Low prevalence of idiopathic peptic ulcer disease: an Italian endoscopic survey.
Peptic ulcer disease (PUD) represents a common condition, although its incidence is decreasing. Previous studies reported a high rate of idiopathic PUD prevalence. To investigate prevalence, relative distribution of etiologic factors and prevalence of complication of PUD in an Italian endoscopic series. All gastroscopies performed in adult patients during 3 years were considered. Patients with PUD, with antral and corporal histology, were included in the study. Helicobacter pylori infection was assessed by histology. Idiopathic PUD was defined as an ulcer without evidence H. pylori infection or prior exposure to NSAIDs. 300 patients with PUD out of 11,148 gastroscopies were included in our study accounting for a prevalence of 2.7%. H. pylori-associated PUD was diagnosed in 62.3%, NSAID/aspirin-associated PUD in 22%, H. pylori/NSAID/aspirin-associated PUD in 11.6%, and idiopathic PUD in the remaining 4% of cases. Regarding ulcer complications the logistic regression analysis identified the following significant risk factors for GI bleeding: NSAIDs and/or aspirin use, age >65 years and coexistent gastric and duodenal ulcers. Our data found a low endoscopic prevalence of peptic ulcer. Both H. pylori infection and NSAIDs and/or aspirin use remain the main determinants and idiopathic ulcer prevalence is very low.


Reaction of spring barley seedlings and H. incongruens crustaceans to the presence of acetylsalicylic acid in soil.
Acetylsalicylic acid (ASA) is one of the more commonly used analgesic, antipyretic, and anti-inflammatory as well as anticoagulant drugs available in the OTC (over the counter) segment. Due to the considerable use of this drug, an attempt was made to determine the effect of ASA on the crustacean Heterocypris incongruens and the monocotyledonous plant spring barley. The tested compounds were introduced into soil in which these organisms "lived". The study showed that ASA had an adverse effect on seed germination potential as well as a negative effect on spring barley growth; however, and photosynthetic pigments content was observed only at the highest concentrations of the studied compounds. ASA did not cause oxidative stress in plants but did also cause disturbances in the growth of H. incongruens, without causing their mortality. As a result, ASA may have certain negative effects on both crustaceans and monocots.


Non-invasive measurement of tendon excursion with a colour Doppler imaging system: a reliability study in healthy subjects.
The excursion of the flexor digitorum profundus tendon during active flexion of the third finger was measured with colour Doppler imaging in 10 healthy volunteers. Repeated measurements were made by one observer in three sessions to assess the test-retest reliability. An analysis of variance (ANOVA) was done to find out the multiple sources of measurement error. The intraclass correlation coefficient was 0.81. For single measurements, the standard error of measurement was not more than 0.17 cm. The smallest detectable difference between two consecutive measurements was 0.48 cm. The test-retest reliability of colour Doppler measurements of excursion of the flexor digitorum profundus III tendon (FDP III) in healthy subjects is good. With series of 25 flexion movements, colour Doppler imaging is applicable in the assessment of tendon excursions in patients.


Conventional and Novel Approaches to Immunosuppression in Lung Transplantation.
Most therapeutic advances in immunosuppression have occurred over the past few decades. Although modern strategies have been effective in reducing acute cellular rejection, excess immunosuppression comes at the price of toxicity, opportunistic infection, and malignancy. As our understanding of the immune system and allograft rejection becomes more nuanced, there is an opportunity to evolve immunosuppression protocols to optimize longer term outcomes while mitigating the deleterious effects of traditional protocols.


Gold Nanorod Array Biochip for Label-Free, Multiplexed Biological Detection.
Gold nanorod (GNR) based label-free sensing has been attractive due to its unique property of localized surface plasmon resonance (LSPR). Compared to bulk gold, the SPR of GNRs is more sensitive to the refractive index change caused by biological binding in the close proximity. Numerous studies have reported biological detection in solution based GNR probes. However, the biosensing has the intrinsic problems of fluctuating readings and short storage time due to nanoparticle aggregation. In contrast, a chip-based nanorod biosensor is a more robust and reliable platform. We have developed a nanoplasmonic biosensor in a chip format by immobilizing functionalized GNRs on a (3-mercaptopropyl)trimethoxysilane modified glass substrate. The covalent Au-S bond ensures a strong GNR deposition on the substrate. This biochip exhibits a high sensitivity and stability when exposed to physiological buffer with high ionic strength. Another advantage of GNR as optical transducer is its LSPR peak dependence on the aspect ratio, which provides an ideal multiplexed detection mechanism. GNRs of different sizes that exhibit distinct SPR peaks are combined and deposited on designated spots of a glass substrate. The spectral shift of the respective peaks upon the biological binding are monitored for simultaneous detection of specific analytes. Coupled with a microplate reader, this spatially resolved GNR array biochip results in a high-throughput assay of samples as well as multiplexed detection in each sample. Since most biological molecules such as antibodies and DNA can be linked to GNR using previously reported surface chemistry protocol, the label-free nanosensor demonstrated here is an effective tool for protein/DNA array analysis, especially for detection of disease biomarkers.


Expression of three mRNA species from a single rat aldolase A gene, differing in their 5' non-coding regions.
The complete nucleotide sequence of the rat aldolase A isozyme gene, including the 5' and 3' flanking sequences, was determined. The gene comprises ten exons, spans 4827 base-pairs and occurs in a single copy per haploid rat genome. The genomic DNA sequence was compared with those of three species of rat aldolase A mRNA (mRNAs I, II and III) that have been found to differ from each other only in the 5' non-coding region and to be expressed tissue-specifically. It revealed that the first exon (exon M1) encodes the 5' non-coding sequence of mRNA I, while the second exon (exon AH1) encodes those of mRNAs II and III and the following eight exons (exons 2 to 9) are shared commonly by all the mRNA species. These results allowed us to conclude that mRNA I and mRNAs II, III were generated from a single aldolase A gene by alternative usage of exon M1 or exon AH1 in addition to exons 2 to 9. S1 nuclease mapping of the 5' ends of their precursor RNAs suggested that these three mRNA species were transcribed from three different initiation sites on the single gene.


Overexpression of the pro-protein convertase furin predicts prognosis and promotes papillary thyroid carcinoma progression and metastasis through RAF/MEK signaling.
Furin belongs to the pro-protein convertases (PCs) family and its aberrant expression has been documented in various types of cancers; however, its role in thyroid cancer remains unclear. We investigated the expression of furin in a large cohort of Middle Eastern papillary thyroid carcinoma (PTC) patient samples and explored its functional role and mechanism in PTC cell lines in vitro and in vivo. Furin overexpression was observed in 44.6% of all PTC cases and was significantly associated with aggressive clinicopathological parameters and poor outcomes. We show that the knockdown of FURIN suppresses tumor growth, proliferation, migration, invasion, spheroid growth, and progression of epithelial-to-mesenchymal transition (EMT) in B-Raf proto-oncogene, serine/threonine kinase (BRAF) mutant cells, whereas its overexpression in BRAF wild-type PTC cell lines reversed the effect. FURIN knockdown in the BRAF mutant cell line led to reduced tumor growth and increased apoptosis. Mechanistically, FURIN knockdown led to MEK/ERK pathway suppression in BRAF mutant cells, although inhibition of MEK did not affect furin expression, which suggests that furin acts through the MEK/ERK pathway. Furthermore, our study revealed the synergistic antitumor effect of furin depletion and anti-MEK inhibitor treatment. Overall, these results indicate that furin is an important prognostic marker in Middle Eastern PTC and that it plays a crucial role in BRAF-associated MAP/ERK pathway activation and tumorigenesis. Furin inhibition could be a potential therapeutic target for aggressive PTC.


Changes in health status, workload, and lifestyle after starting the COVID-19 pandemic: a web-based survey of Japanese men and women.
This study aimed to examine the change in health status of the general public after starting the COVID-19 pandemic and its association with changes in workload and lifestyle. A web-based survey was conducted in November 2020, about 9 months after starting the COVID-19 pandemic in Japan, among 8000 Japanese men and women aged 25-64 years. Participants asked for the changes after starting the COVID-19 pandemic in health status, workload, daily life, and health behavior. Ordinal logistic regression was performed to elucidate factors associated with deterioration in general health status. A deterioration in general health status was reported by 17.0% of male and 19.4% of female. There has been a clear shift to sedentary life with decreasing moderate activity and increasing screen time. The multivariate analysis revealed that deteriorated work style, increased burden of housework, decreased moderate activity, increased digital media exposure, and increased body weight were significantly associated with deteriorating health status. Both men and women have experienced significant changes in workload and lifestyle since the COVID-19 pandemic started. People should be aware of the risks associated with their recent life changes and take self-care measures to prevent serious health consequences.


Radiation-induced moyamoya disease after childhood astrocytoma.
Adjunctive radiation treatment of childhood intracranial neoplasms of grade II or higher creates a risk of subsequent vasculopathy. A 28-year-old male presented with a Glasgow Coma Scale 12 after acute collapse and hemiparesis with an intraparenchymal haematoma. Emergent craniotomy, histopathology and subsequent imaging confirmed the cause as radiation-induced moyamoya disease, subsequent to treatment for a grade 2 astrocytoma 24 years previously. He had been lost to follow-up after normal serial imaging performed up to 10 years after his initial diagnosis. Long term surveillance imaging may be of benefit in identifying treatable vascular anomalies.


Skilled memory in expert figure skaters.
The present studies extend skilled-memory theory to a domain involving the performance of motor sequences. Skilled figure skaters were better able than their less skilled counterparts to perform short skating sequences that were choreographed, rather than randomly constructed. Expert skaters encoded sequences for performance very differently from the way in which they encoded sequences that were verbally presented for verbal recall. Tasks interpolated between sequence and recall showed no significant influence on recall accuracy, implicating long-term memory in skating memory. There was little evidence for the use of retrieval structures when skaters learned the brief sequences used throughout these studies. Finally, expert skaters were able to judge the similarity of two skating elements faster than less skilled skaters, indicating a faster access to semantic memory for experts. The data indicate that skaters show many of the same skilled-memory characteristics as have been described in other skill domains involving memorization, such as digit span and memory for dinner orders.


