Can vitamin E ester derivatives be excellent alternatives of vitamin E: state of art.
Vitamin E (VE) is a natural antioxidant which is widely used in the food fields, while the shortcomings of easy oxidative inactivation and poor water solubility limit its application. Vitamin E esters' (VEEs) derivatives, such as vitamin E acetate (VEA), are more stable and easier to be absorbed while have similar biological activities and physiological functions compared with VE. In this systematic review, the digestion, absorption and physiological function of VEEs were summarized. To promote their further industrial applications, the synthesis strategies of VEEs were also summarized in-depth. In particular, as a new generation of green solvents, ionic liquids (ILs) have been widely used in enzymatic reactions due to the stabilization and activation of enzymes. Their applications in enzymatic synthesis of VEEs were summarized and discussed. Finally, several future perspectives for developing more efficiency strategies of VEEs synthesis, such as enzyme engineering and design of novel ILs, were also discussed.


Mitral regurgitation secondary to kissing aortic valve vegetation.
Infective endocarditis is associated with acute heart failure if the valve involvement leads to significant alteration in the hemodynamics. Vegetation in infective endocarditis invades the tissue causing disruption of the anatomical integrity of the valve structure. Heart failure in infective endocarditis is associated with high morbidity and mortality despite advances in surgical and medical therapies. Aortic valve vegetation may cause involvement of mitral valve through different mechanisms. Here, we present a case of infective endocarditis with vegetation on the aortic valve causing perforation of anterior mitral leaflet leading to severe mitral regurgitation. The online version contains supplementary material available at 10.1007/s12055-023-01486-8.


[Relation of the effectiveness of surgical treatment of vasorenal hypertension and morphologic changes of the kidneys].
Renal puncture and incision biopsy specimens were investigated, using light and electron microscopic techniques, in 34 patients with vasorenal hypertension. The magnitude of the hypotensive effect of reconstructive surgery on renal arteries is shown to be largely dependent on the severity of arteriolosclerosis in the ischemized kidney rather than the contralateral one. Quantitative assessment of the severity of renal arteriolar sclerosis has established a critical vascular index (the ratio of arteriolar wall thickness to lumen diameter) above which the probability of reconstructive surgery producing a hypotensive effect becomes rather low.


Prone ex vivo lung perfusion protects human lungs from reperfusion injury.
We previously reported beneficial effects of prone positioning during ex vivo lung perfusion (EVLP) using porcine lungs. In this study, we sought to determine if prone positioning during EVLP was beneficial in human donor lungs rejected for clinical use. Human double lung blocs were randomized to prone EVLP (n = 5) or supine EVLP (n = 5). Following 16 h of cold storage at 4°C and 2 h of cellular EVLP in either the prone or supine position. Lung function, compliance, and weight were evaluated and transplant suitability determined after 2 h of EVLP. Human lungs treated with prone EVLP had significantly higher partial pressure of oxygen/fraction of inspired oxygen (P/F) ratio [348 (291-402) vs. 199 (191-257) mm Hg, p = 0.022] and significantly lower lung weight [926(864-1078) vs. 1277(1029-1483) g, p = 0.037] after EVLP. 3/5 cases in the prone group were judged suitable for transplant after EVLP, while 0/5 cases in the supine group were suitable. When function of upper vs. lower lobes was evaluated, prone EVLP lungs showed similar P/F ratios and inflammatory cytokine levels in lower vs. upper lobes. In contrast, supine EVLP lungs showed significantly lower P/F ratios [68(59-150) vs. 467(407-515) mm Hg, p = 0.012] and higher tissue tumor necrosis factor alpha levels [100.5 (46.9-108.3) vs. 39.9 (17.0-61.0) ng/ml, p = 0.036] in lower vs. upper lobes. Prone lung positioning during EVLP may optimize the outcome of EVLP in human donor lungs, possibly by improving lower lobe function.


Examining the safety of prednisolone acetate 1% nasal spray for treatment of nasal polyposis.
Topical intranasal corticosteroid sprays are a mainstay of treatment for nasal polyposis. Newer treatment strategies for refractory polypoid disease include "off label" topical steroids such as prednisolone acetate. This study investigates the safety of intranasal prednisolone acetate; evaluating its effect on serum cortisol and adrenocorticotropin hormone (ACTH) levels. This retrospective study included adult patients with refractory nasal polyposis, who had not taken oral steroids for 3 months prior to entry into the study. Patients applied 2 sprays of 1% prednisolone acetate delivered via a 15-mL standardized spray bottle twice daily. Morning serum cortisol and ACTH levels were collected prior to treatment and 6 to 8 weeks posttreatment. Pretreatment and posttreatment values were compared. Nine patients were included in this study. The average serum cortisol and ACTH levels prior to treatment was 12.09 μg/dL (95% confidence interval [CI], 6.94-17.24) and 12.33 ng/L (95% CI, 8.97-15.70), respectively. After 6 to 8 weeks of treatment, the average serum cortisol and ACTH levels were 11.76 μg/dL (95% CI, 9.51-14.00) and 13.22 ng/L (95% CI, 10.68-15.77), respectively. There was no statistically significant difference between pretreatment and posttreatment values for cortisol (p = 0.89) or ACTH (p = 0.63). Intranasal delivery of prednisolone acetate, at the specified dose, does not result in suppression of the adrenal axis. It can be considered as a safe alternative for management of aggressive nasal polyposis refractory to traditional treatment strategies.


Usability evaluation of a comprehensive national health information system: relationship of quality components to users' characteristics.
One of the most important methods for evaluating information systems is usability evaluation. Usability is a context-dependent qualitative feature that is measured by multiple quality components that can be related to users' characteristics. This study was conducted to evaluate the usability of a comprehensive national health information system (SIB; an abbreviation for the Persian equivalent of 'integrated health system') from the perspective of different users and to determine the relationship between quality components and users' characteristics. The study population were users of the national health information system (n = 309) at health centers and health homes affiliated to Kashan University of Medical Sciences, Kashan, Iran. Data were collected using Software Usability Measurement Inventory (SUMI) questionnaire which measures users' experiences of software interface in five quality components (i.e. affect, efficiency, helpfulness, control, and learnability) and provides a global usability score. SUMI scores were analyzed according to an extensive reference database (SUMISCO). The relationships between quality components and users' characteristics were investigated by one-way analysis of variance (ANOVA), independent t-test, and Pearson's correlation coefficient. A total of 250 users completed the questionnaire (response rate = 81%). The mean scores of all quality components were significantly lower than the mean of SUMISCO. Learnability score had significant relationships with the user's position, education level, and field of education (P < 0.001). Physicians scored significantly lower than other users in efficiency, helpfulness and global usability (P < 0.05). Users' practice experience and age had significant linear inverse relationships with efficiency, helpfulness, and learnability (P < 0.05). The national health information system which is used by a large number of users across a developing country have low usability. Given the significant relationships between the users' characteristics of such systems and quality components, it is essential to consider the characteristics and needs of various user groups during the processes of system analysis and design.


The Relationship Between Fat-Free Mass and Glucose Metabolism in Children and Adolescents: A Systematic Review and Meta-Analysis.
To assess the relationship between fat-free mass (FFM) and glucose metabolism in children 0-18 years of age. We performed a systematic review of the literature on Medline/PubMed, SinoMed, Embase, and the Cochrane Library using the PRISMA 2020 guidelines to 12 October 2021; this encompassed observational studies in which the relationship between FFM and glucose metabolism was assessed. Correlation coefficient (r), regression coefficient (β), and odds ratio (OR) values in the studies were extracted and recorded as the primary data. "Agency for Healthcare Research and Quality" quality-assessment forms recommended for cross-sectional/prevalence studies were applied to evaluate the quality of the selected studies, and we executed R software to combine the pooled data. We included eight studies comprising 13,282 individuals, five of which involved the assessment of the relationship between FFM and blood glucose, and four on the relationship between FFM and insulin resistance (IR). Our results showed that FFM was significantly associated with fasting plasma insulin levels (r = 0.34, 95% CI: 0.30-0.39, P < 0.001). Due to high heterogeneity or insufficient quantity of data, the studies of the relationship between FFM and fasting plasma glucose, HOMA-IR, or HbA1c were not congruent, and were therefore not suitable for meta-analysis. Our results indicated that FFM was significantly associated with fasting plasma insulin levels. As far as we have determined, this is the first-ever systematic review and meta-analysis of the associations between FFM and glucose metabolism in children and adolescents; and our results thus provide novel information to fill a gap in the literature in this area. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020150320, PROSPERO CRD42020150320.


Factors associated with mortality in Norwegian broiler flocks.
Our aim in this longitudinal study (covering years from 1996 to 1999) was to use data regularly recorded in a production database, to identify farm- and flock-level factors associated with cumulative mortality in broiler flocks during: (a) the 1st week after housing and (b) the rest of the growout (2nd to 5th week). A total of 1664 broiler flocks kept in 132 broiler farms were included. The average weekly cumulative mortality was 1.54% (95% CI: 1.46, 1.62%) during the 1st week and 0.48% (95% CI: 0.47, 0.49%) during the rest of the growout. The final least-squares regression model of cumulative mortality during the 1st week identified the following significant factors: study year, flock size, stocking density, use of paper underlay for feeding during the 1st week, and the interaction terms between type of ventilation, drinking system and floor insulation. The final model for the 2nd to 5th week demonstrated that the factors age of the broiler house, heating system and control system for the air intake were associated with cumulative mortality, but the effects of the two latter variables were significantly modified by age of the broiler house. A significant difference in mortality between flocks delivered from various hatcheries was found in both analyses. Our results suggest that changes in several housing factors and management routines might reduce the mortality losses, but the relationship depends on the stage of production.


Identification of the novel HLA-A*02:837 and -A*02:888 alleles by next-generation sequencing in two Chinese individuals.
Compared with HLA-A*02:06:01:01, HLA-A*02:837 and HLA-A*02:888 show one single nucleotide substitution respectively.


[Ophthalmological complications of giant cell arteritis].
Giant cell arteritis, temporal arteritis is a systemic vasculitis, which involves large and medium-sized arteries, especially the extracranial branches of the carotid arteries, in patients above the age of 50. Ischemic complications may involve the eye, orbit, or visual pathway, with blindness being the most feared complication. Visual ischemic complications are observed at least in 25% of patients with giant cell arteritis. Irreversible visual loss is mainly due to acute anterior ischemic optic neuropathy. Thus, in any patient above the age of 50 with any manifestation of ocular ischemia, transient or permanent, giant cell arteritis must be considered and ruled out by an emergent targeted investigation and inflammatory work-up. Steroids remain the treatment of choice for giant cell arteritis and must be instituted immediately upon suspicion of the diagnosis, even in the physician's office. The goal is to protect the eye and visual pathways from irreversible blindness or to prevent contralateral disease. Thus, steroid treatment does not constitute a cure for already-incurred visual loss, which will still carry an unfavourable prognosis.


