Ultrasound for pelvic pain II: nongynecologic causes.
Acute pelvic pain in women is a common presenting complaint that can result from various conditions. Because these conditions can be of gynecologic or nongynecologic origin, they may pose a challenge to the diagnostic acumen of physicians, including radiologists. A thorough workup should include clinical history, physical examination, laboratory data, and appropriate imaging studies, all of which should be available to the radiologist for evaluation. Ultrasound is the primary imaging modality in women with acute pelvic pain because of its high sensitivity, low cost, wide availability, and lack of ionizing radiation, particularly when a gynecologic disorder is suspected as the underlying cause. However, other modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) may be very helpful, especially when a nongynecologic condition is suspected.


5-HT2 and 5-HT3 receptors mediate two distinct depolarizing responses in rat dorsal root ganglion neurons.
The effects of serotonin (5-HT) were studied on transmembrane potentials in 188 rat dorsal root ganglion cells (150 A-type, 16 C-type and 22 unidentified neurons). 5-HT produced a concentration-dependent depolarization in 88% of these neurons. Membrane input resistance (Rin), determined from the slope of current-voltage displacement curves, was increased in 51% and decreased in 41% of the responding neurons. Both responses occurred in 8% of the neurons. No differences in these responses were observed between A- and C-type neurons. Norepinephrine (NE) depolarized 75% (n = 20) of the neurons tested while increasing the Rin. In cells where 5-HT decreased Rin, 2-methyl 5-HT, but not alpha-methyl 5-HT, mimicked the response. The selective 5-HT3 antagonist, ICS 205-930, blocked this response, but ketanserin and methiothepin did not affect it. The 5-HT-induced increase in Rin was blocked by 5-HT2 antagonists (ketanserin, methiothepin and spiperone); mimicked by alpha-methyl 5-HT, but not affected by 2-methyl 5-HT. The selective 5-HT3 antagonist, ICS 205-930, did not antagonize this response. The action of NE but not 5-HT was blocked by the selective alpha 1 antagonist, prazosin. These data indicate that the 5-HT induced depolarization with decreased Rin is mediated by 5-HT3 receptors and the depolarization with increased Rin is mediated by 5-HT2 receptors. Furthermore, these two receptors can occur on the same cell.


Radiotherapy-induced toxicity in prostate cancer patients with hip prostheses.
Acute and late toxicity was analysed for prostate cancer patients with bilateral hip prostheses, who received fixed field intensity modulated radiotherapy (IMRT). The aims were (1) to establish whether toxicity rates differed from those of a control group with normal hips, (2) to develop a volumetric modulated arc therapy (VMAT) approach for patients with prostheses and (3) to compare doses to bladder and rectum for the control group, prostheses group and VMAT replans for the prostheses group. Genitourinary (GU) and gastrointestinal (GI) toxicity was scored using Common Terminology Criteria for Adverse Events version 5.0. The incidence of grade 2 or worse (G2+) toxicity was compared using Fisher's exact test. Dose volume histograms (DVHs) and mean doses to organs at risk (OARs) were compared using signed rank tests. There were 17 patients in the prostheses group and 50 in the control group. Acute and late GU toxicity was similar. G2+ late GI toxicity incidence was 31% for the prostheses group and 14% for the control group (p = 0.14). Significant differences (p < 0.05) were seen between the OAR DVHs of the prostheses group who had IMRT and the control group for a range of intermediate doses. The rectum mean dose was significantly different (p < 0.001), but no difference was seen for the bladder mean dose (p = 0.08). No significant differences were seen in GU and GI toxicity incidence between patients with bilateral hip prostheses and a control group. The DVHs for bladder and rectum were significantly higher for patients with prostheses planned with IMRT. Replanning using a VMAT technique significantly reduced doses to the OARs, whilst maintaining good planning target volume coverage.


Beyond adolescence exploring Canadian women and men's perception of overweight.
The research literature strongly corroborates that desires and attempts to lose weight are more prevalent among women who are already within the healthy weight range than men. The development of a distorted weight perception, specifically an overestimation of one's body size, may manifest into caloric restriction and other disordered eating behaviors. However, there is no systematic process to monitor the prevalence of disordered eating behaviors in Canada. The objective of this study was to investigate the prevalence and the sociodemographic characteristics of Canadian adults who have a perception of being overweight when their body mass index indicates that they are normal or underweight based on self-reported heights and weights. The responses to the 2000/2001 Canadian Community Health Survey by a representative sample of Canadians between the ages of 20 and 64 were analyzed. Bivariate and logistic regression analyses were performed. The prevalence of perceiving oneself as overweight when at acceptable weight for height was 23.6% for women and 7.8% for men. The probability was significantly greater in women, some foreign-born residents, those with a higher income level, and with increasing age. These results suggest that, in contrast to mainstream thinking, distorted weight perception is experienced by adult and aging women, and not only by adolescent girls. More research is needed to understand why distorted weight perception increases with age in women and what potential adverse effects it may have in this population.


Continuous intravenous infusion of rocuronium (ORG 9426) in patients receiving balanced, enflurane, or isoflurane anesthesia.
Rocuronium (ORG 9426) is a new nondepolarizing neuromuscular blocking agent with a rapid onset and an intermediate duration of action. This study obtains the infusion requirements of rocuronium in 30 patients in whom anesthesia was maintained with barbiturate-nitrous oxide-opioid, nitrous oxide and enflurane, or nitrous oxide and isoflurane. For all 30 patients, anesthesia was induced with intravenous thiopental and fentanyl, followed by 0.45 mg/kg rocuronium. Patients were randomly allocated to receive either: 1) nitrous oxide in 40% oxygen supplemented with fentanyl, thiopental, and droperidol (balanced anesthesia), 2) 1.25 MAC enflurane-nitrous oxide, or 3) 1.25 MAC isoflurane-nitrous oxide. Once blockade had recovered to 95% depression of twitch height, muscle relaxation was maintained by continuous infusion of rocuronium, adjusted to maintain mechanical twitch response at 95% depression. At 90 and 120 min, the enflurane and isoflurane groups had lower infusion requirements than those receiving barbiturate-nitrous oxide-opioid anesthesia (P < 0.02), but these did not differ significantly between the two volatile agents. Final infusion requirements (mean +/- SD) were 9.8 +/- 3.7, 5.9 +/- 3.1, and 6.1 +/- 2.7 micrograms.kg-1.min-1 for the groups receiving barbiturate-nitrous oxide-opioid, enflurane, and isoflurane anesthesia, respectively. Spontaneous recovery began soon after termination of the infusion; in all patients, twitch tension equaled 10% of control within 5 min. The infusion requirements to maintain 95% twitch depression approximated 10 micrograms.kg-1.min-1 during barbiturate-nitrous oxide-opioid anesthesia. These requirements were reduced by 40% during anesthesia involving enflurane or isoflurane.


The optokinetic response differences between congenital profound and nonprofound unilateral visual deprivation.
The occurrence of monocular naso-to-temporal optokinetic nystagmus (OKN) asymmetry, as a reflection of the immature oculomotor system in infants, and its persistence with early onset monocular visual deprivation, is well known. This asymmetry has been linked with poor binocular function and attributed to disruption of the development of binocular cortical projections to the pretectum. Optokinetic nystagmus symmetry in patients with congenital uniocular total pattern vision deprivation has not been fully investigated. The authors compared the optokinetic responses in six children with "profound" uniocular visual deprivation, who were born with untreated conditions (microphthalmos and persistent hyperplastic primary vitreous), with ten aphakic children treated early for congenital unilateral cataracts (nonprofound unilateral visual deprivation). Eye movements were recorded using dc-electro-oculography, and OKN was elicited using a full-field patterned curtain. Flash and pattern visual-evoked responses were also measured in each subject. Latent nystagmus was present in six children in the nonprofound group, whereas none was detected in the profound group. All children in the nonprofound group showed statistically significant monocular naso-to-temporal asymmetry for either eye. Subjects in the profound group had symmetric OKN. The authors conclude that unequal input from the two eyes and interocular rivalry lead to OKN asymmetry. Their results suggest that if vision from one eye is so negligible that it does not compete with the neuroanatomic connections of the fellow eye, then the input from this eye remains undisturbed, and OKN remains symmetric.


Medical school grades may predict future clinical competence.
In real-world medical education, there is a lack of reliable predictors of future clinical competencies. Hence, we aim to identify the factors associated with clinical competencies and construct a prediction model to identify "improvement required" trainees. We analyzed data from medical students who graduated from National Yang-Ming University with clerkship training and participated in the postgraduate year (PGY) interview at Taipei Veterans General Hospital. Clinical competencies were evaluated using grades of national objective structured clinical examination (OSCEs). This study used data from medical students who graduated in July 2018 as the derivation cohort (N = 50) and those who graduated in July 2020 (n = 56) for validation. Medical school grades were associated with the performance of national OSCEs (Pearson r = 0.34, p = 0.017), but the grades of the structured PGY interviews were marginally associated with the national OSCE (Pearson r = 0.268, p = 0.06). A prediction model was constructed to identify "improvement required" trainees, defined: trainees with the lowest 25% of scores in the national OSCEs. According to this model, trainees with the lowest 25% medical school grades predicted a higher risk of the "improvement required" clinical performance (Q1-Q3 vs Q4 = 15% vs 60%, odds ratio = 8.5 [95% confidence interval = 1.8-39.4], p = 0.029). In the validation cohort, our prediction model could accurately classify 76.7% "improvement required" and "nonimprovement required" students. Our study suggests that interventions for students with unsatisfactory medical school grades are warranted to improve their clinical competencies.


RP-UHPLC-UV-ESI-MS/MS analysis of LPMO generated C4-oxidized gluco-oligosaccharides after non-reductive labeling with 2-aminobenzamide.
Lytic polysaccharide monooxygenases (LPMOs) are able to cleave recalcitrant polysaccharides, such as cellulose, by oxidizing the C1 and/or C4 atoms. The analysis of the resulting products requires a variety of analytical techniques. Up to now, these techniques mainly focused on the identification of non-oxidized and C1-oxidized oligosaccharides. The analysis of C4-oxidized gluco-oligosaccharides is mostly performed by using high pressure anion exchange chromatography (HPAEC). However, the alkaline conditions used during HPAEC analysis lead to tautomerization of C4-oxidized gluco-oligosaccharides, which limits the use of this technique. Here, we describe the use of reverse phase-ultra high performance liquid chromatography (RP-UHPLC) in combination with non-reductive 2-aminobenzamide (2-AB) labeling. Non-reductive 2-AB labeling enabled separation of C4-oxidized gluco-oligosaccharides from their non-oxidized counterparts. Moreover, RP-UHPLC does not require buffered mobile phases, which reduce mass spectrometry (MS) sensitivity. The latter is seen as an advantage over other techniques such as hydrophilic interaction liquid chromatography and porous graphitized carbon coupled to MS. RP-UHPLC coupled to UV detection and mass spectrometry allowed the identification of both labeled non-oxidized and C4-oxidized oligosaccharides. Non-reductive labeling kept the ketone at the C4-position of LPMO oxidized oligosaccharides intact, while selective reducing agents such as sodium triacetoxyborohydride (STAB) reduced this ketone group. Our results show that RP-UHPLC-UV-ESI-MS in combination with non-reductively 2-AB labeling is a suitable technique for the separation and identification of LPMO-generated C4-oxidized gluco-oligosaccharides.


