Relation of habitual snoring with components of metabolic syndrome in Korean adults.
To examine the association between habitual snoring and components of the metabolic syndrome in Korean adults. Whether these associations are independent of obesity was also explored. Four thousand five hundred and six men and 5041 women aged 40-69 years from the Korean Health and Genome Study were examined. Information of snoring frequency was obtained by a questionnaire and components of the metabolic syndrome were measured. There was a clear dose-response relationship between the increasing frequency of snoring and the higher prevalence of each component of the metabolic syndrome (P<0.001). After adjustment for age, abdominal obesity, and the other metabolic components, hypertension was significantly associated with a 1.2-fold excess of habitual snoring in both men (P<0.05) and women (P<0.05). The association of habitual snoring with hypertension was unaltered by obesity. Regardless of the presence or absence of abdominal obesity, there was an increase in the prevalence of habitual snoring as the number of metabolic abnormalities increased. Habitual snoring is associated with hypertension independent of obesity. While the relationship between habitual snoring and obesity is well recognized, characterization of the role of the other components of the metabolic syndrome as a cause or result of habitual snoring warrants a further study.


Design, synthesis, and in silico studies of quinoline-based-benzo[d]imidazole bearing different acetamide derivatives as potent α-glucosidase inhibitors.
In this study, 18 novel quinoline-based-benzo[d]imidazole derivatives were synthesized and screened for their α-glucosidase inhibitory potential. All compounds in the series except 9q showed a significant α-glucosidase inhibition with IC50 values in the range of 3.2 ± 0.3-185.0 ± 0.3 µM, as compared to the standard drug acarbose (IC50 = 750.0 ± 5.0 µM). A kinetic study indicated that compound 9d as the most potent derivative against α-glucosidase was a competitive type inhibitor. Furthermore, the molecular docking study revealed the effective binding interactions of 9d with the active site of the α-glucosidase enzyme. The results indicate that the designed compounds have the potential to be further studied as new anti-diabetic agents.


Effect of titanium tetrafluoride, amine fluoride and fluoride varnish on enamel erosion in vitro.
This study aimed at evaluating the effect of 1 and 4% titanium tetrafluoride (TiF4) gels, amine fluoride (AmF) 1 and 0.25% and a fluoride varnish (FP) on the prevention of dental erosion. Two experimental groups served as controls, one with no pretreatment and another one pretreated with a fluoride-free varnish (FP-blanco). Dental erosion was modelled using bovine enamel samples submitted to alternate cycles of acid exposure in citric acid and remineralization in artificial saliva. Calcium loss of all samples involved in the study was quantified by atomic absorption spectroscopy and erosion depths were estimated. Two samples of each experimental group were also analyzed by white light confocal microscopy. The cumulative erosion depth (in mum) after 72 min was: TiF4 gel 1% 8.29 +/- 0.39; TiF4 gel 4% 8.27 +/- 0.55; AmF 1% 8.69 +/- 0.66; AmF 0.25% 8.86 +/- 0.33; FP 3.43 +/- 1.07; FP-blanco 14.86 +/- 1.59 and control 9.77 +/- 0.49. A statistically significant protective effect (p < or = 0.001) was found only for the group pretreated with the fluoride varnish. Within the limitations of an in vitro study it may be concluded that topical applications of the fluoride varnish tested have a protective effect on the prevention of dental erosion.


Prevalence of 25-hydroxyvitamin D deficiency in the acute inpatient rehabilitation population and its effect on function.
To assess the prevalence of 25-hydroxyvitamin D (25[OH]D) insufficiency and deficiency in the acute inpatient rehabilitation setting, identify risk factors associated with low serum 25(OH)D levels, and assess whether hypovitaminosis D affects the function of rehabilitation patients. Retrospective cohort study. Academic acute rehabilitation facility. Patients (N=101) admitted for acute inpatient rehabilitation between September 2008 and December 2008. Serum 25(OH)D levels drawn within 24 hours of admission. 25(OH)D level, total/motor/cognitive FIM efficiency. Considering patients not receiving 25(OH)D supplementation at the time of admission, 23.0% were 25(OH)D sufficient, 68.9% were insufficient, and 8.1% were deficient. Patients receiving 25(OH)D supplementation at the time of admission had significantly higher 25(OH)D levels than patients not receiving 25(OH)D supplementation (33.4±12.8 vs 23.7±11.4ng/mL; P=.001). A total of 72.2% of patients with any fracture and 80.0% of patients with fracture due to fall were not receiving supplementation at the time of admission; 72.2% of patients with any fracture and 73.3% of patients with fracture due to fall were 25(OH)D insufficient. Unadjusted total FIM efficiency scores were statistically significantly different by 25(OH)D status (2.96±1.42 vs 2.29±1.41ng/mL; P=.039). However, 25(OH)D level was not a significant predictor of total FIM efficiency score after controlling for demographic and clinical factors. Of acute rehabilitation patients, 77% are 25(OH)D insufficient or deficient at admission. 25(OH)D supplementation is associated with a greater 25(OH)D level in these patients; however, almost half those supplemented had 25(OH)D levels less than the reference range. Most inpatients with fracture due to fall were transferred to acute inpatient rehabilitation without 25(OH)D supplementation despite clear guidelines indicating its use in this situation.


Diffusion effects on longitudinal relaxation in poorly mixed compartments.
Diffusion of spins between physical or virtual, communicating compartments having different states of longitudinal magnetization leads to diffusion-driven longitudinal relaxation. Herein, in two model systems, the effects of diffusion-driven longitudinal relaxation are explored experimentally and analyzed quantitatively. In the first case, longitudinal relaxation in a single slice of a water phantom is monitored spectroscopically as a function of slice thickness. In the second case, mimicking vascular flow/diffusion effects, longitudinal relaxation is monitored in a two-compartment, semi-permeable fiber phantom. In both cases, apparent longitudinal relaxation, though clearly multi-exponential, is well-modeled as bi-exponential.


The forced swim test: Historical, conceptual and methodological considerations and its relationship with individual behavioral traits.
The forced swim test (FST), developed by Porsolt and collaborators in 1977 to evaluate antidepressant (AD) treatments in rodents, has become extensively used for this purpose and to evaluate depression-like states. Despite its popularity, studies have raised important concerns regarding its theoretical and predictive validity. In my view and that of others, the FST mainly evaluates coping strategies in an inescapable situation. Although it is reasonable to assume that ADs act favoring active coping whereas negative affective states would favor passive coping, this does not mean that only ADs should enhance active coping or that a depression state has developed, respectively. Given its simplicity, proper interpretation of the FST behavior is critically dependent on how FST behavior relates to other behavioral traits. Unfortunately, this issue has been poorly discussed previously. Then, the present review, using a historical perspective, offers information needed to better understand the meaning and limitations of the FST, discusses critical methodological aspects and analyzes the relationship of FST behavior with classical behavioral traits in rodents.


Quantitative determination of d-psicose based on flexible copper film materials and electrochemical scanning methods.
In this paper, a three-electrode electrochemical detection system was designed. Platinum electrode was used as the counter electrode, saturated KCl electrode as reference electrode, and copper film material as working electrode, respectively. Cyclic voltammetry (CV) and chronoamperometry (i-t) methods were used for d-psicose scanning. CV results indicated that d-psicose presented the oxidation-reduction reacting procedure on the surface of copper film electrode. Testing parameters optimization was conducted using CV scanning in different scanning rates. d-psicose quantitative determination model was developed by i-t scanning results. The sensitivity was9419.1A×cm-2·mol/L, the detection limit was1.04311×10-8mol/L. The proposed method has some advantages including high sensitivity, low detection line, and fast response speed. Negative control testing results by using glucose, sucrose, and NaCl solutions demonstrated that the proposed method had good selectivity.


The amino-terminal sequence of lobster fibrinogen reveals common ancestry with vitellogenins.
The amino-terminal sequence of lobster "fibrinogen" was determined. A computer search of the sequence revealed that the lobster protein is homologous to vitellogenins (precursors of egg-yolk proteins).


Large-scale brain network associated with creative insight: combined voxel-based morphometry and resting-state functional connectivity analyses.
Creative insight occurs with an "Aha!" experience when solving a difficult problem. Here, we investigated large-scale networks associated with insight problem solving. We recruited 232 healthy participants aged 21-69 years old. Participants completed a magnetic resonance imaging study (MRI; structural imaging and a 10 min resting-state functional MRI) and an insight test battery (ITB) consisting of written questionnaires (matchstick arithmetic task, remote associates test, and insight problem solving task). To identify the resting-state functional connectivity (RSFC) associated with individual creative insight, we conducted an exploratory voxel-based morphometry (VBM)-constrained RSFC analysis. We identified positive correlations between ITB score and grey matter volume (GMV) in the right insula and middle cingulate cortex/precuneus, and a negative correlation between ITB score and GMV in the left cerebellum crus 1 and right supplementary motor area. We applied seed-based RSFC analysis to whole brain voxels using the seeds obtained from the VBM and identified insight-positive/negative connections, i.e. a positive/negative correlation between the ITB score and individual RSFCs between two brain regions. Insight-specific connections included motor-related regions whereas creative-common connections included a default mode network. Our results indicate that creative insight requires a coupling of multiple networks, such as the default mode, semantic and cerebral-cerebellum networks.


