Use of a stencil for improved accuracy, speed, and aesthetic results in mini-micrografting.
Two stencils have been developed that improve the accuracy, speed, and aesthetic of mini-micrografting. The stencil most frequently used is for #15 blade incisions (six- to eight-haired minigrafts); the other is for 1.0-2.0-mm holes (three- to four-haired minigrafts). The slit stencil has 20 recipient sites per square inch; the hole stencil has 40. To improve accuracy, speed, and aesthetic results of mini-micrografting. The areas to be incised are markedly preoperatively, utilizing a stencil, which develops a very precise pattern. The slits or holes can then be made very quickly and accurately over these marks. Because bleeding does not obscure the markings, the speed, precision, and the results of the procedures are greatly enhanced. The use of stencil improved the accuracy, speed, and aesthetic results of the mini-micrografting procedure. It also helps the surgeon accurately predict the number of minigrafts that will be needed for a specific area.


Body surface integral maps in patients with arrhythmogenic right ventricular cardiomyopathy.
The aim of this study was to evaluate changes in QRST integral maps in patients with ARVC. Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a progressive disorder of predominantly right ventricle characterized with arrhythmic events possibly leading to sudden cardiac death. QRST integral maps reflect local disparities of ventricular repolarization and resulting vulnerability to arrhythmias. A group of 8 patients with ARVC and a control group of 8 patients with a concealed accessory pathway were studied. Body surface mapping was performed using a 63-lead Savard's system. Mean QRST integral map of patients with ARVC showed abnormal characteristics. The area of negativity was larger than normal and extended to lower border of thorax. Departure map of the mean QRST integral map of patients with ARVC showed areas with departure index < 2 and > 2 in lower part of chest and upper part of back. When statistically analyzed, areas with p < 0.05 covered nearly lower half of chest and upper half of back. We consider body surface QRST integral mapping to be an adequate method for evaluation of dispersion of ventricular repolarization in ARVC patients (Tab. 1, Fig. 5, Ref. 17).


A green and facile approach for fabrication of biocompatible anti-Parkinson chitosan-gelatin-green tea extract composite particles with neuroprotective and Neurotherapeutic effects: In vitro evaluation.
The design and fabrication of bio-inspired materials are valuable for the treatment of Parkinson's disease (PD) due to their remarkable antioxidant properties, biocompatibility, and minor side effects. In this study, novel biocompatible and biodegradable chitosan-gelatin-green tea extract (CS-Gel-GTE) composite particles were fabricated with excellent antioxidant properties for therapeutic purposes in PD. An innovative angle-dependent electrospray system fabricated CS-Gel-GTE composite particles in only 1 min using a single-step method. The composite particles were investigated using various characterization methods. In addition to being facile and cost-effective, our methodology resulted in the formation of particles with a prolonged release time of nine days for GTE with a pH of 7.4. A cellular study was also performed to investigate the composite particles' cell viability and neuroprotective effects. The results showed enhanced cell viability and a significant reduction in cell apoptosis. In addition, the synthesized biomaterials showed the potential to inhibit the formation of reactive oxygen species (ROS), increase tyrosine hydroxylase (TH) enzyme expression and decrease α-syn protein expression. Overall, this study offers exquisite natural biomaterials for PD treatment.


[Improvement of perineal wound healing following rectum amputation by omentum flap].
The aim of the presented study was to find whether significant improvement in perineal woundhealing could be achieved by placing pedunculate parts of greater omentum in the sacral cavity after rectal amputation. 70 patients undergoing rectal amputation were evaluated, in 34 patients pedunculate parts of the greater omentum were positioned in the presacral cavity. Results show that an omentum flap improves primary perineal woundhealing and reduces per secundam woundhealing time (p less than 0.025). Since regular placement of pedunculate parts all wounds were closed after 3 months. Sinus formation is reduced (p less than 0.05). Suction drainage must be removed early, otherwise infections aggravate woundhealing going up the tube (p less than 0.001). We conclude from our results that the placement of pedunculate parts of the greater omentum in the sacral cavity after rectal amputation is a useful method to improve perineal woundhealing and should be done as routine procedure.


Correlation between temperature-dependent cytoplasmic solubility and periplasmic export of a heterologous protein in Escherichia coli.
The coding sequence of mature human tumor necrosis factor (hTNF) was fused to the signal-encoding sequence of beta-lactamase (Bla). Mature hTNF was exported into the periplasm of Escherichia coli. A mutant hTNF [Van Ostade et al., FEBS Lett. 238 (1988) 347-352], which displays a temperature-dependent intracellular solubility, was fused to the same Bla signal-encoding sequence. We found that the export competence of the mutated hTNF was correlated with the intracellular solubility of this protein. We postulate that the secretion proficiency of eukaryotic proteins, when fused to a prokaryotic export signal, depends on the ability of the mature protein to readily fold into a soluble conformation.


Evaluation of Sleep Quality and Fatigue in Patients with Usher Syndrome Type 2a.
To study the prevalence, level, and nature of sleep problems and fatigue experienced by Usher syndrome type 2a (USH2a) patients. Cross-sectional study. Fifty-six genetically confirmed Dutch patients with syndromic USH2a and 120 healthy controls. Sleep quality, prevalence, and type of sleep disorders, chronotype, fatigue, and daytime sleepiness were assessed using 5 questionnaires: (1) Pittsburgh Sleep Quality Index, (2) Holland Sleep Disorders Questionnaire, (3) Morningness-Eveningness Questionnaire, (4) Checklist Individual Strength, and (5) Epworth Sleepiness Scale. For a subset of patients, recent data on visual function were used to study the potential correlation between the outcomes of the questionnaires and disease progression. Results of all questionnaires were compared between USH2a and control cohorts, and the scores of the patients were compared with disease progression defined by age, visual field size, and visual acuity. Compared with the control population, patients with USH2a experienced a poorer quality of sleep, a higher incidence of sleep disorders, and higher levels of fatigue and daytime sleepiness. Intriguingly, the sleep disturbances and high levels of fatigue were not correlated with the level of visual impairment. These results are in accordance with the patients' experiences that their sleep problems already existed before the onset of vision loss. This study demonstrates a high prevalence of fatigue and poor sleep quality experienced by patients with USH2a. Recognition of sleep problems as a comorbidity of Usher syndrome would be a first step toward improved patient care. The absence of a relationship between the level of visual impairment and the severity of reported sleep problems is suggestive of an extraretinal origin of the sleep disturbances. Proprietary or commercial disclosure may be found after the references.


Epidemiology of Barrett's Esophagus and Esophageal Adenocarcinoma: Implications for Screening and Surveillance.
In the United States, the incidence of esophageal adenocarcinoma increased markedly since the 1970s with a recent stabilization. Despite evolving screening and surveillance strategies to diagnose, risk triage, and intervene in Barrett's esophagus patients to prevent esophageal adenocarcinoma, most cases present with advanced disease and poor resultant survival. Epidemiologic studies have identified the main risk factors for these conditions, including increasing age, male sex, white race, gastroesophageal reflux disease, abdominal obesity, cigarette smoking, and lack of infection with Helicobacter pylori. This review summarizes the current epidemiologic evidence with implications for screening and surveillance in Barrett's esophagus and esophageal adenocarcinoma.


Decellularized extracellular matrix mediates tissue construction and regeneration.
Contributing to organ formation and tissue regeneration, extracellular matrix (ECM) constituents provide tissue with three-dimensional (3D) structural integrity and cellular-function regulation. Containing the crucial traits of the cellular microenvironment, ECM substitutes mediate cell-matrix interactions to prompt stem-cell proliferation and differentiation for 3D organoid construction in vitro or tissue regeneration in vivo. However, these ECMs are often applied generically and have yet to be extensively developed for specific cell types in 3D cultures. Cultured cells also produce rich ECM, particularly stromal cells. Cellular ECM improves 3D culture development in vitro and tissue remodeling during wound healing after implantation into the host as well. Gaining better insight into ECM derived from either tissue or cells that regulate 3D tissue reconstruction or organ regeneration helps us to select, produce, and implant the most suitable ECM and thus promote 3D organoid culture and tissue remodeling for in vivo regeneration. Overall, the decellularization methodologies and tissue/cell-derived ECM as scaffolds or cellular-growth supplements used in cell propagation and differentiation for 3D tissue culture in vitro are discussed. Moreover, current preclinical applications by which ECM components modulate the wound-healing process are reviewed.


Synthesis and investigation of antiproliferative activity of Ru-NHC complexes against C6 and HeLa cancer cells.
The 2-methylpyridine, 2-diethylaminoethyl, and isopentyl linked a series of symmetric and unsymmetric benzimidazolium salts 2a-e were prepared and used in the synthesis of silver-N-heterocyclic carbene (NHC) complexes (3a-e). The Ru(II)-NHC complexes (4a-h) were synthesized via transmetalation reaction from 3a-e. 4a-h complexes were converted to Ru(II)-NHC.HCl complexes (5ah) by HCl solution of diethyl ether and characterized by different spectroscopic techniques such as 1H and 13C NMR, LC/MS-Q-TOF, FT-IR, elemental analysis, and melting point detection. We examined the effect of the structural difference of complexes on anticancer activity via different arenes and metal centers. Antiproliferative activity of 5a-h and 3a was tested against human cervix adenocarcinoma (HeLa) and rat glioblastoma (C6) cell lines by ELISA assay. The IC50 value of 5b, 5c and 5e complexes exhibited good cytotoxic activity than cisplatin on C6 (14.2 ± 0.5 mM; 16.2 ± 0.4 mM; 24.2 ± 0.7 mM, respectively) and HeLa (11.1 ± 0.5 mM; 13.7 ± 0.3 mM; 22.8 ± 0.8 mM, respectively) cell lines.


Assessment of Influence of Contact Time between Alginate and Type III Dental Stone on Properties of Cast Model: An in vitro Study.
Alginate is a versatile, irreversible hydrocolloid impression material, which is cost-effective and forms an essential component in dental practice. For elevating the hardness of the cast models, hardeners are combined with stone. Hence, we planned the present study to evaluate the impact of altering the time of contact between alginate and stone after various interim periods. The present study included the assessment of impact of time of contact between alginate and stone by the construction of 90 casts using a cylinder model. Two bisecting lines were marked and were named as y and y'. These lines were used for testing the dimensional stability. Using chemically cured acrylic resin, the construction of ten special trays was done. All the impression casts were randomly divided into two study groups, with 45 casts in each group-group I: control group, casts were removed after 60 minutes; group II: study group, casts were removed after 9 hours. A digital caliper was used for measuring the dimensional stability of the cast. All the data were collected and analyzed. In the specimens of the control group (group I) and the study group (group II), the mean dimensions from y to y' were found to be 17.54 and 17.95 respectively. The mean reading of hardness in the control group and study group was found to be 0.59 and 0.20 respectively. In groups I and II, the number of specimens showing clarity of two lines (X and X") was 0 and 5 respectively. There was no change in the dimensional stability of the dental stone model when the contact time was increased. Within certain limits, the contact time between alginate and stone can be altered without significantly altering the properties of the cast.