A phase IIb study comparing the safety and efficacy of remimazolam and midazolam in patients undergoing colonoscopy.
Remimazolam is an ultra-short-acting benzodiazepine currently being developed for procedural sedation and for induction and maintenance of anesthesia. This trial was the fourth study for procedural sedation. The aim was to compare the safety and efficacy profile of remimazolam and to refine suitable doses for subsequent phase III studies in this indication. This was a randomized, double-blind, parallel group, active controlled clinical trial with 162 male and female patients, aged 18 to 70, scheduled to undergo a routine colonoscopy. Patients were randomized to receive 1 of 3 remimazolam doses or midazolam for sedation. Supplemental oxygen and 100 μg of fentanyl was given before procedures were started, and the colonoscopy commenced as soon as suitable sedation had been achieved (Modified Observer's Assessment of Alertness/Sedation score ≤3). Top-up doses of the study drug and/or fentanyl were allowed to maintain suitable sedation and/or analgesia. Response was defined as sufficient sedation, no rescue sedative, and no ventilation required. This study showed that a single dose of remimazolam or midazolam, followed by top-up doses to maintain suitable sedation, provided adequate sedation with a high success rate (>92%) for the remimazolam groups, compared with 75% for the midazolam group (P = .007). There was no requirement for mechanical ventilation in any group, and procedure failures were all due to use of rescue sedative. The high success rates and good safety profile of remimazolam observed in this study warrants further investigation and confirmation in phase III trials. ( NCT01145222.).


Rationale and assessment of minimally invasive approaches to benign prostatic hyperplasia therapy.
Benign prostatic hyperplasia affects quality of life, with most patients complaining of symptoms related to urination. For this reason, successful treatments can be defined by (1) their effect on lower urinary tract symptoms, (2) their impact on quality of life, and (3) their ability to unobstruct the flow of urine through the prostate. Minimally invasive therapy (MIT), which includes transurethral microwave thermotherapy, water-induced thermotherapy, interstitial devices (eg, transurethral needle ablation), and interstitial laser treatments, offers physicians and their patients cost-effective alternatives for achieving a substantially improved quality of life at an acceptable level of risk. Evidence-based medicine indicates that MIT is safe and achieves significant symptomatic improvement. Compared with long-term medical management, minimally invasive procedures offer effective, well-tolerated 1-time intervention with lasting effects that can be achieved on an outpatient basis. This article reviews the options for MIT.


Efficient chromatographic fractionation of steroids in human serum through regulation of liquid--liquid distribution ratios.
To improve the clean-up process in the analysis of biological fluid constituents, an efficient liquid--liquid distribution system was developed. Closed-bed columns containing fine diatomaceous earth granules were prepared by slurry packing for the fractionation of steroid hormones in human serum before quantitative assay by liquid chromatography or radioimmunoassay. Four columns were connected to construct the aqueous liquid--liquid chromatography--fractionation system. The first was coated with neutral water for distribution of serum, the second was weakly alkaline with sodium hydrogen carbonate for extrusion of strong acidic components, and the third was strongly alkaline with sodium hydroxide to capture oestrogens. The final column was acidic with sulphuric acid to remove basic components. Optimization of the stepwise gradient solvents was achieved on the basis of the results of a linear relationship between the logarithms of the capacity ratios and solvent composition determined from an analytical run. Neutral steroid hormones added to serum were eluted from the column system by a stepwise gradient elution technique to obtain first very non-polar materials, then progesterone and testosterone, and finally to extract the corticosteroids. Phenolic oestrogens were recovered from the strong alkaline column with a mobile phase solvent after the pH of the stationary phase had been adjusted with a phase transfer neutralizer. The fractional constituents were purified and enriched. This procedure was used to determine Solu-medrol, an acidic corticosteroid drug, in human serum.


Investigating Epidermal Interactions Through an In Vivo Cutaneous Wound-Healing Assay.
Cutaneous wound healing is an intricate and multifaceted process. Despite these complexities, the distinct phases of wound healing provide a unique opportunity to evaluate the roles of different targets in these coordinated responses. This protocol details an in vivo wound healing assay to study the intersection of cellular, molecular, and systemic effector pathways. The role of certain proteins in the wound healing process can be efficiently explored in vivo through the generation of tissue-specific deficient mice. This approach, although optimized for use with animal models displaying epithelial deficiencies, can be used for other tissue-specific deficiencies, and utilizes simple and cost-effective methods, allowing investigators to precisely devise their experimental design. The coordination of immunological, epithelial, vascular, and microenvironmental factors in wound healing makes this technique a valuable tool for investigators across fields.


Gold nanoparticle-conjugated pepsin for efficient solution-like heterogeneous biocatalysis in analytical sample preparation protocols.
Immobilization of enzymes on mesoporous microparticulate carriers has traditionally been accompanied by reduction in enzyme activity. Herein, we document that immobilization of pepsin via amide coupling on gold nanoparticles (GNPs) with a carboxy-terminated hydrophilic PEG7 shell resulted in a heterogeneous nanobiocatalyst with essentially equivalent turnover rates, k cat (90 %), and enhanced catalytic efficiencies, k cat/K M (107 %), compared to homogeneous catalysis with pepsin in free solution for cytochrome C as model substrate. This heterogeneous catalyst showed further at least equivalent bioactivity in a digestion reaction of a protein mixture consisting of cytochrome C, bovine serum albumin, and myoglobin. UHPLC-ESI-QTOF-MS/MS analysis of the digests with subsequent Mascot database search allowed unequivocal identification of all proteins with high score and good sequence coverage. The functionalized nanoparticles were further characterized by Vis spectroscopy in terms of the surface plasmon resonance (SPR) band, by dynamic light scattering (DLS) with regard to hydrodynamic diameters, and in view of their ζ potentials at each step of synthesis and surface modification. These measurements also revealed that the pepsin-functionalized GNPs were sufficiently stable over at least 1 month; thus providing a satisfactory shelf life to the heterogeneous catalyst. Advantageously, the pepsin-GNP bioconjugate can be conveniently removed after reaction by simple centrifugation steps which makes them a useful tool for analysis of therapeutic peptides and proteins, including monoclonal antibodies. The practical utility of the nanobiocatalyst was documented by digestion of a monoclonal antibody which yielded the F(ab')2 fragment with a mass of 97,619.4 Da. Graphical Abstract Pepsin conjugated to pegylated gold nanoparticles exhibit properties of homogeneous catalysis such as enzyme activity like pepsin in solution and ability to pipette the stable colloidal suspension whereas one can take benefit from easy removal by centrifugation and re-use which are characteristics of heterogeneous catalysis.


Anterior chamber depth measurement: a-scan versus optical methods.
To evaluate methods of measuring anterior chamber depth (ACD) before and after cataract surgery. St. Erik's Eye Hospital, Stockholm, Sweden. A-scan (BVI Axis) and Scheimpflug imaging (Nidek EAS-1000) were used to measure ACD preoperatively and 6 and 18 weeks after phacoemulsification with implantation of a poly(methyl methacrylate) (PMMA) intraocular lens (IOL) in 23 patients. Because of a large systematic difference between the 2 methods, measurement with Orbscan (Orbtek) and optical pachymetry (Haag-Streit) were included when measurements were repeated 36 weeks postoperatively. A t test for paired observations was used for statistical analysis. Preoperatively, the mean A-scan measurements were significantly shorter than the Scheimpflug values: 3.05 mm +/- 0.36 (SD) and 3.37 +/- 0.35 mm, respectively (P < .001). At 6 weeks, the difference was more pronounced: 3.73 +/- 0.26 mm and 4.65 +/- 0.33 mm, respectively (P < .001). At 36 weeks, the A-scan and Scheimpflug values remained unchanged. The results of the Scheimpflug measurements were confirmed with optical pachymetry and Orbscan analysis. There was good agreement between results obtained with 3 methods based on optical principles. Considering the basic and simple measurement principle of these instruments, they appear to provide the correct result. The A-scan equipment used in this study is unsuitable for determination of ACD in eyes with PMMA IOLs.


Toxicity of aerosol propellants in the respiratory and circulatory systems. VI. Influence of cardiac and pulmonary vascular lesions in the rat.
Three propellants were selected for investigation in rats because of their non-uniform effect in mice and monkeys. Trichlorofluoromethane (FC 11) provoked arrhythmia in all three animal species, dichlorodifluoromethane (FC 12) in monkeys and rats but not in mice, and difluoroethane (FC 152a) only in rats. In rats the alterations in heart rate and electrocardiographic pattern during inhalation of these propellants are largely brought about by release of catecholamines from the adrenal gland, because adrenalectomy or prior injection of beta-adrenergic blocking drugs decreased the incidence of cardiac effects. Rats that have pulmonary vascular thrombosis or cardiac necrosis become more sensitive to proarrhythmic activity of these propellants.


Pain-related magnetic fields following painful CO2 laser stimulation in man.
The initial somatosensory evoked magnetic fields following painful heat stimulation by CO2 laser beam applied to the upper and lower limb were investigated in normal subjects. The main deflections, 'Pain MA' and 'Pain ML' following the arm and leg stimulation, respectively, were identified in the bilateral second sensory cortices (SII). The onset latencies of Pain MA and Pain ML were approximately 150 and 200 ms, respectively. No consistent equivalent current dipole was found in other areas including the primary sensory cortex in each hemisphere. Therefore, we consider that neurons in the bilateral SII are initially activated following painful heat stimulation.


Deep brain stimulation of the internal globus pallidus does not affect the limbic circuit in patients with Parkinson's disease: a PET study.
Internal globus pallidus (GPi) deep brain stimulation (DBS) is a safe and effective alternative treatment in Parkinson's disease (PD) for patients with cognitive impairment. However, no study has yet investigated metabolic changes within a large series of patients undergoing GPi stimulation. We assessed motor, cognitive and psychiatric changes, as well as modifications in brain glucose metabolism measured with FDG-PET, before and after bilateral GPi-DBS. In the same week, 32 patients with PD underwent a motor, cognitive and psychiatric assessment and a resting-state FDG-PET scan, 4 months before and 4 months after GPi-DBS surgery. For the voxelwise metabolic change assessment, the p value was controlled for multiple comparisons using the family wise error rate. After GPi-DBS surgery, patients showed a significant overall improvement in motor status. No cognitive or psychiatric changes were observed after surgery. Nor were any clusters with significantly relative metabolic changes found in the limbic circuit after surgery. Clusters with significantly relative metabolic changes were observed in the left and right Brodmann area (BA) 6, the right BA 9, the right and left BA 39 and the left BA 17. The present study confirmed that GPi-DBS is an effective treatment in patients with advanced PD, owing to metabolic changes in the areas involved in motor execution. The absence of relative metabolic decrease in the limbic circuit and the few changes affecting the associative circuit could explain why GPi-DBS is cognitively safe.


