Calcium hydroxide as an intracanal medication for postoperative pain during primary root canal therapy: A systematic review and meta-analysis with trial sequential analysis of randomised controlled trials.
To evaluate the effectiveness of CH as an intracanal medicament compared to no dressing and / or other intracanal medicaments to control postoperative pain in patients with apical periodontitis requiring primary root canal therapy. We conducted electronic searches in PubMed, EMBASE, Scopus and Cochrane Library, Open Gray, and Google Scholar. A structured Population-Intervention-Comparison-Outcome of the review was as follows: Population: adults who presented with apical periodontitis requiring primary root canal therapy; Intervention: CH intracanal medicament; Comparison: no dressing/other intracanal medicaments; Main Outcome: Postoperative pain. We assessed the risk of bias using Cochrane criteria. Our outcome measures were intensity of pain on a validated scale reported as mean and standard deviation. We performed meta-analysis using the random-effects model. We rated the quality of evidence using GRADE. We included 18 studies with 1192 participants. The overall risk of bias was moderate. We found a significant improvement in postoperative pain at 24 hours in favor of CH over no intracanal medication (4 trials, n = 226: standardised mean difference: -0.71; [95% confidence interval: -1.38, -0.03]; P = .04; I2= 78%; moderate certainty evidence). Ledermix (Lederle Germany) (steroid-antibiotic) and chlorhexidine were significantly more effective than CH for controlling pain at 72 hours postprocedure (low certainty evidence). Silver nanoparticles were more effective than CH at 6 and 24 hours and combinations of CH with dexamethasone or lidocaine HCl were significantly more effective than CH alone at improving postoperative pain. Substantial heterogeneity limits the robustness of findings. Limited evidence suggests that CH may be an effective intracanal medicament for controlling interappointment pain. Combination therapies appear to be more effective than using CH alone. Further research assessing the comparative effectiveness of interventions for managing postoperative pain following root canal therapy is warranted.


Studies of inactivation of encephalomyocarditis virus, M13 bacteriophage, and Salmonella typhimurium by using a visible femtosecond laser: insight into the possible inactivation mechanisms.
We report experimental results on the inactivation of encephalomyocarditis virus, M13 bacteriophage, and Salmonella typhimurium by a visible femtosecond laser. Our results suggest that inactivation of virus and bacterium by a visible femtosecond laser involves completely different mechanisms. Inactivation of viruses by a visible femtosecond laser involves the breaking of hydrogen∕hydrophobic bonds or the separation of the weak protein links in the protein shell of a viral particle. In contrast, inactivation of bacteria is related to the damage of their DNAs due to irradiation of a visible femtosecond laser. Possible mechanisms for the inactivation of viruses and bacteria are discussed.


QUANTITATIVE GENETICS OF HETEROCHRONY.
A model of quantitative-genetic variation in developmental processes is introduced and analyzed. The model is of a bifurcating sequence of events in which traits develop from the same tissue until a transition occurs, after which they develop partially independently. Genetic and environmental variation in both the rates of tissue growth and in the timing of transitions is considered. The model shows how genetic variation in developmental parameters governs variation and covariation in phenotypic traits and how selection on the phenotype alters the distributions of developmental parameters. Particular attention is paid to the conditions under which selection will lead to changes in the average times of developmental events.


Effects of ultrahigh dilutions of 3,5-dichlorophenol on the luminescence of the bacterium Vibrio fischeri.
There is a great need for research in the field of homeopathy for laboratory test systems to investigate the actions of ultrahighly diluted biological effectors. With this in mind, we used the luminescent bacterium Vibrio fischeri, which is used throughout the world in testing water quality. Luminescence inhibition is utilized as a test parameter for the toxicity of a sample. We used ultrahigh dilutions (UHD) of 3,5-dichlorophenol as effector and adapted the standard test procedure for water toxicity in a way that let us evaluate very minute effects. Three groups of samples were prepared and then blinded: 45 dilutions of 3,5-dichlorophenol in steps of 10, starting with 4.2 x 10(-2) M, with vigorous shaking between dilution steps; 45 identical dilutions of 3,5-dichlorophenol without vigorous shaking; and 49 control samples of the diluent. The results of, and the discussion based on, a thorough statistical analysis led to the conclusion that an effect based on UHD, which results in an inhibition of luminescence of less than 1.5%, can be confirmed for some of the potency samples. There were both effective and ineffective samples in the three sample groups. The size of the effect was very small (ca. 1.5%), though statistically significant. The number of effective samples was significantly higher among the vigorously shaken samples than among the controls and the unshaken samples (14, 6 and 7 effective samples, respectively).


Mitophagy controls beige adipocyte maintenance through a Parkin-dependent and UCP1-independent mechanism.
Beige adipocytes are an inducible form of mitochondria-enriched thermogenic adipocytes that emerge in response to external stimuli, such as chronic cold exposure. We have previously shown that after the withdrawal of external stimuli, beige adipocytes directly acquire a white fat-like phenotype through autophagy-mediated mitochondrial degradation. We investigated the upstream pathway that mediates mitochondrial clearance and report that Parkin-mediated mitophagy plays a key role in the beige-to-white adipocyte transition. Mice genetically deficient in Park2 showed reduced mitochondrial degradation and retained thermogenic beige adipocytes even after the withdrawal of external stimuli. Norepinephrine signaling through the PKA pathway inhibited the recruitment of Parkin protein to mitochondria in beige adipocytes. However, mitochondrial proton uncoupling by uncoupling protein 1 (UCP1) was dispensable for Parkin recruitment and beige adipocyte maintenance. These results suggest a physiological mechanism by which external cues control mitochondrial homeostasis in thermogenic fat cells through mitophagy.


Entropy generation in MHD Casson fluid flow with variable heat conductance and thermal conductivity over non-linear bi-directional stretching surface.
This consideration highlights the belongings of momentum, entropy generation, species and thermal dissemination on boundary layer flow (BLF) of Casson liquid over a linearly elongating surface considering radiation and Joule heating effects significant. Transportation of thermal and species are offered by using the temperature-dependent models of thermal conductivity and mass diffusion coefficient. Arising problem appear in the form of nonlinear partial differential equations (NPDEs) against the conservation laws of mass, momentum, thermal and species transportation. Appropriate renovation transfigures the demonstrated problem into ordinary differential equations. Numerical solutions of renovated boundary layer ordinary differential equations (ODEs) are attained by a proficient and reliable technique namely optimal homotopy analysis method (OHAM). A graphical and tabular interpretation is given for convergence of analytic solutions through error table and flow behavior of convoluted physical parameters on calculated solutions are presented and explicated in this examination. Reliability and effectiveness of the anticipated algorithm is established by comparing the results of present contemplation as a limiting case of available work, and it is found to be in excellent settlement. Decline in fluid velocity and enhancement in thermal and species transportation is recorded against the fluctuating values of Hartman number. Also reverse comportment of Prandtl number and radiation parameter is portrayed. Moreover, it is conveyed that supplementing values of the magnetic parameter condenses the fluid velocity and upsurges the thermal and concentration distributions. Negative impact of elevating Joule heating phenomenon is noted on the molecular stability of the system via Brinkman number [Formula: see text] Furthermore, the system's stability at a molecular level is controlled by diminishing values of radiation [Formula: see text] temperature difference [Formula: see text] concentration difference [Formula: see text] diffusion parameters [Formula: see text] and Brinkman number [Formula: see text].


Convolutional Neural Networks for the evaluation of cancer in Barrett's esophagus: Explainable AI to lighten up the black-box.
Even though artificial intelligence and machine learning have demonstrated remarkable performances in medical image computing, their level of accountability and transparency must be provided in such evaluations. The reliability related to machine learning predictions must be explained and interpreted, especially if diagnosis support is addressed. For this task, the black-box nature of deep learning techniques must be lightened up to transfer its promising results into clinical practice. Hence, we aim to investigate the use of explainable artificial intelligence techniques to quantitatively highlight discriminative regions during the classification of early-cancerous tissues in Barrett's esophagus-diagnosed patients. Four Convolutional Neural Network models (AlexNet, SqueezeNet, ResNet50, and VGG16) were analyzed using five different interpretation techniques (saliency, guided backpropagation, integrated gradients, input × gradients, and DeepLIFT) to compare their agreement with experts' previous annotations of cancerous tissue. We could show that saliency attributes match best with the manual experts' delineations. Moreover, there is moderate to high correlation between the sensitivity of a model and the human-and-computer agreement. The results also lightened that the higher the model's sensitivity, the stronger the correlation of human and computational segmentation agreement. We observed a relevant relation between computational learning and experts' insights, demonstrating how human knowledge may influence the correct computational learning.


Case Report: Discovery a Novel SARS-CoV-2 Variant in a Six-Months Long-Term Swab Positive Female Suffering From Non-Hodgkin Lymphoma.
We report the case of a woman with non-Hodgkin lymphoma who remained positive on the molecular assay for SARS-CoV-2 for six months: she has never experienced a severe form of COVID-19 although in absence of seroconversion. The whole SARS-CoV-2 genome analysis was performed by the CleanPlex SARS-CoV-2 Research and Surveillance NGS Panel (PARAGON GENOMICS, Hayward, USA). We found twenty-two mutations in SARS-CoV-2 genome and a novel deleterious ORF3a frameshift c.766_769del corresponding to a unique and novel lineage. The region affected by this frameshift variant is reported as being important in determining SARS-CoV-2 immunogenicity. Patient's immunophenotype showed the absence of B lymphocytes and significantly reduced T-cell count. Only after the treatment with hyperimmune plasma she finally became negative on the swab. Our findings could be helpful in the management of patients with immunodeficiency, particularly when novel variants, potentially altering the virus immune response, are present.


