[Symptomatic atrial fibrillation revealing chronic constrictive pericarditis in a young patient: A case report with a review of the literature].
Chronic Constrictive pericarditis (CCP) is a rare clinical entity that can pose diagnostic problems. Constrictive pericarditis is the final stage of a chronic inflammatory process characterized by fibrous thickening and calcification of the pericardium that impairs diastolic filling, reduces cardiac output, and ultimately leads to right heart failure and to atrial dilatation which can caused supravetricular arrythmia. Transthoracic echocardiography, computed tomography, and cardiac magnetic resonance imaging each can reveal severe diastolic dysfunction, increased pericardial thickness and calcifications. The gold standard for diagnosis is cardiac catheterization with analysis of intracavitary pressure curves, which are high and, in end diastole, equal in all chambers. CCP is the commun cause of recurrent heart failure. At present, idiopathic or viral pericarditis is the predominant cause of CP in the Western world, followed by postcardiotomy irritation and mediastinal irradiation. Tuberculosis is still a cause of pericarditis in developing countries and in immunosuppressed patient. We present a patient with symptomatic atrial fibrillation revealing chronic constrictive pericardis. He underwent to drug cardioversion before radical pericardiectomy and to date has made a good recovery without palpitations with a sinus rythm. The diagnosis of CP is often neglected by physicians, who usually attribute the symptoms to another disease process. This case show the difficulty in diagnosing, illustrated as well as the role of multimodality imaging and the excellent outcome of pericardiectomy for total recovery.


Adrenocortical function after chronic inhalation of fluocortinbutyl and beclomethasone dipropionate.
Fluocortinbutyl (FCB) is a C-21 ester, topically active corticosteroid; no adrenal suppression has been noted after large doses. We compared safety and effects on adrenocortical function of orally inhaled FCB (40 mg/day), beclomethasone dipropionate (BDP) (2 mg/day), and placebo administered in four monitored divided doses for 4 wk by three groups of five healthy men. Circadian plasma cortisol concentration and daily urinary free cortisol excretion were determined before and after 3- and 4-wk exposure. Although pretreatment mean area under the curve (micrograms . hr . dl-1) for plasma cortisol did not differ among groups, mean values after weeks 3 and 4 of treatment were lower (p less than 0.05) in the BDP group (95.1 and 83) than in the FCB (155.8 and 153.7) and placebo (141 and 135.8) groups. Mean urinary cortisol excretion after week 4 for the BDP group (29 micrograms) was less (p less than 0.05) than in the FCB (59 micrograms) and the placebo (69 micrograms) groups. Slopes of individual regression lines noting time trends in plasma and urinary cortisol in the BDP group were negative and less (p less than 0.05) than those of the other groups. A cosyntropin test given intravenously after 4 wk of exposure resulted in similar plasma cortisol responses among groups. No serious adverse effects were noted. Thus after long-term high-dose treatment BDP but not FCB suppressed basal adrenocortical function, but neither suppressed the adrenocortical response to cosyntropin.


Co0 -Coδ+ Interface Double-Site-Mediated C-C Coupling for the Photothermal Conversion of CO2 into Light Olefins.
Solar-driven CO2 hydrogenation into multi-carbon products is a highly desirable, but challenging reaction. The bottleneck of this reaction lies in the C-C coupling of C1 intermediates. Herein, we construct the C-C coupling centre for C1 intermediates via the in situ formation of Co0 -Coδ+ interface double sites on MgAl2 O4 (Co-CoOx /MAO). Our experimental and theoretical prediction results confirmed the effective adsorption and activation of CO2 by the Co0 site to produce C1 intermediates, while the introduction of the electron-deficient state of Coδ+ can effectively reduce the energy barrier of the key CHCH* intermediates. Consequently, Co-CoOx /MAO exhibited a high C2-4 hydrocarbons production rate of 1303 μmol g-1 h-1 ; the total organic carbon selectivity of C2-4 hydrocarbons is 62.5 % under light irradiation with a high ratio (≈11) of olefin to paraffin. This study provides a new approach toward the design of photocatalysts used for CO2 conversion into C2+ products.


A double-blind trial of disopyramide, procaineamide and digoxin in paroxysmal suptraventricular tachycardia.
A double-blind cross-over study has been performed in 10 patients with an established diagnosis of paroxysmal suptraventricular tachycardia to compare the effectiveness of three active agents with placebo. The drugs were administered in random sequence for two-week periods with three-day washout intervals and in standard dose regimes as recommended for prophylaxis by authoritative works on the subject. The results suggest that digoxin is ineffective at the recommended dosage. Procaineamide was effective in controlling some arrhythmias, but disopyramide was the most effective agent studied. All these patients showed a mixture of arrhythmias, and also had a lot of ectopic activity. Arrhythmic activity is erratic and unpredictable, and a larger number of patients would need to be studied for long periods of time to obtain enough data for valid statistical assessment.


Effect of N-phenyl substituent on thermal, optical, electrochemical and luminescence properties of 3-aminophthalimide derivatives.
The seven N-phthalimide derivatives substituted with the amine group at the 3-C position in the phenylene ring were synthesized. The effect of N-substituent chemical structure was investigated. The thermal, electrochemical and optical studies were performed and supported by the density functional theory calculations (DFT). The electrochemical investigations of the synthesized low-molecular phthalimides revealed the one oxidation and reduction process with the HOMO energy level under - 5.81 eV and energy-band gap below 3 eV. The N-phthalimide derivatives were emitted light in a blue spectral region in solutions (in polar and non-polar) with the quantum yield between 2 and 68%, dependent on the substituent at the nitrogen atom, solvent and concentration. The N-phthalimide derivatives were emissive also in a solid state as a thin film and powder. They were tested as a component of the active layer with PVK:PBD matrix and as an independent active layer in the organic light-emitting diodes. The registered electroluminescence spectra exhibited the maximum emission band in the 469-505 nm range, confirming the possibility of using N-phthalimides with PVK:PBD matrix as the blue emitters.


Declining trends in the provision of prenatal care visits by family physicians.
We wanted to measure trends in the proportion of prenatal visits provided by family physicians nationally for a 10-year period and determine characteristics of prenatal visits made to family physicians compared with visits made to obstetricians. We analyzed the National Ambulatory Medical Care Survey to identify prenatal visits made to family physicians and obstetricians between 1995 and 2004. The primary outcome measure was the trend in proportion of prenatal visits seen by family physicians. Multivariate logistic regression analysis determined characteristics of a prenatal visit occurring with a family physician vs an obstetrician. A total of 6,203 records were included in the study, representing 244 million prenatal visits. The percentage of prenatal visits provided by family physicians decreased from 11.6% in 1995-1996 to 6.1% in 2003-2004 (P=.02 for trend). In non-metropolitan statistical areas, family physicians decreased their provision of prenatal visits from 38.6% in 1995-1996 to 12.9% in 2003-2004 (P=.03 for trend). Prenatal visits made to family physicians were associated with location in a non-metropolitan statistical area (OR = 5.56; 95% CI, 3.23-9.62), Medicaid insurance (OR = 1.76; 95% CI, 1.10-2.82), and younger maternal age (aged 30 years and older vs aged less than 24 years: OR = 0.63; 95% CI, 0.41-0.95). Family physicians reduced their provision of prenatal visits by nearly 50% during a 10-year period and at an even greater rate in rural, non-metropolitan statistical areas. These findings should be considered as family medicine considers the role of maternity care and strives to provide accessible prenatal services for all.


"You Helped Create This, Help Me Now": A Qualitative Analysis of Patients' Concerns about Breast Implants and a Proposed Strategy for Moving Forward.
Some women with breast implants express concern about the safety of implants, fearing the possibility of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and breast implant-related illness. A qualitative analysis was performed to examine the perceived challenges, barriers, and worries experienced by these women. Convenience sampling was used to elicit responses from members of Canadian BIA-ALCL Facebook advocacy groups. Three independent coders read and reread the transcripts, using thematic analysis to identify emerging themes. Sixty-four women answered questions posed by the president of the Canadian Society of Plastic Surgeons regarding concerns about their breast implants. Five themes were identified: informing, listening, acknowledging, clarifying, and moving forward. Patients desire improved communication about possible risks before implantation and as new information becomes available (informing), sincere listening to their concerns (listening), acknowledgement that these disease entities may be real and have psychosocial/physical impact on patients (acknowledging), clarification of implant-related problems and their treatment (clarifying), and improved processes for monitoring and treatment of patients with identified problems (moving forward). Consideration of these themes in the context of the five domains of trust theory (i.e., fidelity, competence, honesty, confidentiality, and global trust) suggests significant breakdown in the doctor-patient relationship for a subset of concerned women. Concerns related to BIA-ALCL and breast implant-related illnesses have undermined some women's trust in plastic surgeons. Consideration of these five themes and their impact on the five domains of trust can guide strategies for reestablishing patients' trust in the plastic surgery community.


Location and dynamics of tryptophan in transmembrane alpha-helix peptides: a fluorescence and circular dichroism study.
Amphiphilic and hydrophobic peptides play a key role in many biological processes. We have developed a reference system for evaluating the insertion of such peptides bearing Trp fluorescent reporter groups into membrane mimetic systems. This system involves a set of six 25-amino acid synthetic peptides that are models of transmembrane alpha-helices. They are Lys-flanked polyLeu sequences, each containing a single Trp residue at a different position (P i, with i=3, 5, 7, 9, 11 and 13). These peptides were inserted into micelles of a non-ionic detergent, dodecylmaltoside (DM). We analyzed this system by use of circular dichroism and steady-state and time-resolved fluorescence in combination with Trp quenching with two brominated DM analogs. We found significant variations in the Trp emission maximum according to its position in each peptide (from 327 to 313 nm). This is consistent with the radial insertion of the peptides within DM micelles. We observed characteristic patterns of fluorescence quenching of these peptides in mixed micelles of DM, with either 7,8-dibromododecylmaltoside (BrDM) or 10,11-dibromoundecanoylmaltoside (BrUM), that reflect differences in the accessibility of the Trp residue to the bromine atoms located on the detergent acyl chain. In the isotropic reference solvent, methanol, the alpha-helix content was high and identical (approximately 76%) for all peptides. In DM micelles, the alpha-helix content for P9 to P13 was similar to that in methanol, but slightly lower for P3 to P7. The fluorescence intensity decays were heterogeneous and depended upon the position of the Trp. The Trp dynamics of each peptide are described by sub-nanosecond and nanosecond rotational motions that were significantly lower than those observed in methanol. These results, which precisely describe structural, dynamic and microenvironment parameters of peptide Trp in micelles according to its depth, should be useful for describing the interactions of peptides of biological interest with micelles.