Cephalometric measures correlate with polysomnography parameters in individuals with midface deficiency.
To determine the association between cephalometric measurements and polysomnographic parameters in Brazilian patients with midface deficiency. This was a primary, clinical, observational, longitudinal, retrospective, analytical, and single-center study. Forty-eight patients with midface deficiency were divided into two groups as follows: those who underwent surgically assisted rapid palatal expansion (SARME) and those who received maxillary advancement (MA). Pre- and post-operative cephalometric and polysomnography measurements were obtained. Pearson's correlation was used to verify the presence of any significant associations between PSG scores and cephalometric measurements. Associations between BMI (Body Mass Index) and AHI (Apnea Hypopnea Index) as well as arousals were observed. In the SARME group, associations between AHI and SNA, UAS and MP-H, arousals and SNA, and Co-A and MP-H were noted. Associations between AHI and Co-A, PoOr-A and MP-H, arousals and UAS, and between minimum saturation of O2 and SNA, SNB, and Co-A were observed in the MA group. This study demonstrates the alterations in the middle third of the face that were related to sleep disturbance. In addition, it shows the associations between the polysomnographic parameters and the cephalometric representations corresponding to the analyzed deformities and transverse or anteroposterior maxillary deficiencies.


Three distinct tolerogenic CD14+ myeloid cell types to actively manage autoimmune disease: Opportunities and challenges.
Current treatment for patients with autoimmune disorders including rheumatoid arthritis, multiple sclerosis and type 1 diabetes, often consists of long-term drug regimens that broadly dampen immune responses. These non-specific treatments are frequently associated with severe side effects creating an urgent need for safer and more effective therapy to promote peripheral tolerance in autoimmune diseases. Cell-based immunotherapy may offer an encouraging alternative, where tolerogenic CD14+ myeloid cells are infused to inhibit autoreactive effector cells. In this review, we compared in depth three promising tolerogenic CD14+ candidates for the treatment of autoimmune disease: 1) tolerogenic dendritic cells, 2) monocytic myeloid-derived suppressor cells and 3) CD14+ type 2 conventional dendritic cells. TolDC-based therapy has entered clinical testing whereas evidence from the latter two cell types m-MDSCs and CD14+ cDC2s is predominantly coming from cancer immunology research. These three cell types have distinct cellular properties and immunosuppressive mechanisms offering unique opportunities to be explored. However, these cells differ in stage of development towards immunotherapy each facing additional hurdles. Therefore, we speculate on the potential benefits and risks of these cell types as novel cell-based immunotherapies to control autoimmune disease in patients.


The ultrastructure of paraganglia associated with the inferior mesenteric ganglia in the guinea-pig.
The paraganglia of the inferior mesenteric ganglia in the guinea-pig are composed of small chromaffin cells containing an abundance of granule-containing vesicles. The chromaffin cells are almost completely surrounded by satellite cells. In areas in which satellite cell processes do not intervene, the membranes of adjacent chromaffin cells are closely apposed and often form specialized attachment zones. The paraganglia contain a dense capillary network, the endothelial cells of which are often extremely attenuated and show areas of fenestration. The processes of chromaffin cells approach close to the capillary walls and are often bare of satellite cells covering on the side facing the capillary. Evidence has been obtained for the exocytotic release of the contents of chromaffin cell vesicles into pericapillary spaces. Synapses of cholinergic and noradrenergic axons are seen on the chromaffin cells. The cholinergic axons degenerate when the praganglia are decentralized, but the noradrenergic axons, which appear to arise from the local inferior mesenteric ganglia, remain intact. The results suggest that the paraganglia have an endocrine function.


Effect of selenite and tellurite on the morphological growth and toxin production of Aspergillus parasiticus var. globosus IMI 120920.
Aspergillus parasiticus var. globosus IMI 120920 was able to grow in presence of different concentrations tested (0.052-4.0%) of sodium selenite or concentrations up to 2.0% potassium tellurite. Growth of the fungus was decreased greatly by the increase of metals concentrations. Dark colour colony and black reverse were formed in presence of tellurite while reddish gray to grayish red colony colour and brownish red to orange red reverse were formed in presence of selenite. The fungal biomass was slightly decreased at lower concentrations and highly inhibited at higher concentrations of selenite or tellurite. Selenite slightly stimulated aflatoxin formation at lower concentrations and highly inhibited it at higher concentrations. Aflatoxin production was decreased greatly by increasing tellurite concentrations. Obvious malformations were observed in the morphological features of the fungus in presence of different levels of selenite or tellurite.


Immobilization of acetyl-CoA:arylamine N-acetyltransferase and the preparation of an enzyme reactor for the synthesis of N-[11C]acetylserotonin.
The enzyme arylamine acetyltransferase (acetyl-CoA:arylamine N-acetyltransferase, EC 220.127.116.11) from pigeon liver is immobilized onto differently derivatized controlled pore glass beads. Different silanes, spacer arms and reactive end-groups were tested, and immobilized enzyme stability tests were performed. From these experiments, the method of choice was selected: immobilization on controlled pore glass beads (24 nm pore size, 75-125 microns particle size) derivatized with gamma-aminopropyl and glutaraldehyde as the reactive end group. The kinetic properties of an enzyme reactor were investigated and optimized. The goal was to obtain a rapid high-yield conversion of 0.5-1 mumol acetyl-CoA to N-acetylserotonin, so that the reactor is useful for the 11C-labelling of N-acetylserotonin. Using an enzyme reactor (9.8 x 0.5 cm i.d.) containing 4.6 U active arylamine acetyltransferase immobilized onto 930 mg carrier, a 70% conversion of acetyl-CoA was obtained within 4 min.


Pluripotent stem cells for Schwann cell engineering.
Tissue engineering of Schwann cells (SCs) can serve a number of purposes, such as in vitro SC-related disease modeling, treatment of peripheral nerve diseases or peripheral nerve injury, and, potentially, treatment of CNS diseases. SCs can be generated from autologous stem cells in vitro by recapitulating the various stages of in vivo neural crest formation and SC differentiation. In this review, we survey the cellular and molecular mechanisms underlying these in vivo processes. We then focus on the current in vitro strategies for generating SCs from two sources of pluripotent stem cells, namely embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs). Different methods for SC engineering from ESCs and iPSCs are reviewed and suggestions are proposed for optimizing the existing protocols. Potential safety issues regarding the clinical application of iPSC-derived SCs are discussed as well. Lastly, we will address future aspects of SC engineering.


[Antibiotic residues in organs and muscle tissues of broilers. I. Bacitracin, flavomycin, spiramycin and viriniamycin residues following administration of diets containing low levels of these antibiotics (author's transl)].
Two groups of broilers were fed two different feed mixtures. A feed containing a mixture of bacitracin, flavomycin, spiramycin and virginiamycin (20 ppm each) was administered to sixity broilers. Sixty other broilers were given a similar feed not containing any antibiotics. After slaughter, samples of kidney, liver and breast were examined for the presence of antibiotic residues. All samples were found to be negative for antibiotic residues. Four micro-organisms were used in performing the tests: Bacillus cereus Kiel, Bacillus subtilis 165, Bacillus subtilis BGA and Micrococcus luteus ATCC 9341.


Manifestations of HIV stigma and their impact on retention in care for people transitioning from prisons to communities.
While most people living with HIV who are incarcerated in United States receive appropriate HIV care while they are in prison, interruptions in antiretroviral therapy and virologic failure are extremely common after they are released. The purpose of this study was to describe whether and how HIV stigma influences continuity of care for people living with HIV while they transition from prison to community settings. We conducted semi-structured, telephone-based interviews with 32 adults who received HIV care while residing in a Wisconsin state prison, followed by a second interview 6 months after they returned to their home community. Interview transcripts were analyzed by an interdisciplinary research team using conventional content analysis. We identified themes based on commonly-reported experiences that were characterized as internalized stigma, perceived stigma, vicarious stigma, or enacted stigma. All four forms of HIV stigma appeared to negatively influence participants' engagement in community-based HIV care. Mechanisms described by participants included care avoidance due to concerns about HIV status disclosure and symptoms of depression and anxiety caused by internalized stigma. Supportive social relationships with clinic staff, professional case managers and supportive peers appeared to mitigate the impact of HIV stigma by increasing motivation for treatment adherence. HIV stigma is manifest in several different forms by people living with HIV who were recently incarcerated, and are perceived by patients to negatively influence their desire and ability to engage in HIV care. By being cognizant of the pervasive influence of HIV stigma on the lives of criminal justice involved adults, HIV care providers and clinical support staff can ameliorate important barriers to optimal HIV care for a vulnerable group of patients.


Association of tumor downstaging after neoadjuvant chemotherapy with survival in patients with locally advanced nasopharyngeal carcinoma: a retrospective cohort study.
Assessing the downstaging effects of neoadjuvant chemotherapy (NACT) in patients with locally advanced nasopharyngeal carcinoma (LANPC) and predicting response to treatment remain challenging. The present study aimed to evaluate the long-term prognosis of downstaging after NACT in patients with LANPC and to investigate the prognostic value of post-NACT tumor downstaging on treatment outcomes in the era of concurrent chemoradiotherapy (CCRT). This retrospective study included 226 patients with stage III (n = 188) and IVA (n = 38) NPC admitted to Haikou People's Hospital between 1 October 2009 and 1 October 2012. The patients were grouped as downstaging or no after NACT. Overall survival (OS), locoregional failure-free survival (LFFS), and distant failure-free survival (DFFS) were analyzed. Among 226 patients, 196 (86.7%) were in the downstaging group and 30 (13.3%) were in the non-downstaging group. The longest follow-up was 76 months, and the median was 45 months. The 3-year OS rates of the downstaging group and non-downstaging group were 91.0% (95% CI 0.89-0.93) and 69.5% (95% CI 0.66-0.72) (P = 0.005). The 5-year OS rates were 81.6% (95% CI 0.78-0.86) and 53.3% (95% CI 0.49-0.61) (P = 0.001). N downstaging (3-year OS, HR 0.491, 95% CI 0.221-0.881, P = 0.022; 5-year OS, HR = 0.597, 95% CI 0.378-0.878, P = 0.021) was independently associated with OS. In the treatment of LANPC, the patients with downstaging after NACT have a better prognosis than those without downstaging. This study suggests that NACT can improve the prognosis for patients with LANPC if there is downstaging.


