The Geographic Diversity of Spinocerebellar Ataxias (SCAs) in the Americas: A Systematic Review.
The frequency and presentation of each of the most common forms of spinocerebellar ataxias (SCAs) varies widely. In the case of the Americas, this diversity is particularly dynamic given additional social, demographic, and cultural characteristics. To describe the regional prevalence and clinical phenotypes of SCAs throughout the continent. A literature search was performed in both MEDLINE and LILACS databases. The research was broadened to include the screening of reference lists of systematic review articles for additional studies. Investigations dating from the earliest available through 2019. Only studies in English, Portuguese, and Spanish were included. We analyzed publications with genetically confirmed cases only, ranging from robust samples with epidemiological data to case reports and case series from each country or regions. Overall, SCA3 is the most common form in the continent. Region-specific prevalence and ranking of the common forms vary. On the other hand, region-specific phenotypic variations were not consistently found based on the available literature analyzed, with the exception of the absence of epilepsy in SCA10 consistently described in a particular cluster of cases in South Brazil. Systematic, multinational studies analyzing in detail the true frequencies of SCAs across the Americas as well as distinct clinical signs and clues of each form would be ideal to look for these potential variations.


[Osteotomies for treating developmental disorders of the neurocranium and visceral cranium].
Craniofacial deformities are primarily caused by premature synostosis of cranial sutures. Depending on the involved sutures, typical deformities of the neuro- and visceral cranium are produced. They result in severe functional and aesthetic disturbances. Several osteotomies, which do not only make an aesthetic improvement possible but a correction of severe malfunction, are available for therapy. Preoperative planning and postoperative treatment require the combination of orthodontics and maxillofacial surgery.


The role of the spleen and immunity in the metastatic pattern of a murine reticulum cell sarcoma.
A reticulum cell sarcoma (RCS) which initially metastasizes selectively to the spleen in C3H/HeN mice has been studied. Previous reports indicated that removal of the spleen results in widespread metastases of this tumor. The current experiments utilized a parabiotic system to determine the effect of additional splenic tissue on the gross and microscopic metastatic pattern of this RCS. The results were that the addition of a second spleen in the parabiotic group was followed by a significant decrease in visceral metastases compared with the splenectomized group. Parabiotic animals with splenectomized partners and sham-operated animals did not significantly differ from control (single) animals, with all three of these groups showing visceral metastatic spread intermediate between the parabiotic and splenectomized groups. The protective effect of additional spleen against visceral metastases was found not to be immunologic, since immunosuppression of mice by irradiation produced a metastatic pattern similar to that of control animals.


Anti-phase pulsation of counter-propagating dissipative solitons in a bidirectional fiber laser.
Due to its unique geometric structure, the bidirectional ultrafast fiber laser is an excellent light source for dual-comb applications. However, sharing the same gain between the counter-propagating solitons also gives rise to complex dynamics. Herein, we report the anti-phase pulsation of counter-propagating dissipative solitons in a bidirectional fiber laser. The in-phase and anti-phase soliton pulsation can be manipulated by adjusting the intracavity birefringence. The periodic modulation of polarization-dependent gain (PDG) caused by polarization hole burning (PHB) in the gain fiber can be responsible for anti-phase pulsation of bidirectional dissipative solitons. These findings offer new, to the best of our knowledge, insights into the complex dynamics of solitons in dissipative optical systems and performance improvement of bidirectional ultrafast fiber lasers.


Gut microbiota and neonatal acute kidney injury biomarkers.
One of the most frequent issues in newborns is acute kidney injury (AKI), which can lengthen their hospital stay or potentially raise their chance of dying. The gut-kidney axis establishes a bidirectional interplay between gut microbiota and kidney illness, particularly AKI, and demonstrates the importance of gut microbiota to host health. Since the ability to predict neonatal AKI using blood creatinine and urine output as evaluation parameters is somewhat constrained, a number of interesting biomarkers have been developed. There are few in-depth studies on the relationships between these neonatal AKI indicators and gut microbiota. In order to gain fresh insights into the gut-kidney axis of neonatal AKI, this review is based on the gut-kidney axis and describes relationships between gut microbiota and neonatal AKI biomarkers.


Acute respiratory failure revealing adult-onset Still's disease: diagnostic value of low glycosylated ferritin level.
The authors report three cases of adult-onset Still's disease with severe hypoxemic pulmonary involvement, mimicking severe pulmonary sepsis. Clinicians must be aware of this rare form of such disease. Low (<20%) glycosylated ferritin level in the presence of unexplained prolonged fever with leukocytosis can help in the diagnosis.


A new technique for the histological diagnosis of Paget's disease of the breast using a semiautomated core needle biopsy with a 14-gauge needle.
The aim of our work is to illustrate a new technique for the histological diagnosis of Paget's disease (PD) using a core needle biopsy with a semiautomated 14-gauge needle called nipple-core needle biopsy (N-CNB). We report 3 years' experience in our senology unit. Twenty-six women with 26 clinical of nipple-areola complex (NAC) changes with suspected PD and subjected to core needle biopsy using our new 14G semiautomated needle technique were included in our study group. Institutional review board approval was obtained for this retrospective analysis. A semiautomated biopsy gun with a 14-gauge, 15-cm-long needle was used for this new procedure. After a subcutaneous injection of anesthetic and spray-ice application to the NAC, the 14G needle was opened with the cradle exposed and positioned on the NAC with considerable pressure exerted on the same. The cradle was then closed by triggering the needle spring, and 2-4 core samples were withdrawn by moving the needle position each time. Clinical, instrumental and histological differences between the lesions that gave benign results after N-CNB and those that resulted PD were analyzed by applying the Fisher's exact test. After N-CNB, 13/26 lesions were found to be PD (50%) while 13/26 alterations were benign (50%). No malignant lesions were detected during the follow-up in patients with benign N-CNB results. The diagnosis of PD obtained with N-CNB was confirmed in all 13 cases by means of a histological analysis of the surgical specimens. No significant post-biopsy complications were recorded. Patients with PD more frequently presented nipple retraction (ρ = 0.0407) and associated suspicious (i.e., BI-RADS 4 and 5) mammographic (ρ = 0.0006) findings compared to patients whose N-CNB had given benign results and the difference was statistically significant. In conclusion, with this novel technique, we were able to obtain an easy, painless, major complication-free and accurate diagnosis of PD of the NAC using a semiautomated core needle biopsy with a 14-gauge needle.


Cortisol responses to ipsapirone challenge correlate with aggression, while basal cortisol levels correlate with impulsivity, in personality disorder and healthy volunteer subjects.
This study was performed to test the hypothesis that 5-HT-1a receptors, as assessed by the cortisol (post-synaptic) and temperature (pre-synaptic) responses to the 5-HT-1a agonist, Ipsapirone (IPSAP), play a role in the regulation of impulsive aggressive behavior in human subjects. Fifty-two healthy subjects (28 with Personality Disorder: PD; 24 Healthy Volunteers: HV) underwent acute challenge with the selective 5-HT-1a agonist, ipsaprione (IPSAP: .3 mg/kg po). Residual Peak Delta Cortisol (ΔCORT[IPSAP]-R; after removal of Basal CORT and IPSAP plasma levels) was used as the primary 5-HT-1a post-synaptic receptor variable. Residual Nadir Delta Temperature (ΔTEMP[IPSAP]-R; after removal of Basal TEMP) was used as the primary 5-HT-1a somatodendritic (pre-synaptic) receptor variable. Measures of trait aggression included the Aggression scales of the Buss-Durkee Hostility Inventory (BDHI) and the Life History of Aggression (LHA); trait impulsivity was assessed with the Impulsivity scale of the Eysenck Personality Questionnaire (EPQ-II). Correlations between ΔCORT[IPSAP]-R responses and BDHI Aggression scores varied by group. Specifically, BDHI Aggression correlated inversely with ΔCORT[IPSAP]-R values in PD subjects but directly in HV subjects. While EPQ-II Impulsivity did not correlate with ΔCORT[IPSAP]-R responses, this measure of impulsivity correlated directly with Basal CORT levels in all subjects. ΔTEMP[IPSAP]-R responses did not correlate with measures of trait aggression or trait impulsivity. Physiologic responses of 5-HT-1a post-synaptic receptors may be reduced as a function of trait aggression, but not impulsivity, in PD subjects. In contrast, pre-synaptic 5-HT-1a receptors may not play a role in the regulation of aggression or impulsivity in human subjects.


Osmotic lysis of chromaffin granules treated with the ionophores nigericin and A23187 in isotonic sucrose solution at low pH.
Bovine chromaffin granules were treated with the ionophores nigericin or A23187 in sucrose solutions with the pH varying from 4.7 to 7.0. Nigericin and A23187 induced osmotic lysis of the granules in sucrose solutions at pH values below 5.8, but not at physiological pH. This effect is explained by a progressive protonation of the acidic chromogranins induced by the ionophore-promoted exchange of internal potassium- and calcium ions for external protons. The results support the view that the interactions between catecholamines and ATP with chromogranins play a significant role in osmotic pressure reduction of the granule interior.


Inadvertent Arterial Placement of Central Venous Catheters: Systematic Review and Guidelines for Treatment.
Inadvertent arterial placement of central venous catheters carries serious sequelae, including pseudoaneurysm development and stroke. Although numerous strategies for therapeutic repair after arterial injury have been employed, no treatment provides a definitive standard of care. All articles published between January 2000 and July 2018 involving the placement of central venous catheters in the brachiocephalic or subclavian arteries, carotid artery, vertebral artery, and aortic arch and subsequent treatment were systematically reviewed. Arterial repair consisted of manual pressure, endovascular techniques (balloon tamponade, percutaneous closure devices, and covered stent placement), and open surgery. Success rates favored endovascular techniques and surgery over manual compression.


Endometrial biopsy should be abandoned as a routine component of the infertility evaluation.
Endometrial biopsies are of little value in the evaluation of infertile couples. Their usefulness in the evaluation of couples with repeated early pregnancy loss remains to be demonstrated.


Synergistic effects of intratumor administration of cis-diamminedichloroplatinum(II) combined with local hyperthermia in melanoma bearing mice.
The synergistic effect of local hyperthermia (LHT) with intratumor injection (i.t.) of cis-diamminedichloroplatinum (II) (DDP) was studied using a rodent model with implanted B16 melanoma tumors. The hindfoot of the C57BL/6 mouse bearing the tumor was placed in a water bath at 42.5 +/- 0.2 degrees C (intratumor temperature was at 42.3 +/- 0.1 degrees C) for 30 minutes just after local (i.t.) or systemic (intraperitoneal;i.p.) administration of DDP (1-3 mg/kg once in experiment I and 1-3 mg/kg three times in experiment II). The tumor growth ratio (TGR) at 7 days after treatment in the group given DDP 3 mg/kg (i.t.) with LHT was 1.1 in experiment I and 0.5 in experiment II, and there was a statistically significant difference in both experiments compared to findings in other groups (P < 0.01). The mean survival time was 42.1 days in experiment I and 50.2 days in experiment II, with a significant difference in the latter (P < 0.001). Thus regional injection chemotherapy given concomitantly with local hyperthermia promotes the anticancer effects and improves the prognosis without either severe renal injury or the promotion of hematogenic metastasis.


