An Extended Expectation-Confirmation Model for Mobile Nursing Information System Continuance.
Nursing is critical in health care systems and comprises the planning, execution, and documentation of nursing care. To better manage health care information during patient care, the use of a mobile nursing information system (MNIS) provides more time to care for inpatients by reducing time-consuming and redundant paperwork. The purpose of this study was to extend the expectation-confirmation model and explore the roles of nursing professional competency (skill in use), habit (customary use), satisfaction (with use), and frequency of prior use in the context of MNIS continuance usage. We randomly chose 3 hospitals from among 14 hospitals in Taiwan that had indicated they used an MNIS. We conducted a field survey of nurses who had experience using the MNIS. We used a valid sample of 90 nurses to test the research model, using structural equation modeling with the partial least squares method. The results show that habit and frequency of prior use had a significant impact on MNIS continuance usage. Satisfaction and frequency of prior use had a significant impact on habit. Nurses' professional competence is crucial to perceived usefulness and, thus, is relevant in the context of MNIS continuance usage. When habit weakens over time, the continuance intention predicts continuance usage. This study showed that the extended expectation-confirmation model effectively predicts nurses' MNIS continuance usage and provides implications. Academics and practitioners should understand how nurses' habits form and how they affect continued MNIS use. Understanding the antecedents of habits can help nursing managers identify and manipulate habit formation.


Early anti-VEGF treatment for radiation maculopathy and optic neuropathy: lessons learned.
Radiation therapy has saved both sight and life for eye cancer patients. The most common methods include ophthalmic plaque brachytherapy and external beam techniques. However, subsequent dose-dependent radiation vasculopathy invariably occurs within and around the targeted zone. In 2006, Finger discovered that periodic intravitreal anti-vascular endothelial growth factor (anti-VEGF) bevacizumab could reverse and suppress intraocular radiation vasculopathy. At first, it was administered at the onset of radiation-related vision loss. Though bevacizumab induced regression of macular oedema, retinal haemorrhages and cotton-wool infarcts, most patients were left with residual retinal damage, manifest as metamorphopsia and loss of vision. These results led to earlier and earlier anti-VEGF interventions: first after signs of progressive radiation retinopathy, and then for signs of radiation maculopathy, and finally for high-risk eyes with no clinical signs of retinopathy. Earlier initiation of intravitreal anti-VEGF therapy typically resulted in greater restoration and preservation of macular anatomy, reductions of retinal haemorrhages, resolution of cotton-wool spots and vision preservation. Recent research on optical coherence tomography angiography (OCT-A) has revealed that radiation vasculopathy occurs prior to clinical ophthalmic signs or symptoms. Therefore, it seemed reasonable to consider treating high-risk patients (considered certain to eventually develop radiation maculopathy) to prevent or delay vision loss. Herein, we describe the evolution of treatment for radiation maculopathy as well as recent research supporting anti-VEGF treatment of high-risk patients immediately following radiation to maximize vision outcomes.


Gendered Massacres: Examining the Effects of Cultural and Structural Gender Inequality on the Incidence of Mass Public Shootings.
With nearly 97% of incidents within the past 40 years committed by men, mass public shootings are a gendered social problem. Yet, empirical research on this phenomenon largely neglects gender hierarchy and cultural factors as predictors, in favor of individual- and event-level characteristics. Despite calls from scholars to place masculinity and threats to patriarchal hegemony at the center of analyses, no empirical studies to our knowledge have examined the role of gender inequality in mass public shootings. The findings indicate that gender inequality, structural and ideological, are important predictors of mass public shootings and that future research should continue to investigate such violence from a gendered lens.


The expression of aplysia ras homolog I (ARHI) and its inhibitory effect on cell biological behavior in esophageal squamous cell carcinoma.
Aplysia ras homolog I (ARHI) is a Ras-related maternally imprinted tumor suppressor gene. Loss of ARHI expression contributes to the malignant progression of various tumors. However, reports on the clinical implications and functional role of ARHI expression in esophageal squamous cell carcinoma (ESCC) are limited. This study examined the role of ARHI in ESCC. In total, 81 patients diagnosed with ESCC based on histopathological evaluations who were subjected to surgical resection were included in the study. ARHI expression was analyzed by immunohistochemistry and western blotting, examining the correlations between ARHI expression and patient clinicopathological features. The functional effects of ARHI overexpression were examined using a Cell Counting Kit-8 assay, flow cytometry, a Transwell assay, wound healing, and western blotting in the ECA109 cell line. ARHI was highly expressed in 27.5% (22/81) of ESCC specimens (adjacent noncancerous tissues, 85.2%, 69/81; P<0.05). The ARHI expression level was significantly lower in patients with lymph node metastasis than in patients without (P<0.05). A Kaplan-Meier survival analysis showed that patients with low ARHI expression had shorter survival than patients with high expression (P<0.05), and a multivariate Cox analysis revealed that ARHI is an independent predictor of overall survival (P=0.029). Finally, overexpression of ARHI in ESCC cells indicates that ARHI suppresses proliferative capacity, invasive capacity, and cell cycle progression and may also suppress epithelial-mesenchymal transition and induce apoptosis and autophagy. ARHI may be a prognostic biomarker and a potential therapeutic target in ESCC.


Isolated sleep apnea due to Chiari type I malformation and syringomyelia.
We report an 11-year-old girl with Chiari type I malformation and syringomyelia, who experienced isolated sleep apnea without other neurologic problems. Monitoring with oximetry and movement of thoracic and abdominal walls indicated mixed-type sleep apnea. Chiari type I malformation should be differentiated from other disorders causing sleep apnea.


Geographical heterogeneity of doping-related knowledge, beliefs and attitude among 533 Youth Olympics participants.
Doping-related knowledge, beliefs and attitude influence adolescent athletes' susceptibility to prohibited performance-enhancing substances. They might be modified by different cultural backgrounds. This study's aim was to analyse the geographical heterogeneity of doping-related knowledge, beliefs and attitude among adolescent elite athletes. Cross-sectional study. A questionnaire was distributed to athletes participating in the Winter Youth Olympic Games 2020 in Switzerland. Main outcomes ('subjective and actual knowledge', 'beliefs' and 'attitude') were stratified for athletes' region of origin. Geographical heterogeneity was tested with a two-way analysis of variance, and two multiple regression analyses were conducted to assess independent associations of knowledge, age and athletes' geographical region with doping-related beliefs and attitude. 533 athletes (54% females, mean age: 16.0 ± 1.0 years), completed the questionnaire (response rate: 33%). Actual knowledge was moderate-to-good (9.2 ± 2.9 correct answers out of 13), and scores of attitude and beliefs showed favourable patterns. Considerable geographical heterogeneity was found for knowledge (p < 0.001), beliefs (p = 0.004) and attitude (p < 0.001). Higher subjective knowledge and actual knowledge were favourably associated with attitude (β = -0.096, p = 0.049; β = -0.316, p < 0.001) and beliefs (β = 0.120, p = 0.016; β = 0.212, p < 0.001), independent of age and geographical region. This study demonstrates considerable geographical heterogeneity of doping-related knowledge, beliefs and attitude, which are three essential target factors of doping prevention in adolescent elite athletes. This evidence should encourage medical doctors and other professionals to change their educative anti-doping approach from teaching knowledge about negative consequences into investigating and forming a young athlete's mind-set.


Detection of solid and subsolid pulmonary nodules with lung MRI: performance of UTE, T1 gradient-echo, and single-shot T2 fast spin echo.
Although MRI is a radiation-free imaging modality, it has historically been limited in lung imaging due to inherent technical restrictions. The aim of this study is to explore the performance of lung MRI in detecting solid and subsolid pulmonary nodules using T1 gradient-echo (GRE) (VIBE, Volumetric interpolated breath-hold examination), ultrashort time echo (UTE) and T2 Fast Spin Echo (HASTE, Half fourier Single-shot Turbo spin-Echo). Patients underwent a lung MRI in a 3 T scanner as part of a prospective research project. A baseline Chest CT was obtained as part of their standard of care. Nodules were identified and measured on the baseline CT and categorized according to their density (solid and subsolid) and size (> 4 mm/ ≤ 4 mm). Nodules seen on the baseline CT were classified as present or absent on the different MRI sequences by two thoracic radiologists independently. Interobserver agreement was determined using the simple Kappa coefficient. Paired differences were compared using nonparametric Mann-Whitney U tests. The McNemar test was used to evaluate paired differences in nodule detection between MRI sequences. Thirty-six patients were prospectively enrolled. One hundred forty-nine nodules (100 solid/49 subsolid) with mean size 10.8 mm (SD = 9.4) were included in the analysis. There was substantial interobserver agreement (k = 0.7, p = 0.05). Detection for all nodules, solid and subsolid nodules was respectively; UTE: 71.8%/71.0%/73.5%; VIBE: 61.6%/65%/55.1%; HASTE 72.4%/72.2%/72.7%. Detection rate was higher for nodules > 4 mm in all groups: UTE 90.2%/93.4%/85.4%, VIBE 78.4%/88.5%/63.4%, HASTE 89.4%/93.8%/83.8%. Detection of lesions ≤4 mm was low for all sequences. UTE and HASTE performed significantly better than VIBE for detection of all nodules and subsolid nodules (diff = 18.4 and 17.6%, p = < 0.01 and p = 0.03, respectively). There was no significant difference between UTE and HASTE. There were no significant differences amongst MRI sequences for solid nodules. Lung MRI shows adequate performance for the detection of solid and subsolid pulmonary nodules larger than 4 mm and can serve as a promising radiation-free alternative to CT.


Preparation of qualitative standard mixtures of polychlorinated dibenzo-rho-dioxins and dibenzofurans by ultraviolet and psi-irradiation of the octachloro compounds.
High-resolution gas chromatography using an OV-17 glass capillary column and mass spectrometry were used to analyze uv-and psi-irradiated octachlorodibenzo-rho-dioxin and octachlorodibenzofuran. Under the conditions investigated, dechlorination of these compounds to lower chlorinated dibenzo-rho-dioxins and dibenzofurans appears to be the major reaction pathway. The resulting mixtures of penta-, hexa-and heptachloro compounds can be used as easily and safely prepared qualitative reference samples to determine gas chromatographic, mass spectrometric and other properties of individual components for which pure standards are not available.


