Subclinical left ventricular dysfunction revealed by circumferential 2D strain imaging in patients with coronary artery disease and fragmented QRS complex.
Fragmented QRS (fQRS) complexes on a routine 12-lead electrocardiogram were associated with adverse cardiac events, including sudden death in patients with coronary artery disease (CAD). To investigate the relationship between the fQRS complex and global and regional left ventricular (LV) functions in patients with CAD. The study consisted of 176 patients (68 ± 9 years; 145 [82%] men) with CAD with narrow QRS duration and preserved LV ejection fraction (>45%). All patients underwent detailed 2-dimensional speckle-tracking echocardiography to determine global and segmental (basal, middle, and apical) LV strains and strain rates and were prospectively followed-up in the outpatient clinic. Fifty-five patients (31%) had fQRS complexes. Global, middle, and apical LV longitudinal, radial, and circumferential strains and strain rates were significantly lower in the fQRS group than in the non-fQRS group (all P <.05). Multivariate logistic regression analysis revealed that the fQRS complex was associated with decreased global circumferential strain (odds ratio 1.19; 95% confidence interval 1.06-1.33; P = .003) and multivessel disease (odds ratio 3.69; 95% confidence interval 1.35-10.08; P = .011). Kaplan-Meier analysis revealed that event-free survival for cardiac events was significantly lower in the fQRS group than in the non-fQRS group (P = .036). Our results demonstrated that the fQRS complex in patients with CAD with preserved LV ejection fraction was associated with subclinical global and regional LV dysfunctions as detected by 2-dimensional speckle-tracking imaging, and the results also predicted adverse cardiac events.


Highly sensitive fluorescent sensing platform for imidacloprid and thiamethoxam by aggregation-induced emission of the Zr(Ⅳ) metal - organic framework.
A novel luminescent UiO-66-NH2 (UN) demonstrated great potentials to sense imidacloprid (IM) and thiamethoxam (TH) pesticides with high sensitivity and desirable selectivity. The UN exhibits superb luminescence emission properties, which have been found to enhance the aggregation-induced emission (AIE) of IM and TH. The enhanced AIE of IM and TH on UN has been applied for the sensitive sensing of IM and TH, and a limit of detection (LOD) of IM was estimated to be 5.57 μg/L. LOD of TH was found to be 0.98 μg/L, respectively. Interestingly, the other neonicotinoid pesticides showed a low interference response in recognition of IM and TH. More importantly, we have further demonstrated that the UN are successfully used to sense IM and TH in real samples of fruit juice with a high recovery of 85-116%, and relative standard deviation (RSD) were from 3.42% to 16.07%.


Indium-111 WBC detection of emphysematous gastritis in pancreatitis.
We present a case of emphysematous gastritis initially detected with 111In oxine-labeled white blood cell scintigraphy and subsequently confirmed by computed tomography. Early aggressive antibiotic and supportive therapy resulted in a successful clinical outcome.


Back2Work: a new model of early vocational rehabilitation for people with spinal cord injury.
Objective The aim of this article is to describe the development of a novel evidence-based model of early intervention vocational rehabilitation (EIVR) for people with spinal cord injury (SCI). Methods An extensive literature review and background study guided the collaboration of experienced practitioners and researchers in developing and evaluating the innovative Back2Work model of EIVR for people with SCI in Queensland, Australia. The program is undergoing longitudinal mixed-methods evaluation to the end of 2023. Results The model is central to the successful implementation of the EIVR program, delivered by rehabilitation counsellors in the Queensland Spinal Injuries Unit. Back2Work includes a strong focus on maintaining and nurturing the pre-injury occupational bond between injured workers and employers, and aims to create a positive expectation for return to work (RTW) and increase the rate and timeliness of RTW after SCI. Conclusions The Back2Work program has become an integrated component of the multidisciplinary rehabilitation team, with positive early results in RTW outcomes and additional benefits in participants' sense of well-being and hope. What is known about the topic? Vocational intervention after SCI has traditionally been delivered after hospital discharge and considered outside the scope of early intervention approaches. Emerging evidence suggests EIVR, commencing before hospital discharge, can encourage hope and a positive expectancy for employment after SCI, and is showing promising outcomes in supporting people's quality of life and vocational goals. What does this paper add? This article details the process and product of developing and evaluating a novel EIVR model for people with SCI. The model underpins the Back2Work EIVR program being trialled in the Queensland Spinal Injuries Unit, an example of this emerging field of practice within the primary rehabilitation setting. What are the implications for practitioners? The Back2Work program is based on an innovative and evidence-based model of EIVR for people with SCI. The collaborative and empirically driven process of developing, implementing and evaluating the model will be of interest to researchers and practitioners looking to advance practices in vocational rehabilitation after serious injury.


Iron binding proteins and influx of iron across the duodenal brush border. Evidence for specific lactotransferrin receptors in the human intestine.
The ability of a range of homologous transferrin-like proteins to donate iron to pieces of human duodenal mucosa, was examined with an in vitro incubation technique. In contrast to serum transferrin and ovotransferrin, only lactotransferrin was able to yield its iron to intestinal tissue, but in an autologous system this protein was unable to donate iron to human reticulocyte preparations. Studies with 125I-labelled lactotransferrin and lactotransferrin dual-labelled with 59Fe and 125I, indicated that the intact protein is excluded from entry into the enterocytes. The experiments suggest that iron may be transported across the brush border after delivery to specific protein binding sites at the cell surface.


Therapeutic Fc-fusion proteins: Current analytical strategies.
Fc-Fusion proteins represent a successful class of biopharmaceutical products, with already 13 drugs approved in the European Union and United States as well as three biosimilar versions of etanercept. Fc-Fusion products combine tailored pharmacological properties of biological ligands, together with multiple functions of the fragment crystallizable domain of immunoglobulins. There is a great diversity in terms of possible biological ligands, including the extracellular domains of natural receptors, functionally active peptides, recombinant enzymes, and genetically engineered binding constructs acting as cytokine traps. Due to their highly diverse structures, the analytical characterization of Fc-Fusion proteins is far more complex than that of monoclonal antibodies and requires the use and development of additional product-specific methods over conventional generic/platform methods. This can be explained, for example, by the presence of numerous sialic acids, leading to high diversity in terms of isoelectric points and complex glycosylation profiles including multiple N- and O-linked glycosylation sites. In this review, we highlight the wide range of analytical strategies used to fully characterize Fc-fusion proteins. We also present case studies on the structural assessment of all commercially available Fc-fusion proteins, based on the features and critical quality attributes of their ligand-binding domains.


Activity-based in vitro selection of T4 DNA ligase.
Recent in vitro methodologies for selection and directed evolution of proteins have concentrated not only on proteins with affinity such as single-chain antibody but also on enzymes. We developed a display technology for selection of T4 DNA ligase on ribosome because an in vitro selection method for DNA ligase had never been developed. The 3' end of mRNA encoding the gene of active or inactive T4 DNA ligase-spacer peptide fusion protein was hybridized to dsDNA fragments with cohesive ends, the substrate of T4 DNA ligase. After in vitro translation of the mRNA-dsDNA complex in a rabbit reticulocyte system, a mRNA-dsDNA-ribosome-ligase complex was produced. T4 DNA ligase enzyme displayed on a ribosome, through addition of a spacer peptide, is able to react with dsDNA in the complex. The complex expressing active ligase was biotinylated by ligation with another biotinylated dsDNA probe and selected with streptavidin-coated magnetic beads. We effectively selected active T4 DNA ligase from a small amount of protein. The gene of the active T4 DNA ligase was enriched 40 times from a mixture of active and inactive genes using this selection strategy. This ribosomal display strategy may have high potential to be useful for selection of other enzymes associated with DNA.


Inspecting Mental Health: Depression, Surveillance and Care in Kerala, South India.
Depression has become a major public health concern in Kerala, South India. Media and mental health professionals often attribute the rise of depression and suicide to a discontent around modern transformations and the flipside of the "Kerala model of development". Kerala's primary health care system of health governance, surveillance and care with its backbone of community and multi-purpose health workers is currently being expanded to target inner feelings, emotional suffering and existential despair, as a result of complex global, national and local processes of making visible and stabilizing depression as a public health category. Rather than relying on NGOs and foreign funding, mental health policy planners in Kerala engage the state of Kerala. Using the case of a junior health inspector's counseling, I argue that the reconfiguration of suffering from an existential part of life and symptom of adversity into a medical condition can also lead to mobilization of (gendered) care in a context of familial marginalization and neglect. In this context, individual bodies are healed by restoring social bodies. Medicalization does not necessarily silence social inequalities and marginalization but can become productive in providing an idiom to critique a family's moral economy.


Determinants of low EPSP attenuation in primary dendrites of mitral cells: modeling study.
Efficiency of synaptic potential propagation through neurons depends mainly on their membrane properties and intracellular resistivity. We use a morphologically realistic compartmental model of a mitral cell and data obtained from whole-cell patch-clamp and voltage-imaging experiments to explore passive parameter space in which reported low EPSP attenuation is observed.


Agreement between colposcopy results using the Reid Colposcopic Index and histopathology.
The aim of the study was to evaluate the diagnostic efficacy of colposcopy and to determine the strength of correlation between colposcopic impression using the Reid Colposcopic Index (RCI) and histopathology This was a prospective cross-sectional study carried out at the colposcopy clinic of Bakirköy Dr Sadi Konuk Education and Research Hospital, Department of Obstetrics and Gynecology, between June 2011 and September 2011. A total of 105 women who met the selection criteria were included in the study. All women underwent colposcopy and the final diagnosis was made using RCI. Colposcopy-guided biopsy was obtained from the abnormal areas. In cases when colposcopy did not reveal any lesion, a four-quadrant biopsy from the squamocolumnar junction was taken, which served as the gold standard. According to the Reid scoring system, there were 60% of benign cases, whereas 27.6%, 5.7%, and 6.7% of the women were diagnosed with CIN 1, CIN 2, CIN 3, respectively As far as histologic results were concerned, 62.9% of the subjects were benign, whereas 25.7%, 3.8%, and 7.6% of the patients were diagnosed with CIN 1, CIN 2, CIN 3, respectively. The correlation between the Reid scoring system and histologic results was statistically significant (p > 0.05). The correlation between colposcopic lesions graded with RCI and histology was strong, particularly in women who had HGSIL on a Pap smear. Good correlation between colposcopic imaging using RCI and histopathology makes it a reproducible technique, easy to implement in colposcopy clinics.


