min), highly engaging video game task. Using Kinect Xbox motion tracking technology, we recorded 48 children (27 with ASCs, 21 typically developing) as they imitated a model's dance movements. We implemented an algorithm based on metric learning and dynamic time warping that automatically detects and evaluates the important joints and returns a score considering spatial position and timing differences between the child and the model. To establish construct validity and reliability, we compared imitation performance measured by the CAMI method to the more traditional human observation coding (HOC) method across repeated trials and two different movement sequences. Results revealed poorer imitation in children with ASCs than in typically developing children (ps < .005), with poorer imitation being associated with increased core autism symptoms. While strong correlations between the CAMI and HOC methods (rs = .69-.87) confirmed the CAMI's construct validity, CAMI scores classified the children into diagnostic groups better than the HOC scores (accuracyCAMI = 87.2%, accuracyHOC = 74.4%). Finally, by comparing repeated movement trials, we demonstrated high test-retest reliability of CAMI (rs = .73-.86). Findings support the CAMI as an objective, highly scalable, directly interpretable method for assessing motor imitation differences, providing a promising biomarker for defining biologically meaningful ASC subtypes and guiding intervention.


Characteristics of granulocyte-macrophage colony formation in chronic myelomonocytic leukemia: a comparative study with other myelodysplastic and myeloproliferative disorders.
We studied granulocyte-macrophage (GM) colony formation in chronic myelomonocytic leukemia (CMML, 6 cases), as compared with that in myelodysplastic syndromes (MDS, 6 cases) and myeloproliferative disorders (MPD, 12 cases). GM colony formation of bone marrow cells by colony-stimulating factor (CSF) was normal in CMML and MPD patients, but was decreased in MDS patients. Circulating granulocyte-macrophage progenitors (CFU-GM) were detected in CMML and MPD patients, but not in MDS patients. GM colony formation without CSF was observed in CMML patients, but not in MDS or MPD patients. These endogenous colonies decreased markedly after adherent cell (AdC) depletion, but AdC did not form endogenous colonies in sufficient numbers to explain their marked decrease after AdC depletion. In CMML patients, the numbers of circulating CFU-GM and endogenous colonies correlated with leukocyte and monocyte counts, respectively. The cellular composition of GM colonies was normal in MDS and MPD patients, whereas granulocytic colonies predominated in all CMML patients but one. The CSF-producing capacity of peripheral blood cells was also studied and was found to be increased in CMML patients. This capacity was markedly decreased by AdC depletion; and AdC could produce CSF only in CMML patients. CSF produced by CMML patients supported granulocytic colonies to a greater extent than CSF produced by MDS or MPD patients. These results suggest that enhanced granulopoiesis in CMML patients is closely associated with the possible hyperproduction of granulocytic CSF by their adherent monocytes.


Construction of a large scale membrane reactor system with different compartments for cells, medium and product.
A flat membrane reactor system has been designed where different membranes separate cells from medium and cells from product, respectively. By the use of this system the product can be enriched and partially purified within the reactor. Like other membrane systems perfect protection from mechanical stress of surface adherent as well as suspension type-cells is achieved. The scale up of the design is possible in a wide range. The prototype construction corresponds to a conventional reactor of appr. 300 l and contains a membrane area of 25 m2. Beside the three chamber operation mode it is possible to operate the system as a two chamber reactor. With slightly modified gaskets the reactor resembles a new type of tube reactor, where the cells can be refed on their way through the 50 m long tube.


Neuronavigated repetitive transcranial magnetic stimulation improves depression, anxiety and motor symptoms in Parkinson's disease.
Repetitive transcranial magnetic stimulation (rTMS) is a potential treatment option for Parkinson's disease patients with depression (DPD), but conflicting results in previous studies have questioned its efficacy. To investigate the safety and efficacy of neuronavigated high-frequency rTMS at the left DLPFC in DPD patients, we conducted a randomized, double-blind, sham-controlled study (NCT04707378). Sixty patients were randomly assigned to either a sham or active stimulation group and received rTMS for ten consecutive days. The primary outcome was HAMD, while secondary outcomes included HAMA, MMSE, MoCA and MDS-UPDRS-III. Assessments were performed at baseline, immediately after treatment, 2 weeks, and 4 weeks post-treatment. The GEE analysis showed that the active stimulation group had significant improvements in depression, anxiety, and motor symptoms at various time points. Specifically, there were significant time-by-group interaction effects in depression immediately after treatment (β, -4.34 [95% CI, -6.90 to -1.74; P = 0.001]), at 2 weeks post-treatment (β, -3.66 [95% CI, -6.43 to -0.90; P = 0.010]), and at 4 weeks post-treatment (β, -4.94 [95% CI, -7.60 to -2.29; P < 0.001]). Similarly, there were significant time-by-group interaction effects in anxiety at 4 weeks post-treatment (β, -2.65 [95% CI, -4.96 to -0.34; P = 0.024]) and in motor symptoms immediately after treatment (β, -5.72 [95% CI, -9.10 to -2.34; P = 0.001] and at 4 weeks post-treatment (β, -5.43 [95% CI, -10.24 to -0.61; P = 0.027]). The study suggested that neuronavigated high-frequency rTMS at left DLPFC is effective for depression, anxiety, and motor symptoms in PD patients.


Macrophage responses associated with COVID-19: A pharmacological perspective.
COVID-19 has caused worldwide death and economic destruction. The pandemic is the result of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has demonstrated high rates of infectivity leading to great morbidity and mortality in vulnerable populations. At present, scientists are exploring various approaches to curb this pandemic and alleviate its health consequences, while racing to develop a vaccine. A particularly insidious aspect of COVID-19 is the delayed overactivation of the body's immune system that is manifested as the cytokine storm. This unbridled production of pro-inflammatory cytokines and chemokines can directly or indirectly cause massive organ damage and failure. Systemic vascular endothelial inflammation and thrombocytopenia are potential consequences as well. In the case of COVID-19, the cytokine storm often fits the pattern of the macrophage activation syndrome with lymphocytopenia. The basis for the imbalance between the innate and adaptive immune systems is not clearly defined, but highlights the effect of SARS-CoV-2 on macrophages. Here we discuss the potential underlying basis for the impact of SARS-CoV-2 on macrophages, both direct and indirect, and potential therapeutic targets. These include granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin 6 (IL-6), interferons, and CXCL10 (IP-10). Various biopharmaceuticals are being repurposed to target the cytokine storm in COVID-19 patients. In addition, we discuss the rationale for activating the macrophage alpha 7 nicotinic receptors as a therapeutic target. A better understanding of the molecular consequences of SARS-CoV-2 infection of macrophages could lead to novel and more effective treatments for COVID-19.


Influence of marine vessel emissions on the atmospheric PM2.5 in Japan's around the congested sea areas.
In recent years, PM2.5 concentrations in Japan have decreased as China's measures against the emission of air pollutants were strengthened and the subsequent transport of air pollutants to Japan decreased. On the other hand, along the coast of the Seto inland sea in Japan, the PM2.5 concentration remains high. In this study, in order to evaluate the impact of air pollutants from marine vessels on PM2.5 along the coast of the Seto inland sea, PM2.5 was seasonally collected in the vicinity of a congested sea lane (Akashi Strait) in 2016 and 2017, and a receptor-source analysis was performed to determine the main components of the collected PM2.5. In Japan's congested sea lane, the vanadium (V) concentration was very high and showed a strong correlation with the nickel (Ni) concentration. Also, the V/Ni ratio rose when the wind blew from the sea lane. Positive Matrix Factorization (PMF) analysis clarified that the contributions from marine vessel emissions to PM2.5 at the current observation sites were 2.5-2.7 μg m-3 (17.3-21.4%), and the marine vessel emissions were the main source of PM2.5 along the coast of the Seto inland sea. Fuel oil regulations for marine vessels to be introduced in January 2020 are expected to improve the air quality of coastal areas.


[Electroencephalographic curves in diseases of the basomedian cerebral structures].
In twenty-two patients bilaterosymmetric, slow frequencies occurring in groups frontoprecentrally and frontoparietally, respectively, were found for a total of thirty-four spaceoccupying processes of basomedian structures. Such alterations should not be considered to be characteristic of tumors located adjacent to the median line, but may be regarded as an important indication. The changes themselves are due to the diffuse thalamocortical system as well as the reticular activating system. The overlapping of functions of these systems and the different responses of equal structures to different intensities of stimulation make it impossible for clinicians to assign them to individual basomedian structural levels even if necropsy records and reports on surgical operations are taken into consideration.


