Development and evaluation of competency-based curriculum for continuing professional development among military nurses: a mixed methods study.
Continuing professional development (CPD) is essential for career progression and maintaining military nursing competency. A well-designed CPD programme can improve the effectiveness of transforming knowledge and skills in healthcare organisations. This study aimed to develop a competency-based CPD curriculum for military nurses in China and evaluate its effectiveness from a developmental pilot study. In phase one, a two-round Delphi was conducted to design a competency-based curriculum of CPD based on a clinical ladder model among military nurses. In phase two, the curriculum of one CPD programme was redesigned, and a pilot quasi-experiment was conducted to evaluate the effectiveness of this programme. A competency-based curriculum was developed for primary, intermediate, and senior titles, respectively. The trainees' overall satisfaction with the redesigned CPD programme was 100%. The four themes in the qualitative data were: 1) learning motivation and learning barriers; 2) professional growth; 3) role model promoted career planning; 4) learning environment mattered. This study developed a competency-based curriculum for continuing professional development among military nurses that can be used in designing CPD programmes. Competency-based curriculum can be utilised in the CPD activities to facilitate the improvement of nursing competency.


Quasi-planar B36 boron cluster: a new potential basis for ammonia detection.
Detection of NH3 at a trace level is nowadays of great importance. Here, we investigate the reactivity and sensitivity of a B36 borophene toward NH3 gas employing DFT calculations. The energetic results point out that the adsorption process strongly depends on the orientation of NH3 relative to the B36 sheet. An NH3 molecule preferentially interacts via its N-head with a B atom of the B36 with a change of enthalpy of - 90.5 kJ/mol at room temperature and 1 atm. Mulliken charges analysis results reveal that approximately 0.35 |e| transfers from NH3 to the B36, leaving partially positive NH3. We found that the B36 electronic properties are meaningfully sensitive to the NH3 gas, and it may be a sign of further usage of B36 as a potential NH3 gas sensor. The density of state analysis shows that the B36 gap is expressively decreased from 1.55 to 1.35 eV, increasing its electrical conductance.


Consanguinity in primary immunodeficiency disorders; the report from Iranian Primary Immunodeficiency Registry.
Primary Immunodeficiency Disorders (PiD) are a heterogeneous group of genetic disorders, with different modes of inheritance. This study was accomplished in order to determine the frequency of consanguineous marriages in the families of patients with PiD. In this study, the records 515 Iranian PiD patients were reviewed during a 25-year period. The mean proportion of consanguineous marriages was 65.6% among PiD patients, while the overall rate was 38.6% in the country. The rate of consanguinity was 77.8% in cellular immunodeficiencies, 75.8% in combined immunodeficiencies, 72.5% in defects of phagocytic function, 58.6% in other immunodefiiencies, 54.1% in predominantly antibody deficiencies, and 50% in complement deficiencies. Moreover all patients with immunodeficiency associated with other diseases had consanguineous parents. Such marriages were most common in the parents of patients with Chediak-Higashi syndrome, severe combined immunodeficiencies, primary CD4 deficiency, ataxia-telangiectasia, selective IgG class deficiencies, chronic granulomatous disease, and Schwachman syndrome. It is important to inform the general population about the dangers of consanguinity, which is very common in some areas such as Iran. Premarital examination to avoid genetic diseases could be suggested, especially in a community where the rate of consanguineous marriage is high.


Primary breast squamous cell carcinoma: A case report at a tertiary hospital in Northern Tanzania.
Primary SCC of the breast is a very rare disease.Metastasis from elsewhere should be excluded first.The tumor is a very aggressive with poor prognosis.No standard treatment approaches are available.Managed by surgical excision followed by chemotherapy and radiotherapy. Primary squamous cell carcinoma of the breast is an exceedingly rare disease, and its management is still unclear. A-65-year-old lady presented with a progressive swelling of her right breast that started spontaneously. Other potential primary sites were ruled out. She was kept on a neo-adjuvant chemotherapy (AC-T protocol) of doxorubicin, adriamycin, and paclitaxel. Later, she was underwent modified radical mastectomy with axillary lymph node dissection. Her post-operative recovery was uneventful. Currently, she is followed up at oncology outpatient clinic.


Chemotaxis of fibroblasts toward nonapeptide of elastin.
Bovine ligamentum fibroblasts, which produce elastin, migrate towards a positive chemical gradient of human platelet-derived growth factor and of the tropoelastin repeat hexapeptide Val-Gly-Val-Ala-Pro-Gly, as previously shown. They are also responsive to two permutations of a nonapeptide that repeats in tropoelastin, i.e., Ala-Gly-Val-Pro-Gly-Phe-Gly-Val-Gly and Gly-Phe-Gly-Val-Gly-Ala-Gly-Val-Pro. Concentration curves and checkerboard assays prove that the nonapeptides are chemoattractants. The component pentapeptide, Gly-Phe-Gly-Val-Gly, is chemotactic, while the component tetrapeptide Ala-Gly-Val-Pro is not. The hexapeptide competitively suppresses the nonapeptide chemotaxis suggesting the involvement of a common cell receptor. The results support the concept that elastin has multiple cell recognition sites as measured by the chemotactic response and that among the hydrophobic repeating sequences of elastin chemotacticity is selectively and multiply localized.


Strain differences in response to dietary cholesterol by JAX rabbits: correlation with esterase patterns.
Six strains of genetically defined JAX rabbits were tested for their serum cholesterol levels (total and free) in response to a 0.5% cholesterol diet. Marked differences in response between the 6 strains were found. IIIVO/J and WH/J are low responding strains, X/J and ACEP/J are intermediate responding strains, and OS/J and AX/J are high responding strains. After 4 weeks of the cholesterol diet the total serum cholesterol level of the high responding AX/J strain was about 5-fold greater than the level of the low responding IIIVO/J strain. The esterified/total (E/T) ratio appeared to be higher in the high responding strains, indicating a synergistic effect in the process of atherosclerosis. The response of the individual rabbits to the cholesterol diet was compared with the patterns of serum and liver esterase zymograms. This comparison indicated a correlation of the dietary cholesterol susceptibility with the presence or absence of the esterase zones in the anodal, fast moving region of the gel.


Autoreactive mechanisms in infective endocarditis.
Infective endocarditis is not a simple interaction between a microbial agent and a cardiac valve. For the infection of a non-bacterial thrombotic vegetation, predisposition is required which is at least partially operative by a decreased suppressor T cell activity. During infection, peripheral blood natural killer cell activity is decreased, but normalizes under anti-microbial therapy. Non-major histocompatibility complex-restricted lymphocytotoxicity to isolated heart cells can be present in one third of patients. Circulating immune complexes normalize during therapy. They may be the cause of many clinical symptoms of infective endocarditis. Anti-bacterial and also anti-sarcolemmal antibodies which are cross-reactive to the bacterium are secreted in a polyclonal immune response. Anti-sarcolemmal antibodies which are cytolytic in vitro in the presence of complement may partly explain the myocardial factor of heart failure in patients with only marginal valve incompetence due to the endocarditic vegetation.


How a woman's myomectomy saved her father's life: evidence of fumarate hydratase-deficient uterine leiomyoma and early detection of germline variants in fumarate hydratase.
To describe a case of a personal and family history of early uterine leiomyomatosis that revealed a pathogenic variant in the FH gene encoding fumarate hydratase. After the patient's diagnosis, a first-degree relative was detected with early-stage renal cell carcinoma. The patient decided to undergo preimplantation genetic testing to reduce the risk to her future children. A case report of autosomal dominant hereditary leiomyomatosis and renal cell cancer syndrome where the patient underwent 2 cycles of in vitro fertilization with preimplantation genetic testing for monogenic disease/aneuploidy (PGT-MA) that resulted in 3 unaffected, euploid embryos. Large academic single-center hospital. A 35-year-old nulligravida woman with a personal history of an early-onset uterine leiomyomatosis and a family history of renal cell carcinoma and uterine leiomyomas, who is heterozygous for a pathogenic variant in FH and diagnosed with hereditary leiomyomatosis and renal cell cancer syndrome. Informed consent was obtained. Two laparoscopic myomectomies were performed, and tissue was sent for histopathology and immunostaining. Hereditary leiomyomatosis and renal cell cancer syndrome was confirmed by germline testing, and 2 cycles of PGT-MA were performed. Through PGT-MA, the patient was able to mitigate the risk of passing a known familial variant to her future children. After 2 cycles of in vitro fertilization with PGT-MA, 3 unaffected embryos were available for transfer. An unaffected, euploid embryo was transferred for pregnancy, and the patient is currently pregnant in her second trimester. Pathogenic variants in FH should be suspected in patients with early-onset uterine leiomyomas and a family history of cutaneous and/or uterine leiomyomas. Familial variant testing is crucial in identifying relatives at risk to start early screening.


A Prospective Study of Biometric Stability After Scleral Buckling Surgery.
To assess time to stabilization and factors associated with changes in biometric parameters after scleral buckling (SB). Prospective case series. Seventeen eyes with primary rhegmatogenous retinal detachment (RRD) that underwent SB at the Singapore National Eye Centre were enrolled. SB surgery was performed using an encircling element and segmental buckle. Axial length (AL); anterior chamber depth (ACD), defined as the distance from the corneal epithelium to the anterior lens surface; anterior/posterior corneal curvature (K); and refraction were measured preoperatively and at week 1 and months 1, 3, 6, 9, and 12 postoperatively. Stability of each parameter was defined as the earliest time point at which there is no significant difference compared to its value at month 12. AL increased (26.09 ± 1.46 to 26.51 ± 1.96, P = .01), ACD decreased (3.84 ± 0.47 to 3.32 ± 0.57, P < .001), and a myopic shift of 1.04 diopters (95% CI 0.03-2.05, P = .04) occurred at month 12. Anterior/posterior K were not significantly changed from baseline. AL stabilized at month 3 while ACD and spherical equivalent (SE) stabilized at week 1. Cryotherapy was associated with greater increase in AL (P = .001) and myopic shift (P = .02). More extensive segmental buckling was associated with greater increase in AL (P = .009) and myopic shift (P = .03). Our study suggests that patients requiring cataract surgery after SB should have biometry performed no earlier than 3 months post SB surgery, and intraocular lens power calculation with a fourth-generation formula. A greater increase in AL and myopic shift was associated with cryotherapy and more extensive segmental buckling.