Fungal endocarditis complicated by mycotic aneurysm of sinus of Valsalva, interventricular septal abscess, and infectious pericarditis: unique M-mode and two-dimensional echocardiographic findings.
A 26-year-old male with fungal aortic endocarditis is presented in whom unique M-mode and two-dimensional echocardiographic findings permitted a diagnosis of mycotic aneurysm of right sinus of Valsalva and ventricular septal abscess preoperatively. The aneurysm was excised, and the affected aortic and tricuspid valves were replaced with valve prostheses.


The suitability of isotopic methods in identifying water sources of a shallow-rooted herbaceous plant in a desert steppe.
Isotopic methodologies have gained prominence in investigating the composition of plant water sources; however, concerns regarding their suitability and reliability in diverse environments have emerged in recent years. This study presents a comparative analysis of root, soil, and liquid water (precipitation, dew, and groundwater) samples obtained from a desert steppe using isotope ratio infrared spectrometry (IRIS) and isotope ratio mass spectrometry (IRMS). The objective was to evaluate the applicability of these techniques in discerning the water sources of Stipa breviflora, a shallow-rooted herbaceous plant species. Additionally, we explored the root water uptake characteristics and water use strategy of S. breviflora. Our findings indicate that the IRIS method had more enriched values of D compared to the IRMS method across all samples, while no discernible pattern was observed for 18O. Notably, the differences observed among all samples exceeded the instruments' accuracies. Moreover, an unexpected occurrence was noted, whereby both D and 18O values in the root water were more enriched than in any of the considered water sources, rendering identification of the plant water sources unattainable. By conducting a re-analysis of more refined soil layer samples, we discovered that S. breviflora exhibits the ability to absorb and utilize water sources in close proximity to the soil surface. It further suggested that the shallow-rooted herbaceous plants in desert steppes can exploit small rainfalls, frequently overlooked in their ecological importance. Considering the distinctive soil and plant characteristics of desert steppes, we recommend adopting IRMS methods in conjunction with refined surface soil sampling for isotopic analysis aiming to identify water sources of shallow-rooted herbaceous plants. This study provides novel insights into assessing the suitability of isotopic techniques for analyzing plant water sources, while enhancing our understanding of water use strategies and environmental adaptation mechanisms employed by shallow-rooted herbaceous plants within xerophytic grassland ecosystems.


The functional significance of absolute power with respect to event-related desynchronization.
The question is examined whether the extent of changes in relative band power as measured by event-related desynchronization (ERD) depends on absolute band power. The results for target stimuli of a simple oddball task indicate that the prestimulus (reference) level of absolute band power has indeed a strong influence on ERD. Whereas for the alpha band large band power in the reference interval is related to a strong degree of alpha suppression as measured by ERD, the opposite holds true for the theta band. Here, a low level of band power during the reference interval is related to a pronounced increase in band power during the processing of the target stimulus. In contrast to alpha and theta, ERD in the delta band is not influenced by the magnitude of band power in the reference interval.


Severe Disease Burden and the Mitigation Strategy in the Arsenic-Exposed Population of Kaliprasad Village in Bhagalpur District of Bihar, India.
The present study was carried out in the village Kaliprasad of Bhagalpur district of Bihar to know the arsenic exposure effect in the exposed population. A total of n = 102 households were studied, and their water and biological samples such as urine and hair were collected and analyzed in a graphite furnace atomic absorption spectrophotometer (GF-AAS). The assessment of arsenic-exposed village population reveals that the villagers were suffering from serious health-related problems such as skin manifestations (hyperkeratosis and melanosis in their palm and soles), breathlessness, general body weakness, mental disorders, diabetes, hypertension (raised blood pressure), hormonal imbalance, neurological disorders, and few cancer cases. About 77% of household hand pump water had arsenic level more than the WHO recommended level of 10 µg/L, with highest level of 523 µg/L. Moreover, in 60% individual's urine samples, arsenic concentration was very high with maximum 374 µg/L while in hair 64% individuals had arsenic concentration above the permissible limit with maximum arsenic concentration of 11,398 µg/kg. The hazard quotient (HQ) was also calculated to know the arsenic risk percentage in children as 87.11%, in females as 83.15%, and in males as 82.27% by groundwater. This has surpassed the threshold value of [Formula: see text] for carcinogenic risk (CR) in children, female, and male population group in the village. Hence, the exposed population of Kaliprasad village are at very high risk of the disease burden.


Susceptibility-weighted imaging in acute-stage pediatric convulsive disorders.
The aim of this preliminary study was to investigate the clinical use of acute-stage susceptibility-weighted imaging (SWI) in children with prolonged convulsive disorder. Ten children with prolonged convulsive disorder who underwent SWI within 2 h after termination of seizure (acute-stage SWI group) and 15 control children who underwent SWI > 2 h after their seizures terminated or for other purposes were enrolled. The cerebral venous vasculature was compared between the groups. The acute-stage SWI group was further divided into three subgroups: normal group, those with regional low signals in the cerebral veins (regional group) and those with diffuse low signals in the cerebral veins (generalized group). Inter-ictal electroencephalography (EEG) and venous blood gas findings during seizure activity were compared between these subgroups. All patients in the acute-stage SWI group had low cerebral vein signal. Four patients were assigned to the regional group and six patients to the generalized group. Decrease of venous pH and the increase of venous pCO2 during seizure activity was more prominent in the regional group than in the generalized group. In the regional group, low-signal areas in the cerebral veins were consistent with abnormal areas on EEG; these low-signal areas resolved completely in all patients on follow-up SWI. Ten patients in the control group had normal SWI, and five had a generalized low signal. Acute-stage SWI may be a useful alternative for identifying lateralization of seizures in children with prolonged convulsive disorder.


[Safety problems of modern laser medical equipment].
The authors consider topics connected with improvement of hygienic regulation of laser radiation, define most important problems associated with safety of modern laser medical devices.


Transforming growth factor beta and prostate cancer.
The TGF-beta superfamily is the most versatile considering the ability of its members to regulate proliferation, growth arrest, differentiation, and apoptosis of prostatic stromal and epithelial cells as well as the formation of osteoblastic metastases. TGF-beta mediated action in prostate cells follows a complex signaling pathway from binding and phosphorylation of receptor type II to the TbetaRI kinase to Smad activation, resulting in ligand-induced transcription. TGF-beta as an indirect tumor suppressor, its role of regulating tumor induction, as well as tumor suppression depending on the tissue microenvironment merits further exploration. The rationale for targeting growth factors and their receptors for therapeutic intervention is based upon the fact that these proteins represent the most proximate component of the signal transduction cascade. The alternate targeting of intracellular effectors in the signal transduction may be thwarted by cross talk between signaling pathways (such as the Smads in a dynamic interplay with the androgen receptor). TGF-beta within the context of its well-documented apoptosis regulatory actions in the prostate and the significance its key receptor TbetaRII as a potential tumor suppressor, provides a highly attractive candidate for such targeting with high clinical significance for the treatment and diagnosis of prostate cancer.


Ocular manifestations of oblique facial clefts.
In the Tessier classification, craniofacial clefts are numbered from 0 to 14 and extend along constant axes through the eyebrows, eyelids, maxilla, nostrils, and the lips. We studied a patient with bilateral cleft 10 associated with ocular abnormalities. Clinical report with orbital and cranial computed tomography. After pregnancy complicated by oligohydramnios, digoxin, and lisinopril exposure, a boy was born with facial and ocular dysmorphism. Examination at age 26 months showed bilateral epibulbar dermoids, covering half the corneal surface, and unilateral morning glory anomaly of the optic nerve. Ductions of the right eye were normal, but the left eye had severely impaired ductions in all directions, left hypotropia, and esotropia. Under anesthesia, the left eye could not be rotated freely in any direction. Bilateral Tessier cleft number 10 was implicated by the presence of colobomata of the middle third of the upper eyelids and eyebrows. As the cleft continued into the hairline, there was marked anterior scalp alopecia. Computed x-ray tomography showed a left middle cranial fossa arachnoid cyst and calcification of the reflected tendon of the superior oblique muscle, trochlea, and underlying sclera, with downward and lateral globe displacement. Tessier 10 clefts are very rare and usually associated with encephalocele. Bilateral 10 clefts have not been reported previously. In this case, there was coexisting unilateral morning glory anomaly and arachnoid cyst of the left middle cranial fossa but no encephalocele. Bilateral Tessier facial cleft 10 may be associated with alopecia, morning glory anomaly, epibulbar dermoids, arachnoid cyst, and restrictive strabismus.


Increasing prevalence of designer benzodiazepines in impaired driving: A 5-year analysis from 2017 to 2021.
Designer benzodiazepine (DBZD) use has been increasing over the past decade and poses a threat to human health and safety, particularly when involved in driving under the influence of drug (DUID) cases. Over a 5-year period between 2017 and 2021, there were 1,145 reported DBZDs in 805 blood samples submitted from law enforcement agencies for DUID testing. Eleven different DBZDs were detected, including three metabolite pairs: etizolam/alpha-hydroxyetizolam, clonazolam/8-aminoclonazolam, diclazepam/delorazepam, flualprazolam, flubromazolam, flubromazepam, bromazolam and bromazepam. Etizolam/alpha-hydroxyetizolam (n = 485) and flualprazolam (n = 149) were the most frequently detected DBZDs, at 60% and 18%, respectively. Driving behavior, standardized field sobriety test performance and physical observations of individuals suspected of DUIDs, whose blood sample was toxicologically confirmed for one or more DBZDs, were consistent with the effects caused by central nervous system depressants. Each DBZD has its own unique timeline, and toxicology testing had to be frequently updated to reflect the state of the novel psychoactive substance market. DBZDs play a role in impaired driving and can be the sole intoxicant in DUID cases.


Decitabine can be safely reduced after achievement of best objective response in patients with myelodysplastic syndrome.
Decitabine is standard therapy in patients with myelodysplastic syndrome (MDS). Current recommendations suggest a dose of 20 mg/m(2) intravenously (IV) daily for 5 days every 4 weeks. However, this therapy is associated with frequent grade 3/4 hematologic toxicity, requiring dose delays and/or dose reductions (DD/DR). We investigated the outcomes of 122 patients with MDS who had DD/DR of frontline decitabine therapy. Sixty-five patients (53%) had DR by at least 25% or DD (defined as a delay beyond 5 weeks between cycles). Thirty-five patients (29%) underwent DD/DR after achieving best objective response, 30 patients (25%) underwent DD/DR before best objective response, and 57 (54%) patients had no DD/DR. There was a trend for more durable responses in favor of patients requiring DD/DR after the achievement of best objective response (median not reached) (P = .161). Overall survival rates were significantly higher for patients who had DD/DR after best objective response compared with those who had DD/DR before best objective response or those with no DD/DR (30 vs. 22 vs. 11 months, respectively; P < .001). Progression-free survival (PFS) rates also trended higher for those with DD/DR after best objective response (median not reached) compared with those who required DD/DR before best objective response (median of 15 months) (P = .285). DD/DR may be safely accomplished once the patient has achieved best objective response (preferably complete remission [CR]) without impacting outcome. Prospective evaluation of an approach conceived of a loading dose for induction of a best objective response followed by a maintenance schedule is to be considered.