Renal conservation of carnitine by infants and adults: no evidence of developmental regulation.
To determine the efficiency of renal conservation of carnitine in infants, urinary carnitine excretion was measured at intervals in 10 infants while plasma carnitine concentration was manipulated by supplementing carnitine-free formula with 0 microM, 140 microM and 280 microM L-carnitine. As carnitine supplementation increased from 0 microM to 280 microM, fractional excretion of free carnitine increased tenfold from 0.6% to 6.0%; fractional excretion of acylcarnitine esters increased to a lesser degree (10.5-15.6%). At all supplementation levels fractional excretion of acylcarnitine esters was significantly greater than fractional excretion of free carnitine. We conclude that free and esterified carnitine are handled differently in the infant kidney. Results in infants were compared to previously reported data for adults. Mean fractional excretions of total, free and esterified carnitine by infants (7.2%, 5.4% and 12.7%, respectively) were similar to those by adults (6.5%, 5.0% and 15.0%). Thus, renal losses of carnitine apparently do not account for the low plasma carnitine concentrations observed in infants fed carnitine-free formulas.


Analysis of Deaths and Favorable Developments of Patients with SARS-CoV-2 Hospitalized in the Largest Hospital for Infectious Diseases and Pneumo-Phthisiology in the West of the Country.
Romania is one of the European countries that has been hit the hardest by the severe acute respiratory syndrome caused by the new coronavirus SARS-CoV-2, with over 1.91 million reported cases and over 59,257 deaths. The aim of this study was to identify the main predictors of death in hospitalized patients. In the period from 1 March 2020 to 30 June 2021, an observational, retrospective, randomized, case-control study was conducted, which included a sample of 139 patients who died in hospital and another sample of 275 patients who had been discharged in an improved or healed condition. Confirmation of COVID-19 cases was performed by RT-PCR from nasopharyngeal and oropharyngeal exudates. Statistical data were analyzed by logistic regression, Cox regression and a comparison of survival curves by the log-rank (Mantel-Cox) test. The most powerful logistic regression model identified the following independent predictors of death: history of coagulopathy HR = 30.73 [1.94-487.09], p = 0.015; high percentage of neutrophils HR = 1.09 [1.01-1.19], p = 0.027; and decreased blood-oxygenation HR = 53881.97 [1762.24-1647489.44], p < 0.001. Cox regression identified the following factors that influenced the evolution of cases: history of coagulopathy HR = 2.44 [1.38-4.35], p = 0.000; O2 saturation HR = 0.98 [0.96-0.99], p = 0.043; serum creatinine HR = 1.23 [1.08-1.39], p = 0.001; dyspnea on admission HR = 2.99 [1.42-6.30], p = 0.004; hospitalization directly in the ICU HR = 3.803 [1.97-7.33], p < 0.001; heart damage HR = 16.76 [1.49-188.56], p = 0.022; and decreased blood-oxygenation HR = 35.12 [5.92-208.19], p < 0.001. Knowledge of the predictors of death in hospitalized patients allows for the future optimization of triage and therapeutic case management for COVID-19.


[Endoscopic enucleation of the prostate: Indication, technique and results].
Laser prostatic enucleation is an increasingly popular technique among surgical urology. It is now gradually becoming a contender for gold standard surgical treatments, trans-urethral resection of the prostate (TURP) and open prostatectomy (OP). This study is based on data collected from sources published between June 1995 and June 2017. Medline and Embase database have been used to research the following keywords: Holmium; Thulium; Greenlight; Laser; Prostate; Enucleation; Benign prostatic obstruction; Surgical technique. With HoLEP process, catheterization time varies from 17,7hrs to 46,4hrs with 2 to 2.5 hospitalization days. With ThuLEP process, catheterization time varies from 2 to 2.5 days with 2.15 to 6.5 hospitalization days. With GreenLEP process, catheterization and hospitalization times are both 2 days. IPSS score after a year varies from 12.7 to 19.1 points in different publications. Convincing results of Laser prostatic enucleation make it a valid alternative to existing treatments.


Vestibular testing by electrical stimulation in patients with unilateral vestibular deafferentation: galvanic evoked myogenic responses testing versus galvanic body sway testing.
To investigate the agreement of a lesion site as indicated by two different vestibular tests with electrical stimulation, galvanic body sway testing (GBST) and galvanic evoked myogenic responses (galvanic vestibular evoked myogenic potential; galvanic VEMP) testing, in patients with unilateral vestibular deafferentation. Nineteen patients with unilateral vestibular deafferentation were studied, and the criteria for patient selection were as follows: (1) absence of a caloric response to ice water on the affected side in a supine position, and (2) absence of VEMP to 95 dBnHL clicks on the affected side. We assessed the postural response of the subjects to long duration galvanic stimulation (1 mA, 5 s) by measuring the lateral displacement at the center of foot pressure with a cathode electrode on the forehead, and an anode electrode on the mastoid (GBST). We also recorded the electromyographic (EMG) activities of the sternocleidomastoid muscle (SCM) to short duration galvanic stimulation (3 mA, 1 ms) (galvanic VEMP) with a cathode electrode on the mastoid, and an anode electrode on the forehead. In 18 of the 19 patients, the lesion site indicated by GBST was identical to that indicated by galvanic VEMP. Fourteen patients had abnormal results in both tests while 4 patients had normal results in both tests. One patient with acoustic neuroma had normal results in GBST but abnormal results in galvanic VEMP. These results suggest that electrical stimulation in these two tests stimulates the same area of the peripheral vestibular afferent system, although the duration of stimulation was different, and that the estimate of the lesion site indicated by these tests in patients with complete or nearly complete unilateral vestibular damages is reliable. These results suggest that short-duration galvanic stimulation as well as long-duration galvanic stimulation stimulates the vestibular system at the same level.


Ocular toxicity from ethambutol: a review of four cases and recommended precautions.
To document the clinical and demographic features of cases of ethambutol ocular toxicity, to review the literature on this subject and to critically review current guidelines for ethambutol administration. Cases of ocular toxicity from ethambutol were sought retrospectively at Green Lane and Wellington Hospitals between 1992 and 1995. The records of cases identified were examined. Four subjects with tuberculosis developed ocular toxicity 2 1/2, 7 1/2, 8 and 12 months after starting ethambutol. Normal visual acuity returned in three cases; one patient has severe, permanent visual impairment. Language difficulties were present in three subjects. Impaired communication was potentially very important in this series. Special care is needed in educating patients about ethambutol. We propose additional recommendations: 1. the usual daily dose of ethambutol should be 15 mg/kg/day, not 25 mg/kg/day; using 25 mg/kg/day (or lesser doses in the presence of renal impairment) should prompt regular formal ophthalmological evaluation (e.g. monthly) in cases with comprehension or communication difficulties; 3. both ethambutol and isoniazid should be stopped immediately if severe optic neuritis occurs. Isoniazid should be stopped if less severe optic neuritis does not improve within six weeks after stopping ethambutol.


Small Cell Lung Cancer: Emerging Targets and Strategies for Precision Therapy.
Small cell lung cancer is an aggressive subtype of lung cancer with limited treatment options. Precision medicine has revolutionized cancer treatment for many tumor types but progress in SCLC has been slower due to the lack of targetable biomarkers. This review article provides an overview of emerging strategies for precision therapy in SCLC. Targeted therapies include targeted kinase inhibitors, monoclonal antibodies, angiogenesis inhibitors, antibody-drug conjugates, PARP inhibitors, and epigenetic modulators. Angiogenesis inhibitors and DNA-damaging agents, such as PARP and ATR inhibitors, have been explored in SCLC with limited success to date although trials are ongoing. The potential of targeting DLL3, a NOTCH ligand, through antibody-drug conjugates, bispecific T-cell engagers, and CAR T-cell therapy, has opened up new therapeutic options moving forward. Additionally, new research in epigenetic therapeutics in reversing transcriptional repression, modulating anti-tumor immunity, and utilizing antibody-drug conjugates to target cell surface-specific targets in SCLC are also being investigated. While progress in precision therapy for SCLC has been challenging, recent advancements provide optimism for improved treatment outcomes. However, several challenges remain and will need to be addressed, including drug resistance and tumor heterogeneity. Further research and biomarker-selected clinical trials are necessary to develop effective precision therapies for SCLC patients.


