A systematic review and meta-analysis to compare the efficacy of acyclovir 3% ophthalmic ointment to idoxuridine in curing herpetic keratitis by Day 7 of treatment.
This objective of the review and analysis is to demonstrate that acyclovir (ACV) 3% ophthalmic ointment is superior to idoxuridine (IDU) in treating herpetic keratitis (HK) presenting as dendritic and geographic ulcer sub-types. Publications in human subjects were identified by searching the Ovid MEDLINE database through April 2011, combining medical subject headings (MESH) "Keratitis, Herpetic/" AND "Acyclovir/" limiting by the key words "topical" OR "ointment" and also restricted to MESH "Administration, Topical/" OR "Ointments/". The results were cross checked with the references used in the Cochrane Database Syst Rev. 1:1-134, 2009 and GlaxoSmithKline clinical documents related to acyclovir. Randomized, double-masked studies in subjects diagnosed with HK with head to head comparator arms of ACV ophthalmic ointment and topical IDU that had actual or calculable healing rates at Day seven. Data independently extracted from identified articles by two authors of this manuscript. Data from seven randomized, controlled trials (RCT) evaluating 432 subjects that met inclusion criteria (214 were treated with ACV and 218 were treated with IDU) and had Day seven healing rates calculable. All sub-classified lesions were identified as either dendritic ulcers (n = 185) or geographic ulcers (n = 35). The Cochran-Mantel-Haenszel (CMH) method in Biometrics 10:417-51, 1954 and JNCI 22:719-48, 1959, controlling for study, was performed as the primary analysis using SAS v9. Homogeneity was assessed using Breslow-Day-Tarone (BDT) test in IARC 1:1-32, 1980 and Biometrika 72:91-5, 1985. The analysis was performed with outliers removed to assess their impact. ACV showed statistically significant greater odds of healing HK at Day seven in all subjects (Odds Ratio 3.95, 95% CI2.60, 6.00, p < 0.0001), in dendritic ulcers (Odds Ratio 4.22, 95% CI: 2.14, 8.32; p < 0.0001) and geographic ulcers (Odds Ratio 5.31, 95% CI: 1.09, 25.93; p = 0.0244). ACV 3% ophthalmic ointment is a valuable intervention for dendritic and geographic corneal ulcers. ACV and IDU were generally well tolerated in the studies reviewed.


Antioxidant and hepatoprotective activities of intracellular polysaccharide from Pleurotus eryngii SI-04.
In present study, the intracellular polysaccharide (IPS) and its two fractions of IPS-1 and IPS-2 were obtained and purified by DEAE-52 cellulose chromatography from Pleurotus eryngii SI-04 mycelia, and their hepatoprotective effects were also investigated. The results showed that the IPS-2 had superior hepatoprotective effects by increasing the serum enzyme activities and bilirubin (BIL) levels, decreasing the serum albumin (ALB) and triglyceride (TG) levels, improving the hepatic antioxidant status, and ameliorating the hepatic structure damage. Furthermore, the monosaccharide composition and main bond types were also analyzed. These conclusions demonstrated that the both IPS and its fractions might be suitable for functional foods and natural drugs in preventing the acute liver damage.


Selective and efficient sequestration of phosphate from waters using reusable nano-Zr(IV) oxide impregnated agricultural residue anion exchanger.
There is an urgent need to develop low-cost and effective adsorbents for enhanced removal of phosphate from contaminated waters. In this study, nanosized Zr(IV) oxide particles were immobilized on the amino modified corn staw (MCS) to fabricate a novel nanocomposite (Zr@MCS) with superior application capability. Compared with the widely used commercial anion exchangers in previous studies, the modified agricultural residue was empolyed as the host to avoid the high costs and secondary pollution in the preparation. Zr@MCS displayed remarkable selective removal of phosphate from water even in the presence of coexisting anions (Cl-, SO42-, NO3-) at high levels, as well as with a high adsorption capacity, fast adsorption kinetics and high availability in the wide range of pH 2-8 toward phosphate. The excellent adsorption performance of Zr@MCS is attributed to the synergistic effect of the electrostatic attraction of the quaternary ammonium groups fixed on the host skeleton and the specific adsorption of phosphate derived from the hydroxyl functional groups of Zr(IV) oxide. The exhausted Zr@MCS can be effectively regenerated by 5% NaOH-NaCl solution for sustainably utilized, and phosphorus in the desorption effluent could be recovered as high-quality struvite by a simple struvite recovery process. Furthermore, the considerable treatment volume for the synthetic solution and real wastewater in a fixed-bed flow system indicated that Zr@MCS is of great potential for phosphate removal in practice.


Single Chromium Atoms Supported on Titanium Dioxide Nanoparticles for Synergic Catalytic Methane Conversion under Mild Conditions.
Direct conversion of methane to value-added chemicals with high selectivity under mild conditions remains a great challenge in catalysis. Now, single chromium atoms supported on titanium dioxide nanoparticles are reported as an efficient heterogeneous catalyst for direct methane oxidation to C1 oxygenated products with H2 O2 as oxidant under mild conditions. The highest yield for C1 oxygenated products can be reached as 57.9 mol molCr -1 with selectivity of around 93 % at 50 °C for 20 h, which is significantly higher than those of most reported catalysts. The superior catalytic performance can be attributed to the synergistic effect between single Cr atoms and TiO2 support. Combining catalytic kinetics, electron paramagnetic resonance, and control experiment results, the methane conversion mechanism was proposed as a methyl radical pathway to form CH3 OH and CH3 OOH first, and then the generated CH3 OH is further oxidized to HOCH2 OOH and HCOOH.


Improved distinct bone segmentation in upper-body CT through multi-resolution networks.
Automated distinct bone segmentation from CT scans is widely used in planning and navigation workflows. U-Net variants are known to provide excellent results in supervised semantic segmentation. However, in distinct bone segmentation from upper-body CTs a large field of view and a computationally taxing 3D architecture are required. This leads to low-resolution results lacking detail or localisation errors due to missing spatial context when using high-resolution inputs. We propose to solve this problem by using end-to-end trainable segmentation networks that combine several 3D U-Nets working at different resolutions. Our approach, which extends and generalizes HookNet and MRN, captures spatial information at a lower resolution and skips the encoded information to the target network, which operates on smaller high-resolution inputs. We evaluated our proposed architecture against single-resolution networks and performed an ablation study on information concatenation and the number of context networks. Our proposed best network achieves a median DSC of 0.86 taken over all 125 segmented bone classes and reduces the confusion among similar-looking bones in different locations. These results outperform our previously published 3D U-Net baseline results on the task and distinct bone segmentation results reported by other groups. The presented multi-resolution 3D U-Nets address current shortcomings in bone segmentation from upper-body CT scans by allowing for capturing a larger field of view while avoiding the cubic growth of the input pixels and intermediate computations that quickly outgrow the computational capacities in 3D. The approach thus improves the accuracy and efficiency of distinct bone segmentation from upper-body CT.


CsMYBL2 homologs modulate the light and temperature stress-regulated anthocyanin and catechins biosynthesis in tea plants (Camellia sinensis).
Anthocyanin and catechin production in tea (Camellia sinensis) leaves can positively affect tea quality; however, their regulatory mechanisms are not fully understood. Here we report that, while the CsMYB75- or CsMYB86-directed MYB-bHLH-WD40 (MBW) complexes differentially activate anthocyanin or catechin biosynthesis in tea leaves, respectively, CsMYBL2a and CsMYBL2b homologs negatively modified the light- and temperature-induced anthocyanin and catechin production in both Arabidopsis and tea plants. The MBW complexes activated both anthocyanin synthesis genes and the downstream repressor genes CsMYBL2a and CsMYBL2b. Overexpression of CsMYBL2b, but not CsMYBL2a, repressed Arabidopsis leaf anthocyanin accumulation and seed coat proanthocyanin production. CsMYBL2b strongly and CsMYBL2a weakly repressed the activating effects of CsMYB75/CsMYB86 on CsDFR and CsANS, due to their different EAR and TLLLFR domains and interactions with CsTT8/CsGL3, interfering with the functions of activating MBW complexes. CsMYBL2b and CsMYBL2a in tea leaves play different roles in fine-tuning CsMYB75/CsMYB86-MBW activation of biosynthesis of anthocyanins and catechins, respectively. The CsbZIP1-CsmiR858a-CsMYBL2 module mediated the UV-B- or cold-activated CsMYB75/CsMYB86 regulation of anthocyanin/catechin biosynthesis by repressing CsMYBL2a and CsMYBL2b. Similarly, the CsCOP1-CsbZIP1-CsPIF3 module, and BR signaling as well, mediated the high temperature repression of anthocyanin and catechin biosynthesis through differentially upregulating CsMYBL2b and CsMYBL2a, respectively. The present study provides new insights into the complex regulatory networks in environmental stress-modified flavonoid production in tea plant leaves.


Unusual "double density" colloid cysts.
Third ventricular tumors vary in etiology. Treatment and surgical approach usually depends on preoperative diagnosis. Colloid cysts are the most common tumors of the third ventricle and the occurrence of two colloid cysts in the ventricular system is rare. Here we present a patient with paired colloid cysts of the third and lateral ventricles that had different radiographic characteristics, and both of which were resected through a purely endoscopic approach. This is the third reported patient with dual or paired colloid cysts. It is the second report of a lateral and third ventricular cyst, and to our knowledge the first to be successfully managed with purely endoscopic techniques obviating the need for a craniotomy. This report illustrates the importance of a wide differential when investigating intraventricular lesions and provides another example of a purely endoscopic transcortical approach for the resection of colloid cyst.


Species comparison of renal proteolytic activity for human myelin basic protein peptide 43-88.
1. A species comparison was conducted on the proteolytic activity in human, dog, rabbit, guinea-pig and rat kidney which can degrade human myelin basic protein peptide 43-88. 2. In rat kidney the degrading activity occurred over a pH range of 4-11.5 with the greatest activities at pH 5 and 9. The peptide degrading activity in human, dog, rabbit and guinea-pig kidney was considerably less than in the rat and occurred predominantly at pH 7 with lesser activity at pH 9. 3. The effects of inhibitors of proteolytic enzymes indicated that the peptide degrading activities at the same two pH's of dog, rabbit and guinea-pig were similar to one another but differed from that of human. 4. These results indicate that the activity for degrading a potential autoantigenic material is widespread in renal tissue among different species and that different enzymes are involved. More generally, these findings suggest that renal proteinases differ among commonly used laboratory animals and also differ from the human enzymes.


