Multidisciplinary, exercise-based oncology rehabilitation programs improve patient outcomes but their effects on healthcare service-level outcomes remain uncertain: a systematic review.
What is the effect of multidisciplinary, exercise-based, group oncology rehabilitation programs on healthcare service outcomes and patient-level outcomes, including quality of life and physical and psychosocial function? Systematic review with meta-analysis of randomised controlled trials. Adults diagnosed with cancer. Multidisciplinary, group-based rehabilitation that includes exercise for cancer survivors. Primary outcomes related to health service delivery, including costs, hospitalisations and healthcare service utilisation. Secondary outcomes were patient-level measures, including: the European Organisation for Research and Treatment of Cancer Quality-of-life Questionnaire, 30-second timed sit to stand and the Hospital Anxiety and Depression Scale. The evidence was evaluated using the PEDro Scale and the Grades of Research, Assessment, Development and Evaluation (GRADE) approach. Seventeen trials (1,962 participants) were included. There was uncertainty about the effect of multidisciplinary, exercise-based rehabilitation on healthcare service outcomes, as only one trial reported length of stay and reported wide confidence intervals (MD 2.4 days, 95% CI -3.1 to 7.8). Multidisciplinary, exercise-based rehabilitation improved muscle strength (1RM chest press MD 3.6 kg, 95% CI 0.4 to 6.8; 1RM leg press MD 19.5 kg, 95% CI 12.3 to 26.8), functional strength (30-second sit to stand MD 6 repetitions, 95% CI 3 to 9) and reduced depression (MD -0.7 points, 95% CI -1.2 to -0.1) compared to usual care. There was uncertainty whether multidisciplinary rehabilitation programs are more effective when delivered early versus late or more effective than exercise alone. Adherence was typically high (mean weighted average 76% sessions attended) with no major and few minor adverse events reported. Multidisciplinary, exercise-based oncology rehabilitation programs improve some patient-level outcomes compared with usual care. Further evidence from randomised trials to determine their effect at a healthcare service level are required if these programs are to become part of standard care. PROSPERO CRD42019130593.


Barriers and enablers to access childhood cataract services across India. A qualitative study using the Theoretical Domains Framework (TDF) of behaviour change.
Early presentation for childhood cataract surgery is an important first step in preventing related visual impairment and blindness. In the absence of neonatal eye screening programmes in developing countries, the early identification of childhood cataract remains a major challenge. The primary aim of this study was to identify potential barriers to accessing childhood cataract services from the perspective of parents and carers, as a critical step towards increasing the timely uptake of cataract surgery. In-depth interviews were conducted using a pre-designed topic guide developed for this study to seek the views of parents and carers in nine geographic locations across eight states in India regarding their perceived barriers and enablers to accessing childhood cataract services. A total of 35 in-depth interviews were conducted including 30 at the hospital premises and 5 in the participants' homes. All interviews were conducted in the local language and audio taped for further transcription and analysis. Data were organised using NVivo 11 and a thematic analysis was conducted utilising the Theoretical Domains Framework (TDF), an integrative framework of behavioural theories. The themes identified from interviews related to 11 out of 12 TDF domains. TDF domains associated with barriers included: 'Environmental context and resources', 'Beliefs about consequences' and 'Social influences'. Reported enablers were identified in three theoretical domains: 'Social influences', 'Beliefs about consequences' and 'Motivations and goals'. This comprehensive TDF approach enabled us to understand parents' perceived barriers and enablers to accessing childhood cataract services, which could be targeted in future interventions to improve timely uptake.


Ensuring safe health care and dealing appropriately with patient complaints.
John Tingle discusses two important publications. One is on patient safety from the National Patient Safety Agency and the other is on NHS complaints from the Health Service Ombudsman.


Species identification in protozoa: glucosephosphate isomerase variation in the Paramecium aurelia group.
Results are presented for intra- and interspecies variation in electrophoretic mobility of the enzyme glucosephosphate isomerase in the Paramecium aurelia species complex. Three new observations have been made: (1) the hitherto indistinguishable species 1 and 5 can be distinguished on the basis of GPI electrophoretic mobility, (2) the degree of intraspecies variation is much higher for GPI than for the previously studied mitochondrial dehydrogenases and esterases, and (3) several of the enzymatic variants observed in one species are apparently indistinguishable from some found in other species. The intraspecies variants found have been shown to be allelic, and, on the basis of the enzyme patterns of the heterozygotes, it is proposed that GPI is a dimeric enzyme determined by two loci. In view of the use of enzyme variation as a means of species identification in protozoa, these results suggest that the use of such methods can lead to underestimating the number of species and possibly to misclassification. The implications of these findings together with the results obtained with Tetrahymena are discussed.


Circularly polarized luminescence of AIE-active chiral O-BODIPYs induced via intramolecular energy transfer.
Two AIE-active chiral BINOL-based O-BODIPY enantiomers (R/S-5) were synthesized and showed mirror-image red-color CPL induced via intramolecular energy transfer. The chiroptical properties of the molecules indicate that the chirality of electronic ground and excited states is stable and independent of aggregation.


Selection of high-performance liquid chromatographic methods in pharmaceutical analysis. IV. Selection of most applicable separation system.
Different analytical tasks in the pharmaceutical analysis can be classified according to the separation problems into three main groups: trace analysis, assay methods and separation of closely related compounds including isomers. The most important requirements of high-performance liquid chromatographic (HPLC) methods with respect of the separation problems are summarized. Considerations and recommendations for the selection of the most applicable HPLC system to solve particular analytical problems are discussed. HPLC methods can be compared on the basis of the system resolution (SR) and system selectivity (SS). Criteria developed for the characterization of HPLC methods considering the difficulties created by the different analytical problems are established. The principles of the selection of the most applicable separation systems are demonstrated through some practical examples in pharmaceutical analysis.


TonB-dependent outer membrane transport: going for Baroque?
The import of essential organometallic micronutrients (such as iron-siderophores and vitamin B(12)) across the outer membrane of Gram-negative bacteria proceeds via TonB-dependent outer membrane transporters (TBDTs). The TBDT couples to the TonB protein, which is part of a multiprotein complex in the plasma (inner) membrane. Five crystal structures of TBDTs illustrate clearly the architecture of the protein in energy-independent substrate-free and substrate-bound states. In each of the TBDT structures, an N-terminal hatch (or plug or cork) domain occludes the lumen of a 22-stranded beta barrel. The manner by which substrate passes through the transporter (the "hatch-barrel problem") is currently unknown. Solution NMR and X-ray crystallographic structures of various TonB domains indicate a striking structural plasticity of this protein. Thermodynamic, biochemical and bacteriological studies of TonB and TBDTs indicate further that existing structures do not yet capture critical energy-dependent and in vivo conformations of the transport cycle. The reconciliation of structural and non-structural experimental data, and the unambiguous experimental elucidation of a detailed molecular mechanism of transport are current challenges for this field.