Prenatal Stress Exposure Amplifies Effect of Maternal Suicidal Ideation on Early Childhood Behavioral Trajectories.
The in utero environment influences fetal development and may predispose to disease later in life. This study examines whether maternal suicidal ideation during pregnancy is associated with children's behavioral trajectories across early childhood, and whether prenatal maternal traumatic stress accelerates the trajectories. The study included mother-child dyads (N = 331, 51.1% boys) from the longitudinal Stress In Pregnancy study; 31.1% (n = 103) mothers were Exposed to Superstorm Sandy. During their second trimester, 12.4% (n = 41) women reported suicidal ideation during pregnancy. Mothers completed the Behavior Assessment Scale for Children-2 annually from ages 2- to 6-years-old to assess multiple behavioral domains. Hierarchical linear modeling estimated within-person longitudinal trajectories of clinical behaviors, and between-person effects of maternal suicidal ideation and disaster-related stress in utero on changes in child behavior. For children exposed to both risks, Atypical behaviors (i.e., unusual behaviors, social disconnection) increased linearly across early childhood. Exposure to Superstorm Sandy and maternal suicidal ideation were independently associated with non-linear increases in Anxiety severity and maternal suicidal ideation during pregnancy was associated with a linear increase in Attention problems across early childhood. Maternal suicidal ideation during pregnancy is associated with increased risk for a range of behavioral and emotional difficulties in early childhood and the trajectory of atypical behaviors was amplified by disaster-related traumatic stress. Findings highlight the need for health professionals to screen for suicidal ideation among their pregnant patients. Pregnant women who experience severe stress may require additional monitoring and support to reduce risk for poorer early childhood outcomes.


The protection of lambs from eperythrozoon infection while suckling Eperythrozoon ovis carrier ewes.
When lambs born to and suckling Eperythrozoon ovis carrier ewes were inoculated with heparinised blood containing large numbers of E. ovis organisms, the lambs were either sterilised of the infection or patent infection was suppressed till the lambs were weaned. In vitro infection, transplacental transfer of antibodies or soluble antigens could not be demonstrated.


Extended support with permanent systems: percutaneous versus totally implantable.
Use of circulatory support devices in patients awaiting heart transplantation has provided information about the long-term use of these devices. The Novacor left ventricular assist system has proved reliable for long-term support. The main problems with its use are infection and thromboembolism, but neither seems to prohibit long-term use. Problems with compliance chambers are not as great as previously thought. These results suggest that implantation of a permanent, totally implantable left ventricular assist device in lieu of transplantation is feasible.


Relation of cumulative weight burden to vascular endothelial dysfunction in obesity.
Although excess fat mass is linked to increased cardiovascular risk, the relation between vascular phenotype and degree of obesity in high weight categories is unknown. We examined brachial artery vasomotor responses using ultrasound in 203 consecutive patients with severe obesity (mean age 44 +/- 11 years; body mass index [BMI] 46 +/- 9 kg/m(2), range 30 to 72; and body weight 128 +/- 29 kg, range 69 to 207). We studied a unique population in which 71% of subjects were characterized as morbidly obese (BMI > or =40 kg/m(2)), which included a 31% group of super-obese subjects (BMI > or =50 kg/m(2)). Brachial artery flow-mediated dilation (FMD) and nitroglycerin-mediated dilation were examined as measures of endothelium-dependent and -independent dilation, respectively, in relation to clinical, hemodynamic, and metabolic variables. Endothelial function was significantly impaired in the highest compared with the lowest tertile of body weight (FMD 6.5 +/- 4.6% vs 9.8 +/- 4.8%, p <0.001), whereas nitroglycerin-mediated dilation was similar in all groups. Univariate correlates of FMD were gender, weight, waist circumference, BMI, diastolic blood pressure, and creatinine. In multivariate analysis, weight was a strong independent significant predictor of FMD (beta = -0.23, p = 0.005) in addition to gender. Within an overweight population, cumulative weight burden remains strongly linked to progressive arterial dysfunction. In conclusion, these results suggest that cardiovascular risks intensify with higher degrees of obesity and underscore the importance of therapeutic weight loss interventions.


Fractures and dislocations of the hand in polytrauma patients: Incidence, injury pattern and functional outcome.
Injuries of the hand can cause significant functional impairment, diminished quality of life and delayed return to work. However, the incidence and functional outcome of hand injuries in polytrauma patients is currently unknown. The aim of this study was to determine the incidence, distribution and functional outcome of fractures and dislocation of the hand in polytrauma patients. A single centre retrospective cohort study was performed at a level 1 trauma centre. Polytrauma was defined as patients with an Injury Severity Score of 16 or higher. Fractures and dislocations to the hand were determined. All eligible polytrauma patients with hand injuries were included and a Quick Disability of Arm, Shoulder and Hand questionnaire (QDASH) and Patient-Rated Wrist/Hand Evaluation (PRWHE) were administered. Patients were contacted 1-6 years after trauma. In a cohort of 2046 polytrauma patients 72 patients (3.5%) suffered a hand injury. The functional outcome scores of 52 patients (72%) were obtained. The Metacarpal (48%) and carpal (33%) bones were the most frequently affected. The median QDASH score for all patients with hand injury was 17 (IQR 0-31) and the PRWHE 14 (IQR 0-41). Patients with a concomitant upper extremity injury (p=0.002 for PRWHE, p0.006 for QDASH) and those with higher ISS scores (p=0.034 for PRWHE, QDASH not significant) had worse functional outcome scores. As an example, of the 5 patients with the worst outcome scores 3 suffered an isolated phalangeal injury, all had concomitant upper extremity injury or neurological injuries (3 plexus injuries, 1 severe brain injury). The incidence of hand injuries in polytrauma patients is 3.5%, which is relatively low compared to a general trauma population. Metacarpal and carpal bones were most frequently affected. The functional extremity specific outcome scores are highly influenced by concomitant injuries (upper extremity injuries, neurological injuries and higher ISS).


Identification of QTLs for seed germination capability after various storage periods using two RIL populations in rice.
Seed germination capability of rice is one of the important traits in the production and storage of seeds. Quantitative trait loci (QTL) associated with seed germination capability in various storage periods was identified using two sets of recombinant inbred lines (RILs) which derived from crosses between Milyang 23 and Tong 88-7 (MT-RILs) and between Dasanbyeo and TR22183 (DT-RILs). A total of five and three main additive effects (QTLs) associated with seed germination capability were identified in MT-RILs and DT-RILs, respectively. Among them, six QTLs were identified repeatedly in various seed storage periods designated as qMT-SGC5.1, qMT-SGC7.2, and qMT-SGC9.1 on chromosomes 5, 7, and 9 in MT-RILs, and qDT-SGC2.1, qDT-SGC3.1, and qDT-SGC9.1 on chromosomes 2, 3, and 9 in DT-RILs, respectively. The QTL on chromosome 9 was identified in both RIL populations under all three storage periods, explaining up to 40% of the phenotypic variation. Eight and eighteen pairs additive × additive epistatic effect (epistatic QTL) were identified in MT-RILs and DT-RILs, respectively. In addition, several near isogenic lines (NILs) were developed to confirm six repeatable QTL effects using controlled deterioration test (CDT). The identified QTLs will be further studied to elucidate the mechanisms controlling seed germination capability, which have important implications for long-term seed storage.


[Choroidal melanoma complicated with central retinal vein occlusion].
Various complications for choroidal melanoma have been reported. However, there are no reports on choroidal melanoma complicated with central retinal vein occlusion. A 37-year-old male showed an elevated yellowish white tumor of about 8 discs in diameter, and involving the optic disc in the left eye. Serous retinal detachment and subretinal exudate were noted around the tumor. Central retinal vein occlusion occurred concurrently. Fluorescein angiography revealed blocks due to hemorrhage and fluorescence leakage from the retinal vein. Dilation of retinal capillary vessels and marked leakage of fluorescence from the retinal vein and capillary vessels were found in the tumorous region. In the late stage, the entire tumor presented hyper-fluorescence. On indocyanine green angiography, the tumor on the whole presented hypo-fluorescence from the early to late stage, and an insular hyper-fluorescence suggestive of the presence of intratumor vessels with leakage of fluorescence was seen inside. Ultrasonography revealed choroidal excavation. General examination showed no abnormality. On the basis of these findings the patient was diagnosed with choroidal melanoma. We report a case of choroidal melanoma, which was complicated with central retinal vein occlusion by mechanical compression and invasion of the optic disc from the first medical examination.


[The 2017 WHO classification of pituitary tumors].
The 2017 WHO classification of pituitary tumors is still based on structural analyses and expression of various pituitary hormones. Three innovations have to be considered: (1) The expression of pituitary transcription factors Pit‑1, T‑Pit and SF‑1. (2) The term "atypical adenoma" was replaced by "aggressive adenoma". (3) The three tumor types of the neurohypophysis (pituicytoma, spindle cell oncocytoma, granular cell tumor) are defined by their common expression of TTF‑1. Craniophyryngiomas are identified as adamantinomatous type by focal nuclear expression of β‑catenin or as papillary type by demonstration of BRAF V600E mutation. Further primary tumors of the pituitary are extremely rare. These and also the other tumors of the sellar region can be structurally very similar to pituitary adenomas but can be-nearly without exception-differentiated by immunocytochemistry.


Ferrofluid-assisted rapid and directional harvesting of marine microalgal Chlorella sp. used for biodiesel production.
In this work, a novel harvesting strategy using ferrofluids coupled with flocculation as a magnetic directional harvesting system was developed, providing a fast and easy way to effectively collect microalgae with no further modifications made to the ferrofluids. With a ferrofluid dosage of 25mgL-1, a high harvesting efficiency of 95-100% was achieved within 1min. In addition, we successfully performed a wastewater recycling strategy coupled with a microalgal ferrofluid-harvesting dynamic flow-through system to harvest biomass of Chlorella sp. MTF-7 which could achieve over 80% of the maximum level after three repeated recycling cultivations. This work demonstrated the use of an integrated microalgal ferrofluid-harvesting dynamic flow-through system to develop a simple and effective strategy to enhance microalgal harvesting efficiency, along with wastewater recycling, in a marine microalgal Chlorella sp. MTF-7.


Underutilization of Cardiac Rehabilitation in Women: BARRIERS AND SOLUTIONS.
Despite the known benefits of cardiac rehabilitation (CR), it remains underutilized particularly among women. The aim of this review was to provide an overview regarding women in CR, addressing barriers that may affect enrollment and attendance as well as to discuss the training response and methods to optimize exercise-related benefits of CR. The review examines original studies and meta-analyses regarding women in CR. Women are less likely to engage in CR compared with men, and this may be attributed to lack of referral or psychosocial barriers on the part of the patient. Furthermore, despite having lower levels of fitness, women do not improve their fitness as much as men in CR. This review summarizes the current literature and provides recommendations for providers regarding participation and adherence as well as optimal methods for exercise training for women in CR.


