Vitamin A for non-measles pneumonia in children.
Acute respiratory infections, mostly in the form of pneumonia, are the leading causes of death in children under five years of age in developing countries. Some clinical trials have demonstrated that vitamin A supplementation reduces the severity of respiratory infection and mortality in children with measles. To determine whether adjunctive vitamin A is effective in infants and children diagnosed with non-measles pneumonia. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2004); MEDLINE (1996 to November Week 3, 2004); EMBASE (1990 to September 2004); LILACS (9 January 2004); CINAHL (1990 to November 2004); Biological Abstracts (1990 to November 2004) and Current Contents (1990 to September 2004); and the Chinese Biomedicine Database (CBM) (1994 to November 2004). Only parallel-arm, randomised and quasi-randomised controlled trials in which children (younger than 15 years old) with non-measles pneumonia were treated with adjunctive vitamin A were included. Two authors independently extracted data and assessed trial quality. Study authors were contacted for additional information. Five trials involving 1453 infants and children were included. There was no significant reduction in the mortality associated with pneumonia in children treated with vitamin A compared to those who were not (pooled odds ratio (OR) 1.49; 95% confidence interval (CI) 0.66 to 3.35). In addition, there was a lack of a statistically significant effect on duration of stay in hospital (weighted mean difference (WMD) 0.08; 95% CI -0.43 to 0.59). Vitamin A was associated with a 39% reduction in antibiotic firstline failure (OR 0.65; 95% CI 0.42 to 1.01). Children receiving vitamin A were no more likely to experience vomiting (OR 0.77; 95% CI 0.45 to 1.33), diarrhoea (OR 0.57; 95% CI 0.31 to 1.05), bulging of the fontanelles (OR 8.25; 95% CI 0.44 to 155.37) or irritability (OR 0.93, 95% CI 0.56 to 1.57) than those not receiving vitamin A. There was no statistical significance between vitamin A and placebo groups (OR 0.90; 95% CI -1.10 to 2.90) in chest x-ray results. Disease severity after supplementary high-dose vitamin A was significantly worse in children who received vitamin A compared with placebo. Low-dose vitamin A was associated with a significant reduction in the recurrent rate of bronchopneumonia (OR 0.12; 95% CI 0.03 to 0.46). The evidence did not suggest a significant reduction with vitamin A adjunctive treatment in mortality, measures of morbidity, nor an effect on the clinical course of pneumonia in children with non-measles pneumonia. However, not all studies measured all outcomes, limiting the number of studies that could be incorporated into the meta-analyses, so that there may have been a lack of statistical power to detect statistically significant differences.


Role of pulmonary microvascular endothelial cell apoptosis in murine sepsis-induced lung injury in vivo.
Sepsis remains a common and serious condition with significant morbidity and mortality due to multiple organ dysfunction, especially acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Sepsis-induced ALI is characterized by injury and dysfunction of the pulmonary microvasculature and pulmonary microvascular endothelial cells (PMVEC), resulting in enhanced pulmonary microvascular sequestration and pulmonary infiltration of polymorphonuclear leukocytes (PMN) as well as disruption of the normal alveolo-capillary permeability barrier with leak of albumin-rich edema fluid into pulmonary interstitium and alveoli. The role of PMVEC death and specifically apoptosis in septic pulmonary microvascular dysfunction in vivo has not been established. In a murine cecal ligation/perforation (CLP) model of sepsis, we quantified and correlated time-dependent changes in pulmonary microvascular Evans blue (EB)-labeled albumin permeability with (1) PMVEC death (propidium iodide [PI]-staining) by both fluorescent intravital videomicroscopy (IVVM) and histology, and (2) PMVEC apoptosis using histologic fluorescent microscopic assessment of a panel of 3 markers: cell surface phosphatidylserine (detected by Annexin V binding), caspase activation (detected by FLIVO labeling), and DNA fragmentation (TUNEL labeling). Compared to sham mice, CLP-sepsis resulted in pulmonary microvascular barrier dysfunction, quantified by increased EB-albumin leak, and PMVEC death (PI+ staining) as early as 2 h and more marked by 4 h after CLP. Septic PMVEC also exhibited increased presence of all 3 markers of apoptosis (Annexin V+, FLIVO+, TUNEL+) as early as 30 mins--1 h after CLP-sepsis, which all similarly increased markedly until 4 h. The time-dependent changes in septic pulmonary microvascular albumin-permeability barrier dysfunction were highly correlated with PMVEC death (PI+; r = 0.976, p < 0.01) and PMVEC apoptosis (FLIVO+; r = 0.991, p < 0.01). Treatment with the pan-caspase inhibitor Q-VD prior to CLP reduced PMVEC death/apoptosis and attenuated septic pulmonary microvascular dysfunction, including both albumin-permeability barrier dysfunction and pulmonary microvascular PMN sequestration (p < 0.05). Septic PMVEC apoptosis and pulmonary microvascular dysfunction were also abrogated following CLP-sepsis in mice deficient in iNOS (Nos2 (-/-)) or NADPH oxidase (p47 (phox-/-) or gp91 (phox-/-)) and in wild-type mice treated with the NADPH oxidase inhibitor, apocynin. Septic murine pulmonary microvascular dysfunction in vivo is due to PMVEC death, which is mediated through caspase-dependent apoptosis and iNOS/NADPH-oxidase dependent signaling.


Neddylation controls basal MKK7 kinase activity in breast cancer cells.
The c-Jun NH2-terminal protein kinase (JNK) pathway has been implicated in mammary tumor development. However, the molecular mechanisms regulating JNK activity in breast cancer cells remain unclear. Here, we report that the inhibition of ubiquitination-like post-translational modification neddylation through different strategies results in enhanced basal JNK phosphorylation in human breast cancer cells. The upregulation of basal JNK phosphorylation upon neddylation inhibition is independent of the deneddylation of Cullins, the well-characterized neddylation substrates. Since augmented basal JNK phosphorylation via ectopic MKK7 expression impedes proliferation and the epithelial-to-mesenchymal transition (EMT) phenotype, the neddylation system might contribute to mammary tumor development partially through limiting basal JNK phosphorylation. Further exploration reveals that MKK7, a JNK-specific MAP2K, undergoes neddylation in human breast cancer cells. MKK7 co-precipitates with a fragment of Ran-binding protein 2 (RanBP2), a large multimodular and pleiotropic protein that has been recognized as a SUMO E3 ligase. Knockdown of RanBP2 attenuates MKK7 neddylation and augments basal JNK phosphorylation without affecting the neddylation of Cullins, whereas ectopic expression of a RanBP2 fragment possessing SUMO E3 activity (RanBP2ΔFG) manifests the opposite effects. In vitro neddylation assays confirm that RanBP2ΔFG works as the neddylation E3 ligase for MKK7. The basal kinase activity of endogenous MKK7 increases upon RanBP2 knockdown but decreases upon the ectopic expression of RanBP2ΔFG. Furthermore, purified MKK7 shows reduced basal kinase activity after in vitro neddylation by RanBP2ΔFG. Consistently, RanBP2 knockdown leads to reduced proliferation and impaired EMT phenotype in human breast cancer cells and the effects of RanBP2 knockdown are reversed by simultaneous MKK7 knockdown. Taken together, our data suggest that MKK7 undergoes neddylation in human breast cancer cells, which limits its basal kinase activity.


Severely ill pediatric patients with Shiga toxin-associated hemolytic uremic syndrome (STEC-HUS) who suffered from multiple organ involvement in the early stage.
Shiga toxin-producing Escherichia coli-associated hemolytic uremic syndrome (STEC-HUS) is the main cause of pediatric acute kidney injury (AKI) in Argentina. Endothelial injury is the trigger event in the microangiopathic process. The host inflammatory response to toxin and E. coli lipopolysaccharide (LPS) is involved in disease pathophysiology. This retrospective study describes pediatric STEC-HUS patients with multiorgan involvement at the initial phase of disease. A retrospective study of critically ill HUS patients with evidence of E. coli infection was conducted through a period of 15 years. Forty-four patients 35.4 ± 4.1 months were admitted to the intensive care unit for 21 ± 2 days. Mechanical ventilation was required in 41 patients, early inotropic support in 37, and 28 developed septic shock. Forty-one patients required kidney replacement therapy for 12 ± 1 days. Forty-one patients showed neurological dysfunction. Dilated cardiomyopathy was demonstrated in 3 patients, left ventricular systolic dysfunction in 4, and hypertension in 17. Four patients had pulmonary hemorrhage, and acute respiratory distress syndrome in 2. Colectomy for transmural colonic necrosis was performed in 3 patients. Thirty-seven patients were treated with therapeutic plasma exchange, and 28 patients received methylprednisolone (10 mg/kg for 3 days). Of the surviving 32 patients, neurological sequelae were seen in 11 and chronic kidney failure in 5. Severe clinical outcome at onset suggests an amplified inflammatory response after exposure to Shiga toxin and/or E. coli LPS. STEC-HUS associated with severe neurological involvement, hemodynamic instability, and AKI requires intensive care and focused therapy.


Effect of microcystin on the expression of Nrf2 and its downstream antioxidant genes from Cristaria plicata.
Microcystin (MC) is a cyclic heptapeptide toxin. Nuclear factor erythocyte 2-related factor 2 (Nrf2) can enhance cellular survival by mediating phase 2 detoxification and antioxidant genes. In this study, CpNrf2 cDNA sequences were cloned from freshwater bivalve Cristaria plicata. The full-length CpNrf2 cDNA sequence was 4259 bp, and its homology was the highest with Mizuhopecten yessoensis, reaching 46%. CpNrf2 transcription levels were examined in all tested tissues, and the highest level was in hepatopancreas from C. plicata. The recombinant protein pET32-CpNrf2 was purified with the content of 1.375 mg/mL. The expression levels of CpNrf2 mRNA were raised in hepatopancreas after MC stimulation. After CpNrf2 knockdown, CpNrf2 mRNA levels were significantly down-regulated after 24 h. Compared with control group, the expression levels of ARE-driven enzymes (CpMnSOD, CpCuZnSOD, CpTRX, CpPrx, CpSe-GPx and Cpsigma-GST) were significantly increased, and those enzyme activities were also significantly up-regulated in MC-stimulated group. However, in CpNrf2-iRNA group, they were significantly down-regulated. The results revealed that Nrf2/ARE pathway is very crucial to protect molluscs from MC.