Antidepressant drug induced alterations in binding to central dopamine transporter sites in the Wistar Kyoto rat strain.
The Wistar Kyoto (WKY) rat has been proposed as an animal model of depressive behavior. Exposing WKY rats to stress stimulation produces symptoms such as anhedonia, psychomotor retardation, ambivalence and negative memory bias. Given the role of the mesolimbic dopamine (DA) system in cognitive, emotional and motivational behaviors, we previously examined the distribution of DA transporter (DAT) sites in the brains of WKY compared to Wistar (WIS) and Sprague-Dawley (S-D) rats. WKY rats exhibited significant differences in DAT binding sites in the cell body as well as mesolimbic areas compared to the other strains. It was reasoned that these differences may lead to altered synaptic levels of DA in specific brain regions thus contributing to the behavioral differences observed in this rat strain. Thus, the present study examined whether repeated treatment with antidepressant drugs that block the uptake of DA (nomifensine and bupropion) would modify [3H]-GBR12935 binding to DAT sites in WKY rats compared to WIS and S-D rats. The results indicate that while nomifensine and bupropion increased the binding of [3H]-GBR12935 to DAT sites in the mesocorticolimbic regions in WKY rats, these drugs increased the binding of [3H]-GBR12935 to DAT sites in the cell body areas in WIS rats but not in S-D and WKY rats. The data from this study suggest that antidepressant induced alterations in DAT sites in the mesocorticolimbic brain regions may play a role in the behavioral improvement seen in WKY rats, as measured by the Open Field Test (OFT) and the Porsolt Forced Swim Test (FST).


SCOPE: The South Carolina psycholinguistic metabase.
The number of databases that provide various measurements of lexical properties for psycholinguistic research has increased rapidly in recent years. The proliferation of lexical variables, and the multitude of associated databases, makes the choice, comparison, and standardization of these variables in psycholinguistic research increasingly difficult. Here, we introduce The South Carolina Psycholinguistic Metabase (SCOPE), which is a metabase (or a meta-database) containing an extensive, curated collection of psycholinguistic variable values from major databases. The metabase currently contains 245 lexical variables, organized into seven major categories: General (e.g., frequency), Orthographic (e.g., bigram frequency), Phonological (e.g., phonological uniqueness point), Orth-Phon (e.g., consistency), Semantic (e.g., concreteness), Morphological (e.g., number of morphemes), and Response variables (e.g., lexical decision latency). We hope that SCOPE will become a valuable resource for researchers in psycholinguistics and affiliated disciplines such as cognitive neuroscience of language, computational linguistics, and communication disorders. The availability and ease of use of the metabase with comprehensive set of variables can facilitate the understanding of the unique contribution of each of the variables to word processing, and that of interactions between variables, as well as new insights and development of improved models and theories of word processing. It can also help standardize practice in psycholinguistics. We demonstrate use of the metabase by measuring relationships between variables in multiple ways and testing their individual contribution towards a number of dependent measures, in the most comprehensive analysis of this kind to date. The metabase is freely available at go.sc.edu/scope.


The perceptions of nurse teachers regarding the preparation for their role in Project 2000 programmes.
This paper discusses the findings related to the perceptions of nurse teachers regarding the preparation for their role in Project 2000 programmes. Data were collected by utilising three rounds of a Delphi survey with a panel of experts made up of Grade 2 nurse teachers. The panel of 201 respondents was obtained from 25 of the 28 colleges of nursing and midwifery that had implemented Project 2000 between September 1989 and April 1991. The profile of the respondents revealed that 68% work in general nurse courses, 18% in mental health, 8% in mental handicap and 6% in child care. Over half of the respondents hold a degree related to health care and over a quarter are studying for one. The findings suggest that the nurse teachers working in Project 2000 programmes consider their teacher preparation course an important means of preparation for the activities within their role. Degree and diploma courses are also considered important along with additional professional qualifying courses and subject related courses. What did not appear evident was any preparation for the many specific activities they carry out apart from teaching. Experience came out strongly as an important means of preparation for all the activities. Staff development programmes were said by 52% of respondents to be organised within their colleges and perceived by many as an important means of preparation.


Mesenchymal stem cells: harnessing cell plasticity to tissue and organ repair.
Plastic behavior of cells is a hallmark of embryonic development. The emergence of primary mesenchyme from within the inner cell mass entails the first epithelial-mesenchymal transition step that is then followed by sequential transitions; the formation of new tissues and organs requires transitions from mesenchyme into epithelium and vice versa. Although it is currently believed that in the adult such transitions do not persist, the frequent occurrence of mesenchymal stem cells (MSCs) in various tissues of the adult organisms, and the reported plasticity of such adult mesenchymal cells, raises the question as to whether the frequency of mesenchymal epithelial transitions in the adult have been underestimated. Indeed, adult mesenchymal stem cells have been reported to differentiate in culture into a multitude of mature cell types including epithelial cells. This opens the way to the use of these stem cells for the construction of new tissues and organs for therapeutic purposes, but the question is still open as to whether mesenchymal stem cells transdifferentiate also in vivo. The molecular mechanism that underlies the plasticity of mesenchymal stem cells and their capacity to transdifferentiate is unresolved. We found that these cells have a promiscuous gene expression pattern; mesenchymal cells, whether primary or cloned cell lines, express T cell receptor (TCR) beta and alpha genes, along with other components of the TCR complex. These cells may therefore be in a standby state, in which many gene families are expressed at a low level thereby making the cell readily capable of shifting fates.


Discrepancy between second and first opinion in surgical oncological patients.
To prospectively describe in a population of oncological second opinion patients: (1) the outcome of routine revisions of histopathological and radiological material, (2) the frequency and extent of discrepancy between the second and first opinion and (3) the location of further treatment or follow-up. In a population of 466 consecutive patients seeking a second opinion at the Surgical Oncology Outpatient Clinic, demographic and clinical patient characteristics were registered prospectively, as were the results of routine revision of histopathological and radiological material and the location of further treatment or follow-up. A classification system was developed to categorize the differences between the second and first opinion. The mean age of the 403 eligible patients was 52 years. Most patients (87%) were women, of whom 83% were diagnosed with breast cancer. Revision of histopathological and radiological material was performed in 80 and 61% of the cases, respectively, and resulted in a major change in treatment or prognosis in 3 and 2% of patients, respectively. In 317 patients (79%), the second opinion could be compared with the first opinion, resulting in an identical advise in 68%, a minor discrepancy in 16% and a major discrepancy in another 16% of patients. For further treatment 78% of patients were referred back to their first specialist. One third of patient-initiated second opinion consultations resulted in a discrepancy with the first opinion. Half of these different advise lead to major changes in therapy or prognosis.


A meta-analysis of the rate and related factors of glaucomatous optic nerve damage in patients with Glaucomatocyclitic Crisis.
To systematic analysis of domestic and foreign literature on the incidence and related factors of glaucomatous optic nerve damage (GOND) in patients with Glaucomatocyclitic Crisis (PSS). A computerized literature search was carried out in PubMed database, Wanfang Medical Database, China National Knowledge Infrastructure to collected domestic and foreign research studies on the incidence and related factors of glaucomatous optic nerve damage of Glaucomatocyclitic Crisis. Using Stata 15.1 software, select the indicators: incidence, gender, age, single/double eyes, duration of disease, and intraocular pressure (IOP) at onset for meta-analysis. OR (odds risk) was used as the effect variable for the binary variables, and mean difference was used as the effect variable for the continuous variables. The results are expressed by each effect amount and its 95% Confidence interval (CI). If there was heterogeneity among the original studies, a random effects model was used; otherwise, a fixed effects model was used. A total of 13 studies were included. The incidence of GOND in PSS was 0.251 (95%CI: 0.175-0.327). Three studies include the relevant factor analysis and the results showed: there was a statistically significant difference in age, and duration of disease in PSS patients with/without GOND (p = 0.000, p = 0.000), there was no statistical difference between the two groups in gender, single /double eyes, and IOP at onset (p = 0.468, 0.053, 0.065). Glaucomatocyclitic Crisis can cause glaucomatous optic nerve damage. GOND is more likely to occur in patients who are older, and have a long course of the disease. For such patients, special attention should be paid to the detailed examination of visual function and follow-up.


Atp7b deficiency induces zebrafish eye developmental defects.
As a copper (Cu) transport ATPase, ATP7B plays an important role in maintaining Cu homeostasis in the body and its dysfunction is associated with retinal disease. How ATP7B dysfunction and the subsequent Cu overload induce retinal damage, however, are unknown. Here, we show that atp7b-/- homozygous zebrafish larvae are insensitive to light stimulation, with a reduction in retinal cells but normal like morphological phenotypes. Additionally, a series of differentially expressed genes are unveiled in atp7b-/- mutated larvae, which enrich in photo-transduction, structural constituent of eye lens, sensory perception of light stimulus, oxidative phosphorylation, and ATPase activity. Moreover, we show the Cu accumulation in retinal cells in atp7b-/- mutated larvae, which results in endoplasmic reticulum (ER) stress and retinal cell apoptosis and subsequent retinal defects. The integral data in this study demonstrate that atp7b mutation leads to Cu accumulation in zebrafish retinal cells and the consequence ER stress and retinal cell death. These data may give some possible hints to explain retinal disease occurred in the Cu dysregulation syndromes Wilson's disease with ATP7B mutation.


