Disrespect and Abuse in Obstetric Care in Mexico: An Observational Study of Deliveries in Four Hospitals.
To identify and describe the frequency and characteristics of disrespect and abuse practices towards women during facility-based delivery in four hospitals in two Mexican states in 2017, using a mixed method of direct observation and women's reports of health care experiences. A cross-sectional study was performed to describe disrespect and abuse practices in obstetric care (interactions or conditions that are experienced as or intended to be humiliating or undignified) committed by healthcare providers. We included all pregnant women admitted for childbirth (vaginal and cesarean). Semi-structured interviews were also conducted with women, prior to discharge, regarding their experience at delivery. 867 deliveries were observed. 18.8% of women (n = 163) experienced at least one disrespect and abuse event, especially at secondary care facilities. There were a total of 493 disrespect and abuse events, which, on average, represents three events per woman (39.4% were verbal abuse, 32% were physical abuse, and 28.6% were discrimination). In the majority of cases (> 50%), women did not give consent to not recommended invasive procedures and were not provided with adequate information to those procedures. Direct observation and interviews was a useful tool to identify disrespectful and abusive practices during delivery care. Our findings provide new evidence of the frequency and characteristics of disrespect and abuse during delivery care in Mexico, which can be used to inform maternal health programs. Additionally, these results encourage the creation of surveillance policies and committees in order to guarantee violence-free and dignified treatment of women during delivery care.


Cardiac surgery in the very elderly.
To determine the results of cardiac surgery in the very elderly. A retrospective study of 56 very elderly patients (mean age 82 years, range 79-89 years) undergoing open heart surgery between 1988 and 1991. Thirty-three patients had coronary artery bypass grafting, 12 had valve replacement alone and 11 had valve replacement with an associated procedure. St Francis Xavier Cabrini Hospital, Melbourne--a large private hospital. There were four in-hospital deaths (7%). The one-year actuarial survival rate was 88%. Of the 49 survivors, 92% were in New York Heart Association (NYHA) Class III or IV before operation, whereas 96% were in NYHA Class I or II a mean of 15 months after operation. In very elderly patients with medically refractory cardiac symptoms, cardiac surgery has a tolerable mortality and provides excellent relief of symptoms.


Delivery strategies for CRISPR/Cas genome editing tool for retinal dystrophies: challenges and opportunities.
CRISPR/Cas, an adaptive immune system in bacteria, has been adopted as an efficient and precise tool for site-specific gene editing with potential therapeutic opportunities. It has been explored for a variety of applications, including gene modulation, epigenome editing, diagnosis, mRNA editing, etc. It has found applications in retinal dystrophic conditions including progressive cone and cone-rod dystrophies, congenital stationary night blindness, X-linked juvenile retinoschisis, retinitis pigmentosa, age-related macular degeneration, leber's congenital amaurosis, etc. Most of the therapies for retinal dystrophic conditions work by regressing symptoms instead of reversing the gene mutations. CRISPR/Cas9 through indel could impart beneficial effects in the reversal of gene mutations in dystrophic conditions. Recent research has also consolidated on the approaches of using CRISPR systems for retinal dystrophies but their delivery to the posterior part of the eye is a major concern due to high molecular weight, negative charge, and in vivo stability of CRISPR components. Recently, non-viral vectors have gained interest due to their potential in tissue-specific nucleic acid (miRNA/siRNA/CRISPR) delivery. This review highlights the opportunities of retinal dystrophies management using CRISPR/Cas nanomedicine.


Compact OAM microscope for edge enhancement of biomedical and object samples.
The production of orbital angular momentum (OAM) by using a q-plate, which functions as an electrically tunable spatial frequency filter, provides a simple and efficient method of edge contrast in biological and medical sample imaging for histological evaluation of tissue, smears, and PAP smears. An instrument producing OAM, such as a q-plate, situated at the Fourier plane of a 4f lens system, similar to the use of a high-pass spatial filter, allows the passage of high spatial frequencies and enables the production of an image with highly illuminated edges contrasted against a dark background for both opaque and transparent objects. Compared with ordinary spiral phase plates and spatial light modulators, the q-plate has the added advantage of electric control and tunability.


Inequality in provider continuity for children by Australian general practitioners.
There is little published on provider continuity in Australian general practice and none on its effect on inequality of care for children. Questionnaire administered to parents of the ACT Kindergarten Health Screen asking the name of their child's usual GP and practice address between 2001 and 2008. Parents of 30,789 children named 433 GPs and 141 practices. In each year, an average of 77% of parents could name both the GP and the practice, an average of 11% of parents could name only the practice, and an average of 12% of parents could name neither. In each year, 25% of parents could not name a usual GP for children of Aboriginal or Torres Straight Islander descent, or children born outside of Australia, compared to 10% of all other children (p = < 0.0001). The frequency of GPs displaying continuity of care varied over time with 19% of GPs being present in the ACT in only one year and 39% of GPs being present in every year over the eight years of study. GPs displayed two different forms of transience either by working in more than one practice in each year (5% of GPs), or by not being present in the ACT region from one year to the next (15% of GPs). Fewer parents nominated transient GPs as their child's GP compared to choosing GPs who displayed continuity (p < 0.001). Many GPs (39%) were reported to provide continuity of care for in the ACT region and some GPs (20%) displayed transient care. Indigenous children or children born outside of Australia had less equity of access to a nominated GP than all other children. Such inequity might disappear if voluntary registration of children was adopted in Australian general practice.


Synthesis and biological evaluation of fluoro analogues of antimitotic phenstatin.
With the aim of investigating the influence of fluorine, in particular on the A-ring, a new series of fluoro analogues (7a-l) of phenstatin (3) was synthesized and tested for interactions with tubulin polymerization and evaluated for cytotoxicity on an NCI-60 human cancer cell lines panel. We have shown that the replacement of 3,4,5-trimethoxyphenyl A-ring of phenstatin with 2,4,5-trifluoro-3-methoxyphenyl unit, results in the conservation of both antitubulin and cytotoxic effect. Fluoro isocombretastatin 7k was the most effective anticancer agent in the present study and demonstrated the highest antiproliferative potential on leukemia cell lines SR (GI50=15 nM) and HL-60(TB) (GI50=23 nM) and on melanoma cell line MDA-MB-435 (GI50=19 nM).


Serum Levels of Brain-Derived Neurotrophic Factor Are Associated with Diabetes Risk, Complications, and Obesity: a Cohort Study from Chinese Patients with Type 2 Diabetes.
Brain-derived neurotrophic factor (BDNF) is associated with systemic inflammatory conditions, such as diabetes. The aim of this study was to assess the serum BDNF levels in Chinese patients with type 2 diabetes (T2DM). From the outpatient clinic at the endocrinology department of our hospital, all patients with long-standing T2DM were recruited for this study between August 2014 and December 2014. Serum levels of BDNF were assayed with solid-phase sandwich ELISA, and the demographical and clinical data were evaluated on admission. Median serum BDNF levels were significantly lower in patients with T2DM compared to control subjects (15.9 ng/mL (interquartile range (IQR), 12.6-19.8) VS. 24.6 ng/mL (IQR, 17.2-27.8); P < 0.0001). Serum BDNF levels were inversely correlated with fasting glucose (r = -0.394, P < 0.0001) and duration of illness (r = -0.272, P < 0.0001) in T2DM patients. Based on the receiver operating characteristic (ROC) curve, the optimal cutoff value of serum BDNF levels as an indicator for diagnosis of T2DM was projected to be 23.0 ng/mL, which yielded a sensitivity of 89.0 % and a specificity of 60.9 %, with the area under the curve at 0.794 (95 % confidence interval (CI), 0.747-0.841; P < 0.001). In multivariate logistic regression analysis, after adjusting for other significant factors, BDNF can be seen as an indicator of independent diabetes complications with an odds ratio (OR) of 0.84 (95 % CI, 0.75-0.89; P < 0.001) and obesity with an OR of 0.88 (95 % CI, 0.80-0.92; P < 0.001). Our study suggested that low levels of BDNF accompany impaired glucose metabolism. Importantly, we found that decreased BDNF were correlated with obesity and diabetes complications.


Validation of the REM behaviour disorder phenoconversion-related pattern in an independent cohort.
A brain glucose metabolism pattern related to phenoconversion in patients with idiopathic/isolated REM sleep behaviour disorder (iRBDconvRP) was recently identified. However, the validation of the iRBDconvRP in an external, independent group of iRBD patients is needed to verify the reproducibility of such pattern, so to increase its importance in clinical and research settings. The aim of this work was to validate the iRBDconvRP in an independent group of iRBD patients. Forty iRBD patients (70 ± 5.59 years, 19 females) underwent brain [18F]FDG-PET in Seoul National University. Thirteen patients phenoconverted at follow-up (7 Parkinson disease, 5 Dementia with Lewy bodies, 1 Multiple system atrophy; follow-up time 35 ± 20.56 months) and 27 patients were still free from parkinsonism/dementia after 62 ± 29.49 months from baseline. We applied the previously identified iRBDconvRP to validate its phenoconversion prediction power. The iRBDconvRP significantly discriminated converters from non-converters iRBD patients (p = 0.016; Area under the Curve 0.74, Sensitivity 0.69, Specificity 0.78), and it significantly predicted phenoconversion (Hazard ratio 4.26, C.I.95%: 1.18-15.39). The iRBDconvRP confirmed its robustness in predicting phenoconversion in an independent group of iRBD patients, suggesting its potential role as a stratification biomarker for disease-modifying trials.


The chest radiograph in brucellosis.
A retrospective study of chest radiographs in patients with brucellosis was undertaken at King Khalid University Hospital, Riyadh. The commonest presenting symptoms were fever, back and joint pains, excessive sweating, headache, and cough. Different chest radiographic abnormalities were detected, including soft miliary mottling, parenchymal nodules, consolidation, chronic diffuse changes, hilar or paratracheal lymphadenopathy and pneumothorax. Soft miliary mottling and pneumothorax have not been described before. The high incidence of lung abnormalities is most probably due to the chronicity of the disease in the present series.


Development of tolerance and supersensitivity to phencyclidine in rats after repeated administration of phencyclidine.
In rats treated with phencyclidine (PCP) repeatedly (PCP 10 mg/kg per day for 14 days), the back-pedalling, head-weaving and turning induced by PCP were attenuated (tolerance), while PCP-induced sniffing, rearing and ambulation were potentiated (supersensitivity). The behavior induced by the direct and indirect serotonin (5-HT) agonists, 5-methoxy-N,N-dimethyltryptamine and p-chloroamphetamine, was attenuated, while the sniffing, rearing or licking induced by the direct and indirect dopamine (DA) agonists, apomorphine and methamphetamine, were potentiated in the chronic PCP-treated rats. The DA and 5-HT contents in the nucleus accumbens and the ratio of HVA to DA in the striatum increased following the repeated PCP administration. Pentobarbital-induced sleep time did not change in the chronic PCP-treated rats as compared with the control rats. In addition, there was no significant difference between the disappearance rate of PCP in the brain of the rats treated with PCP repeatedly and the rate in the control rats. These results suggest that functional changes in the dopaminergic and serotonergic neuronal systems develop on repeated administration of PCP but that such changes do not develop in the hepatic drug-metabolizing system. In addition, tolerance develops in the serotonergic neuronal system while supersensitivity develops in the dopaminergic neuronal system. Biochemical findings suggest that increased mesolimbic dopaminergic neuronal function plays an important role in the development of the supersensitivity.


