The kinetic stability of MHC class II:peptide complexes is a key parameter that dictates immunodominance.
T cell priming to exogenous antigens reflects regulated antigen processing in dendritic cells, subsequent homing to lymph nodes, sustained interactions between T cells and antigen-bearing dendritic cells, and, ultimately, selective T cell activation and differentiation. In this study, we test the hypothesis that an intrinsic property of the class II:peptide complex is a key determinant that dictates the specificity of an emerging CD4 T cell response. We found that immunodominant peptides possess extremely long half-lives with class II molecules (t(1/2) > 150 hr), whereas cryptic peptides displayed half-lives of less than 10 hr. Furthermore, and most importantly, by using a peptide shuttle vector and four independent antigens, we demonstrate a direct, causative relationship between the half-life of peptide epitopes and their immunogenicity in vivo. Taken collectively, our results suggest the half-life of class II:peptide complexes is the primary parameter that dictates the ultimate hierarchy of the elicited T cell response.


Production of prostaglandins by dispersed cells and fragments from bovine parathyroid glands.
We studied the production of prostaglandins by fragments and dispersed cells from bovine parathyroid glands. Fragments released 138 +/- 19 (SE), 132 +/- 21, 4.3 +/- 0.5, and 13 +/- 6.6 pg/mg/h of 6-keto-PGF1 alpha, PGF2 alpha, PGE2, and thromboxane B2, respectively (n = 7 - 26), while dispersed cells released 414 +/- 110, 22 +/- 7.3, 27 +/- 3.8, and 29 +/- 11 pg/10(6) cells/h, respectively, of the same compounds (n = 6 - 25). Indomethacin (1 microgram/ml) inhibited the release of 6-keto-PGF1 alpha by 80-90% in fragments and cells, while mellitin stimulated release of this prostaglandin, suggesting de novo synthesis of prostaglandins in these preparations. Calcium stimulated production of 6-keto-PGF1 alpha by 1.3-fold in cells and 2.6-fold in fragments and also enhanced production of PGF2 alpha by 1.9-fold in fragments. Isoproterenol, on the other hand, had no effect on production of 6-keto-PGF1 alpha in either preparation. These results demonstrate that parathyroid tissue as well as parathyroid cells per se produce a variety of prostaglandins. We have previously shown that PGE2 and PGF2 alpha modulate cAMP accumulation and PTH release in dispersed bovine parathyroid cells. The role of the endogenous production of prostaglandins by the parathyroid gland in the acute or chronic regulation of parathyroid function, however, remains to be determined.


Three STAT isoforms formed by selective splicing are involved in the regulation of anti-lipopolysaccharide factor expression in Macrobrachium nipponense during WSSV infection.
White spot syndrome virus (WSSV), a double-stranded DNA virus, is harmful in aquaculture. The signal transducer and activator of transcription (STAT) has been shown to play a role during host infection with the virus, but the exact mechanism by which it acts is unclear. In this study, three STAT isoforms (MnSTAT1, MnSTAT2, and MnSTAT3) were identified in Macrobrachium nipponense. The full-length sequence of MnSTAT1 was 3336 bp, with 2259 bp open reading frame (ORF), encoding a 852 amino acids protein. The full-length sequence of MnSTAT2 was 2538 bp, and the ORF was 2391 bp, encoding 796 amino acids. The full-length sequence of MnSTAT3 sequence was 2618 bp, and the ORF was 2340 bp, encoding 779 amino acids. MnSTAT1-3 is produced by alternative last exon. MnSTAT1-3 all contain a STAT_int, a STAT_alpha, a STAT_bind, and a SH2 structure. MnSTAT1-3 are widely expressed in various tissues tested. The expression levels of MnSTAT1-3 in the intestine of M. nipponense were upregulated at multiple time points following WSSV stimulation. The expression of seven anti-lipopolysaccharide factors (ALFs) was significantly reduced with the knockdown of MnSTATs during WSSV infection. Results showed that MnSTATs regulated the expression of intestinal ALFs and was involved in the innate immunity against WSSV of M. nipponense.


Optimising total RNA quality and quantity by phenol-chloroform extraction method from human visceral adipose tissue: A standardisation study.
A multitude of challenges is faced during RNA extraction from human visceral adipose tissue (VAT) due to its atypical nature and a dearth of existing literature. Our study provides a convenient and inexpensive manual method using TRIzol reagent for the reproducible recovery of intact RNA from sparse human VAT samples. Fifty-two (52) samples were grouped and tested for the effect of different factors viz. initial VAT amount, TRIzol volume per unit tissue mass, residual fat following homogenisation and first centrifugation, an additional chloroform wash, and an additional ethanol wash on the extraction process. We found that increasing initial tissue mass and decreasing TRIzol volume simultaneously improved RNA yield and purity. A fat layer removal step and additional ethanol wash further propel the A260/280 and A260/230 to their desired values. Our modifications in the isolation protocol were combined and tested through reverse transcriptase quantitative PCR, which yielded consistent results, upholding our optimisation.


Novel nanoadjuvants balance immune activation with modest inflammation: implications for older adult vaccines.
Age-associated impairments of immune response and inflammaging likely contribute to poor vaccine efficacy. An appropriate balance between activation of immune memory and inflammatory response may be more effective in vaccines for older adults; attempts to overcome reduced efficacy have included the addition of adjuvants or increased antigenic dose. Next generation vaccine formulations may also use biomaterials to both deliver and adjuvant vaccine antigens. In the context of aging, it is important to determine the degree to which new biomaterials may enhance antigen-presenting cell (APC) functions without inducing potent inflammatory responses of APCs or other immune cell types (e.g., T cells). However, the effect of newer biomaterials on these cell types from young and older adults remains unknown. In this pilot study, cells from young and older adults were used to evaluate the effect of novel biomaterials such as polyanhydride nanoparticles (NP) and pentablock copolymer micelles (Mi) and cyclic dinucleotides (CDN; a STING agonist) on cytokine and chemokine secretion in comparison to standard immune activators such as lipopolysaccharide (LPS) and PMA/ionomycin. The NP treatment showed adjuvant-like activity with induction of inflammatory cytokines, growth factors, and select chemokines in peripheral blood mononuclear cells (PBMCs) of both young (n = 6) and older adults (n = 4), yet the degree of activation was generally less than LPS. Treatment with Mi or CDN resulted in minimal induction of cytokines and chemokine secretion with the exception of increased IFN-α and IL-12p70 by CDN. Age-related decreases were observed across multiple cytokines and chemokines, yet IFN-α, IL-12, and IL-7 production by NP or CDN stimulation was equal to or greater than in cells from younger adults. Consistent with these results in aged humans, a combination nanovaccine composed of NP, Mi, and CDN administered to aged mice resulted in a greater percentage of antigen-specific CD4+ T cells and greater effector memory cells in draining lymph nodes compared to an imiquimod-adjuvanted vaccine. Overall, our novel biomaterials demonstrated a modest induction of cytokine secretion with a minimal inflammatory profile. These findings suggest a unique role for biomaterial nanoadjuvants in the development of next generation vaccines for older adults.


Association between cervical disorders and adverse obstetric outcomes: A retrospective cohort study.
The purpose of this study was to explore the association of cervical disorders on obstetric outcomes of singleton pregnancies in China. This hospital-based retrospective cohort study of women with live singleton births included 71,097 Chinese women. We compared the risk of adverse obstetric outcomes in different types of pregnancies with cervical disorders with those with normal cervix. Logistic regression model was used to estimate the association between cervical disorders and adverse obstetric outcomes. Women with cervical disorders had a higher risk of premature delivery (10.98 vs. 4.41%), preterm premature rupture of membranes (PPROM) (3.48 vs. 1.62%), low birth weight (LBW) (7.62 vs. 2.92%) and very low birth weight (VLBW) (2.01 vs. 0.28%) than women with normal cervix. After adjusting for confounding factors, compared with women with normal cervix, women with high-grade abnormal cervical cytology are at greater risk of premature birth (adjusted OR 1.971, 95% CI: 1.302-2.983), premature rupture of membranes (PROM) (adjusted OR 1.379, 95% CI: 1.047-1.815), LBW (adjusted OR 1.790, 95% CI: 1.059-3.025), and VLBW (adjusted OR 4.519, 95% CI: 1.662-12.292) than women with low-grade abnormal cervical cytology, and women with abnormal cervical cytology after treatment had a higher risk of premature birth (adjusted OR 2.060, 95% CI: 1.348-3.147), PROM (adjusted OR 1.381, 95% CI: 1.038-1.839), PPROM (adjusted OR 1.995, 95% CI: 1.022-3.892), LBW (adjusted OR 1.801, 95% CI: 1.046-3.102), and VLBW (adjusted OR 4.868, 95% CI: 1.788-13.255) than untreated women. Our research showed that pregnant women with cervical disorders were more likely to have premature delivery, PPROM, LBW, and VLBW. Moreover, pregnant women with high-grade abnormal cervical cytology and abnormal cervical cytology after treatment had a higher risk of premature birth, PROM, LBW, and VLBW.


Detection of hepatitis C viral RNA by the polymerase chain reaction in serum of patients with post-transfusion non-A, non-B hepatitis.
Serial serum samples from cardiac patients with a history of chronic or resolved post-transfusion non-A, non-B hepatitis were analyzed by a combination of cDNA synthesis and the polymerase chain reaction (cDNA/PCR) to amplify HCV RNA. Analysis of sera drawn after the acute hepatitis episode from 8 of the patients who had an acute, resolving HCV infection showed no detectable levels of HCV RNA when primers from the NS3 region were used. Evaluation of these sera with primers from the 5'-untranslated (5'-UT) region revealed that one patient was positive for HCV RNA. Further analysis of serial serum samples available from two of these patients indicated that a resolved infection was associated with a disappearance of detectable HCV RNA after a peak level during the acute phase of the disease. In contrast, post-acute samples from 4 of 6 patients with symptomatic acute HCV infection evolving to chronicity were positive for HCV RNA using primers from the NS3 region, however, upon retesting with primers from the 5'-UT region, all 6 patients were found to be positive. Analysis of serial serum samples from 2 of these patients showed the persistence of HCV RNA in 70% of the samples. These two patients were subsequently treated with interferon alpha-2b. One patient resolved his disease and normalized his aminotransferase level during treatment and thereafter, while the other relapsed upon cessation of treatment. In these two patients, normalization of ALT levels was consistent with the absence of HCV RNA while relapse of disease was confirmed by the reappearance of detectable levels of HCV RNA. These results indicate the utility of HCV RNA as a marker for persisting HCV viremia and in differentiating patients with ongoing active HCV infection from those with an acute resolving disease.


