Surface modification of TiO2/ZnO nanoparticles by organic acids with enhanced methylene blue and rhodamine B dye adsorption properties.
The United Nations Organization (UNO) has revealed that approximately 2.1 billion people do not have access to treated water. Methylene blue (MB) and rhodamine B are produced as water pollutants in textile, plastic, and dye industries. In this study, oxalic acid or lactic acid surface-modification were applied to TiO2/ZnO nanoparticles aiming to improve antibacterial and adsorption properties. The mixtures containing the corresponding acid and nanoparticles in 0.25 : 1/0.5 : 1 ratios of ZnO and TiO2 correspondingly were subjected to ultrasonic treatment with a catenoidal ultrasonic probe coupled to a homemade ultrasonic generator with an output power of 750 W, wave amplitude of 50% and variable frequency in the range of 15-50 kHz. To verify the influence of the ultrasonic treatment, different treatment times of 30, 45, 60, and 90 min were applied. Unmodified and modified TiO2/ZnO nanoparticles were characterized by FTIR, TGA, XRD, SEM, and XPS. From the results, obtained from the physicochemical characterization, in the ZTO90 and ZTL90 samples a greater modification was shown. The SEM images showed that a coating was present on the surface of the ceramic particles of the ZTL90 sample. The O 1s deconvolution in the XPS spectra indicates a greater presence of C[double bond, length as m-dash]O bonds in the ZTL90 sample. In parallel, the sample ZTL90 presented 85 and 89% adsorption efficiency for MB and rhodamine B dyes in a time of 12 min, and important antibacterial activity against E. coli and S. epidermis could be evidenced.


Effects of the ammonium stress on photosynthesis and ammonium assimilation in submerged leaves of Ottelia cordata - an endangered aquatic plant.
Although ammonium (NH4+-N) is an important nutrient for plants, increases in soil nitrogen (N) input and atmospheric deposition have made ammonium toxicity a serious ecological problem. In this study, we explored the effects of NH4+-N stress on the ultrastructure, photosynthesis, and NH4+-N assimilation of Ottelia cordata (Wallich) Dandy, an endangered heteroblastic plant native to China. Results showed that 15 and 50 mg L-1 NH4+-N damaged leaf ultrastructure and decreased the values of maximal quantum yield (Fv/Fm), maximal fluorescence (Fm), and relative electron transport rate (rETR) in the submerged leaves of O. cordata. Furthermore, when NH4+-N was ≥ 2 mg L-1, phosphoenolpyruvate carboxylase activity (PEPC) and soluble sugar and starch contents decreased significantly. The content of dissolved oxygen in the culture water also decreased significantly. The activity of the NH4+-N assimilation enzyme glutamine synthetase (GS) significantly increased when NH4+-N was ≥ 10 mg L-1 and NADH-glutamate synthase (NADH-GOGAT) and Fd-glutamate synthase (Fd-GOGAT) increased when NH4+-N was at 50 mg L-1. However, the activity of nicotinamide adenine dinucleotide-dependent glutamate dehydrogenase (NADH-GDH) and nicotinamide adenine dinucleotide phosphate-dependent glutamate dehydrogenase (NADPH-GDH) did not change, indicating that GS/GOGAT cycle may play an important role in NH4+-N assimilation in the submerged leaves of O. cordata. These results show that short-term exposure to a high concentration of NH4+-N is toxic to O. cordata.


Bone marrow as a priming site for T-cell responses to blood-borne antigen.
Although bone marrow is known as a primary lymphoid organ, its potential to serve as a secondary immune organ has hardly been explored. Here we demonstrate that naive, antigen-specific T cells home to bone marrow, where they can be primed. Antigen presentation to T cells in bone marrow is mediated via resident CD11c+ dendritic cells. They are highly efficient in taking up exogenous blood-borne antigen and processing it via major histocompatibility complex class I and class II pathways. T-cell activation correlates with dendritic cell-T cell clustering in bone marrow stroma. Primary CD4+ and CD8+ T-cell responses generated in bone marrow occur in the absence of secondary lymphoid organs. The responses are not tolerogenic and result in generation of cytotoxic T cells, protective anti-tumor immunity and immunological memory. These findings highlight the uniqueness of bone marrow as an organ important for hemato- and lymphopoiesis and for systemic T cell-mediated immunity.


pH dynamics in sewers and its modeling.
pH variation in sewers has a significant effect on hydrogen sulfide production and emissions, and hence its accurate prediction is critical for the optimization of mitigation strategies. In this study, the nature and dynamics of pH variation in a sewer system is examined. Three sewer systems collecting domestic wastewater were monitored, with pH in all cases showing large diurnal variations. pH in fresh sewage in all three cases had a very similar trend with maximum pH in the range of 8.5-8.7. pH variation in fresh sewage followed the same pattern as the sewage flow rate, suggesting that sewage pH is influenced by household water use. Nitrogen content of the wastewater was found to be the most influential factor causing pH variation in fresh sewage, with the total ammonium concentration variation well correlated with the pH variation. A methodology for predicting pH variation in sewers is developed and calibration protocols proposed. The methodology, which is based on the concept of charge balance, was validated using titration curves and field pH data. Measurement of the total ammonium concentration in fresh sewage was found necessary and adequate for the calibration of the charge balance-based pH model.


Dissatisfaction among women with "thunder thighs" undergoing closed aspirative lipoplasty.
In our practice, we have uncovered a small series of female patients with "thunder thighs" who were dissatisfied with results of closed aspirative lipoplasty. The common problem appears to be unrealistic expectations. These patients expected a change in body habitus. This article reiterates the need for careful patient selection and preoperative information of what the procedure can and cannot accomplish.


Factors involved in the uptake of corticosterone by rat liver cells.
Isolated rat liver cells take up corticosterone rapidly; the initial rates increase with increasing temperature. A plot of the initial rates against the concentration of corticosterone indicated the presence of saturable and nonsaturable uptake systems. The Eadie-Hofstee plot showed the presence of two saturable and one nonsaturable uptake components. The apparent Kt values of the saturable systems were 64 +/- 40 nM (n = 3) and 1085 +/- 313 nM (n = 12). The nonsaturable system, probably diffusion, contributed 12% to the total uptake between 15 and 72 nM corticosterone, the physiological concentration of the free corticosterone in rat serum. Metabolic inhibitors did not influence the uptake of corticosterone. N-Ethylmaleimide, 1-fluoro-2,4-dinitrobenzene and sodium ethyl mercurithiosalicylate (1 mM each) decreased the uptake by 40%. Iodoacetate did not have any influence. Treatment of cells with phospholipase A inhibited the uptake 35--45%. In the presence of cortisone, cortisol, dexamethasone, aldosterone, testosterone, estradiol-17beta and estrone (2 muM each) the uptake decreased 30--50%. The presence of serum proteins in the external medium inhibits the uptake of corticosterone. These results suggest that corticosterone is transported into the cell and is accumulated. Only the free hormone is available for uptake which in turn may be regulated by protein and lipid components in the plasma membrane of the liver cell.


Decreased renal expression of the putative calcium oxalate inhibitor Tamm-Horsfall protein in the ethylene glycol rat model of calcium oxalate urolithiasis.
Tamm-Horsfall protein is believed to inhibit calcium oxalate crystallization, aggregation or adhesion to the renal epithelium. We determined whether ethylene glycol induced urolithiasis changes the expression of renal and urinary Tamm-Horsfall protein. For comparison the expression of another calcium oxalate inhibitor, osteopontin, was also analyzed. Male rats were treated with 0.75% ethylene glycol plus an AIN-76 diet (Dyets, Bethlehem Pennsylvania) (ethylene glycol group) or standard rat chow and water (control group) for up to 8 weeks (6 per group for 8 weeks and 3 per group for 3 days to 6 weeks). Kidneys and urine (8 weeks only) were harvested and analyzed by Northern and Western blot analysis, and immunohistochemistry. Tamm-Horsfall protein message and protein (membrane bound form) were decreased, while those of osteopontin were increased in the kidneys of rats treated with ethylene glycol for 8 weeks. As judged by immunochemistry Tamm-Horsfall protein and osteopontin were consistently present in a few tubules in rats in the ethylene glycol and control groups, respectively. In urine expression of the free form of Tamm-Horsfall protein (approximately 75 kDa.) was decreased but detectable in ethylene glycol treated rats. Although readily detected in tissue, osteopontin was not detected in the urine of control or ethylene glycol treated rats. In the time course experiment Tamm-Horsfall protein did not decrease until 4 weeks, when calcium oxalate crystals were detectable in the kidneys of treated rats. In contrast, osteopontin was increased, although inconsistently, beginning at 3 days. Unlike other calcium oxalate inhibitors, such as osteopontin, renal message and protein for Tamm-Horsfall protein was decreased in ethylene glycol treated rats. Tamm-Horsfall protein expression did not decrease until aggregates of crystals had been deposited in the kidneys, while osteopontin expression began to increase almost immediately. Comparisons of the data on kidneys and urine obtained by RNA or protein blot analysis and immunochemistry underscore the need to examine tissue and urine by multiple techniques to obtain the most accurate assessment of how protein expression is changed by a given treatment.


Barriers to the participation of men in reproductive health care: a systematic review and meta-synthesis.
Despite emphasizing the importance and benefits of men's active engagement in reproductive health programs, their engagement in reproductive health care is low. Researchers have identified different barriers to men's avoidance of participation in various aspects of reproductive health in different parts of the world. This study provided an in-depth review of the hindrances to men's non-participation in reproductive health. This meta-synthesis was conducted using keyword searches in databases including PubMed, Scopus, Web of Science, Cochrane, and ProQuest until January 2023. Qualitative English-language studies that investigated barriers to men's participation in reproductive health were included in the study. The critical appraisal skills program (CASP) checklist was used to assess the articles' quality. Data synthesis and thematic analysis were done using the standard method. This synthesis led to the emergence of four main themes such as failure to access all inclusive and integrated quality services, economic issues, couples' personal preferences and attitudes, and sociocultural considerations to seek reproductive healthcare services. Healthcare system programs and policies, economic and sociocultural issues, and men's attitudes, knowledge, and preferences, influence men's participation in reproductive healthcare. Reproductive health initiatives should focus on eliminating challenges to men's supportive activities to increase practical men's involvement in reproductive healthcare.


