Energy expenditure during treadmill walking before and after vertical banded gastroplasty: a one-year follow-up study in 11 obese women.
To find out whether weight reduction induced by vertical banded gastroplasty (VBG) alters the energy expenditure in severely obese women during treadmill walking. A prospective one year follow-up study, patients being their own controls. University hospital, Sweden. A consecutive series of 11 women who had VBG. Indirect calorimetry, body mass index (BMI), preset and comfortable walking speeds, heart rate, perceived exertion, and quality of life. 11 patients were evaluated. Mean BMI (kg/ml) decreased from 41 (range 36-46) before to 32 (range 25-37) 12 months postoperatively. The energy expenditure decreased significantly both at comfortable and preset walking speeds. The comfortable walking speed increased from 2.7 km x h(-1) (range 1.3-3.4) before operation to 3.8 (range 2.0-4.2) one year postoperatively (p = 0.003). All bodily variables in the SF-36 questionnaire showed improvement from 6 months onwards. Weight reduction in women reduces the energy expenditure during walking both at comfortable and preset speeds. The comfortable walking speed is increased. The improvements are reflected in the patients' own assessment.


Bell's Palsy.
Bell's palsy is unilateral, acute onset facial paralysis that is a common condition. One in every 65 people experiences Bell's palsy in the course of their lifetime. The majority of patients afflicted with this idiopathic disorder recover facial function. Initial treatment involves oral corticosteroids, possible antiviral drugs, and protection of the eye from desiccation. A small subset of patients may be left with incomplete recovery, synkinesis, facial contracture, or hemifacial spasm. A combination of medical and surgical treatment options exist to treat the long-term sequelae of Bell's palsy.


The ileal neobladder.
An ileal neobladder for total bladder replacement was created in 11 patients. To achieve a low pressure system, disruption of directional bowel peristalsis with a longitudinal incision at the antimesenteric border of a 70 cm. ileal segment is performed. A spherical pouch, the neobladder, is fashioned and anastomosed to the urethra. The ureters are implanted according to the method of Le Duc and Camey. Videourodynamic studies during various postoperative phases demonstrate this neobladder to be a urinary reservoir with a capacity approximating that of a normal bladder, good compliance during filling by maintaining pressure lower than 30 cm. water and no reflux. Of the 11 patients with the neobladder 8 are completely dry day and night, while 3 have grade I stress incontinence. All 11 patients had recognizable sensations of bladder distension closely simulating those of normal bladders. The use of this ileal neobladder in male patients undergoing radical cystectomy offers an alternative free of a stoma to urinary diversion, resulting in a highly compliant, low pressure bladder.


Phalloidin alters bile canalicular contractility in primary monolayer cultures of rat liver.
We observed the motility of bile canaliculi in isolated rat hepatocytes obtained from animals that were pretreated with phalloidin (500 micrograms/kg body wt) for 1 and 3 days. Time-lapse cinephotomicrographs were taken in each experiment and in controls for 16.25 h. As we previously reported in normal hepatocytes, active contractions of bile canaliculi were observed. The number of contractions was 127.6 in controls, compared with 58.0 in 1-day phalloidin pretreated and 16.2 in 3-day phalloidin pretreated groups. The contraction process itself was not normal in the experimental groups, the contraction phase being slow and sustained. The altered canalicular motility depended on the dose of phalloidin administered. These results suggest that the integrity of actin filaments is necessary for normal bile canalicular motility. Further, dysfunction of actin microfilaments with altered canalicular motility may be involved in the pathogenesis of canalicular cholestasis.


Depletion of GPSM1 enhances ovarian granulosa cell apoptosis via cAMP-PKA-CREB pathway in vitro.
Genetic causes of premature ovarian insufficiency (POI) account for approximately 20 ~ 25% of patients. So far, only a few genes have been identified. Here, we first identified the c.1840C > A on G-protein signaling modulator 1 (GPSM1) as a susceptibility locus for POI in 10 sporadic POI patients by whole-exome sequencing. The frequency of GPSM1 c.1840C > A was then verified as 3/20 in a POI sample of 20 patients (including the above 10 patients) by Sanger sequencing. RT-PCR and western blot analysis showed the expression of GPSM1 in rat ovaries was increased in the large antral follicle stage compared to the primordial follicle stage (P < 0.01). The cell proliferation assay (CCK8) and flow cytometry suggested that the small-interfering RNA-induced silencing of Gpsm1 significantly increased apoptosis and decreased proliferation of rat ovarian granulosa cells (GCs) (P < 0.01). Furthermore, suppression of Gpsm1 in GCs reduced levels of cAMP, PKAc, p-CREB as well as the ratio of Bcl-2/Bax, and increased the expression of Caspase-3 and Cleaved Caspase-3 (P < 0.01). In summary, this study identified a susceptibility variant GPSM1 c.1840C > A of POI for the first time. Gpsm1 was related to rat follicle development, and silencing of Gpsm1 increased apoptosis and decreased proliferation in rat GCs, possibly through inhibition of the cAMP-PKA-CREB pathway.


Characterization of the effects of histamine on the transmembrane electrical activity of guinea-pig and rabbit SA- and AV-node cells.
The effects of histamine on the transmembrane electrical activity of cells of small preparations (0.5 X 0.5 mm) of guinea-pig and rabbit sinoatrial- and atrioventricular-nodes were studied. Histamine at concentrations above 10(-7) mol/l increased the firing rate, the rate of diastolic depolarization, the maximum diastolic potential, the amplitude and the maximum rate of depolarization of the action potential of pacemaker cells of rabbit and guinea-pig sinoatrial cells and rabbit atrioventricular cells. These effects were antagonized by the H2-receptor blocker cimetidine (2.5 X 10(-6)mol/l) but they were not modified by the H1-receptor blocker chlorphenamine (2.5 and 5 X 10(-6)mol/l). Small preparations of guinea-pig atrioventricular node did not exhibit spontaneous activity, but it was induced by histamine and blocked by cimetidine. Histamine increased the maximum upstroke velocity of propagated action potential of cells of the central part of complete atrioventricular node in both species studied. These effects were blocked by cimetidine, but not by chlorphenamine. It is concluded that the increase in automaticity induced by histamine in guinea-pig and rabbit sinoatrial and atrioventricular nodes was due to stimulation of H2-receptors. Histamine did not depress electrical activity of atrioventricular node cells, but rather increased it. This effect was due to H2-receptor stimulation.


Breast cancer knowledge and screening behaviors of female teachers: A cross-sectional survey in Buraydah, Saudi Arabia.
Breast cancer is the second commonest cause of cancer-related deaths in Saudi Arabia. However, several women bypass early discovery and management possibilities. This cross-sectional study was conducted in the governmental secondary girls' schools in Buraydah city, Saudi Arabia, during the period from August 2019 to January 2020. The data were collected using a valid pretested structured self-administered questionnaire. The study included 316 female teachers. The total breast cancer knowledge score was abnormally distributed, as evidenced by significant Shapiro-Wilk test, P < 0.001. The mean ± SD score was 10.66 ± 3.73 (maximum possible score: 15) and the median (IQR) was 11 (8-13). Less than half (42.7%) of the teachers reported performing breast self-examination (BSE (while only 9.5% went to a clinic for clinical breast examination. BSE was performed on monthly basis by only 14.8% of those practiced it. Ignorance of the examination and fear to discover a tumor were mentioned by 24.9% for each as a reason for not performing BSE, whereas 42.5% of those who did not practice it had no definite reason. Mammogram was ever practiced by 22.5% of the female teachers. Older teachers (40-50) reported higher rates of performing mammogram compared to those aged <40, P = 0.012. Also, teachers who had friends with breast cancer were practiced mammogram at higher rate than their counterparts, P = 0.025. The breast cancer knowledge is overall insufficient regarding risk factors and clinical presentation. Improving knowledge regarding risk factors, presentation, and screening tools as BSE and mammogram through educational programs is highly recommended.


[Surgeon's Impact on Graft Endothelial Cell Density and Corneal Thickness after Penetrating Keratoplasty for Keratoconus and Fuchs' Dystrophy].
The aim of this study was to examine the short- and long-term variability of graft endothelial cell density (ECD) and central corneal thickness (CCT) after penetrating keratoplasty (PKP) between different surgeons. 370 eyes with keratoconus (KC) or Fuchs' dystrophy (FUCHS) after standardised primary excimer laser PKP (four experienced surgeons) were analysed. ECD and CCT were determined at 12 months after PKP before suture removal, and at two years after final suture removal. 12 months after PKP, ECD was significantly higher for surgeon 1 in FUCHS as compared to surgeons 3 (p = 0.05) and 4 (p = 0.04), in KC it was significantly higher for surgeon 1 as compared to surgeon 2 (p = 0.001) and for surgeon 1 as compared to surgeon 4 (p = 0.006). However, in FUCHS this difference was no longer significant two years after suture removal (p > 0.5), and in KK only in comparison of surgeons 1 and 2 (p = 0.04). RESULTS concerning CCT were inhomogeneous. The surgeon's individual handwriting seems to have an impact on the ECD in the short-term after PKP. However, differences between surgeons tend to become insignificant in the long run after suture removal.


[Study on acupuncture and moxibustion for treatment of spinal cord injury at the rehabilitation stage].
To explore the mechanism and methods of acupuncture for the patient of spinal cord injury at the stage of rehabilitation. Expound the mechanism of acupuncture for treatment of spinal cord injury and put forward some personal opinions about acupuncture treatment methods according to clinical practice of many years. Acupuncture treatment can improve the motor function at the stage of rehabilitation in the patient of spinal cord injury.


[Multiple cutaneous neoplasms following repeated fluoroscopic examinations. (A case of clear-cell malignant hidradenoma associated with intra-epidermal epitheliomas of the Bowen type)].
A case of some neoplastic lesions of the skin of the back, arisen on undamaged skin, in a patient who underwent therapeutic pneumothorax and was submitted to several fluoroscopic examinations for pulmonary tuberculosis many years ago, is reported and discussed. An attempt of evaluation of the exposure to the ionizing radiations received by the interscapular region of the patient is made. The malignant clear-cell hidradenoma is a very rarely observed carcinoma: nine cases have been so far described.