Role of leuprorelin on ovarian function of patients with receptor-positive premenopausal breast cancer.
This study aims to investigate the clinical efficacy of leuprorelin on ovarian function in premenopausal breast cancer (PBC) with positive Estrogen or Progesterone receptor. Forty receptor-positive PBC patients admitted to our hospital from January 2018 to October 2020 were randomized into control group and observation group, with 20 cases in each group. Tamoxifen and tamoxifen plus leuprorelin was respectively applied. The levels of bFSH and bAFC, total effective rate, survival rate at 6, 18 and 30 months, adverse reactions, the quality of life and activity of life scores were recorded and compared. After treatment, bFSH and bAFC in the observation group group were better. The total effective rate was 90.00% in the observation group and 55.00% in the control group. The survival rate of 18 and 30 months in the observation group was notably higher while the incidence of adverse reactions was lower. The quality of life score and activity of life score in the observation group were higher. Leuprorelin combined with endocrine drugs can obviously protect ovarian function with significant long-term effect, which effectively reduces the impact of adverse reactions on receptor-positive PBC patients, with higher safety and better feasibility.


Feature relocation network for fine-grained image classification.
In fine-grained image classification, there are only very subtle differences between classes. It is challenging to learn local discriminative features and remove distractive features in fine-grained image classification. Existing fine-grained image classification methods learn discriminative feature mainly via manual part annotation or attention mechanisms. However, due to the large intraclass variance and interclass similarity, the discriminative information and distractive information still are not distinguished effectively. To address this problem, we propose a feature relocation network (FRe-Net) which takes advantage of the different natures of features learned from different stages of the network. Our network consists of a distractive feature learning module and a relocated high-level feature learning module. In the distractive feature learning module, we propose to exploit the difference between low-level features and high-level features to design a distractive loss Ldistractive, which guides the attention to locate distractive regions more accurately. In the relocated high-level feature learning module, we enhance the representing capacity of the middle-level feature via the attention module and subtract the distractive feature learned from the distractive feature learning module in order to learn more local discriminative features. In end-to-end model training, the distractive feature learning module and the relocated high-level feature learning module are beneficial to each other via joint optimization. We conducted comprehensive experiments on three benchmark datasets widely used in fine-grained image classification. The experimental results show that FRe-Net achieves state-of-the-art performance, which validates the effectiveness of FRe-Net.


MicroRNA-122 sensitizes HCC cancer cells to adriamycin and vincristine through modulating expression of MDR and inducing cell cycle arrest.
Hepatocellular carcinoma (HCC) is a hypervascular cancer characterized by rapid progression as well as resistance to conventional chemotherapy. It has been shown that microRNAs play critical roles in pathogenesis of HCC. MicroRNA-122 (miR-122) is a liver-specific microRNA and is frequently downregulated in HCC. In the present study, we investigated whether restoration of miR-122 in HCC cells could render cells sensitive to chemotherapeutic agents adriamycin (ADM) or vincristine (VCR). Our data showed that overexpression of miR-122 in HCC cells induced by adenovirus expressing miR-122 could render cell sensitive to ADM or VCR. Analysis of cell cycle distribution showed that the anti-proliferative effect of miR-122 is associated with increase of cell number in the G2/M phase. Moreover, treatment with Ad-miR122 and ADM or VCR resulted in high accumulation of HCC cells in G2/M phase. We further demonstrated that overexpression of miR-122 could modulate the sensitivity of the HCC cells to chemotherapeutic drugs through downregulating MDR related genes MDR-1, GST-π, and MRP, antiapoptotic gene Bcl-w and cell cycle related gene cyclin B1. Taken together, our findings demonstrated that combination of Ad-miR122 with chemotherapeutic agents inhibited HCC cell growth by inducing G2/M arrest and that this arrest is associated, at least in part, with reduced expression of MDR related genes and Cyclin B1.


[Biopolymer of alginate nature with a predominance of L-guluronic acid].
Highly viscous polysaccharide (250-350 kDa) of an alginate nature with a predominance of alpha-L-guluronic acid (M/G = 0.22) was obtained from Azotobacter vinelandi. The yield ofpolysaccharide was 20.5 +/- 0.5 g/l when cultured in a medium containing molasses at a viscosity of the cultural liquid of over 30000 cSt. The biopolymer is stable at pH 4.0-9.0 in a wide temperature range and well soluble in highly mineralized water; it retains a high viscosity level and can be used in the petroleum industry for enhanced oil recovery.


Water-Assisted Concerted Proton-Electron Transfer at Co(II)-Aquo Sites in Polyoxotungstates With Photogenerated RuIII (bpy)33+ Oxidant.
The cobalt substituted polyoxotungstate [Co6 (H2 O)2 (α-B-PW9 O34 )2 (PW6 O26 )]17- (Co6) displays fast electron transfer (ET) kinetics to photogenerated RuIII (bpy)33+ , 4 to 5 orders of magnitude faster than the corresponding ET observed for cobalt oxide nanoparticles. Mechanistic evidence has been acquired indicating that: (i) the one-electron oxidation of Co6 involves Co(II) aquo or Co(II) hydroxo groups (abbreviated as Co6(II)-OH2 and Co6(II)-OH, respectively, whose speciation in aqueous solution is associated to a pKa of 7.6), and generates a Co(III)-OH moiety (Co6(III)-OH), as proven by transient absorption spectroscopy; (ii) at pH>pKa , the Co6(II)-OH→RuIII (bpy)33+ ET occurs via bimolecular kinetics, with a rate constant k close to the diffusion limit and dependent on the ionic strength of the medium, consistent with reaction between charged species; (iii) at pH <pKa , the process involves Co6(II)-OH2 →Co6(III)-OH transformation and proceeds via a multiple-site, concerted proton electron transfer (CPET) where water assists the transfer of the proton, as proven by the absence of effect of buffer base concentrations on the rate of the ET and by a H/D kinetic isotope in a range of 1.2-1.4. The reactivity of water is ascribed to its organization on the surface of the polyanionic scaffold through hydrogen bond networking involving the Co(II)-OH2 group.


[Gastric adenoma of pyloric type associated with familial adenomatous polyposis: A rare histological type not to be overlooked].
We report here two cases of gastric adenomas of pyloric type diagnosed during the follow-up of familial adenomatous polyposis (FAP). This rare histological lesion has been only recently described in this particular context and its clinical and pathological spectrum remains to be evaluated. Our two cases were very different in their clinical and endoscopic presentation. In the first patient, the lesion was diagnosed late during the evolution of FAP; it was very large and protruded above the adjacent mucosa; because of its large size, its treatment proved to be difficult. In the second patient, the lesion was discovered incidentally in gastric biopsies, early in the course of FAP. Both lesions presented the characteristic morphological and immunohistochemical features of pyloric adenoma, including the expression of MUC6. Both showed evidence of dysplasia, including high-grade dysplasia in the largest lesion. Pyloric adenoma belongs to the spectrum of gastric polyps associated with FAP; its prognosis and evolution remain to be evaluated.


Putting effort into infant cognition.
Working memory allows for the manipulation of information in support of ongoing tasks, providing a workspace for cognitive processes such as learning, reasoning, and decision making. How well working memory works depends, in part, on effort. Someone who pays attention at the right time and place will have better memory, and performance. In adult cognitive research studies, participants' devotion of maximal task-focused effort is often taken for granted, but in infant studies researchers cannot make that assumption. Here we showcase how pupillometry can provide an easy-to-obtain physiological measure of cognitive effort, allowing us to better understand infants' emerging abilities. In our work, we used pupillometry to measure trial-by-trial fluctuations of effort, establishing that, just as in adults, it influences how well infants could encode information in visual working memory. We hope that by using physiological measures such as pupil dilation, there will be a renewed effort to investigate the interaction between infants' attentive states and cognition.


[How does the time of diagnosis affect the course of disease in children with kawasaki syndrome? A retrospective analysis at one center].
Kawasaki syndrome was described for the first time by Tomisaku Kawasaki in 1967. This disease is characterized by panvasculitis of the small blood vessels of the skin, the mucous membranes, the internal organs and the coronary vessels and has an unclear etiology. Inflammatory changes in the coronary vessels or late diagnosis are prognostically unfavorable for the early and late mortality. Since two of our patients with Kawasaki syndrome with a short, severe course died despite receiving state-of-the-art treatment, we retrospectively evaluated the medical records of all the children we have treated since October 1978 with regard to the symptoms at the time of diagnosis, intervals between the onset of the disease, diagnosis, beginning of treatment and the result of treatment. Kawasaki syndrome was diagnosed in 80 patients in the period from October 1978 to October 2007. The patients were grouped according to the phase of the disease and the number of organs affected at the time of diagnosis (Asai-Score) as well as the treatment carried out. The time of the first presentation for diagnosis by the pediatrician was also considered. This is a single-institution retrospective analysis of the medical records, echocardiography and angiography findings of all patients. In view of the change of therapy in that year, patients who had been diagnosed before 1987 were compared with those diagnosed after 1987. Before 1987, the patients were treated solely with high doses of acetylsalicylic acid (50-100 mg/kg/day p.o. over two to four weeks). Out of a total of 36 patients, 13 showed involvement of the coronary arteries that persisted in seven patients despite treatment. After 1987, all patients received intravenous immunoglobulins (4 x 0.5 g/kg/day resp. 1 x 2 g/kg i.v. over 12 hours). In 18 out of 44 patients, the coronary arteries were affected at the time of diagnosis, but this did not persist in any of the patients. One child died in each group. Comparing the two treatment groups also revealed that a physician was consulted for the first time after a very much shorter duration of the disease in the second treatment period (3+/-1.8 vs. 6+/-2.4 days after onset of the illness) and that a pediatrician was consulted much more frequently as the first port of call. This was reflected in a significantly earlier beginning of treatment and a simultaneous significantly lower Asai score. The retrospective evaluation of all medical records did not reveal any plausible explanation for the fatal course of the disease in one child in each of the two treatment periods. Besides the combination therapy with intravenous immunoglobulin and oral administration of acetylsalicylic acid, the greater age and the earlier commencement of treatment appeared to be salient factors resulting in complete cure of the disease in the surviving patients in the second period of treatment.


Linking Costs and Quality in Healthcare: Towards Sustainable Healthcare Systems Comment on "Hospitals Bending the Cost Curve With Increased Quality: A Scoping Review Into Integrated Hospital Strategies".
Organisation-wide studies in cost and quality of care are rare, and Wackers et al make a valuable contribution in synthesizing the literature on this issue. Their paper provides a good overview of initiatives and a list of factors that help in furthering organisation-wide change. The eleven factors they distill from the literate however remain rather abstract and more work needs to be done to contextualize the factors and the work that is needed to accomplish them and to see how they are aligned. Challenges in healthcare quality and costs moreover increasingly cross organizational boundaries and we need new methods to study and evaluate these.