Immunosuppressive Drugs in Liver Transplant: An Insight.
Liver transplantation (LT) is the standard of care for end-stage liver failure and hepatocellular carcinoma. Over the years, immunosuppression regimens have improved, resulting in enhanced graft and patient survival. At present, the side effects of immunosuppressive agents are a significant threat to post-LT quality of life and long-term outcome. The role of personalized immunosuppression is to reach a delicate balance between optimal immunosuppression and minimal side effects. Today, immunosuppression in LT is more of an art than a science. There are no validated markers for overimmunosuppression and underimmunosuppression, only a few drugs have therapeutic drug monitoring and immunosuppression regimens vary from center to center. The immunosuppressive agents are broadly classified into biological agents and pharmacological agents. Most regimens use multiple agents with different modes of action to reduce the dosage and minimize the toxicities. The calcineurin inhibitor (CNI)-related toxicities are reduced by antibody induction or using mTOR inhibitor/antimetabolites as CNI sparing or CNI minimization strategies. Post-liver transplant immunosuppression has an intensive phase in the first three months when alloreactivity is high, followed by a maintenance phase when immunosuppression minimization protocols are implemented. Over time some patients achieve "tolerance," defined as the successful stopping of immunosuppression with good graft function and no indication of rejection. Cell-based therapy using immune cells with tolerogenic potential is the future and may permit complete withdrawal of immunosuppressive agents.


3-Bromopyruvate as a potent covalently reversible inhibitor of New Delhi metallo-β-lactamase-1 (NDM-1).
The bacteria, harboring metallo-β-lactamases (MβLs), become resistant on most β-lactam antibiotics, specifically New Delhi metallo-β-lactamase-1 (NDM-1), which hydrolyzes almost all β-lactam antibiotics leading to bacterial multiple-drug resistance. It is highly desirable to develop effective NDM-1 inhibitors in reviving the efficacy of existing antibiotics. Here, we report a potent covalently reversible scaffold, 3-Bromopyruvate (3BP) to target the NDM-1 in vitro and in vivo. Enzymatic kinetic studies revealed that 3BP is capable of inhibiting the B1 and B2 MβLs and exhibited the best inhibition on NDM-1 with an IC50 of 2.57 μM, also, it was found to be a dose- and time-dependent inhibitor. The study of inhibition mechanism suggested that 3BP reversibly inactivate NDM-1, and may form a dynamic reversible covalent bond with cysteine at active site of the enzyme. Besides, 3BP effectively restored the activity of five β-lactam antibiotics on three clinical strains expressing NDM-1, resulting in 2-8-fold reduction in MIC. Moreover, the toxicity evaluation of 3BP against L929 mouse fibroblastic cells indicated that 3BP had low cytotoxicity, implying it may be used as lead molecule for future drug candidate.


Treatment of locally advanced and metastatic non-small cell lung cancer in the elderly.
In locally advanced NSCLC, RT/CHT can be used in fit elderly patients. In cases in which CHT is prohibitive, RT can be used alone. Advanced IIIB stage may be treated with palliative RT or CHT, each given alone. In metastatic NSCLC, platinum-containing regimens are feasible when elderly patients have good renal/cardiac function, but a third-generation drug may be a viable option, the choice depending on its toxicity profile. Short-course, palliative RT given in addition to CHT may play an important role in the treatment of symptomatic intra- and extrathoracic disease. Many questions concerning the optimal treatment for elderly patients with NSCLC remain unanswered and more trials designed for the elderly are urgently needed in the future.


Risk factors for mortality in patients with hypoplastic left heart syndrome after the Norwood procedure.
Several studies have reported mortality risk factors associated with hypoplastic left heart syndrome (HLHS). However, these data are ambiguous and mainly focused on the independent effects of these factors. We examined both the independent and the cumulative effects of preoperative risk factors for poor outcome in patients undergoing the Norwood procedure. Moreover, we studied the risk factors associated with prolonged initial hospital stays in these patients. We performed a retrospective national 18-year observational study of preoperative risk factors for 1 year, as well as total follow-up mortality or need for transplant in patients with HLHS (N = 99) born in Finland between 1 January 2004 and 31 December 2021. Overall, one-year survival was 85.6%. In a multivariable analysis, having a major extracardiac anomaly and being small for gestational age were significant predictors of one-year mortality or the need for a transplant. Aortic atresia was a predictor of total follow-up mortality. An analysis of the cumulative effect indicated that the presence of 2 risk factors was associated with higher mortality. HLHS remains the defect with the highest procedural risks for mortality in paediatric cardiac surgery. From a prognostic point of view, recognition of independent preoperative risk factors as well as the cumulative effect of risk factors for mortality is essential.The results of this study were presented orally at the 55th Annual Meeting of the Association for European Paediatric and Congenital Cardiology, Geneva, Switzerland, 28 May 2022.


Rice Blast Disease Recognition Using a Deep Convolutional Neural Network.
Rice disease recognition is crucial in automated rice disease diagnosis systems. At present, deep convolutional neural network (CNN) is generally considered the state-of-the-art solution in image recognition. In this paper, we propose a novel rice blast recognition method based on CNN. A dataset of 2906 positive samples and 2902 negative samples is established for training and testing the CNN model. In addition, we conduct comparative experiments for qualitative and quantitatively analysis in our evaluation of the effectiveness of the proposed method. The evaluation results show that the high-level features extracted by CNN are more discriminative and effective than traditional hand-crafted features including local binary patterns histograms (LBPH) and Haar-WT (Wavelet Transform). Moreover, quantitative evaluation results indicate that CNN with Softmax and CNN with support vector machine (SVM) have similar performances, with higher accuracy, larger area under curve (AUC), and better receiver operating characteristic (ROC) curves than both LBPH plus an SVM as the classifier and Haar-WT plus an SVM as the classifier. Therefore, our CNN model is a top performing method for rice blast disease recognition and can be potentially employed in practical applications.


Prostaglandin E2 facilitates neurite outgrowth in a motor neuron-like cell line, NSC-34.
Prostaglandin E2 (PGE2) exerts various biological effects by binding to E-prostanoid receptors (EP1-4). Although recent studies have shown that PGE2 induces cell differentiation in some neuronal cells such as mouse DRG neurons and sensory neuron-like ND7/23 cells, it is unclear whether PGE2 plays a role in differentiation of motor neurons. In the present study, we investigated the mechanism of PGE2-induced differentiation of motor neurons using NSC-34, a mouse motor neuron-like cell line. Exposure of undifferentiated NSC-34 cells to PGE2 and butaprost, an EP2-selective agonist, resulted in a reduction of MTT reduction activity without increase the number of propidium iodide-positive cells and in an increase in the number of neurite-bearing cells. Sulprostone, an EP1/3 agonist, also significantly lowered MTT reduction activity by 20%; however, no increase in the number of neurite-bearing cells was observed within the concentration range tested. PGE2-induced neurite outgrowth was attenuated significantly in the presence of PF-0441848, an EP2-selective antagonist. Treatment of these cells with dibutyryl-cAMP increased the number of neurite-bearing cells with no effect on cell proliferation. These results suggest that PGE2 promotes neurite outgrowth and suppresses cell proliferation by activating the EP2 subtype, and that the cAMP-signaling pathway is involved in PGE2-induced differentiation of NSC-34 cells.


Characterization of heterochromatic regions in two Triturus alpestris subspecies (Urodela: Salamandridae).
The fluorescence analysis carried out in Triturus alpestris alpestris and Triturus alpestris cyreni subspecies has revealed differences related to the content and distribution of AT-rich, GC-rich and non-fluorescent heterochromatic bands. These results provide new evidence on the chromosome differentiation undergone in their phylogenetic splitting.


Fine root turnover in forest ecosystems in relation to quantity and form of nitrogen availability: a comparison of two methods.
Two methods of estimating fine root production and turnover are compared for 13 forest ecosystems exhibiting a wide range in form (NH4+ vs. NO3-) and quantity of available nitrogen. The two methods are by comparison of seasonal maxima and minima in biomess and by nitrogen budgeting. Both methods give similar results for stands with low rates of nitrification. The budgeting method predicts higher fine root turnover and productivity than the max-min method for systems with significant rates of nitrification.


Choline plasmalogen synthesis by the methylation pathway in chick neurons in culture.
Choline plasmalogens represent a minor component of lipid membranes in most tissues. In spite of this, their rapid turnover indicates a possible functional role in the cell. The present study demonstrates that these compounds can be synthesized in neuronal cell cultures from chick embryo hemispheres by methylation of ethanolamine plasmalogens since choline plasmalogens were labeled after incubation of cells with tritiated ethanolamine or methionine. This finding could be of a particular interest since it has been suggested that choline plasmalogens, synthesized by methylation, might be involved in receptor activation.


