[Dynamic pancreatography with magnetic resonance after functional stimulus with secretin in chronic pancreatitis].
Magnetic Resonance pancreatography (MRP) was performed before and after the intravenous injection of secretin to assess the improvement in pancreatic duct visualization and to perform a dynamic study of the pancreatic exocrine function. 20 MRP examinations were performed in 18 patients with suspected or known chronic pancreatitis. Coronal T2-weighted half-Fourier SSFSE images were obtained with a phased array surface coil. Images were obtained before and up to 10 minutes after the injection of 1 cu/kg b.w. secretin. Quantitative image analysis included main pancreatic duct enlargement over time after secretin injection and the amount of duodenal filling. Qualitative image analysis included: overall image quality improvement, number of pancreatic duct segments visualized, secondary ducts dilation, intraductal filling defects, the presence of pancreas divisum. After secretin injection the overall image quality was judged sufficient in 2 patients and satisfactory in 18 patients. The number of pancreatic duct segments visualized increased from 40/57 (79%) to 57/57 (100%); secondary ducts were visualized in 4 patients before secretin compared to 18 after secretin. The number of stenosis visualized increased from 6 to 9, while intraluminal filling defects increased from 2 to 6. Pancreas divisum was detected in 2 patients after secretin versus 0 before secretin. The main pancreatic duct enlargement was statistically significant in the head of the pancreas (p < .05). Duodenal filling was normal in 13 patients and decreased in 7. Secretin injection extends the capabilities of MRP in visualizing the morphologic features of pancreatic ducts. The depiction of pancreatic ducts, stenosis, filling defects and pancreas divisum was improved after secretin injection. The exocrine function of the pancreas can be evaluated analyzing the entity and the timing of the duodenal filling.


Recommendations of patients and families of girls with 46XX congenital adrenal hyperplasia in the United Kingdom regarding the timing of surgery.
The timing of surgery for congenital adrenal hyperplasia (CAH) is contentious. We aimed to survey expert families and patients for their recommendations regarding timing of surgery for a family with a newly diagnosed CAH child. A Survey Monkey questionnaire was performed at the 2017 meeting of the CAH support group, "Living with CAH", and also sent to the members of the CAH support group. The surgical-timing responses were a Likert score from 1 (strongly disagree) to 5 (strongly agree). Data were analysed by Kruskal-Wallis test. p < 0.05 taken as significant. Of the 61 respondents, 12 were CAH patients, 43 were CAH parents, 3 were physicians, 1 surgeon and 2 others. For all respondents, the Likert score was 3 for infant, toddler and adult timing of surgery (neutral), not statistically significant (ns). For parents and/or children who had surgery (n = 26), the score was 4 (3-5) for infant vs. 4 (3-4) for toddler-years vs. 2 (1-3) for adulthood. This was statistically significant (p = 0.0002). When only patients who had CAH surgery were included, there were only 8 respondents and their scores were: infancy 3 (2-4) vs. toddler-years 4 (2-4) vs. adulthood 1 (1-4), ns. Expert families and patients in the United Kingdom who have had CAH surgery, recommend surgery in the first few years of life vs. adulthood. There is a selection bias, however this may support MDTs in continuing to discuss surgery as an option in childhood.


Effect of neuraminidase treatment on the lipid fluidity of the intestinal brush-border membranes.
The effect of neuraminidase treatment on the lipid fluidity of the porcine intestinal brush-border membranes was studied using two fluorescence dyes, pyrene and 1,6-diphenyl-1,3,5-hexatriene. By treatment of the membranes with neuraminidase, the fluorescence parameters of pyrene-labeled membranes changed; i.e., a shift of thermal transition temperature, an increase in the fluorescence quenching rate for Tl+ and a decrease in the fluorescence lifetime. These results suggest that the environmental properties around the dye molecules in the membranes change sensitively upon neuraminidase treatment. Perturbation of the lipid domain in the membranes associated with neuraminidase treatment is also demonstrated by a stimulated solubilization of diphenylhexatriene molecules in the membrane lipids, an increased quenching efficiency with Tl+ and a decreased rotational correlation time of diphenylhexatriene-labeled membranes. Based on these results, we conclude that the lipid organization of the membranes is susceptible to neuraminidase treatment and that the membrane lipid fluidity increases by desialylation by the enzyme treatment.


Self-regulation and the behavioural response to DNA risk information: a theoretical analysis and framework for future research.
The few studies conducted to date suggest that DNA risk information may be less likely to achieve behaviour change than other types of health risk information. We draw upon self-regulation theory to explain and predict the characteristics of risk information that are more and less likely to motivate behaviour change. Self-regulation theory describes how information about a health threat is processed within individuals' pre-existing cognitive schema, and how the cognitive representations within these schemas activate coping procedures for dealing with the perceived threat. We explore the proposition that the initial impact of information about a health threat depends upon how well it "fits" with existing cognitive representations of that threat. For example, in one study DNA risk information regarding an inherited form of bowel cancer was perceived as more accurate and had a greater impact on risk perceptions in those whose representation of the threat included genes as the single cause, as opposed to one of several. Since the cognitive representation of a threat activates coping procedures that fit with that representation, we also explore the proposition that cognitive representations of a threat that has a genetic identity are less likely to activate coping procedures that include risk-reducing behaviours. For example, using DNA risk information to assess an inherited predisposition to heart disease increased the extent to which the condition was seen as caused by genes, which in turn reduced the expectation that a behavioural means of coping would be effective (eating a low fat diet), but increased the expectation that a biological means was effective (taking lipid lowering medication). Describing the heuristics that operate between risk information, the cognitive representations of threat and coping procedures could be used to identify the cognitions to target so as to optimize the motivational impact of DNA and other risk information.


Evaluation of a new interferon-gamma release assay and comparison to tuberculin skin test during a tuberculosis outbreak.
The tuberculin skin test (TST) is commonly used for the diagnosis of latent tuberculosis infection (LTBI) in non-bacille Calmette-Guérin (BCG) vaccination settings. In recent years, attention has been drawn to interferon-gamma release assays (IGRAs), especially in BCG-vaccinated populations. In this study, we evaluated the TST and a new whole blood IGRA in BCG-vaccinated individuals during a tuberculosis (TB) outbreak in China. A TB outbreak occurred at a university in Dalian, China from March to November 2010. The TST and a whole blood IGRA were used to screen for TB infection. The correlation between exposure levels, TST, and the IGRA were evaluated. We found that agreement between the IGRA and TST was poor (kappa 0.182-0.290). IGRA positivity was associated with the level of exposure, and IGRA positivity and the level of exposure were risk factors for TB incidence. Neither the IGRA nor the TST alone picked up all TB incidences. However, if a 10 mm cutoff for the TST was used in the highest risk exposure group and IGRA positivity was used in the other risk groups, 19 of the 20 (95%) TB cases were identified. A recommended preventive treatment regimen for China should be based on the level of exposure in conjunction with IGRA and TST test results.


Intraperitoneal Enterobius vermicularis infection: a case report.
Enterobius vermicularis in an ectopic location usually represents an incidental finding in tissue specimens in a patient without symptoms. However, the parasite can lead to inflammation and symptoms in rare cases. A 36-year-old woman had an abdominal hysterectomy for menorrhagia, dyspareunia, and lower abdominal pain. Two small nodules from the posterior aspect of the left broad ligament as well as the uterus were sent for histologic examination. The pathologic findings confirmed the diagnosis of "granulomatous peritoneal nodules due to E. vermicularis." Within the nodules were aggregates of ova of E. vermicularis. This case reminds us that such granulomatous lesions can simulate leiomyoma, fibroma, endometrioma, and tuberculous or malignant lesions. It is important to be aware of this resemblance to avoid unnecessary surgical intervention.


Steam-stable hydrophobic ITQ-29 molecular sieve membrane with H(2) selectivity prepared by secondary growth using Kryptofix 222 as SDA.
A neutral framework cation-free hydrophobic ITQ-29 molecular sieve membrane with hydrogen selectivity was prepared on porous α-Al(2)O(3) supports by using Kryptofix 222 as organic structure directing agent through secondary growth method.


Nuclear DNA changes during pathogenesis of squamous carcinoma of the cervix in 3,4-benzopyrene-treated mice.
The pathogenesis of squamous carcinoma of the uterine cervix was studied by means of morphologic and cytochemical techniques in mice treated with 3,4-benzopyrene. The results indicate that carcinogen-induced transformation of normal cervical epithelium into squamous carcinoma occurs through a sequence of cellular alterations, demonstrated by progressively increasing cellular atypia and a progressively increasing and scattered DNA content.


Serum Zinc Level and Eating Behaviors in Children Receiving Zinc Supplements without Physician Prescription.
The aim of the study was to compare the serum zinc level and eating behaviors in 2-8-year-old children with and without arbitrarily zinc supplementation. This case-control study was conducted from December 2015 to December 2017 in Isfahan, Iran. The case group consisted of seventy children, aged 2-8 years, who have received zinc supplement without physician prescription; the controls were an equal number of age-matched children who did not receive any supplement. The serum zinc level was measured, and eating behaviors were identified using Children's Eating Behavior Questionnaire (CEBQ). There was no significant difference in serum zinc level between two groups (P = 0.18). Some differences in CEBQ subscales were identified between the groups studied. In the control group, the subscale of enjoyment of food was higher than the case group (P < 0.001). In the case group, the subscales of food fussiness and satiety responsiveness were higher than controls (P < 0.001). In this study, serum zinc levels were not significantly different between the two groups, and arbitrarily zinc supplementation does not play an important role in improving anorexia subscales.


Associations among different functional and structural arterial wall properties and their relations to traditional cardiovascular risk factors in healthy subjects: a cross-sectional study.
The arterial wall possesses several functional and structural properties that define arterial health. Once they become impaired, cardiovascular risk increases. We aimed to ascertain the pattern of correlations among different arterial wall properties and to explore their relations to traditional risk factors and cardiovascular risk stratification. To allow such an investigation a middle-aged healthy population was recruited. This cross-sectional study included 100 healthy males (aged 41.9 ± 6.4 years). Pulse wave velocity (PWV), β-stiffness and intima-media thickness (IMT) of the carotid artery, and brachial artery flow-mediated dilation (FMD) were measured by a standardized ultrasound approach. No correlation between FMD and IMT was found; only relatively poor correlations between PWV (or β-stiffness) and FMD existed, as well as between PWV (or β-stiffness) and IMT. PWV and β-stiffness highly correlated. Unexpectedly, only weak associations between PWV, β-stiffness, FMD, IMT and traditional risk factors were revealed. Hence, traditional risk factors (mainly age) explained only 10-50% of variability for PWV, β-stiffness, FMD and IMT. Although the subjects had low cardiovascular risk according to their Framingham score, their arterial wall properties were already impaired, particularly FMD. In healthy middle-age males we found: i) absent or poor correlations among arterial stiffness, IMT and endothelial function; ii) a low impact of traditional risk factors on the studied variables, and iii) the presence of impaired arterial wall properties despite low calculated cardiovascular risk. These results provide a deepened understanding of arterial wall properties and could help to improve cardiovascular risk stratification.