Evaluating the potential applications of brewers' spent grain in biogas generation, food and biotechnology industry: A review.
Breweries, as the major users of fossil fuels, are constantly under economic and environmental pressure to minimize energy consumption and residual management costs. Biogas generation from brewing wastes is a realistic solution for significantly reducing fossil fuel use. Brewers' spent grain (BSG) forms about eighty per cent of the total wastes from a brewing plant. BSG has a high cellulose and non-cellulosic polysaccharides content which makes it potential for biogas production. This paper reviews the potential applications of BSG as an alternative substrate for production of biogas and the recent achievements which have been attained in anaerobic digestion (AD) technology. The usability of BSG in diverse technologies including production of animal and human food and as a medium for growing microorganisms and enzymes is reviewed. The chemical processes involved in producing biogas from BSG are discussed.


The pollination biology and breeding system of Monarda fistulosa (Labiatae).
Successful cross-pollination of Monarda fistulosa is the result of a complex interaction among flower opening, the pollen-bearing areas of the pollinators and/or their behavior, and the maturation of the stigmas. The flowers open continuously from 0800-2000 h providing a temporally predictable rich source of nectar and pollen. Recently opened flowers may reduce the ability of bees to discriminate between resource rich and poor patches and encourage systematic foraging within patches. The continuous opening of flowers coupled with protandry also results in some flowers of most capitula being in the staminate and others in the pistillate phase. Autogamy is highly unlikely due to strong protandry and the spatial separation of anthers and stigmas. Geitonogamy, at least that mediated by Bombus is unlikely because the pollen is spread over a relatively large area of the wings, which reduces the likelihood of a stigma contacting just deposited pollen. Because pollen is transferred from the much smaller coxal area of Anthophora and other bees that mistake the stigmas of early pistillate phase flowers for stamens some geitonogamy seems inevitable. However, the delayed receptivity of young stigmas to self-pollen decreases the likelihood of self-pollen germinating on such stigmas. Older stigmas are equally receptive to self- and cross-pollen and the number of pollen grains germinating and pollen tubes reaching the base of the style increases with flower age.


Pyoderma gangrenosum of the breasts precipitated by breast surgery.
Pyoderma gangrenosum may occur in unusual sites and not be readily recognized. Delays in diagnosis and appropriate treatment may result in extensive ulcerations and scarring. We present two patients with pyoderma gangrenosum involving the breasts after breast operation. Delays in diagnosis resulted in extensive ulcerations and scarring of the breasts.


"To me, it was Just a Vice". Stigma and Other Barriers to Gambling Treatment in Piedmont, Italy.
In Piedmont (northwestern Italy), as in the rest of the Western world, only a small percentage of the estimated problem gamblers (10-20%) turn to a treatment service to overcome their addiction issues. The study sought to gain a better understanding of the cultural factors that stand in the way of seeking help, thorough qualitative in-depth individual interviews with gamblers both in and out of treatment. A total of 30 interviews were conducted in three different health districts, most via video-call. Data were then analyzed using an abductive approach. The findings appear to indicate that the processes of stigma affecting problem gamblers and public gambling treatment services are the main barriers to seeking help. According to the interviewees, awareness of the problem is a necessary but not sufficient motivator for embarking on treatment, since social stigmatization leads them to hide the problem. Moreover, self-stigmatization processes seem to undermine the sense of self-efficacy that plays a key role in recovery. To encourage help-seeking, the study thus suggests that priority should be given to efforts to reduce stigma, i.e., through informational and educational measures together with advocacy interventions, which aim primarily to reframe the gambling problem, shifting responsibility from the individual to the collective level.


Operative complications of abdominal vagotomy.
To assess the incidence of operative complications, mortality, and accuracy of vagotomy in transabdominal vagotomy, 733 cases were reviewed. Statistics are compared with those of other authors. A loose comparison of patients operated on by resident surgeons versus those operated on by attending surgeons is also made. Our preference for immediate microscopic examination of vagotomy specimens is stressed. One unusual complication is described.


Enhancing transient protein expression in HEK-293 cells by briefly exposing the culture to DMSO.
Transient expression of proteins in mammalian cells is a key technique for many functional and structural studies of human and higher eukaryotic genes as well as for the production of recombinant protein therapeutics. Maximizing the expression efficiency to achieve a higher expression yield is desirable and may be even critical when, for instance, an expressed protein must be characterized at the single-cell level. Our goal was to develop a simple method by which protein expression yield in human embryonic kidney (HEK)-293 cells could be enhanced with a brief treatment of dimethyl sulfoxide (DMSO) solution. By expressing green fluorescent protein (GFP) as a reporter protein using the calcium phosphate transfection method and imaging a large population of cells, we found that a 5-min exposure of 10 % DMSO to HEK-293 cells, 4 h after transfection of the protein of interest, leads to ∼1.6-fold increase in the expression yield without causing any appreciable cytotoxicity. By expressing an α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and separately a kainate receptor in HEK-293 cells and measuring glutamate-induced whole-cell current response, we also found that such a brief DMSO treatment did not affect channel activity. This method is simple, efficient and inexpensive to use for enhancing transient transfection yield in HEK-293 cells.


Application of the broad-spectrum bacteriocin enterocin AS-48 to inhibit Bacillus coagulans in canned fruit and vegetable foods.
The enterococcal bacteriocin (enterocin) AS-48 is a broad-spectrum cyclic peptide. Enterocin AS-48 was tested against Bacillus coagulans in three vegetable canned foods: tomato paste (pH 4.64), syrup from canned peaches (pH 3.97), and juice from canned pineapple (pH 3.65). When vegetative cells of B. coagulans CECT (Spanish Type Culture Collection) 12 were inoculated in tomato paste supplemented with 6 microg/ml AS-48 and stored at different temperatures, viable cell counts were reduced by approximately 2.37 (4 degrees C), 4.3 (22 degrees C) and 3.0 (37 degrees C) log units within 24 h storage. After 15-days storage, no viable cells were detected in any sample. Strain B. coagulans CECT 561 showed a poor survival in tomato paste, but surviving cells were also killed by AS-48. The bacteriocin was also very active against B. coagulans CECT 12 vegetative cells in juice from canned pineapple stored at 22 degrees C, and slightly less active in syrup from canned peaches. In food samples supplemented with 1.5% lactic acid, enterocin AS-48 (6 microg/ml) rapidly reduced viable counts of vegetative cells below detection limits within 24 h storage. Addition of glucose and sucrose (10% and 20%) significantly increased bacteriocin activity against vegetative cells of B. coagulans CECT 12. Enterocin AS-48 had no significant effect on B. coagulans CECT 12 spores. However, the combined application of AS-48 and heat (80-95 degrees C for 5 min) significantly increased the effect of thermal treatments on spores.


From non-electroactive to electroactive species: highly selective and sensitive detection based on a dual-template molecularly imprinted polymer electrochemical sensor.
A new strategy for sensitive detection using a dual-template molecularly imprinted based electrochemical sensor was developed using thionine as an electrochemical probe. A single-signal for the non-electroactive template and a dual-signal for the electroactive template in the selective and sensitive detection have been achieved on the prepared sensor.


Drug and device therapy for patients with chronic heart failure.
Untreated heart failure is a terminal illness with a poor prognosis. β-blockers are an established therapy used to reduce morbidity and mortality. Hypotension and bradycardia often hinder optimal β-blocker administration in patients with chronic heart failure. The efficacy of cardiac resynchronization therapy (CRT) in affecting favorable cardiac remodeling and reducing mortality in heart failure patients with electrical dyssynchrony has been demonstrated in landmark trials only in patients receiving optimal medical therapy. This paper demonstrates the favorable effects of CRT on cardiac hemodynamics facilitating uptitration of β-blocker therapy. It highlights the synergistic relationship of the two therapies and emphasizes the importance of optimizing medical therapy before and after CRT implantation.


Meet the authors: Umberto Aiello and Domenico Libri.
First author Umberto Aiello and group leader Domenico Libri speak with Molecular Cell about their childhood motivations for science, the backbone of research, advice for other scientists, and their paper, "Sen1 is a key regulator of transcription-driven conflicts."


Subcellular localization of luteinizing hormone releasing hormone degrading activity in the hypothalamus.
The in vitro degradation of endogenous as well as exogenous luteinizing hormone releasing hormone (LHRH) by subcellular fractions of rat hypothalamic tissue was studied. Endogenous LHRH, localized an isolated nerve terminals (synaptosomes), was found to be resistant to enzymatic degradation (60 min, 37 degrees C) as long as the synaptosomal membrane remained intact. Endogenous LHRH was rapidly degraded by the 900 x g supernatant fluid and cytosol but not by myelin/microsomes, intact synaptosomes, or mitochondria. Lysed synaptosomes rapidly degraded exogenous LHRH. The LHRH degrading activity of synaptosomes was highly concentrated in the 'synaptosol', i.e., the cytosol of the nerve terminal. These data suggest that the LHRH degrading activity of the rat hypothalamus is a readily solubilized component of neurons, and possibly of non-neuronal cells.


Risk factors for septic shock after mini-percutaneous nephrolithotripsy with holmium laser.
To evaluate the risk factors for septic shock after mini-percutaneous nephrolithotripsy (MPCNL) and provide a theoretic basis for the prevention of septic shock after MPCNL. A total of 834 patients who underwent MPCNL from June 2004 to April 2012 were retrospectively analyzed. The χ(2) test and a logistic regression were used to identify key risk factors for septic shock after MPCNL. The incidence of septic shock after MPCNL was 2.40%. Logistic regression analysis identified female sex (odds ratio, 1.055E8; P <.001) and diabetes mellitus (odds ratio, 4.192; P = .001) as independent risk factors for post-MPCNL septic shock. Female sex and diabetes mellitus are the key risk factors for septic shock after MPCNL. Routine administration of antibiotics preoperatively might reduce the incidence of septic shock.


