Conversion of lignin-derived 3-methoxycatechol to the natural product purpurogallin using bacterial P450 GcoAB and laccase CueO.
Purpurogallin is a natural benzotropolone extracted from Quercus spp, which has antioxidant, anticancer, and anti-inflammatory properties. Purpurogallin is typically synthesized from pyrogallol using enzymatic or metal catalysts, neither economically feasible nor environmentally friendly. 3-Methoxycatechol (3-MC) is a lignin-derived renewable chemical with the potential to be a substrate for the biosynthesis of purpurogallin. In this study, we designed a pathway to produce purpurogallin from 3-MC. We first characterized four bacterial laccases and identified the laccase CueO from Escherichia coli, which converts pyrogallol to purpurogallin. Then, we used CueO and the P450 GcoAB reported to convert 3-MC to pyrogallol, to construct a method for producing purpurogallin directly from 3-MC. A total of 0.21 ± 0.05 mM purpurogallin was produced from 5 mM 3-MC by whole-cell conversion. This study provides a new method to enable efficient and sustainable synthesis of purpurogallin and offers new insights into lignin valorization. KEY POINTS: • Screening four bacterial laccases for converting pyrogallol to purpurogallin. • Laccase CueO from Escherichia coli presenting the activity for purpurogallin yield. • A novel pathway for converting lignin-derived 3-methoxycatechol to purpurogallin.


Development of an Enzyme-Linked Immunosorbent Assay (ELISA) for the Quantification of ARID1A in Tissue Lysates.
ARID1A is a subunit of the mammalian SWI/SNF complex, which is thought to regulate gene expression through restructuring chromatin structures. Its gene ARID1A is frequently mutated and ARID1A levels are lowered in several human cancers, especially gynecologic ones. A functional ARID1A loss may have prognostic or predictive value in terms of therapeutic strategies but has not been proposed based on a quantitative method. Hardly any literature is available on ARID1A levels in tumor samples. We developed an indirect enzyme-linked immunosorbent assay (ELISA) for ARID1A based on the current EMA and FDA criteria. We demonstrated that our ELISA provides the objective, accurate, and precise quantification of ARID1A concentrations in recombinant protein solutions, cell culture standards, and tissue lysates of tumors. A standard curve analysis yielded a 'goodness of fit' of R2 = 0.99. Standards measured on several plates and days achieved an inter-assay accuracy of 90.26% and an inter-assay precision with a coefficient of variation of 4.53%. When tumor lysates were prepared and measured multiple times, our method had an inter-assay precision with a coefficient of variation of 11.78%. We believe that our suggested method ensures a high reproducibility and can be used for a high sample throughput to determine the ARID1A concentration in different tumor entities. The application of our ELISA on various tumor and control tissues will allow us to explore whether quantitative ARID1A measurements in tumor samples are of predictive value.


Prevalence of tuberculosis infection among homeless young people in central and eastern Sydney.
To determine the prevalence of tuberculosis (TB) infection among homeless young people (aged 12-25 years) in central and eastern Sydney. A cross-sectional survey was conducted in 16 youth refuges and four drop-in centres in Central and Eastern Sydney Health Areas and at the Cellblock Youth Health Centre, Glebe and the Kirketon Road Centre, Darlinghurst, New South Wales (NSW). Participants completed a questionnaire and underwent Mantoux testing. One hundred and forty-one young people completed questionnaires and 139 received a Mantoux test; 112 (80. 6%) had their Mantoux read and 10 (8.9%) were Mantoux positive (95% confidence interval 3.6-14.2). None of the risk factors examined were found to be associated with increased risk for TB infection. In this sample of homeless young people in central and eastern Sydney, the Mantoux positivity rate appears to be higher than the general population in NSW, but they would not currently be considered a high-risk group for TB infection.


Influence of variable nerve fibre geometry on the excitation and blocking threshold. A simulation study.
The aim of the study was to investigate how variable fibre geometry influences the excitation and blocking threshold of an undulating peripheral nerve fibre. The sensitivity of the excitation and blocking thresholds of the nerve fibres to various geometric and stimulation parameters was examined. The nerve fibres had a spiral shape (defined by the undulation wavelength, undulation amplitude and phase), and the internodal length varied. Diameter-selective stimulation of nerve fibres was obtained using anodal block. Simulation was performed using a two-part simulation model: a volume conductor model to calculate the electrical potential distribution inside a tripolar cuff electrode and a model of a peripheral undulating human nerve fibre to simulate the fibre response to stimulation. The excitation threshold of the undulating fibres was up to 100% higher than the excitation threshold of the straight fibres. When a nerve was stimulated with long pulses, which are typically applied for anodal block (> 400 micros), the blocking threshold of the undulating fibres was up to four times higher than the blocking threshold of the straight fibres. Dependencies of the excitation threshold on geometric and stimulation parameters were the same as for a straight fibre. Dependencies of the blocking threshold on geometric and stimulation parameters were different compared with a straight fibre. Owing to the fibre undulation and variable internodal length, the blocking threshold and the minimum pulse duration to obtain anodal block were generally different in the proximal and distal directions. Owing to variable fibre geometry, the excitation threshold varied by up to +/- 40% of the mean value, and the blocking threshold varied by up to +/- 60 % of the mean value. Owing to undulation, the blocking threshold of large fibres could be higher than the blocking threshold of small-diameter fibres, even if they had the same geometry. The results indicate that, during skeletal muscle stretching and contracting or during variation in joint angle, the excitation and blocking thresholds of the nerve fibres change owing to variations in fibre geometry. A straight fibre model could be too simple for modelling the response of peripheral nerve fibres to electrical stimulation.


Immediate physiotherapy in perforating wounds of the pleural cavity and underlying lung.
Patients suffering from uncomplicated pneumothorax, haemothorax or haemopneumothorax of clinical significance are treated with fluid replacement, intercostal under-water drainage, antibiotics and routine physiotherapy. The commencement of routine physiotherapy may be delayed 8-60 hrs depending on the time the patient is admitted and arrangement of 'out-of-hours' physiotherapy services, but immediate physiotherapy produces superior results from every point of view.


Peptide ligand structure influences the exchange of beta2-microglobulin by cell surface Kb.
We have studied the interactions which occur between the peptide ligand and beta2-microglobulin (beta2m) components of the class I MHC complex by analysing the process of beta2m exchange. We have previously shown that the rate of beta2m exchange on a cell-surface class I MHC complex varies with the peptide ligand to which it is bound. It remains unclear, however, whether the ability of peptide ligand to alter beta2m/heavy-chain association is related to peptide affinity, peptide structure, or both. In this article, we examine the effects of variations in peptide ligand structure on the rate of beta2m exchange by cell surface Kb complexes. Using a panel of alanine substituted variants of the MCMV peptide (YPHFMPTNL), we show that single amino acid changes in peptide sequence can have dramatic effects on the rates of beta2m exchange. The observed changes in beta2m exchange rates are directly due to modification of the peptide ligand structure as they do not reflect changes in peptide affinity. These findings suggest that peptide ligand structure can induce conformational changes in the Kb heavy chain which alter the rates of cell surface beta2m exchange, and provide further evidence for peptide-dependent fluidity of the class I heavy chain.


Should the use of short acting angiotensin-converting enzyme inhibitors be abandoned?
Angiotensin-converting enzyme inhibitors (ACE-I) have different modes of action and different durations of inhibition. The effects of ACE-I on the various components of the renin-angiotensin system (RAS) at trough hours were studied in patients with diabetes mellitus receiving long-term ACE-I treatment. Out of 86 Type 1 and 2 diabetic patients, 49 were untreated, 25 received captopril and 12 received enalapril as chronic treatment. Blood for the determination of plasma renin activity (PRA), serum ACE activity and plasma angiotensin II (Ang II) was drawn in the morning (0700-0900 hours) after an overnight fast, about 12 hours after the last dose. PRA and Ang II were measured by RIA and serum ACE activity was assayed by a radiometric assay using (3)H-hippuryl-glycyl-glycine as a substrate. Mean age was significantly greater in the enalapril-treated patients. Systolic and diastolic blood pressures were not different between the captopril-treated and untreated groups. Serum ACE activity in the captopril-treated diabetic patients was 101.5+/-42.5 nmol/mL/min, values obtained in untreated diabetic patients (101.4+/-25.2 nmol/mL/min). In contrast, ACE activity in the enalapril-treated patients was significantly reduced (5.5+/-7.5 nmol/mL/min) compared with untreated and captopril-treated patients (p<0.00001). PRA values in the ACE-I treated patients were significantly increased. Plasma Ang II levels were significantly increased in the captopril-treated vs. untreated patients (65.1+/-50.2 vs. 36.2+/-31.7 pg/mL, p=0.006), whereas the values in the enalapril-treated patient were slightly, but not significantly, reduced (23.8+/-21.4 pg/mL). CONCLUSIONS Trough serum ACE activity is not suppressed in diabetic patients receiving captopril, compared with those receiving enalapril and we thus question the use of short acting ACE-I in these patients.


Impacts of climate change on vegetation pattern: Mathematical modeling and data analysis.
Climate change has become increasingly severe, threatening ecosystem stability and, in particular, biodiversity. As a typical indicator of ecosystem evolution, vegetation growth is inevitably affected by climate change, and therefore has a great potential to provide valuable information for addressing such ecosystem problems. However, the impacts of climate change on vegetation growth, especially the spatial and temporal distribution of vegetation, are still lacking of comprehensive exposition. To this end, this review systematically reveals the influences of climate change on vegetation dynamics in both time and space by dynamical modeling the interactions of meteorological elements and vegetation growth. Moreover, we characterize the long-term evolution trend of vegetation growth under climate change in some typical regions based on data analysis. This work is expected to lay a necessary foundation for systematically revealing the coupling effect of climate change on the ecosystem.


Knowledge and attitudes of Ugandan midwives regarding HIV.
In Uganda, 60% of HIV-infected adults are women of childbearing age. Considering this, midwives in Uganda play a pivotal role in reducing HIV transmission and providing high quality care to the many women and families affected by the disease. In this pilot study, investigators described the knowledge and attitudes of Uganda's private midwives regarding HIV. Overall knowledge levels were reported to be low, and the majority of participants reported overwhelming fear of contracting the disease from practice. Despite these challenges, the midwives' attitudes regarding HIV were positive. The results of this study support previous results. Additional studies focusing on midwives and traditional birth attendants in Uganda are warranted. The initiation of HIV continuing education programs and professional support for Ugandan midwives is also recommended.


Creatine kinase isoenzyme BB in serum of healthy adults and children.
The activity of the creatine kinase isoenzyme BB was determined in the serum of 26 healthy adults and 31 children. The isoenzyme BB could be proved as a normal component in the human serum. In the adults examined, an activity of 0.56 +/- 0.16 I.U./l (x +/- S.D.) was determined. The activity of creatine kinase isoenzyme BB in the serum does not depend on sex but is subject, however, to a strong age dependence. Only at an age of more than 18 years, isoenzyme BB activities adjust to those of adults.


