Strain rate measurement by doppler echocardiography allows improved assessment of myocardial viability inpatients with depressed left ventricular function.
This study sought to evaluate whether objective assessment of the myocardial functional reserve, using strain rate imaging (SRI), allows accurate detection of viable myocardium. Strain rate imaging is a new echocardiographic modality that allows quantitative assessment of segmental myocardial contractility. In 37 patients (age 58 +/- 9 years) with ischemic left ventricular dysfunction, myocardial viability was assessed using low-dose (10 microg/kg body weight per min) two-dimensional dobutamine stress echocardiography (DSE), tissue Doppler imaging, SRI and (18)F-fluorodeoxyglucose ((18)FDG) positron emission tomography (PET). The peak systolic tissue Doppler velocity and peak systolic myocardial strain rate were determined at baseline and during low-dose dobutamine stress from the apical views. A total of 192 segments with dyssynergy at rest were classified by (18)FDG PET as viable in 94 and nonviable in 98. An increase of peak systolic strain rate from rest to dobutamine stimulation by more than -0.23 1/s allowed accurate discrimination of viable from nonviable myocardium, as determined by (18)FDG PET with a sensitivity of 83% and a specificity of 84%. Receiver operating characteristic (ROC) curve analysis showed an area under the curve for prediction of nonviable myocardium, as determined by (18)FDG PET using SRI, of 0.89 (95% confidence interval [CI] 0.88 to 0.90), whereas the area under the ROC curve using tissue Doppler imaging was 0.63 (95% CI 0.61 to 0.65). The increase in the peak systolic strain rate during low-dose dobutamine stimulation allows accurate discrimination between different myocardial viability states. Strain rate imaging is superior to two-dimensional DSE and tissue Doppler imaging for the assessment of myocardial viability.


A complexity scoring system for degenerative mitral valve repair.
To develop a score to allow stratification of complexity in degenerative mitral valve repair. Retrospective modeling of data from 668 consecutive patients who underwent surgery for mitral valve prolapse. A complexity scoring scale was developed using a consensus approach, assigning a score to each valve, based on the following: prolapsing segments (weight 1 for each posterior segment; weight 2 for each anterior or commissural segment); presence of valve restriction (weight 2); presence of calcification (weight 3 if annulus involved, otherwise weight 2); and prior mitral valve repair (weight 3). Valve repairs were categorized into 3 groups based on the complexity score: 1: Simple (n = 244); 2-4: Intermediate (n = 260); ≥5: Complex (n = 164). Mitral valve repair was successfully performed in 667 patients (repair rate: 99.9%). The complexity score was directly correlated with surrogates of technical complexity. The mean cardiopulmonary bypass time increased with lesion complexity ([in minutes] simple: 152; intermediate: 167; complex 195; P < .001). The median number of repair techniques utilized was related to lesion complexity (simple: 3; intermediate: 4; complex: 5; P < .001). Barlow's type etiology was more prevalent in complex cases (63%), compared with simple (9%) and intermediate (35%) cases (P < .001). Advanced repair techniques were required to complete repair in 51% of complex cases, compared with 14% of intermediate and 0% of simple cases (P < .001). Early and late outcomes were similar. Our scoring system may allow effective stratification of complexity of mitral valve repair. Future studies are required to evaluate the use of our score in a prospective setting.


Side population cells contribute to the genesis of human endometrium.
To investigate whether stem (progenitor) cells are found in human endometrial side population cells. Experimental laboratory study. University-based laboratory in Japan. Normal endometrial tissue samples from 42 patients. Side population cell analysis and staining were performed by using Hoechst 33342, CD31, CD34, EMA, CD105, CD146, and BCRP1/ABCG2. Human endometrial side population cells were isolated and characterized by fluorescence-activated cell sorter analysis. Stem cell activity was evaluated by colony-forming assays and cell cycle analysis. Endometrial side population cells expressed not only the endothelial cell markers CD31 and CD34 and the epithelial cell marker EMA but also mesenchymal stem cell markers CD105 and CD146. Immunohistochemical analysis revealed that BCRP1/ABCG2, known as a marker of side population cells, was strongly expressed in the vascular endothelium and the epithelium of the basal layer of the endometrium. In cell cycle analysis, side population cells isolated directly from tissue were mainly in G0, whereas side population cells sorted after primary culture included populations in G1 and G2/M/S. These sorted side population cells showed greater colony-forming efficiency than non-side population cells and secreted PRL in an in vitro decidualization model. Human endometrial side population cells may include putative stem or progenitor cells.


Investigation of serum β-defensin-1 level in calves with coccidiosis.
Coccidiosis is a protozoan infection that can result in hemorrhagic diarrhea, depression, weakness, weight loss, and even mortality in young animals. β-defensin-1 is an antimicrobial peptide produced largely by epithelial cells in the skin and mucosa. It possesses antifungal, antibacterial, antiparasitic, and antiviral properties. The goal of this study was to evaluate how β-defensin-1 levels changed in coccidiosis-infected calves. The sample included 10 coccidiosis-positive calves and 7 healthy calves, for a total of 17 calves of diverse breeds and older than 15 days. To assess the level of β-defensin-1, blood samples were obtained from the vena jugularis of the animals. The concentrations of β-defensin-1 in the serum were measured using a commercial ELISA kit. Although the serum β-defensin-1 level decreased in infected animals, the drop was not statistically significant when compared to the control group. According to the study's findings, there was no significant change in the serum β-defensin-1 level in coccidiosis-infected calves. We believe that it will be advantageous to conduct additional studies with a larger sample size in order to acquire more precise results.


Germ-line sex determination in Drosophila melanogaster.
In Drosophila melanogaster, the mechanism of sex determination is substantially different in the germ line and in the soma. In the germ line, the process is not completely cell-autonomous, but requires some signals from the soma. Only some of the genes involved in somatic sex determination are also needed for germ cell development. Recent genetic studies have identified loci required for germ-line sex determination.


Heat-shock response is associated with enhanced contractility of vascular smooth muscle in isolated rat aorta.
Stress proteins have been implicated in pathological cardiovascular conditions. We hypothesized that a heat-shock response modulates contractility of vascular smooth muscles. Rat aortic ring preparations were mounted in organ baths, exposed to 42 degrees C for 45 min, and subjected to contractions. Expression of HSP70 and phosphorylation of myosin light chain were examined with immunoblots. Heat shock enhanced contractile response to KCl in parallel with HSP70 expression in rat aortic rings from 8 h but not 1 h after the end of heat shock. Heat shock also augmented vascular contractility to phenylephrine whether endothelium was intact or denuded. Treatment of heat shock-preconditioned aortic rings with Bay K8644, a calcium channel activator, but not treatment with phorbol dibutyrate (1 micromol/l), a protein kinase C activator, enhanced contractions of the rings as compared with those of the control. The levels of phosphorylation of myosin light chains after administration of phenylephrine in heat shock-preconditioned tissues were statistically significantly higher than those in control tissues. Pretreatment with wortmannin (300 nmol/l), an inhibitor of myosin light chain kinase, decreased both contractility and phosphorylation of myosin light chains in parallel. However, heat-shock response did not affect relaxation responses to either acetylcholine in endothelium-intact aortic rings or sodium nitroprusside in endothelium-denuded rings. These results suggest that the heat-shock response is associated with enhanced vascular smooth muscle contractility through a modulation of thick-filament regulation.


Formation of diacyl and alkylacyl glycerophosphocholine in rabbit alveolar macrophages.
The incorporation of various labeled precursors into alkenylacyl, alkylacyl and diacyl phospholipids in rabbit alveolar macrophages was studied. The incorporation rates of the individual precursors were shown to be quite different among the three subclasses of phospholipids. [3H]Glycerol, [14C]16:0, [14C]18:1, [14C]18:2 and [32P]-orthophosphate were preferentially incorporated into choline glycerophospholipids (CGP), especially into diacyl glycerophosphocholine (GPC), indicating that the de novo synthesis of diacyl GPC is extremely high. Considerable portions of the radioactivities of [14C]16:0, [14C]18:1, [14C]18:2 and [32P]orthophosphate were also found in alkylacyl GPC, the incorporation being higher than or comparable to that in the case of diacyl glycerophosphoethanolamine (GPE). We then examined the activities of cholinephosphotransferase and ethanol-aminephosphotransferase, and found that the activity of cholinephosphotransferase was remarkably high in macrophage microsomes compared with that in microsomes from several other tissues. This suggests that diradylglycerols were preferentially utilized by choline-phosphotransferase, which is consistent with the results obtained for intact cells. We confirmed that a considerably higher amount of diacyl GPC as well as alkylacyl GPC was formed through this enzyme reaction with macrophage microsomes than with brain microsomes. The high formation of alkylacyl GPC could be responsible, at least in part, for the accumulation of this unique ether phospholipid, a stored precursor form of platelet-activating factor in macrophages.


Spermatogenesis and the fine structure of the mature spermatozoon in the free proglottis of Trilocularia acanthiaevulgaris (Cestoda, Tetraphyllidea).
Spermatogenesis and the structure of the mature spermatozoon of Trilocularia acanthiaevulgaris have been studied by light microscopic histochemistry and transmission and scanning electron microscopy. The primary spermatogonia occupy the periphery of the testis and undergo four mitotic divisions; incomplete cytokinesis results in two secondary, four tertiary and eight quaternary spermatogonia and sixteen primary spermatocytes. The quaternary spermatogonia and successive stages develop in a plasmodial rosette with their nuclei at the periphery and connected to the cytophore by cytoplasmic bridges. The primary spermatocytes undergo two meiotic divisions, resulting in 64 spermatids that develop into spermatozoa. Intranuclear synaptonemal complexes in primary spermatocytes confirm the first meiotic division. The onset of spermiogenesis is marked by an elongation of the spermatid nucleus and the appearance of "arching membrane-bound clefts" (after Rosario 1964) that delimit the differentiation zone. The latter contains a pair of axonemes with their associated basal bodies and rootlets and, as it extends, the nucleus migrates into it. At first, the axonemes grow at right angles to the extension, but during development they rotate through 90 degrees and come to fuse with the cytoplasmic extension. The mature spermatozoon has a broad head region, a middle piece and a narrow tail region. It consists of a highly coiled nucleus, paired axonemes of the 9 + 1 pattern typical of platyhelminths, one of which extends the full length of the tail and the other ends part-way along the tail, particles of beta-glycogen and peripheral microtubules. A crested body spirals around the outside of the sperm body in the tail region. T. acanthiaevulgaris is placed in context within the phylogenetic schemes for cestodes based on sperm ultrastructure.