[Depth and integration of science modules in medical studies at recognized public and private faculties in Germany: A cross-sectional study].
At the end of November 2020, four years after the adoption of the Masterplan Medizinstudium 2020, the Federal Ministry of Health presented the draft bill for the revision of the medical licensing regulations. This was adapted in August 2021 and stipulates, among other things, the completion of a mandatory scientific project up to the second stage of the medical examination, which is to be conducted within twelve weeks and based on the structured teaching of scientific skills using longitudinal courses. This study examines to what extent the mentioned aspects of the draft bill are already included in the current compulsory curricula in German medical study programs. In a cross-sectional study, we conducted a document analysis and an online survey of the student deaneries of state and private, state-recognized faculties of medicine in Germany. The objective was to assess the integration of curricular science projects and longitudinal science modules. The data was analyzed descriptively. In total, 40 (93%) of 43 faculties were included in the document analysis. 26 (60.5%) of 43 academic deans responded to the online questionnaire. Only twelve (30%) of the faculties offer a mandatory science project according to the document analysis and eight (30.8%) according to the evaluation of the online survey. In relative terms, a mandatory science project is already a curricular component in the majority of model and reform degree programs (document analysis: 83.3%, n=10 / N=12; questionnaire: 87.5%, n=7 / N=8). This contrasts with a significantly smaller number of regular degree programs that currently offer a science project as a mandatory component (document analysis: 16.7%, n=2 / N=12; questionnaire: 12.5%, n=1 / N=8). In the majority of the model and reform courses, a compulsory (longitudinal) science module has already been integrated into the curriculum (document analysis: 75%, n=12 / N=16; questionnaire: 55.5%, n=6 / N=11). This is only true for 25% (n=4 / N=12; document analysis) and 44.5% (n=5 / N=11; questionnaire) of the regular courses. The results of the surveys indicate that the regular study programs, in particular, need to be restructured in order to integrate the intended time frame of twelve weeks for an obligatory science project into the current curriculum. How this is to be achieved without reducing the existing study content seems to be still unclear. Regardless of the current draft bill, however, this step appears to be necessary in order to strengthen the acquisition of scientific competencies in medical studies and to adapt it to international medical education. The majority of the current model and reformed medical study courses already fulfill the requirements of the draft bill for the new licensing regulations with regard to the curricular integration of an obligatory scientific project and longitudinal strand on scientific work, which offer hints on design possibilities for further faculties.


The efficacy and safety of preoperative cholangiography via percutaneous transhepatic gallbladder drainage (PTGBD) for difficult laparoscopic cholecystectomy (LC).
Percutaneous transhepatic gallbladder drainage (PTGBD) is an important procedure for initial treatment of severe acute cholecystitis (AC) that is contraindicated for early laparoscopic cholecystectomy (LC). We presented our primary experience on a new approach of cholangiography via PTGBD (PTGBD-C) for preoperative delineation of biliary anatomy. A retrospective analysis was conducted on 93 patients who received PTGBD followed by LC for AC, with allocation into 2 groups that were PTGBD with (PTGBD-C group, 32 patients) or without (PTGBD-N group, 61 patients) cholangiography. All the clinical data, including demographics, cholangiography findings, operations, and complications, were collected and analyzed. Cholangiography was attempted in 32 patients with a success of 31 cases, and the most common complication was transient fever in 3 patients. PTGBD-C group of patients showed significantly less operation time (83.2 ± 22.32 vs. 106.5 ± 40.25 min, P = 0.041) and conversion rate (0 vs. 2). There was no statistical difference in terms of postoperative hospitalization and complications. PTGBD-C is a feasible and safe procedure for severe AC patients with delayed LC. It has advantages of direct cholangiography, being easy to perform and cost-effective, thus should be considered for clinical usage.


Deuterium oxide effects on excitation-contraction coupling of skeletal muscle.
2H2O (99.8%) Ringer's solution greatly reduces the twitch and tetanus of frog sartorius muscle and, as specially shown here, slows the onset features of the mechanical output of the twitch by: (a) increasing the time (LR) from stimulus to start of latency relaxation; (b) slowing the development of the latency relaxation, and (c) greatly decreasing the rate of onset of tension development. These changes reflect effects of 2H2O on excitation-contraction coupling and they represent the critical direct effects of 2H2O on muscle since it does not depress either the action potential or the intrinsic myofibrillar contractility. The increase in LR is attributed to slowed inward electrical propagation in the T-tubule. But the critical effect of 2H2O on frog muscle is to greatly depress mobilization of activator Ca2+. The depression of the Ca2+ mobilization and of its effects on the activation of contraction evidently result from (a) a lowered rate of release of Ca2+ from the sar coplasmic reticulum, as indicated by the slowed development of the latency relaxation, (b) a decreased amount of Ca2+ released in a twitch, and (c) a reduced speed of diffusion of the Ca2+ to the contractile filaments. The depressed mobilization of Ca2+ is apparently the essential cause of 2H2O's general depression of twitch and tetanus output.


Concordant spiritual orientations as a factor in physician-patient spiritual discussions: a qualitative study.
To understand the impact of physicians' and patients' religious/spiritual orientation on discussions of spiritual issues. We performed semi-structured interviews of 10 Missouri family physicians and 10 patients of these physicians, selecting subjects nonrandomly to represent a range of demographic factors, practice types, and chronic or terminal illness. We coded and evaluated transcribed interviews for themes. Respondents expressed that similar belief systems facilitate patient-physician spiritual interactions and bring confidence to their relationships. Those holding dissimilar faiths noted limited ability to address spiritual questions directly. They cited significant barriers to spiritual interaction but considered that ecumenism, use of patient-centered care, and negotiation skills lessen these barriers. Our respondents view spirituality similarly to other aspects of the physician-patient relationship involving differing viewpoints. Where discordance exists, cross-cultural, patient-centered, diplomatic approaches facilitate spiritual discussions.


In utero early suspicion of superfetation by ultrasound examination: a case report.
We report the case of a dichorionic and diamniotic pregnancy with the unique feature of an early ultrasound diagnosis of a 4-week size difference, which persisted throughout pregnancy. At birth, the twins had a 1-month difference in physical and neurological maturity. We believe that only the phenomenon of a superfetation can explain this difference. We report the cases found in the literature.


Application of the thiobarbiturate assay to the measurement of lipid peroxidation products in microsomes.
By applying two different thiobarbiturate assay procedures in parallel to aliquots of a microsomal incubation mixture one can simultaneously monitor free malondialdehyde and malondialdehyde plus labile lipid peroxidation products. The levels of malondialdehyde increase continuously during the incubation of microsomes, NADPH and ferrous-ADP complex, while the lipid precursors of MDA stop forming when the system becomes depleted in NADPH. In contrast to systems in which lipids are undergoing autooxidation, NADPH-dependent lipid peroxidation does not appear to generate significant amounts of water-soluble malondialdehyde precursors. As a result, quantitative interpretation of results is straightforward in the microsomal system. In spite of the lack of specificity of the thiobarbiturate coupling reaction, interferences can be easily compensated for by using zero time controls.


Conditional Tet-regulated over-expression of Hoxa2 in CG4 cells increases their proliferation and delays their differentiation into oligodendrocyte-like cells expressing myelin basic protein.
Hoxa2 gene was reported to be expressed by oligodendrocytes (OLs) and down-regulated at the terminal differentiation stage during oligodendrogenesis in mice (Nicolay et al. 2004b). To further investigate the role of Hoxa2 in oligodendroglial development, a tetracycline regulated controllable expression system was utilized to establish a stable cell line (CG4-SHoxa2 [sense Hoxa2]), where the expression level of Hoxa2 gene could be up-regulated. The impact of Hoxa2 over-expression on the proliferation and differentiation of CG4-SHoxa2 cells was investigated. Up-regulation of Hoxa2 increased the proliferation of CG4-SHoxa2 cells. The mRNA levels of PDGFαR (platelet-derived growth factor [PDGF] alpha receptor), which is expressed by OL progenitor cells, were not different in CG4-SHoxa2 cells compared to wild-type CG4 cells. Semi-quantitative RT-PCR revealed that the mRNA levels of myelin basic protein (MBP) was lower in CG4-SHoxa2 cells than in wild-type CG4 cells indicating the differentiation of CG4-SHoxa2 cells was delayed when the Hoxa2 gene was up-regulated.


Primary care house staff attitudes toward osteoporosis management.
This study assessed possible institutional and patient-related factors influencing the delivery of postmenopausal osteoporosis (PMO) care and the diagnostic priority placed on addressing PMO, relative to other common medical conditions, by primary care house staff at our institution. A questionnaire was designed and distributed to eligible house staff at our institution. Approximately 50% (n = 52) of the house staff participated. The supervising clinic attending, patients' lack of insurance, accessibility to medical care, comorbid conditions, and university formulary were reported to influence decisions regarding osteoporosis care. Osteoporosis was ranked 6th of 7 medical issues (hypertension, coronary artery disease, diabetes, hypercholesterolemia, adult immunizations, osteoporosis, thyroid disease) to address during a comprehensive medical visit. Our institution's primary care house staff reported multiple influences on decision making regarding osteoporosis care, and an overall low priority to address this issue. Based on PMO's associated morbidity and mortality, primary care training programs are challenged to put resources toward optimizing house staff delivery of osteoporosis care.


Can changes in parentally measured acoustic reflectometry levels predict the middle ear status?
Spectral gradient acoustic reflectometry (SG-AR) may be used to detect middle ear effusion. Our aim was to investigate whether increasing SG-AR levels between two SG-AR examinations indicate deterioration from a healthy middle ear to acute otitis media (AOM). We enrolled 185 children (age 6-35 months) whose parents were willing to use the SG-AR at home daily. Measurement pairs of parental home SG-AR examination results were generated and analyzed. There was one SG-AR examination result obtained within ±1 day of the reference visit and another result within ±1 day of the subsequent visit. We defined the SG-AR level as increasing when the difference between two measurements was ≥2 levels from a lower to a higher level, suggesting development of AOM. When the SG-AR level difference was ≤1, we defined this no change of the SG-AR level. The middle ear diagnosis was determined by pneumatic otoscopy at the study clinic. 361 paired SG-AR home measurements were obtained. The reference measurement was related to a healthy middle ear as determined by pneumatic otoscopy. Increasing SG-AR levels (59/361), were 63% (95% CI 50%-74%) sensitive and 94% (91%-97%) specific for deterioration of a healthy middle ear to AOM. The positive predictive value was 71% (58%-82%) and the negative predictive value was 92% (88%-95%). When there was no SG-AR level difference between the SG-AR examinations, the corresponding figures were 88% (95% CI 84%-92%), 69% (56%-79%), 93% (89%-95%) and 57% (45%-68%), respectively. This study shows that increasing SG-AR levels might not be sufficiently sensitive to detect deterioration of the middle ear status from healthy middle ear to AOM in symptomatic children. Importantly, however, the development of AOM seems to be unlikely in an initially healthy middle ear when there is no difference between the SG-AR levels in two separate measurements.