The European Marine Strategy: Noise Monitoring in European Marine Waters from 2014.
The European Marine Strategy Framework Directive requires European member states to develop strategies for their marine waters leading to programs of measures that achieve or maintain good environmental status (GES) in all European seas by 2020. An essential step toward reaching GES is the establishment of monitoring programs, enabling the state of marine waters to be assessed on a regular basis. A register for impulsive noise-generating activities would enable assessment of their cumulative impacts on wide temporal and spatial scales; monitoring of ambient noise would provide essential insight into current levels and any trend in European waters.


Effect of aluminum phosphate on the bioavailability of ranitidine.
The effect of aluminum phosphate on the bioavailability of ranitidine has been investigated in 10 young, healthy volunteers. Following a random cross over design, each subject took at a 1 week interval 150 mg ranitidine alone or with 11 g aluminum phosphate. Plasma and urine ranitidine levels were measured by HPLC. The antacid reduced both the maximum plasma ranitidine concentration by 40% and the area under the curve by 30%. Elimination of ranitidine was not changed. The results indicate that aluminum phosphate significantly diminished the bioavailability of ranitidine.


Correction to: Jejuno-Jejunal Intussusception after Roux-en-Y Gastric Bypass.
In the original article the authors' first and last names were transposed.


[Shaft lengthening in hip replacement: experimental studies on bending stiffness].
Cortical atrophy of the proximal femur can be seen after wearing a total hip prosthesis for several years because loads are borne distally at the prosthesis tip. To achieve stable prosthesis implantation on the one hand and proximal bone regeneration on the other hand in hip revision arthroplasty, lengthening of the shaft component distributes loading forces to the femoral shaft first. It concentrates them to the proximal femur later through a higher elasticity. In a three-point bending study the bending stiffness of an elastic slotted hip prosthesis shaft lengthening (HSL) was compared with that of the Synthes universal femoral nail (MN) and the unslotted HSL. The slotting of the elastic HSL has a significant influence on its bending stiffness; it lies 1,287 N/mm (76%) over that of the MN, but 1,855 N/mm (38%) under that of the unslotted HSL. Altogether the slotted HSL is rather more comparable to the MN than to the unslotted HSL regarding its bending conduct. The results confirm the elasticity of the slotted HSL in the style of conventional intramedullary nailing and encourage-above all in the context of previous clinical studies-its further use.


Breast MRI in patients with implantable loop recorder: initial experience.
To investigate the feasibility of breast MRI exams and guided biopsies in patients with an implantable loop recorder (ILR) as well as the impact ILRs may have on image interpretation. This retrospective study examined breast MRIs of patients with ILR, from April 2008 to September 2022. Radiological reports and electronic medical records were reviewed for demographic characteristics, safety concerns, and imaging findings. MR images were analyzed and compared statistically for artifact quantification on the various pulse sequences. Overall, 40/82,778 (0.049%) MRIs during the study period included ILR. All MRIs were completed without early termination. No patient-related or device-related adverse events occurred. ILRs were most commonly located in the left lower-inner quadrant (64.6%). The main artifact was a signal intensity (SI) void in a dipole formation in the ILR bed with or without areas of peripheral high SI. Artifacts appeared greatest in the cranio-caudal axis (p < 0.001), followed by the anterior-posterior axis (p < 0.001), and then the right-left axis. High peripheral rim-like SI artifacts appeared on the post-contrast and subtracted T1-weighted images, mimicking suspicious enhancement. Artifacts were most prominent on diffusion-weighted (p < 0.001), followed by T2-weighted and T1-weighted images. In eight patients, suspicious findings were found on MRI, resulting in four additional malignant lesions. Of six patients with left breast cancer, the tumor was completely visible in five cases and partially obscured in one. Breast MRI is feasible and safe among patients with ILR and may provide a significant diagnostic value, albeit with localized, characteristic artifacts. Indicated breast MRI exams and guided biopsies can be safely performed in patients with implantable loop recorder. Nevertheless, radiologists should be aware of associated limitations including limited assessment of the inner left breast and pseudo-enhancement artifacts. • Breast MRI in patients with an implantable loop recorder is an infrequent, feasible, and safe procedure. • Despite limited breast visualization of the implantable loop recorder bed and characteristic artifacts, MRI depicted additional lesions in 8/40 (20%) of cases, half of which were malignant. • Breast MRI in patients with an implantable loop recorder should be performed when indicated, taking into consideration typical associated artifacts.


A least squares algorithm to determine the mechanical time constant distribution of the lung during forced expiration.
A method to determine the mechanical time-constant distribution of the lung during a forced expiration manoeuvre is proposed. The method is based on a least squares algorithm constrained to give reasonably smooth non-negative solutions. The smoothing constraint was imposed by minimizing the second derivative of the distribution function in accordance with the physiological meaning of the time-constant distribution. Nevertheless, the obtained solution depends greatly on the relative weights of the two terms in the objective function to be minimized i.e., the error on the fit of the volume signal and the smoothness of the distribution function. To select the optimum smoothing weight, a criterion based on the stability of the reconstructed distribution shape was defined. The performance of the algorithm and that of the defined criterion were evaluated by using simulated signals of forced expired volume. The error of reconstructed distributions was quantified by means of the area enclosed between this distribution and the original one used to generate the simulated volume signal. The results obtained showed that for all the analyzed signals: (1) There is a value of the weight of the smoothing constraint which gives rise to a solution that is optimum in a least squares sense. (2) The proposed stabilization criterion enables us to approach this optimum solution from experimental signals.


Performing red reflex eye examinations increases the rate of neonatal conjunctivitis.
Red reflex eye examinations often require opening the eyelids, risking infection. We evaluated links between this procedure and neonatal conjunctivitis. We divided 18 872 neonates of more than 35 weeks of gestation into two birth periods, 2008-2009 and 2010-2011, before and after red reflex examinations were carried out by our facility. The rates of clinical conjunctivitis, bacterial conjunctivitis and bacterial growth percentage were compared between the two periods. The 2010-2011 period included more Caesarean deliveries and longer lengths of stay (LOS) than the 2008-2009 period. The clinical conjunctivitis rate increased significantly during 2010-2011 (p = 0.029), but the bacterial conjunctivitis and bacterial growth percentages did not differ between the two periods. Variables that were independently and significantly associated with clinical conjunctivitis included being born in 2010-2011, with an odds ratio (OR) of 1.22, male gender (OR 1.31) and LOS (OR 1.19). Bacterial conjunctivitis was associated with vaginal delivery (OR 3.65), males delivered by Caesarean (OR 2.68) and LOS (OR 1.37). Clinical conjunctivitis was significantly associated with the later study period, male gender and LOS. Conjunctival swab sampling increased significantly following the implementation of red reflex examinations, but without changes in the bacterial conjunctivitis rate and the bacterial growth percentage.


A guide to managing acute liver failure.
Nearly 2,000 cases of acute liver failure occur each year in the United States. This disease carries a high mortality rate, and early recognition and transfer to a tertiary medical care center with transplant facilities is critical. This article reviews the definition, epidemiology, etiology, and management of acute liver failure.


Importance of Pre-Procedure Counselling in Patients Undergoing Flexible Bronchoscopy.
Flexible fiberoptic bronchoscopy is performed very frequently in pulmonology and cardiothoracic services where the patients are most critically ill. This study aims to assess the degree of satisfaction, duration, and level of cooperativeness among patients undergoing flexible bronchoscopy. A quasi-experimental study with 128 flexible bronchoscopy patients was carried out with two groups of patients (control and study group). All the steps of the procedure were discussed with the patient. The anxiety level score, patient satisfaction, cooperation, and duration of the procedure were assessed in both groups. A total of 128 patients were included. They were divided into two groups (study group and control group). In both groups, the majority were illiterate: study group 40 (62.5%), and control group 41 (64.1%). The hospital anxiety scale was statistically better in the study group than in the control group (p-value of 0.0001). The patients' satisfaction rate in the study groups was significantly higher (p-value 0.001, chi-square test 120.508). The duration of the procedure was significantly shorter in the study group (Mean ± SD 4.45, 1.381 min). Patients with better knowledge of bronchoscopy were more comfortable with the procedure and the duration of the procedure was significantly shorter. The online version contains supplementary material available at 10.1007/s12070-023-03767-5.


Achalasia and esophago-gastric junction outflow obstruction: focus on the subtypes.
The choice between pneumatic dilation and surgical myotomy is mainly determined by the preference and expertise of the treating physician. Ideally, however, treatment should be personalized to provide the optimal clinical outcome. The introduction of high resolution manometry has not only improved the specificity to diagnose achalasia, but also identified three different manometric subclasses. To review, the data suggesting differences in clinical response to treatment depending on the manometric profile.


The role of faecal calprotectin in diagnosis and staging of colorectal neoplasia: a systematic review and meta-analysis.
The presence of inflammation is a key hallmark of cancer and, plays an important role in disease progression and survival in colorectal cancer (CRC). Calprotectin detected in the faeces is a sensitive measure of colonic inflammation. The role of FC as a diagnostic test that may categorise patients by risk of neoplasia is poorly defined. This systematic review and meta-analysis aims to characterise the relationship between elevations of FC and colorectal neoplasia. A systematic review was performed using the keywords (MESH terms) and a statistical and meta-analysis was performed. A total of 35 studies are included in this review. CRC patients are more likely than controls to have an elevated FC OR 5.19, 95% CI 3.12-8.62, p < 0.001 with a heterogeneity (I2 = 27%). No tumour characteristics significantly correlated with FC, only stage of CRC shows signs that it may potentially correlate with FC. FC levels are significantly higher in CRC, with high sensitivity. Its low specificity prevents it from being used to diagnose or screen for CRC.


Blockade of muscarinic acetylcholine receptor by scopolamine impairs the memory formation of filial imprinting in domestic chicks (Gallus Gallus domesticus).
Filial imprinting in precocial birds is a useful model for studying memory formation in early learning. The intermediate medial mesopallium (IMM) in the dorsal telencephalon is one of the critical brain regions where the releases of several neurotransmitters increase after the start of imprinting training. Among the increased neurotransmitters, the role of acetylcholine in imprinting has remained unclear. Acetylcholine in the mammalian brain plays an important role in encoding new memories. The muscarinic acetylcholine receptor subtype 1 (M1 receptor) and subtype 3 (M3 receptor) in the hippocampus and cortex of mammalian brain have been shown to be necessary for memory encoding. In this study, we examined whether the imprinting acquisition in chick can be impaired by injecting muscarinic acetylcholine receptor (mAChR) antagonist scopolamine into the bilateral IMM. We show that the injection of scopolamine decreased the preference for the imprinting object in the test, but did not affect the number of approaches to the imprinting object during training. Immunoblotting and immunohistochemistry revealed that M3 receptors were expressed in the IMM. Our data suggest that acetylcholine is involved in the memory formation of imprinting through M3 receptors in the IMM. The scopolamine-injected chicks may be useful as an animal model for dementia such as Alzheimer's disease.