Effects of polychlorinated biphenyls on cytochrome P450 induction in the chick embryo hepatocyte culture.
The effects of pure synthetic polychlorinated biphenyl (PCB) congeners on the induction of cytochrome P450 and associated activities were examined in cultured chick embryo hepatocytes. Dose-response effects for the induction of total cytochrome P450 ethoxyresorufin-O-deethylase (EROD) activity, and benzphetamine demethylase (BPDM) activity were studied using 10 selected tetra- to hexachlorinated PCB congeners. These studies revealed that PCBs caused effects in the chick hepatocyte culture different from previously observed effects in rat liver. Based on their effects in chick hepatocytes, the PCBs could be categorized into two groups. The first group (consisting of 3,3',4,4'-PCB, 3,3',4,4',5-PCB, 3,3',4,4',5,5'-PCB, 2',3,3',4,5-PCB, 2,3,3',4,4',5'-PCB, and 2,3,4,4',5-PCB) induced total cytochrome P450 2.4- to 2.9-fold and EROD activity from 1-2 pmol/min/mg protein to 162-247. There was marked variation in potency, but all these congeners had a maximal inducing dose above which cytochrome P450 concentrations and EROD activities declined. BPDM activities were increased only slightly (1.2- to 1.6-fold) at the maximal cytochrome P450 inducing dose. The second group of congeners (consisting of 2,2',4,5,5'-PCB. 2,2',4,4',5,5'-PCB, and 2,2',3,4,4',6-PCB) induced total cytochrome P450 concentrations 4.0-fold and BPDM activities 2.2- to 2.6-fold with greatest activity occurring at the highest doses which could be added (10-50 microM). However, EROD activities were also increased by these congeners to 60-112 pmol/min/mg protein with declining activities seen at the highest PCB doses (i.e., resembling EROD induction patterns of the first group). The EROD induction patterns with these latter PCB congeners are noteworthy since these PCBs do not induce EROD activity in the rat. For both groups of PCB congeners, EROD induction was associated with increased accumulation of uroporphyrin in cultures exposed to exogenous 5-aminolevulinate. Studies investigating the reason for the depression of cytochrome P450 concentrations and/or EROD activities by high doses of the PCBs revealed that with the first group there was slightly decreased total protein synthesis, decreased total cell heme concentrations, and decreased accumulation of radiolabeled heme synthesized from 5-[14C]aminolevulinate. These changes might represent nonspecific toxic effects of the first group of PCBs. However, since these changes were not seen with the second group of PCBs, it is unlikely that either inhibition of heme synthesis or toxicity cause the depression of EROD activity with high PCB doses.


Role of spontaneous reporting in investigating the relationship between mRNA COVID-19 vaccines and myocarditis: The French perspective.
Post-mRNA coronavirus diseases 2019 (COVID-19) vaccines myocarditis emerged as a rare adverse effect, particularly in adolescents and young adults, and was labeled as such for both vaccines in the summer of 2021. This study aims to summarize the timeline and process of signal detection, substantiation, and quantification of myocarditis cases related to mRNA vaccines in France. The intensive monitoring plan for COVID-19 vaccine safety was based on case-by-case analysis of all cases collected in the French spontaneous reporting database (Base nationale de pharmacovigilance, BNPV). Cases were evaluated by drug safety medical professionals and discussed at a national level for signal detection purposes. Reported cases were compared to the number of vaccine-exposed persons up to September 30th, 2021. Reporting rates (Rr) of myocarditis per 100,000 injections were calculated and stratified according to age, gender, and injection rank of BNT162b2 and mRNA-1273 vaccines. Poisson distribution was used to compute Rrs 95% Confidence Interval (95% CI). The case-by-case analysis detected a possible cluster of myocarditis in April 2021 (5 cases, 4 after the 2nd injection). In June 2021, the signal was substantiated with 12 cases (9 related to BNT162b2, and 3 to mRNA-1273). As of September 2021, almost 73 million BNT162b2 and 10 million mRNA-1273 doses had been injected. The Rr per 100,000 injections was 0.5 (0.5-0.6) for BNT162b2 and 1.1 (95% CI 0.9-1.3) for mRNA-1273. The difference among vaccines was more pronounced after the second injection, particularly in men aged 18-24 years (4.3 [3.4-5.5] for BNT162b2 vs. 13.9 [9.2-20.1] for mRNA-1273) and aged 25-29 years (1.9 [1.2-2.9] vs. 7.0 [3.4-12.9]). The study highlighted the role of the spontaneous reporting system in the detection, assessment, and quantification of myocarditis related to m-RNA vaccines. It suggested from September 2021 that mRNA-1273 was reasonably related to a higher risk of myocarditis than BNT162b2 in people under 30, particularly after the second injection.


Functional polysaccharide-based film prepared from chitosan and β-acids: Structural, physicochemical, and bioactive properties.
β-Acids are natural antibacterial and antioxidant ingredients, obtained from supercritical CO2 hop extract. In this study, β-acids/chitosan complex films were prepared using the casting method. Complex films were characterized using scanning electron microscopy (SEM), atomic force microscope (AFM), Fourier transform infrared spectroscopy (FTIR), and X-ray diffraction analysis (XRD). Structure analysis revealed that β-acids can be successfully combined with the chitosan matrix. Mechanical tests demonstrated that the tensile strength of the films showed a significant upward trend (1.9 MPa to 9.6 MPa) with increase in β-acids content (0.1%-0.3%). Interestingly, the chitosan-based films showed excellent UV barrier capability below 400 nm. The release of β-acids from the film followed Fickian diffusion (n < 0.45). In addition, the complex films inhibited the growth of five food-borne pathogens (Escherichia coli, Staphylococcus aureus, Bacillus subtilis, Salmonella enteritidis and Listeria monocytogenes). This study highlights the promising nature of composite film as a desirable alternative for active packaging.


New species of Acanthocinini Blanchard, 1845 (Coleoptera, Cerambycidae) from Rondônia state, Brazil and notes on some genera.
Three new species of Acanthocinini (Coleoptera, Cerambycidae) from Rondônia State, Brazil, are described and illustrated: Leptostylus obrienorum, Nyssodrysina maculosa and Urgleptes curvatum. We also present a brief generic discussion about these genera.


Nano-magnetic walnut shell-rice husk for Cd(II) sorption: design and optimization using artificial intelligence and design expert.
This study attempted to investigate the use of nanomagnetic activated carbon prepared from walnut shell and rice husk wastes for removal of Cd(II) from aqueous solution via application of ANN and design expert as adsorbent preparation design and optimization tools. The novel adsorbent was characterized using SEM, FTIR, EDS and BET. The result from 2-level factorial design expert revealed 78.58% Cd(II) sorption efficiency could be achieved for adsorbent prepared at optimum calcination temperature, calcination time, SS-RH mixing ratio and magnetite loading of 859.20 °C, 2.32 h, 2.54 and 5.56 wt% respectively. Sensitivity analysis by both proposed methodologies revealed calcination temperature as most influential factor in adsorbent preparation. Average relative errors and R2 values of 1.2931% and 4.806%; and 0.9967 and 0.9055 obtained respectively for developed ANN model with 4-9-1 architecture and 2-level factorial design expert revealed ANN model as better prediction and optimization tool for Cd(II) sorption using NM-WS-RH-AC. Laboratory analysis revealed presence of -OH, -NH and COO- groups on adsorbent surface; presence of Cd(II) after adsorption; change in adsorbent textural and morphological structure after Cd(II) adsorption; and increase in its surface area and average pore diameter due to magnetization. Average relatively stable desorption strength of 62.74% towards Cd(II) was exhibited by adsorbent for four consecutive cycles using 0.1M HNO3. Prepared adsorbent is effective in removing Cd(II) from solution than commercial activated carbon with economically viable regeneration attribute.


Conservation of the plastid sedimentation zone in all moss genera with known gravitropic protonemata.
Moss protonemata from several species are known to be gravitropic. The characterization of additional gravitropic species would be valuable to identify conserved traits that may relate to the mechanism of gravitropism. In this study, four new species were found to have gravitropic protonemata, Fissidens adianthoides, Fissidens cristatus, Physcomitrium pyriforme, and Barbula unguiculata. Comparison of upright and inverted apical cells of P. pyriforme and Fissidens species showed clear axial sedimentation. This sedimentation is highly regulated and not solely dependent on amyloplast size. Additionally, the protonemal tip cells of these species contained broad subapical zones that displayed lateral amyloplast sedimentation. The conservation of a zone of lateral sedimentation in a total of nine gravitropic moss species from five different orders supports the idea that this sedimentation serves a specialized and conserved function in gravitropism, probably in gravity sensing.


Synthesis, molecular docking and anti-diabetic evaluation of 2,4-thiazolidinedione based amide derivatives.
A series of thiazolidinedione based amide derivatives were designed, synthesized and docked against the PPARγ receptor target. 11 compounds from the series with good glide scores were selected for in vivo antidiabetic study based on streptozotocin induced diabetic rat model. It was observed that 4 compounds (6c, 6e, 6m &6n) showed significantly good antidiabetic activity in comparison to rosiglitazone and pioglitazone as reference drugs. Compound 6c appeared as the most potent derivative in lowering blood glucose level and showed excellent interaction with SER 342, ILE 281, pi-pi interaction with ARG 288 and halogen bond interaction with LYS 367. Further, PPARγ transactivation and gene expression studies of compound 6c were carried out to investigate the possible mechanism of action through PPARγ modulation. Compound 6c exhibited 53.65% transactivation and elevated PPARγ gene expression by 2.1 folds. The biochemical parameters (AST, ALT and ALP levels) were found within the range with no noteworthy damage to liver.


An x-ray study of the condensed and separated states of sciatic nerve myelin.
Low-angle X-ray diffraction patterns of peripheral nerve myelin after modification by either rehydration in various solutions or by chemical treatment have been recorded. These X-ray patterns and the previously reported modified nerve myelin patterns demonstrate that nerve myelin has at least five different states: the normal state, condensed state I and II and separated state I and II. There are two membranes per unit cell in the normal state and in states II whereas there is one membrane per unit cell in states I. Under certain conditions normal nerve can go reversibly into either of states II. With continued treatment the nerve myelin structure moves irreversibly from state II to state I and, once in state I, the nerve myelin layers cannot return to the normal state. Our results demonstrate that there is a reversible transformation between condensed state I and separated state I. Fourier profiles of nerve myelin in the normal state, condensed state I and separated state I are presented.