Pd nanoparticles decorated BiVO4 pine architectures for photocatalytic degradation of sulfamethoxazole.
Sulfamethoxazole (SMX) has been extensively detected in wastewater treatment plant effluents and surface water. Because of its potential risks to ecology and health, treatment for eliminating SMX is urgently required. In this study, we report the application of Pd nanoparticles decorated on BiVO4 pine architecture for the photocatalytic degradation of SMX. The results showed that the barer BiVO4 and Pd-BiVO4 eliminated SMX under visible-light irradiation. After 210 min of irradiation, 98.8% of SMX was substantially eliminated by Pd-BiVO4, whereas bare BiVO4 can degraded approximately 36.3% of SMX. Pd-BiVO4 also exhibited a high mineralization rate (84% of total organic carbon (TOC) removal) compared to bare BiVO4 (51% of TOC removal). Through three-dimensional excitation-emission matrix fluorescence spectra, SMX with high fluorescence intensity can be degraded to non-fluorescence intermediate products, further confirming the high mineralization of SMX over Pd-BiVO4 catalyst. Well-dispersed Pd nanoparticles on the {040} facet of BiVO4 pine architecture can support the recombination of photogenerated charge carriers because of the formation of the Schottky junction at the Pd-BiVO4 interface. Besides, the active species trapping tests indicated that •O2- and h+ radicals dominate SMX photodegradation over Pd-BiVO4. The main degradation intermediates of SMX in the reaction solution was also identified through ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry analysis. This investigation can provide insight into designing metallic/semiconductor junctions for antibiotic elimination in water media.


Non-tumor applications of radioimmune imaging.
The application of radioimmune imaging techniques to the evaluation of non-neoplastic disease is largely based on the same principles as tumor imaging; specificity and high affinity of antibodies. Currently the most common non-tumor applications of antibody imaging are the detection of clots (peripheral and pulmonary emboli), myocardial necrosis (myocardial infarction, myocarditis and cardiac transplant rejection) and focal sites of infection/inflammation. In the area of injection imaging, both antigen-specific and non-specific properties of antibodies have been successfully exploited in imaging studies. While the number of non-tumor applications of antibodies are far fewer than the number of tumor studies, in many cases, they appear to be more reliable. The basis for the reliability of antibodies for detecting non-neoplastic lesions is probably related to the availability of abundant antigen, lack of antigen modulation and enhanced permeability at the lesion site. These observations suggest that there will be rapid proliferation of work in this area.


Treatment Outcome and Root Canal Preparation Techniques: 5-Year Follow-Up.
This study aims at comparing treatment outcome and tooth survival of root canal-filled teeth following manual vs rotary instrumentation techniques over a 5-year period. This was a single-centre study conducted as a follow-up to a short-term parallel-arm randomised controlled noninferiority trial in which root canal treatment was performed on teeth using either rotary or manual instrumentation. Patients were monitored at post 6-month, 1-year, 4-year, and 5-year review periods by blinded evaluators. Treatment outcome was categorised as favourable, uncertain, and unfavourable (employing European Society of Endodontology categorisation based on strict clinical and radiographic criteria), and 5-year tooth survival was determined by assessing whether tooth was in situ in the oral cavity or extracted. The Kaplan-Meier method and log rank test evaluated tooth survival. P value <.05 was considered statistically significant. Ninety of 120 treated teeth were assessed in 37 men and 40 women with mean age of 30.6 ± 10.99 years. Treatment outcome was significantly more favourable in the rotary group compared to the manual group at post 6-month (P = .021) and 1-year (P = .043) review periods. The differences in favourable outcome (P = .498) and tooth survival (P = .296) between the 2 groups were, however, not significant at the 5-year review period. The rotary instrumentation technique was shown to be more effective in resolving clinical symptoms and promoting periapical healing after the post 6-month and 1-year review compared to the manual instrumentation technique; however, both groups had similar favourable outcomes and survival rates after an extended 5-year review period.


Large-scale F0 CRISPR screens in vivo using MIC-Drop.
The zebrafish is a powerful model system for studying animal development, for modeling genetic diseases, and for large-scale in vivo functional genetics. Because of its ease of use and its high efficiency in targeted gene perturbation, CRISPR-Cas9 has recently gained prominence as the tool of choice for genetic manipulation in zebrafish. However, scaling up the technique for high-throughput in vivo functional genetics has been a challenge. We recently developed a method, Multiplexed Intermixed CRISPR Droplets (MIC-Drop), that makes large-scale CRISPR screening in zebrafish possible. Here, we outline the step-by-step protocol for performing functional genetic screens in zebrafish by using MIC-Drop. MIC-Drop uses multiplexed single-guide RNAs to generate biallelic mutations in injected zebrafish embryos, allowing genetic screens to be performed in F0 animals. Combining microfluidics and DNA barcoding enables simultaneous targeting of tens to hundreds of genes from a single injection needle, while also enabling retrospective and rapid identification of the genotype responsible for an observed phenotype. The primary target audiences for MIC-Drop are developmental biologists, zebrafish geneticists, and researchers interested in performing in vivo functional genetic screens in a vertebrate model system. MIC-Drop will also prove useful in the hands of chemical biologists seeking to identify targets of small molecules that cause phenotypic changes in zebrafish. By using MIC-Drop, a typical screen of 100 genes can be conducted within 2-3 weeks by a single user.


An NADPH-Dependent Ketoreductase Catalyses the Tetracyclic to Pentacyclic Skeletal Rearrangement in Chartreusin Biosynthesis.
Redox tailoring enzymes play key roles in generating structural complexity and diversity in type II polyketides. In chartreusin biosynthesis, the early 13 C-labeling experiments and bioinformatic analysis suggest the unusual aglycone is originated from a tetracyclic anthracyclic polyketide. Here, we demonstrated that the carbon skeleton rearrangement from a linear anthracyclic polyketide to an angular pentacyclic biosynthetic intermediate requires two redox enzymes. The flavin-dependent monooxygenase ChaZ catalyses a Baeyer-Villiger oxidation on resomycin C to form a seven-membered lactone. Subsequently, a ketoreductase ChaE rearranges the carbon skeleton and affords the α-pyrone containing pentacyclic intermediate in an NADPH-dependent manner via tandem reactions including the reduction of the lactone carbonyl group, Aldol-type reaction, followed by a spontaneous γ-lactone ring formation, oxidation and aromatization. Our work reveals an unprecedented function of a ketoreductase that contributes to generate structural complexity of aromatic polyketide.


Impact of an Endolymphatic Sac Tumor on Subjective and Objective Audiovestibular Function.
This study reports subjective and objective audiovestibular function in patients diagnosed with an endolymphatic sac tumor (ELST), to evaluate the clinical implication of vestibular testing in ELST patients. Retrospective cohort study. Tertiary referral center/university hospital. Five patients diagnosed with unilateral ELST. Subjective and objective audiovestibular tests; pure-tone average; speech discrimination score; the Video Head Impulse Test; the cervical vestibular evoked myogenic potential test; the caloric irrigation test; the Speech, Spatial and Qualities of Hearing Scale; the Tinnitus Handicap Inventory; and the Dizziness Handicap Inventory. Findings and characteristics of both subjective and objective audiovestibular functions. The mean pure-tone average and the mean speech discrimination score were 49 dB HL and 68% on the tumor ear and 13 dB HL and 99% contralaterally. The mean Speech, Spatial and Qualities of Hearing Scale score was 84, and the mean Tinnitus Handicap Inventory score was 64. Caloric testing showed a mean unilateral weakness of 80%. The Video Head Impulse Test of the lateral semicircular canal revealed refixation saccades on all tumor ears and an average gain value of 0.75 on the tumor ear versus 0.94 contralaterally. No cervical vestibular evoked myogenic potentials were elicited on the tumor side, whereas all but one was elicited contralaterally. The average Dizziness Handicap Inventory score was 47. A characteristic pattern of abnormal caloric findings, refixation saccades, and normal vestibulo-ocular reflex gain alongside sensorineural hearing loss on the tumor ear was identified. Asymmetric sensorineural hearing loss in any patient should lead to objective vestibular evaluation to strengthen not only a targeted tumor surveillance strategy and the indication for imaging, but also the design of vestibular rehabilitation. In addition, vestibular findings may guide the choice of surgical approach.


Fetal hypothalamic brain grafts to the ventromedial hypothalamic obese rats: an immunohistochemical, electrophysiological and behavioral study.
Fetal ventromedial hypothalamic (VMH) tissue was transplanted into or around the third ventricle of adult Fischer 344 rats to determine if transplanted VMH tissue could reverse the hyperphagia and obesity produced by bilateral VMH electrolytic lesions. Host VMH-lesioned rats received stereotaxic implants of 13 to 19 postcoitus fetal VMH tissue from normal Fischer pups. The results show that: 1) Fetal VMH tissue survived in the brain (mainly in the third ventricle) of VMH-lesioned rats. The optimal survival and differentiation was at the gestational age of 13 days; 2) VMH-lesioned rats containing VMH grafts tended to consume less food than the controls, but this was not statistically significant. Neural grafts that could compensate the hyperphagia and obesity produced by the VMH lesions (in comparison to the controls) were those placed into the third ventricle; 3) Electrophysiological evidence demonstrated that VMH grafts contain glucoreceptor neurons in grafts not only located in the third ventricle, but also in the thalamus; 4) Immunohistochemical evidence showed the presence of serotonin, beta-endorphin and substance P immunoreactive fibers in the grafts. These results indicated that transplants of fetal VMH tissue in the brain of bilateral VMH-lesioned adult rats may have some functional effects (depending on the location of the graft).


Age at menarche and comparison of the growth and performance of pre- and post-menarcheal girls in China.
The median menarcheal ages (MMAs) of Chinese girls in 1991 were calculated by using the status quo method and probit analysis in 64,322 schoolgirls 8-18 years of age. The sample was randomly selected from 29 provinces of China. The MMAs were 13.01 ± 1.19 and 13.64 ± 1.24 years for urban and rural girls, respectively. These estimates were 0.16 and 0.20 years lower than that of Chinese urban and rural girls in 1985, respectively. The associations between growth status and the timing of menarche were also analyzed by comparing of 10 indicators of somatic growth and motor ability between the pre- and post-menarcheal girls. Early maturers consistently have high means of stature, weight, and vital capacity than late maturers. By contrast, the late maturers tend to have a linear physique and more potential of increasing stature and lower limbs into late adolescence. Late maturers also tend to have more potential in catching up in motor abilities, which were inferior to those of early maturers during early adolescence. Am. J. Hum. Biol. 9:205-212, 1997. © 1997 Wiley-Liss, Inc.


