The relationship between intolerance of uncertainty and anxiety in autism: A systematic literature review and meta-analysis.
People who find it especially hard to cope with the unexpected or unknown are said to have an intolerance of uncertainty. Autistic individuals often report a preference for certainty and experience levels of anxiety that can interfere with their daily life. Understanding more about the link between the intolerance of uncertainty and anxiety in autistic people might lead to better treatments for anxiety being developed. Therefore, this work aimed to review previous research in order to explore this link. Twelve studies were found and their results were compared and contrasted. The autistic people who participated in the studies completed questionnaires that suggested a large number of them experienced very high levels of anxiety and intolerance of uncertainty. Of 10 studies that used relevant statistics, nine found a statistically significant link between anxiety and the intolerance of uncertainty. In general, the strength of the link was about the same as previous research found in people who did not have a diagnosis of autism. This might mean that interventions that aim to help people who are intolerant of uncertainty could be effective for autistic individuals.


[Contemporary methods of diagnosis and monitoring of the excessive iron intake by humans through inhalation].
Determining iron content of target organs, blood and serum through magnetographic methods enables to reveal excessive intake of exogenous iron. Increased iron level could result in some diseases and aging, therefore the presented method determining iron becomes quite topical.


MicroRNA-1275 induces radiosensitization in oesophageal cancer by regulating epithelial-to-mesenchymal transition via Wnt/β-catenin pathway.
Acquired radioresistance is one of the main obstacles for the anti-tumour efficacy of radiotherapy in oesophageal cancer (EC). Recent studies have proposed microRNAs (miRNAs) as important participators in the development of radioresistance in various cancers. Here, we investigated the role of miR-1275 in acquired radioresistance and epithelial-mesenchymal transition (EMT) in EC. Firstly, a radioresistant cell line KYSE-150R was established, with an interesting discovery was observed that miR-1275 was down-regulated in KYSE-150R cells compared to the parental cells. Functionally, miR-1275 inhibition elevated radioresistance in KYSE-150 cells via promoting EMT, whereas enforced expression of miR-1275 increased radiosensitivity in KYSE-150R cells by inhibiting EMT. Mechanically, we demonstrated that miR-1275 directly targeted WNT1 and therefore inactivated Wnt/β-catenin signalling pathway in EC cells. Furthermore, WNT1 depletion countervailed the promoting effect of miR-1275 suppression on KYSE-150 cell radioresistance through hampering EMT, whereas WNT1 overexpression rescued miR-1275 up-regulation-impaired EMT to reduce the sensitivity of KYSE-150R cells to radiation. Collectively, our findings suggested that miR-1275 suppressed EMT to encourage radiosensitivity in EC cells via targeting WNT1-activated Wnt/β-catenin signalling, providing a new therapeutic outlet for overcoming radioresistance of patients with EC.


Incorporation of [14c] arachidonate in pig thyroid lipids and prostaglandins.
In pig and sheep thyroid, the arachidonate content of phosphatidylinositol (14.3--17.5%) is much higher than in the other phospholipids. In the thyroid, phosphatidylinositol seems to play an important role in the biosynthesis of prostaglandins. In neutral thyroid lipids, the arachidonate content is much higher in diacylglycerols (15.8%) than in monoacylglycerols (2.9%) or triacylglycerols (4.2%). However, the most important pool of esterified arachidonate is triacylglycerols (1030 nmol of arachidonate/g tissue). Arachidonate represents a very small part of total free fatty acids measured in the presence of albumin and indomethacin (0.65% or 16.4 nmol/g tissue). Thyrotropin (50 munits/ml) causes after 1 h a 2-fold increase in the level of free arachidonate (37.3 nmol/g tissue). Pig thyroid slices rapidly take up [14C]arachidonate and incorporate it into neutral lipids and phospholipids. Specific activity of phosphatidylinositol is 3-fold higher than that of phosphatidylcholine after an hour incubation. Specific activity of diacylglycerols is 8-fold higher than that of triacylglycerols. Thyrotropin (50 munits/ml) causes a significant decrease (32--33%) of incorporation of radioactivity in lipids as compared with standard incubation. This result is compatible with the isotopic dilution of the labeled [14C]arachidonate by nonradioactive arachidonate liberated in the incubation medium under thyrotropin action. Slices and homogenates of pig thyroid weakly convert [14C]arachidonate to prostaglandins E2 and F2alpha (1--2%. Thyrotropin (50 munits/ml) always diminishes the conversion of radioactivity to prostaglandins as compared with standard incubation. This result is compatible with the above-mentioned hypothesis.


A large neutral fraction of cosmic hydrogen a billion years after the Big Bang.
The fraction of ionized hydrogen left over from the Big Bang provides evidence for the time of formation of the first stars and quasar black holes in the early Universe; such objects provide the high-energy photons necessary to ionize hydrogen. Spectra of the two most distant known quasars show nearly complete absorption of photons with wavelengths shorter than the Lyman alpha transition of neutral hydrogen, indicating that hydrogen in the intergalactic medium (IGM) had not been completely ionized at a redshift of z approximately 6.3, about one billion years after the Big Bang. Here we show that the IGM surrounding these quasars had a neutral hydrogen fraction of tens of per cent before the quasar activity started, much higher than the previous lower limits of approximately 0.1 per cent. Our results, when combined with the recent inference of a large cumulative optical depth to electron scattering after cosmological recombination therefore suggest the presence of a second peak in the mean ionization history of the Universe.


Density functional study on the reaction mechanism of proton transfer in 2-pyridone: effect of hydration and self-association.
The proton-transfer mechanism in the isolated, mono, dehydrated forms and dimers of 2-pyridone and the effect of hydration or self-assistance on the transition state structures corresponding to proton transfer from the keto form to the enol form have been investigated using B3LYP and BH-LYP hybrid density functional methods at the 6-311++G (2d, 2p) basis set level. The barrier heights for both H2O-assisted and self-assisted reactions are significantly lower than that of the bare tautomerization reaction from 2-pyridone to 2-hydroxypyridine, implying the importance of the superior catalytic effect of H2O and (H2O)2 and the important role of 2-pyridone itself for the intramolecular proton transfer. Long-range solvent effects have also been taken into account by using the continuum model (Onsager model and polarizable continuum model (PCM)) of water. The tautomerization energies and the potential energy barriers are increased both for the water-assisted and for the self-assisted reaction because of the bulk solvent, which imply that the tautomerization of PY becomes less favorable in the polar solvent.


Description of Sphingomonas mohensis sp. nov., Isolated from Sediment.
An aerobic, gram-reaction-negative, rod-shaped bacterium, designated strain Z6(T), was isolated from sediment collected at Mohe Basin, China. And its taxonomic position was investigated by applying a polyphasic approach. Growth occurs at 10-45 °C (optimum, 30 °C), at pH 6.0-11.0 (optimum, pH 7.0) and in the presence of 0-3.0 % (w/v) NaCl (optimum, 0 %). The polar lipid profile of strain Z6(T) revealed the presence of diphosphatidylglycerol, phosphatidylethanolamine, sphingoglycolipid and two unidentified phospholipids, and the major quinone was Q-10. The major fatty acids were C18:1 ω7c and/or C18:1 ω6c (summed feature 8) and C16:1 ω6c and/or C16:1 ω7c (summed feature 3). The predominant polyamine was homospermidine. The DNA G + C content of strain Z6(T) is 65.2 mol%. On the basis of the polyphasic evidence presented, strain Z6(T) represents a novel species of the genus Sphingomonas, for which the name Sphingomonas mohensis sp. nov. is proposed. The type strain is Z6(T) (=CGMCC 1.12891(T) = JCM 19983(T)).


Post-coronavirus disease 2019 polyneuropathy with significant response to immunoglobulin therapy: a case report.
The symptoms of coronavirus disease 2019, caused by the novel severe acute respiratory syndrome coronavirus 2, were originally assumed to be mainly respiratory. With increasing knowledge, however, it turned out that the spectrum of complaints varies broadly with age and concomitant diseases. While many neurological symptoms were reported in the context of the disease, ranging from permanent fatigue to recurrent headaches and concentration disturbance, treatment approaches are still in development. This case discusses a possible treatment approach with immunoglobulin therapy and its outcomes. We present the case of a 56-year-old Caucasian female patient who, following coronavirus disease 2019, developed peripheral sensory and autonomic disturbances that fell within subacute demyelinating neuropathy. Because a significant improvement in symptoms as well as in the results of clinical and electrophysiological examination was reported after immunoglobulin therapy, long-term therapy does not appear to be necessary. Given the significant subjective and objective improvement reported, this case provides additional evidence that immunoglobulin therapy can be considered in post-coronavirus disease 2019 syndrome.


Histamine release by vagal stimulation.
The content of acetylcholine and histamine in the effluent of isolated, vagally innerved guinea-pig auricles was determined. Spontaneous or stimulation-induced overflow of acetylcholine was detected only in the presence of acetylcholinesterase inhibitors. The histamine overflow was measurable also in the absence of inhibition of cholinesterase, and neatly increased during vagal stimulation. The vagally evoked histamine overflow was blocked by atropine and potentiated by eserine. The stimulation-induced histamine overflow in the effluent is discussed, presumably assuming that acetylcholine may release histamine from cardiac histamine stores.


Antihepatitis activity (anti-HBsAg and anti-HBeAg) of C19 homolignans and six novel C18 dibenzocyclooctadiene lignans from Kadsura japonica.
Bioassay-directed fractionation of the EtOAc extract of Kadsura japonica has led to the isolation of six new C18 dibenzocyclooctadiene lignans, schizanrins I, J, K, L, M, N, along with four known C19 homolignans, taiwanschirins A, B, C, and heteroclitin F. The elucidations of the new structures were based on spectral analysis. Bioassay evaluation against human type B hepatitis revealed that taiwanschirins A and B showed strong activity for anti-HBsAg and a medium effect for anti-HBeAg at 25 microg/mL (12.9 and 11.9 microM for taiwanschirins A and B, respectively).