The EANM practice guidelines for bone scintigraphy.
The radionuclide bone scan is the cornerstone of skeletal nuclear medicine imaging. Bone scintigraphy is a highly sensitive diagnostic nuclear medicine imaging technique that uses a radiotracer to evaluate the distribution of active bone formation in the skeleton related to malignant and benign disease, as well as physiological processes. The European Association of Nuclear Medicine (EANM) has written and approved these guidelines to promote the use of nuclear medicine procedures of high quality. The present guidelines offer assistance to nuclear medicine practitioners in optimizing the diagnostic procedure and interpreting bone scintigraphy. These guidelines describe the protocols that are currently accepted and used routinely, but do not include all existing procedures. They should therefore not be taken as exclusive of other nuclear medicine modalities that can be used to obtain comparable results. It is important to remember that the resources and facilities available for patient care may vary.


Prostanoid receptor assays.
Prostanoids, which include the prostaglandins (PGs) and thromboxanes (TXs), interact with a specific family of G-protein coupled receptors, of which there are known to be five distinct types, DP, EP, FP, IP and TP, each particularly sensitive to one of the five natural prostanoids, PGD₂, PGE₂, PGF₂(, PGI₂ and TXA₂, respectively. Of these, it is known that the EP receptor comprises four well-characterized subtypes: EP₁, EP₂, EP₃ and EP₄. These receptor subtypes are widely distributed throughout mammals and other species, and show particularly high levels of expression in smooth muscle and blood platelets. Despite the fact that few of these preparations express a single receptor type/subtype in isolation, a range of useful smooth muscle and platelet assays for the various prostanoid receptors are available and are presented in this unit.


Positive and negative chronotropic effects of caffeine in spontaneously beating rabbit sino-atrial node cells.
1. Effects of caffeine on the automaticity in spontaneously beating rabbit sino-atrial node cells were examined. 2. Caffeine (0.5-2 mM) caused only a positive chronotropic effect. At over 5 mM, caffeine caused an initial positive and subsequently a negative chronotropic effect. Both were not modified by pindolol (1 microM) and atropine (1 microM). 3. At 10 mM, a dysrhythmia occurred in all 9 preparations. The effects were reversible, and dysrhythmia also disappeared after washout. 4. When extracellular K+ was increased from 2.7 to 8 mM, the dysrhythmia induced by caffeine (10 mM) was abolished, and the sinus rate was increased. 5. Addition of tetrodotoxin (TTX) (10(-7) M) in the presence of caffeine (10 mM) also abolished the dysrhythmia and increased the sinus rate. 6. In addition, a decrease in extracellular Ca2+ ([Ca]o) to 0.5 mM abolished the dysrhythmia and increased the sinus rate, whereas increasing [Ca]o to 7.4 mM potentiated the negative chronotropic effect and failed to inhibit the dysrhythmia. 7. These results indicate that the positive chronotropic effect is due to the stimulatory effect of caffeine, and the negative effect is directly and indirectly due to development of cellular calcium overload.


Enteric glial cell heterogeneity regulates intestinal stem cell niches.
The high turnover and regenerative capacity of the adult intestine relies on resident stem cells located at the bottom of the crypt. The enteric nervous system consists of an abundant network of enteric glial cells (EGCs) and neurons. Despite the close proximity of EGCs to stem cells, their in vivo role as a stem cell niche is still unclear. By analyzing the mouse and human intestinal mucosa transcriptomes at the single-cell level, we defined the regulation of EGC heterogeneity in homeostasis and chronic inflammatory bowel disease. Ablation of EGC subpopulations revealed that the repair potential of intestinal stem cells (ISCs) is regulated by a specific subset of glial fibrillary acidic protein (GFAP)+ EGCs. Mechanistically, injury induces expansion of GFAP+ EGCs, which express several WNT ligands to promote LGR5+ ISC self-renewal. Our work reveals the dynamically regulated heterogeneity of EGCs as a key part of the intestinal stem cell niche in regeneration and disease.


Monoclonal gammopathy of undetermined significance. Natural history in 241 cases.
Two hundred forty-one patients with a monoclonal protein in the serum but initially no evidence of multiple myeloma, macroglobulinemia, amyloidosis or lymphoma were followed up for more than five years. At the conclusion of the studies the patients were classified as follows: Group 1, patients without significant increase in monoclonal protein, 57 per cent; group 2, patients with more than 50 per cent increase in monoclonal serum protein or development of monoclonal urine protein, 9 per cent; group 3, patients who died without five-year serum studies, 23 per cent; and group 4, patients in whom myeloma, macroglobulinemia or amyloidosis developed, 11 per cent. Initially, the hemoglobin level, size of serum monoclonal protein peak, number of plasma cells in the bone marrow and levels of normal immunoglobulins were not significantly different among the four groups. The median interval from recognition of the monoclonal protein to diagnosis of multiple myeloma was 64 months, of macroglobulinemia 103 months and of amyloidosis 92 months. A significant increase of the monoclonal protein or development of myeloma, macroglobulinemia or amyloidosis occurred in 18 per cent of the patients with monoclonal immunoglobulin G(IgG), in 28 per cent with immunoglobulin A (IgA) and in 25 per cent with immunoglobulin M (IgM). Retrospective analysis of age, sex, presence of organomegaly, hemoglobin level, size and type of serum monoclonal protein peak, presence of small amounts monoclonal light chain in the urine, serum albumin level, levels of uninvolved immunoglobulins, IgG subclass and level of plasma cells in the bone marrow did not show how to distinguish initially between stable benign disease and progressive disease. Therefore, periodic reexamination of patients with monoclonal gammopathy is essential.


Failure to thrive in the term and preterm infants of mothers depressed in the postnatal period: a population-based birth cohort study.
To examine the relationship between failure to thrive in preterm and term infants and postnatal depression in their mothers. In a whole population birth cohort of 12,391 infants (excluding those born after term or with major congenital abnormalities) failure to thrive over the first nine months was identified using a conditional weight gain criterion which identified the slowest-gaining 5%. Depression symptoms were recorded using the Edinburgh Postnatal Depression Scale (EPDS) at 18 and 32 weeks of pregnancy and at 8 weeks and 8 months after delivery. After the birth, high depression scores were significantly more common in the mothers of infants born preterm, and controlling for depression scores in pregnancy did not eliminate this association after the birth. Failure to thrive was identified in 4.5% of the children born at term (531/11718) and in 8.3% of those born preterm (56/673). The difference was highly significant (chi2 = 20.25 with 1 df, p < .0001). Using a conventional cut-off on the EPDS (score > 12) to identify mothers as 'depressed', the prevalence of failure to thrive in the term infants of mothers depressed at 8 weeks postpartum was 5.0%; in the remainder of the population (controls) it was 4.3%. In mothers depressed at 8 months the prevalence was 4.3% in both groups. The prevalence of failure to thrive in the preterm infants of mothers depressed at 8 weeks was 8.8% (7.0% in controls) and in those depressed at 8 months it was 12.3% (6.7% in controls). None of these differences in prevalence was statistically significant, and significant differences did not emerge from further analyses using more stringent criteria for depression. Preterm births are specifically associated with high maternal depression scores in the postpartum period, and with a higher prevalence of failure to thrive. High depression scores in the postpartum period are not themselves associated with a higher prevalence of failure to thrive, however, either in infants born at term or in those born preterm.


An Interacting Multiple Model for Trajectory Prediction of Intelligent Vehicles in Typical Road Traffic Scenario.
This article presents an interacting multiple model (IMM) for short-term prediction and long-term trajectory prediction of an intelligent vehicle. This model is based on vehicle's physics model and maneuver recognition model. The long-term trajectory prediction is challenging due to the dynamical nature of the system and large uncertainties. The vehicle physics model is composed of kinematics and dynamics models, which could guarantee the accuracy of short-term prediction. The maneuver recognition model is realized by means of hidden Markov model, which could guarantee the accuracy of long-term prediction, and an IMM is adopted to guarantee the accuracy of both short-term prediction and long-term prediction. The experiment results of a real vehicle are presented to show the effectiveness of the prediction method.


Two new species of the genus Taphioporus Moseyko & Kirejtshuk (Chrysomelidae: Eumolpinae) from Baltic amber.
Two new species of Taphioporus Moseyko & Kirejtshuk are described and illustrated from Baltic amber: T. rufous sp. nov. and T. carsteni sp. nov. Members of this fossil genus are known from Baltic and Rovno amber. A key to species of Taphioporus is provided.


Characterization and quantification of electron donating capacity and its structure dependence in biochar derived from three waste biomasses.
Biochar has shown a unique electrochemical property being involved in various redox reactions in soil and water. In this study, the electron donating capacities (EDCs) of biochar pyrolyzed at 200-800 °C from pine wood, barley grass and wheat straw were investigated by using the mediated electrochemical oxidation method. The EDC values for all biochar were in the range of 0.18-1.83 mmol e- (g biochar)-1, showing the increase as the temperature increased from 200 °C to 400 °C, the decrease from 400 °C to 650 °C, and then increase from 650 °C until to 800 °C. At low and intermediate temperatures of 200-650 °C, the EDCs were mainly attributed to the phenolic hydroxyl groups, while the conjugated π-electron system associated with aromatic structure dominated the EDCs of biochar at the high temperatures of over 650 °C. The barley grass- and wheat straw-derived biochar had higher EDCs than the pine wood-derived biochar, resulting from the higher phenolic hydroxyl groups in the former samples than the latter one. In conclusion, the reductive property of biochar was mainly attributed to both phenolic hydroxy group and conjugated π-electron system associated with aromatic structure, depending on the pyrolytic temperature and feedstock source. The results will help us to obtain a complete view on the role of biochar in biogeochemical redox reactions and consider developing biochar with controlled redox properties for specific environmental applications such as electron shuttle and catalyst material.


Structural biology of multicomponent assemblies in DNA double-strand-break repair through non-homologous end joining.
The mechanisms mediating the repair of DNA damage in human cells have been the focus of a multitude of studies since the middle of the previous century, and many of the proteins implicated in these processes have been identified as being part of large macromolecular assemblies. This review gives an overview of the current knowledge of protein structures specifically involved in the repair of DNA double strand breaks through Non-Homologous End Joining, with a focus on recent structures obtained via cryo-electron microscopy and prospects for how this rapidly evolving method will impact our understanding of DNA repair.