Resumption of high-dose methotrexate after acute kidney injury and glucarpidase use in pediatric oncology patients.
High-dose methotrexate (HDMTX)-induced acute kidney injury is a rare but life-threatening complication. The methotrexate rescue agent glucarpidase rapidly hydrolyzes methotrexate to inactive metabolites. The authors retrospectively reviewed glucarpidase use in pediatric cancer patients at their institution and evaluated whether subsequent resumption of HDMTX was tolerated. Clinical data and outcomes of all patients who received glucarpidase after HDMTX administration were reviewed. Of 1141 patients who received 4909 courses of HDMTX, 20 patients (1.8% of patients, 0.4% of courses) received 22 doses of glucarpidase. The median glucarpidase dose was 51.6 U/kg (range, 13-65.6 U/kg). At the time of administration, the median plasma methotrexate concentration was 29.1 μM (range, 1.3-590.6 μM). Thirteen of the 20 patients received a total of 39 courses of HDMTX therapy after glucarpidase. The median time to complete methotrexate excretion was 355 hours (range, 244-763 hours) for the HDMTX course during which glucarpidase was administered, 90 hours (range, 66-268 hours) for the next HDMTX course, and 72 hours (range, 42-116 hours) for subsequent courses. The median peak serum creatinine level during these HDMTX courses was 2.2 mg/dL (range, 0.8-9.6 mg/dL), 0.8 mg/dL (range, 0.4-1.6 mg/dL), and 0.6 mg/dL (range, 0.4-0.9 mg/dL), respectively. One patient experienced nephrotoxicity upon rechallenge with HDMTX. Renal function eventually returned to baseline in all patients, and no patient died as a result of methotrexate toxicity. The current results indicated that it is possible to safely resume HDMTX therapy after glucarpidase treatment for HDMTX-induced acute kidney injury.


Preparation of concentrated stable dispersions of uniform Ag nanoparticles using resorcinol as reductant.
Uniform silver nanoparticles ranging in size from 12 to 80nm were prepared by reducing silver ammonia complex with resorcinol in presence of Arabic gum. Despite the high ionic strength of the system, the precipitation process yields stable dispersions at metal concentrations as high as 4.0wt% (0.38moldm(-3)). Stable dispersions with higher solids concentration up to 20wt% silver (1.9moldm(-3)) were obtained by subjecting the 'as precipitated' dispersions to ultrafiltration. The effects of reaction parameters (pH, concentration of reactants, metal/stabilizer ratio, and temperature) on particle size and dispersion stability are discussed and a mechanism for the reduction of silver is proposed.


Association between maternal use of spray formulations and offspring urological anomalies: The Japan Environment and Children's Study.
Concerns exist regarding the effects of maternal inhalation of household products on fetal health. This study aimed to clarify the impact of maternal exposure to household products, including spray formulations, on urological anomalies in offspring up to the age of 1 year. This study included data from 84 237 children from the Japan Environment and Children's Study, an ongoing nationwide cohort study. Using maternal self-report questionnaires, information on the use of organic solvents, waterproof sprays, insect-repellent sprays, insecticide sprays, and herbicides from implantation until the second or third trimester of pregnancy and data on urological anomalies were collected 1 year after delivery. Urological anomalies occurred in 799 infants. Multivariate logistic regression analysis adjusted for maternal age, pregnancy body mass index, gestational diabetes, pre-existing maternal kidney disease, and preterm birth revealed no association between maternal exposure to organic solvents and the prevalence of offspring urological anomalies. Nevertheless, we observed significant associations between waterproof spray use during pregnancy and urological anomalies in boys (odds ratio [OR]: 1.28, 95% confidence interval [CI]: 1.03-1.59) and between the use of insecticide spray during pregnancy and urological anomalies in girls (OR: 1.48, 95% CI: 0.98-2.22). Sub-analysis revealed significant associations between waterproof spray use during pregnancy and vesicoureteral reflux in boys (OR: 2.14, 95% CI: 1.02-4.49) and between the use of insecticide spray during pregnancy and hydronephrosis in girls (OR: 2.23, 95% CI: 1.11-4.47). Spray formulation use during pregnancy might increase the risk of urological anomalies in the offspring.


Nonlinear localized modes at phase-slip defects in waveguide arrays.
We study light localization at a phase-slip defect created by two semi-infinite mismatched identical arrays of coupled optical waveguides. We demonstrate that the nonlinear defect modes possess the specific properties of both nonlinear surface modes and discrete solitons. We analyze the stability of the localized modes and their generation in both linear and nonlinear regimes.


Distribution of galanin receptor 1-immunoreactive neurons in the ovine hypothalamus: colocalization with GnRH.
Galanin is implicated in numerous physiological functions, including reproduction. Where and how galanin acts in the brain is poorly understood, but recent evidence suggests that it is predominantly through the GAL-R1 receptor. Using an antibody raised against the third intracellular loop of rat GAL-R1, a region that is highly conserved among species, our first objective was to determine the distribution of cells expressing immunoreactive GAL-R1 in the hypothalamus of the sheep. GAL-R1-immunoreactive cells were spread widely in the ovine diencephalon and overlapped with the known distribution of GnRH neurons. Galanin has been shown to enhance GnRH secretion, but it is not known whether this effect is transduced at the level of the GnRH neuron or is indirect. Thus, our second objective was to establish if GnRH neurons throughout the hypothalamus expressed GAL-R1 receptors and, if so, whether GAL-R1 expression in GnRH neurons was influenced by season, gender and/or stage of the estrous cycle. In rams and ewes during the non-breeding season, only a tenth of the GnRH neurons expressed immunocytochemically detectable GAL-R1 receptors. In contrast, a fifth of the GnRH neurons expressed immunocytochemically detectable GAL-R1 in the luteal phase, whereas only a twentieth expressed GAL-R1 in the follicular phase. These data suggest that galanin may affect a subpopulation of GnRH neurons through the GAL-R1 receptor and that this affect may be modulated by steroids.


Early-life respiratory trajectories and neurodevelopmental outcomes in infants born very and extremely preterm: A retrospective study.
To determine whether early-life respiratory trajectories are associated with neurodevelopmental impairment (NDI) in infants born very and extremely preterm. The daily type of respiratory supports in the first 8 weeks after birth were analysed in 546 infants (285 males, 261 females; median gestational age = 28.0 weeks, interquartile range = 3 weeks), comprising 301 infants born very preterm (gestation = 28-30 weeks) and 245 infants born extremely preterm (gestation <28 weeks), who survived to discharge from 2004 to 2018 and received follow-up assessment by Bayley Scales of Infant and Toddler Development at a corrected age of 24 months. NDI included cognition or motor impairment, moderate and severe cerebral palsy, or visual and hearing impairment. Clustering analysis identified three respiratory patterns with increasing severity: improving; slowly improving; and delayed improvement. These were significantly associated with increasing rates of NDI in infants born very and extremely preterm and smaller head circumference in infants born extremely preterm (both p < 0.001). By day 28, the proportion of infants who were under different categories of ventilation support significantly differed according to the three trajectory groups in infants born very and extremely preterm (both p < 0.05). Models that included adverse respiratory trajectories demonstrated more negative impacts on neurodevelopment than those without. An adverse early-life respiratory trajectory was associated with NDI at follow-up, especially in infants born extremely preterm, suggesting a lung-brain axis of preterm birth. Clustering analysis identified three respiratory trajectories with increasing severity in infants born preterm. Increasing severity of respiratory trajectories was associated with increasing rates of neurodevelopmental impairment. Adverse respiratory trajectories had a significantly negative impact on neurodevelopmental outcomes.


Curative pelvic exenteration for recurrent cervical carcinoma in the era of concurrent chemotherapy and radiation therapy. A systematic review.
Pelvic exenteration requires complete resection of the tumor with negative margins to be considered a curative surgery. The purpose of this review is to assess the optimal preoperative evaluation and surgical approach in patients with recurrent cervical cancer to increase the chances of achieving a curative surgery with decreased morbidity and mortality in the era of concurrent chemoradiotherapy. Review of English publications pertaining to cervical cancer within the last 25 years were included using PubMed and Cochrane Library searches. Modern imaging (MRI and PET-CT) does not accurately identify local extension of microscopic disease and is inadequate for preoperative planning of extent of resection. Today, only half of pelvic exenteration procedures obtain uninvolved surgical margins. Clear margins are required for curative pelvic exenterations, but are poorly predictable by pre-operative assessment. More extensive surgery, i.e. the infra-elevator exenteration with vulvectomy, is a logical surgical choice to increase the rate of clear margins and to improve patient survival following surgery for recurrent cervical carcinoma.


Effects of metformin on survival outcomes of lung cancer patients with type 2 diabetes mellitus: a meta-analysis.
Anti-cancer effect of metformin on different kinds of lung cancer has been studied frequently. However, the association between metformin and the prognosis of lung cancer in type 2 diabetes patients is still controversial. An electronic search was conducted using PubMed/Medicine, EMBASE and Cochrane library databases. Statistical analyses were carried out using either random-effects or fixed-effects models according to the heterogeneity examined by I (2) statistics. Six studies involving 2350 patients were included in the current meta-analysis. In all, the pooled HR of overall survival (OS) was 0.90 (95 % CI 0.84-0.96; P = 0.003). Sub-group analysis showed that when stratified by region the HR of OS was 0.52 (95 % CI 0.31-0.87; P = 0.012) and 0.86 (95 % CI 0.67-1.11, P = 0.361) for Asian and Western countries. When stratified by study design, the HR of OS was 0.78 (95 % CI 0.52-1.15, P = 0.206) and 0.82 (95 % CI 0.59-1.16, P = 0.264) for cohort and medical data-based studies. When stratified by lung cancer subtype, HR of OS was 0.52 (95 % CI 0.31-0.87; P = 0.012), 1.06 (95 % CI 0.51-2.19; P = 0.878) and 0.82 (95 % CI 0.59-1.16; P = 0.264) for SCLS, NSCLC and non-divided subtypes, respectively. Metformin use may associate with a good prognosis in lung cancer patients with type 2 diabetes but the effect was modest. However, it could achieve benefits in a selective sub-group of lung cancer patients especially in SCLC patients from Asian. Further studies are warranted to confirm this efficacy.