Capability of NIPAM polymer gel in recording dose from the interaction of (10)B and thermal neutron in BNCT.
The capability of N-isopropylacrylamide (NIPAM) polymer gel to record the dose resulting from boron neutron capture reaction in BNCT was determined. In this regard, three compositions of the gel with different concentrations of (10)B were prepared and exposed to gamma radiation and thermal neutrons. Unlike irradiation with gamma rays, the boron-loaded gels irradiated by neutron exhibited sensitivity enhancement compared with the gels without (10)B. It was also found that the neutron sensitivity of the gel increased by the increase of concentration of (10)B. It can be concluded that NIPAM gel might be suitable for the measurement of the absorbed dose enhancement due to (10)B and thermal neutron reaction in BNCT.


Infants with atopic dermatitis: maternal hopelessness, child-rearing attitudes and perceived infant temperament.
Atopic dermatitis (AD) is a common disease of childhood. It frequently starts in the first year of life. There is agreement on the existence of psychological influences on this disease. Although some studies in this field examine aspects of the parent-child relationship, studies concerning early infancy are very rare. The present study was conducted in order to find out whether maternal characteristics relevant to the mother-infant relationship, i.e. depressiveness/hopelessness, child-rearing attitudes and perceived infant behaviour, associated with infant AD. Two cohorts (3- to 4-month- and 10- to 12-month-old infants), each with 20 infants suffering from AD, and 20 healthy infants were recruited. AD infants were further divided into subgroups according to the diagnostic criteria: atopic family history, itching and characteristic locations of eczema. After a paediatric examination of the infant, mothers completed standardized questionnaires concerning depressiveness/hopelessness, child-rearing attitudes and perception of infant behaviour. Varying with different diagnostic features of the infants' AD, mothers of AD infants described themselves as more depressive/hopeless, as more anxious/overprotective and characterized their infant as less frequently positive and more frequently negative in its emotional behaviour compared to the control group. The results underline the importance of psychological support for mothers of infants with AD.


Multigenerational contaminant exposures produce non-monotonic, transgenerational responses in Daphnia magna.
Generally, ecotoxicologists rely on short-term tests that assume populations to be static. Conversely, natural populations may be exposed to the same stressors for many generations, which can alter tolerance to the same (or other) stressors. The objective of this study was to improve our understanding of how multigenerational stressors alter life history traits and stressor tolerance. After continuously exposing Daphnia magna to cadmium for 120 days, we assessed life history traits and conducted a challenge at higher temperature and cadmium concentrations. Predictably, individuals exposed to cadmium showed an overall decrease in reproductive output compared to controls. Interestingly, control D. magna were the most cadmium tolerant to novel cadmium, followed by those exposed to high cadmium. Our data suggest that long-term exposure to cadmium alter tolerance traits in a non-monotonic way. Because we observed effects after one-generation removal from cadmium, transgenerational effects may be possible as a result of multigenerational exposure.


The impact of delayed diagnosis on the outcomes of oral cancer patients: a retrospective cohort study.
The contemporary literature is discordant regarding the role of delayed diagnosis in the prognosis of patients with oral cancer. This study examined data on a previously reported cohort of 101 patients with oral squamous cell carcinoma diagnosed at a single institution between 2008 and 2010. The time interval between symptom onset and initial histological diagnosis (diagnostic delay) was recorded for each patient, as were demographic data and cancer features such as T stage, nodal status, and smoking status. The mean follow-up period was 4 years 10 months. The mean diagnostic delay was 4 months, mean overall survival was 5years 6 months, and mean disease-specific survival was 4 years 9 months. No significant correlation was found between diagnostic delay and overall survival, disease-specific survival, or recurrence rates. Patients with node-positive disease were more likely to be diagnosed earlier, whereas women and non-smokers were more likely to have a delayed diagnosis. Inherent tumour biology is likely an important prognostic factor separate to diagnostic delay. Public education efforts should focus on symptom recognition and encourage early presentation for investigation of oral lesions, particularly for females and non-smokers, so that more aggressive tumours can be treated sooner to give the best chance at survival.


Galanin activates an inwardly rectifying potassium conductance in mudpuppy atrial myocytes.
Galanin- and bethanechol-activated K+ currents have been studied in mudpuppy atrial myocytes. The galanin and bethanechol K+ currents were time-dependent and inwardly rectifying. In GTP gamma S, the galanin and bethanechol currents were reduced progressively as G-protein gated K+ channels became activated. GDP beta S inhibited agonist-induced outward currents. We conclude that galanin and bethanechol activate the same or a very similar inwardly rectifying K+ conductance and that activation of a G protein is required.


Carcinoid tumors of the pancreas: dynamic CT and MRI features with pathological correlation.
Carcinoid tumor of the pancreas is rare, and there are few reports that described its CT or magnetic resonance imaging (MRI) findings. We describe the characteristic CT and MRI findings in four cases of carcinoid tumor of the pancreas. Radiologic and pathologic features were analyzed in four patients. All patients underwent triple-phase dynamic CT and MRI. The tumor size in the four cases ranged 15-20 mm and intratumoral calcification was detected in one case. On triple-phase dynamic CT, the peak enhancement of the tumors was seen at the arterial dominant phase in three cases; the remaining one was at the portal venous phase with prolonged contrast-enhancement effect. The tumors showed low to high signal intensity on T2-weighted images. Dilatation of the main pancreatic ducts (MPDs) distal to the tumors was seen in three cases, in which tumor invasion into the MPDs was pathologically confirmed. Furthermore, the tumors having mild to severe fibrosis pathologically invaded into the peripancreatic lymphatics or nerves. It would be characteristic of carcinoid tumor of the pancreas to be well enhanced at the arterial dominant phase on dynamic CT, and to highly invade into the MPDs and the peripancreatic lymphatics or nerves.


Reference point detection for camera-based fingerprint image based on wavelet transformation.
Fingerprint recognition systems essentially require core-point detection prior to fingerprint matching. The core-point is used as a reference point to align the fingerprint with a template database. When processing a larger fingerprint database, it is necessary to consider the core-point during feature extraction. Numerous core-point detection methods are available and have been reported in the literature. However, these methods are generally applied to scanner-based images. Hence, this paper attempts to explore the feasibility of applying a core-point detection method to a fingerprint image obtained using a camera phone. The proposed method utilizes a discrete wavelet transform to extract the ridge information from a color image. The performance of proposed method is evaluated in terms of accuracy and consistency. These two indicators are calculated automatically by comparing the method's output with the defined core points. The proposed method is tested on two data sets, controlled and uncontrolled environment, collected from 13 different subjects. In the controlled environment, the proposed method achieved a detection rate 82.98%. In uncontrolled environment, the proposed method yield a detection rate of 78.21%. The proposed method yields promising results in a collected-image database. Moreover, the proposed method outperformed compare to existing method.


A modified provisional stenting approach to coronary bifurcation lesions: clinical application of the "jailed-balloon technique".
To demonstrate the application of a novel provisional side branch (SB) stenting strategy for coronary bifurcation lesions using a "jailed-balloon" technique (JBT). Adverse cardiac events are higher for percutaneous coronary intervention (PCI) of bifurcation lesions. Recent studies support the use of provisional SB stenting, but a risk of SB closure and a higher rate of target lesion revascularization (TLR) remain important limitations. From December 2007 to August 2010, 100 patients with 102 bifurcation lesions underwent PCI using the JBT. Baseline and postprocedural quantitative coronary angiography (QCA) analysis were performed. Procedural and immediate clinical outcomes were reviewed. The majority of patients presented with acute coronary syndrome (68%) and had Medina class 1,1,1 bifurcation lesions (91%). TIMI 3 flow was established in 100% of main branch and 99% of SB lesions. QCA revealed preservation of the bifurcation angle after PCI (pre-PCI: 59.6 ± 30.0; post-PCI: 63.3 ± 26.8, P = 0.41). Nine patients (9%) had lesions that required rewiring and two patients (2%) required provisional stenting of the SB. SB loss occurred in one patient (1%). The jailed-balloon or wire was not entrapped during any PCI. One patient (1%) suffered a periprocedural myocardial infarction (MI). Provisional stenting of complex coronary bifurcation lesions using a JBT is associated with a high procedural success rate, improved SB patency, and a low rate of immediate cardiac events. Further study is warranted to evaluate the role of JBT in improving long-term clinical outcomes in PCI of complex bifurcation lesions.


Acta Neuropsychiatrica; Tijdschrift voor een hedendaagse neuropsychiatrie.
Samenvatting De psychiatrie benist op een evenwichtige combinatie van gedragswetenschappelijke (ontwikkelingspsychologische en sociale) en natuurwetenschappelijke (neuropsychiatri-sche) dementen. Ofschoon klinici werkzaam in de gezondheidszorg er vaak in slaagden dit evenwicht rede-lijk te handhaven, werd de officiële psychiatrie tot voor kort meestal nogal modieus gedomineerd door een van deze deelgebieden. Uitgroei tot volwassenheid van de psychiatrie vraagt in deze fase om een aanvulling van de in de laatste decennien sterk tot de verbeelding sprekende psychologische en sociale dementen met de verworvenhe-den van een nieuwe neuropsychiatrie. Geschetst wordt waar uit deze verworvenheden bestaan en hoe deze effectief in de psychiatrische gezondheidszorg onderwijs en onderzoek ingebouwd kunnen worden. Het binnen de psychiatrie tot ontwikkeling brengen van een toegepaste klinische psychofysiologie van essentieel belang.


Lower-limb stiffness mediates speed but not turning angle during unplanned side-step cutting.
An inability to pre-plan a side-step cutting maneuver results in a greater reduction in speed and shallower cut angle. Although leg stiffness has not been directly quantified in cutting, indirect evidence suggest that greater stiffness may benefit cutting speed, but lower stiffness may benefit cut angle. No studies have investigated if stiffness causally mediates the relationship between anticipation, cutting speed and angle. The aims of the present study were to determine the influence of anticipatory cues on leg stiffness, and quantify the mediation effects of stiffness on cutting speed and angle. Seventeen healthy participants performed a 45° cut at an approach speed of 4 m/s. Leg stiffness (% bodyweight/leg length [BW/LL]), cutting angle and change in running speed between initial contact and toe-off of the cut were calculated. Causal mediation analysis was performed with anticipatory cues as the independent variable, cutting speed and angle as the dependent variables, and stiffness as the mediator. Unanticipated cutting significantly increased leg stiffness (β=3.82%BW/LL,P=0.005) compared to anticipated cutting. The average causal mediation effect of stiffness on cutting angle was not significant (P = 0.68). The average causal mediation effect of stiffness on cutting speed was significant (-0.02 m/s [95%CI -0.04 to 0.00 m/s, P = 0.016). Reduced preplanning time in cutting increased leg stiffness. Alterations in leg stiffness only explained the change in speed, and not angle, associated with cutting under different anticipatory cues. Loss of speed when cutting is unplanned may be mitigated by improving leg stiffness.


