Postpartum depression, an autoimmune disease?
Medical conditions with known etiology and typical peripartal/postpartal disease exacerbations are now, without exception, considered autoimmune in etiology. Postpartum psychiatric conditions, and especially postpartum depression, currently, however, are still not understood in their etiology. This paper suggests that the typical postpartum flare pattern, and other clinical characteristics, point towards an autoimmune etiology for (postpartum) depression. The high prevalence of (postpartum) depression led to its designation as a major public health problem. A better understanding of etiology and pathophysiology would greatly advance the, currently still inaccurate, diagnosis of the condition, and improve approaches towards prevention and treatment.


Aluminum speciation studies in biological fluids. Part 3. Quantitative investigation of aluminum-phosphate complexes and assessment of their potential significance in vivo.
Following the discovery that specific health disorders affecting patients with renal disease were due to their excessive body accumulation of aluminum, it was established that aluminum toxicity was mainly due to the ingestion of aluminum-containing phosphate binders. Suspicion of toxicity was thus cast on aluminum-containing antacids, and subsequent tests held on healthy subjects did reveal that aluminum hydroxide gels were also potential oral sources of aluminum, especially in the presence of citric acid. Nevertheless, authors of these tests concluded that there was only marginal absorption of aluminum phosphate. In contrast with these clinical conclusions, it has recently been contended on theoretical grounds that aluminum phosphate represents a serious health hazard. To help elucidate this issue, this paper first deals with a quantitative investigation of aluminum-phosphate equilibria under physiological conditions. Then appropriate computer simulations based on corresponding results are used to assess the actual extent to which phosphate can influence aluminum bioavailability. These simulations confirm that aluminum phosphate is not expected to induce absorption of high amounts of aluminum when administered by itself. Nevertheless, this result may no longer apply in the presence of food, whose various acidic components are likely to modify the involved chemical equilibria. Moreover, it is shown that rising blood plasma phosphate levels should tend to increase aluminum tissue penetration and hence favor its potential toxicity.


Differences in left ventricular and left atrial function assessed during breath-holding and breathing.
To analyze differences in systolic and diastolic left ventricular (LV) as well as left atrial (LA) function parameters obtained from identical cardiac magnetic resonance (MR) imaging techniques during inspiratory breath-holding and breathing (breath-hold to breathing differences). 56 subjects without signs of heart failure (23/33 male/female, age 58 ± 14 years) underwent 3 T MR cine real-time and transmitral phase contrast imaging with the same spatial and temporal resolution during inspiratory breath-holding and free breathing. LV and LA volumetric function parameters were derived from segmentation of cine series, transmitral peak velocities and early-diastolic myocardial peak velocity from phase contrast series. Corresponding breath-hold and breathing parameters were compared by Bland-Altman analysis; repeatability of breath-hold and breathing measurements was quantified by variance component analysis. p < 0.05 was regarded as statistically significant. Mean differences between results obtained during inspiratory breath-holding vs. breathing were significant for LV volumetric function (end-diastolic volume=-7 mL, p = 0.002; end-systolic volume=-7 mL, p < 0.001; ejection fraction = 3 %, p < 0.001; peak ejection rate = 22 mL/s, p = 0.002; early-diastolic peak filling rate=-34 mL/s, p = 0.025), LA volumetric function (maximum volume=-6 mL, p < 0.001; total ejection fraction=-4%, p < 0.001; active ejection fraction=-2%, p = 0.013; before contraction ejection fraction=-4%, p < 0.001) and early-diastolic velocities (transmitral=-6 cm/s, p < 0.001; tissue velocity=-1.8 cm/s, p < 0.001). Standard deviations of breath-hold-to-breathing differences exceeded the corresponding repeatabilities of breath-hold and breathing measurements. Systolic and diastolic LV and LA function parameters acquired during inspiratory breath-holding and breathing differ, and large inter-individual breath-hold-to-breathing variations are possible. Thus, the breathing state should be taken into account, especially when comparing results in patient follow-up acquired in different respiratory states.


Cerebral malaria: we have come a long way.
Despite decades of research, cerebral malaria remains one of the most serious complications of Plasmodium infection and is a significant burden in Sub-Saharan Africa, where, despite effective antiparasitic treatment, survivors develop long-term neurological sequelae. Although much remains to be discovered about the pathogenesis of cerebral malaria, The American Journal of Pathology has been seminal in presenting original research from both human and experimental models. These studies have afforded significant insight into the mechanism of cerebral damage in this devastating disease. The present review highlights information gleaned from these studies, especially in terms of their contributions to the understanding of cerebral malaria.


Three-dimensional comparative evaluation of customized bone-anchored vs tooth-borne maxillary protraction in patients with skeletal Class III malocclusion.
The aim of this prospective study was to assess the 3-dimensional skeletal and dental effects induced by a new maxillary protraction approach using customized miniplates for anchorage compared with a control group of traditional tooth-borne maxillary protraction. Forty-one growing patients at prepubescent stage with skeletal Class III malocclusion participated in this study. These patients were randomly split into 2 groups. In group 1 (n = 20), patients underwent maxillary protraction anchored with customized miniplates. The miniplates were individually designed and inserted using the surgical templates. In group 2 (n = 21), patients underwent tooth-borne maxillary protraction. Pretreatment and posttreatment cone-beam computed tomography scans were obtained, and 30 measurements of cone-beam computed tomography images were acquired and calculated. The changes after treatment and the comparison of the 2 groups were assessed. After maxillary protraction, group 1 showed a greater forward movement of the maxilla than group 2. The maxilla length increased more in group 1 than in group 2. The rotations of the palatal and mandibular planes in group 1 were less than those in group 2. In group 1, the maxillary incisors proclined less, the mandibular incisors retroclined less, and the maxillary first molars extruded less. Compared with tooth-borne maxillary protraction, customized miniplates anchored maxillary protraction produced more maxillary growth, fewer dental changes, and less maxillary and mandibular plane rotation.


Pioglitazone improves superoxide dismutase mediated vascular reactivity in the obese Zucker rat.
To test the hypothesis that the thiazolidinedione agent, pioglitazone, mediates its chronic BP lowering action via improving vascular reactivity. Lean (Fa/fa) and obese (fa/fa) Zucker rats were treated with or without pioglitazone (20 mg/ kg/day) for 4 weeks (n=8 animals per group). Pioglitazone treatment was associated with a significant improvement in oral glucose tolerance in the obese animals (p<0.05 compared with untreated obese). Pioglitazone prevented the development of hypertension seen in obese untreated rats (SBP 126+/-1 versus 138+/-1 mmHg; p<0.0001). Aortic ring preparations from pioglitazone-treated obese rats showed improved relaxation responsiveness (ED(50) 0.28 versus 1.15 U/ ml, p<0.001) to SOD, a NO potentiator, compared with untreated obese animals. SOD-mediated vasorelaxation may contribute to the chronic antihypertensive effect and/or the improvement in insulin sensitivity following pioglitazone treatment.


A randomized, double-blind, parallel trial comparing capsaicin nasal spray with placebo in subjects with a significant component of nonallergic rhinitis.
To investigate the efficacy and safety of ICX72 or Sinus Buster, a proprietary homeopathic preparation of Capsicum annum and Eucalyptol, versus placebo administered continuously over 2 weeks in subjects with a significant component of nonallergic rhinitis (NAR). Forty-two consented subjects meeting inclusion/exclusion criteria were randomized to ICX72 (n = 20) or control (n = 22) administered twice daily over 2 weeks. The primary endpoint was change in total nasal symptom scores (TNSS) from baseline to end of study. Secondary endpoints included changes in individual symptom scores (ISS) over 2 weeks and average time to first relief. Mean TNSS and ISS were recorded after single dosing at different intervals over 60 minutes. Rhinitis quality-of-life, rescue medication, and safety endpoints were analyzed. ICX72 versus placebo subjects exhibited significant differences in changes from baseline to end of study for TNSS and each ISS (P < .01), had an average time to first relief of 52.6 seconds (P < .01), and improvement in nasal congestion, sinus pain, sinus pressure, and headache at 5, 10, 15, and 30 minutes, persisting at 60 minutes for nasal congestion and sinus pain (P < .05). No difference between groups in adverse events or rescue medication was observed. ICX72 versus placebo subjects experienced no rebound congestion or impaired olfaction at the end of the study. This is the first controlled trial demonstrating intranasal capsaicin, when used continuously over 2 weeks, rapidly and safely improves symptoms in rhinitis subjects with a significant NAR component.


A structural analysis of the carbohydrate side chains on class I and class II histocompatibility antigens of the swine facilitated by heteroantisera specific for the denatured polypeptides.
Rabbit heteroantisera specific for the denatured glycoprotein subunits of swine class I and class II major histocompatibility complex (MHC) antigens have been prepared and utilized to monitor changes in the mobilities of these polypeptides on SDS-polyacrylamide gel electrophoresis subsequent to various deglycosylation procedures. This information, in combination with lectin reactivity patterns for the glycoproteins bound to nitrocellulose, has made it possible to define specific structural features of the MHC antigen-associated carbohydrate side chains. Both the class I heavy (alpha) chain and the class II light (beta) chain bear a single, N-linked, complex-type oligosaccharide which reacts with lentil lectin (LcH), but not concanavalin A (Con A); a reactivity pattern suggesting the possibility of a special triantennary structure. In contrast, the class II heavy (alpha) chains appear to possess two carbohydrate units, one an N-linked, LcH-reactive, complex-type side chain, and the other, an N-linked, Con A-reactive, high-mannose-type of oligosaccharide. The data suggest considerable homology between the swine and human MHC antigens with respect to the structure of their carbohydrate side chains. The analysis also serves to illustrate how antibodies specific for the denatured polypeptide backbone of individual glycoproteins, along with lectin reactivity patterns, can be used to extract structural information about the attached carbohydrate moieties using minimal amounts of partially purified glycoproteins.


Interference with sporulation can stimulate the rate of a proteinase synthesis in Bacillus megaterium.
Bacillus megaterium, in which sporulation was blocked either by mutation or with netropsin, synthesizes during the stationary phase more exocellular proteinase than the sporulating culture. The asporogenic mutant synthesizes the enzyme at a higher rate and for a longer time than does the sporulating population. The culture, whose sporulation was inhibited by netropsin, produces the proteinase at a higher rate, although for only a limited time interval.