Performance of WHO growth standards on Indian children with growth related disorders.
To assess performance of WHO 2006 standards on anthropometric measurements of children referred for growth related disorders to a speciality pediatric clinic in Pune, India, from June 2006 through June 2010. Data presented in this study were collected retrospectively from case records of all children from birth to 60 mo (n=1840, mean age 2.7±1.3 y) who presented with growth related disorders; healthy age and sex matched children were recruited as controls (n=824, mean age 2.8±1.2 y). Children were divided as per their clinical diagnosis into eight different groups: growth hormone deficiency, bone disorders, syndromic short stature, familial short stature, hypothyroidism, nutritional and systemic disorder, other endocrinopathies and overgrowth disorders. Anthropometric parameters for all study subjects were converted to standard deviation scores (SD scores) using the WHO Anthro 2005. Mean height SD scores of children with growth related disorders were significantly lower than that of the controls, while that of the tall children were significantly higher (p<0.05). All children who were clinically very short were below the 1st percentile, while none of the children with overgrowth or normal children were classified as stunted. Weight for height SD scores of children with nutritional and systemic disorders were the lowest, while those for the obese children were the highest. The present results suggest that the WHO 2006 growth standards classify children with growth disorders appropriately and the classification is in concordance with the clinical assessment. They provide health practitioners in a clinical setting with an effective tool to assess growth of children.


Comparison of cardiovascular aquaporin-1 changes during water restriction between 25- and 50-day-old rats.
Aquaporin-1 (AQP1) is the predominant water channel in the heart, linked to cardiovascular homeostasis. Our aim was to study cardiovascular AQP1 distribution and protein levels during osmotic stress and subsequent hydration during postnatal growth. Rats aged 25 and 50 days were divided in: 3d-WR: water restriction 3 days; 3d-WAL: water ad libitum 3 days; 6d-WR+ORS: water restriction 3 days + oral rehydration solution (ORS) 3 days; and 6d-WAL: water ad libitum 6 days. AQP1 was evaluated by immunohistochemistry and western blot in left ventricle, right atrium and thoracic aorta. Water restriction induced a hypohydration state in both age groups (40 and 25 % loss of body weight in 25- and 50-day-old rats, respectively), reversible with ORS therapy. Cardiac AQP1 was localized in the endocardium and endothelium in both age groups, being evident in cardiomyocytes membrane only in 50-day-old 3d-WR group, which presented increased protein levels of AQP1; no changes were observed in the ventricle of pups. In vascular tissue, AQP1 was present in the smooth muscle of pups; in the oldest group, it was found in the endothelium, increasing after rehydration in smooth muscle. No differences were observed between control groups 3d-WAL and 6d-WAL of both ages. Our findings suggest that cardiovascular AQP1 can be differentially regulated in response to hydration status in vivo, being this response dependent on postnatal growth. The lack of adaptive mechanisms of mature animals in young pups may indicate an important role of this water channel in maintaining fluid balance during hypovolemic state.


Examining Positive and Negative Affect as Outcomes and Moderators of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy for Social Anxiety Disorder.
Traditional cognitive-behavioral therapy (CBT) for anxiety disorders has been designed to target reductions in negative affect (NA) associated with defense-related processes. However, a subset of anxiety disorders, including social anxiety disorder (SAD), are also characterized by low positive affect (PA) resulting from separate deficits in appetitive-related processes. In contrast to CBT, "third-wave" approaches, such as acceptance and commitment therapy (ACT), align more consistently with motivational processes and, as a result, PA. However, the differential effect of CBT and ACT on PA and NA has yet to be investigated. Using secondary data from a randomized controlled trial, the present study sought to compare CBT's (n = 45) and ACT's (n = 35) effect on PA and NA in SAD. Findings were compared to a wait-list (WL) control condition (n = 31), as well as normative data from a general adult sample. Baseline PA and NA were also examined as moderators and predictors of theory-relevant treatment outcomes. NA decreased significantly in both CBT and ACT from pre to posttreatment. Although ACT outperformed WL in reducing NA, this effect was not observed for CBT. PA increased significantly in both CBT and ACT from pre to posttreatment, with neither ACT nor CBT outperforming WL in increasing PA. Neither PA nor NA were found to moderate theoretically relevant treatment outcomes. Findings suggest that ACT and CBT share common treatment mechanisms, making them more similar than distinct. Further efforts should be focused on optimizing CBT's and ACT's influence on threat and reward learning, and elucidating common processes of change.


Defibrillator/monitor/pacemakers.
In this Evaluation, we present our test results and ratings for two newly evaluated defibrillator/monitor/pacemakers--the Medtronic ERS Lifepak 20 and the Philips HeartStart MRx. We also summarize and update our findings for eight previously evaluated models that are still on the market. We rate the models based on their desirability for in-hospital applications, such as general crash-cart use and in-hospital transport use, and for prehospital applications, specifically emergency medical service (EMS) use. The primary function of the devices examined in this study is to allow operators to assess and monitor a patient's ECG and, when necessary, deliver a defibrillating shock to the heart. However, currently available models can also be equipped to do much more during a resuscitation attempt - from monitoring multiple physiologic parameters to providing noninvasive pacing capability to functioning as an automated external defibrillator (AED). Our testing examined all these capabilities to help hospital and EMS purchasers make effective selection decisions.


Chemical inducer of regucalcin attenuates lipopolysaccharide-induced inflammatory responses in pancreatic MIN6 β-cells and RAW264.7 macrophages.
We previously isolated derrisfolin A, a novel rotenoid derivative, from the stems of Derris trifoliata Lour. (Leguminosae). Here, we report that derrisfolin A induces the expression of endogenous regucalcin (RGN) protein in both pancreatic MIN6 β-cells and RAW264.7 macrophages. Induction of RGN expression by derrisfolin A or retrovirus-mediated gene transfer in MIN6 cells and RAW264.7 macrophages significantly decreased lipopolysaccharide (LPS)-induced mRNA expression of Nos2, Il1b, and Tnf via nuclear factor-κB activation; reduced LPS-induced apoptosis in MIN6 cells, accompanied by decreased production of nitric oxide, interleukin-1β, and tumor necrosis factor-α; and attenuated generation of LPS-induced reactive oxygen species, malondialdehyde, and 3-nitrotyrosine in MIN6 cells. Additionally, in co-cultures of MIN6 cells with RAW264.7 macrophages in the presence of LPS, induction of RGN expression by derrisfolin A or retrovirus-mediated gene transfer in RAW264.7 macrophages attenuated apoptosis and oxidative/nitrosative stress in MIN6 cells. These results suggest that the induction of RGN expression in MIN6 cells was effective in suppressing LPS-induced inflammatory cytotoxicity and that in co-culture conditions, the induction of RGN expression in RAW264.7 macrophages blocked LPS-induced paracrine effects of RAW264.7 macrophages on inflammatory cytotoxicity in MIN6 cells. Our findings suggest that derrisfolin A, a chemical inducer of RGN, might be useful for developing a new drug against macrophage-associated β-cell inflammation in type 2 diabetes.


Localisation of Even-skipped in the mature CNS of the locust, Schistocerca gregaria.
Even-skipped (Eve) is a transcriptional repressor found within the nuclei of a subset of neurons in the embryonic central nervous system of insects. It is necessary for neuronal pathfinding and promotes adhesion of developing motor axons to the intersegmental nerve. Here we show by immunohistochemical staining that Eve is also expressed in the nuclei of a small set of neurons in the thoracic nervous system of larval and adult locusts, suggesting a postembryonic role in transcriptional control. Thirty-two to 39 Eve-positive neurons in four distinct subsets were found in the mesothoracic ganglion of fourth instar larvae and in adults: an anterior, bilaterally paired group of 2-4 neurons; a posterior, bilaterally paired group of 12-15 neurons; 1-2 neurons in a midline position, at the centre of the ganglion; and 1-2 neurons near the midline in a posterior position. These subsets did not change in position or number of neurons within them from fourth instars through to adults, 2 and 35 days post-final moult. The metathoracic ganglion had approximately 48 Eve-positive neurons in four subsets: an anterior, bilaterally paired group of 3-4 neurons; a posterior, bilaterally paired group of 8-10 neurons; a diffuse group of 19 neurons at the midline and a group of 4 neurons in a midline, posterior position. These results suggest that Eve demonstrates both phasic and persistent expression throughout the insect's lifetime and that changes in expression are segment-specific. We suggest Eve helps maintain neural phenotype in the adult CNS, possibly by regulating the expression of cell adhesion molecules.


Hearing impairment and cognitive function among a community-dwelling population in Japan.
Hearing impairment is a prevalent and chronic condition in older people. This study investigated the relationship between cognitive function and hearing impairment in a Japanese population. A pure-tone average (0.5-2.0 kHz) was used to evaluate hearing impairment in 846 participants of the Iwaki Health Promotion Project who were aged at least 50 years old (310 men and 536 women). We also administered the Mini-Mental State Examination (MMSE), the Center for Epidemiologic Studies for Depression (CES-D) scale, Starkstein's apathy scale (AS) and the Short Form Health Survey Version 2 (SF-36v2). A multiple linear regression analysis assessed the association between hearing impairment and mental correlates. The overall prevalence of hearing impairment in this study population was 37.7%. The participants with hearing impairment were older and less educated compared to those with no hearing problems. We observed significant differences in the MMSE and AS scores between the mild/moderate to severe groups versus the non-impaired group. After adjusting for age, gender and amount of education, hearing impairment was significantly associated with MMSE and AS scores, but not with CES-D scores. Hearing impairment was significantly related to the social functioning (SF) and role emotional (RE) scores of the SF-36v2. Hearing impairment is common among older people and is associated with cognitive impairment, apathy and a poor health-related quality of life. Screening for and correcting hearing impairments might improve the quality of life and functional status of older patients.


Evaluation of the Intussusception Risk after Pentavalent Rotavirus Vaccination in Finnish Infants.
An association between rotavirus immunisation and intussusception (IS) has been suggested with present rotavirus vaccines in post-licensure studies. In Finland, rotavirus vaccination programme was implemented in September 2009 using a 2, 3, and 5 months schedule with the pentavalent rotavirus vaccine. By the end of 2013, it is estimated that 719 000 rotavirus vaccine doses have been given in the national programme of which 240 000 were first doses. Nationwide register allows us to evaluate the association between rotavirus vaccination and IS. Cases of IS diagnosed during 1999-2013 were identified from National Hospital Discharge Register. All cases under 250 days of age diagnosed during 2009-2013 were confirmed by reviewing medical charts. Self-controlled case-series method was used to assess the risk of IS during 1-21 days compared to 22-42 days post vaccination. In register data the relative incidence of IS at 2 months of age between the post and pre vaccination era was 9.1 (95%CI 2.0-84.3). We identified 22 verified cases with date of admission less than 43 days after any of the three rotavirus vaccine doses. The incidence of IS in the risk period after the 1st dose relative to the control period was 2.0 (95% CI 0.5-8.4; p = 0.34.) Number of excess IS cases per 100 000 first vaccine doses was therefore estimated to be 1.04 (95% CI 0.0-2.5), i.e. one additional IS case per 96 000 first doses of rotavirus vaccine (95% CI 54 600 to ∞). There was no risk detected after 2nd and 3rd doses. The finding is in line with the recent published estimates. The benefits of rotavirus immunisation programme outweigh possible small risks of intussusception.