Twin births, sex of children and maternal risk of endometrial cancer: a cohort study in Norway.
To explore whether twin births and sex of children influenced maternal risk of endometrial cancer, possibly with effect modification by age. Population-based prospective study. A total of 1,094,017 parous Norwegian women aged 30-74 years, including 3,356 endometrial cancer cases. Among the 27,158 mothers of twins, 101 cases occurred. Incidence rate ratios (IRR) with 95% confidence intervals (CI) were calculated in Poisson regression analyses of person-years at risk. Women ever having experienced a twin birth had an overall higher risk of endometrial cancer than women with singleton births only (IRR=1.26, 95% CI=1.03-1.53). Women with twin boys appeared to be the main contributor to the overall elevated risk (IRR=1.57, 95% CI=1.15-2.14). The risk estimates for women with twin girls or sex-nonconcordant twins were close to unity (IRR of 1.09 and 1.12, respectively). However, age-specific analyses revealed an elevated risk also in women with twin girls, but only before age 55 years (IRR=1.92, 95% CI=1.27-2.89); a lower risk was seen at older ages (IRR=0.41, 95% CI=0.19-0.92). The risk estimates for twin boys and sex-nonconcordant twins were consistently observed across age groups. The effect modification by age was statistically significant (p=0.0024). No association was found with sex of children in singleton mothers. Mothers of twin boys had a significantly higher risk of endometrial cancer than women with singleton births only, whereas women with twin girls had an elevated risk before age 55 years. No significant association was seen with sex-noncordant twins, neither overall nor within age groups.


Assessing the Effect of Dental Implants Thread Design on Distribution of Stress in Impact Loadings Using Three Dimensional Finite Element Method.
Impacts and accidents are considered as the main fac- tors in losing the teeth, so the analysis and design of the implants that they can be more resistant against impacts is very important. One of the important nu- merical methods having widespread application in various fields of engineering sciences is the finite element method. Among its wide applications, the study of distribution of power in complex structures can be noted. The aim of this research was to assess the geometric effect and the type of implant thread on its performance; we also made an attempt to determine the created stress using finite element method. In this study, the three dimensional model of bone by using Cone Beam Computerized Tomography (CBCT) of the patient has been provided. The implants in this study are designed by Solid Works software. Loading is simulated in explicit dynamic, by struck of a rigid body with the speed of 1 mm/s to implant vertically and horizontally; and the maximum level of induced stress for the cortical and trabecular bone in the ANSYS Workbench software was calculated. By considering the results of this study, it was identified that, among the designed samples, the maximum imposed stress in the cortical bone layer occurred in the first group (straight threads) and the maximum stress value in the trabecular bone layer and implant occurred in the second group (tapered threads). Due to the limitations of this study, the implants with more depth thread, because of the increased contact surface of the implant with the bone, caused more stability; also, the implant with smaller thread and shorter pitch length caused more stress to the bone.


Successful gamete intrafallopian transfer following failed artificial insemination by donor: evidence for a defect in gamete transport?
Gamete intrafallopian transfer (GIFT) was offered as an alternative treatment to 48 women who failed to conceive after artificial insemination with donor semen (AID) in numerous attempts (9 to 24 cycles). The evaluation of these women showed no major cause of infertility as evidenced by normal endocrine, cervical, uterine, and tubal factor studies. Their partners were either azoospermic or severely oligoasthenospermic. During the GIFT cycle, follicular development was induced with (1) clomiphene citrate (days 3 to 7) plus human menopausal gonadotropins (hMG) from day 6 on or (2) human follicle-stimulating hormone (days 3 to 4) plus hMG (day 5 on), until ultrasound revealed 2 follicles 16 mm and serum estradiol (E2) was greater than 700 pg/ml. Human chorionic gonadotropin (hCG) 10,000 IU was administered, and 36 hours later follicular aspiration was performed. One to three oocytes and 100,000 motile sperm were transferred to each fallopian tube through the fimbria via laparoscopy or minilaparotomy. Twenty-seven clinical pregnancies were achieved (56%) per GIFT cycle. Eight miscarriages occurred during the first trimester (29% of all pregnancies), whereas no ectopic pregnancies were observed. These data conclusively show the value of the GIFT procedure in the treatment of cases with failed AID.


Multiple primary lung cancers.
Seventy-five cases of multiple primary lung cancers, representing 3.78% of a series of 1980 consecutively resected tumors, were divided into 24 synchronous and 51 metachronous cancers, according to the criteria of Martini and Melamed. They all concerned tobacco-smoking men. The synchronous tumors were symptomatic in 66% of the cases, the metachronous tumors in 37%. Nine synchronous locations were unilateral and 15 were bilateral; 20 metachronous locations were ipsilateral and 31 were contralateral. There were three third metachronous cancers. The resection of both tumours was performed for 15 synchronous cancers and for 19 metachronous cancers, including two third metachronous tumors. There were two deaths related to metachronous cancers. No patient with resected synchronous cancers survived 5 years, while 20% of patients with resected metachronous cancers survived this period. Synchronous cancers appear to represent an advanced stage. Metachronous cancers are often diagnosed too late.


Why imaginary worlds? The role of self-exploration within online gaming worlds.
Dubourg and Baumard posited that preferences for exploration are the key to the popularity in imaginary worlds. This commentary argues that other forms of exploration may also account for the success and appeal of specific types of imaginary worlds, namely self-exploration within interactive imaginary worlds such as videogames.


Association of Japan Coma Scale score on hospital arrival with in-hospital mortality among trauma patients.
The Japan Coma Scale (JCS) score has been widely used to assess patients' consciousness level in Japan. JCS scores are divided into four main categories: alert (0) and one-, two-, and three-digit codes based on an eye response test, each of which has three subcategories. The purpose of this study was to investigate the utility of the JCS score on hospital arrival in predicting outcomes among adult trauma patients. Using the Japan Trauma Data Bank, we conducted a nationwide registry-based retrospective cohort study. Patients 16 years old or older directly transported from the trauma scene between January 2004 and December 2017 were included. Our primary outcome was in-hospital mortality. We examined outcome prediction accuracy based on area under the receiver operating characteristic curve (AUROC) and multiple logistic regression analysis with multiple imputation. A total of 222,540 subjects were included; their in-hospital mortality rate was 7.1% (n = 15,860). The 10-point scale JCS and the total sum of Glasgow Coma Scale (GCS) scores demonstrated similar performance, in which the AUROC (95% CIs) showed 0.874 (0.871-0.878) and 0.878 (0.874-0.881), respectively. Multiple logistic regression analysis revealed that the higher the JCS score, the higher the predictability of in-hospital death. When we focused on the simple four-point scale JCS score, the adjusted odds ratio (95% confidence intervals [CIs]) were 2.31 (2.12-2.45), 4.81 (4.42-5.24), and 27.88 (25.74-30.20) in the groups with one-digit, two-digit, and three-digit scores, respectively, with JCS of 0 as a reference category. JCS score on hospital arrival after trauma would be useful for predicting in-hospital mortality, similar to the GCS score.


A comparison between the University of Washington Head and Neck Disease-Specific measure and the Medical Short Form 36, EORTC QOQ-C33 and EORTC Head and Neck 35.
The University of Washington Head and Neck Disease-Specific questionnaire (UW-QOL) is potentially a suitable routine measure of outcome in head and neck cancer because it is quick and simple for patients to complete and is easy to process. The aim of this study was to compare the UW-QOL with three validated instruments in a group of patients having primary surgery for oral cancer. Between May and December 1995, 34 consecutive patients with previously untreated oral and oropharyngeal squamous cell carcinoma underwent primary surgery. Patients self-completed the following questionnaires: UW-QOL, Medical Outcomes Short Form 36 (SF-36), the European Organisation for Research and Treatment of Cancer (EORTC) QOQ-C33 and the EORTC Head and Neck (H&N35). Questionnaires were distributed at four time intervals: pre-operatively, and at 3, 6 and 12 months. Patients were withdrawn if they developed recurrent disease. 29 patients agreed to participate in this prospective study and cross-sectional comparisons were made on baseline data and trends over time for longitudinal comparisons. This study emphasises the difficulties of one questionnaire to adequately evaluate quality of life. However, it would appear that the UW-QOL is a broad measure suitable for routine "low cost" assessment of disease-specific functional status.


