Preparative scale extraction of mangiferin and lupeol from mango (Mangifera indica L.) leaves and bark by different extraction methods.
High biological value compounds are very important in the food and pharmaceutical sectors. The leading research interests are seeking efficient methods for extracting these substances. The objective of this study was to evaluate different extraction methods to obtain mangiferin and lupeol at preparative scale from leaves and bark of mango tree varieties Ataulfo and Autochthonous from Nayarit, Mexico. Four extraction techniques were evaluated such as maceration, Soxhlet, sonication (UAE) and microwave (MAE). Sonication gave the highest concentration of mangiferin and lupeol, demonstrating that extraction assisted by ultrasound could be an effective alternative to conventional extraction techniques because it is a low cost, simple and reliable process. Finally, mangiferin and lupeol were obtained at preparative scale with a higher concentration of bioactive compounds, 1.45 g 100 g-1 y 0.92 mg 100 g-1 sample on (d.b.), respectively. The barks from Ataulfo and Autochthonous mango trees turned out to be favourable sources for obtaining mangiferin and lupeol.


Lymphomatoid granulomatosis involving central nervous system successfully treated with rituximab alone.
To report the successful treatment of a patient with lymphomatoid granulomatosis (LYG), a rare Epstein-Barr virus-positive lymphoproliferative disorder, using rituximab (anti-CD20 monoclonal antibody). The prognosis for LYG has been reported to be poor, and no satisfactory treatment has been established. Because central nervous system (CNS) involvement of LYG has been known to show poor prognosis, the establishment of an effective treatment for CNS LYG with mild adverse effects is desired. Case report. University hospital. A 48-year-old Japanese man presenting with slowly progressive spastic paraparesis diagnosed as LYG involving the CNS and lungs. The patient was treated with rituximab (375 mg/m2, once weekly for 1 month) alone. Main Outcome Measure Improvement of the lesions on imaging. The neurological signs resolved and the lesions in the CNS and lungs were mostly diminished after the rituximab monotherapy without any adverse effects. The patient stayed in remission for 18 months. Rituximab monotherapy was effective in treating the patient; hence, rituximab should be considered as the initial treatment against LYG involving the CNS.


Fabrication of dense non-circular nanomagnetic device arrays using self-limiting low-energy glow-discharge processing.
We describe a low-energy glow-discharge process using reactive ion etching system that enables non-circular device patterns, such as squares or hexagons, to be formed from a precursor array of uniform circular openings in polymethyl methacrylate, PMMA, defined by electron beam lithography. This technique is of a particular interest for bit-patterned magnetic recording medium fabrication, where close packed square magnetic bits may improve its recording performance. The process and results of generating close packed square patterns by self-limiting low-energy glow-discharge are investigated. Dense magnetic arrays formed by electrochemical deposition of nickel over self-limiting formed molds are demonstrated.


Pediatric tracheotomy: A comparison of outcomes and lengths of hospitalization between different indications.
To assess outcomes of pediatric tracheotomy and duration of associated hospital stay according to indications. In this retrospective study, subjects were 142 consecutive pediatric patients (<18 years old) who underwent tracheotomy at a tertiary referral medical center, National Taiwan University Hospital, in 1997-2012. Age, sex, indications, pre-operative status (oxygen demand, number of repeated intubations), and post-operative status (duration of weaning, length of hospital stay, mortality) were analyzed. The indications included craniofacial anomalies (n = 19, 13.4%), upper airway obstruction (n = 41, 28.9%), neurological deficit (n = 58, 40.8%), prolonged ventilation (n = 15, 10.6%), and trauma (n = 9, 6.3%). Ninety-one patients (64.1%) were successfully weaned off ventilation after tracheotomy (40% in the prolonged ventilation group). Total hospital stay and duration of ventilation before tracheotomy were longest in patients with craniofacial anomalies (150.9 ± 98.8 days, p = 0.004; 108.8 ± 88.2, p < 0.001). The early tracheotomy group had a shorter duration of post-tracheotomy mechanical ventilation support than the late tracheotomy group (14.4 ± 19.0, n = 49 vs. 34.9 ± 58.6, n = 80, p = 0.004). Decannulation was successful in 20 patients (14.1%), with the highest rate in the upper airway obstruction group (n = 14, 34.1%) and lowest in the prolonged ventilation group (none). Thirteen patients (9.2%) died during admission from causes unrelated to tracheotomy. Outcomes of pediatric tracheotomy and duration of hospitalization depend on indications. Children with craniofacial anomalies had earlier tracheotomy age and longer mechanical ventilation before tracheotomy resulted in longer hospitalization. Earlier tracheotomy can shorten the duration of post-tracheotomy mechanical ventilation in several conditions.


SD-CAS: Spin Dynamics by Computer Algebra System.
A computer algebra tool for describing the Liouville-space quantum evolution of nuclear 1/2-spins is introduced and implemented within a computational framework named Spin Dynamics by Computer Algebra System (SD-CAS). A distinctive feature compared with numerical and previous computer algebra approaches to solving spin dynamics problems results from the fact that no matrix representation for spin operators is used in SD-CAS, which determines a full symbolic character to the performed computations. Spin correlations are stored in SD-CAS as four-entry nested lists of which size increases linearly with the number of spins into the system and are easily mapped into analytical expressions in terms of spin operator products. For the so defined SD-CAS spin correlations a set of specialized functions and procedures is introduced that are essential for implementing basic spin algebra operations, such as the spin operator products, commutators, and scalar products. They provide results in an abstract algebraic form: specific procedures to quantitatively evaluate such symbolic expressions with respect to the involved spin interaction parameters and experimental conditions are also discussed. Although the main focus in the present work is on laying the foundation for spin dynamics symbolic computation in NMR based on a non-matrix formalism, practical aspects are also considered throughout the theoretical development process. In particular, specific SD-CAS routines have been implemented using the YACAS computer algebra package (http://yacas.sourceforge.net), and their functionality was demonstrated on a few illustrative examples.


Statistical analysis of image data provided by two-dimensional gel electrophoresis for discovery proteomics.
Standardized methods for the solubilization of proteins prior to proteomics analyses incorporating two-dimensional gel electrophoresis (2-DE) are essential for providing reproducible data that can be subjected to rigorous statistical interrogation for comparative studies investigating disease-genesis. In this chapter, we discuss the imaging and image analysis of proteins separated by 2-DE, in the context of determining protein abundance alterations related to a change in biochemical or biophysical conditions. We then describe the principles behind 2-DE gel statistical analysis, including subtraction of background noise, spot detection, gel matching, spot quantitation for data comparison, and statistical requirements to create meaningful gel data sets. We also emphasize the need to develop reproducible and robust protocols for protein sample preparation and 2-DE itself.


Use of positron emission tomography in anticancer drug development.
Positron emission tomography (PET) is increasingly being used in anticancer drug development. The technique is applicable to studies of drug delivery, and where specific probes are available, to provide pharmacodynamic readouts noninvasively in patients. Mathematical modeling of the imaging data enhances the quality of information that is obtained from such studies. This section provides a review of the PET methodologies that have been used for the development of new cancer therapies. Other than imaging of radiolabeled drugs, PET modeling has found extensive application in studies with 2-[11C]thymidine, [18F]fluorodeoxyglucose, H2(15)O, C15O, and receptor ligands.


Does the Expiratory Disproportion Index Remain Predictive of Airway Stenosis in Obese Patients?
The expiratory disproportion index (EDI) is the ratio of forced expiratory volume in 1 second divided by peak expiratory flow rate multiplied by 100. An elevated EDI (>50) can help differentiate upper airway stenosis from other dyspnea etiologies, but this has not been verified when considering body habitus. We hypothesize that the predictive value of elevated EDI in diagnosing airway stenosis will be lower in obese patients as compared to nonobese patients. Retrospective cohort study. Patients >18 years old with recorded pulmonary function test values, body mass index (BMI), and airway imaging were reviewed retrospectively from January 2011 to October 2018. EDI was recorded for four cohorts: nonobese and nonstenotic, obese and nonstenotic, nonobese and stenotic, and obese and stenotic, to determine the mean EDI and the sensitivity and specificity of an elevated EDI. Mean EDI values were 66.53 ± 17.66 and 49.55 ± 2.04 in the nonobese stenotic and nonstenotic groups, respectively (P < .01). They were 58.00 ± 10.79 and 45.02 ± 1.42 in the obese stenotic and nonstenotic groups, respectively (P < .01). At a threshold of >50, EDI had a sensitivity of 83.3% and specificity of 56.2% in differentiating between stenotic and nonstenotic cases in the nonobese cohort and 50.0% and 71.9% in the obese cohort. As previously established, mean EDI values were significantly different in stenotic and nonstenotic patients in both BMI cohorts. However, at the established threshold of >50, EDI was not as sensitive at identifying stenotic cases in obese patients as in nonobese patients. This suggests that the EDI remains useful in obese patients when elevated but should not be relied upon to rule out stenosis. 4 Laryngoscope, 131:606-609, 2021.


Inhibition of skeletal muscle sarcoplasmic reticulum Ca2+-ATPase by nitric oxide.
The effects of nitric oxide on the activities of thapsigargin-sensitive sarcoplasmic reticulum Ca2+-ATPase (SERCA) and Ca2+ uptake by sarcoplasmic reticulum (SR) membranes prepared from white skeletal muscle of rabbit femoral muscle were studied. Pretreatment of the SR preparations with nitric oxide at concentrations of up to 250 microM for 1 min decreased the SERCA activity concentration dependently, and also decreased their Ca2+ uptake. Both these effects of nitric oxide were reversible. Inhibitors of guanylyl cyclase and protein kinase G (PKG) had no significant effect on the nitric oxide-induced inhibitions of SERCA and Ca2+ uptake. Moreover, dithiothreitol did not reverse the inhibitory effects of nitric oxide on SERCA and Ca2+ uptake. These findings suggest that nitric oxide inhibits SERCA, mainly SERCA 1, of rabbit femoral skeletal muscle by an action independent of the cyclic GMP-PKG system or oxidation of thiols, and probably by a direct action on SERCA protein.