In vitro and in vivo antimicrobial activity of self-assembled melittin nanoparticles: A comparative study with melittin peptide.
The aim of the present study was to analyse the efficacy of self-assembled melittin nanoparticles (MelNP) and compare with native melittin peptide (Mel). Self-assembly formation of the melittin was promoted by heating at 90 °C for 50 min followed by cooling at room temperature. SEM micrographs revealed the formation of nanovesicles. MIC of MelNP against E. coli, S. aureus and P. aeruginosa was found to be 4, 2, and 2 μM, respectively while it was 8, 8 and 4 μM for Mel peptide. Markedly, MelNP showed 12.6 % hemolysis at 8 μM whereas with Mel it was about 71.63 %. The lytic activity of MelNP was also higher in the presence of trypsin/serum than Mel. Both MelNP and Mel exhibited membranolytic activity with cellular disintegration. Further, toxicity analysis studied up to 72 h showed that MelNP was non-toxic to zebrafish embryos up to 6 μM; however, with Mel exposed embryos showed up 30 dead embryos. Bacterial load was markedly reduced in MelNP and Mel exposed infected embryos than compared to the infected one. Moreover, the peptides were also responsible for reducing the infection and prolonging the survivability in infected embryos. Thus, MelNP could be considered an efficient and safer therapeutic molecule that Mel and wherein further experiments are warranted to affirm the broad spectrum efficiency.


Association between the Finnish Diabetes Risk Score and cancer in middle-aged and older adults: Involvement of inflammation.
Diabetes is associated with increased risk of common cancers. However, evidence of cancer risk in individuals with different diabetes risk is still scarce, and the underlying mechanism remains unknown. Therefore, we aimed to evaluate the relationship between the Finnish Diabetes Risk Score (FINDRISC) and risks of cancer incidence and mortality in a prospective study, and to explore whether low-grade inflammation partially mediated the association. A total of 330,384 participants aged 37 to 73 at baseline from the UK Biobank database was included in this study. The Cox proportional hazards model was used to examine the relationship of the FINDRISC and low-grade inflammation with risks of cancer incidence and mortality. Then, we estimated the contribution of higher FINDRISC to risks of overall and site-specific cancers. In addition, the role of low-grade inflammation in the association between FINDRISC and cancer risks was investigated through mediation analysis. The increased FINDRISC was dose-dependently associated with higher incidence and mortality risks of overall cancer and an overwhelming majority of site-specific cancers. The higher FINDRISC was a strong contributor to incidence of eighteen site-specific cancers and mortality of fourteen site-specific cancers, with a population-attributable risk of 8.1 %-39.1 %, 14.2 %-39.7 %, respectively. Additionally, low-grade inflammation mainly mediated the association between the FINDRISC and risks of incidence and mortality of overall cancer, colorectal cancer, etc. CONCLUSIONS: Our findings highlighted the higher FINDRISC as critical risk factors of cancer incidence and mortality, partially mediated by low-grade inflammation. Individuals with increased risk of diabetes are also needed to be concerned about cancer prevention.


The natural process of congenital nasolacrimal duct obstruction and effect of lacrimal sac massage.
This study aimed to examine the rate of symptomatic improvement of congenital nasolacrimal duct obstruction (CNLDO) in infants treated with conservative management within the first year of age. Other purpose of the study is to emphasize the relationship between spontaneous resolution time and effective lacrimal sac massage. Thirty-one infants were diagnosed to have CNLDO by an ophthalmologist prior to 3 months of age. In this study, 36 eyes of 31 patients were included with CNLDO. The patients were divided into two groups. Group 1 (28 eyes of 24 patients) was consisted of the patients who were applied effective lacrimal sac massage regularly during the follow-up period, and patients whose parents did not apply a regular lacrimal passage regularly were accepted as group 2 (8 eyes of 7 patients). Thirty-three eyes of 31 patients (18 rights and 15 left) successfully resolved with only conservative management (91.6 %). In these thirty-three eyes, one eye (3 %) resolved between 0 and 3 months, fourteen eyes (42.5 %) resolved between 4 and 6 months, eleven eyes (33.3 %) resolved between 7 and 9 months, and seven eyes (21.2 %) resolved between 10 and 12 months. CNLDO was resolved in 27 (96.2 %) of 28 eyes in group 1, and in group 2, six eyes (77.7 %) had resolvement. This difference was statistically significant (p = 0.001). The mean age of resolution was 6.8 ± 1.88 months in group 1, 10.3 ± 1.5 months in group 2 (p < 0.001). In light of our study, we believe that conservative management of CNLDO is highly successful. Our study provided a possible objective explanation for the efficacy of lacrimal sac massage. Emphasizing the importance of the massage to parents and describing in detail can reduce the risk of unnecessary surgical interventions.


Assisted reproductive technology and the risk of pregnancy-related complications and adverse pregnancy outcomes in singleton pregnancies: a meta-analysis of cohort studies.
To determine whether there are any increases in pregnancy-related complications and adverse pregnancy outcomes in singleton pregnancies after assisted reproductive technology (ART) compared with those conceived naturally. Meta-analysis. University-affiliated teaching hospital. Singleton pregnancies conceived with ART and naturally. PubMed, Google Scholar, Cochrane Libraries and Chinese database were searched through March 2015 to identify studies that met pre-stated inclusion criteria. Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates. Subgroup analysis was performed to explore potential heterogeneity moderators. Pregnancy-related complications and adverse pregnancy outcomes. Fifty cohort studies comprising 161,370 ART and 2,280,241 spontaneously conceived singleton pregnancies were identified. The ART singleton pregnancies had a significantly increased risk of pregnancy-induced hypertension (relative risk [RR] 1.30, 95% confidence interval [CI] 1.04-1.62; I(2) = 79%), gestational diabetes mellitus (RR 1.31, 95% CI 1.13-1.53; I(2) = 6%), placenta previa (RR 3.71, 95% CI 2.67-5.16; I(2) = 72%), placental abruption (RR 1.83, 95% CI 1.49-2.24; I(2) = 22%), antepartum hemorrhage (RR 2.11, 95% CI 1.86-2.38; I(2) = 47%), postpartum hemorrhage (RR 1.29, 95% CI 1.06-1.57; I(2) = 65%), polyhydramnios (RR 1.74, 95% CI 1.24-2.45; I(2) = 0%), oligohydramnios (RR 2.14, 95% CI 1.53-3.01; I(2) = 0%), cesarean sections (RR 1.58, 95% CI 1.48-1.70; I(2) = 92%), preterm birth (RR 1.71, 95% CI 1.59-1.83; I(2)=80%), very preterm birth (RR 2.12, 95% CI 1.73-2.59; I(2) = 90%), low birth weight (RR 1.61, 95% CI 1.49-1.75; I(2) = 80%), very low birth weight (RR 2.12, 95% CI 1.84-2.43; I(2) = 67%), small for gestational age (RR 1.35, 95% CI 1.20-1.52; I(2) = 82%), perinatal mortality (RR 1.64, 95% CI 1.41-1.90; I(2)=45%), and congenital malformation (RR 1.37, 95% CI 1.29-1.45; I(2)=41%). Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. No evidence of publication bias was observed. The ART singleton pregnancies are associated with higher risks of adverse obstetric outcomes. Obstetricians should manage these pregnancies as high risk.


Endoscopy of the airway in infants and children.
We believe that many of our readers will appreciate having some familiarity with the procedures described in this manuscript. For those who have had difficulty in deciding whether the need for diagnosis justifies the risk of a procedure, this perspective will shed new light on the problem. It is appropriate to warn our readers that complete unanimity on several points is not yet evident. For example, the indications for flexible bronchoscopy, by whom the procedure should be done, and even more specific technical aspects are questions not completely resolved. However, this article is not an effort to instruct anyone in how to do the procedure. Rather, it is an effort to acquaint our readers with progress in the field. With that in mind, we are confident that the remaining questions will be answered on the basis of the training, experience, and, ultimately, the good judgment of all the physicians involved.


Advantages of topical marcaine during spinal surgery. Technical note.
Marcaine applied to irritated nerve roots during extradural spinal surgery may attenuate sympathetically mediated and somatosensory (pain)-related hypertensive and tachycardic crises.


Leukoplakia of the labial commissure.
A white lesion located in the labial commissure can pose problems for both the clinician and the pathologist. The clinician may be limited in his surgical treatment because of aesthetic reasons, whilst the pathologist may be confronted with a lesion with or without candidal involvement, showing the histological features of hyperplastic candidiasis, verrucous hyperplasia, verrucous carcinoma, epithelial dysplasia, carcinoma-in-situ and, occasionally, squamous cell carcinoma. A retrospective study was undertaken of 10 patients with leukoplakic commissural lesions, who visited the Department of Oral Surgery in the Teaching Hospital of the Free University, Amsterdam in the period between 1973-1986. The clinical and histopathological findings are presented. Although a carcinoma in this particular region is rather rare, alertness remains necessary as one patient with the clinical appearance typical of leukoplakia, showed on biopsy the presence of a squamous cell carcinoma at this first visit. In another two patients the areas of leukoplakic change were shown histologically to be based on verrucous carcinoma. In one patient a squamous cell carcinoma developed after several years, in spite of treatment. In view of the small number of patients under discussion and also the somewhat debatable diagnosis of verrucous carcinoma, we do not feel justified in drawing any firm conclusions from our findings with regard to the malignant potential of leukoplakia of the oral commissures.