Are there any psychological factors in male patients with primary spontaneous pneumothorax?
Primary spontaneous pneumothorax (PSP) is usually seen in young male smokers. Pathophysiology of PSP remains unclear, and studies concerning emotional status are scarce. The aim of this study is to investigate psychological factors associated with primary spontaneous pneumothorax. The Beck Depression Inventory, Beck Anxiety Inventory, State-Trait Anger Expression Inventory, and State-Trait Anxiety Inventory were administered. A total of 40 patients and 40 healthy controls were included in this study. The mean age in the patient group was 24.60 years, while that in the control group was 26.45 years. The difference was not significant. The weight and body mass index of the patient group were significantly lower compared to those of the control group. The mean Beck Anxiety Inventory scores in the patient and control groups were 10.37 ± 11.34 and 8.25 ± 10.60, respectively. Anxiety levels did not differ between the groups (p = 0.389). The mean Beck Depression Inventory scores of the patient and control groups were 8.20 ± 8.37 and 6.80 ± 7.57, respectively, but the difference was not significant (p = 0.435). When the anger structures of the groups were compared, no difference was found in any sub-scale. Trait anxiety scores were higher in the patient group compared to those in the control group, but the difference was not significant (p = 0.369). This study's findings indicated that anger, anxiety, and depression levels did not differ between the primary spontaneous pneumothorax and healthy groups.


Primary pulmonary amebic abscess in a patient with pulmonary adenocarcinoma: a case report.
Primary pulmonary amoeba is very rare and here we report a case of a 68-year-old man presenting with primary pulmonary amoeba after undergoing chemotherapy for lung adenocarcinoma. In October 2016, the man aged 68 was admitted to our hospital because of repeated cough for 8 months and hemoptysis for 1 month. He was diagnosed lung adenocarcinoma and underwent surgery in 2012 without receiving chemotherapy. In March 2016, the patients suffered recurrence of cancer and was treated with chemotherapy. After 2 months of chemotherapy, the patient had consistent cough with white sputum, and chest CT showed a local lung nodule. The physicians suspected that the patient had pulmonary infectious diseases, and he was treated with empirical antibacterial treatment. However, his symptom wasn't relieved and later the percutaneous lung biopsy found trophozites of Entamoeba histolytica. After administration of metronidazole, the symptoms of the patient were markedly relieved and the lesions were absorbed. In such cases where patients with pulmonary nodules were in immunodeficiency state and had adequate but ineffective anti-bacterial treatment, Entamoeba histolytica infection could be one of the rare causes. Percutaneous lung biopsy should be recommended and specific dying for parasites should be done when necessary.


De novo design of 7-aminocoumarin derivatives as novel falcipain-3 inhibitors.
The availability of the crystal structure of falcipain-3, knowledge of the peptides carrying the 7-aminocoumarin moiety as falcipain-3 ligands/substrates, and a need for new antimalarial agents stimulated us to look at the possibility of finding some novel falcipain-3 inhibitors. In this paper, we report the effect of substitution at the 7-amino position of the coumarin nucleus on the inhibition of falcipain-3, which is a well-validated antimalarial target. The de novo drug design was assisted by QSAR studies that shed light on the binding patterns of known and the newly designed inhibitors, thus taking this discovery process to the next level.


Transoral robotic surgery hypopharyngectomy (TORSH): feasibility and outcomes.
With the development of minimal invasive procedure, trans-oral robotic surgery (TORS) is expanding in the field of ENT. Most reviews focus on oropharyngeal and laryngeal (supra-glottic) localization. We report here the feasibility and outcomes of TORS hypopharyngectomy (TORSH) for selected patients with hypopharyngeal tumor. Between September 2009 and July 2017, 22 patients, retrospectively included, underwent TORSH with curative intent. From 22 successful hypopharyngectomy, no conversion to open procedure was needed. Three patients (13%) presented a post-operative bleeding and were managed by surgical revision. No fistula was encountered. The 3-year overall survival and disease-specific survival rates were 54 and 92%, respectively. Patients started oral feeding after an average of 7 days. Naso-gastric feeding tubes were removed after a median period of 16 days. Two patients (9%) needed a transient gastrostomy (< 1 year). Three patients (13%) received a transient tracheostomy (< 2 months). Median hospitalization stay was 13 days. TORSH is a safe technique. Patients' outcomes are favorable and the post-operative morbidity is reduced compared to open neck approach. Hospitalization length and safe swallowing time are reduced.


Exposure to heavy metal-contaminated sediments disrupts gene expression, lipid profile, and life history traits in the midge Chironomus riparius.
Despite the concern about anthropogenic heavy metal accumulation, there remain few multi-level ecotoxicological studies to evaluate their effects in fluvial ecosystems. The toxicity of field-collected sediments exhibiting a gradient of heavy metal contamination (Cd, Pb, and Zn) was assessed in Chironomus riparius. For this purpose, larvae were exposed throughout their entire life cycle to these sediments, and toxic effects were measured at different levels of biological organization, from the molecular (lipidomic analysis and transcriptional profile) to the whole organism response (respiration rate, shape markers, and emergence rate). Alterations in the activity of relevant genes, as well as an increase of storage lipids and decrease in membrane fluidity, were detected in larvae exposed to the most contaminated sediments. Moreover, reduced larval and adult mass, decrease of larval respiration rate, and delayed emergence were observed, along with increased mentum and mandible size in larvae and decreased wing loading in adults. This study points out the deleterious effects of heavy metal exposure at various levels of biological organization and provides some clues regarding the mode of toxic action. This integrative approach provides new insights into the multi-level effects on aquatic insects exposed to heavy metal mixtures in field sediments, providing useful tools for ecological risk assessment in freshwater ecosystems.


Summary and conclusions from the SIWI Young Professionals Workshop--the possibilities and threats of globalisation!
The Young Water Professionals Symposium discussed the nature of globalisation as it affects water and water professionals. Globalisation processes can either encourage or cure the problems of scarcity and marginalisation. Different levels of development and rates of progress reinforce the need for diverse thinking to tackle these local variations within the global context. A significant aspect is a change in roles and responsibilities for the water professional - to be less confined to the purely technical and more cooperative across traditional boundaries. To enable water professionals to fulfil these new roles education must be transformed and intellectual barriers overcome. In this way globalisation processes can be made to work for water security for the new century.


Determination of Lead in Water Samples by GFAAS after Collection on Montmorillonite with Slurry Introduction.
In this study, a highly accurate, fast and practical separation/enrichment technique is described to determine the Pb in tap water samples by graphite furnace atomic absorption spectrometry. For this purpose, at first, Pb was collected on montmorillonite by batch technique, the supernatant was decanted and the solid phase was slurried in a mixture of 0.1% Triton X-114 and 0.1 mol L-1 HNO3 then directly introduced into graphite furnace without elution. Since the elution step was not applied, the method was simpler and faster compared to conventional techniques. The risks of elution step on the precision and recovery were eliminated. Up to 50-fold enrichment could be obtained by this method. The limit of detection (3δ, N = 10) and characteristic concentration of the method for Pb were 0.46 and 1.13 μg L-1, respectively. In addition, the Pb in water samples (tap and river) collected from different regions of Turkey were determined.


Alginates as food ingredients absorb extra salt in sodium chloride-treated mice.
Many patients with impaired renal function undergoing dialysis are subject to severe dietary restrictions. Especially overdose of salt is related to crisis of their life, so their meals are basically salt-free or low salt. Therefore, their quality of life is declined due to their yearning for salty taste. In the present study, we searched new salt-adsorbing food materials in dietary fibers to develop food ingredients preventing salt-sensitive hypertension and kidney dysfunction. As a result, calcium alginate and ammonium alginate possessed sodium-binding capacity without releasing potassium which causes a problem in chronic kidney injury. Furthermore, the administration of those fibers inhibited blood NaCl concentration and induced NaCl excretion in mice model. Therefore, calcium alginate and ammonium alginate are new candidate materials as salt-adsorbing materials, thus indicating that the health foods and/or health supplements containing those fibers may be a potentially new tool for prevention of salt-sensitive hypertension and kidney dysfunction.


Reduced caloric intake allows access-induced consumption differences to emerge with concentrated sucrose solutions.
Rats given intermittent access to 4% (w/v) sucrose solution elevate their consumption of solution relative to rats with continuous access, a difference that does not appear at higher concentrations. Here, we examined the hypothesis that a limit on the intake of sucrose calories prevents rats from demonstrating access-induced differences in consumption of a more concentrated sucrose solution. Energy-replete rats were given every day (ED) or every third day (E3D) access to sucrose solutions adulterated with bitter quinine which reduced solution palatability and consumption levels while intake was measured. In experiment 1, previously collected data were compiled to examine the trajectory of consumption of continuously available 4% sucrose solution which was shown to stabilize by day 3 and then informed group assignment. In experiment 2, daily consumption levels were higher for rats with E3D access to 4% sucrose solution than rats with ED access to the same solution, whereas rats consumed similar amounts of 8% sucrose solution across access schedules. In the first hour of solution availability rats with E3D access showed elevated sucrose solution consumption, relative to rats with ED access, for both 4% and 8% sucrose solution. Upon the addition of quinine (0.005%) sucrose solution consumption decreased and the E3D access group consumed more daily sucrose solution than the ED access group for both 4% and 8% sucrose solution. In experiment 3, four groups of rats were given ED or E3D access to 8% sucrose solution adulterated with 0.0025%, 0.005%, 0.01%, or 0.02% quinine. Quinine adulteration reduced 8% sucrose solution consumption and allowed rats with E3D access to elevate their consumption levels relative to rats with ED access; this effect persisted when all groups were switched to 8% sucrose + 0.02% quinine solution. Thus, daily access-induced consumption differences develop but do not emerge because of a caloric limit on sucrose solution intake. This work underscores the interaction of availability and caloric intake as determinants of sugar consumption and highlights an important distinction between animal models of food addiction and binge eating.


The effect of oophorectomy on the ribonucleic acid metabolism of a transplantable uterine tumour.
1. The incorporation of [(14)C]phenylalanine and of [(3)H]uridine into the Guerin T8 uterine carcinoma has been examined. 2. The addition in vitro of polyuridylic acid caused an increase in the incorporation of labelled phenylalanine into tumour microsomes obtained from both oophorectomized and intact animals. 3. Oophorectomy of tumour-bearing animals decreased the specific activity due to the uptake in vivo of [(3)H]uridine into both the soluble and insoluble RNA of the tumour. 4. Actinomycin D caused a decrease in specific activity of RNA in the tumour in vivo, and puromycin inhibited uptake in vitro into tumour microsomes.