Tissue-specific expression of profilin.
Expression of profilin and profilin:actin ratios in vertebrates were determined with polyclonal antibodies against profilin and actin. Profilin was detected in a wide variety of bovine tissues and was enriched in smooth muscle of bovine, porcine and avian origin. The protein was purified from pig stomach muscle tissue. Smooth muscle profilin was found to be more effective in inhibiting the polymerization of skeletal muscle actin than thymus profilin purified by the same method.


Online detection and measurement of elemental mercury vapor by ion mobility spectrometry with chloroform dopant.
A rapid and simple method is proposed for detection of elemental mercury (Hg) vapor by ion mobility spectrometry (IMS). Negative corona discharge (CD) as the ionization source and chloroform as the dopant gas were used to produce Cl- reactant ion. A mass spectrum of the product ions confirmed that the mechanism of ionization is based on Cl- anion attachment to Hg and formation of HgCl- ion. It was found that the optimum drift gas temperature for Hg detection was about 160 °C and the drift gas flow rate should be minimized and just sufficient to clear contaminants and carry-over from the drift cell. The drift time of the HgCl- peak relative to that of the Cl- peak at 160 °C is 1.52 ms corresponding to the reduced mobility of 1.90 cm2/Vs. Because many volatile organic compounds (VOCs) such as alcohols, amines, aldehydes, ketones, and alkanes are not ionized in the negative mode of CD-IMS, these compounds do not interfere with the detection of Hg. Mercaptans peaks also did not show any interference with the Hg signal. Hence, the method is highly selective for detection of Hg in natural gas containing sulfur compounds. The detection limit of Hg obtained by the proposed method was 0.07 mg/m3. The method was successfully verified in determination of the mercury vapor content of a fluorescent lamp, as a real sample.


Report of a case with T1a gallbladder poorly differentiated adenocarcinoma, solid type, which developed into lymph node metastases.
We experienced a case with gallbladder carcinoma growing limited to the mucosa (T1a), which developed massive lymphatic vessel spread and lymph node metastases.A 72-year-old man was referred to our hospital for the swelling of his gallbladder during a routine ultrasound sonography checkup. We diagnosed the patient with gallbladder carcinoma with lymph node metastasis according to the radiographic findings and performed the open cholecystectomy and lymph node dissection. A histological examination showed poorly differentiated adenocarcinoma, solid type, and the tumor was limited to the mucosa. The number of lymphatic vessels was increased in the tumor and peritumor areas, and cancer cells were observed in the lymphatic vessels, which were detected via D2-40 immunohistochemistry. A careful histological examination and follow-up is required for T1a gallbladder carcinoma.


Propofol administration to the fetal-maternal unit reduces cardiac injury in late-preterm lambs subjected to severe prenatal asphyxia and cardiac arrest.
Cardiac dysfunction is reported to occur after severe perinatal asphyxia. We hypothesized that anesthesia of the mother with propofol during emergency cesarean section (c-section) would result in less cardiac injury (troponin T) in preterm fetuses exposed to global severe asphyxia in utero than anesthesia with isoflurane. We tested whether propofol decreases the activity of proapoptotic caspase-3 by activating the antiapoptotic AKT kinase family and the signal transducer and activator of transcription-3 (STAT-3). Pregnant ewes were randomized to receive either propofol or isoflurane anesthesia. A total of 44 late-preterm lambs were subjected to in utero umbilical cord occlusion (UCO), resulting in asphyxia and cardiac arrest, or sham treatment. After emergency c-section, each fetus was resuscitated, mechanically ventilated, and supported under anesthesia for 8 h using the same anesthetic as the one received by its mother. At 8 h after UCO, the fetuses whose mothers had received propofol anesthesia had lower plasma troponin T levels, and showed a trend toward a higher median left ventricular ejection fraction (LVEF) of 84% as compared with 74% for those whose mothers had received isoflurane. Postasphyxia activation of caspase-3 was lower in association with propofol anesthesia than with isoflurane. Postasphyxia levels of STAT-3 and the AKT kinase family rose 655% and 500%, respectively with the use of propofol anesthesia for the mother. The use of propofol for maternal anesthesia results in less cardiac injury in late-preterm lambs subjected to asphyxia than the use of isoflurane anesthesia. The underlying mechanism may be activation of the antiapoptotic STAT-3 and AKT pathways.


A biologically constrained spiking neural network model of the primate basal ganglia with overlapping pathways exhibits action selection.
Action selection has been hypothesized to be a key function of the basal ganglia, yet the nuclei involved, their interactions and the importance of the direct/indirect pathway segregation in such process remain debated. Here, we design a spiking computational model of the monkey basal ganglia derived from a previously published population model, initially parameterized to reproduce electrophysiological activity at rest and to embody as much quantitative anatomical data as possible. As a particular feature, both models exhibit the strong overlap between the direct and indirect pathways that has been documented in non-human primates. Here, we first show how the translation from a population to an individual neuron model was achieved, with the addition of a minimal number of parameters. We then show that our model performs action selection, even though it was built without any assumption on the activity carried out during behaviour. We investigate the mechanisms of this selection through circuit disruptions and found an instrumental role of the off-centre/on-surround structure of the MSN-STN-GPi circuit, as well as of the MSN-MSN and FSI-MSN projections. This validates their potency in enabling selection. We finally study the pervasive centromedian and parafascicular thalamic inputs that reach all basal ganglia nuclei and whose influence is therefore difficult to anticipate. Our model predicts that these inputs modulate the responsiveness of action selection, making them a candidate for the regulation of the speed-accuracy trade-off during decision-making.


First Eastern European experience of isolated limb infusion for in-transit metastatic melanoma confined to the limb: Is it still an effective treatment option in the modern era?
Isolated limb infusion (ILI) with cytotoxic agents is a simple and effective treatment option for patients with melanoma in-transit metastases (ITMs) confined to an extremity. Data for ILIs performed in Europe are sparse and to date no Eastern European ILI experience has been reported. The aim of the current study was to evaluate the efficacy of ILI in Estonia. Data for twenty-one patients were collected and analysed. All patients had melanoma ITMs and underwent an ILI between January 2012 and May 2018. The cytotoxic drug combination of melphalan and actinomycin-D was used. Drug circulation times were 20-30 min under mildly hyperthermic conditions (38-39 °C). Primary outcome measures were treatment response and overall survival. Nineteen lower limb and two upper limb ILIs were performed. The female to male ratio was 18:3. The overall response rate (complete + partial response) was 76% (n = 16), with a complete response in 38% (n = 8). The overall long-term limb salvage rate was 90% (n = 19). During follow-up, eight patients (38%) died, two due to metastatic melanoma. Five-year overall survival was 57%. This first Eastern European report of ILI for melanoma ITMs shows results comparable to those from other parts of the world. In this era of effective targeted and immune therapies, ILI remains a useful treatment option, with a high overall response rate and durable responses in patients with melanoma ITMs confined to a limb.


Handheld ultrasonography in cardiovascular medicine, updates and controversies.
A variety of hand-held ultrasound (HHU) machines have recently become available and offer different capabilities and features. Despite the differences of the individual HHU devices, all offer the potential for faster diagnoses and are more sensitive than clinical assessment in identifying cardiovascular abnormalities. In addition, they provide enhanced transportability, can potentially reduce waiting time for full echocardiograms, and may save health-care resources. Significant potential for the growth of HHU as a tool to facilitate patient care exists when performed by well-trained and competent providers is anticipated. This paper presents the characteristics, benefits, limitations, and future perspectives of HHU devices.


Expression of allograft inflammatory factor-1 (AIF-1) in acute cellular rejection of cardiac allografts.
To date, there are no good biomarkers for diagnosing and predicting the progression of cardiac allograft rejection. Previous studies have shown a correlation of allograft inflammatory factor-1 (AIF-1) to human cardiac allograft rejection; however these studies were limited in sample size and did not address whether AIF-1 could be used as a biomarker in diagnosing and predicting the progression of cardiac allograft rejection. Using immunohistochemistry, AIF-1 expression was determined in cardiomyocytes (CMCs), mononuclear cells (MNCs) and Quilty lesions in 192 allograft endomyocardial biopsies and 37 heart specimens from nontransplant patients with diverse heart diseases. AIF-1 was found in both cardiac allografts and hearts with other cardiac diseases. In cardiac allografts, expression levels of AIF-1 in both CMCs and MNCs directly correlated with the severity of cardiac cellular rejection. AIF-1 expression was also elevated in Quilty B lesions, but not in Quilty A lesions. The rejection grade in subsequent biopsies increased in biopsies that had low-grade rejection with high CMC AIF-1 scores or Quilty B lesions. AIF-1 was expressed in both CMCs and MNCs in hearts with various adverse conditions including but not limited to heart transplantation. In cardiac transplantation, AIF-1 was associated with the severity of cardiac allograft rejection and Quilty B lesions, which could predict subsequent increases in rejection grade. Thus, AIF-1 shows promise that it can be a potential biomarker for cardiac allograft rejection.


A case of the unstable Hb Genova (beta 28 Leu----Pro) in an Arab child associated with severe haemolytic anaemia and growth retardation.
The first case of unstable Hb Genova from North Africa is described. It was found in a 13-year-old girl from Libya suffering from chronic Heinz body haemolytic anaemia and growth retardation. The available data strongly suggest that this case represents a new example for a spontaneous mutation.


Chemotherapy-based control of schistosomiasis haematobia. 3. Snail studies monitoring the effect of chemotherapy on transmission in the Msambweni area, Kenya.
Regular snail sampling was performed at 40 sites, representing the principal snail habitats, during a 4 year chemotherapy programme targetted at school-children in the Msambweni area of the coastal plain of Kenya. Populations of Bulinus africanus group snails, primarily from pools, showed seasonal variations, dropping when sites dried out and rising when they were refilled by the rains. Transmission, judged by the recovery of snails shedding typical fucocercous cercariae, continued throughout the treatment period at very low levels (less than 1% of the snails collected were infected) with peaks in October/November and in January/February after seasonal rains. Spatially, most infected snails were recovered from 2 large pools near the sea, close to the school that responded least well to the initial chemotherapy programme. Later, infected snails were found sporadically in inland pools, rice fields and temporary streams near another school where there was evidence of substantial reinfection as the study progressed. The snail findings are consistent with a reduction but not elimination of transmission associated with the chemotherapy programme.


