Clinical Comparison of 2 Trial-of-Void Methods After Outpatient Midurethral Sling Placement.
This study aimed to assess the efficacy, efficiency, and costs of 2 methods of trial of void (TOV) after midurethral sling (MUS) placement. A retrospective chart review was performed on women who underwent outpatient MUS between January 2013 and April 2014 by 3 urologists. Patients were excluded if they had a concomitant prolapse repair, hysterectomy, bladder/urethral injury, or any procedure that may prolong recovery room (RR) stay. Trial of void was performed by either (1) bladder instillation, catheter removal in the operating room (OR) fill with attempted void in RR, or (2) bladder instillation and catheter removal with immediate attempted void in the RR fill. Intraoperative, postoperative, and cost data were analyzed. Ninety-one of 183 women (mean age, 55.9 ± 12 years; mean body mass index, 28.8 ± 5.8 kg/m) met inclusion criteria. Eighty-three had a transobturator sling. Forty-nine (54%) had an OR fill and 42 (46%) had an RR fill; age and body mass index were similar between groups. The OR fill group had shorter median operative time (15 vs 22 minutes; P = 0.003) and median RR time (138 vs 161, P = 0.033). The OR fill and RR fill groups did not differ in TOV failure rate (3/49 vs 6/42; P = 0.29), overall mean LOS (4.96 vs 5.51 hours; P = 0.055), and median RR costs ($627 vs $678; P = 0.065). No patient had urinary retention after successful TOV. After MUS placement, both OR fill and RR fill TOV methods are effective and efficient with similar TOV failure rates.


The Role of Depression on Treatment Adherence in Patients with Heart Failure-a Systematic Review of the Literature.
Although poor medication adherence is considered an impacting risk factor for worsening heart failure (HF) outcomes, adherence rates in HF patients continue to be considerably low. To improve this condition, several studies investigated the impact of many determinants on medication adherence; however, few authors explored the role of depression on it. The purpose of this systematic review was to explore the association between depressive symptoms and medication adherence in HF patients. In particular, the research question was is depression a barrier to medication adherence in HF patients? A systematic review of quantitative analysis studies was undertaken. Six electronic databases were searched between the end of October and March 2022. Thirty-one trials were included, all of them assessed depression, adherence to medication, and their possible relationship. As was intended, findings showed that the impact of a mild to moderate level of depression was significant on adherence to treatment in HF patients. However, many other risk factors emerged, like family support and health practices (es. low sodium diet). The detection of depression in the setting of HF should be crucial to HF patients' physical health and quality of life. Future research should take depression into account, exploring this area through self-report and qualitative interview as well.


Implications of the new hospice legislation and the accompanying regulations.
Recent government intervention into hospice care resulted from legislation designed to provide payment for care for Medicare recipients. The new regulations are reviewed, financial ramifications are investigated, and the possible implications of this reimbursement system are addressed.


Electrocardiographic Reference Values in Clinically Healthy Lusitano Horses.
The Lusitano horse is gaining popularity in the equestrian world, and as a result, the significance of applied sports medicine for this breed is growing. As cardiology plays a crucial role in this field, numerous studies have been conducted to establish electrocardiographic reference values in various breeds to ensure a more accurate evaluation. However, studies regarding healthy Lusitano horses are lacking. So, this study aimed to establish electrocardiographic reference values for Lusitano horses, utilizing a sample of 82 clinically healthy animals. The evaluation involved lead II and base-apex lead measurements, with a median heart rate of 39 beats per minute being recorded. The P wave demonstrated a predominantly bifid configuration, while the QRS complex exhibited various forms. The most common QRS configurations were QR and R in lead II, and RS in the base-apex lead. Additionally, most T waves displayed a biphasic shape in both methods. Furthermore, statistically significant differences were noted based on age and gender. Some of the electrocardiographic values obtained differed from those previously published for other breeds. Given the relevance of electrocardiogram in cardiovascular evaluation, these findings bring valuable insights regarding the specific parameters for Lusitano horse and emphasize the importance of obtaining breed-specific electrocardiographic reference values.


Tablet Apps and Dexterity: Comparison Between 3 Age Groups and Proof of Concept for Stroke Rehabilitation.
Touch screen tablet technology might be suitable for self-training of impaired dexterity poststroke. We compared performance of app-based hand activities in individuals without a disability from 3-age groups, and assessed the feasibility of using tablet apps in individuals with stroke. Experiment I included 172 Individuals without a disability: 79 young adults (26.2 [3.9] years old), 61 middle-aged adults (55.9 [5.1] years old), and 32 older adults (68.7 [3.0] years old). Experiment II included 20 individuals with stroke, aged 59.3 ± 13.7 years with impairment of the upper extremity. All participants performed the app-based "Tap-it" (tapping) task twice and the Nine Hole Peg Test. The stroke group practiced with additional apps and underwent clinical assessments. Significant differences in the tapping task performance were found between the 3 age groups (dominant hand time: F(2,169) = 30.57; P = 0.0001; and accuracy F(2,169) = 25.20; P = 0.0001; nondominant hand time: F(2,169) = 35.09; P = 0.0001; and accuracy F(2,169) = 19.62; P = 0.0001). Of the 20 individuals with stroke, 15 were able to complete the 2 trials of the tapping task, but all participants reported enjoying the experience and thought the apps may have potential for stroke rehabilitation to improve performance of the stroke-affected hand. Performance of tablet app-based hand activities was affected by impaired hand dexterity in older participants without a disability and in participants with stroke. Tablet apps may potentially provide a way to facilitate self-training of repetitive, task-oriented, isolated finger and hand movements to improve hand dexterity and function after stroke.Video abstract available for additional insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A118).


Neither glycine-extended gastrin nor the 1-13 fragment of gastrin 17 influences gastric acid secretion in humans.
The effect on gastric acid secretion of two gastrin 17-related peptides without the carboxyamide, i.e., the glycine-extended 5-17 fragment and the 1-13 fragment of human gastrin 17, was examined in normal subjects. Acid secretion was stimulated by an intravenous infusion of 21 pmol/kg.h of gastrin 17 or by intragastric instillation of peptone; gastric acid output during simultaneous infusion of 325 pmol/kg.h of the glycine-extended 5-17 fragment or 319 pmol/kg.h of the 1-13 fragment was then compared with acid output during infusion of saline. Neither the glycine-extended 5-17 fragment nor the 1-13 fragment of gastrin 17 influenced gastric acid secretion. By gel and ion-exchange chromatography of serum drawn during infusion, the infused peptide was recovered at the position of the intact synthetic peptide. The disappearance curve of circulating glycine-extended gastrin could be described by two components with half-lives of 3.6 and 48 min. As the glycine-extended fragment was stable in serum or plasma in vitro for 1 h at 37 degrees C, the rapid elimination observed in vivo cannot be ascribed to circulating plasma enzymes.


The Haemoglobins of Algae.
In the last few years, advances in algal research have identified the participation of haemoglobins in nitrogen metabolism and the management of reactive nitrogen and oxygen species. This chapter summarises the state of knowledge concerning algal haemoglobins with a focus on the most widely used model system, namely, Chlamydomonas reinhardtii. Genetic, physiologic, structural, and chemical information is compiled to provide a framework for further studies.


[An enquiry into the WILDE-Intelligence-Test (WIT): comparability of application of the paper-pencil-version vs. the computer based application -- an analysis based on data of the Leipzig Vocational Retraining Center].
This report investigates the equivalence of the computerized version of the WILDE intelligence test (WIT) and its paper-and-pencil analog in a group of occupationally reorienting adults at the Leipzig Vocational Retraining Centre (Berufsförderungswerk Leipzig). In particular, the normative as well as the structural equivalence of the two test formats (paper-and-pencil vs. computer) were examined. The results indicate that both test formats are measuring the same construct, i. e., the two tests are structurally equivalent. Significant differences in mean for the total scores of most of the WIT subtests favour separate standardization of the computerized test format.


Diet restriction in mice causes a decrease in hippocampal choline uptake and muscarinic receptors that is restored by administration of tyrosine: interaction between cholinergic and adrenergic receptors influencing cognitive function.
We have studied the effects of diet restriction (DR) to 60% and 40% of daily requirements, and tyrosine administration on cognitive function in mice, to define the nutritional-neurochemical interactions on autonomic tone involved in behavior and energy regulation. Cognitive function in the Morris Water maze was significantly impaired after 40% DR compared to both control and 60% DR. It was restored after tyrosine in association with increased M1 cholinergic and beta-adrenergic receptor function, and decreased alpha-adrenergic function. DR to 40% significantly decreased choline uptake (p <.05) and M1 receptor number (Bmax) (p <.05), without changes in affinity (Kd), choline acetyl transferase (ChAT) or acetyl cholinesterase (AChE) activity. Tyrosine administration significantly increased choline uptake (Bmax) (p <.05) and M1 density in the 40% DR (p <.01) without changes in affinity. ChAT activity was decreased after tyrosine--significantly after 40% DR (p <.05) while AChE was not affected. Both M1 mRNA and protein were not influenced by DR or tyrosine administration. Tyrosine hydroxylase mRNA was decreased significantly by 40% DR (p <.01). The effect of DR and tyrosine appeared to be both pre- and post-synaptic, indicating modulation of cholinergic activity by adrenergic tone. Nutritional effect on behavior and autonomic tone may have implications for the treatment of mood changes associated with weight loss and semi-starvation.


Polarization of plasma membrane glycoconjugates in amphibian epidermis during metamorphosis.
Wheat germ agglutinin (WGA) binding sites have been examined in tadpole epidermal cells at the level of both light and electron microscopy using the WGA-ovomucoid-gold technique. In premetamorphic tadpoles the reaction was observed on the plasma membranes of epithelial cells showing a gradient from inner to outer membranes. These glycoconjugates were polarized during development, and at the end of metamorphic climax they were only located in plasma membranes of stratum corneum. The existence of an apical cell surface coat is needed to facilitate the absorption of water through the adult epidermis. The possible implications of this polarization process are discussed.