Biological Treatments of Neurofibromatosis Type 2 and Other Skull Base Disorders.
Studies of genomic alterations that occur in skull base tumors have provided information regarding biological aberrations that are necessary for the growth and maintenance of these tumors. This has led to the development and initiation of clinical trials incorporating biological treatments for many skull base tumors. The exciting developments of molecularly targeted therapy for the treatment of skull base tumors may provide noninvasive therapeutic options for patients that can be used either alone or in combination with surgery and/or radiation therapy. Future analysis and continued scientific discovery of treatments for skull base tumors can lead to improved outcomes in patients.


Gut-bladder axis enters the stage: Implication for recurrent urinary tract infections.
The gut microbiome is a critical modulator of systemic physiology, including infectious disease susceptibility. Although this niche is a reservoir for uropathogenic Escherichia coli, knowledge of its role in urinary tract infections (UTIs) is limited. We discuss two recent studies, Thänert et al. (2022) and Worby et al. (2022), that interrogate the roles of the gut-bladder axis in UTIs.


Using environmental DNA metabarcoding to monitor fish communities in small rivers and large brooks: Insights on the spatial scale of information.
Monitoring fish communities is central to the evaluation of ecological health of rivers. Both presence/absence of fish species and their relative quantity in local fish assemblages are crucial parameters to measure. Fish communities in lotic systems are traditionally monitored via electrofishing, characterized by a known limited efficiency and high survey costs. Analysis of environmental DNA could serve as a non-destructive alternative for detection and quantification of lotic fish communities, but this approach still requires further insights in practical sampling schemes incorporating transport and dilution of the eDNA particles; optimization of predictive power and quality assurance of the molecular detection method. Via a controlled cage experiment, we aim to extend the knowledge on streamreach of eDNA in small rivers and large brooks, as laid out in the European Water Framework Directive's water typology. Using a high and low source biomass in two river transects of a species-poor river characterized by contrasting river discharge rates, we found strong and significant correlations between the eDNA relative species abundances and the relative biomass per species in the cage community. Despite a decreasing correlation over distance, the underlying community composition remained stable from 25 to 300 m, or up to 1 km downstream of the eDNA source, depending on the river discharge rate. Such decrease in similarity between relative source biomass and the corresponding eDNA-based community profile with increasing distance downstream from the source, might be attributed to variation in species-specific eDNA persistence. Our findings offer crucial insights on eDNA behaviour and characterization of riverine fish communities. We conclude that water sampled from a relatively small river offers an adequate eDNA snapshot of the total fish community in the 300-1000 m upstream transect. The potential application for other river systems is further discussed.


Structures of RIG-I-Like Receptors and Insights into Viral RNA Sensing.
RIG-I-like receptors (RLRs) are an important family of pattern recognition receptors. They activate the immunological responses against viral infections by sensing RNAs in the cytoplasm. Recent studies provide significant insights into the activation and transduction mechanisms of RLRs family (members including RIG-I, MDA5, and LGP2). Here we review our current understanding of the structures of RLRs. Structural characterizations of RLRs family have revealed the mechanism of their actions at molecular level. The activation mechanisms of RIG-I and MDA5 are different, despite both of them have similar domain organizations and bind to dsRNA ligands. RIG-I, but not MDA5, adopts an auto-suppression conformation in the absence of RNA. In addition to ligand triggered receptor oligomerization, the activities of these receptors are also regulated by several posttranslational modifications, especially ubiquitination. Overall, these structural studies play critical roles in promoting the understanding of viral RNA recognition mechanisms by the host innate immune system, which also contribute to the designing of drugs for treatment of viral infection. However, much work remains to be done in studying the signaling pathway of MDA5 and LGP2, particularly by structural biology.


Analysis of Local Chromatin States Reveals Gene Transcription Potential during Mouse Neural Progenitor Cell Differentiation.
Chromatin dynamics play a critical role in cell fate determination and maintenance by regulating the expression of genes essential for development and differentiation. In mouse embryonic stem cells (mESCs), maintenance of pluripotency coincides with a poised chromatin state containing active and repressive histone modifications. However, the structural features of poised chromatin are largely uncharacterized. By adopting mild time-course MNase-seq with computational analysis, the low-compact chromatin in mESCs is featured in two groups: one in more open regions, corresponding to an active state, and the other enriched with bivalent histone modifications, considered the poised state. A parameter called the chromatin opening potential index (COPI) is also devised to quantify the transcription potential based on the dynamic changes of MNase-seq signals at promoter regions. Use of COPI provides effective prediction of gene activation potential and, more importantly, reveals a few developmental factors essential for mouse neural progenitor cell (NPC) differentiation.


Quantitative approaches for illustrating correlations among the mechanical fragmentation scales, crystallinity and enzymatic hydrolysis glucose yield of rice straw.
Mechanical fragmentation is an important pretreatment in the biomass biotransformation process. Mechanical fragmentation at the tissue scale significantly reduced the particle size of rice straw but did not significantly change its crystalline properties; the increase in the glucose yield was limited from 28.75% (95.55mg/g substrate) to 35.29% (115.28mg/g substrate). Mechanical fragmentation at the cellular scale destroyed the cell wall structure and reduced its crystalline properties. Thus, the glucose yield also showed a significant increase from 35.29% (115.28mg/g substrate) to 81.71% (287.07mg/g of substrate). The quantitative equations among the particle size, crystalline properties and glucose yield (mg/g substrate) are as follows: CrI=44.14×[1-exp(-0.03658×D50)] and CP=(8.403×logD50-24.1836)/(1-4.225/D50^0.5); GY=-5.636CrI+343.7 and GY=-14.62CP+512.1; and GY=97.218+247.5×exp(-0.03824×D50). The quantitative correlations among the mechanical fragmentation scales and crystalline properties can determine the effect and mechanism of mechanical fragmentation on biomass and can further promote the construction of a cost-competitive biotransformation process for biomass.


Morphology and composition of pyrotechnic residues formed at different levels of confinement.
Post explosion residues (PER) are residues from pyrotechnic compositions or explosives that are generated during an explosion. In the recent past SEM/EDX was used several times to analyze PER from pyrotechnic compositions. The results from these studies suggest that there might be a difference in morphology and composition of pyrotechnic residues formed at different levels of confinement. Also because of general thermodynamic principles it is believed that at higher levels of confinement the final pressure and temperature during the explosion is probably (but not necessarily) higher, eventually resulting in smaller and more spherical particles and a more homogeneous elemental composition. If there is a relation between morphology and composition of pyrotechnic residues and the level of confinement at which these are formed, it would be possible to draw conclusions about the conditions at which pyrotechnic residues were formed and the kind and construction of the device used. This may aid forensic scientists not only in the determination of the original explosive composition, but also of the explosive device. To perform controlled experiments with pyrotechnic charges at, at least, two pre-set levels of confinement a test vessel was built by TNO Defence, Security and Safety. For this study, three different flash powder compositions and black powder were selected. The generated residues were sampled on collecting plates and Nucleopore filters connected to a pump system in the immediate vicinity of the venting area for further analyses by SEM/EDX and XRD. From the results it follows that in the pressure range studied, the level of confinement seems to have a minor effect on the features of the generated residue particles. Because passive sampling by means of collector plates seemed doubtful and because the number of experiments had to be limited it is impossible to draw definitive conclusions. In addition to the level of confinement several other variables may affect size, shape and composition of pyrotechnic residues. More experiments and improved sampling methods are necessary to determine what variables have the most pronounced effect on shape size and composition of pyrotechnic residues.


How to assess musculoskeletal conditions. Prognostics.
Both patients and clinicians confronted with rheumatic disease need prognostic information to direct their management strategies. Prognosis refers to the prediction of outcome of disease. Clinicians confronted with prognostic problems in individual patients usually have to rely on evidence from prognostic studies on prognostic factors or clinical prediction models. Prognostic factors are patient characteristics that can be used to predict the outcome of disease. Clinical prediction models are sets of prognostic factors developed by logistic regression modelling. These models estimate the probabilities of the various forms of outcome of a disease and they can be valuable prognostic tools in daily clinical practice. To judge whether an article on prognosis fulfils the necessary methodological standards and contains relevant information, clinicians can use a number of guidelines that are described in this chapter. To find out whether the results of a prognostic study are applicable to individual patients in daily practice, the clinician should obtain clarity on three aspects: (i) generalizability, (ii) the possibility of extrapolating the results to the particular clinical situation, and (iii) feasibility. Decision analysis values the information provided by prognostic testing insofar as it alters treatment strategies. The treatment threshold is the probability of a particular disease outcome for which the net risks of treatment and no treatment are equal. Treatment is indicated if the probability of the disease outcome is higher than the treatment threshold.


Involvement of the mismatch repair system in base analogue-induced mutagenesis.
The influence of the mismatch repair system, and the role of mutS, mutR, and mutL genes, in mutagenesis induced by n2ome6Ade, n2oh6Ade and n2Pur have been investigated. From the frequency of reversion of Arg-Thr- and His- markers in AB2497, and its mut- derivatives, it was concluded that mismatches introduced by n2-ome6Ade and n2oh6Ade are better substrates for mismatch repair enzymes than that introduced by n2Pur. All these mut-gene products are more active in removing spontaneous or base analogue-induced mismatches which, when unexcised, lead to transversion of base repairs, than those which lead to transitions. Active engagements of mutL, mutR, or mutS gene products depend on the kind of mutation, the site of mutagenesis, and the inducing agent. Dam- cells are over-mutated by both n2ome6Ade and n2oh6Ade, but are hyper-sensitive to n2oh6Ade only. It is proposed that hyper-sensitivity of dam- cells is due not only to an increase in overlaping gap formation on both strands of DNA, but to a greater lability of the impaired cells. Results are presented which strongly suggest that n2ome6Ade in mut+ cells and n2oh6Ade in mut- only, can induce GC leads to TA transversions.