Cloning and expression in Escherichia coli and Staphylococcus aureus of the beta-lysin determinant from Staphylococcus aureus: evidence that bacteriophage conversion of beta-lysin activity is caused by insertional inactivation of the beta-lysin determinant.
The beta-lysin determinant (Hlb) from Staphylococcus aureus CN6708 was cloned in Escherichia coli K-12 using the bacteriophage replacement vector lambda L47.1. The Hlb determinant was localised to a 1250 base pair DNA sequence by cloning fragments from a Hlb+ recombinant phage into the plasmid vectors pACYC184 and pBR322 in E. coli K-12, and by the subsequent construction and analysis of several sub-clones, in vitro deletion and Tn5 insertion mutations. E. coli cells harbouring Hlb+ plasmids expressed readily detectable levels of beta-lysin and sphingomyelinase activity, which were located in the cytoplasm. Two polypeptides of molecular weight 38,000 and 33,000 which were encoded by the Hlb determinant were detected in E. coli minicells, but only the 33,000 dalton protein was detected in immunoblotting experiments with specific anti-beta-lysin serum. Hybridisation analysis with probes made from the cloned Hlb determinant and from DNA of the staphylokinase-converting phage phi 13, indicated that bacteriophage conversion of S. aureus to loss of beta-lysin activity is due to insertion of phi 13 DNA into or adjacent to the beta-lysin determinant. A shuttle plasmid was used to transfer the cloned Hlb determinant into a beta-lysin negative strain of S. aureus where the wild-type chromosomal determinant was inactivated by lysogenic conversion. Beta-lysin activity was readily detected in supernatants of S. aureus harbouring the cloned determinant.


Progressive primary sclerosing cholangitis requiring liver transplantation is associated with reduced need for colectomy in patients with ulcerative colitis.
We investigated the association between the severity of primary sclerosing cholangitis (PSC) and clinical outcomes of patients with ulcerative colitis (UC) on the basis of need for colectomy. We analyzed data from 167 patients with PSC and UC who were followed from 1985 to 2011. Patients with PSC and UC were divided into groups that received orthotopic liver transplantation (OLT) (n = 86) or did not (non-OLT, n = 81). Clinical and demographic variables were obtained, and patients were followed until they received OLT or the date of their last clinical visit. The OLT group had significantly more subjects with less severe symptoms of UC (59, 68.6%) than the non-OLT group (12, 14.8%; P < .001). The subjects in the OLT group had a median of 0 UC flares compared with 3 in the non-OLT group (P < .001); fewer subjects in the OLT group required use of azathioprine or mercaptopurine (1, 1.2%), compared with the non-OLT group (14, 17.3%; P = .006). More subjects in the non-OLT group required colectomies (61, 75.3%) than in the OLT group (23, 26.7%; P < .001). On the basis of Cox regression analysis, OLT for PSC independently reduces the need for colectomy (hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.25-0.75; P = .003), as does a high Mayo risk score at diagnosis (HR, 0.52; 95% CI, 0.37-0.72; P < .001). Development of colon neoplasia increased the risk for colectomy (HR, 2.47; 95% CI, 1.63-3.75; P < .001). Severe progressive PSC that requires liver transplantation appears to reduce the disease activity of UC and the need for colectomy.


Could a harmonized tiered approach assess dispersant toxicity in Italy and France?
In recent years, EU countries have recognized national policies to authorize dispersant use to mitigate the petroleum hydrocarbon contamination in case of unintentional oil spills at sea. A harmonization of dispersant approval procedures is needed because the application of different methodologies agrees on dissimilar toxic responses for the same dispersant in different European countries. Actually, different dispersant approval procedures are applied in France and Italy with one French mandatory toxicity test and three Italian bioassays accompanied with different criteria of toxicity classification. In this paper, a harmonized tiered approach is proposed to address the dispersant ecotoxicological assessment in these two nations. Our approach, applicable at the European level, introduces two mandatory tests (algal growth inhibition test and mortality test with crustaceans) and one discretionary test (fish mortality test), by reducing use of vertebrates as much as possible in accordance with humane principles and animal welfare.


Omega-oxygenation of the alkyl sidechain of linear alkylbenzenesulfonate (LAS) surfactant in Parvibaculum lavamentivorans(T).
Parvibaculum lavamentivorans (T) DS-1, an aerobic, heterotrophic bacterium, requires a biofilm on a solid surface (e.g. glass particles) when utilizing commercial linear alkylbenzenesulfonate surfactant (LAS; 20 congeners) for growth. Catabolism involves the undefined 'omega-oxygenation' and beta-oxidation of the LAS side chain, and the organism excretes sulfophenyl carboxylates (SPC) quantitatively. A 3.5-l fermenter was developed which allowed gram-quantities of LAS-grown cells to be grown and harvested from medium with glass particles as the solid support. The catabolism of LAS was dominant: in diauxie experiments with acetate as second carbon source, LAS was utilized first. The biofilm-encoated LAS-grown cells were unsuitable for metabolic work in vitro because cell suspensions clumped and were not disrupted effectively, but the degradative enzymes were found to be expressed constitutively in acetate-grown cells, which formed no biofilm. LAS-dependent oxygen uptake was measured in acetate-grown cells at about 0.6 mkat (kg protein)(-1), but not in extracts of cells. Whole cells converted LAS to SPC in the presence of molecular oxygen only, and the reaction could be saturably inhibited by metyrapone, which acts on e.g. cytochromes P450 (CYP). However, despite the presence of CYP153-like sequences in the genome of strain DS-1(T), the difference spectra did not support the presence of a CYP in crude extracts, and the nature of the LAS-oxygenase remains unclear.


The anatomy of the limbus.
The limbus forms the border between the transparent cornea and opaque sclera, contains the pathways of aqueous humour outflow, and is the site of surgical incisions for cataract and glaucoma. Externally the epithelial cell border between conjunctiva and cornea possesses multipotential cells important for differentiation of the respective cell types. By the same token, the internal limbal border zone between corneal endothelium and anterior trabeculum appears to contain specialised cells some of which are activated to migrate and repopulate the trabecular meshwork after trabecular injury. The oblique interface between corneal and scleral stroma determines the appearance of the surgical limbus whose landmarks vary around the circumference of the globe but predictably correlate with structures of the anterior chamber angle. The vasculature of the limbus derives in primates primarily from the anterior ciliary arteries. Their superficial branches form arcades to supply the limbal conjunctiva and peripheral cornea. Perforating branches contribute to the vascular supplies of the deep limbal structures and the anterior uvea.


Localized ileus of the proximal jejunum: a new sign for acute appendicitis.
A focal dilatation of a loop of small bowel has been identified in the left upper quadrant in a series of individuals with suspected appendicitis. Retrospective review of 100 cases of surgically proven appendicitis demonstrated this sign in 51. No previous description of this sign has been found. This finding is believed to be an early sign of appendicitis and may be a valuable adjunct in combination with a clinical history without other radiologic signs of appendicitis. The more conventional signs of appendicitis such as appendicolith and focal ileus of the terminal ileum reinforce the diagnosis.


Intravascular leiomyosarcoma of the brachiocephalic region -- report of an unusual tumour localisation: case report and review of the literature.
Intravascular leiomyosarcoma is a rare tumour entity originating from venous vessel structures and most frequently affecting the inferior vena cava. A 69-year old patient presented with a biopsy proven leiomyosarcoma of the right supraclavicular region. Tumour resection and histological assessment verified the intravascular tumour origin arising from the internal jugular vein and extending into the surrounding soft tissue. In the presence of a biopsy proven diagnosis of leiomyosarcoma the rare condition of an intravascular tumour origin has to be considered even without signs of venous stases. This may result in an altered surgical strategy. Microthrombembolism and pulmonary metastases may complicate the course of the disease.