Molecular modeling study of the editing active site of Escherichia coli leucyl-tRNA synthetase: two amino acid binding sites in the editing domain.
Aminoacyl-tRNA synthetases (aaRSs) strictly discriminate their cognate amino acids. Some aaRSs accomplish this via proofreading and editing mechanisms. Mursinna and coworkers recently reported that substituting a highly conserved threonine (T252) with an alanine within the editing domain of Escherichia coli leucyl-tRNA synthetase (LeuRS) caused LeuRS to cleave its cognate aminoacylated leucine from tRNA(Leu) (Mursinna et al., Biochemistry 2001;40:5376-5381). To achieve atomic level insight into the role of T252 in LeuRS and the editing reaction of aaRSs, a series of molecular modeling studies including homology modeling and automated docking simulations were carried out. A 3D structure of E. coli LeuRS was constructed via homology modeling using the X-ray structure of Thermus thermophilus LeuRS as a template because the E. coli LeuRS structure is not available from X-ray or NMR studies. However, both the X-ray T. thermophilus and homology-modeled E. coli structures were used in our studies. Amino acid binding sites in the proposed editing domain, which is also called the connective polypeptide 1 (CP1) domain, were investigated by automated docking studies. The root mean square deviation (RMSD) for backbone atoms between the X-ray and homology-modeled structures was 1.18 A overall and 0.60 A for the editing (CP1) domain. Automated docking studies of a leucine ligand into the editing domain were performed for both structures: homology structure of E. coli LeuRS and X-ray structure of T. thermophilus LeuRS for comparison. The results of the docking studies suggested that there are two possible amino acid binding sites in the CP1 domain for both proteins. The first site lies near a threonine-rich region that includes the highly conserved T252 residue, which is important for amino acid discrimination. The second site is located in a flexible loop region surrounded by residues E292, A293, M295, A296, and M298. The important T252 residue is at the bottom of the first binding pocket.


Hemispheric asymmetries in cerebral cortical networks.
Since the middle of the 19th century it has been recognized that several higher cognitive functions, including language, are lateralized in cerebral cortex. Neuropsychological studies on patients with brain lesions and rapid developments in brain imaging techniques have provided us with an increasing body of data on the functional aspects of language lateralization, but little is known about the substrate on which these specializations are realized. Much attention has been focused on the gross size and shape of cortical regions involved, but recent findings indicate that the columnar and connectional structure within auditory and language cortex in the left hemisphere are distinct from those in homotopic regions in the right hemisphere. These findings concern parameters that are closely linked to the processing architecture within the respective regions. Thus, the comparison of these microanatomical specializations with their respective functional counterparts provides important insights into the functional role of cerebral cortical organization and its consequences for processing of cortical information in the implementation of complex cognitive functions.


Real-Time Mass Spectrometry Monitoring of Oak Wood Toasting: Elucidating Aroma Development Relevant to Oak-aged Wine Quality.
We introduce a real-time method to monitor the evolution of oak aromas during the oak toasting process. French and American oak wood boards were toasted in an oven at three different temperatures, while the process-gas was continuously transferred to the inlet of a proton-transfer-reaction time-of-flight mass spectrometer for online monitoring. Oak wood aroma compounds important for their sensory contribution to oak-aged wine were tentatively identified based on soft ionization and molecular mass. The time-intensity profiles revealed toasting process dynamics illustrating in real-time how different compounds evolve from the oak wood during toasting. Sufficient sensitivity was achieved to observe spikes in volatile concentrations related to cracking phenomena on the oak wood surface. The polysaccharide-derived compounds exhibited similar profiles; whilst for lignin-derived compounds eugenol formation differed from that of vanillin and guaiacol at lower toasting temperatures. Significant generation of oak lactone from precursors was evident at 225 (o)C. Statistical processing of the real-time aroma data showed similarities and differences between individual oak boards and oak wood sourced from the different origins. This study enriches our understanding of the oak toasting process and demonstrates a new analytical approach for research on wood volatiles.


Chronic Kidney Disease Classification Predicts Short-Term Outcomes of Patients Undergoing Pancreaticoduodenectomy.
The impact of chronic kidney disease (CKD) on pancreaticoduodenectomy has not been well established. In this study, we investigated the effects of preoperative CKD in patients undergoing pancreaticoduodenectomy. A retrospective review of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database identified patients who underwent pancreaticoduodenectomy between 2015 and 2019. The estimated glomerular filtration rate (eGFR) for each patient was calculated using the CKD-Epidemiology Collaborative (CKD-EPI) 2021 equation. Kidney function was stratified according to the Kidney Disease: Improving Global Outcomes (KDIGO) Classification: G1, normal/high function (estimated glomerular filtration rate ≥ 90 ml/min/1.73 m2); G2-G3, mild/moderate CKD (89-30 ml/min/1.73 m2); and G4-G5, severe CKD (≤ 29 ml/min/1.73 m2). The 30-day overall complications and outcomes were compared using regression models accounting for demographics and comorbidities. A total of 20,656 (55.7% men) patients were identified. Univariate analysis showed that compared to G1 patients, G2-G3 and G4-G5 had higher rates of overall complications (p < 0.001), need for readmission (p = 0.004), need for reoperation (p < 0.001), discharge to the care facility (p < 0.001), death (p < 0.001), and average length of stay (p < 0.001). On multivariable regression, G2-G3 renal function was found to be an independent risk factor for overall (1.10 [1.04-1.17], p = 0.002), pulmonary (1.23 [1.10-1.37], p < 0.001), hematologic (1.08 [1.02-1.16], p = 0.015), and renal (1.29 [1.11-1.49], p < 0.001) complications; discharge to care facility (1.10 [1.02-1.19], p = 0.045); and 30-day mortality (1.25 [1.01-1.56], p = 0.045). G4-G5 renal function was a predictor of worse outcomes for the prior variables and an independent risk factor for cardiovascular complications (2.70 [1.44-4.96], p = 0.001) and length of stay (1.32 [1.13-1.56], p < 0.001). The degree of CKD was related to the overall complications and outcomes after pancreaticoduodenectomy. Therefore, the CKD classification should be strongly considered in the preoperative risk stratification of these patients.


Growth characteristics of children with ectodermal dysplasia syndromes.
Clinical observations suggested that growth abnormalities may be present in children with ectodermal dysplasia (ED) syndromes. This study characterizes the longitudinal pattern of growth in a cohort of children with the ED syndromes. We hypothesized that (1) linear and ponderal growth abnormalities are present in children with ED from infancy through adolescence, and (2) linear and ponderal growth abnormalities differ among the clinical variants of these disorders. We studied 138 children who had ED and were registered with the National Foundation for Ectodermal Dysplasias, 74% of whom had clinical features consistent with the hypohidrotic EDs (HEDs). Height (or length) and weight measurements were obtained by standardized techniques and from review of available medical records. We converted these measurements to weight-for-height (children younger than 5 years and <103 cm in length) or BMI (children > or =2 years old). Height, weight, weight-for-height, and BMI were converted to age- and gender-specific z scores. We applied linear regression, 1-sample t tests, and analysis of variance to detect linear and ponderal growth abnormalities in children with ED compared with a reference population. Mean weight-for-age, weight-for-height, and BMI-for-age z scores but not height-for-age z score, were significantly lower in children with the ED syndromes than in the reference population. Mean weight-for-age and weight-for-height z scores but not BMI-for-age or height-for-age z scores increased significantly with increasing age. The mean height-for-age z score of children with the ED syndromes other than the HEDs was significantly lower than that of children with the HEDs. Growth abnormalities, measured as weight deficits, were present at an early age in children with the ED syndromes and persisted through adolescence. Height deficits were seen only in children with ED syndromes other than HEDs. Clinicians should evaluate carefully children with ED syndromes for growth abnormalities.


The longitudinal impact of the COVID-19 pandemic on adolescents' internalizing symptoms, substance use, and digital media use.
The present study examined the long-term effects of the COVID-19 pandemic on adolescent internalizing symptoms, substance use, and digital media use before and during the pandemic. A nationally representative longitudinal cohort of 3718 Israeli adolescents aged 12-16 at baseline completed measures of internalizing symptoms (anxiety, depression, and somatization), the prevalence of substance use (i.e., previous 30-day use of tobacco, alcohol, and cannabis), and average daily use of internet/television, video games, and social media. Social support and daily routines were assessed as potential protective factors for mental health. Data were collected in 10 public schools at four measurement points: before the Covid-19 outbreak (September 2019), after the first wave lockdown (May 2020), after the third wave lockdown (May 2021), and after the fifth wave of the pandemic (May 2022). Multi-level mixed models were used to analyze the longitudinal data. The results showed significant increases in internalizing symptoms, substance use (tobacco, alcohol, and cannabis), and daily screen time from the start of the study to the 33-month follow-up. Social support and daily routines moderated the increases in internalizing symptoms and digital media use. These findings highlight the need for public and educational mental health services to address the continuing impact of the pandemic on adolescents.


Starch modification with microbial alpha-glucanotransferase enzymes.
Starch is an agricultural raw material used in many food and industrial products. It is present in granules that vary in shape in the form of amylose and amylopectin. Starch-degrading enzymes are used on a large scale in the production of sweeteners (high fructose corn syrup) and concentrated glucose syrups as substrate for the fermentative production of bioethanol and basic chemicals. Over the last two decades α-glucanotransferases (EC 2.4.1.xx), such as branching enzyme (EC 184.108.40.206) and 4-α-glucanotransferase (EC 126.96.36.199), have received considerable attention. These enzymes do not hydrolyze the starch as amylases do. Instead, α-glucanotransferases remodel parts of the amylose and amylopectin molecules by cleaving and reforming α-1,4- and α-1,6-glycosidic bond. Here we review the properties of α-glucanotransferases and discuss the emerging use of these enzymes in the generation of novel starch derivatives.