Clinical review: Present and future prospects of male fertility preservation for children and adolescents.
Rapid progress in fertility preservation strategies has led to the investigation of ways in which fertile gametes could be generated from cryopreserved immature testicular tissue. Childhood cancer patients remain the major group that can benefit from these techniques. Other potential candidates include patients undergoing gonadectomy and patients with Klinefelter's syndrome and cryptorchid testes. This review aims to present an overview of the current state of knowledge in experimental germ cell transplantation, testicular tissue transplantation, and germ cell culture as fertility preservation methods for males. We included English articles published in PubMed as well as personal files with the focus on studies including human or nonhuman material. Germ cell and testicular tissue transplantation demonstrate clinical options to mature germ cells from immature primate testicular tissue. The most promising approach involves autologous grafting of immature testicular tissue, whereas germ cell maturation in vitro provides the best strategies to overcome problems of cancer contamination in cryopreserved testicular tissue. Three-dimensional and organ culture systems offer the possibility to differentiate immature male germ cells up to the stage of elongated spermatids. Further characterization of early germ cell development in humans is needed to modify these systems for clinical use.


The Role of Just World Beliefs in Responding to the COVID-19 Pandemic.
This study investigated whether people's personal belief in a just world (BJW) is linked to their willingness to physically distance themselves from others during the COVID-19 pandemic. Past research found personal BJW to be positively related to prosocial behavior, justice striving, and lower risk perceptions. If social distancing reflects a concern for others, high personal BJW should predict increased interest in social distancing. If social distancing reflects a concern for one's personal risk, high personal BJW should predict decreased interest in social distancing. Results of a pre-registered internet-based study from Germany (N = 361) indicated that the higher people's personal BJW, the more they generally practiced social distancing. This association still occurred when controlling for empathy, another significant predictor of social distancing. There were no mediation effects of empathy and risk perception. The findings extend knowledge on the correlates of social distancing in the COVID-19 pandemic which could be used to increase compliance among citizens.


Lower gastrointestinal bleeding. Diagnostic approach and management conclusions.
The management of patients with lower gastrointestinal bleeding requires a systematic approach based on defined diagnostic and therapeutic methods. Although in 80 percent of patients bleeding will stop spontaneously, 25 percent will have rebleeding and 50 percent of those with rebleeding will bleed again. Angiography documents specific bleeding sites but raises questions related to the incidence, site and frequency of bleeding, as well as the necessity of demonstrating extravasation. We reviewed 49 arteriograms performed for lower gastrointestinal bleeding. We conclude from our findings that angiography identifies a presumptive cause of bleeding in 49 percent of patients; angiography identified the site of bleeding in 86 percent of the patients with active bleeding, thus allowing segmental colectomy. We believe that documentation of angiodysplasia in a patient with lower gastrointestinal bleeding is presumptive evidence for the site of bleeding. Angiography is useful and worthwhile in the work-up of patients with lower gastrointestinal bleeding in an attempt to plan localized, definitive resection, and this may lead to a lower mortality rate.


The Galway Study of Panic Disorder. II: Changes in some peripheral markers of noradrenergic and serotonergic function in DSM III-R panic disorder.
Sixty six patients with panic disorders, fulfilling the DSM III criteria for panic attack, together with a group of age and sex matched controls, were studied for changes in their peripheral noradrenergic and serotonergic status before treatment and during six months treatment with either clomipramine or lofepramine. The results of this study suggest that, despite clinical improvement, the peripheral markers of both adrenergic (platelet aggregation to noradrenaline, platelet alpha 2 receptor density and lymphocyte beta receptor density) and serotonergic (platelet aggregation to serotonin, 3H-ketanserin binding to platelet 5HT2 receptors and 3H-5HT uptake into platelets) function largely remained abnormal. It is concluded that such abnormalities are trait markers of biogenic amine function in patients with panic attack. Further studies are needed to determine whether or not these parameters eventually normalize in those patients showing prolonged remission of symptoms.


Phollow the phosphoinositol: Actin dynamics at the B cell immune synapse.
Actin remodeling promotes B cell activation by enabling B cell antigen receptor clustering in the immune synapse. In the current issue of JCB, Droubi et al. (2022. J. Cell Biol.https://doi.org/10.1083/jcb.202112018) find that this process is initiated by the lipid phosphatase INPP5B, which shapes synaptic actin architecture by locally depleting phosphatidylinositol 4,5 bisphosphate.


Guidelines for MR imaging in rectal cancer: Europe versus United States.
The aim of this study was to compare and contrast recently published guidelines for staging and reporting of MR imaging in rectal cancer from the European Society of Gastrointestinal and Abdominal Radiology and the North American Society of Abdominal Radiology. These guidelines were assessed on the presence of consensus and disagreement. Items were compared by two reviewers, and items with agreement and disagreement between the guidelines were identified and are presented in the current paper. Differences between guidelines are discussed to offer insights in practice variations between both continents and among expert centers, which to some extent may explain the differences between guidelines.


Targeting mammalian serine/threonine-protein kinase 4 through Yes-associated protein/TEA domain transcription factor-mediated epithelial-mesenchymal transition ameliorates diabetic nephropathy orchestrated renal fibrosis.
Tubulointerstitial fibrosis, which is closely related to functional injury of the kidney, can be observed in advanced stages of diabetic nephropathy (DN). Mammalian serine/threonine-protein kinase 4 (MST1), a core component of the Hippo pathway that is involved in cellular proliferation and differentiation, plays a crucial role in the pathogenesis of multiple metabolic diseases, kidney diseases and cancer. In type 1 and type 2 diabetic animals, as well as in human proximal tubular epithelial cells (HK-2), activation of MST1 was analyzed by immunohistochemistry and western blotting. In db/db mice, MST1 protein was knocked down or overexpressed by shRNA, and renal function, fibrosis, and downstream signaling were then investigated. RNA silencing and overexpression were performed by using an MST1 or YAP knockdown/expression lentivirus to investigate the regulation of MST1-mediated YAP/TEAD signaling pathways in the fibrosis process in HK-2 cells. Luciferase and coimmunoprecipitation (co-IP) assays were used to identify whether YAP directly regulated TEAD activation by forming a YAP-TEAD heterodimer, which ultimately leads to tubulointerstitial fibrosis. MST1 activation was significantly decreased in type 1 and type 2 diabetic nephropathy. Notably, the downregulation of MST1 activation was also observed in HK-2 cells in a glucose- and time-dependent manner. In vivo, downregulation of MST1 was sufficient to promote renal dysfunction and fibrosis in db/m mice, whereas overexpression of MST1 ameliorated diabetic nephropathy-induced renal fibrosis. Further mechanistic study demonstrated that activated YAP induced by MST1 inhibition directly upregulated TEAD activation by binding to TEAD and forming a YAP-TEAD heterodimer, resulting in the promotion of epithelial-mesenchymal transition (EMT) and fibrosis in renal tubular epithelial. MST1 activation represents a potential therapeutic strategy to treat or prevent the progression of diabetic nephropathy-induced renal fibrosis.


Pilot evaluation of an internet-based natural family planning education and service program.
To evaluate the efficacy, knowledge of fertility, and acceptability of a web-based natural family planning (NFP) education and service program. A 6-month repeated measure longitudinal evaluation pilot study. A university based online website. The website was piloted with 468 volunteer women seeking NFP services. Of these participants, 222 used the automatic online fertility charting system to avoid pregnancy. The 222 charting participants had a mean age of 29.9 years (SD=5.6), 2.2 children (SD=1.9), 37% were postpartum, and 47% had regular menstrual cycle lengths. Nurse-managed web-based NFP education and service program. Pregnancies were confirmed by an online self-assessed pregnancy evaluation form. A 10-item fertility quiz and 10-item acceptability survey was administered online. Among the 222 users avoiding pregnancy, at 6 months of use, there were two correct-use unintended pregnancies that provided a pregnancy rate of 2% and seven total unintended pregnancies providing a typical use pregnancy rate of 7%. Mean knowledge of fertility increased significantly from time of registration (8.96, SD=1.10) to 1 month of use (9.46, SD=.10), t=4.60, p<.001). Acceptability increased nonsignificantly from 1 month of use (45.6; SD=8.98) to 6 months of use (48.4; SD=8.77). The nurse-managed online NFP system seems to provide adequate knowledge of fertility and help participants meet pregnancy intentions. Acceptability of such a system of NFP is still in question.


Developing a novel magnesium calcium phosphate/sodium alginate composite cement with high strength and proper self-setting time for bone repair.
In this work, novel magnesium calcium phosphate/sodium alginate composite cements were successfully fabricated with a proper setting time (5-24 min) and high compressive strength (91.1 MPa). The physicochemical and biological properties of the cement in vitro were fully characterized. The composite cements could gradually degrade in PBS as the soaking time increase, and the weight loss reached 20.74% by the end of 56th day. The cements could induce the deposition of Ca-P layer in SBF. Cell experiments proved that the extracts of the composite cements can effectively promote the proliferation and differentiation of the mouse bone marrow mesenchymal stem cells (MSCs). These preliminary results indicate that the magnesium calcium phosphate/sodium alginate composite cements could be promising as potential bone repair candidate materials.


The aggravation of mitochondrial dysfunction in nonalcoholic fatty liver disease accompanied with type 2 diabetes mellitus.
Nonalcoholic fatty liver disease (NAFLD) is a mitochondrial disease associated with the metabolic syndrome, but few data are available on the mitochondrial dysfunction of NAFLD after the development of type 2 diabetes mellitus (T2DM). We aimed to identify the changes of mitochondrial function in rat livers when T2DM develops after NAFLD. Rat models of nonalcoholic fatty liver (NAFL) and T2DM were established using high-fat diet and streptozocin. Mitochondria were isolated from the livers. The levels of reactive oxygen species (ROS) and mRNA and protein levels of mitochondrial complex IV (COX IV) and carnitine palmitoyltransferase-1 (CPT-1) were assessed in rat livers. The mitochondrial membrane potential (MP), and the enzyme activities of COX IV and CPT-1 were measured in isolated mitochondria. There were increased ROS, decreased mitochondrial MP, and reduced COX IV and CPT-1 activity in the NAFL and T2DM groups compared with controls (p < 0.05). Compared with NAFL, the T2DM group had higher ROS levels and lower enzyme activity (p < 0.05), but showed no difference in mitochondrial MP. Although COX IV and CPT-1 expression levels in liver decreased in NAFL and T2DM, there was no significant difference between two groups. This study first identified progressively impaired mitochondrial respiratory chain and β-oxidation in NAFLD when T2DM develops, inducing overproduction of ROS, and finally triggering a vicious circle that leads to the aggravation of mitochondrial dysfunction in NAFLD after development of T2DM.