Correlation of TP53 (rs1625895), TP73 (rs3765730), MMP9 (rs17576), and MTHFR (rs868014) polymorphisms with low ovarian reserve.
To investigate the influence of the Single Nucleotide Polymorphisms (SNPs) TP53 rs1625895, TP73 rs3765730, MMP9 rs17576, and MTHFR rs868014 on ovarian reserve (OR) in infertile patients. A prospective cross-sectional study was carried out in 145 infertile women. The patients were divided into two groups according to ovarian reserve, characterized by association between AMH levels and AFC:After patient distribution, both groups were compared (LOR X NOR) regarding the genotypes of the SNPs TP53 T/C rs1625895, TP73 G/A rs3765730, MMP9 Gln/Arg rs17576, and MTHFR A/G rs868014. The frequency of the TP53-T/T genotype was greater in the LOR and the TP53-C/C genotype was more frequent in patients with NOR. This association was confirmed by the frequency of alleles, where the presence of the T allele was significantly higher in patients who exhibited LOR (P = 0.0003). The frequency of the TP73-G/G genotype and of the G allele was higher in the LOR group (P = 0.01). Considering the MMP9 gene, the frequency of the Gln/Gln genotype was higher in the LOR group. However, the Gln/Arg genotype and the Arg allele prevailed in the NOR group (P = 0.006). The frequency of the MTHFR-A/A genotype was higher in the LOR group, whereas that of the MTHFR-GG genotype was higher in the NOR group. The presence of allele A was significantly higher in the LOR group (P = 0.002). The regression analysis shows that patients who present the TP53-T/T, TP73-G/G, MMP9-Gln/Gln, and MTHFR-A/A genotypes are 3.6X, 3.1X, 3.2X, and 3.7X more likely of having LOR, respectively. In addition, the association of the TP53/TT + TP73/GG genotypes increased the chance of women being included in the LOR group in 5.7-fold. The genotypes TP53-T/T, TP73-G/G, MMP9-Gln/Gln, and MTHFR-A/A increase the chance of women to exhibit LOR. These polymorphisms could be useful as genetic markers of low ovarian reserve in infertile patients.


Acute vascular effects of the angiotensin II receptor antagonist olmesartan in normal subjects: relation to the renin-aldosterone system.
The extent to which the clinical effects of angiotensin receptor blockers (ARB) are related to ambient renin system activity remains poorly defined. Therefore, we measured blood pressure (BP), large (C1) and small (C2) arterial compliance, systemic vascular resistance (SVR), plasma renin activity (PRA), and the 24-h urinary excretion of sodium (UNaV) and aldosterone before and 1, 2, 4, and 24 h after administration of single doses of placebo, and 5, 20, and 40 mg of the ARB olmesartan medoximil to 12 unmedicated normotensive subjects. In the basal state, SVR was inversely related to UNaV (r = -0.3, P =.04); the greater the UNaV, the more vasodilated the subject. Indices of arterial compliance, both C1 (r = -0.32, P =.03) and C2 (r = -0.35, P =.02) were inversely related to the basal PRA. Renin also predicted olmesartan-induced changes in C1 (r = 0.43, P =.004) and C2 (r = 0.33, P =.04). The greater the basal PRA, the less the arterial compliance, and the more compliance improved after olmesartan. Both systolic (P =.003) and diastolic (P <.0001) BP fell significantly on olmesartan compared with placebo (MANOVA with time), and relations were observed between the basal PRA and olmesartan-induced changes in pressure (systolic BP: r = -0.414, P =.012; diastolic BP: r = -0.561 P <.0001)-the greater the initial PRA, the more olmesartan lowered BP. Furthermore, the more pressure fell, the more PRA rose reciprocally (r = -0.44, P =.007). Finally, aldosterone excretion fell (sig = 0.05) on each dose of olmesartan compared with placebo. We conclude that 1) the inverse relation of UNaV and SVR illustrates the reciprocal role of volume versus constrictor factors in maintaining normal BP; and 2) PRA is a physiologic determinant of arterial compliance in normal individuals and of the response to the ARB olmesartan. Measurement of PRA may help to predict clinical ARB responses in individual subjects.


Impact of mild anaemia on dyspnoea during exertion and exercise tolerance in patients with acute exacerbation of chronic obstructive pulmonary disease.
Dyspnoea and decreased exercise tolerance are symptoms of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Anaemia is a risk factor for reduced functional capacity and dyspnoea in stable COPD. There is limited information about the impact of anaemia on functional capacity and dyspnoea of patients during AECOPD. The aim of this study was to evaluate the impact of decreased blood haemoglobin concentration on the results of six-minute walking test (6MWT) in patients during AECOPD. A post hoc analysis of data collected from prospective long-term studies on AECOPD. Haemoglobin concentration from the first obtainable hospital measurement were included in the assessment. 6MWT was performed after clinical improvement of the patient. Dyspnoea at baseline and after exercise and oxygen saturation (SpO(2)) during exercise was measured. (presented as means ± SD): 402 patients with exacerbation of COPD (COPD stage 3.5 ± 0.6) were examined. Patients with anaemia (26% of those studied, age 74.5 ± 8.2 years) achieved 258.1 ± 125.1 m during 6MWT, with exertional desaturation of 2.9 ± 2.6%. Patients without anaemia (74% of those studied, age 70.2 ± 8.7 years) achieved 271 ± 136.0 m during 6MWT with exertional desaturation of 3.8 ± 3.7%. The haemoglobin concentration did not correlate with 6MWT, dyspnoea during 6MWT, or exercise oxygenation and blood desaturation during exercise. Mildly decreased blood haemoglobin concentration did not influence the results of 6MWT in patients with AECOPD.


A comparison of methods for measuring intestinal antibodies against Vibrio cholerae in mice.
A re-evaluation was made of the efficiency with which some of the commonly used assays would detect intestinal antibodies. The data indicate that the most sensitive assays for the detection of intestinal antibodies are the baby mouse protection test and the radioimmunoassay. The reasons for the lack of sensitivity with other assay methods are discussed.


Cathepsins B, H, and L activities in urine of patients with transitional cell carcinoma of the bladder.
Cathepsin B, H, and L (CB, CH, CL) are lysosomal proteolytic enzymes that belong to the group of cysteine proteinases. The imbalance between proteinases and their inhibitors is believed to correlate with tumor progression and shortened patient survival. In transitional cell carcinoma (TCC) only limited data have been published. Using spectrofluorometric assays, catalytic activities of CB, CH, and CL in urine were measured to evaluate the potential diagnostic and prognostic value for patients with TCC of the bladder. Second morning urine was collected and used for measurements. CB, CH, and CL activities were determined for groups of patients with superficial disease (Ta-1, n = 43) and muscle-invasive tumors (T2, n = 18; or greater than T2, n = 9), as well as for different tumor grades (G1, n = 12; G2, n = 26; and G3, n = 31). For comparison, 14 urine samples from patients with bladder inflammation and 43 samples from a control group were also included. Compared with the control group, patients with superficial Stage Ta-T1 disease and muscle-invasive Stage T2 or greater disease, as well as patients with G3 tumors, revealed significantly higher urinary CL activity. CB and CH did not show any tumor-related activity increase. CB was significantly lower in patients with nonrecurrent tumors. These results suggest that elevated levels of CL in urine might be indicative of a cellular proteolytic imbalance in TCC of the bladder and may have a prognostic and/or diagnostic value.


PTEN mutations in endometrial cancers with 10q LOH: additional evidence for the involvement of multiple tumor suppressors.
The aim of this study was to assess the involvement of PTEN and other putative 10q tumor suppressors in endometrioid-type adenocarcinomas characterized by loss of 10q sequences. PCR-based single-stranded conformational variant analysis and sequencing of individual PTEN exons in 34 tumor specimens and their corresponding normal DNA were used. Thirteen of the 34 tumors (38%) revealed a PTEN mutation: 2 frameshift, 3 nonsense, 3 missense, 3 splice site alterations, and 2 homozygous deletions. The observation that greater than 60% of endometrial cancers with 10q LOH lack PTEN mutations, in addition to previously reported LOH data, provides evidence for the existence of other tumor suppressors on 10q. Consideration of PTEN mutation status may prove important in deletion mapping studies to locate additional tumor suppressors on the long arm of chromosome 10.


GABA content and synthesis in the aging rat brain.
The content and synthesis of GABA were measured in the cortex and striatum of young adult (4 months), mature (14 months), and old (24 months) male Wistar rats. GABA synthesis was determined from the GABA accumulation induced by aminooxyacetic acid (AOAA). Aging did not affect GABA content in the cortex (1.03 +/- 0.04 mumoles/g in young and 1.06 +/- 0.04 mumoles/g in old rats), or in the striatum (1.63 +/- 0.04 mumoles/g in young and 1.56 +/- 0.05 mumoles/g in old rats). Aging did not significantly change the AOAA-induced GABA accumulation in the striatum (+34% in young, +16% in mature, and +28% in old rats), but significantly reduced it in the cortex where this process takes place to a greater extent than in the striatum: +164% in young, +116% in mature, and +120% in old animals. It can be concluded that while in the striatum aging did not affect AOAA-induced GABA accumulation, in the cortex this was less in mature than young rats, with no further change in the old ones. GABA content was not affected by aging in either region.