Therapeutic arthrography and bursography.
Arthrography and bursography as therapeutic venues have found their place in the musculoskeletal procedure armamentarium. Therapeutic arthrography not only rules in and rules out the origin of pain but can provide 6 to 9 months of pain relief in diseased joints. Therapeutic arthrography allows injections of anesthetic, corticosteroid, or alternatively hyaluronic acid to be delivered accurately to the source of pain. Corticosteroids have a long history of use in osteoarthritis. Alternative therapy with hyaluronic acid is anew procedure. This article reviews the technique of arthrography in different joints and bursae and discusses the pros and cons of the use of corticosteroids versus viscosupplementation in therapeutic arthrography.


Hepatic portal venous gas on postmortem CT scan.
We report on two cases involving hepatic portal venous gas (HPVG) imaging by computed tomography (CT) scans performed shortly after death. One case involved a 9-month-old infant who died of heat stroke, while the other was a 28-year-old man who died of myocarditis. Although both of these two cases were remarkable distension of the gastrointestinal tract with gas, the autopsies were unable to uncover any clinical cause for HPVG, such as necrotic bowel, ulcerative colitis, intra-abdominal abscess, bowel obstruction, or gastric ulcer. The cause of HPVG in our case is not due to organic disease, but due to gastro-intestinal distention due to emergency management using bag-valve-masking or esophageal tracheal combitube, thereby differing from the mechanisms underlying so-called clinical HPVG.


Over-the-counter access to emergency contraception for teens.
This synopsis of teens and OTC access is part of a series of briefs on emergency contraception, which address the following issues as they relate to EC: Is emergency contraception safe? Is emergency contraception effective at preventing pregnancy? Does emergency contraception promote sexual risk-taking? Is emergency contraception cost-effective? Does emergency contraception cause abortion? The full series can be found at http://crhrp.ucsf.edu.


Hsa_circ_0007494 suppresses prostate cancer progression via miR-616/PTEN axis.
Circular RNAs (circRNAs) are important players in prostate cancer (PCa) development and progression, but their detailed mechanisms have not been elucidated. Herein, hsa_circ_0007494 was suppressed in the PCa cell lines and tissues. This resulted in metastasis of tumors to the lymph node and predicted tumor stage. Functionally, overexpression of hsa_circ_0007494 inhibited the proliferation and invasive capacity of the cells in vitro and blocked the growth of tumors in vivo. Hsa_circ_0007494 functioned as a "molecular sponge" for miR-616 and hence upregulated the target of miR-616, PTEN. In addition, rescue assays revealed that PTEN silencing (or miR-616 mimics) blocked the tumor-suppressing effects of hsa_circ_0007494 overexpression on PCa progression. Together, our findings indicate that hsa_circ_0007494 suppresses PCa by forming a negative regulatory network including hsa_circ_0007494/miR-616/PTEN. Thus, hsa_circ_0007494 may be a treatment target for PCa.


Assessing the efficacy of chitosan nanomatrix incorporated with Cymbopogon citratus (DC.) Stapf essential oil against the food-borne molds and aflatoxin B1 production in food system.
The chitosan nanomatrix incorporated with Cymbopogon citratus essential oil (Ne-CcEO) possess enhanced efficacy against the food-borne molds and aflatoxin B1 production compared to free essential oil. The CcEO was encapsulated inside the chitosan nanomatrix with an average size 147.41 ± 16.18 nm and characterized by Scanning electron microscopy, Fourier transforms infrared spectroscopy, and X-ray diffraction assay. The encapsulation efficiency and loading capacity were ranged between (41.68-76.78%) and (5.3-8.80%). The biochemical and in-silico analysis results revealed the interference in functioning of membrane integrity, mitochondrial membrane potential, antioxidant defense, carbon source metabolism, methylglyoxal, and laeA gene in response to treatment of Ne-CcEO (0.5 μl/ml). In addition, Ne-CcEO significantly protects the deterioration of Pennisetum glaucum (L.) R. Br. seed samples by A. flavus, aflatoxin B1 contamination, and lipid peroxidation. The Ne-CcEO could be considered as promising antifungal additives for the control of food-borne molds and aflatoxin B1 contamination in the food system.


Glutathione: Lights and Shadows in Cancer Patients.
In cases of cellular injury, there is an observed increase in the production of reactive oxygen species (ROS). When this production becomes excessive, it can result in various conditions, including cancerogenesis. Glutathione (GSH), the most abundant thiol-containing antioxidant, is fundamental to re-establishing redox homeostasis. In order to evaluate the role of GSH and its antioxi-dant effects in patients affected by cancer, we performed a thorough search on Medline and EMBASE databases for relevant clinical and/or preclinical studies, with particular regard to diet, toxicities, and pharmacological processes. The conjugation of GSH with xenobiotics, including anti-cancer drugs, can result in either of two effects: xenobiotics may lose their harmful effects, or GSH conjugation may enhance their toxicity by inducing bioactivation. While being an interesting weapon against chemotherapy-induced toxicities, GSH may also have a potential protective role for cancer cells. New studies are necessary to better explain the relationship between GSH and cancer. Although self-prescribed glutathione (GSH) implementation is prevalent among cancer patients with the intention of reducing the toxic effects of anticancer treatments and potentially preventing damage to normal tissues, this belief lacks substantial scientific evidence for its efficacy in reducing toxicity, except in the case of cisplatin-related neurotoxicity. Therefore, the use of GSH should only be considered under medical supervision, taking into account the appropriate timing and setting.


A field evaluation of the efficacy of two vaccines against ovine pneumonic pasteurellosis.
Two vaccines against pneumonic pasteurellosis were evaluated for efficacy in lambs transported by sea from New Zealand to Saudi Arabia. One vaccine contained whole cell antigens of Pasteurella haemolytica A2 grown under iron restricted conditions. The other contained Pasteurella haemolytica A1 cell surface and leucotoxin antigens. There was no clear evidence of either vaccine leading to a lower pneumonia death or lesion rate than for the control group.


Serum lipids, lipoproteins and apolipoproteins in black patients with angiographically defined coronary artery disease.
The association between angiographically defined coronary artery disease (CAD) and serum lipids, lipoproteins, and apolipoproteins was evaluated in 151 black men and 245 black women. Patients with 70% or greater narrowing of at least one coronary artery or greater than or equal to 50% stenosis of the left main coronary artery (n = 179) were compared to those with lesions of less than 50% stenosis (n = 217) for total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), LDL-C/HDL-C, triglycerides, apolipoprotein A-I, apolipoprotein B, and apolipoprotein A-I/B. A consistently more atherogenic pattern of lipids, lipoproteins, and apolipoproteins occurred only among the women. Using stepwise selection multiple logistic regression analysis, the ratio of apolipoprotein A-I/B (odds ratio = 0.38, 95% confidence limits 0.24-0.61) was the only statistically significant association of CAD in women, after adjusting for the effects of age, body mass index, and histories of smoking, hypercholesterolemia, hypertension, and diabetes. When stratified by median of total cholesterol, the ratio of apolipoprotein A-I/B was the most strongly associated with the presence of CAD in the lower half of the total cholesterol distribution (less than 208 mg/dl), whereas in the upper half of the total cholesterol distribution the total cholesterol/HDL-C ratio was more strongly associated with CAD. None of the variables studied was associated with CAD in men. These results support other studies suggesting that apolipoproteins may be better predictors of CAD.


Evaluation of knowledge regarding shaken baby syndrome among parents and medical staff.
Shaken baby syndrome (SBS), currently functioning as abusive head trauma (AHT), is a form of violence against children mainly under 2 years of age. The number of SBS might be underestimated, as many cases of violence remain unreported. The aim of the study was the evaluation of the state knowledge of the SBS phenomenon, its scale and diagnostic methods among parents, medical staff and medical students. A total of 639 people were examined: 39% of parents, 32.5% of medical staff members, and 28.5% of medical students; 82% were women. The average age was 34.9±9.78 years, and 70% of them had children. The research tool was an anonymous survey. The 34 questions concerned numerous aspects of violence against children as well as knowledge about SBS. According to 90% of the interviewees shaking a baby may be dangerous but 43% have never heard about shaken baby syndrome. Eighty-eight percent of responders stated that "SBS is a form of violence," but only 57% realize that one-time shaking can lead to death and only 19% indicated men as aggressors. Sixteen percent of medical staff members did not know how long it takes for the consequences of shaking a baby to be revealed. Majority of the medical staff members working with children have never heard about SBS. Only half of the surveyed understands the connection of shaking with vision loss or child's death. Among the long-term consequences of shaking a baby, the greatest knowledge concerns emotional consequences of shaking.


Xanthohumol metabolites in faeces of rats.
Xanthohumol (1), isolated from hop, was fed to rats in a dose of 1000 mg kg(-1) body weight. The faeces of the animals were collected after 24 and 48 h and analysed for metabolites of 1. Approximately 89% of the recovered flavonoid-compounds consisted of unchanged 1. Sixteen metabolites and six previously known metabolites were isolated and characterized by coupling techniques (HPLC-NMR, HPLC-MS and HPLC-DAD). Their structures were elucidated by spectroscopic methods, especially using NMR spectroscopy. Twenty metabolites had a modified chalcone structure and two metabolites were flavanone derivatives.


Anticoagulation in abdominal aortic aneurysm surgery: the approach of vascular surgeons in Great Britain and Ireland.
A questionnaire was sent to 283 vascular surgeons in Great Britain and Ireland regarding their use of heparin in elective abdominal aortic aneurysm surgery. The answers form the basis of this study and show that there is great variation. The majority of surgeons routinely anticoagulate their patients peroperatively. Heparin is usually given intravenously--most giving the drug 2 to 3 min prior to cross clamping the aorta. Approximately half of the respondents use the same dose in all patients, whilst the remainder vary the dose, usually on the basis of weight or "size". Most surgeons use 5000 units but the range of dose varies from 400 to 20,000 units. Just under a quarter of surgeons continue to anticoagulate their patients postoperatively, almost all of these using subcutaneous heparin for prophylaxis against deep vein thrombosis. Only approximately 10% of surgeons routinely reverse the heparin with protamine.


Formation of cereal protein disulfide-linked stable matrices by apigeninidin, a 3-deoxyanthocyanidin.
The food matrix is a factor affecting digestion rate of macronutrients, like starch. Sorghum protein networks surrounding starch have been associated with its comparatively low starch digestibility, though their formation mechanism is unclear. Since sorghums contain 3-deoxyanthocyanidins with redox property that could promote sulfhydryl-disulfide interchanges, we hypothesized that added apigeninidin (a 3-deoxyanthocyanidin) will form matrices in a non-matrix-forming cereal (corn). A model system using ovalbumin determined apigeninidin as a polymerizing agent. Starch digestion and microstructure of cereal porridges from yellow corn with and without added apigeninidin, commercial blue corn, and white sorghum were examined. Apigeninidin addition promoted protein matrices in yellow corn and attenuated initial starch digestion rate that was related to matrix formation rather than α-amylase inhibition. Blue corn with 3-deoxyanthocyanidins formed protein matrices with similar lower overall starch digestibility as sorghum. Promoting matrix formation in cereal-based foods with 3-deoxyanthocyanidins may be a strategy to modulate starch digestion rate.


