Detection of gallbladder disease in patients with normal oral cholecystograms. Results using a simplified biliary drainage technique.
An endoscopic biliary drainage technique was used in the study of 70 patients. All had histories suggestive of gallbladder disease but with normal oral cholecystograms. Of the 29 patients with abnormal drainage studies, 26 had cholecystectomy with all specimens showing cholecystitis, and cholelithiasis was seen in 46%. Five of the 41 patients with normal drainages underwent cholecystectomy, with no abnormality noted in any surgical specimen. Significant differences were seen when the mean WBC count, frequency of leukocytosis, and back pain were compared between the normal and abnormal drainage groups. Biliary drainage is a useful supplemental test when a false-negative oral cholecystogram is suspected.


Sporotrichosis.
Forty-nine patients with culture-proven sporotrichosis were treated between 1957 and 1986. Infections were lymphocutaneous in 36 patients, pulmonary in two, intraarticular in four, and involved multiple deep tissues in seven. Thirty-six infections involved an upper extremity. Five patients with deep infection had some evidence of being immunocompromised. Delay in diagnosis after presentation averaged 4 months overall and 25 months for those with deep infection. Ten of 12 joint infections resulted in significant functional impairment. Treatment with saturated potassium iodide solution was effective for lymphocutaneous infection. Four patients with infection of deeper tissues remain infected despite multiple operations and systemic courses of antifungal medication.


Management of Pink Spot due to Class IV Invasive Cervical Root Resorption using Vital Pulp Therapy: A Case Report.
A 30-year-old male patient with the chief complaint of pink spot discoloration of the tooth crown in his upper left central incisor was referred for endodontic and esthetic management. After thorough clinical and radiographic examinations, the final diagnosis was class IV invasive cervical resorption (ICR) which was conservatively treated with an orthograde approach; i.e. vital pulp therapy with calcium-enriched mixture cement (VPT/CEM). The use of VPT/CEM was successful to restore esthetics and stop the ICR; confirmed clinically, radiographically, and tomographically at one-year recall. The above-mentioned minimally invasive approach reported in the current case study may be considered a practical treatment modality for ICR, specifically in anterior teeth.


Lower-limb joint-coordination and coordination variability during gait in children with cerebral palsy.
Children with cerebral palsy present with poor motor control, altering their ability to perform tasks such as walking. Continuous relative phase analysis is a popular method to quantify motor control impairments via inter-joint coordination and coordination variability; however, it has not been explored in children with cerebral palsy. 45 children with cerebral palsy and 45 typically developing children walked while fit with retroreflective markers. Continuous relative phase analysis for knee-hip and ankle-knee joint pairs quantified inter-joint coordination and coordination variability. The Gait Profile Score estimated gait pathology. Group differences were assessed with unpaired t-tests for coordination amplitude and variability (knee-hip, ankle-knee) across gait events. For the cerebral palsy group, correlations assessed the relation between the gait profile score and coordination metrics. The cerebral palsy group showed more in-phase patterns for knee-hip coupling compared to the typically developing group (initial contact, loading response, mid-stance, terminal swing) (p ≤ 0.03). The cerebral palsy group showed lower knee-hip coordination variability (mid-stance, mid-swing) (p ≤ 0.037) and lower ankle-knee coordination variability (initial contact, loading response, terminal swing) (p < 0.001). The gait profile score correlated weakly to moderately (r = [0.323-0.472]), and negatively with the knee-hip inter-joint coordination (initial contact, loading response, mid-stance, terminal swing) (p ≤ 0.042). Children with cerebral palsy showed a more in-phase gait strategy during challenging transitional gait cycle phases (beginning and end) and less flexible and adaptable motor behaviors. Moreover, the correlation between in-phase joint patterns and increased gait deviations (gait profile score) reinforces the relevance of coordination analysis to assess motor control impairment.


Gamete intrafallopian transfer (GIFT) complicated by bilateral ectopic pregnancy.
A case of bilateral tubal ectopic pregnancies following GIFT is reported. Subsequent pathology revealed follicular salpingitis in both salpingectomy specimens. The need for evaluation of potential risk factors for ectopic gestation following GIFT is discussed.


Superior limbic keratoconjunctivitis in contact lens wearers.
Forty patients with daily wear, cosmetic contact lenses (CL) presented with symptoms of ocular irritation and a keratoconjunctivitis clinically resembling superior limbic keratoconjunctivitis (SLK). Typically the patients were either successful hard CL wearers who changed to soft lenses and used a chemical aseptisizing solution or preserved saline solution, or successful soft CL wearers using salt tablets who switched to a preservative-containing system. In all cases, exposure to thimerosal-preserved solutions was documented. Upon discontinuation of lens wear, all signs and symptoms slowly resolved without permanent sequelae. Positive skin and ocular sensitivity reactions to thimerosal were present in one-third (5/15) of patients tested. Light and transmission electron microscopic examination of conjunctival specimens disclosed intercellular epithelial edema, pseudoepitheliomatous hyperplasia, acute and chronic inflammation, and decreased numbers of goblet cells. Exposure to thimerosal is implicated in the etiology of contact lens-superior limbic keratoconjunctivitis (CL-SLK).


The relationship between the antiviral action of interferon and prostaglandins in virus-infected murine cells.
The relationship between prostaglandins (PG) and interferon (IFN) was investigated. IFN induced the synthesis of immunoreactive PGE and PGA at early and late stages, respectively, of vaccinia virus infection in mouse L fibroblasts. Only species-specific IFN possessed this activity and PG synthesis was stimulated in virus-infected cells, while normal L cells were not affected. The vaccinia virus infection did not significantly alter PG synthesis in the absence of IFN. Indomethacin increased the rate of vaccinia virus replication and partially inhibited the IFN-induced protection of L cells. The addition of exogenous PGA1 only partially reversed this effect. Finally, short-term PGA treatment induced the synthesis of two enzymes (protein kinase and 2,5A synthetase) thought to be partially responsible for the antiviral action of interferon. These findings suggest that a prostaglandin or PG-related compound seems to mediate at least one aspect of IFN action.


Protocol to identify multiple protein targets and therapeutic compounds using an in silico polypharmacological approach.
Polypharmacology aids in the identification of multiple protein targets involved in disease pathology and selecting appropriate therapeutic compounds interacting with protein targets. Here, we present a protocol to identify the targets involved in obesity-linked diabetes and suitable phytocompounds to bind with the identified target. We describe steps to install and use softwares for identifying several protein targets by linking multiple diseases. This protocol allows the use of therapeutic compounds of both phytochemical and synthetic origins. For complete details on the use and execution of this protocol, please refer to Martiz et al.,1 and Maradesha et al.2.


Combined stent-graft and surgical treatment for a thoracoabdominal aortic aneurysm in a high risk patient.
We report a case of thoracoabdominal aortic aneurysm (TAAA) Crawford type I with high-risk factors. A 74-year-old woman, who had a history of myocardial infarction with severe left ventricular dysfunction, asthma, and hypothyroidism, underwent endovascular stent-graft replacement for TAAA and simultaneous surgical reconstruction of the visceral arteries to avoid thoracotomy and extracorporeal circulation. Postoperatively she suffered from weakness of the left leg, with suspected paraparesis, but recovered muscular strength to some extent and was discharged in a wheelchair on postoperative day 74.


Study on therapeutic action of bone marrow derived mesenchymal stem cell combined with vitamin E against acute kidney injury in rats.
The study aims to investigate the effect to treat acute kidney injury (AKI) with bone marrow derived mesenchymal stem cells (BMSCs) combined with vitamin E and to develop a new treatment mode for AKI preclinical study. BMSCs were separated from rat bone marrow. Gentamicin was used as a damage factor in the culture of renal tubular epithelial cells (RTECs) in vitro. After co-cultured with BMSCs and vitamin E, cell proliferation of each group was detected with CCK-8. In vivo, BMSCs (3.3×10(6)cells/kg) combined with vitamin E (80mg/kg) were administered in AKI rats induced by gentamicin intravenously. The pathological changes, biochemical parameters and apoptosis genes after treatment were investigated furthermore. In co-cultured system, proliferating ability of RTECs was improved by BMSCs or vitamin E, especially for the combined group (P<0.05). The treated rats in combined group presented the lowest serum creatinine and the highest urea nitrogen compared to non-treated rats. The improvement in renal pathological changes was followed by less necrosis, degeneration and expansion of renal tubule. Under transmission electron microscope, unclear cell structure and reduction of endoplasmic reticulum in the cytoplasm of RTECs were ameliorated with the treatment. Most apoptosis genes were up-regulated in model group while down-regulated with the therapy. Further analysis showed that the two treatments may act independently with each other. Our data demonstrated that both BMSC and vitamin E hold therapeutic action to AKI induced by gentamicin. Especially, the combined treatment is better than BMSC or vitamin E alone.


Central body temperature as a guide to optimal heart rate.
Studies in man suggest that fixed-rate artificial pacemakers do not return hemodynamic function to normal, since the principal mechanism for the increase in cardiac output with exercise, increased heart rate, is not restored. Special pacemakers are available that can detect atrial activity and pace the ventricles in coordination, but nearly half of the patients receiving artificial pacemakers have abnormal atrial function (atrial fibrillation, sick sinus syndrome). This study examined the effects of exercise on the temperature of blood returning to the right atrium. Precision thermistors, placed in the right hearts of conscious dogs, recorded temperature increases of 1 degree C (range 0.4-1.5 degrees C) during submaximal treadmill exercise. Temperature change correlated well with work load and changes in heart rate.


A review of the validity and reliability of smokeless tobacco dependence measures.
With the growing marketing of alternate tobacco products, advocacy of harm reduction, and smoke free air policies, an overall increase in Smokeless Tobacco (ST) use has been observed since the 1970s. Numerous studies have been published addressing nicotine dependence measures for smokers; however, research in the field of ST dependence measures is scarce. The aim of this study is to summarize the psychometric properties of ST dependence measures by evaluating the reliability and validity of these scales through peer review research. A systematic literature search was conducted within the databases of PubMed and OVID Medline. Four publications reporting on the psychometric properties of ST dependence measures were identified; two regarding FTQ based scales, one regarding an FTND based scale, and one comparing two of these modified scales. A predefined set of criteria was used to assess the psychometric properties of these measures. ST dependence measures depend heavily on two underlying factors, heaviness of tobacco use and withdrawal. The internal consistency of the measures was low to moderate, Cronbach's α ranging from 0.30 to 0.52 Cotinine was used as criterion variable to validate the results of the dependence measures. Concurrent validity against DIS-IV-ND based diagnosis was not established for modified FTQ scale. Predictive validity of these ST dependence scales was measured as abstinence of ST use at three and six months. FTQ-ST was predictive of abstinence at three months however failed to predict six months abstinence. FTQ and FTND based measures have inherited shortcomings and have limited psychometric properties. With ease of use and wide application in tobacco research, these measures provide preliminary foundation for studying ST dependence. However, the complexity of tobacco dependence requires a multidimensional measure with high validity and reliability for effective prevention care and for research purposes.