Fruit and vegetable consumption among older adults: influence of urban food environment in a medium-sized Brazilian city.
To examine the association between urban food environment and regular consumption of fruits and vegetables (FV) by older adults from a medium-sized Brazilian city. Cross-sectional study based on data related to (1) objective assessment of establishments with predominant sale of unprocessed/minimally processed foods, mixed establishments and establishments with predominant sale of ultra-processed foods; (2) regular consumption of FV (≥ 5 times/week), health and socio-demographic variables of community-dwelling older adults. Tertiles of proximity between food establishments and older adults' residence were calculated. Poisson generalised estimating equations with robust variance, adjusted for individual and contextual variables, were used to estimate the independent association between the proximity of establishments and regular consumption of FV. Medium-sized Brazilian city. Representative sample of community-dwelling older adults (n 549). Older adults travelled the longest distances to establishments with predominant sale of unprocessed/minimally processed foods. The longer the distance to establishments with predominant sale of unprocessed/minimally processed foods, the lower the prevalence of regular consumption of FV (tertile 2: prevalence ratio (PR) = 0·86; 95 % CI = 0·74, 0·99; tertile 3: PR = 0·84; 95 % CI = 0·72, 0·97). Older adults living larger distance tertiles from establishments with predominant sale of ultra-processed foods, mixed establishments or all categories of establishments had 16 % (PR = 0·84; 95 % CI = 0·73, 0·96), 19 % (PR = 0·81; 95 % CI = 0·71, 0·93) and 19 % (PR = 0·81; 95 % CI = 0·70, 0·94) lower prevalence of regular consumption of FV, respectively. The food environment is associated with regular consumption of FV among older adults. Longer distances from the residence of older adults to food establishments are independently associated with lower prevalence of regular consumption of FV.


Neural specification, targeting, and circuit formation during visual system assembly.
Like other sensory systems, the visual system is topographically organized: Its sensory neurons, the photoreceptors, and their targets maintain point-to-point correspondence in physical space, forming a retinotopic map. The iterative wiring of circuits in the visual system conveniently facilitates the study of its development. Over the past few decades, experiments in Drosophila have shed light on the principles that guide the specification and connectivity of visual system neurons. In this review, we describe the main findings unearthed by the study of the Drosophila visual system and compare them with similar events in mammals. We focus on how temporal and spatial patterning generates diverse cell types, how guidance molecules distribute the axons and dendrites of neurons within the correct target regions, how vertebrates and invertebrates generate their retinotopic map, and the molecules and mechanisms required for neuronal migration. We suggest that basic principles used to wire the fly visual system are broadly applicable to other systems and highlight its importance as a model to study nervous system development.


Retinal nerve fiber layer defects and microtalc retinopathy secondary to free-basing "crack" cocaine.
There have been several reports in the literature documenting ocular manifestations of cocaine abuse. None have discussed the potential retinal complications stemming from cocaine inhalation. Approximately 60 patients with a history of free-basing "crack" cocaine were examined at the Optometry Clinic. Threshold visual field testing and fundus photographs were obtained and later reviewed. Microtalc retinopathy and associated retinal nerve fiber layer "rake" or "slit" defects were detected exclusively in patients who had free-based "crack" cocaine. Some of these patients manifested visual field changes that mimic glaucoma. Several cases are presented that demonstrate the findings typical of those observed in the patients examined at the Optometry Clinic. Microtalc retinopathy and associated glaucoma-like retinal nerve fiber layer defects indicate the presence of permanent microvascular changes in the eyes, as well as the lungs, brain, and probably other peripheral organs. Optometrists should be aware of these new findings in order to properly manage patients who free-base "crack" cocaine.


Metabolic syndrome as a late effect of childhood hematopoietic stem cell transplantation - A thorough statistical evaluation of putative risk factors.
Metabolic syndrome (MetS) is frequent among survivors of childhood hematopoietic stem-cell transplantation (HSCT), but assessment of risk factors is challenged by survivor and participation bias in long-term follow-up studies. A cohort of 395 pediatric patients transplanted between 1980 and 2018 was investigated. MetS was assessed at follow-up between December 2018 and March 2020. Two composite outcomes ((a) combining MetS and death, (b) combining MetS, death, and nonparticipation) were considered to address the risk of selection bias. Among 234 survivors invited to the follow-up, 96 individuals (median age 27 years) participated. MetS prevalence was 30% among participants. The only significant HSCT risk factor was a variable combining HSCT indication and conditioning with total-body irradiation (TBI) (p = .0011). Compared to acute leukemias (AL) treated with high-grade TBI (8-12 Gy), a lower MetS prevalence was seen for nonmalignant diseases treated with no/low-grade TBI (0-4.5 Gy) (OR = 0.04, 95% confidence interval (CI): 0.00-0.23). Analyses of the composite outcomes indicated overestimation of the effect of high-grade TBI due to selection bias. Scrutiny showed strong residual confounding between HSCT indication and high-grade TBI within AL-patients. The HSCT effect on MetS reflected HSCT effects on high-density-lipoprotein (HDL) and triglycerides. Compared to AL treated with high-grade TBI, nonmalignant diagnoses treated with no/low-grade TBI had higher HDL (+40%, 95% CI: +21% to +62%) and lower triglyceride (-59%, 95% CI: -71% to -42%). The TBI effect on MetS may be overestimated in follow-up studies due to selection bias and confounding. The TBI effect was confined to the potentially modifiable MetS criteria HDL and triglyceride.


Experiences with L-deprenyl in Parkinsonism.
In about 2/3 of the cases studied (152 patients), the combination of deprenyl and the substitution-therapy has a favourable effect as it tends to normalize motor activity. Although the administering of deprenyl renders neither L-Dopa nor the decarboxylase inhibitor superfluous, their side effects can be slightly reduced as their dose is reduced. Therefore it is advised to give all patients a trial with this drug.


[Cytochemical and immunocytochemical characteristics of Meckel's diverticulum with heterotopic rests of pancreatic tissue].
Meckel's diverticulum (MD) is a congenital anomaly of the small intestine. It results from incomplete obliteration and resorption of the proximal omphaloenteric duct connecting yolk sac with primitive gut in the fetal period. A case of 20-year old female with ectopic pancreatic rests in a MD was reported. She was hospitalized with clinical signs of acute appendicitis. During surgery an inflamated Meckel's diverticulum was found and a clinoid resection of the diverticulum was performed. Histologic examination revealed pancreatic tissue in the removed diverticulum. Endocrine cells (EC) were detected with Masson staining and aberrant pancreatic tissue with immunocytochemical LSAB2 method using pan cytokeratin as epithelial marker. Most of MD are asymptomatic and accessory finding during laparothomias for different causes, but complications of undiagnozed MD can be serious (diverticulitis, perforation with peritonitis or intestinal obstruction caused by invagination). In unclear cases, additional cytochemical and immunocytochemical diagnostics could be done.


Pathways from Childhood Bullying Victimization to Young Adult Depressive and Anxiety Symptoms.
Childhood traumatic experiences, such as bullying victimization, are major psychosocial concerns that may cause subsequent behavioral and mental maladjustments over time. This study aimed to examine the pathway from childhood bullying victimization to young adult bullying and depressive and anxiety symptoms. A retrospective and cross-sectional online survey was conducted to collect data from a random sample of 356 university students aged 19-25 (Mage = 20.7). The results indicated that childhood cyberbullying victimization increased subsequent traditional and cyberbullying victimization and cyberbullying perpetration, while childhood traditional victimization increased only later traditional victimization. Meanwhile, childhood traditional victimization increased the risk of depressive and anxiety symptoms, while childhood cyberbullying victimization escalated the risk of anxiety symptoms only. Young adult bullying victimization and perpetration partially mediated the effects of childhood bullying victimization on depressive and anxiety symptoms. Findings underscore the need for prospective studies that evaluate long-term behavioral health practice for children with histories of bullying victimization.


HMGB1 promotes CXCL12-dependent egress of murine B cells from Peyer's patches in homeostasis.
High mobility group box-1 protein (HMGB1) is an alarmin that, once released, promotes inflammatory responses, alone and as a complex with the chemokine CXCL12. Here, we report that the HMGB1-CXCL12 complex plays an essential role also in homeostasis by controlling the migration of B lymphocytes. We show that extracellular HMGB1 is critical for the CXCL12-dependent egress of B cells from the Peyer's patches (PP). This promigratory function of the complex was restricted to the PPs, since HMGB1 was not required for B-cell migratory processes in other locations. Accordingly, we detected higher constitutive levels of the HMGB1-CXCL12 complex in PPs than in other lymphoid organs. HMGB1-CXCL12 in vivo inhibition was associated with a reduced basal IgA production in the gut. Collectively, our results demonstrate a role for the HMGB1-CXCL12 complex in orchestrating B-cell trafficking in homeostasis, and provide a novel target to control lymphocyte migration in mucosal immunity.


Absorption of different elemental diets in a short-bowel syndrome lasting 15 years.
In a patient with total colectomy and only 120 cm of the proximal small bowel remaining after resection for Crohn's disease, comparative studies were performed on the absorption of isocaloric amounts of Vivonex HN, Flexical, Codelid, Jejunal, and Precision LR. These elemental and/or complete diets were fed by a nasogastric tube at a constant rate of 260 ml/hr, 1 cal/ml, 2185-2660 ml per feeding period of 8.4-10.2 hr daily. Discharge of intestinal fluids from the jejunal stoma ranged between 2940 ml (Vivonex HN) to 4760 ml (Jejunal) per daily feeding period, resulting in a net intestinal loss of fluids and dehydration with the exception of Flexical. Jejunostomy discharge on Flexical was only 1325 ml per comparable period. The patient tolerated dietary fat relatively well absorbing 61% of 87 g of fat from Flexical and 60% of 108 g from a natural blenderized diet. The other diets used were either fat-free or with a minimum amount of fat. The second best tolerated diet was Vivonex HN, the feeding of which resulted in the highest intestinal retention of nitrogen (84% of the 16.3 g fed as opposed to 78% of 9.1 g fed in Flexical). Vivonex HN also had the highest intestinal retention of phosphorus. Intestinal fluid absorption was not related to the intestinal transit time measured by a nonabsorbable marker or to the osmolality of diets. Diets containing fat may inhibit secretion by the "enterogastrone-like" effect induced by dietary fat in the remaining bowel. High amino acid content of some of the low-fat diets may release gastrointestinal hormones which stimulate secretion, and the simple carbohydrates prevent fluid absorption. In the short-bowel syndrome with normal functions of the pancreaticobiliary system, diets based on fat and protein hydrolysate should be the nutritional therapy of choice.