Advice and perspectives from navigating the couples match in otolaryngology: A qualitative pilot study.
There is a lack of qualitative analysis of the personal experiences within Couples Matching. In this qualitative study, we aim to record personal attitudes, reflections, and advice on experiences with the Couples Match process. Our survey, consisting of two open-ended questions regarding the experience of Couples Matching, was distributed from January 2022 to March 2022 via email to 106 otolaryngology program directors across the nation. Survey responses were analyzed iteratively using the constructivist grounded theory to construct themes related to pre-match priorities, match-related stressors, and post-match satisfaction. Themes were developed inductively and refined iteratively as the dataset evolved. 18 Couples Match residents responded. In response to the first question: "What was the most difficult part of the process for you and/or your partner?", we identified the following themes: cost and financial burden, increased stress on the relationship, sacrificing top choices, and finalizing the match list. In response to the second question: "Using your experience as a previous applicant, what advice would you give to another couple planning on couples matching?", we identified four common themes: compromise, advocacy, dynamic conversations, and applying broadly. We sought to understand the Couples Match process through the perspective of previous applicants. Analyzing the views and attitudes of Couples Match applicants, our study captures the most challenging aspects of the experience and highlights possible areas to improve advising for couples, including important factors to consider when applying, ranking, and interviewing.


In-silico screening and experimental validation reveal L-Adrenaline as anti-biofilm molecule against biofilm-associated protein (Bap) producing Acinetobacter baumannii.
Acinetobacter baumannii, an ESKAPE pathogen, causes various nosocomial infections and has capacity to produce biofilm. Biofilm produced by this bacterium is highly tolerant to environmental factors and different antibiotics. Biofilm-associated protein (Bap) plays a significant role in the biofilm formation by A. baumannii and found in the extra cellular matrix of the biofilm. Therefore, it becomes essential to find a potential drug against Bap that has capacity to inhibit biofilm formation by A. baumannii. In-silico screening, molecular mechanics and molecular dynamics studies identified ZINC00039089 (L-Adrenaline) as an inhibitor for Bap of A. baumannii. Recently, it is reported that Bap can form amyloid like structure; hence we have created dimer of Bap protein. This inhibitor can bind to dimeric Bap with good affinity. It confirms that ZINC00039089 (L-Adrenaline) can bind with Bap monomer as well as oligomeric Bap, responsible for amyloid formation and biofilm formation. Hence, we have tested Adrenaline as an anti-biofilm molecule and determined its IC50 value against biofilm. The result showed Adrenaline has anti-biofilm activity with IC50 value of 75μg/ml. Therefore; our finding suggests that L-Adrenaline can be developed to inhibit biofilm formation by carbapenem resistant strain of Acinetobacter baumannii.


Autism Diagnostic Interview-Revised and the Childhood Autism Rating Scale: convergence and discrepancy in diagnosing autism.
The agreement between the Autism Diagnostic Interview-Revised (ADI-R) and the Childhood Autism Rating Scale (CARS) was investigated in the diagnostic assessment of 54 children aged 22-114 months referred for possible autism. The observed agreement between the two systems was 66.7% (Cohen's kappa = .40) when the ADI-R definition for autism was applied (i.e., scores reaching cutoff in three domains on the ADI-R), but increased considerably with less stringent criteria; that is, scores reaching cutoffs in two domains and in one domain on the ADI-R. As predicted, the CARS identified more cases of autism than the ADI-R. Children classified as autistic according to both instruments had significantly lower IQ/DQ and more severe autistic symptomatology than those classified with the CARS only.


A Peer Support Scale for Adults Treated for Psychoactive Substance-Use Disorder: A Rasch Analysis.
The literature suggests that peer support is protective of relapse for adults treated for substance-use disorder. However, to our knowledge there is no standard measure of peer support. Therefore, the purpose of this research was to use Rasch analysis to assess a 13-item peer support scale used in a group of adults treated for primary psychoactive substance-abuse disorder. The participants (n = 408) are adults who were discharged from an inpatient substance-abuse treatment program from five successive years, 2004-2009. Overall, it is acceptable to surmise that items 1-12 are part of the same dimension for the 13-item scale. Given the prominence of therapeutic communities as a mode of primary treatment and the importance of peer support, it is important to both the academic and treatment communities to have a standard way to measure peer support. The scale presented here can be useful for this purpose. We asses a peer support scale for those treated for substance abuse.We examine characteristics of the peer support scale.We provide an option to measure peer support for those treated for substance abuse.


Postoperative intussusception in childhood.
Over a period of 10 years, five children developed postoperative intussusception after intra-abdominal procedures at the Department of Pediatric Surgery of the Johannes Gutenberg University Mainz. Two appendectomies, one ileal resection for a Meckel's diverticulum, one operative procedure for Hirschsprung's disease plus intestinal neuronal dysplasia type B, and one hiatoplasty with jejunostomy preceded the intussusception. Three of the five children were older than 2 years. The clinical symptoms consisted primarily of abdominal distension, diffuse abdominal pain, bilious vomiting, and rectal bleeding in one case. Preoperative diagnosis was achieved in four cases by abdominal ultrasound. Plain abdominal radiographs demonstrated dilated loops of small intestine with air-fluid levels in four of the five cases. In the case without radiographic findings, the jejunojejunal intussusception was missed even by a bowel follow-through. The intussusceptions were ileocolic (3), ileoileal (1), and jejunojejunal (1). A hydrostatic procedure to reduce an ileocolic intussusception was not successful. Operative treatment of the intussusception was performed in three cases within 5 days, once at 32 days, and once 3 months after the primary operation, in all cases by laparatomy and simple manual reduction without intestinal resection. In contrast to idiopathic intussusception, noninvasive hydrostatic procedures are not indicated in postoperative intussusception, since protection of intestinal anastomoses from hydrostatic pressure and exclusion of other causes of postoperative ileus are mandatory.


Feedback processing is enhanced following exploration in continuous environments.
Decision-making is typically studied by presenting participants with a small set of options. However, real-world behaviour, like foraging, often occurs in continuous environments. The degree to which human decision-making in discrete tasks generalizes to continuous tasks is questionable. For example, successful foraging comprises both exploration (learning about the environment) and exploitation (taking advantage of what is known). Although progress has been made in understanding the neural processes related to this trade-off in discrete tasks, it is currently unclear how, or whether, the same processes are involved in continuous tasks. To address this, we recorded electroencephalographic data while participants "dug for gold" by selecting locations on a map. Participants were cued beforehand that the map contained either a single patch of gold, or many patches of gold. We then used a computational model to classify participant responses as either exploitations, which were driven by previous reward locations and amounts, or explorations. Our participants were able to adjust their strategy based on reward distribution, exploring more in multi-patch environments and less in single-patch environments. We observed an enhancement of the feedback-locked P300, a neural signal previously linked to exploration in discrete tasks, which suggests the presence of a general neural system for managing the explore-exploit trade-off. Furthermore, the P300 was accompanied by an exploration-related enhancement of the late positive potential that was greatest in the multi-patch environment, suggesting a role for motivational processes during exploration.


Actions of progestins on estrous behaviour in female rats.
The present study evaluated the facilitative actions of progesterone and the synthetic progestin R 5020 on estrous responsiveness in ovariectomized, estrogen-primed female rats. The dose-response and time-response characteristics of the behavior facilitating actions of both progesterone and R 5020 were measured. The threshold doses for the facilitation of estrous behavior in estrogen-primed female rats were 1 microgram of R 5020 and 100 micrograms of progesterone. These doses of progestins facilitated estrous responsiveness with a similar time course that approached maximum at one hour. To examine the possible mechanism(s) of action of each progestin the synthetic progestin antagonist RU 38486 was used. The inhibitory effects of RU 38486 on estrous behavior facilitated by a threshold dose of progesterone or R 5020 were found to be almost identical. RU 38486 (5 mg) administered 1 hr prior to progesterone or R 5020 suppressed lordosis behavior by 44% and 47% respectively. These results suggest that progesterone and R 5020 facilitate estrous responsiveness through the same mechanism.


Natural history of acute and chronic hepatitis B: The role of HBV genotypes and mutants.
Molecular epidemiologic studies reveal remarkable differences in the geographical distribution of hepatitis B virus (HBV) genotypes. The frequency of mutants among HBV genotypes also varies. The role of HBV genotypes/mutants in the pathogenesis of HBV infection and natural history of HBV infection has been extensively investigated. The distribution of HBV genotypes in acute hepatitis B patients reflects the predominant genotypes in a given geographic area. In chronic hepatitis B patients, genotype C and D have a higher frequency of basal core promoter A1762T/G1764A mutations than genotype A and B. HBV genotypes C, D and F carry a higher lifetime risk of cirrhosis and HCC development than genotype A and B. HBV pre-S/S gene mutations were associated with immune escape of hepatitis B immunoglobulin or vaccine-induced immunity. Mutations in the pre-S, core promoter and X regions correlate with an increased risk of cirrhosis and HCC. In summary, HBV genotypes and mutants are associated with the disease progression and long-term outcome of HBV infection. They may serve as viral genetic markers for risk stratification of chronic hepatitis B patients in clinical practice.


Diagnosis of Mycobacterium tuberculosis infection using ESAT-6 and intracellular cytokine cytometry.
Diagnosis of infection with Mycobacterium tuberculosis (MTB) using tuberculin skin testing (TST) is often hampered by prior Bacille Calmette-Guérin (BCG) vaccination. ESAT-6 is a protein that is expressed by MTB but absent in BCG. It has been postulated that it might be useful in distinguishing MTB-specific immune responses. This study measured CD4 T cell responder frequencies specific for ESAT-6 and the TST reagent purified protein derivative (PPD) in patients with tuberculosis (n = 16), controls with non-tuberculous pneumonia (n = 8) and normal subjects (n = 7). Responses were identified using the intracellular cytokine staining technique and flow cytometry on whole blood samples, and performed blinded to the patient condition. Antigen-specific CD4 cells were defined by CD69 positivity and one or more cytokine [interleukin (IL)-2, IL-4, IL-10, interferon (IFN)-gamma] and/or CD40L positivity. With ESAT-6 stimulation it was found that TB patients had significantly higher frequencies of IFN-gamma and CD40L-positive CD4 T cells compared to the normal group, while no significant differences were measured with PPD stimulation. A responder frequency of 0.01% or higher for at least one of the measured cytokines/CD40L was defined as a positive response. Using this criterion to compare the two patient groups, PPD had 100% sensitivity but 0% specificity while ESAT-6 had 100% sensitivity and 88% specificity. Use of MTB-specific proteins such as ESAT-6 in combination with intracellular cytokine staining and flow cytometry has the potential to identify individuals with MTB infection.