Detecting microplastics in organic-rich materials and their potential risks to earthworms in agroecosystems.
Microplastics (MPs) are a major emerging contaminant in agroecosystems, due to their significant resistance to degradation in terrestrial environments. Although previous investigations have reported the harmful effects of MPs contamination on soil biological properties, still little is known about the characteristics and fate of MPs in biosolid-amended soils and their risks to soil biota, particularly earthworms. We determined microplastics' concentration, size distribution, and chemical composition in 3 sewage sludge biosolids and 6 biosolid-amended agricultural soils. In addition, we assessed the potential short-term risks of MPs to earthworms' (Amynthas Gracilis and Eisenia Fetida) survival rate and fitness in an environmentally relevant exposure study (28 days). Biosolid-amended soils (1000-3100 MPs kg-1 dry mass) showed ≈30 times lower MPs content than investigated biosolids (55400-73800 MPs kg-1 dry mass), with microplastic fragment to fibre ratios between 0.2 and 0.6 and 0.3-0.4 in soils and biosolids, respectively. Total MPs dry mass was also ≈19 times lower in assessed soils (12-26 mg kg-1) than biosolids (328-440 mg kg-1). On average 77% and 80% of plastic fragments had a lower dimension than 500 µm, while 50% and 67% of plastic fibres had a length of less than 1000 µm in soil and biosolid samples, respectively. Polyethylene (23.6%) was the major source of microplastic contamination in biosolid-amended soils, while polyethylene terephthalate (41.6%) showed the highest concentration in biosolid samples. Spiked polyethylene MPs did not show any significant effect on earthworms' survival rate (93-99%). However, biosolid application significantly (P < 0.05) decreased survival rate of Eisenia Fetida (81%) but showed no significant effect on Amynthas Gracilis (93%). Biosolid amendment significantly (P < 0.05) decreased earthworms' growth rate, with higher impact on Eisenia Fetida than Amynthas Gracilis, while there were no significant differences between control and microplastic spiked treatments. The overall decrease in MPs concentration of earthworm casts, compared with initial MPs concentrations in soil, indicated that the investigated species did not bioaccumulate MPs during the exposure experiment.


Teaching paediatric residents about learning disorders: use of standardised case discussion versus multimedia computer tutorial.
We developed a standardised case-based educational exercise on the topic of childhood learning disorders, and a multimedia computerised adaptation of this exercise, as part of a national curriculum project based on the Bright Futures guidelines. To explore resident perceptions of the facilitated case discussion (FCD) and the computerised tutorial (CT). Quasi-randomised comparison of two educational interventions. Preclinic teaching conferences at a large urban children's hospital. A total of 46 paediatric residents years 1-3 assigned to either FCD (n = 21) or CT (n = 25). FCD residents met in groups of 8-12 with a trained facilitator for a structured case discussion, while CT residents worked in groups of 2-3 at a computer station linked to an interactive website. Participant responses during semistructured focus group interviews. Focus group transcripts, field notes and computer logs were analysed simultaneously using qualitative grounded theory methodology. Residents experienced CT as fun, offering flexibility, greater auditory and visual appeal and more opportunities for active learning. FCD allowed greater contact with expert faculty and made the material more relevant to clinical practice. FCD participants emphasised the clinical skills gleaned and stated that the learning experience would change their future patient management. Both groups reported that case discussion was more interactive than computer learning. Median time spent on learning was slightly shorter for the CT group. All groups of learners arrived at the correct final diagnosis. FCD and CT stimulate different types of learning among paediatric residents. Future studies are needed to determine how to integrate these two techniques to meet the learning needs of residents in diverse settings.


Effects of an amino acid solution enriched with either branched chain amino acids or ornithine-alpha-ketoglutarate on the postoperative intracellular amino acid concentration of skeletal muscle.
Patients undergoing elective cholecystectomy provide a highly reproducible model of the effects of trauma on intermediary metabolism. Three parenteral nutrition regimens were given to groups of eight such patients. An isonitrogenous total parenteral nutrition, including a commercially available amino acid solution, an amino acid solution enriched with branched chain amino acids or one supplemented with ornithine-alpha-ketoglutarate, was given after operation. The intra cellular free amino acid concentrations of skeletal muscle were determined in tissue specimens obtained before operation and on the third postoperative day using a percutaneous needle biopsy technique. The mean (s.e.m.) decrease in the concentrations of free intracellular glutamine on the third postoperative day was less pronounced (P less than 0.05) in the ornithine-alpha-ketoglutarate group (18.8(7.5)per cent) than in the control group (39.4(5.1)per cent) or the branched chain amino acid group (45.3(6.1)per cent). In conclusion, in the immediate postoperative period total parenteral nutrition supplemented with ornithine-alpha-ketoglutarate countered the decline in the muscle free glutamine. No difference in this parameter was seen between the control group and the branched chain amino acid group.


Exploration of KIR genes and hematological-related diseases in Chinese Han population.
The function of natural killer (NK) cells has previously been implicated in hematopoietic-related diseases. Killer immunoglobulin-like receptors (KIR) play an important role in NK cells after hematopoietic stem cell transplantation. To explore the immunogenetic predisposition of hematological-related diseases, herein, a multi-center retrospective study in China was conducted, analyzing and comparing 2519 patients with hematopathy (mainly, acute lymphoblastic leukemia, acute myeloid leukemia, aplastic anemia, and myelodysplastic syndrome) to 18,108 individuals without known pathology. Genotyping was performed by polymerase chain reaction with specific sequence primers (PCR-SSP). As a result, we discovered four genes including KIR2DL5 (OR: 0.74, 95% CI 0.59-0.93; Pc = 0.0405), 2DS1 (OR: 0.74, 95% CI 0.59-0.93; Pc = 0.0405), 2DS3 (OR: 0.58, 95% CI 0.41-0.81; Pc = 0.0180), and 3DS1 (OR: 0.74, 95% CI 0.58-0.94; Pc = 0.0405) to be protective factors that significantly reduce the risk of aplastic anemia. Our findings offer new approaches to immunotherapy for hematological-related diseases. As these therapies mature, they are promising to be used alone or in combination with current treatments to help to make blood disorders a manageable disease.


Mythological and Prehistorical Origins of Neurosurgery.
Mythology has a cultural appeal, and the description of some neurosurgical procedures in the Hindu, Greek, Egyptian, and Chinese mythology has a bearing to the origins of our professions. The traces to some of our modern-day practices also can be linked back to the ancient prehistoric eras of the Siberian, Persian, and the Andean region. In this historical perspective, we briefly dwell into individual accounts through the prism of different cultures to highlight the development of neurosurgery in mythology and prehistoric era.


GJB2 gene therapy and conditional deletion reveal developmental stage-dependent effects on inner ear structure and function.
Pathogenic variants in GJB2, the gene encoding connexin 26, are the most common cause of autosomal-recessive hereditary deafness. Despite this high prevalence, pathogenic mechanisms leading to GJB2-related deafness are not well understood, and cures are absent. Humans with GJB2-related deafness retain at least some auditory hair cells and neurons, and their deafness is usually stable. In contrast, mice with conditional loss of Gjb2 in supporting cells exhibit extensive loss of hair cells and neurons and rapidly progress to profound deafness, precluding the application of therapies that require intact cochlear cells. In an attempt to design a less severe Gjb2 animal model, we generated mice with inducible Sox10iCre ERT2 -mediated loss of Gjb2. Tamoxifen injection led to reduced connexin 26 expression and impaired function, but cochlear hair cells and neurons survived for 2 months, allowing phenotypic rescue attempts within this time. AAV-mediated gene transfer of GJB2 in mature mutant ears did not demonstrate threshold improvement and in some animals exacerbated hearing loss and resulted in hair cell loss. We conclude that Sox10iCre ERT2 ;Gjb2 flox/flox mice are valuable for studying the biology of connexin 26 in the cochlea. In particular, these mice may be useful for evaluating gene therapy vectors and development of therapies for GJB2-related deafness.


Copeptin in heart failure: Review and meta-analysis.
The aim of this study was to explore the prognostic value of copeptin for predicting all-cause mortality in heart failure (HF). PubMed, Embase and Cochrane databases were systematically searched to identify if a 2×2 contingency table could be constructed based on both the copeptin level and the all-cause mortality in patients diagnosed with HF. The characteristics of test performance were summarized using forest plots and summary receiver operating characteristic curves (SROC). Q-test and I2 index were used to evaluate heterogeneity. Ten prospective cohort studies comprising 4473 patients were eligible in this meta-analysis. An elevated copeptin level was associated with an increased risk of all-cause mortality in HF patients (Relative risk (RR) was 2.64 (95% CI, 2.09-3.32)). The pooled sensitivity (SEN) and specificity (SPE) of copeptin were 0.57 (95% CI, 0.50-0.63) and 0.74 (95% CI, 0.69-0.79), respectively. The positive likelihood ratio was 2.2 (95% CI, 1.90-2.60) and the negative likelihood ratio was 0.58 (95% CI, 0.52-0.66). Furthermore, the summary Diagnostic Odds Ratio (DOR) was 4.00 (95% CI, 3.00-5.00) and the AUC was 0.70 (95% CI, 0.66-0.74) similar to the AUC of NT-proBNP 0.71 (95% CI, 0.67-0.75). Elevated levels of copeptin are associated with all-cause mortality in HF patients. The predictive value of copeptin is comparable with NT-proBNP for all-cause mortality in HF patients. Further studies are warranted to explore the prognostic value of copeptin in conjunction with other biomarkers and to determine an optimal cut-off level.


Molecular Piracy: Redirection of Bacteriophage Capsid Assembly by Mobile Genetic Elements.
Horizontal transfer of mobile genetic elements (MGEs) is a key aspect of the evolution of bacterial pathogens. Transduction by bacteriophages is especially important in this process. Bacteriophages-which assemble a machinery for efficient encapsidation and transfer of genetic material-often transfer MGEs and other chromosomal DNA in a more-or-less nonspecific low-frequency process known as generalized transduction. However, some MGEs have evolved highly specific mechanisms to take advantage of bacteriophages for their own propagation and high-frequency transfer while strongly interfering with phage production-"molecular piracy". These mechanisms include the ability to sense the presence of a phage entering lytic growth, specific recognition and packaging of MGE genomes into phage capsids, and the redirection of the phage assembly pathway to form capsids with a size more appropriate for the size of the MGE. This review focuses on the process of assembly redirection, which has evolved convergently in many different MGEs from across the bacterial universe. The diverse mechanisms that exist suggest that size redirection is an evolutionarily advantageous strategy for many MGEs.


Cesarean section: medical benefits and costs.
Cesarean section rates have risen dramatically in the U.S. over the past 20 years. Although infant mortality has declined during the same period, there is little evidence that more frequent cesarean surgery is the cause. Cesareans save lives or benefit health in certain circumstances, but the incidence of those indications has not increased. Cesarean section also has risks, the most significant for the infant being iatrogenic prematurity or respiratory disease. Maternal mortality is 2-4 times higher and morbidity is 5-10 times higher after a cesarean compared to vaginal birth. The four indications responsible for most of the rise in cesarean rates--previous cesarean, dystocia, breech presentation, and fetal distress--are those conferring the least clear-cut benefit. Demographically, women who are most likely to experience pregnancy complications, low birth weight births, or infant mortality are least likely to have a cesarean. Social, economic, and other factors seem to have a greater influence on the decision to perform a cesarean than does expected medical benefit. The development of neonatal intensive care, expanded access to prenatal care, and greater availability of abortion and family planning have contributed more to falling infant mortality. It has been estimated that approximately half the cesareans currently performed in the U.S. are medically unnecessary, resulting in considerable avoidable maternal mortality and morbidity, and a cost of over $1 billion each year.