Case of Neonatal Fatality from Neuromuscular Variant of Glycogen Storage Disease Type IV.
Glycogen storage disease type IV (GSD-IV), or Andersen disease, is a rare autosomal recessive disorder that results from the deficiency of glycogen branching enzyme (GBE). This in turn results in accumulation of abnormal glycogen molecules that have longer outer chains and fewer branch points. GSD-IV manifests in a wide spectrum, with variable phenotypes depending on the degree and type of tissues in which this abnormal glycogen accumulates. Typically, GSD-IV presents with rapidly progressive liver cirrhosis and death in early childhood. However, there is a severe congenital neuromuscular variant of GSD-IV that has been reported in the literature, with fewer than 20 patient cases thus far. We report an unusual case of GSD-IV neuromuscular variant in a late preterm female infant who was born to non-consanguineous healthy parents with previously healthy children. Prenatally, our patient was found to have decreased fetal movement and polyhydramnios warranting an early delivery. Postnatally, she had severe hypotonia and respiratory failure, with no hepatic or cardiac involvement. Extensive metabolic and neurological workup revealed no abnormalities. However, molecular analysis by whole-exome sequencing revealed two pathogenic variants in the GBE1 gene. Our patient was thus a compound heterozygote of the two pathogenic variants: one of these was inherited from the mother [p.L490WfsX5 (c.1468delC)], and the other pathogenic variant was a de novo change [p.E449X (c.1245G>T)]. As expected in GSD-IV, diffuse intracytoplasmic periodic acid-Schiff-positive, diastase-resistant inclusions were found in the cardiac myocytes, hepatocytes, and skeletal muscle fibers of our patient.


Cerebrovascular Events After Cardiovascular Procedures: Risk Factors, Recognition, and Prevention Strategies.
Stroke has long been a devastating complication of any cardiovascular procedure that unfavorably affects survival and quality of life. Over time, strategies have been developed to substantially reduce the incidence of stroke after traditional cardiovascular procedures such as coronary artery bypass grafting, isolated valve surgery, and carotid endarterectomy. Subsequently, with the advent of minimally invasive technologies including percutaneous coronary intervention, carotid artery stenting, and transcatheter valve therapies, operators were faced with a new host of procedural risk factors, and efforts again turned toward identifying novel ways to reduce the risk of stroke. Fortunately, by understanding the procedural factors unique to these new techniques and applying many of the lessons learned from prior experiences, we are seeing significant improvements in the safety of these new technologies. In this review, the authors: 1) carefully analyze data from different cardiac procedural experiences ranging from traditional open heart surgery to percutaneous coronary intervention and transcatheter valve therapies; 2) explore the unique risk factors for stroke in each of these areas; and 3) describe how these risks can be mitigated with improved patient selection, adjuvant pharmacotherapy, procedural improvements, and novel technological advancements.


Hepatic venous pressure gradient in sinusoidal obstruction syndrome: diagnostic value and link with histological lesions.
Liver sinusoidal obstruction syndrome (SOS) is a well-established complication of myeloablative conditioning regimens used in hematopoietic stem cell transplantation. Hepatic venous pressure gradient (HVPG) >10 mmHg was described as an accurate diagnostic tool for SOS in the 1990s. However, epidemiology and presentation of SOS have dramatically changed. Moreover, elementary histological lesions influencing HVPG are unknown. We retrospectively analyzed the charts of all patients who underwent transjugular liver biopsy with HVPG measurement for a clinical suspicion of SOS at our center. Two expert pathologists unaware of the presence or absence of SOS reviewed all liver samples and graded elementary histological lesions according to a semi-quantitative scoring defined a priori. Out of the 77 included patients, the 30 patients with SOS had higher HVPG than the 47 patients without SOS (median 14 mmHg [IQR 10-18], vs. 6 mmHg [3-9], respectively p <0.001). HVPG >10 mmHg had a specificity of 78% and a positive predictive value of 66% for the diagnosis of SOS. However, almost 40% of the patients with SOS had an HVPG ≤10 mmHg. HVPG correlated with sinusoidal congestion (r = 0.57; p = 0.001) and hepatocyte necrosis (r = 0.42; p = 0.02), but not with other lesions. Even though HVPG is higher in patients with SOS, low HVPG values do not rule out SOS. Thus, HVPG cannot be used alone, and should be combined with transjugular liver biopsy, for the diagnosis of SOS. Hepatic venous pressure gradient >10 mmHg has been described as an accurate tool for the diagnosis of liver sinusoidal obstruction syndrome after hematopoietic stem cell transplantation. This study shows that the sensitivity and specificity of hepatic venous pressure gradient measurement for sinusoidal obstruction syndrome are insufficient, so that liver pressure measurement should be combined with a liver biopsy in this setting.


NaAlTi3O8, A Novel Anode Material for Sodium Ion Battery.
Sodium ion batteries are being considered as an alternative to lithium ion batteries in large-scale energy storage applications owing to the low cost. A novel titanate compound, NaAlTi3O8, was successfully synthesized and tested as a promising anode material for sodium ion batteries. Powder X-ray Diffraction (XRD) and refinement were used to analyze the crystal structure. Electrochemical cycling tests under a C/10 rate between 0.01 - 2.5 V showed that ~83 mAh/g capacity could be achieved in the second cycle, with ~75% of which retained after 100 cycles, which corresponds to 0.75 Na+ insertion and extraction. The influence of synthesis conditions on electrochemical performances was investigated and discussed. NaAlTi3O8 not only presents a new anode material with low average voltage of ~0.5 V, but also provides a new type of intercalation anode with a crystal structure that differentiates from the anodes that have been reported.


Critical view on RNA silencing-mediated virus resistance using exogenously applied RNA.
In almost all eukaryotes, RNA interference (RNAi) is a natural defence mechanism against foreign nucleic acids, including transposons and viruses. It is generally triggered by long double stranded RNA molecules (dsRNA, >50bp) that are processed into small interfering RNAs (siRNAs). RNAi can be artificially activated by the expression of RNAi triggers through viruses (virus-induced gene silencing, VIGS) and transgenes. Moreover, for almost 10 years, exogenous RNA application methods are developed as tools to induce RNAi in plants. In this review, exogenous RNA application techniques having the potential to activate RNAi with a focus on RNAi-mediated virus resistance will be discussed. Limitations of exogenous RNA applications, targeting of virus vectors and open questions related to mechanistic details that still require further investigation will be pointed out.


Development of PUFF-Gaussian dispersion model for the prediction of atmospheric distribution of particle concentration.
Mt. Baekdu's eruption precursors are continuously observed and have become a global social issue. Volcanic activities in neighboring Japan are also active. There are no direct risks of proximity-related disasters in South Korea from the volcanic eruptions at Japan or Mt. Baekdu; however, severe impacts are expected from the spread of volcanic ash. Numerical analysis models are generally used to predict and analyze the diffusion of volcanic ash, and each numerical analysis model has its own limitations caused by the computational algorithm it employs. In this study, we analyzed the PUFF-UAF model, an ash dispersion model based on the Lagrangian approach, and observed that the number of particles used in tracking substantially affected the results. Even with the presence of millions of particles, the concentration of ash predicted by the PUFF-UAF model does not accurately represent the dispersion. To overcome this deficit and utilize the computational efficiency of the Lagrangian model, we developed a PUFF-Gaussian model to consider the dispersive nature of ash by applying the Gaussian dispersion theory to the results of the PUFF-UAF model. The results of the proposed method were compared with the field measurements from actual volcanic eruptions, and the comparison showed that the proposed method can produce reasonably accurate predictions for ash dispersion.


[Distribution of genotype and allele frequencies of dopamine D4 receptor gene 48 bp variable number tandem repeat polymorphism in Chinese Han population in Hunan].
To investigate the distribution of genotype and allele frequencies of the dopamine D4 receptor(DRD4) gene exon 3 48 bp variable number of tandem repeats polymorphism in Hunan Han population. The genotype and alleles of 304 healthy persons were examined with polymerase chain reaction, denaturing polyacrylamide gel electrophoresis and silver staining. Seven alleles and twelve genotypes were found. The most common allele was allele 5 with a frequency of 70.6%. There was statistically significant difference in allele distribution between the Hunan Han population and the Han population of other regions such as Shanghai, Beijing and Sichuan in China (P< 0.05). Different allele frequency distributions were observed when compared to other ethnic populations such as Japanese, American, Mexican, and Italian (P< 0.05). The distributions of allele of DRD4 gene exhibit regional and ethnic heterogeneity.


Online Registry of COVID-19-Associated Mucormycosis Cases, India, 2021.
We established an online registry of coronavirus disease-associated mucormycosis cases in India. We analyzed data from 65 cases diagnosed during April-June 2021, when the Delta variant predominated, and found that patients frequently received antibacterial drugs and zinc supplementation. Online registries rapidly provide relevant data for emerging infections.


Consumption of tyrosine in royal jelly increases brain levels of dopamine and tyramine and promotes transition from normal to reproductive workers in queenless honey bee colonies.
Dopamine (DA) and tyramine (TA) have neurohormonal roles in the production of reproductive workers in queenless colonies of honey bees, but the regulation of these biogenic amines in the brain are still largely unclear. Nutrition is an important factor in promoting reproduction and might be involved in the regulation of these biogenic amines in the brain. To test this hypothesis, we examined the effect of oral treatments of tyrosine (Tyr; a common precursor of DA, TA and octopamine, and a component of royal jelly) in queenless workers and quantified the resulting production of biogenic amines. Tyrosine treatments enhanced the levels of DA, TA and their metabolites in the brain. Workers fed royal jelly had significantly larger brain levels of Tyr, DA, TA and the metabolites in the brains compared with those bees fed honey or sucrose (control). Treatment with Tyr also inhibited the behavior of workers outside of the hive and promoted ovarian development. These results suggest that there is a link between nutrition and the regulation of DA and TA in the brain to promote the production of reproductive workers in queenless honey bee colonies.


Adopt Zero Tolerance for Hospital Staff Bullying Nursing Students.
Negative clinical experiences can have a formative influence on aspiring nurses.


Chiari-like displacement due to spontaneous intracranial hypotension in an adolescent: Successful treatment by epidural blood patch.
Spontaneous intracranial hypotension is a rarely diagnosed cause of headache, especially in children and adolescents. It is due to cerebrospinal fluid (CSF) leakage via spinal fistulae occurring without major trauma. An adolescent patient presented with a 3-month history of strictly postural headache. Cranial magnetic resonance imaging (MRI) showed pronounced Chiari-like prolapse of the cerebellar tonsils, narrow ventricles and enlarged cerebral veins. On spinal MRI, myelographic sequences revealed a large collection of CSF around the first sacral roots. CT myelography proved extensive spinal CSF leakage. Hence, we applied epidural patches at multiple levels. Afterwards, symptoms and radiologic findings, including Chiari-like displacement, completely resolved. A Chiari-like descent of the cerebellar tonsils alone does not secure the diagnosis of a Chiari I malformation. Especially if other findings indicate spinal CSF leakage, a systematic work-up should be initiated. In most cases, interventional techniques seal the leak successfully, resulting in a favorable outcome.