Colonic transit scintigraphy labeled activated charcoal compared with ion exchange pellets.
Scintigraphic measurement of colonic transit is currently performed by delivering 111In ion exchange resin pellets to the colon in a methacrylate-coated capsule. However, use of this method is constrained by the need for an investigational drug permit. We have demonstrated previously optimal adsorption in vitro of commonly used radioisotopes (e.g., 99mTc or 111In) to activated charcoal in milieus that mimicked gastric and small intestinal content. The aim of this study was to compare the transit profiles of radioactive activated charcoal and resin pellets delivered to the colon in the same methacrylate-coated capsule. In 10 healthy volunteers, we compared the colonic transit profiles over 32 hr of simultaneously administered resin pellets labeled with 111In and activated charcoal mixed with 99mTc-diethylenetriaminepentaacetic acid. Transit was summarized as the geometric center (weighted average of counts) in the colon at each scanning period. Colonic transit profiles were virtually identical with the two markers, with less than 0.1 geometric center unit differences in the transit profiles over the 32-hr periods. Activated charcoal is a suitable alternative to resin pellets when delivered in a methacrylate-coated, delayed-release capsule to the colon for measurement of transit by scintigraphy.


Dynamics of Covid-19 mortality and social determinants of health: a spatiotemporal analysis of exceedance probabilities.
To determine the association of social factors with Covid-19 mortality and identify high-risk clusters. Data on Covid-19 deaths across 3,108 contiguous U.S. counties from the Johns Hopkins University and social determinants of health (SDoH) data from the County Health Ranking and the Bureau of Labor Statistics were fitted to Bayesian semi-parametric spatiotemporal Negative Binomial models, and 95% credible intervals (CrI) of incidence rate ratios (IRR) were used to assess the associations. Exceedance probabilities were used for detecting clusters. As of October 31, 2020, the median mortality rate was 40.05 per 100, 000. The monthly urban mortality rates increased with unemployment (IRRadjusted:1.41, 95% CrI: 1.24, 1.60), percent Black population (IRRadjusted:1.05, 95% CrI: 1.04, 1.07), and residential segregation (IRRadjusted:1.03, 95% CrI: 1.02, 1.04). The rural monthly mortality rates increased with percent female population (IRRadjusted: 1.17, 95% CrI: 1.11, 1.24) and percent Black population (IRRadjusted:1.07 95% CrI:1.06, 1.08). Higher college education rates were associated with decreased mortality rates in rural and urban counties. The dynamics of exceedance probabilities detected the shifts of high-risk clusters from the Northeast to Southern and Midwestern counties. Spatiotemporal analyses enabled the inclusion of unobserved latent risk factors and aid in scientifically grounded decision-making at a granular level.


Genes within the major histocompatibility complex of the guinea pig influence susceptibility to Trichostrongylus colubriformis infection.
The influence of genes in the major histocompatibility complex (MHC) of the guinea pig on the susceptibility to infection with the parasitic nematode Trichostrongylus colubriformis was investigated. Back-cross analysis of 2 lines of guinea pigs suggests that genes that map in or near the I region of the guinea pig MHC influence susceptibility to infection by the parasite. However, other genes, possibly not linked to the guinea pig MHC, may also be required for the full expression of susceptibility.


Dopaminergic neurons in the zona incerta modulates ingestive behavior in rats.
The zona incerta, located in the ventral thalamus, is a site of convergence of signals related to drinking. In the present experiments, agonists and antagonists of dopamine receptors were injected into the ZI of animals deprived of water overnight. Injection of 53 nM dopamine or the D2 dopamine receptor agonist PPHT caused a reduction of water and food intake, while the injection of the D1 receptor agonist SKF38393 had no effect. The current results suggest that dopamine injected into the ZI exerts inhibitory influences on drinking behavior mediated by D2 type receptor.


Imaging of hepatocellular carcinoma: practical guide to differential diagnosis.
Hepatocellular carcinoma (HCC) is most commonly seen in patients with cirrhosis. Criteria for diagnosis include arterial-phase enhancement, venous-phase washout, and a capsule on delayed sequences. Tiny HCC are best detected with magnetic resonance imaging using the new hepatocyte-specific gadolinium agents; otherwise, short-term follow up versus biopsy is considered. Diffuse HCC can be difficult to diagnose because of the inherent heterogeneous hepatic parenchyma in cirrhosis, however, portal vein expansion due to thrombosis is a helpful sign.


Molecular basis of the Tfs1/Ira2 interaction: a combined protein engineering and molecular modelling study.
Tfs1p and Ylr179cp are yeast proteins belonging to the PEBP family. Tfs1p, but not Ylr179cp, has been shown to interact with and inhibit Ira2p, a GTPase-activating protein of Ras. Tfs1p has been shown to be a specific inhibitor of the CPY protease and the 3D structure of the complex has been resolved. To shed light on the molecular determinants of Tfs1p involved in the Tfs1/Ira2 interaction, the 3D structure of Ylr179cp has been modelled and compared to that of Tfs1p. Tfs1p point mutants and Tfs1 hybrid proteins combining regions of Tfs1p and Ylr179cp were also designed and their function was tested. Results, interpreted from a structural point of view, show that the accessibility of the surface pocket of Tfs1p, its N-terminal region and the specific electrostatic properties of a large surface region containing these two elements, play a crucial role in this interaction.


Dual Immunity Concomitantly Suppresses HIV-1 Progression.
Broadly neutralizing antibodies (bnAbs) elicited in HIV-1+ elite neutralizers typically are unable to reduce viremia in the same individuals from whom they are isolated. A recent study reports the development of bnAbs in an elite controller that, along with the help of T cells, were associated with restricting HIV-1 progression.


Cysteine and S-sulfocysteine biosynthesis in phototrophic bacteria.
Forteen species (17 strains) of phototrophic bacteria as well as one strain of Thiobacillus denitrificans were tested for cysteine synthase and S-sulfocysteine synthase. All strains contain cysteine sythase active with O-acetylserine; only the Chromatiaceae, two species of the Rhodospirillaceae and T. denitrificans contain S-sulfocysteine synthase. In six species repression by different sulfur compounds in the medium was studied. In Chromatium vinosum, cysteine synthase was found to be constitutive, while in the Rhodospirillaceae tested the enzyme is repressed by sulfide. Thiosulfate had a derepressive effect in Rhodopseudomonas globiformis but strongly repressed cysteine synthase in R. sulfidophila and R. palustris. Cysteine had only moderate effects with the species tested.


Gastrointestinal symptoms are associated with hypothalamic-pituitary-adrenal axis suppression in healthy individuals.
The brain-gut axis has been proposed to influence symptoms in irritable bowel syndrome (IBS). In animal studies corticotropin-releasing hormone (CRH) challenge has been associated with decreased upper gastrointestinal motility and increased colonic motility. The purpose of this study was to investigate the association between gastrointestinal symptoms and the effect of CRH on the hypothalamic-pituitary-adrenal (HPA) axis using a weight-adjusted low-dose dexamethasone test in a group of healthy individuals (n = 157). Pre- and post-dexamethasone morning serum cortisol was analysed. All participants completed questionnaires regarding symptoms of IBS (GSRS-IBS (Gastrointestinal Symptom Rating Scale-IBS) and symptoms of anxiety and depression (HADS (Hospital Anxiety and Depression Scale)). After exclusions, 124 subjects were available for analysis (F/M: 60/64, mean age 55.8 years, SD 15.4, range 21-80 years). A positive correlation was found between the GSRS-IBS score and HADS score (rs =0.36; p <0.001). There was no linear correlation between either pre- (rs = 0.145; p = 0.11) or post-dexamethasone cortisol levels (rs =0.087; p =0.337) and GSRS-IBS scores. By subgrouping the subjects at the lower and higher 25th percentiles of their post-dexamethasone morning cortisol levels, we found a trend towards a higher GSRS-IBS score (median 7.0 versus 5.0; p =0.069) (multivariate adjusted OR 2.6; CI 0.80-8.3) and a significantly higher diarrhoea score (median 2 versus 0; p = 0.021) (multivariate adjusted OR 5.7; CI 1.5-22), and a higher early satiety score (p=0.008) (multivariate adjusted OR 6.7; CI: 1.9-23) in the subjects with high post-dexamethasone cortisol levels (low HPA suppression) compared with the subjects with intermediate post-dexamethasone cortisol levels. Furthermore, individuals with low post-dexamethasone cortisol levels (high HPA suppression) showed a significant, higher score for diarrhoea (median 2.0 versus 0; p =0.010) (multivariate adjusted OR 6.1; CI 1.8-20) and early satiety (p=0.076) (multivariate adjusted OR 3.2; CI 1.0-10) compared with those with intermediate cortisol levels. A trend toward a non-linear relationship between IBS-like symptoms and post-dexamethasone cortisol levels was observed in healthy individuals, with significantly more symptoms of diarrhoea and early satiety in individuals with high or low post-dexamethasone cortisol levels in comparison with those with intermediate post-dexamethasone cortisol levels.


The function and pathogenic mechanism of filamin A.
Filamin A(FLNa) is an actin-binding protein, which participates in the formation of the cytoskeleton, anchors a variety of proteins in the cytoskeleton and regulates cell adhesion and migration. It is involved in signal transduction, cell proliferation and differentiation, pseudopodia formation, vesicle transport, tumor resistance and genetic diseases by binding with interacting proteins. In order to fully elucidate the structure, function and pathogenesis of FLNa, we summarized all substances which directly or indirectly act on FLNa so far, upstream and downstream targets which having effect on it, signaling pathways and their functions. It also recorded the expression and effect of FLNa in different diseases, including hereditary disease and tumors.


Role of anaerobic bacteria in spontaneous peritonitis of cirrhosis: report of two cases and review of the literature.
The role of anaerobic or microaerophillic bacteria in spontaneous peritonitis of cirrhosis has not been clearly defined. Among 126 cases recorded in the literature, in only eight (6 per cent), including the two reported here, was bacterascites associated with anaerobic or microaerophilic bacteria. Clinical features in these cases were indistinguishable from those associated with aerobic bacteria. However, polymicrobial bacterascites occurred in four of eight cases associated with anaerobes, as contrasted with only 10 of 118 cases (8 per cent) associated with aerobes alone. On the other hand, concurrent bacteremia occurred in only one of eight cases associated with anaerobes as contrasted with 52 of 118 cases (44 per cent) of aerobic spontaneous peritonitis. Experimental evidence is cited in an attempt to explain this relatively low incidence of spontaneous peritonitis associated with anaerobic or microaerophilic bacteria, despite the high density of these organisms in the normal bowel flora.