Metallothionein/disulfide interactions, oxidative stress, and the mobilization of cellular zinc.
Glutathione disulfide, the major cellular disulfide, releases zinc from metallothionein (MT) [W. Maret (1994) Oxidative metal release from metallothionein via zinc-thiol/disulfide interchange, Proc. natn. Acad. Sci. U.S.A. 91, 237-241]. Here, the interaction of rabbit liver MT-II with other selected biological disulfides (coenzyme A/glutathione mixed disulfide, coenzyme A disulfide, and cystamine) was investigated by measuring concomitant release of radioactive 65-zinc from MT. These disulfides react more rapidly than glutathione disulfide, thus underscoring the reactivity of zinc sulfur bonds in the clusters of MT and the importance of the MT/disulfide interaction as a chemical mechanism for mobilizing zinc from a thermodynamically stable zinc complex. Two implications of these in vitro findings are discussed. (i) Apparently, in the case of zinc which is redox inert, Nature has availed itself of the redox activity of the cysteine ligand to mobilize the metal, and, presumably to permit redox-control of cellular zinc distribution. The mobilization of zinc from MT suggests a possible function of MT as a physiological zinc donor. (ii) A shift of the glutathione redox balance under conditions of oxidative stress will accelerate metal release from MT. Such a disturbance of metal metabolism has important consequences for the progression of diseases such as Alzheimer's and Parkinson's disease where oxidative stress occurs in affected brain tissue.


An Experimental Model of Chromoblastomycosis Caused by Fonsecaea sp. Species.
The experimental rodent models for the fungal disease are a handy tool for understanding host-fungus interactions. To Fonsecaea sp., one of the causative agents of chromoblastomycosis, there is an extra challenge because the animals preferably used show a spontaneous cure; so until now, there is no model to reproduce the long-term disease similar to human chronic disease. In this chapter, we described an experimental model using rats and mice with a subcutaneous route, with the checkpoints of acute-like and chronic-like lesion analysis comparable with human lesions, the fungal burden, and the lymphocytes investigation.


Elective use of aortic balloon occlusion in cesarean hysterectomy for placenta previa percreta.
Only few reports are available on the use of aortic balloon catheter for cesarean hysterectomy in placenta previa percreta. A 32-year-old woman with placenta previa percreta underwent cesarean hysterectomy at 34 weeks of gestation. Before starting the surgery, an aortic occlusion balloon catheter (30 mm balloon, 5 Fr) was inserted. For total hysterectomy, the aortic balloon catheter was inflated and there was a sudden and dramatic reduction in blood loss, and the surgery was completed safely. An aortic occlusion was sustained for 80 min, with blood loss estimated at 3,200 ml. The postoperative course was uneventful. At 3 months after the operation, the mother and baby remained healthy. An aortic balloon is rapidly and easily inserted, and is an option for major hemorrhage in placenta previa percreta.


Metallurgical and Electrochemical Properties of Super Duplex Stainless Steel Clads on Low Carbon Steel Substrate produced with Laser Powder Bed Fusion.
This study aims to improve the corrosion resistance of the low carbon steel by cladding it with super duplex stainless steel using laser powder bed fusion process. Critical process parameters such as laser power, laser scan speed, hatch spacing, and powder layer thickness were optimized to achieve the best possible metallurgical bonding between the clad and the substrate. The evaporative losses experienced during the laser melting process resulted in clad layers with lower chromium content (12-25 wt. %) as compared to 26 wt. % of the feedstock powder. A clad thickness of 65.8 µm was achieved after melting ten 50 µm thick powder layers. The higher cooling rates associated with laser powder bed fusion resulted in fine high aspect ratio columnar grain structures with predominantly ferrite grains; however, widmanstätten austenite needles were observed with increasing laser scan speeds. Increasing scan speed had a negative impact on the thickness, corrosion resistance, and the pitting potential of the clads exposed to 3.5 wt.% NaCl aqueous solution. Clads produced at the lowest scan speeds showed comparable corrosion resistance to rolled and annealed super duplex stainless steel.


Brachytelephalangic chondrodysplasia punctata: a possible X-linked recessive form.
The author describes four cases of chondrodysplasia punctata with an hypoplasia of the distal phalanges of the fingers. In these cases, growth disturbance is moderate without asymmetry of the limbs, and the facial dysmorphism is similar to that found in Binder's maxillo-facial dysostosis. The phalangeal anomaly is very important for the diagnosis of chondrodysplasia punctata at an age when epiphyseal stippling is no longer present. The relationship of this form of chondrodysplasia with cases in which there is a deletion of the terminal short arm of the X chromosome is discussed. A possible hypothesis is that this form, which is always observed in males, is secondary to an isolated mutation of the Xp localized gene.


Reviving the Weizmann process for commercial n-butanol production.
Developing a commercial process for the biological production of n-butanol is challenging as it needs to combine high titer, yield, and productivities. Here we engineer Clostridium acetobutylicum to stably and continuously produce n-butanol on a mineral media with glucose as sole carbon source. We further design a continuous process for fermentation of high concentration glucose syrup using in situ extraction of alcohols by distillation under low pressure and high cell density cultures to increase the titer, yield, and productivity of n-butanol production to the level of 550 g/L, 0.35 g/g, and 14 g/L/hr, respectively. This process provides a mean to produce n-butanol at performance levels comparable to that of corn wet milling ethanol plants using yeast as a biocatalyst. It may hold the potential to be scaled-up at pilot and industrial levels for the commercial production of n-butanol.


Lysis of CD4+ T cells expressing HIV-1 gag peptides by gag-specific CD8+ cytotoxic T cells.
The vast majority of in vitro experiments testing the cytotoxic T lymphocytes (CTL) activity in HIV infection has been performed with target cells consisting of autologous EBV-transformed B lymphoblastoid cell lines (B-LCLs) expressing Human immunodeficiency virus type I (HIV-1) proteins. However data concerning the lysis of primary CD4+ T lymphocytes expressing HIV-1 antigens by CTLs is still lacking. To study the CTL activity against such primary targets, we used a system involving PBMCs of an HIV+ asymptomatic patient (PT) as effector cells and the CD4+ lymphocytes or B-LCLs of his healthy HLA-identical twin brother (HTW) as target cells. These syngeneic targets were either infected with recombinant vaccinia virus containing HIV-1 gag gene (gag-vac), or coated with HIV-1 gag peptides. We demonstrate in this study that PT CTLs (which were CD3+, CD4-, CD8+, TCRalphabeta+, TCRgammadelta-, CD56-) specifically lysed both types of syngeneic target cells expressing gag-vac; however, CD4+ T cells expressing HIV gag proteins were lysed less efficiently than B-LCLs expressing the same HIV epitopes. On the other hand, no specific lysis was detected when the target cells were uninfected or infected by wild-type vaccinia virus.


Arthroscopic Pectoralis Minor Release After Reverse Shoulder Arthroplasty: A Novel Consideration for Postarthroplasty Pain.
A 74-year-old male patient presenting with chronic radiating shoulder pain, paresthesias, and weakness had previously undergone reverse shoulder arthroplasty and anterior cervical discectomy and fusion for an irreparable cuff tear and cervical radiculopathy, respectively. After being diagnosed with neurogenic thoracic outlet syndrome and undergoing physiotherapy, the patient's recalcitrant condition was surgically managed with arthroscopic pectoralis minor tenotomy, suprascapular nerve release, and brachial plexus neurolysis. This ultimately led to complete pain relief and improved function. By sharing this case, we aim to shed light on this overlooked pathology and help prevent unnecessary procedures for others suffering from similar conditions.


Chemically modified symmetric and asymmetric duplex RNAs: an enhanced stability to nuclease degradation and gene silencing effect.
The present study accents on the relationship between dicing, nuclease stability, and RNAi activity of various types of chemically modified symmetric and asymmetric dsRNAs, covalently bound with amino-groups or cholesterol at one or both terminals. All modified dsRNAs were subjected to cleavage by recombinant Dicer enzyme. They possessed a high resistance to nuclease degradation in cell cultured medium and an excellent RNAi activity in viable cells. The best stability and RNAi activity was detected for 5'-sense amino-modified RNAs. These modifications manifested also a high long-term gene silencing effect within seven days post-transfection, while the RNAi activity of the native 21nt siRNA expired within two days. The conjugation of dsRNA with cholesterol at 5'-sense end resulted in easy intracellular delivery without transfection reagents. After a direct transfection in cells, the cholesterol-conjugated 27nt dsRNA possessed a higher RNAi activity than cholesterol-conjugated 21nt siRNA.


Report summary - The Direct Economic Burden of Socioeconomic Health Inequalities in Canada: An Analysis of Health Care Costs by Income Level.
Canadian research indicates that individuals with lower incomes, less education or lower occupational skill levels tend to be less healthy than those who enjoy greater advantages in these areas. This uneven distribution of health across different socioeconomic status (SES) groups is referred to as "socioeconomic inequality in health." Evidence of the economic cost of health inequalities helps us understand the benefits of reducing these inequalities. However, the data needed to generate such evidence is difficult to obtain. A lack of Canadian data linking health costs and socioeconomic characteristics means that assessment of the degree to which health costs are associated with socioeconomic inequalities at the national level is limited. In order to build evidence on the cost of socioeconomic health inequalities, the Public Health Agency of Canada worked with Statistics Canada to test the feasibility of a "bottom-up" approach to compiling national health cost data. A bottom-up approach relies on individual-level data, which allows costs to be calculated by individual-level characteristics not always found in other data sources. This includes indicators of SES such as level of education or income. In this study, the population was divided into quintiles based on income, and the health care costs incurred by these five income groups were examined for a single year (2007-2008).


Remarkable promotion in particle dispersion and electron transfer capacity of sulfidated nano zerovalent iron by coating alginate polymer.
Alginate has been widely employed to increase the performance of nanoscale zerovalent iron (nZVI)-based materials for site remediation. Yet, the effects of alginate on reactivity of sulfidated nZVI (an efficient reductant material) towards contaminants have been understood poorly. In this study, we have developed a one-step synthesis of alginate-coated sulfidated nZVI (S-nZVI@alginate) under air atmosphere and evaluated the reactivity of S-nZVI@alginate towards tetrabromobisphenol A (TBBPA) debromination. Surface analysis shows that S-nZVI has been successfully coated by alginate through the interaction of OH and COO- groups of alginate with Fe species. The coating of alginate increases particle stability and dispersion under various conditions and facilitates FeS precipitation on the particle surface. Reactivity experiments show that the coating of alginate significantly enhances TBBPA debromination by S-nZVI. The optimized alginate to Fe weight ratio of S-nZVI@alginate is 0.06, with ~3-fold greater TBBPA debromination rate than S-nZVI. S-nZVI@alginate can completely debrominate TBBPA into bisphenol A via a four-sequential step debromination pathway while S-nZVI not. Its superior reactivity may be attributed to that the formation of alginate-Fe complex can lower the redox potential of Fe species to accelerate electron transfer on the particle surface. The TBBPA debromination rate by S-nZVI@alginate is initially enhanced followed by a decrease with an increase in TBBPA concentration, while it can increase 3.3-, 8.9- and 5.6-fold by increasing S-nZVI@alginate dosage, decreasing pH and adding co-contaminant Cd2+, respectively. S-nZVI@alginate has greater performance in aging and reusability tests than S-nZVI, and achieves rapid TBBPA removal from wastewater, which may be due to the role of alginate on inhibiting surface oxidation of Fe and S species. Taken together, these results suggest that S-nZVI@alginate provides better reactivity, longevity and reusability than S-nZVI, having the great potential for application into site remediation.