Studies on intrarenal prostaglandins. Effect of unilateral renal artery constriction on lipid droplets in the medullary interstitial cells of the 'opposite' kidney in rabbits.
The unilateral renal artery in rabbits was constricted, and lipid droplet count in the medullary interstitial cells of the 'opposite' kidney was performed 1 week after surgery. Lipid droplet count in hypertensive rabbits was less than that in both nonhypertensive and normal rabbits and was inversely proportional to the mean blood pressure. Lipid droplet count was significantly correlated with the juxtaglomerular granulation index and the sodium content in the inner medulla. The present results suggest that, in the opposite kidney of rabbits hypertensive due to unilateral constriction of the renal artery, the enhanced release of prostaglandins and the washout of solute in the renal medulla may be induced as a response to increased perfusion pressure and elevated circulating angiotensin.


Ultrafast excited-state dynamics of phenyleneethynylene oligomers in solution.
The excited-state dynamics of oligomeric phenyleneethynylenes (OPEs) of various length and substitution has been investigated by femtosecond time-resolved spectroscopy. The fluorescence lifetime of the OPEs decreases with the number of phenyleneethynylene units up to about 9. This effect is due to an increase of the oscillator strength for the S(1)-S(0) transition. Dynamic features occurring within a few tens of picoseconds and ascribed to structural relaxation directly after population of the S(1) state can be observed in non-viscous solvents. The effect of torsional disorder on the fluorescence intensity is shown to depend strongly on the nature of the substituent on the phenyl groups. All these effects are qualitatively discussed with a simple exciton model.


The nonconscious influence of religious symbols in motivated performance situations.
Anthropological, sociological, and psychological theories suggest that religious symbols should influence motivational processes during performance of goal-relevant tasks. In two experiments, positive and negative religious (Christian) symbols were presented outside of participants' conscious awareness. These symbols influenced cardiovascular responses consistent with challenge and threat states during a subsequent speech task, particularly when the speech topic concerned participants' mortality, and only for Christian participants; similar images lacking Christian meaning were not influential. Results suggested that these effects were due to the learned meaning of the symbols and point to the importance of religion as a coping resource.


Breathlessness catastrophizing relates to poorer quality of life in adults with cystic fibrosis.
Cystic Fibrosis (CF) is the most common genetic disease affecting children and young adults in Canada. It is a multi-system disease, however lung disease is largely responsible for mortality. Treatment advances have resulted in increased life expectancy and a subsequent need to better understand psychosocial issues associated with quality of life in adults living with CF. Emerging research suggests that anxiety and depression are related to poorer health-related quality of life (HRQoL) in CF patients, but there is little research examining cognitive processes, such as breathlessness catastrophizing. The present study addresses this gap in the literature. Participants in this study are based on a convenience sample of patients recruited during their regular CF clinic appointments at a tertiary care center. Forty-five adults (Mage = 30.73 years) completed measures of lung function, depression, anxiety, pain, breathlessness catastrophizing, and HRQoL at one time point. Results of a hierarchical multiple regression indicate that increased breathlessness catastrophizing was related to poorer HRQoL, after controlling for lung function, depression, anxiety, and pain (p < .05). Depression, pain, and breathlessness catastrophizing all emerged as significant unique predictors of HRQoL. Breathlessness catastrophizing is a potential target for clinical intervention and might impact HRQoL. Further research on breathlessness catastrophizing in CF is warranted including longitudinal studies to examine the mechanisms by which breathlessness catastrophizing relates to HRQoL and treatment outcomes in CF.


The values of thin sections and three-dimensional reconstruction in the sellar region.
The computerized freezing milling technique is derived from the virtual human project. It has been widely used in three-dimensional (3D) reconstruction of the human body and organs. With this technique, the study was undertaken to explore the 3D features and adjacent anatomic relationships of the sellar region for skull base surgery. Continuous thin sections on the coronary plane were performed with the computerized freezing milling technique using a human head specimen. The related structures were described in six sections. After segmenting, labeling, and extracting in serial sections, the 3D reconstruction of the sellar region was finished with Amira 4.1 software. A total of 390 thin coronary sections were obtained. In six sections, the anatomic relationships of the pituitary gland, carotid artery, sphenoid sinus, and nerves are displayed. Three-dimensional images of the sellar region are video films that continuously and dynamically display anatomic structures in 3D space at different velocities. It can show that the cavernous segment of the internal carotid artery is located anterolateral to the sphenoid sinus and lateral to the pituitary gland. The optic nerve protrudes into the superolateral portion of the sphenoid sinus. The combination of coronary sectional anatomy and 3D reconstruction can display the anatomic characteristics of the sellar region. The 3D models are video films that continuously and dynamically display anatomic structures in 3D space at different velocities.


Upperbound procedures for the identification of similar three-dimensional chemical structures.
This paper describes techniques for calculating the degree of similarity between an input query molecule and each of the molecules in a database of 3-D chemical structures. The inter-molecular similarity measure used is the number of atoms in the 3-D common substructure (CS) between the two molecules which are being compared. The identification of 3-D CSs is very demanding of computational resources, even when an efficient clique detection algorithm is used for this purpose. Two types of upperbound calculation are described which allow reductions in the number of exact CS searches which need to be carried out to identify those molecules from a database which are similar to a 3-D target molecule.


Sex and the single kidney.
Micropuncture measurements revealed that approximately 9 to 10 months after uninephrectomy and maintenance on a high-protein diet, glomerular capillary BP was significantly higher in male than in virgin female rats. This might account for the greater susceptibility of the male to age- and ablation-induced glomerular damage reported by others, although at the time of the present studies, significant reduction in function and worsening in glomerulosclerosis in males v females was barely evident. In a second group of chronically uninephrectomized females, the effects of multiple (five) consecutive pregnancies and lactations were investigated and did not indicate any severe deleterious long-term effects of pregnancy on the glomeruli in this model of underlying renal compromise. Variable responses to an acute intravenous glycine challenge which did not correlate well with the extent of glomerular damage were observed in each group, suggesting that this test may not always be informative regarding underlying glomerular disease.


Segmentectomy versus lobectomy for inner-located small-sized early non-small-cell lung cancer.
Although segmentectomy is an acceptable alternative to lobectomy for peripheral small-sized non-small-cell lung cancer, the effectiveness of segmentectomy for inner lesions remains unknown. The aim of this study was to examine the feasibility of segmentectomy in comparison with lobectomy for inner lesions. We retrospectively analysed 570 patients with small (≤2 cm) cN0 non-small-cell lung cancer who underwent segmentectomy or lobectomy between January 2007 and March 2021. We focused on patients with lesions located in the inner two-thirds, which were determined using three-dimensional computed tomography (n = 227). After propensity score matching analysis based on sex, age, pulmonary function, serum carcinoembryonic antigen level, radiographic tumour findings and tumour location, we compared the surgical and oncological outcomes in patients who underwent segmentectomy (n = 66) and lobectomy (n = 66). Postoperative mortality or morbidity did not differ significantly between the 2 groups. The 5-year recurrence-free and overall survival rates in the segmentectomy and lobectomy groups were 93.6% vs 84.1% and 95.8% vs 87.9%, respectively. The differences between 2 groups were not significant (P = 0.62 and P = 0.23, respectively). The 2 groups also showed no differences in loco-regional recurrence. Multivariable Cox regression analysis revealed that segmentectomy had a comparable impact on recurrence-free survival (hazard ratio, 0.61; 95% confidence interval, 0.17-2.03; P = 0.43). Segmentectomy for inner-located small-sized non-small-cell lung tumours could be an acceptable treatment in comparison with lobectomy.


The antimetastatic activity of enkephalin-like peptides.
[Met5]Enkephalin and [Leu5]enkephalin, two naturally occurring opioid-like peptides were found to decrease the number of spontaneous pulmonary metastases in C57BL/6J mice implanted in the foot pad with the B16-BL6 melanoma. The number of such metastatic nodules were reduced more than 2-fold. This effect was noted after several different injection schedules. In addition to their effect on metastasis the growth rate of the primary tumor was also decreased by these compounds.


Multiple calcified chondrohamartomas of the lung: CT appearance.
Although pulmonary hamartomas are the most common benign neoplasm of the lung, multiple hamartomas are uncommon and multiple chondromatous hamartomas are very rare. We describe the CT findings in a patient with multiple chondromatous hamartomas without Carney syndrome and review the literature pertaining to this entity.


A Randomized Controlled Exploratory Pilot Study to Evaluate the Effect of Rotigotine Transdermal Patch on Parkinson's Disease-Associated Chronic Pain.
Pain is a troublesome nonmotor symptom of Parkinson's disease (PD). This double-blind exploratory pilot study (NCT01744496) was the first to specifically investigate the effect of a dopamine agonist on PD-associated pain as primary outcome. Patients with advanced PD (ie, receiving levodopa) and at least moderate PD-associated chronic pain (≥3 months, ≥4 points on 11-point Likert pain scale) were randomized to rotigotine (optimal/maximum dose ≤16 mg/24h) or placebo and maintained for 12 weeks. Primary efficacy variable was change in pain severity (Likert pain scale) from baseline to end of maintenance. Secondary variables included percentage of responders (≥2-point Likert pain scale reduction), King's PD Pain Scale (KPPS) domains, and PD Questionnaire (PDQ-8). Statistical analyses were exploratory. Of 68 randomized patients, 60 (rotigotine, 30; placebo, 30) were evaluable for efficacy. A numerical improvement in pain was observed in favor of rotigotine (Likert pain scale: least-squares mean [95%CI] treatment difference, -0.76 [-1.87 to 0.34]; P = .172), and proportion of responders was 18/30 (60%) rotigotine vs 14/30 (47%) placebo. An ∼2-fold numerical improvement in KPPS domain "fluctuation-related pain" was observed with rotigotine vs placebo. Rotigotine improved PDQ-8 vs placebo (-8.01 [-15.56 to -0.46]; P = .038). These results suggest rotigotine may improve PD-associated pain; a large-scale confirmatory study is needed.