Theophylline pharmacokinetics in patients with bronchopulmonary dysplasia.
Theophylline is commonly used to decrease airway resistance in patients with bronchopulmonary dysplasia (BPD). Little is known, however, about theophylline's pharmacokinetics in infants' with BPD. The objectives of this study were: (i) to examine the pharmacokinetics of theophylline; and (ii) to assess the intrapatient variation in theophylline serum concentration in BPD. Nineteen patients (gestational age: 27-33 weeks, postnatal age: 12-165 days) received 2-12 mg/kg/day theophylline. Multiple serum concentrations of theophylline were determined in each patient. Apparent clearance of theophylline ranged from 0.28 to 0.51 ml/min/kg. The steady-state trough serum concentration of theophylline ranged from 3.5 to 11.2 micrograms/ml. Based on our data, theophylline doses of 4-7 mg/kg/day may be required to achieve an average steady-state serum concentration of 10 micrograms/ml. Substantial intrapatient (twofold) variability was observed in theophylline concentrations normalized for dose during therapy. The data indicate that the theophylline serum concentration should be monitored for individualizing therapy in infants with BPD.


Psychological adjustment of 'surgery-only' pediatric neuro-oncology patients: a retrospective analysis.
A recent increase in diagnoses of pediatric neuro-oncology tumors combined with recent advancements in medical treatment of such tumors has resulted in a growing cohort of pediatric brain tumor survivors. These survivors are at risk for short and long-term psychological adjustment problems. Most studies regarding these survivors have focused on children who have received combinations of surgery, radiation, and chemotherapy as medical treatment. The sub-group of pediatric neuro-oncology patients who receive surgery as the only form of medical treatment has not been closely followed for adjustment problems. In this study, data were retrospectively collected from semi-structured clinical interviews with 34 'surgery-only' pediatric neuro-oncology patients who were 2 weeks to 5 years off medical treatment for their tumor. These data suggest that these survivors may be experiencing significant short and long-term mood, behavioral, and academic adjustment problems in comparison to national averages for children regarding these issues. Additional research examining the psychological adjustment process for surgery-only pediatric neuro-oncology patients is needed to validate these preliminary findings and facilitate the development of targeted interventions to address the identified adjustment problems.


Introduction to Epitaxial growth of nanostructures and their properties.
Professor Jin Zou introduces the Nanoscale Advances themed collection on Epitaxial growth of nanostructures and their properties.


Insight into carbapenem resistance and virulence of Acinetobacter baumannii from a children's medical centre in eastern China.
Carbapenem-resistant Acinetobacter baumannii (CRAB) appeared more frequently in children and caused a great threat to global public health. It is urgent to investigate the carbapenem resistance and virulence of CRAB for clinicians to choose appropriate antibiotics. A retrospective study of 77 nonduplicated CRAB isolates was conducted. The carbapenem resistance and virulence genes were characterized by polymerase chain reaction (PCR) and gel electrophoresis. In the present study, A. baumannii mainly came from the intensive care unit and was mostly isolated from sputum samples. The carbapenem resistant rate of A. baumannii in 2018-2020 increased significantly compared with that in 2016-2017. All isolates had carbapenem resistant genes. They were highly resistant to a variety of antibiotics but were relatively sensitive to fluoroquinolones and tetracyclines. blaVIM and blaOXA-23 were detected in all isolates, whereas blaOXA-51, blaIMP and blaNDM were present in 98.70%, 67.53% and 31.17% of isolates, respectively. Notably, 1 isolate A. baumannii was identified as multidrug-resistant A. baumannii (MDR-AB), and 76 other extensively drug-resistance (XDR) isolates were also detected. Virulence genes were present in 100% of all isolates, including genes in the iron acquisition system (basJ), secretion systems (ompA, plcD), quorum sensing system (abaI) and biofilm formation (csuA). adeH, pgaA, and ptk were present in 98.70%, 98.70% and 94.80% of isolates, respectively. CRAB, which is prevalent in east China, carries a large number of drug resistance and virulence genes. Fluoroquinolones and tetracyclines may be effective antibiotics for the treatment of CRAB infection in children. An in-depth understanding of the resistance and virulence of CRAB is conducive to timely guiding empirical drug use and controlling infection.


Hepatocellular carcinoma in patients without cirrhosis in Italy.
In the Western world, hepatocellular carcinoma seldom develops in patients without cirrhosis, and reports describing the characteristics of non-cirrhotic patients with hepatocellular carcinoma are rather infrequent. We evaluated the main clinical characteristics, treatment options, and survival of patients with hepatocellular carcinoma developed in non-cirrhotic liver among the 3027 consecutive cases of hepatocellular carcinoma accrued in the Italian Liver Cancer database during the last 20 years. We identified 52 patients with hepatocellular carcinoma in non-cirrhotic livers (1.7% of all hepatocellular carcinomas), 42 with (80.8%) and 10 without (19.2%) chronic liver disease. In patients without chronic liver disease, median tumour diameter was greater compared to patients with chronic liver disease (7.8 versus 4.0 cm, P=0.046). Curative treatment was feasible in 20 patients (38.5%). Median overall survival was 26 months and 5-year survival rate was 23.7%. Detection of hepatocellular carcinoma outside surveillance (P=0.036), advanced hepatocellular carcinoma stage (P<0.0001), and non-curative treatment (P=0.007) were associated with worse prognosis, but tumour stage was the only independent predictor of survival. In Italy, less than 2% of hepatocellular carcinomas develop in a non-cirrhotic liver, and almost never in a normal liver. These patients frequently present with advanced tumours, have low eligibility rates for curative treatment, and have a dismal prognosis despite their preserved liver function.


Respective roles of immune and nutritional factors in the priming of the immune response in the elderly.
Ninety-six institutionalized elderly (greater than 70 years old) (mean age: 82 +/- 7 years) subjects, negative for tetanus toxoid antibodies were primed with tetanus toxoid vaccination and dinitrochlorobenzene (DNCB). Correlations were studied between some immunological parameters, nutritional parameters prior to immunization and the immune response intensity after it. Levels of tetanus toxoid specific IgG (ELISA assay) were positively correlated with monocyte phagocytosis, DNCB response and prealbumin levels, and negatively correlated with total IgG, monocyte immune degradation and tetanus toxoid lymphocyte stimulation. No correlation was observed with IgA, IgM, PHA stimulation. Tetanus toxoid lymphocyte stimulation correlated positively with response to DNCB, and negatively with tetanus toxoid IgG as well as total IgG. DNCB response correlated with prealbumin, tetanus toxoid IgG and tetanus toxoid lymphocyte stimulation. Therefore, it appears that malnutrition, as measured by prealbumin level, is one of the main factors contributing to the inconstant senile immunodeficiency. Monocyte antigenic degradation function unaltered with age can impair immune response while conserved or increased phagocytosis enhances immune response in the elderly. High total IgG levels were linked with low specific responses to priming antigens. High specific antibody levels also correlated negatively with cellular specific response. It is assumed that regulatory IgG antibody accumulation, likely anti-idiotypic antibodies, play an important role in senile immunological depletion.


Perianal Bowen's disease.
Thirty-three patients with perianal Bowen's disease were treated at the Cleveland Clinic Foundation from 1954 to 1986. Twenty-one patients were women and 12 were men, ranging in age from 30 to 69 years (mean, 48 years). Twenty patients (61 percent) presented with symptomatic perianal disease, while 13 patients (39 percent) were noted as having perianal Bowen's disease upon pathologic examination of routine hemorrhoidectomy specimens. Ten of the patients (30 percent) had prior histories of unrelated cancer. Twenty-seven patients were managed by wide local excision, three patients by simple excision, three patients by fulguration, and one patient by an abdominoperineal resection. During a follow-up period averaging 3.7 years (range, 0.3 to 10 years), one patient developed a new invasive skin cancer while a second patient experienced a recurrence of perianal Bowen's disease. The characteristic gross appearance of this lesion and its failure to respond to conventional therapy should prompt the performance of a biopsy, which readily establishes the diagnosis. This experience confirms that wide local excision is adequate therapy for perianal Bowen's disease and that close clinical follow-up is necessary to identify disease recurrence or the development of a malignancy.


A mixture model for signature discovery from sparse mutation data.
Mutational signatures are key to understanding the processes that shape cancer genomes, yet their analysis requires relatively rich whole-genome or whole-exome mutation data. Recently, orders-of-magnitude sparser gene-panel-sequencing data have become increasingly available in the clinic. To deal with such sparse data, we suggest a novel mixture model, Mix. In application to simulated and real gene-panel sequences, Mix is shown to outperform current approaches and yield mutational signatures and patient stratifications that are in higher agreement with the literature. We further demonstrate its utility in several clinical settings, successfully predicting therapy benefit and patient groupings from MSK-IMPACT pan-cancer data. Availability: https://github.com/itaysason/Mix-MMM .


Identification of Cryptosporidium isolates from cockatiels by direct sequencing of the PCR-amplified small subunit ribosomal RNA gene.
Cryptosporidium is a significant pathogen in humans and animals. Cases of infection by C. meleagridis or C. baileyi with zoonotic potential have also been reported in domestic birds; and recent studies indicate the presence of new host-adapted species or genotype in birds. Therefore, accurately identifying isolates is important for understanding the epizootiology of Cryptosporidium infection in birds and for the control of human cryptosporidiosis. Cryptosporidium has been detected in cockatiels, but the species or genotype of isolates remains unclear because identification was performed using conventional microscopy. We report herein the species or genotype of isolates from two cockatiels distinguished by a PCR-based diagnostic method. The isolates were found to be C. meleagridis and C. baileyi, respectively. This study documents the first discovery of C. meleagridis and C. baileyi in cockatiels and suggests that pet birds may play an important role in the epidemiology of cryptosporidiosis.


Nutritional ecology, infection and immune defence - exploring the mechanisms.
Diet can impact the outcome of parasitic infection in three, non-mutually exclusive ways: 1) by changing the physiological environment of the host, such as the availability of key nutritional resources, the presence of toxic dietary chemicals, the pH or osmolality of the blood or gut, 2) by enhancing the immune response and 3) by altering the presence of host microbiota, which help to digest nutrients and are a potential source of antibiotics. We show that there are no clear patterns in the effects of diet across taxa and that good evidence for the mechanisms by which diet exerts its effects are often lacking. More studies are required to understand the mechanisms of action if we are to discern patterns that can be generalised across host and parasite taxa.


Synthesis of 1,2-dihydro-2-oxo-4-quinolinyl phosphates from 2-acyl-benzoic acids.
We report a facile synthesis of 1,2-dihydro-2-oxo-4-quinolinyl phosphates (1a-l) starting from 2-acyl-benzoic acids (2a-l) in the presence of phosphoryl azides via a one-pot cascade reaction involving a Curtius rearrangement, an intramolecular nucleophilic addition of the enol carbon to the isocyanate intermediate, and an addition-elimination of the enol oxygen to the phosphoryl azide. During the reaction three new bonds are formed under mild conditions to yield 1,2-dihydro-2-oxo-4-quinolinyl phosphates in modest yields.