Role of inflammatory burden and treatment on joint space width in psoriatic arthritis-a high-resolution peripheral quantitative computed tomography study.
To investigate the relationship between disease-related parameters and joint space width (JSW) on high-resolution peripheral quantitative computed tomography (HR-pQCT) in psoriatic arthritis (PsA) patients. PsA patients who underwent HR-pQCT examination of the second to fourth metacarpophalangeal joint (MCPJ 2-4) were recruited in this cross-sectional study. The joint space metrics included joint space volume (JSV), mean, minimum, and maximum JSW, JSW asymmetry, and distribution. Correlation analysis and multivariable linear regression models were used to determine the association between disease-related variables and JSW. Sixty-seven patients [37 (55.2%) males; median (IQR) age: 57.0 (53.0, 63.0); median disease duration: 21 (16, 28) years] were included in this analysis. Multivariable linear regression analysis demonstrated that males had larger JSV (MCPJ 2-4), mean (MCPJ 4), and maximum JSW (MCPJ 3). Longer disease duration (MCPJ 2-3) and higher ESR values (MCPJ 3) were negatively associated with mean and maximum JSW, while higher damage joint count was negatively associated with mean and minimum JSW (MCPJ 2). Use of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) was negatively associated with minimum JSW (MCPJ 3) while use of biologic DMARDs (bDMARDs) was positively associated with minimum JSW (MCPJ 2). Higher inflammatory burden as reflected by longer disease duration, higher ESR levels, and damage joint count was negatively associated with mean, maximum, and minimum JSW, while suppression of inflammation using bDMARDs seems to limit the decline in JSW.


Pacemaker spike alternans: an artifact of digital signal processing.
Marked variability in the amplitude or polarity of pacemaker artifacts may be a clue to generator malfunction or partial electrode fracture. We report a case where "pacemaker spike alternans" occurred factitiously as a result of a digital "roll-over" effect. The widespread introduction of digital electrocardiographs into clinical practice makes recognition of such artifacts important.


Structure of porcine pancreatic phospholipase A2 at 2.6 A resolution and comparison with bovine phospholipase A2.
The previously published three-dimensional structure of porcine pancreatic prophospholipase A2 at 3 A resolution was found to be incompatible with the structures of bovine phospholipase A2 and bovine prophospholipase A2. This was unexpected because of the very homologous amino acid sequences of these enzymes. Therefore, the crystal structure of the porcine enzyme was redetermined using molecular replacement methods with bovine phospholipase as the parent model. The structure was crystallographically refined at 2.6 A resolution by fast Fourier transform and restrained least-squares procedures to an R-factor of 0.241. The crystals appeared to contain phospholipase A2 and not prophospholipase A2. Apparently the protein is slowly converted under the crystallization conditions employed. Our investigation shows that, in contrast to the previous report, the three-dimensional structure of porcine phospholipase A2 is very similar to that of bovine phospholipase A2, including the active site. Smaller differences were observed in some residues involved in the binding of aggregated substrates. However, an appreciable conformational difference is in the loop 59 to 70, where a single substitution at position 63 (bovine Val leads to porcine Phe) causes a complete rearrangement of the peptide chain. In addition to the calcium ion in the active site, a second calcium ion is present in the crystals; this is located on a crystallographic 2-fold axis and stabilizes the interaction between two neighbouring molecules.


Gegen-Qinlian decoction-A traditional Chinese medicine formula-Alleviates methamphetamine withdrawal induced anxiety by targeting GABAergic interneuron-pyramidal neuron pathway in mPFC.
Methamphetamine (Meth) withdrawal elicits anxiety, which is a public health concern with limited therapeutic options. Previous studies implied a strong correlation between mPFC and Meth withdrawal. Here, we examined the role of Gegen-Qinlian decoction (GQD) in Meth withdrawal anxiety and explored potential therapeutic targets in mPFC. We found that intra-gastric administration of GQD during the withdrawal period efficiently alleviated anxiety-like behaviours in Meth-withdrawn mice. Further, GQD could restore Meth withdrawal-triggered pathway of GABAergic interneurons (GABA IN)-pyramidal neurons (PN) in the mPFC of Meth-withdrawn mice, especially the prelimbic cortex (PrL) sub-region and PV-positive GABA IN. While, GQD had no obvious effects on the glial cells in the mPFC of Meth-withdrawn mice. By transcriptomic analysis and validation of several gene candidates, we found that genes in the MAPK signalling pathway, especially those related to heat shock proteins, including Hspa1a, Hspa1b and Hspb1, might be GQD-targeting genes in mPFC to treat Meth withdrawal anxiety, as indicated that these genes were up-regulated by Meth withdrawal but rescued by GQD in mPFC. Collectively, our findings identified for the first time that GQD could efficiently alleviate Meth withdrawal anxiety, partially through regulating the local GABA IN-PN pathway and transcriptomic profile of mPFC. The present study confirms that TCM, such as GQD, will be a desirable therapeutic approach in the treatment of drug addiction and related emotional deficits.


[Patient-reported outcomes (PRO): historical profile, definitions, classifications and problems].
This contribution deals with the use, within healthcare systems, of patient-reported outcomes (PROs), i.e., all measures aimed at quantifying the state of health through the evaluation of outcomes reported by the patient himself. A survey of their cultural background, identified in the patient-centered model of medicine, is followed by a delineation of their historical profile (from 1914, the year of the first outcome measure, to the more recent examples of their use in clinical trial and practice), a classification based on the size they wish to detect and the reconstruction of the main lines of debate around their use in health care.


Vma22p is a novel endoplasmic reticulum-associated protein required for assembly of the yeast vacuolar H(+)-ATPase complex.
The Saccharomyces cerevisiae vacuolar H(+)-ATPase (V-ATPase) is a multi-subunit complex that can be structurally and functionally divided into peripheral (V1) and integral membrane (V0) sectors. The vma22-1 mutation was isolated in a screen for mutants defective in V-ATPase function vma22 delta cells contain no V-ATPase activity due to a failure to assemble the enzyme complex; V1 subunits accumulate in the cytosol, and the V0 100-kDa subunit is rapidly degraded. Turnover of the 100-kDa integral membrane protein was found to occur in the endoplasmic reticulum (ER) of vma22 delta cells. The product of the VMA22 gene, Vma22p, is a 21-kDa hydrophilic protein that is not a subunit of the V-ATPase but rather is associated with ER membranes. The association of Vma22p with ER membranes was perturbed by mutations in VMA12, a gene that encodes an ER membrane protein (Vma12p) that is also required for V-ATPase assembly. These results indicate that Vma22p, along with Vma21p and Vma12p, form a set of ER proteins required for V-ATPase assembly.


The histamine H3 receptor: an attractive target for the treatment of cognitive disorders.
The histamine H3 receptor, first described in 1983 as a histamine autoreceptor and later shown to also function as a heteroreceptor that regulates the release of other neurotransmitters, has been the focus of research by numerous laboratories as it represents an attractive drug target for a number of indications including cognition. The purpose of this review is to acquaint the reader with the current understanding of H3 receptor localization and function as a modulator of neurotransmitter release and its effects on cognitive processes, as well as to provide an update on selected H3 antagonists in various states of preclinical and clinical advancement. Blockade of centrally localized H3 receptors by selective H3 receptor antagonists has been shown to enhance the release of neurotransmitters such as histamine, ACh, dopamine and norepinephrine, among others, which play important roles in cognitive processes. The cognitive-enhancing effects of H3 antagonists across multiple cognitive domains in a wide number of preclinical cognition models also bolster confidence in this therapeutic approach for the treatment of attention deficit hyperactivity disorder, Alzheimer's disease and schizophrenia. However, although a number of clinical studies examining the efficacy of H3 receptor antagonists for a variety of cognitive disorders are currently underway, no clinical proof of concept for an H3 receptor antagonist has been reported to date. The discovery of effective H3 antagonists as therapeutic agents for the novel treatment of cognitive disorders will only be accomplished through continued research efforts that further our insights into the functions of the H3 receptor.


Surgical management of pterygium.
Pterygia are noncancerous growths of conjunctiva that may require surgical removal because of discomfort, cosmesis, or obstruction of vision. Pterygia often recur after excision. The major goal of pterygium treatment is avoiding recurrence, but complication rates and cosmetic results are also considered. Despite the number of techniques available, there is no consensus on the best procedure. Even the best techniques carry risk of recurrence and complications. In this review, different surgical techniques, graft attachment methods, and adjuvant therapies in current use are discussed. Also discussed are newer techniques that early studies have shown to be promising, but require more investigation before becoming a recommended treatment. The review is intended to provide an overview of the current research to inform surgeons with regard to their decisions and aid researchers in hypothesis generation.


Removal of Cr(VI) from aqueous solutions by adsorption on MnO2.
Adsorption of Cr(VI) on MnO2 was investigated with respect to effect of pH, temperature, ionic strength, initial Cr(VI) concentration, co-presence of different anions (HCO3(-), SO4(2-), H2PO4(-), NO3(-) and Cl(-)) and of low molecular weight natural organic materials (LMWNOM) (acetate, oxalate and citrate). The process was rapid during the first 3-5min, reaching equilibrium after one hour. Adsorption decreased with increasing pH, temperature and Cr(VI) initial concentration, and increased with increasing ionic strength. Co-presence of phosphate, sulfate, bicarbonate, citrate and oxalate hindered Cr(VI) adsorption, whereas nitrate, chloride and acetate did not exert any notable influence. The overall order of Cr(VI) adsorption suppression due to co-presence of anions and LMWNOM was H2PO4(-)>HCO3(-)>SO4(2-), and oxalate>citrate, respectively. Highest experimental equilibrium sorption capacity (0.83mgg(-1)) was obtained at 20°C and pH 5.9, while lowest (0.18mgg(-1)) was noticed in the co-presence of H2PO4(-), at 20°C and pH 6.9. Adsorption kinetics was successfully fitted by pseudo-second-order model. Mechanisms for both specific and non-specific adsorption are likely to be involved, while rate-controlling step involved both intra-particle and film diffusion processes. Cr(VI) was strongly bound to MnO2, which makes risks of its subsequent liberation into the environment to be low.