Endodermal sinus tumor of the ovary: the Hacettepe University experience.
The purpose of this study was to evaluate the treatment regimens used for patients with endodermal sinus tumors (EST), and also to examine the prognostic value of surgicopathological variables. Twenty-two patients treated for pure EST, and seven patients who had mixed germ cell tumors with EST components were included. Initial surgery consisting of surgical staging to achieve optimal debulking was the principal mode of therapy. Data were obtained from patients' files, a special gynecologic oncology database, and pathology records. The median age at the time of diagnosis was 18 (range 8-45). Sixteen patients had stage I (55%), and 13 (45%) had stage II-IV disease. As an adjuvant therapy 18 patients (62%) received platin-based chemotherapy, three patients (10%) had non-platin-based chemotherapy, four patients (14%) had radiotherapy, and four patients (14%) had combined radiotherapy plus non-platin-based chemotherapy. The 5-year disease-free and overall survival rates were 47 and 48%, respectively. Survival rates were dismal in patients with stage II-IV disease (P < 0.001). Platin-based chemotherapy achieved significant survival benefit (P = 0.03 and P < 0.001, respectively). Fertility-saving surgery had an overall survival no worse than those who underwent more extensive surgery. There was no significant survival difference with respect to age, histology, and tumor size. Fertility-sparing surgery with a postoperative platin-based combination chemotherapy should be the selected mode of treatment.


Effect of (m)VD-hemopressin against Aβ1-42-induced oxidative stress and apoptosis in mouse hippocampal neurons.
Alzheimer's disease (AD) is a serious neurodegenerative disease. Senile plaques (SPs) composed of amyloid-β (Aβ) are typical features of AD. Aβ plays a key role in the disease and has the ability to induce other pathological characteristics of AD, including oxidative stress injury. (m)VD-hemopressin (VD), a peptide derived from mouse brain extracts, can bind cannabinoid 1 receptor (CB1R) as an agonist. Our previous report indicated that VD reverses memory impairment induced by Aβ1-42 in mice. This study aimed to clarify the mechanism by which VD protects hippocampal neurons against Aβ1-42-induced impairment. Our results showed that VD inhibited oxidative stress injury induced by Aβ1-42, as demonstrated by the VD-induced reversal of the upregulation of reactive oxygen species (ROS) and the intracellular lipid peroxidation product malondialdehyde (MDA) and the downregulation of the activities of the antioxidative enzymes catalase (CAT) and glutathione peroxidase (GSH-PX) in mouse hippocampal neurons. We also found that VD restored the decrease in cell growth and viability induced by Aβ1-42 and reversed Aβ1-42-induced apoptosis mediated by the apoptosis-associated proteins Bcl-2 and Bax. However, cotreatment with AM251 (an antagonist of CB1R) blocked the effects of VD. In brief, this study suggested that through CB1R, VD reversed the impairment of cell growth and viability, oxidative stress injury and apoptosis induced by Aβ1-42. Therefore, VD may be a promising agent for the treatment of diseases that involve oxidative stress injury and apoptosis induced by Aβ1-42, such as AD.


Urinary excretion of mutagens, thioethers and D-glucaric acid in workers exposed to bitumen fumes.
The authors carried out biological monitoring of the mutagenic/carcinogenic hazards associated with exposure to bitumen fumes during paving operations, analysing some biological parameters in the urine of a group of exposed workers. The urine samples were studied for mutagenicity by the Ames test and for thioethers concentration. D-Glucaric acid urine excretion was also determined to investigate the enzymatic induction potential of bitumens. Even though, in a previous environmental monitoring phase, a low content of mutagenic/carcinogenic compounds was found in bitumen and air samples, urinary mutagenicity data of exposed workers were statistically higher than those of a group of unexposed subjects. The urinary mutagenicity increased further if exposure to bitumens was associated with cigarette smoking. Thioethers were higher only in subjects exposed simultaneously to bitumens and cigarettes. D-Glucaric acid excretion did not increase significantly. The authors think that this type of coupled environmental and biological monitoring is a valid tool for a better evaluation of the mutagenic/carcinogenic exposure to bitumens or similar complex mixtures.


A hybrid optimization method for sample partitioning in near-infrared analysis.
The division of calibration and validation is one of the essential procedures that affect the prediction result of the calibration model in quantitative analysis of near-infrared (NIR) spectroscopy. The conventional methods are Kennard-Stone (KS) and sample set partitioning based on joint x-y distances (SPXY). These algorithms use Euclidean distance to cover as many representative samples as possible. This paper proposes an Adaptive Hybrid Cuckoo-Tabu Search (AHCTS) algorithm for partitioning samples based on optimization. The algorithm combines the characteristics of cuckoo search (CS) and tabu search (TS) and fuses with an adaptive function. For comparison, using fishmeal samples as spectral analysis data, KS, SPXY, and AHCTS algorithms were used to divide the modeling samples to establish partial least squares regression (PLSR) models. The experimental results showed that the model established by the proposed algorithm performs better than KS and SPXY. It reveals that the AHCTS method may be an advantageous alternative for quantitative analysis of NIR spectroscopy.


Decreasing D-dimer after recent negative computed tomographic pulmonary angiogram does not rule out pulmonary embolism.
An algorithmic approach to testing utilizing risk stratification and quantitative D-dimer has been considered an acceptable approach to ruling out pulmonary embolism (PE). When D-dimer is elevated, further testing for PE is indicated. However, no evidence exists to guide practitioners when patients return after a recent negative workup for PE who previously had an elevated D-dimer. This case describes a patient who initially had an elevated D-dimer with negative workup for PE who, on repeat visit, had a decreasing D-dimer but was diagnosed with a PE. When evaluating patients after a negative workup for PE after an elevated D-dimer, a decrease in D-dimer cannot be used to rule out PE.


Evaluation of vancomycin susceptibility testing for methicillin-resistant Staphylococcus aureus: comparison of Etest and three automated testing methods.
We evaluated the ability of four commercial MIC testing systems (MicroScan, Vitek 2, Phoenix, and Etest) to detect vancomycin MIC values of ≤1 to ≥2 in 200 methicillin-resistant Staphylococcus aureus (MRSA) strains compared to the Clinical and Laboratory Standards Institute broth microdilution (BMD) reference methods. Compared to the BMD method, absolute agreement (0 ± dilution) was highest for the Phoenix system (66.2%) and the MicroScan turbidity method (61.8%), followed by the Vitek 2 system (54.3%). The Etest produced MIC values 1 to 2 dilutions higher than those produced by the BMD method (36.7% agreement). Of interest, the MicroScan system (prompt method) was more likely to overcall an MIC value of 1 mg/liter (74.1%), whereas the Phoenix (76%) and Vitek 2 (20%) systems had a tendency to undercall an MIC of 2 mg/liter. The ability to correctly identify vancomycin MIC values of 1 and 2 has clinical implications and requires further evaluation.


Patient and physician delay in melanoma diagnosis.
The sequence of events leading ultimately to the diagnosis and treatment of malignant melanoma was investigated. We conducted interviews with 275 patients and the physicians whom they had consulted regarding their suspicious lesions before their eventual referral to a melanoma center. An average of 1 year elapsed from the time that patients first noticed a new or changed lesion and the date of diagnosis. Major components of delay were attributable to both patients and physicians. An average of 6 months elapsed between patients' recognition of a new or changed lesion and their realization that the lesion was suspicious. For 21% of cases, at least 2 months elapsed between physicians' observation of lesions and a definitive diagnosis of malignant melanoma, and 13% were diagnosed a minimum of 4 months following a visit to the physician. Patients routinely cannot distinguish between melanomas and moles. Physicians do not always diagnose melanoma accurately or act promptly in response to suspicious lesions. We have yet to take adequate advantage of the unique opportunity for early detection and cure in this readily visible, rapidly increasing malignancy.


Osteosarcoma associated with Paget's disease: a description of a rare case.
Osteosarcoma associated with Paget's disease is very malignant and has an extremely severe prognosis. This is also related to the usually advanced age of the patient and to the consequent impossibility of carrying out suitable chemotherapy. The case presented here is exceptional because of the young age of the patient, which allowed us to use a neoadjuvant chemotherapy protocol.


[Occurrence of hyperopia among students ranging from 6 to 18 years of age].
To determine the prevalence of hyperopia among students ranging from 6 to 18 years of age. 5023 students from elementary schools, junior high schools and high schools, aged 6-18 years were examined. Measurements of visual acuity as well as retinoscopy after cycloplegia have been carried out. The data was analyzed using chi-square test, u-test and Student's t-test. It was found that 21% of the students, aged from 6 to 18 suffers from hyperopia. It has been observed that from the sixth to the eighteenth years of life along with the age decreases the prevalence of hyperopia. A major decrease in the frequency of hyperopia occurrence among students aged between 6 and 9 years old as well as among those aged 16 and older, has been found. Significant differences between prevalence of hyperopia among boys and girls was not observed.


Diabetes Attitudes, Wishes and Needs Second Study (DAWN2): Understanding Diabetes-Related Psychosocial Outcomes for Canadians with Diabetes.
DAWN2 assessed the psychosocial impact of diabetes on persons with diabetes (PWDs), family members and healthcare professionals (HCPs) across 17 countries. This article reports on the Canadian cohort of PWDs. PWDs completed online, validated self-report scales assessing quality of life (QOL), self-management, beliefs, social support and priorities for improving diabetes care. Analyses used unweighted data. Of 500 participants (80 type 1, 420 type 2) positive self-reported QOL was common (64.6%) and likely depression less common (12.8%). Diabetes distress, however, was identified by almost half of PWDs with type 1 diabetes, and one-quarter of PWDs with type 2 (47.5% vs. 25.7% type 2; p<0.001). Numerous life areas were negatively impacted, particularly finances, work and emotional well-being for those with type 1 diabetes (p<0.001 vs. type 2). Most PWDs reported support from family, friends and HCPs, but few reported being asked by HCPs how diabetes affected their lives. Most PWDs participated in (type 1, 90.0%; type 2, 85.7%) and valued (type 1, 84.7%; type 2, 78.1%) diabetes education. Few PWDs relied on community supports (type 1, 17.5%; type 2, 26.9%), and discrimination was not uncommon for those with type 1 (33.8% vs. 12.4% for type 2; p<0.001). PWDs experience psychological challenges that should be addressed within diabetes management services.


Evaluation of Asthma Control in Children Using Childhood- Asthma Control Test (C-ACT) and Asthma Therapy Assessment Questionnaire (ATAQ).
To evaluate the efficacy of Childhood-asthma control test (C-ACT) and the Asthma therapy assessment questionnaire by (ATAQ) checking its consistency with Global Initiative for Asthma (GINA) criteria. Asthma control of 97 children was assessed using C-ACT, ATAQ and GINA criteria separately, and their results were compared. C-ACT had better performance for evaluating control as per GINA criteria with sensitivity of 48.3%, specificity of 68.9%, and area under the receiver operative curve (ROC) of 0.647. The above parameters for ATAQ were: 93.1%, 17.2% and 0.552, respectively. A cut-off score of 20 for C-ACT is more suitable as it has maximum ROC area (0.667), and higher kappa score (0.315); P= 0.001. C-ACT can be validity used to monitor asthma control. However, the cut-off score 20 is more accurate for the Indian population. The performance of ATAQ in evaluating asthma control is not satisfactory.


