The risk of infection-related hospitalization with decreased kidney function.
Moderate kidney disease may predispose to infection. We sought to determine whether decreased kidney function, estimated by serum cystatin C level, was associated with the risk of infection-related hospitalization in older individuals. Cohort study. 5,142 Cardiovascular Health Study (CHS) participants with measured serum creatinine and cystatin C and without estimated glomerular filtration rate (eGFR) <15 mL/min/1.73 m(2) at enrollment. The primary exposure of interest was eGFR using serum cystatin C level (eGFR(SCysC)). Infection-related hospitalizations during a median follow-up of 11.5 years. In adjusted analyses, eGFR(SCysC) categories of 60-89, 45-59, and 15-44 mL/min/1.73 m(2) were associated with 16%, 37%, and 64% greater risk of all-cause infection-related hospitalization, respectively, compared with eGFR(SCysC) ≥90 mL/min/1.73 m(2). When cause-specific infection was examined, eGFR(SCysC) of 15-44 mL/min/1.73 m(2) was associated with an 80% greater risk of pulmonary and 160% greater risk of genitourinary infection compared with eGFR(SCysC) ≥90 mL/min/1.73 m(2). No measures of urinary protein, study limited to principal discharge diagnosis. Lower kidney function, estimated using cystatin C level, was associated with a linear and graded risk of infection-related hospitalization. These findings highlight that even moderate degrees of decreased kidney function are associated with clinically significant higher risks of serious infection in older individuals.


Dynamical behaviour of a two-predator model with prey refuge.
A three-component model consisting on one-prey and two-predator populations is considered with a Holling type II response function incorporating a constant proportion of prey refuge. We also consider the competition among predators for their food (prey) and shelter. The essential mathematical features of the model have been analyzed thoroughly in terms of stability and bifurcations arising in some selected situations. Threshold values for some parameters indicating the feasibility and stability conditions of some equilibria are determined. The range of significant parameters under which the system admits different types of bifurcations is investigated. Numerical illustrations are performed in order to validate the applicability of the model under consideration.


Anorectal physiology validated: a repeatability study of the motor and sensory tests of anorectal function.
Sixteen subjects (mean (s.d.) age 50.7 (12.8) years, three men) were studied on two separate occasions by two experienced investigators in random order. A standard protocol of anatomical, manometric and electrophysiological assessments of anorectal motor and sensory function was followed. No significant differences were found between the results obtained by the two investigators in the measurements of perineal descent, anal canal length, and canal resting pressure and squeeze pressure, pudendal nerve terminal motor latency, single-fibre electromyography fibre density of the external anal sphincter, and thresholds of mucosal electrosensitivity. This study shows that the standard tests of anorectal sensorimotor function are repeatable by different investigators. In addition, it suggests that comparison of data obtained in different centres using these techniques is valid.


Dentist's Visits and Risk of Brain Abscess: A Nationwide, Population-Based Case-Control Study.
Brain abscesses are frequently caused by oral cavity bacteria, but whether dental status and invasive dental procedures are important risk factors is unknown. A nationwide, population-based, case-control study examined the association between dentist's visits and invasive dental procedures and risk of brain abscess caused by oral cavity bacteria from 1989 through 2016. Date of brain abscess diagnosis was considered the index date. Using risk-set sampling, 10 population controls per case were individually matched by age, sex, and residential area. Conditional logistic regression was used to compute odds ratios with 95% confidence intervals (CIs), adjusted for comorbidity. We identified 362 patients with culture-proven brain abscess caused by oral cavity bacteria. The median age was 53 years (interquartile range, 39-65 years) and 220 (61%) were male. Invasive dental procedures within 6 months before the index date was observed in 21 of 362 (6%) patients with brain abscess and 179 of 3257 (5%) population controls (adjusted odds ratio [aOR], 1.07 [95% CI, .67-1.70]). Two hundred thirteen of 362 (59%) patients with brain abscess had visited their dentist within 1 year before the index date compared with 1944 of 3257 (60%) of population controls (aOR, 0.99 [95% CI, .77-1.26]). Using no dentist's visits as reference, we observed aORs of 0.95 (95% CI, .64-1.40) for 1-2 visits within 3 years of the index date and 1.01 (95% CI, .76-1.35) for 3 or more visits. Recent invasive dental procedures and number of dentist's visits were not associated with culture-verified brain abscess caused by oral cavity bacteria.


Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: An example of structural violence in United States public policy.
Food insecurity continues to be a major challenge in the United States, affecting 49 million individuals. Quantitative studies show that food insecurity has serious negative health impacts among individuals suffering from chronic illnesses, including people living with HIV/AIDS (PLHIV). Formulating effective interventions and policies to combat these health effects requires an in-depth understanding of the lived experience and structural drivers of food insecurity. Few studies, however, have elucidated these phenomena among people living with chronic illnesses in resource-rich settings, including in the United States. Here we sought to explore the experiences and structural determinants of food insecurity among a group of low-income PLHIV in the San Francisco Bay Area. Thirty-four semi-structured in-depth interviews were conducted with low-income PLHIV receiving food assistance from a local non-profit in San Francisco and Alameda County, California, between April and June 2014. Interview transcripts were coded and analysed according to content analysis methods following an inductive-deductive approach. The lived experience of food insecurity among participants included periods of insufficient quantity of food and resultant hunger, as well as long-term struggles with quality of food that led to concerns about the poor health effects of a cheap diet. Participants also reported procuring food using personally and socially unacceptable strategies, including long-term dependence on friends, family, and charity; stealing food; exchanging sex for food; and selling controlled substances. Food insecurity often arose from the need to pay high rents exacerbated by gentrification while receiving limited disability income--a situation resulting in large part from the convergence of long-standing urban policies amenable to gentrification and an outdated disability policy that constrains financial viability. The experiences of food insecurity described by participants in this study can be understood as a form of structural violence, motivating the need for structural interventions at the policy level that extend beyond food-specific solutions.


Detecting differences in activities of daily living between children with and without mild disabilities.
We evaluated whether the Assessment of Motor and Process Skills (AMPS) measures are valid for detecting differences in activities of daily living (ADL) ability among children with and without mild disabilities. Retrospective data from the AMPS database were analyzed using many-facet Rasch analyses and forced regression analyses to evaluate for significant group differences. Regression analyses of data for 10,998 children ages 4-15 who met the inclusion criteria revealed significant Age × Group interaction effects (B ≥ 0.23, T ≥ 6.20, p ≤ .001). Post hoc t tests revealed significant group differences in ADL ability at all ages beyond age 4. ADL process ability effect sizes were moderate to large at all ages, and ADL motor ability was mostly moderate to large at ages 6 or older. These findings support the validity of the AMPS measures when used to identify ADL problems among children with mild disabilities.


Revision Rotator Cuff Repair With Versus Without an Arthroscopically Inserted Onlay Bioinductive Implant in Workers' Compensation Patients.
The addition of onlay biological grafts to augment difficult rotator cuff repairs has shown encouraging results in a case series. The purpose of this study was to determine whether the addition of an onlay bioinductive implant would improve repair integrity, shear wave elastographic appearance of the repaired tendon and patch, and patient-rated and/or surgeon-measured shoulder function when used in workers' compensation patients undergoing revision arthroscopic rotator cuff repair. We hypothesized that the addition of the bioinductive implant would enhance repair integrity and clinical outcomes compared with standard repair. Cohort study; Level of evidence, 3. A post hoc matched-cohort study was conducted on prospectively recruited workers' compensation patients who received a bioinductive implant for revision rotator cuff repair (n = 19). The control group was selected from consecutive workers' compensation revision rotator cuff repair patients before the introduction of bioinductive implants. Then, they were matched for age and tear size (n = 32). Kaplan-Meier curves were generated to compare the primary outcome of repair integrity between groups. The secondary outcomes were to evaluate the elastographic appearance of the tendon and patch in the bioinductive implant group and to compare patient-rated and surgeon-measured shoulder function between groups preoperatively and at 1 week, 6 weeks, 3 months, and 6 months postoperatively. No major complications associated with the bioinductive implants were identified. Six months after the revision rotator cuff repair, the retear rate in the bioinductive implant group was 16% (3/19), compared with 19% (6/32) in the age- and tear size-matched control group (P = .458). At the final follow-up, the retear rate in the bioinductive implant group was 47% (9/19) at a mean of 14 months compared with 38% (12/32) at a mean of 29 months in the control group (P = .489). The shear wave elastographic stiffness of repaired tendons augmented with the bioinductive implant remained unchanged at 6 m/s from 1 week to 6 months postoperatively, which is lower than the stiffness of 10 m/s in healthy tendons. There were no significant differences in patient-rated or surgeon-measured outcomes between groups 6 months postoperatively. There were no differences in repair integrity or clinical outcomes between workers' compensation patients who underwent revision arthroscopic rotator cuff repair with an onlay bioinductive implant compared to those who underwent standard revision rotator cuff repair.


Provider perceptions of telehealth and in-person exposure and response prevention for obsessive-compulsive disorder.
Until recently, psychotherapies, including exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD), have primarily been delivered in-person. The COVID-19 pandemic required OCD providers delivering ERP to quickly transition to telehealth services. While evidence supports telehealth ERP delivery, limited research has examined OCD provider perceptions about patient characteristics that are most appropriate for this modality, as well as provider abilities to identify and address factors interfering with effective telehealth ERP. In the present study, OCD therapists (N = 113) rated the feasibility of delivering telehealth ERP relative to in-person for different (1) patient age-groups, (2) levels of OCD severity, and (3) provider ability to identify and address factors interfering with ERP during in-person and telehealth ERP (e.g., cognitive avoidance, reassurance seeking, etc.). Providers reported significantly greater feasibility of delivering telehealth ERP to individuals ages 13-to-65-years relative to other age groups assessed. Greater perceived feasibility for telehealth relative to in-person ERP was reported for lower versus higher symptom severity levels. Lastly, providers felt better able to identify and address problematic factors in-person. These findings suggest that providers should practice appropriate caution when offering telehealth ERP for certain patients with OCD. Future research may examine how to address these potential limitations of telehealth ERP delivery.