Highly glycosylated flavonols with an O-linked branched pentasaccharide from Iberis saxatilis (Brassicaceae).
Four flavonol glycosides isolated from non-flowering leafy shoots of Iberis saxatilis (Brassicaceae) were characterised by spectroscopic and chemical methods as saxatilisins A-D, the 3-O-β-D-glucopyranosyl-(1→3)-α-L-rhamnopyranosyl-(1→2)[β-D-glucopyranosyl-(1→2)-α-L-rhamnopyranosyl-(1→6)]-β-D-glucopyranoside, 3-O-β-D-glucopyranosyl-(1→3)-α-L-rhamnopyranosyl-(1→2)[α-L-rhamnopyranosyl-(1→6)]-β-D-glucopyranoside, 3-O-(6-O-E-sinapoyl)-β-D-glucopyranosyl-(1→3)-α-L-rhamnopyranosyl-(1→2)[β-D-glucopyranosyl-(1→2)-α-L-rhamnopyranosyl-(1→6)]-β-D-glucopyranoside, and 3-O-(6-O-E-feruloyl)-β-D-glucopyranosyl-(1→3)-α-L-rhamnopyranosyl-(1→2)[β-D-glucopyranosyl-(1→2)-α-L-rhamnopyranosyl-(1→6)]-β-D-glucopyranoside of isorhamnetin (3,5,7,4'-tetrahydroxy-3'-methoxyflavone), respectively. Analysis of (2)J(HC) correlations detected with the H2BC (heteronuclear two-bond correlation) pulse sequence aided the unambiguous assignment of glycosidic resonances in the (1)H and (13)C NMR spectra of these compounds. Saxatilisins A, C, and D, are the first flavonol glycosides to be described with a pentasaccharide chain at a single glycosylation site. Several pentaglycosides of kaempferol and quercetin, tentatively assigned as saxatilisin analogues from LC-MS/MS analyses, were present as minor constituents of the extracts.


Dose-escalated simultaneous integrated-boost treatment of prostate cancer patients via helical tomotherapy.
The goal of this work was to assess the feasibility of moderately hypofractionated simultaneous integrated-boost intensity-modulated radiotherapy (SIB-IMRT) with helical tomotherapy in patients with localized prostate cancer regarding acute side effects and dose-volume histogram data (DVH data). Acute side effects and DVH data were evaluated of the first 40 intermediate risk prostate cancer patients treated with a definitive daily image-guided SIB-IMRT protocol via helical tomotherapy in our department. The planning target volume including the prostate and the base of the seminal vesicles with safety margins was treated with 70 Gy in 35 fractions. The boost volume containing the prostate and 3 mm safety margins (5 mm craniocaudal) was treated as SIB to a total dose of 76 Gy (2.17 Gy per fraction). Planning constraints for the anterior rectal wall were set in order not to exceed the dose of 76 Gy prescribed to the boost volume. Acute toxicity was evaluated prospectively using a modified CTCAE (Common Terminology Criteria for Adverse Events) score. SIB-IMRT allowed good rectal sparing, although the full boost dose was permitted to the anterior rectal wall. Median rectum dose was 38 Gy in all patients and the median volumes receiving at least 65 Gy (V65), 70 Gy (V70), and 75 Gy (V75) were 13.5%, 9%, and 3%, respectively. No grade 4 toxicity was observed. Acute grade 3 toxicity was observed in 20% of patients involving nocturia only. Grade 2 acute intestinal and urological side effects occurred in 25% and 57.5%, respectively. No correlation was found between acute toxicity and the DVH data. This institutional SIB-IMRT protocol using daily image guidance as a precondition for smaller safety margins allows dose escalation to the prostate without increasing acute toxicity.


X-ray induction of chromosome and chromatid aberrations in the same cells after treatment with hydroxyurea.
Vicia faba root meristem cells treated for 24 h with 1.25 mM hydroxyurea and then X-irradiated contained a large number of cells with both chromosome and chromatid aberrations. X-irradiation 4 h after release from the hydroxyurea block yielded cells with almost exclusively chromatid aberrations.


Visual outcomes and graft survival following corneal transplants: the need for an Irish National Corneal Transplant Registry.
To evaluate visual outcomes and corneal graft survival at 12 months postoperatively, and to demonstrate the need for an Irish National Corneal Transplant Registry. Retrospective, single surgeon, single center, analysis of 44 consecutive corneal transplants was performed between 2001 and 2005. Forty-four eyes of 41 patients underwent penetrating keratoplasty (n = 37), lamellar keratoplasty (n = 6) or limbal graft (n = 1). Indications for surgery (%) were keratoconus 45.45%; bullous keratopathy 2.7%; graft failure 9%; Fuchs endothelial dystrophy 2 4.5%; Irido corneal endothelial syndrome 2.27% and tectonic 15.9%. Visual outcome at 1 year (%) were as follows: improved by one or more Snellen lines (79.5%); disimproved by one or more Snellen lines (9%); unchanged (11.5%). Graft survival at 1 year was 93%. Although our findings compare favourably with those of the Australian Corneal Graft Registry, there is no Irish Corneal Transplant Registry with which to compare our results.


The effect of distension of the uterus on plasma renin activity (PRA) in anaesthetized pigs.
It has recently been shown that distension of the uterus in anaesthetized pigs causes reflex haemodynamic responses through efferent sympathetic mechanisms. The present study was undertaken to determine whether these mechanisms include activation of the renin-angiotensin system. The same methods were used in 14 pigs which were anaesthetized with alpha-chloralose and artificially ventilated. Balloons positioned within the uterus were distended for periods of 30 min by injecting 20 ml of warm Ringer solution. The responses of arterial blood pressure and heart rate were respectively prevented by blockade of alpha-adrenergic receptors with phentolamine and atrial pacing. Changes in plasma renin activity (PRA) were assessed during the last minute of distension by radioimmunoassay of angiotensin I. In each of 10 pigs, distension of the uterus (mean uterine transmural pressure of 17 mmHg) caused an increase in PRA in the absence of changes of interfering haemodynamic variables. In the remaining four pigs, this response was graded by step increments of the distension. The increase in PRA caused by uterine distension was abolished by bilateral section of the renal nerves (five pigs) or by blockade of beta-adrenergic receptors with propranolol. The present study showed that distension of the uterus in anaesthetized pigs primarily caused a reflex increase in PRA. This reflex response was mediated by renal nerves and involved beta-adrenergic receptors.


Comparison of 99mTc-methyl diphosphonate bone scintigraphy and 18F-fluorodeoxyglucose positron emission tomography/computed tomography to predict histologic response to neoadjuvant chemotherapy in patients with osteosarcoma.
We compared the usefulness of Tc-methyl diphosphonate (Tc-MDP) bone scintigraphy and F-fluorodeoxyglucose (FDG) for positron emission tomography/computed tomography (PET/CT) in predicting histologic response in patients with osteosarcoma receiving neoadjuvant chemotherapy (NAC).We retrospectively reviewed 62 patients with high-grade osteosarcoma who had received 2 cycles of NAC and surgery. All patients underwent Tc-MDP bone scintigraphy and F-FDG PET/CT before and after NAC. Tc-MDP uptake in the primary tumor was measured quantitatively as the maximum tumor-to-nontumor ratio (T/NTmax) and F-FDG uptake was measured as the maximum standardized uptake value (SUVmax), before and after NAC. The percent changes of T/NTmax (percent changes of the maximum tumor-to-nontumor ratio [Δ%T/NTmax]) and SUVmax (percent changes of the maximum standardized uptake value [Δ%SUVmax]) after NAC were calculated and the correlations between these parameters were evaluated. After surgery, the effects of NAC were graded histopathologically (good vs poor) and the optimum cut-off values of Δ%T/NTmax and Δ%SUVmax for predicting histologic response were assessed using the receiver operating characteristic (ROC) curve analysis.Δ%T/NTmax and Δ%SUVmax were positively correlated with each other (r = 0.494, P < .01). Based on the ROC curve analysis, both Δ%T/NTmax (area under the curve [AUC] = .772, P < .01) and Δ%SUVmax (AUC = .829, P < .01) predicted good histologic response. However, there was no significant difference between the AUCs of Δ%T/NTmax and Δ%SUVmax (P = .44). The sensitivity and specificity for predicting good histologic response were 83.3% and 75.0%, for the criterion Δ%T/NTmax <-12.5%, and 80.0% and 81.3% for the criterion Δ%SUVmax <-49.0%, respectively.The Tc-MDP bone scan and F-FDG PET scan are non-inferior to each other in predicting the histologic response of osteosarcoma treatments. The Tc-MDP bone scan and F-FDG PET scan showed respective advantages with differing features. Therefore, physicians should consider which scan is appropriate for their own institute based on the advantages of each scan and the circumstances of the institute.


Clustering functional data with application to electronic medication adherence monitoring in HIV prevention trials.
Maintaining high medication adherence is essential for achieving desired efficacy in clinical trials, especially prevention trials. However, adherence is traditionally measured by self-reports that are subject to reporting biases and measurement error. Recently, electronic medication dispenser devices have been adopted in several HIV pre-exposure prophylaxis prevention studies. These devices are capable of collecting objective, frequent, and timely drug adherence data. The device opening signals generated by such devices are often represented as regularly or irregularly spaced discrete functional data, which are challenging for statistical analysis. In this paper we focus on clustering the adherence monitoring data from such devices. We first pre-process the raw discrete functional data into smoothed functional data. Parametric mixture models with change-points, as well as several non-parametric and semi-parametric functional clustering approaches are adapted and applied to the smoothed adherence data. Simulation studies were conducted to evaluate finite sample performances, on the choices of tuning parameters in the pre-processing step as well as the relative performance of different clustering algorithms. We applied these methods to the HIV Prevention Trials Network(HPTN) 069 study for identifying subgroups with distinct adherence behavior over the study period.


Phenytoin hypersensitivity with pulmonary involvement in a hemophiliac patient with human immunodeficiency virus infection.
Acquired immunodeficiency syndrome (AIDS), with its attendant sequelae of opportunistic infections and aggressive lymphatic malignancies, continues to dominate the world's medical literature. Pneumocystis carinii pneumonia (PCP) remains as the most commonly encountered infection in AIDS and an early cause of morbidity and mortality. Current therapy for PCP revolves around the administration of either pentamidine isoethionate or trimethoprim-sulfamethoxazole; however, the major AIDS centers report a high incidence of adverse drug reactions to these drugs. We describe an association with human immunodeficiency virus (HIV) infection in a hemophiliac with multiple drug-related hypersensitivity reactions, which include constitutional, dermatologic, and pulmonary manifestations. This observance is intriguing and suggests that the presence of HIV infection may predispose a patient treated with a multitude of drugs and medications to a higher incidence of adverse reactions.