Binder-free CuS/ZnS/sodium alginate/rGO nanocomposite hydrogel electrodes for enhanced performance supercapacitors.
CuS/ZnS/sodium alginate/reduced graphene oxide nanocomposites (CZSrG) were prepared by physical crosslinking followed by one-step reduction and were justified as green binder-free hydrogel high-capacitance electrodes. The physical crosslinking was realized simply through the hydrogen-bond interaction between sodium alginate (SA) and graphene oxide (GO), avoiding the usage of traditional Ca2+ crosslinking agent. The hydrogel structure made of CZSrG possessed the most beneficial effect of avoiding large volume change and increasing cycle stability for supercapacitors. When used as electrode, the specific capacitance of CZSrG was 992 F·g-1 (10 mV·s-1) in a three-electrode system. Furthermore, the fabricated supercapacitors had a specific capacitance of 252.1 F·g-1 (5 mV·s-1), and a power density of 1800 Wh·kg-1 at the energy density of 2.05 Wh·kg-1. Thus, the CZSrG has a favorable electrochemical performance and wide application prospects in supercapacitors.


Genes, pseudogenes and like genes: the case of 21-hydroxylase in Italian population.
Recently, we have considered two new findings in genetics of 21-hydroxylase deficiency with great interested: the existence of rare RCCX trimodular haplotypes, where the CYP21A2 like-gene downstream of the TNXA gene carries from one to six pseudogene mutations, and population specific allelic frequencies of wild-type CYP21A2 loci in the CYP21A1P pseudogene. Both these events represent a further complication in CYP21A2 genetics. Therefore, the choice of the molecular protocol becomes a crucial point when genetic analysis is required. In this regard, we must consider that the literature is still lacking consistent data on the Italian population. For this reason, we report genetic results obtained on 375 healthy individuals of Italian origin. Different genetic protocols were compared and novel molecular strategies were performed. In our group, only two known haplotypes were identified. In addition, specific allelic frequencies of CYP21A2 wild-type loci in the pseudogene have been established. Based on our results, we can affirm that the employment of different molecular methods is necessary to ensure a correct CYP21A2 genotyping. In order to avoid mistakes both in patient diagnosis and/or in risk evaluation of the relatives, each case should be investigated in function of a careful clinical evaluation and the molecular test should be performed in specialized centres.


Prospective intolerance of uncertainty is associated with maladaptive temporal distribution of avoidance responses: An extension of Flores, López, Vervliet, and Cobos (2018).
Excessive maladaptive avoidance has been claimed to be one of the mechanisms through which intolerance of uncertainty (IU) may play its causal role in the development and maintenance of several anxiety and compulsive disorders. Consistently, Flores et al. (2018) found that individuals with higher Prospective IU (P-IU), a specific IU subfactor, display excessive avoidance response repetitions in a free-operant discriminative task to avoid an aversive noise. In the present study we tested the hypothesis that P-IU not only predicts the amount of avoidance responses but also how well the temporal distribution of such responses fits the temporal distribution of threats. Further correlation and hierarchical regression analysis of Flores et al.'s (2018) data served to test this hypothesis. We evaluated two aspects of the temporal distribution of responses: a) for how long participants were performing the responses; b) the behavioral discrimination between threatening and safe time periods. The results showed that scoring high in P-IU was positively associated with longer periods of time dedicated to avoiding and with worse behavioral discrimination between threatening and safe time periods. Hierarchical regression analyses indicated that later addition of inhibitory intolerance of uncertainty and trait anxiety did not significantly improved the explained variance. Our results are exclusively based on the use of a low-cost avoidance response, and the present study does not clarify the precise mechanisms that lead high P-IU people to engage in non-optimal avoidance response distribution through time. These results suggest that excessive avoidance is also driven by uncertainty of threat timing and highlight the relevance of P-IU as a vulnerability factor for excessive and outspread avoidance behaviors.


Pathogenesis of Delayed Tension Intraventricular Pneumocephalus in Shunted Patient: Possible Role of Nocturnal Positive Pressure Ventilation.
Delayed intraventricular pneumocephalus is a very rare and potentially serious complication of ventriculoperitoneal shunt. It can occur several months or years after shunting. Its pathogenesis is unclear. We herein discuss the underlying mechanisms and particularly the possible role of positive pressure ventilation. A 60 year-old man presented with a lateral ventricle neurocytoma microsurgically resected complicated by a late-onset (15 months) postoperative hydrocephalus requiring an adjustable ventriculoperitoneal (VP) shunt. One month later, the patient was diagnosed with a sleep apnea and required a continuous positive airway pressure (CPAP) device. A few weeks afterward the patient presented with headaches and alteration of consciousness. CT-Scan revealed a massive intraventricular pneumocephalus associated with a millimetric left petrous bone defect. A transient breakout of the positive ventilation and a subtemporal surgical repair of the defect led to the rapid resolution of the pneumocephalus. Delayed intraventricular pneumocephalus requires two conditions: a VP shunt and an osteodural defect. The CPAP may play an important trigger role in the pathogenesis of this complication through a ball valve mechanism. The management relies on transient suspension of the positive ventilation and the surgical repair of the identified defect with or without pressure adjustments of the valve. Intraventricular pneumocephalus is a potentially serious complication of patients with a VP shunt and receiving positive pressure ventilation. The introduction of a CPAP device must be discussed with the neurosurgeon beforehand in shunted patients.


Intra-abdominal pressure: an integrative review.
There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. RESUMO Em pacientes críticos com quadros abdominais agudos a esclarecer é crescente a solicitação da aferição da pressão intra-abdominal. Sintetizar resultados de pesquisas sobre a mensuração da pressão intra-abdominal pela via vesical e analisar o nível de evidência foram os objetivos desta revisão integrativa da literatura, realizada nas bases LILACS, MEDLINE e PubMed, no período de 2005 a julho de 2012. Identificaram-se 20 artigos, sendo 12 revisões de literatura, 4 estudos exploratório-descritivos, 2 opiniões de especialistas, 1 estudo de coorte prospectivo e 1 relato de experiência. O método vesical para mensuração da pressão intra-abdominal foi considerado padrão-ouro. Existem variações na técnica, entretanto pontos em comum foram identificados: posição supina completa, na ausência de contratura abdominal, ao final da expiração e expressa em mmHg. A maioria indica posicionar o ponto zero do transdutor na linha axilar média, ao nível da crista ilíaca e instilar 25ml de solução salina estéril. Evidências fortes precisam ser desenvolvidas.


Temperature difference between bulk and surface transition in freely suspended smectic films.
We report an ellipsometric study of freely suspended films of a chiral liquid-crystal compound possessing the phase sequence smectic-C-smectic-A-isotropic with a very broad (67 K) smectic-A phase range. We observe a smectic-C-smectic-A surface transition which is situated more than 60 K above the bulk smectic-C-smectic-A transition temperature. Possible reasons for this unusually large temperature shift are discussed.


Trajectories of regenerating retinal axons in the goldfish tectum: II. Exploratory branches and growth cones on axons at early regeneration stages.
HRP was applied to small sites in the dorsotemporal or dorsonasal retina in fish at 10-36 days after optic nerve section. The anterogradely labeled axons were visualized in tectal whole mounts. Axons traveled through all regions of the tectum in various abnormal routes. Misrouted axons were also seen to alter their orientation and to direct their course toward their target. At all regeneration stages the majority of dorsotemporal axons coursed and achieved target-related orientations preferentially within the rostral tectal half whereas dorsonasal axons proceeded into the caudal tectum. The growing axons exhibited various morphologies. All axons in the superficial fascicle layer stratum opticum (SO) and some in the synaptic layer stratum fibrosum et griseum superficiale (SFGS) were unbranched and tipped with a leading growth cone. Other axons in the synaptic layer carried one to several growth cones at their ends and often filopodia proximal to the growth cone, or they had sprouted numerous side branches with growth cones and filopodia on the shaft and on branches. Some axons at retinotopic or ectopic sites gave rise to several long branches of several hundred microns in length, with growth cones and filopodia. From 32 days onward axons ending in terminal arbors at retinotopic sites became apparent. Thus, numerous axons at early regeneration stages go through a phase of exploratory growth on their way toward their target sites.


Soluble Siglec-9 suppresses arthritis in a collagen-induced arthritis mouse model and inhibits M1 activation of RAW264.7 macrophages.
The aim of this study was to assess the effects of soluble sialic acid-binding immunoglobulin-type lectin (sSiglec)-9 on joint inflammation and destruction in a murine collagen-induced arthritis (CIA) model and in monolayer cultures of murine macrophages (RAW264.7 cells and peritoneal macrophages) and fibroblast-like synoviocytes (FLS) derived from patients with rheumatoid arthritis. DBA/1J mice were immunized with type II collagen. Effects of sSiglec-9 were evaluated using a physiologic arthritis score, histological analysis, serum tumor necrosis factor (TNF)-α concentration, and the proportion of forkhead box P3 (Foxp3)-positive regulatory T (Treg) cells. In vivo biofluorescence imaging was used to assess the distribution of sSiglec-9. Levels of M1 (TNF-α, interleukin [IL]-6, and inducible nitric oxide synthase) and M2 (CD206, Arginase-1, and IL-10) macrophage markers and phosphorylation of intracellular signaling molecules were examined in macrophages, and levels of matrix metalloproteinase (MMP)-1, MMP-3, and MMP-13 were examined in FLS. sSiglec-9 significantly suppressed the clinical and histological incidence and severity of arthritis. The proportion of Foxp3-positive Treg cells significantly improved and serum TNF-α concentration decreased in vivo. Although sSiglec-9 reduced the expression of M1 markers in macrophages, it did not affect the expression of M2 markers and MMPs in FLS. Nuclear factor (NF)-kB p65 phosphorylation was attenuated by sSiglec-9, and chemical blockade of the NF-kB pathway reduced M1 marker expression in RAW264.7 cells. In this study, we have demonstrated the therapeutic effects of sSiglec-9 in a murine CIA model. The mechanism underlying these effects involves the suppression of M1 proinflammatory macrophages by inhibiting the NF-kB pathway. sSiglec-9 may provide a novel therapeutic option for patients with rheumatoid arthritis refractory to currently available drugs.