Non-Gaussian diffusion MRI assessment of brain microstructure in mild cognitive impairment and Alzheimer's disease.
We report the first application of a novel diffusion-based MRI method, called diffusional kurtosis imaging (DKI), to investigate changes in brain tissue microstructure in patients with mild cognitive impairment (MCI) and AD and in cognitively intact controls. The subject groups were characterized and compared in terms of DKI-derived metrics for selected brain regions using analysis of covariance with a Tukey multiple comparison correction. Receiver operating characteristic (ROC) and binary logistic regression analyses were used to assess the utility of regional diffusion measures, alone and in combination, to discriminate each pair of subject groups. ROC analyses identified mean and radial kurtoses in the anterior corona radiata as the best individual discriminators of MCI from controls, with the measures having an area under the ROC curve (AUC) of 0.80 and 0.82, respectively. The next best discriminators of MCI from controls were diffusivity and kurtosis (both mean and radial) in the prefrontal white matter (WM), with each measure having an AUC between 0.77 and 0.79. Finally, the axial diffusivity in the hippocampus was the best overall discriminator of MCI from AD, having an AUC of 0.90. These preliminary results suggest that non-Gaussian diffusion MRI may be beneficial in the assessment of microstructural tissue damage at the early stage of MCI and may be useful in developing biomarkers for the clinical staging of AD.


Clonal analysis of early-stage bilateral papillary thyroid cancer identifies field cancerization.
Bilaterality is a newly identified indicator for aggressive tumor behavior and poor outcome in papillary thyroid cancer. However, the clonal origin of these bilateral tumors remains unclear. Here we analyzed 28 pairs of early-stage papillary thyroid cancers (stage I-II without extra-thyroidal extension, lymph node metastasis or distant metastasis) that underwent surgery at First Affiliated Hospital of Zhejiang University School of Medicine (Hangzhou, China). Genomic DNA was extracted from paraffin-embedded tissues after microdissection and analyzed for BRAF mutation and X-chromosome inactivation. A total of 16 patients (16/28, 57.1%) harbored different BRAF status in bilateral tumors. Fourteen patients were available for X-chromosome inactivation assay and 10 of them achieved informative results. Bilateral tumors from four cases had distinct patterns of X-chromosome inactivation. Combining the results of X-chromosome inactivation and BRAF analysis, we demonstrated that at least 64.3% (18/28) cases harbored discordant X-chromosome inactivation or BRAF status, indicating their independent clonal origin in bilateral tumors. The present study confirms "field cancerization" in early-stage bilateral thyroid cancers, suggesting that these subtype papillary thyroid cancers should be treated as independent and localized tumors.


Effects of activated carbon ageing in three PCB contaminated sediments: Sorption efficiency and secondary effects on Lumbriculus variegatus.
The sorption efficiency and possible secondary effects of activated carbon (AC) (ø 63-200 μm) was studied with Lumbriculus variegatus in three PCB contaminated sediments applying long AC-sediment contact time (3 years). AC amendment efficiently reduced PCB bioavailability as determined with both, L. variegatus bioaccumulation test and passive samplers. However, dose related secondary effects of AC on egestion rate and biomass were observed (applied doses 0.25% and 2.5% sediment dry weight). The sorption capacity and secondary effects remained similar when the experiments were repeated after three years of AC-sediment contact time. Further, transmission electron microscopy (TEM) samples revealed morphological changes in the L. variegatus gut wall microvilli layer. Sediment properties affected both sorption efficiency and secondary effects, but 2.5% AC addition had significant effects regardless of the sediment. In, conclusion, AC is an efficient and stable sorbent to decrease the bioavailability of PCBs. However, sediment dwelling organisms, such as Oligochaete worms in this study, may be sensitive to the carbon amendments. The secondary effects and possible morphological changes in benthic organisms should not be overlooked as in many cases they form the basis of the aquatic food webs.


A promoter of the rat insulin-like growth factor II gene consists of minimal control elements.
We have characterized the cis-control signals in one of the two promoters of the developmentally regulated rat insulin-like growth factor II gene (rIGF-II) by a combination of in-vivo transient expression, in-vitro transcription, footprinting, gel band-shifting and methylation-interference experiments, using a series of deletion mutant templates. Our results indicate that this simple (minimal) promoter (P2) consists of no more than 128 base-pairs, which include an ATA box and four proximal upstream GC boxes binding the general transcription factor Sp1. Three of the latter sites deviate from the known Sp1 consensus recognition sequence. The two types of cis-acting regulatory signals (GC/ATA motif) of the P2 promoter are inter-dependent and sufficient for transcription. A model for the operation of this type of minimal promoter is discussed. S1 nuclease-hypersensitive sites, localized by in-vitro mapping to the region of the P2 Sp1-binding sites, are also present in vivo and correlate with the transcriptional state of chromatin in the rIGF-II locus. We show that recognition sites for Sp1 binding are a subset of sequences that exhibit hypersensitivity to S1.


Synovial fluid β-endorphin level in avascular necrosis, rheumatoid arthritis, and osteoarthritis of the femoral head and knee. A controlled pilot study.
The goal of this study is to determine and compare the β-endorphin levels in the synovial fluid of patients with different joint disorders (avascular necrosis, AVN; osteoarthritis, OA; and rheumatoid arthritis, RA of the hip or knee). Eighty-seven patients were involved in our study with an average age of 62 years. Thirty-three patients had AVN (18 hips, 15 knees). Twenty-three patients were diagnosed with OA (14 hips, 9 knees), and 31 patients suffered from RA (12 hips, 19 knees). We measured the β-endorphin levels of the synovial fluids -harvested from surgery-with radioimmunoassay. No significant difference was found in the β-endorphin levels of the synovial fluid from AVN comparing to OA and RA, however β-endorphin level was significantly higher in RA group than among patients with OA (p = 0.01). Synovial β-endorphin level was slightly lower in knee comparing to hip joint p = (0.06). When examining the different joints separately in compliance with diagnoses, we concluded that the synovial β-endorphin level from AVN was between the values of OA and RA without significant difference, whereas it was significantly higher in the knee of RA, than of OA groups (p = 0.05 knee, p = 0.2 hip). Our results confirmed those experiments which stated that there is a significant increase in synovial β-endorphin level in patients with inflammatory autoimmune diseases (e.g., RA), comparing to the level measured in degenerative conditions (e.g., OA).


Polychlorinated biphenyls-induced lipid peroxidation as measured by thiobarbituric acid-reactive substances in liver subcellular fractions of rats.
Rats were given a 0.05% polychlorinated biphenyls (PCB) diet supplemented with adequate nutrients for 10 days and not only PCB-induced lipid peroxidation as measured by thiobarbituric acid (TBA)-reactive substances but also variations of lipid peroxides scavengers in liver and its subcellular fractions (nuclei and cell debris, mitochondrial, microsomal and cytosolic fractions) were investigated. The lipid peroxidation in liver and subcellular fractions in the PCB-treated group increased significantly except in the nuclei and cell debris fraction. The increase in lipid peroxidation in the microsomal fraction appeared to be associated in part with the decrease in vitamin E (alpha-tocopherol) content and induction of drug-metabolizing enzymes. In the cytosolic fraction, the total lipid content increased, glutathione peroxidase (GSHPx) activity decreased and the quantity of free radical-reactive substances suppressing lipid peroxidation was low as measured by the 1,1-diphenyl-2-picrylhydrazyl (DPPH) value. From these results, the increase in lipid peroxidation in the cytosolic fraction in the PCB-treated group was ascribed to the abundance and availability of oxidizable substrate attended with fatty liver, to the decline in GSHPx activity, and to the insufficiency in antioxygenic activity as observed by the decrease in the DPPH value.


[Further Development and Interoperability in Oncological Care Structures, Quality Control and Research].
How can we improve the interoperability of medical guidelines and the implementation and measurement of outcomes in medical health care for cancer patients as well as for care providers? This is the aim of the working group "Quality and Cross-linking". The following publication gives an overview of the targets reached in the development of guidelines together with quality indicators and documentation in cancer registries.


The physical and surgical aspects of silicone oil in the vitreous cavity.
Silicone oil inside the vitreous cavity exerts forces on to the retina as a result of buoyancy, volume displacement, and surface tension. Surface tension rather than viscosity is the key to understanding why the oil seals retinal breaks effectively. The physics of the tamponade was studied quantitatively. Retinal traction can be counteracted by the oil up to a calculated threshold value, depending on the size and shape of the tear, the strength of the surface tension and, most importantly, the distance between the retina and choroid. For a nearly flat retinal hole, the tamponade is very effective. These theoretical results imply straightforward rules for surgery, rules that have been tested in 150 operations. An attempt must be made to fill 100% of the vitreous cavity. Since the air-water boundary has 3 times the surface tension of the water-oil boundary, the most effective procedure is to flatten the retina by means of a fluid-gas exchange and then clamp it in a flat position, implanting the silicone oil. Silicone in the subretinal space or the anterior chamber tends to retract spontaneously, for surface tension causes the smaller bubble to blow up the larger one. Surgical methods are described to make use of it.


A systematic review of the "Logsplitter" injury: how much do we know?
As an emerging proposed type of ankle joint injury, the concept of logsplitter injury is a unified overview of the high-energy ankle fracture and dislocation accompanied by distal tibiofibular syndesmosis separation and displacement. Since the concept of logsplitter injury is still relatively novel, there is no uniform standard for its clinical classification, diagnosis and treatment currently. Thus, we reviewed previous literatures here to provide certain references for its better clinical diagnosis and treatment in future. The available literatures from January 1985 to June 2020 in five medical databases were searched and analyzed. The original articles that evaluated the outcomes of patients treated surgically for the logsplitter injury were included. The detailed data were then extracted from each research, including the researchers, type of study, level of evidence, type of center research, groups, number of patients, gender, age, causes of injury, time from injury to surgery, operative time, intraoperative blood loss, length of follow-up, postoperative complications and clinical outcomes. The overall search procedures were performed by the two independent reviewers. Seven pieces of researches (199 patients) were eligible for inclusion. All researches were either retrospective or prospective study, and all but one was single center study. Falling from height ranked first in the causes of injury (52.8%), and followed by the traffic accidents (29.6%). Clinical outcomes were all measured using the American Orthopaedic Foot and Ankle Society (AOFAS) score, and the mean AOFAS score at the final follow-up was 77.9 points. None of the definitive consensuses exists on how logsplitter injury should be diagnosed and surgically managed. In light of the novel concept, short presentation time and numerous postoperative complications, the logsplitter injury has not been well understood by most surgeons currently, and its overall situation still needs to be supported by a larger sample size of multicenter research in the future.