In silico design, synthesis and anti-HIV activity of quinoline derivatives as non-nucleoside reverse transcriptase inhibitors (NNRTIs).
A series of quinoline derivatives has been designed, synthesized and screened for their anti-HIV properties. The drug-like properties of compounds were evaluated first and then molecular docking using DS v18.104.22.16895 software showed that the compounds behaved as non-nucleoside reverse transcriptase inhibitors (NNRTIs) while interacting at the allosteric site of target HIV-RT protein (PDB:3MEC). The docking results revealed that all compounds formed hydrogen bonds with Lys101, Lys103, Val179, Tyr188, Gln190, Gly190, Pro225, Phe227, and Tyr318, and showed π-interaction with Tyr188 and Tyr318. TOPKAT (Toxicity Prediction by Komputer Assisted Technology) results confirmed that the compounds were found to be less toxic than the reference drugs. Density functional theory (DFT) analysis was performed to assess the binding affinity of all compounds. Further, molecular dynamics (MD) simulations were performed on compound 6 and delavirdine with HIV-RT enzyme. Comprehensive MD analyses showed a similar pattern of conformational stability and flexibility in both the complexes suggesting alike inhibitory action. The hydrogen-bonding interactions and the binding energy of active-site residues for the compound 6 complex revealed strong inhibitory activity than the reference (delavirdine) complex. Thus, the compound 6 might act as a potential inhibitor against HIV-RT. Overall, this study revealed that compound 6 (5-hydroxy-N-(4-methyl-2-oxo-1,2-dihydroquinolin-8-yl) thiophene-2-sulfonamide) has prudent anti-HIV activity against both HIV-1 (SI = 2.65) and HIV-2 (SI = 2.32) that can further be utilised in drug discovery against HIV virus.


Higher Serum Heavy Metal May Be Related with Higher Serum gamma-Glutamyltransferase Concentration in Koreans: Analysis of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1, 2, 2010, 2011).
Abnormal serum gamma-glutamyltransferase (γ-GT) may be an early and sensitive marker for oxidative stress. This study was performed to evaluate the association between serum heavy metals and γ-GT concentration. This study is a cross-sectional analysis based on data from Korean National Health and Nutrition Examination Survey (V-1, 2, 2010, 2011) regarding serum heavy metal concentrations (lead, mercury, and cadmium) as well as serum γ-GT. Serum heavy metals were categorized into tertiles, and serum γ-GT concentration was compared using an analysis of covariance test after relevant variable adjustments. In addition, we evaluated the odds ratio (OR) of having the highest tertile of serum γ-GT in each heavy metal tertile using logistic regression. The mean serum lead, mercury, and cadmium concentrations were 2.67, 5.08, and 1.02 µg/dL in men and 1.95, 3.60, and 1.21 µg/dL in women, respectively. Partial correlation showed a significant positive relation between each heavy metal and serum γ-GT concentration. Comparing serum γ-GT concentration by the tertile of each heavy metal, serum γ-GT concentration showed a significant increase as the tertiles of serum mercury and cadmium in men and that of serum mercury in women increased, but not with lead. The OR of having the highest tertile of serum γ-GT was significant for cadmium in men (OR, 4.02; 95% confidence interval [CI], 2.54 to 6.35) and mercury in women (OR, 2.00; 95% CI, 1.29 to 3.10) in the top tertile of each heavy metal. Higher serum heavy metal concentration may be related with higher serum γ-GT concentration. In particular, serum cadmium in men and mercury in women showed significant correlation with serum γ-GT concentration.


Inhibition of microsomal and mitochondrial Ca2+-sequestration in rat cerebellum by polychlorinated biphenyl mixtures and congeners. Structure-activity relationships.
Recent studies from our laboratory indicate that polychlorinated biphenyl (PCB) congeners in vitro perturbed signal transduction mechanisms including cellular Ca2+-homeostasis and protein kinase C translocation. We have now investigated the structure-activity relationship (SAR) of three PCB mixtures, 24 PCB congeners and one dibenzofuran for their effects on microsomal and mitochondrial Ca2+-sequestration in rat cerebellum. Ca2+-sequestration by these intracellular organelles was determined using radioactive 45CaCl2. All three mixtures studied, Aroclor 1016, Aroclor 1254 and Aroclor 1260, were equally potent in inhibiting microsomal and mitochondrial Ca2+-sequestration with IC50 values of 6-8 microM. 1,2,3,7,8-Pentachlorodibenzofuran had no effect on Ca2+-sequestration by these organelles. The SAR among the congeners revealed: (1) congeners with ortho-/meta- or ortho-, para-chlorine substitutions were the most potent in inhibiting microsomal and mitochondrial Ca2+-sequestration (IC50 = 2.4-22.3 microM); (2) congeners with only para- but without ortho-substitutions were not effective in inhibiting Ca2+-sequestration by microsomes and mitochondria; (3) increased chlorination was not related to the effectiveness of these congeners. The present SAR studies indicate that the effects of most PCB congeners in vitro may be related to an interaction at specific sites having preference for low lateral substitution or lateral content (meta- or para) in the presence of ortho-substitution.


Reduced levofloxacin susceptibility and tetracycline resistance in a clinical isolate of Haemophilus quentini identified by 16S rRNA sequencing.
This paper reports the first case of Haemophilus quentini bacteremia with reduced susceptibility to levofloxacin and resistance to nalidixic acid identified by 16S rRNA sequencing. There was an S 84 L substitution in gyrA and an S 84 I substitution in par C. The isolate had co-resistance to ampicillin (beta-lactamase positive) and tetracycline mediated by the tet(B) gene.


PRMT5 promotes retinoblastoma development.
Epigenetic mechanism, including DNA methylation and histone modifications, contributes to alterations in the expression patterns of genes regulating malignant phenotype of cancer cells. However, the epigenetic modulation of vascular endothelial growth factor-A (VEGFA) in retinoblastoma (RB) has not been clearly established. We aimed to examine the epigenetic regulation of VEGFA by protein arginine methyltransferase 5 (PRMT5) in RB. Using the GEO database, we identified VEGFA as a pathogenic gene in RB. Silencing of VEGFA in SO-RB50 and Y79 cells inhibited cell proliferation, angiogenesis, and migration, promoted apoptosis, and suppressed tumor growth in mice. Mechanistically, PRMT5 promoted H3K4me3 modification of the VEGFA promoter, thereby activating VEGFA expression. VEGFA could regulate the expression of MMP1, MMP2, and MMP9. Further silencing of VEGFA in RB cells overexpressing PRMT5 constrained the expression of MMP1, MMP2 and MMP9, and suppressed the growth of tumors in mice. In conclusion, this study clarifies that the depletion of PRMT5 reduces H3K4me3-mediated VEGFA transcription and retards the carcinogenesis of RB by suppressing the expression of MMPs.


The bipolar spectrum: myth or reality?
The idea of a "bipolar spectrum" is controversial due to 1) lack of widely accepted definitions, 2) concern that spectrum definitions might subsume cases with non-bipolar disorders, 3) worry that "diagnostic creep" may lead practitioners to overdiagnose bipolar disorder in marginal cases, and 4) worry that more diagnosis of bipolar spectrum may increase aggressive pharmacotherapy. These concerns are weighed against theoretical and empiric evidence converging in support of the bipolar spectrum as having prognostic and prescriptive validity. Practitioners can use inexpensive and practical strategies to incorporate the spectrum concept into their work while minimizing risks of overdiagnosis or unnecessary medication exposure.


Postoperative noninvasive ventilation and complications in esophageal atresia-tracheoesophageal fistula.
This study examines the impact of postoperative noninvasive ventilation strategies on outcomes in esophageal atresia-tracheoesophageal fistula (EA-TEF) patients. A single center retrospective chart review was conducted on all neonates followed at the EA-TEF Clinic from 2005 to 2017. Primary outcomes were: survival, anastomotic leak, stricture, pneumothorax, and mediastinitis. Statistical significance was determined using Chi-square and logistic regression (p ≤ .05). We reviewed 91 charts. Twenty-five infants (27.5%) were bridged with postextubation noninvasive ventilation (15 on Continuous Positive Airway Pressure (CPAP), 5 on Noninvasive Positive Pressure Ventilation (NIPPV), and 14 on High-Flow Nasal Cannula (HFNC)). Overall, 88 (96.7%) patients survived, 25 (35.7%) had a stricture, 14 (20%) had anastomotic leak, 9 (12.9%) had a pneumothorax, and 4 (5.7%) had mediastinitis. Use of NIPPV was associated with increased risk of mediastinitis (P = .005). Use of HFNC was associated with anastomotic leak (P = .009) and mediastinitis (P = .036). These data suggest that postoperative noninvasive ventilation techniques are associated with a significantly higher risk of anastomotic leak and mediastinitis. Further prospective research is needed to guide postoperative ventilation strategies in this population. Retrospective study. IV.


Noninvasive investigation of hepatopulmonary syndrome in children and adolescents with chronic cholestasis.
Early detection of hepatopulmonary syndrome (HPS) may be delayed because of invasiveness of the diagnostic procedures. In this pilot study, we prospectively investigated the usefulness of determining transcutaneous O(2) tension after 100% O(2) (TcPO(2)100) breathing using a transcutaneous hyperoxia test (THT) in 11 children with chronic cholestasis and without primary cardiopulmonary disease. These patients also underwent alveolar-arterial O(2) gradient testing (AaDO(2)) at an inspired oxygen fraction (FiO(2)) of 0.21, lung scintiscan, and contrast transthoracic echocardiography (TTE). Three of them had a liver transplantation because of the downhill course of their liver disease and respiratory status. THT transcutaneous O(2) tension at 21% FiO(2) (TcPO(2)21) was 75 +/- 13 mm Hg, and increased to 488 +/- 106 mmHg after 100% O(2) breathing (TcPO(2)100). Both mean values were not significantly different from those found in 8 age-matched controls (P = 0.9 and P = 0.5, respectively). However, one patient, in spite of her stable liver function, showed an abnormal TcPO(2)21 and TcPO(2)100 (45 mmHg and 210 mmHg, respectively). This same subject was also the only patient with abnormalities of AaDO(2) (54.2 mm Hg; normal value, < 20 mm Hg), lung scintiscan (brain/lung ratio of technetium-99 fixation (B/L SI) = 9, normal value < 1), and TTE, suggesting intrapulmonary vasodilatations and shunts. Given the clinical development of cyanosis and platypnea, all criteria for HPS were fulfilled, and timing of her liver transplantation was therefore accelerated. This resulted in HPS regression. In children with chronic cholestasis, repeated transcutaneous bedside measurements are a rapid and reliable noninvasive test for characterizing the severity of abnormal oxygenation, and may prove useful also in liver posttransplantation monitoring.


Organocatalyzed enantioselective aldol reaction of 1H-pyrrole-2,3-diones.
The enantioselective cross aldol reaction of 1-benzyl 4,5-dioxo-2-aryl-4,5-dihydro-1H-pyrrole-3-carboxylates and ketones was studied with proline derivatives or cinchona alkaloid-derived primary amines as the catalysts for the first time. trans-4-Benzoyloxy-L-proline (15) was found to be the best catalyst for acyclic ketones. For cyclohexanone, the best results were achieved with 9-deoxy-9-epi-aminoquinine (18) as the catalyst in the presence of racemic 1,1'-binaphthyl-2,2'-diyl hydrogen phosphate (19) as the cocatalyst. Using these protocols, 3-alkyl-3-hydroxy-1H-pyrrol-2(3H)-one derivatives were obtained in excellent yields and good to high ee values (up to 94% ee).