Instant intra-operative neutropenia despite the emergence of banded (CD16dim/CD62Lbright) neutrophils in peripheral blood - An observational study during extensive trauma-surgery in pigs.
Deregulation of polymorphonuclear neutrophils (PMNs) is an essential step in the development of inflammatory complications upon trauma. Different neutrophil subtypes have been identified recently, however, the role of neutrophil subtypes in immunoregulation upon trauma is unclear. We hypothesize that extensive trauma surgery causes instant progressive heterogeneity of the blood neutrophil pool, and increased appearance of young (CD16dim/CD62Lbright) neutrophils in peripheral blood. A standardized extensive thoraco-abdominal porcine trauma surgery model was utilized, and 12 animals were included. Blood was collected at defined timepoints and neutrophil numbers and subtypes were studied by flowcytometry. Neutrophil subtypes were identified by differences in cell surface expression levels of CD16 (FcγRIII) and CD62L (L-selectin). Porcine neutrophil subtypes were further characterized after flow sorting. Eleven animals survived the 3-hour surgical protocol. Neutrophil numbers dropped significantly from a mean of 8,6 ± 3,5 × 106 to 2,4 ± 1,8 × 106 cells/ml during 180 min, (p<0.001). Simultaneously, the blood PMN population became increasingly heterogeneous due to the appearance of new neutrophil subtypes. Cell sorting experiments and cytological analysis revealed that these porcine subtypes had specific morphological characteristics, mimicking their human counterparts. At baseline, 88% ± 1 percent of circulatory PMNs comprised of mature (CD16bright/CD62Lbright) PMNs, while at 3 h the blood PMN pool consisted of 59% ± 2 percent of mature subtypes (p<0.001). Despite a marked drop in neutrophil levels during surgery, absolute and relative numbers of banded (CD16dim/CD62Lbright) neutrophils continued to rise throughout surgery. Standardized extensive trauma surgery was associated with instant progressive neutropenia and increased heterogeneity of the blood neutrophil pool. Furthermore, three different neutrophil subsets in peripheral porcine blood were identified over the course of surgery. Further studies should clarify their precise role in the development of early organ failure upon extensive trauma surgery. This for the first time exemplifies experimentally the time constraints and impact of damage control surgery after severe trauma.


Lack of effects of apomorphine, haloperidol and clozapine on the synthesis and utilization of brain GABA.
The synthesis of GABA was studied as the accumulation of GABA following inhibition of the GABA-alpha-ketoglutaric acid aminotransferase by gamma-acetylenic GABA (GAG) or gamma-vinyl GABA. The disappearance of GABA was studied by means of inhibition of glutamate decarboxylase by 4-deoxypyridoxine. Systemic administration of the dopamine receptor agonist apomorphine did not change the accumulation or the disappearance of GABA in the substantia nigra and the corpus striatum of the rat. However, a very high dose of apomorphine somewhat increased the GAG-induced GABA accumulation in the corpus striatum. The dopamine receptor antagonists haloperidol and clozapine did not modify the accumulation and disappearance of GABA in the two structures, except for a slight decrease in the GAG-induced GABA accumulation in the substantia nigra. Following an acute hemisection, the neural connections between the substantia nigra and the corpus striatum are interrupted on one side of the brain. Apomorphine did not influence the accumulation or the disappearance of GABA in the substantia nigra and in the corpus striatum on the sectioned side of the brain. These results indicate that the synthesis and the utilization of GABA in the two structures studied are not influenced to any greater extent by changes in dopamine receptor activity.


Increased vanilloid receptor VR1 innervation in vulvodynia.
Vulvodynia is characterised by painful burning sensation, allodynia and hyperalgesia in the region of the vulval vestibulus. While in many patients the cause of vulvodynia remains uncertain, we and others have previously shown increased intraepithelial and papillary innervation in vulvodynia. The vanilloid receptor VR1 (TRPV1) is expressed by nociceptors, and is triggered by capsaicin, noxious heat, protons, and chemicals produced during inflammation. In the present study we show increased papillary VR1 fibres by immunostaining and image analysis in vulvodynia tissues compared to controls (p<0.002). VR1 expression was found to be significantly increased when the percentage area immunostained was expressed as a ratio of VR1 to PGP 9.5, a pan-neuronal marker (P=0.01). VR1-positive fine epidermal fibres also appeared to be increased in vulvodynia tissues, by inspection. Fibres immunoreactive to the voltage-gated sodium channel SNS1/PN3 (Nav1.8), also expressed by nociceptors, were relatively scarce in both vulvodynia and control tissues. We hypothesize that increased expression of VR1 by nociceptors could mediate some of the symptoms in vulvodynia, for which systemic or topical specific VR1 antagonists may provide novel treatment.


Functional polymorphisms in the interleukin-6 and serotonin transporter genes, and depression and fatigue induced by interferon-alpha and ribavirin treatment.
Depression and fatigue are frequent side effects of interferon-alpha (IFN-alpha) treatment, and there is compelling evidence that the inflammatory response system (including interleukin-6, IL-6) and the serotonergic system is important in the pathophysiology of such symptoms. Functional polymorphisms in the promoter region of the IL-6 gene (rs1800795) and serotonin transporter gene (5-HTTLPR) have been identified as regulating these systems. The present study aimed to determine if these polymorphisms were associated with the development of depression and fatigue during IFN-alpha and ribavirin treatment. Ninety-eight Caucasian patients receiving pegylated IFN-alpha and ribavirin treatment for chronic hepatitis C virus at King's College Hospital, London, and Emory University Hospital, Atlanta, participated in this prospective cohort study. Symptoms of depression and fatigue were measured before treatment and at weeks 4, 8, 12 and 24 during treatment. The 'low IL-6' synthesizing genotype (CC) was associated with significantly fewer symptoms of depression (effect size = 0.7 at week 24; F = 9.4, d.f. = 436, P = 0.002). The 'high transcription' serotonin transporter (5-HTT) genotype (LL) was also associated with significantly fewer symptoms of depression, but with a much smaller effect (effect size = 0.2 at week 24; F = 4.5, d.f. = 436, P = 0.03). Neither polymorphisms were associated with symptoms of fatigue (IL-6: F = 1.2, d.f. = 430, P = 0.2; 5-HTT: F = 0.5, d.f. = 430, P = 0.5). The smaller effects of the 5-HTT polymorphism on depression may be explained by an interaction between the genes (F = 5.0, d.f. = 434, P = 0.02): the 'protective' effect of the 5-HTTLPR polymorphism was evident only in the presence of the 'low IL-6' genotype (F = 5.4, d.f. = 64, P = 0.02), not in the presence of the 'high IL-6' genotype (F = 2.2, d.f. = 369, P = 0.1). The association between the IL-6 polymorphism and reduced risk of depressive symptoms confirms the role of the inflammatory response system in the pathophysiology of IFN-alpha-induced depression; in contrast, the effect of the 5-HTT gene was small and perhaps dependent on the status of the inflammatory response.


Genomes of Subaerial Zygnematophyceae Provide Insights into Land Plant Evolution.
The transition to a terrestrial environment, termed terrestrialization, is generally regarded as a pivotal event in the evolution and diversification of the land plant flora that changed the surface of our planet. Through phylogenomic studies, a group of streptophyte algae, the Zygnematophyceae, have recently been recognized as the likely sister group to land plants (embryophytes). Here, we report genome sequences and analyses of two early diverging Zygnematophyceae (Spirogloea muscicola gen. nov. and Mesotaenium endlicherianum) that share the same subaerial/terrestrial habitat with the earliest-diverging embryophytes, the bryophytes. We provide evidence that genes (i.e., GRAS and PYR/PYL/RCAR) that increase resistance to biotic and abiotic stresses in land plants, in particular desiccation, originated or expanded in the common ancestor of Zygnematophyceae and embryophytes, and were gained by horizontal gene transfer (HGT) from soil bacteria. These two Zygnematophyceae genomes represent a cornerstone for future studies to understand the underlying molecular mechanism and process of plant terrestrialization.


Retired Educators' Career Transition as a New Life Role of Underwriting Career Development in Botswana.
Retired educators of Botswana strongly disagree with the idea that a retiree is a liability and cannot contribute to a system's advancement. The study explores retired educators' view that career development of young persons can benefit from retirees' career transitional experiences, through mentoring. In-depth interviews were conducted with 16 individuals and 3 groups of retirees. Career construction and phenomenological principles informed the study, while, thematic analysis reflected the experiences of retired educators. Four themes emerged, including, Meaningful experiences for retired educators and Recommendations for future education programmes. Interview excerpts are evidence for acquired self-awareness and leadership, soft skills, necessary for career development. Mentoring and reflective forums are some ways retired educators could be engaged in career development.


Direct effects of clomiphene citrate on the steroidogenic capability of human granulosa cells.
The effects of clomiphene citrate (CC), 17 beta-estradiol (E2), and human chorionic gonadotropin (hCG) on the accumulation of progesterone (P) and 20 alpha-hydroxy-4-pregnen-3-one (20 alpha-OHP) in cultured human granulosa cells (GC) were examined. In addition, the metabolism of [4-14C]pregnenolone and accumulation of [4-14C]P in response to CC and E2 were determined. The authors conclude the following: (1) the dose-dependent inhibition of P and 20 alpha-OHP production by CC in GC was not reproduced by E2, (2) hCG abolished these effects of CC, (3) these inhibitory actions of CC were not associated with altered 3 beta-hydroxysteroid dehydrogenase activity nor P catabolism indicating that, (4) these actions by CC on the GC occur at some step(s) during steroidogenesis preceding the formation of pregnenolone. These findings may explain, at least in part, the luteal deficiency experienced by women treated with CC, and they also provide a rationale for the use of hCG supplementation during ovulation induction with CC.


The features of the fatty acid composition of Pyrus L. total lipids are determined by mountain ecosystem conditions.
The composition of fatty acids (FAs) of total lipids of pericarp, seeds, and leaves of Pyrus caucasica Fed. and Pyrus communis L. growing in mountain ecosystems at different altitudes (300, 700 and 1200 m) was studied. It was found that the greatest differences in the relative content of FAs within a species, depending on the altitudes above sea level, were characteristic of the outer tissues of the pericarp (peel) and leaves, which were in direct contact with the external environment. Pericarp parenchyma to a lesser extent, and seeds practically did not differ in FA composition at different heights. At altitudes with increased UV radiation, conjugated octadecadienoates: rumenic acid (9,11-18:2) and 10,12-18:2 were registered in the pericarp and leaf of Purys L., the functions of which in plants were practically not studied. The wild P. caucasica at all growing altitudes was characterized by more very-long-chain FAs (VLCFAs) than the P. communis cultivar. At 700 m, most likely when exposed to fungal infections, the relative number of VLCFAs increased significantly, and new species of individual odd-chaine FAs appeared in their composition in both representatives. It was especially worth noting the appearance in peel and leaf melissic acid (30:0), which was rarely recorded in the plant. A characteristic feature of only P. communis at an altitude of 700 m was the large number of unsaturated individual VLCFAs. Based on the data obtained, a scheme of possible pathways for VLCFA biosynthesis in P. communis were proposed.


