Changes in lipid composition of liver microsomes and fatty acyl-CoA desaturase activities induced by medium chain triglyceride feeding.
Changes in fatty acid composition, microsomal delta 9- and delta 6-desaturase activities and liver contents of cholesterol and phospholipids were studied in rats fed medium chain triglyceride-supplemented diets. Weanling rats were divided into four groups and fed for three weeks a basal diet with different 10%-fat supplements: corn oil, medium chain triglyceride-corn oil, olive oil and medium chain triglyceride-olive oil. The highest relative content of saturated fatty acids corresponded to corn oil-fed animals. Both monounsaturated fatty acid content and delta 9-desaturase activity were higher in the animals fed olive oil diets than in corn oil-fed rats. The long chain polyunsaturated fatty acids of the n-3 series were increased in the olive oil and medium chain triglyceride-olive oil-fed groups probably due to the lower linoleic/alpha-linolenic ratios found in these two diets. The cholesterol/phospholipid molar ratio was unaffected by diet and the unsaturation index was only slightly changed in the four groups. Thus, some mechanism may be operative under these conditions to maintain the homeostasis of the membrane.


How Does Career Calling Influence Preservice Teachers' Learning Engagement? A Multiple Mediating Roles of Occupational Self-Efficacy and Vocational Outcome Expectation.
This study used social cognitive career theory (SCCT) to explore the relationships between career calling, occupational self-efficacy, vocational outcome expectation, and learning engagement among preservice teachers at a normal university in China. Data from 1,029 preservice teachers were analyzed using Structural Equation Modeling. The results revealed that career calling was found to be significantly and positively affected on learning engagement; occupational self-efficacy and vocational outcome expectation were identified as key mediators of this relationship. These findings advance our knowledge of how best to promote the learning engagement of preservice teachers and may inform the future design of teacher development programs.


Symptomatic treatment in multiple sclerosis-interim analysis of a nationwide registry.
To analyze symptomatic treatment in patients with multiple sclerosis (MS). Multiple sclerosis is a chronic inflammatory disease of the central nervous system, with accumulating disability symptoms like spasticity, voiding disorders, depression, and pain might occur. The nationwide German MS registry was initiated 2001 under guidance of the German MS society (Deutsche MS Gesellschaft). This study was performed as an interim analysis to lay foundation for future work on this topic. A subcohort of 5113 patients was assessed for this interim analysis. The mean age of the patients was 45.3 years; mean EDSS was 4.2. More than two-third of the enrolled patients were females (70.9%). Most frequent symptoms were fatigue (60%), followed by spasticity (52.5%) and voiding disorders (51.7%). The likelihood of treatment was highest for epileptic disorders (68.8%), spasticity (68.5%), pain (60.7%), and depression (58.9%). Multivariate regression analysis showed that retirement was the strongest factor predictive for antispastic treatment (β=.061, P=.005). Almost all patients in this analysis suffer from symptoms due to advanced MS. Treatment for the various symptoms differed tremendously. The likelihood of treatment correlated with the availability of effective therapeutic agents. Clinicians should put more awareness on MS symptoms. Symptomatic treatment may improve quality of life.


Advanced glycation endproducts interefere with integrin-mediated osteoblastic attachment to a type-I collagen matrix.
The adhesion of osteoblasts to bone extracellular matrix, of which type-I collagen constitutes >85%, can modulate diverse aspects of their physiology such as growth, differentiation and mineralisation. In this study we examined the adhesion of UMR106 rat osteoblast-like cells either to a control (Col) or advanced-glycation-endproduct-modified (AGEs-Col) type I collagen matrix. We investigated the possible role of different integrin receptors in osteoblastic adhesion, by co-incubating these cells either with beta-peptide (conserved sequence 113-125 of the beta subunit of integrins) or with two other peptides, RGD (Arg-Gly-Asp) and DGEA (Asp-Gly-Glu-Ala), which are recognition sequences for the alpha-subunits of alpha(1,5)beta(1) and alpha(2)beta(1) integrins. Collagen glycation inhibited the adhesion of UMR106 osteoblasts to the matrix (40% reduction versus Col, P > 0.001). beta-Peptide showed a dose- and glycation-dependent inhibitory effect on adhesion, and at a concentration of 100 microM decreased the attachment of UMR106 cells to both matrices (42% to Col, P<0.001and 25% to AGEs-Col, P<0.01). The synthetic peptides RGD (1mM) and DGEA (5mM) inhibited the attachment of UMR106 cells to Col (30 and 20%, P > 0.01 and P< 0.001, respectively), but not to AGEs-Col. beta-Peptide induced an increase in UMR106 cell clumping and a decrease in cellular spreading, while DGEA increased spreading with cellular extensions in multiple directions. These results indicate that both alpha and beta integrin subunits participate in osteoblastic attachment to type-I collagen, probably through the alpha(1,5)beta(1) and alpha(2)beta(1) integrins. AGEs-modification of type-I collagen impairs the integrin-mediated adhesion of osteoblastic cells to the matrix, and could thus contribute to the pathogenesis of diabetic osteopenia.


Membrane conductance changes associated with the response of motion sensitive insect visual neurons.
Intracellular recordings and impedance measurements from directionally-selective visual interneurons of the lobula plate of flies show that during motion, transmembrane conductance increases during both depolarizing responses to preferred directions and hyperpolarizing responses to anti-preferred directions. This provides direct evidence that these interneurons are postsynaptic to two separate populations of excitatory and inhibitory input elements.


Safety and efficacy of nepafenac punctal plug delivery system in controlling postoperative ocular pain and inflammation after cataract surgery.
To evaluate the safety and efficacy of a nepafenac punctal plug delivery system (N-PPDS) after cataract surgery. Three U.S. clinical sites. Prospective, multicenter, randomized (2:1), parallel-arm, double-masked, placebo-controlled, phase II pilot study. Fifty-six subjects (aged older than 22 years) with expected postcataract correctable distance vision of 20/30 or better and lower puncta allowing dilation up to 1.0 mm received either the nepafenac (N-PPDS group; n = 38 eyes) or a placebo punctal plug delivery system (p-PPDS group; n = 18 eyes). All eyes underwent routine unilateral cataract surgery with intraocular lens implantation. The primary and secondary efficacy measures were postoperative ocular pain and inflammation, respectively. There were 38 patients in the experimental N-PPDS group and 18 patients in the control group. The N-PPDS group had a significantly higher percentage of pain-free patients than that in the p-PPDS group (22/32 [69%] vs 6/16 [38%] at 3 days, P = .038; and 24/36 [67%] vs 5/16 [31%] at 7 days, P = .018). A higher percentage of patients in the N-PPDS group (15/29 [52%] vs 0/14 [0%] in p-PPDS) was pain free at all visits (P = .001). Anterior chamber cell scores were better in the N-PPDS group (patients with no anterior chamber cells: 18/36 [50%] vs 3/16 [19%] in p-PPDS; P = .034) at 7 days. The plug retention rate was 98% (55/56) at 14 days. Adverse events having a suspected relationship with the punctal plug treatment occurred in 1 case of the N-PPDS group having to do with placement and zero in the p-PPDS group. The N-PPDS was safe and effective for the management of ocular pain and inflammation after cataract surgery.


Options and limits of angle stable plates in the treatment of comminuted radial head fractures.
New angle-stable plates provide more stability and better anatomical fit than previous plates. 22 patients treated with an angle-stable plate were included. Postoperative the outcomes were evaluated according to the scoring systems of Morrey, Radin and Riseborough. 3 patients received a score of excellent, 14 good, and 5 satisfactory. We detected 3 cases of implant failure and 2 cases of postoperative neurological damage. 3 patientes received a radial head necrosis. Our results show that the angle-stable radial head locking plate can only be used in limited cases in the treatment of multi-fragment radial head fractures.


[Benign retroperitoneal schwannoma in patient with antecedents of Willm's tumor in the infancy].
We report a case of benign retroperitoneal schwannoma diagnosed casual in a 23 years old woman treated of a Wilm's tumour twenty years ago. A review of the on this unusual tumour is included.


Clinical outcome of testosterone supplementation assessed by andropausal male symptom scores in type 2 diabetes testosterone-deficient patients receiving testosterone compared to those not receiving testosterone: A nested case-control study.
This study aimed to explore the proportion of andropause in male patients with type 2 diabetes using an aging male symptoms scale and assess the clinical outcome of testosterone supplementation in patients with deficient testosterone levels at a tertiary care hospital. Male patients with diabetes and total serum testosterone levels (≤12 nmol/L) were included in the study. Patients with testosterone supplementation, the standard of care among testosterone-deficient male patients, were included in the study (n = 35). Those not exposed to testosterone supplementation were considered controls (n = 35) and reassessed over 14 weeks for aging male symptom scores (AMS). The prevalence of andropause among the participants was 11% (117/1057). Data was analyzed as per protocol analysis. Exposure group had a frequency of 25.80%, and 19.35% in moderate and severe symptoms of AMS scores. Non-exposure group had frequency of 26.66% and 23.34% in moderate and severe symptoms of AMS scores. A significant mean difference (t = -2.93, P-value <0.05) was noted between exposure and non-exposure to testosterone supplementation. Results concluded that andropause is prevalent in patients with type 2 diabetes and low testosterone levels. Testosterone therapy affects aging andropausal symptoms such as the feeling of general well-being, joint pain and muscular ache, sleep problems, anxiety, and libido among patients with type 2 diabetes.


Oral ornithine a-ketoglutarate accelerates healing of the small intestine and reduces bacterial translocation after abdominal radiation.
The effect of dietary ornithine a-ketoglutarate (OKG) on intestinal mucosal integrity and bacterial translocation was studied in rats following administration of a single dose of abdominal radiation (1100 cGy). Following the radiation injury the rats were randomized to receive a nutritionally incomplete diet which contained only water and OKG or a control diet with water and the non-essential amino-acid glycine. Four days after radiation, rats were anaesthetized and a laparotomy was performed. Cultures from mesenteric lymph nodes were taken and two tissue samples from the terminal ileum were also taken for light microscopy, protein and DNA determination. We examined the following parameters: number of villi per cm (V/cm), villus height (Vh), number of mitoses per crypt (M/c) and we measured the mucosal protein and DNA content. Nine of 16 rats who received the OKG-free diet had positive cultures but only 3 of 18 rats who received the OKG-enriched diet (P= 0.002). The group on the OKG-enriched diet had a better intestinal mucosal architecture than the group on the OKG-free diet and the studied parameters of the gut mucosa were significantly better: (V/cm: 130 +/- 8.1 vs 99 +/- 7.9, P = 0.001. Vh(mm): 0.40 +/- 0.03 vs 0.24 +/- 0.05, P= 0.002. M/c: 1.71 +/- 0.03 vs 0.34 +/- 0.2, P= 0.001, Protein (mg/cm): 2.300 +/- 0.033 vs 1.207 +/- 0.014, P = 0.002. DNA (microg/cm): 203 +/- 6.41 vs 130 +/- 4.94, P = 0.001. We conclude that OKG-enriched diet prevents the deleterious effects of radiation on intestinal mucosal morphology and integrity, abolishing thus, the increased bacterial translocation observed after abdominal radiation.