The Relationship Between Cerebral Reperfusion And Regional Expression Of Matrix Metalloproteinase-9 In Rat Brain Following Focal Cerebral Ischemia.
We investigated the effect of full and partial mechanical reperfusion on MMP-9 expression in rat brain following middle cerebral artery occlusion, mimicking mechanical thrombectomy. Using percentage hemispheric lesion volume and oedema as measures, partial reperfusion reduced extent of brain damage caused by MCA occlusion, but the protective effect was less pronounced than with complete reperfusion. Using ELISA quantification in fresh frozen tissue, confirmed by immunofluorescence in perfusion fixed tissue, increased MMP-9 expression was observed in infarcted tissue. MMP-9 was increased in lesioned tissue of the anterior and posterior temporal cortex and underlying striatal tissue, but also the normal appearing frontal cortex. No significant increase in MMP-9 in the hippocampus was observed, nor in the unlesioned contralateral hemisphere. Both partial reperfusion and full reperfusion reduced the regional MMP expression significantly. The highest levels of MMP-9 were observed in lesioned brain regions in the non-reperfused group. MMP-9 expression was evident in microvessels and in neuronal cell bodies of affected tissue. This study shows that MMP-9 brain levels are reduced relative to the extent of reperfusion. These observations suggest targeting early increases in MMP-9 expression as a possible neuroprotective therapeutic strategy and highlight the rat MCA occlusion model as an ideal model in which to study candidate therapeutics.


[Non-invasive monitoring of cardiac output with Doppler in aortoiliac surgery. Preliminary study].
The experience about 18 patients subjected to aortoiliac surgery is exposed. The cardiac flow was bloodless monitorized by means of an apparatus, based in Doppler effect, which proved its accuracy and usefulness. Authors considers necessary to monitorize the cardiac flow in this sort of surgery, and this bloodless method has showed its validity and simplicity.


Effect of Y1 receptor deficiency on motor activity, exploration, and anxiety.
Neuropeptide Y (NPY) in the CNS plays an important regulatory role in anxiety-related responses as exogenous administration of NPY exerts an anxiolytic-like effect in rodents. This effect is believed to be mediated by the Y(1) receptor system as pharmacological modulation of this Y(1) receptor system results in an increase in anxiety. Here we present a comprehensive phenotyping strategy for characterizing Y(1) receptor knockout animals at different times of the circadian rhythm using several motor activity-, exploration-, and anxiety-related behavioural tasks including open field, elevated plus maze, light-dark, and hole board test. We show that Y(1) deficiency has an important effect on motor activity and explorative-like behaviours and that it results in marked alterations in anxiety-related behaviours. Importantly, the behavioural phenotype of the Y(1) receptor knockout mice is circadian rhythm-dependent and also influenced by stimuli such as restraint stress. In addition, we found evidence for increases in working memory. Taken together, these findings suggest an important role of Y(1) receptors in the regulation of motor activity, exploration, and anxiety-related behaviours. This role is also influenced by several factors such as circadian rhythm and stress exposure confirming the importance of a comprehensive strategy and of using genetic animal models in behavioural neuroscience.


5-Fluorouracil substitution alters pre-mRNA splicing in vitro.
We are interested in determining whether incorporation of the drug 5-fluorouracil into pre-mRNA can alter RNA processing. The effect of 5-fluorouracil (FUra) substitution on the in vitro splicing of pre-mRNA was studied. 32P-Labeled human beta-globin pre-mRNA containing the first two exons and the first intervening sequence was synthesized in the presence of UTP, FUTP, or both. In vitro splicing reactions generated several abnormal intermediates and products from FUra-substituted transcripts. The appearance of a new minor spliced product was dependent on both the pH of the splicing reaction and the extent of FUra incorporation into pre-mRNA. Abnormal splicing was observed at pH 8.4 and 7.7 but not at pH 6.7. The new minor spliced product was sequenced and found to contain an additional 20 bases derived from the 3'-end of the intervening sequence. The abnormally migrating intermediate had the same structure as the normal lariat-exon intermediate. These results suggest that FUra substitution into pre-mRNA can alter splicing in vitro.


The Implication of Diagnostic Errors.
Diagnostic errors are mistakes in the diagnostic process that lead to a misdiagnosis, a missed diagnosis, or a delayed diagnosis. While the past decade's impetus to improve patient safety has focused on medication errors, health care-associated infections, and postsurgical complications, diagnostic errors have received comparatively less attention. Diagnostic errors will continue to play a major role in the patient safety and quality improvement movement because of their burden on care and their financial burden. Developing a patient-partnered diagnostic approach with self-reflection and awareness of cognitive biases is the key to minimizing the impact of diagnostic errors.


IgA nephropathy with glomerular capillary IgA deposition following SARS-CoV-2 mRNA vaccination: a report of three cases.
IgA nephropathy (IgAN) cases histopathologically showing glomerular capillary IgA deposition represent a rare subtype of primary IgAN. Patients with IgAN categorized to this subtype often exhibit heavy proteinuria, advanced histological findings, and are resistant to therapies. Here, we report three cases of biopsy-proven IgAN with glomerular capillary IgA deposition who presented acute deterioration of urinalysis findings following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccinations. Case 1 was recurrent IgAN. Case 2 and Case 3 were newly diagnosed cases with subclinical microhematuria and proteinuria history. All three cases showed gross hematuria and acute exacerbations of proteinuria following SARS-CoV-2 mRNA vaccinations. In all three cases, kidney biopsy findings showed IgA deposition in glomerular capillary walls in addition to mesangial and para-mesangial areas; acute glomerular lesions, such as intra- and extracapillary proliferations were identified, indicating the possibility of a potentially severe type of IgAN. Therefore, attention should be paid to patients with de novo or relapsing IgAN showing marked capillary IgA deposition following SARS-CoV-2 vaccination.


Cannabinoid CB1 receptors regulate salivation.
Saliva serves multiple important functions within the body that we typically take for granted, such as helping prepare food for swallowing and defense against oral pathogens. Dry mouth is a primary symptom of Sjӧgren's syndrome and is a side effect of many drug treatments. Cannabis users frequently report dry mouth, but the basis for this is still unknown. If the effects occur via the endogenous cannabinoid signaling system, then this may represent a novel mechanism for the regulation of salivation. We examined expression of cannabinoid CB1 receptors in submandibular salivary gland using immunohistochemistry and tested regulation of salivation by THC and cannabinoid-related ligands. We now report that CB1 receptors are expressed in the axons of cholinergic neurons innervating the submandibular gland. No staining is seen in submandibular gland epithelial cells (acinar and ductal), or myoepithelial cells (MECs). Treatment with THC (4 mg/kg, IP) or the cannabinoid receptor agonist CP55940 (0.5 mg/kg) reduced salivation in both male and female mice 1 h after treatment. CBD had no effect on its own but reversed the effect of THC in a concentration-dependent manner. Neither the CB1 receptor antagonist SR141716 (4 mg/kg) nor the CB2-selective agonist JWH133 (4 mg/kg) had an effect on salivation. We also found that fatty acid amide hydrolase (FAAH), the enzyme that metabolizes the endocannabinoid anandamide and related lipids, regulates salivation. Salivation was reduced in FAAH knockout mice as well as mice treated with the FAAH blocker URB597 (4 mg/kg). URB597 had no effect in CB1 knockout mice. FAAH protein is detected intracellularly in acinar but not ductal epithelial cells. In lipidomics experiments, we found that FAAH knockout mice chiefly had elevated levels of acylethanolamines, including anandamide, and reduced levels of acyglycines. Our results are consistent with a model wherein endocannabinoids activate CB1 receptors on cholinergic axons innervating the submandibular gland. THC likely acts by plugging into this system, activating CB1 receptors to reduce salivation, thus offering a mechanism underlying the dry mouth reported by cannabis users.


Suppression of contrast sensitivity during eyelid blinks.
Each blink of the eyelids is associated with a concurrent suppression of vision that lasts as long as 200 msec. Saccadic eye movements are also associated with a concurrent suppression of vision. Previous studies suggested that blink and saccadic suppression may be the result of a single mechanism. Volkmann, Riggs, White and Moore [(1978) Vision Research, 18, 1193-1199] demonstrated that saccadic suppression is most evident for low spatial frequency stimuli. However, the effect of stimulus spatial frequency on blink suppression has not been evaluated. If blink suppression and saccadic suppression result from a single mechanism, then blink suppression should also exhibit its greatest effect at low spatial frequencies. The purpose of this study was to determine the effect of stimulus spatial frequency on blink suppression. The stimulus was a sine-wave grating presented at different times after the blink. Psychometric functions were produced from the data for each post-blink, stimulus onset time and a Weibull function was fit to the data to determine threshold. The magnitude and duration of blink induced contrast sensitivity suppression was found to depend on the spatial frequency of the stimulus employed (similar to saccadic suppression). This is further evidence that a single mechanism may produce both blink induced visual suppression and saccadic suppression.


Trauma-related xanthogranulomatous interstitial nephritis: a clinicopathological analysis.
To investigate the pathogenesis, exact nature, histologic feature of xanthogranulomatous interstitial nephritis (XGIN) as well as its significance in clinical medicine. The medical histories concerned were collected with diagnostic images including CT scanning, ultrasonography, intravenous urography (IVU) and laboratory data being synthesized by comparison with what was discover ed during operations and pathologic examinations. All patients were ever struck on their loins or backs by blunt violence over 4-12 years. The diseases were clinically diagnosed as "renal cancer" before, during and after operations, and treated with ra dic al nephrectomy. Located at cortical parts, the tumor focus had penetrated the renal capsules and invaded other organs. However, immunohistochemistry demonstrated that the lesions were xanthogranulomas, not tumors, in which there were stacks of foam cells and lymphocytes with vast extends of fibrotic tissues obliterating the cortical interstitial structures. Urinary tracts yielded no bacterium, obstruction or calculus. XGIN is likely to be one kind of immunologic mediated granuloma following blunt renal trauma. It is imperative to clarify pathogenesis and character of this lesion so as to find out any approach to diagnosis and cure of such an unusual nephropathy.


A novel lncRNA lncSAMD11-1: 1 interacts with PIP4K2A to promote endometrial decidualization by stabilizing FoxO1 nuclear localization.
Decidualization is essential for a successful pregnancy and determines embryo implantation and pregnancy maintenance. Abnormal decidualization is one of the main causes of recurrent implantation failure (RIF). Studies have shown that large amounts of long noncoding RNAs (lncRNAs) are abnormally expressed in endometrial samples from patients with RIF. However, the functional contributions of lncRNAs to decidualization in RIF have not been explored. In this study, we found that lncSAMD11-1:1 was significantly declined in the endometria of patients with RIF. The knockdown of lncSAMD11-1:1 in human endometrial stromal cells (hESCs) restrained decidualization and embryo implantation in vitro, while the overexpression of lncSAMD11-1:1 facilitated hESC decidualization and embryo implantation in vitro and ameliorated decidualization in RIF patients. Mechanistically, lncSAMD11-1:1 and phosphatidylinositol-5-phosphate 4-kinase type 2 alpha (PIP4K2A) translocated out of nucleus and bound to each other during decidualization, thereby inhibiting the phosphorylation of AKT and promoting FoxO1 nuclear localization. These data suggest that lncSAMD11-1:1 might be a critical novel lncRNA functionally required for human decidualization, and the dysregulation of lncSAMD11-1:1 in the endometrium may be a new predisposing factor of RIF.