Levels of asymmetric dimethylarginine, nitric oxide and lipid peroxidation markers in patients with end-stage renal disease having peritoneal dialysis treatment.
In this study, we aimed to investigate the activities of paraoxonase-1 (PON1) and nitric oxide synthase (NOS) and the levels of asymmetric dimethylarginine (ADMA), nitric oxide (NO), oxidized low-density lipoprotein (oxLDL), ceruloplasmin (CP), thiobarbituric acid-reactive substances (TBARS), malondialdehyde (MDA), 4-hydroxynonenal (HNE) and lipids in serum of patients with end-stage renal disease (ESRD) having continuous ambulatory peritoneal dialysis (CAPD) treatment and controls living in the Antalya region, Turkey. Fifty-three patients with ESRD were enrolled in this study and were treated by CAPD. As the control group (n=32), subjects with normal renal function were included. Serum PON1 activity and high-density lipoprotein-cholesterol (HDL-C) levels were decreased in ESRD patients whereas ADMA, NO, oxLDL, CP, TBARS, MDA and HNE levels and NOS activity were increased with regard to control group. In CAPD patients, ADMA positively correlated with NO, CP, oxLDL, TBARS and MDA levels whereas negatively correlated with PON1 activity. On multiple logistic regression analysis, risk factors associated with ESRD included CP, TBARS, triglycerides (TG) and very low-density lipoprotein-cholesterol (VLDL-C) levels. Our data have demonstrated that ESRD patients on CAPD treatment exhibit increased lipid peroxidation reactions and decreased antioxidant protection. The assay of serum HNE and MDA may be useful to evaluate the individual accumulation of these toxic aldehydes to test the efficiency of new dialysis strategies in removing them.


Resuscitative endovascular balloon occlusion of the aorta: simulation improves performance but may require interval training to prevent skill degradation.
Surgical trainees are exposed to less procedures with increasing need for simulation. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has become increasingly implemented for hemorrhage control, yet most courses are catered to faculty level with little data on trainees. We propose that routine training in this critical procedure will improve trainee performance over time. This is a prospective, observational study at a level I trauma center involving a monthly trauma procedural program. Early in the month, trainees received hands-on REBOA training; at the end, trainees underwent standardized, class-based evaluation on a perfused trainer. Score percentages were recorded (0-100%). Endpoints included early, mid and late performance (2-12 months). Paired T-test and Pearson's coefficient were used to evaluate differences and strength of association between time between training and performance. 25 trainees participated with 5 and 11 repeat learners in the PGY-2 and PGY-3 classes, respectively. Median early performance score was 62.5% (IQR 56-81) for PGY-2s and 91.6% (IQR 75-100) in PGY-3s. Pearson's coefficient between time between and training and score demonstrated a weak correlation in the PGY-2s (r2 = - 0.13), but was more pronounced in the PGY-3s (r2 = - 0.44) with an inflection point at 5 months. Routine REBOA training in trainees is associated with improvement in performance within a short period of time. Skill degradation was most pronounced in trainees who did not receive training for more than 5 months. Trainees can be successfully trained in REBOA; however, this should be done at shorter intervals to prevent skill degradation.


Impaired perceived timing of falls in the elderly.
Falls are the leading cause of injury-related deaths and hospitalizations, with older adults at an increased risk. As humans age, physical changes and health conditions make falls more likely. While we know how the body reflexively responds to prevent injury during a fall, we know little about how people perceive the fall itself. We previously found that young adults required a fall to precede a comparison sound stimulus by approximately 44ms to perceive the two events as simultaneous. This may relate to common anecdotal reports suggesting that humans often describe distortions in their perception of time - time seems to slow down during a fall - with very little recollection of how and when the fall began. Here we examine whether fall perception changes with age. Young (19-25y) and older (61-72y) healthy adults made temporal order judgments identifying whether the onset of their fall or the onset of a comparison sound came first to measure the point of subjective simultaneity. Results show that fall perception is nearly twice as slow for older adults, where perturbation onset has to precede sound onset by ∼88ms to appear coincident, compared to younger adults (∼44ms). We suggest that such age-related differences in fall perception may relate to increased fall rates in older adults. We conclude that a better understanding of how younger versus older adults perceive falls may identify important factors for innovative fall prevention strategies and rehabilitative training exercises to improve fall awareness.


Genotoxic effects induced by the exposure to an environmental mixture of illicit drugs to the zebra mussel.
Despite the growing interest on the presence of illicit drugs in freshwater ecosystems, just recently the attention has been focused on their potential toxicity towards non-target aquatic species. However, these studies largely neglected the effects induced by exposure to complex mixtures of illicit drugs, which could be different compared to those caused by single psychoactive molecules. This study was aimed at investigating the genetic damage induced by a 14-day exposure to a realistic mixture of the most common illicit drugs found in surface waters worldwide (cocaine, benzoylecgonine, amphetamine, morphine and 3,4-methylenedioxymethamphetamine) on the zebra mussel (Dreissena polymorpha). The mixture caused a significant increase of DNA fragmentation and triggered the apoptotic process and micronuclei formation in zebra mussel hemocytes, pointing out its potential genotoxicity towards this bivalve species.


Musculoskeletal capacity of middle-aged women and men in physical, mental and mixed occupations. A 3.5-year follow-up.
The musculoskeletal capacity of 44 women and 39 men, mean age 55.0 +/- 3.4 years, was studied at the beginning and end of a 3.5 year period. The measurements included anthropometrics, maximal isometric trunk flexion and extension strength, maximal isometric hand grip strength and back mobility. According to a job analysis the subjects were divided into three dominating work groups: physical, mental and mixed groups. The results showed significant changes in anthropometrics, maximal isometric muscle strength and in mobility. The body weight and body mass index among women and the body mass index among men increased significantly during the period. The body height and sum of the skinfolds had on the other hand decreased significantly for both women and men. Women showed significant decreases of 9% and 10% (p less than 0.05 and p less than 0.01) in isometric trunk flexion and extension strength, and an increase of 9% in back mobility (p less than 0.05). In mental work, most of the significant changes occurred among women. Men had significant decreases in isometric trunk flexion and extension, 22% and 16% respectively (p less than 0.001) and an increase of 13% in back mobility (p less than 0.001). The men doing physical work had most of the significant changes in musculoskeletal capacity. The results revealed accelerated changes in musculoskeletal capacity in middle-aged employees.


ADORA2A genotype modulates interoceptive and exteroceptive processing in a fronto-insular network.
Facilitated processing of interoceptive and exteroceptive information in the salience network is suggested to promote the development of anxiety and anxiety disorders. Here, it was investigated whether the adenosine 2 A receptor gene (ADORA2A) 1976T/C (rs5751876) variant - previously associated with anxiety disorders and anxiety-related phenotypes as well as general attentional efficiency -was involved in the regulation of this network. In detail, fMRI recordings of 65 healthy participants (female=35) were analyzed regarding ADORA2A genotype effects on brain connectivity related to (1) interoceptive processing in terms of functional connectivity resting-state fMRI, and (2) exteroceptive processing using dynamic causal modeling in task-based fMRI. In a subsample, cardiac interoceptive accuracy was furthermore measured via the Mental Tracking Task. ADORA2A genotype was found to modulate a fronto-insular network at rest (interoceptive processing) and while performing an executive control task (exteroceptive processing). Across both modalities, the ADORA2A TT risk genotype was associated with increased connectivity between the insula and the prefrontal cortex. The strength in connectivity correlated with interoceptive accuracy. It is concluded that alterations in fronto-insular connectivity are modulated by both the adenosinergic system and interoceptive accuracy. Thus, fronto-insular connectivity in synopsis with ADORA2A genotypic information could serve as combined biomarkers for personalized treatment approaches in anxiety disorders targeting exteroceptive and interoceptive dysfunction.


[Serum concentrations and kinetics after intravenous infusion of four grams of cefazolin (author's transl)].
The pharmacokinetics of cefazolin were studied in 25 males and females after administration of 4 g infused over 60 minutes. The mean microbiologically active concentration of cefazolin in serum five minutes after discontinuing the infusion was 410 microgram/ml, after 60 minutes 190 microgram/ml and after 8 hours 8.5 microgram/ml. After 8 hours 84% of the drug was eliminated in the urine of four of the volunteers. The mean serum half-life was 87.38 minutes in the one compartment model, and the volume of distribution 9.20 1. The area under the curve was 44626.15 microgram.min.ml-1. The mean value for the clearance was 73.5 ml/min. The importance of high dosages of cefazolin in severe infections caused by cefazolin-sensitive organisms is discussed. Side-effects were not observed.


The utility of EEG, SSEP, and other neurophysiologic tools to guide neurocritical care.
Neuromonitoring is an emerging field that aims to characterize real-time neurophysiology to tailor therapy for acute injuries of the central nervous system. While cardiac telemetry has been used for decades among patients requiring critical care of all kinds, neurophysiology and neurotelemetry has only recently emerged as a routine screening tool in comatose patients. The increasing utilization of electroencephalography in comatose patients is primarily due to the recognition of the common occurrence of nonconvulsive seizures among comatose patients, the development of quantitative measures to detect regional ischemia, and the appreciation of electroencephalography phenotypes that indicate prognosis after cardiac arrest. Other neuromonitoring tools, such as somatosensory evoked potentials have a complementary role, surveying the integrity of the neuroaxis as an indicator of prognosis or illness progression in both acute brain and spinal injuries.