Effects of GABAB receptor positive allosteric modulator BHF177 and IRS-1 on apoptosis of hippocampal neurons in rats with refractory epilepsy via the PI3K/Akt pathway.
The present study was conducted to determine the effects of the γ-aminobutyric acid B (GABAB ) receptor positive allosteric modulator BHF177 on refractory epilepsy (RE). An RE rat model was initially established via treatment with lithium-pilocarpine. The RE rats were then treated with BHF177 or the GABAB receptor antagonist CGP46381, followed by recording of their seizure rate and assessment of their spatial learning in the Morris water maze test. Treatment of BHF177 reduced the seizure intensity, whereas this effect was revered upoj treatment with CGP46381. Immunohistochemistry revealed that BHF177 treatment diminished P-glycoprotein (P-gp) expression in the hippocampal tissues of RE rats. Next, we found that BHF177 activated GABAB receptor, resulting in upregulated expression of insulin receptor substrate 1 (IRS-1) and PI3K, as well as antiapoptotic factors (Bcl-2 and mTOR), along with suppression of the apoptosis factors Bax and cleaved caspase-3 in the hippocampal tissues. Further, activation of GABAB receptors by BHF177 alleviated the inflammatory response in hippocampal tissues of RE rats, as evidenced by reduced VCAM-1, ICAM-1, and tumor necrosis factor-α levels. Next, we treated primary cultured rat hippocampal neurons with BHF177 and the IRS-1 selective inhibitor NT157. BHF177 inhibited hippocampal apoptosis in rat hippocampal neurons by regulating the IRS-1/PI3K/Akt axis through crosstalk between GABAB and insulin-like growth factor-1 receptors. Collectively, our findings indicate that the BHF177 inhibited neuron apoptosis, thus protecting against RE through the IRS-1/PI3K/Akt axis, which may present a new therapeutic channel for RE.


Production of the biopesticide azadirachtin by hairy root cultivation of Azadirachta indica in liquid-phase bioreactors.
Batch cultivation of Azadirachta indica hairy roots was carried out in different liquid-phase bioreactor configurations (stirred-tank, bubble column, bubble column with polypropylene basket, and polyurethane foam disc as root supports) to investigate possible scale-up of the A. indica hairy root culture for in vitro production of the biopesticide azadirachtin. The hairy roots failed to grow in the conventional bioreactor designs (stirred tank and bubble column). However, modified bubble column reactor (with polyurethane foam as root support) configuration facilitated high-density culture of A. indica hairy roots with a biomass production of 9.2 g l(-1)dry weight and azadirachtin yield of 3.2 mg g(-1) leading to a volumetric productivity of azadirachtin as 1.14 mg l(-1) day(-1). The antifeedant activity in the hairy roots was also evaluated by no choice feeding tests with known concentrations of the hairy root powder and its solvent extract separately on the desert locust Schistocerca gregaria. The hairy root powder and its solvent extract demonstrated a high level of antifeedant activity (with an antifeedant index of 97 % at a concentration of 2 % w/v and 83 % at a concentration of 0.05 % (w/v), respectively, in ethanol).


Cofilin1 is involved in hypertension-induced renal damage via the regulation of NF-κB in renal tubular epithelial cells.
Inflammation mediated by nuclear factor-κB (NF-κB) plays a critical role in the pathogenesis of hypertensive nephropathy (HN). Cytoskeletal remodelling is necessary for the activation of NF-κB. An actin-binding protein, cofilin-1 promotes dynamic alterations to the cytoskeleton by severing actin filaments. However, whether cofilin1 modulates NF-κB activity via cytoskeletal remodelling in the setting of hypertensive renal damage and what mechanisms underlie this phenomenon, remain unknown. Twenty-one-week old spontaneously hypertensive rats (SHRs) were treated with an antioxidant (100 or 250 mg kg(-1) day(-1)), grape seed proanthocyanidins extract (GSPE), for 22 weeks. Twenty-four-hour urinary protein, serum creatinine and urea nitrogen levels were measured. Haematoxylin and eosin (HE) staining was performed, and the expression levels of renal cortex cofilin1, monocyte chemotactic protein 1 (MCP1), interleukin-1β (IL1β) and NF-κB were evaluated via either Western blotting or immunohistochemistry. In vitro, human proximal renal tubular epithelial cells (HK-2 cells) were pre-incubated either with or without GSPE and subsequently treated with angiotensinII (AngII). Furthermore, a lentiviral shRNA-vector was utilized to knockdown cofilin1 expression in the HK-2 cells, which were stimulated with AngII. Actin filaments, NF-κB activity and several downstream inflammatory factors, including MCP1 and IL-1β, were investigated. In addition to elevated blood pressure and 24 h urinary protein levels, NF-κB activity and the expression levels of MCP1 and IL-1β were significantly increased, resulting in tubulointerstitial inflammatory infiltration in SHRs. The phosphorylation (inactivation) of cofilin1 was increased in the kidneys of the SHRs. In vitro, AngII stimulation resulted in the phosphorylation of cofilin1, the formation of actin stress fibres and nuclear translocation of NF-κB p65 in the HK2 cells. Both GSPE pretreatment and the shRNA knockdown of cofilin1 inhibited Rel/p65 nuclear translocation, as well as the expression of both MCP-1 and IL-1β in the AngII-induced HK2 cells. These results demonstrate that cofilin1 is involved in hypertensive nephropathy by modulating the nuclear translocation of NF-κB and the expression of its downstream inflammatory factors in renal tubular epithelial cells.


Electroencephalographic findings in urea-cycle disorders.
Eleven electroencephalograms in 4 infants with urea-cycle disorders were reviewed. All infants had one or more abnormal EEGs. The abnormalities consisted mainly of multiareal spikes, spike-waves, or sharp-and-slow-wave activity. In addition, one patient, a term infant, exhibited exaggerated spindle-delta bursts. This infant, and also one other at a similar age, had monorhythmic paroxysmal theta activity. Clinically, all patients had seizures shortly preceding abnormal EEGs. EEG alterations were encountered over a wide range of elevated serum ammonia levels. Normal EEGs occurred in the face of slightly elevated levels. It is concluded that epileptiform EEG alterations may be a characteristic manifestation of urea-cycle disorders.


Synthesis of 1,2,3-triazolo-carbanucleoside analogues of ribavirin targeting an HCV in replicon.
The synthesis of carbocyclic and phosphonocarbocyclic analogues of ribavirin, an anti-HCV inhibitor, are described. Those compounds were evaluated against HCV but also against other important viruses in order to determine their spectrum of antiviral activity. Compounds 6 and 13 displayed a moderate IC(50) against HIV-1 of 43.8 and 37 microM, respectively.


Functional improvement with digital prosthesis use after multiple digit amputations.
Patients who sustain traumatic amputation of multiple fingers suffer both a functional and psychologic loss. Previous studies of prosthesis use for finger amputees have focused primarily on the psychologic benefits. Clinically our group noticed a functional improvement on hand function tests when patients with multiple digit amputations used a prosthesis. Given the expense of multiple finger prostheses we sought to determine if they led to a consistent functional improvement in these patients. Ten consecutive patients performed a battery of hand function tests and rated their ability to perform a variety of activities of daily living both with and without their prosthesis using the Disabilities of the Arm, Shoulder, and Hand questionnaire. Our results show a significant improvement in 3-finger-pinch strength and grip strength and a trend of improvement of tip-pinch, lateral-pinch, and grip strength in dynamometer positions 1, 2, 3, and 4 in these patients when tested with and without their prostheses. Function in activities of daily living, as assessed by the Disabilities of the Arm, Shoulder, and Hand questionnaire, was improved globally with prosthesis use. In addition, significant improvement was noted in several specific activities including opening a jar, writing, and turning a key, among others. These results show that prosthesis use provides a functional benefit to these patients in multiple activities.


[Analysis of response to treatment. Considerations on changing prognostic variables (time-dependent)].
In the prognostic evaluations the initial variables, obtained at the time of diagnosis, and the evolutive or time-dependent variables, that appear during the course of the disease, should be clearly differentiated. If this separation is not strictly maintained inaccurate results may be obtained. The errors resulting from the use of an inappropriate methodology are illustrated in the present article on the basis of two series of patients. On the other hand, the advantages and shortcomings of alternative methods, which are valid for prognostic studies with evolutive or time-dependent variables, are discussed. Finally, recommendations are given for the particular instance where the response to therapy in a therapeutic trial is being assessed.


Efficacy of EGFR tyrosine kinase inhibitors for non-adenocarcinoma lung cancer patients harboring EGFR-sensitizing mutations in China.
EGFR tyrosine kinase inhibitors (TKIs) have been established as standard therapy for EGFR-mutated adenocarcinomas; for non-adenocarcinoma non-small cell lung cancer (NSCLC) patients, this therapy remains debatable. Stage IIIB/IV patients with non-adenocarcinoma NSCLC who underwent EGFR testing were identified at the Shanghai Chest Hospital from January 2009 to September 2014. A total of 51 patients with EGFR-sensitizing mutations [26 patients with squamous cell carcinoma (SCC), 15 patients with adenosquamous cell carcinoma (ASC), and 10 patients with large cell lung carcinoma (LCLC)] were available for analysis of EGFR TKI treatment efficacy. The progression-free survival (PFS) for the 51 patients harboring EGFR-sensitizing mutations was 4.93 months (95 % CI 3.93-5.93). The PFS for the SCC, ASC, and LCLC patients was 3.98 months (95 % CI 3.32-4.63), 8.08 months (95 % CI 4.17-12.00), and 4.40 months (95 % CI 1.56-7.24), respectively. Among the 51 non-adenocarcinoma NSCLC patients, the PFS of the non-smokers and smokers was 5.49 months (95 % CI 3.28-7.70) and 3.78 months (95 % CI 2.61-4.95), respectively (P = 0.036). The PFS for the patients with a deletion in exon 19 and for those with an exon 21 L858R mutation was 5.16 months (95 % CI 4.21-6.11) and 4.04 months (95 % CI 2.35-5.73), respectively (P = 0.414). EGFR TKIs could be an option for the treatment of EGFR-mutated non-adenocarcinoma NSCLC, especially for patients with adenosquamous histology and non-smokers.


Gancao Xiexin decoction combined with mesalazine in the treatment of ulcerative colitis: A protocol for a systematic review and meta-analysis.
Ulcerative colitis (UC) is a chronic inflammatory disease that involves the rectum, colon and ileum. Gancao Xiexin decoction (GCXXD) is a classic herbal formula in Shanghanlun. More and more research evidence shows that GCXXD has a certain therapeutic effect on UC. Therefore, we designed this study protocol aim to evaluate the efficacy and safety of GCXXD combine with mesalazine for UC. We will systematically search 6 databases, including PubMed, the Cochrane Library, EMBASE, CNKI, VIP, Wang-fang database up to July 2020 to obtain eligible studies. The primary outcomes will focus on the clinical effectiveness. Review Manager 5.3 software will be used for data analysis. This study will provide the systematic evidence of UC treated with GCXXD combine with mesalazine. The findings of this meta-analysis will provide evidence to judge whether GCXXD combine with mesalazine is a more effective intervention compare to mesalazine only for patient of UC. INPLASY202080008.


Congenital coronary artery fistula in an Ethiopian child: case report.
A case of right coronary-artery to right ventricular fistula is described. The patient, a 3-year old Ethiopian female child, was asymptomatic. Examination revealed a machinery type murmur at the third and fourth intercostal spaces. Diagnosis was made by echocardiography, and coronary arteriography, followed by successful ligation of the coronary AV fistula. This is a rare congenital anomaly. The literature on congenital arteriovenous is briefly reviewed and the diagnosis and therapy discussed.