Retrospective Analysis of the Impact of Adalimumab Initiation on Corticosteroid Utilization and Medical Costs Among Biologic-Naïve Patients with Rheumatoid Arthritis.
Treatment guidelines recommend low-dose corticosteroids as short-term therapy among rheumatoid arthritis (RA) patients. However, it may be difficult to wean/eliminate steroids once initiated. Initiation of more effective therapies such as biologics may help to taper corticosteroid use. The objective was to examine the impact of adalimumab (ADA) initiation on steroid utilization and non-drug medical costs among patients with RA. A retrospective analysis was conducted among adult RA patients initiating ADA as the initial biologic in the MarketScan Database (2012-2016). Study outcomes included whether oral/injectable steroids were used, daily dose, dosage categories (< 5 and ≥ 5 mg/day), number of steroid injections, and non-drug medical costs. Outcomes were compared 6 months pre- and post-ADA initiation. Mixed effects logistic, classical linear, multinomial logistic models, and linear model with a log link and gamma distribution were used to adjust for patient demographic and health characteristics. The sample included 7404 ADA initiators. Compared to pre-ADA initiation, in the post-initiation period there was a reduction in proportions of patients using oral steroids (from 71.80 to 62.56%) and injectable steroids (from 34.91 to 29.88%), average daily dose of oral steroids (from 3.30 to 2.62 mg/day), patients with dose ≥ 5 mg/day (from 21.76 to 16.34%), number of injections (from 0.64 to 0.53), and non-drug medical costs (from $5356.30 to $5146.84) (P < 0.01). The multivariate analysis produced similar patterns. For example, post-ADA initiation, patients were less likely to use oral steroids [odds ratio (OR) 0.51; 95% confidence interval (CI) 0.47-0.56]; coefficient estimate for daily dose reduction was - 0.68 (95% CI - 0.81 to - 0.56); ratio estimate for medical costs was 0.91 (95% CI 0.86-0.97). Among patients with RA, following ADA initiation, there is a reduction in steroid utilization and dosage, and non-drug medical costs. Prospective studies should be conducted to confirm this relationship in the future.


Characterization of gp39, a B-lymphocyte associated differentiation antigen which is also present on granulocytes and macrophages.
The biosynthesis and biochemical characteristics of the 39,000 cell surface glycoprotein detected by Mab 41H.16 were investigated. Experiments utilizing tunicamycin, endoglycosidase H, endoglycosidase F and N-glycosidase F indicate that the mature molecule expressed at the cell surface is composed largely of N-linked oligosaccharides of both the complex and high mannose types. When synthesized in the presence of tunicamycin, the molecule appeared on the cell surface with a Mr of 32,000. Digestion with both endoglycosidase H and endoglycosidase F yielded a single band of Mr 37,000. Parallel experiments with N-glycosidase F revealed species of approx. 35,000 and 32,000. Synthesis in the presence of monensin yielded a 37,500 product. [3H]Glucosamine and [3H]mannose were incorporated into the molecule but no evidence for fucose incorporation could be found. Microheterogeneity of gp39 with respect to Mr and oligosaccharide structure was demonstrated by biosynthetic labelling and lectin chromatography. Biosynthetic pulse-chase labelling showed that the de novo synthesis of the 39,000 molecule occurs without detectable precursor formation. Results of temperature-dependent phase separation experiments were consistent with gp39 being an integral membrane protein. Two-dimensional electrophoresis showed heterogeneity of the isoelectric points associated with the N-linked oligosaccharides. Galactose oxidase/NaB[3H]4 labelling showed that a terminal sialic acid protects a galactose residue. All results are consistent with the conclusion that the gp39 molecule is an integral membrane glycoprotein composed of heterogeneous N-linked oligosaccharides of both the complex and high mannose types.


Mitochondrial Metabolism: A New Dimension of Personalized Oncology.
Energy is needed by cancer cells to stay alive and communicate with their surroundings. The primary organelles for cellular metabolism and energy synthesis are mitochondria. Researchers recently proved that cancer cells can steal immune cells' mitochondria using nanoscale tubes. This finding demonstrates the dependence of cancer cells on normal cells for their living and function. It also denotes the importance of mitochondria in cancer cells' biology. Emerging evidence has demonstrated how mitochondria are essential for cancer cells to survive in the harsh tumor microenvironments, evade the immune system, obtain more aggressive features, and resist treatments. For instance, functional mitochondria can improve cancer resistance against radiotherapy by scavenging the released reactive oxygen species. Therefore, targeting mitochondria can potentially enhance oncological outcomes, according to this notion. The tumors' responses to anticancer treatments vary, ranging from a complete response to even cancer progression during treatment. Therefore, personalized cancer treatment is of crucial importance. So far, personalized cancer treatment has been based on genomic analysis. Evidence shows that tumors with high mitochondrial content are more resistant to treatment. This paper illustrates how mitochondrial metabolism can participate in cancer resistance to chemotherapy, immunotherapy, and radiotherapy. Pretreatment evaluation of mitochondrial metabolism can provide additional information to genomic analysis and can help to improve personalized oncological treatments. This article outlines the importance of mitochondrial metabolism in cancer biology and personalized treatments.


Corrigendum: Pregnancy-related stress among pregnant women receiving tocolytic and non-tocolytic treatments where both used complementary medicine.
[This corrects the article DOI: 10.3389/fphar.2022.870659.].


Laparoscopic colorectal resection for cancer: effects of conversion on long-term oncologic outcomes.
The effects of conversion to open surgery during laparoscopic resection for colorectal cancer on long-term oncologic outcomes still are unclear. All 450 laparoscopic colorectal resections for cancer performed at a single center between 1994 and 2008 and included in a prospectively maintained database were considered. Patients who required conversion to open surgery (CONV) were matched 1:2 with laparoscopically completed cases (LAP) and 1:5 with open surgery cases (OPEN) for age, American Society of Anesthesiologists (ASA) score, year of surgery, tumor location, and tumor stage. Fisher's exact, chi-square, and Wilcoxon tests were used as appropriate. Kaplan-Meier curves were compared to analyze survival. In this study, 31 CONV cases were independently compared with 62 LAP and 155 OPEN cases. Compared with the LAP and OPEN patients, the CONV patients were characterized by a numerically higher rate of preoperative comorbidity (61.3% vs LAP, 51.6; P = 0.4 and OPEN, 48.4%; P = 0.2), male gender (77.4% vs LAP, 59.7%; P = 0.09 and OPEN, 58.1%; P = 0.05), and a significantly higher mean body mass index (29.6 vs LAP, 26.8; P = 0.012 and OPEN, 28.8; P = 0.3). The pathologic tumor stage, location, and chemotherapy and radiotherapy rates were comparable among the groups. After a median follow-up period of 4.1, 4.2, and 4.6 years, the 5-year disease-free survival rate was significantly lower for the CONV patients (40.2%) than for the LAP (70.7%, P = 0.01) or the OPEN (63.3%, P = 0.04) patients. However, the 5-year cancer-specific survival rates were similar among the CONV (94.4%), LAP (86.1%, P = 0.36), and OPEN (84.9%, P = 0.14) patients. Conversion to open surgery does not affect oncologic outcomes, although CONV patients have increased comorbidity rates affecting long-term mortality.


Quantification of peptides from immunoglobulin constant and variable regions by LC-MRM MS for assessment of multiple myeloma patients.
Quantitative MS assays for Igs are compared with existing clinical methods in samples from patients with plasma cell dyscrasias, for example, multiple myeloma (MM). Using LC-MS/MS data, Ig constant region peptides, and transitions were selected for LC-MRM MS. Quantitative assays were used to assess Igs in serum from 83 patients. RNA sequencing and peptide-based LC-MRM are used to define peptides for quantification of the disease-specific Ig. LC-MRM assays quantify serum levels of Igs and their isoforms (IgG1-4, IgA1-2, IgM, IgD, and IgE, as well as kappa (κ) and lambda (λ) light chains). LC-MRM quantification has been applied to single samples from a patient cohort and a longitudinal study of an IgE patient undergoing treatment, to enable comparison with existing clinical methods. Proof-of-concept data for defining and monitoring variable region peptides are provided using the H929 MM cell line and two MM patients. LC-MRM assays targeting constant region peptides determine the type and isoform of the involved Ig and quantify its expression; the LC-MRM approach has improved sensitivity compared with the current clinical method, but slightly higher inter-assay variability. Detection of variable region peptides is a promising way to improve Ig quantification, which could produce a dramatic increase in sensitivity over existing methods, and could further complement current clinical techniques.


Two-stage fluid pathways generated by volume expansion reactions: insights from the replacement of pyrite by chalcopyrite.
Volume expansion reactions involved in mineral-fluid interactions are linked to a number of geological processes, including silicate weathering, retrograde metamorphism, and mineralization. However, the effect of volume expansion on replacement reactions remains unclear. Here, we demonstrate that reactions associated with volume expansion during the replacement of pyrite by chalcopyrite involve two competing processes. The reaction is initially augmented because of the development of reaction-induced fractures in the pyrite. However, these fractures are subsequently filled by compacted products, which ultimately disrupts the contact and interaction between bulk fluids and the pristine pyrite surface. These competing processes indicate that replacement reactions are both augmented and inhibited by volume expansion reactions during pyrite replacement.


Recurrent bacteraemia by 2 different Bacillus cereus strains related to 2 distinct central venous catheters.
A 14-y-old girl with osteosarcoma developed 3 episodes of catheter-related bacteraemia by Bacillus cereus. After removal of the first and insertion of a second Hickman catheter, further episodes of B. cereus bacteraemia occurred. PFGE analysis revealed that bacteraemic episodes related to each catheter were caused by a distinct B. cereus strain.