Comparison of Signal Detection Algorithms Based on Frequency Statistical Model for Drug-Drug Interaction Using Spontaneous Reporting Systems.
Adverse events (AEs) caused by polypharmacy have recently become a clinical problem, and it is important to monitor the safety profile of drug-drug interactions (DDIs). Mining signals using the spontaneous reporting systems is a very effective method for single drug-induced AE monitoring as well as early detection of DDIs. The objective of this study was to compare signal detection algorithms for DDIs based on frequency statistical models. Five frequency statistical models: the Ω shrinkage measure, additive (risk difference), multiplicative (risk ratio), combination risk ratio, and chi-square statistics models were compared using the Japanese Adverse Drug Event Report (JADER) database as the spontaneous reporting system in Japan. The drugs targeted for the survey are all registered and classified as "suspect drugs" in JADER, and the AEs targeted for this study were the same as those in a previous study on Stevens-Johnson syndrome (SJS). Of 3924 pairs that reported SJS, the number of signals detected by the Ω shrinkage measure, additive, multiplicative, combination risk ratio, and chi-square statistics models was 712, 3298, 2252, 739, and 1289 pairs, respectively. Among the five models, the Ω shrinkage measure model showed the most conservative signal detection tendency. Specifically, caution should be exercised when the number of reports is low because results differ depending on the statistical models. This study will contribute to the selection of appropriate statistical models to detect signals of potential DDIs.


Comparing Dose Calculation Algorithms for Heterogeneous Media: Analytical Anisotropic Algorithm Versus Acuros XB (Dm/Dw) With Continuous CT Value Variation.
To compare the doses calculated by the analytical anisotropic algorithm (AAA) and two dose reporting modes of Acuros XB (AXB(Dm) and AXB(Dw)) with varied CT values on the Eclipse (Varian Medical Systems, Palo Alto, CA). Virtual phantoms with a central layer of heterogeneous material (thickness = 2 or 5 cm) were created with Eclipse. Using single or opposed fields, the field sizes were 5 x 5 cm2 or 10 x 10 cm2. The photon energies were 6 or 10 MV, and the source-to-target distance was 100 cm. The relative doses at the center of the heterogeneous material layer were evaluated with varied CT values, from -1000 to 3000 HU. Values were normalized with the dose at 0 HU (100%) for comparative analysis. The results obtained from continuous data for a single field, 6 MV, 5 x 5 cm2, and the heterogeneous material 5 cm, where the differences between algorithms were most pronounced, were as follows. In the low-density region (-1000 HU and -800 HU), the dose differences for AXB with reference to AAA were, respectively, -54.5% and +4.6% (AXB(Dm)) and -47.0% and +3.5% (AXB(Dw)), and in the high-density regions (1000 HU and 3000 HU) were -5.7% and -8.8% (AXB(Dm)) and +7.4% and +3.5% (AXB(Dw)), respectively. Consequently, dose differences at arbitrary CT values could be obtained. Dose differences between these algorithms were clarified for heterogeneous materials. The risk of dose reduction or escalation in clinical use was clearly visible between CT values from -1000 to 3000 HU.


Temporal variation in size-assortative mating and male mate choice in a spider with amphisexual care.
Males should be more selective when they have a high investment in reproduction, especially in species with biparental or paternal care. In this context, male mate choice can promote size-assortative mating (SAM) when (1) large males win intrasexual disputes, (2) large females are more fecund, and (3) males prefer larger females to smaller ones. In the spider Manogea porracea, males exhibit high reproductive investment by building their webs above those of females and exhibiting extended care of offspring in the absence of females. Under these circumstances, we expect the occurrence of SAM and male preference for large females. Herein, we performed observations and experiments in the field to evaluate the hypotheses that (1) M. porracea mates assortatively by size and (2) SAM is influenced by male mate choice. Furthermore, we measured variables that could affect mating patterns, the sex ratios, and densities of both sexes. Pairing in M. porracea was positively size-assortative in 2012, but not in 2013. Large males won most disputes for mates and preferred larger females, which produced more eggs. The inconsistency in detection of SAM was due to population dynamics, namely variations in sex ratio and population density across the breeding season. Furthermore, we found that the significance of male mate choice on sexual selection of body size in M. porracea strongly depends on the competition intensity for mating opportunities. The traditional sexual selection hypothesis of SAM needs to be reviewed and must include measures of competition intensity.


Enhanced expression of Fc receptors on neutrophils from calves with leukocyte adhesion deficiency.
The expression of Fc receptors for immunoglobulin G(IgG) and concanavalin A (con A)-binding receptors, luminol-dependent chemiluminescent (LDCL) responses, and the effect of anti-bovine IgG on LDCL responses were evaluated in neutrophils from Holstein calves with leukocyte adhesion deficiency (BLAD). Neutrophils from affected calves showed a 2.1- to 2.5-fold increase in Fc receptor expression compared with those of control calves by flow cytometric analysis. Con A-binding activities of neutrophils from affected calves were similar to those of control calves. Neutrophils from a calf with BLAD, when stimulated with zymosan opsonized with bovine serum (OPZ), heat-aggregated bovine IgG (Agg-bovine IgG), sheep red blood cells (SRBC) sensitized with anti-SRBC antibody (SRBC-anti-SRBC Ab), or con A had LDCL responses of 36 (P < 0.05), 77, 126 and 119% of peak LDCL values of controls, respectively. The NBT-reducing value of neutrophils from a calf with BLAD when stimulated with Agg-bovine IgG after pretreatment with anti-bovine IgG was 116.5% of the values of neutrophils from control calves, but the difference was not significant. The LDCL responses of neutrophils from a control calf and a calf with BLAD stimulated with OPZ were inhibited markedly by pre-incubation with anti-bovine IgG antiserum at concentrations ranging from 1.25 to 20 or 40 micrograms/ml. Although an increase in Fc receptor expression on neutrophils from calves with BLAD was observed, the LDCL responses stimulated with SRBC-anti-SRBC Ab and NBT-reducing activity stimulated with Agg-bovine IgG after pretreatment with anti-bovine IgG did not correlate significantly with the increased Fc receptor expression. These results support that neutrophil functions mediated by the Fc receptors are associated synergistically with the presence of the complement receptor type 3 (CR3)(CD11b/CD18).


The oxidation of dithiothreitol by peroxidases and oxygen.
Horseradish peroxidase (18.104.22.168), lactoperoxidase (188.8.131.52), and the fragment of cytochrome c known as microperoxidase have been shown to catalyze the oxidation of reduced dithiothreitol in an oxygen-consuming reaction. Evidence for horseradish peroxidase intermediates compound III and compound II has been observed, although ferroperoxidase was not identified during the course of the reaction. The stoichiometry has been extablished as 1 : 1 for oxygen consumed to dithiothreitol oxidized. Cysteine and glutathione have also been shown to be substrates for horseradish peroxidase oxidase reaction.


Vitamin B12 biofortification of soymilk through optimized fermentation with extracellular B12 producing Lactobacillus isolates of human fecal origin.
The present study was designed to bio-fortify the soymilk (per se a B12-free plant food matrix). The PCR-based screening characterized the human fecal samples (4 out of 15 tested) and correspondingly identified novel lactobacilli isolates (n = 4) for their B12 production potential and rest (n = 62) as negative for this attribute. Further, 3 out of the 4 selected strains showed ability for extracellular vitamin production. The most prolific strain, Lactobacillus reuteri F2, secreted B12 (132.2 ± 1.9 μg/L) in cobalamin-free-medium with the highest ratio ever reported (0.97:1.00; extra-: intra-cellular). In next stage, the soymilk was biofortified in situ with B12 during un-optimized (2.8 ± 0.3 μg/L) and optimized (156.2 ± 3.6 μg/L) fermentations with a ∼54-fold increase at Artificial Neuro Fuzzy Inference System based R value of >0.99. The added-nutrients, temperature and initial-pH were observed to be the most important fermentation variables for maximal B12 biofortification. We report Lactobacillus rhamnosus F5 as the first B12 producing (101.7 ± 3.4 μg/L) strain from this species. The cyanocobalamin was extracted, purified and separated on UFLC as nutritionally-relevant B12. Besides, the vitamin was bioavailable in an auxotrophic-mutant. The lactobacilli fermentation is suggested, therefore, as an effective approach for B12 biofortification of soymilk.


Revisit of flap factors relating to partial necrosis of distally based sural flaps: an analysis of 435 cases in a single center.
Partial necrosis is an ongoing topic in regard to flap complications of the distally based sural (DBS) flap However, the factors influencing partial necrosis of the flap remain in debate. The aim of the present study is to further illuminate the flap-related risk factors and the effects of several technical improvements. We retrospectively reviewed the data of 429 patients who underwent 435 DBS flaps between April 2001 and December 2019. The reconstruction outcomes, flap viability-related complications, and potential risk factors were compared between the survival group and partial necrosis group, as well as between group A (the procedures performed from April 2001 to March 2010) and group B (those from April 2010 to December 2019). Among the 435 flaps, 39 flaps (8.97%) exhibited partial necrosis. With the increase of the top edge of the flap, the partial necrosis rate increased significantly (P < 0.05). When the length-to-width ratio [LWR] of the flap was more than 5:1 or the total length of the flap (the length of the skin island plus the length of the adipofascial pedicle) was more than 20 cm, the partial necrosis rate increased significantly (P < 0.05). The partial necrosis rate in group B (5.86%, 15/256) was significantly lower than that in group A (13.41%, 24/179) (P = 0.007). The top edge of the flap is an essential indicator for predicting the prognosis of the DBS flap. When the total length of the flap is more than 20 cm or the LWR of the flap more than 5:1, the partial necrosis rate will increase significantly. Various technical modifications can lower the top edge of the flap and reduce the LWR of the flap and width of the skin island, and thus improve the flap survival effectively.