Non-invasive determination of the paternal HLA haplotype of a fetus using kinetic PCR to detect fetal microchimerism in maternal plasma.
Knowledge of fetal HLA type can be important if cord blood (CB) is being considered as a stem cell source for transplantation. The feasibility of determining the paternally inherited HLA haplotype of a fetus was explored through analysis of fetal DNA in the maternal circulation. A 5-year-old child with relapsed acute leukemia was a candidate for transplantation. The HLA type of the fetal sibling was needed to assist with evaluation of this potential cord blood donor. DNA was isolated from maternal plasma and whole blood. Kinetic PCR using sequence-specific primers for paternal HLA-A, -B, and -DRB1 alleles was performed. Alleles corresponding to one paternal haplotype were detectable in plasma, but not in whole blood. Alleles from the alternative haplotype were not detectable. This demonstrated that the fetus shared at least one haplotype with the patient and therefore arrangements were made to bank the CB. The maternal haplotype of the fetus could not be determined in the presence of maternal DNA. The prenatal fetal typing was confirmed by typing the newborn's CB. This rapid non-invasive technique may facilitate the selection of CB units for banking based on needed HLA types.


Dynamic imaging of the pancreas using real-time endoscopic ultrasonography with secretin stimulation.
Obstructive disorders of the pancreas, including strictures, stones, sphincter of Oddi dysfunction, and pancreas divisum, are diagnostic and therapeutic challenges. Conventional extracorporeal ultrasound with secretin stimulation has been used as a noninvasive study to detect obstruction and predict outcome of therapy. Inconsistent results have been obtained because of the inherent limitations of standard ultrasonography. The aim of this study was to evaluate the behavior of the main pancreatic duct by endoscopic ultrasonography during secretin stimulation and to diagnose obstructive disorders of the pancreas. Secretin-stimulated endoscopic ultrasound (SSEUS, 1 IU/kg secretin) was performed in 20 control subjects (no pancreatic or biliary disease), 40 patients with symptomatic chronic pancreatitis, 40 patients with symptomatic pancreas divisum, 20 patients with suspected sphincter of Oddi dysfunction, and 20 patients with suspected occlusion of pancreatic duct stents. Ductal diameter was measured by endoscopic ultrasonography at baseline and at 1-minute intervals, after administration of secretin, for 15 minutes. A result was determined to be abnormal when a 1 mm or greater dilation of the pancreatic duct was observed from baseline after secretin administration. Of the 40 patients with symptomatic chronic pancreatitis, SSEUS correctly predicted obstructive pathology (stones, strictures) in 12 of 13 patients (92%). Of the 40 patients with symptomatic pancreas divisum, 22 underwent stent therapy (16 of 22 with resolution of symptoms). SSEUS accurately predicted response to stent therapy in 13 patients (81%). Seven of twenty patients with suspected sphincter of Oddi dysfunction had abnormal sphincter manometry. SSEUS accurately predicted sphincter dysfunction in only 4 of 7 patients (57%). Finally, 20 patients with suspected occlusion of pancreatic duct stents were studied. Of the 14 stent occlusions confirmed at ERCP, SSEUS correctly predicted premature occlusion in 12 patients (86%). SSEUS appears to be a useful diagnostic modality in the evaluation of patients with suspected obstructive disorders of the pancreas and it can predict which patients may respond to endoscopic therapy.


[Effect of sectioning the celiac and vagus nerves on the activity and isoenzymatic composition of rat liver lactate dehydrogenase].
Total activity of lactate dehydrogenase (LDH) was increased in rat liver cytoplasm after dissection of nervus celiacus; the enzyme activity was, however, decreased after section of nervus vagus. As showen by polyacrylamide gel electrophoresis the alterations in the enzyme activity occurred mainly due to changes in the isoenzyme LDH5, prevailing in this liver fraction. Administration of insulin did not restore the LDH activity, decreased after vagotomy. The suggestion is corroborated that the regulatory effects of sympathetic and parasympathetic nervous systems on glycolysis are of oppositely directed character.


Crop residue stabilization and application to agricultural and degraded soils: A review.
Agricultural activities produce vast amounts of organic residues including straw, unmarketable or culled fruit and vegetables, post-harvest or post-processing wastes, clippings and residuals from forestry or pruning operations, and animal manure. Improper disposal of these materials may produce undesirable environmental (e.g. odors or insect refuges) and health impacts. On the other hand, agricultural residues are of interest to various industries and sectors of the economy due to their energy content (i.e., for combustion), their potential use as feedstock to produce biofuels and/or fine chemicals, or as a soil amendments for polluted or degraded soils when composted. Our objective is review new biotechnologies that could be used to manage these residues for land application and remediation of contaminated and eroded soils. Bibliographic information is complemented through a comprehensive review of the physico-chemical fundamental mechanisms involved in the transformation and stabilization of organic matter by biotic and abiotic soil components.


Influence of age on hair cell loss in the rabbit cochlea.
The surface preparation technique was used for a study of cochlear hair cell loss as a function of age in rabbits 1 week, 6 months, 1 year, and 4 years old. Cytocochleograms from these animals were prepared which indicated damaged or missing hair cells over the entire spiral organ from the apical to the basal coil. The loss in the mean percentage of total outer hair cells (OHC) and inner hair cells (IHC) appeared to increase linearly with increasing age, with a statistically significant correlation. The cell loss was similar in all three rows of OHC in each of the age groups. In animals up to 1 year of age, areas of OHC loss were localized in the apical and basal coils. In 4-year-old rabbits, OHC degeneration had become progressively accentuated and widespread. The pattern of IHC loss was somewhat similar to that of OHC. Age-related hair cell loss in the rabbit is comparable to that in the rat, monkey, and human cochlea.


Neuroscience. Early insult rewires pain circuits.
On page 628, neuroscientists report that painful stimuli delivered to rats shortly after birth permanently rewire the spinal cord circuits that respond to pain. Not only do the circuits contain more axons, but the axons extend to more areas of the spinal cord than they normally would. The results should help convince skeptics of the importance of managing pain in human infants.


Epithelial intracytoplasmic herpes viral inclusions associated with an outbreak of duck virus enteritis.
Several muscovy ducks from a free-roaming flock of 65 muscovy and mallard ducks died over a 3-week period. Three muscovy ducks were necropsied. Gross and microscopic changes were compatible with duck virus enteritis, and the virus was isolated. In addition to intranuclear viral inclusion bodies in several tissues, intracytoplasmic inclusion bodies were present in esophageal and cloacal epithelium. By electron microscopy, the membrane-bound intracytoplasmic inclusions were found to contain enveloped herpesvirus, and nuclei contained herpes viral nucleocapsids.


Facility-level correlates of antimicrobial use in nursing homes.
We assessed the contribution of facility-level variables to antimicrobial use in a cohort of 50 nursing homes and found that antimicrobial use was significantly correlated with the percentage of nursing home residents with feeding tubes, the number of healthcare aides, and the country of origin of the facility.


Usefulness of glycoprotein IIb/IIIa inhibitors in unstable angina due to small vessel disease.
We describe the role of abciximab in unstable angina due to small vessel disease in a 58-year-old patient who was submitted to percutaneous transluminal coronary angioplasty and stenting of an occluded venous graft.


The interaction of liver alcohol dehydrogenase with NADH as studied by differential protein denaturation.
Heat denaturation of horse liver alcohol dehydrogenase was followed in the presence of isobutyramide at various degrees of saturation of the binding sites by NADH. A study of the fluorescence enhancement which is observed when an excess of NADH is added to the partially denatured mixtures provides information regarding the relative concentrations of mono- and bioccupied enzyme molecules. This approach is of value in situations when the association constants for coenzyme are so large that the concentration of the free ligand is negligible. The results obtained indicate that the binding of NADH to liver alcohol dehydrogenase follows the statistically predicted distribution. At the same time evidence was obtained for interaction between the two subunits of the enzyme.


Intra-abdominal fibromatosis: differentiation from gastrointestinal stromal tumour based on biphasic contrast-enhanced CT findings.
To identify the computed tomography (CT) criteria that differentiate intra-abdominal fibromatosis (IAF) from gastrointestinal stromal tumour (GIST). CT images of 34 pathologically proven cases of IAF (n = 15) and GIST (n = 19) were retrospectively reviewed. Location, contour, border, enhancement pattern, presence of necrosis, vessels, and air within the lesion were analysed. Long diameter (LD), short diameter (SD), LD/SD ratio, degree of enhancement, and lesion/aorta (L/A) CT attenuation ratio were measured and calculated. Significant CT criteria were identified using Fisher's exact test, grouped t-test, and receiver operating characteristic (ROC) curve. Sensitivity and specificity values were calculated when single or multiple CT criteria were used. Extra-gastrointestinal location, ovoid or irregular contour, homogeneous enhancement, absence of intra-lesional necrosis, lower degree of enhancement, and L/A CT attenuation ratio differentiated IAF from GIST (p < 0.05). When any three of these eight criteria were combined, the sensitivity and specificity for diagnosing IAF were 100% (15 of 15) and 89.5% (17 of 19), respectively. The following eight CT criteria are helpful to differentiate IAF from GIST: extra-gastrointestinal location, ovoid or irregular contour, homogeneous enhancement, absence of intra-lesional necrosis, a degree of enhancement of less than 40.5 HU in the arterial phase versus 46.5 HU in the portal venous phase, and an L/A CT attenuation ratio <0.315 in the arterial phase versus 0.525 in the portal phase.