Survivor loneliness of women following breast cancer.
To describe the experience of loneliness for women more than a year following breast cancer treatment. Qualitative, phenomenologic. Interviews conducted in women's setting of choice (e.g., home, library). Purposive sample of 13 women, 1-18 years following breast cancer treatment. Streubert's descriptive phenomenologic method based on Husserl's phenomenology. Phenomenon of loneliness. Women conveyed a unique description of loneliness that was termed survivor loneliness. They described how they felt alone in the awareness of mortality and were invalidated in the experience of ongoing symptom burden, a changed sense of identity and connection, and an altered threshold for distress that pervaded their long-term experiences. As they sought ways to lead more authentic lives, the women sometimes withheld truth or projected images they perceived as inauthentic, contributing to their loneliness. Paradoxically, as survivors perceived connections with others as more fragile, they also felt a strengthened vitality of connection, particularly with their children, and a deepened sense of empathy and connectedness to the suffering of others. Findings shed light on the ongoing symptom experience of women and the isolation they experienced as they sought to work through an altered sense of self, connection, and identity as breast cancer survivors. Although survivor loneliness was experienced by all participants, findings suggest that some women may be more vulnerable to heightened psychological distress. Follow-up care should include giving recognition to survivors' experiences and normalizing the situation to allow for survivors' expressions of experience. Through attentive and empathic assessment, clinicians need to be alert to the unmet needs of longer-term survivors, including the experience of survivor loneliness and the importance of identifying and assisting survivors who describe heightened distress. Prospective studies are needed to examine survivor loneliness and the factors that make some women more vulnerable to psychological distress. Grounded theory studies are needed to delineate the phases and challenges of breast cancer survivorship, including survivor loneliness.


Knowledge and practice to prevent COVID-19 and its associated factors among pregnant women in Debre Tabor Town Northwest Ethiopia, a community-based cross-sectional study.
Coronavirus disease is now a global concern with the non-availability of antiviral treatment and attacks all groups of the population. Hence, applying preventive measures is the most critical intervention to control the infection. Pregnant women are particularly susceptible to respiratory pathogens because of their immunosuppressive state and physiological adaptive change during pregnancy. Therefore, this study was aimed to assess knowledge and practice to prevent coronavirus disease and its associated factors among pregnant women in Debre Tabor Town. Community-based cross-sectional study was conducted among 422 participants from May 25-June 15, 2020. A simple random sampling technique was employed. Data were collected by face-to-face interview using a structured and pre-tested questionnaire and analysis using SPSS version 23. Bivariable and multivariable logistic regression analysis was carried out and p-value < 0.05 at 95% CI were considered as statistically significant. Overall 46.8 and 47.6% of women were knowledgeable and had good practice to prevent coronavirus respectively. Women's age (15-24 years) (AOR = 4.85, 95% CI: 1.34-5.42), educational status (AOR:3.70; 95% CI: 1.16-5.40) being civil servant (AOR:2.84; 95% CI: 1.55-5.21), wanted pregnancy (AOR:3.37; 95% CI: 1.20-9.45), antenatal care follow-up (AOR:2.07; 95% CI: 1.03-4.13) were significantly associated with COVID-19 knowledge, whereas educational status (AOR:3.78; 95% CI: 1.19-5.11), number of children (AOR:2.89; 95% CI: 1.29-6.45) and knowledge (AOR:8.42;95% CI: 4.50-15.85), were also found to be statistically significant with practice. Most of the participants had poor knowledge and inappropriate practice. Increasing health education programs via different media, coordinated and combined efforts of authorities and all individuals will be needed to battles the spread of the infection.


Correlation between visualization and size of the areae gastricae and duodenal ulcer.
The relationship between the antral mucosal appearance and the incidence of duodenal ulcer was examined by review of 250 double-contrast barium-meal studies. When the mucosal pattern was seen, the areae gastricae were larger in patients with duodenal ulcer. Failure to see the mucosal pattern occurred more frequently in patients without ulcer.


Covalent attachment of a bioactive hyperbranched polymeric layer to titanium surface for the biomimetic growth of calcium phosphates.
This work is investigating the chemical grafting on Ti surface of a polymer/calcium phosphate coating of improved adhesion for enhanced bioactivity. For this purpose, a whole new methodology was developed based on covalently attaching a hyperbranched poly(ethylene imine) layer on Ti surface able to promote calcium phosphate formation in a next deposition stage. This was achieved through an intermediate surface silanization step. The research included optimization both of the reaction conditions for covalently grafting the intermediate organosilicon and the subsequent hyperbranched poly(ethylene imine) layers, as well as of the conditions for the mechanical and chemical pretreatment of Ti surface before coating. The reaction steps were monitored employing FTIR and XPS analyses, whereas the surface morphology and structure of the successive coating layers were studied by SEM combined with EDS. The analysis confirmed the successful grafting of the hybrid layer which demonstrated very good ability for hydroxyapatite growth in simulated body fluid.


Ewing's tumor metastatic to the clivus, simulating meningitis: case report.
Ewing's sarcoma, which is regarded as one of the most lethal primary bone tumors, lies in the domain of the orthopedic surgeon because it occurs most commonly in the shaft of the long bones, especially in the lower extremities. Pain, leukocytosis, fever, anemia, and an elevated erythrocyte sedimentation rate are commonly seen. We are presenting a case of Ewing's sarcoma of the left greater trochanter with metastasis to the clivus producing a bilateral 6th nerve palsy. The presence of fever, nuchal rigidity, and photophobia simulated meningitis. The rapid evolution of radiological signs will be discussed.


Adoptive transfer of splenocytes to immunocompromised mice.
Analysis of the immune response of mice to Helicobacter infection has been greatly aided by the use of various deficient mouse strains. Here we present protocols for reconstitution of immune-deficient mice with wild-type immune cells and protocols for analysis of the outcome.


[Adipokines: some players of inflammation in inflammatory rheumatic diseases and systemic autoimmune diseases?].
Adipocytokines or adipokines are a group of molecules (such as leptin, adiponectin, visfatine and resistine) mainly produced by adipose tissue. The adipokines are involved in different physiological processes but their participation to inflammatory and immune responses have been recently described. Their contribution to inflammatory diseases such as chronic inflammatory joint diseases and autoimmune diseases, and osteoarthritis as well, is currently growing, suggesting new pathophysiological schema and treatments. Leptin, visfatin and resistin have pro-inflammatory properties while adiponectin is anti-inflammatory, especially for the vascular wall. Adiponectin is considered to be protective for cardiovascular risk. The influence of the treatments given in inflammatory rheumatic diseases and autoimmune diseases (traditional drugs and biologics) on adipokines requires to be studied.


A physical neural mass model framework for the analysis of oscillatory generators from laminar electrophysiological recordings.
Cortical function emerges from the interactions of multi-scale networks that may be studied at a high level using neural mass models (NMM) that represent the mean activity of large numbers of neurons. Here, we provide first a new framework called laminar NMM, or LaNMM for short, where we combine conduction physics with NMMs to simulate electrophysiological measurements. Then, we employ this framework to infer the location of oscillatory generators from laminar-resolved data collected from the prefrontal cortex in the macaque monkey. We define a minimal model capable of generating coupled slow and fast oscillations, and we optimize LaNMM-specific parameters to fit multi-contact recordings. We rank the candidate models using an optimization function that evaluates the match between the functional connectivity (FC) of the model and data, where FC is defined by the covariance between bipolar voltage measurements at different cortical depths. The family of best solutions reproduces the FC of the observed electrophysiology by selecting locations of pyramidal cells and their synapses that result in the generation of fast activity at superficial layers and slow activity across most depths, in line with recent literature proposals. In closing, we discuss how this hybrid modeling framework can be more generally used to infer cortical circuitry.


IBX-mediated alpha-hydroxylation of alpha-alkynyl carbonyl systems. A convenient method for the synthesis of tertiary alcohols.
[reaction: see text] IBX (o-iodoxybenzoic acid) is an excellent reagent for the alpha-hydroxylation of alpha-alkynyl carbonyl compounds without giving dehydrogenation products. The convenient procedure proves to be useful for the construction of a variety of tertiary alcohols (55-91%) under mildly acidic conditions.


[HLA typing of patients with herpes simplex recidivans and postherpetic erythema exsudativum multiforme].
62 patients suffering from recurrent herpes simplex, with ten out of them showing postherpetic erythema multiforme, have been investigated with special reference to histocompatibility standardisation. In comparison with a control group (n = 170), our patients revealed a high and statistically significant level of HLA-B5 (p less than 0,01). Postherpetic erythema multiforme seems to be associated with HLA-A9.


Classification of COVID-19 in X-ray images with Genetic Fine-tuning.
New and more transmissible SARS-COV-2 variants aggravated the SARS-COV-2 emergence. Lung X-ray images stand out as an alternative to support case screening. The latest computer-aided diagnosis systems have been using Deep Learning (DL) to detect pulmonary diseases. In this context, our work investigates different types of pneumonia detection, including COVID-19, based on X-ray image processing and DL techniques. Our methodology comprehends a pre-processing step including data-augmentation, contrast enhancement, and resizing method to overcome the challenge of heterogeneous and few samples of public datasets. Additionally, we propose a new Genetic Fine-Tuning method to automatically define an optimal set of hyper-parameters of ResNet50 and VGG16 architectures. Our results are encouraging; we achieve an accuracy of 97% considering three classes: COVID-19, other pneumonia, and healthy. Thus, our methodology could assist in classifying COVID-19 pneumonia, which could reduce costs by making the process faster and more efficient.


We can reduce negative paediatric appendicectomy rate: A cohort study.
Appendicitis accounts for the most frequent surgical emergencies in childhood. The guidance from the Royal College of Surgeons and poor post operative outcomes in surgical patients during the pandemic, it would be expected that only children who had clinical signs of appendicitis and were unwell, would have undergone surgery. Hence, the negative appendicectomy rate during the pandemic should have decreased.The aim of this retrospective study was to assess the rate of negative appendicectomy amongst children <16 years of age during the first wave of the pandemic, from the announcement of the lockdown and determine if there was a true difference by comparing the rate with the same time period in 2019. Data of all children aged<16 years who were operated for appendicitis between 23/3/2020 and 30/06/2020 was collected retrospectively and compared with that of children operated during the same time period in 2019 for the rate of negative appendicectomy.Data were analysed using the two-tailed t-test for continuous data and χ2 or Fishers exact tests for categorical data with p value of <0.05 considered significant. Twenty three paediatric patients presenting with acute appendicitis underwent appendicectomy during the COVID-19 pandemic and 35 patients during 2019.Overall 17.39% patients underwent laparoscopic appendicectomy in 2020 while 54.29% in 2019. The negative appendicectomy rate was zero during the pandemic while it was 17.14% in 2019. There was no difference in the median length of hospital stay during the two time periods. There was no significant difference in complication or re-admission rate. This study has the lowest reported incidence of negative appendicectomy rate during the pandemic following wider use of pre operative imaging and early senior involvement in decision making. The increased number of complicated appendicitis during the pandemic did not translate to worse clinical outcomes.