Effect of Metal Cations on Colloids-Microcystin-LR Interaction.
Colloidal particles, mixture with continuous molecular weight distribution and multiple organic components, is widespread in lake and have significant impact on the retention, migration, transportation, and fate of contaminants in lake ecosystems. Here we extract sedimentary colloids from algal growth dominant area (AD) in Taihu Lake and further separated into four different particle size ranges by cross-flow ultra-filtration (CFUF). The interaction mechanism between colloids and Microcystin-LR (MC-LR) was investigated under different cation conditions by dialysis equilibrium experiment method. Adsorption kinetics research shows the adsorption of MC-LR by colloids follows second-order kinetics and can be simulated by Freundlich isotherms. The effects of different cations on colloids-MC-LR interaction shows the addition of Mg(II) decreased colloids-MC-LR interaction, while Cu(II) increased colloids-MC-LR binding. MC-LR also increased Cu(II) binding to colloids, while MC-LR decreased Mg(II) binding. Therefore, different effect of cations to colloids-MC-LR interaction was proposed.


VINCIA for hadron colliders.
We present the first public implementation of antenna-based QCD initial- and final-state showers. The shower kernels are [Formula: see text] antenna functions, which capture not only the collinear dynamics but also the leading soft (coherent) singularities of QCD matrix elements. We define the evolution measure to be inversely proportional to the leading poles, hence gluon emissions are evolved in a [Formula: see text] measure inversely proportional to the eikonal, while processes that only contain a single pole (e.g., [Formula: see text]) are evolved in virtuality. Non-ordered emissions are allowed, suppressed by an additional power of [Formula: see text]. Recoils and kinematics are governed by exact on-shell [Formula: see text] phase-space factorisations. This first implementation is limited to massless QCD partons and colourless resonances. Tree-level matrix-element corrections are included for QCD up to [Formula: see text] (4 jets), and for Drell-Yan and Higgs production up to [Formula: see text] (V / H + 3 jets). The resulting algorithm has been made publicly available in Vincia 2.0.


An evaluation of immediate-use steam sterilization practices in adult knee and hip arthroplasty procedures.
Immediate-use steam sterilization (IUSS) is a safe method to sterilize emergently contaminated instruments, but inappropriate use may lead to an increased risk for surgical site infection. This study aimed to identify risk factors, rationale, and variability in procedural adherence in cases of IUSS. This retrospective, case-control study compared adult patients undergoing hip and knee arthroplasty in which IUSS was (n = 104) and was not (n = 81) performed. Multivariate analysis revealed 4 predictive risk factors for IUSS: history of malignancy (odds ratio [OR], 3.2 [95% confidence interval (CI) 1.1-9.3]), obesity (OR, 2.3 [95% CI: 1.02-5.2]), procedure performed in operating room 13 (OR, 2.5 [95% CI: 1.2-5.4]), and Monday procedure (OR, 3.6 [95% CI: 1.4-9.1]). The only factor that protected against IUSS was performing the procedure in the morning (OR, 0.4 [95% CI: 0.2-0.96]). Only 9.5% of cases of IUSS involved an acceptable indication. Documented adherence to core practices was also variable. Several patient- and case-specific factors can help predict the incidence of IUSS. Furthermore, practices should be hardwired to ensure IUSS is utilized for the correct indication. Documentation must be improved to allow institutions to accurately track IUSS.


A regulatory system controlling the production of cytochrome aa3 in Neurospora crassa.
The mitochondria of the cyt-2-1, cya-3-16, cya-4-23 and 299-1 nuclear mutants and the [mi-3] and [exn-5] cytoplasmic mutants of Neurospora crassa are deficient in cytochrome aa3, while the cyb-1-1 and cyb-2-1 mutants have mitochondrial b-cytochrome deficiencies. However, the mitochondria from cyb-1-1 cyt-2-1, cyb-1-1 [mi-3] and cyb-2-1 [mi-3] double mutants contain 30% to 50% of the amount of cytochrome aa3 that is present in mitochondria from wild-type; i.e. cyb-1-1 and cyb-2-2 act as suppressors of the cytochrome aa3 deficiency phenotypes that are associated with cyt-2-1 and [mi-3] mutations. The production of cytochrome aa3 can be induced in cyt-2-1 and [mi-3] by growing cells in medium containing antimycin A, an inhibitor of electron transport in the cytochrome bc1 segment of the mitochondrial electrontransport chain. Moreover, the growth of the [mi-3] mutant is strongly stimulated by low concentrations of antimycin A. The induction of cytochrome aa3 by antimycin treatments does not occur in [exn-5], cya-4-23 and 299-1 cells; but does take place in cya-3-16 cells. Although some of the seven constituent polypeptides of cytochrome aa3 are present in mitochondria of [mi-3], the holoenzyme complex is not formed in the mutant. In contrast, the mitochondria of cyb-1-1 [mi-3] and cyb-2-2 [mi-3] double mutants contain a fully assembled cytochrome oxidase complex as well as some unassembled subunit polypeptides. The observations are indicative of the existence of at least two regulatory systems controlling the production of cytochrome aa3. One of the circuits appears to control the basal or "constitutive" production of cytochrome oxidase, the other seems to coordinate the level of cytochrome aa3 with some function of the mitochondrial cytochrome bc1 complex, possibly electron transport.


Glycomic work-flow for analysis of mucin O-linked oligosaccharides.
The high-throughput analysis of the glycosylation of high molecular weight proteins, such as mucins, has been the aim of glycomics initiatives for the last decade. Here, we present a work-flow for the efficient and reproducible analysis of reduced oligosaccharides from a typical mucin sample. This work-flow can be applied to any similar samples of oligosaccharides. We include recently developed bioinformatic procedures for the statistical analysis of sample sets. These procedures can be applied in any laboratory environment, using free programs that are platform independent. The scripts are explained and can be adjusted to suit the individual experiment. Finally, a number of example results are given to highlight the use of the statistical analysis in a biological context.


Determination of elastic moduli of thin layers of soft material using the atomic force microscope.
We address three problems that limit the use of the atomic force microscope when measuring elastic moduli of soft materials at microscopic scales. The first concerns the use of sharp cantilever tips, which typically induce local strains that far exceed the linear material regime. We show that this problem can be alleviated by using microspheres as probes, and we establish the criteria for their use. The second relates to the common use of the Hertz contact mechanics model, which leads to significant errors when applied to thin samples. We develop novel, simple to use corrections to apply for such cases. Samples that are either bonded or not bonded to a rigid substrate are considered. The third problem concerns the difficulty in establishing when contact occurs on a soft material. We obtain error estimates for the elastic modulus resulting from such uncertainty and discuss the sensitivity of the estimation methods to error in contact point. The theoretical and experimental results are compared to macroscopic measurements on poly(vinyl-alcohol) gels.


Evaluation of technician immunization administration.
To (1) assess technician and supervising pharmacists' attitudes and perceptions toward technicians administering immunizations after a technician training initiative, (2) describe the public health impact of technician-administered COVID-19 immunizations, and (3) describe best practices for technician-administered immunizations. A mixed-methods study collected quantitative and qualitative data. Kentucky technicians who completed an immunization administration training, and their supervising pharmacists. Surveys were administered to Kentucky technicians who completed immunization administration training between January and September 2021. Surveys assessed the effectiveness of the training, integration of technicians in the immunization workflow, and impact of technicians in their organization's immunization efforts. Similar surveys were deployed to supervising pharmacists. Response frequencies were recorded for each question and descriptive statistics were calculated for each item included in the survey. Key informant interviews were conducted with technicians and pharmacists to further explore study concepts, assess needs, and discuss best practices for implementation. Interviews were audio recorded, transcribed verbatim, and analyzed using inductive thematic analysis. Fifty-seven technicians and 37 pharmacists responded to the survey. Technicians were easily integrated into community pharmacy immunization workflow that allowed for increased immunization administration. Ninety-four percent of supervising pharmacists and 98% of technicians supported the use of technicians in the immunization workflow beyond the pandemic. Twenty-seven interviews were conducted. Major themes that emerged from the data included using the "right" technicians, role delineation and collaboration, policies, logistics, financial implications, and public health impact. The utilization of pharmacy technicians in administration helped to accelerate the immunization process, alleviate the burden on pharmacists and other health care professionals, and ensure widespread vaccine distribution to combat the pandemic.


Cycloserine enantiomers inhibit PLP-dependent cysteine desulfurase SufS via distinct mechanisms.
The cysteine desulfurase SufS is a pyridoxal-5'-phosphate-dependent enzyme and is essential for the SUF system, which participates in iron-sulfur cluster biosynthesis. Inhibition of SufS in the SUF system by D-cycloserine (DCS) in Plasmodium falciparum apicoplast has recently been reported, indicating that SufS could be a target for malaria therapeutics. However, the mechanistic details underlying the inhibition of SufS by DCS have not yet been clarified. Moreover, inhibition of SufS by the other enantiomer, L-cycloserine (LCS), has not been investigated. Herein, we investigated the structure-based inhibition mechanisms of SufS by DCS and LCS using Bacillus subtilis SufS, whose catalytic mechanism has been well characterized in comparison to that of the P. falciparum SufS. Surprisingly, DCS- and LCS-mediated inhibitions of SufS occur via distinct mechanisms resulting in pyridoxamine-5'-phosphate (PMP) in DCS-mediated inhibition and PMP-3-hydroxyisoxazole adduct (PMP-isoxazole) in LCS-mediated inhibition. Biochemical and structural evaluation of SufS variants identified conserved His and Arg residues at the active site as the key determinants of the distinct inhibition mechanisms. The importance of structural elements involved in DCS and LCS-mediated inhibitions of SufS provides valuable insights for the structure-based design of new drugs targeting SufS. DATABASE: Structural data are available in PDB database under the accession numbers 6KFY, 7CEO, 7CEP, 7CEQ, 7CER, 7CES, 7CET, 7CEU, 7E6A, 7E6B, 7E6C, 7E6D, 7E6E, and 7E6F.


Muscle blood flow changes during sleep as a function of fibre type composition.
In rabbits blood flow was measured in 19 muscles with the radioactive microsphere technique. Fibre type composition (SO, slow-twitch oxidative; FOG, fast-twitch oxidative-glycolytic; FG, fast-twitch glycolytic) was determined histochemically for the same muscles. While no significant changes occur in the transition from quiet wakefulness (QW) to synchronized sleep (SS), in desynchronized sleep (DS) blood flow decreases in SO and increases in FOG and FG fibres. These changes may be related to the changes in motor activity characteristic of DS: muscle atonia and twitches, respectively.