Alcoholism: theoretical consideration of season of birth and geographic latitude.
Several neurological and immune phenomena associated with cerebral laterality also show an atypical season of birth pattern. Alcoholism is also associated with cerebral laterality. In this pilot study (n = 292), 66% of right-handed alcoholic men were born during the summer and fall (expected 52%, p less than 0.001). This finding suggests that at high latitude more right-handed men would become alcoholic because seasonal effects usually intensify with increasing latitude. In addition, in our sample of alcoholic men, left-handedness was associated with having an alcoholic father or with being first-born. Together, these findings suggest that the prevalence of alcoholism should increase with increasing latitude, and that the frequency in alcoholic men of being left-handed, first-born or having an alcoholic father should decrease with increasing latitude. The available literature tends to substantiate these correlations, but more systematic studies of season of birth and correlations with latitude in alcoholism are required.


The prognostic impact of right ventricular-pulmonary arterial coupling in heart failure: a systematic review and meta-analysis.
The echocardiographic tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP) ratio is a non-invasive surrogate of right ventricular-pulmonary arterial (RV-PA) coupling which corresponds well with the respective invasively derived index. Recently, a wealth of observational data has arisen, outlining its prognostic value in heart failure (HF) patients. To systematically appraise and quantitatively synthesize the evidence of the prognostic value of TAPSE/PASP ratio in left-sided HF regardless of etiology or left ventricular ejection fraction. A systematic literature review was conducted in electronic databases to identify studies reporting the association of TAPSE/PASP ratio with outcomes in patients with HF and, when appropriate, a random-effects meta-analysis was conducted to quantify the unadjusted and adjusted hazard ratios [(a)HRs] for all-cause death and the composite outcome of all-cause death or HF hospitalization. Eighteen studies were deemed eligible encompassing 8,699 HF patients. The applied cut-off value for RV-PA uncoupling varied substantially from 0.27 to 0.58 mm/mmHg, and in most studies values lower than the applied cutoff conveyed dismal prognosis. Eleven studies reported appropriate data for meta-analysis. TAPSE/PASP reduction by 1 mm/mmHg was independently associated with all-cause death (pooled aHR=1.32 [1.06-1.65]; p=0.01; I2=56%) and the composite outcome (pooled aHR=3.48 [1.67-7.25]; p<0.001; I2=0%). When a TAPSE/PASP cutoff value of 0.36 mm/mmHg was applied it yielded independent association with all-cause death (pooled aHR=2.84 [2.22-3.64]; p<0.001; I2=82%). RV-PA coupling assessed by echocardiographic TAPSE/PASP ratio appears to be an independent outcome predictor for HF patients.


Extraction and representation of common feature from uncertain facial expressions with cloud model.
Human facial expressions are key ingredient to convert an individual's innate emotion in communication. However, the variation of facial expressions affects the reliable identification of human emotions. In this paper, we present a cloud model to extract facial features for representing human emotion. First, the uncertainties in facial expression are analyzed in the context of cloud model. The feature extraction and representation algorithm is established under cloud generators. With forward cloud generator, facial expression images can be re-generated as many as we like for visually representing the extracted three features, and each feature shows different roles. The effectiveness of the computing model is tested on Japanese Female Facial Expression database. Three common features are extracted from seven facial expression images. Finally, the paper is concluded and remarked.


Phase change materials for portable isothermal incubators as a solution to shorten effective analysis times in microbiological quality control of drinking water.
The microbiological quality control of water for human consumption of parameters relevant as E.coli and total coliforms does not start on the field despite the existence of test methods that could make it possible. One of the things that makes this difficult is the possibility of initiating an effective and reliable incubation at the sampling site. The appearance of isothermal media with phase change materials solves this limitation. When phase change materials combine a relatively high melting heat with a suitable melting temperature adapted to the application temperature, they become excellent materials for thermal protection and for thermal energy storage. Starting the test at the same sampling point means that the effective times to obtain a result are shorter, improving water quality control. On the other hand, operationally, it also allows longer sampling routes. Both aspects are essential for managers responsible for controlling water quality for human consumption. In this work, the evidence that demonstrates the feasibility of this approach is presented.


Proposal of a population wide genome-based testing for Covid-19.
Our lives (and deaths) have by now been dominated for two years by COVID-19, a pandemic that has caused hundreds of millions of disease cases, millions of deaths, trillions in economic costs, and major restrictions on our freedom. Here we suggest a novel tool for controlling the COVID-19 pandemic. The key element is a method for a population-scale PCR-based testing, applied on a systematic and repeated basis. For this we have developed a low cost, highly sensitive virus-genome-based test. Using Germany as an example, we demonstrate by using a mathematical model, how useful this strategy could have been in controlling the pandemic. We show using real-world examples how this might be implemented on a mass scale and discuss the feasibility of this approach.


Electric Field-Assisted In Situ Precise Deposition of Electrospun γ-Fe2O3/Polyurethane Nanofibers for Magnetic Hyperthermia.
A facial electrospinning method of in situ precise fabricating magnetic fibrous membrane composed of polyurethane (PU) nanofibers decorated with superparamagnetic γ-Fe2O3 nanoparticles with simultaneous heat generation in response to alternating magnetic field (AMF) is reported. In this method, a conical aluminum auxiliary electrode is used to regulate the electrostatic field and affect the process of electrospinning for the in situ rapid and precise deposition of electrospun γ-Fe2O3/PU fibers. The auxiliary conical electrode can extend the jet stabilization zone of the precursor solution four times longer than that of without auxiliary electrode, which can achieve the precise control of the fiber deposition area. Moreover, the electrospun composite fibrous membranes show a rapid temperature increase from room temperature to 43 °C in 70 s under the AMF, which exhibits faster heating rate and higher heating temperature compared to the samples fabricated without the assist of the auxiliary electrode. The present results demonstrate that the in situ precise electrospinning with the help of an auxiliary conical electrode has the potential as a manipulative method for preparing magnetic composite fibers as well as magnetic hyperthermia of cancer therapy.


The Role of Lumen Apposing Metal Stents in the Palliation of Distal Malignant Biliary Distal Obstruction.
Malignant biliary obstruction (DMBO) has been traditionally managed by endoscopic retrograde cholangiopancreatography (ERCP). In the case of ERC failure, percutaneous transhepatic biliary drainage (PT-BD) has been widely utilized as a salvage procedure. However, over the last decade, endoscopic ultrasound-guided biliary drainage (EUS-BD) has gained increasing popularity, especially after the advent of electrocautery-enhanced lumen apposing metal stent devices (EC-LAMSs) which enable a one-step procedure, granting prevention of biliary leakage and minimizing occurrence of adverse events (AEs). In parallel, increasing evidence suggests a possible role of EUS-BD in the management of DMBO as a primary palliative drainage modality. In the current paper, we aim to review all the available evidence on the role of EUS-BD performed with EC-LAMSs and discuss salient technical aspects of this type of procedure.


Correlation of lipocalin 2 and glycolipid metabolism and body composition in a large cohort of children with osteogenesis imperfecta.
Lipocalin 2 (LCN2) is a newly recognized bone-derived factor that is important in regulation of energy metabolism. We investigated the correlation of serum LCN2 levels and glycolipid metabolism, and body composition in a large cohort of patients with osteogenesis imperfecta (OI). A total of 204 children with OI and 66 age- and gender-matched healthy children were included. Circulating levels of LCN2 and osteocalcin were measured by enzyme-linked immunosorbent assay. Serum levels of fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), and low- and high-density lipoprotein cholesterol (LDL-C, HDL-C) were measured by automated chemical analyzers. The body composition was measured by dual-energy X-ray absorptiometry. Grip strength and timed-up-and-go (TUG) were tested to evaluate the muscle function. Serum LCN2 levels were 37.65 ± 23.48 ng/ml in OI children, which was significantly lower than those in healthy control (69.18 ± 35.43 ng/ml, P < 0.001). Body mass index (BMI) and serum FBG level were significantly higher and HDL-C levels were lower in OI children than healthy control (all P < 0.01). Grip strength was significantly lower (P < 0.05), and the TUG was significantly longer in OI patients than healthy control (P < 0.05). Serum LCN2 level was negatively correlated to BMI, FBG, HOMA-IR, HOMA-β, total body, and trunk fat mass percentage, and positively correlated to total body and appendicular lean mass percentage (all P < 0.05). Insulin resistance, hyperglycemia, obesity, and muscle dysfunction are common in OI patients. As a novel osteogenic cytokine, LCN2 deficiency may be relevant to disorders of glucose and lipid metabolism, and dysfunction of muscle in OI patients.


High level of expression of a protective antigen of schistosomes in Saccharomyces cerevisiae.
Strains of Saccharomyces cerevisiae expressing P28-I, an antigen inducing protection against schistosomiasis, have been constructed. Transformants containing a very high copy number of a P28-I expression vector were selected by genetic complementation involving deficient LEU2 or URA3 alleles carried by plasmids. Using the ura3 fur1 auto-selection system, constitutive and stable expression of P28-I could be obtained in cultures grown in rich medium. The accumulation of the foreign protein exceeds 25% of total yeast proteins when estimated by Coomassie Brilliant Blue staining of SDS-PAGE. Moreover, P28-I which was located intracellularly was soluble and biologically active.


Common perinatal mental disorders and alcohol dependence in men in northern Viet Nam.
To establish the prevalence and correlates of the perinatal common mental disorders of depression and anxiety (PCMD) and alcohol dependence (AD) in men in northern Viet Nam. A cross-sectional study of men whose wives were >28weeks pregnant or mothers of newborns recruited from randomly-selected rural and urban communes. Data sources were Structured Clinical Interviews for DSM IV; CAGE assessment of alcohol use and study-specific questionnaires. Odds ratios and 95% CIs were calculated by multiple logistic regressions. Overall, 231/360 eligible men were recruited, of whom 17.7% [95% CI, 12.8-22.7] were diagnosed with a PCMD; 33.8% [95% CI, 27.9-40.1] with AD (CAGE score≥2) and 6.9% [95% CI, 4.3-11.0] with co-morbid PCMD and AD. PCMD were associated with experiences of coincidental life adversity, intimate partner violence, age>30; an unwelcome pregnancy and primiparity. AD was more common among men with low education, living in the poorest households and in unskilled work. Common mental disorders and AD are prevalent, but currently unrecognised among men in northern Viet Nam whose wives are pregnant or have recently given birth.