Crystal structure of an antifungal osmotin-like protein from Calotropis procera and its effects on Fusarium solani spores, as revealed by atomic force microscopy: Insights into the mechanism of action.
CpOsm is an antifungal osmotin/thaumatin-like protein purified from the latex of Calotropis procera. The protein is relatively thermostable and retains its antifungal activity over a wide pH range; therefore, it may be useful in the development of new antifungal drugs or transgenic crops with enhanced resistance to phytopathogenic fungi. To gain further insight into the mechanism of action of CpOsm, its three-dimensional structure was determined, and the effects of the protein on Fusarium solani spores were investigated by atomic force microscopy (AFM). The atomic structure of CpOsm was solved at a resolution of 1.61Å, and it contained 205 amino acid residues and 192 water molecules, with a final R-factor of 18.12% and an Rfree of 21.59%. The CpOsm structure belongs to the thaumatin superfamily fold and is characterized by three domains stabilized by eight disulfide bonds and a prominent charged cleft, which runs the length of the front side of the molecule. Similarly to other antifungal thaumatin-like proteins, the cleft of CpOsm is predominantly acidic. AFM images of F. solani spores treated with CpOsm resulted in striking morphological changes being induced by the protein. Spores treated with CpOsm were wrinkled, and the volume of these cells was reduced by approximately 80%. Treated cells were covered by a shell of CpOsm molecules, and the leakage of cytoplasmic content from these cells was also observed. Based on the structural features of CpOsm and the effects that the protein produces on F. solani spores, a possible mechanism of action is suggested and discussed.


Antibody reactivity with new antigens revealed in multi-transgenic triple knockout pigs may cause early loss of pig kidneys in baboons.
Recent advances in gene editing technology have enabled the production of multi-knockout (KO) and transgenic pigs in order to overcome immunologic barriers in xenotransplantation (XTx). However, the genetic manipulations required to produce these changes may have the unintended consequence of producing or revealing neoantigens reactive with natural antibodies present in baboons. In this study, we examined whether the neoantigens that develop in multi-transgenic (mTg) GalT, Cytidine monophospho-N-acetylneuraminic acid hydroxylase (CMAH), β-1,4-N-acetyl-galactosaminyl transferase 2 (B4) KO pigs can cause rejection of xenografts in baboons. Five baboons that had <35% cytotoxicity against GalT-KO peripheral blood mononuclear cells (PBMCs) in a pre-screening assay received pig kidneys and vascularized thymic grafts (VT + K) from multi-transgenic hCD47, human thrombomodulin (hTBM), human endothelial protein C receptor (EPCR) with/without hCD46 and hCD55 with GalT-KO/NeuGC-KO/B4-KO (mTg Tri-KO) swine. In order to further examine the effects of anti-donor non-Gal natural antibody (nAb), anti-pig preformed IgM and IgG nAb binding against the GalT-KO PBMCs was compared with the donor-type PBMCs using donor pretransplant sera as well as 5 additional naïve baboon sera by flow cytometric analysis. Five baboons that received VT + K grafts had stable renal function in the first 11 days (serum creatinine < 1.5 mg/dL). Two of the five baboons had higher binding of preformed IgG to mTg Tri-KO PBMCs than to GalT-KO PBMCs (mTg Tri-KO > GalT-KO), and they rejected their grafts at POD 20. In contrast, the other three baboons demonstrated either mTg Tri-KO = GalT-KO or mTg Tri-KO < GalT-KO, and they maintained renal function 43, 52, and 154 days without rejection. Among 10 baboon sera, two had less antibody binding against PBMCs that were syngeneic to the mTg Tri-KO than against GalT-KO PBMCs (mTg Tri-KO < GalT-KO); three had similar binding to mTg Tri-KO and GalT-KO PBMCs (mTg Tri-KO = GalT-KO); and five had higher binding to m Tg Tri-KO than to GalT-KO PBMCs (mTg Tri-KO > GalT-KO). These data suggest that neoantigens associated with mTg Tri-KO promote acute xenograft rejection in a pig-to-baboon VT + K XTx model. The screening assays may be useful to select "safe" recipients to receive mTg Tri-KO kidneys.


[Pulmonary epidermoid carcinoma in a 22-year-old patient with multiple cutaneous metastasis].
The authors present one clinical case of lung epidermoid carcinoma with several concurrent features which are uncommon in relation to this type of neoplasia. Consequently, the age of the patient (22), the lack of known risk factors, the histologic type (little differentiated squamous) and an aggressive biologic behaviour of the tumour, preceded of multiple cutaneous metastasis, are circumstances that make this clinical case exceptional. The more significative aspects present at lung carcinoma included in this age group respect to others are analyzed.


Effects and safety of GnRH-a as a luteal support in women undertaking assisted reproductive technology procedures: follow-up results for pregnancy, delivery, and neonates.
To investigate the effects and safety of gonadotropin releasing hormone analogue (GnRH-a) as an addition to progesterone luteal support in women who underwent in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) and achieved a clinical pregnancy. A retrospective analysis was conducted on 214 patients who underwent IVF/ICSI-ET procedures with standard long mid-luteal protocol, of which 123 received GnRH-a-free protocol and 91 received GnRH-a-added protocol. The patients' pregnancy and delivery course, and their neonates' status at birth and growth/development after birth were statistically compared. There was no significant difference between both study groups regarding embryo risks and maternal complications during early pregnancy. as well as fetal risks during the middle and late stages and neonate risks during birth, except that the twin pregnancies of the GnRH-a-added group had a considerably greater male/female ratio, and a significantly higher rate of premature delivery and low birth weight than those of the GnRH-a-free group. In addition, there was no significant difference in neonate risks within 2 years after birth between both cohorts. With precautions taken to control the number of implanted embryos and reduce the incidence of twinning pregnancy, the addition of GnRH-a to luteal support is relatively safe and effective.


Color Doppler ultrasonography in the assessment of vesicoureteric reflux in children with bladder dysfunction.
To determine whether color Doppler ultrasound (DUS) evaluation of ureteric jets could predict vesicoureteric reflux (VUR) in children with non-neuropathic and neuropathic bladder/sphincter dysfunction, 129 children were evaluated to identify the vesicoureteric orifice and measure the distance from the orifice to the midline of the dorsal bladder wall (MVU distance). The type of bladder dysfunction was determined by urodynamic studies. Forty-two children with no history of kidney or bladder disease were examined by DUS as a control group. MVU distances were compared between several groups of children with different urodynamic findings, and the significance was tested. Jets were visualized in 81% of children. MVU distances were significantly lower in children without VUR compared to those with VUR. No statistically significant differences were observed between children without VUR and those with VUR and more severe urodynamic disturbances like dysfunctional voiding. In children with neuropathic bladders, jets were visible in only 57% of refluxive units and the range of MVU distances was very wide (5-22 mm). If a cut-off point of 10 mm is used, in children without bladder dysfunction the sensitivity of MVU measurement in the diagnosis of VUR was 87.5% and the specificity 97%. However, in children with non-neuropathic and neuropathic bladder dysfunction, the sensitivity was only 55% and the specificity 79%. Color Doppler (DUS) and measurement of the MVU distance proved useful in predicting VUR only in children with normal bladder function. In children with neuropathic and non-neuropathic bladder dysfunction it can be used to visualize ureteric jets, but cannot replace radiographic or radionuclide voiding cystourethrography.


Focal myositis of the neck.
Focal myositis is a recently defined, rapidly growing, inflammatory pseudotumor of skeletal muscle. It is characterized by marked myopathic changes of muscle fibers, hypocellular fibrosis of perimysium and endomysium, and an intense inflammatory reaction in the fibrous septa. This report describes the first instance involving the neck muscle of a 40 year old man. A brief discussion of other histologically similar subcutaneous lesions is also presented.


Mutant mice with reduced NMDA-NR1 glycine affinity or lack of D-amino acid oxidase function exhibit altered anxiety-like behaviors.
Several compounds that promote activation of the N-methyl-d-aspartate receptor (NMDAR) glycine site have been proposed as treatments for schizophrenia, but the impact of these putative antipsychotics on anxiety remains unclear. In this study, we employed genetic and pharmacological mouse models of altered NMDAR glycine site function to examine the effects of these proposed treatments in unconditioned tests of anxiety. In the elevated plus-maze, open field, and novel object test, homozygous Grin1(D481N) mutant mice that have a five-fold reduction in NMDAR glycine affinity demonstrated an anxiolytic-like phenotype. In contrast, d-serine, a direct activator of the NMDAR glycine site, and ALX-5407, a glycine transporter-1 (GlyT-1) inhibitor, enhanced anxiety-like behaviors in wild-type and Grin1(D481N) mutant animals. Homozygous Dao1(G181R) mutant mice that lack function of the d-serine catabolic enzyme, d-amino acid oxidase (DAO), displayed an elevation in anxiety. Deficient DAO activity also reversed the anxiolytic effects of diminished NMDAR function in mice carrying both the homozygous Grin1(D481N) and Dao1(G181R) mutation. Thus, a direct agonist of the NMDAR glycine site, a GlyT-1 inhibitor, and suppression of DAO function induced anxiogenic-like behaviors. Consequently, application of these treatments for amelioration of schizophrenic symptoms necessitates caution as an enhancement of comorbid anxiety disorders may result.


Correction to: Lower grip strength and dynamic body balance in women with distal radial fractures.
The article Lower grip strength and dynamic body balance in women with distal radial fractures, written by. K. Fujita, H. Kaburagi, A. Nimura, T. Miyamoto, Y. Wakabayashi, Y. Seki, H. Aoyama, H. Shimura, R. Kato, A. Okawa was originally published electronically on the publisher's internet portal.


Increase in plasma prorenin during the menstrual cycle of a bilaterally nephrectomized woman.
To investigate the origin of the prorenin peak that occurs during the normal menstrual cycle, plasma levels of prorenin, renin, oestradiol, progesterone, LH and FSH were measured serially in a nephrectomized woman having regular haemodialysis. The prorenin peak coincided with the LH surge and preceded the rise of progesterone, whereas renin was below the detection limit during the whole cycle. These findings indicate that the rise in prorenin during the menstrual cycle is not of renal origin but is probably due to increased production by the ovary and supports the increasing evidence for the existence of a local renin-angiotensin system in the ovary.