Plasma protein kinase activity enhanced by interferon is found in platelets.
A protein kinase activity analogous to that found in interferon-treated HeLa cells is detectable in human plasma rich in platelets. This kinase activity is manifested by the phosphorylation of an endogenous Mr 72000 protein which could be conveniently assayed after partial purification on poly(G)-Sepharose. Here, we show that the protein kinase system in the plasma consists of at least 2 components. The protein kinase is found to be localised in the platelets whereas most of the substrate (the Mr 72000 protein) is found free in the plasma and a fraction of it associated with the surface of platelets.


Prognostic significance of branched-chain amino acid transferase 1 and CD133 in triple-negative breast cancer.
Previous studies have shown that branched-chain amino acid transferase 1 (BCAT1) is associated with tumour progression in triple-negative breast cancer (TNBC). Furthermore, CD133 has emerged as a novel cancer stem cell marker for indicating tumour progression. However, the prognostic significance of these two markers remains to be verified. This study was conducted to investigate the correlation between BCAT1 and CD133 expression and clinicopathological features, as well as the prognosis of patients with TNBC. The study cohort included 291 patients with TNBC. Tissue microarrays were constructed for both cancer and normal tissues. The expression of BCAT1 and CD133 was detected by immunohistochemical staining, and the levels were evaluated using an H-scoring system. Cut-off points for BCAT1 and CD133 expression were determined using receiver operating characteristic curves. The median follow-up time for the study participants was 68.73 months (range: 1.37-103.6 months). The 5-year disease-free survival (DFS) and overall survival (OS) rates of the 291 patients with TNBC were 72.51 and 82.47%, respectively. Higher levels of BCAT1 and CD133 expression independently indicated shorter DFS and OS. High levels of both BCAT1 and CD133 expression were detected in 36 (12.37%) patients, who had significantly shorter DFS and OS (both P < 0.001) compared to other patients. BCAT1 and CD133 can be considered as biomarkers with prognostic significance for TNBC.


Biological activities of phthalocyanines. XII: Synthesis tumor uptake and biodistribution of 14C-labeled disulfonated and trisulfonated gallium phthalocyanine in C3H mice.
The biodistribution and metabolism of 14C-labeled disulfonated and trisulfonated gallium phthalocyanine (Ga-PcS) was studied in radiation-induced fibrosarcoma tumor-bearing C3H mice. The [14C]Ga-PcS compounds were prepared via the condensation of [14C]phthalic acid and sulfophthalic acid in the presence of gallium chloride and characterized by their spectroscopic and chromatographic properties. The tissue concentrations of the dyes was measured by scintillation counting of the 14C and by extraction and fluorescence measurements. Elevated dye levels were found in the liver, lungs, kidneys and spleen as well as in the tumor. Lower sulfonation of Ga-PcS favored liver and spleen uptake whereas higher dye sulfonation resulted in greater kidney uptake. Both dyes showed high tumor uptake with peak concentrations exceeding those of most tissues except for the liver in the case of Ga-PcS2. The highest tumor uptake was observed with Ga-PcS3. Both dyes were slowly excreted from the body. The liver-feces pathway was favored in the case of Ga-PcS2 with high activities persisting in the liver, even after 21 days. The Ga-PcS3 was preferentially excreted via the kidney-urine pathway. High performance liquid chromatography analysis of the liver and tumor extracts of [14C]Ga-PcS3-treated animals did not reveal desulfonation of the dye. However, urine analysis showed the presence of radioactive metabolites lacking the characteristic phthalocyanine absorption.


Coincidental Impact of Transcatheter Patent Foramen Ovale Closure on Migraine with and without Aura - A Comprehensive Meta-Analysis.
We analyzed the literature to assess the coincidental impact on migraines of transcatheter patent foramen ovale (PFO) closure performed for secondary stroke prevention. We searched Medline, EMBASE, and the Cochrane database for studies published up until August 2013. We included English-language studies that provided information on complete resolution or improvement in migraine headaches following PFO closure. Two study authors identified 375 original articles and both independently reviewed 32 relevant manuscripts. Data including study methodology, inclusion criteria, PFO closure and migraine outcomes were extracted manually from all eligible studies. Pooled odds (and probability) of resolution or improvement of migraine headaches were calculated using random-effects models. Twenty studies were analyzed. Most were uncontrolled studies that included a small number of patients with cryptogenic stroke who had undergone PFO closure and had variable time of followup. The probability of complete resolution of migraine with PFO closure (18 studies, 917 patients) was 0.46 (95% confidence interval 0.39, 0.53) and of any improvement in migraine (17 studies, 881 patients) was 0.78 (0.74, 0.82). There was evidence for publication bias in studies reporting on improvement in migraines (Begg's p=0.002), but not for studies on complete resolution of migraine (p=0.3). In patients with aura, the probability of complete resolution of migraine post-PFO closure was 0.54 (0.43, 0.65), and in those without aura, complete resolution occurred in 0.39 (0.29, 0.51). Among patients with unexplained stroke and migraine undergoing transcatheter PFO closure, resolution of headaches occurred in a majority of patients with aura and for a smaller proportion of patients without aura.


Elicitor and calatalse activity of conidia suspensions of various strains of Magnaporthe grisea in suspension-cultured cells of rice.
A conidia suspension of Magnaporthe grisea carried elicitor activity that induced the expression of defense-related genes and the production of H(2)O(2) in suspension-cultured rice cells. The levels of H(2)O(2) produced were dependent on fungal isolates and were correlated with the catalase activity in the supernatant fraction of each conidia suspension, not with gene-for-gene interactions.


Evaluating a unique enhanced recovery protocol in laparoscopic donor nephrectomy: A single center experience.
Enhanced recovery after surgery (ERAS) protocols have been associated with a reduction in opioid consumption and a hastening in recovery in abdominal surgery. However, their impact on laparoscopic donor nephrectomy (LDN) has not been fully elucidated. The aim of this study is to evaluate opioid consumption and other relevant outcome measures before and after implementation of a unique LDN ERAS protocol. 244 LDN patients were included in this retrospective cohort study. Forty-six underwent LDN prior to implementation of ERAS, whereas 198 patients received ERAS perioperative care. The primary outcome was daily oral morphine equivalent (OME) consumption averaged over the entire postoperative stay. Due to removal of preoperative oral morphine from the protocol partway through the study period, the ERAS group was further subdivided into morphine recipients and non-recipients for subgroup analysis. Secondary outcomes included the incidence of postoperative nausea and vomiting (PONV), length of stay, pain scores, and other relevant measures. ERAS donors consumed significantly fewer average daily OMEs than Pre-ERAS donors (21.5 vs. 37.6, respectively; p < .0001). There were no statistically significant differences in OME consumption between morphine recipients and non-recipients. The ERAS group experienced less PONV (44.4% requiring one or more rescue antiemetic postoperatively, vs. 60.9% of Pre-ERAS donors; p = .008). A protocol pairing lidocaine and ketamine with a comprehensive approach to preoperative PO intake, premedication, intraoperative fluid management and postoperative pain control is associated with reduced opioid consumption in LDN.


Vagus nerve ultrasound in transthyretin familial amyloid polyneuropathy: A pilot study.
Autonomic dysfunction is common in transthyretin familial amyloid polyneuropathy (TTR-FAP). Because ultrasonography is a powerful tool to study peripheral neuropathy, vagus nerve (VN) ultrasonography was used in our study to investigate the possible changes of the dimension of VN in TTR-FAP. Eighteen patients with TTR-FAP and 17 age- and gender-matched individuals without any neuropathies were enrolled in a pilot study. The cross-sectional areas (CSAs) were measured bilaterally on transverse scans of vagus, median, and ulnar nerves. Clinical data were collected to explore the correlations with CSAs of VN. The median CSAs of VN in TTR-FAP were 3.5 (2.0-6.0) mm2 on the right side and 2.5 (1.0-6.0) mm2 on the left side, compared with 2.0 (1.0-3.0) mm2 and 1.0 (1.0-2.0) mm2 for healthy controls (HCs). There was a significant difference between the two groups on both sides (p < .001). The mean VN CSAs were correlated positively with the course of disease (r = .7203, p = .0016)(not including the patient with the longest disease course), the Composite Autonomic Symptom Score 31 (r = .5252, p = .0252), the left ventricular posterior wall thickness (r = .5426, p = .0200), and the interventricular septum thickness (r = .5103, p = .0305). The cutoff values of right and left VN CSAs to identify TTR-FAP from HCs were 2.5 and 1.5 mm2 and the areas under the curve were .9395 and .8856, with a high sensitivity (.889 and .889) and specificity (.941 and .765), respectively. VN enlargement is prevalent among TTR-FAP patients. VN ultrasonography may be an important clinical tool for assessing the severity of autonomic dysfunction in TTR-FAP.


Intracellular localization of titanium within xenografted sensitive human tumors after treatment with the antitumor agent titanocene dichloride.
In the present study, the intracellular localization of titanium was analyzed in three xenografted human adenocarcinomas of the colon sigmoideum (S 90), the stomach (M-Stg 4), and the lung (L 261) in dependence on the time after application of a single therapeutic dose (80 mg/kg) of the organometallic antitumor agent titanocene dichloride (C5H5)2TiCl2. The investigations were performed by use of electron energy loss spectroscopy (EELS), a method which allows microanalysis in ultrathin sections, in combination with electron spectroscopic imaging (ESI), which offers the possibility to image the two-dimensional localization and distribution of light- and medium-weight elements in animal tissues. In all three tumors which were studied, titanium was at first detected within the nucleus and, some hours and days later, it was additionally found in cytoplasmic lysosomes. In the colon and lung tumors S 90 and L 261, already 12 hr after treatment, titanium was traceable as tender granules in the nuclear chromatin. During the following days, it was then accumulated in certain areas of the nuclear heterochromatin and, in the case of the L 261 tumor, also in the nucleolus. Maximum concentrations were attained in the nuclei and nucleoli at 48 hr after substance application. Thereafter, titanium was increasingly incorporated into cytoplasmic lysosomes which are known to be involved in intracellular degrading and digesting processes and which occurred in increased numbers in treated tumor cells. Regarding the stomach carcinoma M-Stg 4, titanium was recognized in the nuclear heterochromatin only 1 and 2 days after application of titanocene dichloride. At 48 hr, it was additionally detected in cytoplasmic lysosomes. In all cases where titanium was found accumulated in the nucleus and in lysosomes, phosphorus was simultaneously enriched in a similar local distribution and a concentration which even exceeded that within phosphorus-rich areas, e.g., the nuclear heterochromatin and cytoplasmic ribosomes. These results confirm a primary interaction of titanium-containing metabolites deriving from titanocene complexes with nucleic acid molecules, especially with nuclear DNA. They suggest the formation of aggregates between nucleic acids and titanium-containing metabolites which are obviously extruded out of the nuclei and incorporated into cytoplasmic lysosomes, known to be involved in intracellular digesting processes.