Robotic Lower Urinary Tract Reconstruction.
Lower urinary tract reconstruction has traditionally been approached in an open fashion but select complications or disease processes may be suitable for robotic reconstruction, including bladder neck contractures, proximal urethral strictures, and genitourinary fistulas. Here, the authors discuss the novel techniques used and the feasibility of robotic reconstruction for these conditions. The robotic approach is relatively novel, and more data and studies will be required to make definitive statements regarding success rate and complications from the procedure. Preliminary data suggest that the robotic approach may offer comparable success compared with open techniques.


Stress lymphocytes and the dexamethasone suppression test in major depressive disorders.
The Dexamethasone Suppression Test (DST) was administered to 12 patients with major depression and 4 normal controls. Peripheral blood smears were collected before and after the DST, and atypical lymphocytes were counted. Six patients who were nonsuppressors on the DST had a high percentage of so-called stress lymphocytes (Downey type II atypical lymphocytes). Five of six subjects with normal suppressor responses had low stress lymphocyte counts or no such cells (p less than 0.01). The findings suggest that the stress lymphocyte response might be related to nonsuppression on the DST in major depression.


Microsurgical removal of intramedullary spinal cord gliomas in a rat spinal cord decreases onset to paresis, an animal model for intramedullary tumor treatment.
Intramedullary spinal cord tumors (IMSCT) pose significant challenges given their recurrence rate and limited treatment options. Using our previously described rat model of IMSCT, we describe a technique for microsurgical tumor resection and present the functional and histopathological analysis of tumor progression. Twenty-four Fischer 344 rats were randomized into two groups. All animals received a 5-microl intramedullary injection of 9L gliosarcoma cells. Animals were evaluated daily for signs of paralysis using the Basso, Beattie, and Bresnahan (BBB) scale. Group 1 continued with daily assessments using the BBB scale following tumor implantation, but received no further treatment. Group 2 underwent surgical removal of intramedullary tumor on postoperative day five. At a BBB score less than 5 (e.g., functional paraplegia), all animals of both groups were killed and sent for histopathological analysis. Group 1 had a median onset of functional hind limb paraplegia at 15 +/- 1.0 days. Group 2 had a median onset of hind limb paresis at 53 +/- 0.46 days. Hematoxylin-eosin cross-sections confirmed the presence of intramedullary 9L tumor invading the spinal cord in both groups. Animals with 9L IMSCTs consistently developed hind limb paraplegia in a reliable and reproducible manner. Animals undergoing microsurgical resection of IMSCT had a significant delay in the onset of functional paraplegia compared to the untreated controls. These findings suggest that this model may mimic the behavior of IMSCTs following operative resection in humans and thus may be used to examine efficacy of new treatment options for high-grade intramedullary tumors.


Roles of cations, electronegativity difference, and anionic interlayer interactions in the metallic versus nonmetallic character of Zintl phases related to arsenic.
A first-principles Density Functional Theory study of several layered solids structurally related to rhombohedral arsenic has been carried out. The electronic structures of rhombohedral arsenic, CaSi(2), CaAl(2)Si(2), KSnSb, and SrSn(2)As(2) are discussed in detail, emphasizing on the origins of their metallic or nonmetallic behaviours. It is found that all of these systems are metallic except KSnSb. Electronegativity differences between the elements in the anionic sublattice and/or direct interlayer interactions play the main role in controlling the conductivity behavior. CaSi(2) exhibits a peculiar feature since the cation directly influences the conductivity but is not essential for its appearance. Cation-anion interactions are shown to have an important covalent contribution, but despite this fact and the metallic character found for most of these phases, the Zintl approach still provides a valid approximation to their electronic structure.


Improved resistance of chemically-modified nanocellulose against thermally-induced depolymerization.
The study demonstrated the improvement in the resistance of nanocellulose against thermally-induced depolymerization by esterification with benzoyl (BNZ) and pivaloyl (PIV). The change in the degree of polymerization (DP) and molecular weight distribution (MWD) after thermal treatment in nitrogen and in air was investigated using viscometry and gel permeation chromatography. BNZ and PIV nanocellulose esters without α-hydrogens gave higher DP and narrower MWD than pure bacterial cellulose; and the acetyl and myristoyl esters, which possess α-hydrogens. Results also showed that when depolymerization is suppressed, thermal discoloration is also reduced. Resistance against depolymerization inhibits the formation of reducing ends which can be active sites for thermal discoloration. Finally, the findings suggest that benzoylation and pivaloylation can be an excellent modification technique to improve the thermal stability of nanocellulose.


A cost analysis of gastro-oesophageal reflux disease and dyspepsia in Iran.
To provide a first-time report on the health care utilization and costs of gastro-oesophageal reflux disease and dyspepsia in Iran. A consecutive sample of 501 patients referred for upper endoscopy to an outpatient gastroenterology clinic in central Tehran (May 2005 to January 2006) was investigated using two interview-assisted questionnaires for gastro-oesophageal reflux disease (i.e. heartburn or regurgitation on a weekly basis for at least the past 3 months, and symptom onset at least 12 months prior to the study) or dyspepsia symptom (based on Rome II criteria). The frequency of health resource utilization (i.e. physician visit, hospitalization, laboratory tests, instrumental studies, and medications) and productivity loss (days off work) due to gastro-oesophageal reflux disease/dyspepsia-related symptoms in the past 12 months were recorded. Societal perspective was used, and cost of illness per person per year was estimated in purchasing power parity dollars (PPP$). The cost of illness per person per year for patients with gastro-oesophageal reflux disease, and dyspepsia alone were around PPP$195 and PPP$215, respectively. There was no statistically significant difference in the cost of illness between the two patient groups. The direct costs of disease comprised 88%, and 82% of the total costs in gastro-oesophageal reflux disease and dyspepsia patients, respectively with the costs of medications being the dominant component. There was also no statistically significant difference in the cost of disease between the gastro-oesophageal reflux disease patients with and without oesophagitis (based on Los Angeles criteria). As drugs cost was found to be a dominant cost component, cost-minimization studies to find the best medication therapy strategies considering the regional factors is suggested.


Neurosecretory cells of the amygdaloid complex during estrous cycle.
Ultrastructure of neurosecretory cells of the dorsomedial nucleus of the cerebral amygdaloid complex (one of the main zones of sexual dimorphism) was studied in different phases of the estrous cycle. The characteristics of the "light" and "dark" cells change depending on the concentrations of sex steroids during estrus and metestrus.


The history of "modern" anesthesia technology - A critical reappraisal: Part I: Key criteria of "modern" anesthesia: Technology and professionalism definitions, backgrounds and a short introduction to a changing evidence-base.
This paper is the first in a series of publications. These investigate, whether important elements of the historiography of anesthesia require a critical reappraisal. A systematic, combined presentation, contextualization and assessment of recent European research is provided. This includes the author's own findings. These emanate from two extensive projects. They combine very recent findings with results of earlier research, conducted by the author and numerous collaborators over the last 18 years. The findings represent an ever increasing and ever more robust body of evidence. They add an important new element to our international historiography. As an introduction, several definitions will be given for criteria, which designate "modern" anesthesia and its technology. On one of these criteria, the history of professionalization and specialization, a short overview will be given. This will be followed by an overview of general contexts, key features and early achievements of anesthesia-related technology. All results will be compared with a currently dominating narrative: This alleges "dominance" of US-American and British pioneers and developments. Apparent biases and inconsistencies are identified. These suggest that our current, international historiography of anesthesia may require a critical reassessment. Three subsequent articles will focus on specific aspects of anesthesia technique and technology. Their results likewise suggest a history of internationalism and trans-disciplinary reciprocity, rather than of national dominances. Further investigations will aim to ascertain the nature and extent of potential interactions, which may nowadays be underrecognized.


Synthesis and Biological Evaluation of 10-Substituted Camptothecin Derivatives with Improved Water Solubility and Activity.
Despite remarkable clinical achievements, camptothecin (CPT) still suffers from poor solubility and severe toxicity. Therefore, it is necessary to redevelop CPT derivatives as supplementary antitumor agents with good water solubility and small side effects. In this work, 27 camptothecin derivatives were synthesized and screened for their cytotoxicity against A549 (lung) and HCT-116 (colon) cancer cell lines. Among them, compound B7, 7-ethyl-10-(2-oxo-2-(4-methylpiperidin-1-yl)ethoxy)camptothecin,was demonstrated in vitro to be a more potent antitumor agent than SN-38 by comparison of their inhibitory activities against cell proliferation and colony formation and interference effect on process of cell cycle and cell apoptosis. Additionally, a molecular docking model revealed that B7 can interact with the topoisomerase I-DNA complex, and that the solubility of B7 reached 5.73 μg/mL in water. Moreover, B7 significantly inhibited tumor growth in an A549 xenograft model at dosages of 0.4 and 2.0 mg/kg, and exhibited minimum lethal doses comparable to those of irinotecan. These results indicated that B7, with improved solubility, enhanced activity and acceptable acute toxicity, can be used as a lead compound for the development of novel anticancer agents.


The cutaneous bacterium Janthinobacterium lividum inhibits the growth of Trichophyton rubrum in vitro.
Tinea pedis (athlete's foot) is a fungal infection that is both widespread and challenging to treat. Standard treatments consist of topical and systemic therapies of antifungal agents, such as miconazole, itraconazole, and terbinafine. The extended nature of topical therapy and the toxicity of long-term systemic therapy limit the utility of current treatments. An alternate approach relies on an understanding of bacterial-fungal interactions. Specifically, a probiotic antifungal bacterium such as Janthinobacterium lividum can counter infection; Janthinobacterium is a major constituent of the human skin microbiota. Janthinobacterium lividum has been shown to ameliorate the effects of the cutaneous fungal disease chytridiomycosis in a vertebrate species (Rana muscosa). Dual-culture plate challenge assays were performed using J. lividum and Trichophyton rubrum, the leading cause of athlete's foot. In all cases, T. rubrum colonies grew significantly smaller when co-cultured with J. lividum. These in vitro results suggest that J. lividum merits further investigation as a human cutaneous probiotic.


Facile preparation of magnetic porous biochars from tea waste for the removal of tetracycline from aqueous solutions: Effect of pyrolysis temperature.
Pyrolysis process significantly influences the physicochemical properties and potential application of magnetic porous biochars (MPBCs). However, the effects of pyrolysis temperature on the properties of MPBCs as well as substantial adsorption are still unclear. This study reported a facile method to obtain the MPBC from tea waste via pyrolysis of a mixture of hydrochar, KHCO3, and FeCl3·6H2O under different temperatures (500-800 °C), and explored further the adsorption toward tetracycline (TC). Results showed pyrolysis temperature obviously influenced the physicochemical properties of MPBCs, and MPBC pyrolyzed at 700 °C (MPBC-700) has a highest specific surface area (1066 m2 g-1) and pore volume (2.693 cm3 g-1). However, the adsorption potential increased consistently from 59.35 mg g-1 for MPBC-500 to 333.22 mg g-1 for MPBC-800, suggesting that the surface area and pore volume were not the only factors determining TC adsorption. Further analysis showed that the pore-filling, π-π interaction, complexation, and hydrogen bonding contributed together to TC adsorption. Moreover, all MPBCs possessed a high saturation magnetization, indicating the easy separation by an external magnet. Therefore, MPBCs (especially at 700 °C) can act as the excellent adsorbents for contaminant removal due to their high separation, adsorption, and reuse performance.