Recent Advances in Unveiling the Role of Beta-Herpesviruses in Autoimmune Diseases.
A dysregulated immune response can lead to recognition of self-antigens as non-self-antigens, leading to failure of the immune tolerance toward normal cells and tissues, and the consequent development of a variety of autoimmune diseases [...].


Revealing the relationship between molecular weight of lignin and its color, UV-protecting property.
Lignin has great potential as a natural, green, and sustainable broad-spectrum sunscreen active ingredient. However, the coexistence of dark color and sunscreen properties hinders its application in cosmetics. In this study, we focus on the effects of the molecular weight of lignin on tis UV-protecting property and color in order to prepare lignin-based sunscreen with high performance. A prepared sunscreen containing low molecular weight lignin (F5, <1000 g/mol) exhibits good UV-protecting property (sun protection factor (SPF) = 7.14) and light color advantages (ΔE = 46.2). Moreover, a strong synergistic effect on UV-protecting property exists between low molecular weight lignin and ethylhexyl methoxycinnamate (EHMC), resulting in high SPF of F5@EHMC-based sunscreen (55.56). Additionally, added TiO2 can efficiently mitigate the dark color of lignin-based sunscreens due to prominent covering power of TiO2. Moreover, lignin-based sunscreens have good biocompatibility with HaCaT cells. This work is useful for understanding the mechanism of the UV-protecting property and dark color of lignin, and for designing an efficient and safe lignin-based sunscreen.


Endometriosis: a reappraisal of pathogenesis and treatment.
The enigmatic disease of endometriosis continues to baffle both the scientist and the clinician. An encompassing theory of pathogenesis has failed to emerge from contemporary understanding of the immunologic manifestations, the hormonal aberrations, or the evasive infertility associated with endometriosis. Similarly unsettling is the failure of medical or conservative surgical maneuvers to eradicate endometriosis in a manner commensurate with castration. It is hoped that further insight into these areas of research will resolve both of these dilemmas.


Comparison of image quality and radiation dose between combined automatic tube current modulation and fixed tube current technique in CT of abdomen and pelvis.
Tube current is an important determinant of radiation dose and image quality in X-ray-based examination. The combined automatic tube current modulation technique (ATCM) enables automatic adjustment of the tube current in various planes (x-y and z) based on the size and attenuation of the body area scanned. To compare image quality and radiation dose of the ATCM with those of a fixed tube current technique (FTC) in CT of the abdomen and pelvis performed with a 16-slice multidetector row CT. We reviewed 100 patients in whom initial and follow-up CT of the abdomen and pelvis were performed with FTC and ATCM. All acquisition parameters were identical in both techniques except for tube current. We recorded objective image noise in liver parenchyma, subjective image noise and diagnostic acceptability by using a five-point scale, radiation dose, and body mass index (BMI, kg/m(2)). Data were analyzed with parametric and non-parametric statistical tests. There was no significant difference in image noise and diagnostic acceptability between two techniques. All subjects had acceptable subjective image noise in both techniques. The significant reduction in radiation dose (45.25% reduction) was noted with combined ATCM (P < 0.001). There was a significant linear statistical correlation between BMI and dose reduction (r = -0.78, P < 0.05). The ATCM for CT of the abdomen and pelvis substantially reduced radiation dose while maintaining diagnostic image quality. Patients with lower BMI showed more reduction in radiation dose.


A review of potential human health impacts of micro- and nanoplastics exposure.
This systematic review aims to summarize the current knowledge on biological effects of micro- and nanoplastics (MNPs) on human health based on mammalian systems. An extensive search of the literature led to a total of 133 primary research articles on the health relevance of MNPs. Our findings revealed that although the study of MNP cytotoxicity and inflammatory response represents a major research theme, most studies (105 articles) focused on the effects of polystyrene MNPs due to their wide availability as a well characterised research material that can be manufactured with a large range of particle sizes, fluorescence labelling as well as various surface modifications. Among the 133 studies covered in this review, 117 articles reported adverse health effects after being exposed to MNPs. Mammalian in vitro studies identified multiple biological effects including cytotoxicity, oxidative stress, inflammatory response, genotoxicity, embryotoxicity, hepatotoxicity, neurotoxicity, renal toxicity and even carcinogenicity, while rodent in vivo models confirmed the bioaccumulation of MNPs in the liver, spleen, kidney, brain, lung and gut, presenting adverse effects at different levels including reproductive toxic effects and trans-generational toxicity. In contrast, the remaining 16 studies indicated an insignificant impact of MNPs on humans. A few studies attempted to investigate the mechanisms or factors driving the toxicity of MNPs and identified several determining factors including size, concentration, shape, surface charge, attached pollutants and weathering process, which, however, were not benchmarked or considered by most studies. This review demonstrates that there are still many inconsistencies in the evaluation of the potential health effects of MNPs due to the lack of comparability between studies. Current limitations hindering the attainment of reproducible conclusions as well as recommendations for future research directions are also presented.


Detection of ESBL among AmpC producing enterobacteriaceae using inhibitor-based method.
The occurrence of multiple β-lactamases among bacteria only limits the therapeutic options but also poses a challenge. A study using boronic acid (BA), an AmpC enzyme inhibitor, was designed to detect the combined expression of AmpC β-lactamases and extended-spectrum β-lactamases (ESBLs) in bacterial isolates further different phenotypic methods are compared to detect ESBL and AmpC. A total of 259 clinical isolates of Enterobacteriaceae were isolated and screened for ESBL production by (i) CLSI double-disk diffusion method (ii) cefepime- clavulanic acid method (iii) boronic disk potentiation method. AmpC production was detected using cefoxitin alone and in combination with boronic acid and confirmation was done by three dimensional disk methods. Isolates were also subjected to detailed antibiotic susceptibility test. Among 259 isolates, 20.46% were coproducers of ESBL and AmpC, 26.45% were ESBL and 5.40% were AmpC. All of the 53 AmpC and ESBL coproducers were accurately detected by boronic acid disk potentiation method. The BA disk test using Clinical and Laboratory Standards Institute methodology is simple and very efficient method that accurately detects the isolates that harbor both AmpCs and ESBLs.


Fatal automobile accident due to airbag misdeployment.
The purpose of this case report was to demonstrate a fatal motor vehicle accident in which a 33-year-old man died at the scene immediately after his car collided with the roadside curbstone at a normal speed. The autopsy of the deceased body revealed a penetrating injury on the neck as he was struck by the deployed airbag. Pathological examination showed the offending material to be a fractured cylinder-shaped metal piece, which had settled within the fourth cervical vertebral body. Further forensic engineering investigation of the airbag unit found that the metal fragment originated from a defective airbag gas generator, which had exploded upon deployment. These findings reflect on the increasing popularity of airbag-associated trauma across the globe in recent years. We suggest an effective management plan for the evaluation and mitigation of the complications associated with airbag-related incidents.


Effects of color on perceptual and conceptual tests of implicit memory.
Two experiments are reported that explore why recent investigations of implicit memory failed to find any effects of color information on test performance. In the first experiment, participants studied colored pictures as well as words printed in colored ink without any memory instructions. During the test phase, a verbal and a pictorial version of a color-choice task (a conceptual priming test) were compared to two perceptual tests (word-stem completion and picture-fragment identification). Similar and significant amounts of priming to color occurred in both color-choice tasks. The perceptual tests were found to be sensitive to changes in the stimulus-presentation mode from study to test, but stimuli remaining the same color and those changed to black-and-white did not differ in the priming scores. In the second experiment, a mild division of attention was introduced in the study phase. Once again, priming to color was observed only in the verbal version of a color-choice test and not in the word-stem completion test. Dividing attention did not decrease performance on both implicit tests, whereas an explicit test of color recall for studied pictures suffered from dividing attention at encoding. It is concluded that a perceptual attribute such as color may be represented and coded by conceptual processing. Furthermore, automatic (or not attention-demanding) encoding processes may suffice for later conceptual tests of implicit memory. Previous failures to find any effects of color information on implicit performance are attributed to the use of perceptual priming tests.


Generation and reactivity of the dehydrotropylium-Co2(CO)6 ion.
Dehydrotropylium-Co(2)(CO)(6) ion (2) has been generated by the Lewis acid mediated ionization of alcohol (3); it is attacked by relatively strong nucleophiles (N>1), but undergoes a radical homocoupling in the presence of weak nucleophiles (N<1).


The use of simulated crime scenes in teaching undergraduate forensic sciences: Implementing an active learning approach to forensics.
Incorporating a simulated crime scene into one's pedagogy in forensic science undergraduate courses allows students the opportunity to experience a realistic scenario while demonstrating their knowledge and enhancing their critical thinking skills. The purpose of this paper is to examine an active learning approach to using simulated crime scenes to provide an impactful learning experience for students. While potentially challenging for the instructor, constructing a crime scene scenario can provide students with hands-on practical experience while helping to dispel forensic science misconceptions. Through many years of creating crime scenes, best practices for using such high impact activities in forensic science courses are described in detail, including preparatory exercises that culminate in the final crime scene scenario, considerations in preparing and constructing a crime scene activity, and supervising and assessing students once the activity begins. Three major challenges to implementing active learning exercises such as simulated crime scenes in undergraduate forensic science programs include high workload for instructors, limited supplies, and lack of suitable facilities. Workload solutions include instructors and departments considering the cost and benefit of course releases to improve curriculum and student enrollment. Supplies and facilities solutions involve innovation in reuse and repurposing of supplies, and instructor flexibility in using classroom and outdoor spaces.