Mutations in the HBV PreS/S gene related to hepatocellular carcinoma in Vietnamese chronic HBV-infected patients.
Chronic hepatitis B virus (CHB) infection is a major health problem and leading cause of hepatocellular carcinoma (HCC) worldwide. Several point and deletion mutations on the PreS/S gene have been intensively considered associated with HCC. This study aimed to describe the characteristics of HBV PreS/S mutations in Vietnamese CHB-infected patients and their association with HCC. This cross-sectional study was conducted from 02/2020 to 03/2021, recruited Vietnamese CHB-infected patients with HBV-DNA >3 log10-copies/mL and successful PreS/S gene sequencing. Mutations were detected by direct Sanger sequencing. 247 CHB-infected patients were recruited, characterized by 68.8% males, 54.7% HBV genotype B, 57.5% HBeAg positive, 23.1% fibrosis score ≥F3 and 19.8% HCC. 61.8% amino acid replacements were detected throughout the PreS1/PreS2/S genes. The most common point-mutations included N/H51Y/T/S/Q/P (30.4%), V68T/S/I (44.9%), T/N87S/T/P (46.2%) on PreS1 gene; T125S/N/P (30.8%), I150T (42.5%) on PreS2 gene; S53L (37.7%), A184V/G (39.3%), S210K/N/R/S (39.3%) on S gene. The rates of case(s) with any point-mutation on the Major Hydrophylic Region (MHR) and the "a" determinant region were 63.6% and 39.7%, respectively. Most of S point-mutations were presented with low rates such as T47A/E/V/K (9.3%), P120S/T (8.5%), G145R (2%). On multivariable analysis, males (OR = 4.51, 95%CI 1.78-11.4, p = 0.001), age≥40 (OR = 5.5, 95%CI 2.06-14.68, p = 0.001), W4P/R/Y on PreS1 (OR = 11.56, 95%CI 1.99-67.05, p = 0.006) and 4 S point-mutations as: T47A/E/V/K (OR = 3.67, 95%CI 1.19-11.29, p = 0.023), P120S/T (OR = 3.38, 95%CI 1.09-10.49, p = 0.035), S174N (OR = 29.73, 95%CI 2.12-417.07, p = 0.012), P203R (OR = 8.45, 95%CI 1.43-50.06, p = 0.019) were associated with HCC. We detected 61% amino acid changes on PreS/S regions in Vietnamese CHB patients. One point-mutation at amino acid 4 on PreS1 gene and 4 point-mutations at amino acids 47, 120, 174, and 203 on S gene were associated with HCC. Further investigations are recommended to further clarify the relationship and interaction between mutations in HBV genome and HCC progression.


A comparative study of the rate-limiting enzymes of cholesterol synthesis, esterification and catabolism in the rat and rabbit.
1. The rat and rabbit are amongst the animal models most widely used in the study of human atherosclerosis, a disease state correlating with disturbances in cholesterol metabolism. 2. In order to relate the key regulatory enzymes of cholesterol synthesis, esterification and catabolism in the rat and rabbit to their differing degree of susceptibility to atherosclerosis, enzyme levels and their properties were determined in liver and intestine of both species. 3. Hepatic HMG CoA reductase and cholesterol 7 alpha-hydroxylase levels were significantly higher in the rat than in the rabbit, while intestinal HMG CoA reductase activity in the two species was comparable. Conversely, the capacity to esterify cholesterol as measured by ACAT activities was considerably greater in both sites in the rabbit compared to the rat. 4. The data suggest that differences in the key regulatory enzymes of cholesterol metabolism in both liver and intestine may reflect different methods of cholesterol utilization in the two species.


Interaction of phospholipid membranes with poly(ethylene glycol)s.
1. The water-soluble polymer, poly(ethylene glycol), causes concentration-dependent increases in the temperature of the gel--liquid crystalline phase transitions of aqueous dispersions of dipalmitoyl phosphatidylcholine and of dipalmitoyl phosphatidylethanolamine. 2. For dipalmitoyl phosphatidylcholine it has been further demonstrated that poly(ethylene glycol) increases the transition enthalpy and entropy while decreasing the cooperativity of the transition. 3. These results are discussed in relation to the possible modes of action of poly(ethylene glycol) in promoting cell fusion.


Prevalence of thyroid disorders in psychogeriatric inpatients. A possible relationship of hypothyroidism with neurotic depression but not with dementia.
Thyroid disorders are known to manifest occasionally as isolated psychiatric disorders. In order to determine whether thyroid dysfunctions could play a significant role in the pathogenesis of psychiatric disorders in the elderly, the prevalence of thyroid disorders was compared in a group of psychogeriatric patients and in a group of nonpsychiatric elderly patients. Thyroid function screening was performed in 157 patients consecutively admitted to a psychogeriatric unit, and the prevalence of hypothyroidism was determined in the different groups of psychiatric disorders (senile and multi-infarct dementia, organic brain syndrome of other etiologies, psychotic depression, neurotic depression, chronic delusional state, acute confusional state, and personality disorder). Thyroid function screening was performed similarly in 104 unselected elderly patients admitted to the medico-surgical admission unit of the University hospital to assess the prevalence of hypothyroidism in a general, nonpsychiatric, elderly population. Eight patients were diagnosed as hypothyroid based on an elevated basal thyrotropin (TSH) and on thyrotropin-releasing hormone (TRH) test in the total number of patients, two in the nonpsychiatric and six in the psychiatric group. Three had clinical hypothyroidism, with decreased total and free T4 and T3 plasma levels in addition to increased basal TSH, five had biochemical hypothyroidism, with normal T4 and T3 levels and an excess TSH response to oral TRH. The prevalence of hypothyroidism in the two groups did not differ significantly (1.9% in the nonpsychiatric versus 3.8% in the psychiatric group). The prevalence of hypothyroidism in a subgroup of 88 patients with senile and multi-infarct dementia was 2.3%.(ABSTRACT TRUNCATED AT 250 WORDS)


[Problem of early registration of hypertension: combination of x-ray and blood-pressure determination].
In a program aiming at 30,000 blood pressure measurements per year 12,401 persons have been examined in the canton of Berne (population of approx. 1 million) from first of January 1976 to the end of April 1977. This group belongs to the active working part of the inhabitants (age 30 years and more). The introduction of this method was without any problems. 97 to 100 percent of the people participated on a voluntary base. A short personal history of hypertension and smoking habits were requested by a questionnaire. Some results obtained by the use of a general computerprogram are presented: 15.1 % of the screened population had a hypertension greater than or equal to 160/95 mmHg. 55.5 % were unknown to the examined persons. Connections with other findings than hypertension, such as pathologic images of the heart in the x-ray and smoking have been determined. 66.5 % showed one, two or three of the above mentioned findings. The advantages of this method are stressed.