Concurrent agreement between ActiGraphⓇ and activPALⓇ in measuring moderate to vigorous intensity physical activity for adults.
This study aimed to assess the ability of the activPALⓇ monitor (commonly used for measuring Sedentary Behaviour (SB), sitting or reclining with low energy expenditure while awake) to measure moderate to vigorous physical activity (MVPA), by assessing its agreement with the concurrent measurement by ActiGraphⓇ monitor (commonly used for measuring MVPA) to identify if a single monitor could be used to measure both MVPA and SB. A convenience sample of 24 adults (79% female; aged 23-60) wore an ActiGraphⓇ GT3X+ and an activPAL3Ⓡ concurrently for one day during free-living activities. Time spent in MVPA was calculated as an outcome measure using published methods (ActiGraphⓇ, n = 6; activPALⓇn = 4). Agreement was assessed between pairs of outcomes using the Bland & Altman method. Participants engaged in between 60 and 145 min of MVPA. The activPALⓇ method summing time walking with a cadence ≥100 steps/min underestimated MVPA compared with the ActiGraphⓇ but had the lowest aggregate bias (-16 min). Other activPALⓇ methods, based on acceleration counts and the embedded MET algorithm, overestimated MVPA compared to the ActiGraphⓇ. The study was limited by the lack of activPALⓇ acceleration count methods developed for adults. With the recommended methods, the activPALⓇ could be suitable for use as a single monitor to measure both SB and MVPA.


Comparison Between Echocardiography and Cardiac Computed Tomography in the Evaluation of Diastolic Dysfunction and Prediction of Heart Failure.
Recent data indicate that left atrial (LA) function assessment by cardiac computed tomography (CT) is closely related to diastolic dysfunction (DD). Therefore, we aimed to perform a direct comparison between CT and echocardiography for diagnosis of advanced DD and prediction of future heart failure or cardiovascular death. We identified 340 patients who had both spiral cardiac CT and a proximate echocardiogram. LA total emptying fraction (LATEF), a measure of global LA function, was automatically calculated from CT data, as a surrogate for diastolic function and was compared with echocardiographic grades of diastolic function. The area under the receiver operating characteristic curve for LATEF to differentiate between advanced DD (grades 2 and 3) and all other grades was 0.84 (0.79 to 0.88). Over a median of 4 years, 69 events (admissions for heart failure and cardiovascular deaths) occurred. By multivariate Cox analysis, LATEF <40% provided incremental prognostic information after adjustments for advanced DD by echocardiography (hazard ratio 2.15, 95% confidence interval 1.13 to 3.94). There was a significant interaction (p = 0.03) between LATEF and echocardiography-based diastolic grades. Stratified analyses within the diastolic function groups revealed that LATEF <40% was equivalent to echocardiography in predicting events in the subgroup with advanced DD by echocardiography (p = 0.20) but was associated with a significantly higher event rates in patients with normal filling pressures (p = 0.0001) or indeterminate diastolic function (p = 0.04) by echocardiography. In conclusion, LA function derived from CT can accurately detect advanced DD diagnosed by echocardiography and has additive value to echocardiography-derived DD.


Plp1 gene duplication inhibits airway responsiveness and induces lung inflammation.
Mice with Plp1 gene duplication model the most common form of Pelizaeus-Merzbacher disease (PMD), a CNS disease in which patients may suffer respiratory complications. We hypothesized that affected mice would lack airway responsiveness compared to wild-type and carrier mice during methacholine challenge. Wild-type (n = 10), carrier female (n = 6) and affected male (n = 8) mice were anesthetized-paralyzed, tracheostomized and ventilated. Respiratory mechanics were recorded at baseline and during escalating doses of nebulized methacholine followed by albuterol. Lung resistance (RL) was the primary endpoint. Lung tissues were assayed for inflammatory and histological differences. At baseline, phase angles were higher in carrier and affected mice than wild-type. Dose-response RL curves in affected and carrier mice indicated a lack of methacholine response. Albuterol reduced RL in wild-type and carrier, but not affected mice. Affected mice exhibited lower interleukin (IL)-6 tissue levels and alveolar inflammatory infiltrates. Affected and carrier mice, compared to wild-type, lacked airway reactivity during methacholine challenge, but only affected mice exhibited decreased lung tissue levels of IL-6 and inflammation.


Public Stroke Knowledge, Awareness, and Response to Acute Stroke in Isfahan Iran: What is Less or Misinterpreted in Developing Countries.
Considering the high burden of stroke in developing countries, it is important for the community to have adequate information and awareness of this disease. In this study, the baseline knowledge of an Iranian population towards stroke has been evaluated. This study was conducted in a governmental hospital in Isfahan, Iran. The participants were selected from the companions of non-cardio-vascular hospitalized patients. A self-administered questionnaire was designed for gathering information RESULTS: A total of 630 questionnaires were analysed. Hypertension and stress were the most frequently identified risk factors (recognised by 83.7% and 75.8% respectively), while pregnancy, oral contraceptives, and anti-coagulants were the least (recognised by 3.5%, 14.2% and 15.8% respectively). Knowledge of other important risk factors such as cardiac diseases was also relatively low (39.4%). Sudden visual difficulties and irrelevant speech were the least identified warning signs of stroke (45.3% and 34.6% respectively), however, knowledge towards all other warning signs was moderately good (each identified by 60-70%). Importantly only 44.2% of respondents were aware that stroke treatment should be started within the first 3 hours. Participants tended to have moderately good insight of most stroke complications and rehabilitation (60-70%). Urban residence, high level of education and knowing someone with a history of stroke were significant predictors of a higher level of stroke awareness. The findings of this study indicate that there is a need to improve general knowledge of cardiac and hypercoagulable related risk factors. Furthermore, understanding of the importance of time critical stroke management and the ineffectiveness of traditional medicine needs to be raised in the general community.


Bilateral optic neuritis with spine demyelination associated with influenza A H1N1 infection.
To report a rare case of optic neuritis with spine demyelination following H1N1 virus infection. A 66-year-old female presented with decreased vision in both eyes (left > right) following a recent episode of fever and flu. She was diagnosed as H1N1 infection confirmed by viral antigen analysis of throat swab. On examination, she had a profound vision drop in the left eye with optic disc edema. MRI brain and orbit revealed bilateral optic nerve and frontal dural thickening with a ring-enhancing lesion in the right frontal lobe. MRI spine showed long cord signals at T1-T7 suggestive of demyelination. The patient had a complete recovery of vision and visual fields after intravenous and oral steroids. Influenza A virus can manifest with a wide range of symptoms including flu-like illness to neurological complications. This case highlights optic neuritis as a presenting feature of H1N1 infection.


Structure and stability of mRNA synthesized by vaccinia virus-encoded bacteriophage T7 RNA polymerase in mammalian cells. Importance of the 5' untranslated leader.
We have analyzed the structure and stability of RNA synthesized by bacteriophage T7 RNA polymerase in mammalian cells. The T7 polymerase, expressed by a recombinant vaccinia virus, transcribed the Escherichia coli lacZ gene flanked by T7 promoter and terminator signals. The lacZ gene cassette was introduced into infected cells within either a transfected plasmid or a second recombinant vaccinia virus. The T7-lacZ transcripts, which had a half-life of approximately 75 minutes, represented approximately 30% of total cytoplasmic RNA after a 24 hour period. The latter estimation indicated a disparity between the levels of lacZ RNA and beta-galactosidase synthesis. Analysis of the T7 transcripts indicated that they were initiated correctly but that only 5 to 10% contained terminal cap structures, providing an explanation for the low translatability of the RNA. Since the 5' end of the T7 transcripts can form a stem-loop structure that might interfere with capping by vaccinia virus RNA guanylyltransferase, as well as ribosome binding and scanning, a similar vector lacking such sequences was constructed. In vitro experiments demonstrated that T7 RNA polymerase transcribed both templates with similar efficiency and that the RNA lacking the potential to form the stem-loop was capped more rapidly by the purified vaccinia virus enzyme. Nevertheless, when the stem-loop was removed, beta-galactosidase was not expressed in infected cells; moreover, no T7 transcripts could be detected, suggesting that the RNA was not made or more likely was degraded during or shortly after synthesis. There is previous evidence that vaccinia virus RNA guanylyltransferase is associated with the viral transcription complex, thereby allowing RNA synthesis and capping to occur concurrently. We suggest that a lack of coupling between the vaccinia viral RNA guanylyltransferase and bacteriophage T7 RNA polymerase delays capping of T7 transcripts and that, under these conditions, the 5'-terminal double-stranded stem is required to stabilize the nascent RNA against degradation. Although deletion of the 3' palindromic sequence specifying T7 transcriptional termination from the expression cassette resulted in RNA of more heterogeneous lengths, neither the apparent turnover rate nor translation of the RNAs was diminished appreciably.


Technical aspects of catheter-related interventions in the liver of the rabbit.
On the basis of 89 different vascular interventions performed in the livers of 39 rabbits, we attempted to establish the feasibility and technical limitations of these procedures. Forty-five selective hepatic artery catheterizations were carried out using 0.66-mm and 1.0-mm catheters, including superselective proper hepatic catheterizations (n = 14) using a specially designed 0.66-mm introducer/catheter system. The portal system was investigated with both direct (n = 5) and indirect (arterial) (n = 4) portography. Hepatic, vein catheterizations were performed in 22 cases. With the 0.66-mm system, spasm occurred in one of 11 cases in the proper hepatic artery, and no spasm was observed in the common hepatic and celiac arteries. Both arterial portography and hepatic venography were easily performed and were a precise and repeatable method. The 0.66-mm system has proved to be advantageous over the 1.0-mm catheterization in avoiding arterial spasm. Direct portography as well as catheterization of the hepatic vein from a jugular approach are hazardous, leading to serious complications including the death of the animal.


Remote preconditioning combined with nebulized budesonide alleviate lipopolysaccharide induced acute lung injury via regulating HO-1 and NF-κB in rats.
Acute lung injury (ALI) may result in severe systemic inflammation and is life-threatening. Remote inflammatory preconditioning (RIPC) has been confirmed to have an endogenous protective effect against ALI. Budesonide (BS) is a potent corticosteroid typically administered through nebulization that reduces inflammation in the lungs. We speculate that the combined use of RIPC and nebulized BS has a stronger protective effect on ALI. 48 Sprague-Dawley male rats were used for the experiments. Animals were divided evenly and randomly into three groups, control (NS injection), LPS (LPS injection), and RIPC (LPS injection with RIPC). Each group was then divided into two subgroups with inhalation of nebulized normal saline (NS) or BS. Prior to injection of LPS, RIPC was performed by tying and untying the right hind limb for three cycles of 5 min each. Following LPS injection, animals in each subgroup were placed in a same cage for nebulized inhalation. Animals were sacrificed 6 h after LPS injection. Histological evaluation of ALI and lung wet-to-dry weight ratio were measured. Serum lactate acid, inflammatory cytokines, oxidative stress indicators were detected. The expression of HO-1, NF-κB p65 and p-p65 was measured by western blotting. RIPC combined with nebulized BS significantly attenuated the LPS-induced ALI in rats. Reduction of MDA, increasing of SOD activity were found significantly improved by the joint strategy. TNF- and IL-1β rise brought on by LPS was reduced, but IL-10 production dramatically enhanced when compared to the LPS group. The expression of HO-1 was significantly increased by RIPC combined with nebulized BS while the expression of NF-κB p65 and p-p65 was decreased when compared with the LPS group. RIPC combined with nebulized budesonide is protective for ALI induced by LPS in rats.