[Slow P III component of the electroretinogram resulting from the interaction of photoreceptors and cells of Müller in the retina].
Simultaneously recorded slow PIII (sPIII) and the late receptor potential of the frog isolated aspartate-treated retina were studied under different intensity and duration of light stimuli. The earlier suggested model of the sPIII generation in Müller's cells showed that the sPIII kinetic had to be the same as the light photo-receptor-induced decrease in the extracellular potassium ions concentration. There were some differences between the real sPIII time-course and the theoretical one within the photopic range that were, probably, due to infringement of interrelationships proposed by Matsuura et al. for potassium fluxes through the photoreceptor membrane.


Measuring image resolution in optical nanoscopy.
Resolution in optical nanoscopy (or super-resolution microscopy) depends on the localization uncertainty and density of single fluorescent labels and on the sample's spatial structure. Currently there is no integral, practical resolution measure that accounts for all factors. We introduce a measure based on Fourier ring correlation (FRC) that can be computed directly from an image. We demonstrate its validity and benefits on two-dimensional (2D) and 3D localization microscopy images of tubulin and actin filaments. Our FRC resolution method makes it possible to compare achieved resolutions in images taken with different nanoscopy methods, to optimize and rank different emitter localization and labeling strategies, to define a stopping criterion for data acquisition, to describe image anisotropy and heterogeneity, and even to estimate the average number of localizations per emitter. Our findings challenge the current focus on obtaining the best localization precision, showing instead how the best image resolution can be achieved as fast as possible.


Abnormal DNA content in liver-cell dysplasia: a flow cytometric study.
To clarify the true nature of liver-cell dysplasia (LCD), a flow cytometric study has been performed. The DNA content of hepatocytes from 26 cases of cirrhosis with diffuse areas of LCD was investigated and compared to that of hepatocytes from 21 control patients with non-neoplastic and neoplastic liver conditions. Flow cytometric analysis was performed on propidium-stained nuclei from archival paraffin-embedded material. Analysis was directed to assessment of diploid as well as non-diploid peaks by calculation of DNA index (DI), using normal hepatocytes present in each sample as individual and specific references. Since only samples containing at least 10,000 nuclei were considered suitable for analysis, 4 of the 26 LCD cases were discarded. Eight of 22 LCD cases had an abnormal DNA content compared with 0/11 non-neoplastic cases (p less than 0.05) and 8/10 hepatocellular carcinomas (p less than 0.05). Non-neoplastic control cases displayed uniformly diploid stemlines whereas hepatocellular carcinomas had in 8/10 cases bimodal or trimodal populations. Thus, LCD is a heterogeneous lesion in terms of ploidy, and the abnormal DNA content observed in some cases supports its pre-neoplastic nature.


Personalized Treatment Selection Leads to Low Rates of Local Salvage Therapy for Bone Metastases.
Local therapy for patients with nonspine bone metastases is evolving, with data supporting the use of single-fraction treatments, and more recently, showing possible benefit from stereotactic body radiation therapy (SBRT). However, the rate of local salvage therapy (LST) after each technique has not been characterized in real-world clinic settings where patients are selected at physician discretion. We examined rates of LST in patients with nonspine bone metastases. We reviewed records of RT for nonspine bone metastases at our institution from January 1, 2016, to December 31, 2018. We defined LST as the first occurrence of RT or surgery for oncologic progression to a bone metastasis after initial RT. Cumulative incidence functions for retreatment were generated. We conducted multivariate analysis to identify variables associated with LST. A total of 1754 patients were analyzed, with median follow-up of 16.2 months (range, 0-36.8 months). Of all episodes of RT, 51.5% were multifraction external beam radiation therapy (EBRT), 7.0% were single-fraction EBRT, and 41.4% were SBRT. Altogether, 88 patients (5.0%) required LST, with an incidence at 6 months of 2.5%. Incidence of LST at 6 months was 2.1% for SBRT, 5.3% for single-fraction conventional regimens, and 2.4% for multifraction conventional regimens (P = .26). Patients of younger age, who had a higher Karnofsky performance status, and/or who had lesions in the pelvis had a higher risk of retreatment. In this large institutional cohort, the rate of LST was low, with no difference between RT techniques. The findings indicated that SBRT for patients at high risk for treatment failure may reduce the rate of retreatment overall. When treatment modality was selected based on patient characteristics, rates of LST were lower than when treatment was randomly selected.


Pediatric musculoskeletal nuclear medicine.
This article reviews the current role of nuclear medicine in common benign and malignant pediatric musculoskeletal conditions and discusses future applications.


Vitellogenesis: The evolutionary origins of nutrient uptake in animals.
The evolutionary origin of nutrient trafficking, a key development in metazoans, has been relatively unexplored. A new study in a model sea anemone exploits click chemistry and gene editing to provide insight into how nutrient trafficking may have arisen.


Circular dichroic properties of the tyrosine residues in tetrazole analogues of opioid peptides.
CD studies on tetrazole analogues of opioid peptides show that peptides sharing the same N-terminal sequence, H-TyrPsi[CN(4)]Gly-, give very large Cotton effects of the Tyr side chain in the near-UV region. CD spectra of five such peptides: H-TyrPsi[CN(4)]Gly-Gly-Phe-Leu-OH (I), H-TyrPsi[CN(4)]Gly-Phe-Pro-Gly-Pro-Ile-NH(2) (II), H-TyrPsi[CN(4)]Gly-Phe-Pro-NH(2) (III), H-TyrPsi[CN(4)]Gly-Phe-Gly-Tyr-Pro-Ser-NH(2) (IV), and H-TyrPsi[CN(4)]Gly-Phe-Asp-Val-Val-Gly-NH(2) (V), and two others for comparison: H-Tyr-GlyPsi[CN(4)]Gly-Phe-Leu-OH (VI) and H-TyrPsi[CN(4)]Ala-Phe-Gly-Tyr-Pro-Ser-NH(2) (VII), were measured in methanol, 2,2,2-trifluoroethanol, and water at different pH values. The spectra show that the conformations of the Tyr(1) residue in peptides I-V are very similar in all solvents used but differ distinctly from those observed for VI and VII. Strong Tyr bands in the aromatic region result probably from the rigid structure of the common N-terminal part of peptides I-V. These bands are weaker for IV, which maybe due to the presence of a second Tyr residue in that peptide, giving an opposite contribution to the CD spectrum as that arising from Tyr1. It seems that the rigid structure of the N-terminal part of I-V results from the interaction of the Tyr(1) side chain and the tetrazole ring. The CD bands of the Tyr residues of VI and VII are much smaller than those of I-V in all solvents, except VII in trifluoroethanol (TFE) where Tyr bands comparable in intensity to those of I-V are observed. This spectral property may derive from the same sign contribution of both Tyr residues of VII to the CD spectrum.


Aberrant methylation in promoter-associated CpG islands of multiple genes in acute lymphoblastic leukemia.
Methylation profile was analyzed in 10 childhood acute lymphoblastic leukemia (ALL) and nine adult ALL cases. Four genes (p15, p16, RARbeta, FHIT) had methylation in both diseases, four genes (p14, Rb, MLH1, DAPK) showed no methylation in both diseases, and the two genes (APC, RIZ) demonstrated methylation only in adult ALL. Methylation of the RARbeta was more frequent in adult ALL than that in childhood ALL (p=0.01). The number of patients with methylation of multiple genes was higher in adult ALL than that in childhood ALL (p=0.006). Moreover, overall frequency of methylation was higher in adult ALL than that in childhood ALL (p=0.01).


Science to practice: what do molecular biologic studies in rodent models add to our understanding of interventional oncologic procedures including percutaneous ablation by using glyceraldehyde-3-phosphate dehydrogenase antagonists?
In this basic research study, Ganapathy-Kanniappan et al advance our understanding of how to block the glycolytic pathway to inhibit tumor progression by using image guided procedures (1). This was accomplished by demonstrating their ability to perform molecular targeting of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) in human hepatocellular carcinoma (HCC) by using percutaneous injection of either inhibitor--3-bromopyruvate (3-BrPA) or short hairpin RNA (shRNA). They take the critical step of providing further rationale for potentially advancing this therapy into clinical trials by demonstrating that GAPDH expression strongly correlates with c-jun, a proto-oncogene involved in liver tumorigenesis in human HCC (2).


The role of obstetrics and gynecology national societies during natural disasters.
When a natural disaster occurs, such as an earthquake, floods, or a tsunami, the international response is quick. However, there is no organized strategy in place to address obstetric and gynecological (ob/gyn) emergencies. International organizations and national ob/gyn societies do not have an organized plan and rely on the good will of volunteers. Too often, local specialists are ignored and are not involved in the response. The massive earthquake in Haiti in 2010 exemplifies the lack of coordinated response involving national organizations following the disaster. The Society of Obstetricians and Gynaecologists of Canada (SOGC) engaged rapidly with Haitian colleagues in response to the obstetric and gynecological emergencies. An active strategy is proposed.


Addressing the need for education: curriculum development for nurses about intellectual and developmental disabilities.
People with disabilities and national and international agencies are voicing their views, forcing health care providers to look at how people with disabilities are treated in the health care system and to find ways to help them achieve equal access to quality care. Education about nursing care of patients with I/DD is limited in basic nursing education programs and for nurses who are in practice. A number of developmental disabilities nursing projects are addressing this need with curriculum development that has validated the need for education and has begun testing the various methods of instruction. As the curriculum is disseminated in written or Internet-accessible formats, nurses in education and practice will be able to find resources that target a specific topic area or a set of comprehensive instructions to acquire a better understanding of the comprehensive needs of people with I/DD and better ways to provide care. There is a need for a greater integration of curriculum about nursing care of people with developmental disabilities into basic nursing education at all levels and further evaluation of the impact of this curriculum on nursing care for people with I/DD. The hope is that these efforts can improve the education of nurses and other health care providers for the direct benefit of individuals with intellectual disabilities.