Bilateral lacrimal gland disease: clinical features and outcomes.
Patients with bilateral lacrimal gland disease are a unique subset of patients where there is a paucity of literature. This presentation often represents systemic disease or malignancy and can cause diagnostic difficulties. We aim to describe the diagnoses and features of bilateral lacrimal gland disease. Retrospective multi-centre case series involving 115 patients with bilateral lacrimal gland disease from 1995 to 2020. 115 patients were included. Their ages ranged from 9 to 85 (mean 47.3 years) with a female predominance (73, 63.5%). The most common category of diagnosis was inflammatory (69, 60%) followed by lymphoproliferative (23, 20%), structural (17, 14.8%) and other conditions (6, 5.2%). The five most common specific diagnoses were IgG4 related disease (20, 17.4%) and idiopathic orbital inflammatory disease (20, 17.4%), lymphoma (16, 13.9%), lacrimal gland prolapse (13, 11.3%), and sarcoidosis (11, 9.6%). Corticosteroid treatment was used most commonly (29, 25.2%) followed by observation (25, 21.7%). At last follow up, the majority of patients had complete resolution, significant improvement with mild residual disease or stable disease without further progression (104, 90.4%). Bilateral lacrimal disease may be due to a range of aetiologies, most of which are systemic. The most common are inflammatory and lymphoproliferative conditions. Due to the wide range of aetiologies of bilateral lacrimal gland disease, it is extremely difficult to accurately determine a cause based on clinical findings alone, highlighting the vital role of lacrimal gland biopsy in patients presenting with bilateral lacrimal gland disease.


Tibial bone defect prediction based on preoperative artefact-reduced CT imaging is superior to standard radiograph assessment.
The purpose of this study was to evaluate the accuracy of preoperative CT-based Anderson Orthopaedic Research Institute (AORI)-grading and to correlate Computed tomography (CT)-based volumetric defect measurements with intraoperative AORI findings. 99 patients undergoing revision total knee arthroplasty (rTKA) with preoperative CT-images were identified in an institutional revision registry. CT-image segmentation with 3D-Slicer Software was used to create 3D tibial bone defects which were then graded according to the AORI-classification. The AORI classification categorizes tibial defects into three types: Type I has healthy cortical and cancellous bone near the joint line, Type II involves metaphyseal bone loss affecting one or both condyles, and Type III indicates deficient metaphyseal bone with distal defects and potential damage to the patellar tendon and collateral ligament attachments. These 3D-CT gradings were compared to preoperative X-ray and intraoperative AORI grading. The Friedman test was used to investigate differences between AORI values of each measurement method. Volumetric 3D-bone defect measurements were used to investigate the relationship between AORI classification and volumetric defect size in the three anatomic zones of the tibia. Substantial agreements between preoperative 3D-CT AORI and intraoperative AORI (kappa = 0.663; P < 0.01) and fair agreements between preoperative X-ray AORI and intraoperative AORI grading (kappa = 0.304; P < 0.01) were found. Moderate correlations between volume of remaining bone and intraoperative AORI grading were found in epiphysis (rS = - 0.529; P < 0.001), metaphysis (rS = - 0.557; P < 0.001) and diaphysis (rS = - 0.421; P < 0.001). Small volumetric differences between AORI I vs. AORI II defects and relatively large differences between AORI II and AORI III defects in each zone were detected. Tibial bone defect prediction based on preoperative 3D-CT segmentation showed a substantial agreement with intraoperative findings and is superior to standard radiograph assessment. The relatively small difference in defect volume between AORI I, IIa and IIb suggests that updated CT-based classifications might hold benefits for the planning of rTKA. Retrospective Cohort Study; III.


Focused ultrasound robotic system for very small bore magnetic resonance imaging.
A magnetic resonance imaging (MRI) compatible robotic system for focused ultrasound was developed for small animal like mice or rats that fits into a 9.4 T MRI scanner (Bruker Biospec 9420, Bruker Biospin, Ettlingen, Germany). The robotic system includes two computer-controlled linear stages. The robotic system was evaluated in a mouse-shaped, real-size agar-based mimicking material, which has similar acoustical properties as soft tissues. The agar content was 6% weight per volume (w/v), 4% w/v silica while the rest was degassed water. The transducer used has a diameter of 4 cm, operates with 2.6 MHz and focuses energy at 5 cm. The MRI compatibility of the robotic system was evaluated in a 9.4 T small animal scanner. The efficacy of the ultrasonic transducer was evaluated in the mimicking material using temperature measurements. The proposed robotic system can be utilized in a 9.4 T small animal MRI scanner. The proposed system is functional, compact and simple thus providing a useful tool for preclinical research in mice and rats.


Long-term outcome after radioiodine therapy with adjuvant rhTSH treatment: comparison between patients with non-toxic and pre-toxic large multinodular goitre.
In multinodular goitre (MNG), low radioiodine (RAI) activity after recombinant human (rh) TSH is able to reduce thyroid volume (TV) and improve symptoms. Our aim was to evaluate the long-term outcome of RAI after rhTSH treatment in patients who were divided according to their baseline TSH levels. Eighteen patients (69.2 ± 6.1 year) presented non-toxic (TSH >0.3 mIU/l) MNG (TV: 61.0 ± 3.8 ml; group 1), while 13 patients (74.1 ± 7.9 year) had non-autoimmune pre-toxic (TSH <0.3 mIU/l) MNG (TV: 82.6 ± 14.4 ml; group 2). TSH, thyroid hormones, TV (by ultrasonography), body mass index (BMI), symptoms and quality of life (QoL) were evaluated. Treatment induced short-term thyrotoxicosis in both groups, but this was slightly more marked in group 2 than in group 1. The number and severity of adverse events were similar. The follow-up period was 55.3 ± 4.1 months in group 1 and 57.2 ± 5.1 months in group 2. The final TV reduction was similar in groups 1 (63.4 ± 3.6%) and 2 (57.2 ± 4.6%) and TV reduction positively correlated only with initial TV. At the last examination, 14 group-1 subjects were on L-T4 therapy, while 2 group-2 subjects were on methimazole. An increase in BMI was noted only in group 2. MNG-related symptoms were significantly reduced in both groups. Symptoms related to sub-clinical hyperthyroidism improved in group 2, while no significant changes in QoL were noted in either group. This study confirms the effectiveness of rhTSH adjuvant treatment in reducing TV after low RAI activities, irrespective of baseline thyroid status. TSH levels <0.3 mIU/l proved to be predictive of a more severe thyrotoxic phase after rhTSH and RAI, while initial TSH levels >0.3 mIU/l were more frequently followed by a need for L-T4 therapy. Compressive symptoms improved in the majority of subjects.


Nutritional support in surgical practice: Part I.
Critical evaluation of the therapeutic benefit gained from provision of nutritional support requires knowledge regarding the nutritional status of those to whom it was given. The apparent effect of giving parenteral nutrition or enteral nutrition depends not only on how much and how well it is given, but also on how depleted the recipient is. Thus, nutritional assessment requires close examination before proceeding to assess the efficacy and potential benefits of the remedial measures of parenteral nutrition or enteral nutrition. Although preoperative malnutrition is associated with a poor operative outcome, there appears to be no consensus as to whether perioperative nutritional support can reduce postoperative complications to the level occurring in well-nourished patients undergoing similar procedures. This is partly because reports evaluating the effect of perioperative nutritional support on postoperative outcome vary widely as to numbers of patients studied, primary diagnoses, and the duration and quality of perioperative nutritional support. In Part I, these issues are explored in patients who are undergoing operations for cancer, trauma, or burns. Enteral nutrition appears to be as effective as parenteral nutrition in improving operative outcome, as compared with ad libitum oral nutrition. Postoperative enteral nutrition and parenteral nutrition are equally effective in reducing postoperative complications.