Animal nutrition and acid-base balance.
In domestic animals, acid-base balance may be influenced by nutrition. The major research effort in this area has been made on the prevention of hypocalcemic postparturient paresis in dairy cows. This disorder is caused by the sudden increase of calcium secretion into the colostrum. The manipulation of the dietary cation-anion difference makes it possible to maintain the cows in metabolic acidosis during the critical period that precedes calving, presumably via a mechanism that involves the strong ion difference in the extracellular fluid. As a consequence the mobilization of calcium is enhanced and the incidence of the disorder is decreased. Conversely, a dietary induced metabolic alkalosis leads to a more severe degree of hypocalcemia and the incidence of the disease is increased. The underlying mechanisms of the prevention are only partially understood. Nevertheless, this preventive method is already widely applied in practice. Nutrition effects on acid-base balance also influence growth and food intake in higher vertebrates and fish. As a consequence, the incidence of developmental orthopedic diseases in fast-growing domestic animal species may be affected. Also, the bone mineral content of athletic horses may be influenced by dietary induced modification of the acid-base status. The mineral loss due to metabolic acidosis may lead to an increase in the incidence of stress fractures. This overview should give insight into relevant aspects of nutrition and acid-base balance in domestic animal species.


Does beak coloration of male blackbirds play a role in intra and/or intersexual selection?
In many bird species, males may show brightly coloured traits and variance in male mating success may be explained by female preference and/or competition between males favouring the most coloured males. Male beak coloration has been suggested to play an important role in the pairing pattern of European blackbirds. Here, we investigate female preference and male-male interactions in relation to male beak coloration in this species. We used a field experiment to measure female and male responses toward stuffed decoys showing either of two beak coloration representing the extremes of the natural variation from yellow to orange. Decoys were situated on the centre of plots and behaviours of males and females approaching the decoy were recorded. The total number of males and females approaching the decoy did not differ between the two model treatments. Similarly, there was no difference in the mean time that males and females spent near the decoy. The number of males displaying aggressive postures did not differ between treatments and no female adopted a sexual posture. We discuss the relevance of our results and potential limitations associated with the experimental procedure.


Unusual accumulation of copper related to induction of metallothionein in the liver of LEC rats.
Copper (Cu), iron (Fe), zinc (Zn) and manganese (Mn) levels in organs of LEC rats (Long-Evans rats with a cinnamon-like coat color), which develop spontaneous jaundice with hereditary hepatitis, were determined by instrumental neutron activation analysis method. Unusual accumulations of Cu in the liver of LEC rats were found, depending on the age of the animals, the metal concentration being more than approximately 20-40 times those of normal LEA rats (Long-Evans rats with an agouti coat color). Fe and Zn were also accumulated, in addition to Cu, significantly in the LEC rats. The unusual Cu accumulations in the liver of LEC rats were associated with the induction of metallothionein, estimated by radioimmunoassay method, in the liver of LEC rats, rather than that of superoxide dismutase, estimated by electron spin resonance -spin trapping method. These findings suggest that the unusual Cu accumulation in LEC rats is involved in the development of jaundice, hepatic injury and hepatocellular carcinoma.


Bis(3-methyl-1-propyl-1H-imidazol-3-ium) bis-(4,6-disulfanidyl-4,6-disulfanyl-idene-1,2,3,5,4,6-tetra-thia-diphosphinane-κ3 S 2,S 4,S 6)nickel.
The title salt, (PMIM)2[Ni(P2S8)2] (PMIM = 3-methyl-1-propyl-1H-imidazol-3-ium, C7H13N2 +), consists of a nickel-thio-phosphate anion charge-balanced by a pair of crystallographically independent PMIM cations. It crystallizes in the monoclinic space group P21/n. The structure exhibits the known [Ni(P2S8)2]2- anion with two unique imidazolium cations in the asymmetric unit. Whereas one PMIM cation is well ordered, the other is disordered over two orientations with refined occupancies of 0.798 (2) and 0.202 (2). The salt was prepared directly from the elements in the ionic liquid [PMIM]CF3SO3. Whereas one of the PMIM cations is well behaved (it does not exhibit disorder even in the propyl side chain), the other is found in two overlapping positions. The refined occupancies for the two orientations are roughly 80:20. Here, too, there appears to be little disorder in the propyl arm.


Computer-assisted measurement of vessel shape from 3T magnetic resonance angiography of mouse brain.
Blood vessel morphology (vessel radius, branching pattern, and tortuosity) is altered by a multitude of diseases. Although murine models of human pathology are important to the investigation of many diseases, there are few publications that address quantitative measurements of murine vascular morphology. This report outlines methods of imaging mice in vivo using magnetic resonance angiograms obtained on a clinical 3T unit, of defining mouse vasculature from these images, and of quantifying measures of vessel shape. We provide examples of both healthy and diseased vasculature and illustrate how the approach can be used to assess pathology both visually and quantitatively. The method is amenable to the assessment of many diseases in both human beings and mice.


Response of the μ-opioid system to social rejection and acceptance.
The endogenous opioid system, which alleviates physical pain, is also known to regulate social distress and reward in animal models. To test this hypothesis in humans (n=18), we used an μ-opioid receptor (MOR) radiotracer to measure changes in MOR availability in vivo with positron emission tomography during social rejection (not being liked by others) and acceptance (being liked by others). Social rejection significantly activated the MOR system (i.e., reduced receptor availability relative to baseline) in the ventral striatum, amygdala, midline thalamus and periaqueductal gray (PAG). This pattern of activation is consistent with the hypothesis that the endogenous opioids have a role in reducing the experience of social pain. Greater trait resiliency was positively correlated with MOR activation during rejection in the amygdala, PAG and subgenual anterior cingulate cortex (sgACC), suggesting that MOR activation in these areas is protective or adaptive. In addition, MOR activation in the pregenual ACC was correlated with reduced negative affect during rejection. In contrast, social acceptance resulted in MOR activation in the amygdala and anterior insula, and MOR deactivation in the midline thalamus and sgACC. In the left ventral striatum, MOR activation during acceptance predicted a greater desire for social interaction, suggesting a role for the MOR system in social reward. The ventral striatum, amygdala, midline thalamus, PAG, anterior insula and ACC are rich in MORs and comprise a pathway by which social cues may influence mood and motivation. MOR regulation of this pathway may preserve and promote emotional well being in the social environment.


Clinical applications of exhaled nitric oxide for the diagnosis and management of asthma: a consensus report.
Patients with asthma routinely exhibit elevated levels of fractionated exhaled nitric oxide (FE(NO)), and this observation has led to studies investigating FE(NO) as a potential marker of airway inflammation. FE(NO) has been shown to enhance the diagnosis of asthma, detect deterioration in control of patients with asthma, and monitor response to anti-inflammatory therapy. The aim of this work was to determine if FE(NO) measurement provides a noninvasive, well-tolerated, and standardized technique to monitor airway inflammation, and if it has the potential to complement standard asthma monitoring tools (eg, symptom diaries, control questionnaires, and pulmonary function testing) and to improve asthma control and patient outcomes. Thirteen experts in the diagnosis and treatment of asthma met to discuss the use of FE(NO) in the diagnosis and management of patients with asthma. Participants were selected by Aerocrine, a medical, technical company with headquarters in Stockholm, Sweden, in consultation with their medical education partner Cadent Medical Communications located in Irving, Texas, to represent a diversity of specialists, including both clinicians and investigators, in the fields of allergy, immunology, and pulmonology. All participants were nominally compensated for their time to attend this closed scientific roundtable discussion. The meeting was supported by an educational grant from Aerocrine. This report represents the overall consensus reached by the participants on the clinical applicability of this technique. Our understanding of asthma has expanded so that investigators are now focusing on inflammation in addition to airway obstruction and hyper-reactivity. Whereas patient history, symptoms, and pulmonary function testing can assist in diagnosing asthma, they are not direct measures of the extent of airway inflammation. Elevated FE(NO) levels have been shown to reflect airway inflammation and to occur together with other conventional markers used to detect inflammation. Studies have confirmed increased levels of FE(NO) in both adults and children with asthma. In most studies, FE(NO) was found to be elevated 2- to 3-fold compared with normal controls. There are many determinants of FE(NO) levels, however, and factors other than inflammation must be considered when FE(NO) measurement is used to diagnose and monitor asthma. FE(NO) measurement alone is not sufficient for diagnosing or monitoring asthma, but it can be a valuable addition to current clinical tools. FE(NO) measurement is a noninvasive and reproducible test that is a surrogate measure of airway inflammation in patients with asthma. The test has demonstrated utility in diagnosing and managing asthma and in predicting response to therapy and, therefore, may be an important tool to incorporate into clinical care.


Multimodal remote sensing application for weed competition time series analysis in maize farmland ecosystems.
Although weeds cause serious harm to crops through competition for resources, they also have ecological functions. We need to study the change law of competition between crops and weeds, and achieve scientific farmland weed management under the premise of protecting weed biodiversity. In the research, we perform a competitive experiment in Harbin, China, in 2021, with five periods of maize as the study subjects. Comprehensive competition indices (CCI-A) based on maize phenotypes were used to describe the dynamic processes and results of weeds competition. The relation between in structural and biochemical information of maize and weed competitive intensity (Levels 1-5) at different periods and the effects on yield parameters were analyzed. The results showed that the differences of maize plant height, stalk thickness, and N and P elements among different competition levels (Levels 1-5) changed significantly with increasing competition time. This directly resulted in 10%, 31%, 35% and 53% decrease in maize yield; and 3%, 7%, 9% and 15% decrease in hundred grain weight. Compared to the conventional competition indices, CCI-A had better dispersion in the last four periods and was more suitable for quantifying the time-series response of competition. Then, multi-source remote sensing technologies are applied to reveal the temporal response of spectral and lidar information to community competition. The first-order derivatives of the spectra indicate that the red edge (RE) of competition stressed plots biased in short-wave direction in each period. With increasing competition time, RE of Levels 1-5 shifted towards the long wave direction as a whole. The coefficients of variation of canopy height model (CHM) indicate that weed competition had a significant effect on CHM. Finally, the deep learning model with multimodal data (Mul-3DCNN) is created to achieve a large range of CCI-A predictions for different periods, and achieves a prediction accuracy of R2 = 0.85 and RMSE = 0.095. Overall, this study use of CCI-A indices combined with multimodal temporal remote sensing imagery and DL to achieve large scale prediction of weed competitiveness in different periods of maize.