The impact of bleeding event frequency on health-related quality of life and work productivity outcomes in a European cohort of adults with haemophilia A: insights from the CHESS II study.
Haemophilia A carries a substantial healthcare burden, affecting health-related quality of life (HRQoL). The Cost of Haemophilia in Men: a Socioeconomic Survey II (CHESS II), a retrospective real-world study, characterised the burden of haemophilia and its impact on HRQoL and work productivity. The current analysis explored the impact of bleeding events on HRQoL and work productivity in Europe. This analysis focused on data collected from males aged 18 to 64 years with haemophilia A without inhibitors who were receiving replacement factor products or a monoclonal antibody and were not participating in a clinical trial at the time of study recruitment. Descriptive statistics were analysed using scores from EuroQoL's EQ-5D-5L index and EQ-VAS analogue scale and the Work Productivity and Activity Index Specific Health Problem (WPAI:SHP) percentage scores stratified by the number of annual bleeding events (ABs) 0, 1, 2, 3-4, or ≥ 5. Of 918 males with haemophilia A in CHESS II, 318 met inclusion criteria and had data available for HRQoL measures; mean age (SD) was 33.8 (12.1) years and 96% were White. Mean (SD) ABs of 2.7 (2.9) occurred over the preceding 12 months: 20% had 3 or 4 ABs; 17% had ≥ 5 ABs. Mean EQ-5D-5L index scores for patients with 0, 1, 2, 3-4, or ≥ 5 ABs were 0.92, 0.76, 0.76, 0.71, and 0.56, respectively. Mean (SD) EQ-VAS scores were 86.9 (13.6), with 0 ABs versus 69.5 (19.1) for 3 or 4 ABs and 61.2 (17.2) for ≥ 5 ABs. Mean percentage of overall work productivity loss on the WPAI:SHP questionnaire ranged from 9.70 to 0 ABs to 47.65 for ≥ 5 ABs. In this European sample of adult men with haemophilia A, HRQoL and work productivity scores were lower among those reporting more AB events. Bleeding burden appears to affect HRQoL and productivity; however, this cross-sectional analysis limits the ability to draw firm conclusions on causality.


Bis(tetra-phenyl-phospho-nium) bis-[N-(trifluoro-methyl-sulfon-yl)dithio-carbimato(2-)-κS,S']zincate(II).
The title salt, (C(24)H(20)P)(2)[Zn(C(2)F(3)NO(2)S(3))(2)], consists of a complex dianion and two tetra-phenyl-phospho-nium cations. The Zn(II) ion displays a distorted tetra-hedral coordination environment with four S atoms from two S,S'-chelated N-(trifluoro-methyl-sulfonyl-)dithio-carbimate anions. In the crystal, besides the ionic inter-action of the oppositely charged ions, inter-molecular C-H⋯O inter-actions between cations and anions are observed. One of the cations inter-acts with an inversion-related equivalent by π-π stacking between phenyl rings, with a centroid-centroid distance of 3.932 (4) Å.


Venous thrombosis risk assessment in medical inpatients: the medical inpatients and thrombosis (MITH) study.
We sought to define the risk factors present at admission for venous thromboembolism (VTE) in medical inpatients and develop a risk model for clinical use. Between January 2002 and June 2009, 299 cases of hospital-acquired VTE were frequency matched to 601 controls. Records were abstracted using a standard form for characteristics of the thrombosis, medical conditions and other risk factors. Weighted logistic regression and survey methods were used to develop a risk model for hospital-acquired VTE that was validated by bootstrapping. VTE complicated 4.6 per 1000 admissions. Two risk assessment models were developed, one using laboratory data available at admission (Model 1) and the other excluding laboratory data (Model 2). Model 1 consisted of the following risk factors (points): history of congestive heart failure (5), history of inflammatory disease (4), fracture in the past 3 months (3), history of VTE (2), history of cancer in the past 12 months (1), tachycardia (2), respiratory dysfunction (1), white cell count ≥ 11 × 10(9) /L (1), and platelet count ≥ 350 × 10(9) /L (1). Model 2 was similar, except respiratory dysfunction had 2 points and white cell and platelet counts were removed. The c-statistic for Model 1 was 0.73 (95% CI 0.70, 0.77) and for Model 2 0.71 (95% CI 0.68, 0.75). We present a VTE risk assessment model for use in medical inpatients. The score is simple and relies on information known at the time of admission and typically collected in all medical inpatients. External validation is needed.


Amylase in chicken intestine and pancreas.
1. The level and distribution of amylase in the chicken intestine and pancreas in addition to some of their properties were examined. 2. The level of amylase was found to be high in chickens and was present in all parts of the intestine except caeca where only traces were detected. 3. Most of the amylase activity was found in the contents of the jejunal part of the small intestine. This was attributed to the secretion from the intestinal tissue and the pancreas. 4. The investigation of different properties, namely, pH optimum, chloride ions effect and the effect of substrate concentration, revealed that the intestinal tissue amylase is different from pancreatic amylase. 5. As amylase in the intestine was found mainly confined to the jejunal lumenal contents, it is assumed that the jejunum is the major site of starch digestion in chickens.


Gender-specific data-driven adiposity subtypes using deep-learning-based abdominal CT segmentation.
The aim of this study was to quantify abdominal adiposity and generate data-driven adiposity subtypes with different diabetes risks. A total of 3817 participants from the Pinggu Metabolic Disease Study were recruited. A deep-learning-based recognition model on abdominal computed tomography (CT) images (A-CT model) was developed and validated in 100 randomly selected cases. The volumes and proportions of subcutaneous fat, visceral fat, liver fat, and muscle fat were automatically recognized in all cases. K-means clustering was used to identify subgroups using the proportions of the four fat components. The Dice indices among the measurements assessed by the A-CT model and manual evaluation to detect liver fat, muscle fat, and subcutaneous fat areas were 0.96, 0.95, and 0.92, respectively. Three subtypes were generated separately in men and women: visceral fat dominant type (VFD); subcutaneous fat dominant type (SFD); and intermuscular fat dominant type (MFD). Compared with the SFD group, the MFD group had similar diabetes risk, and the VFD group had a 60% higher diabetes risk when age and BMI were adjusted for in men. The adjusted odds ratio for diabetes was 1.92 (95% CI: 1.32-2.78) in the MFD group and 6.14 (95% CI: 4.18-9.03) in the VFD group in women. This study identified gender-specific abdominal adiposity subgroups, which may help clinicians to distinguish diabetes risk quickly and automatically.


Surface modification of two-dimensional layered double hydroxide nanoparticles with biopolymers for biomedical applications.
Layered double hydroxides (LDHs) are appealing nanomaterials for (bio)medical applications and their potential is threefold. One can gain advantage of the structure of LDH frame (i.e., layered morphology), anion exchanging property towards drugs with acidic character and tendency for facile surface modification with biopolymers. This review focuses on the third aspect, as it is necessary to evaluate the advantages of polymer adsorption on LDH surfaces. Beside the short discussion on fundamental and structural features of LDHs, LDH-biopolymer interactions will be classified in terms of the effect on the colloidal stability of the dispersions. Thereafter, an overview on the biocompatibility and biomedical applications of LDH-biopolymer composite materials will be given. Finally, the advances made in the field will be summarized and future research directions will be suggested.


Circular RNA circGFRA1 promotes angiogenesis, cell proliferation and migration of hepatocellular carcinoma by combining with miR-149.
We aimed to explore the effect of circGFRA1 on the progression of hepatocellular carcinoma (HCC) and its underlying mechanism. First, quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was conducted to detect the level of circGFRA1 in HCC tissues and cells. Survival analysis was applied to detect the effect of highly expressed circGFRA1 on the prognosis of HCC patients. Subsequently, circGFRA1 level was silenced in HCC cells, and proliferative, migration and angiogenesis activity of HCC cells was examined using Cell Counting Kit-8 (CCK-8), transwell test, and angiogenesis experiment. Then, we predicted the binding target of circGFRA1 through the bioinformatics website, and verified it through qRT-PCR and Dual-Luciferase reporter assay. Lastly, the interaction between them was verified through a series of in vitro experiments. qRT-PCR analysis showed that circGFRA1 was abnormally highly expressed in HCC tissues and HCC cells, and the high expression of circGFRA1 may lead to poor prognosis in patients with HCC. After transfecting si-circGFRA1 in HCC cells, CCK-8 and transwell experiments showed that the proliferative ability and migration of HCC cells were inhibited. Moreover, angiogenesis experiments showed that the knockdown of circGFRA1 can inhibit the blood vessels replenishment of HCC cells. The bioinformatics website suggested that miR-149 may be able to bind circGFRA1. MiR-149 was upregulated by the knockdown of circGFRA1 in HCC cells. Pearson analysis suggested that the expression levels of the two genes were negatively correlated. Dual-Luciferase reporter assay further indicated that circGFRA1 can bind to miR-149. Reverse experiment showed that the knockdown of miR-149 can partially restore the inhibited proliferative, migration, and angiogenesis activity of HCC cells caused by circGFRA1 knockdown. CircGFRA1 is highly expressed in HCC and its level is negatively correlated with miR-149 expression. CircGFRA1 can promote the proliferative, migration and angiogenic activity of HCC by binding miR-149.


Antisense vimentin cDNA combined with chondroitinase ABC reduces glial scar and cystic cavity formation following spinal cord injury in rats.
The formation of glial scar and cystic cavities restricts axon regeneration after spinal cord injury. Chondroitin sulphate proteoglycans (CSPGs) are regarded as the prominent inhibitory molecules in the glial scar, and their inhibitory effects may be abolished in part by chondroitinase ABC (ChABC), which can digest CSPGs. CSPGs are secreted mostly by reactive astrocytes, which form dense scar tissues. The intermediate filament protein vimentin underpins the cytoskeleton of reactive astrocytes. Previously we have shown that retroviruses carrying full-length antisense vimentin cDNA reduce reactive gliosis. Here we administered both antisense vimentin cDNA and ChABC to hemisected rat spinal cords. Using RT-PCR, Western blotting and immunohistochemistry, we found that the combined treatment reduced the formation of glial scar and cystic cavities through degrading CSPGs molecules and inhibiting intermediate filament proteins. The modified intra- and extra-cellular architecture may alter the physical and biochemical characteristics of the scar, and the combined therapy might be used to inhibit glial scar formation.


Shifting Spike Times or Adding and Deleting Spikes-How Different Types of Noise Shape Signal Transmission in Neural Populations.
We study a population of spiking neurons which are subject to independent noise processes and a strong common time-dependent input. We show that the response of output spikes to independent noise shapes information transmission of such populations even when information transmission properties of single neurons are left unchanged. In particular, we consider two Poisson models in which independent noise either (i) adds and deletes spikes (AD model) or (ii) shifts spike times (STS model). We show that in both models suprathreshold stochastic resonance (SSR) can be observed, where the information transmitted by a neural population is increased with addition of independent noise. In the AD model, the presence of the SSR effect is robust and independent of the population size or the noise spectral statistics. In the STS model, the information transmission properties of the population are determined by the spectral statistics of the noise, leading to a strongly increased effect of SSR in some regimes, or an absence of SSR in others. Furthermore, we observe a high-pass filtering of information in the STS model that is absent in the AD model. We quantify information transmission by means of the lower bound on the mutual information rate and the spectral coherence function. To this end, we derive the signal-output cross-spectrum, the output power spectrum, and the cross-spectrum of two spike trains for both models analytically.