The effect of leukemia inhibitory factor and coculture on the in vitro maturation and ultrastructure of vitrified and nonvitrified isolated mouse preantral follicles.
To develop a system for in vitro maturation of preantral follicles isolated from vitrified and nonvitrified mouse ovaries by leukemia inhibitory factor (LIF) and coculture with cumulus cells. Experimental study. University-based research laboratory. Twelve- to 14-day-old National Medical Research Institute female mice. Vitrification of mouse ovaries and in vitro maturation of follicles. The growth, maturation, steroidogenesis, alkaline phosphatase activity, and ultrastructure of preantral follicles derived from vitrified and nonvitrified mouse ovaries and the developmental capacity of embryos obtained from metaphase II to blastocyst stage. The follicular diameters were increased in the presence of LIF in the simple culture, coculture, and vitrified coculture groups. The survival and developmental rates of follicles were not significantly different between groups. The E(2) production was increased in all groups during the culture period. Alkaline phosphatase activity was observed in the follicles of cryosectioned slices and cultured preantral follicles. There was no remarkable change in ultrastructural maturation features of cultured follicles. LIF alone or in combination with the coculture system increased the growth of cultured preantral follicles but had no effect on their maturation; the ultrastructure, growth, and maturation of vitrified follicles were the same in the cultured groups and in the controls.


Measurement of cardiac time intervals by Doppler tissue M-mode imaging of the anterior mitral leaflet.
We sought to evaluate a new method of measuring cardiac time intervals from Doppler tissue imaging (DTI) of the anterior leaflet of the mitral valve. For a reliable analysis of the regional cardiac performance by DTI, a reference of time intervals of global cardiac events in the same cardiac cycle and based on the same imaging modality is required to reduce measurement error. We conducted a comparison of the measurements of isovolumic contraction and relaxation time and left ventricular (LV) ejection time by DTI M-mode analysis of the anterior mitral leaflet and the traditional approach based on spectral Doppler recordings. The measurements were done in 20 control subjects and 40 patients with cardiac diseases known to affect cardiac time intervals: heart failure, aortic stenosis, and essential hypertension with LV hypertrophy. Mean difference in milliseconds (95% limits of agreement) of measurements were not different overall (-0.20 [-10.58; 10.18], -1.95 [-16.66; 12.76], 1.48 [-8.34; 11.34], and 0 [-0.06; 0.07] for isovolumic contraction time, LV ejection time, isovolumic relaxation time, and calculated index of myocardial performance, respectively). Intraobserver variability was low. Analysis of patients with different categories of cardiac diseases confirmed the expected values for time intervals and index of myocardial performance. Measurement of isovolumic periods and LV ejection time was feasible and reliable by DTI M-mode analysis of the anterior mitral valve leaflet. The DTI method can, therefore, be used for obtaining information of global events in the cardiac cycle from the same heart beat as used for analysis of regional cardiac performance.


d-Serine Mediates Cellular Proliferation for Kidney Remodeling.
d-serine, a long-term undetected enantiomer of serine, is a biomarker that reflects kidney function and disease activity. The physiologic functions of d-serine are unclear. The dynamics of d-serine were assessed by measuring d-serine in human samples of living kidney donors using two-dimensional high-performance liquid chromatography, and by autoradiographic studies in mice. The effects of d-serine on the kidney were examined by gene expression profiling and metabolic studies using unilateral nephrectomy mice, and genetically modified cells. Unilateral nephrectomy in human living kidney donors decreases urinary excretion and thus increases the blood level of d-serine. d-serine is quickly and dominantly distributed to the kidney on injection in mice, suggesting the kidney is a main target organ. Treatment of d-serine at a low dose promotes the enlargement of remnant kidney in mouse model. Mechanistically, d-serine activates the cell cycle for tissue remodeling through an mTOR-related pathway. d-serine is a physiologic molecule that promotes kidney remodeling. Besides its function as a biomarker, d-serine has a physiologic activity that influences kidney function.


Systemic regulation of angiogenesis and matrix degradation in bone regeneration--distraction osteogenesis compared to rigid fracture healing.
Aim of this study was the investigation of systemic biochemical regulation mechanisms of bone regeneration by angiogenic and matrix-degrading enzymes during distraction osteogenesis compared to rigid osteotomy bone healing. Serum samples of 10 otherwise healthy patients with callus distraction for lower limb-lengthening and 10 osteotomy patients undergoing elective axis correction have been collected prospectively in a standardized time schedule before and up to 6 months after the procedure. At the end of the individual investigation period, concentrations of metalloproteinases (MMP-9, -13), tissue inhibitors of metalloproteinases (TIMP-1, TIMP-2) and the angiogenic factors angiogenin and VEGF have been detected by use of commercially available enzyme immunoassays. Results have been compared to our preliminary study on proMMP-1-3. In distraction osteogenesis, significantly elevated serum concentrations compared to baseline could be detected postoperatively for proMMP-1, MMP-9, TIMP-1, angiogenin and VEGF but not for proMMP-2, proMMP-3 or TIMP-2. In patients with rigid osteotomy healing, MMP-9, TIMP-1, TIMP-2, angiogenin and VEGF were significantly increased respectively. Comparison of both patient collectives revealed significantly higher increases of serum proMMP-1, VEGF and TIMP-1 in distraction patients during the lengthening period and significantly higher serum concentrations of TIMP-2 in late fracture healing period in osteotomy patients. Serum levels of MMP-13 were below the lowest standards, and therefore quantitative analysis was not possible. Bone regeneration in distraction osteogenesis and rigid osteotomy healing is accompanied by systemic increase of matrix-degrading and angiogenic factors in a certain time course and quantity. This might reflect biochemical regulation of local bone healing in the circulation. ProMMP-1, VEGF and TIMP-1 seem to be key regulatory factors during distraction osteogenesis.


Age dependence of O6-methylguanine-DNA methyltransferase activity and its depletion after carcinogen treatment in the teleost medaka (Oryzias latipes).
O6-Methylguanine-DNA methyltransferase (O6-MT) is considered to play an important role in the repair of DNA lesions induced by alkylating carcinogens in a wide range of animals. The activity of O6-MT was compared in liver extracts from the teleost medaka (Oryzias latipes) at various ages (3-5 years old) reared under natural conditions. O6-MT activity decreased significantly with advancing age. When medaka were exposed continuously to the alkylating agent methylazoxymethanol (MAM) acetate at levels of 0.1, 0.15 and 0.3 ppm in water, O6-MT activity was markedly reduced from days 1 to 7, with a slight increase thereafter. Furthermore, when fish were exposed to MAM acetate at levels of 1-2 ppm for 1 h and then maintained in normal tap water, O6-MT activity remained suppressed for 2 weeks, followed by a partial recovery.


The nodule conductance to O₂ diffusion increases with phytase activity in N₂-fixing Phaseolus vulgaris L.
To understand the relationship between phosphorus use efficiency (PUE) and respiration for symbiotic nitrogen fixation (SNF) in legume nodules, six recombinant inbred lines of common bean (RIL Phaseolus vulgaris L.), contrasting in PUE for SNF, were inoculated with Rhizobium tropici CIAT899, and grown under hydroaeroponic culture with sufficient versus deficient P supply (250 versus 75 μmol P plant(-1) week(-1)). At the flowering stage, the biomass of plants and phytase activity in nodules were analyzed after measuring O2 uptake by nodulated roots. Our results show that the P-deficiency significantly increased the phytase activity in nodules of all RILs though with highest extent for RILs 147, 29 and 83 (ca 45%). This increase in phytase activity was associated with an increase in nodule respiration (ca 22%) and in use of the rhizobial symbiosis (ca 21%). A significant correlation was found under P-deficiency between nodule O2 permeability and phytase activity in nodules for RILs 104, 34 and 115. This observation is to our knowledge the first description of a correlation between O2 permeability and phytase activity of a legume nodule. It is concluded that the variation of phytase activity in nodules can increase the internal utilization of P and might be involved in the regulation of nodule permeability for the respiration linked with SNF and the adaptation to P-deficiency.


Comparing the strength of behavioural plasticity and consistency across situations: animal personalities in the hermit crab Pagurus bernhardus.
Many phenotypic traits show plasticity but behaviour is often considered the 'most plastic' aspect of phenotype as it is likely to show the quickest response to temporal changes in conditions or 'situation'. However, it has also been noted that constraints on sensory acuity, cognitive structure and physiological capacities place limits on behavioural plasticity. Such limits to plasticity may generate consistent differences in behaviour between individuals from the same population. It has recently been suggested that these consistent differences in individual behaviour may be adaptive and the term 'animal personalities' has been used to describe them. In many cases, however, a degree of both behavioural plasticity and relative consistency is probable. To understand the possible functions of animal personalities, it is necessary to determine the relative strength of each tendency and this may be achieved by comparison of statistical effect sizes for tests of difference and concordance. Here, we describe a new statistical framework for making such comparisons and investigate cross-situational plasticity and consistency in the duration of startle responses in the European hermit crab Pagurus bernhardus, in the field and the laboratory. The effect sizes of tests for behavioural consistency were greater than for tests of behavioural plasticity, indicating for the first time the presence of animal personalities in a crustacean model.


Freshwater trophic status mediates microbial community assembly and interdomain network complexity.
Freshwater microorganisms and their interactions are important drivers of nutrient cycling that are in turn affected by nutrient status, causing shifts in microbial community diversity, composition, and interactions. However, the impact of water trophic status on bacterial-archaeal interdomain interactions remains poorly understood. This study focused on the impact of trophic status, as characterized by trophic state index (TSI), on the interdomain interactions of freshwater microbial communities from 45 ponds in Hangzhou. Our results showed that the mesotrophic wetland bordering on lightly eutrophic (Hemu: TSI of 49; lightly eutrophic is defined as 50 ≤ TSI <60) harbored a much more complex bacterial-archaeal interdomain network, which showed significantly (P < 0.05) higher connectivity than the wetlands with lower (TSI of 38) or higher (TSI of 57) trophic levels. Notably, light eutrophication strengthened the network modules' negative associations with organic carbon through some network hubs, which could trigger carbon loss in wetlands. We also detected a non-linear response of interdomain network complexity to the increasing of nutrients with a turning point of approximately TSI 50. Quantitative estimates of community assembly processes and structural equation modelling analysis indicated that chlorophyll-a, total nitrogen, and total phosphorus could regulate interdomain network complexity (50% of the variation explanation rate) by driving microbial community assembly. This study demonstrates that microbial interdomain network complexity could be used as a bioindicator for ecological changes, which would helpful for improving ecological assessment of the freshwater eutrophication.