[Failures of the issue: how to improve?].
If they are not stopped before transfusion, distribution of blood components (BC) errors can have serious consequences for patients. The study of reported incidents of transfusion chain shows that the risk of failure is important, especially on the steps of patient selection in software, packing and giving the BC to transporter. The analysis of these problems most often state "human" error by misapplication of procedures. These errors are favored by systemic causes: many interfaces with numerous actors in the transfusion process, breaking between different information systems, stress of the emergency and lot of visual self-checks. Improvement may be proposed by a better the organization of the different tasks, by the ergonomic of the work, by improving distribution software and training operators to the management of the emergency. But things must be thought again by all the actors involved in the transfusion management of patients in order to reduce the risks associated with multiple interfaces.


International perspectives on sharing clinical data with patients.
Engaging patients in their care has become a topic of increasing importance, and enabling patients to have access to their clinical data is a key aspect of such engagement. We investigated, on an international scale, the current state of approaches for providing patients with access to their own clinical information. Individuals from 28 countries were invited to participate in a cross-sectional semi-structured interview. Interview questions focused on social and cultural influences that affected patient engagement activities, government support for current and planned initiatives, data ownership models, and technical issues. Interviews were conducted with individuals from 16 countries representing six continents. Respondents reported substantive initiatives for providing information to patients in the majority of countries interviewed. These initiatives were diverse in nature and stage of implementation. Enabling patient access to data is occurring on an international scale. There is considerable variability in the level of maturity, the degree of government involvement, the technical infrastructure, and the plans for future development across the world. As informaticians, we are still in the early stages of deploying patient engagement technologies and have yet to identify optimal strategies in this arena. Efforts to improve patient access to data are active on a global-scale. There are many open questions about best practices and much can be learned by adopting an international perspective to guide future implementation efforts.


FoxO3 regulates hepatic triglyceride metabolism via modulation of the expression of sterol regulatory-element binding protein 1c.
Excessive intrahepatic lipid accumulation is the major characteristic of nonalcoholic fatty liver disease (NAFLD). We sought to identify the mechanisms involved in hepatic triglyceride (TG) homeostasis. Forkhead box class O (FoxO) transcription factors have been shown to play an important role in hepatic metabolism. However, little is known about the effect of FoxO3 on hepatic TG metabolism. Liver biopsy samples from patients with NALFD and liver tissues from high glucose and high sucrose (HFHS) fed mice, ob/ob mice and db/db mice were collected for protein and mRNA analysis. HepG2 cells were transfected with small interfering RNA to mediate FoxO3 knockdown, or adenovirus and plasmid to mediate FoxO3 overexpression. FoxO3-cDNA was delivered by adenovirus to the liver of C57BL/6 J male mice on a chow diet or on a high-fat diet, followed by determination of hepatic lipid metabolism. Sterol regulatory element-binding protein 1c (SREBP1c) luciferase reporter gene plasmid was co-transfected into HepG2 cells with FoxO3 overexpression plasmid. FoxO3 expression was increased in the livers of HFHS mice, ob/ob mice, db/db mice and patients with NAFLD. Knockdown of FoxO3 reduced whereas overexpression of FoxO3 increased cellular TG concentrations in HepG2 cells. FoxO3 gain-of-function caused hepatic TG deposition in C57BL/6 J mice on a chow diet and aggravated hepatic steatosis when fed a high-fat diet. Analysis of the transcripts established the increased expression of genes related to TG synthesis, including SREBP1c, SCD1, FAS, ACC1, GPAM and DGAT2 in mouse liver. Mechanistically, overexpression of FoxO3 stimulated the expression of SREBP1c, whereas knockdown of FoxO3 inhibited the expression of SREBP1c. Luciferase reporter assays showed that SREBP1c regulated the transcriptional activity of the SREBP1c promoter. FoxO3 promotes the transcriptional activity of the SREBP1c promoter, thus leading to increased TG synthesis and hepatic TG accumulation.


Beta-blocker infusion did not improve left ventricular diastolic function in myocardial infarction: a Doppler echocardiography and cardiac catheterization study.
Left ventricular (LV) diastolic function changes after myocardial infarction. It has been suggested that beta blockers may improve diastolic function in hypertensive and heart failure patients. Doppler echocardiographic filling patterns and invasive hemodynamic indices have been used to analyze LV diastolic function. To determine the effect of beta blockers on LV diastolic function, we studied 32 patients with anterior wall myocardial infarction with a mean age of 53 years. Peak early and late flow velocities, peak early-to-late flow velocities ratio, pressure half time, diastolic filling period, isovolumic relaxation time, cardiac index, mean arterial pressure, wedge pressure, and systemic and pulmonary vascular resistance indices were obtained simultaneously before and after an intravenous infusion of 10 mg of atenolol. Cardiac index decreased from 4.27 +/- 0.97 to 3.19 +/- 0.91 l/min/m2 (p = 0.0001); mean arterial pressure decreased from 85 +/- 10 to 80 +/- 11 mmHg (p = 0.004); wedge pressure increased from 11 +/- 5 to 13 +/- 4 mmHg (p = 0.002); systemic vascular resistance index increased from 1586 +/- 409 to 1980 +/- 634 dyn.m2.s/cm5 (p = 0.0002); pulmonary vascular resistance index increased from 115 +/- 58 to 163 +/- 72 dyn.m2.s/cm5 (p = 0.0004); peak late flow velocity decreased from 64 +/- 15 to 49 +/- 14 cm/s (p = 0.0001); early-to-late ratio increased from 0.95 +/- 0.35 to 1.29 +/- 0.36 (p = 0.0001); diastolic filling period increased from 300 +/- 108 to 400 +/- 110 ms (p = 0.0001) and isovolumic relaxation time increased from 133 +/- 29 to 143 +/- 29 ms (p = 0.009). No significant changes were observed for peak early flow velocity and pressure half-time.(ABSTRACT TRUNCATED AT 250 WORDS)


[Modern approaches to neuroprotective treatment of ischemic stroke].
The authors present the results of domestic clinical trials on the efficacy and safety of mexidol in patients with cerebrovascular disorders including ischemic stroke (IS). The use of mexidol is associated with complete and rapid regression of the focal neurological deficit. Mexidol is well tolerated with no significant side-effects. The drug is recommended for enteral and parenteral administration in patients with IS.


Transporter and metabolic enzyme-mediated intra-enteric circulation of SN-38, an active metabolite of irinotecan: A new concept.
SN-38, an active metabolite of irinotecan (CPT-11), is thought to circulate enterohepatically via organic anion-transporting polypeptides (OATPs), UDP-glucuronyl transferases (UGTs), multidrug resistance-related protein 2 (MRP2), and breast cancer resistance protein (BCRP). These transporters and enzymes are expressed in not only hepatocytes but also enterocytes. Therefore, we hypothesized that SN-38 circulates between the intestinal lumen and the enterocytes via these transporters and metabolic enzymes. To test this hypothesis, metabolic and transport studies of SN-38 and its glucuronide (SN-38G) were conducted in Caco-2 cells. The mRNA levels of UGTs, MRP2, BCRP, and OATP2B1 were confirmed in Caco-2 cells. SN-38 was converted to SN-38G in Caco-2 cells. The efflux of intracellularly generated SN-38G across the apical (digestive tract) membranes was significantly higher than the efflux across the basolateral (blood, portal vein) membranes of Caco-2 cells cultured on polycarbonate membranes. SN-38G efflux to the apical side was significantly reduced in the presence of MRP2 and BCRP inhibitors, suggesting that SN-38G is transported across the apical membrane by MRP2 and BCRP. Treatment of Caco-2 cells with OATP2B1 siRNA increased the SN-38 residue on the apical side, confirming that OATP2B1 is involved in the uptake of SN-38 into enterocytes. No SN-38 was detected on the basolateral side with or without siRNA treatment, suggesting that the enterohepatic circulation of SN-38 is limited, contrary to previous reports. These results suggest that SN-38 is absorbed into the enterocytes via OATP2B1, glucuronidated by UGTs to SN-38G, and excreted into the digestive tract lumen by MRP2 and BCRP. SN-38G can be deconjugated by β-glucuronidase from intestinal bacteria in the digestive tract lumen to regenerate SN-38. We named this new concept of local drug circulation "intra-enteric circulation." This mechanism may allow SN-38 to circulate in the intestine and cause the development of delayed diarrhea, a serious side effect of CPT-11.


A new investigation for some steroidal derivatives as anti-Alzheimer agents.
We herein report the anti-Alzheimer activity of some synthesized heterocyclic pyrimidine and thiopyrimidine derivatives fused with steroidal structure. Twenty-one of these compounds were synthesized and conveniently screened for their anti-Alzheimer activities using of Flurbiprofen as the reference drug. Some of these compounds were demonstrated to exhibit remarkable activity and their β-amyloid (Aβ) lowering results as IC(50) values reported.


[Evaluation of a public health programme: direct Clopidogrel administration by cardiology units in acute myocardial infarction].
to compare the benefit of a personalised outpatient therapy prescribed upon discharge by the cardiology unit to the patients undergoing a percutaneous coronary intervention with drug-eluting stent or bare-metal stent vs. the usual practice. controlled, multicentre, non-randomized study that enrolled patients who underwent coronary stent implantation and treated in the year after stent implantation with two protocols: the treatment group received Clopidogrel directly from the cardiology unit at each monitoring visit; the control group received a prescription for outpatient treatment through the standard retail pharmacy channel. the recruited centres adopting the new treatment protocol are Magenta, Legnano, and Rho (ASL Milano1, Magenta - Lombardy Region, Northern Italy), with 477 patients included; the recruited centres following for the standard protocol are Niguarda and San Carlo (ASL Milano), with 307 patients included. We identified all patients aged ≥40 years, discharged after coronary stent implantation between January 1st, 2010 and March 31st, 2011, and followed for 1 year. all coronary events, second coronary interventions or deaths in the year after hospital discharge. we found differences between the two treatments in relation with coronary events: hazard ratio (HR) for the control group in patients with ST-elevation myocardial infarction (STEMI) is 3.32 (95%CI 1.67- 6.62), HR in patients with non-ST elevation myocardial infarction (NSTEMI) is 2.44 (95%CI 1.07-5.57). The compliance at 1 year is 80% in the treated group vs. 70% in the control group, respectively (p-value <0.01). the application of the therapeutic plan, governed by the interventional cardiology, increases treatment adherence and reduces the risk of cardiovascular events subsequent to the insertion of a stent. It is crucial, therefore, to improve the adherence to dual antiplatelet therapy by using high levels of integration between inpatient and outpatient care to reduce adverse health outcomes during post-surgery phase and to ensure the taking in charge of the patient.