Socioeconomic development role in hospitalization related to air pollution and meteorology: A study case in southern Brazil.
Air pollution is one of the foremost environmental threats to human health. However, the meteorological and social factors that lead to respiratory and cardiovascular diseases have not been fully elucidated. In this study, we use Principal Component Analysis and Generalized Linear Model (PCA-GLM) to investigate the combined effect of socioeconomic development and air pollution on cardiorespiratory hospitalization in southern Brazil. This region has the highest rates of hospitalization by cardiorespiratory diseases in the country. We analyze three main sources of data: (i) air pollutants density from TROPOMI/Sentinel-5p satellite; (ii) temperature, humidity, and planetary boundary layer height (PBLH) modeled with the Weather Research Forecast model; and (iii) hospitalization by cardiorespiratory diseases obtained from the Brazilian National Health System. We estimate the Relative Risk (RR) using the PCA-GLM coefficients and interquartile variations of air pollutants density and meteorological parameters. Our results show that the population living in colder and drier municipalities is more prone to cardiorespiratory hospitalization. Regarding respiratory hospitalization, municipalities with lower socioeconomic development are more sensitive to meteorology and pollution variability than highly developed ones. In less developed municipalities, we observe the highest rates of cardiorespiratory hospitalization even if air pollution is low, which we interpret in terms of higher vulnerability. The RR analysis suggests that air pollution is an important environmental risk to cardiovascular diseases and respiratory diseases is more sensitive to air pollution and meteorology than cardiovascular ones. Our findings corroborate the mounting evidence that social vulnerability is a significant factor affecting the increase of cardiorespiratory hospitalization in the world.


Characteristics and Prognostic Factors of Swallowing Dysfunction in Patients with Lateral Medullary Infarction.
Lateral medullary infarction mainly impairs the pharyngeal phase of swallowing. We aimed to investigate the utility of the assessment tools of swallowing function in patients with lateral medullary infarction and to determine the factors that could predict the outcomes of swallowing function. 15 patients with lateral medullary infarction who were admitted to Suiseikai Kajikawa Hospital between August 1, 2016, and March 31, 2020 (age 62.7 ± 14.8 years, 5 women) were enrolled in this prospective study. The diagnosis was made using brain magnetic resonance imaging. We analyzed the factors associated with severe swallowing dysfunction, which was defined as the necessity for tube feeding on the 90th day from admission, with multiple logistic regression analysis. Multivariate analyses identified the repetitive saliva swallowing test, modified water swallowing test, and vertical spread of stroke lesions as independent significant factors affecting severe swallowing dysfunction (p = 0.002, 0.016, and 0.011, respectively). The sub-scores of the pharyngeal phase of the Mann Assessment of Swallowing Ability were also significantly associated with severe swallowing dysfunction (p < 0.001). However, tongue pressure, severe passage pattern abnormality on videofluoroscopic examination, and vertebral artery dissection were not significantly associated with swallowing dysfunction. Since lateral medullary infarction presents with swallowing dysfunction mainly in the pharyngeal phase, tools that can be used to evaluate the pharyngeal phase of swallowing, such as repetitive saliva swallowing test and modified water swallowing test, are moreuseful than tongue pressure measurement.


Osteocartilaginous choristoma of the gingiva.
An interesting example of a gingival cartilaginous choristoma is reported. The term choristoma, because of its histological structure, applies to a tumour-like mass of normal cells in an abnormal location.


Biological control agents: from field to market, problems, and challenges.
Global food security is vulnerable due to massive growth of the human population, changes in global climate, the emergence of novel/more virulent pathogens, and demands from increasingly discerning consumers for chemical-free, sustainably produced food products. Bacterium-based biological control agents (BCAs), if used as part of an integrated management system, may satisfy the above demands. We focus on the advantages, limitations, problems, and challenges involved in such strategies.


The effectiveness of exercise with behavior change techniques in people with knee osteoarthritis: A systematic review with meta-analysis.
The purpose of this systematic review with meta-analysis was to examine the effectiveness of exercise with behavior change techniques (BCTs) on core outcome sets in people with knee osteoarthritis. We searched randomized controlled trials (RCTs) in eight databases (MEDLINE, Embase, CENTRAL, CINAHL, PsycINFO, PEDro, ICTRP, and ClinicalTrials.gov) up to November 4, 2021. Eligible participants were people with knee osteoarthritis. The intervention was exercise with BCTs. Primary outcomes included physical function, quality of life (QOL) 6 to 12 months after intervention, and adverse events. Secondary outcomes were knee pain, exercise adherence, mobility, and self-efficacy 3 months or more after intervention. The bias risk was assessed using the Risk of Bias 2 tool. The random-effects model was used for the meta-analysis. We found 16 individual BCTs, and 37.7% of trials used a single BCT. For meta-analysis, we included 21 RCTs (n = 1623). Most outcomes had a very low certainty of evidence, and the risk of bias was the consistent reason for downgrading evidence levels. The standardized mean difference (SMD) with 95% confidence interval (95% CI) was 0.00 (-0.24, 0.24) in physical function, 0.33 (-0.51, 1.17) in exercise adherence, and 0.04 (-0.39, 0.47) in self-efficacy. The risk ratio (95% CI) of adverse events was 3.6 (0.79, 16.45). QOL was not pooled due to insufficient data (very low certainty of evidence). In contrast, the SMD (95% CI) for knee pain reduction and mobility improvement was -0.33 (-0.53, -0.13) and 0.21 (-0.05, 0.47) with moderate and low certainty of evidence, respectively. The evidence is inconclusive regarding the effectiveness of BCTs with exercises on core outcome sets. Further research should explore the effectiveness of BCTs with valid design. PROSPERO (CRD42020212904).


Process /prá/,ses/n: the action of moving forward progressively from one point to another on the way to completion.
A rationale for the application of a stage process model for the language-disordered child is presented. The major behaviors of the communicative system (pragmatic-semantic-syntactic-phonological) are summarized and organized in stages from prelinguistic to the adult level. The article provides clinicians with guidelines, based on complexity, for the content and sequencing of communicative behaviors to be used in planning remedial programs.


2-(Naphthalen-1-yl)-4-(naphthalen-1-yl-methyl-idene)-1,3-oxazol-5(4H)-one.
In the title compound, C(24)H(15)NO(2), the oxazole ring is oriented at dihedral angles of 10.09 (4) and 6.04 (4)° with respect to the mean planes of the naphthalene ring systems, while the two naphthalene ring systems make a dihedral angle of 4.32 (3)°. Intra-molecular C-H⋯N hydrogen bonds link the oxazole N atom to the naphthalene ring systems. In the crystal, inter-molecular weak C-H⋯O hydrogen bonds link the mol-ecules into centrosymmetric dimers. π-π contacts between the oxazole and naphthalene rings and between the naphthalene ring systems [centroid-centroid distances = 3.5947 (9) and 3.7981 (9) Å] may further stabilize the crystal structure. Three weak C-H⋯π inter-actions also occur.


Glaucomatouslike visual field defects in chronic papilledema.
In 19 patients, 31 eyes with chronic papilledema were found to have visual field defects other than enlarged blind spots. In this series, the inferior nasal quadrant was most frequently involved. Dense paracentral scotomata were found in the Bjerrum area, some of which later progressed to form ring scotomata. Visual acuity usually deteriorated late in the course of the disease. The similarities of visual field defects in papilledema and glaucoma suggest common pathogenetic mechanisms of nerve fiber atrophy in both diseases.


"I am a healthcare practitioner": A qualitative exploration of massage therapists' professional identity.
BackgroundA division has been described among massage therapists, some who identify as healthcare providers while others identify as service providers. The perceived division creates confusion about what it means to be a massage therapist. ObjectiveThis qualitative study answered, "How do massage therapists in Ontario describe their professional identity?" MethodsQualitative description (QD) was used and data were collected from 33 massage therapists using semi-structured interviews. ResultsThe resulting description of massage therapists' identity in Ontario is the first of its kind. The identity described includes passion as professional motivation in practice, the importance of confidence and competence, a focus on the therapeutic relationship, individualized care, and patient empowerment, and a desire to be recognized for their role within the healthcare system. ConclusionThere is still much to be investigated about massage therapists' identity. Future research will explore whether this description resonates with a larger sample of massage therapists in Ontario.


Erratum to Kichloo A, Solanki D, Berger R, et al. Trends in the Use and Complications of Cardiac Resynchronization Therapy Device Implantation in Chronic Kidney Disease. J Innov Cardiac Rhythm Manage. 2023;14(2):5339-5347.
[This corrects the article DOI: 10.19102/icrm.2023.14023.].


CB1R-dependent regulation of astrocyte physiology and astrocyte-neuron interactions.
The endocannabinoid system (ECS) is involved in a variety of brain functions, mainly through the activation of the type-1 cannabinoid receptors (CB1R). CB1R are highly expressed throughout the brain at different structural, cellular and subcellular locations and its activity and expression levels have a direct impact in synaptic activity and behavior. In the last few decades, astrocytes have arisen as active players of brain physiology through their participation in the tripartite synapse and through their metabolic interaction with neurons. Here, we discuss some of the mechanisms by which astroglial CB1R at different subcellular locations, regulate astrocyte calcium signals and have an impact on gliotransmission and metabolic regulation. In addition, we discuss evidence pointing at astrocytes as potential important sources of endocannabinoid synthesis and release. Thus, we summarize recent findings that add further complexity and establish that the ECS is a fundamental effector of astrocyte functions in the brain. This article is part of the special issue on 'Cannabinoids'.


Temozolomide protects against the progression of glioblastoma via SOX4 downregulation by inhibiting the LINC00470-mediated transcription factor EGR2.
Temozolomide is extensively applied in chemotherapy for glioblastoma with unclear exact action mechanisms. This article seeks to address the potential molecular mechanisms in temozolomide therapy for glioblastoma involving LINC00470. Bioinformatics analysis was conducted to predict the potential mechanism of LINC00470 in glioblastoma, which was validated by dual-luciferase reporter, RIP, ChIP, and RNA pull-down assays. LINC00470 expression and the predicted downstream transcription factor early growth response 2 (EGR2) were detected in the collected brain tissues from glioblastoma patients. Following temozolomide treatment and/or gain- and loss-of-function approaches in glioblastoma cells, cell viability, invasion, migration, cycle distribution, angiogenesis, autophagy, and apoptosis were measured. In addition, the expression of mesenchymal surface marker proteins was assessed by western blot. Tumor xenograft in nude mice was conducted for in vivo validation. Mechanistic analysis and bioinformatics analysis revealed that LINC00470 transcriptionally activated SRY-related high-mobility-group box 4 (SOX4) through the transcription factor EGR2. LINC00470 and EGR2 were highly expressed in brain tissues of glioblastoma patients. LINC00470 and EGR2 mRNA expression gradually decreased with increasing concentrations of temozolomide in glioblastoma cells, and SOX4 expression was reduced in cells by temozolomide and LINC00470 knockdown. Temozolomide treatment induced cell cycle arrest, diminished cell viability, migration, invasion, and angiogenesis, and increased apoptosis and autophagy in glioblastoma, which was counteracted by overexpressing LINC00470 or SOX4 but was further promoted by LINC00470 knockdown. Temozolomide restrained glioblastoma growth and angiogenesis in vivo, while LINC00470 or SOX4 overexpression nullified but LINC00470 knockdown further facilitated these trends. Conclusively, temozolomide repressed glioblastoma progression by repressing the LINC00470/EGR2/SOX4 axis.