Spontaneous portosystemic shunt embolization in liver transplant recipients with recurrent hepatic encephalopathy.
Spontaneous portosystemic shunts (SPSS) are a common cause of recurrent hepatic encephalopathy (HE). Shunt occlusion is an effective and safe procedure when performed in patients with cirrhosis and preserved liver function. We aimed to describe our experience with SPSS embolization after liver transplantation (LT). We identified five patients who underwent SPSS embolization after LT. Clinical, biochemical and technical procedure data were collected. At presentation, all patients had developed graft cirrhosis and HE after LT. Median Model for End-stage Liver Disease (MELD) at embolization was 9 (range 7-12), median Child-Pugh was 8 (range 7-9). Splenorenal and mesocaval shunt were the most frequent types of SPSS found. Three patients have been completely free of HE. Of the two patients who had HE recurrence after embolization, one patient had two episodes of HE which was controlled well with medications. The other patient required three embolizations because of recurrent HE. Median follow-up was 4.4 years (range 1.0-5.0) and MELD score at last follow up was 13 (range 10-18) and median Child-Pugh score B, 7 points (range 5-12). SPSS can be considered as a cause of HE after LT. SPSS embolization is feasible and safe in LT recipients.


Improving physical activity program adoption using integrated research-practice partnerships: an effectiveness-implementation trial.
Integrated research-practice partnerships (IRPPs) may improve adoption of evidence-based programs. The aim of this study is to compare adoption of an IRPP-developed physical activity (PA) program (Fit Extension, FitEx) to a typical efficacy-effectiveness-dissemination pipeline model program (Active Living Every Day, ALED). Guided by the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework, a randomized controlled trial assigned health educators (HEs) to FitEx (n = 18) or ALED (n = 18). Fourteen HEs adopted FitEx, while two HEs adopted ALED (χ 2 = 21.8; p < 0.05). FitEx HEs took less time to deliver (p < 0.05), stated greater intentions for continued program delivery (p < 0.05), and reached more participants (n = 1097 total; 83 % female; 70 % Caucasian; M age = 44 ± 11.8) per HE than ALED (n = 27 total; 60 % female; 50 % Caucasian; M age = 41 ± 11.3). No significant difference existed in FitEx or ALED participants' increased PA (M increase = 9.12 ±29.09 min/day; p > 0.05). IRPP-developed programs may improve PA program adoption, implementation, and maintenance and may also result in programs that have higher reach-without reducing effectiveness.


Fat replacement by pecan nut and oregano oil and their impact on the physicochemical properties and consumer acceptability of frankfurters.
A study was conducted to determine the physicochemical quality and consumer acceptability of beef frankfurter-type sausages formulated with pecan nut paste and Mexican oregano oil (MO) of two varieties, Poliomintha longiflora Gray (Mexican oregano Poliomintha, MOP) or Lippia berlandieri (Mexican oregano Lippia, MOL). Frankfurters were processed under six treatment conditions: control (10.67% pork fat), MOP (control + 0.01% MOP), MOL (control + 0.01% MOL), MOP-N (control + 0.01% MOP + 6% pecan nut paste), MOL-N (control + 0.01% MOL + 6% pecan nut paste), and C-N (control + 6% pecan nut paste). The physicochemical properties and the consumer acceptability were determined. The addition of MO and nut did not influence the water holding capacity, drip loss, and luminosity of frankfurters, but those ingredients increased pH and shear force (p<0.05) and decreased redness (p<0.05) of frankfurters. Frankfurters were generally well accepted by consumers. However, general acceptability of sausages decreased with the addition of MO. Control sausages showed the highest acceptability. The MO and pecan nut paste do not affect drastically the quality of frankfurters. These results provide evidence that partial replacement of pork fat by pecan nut in frankfurters maintain a consistent physicochemical quality and its commercialization looks promising given consumers' acceptance.


Simultaneous multiple breath washout and oxygen-enhanced magnetic resonance imaging in healthy adults.
Lung function testing and lung imaging are commonly used techniques to monitor respiratory diseases, such as cystic fibrosis (CF). The nitrogen (N2) multiple-breath washout technique (MBW) has been shown to detect ventilation inhomogeneity in CF, but the underlying pathophysiological processes that are altered are often unclear. Dynamic oxygen-enhanced magnetic resonance imaging (OE-MRI) could potentially be performed simultaneously with MBW because both techniques require breathing of 100% oxygen (O2) and may allow for visualisation of alterations underlying impaired MBW outcomes. However, simultaneous MBW and OE-MRI has never been assessed, potentially as it requires a magnetic resonance (MR) compatible MBW equipment. In this pilot study, we assessed whether MBW and OE-MRI can be performed simultaneously using a commercial MBW device that has been modified to be MR-compatible. We performed simultaneous measurements in five healthy volunteers aged 25-35 years. We obtained O2 and N2 concentrations from both techniques, and generated O2 wash-in time constant and N2 washout maps from OE-MRI data. We obtained good quality simultaneous measurements in two healthy volunteers due to technical challenges related to the MBW equipment and poor tolerance. Oxygen and N2 concentrations from both techniques, as well as O2 wash-in time constant maps and N2 washout maps could be obtained, suggesting that simultaneous measurements may have the potential to allow for comparison and visualization of regional differences in ventilation underlying impaired MBW outcomes. Simultaneous MBW and OE-MRI measurements can be performed with a modified MBW device and may help to understand MBW outcomes, but the measurements are challenging and have poor feasibility.


Carpophiline-ID: an interactive matrix-based key to the carpophiline sap beetles (Coleoptera, Nitidulidae) of Eastern North America.
Carpophiline-ID is presented, a matrix-based LucidTM key, for the adult stage of the known species of Carpophilinae (Coleoptera: Nitidulidae) of North America, east of the Mississippi River. An overview of the features and technical specifications used to build the key is provided. The list of terminal taxa used in the key represents the most current regional account for Carpophilinae, a beetle subfamily of agricultural and ecological importance. The value of matrix-based, free access keys for the identification of difficult taxa is discussed.


Incorporating research in a service setting.
There are similarities between the research process and problem-solving-evaluation mechanisms already in use in nursing service. The author describes the utility of each process and the rationale for implementing research in the nursing service setting. The nursing auit is recommended as the intstitutional mechanism for implementing and sustaining research activities.


Comparison of survival times of advanced cancer patients with palliative care at home and in hospital.
One primary concern about receiving care at home is that survival might be shortened because the quality and quantity of treatment provided at home will be inferior to that given in the hospital. Although our previous study demonstrated a longer survival of those with home-based palliative care (PC), it lacked adjustment for some potential confounders including symptoms and treatments during the stay. We aimed to compare the survival times among advanced cancer patients receiving home-based and hospital-based PC with adjusting for symptoms and treatments. We compared survival time of participants who enrolled two multicenter, prospective cohort studies of advanced cancer patients at 45-home-based PC services between July 2017 and December 2017, and at 23-hospital-based PC services between January 2017 and December 2017. We analyzed with stratification by the estimated survival of Days, Weeks, and Months, which were defined by modified Prognosis in Palliative care Study predictor models-A. We conducted a Cox regression analysis with adjusting for potential confounders including symptoms and treatments during the stay. A total of 2,998 patients were enrolled in both studies and 2,878 patients were analyzed; 988 patients receiving home-based PC and 1,890 receiving hospital-based PC. The survival time of patients receiving home-based PC was significantly longer than that of patients receiving hospital-based PC for the Days Prognosis (estimated median survival time: 10 days [95% CI 8.1-11.8] vs. 9 days [95% CI 8.3-10.4], p = 0.157), the Weeks prognosis (32 days [95% CI 28.9-35.4] vs. 22 days [95% CI 20.3-22.9], p < 0.001), and the Months Prognosis, (65 days [95% CI 58.2-73.2] vs. 32 days [95% CI 28.9-35.4], p < 0.001). In this cohort of advanced cancer patients with a Weeks or Months prognosis, those receiving home-based PC survived longer than those receiving hospital-based PC after adjusting for symptoms and treatments.


Preoperative Digital Subtraction Angiography in Incidental Unruptured Intracranial Aneurysms : How Much is too Much?
Digital subtraction angiography (DSA) is deemed necessary to precisely visualize intracranial aneurysms and define individual treatment strategies. In patients with unruptured intracranial aneurysms (UIA) who were diagnosed by MRI, a four-vessel DSA is usually performed to detect additional aneurysms. This study aimed to evaluate whether the evaluation of all vessels beyond the aneurysm-harboring artery is really necessary. Patients with an UIA that was detected on MRA (TOF/ceMRA) were prospectively included. All patients underwent a four-vessel DSA (including 3D-DSA) and two experienced neuroradiologists independently analyzed the MRI sequences before DSA. The number of aneurysms, size and anatomic localization were documented and correlated with the angiographic findings. The DSA revealed a total of 134 aneurysms in 106 patients. Overall sensitivity and negative predictive value of MRA were 95.6% and 95.6%, respectively. In patients with multiple (≥2) aneurysms, 4 very small aneurysms <3 mm in the A2 segment, posterior communicating artery (PcomA), extradural internal carotid artery (ICA) were missed with MRI alone. In one patient with an ICA aneurysm, an additional small MCA bifurcation aneurysm was overlooked by MRA but detected by DSA. The periprocedural complication rate was 0.9%. The rate of aneurysms that were detected by DSA but not by MRA was very low, thus potentially justifying visualization of the vessel harboring aneurysm alone; however, the four-vessel angiography detected further small aneurysms in patients with multiple aneurysms and therefore seems to be indicated in this specific subgroup. This approach has the potential to reduce the risk of complications, the intervention time and thus radiation exposure.


[Mycobacterium kansasii: drinking water contaminant of a hospital].
Contamination of tap water by Mycobacterium kansasii in an hospital is described. This contamination was responsible for an increased frequency of M. kansasii isolates from gastric washings. The hygiene measures taken to eliminate the mycobacteria from the water distribution system in the hospital are reported.