A novel technique to prevent inadvertent sheath migration.
Inadvertent trocar-sheath migration is annoying to the surgeon and may result in serious visceral injury. Herein is described a novel technique to prevent such migration. A 0.25-in. Penrose drain is wrapped around the trocar-sheath unit as a collar to prevent sheath migration.


Theory of Mind in schizophrenia: first person vs third person perspective.
Patients suffering from schizophrenia have an impaired meta-representation also known as Theory of Mind (ToM). Moreover, the presence of delusions or other positive symptoms of schizophrenia has been correlated to poor ToM performances. Lack of insight is a common symptom of schizophrenia and can be considered a critical manifestation of impaired ToM abilities. In particular, the present study addresses the role of perspective ToM ability in schizophrenic patients. Thirty severely delusional schizophrenic patients completely lack insight when interviewed about their delusions. Seven subsequently gain insight about their mental state when perspective is shifted from the first person to third person. These data suggest that in some delusional schizophrenic patients, it may be possible to gain access to and modify their mental states.


Magnesium transport by isolated rumen epithelium of sheep.
The mechanism of transfer of magnesium across isolated rumen epithelium was studied in vitro using 28Mg. Isolated pieces of rumen epithelium developed a transmural potential difference of 8.2 +/- 2.3 mV, lumen side negative, during the first hour of incubation when mounted between the two halves of an incubation chamber. A significant net transport of magnesium from lumen to blood was measured when the initial concentration of magnesium in the solutions bathing both surfaces of the epithelium was 2.5 mM. Net flux of magnesium took place against an electrical gradient and was dependent on the presence of the transmural potential difference. The process was saturable at magnesium concentrations of about 5 mM and was markedly reduced by lowering the temperature of the bathing solution, by addition of 10(-4) M ouabain and by extending the time of incubation. The findings strongly support the view that magnesium absorption from the rumen is mediated by an active transport process.


The antiviral defense mechanisms in mandarin fish induced by DNA vaccination against a rhabdovirus.
Plasmid DNAs containing Siniperca chuatsi rhabdovirus (SCRV) glycoprotein gene (pcDNA-G) and nucleoprotein gene (pcDNA-N) were constructed, and used to determine the antiviral immune response elicited by DNA vaccination in mandarin fish. In vitro and in vivo expression of the plasmid constructs was confirmed in transfected cells and muscle tissues of vaccinated fish by Western blot, indirect immunofluorescence or RT-PCR analysis. Fish injected with pcDNA-G exhibited protective effect against SCRV challenge with a relative percent survival (RPS) of 77.5%, but no significant protection (RPS of 2.5%) was observed in fish vaccinated with pcDNA-N. Immunohistochemical analysis showed that vaccination with pcDNA-G decreased histological lesions and suppressed the virus replication in fish target organs, e.g. kidney, liver, spleen, gill and heart. Transcriptional analysis further revealed that the expression levels of type I IFN system genes including interferon regulation factor-7 (IRF-7) gene, myxovirus resistance (Mx) gene and virus inhibitory protein (Viperin) gene were strongly up-regulated after injection with pcDNA-G, whereas the level of transcription of immunoglobulin M (IgM) gene did not show a statistically significant change. These results reveal that type I IFN antiviral immune response is rapidly triggered by the plasmid DNA containing rhabdovirus glycoprotein gene in fish, which offers an explanation of molecular mechanisms for DNA vaccination inducing mandarin fish resist to SCRV disease.


Proximal row carpectomy for posttraumatic disorders of the carpus.
Twenty-four patients (23 men and one woman) from 19 to 65 years old underwent proximal row carpectomy following carpal injuries. The injuries were 10 transscaphoid perilunate dislocations with late subluxation and arthritis, 10 ununited scaphoid fractures with arthritis, three scapholunate dissociations with arthritis, and one acute carpal dislocation. All were followed for from 3 to 10 years. Although the result depended on the original injury, wrist extension was 65% to 70% of normal, flexion was 48% to 65%, ulnar deviation 85 1/2, and radial deviation 17%. Grip strength was equal to that in the opposite hand. There was one failure that was converted to a successful fusion.


Pathological, histochemical and ultrastructural studies on sea-blue histiocytes and Gaucher-like cells in acquired lipidosis occurring in leukemia.
Smears of bone marrow aspiration from 82 patients with leukemia and major hematopoietic organs, such as bone marrow, spleen, liver and lymph nodes, obtained from 97 autopsy cases of the disease, were light-microscopically examined. As the results, occurrence of either sea-blue histiocytes or Gaucher-like cells, or of both, was observed in bone marrow smears of 23 patients and in the hematopoietic tissues of 44 out of the examined cases, particularly marked in those of chronic myelogenous leukemia. In acute myelogenous leukemia, these lipid storage cells were also confirmed though less in frequency or degree. Histochemically, the sea-blue histiocytes were substantiated to contain ceroid-like pigments in their cytoplasm uhile the lipid materials stored in the Gaucher-like cells were presumed to be glycolipids. Ultrastructural morphology of the inclusions in the sea-blue histiocytes uas almost consistent with that of ceroid previously reported, but showed more marked variegated and heterogeneous features. Intracytoplasmic inclusions of the Gaucher-like cells differed from those of Gaucher cells seen in Gaucher's disease and were dominated by fibrillar or linear deposits. Transitions from phagocytized leukemic cells to the inclusions characteristic of each type of the cells were traced.


Selectively targeting key inflammatory pathways in cystic fibrosis.
Cystic fibrosis (CF) is a rare genetic disorder caused by a defect in the ion channel Cystic Fibrosis Transmembrane conductance Regulator (CFTR), resulting in ionic imbalance of surface fluid. Although affecting multiple organs, the progressive deterioration of respiratory function by recurrent infections and chronic inflammation represents the main cause of morbidity and mortality in CF patients. The development of modulators targeting the basic defect of CFTR has represented a major breakthrough in CF therapy, but the impact on inflammation has remained enigmatic. The emerging scenario taking hold in the field points to inflammation as a major, somehow missed, therapeutic target for prevention of lung decline. Not surprisingly, the development of anti-inflammatory drugs is taking its share in the drug development pipeline. But the path is not straightforward and targeting inflammation should be balanced with the increased risk of infection. The strategy to restore the homeostatic regulation of inflammation to efficiently respond to infection while preventing lung damage needs to be based on identifying and targeting endogenous immunoregulatory pathways that are defective in CF. We herein provide an overview of anti-inflammatory drugs currently approved or under investigation in CF patients, and present our recent studies on how the knowledge on defective immune pathways in CF may translate into innovative and selective anti-inflammatory therapeutics. Through the discovery of naturally occurring molecules or their synthetic mimics, this review emphasizes the critical importance of selectively targeting key inflammatory pathways to preserve immunocompetence in CF patients.


pH, redox potential and local biofilm potential microenvironments within Geobacter sulfurreducens biofilms and their roles in electron transfer.
The limitation of pH inside electrode-respiring biofilms is a well-known concept. However, little is known about how pH and redox potential are affected by increasing current inside biofilms respiring on electrodes. Quantifying the variations in pH and redox potential with increasing current is needed to determine how electron transfer is tied to proton transfer within the biofilm. In this research, we quantified pH and redox potential variations in electrode-respiring Geobacter sulfurreducens biofilms as a function of respiration rates, measured as current. We also characterized pH and redox potential at the counter electrode. We concluded that (1) pH continued to decrease in the biofilm through different growth phases, showing that the pH is not always a limiting factor in a biofilm and (2) decreasing pH and increasing redox potential at the biofilm electrode were associated only with the biofilm, demonstrating that G. sulfurreducens biofilms respire in a unique internal environment. Redox potential inside the biofilm was also compared to the local biofilm potential measured by a graphite microelectrode, where the tip of the microelectrode was allowed to acclimatize inside the biofilm.


"They're very passionate about making sure that women stay healthy": a qualitative examination of women's experiences participating in a community paramedicine program.
Community paramedicine programs (i.e., physician-directed preventive care by emergency medical services personnel embedded in communities) offer a novel approach to community-based health care. Project Swaddle, a community paramedicine program for mothers and their infants, seeks to address (directly or through referrals) the physical, mental, social, and economic needs of its participants. The objective of this process evaluation was to describe women's experiences in Project Swaddle. By understanding their experiences, our work begins to build the foundation for similar programs and future examinations of the efficacy and effectiveness of these approaches. We completed 21 interviews with women living in Indiana (July 2019-February 2020) who were currently participating in or had graduated from Project Swaddle. Interviews were audio-recorded, transcribed, and analyzed using a six-phase approach to thematic analysis. Program enrollment was influenced by the community paramedics' experience and connections, as well as information received in the community from related clinics or organizations. Participants viewed the community paramedic as a trusted provider who supplied necessary health information and support and served as their advocate. In their role as physician extenders, the community paramedics enhanced patient care through monitoring critical situations, facilitating communication with other providers, and supporting routine healthcare. Women noted how community paramedics connected them to outside resources (i.e., other experts, tangible goods), which aimed to support their holistic health and wellbeing. Results demonstrate Project Swaddle helped women connect with other healthcare providers, including increased access to mental health services. The community paramedics were able to help women establish care with primary care providers and pediatricians, then facilitate communication with these providers. Women were supported through their early motherhood experience, received education on parenting and taking control of their health, and gained access to resources that met their diverse needs.


Multi-dose enteral L-citrulline administration in premature infants at risk of developing pulmonary hypertension associated with bronchopulmonary dysplasia.
Information is needed to guide the design of randomized controlled trials (RCTs) evaluating L-citrulline as a therapy for premature infants with pulmonary hypertension associated with bronchopulmonary dysplasia (BPD-PH). Our goal was to evaluate the tolerability and ability to achieve a target steady-state L-citrulline plasma concentration in prematures treated enterally with a multi-dose L-citrulline strategy based on our single-dose pharmacokinetic study. Six prematures received 60 mg/kg of L-citrulline every 6 hours for 72 hours. Plasma L-citrulline concentrations were measured before the first and last L-citrulline doses. L-citrulline concentrations were compared to concentration-time profiles from our previous study. Plasma L-citrulline concentrations agreed with the simulated concentration-time profiles. No serious adverse events occurred. Simulations based on single-doses can be used to predict target multi-dose plasma L-citrulline concentrations. These results assist the design of RCTs evaluating the safety and effectiveness of L-citrulline therapy for BPD-PH. Clinical trials.gov ID: NCT03542812.