Sequential anaerobic/aerobic treatment of dye-containing wastewaters: colour and COD removals, and ecotoxicity tests.
Colour and COD removals of the azo dyes Congo Red (CR) and Reactive Black 5 (RB5) were individually evaluated in a sequential anaerobic/aerobic treatment system. Additionally, dye toxicity was assessed by using acute ecotoxicity tests with Daphnia magna as the indicator-organism. The anaerobic reactor was operated at approximately 27 °C and with hydraulic retention times of 12 and 24 h. The aerobic reactor was operated in batch mode with a total cycle of 24 h. During anaerobic step, high colour removals were obtained, 96.3% for CR (400 mg/L) and 75% for RB5 (200 mg/L). During the aerobic phase, COD effluent was considerably reduced, with an average removal efficiency of 52% for CR and 85% for RB5, which resulted in an overall COD removal of 88% for both dyes. Ecotoxicity tests with CR revealed that the anaerobic effluent presented a higher toxicity compared with the influent, and an aerobic post-treatment was not efficient in reducing toxicity. However, the results with RB5 showed that both anaerobic and aerobic steps could decrease dye toxicity, especially the aerobic phase, which removed completely the toxicity in D. magna. Therefore, the anaerobic/aerobic treatment is not always effective in detoxifying dye-containing wastewaters, sometimes even increasing dye toxicity.


A comparison of the use of external pin and transnasal Kirschner wire fixation for the unstable tripod malar fracture: a prospective trial.
A prospective study involving 54 patients was undertaken to compare external pin and transnasal Kirschner wire (K-wire) fixation of the unstable, non-comminuted, tripod malar fracture. The features assessed were: (1) The aesthetic result. (2) The ease and speed of both procedures. (3) Per-operative complications. (4) Post-operative complications. (5) Patient tolerance of the procedure.


Role of thirst and visual barriers in the differential behavior displayed by streptozotocin-treated rats in the elevated plus-maze and the open field test.
Conflicting results have been obtained by several groups when studying the effects of streptozotocin (STZ)-treated rats in the elevated plus-maze (EPM). Since thirst is a prominent feature in STZ-induced diabetic-like condition, we studied whether the walls of the closed arms of the EPM, by limiting the search for water in the environment, may contribute to the observed differential behavioral outcomes. The aim of this study was to ascertain whether visual barriers within the EPM have an influence on the behavior of STZ-treated rats in this test of anxiety. A striking similarity between STZ-treated (50 mg/kg, i.p., in two consecutive days) and water deprived rats (72 h) was found in exploratory behavior in the EPM, showing an anxiolytic-like profile. However the anxiolytic response of STZ-treated rats exposed to the EPM shifts into an anxiogenic profile when they are subsequently tested in the open-field test, which unlike the EPM is devoid of visual barriers. Likewise, water deprived rats (72 h) also showed an anxiogenic profile when they were exposed to the open-field test. Our results indicate that experimental outcomes based on EPM observations can be misleading when studying physiological or pathological conditions, e.g. diabetes, in which thirst may increase exploratory behavior.


Caffeine and human cerebral blood flow: a positron emission tomography study.
Positron emission tomography (PET) was used to quantify the effect of caffeine on whole brain and regional cerebral blood flow (CBF) in humans. A mean dose of 250 mg of caffeine produced approximately a 30% decrease in whole brain CBF; regional differences in caffeine effect were not observed. Pre-caffeine CBF strongly influenced the magnitude of the caffeine-induced decrease. Caffeine decreased paCO2 and increased systolic blood pressure significantly; the change in paCO2 did not account for the change in CBF. Smaller increases in diastolic blood pressure, heart rate, plasma epinephrine and norepinephrine, and subjectively reported anxiety were also observed.


Increased levels of soluble CD27 in the cerebrospinal fluid are not diagnostic for leptomeningeal involvement by lymphoid malignancies.
Soluble CD27 (sCD27) reportedly is a sensitive and specific marker for leptomeningeal involvement (LI) of CD27-expressing lymphoproliferations such as B-cell non-Hodgkin's lymphoma (B-NHL) or chronic B-lymphocytic leukemia (B-CLL). Because morphological analysis of cerebrospinal fluid (CSF) in patients suspected of LI is false negative in one-third of patients, a diagnostic marker for LI by B-NHL or B-CLL would be very valuable. sCD27 was determined in the first CSF sample from each of 102 unselected patients submitted for (immuno)morphologic detection of malignant cells. The patients were considered to have LI if either (immuno)morphologic analyses showed tumor cells or if neuroradiological evaluation showed typical abnormalities consistent with LI. Patients were suspected of having LI if CSF samples revealed atypical lymphocytes and/or if clinical symptoms and signs suggestive of LI were present, but clinical follow-up was shorter than 3 months because of deterioration of the patient. LI was considered absent if (immuno)morphologic analyses of CSF samples were negative without evidence for LI during 3 months of clinical follow-up. In patients with chronic lymphoproliferative disorders [mainly B-non-Hodgkin's lymphoma (NHL)], sCD27 concentrations were significantly higher in the CSF samples of 16 patients with confirmed or suspected LI than in those of 46 patients without LI. However, sCD27 was also increased in a variety of other predominantly inflammatory neurological disorders including herpes simplex and zoster infections. The positive predictive value of sCD27 determination for LI was only 54%, but the negative predictive value was 92%. Normal sCD27 concentrations in CSF samples of patients with chronic lymphoproliferation makes LI unlikely, but the determination of CSF sCD27 is not sufficiently specific to serve as a reliable tumor marker.


Impact of the COVID-19 Pandemic on Delivery of Gynecology and Obstetrics Services at a Maximum Care University Hospital in Germany.
Einleitung Die COVID-19-Pandemie bedeutet einschneidende Maßnahmen für das nationale Gesundheitssystem. Dies bot den Anlass, die klinischen und ökonomischen Leistungsindikatoren der gynäkologischen und geburtshilflichen Versorgung des Universitätsklinikums Marburg als regionaler universitärer Maximalversorger zu analysieren. Hierzu wurden die Auswirkungen auf die monatlichen stationären und ambulanten Fallzahlvolumina sowie die entsprechenden ICD- und DRG-Kodierungen ausgewertet, um etwaige Versorgungsdefizite aufzudecken. Material und Methoden Die Studie basiert auf einer retrospektiven Datenanalyse therapierter stationären und ambulanten Fälle der Jahre 2016 bis 2020. Hierzu wurden über das klinikinterne Leistungscontrolling-Programm QlikView die Daten von 9487 Fällen der Klinik für Gynäkologie und 19597 Fällen der Klinik für Geburtshilfe ausgewertet. Ergebnisse Es bildet sich eine der nationalen Pandemiedynamik folgende Abnahme der gynäkologischen stationären Fallzahlen um -6% ab, während das geburtshilfliche Fallzahlvolumen um +11% im Jahr 2020 steigt. Insgesamt fallen die Effekte für die ambulante Versorgung geringer aus. Zudem lässt sich eine standortbezogene Abnahme der C50 "Bösartige Neubildungen der Brustdrüse" und C56 "Bösartige Ovarialtumoren" Diagnosen um -7,4% bzw. -14% feststellen. Eine Rückkehr zu dem Leistungsniveau des Vorjahres konnte im ambulanten in 3 und im stationären Sektor in 5 Monaten erreicht werden. Schlussfolgerung Die negativen Auswirkungen der COVID-19-Pandemie treffen vorwiegend die Klinik für Gynäkologie. Durch das Vertrauen in die Sicherheit der universitären Versorgung und das Serviceangebot, werdende Väter nach Schnelltestung am Geburtsprozess teilhaben zu lassen, konnte eine Fallzunahme in der Geburtshilfe erreicht werden. Die Rückkehr zu präpandemischen Leistungsniveaus gestaltet sich weiterhin schleppend, während sich der ohnehin weniger betroffene ambulante Sektor zügiger erholt. Der standortbezogene Rückgang der Diagnosen C50 und C56 ist besorgniserregend und bedarf epidemiologischer Aufarbeitung. Die fallzahlbezogenen Auswirkungen der Pandemie bilden sich gleichsam in den ökonomischen Leistungskennzahlen ab.


cGMP Signalling: Malarial Guanylyl Cyclase Leads the Way.
When ingested by a mosquito, the malaria parasite relies on an unusual form of gliding motility to escape from the rapidly deteriorating blood meal. A new study on an atypical malaria guanylyl cyclase reveals the importance of spatiotemporal regulation of cGMP production in this process.


The NHL-domain protein Wech is crucial for the integrin-cytoskeleton link.
Integrin transmembrane receptors mediate cell adhesion through intracellular linker proteins that connect to the cytoskeleton. Of the numerous linker proteins identified, only a few, including Talin and Integrin-linked-kinase (ILK), are essential and evolutionarily conserved. The wech gene encodes a newly discovered and highly conserved regulator of integrin-mediated adhesion in Drosophila melanogaster. Embryos deficient in wech have very similar phenotypes to integrin-null or Talin-null embryos, including muscle detachment from the body wall. The Wech protein contains a B-box zinc-finger and a coiled-coil domain, which is also found in RBCC/TRIM family members, and an NHL domain. In beta-integrin or Talin mutants, Wech is mislocalized, whereas ILK localization depends on Wech. We provide evidence that Wech interacts with the head domain of Talin and the kinase domain of ILK, and propose that Wech is required to connect both core proteins of the linker complex during embryonic muscle attachment. Both the NHL and the B-box/coiled-coil domains of Wech are required for proper interaction with Talin and ILK. The single murine Wech orthologue is also colocalized with Talin and ILK in muscle tissue. We propose that Wech proteins are crucial and evolutionarily conserved regulators of the integrin-cytoskeleton link.


The Evolutionary Dynamics of Stochastic Epidemic Model with Nonlinear Incidence Rate.
A stochastic SIRS epidemic model with nonlinear incidence rate and varying population size is formulated to investigate the effect of stochastic environmental variability on inter-pandemic transmission dynamics of influenza A. Sufficient conditions for extinction and persistence of the disease are established. In the case of persistence, the existence of endemic stationary distribution is proved and the distance between stochastic solutions and the endemic equilibrium of the corresponding deterministic system in the time mean sense is estimated. Based on realistic parameters of influenza A in humans, numerical simulations have been performed to verify/extend our analytical results. It is found that: (i) the deterministic threshold of the influenza A extinction R(S)0 may exist and the threshold parameter will be overestimated in case of neglecting the impaction of environmental noises; (ii) the presence of environmental noises is capable of supporting the irregular recurrence of influenza epidemic, and the average level of the number of infected individuals I(t) always decreases with the increase in noise intensity; and (iii) if R(S)0 > 1, the volatility of I(t) increases with the increase of noise intensity, while the volatility of I(t) decreases with the increase in noise intensity if R(S)0 < 1.