Clinical audit on indications and technique of male urethral catheterization in emergency department of a tertiary care hospital.
Urethral catheterization (UC) is a common procedure done in the Emergency Department of a hospital. The main indications for a UC are relieving acute urinary retention and bladder outlet obstruction. This cross-sectional audit was carried out between July 2019 to February 2020, in the Emergency Department (ED). All male patients aged 18 years and above, in whom UC was performed, were included in the audit. A total of 81 male patients were surveyed. Although, sterilized technique was maintained by using sterile gloves and pyodine but hand hygiene (sterilization or hand wash) was not performed before the procedure 80% of times. CDC hand hygiene guidelines were distributed to promote hand hygiene. What do we already know about this topic ? The Lippincott guidelines are considered gold standard which includes hand hygiene as an important element of urinary catheterization UC. The CDC Center of Disease Control CDC promotes the use of mandatory gloves and generous hand sanitizing before procedures. How does your research contribute to the field For continuous improvement and patient focused practice, we must audit the technique of nursing staff, doctors and health care assistants who are involved in insertion and ordering of catheters to provide quality health care and avoid unnecessary catheterization [1]. The aim of this study was to audit the appropriateness of usage of urinary catheters by the healthcare staff and, their technique of insertion and indications for urinary catheterization. What are your research's implications towards theory, practice, or policy? Hand hygiene is an important element of patient care. If done properly it can prevent several hospital-acquired infections. Heathcare facilities must audit their staff on regular basis and provide refreshers and promote the use of proper hand hygiene before urinary catheterization.


Energy metabolism in astrocytes and neurons treated with manganese: relation among cell-specific energy failure, glucose metabolism, and intercellular trafficking using multinuclear NMR-spectroscopic analysis.
A central question in manganese neurotoxicity concerns mitochondrial dysfunction leading to cerebral energy failure. To obtain insight into the underlying mechanism(s), the authors investigated cell-specific pathways of [1-13C]glucose metabolism by high-resolution multinuclear NMR-spectroscopy. Five-day treatment of neurons with 100-micro mol/L MnCl(2) led to 50% and 70% decreases of ATP/ADP and phosphocreatine-creatine ratios, respectively. An impaired flux of [1-13C]glucose through pyruvate dehydrogenase, which was associated with Krebs cycle inhibition and hence depletion of [4-13C]glutamate, [2-13C]GABA, and [13C]glutathione, hindered the ability of neurons to compensate for mitochondrial dysfunction by oxidative glucose metabolism and further aggravated neuronal energy failure. Stimulated glycolysis and oxidative glucose metabolism protected astrocytes against energy failure and oxidative stress, leading to twofold increased de novo synthesis of [3-13C]lactate and fourfold elevated [4-13C]glutamate and [13C]glutathione levels. Manganese, however, inhibited the synthesis and release of glutamine. Comparative NMR data obtained from cocultures showed disturbed astrocytic function and a failure of astrocytes to provide neurons with substrates for energy and neurotransmitter metabolism, leading to deterioration of neuronal antioxidant capacity (decreased glutathione levels) and energy metabolism. The results suggest that, concomitant to impaired neuronal glucose oxidation, changes in astrocytic metabolism may cause a loss of intercellular homeostatic equilibrium, contributing to neuronal dysfunction in manganese neurotoxicity.


Oligohydramnios-induced lung hypoplasia: the influence of timing and duration in gestation.
We drained amniotic fluid for periods of 5 and 10 days at various times in gestation between days 40 and 55 in the guinea pig (term is 67 days). We analyzed the impact of this procedure on fetal lung growth and used untouched littermate fetuses as controls. During the canalicular stage of lung development, total lung DNA per gram of fetal weight was significantly reduced after only 5 days of oligohydramnios and the percent change did not vary between the two consecutive 5-day periods studied (period A, days 40 to 45, delta of -0.047 mg, p = 0.004; period B, days 45 to 50, delta of -0.042 mg, p = 0.002). The impact of the same duration of oligohydramnios on lung growth later in gestation, during the terminal sac stage of lung development, was less (period C, days 50 to 55, delta of -0.027 mg, p = 0.097). This reduction in effect between period A or B and C was significant at the 0.05 level using a one-way analysis of variance. Two overlapping 10-day periods were also studied. In both experiments, the percent changes in lung DNA per gram of fetal weight between experimental and littermate controls were significant (period D, days 40 to 50, delta of -0.072 mg, p = 0.001; period E, days 45 to 55, delta of -0.047 mg, p = 0.001). The inhibitory effect of oligohydramnios on lung growth was more marked in period D than E (significant at the 0.05 level).(ABSTRACT TRUNCATED AT 250 WORDS)


[Clinical implications of the genus Mycoplasma].
Within Mycoplasma genus, M. pneumoniae, M. genitalium, M. hominis or U. urealyticum are the main species that have been traditionally linked to infectious processes. However, there are many other species involved in these conditions and that are, frequently, unfamiliar to healthcare professionals. The aim of this review is to identify all Mycoplasma genus species that have been isolated in human beings and to determine their involvement in infectious pathology.


Hypnotic susceptibility, inhibitory control, and orgasmic consistency.
Willingness to relinquish control, as evidenced by hypnotic susceptibility, enjoyment of alcohol, and inability to control thoughts and movements near the end of coitus, was found in this study to be predictive of the consistency with which females reported experiencing orgasm during sexual intercourse.


The association of general practitioners' awareness of depression and anxiety with change in quality of life in heart failure patients: results of the prospective observational RECODE-HF cohort study.
Depression and anxiety are more prevalent in patients with heart failure (HF) than in the general population and reduce quality of life (QoL); therefore, clinical guidelines recommend screening HF patients for depression/anxiety. We investigated, whether the general practitioners' (GPs) awareness of patients' symptoms of depression and/or anxiety (psychosocial distress) was associated with a change in QoL. In this prospective observational study, we recruited 3,129 primary care HF patients in Germany. Patients completed baseline and 12-month follow-up questionnaires. Their GPs were interviewed. We identified 666 patients with psychosocial distress and compared 2 groups by analysis of covariance: 235 patients with psychosocial distress whose GP was aware of the psychosocial distress and 431 patients with psychosocial distress whose GP was unaware of such distress. Primary outcome was the change in QoL, assessed by the EQ-5D visual analogue scale. Patients with psychosocial distress showed lower baseline QoL than those without (45.9 vs 64.1; P < 0.001). Within the patients with psychosocial distress, the GPs' awareness of psychosocial distress was not associated with improvement of QoL (F = 1.285; P = 0.258) or remission of psychosocial distress (odds ratio = 0.887; P = 0.608). We found no association between the GPs' awareness of psychosocial distress and change in QoL. Although data for effective treatments of depression in HF are currently insufficient, psychosocial distress strongly impairs the QoL in HF patients. These findings might influence the development of clinical practice guidelines in HF.


Psychological Profiles and 12-Month Weight Outcomes of Women Evaluated for Reoperative Bariatric Surgery.
The use of psychological screening instruments prior to bariatric surgery has been well established. However, there is currently no specific literature on psychological screening of candidates for reoperative bariatric surgery. This study evaluated archival data for 40 women who were candidates for reoperative bariatric surgery and completed the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF). Profile analysis examined differences between patient groups who did and did not undergo reoperative surgery. MMPI-2-RF profiles for reoperative patients then were compared to previous samples of preoperative and postoperative patients. Hierarchical linear modeling was used to predict BMI following reoperative surgery over a 12-month period based on MMPI-2-RF scales while controlling for age and initial BMI. Profile analysis results showed no significant differences on MMPI-2-RF scale scores between reoperative candidates who did and did not undergo a second surgery. With some minor differences attributed to minimization of symptoms, there were no systematic differences in MMPI-2-RF scale scores for reoperative surgery patients compared to preoperative and postoperative patient groups. BMI outcomes over a 12-month period showed that age and initial BMI were significantly better predictors than MMPI-2-RF scores. Administration of MMPI-2-RF for reoperative bariatric surgery patients likely is equivalent to its typical use in preoperative screening. Only the MMPI-2-RF Disconstraint scale showed any relationship to BMI outcomes over time following reoperative surgery.


Caring Ability and Professional Values of Polish Nursing Students-A Cross-Sectional Study.
Caring ability and professional values developed and shaped during nursing university studies are often recognised as fundamental components of education and professional nursing attitudes. The aim of this study was to analyse the relationship between caring ability and professional values among nursing students and their correlation with selected sociodemographic variables. A cross-sectional study was conducted among a convenience sample of 379 nursing students. During the research, the Polish versions of the Caring Ability Inventory and the Professional Values Scale were used. The overall result in the Professional Values Scale was 108.78 (SD = 16.17)-which is considered average, and in the Caring Ability Inventory 189.55 (SD = 18.77)-which is considered low. Age correlated negatively with the professional values of students in total and in the subscale "care"; in contrast, "gender", "place of residence" and "financial situation" did not show any correlation with the level of students' professional values and caring ability. The professional values and caring abilities of nursing students depended on the year and mode of study and the type of university. The results of the study revealed that the caring ability and professional values of nursing students undergo changes during their education.


Polyamine levels in sarcoma-bearing rats in relation to growth and necrosis of the tumour cells.
Putrescine (PU), spermidine (SPD) and spermine (SPM) levels in blood serum of MC Sa 1828 P-bearing rats have been studied in relation to tumour weight and the histological picture. A statistically significant increase of PU and SPD was found in the course of tumour development. Decrease in the level of polyamines in the necrosis stage was also found. Only increased SPD level appeared in the period of intensified necrosis, accompanied by lymphocyte infiltration.


Influence of reactivity to novelty and anxiety on hypothalamic-pituitary-adrenal and prolactin responses to two different novel environments in adult male rats.
Since stressor-induced activation of the hypothalamic-pituitary-adrenal (HPA) axis is involved in some stress-related pathologies, much attention has been paid in laboratory animals to the study of the relationship between endocrine, particularly HPA, responsiveness to stressors and other individual characteristics, such as reactivity to novelty and fear/anxiety. In the present study, adult male rats were classified as high or low reactive to novelty (HR versus LR), as a function of the horizontal activity displayed during 30 min in a circular corridor, and as high or low anxiety (HA versus LA) as a function of the time spent in the open arms of the elevated plus-maze. Then, the behavioural and hormonal response to two distinct novel environments (the hole-board and the light-dark) was assessed in the same subjects, using a counterbalanced design. Plasma prolactin, ACTH and corticosterone responses to the hole-board were higher than to the light-dark, a good correlation between the two tests being found for each hormone. Whereas the hormonal response to the novel environments was not affected by anxiety, HR rats showed a consistently higher HPA response than LR rats when the criteria to classify the animals were the activity during the first 15 min in the circular corridor, but not when the activity during the second 15 min was considered. Neither trait affected prolactin response. The present results demonstrate a good within-individual consistency of the endocrine response to novel environments and support the hypothesis of a higher HPA response to stressors for HR versus LR rats. In contrast, no contribution of fear/anxiety to endocrine responsiveness was observed.