Probiotic characteristics of Lactobacillus gasseri TF08-1: A cholesterol-lowering bacterium, isolated from human gut.
Lactobacillus contribute to maintain the human healthy and use for nutritional additives as probiotics. In this study, a cholesterol-lowering bacterium, Lactobacillus gasseri TF08-1, was isolated from the feces of a healthy adolescent, and its probiotic potentials were evaluated through genomic mining and in vitro test. The assembled draft genome comprised of 1,974,590 bp and was predicted total of 1,940 CDSs. The annotation of the genome revealed that L. gasseri TF08-1 harbored abundant categories of functional genes in metabolic and information processing. Moreover, strain TF08-1 has capacity to utilize D-Glucose, Sucrose, D-Maltose, Salicin, D-Xylose, D-Cellobiose, D-Mannose, and D-Trehalose, as the carbon source. The safety assessment showed strain TF08-1 contained few antibiotic resistance genes and virulence factors and was only resistant to 2 antibiotics detected by antimicrobial susceptibility test. A high bile salt hydrolase activity was found and a cholesterol-reducing effect was determined in vitro, which the result showed a remarkable cholesterol removal capability of L. gasseri TF08-1 with an efficiency of 84.40 %. This study demonstrated that the strain showed great capability of exopolysaccharide production, and tolerance to acid and bile salt. Therefore, these results indicate that L. gasseri TF08-1 can be considered as a safe candidate for probiotic, especially its potential in biotherapeutic for metabolic diseases.


Quantitative proteomic analysis of chicken serum reveals key proteins affecting follicle development during reproductive phase transitions.
Avian reproductive behavior is regulated through the neuroendocrine system. The transition from laying to brooding is strictly controlled by the hypothalamus-pituitary-gonadal (HPG) axis. Cross talk on the HPG axis relies on the circulatory system, where the dynamics of serum proteins can be observed during different reproductive phases. Some canonical hormones, such as prolactin and luteinizing hormone, play important roles in the transition through reproductive phases. However, little is known at the whole-proteome level. To discover novel serum proteins, we employed isobaric tags for relative and absolute quantification to assay the serum proteome during different reproductive phases in chicken. We identified a total of 1,235 proteins from chicken serum; 239 of these proteins showed differential expression between the laying and brooding stages, including a low concentration of steroid metabolism-related proteins and a high concentration of calcium signaling-related proteins (fold change ≥1.5 or ≤0.66; P < 0.05). Pathway analysis and protein-protein interaction networks predicated the difference in follicle development between the brooding stage and laying stages and were related to the 14-3-3 protein family, which is associated with oocyte meiosis and maturation. Together, these results provided a proteomics foundation for investigating the dynamic changes taking place in the circulatory system during reproductive phase transition, and also uncovered new insights regarding follicle development that underlie the avian reproductive cycle.


The immune and stress responses of Atlantic cod to long-term increases in water temperature.
Sea-caged cod are limited in their movements in the water column, and thus can be exposed to large seasonal ( approximately 0-20 degrees C) temperature fluctuations. To investigate the physiological response of Atlantic cod to summer-like increases in temperature, we exposed 10 degrees C acclimated juvenile cod to a graded thermal challenge (1 degrees C increase every 5 days) and measured: (1) plasma cortisol and glucose levels; (2) the respiratory burst activity of blood leukocytes; and (3) the expression of specific immune-related genes [MHC Class I, Interleukin-1beta (IL-1beta), beta2-microglobulin (beta2-M), Immunoglobulin M (IgM)-light (L) and -heavy (H) chains] in the blood using quantitative reverse transcription-polymerase chain reaction (QRT-PCR). The experiment was stopped at 19.1 degrees C, with 26.7% of the fish surviving to this point. Plasma glucose levels increased slightly at 16 and 18 degrees C (by 1.39- and 1.74-fold, respectively), in contrast, cortisol levels were elevated significantly (by 2.9-fold) at 16 degrees C but returned to control levels thereafter. The effect of increasing temperature on the expression of immune related genes in blood cells (leukocytes) was variable and depended on the gene of interest. The expression of IgM-H remained stable for the duration of the experiment. In contrast, IL-1beta expression was increased significantly (by approximately 25-fold) at 19 degrees C as compared to time-matched control fish, and changes in the expression of beta2-M, MHC Class I and IgM-L followed a pattern similar to that seen for cortisol: increasing at 16 degrees C (by 4.2-, 5.3- and 17-fold, respectively), but returning to pre-stress levels by 19 degrees C. Interestingly, increasing temperatures had no effect on respiratory burst activity. This study is the first to examine the effects of a chronic regimen of increasing temperature on the stress physiology and immunology of a marine teleost, and suggests that immune function is influenced by complex interactions between thermal effects and temperature-induced stress (elevated circulating cortisol levels).


Perioperative nursing care of the pediatric hypospadias patient.
Advances in the management of the pediatric hypospadias patient have greatly improved his outcome. This article discusses the many facets of nursing care of the pediatric hypospadias patient. Preoperative teaching and postoperative care are defined and explored.


[Effectiveness of the vagino-rectal exudate self-sampling for prenatal screening of Streptococcus agalactiae infection. GALL study].
To evaluate the effectiveness of vagino-rectal swab autotomy for prenatal screening for GBS infection and to identify the barriers and facilitators encountered by the pregnant woman for this intervention. Cross-sectional study of diagnostic tests. A total of 213 pregnant women who attended the primary care midwife's office in 6 health centers of the Basque Health Service/Osakidetza in Bizkaia, who met the inclusion criteria and agreed to participate in the study, participated in the study. The result of the vagino-rectal culture obtained by the pregnant woman was compared with the result of the vagino-rectal culture taken by the midwife in consultation on the same day, and the barriers and facilitators encountered by the women in the self-test were collected. Self-testing as a test for GBS was found to have a sensitivity of 93.3% (95% CI 78.7-98.2), a specificity of 99.4% (95% CI 96.5-99.9), a positive predictive value of 96% (95% CI 82.8-99.4) and a negative predictive value of 98.8% (95% CI 95.6-99.7). 27.3% of respondents encountered some difficulty in the collection, only 4.8% did not feel qualified, 84.2% felt comfortable, 99.5% considered the information provided to be adequate and complete, 94.7% did not find the steps to follow complicated, and 96% were satisfied with the study. Self-collection of vagino-rectal exudate for GBS detection has proved to be valid and reliable, which would make it possible to offer this option to pregnant women in the systematic screening for GBS infection.


Meridian is a three-dimensional network from bio-electromagnetic radiation interference: an interference hypothesis of meridian.
An electromagnetic radiation field within a biological organism is characterized by non-local interference. The interfering beams form a unitary tridimensional network with beams of varying intensity, also called striae, which are distributed on the organism surface. These striae are equivalent to semi-reflectors. The striae carry bio-information of corresponding organs and, thus, integrate all tissues, and organs of the organism. The longitudinal striae are classified as channels, while the transverse striae are collaterals. The acupoints are seen as the points where electromagnetic interfering striae intersect or converge. This hypothesis builds a foundation to understand the traditional Chinese medicine, including acupuncture, from the perspective of scientific knowledge.


Conjugative plasmid pAW63 brings new insights into the genesis of the Bacillus anthracis virulence plasmid pXO2 and of the Bacillus thuringiensis plasmid pBT9727.
Bacillus cereus, Bacillus anthracis and Bacillus thuringiensis belong to the genetically close-knit Bacillus cereus sensu lato group, a family of rod-shaped Gram-positive bacteria. pAW63 is the first conjugative plasmid from the B. cereus group to be completely sequenced. The 71,777 bp nucleotide sequence of pAW63 reveals a modular structure, including a 42 kb tra region encoding homologs of the Type IV secretion systems components VirB11, VirB4 and VirD4, as well as homologs of Gram-positive conjugation genes from Enterococcus, Lactococcus, Listeria, Streptococcus and Staphylococcus species. It also firmly establishes the existence of a common backbone between pAW63, pXO2 from Bacillus anthracis and pBT9727 from the pathogenic Bacillus thuringiensis serovar konkukian strain 97-27. The alignment of these three plasmids highlights the presence of well conserved segments, in contrast to distinct regions of high sequence plasticity. The study of their specific differences has provided a three-point reference framework that can be exploited to formulate solid hypotheses concerning the functionalities and the molecular evolution of these three closely related plasmids. This has provided insight into the chronology of their divergence, and led to the discovery of two Type II introns on pAW63, matching copies of the mobile element IS231L in different loci of pXO2 and pBT9727, and the identification on pXO2 of a 37 kb pathogenicity island (PAI) containing the anthrax capsule genes. The complete sequence determination of pAW63 has led to a functional map of the plasmid yielding insights into its conjugative apparatus, which includes T4SS-like components, as well as its resemblance to other large plasmids of Gram-positive bacteria. Of particular interest is the extensive homology shared between pAW63 and pXO2, the second virulence plasmid of B. anthracis, as well as pBT9727 from the pathogenic strain B. thuringiensis serovar konkukian strain 97-27.


Role of multidimensional factors in the diagnosis and treatment of tonsillopharyngitis in primary care: a qualitative study.
Tonsillopharyngitis is one of the most frequently observed upper respiratory tract infections, for which antibiotics are prescribed in ambulatory care. In most cases, tonsillopharyngitis is benign and self-limiting, mostly a viral condition. The aim of this study was to explore the diagnostic and treatment process of tonsillopharyngitis by general practitioners and to understand decisions regarding antibiotic prescribing and the factors that shape these practices. This was a qualitative interview study in primary care practices in Latvia. Semi-structured face-to-face interviews were conducted with general practitioners from November 2016 to January 2017. Thematic analysis was applied to identify factors that influence the prescribing practice in a primary care setting in conjunction with a specific context in which the prescriber practices. Decisions and practice of general practitioner are not static over time or context; they occur within an environmental setting influenced by individual factors of general practitioners, the health care system, and practice-specific factors that shape the diagnosis and antibiotic prescribing in the tonsillopharyngitis. Interviewed general practitioners rely primarily on their personal experience, perception, and skills acquired in their practice, which are encouraged by the environment, where the necessary tools and resources are not in place to encourage rational prescribing of antibiotics. General practitioners' decision regarding antibiotic prescribing is an unstable concept that differs between prescribers. The health care system could augment the experience of general practitioners through structural changes such as guidelines, availability of antibiotics, and available antibiotics package size.