Effect of electroconvulsive shock on the slow components of the brain stem auditory evoked potential.
The effects of electroconvulsive shock on the slow components of the brain stem auditory evoked potential were investigated in the rat during the ictal and the immediate postictal periods. Shock did not significantly alter any aspect of the slow positive-negative complex which underlies the high-frequency waves of the brain stem auditory evoked potential. However, a succeeding potential of probable cortical origin was markedly reduced in amplitude and its peak latency was temporarily increased.


A new process for acrylic acid synthesis by fermentative process.
With the synthesis of chemical products through biotechnological processes, it is possible to discover and to explore innumerable routes that can be used to obtain products of high added value. Each route may have particular advantages in obtaining a desired product, compared with others, especially in terms of yield, productivity, easiness to separate the product, economy, and environmental impact. The purpose of this work is the development of a deterministic model for the biochemical synthesis of acrylic acid in order to explore an alternative process. The model is built-up with the tubular reactor equations together with the kinetic representation based on the structured model. The proposed process makes possible to obtain acrylic acid continuously from the sugar cane fermentation.


Transition programs in cystic fibrosis centers: perceptions of patients.
There is a growing population of adults with cystic fibrosis (CF) and a need for development of adult CF programs. Recommendations for transfer of patients from pediatric care to an adult program include a transition program. The purpose of this study was to survey adult CF patients to assess their own concerns regarding this issue. A survey was sent to all 1,288 members of the International Association of Cystic Fibrosis Adults (IACFA), with a response rate of 25.9% (n = 334). The majority of patients (81.2%) received care from a CF center; the major difference between those seen at a CF center and those seen at another facility was proximity to a CF center. Nearly one-fourth of patients seen at a CF center continued to receive care from a pediatrician even though a CF-trained internist was available; though these patients were younger, their mean age was still about 30 years. Patients seen by a pediatrician were more like to be students and to live with their parents. Those patients seen in an adult program described a variety of criteria for their transfer to the adult pro-gram, but there were no consistent findings to suggest a standard transition program. Indeed, many patients did not meet the adult team until the time of the transfer. Most importantly, the patients reported their level of concern about transfer as minimal, far less than what CF physicians had perceived. These differences may impede the successful transition of patients into an adult program.


The use of high-frequency electromagnetics in brain tumour surgery.
The first commercially available high-frequency electromagnetic field (EMF) system promises additional functionality for neurosurgical procedures. In a prospective study, we evaluated the optimal use as well as the limitations of this system designed for vaporizing tissue and for coagulation in brain tumour surgery. For the microsurgical treatment of 63 consecutive patients with various intracranial tumours, the EMF system was used in addition to the standard neurosurgical instrumentarium. The system was assessed with respect to its compatibility with the operating room environment. Furthermore, attention was given to the particular techniques required to use the system most effectively. The efficiency of the investigated tool was monitored throughout the study. The EMF system functioned properly in all procedures and did not cause any complications. Specific handling techniques and electrode tip configurations could be defined for optimal use of high-frequency electromagnetics for vaporization and coagulation in different intraoperative settings. Thereby, the efficiency of the device could be increased throughout the study while ineffective use decreased from 7 to 2 cases. Although this tool is designed ergonomically and offers high tactile control, it cannot be used submerged in cerebrospinal fluid or under continuous irrigation, which makes it necessary to use it in tandem with suction devices to obtain a clear view on the surgical field. Maneuvering with the EMF system was substantially different to both monopolar and bipolar systems, clearly necessitating a learning curve for the surgeon. This device was found to be a valuable complementary tool to standard electrosurgical instruments when applied effectively and with elaborated techniques.


Expression and tyrosine phosphorylation of Crk-associated substrate lymphocyte type (Cas-L) protein in human neutrophils.
Crk-associated substrate lymphocyte type (Cas-L) protein, also known as human enhancer of filamentation 1 (Hef1) or neural precursor cell-expressed, developmentally down-regulated gene 9 (Nedd9), belongs to the Cas family of adapter proteins, which are involved in integrin signaling. Previous reports showed that Cas-L is expressed preferentially in lymphocytes and epithelial cells. Cas-L mediates signals from integrins, T-cell receptors, B-cells receptors, and transforming growth factor beta, leading to cell movement and cell division. Here, we report the expression of Cas-L in neutrophils. Cas-L was tyrosine-phosphorylated when human neutrophils were stimulated by fMLP, tumor necrosis factor-alpha (TNF), or lipopolysaccharide. The tyrosine phosphorylation of Cas-L in fMLP- or TNF- stimulated neutrophils was further enhanced by adhesion of the cells to their substrates. Cas-L was found to be localized at focal adhesions in stimulated neutrophils based on immunofluorescence microscopy. These findings suggest that Cas-L is one of the targets of inflammatory cytokines and is also modulated by cell adhesion process in neutrophils.


Coronavirus herd immunity optimizer with greedy crossover for feature selection in medical diagnosis.
The importance of medical data and the crucial nature of the decisions that are based on such data, as well as the large increase in its volume, has encouraged researchers to develop feature selection (FS)-based approaches to identify the most relevant data for specific medical problems In this paper, two intelligent wrapper FS approaches based on a new metaheuristic algorithm named the coronavirus herd immunity optimizer (CHIO) were applied with and without the incorporation of a greedy crossover (GC) operator strategy to enhance exploration of the search space by CHIO. The two proposed approaches, CHIO and CHIO-GC, were evaluated using 23 medical benchmark datasets and a real-world COVID-19 dataset. The experimental results indicated that CHIO-GC outperformed CHIO in terms of search capability, as reflected in classification accuracy, selection size, F-measure, standard deviation and convergence speed. The GC operator was able to enhance the balance between exploration and exploitation of the CHIO in the search and correct suboptimal solutions for faster convergence. The proposed CHIO-GC was also compared with two previous wrapper FS approaches, namely, binary moth flame optimization with Lévy flight (LBMFO_V3) and the hyper learning binary dragonfly algorithm (HLBDA), as well as four filter methods namely, Chi-square, Relief, correlation-based feature selection and information gain. CHIO-GC surpassed LBMFO_V3 and the four filter methods with an accuracy rate of 0.79 on 23 medical benchmark datasets. CHIO-GC also surpassed HLBDA with an accuracy rate of 0.93 when applied to the COVID-19 dataset. These encouraging results were obtained by striking a sufficient balance between the two search phases of CHIO-GC during the hunt for correct solutions, which also increased the convergence rate. This was accomplished by integrating a greedy crossover technique into the CHIO algorithm to remedy the inferior solutions found during premature convergence and while locked into a local optimum search space.


The effect of technology addiction training given to nursing students on the perspectives and addiction levels of students.
The study was conducted to investigate the effect of technology addiction training given to nursing students on their Internet and technology addiction perspectives and addiction levels. The data of the experimental research with a control group and a pretest-posttest design were collected online using the Personal Information Form and the Technology Addiction Scale. Sample size was 82. Technology addiction training was given for 10 weeks. Post-test data were collected after the training. The Mann Whitney-U test, t-test, Tukey HSD test, Kruskal Wallis test, and Bonferroni-Dunn test were used for statistical analysis. The Fisher's Exact Test and the Chi-Square test were used to analyze the categorical variables. The level of technology addiction of the students in the experimental group was 52.69 ± 17.218 in the pre-test and 51.31 ± 14.931 in the post-test. In the control group, the level of technology addiction was found to be 54.03 ± 18.955 in the pre-test and 53.39 ± 20.159 in the post-test. Thus, it can be stated that the students in both groups were moderately addicted to technology and no significant difference was observed between the pre-test and post-test mean scores of the groups after the training. The study revealed that the students were moderately addicted to technology and used technological devices at a high rate. In addition, the ineffectiveness of the training, and being aware of the harms of technology, but disregarding the importance of these harms were the interesting findings that showed the severity of the problem. NCT05277545.


Fearless Dominance and reduced feedback-related negativity amplitudes in a time-estimation task - further neuroscientific evidence for dual-process models of psychopathy.
Dual-process models of psychopathy postulate two etiologically relevant processes. Their involvement in feedback processing and its neural correlates has not been investigated so far. Multi-channel EEG was collected while healthy female volunteers performed a time-estimation task and received negative or positive feedback in form of signs or emotional faces. The affective-interpersonal factor Fearless Dominance, but not Self-Centered Impulsivity, was associated with reduced feedback-related negativity (FRN) amplitudes. This neural dissociation extends previous findings on the impact of psychopathy on feedback processing and further highlights the importance of distinguishing psychopathic traits and extending previous (neuroscientific) models of psychopathy.


Isolation and characterization of resident macrophages from guinea pig and human intestine.
The evaluation of mucosal cellular immune function in the gastrointestinal tract has focused on properties of lymphocytes. We describe methods for use in guinea pig and human tissue that will now permit the maintenance and in vitro study of intestinal macrophages. This study characterizes the resident gastrointestinal macrophage population in the two species and shows that morphologic and ultra-structural characteristics are similar to macrophages from other tissues. Histochemically, the cells are esterase positive and peroxidase negative. They possess surface receptors for immunoglobulin G and complement, and are phagocytic via the Fc receptor.


Length of time between surgery and return to sport after ulnar collateral ligament reconstruction in Major League Baseball pitchers does not predict need for revision surgery.
Pitchers who return to sport (RTS) sooner will have a higher risk of revision ulnar collateral ligament reconstruction (UCLR) than those who return later. All professional (major and minor league) baseball pitchers who underwent UCLR between 1974 and 2016 were identified. Date of the index UCLR was recorded. The date of the first game back at any professional level after surgery and the date the pitcher returned to the same level of play (if applicable) were recorded. Length of time between these dates was compared for pitchers who required a revision UCLR and those who did not. Overall, 569 pitchers (average age, 24.8 ± 4.1 years) underwent UCLR and had reliable game logs after surgery. No statistically significant difference existed in the length of time to RTS at any professional level or at the same professional level between those pitchers who did not require a revision UCLR and those who did (P = .442, P = .238). Pitchers who required revision UCLR returned to any level of play almost 2 months earlier (14.7 vs. 16.5 months) and returned to the same level of play >2 months earlier (15.2 vs. 17.7 months) than matched controls who did not require revision UCLR, although this was not statistically significant (P = .179, P = .204). No statistically significant difference existed in the length of time to RTS after UCLR in professional baseball players who required a revision UCLR and those who did not.