Research on Q-markers of Qiliqiangxin capsule for chronic heart failure treatment based on pharmacokinetics and pharmacodynamics association.
Qiliqiangxin capsule (QLQX), composed of 11 herbs, is an effective traditional Chinese medicine (TCM) that has been widely used for treatment of chronic heart failure (CHF) in China. In the Chinese pharmacopoeia (Ch.P.) only astragaloside was described as the marker component to control the quality of QLQX, which could not reflect the overall effectiveness. The aim of this work was to investigate the quality markers (Q-markers) of QLQX based on the association of the pharmacodynamics (PD) of inhibitory effect on activated renin-angiotensin-aldosterone system (RAAS) and the pharmacokinetics (PK) of bioactive compounds according to the Q-marker theory. The contents of astragaloside, calycosin-7-glucoside, sinapine, ginsenoside Rb1, ginsenoside Rb2, ginsenoside Rg1, salvianolic acid A, salvianolic acid B, danshensu, rosmarinic acid, formononetin, aconitine, mesaconitine, hypaconitine, benzoylaconine, benzoylmesaconine and benzoylhypacoitine were determined by an HPLC-MS/MS method both in QLQX preparation and in the plasma of CHF rats administered intragastrically with QLQX. The effect of lowering angiotensin II (Ang II) production by QLQX was assayed by ELISA. The association between PK and PD was explored and the bioactive compounds with higher content in vitro and better exposure in vivo, which were closely related to the inhibitory effect on the activated RAAS, were identified as Q-markers of QLQX for CHF treatment. The contents of 17 constituents were in the order of salvianolic acid B > danshensu > ginsenoside Rb1 > sinapine > benzoylmesaconine > astragaloside > benzoylhypacoitine > ginsenoside Rb2 > salvianolic acid A > ginsenoside Rg1 > calycosin-7-glucoside > rosmarinic acid > formononetin > benzoylaconine > hypaconitine > aconitine > mesaconitine in QLQX preparation. PK and PD association study of 14 bioactive compounds of QLQX showed the maximum effect (Emax) of astragaloside, calycosin-7-glucoside, sinapine and ginsenoside Rg1 and their peak concentration (Cmax) appeared at the same time; while the time of Emax of ginsenoside Rb1, ginsenoside Rb2, salvianolic acid A, salvianolic acid B, danshensu, rosmarinic acid, formononetin, benzoylaconine, benzoylmesaconine and benzoylhypacoitine was delayed from the time of their Cmax. Astragaloside, calycosin-7-glucoside, sinapine and ginsenoside Rg1 are suitable as the Q-markers of QLQX for CHF treatment, which have higher content in vitro, finer exposure in vivo and a direct correlation with the inhibitory effect on activated RAAS.


Postsplenectomy sepsis in pediatric patients following splenectomy for trauma: a proposal for a multi-institutional study.
Eighteen patients less than 15 years of age (range, 1.5 to 15 years) were followed prospectively after undergoing splenectomy for blunt trauma. Follow-up time ranged from 1 to 12 years with a mean of 5.8 years. During the follow-up period significant septic episodes developed in two of the 18 (11.0%) patients. During the same period 16 patients less than 15 years of age (range 2 to 15 years) who underwent splenorrhaphy were followed. In none of the patients in the splenorrhaphy group has sepsis developed to date (P = .11). Follow-up studies in both groups included a CBC, peripheral smear, platelets counts, history of infections, and radionuclide scans in the patients undergoing splenorrhaphy. The two patients with significant sepsis were an 18-month-old male with pneumococcal septicemia and a 13-year-old with meningococcal meningitis. Both patients survived these episodes. Although the numbers are small, this prospective study reemphasizes the increased risk of sepsis in the asplenic pediatric patient and the need for close surveillance, parental education, appropriate immunizations, and vigorous treatment of infections. The methods used in this prospective study of patients from one institution could be expanded to a multi-institutional study to obtain prospective data concerning the natural history of pediatric patients undergoing splenectomy because of trauma.


Association of hepatitis status with surgical outcomes in patients with dual hepatitis B and C related hepatocellular carcinoma.
The conception that serological hepatitis markers determined surgical prognosis of hepatocellular carcinoma (HCC) associated with hepatitis B (HBV) or hepatitis C (HCV) has been well defined. However, little is known about the relationship between surgical outcomes and serological hepatitis markers in patients with dual HBV and HCV related HCC. A retrospective analysis of the clinical data of 39 HCC patients with HBV-HCV coinfection who underwent curative hepatectomy between 2001 and 2011 was performed. HBV DNA quantification, expression of HBV antigens, anti-HCV signal-to-cutoff ratio (S/CO) and some clinicopathological characteristics were investigated to show the potential relationship among them and the surgical prognosis. The Cox proportional hazards model identified that HBV DNA quantification of 1,000 IU/mL or higher, HBeAg seropositivity, tumor size of greater than 5 cm, multiple tumors, and vascular invasion were risk factors for HCC prognosis. Thus, HBV DNA quantification, HBsAg level, HBeAg status and HCV-Ab level which may reveal the hepatitis status were further analyzed. The overall survival time in the group with high (≥1,000 IU/mL) HBV DNA quantification was significantly lower than the group with low (<1,000 IU/mL) HBV DNA quantification. Similarly, the high HBsAg level (≥1,000 IU/mL) was associated with poor survival compared with the low HBsAg level. Moreover, HBeAg seropositivity determined a higher cumulative risk for death. However, no significant difference was observed in overall survival time between the groups with low (<10.9 S/CO) and high (≥10.9 S/CO) HCV-Ab level. Compared to HCV-Ab high-level group, the serological HBsAg level was observed significantly higher in HCV-Ab low-level group. Furthermore, the data we analyzed showed these 4 serological hepatitis markers were not correlated with cumulative recurrence rate. On multivariate analysis, none of serological hepatitis markers was an independent prognostic factor for HCC patients with dual hepatitis B and C. Among HCC patients with HBV-HCV coinfection, those who with preoperatively high HBV DNA quantification or HBeAg seropositivity had a short survival time and served as poor survival indicators. Serological expression of HBV status rather than HCV status might potentially dominate the surgical outcomes of the Chinese HCC patients with HBV-HCV coinfection.


Whole-exome sequencing: Clinical characterization of pediatric and adult Italian patients affected by different forms of hereditary cardiovascular diseases.
Hereditary cardiovascular diseases comprise several different entities. In this study, we focused on cardiomyopathies (i.e., hypertrophic, dilated, arrhythmogenic, and left ventricular non-compaction), channelopathies (i.e., Brugada syndrome and long QT syndrome), and aortopathies and pulmonary arterial hypertension (i.e., thoracic/abdominal aortic aneurysm and pulmonary arterial hypertension), and genetically characterized 200 Italian patients affected by these diseases. We employed whole-exome sequencing (WES), focused on four in silico gene panels, and the MLPA method for hypertrophic and arrhythmogenic right ventricular cardiomyopathy cases. Cardiomyopathies affected 87.5% of analyzed patients, channelopathies 7%, and aortopathies and pulmonary arterial hypertension 5.5%. The molecular diagnosis was confirmed for 21.5% of cases with a higher detection rate in familial forms (34%) than sporadic ones (14%). We highlighted the importance of family segregation to better understand the pathogenic role of the identified variants and their involvement in the clinical phenotype. Negative results could be ascribed to the high genetic and clinical heterogeneity of hereditary cardiovascular diseases; clinical follow-up and revaluation of WES data will be essential. This study highlights the importance of a multi-step approach (WES and MLPA) to characterize hereditary cardiovascular diseases, provides crucial information for clinical management and recurrence risk estimation, and lays the foundation for future personalized therapies.


Factors influencing bamboo intake of captive giant pandas (Ailuropoda melanoleuca).
Bamboo is the main food source of the giant panda. To increase bamboo intake in captive giant pandas, we studied factors affecting the bamboo intake. Fourteen healthy captive giant pandas in Dujiangyan Base of China Conservation and Research Center for The Giant Panda ("Dujiangyan Base" for short) were selected as research objects. A bamboo feeding experiment was conducted to study the effects of seasons, bamboo age, slope orientations where bamboo grows and felling-feeding time on bamboo intake of the giant panda. We found that the type of bamboo that captive giant pandas feed on was abundant in spring and summer, but relatively homogeneous in winter. With the increase of bamboo age, the intake of bamboo leaves decreased, while bamboo culms increased. The feed intake of 1-year-old bamboo leaves and 5-year-old bamboo culms reached the highest respectively. The slope orientation also affected the panda's bamboo intake, and the bamboo growing on sunny slopes or semi-sunny slopes was more favored by captive giant pandas. Moreover, the bamboo intake reached the highest when felling-feeding time was less than 24 h. In short, we confirmed that seasons, bamboo age, slope orientations and felling-feeding time were factors affecting bamboo intake for captive giant pandas. This study was expected to provide scientific guidance improving the feeding behavior management of captive giant pandas.


Colorimetric method for determining viability of sea urchin sperm applied in toxicity tests.
The aim of this study was to improve the methodological procedure for the evaluation of sea urchin (Lytechinus variegatus) sperm sensitivity in MTT (3-(4,5-dimethylthiazol-2yl)-2,5 diphenyltetrazolium bromide) enzyme reduction assays with the formation of formazan (purple color) in the interior of viable cells. Assays were carried out with the reference toxicants sodium dodecyl sulfate (SDS), copper, zinc, cadmium and ammonium, using a sperm solution previously activated in sea water and a sperm solution prepared in sea water containing 400 μg L-1 verapamil, which enabled activation of the sperm to occur only when exposed to the toxicants. The assays performed with sperm in verapamil presented similar sensitivity to that shown in the fertilization tests with copper, zinc and SDS, while the assays carried out with the pre-activated sperm solution presented greater resistance to the action of the toxicants. It appears that the action of verapamil involves an intracellular effect on the distribution of Ca2+ ions and that the toxicants used prevent the metabolic reactivation of the sperm.