Metagenomic next-generation sequencing for the clinical diagnosis and prognosis of acute respiratory distress syndrome caused by severe pneumonia: a retrospective study.
Metagenome next-generation sequencing (mNGS) is a valuable diagnostic tool that can be used for the identification of early pathogens of acute respiratory distress syndrome (ARDS) in severe pneumonia. Little is known about the use of this technology in clinical application and the evaluation of the prognostic value of ARDS. We performed a retrospective cohort study of patients with ARDS caused by severe pneumonia. Samples were collected from patients in the intensive care unit (ICU) of Jiangmen Central Hospital from January 2018 to August 2019. The no-next generation sequencing (NGS) group was composed of patients given conventional microbiological tests to examine sputum, blood, or bronchoalveolar lavage fluid. The NGS group was composed of patients tested using mNGS and conventional microbiological tests. We evaluated the etiological diagnostic effect and clinical prognostic value of mNGS in patients with ARDS caused by severe pneumonia. The overall positive rate (91.1%) detected by the mNGS method was significantly higher than that of the culture method (62.2%, P = 0.001), and antibody plus polymerase chain reaction (28.9%, P < 0.001). Following adjustment of the treatment plan based on microbial testing results, the Acute Physiology and Chronic Health Evaluation-II (APACHE II) score of the NGS group was lower than that of the no-NGS group 7 days after treatment (P < 0.05). The 28-day mortality rate of the NGS group was significantly lower than that of the no-NGS group (P < 0.05). Longer ICU stay, higher APACHE II score and sequential organ failure assessment score were risk factors for the death of ARDS, and adjusting the medication regimen based on mNGS results was a protective factor. The detection of mNGS can significantly shorten the ICU stay of immunosuppressed patients (P < 0.01), shorten the ventilation time (P < 0.01), and reduce the ICU hospitalization cost (P < 0.05). Metagenome next-generation sequencing is a valuable tool to determine the etiological value of ARDS caused by severe pneumonia to improve diagnostic accuracy and prognosis for this disease. For immunosuppressed patients, mNGS technology can be used in the early stage to provide more diagnostic evidence and guide medications.


Thermoelectric effect in an Aharonov-Bohm ring with an embedded quantum dot.
Thermoelectric effect is studied in an Aharonov-Bohm interferometer with an embedded quantum dot (QD) in the Coulomb blockade regime. The electrical conductance, electron thermal conductance, thermopower, and thermoelectric figure-of-merit are calculated by using the Keldysh Green's function method. It is found that the figure-of-merit ZT of the QD ring may be quite high due to the Fano effect originated from the quantum interference effect. Moreover, the thermoelectric efficiency is sensitive to the magnitude of the dot-lead and inter-lead coupling strengthes. The effect of intradot Coulomb repulsion on ZT is significant in the weak-coupling regime, and then large ZT values can be obtained at rather high temperature.


New records and synonymy in the genus Macropsidius (Hemiptera, Cicadellidae, Macropsinae) from China and description of a new Pediopsis species.
Leafhopper species Macropsidius duuschulus Dlabola and M. niger Matsumura are recorded for the first time from China. Macropsidius fukangensis (Li et Xu) comb. nov. (from Macropsis) is proposed. A new species, Pediopsis bannaensis sp. nov., is described and illustrated from China and Thailand.


Heart failure and sleep apnoea: to sleep perchance to dream.
Heart failure and sleep apnoea are major health problems with an increasingly recognized association; evidence suggests that sleep apnoea may play a role in the progression of heart failure. However, confounding factors such as obesity, hypertension and coronary heart disease make this relationship uncertain and an independent correlation remains unproven. Diagnosis of sleep apnoea is suboptimal, as it is often asymptomatic and polysomnography is expensive and time-consuming. A simple and reliable screening protocol is required. All heart failure patients should be considered to be at high risk of sleep apnoea, as this association might be linked to adverse outcome. Continuous positive airway pressure has shown some beneficial effects, but long-term outcome and improvement in survival remains to be demonstrated. Despite recent advances in the understanding of the complex relationship between heart failure and sleep apnoea, there are a number of areas requiring further investigation, which may have important implications for the management and prognosis of a significant number of patients.


Identification of the arginine/ornithine antiporter ArcD from Halobacterium salinarum.
This paper identifies the first arginine/ornithine antiporter ArcD from the domain of archea. The functional role of ArcD is demonstrated by transport assays with radioactive labelled arginine, by its necessity to enable arginine fermentation under anaerobic growth conditions and by the consumption of arginine from the medium during growth. All three experimentally observables are severely disturbed when the deletion strain DeltaArcD is used. The isolated protein is verified by mass spectrometry and reconstituted in vesicles. The proteoliposomes are attached to a membrane and capacitive currents are recorded which appear upon initiation of the transport process by change from arginine-free to arginine-containing buffer. This clearly demonstrates that the purified 34kD protein is the functional unit.


Memory and psychostimulants: modulation of Pavlovian fear conditioning by amphetamine in C57BL/6 mice.
With the use of prescription stimulants on the rise, it is important to examine the cognitive effects of low and moderate doses of stimulants rather than only those typical of addicts. The present study examined the effects a range of doses (0.005-8 mg/kg) of D: -amphetamine sulfate on cued and contextual Pavlovian fear conditioning in mice. In agreement with previous research, subjects administered with a moderately high dose of amphetamine (8 mg/kg) pre-training, typical of what addicts might take, displayed impaired conditioned freezing when tested off-drug. Alternately, subjects injected with a very low dose of amphetamine (0.005, 0.025, or 0.05 mg/kg) pre-training, similar to the therapeutic doses for attention deficit hyperactivity disorder, displayed enhanced memory when tested off-drug. A control study showed that these effects were not due to state-dependent learning. Thus, dose is a critical determinant of the cognitive effects of psychostimulants.


Draft Genome Sequence of Bacillus velezensis Strain ZeaDK315Endo16.
Here, we report the draft genome sequence of the endophytic Bacillus velezensis strain ZeaDK315Endo16, isolated from DK315 maize from Lyon, France. B. velezensis ZeaDK315Endo16 exhibits a suppressive ability toward Fusarium graminearum, a widely known threat to maize production and quality.


Large meningioma of the foramen magnum in a 4-year-old child.
The case of a 4-year-old boy with 4 months' history of progressive quadriplegia is presented. The neuroradiological work-up, which included computed tomography scanning and magnetic resonance imaging, showed changes consistent with the diagnosis of a large mass lesion in the area of the foramen magnum. At operation a meningioma was completely excised. There was a gradual and almost complete neurological recovery.


Evaluation of omeprazole genotoxicity in a battery of in vitro and in vivo assays.
Omeprazole, a proton pump inhibitor of wide use in the treatment of gastric acid-related disorders, was evaluated for its genotoxic effects in both rat and human cultured cells and in the intact rat. DNA repair synthesis, as revealed by autoradiography, was detected in primary cultures of metabolically competent rat hepatocytes exposed to concentrations ranging from 10 to 100 mg/l, but the responses cannot be considered as clearly positive. Under the same experimental conditions any significant evidence of DNA repair was absent in primary hepatocytes from two human donors. At the same concentrations a modest but dose-related increase of micronucleated cells, that reached the level of statistical significance at 33 mg/l, was present in primary rat hepatocytes and in one of two human donors. In human lymphocytes exposed to subtoxic concentrations ranging from 0.78 to 12.5 mg/l a reproducible concentration dependent clastogenic effect was absent. In partially hepatectomized female rats treated with a single p.o. dose of 1000 mg/kg, the frequency of micronucleated cells was 5.2-fold higher than in controls in the liver, but only 2.0-fold higher in polychromatic erythrocytes of the bone marrow. In rats of the same sex given azoxymethane as initiator of colon carcinogenesis the oral administration for 8 successive weeks of 10 mg/kg omeprazole on alternate days increased the response to azoxymethane, as indicated by the occurrence in colon mucosa of a modest but statistically significant increase in both the average number and size of aberrant crypt foci. Taken as a whole, our results suggest that omeprazole behaves as a weak genotoxic agent for the rat liver. Reliable information about the potential genotoxic risk to humans requires further studies on primary cells from a wide number of donors.


Dorsi-ventral leaf reflectance properties of Carpinus betulus L.: an indicator of urban habitat quality.
The objective of this paper is to give an account of the evaluation of the effect of urban habitat quality on dorsi-ventral leaf reflectance asymmetry to bio-monitor urban habitat pollution. Reflectance in the RGB bands of a reflex camera is measured at the adaxial and abaxial sides of Carpinus betulus L. leaves for two contrasting urban habitats, e.g.; suburban green and industrial habitats in the city of Gent (Belgium). Abaxial leaf reflectance is consistently higher than adaxial leaf reflectance. We quantified leaf dorsi-ventral reflectance asymmetry with a newly defined Normalized Dorsi-ventral Asymmetry Index (NDAI). The NDAI is significantly higher in industrial habitats as opposed to suburban green ones. Our optical observations indicate that changes in Carpinus betulus L. leaf morphology are related to urban habitat quality. Hence, we suggest that leaf dorsi-ventral reflectance asymmetry allows the estimation of the magnitude and spatial extent of environmental pollution in urban environments.