Reference values for the right and left fetal choroid plexus at 11 to 13 weeks: an early sign of "developmental" laterality?
The purpose of this study was to establish reference values for the length, area, and circumference of the right and left fetal choroid plexus at 11 to 13 weeks with respect to the fetal biparietal diameter and to compare the right to the left side. We conducted a prospective study on 114 fetuses at 11 to 13 weeks undergoing first-trimester screening for aneuploidy and structural fetal abnormalities. After the establishment of the fetal situs, the plane of the "butterfly" was obtained on all fetuses, from which the length, area, and circumference of both the right and left choroid plexus were obtained and the right and left sides compared. Using a paired t test, analysis of variance, scatterplots, and linear and logarithmic fittings, reference ranges and charts for the length, area, and circumference of the choroid plexus were then formulated according to their relationship to the fetal biparietal diameter. P < .05 was considered statistically significant. Reference values for the length, area, and circumference of the fetal choroid plexus, with respect to the fetal biparietal diameter, were established. There was a statistically significant difference between the right and left sides for all parameters, with all measurements statistically greater on the left side (P < .0001). Reference values for the length, area, and circumference of the fetal choroid plexus at 11 to 13 weeks are presented. These may prove to be of clinical importance in the early screening for central nervous system abnormalities. In addition, the statistically significant difference between the right and left sides may be an early sign of "developmental" laterality.


PVDF/PLA electrospun fiber membrane impregnated with metal nanoparticles for emulsion separation, surface antimicrobial, and antifouling activities.
Although many superwetting materials have been designed for the treatment of oil-containing wastewater, separation strategies for oil-in-water systems containing bacteria have rarely been reported. Herein, poly(vinylidene difluoride)- and poly(lactic acid)-blended fibrous membranes loaded with silver and copper oxide nanoparticles were successfully prepared by a two-step method of electrostatic spinning and liquid-phase synthesis. The product membrane showed excellent super-oleophilic properties in air and hydrophobicity under oil. It could separate water-in-oil emulsion systems containing surfactants with an efficiency above 90%. More importantly, the nanoparticle-loaded fibers were characterized by material degradability and slowly released ions. The fibers exhibited excellent antibacterial activities against both gram-positive and -negative bacteria. This work provides a feasible strategy for water-in-oil emulsion separation and bacterial treatment of wastewater.


Ionization constants of catechols and catecholamines.
Catecholamines can appear in different charged states: as positive, negative and zwitterion and as zero-charged molecule. The microscopic ionization constants of ten catecholamines were determined spectrophotometrically. For each charged state the fraction of total catecholamine at pH = 7.85 was calculated from the microscopic ionization constants. Some attention is given to the interpretation of the differences between the fractions of corresponding charged states.


Association of peripheral neutrophilia with adverse angiographic outcomes in ST-elevation myocardial infarction.
We hypothesized that absolute and relative neutrophilia would be associated with adverse angiographic outcomes in the 394 patient Limitation of Myocardial Infarction Following Thrombolysis in Acute Myocardial Infarction (LIMIT) Acute Myocardial Infarction (AMI) trial of fibrinolysis in ST-elevation myocardial infarction. The mean neutrophil count was 7.9 x 10(9)/L, with a mean neutrophil percentage of 72%. Patients with time from symptom onset to fibrinolytic treatment more than the median (2.7 hours) had a higher neutrophil count and percentage of neutrophils than patients with shorter time to treatment. Patients with a closed infarct-related artery at 90 minutes (Thrombolysis In Myocardial Infarction [TIMI] grade 0/1 flow) had higher neutrophil counts (8.8 +/- 3.8 vs 7.6 +/- 3.0, p = 0.02) but no difference in the percentage of neutrophils than patients with an open artery. Higher neutrophil counts were also mildly correlated with longer corrected TIMI frame counts (CTFC) in the infarct-related artery (r = 0.14, p = 0.02). Patients with impaired myocardial perfusion by TIMI myocardial perfusion grade (TMPG) had a greater percentage of neutrophils (73.2 +/- 10.7% for TMPG 0/1 vs 69.9 +/- 12.6% for TMPG 2/3, p = 0.047) but no detectable difference in neutrophil counts (8.2 +/- 3.3 vs 7.7 +/- 2.9, p = 0.24). There were no significant associations between other indexes in the cell differential and angiographic or clinical outcomes. Higher neutrophil counts remained independently associated with both closed arteries and CTFC in multivariable models controlling for age, left anterior descending artery infarct location, time to treatment, and pulse and blood pressure on admission. A greater percentage of neutrophils remained independently associated with impaired microvascular perfusion in a similar multivariable model. In patients with ST-elevation myocardial infarction, absolute and relative neutrophilia were associated with impaired epicardial and microvascular perfusion.


Protection of the endothelial glycocalyx by antithrombin in an endotoxin-induced rat model of sepsis.
Injury and loss of the endothelial glycocalyx occur during the early phase of sepsis. We previously showed that antithrombin has a protective effect on this structure in vitro. Here, we investigated the possible protective effects of antithrombin in an animal model of sepsis. Wistar rats were injected with endotoxin, and circulating levels of syndecan-1, hyaluronan, albumin, lactate and other biomarkers were measured in an antithrombin-treated group and an untreated control group (n = 6 in each group). Intravital microscopy was used to observe leukocyte adhesion, microcirculation, and syndecan-1 staining. The circulating levels of syndecan-1 and hyaluronan were significantly reduced in the antithrombin-treated group, compared with the untreated controls. Lactate levels and albumin reduction were significantly attenuated in the antithrombin-treated group. Intravital microscopic observation revealed that both leukocyte adhesion and blood flow were better maintained in the treatment group. The syndecan-1 lining was disrupted after endotoxin treatment, and this derangement was attenuated by treatment with antithrombin. Antithrombin effectively maintained microcirculation and vascular integrity by protecting the glycocalyx in a rat sepsis model.


Nutritional and bioactive constituents and scavenging capacity of radicals in Amaranthus hypochondriacus.
A. hypochondriacus leaves contained ample phytopigments including betalain, anthocyanin, β-xanthin, β-cyanin, and bioactive phytochemicals of interest in the industry of food. We have been evaluating the possibility of utilizing phytopigments of amaranth and bioactive constituents for making drinks. Therefore, we evaluated bioactive phytopigments and compounds including the potentiality of antioxidants in A. hypochondriacus leaves. A. hypochondriacus leaves have abundant protein, carbohydrates, and dietary fiber. We found considerable levels of inorganic minerals including magnesium, calcium, potassium (3.88, 3.01, 8.56 mg g-1), zinc, manganese, copper, iron (16.23, 15.51, 2.26, 20.57 µg g-1), chlorophyll b, chlorophyll ab chlorophyll a (271.08, 905.21, 636.87 μg g-1), scavenging capacity of radicals (DPPH, ABTS+) (33.46, 62.92 TEAC μg g-1 DW), total polyphenols (29.34 GAE μg g-1 FW), β-xanthin, betalain, β-cyanin (584.71, 1,121.93, 537.21 ng g-1), total flavonoids (170.97 RE μg g-1 DW), vitamin C, β-carotene, carotenoids (184.77, 82.34, 105.08 mg 100 g-1) in A. hypochondriacus leaves. The genotypes AHC6, AHC4, AHC11, AHC5, and AHC10 had a good scavenging capacity of radicals. Polyphenols, phytopigments, flavonoids, and β-carotene of A. hypochondriacus had potential antioxidant activity. Extracted juice of A. hypochondriacus can be an ample source of phytopigments and compounds for detoxification of reactive oxygen species (ROS) and attaining nutritional and antioxidant sufficiency.


Hybrid PCL/chitosan-PEO nanofibrous scaffolds incorporated with A. euchroma extract for skin tissue engineering application.
Skin tissue engineering is an advanced method to repair and regenerate skin injuries. Recent research is focused on the development of scaffolds that are safe, bioactive, and cytocompatible. In this work, a new hybrid nanofibrous scaffold composed of polycaprolactone/chitosan-polyethylene oxide (PCL/Cs-PEO) incorporated with Arnebia euchroma (A. euchroma) extract were synthesized by the two-nozzle electrospinning method. Then the synthesized scaffold was characterized for morphology, sustainability, chemical structure and properties. Moreover, to verify their potential in the burn wound healing process, biodegradation rate, contact angle, swelling properties, water vapor permeability, mechanical properties, antibacterial activity and drug release profile were measured. Furthermore, cytotoxicity and biocompatibility tests were performed on human dermal fibroblasts cell line via XTT and LDH assay. It is shown that the scaffold improved and increased proliferation during in-vitro studies. Thus, results confirm the efficacy and potential of the hybrid nanofibrous scaffold for skin tissue engineering.


Pulmonary Mycobacterium bovis infection in a dog.
To describe the clinical course of a dog infected with Mycobacterium bovis causing a granulomatous pneumonia. The dog initially presented with a persistent cough, inappetence and weight loss. Clinical findings included a fever, dyspnoea and tachypnoea, with haematological evidence of a mild neutrophilia and hypoalbuminaemia. Radiographs of the chest demonstrated a concomitant pneumothorax, pleural effusion, and a consolidated area within the left caudal lung lobe. An exploratory thoracotomy revealed this to be a ruptured granulomatous lesion. Subsequent histopathological, microbiological and genetic studies identified M. bovis as the causal agent. Mycobacterium bovis infections should be included in the differential diagnosis of pulmonary disease and pleural effusions in dogs living in regions of New Zealand known to have a high incidence of mycobacterial infection in wildlife and farm animals.


Paediatric CT made easy.
Paediatric computed tomography (CT) imaging has always been associated with challenges. Although the technical background of CT imaging is complex, it is worth considering the baseline aspects of radiation exposure to prevent unwanted excess radiation in paediatric patients. In this review, we discuss the most relevant factors influencing radiation exposure, and provide a simplified and practical approach to optimise paediatric CT.


MET exon 14 skipping mutation, amplification and overexpression in pulmonary sarcomatoid carcinoma: A multi-center study.
High frequency of MNNG HOS transforming (MET) exon 14 skipping mutation (MET exon 14Δ) has been reported in pulmonary sarcomatoid carcinomas (PSCs). However, the frequencies differ greatly. Our study aims to investigate the frequency of MET alterations and the correlations among MET exon 14Δ, amplification, and protein overexpression in a large cohort of PSCs. MET exon 14Δ, amplification, and protein overexpression were detected in 124 surgically resected PSCs by using Sanger sequencing, fluorescent in situ hybridization (FISH), and immunohistochemistry (IHC) respectively. MET exon 14Δ was identified in 9 (7.3%) of 124 cases, including 6 pleomorphic carcinomas, 2 spindle cell carcinomas and 1 carcinosarcoma. MET amplification and protein overexpression were detected in 6 PSCs (4.8%) and 25 PSCs (20.2%), respectively. MET amplification was significantly associated with overexpression (P < 0.001). However, MET exon 14Δ has no correlation with MET amplification (P = 0.370) and overexpression (P = 0.080). Multivariable analysis demonstrated that pathologic stage (hazard ratio [HR], 2.78; 95% confidence interval [CI], 1.28-6.01; P = 0.010) and MET amplification (HR, 4.71; 95% CI, 1.31-16.98; P = 0.018) were independent prognostic factors for poor median overall survival (mOS). MET alterations including MET exon 14Δ and amplification should be recommended as routine clinical testing in PSCs patients who may benefit from MET inhibitors. MET IHC appears to be an efficient screen tool for MET amplification in PSCs.