Comparison of T and B cell analyses on fresh and aged blood.
We have compared T and B cell analyses using whole blood, separated lymphocytes, and separated, frozen, then thawed lymphocytes to see how long blood can be kept before separation and analysis. We also examined the effect of various anticoagulants and the effect of diluting blood in culture media on T and B cell analysis over time. We found that the whole blood method is a very reliable method for T and B cell analysis, even 4 days after the blood is drawn, provided that heparin or ACD is the anticoagulant used. Separated lymphocytes and cryopreserved lymphocytes from blood that was separated within 24 h of collection was satisfactory; however, results were less consistent if separation was delayed more than 24 h. For lymphocyte separation, blood collected in heparin or ACD held up better over time than did blood collected in EDTA, and dilution with either RPMI 1640 or McCoy's medium gave better lymphocyte separation in older blood.


Interactions of phospho- and dephosphosuccinyl coenzyme A synthetase with manganous ion and substrates. Studies of manganese complexes by NMR relaxation rates of water protons.
The interactions of substrates with succinyl-CoA synthetase were investigated by measuring the enhancement of the longitudinal water proton relaxation rate (PRR) due to Mn(II) to the enzyme substrate complexes. The binding of Mn(II) to the enzyme was investigated by EPR. The effects of phosphorylating the enzyme on its interactions with Mn(II) and substrates were also examined. Mn(II) binds weakly to dephosphosuccinyl-CoA synthetase (E) at approximately four sites with a KD value of 0.14 mM, and the PRR enhancement of the complex, epsilonb, at 24.3 MHZ and 25 degree is 18.8. The phosphoenzyme (E-P) binds Mn(II) more strongly at approximately four sites with a KD value of 0.74 mM, and only a small change in epsilonb to 18.1. Mm ADP binds to E at one or two sites with K2 = 0.5 muM, the values of epsilont for the ternary E-Mn-ADP complex is 17.0. Free ADP binds about 126 times more weakly to the enzyme than does Mn-ADP. PRR titrations indicated that the values of epsilont for the ternary E-Mn-ADP and (E-P)-Mn-ADP complexes are about the same. Mn-ATP binds very weakly or not at all to (E-P)-Mn. Formation of the ternary complexes of CoA with E-Mn or (E-P)-Mn could be followed by small but significant increases in the PRR enhancement. No ternary complex with succinate could be detected since the addition of succinate had no effect on the PRR enhancement. However, a large decrease in enhancement, at least 2-fold, was observed upon addition of both succinate and CoA. An increase in the PRR enhancement was produced by the interaction of succinyl-CoA with the E-Mn complex. Upper limits of the dissociation constants for CoA from the quaternary E-Mn-ADP-succinate-CoA complex and for succinyl-CoA from the quaternary E-Mn-ADP-succinyl-CoA complex are 390 and 560 muM, respectively. The epsilon values for the quaternary and quinary complexes are 6.4 and 3.1, respectively. The successive occupation of substrate binding sites of succinyl-CoA synthetase produces alterations in the molecular dynamics or in the conformation of the active site (or both), which are accompanied by progressive decreases in the values of epsilon. Thus, the physical parameter used in these studies relects the previously observed catalytic properties of the enzyme system inasmuch as the catalytic function of succinyl-CoA synthetase is potentiated by substrate binding, and catalytic avtivity in partial reactions is maximized as binding sites are successively occupied.


Neurofibromatosis and neural crest neoplasms: primary acquired melanosis and malignant melanoma of the conjunctiva.
With an occurrence of approximately 1 in 3000 births, von Recklinghausen neurofibromatosis (NF) is one of the most common inherited human disorders. NF is considered a neurocristopathy, a disorder of neural crest derived cells. One of the complications of NF is the development of neural crest derived malignancies such as malignant schwannoma, pheochromocytoma, and malignant melanoma of the skin and choroid. The case history of a patient with NF and conjunctival malignant melanoma which developed in an eye with primary acquired melanosis is yet another example of a neural crest malignancy developing in a NF patient.


The calcitonin-like system is an ancient regulatory system of biomineralization.
Biomineralization is the process by which living organisms acquired the capacity to accumulate minerals in tissues. Shells are the biomineralized exoskeleton of marine molluscs produced by the mantle but factors that regulate mantle shell building are still enigmatic. This study sought to identify candidate regulatory factors of molluscan shell mineralization and targeted family B G-protein coupled receptors (GPCRs) and ligands that include calcium regulatory factors in vertebrates, such as calcitonin (CALC). In molluscs, CALC receptor (CALCR) number was variable and arose through lineage and species-specific duplications. The Mediterranean mussel (Mytilus galloprovincialis) mantle transcriptome expresses six CALCR-like and two CALC-precursors encoding four putative mature peptides. Mussel CALCR-like are activated in vitro by vertebrate CALC but only receptor CALCRIIc is activated by the mussel CALCIIa peptide (EC50 = 2.6 ×10-5 M). Ex-vivo incubations of mantle edge tissue and mantle cells with CALCIIa revealed they accumulated significantly more calcium than untreated tissue and cells. Mussel CALCIIa also significantly decreased mantle acid phosphatase activity, which is associated with shell remodelling. Our data indicate the CALC-like system as candidate regulatory factors of shell mineralization. The identification of the CALC system from molluscs to vertebrates suggests it is an ancient and conserved calcium regulatory system of mineralization.


Fatty acid and sterol metabolism of cultured Trichomonas vaginalis and Tritrichomonas foetus.
Trichomonas vaginalis and Tritrichomonas foetus grown in a fetal calf serum-based culture medium, contained as major lipids (i.e., greater than 10% of total) cholesterol, phosphatidylethanolamine and phosphatidylcholine. T. vaginalis also contained sphingomyelin and T. foetus glycophosphosphingolipids. The culture medium contained (greater than 10%) cholesterol, phosphatidylethanolamine, phosphatidylcholine, sphingomyelin and lysophosphatidylcholine. The fatty acyl groups of these major lipids of the trichomonads and the culture medium were similar. Those present in amounts greater than 5% of the total fatty acyl groups for a given lipid were myristic, palmitic, hexadecaenoic, stearic, oleic, linoleic, arachidonic and docosahexaenoic. When the trichomonads were exposed to radiolabeled lipids and lipid precursors, [14C]-labeled acetate and potential acetate precursors (glucose, threonine) were poorly incorporated and failed to label the fatty acyl groups of the trichomonad lipids. [14C]-labeled, C12-C22 saturated and unsaturated fatty acids were incorporated, unaltered, into phosphoglycerides and sphingolipids (sphingomyelin and glycophosphosphingolipids), but not into cholesteryl esters or triacylglycerols. Phosphoglycerides were preferentially labeled with unsaturated fatty acids and sphingolipids with saturated ones. This information inferred that the trichomonads: 1) were unable to biosynthesize fatty acids de novo, 2) took up unesterified fatty acids from the culture medium and used them in phosphoglyceride and sphingolipid biosynthesis and/or turnover, 4) did not use unesterified fatty acids in the biosynthesis or turnover of cholesteryl esters or triacylglycerols. Phosphatidylcholine and phosphatidylethanolamine, with [14C]labeled fatty acyl groups, and sphingomyelin, with 14C-labeled choline, were incorporated by the trichomonads. The phospholipids strongly labeled phosphoglycerides and sphingolipids, but not triacylglycerols, while the radioactivity of sphingomyelin [14C]choline remained associated solely with trichomonad sphingomyelin. Triacylglycerol, with 14C-labeled fatty acyl groups, was also incorporated, and labeled phosphoglycerides and sphingolipids. The results of those experiments suggested that trichomonads: (1) could take up culture medium phospholipids and triacylglycerols; (2) actively deacylated and reacylated phospholipids, but not triacylglycerols; (3) hydrolyzed exogenous triacylglycerols and used their fatty acyl groups for phospholipid acylations. Radiolabeled acetate, mevalonate and squalene were not incorporated into trichomonad cholesterol or cholesteryl esters. [14C]Cholesterol was incorporated unaltered, but was not esterified.(ABSTRACT TRUNCATED AT 400 WORDS)


Immunological systematics of the extinct quagga (Equidae).
It has been debated whether the extinct quagga was a distinct fourth species of African zebra or whether it was merely the southern variant of the Plains zebra (Equus burchelli). Using a radioimmunoassay (RIA) technique, we have shown that proteins remaining in quagga skins from museums are much more similar to serum proteins of the Plains zebra than to those of the other two extant zebras.


Transosseous access for decompression of an obstructed pelvic kidney.
We report a case of an obstructed pelvic kidney which was decompressed using a transosseous access route. The patient presented with obstructive uropathy and fever, necessitating decompression. Initial access was gained to the kidney by traversing the ilium, allowing subsequent retrograde placement of a double-J ureteric catheter.


The combination of photodynamic therapy and ultrapulse carbon dioxide laser for facial angiofibromas in tuberous sclerosis complex: A case report.
Facial angiofibromas are one of the dermatological hallmarks of tuberous sclerosis complex. Facial angiofibromas often lead to disfigurement and cosmetic concerns, which has a serious negative effect on the quality of life of the patients. There are no guidelines or consensus on the management of facial angiofibromas up to now. We report a patient with extensive facial angiofibromas treated with the combination of photodynamic therapy and ultrapulse carbon dioxide laser, achieving satisfying results. We suggest this might be a promising therapeutic option for facial angiofibromas in tuberous sclerosis complex.


'Change is a marathon, not a sprint'.
Mandisa Greene is a name for the history books. As the first black president of the RCVS, she strives to increase diversity in the professions. Here, Josh Loeb chats to her about her plans for the year.


Association of exposures to perchlorate, nitrate, and thiocyanate with allergic symptoms: A population-based nationwide cohort study.
Allergic diseases have been one of the leading causes of chronic disorders in the United States. Animal studies have suggested that exposures to perchlorate, nitrate, and thiocyanate could induce allergic inflammation. However, the associations have not been examined among general populations. Here, we investigated data of 7030 participants aged ≥6 years from the National Health and Nutritional Examination Survey (NHANES) 2005-2006. Urinary levels of perchlorate, nitrate, and thiocyanate were measured by ion chromatography combined with electrospray tandem mass spectrometry. Information on allergic symptoms (hay fever, allergy, rash, sneeze, wheeze, eczema, and current asthma) was collected by questionnaire. Allergic sensitization was defined by a concentration ≥150 kU/L for total immunoglobulin E (IgE) levels. The associations were estimated using multivariate-adjusted logistic regression models. A positive association was observed for urinary nitrate and eczema (p < 0.001 for the trend). Compared with quartile 1 (lowest quartile), the odds ratios of eczema with 95% confidence intervals [ORs (95% CIs)] from quartiles 2 to 4 were 1.72 (95% CI, 1.41, 2.09), 1.94 (1.53, 2.47) and 2.10 (1.49, 2.97) for urinary nitrate. In addition, urinary thiocyanate was positively related to sneeze (ORQ4 vs. Q1: 1.25, 95% CI: 1.01, 1.55; p = 0.015 for the trend). However, urinary perchlorate was not correlated with any allergic-related outcome. Additionally, the associations were different among subgroups in a four-level polytomous model. Thus, our results suggested that exposures to nitrate and thiocyanate may be associated with allergic symptoms. Further investigations are warranted to concentrate on the practical strategies to monitor exposure levels and the latent mechanisms of the relationship between exposure and allergy.