Ligand-K* Sequence Elimination: A Novel Algorithm for Ensemble-Based Redesign of Receptor-Ligand Binding.
K* is rotamerically ensemble-based approach to compute the binding constant. However, its time-consuming feature limited its application. We present a novel algorithm that not only computes the partition function efficiently, but also avoids the exponential growth of execution time by iteratively pruning the sequence space until the sequence with highest affinity is identified.


Application of the Farm Simulation Model approach on economic loss estimation due to Coronavirus (COVID-19) in Bangladesh dairy farms-strategies, options, and way forward.
The objective of this paper is to quantify the economic loss of the dairy farms due to the pandemic novel Coronavirus (COVID-19) infection by analyzing the real-time data of two typical farms (BD-2 and BD-14 cow) in Bangladesh and propose a strategic plan of action to make policy decisions in order to support the dairy industry. The International Farm Comparison Network (IFCN) Farm Simulation Approach and Technology Impact Policy Impact Calculations (TIPICAL) model was used considering with Corona (WC) and without Corona (WOC). The Integrated Dairy Research Network (IDRN) database (January 2019 to July 2020) was used for simulation of IFCN two typical farms. The milk price is decreased by 17% and feed price is increased by 3.7% due to COVID-19 in March which was used as the base for farm simulation. This resulted in a decrease in milk yield by 7.9% and 8.9% for small household and family farms, respectively. The cost of milk production increased by 19.10% and 10.9% for household and family farms, respectively. This has an overall negative impact on farm income which accounted for national economic loss from dairy farms in Bangladesh to 4.43 million USD/day (36.84 crore BDT). This loss has been fluctuated from April onward and was higher in June (3.83 million USD/day) due to a combination of COVID-19, flood, and seasonality effect on lowering milk production. At the same time, the farmers' response to the resilience capacity (liquidity, operating profit margin, and financial performance) to combat COVID-19-induced situation has been declined substantially. Based on this, we conclude that the government might take a strategy to support farmers by providing financial support for increasing the operating capital and decreasing the cost of milk production. The outcome of this study is expected to be beneficial for policymakers, farmers, and processors in Bangladesh and similar other countries elsewhere.


Preexisting Rotator Cuff Tears as a Predictor of Outcomes in National Football League Athletes.
A preexisting rotator cuff tear may affect the draft status and career performance of National Football League (NFL) players. Preexisting rotator cuff tears decrease a player's draft status, performance, and longevity in the NFL. Retrospective cohort study. Level 3. Medical reports of prospective NFL players during the NFL Scouting Combine from 2003 to 2011 were evaluated to identify players with a previous rotator cuff tear. Athletes were matched to control draftees without documented shoulder pathology by age, position, year drafted, and round drafted. Career statistics and performance scores were calculated. Between 2003 and 2011, 2965 consecutive athletes were evaluated. Forty-nine athletes had preexisting rotator cuff tears: 22 athletes underwent surgical intervention for their tear and 27 were treated nonoperatively. Those with a rotator cuff tear were significantly less likely to be drafted than those without a previous injury (55.1% vs 77.5%, P = 0.002). The 27 drafted athletes with preexisting rotator cuff tears started significantly fewer games (23.7 vs 43.0, P = 0.02) and played significantly fewer years (4.3 vs 5.7, P = 0.04) and significantly fewer games (47.1 vs 68.4, P = 0.04) than matched control athletes without rotator cuff tears. Athletes with a preexisting rotator cuff tear were less likely to be drafted and had decreased career longevity.


Band atrophy of the optic nerve: A report on different anatomical locations in three patients.
Lesions of the optic tract are accompanied by various signs that help to distinguish them from hemianopias located posterior to the lateral geniculate body. Band optic nerve atrophy is one of these signs and typically occurs contralateral to the optic tract lesion. We report on three patients with band atrophy in the fundus of the eye. These three patients present examples of how three lesions with different anatomic locations can cause band atrophy of the optic disk in similar ways. In these cases, the presence of relative afferent pupillary defect (RAPD) and band atrophy becomes important in identifying the injury to the optic tract, because when the hemianopia is complete visual fields do not allow distinguishing optic tract lesions from occipital lesions. The RAPD occurs in the eye in which the visual field defect is greater. In this paper we review the different theories about the explanation for RAPD in patients with optic tract lesions. It does not seem as simple as the anatomical differences between the number of fibers that decussate in particular cases, rather, it is associated with the difference between the sensitivity levels of the two functioning hemiretinas.


3-Ligated Phenothiazinyl-terephthalonitrile Dyads and Triads - Synthesis, Electronic Properties, Delayed Fluorescence and Electronic Structure.
The bromine-lithium exchange-borylation-Suzuki sequence efficiently furnishes phenothiazine-terephthalonitrile donor-acceptor dyads and triads in high yields. In contrast to most phenothiazine-acceptor conjugates the title compounds are ligated in p-position to the phenothiazine nitrogen atom. Moreover, the acceptors are either directly linked or ligated by an arylene bridge and p-anisyl N-substituents on the phenothiazine are chosen to lock the tricycle into an intra-configuration. Cyclic voltammetry reveals effects of bridging and ligation of the N-substituent. Optical spectroscopy likewise displays similar band gaps, large Stokes shifts and substantial to high quantum yields in solution, in the solid state and in PMMA matrix. Time-resolved fluorescence spectroscopy indicates quite long fluorescence decay times in solution and emission components in the microsecond time range. TADF properties are further assessed by fluorescence increase in deoxygenated solution, gated emission spectroscopy and temperature-dependent determination of phosphorescence. The nature of the electronically excited states is investigated by DFT/MRCI. While for the directly ligated dyad a singlet-triplet energy gap Δ E ( S 1 - T 1 ) ${{E}_{{({\rm S}}_{1}-{{\rm T}}_{1})}{\rm \ }}$ of 0.24 eV can be estimated and is consistently confirmed by quantum chemical calculations on the lowest energy conformer, even lower Δ E ( S 1 - T 1 ) ${{\rm \Delta }{E}_{{(S}_{1}-{T}_{1})}{\rm \ }}$ of 0.029 and 0.008 eV are estimated for the investigated dyads and the triad in the solid state and in PMMA matrix.


Metallic carbide nanoparticles as stable and reusable substrates for sensitive surface-enhanced Raman spectroscopy.
We demonstrate for the first time that metallic carbide nanoparticles with a strong localized surface plasmon resonance (LSPR) effect could be used as SERS substrates to detect trace substances. They achieve a noble metal-comparable enhancement factor of 6.4 × 107.


Cognitive components of self esteem for individuals with severe mental illness.
In a sample of 182 individuals with severe mental illness, the applicability of reflected appraisals and self-enhancement theories as explanations for global self-esteem was examined at two time points on components of stigma, mastery, overall functioning, education, and job prestige. Path analysis demonstrated that the two theories work independently; and that stigma, mastery, and overall functioning are significant, persist over time, and have an enduring effect on self-esteem.


A systematic review of early motor interventions for infants with congenital heart disease and open-heart surgery.
Motor development delay is the first neurodevelopmental impairment that becomes apparent in infants with congenital heart disease (CHD). Early interventions have addressed high-risk groups like infants born preterm, but little is known about interventions to improve motor outcome in CHD infants at risk of motor delay. The purpose of this review was to systematically review the literature on type and effect of motor intervention applied during the first year of life in infants with CHD following open-heart surgery. Scoping searches were performed in May 2020 and April 2023 via MEDLINE, Embase, CINAHL, Cochrane, PsycINFO, PEDro, and Scopus. The review included studies published in English from 2015 to 2022. Primary outcome was infants' motor development measured by standardized and non-standardized motor assessments, and if available, infants' language and cognitive development, and any parental quality-of-life assessments as secondary outcomes. The studies' quality was evaluated with a modified Newcastle-Ottawa scale. Four papers with low to high methodological quality met inclusion criteria. All studies investigated the influence of early physiotherapy. Four studies involved parents, and three studies used standardized tools to assess motor outcomes. No conclusion can be drawn about any positive effect of early motor interventions. Early motor intervention in CHD infants may improve motor development; however, the few existing studies do not provide clear evidence. Thus, more prospective early intervention studies are needed. PROSPERO CRD42020200981.


The effect of oil as a dietary component on in vitro dissolution of an acid-labile drug.
The non-benzodiazepine-like anxiolytic agent deramiclane fumarate (EGIA-3886) was used to demonstrate that the presence of high oil/fat content in dissolution media serves as a barrier against accelerated drug degradation in acidic media.


Use of monoclonal antibodies in genetic research with nonhuman primates.
Monoclonal antibodies, because of their specificity and unlimited availability, have become one of the most powerful experimental tools available to the biological sciences. It is possible to make monoclonal antibodies that bind to determinants that are monomorphic in one or more species or to determinants that are polymorphic within a species. Few monoclonal antibodies have been made using immunogens derived from nonhuman primates. However, some monoclonal antibodies that recognize monotypic markers in humans can be used to detect polymorphic markers in nonhuman primates. Thus, the rapid development of monoclonal antibodies specific for human proteins significantly increases the potential number of immunogenetic markers useful for studying phylogenetic relationships and for identifying genetic polymorphisms among nonhuman primates.


Muscular injury in a child diagnosed by 99mTc-MDP bone scan.
An 11-year-old boy had bone scanning to rule out an osseous lesion of the right arm. He presented progressive pain and hard swelling of the right arm. His past medical history and general physical examination were unremarkable. He trained for karate. The scan demonstrated considerable muscular uptake in both arms. CPK and CPK MB levels were both abnormally high, suggesting muscle injury. After a 10-day rest period the bone scan returned to normal.


Is miraa a drug?: categorizing Kenyan khat.
This article examines the varied perceptions of the substance miraa/khat in Kenya, from strong approval in the Nyambene Hills region where it is cultivated to the strong disapproval evident in its frequent denunciation in various segments of Kenyan society. Perceptions are colored by various local and global discourses, and it is argued that of great importance is "war on drugs" rhetoric, which allows the conflation of miraa with other substances also termed "drugs"; much of the Kenyan miraa debate revolves around just how miraa should be categorized and to whether it can be labeled a "drug." War-on-drugs rhetoric is countered by those more enamored of the substance by discourse in which its use is labeled "traditional," "cool," and an "economic miracle."