Kinetic modeling of batch hydrogen production process by mixed anaerobic cultures.
The kinetics of batch anaerobic hydrogen production by mixed anaerobic cultures was systemically investigated in this study. Unstructured models were used to describe the substrate utilization, biomass growth and product formation in the hydrogen production process. The relationship between the substrate, biomass and products were also evaluated. Experimental results show that the Michaelis-Menten equation, Logistic model and modified Gompertz equation all could be adopted to respectively describe the kinetics of substrate utilization, biomass growth and product formation. Furthermore, the relationship between the acidogenic products and biomass was simulated by Luedeking-Piret model very well. The experimental results suggest that the formation of hydrogen and the main aqueous products, i.e., butyrate and acetate, was all growth-associated.


[Concomitant septic and gouty olecranon bursitis].
A case of coexistent acute gout and septic olecranon bursitis is presented. Our hypothesis is that asymptomatic monosodium urate crystals, possibly present in the bursa could secondarily been triggered by the infection.


Cervical involvement of diffuse idiopathic skeletal hyperostosis with dysphagia and rhinolalia.
Osteophytosis in degenerative joint diseases of the cervical spine may result in dysphagia. Recently, diffuse idiopathic skeletal hyperostosis (DISH) or Forestier's disease has also been identified as a cause of dysphagia. A case of DISH with cervical involvement producing dysphagia and rhinolalia is presented. The symptomatology, radiographic features and treatment of DISH involving the cervical region are discussed. The diagnosis of DISH is exclusively radiographic. Recognition of this disorder, unfamiliar to many clinicians, may avoid an unnecessary biopsy procedure of a suspected pharyngeal tumor. Once the diagnosis of DISH is made, a supplemental barium esophagram should be performed to exclude possible coexisting neoplasms. Endoscopy has a definite risk for inducing an inadvertent esophageal perforation and should be avoided, if at all possible. A conservative therapeutic approach is advocated by the authors.


Enhancing the resilience of Zostera noltei seagrass meadows against Arenicola spp. bio-invasion: A decision-making approach.
Seagrass meadows provide important and valuable ecosystem services. They are affected by several natural and human-induced stressors, but a combination of natural recovery and management actions have recently inverted the worldwide reduction. The main objectives of this study were to provide science-based knowledge on ecology and restoration, framed on environmental-related policies. By coupling the general guidelines with practical experience, obtained from sequential in situ experiments carried out for several months in a show-case study area, this study provides guidelines useful for restoration practitioners. A decision-making approach is proposed to answer the following questions: 1) What is the best Zostera noltei transplanting method? 2) What is the best technique to reduce the bioturbation activity of Arenicola spp.?, 3) Do bioturbation reduction techniques affect the survival rate of Z. noltei transplants?, and finally, 4) What are the key steps to maximize the success of a Z. noltei transplant and increase the species' resilience? Having a Portuguese coastal lagoon as show-case (Mira Channel, Ria de Aveiro), different transplant and restoration methodologies were tested (i.e. metal frames, nails, bamboo sticks, shoots inserted unanchored into the sediment, and intact units of sediment with seagrasses, named as SODs) to assure low environmental impact on donor meadows, high survival rate of transplanted shoots and the recovery of fragmented or lost meadows. Moreover, to potentially reverse a degraded Arenicola spp. colonized seagrass habitat, different types of natural membranes were tested. Results showed that the best transplanting method is the use of SODs as the self-facilitation process of Z. noltei is enhanced, while being the least invasive for the donor population. The use of a natural membrane can significantly decrease the bioturbation stress caused by Arenicola spp., with jute membrane being the best option, given its cost-handling-benefit trade-offs. Enhancing the success of seagrass restoration requires the implementation of effective measures by environmental restoration practitioners. We defined a three-step process to improve the resilience of Z. noltei. This stepwise approach consists on 1) Characterization of the donor population, 2) Identification of the constraints and implementation of measures to prevent them, and 3) Scale-up the restoration plan. The application of this stepwise approach in intertidal coastal and estuarine systems management will, therefore, facilitate the success of Z. noltei restoration plans.


[Chronic partial uretheral obstruction by the ovarian vein. A case report and literature review].
We present a female patient with chronic loin pain caused by partial obstruction of the urether secondary to ovarian vein crossing. We highlight the benefit derived from surgical treatment.


Impact of Clostridium difficile infection caused by the NAP1/RT027 strain on severity and recurrence during an outbreak and transition to endemicity in a Mexican tertiary care center.
To describe the clinical characteristics, outcomes, and factors associated with Clostridium difficile infection (CDI) due to ribotype 027 (RT027) and recurrence, including an outbreak period, with transition to endemicity. A case-control study was performed. Clinical and demographic data were collected for patients with CDI during the period January 2008 to December 2015. Ribotyping of the isolates and PCR for toxin A, B, and binary were performed. Among 324 episodes of CDI, 27.7% were caused by RT027. Previous fluoroquinolone use (odds ratio (OR) 1.79, 95% confidence interval (CI) 1.01-3.17), previous gastrointestinal endoscopy (OR 2.17, 95% CI 1.29-3.65), chemotherapy (OR 0.43, 95% CI 0.19-0.95), and total enteral nutrition (OR 0.42, 95% CI 0.18-0.97) were associated with RT027. Age >65 years (OR 2.05, 95% CI 1.02-4.10), severe initial episode (OR 3.35, 95% CI 1.60-6.15), previous proton pump inhibitor use (OR 2.34, 95% CI 1.15-4.74), and continued fluoroquinolones (OR 3.08, 95% CI 1.11-8.51) were associated with recurrence. Among the non-RT027, 59.8% were not assigned by the ribotyping database and 50.7% presented binary toxin. In this population, CDI due to the RT027 strain was not associated with poorer outcomes. This study reinforces the importance of avoiding fluoroquinolones and PPIs to prevent recurrences. The presence of virulence factors among non-RT027 C. difficile strains underscores the importance of performing molecular epidemiology surveillance.


Trans-Golgi Network (TGN) as a regulatory node for β1-adrenergic receptor (β1AR) down-modulation and recycling.
Receptor down-modulation is the key mechanism by which G protein-coupled receptors (GPCRs) prevent excessive receptor signaling in response to agonist stimulation. Recently, the trans-Golgi network (TGN) has been implicated as a key checkpoint for receptor endocytosis and degradation. Here, we investigated the involvement of the TGN in down-modulation of β1-adrenergic receptor in response to persistent isoprotenerol stimulation. Immunofluorescent staining showed that ~50% of endocytosed β1AR colocalized with TGN-46 at 5 h. Disruption of the TGN by brefeldin A (BFA) led to the robust accumulation of endocytosed β1AR in Rab11(+) recycling endosomes, inhibited β1AR entry into LAMP1(+) lysosomes, and as a result enhanced β1AR recycling to the plasma membrane. The lysosomotropic agent, chloroquine, arrested the majority of endocytosed β1AR in the TGN by 4 h. Immunoblot analysis showed that either disruption of the TGN or blockage of the lysosome prevented β1AR degradation. Co-expression of GFP-arrestin-3 in β1AR cells increased the endocytosis of β1AR and facilitated its entry to the TGN but inhibited recycling to the plasma membrane. Arrestin-3-induced inhibition of β1AR recycling was reversed by BFA treatment, whereas chloroquine induced the accumulation of arrestin-3 with β1AR in the TGN. These results demonstrate for the first time that the TGN acts as a checkpoint for both the recycling and down-regulation of β1AR and that arrestin-3 not only mediates β1AR endocytosis but also its recycling through the TGN.


Simultaneous determination of calycosin-7-O-beta-D-glucoside, ononin, astragaloside IV, astragaloside I and ferulic acid in rat plasma after oral administration of Danggui Buxue Tang extract for their pharmacokinetic studies by liquid chromatography-mass spectrometry.
A sensitive and reliable high-performance liquid chromatography-mass spectrometry (HPLC-MS) was developed and validated for simultaneous quantification of five main bioactive components, i.e., calycosin-7-O-beta-D-glucoside, ononin, astragaloside IV, astragaloside I and ferulic acid in rat plasma after oral administration of Danggui Buxue Tang (DBT) extract. Plasma samples were extracted with solid-phase extraction (SPE) separated on an Inertsil ZORBAX C(18) column and detected by MS with electrospray ionization (ESI) interface in negative selective ion monitoring (SIM) mode. Calibration curves offered linear ranges of two orders of magnitude with r(2)>0.99. The method had the lower limit quantification of 0.55, 0.46, 1.07, 1.12 and 4.6 ng/mL for calycosin-7-O-beta-D-glucoside, ononin, astragaloside IV, astragaloside I and ferulic acid, respectively, with precision less than 10%. The RSD of intra- and inter-day variations ranged from 2.10% to 6.19% and 2.37% to 6.72%. This developed method was subsequently applied to pharmacokinetic studies of the five compounds in rats successfully.


Autonomic cardiovascular control and diastolic dysfunction in hypertensive subjects.
Early hypertension is associated with left ventricular diastolic dysfunction due to increased end-diastolic pressure. This increase, through the cardiopulmonary reflexes, can influence autonomic cardiovascular control. We assessed autonomic nervous system modulation of cardiovascular signals by power spectral analysis of RR interval and systolic arterial pressure variabilities in subjects with recently diagnosed hypertension with or without diastolic dysfunction and in normotensive control subjects. Both hypertensive groups had higher low-frequency (LF) power expressed in normalized units (NUs) than normotensive controls (p < 0.05; p < 0.001) during controlled breathing at rest. The LF spectral index measured after tilt was greater in hypertensive subjects with diastolic dysfunction than in those without (p < 0.05). LF NUs measured at rest correlated significantly with the E/A wave ratio and after tilt with the E-wave deceleration time. These results seem to indicate that in subjects with recently diagnosed hypertension sympathetic modulation of the sinus node prevails. During tilt, a maneuver designed to stimulate systemic arterial and cardiopulmonary baroreceptor reflexes, hypertensive subjects with diastolic dysfunction, who presumably also have higher end-diastolic pressures, seem to have greater sympathetic modulation of the sinus node than hypertensive subjects without diastolic dysfunction.


Screening of a highly soluble and oxygen-independent blue fluorescent protein from metagenome.
GFP and its derivatives are commonly used as non-invasive in vivo reporters. These fluorescent proteins have been employed to analyze expression level, localization and movement of proteins, as well as protein interaction. However, they cannot be utilized under anaerobic conditions due to the oxygen requirement for the maturation of the fluorophore. Thus, other proteins with a different mechanism of fluorescence emission are needed. We reported here a blue fluorescent protein, named mBFP, that was derived from metagenomic DNA. This protein consisting of 248 amino acids was overexpressed (>35% of the total protein) in a soluble form in Escherichia coli. mBFP showed a distinct fluorescence pattern that was NADPH-dependent and could be used to image live cells under anaerobic conditions. Thus, mBFP holds great promise for use as a reporter in a broad range of applications.