Mechanism of clozapine-induced agranulocytosis : current status of research and implications for drug development.
Clozapine is an atypical antipsychotic agent that has several advantages over conventional antipsychotics, not least of which is its superior efficacy. However, the high risk of agranulocytosis (0.8% of patients) associated with clozapine therapy has resulted in restricted indications for its use.The mechanism of clozapine-induced agranulocytosis is not clear. The target cells affected are the myeloid precursors, although the mature neutrophil may also be targeted simultaneously. There is no convincing evidence of direct toxicity of the parent compound or its stable metabolites (demethyl-clozapine and clozapine N-oxide). Clozapine is also metabolised by liver microsomes, peripheral blood neutrophils and their bone marrow precursors to a chemically reactive intermediate that has been postulated to be a nitrenium ion. This toxic metabolite has been shown to covalently bind to neutrophil proteins, suggesting that it may be involved in the pathogenesis of the toxicity. However, it is not clear how toxicity is mediated. The nitrenium ion may bind to essential cellular proteins and disrupt neutrophil function or, alternatively, it may act as a hapten and initiate an immune reaction resulting in immune-mediated destruction of the neutrophil. Indirect evidence exists to support both mechanisms, although clear direct evidence is still lacking. The role of cytokines and apoptosis in the pathogenesis of the agranulocytosis is unclear.The reason why only approximately 1% of individuals who are treated with clozapine are affected by agranulocytosis has not been elucidated. Evidence exists to implicate both the major histocompatibility complex antigens and heat shock protein variants in determining individual susceptibility, although more patients of different ethnic backgrounds need to be studied.The ultimate aim of research into clozapine-induced agranulocytosis should be to either prospectively predict which individuals are going to develop agranulocytosis and/or to develop analogues that retain efficacy but are not toxic. The former is complicated by the fact that predisposition may be multifactorial, and thus prediction may require multiple tests that may be of statistical but not absolute validity. The latter depends on identifying the mechanism of toxicity and the chemical characteristics of clozapine that are responsible for the toxicity. This knowledge may allow rational design of new analogues that do not cause agranulocytosis.


Cadmium and lead through an agricultural food chain.
Two experiments measured quantities of soil Cd and Pb in wheat grain and eggs of laying hens that ingested the grain for 34 days and in liver and muscle after a 30 day withdrawal period. Soil Cd (0.6 to 2.9 ppm) induced a direct and linear accumulation in grain which ranged from 1.25 to 5.36 ppm. No response to soil Pb (4.0 to 18.7 ppm) was detected in grain which averaged 2.7 +/- 1.5 ppm. Ingestion by hens of 1500 to 11,000 micrograms Cd kg-1 body wt induced 1.87 ppm in dry albumin but Cd was not detectable in yolk, liver or muscle. Lead ingested after 34 days averaged 13,386 micrograms kg-1 body wt induced a mean of 3.88 and 4.71 micrograms Pb g-1 in yolk and albumin, respectively, but none in liver and muscle. From the soil pool 0.004% Cd and 0.02% Pb accumulated in the grain; 1.6% of grain Cd accumulated in the eggs. Only minuscule quantities (1 X 10(-5#of the Cd and Pb in the soil pool were transferred and retained in hen tissues via ingestion of the grain.


Racial/Ethnic and Nativity Inequalities in Gestational Diabetes Mellitus: The Role of Psychosocial Stressors.
Racial/ethnic and nativity disparities in gestational diabetes mellitus (GDM) persist in the United States. Identified factors associated with these differences do not fully explain them. Research has recognized psychosocial stress as a potentially modifiable risk factor for GDM. We used New York City Pregnancy Risk and Assessment Monitoring System data (2009-2014) linked with birth certificate items (n = 7,632) in bivariate and multivariate analyses to examine associations between 12 psychosocial stressors (modeled three ways: individual stressors, grouped stressors, stress constructs) and GDM across race/ethnicity and nativity, and if stressors explain racial/ethnic/nativity differences in GDM. U.S. and foreign-born Black and Hispanic women reported higher stressors relative to U.S.-born White women. In fully adjusted models, the financial stress construct was associated with a 51% increased adjusted risk of GDM, and adding all stressors doubled the risk. Psychosocial stressors did not explain the elevated risk of GDM among foreign-born Black (adjusted risk ratio, 2.18; 95% confidence interval, 1.53-3.11), Hispanic (adjusted risk ratio, 1.57; 95% confidence interval, 1.10-2.25), or Asian/Pacific Islander (adjusted risk ratio, 4.10; 95% confidence interval, 3.04-5.52) women compared with U.S.-born White women. Historically minoritized racial/ethnic and immigrant women have an increased risk of psychosocial stressors and GDM relative to U.S.-born White women. Although financial and all stressors predicted higher risk of GDM, they did not explain the increased risk of GDM among immigrant women and women from minoritized racial/ethnic groups. Further examination into racial/ethnic and nativity inequalities in stress exposure and rates of GDM is warranted to promote healthier pregnancies and birth outcomes.


EPIYA Motif Genetic Characterization from Helicobacter pylori Isolates in Distinct Geographical Regions of Iran.
This study aimed to determine the current EPIYA motifs of the cagA gene in Helicobacter pylori isolates from patients with gastric disorders, and evaluate the association between these patterns and the clinical outcome of H. pylori infection in different geographical regions of Iran. We examined 150 patients with gastrointestinal disorders from the central and eastern regions of Iran. The detection of H. pylori and screening of cagA was performed by polymerase chain reaction (PCR). The pattern of the motifs was determined by PCR followed by sequencing. The overall prevalence of H. pylori was 66.3% in eastern (Mashad) and 50.6% in the central (Isfahan) part of Iran. The frequency of cagA-positive strains in Mashad and Isfahan were 63.4% and 56.7%, respectively. The pattern of EPIYA motif was as follows: 43 (79.6%) ABC, 7 (12.9%) AB, 4 (7.4%) ABCC, and one (1.9%) ABCCC. We also identified a novel EPIYA C sequence motif which showed association with gastric cancer (GC). The relationship between the frequency of specific EPIYA motifs and GC was statistically significant (P < 0.05). This is the first report for the determination of the cagA EPIYA motif of H. pylori in the Northeast and center of Iran. The prevalence of cagA positive H. pylori between the two regions was significant (P ≤ 0.05). All isolates of the H. pylori cagA were western type (ABC). The increase in the number of EPIYA-C repeats was associated with GC (P ≤ 0.01).


T cells with receptors for IgD.
The role of IgD in the immune response has been elusive, although its predominance on the cell surface suggests a receptor function. We have shown previously that euthymic but not athymic BALB/c mice, injected with IgD before antigen, exhibit enhanced antibody responses which can be transferred by T cells. Isotype-specific T cells have been reported to have both upward and downward immunoregulatory effects. Here we demonstrate the existence of T cells with receptors for IgD, and show that exposure to IgD in vivo or in vitro significantly increases the number of T delta cells in the spleen and lymph nodes but not in the thymus. The kinetics of T delta-cell appearance in vivo parallels that of the immunoenhancing effect which occurs after injection of IgD. These T delta cells are of the Lyt 1+2- T-cell phenotype.


Severe pregnancy-induced deterioration of truncal valve regurgitation in an adolescent patient with repaired truncus arteriosus.
Truncus arteriosus, a rare and complex congenital heart disease, is hallmarked by a single great vessel (truncus) that arises over a large ventricular septal defect and provides both the pulmonary and systemic circulation. Pregnancy reports after repair for truncus arteriosus are scarce. Therefore, the maternal and offspring outcomes are unknown. We report the outcome of a pregnancy in an 18-year-old woman with repaired truncus arteriosus. Despite severe and symptomatic deterioration of truncal valve regurgitation, she successfully delivered a healthy child, and the valve function recovered within 2 weeks postpartum.


An empirical study on the close-range post-ricochet orientation of AK bullets (7.62 mm × 39 mm).
Most of the injuries and deaths from ricocheting bullets in shooting incidents are usually reported due to misaimed shots that had ricocheted close to the victims. Although the destabilisation of ricocheted bullets during their ricochet flights is a generally known phenomenon, no significant quantitative-based scientific studies have attempted to understand bullets' post-ricochet orientations at close distances. This empirical study explores close-range post-ricochet orientations of AK bullets (7.62 mm × 39 mm) on a range of domestic surface types typically encountered during bullet ricochet incidents. This study has revealed that ricocheting AK bullets off of various wood types and tile samples produce side-on impacts into closely located targets following a rightwards yaw action. It has also been shown that AK bullets ricocheting off concrete and cement samples at 5-degree incident angles produced nose-forward impacts on paper witness screens, similar to an orthogonal impact of a direct-fired shot. The findings present important new information on the post-ricochet yawing behaviour of AK bullets, which has the potential to aid future shooting reconstructions in which victims are hit by closely ricocheted bullets.


Effect of different floatation solutions on E. tenella oocyst purification and optimization of centrifugation conditions for improved recovery of oocysts and sporocysts.
Saturated salt floatation method is widely used for coccidian oocyst purification. However, the repeated procedures and inefficient oocysts recovery rate are a continuous challenge. This study aimed to investigate the best suitable floatation solution, along with optimal centrifugation speed and time for Eimeria tenella (E. tenella) oocyst and sporocyst purification. Different floatation solutions i-e, saturated salt, Sheather's sugar and sodium hypochlorite (NaClO) at 20-60% concentrations were used to purify oocyst. It was found that about 96.99% oocysts (8609×g for 10 min) were recovered under these conditions without any effect on the viability of sporocysts. The recovery rate of oocysts using 50% NaClO (V/V) was significantly higher than 35% saturated salt flotation solution (P < 0.05). The optimal method for purification of oocysts based our experimentation was centrifugation at 8609×g for 3 min using 50% NaClO floatation solution, and the optimized centrifugation conditions for improved recovery of sporocysts (about 99.3%) were at 2152×g for 5 min. The present study provided a better method for the coccidian oocyst purification, which could be successfully adopted as a better alternative to existing techniques commonly used for investigations/research pertaining to coccidia.


Supratentorial intraventricular tumors in childhood.
We report on a series of 21 infants and children with tumors of the supratentorial ventricular system, all of whom were assessed by computed tomography and underwent operation using microsurgical techniques. In 7 cases the tumor was found in the 3rd ventricle, whereas the lateral ventricles were involved in the others. Surgical access to the lateral ventricles and the anterior portion of the 3rd ventricle was gained by standard intergyral cortical incision in the precentral or postcentral regions and via the foramen of Monro. The posterior portions of the lateral ventricle of the dominant hemisphere as well as the posterior part of the 3rd ventricle were exposed with minimal risk, using the occipital midsagittal supratentorial route. Following this technique, total removal of the tumors was possible in all cases without substantial postoperative morbidity. After a follow-up period of 6 months to 9 years all patients are in good or excellent neurological condition. Tumor recurrences were not encountered, although a definitive statement cannot be made in some patients with malignant lesions.