Polytheonamide biosynthesis showcasing the metabolic potential of sponge-associated uncultivated 'Entotheonella' bacteria.
The vast majority of microorganisms on the planet have not been grown under laboratory conditions due to unknown metabolic and environmental constraints. This uncultivated majority has enormous potential as a reservoir of unique enzymology and biosynthetic pathways. The following review offers a glimpse into this unexplored enzymatic stockpile through recent progress made on the biosynthesis of the potent polytheonamide cytotoxins. These structurally highly complex pore-forming peptides, isolated from the marine sponge Theonella swinhoei, are synthesized by the ribosome and then modified through numerous unusual transformations including iterative epimerase and N-methyltransferase activities. The bacterial source of these metabolites was identified as the taxonomically remote, uncultivated sponge symbiont 'Entotheonella factor' with a biosynthetic prowess that rivals those of industrially exploited microorganisms.


Ball bearing (BB) guns, ease of purchase and potential for significant injury.
Ball bearing guns are used in the UK for war games, but they have the potential to cause severe injury if used incorrectly. A search was made for availability of these weapons, the ease of purchase and the potential for tissue damage. These weapons are widely available on the Internet and are easy to purchase with no security checks. Once fully charged, an electric BB gun is capable of penetrating a cadaveric animal model at distances up to 5 m (1 m = 25 mm penetration, 3 m = 20 mm penetration, 5 m = 15 mm penetration). BB guns are not toys and have a significant potential to cause injury.


Diversity, structure and function of the coiled-coil domains of plant NLR immune receptors.
Plant nucleotide-binding, leucine-rich repeat receptors (NLRs) perceive pathogen avirulence effectors and activate defense responses. Nucleotide-binding, leucine-rich repeat receptors are classified into coiled-coil (CC)-containing and Toll/interleukin-1 receptor (TIR)-containing NLRs. Recent advances suggest that NLR CC domains often function in signaling activation, especially for induction of cell death. In this review, we outline our current understanding of NLR CC domains, including their diversity/classification and structure, their roles in cell death induction, disease resistance, and interaction with other proteins. Furthermore, we provide possible directions for future work.


Incorporation, metabolism and positional distribution of trans-unsaturated fatty acids in developing and mature brain. Comparison of elaidate and oleate administered intracerebrally.
Mixtures of [1-14C]elaidic acid and [9,10-3H]oleic acid, as well as [1-14C]elaidic or [1-14C]oleic acid alone, were administered by intracerebral injection to 10-day old and adult rats to examine the relative incorporation and metabolism of trans- and cis-monounsaturated fatty acids in developing and mature brain. Rates and extents of total incorporation of label from trans- and cis-acid into complex lipids were similar. Maximum labeling of the neutral lipid, mainly triacylglycerol and cholesterol, occurred prior to 4 h after injection whereas phospholipid, mainly choline phosphoglyceride, was maximally labeled at 4--8 h after injection. The decrease in labeled phospholipid from 24 to 90 h was greater with elaidate than with oleate. At 8 h labeled elaidic acid was preferentially esterified in the 1-position of all phosphoglycerides whereas labeled oleic acid, in contrast to the positional distribution of endogenous oleate, was randomly distributed. Label from elaidate found in palmitate increased with time to 26% of the total recovered label by 48 h. Thus, although some of the trans-fatty acid is oxidized and its labeled carbon is redistributed, most is incorporated unaltered into complex lipid of brain at rates similar to those for its cis-isomer. The developing central nervous system, therefore, does not metabolically exclude the trans-acid, elaidic acid, from membrane lipids.


Influence of Attachment Anxiety on the Relationship between Loneliness and Depression among Long-Term Care Residents.
Attachment styles influence an individual's ability to maintain relationships throughout their lifespan. Insecure attachment has been associated with many aspects of mental health. The study aimed to explore the influence of attachment on loneliness and depression among old-age residents in long-term care facilities. A survey was conducted among residents from long term care facilities (LTC) in Thailand during the COVID-19 pandemic; 221 older people participated in the study. The mean aged was 73.60 ± 7.45 years old, and 57.5% female. All participants completed the Geriatric Depression Scale, the six-item revised version of the University of California Los Angeles Loneliness Scale, and the Revised Experience of Close Relationships questionnaire to measure depressive symptoms, loneliness, and attachment style. Hierarchical multiple regression analysis was performed to find the predictors for depressive symptoms. In all, 40.7% of residents in LTC facilities experienced depression. Male sex, education, loneliness, and attachment anxiety predicted the increased level of depressive symptoms. Loneliness was confirmed to be significantly associated with depressive symptoms, and attachment anxiety was found to be a strong predicting factor of depressive symptoms. Intervention and research regarding reducing loneliness and attachment anxiety should be promoted in LTC settings.


Prevalence of refractive errors among pre-school children at King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Vision disorders are the fourth most common disability of children and the leading cause of handicapping conditions in childhood. The present study was undertaken to identify the prevalence and pattern of refractive errors among the school-entrant children at King Abdul Aziz Medical City (KAMC), Riyadh city - Kingdom of Saudi Arabia. The study population consisted of all the school-entrants (n = 1319), who attended the obligatory health examination for kindergarten and primary school entry during the period from March 2008 until October 2008. Every child was subjected to a 10 min - visual acuity test (VAT) and autorefractive test applied by qualified optometrist. Children with a visual acuity of 20/28 or worse in one or both eyes, or with eye disorder (strabismus, nystagmus, ptosis and others) or abnormal ocular movement, were referred for a 45 min complete ophthalmic examination, which consists of: (1) Distance visual acuity (V/A), (2) cover - uncover test, and (3) non-cycloplpegic retinoscopy. Refractive error cut-off point was defined according to their spherical equivalent refractive error (SERE). Out of the 1319 children, 60 children were diagnosed as having one or more refractive error, with an over-all prevalence of 4.5% (4.2% in boys and 4.9% in girls) with no sex difference. Prevalence of different refractive errors were as follows; Myopia (2.5%, 95%CI1.7:3.3%), hyperopia (2.1%, 95%CI 1.3:2.9%), astigmatism (2.5%, 95%CI 1.7:3.3%), amblyopia (0.5%, 95%CI 0.1:0.9%) and strabismus (0.5%, 95% CI 0.1:0.9%). Our results raise the need for school-based program that provides prescription glasses when needed to students at no cost, through government and non-governmental collaborative fund. However, there is a need for further studies to evaluate the cultural beliefs towards the use of spectacles in Saudi communities.


Spatiotemporal synchronization of biped walking patterns with multiple external inputs by style-phase adaptation.
In this paper, we propose a framework for generating coordinated periodic movements of robotic systems with multiple external inputs. We developed an adaptive pattern generator model that is composed of a two-factor observation model with a style parameter and phase dynamics with a phase variable. The style parameter controls the spatial patterns of the generated trajectories, and the phase variable manages its temporal profiles. By exploiting the style-phase separation in the pattern generation, we can independently design adaptation schemes for the spatial and temporal profiles of the pattern generator to multiple external inputs. To validate the effectiveness of our proposed method, we applied it to a user-exoskeleton model to achieve user-adaptive walking assistance for which the exoskeleton robot's movements need to be coordinated with the user walking patterns and environment. As a result, the exoskeleton robot successfully performed stable biped walking behaviors for walking assistance even when the style of the observed walking pattern and the period were suddenly changed.


PKCα promotes the mesenchymal to amoeboid transition and increases cancer cell invasiveness.
The local invasion of tumor cells into the surrounding tissue is the first and most critical step of the metastatic cascade. Cells can invade either collectively, or individually. Individual cancer cell invasion can occur in the mesenchymal or amoeboid mode, which are mutually interchangeable. This plasticity of individual cancer cell invasiveness may represent an escape mechanism for invading cancer cells from anti-metastatic treatment. To identify new signaling proteins involved in the plasticity of cancer cell invasiveness, we performed proteomic analysis of the amoeboid to mesenchymal transition with A375m2 melanoma cells in a 3D Matrigel matrix. In this screen we identified PKCα as an important protein for the maintenance of amoeboid morphology. We found that the activation of PKCα resulted in the mesenchymal-amoeboid transition of mesenchymal K2 and MDA-MB-231 cell lines. Consistently, PKCα inhibition led to the amoeboid-mesenchymal transition of amoeboid A375m2 cells. Next, we showed that PKCα inhibition resulted in a considerable decrease in the invading abilities of all analyzed cancer cell lines. Our results suggest that PKCα is an important protein for maintenance of the amoeboid morphology of cancer cells, and that downregulation of PKCα results in the amoeboid to mesenchymal transition. Our data also suggest that PKCα is important for both mesenchymal and amoeboid invasiveness, making it an attractive target for anti-metastatic therapies.


Short-term increase of body weight triggers immunological variables in dogs.
Overweight in dogs is, as in other companion animals, a major risk factor for several metabolic disorders. However, it is not yet known whether immunity is challenged by increased body weight in dogs. The aim of this study was to investigate the effect of a short-term increase in body weight on immunological variables in adult healthy beagle dogs. Sixteen dogs, divided into a control group (CG) and weight gain group (WGG), were included. During a period of 13 weeks, the CG was fed at maintenance energy requirement (MER), whereas the WGG received a double amount of food. After 13 weeks, blood samples were taken for immunological and biochemical analyses. Weight gain and increased body condition score in the WGG were accompanied by a significant higher leptin concentration. Weight gain increased the number of lymphocytes and immunoglobulins A and M and was responsible for a higher proliferation of peripheral blood mononuclear cells (PBMC). Short-term increase of body weight thus seems to trigger immunological variables in dogs.


Resuscitation with hydroxyethyl starch solution prevents CD4+ T-lymphocyte apoptosis and modulates the balance of T helper type 1 and T helper type 2 responses in the rat with traumatic virgule/shill hemorrhagic shock.
Trauma/hemorrhagic shock (TH/S) has been associated with inflammation and immunodisorders, leading to immunosuppression, multiorgan dysfunction, and death. However, little is known about the effect of resuscitation with different solutions on the immunological function. To address this issue, groups of male Sprague-Dawley rats were induced with TH/S by fracture in the left femur and continual bleeding to keep the MAP of 30 +/- 5 mmHg for 30 min, followed by resuscitation with 6% hydroxyethyl starch solution (HES), Ringer's lactate solution (RS), or 5% albumin (ALB), and the impact of resuscitation on the activation, differentiation, and survival of CD4 T cells was longitudinally examined after TH/S and resuscitation. After resuscitation, the MAP, as expected, gradually increased regardless of the type of fluids transfused. The percentage of CD4+ T cells decreased to 20% to 25%, and the ratio of T helper type 1 (TH1)/TH2 responses was significantly reduced in all TH/S rats, however, resuscitation with HES alone reversed the trends (49.4% +/- 9.7% vs. 55.2% +/- 2.6% in sham for CD4 T cells; 0.64 +/- 0.23 vs. 0.71 +/- 0.16 in sham for the ratio of TH1/TH2, P > 0.05 for both). Treatment with HES or ALB, but not RS, prevented CD4 T-cell apoptosis (sham, 7.23% +/- 3.4%; HES, 10.2% +/- 4.1%; RS, 15.2% +/- 5.4%; ALB, 10.6% +/- 4.3%; 48 h) and nuclear factor-kappaB p65 activation (sham, 0.17 +/- 0.04; HES, 0.34 +/- 0.05; RS, 0.41 +/- 0.09; ALB, 0.25 +/- 0.09; 48 h) induced by TH/S early after resuscitation. These data demonstrated that HES resuscitation modulated the balance of TH1 and TH2 responses and inhibited TH/S-related nuclear factor-kappaB activation and CD4 T-cell apoptosis in TH/S rats. Our findings provide new insights into understanding the TH/S-related immunodisorders and may aid in the design of new therapy for intervention of TH/S.