Gender differences in the clinical competence of residents in internal medicine.
To study the differences between cognitive and noncognitive skills of men and those of women entering internal medicine. Comparison of program directors' ratings of overall clinical competence and its specific components and pass rates for men and women taking the Certifying Examinations in Internal Medicine in 1984-1987. 14,340 U.S. and Canadian graduates taking the Certifying Examinations of the American Board of Internal Medicine for the first time in 1984-1987. Average program directors' ratings of overall competence were 6.70-6.78 for men and 6.60-6.71 for women. The greatest differences in ratings of specific components of competence were in the areas of medical knowledge and procedural skills, where men were rated higher than women, and humanistic qualities, where women were rated higher than men. Pass rates were stable over the four years of the study, and ranged from 85 to 86% for men and from 79 to 81% for women. Men consistently performed slightly better than women regardless of the type of residency or quality of medical school attended. Small but consistent differences were found in the performances of men and those of women completing training in Internal Medicine as measured by program directors' ratings and ABIM Certifying Examination performances.


Two transplant renal arteries: One important lesson.
High index of suspicion is required for ischemic nephropathy in renal transplant recipients presenting with unexplained acute kidney injury, as it is potentially reversible. Carbon dioxide (CO2) angiogram is a good alternative to evaluate vasculature in patients with renal dysfunction where iodinated contrast is relatively contraindicated.


Feasibility of deconvolution-based multiphase CT angiography perfusion maps in acute ischemic stroke: Simulation and concordance with CT perfusion.
Integration of CT perfusion (CTP) with requisite non-contrast CT and CT angiography (CTA) stroke imaging may allow efficient stroke lesion volume measurement. Using surrogate images from CTP, we simulated the feasibility of using multiphase CTA (mCTA) to generate perfusion maps and assess target mismatch profiles. Patients with acute ischemic stroke who received admission CTP were included in this study. Four CTP images (surrogate mCTA, one pre-contrast and three post-contrast, starting at the arterial peak then at 8 s intervals) were selected according to the CTP arterial time-density curve to simulate non-contrast CT and mCTA images. Cerebral blood flow (CBF) and Tmax maps were calculated using the same model-based deconvolution algorithm for the standard CTP and surrogate mCTA studies. Infarct and penumbra were delineated with CBF < 20% and Tmax > 6 s threshold, respectively. Classification accuracy of surrogate mCTA target mismatch (infarct <70 ml; penumbra ≥15 ml; mismatch ratio ≥1.8) with respect to standard CTP was assessed. Agreement between infarct and penumbra volumes from standard CTP and surrogate mCTA maps were evaluated by Bland-Altman analysis. Of 34 included patients, 28 had target mismatch and 6 did not by standard CTP. Accuracy of classifying target mismatch profiles with surrogate mCTA was 79% with respect to that from standard CTP. Mean ± standard deviation of differences (standard CTP minus surrogate mCTA) of infarct and penumbra volumes were 9.8 ± 14.8 ml and 20.1 ± 45.4 ml, respectively. Surrogate mCTA ischemic lesion volumes agreed with those from standard CTP and may be an efficient alternative when CTP is not practical.


Structural comparison of the Caenorhabditis elegans and human Ndc80 complexes bound to microtubules reveals distinct binding behavior.
During cell division, kinetochores must remain tethered to the plus ends of dynamic microtubule polymers. However, the molecular basis for robust kinetochore-microtubule interactions remains poorly understood. The conserved four-subunit Ndc80 complex plays an essential and direct role in generating dynamic kinetochore-microtubule attachments. Here we compare the binding of theCaenorhabditis elegansand human Ndc80 complexes to microtubules at high resolution using cryo-electron microscopy reconstructions. Despite the conserved roles of the Ndc80 complex in diverse organisms, we find that the attachment mode of these complexes for microtubules is distinct. The human Ndc80 complex binds every tubulin monomer along the microtubule protofilament, whereas theC. elegansNdc80 complex binds more tightly to β-tubulin. In addition, theC. elegansNdc80 complex tilts more toward the adjacent protofilament. These structural differences in the Ndc80 complex between different species may play significant roles in the nature of kinetochore-microtubule interactions.


In vitro progesterone production by maternal and embryonic tissues during gestation in the southern snow skink (Niveoscincus microlepidotus).
The southern snow skink, Niveoscincus microlepidotus, has a protracted gestation, lasting approximately one year. Ovulation occurs in spring (November) and embryonic development is completed by early autumn (March); however, birth does not occur until the following spring. Previous studies have shown that plasma progesterone concentration peaks in preovulatory females (spring, October), remains high during early gestation, and decreases to basal by autumn. In vitro progesterone production by corpora lutea, non-luteal ovary, anterior oviduct, placental tissues, muscle, and embryonic adrenal-gonads from N. microlepidotus was assessed throughout gestation. Tissues were incubated with or without the precursor pregnenolone for 3h at 24 degrees C; the resulting media were analysed for progesterone using radioimmunoassay. In vitro progesterone production by corpora lutea in media only was high during early gestation, dropping to basal by autumn. Maternal adrenal glands produced progesterone in vitro in media only throughout gestation; however, the pattern of production did not correlate with plasma concentrations and may represent steroid that is normally converted to corticosterone. Non-luteal ovary, anterior oviduct, placental tissues, muscle, and embryonic adrenal-gonads produced minimal progesterone in media only, but were able to convert pregnenolone to progesterone; this suggests steroid metabolic capability within these tissues. Further research is needed to address the possible endocrine role(s) of placental and embryonic tissues during gestation in viviparous squamates.


Efficacy of myofascial therapy and kinesitherapy in improving function in shoulder pathology with prolonged immobilization: A randomized, single-blind, controlled trial.
The best physiotherapeutic approach in shoulder pathology that generates prolonged immobilization is still uncertain. Kinesitherapy remains the most widely used option. Myofascial therapy is a therapeutic approach in which the aim is to release fascial tension and regain mobility although its efficacy in shoulder pathology has not been sufficiently studied. This Prospective, single-blind randomized controlled trial in a university hospital setting aimed to compare the efficacy of myofascial therapy and kinesitherapy in improving function in shoulder pathology with prolonged immobilization. Patients were randomly assigned to a control group or to the intervention group.Both groups completed a therapeutic exercise program. The QuickDash questionnaire was the primary outcome, Pain Visual Analog Scale and the Range Of Motion of the shoulder were the secondary outcomes. The outcomes were evaluated at baseline (T0), at 4 (T2), 8 (T2), and 12 weeks (T3) RESULTS: 44 participants were included. In the analysis of evolution over time, a significant improvement in functionality and range of motion measurements was observed in both groups (p < 0.05), although at 12 weeks only Myofasical Group achieved a clinically and statistically significant reduction in pain. Comparative analysis at 12 weeks revealed no statistically significant differences between the two therapies in the variables explored. Both, myofascial therapy and kinesitherapy can improve function, mobility, and pain in patients with painful shoulder associated with prolonged immobilization, with no significant differences between therapies, although in the medium term only myofascial therapy achieves a clinically and statistically significant improvement in pain. Trial registration: ClinicalTrials.gov NCT04944446.


Dysphagia after ischemic and hemorrhagic stroke: A propensity-matched 20-year analysis of the national inpatient sample.
Dysphagia is a common symptom of acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH), but little is known surrounding national trends of this post-stroke condition. Hence, this study aimed to identify the risk factors for dysphagia following AIS and ICH and evaluate in-hospital outcomes in these patients. The 2000-2019 Nationwide Inpatient Sample was queried for patients admitted with AIS (ICD9 433, 43401, 43411, 43491, ICD-10 I63) and ICH (ICD9 431, 432.9, ICD-10 I61, I62.9). Univariate analysis with t-tests or chi-square performed as appropriate. A 1:1 nearest neighbor propensity score matched cohort was generated. Variables with standardized mean differences >0.1 were used in multivariable regression to generate adjusted odds ratios (AOR)/β-coefficients for the presence of dysphagia on outcomes. Of 10,415,286 patients with AIS, 956,662 (9.2%) had in-hospital dysphagia. Total of 2,000,868 patients with ICH were identified; 203,511 (10.2%) had in-hospital dysphagia. Patients with dysphagia after AIS were less likely to experience in-hospital mortality (OR 0.61;95%CI: 0.60-0.63) or be discharged home (AOR 0.51;95%CI: 0.51-0.52), had increased length of stay (Beta-coefficient = 0.43 days; 95%CI: 0.36-0.50), and had increased hospital charges ($14411.96;95%CI: 13565.68-15257.44) (all p < 0.001). Patients with dysphagia after ICH were less likely to experience in-hospital mortality (AOR 0.39;95%CI: 0.37-0.4), less likely to be discharged home (AOR 0.59,95%CI:0.57-0.61), have longer hospital stay (Beta-coefficient = 1.99 days;95%CI: 1.78-2.21), and increased hospital charges ($28251.93; 95%CI: $25594.57-30909.28)(all p < 0.001). This is the first study to report on national trends in patients with dysphagia after AIS and ICH. These patients had longer hospital LOS, worse functional outcomes at discharge, and higher hospital costs.


Two-site immunoenzymometric assays for serum IgG subclass infant/maternal ratios at full-term.
Improvements were made in the range, precision, convenience, automation, and reliability of our previously published two-site immunoenzymometric assays using mouse monoclonal antibodies specific for human IgG and its subclasses. The serum concentration ratios for these immunoglobulin isotypes were measured in neonatal/maternal paired sera from 119 normal full-term deliveries. These ratios are significantly different than 1.0 (P = 0.001) for total IgG, IgG1, and IgG2 (show non-equality of paired neonatal/maternal sera concentrations) but are not significantly different than 1.0 for IgG3 and IgG4. On average, IgG1 is elevated 61%, and IgG2 is depressed 11% in the full-term neonate with respect to its own mother. In some pregnancies, active transport of IgG1 may be selectively enhanced by low material IgG1 concentration and selectively inhibited by high levels.