MEK inhibitor enhances the inhibitory effect of imatinib on pancreatic cancer cell growth.
Imatinib mesylate (imatinib) inhibits the c-Kit-dependent tyrosine kinase activities and highly effective in the treatment of CML and GIST patients. Although pancreatic cancer is reported to express c-Kit, imatinib does not effectively inhibit pancreatic cancer cell growth at physiological concentrations. Therefore, we investigated the mechanism of resistance of pancreatic cancer to imatinib treatment. Imatinib inhibited growth of pancreatic cancer cell lines in concentration and time-dependent fashion regardless of c-Kit expression. However, 5 microM imatinib, which is almost a mean maximal plasma concentration in clinical setting, failed to suppress pancreatic cancer cell growth. Western blot analysis demonstrated that 5 microM imatinib treatment for 1h activated the MEK-MAPK pathway and the activation was independent of Ras activation. Administration of 5 microM imatinib and 1 microM U0126 (MEK inhibitor) significantly suppressed pancreatic cell growth. Our results indicate that a combination therapy of imatinib and MEK inhibitor can be a new therapeutic strategy to suppress the progression of pancreatic cancer.


Usefulness of wearable fitness tracking devices in patients undergoing esophagectomy.
Esophageal cancer surgery requires maintenance and enhancement of perioperative nutritional status and physical function to prevent postoperative complications. Therefore, awareness of the importance of preoperative patient support is increasing. This study examined the usefulness of using a diary in combination with a wearable fitness tracking device (WFT) in patients undergoing surgery for esophageal cancer. Ninety-four patients who underwent esophagectomy between February 2019 and April 2021 were included. Physicians, nurses, dietitians, and physical therapists provided diary-based education for the patients. In addition, a WFT was used by some patients. The perioperative outcomes of patients who used both the diary and WFT (WFT group) and those who used the diary alone (non-WFT group) were compared. In addition, propensity score matching was performed to improve comparability between the two groups. After the propensity score matching, the rate of postoperative pneumonia was significantly lower in the WFT group (0% vs. 22.6%, P = 0.005). The postoperative hospital stay was shorter in the WFT group (P = 0.012). Nutritional status indices, such as the prognostic nutritional index, also improved significantly in the WFT group at 1 month after surgery (P = 0.034). The rate of diary entries was significantly higher in the WFT group (72.3% vs. 28.3%, P < 0.001). The use of a WFT reduced the incidence of postoperative pneumonia and improved postoperative nutritional status and rates of diary entries after esophagectomy, suggesting that its use may be useful for promoting recovery after esophagectomy.


Secondary structures, dynamics, and DNA binding of the homeodomain of human SIX1.
Human sine oculis homeobox homolog (SIX) 1 contains a homeodomain (HD), which is important for binding to DNA. In this study, we carried out structural studies on the HD of human SIX1 using nuclear magnetic resonance (NMR) spectroscopy. Its secondary structures and dynamics in solution were explored. HD is well-structured in solution, and our study shows that it contains three α-helices. Dynamics study indicates that the N- and C-terminal residues of HD are flexible in solution. HD of human SIX1 exhibits molecular interactions with a short double-strand DNA sequence evidenced by the 1 H-15 N-heteronuclear single quantum correlation (HSQC) and 19 F-NMR experiments. Our current study provides structural information for HD of human SIX1. Further studies indicate that this construct can be utilized to study SIX1 and DNA interactions.


Environmental impact efficiency of natural gas combined cycle power plants: A combined life cycle assessment and dynamic data envelopment analysis approach.
The energy sector is still dominated by the use of fossil resources. In particular, natural gas represents the third most consumed resource, being a significant source of electricity in many countries. Since electricity production in natural gas combined cycle (NGCC) plants provides some benefits with respect to other non-renewable technologies, it is often seen as a transitional solution towards a future low‑carbon power generation system. However, given the environmental profile and operational variability of NGCC power plants, their eco-efficiency assessment is required. In this respect, this article uses a novel combined Life Cycle Assessment (LCA) and dynamic Data Envelopment Analysis (DEA) approach in order to estimate -over the period 2010-2015- the environmental impact efficiencies of 20 NGCC power plants located in Spain. A three-step LCA+DEA method is applied, which involves data acquisition, calculation of environmental impacts through LCA, and the novel estimation of environmental impact efficiency (overall- and term-efficiency scores) through dynamic DEA. Although only 1 out of 20 NGCC power plants is found to be environmentally efficient, all plants show a relatively good environmental performance with overall eco-efficiency scores above 60%. Regarding individual periods, 2011 was -on average- the year with the highest environmental impact efficiency (95%), accounting for 5 efficient NGCC plants. In this respect, a link between high number of operating hours and high environmental impact efficiency is observed. Finally, preliminary environmental benchmarks are presented as an additional outcome in order to further support decision-makers in the path towards eco-efficiency in NGCC power plants.


Controlling information duration on rewritable luminescent paper based on hybrid antimony (III) chloride/small-molecule absorbates.
Controlling the duration that information lasts on paper so that it disappears as desired is crucial for information security. However, this area is rarely studied. Here, we report [TEMA]2SbCl5 (1, TEMA+ = methyltriethylammonium), [TEA]2SbCl5 (2, TEA+ = tetraethylammonium), [TEBA]2SbCl5 (3, TEBA+ = benzyltriethylammonium), and [Ph4P]2SbCl5 (4, Ph4P+ = tetraphenylphosphonium) with structure-dependent reversible photoluminescent switching induced by the absorption and thermal release of small guest molecules including H2O, methanol, and ethylene glycol. Comparing the structural disorder levels, bond lengths, and luminescent Stokes shifts of the compounds aided in understanding their selective absorption behavior. Our results indicated that the information duration on the rewritable paper coated with the title compounds is easily tuned by changing the cation of the compounds, the type of guest molecules, and laser heating power. Our study opens previously unidentified avenues for information security and extends the potential applications of rewritable paper.


Natural history and long-term clinical behavior of segmental colitis associated with diverticulosis (SCAD syndrome).
Localized inflammation of the sigmoid colon or segmental colitis associated with diverticulosis (SCAD syndrome) is an increasingly recognized, apparently uncommon, clinical and pathological disorder usually described in older adults. In the present study, 24 symptomatic patients, including 14 males, (58.3%) and 10 females (41.7%) were evaluated over a 20-year period with follow-up intervals ranging from 2 to 16 years. In most, initial clinical symptoms appeared after age 40 years and included rectal bleeding, diarrhea, and abdominal pain. Most (21 of 24, over 80%) initially responded with long-term resolution of their disease after treatment only with a 5-aminosalicylate. In addition, however, spontaneous remissions without any form of drug therapy were documented. In some, persistent, chronically active disease or true episodic recurrences were seen, leading to use of corticosteroids and/or resective surgery. Evidence here also suggested that colonic neoplasia, including adenoma development and cancer, were not related to the presence of this uniquely localized mucosal inflammatory process defined within the sigmoid colon. This study documents the natural history and long-term clinical behavior of this unusual segmental inflammatory process, associated with diverticulosis, and provides additional strong evidence that the SCAD syndrome is very distinct and can be readily separated from other forms of chronic inflammatory bowel disease.


Frailty Is Associated With Adverse Postoperative Outcomes After Lung Cancer Resection.
Frailty is an important predictor of outcomes after noncardiac surgery. The 5-factor Modified Frailty Index (mFI-5) is a recently developed frailty metric that has not been adequately evaluated in relation to surgical therapy for lung cancer. We evaluated whether the mFI-5 is predictive of clinical and administrative outcomes after anatomical lung resection for cancer. Data in the Society of Thoracic Surgeons Database were used to evaluate the relationship of mFI-5 to outcomes of patients undergoing elective anatomical lung resection for cancer from 2015 to 2018 using logistic regression analyses. Results were compared with validated risk predictors, including the American Society of Anesthesiologists Physical Status Classification and the Charlson Comorbidity Index. The mFI-5 score could be calculated for 36,587 patients. On univariate analyses, mFI-5 was significantly associated with all clinical and administrative outcomes in an incremental pattern (p < 0.0001 for each). On multivariate analyses, mFI-5 was significantly associated in an incremental pattern with 13 of 15 postoperative complication and administrative outcome categories; the exceptions were cardiovascular complications and 30-day mortality. The overall performance of the frailty metric mFI-5 was similar to that of the American Society of Anesthesiologists and the Charlson Comorbidity Index. The mFI-5 is independently predictive of almost all outcomes after lung resection for cancer. It can be calculated from data typically collected for thoracic surgical patients. Assessment of surgical candidates using mFI-5 may be useful in risk prediction and may identify patients who would benefit from mitigation of increased surgical risk related to frailty.


[Effect of time of operation and clinic organization on postoperative complications].
During a 1-year period 1082 general surgical interventions were prospectively documented and their complication rates evaluated by a score system. Factors responsible for the complication rates and possibly depending on hospital organization should be analysed. The complication rates were influenced by the selection of the weekday, the length of operation time and the extent of discrepancy between planned and required operation time. Furthermore, the complication rates paralleled the extent of utilization of the operation theatre during a workday. The complication rates were not affected by the beginning of operation and the operation month as well as the monthly utilization of the operation theatres. Whether the weather did influence the complication rates could not be decided: higher complication rates were found in the summer as compared to the winter period, but the complication score was independent of the level of the outside temperature and humidity.


[Possibilities in biological diagnosis and therapy of neoplastic pathology of the oral cavity].
After a brief summary of the role played by immunity in preventing the development of malignant neoplasms, the AA. in a speedy sequence treat of tumoral markers and their possibilities in diagnostic use. Then AA. make a precis of trials of different types of immunotherapy and as well of researches object of future therapeutic use.