Prenatal Hypoxia Induced Dysfunction in Cerebral Arteries of Offspring Rats.
Hypoxia during pregnancy could cause abnormal development and lead to increased risks of vascular diseases in adults. This study determined angiotensin II (AII)-mediated vascular dysfunction in offspring middle cerebral arteries (MCA). Pregnant rats were subjected to hypoxia. Vascular tension in offspring MCA by AII with or without inhibitors, calcium channel activities, and endoplasmic reticulum calcium stores were tested. Whole-cell patch clamping was used to investigate voltage-dependent calcium channel currents. mRNA expression was tested using quantitative real-time polymerase chain reaction. AII-mediated MCA constriction was greater in male offspring exposed to prenatal hypoxia. AT1 and AT2 receptors were involved in the altered AII-mediated vasoconstriction. Prenatal hypoxia increased baseline activities of L-type calcium channel currents in MCA smooth muscle cells. However, calcium currents stimulated by AII were not significantly changed, whereas nifedipine inhibited AII-mediated vasoconstrictions in the MCA. Activities of IP3/ryanodine receptor-operated calcium channels, endoplasmic reticulum calcium stores, and sarcoendoplasmic reticulum membrane Ca2+-ATPase were increased. Prenatal hypoxia also caused dysfunction of vasodilatation via the endothelium NO synthase. The mRNA expressions of AT1A, AT1B, AT2R, Cav1.2α1C, Cav3.2α1H, and ryanodine receptor RyR2 were increased in the prenatal-hypoxia group. Hypoxia in pregnancy could induce dysfunction in both contraction and dilation in the offspring MCA. AII-increased constriction in the prenatal-hypoxia group was not mainly dependent on the L-type and T-type calcium channels; it might predominantly rely on the AII receptors, IP3/ryanodine receptors, and the endoplasmic reticulum calcium store as well as calcium ATPase.


Impact of agricultural policies on caloric consumption.
In this article we use an economic model to link markets for agricultural commodities to food-product markets, and to trace the effects of agricultural policies on prices of food products and, consequently, on food consumption and calorie intake. Contrary to common claims, US agricultural policies have had generally modest and mixed effects on prices and quantities of farm commodities, with negligible effects on the prices paid by consumers for food, and thus a negligible influence on dietary patterns and obesity.


Physico-chemical and MR relaxometry study of bovine serum albumin-coated magneto-plasmonic nanoparticles designed for potential use in cancer nanotheranostics.
In recent years, the use of nanoparticles has been developed to improve MRI contrast. To improve the contrast agents in image-guided therapy by Multifunctional nanoparticles, in this study, we synthesized a theranostic magneto-plasmonic nanocomplex based on magnetic iron oxide nanoparticles and bovine serum albumin-modified gold nanorod (Au@BSA-Fe3O4@CMD). The purpose of synthesizing these nanoparticles was to use them as MRI contrast agent and photothermal agents in in vitro and in vivo experiments. Initially, the properties of the synthesized nanoparticles were investigated by methods such as DLS, TEM, FTIR. MTT assay was used to evaluate the toxicity of nanoparticles. Finally, to evaluate the contrast ability of nanoparticles, MRI images were taken in in vitro and in vivo conditions and then the images were analyzed. MTT test results on CT26 cell line showed no significant cytotoxicity for Au@BSA-Fe3O4@CMD nanoparticles at concentrations up to 20 ppm. The in vitro results demonstrated that the Au@BSA-Fe3O4@CMD nanocomplex has high T2 relaxation rate and great relaxivities (r2 = 140.14 mM-1 s-1, r1 = 2.066 mM-1 s-1, r2/r1 = 67.83). For in vivo conditions, a decrease in T2 signal of 9.64 and 11.01, respectively, was observed for intratumoral and intraperitoneal injection of nanoparticles. These in vitro and in vivo studies show that Au @ BSA-Fe3O4@CMD nanoparticles can significantly reduce the signal intensity of T2-weight MRI images, and therefore can offer significant potential as a theranostic platform for effective tumor MR imaging.


Quality and Quantity of Memories in Patients Who Undergo Awake Brain Tumor Resection.
Awake craniotomy is performed with increasing frequency for brain tumor surgery in eloquent areas; however, little is known about patients' memories of this procedure. Here we retrospectively analyzed the quality and quantity of memories in a series of patients treated following a standardized protocol. We treated 61 consecutive patients within 3 years, 48 of whom were alive when the study was performed. Each of these patients received a questionnaire eliciting information about their perioperative memories and perceptions. The perioperative process was broken down into steps, and for each step the patient was to judge the quantity (nothing-everything) and quality (very negative-very positive) of his or her memories. Thirty-six of the 48 patients completed the questionnaire (75%). The quantity of memories was quite incomplete, even for intraoperative moments when patients were awake and cooperative. On average, the quality of memories was neutral or positive. A higher quantity of memories was associated with a higher quality of memories. The most commonly reported sources of discomfort were placement of the Mayfield clamp, followed by laying on the operating room table with movement restriction, and irritation by the urinary catheter in situ. Awake craniotomy can be performed following our protocol in such a way that it is experienced as (very) comfortable. However, there are moments of discomfort, which can be managed by the team. Extensive preoperative preparation may be considered a crucial part of the procedure. Less amnesia seems to improve patient satisfaction. The results of this study can help guide protocol optimization, expectation management, and information for future patients.


Relapsing polychondritis with features of dementia with Lewy bodies.
We describe a 72-year old man with clinical features suggestive of dementia with Lewy bodies (DLB) who proved neuropathologically to have degeneration induced by relapsing polychondritis (RP), an autoimmune inflammatory disorder of cartilaginous tissues. There was lymphocytic infiltration of the leptomeninges, perivascular cuffing, reactive astrocytosis, and activation of microglia in multiple brain areas all consistent with an immunologically mediated process. There was widespread neuronal loss within the hippocampus, entorhinal cortex, and amygdala as well as diffuse myelin pallor of cortical pathways. Elevated levels of complement proteins and endothelial markers of inflammation were observed, which are similar to previous reports in DLB. This study demonstrates that qualitatively similar inflammation-associated neurodegeneration is present in widespread regions of the brain in a RP case presenting clinically as DLB.


Optimization of heterogeneous vehicle logistics scheduling with multi-objectives and multi-centers.
Industrial enterprises have high requirements on timeliness and cost when delivering industrial products to their customers. For this reason, this paper studies the vehicle routing problem (VRP) of different vehicle models in multiple distribution centers. First of all, we consider the multi-dimensional constraints in the actual distribution process such as vehicle load and time window, and build a multi-objective optimization model for product distribution with the goal of minimizing the distribution time and cost and maximizing the loading rate of vehicles. Furthermore, an Improved Life-cycle Swarm Optimization (ILSO) algorithm is proposed based on the life cycle theory. Finally, we use the order data that Yunnan Power Grid Company needs to deliver to the customer (municipal power supply bureau) on a certain day to conduct a dispatching experiment. The simulation and application results show that the transportation cost of transportation obtained by the ILSO algorithm is reduced by 0.8% to 1.6% compared with the other five algorithms. Therefore, ILSO algorithm has advantages in helping enterprises reduce costs and improve efficiency.


Sustaining a Global Social Network: a quasi-experimental study.
To examine the longer term impact on the social network of participating nurses in the Global Nursing Leadership Institute (GNLI2013) through using differing frequencies of follow-up to assess impact on maintenance of network cohesion. Social network analysis is increasingly been used by nurse researchers, however, studies tend to use single point-in-time descriptive methods. This study utilizes a repeated measures, block group, control-intervention, quasi-experimental design. Twenty-eight nurse leaders, competitively selected through a double-blind peer review process, were allocated to five action learning-based learning groups. Network architecture, measures of cohesion and node degree frequency were all used to assess programme impact. The programme initiated and sustained connections between nurse leaders drawn from a geographically dispersed heterogeneous group. Modest inputs of two to three e-mails over a 6-month period seem sufficient to maintain connectivity as indicated by measures of network density, diameter and path length. Due to the teaching methodology used, the study sample was relatively small and the follow-up data collection took place after a relatively short time. Replication and further cohort data collection would be advantageous. In an era where many policy solutions are being debated and initiated at the global level, action learning leadership development that utilizes new technology follow-up appears to show significant impact and is worthy of wider application. The approach warrants further inquiry and testing as to its longer term effects on nursing's influence on policy formulation and implementation.


[Reticulate evolution of parthenogenetic species of the Lacertidae rock lizards: inheritance of CLsat tandem repeats and anonymous RAPD markers].
The genetic relatedness of several bisexual and of four unisexual "Lacerta saxicola complex" lizards was studied, using monomer sequences of the complex-specific CLsat tandem repeats and anonymous RAPD markers. Genomes of parthenospecies were shown to include different satellite monomers. The structure of each such monomer is specific for a certain pair of bisexual species. This fact might be interpreted in favor of co-dominant inheritance of these markers in bisexual species hybridogenesis. This idea is supported by the results obtained with RAPD markers; i.e., unisexual species genomes include only the loci characteristic of certain bisexual species. At the same time, in neither case parthenospecies possess specific, autoapomorphic loci that were not present in this or that bisexual species.


Synergistic combination of azithromycin and sulfadiazine for treatment of toxoplasmosis in mice.
Experiments were performed in vivo in a mouse model of acute toxoplasmosis to evaluate the effectiveness of the combination azithromycin/sulfadiazine. Azithromycin alone or sulfadiazine alone, at doses that did not provide any protection against death due to toxoplasmosis, were remarkably and significantly synergistic against murine toxoplasmosis when administered in combination.


Altered regulation of heat shock gene expression in heat resistant mouse cells.
The differences in the heat shock gene regulation between the RIF-1 cell line and its heat resistant derivative TR4 are further characterized. In vitro gel retardation assays were used to assess the presence of activated heat shock transcription factor in the two cell lines. The levels of the heat-inducible HSP 70.1, the constitutive HSC 70, the germ line-specific HSP 70.2, and the HSP 28 mRNAs in both untreated and iso-heated RIF-1 and TR4 cells were determined using the polymerase chain reaction coupled with the reverse transcriptase reaction. Induction and decay of induced heat shock protein synthesis was measured by 35S-methionine labeling of proteins. Unheated TR4 cells display characteristics of heat shocked RIF-1 cells. TR4 cells have a constitutively activated heat shock transcription factor and elevated levels of the HSP 70.1, HSC 70, and the HSP 28 mRNAs. Upon an equal heat dose of 45 degrees C, 15 min, the TR4 cells exhibited a more rapid onset in heat shock mRNA and protein induction than did the RIF-1 cells. During the recovery from heat shock, the activated heat shock transcription factor and the induced HSP70 mRNAs decayed more slowly in the TR4 cells, although the protein synthesis pattern of the TR4 cells returned to control levels more rapidly following heat shock than did protein synthesis of the RIF-1 cells. Unheated TR4 cells are similar to heat shocked RIF-1 cells at the transcriptional level. Induced HSP70 expression is modulated by the severity of the heat treatment (or the degree of heat damage) perceived by the cells rather than by the absolute heat dose given. We propose that the unheated TR4 cells are locked into the "ON" state of the heat shock response.