Rescue ross procedure and mitral valve repair on a low birth weight preterm neonate.
Although mid- and long-term outcomes after the Ross procedure for aortic valve disease have been increasingly improving over the years, this is still a rather challenging operation in neonates and small children. This is particularly true for patients with associated congenital heart defects and critical clinical conditions. Herein we describe the application of this procedure as a rescue operation in emergency circumstances in a low-birth-weight neonate with severe aortic stenosis, aortic regurgitation and mitral regurgitation after a previous aortic coartectomy.


Identifying the clonal relationship model of multifocal papillary thyroid carcinoma by whole genome sequencing.
To evaluate the application of whole genome sequencing (WGS) in determining the inter-foci clonal relationship of multifocal papillary thyroid carcinoma (mPTC). After reviewing PTC patient profiles, 8 cancer foci and germline control samples from 3 mPTC patients were analyzed by WGS. Single nucleotide variations (SNVs), copy number variation (CNV), structural variation and mutational signature were examined. The multifocality rate of PTC was 35.1% and mPTC were shown to have larger primary tumor diameter, higher rate of lymph node metastasis and less number of accompanying non-cancerous lesions than single PTC in one or both gender groups. Out of the 8 cancer foci, 5 foci were identified as clonal-independent model with the rest 3 foci as clonal-derived model according to exonic SNVs spectrum. Non-exonic mutations provided compelling evidence at the genome-wide level for the classification. Specific CNV and 12 mutational signatures were also identified. WGS could be an impressive tool in clonal relationship determination of PTC by providing a panoramic view of genome-wide somatic mutations. The substantial sequencing data provided additional information that could help studying the mechanism of carcinogenesis.


Nonpharmacological management of pain during common needle puncture procedures in infants: current research evidence and practical considerations.
All infants undergo painful procedures involving skin puncture as part of routine medical care. Pain from needle puncture procedures is suboptimally managed. Numerous nonpharmacologic interventions are available for these painful procedures, including swaddling, holding, skin-to-skin care, pacifier, sweet-tasting solutions, and breast-feeding. Adoption of nonpharmacologic pain-relieving interventions into routine clinical practice is feasible and should be a standard of care in the delivery of quality health care for infants. This review summarizes current knowledge about the epidemiology of pain from common needle puncture procedures in infants, the effectiveness of nonpharmacologic interventions, implementation considerations, and unanswered questions for future research.


Alternative techniques in reconstructive surgery: bone-anchored extraoral implants for burn cases.
The authors present their experience with the use of extraoral implants for reconstruction of the ear area after burns. The first step of the protocol includes positioning of implants in the mastoid process. The second step, after 3 to 4 months, is to realize the auricle prosthesis and apply it. Extraoral, bone-integrated implants offer low surgical risks and few postsurgical complications, leading to optimal aesthetic results, mainly in the ear area. Compared with traditional surgery techniques, the aesthetic results are better, with less surgery, possibly only two surgery sessions. Adhesive prostheses can be placed without the usual local irritation, and a more correct positioning can be obtained. For this study, two female patients, treated from December 2001 to January 2005, were selected to receive auricle epitheses. In the authors' experience, 79% of case reporting describes the creation of this epithesis type. The patient age has a range of 26 years. The two study patients initially had the same diagnosis: burns of the auricle-temporal region. In all cases, a good aesthetic result was obtained. The authors believe that bone-anchored implants for the treatment of auricle burns is a valid and brilliant technique that complements traditional reconstructive procedures. The advantages are the low incidence of long-term complications and the possibility of obtaining excellent aesthetic lasting results even for very complicated cases that would not have been solved in the past.


Binding of recA protein to Z-form DNA studied with circular and linear dichroism spectroscopy.
Binding of RecA to poly(dG-m5dC) and poly(dG-dC) under B- and Z-form conditions was studied using circular dichroism (CD) and linear dichroism (LD). LD revealed a quantitative binding of RecA to Mg2+-induced Z-form poly(dG-m5dC) with a stoichiometry of 3.1 base pairs/RecA monomer, which is slightly larger than the 2.7 base pairs observed for the B-form. The LD spectra indicate a preferentially perpendicular orientation of DNA bases and a rather parallel orientation of the tryptophan residues relative to the fiber axis in both complexes. The association rate of RecA to Z-form DNA was found to be slower than to B-form. CD measurements showed that the polynucleotide conformation is retained upon RecA binding, and CD and LD confirm that RecA binds to both forms of DNA. The Mg2+-induced Z-form is shown to be retransformed into B-form, both in free and in RecA-complexed polynucleotides by addition of NaCl, whereas the B----Z transition cannot be induced by addition of Mg2+ when the polynucleotide is complexed with RecA. From this it is inferred that RecA does not stabilize the Z-conformation of the polynucleotide but that it can kinetically "freeze" the polynucleotide in its B-conformation. On all essential points, the same conclusions were also reached in a corresponding study of unmethylated poly(dG-dC) with the Z-form induced by Mn2+.


Structural LTP: Signal transduction, actin cytoskeleton reorganization, and membrane remodeling of dendritic spines.
Induction of long-term synaptic potentiation (LTP) in excitatory neurons triggers a transient enlargement of dendritic spines followed by decay to sustained size expansion, a process termed structural LTP which contributes to the cellular basis of learning and memory. The activity-induced structural changes in dendritic spines involve spatiotemporal coordination of actin cytoskeleton reorganization, membrane trafficking and membrane remodeling. In this review, we discuss recent progresses in understanding the complex mechanisms underlying structural LTP, with an emphasis on the interplay between the spine plasma membrane and the actin cytoskeleton. We also highlight open questions and challenges to further understand this interesting cell neurobiological phenomenon.


Draft Genome Sequences of 12 Histophilus somni Strains Isolated from Feedlot Cattle in Alberta, Canada.
Histophilus somni is a Gram-negative opportunistic pathogen associated with respiratory disease in cattle. Here, we report the draft genome sequences of 12 Histophilus somni strains isolated from feedlot cattle in Alberta, Canada, which were diagnosed with respiratory disease.


Human mitochondrial thymidine kinase is coded for by a gene on chromosome 16 of the nucleus.
The expression of human mitochondrial thymidine kinase (mt TK) was investigated by polyacrylamide electrophoresis in 19 independent human-mouse somatic cell hybrids which allowed all human chromosomes to be analyzed. In 8 hybrid clones the presence of this enzymatic activity could be demonstrated. Human mt TK segregated concordantly with human adenine phosphoribosyltransferase (APRT) and human chromosome 16. Discordant segregation with all other human chromosomes was demonstrated by karyotype and isozyme analyses. These results suggest that human mt TK is coded for by a gene on chromosome 16 of the nucleus. Thus human mt TK is genetically different from human cytosol thymidine kinase which is coded for by a gene on chromosome 17. The appearance of one heteropolymer band after electrophoretic separation of human and murine mt TK supports the notion that both enzymes have dimeric structures.


Skin-specific drug delivery: a rapid solution to skin diseases?
In this issue of The Journal of Investigative Dermatology, Kouno et al. achieve skin-specific drug delivery using an antibody to deliver substances in a highly specific manner to nontransformed cells. They make use of a nonpathogenic anti-desmoglein 3 autoantibody that had been derived from a patient with pemphigus vulgaris to deliver drugs to the surface of keratinocytes. This approach may turn out to be a new "magic bullet", thereby revolutionizing the therapy of skin disease. The authors then used a conjugate of this antibody with a new drug entity, TNF-related apoptosis-inducing ligand, to demonstrate, as a proof-of-principle, that their approach has the potential to facilitate the treatment of both cancerous and inflammatory skin diseases.


Expression of bone morphogenetic protein 2 in normal spontaneous labor at term, preterm labor, and preterm premature rupture of membranes.
Genome-wide screening studies of the chorioamniotic membranes unexpectedly identified an increase in the expression of bone morphogenetic protein 2 in spontaneous labor at term. The objective of this study was to determine whether bone morphogenetic protein 2 messenger RNA and protein expression are altered in the chorioamniotic membranes of patients with term labor, preterm labor, and preterm premature rupture of membranes. Chorioamniotic membranes were obtained from patients at term (with and without labor), with preterm labor (with and without histologic chorioamnionitis), and with preterm premature rupture of membranes (with and without histologic chorioamnionitis). The expression of bone morphogenetic protein 2 was studied by real-time quantitative reverse transcriptase-polymerase chain reaction (n = 88) and immunohistochemistry (n = 124). Nonparametric statistics were used for analysis. Primary amnion cells obtained from women at term not in labor were treated with bone morphogenetic protein 2 to examine whether there was increased prostaglandin E2 expression. The median bone morphogenetic protein 2 messenger RNA and protein expression were significantly higher in the membranes of patients with spontaneous labor at term than in those of patients not in labor at term (P < .001 for both). Bone morphogenetic protein 2 messenger RNA and protein expression were increased in patients with preterm labor with histologic chorioamnionitis than in those without histologic chorioamnionitis (P < .05 and P < .001, respectively). There was no difference in bone morphogenetic protein 2 messenger RNA and protein expression in patients with preterm premature rupture of membranes, regardless of chorioamnionitis (P = .13 and P = .08, respectively). There was a correlation between bone morphogenetic protein 2 and cyclooxygenase 2 protein expression in chorioamniotic membranes (R = .34; P < .001). Bone morphogenetic protein 2 messenger RNA and protein expression are increased in the chorioamniotic membranes of patients with spontaneous labor at term and patients with preterm labor associated with histologic chorioamnionitis. Its expression pattern and biologic effects strongly suggest that bone morphogenetic protein 2 is involved in human parturition.


A population-based evaluation of tunica vaginalis mesothelioma: An analysis of the National Cancer Database.
Primary mesothelioma of the tunica vaginalis (TVM) is a rare and poorly understood malignancy with insufficient population-level data to guide management decisions. A retrospective analysis of TVM cases recorded in the National Cancer Database from 2004 to 2015 was performed. Cases were identified using International Classification of Diseases for Oncology histology codes. Associations between demographic, clinical and therapeutic factors were analyzed using Kaplan-Meier survival estimates for overall survival (OS) and Cox proportional hazard modeling. Propensity score matching for receipt of systemic chemotherapy was performed to assess the impact on OS. One hundred fifty-one men with a median age of 65 years (interquartile range [IQR] 51-78) were included. Median OS from diagnosis was 72.5 months (IQR 20.2-Not Reached [NR]) after a median follow up of 34.9 months. Multivariate analysis demonstrated an increased risk of death for patients in the fourth quartile of age (hazard ratio [HR] 5.57, 95% confidence interval [CI] 1.70-18.17, P = 0.004), those with biphasic or fibrous histology (HR 2.59, 95% CI 1.15-6.42, P = 0.04) and positive surgical margins (HR 3.27, 95% CI 1.61-6.63, P = 0.001). There was no significant difference in OS associated with receiving chemotherapy (P = 0.5) even after propensity score matching (P = 0.07). Margin-negative surgical resection is paramount to improving OS. There are insufficient data to recommend for or against adjuvant systemic chemotherapy or RT, although the limited available data does not suggest apparent benefit in terms of OS.