Chemotherapy drugs derived nanoparticles encapsulating mRNA encoding tumor suppressor proteins to treat triple-negative breast cancer.
Triple-negative breast cancer (TNBC) is one type of the most aggressive breast cancers with poor prognosis. It is of great urgency to develop new therapeutics for treating TNBC. Based on current treatment guideline and genetic information of TNBC, a combinational therapy platform integrating chemotherapy drugs and mRNA encoding tumor suppressor proteins may become an efficacious strategy. In this study, we developed paclitaxel amino lipid (PAL) derived nanoparticles (NPs) to incorporate both chemotherapy drugs and P53 mRNA. The PAL P53 mRNA NPs showed superior properties compared to Abraxane® and Lipusu® used in the clinic including high paclitaxel loading capacity (24 wt.%, calculated by paclitaxel in PAL), PAL encapsulation efficiency (94.7% ± 6.8%) and mRNA encapsulation efficiency (88.7% ± 0.7%). Meanwhile, these NPs displayed synergetic cytotoxicity of paclitaxel and P53 mRNA in cultured TNBC cells. More importantly, we demonstrated in vivo anti-tumor efficacy of PAL P53 mRNA NPs in an orthotopic TNBC mouse model. Overall, these chemotherapy drugs derived mRNA NPs provide a new platform to integrate chemotherapy and personalized medicine using tumor genetic information, and therefore represent a promising approach for TNBC treatment.


Impact of exposure to combat during deployment to Iraq and Afghanistan on mental health by gender.
Interest in the mental health of women deployed to modern military campaigns is increasing, although research examining gender differences is limited. Little is known about experiences women have had on these deployments, or whether men and women respond differently to combat exposure. The current study used data from a representative sample of UK Armed Forces personnel to examine gender differences among those deployed to Iraq and Afghanistan (n=432 women, n=4554 men) in three measures of experience: 'risk to self', 'trauma to others' and 'appraisal of deployment'. We examined the impact of such experiences on post-deployment symptoms of post-traumatic stress disorder (PTSD), symptoms of common mental disorder (CMD) and hazardous alcohol use. After adjustment, men reported more exposure to 'risk to self' and 'trauma to others' events and more negative appraisals of their deployment. Among both genders, all measures of combat experience were associated with symptoms of PTSD and CMD (except 'risk to self' events on symptoms of CMD among women) but not with alcohol misuse. Women reported higher scores on the PTSD Checklist--Civilian Version (PCL-C) among those exposed to lower levels of each experience type but this did not hold in the higher levels. Women reported greater symptoms of CMD and men reported greater hazardous alcohol use across both levels of each experience type. Examining men and women separately suggested similar responses to exposure to adverse combat experiences. The current findings suggest that, although gender differences in mental health exist, the impact of deployment on mental health is similar among men and women.


GoWell: the challenges of evaluating regeneration as a population health intervention.
Urban regeneration can be considered a population health intervention (PHI). It is expected to impact on population health but the evidence is limited or weak, in part due to the difficulties of evaluating PHIs. We explore these challenges using GoWell as a case study. A 10-year evaluation of housing improvement and urban regeneration in 15 deprived areas in Glasgow, Scotland (2005-2015). Challenges faced include: definition and changing nature of the intervention; identifying the recipients of the intervention; and constraints of study design affecting capacity to attribute effects. We have met these challenges by: adapting the evaluation to take account of changing intervention plans and delivery; making pragmatic choices about which populations to focus on for different parts of the study; and taking advantage of delayed delivery of some components to identify controls. Commitment to a long-term evaluation by the Scottish Government and other partners has enabled us to develop a package of studies to investigate health and other outcomes, and the processes of a PHI. GoWell will contribute to the evidence base for interventions focused on tackling the wider determinants of health and help policymakers to be more explicit and realistic about what regeneration might achieve.


[Standardized scale instruments for evaluating the relational meanings of motivation, pathogenesis and care in alcoholism].
The authors give synthesis of five scale methods for alcoholism (Alcoholism Severity Scale, Mac Andrew Scale, Bell Alcoholism Scale of Adjustment, Manson Evaluation and Iowa Alcoholic Intake Schedule), four scale means of the type of Psychological tests (Alcadd Test, Michigan Alcoholism Screening Test, Mortimer-Filkins Test and Essential Reactive Alcoholism Dimension) and three procedures of the type of personality inventory and questionnaire (Drinking Behaviour Interview, Alcoholism Assessment Interview and Alcoholism Use Questionnaire) tools that were at the basis of the construction of a "Scale of Estimating Medical Implications in Alcoholism" conceived experimented and validated in the psychiatric clinic of Iaşi.


In vivo challenging of polymyxins and levofloxacin eye drop against multidrug-resistant Pseudomonas aeruginosa keratitis.
The purposes of this study were to establish a rabbit multidrug-resistant Pseudomonas aeruginosa (MDRP) keratitis model, and test the efficacy of levofloxacin, colistin methanesulfate (CL-M), colistin sulfate (CL-S) and polymyxin B (PL-B) against MDRP infection. In a rabbit eye, making a 2-mm circular corneal excision, and MDRP strain #601 or representative P. aeruginosa strain IID1210 were instilled into the corneal concavity. IID1210 was used to confirm this model developed P. aeruginosa keratitis. After MDRP keratitis developed, we treated the eyes with levofloxacin, CL-M, CL-S or PL-B eye drops. The infected eyes were evaluated by clinical score, histopathological examination and viable bacterial count (CFU). Rabbits developed MDRP keratitis reproducibly after instilled the bacteria into the corneal lesion. MDRP produced severe keratitis similarly with IID1210, as shown by slit lamp examination and clinical score. In MDRP keratitis models, clinical scores and viable bacterial counts were significantly lower in levofloxacin- and CL-M-treated groups compared with PBS-treated group, but the magnitudes of reduction were not remarkable. However, clinical scores were dramatically lowered in CL-S- and PL-B-treated groups compared with PBS-treated group. CL-S- and PL-B-treated group were kept corneal translucency and little influx of polymorphonuclear neutrophils in histopathological examination. In addition, both CL-S- and PL-B-treated groups were not detected viable bacteria in infected cornea. Using our MDRP keratitis model, we showed that topical levofloxacin and CL-M are not adequately effective, while CL-S and PL-B are efficacious in controlling MDRP keratitis. Especially, PL-B, which is commercially available eye drop, might be most effective against MDRP.


Mass spectral analysis of murine epidermal growth factor.
Fast atom bombardment mass spectrometry has been used to characterize epidermal growth factor isolated from mouse submaxillary glands. The preparation is found to consist of two peptides, one of which has the average molecular weight predicted for the familiar gene product. The molecular weight of the second component is found to be reduced by the mass of one asparagine residue. These observations are discussed in light of previous reports of heterogeneity.


Tracheal hamartoma: pericardial flap replacement of membranous tracheal wall.
We presented a rare case of large tracheal hamartoma in a 14-year-old boy and its management with a novel technique of reparation with pericardium of entire membranous portion of the trachea, after the failure of more conservative approaches like bronchoscopic resection and stenting. We remark the advantages of autologous material instead of prosthetic material.


Recombinant human monoclonal autoantibodies specific for citrulline-containing peptides from phage display libraries derived from patients with rheumatoid arthritis.
To isolate and characterize monoclonal autoantibodies (Mab) directed to citrullinated antigens from patients with rheumatoid arthritis (RA). Using lymphocytes from bone marrow or peripheral blood from RA patients, we constructed antibody fragment libraries representing the antibody repertoire of these individuals. Antibody fragments recognizing a citrulline-containing peptide were selected from these patient libraries. Individual antibody clones were analyzed for germline gene usage and reactivity toward citrullinated (auto)-antigens. Sequence analysis of the cDNA encoding the 21 distinct antibody fragments that were obtained revealed a restricted germline gene usage. Individual antibody clones were positive in both antiperinuclear factor (APF) and antikeratin antibody (AKA) tests, stained citrullinated filaggrin and fibrinogen on Western blots, and reacted with subsets of citrulline-containing peptides in ELISA, but not with noncitrullinated peptides. Our report describes the first recombinant human Mab fragments reactive with citrulline-containing peptides. The restricted germline gene usage of these antibodies, and the fact that the VH alleles used are not present in all individuals, may indicate the existence of a genetic predisposition for the development of anticitrulline antibodies in individuals with these germline alleles. The selected antibody clones may facilitate studies on the role of these autoantibodies and their target antigens in the development of RA.


Variations in sexual function after laparoendoscopic single-site hysterectomy in women with benign gynecologic diseases.
Laparoendoscopic single-site surgery (LESS) has become a novel minimally invasive approach applied as an option to perform hysterectomy. The aim of the study was to evaluate the influence of LESS hysterectomy on the sexual function in women with benign gynecologic indications. From October 2016 to May 2021, a total of 486 premenopausal, sexually active women were eligible. Female sexual function index (FSFI) was used to assess sexual function preoperatively and 6, 12 months postoperatively. Total FSFI score ≤26.55 indicated female sexual dysfunction (FSD). Compared with pre-operation, each subdomain and total FSFI scores increased at 6 (all p < 0.05) and 12 months (all p < 0.001). Prevalence of FSD decreased at 6 (30 vs 39.9%, p = 0.002) and 12 months (27 vs 39.9%, p < 0.001). In patients with preoperative FSD, each subdomain and total FSFI scores improved at 6 and 12 months (all p < 0.001), while decreased at 6 months (p < 0.001) and had no significant difference at 12 months (p = 0.54) in patients without preoperative FSD. These results suggest that LESS hysterectomy has a significant positive effect on the sexual function in women with benign gynecologic diseases, especially those with preoperative FSD.


Using mobile telephones: cognitive workload and attention resource allocation.
Driver distraction is recognized as being one of the central causes of road traffic incidents and mobile telephones are tangible devices (among many other electronic devices) that can distract the driver through changes in workload. Forty participants completed a motorway route characterized by a low level of road complexity in the form of vehicle handling and information processing. A peripheral detection task (PDT) was employed to gauge mental workload. We compared effects of conversation type (simple versus complex) and telephone mode (hands-free versus handheld) to baseline conditions. The participants' reaction times increased significantly when conversing but no benefit of hands-free units over handheld units on rural roads/motorways were found. Thus, in regard to mobile telephones, the content of the conversation was far more important for driving and driver distraction than the type of telephone when driving on a motorway or similar type of road. The more difficult and complex the conversation, the greater the possible negative effect on driver distraction.


Coverage for the entire population: tackling immunization rates and disparities in Saskatoon Health Region.
Our objective was to determine the effectiveness of an intervention, the Immunization Reminders Project, in terms of a) improving vaccination coverage rates for measles, mumps and rubella (MMR) among 2-year-olds and b) ameliorating geographical disparities in early childhood immunization coverage. All 14-month-old and 20-month-old children in Saskatoon Health Region who were overdue for their immunizations. Saskatoon Health Region (SHR). The intervention involved calling the parents/caregivers of the children in the target population with a reminder about immunizations. After five telephone calls and if the parent/caregiver could not be reached, a letter was mailed to the last known address. If there was no response to the letter, a reminder home visit was attempted for families residing in the low-income neighbourhoods in Saskatoon. Since January 2009, all reminders for families not residing in the low-income neighbourhoods in Saskatoon are made through mailed letters. After the introduction of the Immunization Reminders Project, coverage rates among 2-year-olds for MMR increased significantly overall and in most geographical areas examined. Disparities between geographical subgroups appeared to be declining, but not significantly. A universal approach to early childhood immunization can likely contribute to increases in coverage rates, but there is still room for improvement in SHR. These findings have prompted additional practice and policy changes.