Molecular and functional organization of yeast plasmid pSR1.
The nucleotide sequence of a 6251 base-pair plasmid, pSR1, harbored in an osmophilic haploid yeast, Zygosaccharomyces rouxii (formerly Saccharomyces rouxii), was determined. No homology was detected between the sequences of pSR1 and 2-micron DNA of Saccharomyces cerevisiae. pSR1 has a pair of inverted repeats consisting of completely homologous 959 base-pair sequences, which separate two unique sequences 2654 base-pairs and 1679 base-pairs long. Each inverted repeat has an ARS sequence functional in both Z. rouxii and S. cerevisiae hosts. Short direct repeats or dyad symmetries were observed in the inverted repeats similar to those found close to the replication origin of 2-micron DNA. Three open reading frames, P, S and R, each able to encode a protein of molecular weight larger than 10,000, were found. Insertional inactivation of R gave rise to a defect in the intramolecular recombination at the inverted repeats, and that of S reduced the copy number of pSR1 in the S. cerevisiae host. The maintenance stability of the plasmid was also tested in the heterogeneous S. cerevisiae host, but the results of the insertional inactivation of P, S and R were ambiguous. pSR1 and 2-micron DNA were compatible in S. cerevisiae cells, but the protein factors encoded by these plasmids did not complement each other.


Analysis of Perioperative Platelet Indices and Their Prognostic Value in Head and Neck Cancer Patients Treated with Surgery and Postoperative Radiotherapy: A Retrospective Cohort Study.
Activated platelets might play an important role in tumor progression. Mean platelet volume (MPV) has been used as a surrogate marker for platelet activation, and therefore its value as a marker of tumor prognosis has attracted recent attention. In this study, we aimed to critically evaluate the prognostic significance of the perioperative platelet count (COP), MPV and the MPV/COP ratio in head and neck cancer patients. Additionally, we explored the individual postoperative trajectory of these indices and their association with overall survival (OS) and disease-free survival (DFS). We retrospectively evaluated 122 head and neck squamous cell carcinoma patients receiving surgery with curative intent followed by postoperative radiotherapy. Platelet indices were measured preoperatively and on days 1 and 7 postoperatively. OS and DFS were analyzed using Kaplan-Meier estimators, the log-rank test and uni and multivariable Cox models. Cutoffs to dichotomize patients for Kaplan-Meier curves and log-rank tests were empirically chosen at the respective median. The median follow-up was 8.8 years. The adjusted preoperative COP, MPV and MPV/COP ratio were not associated with disease outcome. A low postoperative COP and a high MPV/COP ratio on the first postoperative day were independently associated with worse OS and DFS. In comparison to the preoperative measurements, patients whose COP increased by day 1 post-op showed a better OS (hazard ratio (HR) per 50 G/L increase: 0.73, 95% confidence interval (CI): 0.58-0.93, p = 0.013) and DFS (HR per 50 G/L increase: 0.74, 95% CI: 0.58-0.94, p = 0.018) in multivariable analysis. Our results suggest that a low postoperative COP and a high MPV/COP ratio represent a negative prognostic factor for OS and DFS. Notably, patients with an increase in COP by day 1 post-op when compared to their preoperative value showed a significantly better OS and DFS.


Reliability and validity of the Group Embedded Figures Test for a grade school sample.
Data on validity of the Group Embedded Figures Test for 22 sixth grade students (9 boys and 13 girls) were obtained. 50 wk. later all subjects were individually screened on the Portable Rod-and-Frame Test and after a period of 2 more weeks, when they were retested on the embedded figures, data on reliability were obtained. Long-term coefficients of stability of .80 and .71 for the 9 boys and 13 girls, respectively, were obtained. Coefficients of internal consistency ranged from .83 to .98 for boys and girls. Coefficients reflecting both construct and concurrent validity were -.60 and .00 for boys and girls, respectively. Customary sex differences with respect to field-dependence--independence were not observed for these small samples.


Unusual form of superficial spreading squamous cell carcinoma of cervix involving the endometrium, bilateral tubes and ovaries: a case report with literature review.
Although the majority of metastatic ovarian tumors arise within the female genital tract, squamous cell carcinoma of the cervix is a rare form of metastases to the bilateral ovaries by endometrial and transtubal spreading. A 53-year-old woman was referred to the oncology clinic with postmenopausal bleeding. On vaginal examination, a 3 cm tumor arising from the cervix was inspected. Multiple cervical biopsies and endocervical curettage revealed large cell, non-keratinized squamous cell cervix carcinoma. Radical hysterectomy and bilateral salpingo-oophorectomy were performed. Bilateral pelvic and para-aortic lymph nodes were also removed. The final pathology report revealed endometrial, focal myometrial, bilateral tubal mucosal, fimbrial and bilateral ovarian squamous cell carcinoma involvement. Pelvic and para-aortic nodes were free from metastases. Although the incidence of ovarian metastases of adenocarcinoma of the cervix is significantly higher, squamous cell carcinoma may also metastasize to the ovaries by endometrial and transtubal spreading in the absence of lymph node involvement. Especially in young patients for whom preservation of the ovaries is supposed, gross intraoperative inspection of the radical hysterectomy specimen and endometrium should be done and ovaries should be evaluated carefully.


Fatty infiltration of the multifidus muscle independently increases osteoporotic vertebral compression fracture risk.
Vertebral compression fractures decrease daily life activities and increase economic and social burdens. Aging decreases bone mineral density (BMD), which increases the incidence of osteoporotic vertebral compression fractures (OVCFs). However, factors other than BMD can affect OVCFs. Sarcopenia has been a noticeable factor in the aging health problem. Sarcopenia, which involves a decrease in the quality of the back muscles, influences OVCFs. Therefore, this study aimed to evaluate the influence of the quality of the multifidus muscle on OVCFs. We retrospectively studied patients aged 60 years and older who underwent concomitant lumbar MRI and BMD in the university hospital database, with no history of structurally affecting the lumbar spine. We first divided the recruited people into a control group and a fracture group according to the presence or absence of OVCFs, and further divided the fracture group into an osteoporosis BMD group and an osteopenia BMD group based on the BMD T-score of -2.5. Using images of lumbar spine MRI, the cross-sectional area and percentage of muscle fiber (PMF) of the multifidus muscle were obtained. We included 120 patients who had visited the university hospital, with 45 participants in the control group and 75 in the fracture group (osteopenia BMD: 41, osteoporosis BMD: 34). Age, BMD, and the psoas index significantly differed between the control and fracture groups. The mean cross-sectional area (CSA) of multifidus muscles measured at L4-5 and L5-S1, respectively, did not differ among the control, P-BMD, and O-BMD groups. On the other hand, the PMF measured at L4-5 and L5-S1 showed a significant difference among the three groups, and the value of the fracture group was lower than that of the control group. Logistic regression analysis showed that the PMF value, not the CSA, of the multifidus muscle at L4-5 and L5-S1 affected the risk of OVCFs, with and without adjusting for other significant factors. High percentage of fatty infiltration of the multifidus muscle increases the spinal fracture risk. Therefore, preserving the quality of the spinal muscle and bone density is essential for preventing OVCFs.


[Validation of a PCR technique for the detection of enteroagreggative Escherichia coli causing traveler's diarrhea].
Detection of enteroaggregative strains of Escherichia coli (EAEC) by the gold standard technique (cellular adherence) is difficult to implement in routine clinical practice. The gold standard was compared with a PCR method for this purpose. With respect to the cellular adherence technique, PCR performance was as follows: sensitivity 0.93, specificity 1, positive predictive value 1, and negative predictive value 0.91. The PCR method studied is a viable alternative for routine detection of EAEC strains.


Measles seroprevalence in Thailand: are adolescents and young adults at risk of measles?
During the last decade, measles has become an important re-emerging disease in Thailand. The objective of this study was to measure measles seroprevalence and its influencing factors and to plan for an improved vaccination program. A total of 600 participants aged between 9 months and 50 years were divided into seven groups those represent birth cohorts that experienced different measles vaccination policies. Participants' blood samples were obtained to measure measles immunoglobulin G (IgG) levels. None of the participants in the 9-month age group had measles IgG levels beyond a protective level. Participants in the following age groups: 2 ½, 5-15, 16-29, 30-33, 34-40, and 41-50 years had 82% (95% confidence interval [CI] 73.3-90.7), 50% (95% CI 36.1-63.9), 52% (95% CI 42.3-62.7), 70% (95% CI 61.1-78.9), 88.8% (95% CI 84.1-93.5), and 98.8% (95% CI 96.4-100.0) measles seropositivity, respectively. The study did not find any significant factors affecting measles seropositivity. Individuals aged 15-34 years are vulnerable to measles infections. Supplementary vaccination in special situations, including post-exposure prophylaxis during an outbreak among young adults or providing for high-risk occupations, such as healthcare personnel, should be encouraged.


Does gastric acid protect the preterm infant from bacteria in unheated human milk?
Although preterm mother's milk has greater nutritional and anti-infective properties than donor milk, it may be highly contaminated with bacteria. We therefore asked three questions: what is the fate of these bacteria in the preterm infant's stomach, is gastric pH important, and what factors affect gastric pH? pH, colony count and bacterial identification were performed on the milk and on serial gastric aspirates in 20 preterm infants on 25 occasions. Seventeen milk samples grew bacteria, five potentially pathogenic and 12 non-pathogenic. Twelve of 25 prefeeding gastric samples were sterile, but following the feeding all the samples grew non-pathogenic bacteria and 70% grew potential pathogens. With time pH decreased and by 2-h samples with pH less than 3.5 had no bacterial growth; Candida albicans still flourished in a low pH (mean 2.8). We concluded that a low gastric pH may be more important than the bacterial count of the milk. In a second study, 91 serial gastric pH measurements were made on 12 preterm infants. pH tended to decrease with increasing age and was significantly lower in infants fed exclusively human milk (2.7 vs. 3.6; human milk versus formula P less than 0.02) We speculate that human milk may influence gastric acid production and thus protect the preterm infant from bacteria in the milk.


Useful Serum Pepsinogen Levels for Detecting Ongoing Helicobacter pylori Infection in Asymptomatic Subjects: A Cross-Sectional Study Based on 13C-urea Breath Test Findings.
The serum pepsinogen (PG) assay is used to screen subjects at high risk for gastric cancer. Currently, there are few studies on the PG levels for the detection of Helicobacter pylori infection. This study aimed to determine the PG assay findings for detecting ongoing infection. Asymptomatic subjects who underwent a 13C-urea breath test (13C-UBT) on the day of gastroscopy and serum assay for cancer screening were included. Subjects with a recent intake of acid suppressants or antibiotics, gastrectomy, or renal failure were excluded. H. pylori infection was defined as a positive 13C-UBT result. Among the 500 included subjects, 167 (33.4%) had current infection. The serum PG II levels of > 12.95 ng/mL (area under the curve [AUC] = 0.930, sensitivity 86.5%, specificity 90.7%) and PG I/II ratios of < 4.35 (AUC = 0.875, sensitivity 86.8%, specificity 79.6%) were related to infection. The PG I/II ratios were inversely correlated with age (r = -0.160, p = 0.039). The cutoff values of PG I/II ratios were lower in older subjects aged ≥ 50 years (< 4.05; AUC = 0.875, sensitivity 80.7%, specificity 88.2%) than in younger subjects aged < 50 years (< 4.35; AUC = 0.873, sensitivity 77.4%, specificity 88.9%). Serum PG II levels > 12.95 ng/mL and PG I/II ratios < 4.35 suggest ongoing infection in asymptomatic subjects; therefore, H. pylori confirmation tests (i.e., 13C-UBT) should be considered under these conditions. Stricter criteria are required in older subjects aged ≥ 50 years (PG I/II ratio < 4.05) to detect ongoing infection than younger subjects.