Deep mining and quantification of oxidized cholesteryl esters discovers potential biomarkers involved in breast cancer by liquid chromatography-mass spectrometry.
Oxidized cholesteryl ester (OxCE) is produced by the oxidation of cholesteryl ester (CE) in the cores of lipoproteins. OxCE production and oxidative stress have been largely associated with breast cancer. Herein, we developed a novel reverse-phase liquid chromatography coupling quadrupole time-of-flight mass spectrometry (RPLC‒Q-TOF‒MS) method based on the iterative acquisition mode and used the MS/MS mode for deep mining and simultaneous quantification of cholesterol (Chol), CEs and OxCEs in human serum. A mathematical model was used to globally profile 57 molecular species of both CEs and OxCEs in the serum of both healthy volunteers and patients with breast cancer, and the qualitative results were verified based on the retention regularity. An abnormal elevation of OxCEs was found in serum samples of breast cancer patients, where OxCEs were produced by the oxidation of the fatty acyl chain of CE (20:4), such as CE (20:1)+3O, CE (20:2)+2O and CE (20:3)+O, which could be regarded as biomarkers. This comprehensive method for the global profiling of Chol, OxCEs and CEs sheds light on the role OxCEs and CEs play in breast cancer and has enabled the discovery of breast cancer biomarkers.


Bubaline herpesvirus 1 associated with abortion in a Mediterranean water buffalo.
During routine analysis of water buffalo foetuses, one sample was positive for herpesvirus and negative to all the other abortive agents investigated. Sequencing of the herpesvirus glycoprotein E gene identified the virus as bubaline herpesvirus 1, showing few differences with the published sequences. This represents the first finding of bubaline herpesvirus in a water buffalo foetus associated with abortion.


Impingement syndromes of the ankle and hindfoot.
Ankle impingement refers to a chronic painful mechanical limitation of ankle motion caused by soft-tissue or osseous abnormality affecting the tibiotalar joint or extraarticular soft tissues. Impingement can be associated with a prior single traumatic event or repetitive microtrauma, often in an adolescent with anatomical predisposition. Impingement syndromes at the tibiotalar joint can be subdivided into anterior, anterolateral, anteromedial, posterior or posteromedial. Extraarticular impingement can consist of talocalcaneal or subfibular impingement. Impingement syndromes are just one possible etiology of persistent ankle pain, and although the diagnosis is often made or suspected clinically, the radiologist might be the first person to raise the possibility of the diagnosis or be called upon to provide support for the clinically suspected diagnosis. In this article I review the etiology, imaging findings and current treatment associated with these conditions.


The asymptotic leading term of anisotropic small-angle scattering intensities. II. Non-convex particles.
For anisotropic particulate samples with scattering contrast (delta n)(2), the leading asymptotic term of the scattering intensity, along a direction q (q/q) of reciprocal space, is [4 pi(2)(delta n)(2)/q(4)]sigmaj [1/kappaG.j(+/-q)]. Here, kappaG.j(+/-q)denotes the Gaussian curvature value at the points (labelled by j) of the interphase surface where the normal is either parallel or antiparallel to q. If the Gaussian curvature vanishes at, say, the jth of these points, the corresponding contribution takes the form Cj/qalpha with 2< or = alphaj<4, Cj and alphaj being determined by the local behaviour of the surface. However, the intensity detected by a counter pixel, with opening solid angle deltaomega(q0) along (mean) direction q0, asymptotically still behaves as 4pi(2) (delta n)(2)(deltaomega(q0))/q(4), where S(deltaomega(q0)) is the area of that part of the interface that has its normals inside deltaomega(q0).


Assessment of COVID-19 Impact on Commercial Sex Workers in India: A Formative Research by Media Scanning.
The COVID-19 pandemic restricted movement, closed businesses, and economic activities which disproportionately affected people globally. This pandemic has resurfaced the existing cracks in the societal set-up and has pushed the vulnerable and marginalized communities like migrant workers, people with disabilities, geriatric population, and commercial sex workers (CSWs) to an edge for their existence. Due to the paucity of peer-reviewed research publications on CSWs, formative research was conducted to identify the determinants and attributes of the challenges faced by CSWs during COVID-19 situation in India. Media scanning approach was used to collate literature from newspaper and magazine reporting, and peer-reviewed articles were referred from research-based search engines. In total, 31 articles were included for content analysis and four domains of issues i.e., economic, social, psychological and health related challenged faced by them were identified which are supported with the verbatims of the community members as reported in the data sources considered for this study. It was identified that the CSWs adopted several protective measures and coping strategies to deal with the pandemic situation. This research highlighted that there is a need for further exploration of issues among CSWs by conducting studies among the communities. Furthermore, this paper provides a scope for future implementation research by identifying the key priorities and determinants of the challenges among the personal livelihood of CSWs in the country.


Digital reconstruction using the distally based osteofasciocutaneous radial forearm flap.
The Chinese forearm flap is a versatile flap in hand reconstruction. Five cases are reported. The mechanism and reliability of retrograde venous return is discussed.


N-antigenemia detection by a rapid lateral flow test predicts 90-day mortality in COVID-19: A prospective cohort study.
To evaluate if the detection of N antigen of SARS-CoV-2 in plasma by a rapid lateral flow test predicts 90-day mortality in COVID-19 patients hospitalized at the wards. The presence of N-antigenemia was evaluated in the first 36 hours after hospitalization in 600 unvaccinated COVID-19 patients, by using the Panbio COVID-19 Ag Rapid Test Device from Abbott (Abbott Laboratories Inc., Chicago, IL, USA). The impact of N-antigenemia on 90-day mortality was assessed by multivariable Cox regression analysis. Prevalence of N-antigenemia at hospitalization was higher in nonsurvivors (69% (82/118) vs. 52% (250/482); p < 0.001). The patients with N-antigenemia showed more frequently RNAemia (45.7% (148/324) vs. 19.8% (51/257); p < 0.001), absence of anti-SARS-CoV-2 N antibodies (80.7% (264/327) vs. 26.6% (69/259); p < 0.001) and absence of S1 antibodies (73.4% (240/327) vs. 23.6% (61/259); p < 0.001). The patients with antigenemia showed more frequently acute respiratory distress syndrome (30.1% (100/332) vs. 18.7% (50/268); p = 0.001) and nosocomial infections (13.6% (45/331) vs. 7.9% (21/267); p = 0.026). N-antigenemia was a risk factor for increased 90-day mortality in the multivariable analysis (HR, 1.99 (95% CI,1.09-3.61), whereas the presence of anti-SARS-CoV-2 N-antibodies represented a protective factor (HR, 0.47 (95% CI, 0.26-0.85). The presence of N-antigenemia or the absence of anti-SARS-CoV-2 N-antibodies after hospitalization is associated to increased 90-day mortality in unvaccinated COVID-19 patients. Detection of N-antigenemia by using lateral flow tests is a quick, widely available tool that could contribute to early identify those COVID-19 patients at risk of deterioration.


Amperometric biosensor based on a functionalized gold electrode for the detection of antioxidants.
A method for the electrochemical detection of antioxidants has been developed, which is based on a radical measurement with a cytochrome c modified electrode. A controlled enzymatic production system for superoxide radicals based on xanthine oxidase was used. The addition of antioxidants facilitated the decomposition of the radical in addition to the spontaneous dismutation. The steady-state of superoxide generation and decomposition was thus shifted to a new situation due to the higher decomposition rate after antioxidant addition. This resulted in a decreased current level at the electrode. Antioxidant activity could be quantified from the response of the sensor electrode by the percentage of the signal decrease. The 50% inhibition value (IC(50)) for different antioxidants was calculated and the antioxidant activity of numerous substances was compared. Thus, a hierarchy of superoxide radical scavenging abilities of flavonoids was established: flavanols>flavonols>flavones>flavonones>isoflavonones.


Phase III study of ranimustine, cyclophosphamide, vincristine, melphalan, and prednisolone (MCNU-COP/MP) versus modified COP/MP in multiple myeloma: a Japan clinical oncology group study, JCOG 9301.
To investigate whether combination chemotherapy with vincristine, cyclophosphamide, prednisolone, and melphalan (COP/ MP) with the addition of ranimustine (MCNU) (MCNU-COP/MP) is superior to the slightly modified COP/MP (mCOP/MP) regimen in multiple myeloma (MM), a multicenter randomized study was performed. Two hundred ten patients with newly diagnosed, overt MM not treated with chemotherapy were enrolled from 32 institutions of the Lymphoma Study Group of the Japan Clinical Oncology Group and were randomized to receive either MCNU-COP/MP or mCOP/MP. The response rate (RR) to mCOP/MP was 43.7% (95% confidence interval [CI], 33.9%-53.8%] and to MCNU-COP/MP was 56.1% (95% CI, 46.1%-65.7%) (P = .097). The progression-free survival (PFS) was significantly longer for patients treated with MCNU-COP/MP than for patients treated with mCOP/MP (median, 23.0 months [95% CI, 18.9-25.8] versus 15.8 months [95% CI, 14.1-19.4]) (P = .014). However, no significant difference in overall survival rate (OS) was observed between the groups (median, 49.9 months [95% CI, 40.4-59.1] versus 44.0 months [95%, CI, 32.8-59.8]) (P = .75). Grades 3 and 4 hematological toxicities were more frequently observed with MCNU-COP/MP than with mCOP/MP, but the incidence of grades 3 and 4 nonhematological toxicities was low in both groups. In conclusion, MCNU-COP/MP in comparison with mCOP/MP improved RR and PFS in overt MM; however, this outcome did not contribute to prolonging OS, indicating that addition of MCNU to mCOP/MP has no benefit on survival.