Hepatitis C virus presumably associated bilateral consecutive anterior ischemic optic neuropathy.
To report a case of bilateral nonarteritic anterior ischemic optic neuropathy (NAION) in a hepatitis C (HCV) infected patient and demonstrate the relationship between HCV and the development of NAION. Case report. A 43-year-old woman with chronic HCV infection and long-term euthyroid autoimmune thyroiditis suddenly lost vision in her right eye, and 6 months later in her left eye, due to NAION. Slightly elevated levels of aminotransferases suggested liver infection activity. Anti-HCV antibody was detected; the genotype of the virus was 1b and the viral RNA level was 1.8 x 106 IU/mL. Liver biopsy proved chronic active hepatitis (Ishak score grading: 7, staging: 2). Except for the elevated levels of antithyroid antibodies and a weak antinuclear factor, the detailed laboratory examinations (thrombophilia, cryoglobulin, anticardiolipin antibodies, co-infections) revealed no other abnormalities; a causative relationship between the underlying chronic hepatitis C and bilateral NAION therefore seems probable. The patient was treated with pegylated interferon and ribavirin for 1 year and a sustained viral remission could be achieved. Her vision has neither improved nor deteriorated further. This appears to be the first reported case of bilateral NAION presumably caused by HCV infection.


Are Biometric Parameters Helpful to Assess the Health Risk of Consuming Organochlorine Compounds Contaminated Silver European Eel (Anguilla anguilla)?
Several organochlorine compounds (OCs) were measured in European eels from the Tevere river (Italy). It followed that some of them are still important chemical contaminants. Concentrations of dichlorodiphenyltrichloroethanes (DDTs) are hazardous for the consumer health; those of the 6 indicator polychlorinated biphenyls (PCBs) are often close to the current European maximum residue limit and always higher than the former limit. The relationship between OC concentrations, biometric parameters and the lipid content was then investigated. A strong positive correlation with eel size emerged for the indicator PCBs and DDTs concentrations expressed on wet weight basis. This is explained by the corresponding higher lipid percentage that characterizes bigger eels and the absence of a dilution effect for compounds of main concerns. On the basis of the PCB-TDI threshold for a 70 kg person, we suggest that 1 should consume no more than 2 eels per week each weighing about 100 g. Thus, we conclude that eel consumption should be limited and restricted to eels relatively shorter and lighter.


Personality traits within a pediatric surgery fellowship applicant pool.
The Big Five framework examines five factors that represent a description of human personality. These factors correlate with success measures and job satisfaction. The Big Five Inventory is a 44-item instrument designed to measure the Big Five framework. Our aim was to document the distribution of Big Five personality traits among Pediatric Surgery fellowship applicants, compare with community norms, surgical residents, between genders, and correlate to the fellowship match results. Forty Pediatric Surgery fellowship applicants at a university hospital completed the Big Five Inventory during the interview process. It was analyzed and compared with general surgery residents' results and community norms. The data were compared regarding gender and match results. Continuous variables were compared by unpaired t-tests and Mann-Whitney tests. A P value <0.05 was considered significant. The 40 applicants were equally divided between male and female. When compared with general surgery residents and community norms, applicants of both genders scored higher on agreeableness (P < 0.01), conscientiousness (P < 0.01), and emotional stability (P < 0.01). Applicants scored higher on openness when compared with surgical residents (P < 0.01). Male applicants scored higher on emotional stability than females (P = 0.026). Matched applicants scored higher for conscientiousness than unmatched applicants (P = 0.016). Pediatric Surgery fellowship applicants expressed higher levels of desirable professional traits compared with general surgery residents and community norms. Male applicants demonstrated higher emotional stability than females. Conscientiousness was higher in matching applicants. This first reported experience with personality testing in Pediatric Surgery fellow selection demonstrated potential utility in applicant matching.


Asthma, chronic obstructive pulmonary disease, tooth loss, and edentulism among adults in the United States: 2016 Behavioral Risk Factor Surveillance System survey.
Adults with chronic respiratory conditions, specifically asthma or chronic obstructive pulmonary disease (COPD), may be at risk of experiencing poor oral health due to systemic inflammation, challenges in routine oral health care, and adverse effects of medications used to treat these conditions. The authors examined the association of asthma, COPD, and coexisting asthma and COPD (asthma-COPD overlap syndrome [ACOS]) with tooth loss among US adults. The authors conducted a cross-sectional study using 2016 Behavioral Risk Factor Surveillance System data (N = 387,217). The authors categorized the participants with missing permanent teeth into 4 groups: asthma only (n = 38,817), COPD only (n = 19,819), ACOS (n = 13,494), no asthma, no COPD (n = 315,087). The authors used adjusted multinomial logistic regressions to examine the associations between asthma and COPD categories and tooth loss. According to the authors, 5.3% of study participants reported they were edentulous; 10.7% reported 6 or fewer missing teeth. Participants with asthma only, COPD only, and ACOS had higher odds of reporting tooth loss (6 or more teeth) than those in the no asthma, no COPD group; adjusted odds ratios were 1.12 (95% confidence interval, 1.00 to 1.26) to 2.04 (95% confidence interval, 1.85 to 2.26). A lower percentage of participants with COPD and ACOS visited dentists in the past year than those with no asthma and no COPD. Interactive associations suggested participants with asthma or COPD with dental visits were less likely to report edentulism than those with neither asthma nor COPD and no dental visits. Participants with asthma or COPD had higher odds of tooth loss compared with those with neither asthma nor COPD. People with asthma or COPD should maintain routine dental visits to reduce the risk of experiencing tooth loss.


Vaccination against tuberculosis: is BCG more sinned against than sinner?
While extensive experimental studies of tuberculosis (Tb) have provided the foundation data for the discovery of cell-mediated immunity, there remains much to be disclosed about the critical pathways of immunity involved in this infectious process and the factors necessary to produce protective immunity. Studies on the aetiology and pathology of this disease have failed to elucidate the mechanisms of protective immunity. Although Tb research has been neglected for the past 30 years, the re-emergence of Tb worldwide as a significant zoonotic disease has re-focused research in this area. Scientific solutions for the control of Tb in man or domestic animals have not been found using empirical methods. Composite studies involving animal models of experimental infection will be necessary to critically evaluate vaccine efficacy and eludiate the basic immunological mechanisms involved in both disease and immunity. Available data which suggest that disease-related hypersensitivity and immunity are dissociable highlight the prospect that immunity to infection may be induced without compromising the continued need for ongoing systems of immunodiagnosis to exclude disease. In populations with a high prevalence of disease it is likely that a combination of immunodiagnosis, chemotherapy and immunoprophylaxis will be required to eradicate the disease.


The usefulness of Olanzapine plasma concentrations in monitoring treatment efficacy and metabolic disturbances in first-episode psychosis.
The role of Olanzapine therapeutic drug monitoring is controversial. The present study explores the associations of Olanzapine plasma concentrations with clinical response and metabolic side effects in first episode psychosis (FEP) after 2 months of treatment. Forty-seven patients were included. Improvement in clinical symptomatology was assessed using the PANSS. Metabolic assessment included weight, blood pressure, waist circumference, blood glucose, total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides. The Olanzapine plasma concentrations after 2 months of treatment were positively correlated with weight gain (r = 0.49, p = 0.003), and a concentration > 23.28 ng/mL was identified as a positive predictor of weight gain (≥ 7%). The Olanzapine concentration to dose (C/D) ratio was positively correlated with the percentage of improvement in the total PANSS (r = 0.46, p = 0.004), and a C/D ratio > 2.12 was identified as a positive predictor of a good response (percentage of improvement > 30%) after 2 months of treatment. We also identified several factors that could alter Olanzapine pharmacokinetics: gender (p = 0.03), diagnosis (p = 0.05), smoking habit (p = 0.05), and co-medications such as valproic acid (p = 0.05) and anxiolytics (p = 0.01). In conclusion, our results suggest that therapeutic drug monitoring of Olanzapine could be helpful to evaluate therapeutic efficacy and metabolic dysfunction in FEP patients treated with Olanzapine.


Recurrent late-onset fibrotic capsular block syndrome after neodymium-yttrium-aluminum-garnet laser anterior capsulotomy: a case report.
Capsular block syndrome is an uncommon complication that occurs after cataract surgery. It is characterized by capsular distension, anterior intraocular lens displacement, anterior chamber shallowing, and unexpected myopic shifts. We report a case of recurrent fibrotic capsular block syndrome with Elschnig's pearl-type posterior capsule opacification 10 months after neodymium-yttrium-aluminum-garnet (Nd:YAG) laser anterior capsulotomy. A 72-year-old Asian man complained of decreased visual acuity 5 years after undergoing phacoemulsification with posterior chamber lens implantation. Under slit-lamp examination, late postoperative capsular block syndrome was diagnosed and Nd:YAG laser anterior capsulotomy was performed. Ten months after anterior capsulotomy, the patient returned with decreased visual acuity and was diagnosed with recurrent fibrotic capsular block syndrome. Nd:YAG laser posterior capsulotomy was performed. We found that fibrotic capsular block syndrome could recur with Elschnig's pearl-type posterior capsule opacification after Nd:YAG laser anterior capsulotomy for late postoperative capsular block syndrome without posterior capsule opacification.


[Morbidity due to intracerebral hemorrhage].
Intracerebral hemorrhage (HIC) represents 10-30% of all stroke. Epidemiological studies have shown factors associated with its high mortality, but those which might lead to lower morbidity are little known. To find the factors which may influence the functional state of a series of patients with intracerebral hemorrhage. We made a prospective study of 203 patients with intracerebral hemorrhage. We recorded vascular risk factors, arterial blood pressure, laboratory and neuroimaging parameters obtained on admission. The functional condition when discharged from hospital was evaluated on the Rankin Scale, in three categories: independent (Rankin 0-1), partially dependent (Rankin 2-3) and totally dependent patients (Rankin 4-5). There was a 23.2% death rate. Of the 156 patients who survived, at the time of hospital discharge 35.8% had a score of 0-1, 50.6% a score of 2-3 and 13.4% a score of 4-5 on the Rankin Scale. Age (p < 0.005), hyperglycaemia (p < 0.05) and size of hemorrhage (p < 0.05) were associated with increased morbidity. The functional condition on hospital discharge was better in younger patients with lower levels of glycemia on admission and smaller hematomas on CT.