Dose titration of sacubitril/valsartan for heart failure with reduced ejection fraction: a real-world study.
The study aims to explore the real-world titration patterns of sacubitril/valsartan in a chronic heart failure (HF) follow-up management system and the effect on the recovery of ventricular remodelling and cardiac function in China. This is a single-centre, observational study of 153 adult outpatients with HF and reduced ejection fraction who were managed in the chronic HF follow-up management system and prescribed with sacubitril/valsartan from August 2017 to August 2021 in China. All patients tried to titrated sacubitril/valsartan to the tolerant dose during follow-up. The primary outcome was the proportion of patients who reached and maintained the target dose of sacubitril/valsartan. The main secondary outcomes were the changes in left atrium diameter, left ventricular end-diastolic diameter (LVEDD), and left ventricular ejection fraction (LVEF) from baseline to 12 months. Among the patients, 69.3% were male, with a median age of 49 years. The baseline systolic blood pressure (SBP) was 117.6 ± 18.3 mmHg before starting the treatment of sacubitril/valsartan. Benefiting from the management system, 117 (76.5%) patients achieved the target dose of sacubitril/valsartan, and the median time to reach the target dose was 3 (IQR 1-5) months. Advanced age and lower SBP may be predictors of failure to reach the target dose. Compared with baseline, standard treatment resulted in a pronounced improvement in left ventricular geometry and cardiac function. The patients showed a significant increase in LVEF [28 (IQR 21-34) % vs. 42 (IQR 37.0-54.3) %, P < 0.001], with a great reduction in left atrium diameter [45 (IQR 40.3-51.0) mm vs. 41 (IQR 37.0-45.3) mm, P < 0.001] and LVEDD [65 (IQR 60.0-70.3) mm vs. 55 (IQR 52-62) mm, P < 0.001] during 12 month follow-up. Of patients, 36.5% had a LVEF ≥50%, 54.1% had LVEF >40%, and 81.1% experienced an increase in LVEF of ≥10%. After 12 month follow-up, the proportion of patients with New York Heart Association classification I or II increased from 41.8% to 96.4%. Additionally, there was a significant improvement in N-terminal pro-B-type natriuretic peptide (P < 0.001). At Month 12, 50% of patients achieved the target dose of beta-blockers. No serious adverse events caused by sacubitril/valsartan were observed during the follow-up. Optimising HF follow-up management was essential and effective in a real-world clinical setting; the majority could reach the target dose of sacubitril/valsartan within the management system and achieve a remarkable improvement in cardiac function and ventricular remodelling.


Capillary electrochromatographic study of the interactions of porphyrin derivatives with amino acids and oligopeptides.
Open-tubular capillary electrochromatography (OT-CEC) was used to study the interactions of synthetic (metallo)porphyrin derivatives (immobilized by physical adsorption to the fused-silica capillary wall) with three aromatic amino acids (phenylalanine, tyrosine, tryptophan), three aliphatic amino acids (beta-alanine, proline, valine) and two oligopeptides (diglycine, triglycine). The effective mobilities of amino acids and peptides measured in OT-CEC mode in the acid and alkaline background electrolytes (BGEs) were compared with those obtained by capillary zone electrophoresis (CZE) in the bare fused-silica capillary in the same BGEs. In this way the influence of the peripheral substituents and the character of the central metal atom in porphyrin derivatives on the interactions with amino acids and peptides in the acid and alkaline media was investigated. Three types of noncovalent interactions, axial ligation to the central metal atom, pi-pi stacking and electrostatic repulsion seem to take part in the interactions of analyzed amino acids and peptides with porphyrin derivatives, resulting in a better separation of these analytes by OT-CEC than by CZE.


The effect of heteroplasmy on cytoplasmic incompatibility in transplasmic lines of Drosophila simulans showing a complete replacement of the mitochondrial DNA.
Unidirectional cytoplasmic incompatibility has been observed in crosses between different strains of Drosophila simulans when the males, but not the females, involved in the crosses are infected with intracellular rickettsia-like microorganisms. In contrast to what is known about this system an unexpected partial incompatibility has been observed between two infected strains. Transplasmic lines have been constructed in the laboratory to investigate this phenomenon. The injection of a foreign infected cytoplasm into a strain which apparently shows the same kind of bacterial infection causes an incompatibility in crosses between injected heteroplasmic males, but not injected females, of the same strain. These findings suggest that several crossing types exist within the Drosophila simulans incompatibility system. The complete replacement of the original mitochondrial DNA observed in some of the transplasmic lines made it possible to analyse and exclude any link between incompatibility and mitochondrial genomes.


Findings from recent studies by the Japan Aerospace Exploration Agency examining musculoskeletal atrophy in space and on Earth.
The musculoskeletal system provides the body with correct posture, support, stability, and mobility. It is composed of the bones, muscles, cartilage, tendons, ligaments, joints, and other connective tissues. Without effective countermeasures, prolonged spaceflight under microgravity results in marked muscle and bone atrophy. The molecular and physiological mechanisms of this atrophy under unloaded conditions are gradually being revealed through spaceflight experiments conducted by the Japan Aerospace Exploration Agency using a variety of model organisms, including both aquatic and terrestrial animals, and terrestrial experiments conducted under the Living in Space project of the Japan Ministry of Education, Culture, Sports, Science, and Technology. Increasing our knowledge in this field will lead not only to an understanding of how to prevent muscle and bone atrophy in humans undergoing long-term space voyages but also to an understanding of countermeasures against age-related locomotive syndrome in the elderly.


Are major depression and generalized anxiety disorder associated with intrauterine growth restriction in pregnant women? A case-control study.
This study examined the prevalence of major depression and generalized anxiety disorder in pregnant women with and without a diagnosis of intrauterine growth restriction (IUGR). The study sample included 56 pregnant women with a diagnosis of IUGR and 92 control subjects. IUGR was determined by means of ultrasound assessment and was defined as estimated fetal weight, by ultrasound scan, which falls below the 10th percentile for the gestational age. Psychiatric evaluations were performed with depression and anxiety symptom scales and with structured clinical interviews. Pregnant women with IUGR had higher scores of depressive and anxiety symptom scores and had a higher prevalence rate of major depression and generalized anxiety disorder. According to the results of the present study, both major depression and generalized anxiety disorder appear to be associated with IUGR in pregnant women.


Syntheses of depsipeptide analogues of the insect neuropeptide proctolin.
Four depsipeptide analogues of the insect neuropeptide proctolin (H-Arg-Tyr-Leu-Pro-Thr-OH) have been prepared, containing a single ester linkage between Arg(1) and Tyr(2), Tyr(2) and Leu(3), and between Pro(4) and Thr(5), respectively. A didepsipentapeptide containing an ester linkage between Tyr(2) and Leu(3) and between Pro(4) and Thr(5), has also been prepared. The depsipeptide 4 is the first example of a backbone-modified proctolin analogue which shows full myotropic activity.


Quantifying injury severity for traumatic brain injury with routinely collected health data.
Routinely collected health data (RCHD) offers many opportunities for traumatic brain injury (TBI) research, in which injury severity is an important factor. The use of clinical injury severity indices in a context of RCHD is explored, as are alternative measures created for this specific purpose. To identify useful scales for full body injury severity and TBI severity this study focuses on their performance in predicting these currently used indices, while accounting for age and comorbidities. This study utilized an extensive population-based RCHD dataset consisting of all patients with TBI admitted to any Belgian hospital in 2016. Full body injury severity is scored based on the (New) Injury Severity Score ((N)ISS) and the ICD-based Injury Severity Score (ICISS). For TBI specifically, the Abbreviated Injury Scale (AIS) Head, Loss of Consciousness and the ICD-based Injury Severity Score for TBI injuries (ICISS) were used in the analysis. These scales were used to predict three outcome variables strongly related to injury severity: in-hospital death, admission to intensive care and length of hospital stay. For the prediction logistic regressions of the different injury severity scales and TBI severity indices were used, and error rates and the area under the receiver operating curve were evaluated visually. In general, the ICISS had the best predictive performance (error rate between 0.06 and 0.23; AUC between 0.82 [0.81;0.83] and 0.86 [0.85;0.86]). A clearly increasing error rate can be noticed with advancing age and accumulating comorbidity. Both for full body injury severity and TBI severity, the ICISS tends to outperform other scales. It is therefore the preferred scale for use in research on TBI in the context of RCHD. In their current form, the severity scales are not suitable for use in older populations.


Some problems with pro-competition reforms.
As the search for effective cost-containment policies continues, health care reform along pro-competition lines has gained considerable backing in the United States. By offering market competition to achieve allocational efficiency and vouchers and tax credits to achieve distributional equity, pro-competition reforms appear to satisfy what many believed were incommensurable goals. A critical review of this strategy reveals two practical difficulties, however. The first concerns the ambiguity arising from the proposals' reliance on the concept of equal access to some basic level of health care as its distributional objective and the second concerns the ethical dilemma arising from the proposals' reliance on physicians as rationers of health care. In considering the distributional goal of guaranteeing access to a basic minimum of health care, we argue that, despite its theoretical attractiveness, there exists no acceptable way of determining or justifying its content, and without a clear definition of the basic minimum there is no guarantee that any equity objective will be achieved under the pro-competition strategy. With regard to the use of physicians and other providers as society's gatekeepers, we point out that this role is in direct conflict with traditional responsibilities that patients expect providers to assume. Requiring doctors to ration services in response to market incentives may further erode the trust relationship between physicians and patients, and clearly puts the more seriously ill at a disadvantage.


Biochemical characterization of hepatic microsomal leukotriene B4 hydroxylases.
omega-Hydroxylation of leukotriene B4 (LTB4) has been reported in human and rodent polymorphonuclear leukocytes; preliminary information indicates that this metabolism is cytochrome P-450 dependent. Therefore, these studies were initiated to characterize the cytochrome P-450-dependent metabolism of LTB4 in other tissues. LTB4 was metabolized by rat hepatic microsomes to two products, 20-hydroxy(omega)-LTB4 and 19-hydroxy(omega-1)-LTB4. The formation of these metabolites was both oxygen and NADPH dependent indicating that a monooxygenase(s) was responsible for these reactions. The apparent Km and Vmax for LTB4 omega-hydroxylase were 40.28 microM and 1202 pmol/min/mg of protein, respectively. In contrast, the apparent Km and Vmax for LTB4 (omega-1)-hydroxylase were 61.52 microM and 73.50 pmol/min/mg of protein, respectively. Both LTB4 omega- and (omega-1)-hydroxylases were inhibited by metyrapone in a concentration-dependent fashion. However, SK&F 525A inhibited LTB4 (omega-1)- but not omega-hydroxylase. In contrast, alpha-naphthoflavone decreased LTB4 omega- but not (omega-1)-hydroxylase activities. The differences in the Km apparent for substrate as well as the differential inhibition by inhibitors of cytochrome P-450 suggest that the omega- and (omega-1)-hydroxylations of LTB4 in hepatic microsomes are mediated by different isozymes of P-450. Furthermore, several additional characteristics of LTB4 hydroxylases indicate that these isozymes of P-450 may be different from those which catalyze similar reactions on medium-chain fatty acids, such as laurate and prostaglandins.