Convergence of sensory input from tooth pulp, optic chiasm and sciatic nerve onto locus coeruleus neurons in the rat.
Electrophysiological studies using rats were performed to determine whether or not neurons in the locus coeruleus (LC), subcoeruleus and parabrachial areas receive convergence of sensory input from tooth pulp (TP), optic chiasm (OC) and sciatic nerve (SN). Convergence of input from these nerves was observed in 23% and 33% of LC and subcoeruleus neurons, respectively, and from two nerves in 31% and 20% of LC and subcoeruleus neurons, respectively, while convergence was rarely detected in parabranchial neurons. These results suggest that there is a convergence of peripheral sensory input onto more than half the noradrenergic coerulear neurons.


Removal of fluoride ions from water by cerium-carboxymethyl cellulose beads doped with CeO2 nanoparticles.
A novel adsorbent for fluoride ions (F-) removal was prepared from cerium ion cross-linked carboxymethyl cellulose (CMC) biopolymer beads loaded with CeO2 nanoparticles (NPs). The characterization of the beads was performed by swelling experiments, scanning electron microscopy and Fourier transforms infrared spectroscopy. The adsorption of fluoride ions from aqueous solutions was carried out with both cerium ion cross-linked CMC beads (CMCCe) and CeO2-NPs added beads (CeO2-CMC-Ce) in a batch system. Optimized adsorption conditions were obtained by testing the parameters such as pH, contact time, adsorbent dose, and shaking rate at 25 °C. The adsorption process is well described by the Langmuir isotherm and pseudo-second-order kinetics. The maximum adsorption capacity was found as 105 and 312 mg/g F- for CMC-Ce and CeO2-CMC-Ce beads, respectively. Reusability studies showed that, the adsorbent beads have exhibited excellent sustainable properties up to 9 cycle usage. This study suggests that, CMC-Ce composite with CeO2 nanoparticles is a very effective adsorbent in removing fluoride from water.


Serum-neuroproteins, near-infrared spectroscopy, and cognitive outcome after beach-chair shoulder surgery: Observational cohort study analyses.
Cerebral hypoxia may occur during surgery but currently used cerebral oxygenation saturation (rSO2) monitors remain controversial with respect to improving clinical outcome. Novel neuroprotein biomarkers are potentially released into systemic circulation and combined with near-infrared spectroscopy (NIRS) could clarify the presence of per-operative cerebral hypoxia. We investigated changes to serum-neuroprotein concentrations post-surgically, paired with NIRS and cognitive outcome, in patients operated in the beach chair position (BCP). A prospective cohort in 28 shoulder surgery patients placed in the BCP. Blood samples were collected before induction of anaesthesia, and 2 hours and 3-5 days post-operatively. We analysed blood levels of biomarkers including tau and neurofilament light (NFL). We post hoc assessed the cross-wise relationship between biomarker levels and post-surgical changes in cognitive function and intraoperatively monitored rSO2 from NIRS. Serum-NFL decreased from 24.2 pg/mL to 21.5 (P = .02) 2 hours post-operatively, then increased to 27.7 pg/mL on day 3-5 (P = .03). Conversely, s-tau increased from 0.77 pg/mL to 0.98 (2 h), then decreased to 0.81 on day 3-5 (P = .08). In 14/28 patients, episodic rSO2 below 55% occurred, and the duration < 55% was correlated to change in s-tau (P < .05). The cognitive function z-score at 1 week and 3 mo. correlated to the change in tau (P = .01), but not to NFL. Some biomarkers were significantly changed with surgery in the beach chair position. The change was at some points associated to post-operative cognitive decline, and to intraoperative low rSO2. (237).


Abnormal neurite orientation dispersion and density imaging of white matter in children with primary nocturnal enuresis.
Several lines of evidence indicate that multiple abnormalities of gray matter are related to the pathogenesis of primary nocturnal enuresis (PNE); however, few studies have been conducted with respect to abnormalities in white matter (WM) of children with PNE. The present work investigated the microstructure of WM in children with PNE using a neurite orientation dispersion and density imaging (NODDI) method. NODDI data were obtained from 29 children with PNE (age = 9.8 ± 1.2 years, 59% males) and 34 healthy controls (age = 10.3 ± 1.6 years, 56% males) in this study. Multi-b-value diffusion-weighted imaging data were acquired with a 3 T MR system, and the orientation dispersion index (ODI) and neurite density index (NDI) maps were calculated. Tract-Based Spatial Statistics analyses of WM tracts were performed with ODI and NDI maps in children with PNE and controls. Children with PNE had lower ODIs in WM fiber tracts of the bilateral superior longitudinal fasciculus (SLF) and higher ODIs in the bilateral internal capsule (IC) and right anterior thalamic radiation (ATR) than controls. PNE children also had lower NDIs in the bilateral IC and the cingulum and higher NDIs in the bilateral SLF. These changes in NODDI indices, which indicated abnormal neural maturation of the WM microstructures, may be related to abnormal sleep and enuresis in children with PNE.


Exogenous jasmonic acid can enhance tolerance of wheat seedlings to salt stress.
Jasmonic acid (JA) is regarded as endogenous regulator that plays an important role in regulating stress responses, plant growth and development. To investigate the physiological mechanisms of salt stress mitigated by exogenous JA, foliar application of 2mM JA was done to wheat seedlings for 3days and then they were subjected to 150mM NaCl. Our results showed that 150mM NaCl treatment significantly decreased plant height, root length, shoot dry weight, root dry weight, the concentration of glutathione (GSH), chlorophyll b (Chl b) and carotenoid (Car), the activities of superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), ascorbate peroxidase (APX), enhanced the concentration of malondialdehyde (MDA), hydrogen peroxide (H2O2) and the rate of superoxide radical (O2•-) generation in the wheat seedlings when compared with the control. However, treatments with exogenous JA for 3 days significantly enhanced salt stress tolerance in wheat seedlings by decreasing the concentration of MDA and H2O2, the production rate of O2•- and increasing the transcript levels and activities of SOD, POD, CAT and APX and the contents of GSH, Chl b and Car, which, in turn, enhanced the growth of salt stressed seedlings. These results suggested that JA could effectively protect wheat seedlings from salt stress damage by enhancing activities of antioxidant enzymes and the concentration of antioxidative compounds to quench the excessive reactive oxygen species caused by salt stress and presented a practical implication for wheat cultivation in salt-affected soils.


Cosmetic applications of selected traditional Chinese herbal medicines.
Because tyrosinase catalyzes melanin synthesis, tyrosinase inhibitors are important in cosmetic skin-whitening. Oxidative stress contributes to skin aging and can adversely affect skin health, which means antioxidants active in skin cells may support skin health. We examined 25 traditional Chinese herbal medicines that might be useful for skin-whitening and skin health. Extracts (100microg/mL) were tested for cytotoxicity on human epidermal melanocytes (HEMn); 12 exhibited low cytotoxicity. Their effects on tyrosinase and melanin inhibitory activities and free radical scavenging activities were further assessed. Phenolic contents were evaluated using Folin-Ciocalteu reagent. Four herbs, Pharbitis nil, Sophora japonica, Spatholobus suberectus, and Morus alba, exhibited potent inhibitory effects on tyrosinase (IC(50) values 24.9, 95.6, 83.9, and 78.3microg/mL, respectively). Melanin inhibition was not dose-dependent. Sophora japonica (IC(50): 14.46microg/mL, 1,1-diphenyl-2-picrylhydrazyl (DPPH); 1.95microg/mL, hydroxyl radical) and Spatholobus suberectus (IC(50): 10.51microg/mL, DPPH; 4.36microg/mL, hydroxyl radical) showed good antioxidative activities and high phenolic contents (255 and 189mg of gallic acid/g extract, respectively). Among active anti-tyrosinase extracts, Sophora japonica and Spatholobus suberectus were especially potent in HEMn cells in terms of free radical scavenging effects and high phenolic contents, making them the strongest candidates for cosmetic application found in the current study.


Long-term potentiation of C-fiber-evoked potentials in the rat spinal dorsal horn is prevented by spinal N-methyl-D-aspartic acid receptor blockage.
Long-term potentiation (LTP) of synaptic potentials is a fundamental mechanism of memory formation in the hippocampus. Here, we have characterized long-term changes of field potentials which were evoked in the lumbar spinal dorsal horn by supramaximal electrical stimulation of the sciatic nerve in urethane anesthetized rats. The field potentials had high thresholds (> or = 7 V), long latencies (90-130 ms, corresponding to conduction velocities between 1.2 and 0.85 m/s) and were not affected by spinalization (at C5-C6) or muscle relaxation (with pancuronium), i.e. the potentials were probably evoked by afferent C-fibers. Tetanic electrical stimulation (0.5 ms pulses, 30-40 V, 100 Hz, given in 4 trains of 1 s duration at 10 s intervals) of sciatic nerve induced in all 9 rats tested a LTP of amplitude of the C-fiber-evoked potential throughout recording periods which lasted between 4 and 9 h. Mean potentiation ranged from +71% to +174%. Superfusion of spinal cord with N-methyl-D-aspartic acid (NMDA) receptor antagonist D-(-)-4-(3-phosphonopropyl)piperazine-2-carboxylic (500 nM), which has little effect on the amplitude of C-fiber-evoked potentials, completely blocked LTP induced by tetanic stimulation in all five rats tested. Superfusion of spinal cord with NMDA (1 microM, 10 microM or 50 microM) induced LTP in only 2 out of 8 rats. This is the first report showing that LTP of C-fiber-evoked field potentials in the spinal dorsal horn in vivo may last for more than 8 h. This LTP in the spinal dorsal horn may underlie plastic changes of spinal nociception.


Anaerobic and complementary treatment of domestic sewage in regions with hot climates--a review.
This study presents a literature review on the treatment of domestic sewage in controlled environments having the anaerobic process and specifically the upflow anaerobic sludge blanket (UASB) concept as the core, under natural hot conditions. The UASB process application is however beset by the preponderance of suspended solids, and the paper looks at its optimization via pre- and post-treatments to curb the prevailing problems, in the light of possible discharge and re-use/recycling/resource recovery, leading to efficient environmental protection. Pre-treatment clarification could be done with ferric chloride/polyelectrolyte, so that phosphate precipitates during the process. The pre-treated liquid phase can be submitted to a high rate anaerobic process, using the simple and robust UASB technology. In a subsequent post-treatment step, ammonium can be removed by ion exchange using a zeolite column through which the wastewater percolates after leaving the anaerobic digester. The various stages can also eliminate a large fraction of the pathogens present in the raw wastewater, mainly through the pre-treatment sedimentation and the ion exchange filtration. The sludge produced in the precipitation stage can be stabilized in a conventional anaerobic digester. Integration of the different treatment steps provides a sustainable technology to treat domestic sewage under hot climate conditions.