Effect of nutritional stress on physiological parameters and seminal attributes of native-crossbred ram in semi-arid tropics.
A prolific three-breed (Malpura, Patanwadi, and Garole) cross Avishaan sheep has been developed in the semi-arid zone to improve farmer's income. Nutritional scarcity is a major limitation in animal husbandry during the dearth period of semi-arid tropics. Therefore, before the inaugural launch of the breed into the field, a study was designed to evaluate the effect of nutritional stress on physiological parameters and seminal attributes of native-crossbred rams in semi-arid tropics. Thus, 16 native adapted (Malpura) and 16 native-crossbred rams were equally distributed into four groups, namely, native control (G1), native nutritional stress (G2), native-crossbred control (G3), and native-crossbred nutritional stress (G4). Both the control groups (G1 and G3) were kept on their maintenance requirement as per their body weight, whereas the nutritional stress groups (G2 and G4) were provided 30% less than their maintenance requirement. The body weight of G4 decline (P<0.05) as compared to their initial weight. The plasma glucose level of G2 and G4 reduced (P<0.05) in comparison with G1 and G3, respectively. The total motile sperm percentage, rapid motile sperm percentage, and sperm viability decrease significantly (P<0.05) within the acceptable limit in native-crossbred rams (G4) under nutritional scarcity. However, the similar blood biochemical along with acceptable seminal attributes of all the rams reflected that native-crossbred rams can cope with the nutritional scarcity in semi-arid tropics and have the potential to contribute to the sustainable small ruminant production system for livelihood security in this region.


Simultaneous Determination of Caffeine and Paracetamol in Commercial Formulations Using Greener Normal-Phase and Reversed-Phase HPTLC Methods: A Contrast of Validation Parameters.
There has been no assessment of the greenness of the described analytical techniques for the simultaneous determination (SMD) of caffeine and paracetamol. As a result, in comparison to the greener normal-phase high-performance thin-layer chromatography (HPTLC) technique, this research was conducted to develop a rapid, sensitive, and greener reversed-phase HPTLC approach for the SMD of caffeine and paracetamol in commercial formulations. The greenness of both techniques was calculated using the AGREE method. For the SMD of caffeine and paracetamol, the greener normal-phase and reversed-phase HPTLC methods were linear in the 50-500 ng/band and 25-800 ng/band ranges, respectively. For the SMD of caffeine and paracetamol, the greener reversed-phase HPTLC approach was more sensitive, accurate, precise, and robust than the greener normal-phase HPTLC technique. For the SMD of caffeine paracetamol in commercial PANEXT and SAFEXT tablets, the greener reversed-phase HPTLC technique was superior to the greener normal-phase HPTLC approach. The AGREE scores for the greener normal-phase and reversed-phase HPTLC approaches were estimated as 0.81 and 0.83, respectively, indicated excellent greenness profiles for both analytical approaches. The greener reversed-phase HPTLC approach is judged superior to the greener normal-phase HPTLC approach based on numerous validation parameters and pharmaceutical assays.


Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as inflammation markers in patients with papilledema due to idiopathic intracranial hypertension.
The aim of this study was to investigate the role of inflammation in the pathogenesis of idiopathic intracranial hypertension (IIH) using the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as inflammation markers. The files of 33 IIH patients and 33 controls were screened for this retrospective study. For each patient, the NLR and PLR values were calculated using a single fasting blood sample. For both eyes, papilledema (PE) grades, best-corrected visual acuity (BCVA), retinal nerve fiber layer thickness (RNFLT), and ganglion cell layer thickness (GCLT) measurements were recorded along with the demographic data, including body mass index (BMI), and complete neurological and ophthalmological findings. Comparisons between the two groups and between the IIH patients with and without PE were made. The associations of NLR and PLR with all other parameters were analyzed independently from age, gender, and BMI. NLR and PLR were higher in patients with IIH than controls (P < 0.05). They were also higher in patients with PE (P < 0.05) in the IIH group. NLR and PLR were found to be associated with BCVA (P < 0.001 and P = 0.023, respectively), global RNFLT (P = 0.004 and 0.012, respectively), RNFLT of the temporal quadrant (P < 0.001 and P = 0.042, respectively) and PE grade (P < 0.001 and P = 0.035, respectively). The NLR and PLR values and their associations with BCVA, RNFLT, and PE support the hypothesis that inflammation is a very important component of the pathogenesis of IIH.


Pituitary apoplexy in endocrinologically silent adenoma during somatostatin analog administration for pancreatic neuroendocrine tumor: A case report.
A dopamine agonist administered for prolactinoma treatment and pituitary stimulation tests are reported as risk factors for pituitary apoplexy. We report a case of an 82-year-old patient who suffered from pituitary apoplexy in an endocrinologically silent adenoma during lanreotide administration. The patient was diagnosed with a pancreatic neuroendocrine tumor with lymph node metastasis and treated with lanreotide for two years. An endoscopic endonasal transsphenoidal approach was used for tumor and hematoma removal. The specimen showed growth hormone and prolactin positivity and was diagnosed as pit1-lineage plurihormonal adenoma. The tumor also showed positivity for somatostatin receptor 2. Thus, lanreotide treatment is a risk factor for pituitary apoplexy even in silent adenoma.


Differential genetic responses to ionizing irradiation in individual families of Japanese medaka, Oryzias latipes.
Although no statistically significant hereditary effects have yet been detected in the children of survivors from the atomic bombings in Hiroshima and Nagasaki, recent animal studies have found that exposure to ionizing radiation can cause genomic and epigenomic instability in the exposed individuals, as well as their offspring, and therefore, may have much larger genetic effects than predicted by earlier studies. When individuals are exposed to various environmental insults, including radiation, individual sensitivity to the insults often varies. Variance in germ-line response to radiation among individuals has been widely recognized, but it is difficult to address due to the use of inbred strains and the limited number of offspring that can be produced by a pair of mice, the common model used to study genetic effects of radiation. Herein is the first study to examine individual family responses to ionizing radiation using a parent-pedigree approach in an outbred strain of a vertebrate model, the Japanese medaka fish. Changes in frequencies of radiation-induced germline mutations at nine microsatellite loci were examined in the same families before and after exposure to one of four acute doses of ionizing radiation (0.1, 0.5, 2.5, 5Gy, plus sham-exposed controls). Families varied significantly in pre-exposure mutation frequencies and responses to irradiation, but germline mutations were elevated in at least one family after 0.1, 0.5, and 5Gy exposures. Variance among individuals in sensitivity to radiation is well documented for many endpoints, and our work now extends these endpoints to include germ-line mutations. Further studies are needed to elucidate dose response, effects at varying stages of spermatogenesis, and the mechanisms underlying the variance in these individual responses to radiation.


Voltage-dependence of ryanodine-sensitive component of contraction in A23187- and isoprenaline-treated cardiac muscles.
1. The ryanodine-sensitive component (RSC) of contraction electrically induced in the presence of A23187 (10(-6) M) and isoprenaline (5 x 10(-8) M) was investigated in guinea-pig papillary muscles that had been partially depolarized to various membrane potentials by increasing [K+]o, and current and voltage clamp techniques. 2. Two components of contraction were produced by A23187 and isoprenaline at a stimulation frequency of 0.2 Hz. The early component was sensitive to ryanodine (10(-6) M) (corresponding to RSC), while the late component was sensitive to nifedipine (10(-6) M). 3. In the presence of nifedipine, RSCs produced by these drugs were selectively observed. Under these conditions, RSCs were voltage-dependently inhibited by a reduction in resting potential that was brought about by increasing [K+]o (10-26 mM). The onset of inhibition of RSCs appeared at a resting potential between -75 and -70 mV, and almost complete inhibition was observed at a potential between -55 and -50 mV, indicating that RSCs produced by these drugs have the same voltage-dependence. 4. In the absence of nifedipine, this voltage-dependent inhibition was also observed on the early component of contraction produced by A23187 without affecting the late component. 5. RSC produced by A23187 was not affected by blocking Na channel activation with tetrodotoxin (6 x 10(-6) M). 6. In current and voltage clamp experiments, this RSC was inhibited by reducing the resting and the holding potentials in much the same way as observed on the preparations depolarized by increasing [K+]o. Such dependence on voltage was not observed with either the slow action potential or the slow Ca inward current. 7. These results suggest that the dependence of RSC on resting potentials is not due to the changes in the fast Na and the slow Ca inward currents. The present RSC via ryanodine-sensitive internal Ca release may be mainly triggered by a mechanism different from Ca influx through slow channels.


A cephalometric study of mandibular cortical bone thickness in dentulous persons and denture wearers.
Cephalometric measurements of the cortical thickness of the inferior mandibular border and the inferior aspect of the mandibular symphysis were compared in two groups of subjects, one with complete dentition and the other wearing complete maxillary and mandibular dentures. Although the cortical thickness of the inferior mandibular border increased slightly with age in both dentition groups, the cortical thickness was significantly less in denture groups than in their respective dentition groups. The opposite was true with the cortical thickness of the inferior aspect of the mandibular symphysis; a decrease in thickness was noted with age, and a slight increase in thickness was noted with edentulousness. The results suggest that bone remodeling can be expected at sites distant from the residual ridge in denture wearers.