Clinical follow-up and immunogenetic studies of 32 patients with eosinophilia-myalgia syndrome.
31 patients with L-tryptophan-associated eosinophilia-myalgia syndrome (EMS) that developed during the United States outbreak in 1989 were followed up prospectively at a university hospital outpatient rheumatology clinic for 16 to 24 months from the onset of their illness. Another patient with EMS associated with L-tryptophan in 1988 was followed up for 30 months. 93% of the 28 survivors from the 1989 cohort continue to have symptoms affecting 1-4 organ systems (median 3) and 3 have died, so the disorder produces considerable morbidity and mortality. The chronic sequelae most often associated with long-term disability are sclerodermatous skin thickening (54%), sensorimotor polyneuropathy (61%), proximal myopathy (36%), and severe episodic myalgias (64%). Thrombocytopenia developed in 1 patient. HLA-class II typing revealed a non-significant trend towards an association with HLA-DR4. Early therapy with corticosteroids did not seem to prevent the development of chronic manifestations.


Synthesis and NK1 receptor antagonistic activity of (+/-)-1-acyl-3-(3,4- dichlorophenyl)-3-[2-(spiro-substituted piperidin-1'-yl)ethyl]piperidines.
(+/-)-1-Acyl-3-(3,4-dichlorophenyl)-3-[2-(spiro-substituted piperidin-1'-yl)ethyl]piperidines and their quaternary ammonium salts were prepared and evaluated for their NK1 receptor antagonistic activity. Some of these inhibited SP-induced contraction in guinea pig ileum with IC50 values at a level of 10(-9) M and showed potent inhibitory activity against selective NK1 receptor agonist-induced bronchoconstriction in guinea pigs.


Postoperative JJ stent is not necessary after balloon high-pressure endoscopic dilatation of primary obstructive megaureter.
A wide range of surgical interventions have been described for the management of primary obstructive megaureter (POM). Endoscopic balloon dilatation has been developed through last decades as a minimally invasive alternative to classic surgery. To assess the need for placement of a double J stent after endoscopic balloon dilatation procedure, by comparing the post-operative related outcomes with and without double J placement. Secondary outcome was the success rate, considering the need for further procedure after endoscopic balloon dilatation and the improvement of the ureteral diameter in the two groups. Historical retrospective comparison of children treated by endoscopic dilatation for POM, with post-operative JJ stent left in place (2012-2014) or without ureteral JJ stent (since 2015). Post-operative complications were reported following Clavien-Dindo grading system and compared between the two groups. Success rate was defined as absence of need for further surgical reimplantation. Ureteral diameters on preoperative and postoperative renal ultrasounds were compared. Endoscopic dilatations were performed in 42 patients for 46 renal units during the study period. There was a significantly higher rate of post-operative complications in the group with JJ stenting compared to the group without double J stenting regarding all Clavien-Dindo grades (56% vs 15%, p = 0.014) and Clavien-Dindo grade III only (31% vs 0%, p = 0,0051) (Figure). The success rate was similar in the JJ group (75%, F-up: 70 months [13-101]) and the no JJ group (81%, F-up: 26 months [12-95]). There was a significant improvement of US renal pelvis and ureter dilatation in both groups, with a median follow-up of 35.5 months [12-101]. The overall rate of complications was slightly higher than in other reports and higher in the JJ group regarding Clavien-Dindo grade III complications. The success rate was comparable to previous studies reviewing endoscopic dilatations and equivalent in the two groups. In our study, the omission of postoperative ureteral drainage by a JJ stent after endoscopic balloon dilatation of POM did not increase post-operative complications rate without demonstrable impact on the success rate.


High-dose therapy and autologous stem cell transplant does not result in long-term disease-free survival in patients with recurrent chemotherapy-sensitive ALK-negative anaplastic large-cell lymphoma.
Primary systemic anaplastic lymphoma kinase (ALK)-negative anaplastic large-cell lymphoma (ALCL) has a poor prognosis. This study sought to determine if high-dose therapy and ASCT results in long-term disease-free survival (DFS) in patients with recurrent, chemotherapy-sensitive ALK-negative ALCL. All patients with non-Hodgkin's lymphoma (NHL) who underwent ASCT at Wake Forest University and Upstate Medical University from 1 January 1990 to 12 December 2002 were reviewed to determine if they had T-, B- or null-cell NHL that was CD30+/CD15-/ALK negative. In all, 16 patients were thus identified as having ALK-negative ALCL. All 16 patients underwent ASCT at the time of first relapse and form the basis of this report. Median age of the 16 patients was 51 years. There were 11 males and five females. International prognostic index scores in 12 patients at the time of relapse were: low 3, LI 6 and HI 3. Of 15 patients, 13 relapsed after ASCT; one patient was lost to follow-up. Median progression-free survival for the 15 patients was 12 weeks (3-212+ weeks). Of 15 patients, 10 have died; nine of recurrent disease. Median overall survival for the 15 evaluable patients was 72 weeks. In our experience, high-dose therapy and ASCT does not produce long-term DFS in patients with recurrent chemotherapy-sensitive ALK-negative ALCL.


Identifying Workflow Disruptions in Robotic-Assisted Bariatric Surgery: Elucidating Challenges Experienced by Surgical Teams.
Bariatric surgery is an effective and durable treatment for weight loss for patients with extreme obesity. Although traditionally approached laparoscopically, robotic bariatric surgery (RBS) has unique benefits for both surgeons and patients. Nonetheless, the technological complexity of robotic surgery presents new challenges for OR teams and the wider clinical system. Further assessment of the role of RBS in delivering quality care for patients with obesity is necessary and can be done through a human factors approach. This observational study sought to investigate the impact of RBS on the surgical work system via the study of flow disruptions (FDs), or deviations from the natural workflow progression. RBS procedures were observed between October 2019 and March 2022. FDs were recorded in real time and subsequently classified into one of nine work system categories. Coordination FDs were further classified into additional sub-categories. Twenty-nine RBS procedures were observed at three sites. An average FD rate of 25.05 (CI = ± 2.77) was observed overall. FDs were highest between insufflation and robot docking (M = 29.37, CI = ± 4.01) and between patient closing and wheels out (M = 30.00, CI = ± 6.03). FD rates due to coordination issues were highest overall, occurring once every 4 min during docking (M = 14.28, CI = ± 3.11). FDs occur roughly once every 2.4 min and happen most frequently during the final patient transfer and robot docking phases of RBS. Coordination challenges associated with waiting for staff/instruments not readily available and readjusting equipment contributed most to these disruptions.


8-Oxo-2'-deoxyguanosine ameliorates UVB-induced skin damage in hairless mice by scavenging reactive oxygen species and inhibiting MMP expression.
Skin is uniquely vulnerable to damage caused by reactive oxygen species (ROS), which are most commonly produced in response to ultraviolet (UV) light. ROS generated at injury sites play an important role in modulating the inflammatory response. Besides inhibiting Rac, 7,8-dihydro-8-oxo-2'-deoxyguanosine (8-oxo-dG) has also shown notable antioxidant action. We tested whether 8-oxo-dG could protect skin from UVB-induced damage by scavenging ROS. HaCaT cells and hairless mice were irradiated with 15 and 180 mJ/cm(2) narrow-spectrum UVB, respectively. ROS generation was detected through incubation with DCFDA and confocal microscopy. Western blot analyses and immunohistochemistry were performed to verify the activities of ERK, JNK, p38, ATF-2, and c-Jun, and the expression of matrix metalloproteinases (MMPs), in UVB-irradiated HaCaT cells and murine skin. Hydrogen peroxide production and protein carbonyl concentrations were measured in UVB-damaged mouse skin. MMP-1 and MMP-9 expression in UVB-irradiated HaCaT cells was measured by quantitative reverse-transcription polymerase chain reaction (qRT-PCR). In UVB-irradiated HaCaT cells, 8-oxo-dG inhibited ROS production, subsequent activation of mitogen-activated protein kinase (MAPK), ATF-2, and c-Jun, and MMP expression. It also prevented UV-induced skin reactions in hairless mice, inhibiting the increase in protein carbonyl content, activation of MAPKs, ATF-2, and c-Jun, the increases in MMP-9 and -13 expression, and epidermal hyperplasia. 8-oxo-dG can be considered an endogenous antioxidant and its potent antioxidant activity might be a beneficial property that could be exploited to protect skin from ROS-associated photodamage.


Changing concepts of motor areas of the cerebral cortex.
Recent development of studies on cerebral cortex of primates provides evidence that there exist multiple motor representation areas in the frontal lobe. By analyzing the activity of single cells in association with performance of a variety of motor behavior, new concepts on the functional role of each area are developing.


Copper deficiency and hypocalcemic rickets in a small-for-date infant.
A case of copper deficiency associated with hypocalcemia, radiological features of rickets and hyperparathyroidism is described in a small-for-date infant (gestational age 39 weeks, B.W 1 240 g). Neonatal serum copper (Cu) levels were found between 223 and 138 mumol/l. She was given daily 2 400 U of vitamin D2 and a load dose of 80 000 IU at the age of 55 days. At the age of 79 days, X-rays of the legs and wrist showed spread, cupped and frayed metaphyses. Serum Ca was 1.35 mmol/l, P = 0.99 mmol/l with high alkaline phosphatases (A.P.) 590 IU/ml. But plasma level of 25 hydroxycholecalciferol (25-OH-CC) was normal = 10.8 ng/ml. Serum Cu was low = 3.14 mumol/l and serum immunoreactive parathormone (iPTH) level was elevated: 520 mulEq/ml (N less than or equal to 100). Administration of vitamin D2 (15 mg) induced an immediate normalization of serum Ca, normal serum iPTH (68 mulEq/ml) in one month, normal X-rays in two months and normal A.P. in four months. Serum Cu and ceruloplasmin levels increased slowly without any supplementation to subnormal levels at the age of eight months (14.9 and 1.65 mumol/l. Serum Cu concentrations were found to be normal (16.0--33.7 mumol/l) in five children with hypocalcemic rickets. These results suggest a role of Cu deficiency in the occurrence of this transient vitamin D-resistant rickets.


Corrigendum: Using Transcranial Direct Current Stimulation to Augment the Effect of Motor Imagery-Assisted Brain-Computer Interface Training in Chronic Stroke Patients-Cortical Reorganization Considerations.
[This corrects the article DOI: 10.3389/fneur.2020.00948.].