Cytokine-induced autophagy promotes long-term VCAM-1 but not ICAM-1 expression by degrading late-phase IκBα.
Pro-inflammatory cytokines are known to induce endothelial cell autophagy, but the role of autophagy in regulating the expression of pro-inflammatory molecules has not been characterized. We hypothesized that autophagy facilitates expression of endothelial adhesion molecules. TNFα and IL-1β induced autophagy markers in human umbilical vein endothelial cells and inhibition of autophagy by 3-methyladenine (3-MA) blocked adhesion of Jurkat lymphocytes. Interestingly, 3-MA suppressed VCAM-1 but not ICAM-1 expression at 24 hours but not 6 hours. 3-MA suppressed VCAM-1 transcription and decreased nuclear NF-κB p65 level at 6 hours but not at 2 hours. Cytokines induced a biphasic degradation of IκBα and 3-MA selectively blocked the late-phase IκBα degradation. Our results suggest that cytokine-induced autophagy contributes to late-phase IκBα degradation, facilitates NF-κB nuclear translocation and VCAM-1 transcription for long-term VCAM-1 expression. With a cytokines array assay, we found that 3-MA also inhibited IP-10 expression. These findings provide new information about the role of endothelial autophagy in persistent expression of VCAM-1 and IP-10 which enhance lymphocyte recruitment and adhesion to endothelium.


Potentiation of morphine-induced antinociception by harmaline: involvement of μ-opioid and ventral tegmental area NMDA receptors.
Morphine is one of the most well-known and potent analgesic agents; however, it can also induce various side effects. Thus, finding drugs and mechanisms which can potentiate the analgesic effects of low doses of morphine will be a good strategy for pain management. The involvement of μ-opioid receptors and ventral tegmental area (VTA) glutamatergic system in harmaline and morphine combination on the nociceptive response were investigated. Also, we examined reward efficacy and tolerance expression following the drugs. Animals were bilaterally cannulated in the VTA by stereotaxic instrument. A tail-flick (TF) apparatus and conditioned place preference (CPP) paradigm were used to measure nociceptive response and rewarding effects in male NMRI mice respectively. Morphine (2 mg/kg, i.p.) had no effect in TF test. Also, harmaline (1.25 and 5 mg/kg, i.p.) could not change pain threshold. Combination of a non-effective dose of harmaline (5 mg/kg) and morphine (2 mg/kg) produced antinociception and also prevented morphine tolerance but had no effect on the acquisition of CPP. Systemic administration of naloxone (0.5 and 1 mg/kg) and intra-VTA microinjection of NMDA (0.06 and 0.1 μg/mouse) before harmaline (5 mg/kg) plus morphine (2 mg/kg) prevented antinociception induced by the drugs. D-AP5 (0.5 and 1 μg/mouse, intra-VTA) potentiated the effect of low-dose harmaline (1.25 mg/kg) and morphine (2 mg/kg) and induced antinociception. Microinjection of the same doses of NMDA or D-AP5 into the VTA alone had no effect on pain threshold. The findings showed that harmaline potentiated the analgesic effect of morphine and reduced morphine tolerance. Glutamatergic and μ-opioidergic system interactions in the VTA seem to have a modulatory role in harmaline plus morphine-induced analgesia.


Introduction of central venous pressure catheters through arm veins with a high success rate.
Studies were carried out to develop a more successful method of inserting central venous catheters through arm veins without using electrocardiographic or fluoroscopic monitoring. It was found that a running infusion attached to a Sorensen catheter gave a success rate of 48 per cent. The highest success rates (98 per cent) occurred when the basilic vein was used, with the patient positioned so that the upper part of the body was raised at 45-90 degrees to the horizontal and using a Bardic 16 gauge catheter with a special insertion technique, which is described. This represents a great improvement over the usual success rate of 70 to 80 per cent.


Characteristic research of lower extremity injuries in elderly pedestrians during collisions.
The aim of this research is to study the trend of pedestrian lower extremity injuries during vehicle-pedestrian collisions. In this study, pedestrian's age, collision angle and pedestrian's position are considered influencing factors. Nine experiments using a novel lower extremity mechanical model are designed with the orthogonal experiment method. Under the same collision angle, collisions in the left and right positions caused more serious tibia injuries than the middle position. As for the collision angle, the tibial injury at +45° is more significant than the tibial injury at -45°, and the injury of oblique collisions is slightly greater than that at 0°. Moreover, tibial injury is more sensitive to research variables than femoral injury. When the collision angle and position are changed, the difference ratio of tibia stress is by 483.2% higher than that of femur stress. The axial force and bending moment of the quadriceps tendon in the left-position collision reach peak values, which are 3.83 kN and 165.98 Nm, respectively. The peak quadriceps tendon axial force is captured with the collision angle of -45°, and the peak quadriceps tendon bending moment is obtained with a collision angle of +45°. The effects of differences in impact position and angle on lower extremity injury in the elderly were analyzed, and the results of this study can be used as a reference for research on lower extremity protection.


Comparison of TWA and PEP as indices of α2- and ß-adrenergic activation.
Pre-ejection period (PEP) and T-wave amplitude (TWA) have been used to assess sympathetic nervous system (SNS) activity. Here we report two single-blinded, placebo-controlled intravenous (IV) drug application studies in which we pharmacologically modified SNS activity with epinephrine (study 1) as well as dexmedetomidine (alpha2-agonist) and yohimbine (alpha2-antagonist) (study 2). Restricted heart rate (HR) intervals were analyzed to avoid confounding effects of HR changes. Study 1 served to replicate previous findings and to validate our approach, whereas study 2 aimed to investigate how modulation of central SNS activity affects PEP and TWA. Forty healthy volunteers (58% females) participated in study 1 (between-subject design). Twelve healthy men participated in study 2 (within-subject design). TWA and PEP were derived from ECG and impedance cardiography, respectively. Epinephrine shortened PEP and induced statistically significant biphasic TWA changes. However, although the two alpha2-drugs significantly affected PEP as expected, no effects on TWA could be detected. PEP is better suited to reflect SNS activity changes than TWA.


Treatment of simple renal cysts with single-session percutaneous ethanol sclerotherapy without drainage of the sclerosing agent.
To evaluate percutaneous single-session sclerotherapy with ethanol without drainage of the sclerosing agent in symptomatic simple renal cysts that require treatment. A prospective series of 30 consecutive patients with symptomatic simple renal cysts with volume of 280.3 +/- 365.23 mL (range 28-1700 mL) estimated by ultrasonography were treated between July 1999 and July 2003. The cysts were punctured with an 18-gauge, 20-cm needle under ultrasound guidance and local anesthesia. A volume of ethanol equivalent to one third of the aspirated volume, up to a maximum of 100 mL, was injected into the cyst and left there. The patients were reassessed at 1, 3, and 6 months. The procedure was technically feasible in all patients. The aspirated volume was 259.8 +/- 265.2 mL (range 30-1900 mL). After 1, 3, and 6 months, the average volume was 52.7 +/- 71.4 mL, 22.7 +/- 43.2 mL, and 11.6 +/- 30.7 mL, respectively. After this period, 28 patients (93%) were asymptomatic, showing total remission of the cyst (17 cases) or at least a 90% decrease (10 cases) or a 50% decrease (1 case) in the initial volume. One patient (3%) had a 50% reduction of the cyst and persistent symptoms, and one patient (3%) had persisting symptoms despite the total remission of the cyst. Single-session percutaneous sclerotherapy with ethanol is a good option for the treatment of symptomatic renal cysts, as it is highly effective and offers the benefits of a less-invasive procedure.


Radiological and functional correlation following "SLIC" scapholunate-intercarpal ligamentoplasty at minimum 12 months' follow-up.
We report outcomes for scapholunate-intercarpal ligamentoplasty ("SLIC procedure"), performed in 22 patients (mean age at surgery, 39.7 years), for reducible static scapholunate (SL) instability without repairable stump. Patients were evaluated for pain and active wrist range of motion, grip strength, functional scores (QuickDASH and PRWE) and radiological appearance (SL gap, SL angle, radiolunate angle, capitolunate angle), preoperatively and at a mean 28.3 months' follow-up (range 12-65). A CT scan without injection was performed at follow-up to measure the posterior radioscaphoid angle (PRSA). The objective was to assess radiological-functional correlations after SLIC ligamentoplasty and to analyze postoperative PRSA correction. The hypothesis was that correcting the PRSA improves clinical and functional outcomes. Pain on a visual analog scale improved significantly, from 2.7 to 0.7 at rest and from 7 to 3.2 during hand use. Mean wrist flexion was 46.4° and extension 59.1°. Grip strength reached 82.8% of the contralateral value. Functional scores improved significantly. Mean SL angle decreased significantly from 81.1° to 73.5°, and static scapholunate gap from 4.7 mm to 3.6 mm. Scaphoid subluxation was fully corrected in 15 cases (68%). PRSA angle was significantly corrected, from a mean 112.7° to 104.2°. Patients in whom PRSA was corrected showed a tendency for better clinical and subjective outcomes. There was 1 case of scaphoid necrosis, 7 of recurrent static instability, including 3 early at 4 months, 3 of scaphocapitate osteoarthritis, and 5 of carpal collapse with SLAC wrist. There were no significant correlations between clinical and radiological results in the medium term after SL ligamentoplasty by the SLIC procedure. The results were quite good in the medium term and pointed to the importance of correcting rotatory subluxation of the scaphoid, revealed by the PRSA, more than correcting the scapholunate gap.


Follow-on biologics: data exclusivity and the balance between innovation and competition.
Legislation to create a regulatory pathway for follow-on biologics is currently being considered by the United States Congress. A critical issue in this respect is the period of data exclusivity for innovator companies before a follow-on competitor can rely in part on data obtained for an original biologic for an abbreviated approval. Given the nature of patents on biologics, the period of data exclusivity is anticipated to have a key role in determining how quickly follow-on competitors emerge, and consequently also on the time available for originator companies to recoup their investment. With this issue in mind, this article discusses factors influencing return on investment on biologic research and development. A break-even analysis for a representative portfolio of biologics provides support for a substantial data exclusivity period.