Better in theory than in practise? Challenges when applying the luck egalitarian ethos in health care policy.
Luck egalitarianism, a theory of distributive justice, holds that inequalities which arise due to individuals' imprudent choices must not, as a matter of justice, be neutralized. This article deals with the possible application of luck egalitarianism to the area of health care. It seeks to investigate whether the ethos of luck egalitarianism can be operationalized to the point of informing health care policy without straying from its own ideals. In the transition from theory to practise, luck egalitarianism encounters several difficulties. We argue that the charge of moral arbitrariness can, at least in part, be countered by our provided definition of "imprudent actions" in the health area. We discuss the choice for luck egalitarianism in health care between ex ante and ex post policy approaches, and show how both approaches are flawed by luck egalitarianism's own standards. We also examine the problem of threshold setting when luck egalitarianism is set to practise in health care. We argue that wherever policy thresholds are set, luck egalitarianism in health care risks pampering the imprudent, abandoning the prudent or, at worst, both. Furthermore, we claim that moves to mitigate these risks in turn diminish the normative importance of the ethos of luck egalitarianism to policy. All in all, our conclusion is that luck egalitarianism cannot be consistently applied as a convincing and relevant normative principle in health care policy.


Cytomegalovirus gastritis: protean radiologic features.
Infection with cytomegalovirus (CMV) is a major feature of acquired immunodeficiency syndrome (AIDS). Gastrointestinal involvement is being seen more frequently. Our collective experience involves nine patients with stomach involvement. Seven patients were intravenous drug abusers or homosexuals with AIDS. One developed CMV gastritis as a complication of leukemia and one patient was a West African with lymphoma and human immunodeficiency virus (HIV) infection. All our patients had biopsy-proven CMV inclusion bodies. The radiographic appearances varied widely. The findings included markedly thickened edematous folds, erosive gastritis with aphthous ulceration, and superficial and deep ulceration. One patient had deep ulceration with fistula formation. Computed tomographic (CT) scans confirmed the greatly thickened gastric wall and coarsened folds in two patients. Associated gastrointestinal infections included candida and herpes, and, in addition, pneumocystis carinii pneumonia (PCP) was present in two patients. CMV gastritis may mimic several other conditions including erosive gastritis, peptic ulceration, lymphoma, and carcinoma. It should be strongly considered in immunosuppressed patients.


Determination of airway hyper-reactivity in asthmatic children: a comparison among exercise, nebulized water, and histamine challenge.
An easy and accurate method of assessing bronchial hyper-reactivity could be of great value in identifying and classifying the degree of severity of asthma in children. The sensitivity and specificity of three methods of provocation, ie, histamine, nebulized water, and exercise, were compared in 20 asthmatic and 20 control children between ages 5 and 13 years. Three clinical categories of severity ranging from slight (Group 1) through moderate (Group 2) to severe asthma (Group 3) were identified. The three methods were compared in each subgroup for detecting a tendency to bronchospasm. An inverse correlation (-0.57) was found between the histamine dose and clinical degree of severity, whereas distilled water and exercise proved to be too insensitive for identifying Group 1 asthmatics. Histamine challenge in children is a safe and sensitive technique for identifying asthma and for monitoring the severity of the disease during follow-up.


Remainers are nostalgic too: An exploration of attitudes towards the past and Brexit preferences.
Nostalgia had a prominent place in the Brexit Referendum campaign, epitomized by Nigel Farage carrying around with him an old-fashioned blue British passport on the campaign trail. In this paper, we seek to examine British attitudes towards the past through a new survey instrument administered online in July and August 2018 (N = 3,000). We empirically establish two dimensions of nostalgia that are differentially associated with political preferences. We conclude that it is the substance of the nostalgia that matters, not the looking towards the past per se.


Hepatitis B: a case for prenatal screening of all patients.
Evaluation of a mass screening program to detect hepatitis B surface antigen in the obstetric population of Shands Hospital, University of Florida in Gainesville, from January 1, 1983, through December 31, 1985, was undertaken. Prevalence of hepatitis B surface antigen seropositivity was 0.54%. Review of medical records revealed that 67% of patients with positive hepatitis B surface antigen screens had no risk factors identifiable by routine prenatal history. Although all patients were screened on admission to the hospital, the results of the immunoassay were not available in time for staff to institute isolation procedures for the laboring mother or unwashed neonate. In 82% of the cases, treatment of neonates occurred later than 12 hours after delivery (the current Centers for Disease Control recommendation). It is recommended that prenatal screening of all patients with a hepatitis B surface antigen immunoassay be done by 34 weeks' gestation where the patient population is of predominantly low socioeconomic status to ensure appropriate isolation and timely neonatal immunoprophylaxis.


Headspace liquid-phase microextraction using ionic liquid as extractant for the preconcentration of dichlorodiphenyltrichloroethane and its metabolites at trace levels in water samples.
A novel technique, high temperature headspace liquid-phase microextraction (HS-LPME) with room temperature ionic liquid (RTIL), 1-butyl-3-methylimidazolium hexafluorophosphate ([C4MIM][PF6]) as extractant, was developed for the analysis of dichlorodiphenyltrichloroethane (p,p'-DDT and o,p'-DDT) and its metabolites including 4,4'-dichlorodiphenyldichloroethylene (p,p'-DDE) and 4,4'-dichlorodiphenyldichloroethane (p,p'-DDD) in water samples by high performance liquid chromatography with ultraviolet detection. The parameters such as salt content, sample pH and temperature, stirring rate, extraction time, microdrop volume, and sample volume, were found to have significant influence on the HS-LPME. The conditions optimized for extraction of target compounds were as follows: 35% NaCl (w/v), neutral pH condition, 70 degrees C, 800 rpm, 30 min, 10 microL [C4MIM][PF6], and 25 mL sample solutions. Under the optimized conditions, the linear range, detection limit (S/N=3), and precision (R.S.D., n=6) were 0.3-30 microg L(-1), 0.07 microg L(-1), and 8.0% for p,p'-DDD, 0.3-30 microg L(-1), 0.08 microg L(-1), and 7.1% for p,p'-DDT, 0.3-30 microg L(-1), 0.08 microg L(-1), and 7.2% for o,p'-DDT, and 0.2-30 microg L(-1), 0.05 microg L(-1), and 6.8% for p,p'-DDE, respectively. Water samples including tap water, well water, snow water, reservoir water, and wastewater were analyzed by the proposed procedure and the recoveries at 5 microg L(-1) spiked level were in the range of 86.8-102.6%.


Feminizing gender-affirming hormone therapy for the transgender and gender diverse population: An overview of treatment modality, monitoring, and risks.
Feminizing gender-affirming hormone therapy (GAHT) can be utilized to help transfeminine transgender and gender diverse (TGD) individuals achieve the transformation of outward sex characteristics, thereby leading to improvements in psychological and social well-being. In this narrative review, we aim to summarize current guidelines for feminizing GAHT management as well as the available literature describing the associated health risks pertaining to cardiovascular disease, thromboembolic disease, bone health, and cancer risks. Relevant literature from January 2019 through July 2022 pertaining to feminizing GAHT was identified using PubMed, Cochrane Library, EMBASE, and MEDLINE. A narrative summary was performed with the inclusion of more recently published guidance from the World Professional Association for Transgender Health, Standards of Care Version 8. Guidance regarding the prescribing of feminizing GAHT with estrogen, antiandrogen, and progesterone medications is summarized along with considerations of the cardiovascular, thromboembolic, bone health, and cancer risks associated with these therapies. Feminizing GAHT is a highly effective method for transfeminine TGD patients to achieve medically necessary changes in secondary sex characteristics. Knowledge of the health risks of feminizing GAHT is largely drawn from research in the cisgender population, with a growing body of literature in TGD-specific patient populations. Feminizing GAHT appears to carry a low risk profile for most patients; however, further research describing the risks of hormone management around the time of gender-affirming surgery and in the aging TGD population is needed to optimize GAHT in the context of the evolving health risks over a TGD patient's lifespan.


Hybrid sialoglycoprotein content of St(a+) red cells.
St(a+) red cells contain a ficin-resistant hybrid sialoglycoprotein (SGP) consisting of the amino terminus of Ss sialoglycoprotein (Ss SGP) and the carboxyl terminus of MN sialoglycoprotein (MN SGP). Ficin-modified St(a+) but not St(a-) red cells were agglutinated by monoclonal antibodies NN5 (anti-N) and 31 (detecting a sialic acid-dependent determinant on the SGPs). SDS-polyacrylamide gel electrophoresis showed three periodic acid-Schiff-staining protein bands in ficin-modified St(a+) but not St(a-) red cell-membranes; these bands bound monoclonal antibodies NN5 and 31 on Western blots. Using Scatchard analysis of 125I-NN5 IgG binding to M+N- red cells, estimates were obtained of 25,000 Ss SGP molecules per red cell per s allele, 33,000 Ss SGP molecules per red cell per S allele, and 75,000 hybrid SGP molecules per red cell per hybrid allele. These results are consistent with the expression of the hybrid SGP gene at a level intermediate between the MN SGP gene and the Ss SGP gene. Monoclonal antibodies NN5 and 31 may be useful in screening ficin-treated red cells for hybrid SGP variants.


An investigation of the intrinsic circuitry of the motor cortex of the monkey using intra-cortical microstimulation.
The motor cortex contains a distributed map of muscles, with a single muscle represented over a wide cortical area. We have searched for inter-connections between distant sites projecting to common muscles by delivering pairs of 20-microA single-pulse intracortical microstimuli (ICMS) to sites separated by 1.5-2 mm in the hand-area primary motor cortex of two macaque monkeys performing a precision grip task. The facilitation of hand- and forearm-muscle rectified EMG was measured. When stimuli were delivered simultaneously, responses were quantified using a technique to correct for non-linearities inherent in the use of averaged, rectified EMG. A spatial facilitation was seen for such simultaneous stimuli; however, it was of the same magnitude as that occurring when ICMS was paired with stimulation of corticospinal axons in the pyramidal tract (PT), so that it was likely to be spinal in origin. When two such distant sites were stimulated separated by a 10- or 20-ms delay, the second response scaled with the level of background EMG in the same way as a response to the PT stimulus. By contrast, when the same site was stimulated twice with these delays, the second response showed a facilitation compared with a similarly timed PT response. There would therefore appear to be a local facilitation of the cortical output at these intervals, which is not seen between distant sites. Antidromically identified pyramidal-tract neurones (PTNs) were recorded whilst stimuli were delivered to a cortical site, with a distance between stimulating and recording electrodes of also 1.5-2 mm. The most common response was a facilitation followed by a suppression. Six of eleven PTNs showed a facilitation in their discharge following this stimulation (maximum connection strength s=0.19), 8/11 showed a suppression (maximum s=0.16). It is concluded that powerful inter-connections do exist between distributed parts of the motor output and that there is widespread cortical activation after even a single ICMS pulse. However, these inter-connections do not lead to interactions between cortical outputs following stimulation, as assessed from the EMG. It is proposed that this is likely to reflect differences in the summation of output cells to local versus remote stimulation.