Outcome of low birthweight in China: a 16-year longitudinal study.
To compare the growth and neurodevelopment of low-birthweight (LBW) and normal-birthweight (control) infants born and raised in China. Prospective cohort study. 203 LBW (1200-2499 g) and 71 control (> or =2500 g) infants born at two Shanghai hospitals in 1983 did not differ for date of birth, gender, parental occupation, parental weight and age. LBW <10th centile at > or =37 wk gestation was defined as small for gestational age (SGA, n=102). LBW at < 37 wk gestation was defined as preterm (n=101). Weight, height, head circumference, Gesell developmental quotient (DQ), Wechsler intelligence quotient (IQ), and scholastic achievement score. Of the 274 enrolled subjects, 234 (85%) returned at 6 mo, 135 (49%) at 6 y, and 104 (38%) at 16 y. SGA, preterm, and control subjects did not differ in rates of follow-up or baseline characteristics. However, SGA and preterm were lower than control subjects in weight and head circumference through 16 y, height through 4 y, DQ through 3 y, IQ at 5 and 16 y, and scholastic achievement at 16 y. Catch-up to growth in the control group, defined as >3rd centile, and normal IQ, defined as > or =85, were both more common among preterm than SGA subjects. Adolescents in China with birthweights of 1200-2499 g, and particularly those who were SGA, lag behind peers with birthweights >2500 g in physical growth, cognitive capacity, and school achievement. The findings suggest that LBW adolescents in China today represent a population in need of evaluation and support.


Morphological changes in porcine bioprosthetic valves of a HeartMate left ventricular assist device.
A 27-year-old man who received a HeartMate (Thoratec Corporation, USA) left ventricular assist device for progressive heart failure as a bridge to orthotopic heart transplantation is described in the present report. The device failed (mechanical failure) after almost 19 months. The porcine bioprosthetic valves in the inflow and outflow cannulae showed hemorrhage, cusp tears and inflammatory cells, located largely on the inflow valve cusps. The role of the inflammatory cell reaction in the bioprosthetic valve is discussed.


A shared tissue transcriptome signature and pathways in psoriasis and ulcerative colitis.
Despite multiple efficacious therapies in common between psoriasis (PS) and Ulcerative Colitis (UC), mechanisms underlying their common pathophysiology remain largely unclear. Here we sought to establish a link by evaluating expression differences and pathway alterations in diseased tissues. We identified two sets of differentially expressed genes (DEGs) between lesional and nonlesional tissues in meta-analyses of data collected from baseline samples in 3 UC and then 3 PS available clinical studies from Pfizer. A shared gene signature was defined by 190 DEGs common to both diseases. Commonly dysregulated pathways identified via enrichment analysis include interferon signaling, partly driven by genes IFI6, CXCL9, CXCL10 and CXCL11, which may attract chemotaxis of Th1 cells to inflammatory sites; IL-23 pathway (IL-23A, CCL20, PI3, CXCL1, LCN2); and Th17 pathway except IL-17A. Elevated expression of costimulatory molecules ICOS and CTLA4 suggests ongoing T-cell activation in both diseases. The clinical value of the shared signature is demonstrated by a gene set improvement score reflecting post-treatment molecular improvement for each disease. This is the first study using transcriptomic meta-analysis to define a tissue gene signature and pathways dysregulated in both PS and UC. These findings suggest immune mechanisms may initiate and sustain inflammation similarly in the two diseases.


Tracking the Trauma Epidemic in KwaZulu-Natal, South Africa.
Trauma remains an important cause of morbidity and mortality in South Africa, but attempts to track the epidemic are often based on mortality data, or derived from individual health facilities. This project is based on the routine collection of trauma data from all public health facilities in the province of KwaZulu-Natal (KZN), between 2012 and 2022. Hospital level data on trauma over the past ten years was drawn from the district health information system (DHIS). Data relating to assaults, gunshots and motor vehicle collisions (MVCs) were recorded in the emergency rooms, whilst data on admissions are recorded in the wards and intensive care units. There were 1,263,847 emergency room visits for assaults, gunshots and MVCs over the ten-year period and trauma admissions ranged between four and five percent of the total number of hospital admissions annually. There was a dramatic decrease in trauma presentations and admissions over 2020/2021 as a result of the COVID lockdowns. Over the entire period, intentional injury was roughly twice as frequent as non-intentional injury. Intentional trauma had an almost equal ratio of blunt assault to penetrating assault. Gunshot-related assault increased dramatically over the 2021/2022 collecting period. The burden of trauma in KZN remains high. The unique feature of this burden is the excessively high rate of intentional trauma in the form of both blunt and penetrating mechanisms. Developing injury-prevention strategies to reduce the burden of interpersonal violence is more difficult than for unintentional trauma.


Alcohol and kidney damage: a Janus-faced relationship.
It has been known for a long time that excessive consumption of alcohol has adverse effects, including adverse impact on kidneys and kidney disease. Recently, observational evidence has been provided that moderate alcohol consumption is associated with less cardiovascular and renal risk. These issues had been summarized and discussed at the recent congress of the European Society for Biomedical Research and Alcoholism in Vienna.


Illness perception of migraineurs from the general population.
This study aims to describe the cognitive representations of migraine through the migraineurs' discourse. A sample of subjects taken at random from a representative sample of the French general population is interviewed about their representations of migraine. A content analysis is performed using the ALCESTE software. The population is composed of 51 subjects. The analysis shows that throughout the corpus, the word 'migraine' does not appear spontaneously. It seems that migraine as a chronic disease that may require long-term treatment is not well understood; people have rather a 'successive crises' representation of illness. In reaction to the crises, it is surprising not to find any clue evoking the field of catastrophsising. However, the cognitive coping strategy of resignation is to be found. The favourite interlocutor to start therapeutic education of the patient is the doctor since subjects say that they do not expect anything of the kind from the media. The results allow us to understand better why migraineurs do not consult for their illness and do not follow recommendations concerning treatments utilisation. The results allow to propose interventions that include patient education taking into account patients' cognitive representations of their illness.


Mutagenic and genotoxic effects and metal contaminations in fish of the Amambai River, Upper Paraná River, Brazil.
The present study evaluated mutagenic and genotoxic effects and metal accumulation in the liver and musculature of Pterygoplichthys ambrosetti and Prochilodus lineatus in the Amambai River, a tributary of the Upper Paraná River in Brazil. We also evaluated the potential for these fish species as environmental bioindicators and performed risk assessment for conservation purposes. We found that P. ambrosetti had a higher frequency of micronuclei compared to P. lineatus (p < 0.0001). There were no significant differences between species in other erythrocyte nuclear abnormalities (ENA) (p > 0.05). For both species, the liver contained a higher concentration of metals (Cd, Pb, Cr, Cu, Fe, Zn, and Ni) than the musculature did (p < 0.0001). Of the two species, P. ambrosetti was more suitable to evaluate mutagenic and genotoxic effects and metal accumulation in the liver and musculature, likely due to its resident behavior; hence, we highlight the potential of this species for use as an environmental bioindicator. The concentrations of non-essential metals observed in the fish confirm conditions of environmental stress in the Amambai River, possibly related to the discharge of pollutants and exacerbated by lack of native vegetation cover along the watercourse.


Brain monoamine levels in the cow during oestrus and metoestrus.
Norepinephrine, dopamine, and serotonin concentrations in the hypothalamus and stalk-median eminence were estimated in nine Hereford heifers at the onset of oestrus or 48 hr later. Significant differences in levels of monoamines at these stages of the oestrous cycle were not evident. Norepinephrine levels were similar in the hypothalamus and the stalk-median eminence, but dopamine and serotonin concentrations were significantly higher in the stalk-median eminence.


Expression of circumsporozoite proteins revealed in situ in the mosquito stages of Plasmodium berghei by the Lowicryl-immunogold technique.
A monoclonal antibody against the circumsporozoite proteins of the Plasmodium berghei sporozoite was used to trace the synthesis and expression of these proteins, via the Lowicryl immunogold technique, within the developing oocyst. The proteins were detected on the endoplasmic reticulum of the oocyst and were present in the sporozoite membranes at the point of their formation.


Serratus anterior muscle activation during knee push-up plus exercise performed on static stable, static unstable, and oscillating unstable surfaces in healthy subjects.
To compare electromyographic (EMG) activity of the serratus anterior (SA) during knee push-up plus exercises according to various surfaces (static stable, static unstable, and oscillating unstable surfaces). Comparative study by repeated measures. Yonsei University laboratory. In total, 15 healthy male subjects participated. The subjects performed knee push-up plus exercises on three different surfaces: static stable, static unstable, and oscillating unstable surfaces. Surface EMG activity of the SA for the peak and average amplitudes were collected from the dominant arm and presented as a percentage of the maximal voluntary contraction. A one-way repeated-measures ANOVA with a Bonferroni post hoc test was performed to compare differences in SA EMG activity according to the surface. The peak and average amplitudes of SA activity were significantly greater during knee push-up plus on the oscillating unstable surface than on the static stable or static unstable surfaces (p < 0.01). Additionally, there was no significant difference between the stable and static unstable surfaces (p > 0.05). Knee push-up plus exercise on an oscillating unstable surface activates the SA more than the same exercise on static stable and static unstable surfaces.