Bridge clinic buprenorphine program decreases emergency department visits.
Opioid withdrawal due to opioid use disorder (OUD) is an increasing health emergency and complaint in emergency departments (EDs) across the United States. As a response to the increased need for OUD treatment, a low threshold buprenorphine program, or Bridge Clinic, was established within our hospital system. Patients are primarily connected to the Bridge Clinic through the ED, and are able to complete their consultation appointment reliably within 1-3 days of referral. This program also serves to connect patients to community resources for continued treatment of OUD. A retrospective chart review was performed to identify ED-based referrals to the Bridge Clinic in the period from January 1, 2017 - December 31, 2018. Outcomes of interest included: (1) ED utilization in the six months before and after consultation at the Bridge Clinic and (2) adherence to buprenorphine therapy at 2-year follow-up. A total of 269 patients were included in the study, with 167 males (62%) and a mean age of 37.8 years. There were 654 total visits to the ED six months before referral to the Bridge Clinic and 381 visits in the six-month period after the initial appointment. There was a high adherence to buprenorphine treatment at 2 year follow up (56%). These early results suggest that prompt referral to a buprenorphine treatment program significantly reduces ED utilization and connects patients to community resources for continued buprenorphine treatment for OUD.


Lower limb entheseal morphology in the Neandertal Krapina population (Croatia, 130,000 BP).
Although the Neandertal locomotor system has been shown to differ from Homo sapiens, characteristics of Neandertal entheses, the skeletal attachments for muscles, tendons, ligaments and joint capsules, have never been specifically investigated. Here, we analyse lower limb entheses of the Krapina Neandertal bones (Croatia, 130,000 BP) with the aim of determining how they compare with modern humans, using a standard developed by our research group for describing modern human entheseal variability. The entheses examined are those of the gluteus maximus, iliopsoas and vastus medialis on the femur, the quadriceps tendon on the patella, and soleus on the tibia. For the entheses showing a different morphological pattern from H. sapiens, we discuss the possibility of recognising genetic versus environmental causes. Our results indicate that only the gluteus maximus enthesis (the gluteal tuberosity), falls out of the modern human range of variation. It displays morphological features that could imply histological differences from modern humans, in particular the presence of fibrocartilage. In both H. sapiens and the Krapina Neandertals, the morphological pattern of this enthesis is the same in adult and immature femurs. These results can be interpreted in light of genetic differences between the two hominins. The possibility of functional adaptations to higher levels of mechanical load during life in the Neandertals seems less likely. The particular morphology and large dimensions of the Krapina enthesis, and perhaps its fibrocartilaginous nature, could have been selected for in association with other pelvic and lower limb characteristics, even if genetic drift cannot be ruled out.


A physiologically based pharmacokinetic model for voriconazole disposition predicts intestinal first-pass metabolism in children.
The effect of ontogeny in drug-metabolizing enzymes on pediatric pharmacokinetics is poorly predicted. Voriconazole, a potent antifungal, is cleared predominantly via oxidative metabolism and exhibits vastly different pharmacokinetics between adults and children. A physiologically based pharmacokinetic (PBPK) model was developed integrating hepatic in vitro metabolism data with physiologic parameters to predict pharmacokinetic parameters of voriconazole in adult and pediatric populations. Adult and pediatric PBPK models integrated voriconazole physicochemical properties with hepatic in vitro data into the models. Simulated populations contained 100 patients (10 trials with 10 patients each). Trial design and dosing was based on published clinical trials. Simulations yielded pharmacokinetic parameters that were compared against published values and visual predictive checks were employed to validate models. All adult models and the pediatric intravenous model predicted pharmacokinetic parameters that corresponded with observed values within a 20% prediction error, whereas the pediatric oral model predicted an oral bioavailability twofold higher than observed ranges. After incorporating intestinal first-pass metabolism into the model, the prediction of oral bioavailability improved substantially, suggesting that voriconazole is subject to intestinal first-pass metabolism in children, but not in adults. The PBPK approach used in this study suggests a mechanistic reason for differences in bioavailability between adults and children. If verified, this would be the first example of differential first-pass metabolism in children and adults.


Eye-open at birth phenotype with reduced keratinocyte motility in LGR4 null mice.
We observed a consistent eye-open at birth (EOB) phenotype in mouse pups homozygous for a leucine-rich repeat containing G-protein coupled receptor 4 (Lgr4) allele deleting the whole transmembrane domain coding region. An in vitro wound-healing scratch assay showed notably reduced keratinocyte motility in the null mice. Phalloidin staining of F-actin in the eyelid epidermis was also reduced. We also generated keratinocyte-specific Lgr4 deficient mice, circumventing the embryonic/neonatal lethality and kidney abnormalities. Most of the conditional Lgr4 knockout mice showed the EOB phenotype. Thus, Lgr4 might be a novel gene class regulating cell motility.


Vocal-cord Only vs. Complete Laryngeal radiation (VOCAL): a randomized multicentric Bayesian phase II trial.
Radiotherapy, along with laser surgery, is considered a standard treatment option for patients with early glottic squamous cell cancer (SCC). Historically, patients have received complete larynx radiotherapy (CL-RT) due to fear of swallowing and respiratory laryngeal motion and this remains the standard approach in many academic institutions. Local control (LC) rates with CL-RT have been excellent, however this treatment can carry significant toxicities include adverse voice and swallowing outcomes, along with increased long-term risk of cerebrovascular morbidity. A recent retrospective study reported improved voice quality and similar local control outcomes with focused vocal cord radiotherapy (VC-RT) compared to CL-RT. There is currently no prospective evidence on the safety of VC-RT. The primary objective of this Bayesian Phase II trial is to compare the LC of VC-RT to that of CL-RT in patients with T1N0 glottic SCC. One hundred and fifty-five patients with T1a-b N0 SCC of the true vocal cords that are n ot candidate or declined laser surgery, will be randomized in a 1:3 ratio the control arm (CL-RT) and the experimental arm (VC-RT). Randomisation will be stratified by tumor stage (T1a/T1b) and by site (each site will be allowed to select one preferred radiation dose regimen, to be used in both arms). CL-RT volumes will correspond to the conventional RT volumes, with the planning target volume extending from the top of thyroid cartilage lamina superiorly to the bottom of the cricoid inferiorly. VC-RT volumes will include the involved vocal cord(s) and a margin accounting for respiration and set-up uncertainty. The primary endpoint will be LC at 2-years, while secondary endpoints will include patient-reported outcomes (voice impairment, dysphagia and symptom burden), acute and late toxicity radiation-induced toxicity, overall survival, progression free survival, as well as an optional component of acoustic and objective measures of voice analysis using the Consensus Auditory-Perceptual Evaluation of Voice. This study would constitute the first prospective evidence on the efficacy and safety of VC-RT in early glottic cancer. If positive, this study would result in the adoption of VC-RT as standard approach in early glottic cancer. ClinicalTrials.gov Identifier: NCT03759431 Registration date: November 30, 2018.


Flow cytometric detection of wild yeast in lager breweries.
A flow cytometric method for detection of wild yeast infections in breweries is reported. It is based on selective enrichment in Malt extract Yeast extract Glucose Peptone broth (MYGP) at 37 degrees C and in MYGP with 200 ppm CuSO4 at 25 degrees C, staining with a fluorochrome precursor and flow cytometry. In experiments with several types of wild yeast isolated from breweries and two different strains of lager yeast it has been possible to detect one wild yeast per 10(6) culture yeast after 48-72 h of incubation and, in some cases, after 24 h.


Synthesis of 5 beta,17 alpha-19-norpregn-20-yne-3 beta,17-diol and of 5 beta,17 alpha-19-norpregn-20-yne-3 alpha,17-diol, human metabolites of norethindrone.
A convenient synthesis of both 5 beta,17 alpha-19-norpregn-20-yne-3 beta,17-diol (1) and 5 beta,17 alpha-19-norpregn-20-yne-3 alpha,17-diol (2) in multigram quantities from estr-4-ene-3,17-dione is reported. Full characterization of these often-cited human metabolites of norethindrone is presented for the first time.


[Radiation exposure in the surrounding of patients after 201Tl myocardial scintigraphy].
It was the aim of the study to assess the additional radiation exposure to patients, attendants and nurses by patients who are undergoing nuclear medicine investigations (myocardial scintigraphy) with 201TL-chloride (201TL-CL). In 16 cases the dose rates at 0.5 1 and 2 m distance from patients were measured at 0.5, 1.5, 3-4 and 24, in some cases until 370 h after administration of 100 +/- 10 MBq 201TL-CL. From the time courses of the dose rates around the patients the possible radiation exposure of other persons were estimated. The initial values of the dose rate were 3.82 microSv/h at 0.5 m, 1.18 microSv/h at 1 m and 0.30 microSv/h at 2 m distance from the patients respectively. The dose rates were decreasing following a monoexponential course with an effective half-life of 60 h. The maximum doses to other persons at 1 m distance from the patients were determined by considering three scenarios. The values were 13 microSv in the waiting room, 26 microSv for nurses, working in the ward and 105 microSv for persons living in the same house hold Even at very restrictive assumptions the closes were far below the maximum permissible dose to non-radiation workers see by radiation protection regulations (1.5 mSv per year).


Performance of functionality measures and phase angle in women exposed to chemotherapy for early breast cancer.
The study aimed to analyze the influence of chemotherapy on nutritional status and the phase angle (PhA) as nutritional indicator for breast cancer women undergoing chemotherapy. A prospective study was performed. Women who were starting chemotherapy with no previous chemotherapy treatment were recruited. Quality of life (QoL) was collected using the EORTC QLQ-BR23 questionnaire. Bioelectrical impedance analysis, performance tests, and blood sample to albumin analyzes were collected at 2-time points: diagnosis (T0) and after 1 month of completion of therapy (T1). Mean, standard deviation, linear regression, and ANOVA in R were used to explore the results. 61 women were included. We did not find any changes in body composition. However, PhA, nutritional risk index (NRI), gait speed (GS), and handgrip strength (HGS) had expressive changes (p < 0.001). 75.4% of women had PhA values below the cut-off point of 5.6°, and the group that had a lower average of PhA also expressed low NRI. PhA was a nutritional status marker and its values were influenced by changes in NRI (p < 0.05). We have found supporting evidence for chemotherapy treatment resulting in worsening of prognostic factors such as PhA, and yet PhA was related to no nutritional risk. Besides a higher prevalence of obesity, 80% of the sample showed some nutritional risk level, implying the possibility of a sub-notification candidate who might benefit, for instance, from nutritional intervention in obesity groups. Further investigation about this theme may improve health measures for the prevention and screening of disease among breast cancer.