High prevalence of SARS-CoV-2 antibodies in pregnant women after the second wave of infections in the inner-city of Johannesburg, Gauteng Province, South Africa.
After South Africa's second wave of COVID-19, this study estimated the SARS-CoV-2 seroprevalence among pregnant women in inner-city Johannesburg, South Africa. In this cross-sectional survey, 500 pregnant women who were non-COVID-19-vaccinated (aged ≥12 years) were enrolled, and demographic and clinical data were collected. Serum samples were tested using the Wantai SARS-CoV-2 spike antibody enzyme-linked immunosorbent assay and Roche Elecsys® anti-SARS-CoV-2 nucleocapsid antibody assays. Seropositivity was defined as SARS-CoV-2 antibodies on either (primary) or both (secondary) assays. Univariate Poisson regression assessed risk factors associated with seropositivity. The median age was 27.4 years, and HIV prevalence was 26.7%. SARS-CoV-2 seroprevalence was 64.0% (95% confidence interval [CI]: 59.6-68.2%) on the primary and 54% (95% CI: 49.5-58.4%) on the secondary measure. Most (96.6%) women who were SARS-CoV-2-seropositive reported no symptoms. On the Roche assay, we detected lower seroprevalence among women living with HIV than women without HIV (48.9% vs 61.7%, P-value = 0.018), and especially low levels among women living with HIV with a clusters of differentiation 4 <350 cells/ml compared with women without immune suppression (22.2% vs 56.4%, prevalence rate ratio = 0.4; 95% CI: 0.2-0.9; P-value = 0.046). Pregnant women attending routine antenatal care had a high SARS-CoV-2 seroprevalence after the second wave in South Africa, and most had asymptomatic infections. Seroprevalence surveys in pregnant women present a feasible method of monitoring the course of the pandemic over time.


Fecal coliform-related bacterial and coliphage populations in five lakes of southeastern Spain.
Aerobic heterotrophic bacteria, fecal and total coliforms, fecal streptococci and coliphages were isolated from five protected lakes in the Antequera area of Spain over the time from January to March (1994-96). The water samples contained large number of heterotrophic bacteria (mean counts 0.2 to 5.0 x 10(7) cfu per 100 ml). Most of the lakes contained fecal streptococci and a relationship between streptococci and salinity of the water samples was established. Coliphages were isolated from lakes containing fecal coliform and these bacteria were taxonomically identified as E. coli. Coliform bacilli do not seem to be an adequate indicator of fecal pollution for these ephemeral small lakes.


Expression and glucocorticoid-regulation of "Bam", a novel BH3-only transcript in acute lymphoblastic leukemia.
Apoptosis is a morphologically defined form of cell death that plays a major role in cell physiology, pathology and cancer therapy. The Bcl-2 family of pro- and anti-apoptotic molecules is a key regulator of this phenomenon, with the sub-family of BH3-only molecules serving as activators and/or facilitators. Apoptosis induced by glucocorticoids (GC) is a central component in the therapy of acute lymphoblastic leukemia (ALL), and defining its molecular basis and that of GC resistance is crucial for therapeutic improvements. We recently identified a novel transcript from the BCL2L11/Bim locus, termed "Bam", by affymetrix based whole genome expression profiling performed on 27 children (13 were already published) with ALL and many additional biological systems. Most children that induced Bam also induced Bim as well, in some cases Bam induction was more pronounced than that of Bim and in one patient only the Bam, but not Bim was induced. In C7H2, PreB697, Jurkat-GR(wt) and GC-sensitive (S-lines), this transcript was induced by GC in a translation-independent manner, suggesting that direct transcriptional induction of this BH3-only molecule by GC might cause apoptosis in at least ALL children and other biological systems.


Metabolic and lipidomic investigation of the antiproliferative effects of coronatine against human melanoma cells.
Melanoma is the most aggressive form of skin cancer, with metastatic melanoma being refractory to currently available conventional therapies. In this study, we evaluated the inhibitory effect of coronatine (COR) on the proliferation of metastatic melanoma cells. COR inhibited the proliferation of melanoma cells but negligibly affected the proliferation of normal melanocytes. Comparative metabolic and lipidomic profiling using gas chromatography-mass spectrometry and direct infusion-mass spectrometry was performed to investigate COR-induced metabolic changes. These analyses identified 33 metabolites and 82 lipids. Of these, the levels of lactic acid and glutamic acid, which are involved in energy metabolism, significantly decreased in COR-treated melanoma cells. Lipidomic profiling indicated that ceramide levels increased in COR-treated melanoma cells, suggesting that ceramides could function as a suppressor of cancer cell proliferation. In contrast, the levels of phosphatidylinositol (PI) species, including PI 16:0/18:0, 16:0/18:1, 18:0/18:0, and 18:0/18:1, which were found to be potential biomarkers of melanoma metastasis in our previous study, were lower in the COR-treated cells than in control cells. The findings of metabolomic and lipidomic profiling performed in the present study provide new insights on the anticancer mechanisms of COR and can be used to apply COR in cancer treatment.


Differential response of murine CD4+CD25+ and CD4+CD25- T cells to dexamethasone-induced cell death.
To evaluate the in vivo effect of immunosuppressive glucocorticoids on CD4+CD25+ T regulatory cells, we injected dexamethasone (Dex) into BALB/c mice. Administration of Dex enhanced the proportion of CD4+CD25+ cells and the ratio of CD4+CD25+ cells to CD4+CD25- cells in the lymphoid organs, especially in the thymus. This correlates with our in vitro observation that CD4+CD25+ T cells express higher levels of glucocorticoid receptor and Bcl-2, and are therefore more resistant to Dex-mediated cell death than CD4+CD25- T cells. Furthermore, IL-2 selectively protected CD4+CD25+ T cells from Dex-induced cell death, while IL-7 and IL-15 did not exert preferential protective effects. Dex-treated CD4+CD25+ T cells expressed higher levels of intracellular CTLA-4 and surface glucocorticoid-induced TNF receptor than fresh CD4+CD25+ T cells, but still failed to respond to TCR stimulation and inhibited proliferation of CD4+CD25- T cells. These results suggest that, in addition to suppressing cytokine transcription, Dex treatment is permissive for the survival of functional CD4+CD25+ T regulatory cells, and this property may contribute to the anti-inflammatory and immunosuppressive efficacy of glucocorticoids. Our data also suggest that selective protection of CD4+CD25+ T cell from apoptosis may constitute a role in immune tolerance for IL-2.


Partial defects of T-cell development associated with poor T-cell function.
For many years, severe combined immune deficiency diseases, which are characterized by virtual lack of circulating T cells and severe predisposition to infections since early in life, have been considered the prototypic forms of genetic defects of T-cell development. More recently, advances in genome sequencing have allowed identification of a growing number of gene defects that cause severe but incomplete defects in T-cell development, function, or both. Along with recurrent and severe infections, especially cutaneous viral infections, the clinical phenotype of these conditions is characterized by prominent immune dysregulation.


The role of dysfunctional HDL in atherosclerosis.
This review focuses on HDL function in modulating LDL oxidation and LDL-induced inflammation. Dysfunctional HDL has been identified in animal models and humans with chronic inflammatory diseases including atherosclerosis. The loss of antiinflammatory function correlated with a loss of function in reverse cholesterol transport. In animal models and perhaps in humans, dysfunctional HDL can be improved by apoA-I mimetic peptides that bind oxidized lipids with high affinity.


Bioinformatics analysis of ceRNA regulatory network of baicalin in alleviating pathological joint alterations in CIA rats.
Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation of synovium, leading to cartilage damage, bone erosion, even joint destruction and deformity. The conventional treatment modalities in RA are associated with side effects, emphasizing the need for alternative therapeutic remedies. Baicalin possesses multiple pharmacological effects and the advantage of low toxicity. This study aimed to reveal the potential gene regulatory mechanisms underlying the alleviating effects of baicalin in joint pathological alterations in Collagen-Induced Arthritis (CIA) rat models. At 28 days after the primary immunization, 60 mg/kg/d of baicalin was administered via intraperitoneal injection once daily for 40 days, and the pathological alterations of hind paw joints were examined with X-ray imaging. Subsequently, the synovial tissue of knee joints was isolated, from which total RNA was extracted, and mRNA and miRNA sequencing libraries were established. Finally, High-throughput transcriptome sequencing(RNA-seq) technology was performed, and the lncRNAs/miRNAs/mRNAs competing endogenous RNA(ceRNA) regulatory network was analyzed. The CIA model was successfully established, and baicalin treatment significantly alleviated the destruction of distal joints of CIA rat models (p < 0.01). We found that 3 potential ceRNA regulatory networks of baicalin were established, including lncRNA ENSRNOT00000076420/miR-144-3p/Fosb, lncRNA MSTRG.1448.13/miR-144-3p/Atp2b2 and lncRNA MSTRG.1448.13/miR-144-3p/Shanks. The validation results from synovial tissue of CIA rats were consistent with the RNA-Seq results. Overall, this study revealed potentially important genes and ceRNA regulatory network that mediate the alleviating effects of baicalin on joint pathological alterations in CIA rats.


Evaluation of a new microquantity blood collector.
A new device for collecting small amounts of blood from laboratory animals offer distinct advantages over standard syringes during the collection of serum or plasma.


Supramolecular self-assemblies of engineered polyethylenimines as multifunctional nanostructures for DNA transportation with excellent antimicrobial activity.
In this study, indole-3-butanoic acid (IBA), a biologically and environmentally safe entity, has been grafted onto low and high molecular weight (1.8 and 25 kDa) polyethylenimines (PEI) mainly through primary amines to obtain amphiphilic indole-3-butanoyl-polyethylenimines (IBPs). Two series of IBPs (IBP1.8 and IBP25) were prepared which, on self-assembly in aqueous medium, yielded multifunctional nanomicellar structures (IBP1.8 and IBP25) capable of transporting genetic material in vitro and exhibiting other biological activities. Physicochemical characterization showed the size of IBP1.8 and IBP25 nanostructures in the range of ~332-234 nm and ~283-166 nm, respectively, with zeta potential varying from ~+29-17 mV and ~+37-25 mV. DNA release assay demonstrated higher release of plasmid DNA from IBP nanostructures as compared to native PEIs. Cytotoxicity showed a decreasing pattern with increasing degree of grafting of IBA onto PEIs making these nanostructures non-toxic. pDNA complexes of these nanostructures (both IBPs1.8 and IBPs25) displayed considerably higher transfection efficiency, however, IBP1.8/pDNA complexes performed much better (~7-9 folds) as compared to native PEI/pDNA and Lipofectamine/pDNA complexes on mammalian cells. CLSM analysis revealed that these complexes entered nucleus in sufficient amounts suggesting higher uptake and efficient internalization of the complexes. Besides, these supramolecular nanostructures not only exhibited excellent antimicrobial potential (MIC ~49-100 µg/ml) against clinical as well as resistant pathogenic strains but also found to possess antioxidant property. Overall, the projected low molecular weight PEI-based vectors could serve as more effective multifunctional nanomaterials having promising potential for future gene therapy applications with capability to provide protection against other bacterial infections.