Expression of Ca2+/calmodulin-dependent protein kinase (CaMK) Ibeta2 in developing rat CNS.
We observed the onset time and distribution pattern of beta2 isoform of Ca2+/calmodulin-dependent protein kinase I (CaMKIbeta2) in the CNS of the rat during the embryonic period until birth using an immunohistochemical method. The expression of CaMKIbeta2 started at embryological day 10 when the three primary brain vesicles and neural tube are generated from the neural plate. During the embryonic period, highly immunoreactive products were ubiquitously detected in neurons in the CNS, although neurons in the caudate-putamen and globus pallidus were faintly immunostained or immunonegative. High expression of CaMKIbeta2 persisted in the olfactory bulb, lymbic system, neocortex, septal nuclei, amygdala complex, some hypothalamic nuclei, pontine nuclei, Purkinje cells and granule cells in the cerebellar cortex through the developing period. At the subcellular level, CaMKIbeta2 was strongly expressed in nuclei of neurons but faintly in their cytoplasm, suggesting that this protein has an important role in the nuclear signaling pathway. This study demonstrates that expression of CaMKIbeta2 begins at the earliest developmental stage of the rat CNS and persists through the developing period.


[Enteral versus parenteral administration of a single dose of profenid after gynecological laparoscopy].
The aim of our study is to compare analgesic effect of single dose Profenid (Sanofi-Aventis)--100 mg administered per rectum or intravenously in woman endured gynecological laparoscopy (LS). We have evaluated 40 woman (divided into two groups each one of 20) sustained planned laparoscopy in department of gynaecology. The effect of administered Profenid over the postoperative pain has been estimated after standard general anaesthesia due to different objective and subjective parameters. As a result of our study we consider that postoperative analgesia with Profenid applied intravenously or by suppository is effective enough method for postoperative analgesia after laparoscopy in gynecology.


Exercise regimens other than pelvic floor muscle training cannot increase pelvic muscle strength-a systematic review.
Although pelvic floor muscle training is widely recommendedin the literature as the gold standard for the treatment of pelvic floor dysfunctions, such as urinary incontinence, interest in other exercise regimens is increasing. However, it is unknown whether other exercise regimens increase pelvic floor muscle strength. This was a systematic review of randomized clinical trials found in PEDro, tridatabase, Cochrane and PubMed on the efficacy of nonspecific exercises, such as Pilates, the Paula method, and hypopressive exercises, in strengthening pelvic floor muscles in adults without underlying neurological disorders and with or without pelvic floor dysfunction. Seven studies were analyzed, and the results demonstrated that Pilates, the Paula method, and hypopressive exercises are ineffective in increasing pelvic muscle strength unless they are performed in conjunction with pelvic floor muscle training. The protocol was registered in the PROSPERO database (www.crd.york.ac.uk/prospero/) under the number CRD42019123396. Considering the available studies, we have concluded that Pilates, the Paula method and hypopressive exercises performed alone do not increase pelvic floor muscle strength. Pelvic floor muscle training continues to be the gold standard for increasing pelvic muscle strength.


Type III procollagen peptide and PZ-peptidase serum levels in pre-cirrhotic liver diseases.
To obtain a dynamic and non-invasive picture of hepatic fibrosis in pre-cirrhotic liver diseases we measured both the concentration of the N-terminal peptide of procollagen III, as a marker of collagen synthesis, and the activity of PZ-peptidase, an enzyme involved in collagen degradation, in the serum of alcoholic or chronic viral hepatitis patients. Peptide serum levels were similar in chronic persistent hepatitis and controls, but significantly higher in chronic active hepatitis. Chronic persistent hepatitis patients had PZ-peptidase levels higher than controls, but similar to chronic active hepatitis. The increase in collagen synthesis without a parallel increase in collagen degradation seen in chronic active hepatitis could be regarded as a sign of impending cirrhosis, whereas the unbalanced rise in PZ-peptidase observed in chronic persistent hepatitis is consistent with the non-progressive character of this disorder. In alcoholic hepatitis both peptide concentration and PZ-peptidase activity were elevated, thus suggesting that both collagen synthesis and degradation are activated. However, the greater increase in PZ-peptidase than in peptide serum levels seen in some patients seems to indicate a minor tendency to progressive fibrosis or a trend towards resolution. Unlike liver disease patients, normal peptide and PZ-peptidase levels were found in patients with pancreatic fibrosis. Since circulating inhibitors and activators of the PZ-peptidase activity can be excluded, as proved by this study, joint peptide and PZ-peptidase serum measurements would seem to offer a simple reliable non-invasive method for differentiating and monitoring progressive and non-progressive forms of hepatic fibrosis.


Multichannel microspectrofluorometry for topographic and spectral analysis of NAD(P)H fluorescence in single living cells.
Starting from a previously described prototype microspectrofluorometer a more versatile apparatus has been developed with rapid optional operation on a topographic mode for the simultaneous multisite evaluation of NAD(P) reduction-reoxidation transients or on a spectral mode for the analysis of natural and exogenous fluorochromes, in single living cells. On the topographic mode, adetailed kinetic analysis of NAD or NAD P-linked dehydrogenases can be made from 50-100 cell points imultaneously via automatic recording of topographic scans upt to 16 times a second, in correlation with microelectrophoretic intracellular inuection of metabolites (e.g. nearly immediate response to glucose 6-phosphate, 20-25 s delay for 6-phosphogluconate). Rapid shifts from topographic to spectral operation make possible the detection of a change in fluorescence intensity at a specific intracellular site and the immediate verification of its nature (NAD(P)H or exogenous fluorochrome) by spectral observations.


Exploring Barriers to the Inclusion of Underrepresented Minorities in Urology: The Temporal and Financial Costs of Residency Interviews.
To investigate whether interview travel cost and time differed for urology residency applicants from medical schools with higher vs lower proportions of students from groups underrepresented in medicine (URiMs). We identified 22 medical schools, 11 with <15% and 11 with >20% URiM students, and 17 "highly ranked" urology residency programs. We contacted the residency programs and requested interview dates, preferred lodging options, and institution-based cost-savings. We constructed interview itineraries for 22 hypothetical students (one from each school), and compared the total cost and time for travel to all 17 interviews. Total travel time and interview costs for the students at schools with <15% and >20% URiM were compared, with findings considered statistically significant at P <.05. Each student was able to attend all 17 interviews. The median total cost was similar for applicants from schools >20% URiM ($8074.80; range: $7027.60-$13702.59) and <15% URiM ($8764.60; range: $6698.48-$11966.83; P = .89). The median aggregate travel time for applicants from schools >20% URiM was 176.4 (range: 93.7-246.2) hours and for applicants from schools <15% URiM was 160.5 (range: 128.2-203.9) hours (P = .62). Financial and temporal costs were similar for applicants from medical schools with <15% or >20% URiM students. Thus, absolute cost considerations are unlikely to account for differences in URiM representation in urology. However, the relative impact of interview costs may be different for URiM students. Effective and durable engagement of URiM students in urology requires an introspective assessment of objective vs anecdotal barriers to recruiting and retaining URiM medical students.


Colorimetric analysis of opaque porcelain fired to different base metal alloys used in metal ceramic restorations.
The popularity of base metal alloys has considerably increased in recent years because of their superior mechanical properties as well as the high cost of noble alloys. However, there is disagreement about their effect on the opaque porcelain color and the color differences among base metal alloys. The purpose of this in vitro study was to determine and compare the influence of various commercially available base metal alloys (excluding titanium-based systems) on the resulting color of opaque porcelain with the use of a colorimetric device. Fourteen different types of Ni-Cr and 3 different types of Co-Cr porcelain bonding alloys were selected with a Au-Pd alloy (V-Delta SF) as the control group for colorimetric measurements and determination of color shift after opaque application. Shade B1 of an opaque porcelain (IPS d.SIGN Opaquer) was applied (0.1 mm) to all specimens (16 mm x 1 mm). The color coordinates of each specimen were measured with a chromameter. The data were displayed in L*, a*, and b* values according to the CIELAB system, and the color differences (DeltaE) between base metal alloys and the control group were calculated. Data were statistically analyzed with 1-way ANOVA (alpha=.05). The ANOVA was followed by Dunnett's multiple comparison test for comparisons with the control group to determine specifically which groups were significantly different from the control group. The L* value of only 1 base metal alloy was significantly different from the control group (P<.001). All base metal alloy groups except 3 had a* values which were significantly different from the control group a* value (P=.001 for Rexillium III, P=.008 for Heracles N, and P<.001 for the remaining 12 alloys), whereas only 3 base metal alloys were not statistically significantly different from the control group in the means of b* values (P<.001). All base metal alloys to which opaque porcelain was applied had significantly different DeltaE values in comparison with the control group (P<.001). The data of the study indicated that a 0.1-mm-thick layer of opaque porcelain applied on the Ni-Cr and Co-Cr alloys did not reliably reproduce the color of opaque porcelain. However, within the limitations of this study, the color differences of base metal alloys measured according to the control group are within clinically acceptable limits (DeltaE<3.5).


Chemopreventive effect of selenium and Chinese medicinal herbs on N-nitrosobis(2-oxopropyl)amine-induced hepatocellular carcinoma in Syrian hamsters.
Oxidative DNA damage by reactive oxygen species is involved in the process of liver carcinogenesis. To test the hypothesis that a remedy containing Scutellaria baicalensis Georgi (Sb) and Bupleurum scorzonerifolfium Willd (Bs) (Sb/Bs remedy) modulates hepatic neoplastic growth, BOP (N-nitrosobis(2-oxopropyl)amine)-induced liver cancers in hamsters were established. Parameters such as survival rate, tumour area, tumour foci, 8-hydroxydeoxyguanosine (8-OHdG), caspase-3, transforming growth factor (TGF-beta1) and tumour necrosis factor-alpha (TNF-alpha) were measured after Sb/Bs remedy treatment during BOP-induced carcinogenesis. The results showed that the Sb/Bs remedy and its constituents Sb and Bs suppressed the tumour area in BOP-induced liver tumours. Because selenium (Sel) is toxic at a high dose (10 mg/kg), with a low survival rate (0%), the combination of Sb/Bs remedy and low-dose Sel (1 mg/kg) was found to decrease the tumour area and the number of tumour foci while increasing serum TNF-alpha and TGF-beta1, but not IL-6 levels. Besides, the Sb/Bs remedy, when combined with low-dose Sel, not only decreased the expression of 8-OHdG and increased caspase-3 expression within the glutathione S-transferase placental form-positive tumour foci but also increased tumour apoptosis in BOP-induced hamsters. We conclude that low-dose Sel has a chemoprevention effect on BOP-induced liver tumours and such an effect was more enhanced when combined with Sb/Bs treatment.