Conformational variations of both phosphodiesterase-5 and inhibitors provide the structural basis for the physiological effects of vardenafil and sildenafil.
Vardenafil has higher affinity to phosphodiesterase-5 (PDE5) than sildenafil and lower administered dosage for the treatment of erectile dysfunction. However, the molecular basis for these differences is puzzling because two drugs have similar chemical structures. Reported here is a crystal structure of the fully active and nonmutated PDE5A1 catalytic domain in complex with vardenafil. The structure shows that the conformation of the H-loop in the PDE5A1-vardenafil complex is different from those of any known structures of the unliganded PDE5 and its complexes with the inhibitors. In addition, the molecular configuration of vardenafil differs from that of sildenafil when bound to PDE5. It is noteworthy that the binding of vardenafil causes loss of the divalent metal ions that have been observed in all the previously published PDE structures. The conformational variation of both PDE5 and the inhibitors provides structural insight into the different potencies of the drugs.


Epithelial tissue confinement inhibits cell growth and leads to volume-reducing divisions.
Cell proliferation is a central process in tissue development, homeostasis, and disease, yet how proliferation is regulated in the tissue context remains poorly understood. Here, we introduce a quantitative framework to elucidate how tissue growth dynamics regulate cell proliferation. Using MDCK epithelial monolayers, we show that a limiting rate of tissue expansion creates confinement that suppresses cell growth; however, this confinement does not directly affect the cell cycle. This leads to uncoupling between rates of cell growth and division in epithelia and, thereby, reduces cell volume. Division becomes arrested at a minimal cell volume, which is consistent across diverse epithelia in vivo. Here, the nucleus approaches the minimum volume capable of packaging the genome. Loss of cyclin D1-dependent cell-volume regulation results in an abnormally high nuclear-to-cytoplasmic volume ratio and DNA damage. Overall, we demonstrate how epithelial proliferation is regulated by the interplay between tissue confinement and cell-volume regulation.


The cathelicidin CATH-2 efficiently neutralizes LPS- and E. coli-induced activation of porcine bone marrow derived macrophages.
Infectious diseases in pigs cause monetary loss to farmers and pose a zoonotic risk. Therefore, it is important to obtain more porcine specific immunological knowledge as a measure to protect against infectious diseases, for example by exploring immunomodulators that are usable as vaccine adjuvants. Cathelicidins are a class of host defence peptides (HDPs) able to directly kill microbes as well as exert a diverse range of effects on the immune system. The peptides have shown promise as immunomodulatory peptides in many applications, including vaccines. However, it is currently unknown what the precise effect of these peptides is on porcine immune cells and whether peptides of other species might also have a strong immunomodulatory effect on porcine macrophages. Mononuclear bone marrow cells of pigs, aged 5-6 months, were cultured into M1 or M2 macrophages and stimulated with LPS or whole bacteria in the presence of host defence peptides (HDPs). CATH-2 and LL-37 strongly inhibited LPS-induced activation of M1 macrophages, the inhibition of LPS-induced activation of M2 macrophages by HDPs was milder, showing that the peptides have selective effects on different cell types. Upon stimulation with whole bacteria, only CATH-2 could effectively inhibit macrophage activation, showing the potent anti-inflammatory potential of this peptide. These results show that porcine peptides are not necessarily the most active in a porcine system, and that CATH-2 is effective in a porcine system as an anti-inflammatory immune modulator, which can be used, for example, in inactivated pathogen vaccines.


The effect of surgery in tenosynovial giant cell tumours as measured by patient-reported outcomes on quality of life and joint function.
The aim of this study was to evaluate health-related quality of life (HRQoL) and joint function in tenosynovial giant cell tumour (TGCT) patients before and after surgical treatment. This prospective cohort study run in two Dutch referral centres assessed patient-reported outcome measures (PROMs; 36-Item Short-Form Health Survey (SF-36), visual analogue scale (VAS) for pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) in 359 consecutive patients with localized- and diffuse-type TGCT of large joints. Patients with recurrent disease (n = 121) and a wait-and-see policy (n = 32) were excluded. Collected data were analyzed at specified time intervals preoperatively (baseline) and/or postoperatively up to five years. A total of 206 TGCT patients, 108 localized- and 98 diffuse-type, were analyzed. Median age at diagnosis of localized- and diffuse-type was 41 years (interquartile range (IQR) 29 to 49) and 37 years (IQR 27 to 47), respectively. SF-36 analyses showed statistically significant and clinically relevant deteriorated preoperative and immediate postoperative scores compared with general Dutch population means, depending on subscale and TGCT subtype. After three to six months of follow-up, these scores improved to general population means and continued to be fairly stable over the following years. VAS scores, for both subtypes, showed no statistically significant or clinically relevant differences pre- or postoperatively. In diffuse-type patients, the improvement in median WOMAC score was statistically significant and clinically relevant preoperatively versus six to 24 months postoperatively, and remained up to five years' follow-up. Patients with TGCT report a better HRQoL and joint function after surgery. Pain scores, which vary hugely between patients and in patients over time, did not improve. A disease-specific PROM would help to decipher the impact of TGCT on patients' daily life and functioning in more detail. Cite this article: Bone Joint J 2019;101-B:272-280.


Facile synthesis of multinuclear complexes based on a tetra(4-pyridyl)amidinate dirhodium(II) dimer.
Four rhenium(I) chromophores attached to a dirhodium(n) core form a new hexametallic light-harvesting assembly as characterised by X-ray crystallography, UV-vis spectroscopy and electrochemistry.


A potential new role for ASL perfusion imaging: Diagnosis of metronidazole induced encephalopathy - Two companion cases.
Metronidazole induced encephalopathy (MIE) is a rare condition due to prolonged high dose administration of metronidazole. MIE with corresponding increased perfusion on MRI arterial spin labeling (ASL) of the involved regions of the brain appears not to have been reported in the literature to date. We present two such cases, a 59-year-old male with recurrent C difficile colitis with classic MR imaging characteristics of MIE, and a companion case of a 65-year-old female with gangrenous cholecystitis also presumed to have MIE. Despite aggressive medical management, both patients expired. Our cases demonstrate a correlation with ASL hyperperfusion to affected brain regions thought to be due to edema or inflammation. Perfusion imaging may play a role in diagnosis of MIE.


Wood mice (Apodemus sylvaticus L.) as pioneers of recolonization in a reclaimed area.
A population of wood mice, Apodemus sylvaticus, was studied by live-trapping for 15 months in an area recently reclaimed from lignite open-mining, where the species is a pioneer of recolonization. Population dynamics, spacing behaviour and feeding habits were compared with data in the literature in order to investigate how these characteristics were affected by the peculiar habitat conditions and the special situation of early colonization. Population density was remarkably high with a peak of 86 individuals/ha in autumn and a low of 20 individuals/ha in late spring. The sex-ratio was always biased towards males except during periods of low density, when the ratio was close to unity. Individual body weights and the annual course of weight class distribution showed no distinct peculiarities, although body weight increased relatively slowly in late winter. Low juvenile survival, relatively low litter sizes and early termination of breeding were special features of the population. Furthermore, very few juveniles matured in the year of birth, and the best winter survival was found in mice born in the middle of the breeding season. Activity ranges were small compared with those given in the literature, and space use was similar in both sexes. As a direct effect of the habitat conditions, the diet was largely dominated by weed seeds. The possible reasons for and causal relations of these features are discussed.


Mathematical modeling of mpox: A scoping review.
Mpox (monkeypox), a disease historically endemic to Africa, has seen its largest outbreak in 2022 by spreading to many regions of the world and has become a public health threat. Informed policies aimed at controlling and managing the spread of this disease necessitate the use of adequate mathematical modeling strategies. In this scoping review, we sought to identify the mathematical models that have been used to study mpox transmission in the literature in order to determine what are the model classes most frequently used, their assumptions, and the modelling gaps that need to be addressed in the context of the epidemiological characteristics of the ongoing mpox outbreak. This study employed the methodology of the PRISMA guidelines for scoping reviews to identify the mathematical models available to study mpox transmission dynamics. Three databases (PubMed, Web of Science and MathSciNet) were systematically searched to identify relevant studies. A total of 5827 papers were screened from the database queries. After the screening, 35 studies that met the inclusion criteria were analyzed, and 19 were finally included in the scoping review. Our results show that compartmental, branching process, Monte Carlo (stochastic), agent-based, and network models have been used to study mpox transmission dynamics between humans as well as between humans and animals. Furthermore, compartmental and branching models have been the most commonly used classes. There is a need to develop modeling strategies for mpox transmission that take into account the conditions of the current outbreak, which has been largely driven by human-to-human transmission in urban settings. In the current scenario, the assumptions and parameters used by most of the studies included in this review (which are largely based on a limited number of studies carried out in Africa in the early 80s) may not be applicable, and therefore, can complicate any public health policies that are derived from their estimates. The current mpox outbreak is also an example of how more research into neglected zoonoses is needed in an era where new and re-emerging diseases have become global public health threats.


Risk of Gonadoblastoma Development in Patients with Turner Syndrome with Cryptic Y Chromosome Material.
Current guidelines recommend that testing for Y chromosome material should be performed only in patients with Turner syndrome harboring a marker chromosome and exhibiting virilization in order to detect individuals who are at high risk of gonadoblastoma. However, cryptic Y chromosome material is suggested to be a risk factor for gonadoblastoma in patients with Turner syndrome. Here, we aimed to estimate the frequency of cryptic Y chromosome material in patients with Turner syndrome and determine whether Y chromosome material increased the risk for development of gonadoblastoma. A total of 124 patients who were diagnosed with Turner syndrome by conventional cytogenetic techniques underwent additional molecular analysis to detect cryptic Y chromosome material. In addition, patients with Turner syndrome harboring Y chromosome cell lines had their ovaries removed prophylactically. Finally, we assessed the occurrence of gonadoblastoma in patients with Turner syndrome. Molecular analysis demonstrated that 10 patients had Y chromosome material among 118 patients without overt Y chromosome (8.5%). Six patients with overt Y chromosome and four patients with cryptic Y chromosome material underwent oophorectomy. Histopathological analysis revealed that the occurrence of gonadoblastoma in the total group was 2.4%, and gonadoblastoma occurred in one of six patients with an overt Y chromosome (16.7%) and 2 of 10 patients with cryptic Y chromosome material (20.0%). The risk of developing gonadoblastoma in patients with cryptic Y chromosome material was similar to that in patients with overt Y chromosome. Therefore, molecular screening for Y chromosome material should be recommended for all patients with Turner syndrome to detect individuals at a high risk of gonadoblastoma and to facilitate proper management of the disease.