Nutrient biomarker patterns and long-term risk of dementia in older adults.
Several nutrients may predict dementia risk. We characterized nutrient biomarker patterns, which integrate the complexity of nutrient exposure and biodisponibility associated with long-term risk of dementia in a large cohort of older persons, the Three-City study. We included 666 nondemented participants with plasma measurements of 22 fat-soluble nutrients at baseline, who were followed up for 12 years for dementia. A "deleterious" pattern combining lower blood status in vitamin D, carotenoids, and polyunsaturated fats and higher saturated fats was strongly associated with a higher risk of dementia. Compared with individuals in the first quintile of the pattern score, participants in the highest quintile of score had an approximately fourfold increased risk of dementia (hazard ratio = 4.53 [95% confidence interval 1.99, 10.32], P for trend <.001) in multivariate models. A blood pattern reflecting lower status in several nutrients among nondemented individuals appeared strongly associated with the long-term risk of dementia in this cohort.


How 'visual' is the visual cortex? The interactions between the visual cortex and other sensory, motivational and motor systems as enabling factors for visual perception.
The definition of the visual cortex is primarily based on the evidence that lesions of this area impair visual perception. However, this does not exclude that the visual cortex may process more information than of retinal origin alone, or that other brain structures contribute to vision. Indeed, research across the past decades has shown that non-visual information, such as neural activity related to reward expectation and value, locomotion, working memory and other sensory modalities, can modulate primary visual cortical responses to retinal inputs. Nevertheless, the function of this non-visual information is poorly understood. Here we review recent evidence, coming primarily from studies in rodents, arguing that non-visual and motor effects in visual cortex play a role in visual processing itself, for instance disentangling direct auditory effects on visual cortex from effects of sound-evoked orofacial movement. These findings are placed in a broader framework casting vision in terms of predictive processing under control of frontal, reward- and motor-related systems. In contrast to the prevalent notion that vision is exclusively constructed by the visual cortical system, we propose that visual percepts are generated by a larger network-the extended visual system-spanning other sensory cortices, supramodal areas and frontal systems. This article is part of the theme issue 'Decision and control processes in multisensory perception'.


Gatekeeping access to community mental health teams: a qualitative study.
Gatekeeping access to services at the interface with primary care has been identified as one of the key issues that community mental health teams (CMHTs) have to confront. The aim of this study was to develop a better understanding of the contextual influences that impact upon the outcome of gatekeeping decisions. An interview-based qualitative study, informed by the philosophy of critical realism. An urban catchment area in Northern England. Twenty-nine interviews were conducted with gatekeeping clinicians and service managers. A convenience sample of clinicians was initially approached to take part in a series of semi-structured interviews. This was followed up by a purposive sample of clinicians and service managers, as specific contextual influences were identified and explored in detail. The emerging analysis was then subjected to critical scrutiny by a further sample of gatekeeping clinicians. A clear hierarchy of appropriateness was identified with four dimensions: severity, risk, beneficence and a moral dimension. It was suggested that the salient contextual influences that shaped the hierarchy were: (a) the need to fit in with strategic planning directives, (b) the burden of responsibility that clinicians carried, (c) the high number of referrals and the relatively slow turnover of patients on clinical caseloads, (d) the position of CMHTs in the economy of care and (e) the character of the relationship between clinicians and service managers. The findings from the study support a multi-level view of the gatekeeping process within CMHTs, which takes account of the role that key contextual influences play in shaping the range of options that are available to gatekeeping clinicians.


Improved prognosis for patients hospitalized with esophageal varices in Sweden 1969-2002.
Liver cirrhosis may be complicated by the development of esophageal varices. The treatment of esophageal varices has changed radically during the last 30 years. Our aim was to study whether the prognosis for patients with esophageal varices had improved in Sweden between 1969 and 2002. We linked register data from the Hospital Discharge Register and from the Causes of Death Register at The National Board of Health in Sweden between 1969 and 2002 to identify and follow-up all patients with esophageal varices according to International Classification of Diseases-8, -9, and -10. There were 12,281 patients hospitalized with esophageal varices, and for all patients there was an increase in the 5-year survival in the years between 1969 and 1979 as opposed to the years between 1990 and 2002. Better survival occurred for women compared with men, for younger patients compared with older, and for patients hospitalized in the latest decade compared with the earlier decades. We found a significant decrease in the mortality caused by esophageal varices during the years studied but no decrease attributable to other causes. In conclusion, mortality for patients hospitalized with esophageal varices in Sweden decreased between 1969 and 2002. The decrease is seen for both 1- and 5-year mortality, and this suggests that the use of new treatment strategies both for acute variceal hemorrhage and secondary prophylaxis has had an impact on prognosis.


Gene and systemic inflammatory effects and neuroendocrine response in surgical patients anesthetized with desflurane-nitrous oxide or desflurane-nitrous oxide-free: A randomized trial.
There is growing interest in assessing possible immunotoxicological effects in anesthetized patients. There are controversial findings concerning the effect of nitrous oxide (N2O) anesthetic gas effect on inflammatory response. We tested the hypothesis that N2O associated with desflurane (inhalational anesthetic) was likely to worsen neuro-immune-endocrine effects when compared with desflurane alone in this randomized trial. The primary endpoint of this study was to evaluate the systemic proinflammatory interleukin (IL)-6, and the secondary endpoints included other systemic (IL-1β, TNF-α, IL-8, IL-10, IL-17A and high-sensitivity C-reactive protein - hs-CRP) and genetic inflammatory markers (NF-kB, IL-6 and COX-2) as well as hormones (adrenocorticotropic hormone, cortisol and prolactin) comparing patients undergoing minor surgery with or without N2O-desflurane. As a second aim, we assessed whether there were changes in the neuro-immune-endocrine profiles within each group. Blood samples were collected before anesthesia, 90 min after anesthesia induction, and the day after surgery. We assessed serum cytokines using a cytometric bead array and hs-CRP by chemiluminescent immunoassay. Expression of three proinflammatory transcripts was assessed by real-time quantitative polymerase chain reaction, and neuroendocrine hormones were detected by chemiluminescent microparticle immunoenzymatic assay. There were no significant between-group differences for any analyzed biomarkers. However, there was a significant increase in: (a) systemic IL-6 and hs-CRP values one day after surgery in both groups and (b) prolactin levels in the intraoperative period compared to baseline and postoperative period levels for both groups. In conclusion, N2O does not impair the inflammatory profile and neuroendocrine response compared to patients who receive only desflurane anesthesia.


Pesticides in aquifers from Latin America and the Caribbean.
In Latin America and the Caribbean (LAC), agriculture is the primary consumer of water and the biggest user of pesticides worldwide. Given that groundwater is a crucial resource in this region, a systematic review was conducted to evaluate the current state of knowledge on the presence of pesticides in aquifers. The review examined 48 research papers published between 1998 and 2020, and found that only six countries in the region have information on pesticides in groundwater. A total of 70 agrochemicals were detected, encompassing legacy pesticides, herbicides, insecticides, fungicides, and metabolites. Herbicides, including the widely used atrazine and glyphosate, were the most commonly detected current-use pesticides. These herbicides are being gradually banned or restricted due to their potentially harmful effects on the environment. Factors that contribute to the presence of these contaminants in aquifers include preferential flows, seasonal variations in rainfall, aquifer type, unsaturated zone thickness, and land use and management practices. Researchers noted that analysis of these contaminants is often beyond the economic or methodological scope, and analytical capacity in the region is generally limited. Based on the findings of this review, there is a clear need for groundwater pesticide monitoring in the region to reduce health risks to humans and ecosystems.


Using administrative databases to evaluate the quality of medical care: a conceptual framework.
Health care is consuming an ever larger share of national resources in the United States. Measures to contain costs and evidence of unexplained variation in patient outcomes have led to concern about inadequacy in the quality of health care. As a measure of quality, the evaluation of hospitals through analysis of their discharge databases has been suggested because of the scope and economy offered by this methodology. However, the value of the information obtained through these analyses has been questioned because of the inadequacy of the clinical data contained in administrative databases and the resultant inability to control accurately for patient variation. We suggest, however, that the major shortcoming of prior attempts to use large databases to perform across-facility evaluation has resulted from the lack of a conceptual framework to guide the analysis. We propose a framework which identifies component areas and clarifies the underlying assumptions of the analytic process. For each area, criteria are identified which will maximize the validity of the results. Hospitals identified as having unexpectedly high unfavorable outcomes when our framework is applied will be those where poor quality will most likely be found by primary review of the process of care.(ABSTRACT TRUNCATED AT 250 WORDS)


The influence of pups on aggressive interactions between smooth-coated otters and water monitor lizards in Singapore.
Smooth-coated otters (Lutrogale perspicillata) and Malayan water monitor lizards (Varanus salvator) occupy similar habitats and interact regularly in Singapore's waterways. These interactions have a range of potential outcomes and are sometimes lethal. Few formal behavioral studies exist for either species. We analyzed interactions between otters and monitor lizards by gleaning data from publicly available videos from citizen scientists to examine what factors influence aggressive and defensive behaviors and what influences vigilance in otters. Behavioral sequence analysis revealed no obvious monitor lizard behavior that predicted otter aggression toward monitors. We found that the presence and number of otter pups are positively associated with otter aggression. Otters also tended to be more vigilant in groups with more pups and more vigilant on land than water. Monitor lizards almost always displayed aggressive and defensive behaviors, regardless of whether otters were aggressive toward the lizards. These observations suggest that otters vary their aggression and vigilance levels depending on their group composition and the physical environment of their interactions with monitor lizards.


Inherited bleeding disorder due to familial type 2 platelet cyclo-oxygenase deficiency.
Inherited platelet cyclo-oxygenase (COX) deficiency is a rare bleeding disorder. We report here the first case of familial type 2 platelet COX deficiency responsible for a moderate bleeding phenotype. The propositus was admitted in the emergency department for major epistaxis following treatment with aspirin. Epinephrine closure time is very sensitive to drugs which inhibit COX but the test was normal in patients with inherited COX deficiency. This clinical and biological data suggest that the anti-platelet effect of aspirin may be dependent on mechanisms other than the inhibition of COX. Thrombin generation test confirmed mild bleeding phenotype in patients with COX deficiency as they had normal thrombin generating capacity.


On the dissolution kinetics of humic acid particles. Effect of monocarboxylic acids.
The dissolution kinetics of humic acid particles has been studied in batch experiments, and the effects of monocarboxylic (formic, acetic, and propionic) acids are reported. The dissolution rate of the particles is significantly affected by the presence of monocarboxylic acids in the pH range 4-10. At pH 7, for example, propionic acid increases 30 times this dissolution rate. The capacity of increasing the dissolution rate is in the order formic acid<acetic acid<propionic acid, and this dissolving capacity of carboxylics seems to be directly related to their affinity for HA molecules located at the surface of the solid particles. The results indicate that carboxylics and related compounds may affect markedly the mobility and transport of humic substances in the environment.