Vertical distribution of aerosols in dust storms during the Arctic winter.
High Latitude Dust (HLD) contributes 5% to the global dust budget, but HLD measurements are sparse. Dust observations from Iceland provide dust aerosol distributions during the Arctic winter for the first time, profiling dust storms as well as clean air conditions. Five winter dust storms were captured during harsh conditions. Mean number concentrations during the non-dust flights were <5 particles cm-3 for the particles 0.2-100 µm in diameter and >40 particles cm-3 during dust storms. A moderate dust storm with >250 particles cm-3 (2 km altitude) was captured on 10th January 2016 as a result of sediments suspended from glacial outburst flood Skaftahlaup in 2015. Similar concentrations were reported previously in the Saharan air layer. Detected particle sizes were up to 20 µm close to the surface, up to 10 µm at 900 m altitude, up to 5 µm at 5 km altitude, and submicron at altitudes >6 km. Dust sources in the Arctic are active during the winter and produce large amounts of particulate matter dispersed over long distances and high altitudes. HLD contributes to Arctic air pollution and has the potential to influence ice nucleation in mixed-phase clouds and Arctic amplification.


Correlation of age and ossification of the medial clavicular epiphysis using computed tomography.
The aim of this study was the examination of relationship between the age and the ossification of medial epiphysis of the clavicle referred to CT examination. Concerning the epiphyseal ossification of the clavicle CT's of 100 patients (50 male and 50 female) between 16 and 25 years (10 patients for each year) were analyzed by three viewers. In the legal relevant age segment (16-25a) we saw a turnover from stage 3 to stage 4 at the age of 21 years. The calculated empiric distribution function showed 95% of stage 4 over 21 years while 75% of the patients with stage 3 were under 21 years. A reconstruction kernel suitable for osseous structures should be used, images should be viewed or presented in a bone window. According to these results it can be concluded that a person with stage 4 is probably 21 years or older, while a stage 3 leads to an estimated age under 21 years. On the other hand, a confidence level of 99.67% is not reached. Therefore, CT of the medial epiphysis of the clavicle will only be suitable for age estimation around the age of 21 years, if this relevant statistic obstacle is defeated. Bearing this in mind, further studies are needed to evaluate slice thickness as the most critical parameter.


Health care utilization and end-of-life care for older patients with acute myeloid leukemia.
Health care utilization in older adults (age ≥60 years) with acute myeloid leukemia (AML) has not been well studied. We conducted a retrospective analysis of 330 consecutive older patients who were diagnosed with AML between May 1, 2005 and December 23, 2011, at 2 hospitals in Boston to examine their health care utilization and end-of-life care. Using multivariable logistic and linear regression models adjusting for covariates, we also compared health care utilization between patients who received intensive induction chemotherapy (n = 197; cytarabine/ anthracycline combination) versus nonintensive chemotherapy (n = 133; single-agent therapy). The median number of hospitalizations for the entire cohort was 4.2 (range, 1-18 hospitalizations). Patients who died spent a mean of 28.3% of their life after diagnosis in the hospital and 13.8% of their life attending outpatient clinic appointments. Although the majority of patients (87.9%) died during the 2-year follow-up period, a minority received palliative care (16.2%) or hospice (23.1%) services. Within 30 days of death, 84.5% of patients were hospitalized, and 61% died in the hospital. Among the patients who died, those who received intensive induction therapy (vs nonintensive therapy) spent 30% more of their life after diagnosis in the hospital (P < .0001) and were less likely to receive hospice services (odds ratio, 0.45; P = .05). The current findings highlight the intensity of health care utilization among older patients with AML, regardless of treatment modality. Despite the poor prognosis, palliative care and hospice services are rarely used. Future work should study novel health care delivery models to optimize care throughout the course of illness and at the end of life.


Analysis of crystallite shape in rat incisor enamel.
The hydroxyapatite crystallites of mammalian enamel appear as hexagons when seen in cross-sections examined with the transmission electron microscope. Using goniometric transmission electron microscopy, stereo-pair electron micrographs and freeze-fracture replicas, two models have been proposed to explain the hexagonal crystallite profile. The "hexagonal ribbon" model proposes that hexagonal profiles are true cross-sections of elongated hexagonal ribbons. The "rectangular ribbon"model proposes that crystallite profiles are three-dimensional rectangular segments (parallelepipeds), which are contained in the Epon sections and project as opaque hexagons in routine transmission electron micrographs. Morphological observations together with predictions from models indicate that the crystallites in rat incisor enamel are flat ribbons with rectangular cross-sectional profiles. The hexagonal images seen in electron micrographs of thin sections of enamel result from viewing parallelepiped-shaped segments of these crystallites as two-dimensional shadows.


Electrospray ionization-mass spectrometry characterization of heterotetrameric sarcosine oxidase.
Electrospray ionization (ESI) Fourier transform ion cyclotron resonance (FTICR) mass spectrometry has been used to characterize heterotetrameric corynebacterial sarcosine oxidase. By using a conventional quadrupole mass spectrometer, no spectra for the intact complex could be obtained (i.e., electrospraying protein at neutral pH), but spectra showing the four protein subunits were obtained when electrospraying from acidic solution. Initial low resolution ESI-FTICR mass spectra of the intact heterotetramer revealed a typical narrow charge state distribution in the range 6000 < m/z < 9000, consistent with retention of a compact structure in the gas phase, and gave a mass measurement about 1000 u higher than predicted. Efficient in-trap clean up, based upon low energy collisionally induced dissociation of adducts, allowed significant improvement in mass measurement accuracy. The present results represent the largest heteromultimeric protein complex successfully analyzed using FTICR mass spectrometry, and clearly illustrate the importance of sample clean up methods for large molecule characterization.


Two-Year Efficacy and Safety Results from the IMPERIAL Randomized Study of the Eluvia Polymer-Coated Drug-Eluting Stent and the Zilver PTX Polymer-free Drug-Coated Stent.
To report additional endpoints, including 2-year primary patency, patient outcomes, and safety results, as well as the initial assessment of hypoechogenic halo from the IMPERIAL Randomized Controlled Trial (RCT). IMPERIAL RCT is a prospective, randomized (2:1), multicenter study of patients with symptomatic femoropopliteal artery lesions (length 30-140 mm, Rutherford category 2-4) treated with the Eluvia paclitaxel-eluting nitinol stent or the Zilver PTX paclitaxel-coated stent. Two-year follow-up included patency, safety, and mortality assessments and core laboratory-reviewed B-mode ultrasound imaging to screen for hypoechogenic halo in the stented segment, and assess blood flow. At 24 months, all-cause mortality was 7.1% (21/295) for Eluvia and 8.3% (12/145) for Zilver PTX (P = 0.6649). The clinically driven target lesion revascularization rate was significantly less for patients treated with Eluvia vs Zilver PTX (12.7% vs 20.1%; P = 0.0495). The Kaplan-Meier estimate of primary patency at 24 months was 83.0% for Eluvia and 77.1% for Zilver PTX (log rank P = 0.1008). Transverse ultrasound imaging was implemented during the 24-month follow-up window and was evaluable for 27.5% (128/465) of patients. Hypoechogenic halo prevalence rates did not differ significantly between Eluvia and Zilver PTX study arms (33.7% [29/86] vs 21.4% [9/42]; P = 0.153). In no case was flow documented within the halo; no adverse events were associated with these ultrasound findings. Two-year follow-up suggests a sustained advantage for Eluvia for avoiding target lesion revascularization. Initial hypoechogenic halo assessment showed no difference in prevalence between the study arms, no flow within the halo, and no associated adverse events. clinicaltrials.gov identifier NCT02574481. Date of registration: October 14, 2015. Level 1; randomized controlled trial.


Pelvic inflammatory disease and tubo-ovarian abscess.
Pelvic inflammatory disease (PID) is common infection among reproductive-aged women. The presentation ranges from acute severe illness to a more indolent and mild clinical picture. Attention has turned to subclinical PID as an important entity. The majority of the public health impact from PID comes from its attributable long-term sequelae, including tubal-factor infertility, ectopic pregnancy, and chronic pelvic pain. Tubo-ovarian abscess (TOA) represents a severe form of PID. Vigilance is required when caring for women who have PID to detect the presence of a TOA given the serious nature of the infection and the potential need for procedural intervention.


Classification of COVID-19 chest X-rays with deep learning: new models or fine tuning?
Chest X-ray data have been found to be very promising for assessing COVID-19 patients, especially for resolving emergency-department and urgent-care-center overcapacity. Deep-learning (DL) methods in artificial intelligence (AI) play a dominant role as high-performance classifiers in the detection of the disease using chest X-rays. Given many new DL models have been being developed for this purpose, the objective of this study is to investigate the fine tuning of pretrained convolutional neural networks (CNNs) for the classification of COVID-19 using chest X-rays. If fine-tuned pre-trained CNNs can provide equivalent or better classification results than other more sophisticated CNNs, then the deployment of AI-based tools for detecting COVID-19 using chest X-ray data can be more rapid and cost-effective. Three pretrained CNNs, which are AlexNet, GoogleNet, and SqueezeNet, were selected and fine-tuned without data augmentation to carry out 2-class and 3-class classification tasks using 3 public chest X-ray databases. In comparison with other recently developed DL models, the 3 pretrained CNNs achieved very high classification results in terms of accuracy, sensitivity, specificity, precision, F 1 score, and area under the receiver-operating-characteristic curve. AlexNet, GoogleNet, and SqueezeNet require the least training time among pretrained DL models, but with suitable selection of training parameters, excellent classification results can be achieved without data augmentation by these networks. The findings contribute to the urgent need for harnessing the pandemic by facilitating the deployment of AI tools that are fully automated and readily available in the public domain for rapid implementation.