Postlobectomy chest radiographic changes: a quantitative analysis.
To provide a quantitative analysis of postlobectomy chest radiographic changes and to evaluate whether the scarring from prior sternotomy affects the size of the hemithorax and the duration of air leak in patients with subsequent lobectomy. In this retrospective case-controlled series, 10 consecutive patients who had a lobectomy after a prior sternotomy and 30 controls, 3 for each case, matched for lobectomy site were identified. Pre- and postoperative chest radiographs were quantitatively analysed for diaphragmic elevation, size of each hemithorax, mediastinal shift, and the presence of pneumothorax. Charts were reviewed for air-leak duration, surgical complications, and duration of hospitalization. There was no difference between patients with lobectomy and with and without prior sternotomy for the following variables expressed as mean (SD): hemidiaphragm elevation (1.5 ± 2.5 vs 0.5 ± 2.0 cm; P = .2), change of hemithorax size (mean transverse, 0.99 ± 0.05 vs 0.97 ± 0.07; P = .5; craniocaudal, 0.93 ± 0.08 vs 0.91 ± 0.08; P = .4) and mediastinal shift (upper, 1.2 ± 0.4 vs 1.3 ± 0.6; P = .5; lower, 1.2 ± 0.4 vs 1.2 ± 0.3; P = .8), the latter 2 were expressed as the ratio of post- to preoperative measurements. These postlobectomy radiographic findings varied, depending on the resected lobe, and became progressively more pronounced during the first 12 months after surgery. There was no difference in pneumothorax duration (mean [SD]) (9.5 ± 21 days vs 6.4 ± 7.5 days; P = .5), air leak duration (mean [SD]) (0.7 ± 0.8 days vs 1.3 ± 3.9 days; P = .6), complication rate (20% vs 30%; P = .5), or hospital stay (mean [SD]) (6.0 ± 1.7 days vs 6.9 ± 4.7 days; P = .6). There are specific patterns of volume loss, mediastinal shift, and hemidiaphragm displacement that can be quantified on postlobectomy chest radiographs. Prior sternotomy did not affect postlobectomy radiographic changes or patient outcome.


Phosphonosphingoglycolipid, a novel sphingolipid from the viscera of Turbo cornutus.
A novel lipid which contained long-chain base, fatty acid, galactose and N-methylamino-ethylphosphonic acid in an equimolar was isolated from the viscera of Turbo cornutus. The method used for the structural elucidation of this lipid were partial acid hydrolysis, alkaline hydrolysis, periodate oxidation and Smith degradation. The structure of break-down products were mainly identified by combined gas chromatography and mass spectrometry. The structure of the novel lipid was determined to be 1-O-[6'-O-(N-methylaminoethyl-phosphonyl) galactopyranosyl] ceramide. Mass spectra of galactose-N-methylaminoethylphospnate and glycerol-N-methylamino-ethylphosphonate are given.


[Surgical infections with anaerobic bacteria (splenic abscess ruptured into the peritoneum].
A case is presented, of a patient aged 19, who, in the course of otic suppuration treated by tetracycline administration, developed a septicemic condition with a gigantic splenic abscess followed by generalized peritonitis. The initially unfavourable evolution had an improved course following splenectomy and peritoneal drainage, especially after the identification of the anaerobic germs that determined the infection (Bacteroides clostridii formis and Clostridium bifermentans) and the introduction of an adequate therapy.


What is the role of dynamic cervical spine radiographs in predicting pseudarthrosis revision following anterior cervical discectomy and fusion?
Postoperative dynamic radiographs are used to assess fusion status after anterior cervical discectomy and fusion (ACDF) with comparable accuracy to computed tomography (CT) scans. To (1) determine if dynamic radiographs accurately predict pseudarthrosis revision in a cohort of largely asymptomatic patients who underwent ACDF, (2) determine how adjacent segment motion is affected by fusion status, and (3) analyze how clinical outcomes differ between patients with symptomatic and asymptomatic pseudarthrosis. Retrospective cohort study. Patients ≥ 18 years who underwent primary one- to four-level ACDF at a single institution over a 10-year period. Interspinous motion on preoperative and postoperative flexion-extension radiographs and preoperative and postoperative Visual Analogue Scale for Neck Pain (VAS Neck) and Arm Pain (VAS Arm), Neck Disability Index (NDI), Modified Japanese Orthopaedic Association scale (mJOA), Mental and Physical Component Scores of the Short-Form 12 (SF-12) Health Survey (MCS-12 and PCS-12) METHODS: The difference in spinous process motion between flexion and extension radiographs was used to determine motion at each level of the ACDF construct. Pseudarthrosis was defined as ≥ 1 mm spinous process motion on dynamic radiographs. A receiver operating characteristic (ROC) curve was generated to predict the probability of surgical revision for pseudarthrosis based on millimeters of interspinous motion at each instrumented level. Patient reported outcome measures (PROMs) were used to assess the effect of pseudarthrosis on clinical outcomes. Alpha was set at p<.05. A total of 597 patients met inclusion criteria including 1,203 ACDF levels. Of those, 215 patients (36.0%) were diagnosed with a pseudarthrosis on dynamic radiographs with 29 patients (4.9%) requiring pseudarthrosis revision. ROC analysis identified a "cutoff" value of 1.00 mm of interspinous process motion for generating an optimal area under the curve (AUC). The negative predictive value (NPV) was 99.6%, whereas the positive predictive value (PPV) was 13.7%. When analyzing adjacent segment motion, the Δ supra-adjacent interspinous process motion (ISM) was significantly lower for patients with a superior construct pseudarthrosis (-1.06 mm vs. 1.80 mm, p<.001), whereas the Δ infra-adjacent level ISM was significantly lower for patients with an inferior construct pseudarthrosis (-1.21 mm vs. 2.15 mm, p<.001). Patients with a pseudarthrosis not requiring revision had worse postoperative NDI (29.3 vs. 23.4, p=.027), VAS Neck (3.40 vs. 2.63, p=.012), and VAS Arm (3.09 vs. 1.85, p=.001) scores at 3 months, but not 1-year, compared with patients who were fused. Patients requiring pseudarthrosis revision had higher 1-year postoperative NDI (38.0 vs. 23.7, p=.047) and lower 1-year postoperative Δ VAS Arm (-0.22 vs. -2.97, p=.016) scores. One-year postoperative dynamic radiographs have a greater than 99% negative predictive value for identifying patients requiring pseudarthrosis revision, but they have a low positive predictive value. Most patients with a pseudarthrosis remain asymptomatic with similar 1-year postoperative patient-reported outcomes compared with patients without a pseudarthrosis.


Acute lumbosacral nerve stimulation does not affect anorectal motor function in a rodent model.
Sacral nerve stimulation has become a first line treatment for fecal incontinence, however, its effect on the motor function of the anorectum is uncertain. The aim of this study was to apply acute lumbosacral nerve stimulation in an animal model and to determine its effect on the external and internal anal sphincter forces, the rectoanal inhibitory and excitatory reflexes, and the slow wave frequency of the internal anal sphincter. Lumbosacral nerve stimulation was applied to 16 nulliparous female rats. A novel in vivo preparation was designed to allow simultaneous monitoring of external and internal anal sphincter forces. The effect of rectal distension on the two anal sphincters was also studied. Lumbosacral nerve stimulation delivered at either S1 or L6 in rodents did not affect sphincter forces, rectoanal reflexes or slow wave frequency of anal canal smooth muscle. The absence of effect on the motor pathways of continence suggests that the mechanism of action is predominantly on sensory feedback mechanisms from the anorectum, thereby increasing cortical awareness of the pelvic floor.


Paradoxical eyelid movement in trisomy 2p.
Paradoxical eyelid movement was reported in a 12-year-old female with 46,XX,dup(2)(p25.3p22.2). Alternating seesaw-like movement of the eyelids during lateral gazing had been observed at 5 months of age when she was first referred to our neuropediatric outpatient department, and the abnormal lid movement persisted without any change for 11 years. The differentiation of the features of the paradoxical lid movements in our patient from those of Duane syndrome were discussed, and a possible pathogenesis is discussed as well. Besides ophthalmologic abnormalities, the patient demonstrated severe psychomotor retardation, marked growth failure, symptomatic generalized epilepsy, and multiple anomalies. The dysmorphism consisted of a cleft lip, a narrow high-arched palate, malalignment, lowset ears, and kyphoscoliosis caused by fused thoracic vertebrae.


Regulation of the density of spermatogonia in the seminiferous epithelium of the Chinese hamster: I. Undifferentiated spermatogonia.
The topographical arrangement of the clones of A single, A paired, and A aligned (As, Apr, and Aal) spermatogonia on the basement membrane of seminiferous tubules of the Chinese hamster was studied. It was found that at least some of these clones are not distributed at random as clones of similar cell number were often seen in clusters. Areas were found with few or many As spermatogonia. Also, clusters of Apr spermatogonia were found, indicating that in such an area many As spermatogonia more or less synchronously formed Apr spermatogonia. Since clusters of clones of 16 Aal spermatogonia were observed, it can be concluded that these clusters of Apr spermatogonia may proliferate in at least a roughly synchronous way. It was found that over large areas the densities of undifferentiated spermatogonia may be very low or high in comparison to the mean density in the animal. Whether the ratio of self-renewal and differentiation of the stem cells changed locally in response to the high or low density of undifferentiated spermatogonia in particular areas was investigated. No indications for a regulatory mechanism to keep the density of stem cells and/or the density of undifferentiated spermatogonial clones at a certain level could be detected in the normal Chinese hamster. This lack of regulation was at least partly responsible for the widely different numbers of A1 spermatogonia that were formed in the various areas studied in stage IX.


Quantitative aspects of structural changes in chorioallantoic placenta of the rat during its development.
Volume analysis of chorioallantoic placenta of the rat from day 12 through day 22 of fetal development shows quantitatively the changes in volume density of fetal and maternal parts, and changes of volume fractions of structural components along with the increase of absolute volume of the placenta.


Potential therapeutic uses of mecamylamine and its stereoisomers.
Mecamylamine (3-methylaminoisocamphane hydrochloride) is a nicotinic parasympathetic ganglionic blocker, originally utilized as a therapeutic agent to treat hypertension. Mecamylamine administration produces several deleterious side effects at therapeutically relevant doses. As such, mecamylamine's use as an antihypertensive agent was phased out, except in severe hypertension. Mecamylamine easily traverses the blood-brain barrier to reach the central nervous system (CNS), where it acts as a nicotinic acetylcholine receptor (nAChR) antagonist, inhibiting all known nAChR subtypes. Since nAChRs play a major role in numerous physiological and pathological processes, it is not surprising that mecamylamine has been evaluated for its potential therapeutic effects in a wide variety of CNS disorders, including addiction. Importantly, mecamylamine produces its therapeutic effects on the CNS at doses 3-fold lower than those used to treat hypertension, which diminishes the probability of peripheral side effects. This review focuses on the pharmacological properties of mecamylamine, the differential effects of its stereoisomers, S(+)- and R(-)-mecamylamine, and the potential for effectiveness in treating CNS disorders, including nicotine and alcohol addiction, mood disorders, cognitive impairment and attention deficit hyperactivity disorder.