Chronic relapsing experimental allergic encephalomyelitis: cerebrospinal fluid cytology and a comparison with meningeal and spinal cord pathology.
Cerebrospinal fluid (CSF) was taken from strain 13 guinea pigs in various stages of chronic relapsing experimental allergic encephalomyelitis, the spinal cords removed for histological examination and meningeal stretch preparations made. CSF cells were counted and characterized by morphological studies, anti-IgG and alpha-naphthyl acetate esterase (ANAE) staining. Approximately 65% of normal CSF lymphocytes were ANAE positive and 10% stained with anti-IgG. No polymorphonuclear leucocytes were seen. Five out of eight relapsing animals had raised cell counts (up to 152/microliters) as did three animals in remission. There was no change in the proportion of various types of CSF cells where increased numbers were recorded. Infiltrating cells in spinal cord sections and meningeal preparations were similarly characterized and the results compared with CSF cells findings. Animals in relapse which had, in addition, macroscopically visible cord plaques showed the most severe infiltrative changes in spinal cord tissue and in the meninges. There were differences between the proportion of various types of CSF cells and meningeal infiltrate cells on ANAE staining reaction. In general there were far more lymphocyte-type cells in the CSF but more monocyte-type cells in meningeal infiltrates.


Medical Therapies of Amblyopia: Translational Research to Expand Our Treatment Armamentarium.
Amblyopia is a developmental brain disorder in which vision is lost due to asymmetric or inadequate visual stimulation early in life. Although amblyopia is responsive to treatment if therapy is initiated early, treatment of older children and adults is usually unsuccessful due to closure of a window of cortical brain plasticity. Extensive basic research has been devoted to understanding modulators in shaping the visual cortex during the critical period of plasticity, and to providing potential clinical applications of neurotransmitters in the treatment of amblyopia. Current pharmacological treatments are reviewed from basic science research extending into clinical use, focusing on the acetylcholinesterase inhibitor donezepil, serotonin receptor inhibitor fluoxetine, dopamine precursors carbidopa-levodopa, and catecholamine modulator citicoline.


The effect of chair massage on muscular discomfort in cardiac sonographers: a pilot study.
Cardiac sonographers frequently have work-related muscular discomfort. We aimed to assess the feasibility of having sonographers receive massages during working hours in an area adjacent to an echocardiography laboratory and to assess relief of discomfort with use of the massages with or without stretching exercises. A group of 45 full-time sonographers was randomly assigned to receive weekly 30-minute massage sessions, massages plus stretching exercises to be performed twice a day, or no intervention. Outcome measures were scores of the QuickDASH instrument and its associated work module at baseline and at 10 weeks of intervention. Data were analyzed with standard descriptive statistics and the separation test for early-phase comparative trials. Forty-four participants completed the study: 15 in the control group, 14 in the massage group, and 15 in the massage plus stretches group. Some improvement was seen in work-related discomfort by the QuickDASH scores and work module scores in the 2 intervention groups. The separation test showed separation in favor of the 2 interventions. On the basis of the results of this pilot study, larger trials are warranted to evaluate the effect of massages with or without stretching on work-related discomfort in cardiac sonographers. NCT00975026 ClinicalTrials.gov.


Sex pheromone of the American warble fly, Dermatobia hominis: the role of cuticular hydrocarbons.
Chemical communication between adults of the American warble fly, Dermatobia hominis (Diptera: Oestridae), was investigated by electroantennography and behavioral bioassays. Significant electroantennographic responses were recorded from both sexes to hexane-soluble cuticular lipids from either sex. Olfactometer tests indicated an attraction between males and females, and between females. Copulatory behavior of males with a white knotted string treated with female extract confirmed production of a sexual stimulant by females. Such behavior was not observed in tests with male extract, demonstrating that the pheromone acts also as a sex recognition factor. Cuticular hydrocarbons of sexually mature female and male D. hominis were identified by Gas chromatography-mass spectrometry and consist of a mixture of saturated n-, monomethyl-, and dimethylalkanes in both sexes. Sexual dimorphism was characterized by a higher relative concentration of dimethylalkanes in males and the presence of alkenes only in females.


Individual trigger factors for hemorrhagic stroke: Evidence from case-crossover and self-controlled case series studies.
Hemorrhagic stroke (HS) is a sudden-onset disease with high mortality and disability rates, and it is crucial to explore the triggers of HS. In this study, we analyzed individual triggers for HS to provide a basis for HS prevention and intervention. A systematic search of five databases was conducted until December 2022. Studies on HS-related individual triggers conducted using a case-crossover study or self-controlled case series design were included in the descriptive summary and comprehensive evidence synthesis of each trigger. A total of 39 studies were included after the screening, and 32 trigger factor categories were explored for associations. Potential trigger factors for HS were as follows: Antiplatelet (odd ratio (OR), 1.10; 95% confidence interval (CI), 1.00-1.21) and anticoagulant (OR, 5.43; 95% CI, 2.04-14.46) medications, mood stabilizers/antipsychotics (OR, 1.33; 95% CI, 1.07-1.65), infections (OR, 2.15; 95% CI, 1.73-2.67), vaccinations (relative risk, 1.11; 95% CI, 1.02-1.21), physical exertion (OR, 2.08; 95% CI, 1.58-2.74), cola consumption (OR, 5.45; 95% CI, 2.76-10.76), sexual activity (OR, 7.49; 95% CI, 2.23-25.22), nose blowing (OR range, 2.40-56.40), defecation (OR, 16.94; 95% CI, 3.40-84.37), and anger (OR, 3.59; 95% CI, 1.56-8.26). No associations were observed with illicit drug use (OR, 2.05; 95% CI, 0.52-8.06) or cigarette smoking (OR, 0.81; 95% CI, 0.52-1.24) and HS. Individual triggers, including several medications, infections, vaccinations, and behaviors, may trigger HS onset. Direct control measures for behavioral triggers can play a crucial role in preventing HS. High-risk populations should receive personalized therapies and monitoring measures during the medication treatment to balance the risk of acute HS and the basic diseases.


Life of Listeria monocytogenes in the host cells' cytosol.
In the past decades impressive knowledge has been accumulated concerning the basic mechanisms of interactions between intracellular bacteria and their host cells. Comparatively little is known on the metabolic requirements necessary for efficient replication of these bacteria within their specific host cell compartments. Recent developments in functional genomics have led to more extensive studies of the metabolic aspects that may be crucial for understanding the pathogenesis of intracellular bacteria. Here we summarize our present knowledge on the physiology of L. monocytogenes with emphasis on those parts that seem to be important for its ability to replicate in the cytosol of mammalian host cells.


Comparative study of the cellular fatty acids of methicillin-resistant and -susceptible Staphylococcus aureus.
The cellular fatty acid compositions of 26 strains of methicillin-resistant Staphylococcus aureus (MRSA) and 17 strains of methicillin-susceptible S. aureus (MSSA) were analyzed by gas-liquid chromatography. The fatty acid compositions of the two groups were very similar with 16 identified components. The major fatty acids were Ci14 = 0, Ci15 = 0, C18 = 0 and C20 = 0. Among these fatty acids, the percentage of the Ci15 = 0 fatty acid component of MRSA strains (11.4 +/- 3.9%) was statistically higher than that of MSSA strains (6.2 +/- 2.4%) (p < 0.001). On the other hand, the percentage of the C20 = 0 fatty acid components of MRSA strains (20.2 +/- 8.8%) was statistically lower than that of MSSA strains (30.7 +/- 10.4%) (p < 0.001). The production of beta-lactamase and beta-hemolysin in both groups' strain was also unrelated to the relative amounts of the fatty acid components. These results indicated a statistical tendency for the percentage fatty acid compositions of the MRSA strains to be quantitatively different from those of the MSSA for both the Ci15 = 0 and C20 = 0 fatty acid components. Analysis of the fatty acid compositions may have an application in the differentiation of MRSA and MSSA strains.


Candidate loci involved in domestication and improvement detected by a published 90K wheat SNP array.
Selection is one of the most important forces in crop evolution. Common wheat is a major world food crop and a typical allopolyploid with a huge and complex genome. We applied four approaches to detect loci selected in wheat during domestication and improvement. A total of 7,984 candidate loci were detected, accounting for 23.3% of all 34,317 SNPs analysed, a much higher proportion than estimated in previous reports. We constructed a first generation wheat selection map which revealed the following new insights on genome-wide selection: (1) diversifying selection acted by increasing, decreasing or not affecting gene frequencies; (2) the number of loci under selection during domestication was much higher than that during improvement; (3) the contribution to wheat improvement by the D sub-genome was relatively small due to the bottleneck of hexaploidisation and diversity can be expanded by using synthetic wheat and introgression lines; and (4) clustered selection regions occur throughout the wheat genome, including the centromere regions. This study will not only help future wheat breeding and evolutionary studies, but will also accelerate study of other crops, especially polyploids.


Efficiency of a few retinoids and carotenoids in vivo in controlling benzo[a]pyrene-induced forestomach tumour in female Swiss mice.
The anticarcinogenic effect of vitamin A2 (dehydroretinol and 3-hydroxyretinol) compounds was studied and compared with that of vitamin A1 (retinoic acid, retinol and retinal) and carotenoids (lutein and beta-carotene) in the benzo[a]pyrene (B(a)P)-induced forestomach tumour model of female Swiss mice in vivo. Tumour growth and gross tumour incidence observed after the administration of B(a)P (eight doses of 1 mg, twice weekly for 4 weeks) and retinoids/carotenoids (2.5 and 4.7 microm per animal per d, 2 weeks before, during and 2 weeks after B(a)P) showed that the groups supplemented with lutein and 3-hydroxyretinol produced the best results in inhibiting tumour growth and had low tumour incidence compared with the control group given B(a)P only (P<0.05). Weights recorded after the different treatments showed that the beta-carotene-supplemented group exhibited maximum weight gain, followed by retinal, retinol, retinoic acid, lutein, dehydroretinol and 3-hydroxyretinol. These results indicate that the anticarcinogenicity of the compounds is not related to the vitamin A biopotencies. Vitamin A2 compounds having half the biopotency of the vitamin A1 compounds were seen to be anticarcinogenic. Again, among the carotenoids, lutein, having 50 % less biopotency, showed more significant results than beta-carotene. Thus it is imperative to conclude that the low animal growth achieved with these compounds has a correlation with the highest suppression of tumour occurrence in the present experiment. Therefore, the daily consumption of foods having high content of lutein and vitamin A2 should be given due importance and weight in further studies.