Reproductive health interventions for Inuit youth in the north: a scoping review.
Inuit have thrived in the northern regions of Canada and Alaska for thousands of years. Recent evidence suggests that Inuit in this region have experienced systemic barriers to reproductive health with resulting disparities in reproductive health-related outcomes including those among youth. Northern youth-focused reproductive health intervention research or evaluations have not to date been well summarized. The objective of this scoping review was to summarize the literature over the past twenty years focusing on reproductive health interventions for adolescents in northern Inuit communities. English-language articles from 2000 to 2020 were identified from seven scientific databases, a general internet search and a review of relevant websites. Two reviewers screened titles, abstracts and full texts and included articles if they mentioned a reproductive health intervention and pertained, directly or indirectly, to reproductive health for Inuit aged 10-19 in northern communities. Seventeen articles met the inclusion criteria, across six themes: (1) Barriers to reproductive health interventions in the north; (2) Northern midwifery; (3) Northern birthing centres; (4) Fetal fibronectin tests for identifying high-risk pregnancies; (5) Prenatal education classes; and (6) Interventions to improve access to and quality of reproductive health supports. Overall there is relatively limited evidence base specific to reproductive health interventions and northern Inuit youth. What does exist largely focuses on maternal health interventions and is inclusive of but not specific to youth. There is some evidence that youth specific educational programs, participatory action research approaches and the promotion of northern birthing centres and midwifery can improve reproductive health for adolescents and young mothers in northern Inuit communities. Future initiatives should focus on the creation and evaluation of culturally relevant and youth specific interventions and increasing community and youth participation in intervention research for better reproductive health.


Associations between Poorer Mental Health with Work-Related Effort, Reward, and Overcommitment among a Sample of Formal US Solid Waste Workers during the COVID-19 Pandemic.
Effort-reward imbalance (ERI) and overcommitment at work have been associated poorer mental health. However, nonlinear and nonadditive effects have not been investigated previously. The association between effort, reward, and overcommitment with odds of poorer mental health was examined among a sample of 68 formal United States waste workers (87% male). Traditional, logistic regression and Bayesian Kernel machine regression (BKMR) modeling was conducted. Models controlled for age, education level, race, gender, union status, and physical health status. The traditional, logistic regression found only overcommitment was significantly associated with poorer mental health (IQR increase: OR = 6.7; 95% CI: 1.7 to 25.5) when controlling for effort and reward (or ERI alone). Results from the BKMR showed that a simultaneous IQR increase in higher effort, lower reward, and higher overcommitment was associated with 6.6 (95% CI: 1.7 to 33.4) times significantly higher odds of poorer mental health. An IQR increase in overcommitment was associated with 5.6 (95% CI: 1.6 to 24.9) times significantly higher odds of poorer mental health when controlling for effort and reward. Higher effort and lower reward at work may not always be associated with poorer mental health but rather they may have an inverse, U-shaped relationship with mental health. No interaction between effort, reward, or overcommitment was observed. When taking into the consideration the relationship between effort, reward, and overcommitment, overcommitment may be most indicative of poorer mental health. Organizations should assess their workers' perceptions of overcommitment to target potential areas of improvement to enhance mental health outcomes.


Epidemiology and evaluation: steps toward hypertension treatment in the 1990s.
The percentage of persons in the United States over age 65--especially over 85--is increasing more rapidly than other age groups. Two thirds of people over age 65 have blood pressure higher than 140 mm Hg systolic or 90 mm Hg diastolic. Isolated systolic hypertension (systolic blood pressure greater than 160 mm Hg with diastolic blood pressure less than 90 mm Hg) is also highly prevalent. In a number of clinical trials, treatment of diastolic hypertension in the elderly has been shown to be beneficial, although the value of treatment of isolated systolic hypertension is not yet established. The benefit of antihypertensive therapy on the incidence of stroke and heart failure has been clearly established, but prevention of the atherosclerotic complications of high blood pressure (sudden death or myocardial infarction, for example) has not been convincingly demonstrated. Since clinical trials designed to investigate this atherosclerotic complication of hypertension have relied on stepped-care regimens (diuretics and beta blockers), the question arises whether the use of different drugs might have a better effect on prevention of myocardial infarction. The basis for this supposition includes the known adverse effects of diuretics and beta blockers on electrolytes, lipid metabolism, glucose metabolism, insulin resistance, and quality of life. Hypertension treatment in the 1990s will focus on the mechanisms by which blood pressure is lowered by various antihypertensive agents, as well as individualization of drug therapy based on coexisting diseases and conditions. Emphasis will be placed on use of monotherapy whenever possible; diuretics in low doses will probably be used more frequently for second-line therapy. In recognition of their lack of adverse lipid effects and their tolerability, first-line therapy with alpha blockers, angiotensin-converting enzyme inhibitors, and calcium antagonists will become increasingly common. The goal of antihypertensive therapy will be to extend the life expectancy of hypertensive patients to that of subjects without high blood pressure; hopefully, these new treatment approaches will bring us closer to that goal.


Measuring 0.1-nm motion in 1 ms in an optical microscope with differential back-focal-plane detection.
Back-focal-plane detection of micrometer-sized beads offers subnanometer resolution for single-molecule, optical trapping experiments. However, laser beam-pointing instability and mechanical drift of the microscope limit the resolution of optical-trapping experiments. By combining two infrared lasers with improved differential beam-pointing stability (< or = 0.05 microrad), we simultaneously measure and subtract the motion of the microscope stage, leading to a resolution of <0.1 nm in 1 ms and stability of 0.5 nm over 60 s. Repeated steps of 0.4 nm at 1 Hz are resolved with a signal-to-noise ratio of 25.


Epigenetic insight into regulatory role of chromatin covalent modifications in lifecycle and virulence of Phytophthora.
The Oomycota phylum includes fungi-like filamentous microorganisms classified as plant pathogens. The most destructive genus within oomycetes is Phytophthora, which causes diseases in plants of economic importance in agriculture, forestry and ornamental. Phytophthora species are widespread worldwide and some of them enable adaptation to different hosts and environmental changes. The development of sexual and asexual reproductive structures and the secretion of proteins to control plant immunity are critical for the adaptative lifestyle. However, molecular mechanisms underlying the adaptation of Phytophthora to different hosts and environmental changes are poorly understood. In the last decade, the role of epigenetics has gained attention, and important evidence has demonstrated the potential role of chromatin covalent modifications, such as DNA methylation and histone acetylation/methylation, in the regulation of gene expression during Phytophthora development and plant infection. Here, we review for the first time the evidence of the potential role of chromatin covalent modifications in the lifecycle of the phytopathogenic genus Phytophthora, including virulence, and host and environment adaptation processes.


Pulmonary sequelae of prolonged total venoarterial bypass: evaluation with a new experimental model.
Total normothermic venoarterial bypass was established in 6 healthy pigs over a period of 18 hours. A heparin-coated closed extracorporeal system was used and no heparin was administered systemically. During the bypass period the main pulmonary artery was occluded and the heart was maintained in a beating state. All the animals maintained stable hemodynamics and normal blood gases during the entire period of bypass. In the postbypass period, the central hemodynamics continued to be stable while the arterial oxygen tension (inspired oxygen fraction = 0.21) decreased significantly (p less than or equal to 0.05). The total body oxygen uptake, on the other hand, remained unaltered. All the animals died within 4 hours after weaning off the venoarterial bypass circuit on account of pulmonary edema in 2 and cardiac arrest in 4. Death was preceded by progressive pulmonary hypertension and lactacidosis in all the animals. Histological examination of the lungs showed pulmonary parenchymal damage ranging from interstitial edema to intraalveolar hemorrhage and parenchymal necrosis involving more than 80% of the pulmonary parenchyma. A normothermic total venoarterial bypass of 18 hours duration or more produces pulmonary edema of varying severity, pulmonary hypertension, pulmonary parenchymal necrosis, and lactacidosis in healthy juvenile pigs, resulting uniformly in their death. Despite these sequelae the systemic arterial hypoxemia may only be mild to moderate.


Cysteine protected cells from H2O2-induced damage and promoted long-chain fatty acids synthesis in vivo to improve γ-aminobutyric acid production in Levilactobacillus brevis.
Levilactobacillus brevis NPS-QW-145 isolated from kimchi is deficient in glutamate dehydrogenase-encoding gene (gdhA) to form glutamate, hence it required exogenous supplementation of glutamate/monosodium glutamate (MSG) for decarboxylation reaction to produce γ-aminobutyric acid (GABA). However, GABA conversion rate from MSG was relatively low. The individual effect of 20 amino acids on regulating GABA biosynthesis was investigated. Cysteine was selected to significantly improve GABA production from MSG. It was found that Lb. brevis was capable of producing H2O2, cysteine protected Lb. brevis against H2O2-induced oxidative damage to increase cell viability for the enhancement of GABA production. Moreover, cysteine promoted glucose consumption to produce acetyl-CoA for synthesizing long-chain fatty acids to significantly up-regulate GABA biosynthesis. These findings deciphered antioxidative capability of cysteine in Lb. brevis 145 and provided a theoretical basis for fatty acids synthesis-mediated GABA synthesis in Lb. brevis 145, and possibly in other lactic acid bacteria.


Methods to study dynamic interaction of androgen receptor with chromatin in living cells.
Androgen receptor (AR) is a ligand-dependent transcription factor that belongs to the nuclear receptor superfamily. In the presence of its specific ligands, AR translocates into the nucleus, interacts with chromatin at hormone response elements (HREs) and recruits a variety of coregulators and basal transcription factors to regulate transcription. Using green fluorescent protein (GFP) labelling and the tandem gene array system of mouse mammary tumour virus (MMTV), the interaction of AR with HREs can be visualized and studied in live cells. The MMTV array in nuclei can be specifically detected by DNA fluorescence in situ hybridization (DNA FISH) and thereby specific binding of GFP-AR to the array can be confirmed in the presence of specific ligands. The transcriptional activity of GFP-AR at the MMTV array can be visualized by RNA FISH in combination with interactions of GFP-AR or its cofactors, or different components of the transcriptional initiation complex, by indirect immunofluorescence (IF). Finally, using fluorescence recovery after photobleaching (FRAP), dynamic interactions of GFP-AR with the chromatin template can be studied. Methods to carry out these experiments are described herein.


Creatine, L-carnitine, and ω3 polyunsaturated fatty acid supplementation from healthy to diseased skeletal muscle.
Myopathies are chronic degenerative pathologies that induce the deterioration of the structure and function of skeletal muscle. So far a definitive therapy has not yet been developed and the main aim of myopathy treatment is to slow the progression of the disease. Current nonpharmacological therapies include rehabilitation, ventilator assistance, and nutritional supplements, all of which aim to delay the onset of the disease and relieve its symptoms. Besides an adequate diet, nutritional supplements could play an important role in the treatment of myopathic patients. Here we review the most recent in vitro and in vivo studies investigating the role supplementation with creatine, L-carnitine, and ω3 PUFAs plays in myopathy treatment. Our results suggest that these dietary supplements could have beneficial effects; nevertheless continued studies are required before they could be recommended as a routine treatment in muscle diseases.