Pneumocystis pneumonia in a treatment-naive rheumatoid arthritis patient.
A HIV-negative, newly diagnosed patient with rheumatoid arthritis (RA) was found to have pneumocystis jiroveci pneumonia. The infection was treated with three weeks of atovaquone and corticosteroids. Clinicians should be aware of pneumocystis pneumonia as an infection in RA patients not receiving treatment.


Retrovirus receptor PiT-1 of the Felis catus.
We isolated a cDNA encoding a feline homolog of human PiT-1, a sodium-dependent phosphate symporter which is utilized by gibbon ape leukemia virus (GALV) as a receptor for entry into host cells. The overall homology between the human and feline receptors is 92 and 93% at the nucleotide and deduced amino acid levels, respectively. Hydropathy analyses implied ten potential membrane spanning regions and, in analogy to human and murine homologs, five extracellular and four intracellular loops. Strikingly, the amino acid sequence of the fourth extracellular loop, which is critical for GALV surface glycoprotein binding, has complete identity between the human and feline PiT-1s, while the mouse PiT-1, non-functional for GALV entry, is quite divergent. Ectopic expression of the feline PiT-1 in guinea pig cells, which are non-permissive to feline leukemia virus (FeLV), subgroup B virus, conferred susceptibility to FeLV-B infection confirming the functional ability of the cloned product to serve as a receptor for a natural retrovirus of the homologous species.


Sturge-Weber syndrome. A case with thyroid and choroid plexus hemangiomas and leptomeningeal melanosis.
We studied a case of Sturge-Weber syndrome in a 66-year-old woman, who displayed associated angiomas of the thyroid gland and choroid plexi and leptomeningeal melanosis. These findings are discussed in light of the proposed pathogenesis of the syndrome and its relationship to the other neuroectodermal dysplasias.


Epidemiologic review of marijuana use and cancer risk.
Marijuana is the most commonly used illegal drug in the United States and is considered by young adults to be the illicit drug with the least risk. On the other hand, marijuana smoke contains several of the same carcinogens and co-carcinogens as the tar from tobacco, raising concerns that smoking of marijuana may be a risk factor for tobacco-related cancers. We reviewed two cohort studies and 14 case-control studies with assessment of the association of marijuana use and cancer risk. In the cohort studies, increased risks of lung or colorectal cancer due to marijuana smoking were not observed, but increased risks of prostate and cervical cancers among non-tobacco smokers, as well as adult-onset glioma among tobacco and non-tobacco smokers, were observed. The 14 case-control studies included four studies on head and neck cancers, two studies on lung cancer, two studies on non-Hodgkin's lymphoma, one study on anal cancer, one study on penile cancer, and four studies on childhood cancers with assessment of parental exposures. Zhang and colleagues reported that marijuana use may increase risk of head and neck cancers in a hospital-based case-control study in the United States, with dose-response relations for both frequency and duration of use. However, Rosenblatt and co-workers reported no association between oral cancer and marijuana use in a population-based case-control study. An eightfold increase in risk among marijuana users was observed in a lung cancer study in Tunisia. However, there was no assessment of the dose response, and marijuana may have been mixed with tobacco. Parental marijuana use during gestation was associated with increased risks of childhood leukemia, astrocytoma, and rhabdomyosarcoma, but dose-response relations were not assessed. In summary, sufficient studies are not available to adequately evaluate marijuana impact on cancer risk. Several limitations of previous studies include possible underreporting where marijuana use is illegal, small sample sizes, and too few heavy marijuana users in the study sample. Recommendations for future studies are to (1) focus on tobacco-related cancer sites; (2) obtain detailed marijuana exposure assessment, including frequency, duration, and amount of personal use as well as mode of use (smoked in a cigarette, pipe, or bong; taken orally); (3) adjust for tobacco smoking and conduct analyses on nonusers of tobacco; and (4) conduct larger studies, meta-analyses, or pooled analyses to maximize statistical precision and investigate sources of differences in results. Despite the challenges, elucidation of the association between marijuana use and cancer risk is important in weighing the benefits and risks of medical marijuana use and to clarify the impact of marijuana use on public health.


Exposure to static magnetic field facilitates selective attention and neuroplasticity in rats.
Static magnetic fields (SMF) have neuroprotective and behavioral effects in rats, however, little is known about the effects of SMF on cognition, motor function and the underlying neurochemical mechanisms. In this study, we focused on the effects of short-term (5-10d) and long-term (13-38d) SMF exposure on selective attention and motor coordination of rats, as well as associated alterations in expression level of neuroplasticity-related structural proteins and cryptochrome (CRY1) protein in the cortex, striatum and ventral midbrain. The results showed that 6d SMF exposure significantly enhanced selective attention without affecting locomotor activity in open field. All SMF exposures non-significantly enhanced motor coordination (Rotarod test). Neurochemical analysis demonstrated that 5d SMF exposure increased the expression of cortical and striatal CRY1 and synapsin-1 (SYN1), striatal total synapsins (SYN), and synaptophysin (SYP), growth associated protein-43 (GAP43) and post-synaptic density protein-95 (PSD95) in the ventral midbrain. Exposure to SMF for 14d increased PSD95 level in the ventral midbrain while longer SMF exposure elevated the levels of PSD95 in the cortex, SYN and SYN1 in all the examined brain areas. The increased expression of cortical and striatal CRY1 and SYN1 correlated with the short-lasting effect of SMF on improving selective attention. Collectively, SMF's effect on selective attention attenuated following longer exposure to SMF whereas its effects on neuroplasticity-related structural biomarkers were time- and brain area-dependent, with some protein levels increasing with longer time exposure. These findings suggest a potential use of SMF for treatment of neurological diseases in which selective attention or neuroplasticity is impaired.


Infertility workup: identifying endometriosis.
Endometriosis was classically diagnosed during diagnostic laparoscopies, which used to be routinely performed up until a decade ago or so. This practice fitted with the long-held belief that surgery was the gold standard for diagnosing endometriosis. Today, the abandon of routine diagnostic laparoscopies-in favor of assisted reproductive technology-first therapeutic approaches-has created a void for diagnosing endometriosis. Modern-day imaging techniques-ultrasound and magnetic resonance imaging-when used with a systematic approach have offered a reliable replacement option for diagnosing endometriosis. In infertility, endometriosis should be identified or excluded on the basis of past history or confirmation or exclusion suspicion on the basis of history and/or physical examination.


Quantitative histochemical and stereological study of alkaline phosphatase in the rat thyroid gland.
The histochemical alkaline phosphatase reaction in thyroid vascular endothelium was estimated spectrophotometrically and stereologically. Thus two main characteristics of the reaction were obtained: 1. the average enzyme activity, reflecting the level of transport processes in the capillary-thyrocyte system; 2. the relative volume of functioning vessels. An index of thyroid vascularity is proposed that is equal to the product of these two characteristics. The changes of the primary characteristics as well as of the vascularity index, caused by experimental hypo- and hyperplasia of the gland, are discussed.