Equivalent outcomes using reduced intensity or conventional myeloablative conditioning transplantation for patients aged 35 years and over with AML.
Allogeneic hematopoietic stem cell transplantation provides the best chance of long-term survival for patients with AML, but is associated with an unpredictable risk of treatment-related mortality. From January 2000 to December 2010, we compared the outcomes for patients with AML aged 35 and over using reduced-intensity conditioning (RIC, N=60) or conventional myeloablative conditioning (MAC) regimen (N=72) transplantation. The median follow-up was 47 months (10-134). The 4-year cumulative incidence of non-relapse mortality was 21%. After adjusting for cytogenetic risk, gender donor/recipient mismatch and CD34+ cells, non-relapse mortality was significantly lower with the RIC regimen (P=0.027). The 4-year cumulative incidence of relapse was 38% and no difference was observed in the adjusted relapse rate between the two groups. The 4-year OS rate was 46%. Using both Cox regression and inverse probability-of-treatment weighted (IPTW) method, a similar OS rate was found with both regimens (adjusted hazard ratios for conventional vs reduced of 1.14 (95% CI 0.67-1.93, P=0.64) with Cox regression, and 1.14 (95% CI 0.55-2.34, P=0.73) with IPTW). Until prospective trials are completed, this study supports the use of a reduced-intensity regimen prior to transplantation for patients with AML aged 35 and over.


Chromatographic profiles at E-280 nm for urinary precipitates in morbus Rett.
Previously we have observed different characteristic chromatographic ultraviolet absorbancy profiles at 280 nm for urinary protein precipitates from patients with behavioral disorders. The purpose with this study was to look for similar changes in urinary protein excretion from the grossly disabled patients with the Rett syndrome. Benzoic acid precipitates from the urine from 20 patients were chromatographed on a Sephadex G-25 gel column. There appeared 3 different profiles: 6 as observed in normal controls, 5 like that in compulsive behavior, and 9 were similar to those observed for autistiform-schizophreniform patients. The profiles did not mirror the behavioral observations for the patients, although the first group of 6 patients were the least disabled, whereas the last 9 patients were the most seriously ill. In conclusion the chromatographic profiles suggest a heterogeneous group of patients, but we need more observations for several patients over time, as there may be a change with the exacerbation of the disease.


Generation of time-domain-multiplexed two-dimensional cluster state.
Entanglement is the key resource for measurement-based quantum computing. It is stored in quantum states known as cluster states, which are prepared offline and enable quantum computing by means of purely local measurements. Universal quantum computing requires cluster states that are both large and possess (at least) a two-dimensional topology. Continuous-variable cluster states-based on bosonic modes rather than qubits-have previously been generated on a scale exceeding one million modes, but only in one dimension. Here, we report generation of a large-scale two-dimensional continuous-variable cluster state. Its structure consists of a 5- by 1240-site square lattice that was tailored to our highly scalable time-multiplexed experimental platform. It is compatible with Bosonic error-correcting codes that, with higher squeezing, enable fault-tolerant quantum computation.


Childhood neurodevelopment after spontaneous versus indicated preterm birth.
Preterm birth is the leading cause of neonatal morbidity and mortality. Individuals who survive preterm birth are at a higher risk for many long-term adverse effects, including neurodevelopmental deficits. There are many well-established risk factors for worse neurologic outcomes spanning the prenatal and postnatal periods; however, investigators have yet to assess whether the cause of preterm birth has an impact on neurodevelopment. Our objective was to assess whether neurologic outcomes differ by children born via indicated versus spontaneous preterm birth. We performed secondary analysis of a multicenter trial assessing magnesium for neuroprotection in women at risk for preterm delivery from 24 to 31 weeks. We included women with live, nonanomalous, singleton gestations who delivered preterm; we excluded women whose children were missing 2-year follow-up information for reasons other than perinatal demise. The primary exposure was type of preterm birth: (1) spontaneous if the child's mother presented with preterm labor or ruptured membranes, or (2) indicated if the child was delivered preterm iatrogenically. The primary outcome was death (including stillbirths, neonatal intensive care unit deaths, and deaths after discharge) or an abnormal Bayley II score by 2 years of age, defined as a Mental Developmental Index score or Psychomotor Developmental Index score 2 standard deviations below the mean. Secondary outcomes included death or Mental Developmental Index and Psychomotor Developmental Index scores 1 standard deviation or less, and neonatal morbidities associated with prematurity. Bivariate analyses of baseline characteristics by exposure were conducted. A logistic regression model was fitted to adjust for confounders. Of 1678 subjects, 1631 (97.2%) underwent spontaneous preterm birth and 47 (2.8%) underwent indicated preterm birth. Baseline maternal demographics and gestational age at delivery were similar between groups (29.6 weeks ± 7.8 versus 28.8 weeks ± 2.5, P = .07). A Psychomotor Developmental Index score 2 standard deviations or less below the mean or death occurred in 340 (20.9%) spontaneous preterm birth subjects and 17 (36.2%) indicated preterm birth subjects (P = .01). When adjusting for confounders, there remained an increased probability of a Psychomotor Developmental Index scores 2 standard deviations or less or death in indicated preterm birth subjects (P = .02). Although not statistically significant, indicated preterm birth was also associated with higher odds of Mental Developmental Index scores 2 standard deviations or less or death, Psychomotor Developmental scores 1 standard deviation or less or death, and Mental Developmental Index scores 1 standard deviation or less or death (1.76, 1.59, and 1.45, respectively). Limiting the analysis to small for gestational age infants, there was no difference in neurologic outcomes. The same was true for when we excluded small for gestational age infants from our analysis. However, after adjusting for small for gestational age, the odds of a Psychomotor Developmental Index score 2 standard deviations or less or death remained significant higher in the indicated preterm birth group (adjusted odds ratio, 1.98; 95% confidence interval, 1.01-3.88). In this cohort of pregnant women who delivered preterm, indicated deliveries were associated with worse psychomotor development than were spontaneous deliveries. Other outcomes appeared to be poor, but our numbers were limited. This finding should be confirmed in a larger cohort of women undergoing medically indicated preterm deliveries.


Heavy metal carbohydrate complexes for demonstration of lectin surface receptors. The preparation of a galactan-iron complex.
The preparation of a galactan-iron complex is described. The galactan iron complex can be used for electron microscopic demonstration of membrane bound Ricinus communis lectin because the high reactivity of this lectin toward the galactan.


Iron stimulation of ferritin synthesis. II.-Involvement of polysomal kc1 extracts in the mechanism of stimulation.
The iron stimulation of ferritin synthesis is a translational phenomenon. Iron acts through a modification of the microsomal apparatus as shown previously. In the present study we have shown that the factor(s) involved in this stimulation are present in the KC1 extracts from polysomes of iron-treated rats.


Associations of testosterone and cortisol concentrations with sleep quality in Japanese male workers.
Low testosterone concentrations are associated with disrupted sleep, and high levels of cortisol, which is elevated in response to stress, lead to insomnia. This study aimed to investigate the associations of testosterone and cortisol concentrations with sleep quality and to examine potential interactions between them in Japanese working men. This study was a cross-sectional design, and testosterone and cortisol concentrations in blood were the exposure variables and sleep parameters were the outcome variables. The Japanese version of the Pittsburgh Sleep Quality Index was used to measure sleep quality, and it included the total duration of sleep, time in bed (TIB), and sleep efficacy. We included 178 men (mean age = 49.1 years, standard deviation = 9.0) who completed all components in the questionnaire related to sleep and provided blood samples. Testosterone and cortisol concentrations were negatively associated with TIB (standardized beta = -0.15 and -0.24, p < 0.05, respectively), while only testosterone concentrations were positively associated with sleep efficacy (standardized beta = 0.15, p < 0.05). An interaction effect of testosterone and cortisol was significant for TIB and sleep efficacy (standardized beta for interaction term = 0.40, p < 0.001 and -0.22, p = 0.012, respectively). When stratified by cortisol concentrations, the associations between testosterone concentrations and sleep parameters were modified. Our findings suggest that associations between testosterone concentrations and sleep parameters are stronger at low cortisol concentrations, but not at high cortisol concentrations. High cortisol concentrations may diminish associations between low testosterone concentrations and diminished sleep efficacy.


Influence of income on diet quality and daily iron and zinc intake: analysis of the National Diet and Nutrition Survey of British females aged 11-14 and 15-18 years.
A negative socio-economic gradient exists for diet and health outcomes. Since cheaper diets are associated with increased energy and lower nutrient density, we investigated the influence of income on iron and zinc intakes and overall diet quality for adolescent (DQI-A) females aged 11-18 years. National Diet and Nutrition Survey (NDNS years 7 and 8) data for iron and zinc intake and overall diet quality was assessed by household income quintile across females aged 11-18 years. Equivalised household income positively correlated with Diet quality index for adolescents (DQI-A) (P < 0.001) Females aged 15-18 years in income quintiles (IQs) I and 2, had a greater proportion of respondents with low to intermediate DQI-A score compared to higher IQs (P = 0.002). NDNS data showed intake was negatively influenced by income amongst females aged 11-14 years for iron (P = 0.009) and zinc (P = 0.001) with those from the lowest incomes consistently consuming significantly less than those from the highest. DQI-A was positively correlated with iron intakes for 11-14 (P = 0.001) and 15-18 years (P < 0.001). Forty-one percent of 15-18-year-olds plasma ferritin stores were below the 15 µg L-1 and 21% had some form of anaemia. Cereal and cereal products were the greatest contributors to iron in all groups. Females in the lowest income groups are at greater risk of lower overall diet quality and inadequate iron and zinc intakes. Amongst older adolescents, there is evidence of iron stores being depleted and an increased prevalence of anaemia.


Independent host switching events by digenean parasites of cetaceans inferred from ribosomal DNA.
Cetaceans harbour a unique fauna of digeneans whose origin and relationships have sparked considerable debate during recent decades. Disparity in the species reported indicates that they do not share close affinities, but their unusual morphology has made their taxonomic identities and phylogenetic positions uncertain. Here we use sequence data to investigate the phylogenetic relationships of the main species of flukes infecting cetaceans. We sequenced the 18S, 28S and internal transcribed spacer 2 rDNA of digenean species representing all known families reported from cetaceans: Braunina cordiformis (Brauninidae), Ogmogaster antarcticus (Notocotylidae), Pholeter gastrophilus (Heterophyidae), and Campula oblonga, Nasitrema sp. and Oschmarinella rochebruni (Brachycladiidae). The phylogenetic position of the taxa was estimated by Bayesian inference and maximum likelihood incorporating published sequences of 177 species of Digenea. Further Bayesian and maximum likelihood analyses were performed with sequences of 14 Heterophyidae and Opisthorchiidae taxa, incorporating new sequences of P. gastrophilus. Species nominally assigned to the Brachycladiidae formed a clade that was embedded among species of the Acanthocolpidae, thus making the latter family paraphyletic. Braunina cordiformis formed a sister lineage to the Strigeidae and Diplostomidae, whereas O. antarcticus was placed within the Notocotylidae, in agreement with the previous taxonomy of this genus. Similarly, P. gastrophilus was placed within the Heterophyidae as originally described. Our results suggest a paraphyletic relationship between the Heterophyidae and Opisthorchiidae, mirroring the uncertain taxonomic placement of P. gastrophilus, which has been assigned to both families in the past. The digenean families involved are parasites of fish-eating birds and mammals (i.e. Strigeidae, Diplostomidae and Heterophyidae), parasites of marine fish (i.e. Acanthocolpidae) and other herbivorous aquatic birds and mammals (i.e. Notocotylidae). The phylogenetic positions of these taxa indicate that the digenean fauna of cetaceans may have been acquired through independent host-capture events, with two clades showing subsequent diversification exclusively among marine mammals.