Expansion of Human Pluripotent Stem Cell-derived Early Cardiovascular Progenitor Cells by a Cocktail of Signaling Factors.
Cardiovascular progenitor cells (CPCs) derived from human pluripotent stem cells (hPSCs) are proposed to be invaluable cell sources for experimental and clinical studies. This wide range of applications necessitates large-scale production of CPCs in an in vitro culture system, which enables both expansion and maintenance of these cells. In this study, we aimed to develop a defined and efficient culture medium that uses signaling factors for large-scale expansion of early CPCs, called cardiogenic mesodermal cells (CMCs), which were derived from hPSCs. Chemical screening resulted in a medium that contained a reproducible combination of three factors (A83-01, bFGF, and CHIR99021) that generated 1014 CMCs after 10 passages without the propensity for tumorigenicity. Expanded CMCs retained their gene expression pattern, chromosomal stability, and differentiation tendency through several passages and showed both the safety and possible cardio-protective potentials when transplanted into the infarcted rat myocardium. These CMCs were efficiently cryopreserved for an extended period of time. This culture medium could be used for both adherent and suspension culture conditions, for which the latter is required for large-scale CMC production. Taken together, hPSC-derived CMCs exhibited self-renewal capacity in our simple, reproducible, and defined medium. These cells might ultimately be potential, promising cell sources for cardiovascular studies.


Revision of Pristonesia (Hymenoptera, Bethylidae, Pristocerinae), an endemic Afrotropical genus.
The Afrotropical pristocerine genus Pristonesia is revised. Seven species are recognized, one previously described species, P. nyamuragira (Benoit), and six species are described and illustrated as new: P. oracil sp. nov., P. parcetil sp. nov., P. querfil sp. nov., P. sicril sp. nov., P. tainatril sp. nov., and P. uvenil sp. nov. A key to the Afrotropical species is presented. Additionally, the main morphological diagnostic characters and the morphological relationships of Pristonesia with other pristocerine genera are discussed. The diagnostic characters are revised, and the genus can be identified by the presence of apical projections on the harpe; a setose apical aedeagal lobe; a predominantly flattened cuspis; and the absence of a cupula on the ventral side of the genitalia.


Pregnancy outcomes after successful chemotherapy for choriocarcinoma and invasive mole: long-term follow-up.
In order to preserve the fertility of young patients with choriocarcinoma and invasive mole, chemotherapy alone was given without hysterectomy in 265 cases from 1959 through 1980. By the end of 1985, 205 patients had become pregnant after recovery, with a total of 355 pregnancies. Among these, 23 were terminated by induced abortions, 26 as miscarriages, two as ectopic gestations, two as intrauterine deaths, and three as stillbirths. Among 303 livebirths (including four sets of twins), six infants died neonatally, three of whom were found to have congenital anomalies incompatible with life, and two died during infancy. All the remaining 295 children had normal growth and development, the oldest now being 25 years of age. The rates of fetal wastage, malformations, twin pregnancies, and neonatal and infantile deaths did not deviate from the normal. Cytogenetic study of the peripheral lymphocytes of 94 of the children revealed no increase of chromosomal aberrations. The rates of recurrence of disease and of death caused by recurrence of disease in these were not increased in comparison with those in patients who underwent hysterectomy. These data indicate that treatment of malignant trophoblastic neoplasms with chemotherapy alone is compatible with the preservation of fertility in most women.


Pain-related somatosensory evoked potentials following CO2 laser stimulation in peripheral neuropathies.
Pain-related somatosensory evoked potentials (pain SEPs) following CO2 laser stimulation were examined in 30 patients with peripheral neuropathies, and the results were compared with clinical sensory findings. Pain SEP findings showed a significant correlation with the clinical impairment of pain sensation, but not with the impairment of deep sensations. In contrast, conventional electrically-stimulated SEPs (electric SEPs) showed a significant correlation with deep sensations, but not with the impairment of pain sensation. Examinations of both pain SEPs and electric SEPs, therefore, are considered to be very useful to evaluate physiological functions of sensory nerves in patients with peripheral neuropathies.


Driving performance during concurrent cell-phone use: are drivers aware of their performance decrements?
Prior research has documented the manner in which a variety of driving performance measures are impacted by concurrent cell-phone use as well as the influence of age and gender of the driver. This current study examined the extent to which different driver groups are aware of their associated performance decrements. Subjects' confidence in dealing with distractors while driving and their ratings of task performance and demand were compared with their actual driving performance in the presence of a cell-phone task. While high confidence ratings appeared to be predictive of better driving performance for male drivers (as confidence increased, the size of the distraction effects decreased), this relationship did not hold for females; in fact, for older females, as confidence increased, performance decreased. Additionally, when drivers were matched in terms of confidence level, brake responses of older females were slowed to a much greater extent (0.38 s) than were brake responses of any other group (0.10s for younger males and females and 0.07 s for older males). Finally, females also rated the driving task as less demanding than males, even though their performance was more greatly affected by distraction. These results suggest that many drivers may not be aware of their decreased performance while using cell-phones and that it may be particularly important to target educational campaigns on driver distraction towards female drivers for whom there tended to be a greater discrepancy between driver perceptions and actual performance.


Possible inflammatory mediators in tympanosclerosis development.
Tympano/myringosclerosis is a sequelae following otitis media, causing hearing disability. There is no curative treatment for this condition. In order to illuminate the correlation of inflammatory mediators in otitis media and tympanosclerosis development, the present study was performed. In an animal model, Streptococcus pneumonia bacteria were inoculated to the middle ear. Furthermore, biopsies were harvested during surgery, from children suffering from secretory otitis media and from patients with already established tympanosclerosis. The early inflammatory parameters were investigated in the rat model as well as in the patient material. The lymphocytic population, macrophages, interleukin-6, inducible nitric oxide synthase and MHC class II were studied by immunohistochemistry and by mRNA in situ hybridization. Myringosclerosis was produced in 30% of the rats studied. Macrophages were the first cells to invade the middle ear after induction of otitis media, followed by B-cells and T-cells. IL-6 m-RNA was found as early as 1 h after inoculation. Cells, expressing inducible nitric oxide synthase, seemed to be activated macrophages. Osteoclast like cells, positive in immunohistechemical macrophage staining, were found close to the insertion of the tympanic membrane. The human specimens showed a more immunological active stage in the secretory otitis media group as compared to the specimens with tympanosclerosis. The immunocompetent cells and some mediators are presented time dependently in otitis media and a possible reaction sequence, leading to differentiation of macrophages into osteoclasts is presented. This may lead to tympanosclerosis development.


Molecular epidemiology of Candida parapsilosis sepsis from outbreak investigations in neonatal intensive care units.
The DNA probe, Cp3-13, was used in a Southern blot assay for genotyping Candida parapsilosis (CP) from 3 fungemia outbreaks in neonatal intensive care units (NICUs) in the southeastern U.S. Genotyping, in 2 outbreaks, supplied evidence of horizontal transmission of CP. In the third outbreak, bloodstream isolates (BSIs) of 2 genotypes circulated in the NICU, one was shared by a BSI and a healthcare worker's hand culture. A fourth cluster of recurrent episodes of fungemia occurred in outpatients of a children's hospital receiving total parenteral nutrition (TPN) at home. Each child was infected with a different CP genotype which persisted during recurrences. These genotypes were included in a dendrogram from a CDC population-based surveillance for candidemia consisting of 73 clone-corrected Cp3-13 genotypes (overall SAB = 0.36). Analysis revealed a cluster of 11 genotypes (mean SAB = 0.66) including 3 pairs with identical hybridization profiles. A second cluster of 8 genotypes contained clones from 3 outbreaks (mean SAB = 0.76) but no clustering of genotypes specific for neonates was identified. No decreased susceptibility to azole and polyene antifungal agents was detected in this collection of CP. The frequent occurrence of transmission of CP in this vulnerable population underlines the relevance of Cp3-13 subtyping to investigate suspected transmission and persistence of CP strains in the NICU.


Evaluation of fetal maturity by amniotic fluid creatinine concentrations and lecithin/sphingomyelin ratio.
In a material of 144 samples of amniotic fluid from the last trimester, creatinine concentration, lecithin/sphingomyelin (L/S) ration and their correlation, have been examined. Amniotic fluid creatinine concentration (a.f.c.) increased gradually through the last trimester up to 39 weeks (273-279 days p.m.) with median values of 2 mg/100 ml at 37 weeks and 2.5 mg/100 ml at 39 weeks gestation. The great range makes a.f.c. of doubtful value in assessment of gestional age in individual samples. The correlation between a.f.c. and L/S ratio was highly significant (Kendall's T=0.56). Even so lung maturity cannot be predicted from a.f.c. A low L/S ratio with a.f.c. larger than or equal to 2 mg/100 ml was found in 8-9%, while a.f.c. 1.1-1.9 mg/100 ml was combined with L/S ratios larger then or equal to 2 in a great number of cases. A.f.c. less than 1.1 mg/100 ml was invariably correlated with low L/S ratios.


Community and school mental health professionals' knowledge and use of evidence based substance use prevention programs.
Youth with learning and behavioral problems are at elevated risk for substance use during adolescence. Although evidence-based substance use prevention and screening practices are described in the literature, the extent with which these are provided to these youth is unclear. Mental health professionals in schools and community mental health centers are in an ideal position to conduct substance use screening and prevention practices since they have frequent contact with this high risk group. In order to determine whether these mental health professionals were using evidence based substance use screening and prevention programs with these youth, we analyzed 345 completed surveys from mental health professionals in schools and community clinics throughout a mid-Atlantic state. Results indicated that a large portion of the respondents were unfamiliar with evidence based practices and they were infrequently used. Implications for the division of labor at schools and community mental health centers are discussed in relation to time allotment and priority for these procedures.


Revisiting racial disparities in ED CT utilization during the Affordable Care Act era: 2009-2018 data from the NHAMCS.
To examine the trends in CT utilization in the emergency department (ED) for different racial and ethnic groups, factors that may affect utilization, and the effects of increased insurance coverage since passage of the Affordable Care Act in 2010. Data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) for the years 2009-2018 were used for the analysis. The NHAMCS is a cross-sectional survey which has random and systematical samples of more than 200,000 visits to over 250 hospital EDs in the USA. Patient demographic characteristics, source of payment/insurance, clinical presentation, and disposition from the ED were recorded. Descriptive statistics and multivariate logistic regression were performed. Between 2009 and 2018, the rate of uninsured patients in the ED decreased from 18.1% to as low as 9.9%, but this was not associated with a decrease in the disparity in CT utilization between non-Hispanic Black and non-Hispanic White patients. CT use rate increased 38% over the study period. Factors strongly associated with CT utilization include age, source of payment, triage category, disposition from the ED, and residence. After controlling for these factors, non-Hispanic White patients were 21% more likely to undergo CT than non-Hispanic Black patients, though no disparity was seen for Hispanic or Asian/other groups. Despite increased insurance coverage over the sample period, racial disparities between non-Hispanic Black and non-Hispanic White patients persist in CT utilization, though no disparity was seen for Hispanic or Asian/other patients. The source of this disparity remains unclear and is likely multifactorial.