Role of glucocorticoids and progesterone in the development of rough endoplasmic reticulum involved in casein biosynthesis.
Hydrocortisone acetate injected into pseudopregnant rabbits induced casein synthesis and a parallel accumulation of casein mRNA. These effects were not accompanied by any enrichment of total RNA in the mammary cell. Hydrocortisone acetate did not favour the attachment of polysomes to endoplasmic reticulum. Casein mRNA concentration was enhanced in free and membrane-bound polysomes. After long treatments, the concentration of casein mRNA reached a plateau in membrane bound polysomes whereas it continued to be accumulated in free polysomes, suggesting that a substantial part of casein synthesis is then carried out by free polysomes. Progesterone injected with high doses of prolactin was unable to prevent the stimulatory action of prolactin on the synthesis of casein, the accumulation of casein mRNA and mammary gland growth, as judged by DNA content. By contrast, the increase in the total RNA content of mammary gland was still significantly reduced by progesterone. In addition, progesterone inhibited almost completely the formation of membrane-bound polysomes and the anchorage of casein mRNA to endoplasmic reticulum. From these data, it was concluded that the formation of the endoplasmic reticulum is not a prerequisite for the initiation of casein synthesis. Glucocorticoids do not play a major role in the formation of the endoplasmic reticulum and the Golai apparatus and in the binding of casein synthesizing polysomes to membranes. Progesteronne is capable of inhibiting preferentially and gradually the stimulation of cellular functions requiring the most potent prolactin stimulation.


Characterization of the estrous cycle and reproductive traits of the aoudad (Ammotragus lervia) in captivity.
In this study the estrous cycle of the aoudad has been analyzed and characterized for the first time, using non-invasive methods for tracking reproductive cyclicity. The duration of the estrous cycle is 23 days (range 16-32 days), with a luteal phase of 17 days (range 12-27 days) and an interluteal phase of 6 days (range 3-14 days). The estrous cycle did not differ between females, but it was affected by the time of the year. Intraindividual variation of the cycle was observed in one out of the nine individuals. The average hormone concentration values, the estrogen:progestogen ratio, as well as their minimum and maximum values for each interluteal and luteal phases of the estrous cycle, are shown. Interindividual differences found in these values were basically associated with age. Females tended to start their cycle when in the presence of an adult male. Anestrus was observed in study females except for the oldest (14 years old). Age and anestrus onset were correlated, with younger females starting earlier than the older ones. This study reveals that Ammotragus reproductive biology is more similar to that of Capra than Ovis, except for some endocrinological features.


Association of Thyroid Function With Life Expectancy With and Without Cardiovascular Disease: The Rotterdam Study.
Variations in thyroid function within reference ranges are associated with an increased risk of cardiovascular disease (CVD) and mortality. However, the impact of thyroid function on life expectancy (LE) and the number of years lived with and without CVD remains unknown. To investigate the association of thyroid function with total LE and LE with and without CVD among euthyroid individuals. The Rotterdam Study, a population-based, prospective cohort study. We included participants without known thyroid disease and with thyrotropin and free thyroxine (FT4) levels within the reference ranges. Multistate life tables were used to calculate total LE and LE with and without CVD among thyrotropin and FT4 tertiles. Life expectancy estimates in men and women aged 50 years and older were obtained using prevalence, incidence rates, and hazard ratios for 3 transitions (healthy to CVD, healthy to death, and CVD to death), adjusting for sociodemographic and cardiovascular risk factors. The mean (SD) age of the 7785 participants was 64.7 (9.8) years, and 52.5% were women. Over a median follow-up of 8.1 (interquartile range, 2.7-9.9) years, we observed 789 incident CVD events and 1357 deaths. Compared with those in the lowest tertile, men and women in the highest thyrotropin tertile lived 2.0 (95% CI, 1.0 to 2.8) and 1.4 (95% CI, 0.2 to 2.4) years longer, respectively, of which, 1.5 (95% CI, 0.2 to 2.6) and 0.9 (95% CI, -0.2 to 2.0) years longer without CVD. Compared with those in the lowest tertile, the difference in life expectancy for men and women in the highest FT4 tertile was -3.2 (95% CI, -5.0 to -1.4) and -3.5 (95% CI, -5.6 to -1.5) years, respectively, of which, -3.1 (95% CI, -4.9 to -1.4) and -2.5 (95% CI, -4.4 to -0.7) years without CVD. At the age of 50 years, participants with low-normal thyroid function live up to 3.5 years longer overall and up to 3.1 years longer without CVD than participants with high-normal thyroid function. These findings provide supporting evidence for a reevaluation of the current reference ranges of thyroid function and can help inform preventive and clinical care.


Ludwig Rehn: the first successful cardiorrhaphy.
The first successful suture of a wound of the heart was performed by Ludwig Rehn in 1896. This landmark operation--set against a background of widespread doubt with regard to its possibility and censure of its very contemplation--reversed the prevailing belief in the inviolability of the heart. It marks the beginning of cardiac surgery.


A randomized comparison of labetalol and nitroprusside for induced hypotension.
In a randomized study, labetalol-induced hypotension and nitroprusside-induced hypotension were compared in 20 patients (10 in each group) scheduled for major orthopedic procedures. Each patient was subjected to an identical anesthetic protocol and similar drug-induced reductions in mean arterial blood pressure (BP) (50 to 55 mmHg). Nitroprusside infusion was associated with a significant (p less than 0.05) increase in heart rate and cardiac output; rebound hypertension was observed in three patients after discontinuation of nitroprusside. Labetalol administration was not associated with any of these findings. Arterial PO2 decreased in both groups. It was concluded that labetalol offers advantages over nitroprusside.


Label-free biosensor based on an electrical tracing-assisted silicon microring resonator with a low-cost broadband source.
We present a novel biosensor based on an electrical tracing-assisted silicon dual-microring resonator sensor system. The dual-microring system comprises one microring resonator as a sensing element and the other microring resonator integrated with an electrical controller as a tracing element. The resonance wavelength shift of the sensing microring induced by the refractive index change due to antigen-ligand bindings is traced and determined by direct voltage applied to the electrical tunable tracing microring. The sensor system enables the use of a low-cost broadband light source instead of a bulky and expensive tunable laser, which allows the development of cost-effective point-of-care diagnostic devices by significantly reducing the device cost and increasing its portability. The sensing capability of the developed dual-microring sensor was investigated using biotin-streptavidin binding as a model system. We have demonstrated the quantitative detection of streptavidin over a broad range of concentrations down to 190 pM by monitoring the electrical power applied to the tracing ring. We have also validated the sensing principle of the dual-microring system by a direct comparison between the calculated and measured values for the resonance wavelength shift of the sensing microring. Furthermore, we have shown the quantitative and specific detection of a well-known breast cancer biomarker, human epidermal growth factor receptor 2 (HER2), in a bovine serum albumin solution using the antibody-modified dual-microring sensor system.


Ventilatory changes in heat-stressed humans with spinal-cord injury.
Single trial using matched subjects under tightly-controlled experimental conditions. Humans with spinal-cord injury have a reduced ability to dissipate heat. The current project examined the possibility that, in such people, an elevated ventilatory response (panting) may act as a supplementary avenue for heat loss. Australia, New South Wales. Breathing frequency was measured during a resting heat exposure (<or=2 h) in 10 subjects with spinal-cord injury (C4-L5), and in 10 mass- and age-matched, able-bodied subjects. Subjects with spinal-cord injury displayed a ventilatory sensitivity, relative to mean body temperature change (2.4 breaths/min/ degrees C +/-0.9), more than twice that of able-bodied subjects (1.1 breaths/min/ degrees C +/-0.6; P=0.042). Furthermore, the higher the level of spinal-cord injury, the greater was the ventilatory response (r2=0.51, P=0.048). While these ventilatory changes were apparently thermally mediated, they did not represent a true panting response, nor did the increased breathing frequency confer a physiologically significant thermoregulatory benefit that may help compensate for the loss of sympathetic flow to eccrine sweat glands and cutaneous blood vessels in people with spinal-cord injury.


Refinement on single-beat determination of left ventricular systolic function in patients with atrial fibrillation.
Single-beat determination of left ventricular systolic function at a beat with equal subsequent cardiac cycles has been proposed as an accurate method in atrial fibrillation. However, there has still been substantial variability between the values calculated from beats with equal subsequent cycles. Therefore, some refinement on the single-beat method is needed. In 100 patients with atrial fibrillation, Doppler aortic flow time-velocity integral was determined for at least 20 consecutive cardiac cycles. The values at beats with equal subsequent cardiac cycles were chosen and compared with the average values over all cardiac cycles. The values at beats with cycle lengths shorter than 500 milliseconds were usually far below the average values over all cardiac cycles. Bland-Altman agreement analysis revealed improved accuracy by gradually narrowing the range of the limits of agreement when 2 or 3 beats with equal subsequent cycles and cycle lengths longer than 500 milliseconds were used for evaluation.


Serum osmolality in alcohol ingestions: differences in availability among laboratories of teaching hospital, nonteaching hospital, and commercial facilities.
Freezing point depression osmometry is preferred over vapor pressure with ingestions of volatile substances. Sixty-six laboratories nationwide (23 teaching hospital, 22 nonteaching hospital, and 21 commercial facilities) were surveyed to determine the availability and use of these techniques. Overall, 80% conducted serum osmometry (teaching, 100%; nonteaching, 82%; commercial, 57%). Freezing point depression was the most common method used by all laboratories; however, 33% of commercial laboratories and 11% of nonteaching laboratories used vapor pressure exclusively. One half of all laboratory supervisors did not identify why one method was preferred. Only 3% identified vapor pressure as a possible source of error in ingestions of volatile substances. Most laboratories estimated that they were aware of the patient diagnosis less than 50% of the time. Because vapor pressure osmometry is a potential source of false negative results when estimating serum concentrations of volatile substances, clinicians treating patients who have ingested ethanol, ethylene glycol, isopropanol, or methanol need to be aware of the methodology used in their reference laboratories.


Plants traditionally used in age related brain disorders--a survey of ethnobotanical literature.
In traditional herbal medicine, numerous plants have been used to treat age related cognitive disorders. In this review we compiled available literature from four Swiss university libraries, scientific journals and online database query's on plants and remedies used in traditional medicinal systems for such diseases. Over 150 plant species in various preparations and mixtures were found. European herbals from the 16th and 17th century alongside traditional Chinese and Indian medicinal works were the most prolific sources. The information is organised into geographic regions and when available the findings are discussed in the light of more recent scientific findings concerning their secondary metabolites and in vitro and in vivo activities relevant to dementia and Alzheimer's disease.