Neuropathic bladder dysfunction in patients with motor complete and sensory incomplete spinal cord lesion.
A retrospective study of patients with motor complete spinal cord lesion and somatosensory preservation (American Spinal Injury Association (ASIA) impairment scale B). To determine whether neuropathic bladder dysfunction is more or less severe with more or fewer complications in patients with somatosensory preservation. 2nd Department of Physical and Rehabilitation Medicine, Neuropathic Bladder Unit, National Rehabilitation Center, EIAA, Athens, Greece. The classification of spinal cord injured patients was determined according to ASIA protocol. All patients underwent urodynamics and retrograde cystography, with a follow-up period of at least 18 months. The study sample consisted of 154 patients: 28 ASIA B patients compared with 126 ASIA A patients. We analyzed 140 traumatic and 14 nontraumatic lesions for (1) specific type of neuropathic bladder, (2) detrusor overactivity volume and pressure, (3) bladder compliance, (4) vesicoureteric reflux, (5) formation of bladder stones, (6) method of bladder emptying and (7) daily dose of anticholinergics needed to achieve safe bladder function. We also studied the presence of spasticity, autonomic dysreflexia and pain syndrome. Statistically significant differences were found between ASIA A and B patients in daily dose of anticholinergics needed to achieve safe bladder function, in the incidence of incontinence episodes and in formation of bladder stones. Patients with somatosensory incomplete lesion of spinal cord seem to have an advantage in the management of neuropathic bladder dysfunction (fewer anticholinergics needed, fewer incontinence episodes and fewer bladder stones).


Hemodynamic benefit of atrioventricular synchrony: prediction from baseline Doppler-echocardiographic variables.
The purpose of this study was to determine if baseline Doppler-echocardiographic variables of systolic or diastolic function could predict the hemodynamic benefit of atrioventricular (AV) synchronous pacing. Twenty-four patients with a dual chamber pacemaker were studied. Baseline M-mode and two-dimensional echocardiograms were obtained and Doppler-echocardiographic measurements of mitral inflow and left ventricular outflow were made in VVI mode (single rate demand) and in VDD (atrial synchronous, ventricular inhibited) and DVI (AV sequentially paced) modes at AV intervals ranging from 50 to 300 ms. Forward stroke volume and cardiac output were determined in each mode at each AV interval from the left ventricular outflow tract flow velocities, and the percent increase in cardiac output over VVI mode was determined. M-mode measurements, including left ventricular end-diastolic dimension, shortening fraction and left atrial size and Doppler measurement of diastolic filling, including peak early velocity and percent atrial contribution, did not correlate with the percent increase in cardiac output during physiologic pacing. The stroke volume in VVI mode correlated significantly with the percent increase in cardiac output during physiologic pacing (r = -0.61, p less than 0.005 for VDD mode and r = -0.55, p less than 0.05 for DVI mode). Five of the 15 patients with VVI stroke volume less than 50 ml but none of the 9 patients with stroke volume greater than 50 ml had ventriculoatrial (VA) conduction.(ABSTRACT TRUNCATED AT 250 WORDS)


[Collagenase inhibition: an experiment in the treatment of scleromalacia perforans (author's transl)].
Report on local application of Cystin eye drops in a case of scleromalacia perforans. This medication brought the necrotizing disease process to a standstill. There was even discrete neoformation of scleral tissue, which we attribute to the collagenase inhibiting action of this drug.


Evaluation of predictor factors of psychological distress in women with unexplained infertility.
The objective of this study was to establish the frequency of anxiety and depressive symptoms among women diagnosed with unexplained infertility and to identify risk factors. We conducted a descriptive cross-sectional study. Forty-two women from the CHU de Quebec fertility clinic were recruited. Women completed the 'Hospital Anxiety and Depression Scale' (HADS) self-administered questionnaire, used to estimate prevalence of anxiety and depressive symptoms (score ≥ 8). Overall, 55% (n = 23) of participants were identified with anxiety or depressive symptoms according to the HADS questionnaire. Anxiety symptoms were more frequent (55%) compared with depressive symptoms (10%). According to a logistic regression model, being under 35 years old [odds ratio (OR) = 16.6, confidence interval (CI): 1.9-25.0], never had a previous spontaneous abortion (OR = 5.6, CI: 1.1-43.5) and never sought fertility treatment (OR = 5.5, CI: 1.1-45.4) were associated with a higher risk of anxiety and depressive symptoms. Anxiety and depressive symptoms are common among women with unexplained infertility, and strategies should be developed to better support and treat this high-risk population.


CD200 expression in mantle cell lymphoma identifies a unique subgroup of patients with frequent IGHV mutations, absence of SOX11 expression, and an indolent clinical course.
CD200, a marker currently utilized in the diagnosis of B-cell lymphoma, is uniformly positive in chronic lymphocytic leukemia/chronic lymphocytic leukemia, and is usually absent in mantle cell lymphoma. Over a 6 year-period, of 668 mantle cell lymphoma assessed by flow cytometry, CD200 expression was detected in 25 patients (~4%). All 25 patients had bone marrow involvement; however, 11 (44%) patients had no nodal or extranodal disease and belonged to non-nodal leukemic variant mantle cell lymphoma. Morphologically, bone marrow showed an unusual interstitial infiltrative pattern in 14/25 (56%) and small round cells resembling chronic lymphocytic leukemia in 9/25 (36%). CD23 was positive in 19/25 (76%) patients; and SOX11 was only positive in 5/21(24%). All 4 patients tested showed IGHV mutations. With a median follow-up of 23 months, 12/24 (50%) patients were not treated. These clinicopathological features were significantly different from 154 randomly chosen CD200-negative mantle cell lymphoma patients, in SOX11 positivity (24% versus 74%, P<0.0001), CD23 expression (76% versus 8%, P<0.0001), a non-nodal leukemic presentation (44% versus 2%, P<0.001), and therapy requirement (50% versus 92%, P<0.0001). This is the first study to show that CD200 expression in mantle cell lymphoma, though uncommon, identifies a subgroup of mantle cell lymphoma patients with characteristic pathological features, frequent non-nodal leukemic variant, and an indolent clinical course.


The Application of Uniportal Video-Assisted Thoracoscopic Anatomical Segmentectomy for Lung Resection: A Retrospective Clinical Study.
Video-assisted thoracoscopic surgery (VATS) is a new area of exploration and evolution in thoracic minimal invasive surgery. The uniportal VATS approach has become popular during lung resection for small nodules and ground glass lesions. Our objective is to investigate the efficacy, availability and safety of uniportal VATS anatomical segmentectomy compared with conventional VATS in patients for lung resection. Surgical patients of perioperative period who admitted and underwent uniportal, two-port and conventional three-port VATS segmentectomy were analyzed and compared retrospectively during the year 2017 to 2018. During the research period, of 111 patients who had VATS anatomical segmentectomy, 38 underwent uniportal, 43 underwent two-port, and 30 underwent three-port VATS. Four patients underwent conversion to thoracotomy. There were no postoperative mortalities, and there were no significant differences among the three groups in surgical outcomes, including operative time, blood loss, conversions to thoracotomy, drainage time and volume, lymph node dissection, postoperative complications and hospital stay. The pain scores of visual analog scale (VAS) significantly decreased in uniportal group when operation is finished (P < 0.05). This study demonstrates that uniportal VATS anatomical segmentectomy is a quite safe surgical technology, as well as feasible, which can cause reduced postoperative pain and less surgical trauma compared to conventional VATS. More experiences and observations of large samples are on the way.


End-of-life fishing gear in Spain: Quantity and recyclability.
European Commission has approached the challenge of End-Of-Life (EOL) fishing gear and Abandoned, Lost, or otherwise Discarded Fishing Gear (ALDFG) by focusing on circular economy. Current directives highlight the need to provide a proper management to EOL fishing gears, fostering their separate collection, transport, and treatment from a circular perspective. They also request Member States to set collection and treatment targets. However, this is far from being widely implemented in a coordinated manner. In the quest to explore the Spanish case, this contribution aims at providing insights on the amount and type of EOL fishing gear and management practices carried out in different Spanish ports, as well as recycling options for such gears. Data was collected through an online survey, interviews to stakeholders, and visits to ports. Composition, degradation and mechanical recyclability of EOL samples were assessed. Yearly, 1643 tonnes of EOL fishing gear (mainly nets) are discarded in Spanish ports from trawling (97.5%), gillnet/trammel nets (2.3%) and purse seine (0.2%) fisheries. High-density polyethylene (from trawling nets) is the most common discarded polymer, followed by polyamide 6 (from gillnets/trammel net and purse seine nets). EOL fishing gear management is diverse in Spain as it depends on the nature of the port (who governs it, either regional or national govern), special agreements between local fishers' guilds and waste managing companies, the waste managers in port, etc. Polyamide nets are degraded but in good condition to be recycled mechanically; for trawl nets chemical recycling is more suited due to their degraded state. Currently, few recycling companies exists in Spain that are engaged on mechanical recycling of EOL fishing gears, none in chemical recycling. Therefore, a more comprehensive analysis, coordination, and smart logistics are needed to make the collection and recycling of EOL fishing gear possible.


Functional characterization of an uncoupling protein in goldfish white skeletal muscle.
Uncoupling proteins (UCP) are able to increase H(+) leakage across the inner mitochondrial membrane, thus dissipating the membrane potential and increasing oxygen consumption. Despite the identification of several UCP orthologs in birds, reptiles, amphibians and fish, little is known about their functional properties in fish. The aim of this work was to identify and characterize a UCP in mitochondria found in goldfish white skeletal muscle. Western blot analysis, using a polyclonal antibody raised against mammalian UCP3, showed a single band at approximately 32 kDa. During non-phosphorylating respiration, we observed that palmitate promoted a dose-dependent increase in oxygen consumption that is abolished by addition of BSA (fatty acid chelator). Interestingly, this palmitate-induced increase in oxygen consumption was not inhibited by GDP, a well-known UCP inhibitor. In phosphorylating mitochondria, palmitate lowered both ADP/O ratio (number of atoms of phosphorus incorporated as ATP per molecule of O2 consumed) and the respiratory control ratio. Moreover, we found that different fatty acids can modulate mitochondrial membrane potential. In conclusion, our results suggest that goldfish UCP is functionally similar to the UCP found in other species, including mammals.