Effects of nitrogen on the longitudinal and vertical patterns of the composition and potential function of bacterial and archaeal communities in the tidal mudflats.
Increasing attention has been focused on the diminishing health of coastal ecosystems. Understanding the effects of eutrophication on tidal flat ecosystems is beneficial for the restoration and management of coastal ecosystems. However, previous studies did not consider the effects of nitrogen on the structure and function of bacterial and archaeal communities in longitudinal and vertical profiles. Here, the diversity, composition, assembly mechanism, and potential metabolic function of the bacterial and archaeal communities were studied in two longitudinal tidal sections at different eutrophic levels. Nitrogen and salinity were the critical factors that influenced the bacterial and archaeal community composition using canonical correspondence and multivariate regression tree analyses. For the bacterial community, the higher nitrogen loading in tidal mudflats resulted in the convergence of diversity and structure in the longitudinal profile of bacteria, but divergence was detected in the vertical profile. For archaea, the diversity tended to be convergent in longitudinal and vertical profiles in the higher nitrogen area, but the change of structure was similar to that of bacteria. Besides the homogeneous processes influenced by salinity, the assembly process of the bacterial community was mainly influenced by heterogeneous selection (34.8%) and that of archaea by dispersal limitation (19.5%). However, the bacterial and archaeal communities in the higher nitrogen section presented more of an influence of heterogeneous selection (respectively, 39 and 5.6%) than that of the lower nitrogen section (respectively, 10 and 0.2%). Structural equation modeling indicated that nitrogen may have inhibited the effects of the bacterial community on nitrogen turnover in nitrogen-rich anoxic sediment environments, but may have strengthened the effect of the archaeal community on carbon metabolism compared to bacteria. This work deepens our understanding of the responses of bacterial and archaeal community structure and potential function to nitrogen pollution in tidal mudflats.


Altitude and COVID-19 in Colombia: An updated analysis accounting for potential confounders.
We assessed the relationship between the altitude of municipalities and the incidence, mortality, and fatality from COVID-19 and excess of mortality in Colombia between 2020 and 2022. We conducted an ecologic study including all 1122 municipalities in Colombia and used categories of altitude as main independent variable. We fit multivariable regression models for incidence, mortality, fatality rates, and excess of mortality controlling for several variables at municipality level. There was a higher incidence rate, similar mortality rate and lower case-fatality rate for COVID-19 during 2020-2022 in municipalities in the upper category of altitude (>=2500 masl) compared to the lower category (<1000 masl). The excess of mortality was lower but not statistically different in municipalities in the upper category of altitude, and significantly lower in the intermediate altitude category compared to the lowlands. Our findings provide evidence that municipalities with high altitude had similar mortality rate, and lower case-fatality rate and excess of mortality for COVID-19 compared to lowlands in Colombia.


Incremental value of ischemic stunning on the detection of severe and extensive coronary artery disease in dipyridamole Tl-201 gated myocardial perfusion imaging.
The sensitivity of nuclear myocardial perfusion imaging in detecting coronary artery disease is high. However, false-negative results may be encountered if all the myocardial territories were uniformly affected. Ischemic stunning after dipyridamole-stress on gated SPECT may be an indicator of severe and extensive coronary artery disease, and can help the interpretation of borderline perfusion images and the elimination of false-negatives secondary to relatively balanced lesions in three-vessel disease.


Eye Findings in Infants With Suspected or Confirmed Antenatal Zika Virus Exposure.
: media-1vid110.1542/5804915134001PEDS-VA_2018-1104Video Abstract OBJECTIVES: To characterize ophthalmic manifestations of confirmed or suspected antenatal Zika virus (ZIKV) exposure. Infants with antenatal ZIKV exposure were referred for evaluation during the 2015-2016 Rio de Janeiro outbreak. Mothers with symptomatic ZIKV infection during pregnancy and/or infants with microcephaly or other findings that were suggestive of suspected antenatal exposure were tested with reverse transcriptase polymerase chain reaction (RT-PCR). Complete eye examinations were performed by pediatric ophthalmologists between January 2016 and February 2017. The main outcome measure was eye abnormalities in RT-PCR-positive and suspected (ie, not tested or RT-PCR-negative) antenatal ZIKV cases. Of 224 infants, 189 had RT-PCR testing performed. Of 189 patients, 156 had positive RT-PCR results in their blood, urine, and/or placenta. Of 224 infants, 90 had central nervous system (CNS) abnormalities, including microcephaly (62 infants). Eye abnormalities were present in 57 of 224 (25.4%) infants. Optic nerve (44 of 57; 77.2%) and retina abnormalities (37 of 57; 64.9%) were the most common. The group with suspected ZIKV infection (68 infants) had proportionally more eye (36.8% vs 20.5%; P = .022) and CNS abnormalities (68.3% vs 28.1%; P = .008), likely because of referral patterns. Eye abnormalities consistent with ZIKV infection were clinically comparable in both RT-PCR-positive and unconfirmed groups, including 4 RT-PCR-positive infants of 5 without any CNS abnormalities. Similar eye manifestations were identified regardless of laboratory confirmation. Well-appearing infants were also found to have eye abnormalities. Therefore, all infants born after ZIKV outbreaks should be universally screened for eye abnormalities.


Retinal vessel oximetry in children with inherited retinal diseases.
Retinal vessel oximetry (RO) has been used to show altered metabolic function in patients with inherited retinal diseases (IRDs). The aim of this study was to investigate RO parameters of children with IRDs and presumed IRD carriers (pIRDc) and to compare them to controls. In this cross-sectional cohort study, 142 eyes from 71 Caucasian subjects were included: 40 eyes with IRDs, 26 eyes with pIRDc and 76 control eyes. The oxygen saturation was measured with the Retinal Vessel Analyser (IMEDOS Systems UG, Jena, Germany). Mean oxygen saturations in the peripapillary retinal arterioles (A-SO2 ; %) and venules (V-SO2 ; %) were estimated, and their difference (A-V SO2 ; %) was calculated. In addition, we evaluated the mean diameter in all major retinal arterioles (D-A; μm) and venules (D-V; μm). anova-based linear mixed-effects models were calculated with SPSS® . In general, children suffering from IRDs differed from controls when the A-SO2 and A-V SO2 were taken into account: both the A-SO2 and the A-V SO2 were significantly increased (p = 0.012). In subgroup analyses, children suffering from rod-cone dystrophy (RCD) presented an A-SO2 increase (99.12 ± 8.24%) when compared to controls (91.33 ± 10.34%, p = 0.014) and pIRDc (92.37 ± 6.57%, p = 0.065). For V-SO2 significant changes in RCD (67.42 ± 9.19%) were found in comparison with controls (58.24 ± 11.74%, p < 0.041), pIRDc (56.67 ± 7.16%, p = 0.007), cone-rod dystrophies (CRD, 52.17 ± 5.32%, p < 0.001) and inherited macular dystrophies (IMD, 55.74 ± 6.96%, p = 0.004), In addition, A-V SO2 was decreased in RCD (31.69 ± 3.92%) when measured against CRD (41.9 ± 8.87%, p = 0.017) or IMD (39.52 ± 8.95%, p = 0.059). In general, we found that children with IRDs presented early metabolic changes. Within IRDs, children with RCD showed more affected metabolic changes. Thus, RO may support early screening to rule out IRDs in children, and more precisely may help to differentiate those suffering from RCD.


Effects of adrenalectomy before weaning in the genetically obese Zucker rat (fa/fa).
1. Lean (Fa/?) and obese (fa/fa) Zucker rats were adrenalectomized or sham-operated at 19 d of age (3 d before weaning). Injection of corticosterone for 3 d after weaning (1.0 mg/d) was necessary to ensure survival of adrenalectomized fa/fa but not Fa/? rats. Intact and adrenalectomized fa/fa rats had a lower rectal temperature than Fa/? animals before and 3 d after adrenalectomy. The post-weaning survival of adrenalectomized fa/fa rats was enhanced by maintenance at an ambient temperature of 30 degrees rather than 22 degrees. 2. Adrenalectomized and sham-operated rats were therefore kept at 30 degrees, fed ad-lib. and killed at 34 d. Adrenalectomy had only small effects on the growth, body composition and appetite of Fa/? rats. The hyperphagia, greater lipid content, reduced protein content and hyperinsulinaemia of fa/fa rats were completely abolished by adrenalectomy. 3. Intact fa/fa rats had higher liver glycogen contents and higher activities of the hepatic enzymes tyrosine aminotransferase (EC 22.214.171.124) and acetyl CoA carboxylase (EC 220.127.116.11) than intact Fa/? animals. Adrenalectomy abolished these phenotypic differences. 4. Injection of adrenalectomized rats with 1.0 mg corticosterone-21-acetate daily from weaning to 34 d restored the abnormal body composition, hyperphagia, hyperinsulinaemia, higher hepatic glycogen and enzyme activities of fa/fa rats. 5. In a second experiment adrenalectomized rats were injected with 1.0 mg corticosterone-21-acetate daily from weaning to 34 d and kept at 22 degrees. fa/fa rats adrenalectomized and injected with corticosterone had a reduced body lipid content compared with intact fa/fa rats but still contained more lipid than intact or similarly treated Fa/? animals. 6. In both experiments adrenalectomized Fa/? and fa/fa rats injected daily with corticosterone had the same plasma concentrations of this hormone when killed 3 h after the last injection at 34 d. It is concluded that corticosterone is required for expression of the abnormal appetite, hyperinsulinaemia and body composition of the fa/fa rat.


Nicotinamide mononucleotide inhibits hepatic stellate cell activation to prevent liver fibrosis via promoting PGE2 degradation.
Liver fibrosis is a reversible wound-healing response to acute or chronic liver injury that can progress to cirrhosis and liver cancer. Finding new strategies for prevention and management of liver fibrosis is urgently needed. It is known that hepatic stellate cell (HSC) is the primary source of extracellular matrix that drives liver fibrosis progression. Herein, we carried out a comprehensive secretome profiling to identify NMN-induced changes in secretory proteins and found that NMN suppressed the secretion of profibrotic protein and oxidoreductase in activated HSC (LX-2) cells, while real-time quantitative PCR analysis revealed that NMN downregulated profibrotic gene expression, resulting in HSC inactivation. Next, we demonstrated that nicotinamide mononucleotide (NMN) reduced the accumulation of liver extracellular matrix in thioacetamide (TAA) and carbon tetrachloride (CCl4) induced mouse models for liver fibrosis. Furthermore, we determined that NMN inhibited oxidation-mediated 15-PGDH degradation to promote prostaglandin E2 degradation and suppress HSC activation. In summary, our results propose that NMN supplementation is a new therapeutic approach for liver fibrosis prevention.