Inhibition of insulin receptors by vanadate and ouabain.
Insulin binding studies were performed, using cells from 5 non-obese, non-diabetic subjects, on four separate days: 2 were paired control studies to demonstrate precision, and 2 other sets were binding studies in which one incubation solution was a control and the other contained either vanadate, (10(-4) M) or ouabain (10(-4) M). For both substances tracer binding of 125I insulin was reduced significantly, 27% by vanadate and 30% by ouabain. Furthermore, at all points on the binding curve these substances inhibited binding by 18-98%, in a pattern consistent with reduced receptor number. The concentrations of vanadate or ouabain which we used did not change cell volume or inhibit trypan blue dye exclusion, as an index of cell viability. Because vanadate and ouabain inhibit Na+K+ATPase and have largely dissimilar effects on a variety of cell systems, our observations may reflect specific involvement of Na+K+ATPase in binding or closely related processes.


A Web-based database for pathology faculty effort reporting.
To ensure appropriate mission-based budgeting and equitable distribution of funds for faculty salaries, our compensation committee developed a pathology-specific effort reporting database. Principles included the following: (1) measurement should be done by web-based databases; (2) most entry should be done by departmental administration or be relational to other databases; (3) data entry categories should be aligned with funding streams; and (4) units of effort should be equal across categories of effort (service, teaching, research). MySQL was used for all data transactions (http://dev.mysql.com/downloads), and scripts were constructed using PERL (http://www.perl.org). Data are accessed with forms that correspond to fields in the database. The committee's work resulted in a novel database using pathology value units (PVUs) as a standard quantitative measure of effort for activities in an academic pathology department. The most common calculation was to estimate the number of hours required for a specific task, divide by 2080 hours (a Medicare year) and then multiply by 100. Other methods included assigning a baseline PVU for program, laboratory, or course directorship with an increment for each student or staff in that unit. With these methods, a faculty member should acquire approximately 100 PVUs. Some outcomes include (1) plotting PVUs versus salary to identify outliers for salary correction, (2) quantifying effort in activities outside the department, (3) documenting salary expenditure for unfunded research, (4) evaluating salary equity by plotting PVUs versus salary by sex, and (5) aggregating data by category of effort for mission-based budgeting and long-term planning.


Assessing unmet need for services for pediatric undernutrition. HSPH MPH Student Research Team.
Evaluation and treatment of undernourished children in Massachusetts has been provided since 1984 by the seven outpatient Growth and Nutrition (GN) Clinics administered by the Massachusetts Department of Public Health (MDPH). This study explored the potential unmet need for nutritional services among low-income, multiethnic children ages birth to 36 months presenting to an inner-city pediatric emergency department (ED). During March 1992, staff obtained weight and stature on all children under 36 months of age brought to the ED. A structured interview questionnaire obtained data on demographic characteristics, birth history, and participation in means-tested federal benefit programs and MDPH GN Clinics. Among 252 children with complete anthropometric data, 22 (8.9%) had at least one anthropometric index (weight-for-age, height-for-age, weight-for-height) below the fifth percentile. Birthweights < 2500 g were reported by 18.5% of caregivers; 58% of children with height-for-age less than the fifth percentile and 63% of those with weight-for-age less than the fifth percentile were low birthweight (LBW) (Fisher's exact test, P < .002 and P < .006, respectively). Thirteen percent of families had no health insurance, and 77.1% received Medicaid. Among 22 children with anthropometry less than the fifth percentile, one half to three quarters participated in federally funded programs including Special Supplemental Food Program for Women, Infants, and Children (WIC), Aid to Families With Dependent Children (AFDC), and Food Stamps, but only 11% had been referred to the GN Clinics. These findings suggest that federal means-tested benefit programs and MDPH GN Clinic services were underused by groups at nutritional risk.(ABSTRACT TRUNCATED AT 250 WORDS)


Specific imaging features indicate the clinical features of patients with hepatic perivascular epithelioid cell tumor by comparative analysis of CT and ultrasound imaging.
The objective of the study was to explore the CT and ultrasound features and clinical significance of perivascular epithelioid cell tumor (PEComa) of the liver. Eleven hepatic PEComa patients treated in our hospital were retrospectively analyzed based on the characteristics of the imaging results of the patients, including conventional ultrasound, CDFI, contrast-enhanced ultrasound (CEUS), and contrast-enhanced CT (CECT). CT scans showed that all lesions were hypodense. Ultrasonography showed that lesions were either hyperechoic (4/11, 36.36%), hypoechoic (4/11, 36.36%), isoechoic (1/11, 9.09%), or heterogeneously echoic (2/11, 18.18%). CDFI showed that most of the lesions had an abundant blood supply (9/11, 81.82%). Whether on CT scan or ultrasonography, the margins of the lesions were dominated by clear margins. Ultrasonography revealed more features: hyperechoic patterns around lesions (3/11, 27.27%) and lateral shadow (5/11, 45.45%). The CDFI showed that large blood vessels were observed around the lesions (9/11, 81.82%). CECT shows two enhancement patterns: "fast in and fast out (FIFO)" (8/11, 72.72%) and "fast in and slow out (FISO)" (3/11, 27.27%). CEUS shows that all lesions had the enhancement pattern of "FISO," which was different from CECT. All lesions displayed rapid enhancement during HAP in CEUS during 7-20 s. Four patients (36.36%) washed out at 60-180 s, another four (36.36%) washed out at 180-300 s, and the remaining three patients (27.27%) showed no signs of washout even at 360 s. Some imaging features, such as clear margins, peripheral hyperechoic around the lesion, lateral shadow, the large blood vessels around lesions, and the "FISO" enhancement pattern, may indicate expansive growth of the tumor and be helpful in the diagnosis of PEComa. Ultrasound images may provide more details for clinical reference.


Corrigendum to "Novel Insights into the Predictors of Obstructive Sleep Apnea Syndrome in Patients with Chronic Coronary Syndrome: Development of a Predicting Model".
[This corrects the article DOI: 10.1155/2022/5497134.].


Organizational Culture as a Determinant of Outcome in Teams: Implications for the Pediatric Cardiac Specialist.
Although enormous effort has focussed on how to build an effective culture in the business community, relatively little effort has addressed how to achieve this in the hospital environment, specifically related to the field of congenital heart disease teams. The examination of culture in pediatric cardiac care is particularly important for several key reasons: first, it represents high-stakes medicine, second, there are multiple stakeholders requiring collaboration between cardiologists, surgeons, anaesthesiologists, perfusionists, nursing staff, and allied health care professionals, and finally, both the patient and the family are intimately involved in the care pathway. This review article investigates some of the critical components to building an effective culture, drawing upon similarities in other disciplines, thereby fostering high performance multidisciplinary teams in congenital cardiology care. Strategies to change culture such as Kotter's model of change are also discussed. High performance teams share one common vital characteristic: psychological safety for team members to speak their minds, thereby fostering an open culture, in which creativity can flourish to facilitate major breakthroughs. Adoption of the "Flight Plan" review promotes patient centric care and champions a psychologically safe culture.


cDNA copies of the testis-specific lactate dehydrogenase (LDH-C) mRNA are present in spermatogenic cells in mice, but processed pseudogenes are not derived from mRNAs that are expressed in haploid and late meiotic spermatogenic cells.
Retroposons are a class of genes created by reverse transcribing a processed mRNA and inserting the DNA copy into genomic DNA in germ-line cells. The present study concerns the question: Are retroposons created in meiotic and haploid spermatogenic cells? We demonstrate that polymerase chain reaction amplifies cytoplasmic DNAs with the expected intronless-structure of endogenous reverse transcriptase copies of the processed lactate dehydrogenase C mRNA encoding the testis-specific isoform of lactate dehydrogenase. Quantification of cytoplasmic LDH-C mRNA and endogenous cDNA by competitive RT-PCR and PCR, respectively, indicates that the level of LDH-C cDNA is lower by a factor of about 10(7) than the level of LDH-C mRNA in the cytoplasmic nucleic acids extracted from the testes of 14-day-old mice, and that about 1 in 10(5) meiotic cells contains an endogenous cDNA copy of LDH-C mRNA. A review of the literature reveals that a large number of genes including the LDH-C gene, whose expression is restricted to spermatogenic cells, are always single copy. Collectively, these observations suggest that reverse transcriptase cDNA copies of mRNAs are present in meiotic and haploid spermatogenic cells, but these cDNAs are not integrated into genomic DNA.


Tryptophan availability for kynurenine pathway metabolism across the life span: Control mechanisms and focus on aging, exercise, diet and nutritional supplements.
Tryptophan (Trp) availability for the kynurenine pathway (KP) across the life span is discussed. Free (non-albumin-bound) plasma Trp is the major determinant of the flux of Trp down the KP. Flux is the major determinant of kynurenine metabolite formation and is more effective than induction of hepatic Trp 2,3-dioxygenase (TDO) or extrahepatic indoleamine 2,3-dioxygenase (IDO). Flux is better expressed using the sum of plasma kynurenine and its metabolites, rather than kynurenine only. Under normal conditions, TDO controls Trp flux in liver and availability in plasma and can supply kynurenine for the extrahepatic pathway. Under certain pathological conditions associated with immune activation, IDO assumes the major role in control of Trp availability. Plasma Trp availability is increased during pregnancy, at birth, and by exercise, high protein and fat intake. Aging does not seem to exert a major effect on plasma Trp. Assessment of plasma Trp availability in health and disease requires measurement of concentrations of both free and total [Trp] in the first instance, followed, if necessary, by those of albumin and the physiological displacers of albumin-bound Trp, non-esterified fatty acids. Additional measures should include cortisol, cytokines, kynurenine and its metabolites. This article is part of the Special Issue entitled 'The Kynurenine Pathway in Health and Disease'.


Piezoelectric line detector array for photoacoustic tomography.
Photoacoustic tomography relies on a dense coverage of the surface surrounding the imaged object with ultrasound sensors in order to enable an accurate reconstruction. A curved arrangement of integrating line sensors is proposed that is able to acquire data for a linear projection image of the absorbed energy density distribution in the object. Upon rotation of the object relative to the array, three-dimensional (3D) images can be obtained. The proposed design is based on the cost-effective piezoelectric polymer film technology with 64 line shaped sensors arranged on a half-cylindrical surface. It is combined with an optical parametric oscillator for the near infrared as a source for laser pulses. Image reconstruction from recorded signals consists of two-dimensional (2D) back projection followed by an inverse Radon transform. The tomograph exhibits a spatial resolution on the order of 200 to 250 μm. In a phantom experiment, the steps from acquisition of a single, 2D projection image to a full 3D image are demonstrated. Finally, in vivo projection images of a human finger are shown, revealing the near real-time imaging capability of the device in 2D.