[Calcitonin gene-related peptide inhibits the expression of Nod-like receptor protein 3 to Dromote osteoblast differentiation in mouse osteoblasts in vitro].
This study aims to investigate the regulatory effects of calcitonin gene-related peptide (CGRP) on Nod-like receptor protein 3 (NLRP3) and interleukin-1β (IL-1β) to promote osteoblast differentiation. Different concentrations of CGRP (0, 10, 30, 100 ng · mL⁻¹) were added to mouse osteoblasts in vitro. The mRNA and protein expression levels of both NLRP3 and IL-1β were examined using Real-time polymerase chain reaction and Western blot, respectively. Moreover, the concentrations of IL-1β protein and intracellular reactive oxygen species (ROS) were detected using enzyme-linked immunosorbent assay and flow cytometry, respectively. The osteogenic differentiation of mouse osteoblasts was identified through alizarin red staining. The protein and mRNA expression levels of both NLRP3 and IL-1β significantly decreased (P < 0.05) with increasing CGRP concentration. Moreover, the contents of intracellular ROS gradually decreased (P<0.05). The osteogenic differentiation of the osteoblasts was more enhanced in the group treated with 100 ng · mL⁻¹ CGRP than in the empty group (0 ng · mL⁻¹ CGRP). CGRP promotes osteoblast differentiation by inhibiting the expression of inflammatory factors.


Prediction of the invasive level of basal cell carcinomas in the facial area: Analysis of 718 Japanese cases.
Basal cell carcinoma (BCC) is the most common skin cancer. While Mohs micrographic surgery is commonly accepted for BCC treatment, surgical excision with free margins is widely considered the best treatment modality for BCCs in Japan. However, little is known about the predictors of the invasion levels of BCCs. To investigate the optimization of deep surgical margins by identifying factors significantly influencing the invasion levels of facial BCCs. The tumor invasion level was defined as the deepest part of a tumor. Tumor thickness was measured from the top of the granular layer to the deepest extension of the tumor or from the ulcer base overlying the deepest point of invasion in ulcerated lesions. Factors independently associated with tumor thickness and invasion level were identified by multivariate analysis. Six variables were tested: age, sex, anatomical region (nose, orbit, others), histologic pattern (aggressive, non-aggressive), presence of pigmentation, and diameter. We included 718 cases of facial BCCs involving 705 Japanese patients. The most frequent anatomical region and histologic pattern were the nose and nodular pattern, respectively. Only tumor diameter showed a correlation with tumor thickness (β = 0.377, P < 0.001). Tumor diameter (AOR = 71.189, 95 % CI: 11.420-430.931, P = 0.01) and the following anatomical regions showed correlations with the invasion level: nose/others: AOR=2.769, 95 % CI: 1.235-6.493, P = 0.01; orbit/others: AOR=6.369, 95 % CI: 2.728-15.429, P < 0.001; orbit/nose: AOR=2.300, 95 % CI: 1.056-4.984, P = 0.04. This study serves as a guide for optimizing deep surgical margins and planning surgery for facial BCCs considering independently associated factors.


[The evaluation of concentration myeloperoxidase and interleukin-8 in blood serum of pregnant women with or without pregnancy induced hypertension].
In the serum of woman during the pregnancy with and without PIH the activity of interleukin-8 and myeloperoxydase was measured. 40 pregnant woman with PIH and 16 normal pregnant woman were included in the study. We have not found significative difference between examined populations.


Generation and consequence of nano/microplastics from medical waste and household plastic during the COVID-19 pandemic.
Since the end of 2019, the world has faced a major crisis because of the outbreak of COVID-19 disease which has created a severe threat to humanity. To control this pandemic, the World Health Organization gave some guidelines like wearing PPE (personal protective equipment) (e.g., face masks, overshoes, gloves), social distancing, hand hygiene and shutting down all modes of public transport services. During this pandemic, plastic products (e.g., household plastics, PPE and sanitizer bottles) have substantially prevented the spread of this virus. Since the outbreak, approximately 1.6 million tons of plastic waste have been generated daily. However, single-use PPE like face masks (N95), surgical masks and hand gloves contain many non-biodegradable plastics materials. These abandoned products have created a huge number of plastic debris which ended up as microplastics (MPs) followed by nanoplastics (NPs) in nature that are hazardous to the eco-system. These MPs and NPs also act as vectors for the various pathogenic contaminants. The goal of this review is to offer an extensive discussion on the formation of NPs and MPs from all of these abandoned plastics and their long-term impact on the environment as well as human health. This review paper also attempts to assess the present global scenario and the main challenge of waste management to reduce the potential NP/MPs pollution to improve the eco-systems.


Frosted branch angiitis caused by Varicella Zoster virus in an immunocompetent patient.
Frosted branch angiitis(FBA) is a panuveitis with sheating of all retinal vesssels. Herein we report an immunocompetent person who presented with fever, headache, atypical rash, and hazy vision. Ophthalmoscopy of both eyes revealed perivascular sheathing with frosted branch angiitis pattern in veins, patchy retinal hemorrhages. Aqueous PCR analysis turned positive for VZV. This case illustrates that VZV should be considered in the differential diagnosis of retinal perivasculitis. Since a rapid and accurate diagnosis is crucial for prompt administration of antiviral therapy, PCR-based analysis of aqueous humor is a valuable tool for detecting viruses.


A brief review of techniques used to seal corneal perforation using cyanoacrylate tissue adhesive.
There are many modalities in use to treat corneal perforations. One of most commonly used modality these days is the use of tissue adhesive. Cyanoacrylate adhesive is the commonest type of tissue adhesive used. To describe various techniques used for corneal glueing with cyanoacrylate tissue adhesive and to suggest a new technique for the same. We describe here a brief review of different techniques of tissue glue application and suggest a modified new technique to apply tissue glue over the area of corneal perforation to achieve a nice smooth and stable seal. The importance of good glueing technique is to provide a stable and a closed wound so that it can help the epithelium grow and close the perforation. We present three different techniques of corneal glueing to seal corneal perforations. These different techniques of glueing can be used to seal corneal perforations. It is up to the reader to try all three techniques and then follow whichever gives the best and smooth results.


Chromosome doubling influences the morphological, physiological, biochemical and genetic traits related to essential oil biosynthesis of peppermint (Mentha piperita) under salinity stress.
Peppermint (Mentha piperita L.) is an important medicinal aromatic plant. In this study, the morphology, physiology, biochemistry and gene expression of chromosomes doubling peppermint (D1 lines) were analyzed. The analysis showed that D1 lines had larger, thicker and darker leaves, and stronger roots when planted in the pots, but delayed growth in the field condition. Under NaCl stress, the D1 lines increased cell oxidative defense through more active antioxidant enzymes and decreased the oxidative damages of cell membrane, leading to a significantly greater survival rate and photosynthesis intensity than WT lines. The size and density of glandular trichomes of D1 lines was larger, which contributed to its higher essential oil yield. In addition, chromosome doubling reduced the inhibition of NaCl stress on essential oil yield and quality, through changing the expression of genes in the oil biosynthesis pathway. The traits of chromosome doubling peppermint provide new technical and theoretical evidence for peppermint germplasm improvement.


Law, ethics and clinical judgment in end-of-life decisions--how do Norwegian doctors think?
According to Norwegian law, an autonomous patient has the right to refuse life-prolonging treatment. If the patient is not defined as dying, however, health personnel are obliged to instigate life-saving treatment in an emergency situation even against the patient's wishes. The purpose of this study was to investigate how doctors' attitudes and knowledge agree with these legal provisions, and how the statutory provision on emergency situations influences the principle of patient autonomy for severely ill, but not dying, patients. A strategic sample of 1175 Norwegian doctors who are specialists in internal medicine, paediatrics, surgery, neurology and neurosurgery received a mail questionnaire about decisions on end-of-life care in hypothetical scenarios. The case presented concerns a 45-year-old autonomous patient diagnosed with end-stage ALS who declines ventilatory treatment. Recipients were randomly selected from the membership roster of the Norwegian Medical Association. 640 (54.5%) responded; of these, 406 had experience with end-of-life decisions. 56.1% (221/394) stated that ALS patients in such situations can always refuse life-prolonging treatment, and 42.4% (167/394) were of the opinion that the patient can normally refuse life-prolonging treatment. 1.5% (6/394) stated that the patient cannot refuse life-prolonging treatment. The answers indicate that the respondents include patients' refusal in an overall clinical judgement, and interpret patients' right to decline life-saving treatment in different ways. This may reflect the complex legal situation in Norway regarding patient autonomy with respect to the right of severely ill, but not dying, patients' right to decline acute life-saving treatment.


Targeted antiangiogenic agents in combination with cytotoxic chemotherapy in preclinical and clinical studies in sarcoma.
Sarcomas are a heterogeneous group of mesenchymal malignancies. In recent years, studies have demonstrated that inhibition of angiogenic pathways or disruption of established vasculature can attenuate the growth of sarcomas. However, when used as monotherapy in the clinical setting, these targeted antiangiogenic agents have only provided modest survival benefits in some sarcoma subtypes, and have not been efficacious in others. Preclinical and early clinical data suggest that the addition of conventional chemotherapy to antiangiogenic agents may lead to more effective therapies for patients with these tumors. In the current review, the authors summarize the available evidence and possible mechanisms supporting this approach.


Unplanned Return to the Operating Room after Elective Oncologic Thoracic Surgery: A Further Quality Indicator in Surgical Oncology.
Background: An unplanned return to the operating room (UROR) is defined as a readmission to the operating room because of a complication or an untoward outcome related to the initial surgery. The aim of the present report is to evaluate the role of URORs after elective oncologic thoracic surgery. Methods: In the study, 4012 consecutive patients were enrolled; among them, 71 patients (1.76%) had an unplanned return to the operating room. Age, sex, Charlson comorbidity index, induction treatments, type of the first operation, indication to readmission to the operating room and type of second operation, length of stay, complication after reoperation and outcomes were collected. Results: The mean age was 63.3 (SD: 13.0); there were 53 male patients (74.6%); the type of the first procedure was: lower lobectomy (11.3%), middle lobectomy (1.4%), upper lobectomy (22.5%), metastasectomy (5.6%), extrapleural pneumonectomy (4.2%), pneumonectomy (40.9%), pleural biopsy (5.6%) and other procedures (8.5%). Patients presenting complications after UROR had undergone a significantly longer first procedure (p < 0.02), had a longer length of stay (p < 0.001) and had higher post-operative mortality (p < 0.001). Conclusions: The patients experiencing UROR after elective oncologic thoracic surgery have significantly higher morbidity and mortality rates when compared to standard thoracic surgery. Bronchopleural fistula remains the most lethal complication in patients undergoing UROR.