The functional assessment for control of trunk (FACT): An assessment tool for trunk function in stroke patients.
The Functional Assessment for Control of Trunk (FACT) was developed to evaluate trunk function after stroke. However, only a few studies used FACT to show functional outcome. This study aimed to validate the FACT predictive ability for functional outcome following stroke and create an English version of the FACT. This retrospective, observational study was conducted with patients aged≥65 years with stroke. Patients were divided into two groups according to the median FACT score at admission: trunk impairment or high trunk function group. Multiple regression analysis was performed for Functional Independence Measure (FIM) gain and FIM efficiency to examine the relationship between trunk function assessed by FACT at admission and functional prognosis. 105 participants (mean age, 80.2±7.6, 57.1%were men) were included. Of these, 48 (45.7%) and 57 (54.3%) were categorized to the trunk impairment group and high trunk function group, respectively. FACT score at admission was associated with FIM gain (coefficient = 0.875, P = 0.001) and FIM efficiency (coefficient = 0.015, P = 0.016) after adjusting for confounders. Trunk impairment at admission assessed by FACT could predict functional prognosis. The English version of FACT was created and further demonstrated the validity of FACT.


[The influence of non-steroidal anti-inflammatory drugs on clinical outcome in patients with bleeding peptic ulcers].
We conducted this study to find the clinical characteristics of ulcer bleeding that occurred in patients who had been taking non-steroidal anti-inflammatory drugs (NSAIDs) and to evaluate the influences of NSAIDs on clinical outcomes. Between January 2000 and December 2002, a total of 310 patients with ulcer bleeding were analyzed. Study group composed of 49 patients who had taken NSAIDs regularly for at least 4 weeks before the admission. Other 261 patients who had not taken NSAIDs were classified as control group. Relevant informations were obtained from the medical records. Of the NSAIDs group, aspirin was the most common medication. The mean age and the proportion of females in the NSAIDs group were significantly higher than those of the control group. Prevalence of co-morbid illness was significantly higher in the NSAIDs group than in the control group (85.7% vs 30.7%, p<.001). The severity of bleeding which was assessed by hemoglobin level at presentation, amount of transfusion, and duration of admission, was not different between two groups. There were no significant differences in frequency of re-bleeding, urgent surgery, and mortality. Ulcer bleeding among patients taking NSAIDs occurred more frequently in older females with co- morbid illness. However, NSAIDs is not associated with higher morbidity and mortality.


Resolute Italian study in all comers: immediate and one-year outcomes.
To assess clinical performance of the second-generation Endeavor Resolute(®) drug-eluting stents (DES) in an unrestricted high-risk cohort of patients. New-generation DESs aim to further increase its clinical safety and efficacy by means of more biocompatible components limiting inflammatory response, assuring strut coverage and preserving endothelial vascular function. Between January 2008 and April 2009 820 unselected consecutive high-risk patients (1,352 lesions) treated with the Endeavor Resolute(®) stent were enrolled in an independent multicenter registry. Primary end-points of this registry were immediate procedural outcome, incidence of target lesion failure (TLF, defined as composite of cardiac death, myocardial infarction, and target lesion revascularization) and rate of ARC stent thrombosis at 12-months follow-up. High-risk patient/lesion profile included acute coronary syndrome diagnosis in 57% of patients, diabetes mellitus in 23% and ACC/AHA type B2/C lesion in 74%. Endeavor Resolute(®) stent was used in an off-label indication in 52% of cases with stent/patient ratio of 1.93 and average stented segment of 39.8±26.6 mm. Immediate procedural success was accomplished in 96.0% of cases and at median 12-month follow-up TLF rate was 7.1% with 4.0% of clinically driven repeat revascularizations and 1.1% of definite/probable stent thrombosis incidence. At multivariable analysis, nor off-label Endeavor Resolute(®) stent use or multiple stent implantations were associated to an increased risk of adverse events. Extensive use of the new Endeavor Resolute(®) stent was associated with favorable procedural and 12-month outcomes despite the treatment of unselected complex clinical and anatomical presentation. Endeavor Resolute(®) stent showed excellent safety and efficacy profile also in off-label indications.


Hepatic GVHD after HLA-haploidentical bone marrow transplantation in children with severe combined immunodeficiency: the effect of ursodeoxycholic acid.
We describe two children with a severe combined immune deficiency (SCID) with B cells. Following a T-cell-depleted haploidentical bone marrow transplantation (BMT), they both developed a chronic graft-versus-host disease (GVHD) of the skin and a severe persisting hyperbilirubinaemia and elevated liver enzymes. The diagnosis of a vanishing bile duct syndrome was confirmed by liver biopsies. Because corticosteroids and cyclosporin A induced only a partial response, ursodeoxycholic acid (UDCA) was added to their treatment schedule. Serum bilirubin and liver enzymes returned to normal within months. A control liver biopsy showed normal and proliferating bile ducts without cholestatic damage. We conclude that UDCA was well tolerated and may be of value as an additional treatment for hepatic GVHD in SCID.


Primary Nonadherence to Oral Anticoagulants in Patients with Atrial Fibrillation: Real-World Data from a Population-Based Cohort.
Primary nonadherence (not filling a first prescription) is an important yet unstudied aspect of adherence to oral anticoagulant (OAC) therapy. To estimate the rates of primary nonadherence to OACs and determine associated factors in real-world practice. This population-based retrospective cohort study set in the Valencia region of Spain (about 5 million inhabitants) included all patients with atrial fibrillation who were newly prescribed OACs during 2011-2014 (N = 18,715). Primary nonadherence was obtained by linking electronic prescription and dispensing data and assessed by type of OAC-vitamin K antagonists (VKAs) or non-VKA oral anticoagulants (NOACs). Covariates were obtained from diverse databases, including electronic medical records. Multivariate logistic regression models were used to assess characteristics associated with primary nonadherence, adjusting for a propensity score to minimize confounding by indication. Primary nonadherence to OACs was 5.62% (VKA 4.29% vs. NOAC 10.81%; P < 0.001), with varying rates among specific drugs (acenocoumarol 4.2%, warfarin 10.9%, apixaban 5.0%, dabigatran 7.9%, and rivaroxaban 15.5%). After adjusting for potential confounders, the likelihood of not filling the first prescription was higher for NOAC patients than for VKA patients (OR = 2.76, 95% CI = 2.41-3.15). High coinsurance in the older groups (OR = 2.63, 95% CI = 1.47-4.69 for patients aged 66-75 years and OR = 3.02, 95% CI = 1.58-5.76 for patients aged > 75 years); being a non-Spanish European (OR = 1.49, 95% CI = 1.12-1.99); and having dementia (OR = 1.72, 95% CI = 1.37-2.16) were positively associated with primary nonadherence. Electronic transmission of prescriptions (OR = 0.85, 95% CI = 0.74-0.96); liver disease (OR = 0.73, 95% CI = 0.54-0.99); and polypharmacy (OR = 0.59, 95% CI = 0.50-0.70) were inversely associated with primary nonadherence. Overall, primary nonadherence to OACs was relatively low (5%). However, important differences were found between VKAs and NOACs. After adjustment, patients prescribed NOACs nearly tripled the likelihood of nonadherence compared with patients prescribed VKAs, which could negatively affect their effectiveness in clinical practice. Identified correlates were similar to those shown in the limited evidence for other medications. This work was partially supported by the 2013 Collaboration Agreement between the Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO) from the Valencia Ministry of Health and Boehringer Ingelheim, a nonconditioned program to conduct independent research in chronic health care, pharmacoepidemiology, and medical practice variation. Rodriguez-Bernal was funded by the Instituto de Salud Carlos III, Spanish Ministry of Health, and cofinanced by the European Regional Development Fund (grant number RD12/0001/0005). The views presented here are those of the authors and not necessarily those of the FISABIO Foundation, the Valencia Ministry of Health, or the study sponsors. The funding sources had no access to study data and did not participate in any way in the design or conduct of the study, data analysis, decisions regarding the dissemination of findings, the development of the manuscript, or its publication. Peiró has received fees for participation in scientific meetings and courses sponsored by Novartis and Ferrer International. In 2014, Sanfélix-Gimeno participated in an advisory meeting of Boehringer Ingelheim. García-Sempere is a former employee of Boehringer Ingelheim. Rodriguez-Bernal and Hurtado have no relationships relevant to the contents of this article to disclose. This work was previously submitted as an abstract (podium presentation) at the 31st International Society of Pharmacoepidemiology (ISPE) Annual Conference; August 22-26, 2015; Boston, Massachusetts.


Histone deacetylase 2 knockout suppresses immune escape of triple-negative breast cancer cells via downregulating PD-L1 expression.
The PD-L1 overexpression is an important event of immune escape and metastasis in triple-negative breast cancer (TNBC), but the molecular mechanism remains to be determined. Interferon gamma (IFNγ) represents a major driving force behind PD-L1 expression in tumor microenvironment, and histone deacetylase 2 (HDAC2) is required for IFN signaling. Here, we investigated the regulation of HDAC2 on the IFNγ-induced PD-L1 expression in TNBC cells. We found the HDAC2 and PD-L1 expression in TNBC was significantly higher than that in non-TNBC, and HDAC2 was positively correlated with PD-L1 expression. HDAC2 promoted PD-L1 induction by upregulating the phosphorylation of JAK1, JAK2, and STAT1, as well as the translocation of STAT1 to the nucleus and the recruitment of STAT1 to the PD-L1 promoter. Meanwhile, HDAC2 was recruited to the PD-L1 promoter by STAT1, and HDAC2 knockout compromised IFNγ-induced upregulation of H3K27, H3K9 acetylation, and the BRD4 recruitment in PD-L1 promoter. In addition, significant inhibition of proliferation, colony formation, migration, and cell cycle of TNBC cells were observed following knockout of HDAC2 in vitro. Furthermore, HDAC2 knockout reduced IFNγ-induced PD-L1 expression, lymphocyte infiltration, and retarded tumor growth and metastasis in the breast cancer mouse models. This study may provide evidence that HDAC2 promotes IFNγ-induced PD-L1 expression, suggesting a way for enhanced antitumor immunity when targeting the HDAC2 in TNBC.