Neural Adjustments during Repeated Braking and Throttle Actions on a Motorcycle Setup.
The aim of the study was to assess neuromuscular changes during an intermittent fatiguing task designed to replicate fundamental actions and ergonomics of road race motorcycling. Twenty-eight participants repeated a sequence of submaximal brake-pulling and gas throttle actions, interspaced by one maximal brake-pulling, until failure. During the submaximal brake-pulling actions performed at 30% MVC, force fluctuations, surface EMG, maximal M-wave (Mmax) and H-reflex were measured in the flexor digitorum superficialis. At the end of the task, the MVC force and associated EMG activity decreased (P<0.001) by 46% and 26%, respectively. During the task, force fluctuation and EMG activity increased gradually (106% and 61%, respectively) with respect to the pre-fatigue state (P≤0.029). The Mmax first phase did not change (P≥0.524), whereas the H-reflex amplitude, normalized to Mmax, increased (149%; P≤0.039). Noteworthy, the relative increase in H-reflex amplitude was correlated with the increase in EMG activity during the task (r=0.63; P<0.001). During the 10-min recovery, MVC force and EMG activity remained depressed (P≤0.05) whereas H-reflex amplitude and force fluctuation returned to pre-fatigue values. In conclusion, contrarily to other studies, our results bring forward that when mimicking motorcycling brake-pulling and gas throttle actions, supraspinal neural mechanisms primarily limit the duration of the performance.


Evaluation of a multiresidue method for pesticides in cereals using supercritical fluid extraction and gas chromatographic detection.
Supercritical fluid extraction (SFE) was evaluated to be applied for residue analysis of 22 gas chromatography/electron capture detector-nitrogen phosphorus detector (GC/ECD-NPD) amenable pesticides in rice, wild rice and wheat. Samples were extracted with supercritical carbon dioxide at 200 atm pressure and 50 degrees C temperature, using methanol as a static modifier. Mean recoveries obtained with the proposed SFE method at two spiking levels with four replicates per level are compared with those obtained with an ethyl acetate-based solvent extraction/gel permeation chromatography (GPC) clean up method. Both methods gave consistent high recoveries for almost all the pesticides from all the commodities with overall mean recoveries higher than 70% with relative standard deviations lower than 20%. Remarkable exceptions were captafol and dimethoate, for which low and/or non-reproducible recoveries were obtained with the SFE method. Residue levels determined with both methods in nine different incurred samples of wheat, containing some of the studied pesticides, were very similar, but, in all cases, slightly higher levels were determined with the SFE method.


Family planning with inflammatory bowel disease: the challenge of childlessness and parent concerns.
In patients with inflammatory bowel disease (IBD), diagnosis is often established at the beginning of childbearing age. Accordingly, concerns about family planning and pregnancy (FPP) are common. Poor knowledge regarding FPP might contribute to increased childlessness in patients with IBD. The Crohn's and Colitis Pregnancy Knowledge Score (CCPKnow, 17 multiple-choice questions) was translated into German and then used for a web-based survey. Childlessness was analyzed with respect to socio-demographic and disease-related information, and the knowledge (CCPKnow) and concerns of IBD patients with children were compared to those of voluntarily childless (VC) and non-voluntarily childless (NVC) IBD patients. Childlessness was observed in 57.4 % of the 533 participants (90.6 % women, 63.0 % Crohn's disease, 31.5 % ulcerative colitis, mean age 33.2 ± 8.6 years), voluntary childlessness in 9 %. The mean overall CCPKnow was adequate (9.38 ± 3.96). Poor knowledge was not associated with increased childlessness (CCPKnow of < 8 was found in 29.8 % of patients with children and 28.9 % of childless patients, p > 0.5). Instead, the patients' education, medical advice, FPP-related concerns, impaired body image, and sexual dysfunction had a significant impact on childlessness. Frequent concerns included adverse effects of the patient's medication on their child (36 % of the respondents), malformation (33 %), miscarriage (34.5 %), and the inheritability of IBD (57 %). Factual knowledge does not reduce disease-related concerns or childlessness. Correct but possibly bothersome information on FPP might contribute to childlessness in patients with IBD. Our findings underline the need for qualified counseling of IBD patients regarding FPP by an experienced IBD physician.


Periprocedural Anticoagulation for Cardioversion of Acute Onset Atrial Fibrillation and Flutter: Evidence Base for Current Guidelines.
The practice of electrical or pharmacological cardioversion (CV) to restore sinus rhythm in patents with symptomatic atrial fibrillation (AF) or atrial flutter has been a part of clinical practice for more than 100 years. For almost as long as CV has been performed, it has been recognized that the act of restoring sinus rhythm is associated with an increased risk of stroke and systemic embolism, and that oral anticoagulant (OAC) therapy can be used to prevent peri-CV thromboembolism. Although it has been widely accepted that OAC therapy is necessary to prevent thromboembolism in patients with chronic AF/atrial flutter who undergo CV, previous clinical practice recommendations have suggested that OAC therapy may be omitted in patients at low risk of stroke. However, in recent years, evidence has emerged from several sources challenging these historical conventions. In 2018 the Canadian Cardiovascular Society AF guidelines updated the previous recommendations regarding CV of acute onset AF, and the use of peri-CV anticoagulation. In this article we present an extensive review of the evidence informing the previous recommendations, as well as the novel evidence that informed the change in recommendations. In addition, the current Canadian Cardiovascular Society AF guideline recommendations are examined within the context of contemporary international major society guidelines.


A Push For Examining Subjective Experience in Value-Based Decision-Making.
Subjective experience is a powerful contributor to value-based decision-making. Not every decision is the same, nor made in isolation. Rather, decision-making relies on historical information and internal states for adaptive control. Hence, it is inherently continuous with respect to time - one decision or action evolves into the next. However, forays into the neurobiological underpinnings of decision-making have too frequently ignored the contribution of such continuous subjective experience, instead tying circuit activity and brain area involvement to discrete averaged behaviors and task parameters. While much information has been gained through these investigations, recent works have demonstrated the potential for a greater understanding of neural mechanisms when the continuous, experiential nature of behavior is integrated into the investigation. Such integration has important implications for disease states with disordered decision-making such as addiction, where subjective experience is a large contributor to the disorder.


[An undesirable drug interaction in horses? Complications which can occur during the administration of coumarin derivatives and phenylbutazone].
A study of the literature was done because of questions asked in a court of justice concerning possible poisoning in a jumper, resulting from administration of both phenylbutazone and a coumarin derivative within a particular period. In view of the mechanisms of action and the pharmacokinetic characteristics of the agents, these forms of combined treatment are also highly inadvisable in horses.


Detection of p53 gene mutations in fine-needle aspiration biopsied breast cancer specimens: correlations with nuclear p53 accumulations and tumor DNA aneuploidy patterns.
Using the polymerase chain reaction and a single strand conformation polymorphism (PCR-SSCP) analysis, p53 gene mutations have been examined preoperatively in aspirated biopsy specimens from 22 breast cancers. In eight (36%) of the studied cases, abnormal bands indicating mutations were detected and were more frequently present in common invasive breast carcinomas. Eight of the breast cancer cases were found to be positive for mutations: direct DNA sequencing confirmed eight mutations and revealed G to A and A to G nucleotide changes in five (63%) and two (25%) cases, respectively. The mutations that were localized at the CpG site of the gene were seen in three cases. Additionally, an immunohistochemical investigation of the presence of the p53 protein and a DNA flow-cytometrical analysis of the 22 resected breast cancers were also performed. Nuclear p53 protein accumulations and a DNA aneuploidy pattern were detected in 11 (50%) cases and in 16 (73%) cases, respectively, and both significantly correlated with p53 gene mutations (P < 0.01 and P < 0.001, respectively; Fisher's exact test). In contrast, in five cases of a breast cancer with a lower histologic grade, no p53 gene mutations, nuclear p53 protein accumulations, or DNA aneuploidy patterns were detected. These results thus suggest that p53 gene mutations, nuclear accumulations of the p53 protein, and a DNA aneuploidy pattern are events that occur with close relationship in the progression of a breast cancer, and that p53 abnormalities appear to correlate with a high grade of the malignancy. Therefore, the detection of p53 gene mutations in aspirated biopsy specimens of breast cancers may be helpful for an accurate and rapid cytological diagnosis, which reflects the prognosis.


What came first, major depression or substance use disorder? Clinical characteristics and substance use comparing teens in a treatment cohort.
This study utilized data on a treatment cohort from a randomized clinical trial that recruited adolescents with co-occurring major depression and substance use disorder (N=126). The purpose of this study was to compare adolescents for whom the onset of depression was first versus those for whom the onset of substance use disorder was first or in the same year as depression. Intake clinical evaluations were abstracted to yield common stressors that included childhood abuse, early loss or death, exposure to violence, and attachment problems. Tobacco, alcohol, and cannabis initiation and dependence were compared for the depression first and substance use disorder first groups, and within those groups by gender. Among the substances studied, only cannabis dependence was significantly more prevalent among those with depression first. Comparisons suggest some differences in the developmental path toward comorbid depression and substance use disorders, but remarkable similarity in measures of dependence and severity. Although small samples limited statistical significance, observed differences suggest possible avenues for prevention or intervention.


Interplay between storage temperature, medium and leaching kinetics of hazardous wastes in Metakaolin-based geopolymer.
Notwithstanding the success of carbon-free nuclear power in the new energy industry, an effective way to address nuclear contamination is still lacking. As a generally accepted method to date, immobilization of radioactive nuclear wastes with inexpensive and environment-friendly matrix such as geopolymer has attracted extensive attention. In this contribution, Na-based and K-based metakaolin geopolymer were prepared to encapsulate simulated radioactive Cs+ and Sr2+ under different temperatures and environments during long-term leaching tests. The temperature-dependent and environmental-dependent leaching kinetics as well as their dominant leaching mechanisms have been revealed. The results showed that Na-based and K-based geopolymer exhibited better immobilization performance than that of Portland cement, ceteris paribus. For the immobilization of Cs+, Na-based geopolymer showed lower leaching rate than K-based geopolymer under the same leaching conditions. Both higher temperature and salt solution accelerated the leaching behaviors of Sr+ and Cs2+ from the encapsulation matrix. This contribution sheds light on understanding the dominant leaching mechanisms of hazardous elements under different storage environments and highlights the significance of salt-tolerant matrix for the immobilization of nuclear wastes.


Polydopamine coating of uncrosslinked chitosan as an acellular scaffold for full thickness skin grafts.
There is an unmet need for skin grafting materials that are readily available for large area wounds, due to complex, lengthy and costly manufacturing processes that are not compatible with this type of wounds. Here we developed an acellular skin graft material based on surface coating of uncrosslinked porous (UCLP) chitosan. UCLP chitosan membranes had mechanical properties in ranges suitable for skin grafting. Polydopamine (PDA) coating improved hydrophilicity and resulted in a significant increase in attachment and metabolic activity of mammalian cells in vitro. PDA coating also decreased the attachment of pseudomonas aeruginosa - a common bacteria infecting skin wounds. Finally, the PDA-coated membranes were implanted in full thickness surgical wounds in a rodent model and resulted in complete would closure in 5 days. The current study suggests that PDA-coated UCLP chitosan membranes could be a simple and effective strategy for the development of grafting materials for large area wounds.