Prevalence and associated risk factors of low back pain among users of a primary health care clinic serving semi-urban and rural settlements in KwaZulu-Natal, South Africa.
Low back pain (LBP) is one of the most frequent musculoskeletal conditions and a common work-related health problem. In South Africa, people from lower socio-economic strata are involved in physical labour and also have unequal access to health services. There is minimal data on the prevalence of LBP in these communities. This study determined the prevalence and associated risk factors of LBP among public sector health care users in a semi-urban/rural area of KwaZulu-Natal, South Africa. The study was conducted at a primary health care clinic in the Umdoni municipality, KwaZulu-Natal, South Africa. Convenience sequential sampling was used. An interviewer-administered questionnaire was utilized due to literacy constraints. Participants (n=400) answered the questionnaire in either English or isiZulu. The lifetime prevalence of LBP was 79.3%. Female gender and lifting heavy objects were associated with LBP. The direct impact of LBP was faced in the work place resulting in absenteeism, often followed by unemployment. In this setting, where the prevalence of LBP was high, specialized treatments for LBP were not available at the primary health care facility. Incorporation of such treatments will be useful, for people in lower socio-economic strata, to overcome the burden of LBP.


Relationship between maternal and fetal fuels and placental glucose transfer in rats with maternal diabetes of varying severity.
Gestational diabetes mellitus (GDM) is a nonhomogeneous entity known to affect fetal development in different ways in both rats and human beings. The degree of severity of diabetes could affect the maternal-fetal transfer of metabolic fuels and consequently influence fetal development. To study this hypothesis, pregnant rats were made diabetic by streptozocin (STZ) treatment (45 mg/kg) at day 7 of gestation and were treated with different daily doses of insulin until the 20th day of gestation, when they were killed and examined. Differences in plasma glucose levels in the groups studied were not accompanied by differences in plasma glycerol, beta-hydroxybutyrate (beta-OHB), or total amino acid levels in mothers or their fetuses. Fetal/maternal ratios of these circulating fuels were not modified by maternal diabetes, whereas the glucose level was enhanced in diabetic rats not treated with insulin. Placental glucose transfer was studied directly with a recently reported in situ experimental design and was found to increase linearly with maternal glycemia, independently of whether this was modified by insulin treatment or by acute intravenous (i.v.) infusion of glucose in normal animals. Lactate production by the fetal/placental unit decreased in proportion to the glucose level in the maternal circulation. The present data indicate that the diabetic condition of the mother rat does not modify the mechanisms of placental transfer of metabolic fuels to the fetus, and that the actual transfer is mainly dependent on the concentrations of these fuels in the maternal circulation.(ABSTRACT TRUNCATED AT 250 WORDS)


Swelling-enhanced catalytic degradation of brominated epoxy resin in waste printed circuit boards by subcritical acetic acid under mild conditions.
Waste printed circuit boards (WPCBs) contain a large amount of brominated epoxy resins (BERs), which may cause environmental problems. However, BERs degradation under mild conditions is challenging due to the good thermal and chemical stabilities of BERs. This study proposes a mild and efficient method that uses subcritical acetic acid (220 °C-260 °C, 2.6-3.6 MPa) to decompose BERs. BERs swell quickly at 200 °C and are thoroughly decomposed into bisphenol A and phenol at 220 °C when the acetic acid mass concentration and holding time are fixed at 49.90% and 1 h, respectively. Experimental results show that subcritical acetic acid has excellent swelling and catalytic degradation effects on BERs. The quick swelling of BERs allows the free migration of the catalyst in the epoxy network and thus significantly enhances the catalytic degradation effect. Therefore, BERs can be thoroughly decomposed by subcritical acetic acid under mild conditions. Temperature and acetic acid concentration are the major parameters that control the resin degradation rate. Bromine-free oil phase products are obtained at ≥240 °C. The possible decomposition pathway of BERs in subcritical acetic acid is also investigated. Most of the bromine is transformed into HBr and enriched in the aqueous phase. In conclusion, the proposed mild method could be used as a novel practical and industrial procedure for the degradation and debromination of BERs.


Eroticizing inequality in the United States: the consequences and determinants of traditional gender role adherence in intimate relationships.
This article reviews the research on traditional gender-role adherence and sexuality for heterosexual men and women. Specifically, the consequences and predictors of following traditional gender roles of female submissiveness and male dominance in sexual relationships is examined. Despite evidence that men and women's sexual roles are becoming more egalitarian over time, empirical evidence suggests that the traditional sexual roles continue to dominate heterosexual relations. This article explores whether the sexual context is one in which both men and women feel particularly compelled to engage in gender stereotypic behavior, and why. In addition, this article reports on research that finds that men and women have automatic associations between sexuality and power that reinforce their gender stereotypic behavior in sexual contexts. The negative effects of traditional gender-role adherence for women's sexual problems and satisfaction is demonstrated. This article concludes that traditional sexual scripts are harmful for both women's and men's ability to engage in authentic, rewarding sexual expression, although the female submissive role may be particularly debilitating. Future directions of research are suggested, including interventions to reduce women's adherence to the sexually submissive female script.


Non-HDL-cholesterol to HDL-cholesterol ratio as an independent risk factor for the development of chronic kidney disease.
Dyslipidemia contributes to the development and progression of renal disease. The objective of this study was to investigate whether an elevated non-HDL-cholesterol to HDL-cholesterol ratio (NonHDLc/HDLc) predicts new-onset chronic kidney disease (CKD). We followed 1891 Chinese adults with normal or near-normal kidney function at baseline who participated in an annual health checkup program for the occurrence of new-onset CKD [defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m(2) (low eGFR) and/or proteinuria (defined as urinary protein ≥1 + on dipstick testing)] or low eGFR. Cox proportional hazards models were used to examine the independent relationship between the plasma NonHDLc/HDLc ratio and new-onset CKD. During a median follow-up period of 2.8 years, 3% (n = 57) of participants developed new-onset CKD. Compared with patients in the lowest tertile, patients with NonHDLc/HDLc ratios in the highest tertile had a 1.45-fold higher risk of new-onset CKD (hazard ratio [HR], 2.45; 95% confidence interval [95% CI], 1.07 to 5.61; P = 0.035) after adjustment for potential confounders. There was a marginally significant association with low eGFR (tertile 3 versus tertile 1: HR, 2.94; 95% CI, 0.98 to 8.82; P = 0.054). NonHDLc/HDLc ratio is an independent risk factor for the development of CKD. Assessment of NonHDLc/HDLc ratio may help identify high risk groups with chronic kidney disease.


An evaluation of the accuracy of bracket positioning with and without loupes using 3Shape Ortho Analyzer software.
The accuracy of bracket positioning is very important for successful orthodontic treatment. Precisely placed brackets aid in the enhancement of treatment outcomes. The aim of the present study was to evaluate the accuracy of bracket positioning with and without dental loupes and compare this method with bracket positioning achieved using the 3Shape Ortho Analyzer. A single blinded, split-mouth, randomized and controlled trial was conducted in the Department of Orthodontics. Three-dimensional (3D) scanned models of the maxillary arches of the subjects were obtained using 3Shape Ortho Analyzer software and virtual setups were prepared. Right and left quadrants of the maxillary arch of the 10 subjects were randomly allocated for manual bonding with loupes or without loupes. The manually bonded maxillary arch was then scanned and 3D models were obtained; these were then compared with bracket positioning achieved with the 3Shape Ortho Analyzer. In the two quadrants, deviations in the position of each bonded bracket was compared in the mesio-gingival, disto-gingival, mesio-occlusal, disto-occlusal, distal and mesial areas and then further compared with the virtual set up. Finally, bracket positioning errors were measured. An independent sample t-test was performed to compare both the area-wise and teeth-wise mean error in bracket positioning with loupes and without loupes which showed no statistically significant difference. There was no significant difference in bracket positioning with or without loupes. The results of this current study showed that bracket positioning can be performed with loupes or without loupes.


Neurotrophic factors, childhood trauma and psychiatric disorders: A systematic review of genetic, biochemical, cognitive and imaging studies to identify potential biomarkers.
Exposure to traumatic experience represents one of the key environmental factors influencing the risk for several psychiatric disorders, in particular when suffered during childhood, a critical period for brain development, characterized by a high level of neuroplasticity. Abnormalities affecting neurotrophic factors might play a fundamental role in the link between childhood trauma (CT) and early life stress (ELS) and psychiatric disorders. A systematic review was conducted, considering genetic, biochemical and expression studies along with cognitive and brain structure imaging investigations, based on PubMed and Web of Science databases (available up until November 2021), to identify potential neuroplasticity related biomarkers associated both with CT/ELS and psychiatric disorders. The search was followed by data abstraction and study quality assessment (Newcastle-Ottawa Scale). 103 studies met our eligibility criteria. Among them, 65 were available for genetic, 30 for biochemical and 3 for mRNA data; 45 findings were linked to specific symptomatology/pathologies, 16 with various cognitive functions, 19 with different brain areas, 6 on methylation and 36 performed on control subjects for the Brain Derived Neurotrophic Factor (BDNF); whereas 4 expression/biochemical studies covered Neurotrophin 4 (NT-4), Vascular Endothelium Growth Factor (VEGF), Epidermal Growth Factor (EGF), Fibroblast Growth Factor (FGF), and Transforming Growth Factor β1 (TGF-β1). Heterogeneity of assessments (biological, psychological, of symptomatology, and CT/ELS), age range and ethnicity of samples for BDNF studies; limited studies for other neurotrophins. Results support the key role of BDNF (in form of Met allele) as biomarker, both at genetic and biochemical level, in mediating the effect of CT/ELS in psychiatric disorders, passing through specific cognitive functions and specific brain region architecture.