Circ_PGPEP1 Serves as a Sponge of miR-1297 to Promote Gastric Cancer Progression via Regulating E2F3.
Circular RNA (circRNA) is a special kind of noncoding RNA that plays a vital function in the progression of gastric cancer (GC). However, the role of a new circRNA, circ_PGPEP1, in GC is unclear. Exploring the role and mechanism of circ_PGPEP1 in GC progression. The expression levels of circ_PGPEP1, miR-1297, and E2F transcription factor 3 (E2F3) were determined using quantitative real-time PCR. Flow cytometry, colony formation assay, MTT assay, and transwell assay were used to evaluate cell cycle, apoptosis, proliferation, migration, and invasion. The protein levels of apoptosis-related markers and E2F3 were measured by western blot analysis. The interaction between circ_PGPEP1 and miR-1297 or miR-1297 and E2F3 was confirmed by dual-luciferase reporter assay. In addition, animal experiments were performed to assess the effect of circ_PGPEP1 on GC tumor growth in vivo. Circ_PGPEP1 was a highly expressed circRNA in GC. Loss-of-function experiment indicated that circ_PGPEP1 silencing could induce cell cycle arrest and apoptosis, while inhibit proliferation, migration, and invasion in GC cells. MiR-1297 could be sponged by circ_PGPEP1, and its expression was downregulated in GC. MiR-1297 inhibitor could reverse the negatively regulation of circ_PGPEP1 knockdown on GC progression. Furthermore, we also found that E2F3 could be targeted by miR-1297, and its expression was positively regulated by circ_PGPEP1. Overexpression of E2F3 could invert the inhibitory effect of miR-1297 on GC progression. Animal experiments suggested that silenced circ_PGPEP1 could reduce GC tumor growth. Our research showed that circ_PGPEP1 might serve as a potential biomarker for GC.


Outcomes of re-irradiation for brain recurrence after prophylactic or therapeutic whole-brain irradiation for small cell lung Cancer: a retrospective analysis.
Small cell lung cancer (SCLC) can recur in the brain after whole-brain irradiation (WBI). We documented outcomes after treatment of such recurrences and sought predictors of local control and overall survival (OS). Eighty-five patients with SCLC and brain recurrence after prophylactic or therapeutic WBI in 1998-2015 were identified and data were extracted from the medical records. Survival was estimated with the Kaplan-Meier method, and univariate and multivariate Cox proportional hazards modeling was used to identify factors associated with OS or further brain progression. Brain recurrence was treated by stereotactic radiosurgery (SRS) in 33 patients (39%), repeat WBI in 14 (16%), chemotherapy-only in 16 (19%), and observation in 22 (26%). Median OS time after brain recurrence (OSrec) was 4.3 months for all patients; 6-month OSrec rates were 58% after SRS, 21% after repeat WBI, 50% after chemotherapy-only, and 5% after observation (P < 0.001). Inferior OSrec was associated with poor performance status (ECOG score ≥ 3) and uncontrolled extracranial disease. Superior OSrec was associated with receipt of ≥4 chemotherapy cycles before brain recurrence and receipt of chemotherapy, SRS, or repeat WBI afterward. Receipt of chemotherapy after brain recurrence correlated with brain progression. Some patients with brain recurrence after WBI for SCLC can survive for extended periods with appropriate intervention, especially those with adequate performance status or controlled extracranial disease.


GnRH antagonist versus long GnRH agonist protocol in poor IVF responders: a randomized clinical trial.
To compare the efficacy of the long GnRH agonist and the fixed GnRH antagonist protocols in IVF poor responders. This was a randomized controlled trial performed in the Iakentro IVF centre, Thessaloniki, from January 2007 to December 2011, concerning women characterised as poor responders after having 0-4 oocytes retrieved at a previous IVF cycle. They were assigned at random, using sealed envelopes, to either a long GnRH agonist protocol (group I) or a GnRH antagonist protocol (group II). Overall 364 women fulfilled the inclusion criteria and were allocated to the two groups: finally 330 participated in our trial. Of these, 162 were treated with the long GnRH agonist protocol (group I), and 168 with the fixed GnRH antagonist protocol (group II). Numbers of embryos transferred and implantation rates were similar between the two groups (P=NS). The overall cancellation rate was higher in the antagonist group compared to the agonist group, but the difference was not significant (22.15% vs. 15.2%, P=NS). Although clinical pregnancy rates per transfer cycle were not different between the two groups (42.3% vs. 33.1%, P=NS), the clinical pregnancy rate per cycle initiated was significantly higher in the agonist compared to the antagonist group (35.8% vs. 25.6%, P=0.03). Although long GnRH agonist and fixed GnRH antagonist protocols seem to have comparable pregnancy rates per transfer in poor responders undergoing IVF, the higher cancellation rate observed in the antagonist group suggests the long GnRH agonist protocol as the first choice for ovarian stimulation in these patients.


Psychedelics and schizophrenia.
Research on psychedelics such as lysergic acid diethylamide (LSD) and dissociative drugs such as phencyclidine (PCP) and the symptoms, neurochemical abnormalities and treatment of schizophrenia have converged. The effects of hallucinogenic drugs resemble some of the core symptoms of schizophrenia. Some atypical antipsychotic drugs were identified by their high affinity for serotonin 5-HT(2A) receptors, which is also the target of LSD-like drugs. Several effects of PCP-like drugs are strongly affected by both 5-HT(2A) and metabotropic glutamate 2/3 receptor modulation. A serotonin-glutamate receptor complex in cortical pyramidal neurons has been identified that might be the target both of psychedelics and the atypical and glutamate classes of antipsychotic drugs. Recent results on the receptor, signalling and circuit mechanisms underlying the response to psychedelic and antipsychotic drugs might lead to unification of the serotonin and glutamate neurochemical hypotheses of schizophrenia.


Evolution of resistance in Staphylococcus aureus in Australian teaching hospitals. Australian Group on Antimicrobial Resistance (AGAR).
To assess the changes in antibiotic resistances in Staphylococcus aureus, both methicillin-susceptible and methicillin-resistant strains, in Australia. Retrospective review of data collected annually. Twenty metropolitan teaching hospitals in the six States of Australia and the Australian Capital Territory from 1988 to 1994. Changes in prevalence and resistance rates of methicillin-resistant S. aureus (MRSA) and methicillin-susceptible strains, based on antibiotic susceptibility testing of clinical isolates of S. aureus. Prevalence of MRSA has remained constant on the eastern seaboard of Australia. A distinctive strain of MRSA emerged in Western Australia which had different antimicrobial susceptibilities. Resistances emerged in MRSA strains from eastern Australia, principally to ciprofloxacin and rifampicin, while resistance to fusidic acid remained stable and resistance to chloramphenicol significantly declined. Resistances in methicillin-susceptible strains remained fairly stable, except for a decline in resistance levels for tetracycline. High levels of resistance were seen to penicillin, moderate levels to erythromycin and low levels to trimethoprim and fusidic acid in methicillin-susceptible strains. The continued high prevalence of and increasing resistance in MRSA in some Australian hospitals have meant that some strains are now untreatable with oral antibiotics.


Morphometric study of sciatic nerve and its topographic anatomical variations in relation to landmark structures around pelvis: a Nigerian population study.
Sciatic nerve (SN) presents significant variations that pertain to its topography and divisions. The topographic variation shows sex effect due to differences in the dimension of pelvis that makes for the adaptability of female pelvis for pregnancy and childbirth. The objective therefore was to evaluate the SN morphology and its topographical variations in relation to landmark structures in the pelvis of both sexes. Ninety-eight lower limb adult cadavers, 66 males and 32 females devoid of any gross pathology from Nigerians were used for the study. The cadavers were dissected to expose the SNs and the variations recorded. Anthropological measurements were taken and analysed using a Spearman's rank-order correlation model. The relationships between SN and the piriformis muscle shows five varied types with the typical type comprising 83.0%. The largest thickness of SN in males and females were 18.5 cm and 17.3 cm, respectively while the smallest thickness were 8.6 cm and 11.9 cm, respectively. The dimensions between posterior superior iliac spine and greater trochanter (PSIS-GT) and between lateral edges of SN intersection with piriformis to the tip of greater trochanter (LESN-GT) shows inverse correlation relationship between the two sexes. In males, there was a weak positive correlation (rs = 0.165) between LESN-GT (4.75 ± 1.52) and PSIS-GT (15.3 ± 2.90) which was not statistically significant at 0.01 level (p = 0.989). In females, the relationship between LESN-GT (6.39 ± 0.59) and PSIS-GT (12.2 ± 3.70) shows moderate negative correlation (rs = -0.476) which was not statistically significant at 0.01 level (p = 0.195). The dimension of LESN-GT which was observed to be longer in females was deemed to account for the deviation of sciatic nerve of females from the males' topographic anatomical relations.


Use of the enzyme-linked immunosorbent assay for detection of antibodies to Chlamydia trachomatis.
An enzyme-linked immunosorbent assay (ELISA) using a soluble antigen prepared from the D strain of Chlamydia trachomatis was used for titration of IgG antibodies to Chlamydia trachomatis in 153 sera from 126 patients with non-specific genital infection and from 27 healthy subjects. The results were compared to those obtained with the micro-immunofluorescence method and were in complete agreement in 143 of the 153 sera. The ELISA proved to be reproducible and as sensitive as the micro-immunofluorescence method.


Ethnopharmacology of medicinal plants of carrasco, northeastern Brazil.
The goal of this study was to conduct an ethnobotanical survey of medicinal species from the carrasco vegetation of the Araripe National Forest, state of Ceará, Brazil, as well as determining species with bioprospecting potential The ethnobotanical data were collected through semi-structured interviews and a free list. The relative importance of the plants cited was assessed, as well as species that stood out with respect to bodily systems, on the basis of informant consensus. A total of 32 species belonging to 29 genera and 20 families were recorded. Of this total, six species (19%) showed great versatility regarding their uses in regard to up to seven bodily systems. The therapeutic indications were grouped into 14 categories of bodily systems. Circulatory and genitourinary disorders, endocrine, nutritional and metabolic diseases, and undefined pain or disease showed the greatest consensus between informants. Ximenia americana, Himathantus drasticus, Stryphnodndron rotundifolium, Bowdichia virgilioides, and Hymenaea courbaril were the species warranting more in-depth study, on the basis of versatility and informant consensus on the uses of the species.