The use of gamma functions in the calculation of organ perfusion functions for non-diffusible radioactive tracers.
This paper introduces a method for quantification of mean organ perfusion by the impulse response function using the experimental time-activity curves for the organ of interest and its supplying artery. These are approximated by gamma functions and a general expression for the impulse response function is then derived. In any particular case, the impulse response function can be calculated simply by insertion of the numerical parameters. The procedure combines speed with freedom from random measurement errors. As an example of a clinical application, the impulse response function of healthy brain tissue is calculated and some clinically important parameters are tabulated.


Cushing's disease with pituitary apoplexy leading to hypopituitarism, empty sella, and spontaneous fracture of the dorsum sellae. Case report.
A patient with a pituitary adenoma secreting adrenocorticotropin hormone manifested panhypopituitarism after an episode of pituitary apoplexy. The previously elevated urinary levels of 17-ketogenic steroids dropped sharply, and plasma cortisol became undetectable. The apoplexy also resulted in a partially empty sella on which the dorsum sellae collapsed. Recurrent Cushing's disease developed and was cured by transsphenoidal resection of a microadenoma.


Pericardial patch augmentation of anterior tricuspid leaflet in Ebstein's anomaly.
Although refinement of tricuspid valvuloplasty and plication techniques has opened the way to a satisfactory outlook for the majority of patients with Ebstein's anomaly, paucity of tissue in the anterior tricuspid leaflet may preclude successful valve repair. In this particular circumstance, a modified Carpentier repair of the tricuspid valve with additional pericardial patch augmentation of the anterior leaflet may result in a well-functioning monocusp tricuspid valve.


Replacement therapy for alpha-1-protease inhibitor deficiency in PiZ subjects with chronic obstructive lung disease.
In a six-month multicenter feasibility and safety study, 20 patients, who all had a congenital deficiency of alpha-1-protease inhibitor (A1PI) of the PiZ phenotype accompanied by a chronic obstructive lung disease, were treated with human-plasma-derived A1PI. A weekly dose of 60 mg/kg, administered intravenously, was shown to be sufficient to maintain patient serum levels above the threshold limit of 35 percent, the serum level of healthy persons of the MZ phenotype. This is supposed to be the minimal effective level for protection against the elastolytic attack of the lung and, therefore, satisfies one of the most important criteria of feasibility of long-term replacement therapy. The global concentration in serum or bronchiolar lavage fluid A1PI including active and inactivated A1PI was measured immunologically by rate nephelometry and radial immunodiffusion. The functional activity of A1PI, expressed as free inhibitor activity against trypsin and leukocyte elastase, confirmed that the infused A1PI remained mostly in its active form in the circulation. Reported adverse reactions were moderate and did not require alteration to the schedule of the infusions and/or the dose and rate of administration. Antibodies to A1PI as measured by the Ouchterlony method did not develop. Laboratory and physical signs of possible hepatitis virus contamination were not observed. The long-term replacement therapy, therefore, appears to be safe.


Modelling compound action potentials of peripheral nerves in situ. I. Model description: evidence for a non-linear relation between fibre diameter and velocity.
Compound sensory nerve action potentials of sural nerves of healthy volunteers have been measured at 7 different distances between the site of stimulation and the site of recording. The results are used to adjust a model description for the generation of compound nerve action potentials. A fairly good agreement between experiment and model is obtained when a weak non-linear, S-shaped relation between external fibre diameter and propagation velocity of the single fibre action potential is assumed. This result corresponds surprisingly well with findings in "classical' reconstruction attempts reported in the literature.


Medullomyoblastoma treated with craniospinal radiation and adjuvant chemotherapy: Report of 4 cases and review of the literature.
Medullomyoblastoma (MMB) is a rare primitive neuro-epithelial tumor and seen in mainly pediatric age group1. There have been about 50 cases reported so far in the literature. In this report, we describe the clinical features and treatment of 4 cases of MMB.


Acoustic voice analysis in different phonetic contexts after larynx radiotherapy for T1 vocal cord carcinoma.
Radiotherapy for early vocal cord carcinoma affects quality of voice. Nevertheless, most patients refer to having a high satisfaction level with their voice. The few acoustic studies on quality of voice have been performed only in prolonged vowel production, which is not a usual speech situation. The present study has been done with the aim of establishing which phonetic situations reflect a greater alteration in voice production related to irradiation. Eighteen male patients irradiated for Tis-T1 vocal cord carcinoma and a control group of 31 non-irradiated subjects were included in a study of acoustic voice analysis. This analysis was performed one year after radiotherapy. Patients and control group voices were tape recorded in extended vowel production, oral reading of a standard paragraph, spontaneous speech and in a song. Acoustic analysis was performed by a Kay Elemetric's Computerized Speech Lab (model CSL #4300). Fundamental frequency, jitter, shimmer and harmonics-to-noise ratio were obtained in both groups. Statistical test: Lin concordance coefficient and Pearson's correlation coefficient, Student's t-test and ROC curves. Concordance and correlation studies did not allow selection of any subgroup in acoustic parameters and different acoustic situations. Acoustic parameters had higher median values in irradiated patients. Student's t-test showed significant differences for fundamental frequency in sustained vowel production and spontaneous speech; for jitter there was statistical significance in all the acoustic situations and for shimmer in oral reading and song. Jitter showed a cut-off of 2.02% with a sensitivity of 89% and specificity of 97% in classifying irradiated and non-irradiated groups. The ROC curve for jitter correctly classified 94% of subjects into irradiated or non-irradiated groups. The present study showed that jitter obtained from spontaneous speech was the most relevant parameter in discriminating voice in irradiated patients by acoustic analysis. Jitter in spontaneous speech is in need of more analysis in bigger series and in more advanced stages of larynx cancer as its relevance has been demonstrated.


Management comparison for acute myocardial infarction: direct angioplasty versus sequential thrombolysis-angioplasty.
To compare the results and outcome of different management approaches for acute myocardial infarction, we analyzed our experience with early (i.e., within 6 hours of infarct onset) direct percutaneous transluminal coronary angioplasty (group A) versus initial treatment with thrombolytic therapy (group B) followed by angioplasty. From 1982 to 1989 a total of 214 patients underwent primary angioplasty for acute myocardial infarction. During this time 157 patients underwent initial thrombolytic therapy, 104 with intravenous streptokinase and 53 with intravenous tissue-type plasminogen activator followed by angioplasty. Other than age (group A, 61.7 +/- 11.5 years; group B, 57.3 +/- 11.6 years; p = 0.0002), the clinical characteristics of the groups were similar. In group A, 197 (92.1%) had successful results, and 17 (7.9%) were failures. Of the group treated with thrombolytic therapy, there was an overall 81.5% patency rate for patients treated with streptokinase and tissue-type plasminogen activator with no significant difference between the agents. Angioplasty success after thrombolytic therapy was 94.3%. In-hospital and 1-year survival was significantly better in group B patients (95.5% and 95.5%, respectively) than in group A patients (92.1% and 89.3%, respectively). We conclude that both direct angioplasty and thrombolytic therapy followed by angioplasty provide high recanalization rates but that short- and long-term survival is improved when thrombolytic therapy precedes angioplasty in acute myocardial infarction patients.


[Study on the knowledge of nutrition and related dietary behavior among "floating" women under pregnancy].
The aim of this study was to assess the knowledge, attitude, practice (KAP) on nutrition and related influencing factors among the "floating" women under pregnancy. 171 subjects in Chengdu, China were surveyed cross-sectionally by questionnaires. Most participants expressed a positive attitude towards nutrition and health, however, only 25.1% of the subjects under study had a better knowledge on nutrition and on healthy dietary practices. Frequency of the important foods (milk, egg, soy bean, nut, seafood etc.) intake were not enough during pregnancy. A significantly positive correlation was found between nutrition K, A and P (r = 0.322, 0.285, 0.173; P < 0.05). Level of education among the pregnant women under mobility and occupation of their husbands were the major contributing factors to their KAP level on nutrition (beta = 0.248, 0.312; P < 0.01). Medical staff, dietitians and specific books were the major sources of information on nutrition. More educational programs were needed to improve the knowledge and dietary behavior on nutrition to this population.


Health risks.
The health risks associated with ozone depletion will principally be those due to increased ultraviolet B (UV-B) radiation in the environment, i.e., increased damage to the eyes, the immune system, and the skin. Some new risks may also be introduced with the increased use of alternatives to the ozone-depleting substances (ODSs). Quantitative risk estimates are available for some of the UV-B-associated effects, e.g., cataract and skin cancer; however, the data are insufficient to develop similar estimates for effects such as immunosuppression and the toxicity of alternatives. Ocular damage from UV exposures includes effects on the cornea, lens, iris, and associated epithelial and conjunctival tissues. The most common acute ocular effect of environmental ultraviolet radiation (UVR) is photokeratitis. Also known as snowblindness in skiers, this condition also occurs in other outdoor recreationists. Chronic eye conditions likely to increase with ozone depletion include cataract, squamous cell carcinoma, ocular melanoma, and a variety of corneal/conjunctival effects, e.g., pterygium and pinguecula. Suppression of local (at the site of UV exposure) and systemic (at a distant, unexposed site) immune responses to a variety of antigens has been demonstrated in both humans and animals exposed to UV-B. In experiments with animals these effects have been shown to worsen the course/outcome of some infectious diseases and cancers. There is reasonably good evidence that such immunosuppression plays a role in human carcinogenesis; however, the implications of such immunosuppression for human infectious diseases are still unknown. In light-skinned populations, exposure to solar UVR appears to be the most important environmental risk factor for basal and squamous cell carcinomas and cutaneous melanoma. Originally it was believed that total accumulated exposure to UVR was the most important environmental factor in determining risk for these tumors. Recent information now suggests that only squamous cell carcinoma risk is related to total exposure. In the cases of both basal cell carcinoma and melanoma, new information suggests that increases in risk are tied to early exposures (before about age 15), particularly those leading to severe sunburns. Testing of a number of the chlorofluorocarbon (CFC) alternatives indicates that most of these chemicals have low acute toxicity, and low to moderate chronic toxicity. Some chemicals that were originally proposed as alternatives have been dropped from consideration because these tests raised concerns about toxicity and/or manufacturing difficulties. In one instance, high accidental occupational exposure was associated with liver damage, underlining the need for care in the use of these substitutes. Recent quantitative risk estimates have been developed for cataract, melanoma, and all skin cancers combined. These estimates indicate that under the Montreal Adjustments, cataract and skin-cancer incidence will peak mid-century at additional incidences of just under 3 per 100,000 and about 7 per 100,000, respectively.