GP consultation rates for sequelae after acute covid-19 in patients managed in the community or hospital in the UK: population based study.
To describe the rates for consulting a general practitioner (GP) for sequelae after acute covid-19 in patients admitted to hospital with covid-19 and those managed in the community, and to determine how the rates change over time for patients in the community and after vaccination for covid-19. Population based study. 1392 general practices in England contributing to the Clinical Practice Research Datalink Aurum database. 456 002 patients with a diagnosis of covid-19 between 1 August 2020 and 14 February 2021 (44.7% men; median age 61 years), admitted to hospital within two weeks of diagnosis or managed in the community, and followed-up for a maximum of 9.2 months. A negative control group included individuals without covid-19 (n=38 511) and patients with influenza before the pandemic (n=21 803). Comparison of rates for consulting a GP for new symptoms, diseases, prescriptions, and healthcare use in individuals admitted to hospital and those managed in the community, separately, before and after covid-19 infection, using Cox regression and negative binomial regression for healthcare use. The analysis was repeated for the negative control and influenza cohorts. In individuals in the community, outcomes were also described over time after a diagnosis of covid-19, and compared before and after vaccination for individuals who were symptomatic after covid-19 infection, using negative binomial regression. Relative to the negative control and influenza cohorts, patients in the community (n=437 943) had significantly higher GP consultation rates for multiple sequelae, and the most common were loss of smell or taste, or both (adjusted hazard ratio 5.28, 95% confidence interval 3.89 to 7.17, P<0.001); venous thromboembolism (3.35, 2.87 to 3.91, P<0.001); lung fibrosis (2.41, 1.37 to 4.25, P=0.002), and muscle pain (1.89, 1.63 to 2.20, P<0.001); and also for healthcare use after a diagnosis of covid-19 compared with 12 months before infection. For absolute proportions, the most common outcomes ≥4 weeks after a covid-19 diagnosis in patients in the community were joint pain (2.5%), anxiety (1.2%), and prescriptions for non-steroidal anti-inflammatory drugs (1.2%). Patients admitted to hospital (n=18 059) also had significantly higher GP consultation rates for multiple sequelae, most commonly for venous thromboembolism (16.21, 11.28 to 23.31, P<0.001), nausea (4.64, 2.24 to 9.21, P<0.001), prescriptions for paracetamol (3.68, 2.86 to 4.74, P<0.001), renal failure (3.42, 2.67 to 4.38, P<0.001), and healthcare use after a covid-19 diagnosis compared with 12 months before infection. For absolute proportions, the most common outcomes ≥4 weeks after a covid-19 diagnosis in patients admitted to hospital were venous thromboembolism (3.5%), joint pain (2.7%), and breathlessness (2.8%). In patients in the community, anxiety and depression, abdominal pain, diarrhoea, general pain, nausea, chest tightness, and tinnitus persisted throughout follow-up. GP consultation rates were reduced for all symptoms, prescriptions, and healthcare use, except for neuropathic pain, cognitive impairment, strong opiates, and paracetamol use in patients in the community after the first vaccination dose for covid-19 relative to before vaccination. GP consultation rates were also reduced for ischaemic heart disease, asthma, and gastro-oesophageal disease. GP consultation rates for sequelae after acute covid-19 infection differed between patients with covid-19 who were admitted to hospital and those managed in the community. For individuals in the community, rates of some sequelae decreased over time but those for others, such as anxiety and depression, persisted. Rates of some outcomes decreased after vaccination in this group.


Uncharacterized ORF HUR1 influences the efficiency of non-homologous end-joining repair in Saccharomyces cerevisiae.
Non-Homologous End Joining (NHEJ) is a highly conserved pathway that repairs Double-Strand Breaks (DSBs) within DNA. Here we show that the deletion of yeast uncharacterized ORF HUR1, Hydroxyurea Resistance1 affects the efficiency of NHEJ. Our findings are supported by Protein-Protein Interaction (PPI), genetic interaction and drug sensitivity analyses. To assess the activity of HUR1 in DSB repair, we deleted its non-overlapping region with PMR1, referred to as HUR1-A. We observed that similar to deletion of TPK1 and NEJ1, and unlike YKU70 (important for NHEJ of DNA with overhang and not blunt end), deletion of HUR1-A reduced the efficiency of NHEJ in both overhang and blunt end plasmid repair assays. Similarly, a chromosomal repair assay showed a reduction for repair efficiency when HUR1-A was deleted. In agreement with a functional connection for Hur1p with Tpk1p and NEJ1p, double mutant strains Δhur1-A/Δtpk1, and Δhur1-A/Δnej1 showed the same reduction in the efficiency of plasmid repair, compared to both single deletion strains. Also, using a Homologous Recombination (HR) specific plasmid-based DSB repair assay we observed that deletion of HUR1-A influenced the efficiency of HR repair, suggesting that HUR1 might also play additional roles in other DNA repair pathways.


Relationship between the affected ear in benign paroxysmal positional vertigo and habitual head-lying side during bedrest.
To assess the association between the habitual head position during bedrest and the affected ear in benign paroxysmal positional vertigo (BPPV). Prospective trial of patients with active BPPV of the posterior semicircular canal, confirmed on physical examination. Seventy-five patients were asked to explain the head position and lying side they were accustomed to before falling asleep in bed. Fifty patients (67 per cent) habitually adopted a lateral head position during bedrest. The ear affected by BPPV was found to be consistent with the head-lying side during bedrest in 43 cases (86 per cent) (29 cases for the right ear and 14 cases for the left ear). Habitual lateral head-positioning during bedrest can be a major factor leading to the development of BPPV in the ipsilateral ear.


Glatiramer acetate, an anti-demyelination drug, reduced rats' epileptic seizures induced by pentylenetetrazol via protection of myelin sheath.
Glatiramer acetate (GA) is a clinically prescribed immunomodulator drug used to treat demyelinating disease like multiple sclerosis (MS). Persistent down-regulation in the expression of myelin sheath proteins has been observed in both rats with pentylenetetrazol (PTZ) induced chronic epilepsy and some clinical epilepsy patients. Hypothetically, protection of myelin sheath by pharmaceutical means in the process of epilepsy might, to some extent, be helpful to control epileptic seizures. Therefore, we tried to use GA to treat PTZ-induced epilepsy rats. GA treatment successfully protected rats' myelin sheath from demyelination in the process of PTZ-induced epileptic seizures. Notably, electroencephalogram (EEG) monitoring demonstrated that GA-treated epilepsy rats showed significantly lowered epileptiform discharges. Correspondingly, behavioral recording showed reduced frequency of seizures in GA-treated epilepsy rats. The results indicate that epilepsy associated demyelination may be a contributing factor in seizures behavior, and early intervention with anti-demyelination drugs may be beneficial to reduce the severity of seizures behavior.


Comparison of toxicity effects of ropivacaine, bupivacaine, and lidocaine on rabbit intervertebral disc cells in vitro.
It has been shown that bupivacaine, the most commonly used local anesthetic to relieve or control pain in interventional spine procedures, is cytotoxic to intervertebral disc (IVD) cells in vitro. However, some other common local anesthetics, such as ropivacaine and lidocaine, are also frequently used in the treatment of spine-related pain, and the potential effects of these agents remain unclear. The purpose of this study was to evaluate the effect of various local anesthetics on rabbit IVD cells in vitro and further compare the cytotoxicity of ropivacaine, bupivacaine, lidocaine, and saline solution control. Controlled laboratory study. Rabbit annulus fibrosus (AF) and nucleus pulposus (NP) cells were isolated from Japanese white rabbits. Both AF and NP cells at the second generation maintained in monolayer were exposed to various concentrations of local anesthetics (eg, bupivacaine) or different durations of exposure and evaluated for cell viability by use of cell counting kit-8 (CCK-8). In addition, to compare the cytotoxicity of ropivacaine, bupivacaine, lidocaine, and saline solution control in commercial concentration, the viability was analyzed by flow cytometry after 60-minute exposure, and the morphologic changes were observed by the phase-contrast microscopy. Apoptosis and necrosis of IVD cells were confirmed by using fluorescence microscopy with double staining of Hoechst 33342 and propidium iodide. Rabbit IVD cell death demonstrated a time and dose dependence in response to bupivacaine and lidocaine. However, ropivacaine only exerted a significant time-dependent effect on IVD cells. There was no significant difference in IVD viability after treatment with different doses of ropivacaine. In addition, the results showed that lidocaine was the most toxic of the three local anesthetics and that ropivacaine presented less cytotoxicity than lidocaine and bupivacaine. Fluorescence microscopy also confirmed that the short-term toxic effect of local anesthetics on both AF and NP cells was mainly caused by necrosis rather than apoptosis. Results show that bupivacaine and lidocaine decrease cell viability in rabbit IVD cells in a dose- and time-dependent manner. All local anesthetics should be avoided if at all possible. Ropivacaine may be a choice if necessary, but it is also toxic. The increase in cell death is more related with cell necrosis rather than cell apoptosis. If these results can be corroborated in tissue explant models or animal studies, caution regarding diagnosing, treating, and controlling spine-related pain with local anesthetics is prompted.


Micropatterning cell adhesion on polyacrylamide hydrogels.
Cell shape and substrate rigidity play critical roles in regulating cell behaviors and fate. Controlling cell shape on elastic adhesive materials holds great promise for creating a physiologically relevant culture environment for basic and translational research and clinical applications. However, it has been technically challenging to create high-quality adhesive patterns on compliant substrates. We have developed an efficient and economical method to create precise micron-scaled adhesive patterns on the surface of a hydrogel (Rape et al., Biomaterials 32:2043-2051, 2011). This method will facilitate the research on traction force generation, cellular mechanotransduction, and tissue engineering, where precise controls of both materials rigidity and adhesive patterns are important.


The Exploitation of Drug Users.
Drug users have been exploited in research studies and clinical practice. We explore ways in which exploitation has occurred and strategies to help patients, research subjects and communities to prevent or avoid exploitation.


Cerebral Neurovascular Coupling Impairment in Central Serous Chorioretinopathy.
Central serous chorioretinopathy (CSCR) is a chorioretinal disorder resulting from choroidal hyperpermeability. Its comorbidities as hypertension, coronary disease, and psychological stress, suggest that it might reflect a more generalized vascular dysfunction. The aim of the study was to assess the cerebrovascular regulation integrity, using cerebral autoregulation (CA), carbon dioxide vasoreactivity (VR), and neurovascular coupling (NVC) in CSCR. This observational pilot study included 20 CSCR patients and 14 age- and sex-matched controls. A State-Trait Anxiety Inventory (STAI) inquiry was full-filled. Continuous measurement of cerebral blood flow velocity (CBFV), arterial blood pressure, heart rate, and end-tidal carbon dioxide was performed. VR was assessed during hypercapnia (inhaling carbogen gas) and hypnocapnia (hyperventilation). For NVC, the CBFV relative increase during mental activation using the N-Back Task was calculated. No significant differences in systemic hemodynamic parameters, CA or VR, were found between both groups. During the NVC performance, the average CBFV rise during mental stress was significantly lower in CSCR (p = 0.011). A significant negative correlation was found between STAI scores and NVC. CSCR patients presented a significantly impaired cerebral NVC compared to controls, supporting the theory of a potential systemic vascular dysfunction. Stress could be related to this NVC impairment.