Synthesis and molecular modelling studies of novel carbapeptide analogs for inhibition of HIV-1 protease.
Novel glycopeptides containing amino acids such as valine and alanine were designed, synthesized and tested for inhibition of the wild type C-SA HIV-1 protease enzyme. The incorporation of dipeptide sequences Val-Ala/Ala-Val to the sugar B-amino acid at two side chain positions resulted in a series of nine novel compounds. Compounds 3a, 3b, 3c, 3d, 4a, 4b and 5 displayed significant activities against the HIV protease enzyme. The glycopeptides are orders of magnitude less toxic to human MT-4 cells than lopinavir. Computational results were in good agreement with the experimental HIV-PR activity. The sugar hydroxyl group at the C(3) position interacts with the enzymatic Asp25/Asp25' residues. The docked position of the inhibitor is preserved during MD simulations and at least five hydrogen bond forms between the inhibitor and the enzymatic pocket. The results provide a platform for the progress of more effective carbohydrate supported inhibitors of HIV-1 and other aspartic proteases.


Freeze-fracture electron microscopy of the nuclear envelope of the human odontoblast.
The nuclear envelope was studied in several planes on freeze-fracture replicas. The inner and outer nuclear membranes were similar. Each presented two fracture faces, one with a higher intra-membranous particle density than the other. The perinuclear cisterna was bounded by outer and inner nuclear membranes about 40 nm apart. The nuclear pores of 85 nm diameter were evenly distributed over the nuclei. The pore density (5/micron2) was low compared with that in many other cells, but was of the same magnitude as is reported for the rat odontoblast.


Lack of association between B 12 and Body Mass Index among Saudi multiple sclerosis patients.
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system. It is an autoimmune disease of multifactorial etiology, linked to a variety of genetic and well-defined environmental factors. It typically affects more women than men and more frequently affects adults aged 20-45 years. Besides, vitamin B12 deficiency and obesity are associated with exacerbating central nervous system inflammation and a higher clinical disability. The study aims to determine the association of the vitamin B12 serum concentration with the Body Mass Index BMI, thyroid-stimulating hormone serum levels and MS clinical features in Saudi MS patients. This is a retrospective cohort study, and data were collected from the MS database at the King Fahad Medical City Multiple Sclerosis Clinic, from December 2015 to December 2019. Data were entered and analyzed using the Statistical Package for Social Sciences (SPSS ver. 20, Chicago, IL, USA). Cobalamin, also known as vitamin B12, has a reference concentration that ranges from 138 to 652 Pmol/L in adults. The patient's BMI was calculated by dividing the weight (in kilograms) by the square of the height (in square meters), expressed in kg/m2.Data for 169 MS subjects were collected. A total 83 of them, with a mean age of 36.2 ± 9.57 years, had vitamin B12 results. Of all patients, 16.6% had vitamin B12 deficiency (<138 pmol/L) and 9.52% of them were overweight, BMI kg/m2 = (25-29.9). The mean vitamin B12 level in all MS subjects was 240 ± 117 pmol/L. Moreover, 58.33% of the MS patients had high BMIs (BMI >25). However, no significant correlation was found between vitamin B12 deficiency neither with the BMI nor TSH concentration in MS cases (r = 0.03, p = 0.64), (r = 0.00, P = 0.9) respectively. These findings revealed no association between serum vitamin B12 concentration and TSH, BMI in MS clinical parameters, however, further studies are required to validate these results.


HFE gene: Structure, function, mutations, and associated iron abnormalities.
The hemochromatosis gene HFE was discovered in 1996, more than a century after clinical and pathologic manifestations of hemochromatosis were reported. Linked to the major histocompatibility complex (MHC) on chromosome 6p, HFE encodes the MHC class I-like protein HFE that binds beta-2 microglobulin. HFE influences iron absorption by modulating the expression of hepcidin, the main controller of iron metabolism. Common HFE mutations account for ~90% of hemochromatosis phenotypes in whites of western European descent. We review HFE mapping and cloning, structure, promoters and controllers, and coding region mutations, HFE protein structure, cell and tissue expression and function, mouse Hfe knockouts and knockins, and HFE mutations in other mammals with iron overload. We describe the pertinence of HFE and HFE to mechanisms of iron homeostasis, the origin and fixation of HFE polymorphisms in European and other populations, and the genetic and biochemical basis of HFE hemochromatosis and iron overload.


[Serum IgG subtypes features and differential diagnosis of autoimmunepancreatitis patients].
To investigate clinical value of serum IgG subclass distribution in differential diagnosis of autoimmune pancreatitis. Inpatients were enrolled as follow, autoimmune pancreatitis (AIP, n=28), acute and chronic pancreatitis (ACP, n=112), pancreatic cancer (PC, n=15), cholangiocarcinoma (CC, n=9), retroperitoneal fibrosis (RPF, n=37), together with healthy controls (n=52). IgG subtypes, amylase, lipase, glucose and CA19-9 were tested.For patients with autoimmune pancreatitis and pancreatic cancer, radiographic CT of abdomen and pathological staining were included for comparison. IgG4 subtype distributed in a wide range as 7.6(1.7-13.8) g/L in AIP, 0.4(0.2-0.7) g/L in ACP, 0.7(0.2-0.9) g/L in PC, 0.5(0.4-6.5) g/L in CC and 0.4(0.2-0.7) g/L in control group, the difference was significant (H=40.536, P<0.001). There were no significant differences of IgG1, IgG3 level in AIP, RPC and control group (all P>0.05). While IgG4 level was 7.6(1.7-13.8), 1.3(0.5-2.6), 0.4(0.2-0.7) g/L in AIP, RPC and control group, respectively. The difference was significant (H=36.833, P<0.001). IgG4 level in RPC group was lower than that in AIP group (P<0.05). And it was meaningful in the differential diagnosis. Serum IgG4 subtype plays an important role in differentiation of autoimmune pancreatitis from associated diseases.


Cutaneous leishmaniasis in Guatemala: isoenzyme characterization of isolates from humans.
Leishmania organisms cultivated from cutaneous lesions of humans in Guatemala were characterized by cellulose acetate electrophoresis. Six isolates had electrophoretic enzyme patterns identical to World Health Organization reference strains of Leishmania braziliensis braziliensis, and 5 had patterns identical to reference strains of Leishmania mexicana mexicana.


Randomized controlled trial of tranexamic acid among parturients at increased risk for postpartum hemorrhage undergoing cesarean delivery.
To assess the effects of tranexamic acid among patients undergoing cesarean delivery who were at high risk of postpartum hemorrhage. Between August 1, 2012, and April 30, 2013, a randomized controlled trial was performed at a tertiary care center in India. Women undergoing an elective or emergency cesarean delivery who were at high risk for postpartum hemorrhage were enrolled. They were randomly assigned using sealed, opaque envelopes to receive 10mg/kg tranexamic acid or normal saline 10min before skin incision. Anesthesiologists were not masked to group assignment, but patients and obstetricians were. The primary outcome was need for additional uterotonic drugs within 24h after delivery. Analyses were by intention to treat. Thirty patients were assigned to each group. Additional uterotonic drugs were required in 7 (23%) patients assigned to tranexamic acid and 25 (83%) patients in the control group (P<0.001). Intravenous tranexamic acid, administered before skin incision, significantly reduced the requirement for additional uterotonics among women at increased risk for postpartum hemorrhage. Clinical Trials Registry India: CTRI/2015/05/005752.


The influence of the hippocampus and declarative memory on word use: Patients with amnesia use less imageable words.
Hippocampal functioning contributes to our ability to generate multifaceted, imagistic event representations. Patients with hippocampal damage produce event narratives that contain fewer details and fewer imagistic features. We hypothesized that impoverished memory representations would influence language at the word level, yielding words lower in imageability and concreteness. We tested this by examining language produced by patients with bilateral hippocampal damage and severe declarative memory impairment, and brain-damaged and healthy comparison groups. Participants described events from the real past, imagined past, imagined present, and imagined future. We analyzed the imageability and concreteness of words used. Patients with amnesia used words that were less imageable than those of comparison groups across time periods, even when accounting for the amount of episodic detail in narratives. Moreover, all participants used words that were relatively more imageable when discussing real past events than other time periods. Taken together, these findings suggest that the memory that we have for an event affects how we talk about that event, and this extends all the way to the individual words that we use.


Dual kilovoltage at computed tomography: a prereconstruction method for estimation of effective atomic number and electron density.
Some of the prior efforts at using postreconstruction dual kilovoltage CT scans to obtain an effective atomic number and electron density are reviewed. A prereconstruction method which avoids beam hardening is applied to a phantom and a beginning clinical trial is described.


CDK5 activator p35 downregulates E-cadherin precursor independently of CDK5.
Dysfunction of E-cadherins often results in metastasis of cancerous cells. Here we show that p35, a critical regulator of cyclin-dependent kinase 5 (CDK5), specifically depletes the precursor form of E-cadherin, but not the mature form, by using a precursor-specific antibody. Most intriguingly, this downregulation of precursor E-cadherin by p35 is unequivocally independent of CDK5. Moreover, we found that p35 forms complexes with E-cadherin proteins. We also found that p35 co-expression can target E-cadherin to lysosomes and that p35-triggered disappearance of E-cadherin precursor can be blocked specifically by lysosomal protease inhibitors, indicating that p35 induces endocytosis and subsequent degradation of precursor E-cadherin.


Effects of intravenous kainic acid, N-methyl-D-aspartate, and (--)-nuciferine on the cat spinal cord.
Kainic acid (a rigid conformational analogue of glutamate), N-methyl-D-aspartate (the methylated derivative of aspartate), and (--)-nuciferine (an aporphine alkaloid with a depressant effect on glutamate-induced neuronal firing), which, so far, have been examined in microiontophoretic studies, were investigated in spinal cats for their effects on some spinal cord activities after intravenous injections. At low doses, kainic acid (0.3 mg kg-1) enhanced segmental monosynaptic but not polysynaptic ventral root reflexes and increased the excitability of motoneurones, whereas N-methyl-D-aspartate (3 mg kg-1) facilitated polysynaptic but not monosynaptic reflexes. Higher doses of the two amino acids depolarized motoneurones and primary afferent endings, enhanced monosynaptic reflexes and depressed polysynaptic reflexes. (--)-Nuciferine (1--10 mg kg-1) depressed monosynaptic but not polysynaptic ventral root reflexes in a dose-dependent manner and antagonized the effects of kainic acid but not of N-methyl-D-aspartate on the spinal cord. The results are consistent with the hypothetical excitatory transmitter role of glutamate in primary afferents and of aspartate in excitatory spinal cord interneurones; the findings also suggest that (--)-nuciferine may be used as a systemically effective, rather selective blocker of central glutamate receptors.