To study hypoactive sexual desire disorder in a fragile X carrier female successfully treated with local testosterone application.
There is still considerable controversy concerning the role of androgen therapy for hypoactive sexual desire disorder in females. Clinical trials have shown that exogenous testosterone therapy improves arousability, sexual desire and fantasy, frequency of sexual activity and orgasm, and satisfaction and pleasure from the sexual act. We report our experience of 36-year-old fragile X carrier female presented to our department with low sex drive and subjectively poor arousal for the past 1 year. We decided to treat her with local testosterone in a pump form (1% 5 g twice a week). She responded very well to the treatment, and in 3 weeks her libido and sexual functions improved dramatically. We decided to continue the same treatment for almost 1 year following up her free and total testosterone, complete lipid profiles, liver functions and complete blood picture every 3 months. During the whole course of treatment, she had mild facial acne, which was resolved in 2 months after completing treatment with testosterone. This is our first and only case of this syndrome with low sexual desire disorder treated with local testosterone in a pump form. Based upon our 1 year follow-up, low-dose testosterone is a safe and effective approach in treating hypoactive sexual desire disorder in a fragile X carrier female, provided the patient is monitored every 3 months for blood counts, lipid profiles, liver functions and free and total testosterone levels.


Effect of lesion of the hypothalamic mamillary nuclei on skin blood vessel permeability in normal and capsaicin-pretreated rats.
Contralateral increased exudation of plasma proteins, as measured by Evans Blue leakage into the fore paws, was produced by unilateral electrocoagulation of the mamillary nuclei in rats. Ten days after adult capsaicin pretreatment (increasing doses/4 days total 200 mg/kg, s.c.) the unilateral destruction of these nuclei did not evoke any changes of skin blood vessel permeability in both contralateral and unilateral paws. The findings show that the central nervous system may modulate the capsaicin-sensitive peptidergic neuron action on blood vessel permeability.


Regional variations in dietary intake and body mass index of first-generation Asian-Indian immigrants in the United States.
Asian Indians (AIs) have considerable within-group diversity in education levels, socioeconomic status, language, and diet based on the region of origin in India. The objective of this study was to determine if dietary intake patterns vary based on region of origin among first generation AI immigrants and if these differences influence body mass index (BMI). AI men and women (n=237), over 40 years, in southern US participated in a telephone survey. Responses to the Block food frequency questionnaire suggest that the diet of the study participants was low in dietary fiber while dietary fat intake was within guidelines. Intake of individual foods varied by region of origin. BMI also varied by region of origin (P<.05), with individuals from the north having a higher BMI (26.3) compared to those from the south and west (24.3). Regression analysis showed BMI to be significantly related to total fat intake, physical activity, and north region. Results suggest that dietary advice and lifestyle recommendations should be individualized.


Increased end-expiratory pressures improve lung function in near-term newborn rabbits with elevated airway liquid volume at birth.
Approximately 53% of near-term newborns admitted to intensive care experience respiratory distress. These newborns are commonly delivered by cesarean section and have elevated airway liquid volumes at birth, which can cause respiratory morbidity. We investigated the effect of providing respiratory support with a positive end-expiratory pressure (PEEP) of 8 cmH2O on lung function in newborn rabbit kittens with elevated airway liquid volumes at birth. Near-term rabbits (30 days; term = 32 days) with airway liquid volumes that corresponded to vaginal delivery (∼7 mL/kg, control, n = 11) or cesarean section [∼37 mL/kg; elevated liquid (EL), n = 11] were mechanically ventilated (tidal volume = 8 mL/kg). The PEEP was changed after lung aeration from 0 to 8 to 0 cmH2O (control, n = 6; EL, n = 6), and in a separate group of kittens, PEEP was changed after lung aeration from 8 to 0 to 8 cmH2O (control, n = 5; EL, n = 5). Lung function (ventilator parameters, compliance, lung gas volumes, and distribution of gas within the lung) was evaluated using plethysmography and synchrotron-based phase-contrast X-ray imaging. EL kittens initially receiving 0 cmH2O PEEP had reduced functional residual capacities and lung compliance, requiring higher inflation pressures to aerate the lung compared with control kittens. Commencing ventilation with 8 cmH2O PEEP mitigated the adverse effects of EL, increasing lung compliance, functional residual capacity, and the uniformity and distribution of lung aeration, but did not normalize aeration of the distal airways. Respiratory support with PEEP supports lung function in near-term newborn rabbits with elevated airway liquid volumes at birth who are at a greater risk of suffering respiratory distress.NEW & NOTEWORTHY Term babies born by cesarean section have elevated airway liquid volumes, which predisposes them to respiratory distress. Treatments targeting molecular mechanisms to clear lung liquid are ineffective for term newborn respiratory distress. We showed that respiratory support with an end-expiratory pressure supports lung function in near-term rabbits with elevated airway liquid volumes at birth. This study provides further physiological understanding of lung function in newborns with elevated airway liquid volumes at risk of respiratory distress.


Synthesis of α-Difluoromethyl Aryl Ketones through a Photoredox Difluoromethylation of Enol Silanes.
We report here an efficient and highly straightforward access to α-difluoromethylated ketones through a visible light-mediated difluoromethylation of readily available enol silanes. The method, which takes advantage of the polyvalence of Hu's reagent, N-tosyl-S-difluoromethyl-S-phenylsulfoximine, used here as a CHF2 radical precursor under catalytic photoredox conditions, is practical, scalable, and provides the corresponding α-CHF2 ketones in good to excellent yields.


A review of conservation status of freshwater fish diversity in China.
China harbors a high species diversity of freshwater fishes not shared with any of its neighboring nations. Freshwater fish diversity in the country has been under severe threat from human activities over the past decades, thus conservation freshwater fishes and ecosystems is urgently needed. To accumulate baseline data for guiding protection actions, the third red list assessment of Chinese freshwater fishes was carried out. Among Chinese freshwater fishes assessed, there are 355 at-risk species (22.3% of the total), including 69 ranked as Critically Endangered, 97 as Endangered, and 189 as Vulnerable. Two species are classified as Extinct and one as Regionally Extinct. China's threat level seems to be lower than the known average level found in the IUCN's global assessment of freshwater fishes, but this is an artifact of a high rate of species classified as Data Deficient. Conservation of freshwater fishes is presently facing a grim situation in China. Imperilment of Chinese freshwater fishes is primarily attributed to habitat loss and degradation arising from human perturbations, particularly river damming. Despite the adoption of protected areas setting up, captive breeding and release, and a fishing moratorium, conservation efforts for freshwater fishes are compromised by disproportional attention in China's biodiversity conservation, baseline data deficiency, insufficiently designed protection networks, and inefficient or inadequate implementation of conservation strategies. To achieve the objectives of Chinese freshwater fish conservation, it is proposed to conduct a national-scale survey of fish diversity and reassess their at-risk status, develop systematic conservation planning of freshwater fish diversity and ecosystems, prioritize strategies for protected areas development, perform genetic-based captive breeding for releasing in concert with other protection actions, and implement flexible fishing moratorium strategies in different water bodies.


The detrimental effects of micro-and nano-plastics on digestive system: An overview of oxidative stress-related adverse outcome pathway.
With the massive manufacture and use of plastics, plastic pollution-related environmental impacts have raised great concern in recent years. As byproducts of plastic fragmentation and degradation, microplastics (MPs) and nanoplastics (NPs) have been identified as novel pollutants that posed a threat to the ecosystem and humans. Since MPs/NPs could be transported via the food chain and retained in the water, the digestive system should be one of the major targets of MPs/NPs-related toxicity. Although considerable evidence has supported the digestive toxicity of MPs/NPs, the proposed mechanisms remained ambiguous due to the variety of study types, models, and endpoints. This review provided a mechanism-based perspective on MPs/NPs-induced digestive effects by adopting the adverse outcome pathway framework as a promising tool. The overproduction of reactive oxygen species was identified as the molecular initiating event in MPs/NPs-mediated injury to the digestive system. A series of detrimental effects including oxidative stress, apoptosis, inflammation, dysbiosis, and metabolic disorders were summarized as key events. Finally, the occurrence of these effects eventually led to an adverse outcome, suggesting a possible increase in the incidence of digestive morbidity and mortality.


Biomarker research for moyamoya disease in cerebrospinal fluid using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry.
Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by steno-occlusive change in bilateral internal carotid arteries with unknown etiology. To discover biomarker candidates in cerebrospinal fluid from MMD patients, proteome analysis was performed by the surface-enhanced laser desorption/ionization time-of-flight mass spectrometry. Three peptides, 4473Da, 4475Da, and 6253Da, were significantly elevated in MMD group. A positive correlation between 4473Da peptide and postoperative angiogenesis was determined. Twenty MMD patients were enrolled in this pilot study, including 11 pediatric cases less than 18 years of age (mean age, 8.67 years) and 9 adult MMD patients (mean age, 38.1 years). This study also includes 17 control cases with the mean age of 27.9 years old. In conclusion, 4473Da peptide is supposed to be a reliable biomarker of MMD. 4473Da peptide showed higher intensity peaks especially in younger MMD patients, and it was proved to be highly related to postoperative angiogenesis. Further study is needed to show how 4473Da peptide is involved with the etiology and the onset of MMD.


Pouch size: the important functional determinant after restorative proctocolectomy.
Sixty-seven patients with a J-shaped ileonanal pouch were studied over a 2-year period with regular recording of sphincter and pouch characteristics and analysis of their role in functional outcome. Although there was a 27 per cent permanent reduction in resting anal pressure (RAP) (P less than 0.001), two-thirds of the patients still had a RAP within the normal range. The mean(s.d.) pouch volume increased during the first year from 132(46) ml to 282(85) ml. RAP was not related to functional outcome and preoperative RAP was not predictive of subsequent function. Large pouch volume and compliance correlated with low defaecation frequency (range of r = 0.27-0.36; P less than 0.05) and good overall function (r = 0.37-0.56; P less than 0.01). The initial pouch volume was predictive of subsequent overall function. The ileal length used for pouch construction predicted subsequent pouch volume (r = 0.48; P less than 0.001) and to some extent functional outcome (r = 0.28-0.37; P less than 0.05). However, the studied variables accounted for only 21 per cent of the total variance of functional outcome.