Assessment of diaphragm function after stellate ganglion block using magnetic stimulation.
Stellate ganglion block is a procedure frequently used for the management of patients with chronic sympathetically mediated pain affecting the arm, neck or head. We studied the effect of stellate ganglion block on ipsilateral phrenic nerve function, and hence diaphragmatic strength, in 11 adult patients with chronic sympathetically mediated pain. Pre- and post-block forced vital capacity (FVC) measurements were recorded using a pneumotachograph and a Magstim nerve stimulator was used to generate pre- and post-block twitch mouth pressures (P(TWM)). This device can be used to stimulate the phrenic nerves and hence the diaphragm. The resulting change in airway pressure was measured at the mouth and has previously been shown to reflect diaphragm strength. There was no statistically significant difference in FVC or P(TWM) pre- or post stellate ganglion block. In conclusion, a stellate ganglion block has no adverse effect on ipsilateral phrenic nerve function or diaphragm strength in healthy adult patients.


Ground Waste Tire Rubber as a Total Replacement of Natural Aggregates in Concrete Mixes: Application for Lightweight Paving Blocks.
The use of waste materials as alternative aggregates in cementitious mixtures is one of the most investigated practices to enhance eco-sustainability in the civil and construction sectors. For specific applications, these secondary raw materials can ensure adequate technological performance, minimizing the exploitation of natural resources and encouraging the circular disposal of industrial or municipal waste. Aiming to design and develop lightweight paving blocks for pedestrian or very light-traffic purposes (parking area, garage, sidewalk, or sports surfaces), this paper presents the material characterization of rubberized cement mortars using ground waste tire rubber (0-1 mm rubber powder and 1-3 mm rubber granules) to totally replace the mineral aggregates. Considering recommended requirements for concrete paving members in terms of mechanical strength, water drainage performance, acoustic attenuation, and dynamic and energy absorption behavior, a comprehensive laboratory testing is proposed for five different formulations varying the sand-rubber replacement level and the proportion ratio between the two rubber fractions. Tests highlighted positive and promising results to convert laboratory samples into pre-cast members. The "hot" finding of the work was to prove the feasibility of obtaining totally rubberized mortars (0 v/v% of sand) with suitable engineering performance and enhanced eco-friendly features.


Vasoactive hormones in the renal response to systemic sepsis.
The pathophysiology of renal dysfunction in generalized sepsis remains unknown. In this study, 24 hours after surgical induction of peritonitis in 20 volume-loaded sheep, three patterns of renal function were seen. In group 1 (n = 8), glomerular filtration rate (GFR) decreased by 70%, urine volume by 85%, absolute sodium excretion by 95%, and fractional sodium excretion by 83%. Group 2 (n = 4) exhibited similar sodium retention but GFR did not fall. Group 3 (n = 8) showed no change in GFR or urine volume and only minimally reduced sodium excretion. Mean arterial pressure fell 17% in group 1 only; central venous pressure, pulmonary capillary wedge pressure, and plasma volume were maintained at or above presepsis values in all groups. Cardiac index was either increased or unchanged, and renal plasma flow was maintained in all groups; there was thus no hemodynamic evidence to suggest volume contraction. Histologic examination showed only minor changes with no consistent pattern. Renal functional changes correlated with other manifestations of severe sepsis--GFR and sodium retention correlated significantly with increased cardiac index, decreased systemic vascular resistance, pulmonary arterial hypertension, leukopenia, hypoproteinemia, and hypoglycemia. All of these changes were most marked in group 1. In groups 1 and 2, plasma renin activity (PRA) increased and urinary kallikrein excretion decreased. PRA correlated inversely with GFR, urine volume, and sodium excretion; urinary kallikrein excretion correlated positively with urine volume and sodium excretion. Urinary excretion of 6-keto-PGF1 alpha was increased in groups 1 and 2 and correlated inversely with mean arterial pressure in group 1 animals. During sepsis, urinary thromboxane B2 excretion continued at presepsis values in all groups. The results suggest that unusual reciprocal changes in activity of the renin-angiotensin and renal kallikrein-kinin systems may play a role in the renal response to sepsis. PGI2 synthesis is increased and may affect systemic hemodynamics and renal function; the role of thromboxane A2 in this context is unknown.


The impact of the meta-analysis of pulmonary rehabilitation by Lacasse and colleagues: transforming pulmonary rehabilitation from "art to science".
#Pulmonaryrehab was transformed in the 1990s into the standard of care for COPD: this article focuses on the impact of the 1996 meta-analysis by Lacasse and colleagues which provided the evidence to silence the sceptics https://bit.ly/3MIntBC.


Multi-analyte gas chromatography-mass spectrometry method to monitor bisphenols, musk fragrances, ultraviolet filters, and pesticide residues in seafood.
A gas chromatography-mass spectrometry method for the analysis of thirty-six anthropogenic contaminants in the edible portion of four distinct seafood items is reported. Considering the heterogeneous composition of algae, mussels, and lean/fatty fish muscles, a generic sample preparation based on the QuEChERS procedure combined with dispersive liquid-liquid microextraction (DLLME) with in situ acetylation was successfully applied for quantification of pesticide residues, bisphenols, musk fragrances and UV-filters. Matrix effects were influenced by the type of seafood, with the lowest effects being observed with EMR-lipid and graphitized carbon black sorbents in dispersive solid-phase extraction cleanup step. Method performance features were successful evaluated in the different seafood samples - algae, mussel, lean and fatty fish muscles, following the criteria established by SANTE/12682/2019 for analytical methods for pesticide residues analysis. The detection and quantification of bisphenol F, musk fragrances (galaxolide and tonalide), UV-filters (2-ethylhexyl salicylate, 2-ethylhexyl 4-methoxycinnamate, and isoamyl 4-methoxycinnamate), and residues of permethrin in commercial samples of algae, mussel and fish collected in a Portuguese estuary support the suitability of the proposed method for future seafood monitoring by food safety authorities.


Early motor development of children with a congenital cytomegalovirus infection.
Congenital cytomegalovirus (cCMV) infection is the most important etiology of non-hereditary childhood hearing loss and an important cause of neurodevelopmental delay. The current study aimed to investigate the early motor development of symptomatic and asymptomatic cCMV infected children with and without sensorineural hearing loss (SNHL). Sixty-four children with a cCMV infection, without cerebral palsy, were compared to a control group of 107 normal hearing children. They were assessed around the ages of 6, 12, and 24 months with the Peabody Developmental Motor Scales-2 (PDMS-2), Alberta Infant Motor Scales (AIMS), and Ghent Developmental Balance Test (GDBT). The cCMV infected children were subdivided into a symptomatic (n=26) and asymptomatic cCMV group (n=38) but also into a cCMV group with SNHL (n=19) and without SNHL (n=45). Symptomatic cCMV infected children and cCMV infected children with SNHL performed significantly weaker for all gross motor outcome measures. A congenital CMV infection is a risk factor for a delay in the early motor development. Follow-up will be necessary to gain insight into the exact cause of this motor delay and to define the predictive value of early motor assessment of cCMV infected children.


Major impact of an early bone marrow checkpoint (day 21) for minimal residual disease in flow cytometry in childhood acute lymphoblastic leukemia.
The early persistence of minimal residual disease (MRD) is considered a poor prognostic factor indicative of chemoresistance in acute lymphoblastic leukemia. In French children, chemosensitivity is assessed at day 21 post-induction by cytomorphology. Here, it was investigated whether a more precise evaluation could be obtained at this time point with multiparameter flow cytometry (MFC). This study enrolled 123 children with de novo acute lymphoblastic leukemia. MRD0 was investigated at day 21 in MFC with a combination of antibodies based on the immunophenotype of diagnosis. It was also evaluated at day 35 by immunoglobulin/T-cell receptor quantitative real-time polymerase chain reaction (MRD1). Three risk groups could be delineated based on MRD0. Patients with MFC/MRD0 levels >10-2 (n = 25) were considered high risk, those with levels between 10-2 and 10-4 (n = 46) intermediate risk, and those <10-4 (n = 50) low risk. Overall survival (p = 0.048) and event-free survival (EFS, p = 0.00017) were significantly different between these three groups. EFS of the 14 corticoresistant patients strongly depended on their MRD0 level (p = 0.004). Similarly, both EFS (p = 0.0004) and overall survival (p = 0.02) were significantly different in the 109 chemosensitive patients, according to MRD0 levels. MRD0 and MRD1 levels, compared with 112 patients, were consistent (-/- or +/+) in 57.2% of the cases. Both MRD0+/MRD1+ and MRD0+/MRD1- patients had a significantly worse EFS (p = 0.0001) than those with undetectable MRD at both MRD0 and MRD1. This study confirms the usefulness and superiority of an early point of MRD detection by MFC. In addition, MRD0 in MFC identifies a subgroup of patients with poorer prognosis (MRD0+/MRD1-). Copyright © 2015 John Wiley & Sons, Ltd.


Sequential first-pass elimination of a metabolite derived from a precursor.
We examined data from our previous studies in which we not only delivered perfusate containing tracer concentrations of [14C]phenacetin and its metabolite [3H]acetaminophen under constant perfusate flow (10 ml/min/liver) into the rat liver preparation just once, but also recirculated fresh reservoir perfusate containing a tracer dose of [14C]phenacetin through the same rat liver preparation. From the single-pass studies, estimates of fm, the fractional rate of conversion for [14C]phenacetin to form [14C]acetaminophen, and F(M.P), the apparent availability of [14C]acetaminophen, were obtained by determining the concentrations of [14C]acetaminophen in the perfusate before and after incubation with Glusulase. These estimates were fm = 0.871 +/- 0.16 and F(M.P) = 0.43 +/- 0.10. These and the steady-state clearance values of phenacetin (9.1 +/- 0.8 ml/min) and acetaminophen (6.7 +/- 0.7 ml/min) from the single-pass studies were used to predict the concentrations of [14C]acetaminophen in the reservoir perfusate on recirculation of [14C]phenacetin. We found that the sequential first-pass elimination of the metabolite must be considered when the metabolite is highly extracted by the liver. If we had neglected to take this into account, the fractional rate of conversion of a precursor to form a metabolite and the rate of formation of the metabolite would have been underestimated by the factor F(M.P).


The Feasibility of Maintaining Biological Phosphorus Removal in A-Stage via the Short Sludge Retention Time Approach: System Performance, Functional Genus Abundance, and Methanogenic Potential.
The increasing concerns on resource and energy recovery call for the modification of the current wastewater treatment strategy. This study synthetically evaluates the feasibility of the short sludge retention time approach to improve the energy recovery potential, but keeping steady biological phosphorus removal and system stability simultaneously. SBRS-SRT and SBRcontrol that simulated the short sludge retention time and conventional biological phosphorus removal processes, respectively, were set up to treat real domestic sewage for 120 d. SBRS-SRT achieved an efficient COD (91.5 ± 3.5%), PO43--P (95.4 ± 3.8%), and TP (93.5 ± 3.7%) removal and maintained the settling volume index around 50 mL/gSS when the sludge retention time was 3 d, indicating steady operational stability. The poor ammonia removal performance (15.7 ± 7.7%) and a few sequences detected in samples collected in SBRS-SRT indicated the washout of nitrifiers. The dominant phosphorus accumulating organisms Tetrasphaera and Hydrogenophaga, which were enriched with the shortened sludge retention time, was in line with the excellent phosphorus performance of SBRS-SRT. The calculated methanogenic efficiency of SBRS-SRT increased significantly, which was in line with the higher sludge yield. This study proved that the short sludge retention time is a promising and practical approach to integrate biological phosphorus removal in A-stage when re-engineering a biological nutrient removal process.