The relationships between fat talk, body dissatisfaction, and drive for thinness: perceived stress as a moderator.
Although body dissatisfaction and drive for thinness are commonplace in college-aged women, their relationships with fat talk and stress are understudied. This study examined (a) whether fat talk predicts body dissatisfaction and drive for thinness and (b) whether stress moderates these relationships. Results from self-report questionnaires completed by 121 female college students revealed that fat talk and perceived stress were significantly positively correlated with body dissatisfaction and drive for thinness. Although fat talk was a significant independent predictor of body dissatisfaction and drive for thinness, stress moderated these relationships such that they were stronger at lower stress levels. Although contrary to predictions, these results are logical when means are considered. Results suggest that fat talk positively predicts body dissatisfaction and drive for thinness in students with relatively lower stress levels, but does not for students under high stress because mean levels of these constructs are all already high.


Carcinoma cuniculatum of the oral mucosa: a potentially underdiagnosed entity in the absence of clinical correlation.
To delineate the features of carcinoma cuniculatum (CC), emphasizing potential management errors. A retrospective study examined archival cases of CC. An analysis of clinical, microscopic, and management parameters was performed. Ten cases were identified, and their clinical and microscopic features were summarized. CC exhibits a sessile pink/red mildly papillary surface. Histologically, CC presents a tortuous invasive component with a more subtle papillary appearance than verrucous carcinoma. CC is an uncommon variant of squamous cell carcinoma distinct from verrucous carcinoma. Diagnostic delays result from misinterpretation of superficial samples or lack of awareness of the entity. Bland cytology and unusual architecture result in underdiagnosis of CC without clinicopathologic correlation. Clinicians should submit multiple deep samples of lesions displaying a cobblestone-like surface and provide a clinical photograph to the pathologist. Pathologists can avoid underdiagnosis by thorough sampling of biopsies and requesting additional tissue as needed.


Critical period-dependent reduction of the permissiveness of cat visual cortex tissue for neuronal adhesion and neurite growth.
During postnatal development, the visual cortex undergoes an experience-dependent refinement of its circuitry. This process includes synapse formation, as well as synapse elimination. Both mechanisms appear to be restricted to a limited 'critical period' which lasts for approximately 2 months in cats. We tested whether the termination of the critical period for cortical malleability is paralleled by changes in the growth permissiveness of the tissue. These changes may inhibit progressive reorganization of functional circuitries mediated by axon growth. Embryonic cortical neurons were cultured on unfixed cryostat sections of the visual cortex obtained from cats aged 2-50 weeks. After 2-3 days in vitro the distribution of viable cells and the percentage of neurite-bearing cells were determined and analysed with respect to the developmental age and subdivisions of the underlying tissue substrate. It was shown that cell adhesion and neurite formation are correlated with the developmental age of the substrate tissue and the time period of myelination. While embryonic neurons adhered and survived on grey and white matter tissue from 2- and 4-week-old kittens, there was a significant reduction in cell adhesion on the myelinated white matter regions of the tissue sections of older animals. Quantitative analyses showed that neurite formation by cultured neurons also became successively impaired on grey and white matter areas of tissue substrates, corresponding to the time course of the critical period for cortical malleability. On grey matter tissue this effect was most pronounced between the second and sixth postnatal weeks. The effects were not antagonized by coating the substrate sections with the growth-promoting molecule laminin. It is therefore proposed that neurite growth-inhibiting factors, most probably associated with central nervous system myelin, are gradually expressed postnatally and may contribute to the termination of the critical period in the visual cortex of cats.


[Immune reconstitution syndrome and mycobacterial disease during highly active antiretroviral therapy. Retrospective study of six cases].
Soon after starting highly active antiretroviral therapy (HAART), some patients experience clinical deterioration due to the reactivation of their immune system. Mycobacteria are the principal agents complicating this immune reconstitution period. A retrospective examination of patients with mycobacterial disease before or shortly after beginning HAART at Grenoble University Hospital from January 2001 through July 2004 identified six subjects (among 650 outpatients per year) with a new or aggravated mycobacterial disease after starting HAART. Clinical manifestations were: adenopathy (4/6), hyperthermia (3/6), thoracic pain (2/6), abscess (2/6), and neurological deterioration (1/6). Severely immunosuppressed patients who begin HAART may reactivate or aggravate a mycobacterial disease such as tuberculosis. In such cases, current recommendations call for continuing HAART, beginning or continuing the antimycobacterial therapy, and considering corticosteroids on a case-by-case basis. For patients with AIDS, opportunistic infections that might be reactivated should be actively sought before HAART.


Predicting graft-versus-host disease.
Graft-versus-host disease (GVHD) is a serious complication that occurs after allogeneic bone marrow transplantation and contributes to transplant-related morbidity and mortality. Recent advances in the measurement of recipient-specific alloreactivity before marrow grafting have led to the development of in vitro assays that sufficiently predict the occurrence of moderate to severe acute GVHD. This predictive information provides the basis for attempts to minimize, or prevent, GVHD by prospective donor selection and individualized immunotherapeutic strategies.


Preparation of red cells coated with C4 and C3 subcomponents and production of anti-C4d and anti-C3d.
Methods of preparing red cells coated only with C4b, C3b or C3d have previously been described by others; the present observations supply further information about the optimal conditions for preparing such cells and also describe conditions for the operation of cells carrying only C4d. In addition, the preparation of specific anti-C4d and anti-C3d sera is described.


Executive functions and neurocognitive aging: dissociable patterns of brain activity.
Studies of neurocognitive aging report altered patterns of brain activity in older versus younger adults performing executive function tasks. We review the extant literature, using activation likelihood estimation meta-analytic methods, to compare age-related differences in the pattern of brain activity across studies examining 2 categories of tasks associated with executive control processing: working memory and inhibition. In a direct contrast of young and older adult activations, older adults engaged bilateral regions of dorsolateral prefrontal cortex as well as supplementary motor cortex and left inferior parietal lobule during working memory. In contrast, age-related changes during inhibitory control were observed in right inferior frontal gyrus and presupplementary motor area. Additionally, when we examined task-related differences within each age group we observed the predicted pattern of differentiated neural response in the younger subjects: lateral prefrontal cortex activity associated with working memory versus right anterior insula/frontal opercular activity associated with inhibition. This separation was largely maintained in older subjects. These data provide the first quantitative meta-analytic evidence that age-related patterns of functional brain change during executive functioning depend on the specific control process being challenged.


Quantitative deconvolution microscopy.
The light microscope is an essential tool for the study of cells, organelles, biomolecules, and subcellular dynamics. A paradox exists in microscopy whereby the higher the needed lateral resolution, the more the image is degraded by out-of-focus information. This creates a significant need to generate axial contrast whenever high lateral resolution is required. One strategy for generating contrast is to measure or model the optical properties of the microscope and to use that model to algorithmically reverse some of the consequences of high-resolution imaging. Deconvolution microscopy implements model-based methods to enable the full diffraction-limited resolution of the microscope to be exploited even in complex and living specimens.


From endosymbiosis to holobionts: Evaluating a conceptual legacy.
In her influential 1967 paper, Lynn Margulis synthesized a range of data to support the idea of endosymbiosis. Building on the success of this work, she applied the same methodology to promote the role of symbiosis more generally in evolution. As part of this broader project, she coined the term 'holobiont' to refer to a unified entity of symbiont and host. This concept is now applied with great gusto in microbiome research, and often implies not just a physiological unit but also various senses of an evolving system. My analysis will track how Margulis came to propose the term, its current use in microbiome research, and how those applications link back to Margulis. I then evaluate what contemporary use says about Margulis's legacy for microbiome research.


Geriatric health promotion goals for the year 2000 in the United States.
The United States undertakes the development of health objectives for 10-year cycles, covering the full range of federal health care delivery and policy. The goals for the cycle ending in the year 2000 have recently been announced.


Science, alchemy and light: paintings by Joseph Wright of Derby.
This article considers two paintings by the English painter, Joseph Wright of Derby (1734-97), 'An Experiment on a Bird in the Air Pump' and 'The Alchemist in Search of the Philosopher's Stone' as painterly reflections on the early industrial culture. Particularly interesting in the "Experiment on a Bird" is the broad spectrum of spectator's reactions to the experiment; this can be related to the contemporary debate on the contextualization of science.


Cerebrospinal fluid leakage after intradural spinal surgery in children.
This study aimed to establish the incidence of CSF leakage in children and associated complications after intradural spinal surgery in three tertiary neurosurgical referral centers and to describe the treatment strategies applied. Patients of 18 years or younger who underwent intradural spinal surgery between 2015 and 2021 in three tertiary neurosurgical referral centers were included. Patients who died or were lost to follow-up within six weeks after surgery were excluded. The primary outcome measure was CSF leakage within six weeks after surgery, defined as leakage of CSF through the skin. Secondary outcome measures included the presence of pseudomeningocele (PMC), meningitis, and surgical site infection (SSI). We included a total of 75 procedures, representing 66 individual patients. The median age in this cohort was 5 (IQR = 0-13 years. CSF leakage occurred in 2.7% (2/75) of procedures. It occurred on days 3 and 21 after the index procedure, respectively. One patient was treated with a pressure bandage and an external lumbar drain on day 4 after diagnosis of the leak, and the other was treated with wound revision surgery on day 1 after the leak occurred. In total, 1 patient developed a PMC without a CSF leak which was treated with wound revision surgery. SSI occurred in 10.7%, which included both cases of CSF leak. CSF leakage after intradural spinal surgery in the pediatric population is relatively rare (2.7%). Nevertheless, the clinical consequences with respect to secondary complications such as infection and the necessity for invasive treatment are serious.


Clostridium paraputrificum: An atypical and rare case of septic arthritis mimicking an acute sickle cell crisis.
Clostridium paraputrificum is an extremely rare species and constitutes only 1% of all clostridium infections in literature. Septic arthritis from Clostridium paraputrificum is even less documented, and currently there is only one known case report. Specifically, patients with sickle cell disease have a well-documented and increased susceptibility to infections with Salmonella, Streptococcus pneumoniae, Hemophilius influenzae, and Enterobacter-klebsiella. Clostridium infection in sickle cell patients has been less studied and described. Here we present a case of septic arthritis from Clostridium paraputrificum in a sickle cell disease patient likely provoked by underlying avascular necrosis of the right shoulder.