Phosphate enhanced uranium stable immobilization on biochar supported nano zero valent iron.
Uranium (U) immobilization from wastewater by zero valent iron (ZVI) was widely concerned through reduction and surface adsorption. Releasing of U due to re-oxidation of U(IV) into U(VI) limited the application of ZVI in U decontamination. In this work, a kind of biochar supported nano zero valent iron (Fe/BC(900)) was obtained by carbothermal reduction of starch mixed with ferric nitrate at 900 °C. U immobilization behavior by Fe/BC(900) in the presence of phosphate (P) was investigated. The U immobilization reaction was adjusted by controlling the sequence of U, Fe/BC(900) and P. U immobilization efficiency was enhanced to 99.9% in the presence of P. Reaction sequence of U, Fe/BC(900) and P influenced the U immobilization efficiency, which followed the order of (U-P)+Fe/BC(900)>(U- Fe/BC(900))+P>U+Fe/BC(900)>(P-Fe/BC(900))+U. P and nZVI both contributed to enhancing U immobilization through precipitation of uranyl-P and reductive co-precipitate (U(IV)) in a wide pH range. The released Fe ions could precipitate with uranyl and phosphate. Consumption of P and nZVI in the (P-Fe/BC(900))+U system limited U immobilization ability. The precipitate is highly dependent on U, P and Fe elements. U desorption in (U-P)+Fe/BC(900) system was not observed with stability.


Ethical dilemmas during cardiac arrest incidents in the patient's home.
The majority (70%) of cardiac arrests in Sweden are experienced in the patient's home. In these situations, the ambulance nurses may encounter several ethical dilemmas. The aim was to investigate Swedish specialist ambulance nurses' experiences of ethical dilemmas associated with cardiac arrest situations in adult patients' homes. Nine interviews were conducted with specialist ambulance nurses at four different ambulance stations in the southeast region of Sweden. Data were analysed using content analysis. Ethical principles mandated by the Swedish Research Council were carefully followed during the whole process. Two main themes with six sub-themes were identified: The scene - creating a sheltered space for caring and Ethical decision-making. The results showed that ethical dilemmas might occur when trying to create a sheltered space to preserve the patients' integrity and dignity. A dilemma could be whether or not to invite significant others to be present during the medical treatment. Ethical decision-making was dependent on good communication and ethical reasoning among all parties. In certain situations, decisions were made not to commence or to terminate care despite guidelines. The decision was guided by combining the medical/nursing perspectives and ethical competence with respect to the human being's dignity and a will to do good for the patient. The nurses followed the voice of their heart and had the courage to be truly human. The ambulance nurses were guided by their ethos, including the basic motive to care for the patient, to alleviate suffering, to confirm the patient's dignity and to serve life and health.


Neonatal hair profiling reveals a metabolic phenotype of monochorionic twins with selective intrauterine growth restriction and abnormal umbilical artery flow.
Selective intrauterine fetal growth restriction (sIUGR) in monochorionic diamniotic twins, especially types 2&3 with abnormal umbilical artery Doppler, results in increased risk of fetal/perinatal mortality and postnatal disability. We investigate whether the hair metabolome profiles of neonates were associated with the pathophysiological differences across the different clinical forms of sIUGR in twins. Hair samples were collected at delivery from 10 pairs of type 1 sIUGR twins, 8 pairs of types 2&3 sIUGR twins, and 11 pairs of twins without sIUGR. The hair metabolome was characterized using gas chromatography-mass spectrometry. Our results demonstrated that the hair metabolite profiles of the different sIUGR subclinical forms were associated with the averaged fetal growth rate after 28 weeks of gestation but not with birthweight. The hair profiles were capable of discriminating type2&3 sIUGR twins from twins without sIUGR. In particular, the metabolites 2-aminobutyric acid, cysteine, alanine, and tyrosine all displayed areas under the receiver operating characteristic curve were above 0.9. The metabolic pathway analysis highlighted the associations of sIUGR twins with abnormal umbilical artery flow with increased metabolites from a nutrient depletion pathway, glutathione metabolism, and nerve development. This study offers novel insight into the severity of intrauterine ischemia and hypoxia for T2&3 sIUGR twins, through evaluation of the neonatal hair metabolome.


Microwave prepared nitrogen and sulfur co-doped carbon quantum dots for rapid determination of ascorbic acid through a turn off-on strategy.
A simple and eco-friendly microwave method was applied for the preparation of highly fluorescent nitrogen and sulfur co-doped carbon quantum dots (NS-CQDs) and used for the determination of ascorbic acid (ASC) in pharmaceutical dosage forms. The prepared NS-CQDs had bright blue fluorescence at a maximum emission wavelength of 440 nm, after excitation with 350 nm, with a quantum yield of 62.5 %. The developed NS-CQDs were prepared from citric acid and l-cysteine in one minute. The native fluorescence of NS-CQDs was quenched by ferric ions due to the formation of non-fluorescent CQDs/ Fe3+ complex. The quenched fluorescence could be restored by the addition of ASC due to the reducing properties of ASC which converts Fe3+ to Fe2+. The method was found linear over the concentration range of 2.0-100 μg/mL, with a limit of detection was 0.6 μg/mL and a coefficient of determination of 0.9965. The proposed method was cross-validated and statistically compared with a reported HPLC method. The results indicated that the developed method was greener, according to the analytical eco-scale and the green analytical procedure index (GAPI). The prepared NS-CQDs were used for spectrofluorometric determination of ASC in pharmaceutical dosage forms, with percentage recoveries ranging between 98 and 102 %, and relative standard deviations less than 2 %. The method was easy, rapid, reliable, and sensitive and did not require expensive reagents or sophisticated equipment.


Fusion gene-negative alveolar rhabdomyosarcoma is clinically and molecularly indistinguishable from embryonal rhabdomyosarcoma.
To determine whether the clinical and molecular biologic characteristics of the alveolar rhabdomyosarcoma (ARMS) and embryonal rhabdomyosarcoma (ERMS) subtypes have relevance independent of the presence or absence of the PAX/FOXO1 fusion gene. The fusion gene status of 210 histopathologically reviewed, clinically annotated rhabdomyosarcoma samples was determined by reverse transcriptase polymerase chain reaction. Kaplan-Meier analysis was used to assess event-free survival and overall survival in fusion gene-negative ARMS (ARMSn; n = 39), fusion gene-positive ARMS (ARMSp; n = 94), and ERMS (n = 77). A total of 101 RMS samples were also profiled for whole-genome expression, and 128 were profiled for genomic copy number imbalances. Profiling data were analyzed by supervised and unsupervised methods to compare features related to histopathology and fusion gene status. Results were also projected by meta-analysis techniques across three separate publically available data sets. Overall and event-free survival, frequency of metastases, and distribution of site at initial presentation were not significantly different between ARMSn and ERMS. Consistent with this, analysis of gene expression signatures could not reproducibly distinguish ARMSn from ERMS whereas fusion gene-positive cases were distinct. ARMSn and ERMS frequently show whole-chromosome copy number changes, notably gain of chromosome 8 with associated high levels of expression of genes from this chromosome. The clinical behavior and molecular characteristics of alveolar cases without a fusion gene are indistinguishable from embryonal cases and significantly different from fusion-positive alveolar cases. This implies that fusion gene status irrespective of histology is a critical factor in risk stratification of RMS.


Effects of recombinant activated factor VII on coagulation measured by thromboelastography in liver transplantation.
Besides the conventional laboratory tests, thromboelastography (TEG) is used to monitor hemostasis during liver transplantation. A previous pilot study suggested a beneficial effect of recombinant activated factor VII (rFVIIa) on transfusion requirements in liver transplantation. In the present study, we assess the effects of rFVIIa on coagulation variables and TEG. In six study patients, the prothrombin time (PT), the activated partial thromboplastin time (aPTT) and TEG variables [reaction time (r), kinetic time (k), or clot formation time, alpha angle (alpha), and maximal amplitude (MA)] were recorded before and after the administration of a bolus of 80 microg/kg rFVIIa. These patients were compared with six controls who did not receive rFVIIa. In contrast with the control group, a significant shortening of PT (P = 0.028) and aPTT (P = 0.028), r (P = 0.046) and k (P = 0.043) values, and a significant incline of the alpha angle (P = 0.028) were noticed after injection of rFVIIa, whereas MA increased not significantly (P = 0.075). rFVIIa rapidly improved coagulation variables in liver transplant patients including PT and aPTT. Of the TEG variables, r, k and alpha angle significantly improved, and MA showed a trend to increase. These data suggest that rFVIIa not only influences the speed of clot formation, but also the physical properties of the clot, which cannot be detected by routine coagulation tests.


Pattern stability in the insect segment : II. The intersegmental region.
1. InDysdercus the abdominal segments are isolated from each other by an intersegmental region which can be distinguished on the basis of morphological and physiological criteria. 2. The intersegmental region (ISR) consists of the visible segment border and narrow strips of cells anterior and posterior to it. 3. The anterior strip (w-ISR) is white and merges with the white segment region (wS) in front of it, and the posterior strip (r-ISR) is red and merges posteriorly with the red segment region (rS). The wS and the rS meet in the middle of the segment; together they form the segment proper. 4. Grafts from the ISR have been transplanted to various positions within a segment. The reactions of graft and host, respectively, can be distinguished in combinations involving a colour mutant and/or individuals of different sexes. 5. The results show that cells of the r-ISR and the w-ISR each have some adhesiveness towards those tissues which they border in situ, and less adhesiveness towards other tissues. That is, the w-ISR is adhesive towards the r-ISR and wS and is usually rejected by tissue of the rS, whereas the r-ISR is adhesive towards tissue of the w-ISR and rS, but is rejected by tissue of the wS. 6. The role which the ISR plays as a barrier between adjacent segments can essentially be interpreted on the basis of differences in cell adhesiveness. 7. Besides these adhesiveness properties the two parts of the ISR show a long-range influence on polarity and pigment synthesis in surrounding segment tissue. 8. The adhesiveness properties of the r-ISR and w-ISR can explain why the segment boundary forms such a straight line and why the ISR tends to grow between tissues from non-contiguous segment levels. This property can explain the hitherto not understood healing capacity of the ISR which even after wounding prevents cellular interactions between adjacent segments so effectively.