Topological surface states in lead-based ternary telluride Pb(Bi(1-x)Sb(x))2Te4.
We have performed angle-resolved photoemission spectroscopy on Pb(Bi(1-x)Sb(x))2Te4, which is a member of lead-based ternary tellurides and has been theoretically proposed as a candidate for a new class of three-dimensional topological insulators. In PbBi2Te4, we found a topological surface state with a hexagonally deformed Dirac-cone band dispersion, indicating that this material is a strong topological insulator with a single topological surface state at the Brillouin-zone center. Partial replacement of Bi with Sb causes a marked change in the Dirac carrier concentration, leading to the sign change of Dirac carriers from n type to p type. The Pb(Bi(1-x)Sb(x))2Te4 system with tunable Dirac carriers thus provides a new platform for investigating exotic topological phenomena.


The effects of 5-HT1A, 5-HT1B and 5-HT1D receptor agonists on trigeminal nociceptive neurotransmission in anaesthetized rats.
Pre-clinical studies have suggested that one mechanism of antimigraine action of the 'triptan' 5-HT1B/1D receptor agonists may be through inhibition of central nociceptive transmission in the trigeminal dorsal horn. In anaesthetized rats, the 5-HT1B/1D receptor agonist, zolmitriptan (up to 3 mg kg(-1), i.v.), inhibited the action potential discharge of single trigeminal neurones to noxious electrical stimulation of the middle meningeal artery. In contrast, the selective 5-HT1B receptor agonist, CP-93,129 (3-(1,2,5,6-tetrahydropyrid-4-yl)pyrrolo[3,2-b]pyrid-5-one), and the 5-HT1A receptor selective agonist 8-hydroxy-2-(di-n-propylamino)-tetralin (8-OH-DPAT) had no effect in this assay at up to 3 mg kg(-1), i.v.. Brain penetrant, triptan 5-HT1B/1D receptor agonists may therefore mediate their central trigeminal anti-nociceptive action in the rat via 5-HT1D, but not 5-HT1B or 5-HT1A, receptors.


Assessment of regional aortic stiffness with cardiac magnetic resonance imaging in a healthy Asian population.
The aim of this study was to determine the normal values for aortic pulse wave velocity (PWV) and distensibility using cine and phase contrast cardiac magnetic resonance imaging (CMRI) in patients without cardiovascular risk factors. PWV and distensibility are indispensible predictors of global and regional cardiovascular risk. Regional heterogeneity in aortic stiffness plays an important role in the pathogenesis of cardiovascular disease. Contrary to global estimates of aortic PWV that are commonly measured with tonometry, CMRI has emerged as an important method for estimating regional PWV and distensibility. A total of 124 Korean patients, aged 20-79 years and free of cardiovascular risk factors, were categorized by age decade. Using cine and phase contrast sequences, the cross-sectional area for distensibility and average blood flow were measured at four aortic levels: the ascending, upper descending thoracic, lower thoracic and abdominal aorta. Regional PWV was determined in four aortic segments: proximal, descending thoracic, abdominal aorta and across the entire aorta. Distensibility at the four levels of the aorta from the ascending to distal (4.4 ± 2.5, 4.0 ± 1.6, 5.2 ± 1.9, and 3.3 ± 1.7 × 10(-3) mm/Hg, respectively) was higher in women (P < 0.001) and decreased with age. The regional PWV was highest in the descending thoracic aorta and increased with age. The present study is the first to show the heterogeneity in aortic PWV and distensibility, as well to provide normal values for these parameters using CMRI in an Asian sample.


Left bundle branch area pacing in patients with atrioventricular conduction disease: A prospective multicenter study.
The reported success rate of His-bundle pacing (HBP) in patients with infranodal atrioventricular (AV) conduction disease is only 52%-76%. The success rate of left bundle branch area pacing (LBBAP) in this cohort is not well studied. The purpose of this study was to evaluate the feasibility, safety, and electrophysiological characteristics of LBBAP in patients with AV conduction disease. Patients with AV conduction disease referred for pacemaker implantation at 2 centers between February 2019 and June 2021 were considered for LBBAP. Baseline demographic characteristics, procedural success rates, electrophysiological parameters, and complications were assessed. LBBAP was successful in 340 of 364 patients (93%). Mean age was 72 ± 13 years, and mean follow-up was 331 ± 244 days. Pacing indications were Mobitz I in 27 patients (7%), Mobitz II or 2:1 AV block or high-grade AV block in 94 patients (26%), complete heart block in 199 patients (55%), and sick sinus syndrome with isolated bundle branch block in 44 patients (12%). Left bundle branch block and right bundle branch block were present in 57 patients (16%) and 140 patients (38%), respectively. Procedural success rates did not differ between indications (92.6%, 93.6%, 92.9%, and 95%, respectively) or between patients with narrow (<120 ms) vs wide QRS (≥120 ms). Mean LBBAP threshold was 0.77 ± 0.34 V at 0.4 ms at implant and remained stable during follow-up. There were 4 (1.2%) acute LBBAP lead dislodgments. LBBAP is safe and feasible with high success rates for patients with AV conduction disease. In contrast to HBP, LBBAP success rates remain high over the entire spectrum of AV conduction disease, and lead parameters remain stable during follow-up.


Cloxazolam treatment for patients with intractable epilepsy.
We examined the antiepileptic effect of cloxazolam on seizures in 23 patients with intractable epilepsy. Most of the patients had central nervous system complications, as well as frequent seizures, and were being treated with polypharmacy. Cloxazolam was administered 1 to 5 mg/day (0.05 to 0.14 mg/kg) at initiation, in two divided doses daily, and gradually increased (1 to 4 mg/day; 0.05 to 0.15 mg/kg) every month at the outpatient clinic. Plasma levels of the main active metabolite, chloro-N-desmethyldiazepam, were measured in 13 patients. Four of 23 patients (17%) became seizure-free, and nine patients (39%) manifested a good response. Both patients with generalized and partial epilepsy manifested a good response. The spectrum of cloxazolam as an antiepileptic was wide. Effective doses were 0.07 to 0.56 mg/kg, and plasma effective levels of chloro-N-desmethyldiazepam were 12.3-115.1 ng/mL. Cloxazolam may be an effective and safe antiepileptic for intractable epilepsy, and should be used as an adjunct to other antiepileptic drugs or administered after other agents.


P300 investigation of phoneme change detection in dyslexic adults.
A specific impairment in phoneme awareness has been hypothesized as one of the current explanations for dyslexia. We examined attentional shifts towards phonological information as indexed by event-related potentials (ERPs) in normal readers and dyslexic adults. Participants performed a lexical decision task on spoken stimuli of which 80% started with a standard phoneme and 20% with a deviant phoneme. A P300 modulation was expected for deviants in control adults, indicating that the phonological change had been detected. A mild and right-lateralized P300 was observed for deviant stimuli in controls, but was absent in dyslexic adults. This result suggests that dyslexic adults fail to make shifts of attention to phonological cues in the same way that normal adult readers do.


Effect of substance P on the lower esophageal sphincter of the opossum.
Since the original observations by Von Euler and Gaddum, considerable interest has developed regarding the role of substance P in smooth muscle function. The purpose of the present investigation was to evaluate the effect of intravenously administered substance P on the vivo motor function of the lower esophageal sphincter (LES). Intraesophageal pressures were monitored by an assembly of polyvinyl catheters attached to pressure transducers and a recorder. The catheters were continuously perfused with bubble-free water. Administration of 5, 10, 25, 50, and 100 ng per kg of substance P stimulated the LES, respectively, 16, 32, 57, 147, and 169% above control values. Tetrodotoxin, phentolamine, hexamethonium, methysergide, and bilateral cervical vagotomy did not alter the response of the LES to substance P. Atropine in 40-, 250-, and 500-microgram per kg doses significantly but partially inhibited the response of the LES to substance P. It is concluded that subtance P is a potent stimulant of the LES. The stimulatory effect of substance P may involve both cholinergic muscarinic and noncholinergic mechanisms. It is conceivable that substance P may be a modulator of LES pressure, although the exact physiological significance is not clear at the present time.


New statistical models of nonergodic cognitive systems and their pathologies.
Cognition most singularly involves choice that reduces uncertainty. Reduction of uncertainty implies the existence of an information source 'dual' to the cognitive process under study. However, information source uncertainty for path-dependent nonergodic systems cannot be described as a conventional Shannon 'entropy' since time averages are not ensemble averages. Nonetheless, the essential nature of information as a form of free energy allows study of nonergodic cognitive systems having complex dynamic topologies whose algebraic expression is in terms of directed homotopy groupoids rather than groups. This permits a significant extension of the Data Rate Theorem linking control and information theories via an analog to the spontaneous symmetry breaking arguments fundamental to modern physics. In addition, the identification of information as a form of free energy enables construction of dynamic empirical Onsager models in the gradient of a classic entropy that can be built from the Legendre transform of even path-dependent information source uncertainties. The methodology provides new analytic tools that should prove useful in understanding failure modes and their dynamics across a broad spectrum of cognitive phenomena, ranging from physiological processes at different scales and levels of organization to critical system automata and institutional economics.


The Publication Ranking Score for pediatric urology: quantifying thought leadership within the subspecialty.
Clinical care parameters are frequently assessed by national ranking systems. However, these rankings do little to comment on institutions' academic contributions. The Publication Ranking Score (PRS) was developed to allow for objective comparisons of scientific thought-leadership at various pediatric urology institutions. Faculty lists were compiled for each of the US News & World Report (USNWR) top-50 pediatric urology hospitals. A list of all faculty publications (2006-2011) was then compiled, after adjusting for journal impact factor, and summed to derive a Publication Ranking Score (PRS). PRS rankings were then compared to the USNWR pediatric urology top-50 hospital list. A total of 1811 publications were indexed. PRS rankings resulted in a mean change in rank of 12 positions, compared to USNWR ranks. Of the top-10 USNWR hospitals, only 4 were ranked in the top-10 by the PRS. There was little correlation between the USNWR and PRS ranks for either top-10 (r = 0.42, p = 0.23) or top-50 (r = 0.48, p = 0.0004) hospitals. PRS institutional ranking differs significantly from the USNWR top-50 hospital list in pediatric urology. While not a replacement, we believe the PRS to be a useful adjunct to the USNWR rankings of pediatric urology hospitals.