Reliability and validity of the cross-culturally adapted Turkish version of the Core Outcome Measures Index for low back pain.
To produce a cross-culturally adapted and validated Turkish version of The Core Outcome Measure Index (COMI) Back questionnaire. Ninety-six Turkish-speaking patients with non-specific low back pain (LBP) were recruited from orthopedic and physical therapy outpatient clinics in a public hospital. They completed a booklet of questionnaires containing Turkish version of COMI, adjectival pain scale, Roland Morris disability questionnaire, European 5 Dimension Questionnaire and brief version of World Health Organization Quality of Life Questionnaire. Within following 7-14 days, 67 patients, reported no or minimal changes in their back pain status, completed the Turkish COMI again to assess reproducibility. Data quality was good with very few missing answers. COMI summary index score displayed 3% floor effects and no ceiling effects. The correlations between the COMI summary index score and each of the full instrument whole scores were found to be excellent to very good (ρ = - 0.81 to 0.74). Reliability expressed as intraclass correlation coefficient (ICC) was 0.95 (95% CI 0.91-0.97). Standard error of measurement (SEMagreement) was acceptable at 0.41 and the minimum detectable change (MDC95%) was 1.14. Turkish version of the COMI has acceptable psychometric properties. It is a valid and reliable instrument and cross-culturally adapted, in accordance with established guidelines, for the use by Turkish-speaking patients. It can be recommended for use in evaluation of patients with chronic LBP in daily practice, in international multicenter studies and in spine registry systems.


Thermophilic and halophilic β-agarase from a halophilic archaeon Halococcus sp. 197A.
An agar-degrading archaeon Halococcus sp. 197A was isolated from a solar salt sample. The agarase was purified by hydrophobic column chromatography using a column of TOYOPEARL Phenyl-650 M. The molecular mass of the purified enzyme, designated as Aga-HC, was ~55 kDa on both SDS-PAGE and gel-filtration chromatography. Aga-HC released degradation products in the order of neoagarohexose, neoagarotetraose and small quantity of neoagarobiose, indicating that Aga-HC was a β-type agarase. Aga-HC showed a salt requirement for both stability and activity, being active from 0.3 M NaCl, with maximal activity at 3.5 M NaCl. KCl supported similar activities as NaCl up to 3.5 M, and LiCl up to 2.5 M. These monovalent salts could not be substituted by 3.5 M divalent cations, CaCl2 or MgCl2. The optimal pH was 6.0. Aga-HC was thermophilic, with optimum temperature of 70 °C. Aga-HC retained approximately 90 % of the initial activity after incubation for 1 hour at 65-80 °C, and retained 50 % activity after 1 hour at 95 °C. In the presence of additional 10 mM CaCl2, approximately 17 % remaining activity was detected after 30 min at 100 °C. This is the first report on agarase purified from Archaea.


Overexpression and characterization of a lipase from Bacillus subtilis.
A novel plasmid, pBSR2, was constructed by incorporating a strong lipase promoter and a terminator into the original pBD64. A mature lipase gene from Bacillus subtilis strain IFFI10210, an existing strain for lipase expression, was cloned into the plasmid pBSR2 and transformed into B. subtilis A.S.1.1655. Thus, an overexpression strain, BSL2, was obtained. The yield of lipase is about 8.6 mg protein/g of wet weight of cell mass and 100-fold higher than that in B. subtilis strain IFFI10210. The recombinant lipase was purified in a three-step procedure involving ammonium sulfate fractionation, ion exchange, and gel filtration chromatography. Characterizations of the purified enzyme revealed a molecular mass of 24 kDa in sodium dodecyl sulfate-polyacrylamide gel electrophoresis, maximum activity at 43 degrees C and pH 8.5 for hydrolysis of p-nitrophenyl caprylate. The values of Km and Vm were found to be 0.37 mM and 303 micromol mg-1 min-1, respectively. The substrate specificity study showed that p-nitrophenyl caprylate is a preference of the enzyme. The metal ions Ca2+, K+, and Mg2+ can activate the lipase, whereas Fe2+, Cu2+, and Co2+ inhibited it. The activity of the lipase can be increased about 48% by sodium taurocholate at the concentration of 7 mM and inhibited at concentrations over 10 mM.


Impaired blockade of insulin-like growth factor I (IGF-I)-induced hypoglycemia by IGF binding protein-3 analog with reduced ternary complex-forming ability.
The hypoglycemic potential of circulating IGFs is thought to be regulated through the formation of ternary complexes consisting of an IGF, either IGF binding protein-3 (IGFBP-3) or IGFBP-5, and the acid-labile subunit. These high molecular weight complexes are confined to the circulation and represent a reservoir of IGF with a prolonged half-life. In this study, we show that hypoglycemia, induced by a bolus injection of recombinant human IGF-I into rats, can be blocked by coadministering equimolar concentrations of either recombinant glycosylated IGFBP-3 or nonglycosylated IGFBP-3 (IGFBP-3NG). In contrast, an IGFBP-3 mutant with reduced acid- labile subunit affinity (IGFBP-3MUT) only partially blocked the IGF-I hypoglycemic effect. IGFBP-3 and IGFBP-3NG significantly enhanced IGF-I retention in the circulation, whereas IGFBP-3MUT had a smaller effect. IGFBP-3MUT clearance was more rapid than that of the other IGFBP-3 forms, and the retention of all IGFBP-3 forms was greatly enhanced by coadministration of IGF-I. Characterization of the molecular mass distribution of the IGFBP-3 analogs indicated that 60% of IGFBP-3 and IGFBP-3NG was initially found in ternary complexes compared with 30% of IGFBP-3MUT. These data confirm the hypothesis that regulation of IGF-I bioactivity in vivo by IGFBP-3 depends on its ability to form ternary complexes.


Police interviews with adult reporters of historical child sexual abuse: Exploring the link between verbal rapport and information obtained.
Police officers and academics agree that rapport is important when interviewing victims and witnesses, although previous research has found that officers do not always engage in rapport-building behaviours during interviews. Interviews with complainants reporting historical child sexual abuse may be key to police investigations, as physical or corroborating evidence is often not available. This research explored the possible effect of verbal rapport-building behaviour on the elicitation of investigation-relevant details in historical child sexual abuse victim interviews. A sample of interviews (N = 44) with adults reporting historical child sexual abuse in a northern Canadian territory with a large Indigenous population was examined. Interviews were evaluated for interviewer verbal rapport-building behaviours, using a framework derived from Tickle-Degnen and Rosenthal's three domain model of rapport. Interviews were also coded for details given by the interviewee. Results showed that verbal rapport was significantly positively correlated with both total details (r = 0.621, p < .001) and abuse relevant details (r = 0.518, p < .001). Chronological Rapport Maps were piloted, to show the use of rapport behaviours over the course of interviews, and the possible effect over time of these behaviours on information yield. The results show that information yield is higher when more rapport behaviours are demonstrated and both parties work together harmoniously, even after a long delay. Further research is needed on the experience of police interviews for Indigenous complainants.


Effect of acid, steam explosion, and size reduction pretreatments on bio-oil production from sweetgum, switchgrass, and corn stover.
Bio-oil produced from biomass by fast pyrolysis has the potential to be a valuable substitute for fossil fuels. In a recent work on pinewood, we found that pretreatment alters the structure and chemical composition of biomass, which influence fast pyrolysis. In this study, we evaluated dilute acid, steam explosion, and size reduction pretreatments on sweetgum, switchgrass, and corn stover feedstocks. Bio-oils were produced from untreated and pretreated feedstocks in an auger reactor at 450 °C. The bio-oil's physical properties of pH, water content, acid value, density, and viscosity were measured. The chemical characteristics of the bio-oils were determined by gas chromatography-mass spectrometry. The results showed that bio-oil yield and composition were influenced by the pretreatment method and feedstock type. Bio-oil yields of 52, 33, and 35 wt% were obtained from medium-sized (0.68-1.532 mm) untreated sweetgum, switchgrass, and corn stover, respectively, which were higher than the yields from other sizes. Bio-oil yields of 56, 46, and 51 wt% were obtained from 1% H(2)SO(4)-treated medium-sized sweetgum, switchgrass, and corn stover, respectively, which were higher than the yields from untreated and steam explosion treatments.


Transfer of axonally transported phospholipids into myelin isolated from the rabbit optic pathway.
The contribution of the axonal transport to the biosynthesis of myelin phospholipids was investigated in the rabbit optic pathway. A double labeling technique was used. The same animals were injected with one isotope intravitreally and the other intraventricularly. This procedure allows double labeling of the optic nerves, optic tracts, lateral geniculate bodies (LGB), and superior colliculus (SC). The precursors simultaneously injected were: [1-14C]palmitate (15 microCi intravitreally in both eyes or 50 microCi intraventricularly) and [2-3H]glycerol (50 microCi intravitreally in both eyes of 100 microCi intraventricularly). Twenty four hours and 10 days after the injections, myelin was purified from pooled optic nerves and optic tracts as well as from pooled LGBs or SCs. The phospholipids were extracted and then separated by thin-layer chromatography; the specific radioactivity of the various classes of phospholipids was determined. Using both administration routes of C- or 3H-precursors, the distribution of label and specific radioactivity of myelin phospholipids in the retina and in all other optic structures were very similar. Phosphatidylcholine, phosphatidylethanolamine and phosphatidylserine + phosphoinositol were preferentially labeled with both precursors. These results suggest that, in the rabbit optic pathway the phospholipids synthesized in the retinal ganglion cells and transported along the axons, could undergo transaxonal transfer into myelin.


Associations of longitudinal height and weight with clinical outcomes in pediatric kidney replacement therapy: results from the ESPN/ERA Registry.
Associations between anthropometric measures and patient outcomes in children are inconsistent and mainly based on data at kidney replacement therapy (KRT) initiation. We studied associations of height and body mass index (BMI) with access to kidney transplantation, graft failure, and death during childhood KRT. We included patients < 20 years starting KRT in 33 European countries from 1995-2019 with height and weight data recorded to the ESPN/ERA Registry. We defined short stature as height standard deviation scores (SDS) < -1.88 and tall stature as height SDS > 1.88. Underweight, overweight and obesity were calculated using age and sex-specific BMI for height-age criteria. Associations with outcomes were assessed using multivariable Cox models with time-dependent covariates. We included 11,873 patients. Likelihood of transplantation was lower for short (aHR: 0.82, 95% CI: 0.78-0.86), tall (aHR: 0.65, 95% CI: 0.56-0.75), and underweight patients (aHR: 0.79, 95%CI: 0.71-0.87). Compared with normal height, patients with short and tall statures showed higher graft failure risk. All-cause mortality risk was higher in short (aHR: 2.30, 95% CI: 1.92-2.74), but not in tall stature. Underweight (aHR: 1.76, 95% CI: 1.38-2.23) and obese (aHR: 1.49, 95% CI: 1.11-1.99) patients showed higher all-cause mortality risk than normal weight subjects. Short and tall stature and being underweight were associated with a lower likelihood of receiving a kidney allograft. Mortality risk was higher among pediatric KRT patients with a short stature or those being underweight or obese. Our results highlight the need for careful nutritional management and multidisciplinary approach for these patients. A higher resolution version of the Graphical abstract is available as Supplementary information.