Comparison of laparoscopic versus open pancreaticoduodenectomy in patients with resectable pancreatic ductal adenocarcinoma: A propensity score-matching analysis of long-term survival.
Many studies have shown the short-term feasibility and effectiveness of laparoscopic pancreaticoduodenectomy (LPD) are comparable to open pancreaticoduodenectomy (OPD). However, the long-term oncological safety of LPD in patients with pancreatic ductal adenocarcinoma (PDAC) remains to be elucidated. Patients who underwent LPD or OPD between July 2014 and July 2018 at our institution were identified, and those with resectable, pathologically diagnosed PDAC were analyzed. The primary outcome was overall survival (OS). Propensity score-matching (PSM) analysis was performed to balance the baseline characteristics between groups. Cox proportional hazards model was constructed to determine independent predictors of OS. The original cohort consisted of 64 LPD and 80 OPD cases, in which, the laparoscopic group had a significantly longer median OS (25 vs. 17 months; P = 0.034). A higher proportion of laparoscopic patients received adjuvant therapy (51.6 vs. 32.5%; P = 0.021). PSM analysis identified 47 patient pairs. No significant differences in OS (21 vs. 17 months; P = 0.220) or adjuvant therapy utilization (53.2 vs. 38.3%; P = 0.248) were observed between the matched groups. Multivariate Cox analyses showed that receiving adjuvant therapy (HR = 0.44; 95% CI, 0.28-0.68), histopathological differentiation (poor vs. moderate-to-well differentiation; HR = 1.93; 95% CI, 1.26-2.95), and sex (female vs. male, HR = 0.47, 95% CI, 0.30-0.75) were independent predictors of OS. LPD can be comparable to OPD in terms of long-term safety for patients with resectable pancreatic ductal adenocarcinoma when performed in a high-volume center.


Cancer and Employment Issues: Perspectives from Cancer Patient Navigators.
Among individuals diagnosed with cancer, 40 % are working-age adults who will face numerous challenges in returning to work, yet oncology providers report limited guidance and uncoordinated communication processes in addressing patients' work-related issues. Cancer patient navigators are uniquely positioned to fill this care and communication gap due to their focus on both practical matters and clinical care. This cross-sectional study utilized survey methodology to collect quantitative and qualitative data from 58 cancer patient navigators to (1) identify patients' cancer and employment issues that commonly challenge navigators and (2) identify the necessary training navigators felt would allow them to more effectively help patients deal with cancer and employment issues. Participants from the southeast USA were invited to complete a paper survey while in attendance at a statewide cancer patient navigator conference or online via the state comprehensive cancer coalition's cancer patient navigator listserv. Results suggest financial burdens, work and treatment conflicts, taking unpaid leave for cancer care, and working through treatment were common concerns among their patients. Navigators also identified employment, legal, government programs, and financial resources as important training and education topics that would help them address their clients' employment and cancer conflicts. Given the fact that employment issues remain one of the most common unmet need of survivors and the increasing presence of navigators across the USA, it is important to address the role of navigators in meeting patients' needs regarding cancer and employment and ensure they are provide with adequate training and resources.


Novel criteria for the diagnosis of Marek's disease virus-induced lymphomas.
Several novel criteria have been tested to assist in the differential diagnosis of tumours induced by Marek's disease virus (MDV) from those induced by avian leukosis virus (ALV) and reticuloendotheliosis virus (REV). A collection of tumours induced by inoculation of specific strains of MDV, ALV and REV, alone or in combination, were tested for quantification of MDV DNA by real-time polymerase chain reaction, expression of the MDV oncogene Meq, expression of several cell markers associated with transformation (CD30, Marek's disease-associated surface antigen, and p53), and level of DNA methylation in the tumour cells. In addition, tissues latently infected with MDV and non-infected tissues were tested as controls. Tumours induced by MDV had about 10(2)-fold more copies of MDV DNA than either tissues latently infected by MDV or tumours induced by retrovirus in MDV-vaccinated chickens. Moreover, the MDV antigen Meq was consistently expressed in all MDV tumours but it could not be detected in tissues latently infected with MDV or in tumours induced by retrovirus in MDV-vaccinated chickens. Other markers studied were not specific for MDV and therefore had limited value for diagnosis. Nonetheless, some of these markers might have potential value in research as they will help to identify transformed cells.


The Leipzig prospective vascular ultrasound registry in radial artery catheterization: impact of sheath size on vascular complications.
This study investigated the impact of sheath size on the rate of radial artery occlusions (RAO) (primary objective) and other access site complications (hemorrhage, pseudoaneurysm, arteriovenous fistula) as secondary objectives after transradial coronary catheterization. The number of vascular access complications in the published data ranges from 5% to 38% after transradial catheterization. Between November 2009 and August 2010, 455 patients 65.3 ± 10.9 years of age (62.2% male) with transradial access with 5-F (n = 153) or 6-F (n = 302) arterial sheaths were prospectively recruited. Duplex sonography was obtained in each patient before discharge. Patients with symptomatic RAO were treated with low-molecular-weight heparin (LMWH), and a follow-up was performed. The incidence of access site complications was 14.4% with 5-F sheaths compared with 33.1% with 6-F sheaths (p < 0.001). Radial artery occlusion occurred in 13.7% with 5-F sheaths compared with 30.5% with 6-F sheaths (p < 0.001). There was no difference between groups with regard to hemorrhage, pseudoaneurysms, or arteriovenous fistulas. Female sex, larger sheath size, peripheral arterial occlusive disease, and younger age independently predicted RAO in multivariate analysis. In total, 42.5% of patients with RAO were immediately symptomatic; another 7% became symptomatic within a mean of 4 days. Of patients with RAO, 59% were treated with LMWH. The recanalization rates were significantly higher in patients receiving LMWH compared with conventional therapy (55.6% vs. 13.5%, p < 0.001) after a mean of 14 days. The incidence of RAO by vascular ultrasound was higher than expected from previous data, especially in patients who underwent the procedure with larger sheaths.


Preparation of gold nanoparticles/functionalized multiwalled carbon nanotube nanocomposites and its glucose biosensing application.
Gold nanoparticles stabilized by amino-terminated ionic liquid (Au-IL) have been in situ noncovalently deposited on poly(sodium 4-styrene-sulfonate) (PSS)-functionalized multiwalled carbon nanotubes (MWCNTs) to form a MWCNTs/PSS/Au-IL nanocomposite. PSS can interact with MWCNTs through hydrophobic interaction. Amino-terminated ionic liquid was applied to reduce aqueous HAuCl(4), and the resulting gold nanoparticles were attached to the PSS-functionalized MWCNTs simultaneously. Most gold nanoparticles dispersed well on the functionalized MWCNTs. Transmission electron microscopy, Raman and X-ray photoelectron spectroscopy were used to confirm the composition and structure of the nanocomposites. The resulting MWCNTs/PSS/Au-IL composite exhibits good electrocatalysis toward oxygen and hydrogen peroxide reduction. And good biocompatibility with glucose oxidase was also demonstrated due to its good biocatalysis toward glucose substrate, which offered a friendly environment for the immobilization of biomolecules. Such bionanocomposite provides us potential applications in fabrication of biosensors. The resulting biosensor exhibits good response to glucose with a low detection limit 25 microM. It also has excellent reproducibility, satisfied operational stability and good storage stability.


Manual discrimination and identification of length by the finger-span method.
Experiments were conducted on length resolution for objects held between the thumb and fore-finger. The just noticeable difference in length measured in discrimination experiments is roughly 1 mm for reference lengths of 10 to 20 mm. It increases monotonically with reference length but violates Weber's law. Also, it decreases when the subject is permitted to maintain a constant finger span between trials; however, it tends to increase when the nondominant hand is used. As would be expected from studies of other stimulus dimensions in other sense modalities, resolution is considerably poorer in identification experiments than in discrimination experiments. For stimulus sets that cover a broad range (90 mm), the total information transfer is roughly 2 bits; for those that cover a relatively small range (18 mm), it is roughly 1 bit. The data are analyzed and interpreted using analysis techniques and models that have been used previously in studies of audition (e.g., Durlach & Braida, 1969).


Helix-loop-helix proteins regulate pre-TCR and TCR signaling through modulation of Rel/NF-kappaB activities.
E2A and HEB are basic helix-loop-helix transcription factors essential for T cell development. Complete inhibition of their activities through transgenic overexpression of their inhibitors Id1 and Tal1 leads to a dramatic loss of thymocytes. Here, we suggest that bHLH proteins play important roles in establishing thresholds for pre-TCR and TCR signaling. Inhibition of their function allows double-negative cells to differentiate without a functional pre-TCR, while anti-CD3 stimulation downregulates bHLH activities. We also find that the transcription factor NF-kappaB becomes activated in transgenic thymocytes. Further activation of NF-kappaB exacerbates the loss of thymocytes, whereas inhibition of NF-kappaB leads to the rescue of double-positive thymocytes. Therefore, we propose that E2A and HEB negatively regulate pre-TCR and TCR signaling and their removal causes hyperactivation and apoptosis of thymocytes.


Manganese superoxide dismutase from Biomphalaria glabrata.
The investigation of the response of Biomphalaria glabrata snails to Echinostoma paraensei (digenea) at 2 days post-exposure by suppression subtractive hybridization yielded a partial sequence of the anti-oxidant enzyme manganese superoxide dismutase (MnSOD). Full-length MnSOD (669nt) from M line and BS-90 strains of B. glabrata differed by one synonymous nucleotide replacement. B. glabrata has 1-4 MnSOD loci (Southern hybridization). Both snail strains expressed MnSOD at equal baseline levels (quantitative PCR). Susceptible snails increased expression of MnSOD following infection with E. paraensei or Schistosoma mansoni, and expression was reduced in the incompatible combination (BS-90 B. glabrata and S. mansoni). Thus, MnSOD did not determine resistance or susceptibility for these parasites, but expression of MnSOD is consistent with its involvement in a stress response of B. glabrata.