Peripheral RAGE (receptor for advanced glycation endproducts)-ligands in normal pregnancy and preeclampsia: novel markers of inflammatory response.
Inflammatory response in preeclampsia (PE) is a key feature in its pathophysiology. Advanced Glycation Endproducts (AGEs), receptors for AGEs (RAGE), and RAGE ligands are involved in systemic inflammation in various pathological conditions. In this study, we measured serum RAGE ligands in normal pregnancy controls and PE patients. Levels of Carboxymethyl Lysine (CML), HMGB1 and S100A12/EN-RAGE were measured in thirty-three normal pregnant women 3 times at 10-12 (1st measurement), 28 (2nd measurement), and 36 (3rd measurement) weeks during gestation for paired analysis. We also measured those in serum samples from 17 severe PE patients at admission using ELISA. Early onset (EO, <32 weeks) and late onset (LO, ≥32 weeks) PE patients were compared with the 2nd and 3rd measurements of normal controls, respectively. CML and HMGB1 did not change during normal pregnancy. However, S100A12/EN-RAGE decreased from the 1st to 2nd measurement (P<0.0001). Across all PE patients, serum CML was unaltered, while HMGB1 significantly increased compared to 2nd (P=0.0002) and 3rd (P<0.0001) measurement as well as individually compared to both EO (P=0.018) and LO groups (P=0.0001). S100A12 in all PE patients increased over 2nd (P=0.0015) and 3rd (P=0.0002) measurements, although only LO was significantly increased compared to the 3rd measurement (P=0.0005). Our data suggest that patterns of serum RAGE ligand concentration indicate different inflammatory pathways in normal pregnancy, EO-PE, and LO-PE.


Enhanced p62 Is Responsible for Mitochondrial Pathway-Dependent Apoptosis and Interleukin-1β Production at the Early Phase by Monosodium Urate Crystals in Murine Macrophage.
The aim of this study was to clarify the role of p62-dependent mitochondrial apoptosis in the initiation of monosodium urate (MSU) crystal-induced inflammation in macrophages. The induction of mitochondrial apoptosis in RAW 264.7 murine macrophages by MSU crystals was measured using western blotting and quantitative real-time polymerase chain reaction for Bax, caspase-3, caspase-9, or PARP1, and by flow cytometric analysis. Immunoprecipitation and western blotting was applied to detect ubiquitination of p62, TRAF6, and caspase-9. Mitochondrial apoptosis, reactive oxygen species (ROS) generation, and cell proliferation were assessed in cells transfected with p62 small interfering RNA (siRNA). Treatment of RAW 264.7 cells with MSU crystals induced activation of Bax, caspase-3, caspase-9, and PARP1 at the early phase, in addition to enhancing IL-1β expression, but these findings were attenuated at the late phase. MSU crystals induced ubiquitination of p62, followed by ubiquitination of TRAF6 and caspase-9, which were significantly reversed by ascorbic acid. RAW 264.7 cells transfected with p62 siRNA showed attenuated expression of Bax, caspase-3, caspase-9, and PARP1, decreased ROS and IL-1β production, and increased cell proliferation, compared to controls. The antioxidant ascorbic acid inhibited p62, caspase-9, and IL-1β expression increased by MSU crystals. p62 may be a crucial mediator for the mitochondrial apoptosis pathway in MSU crystal-induced inflammation, which is linked to the acute inflammatory response during the early phase of gout.


Colonoscopic screening in average-risk individuals ages 40 to 49 vs 50 to 59 years.
Screening guidelines for colorectal cancer include colonoscopy starting at age 50 years based on the prevalence of adenomas and the incidence of colon cancer at that age. However, only one prior study has investigated the prevalence of colorectal neoplasia with colonoscopic screening in asymptomatic average-risk individuals ages 40-49 years in the United States. We analyzed the results of screening colonoscopies offered to patients of a health care provider that offers screening services as part of an employer-provided wellness program. The primary end points were prevalence of adenomas and cancers for those aged 40-49 years vs those 50-59 years. We analyzed 553 screening colonoscopies for patients ages 40-49 years and 352 screening colonoscopies for patients ages 50-59 years. In the 40-49 years age group, 79 patients (14%) had 1 or more adenomas, of which 11 (2% of screened) had an advanced neoplasm (>1 cm). In the 50-59 years age group, 56 patients (16%) had 1 or more adenomas detected. Of those patients, 13 (3.7% of screened) had an advanced neoplasm, and 1 patient (0.3%) had an adenocarcinoma detected. We found on colonoscopic screening that the prevalence of total adenomas was similar in individuals ages 40-49 and in those 50-59 years, although the prevalence of advanced neoplasia in the 50-59 years age group may be higher than that in the 40-49 years age group.


Presentation format effects in working memory: the role of attention.
Four experiments are reported in which participants attempted to remember three or six concrete nouns, presented as pictures, spoken words, or printed words, while also verifying the accuracy of sentences. Hypotheses meant to explain the higher recall of pictures and spoken words over printed words were tested. Increasing the difficulty and changing the type of processing task from arithmetic to a visual/spatial reasoning task did not influence recall. An examination of long-term modality effects showed that those effects were not sufficient to explain the superior performance with spoken words and pictures. Only when we manipulated the allocation of attention to the items in the storage task by requiring the participants to articulate the items and by presenting the stimulus items under a degraded condition were we able to reduce or remove the effect of presentation format. The findings suggest that the better recall of pictures and spoken words over printed words result from the fact that under normal presentation conditions, printed words receive less processing attention than pictures and spoken words do.


Dietary calcium modulates spinal cord content of calcitonin gene-related peptide in the rat.
This study was undertaken to determine if calcium status modulates calcitonin gene-related peptide (CGRP) neuronal content. In two separate experiments, young, growing rats and mature rats were placed on low, normal, and high calcium diets for four weeks. CGRP immunostaining was localized immunocytochemically in laminae I and II of the upper thoracic spinal cord in young rats and in the upper thoracic and lumbar spinal cord in mature rats. Low calcium intake decreased dorsal horn CGRP content in young, growing rats, while high calcium diet significantly increased CGRP content, as determined by computer-assisted image processing, in both young and adult rats. A significant positive correlation was found between the serum ionized calcium and CGRP content in laminae I and II. Thus, calcium balance appears to modulate neuronal CGRP content.


Cell proliferation in normal and diseased gastric mucosa. Autoradiography after in vitro continuous labelling with tritiated thymidine.
The rate of gastric epithelial cell proliferation was studied in healthy volunteers and in patients with different degrees of gastritis. Endoscopic biopsies from the antral and fundic part of the stomach were incubated in vitro with 3H-thymidine for 30, 120, and 210 minutes respectively. Autoradiographs were prepared, and the percentage of DNA-synthesizing cells (labeling index) in the progenitor cell region was estimated. From the successive labeling indices the rate of entry of cells into DNA-synthetic phase (S-phase) and the duration of the S-phase could be estimated. All the biopsies were classified according to the degree of gastritis. The mean (+/-SEM) length of the S-phase was found to be 7.4 +/- 0.3 hours in antral mucosa and 7.2 +/- 0.4 hours in fundic mucosa. There was no significant difference between the S-phase duration in normal mucosa, superficial gastritis, mild atrophic gastritis and severe atrophic gastritis. This observation suggests that the labeling index can be used as an expression for the rate of cell proliferation in human gastric mucosa. A significant correlation between the labelling indices and the degree of gastritis was found in both antral and fundic mucosa. In six cases, labelling indices estimated by cell counts performed on longitudinal or cross sections of foveolae were compared. Ther was no significant difference between the results obtained by the two different counting techniques.