Mammillotegmental tract in the human brain: diffusion tensor tractography study.
Several animal studies have been conducted for the identification of the mammillotegmental tract (MTT); however, no study has been reported in the human brain. In the current study, using diffusion tensor tractography (DTT), we attempted to identify the MTT in the human brain. We recruited 31 healthy volunteers for this study. Diffusion tensor images were acquired using 1.5 T, and the MTT was obtained using a probabilistic tractography method based on a multi-fiber model. Values of fractional anisotropy, mean diffusivity, and tract volume of the MTT were measured. MTTs of all subjects, which originated from the mammillary body, ascended posteriorly to the bicommissural level along the third ventricle and then turned caudally and terminated at the tegmentum of the midbrain. No significant differences were observed in terms of fractional anisotropy, mean diffusivity, and tract volume according to hemisphere and sex (P < 0.05). Using DTT, we identified the MTT in the human brain. We believe that the methodology and results of this study would be helpful in research on the MTT in the human brain.


[Iron deficiency anemia caused by occult intestinal bleeding due to milk allergy (author's transl)].
With the passive hemagglutination method the authors proved antibodies against milkprotein fractions in three of nine patients with hypochrome anemia aged 7, 12 and 17 months. In these children the X-ray examination showed an intestinal allergy, presumably the reason for occult intestinal bleeding which inturn caused hypochrome anemia. After milk was eliminated from the diet iron therapy restored a normal haemoglobin content. Iron therapy alone only improved the anemia, since continuing intestinal bleeding prevented fullrecovery.


Single-unit activity in the auditory cortex of monkeys actively localizing sound sources: spatial tuning and behavioral dependency.
Single-unit recordings were made from the auditory cortex of unanesthetized rhesus monkeys which were trained to perform a second localization task. Recordings were made from 196 units in 4 animals. Five sound sources were located at 0 degrees (midline) and on either side at azimuths of 37.5 degrees and 75 degrees. Almost most units responded to each of the 5 sources, 49% of the units had peak firing rates for the source on the contralateral side at 75% azimuth. Another 26% of the units had peak firing rates at the 37.5 degrees contralateral location, while only 11% had peak rates for the ipsilateral locations. In order to determine whether the behavior of actively locating a sound source affected units in auditory cortex, response rates compared under two behavioral conditions: one which required the detection of a sound regardless of location and another condition which required identification of a sound's location. of the 196 units, 16 had different response rates for the two conditions, with 15 of the 16 units having higher evoked rates in the localization task. For the 16 units, the difference in firing rate was typically observed for a single speaker location. No correlation could be determined between a unit's location within the subdivisions of auditory cortex and its spatial tuning response properties or its dependency upon behavioral condition.


Myosin light chain phosphorylation in intact rat uterine smooth muscle. Role of calcium and cyclic AMP.
Myometrial strips from oestrogen-primed rat uterus were exposed to various treatments, isometric contraction was measured, and the extent of myosin light chain phosphorylation determined after rapid freezing in liquid nitrogen. Two-dimensional electrophoresis revealed five spots having the same molecular weight as the light chain, with isoelectric points comprised between 5.15 and 4.95. Two of these spots (pI 5.09 and 5.00) were not present in pure uterine myosin, whether prepared from incubated or nonincubated tissue; they do not represent light chain isoforms or electrophoresis artefacts but rather degradation products appearing during the treatment. Two spots (pI 5.15 and 5.06) were identified as the nonphosphorylated and the phosphorylated forms of the light chain. The fifth minor spot (pI 4.95) may represent a diphosphorylated myosin species. Strips incubated in a normal Ca2+-medium 0.8 mM) exhibited basal contractions and an incorporation of 0.2 mol phosphate per mol light chain. Removal of Ca2+ resulted in almost complete dephosphorylation, coincident with a total relaxation of the muscle. Exposure of the myometrium to carbachol caused tetanic contractions with an increase to 0.5 mol phosphate per mol light chain. Isoproterenol, a beta-adrenergic agonist elevated intracellular cyclic AMP and induced uterine relaxation. Addition of isoproternol to a resting myometrium caused a slight but significant decrease in phosphorylation; its addition prior to carbachol markedly prevented the increase in myosin phosphorylation normally induced by the cholinergic effector. Forskolin (1 microM) increased intracellular cyclic AMP, caused relaxation and a concomitant decrease in basal myosin phosphorylation. Prostaglandin E2-induced elevation in intracellular cyclic AMP was however accompanied by an increase in contraction together with an increase in light chain phosphorylation. The data imply that light chain phosphorylation-dephosphorylation, regulated by Ca2+-dependent mechanisms, is essential for both uterine contraction and relaxation but question the role of cyclic AMP in exclusively mediating relaxation and myosin dephosphorylation in intact myometrium.


Intravenous immunoglobulin therapy for aspirin-heparinoid-resistant antiphospholipid syndrome.
We encountered a woman who had a history of repeated fetal losses and positive tests for lupus anticoagulant, phosphatidylserine-dependent antiprothrombin (aPS/PT) IgG, IgM and kininogen-dependent antiphosphatidylethanolamine (aPE) IgG, IgM. Her previous pregnancy had ended in intrauterine fetal death at 24 weeks of gestation despite a therapy of low-dose aspirin, prednisolone and danaparoid. During the present pregnancy, she was treated with repeated intravenous infusions of immunoglobulin (IVIg) together with low-dose aspirin, prednisolone and heparin. When thrombocytopenia developed, she delivered a female baby weighing 2,152 g at 34 weeks of gestation by cesarean section. Titers of aPS/PT IgM and aPE IgM were reduced or maintained at low levels by repeated IVIg therapies. The IVIg therapy might be effective for aspirin-heparinoid-resistant antiphospholipid syndrome.


Binding of progesterone receptor by nuclear preparations of rabbit and guinea pig uterus.
Guinea pig and rabbit uterine nuclei bound [3H] progesterone in vitro only in the presence of cytosol from estrogen-stimulated uteri. Nuclei from unstimulated and estrogen-stimulated uteri bound progesterone equally well. Nuclei of nontarget tissues also bound progesterone, but to a lesser extent. The rate of nuclear bindins increased with temperature from 0-30 degrees. At 25 degrees nuclear binding remained stable for at least 3 h, but at temperatures of 30 degrees and greater, nuclear binding decreased rapidly after 15 min. Activation of the progesterone-cytoplasmic receptor complex (the change in the complex that enables it to bind quickly to nuclei at 0 degrees) took place slowly at temperatures from 0-5 degrees and rapidly at 10-25 degrees. Activation was facilitated by dilution of the cytosol. Some activation occurred in diluted cytosol in the absence of added progesterone. The cytoplasmic progesterone receptor had a sedimentation coefficient of 7 S when concentrated cytosol (20 mg of protein/ml) was incubated with progesterone at 0 degrees in 5 mM phosphate buffer. Diluting the cytosol and increasing the temperature to 20 degrees caused the sedimentation coefficient to decrease to 5.5 S. Gel filtration of guinea pig uterine cytosol on Sephadex G-100, in the absence of progesterone, yielded a progesterone-binding fraction in the void volume, with a sedimentation coefficient of 5.5 S. The complex of progesterone with the material in the void volume was taken up by nuclei at 0 degrees more rapidly than the complex of progesterone and crude cytosol. The nuclear uptake of progesterone was decreased in phosphate buffer of concentrations greater than 80 mM. Under conditions that favor the nuclear binding of progesterone, the sedimentation coefficient of the cytoplasmic progesterone receptor was 5.5 S. This may be the form of the preceptor which is taken up by nuclei. In decreasing order of effectiveness, unlabeled progesterone, 5 alpha-pregnane-3,20-dione, corticosterone 20 alpha-hydroxy-4-pregnen-3-one, testosterone, estradiol-17 beta, and cortisol competed with [3H] progesterone for binding to nuclei.


Polymorphism of the CA-I locus of carbonic anhydrase in baboon.
Polymorphism of erythrocytic carbonic anhydrase was studied by means of the usual technique of starch gel electrophoresis in Papio papio, Papio hamadryas, Papio cynocephalus and Papio anubis. In a sample containing both Papio cynocephalus and Papio anubis, examples of the homozygote CA-Ib/CA-Ib were found. A study of parental transmission established the CA-Ib allelic form.


Dielectric meta-atom with tunable resonant frequency temperature coefficient.
In this paper, we present a proof-of-concept of a new approach to achieving tailored resonant frequency temperature coefficients in dielectric meta-atoms. The technique involves introducing a thermally expanding or contracting material joining the active high permittivity dielectric absorbers. Both simulation and experiment show that by careful design of the element size and appropriate choice of thermomechanical intermediate layer material, increased or decreased resonant frequency shift temperature sensitivity is possible. Once the active dielectric material is chosen, and a meta-atom design determined, we show the resonant frequency shift depends on the thermal expansion coefficient of the intermediate layer. This work demonstrates the feasibility of manipulating the blue or red shift of metamaterial devices by introducing temperature responsive intermediate layers into meta-atoms.


Enhanced organics degradation by three-dimensional (3D) electrochemical activation of persulfate using sulfur-doped carbon particle electrode: The role of thiophene sulfur functional group and specific capacitance.
For further enhancing the electrochemical oxidation performance, sulfur-doped carbon particle electrode was employed in the three-dimensional (3D) electro-assisted activation of persulfate process (ACS/PS/EC). Herein, an in situ S-doped activated carbon (ACS) was prepared and applied as the particle electrode as well as catalyst in ACS/PS/EC system. Several carbon particle electrodes with different annealing temperature were prepared and characterized via EA, BET, XPS and Raman spectra. Cyclic voltammetry (CV) was perform to obtain the specific capacitance and investigate the interfacial electron transfer of ACS particle. The results of comparative experiments showed significant synergy between electric and catalytic activations of PS. Especially, the as-prepared sample treated at 850 °C (ACS-850) exhibited an outstanding catalytic performance, and the phenol degradation rate was greatly improved by nearly 100% with the application of electric field. By comparing of several carbon particle electrodes with different functional groups and specific capacitances, it is revealed that thiophene sulfur functional group is the mainly active site for both electric and catalytic activation of PS, and the specific capacitance acts as assistant factor. Quenching experiments proved that the 3D electro-assisted activation of PS proceeded through both radical and non-radical pathway. Possible mechanism for ACS/PS/EC electrochemical process was proposed.