Long COVID: rheumatologic/musculoskeletal symptoms in hospitalized COVID-19 survivors at 3 and 6 months.
To document the detailed characteristics including severity, type, and locations of rheumatic and musculoskeletal symptoms along with other COVID-19 persistent symptoms in hospitalized COVID-19 survivors at 3 and 6 months. In this extension cohort study, two telephone surveys at 3 and 6 months following the hospitalization were carried out. In these telephone surveys, participants were asked regarding their symptoms through a previously designed standard questionnaire. At 3 months, 89.0% of survivors had at least one symptom, 74.6% had at least one rheumatic and musculoskeletal symptom, and 82.1% had at least one other COVID-19 symptom. At 6 months, 59.6% of survivors had at least one symptom, 43.2% had at least one rheumatic and musculoskeletal symptom, and 51.2% had at least one other COVID-19 symptom. Regarding the rheumatic and musculoskeletal symptoms, 31.6% had fatigue, 18.6% had joint pain, and 15.1% had myalgia; and regarding the other-COVID-19-symptoms, 25.3% had dyspnea, 20.0% had hair loss, and 17.2% sweat at 6 months. In an adjusted model, female patients were more likely to have fatigue (OR: 1.99, 95% CI: 1.18-3.34), myalgia (3.00, 1.51-5.98), and joint pain (3.39, 1.78-6.50) at 6 months. Approximately 3 in 5 patients had at least one symptom with ≈2 in 5 patients had at least one rheumatic and musculoskeletal symptom. Fatigue, joint pain, and myalgia were the most frequent rheumatic and musculoskeletal symptoms. Joint pain and myalgia were mostly widespread. This information guide rheumatologists to understand the nature and features of persistent rheumatic and musculoskeletal symptoms in hospitalized COVID-19 survivors and may contribute to better management of these individuals. Key Points • Approximately 3 in 5 patients had at least one symptom with ≈2 in 5 patients had at least one rheumatic and musculoskeletal symptom at 6 months • Fatigue, joint pain, and myalgia were the most frequent rheumatic and musculoskeletal symptoms followed by back pain, low back pain, and neck pain • Dyspnea, hair loss, and sweat were the most frequent other-COVID-19-symptoms.


A community based study on haemoglobinopathies and G6PD deficiency among particularly vulnerable tribal groups in hard-to-reach malaria endemic areas of Odisha, India: implications on malaria control.
Haemoglobinopathies and G6PD deficiency are inherited disorders found mostly in malaria-endemic areas among different tribal groups of India. However, epidemiological data specific to Particularly Vulnerable Tribal Groups (PVTGs), important for planning and implementing malaria programmes, is limited. Therefore, the present community-based study aimed to assess the prevalence of haemoglobinopathies and G6PD deficiency among the 13 PVTGs found in the state of Odisha, reporting the maximum malaria cases in the country. This cross-sectional study was conducted from July 2018 to February 2019 in 12 districts, home to all 13 PVTGs, in an estimated sample size of 1461, selected two-stage sampling method. Detection of haemoglobinopathies was done by the variant analyser. Screening of G6PD deficiency was carried out using DPIP method followed by quantification using spectrophotometry. The PCR-RFLP technology was used to determine variant of G6PD deficiency and haplotype analysis of sickle cell, while ARMS-PCR and GAP-PCR was used for detecting the mutation pattern in β-thalassaemia and α-thalassaemia respectively. The diagnosis of malaria was done by Pf-PAN RDT as point of care, followed by nPCR for confirmation and Plasmodium species identification. The prevalence of sickle cell heterozygotes (AS) was 3.4%, sickle cell homozygous (SS) 0.1%, β-thalassaemia heterozygotes 0.3%, HbS/β-thalassaemia compound heterozygote 0.07%, HbS-α-thalassaemia 2.1%, G6PD deficiency 3.2% and malaria 8.1%. Molecular characterization of βS revealed the presence of Arab-Indian haplotype in all HbS cases and IVS 1-5 G → C mutation in all β-thalassaemia cases. In case of α-thal, αα/α-3.7 gene deletion was most frequent (38%), followed by αα/α-4.2 (18%) and α-3.7/α-3.7 (4%). The frequency of G6PD Orissa (131C → G) mutation was found to be 97.9% and G6PD Mediterranean (563C → T) 2.1%. Around 57.4% of G6PD deficient individuals and 16% of the AS were found to be malaria positive. The present study reveals wide spread prevalence of sickle cell anaemia, α-thalassaemia, G6PD deficiency and malaria in the studied population. Moderate to high prevalence of G6PD deficiency and malaria warrants G6PD testing before treating with primaquine (PQ) for radical cure of Plasmodium vivax. Screening and counselling for HbS is required for the PVTGs of Odisha.


Synthesis of α-Alkenyl α,β-Unsaturated Ketones via Dehydrogermylation of Oxagermacycles with Regeneration of the Germanium(II) Species.
The synthesis of α-alkenyl α,β-unsaturated ketones using germanium(II) salts is reported. Oxagermacycles derived from α,β-unsaturated ketones with germanium(II) salts and aldehydes can be transformed into α-alkenyl α,β-unsaturated ketones. Ammonium salts promoted the elimination of Ge(II) species to afford the two classes of α-alkenyl α,β-unsaturated ketones in good yields. The α-alkenyl α,β-unsaturated ketones are precursors for multisubstituted heterocycles.


Progress and future prospective of FDG-PET/CT imaging combined with optimized procedures in lung cancer: toward precision medicine.
With a 5-year overall survival of approximately 20%, lung cancer has always been the number one cancer-specific killer all over the world. As a fusion of positron emission computed tomography (PET) and computed tomography (CT), PET/CT has revolutionized cancer imaging over the past 20 years. In this review, we focused on the optimization of the function of 18F-flurodeoxyglucose (FDG)-PET/CT in diagnosis, prognostic prediction and therapy management of lung cancers by computer programs. FDG-PET/CT has demonstrated a surprising role in development of therapeutic biomarkers, prediction of therapeutic responses and long-term survival, which could be conducive to solving existing dilemmas. Meanwhile, novel tracers and optimized procedures are also developed to control the quality and improve the effect of PET/CT. With the continuous development of some new imaging agents and their clinical applications, application value of PET/CT has broad prospects in this area.


Synthesis and antiulcer activity of the metabolites of 2-(4-ethyl-1-piperazinyl)-4-phenylquinoline dimaleate (AS-2646), a novel gastric antisecretory and antiulcer agent.
The metabolites 3 and 4 of 2-(4-ethyl-1-piperazinyl)-4-phenylquinoline dimaleate (AS-2646, 1), a candidate as a gastric antisecretory and antiulcer drug, were synthesized to confirm the proposed structures. The effects of the metabolites 2-4 on ulcer induced by stress were determined.


Replacement therapy with levothyroxine modulates platelet activation in recent-onset post-thyroidectomy subclinical hypothyroidism.
Subclinical hypothyroidism has been linked to increased risk of atherosclerotic disease. Soluble CD40 ligand (sCD40L), mainly derived from activated platelets, and the lipid peroxidation product 8-iso-prostaglandin F2α (8-iso-PGF2α) are known to play a relevant pathophysiological role in atherogenesis. In this study, we analyzed the relationship between thyroid hormones and circulating levels of sCD40L and 8-iso-PGF2α in patient with recent-onset post-thyroidectomy subclinical hypothyroidism under replacement therapy. Circulating levels of thyroid hormones, sCD40L, and 8-iso-PGF2α were assessed in 40 recently thyroidectomized patients (33 females, mean age 52.0 ± 11.7 years) at baseline (5-7 day after surgery) and after 2 months under replacement therapy with levothyroxine (LT-4). At baseline, circulating levels of thyroid hormones were indicative of a subclinical hypothyroidism (TSH 7.7 ± 3.9 μU/mL, FT3 1.8 ± 0.6 pg/mL, and FT3 8.9 ± 3.0 pg/mL). Circulating levels of sCD40L and 8-iso-PGF2α were directly correlated with each other (r = 0.360, p = 0.023) and with TSH levels (r = 0.322, p = 0.043 and r = 0.329 p = 0.038, respectively). After 2 months under the replacement therapy with LT-4 circulating levels of TSH (from 7.7 ± 3.9 to 2.7 ± 2.8 μU/mL, p < 0.0001), sCD40L (from 6.11 ± 2.41 to 2.43 ± 2.00 ng/mL, p < 0.0001) and 8-iso-PGF2α (from 45.33 ± 6.94 to 40.36 ± 6.20, p < 0.0001) significantly decreased. Changes in circulating levels of sCD40L and 8-iso-PGF2α were directly correlated with each other (r = 0.349 p = 0.028) and with changes in TSH levels (r = 0.367 p = 0.020 and r = 0.339 p = 0.032, respectively). Our study suggests an influential role of TSH on proatherogenic activation of platelets, probably through enhanced lipid peroxidation. These findings could partially explain the increased susceptibility of patients with subclinical hypothyroidism to develop atherosclerotic disease.


[Genetic polymorphism of a pelagic fish species, little Baikal oilfish Comephorus dybowski, deduced from analysis of microsatellite loci].
Intraspecific genetic polymorphism of a Baikal Lake endemic, little Baikal oilfish (Comephorus dybowski Korotneff, 1905), was evaluated based on microsatellite analysis. Six microsatellite loci designed for the European sculpin, Cottus gobio, were used. Each locus was typed using 25 to 35 individuals from each of the Baikal trenches (southern, middle, and northern). Analysis of genetic differentiation (F(ST) and R(ST)) revealed no statistical significant differences between the samples. The data showed that the target species was represented by a single panmictic stable population.


Thresholds in the relationship between mortality and left ventricular hypertrophy defined by electrocardiography.
Electrocardiographic criteria for the diagnosis of left ventricular hypertrophy in current use were defined using autopsy results or echocardiography; criteria defined using mortality might be more clinically meaningful. Using data from Third National Health and Nutrition Examination Survey (NHANES III), we selected electrocardiographic measures that best differentiated those surviving at 5 years from those who did not. We identified voltage thresholds using regression techniques and then compared survival for subjects above and below the thresholds. Cornell voltage, Cornell product, and Novacode estimate of left ventricular mass index were discriminative for mortality and had identifiable thresholds present in their relationships with mortality. Independent of systolic blood pressure, there were significant associations with 5-year mortality for Novacode index above threshold; hazard ratios were 1.58 for women and 1.27 for men, and for 5-year cardiovascular mortality were 1.78 for women and 2.34 for men. Electrocardiographic criteria for left ventricular hypertrophy validated against mortality might be clinically useful.