Characterization of Gazdar murine sarcoma virus by nucleic acid hybridization and analysis of viral expression in cells.
Gazdar murine sarcoma virus (Gz-MSV) and Moloney murine sarcoma virus (M-MSV) are closely related. The complete M-MSV-specific nucleic acid sequences constituted a major portion of Gz-MSV-specific sequences. The MSV-specific sequences in both Gz-MSV and M-MSV genomes shared homology with hamster leukemia virus nucleic acid sequences. Both rat cells (S+L+) and hamster (S+L-) cells expressed two viral proteins of 68,000 and 70,000 daltons. These proteins were immunologically related to p60 purified from m1 virions of M-MSV.


Needle puncture of fetus: a complication of second-trimester amniocentesis.
Needle puncture of the fetus has rarely been reported with midtrimester amniocentesis. This paper contains the report of five cases of needle scars in infants born after second-trimester amniocentesis for prenatal diagnosis of fetal genetic disorders. Since this complication may be more frequent than has been previously believed, there is the possibility that damage to the fetus may occur. It is suggested that the products of all abortions and all live-born and stillborn infants delivered following amniocentesis should be examined for evidence of injury.


Approach to the Adult Colorectal Patient with a History of Pediatric Abdominal Surgery.
Children with colorectal diseases often undergo operative management in their youth. As these patients become adult, it is important for surgeons to understand their postoperative anatomy as well as the pathophysiology of their diseases. Here, we present a description of common colorectal diseases of childhood that may have significant impact on patients' presentations as adult. We also discuss the diagnosis and management of conditions that are usually seen early in life but may present during adulthood as well.


Simultaneous mitigation of methane and odors in a biowindow using a pipe network.
In this study, a biowindow with a piped gas collection network is proposed as an area-efficient landfill gas treatment system. A 9-m2 biowindow was constructed for treating landfill gas collected from an area of 450 m2 in a sanitary landfill, and its performance was evaluated for 224 days. The methane removal efficiency was 59-100% at 146.3-675.1 g-CH4 m-2 d-1. Odorous compounds were also removed by the biowindow, with a complex odor intensity removal rate of 93-100%. In particular, the removal efficiency for hydrogen sulfide and methanethiol, major contributors to the complex odor intensity, was 97% and 91%, respectively. Metagenomic analysis showed that the dominant bacterial genera shifted from Acinetobacter and Pseudomonas to Methylobacter and Methylocaldum due to the high concentration of methane. A high bacterial diversity was maintained, which may have contributed to the robust performance of the biowindow against environmental fluctuations. At 1/50th of the size of conventional biocovers, the proposed biowindow can greatly reduce the required installation area and represents a competitive method for the simultaneous treatment of methane and odor in landfills.


Evolutionary conservation of essential and highly expressed genes in Pseudomonas aeruginosa.
The constant increase in development and spread of bacterial resistance to antibiotics poses a serious threat to human health. New sequencing technologies are now on the horizon that will yield massive increases in our capacity for DNA sequencing and will revolutionize the drug discovery process. Since essential genes are promising novel antibiotic targets, the prediction of gene essentiality based on genomic information has become a major focus. In this study we demonstrate that pooled sequencing is applicable for the analysis of sequence variations of strain collections with more than 10 individual isolates. Pooled sequencing of 36 clinical Pseudomonas aeruginosa isolates revealed that essential and highly expressed proteins evolve at lower rates, whereas extracellular proteins evolve at higher rates. We furthermore refined the list of experimentally essential P. aeruginosa genes, and identified 980 genes that show no sequence variation at all. Among the conserved nonessential genes we found several that are involved in regulation, motility and virulence, indicating that they represent factors of evolutionary importance for the lifestyle of a successful environmental bacterium and opportunistic pathogen. The detailed analysis of a comprehensive set of P. aeruginosa genomes in this study clearly disclosed detailed information of the genomic makeup and revealed a large set of highly conserved genes that play an important role for the lifestyle of this microorganism. Sequencing strain collections enables for a detailed and extensive identification of sequence variations as potential bacterial adaptation processes, e.g., during the development of antibiotic resistance in the clinical setting and thus may be the basis to uncover putative targets for novel treatment strategies.


Multicriteria global optimization for biocircuit design.
One of the challenges in Synthetic Biology is to design circuits with increasing levels of complexity. While circuits in Biology are complex and subject to natural tradeoffs, most synthetic circuits are simple in terms of the number of regulatory regions, and have been designed to meet a single design criterion. In this contribution we introduce a multiobjective formulation for the design of biocircuits. We set up the basis for an advanced optimization tool for the modular and systematic design of biocircuits capable of handling high levels of complexity and multiple design criteria. Our methodology combines the efficiency of global Mixed Integer Nonlinear Programming solvers with multiobjective optimization techniques. Through a number of examples we show the capability of the method to generate non intuitive designs with a desired functionality setting up a priori the desired level of complexity. The methodology presented here can be used for biocircuit design and also to explore and identify different design principles for synthetic gene circuits. The presence of more than one competing objective provides a realistic design setting where every solution represents an optimal trade-off between different criteria.


Novel carbon nano-onions from paraffinum liquidum for rapid and efficient removal of industrial dye from wastewater.
Carbon nano-onions (CNOs) are fascinating zero-dimensional carbon materials owning distinct multi-shell architecture. Their physicochemical properties are highly related to the parent material selected and the synthesis protocol involved. In the present work, we report for the first time novel CNO structures encompassing discrete carbon allotropes, namely, H18 carbon, Rh6 carbon, and n-diamond. These structures were cost-effectively synthesized in gram scale by facile flame pyrolysis of paraffinum liquidum, a highly refined mineral oil. The as-synthesized and chemically refashioned CNOs are quasi-spherical self-assembled mesopores, manifesting remarkable stability and hydrophilicity. The CNO structures exhibit excellent dye adsorption characteristics with high removal capacity of 1397.35 mg/g and rapid adsorption kinetics with a minimal adsorbent dosage of 10 mg/L, for a low concentration of 20 mg/L methylene blue dye. The novel CNOs assure potential implementation in the remediation of low concentration and high volume of dye-contaminated wastewater.Graphical abstract.


Hepatic vein stenosis (Budd-Chiari syndrome) as a cause of ascites in a cat.
A 10-year-old cat presented with a history of unexplained ascites. Ultrasound and angiography identified an isolated stenosis of the middle hepatic vein resulting in Budd-Chiari Syndrome. Balloon dilation of the stenosis was attempted but the patient expired. Necropsy revealed a discrete membranous stenosis at the junction of the caudal vena cava and the middle hepatic vein. The literature was reviewed to assess clinical and diagnostic findings, as well as therapeutic options in humans with hepatic vein stenosis.


A combination of anti-PD-1 therapy and apatinib successfully treated a patient with EGFR mutation-negative advanced lung adenocarcinoma: A case report.
Here, we report the case of a patient with advanced lung adenocarcinoma with negative driver genes, who benefited from treatment with anti-programmed cell death-1 (anti-PD-1) therapy combined with a low dose of apatinib. From February 2020, the patient was treated with camrelizumab combined with pemetrexed disodium. The treatment regimen was adjusted to camrelizumab combined with a low dose of apatinib every 3 weeks because the patient could not tolerate the side effects of the previous chemotherapy, and camrelizumab led to reactive cutaneous capillary endothelial proliferation (RCCEP). After six cycles of camrelizumab plus a low dose of apatinib, the curative effect achieved was complete response (CR), with milder symptoms of RCCEP than before. Until the follow-up time of March 2021, the efficacy evaluation reached CR and the symptoms of RCCEP disappeared. This case report provides a theoretical basis for camrelizumab combined with a low dose of apatinib for the treatment ofcarcinoma patients with advanced lung adenocarcinoma with negative driver genes.


Differential requirement for EGF-like ligands in Drosophila wing development.
Signaling through the Drosophila EGF receptor (DER) is important for the growth and differentiation of the wing. These processes may be mediated by different DER ligands including Spitz (Spi) and Vein (Vn). Here I investigate the roles of these ligands and other DER pathway components in wing disc development using in vivo culture to produce mutant discs from genotypes which are normally embryonic lethal. I find no role for spi in wing disc growth, whereas vn is essential. spi mutant wing discs are morphologically normal as judged by expression of the vein marker rhomboid (rho) and analysis of the differentiated wing tissue. rho, Star (S) and argos (aos) which are known to be involved in Spi/DER signaling are likewise not required for wing growth, whereas pointed (pnt), which acts at the end of the intracellular pathway, is required. The results suggest different ligands and molecular mechanisms control DER signaling in wing growth and differentiation.


Uterine artery blood flow volume in pregnant women with an abnormal pulsatility index of the uterine arteries delivering normal or intrauterine growth restricted newborns.
The aim of this study was to assess and compare uterine artery (UtA) blood flow volume in pregnant patients with an abnormal uterine Doppler pulsatility index (PI) who delivered fetuses with an appropriate weight for gestational age (AGA) or with intrauterine growth restricted (IUGR). We prospectively recruited singleton pregnancies with abnormal uterine arteries P.I. between 18 and 38 weeks of gestation regardless of estimated fetal weight (EFW). Vessel diameter and blood flow velocity were measured along the UtA upstream to the vessel bifurcation in both the right and left UtAs. Uterine blood flow volumes measured in these pregnancies were compared to historical Control-pregnancies. Forty-three patients delivered at term a normal weight newborn (AGA-pregnancies). Thirty patients delivered growth restricted newborns at 32 weeks (i.r. 29-36w) with a median weight of 1160 gr (i.r. 1000-2065 gr) (IUGR-pregnancies). At mid-gestation (18 + 0 - 25 + 6 weeks + days of gestation) a significantly lower uterine blood flow volume per unit weight was observed between the two study groups and compared to controls: 142 ml/min/kg in IUGR-pregnancies, 217 ml/min/kg in AGA-pregnancies and 538 ml/min/kg in Control-pregnancies. These striking differences in blood flow volume were already present at mid-gestation, at a time when EFW was still normal. In late gestation (27 + 0 - 37 + 6 weeks + days of gestation), pregnancies with an abnormal uterine P.I. showed persistently low UtA flow (<50% of controls) even when corrected for fetal weight: 81 ml/min/kg in IUGR-pregnancies, 105 ml/min/kg in AGA-pregnancies, and 193 ml/min/kg in Control-pregnancies; p < 0.0001. Our findings are consistent with other recent studies regarding the association between reduced uterine blood flow volume and fetal growth restriction. However, the study brings new insight into the finding of abnormal uterine P.I. in normally grown fetuses typically dismissed as "falsely abnormal" or "false positive" findings. Our study suggests that blood flow volume measurement may serve as a new tool to assess this group of patients and possibly those with ischemic placental diseases that may provide some basis for therapeutic interventions.