Role of MRI in characterizing serous borderline ovarian tumor and its subtypes: Correlation of MRI features with clinicopathological characteristics.
This study aimed to investigate the diagnostic value of MRI in serous borderline ovarian tumor (SBOT), and to determine the MRI features of SBOT and their correlations with clinicopathological characteristics. A total of 121 patients suspected of SBOT by preoperative MRI and then underwent surgery at our hospital were retrospectively reviewed. The accuracy of MRI in diagnosing SBOT was assessed. MRI features of the SBOT subtypes were compared and their correlations with clinicopathological characteristics were evaluated. SBOT was confirmed by postoperative pathology in 95 patients, including 77 patients with conventional SBOT (SBOT-C) and 18 patients with micropapillary SBOT (SBOT-MP). The accuracy of MRI in diagnosing SBOT was 87.6%. Three MRI morphological patterns of SBOT were identified: (i) mainly solid, (ii) mainly cystic, and (iii) mixed. Branching papillary architecture and internal branching (PA&IB) structures corresponding to multiple branching papillary projections and internal fibrous stalks in tumors were observed in 69.7% of SBOTs on T2-weighted images. MRI findings were consistent with postoperative pathology. Compared with SBOT-C, patients with SBOT-MP were more likely to display elevated cancer antigen 125, bilateral tumors, peritoneal implantation, lymph node metastasis, and advanced tumor staging. No significant differences were observed in MRI features between SBOT-C and SBOT-MP groups. MRI has good performance in diagnosing SBOT. MRI findings of SBOT are consistent with clinicopathological characteristics. The PA&IB structure is the characteristic MRI finding of SBOT. Compared to SBOT-C, SBOT-MP tends to display more aggressive clinical behavior, but their MRI features are similar.


Management of acute distal radioulnar dislocations associated with radial shaft substance loss.
In patients with distal radioulnar dislocations that are associated with a loss of radial shaft substance, the use of an external distractor that is applied to the distal radial fragment and the proximal ulnar shaft allows proper reduction of distal radioulnar articulation. The pins should be placed close to a joint so that the holes left after the pins are removed do not act as diaphyseal stress risers. The position is maintained by appropriate internal fixation and bone grafting of the radius. In cases where the bone is severely crushed and internal fixation cannot be applied, the external distractor may be converted to an external fixator.


The basic reproduction number for complex disease systems: defining R(0) for tick-borne infections.
Characterizing the basic reproduction number, R(0), for many wildlife disease systems can seem a complex problem because several species are involved, because there are different epidemiological reactions to the infectious agent at different life-history stages, or because there are multiple transmission routes. Tick-borne diseases are an important example where all these complexities are brought together as a result of the peculiarities of the tick life cycle and the multiple transmission routes that occur. We show here that one can overcome these complexities by separating the host population into epidemiologically different types of individuals and constructing a matrix of reproduction numbers, the so-called next-generation matrix. Each matrix element is an expected number of infectious individuals of one type produced by a single infectious individual of a second type. The largest eigenvalue of the matrix characterizes the initial exponential growth or decline in numbers of infected individuals. Values below 1 therefore imply that the infection cannot establish. The biological interpretation closely matches that of R(0) for disease systems with only one type of individual and where infection is directly transmitted. The parameters defining each matrix element have a clear biological meaning. We illustrate the usefulness and power of the approach with a detailed examination of tick-borne diseases, and we use field and experimental data to parameterize the next-generation matrix for Lyme disease and tick-borne encephalitis. Sensitivity and elasticity analyses of the matrices, at the element and individual parameter levels, allow direct comparison of the two etiological agents. This provides further support that transmission between cofeeding ticks is critically important for the establishment of tick-borne encephalitis.


Fluid dynamics of the upper airway in pediatric patients with severe laryngomalacia.
Laryngomalacia is the top cause of pediatric laryngeal wheeze. We used computational fluid dynamics to study the inspiratory airflow dynamics in severe pediatric laryngomalacia. Computed tomography was performed on the upper airways of two infants, one with severe laryngomalacia and one with normal airway, and 3D models were reconstructed. ANSYS CFD-POST software was used to simulate airflow in these models to compare the volumetric flow rate, flow velocity, pressure, wall shear, and vortex. The volume flow rate in the laryngomalacia model was significantly reduced compared with the control model. Under inspiratory pressures, the peak flow velocity, pressure, and shear force in the control model appeared at the soft palate stenosis, while that in the laryngomalacia model appeared at the supraglottis stenosis. In both models, the maximum flow velocity and shear force increased with decreasing inspiratory pressure, while the minimum pressure decreased with decreasing inspiratory pressure. In the control model, the airflow vortex appeared anteriorly below the posterior section of the soft palate. In the laryngomalacia model, the vortex appeared anteriorly below the posterior section of the soft palate and anteriorly below the vocal folds. Our methodology provides a new mechanistic understanding of pediatric laryngomalacia.


Lysosomal acid phosphatase is transported via endosomes to lysosomes.
Involvement of endosomes in transport of newly synthesized acid phosphatase to lysosomes was investigated using the Golgi fraction (GF1 + 2), enriched in endosomes. The Golgi fraction (GF1 + 2) was prepared from the livers of rats given [35S]methionine and asialofetuin conjugated-horseradish peroxidase (HRP). Newly synthesized acid phosphatase in the endosomes containing internalized asialofetuin-HRP was measured as a loss of the detectable labeled enzyme after 3,3'-diaminobenzidine (DAB) and H2O2 reaction, due to formation of insoluble polymers which reduce protein antigenicity. With this procedure, acid phosphatase was all but undetectable in the Golgi fraction. Thus, newly synthesized acid phosphatase is apparently transported to lysosomes by endosomes.


Automatic coronavirus disease 2019 diagnosis based on chest radiography and deep learning - Success story or dataset bias?
Over the last 2 years, the artificial intelligence (AI) community has presented several automatic screening tools for coronavirus disease 2019 (COVID-19) based on chest radiography (CXR), with reported accuracies often well over 90%. However, it has been noted that many of these studies have likely suffered from dataset bias, leading to overly optimistic results. The purpose of this study was to thoroughly investigate to what extent biases have influenced the performance of a range of previously proposed and promising convolutional neural networks (CNNs), and to determine what performance can be expected with current CNNs on a realistic and unbiased dataset. Five CNNs for COVID-19 positive/negative classification were implemented for evaluation, namely VGG19, ResNet50, InceptionV3, DenseNet201, and COVID-Net. To perform both internal and cross-dataset evaluations, four datasets were created. The first dataset Valencian Region Medical Image Bank (BIMCV) followed strict reverse transcriptase-polymerase chain reaction (RT-PCR) test criteria and was created from a single reliable open access databank, while the second dataset (COVIDxB8) was created through a combination of six online CXR repositories. The third and fourth datasets were created by combining the opposing classes from the BIMCV and COVIDxB8 datasets. To decrease inter-dataset variability, a pre-processing workflow of resizing, normalization, and histogram equalization were applied to all datasets. Classification performance was evaluated on unseen test sets using precision and recall. A qualitative sanity check was performed by evaluating saliency maps displaying the top 5%, 10%, and 20% most salient segments in the input CXRs, to evaluate whether the CNNs were using relevant information for decision making. In an additional experiment and to further investigate the origin of potential dataset bias, all pixel values outside the lungs were set to zero through automatic lung segmentation before training and testing. When trained and evaluated on the single online source dataset (BIMCV), the performance of all CNNs is relatively low (precision: 0.65-0.72, recall: 0.59-0.71), but remains relatively consistent during external evaluation (precision: 0.58-0.82, recall: 0.57-0.72). On the contrary, when trained and internally evaluated on the combinatory datasets, all CNNs performed well across all metrics (precision: 0.94-1.00, recall: 0.77-1.00). However, when subsequently evaluated cross-dataset, results dropped substantially (precision: 0.10-0.61, recall: 0.04-0.80). For all datasets, saliency maps revealed the CNNs rarely focus on areas inside the lungs for their decision-making. However, even when setting all pixel values outside the lungs to zero, classification performance does not change and dataset bias remains. Results in this study confirm that when trained on a combinatory dataset, CNNs tend to learn the origin of the CXRs rather than the presence or absence of disease, a behavior known as short-cut learning. The bias is shown to originate from differences in overall pixel values rather than embedded text or symbols, despite consistent image pre-processing. When trained on a reliable, and realistic single-source dataset in which non-lung pixels have been masked, CNNs currently show limited sensitivity (<70%) for COVID-19 infection in CXR, questioning their use as a reliable automatic screening tool.


Effects of design, porosity and biodegradation on mechanical and morphological properties of additive-manufactured triply periodic minimal surface scaffolds.
The main aim of this paper is to assess the impacts of design, porosity, and biodegradation on the mechanical and morphological properties of triply periodic minimal surface (TPMS) scaffolds. The TPMS scaffolds were designed and manufactured with different porosities by using fused deposing modeling (FDM) technique. The biodegradation test on the scaffolds was performed for four and six months. The mechanical properties were assessed employing ASTM standard compression test and an in-situ mechanical testing stage. Microcomputed tomography (Micro-CT) technique was used to investigate detailed morphological properties of the scaffolds in 3D. Results indicate that the Schwarz-D scaffolds exhibit the highest compressive strength in lower porosity scaffolds but lose mechanical properties when the porosity was increased. On the contrary, Gyroid scaffolds maintain their strength as the porosity was increased. In addition, Gyroid scaffolds preserve a higher percentage of their compressive strength after six months of biodegradation. It was also observed that biodegradation phenomenon transformed the mechanical failure mode of the scaffolds from ductile to brittle. Morphological analysis of the scaffolds revealed detailed information, which support and clarify the observed variations in the mechanical properties.