CK2 modulation of NF-kappaB, TP53, and the malignant phenotype in head and neck cancer by anti-CK2 oligonucleotides in vitro or in vivo via sub-50-nm nanocapsules.
The aim of this study is to investigate the expression of CK2 subunits and CK2 effects on NF-kappaB-mediated and TP53-mediated signal activation and gene expression, the malignant phenotype, and chemosensitivity in head and neck squamous cell carcinoma (HNSCC) in vitro and in vivo. Protein expression of CK2 subunits was investigated by Western blot and immunohistochemistry. CK2 subunits were knocked down by small interfering RNA, and NF-kappaB activation was examined using DNA binding, Western blot, and luciferase reporter assays. Gene expression was measured by quantitative reverse transcription-PCR. Cell growth, survival, motility, and sensitivity to cisplatin were measured by MTT, flow cytometry, and migration assays. In vivo targeting of CK2alpha/alpha' in HNSCC xenograft models was achieved using anti-CK2alpha/alpha' oligodeoxynucleotide encapsulated in sub-50-nm tenfibgen nanocapsules. CK2 subunit proteins were overexpressed in HNSCC lines and tissues. Knockdown of CK2 subunits differentially inhibited IkappaBalpha degradation, NF-kappaB nuclear localization, phosphorylation, DNA binding, and reporter activity. CK2 subunits modulated gene expression and the malignant phenotype involved in cell cycle and migration, whereas CK2alpha is critical to promote proliferation, antiapoptosis, and cisplatin resistance in vitro. Furthermore, in vivo delivery of anti-CK2alpha/alpha' oligodeoxynucleotide nanocapsules significantly suppressed tumor growth in HNSCC xenograft models, in association with modulation of CK2 and NF-kappaB regulated molecules, TP53 family proteins, and induction of apoptosis. Our study reveals a novel role of CK2 in coregulating NF-kappaB activation, TP53/p63 expression, and downstream gene expression. Downregulation of CK2 in HNSCC models in vitro and in vivo shows antitumor effects as well as sensitization to cisplatin.


Risk factors for antiplatelet drug-associated intracranial hemorrhage: a systematic review and meta-analysis.
Antiplatelet drug-associated intracranial hemorrhage has a high mortality rate, and many factors can cause antiplatelet drug-associated intracranial hemorrhage. Until now, systematic reviews and assessments of the certainty of the evidence have not been published. We conducted a systematic review to identify risk factors of antiplatelet drug-associated intracranial hemorrhage. The protocol for this systematic review was prospectively registered with PROSPERO (CRD42022311647). All studies written in English that met the inclusion criteria published before January 2022 were obtained from PubMed, EMBASE, Web of Science, and Cochrane Library. Two researchers independently screened articles, extracted data, and evaluated the quality and evidence of the included studies. Risk factors for antiplatelet drug-associated intracranial hemorrhage were used as the outcome index of this review. Random or fixed-effect models were used in statistical methods. I2 statistics were used to evaluate heterogeneity. Of 2844 citations, we included 6 studies in our analysis. For intracranial hemorrhage, moderate-certainty evidence showed a probable association with race, low BMI, GCS, severe bleeding, headache or vomiting, cerebrovascular disease, lacunar small vessel disease, cardiovascular disease, blood sugar, blood pressure, CT-defined white matter hypodensity, antihypertensive drugs, and antiplatelet therapy. In addition, we found low-certainty evidence that there may be little to no association between risk of intracranial hemorrhage and age, sex, and dual antithrombotic treatment or anticoagulant. CT-defined white matter hypodensity is not included in most intracranial hemorrhage risk assessment models. This study summarizes risk factors for antiplatelet drug-associated intracranial hemorrhage, which is significant in preventing intracranial hemorrhage.


Shoulder function and work disability after decompression surgery for subacromial impingement syndrome: a randomised controlled trial of physiotherapy exercises and occupational medical assistance.
Surgery for subacromial impingement syndrome is often performed in working age and postoperative physiotherapy exercises are widely used to help restore function. A recent Danish study showed that 10% of a nationwide cohort of patients retired prematurely within two years after surgery. Few studies have compared effects of different postoperative exercise programmes on shoulder function, and no studies have evaluated workplace-oriented interventions to reduce postoperative work disability. This study aims to evaluate the effectiveness of physiotherapy exercises and occupational medical assistance compared with usual care in improving shoulder function and reducing postoperative work disability after arthroscopic subacromial decompression. The study is a mainly pragmatic multicentre randomised controlled trial. The trial is embedded in a cohort study of shoulder patients referred to public departments of orthopaedic surgery in Central Denmark Region. Patients aged ≥18-≤63 years, who still have shoulder symptoms 8-12 weeks after surgery, constitute the study population. Around 130 participants are allocated to: 1) physiotherapy exercises, 2) occupational medical assistance, 3) physiotherapy exercises and occupational medical assistance, and 4) usual care. Intervention manuals allow individual tailoring. Primary outcome measures include Oxford Shoulder Score and sickness absence due to symptoms from the operated shoulder. Randomisation is computerised with allocation concealment by randomly permuted block sizes. Statistical analyses will primarily be performed according to the intention-to-treat principle. The paper presents the rationale, design, methods, and operational aspects of the Shoulder Intervention Project (SIP). SIP evaluates a new rehabilitation approach, where physiotherapy and occupational interventions are provided in continuity of surgical episodes of care. If successful, the project may serve as a model for rehabilitation of surgical shoulder patients. Current Controlled Trials ISRCTN55768749.


Neutrophil-inspired photothermo-responsive drug delivery system for targeted treatment of bacterial infection and endotoxins neutralization.
P. aeruginosa, a highly virulent Gram-negative bacterium, can cause severe nosocomial infections, and it has developed resistance against most antibiotics. New therapeutic strategies are urgently needed to treat such bacterial infection and reduce its toxicity caused by endotoxin (lipopolysaccharide, LPS). Neutrophils have been proven to be able to target inflammation site and neutrophil membrane receptors such as Toll-like receptor-4 (TLR4) and CD14, and exhibit specific affinity to LPS. However, antibacterial delivery system based on the unique properties of neutrophils has not been reported. A neutrophil-inspired antibacterial delivery system for targeted photothermal treatment, stimuli-responsive antibiotic release and endotoxin neutralization is reported in this study. Specifically, the photothermal reagent indocyanine green (ICG) and antibiotic rifampicin (RIF) are co-loaded into poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NP-ICG/RIF), followed by coating with neutrophil membrane to obtain antibacterial delivery system (NM-NP-ICG/RIF). The inflammation targeting properties, synergistic antibacterial activity of photothermal therapy and antibiotic treatment, and endotoxin neutralization have been studied in vitro. A P. aeruginosa-induced murine skin abscess infection model has been used to evaluate the therapeutic efficacy of the NM-NP-ICG/RIF. Once irradiated by near-infrared lasers, the heat generated by NP-ICG/RIF triggers the release of RIF and ICG, resulting in a synergistic chemo-photothermal antibacterial effect against P. aeruginosa (~ 99.99% killing efficiency in 5 min). After coating with neutrophil-like cell membrane vesicles (NMVs), the nanoparticles (NM-NP-ICG/RIF) specifically bind to inflammatory vascular endothelial cells in infectious site, endowing the nanoparticles with an infection microenvironment targeting function to enhance retention time. Importantly, it is discovered for the first time that NMVs-coated nanoparticles are able to neutralize endotoxins. The P. aeruginosa murine skin abscess infection model further demonstrates the in vivo therapeutic efficacy of NM-NP-ICG/RIF. The neutrophil-inspired antibacterial delivery system (NM-NP-ICG/RIF) is capable of targeting infection microenvironment, neutralizing endotoxin, and eradicating bacteria through a synergistic effect of photothermal therapy and antibiotic treatment. This drug delivery system made from FDA-approved compounds provides a promising approach to fighting against hard-to-treat bacterial infections.


Recombinant FVIIIFc Versus BAY 94-9027 for Treatment of Patients with Haemophilia A: Comparative Efficacy Using a Matching Adjusted Indirect Comparison.
Prophylaxis with recombinant factor VIII (rFVIII) is the current standard of care for haemophilia A. Several approaches have been used to extend the half-life of rFVIII to improve prophylaxis outcomes. An indirect comparison of pivotal clinical trial data was performed to evaluate the relative efficacy of two extended half-life therapies approved for the prophylactic treatment of haemophilia A: recombinant FVIII-IgG1 Fc domain fusion protein (rFVIIIFc) and pegylated rFVIII (BAY 94-9027). Matching-adjusted indirect comparison (MAIC) was conducted to compare the rFVIIIFc individualised prophylaxis arm of the A-LONG phase III clinical trial (n = 117) and the BAY 94-9027 approved dosing regimens of the PROTECT VIII phase II/III study (n = 110). Following matching for baseline characteristics, mean annualised bleeding rate (ABR) and the proportion of patients with zero bleeds were compared for rFVIIIFc and BAY 94-9027. Additional supportive analyses comparing rFVIIIFc individualised prophylaxis and the individual prophylaxis regimens included in the PROTECT VIII group (twice weekly, and every 5 and 7 days [Q5D and Q7D]) were conducted. Mean ABR was lower in the rFVIIIFc individualised prophylaxis group versus the BAY 94-9027 pooled prophylaxis population (3.0 versus 4.9), providing a clinically relevant and statistically significant difference (mean difference [MD] - 1.9; 95% confidence interval [CI] - 3.5 to - 0.4). A statistically significant difference in ABR was also observed for rFVIIIFc compared with BAY 94-9027 Q7D (3.2 versus 6.4; MD - 3.3; 95% CI - 6.4 to - 0.2). The difference in the proportion of patients with zero bleeds between rFVIIIFc (46.5%) and BAY 94-9027 pooled prophylaxis population (38.2%) was not statistically significant (odds ratio 1.4; 95% CI 0.8 to 2.5). This indirect treatment comparison indicates a statistically significant and clinically relevant difference in ABR favouring individualised prophylaxis with rFVIIIFc versus BAY 94-9027 prophylaxis. The proportion of patients with zero bleeds was numerically greater with rFVIIIFc treatment but did not achieve statistical significance.