The effects of hormonal and other stimuli on cell-surface Ro/SSA antigen expression by human keratinocytes in vitro: their possible role in the induction of cutaneous lupus lesions.
Ultraviolet B light (UVB) has previously been shown to induce the expression of the extractable nuclear antigens (e.g. Ro/SSA) on the surfaces of human keratinocytes in vitro. This study assessed whether injurious, metabolic, inflammatory, immunological or hormonal stimuli would also induce this expression or modulate that produced by UVB. No stimulus initiated expression alone, but 17-beta oestradiol doubled that found in response to UVB. These findings confirm the potential role of UVB in the initiation and potentiation of cutaneous lupus lesions and may help to explain the female preponderance of the disease.


Knowledge, attitudes, beliefs, and behaviors of parents and healthcare providers before and after implementation of a universal rotavirus vaccination program.
In Canada, rotavirus vaccine is recommended for all infants, but not all provinces/territories have publicly funded programs. We compared public and healthcare provider (HCP) knowledge, attitudes, beliefs, and behaviors in a province with a public health nurse-delivered, publicly funded rotavirus vaccination program to a province with a publicly funded, physician-delivered program. A third province with no vaccination program acted as a control. Information about knowledge, attitudes, beliefs, and behaviors of parents whose children were eligible for the universal program and healthcare providers responsible for administering the vaccine were collected through the use of two validated surveys distributed in public health clinics, physicians' offices, and via e-mail. Early and postvaccine-program survey results were compared. A total of 722 early implementation and 709 postimplementation parent surveys and 180 early and 141 postimplementation HCP surveys were analyzed. HCP and public attitudes toward rotavirus vaccination were generally positive and didn't change over time. More parents postprogram were aware of the NACI recommendation and the vaccination program and reported that their healthcare provider discussed rotavirus infection and vaccine with them. Prior to the program across all sites, more physicians than nurses were aware of the national recommendation regarding rotavirus vaccine. In the postprogram survey, however, more nurses were aware of the national recommendation and their provincial universal rotavirus vaccination program. Nurses had higher knowledge scores than physicians in the postprogram survey (p<0.001). Parents of young infants were also more knowledgeable about rotavirus and rotavirus vaccine in the two areas where universal programs were in place (p<0.001). Implementation of a universal rotavirus vaccination program was associated with an increase in knowledge and more positive attitudes toward rotavirus vaccine amongst parents of eligible infants. Nurses involved in a public health-delivered vaccination program were more knowledgeable and had more positive attitudes toward the vaccine than physicians in a jurisdiction where vaccine was physician-delivered.


Light-mediated activation of Rac-1 in photoreceptor outer segments.
Small GTP binding proteins regulate diverse biological processes including gene expression, cytoskeleton reorganization, and protein and vesicular transport. While small GTPases have been investigated in a wide variety of cells, few studies have addressed their role in photoreceptors. In vertebrate retinal rods, the light stimulus is transmitted from rhodopsin via the pathway mediated by the heterotrimeric G protein transducin. To increase their sensitivity to light, photoreceptors accumulate remarkably high concentrations of rhodopsin and transducin in specialized cellular compartments, the outer segments (OS). Transport of these proteins from the inner segments is regulated by the small GTPases Rab6 and Rab8, which do not enter OS. Here, we asked if small G proteins have other functions in photoreceptors. We show that OS contain the small GTPase Rac-1, a member of the Rho family. In contrast to other cells, Rac-1 in OS is exclusively associated with the membranes and resides in lipid rafts. Most importantly, Rac-1 is activated by light. This activation is specifically blocked by a synthetic peptide corresponding to the Asn-Pro-X-X-Tyr motif found in rhodopsin, and Rac-1 coprecipitates with rhodopsin on Concanavalin A Sepharose. These data provide the first direct evidence for the existence of a novel pathway activated by rhodopsin.


Clinicopathologic factors linked to oncologic outcomes for renal cell carcinoma with sarcomatoid dedifferentiation: A PRISMA-compliant systematic review and meta-analysis.
There are still differences in the prognostic factors of renal cell carcinoma with sarcomatoid dedifferentiation (sRCC). The aim of this study was to evaluate important predictors of survival in patients with sRCC. A comprehensive search of PubMed, Embase, and Cochrane Library was conducted to identify eligible studies. The endpoints embraced overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS). Hazard ratios (HRs) and related 95% confidence intervals (CIs) were extracted. A total of 13 studies were included for analyses. The pooled results showed that high European Cooperative Oncology Group performance score (HR 2.39, 95% CI 1.32-4.30; P = 0.004), high T stage (HR 2.18, 95% CI 1.66-2.86; P < 0.001), positive lymph node (HR 1.54, 95% CI 1.40-1.69; P < 0.001), distant metastasis (HR 2.52, 95% CI 1.99-3.21; P < 0.001), lung metastases (HR 1.45, 95% CI 1.16-1.80; P < 0.001), liver metastases (HR 1.71, 95% CI 1.30-2.25; P < 0.001), tumor necrosis (HR 1.78, 95% CI 1.14-2.80; P = 0.010), and percentage sarcomatoid ≥50% (HR 2.35, 95% CI 1.57-3.52; P < 0.001) were associated with unfavorable OS. Positive lymph node (HR 1.57, 95% CI 1.33-1.85; P < 0.001) and high neutrophil to lymphocyte ratio (HR 1.16, 95% CI 1.04-1.29; P = 0.008) were associated with unfavorable CSS. High T stage (HR 1.93 95% CI 1.44-2.58; P < 0.001) was associated with unfavorable progression-free survival. A meta-analysis of available data identified important prognostic factors for CSS, OS, and PFS of sRCC, which should be systematically evaluated for patient counseling, risk stratification, and treatment selection. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=249449.


Highly sensitive electrochemical detection of immunospecies based on combination of Fc label and PPD film/gold nanoparticle amplification.
A highly sensitive electrochemical immunoassay strategy based on the combination of ferrocene (Fc) label and poly(o-phenylenediamine) (PPD) film/gold nanoparticle (GNP) amplification for the detection of immunospecies is proposed using human IgG as the model analyte. A gold electrode is firstly modified with an electropolymerized film of poly(o-phenylenediamine), which provides a stable matrix with abundant amino-groups for the fabrication of sensing interface. Using glutaraldehyde as a cross-linker, cystamine is coupled onto the modified electrode. Subsequently, gold nanoparticle monolayer is assembled onto the resulting surface. Making use of the unique properties of gold nanoparticles, antibodies can be self-assembled onto the surface-confined gold nanoparticles via amine-Au affinity with a high loading amount and reserve high immunological activity. After the introduction of model analyte, the ferrocene (Fc)-labeled antibody is immobilized on the sensing interface by antibody-antigen specific reaction, resulting in a redox current signal. The peak current is proportional to the amount of the analyte. Under the optimized experimental conditions, the proposed sensing strategy provides a wide linear dynamic range from 25 to 1000 pg/mL with a low detection limit of 10 pg/mL. In addition, good reproducibility, high selectivity and stability are achieved. In particular, the extremely high stability of both poly(o-phenylenediamine) and gold nanoparticle monolayer allows the designed biosensing interface to withstand harsh regeneration treatment, making it reusable.


Signs of early damage in glaucomatous monkey eyes: low spatial frequency losses in the pattern ERG and VEP.
Experimental glaucoma was created in one eye of three cynomolgus monkeys by argon laser application to the mid-trabecular meshwork. Simultaneous pattern electroretinograms (PERG) and pattern visual evoked potentials (PVEP) were measured in both control and glaucoma eyes to spatial frequencies of 0.5, 1.25, 2.5, and 3.5 cpd which were counterphase modulated at 6 Hz. The transient flash electroretinogram was also measured. While normal flash electroretinograms were recorded in all eyes both before and after the unilateral production of elevated intraocular pressure (IOP), reductions in PERG and PVEP amplitude were seen in the eyes with glaucoma as early as two weeks following a sustained increase of IOP, despite the absence of cupping of the optic nervehead judged by ophthalmoscopic examination and analysis of photograph by two observers. Optic nervehead abnormalities occurred subsequently. In glaucomatous monkey eyes, the earliest PERG and PVEP changes were most evident with lower spatial frequencies of stimulation. Our data suggest that the optimal stimulus parameters for the detection of early glaucoma are low spatial frequency patterns presented at a rapid rate of temporal modulation.


Applicability of the Debye-Waller damping factor for the determination of the line-edge roughness of lamellar gratings.
Periodic nanostructures are fundamental elements in optical instrumentation as well as basis structures in integrated electronic circuits. Decreasing sizes and increasing complexity of nanostructures have made roughness a limiting parameter to the performance. Grazing-incidence small-angle X-ray scattering is a characterization method that is sensitive to three-dimensional structures and their imperfections. To quantify line-edge roughness, a Debye-Waller factor (DWF), which is derived for binary gratings, is usually used. In this work, we systematically analyze the effect of roughness on the diffracted intensities. Two different limits to the application of the DWF are found depending on whether the roughness is normally distributed or not.


Systematic review of evidence to support the theory of psychobiotics.
The theory that supplemented probiotic bacteria could affect psychological outcomes has recently been outlined in narrative reviews; to date, however, this area of research has not been systematically reviewed. The objective of this review was to compare the effects of probiotics with those of placebo on psychological outcomes and symptoms of psychiatric disorders. The Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PubMed, PsycINFO, and PsycARTICLES databases were searched electronically for studies published up to July 17, 2014. Reference lists of relevant articles were searched manually. Only double-blind, randomized, placebo-controlled human trials that used a standardized, validated scale to assess the effects of probiotic interventions compared with placebo on psychological outcomes or symptoms of psychiatric disorders were included. Two researchers independently assessed trials and evaluated them for methodological quality. Data were extracted from the included studies using a data extraction form. Ten trials met the inclusion criteria. Overall, there is very limited evidence for the efficacy of probiotic interventions in psychological outcomes. The evidence base is incomplete and lacks applicability. More trials are necessary before any inferences can be made about the efficacy of probiotics in mental health applications.