Risk of uncommon cancers in patients with psoriasis: a Danish nationwide cohort study.
Cancer-associated mortality is increased in psoriasis. However, little is known about the risk of less common cancers. We aimed to evaluate the risk of less common cancers in patients with psoriasis compared to persons without psoriasis using a nationwide cohort study. Between 1 January 2008 and 31 December 2012, we identified all Danish patients with a first-time hospital diagnosis of a less common cancer defined as <100 new cases/year/100.000 persons in Denmark. The primary endpoint was the occurrence of a diagnosis of cancer. We included 4 361 869 individuals. Of these, 58 138 were classified as having psoriasis. After adjusting for age, sex, socio-economic status and healthcare consumption, we found significantly elevated hazard ratios for cancers of bone and cartilage (HR 4.97 [2.32-10.62], P < 0.0001) in patients with psoriasis on systemic treatment. We provide further evidence of an increased cancer of bone and cartilage risk in patients with psoriasis.


Studying the metabolic factors that may impact the growth of co-cultured Listeria monocytogenes strains at low temperature.
The simultaneous presence of more than one strains of Listeria monocytogenes in the same food product may affect the growth capacity of each strain. The present study evaluated the metabolites composition that may potentially influence the growth of individual L. monocytogenes strains in a dual strain composite. Based on previous studies, L. monocytogenes strains, C5 (4b) and 6179 (1/2a) were selected due to the remarkable interaction, which was observed during their co-culture. The selected strains were inoculated (2.0 - 3.0 log CFU/mL) in Tryptic Soy Broth with 0.6% Yeast Extract (TSB-YE) in single and two-strain cultures (1:1 strain ratio). Bacterial growth was assessed during storage at 7 °C, under aerobic conditions (AC). Their resistance to different antibiotics enabled the selective enumeration of each strain in the co-culture. After reaching stationary phase, single and dual cultures were centrifuged and filtered. The cell-free spent medium (CFSM) was either characterized by Fourier transform infrared (FTIR-ATR) spectrometry or re-inoculated, after the addition of concentrated TSB-YE (for nutrient replenishment), with single and two-strain cultures for the evaluation of growth under the influence of metabolites produced from the same singly and co-cultured strains in the different combinations of strains and CFSM origin (7 °C/AC) (n = 2x3). By the end of storage, singly-cultured C5 and 6179 had reached 9.1 log CFU/mL, while in dual culture, 6179 was affected by the presence of C5 attaining only 6.4 ± 0.8 log CFU/mL. FTIR-ATR spectra of CFSM produced by singly-cultured 6179 and the co-culture were almost identical. Characteristic peaks in FTIR-ATR spectrum of CFSM of singly-cultured C5 at 1741, 1645 and 1223 cm-1 represent functional groups which were not present in the CFSM of the co-culture. These molecules may be located intracellularly or mounted on bacterial cell surface and removed from the supernatant during cell filtration of the co-culture. Both singly- and co-cultured 6179 managed to grow similarly regardless of CFSM origin. Contrarily, both singly- and co-cultured C5 managed to outgrow 6179 in CFSM which contained high concentration of C5 metabolites, while in CFSM produced by singly-cultured 6179, C5 did not grow, suggesting that the produced metabolites of strain 6179 appears to be harmful to strain C5. However, during co-culture, C5 may produce molecules that counteract the inhibitory effect of 6179. The findings shed more light on the mechanism behind the inter-strain interactions of L. monocytogenes indicating that both contact of cells and extracellular metabolites may influence the behavior of the different co-existing strains.


Great expectations: views and perceptions of professionalism amongst mental health services staff, patients and carers.
Numerous studies have explored the concept of 'professionalism' in medicine, yet little attention has been paid to the concept in a mental health services context. This study sought to determine how the lived experience of patients, carers and healthcare professionals in mental health services align with medically defined, generic, professionalism standards. Interviews and focus groups were conducted with patients, carers, nurses, occupational therapists, psychiatrists and psychologists. A framework analysis approach was used to analyse the data, based on the 'Improving Selection to the Foundation Programmes' Professional Attributes Framework. Fifty-six individuals participated. Data aligned to all nine attributes of the Professional Attributes Framework, however the expectations within each attribute varied from that originally cited. A tenth attribute was devised during the process of analysis; Working with Carers. This attribute acknowledges the need to liaise with, and support carers in mental health services. Situational examples included both online and offline behaviours and the topic of 'black humour' emerged. Compared to a conventional medical definition of professionalism, additional themes and differing emphases were observed for mental health and learning disability services. These findings should be used to inform the teaching and evaluation of professionalism, especially for staff pursuing mental health service careers.


'Simultaneous' urethral pressure profilometry: variations in intravesical pressure with respiration.
Pressure changes in the urinary bladder due to respiration were measured in 75 bitches. The changes fell within a narrow range (0.5 to 2.5 cm water) and were unaffected by size or whether the bitches were entire or spayed. Significant differences were found, however, between continent (mean +/- SD, 1.1 +/- 0.4 cm water) and incontinent (mean +/- SD, 1.4 +/- 0.5 cm water) animals (P less than 0.01).


[Periapical lesions treated with CaO. Histological controls].
The results of histological examinations conducted on 2 granulomas found in teeth and treated with calcium oxide are reported. It is concluded that the treatment produces significant changes in the histological picture with the formation of scar tissue that precedes the growth of newborn in a relatively short time.


Exploring potential machine learning application based on big data for prediction of wastewater quality from different full-scale wastewater treatment plants.
Water pollution generated from intensive anthropogenic activities has emerged as a critical issue concerning ecosystem balance and livelihoods worldwide. Although optimizing wastewater treatment efficiency is widely regarded as the foremost step to minimize pollutants released into the environment, this widespread application has encountered two major problems: firstly, the significant variation of influent wastewater constituents; secondly, complex treatment processes within wastewater treatment plants (WWTPs). Based on the data collected hourly using real-time sensors in three different full-scale WWTPs (24 h × 365 days × 3 WWTPs × 10 wastewater parameters), this work introduced the potential application of Machine Learning (ML) to predict wastewater quality. In this work, six different ML algorithms were examined and compared, varying from shallow to deep learning architectures including Seasonal Autoregressive Integrated Moving Average (SARIMAX), Random Forest (RF), Support Vector Machine (SVM), Gradient Tree Boosting (GTB), Adaptive Neuro-Fuzzy Inference System (ANFIS) and Long Short-Term Memory (LSTM). These models were developed to detect total phosphorus in the outlet (Outlet-TP), which served as an output variable due to the rising concerns about the eutrophication problem. Irrespective of WWTPs, SARIMAX consistently demonstrated the best performance for regression estimation as evidenced by the lowest values of Mean Square Error (MSE), Mean Absolute Error (MAE), Mean Absolute Percentage Error (MAPE) and the highest coefficient of determination (R2). In terms of computation efficiency, SARIMAX exhibited acceptable time computation, acknowledging the successful application of this algorithm for Outlet-TP modeling. In contrast, the complex structure of LSTM made it time-consuming and unstable coupled with noise, while other shallower architectures, i.e., RF, SVM, GTB, and ANFIS were unable to address large datasets with nonlinear and nonstationary behavior. Consequently, this study provides a reliable and accurate approach to forecast wastewater effluent quality, which is pivotal in terms of the socio-economic aspects of wastewater management.


Using data calibration to reconcile outputs from different survey methods in long-term or large-scale studies.
Understanding the impact of management interventions on the environment over decadal and longer timeframes is urgently required. Longitudinal or large-scale studies with consistent methods are best practice, but more commonly, small datasets with differing methods are used to achieve larger coverage. Changes in methods and interpretation affect our ability to understand data trends through time or across space, so an ability to understand and adjust for such discrepancies between datasets is important for applied ecologists. Calibration or double sampling is the key to unlocking the value from disparate datasets, allowing us to account for the differences between datasets while acknowledging the uncertainties. We use a case study of livestock grazing impacts on riparian vegetation in southeastern Australia to develop a flexible and powerful approach to this problem. Using double sampling, we estimated changes in vegetation attributes over a 12-year period using a pseudo-quantitative visual method as the starting point, and the same technique plus point-intercept survey for the second round. The disparate nature of the datasets produced uncertain estimates of change over time, but accounting for this uncertainty explicitly is precisely the objective and highlights the need to look more closely at this very common problem in environmental management, as well as the potential benefits of the double sampling approach.


Cardiac memory induced by QRS widening due to propafenone toxicity.
Propafenone toxicity can cause significant QRS widening and markedly abnormal ventricular activation pattern. Aberrant ventricular activation upon its resolution is known to produce persistent T-wave changes known as "cardiac memory" (CM). A 74-year-old woman presented with a severely abnormal electrocardiogram consistent with propafenone toxicity. As her QRS complex narrowed, T-wave inversions developed with the T-wave axis and resolution kinetics consistent with CM. Abnormal ventricular activation due to propafenone toxicity can result in CM development.


Physiological upper limits of left ventricular dimensions in highly trained junior tennis players.
The differentiation between physiological cardiac enlargement and cardiomyopathy is crucial, considering that most young non-traumatic deaths in sport are due to cardiomyopathy. Currently, there are few data relating to cardiac dimensions in junior elite tennis players. The aim of this study was to define the upper limits of left ventricular dimensions in a large cohort of national adolescent tennis players. Between 1996 and 2003, 259 adolescent tennis players (152 males), mean (SD) age 14.8 (1.4) years (range 13-19) and 86 healthy age, gender and body surface matched sedentary controls underwent 12-lead ECG and 2D-transthoracic echocardiography. Inter-ventricular septal end diastolic dimension (IVSd), left ventricular end diastolic dimension (LVEDd) and left ventricular end diastolic posterior wall dimension (LVPWd) in tennis players were significantly higher than in controls (8.9 mm vs 8.3 mm p<0.001, 48.9 mm vs 47.9 mm p<0.05 and 9 mm vs 8.3 mm p<0.001 respectively), however in absolute terms, the difference did not exceed 7%. None of the tennis players had a wall thickness exceeding 12 mm or a left ventricular cavity size exceeding 60 mm. Tennis players exhibit modest increases in cardiac dimensions, which do not resemble those seen in individuals with cardiomyopathy affecting the left ventricle.


Retracted: Comparison of Short-Term Restorative Effects and Periodontal Health Status of Restorations Made of Different Materials in Full-Crown Restoration of Mandibular Premolar Tooth Defects.
[This retracts the article DOI: 10.1155/2022/3682741.].