Comparative Performance Analysis of Urised 3 and DIRUI FUS-200 Automated Urine Sediment Analyzers and Manual Microscopic Method.
Microscopic examination of urine sediment is necessary for evaluation of renal and urinary tract diseases. In this study, we evaluated and compared analytic and diagnostic performances of DIRUI FUS-200 and a new image-based automated urine sediment analyzer Urised 3. A total of 440 urine samples, submitted to our laboratory, were evaluated by two automated urine sediment analyzers and a standardized manual microscopy. Precision, linearity and method comparison studies were performed according to CLSI guidelines. Considering the red blood cell (RBC) and white blood cell (WBC) counts, strong correlations existed between FUS-200 and manual microscopy (r=0.993 vs 0.861), Urised 3 and manual microscopy (r=0.962 vs 0.818), FUS200 and Urised 3 (r=0.961 vs 0.961). Clinical non-concordance ranged from 7% to 14.16% among all methods. The concordance between the analyzers and manual microscopy for WBC was better than that of RBC. The concordance between the two analyzers was better for WBC and RBC, with respect to the manual microscopy. Although the Urised 3, FUS-200 and manual microscopy counts were in agreement; confirmation of the results of automated analyzers with manual microscopy is particularly helpful, for pathological samples with near cut-off values.


The Transcriptome Response to Azole Compounds in Aspergillus fumigatus Shows Differential Gene Expression across Pathways Essential for Azole Resistance and Cell Survival.
The opportunistic pathogen Aspergillus fumigatus is found on all continents and thrives in soil and agricultural environments. Its ability to readily adapt to novel environments and to produce billions of spores led to the spread of azole-resistant A. fumigatus across the globe, posing a threat to many immunocompromised patients, including critically ill patients with severe influenza or COVID-19. In our study, we sought to compare the adaptational response to azoles from A. fumigatus isolates that differ in azole susceptibility and genetic background. To gain more insight into how short-term adaptation to stressful azole compounds is managed through gene expression, we conducted an RNA-sequencing study on the response of A. fumigatus to itraconazole and the newest clinically approved azole, isavuconazole. We observed many similarities in ergosterol biosynthesis up-regulation across isolates, with the exception of the pan-azole-resistant isolate, which showed very little differential regulation in comparison to other isolates. Additionally, we found differential regulation of membrane efflux transporters, secondary metabolites, iron metabolism, and various stress response and cell signaling mechanisms.


Nitric oxide prevents oxidised LDL-induced p53 accumulation, cytochrome c translocation, and apoptosis in macrophages via guanylate cyclase stimulation.
Oxidatively modified low density lipoprotein (OxLDL) induces apoptosis in vascular cells including macrophages, while NO exerts antiapoptotic effects. Here we studied the impact of nitric oxide (NO) on OxLDL-induced cytochrome c release, apoptosis, and expression of the proapoptotic p53 in macrophages. Human LDL was oxidised by Cu(2+), and monocytes were prepared from human buffy coats. Differentiation to macrophages was achieved by culturing cells in the presence of human serum and was followed by detecting monocyte chemoattractant protein 1 (MCP-1) expression (RT-PCR). Cytochrome c release and p53 expression of macrophages were detected by immunoblotting, and apoptosis by visualisation of nuclear condensation. OxLDL dose-dependently (50-200 microg/ml) induced cytochrome c release that was prevented by preincubation with the NO-donor S-nitrosoglutathione (GSNO) (100 microM) or with the cGMP analogue 8-br-cGMP (100 microM) for 15 h. In cells co-treated with GSNO and the soluble guanylate cyclase (sGC) inhibitor oxadialoquinoxalione (ODQ, 10 microM, 15 h), OxLDL-evoked cytochrome c release remained effective, indicating that NO acted via sGC-dependent cGMP formation. Parallel incubation of macrophages with 8-br-cGMP (100 microM) and ODQ (10 microM) for 15 h left the protective effect of 8-br-cGMP unaltered. Short pre-incubation (30 min) with GSNO or 8-br-cGMP was ineffective in preventing OxLDL-elicited cytochrome c release. Initiation of cytochrome c release in macrophages was paralleled by a dose-dependent accumulation of the proapoptotic factor p53, and by enhanced rate of nuclear condensation. Stabilisation of p53 was prevented by preincubation with the NO-donor GSNO or 8-br-cGMP, thus implying a downmodulatory effect of cGMP on pathways that upregulate the tumor suppressor p53. OxLDL induces cytochrome c release and apoptosis in human macrophages in close association with p53 accumulation. NO attenuates OxLDL-induced cytochrome c release and p53 accumulation via activation of sGC and cGMP formation. These effects may be of particular importance in arterial tissue with reduced NO activity.


Chest MRI in children.
MRI of the pediatric chest appears useful in evaluating the mediastinum, the bony thorax, and the lung parenchyma. MR seems to be more useful than other imaging modalities in evaluation of the mediastinum, particularly in defining the extent of the lesions. Coronal images provide additional information to those obtained axially. MR can in a selected number of cases replace x-ray CT in evaluation of the pediatric chest.


A retrospective study assessing the characteristics of COVID-19 convalescent plasma donors and donations.
Although many trials are currently investigating the safety and efficacy of convalescent plasma (CP) in critically ill COVID-19 patients, there is a paucity of ongoing and published studies evaluating the CP donors' side. This retrospective study reports the first Italian experience on CP donors' selection and donations. Patients aged 18-68 years who had recovered from COVID-19 at least 2 weeks previously were recruited between March 18 and June 30, 2020 in a study protocol at the Italian hospitals of Pavia and Mantova. During the study period, 494 of 512 donors recruited were judged eligible and underwent 504 plasmapheresis procedures. Eighty-five percent (437/512) of the CP donors were males. The average time between symptom recovery and CP donation was 36.6 (±20.0) days. Four hundred and eighty-eight plasmapheresis procedures (96.8%) were concluded and each unit was divided into two subunits (total 976) with an average volume of 316.2 (±22.7) mL. Ninety-three percent (460/494) of CP donors at the time of plasma donation had a neutralizing IgG titer ≥1:80. Plasmapheresis-related adverse reactions occurred in 2.6% (13/504) of cases; all the reactions were mild and none required therapeutic intervention. Donors' age and COVID-19 severity were positively associated with greater antibody responses. This study demonstrates the feasibility and safety of a pilot CP program conducted in Italy. The identification of factors (ie, age and severity of COVID-19) positively associated with higher neutralizing antibody titers at the time of donation may help to optimize the selection of CP donors.


Cystic avascular necrosis of the triquetrum.
Carpal bones are rarely affected by avascular necrosis (AVN) in the absence of fractures. The lunate is the most frequently affected carpal bone, followed by the scaphoid and the capitate. The triquetrum is rarely affected by AVN. We report a case of multiple cystic changes in the triquetrum in a patient with a history of trauma. He was treated by below elbow Colles plaster cast for 3 months, with no improvement. Cystic changes resulted from irreversible AVN of the triquetrum. This is the first case to be reported in the literature with cystic AVN changes in the triquetrum.


TOX expression in cutaneous T-cell lymphomas: an adjunctive diagnostic marker that is not tumour specific and not restricted to the CD4(+) CD8(-) phenotype.
TOX (thymocyte selection-associated high-mobility group box) was shown to be aberrantly expressed in mycosis fungoides (MF) and Sézary syndrome (SS) and is suggested to have additional diagnostic value. However, data on expression in other types of cutaneous T-cell lymphoma (CTCL) are scarce and it is unknown whether TOX is expressed only by MF with a CD4(+) CD8(-) phenotype. To investigate TOX expression in various types of CTCL with different T-cell phenotypes. Immunohistochemical expression of TOX was evaluated on 153 skin biopsies of 132 patients with CTCL and 60 patients with benign inflammatory dermatoses (BIDs). TOX was expressed by > 50% of the neoplastic T cells in 49 of 59 patients (83%) with MF and in 19 of 22 patients (86%) with SS. The TOX(+) cases of MF included 34 of 35 cases (97%) with a CD4(+) CD8(-) phenotype, but also five of eight cases (63%) with a CD4(-) CD8(+) phenotype and 10 of 16 cases (63%) with a CD4(-) CD8(-) phenotype. TOX expression in other types of CTCL was common but showed variable intensity. Although only one of 60 patients (2%) with a BID expressed TOX in > 50% of the skin-infiltrating T cells, some caution is warranted, as the majority of BIDs had TOX(+) T cells varying between 11% and 50%. TOX expression is not tumour specific, is not restricted to CTCL with a CD4(+) CD8(-) phenotype, and, on its own, is insufficient for diagnosis of CTCL. However, it may have an adjunctive diagnostic role in conjunction with other clinical and histological data.


Influence of the pore size and porosity of selective laser melted Ti6Al4V ELI porous scaffold on cell proliferation, osteogenesis and bone ingrowth.
This paper systematically investigates the biomedical performance of selective laser melted (SLM) porous Ti6Al4V ELI scaffolds for bone implantation through in vitro and in vivo experiments. Scaffolds with pore sizes of 500 μm, 600 μm and 700 μm and porosities of 60% and 70% were manufactured in order to explore the optimum pore size and porosity. Rat bone marrow mesenchymal stem cells (rBMMSCs) were used in the in vitro experiments. Cell Counting Kit-8, live/dead staining and scanning electron microscope were used to assess the cytotoxicity of the porous scaffolds. DNA content quantification was performed to investigate cell proliferation on the porous scaffolds. The osteogenic differentiation of cells was measured by alkaline phosphatase (ALP) activity and osteogenic gene expressions, including bone morphogenetic protein-2 (BMP-2), collagen type 1α1 (COL-1), osteocalcin (OCN), osteopontin (OPN) and runt-related transcription factor-2 (RUNX-2). The Sprague-Dawley (SD) rat models with distal femoral condyles defect were used in the in vivo experiments. Micro-CT analysis and histological analysis were performed after implantation surgery to reveal the bone ingrowth into the porous scaffolds. All in vitro data were analyzed by one-way ANOVA followed by Tukey post hoc tests, in vivo data were analyzed using Kruskall-Wallis ANOVA and Conover-Inman post-hoc test. Based on the in vitro and in vivo experiments, it is found that the porous scaffolds manufactured by SLM did not induce a cytotoxic effect. Among all the porous scaffolds, the scaffold with a pore size of 500 μm and porosity of 60% showed the best cell proliferation and osteogenic differentiation (in vitro experiments) and bone ingrowth (in vivo experiments).


Methylprednisolone pulse therapy in severe dysthyroid optic neuropathy.
Five patients with severe dysthyroid optic neuropathy were treated with intravenous methylprednisolone (1 g daily for 3 consecutive days). Before administration, visual acuity of the more severely affected eyes of each patient was counting fingers at 5 feet, 8/200, 20/400, 20/200, and 20/80. Immediately after completion of pulse therapy, visual acuity improved to 20/25 in four patients and 20/30 in one. Remissions were maintained with oral prednisone and external beam irradiation of the orbit. Pulse methylprednisolone therapy appears to be beneficial in the initial management of severe dysthyroid optic neuropathy.