Identification and validation of hub genes of synovial tissue for patients with osteoarthritis and rheumatoid arthritis.
Osteoarthritis (OA) and rheumatoid arthritis (RA) were two major joint diseases with similar clinical phenotypes. This study aimed to determine the mechanistic similarities and differences between OA and RA by integrated analysis of multiple gene expression data sets. Microarray data sets of OA and RA were obtained from the Gene Expression Omnibus (GEO). By integrating multiple gene data sets, specific differentially expressed genes (DEGs) were identified. The Gene Ontology (GO) functional annotation, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways and protein-protein interaction (PPI) network analysis of DEGs were conducted to determine hub genes and pathways. The "Cell Type Identification by Estimating Relative Subsets of RNA Transcripts (CIBERSORT)" algorithm was employed to evaluate the immune infiltration cells (IICs) profiles in OA and RA. Moreover, mouse models of RA and OA were established, and selected hub genes were verified in synovial tissues with quantitative polymerase chain reaction (qPCR). A total of 1116 DEGs were identified between OA and RA. GO functional enrichment analysis showed that DEGs were enriched in regulation of cell morphogenesis involved in differentiation, positive regulation of neuron differentiation, nuclear speck, RNA polymerase II transcription factor complex, protein serine/threonine kinase activity and proximal promoter sequence-specific DNA binding. KEGG pathway analysis showed that DEGs were enriched in EGFR tyrosine kinase inhibitor resistance, ubiquitin mediated proteolysis, FoxO signaling pathway and TGF-beta signaling pathway. Immune cell infiltration analysis identified 9 IICs with significantly different distributions between OA and RA samples. qPCR results showed that the expression levels of the hub genes (RPS6, RPS14, RPS25, RPL11, RPL27, SNRPE, EEF2 and RPL19) were significantly increased in OA samples compared to their counterparts in RA samples (P < 0.05). This large-scale gene analyses provided new insights for disease-associated genes, molecular mechanisms as well as IICs profiles in OA and RA, which may offer a new direction for distinguishing diagnosis and treatment between OA and RA.


Interaction between ACTH fragments, brain opiate receptors and morphine-induced analgesia.
The present study confirms that N-terminal fragments of ACTH have an affinity for rat brain opiate receptors in vitro. Such peptides, devoid of corticotrophic activity, were found to inhibit morphine-induced analgesia if they also possessed affinity for opiate receptors in vitro. The structure-activity relationship for these two parameters is comparable to that observed for the same peptides on the induction of excessive grooming.


Perineural infiltration of cutaneous squamous cell carcinoma and basal cell carcinoma without clinical features.
To review the factors that influence outcome and patterns of relapse in patients with cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) with perineural infiltration (PNI) without clinical or radiologic features, treated with surgery and radiotherapy. Between 1991 and 2004, 222 patients with SCC or BCC with PNI on pathologic examination but without clinical or radiologic PNI features were identified. Charts were reviewed retrospectively and relevant data collected. All patients were treated with curative intent; all had radiotherapy, and most had surgery. The primary endpoint was 5-year relapse-free survival from the time of diagnosis. Patients with SCC did significantly worse than those with BCC (5-year relapse-free survival, 78% vs. 91%; p < 0.01). Squamous cell carcinoma with PNI at recurrence did significantly worse than de novo in terms of 5-year local failure (40% vs. 19%; p < 0.01) and regional relapse (29% vs. 5%; p < 0.01). Depth of invasion was also a significant factor. Of the PNI-specific factors for SCC, focal PNI did significantly better than more-extensive PNI, but involved nerve diameter or presence of PNI at the periphery of the tumor were not significant factors. Radiotherapy in conjunction with surgery offers an acceptable outcome for cutaneous SCC and BCC with PNI. This study suggests that focal PNI is not an adverse feature.


Immune-mediated neurological syndromes in SARS-CoV-2-infected patients.
Evidence of immune-mediated neurological syndromes associated with the severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection is limited. We therefore investigated clinical, serological and CSF features of coronavirus disease 2019 (COVID-19) patients with neurological manifestations. Consecutive COVID-19 patients with neurological manifestations other than isolated anosmia and/or non-severe headache, and with no previous neurological or psychiatric disorders were prospectively included. Neurological examination was performed in all patients and lumbar puncture with CSF examination was performed when not contraindicated. Serum anti-gangliosides antibodies were tested when clinically indicated. Of the 349 COVID-19 admitted to our center between March 23rd and April 24th 2020, 15 patients (4.3%) had neurological manifestations and fulfilled the study inclusion/exclusion criteria. CSF examination was available in 13 patients and showed lymphocytic pleocytosis in 2 patients: 1 with anti-contactin-associated protein 2 (anti-Caspr2) antibody encephalitis and 1 with meningo-polyradiculitis. Increased serum titer of anti-GD1b antibodies was found in three patients and was associated with variable clinical presentations, including cranial neuropathy with meningo-polyradiculitis, brainstem encephalitis and delirium. CSF PCR for SARS-CoV-2 was negative in all patients. In SARS-Cov-2 infected patients with neurological manifestations, CSF pleocytosis is associated with para- or post-infectious encephalitis and polyradiculitis. Anti-GD1b and anti-Caspr2 autoantibodies can be identified in certain cases, raising the question of SARS-CoV-2-induced secondary autoimmunity.


Cutaneous silent period in fibromyalgia.
The pathogenesis of widespread pain and increased tenderness in Fibromyalgia (FM) are still unknown. Recently, the role of central nervous system hyperexcitability is emphasized in pathogenesis of FM. The central sensitization was demonstrated with decrease in nociceptive flexion reflex (NFR) threshold in patients with FM. The NFR and cutaneous silent period (CuSP) are excitatory and inhibitory parts of the same spinal protective reflex, respectively. The aim of this study was to evaluate the changes in CuSP in FM. Twenty-eight patients with FM and 18 healthy volunteers were subjected to the study. CuSPs on right abductor pollicis brevis muscle evoked by electrical stimulation of the right fifth digit were recorded. The CuSP onset latencies were significantly longer in patients with FM. There was not any significant difference in CuSP duration between patients and controls. The latency elongation of the CuSP shows that there is some delay in the development of the inhibitory part of the spinal protective reflex in patients with FM. The observed changes in CuSP of the patients with FM may suggest some abnormalities in the circuits of sensorimotor integration at spinal and supraspinal levels. The results regarding the changes observed in the CuSP in patients with FM should be confirmed by further studies.


A multicompartmental model to describe marker excretion patterns in ruminant faeces.
A multicompartmental model, which assumes first-order kinetics, is proposed to describe digesta flow along the gastrointestinal tract of ruminants. Solution of the model yields a multiplicative equation, containing a single-exponential term and a double-exponential term, for describing faecal outflow rate. The logarithmic transformation of the equation was fitted to eighty-two excretion curves obtained after the administration of marker into the rumen of cattle and sheep, and compared with other published models. It was found to be superior to the other models in that it fitted all the data sets successfully.


Whole-chromosome arm acquired uniparental disomy in cancer development is a consequence of isochromosome formation.
Using SNP-based microarray data from The Cancer Genome Atlas (TCGA), we investigated isochromosomes (deletion of one arm and duplication of the other arm) and related acquired uniparental disomy in 12 tumor types. We observed a high frequency of isochromosomes (25.98%) across all type of tumors except thyroid cancers. The highest frequency of isochromosomes was found in lung squamous cell carcinoma (54.18%). Moreover, whole-chromosome arm acquired uniparental disomy (aUPD) was common in the deleted arms of isochromosomes. These data are consistent with whole-chromosome arm aUPD likely being a consequence of isochromosomes formation. Our findings implicated aUPD as occurring through error-prone DNA repair of a deleted arm or segment of a chromosome that leads to homozygosity for existing alterations. Isochromosomes were significantly more frequent in TP53 mutated samples than wild types in 6 types of tumors with loss of TP53 function potentially contributing to development of isochromosomes. Isochromosomes are common alterations in cancer, and losing one arm of a chromosome could result in duplication of the lost arm. Duplication of the remaining arm leads promulgation of the effects on any defects in the remaining allele, due to subsequent homozygosity.


Directed graph mapping exceeds phase mapping in discriminating true and false rotors detected with a basket catheter in a complex in-silico excitation pattern.
Atrial fibrillation (AF) is the most frequently encountered arrhythmia in clinical practise. One of the major problems in the management of AF is the difficulty in identifying the arrhythmia sources from clinical recordings. That difficulty occurs because it is currently impossible to verify algorithms which determine these sources in clinical data, as high resolution true excitation patterns cannot be recorded in patients. Therefore, alternative approaches, like computer modelling are of great interest. In a recent published study such an approach was applied for the verification of one of the most commonly used algorithms, phase mapping (PM). A meandering rotor was simulated in the right atrium and a basket catheter was placed at 3 different locations: at the Superior Vena Cava (SVC), the Crista Terminalis (CT) and at the Coronary Sinus (CS). It was shown that although PM can identify the true source, it also finds several false sources due to the far-field effects and interpolation errors in all three positions. In addition, the detection efficiency strongly depended on the basket location. Recently, a novel tool was developed to analyse any arrhythmia called Directed Graph Mapping (DGM). DGM is based on network theory and creates a directed graph of the excitation pattern, from which the location and the source of the arrhythmia can be detected. Therefore, the objective of the current study was to compare the efficiency of DGM with PM on the basket dataset of this meandering rotor. The DGM-tool was applied for a wide variety of conduction velocities (minimal and maximal), which are input parameters of DGM. Overall we found that DGM was able to distinguish between the true rotor and false rotors for both the SVC and CT basket positions. For example, for the SVC position with a CVmin=0.01cmms, DGM detected the true core with a prevalence of 82% versus 94% for PM. Three false rotors where detected for 39.16% (DGM) versus 100% (PM); 22.64% (DGM) versus 100% (PM); and 0% (DGM) versus 57% (PM). Increasing CVmin to 0.02cmms had a stronger effect on the false rotors than on the true rotor. This led to a detection rate of 56.6% for the true rotor, while all the other false rotors disappeared. A similar trend was observed for the CT position. For the CS position, DGM already had a low performance for the true rotor for CVmin=0.01cmms (14.7%). For CVmin=0.02cmms the false and the true rotors could therefore not be distinguished. We can conclude that DGM can overcome some of the limitations of PM by varying one of its input parameters (CVmin). The true rotor is less dependent on this parameter than the false rotors, which disappear at a CVmin=0.02cmms. In order to increase to detection rate of the true rotor, one can decrease CVmin and discard the new rotors which also appear at lower values of CVmin.