A Short-Term Western Diet Impairs Cholesterol Homeostasis and Key Players of Beta Amyloid Metabolism in Brain of Middle Aged Rats.
Cholesterol homeostasis is crucial for brain functioning. Unhealthy nutrition can influence cerebral physiology, but the effect of western diets on brain cholesterol homeostasis, particularly at middle age, is unknown. Given the link between brain cholesterol alteration and beta amyloid production, the aim is to evaluate whether a diet rich in fat and fructose affects the protein network implicated in cholesterol synthesis and shuttling between glial cells and neurons, as well as crucial markers of beta amyloid metabolism. Middle aged rats are fed a high fat-high fructose (HFF) or a control diet for 4 weeks. Inflammatory markers and cholesterol levels significantly increase in hippocampus of HFF rats. A higher activation of 3-hydroxy 3-methylglutaryl coenzyme-A reductase, coupled with lower levels of apolipoprotein E, LXR-beta, and lipoproteins receptors is measured in hippocampus from HFF rats. The alteration of critical players of cholesterol homeostasis is associated with increased level of amyloid precursor protein, presenilin 1, and nicastrin, and decreased level of insulin degrading enzyme. Overall these data show that a western diet is associated with perturbation of cholesterol homeostasis in middle aged rats, mostly in hippocampus. This might trigger molecular events involved in the onset of neurodegenerative diseases.


Effects of ozone nano-bubble water on mucositis induced by cancer chemotherapy.
No effective, reliable treatment for stomatitis associated with cancer therapy has been established. This study focused on the its effectiveness of ozone nano-bubble water (ONBW) for the treatment of chemotherapy-induced stomatitis. Oral mucositis was induced in 14-week-old male Sprague-Dawley rats (N = 21). The animals were randomly divided into 3 groups: 7 without treatment (control); 7 treated with physiological salt solution (saline); and 7 treated with ONBW. Animals were weighed on Days 7, 9, 11, and 16. Stomatitis grade evaluation and bacterial count measurements were performed before rinsing in all animals 3, 5, and 10 days after acetic acid irritation (Days 9, 11, and 17 respectively). Weight loss after stomatitis creation was observed in all groups, with significant differences between the control and ONBW groups and between the saline and ONBW groups on Day 16. The stomatitis grade did not worsen during the experimental period in any group, with the lowest grades in the ONBW group on Days 11 and 16. Significant differences were identified between the control and ONBW groups and between the saline and ONBW groups on Days 11 and 16. Oral bacterial counts tended to decrease over time in all three groups, with the greatest decrease in the ONBW group, followed by the saline group. The decrease in the bacterial count was steepest in the ONBW group. Rinsing out the oral cavity with ONBW decreased bacterial counts and encouraged the healing of oral chemotherapy-induced stomatitis. ONBW may be an effective treatment for chemotherapy-induced stomatitis.


Clinical characteristics and diagnostic clues in inborn errors of creatine metabolism.
Creatine deficiency syndromes are a newly described group of inborn errors of creatine synthesis (arginine:glycine amidinotransferase (AGAT) deficiency and guanidinoaceteate methyltransferase (GAMT) deficiency) and creatine transport (creatine transporter (CRTR) deficiency). The common clinical denominator of creatine deficiency syndromes is mental retardation and epilepsy, suggesting the main involvement of cerebral grey matter (grey matter disease). Patients with GAMT deficiency exhibit a more complex clinical phenotype with dystonic hyperkinetic movement disorder and epilepsy that in some cases is unresponsive to pharmacological treatment. The common biochemical denominator of creatine deficiency syndromes is cerebral creatine deficiency which is demonstrated by in vivo proton magnetic resonance spectroscopy. Measurement of guanidinoacetate in body fluids may discriminate GAMT (high concentration), AGAT (low concentration) and CRTR (normal concentration). Further biochemical characteristics include changes in creatine and creatinine concentrations in body fluids. GAMT and AGAT deficiency are treatable by oral creatine supplementation, while patients with CRTR deficiency do not respond to this type of treatment. Further recognition of patients will be of major importance for the estimation of the frequency, for the understanding of phenotypic variations and for treatment strategies.


Croconaine nanoparticles with enhanced tumor accumulation for multimodality cancer theranostics.
A novel nanoparticle self-assembled by polyethylene glycol (PEG) modified croconaine dye (CR780) is presented for photoacoustic (PA)/near-infrared (NIR) fluorescence imaging-guided photothermal therapy (PTT). The simple PEGylation made CR780 amphiphilic, and led to their self-assembly into well-defined and uniform nanostructures with size tunable by controlling the assembly conditions. The CR780-PEG5K not only displayed the strength of small molecules (including rapid distribution to different organs, fast renal clearance and minimal accumulation to normal tissues), but also demonstrated the advantages of nanomaterials (including high physiological stability, multimodal theranostic ability, high tumor accumulation and retention). These facilely synthesized molecular nanoprobes showed great clinical translation potential as a versatile theranostic agent.


Consequences of damage to the sensorimotor cortex in neonatal and adult cats. I. Sparing and recovery of function.
Postural reflexes and locomotion were studied in order to assess the effects of unilateral sensorimotor cortical ablations in neonatal (1 day old) and adult cats. To document the infant lesion effect and to distinguish recovery from sparing of function, development of motor function was studied in neonatal operates and in normal littermates. Once neonatal operates achieved maturity, their motor performance was compared with that of chronic adult operates. The emergence of motor behavior during development in neonatal operates appeared to follow the same pattern as in normal animals although with a protracted time course and motor behavior did not attain the level of maturity of normal animals. Some deficits were not apparent immediately but evolved with time. Adult operates exhibited recovery of function of some behavior but neonatal operates exhibited greater recovery and sparing. Adult operates, like neonatal operates, were able to mask certain deficits by compensatory mechanisms. Kinematic analysis revealed that neonatal and adult operates often executed movements abnormally. It is hypothesized that somewhat different mechanisms underlie recovery in neonatal and adult operated animals.


TEQUILA-seq: a versatile and low-cost method for targeted long-read RNA sequencing.
Long-read RNA sequencing (RNA-seq) is a powerful technology for transcriptome analysis, but the relatively low throughput of current long-read sequencing platforms limits transcript coverage. One strategy for overcoming this bottleneck is targeted long-read RNA-seq for preselected gene panels. We present TEQUILA-seq, a versatile, easy-to-implement, and low-cost method for targeted long-read RNA-seq utilizing isothermally linear-amplified capture probes. When performed on the Oxford nanopore platform with multiple gene panels of varying sizes, TEQUILA-seq consistently and substantially enriches transcript coverage while preserving transcript quantification. We profile full-length transcript isoforms of 468 actionable cancer genes across 40 representative breast cancer cell lines. We identify transcript isoforms enriched in specific subtypes and discover novel transcript isoforms in extensively studied cancer genes such as TP53. Among cancer genes, tumor suppressor genes (TSGs) are significantly enriched for aberrant transcript isoforms targeted for degradation via mRNA nonsense-mediated decay, revealing a common RNA-associated mechanism for TSG inactivation. TEQUILA-seq reduces the per-reaction cost of targeted capture by 2-3 orders of magnitude, as compared to a standard commercial solution. TEQUILA-seq can be broadly used for targeted sequencing of full-length transcripts in diverse biomedical research settings.


Pulmonary embolism: CT signs and cardiac biomarkers for predicting right ventricular dysfunction.
The aim of this study was to prospectively evaluate the accuracy of quantitative cardiac computed tomography (CT) parameters and two cardiac biomarkers (N-terminal-pro-brain natriuretic peptide (NT-pro-BNP) and troponin I), alone and in combination, for predicting right ventricular dysfunction (RVD) in patients with acute pulmonary embolism. 557 consecutive patients with suspected pulmonary embolism underwent pulmonary CT angiography. Patients with pulmonary embolism also underwent echocardiography and NT-pro-BNP/troponin I serum level measurements. Three different CT measurements were obtained (right ventricular (RV)/left ventricular (LV)(axial), RV/LV(4-CH) and RV/LV(volume)). CT measurements and NT-pro-BNP/troponin I serum levels were correlated with RVD at echocardiography. 77 patients with RVD showed significantly higher RV/LV ratios and NT-pro-BNP/troponin I levels compared to those without RVD (RV/LV(axial) 1.68 ± 0.84 versus 1.00 ± 0.21; RV/LV(4-CH) 1.52 ± 0.45 versus 1.01 ± 0.21; RV/LV(volume) 1.97 ± 0.53 versus 1.07 ± 0.52; serum NT-pro-BNP 6,372 ± 2,319 versus 1,032 ± 1,559 ng · L(-1); troponin I 0.18 ± 0.41 versus 0.06 ± 0.18 g · L(-1)). The area under the curve for the detection of RVD of RV/LV(axial), RV/LV(4-CH), RV/LV(volume), NT-pro-BNP and troponin I were 0.84, 0.87, 0.93, 0.83 and 0.70 respectively. The combination of biomarkers and RV/LV(volume) increased the AUC to 0.95 (RV/LV(volume) with NT-pro-BNP) and 0.93 (RV/LV(volume) with troponin I). RV/LV(volume) is the most accurate CT parameter for identifying patients with RVD. A combination of RV/LV(volume) with NT-pro-BNP or troponin I measurements improves the diagnostic accuracy of either test alone.