Fluorine-Retentive Strategies for the Functionalization of gem-Difluoroalkenes.
gem-Difluoroalkenes are readily available fluorinated building blocks, and the fluorine-induced electronic perturbations of the alkenes enables a wide array of selective functionalization reactions. However, many reactions of gem-difluoroalkenes result in a net C─F functionalization to generate monofluorovinyl products or addition of F to generate trifluoromethyl-containing products. In contrast, fluorine-retentive strategies for the functionalization of gem-difluoroalkenes remain less generally developed, and is now becoming a rapidly developing area. This review will present the development of fluorine-retentive strategies including electrophilic, nucleophilic, radical, and transition metal catalytic strategies with an emphasis on key physical organic and mechanistic aspects that enable reactivities.


What is the role of light in persulfate-based advanced oxidation for water treatment?
Persulfate-based advanced oxidation processes (PS-based AOPs) under UV, visible, or solar irradiation are being intensively investigated for water treatment. Tremendous advances have been made for enhancing the performance towards the destruction of target pollutants, but a deeper understanding of the role of light in different photo-activated PS-based AOPs is still needed as a basis for improving the efficiency. This paper intends to provide an in-depth review of the underlying photo-activation mechanisms and recent progress in various common photo-activated PS-based AOPs reported over the last decade. Based on a comprehensive survey of previous studies, we categorize these processes according to their reaction mechanisms, including activation by direct UV radiation, processes based on dye-photosensitization, activation through ligand-to-metal charge transfer (LMCT), and photocatalytic processes. Moreover, the improvement in performance of contaminant degradation in these processes compared with those in the absence of light are summarized. Finally, we conclude this review by proposing critical challenges and future perspectives for developing efficient photo-activated PS-based AOPs toward improvement in water treatment and remediation.


Adipose-derived mesenchymal stem cells attenuate ischemic brain injuries in rats by modulating miR-21-3p/MAT2B signaling transduction.
To explore the mechanism underlying the protective effect of adipose-derived mesenchymal stem cells (ADMSCs) against ischemic stroke by focusing on miR-21-3p/MAT2B axis. Ischemic brain injury was induced in 126 rats by middle cerebral artery occlusion (MCAO). The effect of ADMSC administration on blood-brain barrier (BBB) condition, apoptosis, inflammation, and the activity of miR-21-3p/MAT2B axis was assessed. The role of miR-21-3p inhibition in the function of ADMSCs was further validated in in vitro neural cells. ADMSCs administration improved BBB condition, inhibited apoptosis, and suppressed inflammation. It also reduced the abnormally high level of miR-21-3p in MCAO rats. Dual luciferase assays showed that miR-21-3p directly inhibited the MAT2B expression in neural cells, and miR-21-3p inhibition by inhibitor or ADMSC-derived exosomes in neurons attenuated hypoxia/reoxygenation-induced impairments similarly to that of ADMSCs in vivo. This study confirmed the protective effect of ADMSCs against ischemic brain injury exerted by suppressing miR-21-3p level and up-regulating MAT2B level.


Treatment-ladder and genetic characterisation of parasites in refractory giardiasis after an outbreak in Norway.
To evaluate the efficacy of a treatment ladder in metronidazole-refractory giardiasis, and to compare genetic characteristics of the parasites. A clinical observational study was carried out in 38 adult patients with metronidazole-refractory giardiasis, during an outbreak in Norway with more than 1200 cases. All patients were treated with albendazole in combination with metronidazole. Those who failed were treated with paromomycin. Those who failed on paromomycin were treated with quinacrine in combination with metronidazole. Giardia isolates from 17 patients were characterised by PCR and sequencing at two separate genes. Metronidazole in combination with albendazole was effective in 30 (79%) out of 38 patients. Paromomycin was effective in three out of six patients. Quinacrine in combination with metronidazole was effective in 3 patients. Molecular characterisation of the Giardia isolates revealed that these parasites were identical at two different gene segments, while sequence profiles from isolates at the peak of the outbreak were more heterogenous. Albendazole and quinacrine both in combination with metronidazole were effective in treating metronidazole-refractory giardiasis in this cohort. Paromomycin was less effective. Particular Giardia sub-genotypes may have been associated with the treatment-refractory giardiasis in these patients, although other undefined factors are probably also of importance.


Low-multiplicity infection of Moloney murine leukemia virus in mouse cells: effect on number of viral DNA copies and virus production in producer cells.
Mouse cells infected with Moloney murine leukemia virus (M-MuLV) were prepared by two methods, and the number of M-MuLV-specific DNA copies in the infected cells was measured. The number of M-MuLV-specific DNA copies detected varied from one to eight per infected cell in different cell lines. Cells in which multiple rounds of viral infection occurred during establishment had on the average more viral DNA copies than cells in which infection at low multiplicity was performed, followed by cloning of the cells. However, even in cells derived by the low multiplicity of infection method, most cell lines carried more than one copy of M-MuLV-specific DNA. Virus production per cell was also measured, and no strict correlation was observed between the number of M-MuLV DNA copies present and the amount of virus produced.


Kidney allograft tolerance in diabetic patients after total lymphoid irradiation (TLI).
The value of total lymphoid irradiation (TLI) combined with low dose prednisone as sole immunosuppressive regimen in renal allograft transplantation in humans has been investigated. Seventeen patients with end-stage diabetic nephropathy received TLI to a cumulative dose of 20-30 Gy in fractions of 1 Gy. Cadaver kidneys were grafted as soon as they were available after completion of TLI. Low dose prednisone was given after transplantation. Profound and long-term immunosuppression has been achieved in all patients. Six patients live already more than one year (greater than 2 years in 3 of them) and 7 for less than one year with a functioning kidney graft. Two out of these 13 patients had repeated rejection episodes necessitating a supplementary immunosuppressive treatment with cyclosporine A. One patient returned to chronic hemodialysis 11 months after transplantation and died of pericardial tamponade one month later. One patient had severe acute rejection for which cyclosporine A was administered; he died of septic shock as a consequence of immune deficiency a month later. The other two patients succumbed to other causes (myocardial infarction and hyperglycemia). The amount of steroids and azathioprine administered to these patients was substantially lower than in the case of conventional immunosuppression. The preliminary results are thus encouraging. However, the treatment schedule as used in the present study can not yet be considered as optimal since the majority of patients still had one or more rejection episodes. Further investigations are warranted. The optimal dose of radiation, the importance of the interval between TLI and organ transplantation, the influence of splenectomy on the immunity, etc., are still to be assessed.


A three-factor preoperative scoring model predicts risk of recurrence after liver resection or transplantation in hepatocellular carcinoma patients with preserved liver function.
No staging systems of hepatocellular carcinoma (HCC) are tailored for assessing recurrence risk. We sought to establish a recurrence risk scoring system to predict recurrence of HCC patients receiving surgical curative treatment (liver resection or transplantation). We retrospectively studied 286 HCC patients with preserved liver function receiving liver resection (n=184) or transplantation (n=102). Independent risk factors were identified to construct the recurrence risk scoring model. The recurrence free survival and discriminatory ability of the model were analyzed. Total tumor volume, HBsAg status, plasma fibrinogen level were included as independent prognostic factors for recurrence-free survival and used for constructing a 3-factor recurrence risk scoring model. The scoring model was as follows: 0.758 x HBsAg status (negative: 0; positive: 1) + 0.387 x plasma fibrinogen level (≤ 3.24 g/L: 0; >3.24 g/L: 1) + 0.633 x total tumor volume (≤ 107.5 cm3: 0; > 107.5 cm3: 1). The cut-off value was set to 1.02, and we defined the patients with the score ≤ 1.02 as a low risk group and those with the score > 1.02 as a high risk group. The 3-year recurrence-free survival rate was significantly higher in the low risk group compared with that in the high risk group (67.9% vs 41.3%, P < 0.001). In the subgroup analysis, liver transplantation patients had a better 3-year recurrence-free survival rate than the liver resection patients in the low risk group (80.0% vs 64.0%, P < 0.01). Additionally for patients underwent liver transplantation, we compared the recurrence risk model with the Milan criteria in the prediction of recurrence, and the 3-year recurrence survival rates were similar (80.0% vs 79.3%, P = 0.906). Our recurrence risk scoring model is effective in categorizing recurrence risks and in predicting recurrence-free survival of HCC before potential surgical curative treatment.


Evaluation of Jumonji C lysine demethylase substrate preference to guide identification of in vitro substrates.
Within the realm of lysine methylation, the discovery of lysine methyltransferase (KMTs) substrates has been burgeoning because of established systematic substrate screening protocols. Here, we describe a protocol enabling the systematic identification of JmjC KDM substrate preference and in vitro substrates. Systematically designed peptide libraries containing methylated lysine residues are used to characterize enzyme-substrate preference and identify new candidate substrates in vitro. For complete details on the use and execution of this protocol, please refer to Hoekstra and Biggar (2021).


Amplification and expression of the N-myc gene in neuroblastoma.
Genomic configuration and expression of the N-myc gene was investigated by Southern and Northern blot analyses in 18 neuroblastomas of different clinical stages. We observed a 4-100-fold amplification of this oncogene in one of six stage III, two of four stage IV as well as one of five stage IVS tumours. Remarkably, an 80-fold N-myc amplification was demonstrated in a patient with stage IV neuroblastoma being in remission for more than 2 years; moreover, a 100-fold amplification could be detected in a stage IVS tumour from a newborn. These data are discussed in view of the recently postulated close association of N-myc amplification with rapid progression of neuroblastomas.


The dynamics of fidelity over the time course of long-term memory.
Bayesian models of cognition assume that prior knowledge about the world influences judgments. Recent approaches have suggested that the loss of fidelity from working to long-term (LT) memory is simply due to an increased rate of guessing (e.g. Brady, Konkle, Gill, Oliva, & Alvarez, 2013). That is, recall is the result of either remembering (with some noise) or guessing. This stands in contrast to Bayesian models of cognition while assume that prior knowledge about the world influences judgments, and that recall is a combination of expectations learned from the environment and noisy memory representations. Here, we evaluate the time course of fidelity in LT episodic memory, and the relative contribution of prior category knowledge and guessing, using a continuous recall paradigm. At an aggregate level, performance reflects a high rate of guessing. However, when aggregate data is partitioned by lag (i.e., the number of presentations from study to test), or is un-aggregated, performance appears to be more complex than just remembering with some noise and guessing. We implemented three models: the standard remember-guess model, a three-component remember-guess model, and a Bayesian mixture model and evaluated these models against the data. The results emphasize the importance of taking into account the influence of prior category knowledge on memory.