Improved image contrast with mangafodipir trisodium (MnDPDP) during MR-guided percutaneous cryosurgery of the liver.
The present study was undertaken to measure the gain observed in the liver-to-tumor contrast of perioperative images when using mangafodipir trisodium, a liver-specific contrast agent, during percutaneous cryosurgery of the liver performed under the guidance of magnetic resonance images. Retrospective quantitative analyses of MR images were performed on eleven patients having a total of 30 liver tumors treated by MR-guided percutaneous cryosurgery. An initial group of four patients were treated with no contrast agent, and was compared with a second group of 7 patients who received an intravenous injection of 5 microM/kg of mangafodipir for their cryosurgery. The percutaneous cryosurgery was monitored under the near-real-time-imaging mode of a 0.5T open-configuration MRI system using a T(1)-weighted Gradient-recalled echo pulse sequence. A significant improvement in the liver-to-tumor contrast-to-noise ratio was observed with mangafodipir (p < 0.05, paired t test) in 0.5T preoperative images. Along with the stability of the mangafodipir contrast enhancement during the entire cryosurgical procedure, the resulting gain in contrast allowed for better visualizing the presence of residual untreated tumor margins at the periphery of the cryosurgery iceball directly from perioperative images acquired with patients under narcosis. Consequently, it not only became easier for the interventionalist to determine the need for an additional cryoprobe to increase the size of the iceball during the procedure, but also to decide on the appropriate end point of the cryosurgery.


Influences on the examination performance of medical students: the pressure of other examinations.
Third-year medical students in Birmingham sat two examinations at times varying from 10 days apart to the same day. The influence of the proximity of two examinations on performance in the second examination is explored, together with other influences on examination performance. The sex of the student is the most significant discriminating factor, but proximity of examinations also affects marks in the second examination. We recommend, as did Birmingham students 10 years ago, that examinations should be separated by at least 5 days.


Caregivers as Interventionists and Trainers: Teaching Mands to Children with Developmental Disabilities.
We evaluated the use of behavioral skills training (BST) to train caregivers to conduct procedures commonly associated with mand training. We trained two caregivers on the following procedures: (a) conducting preference assessments, (b) delivering preferred items contingent on appropriate behavior, (c) capturing and contriving motivating operations, (d) conducting probes to assess the child's current mand repertoire, (e) errorless prompting procedures using echoic prompts, (f) vocal shaping, (g) collecting data, and (h) correcting errors. We also assessed whether a trained caregiver could in turn train their spouse on these procedures. We evaluated the effects of the intervention on the frequency of child spontaneous and prompted mands. The three caregivers performed near zero percent accuracy during baseline but increased to above 80 % accuracy with training, and high performance persisted during most maintenance probes. These results were replicated for the parent who received training from their spouse. In addition, spontaneous mands were occurring more frequently than prompted mands by the end of the study. The implications of caregivers implementing mand training procedures based on Skinner's analysis of verbal behavior are discussed.


Stereotactic radiofrequency ablation as a valid first-line treatment option for hepatocellular adenomas.
This study aimed to assess the safety and efficacy of stereotactic radiofrequency ablation (SRFA) in patients with hepatocellular adenomas (HCA). Retrospective analyses of all patients referred for SRFA treatment at our institution between January 2010 and October 2020 revealed 14 patients (10 women; mean age 34.4 [range, 17-73 years]) with 38 HCAs treated through 18 ablation sessions. Ablations were considered successful if a safety margin >5 mm was achieved. Demographic, interventional, and outcome data were collected and analyzed. Primary and secondary technical efficacy rates were assessed based on follow-up images consisting of contrast-enhanced CT or MR scans. The mean tumor size was 22 mm (range, 7-75 mm). Overall, 37/38 (97.4%) tumors were successfully ablated at the initial SRFA (primary efficacy rate of 97.4%). The median follow-up duration was 49.6 months. No deaths or adenoma-related complications (hemorrhage or malignant transformation) were observed. Disease-free survival rates at 1, 3, and 5 years from the date of the first SRFA were 100%, 85.8%, and 85.8%, respectively. Two patients developed new distant tumors retreated with consecutive re-ablation. No major complications occurred during any of the 18 ablation sessions. Percutaneous thermal ablation is efficient in the treatment of HCAs and may thus be considered a valid first-line treatment option. In addition, SRFA allows for an effective, minimally invasive treatment of large and multiple hepatic tumors within one session.


Determination of heteronuclear three-bond J-coupling constants in peptides by a simple heteronuclear relayed E.COSY experiment.
A simple heteronuclear relayed E.COSY pulse sequence with a minimum number of pulses is proposed for the quantitative determination of heteronuclear three-bond J-coupling constants in uniformly 13C-enriched polypeptide samples. Numerous heteronuclear three-bond coupling constants, including 3JHNC, 3JHNC beta, 3JH beta C, and 3JH alpha C gamma, can be determined for each residue from a single heteronuclear relayed E.COSY spectrum. Couplings relevant for stereospecific assignments as well as for the determination of dihedral angles in the amino acid backbone and in side chains are obtained. The method is demonstrated on the uniformly 13C-enriched decapeptide antamanide (-Val1-Pro2-Pro3-Ala4-Phe5-Phe6-Pro7-Pro8-Phe9-Phe1 0-).


Consumer experiences of long-term oral nicotine replacement therapy and related health information-seeking: A qualitative study.
Nicotine replacement therapy (NRT) delivers a therapeutic dose of nicotine to support smoking cessation, and is currently approved for short-term use (typically ≤12 weeks). Yet, research on real-world over-the-counter NRT use indicates that some consumers continue to use these products long-term. This study sought to understand consumers' experiences of long-term oral NRT use, including self-reported reasons for continued use, and health information-seeking regarding long-term use. In-depth semi-structured telephone interviews were conducted between May and June 2021 with 21 current and former NRT consumers aged ≥18 years from across Australia, with oral NRT use of ≥1 year. Interviews were thematically analysed using the Framework Method. The majority of participants reported achieving NRT-assisted smoking cessation and related health benefits (e.g. respiratory health, improved physical appearance). However, nearly all participants reported experiencing addiction to oral NRT, with many attributing their long-term use to dependence on these products. Participants reported low engagement with NRT health information sources; just half reported consulting with a health professional regarding their long-term NRT use, and some reported negative experiences when health professional advice was sought (e.g. perceptions of not being taken seriously, perceived lack of health professional knowledge). Less than half of participants accurately identified the duration of use recommended in NRT consumer medicine information, and some reported actively dismissing this information. Findings highlight consumers' perceived benefits of continued NRT use whilst also identifying two key concerns - the addictive potential of oral NRT, and low health information-seeking and health professional engagement regarding long-term use. While oral NRT is indisputably safer than tobacco smoking, public health strategies to raise consumer and health professional awareness about the safe use of NRT, which acknowledge the current evidence gap regarding safety and efficacy of long-term use, are needed to maximise their benefits as a harm reduction strategy for smoking cessation.


kc-hits: a tool to aid in the evaluation and classification of chemical carcinogens.
The evaluation of chemicals for their carcinogenic hazard requires the analysis of a wide range of data and the characterization of these results relative to the key characteristics of carcinogens. The workflow used historically requires many manual steps that are labor-intensive and can introduce errors, bias and inconsistencies. The automation of parts of the evaluation workflow using the kc-hits software has led to significant improvements in process efficiency, as well as more consistent and comprehensive results. https://gitlab.com/i1650/kc-hits.git. Supplementary data are available at Bioinformatics online.


Saccharopolyspora cavernae sp. nov., a novel actinomycete isolated from the Swallow Cave in Yunnan, south-west China.
A Gram-positive, aerobic, non-motile actinobacterial strain, designated YIM C01235(T), was isolated from a soil sample collected from the Swallow Cave, Yunnan province, south-west China. The isolate grew at 10-30 °C, pH 6.0-9.0 and 0-8 % (w/v) NaCl. Phylogenetic analysis based on 16S rRNA gene sequences revealed highest similarity to Saccharopolyspora gloriosae YIM 60513(T) (96.8 %), and lower 16S rRNA gene sequence similarities (95.1-96.7 %) with the other species of the genus Saccharopolyspora. The whole-cell hydrolysates contained meso-diaminopimelic acid (meso-DAP), arabinose and galactose. The polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylcholine, phosphatidylethanolamine, phosphatidylmethylethanolamine, two unknown glycolipids, two unknown phospholipids and one polar lipid. MK-9(H4) was the predominant menaquinone. The major fatty acids were iso-C15:0, iso-C16:0, anteiso-C15:0 and anteiso-C17:0. Mycolic acids were not detected. The genomic DNA G+C content was 69.1 mol%. These chemotaxonomic data, together with its morphological properties, were consistent with the assignment of strain YIM C01235(T) to the genus Saccharopolyspora. The results of physiological and biochemical tests allowed strain YIM C01235(T) to be differentiated phenotypically from all the recognized Saccharopolyspora species. On the basis of evidence from this polyphasic study, the novel species Saccharopolyspora cavernae sp. nov. is proposed. The type strain is YIM C01235(T) (=DSM 45825(T) = CCTCC AA 2012022(T)).


Development and validation of a screening tool for SPondyloArthritis Screening in Sub-Saharan Africa: SpASSS questionnaire.
To develop and validate a screening tool to identify patients with a high likelihood for Spondyloarthritis (SpA) in the Democratic Republic of the Congo (DR Congo). The development of the SpA Screening questionnaire in Sub Saharian Africa (SpASSS) questionnaire followed 3 steps: The item generation was carried out by a systematic literature review according to the PRISMA guidelines on the clinical manifestations of SpA, interviewing clinical experts and the classification criteria for Spondyloarthritis. The candidate questions were tested in a population of 50 consecutive patients with confirmed diagnosis of spondyloarthritis, in a control population of rheumatic disease excluding SpA and in a group of 200 non-rheumatic participants, randomly chosen in the general population for question reduction and validation. Descriptive statistical analyses were performed to assess socio-demographic characteristics and response distribution for each item. Their diagnostic performance was investigated using ROC curves. For validation, principal component analysis was performed using factor analysis. Referral strategy score for SpA was determined by adjusted Cronbach's alpha coefficient. Mean ± SD age of SpA cases was 41.8 ± 14.4 years, 56% were men compared to diseased controls 60.0 ± 12.5 years, 28.7% men (p < 0.001). 14/20 items showed a statistically significant difference (p < 0.05) between SpA cases and control groups. All items were factorable and 6 components were identified. Only the two first components (C1 with 8 items, C2 with 3 items) showed a significant threshold for reliability in detection of suspected SpA with a Cronbach's alpha of 0.830 and 0.708. All validated items of these two components showed the global reliability threshold with α-adjusted Cronbach calculated at 66.9%. The performance for correctly screening SpA was demonstrated with an area under the curve of 0.938 (0.884-0.991) and 0.794 (0.728-0.861) for C1 and C2 respectively. This validation and item reduction of the SpASSS questionnaire for SpA might identify patients to refer for case ascertainment and will help conducting future epidemiological and clinical studies in the DR Congo. • To the best of our knowledge, this is the first study in Sub-Saharan Africa based on local data to develop a screening tool for SpA in the population for epidemiological and clinical use. • Referral strategies based on context-specific data are necessary to provide accurate case definition and epidemiological data, thus reducing methodological bias. • In the SpA group, no discrimination was made regarding SpA subtypes, disease duration, activity and severity.