Pharmacotherapy problems and associated factors among type 2 adult diabetic patients on follow up at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia.
Over the past few decades, drug therapy problems (DTPs) have become a significant public health concern worldwide. DTPs in patients with diabetes are responsible for uncontrolled glycemia, disease worsening, early development of complications, high healthcare expenses, prolonged and recurrent hospitalizations, and mortality. This study aimed to identify the prevalence of drug therapy problems and determine the associated factors among patients with type II Diabetes Mellitus at a University Teaching Hospital in Southwest Ethiopia. Hospital-based cross-sectional study was conducted between September and October 2022. Data were collected through medical record reviews and interviewer-administered structured questionnaires, which were then analyzed using SPSS version 26. Cipolle's method was adapted for classification of DTPs. Bivariate followed by multivariate logistic regression analysis was used to assess the association between predictor variables and the outcome variable. P-value ≤ 0.05 was employed as a cut-off point to determine statistical significance. Among 117 participants, 172 drug therapy problems (DTPs) were identified, with an average of 1.47 DTPs per patient, and83 (70.9%) participants had at least one type of drug therapy problem. Of the seven DTPs identified, need additional drug therapy was the most common, 50 (42.7%), followed by non-compliance with medication, 45 (38.5%) and ineffective drug therapy, 25 (21.4%). Occupational status and comorbidity were factors that associated with the occurrence of DTPs. Farmers were approximately four times more likely to develop DTPs than housewives were (adjusted odds ratio (AOR) = 3.56, 95% CI: 1.12-11.38, P = 0.03). The odds of drug therapy problems were twice as high in those with four comorbid conditions than in those without comorbidities (AOR = 1.95, 95% CI: 0.90-3.76, p = 0.02). In the current study, the proportion of type 2 diabetes patients with drug therapy problems was high. This potentially lead to uncontrolled glycemia and early development of comorbid conditions, increasing morbidity and mortality rates. This could be attributed to the failure to effectively integrate clinical pharmacy services in different hospital wards, which is the case in virtually all hospitals in Ethiopia.


Reducing the bioburden on organic sanitary napkins and attempt to solve the sterility issue.
Sanitary napkins are technical textile products that women use to hygienically collect menstrual fluids when they are menstruating. Because sanitary napkins must simultaneously fulfil a number of end-use requirements, they have layered constructions. Through the Unnat Bharat Abhiyan, Surat, India, this study explores the eco-friendly (organic material) sanitary napkin production facility in the village of Bhatlai in the Gujarat province of India and identifies an issue. With eco-friendly organic sanitary products, bioburdens are a big problem. The Unnat Bharat Abhiyan accepts recommendations and improvements relating to sterility in a sanitary manufacturing unit after bioburden testing is conducted using various approaches outlined by Sanitary Napkins - Specification (IS 5405:2019). This study seeks to develop sanitary napkins that are sterilized and have no bioburden to replace SAPs (super absorbent polymer) with an ecologically friendly biopolymer that provides competent performance and characteristics to rural women of India living near or below poverty line.


Debye-Hückel theory of mixed charged-zwitterionic lipid layers.
Modeling electrostatic properties of macroions such as charged lipid membranes is especially simple within linear Debye-Hückel theory where analytical solutions are often available. Charged lipid layers typically also contain zwitterionic lipids that possess a large headgroup dipole. We incorporate the presence of zwitterionic lipids into the Debye-Hückel description and derive analytical expressions for the free energies of isolated and interacting lipid layers. Our approach accounts for two major characteristic features of zwitterionic lipids, the firm linkage of the dipole's negatively charged phosphate end to the lipid chain and the comparatively large conformational freedom of the opposite, positively charged, dipole end. This leads to differences in structural properties of mixed anionic and cationic lipid layers that are known from experiment and that the Debye-Hückel description qualitatively recovers. Most notably, this includes the different dependencies of the average cross-sectional area per lipid on the composition of mixed anionic and cationic membranes. In addition, we study the predictions of Debye-Hückel theory regarding the electrostatic influence of zwitterionic lipids on the stability of non-ideally mixed membranes as well as on the adsorption energy of oppositely charged macroions.


Excision of duplicated ectopic ureter: re-emphasis on technique.
Excision of the residual duplicated ectopic ureter after partial nephrectomy is an uncommon but often difficult surgical procedure. The awareness of the benefits of the transvesical approach should be part of every urologist's surgical knowledge.


Swallowing abnormalities in multiple sclerosis: correlation between videofluoroscopy and subjective symptoms.
The purpose of this study was to evaluate if subjective symptoms indicating an impaired deglutition correlate with videofluoroscopic findings in patients with multiple sclerosis (MS). Videofluoroscopic examinations of 18 MS patients were analyzed by a radiologist and a logopedist and compared with the symptoms of these patients. Four patients complained about permanent dysphagia. Six patients reported mild and intermittent difficulties in swallowing, but were asymptomatic at the time of videofluoroscopy. Eight patients had no symptoms regarding their deglutition. All patients ( n=4) who complained of permanent dysphagia showed aspiration. All patients ( n=6) with mild and intermittent difficulties in swallowing showed undercoating of the epiglottis and/or laryngeal penetration. Of those 8 patients without any swallowing symptoms, only 2 had a normal videofluoroscopy. Swallowing abnormalities seem to be much more frequent in patients with MS than generally believed and they may easily be missed clinically as long as the patients do not aspirate.


Sepsis-induced elevation in plasma serotonin facilitates endothelial hyperpermeability.
Hyperpermeability of the endothelial barrier and resulting microvascular leakage are a hallmark of sepsis. Our studies describe the mechanism by which serotonin (5-HT) regulates the microvascular permeability during sepsis. The plasma 5-HT levels are significantly elevated in mice made septic by cecal ligation and puncture (CLP). 5-HT-induced permeability of endothelial cells was associated with the phosphorylation of p21 activating kinase (PAK1), PAK1-dependent phosphorylation of vimentin (P-vimentin) filaments, and a strong association between P-vimentin and ve-cadherin. These findings were in good agreement with the findings with the endothelial cells incubated in serum from CLP mice. In vivo, reducing the 5-HT uptake rates with the 5-HT transporter (SERT) inhibitor, paroxetine blocked renal microvascular leakage and the decline in microvascular perfusion. Importantly, mice that lack SERT showed significantly less microvascular dysfunction after CLP. Based on these data, we propose that the increased endothelial 5-HT uptake together with 5-HT signaling disrupts the endothelial barrier function in sepsis. Therefore, regulating intracellular 5-HT levels in endothelial cells represents a novel approach in improving sepsis-associated microvascular dysfunction and leakage. These new findings advance our understanding of the mechanisms underlying cellular responses to intracellular/extracellular 5-HT ratio in sepsis and refine current views of these signaling processes during sepsis.


Exploiting Mitochondria In Vivo as Chemical Reaction Chambers Dependent on Membrane Potential.
Recently in Cell Metabolism, Logan et al. (2016) exploit membrane potential-dependent mitochondrial accumulation of charged precursors, causing them to combine by "click" chemistry 1,000,000 times faster than without accumulation to generate an ultrasensitive indicator for membrane potentials and foreshadow targeted drug synthesis in vivo.


A combined orbital and antral approach to surgical decompression of the orbit.
A combined orbital decompression procedure has been found effective in treating proptosis. The procedure includes a lower eyelid incision by an ophthalmologist to expose the floor of the orbit, while a Caldwell-Luc antrotomy is performed simultaneously by an otolaryngologist. The ophthalmologist has a better view of the contents of the orbit and the anterior orbital floor. The otolaryngologist has better access to the posterior orbital floor and ethmoid sinus. Together, isolation and preservation of the second division of the fifth cranial nerve are facilitated. The headlight worn by each surgeon helps illuminate the other's field of dissection. This combined approach offers advantages over separate operations.


Testing the Bethe ansatz with large N renormalons.
The ground-state energy of integrable asymptotically free theories can be conjecturally computed using the Bethe ansatz once the theory has been coupled to an external potential through a conserved charge. This leads to a precise prediction for the perturbative expansion of the energy. We provide a non-trivial test of this prediction in the non-linear sigma model and its supersymmetric extension, by calculating analytically the associated Feynman diagrams at next-to-leading order in the 1/N expansion, and at all loops. By investigating the large order behavior of the diagrams, we locate the position of the renormalons of the theory and we obtain an analytic expression for the large N trans-series associated to each. As a spin-off of our calculation, we provide a direct derivation of the beta function of these theories, at next-to-leading order in the 1/N expansion.


Biology and molecular aspects of herpes simplex and varicella-zoster virus infections.
The herpes simplex and varicella-zoster viruses are members of the subfamily alpha herpesviruses with specific properties of the virion and with the capacity to establish latent infections in humans. The genome of each of these viruses has been determined with an estimate of the number of genes and proteins encoded. The biology and molecular events of the herpes simplex virus productive and latent infection have been detailed with the use of both in vitro and in vivo model systems. The neuron is the site of latency in the ganglia with a limited transcription of genes expressed during the latent period. The specific molecular regulation of latency and reactivation are not well established. There are co-cultivation, electron microscopy, and biochemical studies that support the concept of corneal latency, although this has not been proven conclusively. Details about the varicella-zoster virus biology and molecular events are not as well advanced since animal models have been lacking. The biology of the productive infection (varicella) is different from herpes simplex virus infection since the portal of entry is the respiratory system. Data support the concept of the maintenance of latency within satellite cells in the ganglia rather than within neurons. There are multiple genes expressed during this latency. These features may explain the different clinical presentations and course of reactivation (zoster) compared with herpes simplex virus reactivation.


Benefit of Early Statin Initiation within 48 Hours after Admission in Statin-Naïve Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention.
Although current guidelines recommend early initiation of statin in patients with acute myocardial infarction (AMI), there is no consensus for optimal timing of statin initiation. A total of 3,921 statin-naïve patients undergoing percutaneous coronary intervention were analyzed, and divided into 3 groups according to statin initiation time: group 1 (statin initiation <24 hours after admission), group 2 (24-48 hours) and group 3 (≥48 hours). We also made 3 stratified models to reduce bias: model 1 (<24 hours vs. ≥24 hours), model 2 (<48 hours vs. ≥48 hours) and model 3 (<24 hours vs. 24-48 hours). The endpoint was major adverse cardiac events (MACE; composite of cardiac death, myocardial infarction and target-vessel revascularization) during median 3.8 years. During follow-up, incidence of MACE was lower in early statin group in both model 1 (14.3% vs. 18.4%, hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.66-0.91; p=0.002) and model 2 (14.6% vs. 19.7%, HR, 0.81; 95% CI, 0.67-0.97; p=0.022). After propensity-score matching, results remained unaltered. Statin initiation <24 hours reduced MACE compared to statin initiation ≥24 hours in model 1. Statin initiation <48 hours also reduced MACE compared to statin initiation later in model 2. However, there was no difference in incidence of MACE between statin initiation <24 hours and 24-48 hours) in model 3. Early statin therapy within 48 hours after admission in statin-naïve patients with AMI reduced long-term clinical outcomes compared with statin initiation later. ClinicalTrials.gov Identifier: NCT02385682.