Kuanxiong aerosol inhibits apoptosis and attenuates isoproterenol-induced myocardial injury through the mitogen-activated protein kinase pathway.
Kuanxiong aerosol (KXA) is a common clinical drug based on Fangxiang Wentong (FXWT) therapy in the treatment of angina pectoris. However, the pharmacological mechanism of KXA in the prevention and treatment of myocardial injury (MI) is not clear. The purpose of this study was to explore the protective effect of KXA on isoproterenol (ISO)-induced MI in rats. The study included male Wistar Kyoto rats (age: 6 weeks). The rats were randomly divided into the following 5 groups (n = 6 per group): control group, ISO group, isosorbide mononitrate (ISMN) group (5 mg/kg), KXA-L group (0.1 mL/kg), and KXA-H group (0.3 mL/kg). The rats in the last three groups were given intragastric administration for 14 days, and rats in control group and ISO group were given the same amount of normal saline daily. ISO (120 mg/kg) was used to induce MI on the 13th and 14th days. We assessed electrocardiograms (ECGs), myocardial specific enzymes, histopathological changes, and apoptosis. We found that KXA reduced the increase in the ST-segment amplitude (elevation or depression) and the levels of myocardial marker enzymes induced by ISO in MI rats, improved the pathological changes in myocardial tissue, and reduced cardiomyocyte apoptosis. At the same time, KXA significantly inhibited the up-regulation of caspase-3 and Bax expression and down-regulation of Bcl-2 expression induced by ISO. RNA sequencing showed that 90 up-regulated genes induced by ISO were down-regulated after KXA treatment, whereas 27 down-regulated genes induced by ISO were up-regulated after KXA treatment. In addition, KEGG pathway enrichment analysis showed that the mitogen-activated protein kinase (MAPK) signaling pathway may be an important target of KXA in the treatment of ISO-induced MI in rats. The results of RNA sequencing verified by Western blot analysis showed that KXA significantly inhibited the activation of the ISO-induced MAPK pathway. KXA improves cardiac function in MI rats by inhibiting apoptosis mediated by the MAPK signaling pathway.


Descriptions of five new eriophyoid mite species of the Diptilomiopidae (Acari: Trombidiformes: Eriophyoidea) from Zhejiang Province, China.
Five new eriophyoid mite species from Zhejiang Province, China are described and illustrated: Diptacus coreanus sp. nov. from Litsea coreana H. Lév. (Lauraceae), Neorhynacus camphoratus sp. nov. from Cinnamomum camphora (L.) J. Presl (Lauraceae), Rhinotergum boehmerius sp. nov. from Boehmeria gracilis C.H. Wright (Urticaceae), Rhyncaphytoptus cathayensis sp. nov from Carya cathayensis Sarg. (Juglandaceae) and Rhyncaphytoptus lanceolatus sp. nov. from Cunnighamia lanceolata (Lamb.) Hook (Cupressaceae). All species were vagrant on their host plants with no visible damage observed.


Bioprocess intensification: Cases that (don't) work.
Development of affordable and low carbon biobased manufacturing depends critically on strategies that reduce cost and emission profiles. This paper indicates that efforts around the reduction of capital costs by intensification of process equipment need to be carefully weighed against the inherently fast increasing financial and climate costs of driving forces used for the intensification. The fundamental relation between capital expenditures (CAPEX) and operational expenditures (OPEX) of intensified and non-intensified biobased processes and their financial and climatic impacts are emphasized and provisionally explored for a few industrial processes. General learnings flag the importance in particular of OPEX minimisation for sustainable bio-economic development.


Pharmacy staff perceptions and self-reported behaviors related to providing contraceptive information and counseling.
To evaluate pharmacy staff perspectives of a 2-year pharmacy intervention aimed at reducing unintended pregnancy in 18- to 30-year-old women. Pharmacy staff completed a 48-item, self-administered paper survey consisting of scaled and open-ended questions. 55 community pharmacies in 12 Iowa counties. All pharmacy staff participated, including pharmacists, pharmacy technicians, and other pharmacy employees. Online continuing education (CE) training was made available to all pharmacy staff. Promotional materials including posters, brochures, and shelf talkers were displayed in all of the pharmacies. Pharmacy staff perceptions and self-reported behaviors related to displaying posters, brochures, and shelf talkers in their pharmacies and providing contraceptive information and counseling to patients/customers. A total of 192 (43% return rate) pharmacy staff responded. Only 44% of respondents consistently provided contraceptive information and counseling, yet more than 90% felt that talking with patients/customers about contraceptives was easy, and more than 50% could do so privately. The study showed increased pharmacy staff desire to make this topic a priority. Community pharmacy staff can play a key role in educating and counseling young adult women about contraceptive health and pregnancy planning. This study indicates that staff are comfortable providing this service and that patients/customers are open to receiving guidance from pharmacists. However, pharmacy staff are missing additional opportunities to provide information and counseling. There is also a need for greater attention to provision of nonprescription contraceptive education.


Molecular Characterization of UL50 (dUTPase) Gene of Bovine Herpes Virus 1.
Bovine herpes virus -1 (BoHV-1) infection leads to upper respiratory tract infection, conjunctivitis and genital disorders in cattle. To control BoHV-1, it is important to understand the role of viral proteins in viral infection. BoHV-1 has several gene products to help in viral replication in infected cell. One such gene is deoxyuridine triphosphate nucleotidohydrolase (dUTPase) also known as UL50. In this study, we analyzed the amino acid sequence of UL50 (dUTPase) using bioinformatics tools and found that it was highly conserved among herpesvirus family. Then, it was cloned and expressed in Escherichia coli Rosetta (DE3), induced by isopropy1-b-D-thiogalactopyranoside (IPTG) and the recombinant UL50 protein was purified to immunize rabbits for the preparation of polyclonal antiserum. The results indicated that the UL50 gene of BoHV-1 was composed of 978 nucleotides, which encoded 323 amino acids. Western blot analysis revealed that polyclonal sera against UL50 reacted with a band of 34 kDa. Furthermore, immunofluorescence assay showed that UL50 localized in the cytoplasmic area. Taken together, UL50 was successfully cloned, expressed and detected in BoHV-1-infected cells and was localized in the cytoplasm to help in the replication of BoHV-1 in infected cells.


Structural analysis of β-prism lectin from Colocasia esculenta (L.) S chott.
The Mannose-binding β-Prism Colocasia esculenta lectin (β-PCL) was purified from tubers using ion exchange chromatography. The purified β-PCL appeared as a single band of ∼12kDa on SDS-PAGE. β-PCL crystallizes in trigonal space group P3121 and diffracted to a resolution of 2.1Å. The structure was solved using Molecular replacement using Crocus vernus lectin (PDB: 3MEZ) as a model. From the final refined model to an R-factor of 16.5% and an Rfree of 20.4%, it has been observed that the biological unit consists of two β-Prism domains augmented through C-terminals swap over to form one of faces for each domain. Cα superposition of individual domains of β-PCL with individual domains of other related structures and superposition of whole protein structures were carried out. The higher RMS deviation for the superposition of whole structures suggest that β-prism domains assume different orientation in each structure.


An ensemble of structures of Burkholderia pseudomallei 2,3-bisphosphoglycerate-dependent phosphoglycerate mutase.
Burkholderia pseudomallei is a soil-dwelling bacterium endemic to Southeast Asia and Northern Australia. Burkholderia is responsible for melioidosis, a serious infection of the skin. The enzyme 2,3-bisphosphoglycerate-dependent phosphoglycerate mutase (PGAM) catalyzes the interconversion of 3-phosphoglycerate and 2-phosphoglycerate, a key step in the glycolytic pathway. As such it is an extensively studied enzyme and X-ray crystal structures of PGAM enzymes from multiple species have been elucidated. Vanadate is a phosphate mimic that is a powerful tool for studying enzymatic mechanisms in phosphoryl-transfer enzymes such as phosphoglycerate mutase. However, to date no X-ray crystal structures of phosphoglycerate mutase have been solved with vanadate acting as a substrate mimic. Here, two vanadate complexes together with an ensemble of substrate and fragment-bound structures that provide a comprehensive picture of the function of the Burkholderia enzyme are reported.