Prospective Inverse Probability of Treatment-Weighting Analysis of the Clinical Outcome of Red Blood Cell Transfusion Practice in Critically Ill Children.
To study the clinical outcomes of red blood cell (RBC) transfusion practices in critically ill children. This prospective cohort study was conducted in a tertiary care pediatric intensive care unit (PICU) from March-2015 to January-2018. Inverse probability of treatment weighting (IPTW) using propensity score analysis was used. Children aged 1 mo to 12 y admitted to the PICU were screened. Patients were classified into 'transfused' and 'nontransfused', based on whether they received a transfusion or not. Patients with hematological malignancies, or immunosuppressant drugs, or those who received repeated transfusions, or received transfusion before admission, or died within 24 h were excluded. The primary outcome was all-cause 28 d mortality. Secondary outcomes were new-onset organ dysfunction, mechanical ventilation duration, and length of PICU and hospital stay. A total of 1014 patients [transfused = 277; nontransfused = 737) were included. In IPTW analysis, the risk of all-cause 28 d mortality was 53% higher in transfused than nontransfused patients [hazard ratio = 1.53, 95% CI: 1.18-1.98, p = 0.001 by Log-rank test]. Organ dysfunction was higher in transfused than nontransfused patients [3.8% vs. 1.3%, hazard ratio = 3.0, 95% CI: 1.40-6.48, p = 0.005]. The risk of staying in the mechanical ventilation was similar in both groups [hazard ratio = 1.03, 95% CI: 0.86-1.23, p = 0.756]. The risk of extended stay in the PICU and hospital was 16% and 21% higher in transfused than nontransfused patients [hazard ratio = 1.16, 95% CI: 1.03-1.30; p = 0.005; and 1.21, 95% CI: 1.08-1.36; p = 0.001], respectively. Red blood cell transfusion was independently associated with higher all-cause 28 d mortality and morbidities in critically ill children.


Urinary nerve growth factor in patients with detrusor overactivity.
Detrusor overactivity (DO) is one of the most frequent bladder dysfunctions in children up to the age of 18. Nowadays, the only way to confirm DO is by urodynamic investigation, which is an invasive procedure. Among the many mediators influencing bladder function, nerve growth factor (NGF) plays an important role. The present study was designed to measure urinary NGF (uNGF) levels in patients with DO diagnosed by urodynamic study in comparison with healthy controls. The investigation was conducted on 44 children, divided into two groups (24 patients with DO, 20 healthy children). Uroflowmetry was performed in all enrolled to the study and cystometry only to patients. uNGF levels were estimated in both studied groups. The median uNGF level in patients with DO before treatment was higher compared with healthy controls. There were no differences between uNGF levels in patients after anticholinergic treatment and the controls. We found differences in uroflowmetry parameters between the reference group and the patients. We found correlations between uroflowmetry parameters and uNGF/cr. level. 1. The uNGF level could be used for detecting DO in children and adolescents. 2. Measuring uNGF level is a simple, noninvasive procedure and very useful for choosing therapy in patients with DO in various clinical conditions.


[Bariatric surgery in extremely obese children and adolescents].
The management of childhood obesity is a clinical dilemma. Validated and evidence-based intervention programs are still missing for this age group, and pediatricians increasingly see children with morbid obesity and with obesity-related comorbidities. For those extremely obese patients who failed to respond to the classical therapeutic approaches, bariatric surgery is a therapeutic option. Although available data for bariatric surgery in childhood and adolescence is limited to date, significant postoperative reduction in BMI and an evident improvement of preoperatively existing metabolic and cardiovascular comorbidities and psychosocial well-being have been reported. The indication for bariatric surgery in adolescents follows strict criteria and should be proposed within an interdisciplinary team in specialized centers, including a clinical ethics committee. This review discusses the present guidelines for bariatric surgery in childhood and adolescence as well as available follow-up data for both adults and pediatric patients.


Development of preschool-aged children of different social and ethnic groups: implications for developmental screening.
The developmental status of 1,180 children representing a cross section of Denver's ethnic and parental occupational groups was compared with that of 1,055 children (349 Anglo, 354 Spanish surname, and 352 Black) whose parents were unskilled workers. The children varied in age from 2 weeks to 6.4 years and were evaluated with the Denver developmental screening test. Comparisons were made in developmental achievements as reflected by individual item differences for Anglo children from unskilled families with Anglos from cross-sectional families. A second comparison of Anglo, Spanish, and Black children of the unskilled sample was also made. The first analysis comparing 910 Anglo children from the cross-sectional sample with 349 Anglo children from the unskilled families demonstrated significant differences (p smaller than 0.05) for 39 of the 105 items. Below 20 months of age, children of the unskilled sample were more advanced, whereas after 20 months of age, the children of the cross-sectional sample were advanced in all test sectors except for items in the personal-social sector. Comparisons of Anglo, Black, and Spanish surname children from the unskilled families showed fewer differences in rates of development.


(5-Hy-droxy-3-methyl-5-phenyl-4,5-dihydro-1H-pyrazol-1-yl)(pyridin-4-yl)methanone monohydrate.
In the title compound, C(16)H(15)N(3)O(2)·H(2)O, the mean plane of the approximately planar pyrazole ring [maximum deviation = 0.0474 (18) Å] makes dihedral angles of 86.32 (11) and 45.04 (10)° with the phenyl and pyridine rings, respectively. The dihedral angle between the phenyl and pyridine rings is 69.62 (11)°. In the crystal, inter-molecular O-H⋯O and O-H⋯N hydrogen bonds connect the components into chains along [010]. The crystal structure is further stabilized by π-π stacking inter-actions with centroid-centroid distances of 3.7730 (12) Å.


[3H]methylcarbamylcholine, a new radioligand for studying brain nicotinic receptors.
A new radioligand, [3H]methylcarbamylcholine, has been developed for the study of the nicotinic cholinergic and nicotine-like binding sites in rat brain membranes. A Scatchard analysis with the radioligand yielded a Kd of 1.1 X 10(-9) M and a Bmax of 4.0 X 10(-14) moles/mg protein which compares with a lower affinity site for (-)-[3H]nicotine having a Kd of 3 X 10(-9) M and a Bmax of 2 X 10(-14) moles/mg. Comparable values for the Kd were obtained from a Hill plot and from calculations based on rate constants for association and dissociation. A comparison of the binding affinities of various nicotine analogues, nicotinic cholinergic agents, and other neurotropic agents revealed a close similarity between the two radioligands, with the exception that quaternization of nicotine or carbamate esters increased affinity by at least an order of magnitude with [3H]methylcarbamylcholine and resulted in a comparable decrease in affinity with [3H]nicotine as the ligand. The binding of [3H]methylcarbamylcholine, like [3H]nicotine, was not displaceable by muscarinic cholinergic antagonists. It was concluded that, although [3H]methylcarbamylcholine and [3H]nicotine bind to a common receptor in brain, the functional and chemical characteristics of the receptor(s) differ in some respects from peripheral nicotinic cholinergic receptors.


SUBRETINAL FLUID ASSOCIATED WITH DRUSENOID PIGMENT EPITHELIAL DETACHMENT.
To analyze the clinical characteristics of drusenoid pigment epithelial detachment (PED) with subretinal fluid (SRF) and to evaluate the impact of SRF on the long-term visual and anatomical outcomes. Forty-seven eyes with drusenoid PED (47 patients) who completed >24 months of follow-up were retrospectively analyzed. Intergroup comparisons of the visual and anatomical outcomes with and without SRF were made. The mean duration of follow-up was 32.9 ± 18.7 months. The group with drusenoid PED with SRF (14 eyes) showed significantly higher PED height (468 ± 130 µ m vs. 313 ± 88 µ m, P < 0.001), larger PED diameter (2,328 ± 953 µ m vs. 1,227 ± 882 µ m, P < 0.001), and larger PED volume (1.88 ± 1.73 mm 3 vs. 1.12 ± 1.35 mm 3 , P = 0.021) than that in the group with drusenoid PED without SRF (33 eyes) at baseline. No significant intergroup difference was found regarding the best-corrected visual acuity at the final visit. In addition, the incidence of complete retinal pigment epithelial and outer retinal atrophy (cRORA; 21.4%) and the development of macular neovascularization (MNV; 7.1%) for the group with drusenoid PED with SRF showed no difference compared with those (39.4% for cRORA development and 9.1% for MNV development) with drusenoid PED without SRF. The size, height, and volume of drusenoid PED were associated with the development of SRF. The SRF in drusenoid PED did not affect the visual prognosis or the development of macular atrophy during long-term follow-up.


Posterior uveal melanoma incidence and survival by AJCC tumour size in a 70-year nationwide cohort.
While early treatment of posterior uveal melanoma can save the eye, the effect of early treatment on survival remains unknown. Therefore, we aimed to determine whether the tumour size at diagnosis has changed over time, and if this has affected survival rates of patients with posterior uveal melanoma in Denmark. Nationwide retrospective cohort study linking data from registry-based resources to data from clinical charts and pathology records. Including all Danish patients diagnosed with posterior uveal melanoma from 1943 to 2017. Incidence rates were estimated as annual percentage change (APC) overall and by American Joint Committee on Cancer (AJCC) tumour sizes. The age-period-cohort model was applied to estimate the relative risk of calendar period. The cox proportional hazards model, relative survival Kaplan-Meier curves and cumulative incidence curves were applied to estimate the effect of calendar period on survival. An overall increase in incidence rate of uveal melanoma was found (APC = 0.25%, 0.08-0.42; 95% CI). This was due to increasing incidence rate of AJCC T1 + T2 tumours (APC = 0.97%, 0.57-1.37; 95% CI), whereas no increase in incidence rates of AJCC T3 + T4 tumours was found (APC = -0.01%, -0.26 to 0.25; 95% CI). The disease-specific survival improved with calendar period for all tumour sizes (HR = 0.988; 0.984-0.993; 95% CI). Increasing incidence rate and improved survival rate for uveal melanoma was found concordantly with a decrease in tumour size during a 70-year period.