Failure of anti-CD20 monoclonal antibody therapy to prevent antibody-mediated rejection in three crossmatch-positive renal transplant recipients.
There is no optimal desensitization protocol for cadaveric renal transplant recipients who display high levels of donor-specific alloantibodies as defined by a positive T- or B-cell cytotoxic crossmatch. We used anti-CD20 monoclonal antibodies (Rituximab) to try to prevent antibody-mediated rejection in three crossmatch-positive renal transplants recipients (standard and sensitized techniques). The three patients received a first, second, or third cadaveric donor renal transplant. Patient one had an historical positive T- and B-cell cytotoxicity crossmatch: negative T- and B-cell cytotoxicity crossmatch at the day of transplantation. The panel reactive antibody (PRA) level was 100%. Patients 2 and 3 showed positive B-cell cytotoxicity crossmatches: historical and on the day of transplantation; PRA levels were 50% and 71%, respectively. All recipients were treated pretransplant with rituximab (375 mg/m(2)) and 4 days of intravenous immunoglobulin (0.5 g/kg body weight) per day posttransplant plus 5 days of thymoglobulin. Maintenance immunosuppression consisted of tacrolimus, mycophenolate mofetil, and prednisone. Antibody-mediated rejection occurred in all patients at day 6, day 10, or 8 months after renal transplantation. For patient 1, the rejection was not reversible and the graft was lost at day 15. Patient 2 had poor renal function with an MDRD estimate of glomerular filtration rate at 36 mL/min/1.73 m(2) at 18 months posttransplantation, and the graft of patient 3 was lost at 9 months posttransplantation due to resistant antibody-mediated rejection with thrombotic microangiopathy. In these three cases of crossmatch-positive patients, rituximab failed to prevent antibody-mediated rejection. Others studies will be needed to determine the place of rituximab in these patients.


Stabilization of urinary biogenic amines measured in clinical chemistry laboratories.
Urinary 5-hydroxyindoleacetic acid (5-HIAA), vanillylmandelic (VMA), homovanillic acid (HVA), catecholamines and metanephrines are produced in excess by catecholamine-producing tumors. These biogenic amines are unstable at low or high pH and require hydrochloric acid (HCl) to prevent their degradation. However, HCl addition may result in very low pH causing degradation or deconjugation of several metabolites. This study evaluated the buffering properties of sodium citrate to stabilize all biogenic amines. The metabolite concentrations were measured by LC-MS/MS or by a coulometric assay in 22 urine samples collected native and with HCl or sodium citrate. We studied the effect of pH, time (48 h, four weeks) and storage temperature at 22 °C, 4 °C, and -20 °C. We found that catecholamines degradation was prevented by HCl and citrate and that 5-HIAA was degraded in 5 out of 22 samples collected with HCl. All biogenic amines were efficiently stabilized by citrate for four weeks at 22 °C, except epinephrine (48 h at 4 °C, or four weeks at -20 °C). Sodium citrate did not cause quantification or analytical artefacts concerns. In conclusion, sodium citrate is a non-hazardous alternative to HCl for patients to send unfrozen urine samples to the laboratory which may safely store the sample for four weeks.


Getting inside acupuncture trials--exploring intervention theory and rationale.
Acupuncture can be described as a complex intervention. In reports of clinical trials the mechanism of acupuncture (that is, the process by which change is effected) is often left unstated or not known. This is problematic in assisting understanding of how acupuncture might work and in drawing together evidence on the potential benefits of acupuncture. Our aim was to aid the identification of the assumed mechanisms underlying the acupuncture interventions in clinical trials by developing an analytical framework to differentiate two contrasting approaches to acupuncture (traditional acupuncture and Western medical acupuncture). Based on the principles of realist review, an analytical framework to differentiate these two contrasting approaches was developed. In order to see how useful the framework was in uncovering the theoretical rationale, it was applied to a set of trials of acupuncture for fatigue and vasomotor symptoms, identified from a wider literature review of acupuncture and early stage breast cancer. When examined for the degree to which a study demonstrated adherence to a theoretical model, two of the fourteen selected studies could be considered TA, five MA, with the remaining seven not fitting into any recognisable model. When examined by symptom, five of the nine vasomotor studies, all from one group of researchers, are arguably in the MA category, and two a TA model; in contrast, none of the five fatigue studies could be classed as either MA or TA and all studies had a weak rationale for the chosen treatment for fatigue. Our application of the framework to the selected studies suggests that it is a useful tool to help uncover the therapeutic rationale of acupuncture interventions in clinical trials, for distinguishing between TA and MA approaches and for exploring issues of model validity. English language acupuncture trials frequently fail to report enough detail relating to the intervention. We advocate using this framework to aid reporting, along with further testing and refinement of the framework.


Fat-forming solitary fibrous tumor of the sacrum: A case report and literature review.
Fat-forming variant of solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm. Here we report the case of a 33-year-old woman who developed pain and muscle weakness from the posterior aspect of the right hip to lower extremity. Imaging examinations revealed a mass with fatty components and hypervascular solid components filling the sacral spinal canal and sacral foramen. The sacral mass was resected and histological examination of the specimens revealed patternless proliferation of short spindle-shaped cells with staghorn blood vessels. A number of mature adipocyte-like cells were also observed. The tumor cells were positive for STAT6 and the nuclei of the adipocytes were also positive, which was diagnostic for fat-forming SFT.


Effects of superficial temporal artery to middle cerebral artery bypass on postoperative infarction rates among young children (≤ 5 years old) with moyamoya disease.
Revascularization surgery for young children with moyamoya disease (MMD) is challenging. Although indirect revascularization is preferred because of the technical difficulty in direct anastomosis, higher risks of postoperative infarction remain a problem. We aimed to investigate the effect of superficial temporal artery to middle cerebral artery (STA-MCA) bypass on postoperative outcomes during the acute postoperative period in young children ≤ 5 years old with MMD. This retrospective study included consecutive young children with MMD who underwent surgical revascularization of the anterior cerebral circulation. Groups were determined according to the procedures performed, namely, the combined (STA-MCA bypass with indirect revascularization) and the indirect revascularization groups. The incidences of radiological or symptomatic infarction, transient neurological events, and new neurological deficits that remained at discharge were compared between groups. Of 38 surgical procedures, there were 23 combined and 15 indirect revascularizations. The median age of the patients was 3.0 years, which was significantly different between groups (P < .01). When comparing the postoperative outcomes between groups, the incidences of radiological and symptomatic infarction and new neurological deficits that remained at discharge were significantly lower in the combined revascularization group (P < .05). Logistic regression analysis adjusted for potential confounders found that surgical modality was a statistically significant independent risk factor associated with radiological and symptomatic infarctions (indirect/combined, odds ratio: 10.2; 95% confidence interval: 1.30-79.7; P < .05). STA-MCA bypass combined with indirect revascularization can reduce the incidence of postoperative infarction in young children with MMD and might lead to better neurological outcomes.


Visual impairment and blindness due to macular diseases globally: a systematic review and meta-analysis.
To estimate the number of people visually impaired or blind due to macular diseases except those caused by diabetic maculopathy. Meta-analysis. Based on the Global Burden of Disease Study 2010 and ongoing literature research, we examined how many people were affected by vision impairment (presenting visual acuity <6/18, ≥3/60) and blindness (presenting visual acuity <3/60) due to macular diseases, with diabetic maculopathy excluded. In 2010, of 32.4 million blind people and 191 million vision-impaired people, 2.1 million (95% uncertainty interval [UI]: 1.9, 2.7) people were blind, and 6.0 million (95% UI: 5.2, 8.1) million were visually impaired due to macular diseases. In 2010, macular diseases caused 6.6% (95% UI: 6.0, 7.9) of all blindness and 3.1% (95% UI: 2.7, 4.0) of all vision impairment, worldwide. These figures were lower in regions with young populations than in high-income regions. Between 1990 and 2010, the number of people who were blind or visually impaired due to macular diseases increased by 36%, or 0.6 million people (95% UI: 0.5, 0.8) and by 81%, or 2.7 million (95% UI: 2.6, 3.9) people, respectively, whereas the global population increased by 30%. Age-standardized global prevalence of macula-related blindness and vision impairment in adults 50 years of age and older decreased from 0.2% (95% UI: 0.2, 0.2) in 1990 to 0.1% (95% UI: 0.1, 0.2) in 2010 and remained unchanged from 0.4% (95% UI: 0.3, 0.5) to 0.4% (95% UI: 0.4, 0.6), respectively. In 2010, 2.1 million people were blind and 6.0 million people were visually impaired due to macular diseases, except those caused by diabetic maculopathy. Of every 15 blind people, 1 was blind due to macular disease, and of every 32 visually impaired people, 1 was visually impaired due to macular disease.


[Comparative characteristics of the serotonin and histamine content in the blood of surgical patients before and after antibiotic administration against a background of droperidol, promedol and atropine premedication].
The effect of intramuscular administration of ceporin and megacillin in single doses of 500 mg and 1000000 Units respectively on serotonin and histamine blood levels in 34 patients against the background of premedication with droperidol, promedol or atropine was studied. The observations showed that after megacillin injection the serotonin blood levels decreased. Ceporin had no effect on serotonin and histamine blood levels.


[Karyotype analysis of Lonicera japonica and L. maackii].
To study Lonicera japonica Thunb. and Lonicera maackii (Rupr. ) Maxim. chromosome number, karyotype, volume. Sections combined with micrograph were used to analyse chromosome. Lonicera japonica Thunb. normal diploid 2n = 18; the relative length was 2n = 18 = 2L +8M, + 6M1 + 2S; karyotpye formula was K(2n) = 2X = 18 = 10 sm + 6 m + 2st, which belong to "2A" type; the AS. K% was 66.65%. Lonicera maackii (Rupr.) Maxim. normal diploid 2n = 18; the relative length was 2n = 18 = 4L + 4M, + 10M1; karyotype formula was K(2n) = 2X = 18 = 10 sm + 8m, which belong to"2A" type; the AS. K% was 63.28%. The chromosome number, karyotype, and chromosome volume of Lonicera japonica Thunb. and Lonicera maackii (Rupr.) Maxim. were showed clear.


A system for in vivo measurement of bone calcium by local neutron activation of the hand.
A 252Cf neutron-irradiation facility designed specifically for clinical in vivo measurement of calcium in the hand is described. Results of preliminary measurements are presented. Hand phantoms were exposed to the neutron beam for 10 min and the induced 49Ca activities were counted for 10 min after an elapsed time of 2 min. The results indicate that with a 2 X 100 micrograms 252Cf neutron source and two 20.3 X 12.7 cm NaI crystals, the counts per gram of bone mineral mass changes by about 4% for each 100 cm3 change in the overall volume (soft tissue plus bone) of the hand. For hands of equal volumes the counts per gram are expected to be almost independent of the bone volume. With an absorbed dose equivalent of 150 mSv (15 rem), the sensitivity is about 200 counts per 10 min per gram Ca. The statistical reproducibility of the results is better than 3% for the average value of 11 g Ca in the normal hand.