Conductometric method for the quantitative analysis of Pb(II) and Cd(II) with 2-mercapto-5-R-amino-1, 3, 4-thiadiazole derivatives.
The reactions of the cations with 2-mercapto-5-R-amino-1,3,4-thiadiazole derivatives were studied conductometrically with the purpose of establishing a new conductometric method for the quantitative analysis of Pb(II) and Cd(II). Aqueous solutions of Pb(NO3)2 and Cd(CH3COO)2 were titrated with hidroalcoholic solutions of 2-mercapto-5-amino-1,3,4-thiadiazole (MATD), 2-mercapto-5-allylamino-1,3,4-thiadiazole (MA1ATD) and 2-mercapto-5-acetylamino-1,3,4-thiadiazole (MAcATD) and 2-mercapto-5-phenilamino-1,3,4-thiadiazole (MFATD) in different concentrations. The reactions takes place at pH 6.5 (realised with acetate buffer). A linear classical titration curves was obtained. In solutions more concentrated than 10(-2) M just one equivalence point can be noticed, corresponding to 1:2 Me:R stoechiometries. For concentration less than 10(-2) M two equivalence point were observed at 1:1 and 2:1 ratio of Me:R, indicating the step formation of the complex. Accurate conductometric determinations can be made using the second break points of the titration curves as equivalence points. The amounts of Cd(II) and Pb(II) taken and recovered are good, with an error less than 1%.


Alpha 2 adrenergic agonists. Neurochemistry, efficacy, and clinical guidelines for use in children.
The alpha 2 adrenergic agonists are used to treat a variety of psychiatric disorders and their usage has been increasing. This article presents the rationale and neurochemical basis for treatment of psychiatric disorders with alpha 2 agents, reviews studies examining clinical efficacy, and develops guidelines for usage. Case vignettes are presented to illustrate how the alpha 2 agents can successfully be used in practice.


Mushroom Cultivation: An Illustrated Guide to Growing Your Own Mushrooms at Home.
Understanding how mushrooms grow is crucial to successfully cultivating them, and Mushroom cultivation offers comprehensive instruction both on how mushrooms grow and how you can cultivate them yourself.


Assessment of Cpa, Scl1 and Scl2 in clinical group A streptococcus isolates and patients from north India: an evaluation of the host pathogen interaction.
Group A streptococcus (GAS) infection remains a major concern due to multiple diseases including pharyngitis, impetigo, acute rheumatic fever (ARF) and rheumatic heart disease (RHD). It uses different adhesins and virulence factors like Cpa (collagen binding protein) and Scl (collagen-like protein) in its pathogenicity. Scl having similarities with human collagen may contribute to inducing autoimmunity in the host. Here we assessed gene expression, antibody titer of Cpa, Scl1 and Scl2 in both clinical GAS isolates (n = 45) and blood (n = 45) obtained from pharyngitis, ARF (acute rheumatic fever) and RHD respectively. Skin isolates (n = 30) were obtained from impetigo patients. The study revealed a total of 27 GAS emm types. Frequency of cpa, scl1, scl2 was high in ARF isolates. The antibody titer of these proteins was high in all isolates, and also in patients with pharyngitis and ARF. All isolates showed high binding affinity toward collagen I and IV, which further indicates a potential host pathogen interaction. Our study reflects a strong association of Cpa and Scls in early and post-GAS pathogenicity. However, the increased antibody titer of Scl1 and Scl2 during ARF may be attributed to a cogent immune response in the host.


7,8-Dihydroxycoumarin Alleviates Synaptic Loss by Activated PI3K-Akt-CREB-BDNF Signaling in Alzheimer's Disease Model Mice.
Alzheimer's disease (AD) is a progressive neurodegenerative disorder and is clinically characterized by the impairment of memory and cognition. Accumulation of β-amyloid (Aβ) in the brain is considered as a key process in the development of AD because it impairs the synapses' function to impair memory formation. Recent research studies have indicated that a group of edible plant-derived Thymelaeaceae compounds known as coumarin may exert particularly powerful actions on alleviating learning and memory impairment. 7,8-Dithydroxycoumarin (7,8-DHC), a bioactive component of coumarin derived from Thymelaeaceae, showed its function in neuroprotection before. In this study, we found that 7,8-DHC was able to mitigate Aβ accumulation via reducing the level of BACE1 and increasing the level of ADAM17 and ADAM10. More importantly, we found that 7,8-DHC could mitigate memory impairment, promote the dendrite branch density, and increase synaptic protein expression via activating PI3K-Akt-CREB-BDNF signaling. Hence, these results suggested that 7,8-DHC represented a novel bioactive therapeutic agent in mitigating Aβ deposition and synaptic loss in the process of treating AD.


Accessory pancreatic lobe in association with a gastric duplication cyst.
Gastric duplication cysts are an extremely rare anomaly with few reported cases in association with accessory pancreatic tissue. Diagnosis can be challenging given a presentation of recurrent pancreatitis and resemblance to pancreatic pseudocysts. We report the case of a 6-year old boy with multiple episodes of pancreatitis who was discovered to have an accessory pancreatic lobe connected to a gastric duplication cyst, successfully treated with surgical excision.


Modular Total Synthesis of Farnesyl Analogues of Cell Wall Precursors Lipid I and II Containing the Staphylococcus aureus Pentaglycine Bridge Modification.
A scalable and modular total synthesis of 3-lipid I and 3-lipid II was accomplished by a novel route involving an efficient solid phase synthesis of the peptide fragment and an effective chemoenzymatic attachment of the second sugar moiety. The generality of this route was further documented by the synthesis of an analogue bearing the pentaglycine interpeptidic bridge modification characteristic for the human pathogen Staphylococcus aureus.


Analysis of clinical correlation between pelvic organ prolapse and HR-HPV infection.
To explore the influence of pelvic organ prolapse (POP) on the risk of high-risk human papilloma virus (HR-HPV) infection. Retrospective analysis of the HR-HPV infection results of 1183 patients with POP who were treated at the First Affiliated Hospital of Chongqing Medical University, Liangping District People's Hospital affiliated to Chongqing Medical University, and the 13th People's Hospital of Chongqing between October 2018 and October 2021. Patients without POP who underwent HR-HPV examination at the same time were selected as the control group, and the HR-PV infection rate was compared between the two groups. Patients diagnosed with POP were stratified to analyse whether age, menopausal status, degree of POP, location of POP and duration of POP were associated with HR-HPV infection. The rate of HR-HPV infection was lower for patients with POP compared with patients without POP over the same time period. The highest rate of infection was seen in patients aged 60-69 years (14.7%) and the lowest rate (7.5%) was seen in patients aged 50-59 years; differences between age groups were significant. The rate of HR-HPV infection in postmenopausal patients with POP was slightly higher than that in non-menopausal patients with POP, but the difference was not significant. No significant differences in the rate of HR-HPV infection were associated with location of POP, duration of POP or degree of POP. POP does not increase the risk of HR-HPV infection.


Spinocerebellar projections from the thoracic cord in the cat, as studied by anterograde transport of wheat germ agglutinin-horseradish peroxidase.
The projection fields of the spinocerebellar tracts arising from thoracic segments were studied by the anterograde transport of wheat germ agglutinin bound to horseradish peroxidase (WGA-HRP) in the cat. Following injections of WGA-HRP into upper and middle thoracic segments, labeled mossy fiber terminals were seen in all lobules of the anterior lobe, lobules VI, VIII, and IX, soblobule VIIb, the paramedian lobule, medial parts of the dorsal paraflocculus, crus I, crus II, and the simple lobule. In the anterior lobe labeled terminals in sublobules IIb-Vb accounted for about 50-60% of the total labeled terminals, of which about 14-18% were present in lobule III and 11-13% were present in lobule IV. The labeled terminals were concentrated within 1.0-1.5 mm from the midline in the vermal region, accounting for about 45-75% of the total in each sublobule. Following injections into lower thoracic segments, labeled terminals tended to distribute more numerously in the lateral part of the vermis and the intermediate region. In the posterior lobe about 5% of the total labeled terminals were distributed in lobules VI and VIII, respectively, and about 16-23% were in the paramedian lobule (mainly sublobules B and C). Cases with injections preceded by a lateral cordotomy have shown that about 65% of the total labeled terminals in each lobule of the anterior lobe were distributed ipsilaterally and 35%, contralaterally. In the paramedian lobule the labeled terminals were distributed predominantly ipsilaterally. Projection fields in the horizontal plane were reconstructed from a series of transverse sections through each lobule. In lobules III and IV the labeled terminals were distributed in nine areas: areas 1-4 in the vermis and areas 5-9 in the intermediate-lateral regions. The two medial areas 1 and 2 were located within 0.5 mm from the midline in zone A1 of Voogd and area 3 appeared to be located in zone A2. Area 4 was located between 0.75 and 1.5 mm in the medial part of zone B. These areas extended longitudinally in the middle part of the apicobasal extent. The five areas in the intermediate-lateral regions were localized in the basal part of the lobule: area 5 in zone C1, areas 6-8 in zones C2 and C3, and area 9 in zone D. Some of these projection areas were identified also in lobules I, II, and V.(ABSTRACT TRUNCATED AT 400 WORDS)


Failure and success of percutaneous angioplasty in a hypertensive child with bilateral renal artery stenosis.
We describe the clinical course of a 5-year-old girl with severe arterial hypertension that was uncontrollable with antihypertensive medication. Renal angiography revealed bilateral renal artery stenoses. Because percutaneous transluminal renal angioplasty (PTRA) failed to dilate the stenotic lesions, a renal artery bypass grafting in both renal arteries was performed. The patient remained normotensive for 7 months, and after that the arterial pressure increased again. Digital subtraction angiography demonstrated stenosis at the peripheral and central anastomosis of the vein graft that was used for revascularization of the left kidney. PTRA was decided on and successful patency was achieved. The patient has now been normotensive for a period of 5 years.