Quantitation of types I and III collagen in biopsy lung samples from patients with cryptogenic fibrosing alveolitis.
The role of changes in the relative amounts of types I and III collagen in cryptogenic fibrosing alveolitis was investigated using a biochemical method adapted for small amounts of human lung tissue. Measurements were performed in 18 biopsy and seven post-mortem lung samples from patients with cryptogenic fibrosing alveolitis and the results were compared with clinical, physiological, radiological and histological data. The mean percentage type III collagen, compared with type I collagen, was significantly lower in post-mortem lung samples from patients with cryptogenic fibrosing alveolitis who died from the disease compared with the biopsy lung samples (p less than 0.01) and with the control lung samples (p less than 0.05). There was a positive correlation between the percentage of type III collagen and response to treatment at six months as shown by the improvement in the percentage predicted Kco (p less than 0.005) and FVC (p less than 0.01) and with the radiological changes (p less than 0.05). These changes remained significant at one year (p less than 0.05 in all cases). These results suggest that patients with a higher proportion of type III collagen have earlier disease and show a better response to treatment than those with a lower proportion of type III collagen. The potential advantages of measuring collagen types for staging cryptogenic fibrosing alveolitis are discussed.


[Gerontological and geriatric problems in stomatology. 1: Effects of age related physical changes on prosthetic therapy].
Morphological changes in the mouth due to age, e.g. changes in the oral mucosa, the blood supply of the lower jaw, and the nervous system, make variations of prosthetical therapy necessary. By means of a classification of old-age patients, the significance of such variations for the prosthetical treatment of partially edentulous jaws is demonstrated.


Nonlinear modeling of growth and study of a new characterization point applied to Timahdit breed sheep under uncertain paternity.
The objectives of this study are to determine which model, among those of Brody, Logistic, Gompertz, Von Bertalanffy and Richards, is the most appropriate to describe the growth of this breed and to choose a point for this model which would be closest to the slaughter weight which have to be used as a selection criterion. Also, in preparation for genetic evaluation under uncertain paternity, Henderson's Average Numerator Relationship Matrix method was used and an R code was developed for the creation of the inverse matrix A which was replaced the pedigree in the animal model. To do this, 64,282 observations corresponding to 12,944 animals, collected between 2009 and 2016, were analyzed. The Von Bertalanffy function had the smallest AIC, BIC, and deviance criteria values, indicating better data representation for both sexes. Considering the average slaughter live weight of 29.4 kg in the study area, the new point of characterization named f(tbm), later than the inflection point of the growth curve, is closer to the commercial target for females intended for regular slaughter supplying butchers and for animals of both sexes intended for religious festivals. Therefore, it would be appropriate to consider this point as a selection criterion for this breed. The developed R code will be integrated into a free R package allowing the estimation of the genetic parameters of the traits of the Von Bertalanffy model.


Systemic Inflammatory Response Syndrome and Prosthetic Joint Infection.
The development of systemic inflammatory response syndrome (SIRS) criteria leads to increased mortality. Little is known about development of SIRS in patients who have prosthetic joint infection (PJI). We aimed to determine the incidence, risk factors, clinical outcomes, and causative organisms in patients who develop SIRS with PJI. We retrospectively identified 655 patients (321 men, 334 women; 382 total hip, 273 total knee) who have hip or knee PJI at 1 institution between July 1, 2015 and December 31, 2020. We formed 2 groups: patients who have SIRS alert (PJI + SIRS) and patients who do not have SIRS alert (PJI). We analyzed clinical outcomes, comorbidities, and operating room culture results. Of 655 patients, 63 developed SIRS with PJI (9.6%). Intensive care unit (ICU) admission rates (27.0 versus. 6.9%, P < .001) and length of stay (7.7 versus. 5.6 days, P = .003) were greater in PJI + SIRS. At 2 years, reoperation (36.5 versus. 22.3%, P = .01) and mortality rates (17.5 versus. 8.8%, P = .03) were greater in PJI + SIRS. Risk factors included deficiency anemia (P = .001), blood loss anemia (P = .013), uncomplicated diabetes (P = .006), diabetes with complication (P = .001), electrolyte disorder (P < .00001), neurological disorder (P = .0001), paralysis (P = .026), renal failure (P = .005), and peptic ulcer disease (P = .004). Staphylococcus aureus more commonly speciated on tissue cultures in PJI + SIRS (P = .002). The incidence of SIRS is 10% among patients who have PJI. Development of PJI + SIRS is associated with increased lengths of stay, ICU admissions, and 2-year reoperation and mortality rates. Identifying certain comorbidities can stratify patients' risk of developing PJI + SIRS.


Therapeutic implications of the tumor microenvironment in ovarian cancer patients receiving PD-1/PD-L1 therapy.
Epithelial ovarian cancer (EOC) ranks as the second most common cause of gynecologic cancer death. The conventional treatment for patients with EOC is postoperative therapy along with platinum chemotherapy. However, a more efficient treatment regimen is of great need for these patients diagnosed with advanced disease (FIGO stages III-IV), whose survival is approximately 29%. Immunotherapy seems to be an encouraging therapeutic strategy for EOC. Given the crucial role in the complicated interactions between tumor cells and other cells, the tumor microenvironment (TME) influences the response to immunotherapy. In this review, we discuss feasible strategies for EOC immunotherapy by exploiting the reciprocity of cancer cells and the constituents of the TME.


P2X7 receptor is essential for cross-dressing of bone marrow-derived dendritic cells.
T cell activation requires the processing and presentation of antigenic peptides in the context of a major histocompatibility complex (MHC complex). Cross-dressing is a non-conventional antigen presentation mechanism, involving the transfer of preformed peptide/MHC complexes from whole cells, such as apoptotic cells (ACs) to the cell membrane of professional antigen-presenting cells (APCs), such as dendritic cells (DCs). This is an essential mechanism for the induction of immune response against viral antigens, tumors, and graft rejection, which until now has not been clarified. Here we show for first time that the P2X7 receptor (P2X7R) is crucial to induce cross-dressing between ACs and Bone-Marrow DCs (BMDCs). In controlled ex vivo assays, we found that the P2X7R in both ACs and BMDCs is required to induce membrane and fully functional peptide/MHC complex transfer to BMDCs. These findings show that acquisition of ACs-derived preformed antigen/MHC-I complexes by BMDCs requires P2X7R expression.


Design and Assembly of Membrane-Spanning DNA Nanopores.
Versatile lipid membrane-inserting nanopores have been made by functionalizing DNA nanostructures with hydrophobic tags. Here, we outline design and considerations to obtain DNA nanopores with the desired dimensions and conductance properties. We further provide guidance on their reconstitution into lipid membranes.


A fatal enteric syndrome in Mystromys albicaudatus (white tailed rat) following topical antibiotic treatment.
Heavy death losses (59%) occurred in adult Mystromys 3--14 days after muscle biopsies were taken from their rear legs. Clinical signs included anorexia, depression, and rough hair coat. Predominant necropsy findings were hrmorrhagic typhlitis and colitis. Results of studies evaluating the roles of the anesthetic and the tropical antibiotic ointment suggested that the deaths were caused by ingestion of the topically applied antibiotic.


A genetically encodable and fluorogenic photo-crosslinker via photo-induced defluorination acyl fluoride exchange.
We report a genetically encodable m-trifluoromethylaniline modified L-lysine (m-TFMAK) which defluorinates upon light activation and covalently conjugates to native residues via acyl fluoride exchange. The encoded m-TFMAK photo-crosslinks with temporal controllability, residue selectivity, and fluorogenic tracking features, making it suitable for identifying protein interactions in living systems.


Telomere shortening with aging in human thyroid and parathyroid tissue.
Progressive telomere shortening with aging was studied using normal thyroid tissue specimens from 46 human subjects aged between 0 and 98 yr and normal parathyroid tissue specimens from 21 human subjects aged between 0 and 83 yrs. There has hitherto been no information documented about telomere length in such thyroid and parathyroid tissues. Age-related shortening at rates of 91 and 92 base pairs (bp) per year, respectively, were observed. Telomere lengths of normal thyroid tissues were 16.53 +/- 1.10 (mean +/- SE), 14.31 +/- 0.80, 11.27 +/- 0.68 and 8.73 +/- 1.08 kbp for age groups less than 2, 20-50, 51-80 and more than 80 yr. Telomere lengths of normal parathyroid tissues were 15.80 +/- 1.46 (mean +/- SE), 15.36 +/- 0.86 and 10.93 +/- 0.78 kbp for age groups less than 4, 20-50 and 51-80 yr. Telomere shortening occurred after 50 yr of age in thyroid and parathyroid tissues. Human thyroid and parathyroid tissues do not seem to show the rapid reduction in telomere length early in life that was reported for some human cell types, suggesting that the rate of telomere shortening has tissue-specific characteristics.


Goniothalamicin and annonacin: bioactive acetogenins from Goniothalamus giganteus (Annonaceae).
Using brine shrimp lethality for activity-directed fractionation, goniothalamicin (I), a new tetrahydroxy-mono-tetrahydrofuran fatty acid gamma-lactone (acetogenin), has been isolated from ethanolic extracts of the stem bark of Goniothalamus giganteus Hook. f., Thomas (Annonaceae). This novel compound was found to be cytotoxic and insecticidal and inhibited the formation of crown gall tumors on potato discs. Annonacin (II), the only other reported mono-tetrahydrofuran acetogenin, was also isolated; the previously reported 9ASK (astrocytoma reversal) activity of II was confirmed, and II is now also found to be weakly active against 3PS murine leukemia.


Isozyme and allozyme patterns in embryonic Drosophila cell culture lines.
Two independently derived embryonic Drosophila cell culture lines were examined for 19 gene-enzyme systems. At two loci, alpha-glycerophosphate dehydrogenase on chromosome 2, and isocitrate dehydrogenase on chromosome 3, allelic variation was detected. These can now serve as genetic markers to identify hybrid cell clones. Quantitative differences between cell lines were found for five enzymes.