Erythropoietin biosimilars currently available in hematology-oncology.
The discovery of epoietin (EPO) and the cloning of its gene facilitated the understanding of the mechanism of control behind red blood cell formation. This cloning was followed by the commercial development of recombinant human EPO (rHuEPO). The use of erythropoiesis-stimulating agents (ESAs) (epoietin, ESA, EPO) is important for the treatment of anemia in patients with chronic renal failure and cancer patients with chemotherapy-induced anemia. After several years of discussions, debates and questions, ESA, intravenous iron and blood transfusions seem to have finally found their respective indications in the treatment of anemia in cancer patients receiving chemotherapy. Now, a new question arises: What is the role of ESA biosimilars?


Evaluating diabetic ketoacidosis via a MOF sensor for fluorescence imaging of phosphate and pH.
Herein, a new type of composite metal-organic framework sensor for evaluating diabetic ketoacidosis was designed and prepared using in situ fluorescence imaging of phosphate and pH, which provides a new way to effectively evaluate the diabetic complication-ketoacidosis in the early clinical stage.


Trans-arterial embolization of renal cell carcinoma: a systematic review and meta-analysis.
To evaluate if trans-arterial embolization (TAE) of the primary tumor in patients with renal cell carcinoma (RCC) improves symptomatology such as pain and hematuria or oncologic outcomes such as progression-free survival (PFS) and overall survival (OS). The systematic review search included PubMed, Ovid/MEDLINE, and Embase for full-text English articles including randomized and non-randomized prospective trials as well as prospective and retrospective case series. To be included, prospective trials needed ≥ 25 patients in each arm while case series and retrospective chart reviews required at least two patients. Evaluated outcomes included PFS, OS, change in tumor size, improvements in pain, improvements in hematuria, and adverse events (AEs). 1327 articles were retrieved and screened. Nine studies met inclusion criteria (retrospective case series, n = 8; non-randomized prospective trial, n = 1) which included 237 patients (M = 156 (65.8%); F = 56 (23.6%); gender unreported = 25 (10.5%); mean age: 69.4 (range: 38-87)) with a mean tumor diameter of 9.3 cm (5.2-10.5). When reported, the TNM stages were stage I (n = 10), II (n = 18), III (n = 36), and IV (n = 121). 60 patients were treated for pain and hematuria. After TAE, pain improved in 59 patients (98.3%) and hematuria improved in 57 patients (95%). A meta-analysis for improvements in pain and hematuria demonstrated an event rate of pain improvement of 0.952 (0.788-0.990; p < 0.001) and an event rate for hematuria improvement of 0.923 (0.809-0.971; p < 0.001). Median OS ranged from 1 to 39 months but only one study reported PFS (10.5 months). Only one study demonstrated a statistically significant improvement in OS with TAE when compared with patients that did not undergo TAE (p = 0.02). A reduction in tumor size was only achieved in 17 patients (17/49; 34.7%) limiting evaluation. AEs included fever (n = 115/237; 48.5%), flank pain (n = 72/237; 30.4%), nausea (n = 58/237; 24.5%), hematuria (n = 12/237; 5.1%), hypertension (n = 12/237; 5.1%), reduced GFR (n = 6/237; 2.5%), hematoma (n = 6/237,2.5%), and ileus (n = 3/237; 1.3%). TAE monotherapy of the primary tumor in patients with RCC improves symptomatology such as pain and hematuria with an acceptable safety profile.


In infants with congenital heart disease autonomic dysfunction is associated with pre-operative brain injury.
Brain injury is a serious and common complication of critical congenital heart disease (CHD). Impaired autonomic development (assessed by heart rate variability (HRV)) is associated with brain injury in other high-risk neonatal populations. To determine whether impaired early neonatal HRV is associated with pre-operative brain injury in CHD. In infants with critical CHD, we evaluated HRV during the first 24 h of cardiac ICU (CICU) admission using time-domain (RMS 1, RMS 2, and alpha 1) and frequency-domain metrics (LF, nLF, HF, nHF). Pre-operative brain magnetic resonance imaging (MRI) was scored for injury using an established system. Spearman's correlation coefficient was used to determine the association between HRV and pre-operative brain injury. We enrolled 34 infants with median birth gestational age of 38.8 weeks (IQR 38.1-39.1). Median postnatal age at pre-operative brain MRI was 2 days (IQR 1-3 days). Thirteen infants had MRI evidence of brain injury. RMS 1 and RMS 2 were inversely correlated with pre-operative brain injury. Time-domain metrics of autonomic function measured within the first 24 h of admission to the CICU are associated with pre-operative brain injury, and may perform better than frequency-domain metrics under non-stationary conditions such as critical illness. Autonomic dysfunction, measured by heart rate variability (HRV), in early transition is associated with pre-operative brain injury in neonates with critical congenital heart disease. These data extend our earlier findings by providing further evidence for (i) autonomic dysfunction in infants with CHD, and (ii) an association between autonomic dysfunction and brain injury in critically ill neonates. These data support the notion that further investigation of HRV as a biomarker for brain injury risk is warranted in infants with critical CHD.


The Impact of End-of-Life Care Among Nurses Working in the Pediatric Intensive Care Unit.
Health care providers caring for patients at the end of life (EOL) are faced with a multitude of emotions such as guilt, anger, sadness, and helplessness. Because of the negative impact of initiating EOL care (EOLC) to the pediatric population, organizations must be proactive in instituting education and resources on EOLC. They must also provide advanced skills to nurses who take care of patients at their EOL. Understanding the consequences of providing EOL care to patients in the pediatric intensive care unit allows for better allocation of resources and support services for nurses. This improves patient outcomes and nurse retention.


Comparison of sound touch elastography and quantification for assessing the renal pathologic changes in patients with proteinuria.
Sound touch elastography (STE) and sound touch quantification (STQ) are novel imaging methods to evaluate tissue stiffness. This study aims to investigate renal stiffness in patients with chronic kidney disease (CKD) by STE and STQ, using renal biopsy as 'gold standard'. Between 2019 January and 2022 June, 60 patients who underwent renal biopsy for proteinuria (cases) and 45 healthy volunteers (controls) at our hospital were included in this study. The maximum and mean elastic modulus (Emax, Emean) of region of interest in right kidney were measured by STE and STQ techniques. Biochemical profiles and renal biopsy findings were recorded. Both Emax and Emean measured by STE were significantly different between cases and controls. ROC analysis of STE measurements revealed using a cutoff of 13.53 kPa for Emax and 10.16 kPa for Emean, the area under the curve (AUC) to distinguish nephropathy from healthy was 0.718 and 0.744. Analysis of ROC for STQ measurements showed that using a cutoff value of 15.87 kPa for Emax and 9.95 kPa for Emean, the AUC for the nephropathy was 0.612 and 0.569. Emax and Emean values were significantly different among CKD patients with mild, moderate and severe pathological stage. The Emax value for STE was positively related to Scr, β2-MG (r = 0.257, 0.292, p < 0.05). Both STE and STQ are non-invasive, feasible methods to quantitatively evaluate renal stiffness. STE is more effective than STQ in the diagnosis of CKD patients with proteinuria. Sound touch elastography is more effective than sound touch quantification in the diagnosis of chronic kidney disease patients with proteinuria. • Emax and Emean measured by STE were different between cases and controls. • Emax and Emean were different among CKD patients with different pathological stages. • The Emax value for STE was positively related to serum creatinine, β2-microglobulin.


Recommendations for evaluation and diagnosis of extra-glandular manifestations of primary sjogren syndrome: results of an epidemiologic systematic review/meta-analysis and a consensus guideline from the Brazilian Society of Rheumatology (articular, pulmonary and renal).
Sjogren's Syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, these systemic manifestations are not routinely evaluated and there is no homogenous approach to their diagnosis or evaluation. To close this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of these manifestations and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. The first part of this guideline summarizes the most important topics, and 11 recommendations are provided for the articular, pulmonary, and renal care of SS patients.


Wavelength-shift-based visual fluorescence sensing of aspartic acids using Eu/Gd-MOF through pH triggering.
With the increasing demand for on-site detection, the current approach of building dual-emission or multi-emission luminescence sensors based on metal-organic frameworks (MOFs) which possess the capacity of self-reference for numerous non-analyte factors falls short of meeting sensing requirements. Therefore, we have designed a novel strategy for constructing wavelength shift-based luminescence sensor named Eu/Gd(TCPP), which exhibits dual-emitting from metal ions Eu3+ and flexible rotating aggregation-induced emission (AIE) ligands H4TCPP (2,3,5,6-tetrakis(4-carboxyphenyl)pyrazine). This sensor was prepared by a simple, green and fast plasma synthesis method. It's worth noting that the fluorescence emission of Eu/Gd(TCPP) shows a specific wavelength shift from ligand peak, and a visual color change from red to blue within a pH range of 4 to 3. Moreover, various characterization data verified that the luminescence switching mechanism of Eu/Gd(TCPP) was attributed to the H+-induced collapse of the Eu/Gd(TCPP) crystal structure, followed by untwisting of free ligands that lose rigid MOFs confinement. This hindered the antenna effect from H4TCPP to Ln3+ ions and restricted the rotation emission of ligand, resulting in the red-shifting of the ligand emission and corresponding luminescence switching. By tactfully utilizing the short-range pH response property of Eu/Gd(TCPP), highly sensitive and selective on-site visual detection of acidic aspartic acid can be achieved.


Decreased expression of CD44 splicing variants in advanced colorectal carcinomas.
CD44v6 expression appears to be associated with adverse prognosis and propensity for metastasis in patients with colorectal cancer. However, expression of CD44 variants in different tumour stages has been poorly characterised. CD44 variant expression was investigated in normal colonic mucosa (n = 36), colorectal adenomas (n = 15), carcinomas (n = 62) and metastases (n = 6) by reverse transcriptase-polymerase chain reaction (RT-PCR) and Southern blotting with exon-specific probes. High frequencies of CD44 standard (CD44s) and CD44 epithelial (CD44e) were observed in normal and neoplastic tissue. CD44v2 was seen predominantly in adenomas (27%) and UICCI carcinomas (29%). CD44v5 expression was low in normal mucosa (3%), higher in adenomas and carcinomas (29-33%), independent of tumour stage. CD44v6 expression was low in normal mucosa (6%) and higher in adenomas (47%) and carcinomas (42%). Surprisingly, a significant decrease of CD44v6 was observed in metastatic primary tumours (8%) and metastases (17%) (UICCIV) (P < or = 0.05). Therefore, the concept of CD44v6 conferring metastatic potential to malignant cells cannot be supported by our data.