Reduced levels of serum IGF-1 is related to the presence of osteoporotic fractures in male idiopathic osteoporosis.
The pathophysiology of male idiopathic osteoporosis (MIO) remains unknown. The aim of this study was to evaluate the involvement of IGF-1 in MIO, and to explore the relationships between bone mineral density and serum levels of IGF-1 and sex hormones. Inclusion criteria were osteoporosis (T-score<-2.5 SD) and/or an osteoporotic fracture. The osteoporotic patients were included after an exhaustive work-up to exclude the principal causes of secondary osteoporosis. Serum levels of IGF-1, estradiol, testosterone, SHBG, markers of bone turnover, and bone mineral density were compared between 79 MIO and 26 healthy subjects. A significant reduction in serum IGF-1 was found in MIO patients (p=0.0189). This remained significant after adjustment for body mass index (BMI). A negative correlation was found between SHBG and serum IGF-1 (r=-0.231, p=0.048). SHBG levels were higher in osteoporotic patients (p=0.001). The Free Testosterone Index (FTI, total testosterone/SHBG) (p=0.002) was also lower in MIO patients. After adjustment for FTI and BMI, a significant association was observed between IGF-1 level and the presence of an osteoporotic fracture, indicating an independent effect of IGF-1 level on fracture risk. The odds ratio (OR) for fracture for each SD decrease in IGF1 level was 1.8 [CI: 1.09-2.96] (p=0.021). Our study indicates a decrease in serum IGF-1 levels in MIO. This could be either the cause or the consequence of a disturbance in sex hormone metabolism with increased SHBG serum levels.


Microsatellites for mahoganies: twelve new loci for Swietenia macrophylla and its high transferability to Khaya senegalensis.
A new set of 12 microsatellite markers was developed and characterized for big-leaf mahogany (Swietenia macrophylla King, Meliaceae) and its transferability assayed in the African mahogany, Khaya senegalensis (Desr.) A. Juss. (Meliaceae), to study population and conservation genetics of these threatened tropical timber species. Using an enriched library approach twelve novel microsatellite loci were identified for S. macrophylla. The number of alleles per locus ranged from 5 to 14 and mean observed and expected heterozygosities were 0.819 and 0.822, respectively. Twenty microsatellite loci developed for S. macrophylla (12 from this study and eight previously published) were tested for K. senegalensis and 10 polymorphic were characterized. The results show the highly informative content of the new SSR loci for Swietenia macrophylla and the high effectiveness of these microsatellites for population genetics, gene flow, and mating system studies in Khaya senegalensis.


Super-assembly of integrated gold magnetic assay with loop-mediated isothermal amplification for point-of-care testing.
With the increasing global threat of various diseases and infections, it is essential to develop a fast, low-cost, and easy-to-use point-of-care testing (POCT) system for inspections at all levels of medical institutions and self-examination at home. In this work, gold magnetic nanoparticles (GMNPs) are used as the key material, and a rapid visual detection method is designed through integrating loop-mediated isothermal amplification (LAMP) and lateral flow assay (LFA) biosensor for detecting a variety of analytes which includes whole blood, buccal swabs, and DNA. It is worth to note that the proposed method does not need DNA extraction. Furthermore, uracil DNA glycosylase (UDG) is employed to eliminate carrier contamination for preventing false positive results. The whole detection process can be finished within 25 min. The accuracy of detection is measured by assessing the polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) C677T. The detection limit of the newly developed extraction-free detection system for MTHFR C677T is 0.16 ng/μL. A preliminary clinical study of the proposed method is carried out by analyzing 600 clinical samples (including 200 whole blood samples, 100 buccal swabs, and 300 genomic DNA samples). The results indicate that the proposed method is 100% consistent with the sequencing results which provides a new choice for POCT and shows a broad application prospect in all levels of medical clinics and at home. Supplementary material (details for MTHFR C677T primer sequences, the cell count results of samples at different dilution ratios, genotyping results and frequency samples, a Hardy-Weinberg equilibrium test, the sensitivity of the system, detection results of multiple samples, and optimization of the system) is available in the online version of this article at 10.1007/s12274-022-4692-9.


ZINBA integrates local covariates with DNA-seq data to identify broad and narrow regions of enrichment, even within amplified genomic regions.
ZINBA (Zero-Inflated Negative Binomial Algorithm) identifies genomic regions enriched in a variety of ChIP-seq and related next-generation sequencing experiments (DNA-seq), calling both broad and narrow modes of enrichment across a range of signal-to-noise ratios. ZINBA models and accounts for factors that co-vary with background or experimental signal, such as G/C content, and identifies enrichment in genomes with complex local copy number variations. ZINBA provides a single unified framework for analyzing DNA-seq experiments in challenging genomic contexts.


Nomenclature systems for the neuroprostanes and for the neurofurans.
The isolation of two new classes of human docosahexaenoic acid oxidation products, the neuroprostanes and the neurofurans, have been reported. Facile nomenclature systems that will allow the rational differentiation of each of the isomeric structures comprising the families of NeuroP's and NeuroF's, represented, respectively, by 17-F(4t)-NeuroP 1 and 10-epi-ST-Delta(15)-11-NeuroF 2 are presented.


Change of Sagittal Spinopelvic Parameters after Selective and Non-Selective Fusion in Lenke Type 1 Adolescent Idiopathic Scoliosis Patients.
To compare the postoperative changes of both sagittal spinal and spinopelvic parameters in patients with Lenke Type 1 adolescent idiopathic scoliosis (AIS) who underwent selective and non-selective fusion surgery. We conducted a retrospective study among 53 Lenke Type 1 AIS patients who underwent corrective surgery at our centre between 2006 and 2012. Patients were classified as group 1 if they underwent selective surgery and as group 2 if they underwent non-selective surgery. Surgical results of preoperative and postoperative sagittal and spinopelvic measurements, pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL) and thoracic kyphosis (TK) values were analysed using the SURGIMAP© Software (Nemaris İnc. USA) measurement system. In both groups, a comparison of pre- and postoperative sagittal spinal parameters did not show a statistically significant difference. In both groups, pre- and postoperative measurements of LL and TK did not show a statistically significant difference. After selective and non-selective surgery, sagittal spinal and spinopelvic parameters are not affected in the middle term. We think that the long-term studies to be done in this regard will increasingly require the necessity of keeping the pelvis in mind while evaluating the sagittal plan in AIS surgery.


[18,19,20-trinor-17-cyclohexyl-13,14-dehydro PGF 2 alpha methylester as the cause of hypertension in pulmonary circulation].
The hemodynamic effects of a synthetic compound of PGF 2 alpha have been studied before and after vagosympathectomy. Synthetic PGF 2 alpha caused a marked hypertension in the pulmonary circulation linked with the vasoconstrictor action of this substance on the small lung vessels. A slight hypotension was observed in the denervated animal where the highest values of pulmonary pressure were reached. The authors conclude that this fact may be due to an inhibition of the vasoconstrictor systemic tone secondary to the pulmonary hypertensive state.


Abnormal anatomy of inferior orbital fissure and herniation of buccal fat pad.
The anatomy of the inferior orbital fissure has been well studied, and its reported dimensions vary little. It is encountered during exploration of the orbital floor and when possible is not disturbed. We describe a case of herniation of buccal fat through the inferior orbital fissure that was found during exploration and repair of the orbital floor.


Outcomes of osteosarcoma, chondrosarcoma and chordoma treated with image guided-intensity modulated radiation therapy.
To evaluate the efficacy and toxicity of dose-escalated image guided-intensity modulated radiation therapy (IG-IMRT) in osteosarcoma (OGS), chondrosarcoma (CS) and chordoma (CH) of head and neck (H&N) and pelvis. In this prospective non-randomized study, 65 patients of H&N or pelvic OGS (24), CS (7) and CH (34) mandating definitive or post-operative radiotherapy from May 2013 to December 2018 were included. Radiotherapy doses in definitive setting were 72.0 Gy for CH and 70.2 Gy for OGS and CS; while in post-operative setting it was 66.6 Gy and 64.8 Gy respectively (at 1.8 Gy per fraction). Planned doses of radiotherapy could be completed in 61 (93.8%) patients; with grade III or higher acute and late toxicities of 3% and 0% respectively. With a median follow-up of 52 (range 6-92) months, the five-year actuarial local control (LC) rates were 66% in OGS, 38.1% in CS and 75.9% in CH; while cause-specific survival (CSS) rates were 54.7%, 64.3% and 92.2% respectively. There was no statistically significant difference in outcomes for patients receiving definitive and post-operative radiotherapy. Locally controlled disease at first follow-up after radiotherapy was associated with improved CSS and OS in CS (p = 0.014) and CH (p < 0.001). Radiotherapy resulted in significant and sustained improvement in Musculoskeletal tumour society (MSTS) score and reduction in pain score. Salvage re-irradiation was feasible in local progression after radiotherapy, with good outcomes and tolerability. Dose-escalated IG-IMRT results in good LC & functional improvement with minimal toxicity in OGS, CS and CH.


Comparison of brain nicotine uptake from electronic cigarettes and combustible cigarettes.
Brain accumulation rate and magnitude are critical for the acute reinforcing effects of nicotine. Despite electronic cigarettes' (E-cigs) appeal as substitutes for traditional combustible cigarettes (C-cigs), brain nicotine accumulation (BNA) from E-cigs has not been compared with that from C-cigs using a within-subjects design. BNA was directly assessed with 16 adult dual users (10 females) of E-cigs (e-liquid pH 9.4) and C-cigs, using 11C-nicotine and positron emission tomography (PET). Participants went through two 15-min head scanning sessions during which they inhaled a single puff of E-cig vapor or C-cig smoke containing 11C-nicotine in a randomized order. A full-body scan was also conducted at each session to measure total absorbed dose of 11C-nicotine. Mean maximum concentration (Cmax) and area under curve of BNA were 22.1% and 22.7% lower, respectively, following E-cig compared with C-cig inhalation. Meanwhile, T1/2 was 2.7 times longer following inhalation of E-cig vapor relative to C-cig smoke (all ps < 0.005). Whole-body imaging indicated greater nicotine retention in the respiratory tract from vapor versus smoke inhalation (p < 0.0001). Following vapor inhalation, nicotine retention in the respiratory tract was correlated with Cmax values of BNA (rs = -0.59, p < 0.02). Our results confirm that E-cigs with alkaline pH e-liquid can deliver nicotine rapidly to the brain, albeit less efficiently than C-cigs partly due to greater airway retention of nicotine. Since brain nicotine uptake mediates reinforcement, these results help elucidate actions of E-cigs in terms of abuse liability and effectiveness in substituting for combustible cigarettes.