Constipation in the elderly. A physiologic study.
Colorectal motility was studied in 25 elderly patients with chronic constipation and compared with an asymptomatic control group (N = 17). Proctometrograms were performed to measure rectal volumes at sensory threshold and maximal tolerance, and rectal compliance. Anal sphincter pressures and reflexes were measured by conventional techniques. Indices of colonic motility were also assessed. Significant impairment of rectal sensory threshold was apparent in constipation. Six patients presenting with impaction demonstrated functional megarectums. The remaining 19 showed a significant reduction in maximal rectal volume and rectal compliance and 14 extruded the balloon. There were no differences in sphincter length or presence of the rectosphincteric reflex. Four patients had an absent pudendoanal reflex and the remainder significant prolongation. Total gastrointestinal transit times were prolonged in the constipation group, mainly distally due to rectal stasis. In two patients bisacodyl failed to elicit a sigmoid motor response. Constipation in the elderly is not merely due to delayed transit. Neurogenic deficits of sacral spinal cord function may be responsible for abnormalities in rectal motor and sensory function.


Time-resolved fluorescence microscopy for quantitative Ca2+ imaging in living cells.
Calcium (Ca(2+)) is a ubiquitous intracellular second messenger and involved in a plethora of cellular processes. Thus, quantification of the intracellular Ca(2+) concentration ([Ca(2+)]i) and of its dynamics is required for a comprehensive understanding of physiological processes and potential dysfunctions. A powerful approach for studying [Ca(2+)]i is the use of fluorescent Ca(2+) indicators. In addition to the fluorescence intensity as a common recording parameter, the fluorescence lifetime imaging microscopy (FLIM) technique provides access to the fluorescence decay time of the indicator dye. The nanosecond lifetime is mostly independent of variations in dye concentration, allowing more reliable quantification of ion concentrations in biological preparations. In this study, the feasibility of the fluorescent Ca(2+) indicator Oregon Green Bapta-1 (OGB-1) for two-photon fluorescence lifetime imaging microscopy (2P-FLIM) was evaluated. In aqueous solution, OGB-1 displayed a Ca(2+)-dependent biexponential fluorescence decay behaviour, indicating the presence of a Ca(2+)-free and Ca(2+)-bound dye form. After sufficient dye loading into living cells, an in situ calibration procedure has also unravelled the Ca(2+)-free and Ca(2+)-bound dye forms from a global biexponential fluorescence decay analysis, although the dye's Ca(2+) sensitivity is reduced. Nevertheless, quantitative [Ca(2+)]i recordings and its stimulus-induced changes in salivary gland cells could be performed successfully. These results suggest that OGB-1 is suitable for 2P-FLIM measurements, which can gain access to cellular physiology.


Highly sensitive determination of chloramphenicol based on thin-layered MoS2/polyaniline nanocomposite.
The nanocomposite of molybdenum disulfide (MoS2) and polyaniline (PANI) was prepared through in situ polymerization of aniline on the surface and interlayer of thin-layered MoS2. Owing to the physisorption of aromatic aniline onto the basal plane of MoS2, the electrochemical properties of MoS2/PANI nanocomposite were improved. And a novel electrochemical sensor based on MoS2/PANI nanocomposite was used to determine chloramphenicol by differential pulse voltammetry, exhibiting excellent performance. The detection range was from 1×10(-7) mol L(-1) to 1×10(-4) mol L(-1), with a high sensitivity and a low detection limit of 6.9×10(-8) mol L(-1). In addition, this sensor can be used for the determination of chloramphenicol in real samples.


Experience with fibrin seal (Tisseel) in operations for congenital heart defects.
Tisseel (human fibrin seal) was used in 38 children with complex congenital heart defects (2.8% of all operations for congenital heart defects) between July, 1980, and August, 1983. Control of bleeding was excellent in 31 patients, good in 6 patients, and unsatisfactory in 1 patient. Best results were achieved when Tisseel was applied on collagen substrate. If bleeding was particularly difficult to control, a combination of Tisseel with pharmacological hypotension (sodium nitroprusside) was used. We recommend the use of Tisseel to preseal Dacron conduits and to control bleeding from multiple suture lines (conduits, arterial switch operations, complex reconstructions of the pulmonary arteries), near major coronary arteries, from Gore-Tex patches in high-pressure systems, and from the raw areas of the heart at reoperation.


Pathogenesis and management of hypoxic-ischemic encephalopathy in the term newborn.
The pathogenesis and management of hypoxic-ischemic encephalopathy in the term infant is reviewed. Specifically, the potential significance of a variety of factors on the pathogenesis of brain injury is discussed including changes in cerebral blood flow, brain swelling, carbohydrate status, alterations in ion homeostasis, and synaptic activity. Management is reviewed in terms of prevention, supportive care, corrections of metabolic derangements, control of seizures, and prevention of fluid overload.


Factors Influencing Medication Non-Adherence among Chinese Older Adults with Diabetes Mellitus.
This study aimed to examine the prevalence of medication non-adherence among older adults with diabetes mellitus (DM) in Shandong province, China and to identify its influencing factors. A sample of 1002 older adults aged 60 or above with DM was analyzed. Medication adherence was measured using the Morisky-Green-Levine (MGL) Medication Adherence Scale. Descriptive statistical analysis, chi-square test, univariate and multivariate logistic regression analyses were employed. The prevalence of self-reported medication non-adherence among older adults with DM was 19.9%. Female respondents (adjusted odds ratio (AOR) = 1.56, 95% CI: 1.09-2.24) and respondents who perceived medication adherence to be unimportant (AOR = 1.69, 95% CI: 1.05-2.74) were more likely to experience medication non-adherence. Respondents with 5 years of disease duration or longer were less likely (AOR = 0.63, 95% CI: 0.46-0.87) to experience medication non-adherence. This study showed that about one out of five older adults with DM in Shandong province, China, experienced medication non-adherence, and that gender, disease duration and perceived importance of medication adherence were associated with medication non-adherence in this population group. Provision of counseling and health education programs could be the future priority to raise patients' awareness of the importance of medication adherence and improve patients' self-management of DM.


Sonocatalytic removal of methylene blue from water solution by cobalt ferrite/mesoporous graphitic carbon nitride (CoFe2O4/mpg-C3N4) nanocomposites: response surface methodology approach.
In this study, cobalt ferrite/mesoporous graphitic carbon nitride (CoFe2O4/mpg-C3N4) nanocomposites were successfully synthesized by using a two-step protocol. Firstly, monodispersed CoFe2O4 nanoparticles (NPs) were synthesized via thermal decomposition of metal precursors in a hot surfactant solution and then they were assembled on mpg-C3N4 via a liquid phase self-assembly method. The sonocatalytic performance of as-synthesized CoFe2O4/mpg-C3N4 nanocomposites was evaluated on the methylene blue (MB) removal from water under ultrasonic irradiation. For this purpose, response surface methodology (RSM) based on central composite design (CCD) model was successfully utilized to optimize the MB removal over CoFe2O4/mpg-C3N4 nanocomposites. Analysis of variance (ANOVA) was applied to investigate the significance of the model. The results predicted by the model were obtained to be in reasonable agreement with the experimental data (R2 = 0.969, adjusted R2 = 0.942). Pareto analysis demonstrated that pH of the solution was the most effective parameter on the sonocatalytic removal of MB by CoFe2O4/mpg-C3N4 nanocomposites. The optimum catalyst dose, initial dye concentration, pH, and sonication time were set as 0.25 g L-1, 8 mg L-1, 8, and 45 min, respectively. The high removal efficiency of MB dye (92.81%) was obtained under optimal conditions. The trapping experiments were done by using edetate disodium, tert-butyl alcohol, and benzoquinone. Among the reactive radicals, •OH played a more important role than h+ and [Formula: see text] in the MB dye removal process. Moreover, a proposed mechanism was also presented for the removal of MB in the presence of CoFe2O4/mpg-C3N4 nanocomposites under the optimized sonocatalytic conditions. Finally, a reusability test of the nanocomposites revealed a just 9.6% decrease in their removal efficiency after five consecutive runs.


Kimura Disease in an Adult Indian Female, A Rare Presentation: A Novel Treatment with a Review of Literature.
Kimura disease (KD) is a chronic inflammatory disorder, which is quite rare and has an unclear and much debated etiology. KD is characterized by painless, nodular, subcutaneous swellings along with lymphadenopathy, encountered in the head and neck region more often. It is also known to affect major salivary glands. It is also associated with elevated Immunoglobulins (IgE) and peripheral blood and tissue eosinophilia. Kimura disease generally affects young Asian males. There is considerable difficulty in arriving at clinical diagnosis and often it is frustrating to both patients and the treating physicians because of the difficulty in its management. We are presenting and reporting a case of Kimura disease in a young adult Indian female patient who presented with a swelling in the left parotid region. We have successfully managed this patient medically with a unique combination of drugs, most of which have already been tried and reported in literature by various authors.


S100A8/A9 Induced by Interaction with Macrophages in Esophageal Squamous Cell Carcinoma Promotes the Migration and Invasion of Cancer Cells via Akt and p38 MAPK Pathways.
Tumor-associated macrophages are associated with more malignant phenotypes of esophageal squamous cell carcinoma (ESCC) cells. Previously, an indirect co-culture assay of ESCC cells and macrophages was used to identify several factors associated with ESCC progression. Herein, a direct co-culture assay of ESCC cells and macrophages was established, which more closely simulated the actual cancer microenvironment. Direct co-cultured ESCC cells had significantly increased migration and invasion abilities, and phosphorylation levels of Akt and p38 mitogen-activated protein kinase (MAPK) compared with monocultured ESCC cells. According to a cDNA microarray analysis between monocultured and co-cultured ESCC cells, both the expression and release of S100 calcium binding protein A8 and A9 (S100A8 and S100A9), which commonly exist and function as a heterodimer (herein, S100A8/A9), were significantly enhanced in co-cultured ESCC cells. The addition of recombinant human S100A8/A9 protein induced migration and invasion of ESCC cells via Akt and p38 MAPK signaling. Both S100A8 and S100A9 silencing suppressed migration, invasion, and phosphorylation of Akt and p38 MAPK in co-cultured ESCC cells. Moreover, ESCC patients with high S100A8/A9 expression exhibited significantly shorter disease-free survival (P = 0.005) and cause-specific survival (P = 0.038). These results suggest that S100A8/A9 expression and release in ESCC cells are enhanced by direct co-culture with macrophages and that S100A8/A9 promotes ESCC progression via Akt and p38 MAPK signaling pathways.