Fiber optic muzzle brake tip for reducing fiber burnback and stone retropulsion during thulium fiber laser lithotripsy.
The experimental thulium fiber laser (TFL) is being explored as an alternative to the current clinical gold standard Holmium:YAG laser for lithotripsy. The near single-mode TFL beam allows coupling of higher power into smaller optical fibers than the multimode Holmium laser beam profile, without proximal fiber tip degradation. A smaller fiber is desirable because it provides more space in the ureteroscope working channel for increased saline irrigation rates and allows maximum ureteroscope deflection. However, distal fiber tip burnback increases as fiber diameter decreases. Previous studies utilizing hollow steel sheaths around recessed distal fiber tips reduced fiber burnback but increased stone retropulsion. A "fiber muzzle brake" was tested for reducing both fiber burnback and stone retropulsion by manipulating vapor bubble expansion. TFL lithotripsy studies were performed at 1908 nm, 35 mJ, 500 ?? ? s , and 300 Hz using a 100 - ? m -core fiber. The optimal stainless steel muzzle brake tip tested consisted of a 1-cm-long, 560 - ? m -outer-diameter, 360 - ? m -inner-diameter tube with a 275 - ? m -diameter through hole located 250 ?? ? m from the distal end. The fiber tip was recessed a distance of 500 ?? ? m . Stone phantom retropulsion, fiber tip burnback, and calcium oxalate stone ablation studies were performed ex vivo. Small stones with a mass of 40 ± 4 ?? mg and 4-mm-diameter were ablated over a 1.5-mm sieve in 25 ± 4 ?? s


High-Efficiency Photovoltaic Modules on a Chip for Millimeter-Scale Energy Harvesting.
Photovoltaic modules at the mm-scale are demonstrated in this work to power wirelessly interconnected mm-scale sensor systems operating under low flux conditions, enabling applications in the Internet of Things and biological sensors. Module efficiency is found to be limited by perimeter recombination for individual cells, and shunt leakage for the series-connected module configuration. We utilize GaAs and AlGaAs junction barrier isolation between interconnected cells to dramatically reduce shunt leakage current. A photovoltaic module with eight series-connected cells and total area of 1.27-mm2 demonstrates a power conversion efficiency of greater than 26 % under low-flux near infrared illumination (850 nm at 1 μW/mm2). The output voltage of the module is greater than 5 V, providing a voltage up-conversion efficiency of more than 90 %. We demonstrate direct photovoltaic charging of a 16 μAh pair of thin-film lithium-ion batteries under dim light conditions, enabling the perpetual operation of practical mm-scale wirelessly interconnected systems.


Use of immobilized adenosine deaminase (EC 126.96.36.199) for the rapid purification of native human CD26/dipeptidyl peptidase IV (EC 184.108.40.206).
The leukocyte differentiation antigen CD26 identified as dipeptidyl peptidase IV.(EC 220.127.116.11), cleaves off N-terminal dipeptides from peptides when a proline or alanine is located at the penultimate position. Seminal plasma and especially prostasomes, prostate-derived organelles which occur freely in seminal plasma, contain high amounts of CD26/dipeptidyl peptidase IV and therefore are suitable sources for the purification of the protein. The use of adenosine deaminase (EC 126.96.36.199) affinity chromatography for its purification is described. CD26/dipeptidyl peptidase IV was purified from human seminal plasma and prostasomes by a two step procedure. Ion exchange chromatography on DEAE-Sepharose, followed by affinity chromatography on adenosine deaminase-Sepharose resulted in the pure, native protein with an overall yield ranging from 35 to 55%. The N-terminal sequence of the amphiphilic enzyme purified from human prostasomes was determined to be Met-Lys-Thr-Pro-Trp-Lys-Val-Leu. The preparation obtained was free of contaminating aminopeptidase activity and proved to be very stable (up to 1 month at 37 degrees C). The calf intestinal adenosine deaminase we used is commercially available and can be employed for the purification of human, bovine and rabbit CD26/dipeptidyl peptidase IV. High affinity binding of porcine dipeptidyl peptidase IV was not observed. The availability of a source with high specific activity and the introduction of adenosine deaminase affinity chromatography permits the rapid purification of milligram quantities of natural mammalian CD26/dipeptidyl peptidase IV.


Striatal dopamine uptake in the rat: in vivo analysis by fast cyclic voltammetry.
Electrical stimulation of the median forebrain bundle of the chloral hydrate anaesthetised rat evoked dopamine release in the ipsilateral striatum, which was monitored with fast cyclic voltammetry. On cessation of stimulation, the extracellular concentration of dopamine fell to sub-detectable levels over a period of about 15 s. This fall appeared to be due to a saturable, low affinity uptake system that could be inhibited by nomifensine (20 mg/kg i.p.). These experiments constitute the first characterisation of a dopamine uptake mechanism obtained in the intact animal.


PCSK9 and cancer: Rethinking the link.
Cancer is emerging as a major problem globally, as it accounts for the second cause of death despite medical advances. According to epidemiological and basic studies, cholesterol is involved in cancer progression and there are abnormalities in cholesterol metabolism of cancer cells including prostate, breast, and colorectal carcinomas. However, the importance of cholesterol in carcinogenesis and thereby the role of cholesterol homeostasis as a therapeutic target is still a debated area in cancer therapy. Proprotein convertase subtilisin/kexin type-9 (PCSK9), a serine protease, modulates cholesterol metabolism by attachment to the LDL receptor (LDLR) and reducing its recycling by targeting the receptor for lysosomal destruction. Published research has shown that PCSK9 is also involved in degradation of other LDLR family members namely very-low-density-lipoprotein receptor (VLDLR), lipoprotein receptor-related protein 1 (LRP-1), and apolipoprotein E receptor 2 (ApoER2). As a result, this protein represents an interesting therapeutic target for the treatment of hypercholesterolemia. Interestingly, clinical trials on PCSK9-specific monoclonal antibodies have reported promising results with high efficacy in lowering LDL-C and in turn reducing cardiovascular complications. It is important to note that PCSK9 mediates several other pathways apart from its role in lipid homeostasis, including antiviral activity, hepatic regeneration, neuronal apoptosis, and modulation of various signaling pathways. Furthermore, recent literature has illustrated that PCSK9 is closely associated with incidence and progression of several cancers. In a number of studies, PCSK9 siRNA was shown to effectively suppress the proliferation and invasion of the several studied tumor cells. Hence, a novel application of PCSK9 inhibitors/silencers in cancer/metastasis could be considered. However, due to poor data on effectiveness and safety of PCSK9 inhibitors in cancer, the impact of PCSK9 inhibition in these pathological conditions is still unknown. A vast literature search was conducted to find intended studies from 1956 up to 2020, and inclusion criteria were original peer-reviewed publications. To date, PCSK9 has been scantly investigated in cancer. The question that needs to be discussed is "How does PCSK9 act in cancer pathophysiology and what are the risks or benefits associated to its inhibition?". We reviewed the available publications highlighting the contribution of this proprotein convertase in pathways related to cancer, with focus on the potential implications of its long-term pharmacological inhibition in cancer therapy.


SciApps: An Automated Platform for Processing and Distribution of Plant Genomics Data.
SciApps is an open-source, web-based platform for processing, storing, visualizing, and distributing genomic data and analysis results. Built upon the Tapis (formerly Agave) platform, SciApps brings users TB-scale of data storage via CyVerse Data Store and over one million CPUs via the Extreme Science and Engineering Discovery Environment (XSEDE) resources at Texas Advanced Computing Center (TACC). SciApps provides users ways to chain individual jobs into automated and reproducible workflows in a distributed cloud and provides a management system for data, associated metadata, individual analysis jobs, and multi-step workflows. This chapter provides examples of how to (1) submitting, managing, constructing workflows, (2) using public workflows for Bulked Segregant Analysis (BSA), (3) constructing a Data Analysis Center (DAC), and Data Coordination Center (DCC) for the plant ENCODE project.


Control of kidney development by calcium ions.
From the formation of a simple kidney in amphibian larvae, the pronephros, to the formation of the more complex mammalian kidney, the metanephros, calcium is present through numerous steps of tubulogenesis and nephron induction. Several calcium-binding proteins such as regucalcin/SMP-30 and calbindin-D28k are commonly used to label pronephric tubules and metanephric ureteral epithelium, respectively. However, the involvement of calcium and calcium signalling at various stages of renal organogenesis was not clearly delineated. In recent years, several studies have pinpointed an unsuspected role of calcium in determination of the pronephric territory and for conversion of metanephric mesenchyme into nephrons. Influx of calcium and calcium transients have been recorded in the pool of renal progenitors to allow tubule formation, highlighting the occurrence of calcium-dependent signalling events during early kidney development. Characterization of nuclear calcium signalling is emerging. Implication of the non-canonical calcium/NFAT Wnt signalling pathway as an essential mechanism to promote nephrogenesis has recently been demonstrated. This review examines the current knowledge of the impact of calcium ions during embryonic development of the kidney. It focuses on Ca(2+) binding proteins and Ca(2+) sensors that are involved in renal organogenesis and briefly examines the link between calcium-dependent signals and polycystins.


Pathologist-trained machine learning classifiers developed to quantitate celiac disease features differentiate endoscopic biopsies according to modified marsh score and dietary intervention response.
Histologic evaluation of the mucosal changes associated with celiac disease is important for establishing an accurate diagnosis and monitoring the impact of investigational therapies. While the Marsh-Oberhuber classification has been used to categorize the histologic findings into discrete stages (i.e., Type 0-3c), significant variability has been documented between observers using this ordinal scoring system. Therefore, we evaluated whether pathologist-trained machine learning classifiers can be developed to objectively quantitate the pathological changes of villus blunting, intraepithelial lymphocytosis, and crypt hyperplasia in small intestine endoscopic biopsies. A convolutional neural network (CNN) was trained and combined with a secondary algorithm to quantitate intraepithelial lymphocytes (IEL) with 5 classes on CD3 immunohistochemistry whole slide images (WSI) and used to correlate feature outputs with ground truth modified Marsh scores in a total of 116 small intestine biopsies. Across all samples, median %CD3 counts (positive cells/enterocytes) from villous epithelium (VE) increased with higher Marsh scores (Type 0%CD3 VE = 13.4; Type 1-3%CD3 VE = 41.9, p < 0.0001). Indicators of villus blunting and crypt hyperplasia were also observed (Type 0-2 villous epithelium/lamina propria area ratio = 0.81; Type 3a-3c villous epithelium/lamina propria area ratio = 0.29, p < 0.0001), and Type 0-1 crypt/villous epithelial area ratio = 0.59; Type 2-3 crypt/villous epithelial area ratio = 1.64, p < 0.0001). Using these individual features, a combined feature machine learning score (MLS) was created to evaluate a set of 28 matched pre- and post-intervention biopsies captured before and after dietary gluten restriction. The disposition of the continuous MLS paired biopsy result aligned with the Marsh score in 96.4% (27/28) of the cohort. Machine learning classifiers can be developed to objectively quantify histologic features and capture additional data not achievable with manual scoring. Such approaches should be further investigated to improve biopsy evaluation, especially for clinical trials.