Impaired differentiation of small airway basal stem/progenitor cells in people living with HIV.
With highly active anti-retroviral therapy (HAART), higher incidence of airway abnormalities is common in the HIV population consistent with the concept of accelerated lung "aging". Our previous findings demonstrated that HIV induces human airway basal cells (BC) into destructive and inflammatory phenotypes. Since BC function as stem/progenitor cells of the small airway epithelium (SAE), responsible for self-renewal and differentiation of SAE, we hypothesized that BC from people living with HIV (PLWH) may have altered differentiation capacity that contribute to premature aging. The data demonstrates that BC from PLWH have impaired capacity to differentiate in vitro and senescent phenotypes including shortened telomeres, increased expression of β-galactosidase and cell cycle inhibitors, and mitochondrial dysfunction. In vitro studies demonstrated that BC senescence is partly due to adverse effects of HAART on BC. These findings provide an explanation for higher incidence of airway dysfunction and accelerated lung aging observed in PLWH.


Fluorescence energy transfer distance measurements using site-directed single cysteine mutants. The membrane insertion of colicin A.
The ion-channel-forming C-terminal fragment of colicin A binds to negatively charged lipid vesicles and provides an example of insertion of a soluble protein into a lipid bilayer. The soluble structure is known from X-ray crystallography and consists of a ten-helix bundle containing a hydrophobic helical hairpin. In this work fluorescence spectroscopy was used to study the membrane-bound structure. An extrinsic probe, N'-(iodoacetyl)-N'-(5-sulfol-naphthyl)ethylenediamine (IAEDANS) was attached to mutant proteins each of which bears a unique cysteine residue. Three mutants K39C (helix 2), T127C (between helices 6 and 7) and S16Crpt (helix 1, which bears a decapeptide repeat before the mutation) gave useful derivatives. In the soluble protein they showed emission wavelengths decreasing in the order K39C greater than T127C greater than S16Crpt and although all showed blue shifts on addition of dimyristoylphosphatidylglycerol (DMPG) this order was maintained in the membrane-bound state. These shifts were not indicative of deep membrane insertion. Polarization of IAEDANS revealed differences in mobility between mutants. The three tryptophan residues were used as a compound donor to IAEDANS in resonance energy transfer distance determinations. The values obtained for the soluble form were 1.2 A to 3.2 A longer than in the crystal structure. On addition of lipids the indicated distances increased: S16Crpt-I(AEDANS) 6.45 A (22%), K39C-I 5.45 A (18%) and T127C-I 2.4 A (14%). N-bromosuccinimide (NBS) completely abolishes the tryptophan emission from the thermolytic fragment. When lipids were added to a mixture containing ten NBS-treated channel-forming fragments to one IAEDANS labelled fragment the indicated distances increased rather more: S16Crpt-I 9.7 A (38%), K39C-I 8.1 A (36%) and T127C-I 2.5 A (16%). This showed that intermolecular transfer reduces the distance estimated in samples containing only labelled protein. The ensemble of results shows that the amphipathic helices of the C-terminal fragment open out on the surface of the lipid bilayer during the initial phase of membrane insertion.


Hypothalamic-pituitary-adrenal axis function and suicidal behavior in depression.
Hypothalamic-pituitary-adrenal (HPA) axis function was examined in relation to suicidal behavior in depression. There were no significant differences between depressed patients who had or had not attempted suicide for either cerebrospinal fluid concentrations of corticotropin-releasing hormone, plasma cortisol levels predexamethasone or postdexamethasone, or for urinary-free cortisol outputs. However, depressed patients who had made a violent suicide attempt had significantly higher 4 PM and maximum postdexamethasone plasma cortisol levels, and significantly more of them were cortisol nonsuppressors than patients who had made nonviolent suicide attempts. A 5-year follow-up was carried out. There were no significant differences on indices of HPA function between depressed patients who did or did not reattempt suicide during the follow-up or who had never attempted suicide. These results suggest the possibility that dysregulation of the HPA axis may be a determinant of violent suicidal behavior in depression.


The Saga of Pulse Oximetry Screening for Critical Congenital Heart Disease in Israel: A Historical Perspective.
Many countries have adopted a mandatory routine pulse oximetry screening of newborn infants to identify babies with otherwise asymptomatic critical congenital heart disease (CCHD). To describe the current status of pulse oximetry CCHD screening in Israel, with a special emphasis on the experience of the Shaare Zedek Medical Center. We review the difficulties of the Israeli Medical system with adopting the SaO2 screening, and the preliminary results of the screening at the Shaare Zedek Medical Center, both in terms of protocol compliance and CCHD detection. Large scale protocol cannot be implemented in one day, and regular quality assessment programs must take place in order to improve protocol compliance and identify the reasons for protocol failures. Quality control reviews should be conducted soon after implementation of the screening to allow for prompt diagnosis and quick resolution.


Trends in hospitalization for alcoholic hepatitis from 2011 to 2017: A USA nationwide study.
Severe alcoholic hepatitis (AH) is one of the most lethal manifestations of alcohol-associated liver disease. In light of the increase in alcohol consumption worldwide, the incidence of AH is on the rise, and data examining the trends of AH admission is needed. To examine inpatient admission trends secondary to AH, along with their clinical outcomes and epidemiological characteristics. The National Inpatient Sample (NIS) database was utilized, and data from 2011 to 2017 were reviewed. We included individuals aged ≥ 21 years who were admitted with a primary or secondary diagnosis of AH using the International Classification of Diseases (ICD)-9 and its correspondent ICD-10 codes. Hepatitis not related to alcohol was excluded. The national estimates of inpatient admissions were obtained using sample weights provided by the NIS. AH-related hospitalization demonstrated a significant increase in the USA from 281506 (0.7% of the total admission in 2011) to 324050 (0.9% of the total admission in 2017). The median age was 54 years. The most common age group was 45-65 years (range 57.8%-60.7%). The most common race was white (63.2%-66.4%), and patients were predominantly male (69.7%-71.2%). The primary healthcare payers were Medicare (29.4%-30.7%) and Medicaid (21.5%-32.5%). The most common geographical location was the Southern USA (33.6%-34.4%). Most patients were admitted to a tertiary care center (50.2%-62.3%) located in urban areas. Mortality of AH in this inpatient sample was 5.3% in 2011 and 5.5% in 2017. The most common mortality-associated risk factors were acute renal failure (59.6%-72.1%) and gastrointestinal hemorrhage (17.2%-20.3%). The total charges were noted to range between $25242.62 and $34874.50. The number of AH inpatient hospitalizations significantly increased from 2011 to 2017. This could have a substantial financial impact with increasing healthcare costs and utilization. AH-mortality remained the same.


A taste aversion model of drug discrimination learning: training drug and condition influence rate of learning, sensitivity and drug specificity.
A model of drug discrimination based on a lithium chloride (LiCl) flavour aversion was described and examined. Mildly thirsty rats were presented daily with 4 ml of a distinctly flavoured solution which was followed on 50% of the days by an IP injection of LiCl. Prior to the flavour presentation, the rats were injection SC with saline or a training drug (0.04 mg/kg fentanyl or 20 mg/kg pentobarbital) to signal whether LiCl would follow. Almost all rats eventually exhibited stable behaviour that involved drinking most or all of the fluid when it was not to be followed by LiCl and little or no drinking when it was. Such discrimination occurred regardless of whether drug predicted LiCl (learned-discomfort) or predicted no LiCl (learned-safety). However, with fentanyl there were clear differences between rats trained with drug under learned-safety and under learned-discomfort conditions for 1) the rate of acquisition of stable performance as a function of LiCl dose, 2) generalization of the training dose to a test dose that was lower, and 3) elicitation of fentanyl responses by pentobarbital. These findings, together with indications that such effects did not always occur with pentobarbital as the training drug, were discussed from theoretical and practical perspectives.


Association of epicardial fat thickness with left ventricular diastolic function parameters in a community population.
We examined the relationship between epicardial fat thickness (EFT) measured by echocardiography and left ventricular diastolic function parameters in a Beijing community population. We included 1004 participants in this study. Echocardiographic parameters including E and A peak velocity, the early diastolic velocities (e') of the septal and lateral mitral annulus using tissue doppler imaging, E/e', and EFT were measured. EFT1 was measured perpendicularly on the right ventricular free wall at end diastole in the extension line of the aortic root. EFT2 was the maximum thickness measured perpendicularly on the right ventricular free wall at end diastole. Multivariable linear regression was used to analyze the relationship between EFT and the mean e' and E/e'. The mean age of the participants was 63.91 ± 9.02 years, and 51.4% were men. EFT1 and EFT2 were negatively correlated with lateral e', septal e', and mean e' (p < 0.05), and the correlation coefficient for EFT1 and EFT2 and mean e' was - 0.138 and - 0.180, respectively. EFT1 and EFT2 were positively correlated with lateral E/e', septal E/e', and mean E/e' (p < 0.05), and the correlation coefficient for EFT1 and EFT2 and mean e' was 0.100 and 0.090, respectively. Multivariable egression analysis showed that EFT2 was independently and negatively associated with e' mean (β = - 0.078 [95% confidence interval = - 0.143, - 0.012, p = 0.020]). There were no interactions between EFT2 and any covariates, including age or heart groups, sex, BMI, or presence of hypertension, diabetes, or coronary heart disease, in relation to left ventricular diastolic dysfunction. EFT2 was negatively and independently associated with e' mean, which suggests that more attention to this type of adipose fat is required for cardiovascular disease therapy.


Hospitalizations for COVID-19 in Poland: a study based on data from a national hospital register.
INTRODUCTION COVID‑19 has been identified by the World Health Organization as a pandemic. Poland introduced extensive antiepidemic measures relatively early in order to slow down the spread of the disease. OBJECTIVES The study aims to present recent data on COVID‑19 hospitalizations during the first months of the disease outbreak in Poland. PATIENTS AND METHODS This is a retrospective, population‑based study conducted using hospital discharge records that included a diagnosis of COVID-19. Data were obtained from the National Institute of Public Health, where they had been originally collected for a Polish hospital morbidity study. They included 8840 hospitalization records from the period between February and September 2020. RESULTS Overall, there were 8252 records of patients hospitalized for COVID‑19 for the first time, which accounted for 93% of all hospitalizations. The study group consisted of 4161 men (50.4%) and 4091 women (49.6%). Significantly more patients from urban than rural areas were hospitalized (21.8 per 100 000 vs 20.5 per 100 000; P <0.02). In the period subject to analysis, 1073 in‑hospital deaths were observed (13% of all patients), 965 of which occurred during first‑time hospitalizations (11.7% of all patients). In the study group, patients who died during hospitalization compared with those who survived hospitalization were significantly older, more frequently lived in urban areas, and had more comorbidities. CONCLUSIONS The findings of our study, especially the differences between survivors and nonsurvivors with COVID-19, may be helpful in recognizing patients requiring special medical care and preventive measures during hospitalization.