Adrenocortical carcinoma with intracaval extension.
We describe the presenting features, treatment approach and prognosis of adrenocortical carcinoma with intracaval extension of tumor thrombus. In addition to 3 patients with adrenocortical carcinoma associated tumor thrombus treated at our institution, we reviewed an additional 26 patients described in the literature from 1972 to 1997 with regard to presentation, management and outcome. We identified 23 female and 6 male patients 6 to 77 years old (mean age 41.3). Of the lesions 24 originated in the right adrenal gland. Mean tumor size was 10.1 cm. and 89% of lesions were at least 9 cm. in greatest dimension. Tumor thrombus extended to the atrium in 15 patients, retrohepatic cava in 7 and subhepatic cava in 7. Flank or abdominal discomfort was the most common presenting complaint and abnormal steroid metabolism was documented in 76% of patients. Cardiac bypass techniques were used in 14 patients and none of the 3 intraoperative mortalities, 2 thromboemboli and 1 exsanguination, occurred using this approach. Eight patients received postoperative mitotane, 6 of whom had no evidence of residual disease at the time of case description. All patients with large adrenal tumors, especially those arising from the right gland, should undergo careful evaluation of the vena cava for thrombus. The best chance for survival is via complete surgical extirpation which is facilitated by the use of cardiac bypass techniques. There is evidence to support the early use of postoperative mitotane if there is a suspicion of residual or recurrent disease.


[Microflora of spiruline preparations].
A study, by direct microscopic examination and cultures, shows that the microflore which accompanies the spirulines preparations, varies as the origin and the technologie treatment quality. The main species are bacillacees; then, come faecal streptococcus which are the best contaminations indicators; enterobacteries, yeasts, moulds spores, are exceptional. Dry products as getting old, entail a great decrease of all the species, the anaerobies being more resistant.


Phosphorylated eIF2α predicts disease-free survival in triple-negative breast cancer patients.
Phosphorylated eukaryotic translation initiation factor 2α (p-eIF2α), which functions as a marker of endoplasmic reticulum stress, has been reported to be associated with patient prognosis in various cancers. However, little is known about the prognostic value of p-eIF2α in breast cancer, particularly in different breast cancer subtypes. An immunohistochemistry screen for p-eIF2α was performed using a tissue microarray containing 233 tumors and paired peritumoral tissues from female patients diagnosed with breast cancer. The staining results were scored semiquantitatively, and the p-eIF2α expression level in breast cancer and its potential prognostic value were investigated. In this retrospective cohort study, we found that p-eIF2α levels were significantly upregulated in breast cancer (P < 0.001). p-eIF2α level was negatively correlated with lymph node status (P = 0.039). Survival analysis by Kaplan-Meier estimation and Cox regression showed that p-eIF2α level was correlated with better disease free survival (P = 0.026) and served as an independent prognostic factor (P = 0.046) in patients with triple-negative breast cancer. Our study revealed that p-eIF2α was upregulated in breast cancer and represented a novel predictor of prognosis in patients with triple-negative subtype.


Endothelial cells and coagulation.
Endothelial cells form a monolayer, which lines blood vessels. They are crucially involved in maintaining blood fluidity and providing controlled vascular hemostasis at sites of injury. Thereby endothelial cells facilitate multiple mechanisms, including both procoagulant and anticoagulant, which must be kept in balance. Under physiological conditions, endothelial cells constitute a nonadhesive surface preventing activation of platelets and the coagulation cascade. Multiple fibrinolytic and antithrombotic properties act on their cell surface contributing to the maintenance of blood fluidity. These include platelet inhibition, the heparin-antithrombin III system, tissue factor pathway inhibition, thrombomodulin/protein C system, and fibrinolytic qualities. At sites of vascular damage, platelets react immediately by adhering to the exposed extracellular matrix, followed by platelet-platelet interactions to form a clot that effectively seals the injured vessel wall to prevent excessive blood loss. For solid thrombus formation, functional platelets are essential. In this process, endothelial cells serve as a support surface for formation of procoagulant complexes and clotting. This review gives an overview about the central role of the endothelium as a dynamic lining which controls the complex interplay of the coagulation system with the surrounding cells.


Bim may be a poor prognostic biomarker in breast cancer patients especially in those with luminal A tumors.
Bcl-2 interacting mediator of cell death (Bim) appears to have contradictory roles in cancer. It is uncertain whether Bim show prognostic significance in patients with breast cancer. To investigate the correlation between Bim expression and clinicopathological characteristics of breast cancer and to evaluate Bim's effect on overall survival (OS). We used immunohistochemistry (IHC) technique to detect the expression of Bim via tissue microarray in 275 breast cancer samples, Kaplan-Meier analysis to perform survival analysis, and Cox proportional hazards regression model to explore the risk factors of breast cancer. The results revealed that Bim expression was significantly correlated with age, estrogen receptor (ER) and/or progesterone receptor (PR), human epidermal growth factor receptor (HER2) and Ki67 expression (P< 0.05). Bim expression was significantly different in the four molecular subtypes (P= 0.000). Survival analysis showed that Bim positive expression contributed to a shorter OS (P= 0.034), especially in patients with luminal A tumors (P= 0.039). Univariate and multivariate regression analysis showed that Bim was an independent prognostic factor for breast cancer (P< 0.05). Bim may serve as an effective predictive factor for lower OS in breast cancer patients, especially in those with luminal A tumors.


Levels and species-specific organochlorine accumulation in three shark species from the western Gulf of California with different life history traits.
Organochlorine compounds (OCs), such as organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs), remain ubiquitous in marine ecosystems despite their prohibition or restriction, posing a risk to marine wildlife and humans. Their accumulation in liver tissue and potential toxicity in three exploited shark species (the scalloped hammerhead, Sphyrna lewini; the Pacific sharpnose shark, Rhizoprionodon longurio; and the Pacific angel shark, Squatina californica) with different physiological and ecological features from the western Gulf of California (GC) were investigated. Forty of the 47 OCs analyzed were identified, evidencing a greater agricultural than industrial influence considering the high DDTs/PCBs ratios. The DDT group was the main contributor to ∑OCs in the three species, while hexa- and hepta-CBs dominated the PCB profiles. S. lewini (juveniles) and R. longurio (juveniles and adults) had similar and significantly (p < 0.05) higher ∑OCP concentrations than S. californica (juveniles and adults), which is attributed to their migration to other polluted regions of the gulf. The three species' ∑PCB levels (lipid weight) were comparable and considered low in comparison to those documented in prior studies conducted worldwide. No intraspecific differences were observed when comparing by sex, but OC concentrations were higher in larger individuals. S. lewini and R. longurio showed different OC bioaccumulation trends against size, while no relationship between size and ∑OC concentrations was observed in S. californica. All shark species' toxic equivalents (TEQs) were calculated from dioxin-like PCB concentrations and were far below the established TEQ fish thresholds. However, future research is needed regarding the possible PCB and OCP effects in elasmobranchs. This study provides the basis for monitoring organic contaminants in predatory sharks from the western GC. It also highlights the importance of further research on unintentionally produced organochlorine environmental levels and sources.


Genetic determinism of prickles in rose.
The genetic determinism of prickle in rose is complex, with a major locus on LG3 that controls the absence/presence of prickles on the rose stem. Rose is one of the major ornamental plants. The selection of glabrous cultivars is an important breeding target but remains a difficult task due to our limited genetic knowledge. Our objective was to understand the genetic and molecular determinism of prickles. Using a segregating diploid rose F1 population, we detected two types of prickles (glandular and non-glandular) in the progeny. We scored the number of non-glandular prickles on the floral and main stems for three years. We performed QTL analysis and detected four prickle loci on LG1, 3, 4 and 6. We determined the credible interval on the reference genome. The QTL on LG3 is a major locus that controls the presence of prickles, and three QTLs (LG3, 4 and 1) may be responsible for prickle density. We further revealed that glabrous hybrids are caused by the combination of the two recessive alleles from both parents. In order to test whether rose prickles could originate from a 'trichome-like structure,' we used a candidate approach to characterize rose gene homologues known in Arabidopsis, involved in trichome initiation. Four of these homologues were located within the overlapping credible interval of the detected QTLs. Transcript accumulation analysis weakly supports the involvement of trichome homologous genes, in the molecular control of prickle initiation. Our studies provide strong evidence for a complex genetic determinism of stem prickle and could help to establish guidelines for glabrous rose breeding. New insights into the relationship between prickles and trichomes constitute valuable information for reverse genetic research on prickles.


Flow cytometric immunophenotyping of plasma cells across the spectrum of plasma cell proliferative disorders: A fresh insight with pattern-based recognition.
The expression pattern of common antigens including cytoplasmic kappa/lambda ratio (cyKLR) was evaluated by flow cytometric immunophenotyping (FCMI) to explore their relevance in discriminating normal and aberrant plasma cells (NPC and APC, respectively) across spectrum of plasma cell proliferative disorders (PCPD). In this prospective analysis, 791 samples from PCPD (treatment naive = 455; partially treated = 336) were evaluated for expression of CD38, CD138, CD45, CD19, CD56, CD27, CD81, CD117, Cy-kappa, and Cy-lambda using FCMI. Amongst the entire cohort, 20.7% (n = 164) samples displayed only APC, 21% (n = 165) only NPC and 58% (n = 462) showed coexistence of NPC and APC. Using pattern-based recognition (PBR) for three common patterns (CD19 vs. CD56; CD27 vs. CD56 and CD19 vs. CD27), APC was separable from NPC in 93% samples. In 6.5% samples, the gating markers contributed in APC-NPC differentiation and in the remaining 0.5% CD117 and CD81 proved useful. Clonality assessment was found to be crucial to label plasma cell compartment as completely normal or aberrant in 42% cases with either all NPC or all APC. Sixty one out of 462 cases (13%) revealed cyKLR within normal reference range and in these cases; abnormal cyKLR was demonstrable only after gating APC separately based on PBR. Fair discrimination between NPC and APC is achievable in all PCPD samples using eight markers (Gating: CD38, CD138, CD45; PBR:CD19, CD56, CD27; clonality: Cy-kappa and Cy-lambda). Thus, combined assessment of clonality and immunophenotypic aberrancies is required for accurate, reliable and precise assessment of NPC and APC compartments in PCPD.