An international observational study suggests that artificial intelligence for clinical decision support optimizes anemia management in hemodialysis patients.
Managing anemia in hemodialysis patients can be challenging because of competing therapeutic targets and individual variability. Because therapy recommendations provided by a decision support system can benefit both patients and doctors, we evaluated the impact of an artificial intelligence decision support system, the Anemia Control Model (ACM), on anemia outcomes. Based on patient profiles, the ACM was built to recommend suitable erythropoietic-stimulating agent doses. Our retrospective study consisted of a 12-month control phase (standard anemia care), followed by a 12-month observation phase (ACM-guided care) encompassing 752 patients undergoing hemodialysis therapy in 3 NephroCare clinics located in separate countries. The percentage of hemoglobin values on target, the median darbepoetin dose, and individual hemoglobin fluctuation (estimated from the intrapatient hemoglobin standard deviation) were deemed primary outcomes. In the observation phase, median darbepoetin consumption significantly decreased from 0.63 to 0.46 μg/kg/month, whereas on-target hemoglobin values significantly increased from 70.6% to 76.6%, reaching 83.2% when the ACM suggestions were implemented. Moreover, ACM introduction led to a significant decrease in hemoglobin fluctuation (intrapatient standard deviation decreased from 0.95 g/dl to 0.83 g/dl). Thus, ACM support helped improve anemia outcomes of hemodialysis patients, minimizing erythropoietic-stimulating agent use with the potential to reduce the cost of treatment.


The silkmoth eggshell as a natural amyloid shield for the safe development of insect oocyte and embryo: insights from studies of silkmoth chorion protein peptide-analogues of the B family.
Silkmoth chorion is the major component of the silkmoth eggshell. The proteins that constitute more than 95% of its dry mass have remarkable mechanical and physicochemical properties forming a protective natural shield for the oocyte and the developing embryo from a wide range of environmental hazards. Peptide-analogues of the central conservative domain of the two major families of silkmoth chorion proteins, the A's and the B's, form amyloid fibrils under a variety of conditions, which prompted us to propose, 10 years ago, that silkmoth chorion is an amyloid with protective properties. Following our finding, a number of studies verified the existence of several functional amyloids. In this study, we designed, synthesized and studied two peptide-analogues of the central conservative domain of the B family of silkmoth chorion proteins, and we present experimental results, which show: (a) that the amyloidogenic properties of silkmoth chorion peptides are encoded into the tandemly repeating hexapeptides comprising the central domain of silkmoth chorion proteins, confirming our previous findings from peptide analogues of the A family of chorion proteins, and, (b) they suggest how silkmoth chorion proteins of the B family self-assemble in vivo, for the formation of the helicoidal architecture of silkmoth chorion.


The cost-effective synthesis of furan- and thienyl-based microporous polyaminals for adsorption of gases and organic vapors.
This work reveals that furfural and 2-thenaldehyde can readily react with melamine via "one-step" polycondensation to yield hyper-cross-linked sulfur-, nitrogen- and oxygen-rich microporous polyaminals with promising applications in adsorption of gases and toxic organic vapors.


Resolvin-D2 targets myogenic cells and improves muscle regeneration in Duchenne muscular dystrophy.
Lack of dystrophin causes muscle degeneration, which is exacerbated by chronic inflammation and reduced regenerative capacity of muscle stem cells in Duchenne Muscular Dystrophy (DMD). To date, glucocorticoids remain the gold standard for the treatment of DMD. These drugs are able to slow down the progression of the disease and increase lifespan by dampening the chronic and excessive inflammatory process; however, they also have numerous harmful side effects that hamper their therapeutic potential. Here, we investigated Resolvin-D2 as a new therapeutic alternative having the potential to target multiple key features contributing to the disease progression. Our in vitro findings showed that Resolvin-D2 promotes the switch of macrophages toward their anti-inflammatory phenotype and increases their secretion of pro-myogenic factors. Moreover, Resolvin-D2 directly targets myogenic cells and promotes their differentiation and the expansion of the pool of myogenic progenitor cells leading to increased myogenesis. These effects are ablated when the receptor Gpr18 is knocked-out, knocked-down, or blocked by the pharmacological antagonist O-1918. Using different mouse models of DMD, we showed that Resolvin-D2 targets both inflammation and myogenesis leading to enhanced muscle function compared to glucocorticoids. Overall, this preclinical study has identified a new therapeutic approach that is more potent than the gold-standard treatment for DMD.


Median Arcuate Ligament Syndrome in a patient with Crohn's disease.
The Median Arcuate Ligament Syndrome is a rare condition characterized by postprandial abdominal pain, bowel function disorder and weight loss. We report the first case to our knowledge of Crohn's disease and Median Arcuate Ligament Syndrome. The patient was a 33 year-old female with a previous diagnosis of Crohn's disease. Acute postprandial abdominal pain affected the patient every day; she was, therefore, referred to US-Doppler and magnetic resonance angiography of the abdominal vessels and received a diagnosis of Median Arcuate Ligament Syndrome. Consequently, the patient was surgically treated, releasing the vascular compression. After the operation, she reported a complete relief from postprandial pain which was one of her major concerns. Subocclusive symptoms occurred after six months due to the inflammatory reactivation of the terminal ileitis. The diagnosis of Median Arcuate Ligament Syndrome is mainly based on the exclusion of other intestinal disorders but it should be always confirmed using noninvasive tests such as US-Doppler, angio-CT or magnetic resonance angiography. This case demonstrates that the Median Arcuate Ligament Syndrome could be the major cause of symptoms, even in presence of other abdominal disorders.


An augmented reality system for image-guided surgery.
The introduced new developed navigation system is a High Intensity Approach Light System for augmented reality in image-guided surgery. The surgeon follows the projected approach lights with his ordinary surgical instruments. Thus, tracked instruments are not necessary with this system.


A supernormal period in central axons following single cell stimulation.
Intracellular recordings were obtained from caudate (Cd) nucleus efferent neurons in the cat. A supernormal period, as characterized by increased excitability and conduction velocity, was found for the Cd efferent fibers following either a conditioning antidromic action potential, or a single orthodromic action potential induced by direct current application through the recording microelectrode. These data indicate that the impulse activity of a single fiber can modulate excitability and conduction velocity independent of surround impulse activity.


[A rare case of intrapulmonary fetus-in-fetu].
Fetus-in-fetu (FIF) is a rare pathological condition, which presents as a congenital tumor, usually in the abdomen or retroperitoneum. A few cases have been reported in the cranial cavity, cervical spine, ovarium, scrotum and liver. We presently report a case of intrapulmonary FIF in a 12-year-old girl who was on treatment for pulmonary tuberculosis and had no symptoms related to the tumor. To our knowledge this is the first reported case of FIF with pulmonary presentation.


Accessory cell function of thoracic duct nonlymphoid cells, dendritic cells, and splenic adherent cells in the Brown-Norway rat.
Thoracic duct lymph of lymphadenectomized Brown-Norway (BN) rats is highly enriched for nonlymphoid cells (NLC) which share several characteristics with splenic dendritic cells (DC), e.g., the binding of monoclonal antibody OX2. The accessory cell activity of NLC was analyzed by comparing these cells with DC and splenic adherent cells (SAC). In concanavalin A (Con A)-induced T-cell proliferation NLC, like DC, were very effective accessory cells at low cell numbers, as a consequence of an efficient induction of interleukin 2 (IL-2) production and IL-2 responsiveness. Responses in the presence of SAC were poor, even after the addition of excess IL-2. A fourfold enhancement of accessory cell activity of SAC was achieved by the depletion of FcR-positive cells, which were responsible for suppression of the Con A response. Low responsiveness of BN rats with respect to Lewis rats can in part be explained by a higher suppressive activity of macrophages in the BN rat.


In Vitro Digestion for Control and Monitoring of Food Effects in Relation to Micellarization Index of Carotenoids.
The multifactorial system that influences the availability of macronutrients, micronutrients, and phytoconstituents with relevant bioactivities has been assessed by in vitro digestion protocols, which have become an effective technique to support the health-through-food strategy. The measurement of the significance of food structure, food matrix, synergies and competitive effects, processing features, and even some physiological issues has created valuable scientific and technological information, and the development of harmonized protocols. Now it is possible to make further advances by applying this knowledge to obtain data regarding the potential availability of target compound(s) in the food source within a standard meal context. This protocol describes the measurement of the micellarization index of carotenoids from dietary rich sources with test meals accounting the effects of high vs. low fat and normo-, hypo-, and hypercaloric content.


Parasitic infections: therapeutic considerations.
Parasitic infections are a problem even in developed countries. Since the agents used to treat these infections are infrequently used, most physicians are unfamiliar with antiparasitic compounds. The activity, mode of action, and use of antiparasitic agents is reviewed.


Convolutional neural network for soil microplastic contamination screening using infrared spectroscopy.
Microplastics are emerging pollutants that exist in our environment. Microplastics are synthetic polymers that have particles size smaller than 5 mm. Rapid screening of microplastics contamination in the soil could assist in identifying anomalous concentrations of microplastics in the terrestrial environment. Because there is no rule on the maximum concentration limit on how much microplastics can exist within the soil, the concentration of microplastics collected from industrial areas around metropolitan Sydney was used as a baseline. Spectra obtained from the visible-near-infrared (vis-NIR) spectra has been shown to be feasible in predicting microplastics in the soil. Instead of creating a regression model predicting the concentration of microplastic, a classification model for screening was proposed. A convolutional neural network (CNN) model was trained to classify the soil sample into various degrees of contamination based on concentration. We also delved into the CNN model to understand how the CNN model classifies the spectral data input. The model performance was first tested on two levels of classification (contaminated vs. non-contaminated). The model was able to classify the uncontaminated samples into the appropriate class more accurately than the contaminated samples. When the number of classes were gradually increased, the classification accuracy for the higher level of contaminated samples improved. Transfer learning CNN model further improved the classification prediction only on the extremes, but not the intermediate classes.