[Effect of endogenous factors on ash concentration and contents of calcium, magnesium, potassium, sodium, phosphorus, zinc, iron, copper and manganese in the bristles of pigs. 5. Mineral composition of pig bristels influenced by pregnancy and lactation].
77 sows were used in a trial bristles were taken from these animals (a) on the 84th day of pregnancy, (b) on the day of gestation and (c) on the 42nd day of lactation. The average ash content of the bristles was 1.23%. It was not found to be influenced by gestation. Before gestation the Ca content of the bristles rose significantly while the Na and K content decreased (P less than 0.05). The Mg, P and Cu content of the bristles increased during lactation whereas the F content fell significantly. The concentrations of all other elements did not change significantly in the phase of pregnancy and during lactation.


Neutralizing antibody responses following natural SARS-CoV-2 infection: Dynamics and correlation with commercial serologic tests.
The prediction of SARS-CoV-2 immunity by commercially available serologic tests will be crucial to assess the efficacy of vaccination. We used plaque reduction neutralization testing as the reference standard to evaluate the diagnostic performance of six commercial serologic tests for monitoring SARS-CoV-2 neutralizing antibodies. Euroimmun ELISA anti-spike 1 IgG, Euroimmun anti-spike 1 IgG QuantiVac ELISA, Elecsys Anti-nucleocapsid protein total antibodies, Elecsys Anti-receptor-binding domain total antibodies, VIDAS anti-spike subdomain IgG, and Microblot-Array COVID-19 IgG assay were performed on 228 sera from 89 healthcare workers who participated in a six-month seroprevalence survey. Although all immunoassays demonstrated similar performances, VIDAS SARS-CoV-2 IgG and Euroimmun QuantiVac IgG (area under the curve 0.96 and 0.95 respectively) showed the better ability to detect Nabs. Except for the Elecsys Anti-SARS-CoV-2 and the Elecsys Anti-SARS-CoV-2 S assays, the commercial serologic tests evaluated here showed a significant decrease of antibody titers in the 6-month follow-up samples. Depending on the immunoassay, 21% to 33% of the participants became seronegative, and 16.9% had a loss of neutralizing antibodies. Microblot-Array assay results showed cross-reactivity with HCoVNL63 in only one sample, and this sample showed SARS-CoV-2 neutralizing capacity. In conclusion, our results support the use of VIDAS SARS-CoV-2 IgG, Euroimmun Anti-SARS-CoV-2 ELISA IgG, Euroimmun Anti-SARS-CoV-2 QuantiVac ELISA IgG and Microblot-Array COVID-19 IgG assays to monitor neutralizing antibody response following natural SARS-CoV-2 infection. These immunoassays could facilitate the prediction of post-vaccine protection in the long term and the allocation of booster doses.


Hospitals and school districts: creating a partnership for child protection services.
This article reports the initiation of a joint hospital-school district child protection committee in an urban setting of socio-economic blight. The committee provided a structure for consultation about troubling, complex situations of school children at high risk for physical and sexual abuse and medical neglect.


An Open Access Standardised Voice Evaluation Protocol.
A comprehensive protocol to evaluate voice quality can support a full characterisation of voice disorders and be used to plan voice interventions. The purpose of this study was to develop and validate a standardised protocol for voice assessment, contributing with a comprehensive and valuable tool for clinician practice and research. The initial structure and content of the protocol was based on an extensive literature review of existing voice assessment tools. The content validity was then assessed by a panel of voice specialist, using a modified Bland and Altman graphical method and the intraclass correlation coefficient (ICC). A group of participants with vocal pathology was finally assessed by two voice specialists on the same day (inter-rater reliability), and, on a second day, by a single evaluator (intra-rater reliability). Inter and intra-reliability were evaluated through Cohen's kappa (k) for nominal variables, and Spearman's Correlation Coefficient (ρ) for quantitative and ordinal variables. The Bland and Altman analysis, revealed a reasonable agreement between the experts and the ICC values were lower than expected, but the confidence intervals were very wide. The intra-rater reliability of the protocol's nominal variables was almost perfect, with a mean k of 0.977; inter-rater reliability of nominal variables was also almost perfect, with a mean k of 0.893. The ordinal and quantitative variables revealed a very good to excellent relationship, with a mean ρ of 0.912. Evidence of content validity, high intra and inter-rater reliability of a standardised protocol for voice assessment, have been shown. This protocol can be used to assess and collect data from patients, to train voice specialists and to develop reference voice databases. It has been designed to serve voice experts with diverse backgrounds and assessment needs.


Specialized sugar sensing in diverse fungi.
S. cerevisiae senses glucose and galactose differently. Glucose is detected through sensors that reside in the cellular plasma membrane. When activated, the sensors initiate a signal-transduction cascade that ultimately inactivates the Rgt1 transcriptional repressor by causing degradation of its corepressors Mth1 and Std1. This results in the expression of many HXT genes encoding glucose transporters. The ensuing flood of glucose into the cell activates Mig1, a transcriptional repressor that mediates "glucose repression" of many genes, including the GAL genes; hence, glucose sensing hinders galactose utilization. Galactose is sensed in the cytoplasm via Gal3. Upon binding galactose (and ATP), Gal3 sequesters the Gal80 protein, thereby emancipating the Gal4 transcriptional activator of the GAL genes. Gal4 also activates expression of MTH1, encoding a corepressor critical for Rgt1 function. Thus, galactose inhibits glucose assimilation by encouraging repression of HXT genes. C. albicans senses glucose similarly to S. cerevisiae but does not sense galactose through Gal3-Gal80-Gal4. Its genome harbors no GAL80 ortholog, and the severely truncated CaGal4 does not regulate CaGAL genes. We present evidence that C. albicans senses galactose with its Hgt4 glucose sensor, a capability that is enabled by transcriptional "rewiring" of its sugar-sensing signal-transduction pathways. We suggest that galactose sensing through Hgt4 is ancestral in fungi.


Controlling residual hydrogen gas in mass spectra during pulsed laser atom probe tomography.
Residual hydrogen (H2) gas in the analysis chamber of an atom probe instrument limits the ability to measure H concentration in metals and alloys. Measuring H concentration would permit quantification of important physical phenomena, such as hydrogen embrittlement, corrosion, hydrogen trapping, and grain boundary segregation. Increased insight into the behavior of residual H2 gas on the specimen tip surface in atom probe instruments could help reduce these limitations. The influence of user-selected experimental parameters on the field adsorption and desorption of residual H2 gas on nominally pure copper (Cu) was studied during ultraviolet pulsed laser atom probe tomography. The results indicate that the total residual hydrogen concentration, HTOT, in the mass spectra exhibits a generally decreasing trend with increasing laser pulse energy and increasing laser pulse frequency. Second-order interaction effects are also important. The pulse energy has the greatest influence on the quantity HTOT, which is consistently less than 0.1 at.% at a value of 80 pJ.


Cold-sensitive growth of a mutant of Escherichia coli with an altered ribosomal protein S8: analysis of revertants.
26 cold-resistant revertants of a cold-sensitive Escherichia coli mutant with an altered ribosomal protein S8 were analyzed for their ribosomal protein pattern by two-dimensional polyacrylamide gel electrophoresis. It was found that 16 of them had acquired the apparent wild-type form of protein S8, one exhibits a more strongly altered SC than the original mutant and two revertants regained the wildtype form of S8 and, in addition, possess alterations in protein L30. The ribosomes of the residual revertants showed no detectable difference from those of the parental S8 mutant. The mutation leading to the more strongly altered S8 was genetically not separable from the primary S8 mutation; this indicates that both mutations are very close to each other or at the same site. The structural gene for ribosomal protein L30 was mapped relative to two other ribosomal protein genes (for proteins S5 and S8) by the aid of one of the L30 mutants: The relative order obtained is: aroE....rpmD(L30)....rpsE(S5)....rpsH(S8)....rpsL(S12). The L30 mutation impairs growth and ribosomal assembly at 20 degrees C and is therefore the first example of a mutant with defined 50S alteration that has (partial) cold-sensitive ribosome assembly. A double mutant was constructed which possesses both the S8 and the L30 mutations. It was found that the L30 mutation had a slight antagonistic effect on the growth inhibition caused by the S8 mutation. Thus the L30 mutants might have possibly arisen from the original S8 mutant first as S8/L30 double mutants which was followed by the loss of the original S8 lesion.


DNA binding alters coactivator interaction surfaces of the intact VDR-RXR complex.
The vitamin D receptor (VDR) functions as an obligate heterodimer in complex with the retinoid X receptor (RXR). These nuclear receptors are multidomain proteins, and it is unclear how various domains interact with one another within the nuclear receptor heterodimer. Here, we show that binding of intact heterodimer to DNA alters the receptor dynamics in regions remote from the DNA-binding domains (DBDs), including the coactivator binding surfaces of both co-receptors, and that the sequence of the DNA response element can determine these dynamics. Furthermore, agonist binding to the heterodimer results in changes in the stability of the VDR DBD, indicating that the ligand itself may play a role in DNA recognition. These data suggest a mechanism by which nuclear receptors show promoter specificity and have differential effects on various target genes, providing insight into the function of selective nuclear receptor modulators.


Sustained response of adenocarcinoma of the urinary bladder to FOLFOX plus bevacizumab.
A 44-year-old patient presented with intermittent macroscopic hematuria on a background of chronic left-sided hydronephrosis and intestinal metaplasia of the bladder. Cystoscopic examination revealed a mass at the dome of the urinary bladder, which was resected. Histopathologic analysis of the specimen confirmed the presence of muscle-invasive adenocarcinoma. Radical cystectomy with curative intent was planned, but review of systems and subsequent CT demonstrated pleural effusion with positive cytology, confirming metastatic disease. Owing to the histologic similarity between this patient's tumor and colorectal cancer, palliative FOLFOX6 (folinic acid, 5-fluorouracil and oxaliplatin) chemotherapy plus bevacizumab was administered. After 3 months of treatment the patient showed a good response, which was sustained for more than 10 months after diagnosis. However, his disease subsequently relapsed, and the patient died shortly thereafter. Physical examination, cystoscopy, transurethral resection of bladder tissue, CT, histopathologic, cytopathologic and immunohistochemical analysis. Metastatic adenocarcinoma of the urinary bladder. 12 cycles of infused and bolus 5-fluorouracil, folinic acid and oxaliplatin (FOLFOX6) plus bevacizumab.