Complications of vesicoureteral operations from incoordination of micturition.
Recently, a study was made of 8 boys with complications after corrective surgical procedures for dysfunction of the voiding mechanism. One of these patients already had been subjected to irreversible diversion before the basic disorder was recognized but the majority was treated with suggestion (often with hypnosis) as well as with drugs affecting the smooth muscle (1 adolescent was too hostile to accept treatment). Because the bladder was dysfunctional, the operations either failed or sequelae persisted until measures such as suggestion, hypnotherapy and retraining reversed the incoordination of micturition. Operation or reoperation in 5 children might not have been necessary if bladder coordination had been established earlier. The case of boys with poor urinary control but free of neurologic stigmas are suspect. If they require an operation for repair of congenital urinary defects such as reflux, equal attention must be paid to psychologic and habit patterns causing bladder dysfunction. Otherwise, the operation is done essentially into a neurogenic bladder. It is concluded that psychologically conditioned incoordination of voiding may alone produce mid and upper tract damage. The cases of boys with problems of urinary control not explained by neurologic or anatomic defects should be suspected and corrective surgical procedures may fail if bladder dysfunction is not corrected by retraining, suggestion and even hypnotherapy.


The Association of Social Connectivity and Body Weight With the Onset of Type 2 Diabetes: Findings From the Population-Based Prospective MONICA/KORA Cohort.
Low levels of social connectivity are related to the onset of type 2 diabetes mellitus (T2D), and this study investigates the role of body weight in this association. In a sample of 9448 participants followed for a mean of 15.3 years (186,158.5 person-years) from the Monitoring of Trends and Determinants in Cardiovascular Disease Augsburg/Cooperative Health Research in the Region of Augsburg population-based cohort conducted in Germany, we investigated the association of social connectivity, measured by the Social Network Index, and body mass index (BMI) with the risk of clinically validated T2D incidence using stratified Cox proportional hazards regression models adjusted for sociodemographic, life-style, cardiometabolic, and psychosocial risk factors. During a mean follow-up of 14.1 years (186,158.5 person-years), 975 (10.3%) participants developed T2D. Participants with low social connectivity developed T2D at a higher rate than socially connected participants (10.0 versus 8.0 cases/10,000 person-years); however, BMI played a significant role in the association of social connectivity with T2D ( p < .001). In comparison to their socially connected counterparts, low social connectivity was associated with a higher rate of T2D incidence in normal-weight (6.0 versus 2.0 cases/10,000 person-years), but not overweight (13.0 versus 13.0 cases/10,000 person-years) or obese participants (32.0 versus 30.0 cases/10,000 person-years). Correspondingly, Cox regression analysis showed that 5-unit increments in BMI increased the risk of T2D in socially connected participants (hazard ratio = 3.03, 95% confidence interval = 2.48-3.79, p < .001) at a substantially higher rate than in low socially connected participants (hazard ratio = 1.77, 95% confidence interval = 1.45-2.16, p < .001). The detrimental link between low social connectivity and increased risk of T2D is substantially stronger in participants with a lower BMI.


Embryopathic effects of thromboxane B2 in the chick.
Several prostaglandins of the E and F series are now known to be involved in reproduction and developmental events. However, there is as yet no such evidence for any of the other arachidonate metabolites. Thromboxane B2 is the stable metabolic end product of the biologically active but unstable intermediate thromboxane A. Administered to developing chick embryos at 48 and 72 hours incubation, thromboxane B2 caused growth retardation and induced a high incidence of anomalies, in particular, everted viscera.


A study of the HLA-D region in patients with classic Kaposi's sarcoma.
The HLA-D region in nine Sardinian patients with classic Kaposi's sarcoma was studied with two restriction enzymes, Eco RI and Eco RV, and two cDNA probes, DR beta and DQ beta. A total of 41 polymorphic restriction fragments were identified. One, an 11.5 kb Eco RV DQ beta fragment, was present in three of the patients but in none of the controls; a second, an 8.0 kb Eco RV DR beta fragment, was present in six patients and all the controls. No single fragment was identified which was significantly over or under-represented in either group.


Halogen Atom Participation in Guiding the Stereochemical Outcomes of Acetal Substitution Reactions.
Acetal substitution reactions of α-halogenated five- and six-membered rings can be highly stereoselective. Erosion of stereoselectivity occurs as nucleophilicity increases, which is consistent with additions to a halogen-stabilized oxocarbenium ion, not a three-membered-ring halonium ion. Computational investigations confirmed that the open-form oxocarbenium ions are the reactive intermediates involved. Kinetic studies suggest that hyperconjugative effects and through-space electrostatic interactions can both contribute to the stabilization of halogen-substituted oxocarbenium ions.


Mid-term outcome of magnetic resonance-guided focused ultrasound surgery for uterine myomas: from six to twelve months after volume reduction.
To clarify the volume change ratio of uterine myomas treated with magnetic resonance-guided focused ultrasound surgery (MRgFUS), in relation to the signal intensity of T(2)-weighted magnetic resonance (MR) images. Prospective study (Canadian Task Force classification II-3). Department of Gynecology, Shinsuma General Hospital, Kobe, Japan. Forty-eight myomas in 35 patients were followed up with MR images 6 months after MRgFUS, and 23 myomas in 17 patients were followed up 12 months after MRgFUS. Before treatment, the myomas were classified into 3 types on the basis of the signal intensity of T(2)-weighted MR images as follows: Type 1, low intensity; type 2, intermediate intensity; type 3, high intensity. Thermal ablation therapy was performed with an MRgFUS system (ExAblate 2000). MRgFUS produced a greater volume reduction in type 1 and type 2 myomas than in type 3 myomas. Nonperfused areas always diminished in the period after MRgFUS; however, the volume change was affected by the volume change ratio of perfused areas inside the treated myomas. At present, type 3 myomas should be exempted from the application of MRgFUS, because the nonperfused ratio immediately after the procedure was small compared with that in type 1 and type 2 myomas, and the subsequent volume change was unfavorable.


Genetic variants of D2 but not D3 or D4 dopamine receptor gene are associated with rapid onset and poor prognosis of methamphetamine psychosis.
D2-like receptors are key targets for methamphetamine in the CNS, and their activation is an initial and indispensable effect in the induction of dependence and psychosis. It is possible that genetic variants of D2-like receptors may affect individual susceptibility to methamphetamine dependence and psychosis. To test this hypothesis, 6 putatively functional polymorphisms of D2-like receptors, -141C Ins/Del, Ser311Cys and TaqIA of the DRD2 gene, Ser9Gly of the DRD3 gene, and -521C>T and a variable number of tandem repeats in exon 3 of the DRD4 gene, were analyzed in 202 patients with methamphetamine dependence and/or psychosis and 243 healthy controls in a Japanese population. No polymorphism examined showed significant association with methamphetamine dependence, but two polymorphisms of DRD2 were associated with the clinical course and prognosis of methamphetamine psychosis. The A1/A1 homozygote of DRD2 was a negative risk factor for a poorer prognosis of psychosis that continues for more than 1 month after the discontinuance of methamphetamine abuse and the beginning of treatment with neuroleptics (p=0.04, odds ratio (OR)=0.42, 95% CI; 0.27-0.65) and the complication of spontaneous relapse of methamphetamine psychosis after remission (p=0.014, OR=0.34, 95% CI; 0.22-0.54). The genotype of -141C Del positive (Del/Del and Del/Ins) was at risk for rapid onset of methamphetamine psychosis that develops into a psychotic state within 3 years after initiation of methamphetamine abuse (p=0.00037, OR=3.62, 95% CI 2.48-5.28). These findings revealed that genetic variants of DRD2, but not DRD3 or DRD4, confer individual risks for rapid onset, prolonged duration, and spontaneous relapse of methamphetamine psychosis.


Manganese-cobalt hydroxide nanosheets anchored on a hollow sulfur-doped bimetallic MOF for high-performance supercapacitors and the hydrogen evolution reaction in alkaline media.
Nonmetallic doping and in situ growth techniques for designing electrode materials with excellent electrocatalytic activity are effective strategies to enhance the electrochemical performance. Bifunctional electrode materials for supercapacitors (SCs) and the hydrogen evolution reaction (HER) have attracted great interest due to their potential applications in green energy storage and conversion. Herein, the bimetallic MnCo LDH is anchored on a hollow sulfur (S)-doped MnCo-MOF-74 surface, forming a poplar flower-like 3D composite which is used for SCs and the HER in alkaline media. The fabricated S-MnCo-MOF-74@MnCo LDH/NF electrode exhibits a favorable specific capacitance of 1875.4 F g-1 at 1 A g-1 and steady long-term cycling performance. Moreover, the assembled HSC using S-MnCo-MOF-7@MnCo LDH/NF as the cathode material and active carbon (AC) as the anode material shows 546.4 F g-1 capacitance (1 A g-1) with a maximum energy density of 58 W h kg-1 at 14 000 W kg-1 power density. As an electrocatalyst, S-MnCo-MOF-7@MnCo LDH/NF exhibits excellent HER properties with a small Tafel slope of 128.9 mV dec-1 a low overpotential of 197 mV at 10 mA cm-2 and durable performance for 10 hours in alkaline media. The present work provides insights into understanding and designing active electrode materials for stable hydrogen evolution and high-performing supercapacitors in an alkaline environment.


Barcelona Clinic Liver Cancer staging system and survival of untreated hepatocellular carcinoma in a hepatitis B virus endemic area.
A uniform staging system for hepatocellular carcinoma (HCC) is needed. In this study, the discrimination abilities of HCC staging systems (American Joint Committee on Cancer [AJCC], Barcelona Clinic Liver Cancer [BCLC], Cancer of the Liver Italian Program, and Okuda stage) were compared during the course of untreated HCC. We included consecutive 80 patients diagnosed with HCC, but were not treated for HCC, at a single medical center in Korea. In addition, 177 treated patients matched by prognostic factors were included to evaluate the survival gain owing to locoregional treatment. The mean age of untreated patients was 58.7 years. During the observation period (median = 41.1 months), 72 patients died (median survival = 2.1 months; range = 1.6-33.7 months). Among various staging systems, the BCLC system had the best discrimination ability (linear trend χ2 = 16.35). Multivariate analysis indicated that the intrahepatic tumor classification (AJCC T classification) was an independent predictor of overall survival (OS) (P = 0.001). However, either node or metastasis classification failed to affect the OS significantly (both P > 0.05). Patients undergoing intrahepatic tumor control with locoregional therapy showed prolonged survival in those patients with nodal involvement (hazard ratio = 0.315; P = 0.004) and extrahepatic metastasis (hazard ratio = 0.658; P = 0.258), respectively, after adjustment for independent prognostic factors. Compared with untreated patients, BCLC stage A and B patients had > 1 year of survival gain but those with stage C and D did not, owing to locoregional therapy. The BCLC system had the best discrimination among untreated HCC patients. However, re-evaluation of the clinical importance of nodal and metastasis classification might be required.