The role of zinc with special reference to the essential thiol groups in delta-aminolevulinic acid dehydratase of bovine liver.
delta-Aminolevulinic acid dehydratase (5-aminolevulinic acid hydro-lyase (adding 5-aminolevulinic acid and cyclizing), EC 22.214.171.124 purified from bovine liver in the presence of both SH-reducing reagent and zinc during the purification contained one zinc atom and eight SH groups/subunit. This preparation showed the full enzymatic activity even in the absence of thiol activator. It was found that two cysteine residues, one zinc atom and two histidine residues were involved in the active site. The enzyme was fullly active as long as two SH groups in the active site remained in the reduced form even in the absence of zinc. However, the enzymatic activity was completely lost, with a concomitant loss of bound zinc, upon oxidation of the SH groups to a disulfide bond, modification of SH groups with chemical reagents, or mercaptide formation by heavy metals. Thus, it is apparent that the activity depends on the essential SH groups. The zinc is not absolutely essential for the activity but may be required to prevent the essential SH groups from autooxidation by coordination. Binding experiments indicated that there was one binding site of zinc/subunit. Photooxidation of histidine residues diminished both enzymatic activity and bound zinc, suggesting that the histidine residues not only constituted the active site but also served as a possible ligand to zinc.


Robotic Transfer of the Latissimus Dorsi.
Robotic surgery has been used for a long time; it is earning space and its use is expanding in daily medical practice in several surgical specialties, with advantages over traditional surgical methods. This Technical Note presents an endoscopic robotic posterior shoulder approach that allows the surgeon to perform latissimus dorsi transfer endoscopically. This Technical Note describes the use of the da Vinci robot (Intuitive Surgical, Sunnyvale, CA) for transfers related to rotator cuff tears.


Capillary gas chromatography of lupin alkaloids.
The resolution and identification of twelve lupin alkaloids are demonstrated using capillary gas chromatography and gas chromatography-mass spectrometry. The quantitative capabilities of capillary gas chromatography are illustrated by specific reference to the four major alkaloids of lupinus angustifolius, namely lupanine, 13-hydroxylupanine, augustifoline and alpha-isolupanine.


Development of a Photonumeric Lip Health Scale.
The lips are important facial anatomic features with particular vulnerability to environmental damage, yet they have received little attention in the dermatologic literature. A photonumeric rating scale for clinically assessing lip heath is needed to advance lip research. To develop a photonumeric lip health assessment scale for clinical use that can evaluate the efficacy of products for improving lip health. The VISIA®-CR 4.3 system was used to photograph the frontal face of 103 subjects with Fitzpatrick skin types I–III exhibiting a range of lip health status based on the key characteristics of lip shine, texture, and vermilion border. An expert panel comprising 3 dermatologists independently rated the images based on the proposed rating scale. Images with ≥75% rater agreement were redistributed to the panel for selecting the final images and verification of the final scale. The panel selected 15 images for the final scale: 5 for each of the key characteristics (lip shine, texture, and vermilion border) and 1 for each ordinal rating of 0–5 within a characteristic (eg, 0=very shiny, 5=very dull). All of these images achieved 100% agreement among the raters. This scale provides healthcare professionals and researchers a way to evaluate current lip health, track improvement, and evaluate the efficacy of treatments. It can be used to communicate with patients during discussions about lip conditions, recommending treatments, and setting goals. The scale also provides a research tool to evaluate different formulations for developing lip care products. J Drugs Dermatol. 2020;19(6):   doi:10.36849/JDD.2020.5139.


Video-Based Patient Education Improves Patient Attitudes Toward Resident Participation in Outpatient Surgical Care.
Decipher if patient attitudes toward resident participation in surgical care can be improved with patient education using a video-based modality. A survey using a 5-pt Likert scale was created, piloted, and distributed in general and colorectal surgery outpatient clinics that had residents involved with patient care at 2 facilities, both with control and intervention groups. The intervention group viewed a short video (∼4 min) explaining the role, education, and responsibilities of medical students, residents, and attending surgeons prior to answering the survey. General and colorectal surgery outpatient clinics at the University of Texas Health San Antonio, Texas. A total of 383 responses were collected, all clinic patients were eligible. The majority of patients (82%) welcomed resident participation in their health care. Eighteen percent of patients did not expect residents to be involved in their care. Patients had favorable views of residents participating during their surgical procedures with 77% responding "agree" or "strongly agree" to a senior resident assisting with a complicated procedure. Patients who viewed the video versus control were less concerned with how much of the procedure the resident would perform (76% vs 86%, p = 0.010). Patients who viewed the video felt less inconvenienced (p = 0.004). The majority of patients are welcoming to resident participation in their surgical care but only 54% were expecting resident involvement at their clinic visit. Early explanation with an educational video of resident roles, education, and responsibilities may help bridge the gap and improve patient experience.


Evaluation of nutritional counselling in HIV-associated malnutrition.
In HIV-infected patients, the outcome of counselling as the first step of a nutritional intervention programme was evaluated, in order to identify clinical and nutritional predictors for its efficacy. 75 HIV-infected patients were investigated, most with advanced disease. Nutritional status was determined by body weight, bioelectrical impedance and 7-day food intake record. Prior mean weight loss was 10% (range = +4% to -31%). Counselling facilitated weight gain in 40 75 patients (1-4 months later, overall mean difference +1.4 +/- 6.2%) and in 14 34 patients (8-11 months later, overall mean difference -1.4 +/- 9.0%). Weight changes correlated with changes in body cell mass (r(2) = .69, p < .001) and in body fat (r(2) = .29, p < 0.05), but not extracellular mass. Underlying conditions such as AIDS definition, fever, and diarrhoea correlated to prior weight loss (p < .001) but not to the outcome of counselling. Low energy intake (before counselling, < 31.5 kcal/kg) did not correlate to prior weight loss but it predicted further weight loss (p < 0.05 towards normal intake). High energy intake (> 38.5 kcal/kg) correlated (p < 0.05) with more prior weight loss but not with further weight changes. Nutritional counselling may be an effective first-line intervention for malnourished HIV infected patients. More than half of patients gain weight without other nutritional treatment. Whereas the severity of malnutrition is influenced by the underlying disease, fever, and diarrhoea, the course of weight change after nutritional intervention is not. Counselling may reduce the nutritional impact of these risk factors. In patients with low spontaneous intake, efficacy of counselling alone is limited, but it may help to identify those who require more invasive nutritional treatment.


Quantitation of serological cross-reactivity between two geographical isolates of Oryctes baculovirus by a modified ELISA.
An assay was developed for quantitation of the antigenic relationship between viruses, by modification of the indirect ELISA. The principle of this method is to estimate the epitopes not shared between the related viruses, after titration of the antibodies specific to the common epitopes as in a blocking ELISA. In practice, varying concentrations of purified virus are preincubated with a fixed dilution of heterologous or homologous antiserum and the unbound antibodies present in the mixture are back titrated with virus particles bound to microtitre plates. The antigenic relationship is described in terms of differentiation index (DI) and total antigenic reactivity (TAR). This method has been used to quantitate cross-reactivity between two geographically different isolates of Oryctes baculovirus.


Changes in treatment of hyperglycemia in a hypertensive type 2 diabetes population as renal function declines.
Cardiovascular complications associated with expensive noninsulin agents for type 2 diabetes are the focus of concern in light of the risk of kidney dysfunction with aging. Head-to-head comparisons are unavailable to guide the choice of new drugs for hyperglycemia in patients with type 2 diabetes, decreased estimated glomerular filtration rate (eGFR) and increased cardiovascular risk. A first approach would be to document current medication choices. All prescriptions for 10 151 patients (5623 males/4528 females) with both type 2 diabetes and hypertension seen two or more times during a 5-year period (2007-12) at Joslin Diabetes Center were evaluated. {mean age 64 years [interquartile range (IQR) 64-65)], body mass index 31 kg/m2 (IQR 30-32) and mean eGFR 78 mL/min/1.73 m2 (IQR 78, 78)}. Insulin was used in >60% of patients, metformin in 50% and sulfonylurea derivatives in 25%. Dipeptidyl peptidase 4 (DPP4) and acarbose class drugs were prescribed in 10% of patients, GLP-1 in 8% and other classes [including thiazolidinediones (TZD)] in <5%. Patients were grouped into four drug Categories none, 447 (4%); insulin only, 3836 (38%); other than insulin, 2910 (29%) and insulin combinations, 2955 (29%). Common combinations included insulin/metformin [n = 2493 (25%)], insulin/sulfonylureas [706 (7%)], metformin/sulfonylureas [2017 (20%)], metformin/GLP1 [949 ( 9%)], metformin/DPP4 [895 (9%)] and metformin/TZD [500 (5%)]. Insulin use increased to 70% from 35% as eGFR dropped to <30 mL/min/1.73 m2; use of insulin combined with other drugs dropped to 12% from 31% and the use of other drugs alone without insulin dropped similarly to 12% from 30%. Reduced renal function was associated with increased use of insulin and decreased use of other anti-diabetic agents in a statistically significant progression. BMI and gender did not influence medication choice.


No influence of socioeconomic factors on severe malarial anaemia, hyperparasitaemia or reinfection.
Malaria is responsible for nearly 500 million clinical cases per year, only a small proportion of whom will become severely ill. Socioeconomic risk factors may play a role in the development of severe malaria in African children and in their susceptibility to reinfection. In Gabon, 100 children suffering from severe malaria, defined as hyperparasitaemia and/or severe anaemia, were matched for sex, age and provenance to 100 children with mild malaria. Socioeconomic factors were assessed using a standard questionnaire and compared between the 2 groups. The children were followed-up and the time to first reinfection was recorded. No significant influence of socioeconomic factors could be detected on the severity of disease or the time to first reinfection. Socioeconomic factors are not major determinants of severe malarial anaemia and hyperparasitaemia in children in Gabon.


Effect of cyclic loading on the nanoscale deformation of hydroxyapatite and collagen fibrils in bovine bone.
Cyclic compressive loading tests were carried out on bovine femoral bones at body temperature (37 °C), with varying mean stresses (-55 to -80 MPa) and loading frequencies (0.5-5 Hz). At various times, the cyclic loading was interrupted to carry out high-energy X-ray scattering measurements of the internal strains developing in the hydroxyapatite (HAP) platelets and the collagen fibrils. The residual strains upon unloading were always tensile in the HAP and compressive in the fibrils, and each increases in magnitude with loading cycles, which can be explained from damage at the HAP–collagen interface and accumulation of plastic deformation within the collagen phase. The samples tested at a higher mean stress and stress amplitude, and at lower loading frequencies exhibit greater plastic deformation and damage accumulation, which is attributed to greater contribution of creep. Synchrotron microcomputed tomography of some of the specimens showed that cracks are produced during cyclic loading and that they mostly occur concentric with Haversian canals.