Cardioprotective activity of Amaranthus viridis Linn: effect on serum marker enzymes, cardiac troponin and antioxidant system in experimental myocardial infarcted rats.
Cardiovascular diseases (CVDs) have a high prevalence in developing and developed countries and myocardial infarction accounts for majority of deaths and disabilities. The current study dealt with the protective role of Amaranthus viridis Linn on isoproterenol (ISO)-induced myocardial infarction (MI) in rats. Subcutaneous injection of ISO (20 mg/kg body weight in 1 ml saline) to rats for two consecutive days offered significant alteration in cardiac marker enzymes (AST, ALT, LDH and CPK), cardiac troponin, lipid peroxidation products (TBARS and hydroperoxide) and antioxidant system (CAT, SOD, GPx, GST, GSH and GSSG). ISO-induced myocardial damage was indicated by increased activities of marker enzymes in serum and the levels of cardiac troponin in the serum. In addition to these diagnostic markers, the levels of lipid peroxidation products in the heart were significantly (p<0.05) increased and the activities of enzymic antioxidants and non-enzymic antioxidant such as glutathione in the heart was significantly (p<0.05) decreased and GSSG in the heart was increased in ISO-induced rats. Effect of Amaranthus viridis oral treatment (100, 200 and 300 mg/kg body weight) for 45 days elicited a significant cardio protective activity by lowering the levels of serum marker enzymes, cardiac troponin, GSSG and lipid peroxidation and elevated the levels of antioxidant enzymes and GSH. The effect at a dose of 300 mg/kg of A. viridis was more pronounced than that of the dose 100 mg/kg and 200mg/kg and brought back all the parameters to near normal. The effect produced by A. viridis was compared with α-tocopherol. The present findings have demonstrated that the cardioprotective effects of A. viridis in ISO-induced oxidative damage may be due to an augmentation of the endogenous antioxidants and inhibition of lipid peroxidation of membrane.


The forgotten node: Axillary surgery mandates expertise.
The therapeutic role of axillary dissection in breast cancer is gradually abandoned. However, in some cases axillary dissection is still indicated, and this mandates expertise in planning the operation according to imaging, understanding of current methods of axillary marking, and expertise in performing a more radical resection. In this comment we describe cases of gross nodal disease that was left behind at the time of axillary dissection and was later noted on a radiation planning CT.


Therapeutic efficacy of vacuum sealing drainage-assisted irrigation in patients with severe multiple-space infections in the oral, maxillofacial, and cervical regions.
We compared the clinical efficacy between the vacuum sealing drainage (VSD)-assisted irrigation technique and traditional abscess incision and drainage technique in the treatment of severe multiple-space infections in the oral, maxillofacial, and cervical regions. Data of 73 patients with severe oral, maxillofacial, and cervical infections, who were admitted to the Oral and Maxillofacial Surgery Department at the First Affiliated Hospital of Fujian Medical University between June 2014 and May 2017, were retrospectively collected. Patients were divided into two groups based on the treatments. The cure duration, incision length, physician workload (frequency of dressing-change), and treatment costs were compared between the two groups. Of 73 patients, 38 were treated with the VSD-assisted irrigation technique, and 35 with the traditional technique. All patients were cured following treatment. The cure duration, surgical scar length, and physician workload were smaller for the former group than for the latter group (p < 0.05). There was no difference in the treatment costs between the two groups (p > 0.05). VSD-assisted irrigation technique used in the treatment of severe multiple-space infection in the oral and maxillofacial cervical regions shows favorable clinical effects and enables short treatment duration, lesser pain-experience, and high clinical and therapeutic efficacy.


Successful treatment of an adult with Kasabach-Merritt syndrome using thalidomide, vincristine, and prednisone.
Kasabach-Merritt syndrome is a rare disease that mainly occurs in infants and adolescents. It usually manifests as disseminated intravascular coagulation and severe bleeding, and is associated with high mortality. However, its low incidence and clinical rarity in adults mean that there is currently no well-verified treatment regimen for this disease. We report on an effective novel therapeutic regimen in a patient with Kasabach-Merritt syndrome. A woman with Kasabach-Merritt syndrome presented with a recurrent subcutaneous mass and disseminated intravascular coagulation, and was treated with prednisone, vincristine and thalidomide. This treatment regimen successfully resolved the patient's symptoms, with tumor regression. The patient remained disease-free after 6 years of follow-up. Prednisone combined with vincristine and thalidomide may be an effective treatment for Kasabach-Merritt syndrome, but further studies are needed to verify the use of this regimen.


Adherence to antimalarial chemoprophylaxis among Israeli travelers visiting malaria-endemic areas.
Travelers are recommended to take antimalarial chemoprophylaxis (AMC) when traveling to endemic areas. This prospective comparative cohort study included 400 Israeli travelers to malaria-endemic areas, recruited in pre-travel clinics. They were contacted within one month following their return and asked about their actual adherence and the reasons for non-adherence. Of 400 travelers with a mean age of 24.6 [SD = 4] years, 201 (50.2%) were men and 328 (82%) were singles. The majority (N = 185, 46.3%) traveled with friends, and the most common travel destination was southeast Asia (N = 267, 66.8%). Most travelers (N = 340, 85%) did not adhere to the AMC. In the multivariate analysis, non-adherence was found to be significantly associated with traveling solo or with friends, traveling to southeast Asia and longer travel duration. The most common reason for non-adherence among travelers was the perception that the risk of contracting malaria is low (N = 251, 73.8%). In this study, 85% of the Israeli travelers did not adhere to the AMC, especially those traveling solo or with friends, visiting southeast Asia and for a long period. Counselors at the pre-travel clinics should stress the importance of AMC in highly endemic countries and consider alternative treatment strategies, especially in low risk areas or long duration travel, such as short-term schedule or reserve AMC for field trips.


Inhibition of ultraviolet B radiation-induced interleukin 10 expression in murine keratinocytes by selenium compounds.
Selenium is an essential trace nutrient necessary for the normal function of the immune system. Selenium compounds protect mice against ultraviolet (UV) B-induced tumours, probably by preventing oxidative damage to the host skin cells and to the host immune system. One possible mechanism of protection is that selenium can prevent oxidative stress-induced release of cytokines such as interleukin (IL)-10, which could suppress cell-mediated immunity. To determine whether selenium compounds can inhibit UVB induction of IL-10 protein in murine keratinocytes. The murine keratinocyte cell line PAM 212 was treated with or without selenomethionine (50-200 nmol L-1) or sodium selenite (1-50 nmol L(-1)) for 24 h before exposure to 200 J m(-2) UVB. The cells were stained with an antibody to IL-10, 24 h after irradiation. Preincubation with both selenium compounds inhibited UVB induction of IL-10 immunostaining, although selenomethionine was more effective. Pretreatment with 200 nmol L(-1) selenomethionine decreased IL-10 immunostaining to levels seen in the unirradiated controls. The protective effects of selenium against UVB-induced skin cancer in murine models may result, in part, from its ability to inhibit release of cytokines that are capable of suppressing cell-mediated immunity.


Texture synthesis for generating realistic-looking bronchoscopic videos.
Synthetic realistic-looking bronchoscopic videos are needed to develop and evaluate depth estimation methods as part of investigating vision-based bronchoscopic navigation system. To generate these synthetic videos under the circumstance where access to real bronchoscopic images/image sequences is limited, we need to create various realistic-looking image textures of the airway inner surface with large size using a small number of real bronchoscopic image texture patches. A generative adversarial networks-based method is applied to create realistic-looking textures of the airway inner surface by learning from a limited number of small texture patches from real bronchoscopic images. By applying a purely convolutional architecture without any fully connected layers, this method allows the production of textures with arbitrary size. Authentic image textures of airway inner surface are created. An example of the synthesized textures and two frames of the thereby generated bronchoscopic video are shown. The necessity and sufficiency of the generated textures as image features for further depth estimation methods are demonstrated. The method can generate textures of the airway inner surface that meet the requirements for the texture itself and for the thereby generated bronchoscopic videos, including "realistic-looking," "long-term temporal consistency," "sufficient image features for depth estimation," and "large size and variety of synthesized textures." Besides, it also shows advantages with respect to the easy accessibility to required data source. A further validation of this approach is planned by utilizing the realistic-looking bronchoscopic videos with textures generated by this method as training and test data for some depth estimation networks.


Double rotation of the opening (closing) elytra in beetles (Coleoptera).
Transient movements of the elytra (opening and closing) were filmed in beetles tethered from below. A total of 39 specimens of 18 species representing 11 families were examined. Bright markers glued to the elytra were traced frame by frame. Body-fixed 3D traces of apical and shoulder markers were reconstructed. Shapes of traces reflected different steps of elytral movement and different types of flight. Flat circular arcs were fitted to scattered traces using the least square method. The rotation axis of the apical marker was always directed at the contralateral side. The trace of the shoulder marker was, as a rule, non-parallel to the apical trace. Usually, the shoulder marker on the costal edge of the elytron uniformly supinated in the course of adduction of the apical marker. Traces of opening and closing coincided, hence the double rotation of the elytron had one degree of freedom. The elytron to body articulation in beetles is, presumably, a spherical mechanism with two separate but linked drives for a broad swing during opening (closing).


Carpal tunnel syndrome grading system in rheumatoid arthritis.
The grading system of Hashizume and Hirooka for carpal tunnel syndrome (CTS) was modified to refine the system for surgical treatment selection for specific subsets of CTS in patients with rheumatoid arthritis (RA). The grading system uses clinical signs and symptoms of CTS, including pain indications, to identify surgical subsets of patients to facilitate treatment selection. Retrospective analysis of the system included radiographic and electromyographic findings. Twenty-nine hands of 21 adult patients with CTS in RA were graded in the current study. Eight hands with mild synovitis received conservative treatment only. Endoscopic carpal tunnel release (ECTR), using Okutsu's universal subcutaneous endoscopic system with a clear cannula, was performed in 11 hands with moderate synovitis. Open carpal tunnel release (OCTR) combined with flexor tenosynovectomy was performed in 9 hands with severe synovitis. One more hand required OCTR after ECTR when malignant RA was diagnosed. Clinical results, evaluated using Kelly's criteria, were: excellent in 19 hands, good in 5, fair in 4, and poor in the 1 patient with malignant RA. Clinical symptoms of CTS improved in all but the latter patient. Although the sample size in the current study is small, the results appear to warrant further study to determine the clinical utility of the grading system.