K252a, a new inhibitor of protein kinase C, concomitantly inhibits 40K protein phosphorylation and serotonin secretion in a phorbol ester-stimulated platelets.
K252a isolated from microbial origin was found to potently inhibit protein kinase C in vitro (1). This agent inhibits phosphorylation of 40,000 dalton protein (40K protein) induced by 12-0-tetradecanoylphorbol-13-acetate(TPA) in intact rabbit platelets. This indicates that K252a exhibits the inhibition of protein kinase C in intact cells. The serotonin secretion induced by TPA was inhibited by K252a at nearly equal concentrations required to inhibit the phosphorylation of 40K protein. This provides the evidence to support the cause-effect relationship between the protein phosphorylation and the secretion in TPA-stimulated platelets.


Comparison of safety and effectiveness between laparoscopic and open pancreatoduodenectomy: A systematic review and meta-analysis.
Validity of the laparoscopic approach in pancreatic head lesion remains debatable. This study aims to compare the safety and effectiveness of laparoscopic pancreatoduodenectomy (LPD) and open pancreatoduodenectomy (OPD) and investigate the source of heterogeneity from surgeons' and patients' perspectives. We searched PubMed, Cochrane, Embase, and Web of Science for studies published before February 1, 2021. Of 6578 articles, 81 were full-text reviewed. The primary outcome was mortality. Three independent reviewers screened and extracted the data and resolved disagreements by consensus. Studies were evaluated for quality using ROB2.0 and ROBINS-I. According to different study designs, sensitivity and meta-regression analyses were conducted to explore the heterogeneity source. This meta-analyses was also conducted to explore the learning curve's heterogeneity. This study was registered with PROSPERO, CRD42021234579. We analyzed 34 studies involving 46,729 patients (4705 LPD and 42,024 OPD). LPD was associated with lower (P = 0.025) in unmatched studies (P = 0.017). No differences in mortality existed in randomized controlled trials (P = 0.854) and matched studies (P = 0.726). Sensitivity analysis found no significant difference in mortality in elderly patients, patients with pancreatic cancer, and in high- and low-volume hospitals (all P > 0.05). In studies at the early period of LPD (<40 cases), higher mortality (P < 0.001) was found (all P < 0.05).LPD showed non-inferiority in length of stay, complications, and survival outcomes in all analyses. In high-volume centers with adequate surgical experience, LPD in selected patients appears to be a valid alternative to LPD with comparable mortality, LOS, complications, and survival outcomes.


COVID-19 vaccine acceptance and its determinants among Vietnamese teachers: a web-based cross-sectional survey.
This paper aimed to describe acceptance of the COVID-19 vaccine and its determinants among Vietnamese teachers. This was a web-based cross-sectional survey with a sample of 17,176 teachers from kindergarten to high school who currently reside in Vietnam. A participant who exhibited "acceptance" towards the vaccine gave the following response: "have the readiness to get COVID-19 vaccine". About 88% of all participants were accepting of the COVID-19 vaccine, while 70.4% were willing to pay (WTP) for it. The vaccine acceptance rate increased by age with odds ratios (OR) of 1.65 (1.41-1.93), 1.96 (1.67-2.29), and 2.4 (1.95-2.95) for the age groups 30-39, 40-49, and 50-59 respectively, when compared to the 18-29 age group. Male were found to be more likely to accept the vaccination than females (OR = 1.16; 95% CI: 1.02-1.31); teachers without a chronic disease were 4.13 times (95% CI: 2.67-6.37) more likely to accept the vaccine than those with an underlying condition. Willingness to pay and beliefs about the safety and efficacy of the vaccine were major factors in driving participants' responses. A high proportion of COVID-19 vaccine acceptance is a promising indicator of high coverage among this priority group for vaccination. Communication campaigns should consider addressing determinants uncovered by this study to achieve better vaccine acceptance.


Potent necrosis effect of methanethiol mediated by METTL7B enzyme bioactivation mechanism in 16HBE cell.
Methanethiol is a widely existing malodorous pollutant with health effects on the human population. However, the cytotoxicity mechanism of methanethiol in vitro and its metabolic transformation (bioactivation or detoxification) have not been fully elucidated. Herein, the metabolites of methanethiol during cell culture and the cytotoxicity of methanethiol in human bronchial epithelial (16HBE) cells were investigated. Results indicate that methanethiol (10-50 μM) was partially converted into dimethyl sulfide, mainly catalyzed by thiol S-methyltransferase in the 16HBE cells, and then it induced potent cytotoxicity and cell membrane permeability. Moreover, methanethiol induced intracellular reactive oxygen species (ROS) up to 50 μM and further activated the tumor necrosis factor (TNF) signaling pathway, which eventually led to the decline in the mitochondrial membrane potential (MMP) and cell necrosis. However, all these effects were significantly alleviated with gene silencing of the methyltransferase-like protein 7B (METTL7B). These results indicate that methanethiol may induce cell necrosis in human respiratory tract cells mainly mediated by S-methyltransferase with interfering TNF and ROS induction. Non-target metabolomics results suggest that methanethiol potently affects expression of endogenous small molecule metabolites in 16HBE cells. To some extent, this work shows the possible conversion path and potential injury mechanism of human respiratory tract cells exposed to methanethiol.


"Flip-flap" mastopexy.
The "flip-flap" mastopexy modifies the McKissock vertical bipedicle design by creating a wide superiorly based flap of breast tissue deep to the vertical bipedicle. Transposition of this flap up and beneath the upper breast, with suture anchoring to the pectoralis fascia at the level of the second rib, restores upper breast fullness, decreases mastopexy-wrecking lower breast bulk, and provides a pleasant forward thrust of the nipple-areolar complex. The "flip-flap" is effective for improving the long-term aesthetic outcome for both reduction mammaplasty and mastopexies of moderate- to full-sized breasts.


An ultrastructural and light microscopic study of the synovium in ochronotic arthropathy.
The synovium in two well-documented cases of alkaptonuric ochronosis was studied by transmission electron and light microscopy. A feature of alkaptonuria previously unreported in the English-language literature was the presence of phagocytosis of large collagen fibrils by synovial macrophages in both cases. The origin of these fibrils appeared to have been shards of ochronotic cartilage and areas of metaplastic cartilage. This finding suggests that active remodeling of the synovial tissues occurs in advanced ochronotic arthropathy. Numerous shards of ochronotic cartilage were embedded in the synovium. In addition, small aggregates of large collagen fibrils encrusted with apparent ochronotic pigment were occasionally noted in the interstitium. These aggregates of ochronotic collagen are best described as microshards, and they have not generally been recognized in the literature. What appeared by light microscopy to represent ochronotic pigment deposition in interstitial collagen actually represented embedded microshards of ochronotic cartilage in the interstitium. Slender and elongated microshards were most likely to be confused by light microscopy as ochronotic interstitial collagen.


AFM for diagnosis of nanocrystallization of steels in hardening processes.
The aim of this study is to investigate the nanocrystallization of steels caused by the transformation from the austenitic to the martensitic phase induced by a severe plastic deformation (SPD) treatment. In this framework, we applied an air blast shot peening treatment, which is a simple protocol widely used for industrial purposes. AISI 286 and AISI 316 specimens were peened for different times and polished using diamond pastes in order to remove corrugations higher than 1 mum. The characterization of the steel surfaces was performed by atomic force microscopy (AFM) operating in contact mode. Additional EDXD measurements were performed to confirm the phase transition. An AFM-based characterization at nanometric level of the steel surfaces is provided. When the peening exceeds a threshold time that, as expected, depends on the steel composition, a uniform nanostructuration is detected. It is well known that such rearrangement is associated to the growth of a martensitic phase. To date, AFM has been employed in this field only for few applications and to solve specific problems. On the other hand, our results demonstrate that this is a useful technique for the characterization of hardened surfaces, especially when non-destructive sample preparation treatments are required. Moreover, we show that AFM can be a useful tool also for in situ industrial diagnostics of metallic parts.


Early administration of postoperative BCAA-enriched PPN may improve lean body mass loss in gastric cancer patients undergoing gastrectomy.
It has been reported that weight loss or lean body mass (LBM) loss after gastrectomy for gastric cancer is associated with prognosis and nutritional support alone is insufficient to prevent LBM loss. Branched-chain amino acids (BCAA) play an important role in muscle catabolism, however their clinical effects on suppression of LBM loss in gastric cancer patients undergoing gastrectomy remains elusive. In this current study, we investigated the effect of our original PPN regimen including BCAA (designated to BCAA-regimen) on LBM loss. We conducted a randomized controlled trial (RCT) at a single institution where patients undergoing gastrectomy were assigned to either receive a five-day early postoperative course of the BCAA-regimen (BCAA group) or conventional nutrition. The primary endpoint was the % reduction in LBM at postoperative day 7. The secondary endpoints included the % reduction in LBM at 1 and 3 months postsurgery. At postoperative day 7, LBM loss in the BCAA group tended to be lower than in the control group (0.16% vs. 1.7%, respectively; P = 0.21), while at 1 month postsurgery, LBM loss in the BCAA group was significantly different to that of the control group (- 0.3% vs. 4.5%, respectively; P = 0.04). At 3 months postgastrectomy, however, LBM loss was similar between the BCAA and the control groups. Our RCT clinical trial clarified that early administration of the postoperative BCAA regimen improved LBM loss at 1 month after surgery in gastric cancer patients undergoing gastrectomy.


Stimulus-Stimulus Pairing of Vocalizations: A Systematic Replication.
The current study replicated an enhanced stimulus-stimulus pairing (SSP) procedure used by Esch et al. (Journal of Applied Behavior Analysis 42: 42-225, 2009) for increasing vocalizations in children with autism. The enhanced SSP procedure consisted of pairing target vocalizations with high-preference items, interspersed target and nontarget trials, an observing response, and the presentation of the vocalizations in "motherese" speech. Results showed substantial increases in target vocalizations above baseline levels and above nontarget vocalizations for two of three participants.