[Tungiasis--an increasingly frequent vacation dermatosis].
Because of the increase in international air travel to the tropical areas, we often observe skin diseases now that were formerly restricted to the equatorial zones. As we have recently observed several cases of tungiasis in our department, we report here the epidemiology, clinical appearance and treatment of this "tourism-transmitted" rare form of tropical parasitosis.


Lack of CD45 in FLT3-ITD mice results in a myeloproliferative phenotype, cortical porosity, and ectopic bone formation.
The receptor tyrosine kinase FLT3 is expressed in myeloid and lymphoid progenitor cells. Activating mutations in FLT3 occur in 25-30% of acute myeloid leukaemia (AML) patients. Most common are internal tandem duplications of sequence (ITD) leading to constitutive FLT3-ITD kinase activity with an altered signalling quality promoting leukaemic cell transformation. Here, we observed the attenuating role of the receptor-like protein tyrosine phosphatase (RPTP) CD45/Ptprc in FLT3 signalling in vivo. Low level expression of this abundant RPTP correlates with a poor prognosis of FLT3-ITD-positive AML patients. To get a further insight into the regulatory role of Ptprc in FLT3-ITD activity in vivo, Ptprc knock-out mice were bred with FLT3-ITD knock-in mice. Inactivation of the Ptprc gene in FLT3-ITD mice resulted in a drastically shortened life span and development of severe monocytosis, a block in B-cell development and anaemia. The myeloproliferative phenotype was associated with extramedullary haematopoiesis, splenohepatomegaly and severe alterations of organ structures. The phenotypic alterations were associated with increased transforming signalling of FLT3-ITD, including activation of its downstream target STAT5. These data reveal the capacity of Ptprc for the regulation of FLT3-ITD signalling activity in vivo. In addition, histopathology and computed tomography (CT) revealed an unexpected bone phenotype; the FLT3-ITD Ptprc-/- mice, but none of the controls, showed pronounced alterations in bone morphology and, in part, apparent features of osteoporosis. In the spleen, ectopic bone formation was observed. The observed bone phenotypes suggest a previously unappreciated capacity of FLT3-ITD (and presumably FLT3) to regulate bone development/remodelling, which is under negative control of CD45/Ptprc.


The natural history of food sensitivity.
The natural history of food sensitivity has long been the subject of anecdotes about children "outgrowing" their problem, but prospective systematic studies are not easily found that document these opinions. Children who had had adverse reactions to foods during double-blind food challenges 1 to 7 yr prior to this study were evaluated. In children over 3 yr of age, 19% of the previously positive food challenges were negative at the time of the follow-up; in children 3 yr of age or younger, 44% of the food challenges that had been positive were negative. The data collected thus far suggest that children who have their food sensitivity diagnosed at older ages tend not to outgrow the problem. Skin testing was performed over a period of years on some of the subjects, and skin sensitization was found to be markedly persistent, even in subjects who could consume the sensitizing food without symptoms.


The Effect of Needle Gauge on the Risk of Pneumothorax and Chest Tube Placement After Percutaneous Computed Tomographic (CT)-Guided Lung Biopsy.
The aim of this study was to evaluate the effect of coaxial guide needle gauge (18 vs. 19 gauge) on the risk of pneumothorax and chest tube placement after CT-guided lung biopsy. Imaging records of all patients who had undergone CT-guided lung biopsies at our institution from March 1, 2006 to December 9, 2010 were retrospectively reviewed. Univariate and multivariate logistic regression analyses were performed to assess the effect of various patient-, lesion-, and procedure-related variables on subsequent pneumothorax and chest tube placement rates. The study included 4262 biopsies (2304 with 18-gauge and 1958 with 19-gauge coaxial guide needles) in 3917 patients. The rates of pneumothorax and chest tube placement were 30.2 and 15%, respectively. Pneumothorax occurred in 35% of procedures performed with 18-gauge needles and in 24.5% of procedures performed with 19-gauge needles (p < 0.0001). Chest tube insertion occurred in 16.7% of procedures performed with 18-gauge needles and in 13.1% of procedures performed with 19-gauge needles (p = 0.0011). Multivariate logistic regression models demonstrated that the use of an 18-gauge needle was associated with a higher rate of pneumothorax (p < 0.0001) and chest tube placement (p = 0.0003). The following factors were also associated with higher rates of pneumothorax and chest tube placement: older age, emphysema, greater number of pleural surfaces crossed, and a longer biopsy needle path length. The use of a 19-gauge coaxial guide needle significantly decreases the risk of pneumothorax and chest tube placement compared with an 18-guage needle.


Role of calcium in the phenylephrine-induced activation of phosphorylase "A" in isolated liver cells.
The ability of phenylephrine to activate phosphorylase in liver cells with variable degrees of Ca2+ loading was studied. Phenylephrine has been found to be capable of stimulating phosphorylase at saturating Ca2+ concentrations that precluded any further action of this ion. Furthermore the degree of activation was proportional to the cellular calcium content. These results allow to conclude that alpha-adrenergic agonists activate phosphorylase by a mechanism apparently unrelated to their ability to mobilize and subsequently increase the cytosolic concentration of free Ca2+.


Design, Synthesis and in Vitro Evaluation of Tylophorine Derivatives as Possible Antitumor Agents.
Structural simplification and modification of natural products are always very important resources to antitumor drugs. By introducing various aminomethyl groups and amide groups into the phenanthrene ring of tylophorine, a novel series of tylophorine derivatives have been designed and synthesized, and their antiproliferative activities against MCF-7, A549 and HepG-2 cells have been evaluated, too. The results indicated that most of the prepared compounds exhibited good antitumor activities. Especially, one compound with an {ethyl[2-(morpholin-4-yl)ethyl]amino}methyl group at the side chain exhibited the most significant cytotoxic effects.


Forecasting individual breast cancer risk using plasma metabolomics and biocontours.
Breast cancer is a major cause of death for women. To improve treatment, current oncology research focuses on discovering and validating new biomarkers for early detection of cancer; so far with limited success. Metabolic profiling of plasma samples and auxiliary lifestyle information was combined by chemometric data fusion. It was possible to create a biocontour, which we define as a complex pattern of relevant biological and phenotypic information. While single markers or known risk factors have close to no predictive value, the developed biocontour provides a forecast which, several years before diagnosis, is on par with how well most current biomarkers can diagnose current cancer. Hence, while e.g. mammography can diagnose current cancer with a sensitivity and specificity of around 75 %, the currently developed biocontour can predict that there is an increased risk that breast cancer will develop in a subject 2-5 years after the sample is taken with sensitivity and specificity well above 80 %. The model was built on data obtained in 1993-1996 and tested on persons sampled a year later in 1997. Metabolic forecasting of cancer by biocontours opens new possibilities for early prediction of individual cancer risk and thus for efficient screening. This may provide new avenues for research into disease mechanisms.


The glycolipid of Halobacterium trapanicum.
The structural elucidation of the polar lipids in Halobacterium trapanicum is reported with particular emphasis on a new sulfated disaccharide derivative of 2,3-di-O-phytanyl-sn-glycerol. The full structural designation of this glycolipid is 2,3-di-O-phytanyl-1-O- (mannopyranosyl-(2-sulfate)-alpha-D-1-2-glucopyranosyl-alpha-D)-sn-glyce rol. The value of glycolipid structures in the taxonomy of halophilic Archaea is also discussed.


Cartilage of the baboon contains estrogen receptors.
Castrated-adrenalectomized aged female baboons were injected with 3H-estradiol-17 B (E2) and killed one hour later. Specimens from all regions of the larynx and oral cavity were taken and processed for autoradiography. A consistent and heavy uptake of 3H-E2 by the perichondrium and cartilage was found in all laryngeal sections with cartilage present and in the articular cartilage of the condyle of the mandible. These data provide evidence that cartilage contains receptors for estrogen. These data along with data already present in the literature suggest that circulating estrogen may act directly on cartilage to modulate collagen synthesis and further that the loss in circulating estrogen associated with menopause might in part explain the large sexual dimorphism associated with the incidence of osteoarthritis.


Effect of Tactile-Kinesthetic Stimulation on Weight in Preterm Neonates in Neonatal Intensive Care Unit.
This study evaluated the efficacy of tactile kinesthetic stimulation on the weight of 40 preterm (28 weeks to <37 weeks) infants. Experimental group received two sessions per day of tactile-kinesthetic stimulation, for 10 consecutive days along with routine hospital care (RHC) and control group received only RHC. Increase in mean (SD) weight gain was significantly higher in the experimental group as compared to control group [10.79 (0.62) g vs 4.03 (0.89) g; P< 0.001].


Coeliac disease, diet adherence and depressive symptoms.
We aimed to investigate whether long-term adherence to a gluten-free diet is related to depressive symptoms in coeliac disease (CD) patients. A cross-sectional survey was performed in 2265 adult CD patients recruited through the Dutch Coeliac Association. Self-reported diet adherence was compared among groups based on self-reported depressive symptoms (categorized into current [1-month], remitted, and never). The life-time prevalence rate of self-reported depressive symptoms was 39.0% (n=883), of whom 270 (11.9%) suffered from current depressive symptoms. Adherence to gluten-free diet was strict in 50.2% of patients, sufficient in 46.3%, and insufficient in 3.6%. Insufficient adherence was not associated with current depressive symptoms (odds ratio [OR] 0.95; 95% confidence interval [CI]: 0.48-1.92). Keeping a gluten-free diet for longer than five years was associated with lower OR of current depressive symptoms compared to being on a diet for less than two years (OR 0.69; 95% CI: 0.50-0.95). Lifetime depressive symptoms may be present in one third of the CD patients who adhere to gluten-free diet. Long-term adherence to the gluten-free diet may reduce the risk of current depressive symptoms.


Dysregulated lipid metabolism in TMZ-resistant glioblastoma: pathways, proteins, metabolites and therapeutic opportunities.
Glioblastoma (GBM) is a highly aggressive and lethal brain tumor with limited treatment options, such as the chemotherapeutic agent, temozolomide (TMZ). However, many GBM tumors develop resistance to TMZ, which is a major obstacle to effective therapy. Recently, dysregulated lipid metabolism has emerged as an important factor contributing to TMZ resistance in GBM. The dysregulation of lipid metabolism is a hallmark of cancer and alterations in lipid metabolism have been linked to multiple aspects of tumor biology, including proliferation, migration, and resistance to therapy. In this review, we aimed to summarize current knowledge on lipid metabolism in TMZ-resistant GBM, including key metabolites and proteins involved in lipid synthesis, uptake, and utilization, and recent advances in the application of metabolomics to study lipid metabolism in GBM. We also discussed the potential of lipid metabolism as a target for novel therapeutic interventions. Finally, we highlighted the challenges and opportunities associated with developing these interventions for clinical use, and the need for further research to fully understand the role of lipid metabolism in TMZ resistance in GBM. Our review suggests that targeting dysregulated lipid metabolism may be a promising approach to overcome TMZ resistance and improve outcomes in patients with GBM.