[Functional reorganization in the system of corticotectal connections after unilateral deafferentation of the cortex].
The responses of the cat's collicular neurons to direct stimulation (DCR) of contralateral neocortex were studied in various periods after unilateral dissection of cortico-subcortical connections. The data obtained suggest that, in intact cat's brain, during early hours of postoperative period, and within 1-2 years after the operation, functional specifics of contralateral motor and sensory projections to superior colliculus played a major part in determining basic features of compensatory shifts of the impulse activity of collicular neurons.


Failed pelvic arterial embolization for postpartum hemorrhage: clinical outcomes and predictive factors.
To evaluate clinical outcomes of failed pelvic arterial embolization (PAE) and determine predictive factors associated with this failure in the treatment of postpartum hemorrhage (PPH). This retrospective study included all consecutive patients who underwent PAE for life-threatening PPH between March 2004 and January 2011 at a tertiary-care center. Medical records and imaging studies were reviewed to identify cases of failed PAE and their clinical outcomes. Multiple parameters were compared between the failed and successful PAE groups, and multivariate analysis was performed to determine the predictive factors associated with failed PAE. PAE was performed in 257 patients (mean age, 32 y; range, 20-40 y). A total of 24 cases of PAE involved a failure to achieve hemostasis (9.3%). Patients in the failed PAE group experienced more major complications than those in the successful PAE group (37.5% [nine of 24] vs 9.4% [22 of 233]). Factors more frequently found in failed PAE included hemodynamic instability, hemoglobin level lower than 8g/dL, disseminated intravascular coagulation (DIC), and extravasation detected on angiography. After multivariate analysis, DIC emerged as the only significant predictive factor (odds ratio, 6.569; 95% confidence interval, 1.602-26.932; P = .009). PAE is an effective treatment for medically intractable PPH. However, PAE failed in a high percentage of patients and was commonly associated with major complications. DIC was the only significant predictor of failed PAE.


Rule and similarity in grammar: their interplay and individual differences in the brain.
Previous research on artificial grammar has indicated that the human ability to classify sentences or letter strings according to grammaticality relies on two types of knowledge. One is a superficial, familiarity-based understanding of a grammar the other is the knowledge of rules and critical features underlying a grammar. The fundamentally different characteristics of these systems permit an analysis of receiver-operating characteristics (ROC), which measures the extent to which each type of knowledge is used in grammaticality judgments. Furthermore, violations of a grammar can be divided into hierarchical and local violations. The present study is the first to combine the use of ROC analyses, fMRI and a grammaticality dichotomy. Based on previous neuroimaging studies, it was hypothesized that judgments based on rule knowledge, as extracted from individual ROC analyses, involve the left inferior frontal gyrus (IFG), whereas similarity would involve right IFG, as well as left hippocampal regions. With regards to violation types, it was hypothesized that hierarchical violations would recruit the opercular part of the left IFG as well as the posterior operculum, whereas local violations would bilaterally activate the premotor cortex (PMC). Results indicated that for greater reliance on rule knowledge, a ventral part of the left PMC was activated for ungrammatical items, whereas other PMC areas show a differentiated response for grammaticality for individuals less reliant on similarity. The right IFG was related to ungrammatical items as a function of similarity. Results are discussed with regards to possible error detection systems and differentiated efficiencies for respective classification strategies.


Automated characterization of spatial and dynamical heterogeneity in supercooled liquids via implementation of machine learning.
A computational approach by an implementation of the principle component analysis (PCA) withK-means and Gaussian mixture (GM) clustering methods from machine learning algorithms to identify structural and dynamical heterogeneities of supercooled liquids is developed. In this method, a collection of the average weighted coordination numbers (WCNs‾) of particles calculated from particles' positions are used as an order parameter to build a low-dimensional representation of feature (structural) space forK-means clustering to sort the particles in the system into few meso-states using PCA. Nano-domains or aggregated clusters are also formed in configurational (real) space from a direct mapping using associated meso-states' particle identities with some misclassified interfacial particles. These classification uncertainties can be improved by a co-learning strategy which utilizes the probabilistic GM clustering and the information transfer between the structural space and configurational space iteratively until convergence. A final classification of meso-states in structural space and domains in configurational space are stable over long times and measured to have dynamical heterogeneities. Armed with such a classification protocol, various studies over the thermodynamic and dynamical properties of these domains indicate that the observed heterogeneity is the result of liquid-liquid phase separation after quenching to a supercooled state.


[Sclerosing angiomatoid nodular transformation of the spleen].
Sclerosing angiomatoid nodular transformation (SANT) of the spleen is a complex vascular lesion recently described. We present a case of SANT occurring in a 49-year-old woman who was treated for choroid melanoma. The computed tomography abdominal scan revealed an asymptomatic mass in the spleen. Splenectomy was performed due to the risk of metastasis from the melanoma. The histopathologic examination revealed an angiomatoid lesion composed of three types of vessels recapitulating the normal composition of the red pulp of the spleen. In this report, we discuss the pathology of this lesion and the differential diagnosis of SANT with other lesions such as hemangiomas, hamartomas and inflammatory pseudotumors.


Probability of prostate cancer as a function of the percentage of free prostate-specific antigen in patients with a non-suspicious rectal examination and total prostate-specific antigen of 4-10 ng/ml.
Our aim was to assess the usefulness of measuring the percentage of free prostate specific antigen (PSA) in serum in relation to reducing the number of prostate biopsies in men with benign prostate examinations and serum PSA levels between 4 and 10 ng/ml. The percentage of free PSA (Immulite) in serum was analyzed prospectively in 500 men, all of whom underwent ultrasound-guided sextant prostate biopsies. Cancer was detected in 21.4% (107/500) of the patients. Using a free PSA cutoff of < or = 23% as a criterion for performing prostate biopsy would have detected 94.4% of cancers, avoided 18.8% of benign biopsies and yielded a positive predictive value of 25.3%. The percentage of free PSA increased with prostate volume. Mean total PSA and mean free percent PSA values increased as patient age increased, influencing the calculation of cutoff values, sensitivity and specificity. PSA density had a sensitivity and specificity not significantly different than the percentage of free PSA. Measurement of the percentage of free serum PSA improves the specificity of prostate cancer detection in patients with elevated total serum PSA levels and benign prostate examinations.


Intraoperative Sufentanil Consumption and the Risk of Postoperative Nausea and/or Vomiting: A Retrospective Observational Study.
Post-operative nausea and/or vomiting (PONV) is a common post-operative adverse reaction and has been associated with post-operative sufentanil injection. The assessment of the relationship between intraoperative opioid consumption and PONV has been understudied. This study examined the relationship between intraoperative sufentanil administration and PONV. This was a single-center retrospective observational study. Patients who underwent video-assisted thoracoscopic surgery under general anesthesia with the preoperative thoracic paravertebral block between January 2017 and June 2020 at the Peking University People's Hospital were recruited for this study. Patients were grouped into two groups according to whether or not PONV occurred on postoperative day 1 (POD1). The factors associated with PONV were analyzed using logistic regression. A total of 2733 patients, 1510 males and 1223 females, were included in this study. Among them, 143 patients developed PONV, a 5.2% (143/2733) PONV incidence. Logistic regression analysis showed that female, nonsmoking, sufentanil patient-controlled intravenous analgesia (PCIA), POD1 opioids consumption, and a time-weighted average of intraoperative sufentanil (twSuf) were associated with PONV. All patients were further divided into four subgroups based on intraoperative twSuf. Logistic regression analysis revealed that twSuf higher than 0.21 μg kg-1 h-1 was an independent risk factor for PONV. Intraoperative sufentanil injection with a twSuf higher than 0.21 μg kg-1 h-1 increased the risk of PONV in patients undergoing thoracoscopic surgery under general anesthesia after a preoperative thoracic paravertebral block.


Does antenatal education reduce fear of childbirth?
The aim of this study was to determine the effect of antenatal education on fear of childbirth, acceptance of pregnancy and identification with motherhood role. There is insufficient evidence pertaining to the effect of antenatal education on fear of childbirth, acceptance of pregnancy and identification with motherhood role. The purpose of antenatal education is to help couples make the right decisions during delivery. Through antenatal education, couples prepare themselves for delivery. This is a quasi-experimental and prospective study that employs a pre- and post-education model. In total, 192 pregnant women (education group, n = 69 and control group, n = 123) participated in the study. Data were collected using the pregnancy identification form: the Prenatal Self-Evaluation Questionnaire and a version of the Wijma Delivery Expectancy/Experience Questionnaire. Prior to participating in the study, the education group and control group had similar levels of acceptance of pregnancy and identification with motherhood role, whereas a significant difference was found in their fear of childbirth levels. When surveyed again after receiving education, the two groups' levels of acceptance of pregnancy and fear of childbirth were found to be significantly different. However, they had similar levels of identification with the motherhood role. Antenatal education appears to increase the acceptance of pregnancy, does not affect the identification with motherhood role and reduces the fear of childbirth. A systematic antenatal education programme, as part of routine antenatal care services, would help reduce the rate of interventional labour and facilitate pregnant women's conscious participation in the act of labour by reducing their fear of childbirth.


Identification of new, very long-chain polyunsaturated fatty acids in fish by gas chromatography coupled to quadrupole/time-of-flight mass spectrometry with atmospheric pressure chemical ionization.
The characterization of very long-chain (>C24) polyunsaturated fatty acids (VLC-PUFAs), which are essential in the vision, neural function, and reproduction of vertebrates, is challenging because of the lack of reference standards and their very low concentrations in certain lipid classes. In this research, we have developed a new methodology for VLC-PUFA identification based on gas chromatography coupled to quadrupole/time-of-flight mass spectrometry with an atmospheric pressure chemical ionization source (GC-APCI-QTOF MS). The mass accuracy attainable with the innovative QTOF instrument, together with the soft ionization of the APCI source, provides valuable information on the intact molecule, traditionally lost with electron ionization sources due to the extensive fragmentation suffered. We have identified, for the first time, VLC-PUFAs with chains up to 44 carbons in eyes, brain, and gonads of gilthead sea bream, a commercially important fish in the Mediterranean. The added value of ion mobility-mass spectrometry (IMS), recently developed in combination with GC-QTOF MS, and the contribution of the collisional cross section (CCS) parameter in the characterization of novel VLC-PUFAs (for which reference standards are not available) have been also evaluated. The methodology developed has allowed assessing qualitative differences between farmed and wild fish, and opens new perspectives in a still scarcely known field of research.