Isoniazid Preventive Therapy and Pregnancy Outcomes in Women Living With Human Immunodeficiency Virus in the Tshepiso Cohort.
Both pregnancy and human immunodeficiency virus (HIV) increase the risk of tuberculosis disease, which results in poor maternal, pregnancy, and infant outcomes. Isoniazid preventive therapy (IPT) reduces mortality among individuals living with HIV in high-burden settings but has recently been associated with adverse pregnancy outcomes when initiated during pregnancy. In this secondary analysis, we used multivariable logistic regression to evaluate the association between IPT exposure and adverse pregnancy outcomes (fetal demise, prematurity, low birth weight, congenital anomaly) in pregnant women living with HIV enrolled as controls in the Tshepiso study, a prospective observational cohort of pregnant women living with HIV with and without tuberculosis disease in Soweto, South Africa, from 2011-2014. There were 151 women enrolled with known pregnancy outcomes; 69 (46%) reported IPT initiation during pregnancy. Of the 69 IPT-exposed women, 11 (16%) had an adverse pregnancy outcome compared with 23 (28%) IPT-unexposed women. The adjusted odds of having an adverse pregnancy outcome was 2.5 (95% confidence interval, 1.0-6.5; P = .048) times higher in IPT-unexposed women compared with IPT-exposed women after controlling for maternal age, CD4 count, viral load, antiretroviral regimen, body mass index, and anemia. IPT exposure during pregnancy was not negatively associated with pregnancy outcomes after controlling for demographic, clinical, and HIV-related factors. These results provide some reassurance that IPT can be safely used in the second or third trimester of pregnancy. Additional research is needed to evaluate the safety of IPT and new short-course tuberculosis preventive therapies during pregnancy.


Quantification of dynamic EMG patterns during gait in children with cerebral palsy.
Our goal was to simplify the representation and interpretation of surface electromyographic (EMG) activity during gait to develop a clinical method for evaluating gait disabilities in children with cerebral palsy (CP). EMG was recorded from four muscles of a lower extremity. Gait cycles were tracked from one force-sensing resistor signal that was recorded synchronously with EMG. The method is based on the comparison of a patient's dynamic EMG envelope shapes and the normative gait-related patterns (norms). Developed norms were based on EMG data obtained in 10 healthy children. Due to newly introduced techniques for time and amplitude normalization, norms were developed regardless of differences in subject age, gender, basic gait parameters and the EMG measurement process. The proposed gait metric quantifies the similarity between a patient's gait-related patterns and norms by a single global value suitable for gait analysis in general, including a detailed analysis using the 10 partial values. The gait metric was experimentally validated with a control group of healthy children and a group of children with CP with different degrees of motor deficits. Gait metric values obtained in children from the control group are high for all muscles, which means that gait-related patterns are close to norms, whereas in children with CP the higher the degree of motor deficit, the lower the gait metric values. The method could be a very useful clinical tool for the recognition and tracking of motor disorders of the lower extremities in children with CP as well as many other neuromotor pathologies.


Neurobehavioral performance in preschool children from agricultural and non-agricultural communities in Oregon and North Carolina.
Organophosphate (OP) pesticides produce acute toxic effects but little is known about low-level chronic exposures. Latino children of agricultural workers have a high risk of exposure to pesticides because of the close proximity of their homes to fields where pesticides are applied and from take-home exposure. Neurobehavioral performance of preschool children from agricultural (AG) communities was compared to performance of those from non-agricultural (Non-AG) communities in Oregon and North Carolina. Seventy-eight children aged 48-71 months completed a battery of neurobehavioral tests two times, approximately 1 month apart. Multiple regression revealed that the AG children performed poorer on measures of response speed (Finger Tapping) and latency (Match-to-Sample) compared to the Non-AG children. These results demonstrate modest differences in AG children compared to Non-AG children that are consistent with functional effects seen in adults exposed to low concentrations of OP pesticides. Just as was the case following early research on adults poisoned by pesticides, this study points to the need for additional investigations to test the hypothesis that low-concentration OP exposures affect acquisition of test performance, response speed and latency in children of agricultural workers.


Significant changes in impedance planimetry (EndoFLIP™) measurements after peroral pyloromyotomy for delayed gastric emptying.
The endoluminal functional lumen imaging probe (FLIP) can be used to obtain real-time measurements of the diameter (Dmin), cross-sectional area (CSA), and distensibility of the pylorus before and after peroral pyloromyotomy (POP), an emerging endoscopic treatment for delayed gastric emptying. Our study aims to report our single-center experience in performing POP with FLIP measurements before and after pyloromyotomy. A retrospective review of a prospectively maintained gastroesophageal database was performed. Demographic and perioperative data, including intraoperative FLIP measurements of the pylorus before and after POP, were analyzed. Measurements were compared using paired t tests. Thirty-four patients underwent POP between February 2017 and July 2020. Twenty-three (67.7%) patients were male and the average age was 59 years. The etiology of delayed gastric emptying was post-vagotomy in 22 patients, idiopathic gastroparesis in 7 patients, and diabetic gastroparesis in 5 patients. There were no significant differences in pre-myotomy or post-myotomy FLIP measurements when comparing the post-vagotomy versus the gastroparesis groups. There were significant increases in Dmin, CSA, and distensibility index when comparing pre-myotomy and post-myotomy readings for all patients (all p < 0.001). At follow-up, 64.7% of patients reported resolution of all symptoms. POP is an effective intervention in patients with delayed gastric emptying. Significant changes in FLIP measurements before and after POP suggest that FLIP may be a useful adjunct in guiding the management of delayed gastric emptying.


Anisakiasis of the colon: report of two cases with emphasis on the diagnostic and therapeutic value of colonoscopy.
Anisakiasis of the colon is a rare entity as compared with gastric anisakiasis, and its diagnosis is very difficult. We present here two cases--a 42-year-old woman and a 30-year-old woman--of anisakiasis of the colon treated by colonoscopic removal of the worm without surgery. The importance of colonoscopy for the diagnosis and treatment of this disease is briefly discussed.


Application of PCR for detection and identification of mycoplasma contamination in virus stocks.
A nested polymerase chain reaction (PCR) was used to detect and identify mycoplasma contaminants in viral stocks. The results of the PCR assay proved to be a sensitive and accurate indicator of the true status of the stock tested. Those samples positive by agar culture or Hoechst stain were also positive by PCR. Those samples that were inconclusive by Hoechst stain (10.05%) could be clearly determined to be mycoplasma positive or negative by PCR. The PCR assay also detected those fastidious species of mycoplasma that gave false negative results by the direct culture method. In many respects the PCR-based mycoplasma detection method described is superior to the agar culture and Hoechst staining detection methods. In this study, the PCR assay detected substantially more mycoplasma-positive viral stocks than did the agar culture assay. Due to its speed, sensitivity, and reliability, the PCR assay is of particular value in monitoring the process of removing mycoplasma from contaminated stocks. Furthermore, the PCR amplification products can be analyzed by restriction analysis to rapidly identify the species of the mycoplasma contaminating the stock tested.


Caregivers' Grit Moderates the Relationship Between Children's Executive Function and Aggression.
Previous studies have shown that the impairment of executive function is positively related to aggression in children and adolescents. What is worth investigating is the moderator of such a relationship so that aggressive behavior can be reduced effectively in those who have executive function problems. The present study examined the association between executive function and two major subtypes of aggression (proactive and reactive aggression) and whether their caregivers' grit (perseverance) moderated such relationship. Executive function and reactive and proactive aggression were assessed in 254 children and adolescents aged 8-19 years old, and their caregivers' grit was measured. Results show that caregivers' grit plays a significant role in moderating the relationship between children's executive function and proactive aggression after controlling for the covariates including the children's age, gender, and family income. Specifically, children's executive function became more negatively associated with proactive aggression when caregivers' grit was high while the association was positive when it was low. On the other hand, the association between children's executive function and reactive aggression did not vary across different levels of caregivers' grit. These findings suggest that proactive aggression may be reduced in those who have better executive function by enhancing their caregivers' grit, which inform the design of interventions in adjunct with the current approach (e.g., executive function training) to reduce aggression in children and adolescents in the community.


Do associations between suicide ideation and its correlates (substance use, anxiety, and depression) differ according to victimization type among youth? A Smart platform study.
The issues associated with mental health, substance misuse, and suicide ideation are complex and sensitive among youth. We sought to investigate the role that subjective health, internalizing and externalizing risk factors play in the association between victimization and suicide ideation among youth in Canada via used a custom-built digital epidemiological smartphone application (Smart Platform) on their personal smartphones. A sample of 818 youth citizen scientists in Saskatchewan, Canada downloaded the app to provide information on victimization, subjective health, internalizing problems (symptoms of stress, anxiety, and depression), externalizing behaviours (cannabis use, alcohol, smoking), and suicide ideation. Binary regression models were used to estimate associations and controlled for gender, age, perpetration, and ethnicity. From our sample, 23% of youth reported suicide ideation (i.e., thoughts) in the past year. Three types of victimization (cyberbullied, made fun or teased, or bullied via being left out) are associated with a two-times higher risk of suicide ideation. Although certain risk factors (anxiety, poor subjective health, and cannabis use) were associated with higher suicide ideation risk, they did not moderate the association between victimization and suicide ideation. Symptoms of depression were found to be protective against suicide ideation. Suicide ideation is high among this sample of youth in Canada. Certain types of victimization, internalizing and externalizing risk factors, and poor subjective health are associated with a higher risk of suicide ideation. However, our findings confirm that the pathway from victimization to suicide ideation is complex and is potentially moderated by factors other than the ones explored here.


Shen-Shuai-Ling Formulation Attenuates Renal Interstitial Fibrosis in Chronic Kidney Disease by Regulating SHH-Gli1 Signaling Pathway.
Shen-Shuai-Ling Formulation (SSLF) has apparent effects on improving renal function, delaying the progression of chronic kidney disease (CKD). Fifty male SD rats were randomly divided into 5 groups: Sham group, Model group, SSLF group, CPN group, and C + S group. The morphological changes and the collagen fibers of the rat kidneys were observed by HE staining. The expression of α-SMA, Col I, SHH, Gli1, and snail1 was detected by Western blot and qPCR. Then, the cells were divided into the control group, SHH group, and SHH + SSLF serum group. Compared with the Model group, the fibrosis in SSLF, CPN, and C + S groups was significantly alleviated. And, compared with those in the Model group, the expression of α-SMA, Col I, SHH, Gli1, Snail in SSLF, CPN, and C + S groups decreased remarkably. SSLF remarkably improves renal function and alleviates renal interstitial fibrosis in UUO rats.