Morphometrical study of the arterial perforators of the deep inferior epigastric perforator flap.
Although abdominal perforator flaps based on a cutaneous branch of the deep inferior epigastric artery (DIEP flaps) have many advantages, preparing these flaps is technically difficult and requires great skill, especially as the portion of the artery running under the anterior rectus abdominis sheath must be operated upon "blind". To allow easier preparation and elevation of a DIEP flap pedicle, we propose that the arterial perforator should: 1) be more than 1.0 mm large; 2) run a straight intramuscular course, parallel to the rectus abdominis m. fibers, with no large muscular branches; and 3) have only a short portion running immediately under the anterior rectus abdominis sheath. We examined 329 perforators (more than 0.5 mm in diameter at the anterior sheath) in 66 rectus abdominis mm. from 33 cadavers among them: 1) 52 "large" perforators were over 1.0 mm in diameter; 2) 107 "suitable" perforators ran parallel to the muscle fibers without giving off large muscular branches; and 3) 35 "ideal" perforators combined these characteristics. The ideal perforators were usually located in the mid-abdominal region, 10-30 mm lateral to the umbilicus. The suitable perforators were usually present, often in combination with the ideal perforator(s), in a restricted area 20 mm cranial and 40-50 mm lateral to the umbilicus. We classified the course and ramification pattern of the deep inferior epigastric a. into six patterns, depending on whether the anastomosis was sited in the medial or lateral branch and the level at which the branches originated.


Initial results from a multi-center population-based cluster randomized trial of esophageal and gastric cancer screening in China.
We initiated the first multi-center cluster randomized trial of endoscopic screening for esophageal cancer and gastric cancer in China. The objective of the study was to report the baseline screening findings in this trial. We recruited a total of 345 eligible clusters from seven screening centers. In the intervention group, participants from high-risk areas were screened by endoscopy; in non-high-risk areas, high-risk individuals were identified using a questionnaire and advised for endoscopy. Lugol's iodine staining in esophagus and indigo carmine dye in stomach were performed to aid in the diagnosis of suspicious lesions. The primary outcomes of this study were the detection rate (proportion of positive cases among individuals who underwent endoscopic screening) and early detection rate (the proportion of positive cases with stage 0/I among all positive cases). A total of 149,956 eligible subjects were included. The detection rate was 0.7% in esophagus and 0.8% in stomach, respectively. Compared with non-high-risk areas, the detection rates in high-risk areas were higher, both in esophagus (0.9% vs. 0.1%) and in stomach (0.9% vs. 0.3%). The same difference was found for early-detection rate (esophagus: 92.9% vs. 53.3%; stomach: 81.5% vs. 33.3%). The diagnostic yield of both esophagus and stomach were higher in high-risk areas than in non-high-risk areas, even though in non-high-risk areas, only high-risk individuals were screened. Our study may provide important clues for evaluating and improving the effectiveness of upper-endoscopic screening in China. Protocol Registration System in Chinese Clinical Trial Registry, ChiCTR-EOR-16008577. Registered 01 June 2016-Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=14372.


Asymmetric disposition of detergents within vesicle bilayer and its effect on ion permeation through the membrane.
Phospholipid vesicles were prepared by detergent removal using hydrophobic porous beads, Amberlite XAD-2, or dialysis from detergent-phospholipid mixed micelles. The liposomes formed were found to be mostly unilammellar vesicles. The vesicle diameter was estimated, by both quasi-elastic light-scattering and gel-exclusion chromatography on Sephacryl S-1000, to be 80 nm for the vesicles formed by removal of octaethylene glycol monododecyl ether by the bead method. The effect of detergents within a bilayer on ion permeation was demonstrated. When the content of octaethylene glycol monododecyl ether reached a molar ratio of 0.2, the intrinsic ion selectivity of the phospholipid membrane between anion and cation was diminished. The ion permeability measured for vesicles with detergent incorporated into initially detergent-free vesicles was about 10-times greater than that for vesicles with detergent remaining following the process of detergent removal. This observation was explained by the different disposition of the detergent in the bilayer, that is, when vesicles were formed by the removal of detergent from mixed micelles, the residual detergent became distributed in both the outer and inner leaflets, and when the detergent was incorporated into initially detergent-free vesicles, the detergent became distributed only in the outer leaflet within the experimental time limits. This idea was supported by the NMR studies. It was also found that, as a detergent, octaethylene glycol monododecyl ether has a stronger effect on ion permeation than octyl glucoside.


Reaction time and movement time after active and passive smoking.
Reaction time and movement time were studied following active and passive smoking in two groups of 20 women. All subjects were tested under a clean air and smoky air condition and the results showed that, while there was no difference between groups for either measure in the clear air condition, the active smokers had faster reaction time and movement time in the smoky air condition. Smoky air had no significant effect on the responses of the passive smoking group.


Effectiveness of ototopical antibiotics for chronic suppurative otitis media in Aboriginal children: a community-based, multicentre, double-blind randomised controlled trial.
To compare the effectiveness of ototopical ciprofloxacin (0.3%; CIP) with framycetin (0.5%), gramicidin, dexamethasone (FGD) eardrops (5 drops twice daily for 9 days) together with povidone-iodine (0.5%) ear cleaning as treatments for chronic suppurative otitis media (CSOM) in Aboriginal children. Aboriginal community-controlled, community-based, multicentre, double-blind, randomised controlled trial in eight Aboriginal Community Controlled Health Services across northern Australia, involving 147 Aboriginal children with CSOM. Resolution of otorrhoea (clinical cure), proportion of children with healed perforated tympanic membrane (TM) and improved hearing, 10-21 days after starting treatment. 111 children aged 1-14 years (CIP, 55; FGD, 56) completed treatment. CSOM cures occurred in 64% (CIP, 76.4%; FGD, 51.8%), with a significantly higher rate in the ciprofloxacin group (P = 0.009, absolute difference of 24.6% [95% CI, 15.8%-33.4%]). TM perforation size and the level of hearing impairment did not change. Pseudomonas aeruginosa was the most common bacterial pathogen (in 47.6%), while respiratory pathogens were rare (in 5.7%). Twice-daily ear cleaning and topical ciprofloxacin is effective at community-level in achieving cure for CSOM. Healthcare providers to Aboriginal children with CSOM should be given special access to provide ototopical ciprofloxacin as first-line treatment.


Serum calcium ion activity. Some aspects on methodological differences and intraindividual variation.
Sera were analyzed for calcium ion activity on the Orion 99-20 and SS-20 systems. Samples from 84 healthy subjects were analyzed on both systems and, because of a change of electrode composition, 74 of them were reanalyzed after this change. Additional 89 were analyzed on only SS-20. The distribution of serum calcium ion activity was close to Gaussian. The difference between the 99-20 and SS-20 readings was 0.048+/-0.017 mmol/liter (range -0.01 to 0.08) before the electrode change and -0.085+/-0.027 mmol/liter (range -0.14 to 0.02) after. The reference ranges were 1.02--1.23 mmol/liter for 99-20 and 0.93--1.20 mmol/liter for SS-20 before the electrode change. The following characteristics may contribute to differences in the readings: higher temperature, higher flow rate, new calcium and reference electrodes, new liquid junction construction and a new pumping procedure. For 74 subjects the determination of serum calcium ion activity (99-20 system) was performed with a five year interval and the difference between the first and second measurements was -0.0046+/-0.0168 mmol/liter (mean +/-SD), ranging from -0.04 to 0.03 mmol/liter. This corresponded to an intraindividual variation of 1.5%. The corresponding variations for serum total calcium and corrected calcium were 4.8% and 3.3% respectively.


Effects of moderate chronic ethanol consumption on hippocampal nicotinic receptors and associative learning.
A number of studies have reported that ethanol exposure induces changes in different brain systems. The hippocampus is a brain region that is very vulnerable to ethanol exposition, which functionally results in impairment of learning and memory processes reported in heavy drinkers. Hippocampal nicotinic receptors are involved in learning and memory. In this study, we determined the effects of ethanol on the main hippocampal subtypes of neural nicotinic receptors (alpha7 and alpha4beta2) in rats non-selected for alcohol consumption, in order to check for possible changes on these receptors that could be linked with alterations in learning acquisition. Binding assays were carried out with [3H]methyllycaconitine ([3H]MLA) to study the alpha7 and [3H]nicotine to study alpha4beta2 receptors. Auto-shaping, continuous ratio and extinction procedures were used as behavioral tests. The results show that moderate chronic ethanol consumption for 10 weeks produces: (a) a decrease of both hippocampal nicotinic receptor subtypes without alterations in affinity; (b) no differences in behavioral performance between control rats and ethanol-drinking rats in auto-shaping and continuous ratio; (c) an improvement of performance of extinction paradigm. These results indicate that chronic ethanol consumption, at moderate levels, induces changes in hippocampal nicotinic receptors but does not impair acquisition and performance of new associative learning and even improves some kind of paradigms. These results may have implications in the biochemical basis of interactions between alcohol and nicotine and the effects of these drugs on behavior.


The study of insect blood-feeding behaviour. 1: Feeding equipment, physical and endogenous factors, dose effect analysis, and diet destination.
Experimental techniques that we have found useful during our studies of insect blood-feeding behaviour are reviewed. Some of the principal findings resulting from these techniques are discussed. Where directly applicable, the work of others is included, but no complete review of the subject has been attempted.


[Idiopathic partial thrombosis of the corpus cavernosum (IPTCC) : A rare urological emergency].
Idiopathic partial thrombosis of the corpus cavernosum (IPTCC) is a rare, semi-acute disease in young, healthy men. In addition to an anatomical predisposition, perineal microtrauma is stated as the main risk factor. A case report and the results of a literature search with descriptive-statistical processing of 57 peer-reviewed publications are presented. A therapy concept was drawn up for clinical practice. Our patient was treated conservatively and was consistent with the 87 cases which have been published since 1976. IPTCC is a disease of young men (33.2 years, range 18-70), which is associated with pain and perineal swelling in 88%. Sonography and contrast-enhanced magnetic resonance imaging (MRI) proved to be the diagnostic modality of choice, demonstrating the thrombus and in 89% a connective tissue membrane inside the corpus cavernosum. Treatment included antithrombotic and analgesic (n = 54, 62.1%), surgical (n = 20, 23%), analgesic (n = 8, 9.2%), via injection (n = 2, 2.3%), as well as radiological interventional (n = 1, 1.1%) options. In 12 cases, erectile dysfunction, mostly temporary, which required phosphodiesterase (PDE)-5 therapy developed. Recurrence and prolonged courses were rare. IPTCC is a rare disease in young men. Conservative therapy with antithrombotic and analgesic treatment has shown good chances of full recovery. If relapse occurs or the patient refuses antithrombotic treatment, operative/alternative therapy management should be considered.