The effects of educational program on health volunteers' knowledge regarding their approach to earthquake in health centers in Tehran.
The people's mental, intellectual and physical non-readiness to confront earthquake may result in disastrous outcomes. This research aimed to study of effects of a training intervention on health connector's knowledge regarding their approach to earthquake in health-training centers in East of Tehran. This research which is a semi-experimental study was designed and executed in 2011, using a questionnaire with items based on the information of Crisis Management Org. After a pilot study and making the questionnaire valid and reliable, we determined the sample size. Then, the questionnaires were completed before and after the training program by 82 health connectors at health-treatment centers in the East of Tehran. Finally, the collected data were analyzed by SPSS 14, using paired sample t-test and Pearson's correlation coefficient. Health connectors were women with the mean age of 43.43±8.51 years. In this research, the mean score of connectors' knowledge before and after the training was 35.15±4.3 and 43.73±2.91 out of 48, respectively. The difference was statistically significant (p=0.001). The classes were the most important source of information for the health connectors. The people's knowledge to confront earthquake can be increased by holding training courses and workshops. Such training courses and workshops have an important role in data transfer and readiness of health connectors.


Improving the analysis accuracy of components in blood by SSP-MCSD and multi-mode spectral data fusion.
In recent years, spectral quantitative analysis for blood components has been a research hotspot in biomedical engineering. But researches have been limited to the application of high-sensitivity spectroscopy instruments and the complexity of blood components-the overlapping of absorption curves for many components is severe. This has led to the difficulty in achieving satisfactory results when using spectroscopy to quantify components in blood. In order to enhance the model robustness and improve the model performance, this paper proposed a sample set partitioning strategy based on multi-component spatial distance (SSP-MCSD). Different from the other sample set partitioning strategies, which only consider the uniformity of the concentration distribution of the target component, this strategy also concerns to the concentration distribution of non-target components. The concentration of the target component and non-target components are used to construct a multi-dimensional space, and the Euclidean Distance of sample points in this space is used as the criterion to partition the sample set. At the same time, the spectra collected in multi-modes are fused for increasing the amount of information. So as to enhance the model robustness and to improve the analysis accuracy of the target components. In order to verify the effectiveness of this strategy, the serum of 101 volunteers was analyzed. Taking total protein in serum as the non-target component, the regression model for bilirubin concentration was established by transmission spectra, fluorescence spectra, and the joint spectra after fusion of the above two spectra, respectively. The experimental results showed that the prediction accuracy of the model established by SSP-MCSD combined with multi-mode spectral fusion is obviously higher than that of other methods. It can effectively improve the analysis accuracy of blood components.


Respiratory motion compensation for 3-D freehand echocardiography.
Motion of the diaphragm during respiration causes a displacement of the heart relative to the position of a transthoracic ultrasound (US) probe. These respiration-induced shifts of cardiac position can lead to spatial misalignments of data when reconstructed in 3-D. We show how to compensate for this motion using a technique that extends the tracking of the probe to additionally monitor a marker placed on the patient umbilicus. The motion of the umbilicus is calibrated to that of the diaphragm using one additional scan. This calibration is used to correct the 3-D spatial positions of cardiac images acquired from multiple acoustic views. At both systole and diastole, segmentations of the endocardial border visually appear more consistent after our correction than with no correction. Long and short axis segmentations should intersect on the endocardium. After correction, their separation at the closest point is shown to be reduced.


Brain mechanisms associated with facial encoding of affective states.
Affective states are typically accompanied by facial expressions, but these behavioral manifestations are highly variable. Even highly arousing and negative valent experiences, such as pain, show great instability in facial affect encoding. The present study investigated which neural mechanisms are associated with variations in facial affect encoding by focusing on facial encoding of sustained pain experiences. Facial expressions, pain ratings, and brain activity (BOLD-fMRI) during tonic heat pain were recorded in 27 healthy participants. We analyzed facial expressions by using the Facial Action Coding System (FACS) and examined brain activations during epochs of painful stimulation that were accompanied by facial expressions of pain. Epochs of facial expressions of pain were coupled with activity increase in motor areas (M1, premotor and SMA) as well as in areas involved in nociceptive processing, including primary and secondary somatosensory cortex, posterior and anterior insula, and the anterior part of the mid-cingulate cortex. In contrast, prefrontal structures (ventrolateral and medial prefrontal) were less activated during incidences of facial expressions, consistent with a role in down-regulating facial displays. These results indicate that incidences of facial encoding of pain reflect activity within nociceptive pathways interacting or possibly competing with prefrontal inhibitory systems that gate the level of expressiveness.


Childhood maltreatment and suicide risk: The mediating role of self-compassion, mentalization, depression.
Childhood maltreatment (CM) is a well-established risk factor for depression and increased suicide risk. This study aimed to investigate the distinctive mechanisms of individual types of CM on young adult suicide risk, by exploring the potential mediating role of mentalization, self-compassion, and depression. A total of 4873 adults completed a survey screening for experiences of CM, self-compassion, mentalization, depression, and suicide risk. The path analysis revealed significant direct effects of mentalization, self-compassion, and depression on suicide risk. Moreover, mentalization, self-compassion, and depression mediated the relationship between emotional abuse/neglect and suicide risk, whereas physical neglect contributed to suicide risk only through mentalization and depression. Furthermore, sexual abuse had a significant direct effect on suicide risk, whereas physical abuse did not show any direct or indirect effects. The cross-sectional design of the study limits its ability to establish causality, and the risk of recall bias in reporting physical or sexual abuse cannot be ignored. This study represents the first identification of disturbances in self-compassion, mentalization, and depression that mediate the relationship between various types of CM and suicide risk in young adults. Our findings suggest substantive differences in the impact of emotional CM compared to other forms of CM. Enhancing self-compassion and mentalization abilities could be valuable intervention strategies for individuals with a history of emotional CM. Addressing factors that hinder the recall of relevant subjective experiences of physical and sexual abuse is also critical.


Post-treatment residual thrombus increases the risk of recurrent deep vein thrombosis and mortality.
Recurrent thromboembolic events after an initial deep vein thrombosis (DVT) are relatively frequent. Residual thrombus in the affected veins on ultrasound scan at the completion of anticoagulant therapy has been described as a recurrence risk factor, and may have utility in stratifying those patients at risk. The aims of the study were to correlate the risk of recurrence of DVT with the results of ultrasound at completion of oral anticoagulant therapy. A secondary aim was to review the mortality in this population. A cohort of 316 DVT patients was included. The patients were divided into those with completely clear vessels on follow-up scan (45%) and those with residual thrombus identified (55%). The cumulative incidence of recurrence was 10% by 2 years and 23% by 5 years. Patients with residual thrombus on follow-up ultrasound were at higher risk of recurrence (hazard ratio [HR] 2.2, 1.19-4.21; P = 0.012) which remained significant after multivariate adjustment for age, gender and malignancy (HR 2.2, 1.15-4.17; P = 0.018). During follow-up, the cumulative mortality was 12% at 2 years and 27% by 5 years. The risk of death was increased in patients with residual thrombus on follow-up scan (HR 3.9, 1.93-7.71; P < 0.001) and this risk persisted after multivariate analysis of age, gender and malignancy (2.8, 1.37-5.72; P = 0.005). The majority of deaths were due to malignancy (68%) however 10 (18%) died from vascular causes. There was a trend towards increased vascular death in the patients with residual thrombus on follow-up ultrasound scan, which did not reach significance (HR 4.1, 0.87-19.33; P = 0.13). Consistent with previous cohort studies, recurrence risk is increased in patients with residual thrombus on ultrasound. The increased risk of death in patients with residual thrombus, with a trend towards increased vascular death, may suggest that failure of thrombus resolution is a marker of more global vascular dysfunction.


How effective is email communication for patients requiring elective surgery?
Patients increasingly use the Internet for communication as well as to obtain information, but there are few published reports on either the utilization or effectiveness of email as a means of communication between patient and surgeon. The aim of the present study is to examine the effectiveness of email communication by patients prior to undergoing elective surgery. This is a retrospective cohort study of 306 patients undergoing thyroid or parathyroid surgery at a tertiary referral centre who had been provided with an information sheet promoting email communication compared to 352 patients in a control group who had not been provided with the same information. In the study group 50 of 306 patients (16%) utilized email communication. There was a statistically significant difference (P = 0.0004) in the age distribution between those who did (mean: 46.2, 95% confidence interval (CI): 42.0-50.4) and those who did not (mean: 54.6, 95%CI: 52.7-56.4) utilize emails, with the email users representing a younger population. In the control group, only 10 of 352 (3%) used email, a significantly lower percentage (P = 0.0001) than in the study group. A total of 101 emails were sent by 50 patients in the study group. Of these, the majority did so only once (n = 28-56%), with one patient sending seven separate emails. Most emails sent focused on only one issue, but some patients raised multiple issues with the most being seven issues in a single email. Despite concerns about potential medicolegal issues and other disadvantages, routine email communication between physician and patient provides an effective means of communication for patients undergoing elective surgery.


Development of a Species Diagnostic Molecular Tool for an Invasive Pest, Mythimna loreyi, Using LAMP.
The Mythimna loreyi (Duponchel) is one of the well-known invasive noctuid pests in Africa, Australia, and many Asian countries. However, it is difficult to identify the invasive and morphologically similar species, Mythimna separate, which occur at the cornfield in the larvae stage. Currently, the molecular biology method for diagnosing M. loreyi species is only using the mtCO1 universal primer (LCO1490, HCO2198), which requires a lot of time and effort, such as DNA extraction, PCR, electrophoresis, and sequencing. In this study, the LAMP assay was developed for rapid, simple, effective species identification. By analyzing the mitochondrial genome, the species-specific sequence was found at the coding region of the NADH dehydrogenase subunit 5 gene. Based on this unique sequence, four LAMP primers and two loop primers were designed. The F3 and B3 primers were able to diagnose species-specific, in general, and multiplex PCR and specifically reacted within the inner primers in LAMP assay. The optimal incubation condition of the LAMP assay was 61 °C for 60 min with four LAMP primers, though additional loop primers, BF and LF, did not significantly shorten the amplification time. The broad range of DNA concentration was workable in LAMP assay, in which the minimum detectable DNA concentration was 100 pg. DNA releasing method was applied, which took five minutes of incubation at 95 °C without the DNA extraction process. Only some pieces of tissue of larvae and adult samples were needed to extract DNA. The incidence of invasive pests is gradually diversifying. Therefore, this simple and accurate LAMP assay is possibly applied in the intensive field monitoring for invasive pests and integrated management of Mythimna loreyi.