Exposure assessment of potash miners at elevated CO2 levels.
In a potash mine in the center of Germany, stationary measurements 40 cm above ground level have revealed occasional increases in the carbon dioxide (CO2) levels that exceed the 0.5 vol.% German occupational exposure limit (OEL). This study, therefore, aimed to examine the individual exposures of potash miners to CO2 at their underground workplaces. 119 miners were equipped with personal CO2 detectors to log the individual CO2 exposures during underground work. We decided to use electrochemical monitors due to their compactness and minimal mass. Furthermore, generated CO2 measurements with precipitated overshooting and false positive CO2 values were studied using diverse CO2 test gases and different fumigation times. The personal detectors showed short-term CO2 peak exposures at very high concentrations in a limited number of workers. Twenty-two threshold limit value violations were observed according to the present OEL, and the personal CO2 monitoring allowed categorization into three exposure groups, low (n = 83), moderate (n = 26) and high burdens (n = 10) of CO2. The electrochemical sensors used have numerous properties that can potentially influence the assessment of exposures. The current findings suggest that assessing similar exposure scenarios, with respect to elevated and strongly fluctuating CO2 concentrations, the behavior of electrochemical sensors should be taken into consideration.


Comparative biochemical, histochemical and autoradiographic studies of Na+/k+-ATPase in the rectum of dragonfly larvae (Odonata, Aeshnidae).
Na+/K+-ATPase localization in the rectal wall of larval Aeshna cyanea (Insecta, Odonata) was studied with histochemical precipitation techniques and 3H-ouabain autoradiography in conjunction with biochemical measurements of enzyme activities and radiospectrometry of 3H-ouabain binding, respectively. The NPP-strontium and ATP-lead methods led to complete inhibition of Na+/K+-ATPase in this organ and hence to unreliable histochemical results. The 3H-ouabain binding technique revealed sodium pump sites at the basolateral plasma membranes of the absorptive rectal chloride epithelia.


Corticotropin-inhibiting peptide enhances aldosterone secretion by dispersed rat zona glomerulosa cells.
Corticotropin-inhibiting peptide (CIP), the 7-38 fragment of human ACTH(1-39), is known to act as an antagonist of ACTH receptors. Accordingly, CIP has been found to inhibit ACTH-stimulated glucocorticoid secretion of dispersed rat adrenocortical cells, without per se affecting the basal production. We confirmed these findings, but unexpectedly observed that CIP concentration-dependently raised basal aldosterone secretion from fresh suspensions of rat zona glomerulosa (ZG) cells, maximal effective concentration being 10(-6) M. CIP (10(-6) M) partially reversed the ZG-cell response to ACTH, but not to the Ca2+-dependent agonists angiotensin-II (ANG-II) and K+. The aspecific ANG-II-receptor antagonist saralasin (10(-6) M) blocked the aldosterone response of ZG cells to 10(-6) M CIP, and in the presence of the Ca2+-channel blocker verapamil CIP was ineffective. Collectively, these findings suggest that CIP enhances aldosterone secretion of rat ZG through a mechanism involving the activation of ANG-II receptors and the consequent rise in the cytosolic Ca2+ concentration. They also stress that this side-effect of CIP must be taken into account in interpreting the results of investigations on the adrenal cortex, where CIP has been employed as an ACTH-receptor antagonist.


Prognostic value of LI-RADS category on gadoxetic acid-enhanced MRI and 18F-FDG PET-CT in patients with primary liver carcinomas.
To evaluate the postoperative prognostic value of the Liver Imaging Reporting and Data System (LI-RADS) category on gadoxetic acid-enhanced MRI and 18F-fluorodeoxyglucose PET-CT in patients with primary liver carcinomas (PLCs). A total of 189 patients with chronic liver disease and surgically proven single PLC (42 intrahepatic cholangiocarcinomas and 21 combined hepatocellular-cholangiocarcinomas and 126 hepatocellular carcinomas [2:1 matching to non-HCC malignancies]) were retrospectively evaluated with gadoxetic acid-enhanced MRI and PET-CT. Two independent reviewers assigned an LI-RADS category for each observation. The tumor-to-liver standardized uptake value ratio (TLR) was calculated. The overall survival (OS), recurrence-free survival (RFS), and the associated factors were evaluated. In multivariable analysis, LI-RADS category (LR-4 or LR-5 [LR-4/5] vs. LR-M; OS, hazard ratio [HR] 2.24, p = 0.006; RFS, HR 1.61, p = 0.028) and TLR (low, < 2.3 vs. high, ≥ 2.3; OS, HR 2.09, p = 0.014; RFS, HR 2.17, p < 0.001) were the independent factors for OS and RFS. For the LR-M group, the high TLR group showed lower OS and RFS rates than the low TLR group (OS, p = 0.008; RFS, p < 0.001). For the LR-4/5 group, the OS and RFS rates were not significantly different between the high TLR and low TLR groups (both p > 0.05). Both LI-RADS category on MRI and TLR on PET-CT are associated with the postoperative prognosis of PLCs. The prognosis of PLCs classified as LR-M can be further stratified according to the TLR group, but not for the PLCs classified as LR-4/5. • The LI-RADS category (LR-4/5 vs. LR-M) and tumor-to-liver standardized uptake value ratio (TLR, low vs. high) were independent factors for postoperative prognosis of primary liver carcinomas (PLCs). • For PLCs classified as LR-M, the TLR group helps stratify the postoperative prognosis of PLCs, with the high TLR group having a poor prognosis and the low TLR group having a better prognosis (p = 0.008 for OS and p < 0.001 for RFS). • For PLCs classified as LR-4/5, the OS and RFS rates were not significantly different between the high TLR and low TLR groups (both p > 0.05).


Differences in taste-potentiated odor aversions with O+/OT+ versus OT+/O+ conditioning: Implications for configural associations.
The present research demonstrates a conditioning order effect difference: Odor-aversion conditioning is stronger following OT+/O+ conditioning than following O+/OT+ conditioning with specific odor (O) and taste (T) cues. When a weak odor cue was used in Experiments 1A and 1B, OT+/O+ conditioning produced significantly stronger odor aversions than did either O+/OT+ or O+/O+ conditioning, which did not differ. The same design was used in Experiment 2 with a strong odor, but the order effect difference was not replicated, suggesting that the order effect difference is specific to conditions that produce taste-potentiated odor aversions. The interpretation that O+/OT+ conditioning is weaker because of the absence of a taste-odor within-compound association was not supported in Experiments 3 and 4. Notably, using stimuli that supported potentiation in earlier experiments, in Experiment 4, we found evidence of a taste-odor within-compound association in the absence of potentiation. These results confirm that previous theories of potentiation (within-compound association model, sensory-and-gate channeling model) are not sufficient to produce potentiation. Instead, these results are interpreted in terms of taste-odor configural associations.


Revascularization of the lateral wall: long-term angiographic and clinical results of radial artery versus right internal thoracic artery grafting.
We sought to evaluate whether the radial artery provides the same results as the right internal thoracic artery in lateral wall revascularization in the long term. From January 1992 to September 1996, 288 patients had myocardial revascularization with the left internal thoracic artery anastomosed to the left anterior descending coronary artery. The lateral wall was grafted with the radial artery in 139 patients (group A) and with the right internal thoracic artery in 149 patients (group B). Groups were different only because of older age and a higher incidence of patients requiring urgent treatment in group A. Y grafting was used in 86.4% of patients in group A and in 34.8% of patients in group B (P < .001). Anastomoses per patient were similar in both groups (3.2 +/- 0.8 vs 3.2 +/- 0.9, P = 1.000). Thirty-day mortality was similar (2.1% vs 2.0%, P = .722). There were 15 late deaths in group A versus 11 in group B (P = .418). Cause of death was cardiac related in 6 patients in group A versus 7 in group B. Late redo or percutaneous transluminal coronary angioplasty was performed in 3 patients in group A and in 1 patient in group B (P = 0.538). Eight-year survival was 86.7% +/- 2.9% in group A versus 89.6% +/- 2.8% in group B (P = .477); event-free survival was 84.2% +/- 3.2% versus 88.9% +/- 2.9%, respectively (P = .430). The patency rate within 30 days was 99.1% in group A (105/106 left internal thoracic artery plus radial artery anastomoses) versus 100% in group B (52/52 bilateral internal thoracic artery anastomoses; P = .715). After a mean of 35 +/- 28 months, the patency rate was 99.0% in group A (100/101 left internal thoracic artery plus radial artery anastomoses) and 100% in group B (33/33 bilateral internal thoracic artery anastomoses, P = .560). In the long-term, lateral wall grafting with the radial artery provides the same clinical and angiographic results as right internal thoracic artery grafting.


Systematic review of sarcopenia in patients operated on for gastrointestinal and hepatopancreatobiliary malignancies.
Preoperative risk assessment in cancer surgery is of importance to improve treatment and outcome. The aim of this study was to assess the impact of CT-assessed sarcopenia on short- and long-term outcomes in patients undergoing surgical resection of gastrointestinal and hepatopancreatobiliary malignancies. A systematic search of Embase, PubMed and Web of Science was performed to identify relevant studies published before 30 September 2014. PRISMA guidelines for systematic reviews were followed. Screening for inclusion, checking the validity of included studies and data extraction were carried out independently by two investigators. After screening 692 records, 13 observational studies with a total of 2884 patients were included in the analysis. There was wide variation in the reported prevalence of sarcopenia (17.0-79 per cent). Sarcopenia was independently associated with reduced overall survival in seven of ten studies, irrespective of tumour site. Hazard ratios (HRs) of up to 3.19 (hepatic cancer), 1.63 (pancreatic cancer), 1.85 (colorectal cancer) and 2.69 (colorectal liver metastases, CLM) were reported. For oesophageal cancer, the HR was 0.31 for increasing muscle mass. In patients with colorectal cancer and CLM, sarcopenia was independently associated with postoperative mortality (colorectal cancer: odds ratio (OR) 43.3), complications (colorectal cancer: OR 0.96 for increasing muscle mass; CLM: OR 2.22) and severe complications (CLM: OR 3.12). Sarcopenia identified before surgery by single-slice CT is associated with impaired overall survival in gastrointestinal and hepatopancreatobiliary malignancies, and increased postoperative morbidity in patients with colorectal cancer with or without hepatic metastases.


[Tongue disorders and jaw deformities. Nosological aspects and therapeutic concepts].
Tongue's disorders as abnormal volume, modified position and mobility can cause maxillary deformation. Nosological and therapeutic aspects are considered.


Pyrexia of unknown origin: a prospective study of 100 cases.
There are few studies on pyrexia of unknown origin (PUO) from India. The present study was planned to elucidate the causes of in PUO Eastern India and to define the changing patterns of PUO, if any. Prospective case series. One hundred patients meeting the classic criteria of pyrexia of unknown origin. The final diagnosis established at discharge or during follow up. Infections, especially tuberculosis was the most dominant cause (53%), followed by neoplasms (17%), and collagen vascular disorders (11%), Miscellaneous causes were responsible in 5% cases and in 14% the cause of fever remained undiagnosed. It is concluded that infections remain the most important cause of PUO in India, confirming the trends found earlier in other studies. The incidence of neoplasms was much higher compared to other studies from India.