Recognition and Management of Severe Cutaneous Adverse Drug Reactions (Including Drug Reaction with Eosinophilia and Systemic Symptoms, Stevens-Johnson Syndrome, and Toxic Epidermal Necrolysis).
Severe cutaneous adverse reactions to medications (SCARs) include drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, toxic epidermal necrolysis, and acute generalized exanthematous pustulosis. They are all non-immunoglobulin E mediated hypersensitivity reaction patterns, distinguished from simple cutaneous drug eruptions by immunologic pathogenesis and internal organ involvement. Herein the clinical features, diagnostic workup, and management considerations are presented for each of these major SCARs.


Low-Energy-Consumption and Electret-Free Photosynaptic Transistor Utilizing Poly(3-hexylthiophene)-Based Conjugated Block Copolymers.
Neuromorphic computation possesses the advantages of self-learning, highly parallel computation, and low energy consumption, and is of great promise to overcome the bottleneck of von Neumann computation. In this work, a series of poly(3-hexylthiophene) (P3HT)-based block copolymers (BCPs) with different coil segments, including polystyrene, poly(2-vinylpyridine) (P2VP), poly(2-vinylnaphthalene), and poly(butyl acrylate), are utilized in photosynaptic transistor to emulate paired-pulse facilitation, spike time/rate-dependent plasticity, short/long-term neuroplasticity, and learning-forgetting-relearning processes. P3HT serves as a carrier transport channel and a photogate, while the insulating coils with electrophilic groups are for charge trapping and preservation. Three main factors are unveiled to govern the properties of these P3HT-based BCPs: i) rigidity of the insulating coil, ii) energy levels between the constituent polymers, and iii) electrophilicity of the insulating coil. Accordingly, P3HT-b-P2VP-based photosynaptic transistor with a sought-after BCP combination demonstrates long-term memory behavior with current contrast up to 105 , short-term memory behavior with high paired-pulse facilitation ratio of 1.38, and an ultralow energy consumption of 0.56 fJ at an operating voltage of -0.0003 V. As far as it is known, this is the first work to utilize conjugated BCPs in an electret-free photosynaptic transistor showing great potential to the artificial intelligence technology.


Pediatric Point-of-Care Lung Ultrasonography: A Narrative Review.
Point-of-care lung ultrasonography is an evidence-based application that may play a vital role in the care of critically ill pediatric patients. Lung ultrasonography has the advantage of being available at the patient's bedside with results superior to chest radiography and comparable to chest computed tomography for most lung pathologies. It has a steep learning curve. It can be readily performed in both advanced healthcare systems and resource-scarce settings. The purpose of this review is to discuss the basic principles of lung ultrasonography and its applications in the evaluation and treatment of critically ill pediatric patients.


Systematic Review of Transradial Access for Flow Diversion of Intracranial Aneurysms.
Transradial access is an increasingly popular route for cerebral angiography and neurointerventions. However, obstacles to wider adoption remain, especially for complex interventions typically performed with larger, multiaxial systems such as flow diversion. We sought to analyze the published evidence for transradial flow diversion of intracranial aneurysms. Using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, a literature review was performed to identify all published reports and studies of transradial flow diversion for intracranial aneurysm. The search was limited from April 2011 to February 2021. Primary outcome was successful completion of the procedure via a transradial approach. Heterogeneity was analyzed with Q and I2 statistics. Secondary outcomes were transradial access-site complications and other complications. In total, 11 studies involving 290 treated aneurysms were identified; 90.7% of the procedures were completed via the transradial approach. The heterogeneity between studies was high, with an I2 of 56.9%. There were no transradial access-site complications. The procedural complication rate was 2.41%. Transradial access has a high success rate for both anterior and posterior circulation flow-diversion embolizations. The success rate may be particularly high for posterior circulation and right anterior circulation aneurysms. It has a negligible access-site complication rate. Transradial access is a viable alternative to transfemoral access for flow diversion and should be considered as a first-line approach.


Pyoderma gangrenosum after hip hemiarthroplasty; a case report.
Pyoderma gangrenosum is a severe and rare neutrophilic disorder that can present as a complication following any kind of surgery, usually after breast and abdominal surgery. This condition mimics infection, delaying prompt diagnosis and appropriate treatment with high dose of corticosteroids. We describe a case of pyoderma gangrenosum after hip hemiarthroplasty, in an 86-year-old woman, who sustained a neck of femur fracture after a simple fall. The patient was diagnosed 2 weeks postoperatively with pyoderma gangrenosum through a biopsy with clinical manifestations from other systems such as seizures and atrial fibrillation.


Impact of functional support on health-related quality of life in patients with colorectal cancer.
It has been shown that social integration and the availability of social support influence quality of life. However, little is known about the relation between social support and mental and physical health in patients with colorectal cancer. In the current study, the authors examined the effects of social network size, as well as emotional and instrumental support, on health-related quality of life (HRQOL) in patients with colorectal cancer. Six hundred thirty-six veterans with colorectal cancer were asked to complete a telephone interview, which included a measure of social support (the Berkman-Syme Index) and the Medical Outcomes Study Short Form 12-Item Survey. Mean physical composite scale (PCS) and mental composite scale (MCS) scores were compared across groups. No difference in mean PCS or MCS scores was found between patients who had larger social networks and patients who had smaller social networks. The availability of emotional and instrumental support was associated with higher MCS scores, whereas the availability of instrumental support was associated with lower PCS scores. Irrespective of network size, the availability of emotional support and instrumental support had an impact on HRQOL in patients with colorectal cancer. More emphasis needs to be placed on understanding how various types of social support, individually and collectively, influence physical and mental health in patients with colorectal cancer.


Lipid management in patients with vascular disease.
Cardiovascular disease is the leading cause of disability and death in the United States. Although the role of lipids in the atherosclerotic process is well established, the management of dyslipidemia is often suboptimal. The National Cholesterol Education Program and its Adult Treatment Panel III have established treatment guidelines for dyslipidemia. This article will define the problem of dyslipidemia in vascular patients and discuss the recommendations of the National Cholesterol Education Program and Adult Treatment Panel III and the implications for health care personnel.


An analysis of the results of Dwyer and Zielke instrumentations in the treatment of scoliosis.
From 1974 to the end of 1985, 76 operations for correction of scoliosis by the anterior approach using the techniques of Dwyer and Zielke were carried out. This review reports the results of follow-up examination of 55 patients. Differences concerning etiology of curvatures and age of patients are considerable. Twelve patients underwent operation with the Dwyer instrumentation; in the remaining 43 patients the Zielke instrumentation (VDS) was used. Complications were rare and could be managed easily. In the Dwyer group an average correction of 78% could be obtained; the results obtained with the VDS instrumentation were slightly better, with 87% correction of curvatures. With reference to pelvic obliquity, both methods produced similarly good results of 70% and 73% respectively. As for stability, the VDS system is superior to the Dwyer technique; it also offers the possibility of derotation and better lordosis.


Characterization, chromosomal localization, and genetic variation of the porcine heart fatty acid-binding protein gene.
The purpose of this study was to detect genetic variation in the porcine H-FABP gene, a candidate gene for meat quality traits in pigs. Lambda phages containing the porcine H-FABP gene were isolated by plaque hybridization with human H-FABP cDNA. The coding and flanking intronic sequences of the porcine H-FABP gene were determined as well as 1.6 kb of the 5' upstream region. The various potential regulatory sequences in this region are in accordance with the function and expression of the protein in muscle and mammary tissue. Furthermore, comparison with the homolog region of the mouse identified a highly conserved 13-bp element (CTTCCT [A/C] TTTCGG) that may be involved in regulation of expression. The porcine H-FABP gene was localized on Chromosome (Chr) 6 by porcine sequence-specific PCR on DNA from a pig/rodent cell hybrid panel. In addition, part of the H-FABP gene was screened for genetic variation by PCR-RFLP analysis. Three PCR-RFLPs were detected, one in the upstream region (HinfI) and two in the second intron (HaeIII and MspI). In most pig breeds the corresponding alleles have a variable distribution, possibly a consequence of selective breeding. This genetic variation will enable us to investigate the role of the H-FABP locus in porcine production and meat quality traits.


Flexible electrochemical uric acid and glucose biosensor.
Fully integrated uric acid (UA) and glucose biosensors were fabricated on polydimethylsiloxane/polyimide platform by facile one step laser scribed technique. The laser scribed graphene (LSG) on the thin polyimide film was functionalized using pyrenebutanoic acid, succinimide ester (PBSE) to improve the electrochemical activity of the biosensors. The LSG was further decorated with platinum nanoparticles (PtNPs) to promote the electrocatalytic activity towards the oxidation of UA. Glucose oxidase was immobilized on the PtNPs modified surface for selective detection of glucose. The fabricated biosensors were characterized via scanning electron microscopy (SEM), Energy dispersive X-ray (EDX), X-ray photoelectron spectroscopy (XPS), and electrochemical methods (cyclic voltammetry and amperometry measurements). Outstanding electrocatalytic activities toward oxidation of UA and glucose were demonstrated. A wide detection range of 5 µM to 480 µM UA with a high sensitivity of 156.56 µA/mMcm2 and a calculated detection limit (LOD) of 0.018 μM (S/N = 3) were achieved for the UA biosensor. The glucose biosensor exhibited a detection range of 5 µM to 3200 µM with a sensitivity of 12.64 µA/mMcm2 and an LOD of 2.57 µM (S/N = 3). These integrated biosensors offer great promise for potential applications in wearable UA and glucose sensing due to their good sensitivity, selectivity, and stability properties.


Measurement of synchronous activity by microelectrode arrays uncovers differential effects of sublethal and lethal glutamate concentrations on cortical neurons.
We grew cultures of rat cortical cells on microelectrode arrays to investigate the effects of glutamate-mediated neurotoxicity as a model of traumatic brain injury. Treatment with two different concentrations of glutamate, 175 and 250 μM, led to different outcomes. Cultures treated with 250 μM glutamate suffered a loss in overall activity that was not seen in cultures treated with 175 μM glutamate. An analysis of the changes in the synchronization of action potential firing between electrodes, however, revealed a loss of synchronization in subsets of electrode pairs treated with both the higher and lower concentrations of glutamate. We found that this loss of action potential synchronization was dependent on the initial amount of synchronization prior to injury. Finally, our data suggest that the synchronization of electrical activity as well as the susceptibility to loss of firing synchrony is independent of the distance between neurons in a network.