Photodegradation of brominated flame retardants in polystyrene: Quantum yields, products and influencing factors.
Brominated flame retardants (BFRs) are widely used as additives in plastics, textiles and electronics materials. Here, we investigated the photodegradation of four BFRs including decabromobiphenylether (BDE-209), tetrabromobipsphenol A (TBBPA), tetrabromobisphenol A-bis(2,3-dibromopropylether) (TBBPA-DBPE) and tetrabromobisphenol A bis (allyl) ether (TBBPA-BAE). Experiments were carried out in polystyrene (PS) films using monochromatic and polychromatic irradiations. For comparison, irradiations were also carried in a solvent (tetrahydrofuran: THF). Monitoring of BFR degradation was performed using bulk and surface infrared (IR) measurements, as well as by extraction and HPLC-UV. Photoproducts were characterized using HPLC-high resolution electrospray ionization mass spectrometry (HPLC-ESI-Orbitrap-MS). All four BFRs underwent photochemical transformation in THF at 290 nm with a quantum yield (Φ) ranging from 0.05 for TBBPA to 0.27 for BDE-209, indicating an increase of photoreactivity with the number of Br atoms in BFRs. On the other hand, no major difference in the Φ values was observed when BFRs were embedded in PS films (Φ: 0.82-0.89). The higher photoreactivity in PS appears to be associated with a fast oxidation of PS as revealed by infrared (IR) analysis and yellowing of the films. Interestingly, the faster the yellowing occurred, the faster the BFR degradation was inhibited due to light screening effect. Several major photoproducts were identified for TBBPA and TBBPA-DBPE. Additional photoproducts possibly arising from PS oxidation and bromination by Br● were observed for the first time. This work provides a better understanding of the reactivity and fate of BFRs in polymers allowing for a better assessment of their environmental impacts.


Muslims' experiences of equality recognition in Germany: Effects on identification with the larger society and on equality recognition of other societal subgroups.
Fostering the identification of societal minorities with the larger society is an essential political aim. In this article, we analyze whether minority members' perception of being recognized by society leads to a stronger identification with society, and whether this identification fosters more willingness to recognize other societal subgroups' members as equal members of society. Our analysis is based on both a cross-sectional (N = 1,059, 49% female, mean age = 31 years, 78% with migration background, i.e., first- to third-generation) and a longitudinal (N = 159, 57% female, mean age = 30 years, 76% with migration background) sample of Muslims living in Germany. Structural equation modeling and path analyses suggested that the perception to be recognized by society as equals yielded stronger identification with Germany. In contrast, the perception that one's needs are recognized had no effect on the identification with Germany, while the perception of achievement recognition even tended to decrease identification with Germany. Identification with Germany, in turn, led to an increased willingness of respondents to extend equality recognition to subgroups' members whose beliefs and/or practices our respondents (on average) disapproved. When the societal majority imparts to minorities a sense of being recognized as equals, this equality recognition colors the broader societal framework within which intergroup relations take shape. We further suggest that-if it is desired that subgroups identify with society-the most viable option is a multicultural model of society, which enables minorities to simultaneously retain their subgroup identity. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


The effects of biguanides on thrombokinase, thrombin and trypsin.
A purified preparation of bovine thrombokinase (activated Factor X) loses the ability to hydrolyze TAME (p-toluenesulfonyl-L-arginine methyl ester) when it is incubated at 37 degrees in 0.25 M Tris. HCl buffer, pH 7.4 with lauroxypropyl biguanide, N1, N5-dimethyl, N1-lauroxypropyl biguanide, N1-p-chlorophenethyl, N5-phenethyl biguanide, or N1-methyl, N1-p-chlorobenzyl, N5-o,p-dichlorobenzyl biguanide. Activity is lost much more slowly when 0.15 M NaCl is also present. Lauroxypropyl biguanide is the most potent of the compounds tested, 0.22 mM causing thrombokinase to lose almost all of its activity in about 30 minutes at 37 degrees in pH 7.4 buffered saline. Topical bovine thrombin also loses activity when incubated with either of the lauroxypropyl biguanides but not with the diphenethyl or the dibenzyl compound. Instead, the latter biguanides accelerate thrombin's hydrolysis of TAME. The percent acceleration is not affected or only slightly decreased by the presence of 0.15 M NaCl or KCl, and it is also unaffected by incubating the enzyme with the compounds in buffered saline for 4 to 120 minutes. Purified bovine trypsin is stabilized by both lauroxypropyl and the diphenethyl biguanide when incubated at 37 degrees in pH 7.4 buffered saline for the 60 minute test period but neither compounds has any effect on its rate of hydrolysis of TAME. It is postulated that the enzymes first react rapidly and reversibly with all of the test biguanides and, depending upon the enzyme and the substrate, the rate of hydrolysis of the substrate is unaffected, accelerated or inhibited. The lauroxypropyl biguanides also undergo a second, slower reaction with both thrombokinase and thrombin that produces loss of enzymatic activity. The dibenzyl and diphenethyl biguanides also undergo this second slow reaction with thrombokinase but not with thrombin, and none of the biguanides undergo this second reaction with trypsin.


Universal Community Nucleic Acid Testing for Coronavirus Disease 2019 (COVID-19) in Hong Kong Reveals Insights Into Transmission Dynamics: A Cross-Sectional and Modeling Study.
Testing of an entire community has been used as an approach to control coronavirus disease 2019 (COVID-19). In Hong Kong, a universal community testing program (UCTP) was implemented at the fadeout phase of a community epidemic in July to September 2020. We described the utility of the UCTP in finding unrecognized infections and analyzed data from the UCTP and other sources to characterize transmission dynamics. We described the characteristics of people participating in the UCTP and compared the clinical and epidemiological characteristics of COVID-19 cases detected by the UCTP versus those detected by clinical diagnosis and public health surveillance (CDPHS). We developed a Bayesian model to estimate the age-specific incidence of infection and the proportion of cases detected by CDPHS. In total, 1.77 million people, 24% of the Hong Kong population, participated in the UCTP from 1 to 14 September 2020. The UCTP identified 32 new infections (1.8 per 100000 samples tested), consisting of 29% of all local cases reported during the two-week UCTP period. Compared with the CDPHS, the UCTP detected a higher proportion of sporadic cases (62% vs 27%, P<.01) and identified 6 (out of 18) additional clusters during that period. We estimated that 27% (95% credible interval: 22%, 34%) of all infections were detected by the CDPHS in the third wave. We reported empirical evidence of the utility of population-wide COVID-19 testing in detecting unrecognized infections and clusters. Around three quarters of infections have not been identified through existing surveillance approaches including contact tracing.


Gonadal function in galactosemics and in galactose-intoxicated animals.
Gonadal dysfunction, specifically hypergonadotropic hypogonadism, in female galactosemics is an almost universal finding. Minimal transferase activity may modulate ovarian function and the time of menopause. In contrast, male galactosemics have a relatively low risk of gonadal dysfunction. Animal models have variously suggested prenatal and postnatal insults which may play a role in the gonadal pathology. Several candidate toxic states may be involved. Current dietary restrictions are inadequate to prevent ovarian failure. Until such time as the pathophysiology is better understood, therapy will remain palliative and supportive. Exogenous estrogen and progesterone have roles in assisting pubertal changes and in prevention of the sequelae of a post-menopausal state.


Temporomandibular disorder: otologic implications and its relationship to sleep bruxism.
Temporomandibular disorder is an umbrella term for various clinical problems affecting the muscles of mastication, temporomandibular joint and associated structures. This disorder has a multifactor etiology, with oral parafunctional habits considered an important co-factor. Among such habits, sleep bruxism is considered a causal agent involved in the initiation and/or perpetuation of temporomandibular disorder. That condition can result in pain otologic symptoms. The aim of the present study was to investigate the relationship between temporomandibular disorder and both otologic symptoms and bruxism. A total of 776 individuals aged 15 years or older from urban areas in the city of Recife (Brazil) registered at Family Health Units were examined. The diagnosis of temporomandibular disorder was determined using Axis I of the Research Diagnostic Criteria for temporomandibular disorders, addressing questions concerning myofascial pain and joint problems (disk displacement, arthralgia, osteoarthritis and osteoarthrosis). Four examiners had previously undergone training and calibration exercises for the administration of the instrument. Intra-examiner and inter-examiner agreement was determined using the Kappa statistic. Individuals with a diagnosis of at least one of these conditions were classified as having temporomandibular disorder. The diagnosis of otologic symptoms and bruxism was defined using the same instrument and a clinical exam. Among the individuals with temporomandibular disorder, 58.2% had at least one otologic symptom and 52% exhibited bruxism. Statistically significant associations were found between the disorder and both otologic symptoms and bruxism (p<0.01 for both conditions; OR=2.12 and 2.3 respectively). Otologic symptoms and bruxism maintained statistical significance in the binary logistic regression analysis, which demonstrated a 1.7 fold and twofold greater chance of such individuals have temporomandibular disorder, respectively. The logistic regression analysis demonstrated strong associations between the disorder and both otologic symptoms and bruxism when analyzed simultaneously, independently of patient age and gender.


High-resolution particle size and shape analysis of the first Samarium nanoparticles biosynthesized from aqueous solutions via cyanobacteria Anabaena cylindrica.
Samarium (Sm) is one of the most sought-after rare earth metals. Price trends and dwindling resources are making recovery increasingly attractive. In this context, the use of cyanobacteria is highly promising. For Sm it was unclear whether Anabaena cylindrica produces particles through metabolically active Sm3+ uptake. High-resolution (HR) imaging now clearly demonstrates microbe generated biosynthesis of Sm nano-sized particles (Sm NPs) in vivo. Furthermore, a simple method to determine particle size and shape with high accuracy is presented. Digital image analysis with ImageJ of HR-TEMs is used to characterize Sm NPs revealing a nearly uniform local size distribution. Assuming round particles, the overall average area size is 135.5 nm2, resp. 11.9 nm diameter. In HR, where different cell sections of the same cell are averaged, the mean particle is smaller, 76.7 nm2 resp. 8.9 nm diameter. The reciprocal aspect ratio is 0.63. The Feret major axis ratio is calculated as shape factor, with 35% of the particles between 1.2 and 1.4. A roundness classification shows that 38% of particles are fairly round and 41% are very round. Consequently, A. cylindrica represents a suitable microorganism for possible Sm recovery and biosynthesis of roundish nano-sized particles.