Effectiveness of music therapy for alleviating pain during haemodialysis access cannulation for patients undergoing haemodialysis: a multi-facility, single-blind, randomised controlled trial.
Repeated pain during haemodialysis access cannulations is a serious problem for haemodialysis patients even when prescribed oral or topical analgesics. Although some studies have observed the efficacy of music therapy for improving pain and anxiety, its effectiveness during haemodialysis access cannulations during dialysis is uncertain. The purpose of this study is to investigate the effects of music therapy for pain when cannulating haemodialysis access for haemodialysis patients. A prospective, multi-facility, single-blind, crossover, randomised controlled trial will be implemented. The intervention includes listening to Mozart, along with a white noise control condition. One hundred twenty haemodialysis patients will be enrolled across five facilities. Patients will be randomly allocated to either an Early-sequence group or a Later-sequence group. The Early-sequence group will receive cannulation while listening to Mozart's Sonata for two pianos in D major (K.448) during the second week (Music period) and white noise during the fourth week (White noise period). The Later-sequence group will receive cannulation along with white noise first, followed by Mozart. All patients will also undergo cannulation during a no-sound period (wearing only headphones) during the first and third week (No-sound period). The music or no-music protocol will begin 8 min prior to the cannulating procedure, and participants will finish listening after starting haemodialysis during each period. The primary outcomes that will be assessed include the Visual Analogue Scale (VAS) score for pain during cannulation, and secondary outcomes are blood pressure, heart rate, VAS anxiety score, State-Trait Anxiety Inventory score, and salivary amylase activity. The operators who are in charge of haemodialysis access cannulation will be blind to the listening condition and VAS report. The proposed study has several methodological benefits. First, using white noise is a suitable control condition for addressing the role of sound in pain management. Additionally, using a crossover design with repeated measurements can help control individual differences between participants, which should better distinguish between- and within-participant variability. Overall, music therapy is a safe and inexpensive intervention that does not have the problematic side effects typically associated with pharmacological treatment. If effective, music therapy can be easily implemented for reducing pain and anxiety during cannulation. This trial was prospectively registered to UMIN Clinical Trials Registry on 1 July 2018 (UMIN 000032850).


Automated chronic wounds medical assessment and tracking framework based on deep learning.
Chronic wounds are a latent health problem worldwide, due to high incidence of diseases such as diabetes and Hansen. Typically, wound evolution is tracked by medical staff through visual inspection, which becomes problematic for patients in rural areas with poor transportation and medical infrastructure. Alternatively, the design of software platforms for medical imaging applications has been increasingly prioritized. This work presents a framework for chronic wound tracking based on deep learning, which works on RGB images captured with smartphones, avoiding bulky and complicated acquisition setups. The framework integrates mainstream algorithms for medical image processing, including wound detection, segmentation, as well as quantitative analysis of area and perimeter. Additionally, a new chronic wounds dataset from leprosy patients is provided to the scientific community. Conducted experiments demonstrate the validity and accuracy of the proposed framework, with up to 84.5% in precision.


Improvements in staging of gastric carcinoma from using the new edition of TNM classification.
To recognize possible advantages of the 5th edition of TNM of gastric carcinoma in comparison to the former edition. Data from Erlangen Cancer Center for 898 patients with gastric carcinoma treated surgically by total or subtotal gastrectomy with en bloc lymphadenectomy were analysed. The prognostic significance of TNM has been improved by the new edition as demonstrated by the likelihood ratio test. In addition, uncertainties of method in the pathological classification of regional lymph-node metastasis inherent in the 4th edition can now be avoided. The changes in the TNM classification introduced by the 5th edition are justified by data from the Erlangen Cancer Center, have methodic advantages in determining the N classification, and lead to an improvement in estimation of outcome.


Group B streptococcal necrotizing pneumonia in a diabetic adult patient.
The aim of this report is to describe a rare case of necrotizing pneumonia due to group B Streptococcus serotype III in a relatively young male adult (48 years old) suffering from diabetes. The organism was isolated from his pleural fluid and was only resistant to tetracycline. The patient first received ceftazidime (2g/8h i.v.)+clindamycin (300mg/8h) for 18 days and then he was discharged home and orally treated with amoxicillin clavulanic acid (1g/12h) for 23 days with an uneventful evolution. As in the cases of invasive infection by Streptococcus pyogenes, clindamycin could prevent streptococcal toxic shock syndrome.


Antiretroviral therapy prescribing in hospitalized HIV clinic patients.
Antiretroviral therapy (ART) medication prescribing errors in hospitalized patients still remain common. This study aimed to examine the initial prescribing of antiretroviral drug regimens for HIV clinic patients admitted to an urban academic teaching hospital. A retrospective chart review of all patients with a discharge diagnosis of HIV or AIDS was performed. Only patients actively managed by the hospital out-patient HIV clinic at the time of discharge were included in the final analysis. We compared the ART initially prescribed during hospitalization with the clinic records. Medication errors were separated by type and the prescriber's area of specialty was noted. From 1 January 2009 to 31 December 2009, 90 admissions in 62 patients were included in the final analysis. In 47 of those admissions, the patient had an initial regimen considered to be incorrectly prescribed; in 17 of these 47 admissions, the patient was not prescribed any ART, and in the remainder the errors were related to drug omissions, incorrect frequency/dose, and prescription of the wrong drug. The majority of admissions were by an internal medicine or non-infectious disease (ID) specialist. Average time to ART initiation was comparable among all prescribers. No statistically significant correlation was found between the number of admissions per patient or the prescriber's area of specialty and the percentage of incorrect regimens ordered. Hospital HIV medication management still remains an area of focus because of the complexity of regimens, poor medication reconciliation and limited non-HIV/ID specialist knowledge.


A free energy calculation can be used to predict K(+)-binding constants for new macrotetrolide antibiotics.
A free energy calculation technique was used to predict K+ binding constants for new macrotetrolides. The technique was validated by successfully predicting affinity constants for known, naturally produced, macrotetrolides.


Intraocular pressure and gonioscopic findings in rural communities mesoendemic and nonendemic for onchoceriasis, Kaduna State, Nigeria.
To report on glaucoma-related ocular parameters, namely intraocular pressure and peripheral anterior synechiae, in the presence of onchocercal infection. Two computer-generated random samples of individuals were drawn from communities mesoendemic and nonendemic for onchocerciasis respectively. Applanation tonometry and gonioscopy were carried out on these individuals. Four hundred and thirty-six and 319 individuals from the mesoendemic and nonendemic communities were examined respectively. The mean intraocular pressure was 1.58 mmHg lower in the individuals from the mesoendemic communities compared with those from the nonendemic communities (p < 0.001) despite the prevalence of peripheral anterior synechiae being higher in the mesoendemic communities. In these communities, there was strong evidence that the prevalence of peripheral anterior synechiae increased with increasing microfilarial load. Onchocercal infection produces a low-grade inflammatory process, which may result in a lowering of intraocular pressure despite the formation of peripheral anterior synechiae. Glaucomatous optic nerve damage may therefore not be the primary cause of visual loss in ocular onchocerciasis as this occurs late and is probably preceded by other blinding onchocercal pathology.


A cytochrome P-450 multigene family. Characterization of a gene activated by phenobarbital administration.
The capacity of the liver microsomal mixed function oxidase system to metabolize a great variety of exogenous as well as endogenous compounds is thought to reflect the participation of multiple forms of the terminal oxidase, cytochrome P-450, which have different broad, but overlapping, substrate specificities. Several of these isozymes accumulate in the liver after exposure of animals to specific inducing agents. In order to approach the questions of the genetic basis for the existence of multiple cytochrome P-450 isozymes and the molecular mechanisms of the induction process, we have used a cloned cDNA for a major phenobarbital-induced form of cytochrome P-450 to identify and characterize thirteen distinct rat genomic clones containing segments of six different genes. Only three clones, representing overlapping segments of a single gene, hybridized to the cloned cDNA or to phenobarbital-induced mRNA under conditions of high stringency. In vitro transcription studies with isolated rat liver nuclei indicated that only this gene, but not the genes represented by the other genomic clones, appears to be markedly activated by phenobarbital treatment of rats. Although there are a small number of differences, DNA sequence analysis of the eight exons of the gene present in these genomic clones indicates that they encode residues 58 to 491 (the COOH terminus) of cytochrome P-450e, a major phenobarbital-induced isozyme. It appears that the other cloned genes may contain only a small region of very strong homology to the cytochrome P-450e gene, a region which includes the exon encoding a tridecapeptide which is also present in two dissimilar forms of rabbit liver cytochrome P-450, one constitutive and one induced by phenobarbital. Southern blotting analysis of rat liver DNA indicates that the rat genome may contain two additional genes which are very closely related to the cytochrome P-450e gene but which we have not yet isolated from the genomic library. One of these genes is likely to encode cytochrome P-450b, the major phenobarbital induced form of cytochrome P-450 whose mRNA is greater than 95% homologous to that encoding cytochrome P-450e.


Pseudo-orbital apex syndrome.
A 48-year-old man had symptoms and signs of the orbital apex syndrome. All orbital and systemic studies were unrevealing . The computed tomoggraphy scan showed a cystic lesion external to the pons. The lesion proved to be a cholesteotoma originating in the peduncular fossa area, comprising the oculomotor nerve proximally and extending anteriorly in a finger-like projection to involve the ipsilateral optic nerve.


Mitigating the anti-nutritional effect of polyphenols on in vitro digestibility and fermentation characteristics of browse species in north western Ethiopia.
Browse species are important sources of forage for livestock in Ethiopia, especially during the dry season, when the quality and quantity of green herbage is limited. However, browse species have anti-nutritional factors, such as polyphenols. This study evaluated the extent to which polyethylene glycol (PEG) can reduce the anti-nutritional effects of polyphenols whose extent is expected to vary depending on the species type and season on the in vitro fermentation of these plant samples. We selected ten browse species commonly used as livestock feed based on their tannin content, and sixty samples of the leaf and twig of these species were collected during the wet and dry seasons. The study was designed as 10 × 2 × 2 factorial arrangement with 10 browse species (Acacia nilotica, Crateva adonsonia, Dombeya torrida, Ekebergia capensis, Ensete ventricosum, Erythrina brucei, Maesa lanceolate, Sesbania sesban, Stereospermum kunthianum, and Terminalia laxiflora), 2 seasons (wet and dry) and 2 states of PEG (with and without PEG). The effects of tannin on the nutritive characteristics were also evaluated by adding PEG as a tannin-binding agent. The chemical composition and in vitro fermentation products of these samples differed significantly (p < 0.001) among browse species. Specifically, total extractable phenol (TEP) ranged from 26.3 to 250.3 g/kg, total extractable tannin (TET) from 22.8 to 210.9 g/kg, and condensed tannin (CT) from 11.1 to 141.3 g/kg, respectively. Season, species, and their interaction have a significant (p < 0.05) effect on the chemical composition and fermentation characteristics of most browse species. The addition of PEG increased gas production (GP), in vitro organic matter digestibility (IVOMD), metabolizable energy (ME) concentration, dry matter degradability (DMD), and volatile fatty acids (VFA), on average, by 76.8%, 47.9%, 42.2%, 21.2%, and 20.2%, respectively. Secondary polyphenols (TEP, TET, CT, and SCT) were significantly (p < 0.001) and negatively correlated with GP, IVOMD, ME, and VFA. Preferable species namely E. ventricosum, S. sesban, M. lanceolata, E. capensis, and A. nilotica were selected for supplementation in terms of their chemical composition, IVOMD, and mitigating effects of PEG on anti-nutritional functions of their secondary compounds. In conclusion, PEG markedly reduced the anti-nutritional effects of polyphenols and improved the in vitro fermentation of browse species harvested in contrasting seasons.