Parkinson's disease. Quality of life issues.
PD affects many dimensions of quality of life. This article has identified motor and nonmotor features of PD that are directly related to a patient's quality of life. Medication therapy can help to ameliorate some of the symptoms, yet side effects can be as disabling as the symptoms of PD. Nursing care should include assessment, intervention, and evaluation of both physical and psychosocial aspects of care for patients with PD to assist them in achieving maximum functioning.


Necessary but not sufficient: motion perception is required for perceiving biological motion.
Researchers have argued that biological motion perception from point-light animations is resolved from stationary form information. To determine whether motion is required for biological motion perception, we measured discrimination thresholds at isoluminance. Whereas simple direction discriminations falter at isoluminance, biological motion perception fails entirely. However, when performance is measured as a function of contrast, it is apparent that biological motion is contrast-dependent, while direction discriminations are contrast invariant. Our results are evidence that biological motion perception requires intact motion perception, but is also mediated by a secondary mechanism that may be the integration of form and motion, or the computation of higher-order motion cues.


Ground surface settlement analysis of shield tunneling under spatial variability of multiple geotechnical parameters.
This paper presents an efficient method of shield tunneling reliability analysis using spatial random fields. We introduced two stochastic methods into numerical simulation. The first one computes the maximal ground surface settlement using classical statistics, in which the response surface method is utilized to calculate the failure probability by first-order second moment. Cohesion, internal friction angle, Young's modulus and mechanical model factor are considered as random variables. The second method is the spatial random fields of aforementioned three key geotechnical parameters. Using these two methods, similar multiple soil layers are converted into a stationary random field by local regression as the first step, and then the process is followed by the spatially conditional discretization of multivariate. Failure probability of maximal ground surface settlement is calculated by a subset Monte-Carlo Algorithm. This approach is applied into the four-overlapping shield tunnels of the 5th and 6th metro lines intersecting at Huanhu W Rd station, Tianjin China. The failure analysis results indicated that classical statistics of geotechnical parameters showing higher variability than spatial random fields, which substantially support the complex shield tunneling project.


Antibiotics along an alpine river and in the receiving lake with a catchment dominated by grazing husbandry.
The livestock breeding industries face overuse of antibiotics, which has been intensively studied in recent years. However, the occurrence and fate of antibiotics as well as their potential threats to the aquatic environments in alpine and arid regions remain unclear. This study investigated the relationship of the occurrence and concentrations of antibiotics between the Kaidu River and Bosten Lake in a typical alpine basin in China. Hot spots with antibiotic pollution source were explored. The antibiotic concentrations in river water and suspended sediment (SPS) were 2.20-99.4 ng/L and 1.03-176 ng/g. The dominant antibiotics were tetracyclines, sulphacetamide, and ofloxacin in river water and sulfonamides, clarithromycin, roxithromycin, and ofloxacin in SPS. The apparent differences in pollution sources and landscapes in different reaches led to the obvious spatial patterns of antibiotics in the Kaidu River. Higher partition coefficient of antibiotic between SPS and water phases for sulfonamides than tetracyclines was because that tetracyclines strongly responded to clay contents while sulfonamides significantly responded to organic carbon contents in SPS. There were significant differences in detected antibiotic categories between the river and the lake. Fluoroquinolones (especially ciprofloxacin and enrofloxacin) were detected in the lake while sulphacetamide was only detected in the river. Therefore, the surrounding husbandry and aquaculture around the Bosten Lake was an important antibiotic pollution source in addition to inputs from the Kaidu River. This research suggested that alpine lakes could be an important sink of antibiotics in alpine dry regions, and thus impose greater threats to the aquatic ecosystem.


Virtual pain stimulation of allodynia patients activates cortical representation of pain and emotions: a functional MRI study.
The present study investigated neural correlates of affect processing in allodynia patients (n=8) and healthy controls (n=12) with the aid of virtual tactile stimulation. Whole brain functional magnetic resonance imaging was performed for allodynia patients and healthy volunteers while they were shown a video demonstrating light stimulation of the palm and another stimulation aimed at producing anticipation of palm stimulation. Contrasting with controls, patients displayed activation of the cortical areas related to pain and emotions: prefrontal cortex (Brodmann's area BA 10) and anterior cingulate cortex (BA 24). These findings may indicate involvement of an emotional component of pain perception in all odynia patients.


A phase II clinical trial of toripalimab combined with neoadjuvant chemoradiotherapy in locally advanced esophageal squamous cell carcinoma (NEOCRTEC1901).
To evaluate the efficacy and safety of toripalimab combined with neoadjuvant chemoradiotherapy (NCRT) for locally advanced esophageal squamous cell carcinoma (ESCC). In this single arm, phase II trial, 44 ESCC patients were enrolled from December 2019 to July 2021 at Sun Yat-sen University Cancer Center (Guangzhou, China). All patients received concurrent radiotherapy (44 Gy in 20 fractions), chemotherapy (paclitaxel 50 mg/m2 and cisplatin 25 mg/m2 on days 1, 8, 15, and 22), and toripalimab (240 mg on days 1 and 22). Within 6-8 weeks of neoadjuvant treatment, patients underwent surgery. The results of the study patients were compared with those of 86 matched patients between July 2015 and March 2022. The primary endpoint was pathological complete response (pCR) rate, and the secondary endpoints were treatment-related adverse events and R0 rates. This trail was registered with ClinicalTrails.gov, NCT04006041. All patients received neoadjuvant treatment, and 42 completed esophagectomy. Of the 42 patients, 21 (50%; 95% CI 35-65) achieved pCR and 2 (5%) patients were ypT0N+. The R0 resection rate was 98% (41/42). Nine (20%) of 44 patients had grade 3/4 adverse events. Among the perioperative complications (n = 42), anastomotic leakage occurred in five cases (12%), tracheal fistula in three cases (7%), and postoperative death in one case (2%) due to tracheal fistula. Compared with the control cohort, the pCR rate of the study group was higher but without significant difference (50% vs. 36%, P = 0.19). Toripalimab combined with NCRT failed to show significantly better pCR rate than historical data. Nevertheless, considering the signs of efficacy and acceptable safety of this regimen, further evaluation in phase III randomized trials might be warranted. National Natural Science Foundation of China.


Rapid changes in the expression of a gene encoding a calcium-binding protein in Schistosoma mansoni.
Genes expressed in a stage-specific manner may help us understand the molecular events controlling the complex life cycle of schistosomes. cDNA and genomic clones encoding a calcium-binding protein (CaBP) were obtained from cercariae and their sequence determined. The encoded protein (69 amino acids long) shows clear resemblance to the domain structure and organization of CaBP molecules. It contains two typical calcium-binding loops, the distance between which is identical to the length conserved in other CaBP molecules. In addition, the schistosome CaBP shows Ca2+-dependent electrophoretic mobility (increased with Ca2+-ions and decreased with EGTA). Northern blots revealed expression of the CaBP gene in cercariae but not in sporocyst or worm (developmental stages preceding and following cercaria). The preferential expression of this CaBP in the cercaria raises questions as to what cercaria-specific function(s) it performs. The structure of the gene is similar to that in other eukaryotes, and one intron interrupts the coding sequence. The region of the cap site was determined, and there was no evidence of the spliced leader sequence found in the mRNAs of other parasites. The CaBP reveals a rapid change in gene expression, since the mRNA is missing in the parasite residing in infected snails, but is readily detected in cercariae 1 h after shedding. We identified other genes which are turned on (like the CaBP) or shut off within the short period of transition from cercariae in the snail to free-swimming cercariae.


Variations in arsenic methylation capacity and oxidative DNA lesions over a 2-year period in a high arsenic-exposed population.
To assess long-term variations in arsenic methylation and oxidative DNA lesions of chronic high arsenic-exposed populations. A follow-up study was conducted in 64 chronic high arsenic-exposed subjects from 2004 to 2006. Urinary arsenic species and 8-hydroxydeoxyguanine were measured. Percentages of urinary inorganic arsenic, monomethylarsonate and urinary 8-hydroxydeoxyguanine (8-OHdG) level were significantly higher, but the percentage of dimethylarsinate, the primary methylation index (PMI) and secondary methylation index (SMI) was lower in the ninth year of arsenic exposure compared with the seventh year. Substantial differences in relative arsenic methylation capacity were observed between the seventh and ninth year. Percentages of arsenic species, PMI and SMI were significantly correlated between siblings, and between parents and children. Arsenic methylation may decrease, but oxidative DNA lesions may increase with the increase of cumulative arsenic exposure level. Both genetic and environmental factors may contribute to variability in arsenic methylation.


Metastasis suppressor pathways--an evolving paradigm.
A greater understanding of the processes of tumor invasion and metastasis, the principal cause of death in cancer patients, is essential to determine newer therapeutic targets. Metastasis suppressor genes, by definition, suppress metastasis without affecting tumorigenicity and, hence, present attractive targets as prognostic or therapeutic markers. This short review focuses on those twelve metastasis suppressor genes for which functional data exist. We also outline newly identified genes that bear promising traits of having metastasis suppressor activity, but for which functional data have not been completed. We also summarize the biochemical mechanism(s) of action (where known), and present a working model assembling potential metastasis suppression pathways.


Generalized oedema of newborn associated with the administration of dipyrone.
In fourteen infants, aged 9--60 days, with generalized oedema seen during a one year period the common denominator was the administration of dipyrone one to two days prior to the development of oedema. None of the other causes of oedema in early life could be incriminated in any of these babies. Pediatricians should be aware of this iatrogenic cause whenever they encounter a young infant with generalized oedema. Oedema disappeared in all the cases following discontinuation of dipyrone but anuria lasted for more than four days in one case. This stydy re-emphasizes the need to without this potentially dangerous drug, especially during the neonatal period.