Individual protomers of a G protein-coupled receptor dimer integrate distinct functional modules.
Recent advances in proteomic technology reveal G-protein-coupled receptors (GPCRs) are organized as large, macromolecular protein complexes in cell membranes, adding a new layer of intricacy to GPCR signaling. We previously reported the α1D-adrenergic receptor (ADRA1D)-a key regulator of cardiovascular, urinary and CNS function-binds the syntrophin family of PDZ domain proteins (SNTA, SNTB1, and SNTB2) through a C-terminal PDZ ligand interaction, ensuring receptor plasma membrane localization and G-protein coupling. To assess the uniqueness of this novel GPCR complex, 23 human GPCRs containing Type I PDZ ligands were subjected to TAP/MS proteomic analysis. Syntrophins did not interact with any other GPCRs. Unexpectedly, a second PDZ domain protein, scribble (SCRIB), was detected in ADRA1D complexes. Biochemical, proteomic, and dynamic mass redistribution analyses indicate syntrophins and SCRIB compete for the PDZ ligand, simultaneously exist within an ADRA1D multimer, and impart divergent pharmacological properties to the complex. Our results reveal an unprecedented modular dimeric architecture for the ADRA1D in the cell membrane, providing unexpected opportunities for fine-tuning receptor function through novel protein interactions in vivo, and for intervening in signal transduction with small molecules that can stabilize or disrupt unique GPCR:PDZ protein interfaces.


Biomineralization Guided by Paper Templates.
This work demonstrates the fabrication of partially mineralized scaffolds fabricated in 3D shapes using paper by folding, and by supporting deposition of calcium phosphate by osteoblasts cultured in these scaffolds. This process generates centimeter-scale free-standing structures composed of paper supporting regions of calcium phosphate deposited by osteoblasts. This work is the first demonstration that paper can be used as a scaffold to induce template-guided mineralization by osteoblasts. Because paper has a porous structure, it allows transport of O2 and nutrients across its entire thickness. Paper supports a uniform distribution of cells upon seeding in hydrogel matrices, and allows growth, remodelling, and proliferation of cells. Scaffolds made of paper make it possible to construct 3D tissue models easily by tuning material properties such as thickness, porosity, and density of chemical functional groups. Paper offers a new approach to study mechanisms of biomineralization, and perhaps ultimately new techniques to guide or accelerate the repair of bone.


[TPS and SCC antigens in diagnosis and monitoring treatment of patients with cervical cancer].
The purpose was to evaluate the usefulness of serum TPS and SCC assay for the monitoring radiotherapy of patients with cervical cancer. 38 patients with cervical cancer treated with radiotherapy were included in this study. The concentrations of TPS and SCC were determined prior to radiotherapy, after radiotherapy, 3 and 6 months after radiotherapy. The increase in TPS levels prior to treatment was observed in serum of 80% women, SCC rose by 71%. The frequency of increased results and absolute value of TPS levels showed tendency to significant increase together with development of disease and degree of histological differentiation. A significant decrease of TPS and SCC level was observed during radiotherapy. The TPS levels decreased above cut-off values in all patients, SCC in 90% patients with remission after radiotherapy. In cases of patients who still had high TPS antigen level after treatment, progression of cancer was found. These results suggest that TPS and SCC are useful in monitoring treatment of patients with cervical cancer.


[Principles of acute pain therapy-An overview taking special features in the patient collective of ophthalmology into consideration].
For many years the quality of perioperative pain management in general has been repeatedly reported as inadequate and there is significant evidence to indicate that this is also true after surgical procedures in ophthalmology. The patient population in ophthalmology is quite challenging due to numerous comorbidities and a high average age resulting in numerous contraindications and organ dysfunctions and requiring special knowledge to ensure high quality acute pain management. The following overview covers basic knowledge of acute pain management, with a particular focus on analgesic approaches and the specifics of the patient population and the associated limitations in terms of analgesic and co-analgesic pharmacological options.


Azathioprine reduces intrathecal IgG synthesis in multiple sclerosis.
Intrathecal IgG synthesis and CSF oligoclonal bands were reexamined after 18-24 months in 66 patients with multiple sclerosis; 40 of them received azathioprine (AZA) 2.5 mg/Kg/die; all received a course of dexamethasone (DEXA) during clinical relapses. The IgG Index was significantly reduced in the group treated with AZA, especially in patients with short disease duration, low disability and high IgG index. Changes observed in CSF banding pattern were not significant. These results suggest an effect of AZA on IgG synthesis, as reported by in vitro studies.


Heart Valve Clinics, Centers, and Networks.
There is consensus on important aspects of managing heart valve disease. Despite this, many patients are managed by general physicians or cardiologists without specialist competencies in valve disease, which leads to suboptimal outcomes. Multidisciplinary heart valve clinics bring together cardiologists, surgeons, nurses, and in some countries scientists to deliver expert guidelines and experience-driven optimal care. Patients are referred at the optimal time for interventions at heart valve centers, defined by strict standards of facilities and processes. Valve networks link valve clinic, heart valve center, and the community to improve the passage of patients at every level of care.


Comparative long-term efficacy and safety of drug-eluting stent versus coronary artery bypass grafting in ostial left main coronary artery disease: analysis of the MAIN-COMPARE registry.
To date, drug-eluting stent (DES) implantation has not been compared with coronary artery bypass grafting (CABG) for ostial left main coronary artery (LMCA) lesions. Of the 263 patients in the MAIN-COMPARE registry with ostial LMCA stenosis, 123 were treated with percutaneous coronary intervention (PCI) with DES and 140 with CABG. We compared their 5-year overall survival, composite outcomes of death, Q-wave myocardial infarction (MI) or stroke, and target vessel revascularization (TVR) rates. Unadjusted analysis showed no significant differences between CABG and DES in overall survival rates (95% confidence interval (CI) for hazard ratio (HR): 0.44 to 1.77, P = 0.71), composite outcomes (death, Q-wave MI, or stroke)-free survival rates (95% CI for HR: 0.41-1.63, P = 0.56), and TVR-free survival rates (95% CI for HR: 0.79-5.03, P = 0.14). Multivariate adjusted Cox regression analysis also showed no significant between-group differences in TVR (95% CI for HR: 0.52-3.79, P = 0.49), death (95% CI for HR: 0.79-2.82, P = 0.22) and the composite of death, Q-wave MI, or stroke (95% CI for HR: 0.65-2.57, P = 0.46). These results were sustained after propensity score adjustment and propensity score matching analysis. DES implantation for ostial LMCA lesions showed similar 5-year outcomes of death, major adverse events, and TVR compared with CABG. Although meticulous adjustments decreased baseline difference between the two treatments, the absence of statistical significance could be attributable to the size of the study sample and hidden bias.


A turn-on unlabeled colorimetric biosensor based on aptamer-AuNPs conjugates for amyloid-β oligomer detection.
Amyloid-β oligomers (AβO) have been identified as core biomarkers for early diagnosis of Alzheimer's disease (AD). For the first time, a "turn-on" unlabeled colorimetric aptasensor based on aptamer-polythymine (polyT)-polyadenine (polyA)-gold nanoparticles (pA-pT-apt@AuNPs) was developed for highly sensitive and specific detection of amyloid-β1-40 oligomers (Aβ40-O). In this system, polyA sequence could preferentially anchor onto AuNPs surface as well as reduce the non-specific adsorption, and the aptamer could form upright conformation for the specific recognition of Aβ40-O. The aggregation of pA-pT-apt@AuNPs was induced by MgCl2. However, the addition of Aβ40-O enabled the aptamer fold adaptively upon recognition and aptamer-Aβ40-O complex formed surrounding AuNPs, effectively stabilizing pA-pT-apt@AuNPs against salt-induced aggregation, therefore the color of pA-pT-apt@AuNPs solution still retained red. Based on this principle, the proposed aptasensor exhibited high sensitivity with the limit of detection of 3.03 nM and a linear detectable range from 10.00 nM to 100.0 nM. The superb sensitivity was achieved via the optimization of the length of polyA and polyT spacer. This pA-pT-apt@AuNPs based colorimetric aptasensor provides a rapid, cost-effective, highly sensitive detection method for Aβ40-O, which is valuable for the early diagnosis of AD.


Kinetic and pharmacologic characterization of dopamine binding in the mouse cerebellum and the effects of the reeler mutation.
The purpose of this study was to characterize the dopaminergic system in the mouse cerebellum and to determine whether the dyskinesia of the reeler mutant is accompanied by alterations in cerebellar and/or striatal dopamine binding. From the analysis of (3H) dopamine ((3H)DA) and (3H)spiperone ((3H)Sp) binding, the study of the effects of several drugs on this binding, and the comparison of these parameters between the cerebellum and striatum, we conclude that a dopaminergic system exists in the cerebellum with properties common to the striatal system but also with some differences. That is, 1) with (3H)DA as ligand, we find two binding sites in cerebellum with similar Kd to those of striatum but of lower density, 2) with (3H)Sp as ligand we observe two binding sites in cerebellum and one in striatum, and 3) the competition of (3H)DA binding by various drugs shows that among the cerebellar sites, relative to striatum, there is a higher proportion that corresponds to high affinity D3 and D4 (D2 high) binding sites. In cerebellum and striatum of reeler mice, (3H)DA binding increases 125-174% and 14%, respectively.


Fournier's gangrene: a clinical presentation of necrotizing fasciitis after bone marrow transplantation.
Three patients with ANLL developed Fournier's gangrene as an early complication after allo-BMT (two cases) and auto-BMT (one case); two patients were in first CR, the third had resistant disease. Patients developed fever, perineal pain, swelling and blistering of the genital area. Pseudomonas aeruginosa was isolated from the lesions and patients received systemic antibiotic therapy, surgical debridement and medication with potassium permanganate solution. Two patients made a complete recovery although one died of sepsis. The third had progressive involvement of the abdominal wall and later died of leukemia. Early diagnosis of this disorder and prompt initiation of appropriate therapy can prevent progression of this acute necrotizing infection.