Pharmacokinetic and pharmacodynamic considerations for the next generation protein therapeutics.
Increasingly sophisticated protein engineering efforts have been undertaken lately to generate protein therapeutics with desired properties. This has resulted in the discovery of the next generation of protein therapeutics, which include: engineered antibodies, immunoconjugates, bi/multi-specific proteins, antibody mimetic novel scaffolds, and engineered ligands/receptors. These novel protein therapeutics possess unique physicochemical properties and act via a unique mechanism-of-action, which collectively makes their pharmacokinetics (PK) and pharmacodynamics (PD) different than other established biological molecules. Consequently, in order to support the discovery and development of these next generation molecules, it becomes important to understand the determinants controlling their PK/PD. This review discusses the determinants that a PK/PD scientist should consider during the design and development of next generation protein therapeutics. In addition, the role of systems PK/PD models in enabling rational development of the next generation protein therapeutics is emphasized.


The structural kinetics of switch-1 and the neck linker explain the functions of kinesin-1 and Eg5.
Kinesins perform mechanical work to power a variety of cellular functions, from mitosis to organelle transport. Distinct functions shape distinct enzymologies, and this is illustrated by comparing kinesin-1, a highly processive transport motor that can work alone, to Eg5, a minimally processive mitotic motor that works in large ensembles. Although crystallographic models for both motors reveal similar structures for the domains involved in mechanochemical transduction--including switch-1 and the neck linker--how movement of these two domains is coordinated through the ATPase cycle remains unknown. We have addressed this issue by using a novel combination of transient kinetics and time-resolved fluorescence, which we refer to as "structural kinetics," to map the timing of structural changes in the switch-1 loop and neck linker. We find that differences between the structural kinetics of Eg5 and kinesin-1 yield insights into how these two motors adapt their enzymologies for their distinct functions.


Hemorrhagic shock with paradoxical bradycardia.
Two hundred and seventy-three acute hemorrhagic shocks were treated in 1984 in a pre-hospital emergency care unit. Twenty patients (7%) had a paradoxical bradycardia: they were conscious, 9 of them had an undetectable systolic arterial pressure with the sphygmomanometric method but the femoral pulse was still present. All of them recovered from bradycardia with fluid loading alone. The comparison between patients with paradoxical bradycardia and those with tachycardia showed that the former had more severe and rapid hemorrhages. During 1985, 7 new cases of acute hemorrhagic shock with paradoxical bradycardia were treated with an antishock trouser. These patients recovered from bradycardia more quickly (p less than 0.01) and with a less important fluid loading (p less than 0.01) than those previously treated without the antishock trouser. Two other patients were treated with atropine before antishock trouser inflation and experienced ventricular premature beats and one developed ventricular fibrillation. A paradoxical bradycardia can occur in hemorrhagic shock and denotes a rapid and severe hemorrhage requiring a massive and rapid fluid loading. The preliminary results of the antishock trouser in this setting are encouraging. The treatment of bradycardia per se may be deleterious and atropine must be avoided in conscious patients with hemorrhagic shock and paradoxical bradycardia.


Photodegradation of the antibiotics nitroimidazoles in aqueous solution by ultraviolet radiation.
The objective of this study was to analyze the efficacy of ultraviolet (UV) radiation in the direct photodegradation of nitroimidazoles. For this purpose, i) a kinetic study was performed, determining the quantum yield of the process; and ii) the influence of the different operational variables was analyzed (initial concentration of antibiotic, pH, presence of natural organic matter compounds, and chemical composition of water), and the time course of total organic carbon (TOC) concentration and toxicity during nitroimidazole photodegradation was studied. The very low quantum yields obtained for the four nitroimidazoles are responsible for the low efficacy of the quantum process during direct photon absorption in nitroimidazole phototransformation. The R(254) values obtained show that the dose habitually used for water disinfection is not sufficient to remove this type of pharmaceutical; therefore, higher doses of UV irradiation or longer exposure times are required for their removal. The time course of TOC and toxicity during direct photodegradation (in both ultrapure and real water) shows that oxidation by-products are not oxidized to CO(2) to the desired extent, generating oxidation by-products that are more toxic than the initial product. The concentration of nitroimidazoles has a major effect on their photodegradation rate. The study of the influence of pH on the values of parameters ɛ (molar absorption coefficient) and k'(E) (photodegradation rate constant) showed no general trend in the behavior of nitroimidazoles as a function of the solution pH. The components of natural organic matter, gallic acid (GAL), tannic acid (TAN) and humic acid (HUM), may act as promoters and/or inhibitors of OH· radicals via photoproduction of H(2)O(2). The effect of GAL on the metronidazole (MNZ) degradation rate markedly differed from that of TAN or HUM, with a higher rate at low GAL concentrations. Differences in MNZ degradation rate among waters with different chemical composition are not very marked, although the rate is slightly lower in wastewaters, mainly due to the UV radiation filter effect of this type of water.


Analysis of neutron flux distribution for the validation of computational methods for the optimization of research reactor utilization.
In order to verify and validate the computational methods for neutron flux calculation in TRIGA research reactor calculations, a series of experiments has been performed. The neutron activation method was used to verify the calculated neutron flux distribution in the TRIGA reactor. Aluminium (99.9 wt%)-Gold (0.1 wt%) foils (disks of 5mm diameter and 0.2mm thick) were irradiated in 33 locations; 6 in the core and 27 in the carrousel facility in the reflector. The experimental results were compared to the calculations performed with Monte Carlo code MCNP using detailed geometrical model of the reactor. The calculated and experimental normalized reaction rates in the core are in very good agreement for both isotopes indicating that the material and geometrical properties of the reactor core are modelled well. In conclusion one can state that our computational model describes very well the neutron flux and reaction rate distribution in the reactor core. In the reflector however, the accuracy of the epithermal and thermal neutron flux distribution and attenuation is lower, mainly due to lack of information about the material properties of the graphite reflector surrounding the core, but the differences between measurements and calculations are within 10%. Since our computational model properly describes the reactor core it can be used for calculations of reactor core parameters and for optimization of research reactor utilization.


Comprehensive medication therapy management: identifying and resolving drug-related issues in a community pharmacy.
The aim of this study was to characterize comprehensive medication therapy management (MTM) involving a community pharmacy and local physicians by describing the drug-related issues encountered, identifying which medication types were associated with these issues, and listing the actions taken by physicians and pharmacists to address them. In the MTM program studied, community pharmacists and physicians worked together to manage the drug therapy of ambulatory Iowa Medicaid recipients dispensed > or =4 medications for chronic conditions by a community pharmacy. After initial assessment, pharmacists made written recommendations to the patient's physician, and the physicians subsequently responded. Data were extracted from pharmacy records for patients who made > or =1 visit during the first 2 years of the program. Collected data included patient demographics, number of chronic conditions and medications at enrollment, type and number of drug-related issues, medication category, pharmacist recommendations, and physician acceptance of recommendations. Data were gathered for 150 patients. The mean (SD) age was 54.4 (19.4) years and 74.0% were female. They were taking a mean (SD) of 9.3 (4.6) medications and had a mean (SD) of 6.1 (3.1) medical conditions at enrollment. A total of 886 drug-related issues were classified into 7 categories: inappropriate adherence (25.9%), needs additional therapy (22.0%), wrong drug (13.2%), unnecessary drug therapy (12.9%), adverse drug reaction (11.1%), dose too low (9.7%), and dose too high (5.3%). Overall, physicians accepted 313 (47.4%) of the 659 recommendations to alter drug therapy made by pharmacists, with the highest rates of agreement to stop or change a medication (50.3% and 50.0%, respectively) and the lowest rate of agreement to start a new medication (41.7%). The MTM program showed that drug therapy for ambulatory patients taking multiple medications to treat chronic conditions can be improved through collaboration between physicians and community pharmacists.


Characterization of cell lines stably transfected with rubella virus replicons.
Rubella virus (RUBV) replicons expressing a drug resistance gene and a gene of interest were used to select cell lines uniformly harboring the replicon. Replicons expressing GFP and a virus capsid protein GFP fusion (C-GFP) were compared. Vero or BHK cells transfected with either replicon survived drug selection and grew into a monolayer. However, survival was ~9-fold greater following transfection with the C-GFP-replicon than with the GFP-expressing replicon and while the C-GFP-replicon cells grew similarly to non-transfected cells, the GFP-replicon cells grew slower. Neither was due to the ability of the CP to enhance RNA synthesis but survival during drug selection was correlated with the ability of CP to inhibit apoptosis. Additionally, C-GFP-replicon cells were not cured of the replicon in the absence of drug selection. Interferon-alpha suppressed replicon RNA and protein synthesis, but did not cure the cells, explaining in part the ability of RUBV to establish persistent infections.


On the significance of in situ production of oestrogens in human breast cancer tissue.
We have previously shown that human breast cancer is autonomous in the regulation of its intra-tissue oestradiol concentration. Breast fatty tissue does not have this capacity, but rather reflects changes in the peripheral oestradiol concentration. To further evaluate the relative contribution of breast cancer and fatty tissue to the maintenance of tumour oestradiol we investigated whether a tumour-directed gradient in aromatase activity and oestrogen levels existed in mastectomy specimens. No such gradient was found, however, for aromatase, oestrone, oestradiol and their sulphates. Aromatase activity (expressed per gram of tissue) and the concentrations of oestradiol, oestradiol sulphate and oestrone sulphate were higher in tumour than in breast fatty tissue. Fatty tissue had a higher oestrone concentration. It is tentatively concluded that breast tumour aromatase activity is more important for the maintenance of tumour oestradiol levels than aromatase in breast fatty tissue.


Separation technique for the determination of ⁹⁹Tc in milk and dairy products in case of emergency.
A method for the determination of (99)Tc (T1/2: 2.1 × 10(5)a) in milk and dairy products is presented in detail. The method includes the separation of fat and proteins from milk, the separation of Tc by anion exchange from other metals and the purification of Tc by extraction chromatography with subsequent measurement using LSC. A recommendation is given on how to use rhenium as a carrier for this particular matrix. The full analysis is done in 24h. The detection limit for milk is 0.2 Bq/l.