Enzyme-linked immunosorbent assay for detection of soluble Toxoplasma gondii antigen in acute-phase toxoplasmosis.
Sixty-two sera from 51 patients with lymphadenopathy presumed to be due to acute-phase toxoplasmosis were tested for specific IgM class antibodies by both the immunofluorescence antibody to Toxoplasma gondii in sera were first dissociated in 3 M NaSCN. Antigen attached to the solid phase was detected with enzyme-coupled IgG antibody to Toxoplasma antibody to Toxoplasma gondii in sera were first dissociated in 3 M NaSCN. Antigen attached to the solid phase was detected with enzyme-coupled IgG antibody to Toxoplasma gondii. Neither hepatitis B surface antigen nor antigen of Mycoplasma pneumoniae, rubella, cytomegalovirus or herpes simplex virus interfered with this ELISA. Soluble antigen was detected in 13 (30%) of 42 IgM-positive acute-phase toxoplasmosis patients and in only one of 20 sera cleared of IgM. None of an additional 44 IgM-negative patients with low IgG titres had a positive result in the antigen ELISA. Follow-up studies in four acute-phase toxoplasmosis patients showed that the soluble antigen cleared in all cases before the specific IgM antibodies. Simultaneous detection of IgM antibodies to Toxoplasma gondii and soluble antigen would thus seem to indicate an early stage of the infection.


What does recovery from anomia tell us about the underlying impairment: the case of similar anomic patterns and different recovery.
Although word-finding difficulties have been largely studied from a theoretical and a rehabilitation point of view, recovery mechanisms and especially the fact that patients with similar anomic patterns may exhibit different recovery, are still not fully understood. In the first part of the present study we investigated the word retrieval curve during therapy and the psycholinguistic variables affecting word-finding recovery patterns in three anomic subjects (PG, AH and TM). Despite the fact that all patients had similar anomia at baseline, they presented different recovery patterns during an identical therapy program. The progress during therapy and the number of sessions necessary to reach satisfactory improvement was similar in two patients (AH and TM), but differed in the third patient (PG), who needed more treatment sessions. Moreover, these two different patterns were affected by different psycholinguistic variables: words age of acquisition predicted improvement in AH and TM, whereas phonological neighbourhood predicted improvement in PG. Following the observation that phonological neighbourhood density affected the slower progress during therapy, in the second study we analysed whether this variable also predicts pseudo-word learning in healthy controls and in anomic subjects. Indeed, phonological neighbourhood predicted pseudo-word learning speed in controls and in some anomic patients. We suggest that the analysis of progress during therapy for anomia and the comparison of the variables affecting learning and recovery may provide information about the underlying nature of the anomic deficit that is not available through the simple assessment of performance.


Are women living with HIV prone to osteoporosis in postmenopause? A systematic review.
Some researchers have suggested that HIV infections can increase the cytokines, which might interfere with the bone metabolism and increase the risk of bone mass loss. However, this issue has yet to be consolidated in postmenopausal women. To analyze studies that evaluated the loss of bone mass through DEXA in women living with HIV. MATERIALS AND METHODS: A systematic review was conducted following the PRISMA guideline. The MEDLINE, EMBASE and Cochrane databases were consulted from January 1987 to March 2017. Studies assessing bone mineral density (BMD) in postmenopausal women living with HIV were included. The secondary outcome was to evaluate the impact of antiretroviral on BMD. Sixty percent of the manuscripts suggested that women living with HIV had more bone loss than women in the control group, mainly in the lumbar spine. Forty percent did not observe any difference between groups. One study reported the influence of antiretroviral drugs on bone mass but did not find any difference between groups. Our data suggest that HIV infections may have a negative influence on bone mass loss in women. Further studies on the mechanism of this HIV consequence are necessary to clarify the connection as well as the impact of the antiretroviral action on BMD in postmenopausal women.


Clinical features and natural history of Crohn's disease.
Records of 1084 patients entered into the National Cooperative Crohn's Disease Study were analyzed to gather information concerning the natural history and clinical features of Crohn's disease. The age of onset reached a single peak between the second and fourth decade and was evenly distributed in both sexes. There was an average interval of 35 mo from onset of symptoms to diagnosis. Involvement of both colon and terminal ileum was the most frequent pattern and was present in 55% of patients. The disease was confined to the terminal ileum, other areas of the small intestine, or colon-only in 14%, 3%, and 15% of patients, respectively. Sigmoidoscopic abnormalities were seen in 34% of all patients and 51% of patients with Crohn's colitis. Diarrhea, abdominal pain, weight loss, and fever were present in the majority of the patients. Lower GI bleeding, fever, and perianal complications characterized patients with colon-only involvement. The frequency of extra intestinal manifestations was similar in all groups. Among patients who were randomized to placebo, 32% achieved a spontaneous remission by the end of 17 wk, and 53% of these were still in remission at the end of 24 mo. Clinical remission was associated with an improvement in barium x-rays in 18% of the patients. The predicted factors associated with favorable outcome in placebo-treated patients were: previous surgical removal of all observable disease, absence of perianal disease, and Crohn's Disease Activity Index value under 200.


Assembly of functional photosystem complexes in Rhodobacter sphaeroides incorporating carotenoids from the spirilloxanthin pathway.
Carotenoids protect the photosynthetic apparatus against harmful radicals arising from the presence of both light and oxygen. They also act as accessory pigments for harvesting solar energy, and are required for stable assembly of many light-harvesting complexes. In the phototrophic bacterium Rhodobacter (Rba.) sphaeroides phytoene desaturase (CrtI) catalyses three sequential desaturations of the colourless carotenoid phytoene, extending the number of conjugated carbon-carbon double bonds, N, from three to nine and producing the yellow carotenoid neurosporene; subsequent modifications produce the yellow/red carotenoids spheroidene/spheroidenone (N=10/11). Genomic crtI replacements were used to swap the native three-step Rba. sphaeroides CrtI for the four-step Pantoea agglomerans enzyme, which re-routed carotenoid biosynthesis and culminated in the production of 2,2'-diketo-spirilloxanthin under semi-aerobic conditions. The new carotenoid pathway was elucidated using a combination of HPLC and mass spectrometry. Premature termination of this new pathway by inactivating crtC or crtD produced strains with lycopene or rhodopin as major carotenoids. All of the spirilloxanthin series carotenoids are accepted by the assembly pathways for LH2 and RC-LH1-PufX complexes. The efficiency of carotenoid-to-bacteriochlorophyll energy transfer for 2,2'-diketo-spirilloxanthin (15 conjugated C = C bonds; N=15) in LH2 complexes is low, at 35%. High energy transfer efficiencies were obtained for neurosporene (N=9; 94%), spheroidene (N=10; 96%) and spheroidenone (N=11; 95%), whereas intermediate values were measured for lycopene (N=11; 64%), rhodopin (N=11; 62%) and spirilloxanthin (N=13; 39%). The variety and stability of these novel Rba. sphaeroides antenna complexes make them useful experimental models for investigating the energy transfer dynamics of carotenoids in bacterial photosynthesis.


Are maxillomandibular fixation screws a better option than Erich arch bars in achieving maxillomandibular fixation? A randomized clinical study.
The aim of this study is to see the efficacy of maxillomandibular fixation (MMF) screws with arch bars and to compare the plaque index in between 2 methods of MMF. This study is a randomized clinical trial. The study sample was derived from the population of patients who reported to Department of Oral and Maxillofacial Surgery, Wardha, Maharasthra, India between October 2006 and September 2008 and who required MMF. The patients were assessed for the time required in minutes for the placement and removal of screws and arch bar. Postoperative stability after achieving the MMF of both groups was analyzed and the plaque that was accumulated in both groups was evaluated by using TURESKY-GILMORE-GLICKMAN modification of the QUIGLEY-HEIN plaque index. Statistical analysis was performed with SPSS statistical software for Windows, version 8.0 (SPSS, Inc, Chicago, IL) using the χ(2) test and Student t test. The average working time for placement and removal of MMF screws is 18.67 minutes and 10.20 minutes, respectively, and for arch bars is 95.06 minutes and 29 minutes, respectively. The mean value of plaque index in group I is 1.88 and in group II is 2.69. It signifies that plaque deposition was more in group II. No occlusal disturbance was seen in both groups. Incidence of MMF screws causing damage to tooth root is 5.81% and incidence of screw breakage was seen in 3.33% of patients. Oral hygiene maintenance is better in patients with MMF screws than with arch bars with fewer complications and less operating time. Erich arch bars are the preferred choice in patients who require long-term MMF, because the screws start loosening after 5 to 6 weeks.


Medical education reform in Tajikistan: comparison of the conventional one-year family medicine residency program and the new two-year residency program for postgraduate medical education.
The last two decades have seen a shift in former Soviet countries from highly specialized to more family medicine-focused systems. Medical education has slowly adjusted to these reforms, although the region is still at risk to have a chronic shortage of family doctors. This paper presents the evaluation of a new post-graduate family medicine program in Tajikistan, focused on competency-based training. The findings are relevant for policy makers, international organizations and practitioners participating in similar medical education reform programs. We employed a quasi-experimental control group design and compared intervention residents, control group residents with traditional training, and 1st year residents with no training in two outcomes, clinical knowledge and competencies. We employed two objective measures, a written multiple-choice question test (MCQT) and an Objective Structured Clinical Examination (OSCE), respectively. We report reliability and validity of the measures along with ANOVA, planned contrasts and effect size estimates to examine differences across groups. We found statistically significant differences in both clinical knowledge and competencies between intervention and control groups. We also detected a large intervention effect size. Participants in the intervention outperformed control group participants in the two measures. Our analysis suggests that intervention and control group participants are comparable in terms of initial knowledge and competencies, strengthening the argument that the intervention caused the improvement in the program outcomes. Receiving tailored training and structured opportunities to practice knowledge and competencies in clinical settings have a positive effect on the education of family medicine doctors in Tajikistan. Our results support curriculum reform and investment in medical education in the form of longer and supervised on-the-job preparation designed to be more in line with international standards. We discuss suggestions for future studies and potential requirements to inform replicability in other countries. Family medicine is well recognized as central to health systems throughout the world, but high quality residency training lags behind in some countries. Our study showed that investing in family medicine residency programs and structured training is effective in increasing critical clinical competencies. We encourage promoting comprehensive post graduate family medicine doctor training so that the goals of a family medicine centered health system are attainable.


Gentle fabrication of colorful superhydrophobic bamboo based on metal-organic framework.
The efficient use of abundant renewable bamboo as high value-added decoration and building materials is of great significance for mitigating carbon dioxide emissions and maintaining sustainable development. The key challenge is to explore efficient and gentle methods to improve the undesirable surface properties of bamboo. Herein, a colorful and superhydrophobic bamboo is gently fabricated by a facile in-situ growth and conversion method based on metal-organic framework (for constructing micro-nano composite structures) and subsequent coating of sodium laurate (for reducing surface energy) at room temperature. The resulting sodium laurate-coated cobalt-nickel double hydroxide layer (CoNi-DH-La) is demonstrated as an efficient superhydrophobic layer to exhibit excellent chemical and mechanical stability. Impressively, the as-obtained CoNi-DH-La-coated bamboo sheet (BS-CoNi-DH-La) shows positive performances in terms of mildew resistance, flame retardancy, and self-cleaning. More importantly, this gentle method can endow bamboo with multiple unfading colors by changing the type of inorganic salts during the preparation process and display good potential for large-scale production.