Trajectories of physical and mental functioning over 25 years before onset of frailty: results from the Whitehall II cohort study.
Research on frailty, a major contributor to heterogeneity in health, is undertaken on older adults although the processes leading to frailty are likely to begin earlier in the life course. Using repeat data spanning 25 years, we examined changes in physical and mental functioning before the onset of frailty, defined using Fried's frailty phenotype (FFP). Functioning was measured using the Short-Form 36 General Health Survey (SF-36) on nine occasions from 1991 (age range 40-63 years) to 2015 (age range 63-85 years). The poorest of four FFP scores from 2002, 2007, 2012 and 2015 was used to classify participants as frail, pre-frail, or robust. We used linear mixed models with a backward timescale such that time 0 was the person-specific date of frailty classification for frail and pre-frail participants and the end of follow-up for robust participants. Analyses adjusted for socio-demographic factors, health behaviours, body mass index and multi-morbidity status were used to compare SF-36 physical (PCS) and mental (MCS) component summary scores over 25 years before time 0 as a function of FFP classification, with estimates extracted at time 0, -5, -10, -15, -20 and -25 years. We also used illness-death models to examine the prospective association between SF-36 component summary scores at age 50 and incident FFP-defined frailty. Among 7044 participants of the Whitehall II cohort study included in the analysis [29% female, mean age 49.7 (SD = 6.0) at baseline in 1991], 2055 (29%) participants remained robust, and 4476 (64%) became pre-frail and 513 (7%) frail during follow-up. Frail compared with robust participants had lower SF-36 scores at t = -25 before onset of frailty with a difference of 3.4 [95% confidence interval (CI) 1.6, 5.1] in PCS and 1.8 (-0.2, 3.8) in MCS. At t = 0, the differences increased to 11.5 (10.5, 12.5) and 9.1 (8.0, 10.2), respectively. The differences in SF-36 between the robust and pre-frail groups, although smaller [at t = 0, 1.7 (1.2, 2.2) in PCS and 4.0 (3.4, 4.5) in MCS], were already observed 20 and 25 years, respectively, before the onset of pre-frailty. Prospective analyses showed that at age 50, scores in the bottom quartiles of PCS [hazard ratio (HR) compared with the top quartile = 2.39, 95% CI 1.85, 3.07] and MCS [HR = 1.49 (1.15, 1.93)] were associated with a higher risk of FFP-defined frailty at older ages. Differences in trajectories of physical and mental functioning in individuals who developed physical frailty at older ages were observable 25 years before onset of FFP-defined frailty. These findings highlight the need for a life course approach in efforts to prevent frailty.


Perception of shape from shading.
The human visual system can rapidly and accurately derive the three-dimensional orientation of surfaces by using variations in image intensity alone. This ability to perceive shape from shading is one of the most important yet poorly understood aspects of human vision. Here we present several findings which may help reveal computational mechanisms underlying this ability. First, we find that perception of shape from shading is a global operation which assumes that there is only one light source illuminating the entire visual image. This implies that if two identical objects are viewed simultaneously and illuminated from different angles, then we would be able to perceive three-dimensional shape accurately in only one of them at a time. Second, three-dimensional shapes that are defined exclusively by shading can provide tokens for the perception of apparent motion, suggesting that the motion mechanism is remarkably versatile in the kinds of inputs it can use. Lastly, the occluding edges which delineate an object from its background can also powerfully influence the perception of three-dimensional shape from shading.


Preparation and characterization of palladium nano-crystallite decorated TiO₂ nano-tubes photoelectrode and its enhanced photocatalytic efficiency for degradation of diclofenac.
TiO2 has been considered as a versatile candidate for the photoelectrochemical (PECH) application. In this study, Pd nano-crystallite decorated TiO₂ nano-tubes (Pd/TNTs) photoelectrode was prepared through electrochemical deposition. The resulting Pd/TNTs samples were characterized by SEM, XRD, DRS and XPS. It was found that the decorated Pd nano-crystallite existed in the form of Pd(0) with an average diameter of 30 nm, and could improve the light absorption in visible region. In addition, PECH properties of Pd/TNTs photoanode were investigated through transient open circuit potential, photocurrent response, electro-chemical impedance spectroscopy (EIS) and Mott-Schottky analysis. Moreover, the generation rate of hydroxyl radicals (•OH) was detected by a photoluminescence (PL) spectra using terephthalic acid (TA) as a probe molecule. Results showed that Pd/TNTs photoelectrode exhibited high transient photoinduced current of 0.094 mA cm(-2), open circuit photovoltage of -0.339 mV cm(-2) and effective photoelectrocatalytic (PEC) efficiency of 67.7% (0.4V vs. SCE) for the degradation of diclofenac (DCF). The high PC and PEC efficiency could mainly be attributed to the decoration of Pd nano-crystallite which could provide pathway for the transfer of photoinduced charge carriers. Furthermore, the contribution of series of active species was applied to clarify the enhanced PC mechanism.


Differential expression of the natural antimicrobials, beta-defensins 3 and 4, in human endometrium.
beta-Defensins are small cationic molecules that have antimicrobial actions against bacteria, fungi and viruses and contribute to mucosal immune responses at epithelial sites. The female reproductive tract is an important site of defensin production and innate defences are crucial to the preservation of fertility and successful pregnancy. This study details the expression of the recently characterized defensins, HBD3 and 4, in human endometrium. Using real-time quantitative RT-PCR, we have shown that HBD3 mRNA expression is highest during the secretory phase of the menstrual cycle while HBD4 mRNA levels peak in the proliferative phase. Both antimicrobials are expressed by endometrial epithelium. Exogenous steroid hormones in the form of the combined oral contraceptive pill (COCP) alter expression of both defensins in vivo, while treatment of endometrial explants with progesterone in vitro does not alter expression of HBD3 or HBD4. In in vitro cultures of primary endometrial epithelial cells, HBD3 mRNA expression is upregulated by treatment with inflammatory molecules including IL-1 beta+TNF alpha, IFN gamma and phorbol ester. HBD4 mRNA was not expressed in these primary cell cultures. These results show that the human endometrium expresses both HBD3 and HBD4 in a cycle-dependent manner. These natural antimicrobials will contribute to innate defences present in human endometrium protecting against uterine infection. Expression is altered as a result of hormonal contraceptive use and this may contribute to differential infection rates in COCP users relative to non-users. In addition, expression of HBD3 will be upregulated during infection allowing an increased innate immune response at this time.


Coma and brain death.
Coma must persist for at least 1 hour to distinguish it from transient unconsciousness. Traumatic and nontraumatic coma are common problems in pediatric practice with high mortality and morbidity. Emergency neuroimaging is worthwhile even when etiology is known, as treatable complications, such as venous sinus thrombosis, as well as extradural and intracerebral hemorrhage, are commonly diagnosed. There is a wide range of possible etiologies in the previously well child, most of which may be diagnosed from neuroimaging and laboratory testing available as an emergency, or can be treated presumptively, e.g., with antimicrobials for infections. The modified Child's Glasgow Coma Scale (CGCS) for recording depth of consciousness in children is widely used and should be supplemented by examination for the signs of reversible central and uncal brainstem herniation due to acute intracranial hypertension. An evidence-based guideline for the investigation and management of decreased level of consciousness in children, written by an expert panel using the DELPHI principles, is available. Monitoring and rehabilitation should also be part of the management plan. Etiology, depth and duration of coma, and serial neurophysiology and imaging are predictors of outcome in survivors but must be interpreted cautiously. There are no reports of children meeting adult brain death criteria making good neurological recovery.


Reduced blood BDCA-2+ (lymphoid) and CD11c+ (myeloid) dendritic cells in systemic lupus erythematosus.
Type 1 IFN is thought to be implicated in the autoimmune process of SLE. Plasmacytoid dendric cells (DC), which are natural IFN-alpha producing cells, play a pivotal epipathogenic role in SLE. The present study was undertaken to investigate the phenotypic characteristics of peripheral blood DC in SLE patients in comparison with those of healthy controls. Samples from 20 SLE patients and 18 healthy controls were studied. Three-colour flow cytometry was performed to identify myeloid DC, as CD11c(+) lineage marker(-), and HLA-DR(+) cells and plasmacytoid DC, as BDCA-2(+) linage marker(-), and HLA-DR(+) cells. We used the whole blood 'lyse/no-wash' procedure, which allows precise counting of peripheral blood DC. BDCA-2(+) plasmacytoid DC and CD11c(+) myeloid DC were reduced in SLE patients compared with controls. Similarly, BDCA-3(+) DC were reduced in SLE patients. These results indicated that SLE patients had a reduced number of both BDCA-2(+) plasmacytoid DC and CD11c(+) myeloid DC. These alternations of the DC subset may drive the autoimmune response in SLE.


On the conversion of tritium units to mass fractions for hydrologic applications.
We develop a general equation for converting laboratory-reported tritium levels, expressed either as concentrations (tritium isotope number fractions) or mass-based specific activities, to mass fractions in aqueous systems. Assuming that all tritium is in the form of monotritiated water simplifies the derivation and is shown to be reasonable for most environmental settings encountered in practice. The general equation is nonlinear. For tritium concentrations c less than 4.5 × 10(12) tritium units (TU) - i.e. specific tritium activities<5.3 × 10(11) Bq kg(-1) - the mass fraction w of tritiated water is approximated to within 1 part per million by w ≈ c × 2.22293 × 10(-18), i.e. the conversion is linear for all practical purposes. Terrestrial abundances serve as a proxy for non-tritium isotopes in the absence of sample-specific data. Variation in the relative abundances of non-tritium isotopes in the terrestrial hydrosphere produces a minimum range for the mantissa of the conversion factor of [2.22287; 2.22300].


Age related changes in total DNA and RNA and incorporation of uridine and thymidine in rat brain.
1. Total brain DNA and total brain RNA and the incorporation of thymidine[14C] and uridine[3H] were measured in young and aged rats. 2. From 20 days to the time of sexual maturation, both DNA and RNA levels increase. Total RNA exceeds total DNA at all ages. Comparatively, the ratio of total DNA/RNA is higher in young than in aged animals. 3. The incorporation of thymidine[14C]/g of DNA and of uridine[3H]/g of RNA decreases with age. This decrease is rapid in young animals. After 350 days of age, the incorporation becomes very low. The significance of data is discussed.


Ion mobility and material transport on KBr in air as a function of the relative humidity.
Surfaces exposed to air can change their structure due to external influences such as chemical reactions or material exchange and movement. The adsorbed water layer that is present under ambient conditions plays an important role especially for highly soluble materials. Surface atoms can easily diffuse into the thin water layer and, when surface conditions are favorable, they can re-attach to the surface. We collected atomic force microscopy images of KBr surfaces in a humidity-controlled glove box at various relative humidities below 40%. By scratching and poking the surface with the AFM tip, we constructed energetically unfavorable holes or scratch sites and material accumulations and recorded the evolution of these defects as a function of the time. We observed an exponential decay of the size of the defects and material accumulations, and from this data we determined energy barriers to dissolution and aggregation of approximately 0.9 eV.