Kinetic studies on pig heart cytoplasmic malate dehydrogenase.
Kinetic studies on the pig heart cytoplasmic malate dehydrogenase have been performed over a wide range of conditions using the full time course of the reaction and computer simulation to obtain the kinetic parameters. The maximum velocity and Michaelis constants for the oxidation of reduced coenzyme have been determined as a fundtion of pH in 0.05 M phosphate buffer at 15 degrees. At pH 7.5 and at low substrate concentrations, the kinetic data are consistent with a sequential addition of substrates, coenzyme binding first, and involving the formation of at least one ternary complex. No oxalacetate binding to the enzyme was observed. The rate constants for the dissociation of coenzyme from the enzyme-coenzyme complex are small enough to define the maximum velocity in either direction of the reaction. These data, plus data using deuterated reduced coenzyme, indicate that the chemical transformation step is not rate determining. It is also shown that DPNH binding can be tight enough to practically exclude the possibility of obtaining initial velocities when measuring the reduction of DPN. Kinetic abnormalities do appear at higher substrate or product concentrations, but these do not appear to be related to the formation of inactive abortice, complexes.


Direct non-invasive techniques for assessing coronary bypass graft patency.
Venous digital subtraction angiography (vDSA) and computed tomography (CT) are two non-invasive techniques that allow direct imaging of coronary grafts. Neither of them is 100% accurate when compared to selective angiography. We studied 52 patients with 107 coronary grafts (101 saphenous and 6 mammary artery grafts) by CT and vDSA. Fifty patients had control selective angiography and 2 had control digital arterial aortography. CT correctly diagnosed 88 of the 95 patent grafts and 8 out of the 12 occluded grafts (in 1 patient 3 patent grafts could not be well analyzed owing to artifacts from pacemaker wires). vDSA correctly identified 93 patent grafts and the 12 occluded grafts, allowing the correct diagnosis of the 11 non/or misdiagnosed CT grafts. CT allowed the correct identification of the 2 misdiagnosed vDSA grafts. These results show that when there was agreement between CT and vDSA there were no diagnostic errors and that the combination of these two non-invasive techniques may avoid selective angiography for studying coronary bypass graft patency.


Comparison of distortion product otoacoustic emissions with auditory brain-stem response for clinical use in neonatal intensive care unit.
This study compares the clinical usefulness of distortion product otoacoustic emissions (DPOAEs) with the auditory brain-stem response (ABR) for neonates in the neonatal intensive care unit for the evaluation of hearing impairment. Both DPOAEs and ABR were performed on 36 neonates (67 ears) on the same day. We defined neonates as having normal hearing when the thresholds of wave V of ABR were < or =45 dB hearing level. (1) We could not obtain DPOAEs at f2 = 977 Hz in neonates with normal hearing because of high noise floors. DPOAE recording time was 36 min shorter than that of ABR. (2) We defined as normal DPOAEs, the number of frequencies which showed the DPgram-noise floor > or =4 dB was > or =4 at 6 f2 frequencies, from 1416 Hz to 7959 Hz. (3) Normal thresholds of ABR and normal DPOAEs showed the same percentages, i.e. 68.7%, but the percentage of different results between ABR and DPOAEs was 6.0%. Our study indicates that DPOAEs represent a simple procedure, which can be easily performed in the NICU to obtain reliable results in high-risk neonates. Results obtained by DPOAEs were comparable to those obtained by the more complex procedure of ABR.


Interleukin-2 levels in serum and cerebrospinal fluid of multiple sclerosis patients.
A sensitive enzyme-linked immunosorbent assay method was employed to measure interleukin-2 (IL-2) levels in cerebrospinal fluid (CSF) and sera from 30 patients with multiple sclerosis (MS) and 8 patients with other neurological diseases. Detectable levels of IL-2 were found in 6 sera and 9 CSF samples of 21 patients with acute relapse of MS. However, only 3 patients showed measurable IL-2 both in CSF and in serum. IL-2 was not detected in specimens from 9 patients with chronic-progressive MS, whereas high levels were found in 2 CSF samples from patients with aseptic meningitis. Our data suggest that systemic activation of a T-cell population is present in some MS patients; moreover, an active immune mechanism involving IL-2 production takes place within the central nervous system.


Audit of decontamination procedures for specialist ophthalmic equipment.
A survey of ophthalmic decontamination protocols in eight district hospitals was undertaken. Procedures differed widely. A literature search revealed only four publications on the subject, all of which dealt with tonometer head disinfection only. After discussion with several manufacturers, whose advice was restricted largely to acrylic lens disinfection and which varied considerably, a local policy for ophthalmic decontamination was established. Nationally agreed disinfection guidelines for high risk ophthalmic instruments are needed.


S100A8 transported by SEC23A inhibits metastatic colonization via autocrine activation of autophagy.
Metastasis is the main cause of failure of cancer treatment. Metastatic colonization is regarded the most rate-limiting step of metastasis and is subjected to regulation by a plethora of biological factors and processes. On one hand, regulation of metastatic colonization by autophagy appears to be stage- and context-dependent, whereas mechanistic characterization remains elusive. On the other hand, interactions between the tumor cells and their microenvironment in metastasis have long been appreciated, whether the secretome of tumor cells can effectively reshape the tumor microenvironment has not been elucidated mechanistically. In the present study, we have identified "SEC23A-S1008-BECLIN1-autophagy axis" in the autophagic regulation of metastatic colonization step, a mechanism that tumor cells can exploit autophagy to exert self-restrain for clonogenic proliferation before the favorable tumor microenvironment is established. Specifically, we employed a paired lung-derived oligometastatic cell line (OL) and the homologous polymetastatic cell line (POL) from human melanoma cell line M14 that differ in colonization efficiency. We show that S100A8 transported by SEC23A inhibits metastatic colonization via autocrine activation of autophagy. Furthermore, we verified the clinical relevance of our experimental findings by bioinformatics analysis of the expression of Sec23a and S100A8 and the clinical-pathological associations. We demonstrate that higher Sec23a and Atg5 expression levels appear to be protective factors and favorable diagnostic (TNM staging) and prognostic (overall survival) markers for skin cutaneous melanoma (SKCM) and colon adenocarcinoma (COAD) patients. And we confirm the bioinformatics analysis results with SKCM biopsy samples.


Attributing seizures to TBI: Validation of a brief patient questionnaire.
Traumatic brain injury (TBI) is an important cause of epilepsy and has also been associated with psychogenic nonepileptic seizures (PNES). We designed a brief questionnaire assessing patient beliefs regarding TBI as the cause of their seizures (Patient Seizure Etiology Questionnaire; PSEQ). This study reports content validity for the PSEQ. Ninety Veterans undergoing comprehensive evaluation at 3 VA epilepsy centers completed the PSEQ, a series of questions regarding possible causes for their seizures, including TBI. The PSEQ was scored as YES vs. NO for TBI as the proposed cause of seizures. For each patient, two expert reviewers independently completed a structured chart review to determine whether TBI was the proposed cause of seizures (n=180 reviews). Kappa statistic was used to assess agreement between the PSEQ and each chart review and between the PSEQ and combined chart reviews where both reviewers agreed on a TBI seizure etiology. The PSEQ scored higher overall rates for a TBI seizure etiology than did expert chart reviews (40% vs. 28%; p<0.001). The PSEQ agreed with 82% of 180 independent chart reviews (sensitivity 88%; specificity 79%). Kappa statistic for agreement was 0.60. The two reviewers agreed on a probable TBI seizure etiology for 83% of chart reviews. The PSEQ sensitivity increased to 100% when both reviewers were in agreement. The PSEQ provides a direct, standardized measure of patient beliefs regarding TBI as the cause of their seizures and has moderate-substantial agreement with expert chart reviews.


Mechanistic links between acute respiratory tract infections and acute coronary syndromes.
Cardiovascular disease has emerged as the leading cause of mortality worldwide. Acute coronary syndromes occur as a result of thrombotic complications at the site of atherosclerotic plaques, often following rupture of the fibrous cap of vulnerable plaques. A growing body of evidence from clinical and experimental studies suggests that acute respiratory tract infections can act as a trigger for acute coronary syndromes. The mechanism underlying this association has yet to be established. We explore the mechanistic links between acute respiratory tract infection and acute coronary syndromes, with a particular focus on the host response to infection and its potential interaction with pathogenic processes involved in atherosclerosis and atherosclerotic plaque rupture. The prothrombotic and haemodynamic effects of acute respiratory infection are also discussed. We review mechanistic studies as well as clinical trial data to investigate potential links between acute coronary syndromes and acute respiratory infection. Understanding the link between acute respiratory infections and acute coronary syndromes should help improve the outcome of acute coronary syndromes.


Variable HCO 3- affinity of Elodea canadensis Michaux in response to different HCO 3- and CO2 concentrations during growth.
Elodea canadensis grows over a wide range of inorganic carbon, nutrient, and light conditions in lakes and streams. Affinity for HCO 3- use during photosynthesis ranged from strong to weak in Elodea collected from seven localities with different HCO 3- and CO2 concentrations. The response to HCO 3- was also very plastic in plants grown in the laboratory at high HCO 3- concentrations and CO2 concentrations varying from 14.8 to 2,200 μM. Bicarbonate affinity was markedly reduced with increasing CO2 concentrations in the growth medium so that ultimately HCO 3- use was not detectable. High CO2 concentrations also decreased CO2 affinity and induced high CO2 compensation points (360μM CO2) and tenfold higher half-saturation values (∼800 μM CO2).The variable HCO 3- affinity is probably environmentally based. Elodea is a recently introduced species in Denmark, where it reproduces only vegetatively, leaving little opportunity for genetic variation. More important, local populations in the same water system had different HCO 3- affinities, and a similar variation was created by exposing one plant collection to different laboratory conditions.Bicarbonate use enabled Elodea to photosynthesize rapidly in waters of high alkalinity and enhanced the carbon-extracting capacity by maintaining photosynthesis above pH 10. On the other hand, use of HCO 3- represents an investment in transport apparatus and energy which is probably not profitable when CO2 is high and HCO 3- is low. This explanation is supported by the findings that HCO 3- affinity was low in field populations where HCO 3- was low (0.5 and 0.9 m M) or CO2 was locally high, and that HCO 3- affinity was suppressed in the laboratory by high CO2 concentrations.


Magnetic Resonance Enema in Rectosigmoid Endometriosis.
Intestinal endometriosis occurs in 4% to 37% of women with deep endometriosis (DE). Noninvasive diagnosis of presence and characteristics of rectosigmoid endometriosis permits the best counseling of patients and ensures best therapeutic planning. Magnetic resonance enema (MR-e) is accurate in diagnosing DE. After colon cleansing, rectal distention and opacification improves the performance of MR-e in diagnosing rectosigmoid endometriosis. MR imaging cannot optimally assess the depth of penetration of endometriosis in the intestinal wall. There is a need for multicentric studies with a larger sample size to evaluate reproducibility of MR-e in diagnosis of rectosigmoid endometriosis for less experienced radiologists.