Facing two deadly viruses.
As covid-19 begins to take hold, the Democratic Republic of the Congo has detected its first new Ebola cases in months, reports Peter Yeung.


Body fluids and temperature responses of heat-exposed women before and after ovulation with and without rehydration.
1. Four females (21-25 yr) were exposed to 43.3 degrees C dry bulb, 28-29 degrees C wet bulb, for 10 hr both early and late in two menstrual cycles. During the experiments in one cycle, the subjects were rehydrated while during the experiments in another cycle, the subjects were allowed to progressively dehydrate.2. Rates of weight loss and oral temperatures were determined hourly while venous blood samples were obtained before and then after 1, 2, 3, 4, 6, 8, and 10 hr of heat exposure.3. Pre-ovulatory results were compared with post-ovulatory results and dehydration experiments with rehydration experiments. In addition, the data on these female subjects were compared with those presented elsewhere for similarly treated male subjects.4. When compared to males, these resting females did not significantly haemodilute when heat exposed. In addition, the female subjects apparently suffered a decrease in plasma volume and body water at a rate some 1.5 times that of similarly exposed males.5. In general,% change in total protein/unit volume of plasma for these female subjects was similar to previously published results for males. However, there were significant differences in the manner in which albumin and globulin fractions changed before and after ovulation.6. The rates of body weight loss for these subjects were similar to those determined for males. No difference was noted between pre- and post-ovulatory rates of weight loss. Dehydration significantly depressed the rates of weight loss during heat exposure.7. Stimulation of sweating (assessed as weight loss) appeared to require similar amounts of heat storage before and after ovulation though initial post-ovulatory temperatures were generally higher.8. Progressive dehydration of females before ovulation was accompanied by rates of increase in oral temperatures that were similar to those seen for similarly exposed males.9. When females progressively dehydrated after ovulation, there was no statistically significant correlation between temperature rise and weight loss as had been noted in pre-ovulatory experiments. In addition, for all subjects, the rise in body temperature with dehydration was less after than before ovulation. Two subjects showed an ability to decrease their body temperature in the face of continued dehydration.10. Based on these results, the differences in the responses of males and females to heat exposure were ascribed mainly to two causes: a, inherent differences such as skin surface: blood volume ratios, and b, the inability of females to maintain their vascular volume during heat exposure.


Triple negative breast cancer: approved treatment options and their mechanisms of action.
Breast cancer, the most prevalent cancer worldwide, consists of 4 main subtypes, namely, Luminal A, Luminal B, HER2-positive, and Triple-negative breast cancer (TNBC). Triple-negative breast tumors, which do not express estrogen, progesterone, and HER2 receptors, account for approximately 15-20% of breast cancer cases. The lack of traditional receptor targets contributes to the heterogenous, aggressive, and refractory nature of these tumors, resulting in limited therapeutic strategies. Chemotherapeutics such as taxanes and anthracyclines have been the traditional go to treatment regimens for TNBC patients. Paclitaxel, docetaxel, doxorubicin, and epirubicin have been longstanding, Food and Drug Administration (FDA)-approved therapies against TNBC. Additionally, the FDA approved PARP inhibitors such as olaparib and atezolizumab to be used in combination with chemotherapies, primarily to improve their efficiency and reduce adverse patient outcomes. The immunotherapeutic Keytruda was the latest addition to the FDA-approved list of drugs used to treat TNBC. The following review aims to elucidate current FDA-approved therapeutics and their mechanisms of action, shedding a light on the various strategies currently used to circumvent the treatment-resistant nature of TNBC cases. The recent approval and use of therapies such as Trodelvy, olaparib and Keytruda has its roots in the development of an understanding of signaling pathways that drive tumour growth. In the future, the emergence of novel drug delivery methods may help increase the efficiency of these therapies whiel also reducing adverse side effects.


The calcium-dependent transient inactivation of recombinant NMDA receptor-channel does not involve the high affinity calmodulin binding site of the NR1 subunit.
N-methyl-D-aspartate (NMDA) receptor function can be regulated by direct binding of calmodulin to a low and high affinity (C1 exon cassette) site in the C-terminal region of the NR1 subunit. To evaluate the involvement of the high affinity binding site in the transient inactivation of the NMDA receptor-channels by intracellular calcium, several splice variants of the NR1 subunit have been individually co-transfected with the NR2A subunit in HEK 293 cells. The transient Ca2+ induced inactivation (40-50%) of the heteromeric receptors was similar whether the NR1 variants contained (NR1-1a, 1b) or lacked (NR1-2a, 2b, 4a, 4b) the C1 exon cassette bearing the high affinity binding site for calmodulin. This demonstrates that this site is not involved in the Ca2+ dependent transient inactivation of NMDA receptors.


Growth stimulation of sparse, serum deprived and of confluent, contact inhibited mammalian fibroblasts by a preparation of 3':5'-cyclic AMP phosphodiesterase.
Resting mammalian fibroblasts, either sparse and maintained in a serum-free medium, or confluent and contact inhibited, are stimulated to divide by treatment with a preparation of 3':5'-cyclic AMP phosphodiesterase. This enzyme preparation contained a low level of trypsin-like and alpha-chymotrypsin-like activity, but its effect on cell growth could not be mimicked by pure, crystallized trypsin and alpha-chymotrypsin at concentration equivalent to their contamination in the above preparation. Preincubation of the 3':5'-cyclic AMP phosphodiesterase preparation with the protease inhibitor, phenyl methane sulfonyl fulride, did not affect, either, its stimulation of DNA synthesis in fibroblasts, or its enzymatic hydrolysis of cyclic AMP.


High versus Medium Dose of Inhaled Corticosteroid in Chronic Obstructive Lung Disease: A Systematic Review and Meta-Analysis.
Inhaled corticosteroids (ICSs) combined with bronchodilators have been identified to improve outcomes in COPD but also to be associated with certain adverse effects. We performed a systematic review and meta-analysis to compile and summarize data on the efficacy and safety of dosing levels (high versus medium/low) of ICS alongside ancillary bronchodilators following PRISMA guidelines. Medline and Embase were systematically searched until December 2021. Randomized, clinical trials (RCTs) that met predefined inclusion criteria were included. Risk ratios (RRs) with 95% confidence intervals (CI) were extracted. Any acute exacerbation of COPD (AECOPD) risk was chosen as the primary efficacy outcome, mortality rate as the primary safety outcome, moderate/severe AECOPD risk as the secondary efficacy outcome and pneumonia risk as the secondary safety outcome. Subgroup analyses of individual ICS agents, of patients with baseline moderate/severe/very severe COPD and of patients with recent COPD exacerbation history were also performed. A random-effects model was used. We included 13 RCTs in our study. No data on low doses were included in the analysis. High dose ICS was not associated with a statistically significant difference in any AECOPD risk (RR: 0.98, 95% CI: 0.91-1.05, I2: 41.3%), mortality rate (RR: 0.99, 95% CI: 0.75-1.32, I2: 0.0%), moderate/severe AECOPD risk (RR: 1.01, 95% CI: 0.96-1.06, I2: 0.0%) or pneumonia risk (RR: 1.07, 95% CI: 0.86 -1.33, I2: 9.3%) compared to medium dose ICS. The same trend was identified with the several subgroup analyses. Our study collected RCTs investigating the optimal dosing level of ICS prescribed alongside ancillary bronchodilators to patients with COPD. We identified that the high ICS dose neither reduces AECOPD risk and mortality rates nor increases pneumonia risk relative to the medium dose.


Extra-adrenal chromaffin cells grown in tissue culture.
1. Extra-adrenal chromaffin cells from adult frogs were grown in tissue culture and their morphology and behaviour observed with both light and electron microscopy. 2. Two types of chromaffin cells were distinguished: Type A cells contain large, electron dense vesicles (2000-6000 A) and are equated to Type I chromaffin cells seen in vivo, i.e. they contain noradrenaline; Type B cells contain smaller vesicles (700-2000 A) which are incompletely filled with an electron dense material and are equated to Type III chromaffin cells seen in vivo, i.e. cells depleted of their catecholamines by stimulation. No cells comparable to Types II and IV cells in vivo were seen. 3. Close associations between the cultured chromaffin cells and sympathetic neurons were observed with the light microscope, but no examples of synaptic structures were seen in the material examined with electron microscopy in this study.


Accumulation of cardiac lipofuscin in mammals: correlation between sexual maturation and the first appearance of lipofuscin.
Accumulation of lipofuscin is an important phenomenon of the cellular aging process. The first appearance of cardiac lipofuscin showed a good correlation with sexual maturation, which was correlated with maximum life-span of mammals. Large metabolic changes occurred at sexual maturation. From these results, it is suggested that sexual maturation of mammals is the initiation period of the aging process. Correlation between sexual maturation and longevity was re-evaluated using many mammals. Domestic and laboratory animals showed an earlier sexual maturation than other mammals, including rodents.


Glatiramer acetate (GA), the immunomodulatory drug, inhibits inflammatory mediators and collagen degradation in osteoarthritis (OA) cartilage.
Glatiramer acetate (GA), the generic name for Copaxone, an immunomodulatory agent, has been shown to induce interleukin-1 receptor antagonist (IL-1Ra) production in macrophages. We therefore tested the effects of GA on the catabolic activities of osteoarthritis (OA) chondrocytes. Primary human chondrocytes and OA cartilage explants were utilized in this study. IL-1Ra, pro-matrix metalloproteinase-13 (proMMP-13) and prostaglandin E(2) (PGE(2)) were estimated in the cell culture supernatants and in vitro MMP-13 activity was measured using fluorogenic substrate. TaqMan Real-Time quantitative polymerase chain reaction (RT-qPCR) was performed to estimate relative expression levels of genes. GA treatment significantly increased transcription and production of sIL-1Ra (P=0.001) in both culture models. Furthermore, addition of GA (100 μg) inhibited: (1) spontaneous collagen degradation as assayed by CTX II enzyme-linked immunosorbent assay (ELISA) [mean CTX II (ng/g cartilage)] in control was 7.79 [95% confidence interval (CI) 2.57-13.02]-3.415 (95% CI 0.81-6.02) (P=0.0286); (2) spontaneous proMMP-13 secretion [mean MMP-13 (ng/g cartilage)] in control was 16.98 (95% CI 7.739-26.23)-6.973 (95% CI 1.632-12.31) (P=0.0286); (3) production of IL-1β-induced inflammatory mediators such as nitric oxide (NO) [mean NO (μM)] in IL-1 cultures was 11.47 (95% CI 7.10-15.83)-0.87 (95% CI 0.18-1.56) (P=0.0022); and (4) recombinant MMP-13 in vitro activity (15-25%; P=0.004). These data suggest that GA effects may be due to upregulation of IL-1Ra as well as direct inhibition of MMP-13 activity. Based on these studies, we propose that GA has potential for disease modifying properties in OA and should be evaluated in vivo in animal studies.