Overexpression of the active diacylglycerol acyltransferase variant transforms Saccharomyces cerevisiae into an oleaginous yeast.
Lipid production by Saccharomyces cerevisiae was improved by overexpression of the yeast diacylglycerol acyltransferase Dga1p lacking the N-terminal 29 amino acids (Dga1∆Np), which was previously found to be an active form in the ∆snf2 mutant. Overexpression of Dga1∆Np in the ∆snf2 mutant, however, did not increase lipid content as expected, which prompted us to search for a more suitable strain in which to study the role of Dga1∆Np in lipid accumulation. We found that the overexpression of Dga1∆Np in the ∆dga1 mutant effectively increased the lipid content up to about 45 % in the medium containing 10 % glucose. The high lipid content of the transformant was dependent on glucose concentration, nitrogen limitation, and active leucine biosynthesis. To better understand the effect of dga1 disruption on the ability of Dga1∆Np to stimulate lipid accumulation, the ∆dga1-1 mutant, in which the 3'-terminal 36 bp of the dga1 open reading frame (ORF) remained, and the ∆dga1-2 mutant, in which the 3'-terminal 36 bp were also deleted, were prepared with URA3 disruption cassettes. Surprisingly, the overexpression of Dga1∆Np in the ∆dga1-1 mutant had a lower lipid content than the original ∆dga1 mutant, whereas overexpression in the ∆dga1-2 mutant led to a high lipid content of about 45 %. These results indicated that deletion of the 3' terminal region of the dga1 ORF, rather than abrogation of genomic Dga1p expression, was crucial for the effect of Dga1∆Np on lipid accumulation. To investigate whether dga1 disruption affected gene expression adjacent to DGA1, we found that the overexpression of Esa1p together with Dga1∆Np in the ∆dga1 mutant reverted the lipid content to the level of the wild-type strain overexpressing Dga1∆Np. In addition, RT-qPCR analysis revealed that ESA1 mRNA expression in the ∆dga1 mutant was decreased compared to the wild-type strain at the early stages of culture, suggesting that lowered Esa1p expression is involved in the effect of dga1 disruption on Dga1∆Np-dependent lipid accumulation. These results provide a new strategy to engineer S. cerevisiae for optimal lipid production.


Targeted Therapeutic-Immunomodulatory Nanoplatform Based on Noncrystalline Selenium.
Developing versatile nanomaterials has offered a myriad of opportunities to surmount cancer. In particular, the combination of therapy and immunomodulatory effect to further enhance immune response provides a new idea for effective tumor treatment. Herein, for the first time, an in situ growth strategy is developed to construct highly dispersed noncrystalline selenium nanoparticles (Se NPs) with thiolated cyclo(Arg-Gly-Asp-Phe-Lys-(mpa)) (RGD) peptide modification (R-Se@DMSND) for targeted cancer treatment. Se NPs could be homogeneously grown into the pore channels of dendritic mesoporous silica nanoparticles (DMSNs) since the DMSNs could stabilize Se NPs to prevent their aggregations. Moreover, Se NPs could not only act as a therapeutic agent, inducing ROS overproduction, to effectively suppress primary tumor but also as an immunomodulatory agent to simultaneously inhibit the growth of secondary tumors by enhancement of the immune response, as confirmed by the in vivo results. Such the therapeutic-immunomodulatory strategy for tumorous therapy combining with immunomodulation using one simple nanoplatform may pave a new avenue in the biomedical field.


Physical activity and cardiorespiratory fitness-A ten-year follow-up.
Physical activity (PA) may influence cardiorespiratory fitness (CRF). Yet, PA takes place in different domains (i.e., sports-related physical activity [SPA], leisure time related physical activity [LTPA], and work-related physical activity [WPA]) and not all domain-specific PA may help to maintain high CRF levels throughout life. We assessed the relationship between changes in domain-specific PA and the age-related decline in CRF. We analyzed data of 353 men (median age 50 years; inter-quartile range [IQR] 40 to 60) and 335 women (median age 50 years; IQR 41 to 59) with data for domain-specific PA as well as CRF testing measured ten years apart. CRF was assessed with cardiorespiratory exercise testing. Domain-specific PA was measured using the Baecke questionnaire. During the 10-year follow-up, CRF decreased in men from 29.3 (IQR 25.0 to 34.7) mL/min/kg to 24.3 (IQR 20.8 to 27.3) mL/min/kg. In women, CRF declined from 26.0 (IQR 21.0 to 30.9) to 21.4 (IQR 18.3 to 25.6) mL/min/kg. A one point higher SPA at baseline was related to a 1.14 (95% confidence interval [CI] -1.50 to -0.53) mL/min/kg greater decrease in VO2peak . A one point greater SPA and LTPA over time was associated with a 1.68 (95% CI 1.06 to 2.29) mL/min/kg and 1.24 (95% CI 0.57 to 1.90) mL/min/kg lower decrease in VO2peak , respectively. Neither baseline values nor changes of WPA were associated with CRF. Sports and leisure time related PA may attenuate the age-related decline in CRF.


No evidence of perfusion abnormalities in the basal ganglia of a patient with generalized chorea-ballism and polycythaemia vera: analysis using subtraction SPECT co-registered to MRI.
Polycythaemia vera is a well-known cause of symptomatic chorea, however, the pathophysiology of this correlation remains unclear. We report on a patient with generalized chorea-ballism associated with polycythaemia vera, and we present the findings of 99mTc-hexamethylpropylene amine oxime (HMPAO) SPECT done in both the choreic state and the non-choreic state. The SPECT during both the choreic and the non-choreic states did not reveal any definite perfusion changes in specific regions of the brain, as compared with 6 age-matched controls. In addition, the subtraction SPECT co-registered to MRI (SISCOM) analysis did not show any difference in cerebral blood flow during the choreic and non-choreic states. This result suggests that the basic mechanism of chorea associated with polycythaemia vera does not appear to be associated with a reduction in cerebral perfusion to a specific cerebral area, such as the basal ganglia or its thalamocortical connections.


Gum arabic/maltodextrin microencapsulation confers peroxidation stability and antimicrobial ability to pepper seed oil.
In this study, pepper seed oil (PSO) was microencapsulated by spray drying at optimum conditions: oil/total solid material at 20% (w/w), gum Arabic/maltodextrin (GA/MD) at 1/5 (w/w), and air inlet temperature of 184 °C. Particle size distribution and morphology of the PSO powder (PSOP) were determined by a laser particle diameter analyzer and scanning electron microscopy (SEM). Fourier transform infrared spectroscopy (FTIR) and nuclear magnetic resonance (NMR) were employed to identify the specific chemical groups of PSO, MD, and GA in the PSO-GA/MD complexes. The thermal stability of PSOP was evaluated by thermogravimetric (TGA) and differential thermal analysis (DTA). PSOP displayed inhibitory activity against Staphylococcus aureus, Pseudomonas aeruginosa, and Enterococcus faecalis although PSO had an antimicrobial activity against only Staphylococcus aureus. GA/MD microencapsulation resulted in significant preservation of PSO against oxidation during storage period.


The scrambling theorem: a simple proof of the logical possibility of spectrum inversion.
The possibility of spectrum inversion has been debated since it was raised by and is still discussed because of its implications for functionalist theories of conscious experience (e.g., Palmer, 1999). This paper provides a mathematical formulation of the question of spectrum inversion and proves that such inversions, and indeed bijective scramblings of color in general, are logically possible. Symmetries in the structure of color space are, for purposes of the proof, irrelevant. The proof entails that conscious experiences are not identical with functional relations. It leaves open the empirical possibility that functional relations might, at least in part, be causally responsible for generating conscious experiences. Functionalists can propose causal accounts that meet the normal standards for scientific theories, including numerical precision and novel prediction; they cannot, however, claim that, because functional relationships and conscious experiences are identical, any attempt to construct such causal theories entails a category error.


Effects of the particle sizes and concentrations on the X-ray absorption by CuO compounds.
This work presents a study on the effects of the particle size, material concentration and radiation energy on the X-ray absorption. CuO nanoparticles and microparticles were incorporated separately into a polymeric resin in concentrations of 5%, 10% and 30% relative to the resin mass. X-ray absorption by these materials was analyzed with a CdTe detector. The X-ray absorption is higher for the nanostructured material compared to the microstructured one for low energy X-ray beams for all CuO concentrations.


[Effect of adrenergic beta blockers on hemodynamics, diastolic relaxation and distensibility of left-ventricular myocardium in patients with ischemic heart disease].
Altogether 32 patients were investigated by catheterization of the left ventricular cavity with volume loading of 76% solution of verographin++ administered at 0.65 ml per kg body mass. beta-blockade with preliminary i.v. administration of 5 mg obsidan or 10 mg cordanum was shown to improve myocardial diastolic function as a result of improved myocardial distensibility in CHD patients.


MPK14-mediated auxin signaling controls lateral root development via ERF13-regulated very-long-chain fatty acid biosynthesis.
Auxin plays a critical role in lateral root (LR) formation. The signaling module composed of auxin-response factors (ARFs) and lateral organ boundaries domain transcription factors mediates auxin signaling to control almost every stage of LR development. Here, we show that auxin-induced degradation of the APETALA2/Ethylene Responsive Factor (AP2/ERF) transcription factor ERF13, dependent on MITOGEN-ACTIVATED PROTEIN KINASE MPK14-mediated phosphorylation, plays an essential role in LR development. Overexpression of ERF13 results in restricted passage of the LR primordia through the endodermal layer, greatly reducing LR emergence, whereas the erf13 mutants showed an increase in emerged LR. ERF13 inhibits the expression of 3-ketoacyl-CoA synthase16 (KCS16), which encodes a fatty acid elongase involved in very-long-chain fatty acid (VLCFA) biosynthesis. Overexpression of KCS16 or exogenous VLCFA treatment rescues the LR emergence defects in ERF13 overexpression lines, indicating a role downstream of the auxin-MPK14-ERF13 signaling module. Collectively, our study uncovers a novel molecular mechanism by which MPK14-mediated auxin signaling modulates LR development via ERF13-regulated VLCFA biosynthesis.


Interhospital Transport of Infants on Bubble Continuous Positive Airway Pressure via Ground and Air.
The purpose of this study was to evaluate the use of a respiratory protocol for the interhospital transport of infants with respiratory distress on bubble continuous positive airway pressure (bCPAP) and provide information on the safety of bCPAP during transport via ground and helicopter. We evaluated a retrospective cohort study of neonates (gestational age 22-41 weeks) transported to our level 4 neonatal intensive care unit (NICU) before (n = 529) and after implementing (n = 540) protocols for increasing bCPAP and intubation criteria. Infants were evaluated for intubation before transport, the safety of transport, and the need for intubation shortly after arrival in the NICU. After initiating the protocols, less infants received mechanical ventilation, and more infants received bCPAP for transport via ground and helicopter. Upon arrival to the NICU, infants using the protocols had lower fraction of inspired oxygen and higher continuous positive airway pressures, and similar numbers required intubations in the first 12 hours. There were no differences in the rate of pneumothoraces. bCPAP can be used on both ground and helicopter transport of very small infants. Respiratory protocols decreased mechanical ventilation during transport without increasing the need for intubation within 12 hours of arrival.