High sodium intake is associated with increased glucocorticoid production, insulin resistance and metabolic syndrome.
High sodium (HS) diet is associated with hypertension (HT) and insulin resistance (IR). We evaluated whether HS diet was associated with a dysregulation of cortisol production and metabolic syndrome (MetS). We recruited 370 adults (18-85 years, BMI 29·3 ± 4·4 kg/m(2) , 70% women, 72% HT, 61% MetS). HS diet (urinary sodium >150 mEq/day) was observed in 70% of subjects. We measured plasma hormones, lipid profile, urinary free cortisol (UFC) and cortisol tetrahydrometabolites (THM). Urinary sodium was correlated with UFC (r = +0·45, P < 0·001), cortisol THM (r = +0·41, P < 0·001) and inversely with adiponectin, HDL and aldosterone, after adjusting by age, gender and BMI. Subjects with high, compared with adequate sodium intake (50-149 mEq/day) had higher UFC (P < 0·001), THM (P < 0·001), HOMA-IR (P = 0·04), HT (81% vs 50%, P < 0·001), MetS (69% vs 41%, P < 0·001) and lower adiponectin (P = 0·003). A multivariate predictive model adjusted by confounders showed a high discriminative capacity for MetS (ROC curve 0·878) using four clinical variables: HS intake [OR = 5·6 (CI 2·3-15·3)], HOMA-IR [OR 1·7 (1·3-2·2)] cortisol THM [OR 1·2 (1·1-1·4)] and adiponectin [OR = 0·9 (0·8-0·9)], the latter had a protective effect. High sodium diet was associated with increased urinary cortisol and its metabolites. Also, HS diet was associated with HT, insulin resistance, dyslipidaemia and hypoadiponectinaemia, even when adjusting by confounding variables. Further, we observed that high salt intake, IR and higher cortisol metabolites, alone or combined in a clinical simple model, accurately predicted MetS status, suggesting an additive mechanism in obesity-related metabolic disorders.


Long-term visual outcome of arteriovenous adventitial sheathotomy on branch retinal vein occlusion induced macular edema.
To evaluate long-term visual outcome of arteriovenous adventitial sheathotomy in BRVO-induced macular edema. The visual outcomes of 8 patients following vitrectomy with arteriovenous adventitial sheathotomy for BVO-induced macular edema (surgery group) were retrospectively evaluated. The three-year post-operative visual acuity of the surgery group was compared with that of the conservatively managed controls. All patients were followed for a minimum of 36 months. Mean BCVA (logMAR) in the surgery group changed from 1.10+/-0.34 to 1.19+/-0.70 and to 0.80+/-0.36 at 12 and 36 months, respectively (p=0.959 at 12 months, p=0.018 at 36 months). In the control group, visual acuity improved from 1.15+/-0.43 to 0.43+/-0.44 and to 0.43+/-0.39 at 12 and 36 months, respectively (p=0.015 at 12 months, at p=0.003 at 36 months). A strong trend toward better visual acuity at 12 months and final examination was observed for controls. (surgery vs. control group, p=0.052 at 12 months, p=0.066 at 36 months). Considering the favorable natural course of BVO and the unproven effect of reperfusion on macular edema, surgical efficacy of arteriovenous adventitial sheathotomy requires further evaluation.


Screening for viral markers in volunteer and replacement blood donors in West Africa.
West Africa is a highly endemic area for viral infections. The prevalence of five viral markers was determined in Ghanaian blood donors. Replacement and volunteer blood donors were screened using enzyme immunoassays (EIAs) for hepatitis B surface antigen (HBsAg), human immunodeficiency virus antibodies (anti-HIV), HIV p24 antigen, human T-cell lymphocytotrophic virus-I and -II antibodies (anti-HTLV-I/II) and hepatitis C virus antibodies (anti-HCV). HBsAg was present at an equally high frequency (15%) in young volunteer (median age 18 years) and older replacement (median age 33 years) blood donors. In contrast, the prevalence of anti-HIV and anti-HCV was significantly higher in replacement blood donors (2.4 and 0.3%, respectively, P < 0.001). HCV RNA was detected in 74 or 55% of seropositive donors, depending on the confirmatory criteria used. No p24 antigen-positive/anti-HIV-negative donations were found. The prevalence of HTLV-I/II was generally low (0.5%). All blood donations should be screened for hepatitis B virus (HBV), HIV and HCV markers.


Preparation of new natural silk non-woven fabrics by using adhesion characteristics of sericin and their characterization.
Electro-spun regenerated silk webs have been extensively studied for biomedical applications because of the simplicity of their fabrication methods However, the productivity of the electro-spinning process is low for web fabrication and the mechanical properties of the electro-spun silk web are not satisfactory, which restricts its commercialization. In this study, a new silk non-woven fabric was successfully fabricated by wetting and hot press treatments using the excellent binding characteristic of sericin. The effects of the press temperature and residual sericin content on the preparation, structure, and properties of the silk non-woven fabric were examined. A press temperature of 200°C was optimum for obtaining non-woven fabrics with best mechanical properties, without yellowing. The silk non-woven fabric could not be fabricated without sericin, and a minimum of 8% sericin was required to fabricate it. As the sericin content was increased, the strength and Young's modulus of the silk non-woven fabric increased, while the tensile elongation remained constant. Regardless of the press temperature and sericin content, all the silk non-woven fabrics showed good cell viability, comparable to that of the tissue culture plate (TCP) used as a control until 4days, which however decreased compared to that of TCP after 7days.


HLA Profile of Celiac Disease among First-Degree Relatives from a Tertiary Care Center in North India.
To study the prevalence of Celiac disease (CD) in first-degree relatives (FDR) of CD children. This observational study was performed in FDR (parents and siblings) of consecutive newly diagnosed cases of CD enrolled from January 2011 through March 2012. Screening for CD in FDR was done using IgA tissue transglutaminase (tTG) levels in serum and the seropositive subset underwent upper gastrointestinal (UGI) endoscopy and biopsy to confirm the disease. In addition, HLA analysis for CD was performed in most of the index cases and FDR. Of 202 FDR of the 64 index cases with CD, 17.3 % (35/202) were seropositive for IgA tTG while confirmed biopsy proven CD was diagnosed in 10.2 % (8/78) of children and 8.1 % (10/124) of adults. HLA DQ2/DQ8 was positive in 96.7 % of the index cases and all FDR with confirmed CD. The prevalence of CD among FDR is 9 fold higher than the general population. High prevalence of CD in presence of anemia and short stature in seropositive FDR in index study indicates need of targeted screening of this subgroup for the presence of CD.CD is unlikely in the absence of HLADQ2/DQ8.


The influence of dust on extreme precipitation at a large city in North China.
In recent decades, the Beijing-Tianjin-Hebei city cluster is experiencing rapid urbanization along with economic booming. Meanwhile, these cities are suffering the influence of extreme precipitation and dust storms. In this study, the impact of dust aerosol on extreme precipitation that occurred in Beijing during 19-21 July 2016 is investigated using both satellite retrievals and Weather Research and Forecasting model coupled to Chemistry (WRF-Chem) model simulations. Results reveal that the dust particles can increase extreme precipitation by promoting the formation of ice clouds and enhancing convections. The dust is lifted into the upper troposphere (>10 km) via strong convection and affects the physical process of precipitation after long-range transport. It further transforms the supercooled water into the middle and high levels of ice nuclei (IN). These promote the formation of ice clouds according to the decreased effective radius of IN and increased ice water path, respectively. Along with sufficient water vapor transport and strong convergence, the formation of IN could release more latent heat and further strengthen convection development. Thus, the precipitation amount in southern Beijing is almost enhanced by 40 % (>80 mm). This study will provide a deep insight into understanding the causes of urban extreme precipitation.


[Health care in dementia: satisfaction and needs of the caregiver].
Primary care (PC) and general neurology clinics (NC) assume the leading role in the health care of patients with dementia. There are hardly any studies on the satisfaction of the caregiver at these settings of health care. A questionnaire was designed and distributed to 75 caregivers of patients with dementia who were reviewed in an NC and who had been referred from PC. The questionnaire included questions associated with the care, the use of services, and satisfaction. Sociodemographic and clinical variables were also collected. The results of the questionnaire are described and a simple correlation analysis (Spearman r) was performed to determine the factors associated with satisfaction. The majority of carers were sons or daughters (60%) or spouses (31%), of which 73% were women. The service most used was home help (36%), but 41% of patients had no services available. Satisfaction was high (84% quite or very satisfied with PC, 97% quite or very satisfied with the NC, P<.01). A greater number of years giving care was associated with a lower satisfaction with PC ((r=-0.37, P<.005), while institutionalisation was associated with a lower satisfaction with the NC (r=-0.30, P<.01). In a context of a scarcity of resources, the satisfaction of the caregivers of patients with dementia, as regards health care, was high, possibly due to the motivation of the health professionals and the positive attitude of the caregivers themselves.


Enhancing the 4Cs among college students of a communication skills course in Tanzania through a project-based learning model.
The development of technology has changed the way people communicate in academic contexts as well as working places, for example from print messages to screened messages, and from face-to-face classroom and office meetings to virtual classes and offices. This has prompted the shift from traditional teaching practices to student-centered in which students are guided by their teachers to develop skills for 21st Century careers through the Project-Based Learning model. However, in Tanzania colleges, the teaching of a Communication Skills Course perpetuates traditional teaching practices, which could reduce the chance for students to participate in global democratic activities. Consequently, the present study aimed at exploring how to enhance the 4 C's (critical thinking, communication, collaboration, and creativity) among the college students of the Communication Skills Course in Tanzania through the Project-Based Learning model. Qualitative participatory action research with two cycles was adopted. Data from ten students, one teacher, and the curriculum were collected through observation, document analysis, and reflective journals. Data were analyzed thematically. Findings show that current teaching practices for Communication Skills Course in Tanzania colleges hardly enhance the development of the 4 C's among students. It was also observed that the implementation of PBL resulted in enhancing the 4 C's among college students in Tanzania colleges. However, large class sizes, poor technological infrastructure, and lack of facilities are among the challenges experienced during the implementation of PBL in enhancing the 4Cs. The study recommends the reformation of current teaching practices, to focus on developing skills needed to cope with students' real-life contexts, instead of focusing on content knowledge. Also, the study calls for the adoption of PBL in Tanzania colleges in teaching Communication Skills to develop necessary skills for the 21st Century. To cope with any potential challenges, the study suggests that there should be collaborative efforts among education stakeholders.