Trisomy 3q : two clinically similar but cytogenetically different cases.
The clinical and cytogenetic findings in two unrelated infants both trisomic for differing amounts of the long arm of chromosome 3 are described and discussed in relation to previously reported cases and the existence of a distinct syndrome of trisomy 3q is confirmed. Assignment of the gene for human red blood cell galactose-1-uridyltransferase is discussed.


Graphitic nitride-catalyzed advanced oxidation processes (AOPs) for landfill leachate treatment: A mini review.
Landfill leachate poses significant risks to public health via the release of high-toxicity contaminants, including refractory organic compounds, ammonia-nitrogen compounds, and heavy metals. Significant efforts have been made to develop useful methods for leachate disposition and treatment. Advanced oxidation processes (AOPs) are one of the most promising methods, because they can rapidly degrade diverse pollutants and significantly improve the biodegradability of leachate. Graphitic carbon nitride (g-C3N4), a fascinating conjugated polymer, has become a hot topic in AOP research due to its metal-free benefits and high photosensitivity. Thus, combining AOPs with g-C3N4 achieves excellent degradation of refractory pollutants in leachate. Since the composition of leachate is complex in the practical conditions, the information reported by current studies of using g-C3N4 as a remediator is still incomplete and fragmented. Thus, in this review, the recent status of leachate treatment and approaches for its disposal has been summarized and some conclusions have been drawn. In addition, a brief introduction to g-C3N4 and its application in AOPs for leachate treatment have been critically discussed and with its future outlook assessed. Although the development of g-C3N4 in AOPs for leachate treatment is highly efficient and practical, comprehensive study about its application and technology expansion is urgently needed, based on the complex operating conditions. Perspectives on the treatment of leachate using g-C3N4-AOPs are also included. The information and perspectives provided in this review will provide guidance and novel understanding to accelerate the development of g-C3N4-based AOPs for leachate treatment.


Smoking behaviour and personality: a population-based study in Japan.
The aim of our study was to determine whether the previously reported findings also apply to a general population in Japan and whether, among current smokers, such personality characteristics can be correlated with the age they started to smoke and their present daily consumption of cigarettes. Cross-sectional survey. Miyagi prefecture, in northern Japan. 20,538 residents in Miyagi, aged 40-64 years. A self-administered questionnaire involving smoking status (current, ex- and non-smokers) and patterns and the Japanese version of the short-form Eysenck Personality Questionnaire-Revised (EPQ-R). (1) Current and ex-smokers were higher on Extraversion and Psychoticism than non-smokers for both genders. (2) Heavy smokers were higher on Psychoticism than light smokers and those who started to smoke prior to the legally permitted age were higher on Psychoticism than those who did not. (1) Our study confirmed that the findings which had been previously reported in selected samples in western countries also apply to a general population in Japan; (2) current smokers were found to be heterogeneous in terms of Psychoticism when the age they started to smoke and their present daily consumption of cigarettes were taken into account.


Health of migrants and migrant health policy, The Netherlands as an example.
In The Netherlands, as in many other countries, many studies have addressed the health situation of migrant groups. After a discussion on methodological pitfalls in migrant studies, the article reviews the most important results. The data show that there are differences in the health status and mortality patterns between migrant groups and the indigenous population. Most, but not all, of the differences are in disfavour of ethnic groups. Possible determinants of these differences are evident in socio/cultural, genetic and socio-economic factors. A model is presented that demonstrates the relation between these factors and health and disease. Implications for research and for health policy are discussed.


Do children's individual correlates of physical activity differ by home setting?
We investigated whether physical activity (PA) correlates differed for 9-10 year-old British children living in urban, suburban and rural settings. We analysed cross-sectional data on 1653 children (SPEEDY study). Exposure variables were self-reported, whilst PA was measured using Actigraph accelerometers. Data were analysed using multilevel hierarchical regression models, stratified by home setting. PA levels did not differ by home setting. Boys, those of normal weight and those having a preference for PA had higher PA levels in all strata, but additional correlates were identified within each setting. These results highlight the potential importance of tailoring interventions to specific environmental and population strata.


MRI assessment of piriformis-sparing posterior approach in total hip arthroplasty.
In total hip arthroplasty (THA), the posterior approach is the most common throughout the world. Dislocation is one of the main complications incurred, but the risk may be reduced by sparing posterior structures. Thus, piriformis-sparing posterior approaches (PSPA) were described, and satisfactory conservation of the muscle was reported. On the other hand, a recent cadaver study reported occult intrapelvic piriformis lesions in 91% of cases. In the light of this discordance, we performed pre- and postoperative MRI in THA by PSPA: 1) to assess the fatty infiltration of the piriformis induced by the approach, with particular attention to intrapelvic lesions; and 2) to assess fatty infiltration of the other periarticular muscles. The piriformis muscle will show little fatty infiltration following PSPA. A continuous prospective single-surgeon series of THA by PSPA included 25 patients. MRI was performed preoperatively and at 3 months and 1 year postoperatively. Fatty infiltration was assessed on the Goutallier classification in all periarticular muscles. Preoperative MRI was lacking in 4 patients, who were excluded from analysis; 21 patients with MRI were thus analyzed. In the piriformis muscle, there was no significant change in fatty infiltration between preoperative and 3-month (p=0.29) or 1-year (p=0.41) MRI. Two of the 21 patients (9.5%) showed grade 3 or 4 fatty infiltration at 1 year, compared to 0/21 (0%) preoperatively; both showed sacral avulsion of the piriformis. Significant differences between preoperative and 1-year MRI were found for the obturator internus and externus, with grade 3 or 4 infiltration at 1 year in 14 cases for the obturator internus (14/21: 66.7%), in 3/21 for the obturator externus (14.3%) and in 6/21 for the quadratus femoris (28.6%), compared to respectively 0/21 (0%), 0/21 (0%) and 3/21 (14.3%) preoperatively. There were no significant differences for any of the other periarticular muscles. PSPA in THA ensured good conservation of the piriformis. There may, however, be rare and irreversible sacral lesions invisible intraoperatively. IV; prospective case series.


Splenic infarct: a rare cause of spontaneous rupture leading to massive haemoperitoneum.
A 76-year-old woman presented to the accident and emergency department with an acute surgical abdomen. She did not have any significant medical history or history of trauma. Examination findings revealed generalized peritonitis. Preliminary investigations were unhelpful in revealing a cause. On urgent exploratory laparotomy, a ruptured spleen was found and splenectomy performed. The hollow viscera were normal. The gross and microscopic appearances were suggestive of splenic rupture occurring through areas of infarction. We proceed to analyse the causes of spontaneous rupture of the spleen in our discussion of this case.


Fast spin echo magnetic resonance imaging: clinical application in screening for acoustic neuroma.
The advent of magnetic resonance imaging has greatly improved our ability to diagnose acoustic tumors, but it is a relatively expensive imaging modality. In the present climate of medical cost restraints, methods that reduce costs but maintain quality are extremely desirable. We report a new magnetic resonance imaging technique that uses fast spin echo without gadolinium. It provides ultrahigh-resolution images of the internal auditory canal and cerebellopontine angle. The sensitivity of this technique for the detection of acoustic tumors is equivalent to conventional gadolinium-enhanced magnetic resonance imaging, but the global cost is comparable with that of brain stem audiometry. In our practice fast spin echo magnetic resonance imaging has replaced brain stem audiometry as a screening modality to evaluate most acoustic tumor suspects. Also, the intricate detail of the internal auditory canal anatomy provided by this technique is useful in planning surgical removal of acoustic tumors.


High-speed counter-current chromatographic isolation of ricinine, an insecticide from Ricinus communis.
The alkaloid ricinine, an insecticide for leaf-cutting ant (Atta sexdens rubropilosa), was obtained from Ricinus communis. A two-phase solvent system composed of CH(2)Cl(2)/EtOH/H(2)O (93:35:72, v/v/v) was used for high-speed counter-current chromatographic (HSCCC) isolation of ricinine in high yield and with over 96% purity, as determined by liquid and gas chromatography-mass spectrometry (LC-MS and GC-MS). Identification of ricinine was performed by comparison of (1)H NMR, (13)C NMR and LC-MS/MS data.


Reducing body myopathy - A new pathogenic FHL1 variant and literature review.
Reducing body myopathy (RBM) is a rare disease marked by progressive muscle weakness caused by a mutation in FHL1 gene. We describe a new pathogenic variant and contrasted it with 44 other cases identified in the literature. A male child presented at age 3 suffering frequent falls and progressive muscular weakness. At age 8, he was wheelchair-bound and required ventilatory support. His mother and sister died due to the same problem. Creatine kinase was 428 IU/L (<190). Muscle biopsy showed typical reducing bodies, and genetic analysis identified a novel pathogenic hemizygous variant, c.370_375del. We identified 44 previous reported cases separated in two groups: 28 cases with mean age onset 7.6 ± 5 years and 16 with 26.7 ± 4.2 years. The time for the diagnosis was shorter to younger group. The initial symptoms, rigid spine, contractures, scoliosis and axial and neck weaknesses, dysphagia, cardiac involvement, were predominant in younger group. The variant c.369C > G predominated in younger group and c.448T > C in older one. Pathogenic variants positions seemed related to severe phenotype. Most wheelchair patients belonged to younger group. The data from this compilation and our case provided a general characterization spectrum and prognosis between two groups of age onset with RBM.


NLK, a novel target of miR-199a-3p, functions as a tumor suppressor in colorectal cancer.
We previously reported that miR-199a-3p is a newly biomarker for diagnosis and novel prognostic indicator in colorectal cancer. However, the miR-199a-3p regulatory mechanism and its target genes are still unclear. In our present study, we demonstrated miR-199a-3p could directly target 3'-UTR of NLK gene by luciferase reporter assay and western blot analysis. We detected NLK expressions in 92 colorectal cancer cases to evaluate its clinicopathologic characteristics in colorectal cancer. Our results showed that NLK expression was significantly downregulated in cancer tissues than NATs, and NLK low-expression was associated with lymph node metastasis, venous invasion, liver metastasis and the TNM stage (P<0.05). Moreover, Kaplan-Meier analysis showed that low expression of NLK correlated with a shorter overall survival rates of patients with CRC (P<0.05). In vitro, we also found that NLK suppressed the biological behaviors of colorectal cancer cells, including the abilities of cell proliferation, clone formation, wound healing, migration and invasion (P<0.05), while overexpression of NLK increased the apoptotic rate of colorectal cancer cells. All these results suggested that NLK was an identified miR-199a-3p target gene and functioned as a tumor suppressor gene in colorectal cancer. NLK could be a novel direction for developing diagnostic and therapeutic approaches in colorectal cancer.