Synthesis, DNA-binding, DNA-photonuclease profiling and antimicrobial activity of novel tetra-aza macrocyclic Ni(II), Co(II) and Cu(II) complexes constrained by thiadiazole.
A new tetra-aza macrocyclic ligand, L (C(24)H(16)N(12)O(2)S(4)) and its complexes of type, [MLCl(2)] and [CuL]Cl(2) (where M=Ni(II), Co(II); L=N,N'-(benzene-1,3-diyldi-1,3,4-thiadiazole-5,2-diyl)bis{2-[(5-benzene-1,3-diyl-1,3,4-thiadiazol-2-yl)amino]acetamide}) were synthesized and characterized by the spectral and analytical techniques. An octahedral geometry has been proposed for Ni(II) and Co(II) complexes while Cu(II) complex exhibit a square planar geometry. All the synthesized metal complexes were screened for their in vitro antimicrobial activity against selected species of pathogenic bacteria and fungi. The binding property of the complexes with CT-DNA was studied by absorption spectral analysis, followed by viscosity measurement and thermal denaturation studies. The photo induced cleavage studies revealed that the complexes possess photonuclease property against pUC19 DNA under UV-visible irradiation.


Young-old versus old-old and the use of health services. Does the difference make a difference?
The literature indicates the necessity for different levels of health service for various age cohorts among the elderly. The present study concerns the relationship between age cohorts and the use of community-based ancillary health services in comparison with other enabling, predisposing, and health status factors. In a probability sample of Western Canadian older persons, three enabling variables were found to be most closely associated with the use of such health service, i.e., knowledge of health services, education, and monthly family income. Age difference among the elderly, a predisposing variable, were unrelated. Implications for the delivery of health services are discussed.


Afferent influences on brain stem auditory nuclei of the chicken: effects of conductive and sensorineural hearing loss on n. magnocellularis.
Nucleus magnocellularis is the avian homologue of the spherical cell region of the mammalian anteroventral cochlear nucleus. Its primary excitatory synaptic input is from large end bulbs of Held from the eighth nerve ganglion cells. We have examined the effects of three peripheral manipulations--middle ear ossicle (columella) removal (monaural and binaural), columella removal and oval window puncture (monaural), and monaural earplug--on cross-sectional cell area ("cell size") of second-order auditory neurons in n. magnocellularis of the chicken. Manipulations were performed between embryonic day 19 and posthatch day 4. Survival time was varied from 2 to 60 days. Air conduction and bone conduction thresholds were determined to assess for conductive and sensorineural hearing loss associated with each of these manipulations. Hair cell counts were made from basilar papillae of each experimental group. We found that a columella removal alone, which produced a 50-55-dB purely conductive hearing loss, was not associated with changes in cell size of n. magnocellularis neurons. Similarly, chronic monaural earplugging did not affect the cross-sectional area of these second-order auditory neurons. Conversely, a combined columella removal and oval window puncture, which produced a mixed hearing loss with a 15-40-dB sensorineural component was associated with an 18-20% reduction in n. magnocellularis cell area. Hair cell counts for experimental ears were not significantly different from control ears. These results, in conjunction with measurements of multiunit activity recorded in n. magnocellularis, suggest that manipulations which markedly attenuate extrinsic auditory stimulation, but do not result in chronic change in the average activity levels, also do not influence the size of n. magnocellularis cell bodies. On the other hand, a manipulation which influences overall activity levels, but does not result in degeneration of receptor cells, resulted in marked changes in n. magnocellularis cell size.


Immunization with the iron uptake ABC transporter proteins PiaA and PiuA prevents respiratory infection with Streptococcus pneumoniae.
Previous studies show that vaccination with the recombinant Streptococcus pneumoniae lipoproteins PiuA and PiaA protects mice against systemic S. pneumoniae disease. The aim of this study was to assess the level of conservation of PiaA and PiuA and a third iron uptake ABC transporter lipoprotein, PitA, between common S. pneumoniae capsular serotypes by sequencing the corresponding genes, and to investigate whether these antigens can protect against respiratory infection. The nucleotide sequences of piuA and piaA were highly conserved in all strains, whereas pitA had significant variation in its nucleotide sequence making PitA an unattractive vaccine candidate. Mucosal vaccination of mice with PiuA and PiaA elicited specific antibody responses in serum and respiratory secretions, and protected against intranasal challenge with S. pneumoniae. These results provide further data indicating that PiuA and PiaA would be suitable candidates for a S. pneumoniae protein antigen vaccine.


Observation of different azimuthal emission patterns of K+ and of K- mesons in heavy-ion collisions at 1-2 A GeV.
Azimuthal distributions of pi+, K+, and K- mesons have been measured in Au+Au reactions at 1.5A GeV and Ni+Ni reactions at 1.93 A GeV. In semicentral collisions at midrapidity, pi+ and K+ mesons are emitted preferentially perpendicular to the reaction plane in both collision systems. In contrast for K- mesons in Ni+Ni reactions, an in-plane elliptic flow was observed for the first time at these incident energies.


North Carolina Emergency Department data: January 1, 2007-December 31, 2007.
The purpose of this paper is to describe patient characteristics and clinical conditions seen in North Carolina emergency departments (EDs) in 2007. Data were analyzed from a static database of all 2007 ED visits in the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT). Data were captured from 80% of North Carolina EDs on January 1, 2007 and 93% as of December 31, 2007. ED visits were analyzed by age, sex, method of ED arrival, return and repeat ED visits, expected source of payment, and ED disposition. Data were also analyzed by selected disease and injury groups that were thought by the authors to be of epidemiologic or demographic importance to North Carolina. The first and second leading ED visit diagnosis groups in North Carolina were abdominal pain and chest pain. The top three disease groups resulting in ED visits were chest pain/ischemic heart disease (17.9% of all ED visits), substance and alcohol abuse or withdrawal (11.2%), and diabetes (78%). Falls were the most common cause of injury-related ED visits in North Carolina, almost twice as common as motor vehicle crashes. This study reports only on acute disorders resulting in ED visits. North Carolina legislation limits the types of data elements collected. All data depend on institutional coding practices. Emergency department data can provide valuable information on the proportions and rates of ED visits for illness and injury statewide and can help identify vulnerable populations in the state.


Acute disseminated encephalomyelitis: a 10-year cohort study in Thai children.
Childhood acute disseminated encephalomyelitis (ADEM) is a demyelinating disease with variable clinical courses and outcomes. Its evolution to multiple sclerosis in Asian children is yet to be determined. Medical records, investigation results and magnetic resonance imaging of brain of Thai children aged less than 15 years with initial diagnosis of ADEM at a referral university hospital in Thailand from January 1997 to December 2006 were reviewed. Clinical course and the outcome were finalized by telephone interview, self-report questionnaire, and/or neurological examination by December 2008. Modified Rankin Score was applied for determination of disability. MRI findings were categorized along with the locations and number of areas of abnormalities shown by T2-weight and FLAIR. 16 patients consisting of 5 boys and 11 girls (age-range 1-14 years, mean 6.9 ± 3.6 years, median 6 years) were identified. Nine patients had cranial nerve dysfunctions including one child with optic neuropathy. One patient died with confirmed pathological diagnosis of ADEM. Among the remaining 15, who were followed from 2 to 10 years (mean 5.8 years), 13 and 3 patients were classified into monophasic ADEM and multiple sclerosis, respectively. Ten of 13 with final diagnosis of ADEM had complete recovery. There was no association between number of lesions or location in the initial MRI and the outcome and final diagnosis. ADEM in Thai children had similar clinical presentation and outcome to previous studies in Western countries. ADEM can occasionally evolve to multiple sclerosis in Thai children as being shown in previous reports from other Asian countries.


Differential responses of the photoperiodic clock in two passerine birds possessing a strongly self-sustained circadian system.
To investigate whether the photoperiodic clocks of species possessing strongly self-sustaining circadian clocks share identical features, we compared the full response cycle (initiation and termination of the response) in body mass and testes of the non-migratory house sparrow (Passer domesticus) with that of the migratory redheaded bunting (Emberiza bruniceps) under Nanda-Hamner experiments. Birds were exposed to a 36 h day (L:D=6:30 h), controls exposed to a 24 h day (L:D=6:18 h), for a period of 31 weeks. By week 18 of L:D=6:18 h, there was a small increase in body mass among sparrows, but not among buntings, and the testes of bunting did not grow, while those of sparrow grew slightly. The response to L:D=6:30 h is of particular interest. There was a rapid gain and subsequent loss in the body mass of bunting, but not of sparrows. Further, both species underwent a testicular cycle as if they were exposed to long days, but the response of sparrows was slower and hence delayed the attainment of peak testicular size. Such a differential response to exotic light cycles between these two photosensitive species, despite their similar circadian oscillatory properties (strong self-sustainment), could suggest a species-specific adaptation of the endogenous clock involved in photoperiodic regulation of avian seasonality.


Stimulation by oleic acid of incorporation of L-[4,5-3H]leucine into very low density lipoprotein apoprotein by the isolated perfused rat liver.
Livers from normal fed or fasted (24h) rats were perfused in vitro to determine whether fatty acid affects the biosynthesis of very low density lipoprotein (VLDL) apoprotein. Oleate stimulated VLDL triacylglycerol output and increased incorporation of L-[4,5-3H]leucine into VLDL apoprotein in both the fed and fasted groups. The increased incorporation of [3H]leucine was mainly into VLDL-apoprotein E. The total mass of VLDL apoprotein secreted was also stimulated by oleate proportionately. These data suggest that fatty acids may stimulate hepatic synthesis and/or secretion of the VLDL apoproteins and that apo E, may be required for the formation and secretion of triacyl-glycerol in the VLDL.