Pre-operative parenteral nutrition in patients with oesophageal cancer: a prospective, randomised clinical trial.
A prospective randomised clinical trial was conducted to examine the efficacy of 2 weeks pre-operative parenteral nutrition (PPN) for the prevention of complications following surgery for oesophageal cancer. Forty patients were studied, the diet of twenty being supplemented by pre-operative parenteral nutrition. There were no significant differences in age, nutritional status, tumour staging and histology between the two groups of patients. The use of PPN resulted in a significant gain in body weight and nitrogen but failed to produce an overall reduction in post-operative morbidity and mortality rates. However patients receiving PPN exhibited two types of changes in serum albumin levels. Those with a fall in serum albumin levels associated with an increase in body weight (indicating an expansion of extracellular volume) had a significantly higher incidence of post-operative pulmonary complications than the group exhibiting a rise in serum albumin levels concomitant with increase in body weight. These data suggested that two weeks PPN might not be adequate in certain patients and a longer period of PPN is required. They also show no clinical benefit from the routine use of pre-operative parenteral nutrition in all patients, but do not exclude benefit in selected groups.


Efficient synthesis of α(1,2)-linked oligomannoside derivatives through one-pot glycosylation.
An α(1,2)-linked oligomannoside derivative having a free C-2 hydroxyl group and a C-3 pivaloyl group was synthesized from a thiophenyl mannose derivative 1 using a one-pot self-condensation and applying a α-stereoselective procedure. The mannosylation exclusively generated α-mannoside linkages. The observed α-directing effect was rationalized by the remote participation of the pivaloyl group in C-3 position. The polymerization degree was controlled by the promoter amount providing the mannobiose derivative as a major product. Applying this method eliminated many synthetic steps. The α(1,2)-linked oligomannoside derivatives, which are key intermediates for the synthesis of oligomannose type N-glycans for glycoproteins, were easily prepared.


Diosgenin-3,6-dione: second polymorph in space group P212121.
The title steroid, [(25R)-spirost-4-en-3,6-dione, C27H38O4], is obtained by oxidation of diosgenin, using the Jones reagent (CrO3/H2SO4). The crystal structure was previously reported in space group P212121, but nonetheless with the wrong absolute configuration and omitting positions for H atoms [Rajnikant et al. (2000 ▸). Mol. Cryst. Liq. Cryst. Sci. Technol. Sect. C, 12, 101-110]. The diffraction data set reported herein is for a second polymorph in the same space group, as evidenced by simulated powder patterns. Both forms are characterized by a similar ortho-rhom-bic unit cell, and a similar arrangement of the mol-ecules in the crystal structure. However, the conformation of the A/B rings in the steroid nucleus is slightly modified, leading to the observed polymorphism.


Effect of diltiazem on spontaneous cyclic Ca2+ release from sarcoplasmic reticulum.
We used saponin-treated skinned fibers isolated from papillary muscles of the right ventricle of guinea pigs to compare the effects of diltiazem on the spontaneous cyclic Ca2+ release from the sarcoplasmic reticulum (SR) of cardiac muscle with the effects of caffeine. Both diltiazem and caffeine increased the frequency of cyclic contractions in EGTA (ethyleneglycol-bis-(beta-aminoethylether) N,N,N',N'-tetra-acetate)-free solution and induced an incomplete, concentration-dependent relaxation of the muscle. The results suggest that the spectrum of the pharmacological effects of diltiazem on the SR is similar to that for caffeine, that is diltiazem accelerates the spontaneous Ca2+ release from the SR and suppresses Ca2+ reuptake by the SR, and that diltiazem as well as caffeine may act on the SR in vivo in a specific condition.


Physician recognition of ophthalmoscopic signs of open-angle glaucoma: effect of an educational program.
To evaluate a short educational intervention instructing primary care physicians in the recognition of glaucomatous changes of the optic disc. Comparison of performances on a pretest and a posttest consisting of fundus slides in color. Educational conferences at two university-affiliated teaching hospitals and one staff-model health maintenance organization. Thirty-six internal medicine residents and ten practicing internists. A 20-minute slide/narration educational program, which covered diagnostic criteria for open-angle glaucoma, normal and abnormal optic disc anatomy, and funduscopic signs of open-angle glaucoma. Following the intervention, residents showed improved sensitivity (0.76 to 0.88, p = 0.007), specificity (0.65 to 0.88, p less than 0.001), and accuracy (0.71 to 0.88, p less than 0.001). Internists showed similar increments in sensitivity, specificity, and accuracy: 0.67 to 0.86 (p = 0.01), 0.59 to 0.84 (p = 0.01), and 0.63 to 0.85 (p = 0.002), respectively. A brief educational intervention can result in meaningful improvement in physician diagnostic accuracy in recognizing ophthalmoscopic signs of open-angle glaucoma.


Plasticity in life-history traits of the bark beetle Ips calligraphus as influenced by phloem thickness.
Reproduction and development of Ips calligraphus (Germar) (Coleoptera: Scolytidae) occur primarily in the phloem (inner bark) tissue of its pine hosts. In slash pine (Pinus elliottii Engelm. var. elliottii), phloem thickness can vary widely from tree to tree. We compared adult residence time and fecundity and progeny development time, body size, and sex ratio of this beetle when reared in slash pine bolts and bark slabs with phloem thicker or thinner than average adult body width. Most studies were conducted at 20°, 25°, and 30° C. Residence time of parent males and females decreased with increasing temperature but it was not affected by phloem thickness. Residence time of parent males was about 2 days shorter than that of parent females at each temperature. Reproductive fitness was greater in thick phloem at all temperatures as measured by faster larval development, earlier emergence of progeny (F 1 ) adults, and emergence of more progeny adults per parent female. Progeny survival was similar between phloem those from thick phloem, and their sex ratio was female biased (1:2 vs 1:1, male:female). When allowed to inhabit thick phloem, the progeny (F 2) of adults from thin phloem were just as large and of similar sex ratio (1:1) as were progeny of F 1 adults from thick phloem. The high degree of plasticity in the life-history traits of this beetle may enable it to successfully colonize pines that vary widely in phloem thickness.


Canine tungiasis: High prevalence in a tourist region in Bahia state, Brazil.
Tungiasis is a parasitic skin disease neglected by authorities, health professionals, and the general population. Its occurrence is significantly associated with poverty. A cross-sectional study was conducted to describe the prevalence of tungiasis, associated clinical signs and risk factors of the canine population at a tourist site in the city of Ilhéus, Bahia (northeast Brazil). All village households were visited and dogs inspected after authorization by owners. A semi-structured questionnaire was administered. Of the 114 dogs included in the study, 71 (62.3%) were infested; all of them had lesions on their pads. An ectopic lesion on the nose was observed in one dog (1.4%). The number of manipulated lesions outnumbered the number of vital and avital lesions with an average of 88.3%. Edema (95.8%) and hyperkeratosis (85.9%) were the most prevalent clinical signs. Behavioral disorders such as excessive licking (6/71; 8.5%), disobedience (1/71; 1.4%) and prostration (2/71; 2.8%) were reported. In the multi-variate analysis, semi-restricted condition of the dogs (adjusted OR=8.58; 95% CI=2.47-29.76) and the presence of sand on the compound (adjusted OR=14.23, 95% CI=2.88-70.28) were significantly associated with infestation. We concluded that, infestation with Tunga spp. is highly endemic in the canine population of the village. The low level of restrictions on dogs and the presence of sand in areas most frequented by the animals are perpetuating factors of infestation in the community, subject to integrated and multidisciplinary intervention measures.


Preliminary results of primary screening for breast cancer with the Mama Program.
In 1972 a comprehensive BSE screening strategy for the early detection of breast cancer, the "Mama Program Screening" (MPS), was developed in Finland by the author on the initiative of women's organizations. The program consists of a) initial information about the facilities of the program and BSE-performance, b) prospective surveillance of the BSE-behaviour of complying women, who use a specially designed Mama calendar for regular notes on their BSE behaviour and c) a pre-organized system for women with self-identified anomalies in the breasts to self-refer to physicians in public health care. From 1973 to 1975 an MPS project was carried out in Finland with 56,000 exposed women. Compliance to BSE-performance of once a month increased from 2% prior to the enrollment to 55%, and resulted in 2% of self-referrers. In the compliers, mortality from breast cancer was reduced overall by 29%, the screening being effective in all age groups, also in those under 50 years. The MPS was easy and inexpensive to implement in existing public health care systems with the information material developed for the study and with physicians in PHC facilities.


A high relaxivity Gd(III)DOTA-DSPE-based liposomal contrast agent for magnetic resonance imaging.
The field of molecular imaging aims to visualize and quantify (patho)physiological processes at the cellular and molecular level. Sensitive and site-targeted contrast agents are employed to visualize molecular constituents of processes of interest. The principal aim of this study was to develop a magnetic resonance imaging (MRI) detectable liposome with high relaxivity and stability. To this end, Gd(III)DOTA-DSPE was synthesized and incorporated in a liposomal formulation. The resulting liposomes were extensively characterized in vitro in terms of contrast agent efficiency and structural properties. The liposomes were shown to have a high longitudinal relaxivity, which is crucial for the detection of low concentration molecular markers in molecular imaging studies. We also demonstrated that Gd(III)DOTA-DSPE exhibits no detectable transmetallation upon incubation with Zn(II). This is important as it significantly contributes to the biocompatibility of the contrast agent. The present liposome preparation will serve as versatile and well characterized platform for molecular imaging and targeted drug delivery studies.


Glutathione-deficient Plasmodium berghei parasites exhibit growth delay and nuclear DNA damage.
Plasmodium parasites are exposed to endogenous and exogenous oxidative stress during their complex life cycle. To minimize oxidative damage, the parasites use glutathione (GSH) and thioredoxin (Trx) as primary antioxidants. We previously showed that disruption of the Plasmodium berghei gamma-glutamylcysteine synthetase (pbggcs-ko) or the glutathione reductase (pbgr-ko) genes resulted in a significant reduction of GSH in intraerythrocytic stages, and a defect in growth in the pbggcs-ko parasites. In this report, time course experiments of parasite intraerythrocytic development and morphological studies showed a growth delay during the ring to schizont progression. Morphological analysis shows a significant reduction in size (diameter) of trophozoites and schizonts with increased number of cytoplasmic vacuoles in the pbggcs-ko parasites in comparison to the wild type (WT). Furthermore, the pbggcs-ko mutants exhibited an impaired response to oxidative stress and increased levels of nuclear DNA (nDNA) damage. Reduced GSH levels did not result in mitochondrial DNA (mtDNA) damage or protein carbonylations in neither pbggcs-ko nor pbgr-ko parasites. In addition, the pbggcs-ko mutant parasites showed an increase in mRNA expression of genes involved in oxidative stress detoxification and DNA synthesis, suggesting a potential compensatory mechanism to allow for parasite proliferation. These results reveal that low GSH levels affect parasite development through the impairment of oxidative stress reduction systems and damage to the nDNA. Our studies provide new insights into the role of the GSH antioxidant system in the intraerythrocytic development of Plasmodium parasites, with potential translation into novel pharmacological interventions.