"Arcus retinalis": A novel clinical marker of sub-internal limiting membrane hemorrhage.
Preretinal hemorrhages can be located in subhyaloid or sub-internal limiting membrane (ILM) space. Though optical coherence tomography (OCT) may help to distinguish the exact location of hemorrhage in selected cases, it is often difficult to discern clinically. The purpose is to describe a novel clinical sign named "arcus retinalis" as a clinical marker of sub-ILM hemorrhage. Retrospective observational case series. Ophthalmic records of 31 eyes with sub-ILM hemorrhage were analyzed. The sub-ILM nature of the hemorrhage was confirmed either by the presence of two distinct layers (ILM and posterior hyaloid) on OCT or on intraoperative sub-ILM localization of the hemorrhage during vitrectomy. 15 out of 31 eyes with sub-ILM hemorrhage demonstrated a retinal yellowish-white arc corresponding to the outer margin of the sub-ILM hemorrhage. A complete circle was not seen in most of the cases. This arc corresponded to a vertical peg-like structure in the outer retina on OCT and had a tendency to fade away over months. In 10 eyes, it was visible at presentation and in five eyes it could only be seen after clearing of the hemorrhage. Retinal yellowish-white arc ("arcus retinalis") is a useful clinical marker of sub-ILM hemorrhage with distinct OCT features that tends to disappear with time.


Effects of low-molecular-weight organic ligands and phosphate on adsorption of Pseudomonas putida by clay minerals and iron oxide.
Adsorption of Pseudomonas putida on kaolinite, montmorillonite and goethite was studied in the presence of organic ligands and phosphate. Citrate, tartrate, oxalate and phosphate showed inhibitive effect on P. putida adsorption by three minerals in a broad range of anion concentrations. The highest efficiencies of the four ligands in blocking the adsorption of P. putida on goethite, kaolinite and montmorillonite were 58-90%, 35-76% and 20-48%, respectively. The ability of organic ligands in prohibiting the binding of P. putida cells to the minerals followed the sequence of citrate>tartrate>oxalate>acetate. The significant suppressive effects on P. putida adsorption were ascribed to the increased negative charges by adsorbed ligands and the competition of ligands with bacterial surface groups for binding sites. The inhibitive effects on P. putida adsorption by organic ligands were also dependent on the steric hindrance of the molecules. Acetate presented promotive effect on P. putida adsorption by kaolinite and goethite at low anion concentrations. The results obtained in this study suggested that the adsorption of bacteria in soils especially in the rhizosphere can significantly be impacted by various organic and inorganic anions.


Finite element modeling of cooled-tip probe radiofrequency ablation processes in liver tissue.
Finite element model of radiofrequency ablation (RFA) with cooled-tip probe in liver has been developed by employing COMSOL Multiphysics software. It describes coupled electric, thermal and sodium chloride solution infiltration flow phenomena taking place during ablation processes. Features of hydraulic capacity, saturation of the tissue by infiltration, and dependency of electrical conductivity on the damage integral of the tissue have been supplied to the model. RFA experiments have validated the model. Physical parameters describing hydraulic capacity and hydraulic conductivity in the tissue, as well as, the relation of electrical conductivity against the value of damage integral have been determined.


[Human immunodeficiency virus-infected patients with community-acquired pneumonia: implication of respiratory viruses].
The role of respiratory viruses in community-acquired pneumonia (CAP) in human immunodeficiency virus (HIV)-infected patients has not been extensively investigated. The objective was to study the implication of respiratory viruses in HIV patients with CAP, through a prospective, three-year study in a third-level hospital. Respiratory viruses were implicated in 14 of the 67 cases of CAP diagnosed and were the only microorganism isolated in 8 of them. Evolution of the disease was similar in patients with CAP associated with respiratory virus infection and those with CAP alone. Respiratory virus infection in HIV-infected patients with CAP is not associated with a poorer prognosis.


Recycling factors for ribosome disassembly in the apicoplast and mitochondrion of Plasmodium falciparum.
The reduced genomes of the apicoplast and mitochondrion of the malaria parasite Plasmodium falciparum are actively translated and antibiotic-mediated translation inhibition is detrimental to parasite survival. In order to understand recycling of organellar ribosomes, a critical step in protein translation, we identified ribosome recycling factors (RRF) encoded by the parasite nuclear genome. Targeting of PfRRF1 and PfRRF2 to the apicoplast and mitochondrion respectively was established by localization of leader sequence-GFP fusions. Unlike any RRF characterized thus far, PfRRF2 formed dimers with disulphide interaction(s) and additionally localized in the cytoplasm, thus suggesting adjunct functions for the factor. PfRRF1 carries a large 108-amino-acid insertion in the functionally critical hinge region between the head and tail domains of the protein, yet complemented Escherichia coli RRF in the LJ14frr(ts) mutant and disassembled surrogate E. coli 70S ribosomes in the presence of apicoplast-targeted EF-G. Recombinant PfRRF2 bound E. coli ribosomes and could split monosomes in the presence of the relevant mitochondrial EF-G but failed to complement the LJ14frr(ts) mutant. Although proteins comprising subunits of P. falciparum organellar ribosomes are predicted to differ from bacterial and mitoribosomal counterparts, our results indicate that the essential interactions required for recycling are conserved in parasite organelles.


Dietary adenosine supplementation improves placental angiogenesis in IUGR piglets by up-regulating adenosine A2a receptor.
Abnormal placental angiogenesis is associated with the occurrence of intrauterine growth restriction (IUGR) in piglets, and effective treatment strategies against this occurrence remain to be explored. Adenosine has been reported to play an important role in angiogenesis, but its role in placental angiogenesis is still unknown. Here, we investigated the effect of dietary adenosine supplementation on IUGR occurrence in piglets by analyzing the role of adenosine in placental angiogenesis for Normal and IUGR piglets. Specifically, 88 sows were allotted to 2 treatments (n = 44) and fed a basal diet supplemented with 0% or 0.1% of adenosine from day 65 of gestation until farrowing, followed by collecting the placental samples of Normal and IUGR piglets, and recording their characteristics. The results showed that adenosine supplementation increased the mean birth weight of piglets (P < 0.05) and placental efficiency (P < 0.05), while decreasing the IUGR piglet rate (P < 0.05). Expectedly, the placenta for IUGR neonates showed a down-regulated vascular density (P < 0.05) and angiogenesis as evidenced by the expression level of vascular cell adhesion molecule-1 (VCAM1) (P < 0.05). Notably, dietary adenosine supplementation promoted angiogenesis (P < 0.05) both in the Normal and IUGR placenta. More importantly, the expression level of adenosine A2a receptor (ADORA2A) was lower (P < 0.05) in the IUGR placenta than in Normal placenta, whereas adenosine treatment could significantly increase ADORA2A expression, and also had an interaction effect between factors IUGR and Ado. Collectively, placentae for IUGR piglets showed impaired angiogenesis and down-regulated expression level of ADORA2A, while dietary adenosine supplementation could activate ADORA2A expression, improve the placental angiogenesis, and ultimately decrease the occurrence of IUGR in piglets.


Implantable cardioverter defibrillator utilization based on discharge diagnoses from Medicare and managed care patients.
Implantable cardioverter defibrillators (ICDs) have become an accepted therapy for patients at high risk of sudden cardiac death. To assess the current utilization of this therapy, we estimated the number of patients at risk of sudden death using an historical claims-based study and compared these results to current ICD usage volumes. Managed care and Medicare databases (claims related to 4.6 million covered U.S. lives during a 12-month period) were analyzed to identify patients who had either a primary or secondary diagnosis of ventricular tachycardia, ventricular fibrillation, ventricular flutter, or cardiac arrest. These patients were further required to have a diagnosis code indicating a previous myocardial infarction or congestive heart failure. Patients who died during the study period or did not have medical insurance were excluded. In the base case scenario, 1,226 patients per million population were identified as potential ICD candidates. Sensitivity analyses reduced that value to a range from 736 to 1,140 ICD candidates per million population. Sensitivity factors considered included acute myocardial infarction, comorbidities, age, secondary ventricular tachycardia/ventricular fibrillation diagnosis, and varying degrees of left ventricular dysfunction. These results contrast with an ICD usage rate of 416 per million population in the United States and lower rates in other countries. This study suggests that, based on discharge diagnoses, many patients who could benefit from ICDs are not receiving this therapy. Diverse reasons for this underutilization should be addressed to improve access to, and appropriate use of, this therapy.


Composition and sources of organic matter and its solvent extractable components in surface sediments of a bay under serious anthropogenic influences: Daya Bay, China.
Organic matter of nine surface sediments from the Daya Bay was Soxhlet-extracted with a mixture of 2:1 (v/v) dichloromethane-methanol and separated into five fractions: non-aromatic hydrocarbons, aromatic hydrocarbons, ketones, alcohols, and fatty acids and asphaltenes, and analyzed to determine their bulk and biomarker composition. Marine autogenic input appears to be a major source of organic matter. Generally, non-aromatic hydrocarbons are the most dominant fraction of solvent-extractable organic matter (EOM) followed by the other four fractions in decreasing amounts: fatty acids and asphaltenes, ketones, alcohols and aromatic hydrocarbons. On average, both non-aromatic hydrocarbon fraction and fatty acid and asphaltene fraction account for approximately 40% of EOM. The sources of acyclic methyl ketones, alkanols and fatty acids were examined. For n-alkan-2-ones, allochthonous input is a more important source than marine autogenetic input; the reverse is true for n-fatty acids; for n-alkanols, allochthonous and autogenetic inputs seem comparable. Both n-alkan-2-ones and n-fatty acids in the surface sediments of different areas appear to be derived from common sources.


Diffusion-weighted imaging of malignant breast tumors: the usefulness of apparent diffusion coefficient (ADC) value and ADC map for the detection of malignant breast tumors and evaluation of cancer extension.
The authors used breast diffusion-weighted imaging (DWI) to diagnose breast cancer and identify cancer extension. Isotropic DWI was performed with EPI. The apparent diffusion coefficient (ADC) value was calculated and displayed on an ADC map. The authors compared between the distribution of low ADC values and pathologic cancer extension. The mean ADC value of breast cancer was 1.12 +/- 0.24 x 10(-3) mm/s, which was lower than that of normal breast tissue. The ADC value for invasive ductal carcinoma was lower than that of noninvasive ductal carcinoma. The sensitivity of the ADC value for breast cancer using a threshold of less than 1.6 x 10(-3) mm/s was 95%. Seventy-five percent of all cases showed precise distribution of low ADC value as cancer extension. The causes of underestimation were susceptibility artifact from bleeding and the limit of spatial resolution. Benign proliferative change showed a low ADC value. The authors conclude that DWI has a potential for clinical appreciation in detecting breast cancer.