The role of nerve growth factor in neuropathic pain inhibition produced by resiniferatoxin treatment in the dorsal root ganglia.
Resiniferatoxin (RTX), an excitotoxic agonist for vanilloid receptor 1, is a promising candidate for intractable pain treatment. We evaluated the effects of RTX, applied to dorsal root ganglia (DRG) at high doses (1200 ng), in sensory-motor function and nerve growth factor (NGF) alterations in a photochemical sciatic nerve injury rat model. Following RTX injection into the L3-6 DRG at high doses and behavioral evaluation, the rats were sacrificed and the DRG were tested by immunohistochemistry and mRNA analysis for NGF and its' receptors, tyrosine kinase A (TrkA) and p75. The correlation between neuropathic pain and NGF, TrkA, and p75 expression was analyzed. The treated rats had preserved touch, cold, pain, and high-heat sensations, and exhibited hypoalgesia to low-heat stimulation. After RTX treatment, TrkA and p75 altered their expressions from one neuronal type to another in the DRG. NGF and p75 expression changed from the small-size neurons in neuropathic rat DRG to the large- and medium-size neurons in non-neuropathic and RTX-treated animals, concomitantly with neuropathic pain suppression. TrkA was expressed in the small-size neurons in neuropathic rat DRG, and was drastically reduced in all size neurons after RTX treatment. NGF, TrkA, and p75 mRNA expression supported these phenotypic changes in the DRG. The pathway of NGF-TrkA expressed in the small-size neurons, associated with neuropathic pain, was shifted to the NGF-p75 pathway expressed in the large-size neurons after RTX treatment, in association with neuropathic pain inhibition. These findings may play an important role in clinical trial designs.


Association of psychosocial work characteristics with low back pain outcomes.
This is a secondary analysis of a prospective cohort of 295 patients with acute low back pain presenting to 31 primary care physicians in North Carolina. This study examines the hypothesis that dissatisfaction with job tasks and lack of social support from coworkers and supervisor are associated with poorer low back pain outcomes. Psychosocial work characteristics are thought to be associated with the occurrence, report, and development of long-term disability from low back pain, but the studies are inconclusive. METHOD.: Three psychosocial work characteristics were separately compared to these outcomes: time to functional recovery, attainment of complete recovery, and clinically relevant change on the Modified Roland Scale. Relative to subjects with more social support from coworkers, subjects with less social support from coworkers have 1.55 (95% CI = 1.04-2.34) times the risk of not attaining complete recovery from low back pain at 8 weeks. For all other outcomes evaluated in this study, there was not an association with the psychosocial work characteristics. Biomechanical demands were found not to modify this association. This analysis provides evidence that social support in the workplace from coworkers but not social support from a supervisor or job task satisfaction are likely targets for intervention.


Naltrexone moderates the association of alcohol use and affect among adolescent drinkers in daily life.
Naltrexone is an efficacious medication for the treatment of alcohol use disorder in adults. As an opioid receptor antagonist, naltrexone blocks activation of the endogenous opioid system, which is involved in the affectively reinforcing properties of substance use. Few studies, however, have examined the moderating effect of naltrexone on the association between affect and alcohol use. Additionally, most existing research on naltrexone has been with adults in the human laboratory. We conducted a secondary analysis of ecological momentary assessment data from a randomized, double-blinded, placebo-controlled cross-over study that compared naltrexone (50 mg/daily) and placebo in 26 adolescents (15 to 19 years old) who exhibited problematic drinking patterns. Multilevel models tested whether naltrexone moderated associations of alcohol use with both positive and negative affect (PA, NA). Results indicated that, during naltrexone treatment, greater estimated blood alcohol concentration (eBAC) levels were associated with greater NA further into drinking episodes. In turn, greater NA after the first drink of an episode was associated with reduced subsequent eBAC values during naltrexone treatment. Low PA was also associated with lower subsequent eBAC levels in the naltrexone condition after the first drink. These findings support the idea that naltrexone can disrupt the association between affect and alcohol use, effects that emerge later in drinking episodes. Greater attention to the effects of naltrexone on affect and reinforcement may help to tailor psychotherapy to maximize the benefits of naltrexone. However, in the present study, as most drink reports were in the first 2 h of the drinking episode and participants reported affect only at the first three end-drink reports of a drinking episode (limiting the number of drinks reported), we had reduced power to detect effects in the continuation phase. Thus, replication of the findings is needed using a design that assesses the impact of naltrexone across the entire episode.


Production of bioactive films of carboxymethyl cellulose enriched with green coffee oil and its residues.
Carboxymethyl cellulose (CMC)-based films were developed by incorporating green coffee oil (GCO) obtained by cold pressing and hydroalcoholic extracts of its residues. The effect of cake (CE) and sediment extracts (SE) in different proportions (20-40%) and GCO on chemical, morphological, physical, mechanical, optical, and antioxidant properties of the films was investigated. Eight fatty acids and four major phenolic compounds were identified by High-Resolution Direct-Infusion Mass Spectrometry in GCO and residue extracts. FTIR indicated interactions among CMC, phenolic compounds, and fatty acids. Films enriched with residue extracts presented heterogeneous microstructure. The tensile strength of the films decreased from 58 to 3 MPa with the extracts concentration, while elongation increased from 28 to 156% (p < 0.05). The water vapor permeability (averaging 3.94 × 10-8 g mm/cm2 h Pa) was not significantly affected by the extracts and GCO. The surface color was influenced by the type and concentration of extracts (p < 0.05), the film with SE40% had remarkable UV-vis barrier properties. The incorporation of GCO residue extracts imparted high antioxidant capacity to the CMC-based films, especially with CE40% (643.8 µmol Trolox eq./g dried film; 51.3 mg GAE/g dried film). General observations indicated the potential of these films, mainly the ones containing CE, like active packaging material for food applications.


Humoral immune response after COVID-19 infection or BNT162b2 vaccine among older adults: evolution over time and protective thresholds.
The objectives of this study were to assess the dynamics of the SARS-CoV-2 anti-RBD-IgG response over time among older people after COVID-19 infection or vaccination and its comparison with indicative levels of protection. Geriatric patients with SARS-CoV-2 serological test results were included and divided into three groups. A vaccine group (n = 34), a group of natural COVID-19 infection (n = 32), and a group who contracted COVID-19 less than 15 days after the first injection (n = 17). Eighty-three patients were included; the median age with IQR was 87 (81-91) years. In the vaccine group at 1 month since the first vaccination, the median titer of anti-RBD-IgG was 620 (217-1874) BAU/ml with 87% of patients above the theoretical protective threshold of 141 BAU/ml according to Dimeglio et al. (J Infec. 84(2):248-88, [7]). Seven months after the first vaccination, this titer decreased to 30 (19-58) BAU/ml with 9.5% of patients > 141 BAU/ml. In the natural COVID-19 infection group, at 1 month since the date of first symptom onset, the median titer was 798 (325-1320) BAU/ml with 86.7% of patients > 141 BAU/ml and fell to 88 (37-385) with 42.9% of patients > 141 BAU/ml at 2 months. The natural infection group was vaccinated 3 months after the infection. Five months after the vaccination cycle, the median titer was 2048 (471-4386) BAU/ml with 83.3% of patients > 141 BAU/ml. This supports the clinical results describing the decrease in vaccine protection over time and suggests that vaccination after infection can maintain significantly higher antibody titer levels for a prolonged period of time.


Estrogen- and xenoestrogen-induced ERK signaling in pituitary tumor cells involves estrogen receptor-α interactions with G protein-αi and caveolin I.
Multiple physiologic estrogens (estradiol, estriol, and estrone), as well as xenoestrogenic compounds (including alkylphenols and bisphenol A), can act via nongenomic signaling initiated by liganding of the plasma membrane estrogen receptor-α (mERα). We examined heterotrimeric G protein involvement leading to extracellular-regulated kinase (ERK) activation in GH3/B6/F10 rat anterior pituitary tumor cells that express abundant mERα, and smaller amounts of mERβ and GPR30. A combination of microarrays, immunoblots, and quantitative immunoassays demonstrated the expression of members of all α, β, and γ G protein classes in these cells. Use of selective inhibitors showed that the G(αi) subtype was the primary initiator of downstream ERK signaling. Using antibodies against the GTP-bound form of G(α) protein subtypes i and s, we showed that xenoestrogens (bisphenol A, nonylphenol) activated G(αi) at 15-30s; all alkylphenols examined subsequently suppressed activation by 5min. GTP-activation of G(αi) for all estrogens was enhanced by irreversible cumulative binding to GTPγS. In contrast, G(αs) was neither activated nor deactivated by these treatments with estrogens. ERα and G(αi) co-localized outside nuclei and could be immuno-captured together. Interactions of ERα with G(αi) and caveolin I were demonstrated by epitope proximity ligation assays. An ERα/β antagonist (ICI182780) and a selective disruptor of caveolar structures (nystatin) blocked estrogen-induced ERK activation. Xenoestrogens, like physiologic estrogens, can evoke downstream kinase signaling involving selective interactions of ERα with G(αi) and caveolin I, but with some different characteristics, which could explain their disruptive actions.


Morphological analysis of the acute effects of overdistension on the extracellular matrix of the rat urinary bladder wall.
To investigate the morphological effects of acute overdistension in the structure of the extracellular matrix of the bladder wall in rats. The bladders of a group of 6 male Wistar rats were transurethrally overdistended for 3 hours. Another identical group (the control group) was only submitted to a sham operation. Specimens from the bladder dome were analyzed with light microscopy (LM), transmission electron microscopy (TEM) and scanning electron microscopy (SEM). LM--The control group bladders had a 4 to 5 layer urothelium, a lamina propria, and a smooth muscle layer with longitudinal and transversal fibers. The overdistended bladders presented an intense interstitial infiltrate in the lamina propria, and a less intense infiltrate among the smooth muscle fibers. TEM--The cells of the overdistended bladders had a significant amount of vacuoles, unlike the control bladders, where such vacuoles were scarce or absent. SEM--A delicate three-dimensional mesh of collagen fibrils was observed in the lamina propria of the bladder walls from the control group. Whilst for the control group this mesh consisted of distinct geometric structures, with mostly circular cellular spaces surrounded by the fibrils, the overdistended group showed evidence of distortion of the mesh, with flattened and elongated cellular spaces. Acute bladder overdistension induces structural modifications, altering the arrangement and interaction of collagen fibrils, as well as incipient tissue damage as edema in the lamina propria and smooth muscle layers.