Comorbidities and health-related quality of life in Patients with Antineutrophil Cytoplasmic Antibody (ANCA) - associated vasculitis.
The optimization of immunosuppressive therapies has led to a marked improvement in the survival of ANCA-associated vasculitides (AAV). The main issue now appears to be the management of comorbidities and the improvement of quality of life. The objective of this review was to investigate the incidence and the impact of AAV-associated comorbidities, as well as the determinants of health-related quality of life (HRQoL). We performed a systematic literature review of articles published in Medline from 2001 to 04/28/2020. We selected relevant articles about AAV-associated comorbidities as well as HRQoL and fatigue. For each selected article, data on the incidence of comorbidity were extracted, and factors associated with the Mental component score (MCS) and the Physical component score (PCS) were identified. Among the 10,993 references identified, 103 were retained for the final analysis. A significant increase in cardiovascular risk was evidenced, particularly for coronary artery disease and thromboembolic events, especially during the active phase of the disease. AAV was also associated with bronchiectasis, thyroid diseases and osteoporosis. A marked decrease in HRQoL and an increase in fatigue and anxiety were reported. Decrease in PCS and MCS was associated with fatigue, mood disorders, sleep disturbance, and/or unemployment. The excess mortality of AAV is still a concern, partly in connection with cardiovascular and thromboembolic comorbidities. AAV patients also experiment a reduction in their HRQoL that requires integrated management. Patients with AAV need comorbidity management strategies to improve their quality of life and outcomes.


Liver Transplantation Within 7-Days of Listing Improves Survival in ACLF-3.
Patients with acute on chronic liver failure (ACLF-3) have a very high short-term mortality without liver transplantation (LT). Our objective was to determine whether early LT (ELT; ≤ 7 days from listing) had an impact on 1 year patient (PS) in patients with ACLF-3 compared to late LT (LLT; days 8-28 from listing). All adults with ACLF-3 listed for LT with the United Network for Organ Sharing (UNOS) between 2005 and 2021 were included. We excluded status one patients and those with liver cancer or listed for multi-organ or living donor transplants. ACLF patients were identified using the European Association for the Study of the Liver-Chronic Liver Failure criteria. Patients were categorized as ACLF-3a and ACLF-3b. During the study period, 7607 patients were listed with ACLF-3 (3a-4520, 3b-3087); 3498 patients with ACLF-3 underwent ELT and 1308 had LLT. The overall 1 year PS after listing was 64.4% in ACLF-3a and 50% in ACLF-3b. In 4806 ACLF-3 patients who underwent LT, 1 year PS was 86.2%, but those who had ELT had higher survival (87.1 vs. 83.6%, P = 0.001) than the LLT group. These survival benefits were seen in both ACLF-3a and ACLF-3b. On multivariable analysis, age (HR 1.02, CI 1.01-1.03), diabetes (HR 1.40, CI 1.16-1.68), respiratory failure (HR 1.76, CI 1.50-2.08), donor risk index > 1.7 (HR 1.24, CI 1.06-1.45), and LLT (HR 1.20, CI 1.02-1.43) were independent predictors of higher 1 year mortality while higher albumin (HR 0.89, CI 0.80-0.98) was associated with reduced mortality. Early LT (≤ 7 days from listing) in ACLF-3 is associated with better 1 year survival compared to late LT (days 8-28 from listing).


Evolution of public attitudes about mental illness: a systematic review and meta-analysis.
To explore whether the increase in knowledge about the biological correlates of mental disorders over the last decades has translated into improved public understanding of mental illness, increased readiness to seek mental health care and more tolerant attitudes towards mentally ill persons. A systematic review of all studies on mental illness-related beliefs and attitudes in the general population published before 31 March 2011, examining the time trends of attitudes with a follow-up interval of at least 2 years and using national representative population samples. A subsample of methodologically homogeneous studies was further included in a meta-regression analysis of time trends. Thirty-three reports on 16 studies on national time trends met our inclusion criteria, six of which were eligible for a meta-regression analysis. Two major trends emerged: there was a coherent trend to greater mental health literacy, in particular towards a biological model of mental illness, and greater acceptance of professional help for mental health problems. In contrast, however, no changes or even changes to the worse were observed regarding the attitudes towards people with mental illness. Increasing public understanding of the biological correlates of mental illness seems not to result in better social acceptance of persons with mental illness.


Does T2 inversion aid in identifying disc pathologies?
T2 inversion sequence is used in routine radiology practice mainly to heighten contrast resolution within the region to be studied but no evidence exists in current literature to assess it's true efficacy for lumbar disc degeneration. The objective of this study was to analyse T2 inversion and evaluate it's efficacy in assessment of lumbar disc pathology,. This retrospective single-centre study included 50 randomly selected patients presenting with back pain and radiculopathy. T2 inversion sequence was obtained in both axial and sagittal planes in addition to routine sequences. All the Magnetic Resonance Imaging (MRI) procedures were performed on 3T. One senior Musculoskeletal (MSK) radiologist, 2 general radiologists and a spinal surgeon blinded to final results reviewed images for the various disc pathologies individually analysing conventional and T2 inversion images. Data was analysed using Fischer's test and Chi2 test with a p value of <0.05 considered as significant. Fifty randomly selected patients (mean age was 47.3 years(range 35-55 years) with back pain and radicular symptoms were included. The spectrum of disc pathologies included protrusions, annular fissures, discal cysts and calcified discs. Based on the above findings, T2 inversion sequence is not proved to be an alternative imaging sequence to routine MR imaging sequences for the depiction of various disc pathologies. T2 inversion sequence does not increase the depiction of various lumbar disc pathologies in comparison with conventional sequences when used by experienced MSK radiologists. It may highlight abnormalities better for relatively inexperienced readers such as general radiologists and spinal surgeons.


Psychosomatic dental disease: is mental stress in adults followed by acute dental caries in all racial groups?
The following data indicate that the onset of acute dental circles in adults, following severe mental stress, is seen not only in people of European stock but also in Polynesians and Micronesians. This suggests that this reaction to stress might occur in all races.


Toxicogenomic analysis of physiologically important metals: An integrated in silico approach.
Biologically important metals regulate cellular homeostasis in living systems. Anthropogenic exposure to these metals can cause adverse effects, including an increased incidence of diseases in humans such as cancer, lung, and cardiovascular defects. However, the effects of metals and the common genes/signaling pathways involved in metal toxicity have not been elucidated. Hence, the present study used toxicogenomic data mining with the comparative toxicogenomics database to explore the impact of these metals. The metals were categorized into transition, alkali, and alkaline earth. The common genes were identified and subjected to functional enrichment analysis. Further, gene-gene and protein-protein interactions were assessed. Also, the top ten transcription factors and miRNAs that regulate the genes were identified. The phenotypes and diseases that have increased incidence upon alterations of these genes were detected. Overall, we were able to identify IL1B and SOD2 as the common genes, along with the AGE-RAGE signaling pathway in diabetic complications as the common pathway altered. Enriched genes and pathways specific to each metal category were also found. Further, we identified heart failure as the major disease that could have increase in the incidence upon these metals' exposure. In conclusion, exposure to essential metals might cause adverse effects via inflammation and oxidative stress.


The role of HiTI, a serine protease inhibitor from Haematobia irritans irritans (Diptera: Muscidae) in the control of fly and bacterial proteases.
Blood-sucking arthropods are vectors responsible for the transmission of several pathogens and parasites to vertebrate animals. The horn fly Haematobia irritans irritans (Diptera: Muscidae) and the tick Boophilus microplus are important hematophagous ectoparasites that cause losses in cattle production. A serine protease inhibitor from a thorax extract of the fly H. irritans irritans (HiTI) was previously isolated, characterized and cloned. In the present study we described the expression, purification, and characterization of the recombinant HiTI (rHiTI) and its possible role in the control of different endogenous and bacterial proteases. rHiTI was successfully expressed using the pPIC9 expression vector with a yield of 4.2 mg/L of active rHiTI. The recombinant HiTI purified by affinity chromatography on trypsin-Sepharose had a molecular mass of 6.53 kDa as determined by LS-ESI mass spectrometry and inhibition constants (Kis) similar to those of native HiTI for bovine trypsin and human neutrophil elastase of 0.4 and 1.0 nM, respectively. Purified rHiTI also showed inhibitory activity against the trypsin-like enzyme of H. i. irritans using its possible natural substrates, fibrinogen and hemoglobin; and also inhibited the OmpT endoprotease of Escherichia coli using fluorogenic substrates. The present results confirm that HiTI may play a role in the control of fly endogenous proteases but also suggest a role in the inhibition of pathogen proteases.


Effect of neuroleptics on cytochrome P450 2C11 (CYP2C11) in rat liver.
The aim of the present study was to investigate the influence of classic and atypical neuroleptics on the activity of cytochrome P450 2C11 (CYP2C11), measured as a rate of testosterone 2α- and 16α-hydroxylation. The reaction was studied in control liver microsomes in the presence of neuroleptics, as well as in the microsomes of rats treated intraperitoneally (ip) with pharmacological doses of the drugs (promazine, levomepromazine, thioridazine and perazine 10 mg/kg; chlorpromazine 3 mg/kg; haloperidol 0.3 mg/kg; risperidone 0.1 mg/kg; sertindole 0.05 mg/kg) for one day or two weeks (twice a day), in the absence of the neuroleptics in vitro. The investigated neuroleptics added to control liver microsomes produced some inhibitory effects on CYP2C11 activity, which were moderate (thioridazine: K(i) = 55), modest (sertindole and perazine: K(i) = 76 and 94 μM, respectively) or week (promazine, levomepromazine, haloperidol and chlorpromazine: K(i) = 285, 280, 223 and 157 μM, respectively). Risperidone had the weakest inhibitory effect on the CYP2C11 activity (K(i) = 641 μM). One-day exposure of rats to the neuroleptics did not significantly change the activity of CYP2C11 in liver microsomes. Of the neuroleptics studied, only chronic treatment with levomepromazine, perazine and thioridazine diminished CYP2C11 activity; those effects were positively correlated with the observed decreases in the protein level of the enzyme. The in vivo inhibition of CYP2C11 by chronic treatment with the three phenothiazines suggests their influence on the enzyme regulation. A possible mechanism of CYP2C11 regulation by the neuroleptics and its pharmacological significance are discussed.


Quantitated trauma following radial keratotomy in rabbits.
Radial keratotomy was performed in 33 rabbits using an eight-incision technique. At various postoperative intervals up to 90 days, these eyes were enucleated and subjected to increasing quantitated trauma until ocular rupture occurred. Control animals (13 eyes) were subjected to similar trauma. The eyes that had surgery required approximately 50% of the control energy to rupture over the 90-day period (P less than 0.001). Corneal microperforations at surgery greatly increased the trauma risk (P = 0.02). Consistent rupture patterns resulted, both grossly and microscopically.