LINC00470 accelerates the proliferation and metastasis of melanoma through promoting APEX1 expression.
Recently studies found that APEX1 was abnormally expressed in melanoma, indicating that it might be involved in the development of melanoma. However, the underlying mechanism and the interaction between APEX1 and LINC00470 in melanoma are not clear. Therefore, we aimed to investigate the role of LINC00470 in the development of melanoma in this work. We discovered that LINC00470 was overexpressed in melanoma tissues and cells compared with the adjacent normal tissues and cells by qPCR. The overexpression of LINC00470 promoted the proliferation and migration of melanoma cells. The functional investigation demonstrated that LINC00470 activated the transcription factor, ZNF131, to regulate the APEX1 expression, which finally promoted cell proliferation and migration. In contrast, knockdown of LINC00470 could significantly inhibit the melanoma cell proliferation and migration, and suppress the growth of tumor in vivo. Overexpression of APEX1 could reverse the impact of the silence of LINC00470 in melanoma cells. In summary, our studies revealed that LINC00470 promoted melanoma proliferation and migration by enhancing the expression of APEX1, which indicated that LINC00470 might be a therapeutic target for the treatment of melanoma.


Spectroscopic characterization and fluorescence imaging of Helicobacter pylori endogenous porphyrins.
Conventional antimicrobial strategies have become increasingly ineffective due to the rapid emergence of antibiotic resistance among pathogenic bacteria. In order to overcome this problem, antimicrobial PhotoDynamic Therapy (PDT) is considered a promising alternative therapy. PDT has a broad spectrum of action and low mutagenic potential. It is particularly effective when microorganisms present endogenous photosensitizing pigments. Helicobacter pylori (Hp), a pathogen notoriously responsible of severe gastric infections (chronic gastritis, peptic ulcer, MALT lymphoma and gastric adenocarcinoma), produces and accumulates the photosensitizers protoporphyrin IX and coproporphyrin, thus it might be a suitable target of antimicrobial PDT. With the aim to design and develop an ingestible LED-based robotic pill for intragastric phototherapy, so that irradiation can be performed in situ without the use of invasive endoscopic light, photophysical studies on the Hp endogenous photosensitizers were carried out. These studies represent an important prerequisite in order to select the most effective irradiation conditions for Hp eradication. The photophysical characterization of Hp porphyrins, including their spectroscopic features in terms of absorption, steady-state and time-resolved fluorescence, was performed on bacterial extracts as well as within planktonic and biofilm growing Hp cells.


New femoral remains of Nacholapithecus kerioi: Implications for intraspecific variation and Miocene hominoid evolution.
The middle Miocene stem kenyapithecine Nacholapithecus kerioi (16-15 Ma; Nachola, Kenya) is represented by a large number of isolated fossil remains and one of the most complete skeletons in the hominoid fossil record (KNM-BG 35250). Multiple fieldwork seasons performed by Japanese-Kenyan teams during the last part of the 20th century resulted in the discovery of a large sample of Nacholapithecus fossils. Here, we describe the new femoral remains of Nacholapithecus. In well-preserved specimens, we evaluate sex differences and within-species variation using both qualitative and quantitative traits. We use these data to determine whether these specimens are morphologically similar to the species holotype KNM-BG 35250 (which shows some plastic deformation) and to compare Nacholapithecus with other Miocene hominoids and extant anthropoids to evaluate the distinctiveness of its femur. The new fossil evidence reaffirms previously reported descriptions of some distal femoral traits, namely the morphology of the patellar groove. However, results also show that relative femoral head size in Nacholapithecus is smaller, relative neck length is longer, and neck-shaft angle is lower than previously reported for KNM-BG 35250. These traits have a strong functional signal related to the hip joint kinematics, suggesting that the morphology of the proximal femur in Nacholapithecus might be functionally related to quadrupedal-like behaviors instead of more derived antipronograde locomotor modes. Results further demonstrate that other African Miocene apes (with the exception of Turkanapithecus kalakolensis) generally fall within the Nacholapithecus range of variation, whose overall femoral shape resembles that of Ekembo spp. and Equatorius africanus. Our results accord with the previously inferred locomotor repertoire of Nacholapithecus, indicating a combination of generalized arboreal quadrupedalism combined with other antipronograde behaviors (e.g., vertical climbing).


COVID-19 and the kidney: A retrospective analysis of 37 critically ill patients using machine learning.
There is evidence that SARS-CoV2 has a particular affinity for kidney tissue and is often associated with kidney failure. We assessed whether proteinuria can be predictive of kidney failure, the development of chronic kidney disease, and mortality in 37 critically ill COVID-19 patients. We used machine learning (ML) methods as decision trees and cut-off points created by the OneR package to add new aspects, even in smaller cohorts. Among a total of 37 patients, 24 suffered higher-grade renal failure, 20 of whom required kidney replacement therapy. More than 40% of patients remained on hemodialysis after intensive care unit discharge or died (27%). Due to frequent anuria proteinuria measured in two-thirds of the patients, it was not predictive for the investigated endpoints; albuminuria was higher in patients with AKI 3, but the difference was not significant. ML found cut-off points of >31.4 kg/m2 for BMI and >69 years for age, constructed decision trees with great accuracy, and identified highly predictive variables for outcome and remaining chronic kidney disease. Different ML methods and their clinical application, especially decision trees, can provide valuable support for clinical decisions. Presence of proteinuria was not predictive of CKD or AKI and should be confirmed in a larger cohort.


The perspective of meat and meat-alternative consumption in China.
This study provides an overview of Chinese meat consumption based on literature review. China, having the largest mid-income population, has become the world's largest meat consumer. Its per capita meat consumption has been growing fast over the past decades to 49 kg, half of that of the US. Chinese consumers are aware of the environmental, health and animal welfare concerns, and can accept plant-based and lab cultured meats. Their adoption rate of these meat alternatives is low and their willingness-to-pay for them is also low from 5% below to 5% above conventional meat, compatible to the level in the US and EU countries. China, as an emerging economy, takes it as a serious challenge for food and nutrition security, where meat plays an indispensable role. Malnutrition still exists among children and the low-income population due to low meat intake. Government is playing an active role in boosting its domestic meat production to meet its market demand for more meat.


Herbert Spencer, Sociological Theory, and the Professions.
This article presents new insights into Spencer's theoretical sociology as he applied it to the professions and professional institutions, which he discussed extensively, particularly in his Principles of Sociology. The first part of this article notes the main conceptual insights which he established and aligns them within the wider context of a re-reading of Spencer's sociology. Particular attention is paid to the "social organism" and the spontaneous cooperation of social individuals in society (with each possessing "social self-consciousness"). This part also reappraises Spencer's account of the emergence of "professionals" and their distinctive "cunning, skill, and acquaintance with the nature of things," which professionals have brought to bear on what has been experienced in the ordinary social lives of people as complexity or the unfamiliar in the world. The subsequent discussion focuses on, first, a retrieval of Spencer's theoretical stance on the activities of the professions, and on work and conditions in general, and, second, on reviewing some of the major resonances which his work has with practical problems and the associated theoretical issues concerning the sociological understanding of professional/service-user interaction in social life today.


Species distribution and genes encoding antimicrobial resistance in enterococcus spp. isolates from rabbits residing in diverse ecosystems: A new reservoir of linezolid and vancomycin resistance.
Worldwide, studies regarding antimicrobial resistance in rabbits are scarce. In addition, it seems that rearing conditions have important impact on emergence and spread of antimicrobial-resistant bacteria. Thus, the authors sought to (1) assess the role of rabbits residing across diverse ecosystems as potential reservoirs of antimicrobial-resistant enterococci and (2) investigate the genetic background of detected resistances. Faecal samples from 60 healthy farmed rabbits (one farm), 35 laboratory rabbits and 31 wild rabbits were analysed. Overall, 97 enterococci isolates were accumulated, as follows: 44 E. faecium, 37 E. faecalis, 7 E. gallinarum, 5 E. durans and 4 E. avium. E. faecalis isolates were statistically associated with farm rabbits and wild rabbits (p < 0.05). High rates of resistance were observed for tetracycline (60.8%; tetM [n = 48; 81.3%], tetO [n = 7; 11.8%] and tetL [n = 1; 1.7%]), erythromycin (43.3%; msr(A) [n = 14; 33.3%] and ermB [n = 13; 31%]), ampicillin (29.9%), streptomycin (26.8%; ant(6)-Ia [n = 3, 11.5%]) and vancomycin (21.6%; vanA [one E. faecium + one E. faecalis; 9.5%]). Low frequencies of resistance were observed for teicoplanin (9.2%), linezolid (8.2%), ciprofloxacin (7.2%) and gentamicin (1%; aac(6')-Ie-aph(2″)-Ia). Resistance to ampicillin and vancomycin was associated with laboratory rabbits (p < 0.05). Int-Tn (Tn916/1545) was detected in 27 (27.8%) isolates, of which 10 isolates co-harboured tetM and ermB genes, while 16 comprised tetM. Findings indicate that clinically relevant enterococci species isolated from rabbits are frequently resistant to antimicrobials and harbour a range of genes associated with the Tn916/1545 family. This study highlights the high rates of antimicrobial-resistant enterococci from rabbits and the occurrence of both vancomycin- and linezolid-resistant isolates, potentially representing a very serious threat to human and animal health.


DNA and low titer, helper-free, recombinant AAV prime-boost vaccination for cytomegalovirus induces an immune response to CMV-pp65 and CMV-IE1 in transgenic HLA A*0201 mice.
A prime-boost immunization regimen allowed the use of low titer, helper-free rAAV-pp65mII and rAAV-IE1 virus to elicit specific humoral and cellular responses to two important cytomegalovirus (CMV) antigens: the immediate-early 1 (IE-1) and pp65 proteins. Simultaneous immunization of both CMV proteins, using DNA vaccine priming followed by rAAV boost, induced antibody (Ab) response, CD8 lymphocytes with cytotoxic function, and detectible binding of the cognate peptide epitopes for human HLA A*0201 restriction using tetramer technology.


Stress hyperglycemia ratio: an independent predictor for in-hospital major adverse cardiovascular and cerebrovascular events in patients with st-segment elevation myocardial infarction.
To assess the predictive accuracy of the stress hyperglycemia ratio (SHR) for in-hospital major adverse cardiovascular and cerebrovascular events (MACCE) in patients with ST-segment elevation myocardial infarction (STEMI). A total of 1,944 patients were enrolled within 24 h of a new STEMI diagnosis. The SHR was obtained by dividing the blood glucose level at admission by the estimated average glucose. MACCE were defined as acute cerebral infarction, mechanical complications of myocardial infarction, cardiogenic shock, and all-cause death. Patients were then categorized into the MACCE and non-MACCE groups according to the occurrence of in-hospital MACCE. Propensity score matching was used to balance confounding factors, and logistic regression was used to identify the potential predictive factors for MACCE. A total of 276 patients were included after 1:1 matching, and the confounding factors were balanced between the two groups. The SHR was an independent predictor of in-hospital MACCE (odds ratio = 10.06, 95% confidence interval: 4.16-27.64, P < 0.001), while blood glucose at admission was not. The SHR was also an independent predictor for in-hospital MACCE in nondiabetic patients with STEMI (odds ratio = 11.26, 95% confidence interval: 3.05-55.21, P < 0.001). SHR is an independent predictor of in-hospital MACCE in patients with acute STEMI, especially in nondiabetic patients.