Prokaryotic versus eukaryotic recombinant Lutheran blood group protein for antibody identification.
At present, identification of antibodies against high-frequency antigens is limited to reference laboratories having panels of rare red blood cell (RBC) specimens in stock. Antibodies against Lu(b) are among the most frequent clinically relevant antibody specificities directed against high-frequency antigens. Soluble recombinant Lu(b) fusion proteins consisting of the first three N-terminal immunoglobulin superfamily domains and a V5-His tag were generated. Eukaryotic recombinant Lu(b) proteins were isolated from cell culture supernatant of stably transfected HEK293 cells with anti-V5 Sepharose. Prokaryotic Lu(b) fusion proteins were expressed in Escherichia coli, purified by Ni-NTA, and refolded by chromatographic procedures. Ten anti-Lu(b) serum samples, 6 anti-Lu(a) serum samples, 30 serum samples directed against other blood group antigens, 10 serum samples from patients with RBC autoantibodies, and 100 serum samples from randomly selected donors were used for antibody screening. Eukaryotic and prokaryotic recombinant Lu(b) proteins proved to be equally suited for identification of anti-Lu(b). Recombinant Lu(b) protein-based enzyme-linked immunosorbent assay correctly identified samples containing anti-Lu(b) sera, and the titers were at least two times higher than those measured by the gel agglutination-based indirect antiglobulin test. In hemagglutination inhibition assays, recombinant Lu(b) protein neutralized all anti-Lu(b), but none of the other alloantibodies decreased in reactivity. Antibody detection systems based on soluble eukaryotic or prokaryotic recombinant blood group proteins have the potential to replace current systems with rare RBCs for identification of alloantibodies against high- or low-frequency antigens. This innovation could bring routine laboratories one step closer to specialized antibody diagnostics.


Congenital muscular dystrophy of non-Fukuyama type with characteristic CT images.
A 9-year-old Japanese boy with congenital muscular dystrophy (CMD) with normal intelligence was presented. He was extremely floppy and had joint contractures since birth. Motor milestones were delayed and he did not learn to walk alone. Intellectual development was normal and no convulsions were observed. On physical examination at 9 years old, he had diffuse muscle weakness and atrophy and flexion contractures of joints. Creatine kinase was normal and IQ was 95. Biopsied muscle showed myopathic changes consistent with muscular dystrophy. CT scans of the head revealed diffuse low density area in the white matter of the cerebrum. These findings suggest central nervous system involvement in CMD is not confined to Fukuyama-type CMD.


Community mental health treatment: what works for whom?
The research literature does not establish with any consistency an integrated model of what type of patient functions best in what type of community setting. The findings do, however, identify the relationship of certain patient characteristics to re-hospitalization: number of prior hospitalizations, length of hospitalization and history of unemployment being positively related; educational level, occupational level, and race being unrelated; and sex, marital status, age, and diagnosis being inconsistently related. Also identified in the literature were those community programs that were found to be the most effective based on a review of four outcome measures including recidivism, symptomatology, social functioning, and employment.


Minimal effective dose of magnesium sulfate for attenuation of intubation response in hypertensive patients.
To study the minimal effective dose of magnesium sulfate to control blood pressure (BP) during intubation in hypertensive patients. Prospective, randomized, double-blind study. Operating room of an academic medical center. 80 adult, ASA physical status 1 and 2, controlled hypertensive patients undergoing elective surgery under general anesthesia and requiring endotracheal intubation. Patients were randomized to 4 groups. Patients in study groups received a magnesium sulfate infusion at a dose of 30 (Group I), 40 (Group II), or 50 mg/kg (Group III) before induction of anesthesia, while patients in control group (Group IV) received a 1.5 mg/kg lidocaine bolus 90 seconds before intubation. Anesthesia was induced and maintained with a propofol infusion. Laryngoscopy and intubation were performed 4 minutes after administration of vecuronium. Heart rate (HR) and BP were recorded before, during, and after endotracheal intubation for 10 minutes. Measures to manage hemodynamic instability were recorded. Serum magnesium levels were also recorded. The changes in HR were comparable among groups. Mean arterial pressure (MAP) was maintained within normal limits in Group I patients while Groups II and III patients showed a significant decrease in MAP (P = 0.01) compared with baseline. A total of 6 patients (30%) in Group II and 10 patients (50%) in Group III required interventions (P = 0.001). No patient in Group I and only one patient (5%) in Group IV required intervention. Magnesium 30 mg/kg is the optimum dose to control BP during intubation in hypertensive patients. A further increase in the dose of magnesium may cause significant hypotension.


Effects of climate and land use changes on water quantity and quality of coastal watersheds of Narragansett Bay.
Land use is rapidly changing in coastal watersheds, with implications on eutrophication of coastal watersheds. The long-term consequences of climate change on these impacts are critical to watershed management. With coastal watersheds facing frequent hypoxic events and cultural eutrophication, the coupled influence of land use and climate change can lead to policies under nonstationarity assumptions. This study aims to model a regional coastal watershed system using a dynamic simulation with future land use and climate stressors for watershed sustainability. The efficacy of current nutrient management efforts may be limited or undone if future changes in climate or land use increase nutrient and sediment loads to the Narragansett Bay. The baseline model was calibrated and validated to accurately reflect watershed processes to simulate water quantity and quality under the independent and combined influence of future climate and land scenarios. Results show significant effects of climate change and land-use change on the watershed, with demonstrated impacts on sediment loading, organic N, organic P, and nitrates. Climate impacts were much more significant than land-use effects, but land-use impacts displayed greater regional variation. The results from combined simulations indicate that future climate and land-use change will likely negatively impact the coastal system and need restoration efforts that consider nonstationarity. However, the results also highlight the potential to utilize land use to mitigate and adapt to climate change impacts.


Acne inversa complicated by Actinomyces neuii.
Acne inversa (AI) is a chronic and recurrent inflammatory skin disease. It occurs in intertriginous areas of the skin and causes pain, drainage, malodor and scar formation. While supposedly caused by an autoimmune reaction, bacterial superinfection is a secondary event in the disease process. A unique case of a 43-year-old male patient suffering from a recurring AI lesion in the left axilla was retrospectively analysed. A swab revealed Actinomyces neuii as the only agent growing in the lesion. The patient was then treated with Amoxicillin/Clavulanic Acid 3 × 1 g until he was cleared for surgical excision. The intraoperative swab was negative for A. neuii. Antibiotics were prescribed for another 4 weeks and the patient has remained relapse free for more than 12 months now. Primary cutaneous Actinomycosis is a rare entity and the combination of AI and Actinomycosis has never been reported before. Failure to detect superinfections of AI lesions with slow-growing pathogens like Actinomyces spp. might contribute to high recurrence rates after immunosuppressive therapy of AI. The present case underlines the potentially multifactorial pathogenesis of the disease and the importance of considering and treating potential infections before initiating immunosuppressive regimens for AI patients.


Brain injury: current management and investigations.
Radiation, surgery, and chemotherapy, singly or combined, are modalities that are frequently used for the treatment of primary brain malignancies and metastases that secondarily spread to the brain. Each of the 3 modalities continues to improve with time; likewise the efficacy in management of malignant brain tumors has gradually improved. As cancer therapies become more effective with regard to disease control and survival, the potential impact of each modality on brain injury, either alone or when combined, becomes even more significant. In addition, with increasing survival, the likelihood of observing long-term injury is likely to increase. Thus, the expression of acute and long-term brain injury is becoming a more important factor in the management of patients with brain malignancies. This review presents current management and investigations associated with these modality-related injuries.


Portomesenteric Reconstruction during Whipple Procedure Using Autologous Left Renal Vein Patch Graft in a Patient with a Gastric Cancer Recurrence.
The case of vascular reconstruction of the superior mesenteric and portal vein confluence using a left renal vein (LRV) graft has been researched in this paper. The patient was a 66-year-old female who presented with features of biliary obstruction. A contrast-enhanced computed tomography scan revealed bile duct dilatation and a common bile duct tumor mass. Four years ago, she underwent stomach resection with subsequent Billroth II gastrojejunostomy due to gastric cancer. After surgical resection, on histopathological and immunohistochemistry examination, a recurrence of previously resected poorly cohesive gastric cancer was found.


Exploring the coping strategies of women after self-immolation: A qualitative study.
Women confront a slew of issues following self-immolation, and it is crucial to examine how women react after self-immolation and live with their scars. Therefore, this study was conducted with the aim of exploring the coping strategies of Kurdish women following self-immolation using a qualitative methodology. The conventional content analysis approach was used in this qualitative investigation. Semi-structured face-to-face and phone interviews were conducted with 26 Kurdish women who had self-immolated and were chosen using purposeful sampling and snowballing for this study. To reinforce the research, Guba and Lincoln's trustworthiness criteria were fulfilled. The data analysis yielded 2 categories, 11 subcategories, and 85 initial codes. Positive coping is one of the categories and subcategories (spirituality, rebuilding their body, psychological rehabilitation, hiding the scars, restoring self-confidence, changing the lifestyle, forming a new life) 2- Negative coping (separation from society, neglecting the body and mind, violence and aggression, staying in the past). Using the capacity of religious organizations to help victims of self-immolation, providing appropriate conditions and facilities to heal the scars caused by self-immolation, and facilitating access to counseling services can provide the conditions for women to better adapt after self-immolation.


Genome-wide variants and polygenic risk scores for cognitive impairment following blood or marrow transplantation.
Cognitive impairment is prevalent in blood or marrow transplantation (BMT) recipients, albeit with inter-individual variability. We conducted a genome-wide association study of objective cognitive function assessed longitudinally in 239 adult BMT recipients for discovery and replicated in an independent cohort of 540 BMT survivors. Weighted genome-wide polygenic risk scores (PRS) were constructed using linkage disequilibrium pruned significant SNPs. Forty-four genome-wide significant SNPs were identified using additive (n = 3); codominant (n = 20) and genotype models (n = 21). Each additional copy of a risk allele was associated with a 0.28-point (p = 1.07 × 10-8) to a 1.82-point (p = 6.7 × 10-12) increase in a global deficit score. We replicated two SNPs (rs11634183 and rs12486041) with links to neural integrity. Patients in the top PRS quintile were at increased risk of cognitive impairment in discovery (RR = 1.95, 95%CI: 1.28-2.96, p = 0.002) and replication cohorts (OR = 1.84, 95%CI, 1.02-3.32, p = 0.043). Associations were stronger among individuals with lowest clinical risk for cognitive impairment. These findings support potential utility of PRS-based risk classification in the development of targeted interventions aimed at improving cognitive outcomes in BMT survivors.