A rapid general method for the identification of PCR products using a fibre-optic biosensor and its application to the detection of Listeria.
A 200-mer fragment of the flaA gene from Listeria monocytogenes was amplified using the polymerase chain reaction (PCR) incorporating biotin- and fluorescein amadite (FAM-)labelled primers. Methods are described for isolating the single stranded FAM-labelled 200-mer. A central portion of this 200-mer was successfully hybridized onto a complementary sequence coated onto a fibre optic biosensor. Advantages in the specificity and speed of this approach compared to standard agarose gel electrophoresis and probing methods are discussed.


Egg-laying and hatching rhythms in the monogenean Diplozoon homoion gracile from the southern barbel (Barbus meridionalis).
Diplozoon homoion gracile from the southern barbel (Barbus meridionalis) displays an egg-laying and an egg hatching rhythm, the latter being more clearly defined. Egg laying continues both day and night but significantly more eggs are laid at night. The oncomiracidia hatch at dusk. If parasite eggs are eaten by the host they pass through the gut undamaged and hatch normally.


Apoptosis of human abdominal preadipocytes before and after differentiation into adipocytes in culture.
Differentiation of murine 3T3-L1 preadipocytes into adipocytes is associated with the acquisition of apoptotic resistance accompanied by the upregulation of cell survival genes. We have now examined the effect of adipogenesis on apoptotic susceptibility of human abdominal preadipocytes in primary culture. To induce apoptosis, human preadipocytes, or their differentiated counterparts, were serum-deprived for 24 or 48 hours. When indicated, ceramide was also used as an apoptotic trigger. Cell death was assessed by enumeration of adherent viable cells, and its apoptotic nature was verified by Hoechst staining and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). After 48 hours of serum withdrawal, cell death was 26% +/- 4% in preadipocytes and was increased to 41% +/- 4% in differentiated adipocytes (mean +/- SE; n = 7 patients; P <.002). Under serum-free conditions for 24 hours, ceramide-induced cell death was 40% +/- 6% in preadipocytes and increased to 68% +/- 8% in adipocytes (mean +/- SE; P <.01; n = 8 patients). Neuronal apoptosis inhibitor protein (NAIP), an antiapoptotic protein cell survival that increases upon 3T3-L1 adipogenesis, was reduced in human preadipocytes undergoing differentiation (n = 6 patients). Preadipocytes derived from omental versus subcutaneous abdominal fat were more susceptible to apoptosis induced by serum deprivation, 16% +/- 4% versus 31% +/- 3% cell death, respectively (mean +/- SE; P <.02; n = 7 patients). Although the murine 3T3-L1 preadipocyte cell line is a useful model that approximates primary preadipocyte cell biology, our data derived from human preadipocyte studies suggest important differences with respect to the regulation of apoptosis.


Pituitary-gonadal hormones and adrenal androgens in non-cirrhotic female alcoholics after cessation of alcohol intake.
To investigate the sex-hormone profiles associated with chronic alcoholism in women we examined 16 non-cirrhotic alcohol abusers (aged 18-46 years). They were admitted for the treatment of alcoholism (duration of 2-16 yrs) to a social hospital for 6 weeks. Their mean daily alcohol consumption was 170 g. Blood samples for serum LH, FSH, prolactin (PRL), oestrone (E1), oestradiol (E2), progesterone (P), 17-alpha-hydroxyprogesterone (17-OHP), androstenedione (A) and dehydroepiandrosterone (DHEA) were drawn three times a week during the hospital stay. Similar blood samples were taken from 10 control women during one menstrual cycle. The cycles were anovulatory in two patients and in none of controls. Serum LH and FSH levels were similar in alcoholic and control women but serum concentrations of PRL were increased 2-4-fold in alcoholic women. In the patients serum, concentrations of E1 and E2 tended to be lower during the follicular and midcycle phases, as did those of P and 17-OHP during the luteal phase. Compared with the controls, serum levels of A were increased 2-3-fold in the patients. A parallel difference between the two groups was seen in serum DHEA concentrations. We conclude that until liver injury, even heavy alcohol drinking has only minor effects on the secretion of gonadotrophins and ovarian steroids. Hypersecretion of PRL and adrenal androgens may well be an initiating mechanism for sexual dysfunction of female alcoholics.


Multiple myeloma imaging.
Imaging myeloma is often performed when complications occur which may reveal the disease. Since the malignant plasma cell proliferation characteristic of this disease can affect the whole of the bony skeleton to various degrees, examination of the bones should be as complete as possible. The radiographic images must be studied for lytic lesions or signs of diffuse osteopenia, as well for fracture complications such as vertebral compression. Slice imaging has the advantage of being more sensitive and showing extra-osseous extension well. With a CT scan and MRI, spinal compression can be detected or a surgical procedure planned, while MRI or a PET scan can be used to assess extension of the disease and the response to treatment.


Effect of Skin-to-Skin Holding on Stress in Mothers of Late-Preterm Infants: A Randomized Controlled Trial.
To examine the effect of skin-to-skin care (SSC) on stress perception between mothers who provided SSC to their late-preterm born infants and mothers who provided blanket holding. This was a longitudinal 2-group randomized controlled trial of 40 infant-mother dyads recruited from a level 3 neonatal intensive care unit in the upper Midwest. Maternal stress was measured using the Parental Stressor: Neonatal Intensive Care Unit (PSS: NICU) scale pre- and post-SSC intervention. Demographic and other mother and infant covariates were extracted from medical records. Physiologic stability was measured by the Stability of the Cardiorespiratory System in Preterm Infants (SCRIP) score. Study personnel used daily logs to track frequency and duration of SSC and holding sessions. The intervention and the control groups had similar pre- (mean ± standard deviation, 2.34 ± 0.86 for SSC and 2.94 ± 0.87 for holding) and post-intervention (mean ± standard deviation, 2.55 ± 0.95 for SSC and 2.78 ± 0.90 for holding) overall stress scores. Hours of SSC holding positively correlated with the change in stress scores for the entire scale (r = 0.58; P = .001), and for infant appearance (r = 0.58; P = .001) and parent role alteration (r = 0.48; P = .02) subscales. This relationship remained significant after controlling for the infant's length of stay and SCRIP score. Mothers who provide SSC may experience more stress related to a more facilitated progression in the mother and infant relationship. The relationship between increased stress and the number of hours of SSC holding warrants further investigation.


m-Trifluoromethyl-diphenyl diselenide (m-CF3-PhSe)2 modulates the hippocampal neurotoxic adaptations and abolishes a depressive-like phenotype in a short-term morphine withdrawal in mice.
The opioid withdrawal syndrome is defined as a complex phenomenon involving multiple cellular adaptations, which leads to the emergence of aversive physical and affective signs. The m-trifluoromethyl-diphenyl diselenide (m-CF3-PhSe)2 elicits an antidepressant-like effect by modulating the opioid system in different animal models of mood disorders. Notably, repeated exposure to (m-CF3-PhSe)2 developed neither tolerance nor withdrawal signs in mice. The aim of the present study was to investigate whether (m-CF3-PhSe)2 attenuates the physical signs and the depressive-like phenotype during morphine withdrawal through its neuroprotective effects on oxidative stress, the NMDA receptor and the proBDNF/mBDNF signaling in the hippocampus of mice. Adult Swiss mice received saline solution or escalating doses (20-100 mg/kg, sc) of morphine for six days. For the next three days, the animals were treated with canola oil, (m-CF3-PhSe)2 (5 and 10 mg/kg, ig) or methadone (5 mg/kg, sc) whereas morphine injections were discontinued. On day 9, physical withdrawal signs and depressive-like behavior were assessed 30 min after the last administration of (m-CF3-PhSe)2. Although short-term treatment with (m-CF3-PhSe)2 at both doses suppressed the aversive physical and affective signs in morphine withdrawn-mice, the highest dose of (m-CF3-PhSe)2 per se increased the teeth chattering manifestation. The intrinsic antioxidant property of (m-CF3-PhSe)2 modulated oxidative stress, it also restored the NMDA receptor levels in the hippocampus of morphine withdrawn-mice. Besides, (m-CF3-PhSe)2 downregulated the proBDNF/p-75NTR/JNK pro-apoptotic pathway without affecting the mBDNF/TrkB/ERK/CREB pro-survival signaling in the hippocampus of morphine withdrawn-mice. The results show that (m-CF3-PhSe)2 treatment modulated the hippocampal neurotoxic adaptations and abolished the depressive-like phenotype following morphine withdrawal in mice.


Chemical evolution and the evolution of the earth's crust.
It is hypothesized that there is a close relationship between the geologic evolution of the global plates of the Earth's crust and the chemical evolution of life on the Earth. Characteristics of the axes of plate spreading are discussed in relation to postulated environments conductive to the synthesis of chemical compounds thought to be important biological precursors. Likely locations for in situ measurements to test the hypothesis are identified.


Perinatal phencyclidine treatment alters neuregulin 1/erbB4 expression and activation in later life.
Schizophrenia is a complex and devastating mental disorder of unknown etiology. Hypofunction of N-methyl-D-aspartate (NMDA) receptors are implicated in the disorder, since phencyclidine (PCP) and other NMDA receptor antagonists mimic schizophrenia-like symptoms in humans and animals so well. Moreover, genetic linkage and post mortem studies strongly suggest a role for altered neuregulin 1 (Nrg1)/erbB4 signaling in schizophrenia pathology. This study investigated the relationship between the NMDA receptor and Nrg1 signaling pathways using the perinatal PCP animal model. Rats (n=5/group) were treated with PCP (10 mg/kg) or saline on postnatal days (PN) 7, 9 and 11 and were sacrificed on PN12, 5 weeks and 20 weeks for biochemical analyses. Western blotting was used to determine total and phosphorylated levels of proteins involved in NMDA receptor/Nrg1 signaling in the prefrontal cortex and hippocampus. In the cortex, PCP treatment altered Nrg1/erbB4 expression levels throughout development, including decreased Nrg1 and erbB4 at PN12 (-25-30%; p<0.05); increased erbB4 and p-erbB4 (+18-27%; p<0.01) at 5 weeks; and decreased erbB4 and p-erbB4 (-16-18%; p<0.05) along with increased Nrg1 (+33%; p<0.01) at 20 weeks. In the hippocampus, levels of Nrg1/erbB4 were largely unaffected apart from a significant decrease in p-erbB4 at 20 weeks (-13%; p<0.001); however NMDA receptor subunits and PSD-95 showed increases at PN12 and 5 weeks (+20-32%; p<0.05), and decreases at 20 weeks (-22-29%; p<0.05). This study shows that NMDA receptor antagonism early in development can have long term effects on Nrg1/erbB4 expression which could be important in understanding pathological processes which might be involved in schizophrenia.