Expression of IL-13Rα2 and FUS in glioma: clinicopathological and prognostic correlation.
IL-13Rα2 is one of the most widely studied tumor-associated antigens in glioma research. Fused in sarcoma (FUS) is a DNA/RNA binding protein that is dysfunctional in various malignant tumors. However, the expression of IL-13Rα2 and FUS, their relationship with clinicopathological parameters and their prognostic value in glioma remain unclear. In the present study, the expression of IL-13Rα2 and FUS was measured in a glioma tissue array by immunohistochemistry. Pearson's X2 test was used to determine the correlation between immunohistochemical expressions and clinicopathological parameters. Pearson's or Spearman's correlation test was used to determine the association between these two proteins expression. The Kaplan-Meier analysis was used to investigate the effect of these proteins on prognosis. The expressions of IL-13Rα2 were significantly higher in high-grade gliomas (HGG) than that in low-grade gliomas (LGG) and was associated with IDH mutation status, whereas FUS location demonstrated no significant correlation with clinicopathological parameters. Moreover, a positive relationship was found between nuclear and cytoplasmic co-localization FUS and IL-13Rα2 expression. Kaplan-Meier analysis revealed that patients with IDH wide type or IL-13Rα2 had worst overall survival (OS) compared to other biomarkers. In HGG, IL-13Rα2 combined with nuclear and cytoplasmic co-localization of FUS was associated with worse OS. Multivariate analysis showed that tumor grade, Ki-67, P53 and IL-13Rα2 could be the independent prognostic factors for OS. IL-13Rα2 expression was significantly associated with cytoplasmic distribution of FUS in human glioma samples and could be the independent prognostic factors for OS, while the prognostic value of its co-expression with cytoplasmic FUS in glioma need to be addressed in the future studies.


Total workflow uncertainty of frameless radiosurgery with the Gamma Knife Icon cone-beam computed tomography.
Frameless treatment with the Gamma Knife Icon is still relatively new as a treatment option. As a result, additional confidence/knowledge about the uncertainty that exists within each portion of the treatment workflow could be gained especially regarding steps that have not been previously studied in the literature. The Icon base delivery device (Perfexion) uncertainty is quantified and validated. The novel portions of the Icon such as mask immobilization, cone-beam computed tomography image guidance, and the intrafraction motion management methods are studied specifically and to a greater extent to determine a total workflow uncertainty of frameless treatment with the Icon. The uncertainty of each treatment workflow step has been identified with the total workflow uncertainty being identified in this work as 1.3 mm with a standard deviation of 0.51 mm. The total uncertainty of frameless treatment with the Icon has been evaluated and this data may indicate the need for setup margin in this setting with data that could be used by other institutions to calculate needed setup margin per their preferred recipe after validation of this data in their context.


Surveys of community garden affiliates and soils in Houston, Texas.
Although urban community food gardens have the capacity to strengthen and support neighborhoods in need, the benefits of such operations must be considered in tandem with the potential risks associated with urban environmental contamination. Therefore, research is needed to characterize existing community gardens in urban areas. In the present study, a survey of Houston, TX, community gardeners (N = 20) was conducted to better understand their risk-based knowledge and perceptions, current gardening practices, and willingness to implement risk mitigation measures. Soil samples collected from the beds (N = 22) and surrounding grounds (N = 24) of existing community garden sites in Houston, TX, were screened for trace and heavy metals using X-ray fluorescence spectrometry. The survey indicated that community gardeners had few concerns with regard to potential soilborne hazards and were generally willing to use diverse strategies to reduce potential hazards related to garden soil contamination. Ground and garden bed soil collected from community gardens were found to have excess concentrations of arsenic compared to federal health screening limits. The information provided here provides insight into possible discordance between community gardening risk perception and contamination risk that could be addressed through outreach, engagement, and remediation approaches.


Lipid rafts make for slippery platforms.
What's in a raft? Although cell membranes are certainly not homogeneous mixtures of lipids and proteins, almost all aspects of lipid rafts-how to define them, their size, composition, lifetime, and biological relevance-remain controversial. The answers will shape our views of signaling and of membrane dynamics.


Standing crops and primary productivity of the epipelon of two small ponds in North Somerset, U. K.
The primary productivity and the standing crop of the epipelic algal communities in two small ponds of contrasting nutrient status were measured over a 2 year period. Standing crops reflected the richer nutrient status of the eutrophic Abbot's Pond compared with the oligotrophic Priddy Pool as did the productivity results when the same depth category in both ponds was examined. Production resulted from an interrelationship among light intensity, standing crop size and other variable environmental factors in both pools, however light in Abbot's Pond appeared to be the most important factor in limiting standing crop size and production in the deeper depth categories.


Pharyngeal narrowing as a common feature in pycnodysostosis--a cephalometric study.
We report on pycnodysostosis presenting as severe snoring caused by pharyngeal narrowing in two siblings. Cephalograms showed pharyngeal narrowing at the level of the soft palate and the base of the tongue caused by the long soft palate and mandibular hypoplasia. From the literature review and our results, we suggest that respiratory insufficiency such as snoring or obstructed sleep apnea are common and under-appreciated symptoms of pycnodysostosis.


A Simple, Robust, and Convenient HPLC Assay for Urinary Lactulose and Mannitol in the Dual Sugar Absorption Test.
Heterogeneous laborious analytical methodologies for the determination of urinary lactulose and mannitol limit their utility in intestinal permeability testing. We developed an assay using a Shimadzu HPLC system, an Aminex HPX87C column, and refractive index detection. The test was calibrated using a series of dilutions from standard stock solutions of lactulose and mannitol 'spiked' into urine samples. The utility to quantify urinary excretion during the dual sugar absorption test over 6 h was also determined. Lactulose and mannitol were eluted isocratically at 5.7 and 10.1 min, respectively, with water as a mobile phase at a flow rate of 0.3 mL min-1, 858 psi, 60 °C. The calibration curves for both sugars were linear up to 500 µg mL-1 with a limit of detection in standard solutions at 4 µg mL-1 and in 'spiked' urine samples at 15 µg mL-1. The intra-assay and inter-assay CVs were between 2.0-5.1% and 2.0-5.1% for lactulose and 2.5-4.4% and 2.8-3.9% for mannitol. The urinary profiles of the 6 h absorption of lactulose and mannitol showed similar peak-retention times to standard solutions and were well-resolved at 5.9 and 10.4 min, respectively. The assay was easy to automate, using commonly available equipment and convenient requiring no prior laborious sample derivatization. The simplicity, reproducibility, and robustness of this assay facilitates its use in routine clinical settings for the quantification of intestinal permeability.


Sequencing our way towards understanding global eukaryotic biodiversity.
Microscopic eukaryotes are abundant, diverse and fill critical ecological roles across every ecosystem on Earth, yet there is a well-recognized gap in understanding of their global biodiversity. Fundamental advances in DNA sequencing and bioinformatics now allow accurate en masse biodiversity assessments of microscopic eukaryotes from environmental samples. Despite a promising outlook, the field of eukaryotic marker gene surveys faces significant challenges: how to generate data that are most useful to the community, especially in the face of evolving sequencing technologies and bioinformatics pipelines, and how to incorporate an expanding number of target genes.


Safety assessment of ethanolic root extract of Zaleya decandra (EEZD) in Wistar rats.
Zaleya decandra is a prostrate, glabrous, succulent herb of the family Aizoaceae. In recent years the pharmacological efficacy of the plant such as the hepatoprotective, antimicrobial, antidiabetic, anti-inflammatory and anticancer activities has been reported. However, a long-term toxicity study of Z. decandra is yet to be carried out. In the present study, the acute dose of 2000 mg/kg b.w. of ethanolic extract of Z. decandra (EEZD) administered orally to Wistar rats gained gradual weight with time and appeared healthy without any record of mortality. In the sub-chronic toxicity study, the rats showed no remarkable increase or decrease in their weight even at the highest dose of 500 mg/kg b.w. The haematological, biochemistry and serum marker enzyme parameters did not show any dose dependent change in the values. Further, the histology micrographs confirmed that the tissue architecture of all the vital organs were not affected by EEZD treatment. Hence, the EEZD (500 mg/kg b.w.) is considered safe for a 90-day period. Therefore, the present study warrants extensive investigation of EEZD using higher pre-clinical model system to substantiate the findings. The GC-MS analysis revealed the presence of 39 phytoconstituents including octadecenoic acid, hexadecanoic and phytosterols such as campesterol, sitosterol and stigmasterol.


Phelan-McDermid Syndrome.
Phelan-McDermid syndrome is a rare neurodevelopmental syndrome associated with severe intellectual disability, motor delay, and autistic traits. This article reviews a case of a complicated presentation of Phelan-McDermid syndrome and addresses etiology, diagnosis, and management.


Cloning and unusual expression profile of the aldolase B gene from Atlantic salmon.
A full-length clone of the aldolase B gene has been isolated from a cDNA library constructed from liver of Atlantic salmon (Salmo salar). Sequencing showed that the clone encodes a typical aldolase B, possessing a number of amino acid residues which are seen in aldolase B, but not in other aldolase isoforms. RT-PCR analysis showed that the gene is expressed in liver, kidney and intestine as expected. However, in contrast to mammalian and avian aldolase B, expression was also found in a number of other tissues. Levels of aldolase B mRNA in liver and kidney were not significantly altered during smoltification, the transformation of freshwater-dwelling salmon (parr) into saltwater-adapted salmon (smolts).


Infection with Ostertagia ostertagi in goats and calves.
In order to determine the usefulness of the goat as a model host for Ostertagia ostertagi, a series of experiments was conducted in which young goats and calves were experimentally infected with L3 of calf-source and goat-source isolates. The goat-source isolate was derived from a continuous passage of the bovine parasite in goats. Patent infections resulted in 73 out of 86 inoculated goats (85%). The largest number of patent infections was observed when inoculation consisted of a single dose of goat-source larvae. Percent establishment of infection was generally low in goats inoculated with either larval source. Time taken to achieve patency in goats was frequently within the range normal for cattle infections, but was often extended (21-67 days). With the exception of the generally higher level of establishment of goat- or calf-source isolates in calves and the low frequency of the vulval flap in adult female worms established in goats, little difference was observed in percent establishment or worm population characteristics of the two isolates in goats as based on source of larval inoculum, inoculation course, and age of host at inoculation. Prolonged passage of infection in goats did not result in stabilized isolate more adapted to the goat or less adapted to calves. Fecal egg counts were generally minimal or negative in goats during the first 30 days of infection, but were often increased and not substantially lower than counts in calf infections after 60 or 90 days. Low level egg counts in goats were observed to persist for up to 17 months. During the spring of 2 years, goat kids grazed on a cattle pasture acquired O. ostertagi infections which included adult worms, but a larger number of early L4. The latter were presumed to be inhibited in development just as such inhibition occurs in cattle during spring.