Regular abdominal pain and fever in each menstruation onset: an unusual menses-associated familial Mediterrenean fever attacks and a favor result on colchicine treatment.
We present a 38-year-old woman suffering from regular abdominal pain and fever only in each menstruation onset for 7 years. The clinical symptoms, along with inflammatory findings during painful attacks, the beneficial effect of colchicine and genetic mutation (M694 V and M680I) supported the diagnosis of familial Mediterranean fever (FMF). A literature review indicated that FMF attacks occurring only during menstruation are rarely seen. This clinical picture may be confused with gynecological disorders especially in the people of Mediterranean origin.


A novel fluorescent "OFF-ON" sensing strategy for Hg (II) in water based on functionalized gold nanoparticles.
Mercury ion (Hg2+) is a heavy metal pollutant that can affect the safety of water environment and endanger human health. A novel detection strategy (GNPs-L-Cys-Rh6G2) for Hg2+ based on a fluorescence "OFF-ON" was proposed. Gold nanoparticles (GNPs) were assembled with l-cysteine (L-Cys), which was used as a "bridge" to link with rhodamine 6G derivatives (Rh6G2). The fluorescence state transition of GNPs-L-Cys-Rh6G2 switching from "OFF"-"ON" was observed because Hg2+ opened the spirolactam ring through a catalytic hydrolysis mechanism. The fluorescence signal of the GNPs-L-Cys-Rh6G2 system mixed with Hg2+ in the concentration range of 10-100 μM was analyzed and determined with a limit of detection (LOD) of 2 μM (S/N = 3). Moreover, the spiked Hg2+ concentration in real water samples were successfully quantified by GNPs-L-Cys-Rh6G2, which was in line with the ideal average recovery rate and relative standard deviation. The proposed strategy exhibited high specificity, sensitivity and stability, providing a novel sensing platform for heavy metal ions detection in water environment.


Kinetics of action of two leukotriene antagonists on guinea pig ileum.
The kinetics of action of two selective leukotriene (SRS-A) antagonists, FPL 55712 and FPL 59257, on guinea pig isolated ileum were examined by measuring pA2, pD'2 and the rate constants K1, K2, Ke and Kon. FPL 55712 was shown to be a competitive antagonist, producing a parallel displacement of dose response curves to LTD4 with no depression of the maximum. FPL 59257, however, was shown to be a non-competitive antagonist which depressed the maximum response to LTD4 and yielded a Schild plot slope significantly less than unity. FPL 59257 has a slower onset and greater duration of action than FPL 55712, as reflected in the rate constants K2 and Kon. The implications of these results are discussed.


Biaxially stretched nematic liquid crystalline elastomers.
The biaxial stretching of sheets of liquid crystalline neo-Hookean elastomer has been studied in the isotropic case. The results suggest two types of laminate structures in the process of quasiconvexification of the free energy, a fact that implies the appearance of several shear terms in the deformation gradient matrix. More that one decomposition of the deformation gradient is possible, which is consistent with a bifurcation in the undeformed configuration (λ = 1) . This situation is similar to the well-known Rivlin's problem of the triaxial symmetric traction of a neo-Hookean cube. The problem can easily be generalized for an anisotropic material by introducing a semisoft term in the free-energy expression. In this case, the horizontal plateau corresponding to the minimal energy, characteristic of the soft elasticity, disappears, and only an equilibrium condition is obtained.


Inhibition of breast cancer cell extracellular matrix degradative activity by chemically modified tetracyclines.
Inhibition of tumour cell proliferation, invasion and metastasis by chemically modified tetracyclines has been ascribed to inhibition of matrix metalloproteinase (MMP) activity. Exposure of the human breast carcinoma cell line MDA-MB-231 or its MMP-9-overproducing transfected clone (E-10) to 6-demethyl, 6-deoxy, 4-de [dimethylamino]-tetracycline (CMT-3), a chemically modified non-antimicrobial tetracycline followed by analysis using gelatinase activity assay, zymography, degradation of radiolabelled extracellular matrix (ECM), Western blotting, TNF-alpha ELISA and cell viability assays. CMT-3 treatment results in diminution in extracellular MMP-9 protein levels as well as inhibition of gelatinase activity. This prevents cell-mediated ECM degradation without inducing general cytostasis or cytotoxicity. Culturing E-10 cells in 10 or 20 microM CMT-3 diminished secreted MMP-9 levels by 45% or 60%, respectively, but did not affect levels of most other secreted proteins, including tissue inhibitor of Metalloproteinases (TIMP-1). ECM degradation by E-10 cells or their conditioned medium was inhibited by approximately 20%-30% in the presence of 20 microM CMT-3, reflecting inhibition of MMP-9 activity in addition to diminution of released MMP-9 levels. TNF-alpha levels were also diminished in E-10 conditioned medium in the presence of CMT-3, but cell viability, measured by MTS reduction and cytosolic LDH retention, was unaffected. It is proposed that the reduction in ECM-degradative activity reflects diminished levels of expression as well as inhibition of enzymatic activity of MMPs released by cells in the presence of CMT-3. These multiple effects of CMT-3 may offer promise for use in suppressing tumour invasion, and if used in conjunction with other chemotherapy agents, may lead to more successful treatment of cancer.


A recruitment manoeuvre performed after endotracheal suction does not increase dynamic compliance in ventilated paediatric patients: a randomised controlled trial.
Does a recruitment manoeuvre after suctioning have any immediate or short-term effect on ventilation and gas exchange in mechanically-ventilated paediatric patients? Randomised controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Forty-eight paediatric patients with heterogeneous lung pathology. Fourteen patients were subsequently excluded from analysis due to large leaks around the endotracheal tube. The experimental group received a single standardised suctioning procedure followed five minutes later by a standardised recruitment manoeuvre. The control group received only the single suctioning procedure. Measurements of ventilation (dynamic lung compliance, expiratory airway resistance, mechanical and spontaneous expired tidal volume, respiratory rate) and gas exchange (transcutaneous oxygen saturation) were recorded, on three occasions before and on two occasions after the recruitment manoeuvre, using a respiratory profile monitor. There was no difference between the experimental and the control group in dynamic compliance, expired airway resistance, or oxygen saturation either immediately after the recruitment manoeuvre, or after 25 minutes. The experimental group decreased mechanical expired tidal volume by 0.3 ml/kg (95% CI 0.1 to 0.6), increased spontaneous expired tidal volume by 0.3 ml/kg (95% CI 0.0 to 0.6), and increased total respiratory rate by 3 bpm (95% CI 1 to 4) immediately after the recruitment manoeuvre compared with the control group, but these differences disappeared after 25 minutes. There is insufficient evidence to support performing recruitment manoeuvres after suctioning infants and children.


Electrochemical assay of the antioxidant ascorbyl palmitate in mixed medium.
Electrooxidation of ascorbyl palmitate (AP) over gold screen-printed electrode (AuSPE) and gold nanoparticles modified graphite (AuNPs/gr) was examined in mixed water-alcohol medium. Voltammetric and amperometric studies showed that: (i) AP oxidation on the AuSPE proceeds at higher potential than on AuNPs/gr; (ii) the current density on AuNPs/gr was 2.4 times higher than on AuSPE; (iii) the linear dynamic range for AuNPs/gr doubled that for AuSPE. At the optimal for AuNPs/gr operating potential (250 mV) the following operational parameters were determined: sensitivity 1.627 ± 0.138 μA mM(-1) mm(-2); linearity up to 500 μM; LOD=5.8 μM. Quantification of the AP content in a real sample - stabilised flaxseed oil, was performed.