Cervical cancer of the uterus complicated by renal AA amyloidosis.
Cervical cancer of the uterus rarely develops systemic secondary amyloidosis. We present the case of a 66-year-old female patient who manifested systemic amyloid A (AA) amyloidosis in the kidney, digestive tract, and cervix of the uterus, secondary to cervical cancer. She exhibited nephrotic syndrome, intractable diarrhea, and mild fever 3 months after she underwent an extended hysterectomy with postoperative cisplatin-based chemotherapy and whole pelvic irradiation. Further examinations revealed AA amyloidosis of the kidney and colon and cytomegalovirus infection in the colon. AA amyloid deposition was positive in the resected tissues of uterine cancer. The patient was diagnosed with systemic AA amyloidosis consecutive to cervical cancer. Despite a decrease in urinary protein after antiviral therapy, it increased 14 months later with neither apparent symptoms nor an increase in tumor marker. A second renal biopsy revealed AA amyloidosis of the kidney. Subsequent investigations revealed the recurrence of cervical cancer in the lung, liver, and lymph nodes. This case report indicated that AA amyloidosis would complicate cervical cancer and recur even after resection of neoplasm owing to other stimulation. Moreover, urine protein could be a marker for cancer relapse in known cases of cancer-derived AA amyloidosis.


NGS meta data analysis for identification of SNP and INDEL patterns in human airway transcriptome: A preliminary indicator for lung cancer.
High-throughput sequencing of RNA (RNA-Seq) was developed primarily to analyze global gene expression in different tissues. It is also an efficient way to discover coding SNPs and when multiple individuals with different genetic backgrounds were used, RNA-Seq is very effective for the identification of SNPs. The objective of this study was to perform SNP and INDEL discoveries in human airway transcriptome of healthy never smokers, healthy current smokers, smokers without lung cancer and smokers with lung cancer. By preliminary comparative analysis of these four data sets, it is expected to get SNP and INDEL patterns responsible for lung cancer. A total of 85,028 SNPs and 5738 INDELs in healthy never smokers, 32,671 SNPs and 1561 INDELs in healthy current smokers, 50,205 SNPs and 3008 INDELs in smokers without lung cancer and 51,299 SNPs and 3138 INDELs in smokers with lung cancer were identified. The analysis of the SNPs and INDELs in genes that were reported earlier as differentially expressed was also performed. It has been found that a smoking person has SNPs at position 62,186,542 and 62,190,293 in SCGB1A1 gene and 180,017,251, 180,017,252, and 180,017,597 in SCGB3A1 gene and INDELs at position 35,871,168 in NFKBIA gene and 180,017,797 in SCGB3A1 gene. The SNPs identified in this study provides a resource for genetic studies in smokers and shall contribute to the development of a personalized medicine. This study is only a preliminary kind and more vigorous data analysis and wet lab validation are required.


Recovery of Agrobacterium tumefaciens T-DNA molecules from whole plants early after transfer.
A system for the analysis of independent T-DNA transfer events from Agrobacterium to plants is described. The complete T-DNA except for the 25 bp border sequences was replaced by one genome of a plant virus so that upon transfer to the plant, a viable replicon is produced by circularization. Rescue of virus from such infected plants allowed analysis of DNA sequences at or close to the ends of T-DNA molecules. A rather conserved right border remnant of three nucleotides was found, whereas the sequences remaining at the left end were more variable. A point deletion in the left 25 bp sequence results in even less precise processing at the left end. In addition, many rescued T-DNA molecules carry small direct repeats between the joined T-DNA ends; linear T-DNA molecules are therefore transported to the plant.


Mycobacterium avium-complex pericarditis: a case of unmasking immune reconstitution inflammatory syndrome.
Immune reconstitution inflammatory syndrome is a clinical entity with a broad presentation, described in both HIV and non-HIV-infected patients. We report a case of Mycobacterium avium-complex pericarditis as a rare but life-threatening manifestation of this syndrome in a patient with AIDS.


Improved Survival of Elderly-fit Patients With Acute Myeloid Leukemia Requiring Intensive Therapy: 3-Year Multicenter Analysis From TALWG.
Elderly patients with acute myeloid leukemia (AML) have a poorer prognosis than younger ones. Several factors contribute to the poor outcomes for this patient group. This study investigated the epidemiology, clinical characteristics, treatment, and clinical outcomes of elderly Thai patients with AML. This 3-year, prospective, multicenter study was focused on Thai patients with AML aged over 60 years who were diagnosed between 2014 and 2016. Of 680 patients with AML, 235 elderly patients with AML (34.6%) were identified, with a mean age of 70 ± 8 years. Using a 3-group cytogenetic risk classification (favorable, intermediate, and adverse risk), the proportions of patients in each category were 3.6%, 73.8%, and 22.6%, respectively. The median follow-up time for surviving patients was 846 days. The median overall survival (OS) of the patients was 128.2 days (range, 0-1205 days), with a 1-year OS of 13%. From a multivariate analysis, the significant factors associated with an improved long-term OS were patients with an Eastern Cooperative Oncology Group performance status 0 to 2 and those receiving intensive therapy. Our study confirms the high prevalence of AML in elderly patients with generally poor outcomes. Selected patients with a good performance status and those who received intensive induction treatment could have a long-term survival.


[Study of normal range of speed of sound in tibia in Beijing area].
To study the normal reference value of adult tibial speed of sound (tibia SOS) in Beijing region. 951 normal volunteers (male/female = 461/490) were included in this study. Speed of sound were measured in the middle of tibia by ultrasound scan (Sound Scan 2000, Myrid, Isereal). According to their gender and age, all subjects were divided into different subgroup by 10 year-age period. The peak value of SOS presented in 30-39 years period in both male and female. The peak value was higher in males than in females. After reach the peak value, the tibial SOS begin to decline. The decreasing rate was fast in SOS were found at 50-59 period in female and over 50-59 years old in male. The tibia values of SOS of postmenopausal was obviously lower than that of premenopausal women. The relationship of menopausal duration and the values if tibial SOS was found to be a non-linear curve, which included 3 stages: the quick decrease, stabilization and further decrease. The tibia values of SOS provides a kind of meaningful diagnostic criteria of osteoporosis.


Natural occurrence of zeralenone in feeds and feedstuffs used in poultry and pig nutrition in colombia.
A total of 200 samples of feedstuffs and mixed feeds used for poultry and pig nutrition in Colombia were analysed for zearalenone using a LC technique with a limit of detection of 20 μg/kg. Samples of grain sorghum, maize, processed soybean, rice meal, cottonseed meal, and poultry and pig feeds, representative of the Colombian production for the 1995-1996 harvest, were taken at feed manufacturing plants located in different cities of the country. Zearalenone was detected in 25 of 45 samples of sorghum, 2 of 33 samples of maize, 7 of 22 samples of rice meal, 9 of 17 samples of cottonseed meal, 11 of 30 samples of poultry feed and 6 of 16 samples of pig feed. Zearalenone was not detected in soybean or other feedstuff s analysed (wheat by- products, cassava meal, palm). Overall levels of zearalenone ranged from 29 to 3956 μg/kg, with a mean value of 436 μg/kg. Only one of the 6 positive samples of pig feed had a zearalenone concentration above 500 μg/kg, which is normally considered as the safe level for pigs.


An unexpectedly labile mitochondrially encoded protein is required for Mta expression.
Maternally transmitted antigen (Mta) is a mouse major histocompatibility antigen recognized by cytotoxic T lymphocytes. A role for mitochondria in expression of this class I-like cell surface antigen has been previously established. We now show that a labile product of mitochondrial protein synthesis is required for Mta expression. Reexpression of Mta determinants after enzymatic removal occurred within 24 h, and the regeneration process was sensitive to chloramphenicol (CAP), a selective inhibitor of mitochondrial protein synthesis. Additionally, target cells treated with CAP for as little as 18 h showed diminished expression of Mta. The estimated half-life for Mtf products ranged from 6 to 15 h, less than the half-lives of known mitochondrial translation products. This suggests that the Mtf product is not generated by the normal turnover of stable mitochondrial respiratory proteins. Instead, these results indicate the existence of either labile unknown mitochondrially encoded peptides or a rapid turnover pathway for known mitochondrial products.


The GOLD initiative 2011: a change of paradigm?
Ten years after the publication of the first GOLD strategy (Global Strategy for the Diagnosis, Management, and Prevention of COPD) for chronic obstructive pulmonary disease (COPD), the new revision published on the GOLD website at the end of 2011 represents a significant change in the diagnostic approach, clinical evaluation and therapeutic treatment of the disease. This revision debates not only the most significant aspects, which remain relatively intact, but also, and in particular, those that have been substantially modified compared with the GOLD revision from 2006.


Oleanolic acid derivative methyl 3,11-dioxoolean-12-en-28-olate targets multidrug resistance related to ABCB1.
Multidrug resistance (MDR) in leukemia patients is a great incentive to the development of new drugs. In a search for potential multidrug resistance modulators we tested a group of oleanolic acid (OA) analogues modified at C-3, C-11, C-12 and C-28 using an experimental model consisting of three human acute lymphoblastic leukemia cell lines (CCRF-CEM and the multidrug resistant sublines CCRF-VCR1000 and CCRF-ADR5000). The most effective compound, methyl 3,11-dioxoolean-12-en-28-olate (DIOXOL) was more potent in cell viability inhibition than its precursor - OA, and showed similar or even higher activity in the drug resistant than in the wild-type cells. Resistance factor (RF) values obtained for CCRF-VCR1000 and CCRF-ADR-5000 cells using MTT assay were 0.7 and 0.8 (24 h of treatment) and after 72 h of treatment 0.9 and 1.1, respectively. Moreover, 5 μM DIOXOL significantly reduced the expression of the ABCB1 gene in MDR cells by around 30%, and also decreased the level of P-gp protein. Compared to untreated control cells, DIOXOL treatment resulted in a significant P-gp decrease (30% in CCRF-ADR5000 and 50% in CCRF-VCR1000), that was detected by western blot and confirmed by flow cytometry analysis. Moreover, DIOXOL (at 10 μM) significantly inhibited P-gp transport function by more than twofold comparing to control, untreated cells that was demonstrated using rhodamine 123-based functional test. The compound exhibited synergistic activity with ABCB1 substrate - adriamycin in CCRF-VCR1000 cells, indicating partial but significant MDR reversing ability.