Chemistry, astronomy and physics of H3+.
The great developments in the chemistry, astronomy and physics of H(3)(+) since 2006, which have led to this Royal Society Theo Murphy Meeting, are reviewed.


Comparison of Effect on Sicca Symptoms of Anticentromere Antibody-positive Sjögren Syndrome and Primary Sjögren Syndrome Alone.
To determine whether positive anticentromere antibody (ACA) serology affects the severity of sicca symptoms in patients with primary Sjögren syndrome (pSS). Evaluation to detect subjective and objective sicca symptoms included questionnaires, physical examination, and pathology. Cases of pSS were classified according to the 2002 American-European Consensus Group (AECG) criteria. All patients were evaluated for presence of anti-Ro, anti-La, and ACA serology. Patients with pSS were categorized into ACA+ SS and ACA-SS. The groups were compared for measures of severity of oral and ocular sicca. The pSS group had 446 patients, of whom 26 were ACA+ SS. Subjective ocular sicca measured 7.0 ± 2.4 (out of 10) in ACA+ SS and 6.4 ± 2.6 in ACA-SS (p = 0.197). Objective ocular sicca measured 3.2 mm ± 1.8 mm/5 min in ACA+ SS and 4.2 mm ± 4.4 mm/5 min in ACA-SS (p = 0.038). Subjective oral sicca measured 8.5 ± 1.4 in ACA+ SS and 6.7 ± 2.4 in ACA-SS (p < 0.001). Objective oral sicca measured 0.1 ml ± 0.2 ml/15 min in ACA+ SS and 0.4 ml ± 1.0 ml/15 min in ACA-SS (p < 0.001). Only 35% of ACA+ patients with SS were anti-Ro-positive or anti-La-positive compared with 77% of the ACA-patients with SS (p < 0.001). There was no significant difference in minor salivary gland fibrosis or focus scores between ACA+ SS and ACA-patients with SS. ACA+ SS is associated with more severe objective ocular sicca and more severe subjective and objective oral sicca compared to ACA-SS. The majority of ACA+ patients with SS meet AECG criteria for pSS despite negative serology for anti-Ro/La antibodies.


Early stages of legume-rhizobia symbiosis are controlled by ABCG-mediated transport of active cytokinins.
Growing evidence has highlighted the essential role of plant hormones, notably, cytokinins (CKs), in nitrogen-fixing symbiosis, both at early and late nodulation stages1,2. Despite numerous studies showing the central role of CK in nodulation, the importance of CK transport in the symbiosis is unknown. Here, we show the role of ABCG56, a full-size ATP-binding cassette (ABC) transporter in the early stages of the nodulation. MtABCG56 is expressed in roots and nodules and its messenger RNA levels increase upon treatment with symbiotic bacteria, isolated Nod factor and CKs, accumulating within the epidermis and root cortex. MtABCG56 exports bioactive CKs in an ATP-dependent manner over the plasma membrane and its disruption results in an impairment of nodulation. Our data indicate that ABCG-mediated cytokinin transport is important for proper establishment of N-fixing nodules.


Oat cell carcinoma of the esophagus: unusual radiological appearances.
Primary oat cell carcinoma of the esophagus is a very rare tumour. The radiographic appearance of the three cases described in this paper are unusual because they resemble benign lesions such as leiomyoma, fibrous polyp and candidiasis. It would be interesting to investigate whether such an unusual appearance is common for this neoplasm.


Form categorization in 10-month-olds.
In five experiments, 10-month-olds were habituated to exemplars of a form category and tested for categorization in paired-comparison trials involving in-category versus out-of-category stimuli. Across these experiments, color was systematically manipulated during habituation and/or test trials. Infants categorized form when color was either held constant or varied during habituation, but failed to categorize form when exposed to color-constant stimuli during habituation and tested for categorization with novel-color form exemplars. Two subsequent experiments traced this failure to the narrow experience of exposure to color-constant exemplars during habituation. These results suggest that (a) infants' internal representation for a category will not include a stimulus dimension not varied in the exemplars from which the category was derived, but (b) if variation in that dimension is experienced, exemplars constructed of novel instances of that dimension will still be regarded as belonging to the category.


Performance evaluation of a draw-over vaporizer with a nonbreathing circuit during simulated adverse conditions.
Performance evaluation of a draw-over vaporizer with a nonrebreathing circuit during simulated adverse conditions. Open laboratory study. University hospital laboratory. The output (%) of a temperature-compensated Ohmeda Cyprane PAC (portable anesthesia complete) draw-over vaporizer (Ohmeda, Madison, WI) using isoflurane attached to a nonrebreathing circuit was tested in the laboratory during manual ventilation under normal and simulated adverse conditions. The adverse conditions tested were high ambient temperature and static and dynamic positional variation. The results show that the output bias of the PAC vaporizer has a generally consistent profile as tested, except when placed in the 180 degrees full-inversion or 90 degrees anterior-tilt position. We also conducted trials with the Penlon ventilator (Ohmeda, Abingdon, Oxford, U.K.) attached to the circuit at each of its input ports. Ventilation at one input port produced dangerously high airway pressures (within the circuit), thus supporting the manufacturer's recommendation against the use of this port for positive-pressure ventilation. Using the recommended port, the test lung was seen to inflate and deflate appropriately, but, surprisingly, no vapor output was detected by the agent monitor at any vaporizer setting when using the ventilator at the recommended port. Anesthetists should be aware of the pitfalls and possible problems that may be associated with this type of anesthetic delivery system.


DisMaNET: A network-based tool to cross map disease vocabularies.
The growing integration of healthcare sources is improving our understanding of diseases. Cross-mapping resources such as UMLS play a very important role in this area, but their coverage is still incomplete. With the aim to facilitate the integration and interoperability of biological, clinical and literary sources in studies of diseases, we built DisMaNET, a system to cross-map terms from disease vocabularies by leveraging the power and interpretability of network analysis. First, we collected and normalized data from 8 disease vocabularies and mapping sources to generate our datasets. Next, we built DisMaNET by integrating the generated datasets into a Neo4j graph database. Then we exploited the query mechanisms of Neo4j to cross-map disease terms of different vocabularies with a relevance score metric and contrasted the results with some state-of-the-art solutions. Finally, we made our system publicly available for its exploitation and evaluation both through a graphical user interface and REST APIs. DisMaNET contains almost half a million nodes and near nine hundred thousand edges, including hierarchical and mapping relationships. Its query capabilities enabled the detection of connections between disease vocabularies that are not present in major mapping sources such as UMLS and the Disease Ontology, even for rare diseases. Furthermore, DisMaNET was capable of obtaining more than 80% of the mappings with UMLS reported in MonDO and DisGeNET, and it was successfully exploited to resolve the missing mappings in the DISNET project. DisMaNET is a powerful, intuitive and publicly available system to cross-map terms from different disease vocabularies. Our study proves that it is a competitive alternative to existing mapping systems, incorporating the potential of network analysis and the interpretability of the results through a visual interface as its main advantages. Expansion with new sources, versioning and the improvement of the search and scoring algorithms are envisioned as future lines of work.


Complications of Minimally Invasive Surgery for Hallux Valgus and How to Deal with Them.
This article discusses the possible complications in minimally invasive surgery (MIS) for hallux valgus. The rate of complications and the outcomes are at least comparable with open techniques. A percutaneous technique provides the best conditions for undisturbed healing. Some possible complications exist in MIS that do not exist in open surgery, such as lesion of soft tissue structures that are not under direct visible control or skin burns. These complications usually result from technical mistakes in performing the operation. It is therefore crucial to get proper education from cadaver training and visiting experienced colleagues, as is done in open surgery.


Evaluation of lytic activity of staphylococcal bacteriophage Sb-1 against freshly isolated clinical pathogens.
In recent decades the increase in antibiotic-resistant bacterial strains has become a serious threat to the treatment of infectious diseases. Drug resistance of Staphylococcus aureus has become a major problem in hospitals of many countries, including developed ones. Today the interest in alternative remedies to antibiotics, including bacteriophage treatment, is gaining new ground. Here, we describe the staphylococcal bacteriophage Sb-1 - a key component of therapeutic phage preparation that was successfully used against staphylococcal infections during many years in the Former Soviet Union. This phage still reveals a high spectrum of lytic activity in vitro against freshly isolated, genetically different clinical samples (including methicillin-resistant S. aureus) obtained from the local hospitals, as well as the clinics from different geographical areas. The sequence analyses of phage genome showed absence of bacterial virulence genes. A case report describes a promising clinical response after phage application in patient with cystic fibrosis and indicates the efficacy of usage of Sb-1 phage against various staphylococcal infections.


Moving beyond disclosure: Stages of care in preclinical Alzheimer's disease biomarker testing.
Alzheimer's disease (AD) begins with an asymptomatic "preclinical" phase, in which abnormal biomarkers indicate risk for developing cognitive impairment. Biomarker information is increasingly being disclosed in research settings, and is moving toward clinical settings with the development of cheaper and non-invasive testing. Limited research has focused on the safety and psychological effects of disclosing biomarker results to cognitively unimpaired adults. However, less is known about how to ensure equitable access and robust counseling for decision-making before testing, and how to effectively provide long-term follow-up and risk management after testing. Using the framework of Huntington's disease, which is based on extensive experience with disclosing and managing risk for a progressive neurodegenerative condition, this article proposes a conceptual model of pre-disclosure, disclosure, and post-disclosure phases for AD biomarker testing. Addressing research questions in each phase will facilitate the transition of biomarker testing into clinical practice.