Proficiency for Advanced Laparoscopic Procedures in Gynecologic Residency Program: Do all Residents Need to be Trained?
To assess the current state of laparoscopic gynecologic surgery in the Dutch residency program, the level of competence among graduated residents, and whether they still perform these procedures. Furthermore, their current attitudes toward the implementation of minimally invasive surgery into residency training were assessed. An online survey (Canadian Task Force Classification III) regarding the level of competence, performance, training, and interest for gynecologic laparoscopic procedures. Gynecologists who finished residency training between 2008 and 2013 in the Netherlands. Response rate was 73% (171/235). The scores for all basic and intermediate laparoscopic procedures performed immediately after residency showed the highest competence level (median 5, of scale 1-5). The competence level for advanced laparoscopic procedures was less at 3, indicating that the graduated residents are not able to perform these procedures without supervision. Overall, 56% of the gynecologists no longer perform any level 3 advanced procedures, and 86% do not perform level 4 advanced procedures. Gynecologists who still perform the inquired laparoscopic procedures scored a significantly higher competence level immediately after residency training for most of procedures compared with the gynecologists who do not perform these procedures. Residents are sufficiently trained for basic and intermediate laparoscopic procedures during residency training. However, they are not sufficiently equipped to perform advanced laparoscopic procedures without supervision. We should consider training advanced procedures especially to a selected group of residents because most gynecologists do not perform these procedures after residency. The learning curve for advanced procedures continues to rise after finishing residency for those who keep on performing these procedures, therefore an additional fellowship is recommended for this group.


Liver tumors and oral contraceptives.
A possible causal relationship between oral contraceptives and liver cell adenomas has been postulated in the recent literature. In this presentation three additional cases are reported to support the existence of such an association. The possible etiologic causes for this newly described condition and specific diagnostic procedures for its accurate diagnosis are presented.


Sexuality and everydayness in a transnational context: toward a re-imagined West-China relationship?
This paper examines how Chinese immigrants to Canada perceive and experience sexuality in a transnational context as revealed in a qualitative study. It identifies cultural interactions and tensions between 'the West' and 'China' embedded in participants' sexual narratives. Three thematic aspects of sexuality are explored: different views toward 'relationships' and how sex is involved in different stages of a relationship; physical desire and sexual attraction based on individuals' dialogues with contemporaries and their own cross-racial dating experience; and perceptions of sexual risks associated with an increasing awareness of China's opening up, in particular risks associated with attitudes towards condom use. The paper also discusses how such sexual narratives challenge dichotomous imaginings of 'sexual openness/conservativeness' in the West-China relationship. Findings help us to better understanding how Chinese immigrants to Canada view the West through the lens of sexuality, and how their transnational experiences have challenge the West-China dichotomy in the sexual imagination and shape understandings of sexual risk.


Carbon monoxide mediates protection against nitric oxide toxicity in HeLa cells.
Nitric oxide (NO) mediates cell signaling at low (nanomolar) concentrations, but can be cytotoxic at higher concentrations. Heme oxygenase-1 (HO-1), implicated in a role in NO resistance, might confer its protective effect through the direct products biliverdin and CO or the secondary product bilirubin. We have therefore tested whether biliverdin, bilirubin, or CO can provide resistance to NO toxicity. HeLa cells treated with bilirubin or biliverdin (up to 25 microM) had unchanged survival of an NO challenge (1 mM spermine-NONOate or 2 mM DEA-NO), although they displayed increased resistance to H2O2 (350 microM). In contrast, prior exposure to CO (up to 100 ppm) increased NO resistance. An interval between CO exposure and NO resistance was required for the increased NO resistance. Because the CO-activated NO resistance was also blocked by the transcription inhibitor actinomycin D, inducible gene expression seems critical for the cytoprotection elicited by CO. Experiments in the presence of HO and guanylate cyclase inhibitors indicated that HO activity and cGMP signaling are not essential for the CO-protective effect. Last, inhibition of p38 MAPK activation fully blocked the CO-protective effect, indicating the involvement of this signaling pathway(s) in the CO response.


Development and user testing study of MozzHub: a bipartite network-based dengue hotspot detector.
Traditionally, dengue is controlled by fogging, and the prime location for the control measure is at the patient's residence. However, when Malaysia was hit by the first wave of the Coronavirus disease (COVID-19), and the government-imposed movement control order, dengue cases have decreased by more than 30% from the previous year. This implies that residential areas may not be the prime locations for dengue-infected mosquitoes. The existing early warning system was focused on temporal prediction wherein the lack of consideration for spatial component at the microlevel and human mobility were not considered. Thus, we developed MozzHub, which is a web-based application system based on the bipartite network-based dengue model that is focused on identifying the source of dengue infection at a small spatial level (400 m) by integrating human mobility and environmental predictors. The model was earlier developed and validated; therefore, this study presents the design and implementation of the MozzHub system and the results of a preliminary pilot test and user acceptance of MozzHub in six district health offices in Malaysia. It was found that the MozzHub system is well received by the sample of end-users as it was demonstrated as a useful (77.4%), easy-to-operate system (80.6%), and has achieved adequate client satisfaction for its use (74.2%).


Evidence that AV nodal re-entrant tachycardia does not require participation of the entire AV node.
Electrophysiologic studies in a case of AV nodal re-entrant tachycardia showed that a programmed atrial premature depolarization induced during the tachycardia did not change the tachycardia cycle but caused a delay in the following atrial echo. Analysis of such a phenomenon suggests that the atrial premature depolarization was conducted to the upper part of the AV node but not to the site of the re-entry. Therefore, AV nodal re-entry can persist without the participation of the upper part of the AV node. This case illustrates that the upper common pathway connecting the dual AV nodal pathways cranially is most likely located within the AV node and consists of AV nodal tissue.


Unraveling the Molecular Mechanisms of Tomatoes' Defense against Botrytis cinerea: Insights from Transcriptome Analysis of Micro-Tom and Regular Tomato Varieties.
Botrytis cinerea is a devastating fungal pathogen that causes severe economic losses in global tomato cultivation. Understanding the molecular mechanisms driving tomatoes' response to this pathogen is crucial for developing effective strategies to counter it. Although the Micro-Tom (MT) cultivar has been used as a model, its stage-specific response to B. cinerea remains poorly understood. In this study, we examined the response of the MT and Ailsa Craig (AC) cultivars to B. cinerea at different time points (12-48 h post-infection (hpi)). Our results indicated that MT exhibited a stronger resistant phenotype at 18-24 hpi but became more susceptible to B. cinerea later (26-48 hpi) compared to AC. Transcriptome analysis revealed differential gene expression between MT at 24 hpi and AC at 22 hpi, with MT showing a greater number of differentially expressed genes (DEGs). Pathway and functional annotation analysis revealed significant differential gene expression in processes related to metabolism, biological regulation, detoxification, photosynthesis, and carbon metabolism, as well as some immune system-related genes. MT demonstrated an increased reliance on Ca2+ pathway-related proteins, such as CNGCs, CDPKs, and CaMCMLs, to resist B. cinerea invasion. B. cinerea infection induced the activation of PTI, ETI, and SA signaling pathways, involving the modulation of various genes such as FLS2, BAK1, CERK1, RPM, SGT1, and EDS1. Furthermore, transcription factors such as WRKY, MYB, NAC, and AUX/IAA families played crucial regulatory roles in tomatoes' defense against B. cinerea. These findings provide valuable insights into the molecular mechanisms underlying tomatoes' defense against B. cinerea and offer potential strategies to enhance plant resistance.


Temporal current-source of spikes suggests initial treatment failure in childhood absence epilepsy.
In addition to the frontal lobe, the temporal lobe may also be involved in typical absence seizures. However, few studies have addressed the relationship between this involvement and drug responsiveness in childhood absence epilepsy (CAE). In this study, we observed the current-source distribution (CSD) of generalized spike-and-wave discharges (GSWDs) and investigated the relationship between temporal lobe involvement in the CSD and responsiveness to initial antiepileptic drug (AED) in CAE. Seventeen consecutive patients with CAE were retrospectively enrolled in the study. Patients were divided into an initial-response group and an initial-failure group, according to their responsiveness to the initial AED treatment. For each patient, the spike peak CSD of an averaged GSWD was obtained from the initial electroencephalogram. We compared the incidence of temporal involvement in the CSD between the two groups. We also compared clinical variables, including age of onset, gender, type and dose of first AED, time to cessation of clinical seizures, and seizure-free status. The initial-response and initial-failure groups contained 12 and five patients, respectively. Temporal lobe involvement was more frequent (80% vs. 17%, p = 0.03), and time to cessation of clinical seizures was more prolonged (median 2.5 months vs. 8 months, p<0.01) in the initial-failure than in the initial-response group. None of the other variables studied differed between groups. Initial AED failure was associated with temporal involvement in the CSD of CAE patients. This electrophysiological information may be helpful in clinical practice by estimating the efficacy of initial AED treatment in AED-naïve CAE patients in advance.


Genetic polymorphisms for 11 Y-STRs haplotypes of Chinese Yi ethnic minority group.
Eleven Y-STRs loci including minimal haplotypes (DYS19, DYS389I, DYS389II, DYS390, DYS391, DYS392, DYS393, and DYS385a,b) and two additional loci, namely DYS438 and DYS439 have been co-amplified in 100 healthy unrelated males of Chinese Yi minority ethnic group using the Y-PLEX 5 and Y-PLEX 6 kit, in order to investigate allele and haplotype frequencies of Yi population, evaluate their usefulness in forensic paternity testing and human identification, and enrich Chinese population genetic informational resources. Out of a total of 100 individuals 85 showed different haplotypes, while 8 haplotypes occurred more than once. The overall haplotype diversity for 11 Y-STRs loci was 0.9945.