Protein phosphorylation in human synaptosomal membranes: evidence for the presence of substrates for cyclic nucleotide guanosine 3'-5'-monophosphate dependent protein kinases.
Synaptosomal membranes prepared from different anatomical regions of postmortem human brain readily incorporate phosphate when incubated with labelled ATP in vitro. Separation of proteins on SDS slab gels indicated up to 30 protein bands stained by Coomassie blue of which ten incorporated label, as detected by radioautography (mol. wt. range 16-110 K with a major double band at 49-50 K). Incorporation into the 110 K region appeared to increase in older persons, and that into the 49-50 K region decreased. Human but not rat membranes subjected to similar conditions of treatment failed to respond to the addition of cAMP at 10(-5) - 10(-7) M but were highly sensitive to the addition of cGMP at 10(-6) M, which led to intensification of existing bands and the appearance of a major band at 60 K. The 110 K band present in high concentration in white matter striatum, caudate nucleus, and putamen was insensitive to cGMP addition. The presence of cGMP-dependent protein kinase substrates has not previously been reported in synapses, and it may be of significance in view of the known sensitivity of this system to biological regulatory agents.


A temperature controller for in vitro recording chambers.
An inexpensive, electrically quiet temperature controller designed to provide biological temperatures in chambers used to maintain tissue slices for in vitro recording is described. The circuit incorporates several advantageous features: (1) an integrated circuit temperature sensor is used which produces a linear output and is immune to self-heating error; (2) a single +12-18 V, 1 A DC supply will power the unit; (3) the output regulator cannot be damaged by overheating or short-circuiting; and (4) the temperature of the preparation is displayed.


Effect of age on some properties of mice erythrocytes.
The hematological parameters of young (2-month-old) and old (2-year-old) mice were compared. No differences could be detected with the exception of an increased percentage of reticulocytes in the old animals suggesting that anemia in senescent mice does not occur. Red blood cell mean half-life in old mice was 8 +/- 0.8 days compared to 12 +/- 1 days in young mice. This reduced survival of red blood cell is not due to a different rate of cell phagocytosis in the reticulohistiocytic system of young and old animals since erythrocytes from young mice have the same mean half-life when injected both in young and old animals and vice versa. Thus, the old mice have a reduced red cell life-span but the same hematocrit of the young, suggesting that old animals possess a chronologically younger population of erythrocytes than do young animals. This has been confirmed by measuring the specific activities of some red blood cell age-dependent enzymes (hexokinase, glucose-6-phosphate dehydrogenase, pyruvate kinase) that were found to be higher in the older animals, and by the separation of erythrocytes into different density (age) groups by Percoll/albumin density gradient centrifugation. However, the erythrocytes osmotic fragility, and the cellular contents of adenine and pyridine nucleotides, as well as the content of 2,3-diphosphoglycerate and reduced glutathione, show that circulating erythrocytes in old animals constitute an heterogeneous cell population whose properties cannot be explained on the basis of a chronologically younger erythrocyte population. Furthermore, evaluation of cell components in hemopoietic tissues have shown an increased porportion of erythroid precursor cells in old animals confirming that old mice compensate for reduced red cell survival with an increased erythropoiesis.


Cystosonography in the staging of gynecological malignancy.
Five patients with carcinoma of the cervix and one with carcinoma of the vagina were examined by both cystoscopy and endosonography. Both techniques revealed malignant infiltration of the bladder in 4 patients. In the other 2 cystoscopy showed an intact bladder mucosa despite cystosonographic evidence of invasion of the bladder wall by tumor.


Implications of a Reduced Length of Postpartum Hospital Stay on Maternal and Neonatal Readmissions, an Observational Study.
Reducing the Length Of postpartum Stay (LOS) is associated with lower hospital costs, a major reason for initiating federal projects in Belgium. Disadvantages following the reduction of LOS are the risks of maternal and neonatal readmissions. This study compares readmissions with or without reduced LOS, by introducing the KOZI&Home program in the university hospital Brussels. This is an observational study comparing the readmission rates of the length of postpartum hospital stay between two groups: the non-KOZI&Home group (> 2 days for vaginal birth and > 4 days for caesarean section) and KOZI&Home group (≤ 2 days for vaginal birth and ≤ 4 days for caesarean section). A follow-up period of 16 weeks was set up. The maternal readmission rate was 4,8% for the non-KOZI&Home group (n = 332) and 3.3% for the KOZI&Home group (n = 253). Neonatal readmission rates were 7.2% and 15.9% respectively. After controlling influencing factors in a multivariate model for maternal and neonatal readmissions, there were no statistical significant differences. Factors negatively affecting neonatal readmissions are (1) dismissal period October-January (OR:3.22;95% CI 1.10-9.42) and (2) low education level (OR:3.44;95% CI 1.54-7.67), for maternal readmissions it concerns whether or not LOS is known (OR:3.26;95% CI 1.21-8.81). There is no effect of the KOZI&Home program on maternal nor neonatal readmission rates. Systematically informing about postpartum LOS antenatally will enforce preparation and is important to reduce maternal readmissions. Personalized information should be given to women discharged in the period October-January and to those with a lower education level, in order to reduce neonatal readmissions.


Subintimal Plaque Modification and Subintimal Dissection and Reentry: Strategies to Turn Failure into Success.
The success of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) depends on the execution of bailout strategies, like subintimal dissection and reentry (STAR) and subintimal plaque modification (SPM). These are invaluable when traditional techniques fail. SPM is a modification of the STAR technique in which angioplasty is performed of the occluded segment without true lumen access in the distal vessel. Available data on SPM has shown favorable outcomes with a greater than 90% success rate when the failed CTO is reattempted in 8-12 weeks after SPM has been performed. Future studies are needed to better assess its role.


Bladder surgery as first-line treatment of complete duplex system complicated with ureterocele.
We retrospectively analyzed our experience to determine the optimum management of complete duplex system complicated with ureterocele. Between 1994 and 2003, we reviewed 15 patients treated with bladder surgery for complete duplex system complicated with ureterocele. The associated anomalies were seven vesicoureteral reflux (VUR) of the lower pole ureter and one of both poles. All patients had ureterocele (11 intravesical, 4 extravesical) and a functioning upper moiety. Initial treatment was transurethral incision of ureterocele (TUI) (14) or common sheath reimplantation (1). The median follow-up was 30 (13-48) months. There were no requirements for secondary procedures, with a significant improvement or conservation of ipsilateral renal function and no reflux, in 10 patients (67%). Five patients (33%) with ureterocele (1 intravesical, 4 extravesical) who initially underwent TUI required additional operative management due to moderate to severe VUR, recurrent urinary tract infection or decreased function of upper moiety. The secondary operation performed was lower pole nephrectomy with ureteral reimplantation (1), ureteroureterostomy with ureteral reimplantation (2) or common sheath reimplantation (2). One patient who underwent common sheath reimplantation as secondary operation needed a nephrectomy due to breakthrough febrile urinary tract infection and decreased renal function. TUI is recommended as the first-line treatment of complete duplex system with intravesical ureterocele and well-conserved renal function.


[Management of a compressive goiter in a pregnant woman].
Emergency physicians frequently encounter patients with thyroid disease. However, it is unusual for these thyroid disorders to create acute, life-threatening situations. Critical airway compression attributable to benign thyroid enlargement may occur suddenly and require urgent treatment. We report a case of pregnant women who was admitted for compressive goiter with laryngeal dyspnea, which required emergency total thyroidectomy. Urgent thyroidectomy in pregnant women can be performed if we respect the precautions.


Role of renin-angiotensin system and oxidative status on the maternal cardiovascular regulation in spontaneously hypertensive rats.
The purpose of this study was to investigate the contribution of renin-angiotensin system (RAS) and oxidative status on the maternal cardiovascular regulation at the end of pregnancy in normotensive and spontaneously hypertensive rats (SHR). Blood pressure (BP), mesenteric arterial bed (MAB) reactivity, mesenteric oxidative damage, protein expression, and antioxidant activities were compared between four groups: SHR (SHR-P) and normotensive Wistar controls (W-P) in the 20th day of pregnancy or age-matched nonpregnant rats (SHR-NP and W-NP). BP in W-P and SHR-P was reduced at the end of pregnancy. The vasodilator effects of angiotensin II (Ang II) and angiotensin 1-7 (Ang-(1-7)) were higher in SHR-P than in other groups. Endothelial nitric oxide synthase (eNOS) expression was increased in W-P and SHR-P compared to nonpregnant groups. Angiotensin-converting enzyme (ACE) and AT(1) receptor expressions were increased in SHR-NP compared to normotensive groups and pregnancy reduced their expressions in SHR. No difference was observed in AT(2) receptor expression among the groups. ACE2 expression was higher in hypertensive than normotensive groups. The levels of thiobarbituric acid-reactive substances (TBARS) were reduced in pregnant compared to nonpregnant groups. Superoxide dismutase (SOD) activity was reduced in SHR-P compared to SHR-NP. However, pregnancy increased catalase (CAT) and glutathione peroxidase (GPx) activities in normotensive rats and SHR, respectively. The results suggest that the reduction of BP to normal values at the end of pregnancy in SHR may be related to an increased NO production and vasorelaxation to Ang II and Ang-(1-7) associated with decreased expression of vascular ACE and AT(1) receptors and oxidative status.