Management of Acute, Uncomplicated Type B Aortic Dissection.
For decades, the mainstay of management for acute, uncomplicated type B aortic dissection (TBAD) has been anti-impulse medical therapy, focusing on close control of blood pressure, and heart rate. However, the natural history of this entity has remained one of aortic degeneration over time and significant morbidity and mortality. More recently, the advent of endovascular therapy has driven a revolution in the management of TBAD. While thoracic endovascular aortic repair (TEVAR) was rapidly adopted for the treatment of complicated type B aortic dissection due to significantly improved morbidity and mortality when compared with tradition open surgical techniques, its role in the management of uncomplicated dissection remained controversial. However, the accumulation of favorable data on aortic remodeling and survival following early TEVAR for uncomplicated dissection is driving a shift in paradigm and practice. This is particularly true of patients exhibiting certain features at the time of presentation that are associated with increased risk of failure of optimal medical therapy. This article reviews the current evidence in the literature addressing TEVAR for acute, uncomplicated TBAD. In addition, it presents the state of the art in FDA-approved thoracic endograft platforms, guidance regarding case planning, and step-by-step procedural description, including the management of common challenges, and complications.


Non-alcoholic fatty liver disease in young adult severely obese non-diabetic patients in South Italy.
In the absence of other causes, obesity increases the risk of liver disease. We evaluated the prevalence and degree of metabolic and hepatic abnormalities associated with non-alcoholic fatty liver disease (NAFLD) in type II-III obesity in a metropolitan area of South Italy. 187 (81 M, 106 F) young adult non-diabetic obese patients, age range 18-50 years (mean 31.9 +/- 8.8), body mass index (BMI) > or =30 (mean 47.5 +/- 9.6), consecutively admitted from January 2000 to April 2003 to the Obesity Outpatients Clinic entered into the study. Patients were divided into two groups: (1) BMI 30.0-39.9, and (2) BMI> or =40. Ultrasound detected liver steatosis was classified as: (I) mild; (II) moderate, and (III) severe. All patients, except 4, showed a variable degree of steatosis: mild was more frequent among females, severe steatosis present only in grade III obesity, with higher prevalence in males than in females (p < 0.001). Mean serum transaminases, in particular alanine aminotransferase (ALT), increased according to BMI and degree of steatosis. Homeostasis Model Assessment (HOMA) index, ferritin and fibrinogen levels increased with BMI, particularly in severe steatosis. In group 2, patients with BMI> or =40 showed a positive correlation between ferritin, aspartate aminotransferase (AST) (r = 0.46, p < 0.018), ALT (r = 0.41, p < 0.036) and gamma-glutamyltransferase (gammaGT) (r = 0.51, p < 0.007), between serum triglycerides (TG) and AST (r = 0.28, p < 0.036), ALT (r = 0.30, p < 0.02) and between HOMA and ALT (r = 0.30, p < 0.03) and gammaGT (r = 0.35, p < 0.012). In group 2 patients with severe steatosis the prevalence of metabolic syndrome according to Adult Treatment Panel III (ATP III) was 40%. These data suggest that, in young adult non-diabetic grade III obese patients, fatty liver is always present and strictly related to insulin resistance which, in the presence of severe liver steatosis, is also related to serum ferritin.


Endocrine and cellular characteristics of corpora lutea from cows with a delayed post-ovulatory progesterone rise.
The timing of the post-ovulatory progesterone rise is critical to the embryonic development and survival. The aim of this study was to determine the underlying causes of delayed post-ovulatory progesterone rises. Two groups of non-lactating dairy cows with early (n = 11) or late (n = 9) post-ovulatory progesterone rises were created by inducing luteolysis in the presence of either a large (> 10 mm) or small (< 10 mm) follicle, respectively. LH pulses were measured on days 4 (all cows) and 7 (n = 7, early; n = 5, late) (day 1= ovulation). The cows were slaughtered on day 5 (n = 4 each group) or 8 (n = 7, early; n = 5, late). Immunohistochemical analysis for endothelial cells (von Willebrand Factor, VWF), steroidogenic cells (3beta-HSD) and proliferation marker (Ki67) were performed. The basal progesterone production and LH responsiveness (0.001-100 ng/ml) of dispersed luteal cells was investigated. The luteal concentrations of FGF-2 and VEGF were measured by ELISA and RIA, respectively. There were no differences in LH pulse characteristics, area of VWF staining, proliferation index, steroidogenic cell characteristics, basal or LH-stimulated progesterone production by luteal cells between cows with an early or late progesterone rise (P > 0.10). However, the area of VWF staining increased from days 5 to 8, while the proliferation index decreased (P < 0.05). Furthermore, the luteal cells were more responsive to LH on day 8 (P < 0.01). Luteal concentrations of FGF-2 were higher on day 5 (P = 0.05), while VEGF was greater on day 8 (P < 0.01). In conclusion, we have clearly shown that LH support, degree of vascularization or luteal cell steroidogenic capacity were not the major factors responsible for inadequate secretion of progesterone by the developing bovine CL.


Antitumor effect of Melaleuca alternifolia essential oil and its main component terpinen-4-ol in combination with target therapy in melanoma models.
Essential oils (EOs) have been recently emerging for their promising biological activities in preventing tumorigenesis or progression of different tumor histotypes, including melanoma. In this study, we investigated the antitumor activity of a panel of EOs in different tumor models. The ability of Melaleuca alternifolia (tea tree oil) and its main component, terpinen-4-ol, to sensitize the target therapy currently used for melanoma treatment was also assessed. Our results demonstrated that EOs differently affect the viability of human cancer cells and led us to select six EOs effective in melanoma and lung cancer cells, without toxic effects in human fibroblasts. When combined with dabrafenib and/or trametinib, Melaleuca alternifolia synergistically reduced the viability of melanoma cells by activating apoptosis. Through machine learning classification modeling, α-terpineol, tepinolene, and terpinen-4-ol, three components of Melaleuca alternifolia, were identified as the most likely relevant components responsible for the EO's antitumor effect. Among them, terpinen-4-ol was recognized as the Melaleuca alternifolia component responsible for its antitumor and proapoptotic activity. Overall, our study holds promise for further analysis of EOs as new anticancer agents and supports the rationale for their use to improve target therapy response in melanoma.


The Hey antigen and antibody. A second family study and the first example of an IgG anti-Hey.
A three generation family with 16 members shows that the Hey red blood cell antigen is not in the Rh, P or Kidd systems. The mother of the proband was found to have an IgG component in her anti-Hey, probably the result of alloimmunization by her two Hey-positive children. the wife of the proband who had 1 Hey-positive child, and 4 recipients of a single unit of Hey-positive blood did not have detectable anti-Hey. The presence of the IgG component of the mother's anti-Hey raises the possibility that both hemolytic disease of the newborn (HDN) and hemolytic transfusion reactions (HTR) could occur due to anti-Hey.


Independent validation of the Sleep Apnoea Quality of Life Index.
Obstructive sleep apnoea (OSA) affects important domains of quality of life which remain unexplored by conventional sleep recordings. The objective of this study was to examine the measurement properties (both discriminative and evaluative) of the Sleep Apnoea Quality of Life Index (SAQLI), a new OSA specific quality of life questionnaire. Consecutive patients recently diagnosed with OSA completed a French version of the SAQLI twice over a 3 month period. Its construct validity and responsiveness were tested by comparing baseline and change scores obtained in each domain (symptoms, activities, emotions, social interactions) with those of questionnaires measuring related constructs (SF-36, Epworth Scale, Beck Depression Inventory, and Symptom Checklist 90). The symptoms scores were also correlated with physiological measures obtained at baseline polysomnographic recording. Forty seven patients (40 men) of mean (SD) age 53 (10) years and mean (SD) apnoea/hypopnoea index 38 (21) participated in the study. During the study period 33 of the 47 patients were treated for OSA (31 with nasal CPAP, one with uvulopalatopharyngoplasty, and one with an oral appliance). Moderate to high correlations were found between the scores in each domain of the SAQLI and the corresponding instruments. There were significant differences in change scores between patients who were treated and those who were not, moderate correlations between SAQLI change scores and changes in the corresponding instruments, and no correlation between the symptoms scores and the baseline nocturnal features. Most of these correlations met the a priori predictions made regarding their magnitude. The SAQLI has strong construct validity and is responsive to change in quality of life but has the disadvantage of having to be administered by an interviewer.


Redefining Chlorobotryaceae as one of the principal and most diverse lineages of eustigmatophyte algae.
Eustigmatophyceae is one of the ∼17 classes of the vast algal phylum Ochrophyta. Over the last decade, the eustigmatophytes emerged as an expansive group that has grown from the initially recognized handful of species to well over 200 genetically distinct entities (potential species). Yet the majority of eustigs, remain represented by unidentified strains, or even only metabarcode sequences obtained from environmental samples. Moreover, the formal classification of the group has not yet been harmonized with the recently uncovered diversity and phylogenetic relationships within the class. Here we make a major step towards resolving this issue by addressing the diversity, phylogeny and classification of one of the most prominent eustigmatophyte clades previously informally called the "Eustigmataceae group". We obtained 18S rDNA and rbcL gene sequences from four new strains from the "Eustigmataceae group", and from several additional eustig strains, and performed the most comprehensive phylogenetic analyses of Eustigmatophyceae to date. Our results of these analyses confirm the monophyly of the "Eustigmataceae group" and define its major subclades. We also sequenced plastid genomes of five "Eustigmataceae group" strains to not only improve our understanding of the plastid gene content evolution in eustigs, but also to obtain a robustly resolved eustigmatophyte phylogeny. With this new genomic data, we have solidified the view of the "Eustigmataceae group" as a well-defined family level clade. Crucially, we also have firmly established the genus Chlorobotrys as a member of the "Eustigmataceae group". This new molecular evidence, together with a critical analysis of the literature going back to the 19th century, provided the basis to radically redefine the historical concept of the family Chlorobotryaceae as the formal taxonomic rubric corresponding to the "Eustigmataceae group". With this change, the family names Eustigmataceae and Characiopsidaceae are reduced to synonymy with the Chlorobotryaceae, with the latter having taxonomic priority. We additionally studied in detail the morphology and ultrastructure of two Chlorobotryaceae members, which we describe as Neustupella aerophytica gen. et sp. nov. and Lietzensia polymorpha gen. et sp. nov. Finally, our analyses of partial genomic data from several Chlorobotryaceae representatives identified genes for hallmark flagellar proteins in all of these strains. The presence of the flagellar proteins strongly suggests that zoosporogenesis is a common trait of the family and also occurs in the members never observed to produce flagellated stages. Altogether, our work paints a rich picture of one of the most diverse principal lineages of eustigmatophyte algae.