Behavior of vitamin E acetate delivery systems under simulated gastrointestinal conditions: lipid digestion and bioaccessibility of low-energy nanoemulsions.
Colloidal delivery systems are needed to incorporate oil-soluble vitamins into aqueous-based foods and beverage products. In this study, we encapsulated vitamin E acetate into oil-in-water nanoemulsions produced using either a low-energy method (Emulsion Phase Inversion, EPI) or a high energy method (microfluidization). Oil-in-water nanoemulsions (d<200 nm) could be produced using both low- and high-energy methods from a non-ionic surfactant (Tween 80) and medium chain triglycerides (MCTs). The influence of surfactant-to-oil ratio (SOR) on lipid digestion and vitamin bioaccessibility of EPI nanoemulsions was determined using a gastrointestinal tract (GIT) model that simulated the mouth, stomach, and small intestine. There were increases in the size and negative charge of the oil droplets after passage through the GIT, which was attributed to droplet coalescence and changes in interfacial composition. The rate and extent of lipid digestion decreased with increasing surfactant concentration, but the bioaccessibility of vitamin E acetate was high in all of the samples (>95%). No appreciable influence of the preparation method (low-energy versus high-energy) on lipid digestion and vitamin bioaccessibility was observed. The major advantage of the EPI method for forming nanoemulsions is that no expensive equipment is required, but relatively high surfactant concentrations are needed compared to microfluidization.


Association study of SNPs in LncRNA CDKN2B-AS1 with breast cancer susceptibility in Chinese Han population.
The study aimed to analysis the genetic variation of the lncRNA CDKN2B-AS1 SNPs, and explored the regulation of SNPs on the invasion and metastasis of Breast cancer (BC). The SNPs (Single Nucleotide Polymorphisms) was screened for genotyping among 504 Chinese Han patients and 505 controls, which were frequency-matched for age ( ± 2 years). Logistic analysis was to explore the relationship between SNPs and the BC risk. Interactions between SNPs and reproductive factors was explored using the multifactor dimensionality reduction (MDR) method. qRT-PCR was conducted to detect the CDKN2B-AS1 expression in plasma of different rs10965215 and rs2518723 genotypes. The effect of rs10965215 A>G mutation on the binding ability of CDKN2B-AS1 and miR-4440 was verified by dual luciferase experiment. CCK-8, scratch and Transwell experiment were performed to explore the effect of miR-4440 over-expression on BC cell proliferation, migration and invasion. A total of 13 SNP was screened. The individuals with SNPs rs2518723C>T, rs10965215 A>G, rs77792598C>G, rs4977753 T > C, rs75917766C>T and rs78545330C>G mutations might increase the BC risk. MDR results revealed that individuals with rs10965215 G genotype who age at menarche≥ 13 and regardless of the number of abortion< 2 or ≥ 2 had a higher risk of BC. The relative expression of CDKN2B-AS1 in rs10965215 homozygous wild AA genotype (8.88 ± 3.43) was lower than heterozygous GA (11.08 ± 2.90) and homozygous mutant GG genotype (11.31 ± 2.90). When rs10965215 wild A genotype was carried, there was an interaction between CDKN2B-AS1 and miR-4440. The CCK-8, Transwell, and scratch experiment were all found that miR-4440 over-expression might enhance the proliferation, invasion and migration of BC cells. CDKN2B-AS1 gene polymorphism might be related to the susceptibility of BC, CDKN2B-AS1 rs10965215 A/G genotype probably affect the proliferation, invasion and migration of BC cells by modulating the interactions with of miR-4440.


Parasites in biodiversity conservation: friend or foe?
Parasites stabilise food webs and facilitate species coexistence but can also lead to population- or species-level extinctions. So, in biodiversity conservation, are parasites friends or foes? This question is misleading: it implies that parasites are not part of biodiversity. Greater integration of parasites into global biodiversity and ecosystem conservation efforts is required.


Chronic management and health supervision of individuals with propionic acidemia.
Propionic acidemia is a relatively rare inborn error of metabolism. Individuals with propionic acidemia often have life-threatening episodes of hyperammonemia and metabolic acidosis, as well as intellectual disability. There are many reports of additional problems, including poor growth, stroke-like episodes of the basal ganglia, seizures, cardiomyopathy, long QTc syndrome, immune defects, pancreatitis and optic neuropathy; however, there is little information about the incidence of these problems in this rare disease. Additionally, there are no clear guidelines for medical or surgical management of individuals with propionic acidemia. Through a comprehensive and systematic review of the current medical literature and survey of expert opinion, we have developed practice guidelines for the chronic management of individuals with propionic acidemia, including dietary therapy, use of medications, laboratory monitoring, chronic health supervision, use of gastrostomy tubes and liver transplantation.


The ecology of medical care in Taiwan.
In regular administrative statistics for medical services, utilization data are usually presented as aggregate data and lack an individual perspective. The aim of this study was to provide an overview of medical care utilization in Taiwan using a long-established analytical framework, the so-called ecology model. Claims data for a cohort of one million people from the National Health Insurance (NHI) Research Database were used to estimate the yearly and monthly prevalence of health care utilization in Taiwan in 2005. Analyses were extended to different types of healthcare settings and were stratified by age and sex. Results are presented per 1000 of the population. Per 1000 people, 74 did not utilize any NHI services during the year. In a month, 503 people on average utilized at least once NHI service of any kind, 329 visited a physician's clinic (Western medicine), 152 visited a hospital-based outpatient clinic, 19 visited an emergency department, 10 were hospitalized and 3 were hospitalized in an academic medical center. Women were more likely to utilize NHI services than men (274/504 vs. 229/496 in a month). In a month on average, 40.3% (146/362) of young people, 52.2% (166/318) of middle-aged people, 53.3% (121/227) of children and 75.0% (70/93) of elderly people utilized NHI services. Over the whole year, 22.0% (21/93) of elderly people were hospitalized and nearly one-third of them were hospitalized in academic medical centers. People in Taiwan utilized NHI services frequently and tended to seek medical help in hospitals. Although these features might reflect the higher availability and accessibility of medical care within the NHI in Taiwan, the possibility of overuse deserves further attention.


Carboxyatractylate inhibits the uncoupling effect of free fatty acids.
The ATP/ADP-antiporter inhibitors and ADP decrease the palmitate-induced stimulation of the mitochondrial respiration in the controlled state. The degree of inhibition decreases in the order: carboxyatractylate greater than bongkrekic acid, palmitoyl-CoA, ADP greater than atractylate. GDP is ineffective. The inhibiting concentration of carboxyatractylate coincides with this arresting the state 3 respiration. Carboxyatractylate inhibition decreases when the palmitate concentration increases. Stimulation of controlled respiration by FCCP or gramicidin D at any concentration of these uncouplers is carboxyatractylate-resistant, whereas that by low concentrations of DNP is partially suppressed by carboxyatractylate. These data together with observations that palmitate does not increase H+ conductance in bilayer phospholipid membranes and in cytochrome oxidase-asolectin proteoliposomes indicate that the ATP/ADP-antiporter is somehow involved in the uncoupling by low concentrations of fatty acids (or DNP), whereas that by FCCP and gramicidin D is due to their effect on the phospholipid bilayer. It is suggested that the antiporter facilitates translocation of palmitate anion across the mitochondrial membrane.


Studying Adipocyte and Immune Cell Cross Talk Using a Co-culture System.
The co-culture of adipocytes and immune cells, such as macrophages or T cells (CD4+ or CD8+ subsets), is a novel experimental approach used to study paracrine interactions (or the cross talk) between cultured cell types in isolation, in order to understand their role in obese adipose tissue (AT) inflammation and dysfunction. Here we describe the general methodologies required for the co-culture of mature adipocytes (differentiated 3T3-L1 pre-adipocyte cell line) with primary immune cell subsets purified from mouse splenic mononuclear cells using a magnetic MicroBead positive selection, wherein multiple immune cell populations can be purified sequentially from a single mouse spleen, thereby providing diversity in the types of immune cells that can be co-cultured with adipocytes. Additionally, we describe experimental procedures for co-culturing adipocytes and immune cells in two different co-culture systems, including a cell contact-dependent co-culture system, wherein the cells are in direct physical contact, and a cell contact-independent, soluble mediator-driven co-culture system wherein the cells are physically separated by a trans-well semipermeable membrane. Finally, we discuss how these co-culture models can be utilized to recapitulate the AT microenvironment in obesity by utilizing physiologically relevant ratios of adipocytes:immune cells (specifically CDllb+ macrophages, CD4+ T cells, or CD8+ T cells) and lipopolysaccharide stimulation that mimics endotoxin concentrations observed in obesity.


Primary Aldosteronism: A Pragmatic Approach to Diagnosis and Management.
Primary aldosteronism is a prevalent but underdiagnosed cause of hypertension, contributing to increased cardiovascular and cerebrovascular events and end-organ damage independent of blood pressure. Prompt diagnosis and treatment with targeted surgical or medical therapy reduce the risk of complications and improve prognosis. This review outlines a practical approach to diagnosis and management of primary aldosteronism for global practitioners.


Copper and cadmium removal from synthetic industrial wastewater using chitosan and nylon 6.
Chitosan with nylon 6 membranes was evaluated as adsorbents to remove copper and cadmium ions from synthetic industrial wastewater. Chitosan and nylon 6 with glutaraldehyde blend ratio with (1:1+Glu, 1:2+Glu, and 2:1+Glu) have been prepared and these were used as membranes to remove copper and cadmium ions from synthetic industrial wastewater. Characterization of the synthesized membrane has been done with FTIR, XRD, TGA/DTA, DSC, and SEM. Chemical parameters for quantities of adsorption of heavy metal contamination have been done and the kinetics of adsorption has also been carried out. The optimal pH for the removal of Cd(II) and Cu(II) using chitosan with nylon 6. Maximum removal of the metals was observed at pH 5 for both the metals. The effect of adsorbent dose also has a pronounced effect on the percentage of removal of the metals. Maximum removal of both the metals was observed at 5 g/100 ml of the adsorbent. Copper and cadmium recovery is parallel at all time. The percentage of removal of copper increased with increase in the pH from 3 to 5. In the case of cadmium containing wastewater, the maximum removal of metal occurred at pH 5. The uptake amount of Cu(2+) ions on chitosan increased rapidly with increasing contact time from 0 to 360 min and then reaches equilibrium after 360 min; the equilibrium constant for copper and cadmium ions is more or less the same for the adsorption reaction.


Trauma and aging effects on hospital costs and length of stay.
Two hundred eleven consecutive admissions entered into the trauma registry of an inner-city hospital over a six-month period were studied. Length of stay, age, mechanism of injury, trauma score, gross financial charges, daily charges, and reimbursement rates were analyzed by linear multiple regression. Length of stay and gross financial charges were found to be significantly associated with age and trauma score. Daily charges were associated with length of stay and trauma score. Reimbursement rates were inversely associated with age and length of stay. The elderly make up a significant proportion of trauma victims and the cost of their care is higher than for younger patients. Because reimbursement for this age group is based largely on diagnosis-related groups, which pay only fixed costs, trauma centers must analyze the potential economic impact of older trauma victims.