Genomic approaches reveal unexpected genetic divergence within Ciona intestinalis.
The invertebrate chordate Ciona intestinalis is a widely used model organism in biological research. Individuals from waters ranging from arctic to temperate are morphologically almost indistinguishable. However, we found significant differences in whole genomic DNA sequence between northern European and Pacific C. intestinalis. Intronic and transposon sequences often appear unrelated between these geographic origins and amino acid substitutions in protein coding sequences indicate a divergence time in excess of 20 MYA. This finding suggests the existence of two cryptic species within the present C. intestinalis species. We found five marker loci which distinguish the two genetic forms by PCR. This analysis revealed that specimens from Naples, Italy, have the Pacific-type genome, perhaps due to human-mediated marine transport of species. Despite major genomic divergence, the two forms could be hybridized in the laboratory.


Low HIV-1 proviral DNA burden detected by negative polymerase chain reaction in seropositive individuals correlates with slower disease progression.
During 1989, 316 members of a cohort of homosexual men were tested for HIV-specific DNA by the polymerase chain reaction (PCR) using a pair of gag-region primers. Of 125 HIV-seronegative subjects, 123 (98.4%) were PCR-negative while 158 (82.7%) of 191 HIV-seropositive subjects were PCR-positive. Fewer of the 33 subjects who were seropositive and PCR-negative were at Centers for Disease Control (CDC) stage IV than the seropositive, PCR-positive subjects (6 versus 25%; P = 0.030). The seropositive, PCR-negative group had higher mean CD4 counts (640 versus 490 x 10(6) cells/l; P = 0.006), higher CD4: CD8 ratios (0.92 versus 0.64; P = 0.004), lower immunoglobulin (Ig) G levels (1290 versus 1645 mg/dl; P = 0.002), lower IgA levels (168 versus 251 mg/dl; P less than 0.001), and lower C1q binding activity (8 versus 14%; P = 0.010) than the seropositive, PCR-positive subjects. The median rate of CD4 cell decline in the 3 years preceding the PCR sample was less marked in the seropositive, PCR-negative group than the seropositive, PCR-positive group (-58 versus -77 x 10(6) cells/l per year; P = 0.028). To control for duration of infection, we restricted the analysis to the subgroups of 11 seropositive, PCR-negative subjects and 34 seropositive, PCR-positive subjects who had seroconverted earlier in the cohort study. Both subgroups had similar durations of infection, yet the same pattern of differences persisted.(ABSTRACT TRUNCATED AT 250 WORDS)


[Comparison of "home treatment" with traditional inpatient treatment in a mental hospital in rural southern Germany].
To investigate the clinical effectiveness of "Home Treatment" (HT) in comparison to the usual inpatient treatment in patients with acute psychiatric illness. In a prospective observational study we compared 60 of our HT patients to 18 patients receiving inpatient treatment as usual (TAU) with regard to psychopathological symptoms (PANSS, HAM-D 21), global functioning (GAF), symptom severity (HoNOS-D) and sociodemographic parameters at admission and discharge. HT was a feasible alternative in patients with several different psychiatric diagnoses and appeared to be similar to TAU in view of clinical effectiveness. In potentially suitable patients fulfilling criteria of hospital admission, the alternative of HT can be actively considered.


Impact of preventive primary care on children's unplanned hospital admissions: a population-based birth cohort study of UK children 2000-2013.
Universal health coverage (UHC) aims to improve child health through preventive primary care and vaccine coverage. Yet, in many developed countries with UHC, unplanned and ambulatory care sensitive (ACS) hospital admissions in childhood continue to rise. We investigated the relation between preventive primary care and risk of unplanned and ACS admission in children in a high-income country with UHC. We followed 319,780 children registered from birth with 363 English practices in Clinical Practice Research Datalink linked to Hospital Episodes Statistics, born between January 2000 and March 2013. We used Cox regression estimating adjusted hazard ratios (HR) to examine subsequent risk of unplanned and ACS hospital admissions in children who received preventive primary care (development checks and vaccinations), compared with those who did not. Overall, 98% of children had complete vaccinations and 87% had development checks. Unplanned admission rates were 259, 105 and 42 per 1000 child-years in infants (aged < 1 year), preschool (1-4 years) and primary school (5-9 years) children, respectively. Lack of preventive care was associated with more unplanned admissions. Infants with incomplete vaccination had increased risk for all unplanned admissions (HR 1.89, 1.79-2.00) and vaccine-preventable admissions (HR 4.41, 2.59-7.49). Infants lacking development checks had higher risk for unplanned admission (HR 4.63, 4.55-4.71). These associations persisted across childhood. Children who had higher consulting rates with primary care providers also had higher risk of unplanned admission (preschool children: HR 1.17, 1.17-1.17). One third of all unplanned admissions (62,154/183,530) were for ACS infectious illness. Children with chronic ACS conditions, asthma, diabetes or epilepsy had increased risk of unplanned admission (HR 1.90, 1.77-2.04, HR 11.43, 8.48-15.39, and HR 4.82, 3.93-5.91, respectively). These associations were modified in children who consulted more in primary care. A high uptake of preventive primary care from birth is associated with fewer unplanned and ACS admissions in children. However, the clustering of poor health, a lack of preventive care uptake, and social deprivation puts some children with comorbid conditions at very high risk of admission. Strengthening immunisation coverage and preventive primary care in countries with poor UHC could potentially significantly reduce the health burden from hospital admission in children.


Two new species of subgenus Tripodura Towns (Diptera, Chironomidae, Polypedilum) from Oriental China.
P. (T.) anningense sp. n. and P. (T.) biloborum sp. n. are described and illustrated as male imagines from Oriental China. DNA barcodes of two new species are also presented. A key to known male imagines of the subgenus Tripodura from China is given.


Functional imaging of adrenal cortex.
The rising number of high-resolution imaging scans has increased the adrenal lesions detection, which require a differential diagnosis. Currently, the most commonly used scans are CT and MRI, but these are sometimes not very specific. In these cases, nuclear medicine scans with 131I-norcolesterol, 11C-metomidate and 18F-fludeoxyglucose help to differentiate benign vs. malignant lesions, to lateralize the involvement in hypersecretion disease, as well as to guide the therapeutic strategy in both unilateral and bilateral lesions.


Impact of Mass Screening on the Number of Confirmed Cases, Recovered Cases, and Deaths Due to COVID-19 in Iran: An Interrupted Time Series Analysis.
Mass screening for the coronavirus disease 2019 (COVID-19) began in Iran on March 23, 2020, with the purpose of improving early detection of patients for their own health and to prevent onward transmission to others. In this study, we evaluated the impact of the change towards mass screening on new cases reported, cases recovered, and deaths due to COVID-19. This study analyzed the daily reports on the number of new cases confirmed by polymerase chain reaction (PCR) testing, cases recovered, and deaths due to COVID-19 provided to the Ministry of Health and Medical Education of Iran. Changes in trends on these outcomes were evaluated using interrupted time series analysis. From February 19 to May 6, 2020, a total of 519544 COVID-19 tests were done and 101650 diagnoses were made (case/ test ratio 19.6%). For the same period, 6418 deaths due to COVID-19 were reported (case fatality ratio 6.3%). The number of cases detected increased significantly over the period of scale-up of mass screening (P=0.003), as did the number of recovered cases (P=0.001). The number of deaths due to COVID-19 did not change before versus after mass screening. Following the scale-up of mass screening for COVID-19 in Iran, the rate of new cases detected and reported recovered accelerated significantly. Mass screening is likely to have detected many mild and asymptomatic cases that were infectious. Our data support the role that mass screening, coupled with isolation and contract tracing, can have in slowing the COVID-19 epidemic.


Immediate function with fixed implant-supported maxillary dentures: a 12-month pilot study.
Immediate occlusal loading of dental implants in the edentulous mandible has proven to be an effective, reliable, and predictable procedure. There is little long-term data available on similar treatments in the edentulous maxilla. The purpose of this study was to evaluate the 12-month implant survival after immediate loading of 4 to 6 implants with fixed screw-retained prostheses in edentulous maxillae. Twenty-one patients, edentulous or with remaining teeth to be extracted in the maxilla, received 4 to 6 implants (n=111). The patients were restored with screw-retained fixed provisional prostheses supported by palladium-alloy frameworks within 24 hours after surgery. Insertion torques for implants were at least 40 Ncm. Implants, grouped as tapered or cylindrical screws, were placed in healed bone or extraction sockets. Implants were also classified as either vertical or off-angle. Definitive prostheses were placed after a mean healing time of 18 weeks. Radiographic examinations were made at the time of placement of provisional prostheses and 12 months later. Between-groups bone resorption was compared using 2-way ANOVA (alpha=.05). The mean follow-up time for all of the patients was 20 months (range, 13 to 28 months). The cumulative implant survival rate at the 12-month follow-up visits (after surgery) was 92.8%; the prostheses survival rate was 100%. No significant differences were found between the survival of tapered or cylindrical screw-type implants placed in postextraction sockets versus those in healed edentulous sites or between vertical and off-angle placed implants. Eight implants failed during the first 3 months, 5 of which were the most distal implants. The mean reduction in marginal bone height over the 12-month observation period was 0.84 mm (CI 95%; 0.68-0.99 mm). In this study with 12-month follow-up, 4 to 6 implants were sufficient to successfully support fixed implant screw-retained prostheses in the edentulous maxillae of 21 patients.


Promovision: designing a capacity-building program to strengthen and expand the role of promotores in HIV prevention.
This article describes the development of Promovisión, a program based on the utilization of promotores in community-based organizations (CBOs) to improve the provision of HIV prevention services to recent immigrants and Latinos who are less acculturated. Promovisión aims to demonstrate the contribution of promotores as a cost-effective strategy in HIV prevention efforts, and how promotores facilitate the formation of community, regional, and national CBO networks working collaboratively to prevent the spread of HIV in Latino communities. In addition, this article examines the interpersonal, organizational, community, and sociocultural dimensions that facilitate or hinder community mobilization, and coalition formation and growth, and how these findings shaped the final design of the program. Finally, the Promovisión program seeks to demonstrate that a promotor-based program is a culturally appropriate model for HIV prevention and care, which can be successfully implemented in community and clinical settings among ethnic populations with limited English proficiency.