Optimization of Gelatin Extracting Condition from Korean Native Black Goat Skin and Quality Comparison with Commercial Gelatin.
The practical use of Korean native black goat skin as a source of gelatin extraction is limited. The objective of this study was to optimize the extraction temperature and time of gelatin from Korean native black goat skin, and to compare the quality characteristics of goat skin gelatin and other commercial gelatin products. Response surface methodology was applied to optimize the extraction temperature and time of gelatin obtained from native Korean black goat skin. The effects of temperature (50°C-70°C) and time (2-4 h) on extraction yield and gel strength were investigated using a face-centered central composite design with 13 experiments. Gelatin extraction from Korean native black goat skin was prepared through the serial processes of alkali pre-treatment, bleaching, neutralization, hot-water extraction, and freeze-drying. Using the optimization plot of Minitab software, the optimized conditions for extracting temperature and time of goat skin gelatin were 59.49°C and 3.03 h, and the optimized values of extraction yield and gel strength were 12.52% and 263.37 g, respectively. Based on a quality comparison of goat skin gelatin with commercial gelatin, the pH value of gelatin extracted from Korean native black goat skin was 5.57. The color of gelatin extracted from Korean native black goat skin was darker than that of commercial gelatin (p<0.05). Higher emulsifying properties and gel strength of goat skin gelatin were observed when compared to those of commercial gelatin (p<0.05). Therefore, the results of this study indicate that Korean native black goat skin may be a valuable source for gelatin extraction.


Laparoscopic Adrenalectomy: Tailoring Approaches for the Optimal Resection of Adrenal Tumors.
In this study, we investigated the outcomes of laparoscopic approaches for adrenal tumor resection in 67 patients from a single center with a median age of 51 (range 40-79). Predominantly comprising women, the majority of patients were overweight or obese. Adrenal tumors larger than 6 cm were mostly treated using the laparoscopic transperitoneal method (p < 0.001). Our results revealed that patients subjected to the retroperitoneal approach exhibited quicker recovery, as evidenced by faster resumption of oral intake and ambulation, along with reduced intraoperative blood loss and shorter hospitalization (p-value < 0.05). In contrast, patients subjected to the transperitoneal approach experienced minimal complications, though not statistically significant, despite the technique's intricacy and slower recovery. These findings emphasize the significance of tailoring the surgical approach to individual patient characteristics, with particular emphasis on the tumor size. The choice between the retroperitoneal and transperitoneal methods should be informed by patient-specific attributes to optimize surgical outcomes. This study underscores the need for a comprehensive evaluation of factors such as tumor characteristics and postoperative recovery when determining the most suitable laparoscopic approach for adrenal tumor resection. Ultimately, the pursuit of individualized treatment strategies will contribute to improved patient outcomes in adrenal tumor surgery.


Person-centered home-based rehabilitation for persons with Parkinson's disease: A scoping review.
Due to vague, initial symptoms, persons with Parkinson's disease (PD) usually receive a definitive diagnosis after a prolonged period of time. At the time of diagnosis, they have already experienced limitations in activities of daily living and quality of life and are thus in need of immediate rehabilitation. To describe the existing knowledge on the rehabilitation of persons with PD suitable to a home environment and to describe the person-centeredness, interprofessionality and clinical effectiveness of existing rehabilitation activities. 67 full-text papers from the EBSCO, CINAHL, Medline, Google and Google Scholar databases, published in English, Swedish or Finnish between January 2010 and October 2018, were charted (type of rehabilitation, sample, instrumentation, reported effects) and summarized. Rehabilitation through physical activities still appears to be the most common form of rehabilitation, varying from walking to individually tailored exercise programs. The majority of physical rehabilitation activities were conducted outside the home even though they were suitable for a home setting. Physical activities not only improved several physical outcomes but also quality of life, well-being and activities of daily living functions, especially when digital devices were used. Cognitive and psychosocial rehabilitation were much less researched but seen to be an emerging area of research. The focus of rehabilitation seems to lie on persons with PD, not their near-ones. The majority of interventions were planned without discussing in advance with the persons with PD about their preferences, needs or values. Very few interventions were individually tailored or conducted in a home setting, and many studies included patient-recorded outcome measures, but only as secondary to clinical measures. Only a few studies focused on an interprofessional approach to PD rehabilitation, despite the approach being found effective in regard to quality of life for persons with PD. There appears to be a focus on physical outcomes and symptom management in the rehabilitation of persons with PD, even though cognitive and psychosocial well-being are often explored as secondary outcomes. Very few rehabilitation interventions were planned with persons or conducted in a home setting, and no interventions were seen that included near-ones. The majority of interventions were planned without the involvement of persons with PD. Still, many of the studies included patient-recorded outcome measures. Digital devices that assist in physical rehabilitation and an interprofessional approach to rehabilitation yield positive clinical outcomes, which in turn promotes a person-centered and holistic approach to rehabilitation.


Tryptophan hydroxylase(2) gene polymorphisms predict brain serotonin synthesis in the orbitofrontal cortex in humans.
Brain regional serotonin synthesis can be estimated in vivo using positron emission tomography (PET) and α-[((11))C]methyl-L-tryptophan ((11)C-AMT) trapping (K*) as a proxy. Recently, we reported evidence of lower normalized (11)C-AMT trapping in the orbitofrontal cortex (OBFC) of subjects meeting the criteria for an impulsive and/or aggressive behavioral phenotype. In this study, we examined whether part of the variance in OBFC serotonin synthesis is related to polymorphisms of the gene that encodes for the indoleamine's rate-limiting enzyme in the brain, tryptophan hydroxylase-2 (TPH(2)). In all, 46 healthy controls had PET (11)C-AMT scans and were genotyped for 11 single-nucleotide polymorphisms (SNPs) distributed across the TPH(2) gene and its 5' upstream region. Several TPH(2) SNPs were associated with lower normalized blood-to-brain clearance of (11)C-AMT in the OBFC. Dose-effect relationships were found for two variants (rs6582071 and rs4641527, respectively, located in the 5' upstream region and intron 1) that have previously been associated with suicide. Associations in the OBFC remained statistically significant in a mixed larger sample of patients and controls. These results suggest that in humans, genetic factors might partly account for variations in serotonin synthesis in the OBFC.


Transcranial ultrasound diagnostic value of hemodynamic cerebral changes in preterm infants for early-onset sepsis.
Due to the limitation of blood culture diagnosis, this study sought to evaluate the cerebral hemodynamic changes by Doppler ultrasound for timely and objective diagnosis techniques in preterm infants with early onset-neonatal sepsis. In this retrospective study, 86 preterm infants treated at the Department of Neonatology, Renmin Hospital of Wuhan University from January 1, 2019 to March 31, 2021, were divided into the following 2 groups: (I) the early onset neonatal sepsis (EONS) group (G1, n=41); (II) the normal control group (G2, n=45). The cerebral hemodynamic changes were examined by transcranial ultrasound. Stata15.0 and SPSS26.0 software were used for the data analysis. The pair-wise comparisons of the receiver operating characteristic (ROC) curves were on the MedCalc18.2.1 software. For all the statistical analyses, P value <0.05 was considered significant. Sex, birth weight, and gestational age did not differ significantly between the groups (P>0.05); the peak systolic velocity (PSV), mean velocity (MV), end diastolic velocity (EDV) (cm/s), resistivity index (RI), pulsatility index (PI) of the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA) differed significantly between 2 groups (P<0.05). In relation to the diagnostic sensitivity, the area under the receiver operating characteristic (AUROC) analyses showed that compared to IL-6 (0.95, 1.00), EDV of the ACA, and PSV, EDV and MV of the MCA and PCA had a higher sensitivity than the others (AUROC: 1, all 95% CI: 1.00, 1.00). The diagnostic points of the EDV and MV of the ACA were 9.8 and 17.3 cm/s, respectively, the PSV, EDV, and MV of the MCA were 55.9, 10.9, and 20.4 cm/s, respectively, and the PSV, EDV, and MV of the PCA were 27.5, 7.5, and 9.8 cm/s, respectively. The study showed that PI increases and RI decreases, MV increases, and cerebral blood flow increases in EONS. Further, the EDV and MV of the ACA and the PSV, EDV, and MV of the MCA and PCA showed higher sensitivity than IL-6.


Phytol suppresses parasitemia and ameliorates anaemia and oxidative brain damage in mice infected with Plasmodium berghei.
The quest for the development of a novel antimalarial drug informed the decision to subject phytol to in vivo trials following a demonstration of therapeutic potential against chloroquine sensitive strain of Plasmodium falciparum under in vitro condition. On this basis, the in vivo anti-Plasmodium berghei activity of phytol including the ameliorative effects of the compound on P. berghei-associated anaemia and organ damage were investigated. Mice were infected with chloroquine-sensitive strain of P. berghei and were treated with phytol at a dose of 10 and 20 mg/kg body weight (BW) for four days. The levels of parasitemia, packed cell volume and redox sensitive biomarkers of liver, brain and spleen tissues were determined. Our result revealed that phytol significantly (p < 0.05) suppressed the multiplication of P. berghei in a dose-dependent manner. Additionally, the phytol significantly (p < 0.05) ameliorated the P. berghei-induced anaemia and brain damage. Data from the present study demonstrated that phytol has suppressive effect on P. berghei and could ameliorate some P. berghei-induced pathological changes.


Analysis of eye tracking movements using innovations generated by a Kalman filter.
A simple but efficient algorithm has been developed for computer analysis of eye tracking movements. The program separates smooth pursuit and saccadic eye movements. Separation of the two components is achieved using a two-step process of saccade detection. First, an AR model of the velocity of the smooth component is identified and used to determine a Kalman filter. Secondly the innovation sequence generated by this filter allows saccade detection. The precise beginning and end of each saccade are found using a Hinkley algorithm. Examples are given of analysis procedure for eye tracking of a random moving target. The method proved to be highly reliable and could be easily extended to other eye movements such as nystagmus.


Graphene family for hydrogen peroxide production in electrochemical system.
The development of carbon-based materials to catalyze two-electron (2e-) pathway of oxygen reduction reaction (ORR) offers great potential for hydrogen peroxide (H2O2) production. As a class of novel two-dimensional (2D) carbon materials, graphene and its derivatives have raised increasing attention as excellent noble-metal-free catalysts in 2e ORR due to their unique structure, physical and chemical properties. This review focuses on the synthesis of main graphene family members and graphene based electrodes, as well as their applications for H2O2 generation in electrochemical systems. We describe the functions of the graphene family in electrochemical systems, such as accelerating electron transfer and increasing oxygen transfer for cathodes in electrochemical systems, aiming to reveal the enhancement mechanisms of graphene and its derivatives on H2O2 production. Furthermore, the challenges and prospects for graphene family used as catalyst for H2O2 production in the future are also proposed.