Using peer feedback to enhance nursing students' reflective abilities, clinical competencies, and sense of empowerment: A mixed-methods study.
To assess the use of a framework to provide structured peer feedback and compare the effects of peer video feedback, peer verbal feedback versus faculty feedback on nursing students and peer tutors' learning outcomes and experiences BACKGROUND: Peer feedback has been utilized widely in health professions education to fill the gap for timely feedback, but some students were concerned with its quality, leading to perceptions that peer feedback may not be useful. Sequential explanatory mixed-methods study METHODS: The study took place from January to February 2022. In phase 1, a quasi-experimental pretest-posttest design was used. First-year nursing students (n = 164) were allocated to peer video feedback, peer verbal feedback or faculty feedback arms. Senior nursing students (n = 69) were recruited to be peer tutors or the control group. The Groningen Reflective Ability Scale was used by first-year students to assess their reflective abilities, while the Simulation-based Assessment Tool was used by peer or faculty tutors to evaluate nursing students' clinical competence of a nursing skill during the simulation. The Debriefing Assessment for Simulation in Healthcare-Student Version was used by students to assess their peer/faculty tutors' feedback quality. Senior students' empowerment levels were measured using the Qualities of an Empowered Nurse scale. In phase 2, six semi-structured focus group discussions with peer tutors (n = 29) were conducted and thematically analyzed. Peer video feedback and peer verbal feedback significantly improved students' reflective abilities but not in the faculty feedback arm. Students' clinical competence in a technical nursing skill significantly improved in all three arms. Improvements were significantly larger in those receiving peer video feedback and peer verbal feedback than faculty feedback, with no significant differences between peer video feedback and peer verbal feedback. Debriefing Assessment for Simulation in Healthcare-Student Version scores were not significantly different among the 3 arms. Empowerment levels of peer tutors significantly improved after providing peer feedback but not those in the control group. Seven themes were generated from the focus group discussions. Although peer video feedback and peer verbal feedback were similarly effective in improving clinical competencies, peer video feedback was more time-consuming and stressful to students. The use of structured peer feedback improved peer tutors' feedback practices and were comparable to quality of faculty feedback. It also significantly increased their sense of empowerment. Peer feedback was widely supported by peer tutors who agreed that it should supplement faculty teaching.


Fatty acid oxidation is dispensable for human macrophage IL-4-induced polarization.
Macrophage polarization elicits various metabolic alterations which in turn influence the polarized phenotype. Activation of glycolytic metabolism accompanies and supports macrophage pro-inflammatory M1 polarization. In contrast, M2 polarization of murine macrophages in response to the Th2 cytokine interleukin-4 (IL-4) was linked to the up-regulation of mitochondrial oxidative metabolism and fatty acid oxidation (FAO), which was necessary for coining an IL-4-polarized phenotype. Here we investigated whether similar mechanisms operate in human macrophages stimulated with IL-4. IL-4 causes only moderate changes of mitochondrial oxidative metabolism and FAO, correlating with an unaltered expression of peroxisome proliferator-activated receptor-γ coactivator 1 α/β (PGC-1α/β), the master transcriptional regulators of mitochondrial biogenesis. Furthermore, attenuating FAO had no effect on IL-4-induced polarization-associated gene expression. Apparently, FAO is dispensable for IL-4-induced polarization of human macrophages, pointing to fundamental differences in the metabolic requirements of macrophage phenotype alterations between mice and humans.


[Effects of resveratrol-mediated inhibition of NOD-like receptor protein 3 inflammasomevia activating silent information regulator 1 on the injury of intestinal mucosal barrier function after sepsis].
To explore whether resveratrol (RSV) could activate silent information regulator 1 (SIRT1) to regulate the activation of NOD-like receptor protein 3 (NLRP3) inflammasome in sepsis induced intestinal injury model, and then reduce intestinal inflammation and cell apoptosis, so as to play a protective role in intestinal barrier function. (1) In vitro experiment: human Colorectal adenocarcinoma cells (Caco-2) were cultured, which were divided into normal group (normal culture on complete medium for 48 hours), lipopolysaccharide (LPS) group (normal culture on complete medium for 24 hours, then LPS containing 2 mg/L complete medium intervention for 6 hours), RSV low, medium and high concentration groups and SIRT1 inhibitor (EX-527) group (complete medium normal culture for 24 hours, LPS containing 2 mg/L complete medium intervention for 6 hours, followed by RSV 10, 20, 40 μmol/L or EX-527 10 μmol/L intervention for 6 hours, respectively). The levels of tumor necrosis factor-α (TNF-α) and interleukins (IL-6, IL-18, IL-1β) in the cell supernatant were determined by enzyme linked immunosorbent assay (ELISA). The apoptosis level of the cells was detected by flow cytometry. Western blotting was used to detect the protein levels of NLRP3, SIRT1, caspase-1 and apoptosis-related point-like protein (ASC). (2) In vivo experiment: according to random number table method, 24 male Wistar rats were divided into sham operation group (Sham group), cecal ligation and perforation (CLP) 6 hours group (CLP 6 h group), CLP 24 h group and RSV intervention group [RSV (20 mg/kg) was intraperitoneally injected 6 hours and 12 hours after CLP], with 6 rats in each group. The levels of NLRP3, caspase-1 and ASC in the intestine of rats were detected by immunohistochemistry. (1) Compared with the normal group, the levels of inflammatory factors in the cell supernatant of the LPS group were increased and the expression of SIRT1 protein was decreased, while the protein expressions of NLRP3, caspase-1 and ASC were increased. Compared with LPS group, different concentrations of RSV reduced the level of inflammatory factors, increased the activity of SIRT1, inhibited the expression of NLRP3 inflammasome and its downstream products caspase-1 and ASC, and the effect of high concentration of RSV (40 μmol/L) was the most significant [TNF-α (ng/L): 8.77±0.43 vs. 12.66±0.81, IL-6 (ng/L): 1.35±0.20 vs. 1.93±0.09, IL-1β (ng/L): 1.05±0.04 vs. 1.31±0.07, IL-18 (ng/L): 519.50±11.16 vs. 622.70±30.69, SIRT1/β-actin: 0.80±0.05 vs. 0.58±0.02, caspase-1/β-actin: 0.55±0.06 vs. 0.78±0.06, ASC/β-actin: 0.78±0.08 vs. 1.04±0.15, all P < 0.05], while SIRT1 inhibitor EX-527 had the opposite effects. There was no significant difference in the apoptosis rate among normal group, LPS group, and low, medium and high concentration RSV groups, as well as EX-527 group [(7.03±0.57)%, (9.67±0.55)%, (9.57±0.70)%, (9.30±2.15)%, (9.87±0.97)%, (9.07±0.93)%, F = 2.590, P = 0.082]. (2) Immunohistochemical results showed that compared with the Sham group, the expressions of NLRP3 inflammasomes and downstream products caspase-1 and ASC in the intestinal epithelial cells in CLP 6 h group, CLP 24 h group and RSV intervention group were significantly increased. The percentage of ASC-positive area in intestinal epithelium of RSV intervention group was significantly lower than that of CLP 6 h group [(15.22±2.73)% vs. (19.88±2.67)%, P < 0.05], and the expressions of NLRP3 and caspase-1 were significantly lower than those of CLP 24 h group [(9.31±1.37)% vs. (13.19±1.92)%, (19.57±3.92)% vs. (27.28±6.33)%, both P < 0.05]. After sepsis, high concentration of RSV could inhibit the activation of NLRP3 inflammasome by activating SIRT1, thereby reduce the expression of caspase-1 and ASC, and inhibit the secretion of inflammatory factors to reduce the inflammatory response.


Isolated single coronary artery (RII-B type) presenting as an inferior wall myocardial infarction: a rare clinical entity.
Isolated single coronary artery without other congenital cardiac anomalies is very rare among the different variations of anomalous coronary patterns. The prognosis in patients with single coronary varies according to the anatomic distribution and associated coronary atherosclerosis. If the left main coronary artery travels between the aorta and pulmonary arteries, it may be a cause of sudden cardiac death. We present multimodality images of a single coronary artery, in which the whole coronary system originated by a single trunk from the right sinus of Valsalva with inter-arterial course of left main coronary artery. This rare type of single coronary artery was classified as RII-B type according to Lipton's scheme of classification. A significant flow-limiting lesions were found in the right coronary artery that was successfully treated with percutaneous coronary intervention.


Effect of burnout temperature on strength of phosphate-bonded investments.
The high-temperature strength behaviour of dental phosphate-bonded investments is not clearly understood. The present purpose was to determine their variation in strength with temperature and to seek explanations for that variation. The clamped-edge disc-rupture test was used in a sequential testing protocol, with a variable casting metal mass, to determine the effect of burnout temperature (ranging from 400 to 1100 degrees C) on the strength of six phosphate-bonded investments. The strength of phosphate-bonded investment is temperature sensitive, generally showing a distinct minimum in the tested temperature range. Low temperature strength gives little information about high temperature behaviour. The variation of strength with temperature seems amenable to explanation in terms of investment composition. Since strength varies greatly with temperature and brand, the inconsistency of previous results is explained. On the other hand, low-temperature strength is no guide for the high-temperature strength, so that information on both the room and the service temperature strength is required. Inversion of silica at high temperature may decrease the strength of phosphate-bonded investments.


The influences of divalent metal ions on fibrin monomer polymerization.
This work was undertaken in an attempt to clarify the influences of divalent metal ions on the polymerization of fibrin monomer. Polymerization was strongly inhibited by such Ca-binding chelating agents as 1,2-cyclohexanediaminetetraacetic acid, ethylenediaminetetraacetic acid and glycoletherdiaminetetraacetic acid, and a close relationship was seen between their inhibitory capacity and their stability against Ca2+. The polymerization inhibited by ethylenediaminetetraacetic acid could not be reversed by the addition of Mg2+, Sr2+ or Ba2+, whose stability constants are smaller than that of Ca2+, but it could be completely reversed, and even directly accelerated by Zn2+, Cu2+, Cd2+ or Co2+ whose stability constants are greater than that of Ca2+.


Reactions of silicon atoms and small clusters with CO: experimental and theoretical characterization of SinCO (n=1-5), Si2(CO)2, c-Si2(mu-O)(mu-CSi), and c-Si2(mu-O)(mu-CCO) in solid argon.
Reactions of silicon atoms and small clusters with carbon monoxide molecules in solid argon have been studied using matrix isolation infrared absorption spectroscopy. In addition to the previously reported SiCO monocarbonyl, Si(2)(CO)(2) and Si(n)CO (n=2-5) carbonyl molecules were formed spontaneously on annealing and were characterized on the basis of isotopic substitution and theoretical calculations. It was found that Si(2)CO, Si(3)CO, and Si(5)CO are bridge-bonded carbonyl compounds, whereas Si(4)CO is a terminal-bonded carbonyl molecule. The Si(2)(CO)(2) and Si(3)CO molecules photochemically rearranged to the more stable c-Si(2)(mu-O)(mu-CCO) and c-Si(2)(mu-O) (mu-CSi) isomers where Si(2) is inserted into the CO triple bond.