Impact of outpatient radiotherapy on direct non-medical cost in patients in the Central Macro Region of Peru 2021.
Financial toxicity arises in cancer patients due to the objective financial burden of the disease or treatment, being associated with worse clinical outcomes. Direct non-medical spending on cancer patients undergoing radiotherapy in Peru under its publicly funded health system has not been described. To know the expenses related to the transfer of the radiotherapy outpatient. For patients who started radiation therapy in 2021, treatment demographics and expenses related to transporting the patient from home to the radiation therapy center were prospectively collected. Association and connection tests were used, such as the Mann-Whitney/Kruskal-Wallis U-test and Spearman's Rho. A value of p < 0.05 is considered statistically significant. 398 patients were collected, with average weekly expenses for transportation, lodging and food of $17.04, $6.69 and $45.91, respectively. Confirmation was positive between weekly spending and remoteness, likewise it was negative between effective teletherapy and remoteness, both analyses being statistically significant. The expense associated with transfer for radiotherapy is high, exceeding the average monthly income of the patient, as a consequence they have a worse therapeutic result, and may cause financial toxicity in cancer patients.


DNA damage alters binding conformations of E. coli single-stranded DNA-binding protein.
Single-stranded DNA-binding proteins (SSBs) are essential cellular components, binding to transiently exposed regions of single-stranded DNA (ssDNA) with high affinity and sequence non-specificity to coordinate DNA repair and replication. Escherichia coli SSB (EcSSB) is a homotetramer that wraps variable lengths of ssDNA in multiple conformations (typically occupying either 65 or 35 nt), which is well studied across experimental conditions of substrate length, salt, pH, temperature, etc. In this work, we use atomic force microscopy to investigate the binding of SSB to individual ssDNA molecules. We introduce non-canonical DNA bases that mimic naturally occurring DNA damage, synthetic abasic sites, as well as a non-DNA linker into our experimental constructs at sites predicted to interact with EcSSB. By measuring the fraction of DNA molecules with EcSSB bound as well as the volume of protein bound per DNA molecule, we determine the protein binding affinity, cooperativity, and conformation. We find that, with only one damaged nucleotide, the binding of EcSSB is unchanged relative to its binding to undamaged DNA. In the presence of either two tandem abasic sites or a non-DNA spacer, however, the binding affinity associated with a single EcSSB tetramer occupying the full substrate in the 65-nt mode is greatly reduced. In contrast, the binding of two EcSSB tetramers, each in the 35-nt mode, is preserved. Changes in the binding and cooperative behaviors of EcSSB across these constructs can inform how genomic repair and replication processes may change as environmental damage accumulates in DNA.


[The deterioration of the aquatic ecosystem because of civilization].
The surface waters of northwestern Europe belong to the most heavily loaded waters of the world. Within the last decades, pollution by non-biogenic organic substances has often become more important than pollution by domestic sewage. Ecologic concepts aid in understanding the various modes of disturbance of aquatic ecosystems. Stream pollution control consists not only of waste treatment.


Prevalence of enterotoxin producing Staphylococcus aureus in stools of patients with nosocomial diarrhea.
Nosocomial diarrhea causes prolonged hospital stay leading to additional diagnostic and therapeutic procedures resulting in higher costs. A total of 20%-25% of antibiotic-associated diarrhea (AAD) cases are attributed to Clostridium difficile. Other microorganisms like Clostridium perfringens and Staphylococcus aureus are discussed to be associated with AAD. This study evaluated the prevalence of enterotoxigenic S. aureus in stool samples submitted to the laboratory with the diagnosis nosocomial diarrhea. A total of 2,727 stools from clinical patients were investigated for S. aureus and C. difficile. Samples were cultured for both bacteria and a C. difficile toxin A and B assay was performed from all stools. Isolated S. aureus were investigated for enterotoxin production and for resistance against methicillin. In addition, both assays were evaluated for determination of S. aureus enterotoxins directly in stool samples. Out of 2,727 stools investigated, 198 grew S. aureus and 148 C. difficile. Toxins A/B from C. difficile were detected in 184 stools. A total of 114 S. aureus strains produced the following enterotoxins in vitro: A, 36; B, 20; C, 19; D, 68; E, 2. Both pathogens were found in 25 stools. Twenty-nine (14.6%) S. aureus strains were identified as methicillin-resistant. The two toxin assays evaluated in this study were not able to detect S. aureus enterotoxins directly in stools. The role of enterotoxigenic S. aureus in the pathogenesis of nosocomial and AAD needs further consideration. It might be necessary to investigate stool samples from patients with AAD/nosocomial diarrhea for S. aureus on a routine basis.


Paraproteinosis and amyloidosis of the cerebral vessels and senile plaques.
A case is reported of progressive dementia and a terminal picture of generalized tetaniform contractures. The relationship of the generalized tetaniform contractures to the stiff-man syndrome is discussed. Morphologically, diffuse amyloid deposition was found in the pial and cortical vessels, accompanied by amyloid deposition in the senile plaques in the cortical and cerebellar cortex. Apart from the typical staining and ultrastructural aspects of amyloid, a deposition of material was observed, corresponding in optical and electron microscopy to a paraprotein. This case demonstrated not only the relationship between the deposition of amyloid and the formation of senile plaques, but also sustains the direct connection between amyloid in senile plaques and the paraprotein substances deriving from the blood. The probable relationship between the unusual deposition of paraproteins in the vessels and nervous system and the treatment with immunoglobulins is discussed.


Growth factors and the regulation of pre- and postnatal growth.
Peptide growth factors represent a largely paracrine level of intercellular communication that is basic to the process of life. Growth factors are present in the ovum and are amongst the first products expressed by the embryonic genome. They function as both signals and progression factors for embryonic tissue growth, induction, differentiation, maturation and function. While a widespread tissue expression is demonstrable during fetal development, and in certain postnatal tissues such as the epiphyseal growth plate, growth factor presence in the adult is restricted to tissues sharing rapid cellular turnover such as ovary. However, a transient re-expression of peptide growth factors occurs during adult tissue repair. In addition to mitogenic peptides such as IGFs or EGF, the family of growth factors also includes physiological growth inhibitors such as TGF beta and certain neuropeptides. Insulin is mitogenic in the early embryo and evidence is presented to support a continuation of this role, under defined nutritional conditions, in late gestation. The importance of insulin to pre- and postnatal growth has prompted an expanding literature dealing with the interactions of nutrients, hormones and growth factors during the growth and functional maturation of the islets of Langerhans. While the expression of growth factors in the early embryo is apparently autonomous, some, such as IGFs, become increasingly dependent on nutrient, insulin and GH availability during fetal development and in childhood growth. This has resulted in circulating IGF I and II determinations becoming useful diagnostic markers of endocrine-based growth disorder and nitrogen balance.


Fluctuating magnetic droplets immersed in a sea of quantum spin liquid.
The search of quantum spin liquid (QSL), an exotic magnetic state with strongly fluctuating and highly entangled spins down to zero temperature, is a main theme in current condensed matter physics. However, there is no smoking gun evidence for deconfined spinons in any QSL candidate so far. The disorders and competing exchange interactions may prevent the formation of an ideal QSL state on frustrated spin lattices. Here we report comprehensive and systematic measurements of the magnetic susceptibility, ultralow-temperature specific heat, muon spin relaxation (μSR), nuclear magnetic resonance (NMR), and thermal conductivity for NaYbSe2 single crystals, in which Yb3+ ions with effective spin-1/2 form a perfect triangular lattice. All these complementary techniques find no evidence of long-range magnetic order down to their respective base temperatures. Instead, specific heat, μSR, and NMR measurements suggest the coexistence of quasi-static and dynamic spins in NaYbSe2. The scattering from these quasi-static spins may cause the absence of magnetic thermal conductivity. Thus, we propose a scenario of fluctuating ferrimagnetic droplets immersed in a sea of QSL. This may be quite common on the way pursuing an ideal QSL, and provides a brand new platform to study how a QSL state survives impurities and coexists with other magnetically ordered states.


Coronary artery revascularization using both ITAs as free conduits in patients with three-vessel disease--the lambda graft.
There is little information on using internal thoracic arteries (ITA) as free conduits in coronary artery bypass grafting. This study examines the results using both ITAs as free grafts in a lambda configuration implanting the common trunk into the ascending aorta. Over a 6-year period, 317 patients underwent coronary artery revascularization with both ITAs as free grafts in a lambda configuration. An average of 4.9 distal anastomoses per patient was performed. There were 4 deaths (three early and one late). The mean NYHA class improved from preoperatively 2.8 to 1.1 at the last check. All 16 patients with suspected recurrent angina or a pathologic exercise test were restudied by angiography. Segmental graft stenosis or occlusion was found in 13 (in only one at aortic anastomosis). Five patients underwent late PTCA, and two underwent coronary reoperation. The six-year actuarial survival was 98% (90 % CL+/- 2 %), intervention-free survival 96 % (90 % CL +/- 2 %). Revascularization using both ITAs as free grafts in a lambda configuration gives good early and mid-term results for up to 6 years. The aortic ITA anastomosis can be considered safe.


Occult pulmonary lymphangitic carcinomatosis presenting as 'chronic cough' with a normal HRCT chest.
A diagnosis of 'chronic cough' (CC) requires the exclusion of sinister pulmonary pathology, including infection and malignancy. We present a patient with a 3 month history of CC who had an extensive workup including a normal high resolution computed tomography of the chest (HRCT) 6 weeks prior to consultation at our center. He subsequently developed constitutional symptoms including weight loss and loss of appetite 5 weeks after initial consultation. A repeat HRCT chest and a subsequent whole body PET scan found that he had developed extensive pulmonary lymphangitic carcinomatosis (PLC) from a colon primary. Treatment of the colon cancer resulted in significant decrease in metastatic disease burden and cough resolution. PLC is a very rare cause of 'chronic cough' and incipient/occult PLC presenting with chronic cough and a normal initial HRCT chest has not been previously reported.


Epidural abscess secondary to Streptococcus pneumoniae. A case report and review of the literature.
While spinal epidural abscess is a well described disease process, this condition is rarely caused by Streptococcus pneumoniae. This case describes a case of spinal epidural abscess secondary to S. pneumoniae in an otherwise healthy, immunocompetent 61-year-old female without a history of spinal procedures, obvious source of hematogenous seeding, or clear risk factors for invasive pneumococcal infection. She was treated with IV and oral antibiotic therapy and made a full recovery.