Hemodynamic performance and incidence of patient-prosthesis mismatch of the complete supraannular perimount magna bioprosthesis in the aortic position.
Complete supraannular placement and smaller stent design allow the implantation of a Perimount Magna bioprosthesis with a larger inner diameter than that of a standard Perimount. This study compares the hemodynamic performance and the incidence of patient-prosthesis mismatch (PPM) of both prostheses. 128 patients underwent aortic valve replacement, receiving either a Magna (n = 57) or a standard (n = 71) prosthesis. Inner aortic annulus diameter was measured intraoperatively by a hegar dilator to match echocardiographically obtained results to the annulus diameter instead of matching them to labelled valve size. The Magna was significantly superior with respect to mean pressure gradient and effective orifice area in patients with an annulus diameter of 22-23 mm. In patients with an annulus diameter < 22 mm or > 23 mm, there was a non-significant trend towards superior hemodynamics in the Magna group. Severe PPM (effective orifice area index < or = 0.65 cm (2)/m (2)) was present in 11.1% (Magna) vs. 42.1% (Standard) of patients with an annulus diameter < 22 mm; in 0% (Magna) vs. 13.8% (Standard) with an annulus diameter of 22-23 mm; no PPM was seen in patients with annulus diameter > 23 mm in both groups. The Perimount Magna had a significantly reduced incidence of patient-prosthesis mismatch and superior hemodynamics compared to the standard Perimount.


Neuronal populations and single cells representing learned auditory objects.
The neural representations associated with learned auditory behaviours, such as recognizing individuals based on their vocalizations, are not well described. Higher vertebrates learn to recognize complex conspecific vocalizations that comprise sequences of easily identified, naturally occurring auditory objects, which should facilitate the analysis of higher auditory pathways. Here we describe the first example of neurons selective for learned conspecific vocalizations in adult animals--in starlings that have been trained operantly to recognize conspecific songs. The neuronal population is found in a non-primary forebrain auditory region, exhibits increased responses to the set of learned songs compared with novel songs, and shows differential responses to categories of learned songs based on recognition training contingencies. Within the population, many cells respond highly selectively to a subset of specific motifs (acoustic objects) present only in the learned songs. Such neuronal selectivity may contribute to song-recognition behaviour, which in starlings is sensitive to motif identity. In this system, both top-down and bottom-up processes may modify the tuning properties of neurons during recognition learning, giving rise to plastic representations of behaviourally meaningful auditory objects.


Pelvic arteriovenous malformation (AVM) with recurrent hematuria: A case report.
Arteriovenous malformation (AVM) leads to a direct connection between arterial and venous networks, in which capillary branches are not involved. Pelvic AVM is a benign and rare condition causing severe pain, hematuria, and rectal or vaginal bleeding. A 36-year-old woman presented with five months history of hematuria. Her medical history was unremarkable, and laboratory findings were all within normal ranges. Abdominopelvic computed tomography (CT) scan revealed a vascular mass in the left lateral pelvis that extended to the bladder neck and was suggestive of an AVM. The patient underwent a laparotomy for the resection of AVM. The first angiography revealed an AVM in the left internal iliac artery. The patient underwent embolization with coil and gel foam. The second angiography revealed complete obstruction of the left internal iliac artery due to multiple coils and AVM of the right internal iliac artery (RIIA), embolized with glue and lipiodol. A week later, venography revealed another left iliac vein malformation embolized with foam sclerotherapy. Forty days later, the third angiography revealed another AVM in the right iliac artery, embolized with three vials of polyvinyl alcohol (PVA). Following two months of follow-up, the symptoms did not return. The present study reported a rare case of recurrent pelvic AVM causing painless hematuria in a female patient. The lesion was treated with several angioembolization sessions. Angioembolization is one of the main therapeutic options for AVM. Appropriate material should be precisely chosen for AVM embolization regarding the AVM's location, size, and condition.


Effect of the presence of a nonhost herbivore on the response of the aphid parasitoid Diaeretiella rapae to host-infested cabbage plants.
The vast majority of studies of plant indirect defense strategies have considered simple tritrophic systems that involve plant responses to attack by a single herbivore species. However, responses by predators and parasitoids to specific, herbivore-induced, volatile blends could be compromised when two or more different herbivores are feeding on the same plant. In Y-tube olfactometer studies, we investigated the responses of an aphid parasitoid, Diaeretiella rapae (McIntosh) (Hymenoptera: Braconidae), to odors from cabbage plants infested with the peach-potato aphid Myzus persicae (Sulzer) (Homoptera: Aphididae), in both the presence and absence of a lepidopteran caterpillar, Plutella xylostella L. (Lepidoptera: Plutellidae). Female parasitoids chose aphid-infested plants over uninfested plants but did not distinguish between caterpillar-infested and uninfested plants. When given a choice between odors from an aphid-infested plant and those from a plant infested with diamondback moth larvae, they significantly chose the former. Furthermore, the parasitoids responded equally to odors from a plant infested with aphids only and those from a plant infested with both aphids and caterpillars. The results support the hypothesis that the aphid and the caterpillar induce different changes in the volatile profile of cabbage plants and that D. rapae females readily distinguish between the two. Furthermore, the changes to the plant volatile profile induced by the caterpillar damage did not hinder the responses of the parasitoid to aphid-induced signals.


Implementation of ask-advise-connect for smoking cessation in Dutch general practice during the COVID-19 pandemic: a mixed-methods evaluation using the CFIR framework.
The Ask-Advise-Connect (AAC) approach can help primary care providers to increase the number of people who attempt to quit smoking and enrol into cessation counselling. We implemented AAC in Dutch general practice during the COVID-19 pandemic. In this study we describe how AAC was received in Dutch general practice and assess which factors played a role in the implementation. A mixed-methods approach was used to evaluate the implementation of AAC. Implementation took place between late 2020 and early 2022 among 106 Dutch primary care providers (general practitioners (GPs), practice nurses and doctor's assistants). Quantitative and qualitative data were collected through four online questionnaires. A descriptive analysis was conducted on the quantitative data. The qualitative data (consisting of answers to open-ended questions) were inductively analysed using axial codes. The Consolidated Framework for Implementation Research was used to structure and interpret findings. During the study, most participants felt motivated (84-92%) and able (80-94%) to apply AAC. At the end of the study, most participants reported that the AAC approach is easy to apply (89%) and provides advantages (74%). Routine implementation of the approach was, however, experienced to be difficult. More GPs (30-48%) experienced barriers in the implementation compared to practice nurses and doctor's assistants (7-9%). The qualitative analysis showed that especially external factors, such as a lack of time or priority to discuss smoking due to the COVID-19 pandemic, negatively influenced implementation of AAC. Although AAC was mostly positively received in Dutch general practice, implementation turned out to be challenging, especially for GPs. Lack of time to discuss smoking was a major barrier in the implementation. Future efforts should focus on providing additional implementation support to GPs, for example with the use of e-health.


Vascular dysfunction and its recovery after transradial coronary angioplasty- A serial observational study.
To serially evaluate the effect of trans-radial coronary angioplasty (TRA) on the vascular function of radial artery (RA) and upstream brachial artery (BA) and to find out the relative contribution of endothelial dependent flow-mediated vasodilatation (FMD) and endothelial independent nitrate mediated dilatation (NMD). Forty patients of chronic stable angina with successful TRA were studied. FMD and NMD of bilateral RA and BA were measured with high-resolution ultrasound, before and at 24 h and at 3 months, after catheterization. FMD as well as NMD were significantly decreased in right RA (16.3 ± 3.6% to 5.7 ± 1.8%; p = 0.001, and 24.1 ± 5.3% to 9.7 ± 2.8%; p = 0.001, respectively) as well as in upstream BA (17.0 ± 1.6% to 9.4 ± 0.5%; p = 0.001,and 26.5 ± 6.8% to 20.5 ± 3.7%; p = 0.001, respectively) at 24 h. FMD/NMD ratio was also decreased in RA (70 ± 10% to 60 ± 10%; p = 0.04) and as well as in BA (70 ± 20% to 50 ± 10%; p = 0.03). The endothelial dysfunctions returned to normal at 3 months. Control arm did not show any change in vascular function at any point of time. Radial artery diameter/sheath ratio <1 and catheter exchanges >2 were the independent predictors for >50% decrease in FMD. TRA results in reversible depression in FMD as well as NMD in the radial artery as well as upstream brachial artery. These vascular dysfunctions are limited to the catheterized arm only and return to normal after 3 months.


Monocyte-mediated suppression of rheumatoid factor production in normal subjects.
The regulatory role of normal monocytes in the production of rheumatoid factor (RF) was investigated. Monocyte depletion from normal mononuclear cells (MNC) resulted in an elaboration of IgM RF in 18 of 20 subjects. The increased RF production was inhibited by the addition to the cultures of adherent cells or their culture supernatants. These observations demonstrate the suppressive role of normal monocytes in the production of RF. Supernatants obtained from normal monocytes cultured with indomethacin could suppress the RF production, suggesting that prostaglandin E2 may not be involved in the regulation of IgM RF production.


Serotypes of Nag Vibrios isolated from clinical and environmental sources.
Nag Vibrios isolated in two districts in Romania were typed with the 38 "O" Nag antisera prepared in our laboratory. Nag serotype O:5 was found to be prevalent.


WNK kinases sense molecular crowding and rescue cell volume via phase separation.
When challenged by hypertonicity, dehydrated cells must recover their volume to survive. This process requires the phosphorylation-dependent regulation of SLC12 cation chloride transporters by WNK kinases, but how these kinases are activated by cell shrinkage remains unknown. Within seconds of cell exposure to hypertonicity, WNK1 concentrates into membraneless condensates, initiating a phosphorylation-dependent signal that drives net ion influx via the SLC12 cotransporters to restore cell volume. WNK1 condensate formation is driven by its intrinsically disordered C terminus, whose evolutionarily conserved signatures are necessary for efficient phase separation and volume recovery. This disorder-encoded phase behavior occurs within physiological constraints and is activated in vivo by molecular crowding rather than changes in cell size. This allows kinase activity despite an inhibitory ionic milieu and permits cell volume recovery through condensate-mediated signal amplification. Thus, WNK kinases are physiological crowding sensors that phase separate to coordinate a cell volume rescue response.


Avoiding false positives with PCR.
The exquisite sensitivity of the polymerase chain reaction means DNA contamination can ruin an entire experiment. Tidiness and adherence to a strict set of protocols can avoid disaster.


Arthroscopic versus open synovectomy in the rheumatoid knee.
We report the clinical and radiological results after arthroscopic synovectomy (41 knees) and open capsulosynovectomy (26 knees) in patients with rheumatoid arthritis, with an average follow-up of more than ten years. The clinical outcome was much the same in both groups, but there was gradual deterioration, especially after eight years. Radiological changes of osteoarthritis were worse in the knees treated by open capsulosynovectomy compared with the arthroscopic group. Arthroscopic synovectomy has many advantages and we believe that it is better than open capsulosynovectomy for patients with rheumatoid arthritis of the knee.