[Ochratoxin A in sultanas].
In the Lebensmittelinstitut Braunschweig 89 samples of sultanas were analysed for Ochratoxin A in 2003. The samples were slurried with water to get a homogeneous test-material. After the extraction with acetonitrile the sample-filtrates were cleaned-up by immuno affinity columns. The measurement was performed by HPLC with fluorescence-detection. As the result we asserted a high contamination of sultanas with OTA. The median concentration amounted 2,7 μg/kg at a contamination rate of 95%. 8% of all samples above the limit value of 10 μg/kg with a maximum value of 28,5 μg/kg.


Are We Ready for Bariatric Surgery in a Liver Transplant Program? A Meta-Analysis.
Obesity-related non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are two main causes of end-stage liver disease requiring a liver transplantation. Studies exploring bariatric surgery in the liver transplantation setting have increased in recent years; however, a systematic analysis of the topic is lacking to date. This meta-analysis was conducted to explore the perioperative and long-term outcomes of bariatric surgery in obese patients undergoing liver transplantation. Electronic databases were systematically searched for studies reporting bariatric surgery in patients undergoing liver transplantation. The primary outcomes were postoperative complications and mortality. We also extracted data about excess weight loss, body mass index, and improvement of comorbidities after bariatric surgery. A total of 96 patients from 8 articles were included. Bariatric surgery-related morbidity and mortality rates were 37% (95% CI 0.27-0.47) and 0.6% (95% CI 0.02-0.13), respectively. Body mass index at 24 months was 31.02 (95% CI 25.96-36.09) with a percentage excess weight loss at 12 and 24 months of 44.08 (95% CI 27.90-60.26) and 49.2 (95% CI 31.89-66.66), respectively. After bariatric surgery, rates of improvement of arterial hypertension and diabetes mellitus were 61% (95% CI 0.45-0.75) and 45% (95% CI 0.25-0.66), respectively. In most patients, bariatric surgery was performed after liver transplant and the most frequent technique was sleeve gastrectomy. Bariatric surgery can be performed safely in the setting of liver transplantation resulting in improvement of obesity-related comorbidities. The optimal timing and technique require further studies.


Patient-Reported Quality of Life Outcomes after Moderately Hypofractionated and Normofractionated Proton Therapy for Localized Prostate Cancer.
We retrospectively evaluated the three-year patient-reported quality of life (QOL) after moderately hypofractionated proton therapy (MHPT) for localized prostate cancer in comparison with that after normofractionated PT (NFPT) using the Expanded Prostate Cancer Index Composite-50. Patients who received MHPT (60-63 Gy (relative biological effectiveness equivalents; RBE)/20-21 fractions) (n = 343) or NFPT (74-78 Gy (RBE)/37-39 fractions) (n = 296) between 2013 and 2016 were analyzed. The minimum clinically important difference (MCID) threshold was defined as one-half of a standard deviation of the baseline value. The median follow-up was 56 months and 83% completed questionnaires at 36 months. Clinically meaningful score deterioration was observed in the urinary domain at 1 month in both groups and in the sexual domain at 6-36 months in the NFPT group, but not observed in the bowel domain. At 36 months, the mean score change for urinary summary was -0.3 (MHPT) and -1.6 points (NFPT), and that for bowel summary was +0.1 and -2.0 points; the proportion of patients with MCID was 21% and 24% for urinary summary and 18% and 29% for bowel summary. Overall, MHPT had small negative impacts on QOL over three years, and the QOL after MHPT and NFPT was similar.


Chromatographic approaches to the quality control of chiral propionate anti-inflammatory drugs and herbicides.
The chiral analysis of a range of propionate anti-inflammatory drugs and herbicides was accomplished by gas chromatographic separation of their R-alpha-phenylethylamide diastereomeric derivatives. Using a packed column (3% OV-l on Chromosorb G) good separations were obtained but analysis times were rather long. Examination of the same crystalline derivatives using a capillary column (bonded methylsilicone) resulted in good separations together with much reduced total analysis times. The technique was validated through the analysis of several derivatives prepared on a micro scale and examined directly by gas chromatography without any crystallisation step. Racemic materials all gave virtually 50:50 response ratios while the analysis of optically pure samples produced no evidence of significant racemization. Derivatives of phenoxyacetic acid and myristic acid were also prepared and chromatographed as potential internal standards.


Protein-DNA electrostatics: toward a new paradigm for protein sliding.
Gene expression and regulation rely on an apparently finely tuned set of reactions between some proteins and DNA. Such DNA-binding proteins have to find specific sequences on very long DNA molecules and they mostly do so in the absence of any active process. It has been rapidly recognized that, to achieve this task, these proteins should be efficient at both searching (i.e., sampling fast relevant parts of DNA) and finding (i.e., recognizing the specific site). A two-mode search and variants of it have been suggested since the 1970s to explain either a fast search or an efficient recognition. Combining these two properties at a phenomenological level is, however, more difficult as they appear to have antagonist roles. To overcome this difficulty, one may simply need to drop the dichotomic view inherent to the two-mode search and look more thoroughly at the set of interactions between DNA-binding proteins and a given DNA segment either specific or nonspecific. This chapter demonstrates that, in doing so in a very generic way, one may indeed find a potential reconciliation between a fast search and an efficient recognition. Although a lot remains to be done, this could be the time for a change of paradigm.


Structure of the monosialyl oligosaccharides derived from salivary gland mucin glycoproteins of the Chinese swiftlet (genus Collocalia). Characterization of novel types of extended core structure, Gal beta(1----3)[GlcNAc beta(1----6)] GalNAc alpha(1----3)GalNAc(-ol), and of chain termination, [Gal alpha(1----4)]0-1[Gal beta(1----4)]2GlcNAc beta(1----.).
The mucus glycoproteins, the so-called nest-cementing substance, from the salivary gland of Chinese swiftlets (genus Collocalia) are mainly constituted of sialic acid-rich O-glycosylproteins. Alkaline reductive treatment of the crude material led to the release of some neutral and numerous monosialyl and disialyl oligosaccharides. These were fractionated by gel filtration, anion-exchange chromatography, and high-performance liquid chromatography. The structures of the monosialyl oligosaccharides were established by combination of sugar and methylation analysis, fast atom bombardment-mass spectrometry, and electron impact-mass spectrometry after permethylation and 1H NMR spectroscopy (at 500 MHz). Typically, some of the monosialyl oligosaccharides appeared to possess the core structure Gal beta(1----3)[GlcNAc beta(1----6)]GalNAc alpha(1----3)GalNAc-ol. Moreover, the (1----6)-linked branch consisted of an unusual di- or trigalactosyl sequence, [Gal alpha(1----4)0-1Gal beta(1----4)Gal beta (1----4)GlcNAc beta(1----6). Thus, the most complex representatives of the monosialyl fraction from Collocalia mucin were found to be: (Formula: see text) The other compounds identified are partial structures thereof.


Surgical treatment of diastasis recti: the importance of an overall view of the problem.
Diastasis recti (DR) is characterized by an alteration of the linea alba with increased inter-recti distance (IRD). It is more frequent in females, and when symptomatic or associated with midline hernia it needs to be surgically repaired. This retrospective study aims to demonstrate how an overall approach to DR leads to good results in terms of functional and morphological outcomes and quality of life (QoL). From January 2018 to December 2019, 94 patients were operated for DR > 50 mm, with or without midline hernias. Three different surgical approaches were used: complete laparoabdominoplasty, laparominiabdominoplasty and minimally invasive (endoscopic) technique. QoL was assessed with the EuraHS-QoL tool. All patients were female except two males. We performed 26 endoscopic treatments (27.7%), 39 laparoabdominoplasties (41.5%) and 29 laparominiabdominoplasties (umbilical float procedure) (30.9%). The total median operative time was 160 min. No intraoperative complications were registered. In three (4.2%) cases, major surgical complications occurred, all after open operations. In 13 open surgery cases, vacuum-assisted closure (VAC) therapy was used to repair the cutaneous ischemic defect. No recurrence was registered to date. Minimally invasive surgery showed fewer complications and lower hospital stay than the open approach. The QoL was significantly improved. Our experience shows the importance of an overall view of the functional and cosmetic impairment created by DR. The surgeon should obtain an optimal repair of the function, by open or minimally invasive surgery, also considering the morphological aspects, which are very important for the patients in terms of QoL.


[Effects of rehabilitation on functional capacity, obesity and health behavior, among cardiac patients with DM2].
Present study examines the prevalence of type 2 diabetes (DM2) in patients attending cardiac rehabilitation (CR) compared to the general population utilising data from the Icelandic Heart Association population study. The study also examined the efficacy of CR for promoting health behaviors. A prospective study among DM2 patients attending CR at Reykjalundur Rehabilitation centre. The DM2 group was compared to other cardiac patients, with respect to obesity and exercise capacity at the beginning and end of 4-6 weeks of CR. Additionally, in the DM2 group, weight, smoking cessation, physical activity and walking capacity were assessed at 3 and 6 months follow-ups. The prevalence of DM2 was 2-4 times higher in CR participants than in the general population. Compared to other CR participants, the DM2 group was heavier, with increased waist circumference and less exercise capacity. During the CR both groups lost weight and waist circumference decreased to similar extent, but the exercise capacity increased less in the DM2 group. In follow up after 6 months the DM2 group´s weight and glucose values were back to same level as before CR, but waist circumference was still decreased and they retained increased physical activity and walking capacity. DM2 is more prevalent among patients in cardiac rehabilitation than in the general population. The DM2 group was more obese, had lower exercise capacity and responded somewhat less to CR than other cardiac patients. Follow up after 6 months did however show that they continued their regular exercise and walking capacity was still retained.


[Use of emergency departments in rural and urban areas in Spain].
Describe the use of emergency departments (ED), and analyse the differences in use between residents in rural and urban areas. Using data from the National Health Survey of 2006 and 2011, the profiles of patients with ED visits by population size of place of residence were obtained. The variables associated with making one visit to the ED were also evaluated, in order to determine the effect of the population size of place of residence. A higher use of ED is observed in persons with a higher frequency of use of Primary Care and hospital admissions, and increases with worse self-perceived health and functional status, with more chronic diseases, in people from lower social classes, and younger ages. Adjusting for the other variables, residents in larger cities have a higher use of ED than residents in rural areas, who show a higher use of public and non-hospital based ED, than residents in urban areas. There is a higher use of ED by inhabitants of urban areas that cannot be justified by a worst health status of that population. This tends to indicate that the use of ED is not under-used in rural areas, but overused in urban areas.