Examining the validity and reliability of childhood abuse scales: putting The Courage To Heal to the test.
The main purpose of the current study was to examine the validity and reliability of The Courage To Heal Workbook checklist (Davis, 1990) in part, through examining the internal consistency and studying whether the CTHC distinguished between the participants reporting sexual abuse histories and those who did not. Two hundred and seventy-nine college students were surveyed utilizing the symptom checklist from the Courage to Heal Workbook, Trauma Symptom Checklist-40 (TSC-40), Abusive Behavior Inventory (ABI), and questions related to participants' beliefs that they had been abused as a child. Results indicated that the Courage to Heal Checklist (CTHC) has robust reliability (alpha = .97) and can significantly discriminate between reported abuse survivors and nonsurvivors. Fifty-five percent of those participants reporting sexual abuse, 47% of those reporting physical abuse, and 34% of those reporting emotional abuse indicated a period of time during which they did not remember the abuse. Results indicate that the CTHC reliably differentiated between participants reporting past sexual abuse and those who did not. Mounting evidence continues to support that adult symptom profiles are able to indicate that some form of trauma is likely to have occurred in the past; however, differentiating between types of abuse based on symptom profiles may be impossible.


Experimental study of a newly developed bilayer artificial skin.
A bilayer artificial skin composed of an outer layer of silicone polymer and an inner sponge layer of collagen containing chondroitin 6-sulphate was developed by modifying the technique proposed by Yannas et al. The artificial skin was placed on the skin defects on the backs of rats. Histological observation indicated that fibroblasts and capillaries infiltrated into the pores and filled in lattice spaces, resulting in synthesis of the connective tissue matrix and absorption of the original network of collagen and chondroitin 6-sulphate. Epidermal cells migrated from the edge of the wound between the two layers. Post-operative contracture in the wound with the artificial skin was significantly less than in the control.


Fetal pulmonary cyst: intrauterine diagnosis and management.
This case report describes the antenatal diagnosis of a fetal pulmonary anomaly. Early detection afforded detailed parental counseling and prompt neonatal diagnosis and treatment.


Current assessment and future directions of surgical skills laboratories.
Educational, medicolegal, and financial constraints have pushed surgical residency programs to find alternative methods to operating room teaching for surgical skills training. Several studies have demonstrated that the use of skills laboratories is effective and enhances performance; however, little is known about the facilities available to residents. A survey was distributed to 40 general surgery program directors who, in an earlier questionnaire, indicated that they had skills laboratory facilities at their institutions. The survey included the following sections: demographics, facilities, administrative infrastructure, curriculum, learners, and opinions/thoughts of program directors. Of the 34 program directors that completed the survey, 76% are from a university program. The average facility is 1400 square feet, and most skills laboratories are located in the hospital. Nearly all skills facilities have dry laboratories (90%), and the most common equipment is box trainers (90%). Average start-up costs were $450,000. Sixty-two percent of programs have a skills curriculum for residents. Responders agreed that skills laboratories have a high value and should be part of residency curricula. The results of this survey provide a preliminary view of skills laboratories. There is variation in the size, location, and availability of simulators in skills laboratory facilities. Variations also exist in types of curricula formats, subspecialties who make use of the laboratory, and some administrative approaches. There is strong agreement among respondents that skills laboratories are a necessary and valuable component of residency education. Results also indicated concerns for recruiting faculty to teach in the skills laboratory, securing ongoing funding, and implementing a skills laboratory curriculum.


Boron oxynitride two-colour fluorescent dots and their incorporation in a hybrid organic-inorganic film.
Bottom-up synthesis of fluorescent boron-nitride based dots is a challenging task because an accurate design of the structure-properties relationship is, in general, difficult to achieve. Incorporation of the dots into a solid-state matrix is also another important target to develop light-emitting devices. Two-colour fluorescent boron oxynitride nanodots have been obtained by a bottom-up synthesis route and incorporated into a hybrid organic-inorganic film. A combination of different analytical techniques such as XPS, XRD, TEM, UV-Vis, TGA-DTA and fluorescence has been used to characterise the structure, composition and properties of the boron oxynitride dots. The presence of defects in the boron oxynitride structure is the source of the two-colour fluorescence. The BN dots thermal stability is limited to around 100 °C; higher temperatures induce condensation of the structure, which leads to a lower emission. Upon incorporation into a hybrid organic-inorganic film deposited by spin-coating, the boron oxynitride dots maintain their fluorescence and have shown to be highly compatible with the sol-gel chemistry.


The impacts of the COVID-19 pandemic on the teaching of dentistry in Brazil.
A new disease called coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) virus, was discovered in the city of Wuhan in China in December 2019, and has reached, quickly and progressively, several countries on different continents. Even before the World Health Organization recognized the COVID-19 epidemic as a pandemic, the Brazilian Ministry of Health had already declared COVID-19 a national public health emergency due to the confirmation of cases in Brazil. In this scenario, the educational sector was one of the first to suffer the effects of the pandemic soon after the announcement of social distancing as a way to prevent the collapse of the Unified Health System. The aim of this paper is to report how Brazilians dental schools are leading with the new coronavirus pandemic.


[Evaluation of a referral protocol to primary health care for patients eligible for health service access points following hospitalization].
PASS is a hospital care unit that provides access to health care for precarious persons and supports them as soon as they have obtained primary health care insurance. No details of this support had previously been described. A Hospital-to-Community protocol for referral to the public health system has been developed at the adult PASS unit of the Marseille public hospitals (AP-HM). The objectives of this study are to describe how this protocol is applied, to evaluate at six months the inclusion in general practice of patients having benefited (or not) from this protocol and to determine the key influencing factors. This two-arm prospective observational study collected data on the primary care pathways of precarious patients six months after their having obtained health coverage, and found out whether or not the newly existing protocol had been effectively implemented. It was carried out on a cohort of people included in the PASS-MULTI study who had acquired complete health coverage. Sixty patients were included between November 2020 and August 2022, 35 of whom had availed themselves of the Hospital-to-Community protocol. Among them, 68.8% in the interventional group had consulted their referring general practitioner within six months, vs. 40% in the control group (p = 0.04). The initiation of follow-up in general medicine was associated with application of the protocol (p = 0.04). This study described an initial Hospital-to-Community protocol for referral to the primary healthcare system of patients followed up in the PASS unit and found an association between application of this protocol and initiation of follow-up in primary healthcare.


The silent crisis of child abuse in the COVID-19 pandemic: A scoping review.
The global outbreak of COVID-19 has become an international concern. The lives of children are severely affected by COVID-19 pandemic. There is evidence of a pandemic impact on violence against children. This scoping review study aimed to investigate the effects of the COVID-19 pandemic on child abuse. We searched PubMed, Scopus, and Web of Science databases to retrieve related studies. Regarding the recent incident of COVID-19, the articles were reviewed from 2019 to June 1, 2021. The terms Child abuse and COVID-19 were used in the precise search technique of each database. The search techniques were created to work with any scientific database that used the keywords given. In the initial search of scientific databases, 568 articles were retrieved. After applying the inclusion and exclusion criteria during the screening process, 16 papers were included in the scoping review. Twelve articles have mentioned the increase of physical, psychological, and neglect types of abuse. However, sexual violence has not been reported in any of the articles. Four articles reported a reduction in the incidence of child abuse. During the COVID-19 pandemic, a crisis occurred in the form of an upsurge in violence toward children, since limits made to diminish the virus, in general, increased the danger to children. Numerous factors such as stress, poverty, financial situation, history of violence, school closures, and lack of contact with support organizations contribute to this phenomenon. Social action and support needed is the right of every child in need in this critical situation.


Intrauterine inflammation alters cardiopulmonary but not cerebral hemodynamics during open endotracheal tube suction in preterm lambs.
Intrauterine inflammation adversely affects cardiopulmonary, systemic, and cerebral hemodynamics in preterm neonates, but its impact on responses to endotracheal tube (ETT) suction, known to affect hemodynamics, is unknown. We hypothesized that intrauterine inflammation would alter the cardiopulmonary and cerebral hemodynamic response to open ETT suction in preterm lambs. Chronically instrumented fetuses received intra-amniotic lipopolysaccharide (LPS; to induce intrauterine inflammation) or saline at 118 d of gestation (term ~147 d). At 125 d of gestation, lambs were delivered and mechanically ventilated. Open ETT suction was performed 30 min after delivery. Pulmonary and cerebral arterial pressures and flows were recorded continuously. Intrauterine inflammation reduced pulmonary blood flow (PBF) and increased pulmonary vascular resistance (PVR) after preterm birth. PBF and left-ventricular output (LVO) increased during and immediately after ETT suction in both groups, but the values were higher in LPS-exposed lambs. Preductal oxygenation significantly decreased during ETT suction but to a greater extent in LPS-exposed lambs. Cerebral blood flow and systemic arterial pressure were increased by open ETT suction similarly in the two groups. Intrauterine inflammation exacerbates the neonatal hemodynamic response to open ETT suction.


[3H]LY341495, a highly potent, selective and novel radioligand for labeling Group II metabotropic glutamate receptors.
We report herein the synthesis and pharmacological characterization of a tritiated version of the potent and selective cyclopropyl amino acid LY341495 as a radioligand to label group II metabotropic glutamate receptors in rat brain homogenates.


Perspectives on children's autistic traits in UK-based British and Egyptian/Sudanese communities.
While most autism research is conducted in White Western samples, culture may affect perceptions and reporting of autistic traits. We explored how UK-based British and Egyptian/Sudanese communities perceive autism features. Nineteen participants self-identifying as British and 20 as Egyptian/Sudanese participated in focus group discussions on child development norms, and individual interviews on items of the Autism-spectrum Quotient: Children's version (AQ-Child; Auyeung et al., 2007), measuring autistic traits. Data were analysed using template analysis. Three themes were developed: 1) Value judgements of behaviours; 2) Considerations on differences between children; 3) Problematic interpretations of AQ-Child items. These processes may affect how parents and community members report on children's autistic traits. Cross-cultural comparisons suggested subtle differences in interpretations and judgements, and British participants referred to age expectations and comparisons with other children more than Egyptian/Sudanese participants. However, within-group variability, sometimes attributed to socioeconomic status and generation, appeared larger than cross-cultural differences. Our findings further the insights on influence of culture and within-community factors on reporting children's behaviour relevant to autism. These can inform the adaptation of screening tools in multi-cultural settings, to promote better autism recognition in communities where it may be underdiagnosed.


Psychopharmacohazardology: major hazards of the new generation of psychotherapeutic drugs.
Balancing the benefits and risks of prescribing psychotherapeutic drugs requires knowledge of the baseline risks of genetics, lifestyle and morbidity of untreated illness. Superimposed upon these risks are some rare but potentially dangerous, uncomfortable or irreversible hazards of the antipsychotics, mood stabilizers, antidepressants and tranquillizers. Knowledge of these hazards facilitates monitoring and prompt intervention at the earliest sign of problems.