Homologous meniscus transplantation. Experimental and clinical results.
The increase in severe ligament injuries of the knee has led to consideration of the need for meniscal transplantation in reconstructive operations for chronic rotational instability. Transplantation of the medial meniscus was carried out in two groups of 15 sheep. In one group lyophilised, gamma-sterilised allogenic menisci were transplanted and these underwent a complete remodelling in 48 weeks. In the other group, deep frozen allogenic menisci were used and these remained fully functional without remodelling. We then carried out meniscal transplantation in 22 patients who were followed-up for a mean of 14 months. Arthroscopy was possible in two-thirds of the cases at an average of 8 months after operation. Both types of transplanted menisci, lyophilised and deep frozen, decreased in size, as small as a regenerated meniscus in some cases. In general the deep frozen menisci showed better results.


Unmarried Women and Unintended Pregnancy: An Indonesian Cross-Sectional Study.
Indonesia has moral norms consider pregnancy among unmarried women a disgrace. The study analyzes the factors influencing unintended pregnancies among unmarried women in Indonesia. The study examined 1,050 women. The author analyzed unintended pregnancy and six other variables (residence, age, education, employment, wealth, and parity). Multivariate analysis used binary logistic regression. 15.5% of unmarried women in Indonesia have experienced an unintended pregnancy. Women living in urban areas are more likely to experience unintended pregnancies than women in rural areas. The 15-19 have the highest chance of experiencing an unintended pregnancy. Education is a protective factor from unintended pregnancy. Employed women are 1.938 times more likely than unemployed. Poverty is a risk factor for experiencing an unintended pregnancy. Multiparous is 4.095 times more likely than primiparous. The study identified six variables that affect unintended pregnancy among unmarried women in Indonesia: residence, age, education, employment, wealth, and parity.


A computerized data management system for head and neck oncology.
Medical information, diagnostic technology, and modes of therapeutic intervention available for treatment of head and neck cancer have increased exponentially. The concurrent explosion of microcomputer technology has created an ideal instrument for organizing, storing, and reporting the expanded data the head and neck oncologist must now consider. This paper presents the principles, design, and operation of a recently developed head and neck oncological database program (HNODB). Details of implementation on a microcomputer are also described. A historical review of currently used prominent cancer registration programs is presented. It defines the fundamental elements of cancer registration. A review of cancer registration in the United States shows that current systems have various deficiencies and have not kept pace with the evolution of diagnostics, treatments, and computer technologies. The HNODB database program, however, is a valuable model for cancer data management, for it can be applied to small or extensive data collection needs, and it provides an accurate system to identify risk factors, numbers of patients treated and types of treatment given. The program allows for rapid analysis of treatment, results, follow-up, and survival rates of patients with carcinoma of the head and neck.


Dual-modality monitoring of targeted intraarterial delivery of mesenchymal stem cells after transient ischemia.
In animal models of stroke, functional improvement has been obtained after stem cell transplantation. Successful therapy depends largely on achieving a robust and targeted cell engraftment, with intraarterial (IA) injection being a potentially attractive route of administration. We assessed the suitability of laser Doppler flow (LDF) signal measurements and magnetic resonance (MR) imaging for noninvasive dual monitoring of targeted IA cell delivery. Transient cerebral ischemia was induced in adult Wistar rats (n=25) followed by IA or intravenous (IV) injection of mesenchymal stem cells (MSCs) labeled with superparamagnetic iron oxide. Cell infusion was monitored in real time with transcranial laser Doppler flowmetry while cellular delivery was assessed with MRI in vivo (4.7 T) and ex vivo (9.4 T). Successful delivery of magnetically labeled MSCs could be readily visualized with MRI after IA but not IV injection. IA stem cell injection during acute stroke resulted in a high variability of cerebral engraftment. The amount of LDF reduction during cell infusion (up to 80%) was found to correlate well with the degree of intracerebral engraftment, with low LDF values being associated with significant morbidity. High cerebral engraftment rates are associated with impeded cerebral blood flow. Noninvasive dual-modality imaging enables monitoring of targeted cell delivery, and through interactive adjustment may improve the safety and efficacy of stem cell therapy.


Positioning analysis of Spanish politicians through their Twitter posts versus Spanish public opinion.
The evolution of Information and Communication Technologies (ICT) has changed the way we communicate. Access to the Internet and social networks has even changed the way we organise ourselves socially. Despite advances in this field, research on the use of social networks in political discourse and citizens' perceptions of public policy remains scarce. So, the empirical study of politicians' discourse on social networks in relation to citizens' perception of public and fiscal policies according to their political affinity is of particular interest. The aim of the research is, therefore, to analyse positioning, from a dual perspective. Firstly, the study analyses the positioning in the discourse of the communication campaigns posted on social networks of Spain's most prominent politicians. And secondly, it evaluates whether this positioning is reflected in citizens' opinions about the public and fiscal policies being implemented in Spain. To this end, a qualitative semantic analysis and a positioning map is performed on a total of 1553 tweets published between 1 June and 31 July 2021 by the leaders of the top ten Spanish political parties. In parallel, a cross-sectional quantitative analysis is carried out, also through positioning analysis, based on the database of the Public Opinion and Fiscal Policy Survey of July 2021 by the Sociological Research Centre (CIS), whose sample is 2849 Spanish citizens. The results show a significant difference in the discourse of political leaders' social network posts-which is more pronounced between right-wing and left-wing parties-and only some differences in citizens' perception of public policies according to their political affinity. This work contributes to identifying the differentiation and positioning of the main parties and helps to guide the discourse of their posts.


Eco-friendly geopolymer prepared from solid wastes: A critical review.
Solid wastes are generated from human activities which could cause damage to the ecological environment and human beings. In recent years, there has been extensive research on solid wastes utilized as precursors, aggregates, fibers, etc. to prepare the geopolymers, which has invariably been a research hotspot. This review classifies the solid wastes utilized for geopolymers into three main categories: industrial waste, agricultural waste, and municipal waste. Accordingly, we systematically dissert solid wastes-based geopolymer from the perspectives of structure, properties, and application. The chemical composition, morphology, particle size, thermal conductivity, and other characteristics of solid wastes can trigger changes in the specific properties of geopolymers. On this account, solid wastes-based geopolymers have great potential in the domain of concrete, fireproof materials, impermeable materials, catalysts, adsorbents, and energy storage materials, etc. More importantly, geopolymers have obvious advantages in immobilizing heavy metals in solid wastes. Therefore, it can demonstrate geopolymer is a sustainable and environmentally friendly "green material". However, it still confronts the challenges of solid wastes utilized in geopolymer (technology, economy, administration). It requires the government, enterprises, and the public to work together for co-governance to accomplish industrialization and commercialization of solid wastes-based geopolymer.


Molecular evaluation of vitamin D responsiveness of healthy young adults.
Vitamin D3 has via its metabolites 25-hydroxyvitamin D3 (25(OH)D3) and 1α,25-dihydroxyvitamin D3 (1,25(OH)2D3) direct effects on the transcriptome and the epigenome of most human cells. In the VitDbol study we exposed 35 healthy young adults to an oral vitamin D3 dose (2000μg) or placebo and took blood samples directly before the supplementation as well as at days 1, 2 and 30. Within 24h the vitamin D3 intake raised the average serum levels of both 25(OH)D3 and 1,25(OH)2D3 by approximately 20%. However, we observed large inter-individual differences in these serum levels, reflected by the average ratios between 25(OH)D3 and 1,25(OH)2D3 concentrations ranging from 277 to 1365. Interestingly, average serum parathyroid hormone (PTH) levels increased at day 1 by some 10% but then decreased within the following four weeks to levels 5% below baseline. In peripheral blood mononuclear cells (PBMCs) that were isolated at the same time points we determined vitamin D-modulated chromatin accessibility by FAIRE-qPCR at selected genomic loci. This method is well suited to evaluate both short-term and long-term in vivo effects of vitamin D on the epigenome of human subjects. The differential vitamin D responsiveness of the VitDbol study participants was determined via individual changes in their PTH levels or chromatin accessibility in relation to alterations in 25(OH)D3 concentrations. This led to the segregation of the subjects into 14 high, 11 mid and 10 low responders. In summary, the vitamin D responsiveness classification provides additional information compared to a vitamin D status assessment based on single 25(OH)D3 serum measurements. The study was registered at Clinicaltrials.gov (NCT02063334).


Liquidambarines A - C, three new abietane diterpenoids from Liquidambar formosana Hance and their anti-inflammatory activities.
Liquidambarines A - C (1-3), three new abietane-type diterpenoids, together with five known compounds (4-8) were isolated from the resin of Liquidambar formosana Hance. Their structures were elucidated by the combination of spectroscopic and computational methods. We explored their anti-inflammatory potential by analyzing the protein expression of iNOS and COX-2. Compounds 1 and 3 exhibit significant anti-inflammatory activities without cytotoxicity. These experimental studies suggest these new abietane-type diterpenoids have the potential to be candidates for inflammation-associated diseases.


[Werner's syndrome. Clinical and radiologic manifestations. Apropos of 2 new cases].
In this work we present two cases of Werner's Syndrome. Its typical manifestations, the clinical and radiological aspects and diagnostic criteria are mainly commented.


Characterization of human corticotrophin-releasing hormone and pro-opiomelanocortin-related peptides in a thymic carcinoid tumour responsible for Cushing's syndrome.
Severe Cushing's syndrome developed in a man of 35 years. Plasma ACTH and lipotrophin hormone levels were supranormal, and dexamethasone failed to stop their production. An ACTH-producing thymic carcinoid tumour was found to be responsible for the Cushing's syndrome. The tumour tissue contained pro-opiomelanocortin (POMC)-mRNA and POMC-related peptides. In addition, human corticotrophin-releasing hormone (h-CRH) (0.25 ng/mg wet tissue) was identified in the tumour extract. Among a series of extracts from two normal and three tumoral (Nelson's syndrome) pituitary glands, six non-pituitary POMC-producing tumours and five normal thymuses examined, only the extract from the thymic tumour of our patient contained h-CRH. The molecule isolated had the same properties as synthetic h-CRH (dilution, Sephadex G 50 chromatography). Circulating h-CRH levels, however, were normal. The possible involvement of such ectopic CRH production in the aetiology of Cushing's syndrome remains uncertain.


[Treatment of tibial pseudoarthrosis. Complications after intramedullary, allogeneic fibular grafting].
A 24-year-old woman underwent cosmetic bilateral tibial lengthening with severe complications. In all, 15 operations, including allogeneic fibular grafting of both tibia, were required to treat unstable bilateral non-union, malalignment, and osteomyelitis of the right tibia.The present article describes the surgical strategy of revision to achieve good recovery with full consolidation and proper alignment of the lower leg. Furthermore, the indications for allogeneic bone grafting, which was described by Erich Lexer 100 years ago, are discussed. For surgical revision, a T-external fixator was used on the right leg, while a customized tibial nail was used on the left leg. Using these techniques, full consolidation and proper alignment was achieved. Allogeneic bone grafts in upper extremity defects cannot be recommended.