A Longitudinal Examination of the Family Stress Model of Economic Hardship in Seven Countries.
The Family Stress Model of Economic Hardship (FSM) posits that economic situations create differences in psychosocial outcomes for parents and developmental outcomes for their adolescent children. However, prior studies guided by the FSM have been mostly in high-income countries and have included only mother report or have not disaggregated mother and father report. Our focal research questions were whether the indirect effect of economic hardship on adolescent mental health was mediated by economic pressure, parental depression, dysfunctional dyadic coping, and parenting, and whether these relations differed by culture and mother versus father report. We conducted multiple group serial mediation path models using longitudinal data from adolescents ages 12-15 in 2008-2012 from 1,082 families in 10 cultural groups in seven countries (Colombia, Italy, Jordan, Kenya, the Philippines, Thailand, and the United States). Taken together, the indirect effect findings suggest partial support for the FSM in most cultural groups across study countries. We found associations among economic hardship, parental depression, parenting, and adolescent internalizing and externalizing. Findings support polices and interventions aimed at disrupting each path in the model to mitigate the effects of economic hardship on parental depression, harsh parenting, and adolescents' externalizing and internalizing problems.


The Transition to High School: Current Knowledge, Future Directions.
In the American educational system, school transitions are frequent and predictable, but they can disrupt student functioning across developmental domains. How students experience school transitions has been a focus of research for some time, but the high school transition has received less attention, and the limited research often focuses on a particular developmental domain (e.g., academics and socioemotional well-being) to the exclusion of a more integrated model. This review relies on life course theory to establish an organizational framework for interpreting and connecting the diffuse and sometimes disparate findings on the high school transition, including adolescent developmental trajectories and the influence of social ties, changing sociocultural contexts, and stratification systems. Conclusions identify aspects for future inquiry suggested by current knowledge and the tenets of the life course perspective.


TEMPER: an acronym for ankle sprain rehabilitation.
As has been previously discussed, the incidence and resultant associated disabilities of ankle sprains have been well documented in the literature. The staggering statistics on long-term disability show that there is no such thing as a simple ankle sprain. The degree of disability is related to the extent of the initial injury as well as the follow-up medical care provided. It is this fact that requires a complete understanding of the injury as well as a proper treatment and rehabilitation program. One of the reasons cited for the long-term disability or lack of consistently good results in treating ankle sprains is the lack of uniformity in treatment. One possible reason is the lack of agreement in diagnostic techniques as well as the end diagnosis of a particular grade of ankle sprain. If a sprain is managed correctly, resultant disability will be kept to a minimum. A proper rehabilitation program may be the most important factor in preventing chronic instability. The acronym RICE falls short of complete ankle management. RICE primarily addresses the ankle edema. Thus, the patient's ankle is only partially rehabilitated. A rational approach to the management of ankle sprains is given. Upon reviewing a complete protocol for ankle sprain rehabilitation, the acronym TEMPER can be used judiciously to remember the key steps in the treatment plan. Through the use of this acronym, one can institute a complete rehabilitation program.


US and color Doppler findings in angiolymphoid hyperplasia with eosinophilia involving the superficial temporal artery.
Reported here is a 60-year-old man with multiple localizations of angiolymphoid hyperplasia with eosinophilia (ALHE) in the temporal region, involving the superficial temporal artery, detected and analyzed with ultrasound and color Doppler. The usefulness of this diagnostic technique and the peculiar signs of ALHE are discussed.


Target-selective photo-degradation of verotoxin-1 and reduction of its cytotoxicity to Vero cells using porphyrin-globotriose hybrids.
Designed and synthesized porphyrin-globotriose hybrids effectively degraded verotoxin-1, which causes severe bloody diarrhoea and fetal hemolytic uremic syndrome (HUS). Degradation was achieved using long-wavelength UV or visible light irradiation in the absence of any additives and under neutral conditions. Moreover, the hybrids neutralized the cytotoxicity of verotoxin upon photo-irradiation.


Anterior skull base olfactory tumours, which is what? A case report and review.
Intracranial schwannomas not originating from cranial nerves are rare. In this paper, we report a case of a 50-year-old male who presented with worsening headaches, diplopia and nausea over two years. Radiological imaging revealed a large tumour arising from the olfactory groove region with a preoperative diagnosis of olfactory groove meningioma (OGM). Intraoperatively, the tumour originated from the region of the attachment of the falx to the crista galli. The patient recovered without complication and histopathology reported an unexpected diagnosis of WHO Grade 1 schwannoma. However, as olfactory groove schwannomas (OGSs) cannot be distinguished from olfactory ensheathing cell tumours (OECTs), it is possible that the tumour could have been either an OGS or an OECT. Distinguishing between OGSs, OECTs and OGMs preoperatively is difficult. OGMs exhibit distinct histopathological features from OGSs/OECTs, however, OGSs and OECTs currently cannot be distinguished from each other. Here, we review the literature to discuss the differentiating features and cellular origins of these three tumours.


Correction to: Evaluation of the surface water quality in the Kebir-Rhumel catchment area (Northeast Algeria) using biotic indices and physico-chemical analyses.
The correct title is presented in this paper.


A video-based training to effectively teach CPR with long-term retention: the ScuolaSalvaVita.it ("SchoolSavesLives.it") project.
Enhancing CPR knowledge in schools is the key to improving bystander CPR rate and survival after an out-of-hospital cardiac arrest, but the best method to do so in a whole area is unknown. We wanted to assess if a province-based project, which involves the Secondary Schools of a whole Province, is effective in teaching schoolchildren CPR, and how well the skills are retained. We trained 100 teachers from the 21 Secondary Schools of the Province of Pavia with a BLS/AED course and we supplied each school with 10 low-budget manikins and four educational videos. These videos, about 2 min each, consist of a motivational part, an instructive part, a demonstrative part and a practice-while-watching part. We explained to the teachers how to use manikins and videos in a 2-h course. We carried out both a theoretical and a practical test in 21 classes, randomly selected between the classes trained by the teachers, 3 months and 6 months after the training. In the first 5 months of the project, 5146 schoolchildren aged 14-19, in the 21 Secondary Schools of our Province, were trained by their teachers. We tested 304 students 3 months after the course and 318 students 6 months after the course, with good results both in theoretical and practical skills. Our study demonstrates that the ScuolaSalvaVita project is able to effectively teach CPR through teachers using a video-based training in the Secondary Schools of a whole Province obtaining good long-term memory of CPR skills.


A pediatric patient with acute hepatitis E in Japan.
We encountered a 14-year-old Bangladeshi boy who developed acute hepatitis E in Japan. He showed improvement without the development of fulminant hepatitis. His hepatitis E virus (HEV) genotype was I, which causes epidemics mainly in South Asia. He developed this disease more than 6 months after coming to Japan. Considering the latent period, it was suspected that he had been infected with HEV in Japan, although the HEV virus is presumed not to be indigenous to Japan.


CENTRAL RETINAL VEIN OCCLUSION IN 12-YEAR-OLD GIRL WITH METHYLENETETRAHYDROFOLATE REDUCTASE MUTATION: A CASE REPORT AND REVIEW OF THE LITERATURE.
This case report describes a central retinal vein occlusion in a healthy 12-year-old girl who developed retinal neovascularization at 24 years of age. To the knowledge of the authors, this is the longest time between a reported pediatric central retinal vein occlusion event and neovascularization. The patient underwent a full history, physical examination, and laboratory workup to determine potential risk factors contributing to the vascular event. Fundus photographs, optical coherence tomography, and fluorescein angiography were performed throughout the patient's treatment course. Family history was noncontributory, but laboratory testing revealed a mildly elevated homocysteine level and homozygous C677T mutation in methylenetetrahydrofolate reductase. As a result, she was started on folate supplementation. The patient has had no further ocular or systemic thrombotic events to date. Pediatric patients presenting with central retinal vein occlusion should undergo a systemic workup and require long-term follow-up to avoid complications, such as intraocular hemorrhage, tractional retinal detachments, and neovascular glaucoma.


How reliable is the evidence for screening mammography?
Substantial reduction in breast cancer mortality has been proven in randomized trials of screening mammography. These trials have found a statistically significant benefit both for women ages 40-49 years and for women age 50 years and older at onset of screening. In fact, it is likely that the trials actually underestimate the benefit for an individual woman who is screened. Service screening programs have shown a 63% reduction in deaths from breast cancer among women who are screened. Virtually all major medical organizations now advise screening mammography for women ages 40 and older. Two recent studies that questioned the validity of results from screening mammography trials are themselves fatally flawed.


Infra-auricular Sinus: A Very Rare Case Presentation.
A 22-year-old male patient presented with right infra-auricular sinus since birth with preauricular swelling and discharge on and off since age of 3 years. He had no history of previous surgery. Patient noted frequent swelling and foul smelling discharge inferior to right tragus through a small puncta every 3-6 monthly, resulting in abscess formation and scaring around 1-1.5 cms below and anterior to puncta site. The infra tragal sinus tract and the cyst were completely removed surgically by infra-auricular approach. The histopathology report was suggestive of an infra-auricular preauricular sinus. No recurrence was noted on follow up to 2 years. We report this case for its rarity since less than 5 cases have been reported in literature.


Increase in the thermic effect of food in women by adrenergic amines extracted from citrus aurantium.
To compare the thermic response to a meal between men and women of varied body composition and to determine whether adrenergic amines extracted from citrus aurantium (CA) induce an increase in metabolic rate and enhance the thermic response to the meal. In 30 healthy weight-stable subjects (17 women, 13 men; BMI: 20 to 42 kg/m2), body composition was determined by bioimpedance analysis followed by resting energy expenditure for 20 minutes, and the thermic effect of food (TEF) of a 1.7-MJ, 30-gram protein meal was determined intermittently for 300 minutes by indirect calorimetry. In a subset of 22 subjects, the TEFs of CA alone and when added to the same 1.7-MJ meal were determined. Blood pressure and pulse before and throughout the studies and catecholamine excretion were determined. TEF was significantly lower in women than men (152 +/- 7 vs. 190 +/- 12 kJ and 8.8 +/- 0.4% vs. 11.0 +/- 0.7% of meal), independently of age and magnitude of adiposity. The thermic response to CA alone was higher in men, but, when added to the meal, CA increased TEF only in women and to values no longer different from men. CA had no effect on blood pressure and pulse rate but increased epinephrine excretion by 2.4-fold. A 20% lower TEF in women suggests a diminished sympathetic nervous system response to meals, because with CA, TEF increased by 29% only in women. However, this acute response may not translate into a chronic effect or a clinically significant weight loss over time.