Accuracy of prehospital sphygmomanometers.
The first requisite for valid blood pressure determination is a correctly calibrated manometer. A total of 125 aneroid sphygmomanometers in prehospital use were calibrated against a mercury manometer standard. A total of 43 (34.4%) aneroid instruments deviated by more than +/- 4 mm Hg tolerance (average of four readings). A deviation of greater than +/- 8 mm Hg was shown by 10.4% (13) of the maeters. These aneroid gauges are easily calibrated by prehospital personnel using a mercury standard and Y-tube connection. Departments with routine maintenance policies had fewer inaccurate instruments. Emergency medical services advisors should ensure periodic maintenance and calibration of sphygmomanometers used in emergency care situations.


Vascular permeability changes induced by complement-derived peptides.
The polypeptides C3a and C5a are released as protein cleavage byproducts during activation of the complement system. These substances are able to release histamine from mast cells and this has generally been thought to be the link between complement activation and increased microvascular permeability in inflammatory reactions. Recent observations of inflammatory responses in the skin suggest that there is another link, which does not involve histamine. This is potentially of more general importance since antihistamines have limited effects on the majority of inflammatory reactions. One of the complement protein fragments, C5a (with or without carboxyl terminal arginine which is necessary for histamine release), is very potent in increasing vascular permeability. However, protein leakage leading to tissue oedema in skin is difficult to detect unless an arteriolar dilator is present. There is evidence that C5a and a vasodilator prostaglandin can be generated together extravascularly in response to a microbial stimulus. Unlike histamine, C5a does not act directly on venular endothelial cells, but triggers a very rapid interaction between circulating polymorphonuclear leukocytes and venular endothelial cells which, by an unknown mechanism, results in elevated venular permeability to plasma proteins.


Blended learning in postgraduate oral medical and surgical training - An overall concept and way forward for teaching in LMICs.
E-learning programmes have become established in postgraduate oral medical education and training. Internet and literature researches show a variety of good concepts that provide an attractive alternative to face-to-face training. What is missing is an overall concept in which continuing education and training are offered in bundled form in various teaching and learning formats. We discuss the blended learning concept which offers the best options, which has been proven by scientific studies. Using the example of the International Medical College (IMC) at the University of Duisburg-Essen, a blended learning overall concept for postgraduate continuing education is presented.


Non-Hodgkin's lymphoma in pregnancy.
Non-Hodgkin's lymphoma associated with pregnancy is rare. To date, only 1 case in which lymphoma was diagnosed and treated during pregnancy, with normal pregnancy outcome, has been reported. We describe another case where life-threatening, diffuse, poorly differentiated lymphocytic lymphoma was diagnosed during the 13th week of pregnancy. Combination chemotherapy (cyclophosphamide, vincristine, bleomycin, and prednisone) resulted in remission and a health full-term infant was born.


Fluid Intake and Urinary Symptoms in Patients with Multiple Sclerosis.
The relationship between fluid intake and lower urinary tract symptoms in individuals with neurogenic bladder is unknown. We investigated the association between fluid intake and urinary symptoms in patients with multiple sclerosis. A prospective cross-sectional study of patients with multiple sclerosis presenting to the neurology office was conducted. Fluid intake and lower urinary tract symptoms were assessed by the questionnaire based voiding diary and the American Urological Association Symptom Score, respectively. The relationship between fluid intake and lower urinary tract symptoms was assessed using univariate and multivariate analyses. Among 200 individuals with multiple sclerosis the mean total daily fluid intake was 2,489 ml (SD 1,883) and did not differ according to severity (ie mild, moderate, severe) of lower urinary tract symptoms (F=0.30, p=0.74). Fluid restricting behavior to control urinary symptoms was reported by 47% of subjects. Subjects who reported fluid restricting were more likely to have worse urinary symptoms (OR 1.95, 95% CI 1.53-2.47, p <0.01). After accounting for fluid restricting behavior on multivariate analysis, there was a minimal relationship between caffeinated fluid intake and lower urinary tract symptom severity (OR 1.00, 95% CI 1.00-1.01, p=0.01), and there was no relationship between total fluid intake and lower urinary tract symptom severity (OR 1.00, 95% CI 1.00-1.00, p=0.07). Caffeinated fluid intake has a minimal effect on lower urinary tract symptoms in patients with multiple sclerosis. On average, patients with multiple sclerosis do not hydrate excessively and a considerable proportion restrict fluid intake to control urinary symptoms. Fluid intake may not contribute considerably to lower urinary tract symptoms in patients with multiple sclerosis.


Genetic mapping of the pear scab resistance gene Vnk of Japanese pear cultivar Kinchaku.
Pear scab (caused by Venturia nashicola) is one of the most harmful diseases of pears, especially Japanese and Chinese pear species. The molecular identification and early selection of resistant plants could greatly improve pear breeding. We have identified the position of the scab resistance gene, designated Vnk in an indigenous Japanese pear cultivar Kinchaku, within the pear genome by using simple sequence repeat (SSR) markers derived from pear and apple. The position of Vnk was identified in the central region of linkage group 1 of Kinchaku. Several amplified fragment length polymorphism (AFLP) markers linked to Vnk were obtained by bulked segregant analysis. Among them, the AFLP marker closest to Vnk was converted into a sequence tagged site (STS) marker. Four random amplified polymorphic DNA (RAPD) markers previously found to be loosely associated with Vnk (Iketani et al. 2001) were successfully converted into STS markers. Six markers (one SSR Hi02c07 and five STSs converted from AFLP and RAPD) showed tight linkages to Vnk, being mapped with distances ranging from 2.4 to 12.4 cM. The SSR CH-Vf2, which was isolated from a BAC clone of the contig containing the apple scab gene Vf, was mapped at the bottom of linkage group 1 in Kinchaku, suggesting that the Vnk and Vf loci are located in different genomic regions of the same homologous linkage group.


Letter Regarding "The Prostacyclin Analogue Iloprost as an Early Predictor of Successful Revascularization in Diabetic Patients Affected by Critical Limb Ischemia and Foot Ulcers".
The aim of this study is to evaluate the role of Iloprost as an early predictor of successful revascularization in patients affected by ischemic diabetic foot ulcers (DFUs). Consecutive patients with ischemic DFUs with persistent low TcPO2 (<30mmHg) one day after a technical successful Percutaneous Transluminal Angioplasty (PTA) have been included. All patients underwent Iloprost infusion and TcPO2 has been recorded at days 3, 14 and 30. According to the TcPO2 reported at day 3, patients were divided into two groups: group A (patients with TcPO2 ≥30mmHg) and group B (patients with TcPO2 <30mmHg). Baseline TcPO2 values at days 3, 14 and 30 after Iloprost infusion and needing of re-intervention (re-PTA) have been evaluated. Twenty-five patients have been included, 12/25 (48%) in Group A and 13/25 (52%) in Group B. There were no significant differences at the baseline and one day after PTA between the two groups while TcPO2 values recorded in Group A at days 3, 14 and 30 after Iloprost infusion were significant higher in comparison to the Group B (χ = 0.005). The rate of re-PTA were respectively 33,3% (Group A) and 53,8% (Group B) (p = 0.03). Iloprost may be an early predictor of successful revascularization in patients affected by critical limb ischemia (CLI) and DFUs.


Insight into different adsorption behaviors of two fluoroquinolone antibiotics by sediment aggregation fractions.
Sediment, consisting of different aggregation fractions, is a hotspot site for transport and transformation of various pollutants including antibiotics. However, the fate of different antibiotics in aquatic sediments mediated by sediment aggregation fraction adsorption and the mechanism behinds are still unclear. In this study, we investigated the adsorption behavior of two fluoroquinolone antibiotics (ciprofloxacin and ofloxacin) on four aggregation fractions separated from the sediment of Taihu Lake, a typical lake contaminated by antibiotics in China. The results showed that the adsorption of ciprofloxacin and ofloxacin fitted the Freundlich model, irrespective of sediment aggregation size. The adsorption of ciprofloxacin and ofloxacin was depended on the size of sediment aggregation fractions, and the macroaggregation (> 200 μm) exhibited the strongest capacity, followed by large microaggregation (63-200 μm), medium microaggregation (20-63 μm), and small and primary microaggregation (< 20 μm). This fraction size-dependent effects of sediment aggregations on antibiotic adsorption might be closely related to the differences in their specific surface areas, organic matter contents, and surface functional groups. The adsorption of ciprofloxacin and ofloxacin by sediment aggregation fractions was characterized by a combination of chemical and physical adsorptions, with the former being the dominant process. Compared with ofloxacin, ciprofloxacin could be more rapidly and easily absorbed by four sediment aggregation fractions, and more readily complexed with carboxyl groups on macroaggregation surface. The adsorption of two antibiotics by extracellular polymeric substance showed that tryptophan and tyrosine protein-like, humic-like substance on the surface of sediment could bind to both antibiotics through a complexation reaction. The π-π electron donor-acceptor interaction and hydrogen bonds were responsible for the antibiotic adsorption by sediment aggregation.


COVID19: A Systematic Approach to Early Identification and Healthcare Worker Protection.
The COVID-19 outbreak spread rapidly throughout the globe, with worldwide infections and deaths continuing to increase dramatically. To control disease spread and protect healthcare workers, accurate information is necessary. We searched PubMed and Google Scholar for studies published from December 2019 to March 31, 2020 with the terms "COVID-19," "2019-nCoV," "SARS-CoV-2," or "Novel Coronavirus Pneumonia." The main symptoms of COVID-19 are fever (83-98.6%), cough (59.4-82%), and fatigue (38.1-69.6%). However, only 43.8% of patients have fever early in the disease course, despite still being infectious. These patients may present to clinics lacking proper precautions, leading to nosocomial transmission, and infection of workers. Potential COVID-19 cases must be identified early to initiate proper triage and distinguish them quickly from similar infections. Early identification, accurate triage, and standardized personal protection protocols can reduce the risk of cross infection. Containing disease spread will require protecting healthcare workers.