[Suicide prevention - current practice and theory].
The present situation of suicide prevention is portrayed by an historical outline, and the description of the practice and the theoretical foundations. It is established that suicide prevention was intensified after 1948 through the fundamental practical and theoretical works of Erwin Ringel. The present situation is characterized by the fact that after the initial recovery of desperate persons as patients for medicine, the defamation of the suicidal act by society could be avoided in another manner than by merely classifying it as a sickness. Increasing interest is being granted to political and other suicides who depict suicide as a possibility of mankind. The practical application of suicide prevention consists in the organization of rest-centres, the interdisciplinary participation of various professional groups and the application of various medical, psychological and social therapies. The theoretical foundation includes the theories of early and present psychoanalysis, social science and theoretical learn-oriented psychology. This formation and this global view of suicide prevention-practice and theory today, allow us to draw the conclusion that every physician, psychologist, social worker or other human being who comes into contact with desperate persons applies the most effective suicide prevention when he behaves in a straight forward manner, and is interested unreservedly in a candid, unforced way in the psychic and social conflict situation of the other, allthewhile respecting that person's freedom.


Tryptophan metabolite concentrations in depressed patients before and after electroconvulsive therapy.
Tryptophan and kynurenine pathway (KP) metabolites are implicated in the pathophysiology of depression. We aimed to investigate their plasma concentrations in medicated patients with depression (n = 94) compared to age- and sex-matched healthy controls (n = 57), and in patients with depression after electroconvulsive therapy (ECT) in a real-world clinical setting, taking account of co-variables including ECT modality and heterogenous psychopathology. Depression severity was assessed using the Hamilton Depression Rating Scale (HAM-D24). Tryptophan (TRP) and kynurenine (KYN) metabolite concentrations [anthranilic acid (AA), 3-hydroxyanthranilic acid (3HAA), picolinic acid (PA), kynurenic acid (KYNA), and xanthurenic acid (XA)] and KYNA/KYN and KYNA/quinolinic acid (QUIN) ratios were lower in patients compared to controls. For the total group there was no significant change in KP metabolites post-ECT or correlations with mood ratings. However, improvements in mood score were correlated with increased KYN, 3-hydroxykynurenine (3HK), 3HAA, QUIN, and KYN/TRP in a subgroup of unipolar depressed patients. Additionally, in remitters baseline KYN, 3HK, and QUIN were associated with baseline HAM-D24 scores, and changes in 3HK and 3HAA concentrations post-ECT correlated with improvement in mood. KYN, KYNA, AA, 3HK, XA, PA, and QUIN were increased in a smaller 3-month follow-up group (n = 19) compared to pre-ECT concentrations. Overall, the results indicate that ECT mobilizes the KP, where a moderate association between selected metabolites and treatment response in unipolar depressed patients is evident.


"Even if someone has a physical disability, they can still participate": Youth with physical disabilities' motivational physical activity message preferences.
Youth with disabilities (YWD) experience unique physical activity (PA) needs and subsequently experience low levels of PA and are vulnerable to the risks associated with physical inactivity. Persuasive PA messages have been shown to motivate able-bodied youth to engage in PA, but there is no known research examining the PA motivational messaging needs preferences of YWD. The objective of this study was to examine and understand the PA motivational messaging needs and preferences of YWD. Sixty YWD were randomized to view three PA messages: a) no youth, b) non-inclusive, and c) targeted. After viewing the PA messages, participants completed a survey which consisted of three open-ended questions probing participants about their PA messaging needs and preferences. Responses were analyzed using a qualitative approach through an interpretivist lens. Two main themes emerged from the data: (1) factors that facilitate motivation for PA, with subthemes of reliability, happiness/hope, disability does not limit PA, thinking deeply, motivational, inclusivity, accessible information, and success stories; and (2) factors that negatively influence motivation for PA, with subthemes of sad and negative feelings, jealousy, not relatable, and reinforced physical limitations. An improved understanding of the messaging needs and preferences of YWD can inform the development of optimally effective targeted messages to promote and motivate PA among YWD. The results of this study can be useful for PA organizations in order to develop inclusive PA messages for YWD.


Constructing a composite quality score for the care of acute myocardial infarction patients at discharge: impact on hospital ranking.
To determine the impact on hospital ranking of different aggregation methods when creating a composite score from a set of quality indicators relating to a single clinical condition. The analysis was based on 14966 medical records taken from all French hospitals that treated over 30 patients with acute myocardial infarction in 2008 (n=275). Five quality indicators measuring the quality of care delivered to patients with acute myocardial infarction at hospital discharge were aggregated by 5 methods issued from a variety of activity sectors (indicator average, all-or-none, budget allocation process, benefit of the doubt, and unobserved component model). Each aggregation method was used to rank hospitals into 3 categories depending on the position of the 95% confidence interval of the composite score relative to the overall mean. Variations in rank according to method were estimated using weighted κ coefficients. Agreement between methods ranged from poor (κ=0.20) to almost perfect (κ=0.84). A change of method led to a change in rank for 71% (196 of 275) of hospitals. Only 14 of 121 hospitals which were ranked top and 20 of 118 which were ranked bottom, by at least 1 of the 5 methods, held their rank on a switch to the 4 other methods. Hospital ranking varied widely according to 5 aggregation methods. If one method has to be chosen, for instance for reporting to governments, regulatory agencies, payers, health care professionals, and the public, it is necessary to provide its rationale and characteristics, and information on score uncertainty.


Pleural hemangioma: A case report and review of the literature.
A middle-aged female with history of multinodular goiter, Hashimoto disease, and chronic vitamin B12 deficiency presented with palpitations and subsequent exertional dyspnea. Initial radiographic analysis suggested mediastinal cavernous hemangioma, but biopsy showed features consistent with pleural hemangioma. Pleural hemangioma should be considered among the differential diagnoses for recurrent unilateral pleural effusion. Pleural hemangioma should be distinguished from other more common entities including the similarly benign pulmonary hemangioma and the more aggressive pleural hemangioendothelioma.


Effects of face masks on acoustic analysis and speech perception: Implications for peri-pandemic protocols.
Wearing face masks (alongside physical distancing) provides some protection against infection from COVID-19. Face masks can also change how people communicate and subsequently affect speech signal quality. This study investigated how three common face mask types (N95, surgical, and cloth) affected acoustic analysis of speech and perceived intelligibility in healthy subjects. Acoustic measures of timing, frequency, perturbation, and power spectral density were measured. Speech intelligibility and word and sentence accuracy were also examined using the Assessment of Intelligibility of Dysarthric Speech. Mask type impacted the power distribution in frequencies above 3 kHz for the N95 mask, and above 5 kHz in surgical and cloth masks. Measures of timing and spectral tilt mainly differed with N95 mask use. Cepstral and harmonics to noise ratios remained unchanged across mask type. No differences were observed across conditions for word or sentence intelligibility measures; however, accuracy of word and sentence translations were affected by all masks. Data presented in this study show that face masks change the speech signal, but some specific acoustic features remain largely unaffected (e.g., measures of voice quality) irrespective of mask type. Outcomes have bearing on how future speech studies are run when personal protective equipment is worn.


Contrasting tree ring Hg records in two conifer species: Multi-site evidence of species-specific radial translocation effects in Scots pine versus European larch.
Tree ring records are increasingly being used as a geochemical archive of past atmospheric mercury (Hg) pollution. However, it is not clear whether all tree species can be used reliably for this purpose. We compared tree-ring Hg records of two coniferous species - widely used Scots pine (Pinus sylvestris) and less frequently used European larch (Larix decidua) at 6 study sites across the Czech Republic. Site-specific mean Hg concentrations in tree-ring segments of larch ranged from 2.1 to 5.2 μg kg-1, whereas pine had higher mean Hg concentrations (3.6-8.3 μg kg-1). Temporal records of Hg concentrations in tree rings of larch and pine differed significantly. Comparisons with previously documented peat Hg records showed that larch tree-ring Hg records more closely agreed with peat archive records. For pines, which had a large, tree-age dependent number of sapwood rings (62 ± 17, 1SD), we found a strong relationship between the year of peak Hg and the number of sapwood tree rings (p = 0.012, r2 = 0.35), as well as between peak Hg year and the sapwood-heartwood boundary year (p < 0.001, r2 = 0.65), rather than with temporal changes in atmospheric Hg levels. The much greater number of pine sapwood tree rings appears to promote radial Hg translocation, resulting in the shift of Hg peaks backward in time through the tree-ring record. In contrast, Larch consistently had a low number of sapwood tree rings (19 ± 6, 1SD), and more closely agreed with peat Hg records. This study suggests that European larch, a tree species characterized by a relatively low and consistent number of sapwood tree rings, records changes in atmospheric Hg concentrations more reliably than does Scots pine, a species with a relatively high and variable number of sapwood tree rings.


Case report 589: Use of Ostamer in fusion of lumbar spine, postoperative appearance.
In the late 1950s and early 1960s there was intense orthopedic interest in a plastic polyurethane foam (Ostamer) that could be used in the fixation of fractures, performance of arthrodesis, and in spinal fusions. It saw limited success at that time but eventually fell from favor. A patient presenting with a draining sinus in the buttock, back pain, and a history of lumbar spinal fusion with Ostamer was recently scanned in our department. The CT appearance of Ostamer and a brief review of the literature are reported.