Inferior health-related quality of life and psychological well-being in immigrant cancer survivors: a population-based study.
This study compared health-related quality of life (QOL) and psychological morbidity in a population-based sample of first generation immigrant and Anglo-Australian cancer survivors. Eligible participants, recruited via three State Cancer Registries, included those: with a new diagnosis of one of 12 most incident cancers (all stages) 1-6years earlier; aged 18-80 at diagnosis; born in a Chinese, Arabic, or Greek speaking country and able to speak one of these languages. A random sample of English-speaking Anglo-Australian-born controls frequency matched for cancer diagnosis was recruited. 596 patients (277 of whom were immigrants) participated (a 26% response rate). In multiple linear regression models adjusted for age, sex, education, marital status, socio-economic status, time since diagnosis and type of cancer, immigrants had clinically significantly worse QOL (5.4-8.5 points on Functional Assessment of Cancer Therapy - General (FACT-G), P<0·0001), higher depression (P<0·0001) and higher incidence of clinical depression (P<0·01) than Anglo-Australians. Understanding the health system partially mediated this relationship for depression (P=0·0004) and QOL (P=0·001). Immigrant survivors of cancer have worse psychological and QOL outcomes than Anglo-Australians. Potential targets for intervention include assistance in navigating the health system, translated information and cultural competency training for health professionals.


[Nursing mothers satisfaction with the promotion of breastfeeding and professionals adherence to the recommendations. Multi-center study.]
The Baby-friendly Hospital Initiative or clinical practice guideline implementation programs have a positive impact on the promotion of breastfeeding (BF). There are knowledge gaps regarding the perceptions of new mothers towards these initiatives, and their degree of satisfaction. Our objective was to describe the satisfaction of BF mothers and adherence to the recommendations of the "Breastfeeding" guide from the Registered Nurses' Association of Ontario (RNAO). Between 2018-2019, in 9 Spanish hospitals that implemented the guide, 2,397 nursing mothers were surveyed who met inclusion criteria. A self-administered survey was designed with sociodemographic data, mother-child, BF promotion interventions carried out and degree of satisfaction. Descriptive and bivariate analysis was performed. The recommendations for skin-to-skin contact, help in breastfeeding, observation of a breastfeeding session and resolution of doubts presented adhesions >84%. Information about support groups, rooming-in and recognize signs of baby satisfaction obtained adhesions <40%. The exclusive BF rate at discharge was 77.5%. The mean satisfaction with skin-to-skin contact and the percentage of satisfaction at discharge were 5.8 and 96.8% respectively. The differences were significant between the degree of satisfaction and the educational level, age, work situation, type of delivery and type of hospital (p<0.05). According to puerperal women, adherence to the recommendations of the Clinical Practice Guide is good for most interventions and the degree of satisfaction is high.


Rapid separation of oligomers of polysialic acid by high-performance liquid chromatography.
A rapid procedure utilizing high-performance liquid chromatography was developed for the separation of homooligomers of sialic acid (N-acetylneuraminic acid). The method utilizes the anion exchanger Mono-Q HR 5/5 and can resolve sialyl oligomers with degrees of polymerization (DP) from 2 to 20 in 25 min. Previous methods required 1 to 9 days. Recoveries are quantitative and the method can be used either analytically to analyze the enzymatic digestion products of polysialic acid or semipreparatively to prepare sialyl oligomers of defined length. The method is potentially useful for analyzing other anionic oligosaccharides.


The biomedical standardization of premenstrual syndrome.
This essay traces the history of premenstrual syndrome (PMS) in French, British, and American medical literature from 1950 to 2004. Aetiological theories, treatments and diagnostic criteria have varied over time and place, reflecting local conditions and changing notions of objectivity and evidence. During the 1970s researchers in each nation utilised different research strategies to overcome variation and contradictory results characteristic of PMS research. Since the 1980s, attempts have been made to standardise research internationally through prospective daily rating questionnaires that diagnose and measure PMS. Amidst controversy, a psychiatric reformulation of the syndrome was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM). While the diagnostic criteria for this psychiatric category, now called premenstrual dysphoric disorder (PMDD), are widely accepted for research purposes, efforts to transfer them to medical practice have been less successful. PMDD remains a contested disease construct.


Desmoplastic small round cell tumor: a clinicopathologic, immunohistochemical and molecular study of four patients.
Desmoplastic small round cell tumor (DSRCT) is a rare but highly aggressive tumor that usually occurs in the abdominal cavity of young males. Immunohistochemical staining plays an important role in the differentiation of DSRCT from other small round cell neoplasms. Recently, a novel translocation of chromosome 11 and 22 [t(11;22)(p13+q12)] was identified in DSRCTs, which could result in the formation of the chimeric EWS-WT1 fusion gene. Reverse transcriptasepolymerase chain reaction (RT-PCR) has been applied to detect the fusion gene in fresh tissue and confirm the diagnosis. Only a few studies using RT-PCR with formalin-fixed and paraffin-embedded (FFPE) tissue sections to detect the specific transcript have been reported. We collected four patients who had been diagnosed with DSRCT from the archives of the Department of Pathology, National Taiwan University Hospital, between 1996 and 2006. The clinical information and histologic sections of the patients were reviewed. Panel of primary antibodies including cytokeratin, vimentin, desmin and WT-1 were used for immunohistochemical staining. RNA extracted from the FFPE tissue sections was used for RT-PCR to identify the transcript of EWS-WT1. All four patients were male, with a mean age of 24 years. All of the tumors originated in the abdominal cavity and liver metastases were found in two patients. Two patients died of disease within 2 years, and the other two remained alive with disease. Histologically, the tumors were composed of nests of primitive small round cells within a desmoplastic stroma. Immunohistochemically, all the tumor cells were reactive to cytokeratin, vimentin, desmin and WT-1. The characteristic EWS-WT1 fusion gene could be identified in the FFPE specimens of all three patients who had tissue sections available for RT-PCR analysis. DSRCT is an aggressive tumor that usually occurs in the peritoneum of young males. The tumor is characterized by the expression of cytokeratin, vimentin, desmin and WT-1. RT-PCR, using paraffin-embedded tissue sections, can effectively detect the characteristic EWS-WT1 fusion gene transcript.


Dynamics of swallowing-induced cardiac chronotropic responses in healthy subjects.
Simultaneous recording of ECG and swallowing movements in healthy humans (n=23, age 20-57 years) showed that each swallow is accompanied by transient tachycardia with initial abrupt and pronounced heart rate increase. These rapid changes in heart rate (evaluation by maximum increment of heart rate over two successive heartbeats, Delta HR(2bt)) are typical of vagal chronotropic responses. The amplitude of tachycardia induced by a single swallow was significantly higher in the supine position (13.1 +/- 5.6 bpm) compared to the standing position (8.5 +/- 3.8 bpm; p<0.0001). Chronotropic responses to a series of three or more successive swallows consisted of two phases, the initial abrupt acceleration and subsequent slower growth of heart rate. In the standing position, the portion of the first rapid phase significantly decreased, while the portion of the slower phase increased compared to the supine position. The amplitude of tachycardia induced by a single swallow and parameter Delta HR(2bt) can serve as indices of the strength of parasympathetic modulation of the heart. By contrast, further slow increase in the heart rate determined by summation of responses to a series of successive swallows can result from not only inhibition of the parasympathetic influences, but also enhancement of sympathetic activity during swallowing.


Immune carrier properties of acid-treated Salmonella minnesota R595 bacteria. The immune response to TNP-bacterial conjugates in rabbits and mice.
Salmonella minnesota R595 bacteria from which the core region of the lipopolysaccharide on the cell wall had previously been removed by mild acid treatment were trinitrophenylated. Differing amounts of these trinitrophenyl naked bacterial conjugates (TNP-NB), covering a range of epitope densities, were used for immunising mice and rabbits via the intraperitoneal or intravenous routes without adjuvants. It was found that such acid-treated, naked bacteria were effective carriers for the covalently linked hapten, TNP, with an optimum epitope density of 15 micrograms TNP/mg NB. Significant immune responses were obtained with dose levels as low as 50 ng TNP. The possible applications of acid-treated, naked bacteria as universal carriers having inherent adjuvant activity are discussed.


Synthesis of acetylene bridged germanium phthalocyanines.
The octaalkyl- or octaalkoxysubstituted phthalocyaninatogermanium dichlorides 10b,d,e and 10a-c were reacted with bisbromomagnesiumacetylene 16 and bisbromomagnesium-p-diethynylbenzene 18, respectively with formation of the corresponding acetylene bridged oligomers 17a-c and 19a-c, respectively.