Prophylactic EUS-guided gallbladder drainage prevents acute cholecystitis in patients with malignant biliary obstruction and cystic duct orifice involvement: a randomized trial (with video).
Patients with distal malignant biliary obstruction (MBO) and cystic duct orifice tumoral involvement have an increased risk for the development of acute cholecystitis after self-expandable metallic stent (SEMS) placement. We aimed to determine whether primary EUS-guided gallbladder drainage prevents acute cholecystitis in these patients. This was a single-center, randomized control trial in patients with distal MBO enrolled from July 2018 to July 2020. Patients were randomized into 2 groups: an interventional group treated with conventional ERCP biliary drainage with SEMS placement and subsequent primary EUS-guided gallbladder drainage (EUS-GBD) and a control group treated with conventional biliary drainage alone. The primary outcome of the study was the occurrence of post-treatment acute cholecystitis, assessed for ≤12 months or until death. The secondary outcomes were hospitalization length and median survival time. Forty-four patients were included in the study: 22 in each group. Five patients in the control group (22.7%) and none in the intervention group experienced acute cholecystitis. The median hospitalization time was significantly lower in the interventional group than in the control group (2 days vs 1 day, P = .017). There was no difference in the observed median survival rates in the primary EUS-GBD group (2.9 months) and the control group (2.8 months) (P = .580). In this single-center study of patients with unresectable MBO and occlusion of the cystic duct orifice, prophylactic EUS-GBD demonstrated a reduced incidence of acute cholecystitis.


Impact of salinity on organic matter and nitrogen removal from a municipal wastewater RO concentrate using biologically activated carbon coupled with UV/H2O2.
The concentrate streams generated from reverse osmosis (RO)-based municipal wastewater reclamation processes contain organic substances and nutrients at elevated concentrations, posing environmental and health risks on their disposal to confined receiving environments such as bays. The impact of salinity (TDS at 7, 10 and 16 g/L) of a RO concentrate (ROC) on the treatment efficiency of a biological activated carbon (BAC) system after pre-oxidation with UV/H2O2 was characterised in terms of removal of organic matter and nitrogen species, and the bacterial communities. Organic matter removal was comparable for the ROC over the tested salinity range, with 45-49% of DOC and 70-74% of UVA254 removed by the combined treatment. However, removal in total nitrogen (TN) was considerably higher for the ROC at the high salinity (TDS ∼ 16 mg/L) compared with the low (∼7 g/L) and medium salinity (∼10 g/L). Effective nitrification with high ammonium removal (>90%) was achieved at all salinity levels, whereas greater denitrification (39%) was obtained at high salinity than low (23%) and medium salinity (27%) which might suggest that the bacterial communities contributing to the greater denitrification were more halotolerant. Microbiological characterisation using polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) and culture based techniques showed that diversified bacterial communities were present in the BAC system as evident from different 16S rDNA. The major bacterial groups residing on the BAC media belonged to Bacillus (Firmicutes), Pseudomonas (γ-Proteobacteria), and Rhodococcus (Actinobacteria) for all salinity levels, confirming that these microbial communities could be responsible for carbon and nitrogen removal at the different salinity levels. This has implications in understanding the effectiveness and robustness of the BAC system over the salinity range of the ROC and so would be useful for optimising the treatment efficiency of the BAC system.


NMR relaxation induced by iron oxide particles: testing theoretical models.
Superparamagnetic iron oxide particles find their main application as contrast agents for cellular and molecular magnetic resonance imaging. The contrast they bring is due to the shortening of the transverse relaxation time T 2 of water protons. In order to understand their influence on proton relaxation, different theoretical relaxation models have been developed, each of them presenting a certain validity domain, which depends on the particle characteristics and proton dynamics. The validation of these models is crucial since they allow for predicting the ideal particle characteristics for obtaining the best contrast but also because the fitting of T 1 experimental data by the theory constitutes an interesting tool for the characterization of the nanoparticles. In this work, T 2 of suspensions of iron oxide particles in different solvents and at different temperatures, corresponding to different proton diffusion properties, were measured and were compared to the three main theoretical models (the motional averaging regime, the static dephasing regime, and the partial refocusing model) with good qualitative agreement. However, a real quantitative agreement was not observed, probably because of the complexity of these nanoparticulate systems. The Roch theory, developed in the motional averaging regime (MAR), was also successfully used to fit T 1 nuclear magnetic relaxation dispersion (NMRD) profiles, even outside the MAR validity range, and provided a good estimate of the particle size. On the other hand, the simultaneous fitting of T 1 and T 2 NMRD profiles by the theory was impossible, and this occurrence constitutes a clear limitation of the Roch model. Finally, the theory was shown to satisfactorily fit the deuterium T 1 NMRD profile of superparamagnetic particle suspensions in heavy water.


Immature platelet fraction and high-on treatment platelet reactivity with ticagrelor in patients with acute coronary syndromes.
Residual high-on treatment platelet reactivity (HRPR) has been associated with a 2-9 fold increased risk of acute ischemic events in patients with acute coronary syndromes or coronary stenting. However, the mechanism of suboptimal platelet inhibition are still poorly understood. Aim of present study was to evaluate the role of the percentage of reticulated platelets on HRPR with ticagrelor. In patients treated with ASA (100-160 mg) and ticagrelor (90 mg twice a day) platelet reactivity and the reticulated platelets fraction (immature platelets fraction, IPF) were assessed at 30-90 days after acute coronary syndrome. Aggregation was assessed by multiple-electrode aggregometry. HRPR was defined as ADP test >417 AU*min. Our population is represented by 190 patients, divided according to tertiles values of IPF (<2.5; 2.5-3.99; ≥4 %). Higher IPF was associated to a larger platelet volume and lower platelets count (p < 0.001), and inversely related with a history of previous coronary revascularization (p = 0.03). Twenty-one out of 190 (11.0 %) patients displayed HRPR. No difference in the levels of circulating IPF was found in patients with or without HRPR (p = 0.25), with no correlation between the rate of reticulated platelets and platelet reactivity at ADP test (r = -0.084, p = 0.26). In fact no association was observed between high levels of IPF and the occurrence of HRPR (adjusted OR[95 % CI] = 0.69[0.34-1,37], p = 0.28), even after correction for baseline differences. In patients treated with ticagrelor, the levels of circulating reticulated platelets assessed at 30-90 days post-ACS are not associated with platelet reactivity or the occurrence of HRPR.


Humoral immune responses against the malaria vaccine candidate antigen Plasmodium vivax AMA-1 and IL-4 gene polymorphisms in individuals living in an endemic area of the Brazilian Amazon.
Several studies have recently demonstrated that the immune responses against malaria is governed by different factors, including the genetic components of the host. The IL-4 gene appears to be a strong candidate factor because of its role in the regulation of the Th2 response. The present study investigated the role of IL-4 polymorphisms in the development of IgG antibodies against PvAMA-1 and the IL-4 levels in individuals infected with Plasmodium vivax in a malaria endemic area in the Brazilian Amazon. The study sample included 83 patients who were diagnosed with P. vivax infection using thick smear and confirmed by nested-PCR. The IL-4 -590C>T and IL-4 -33C>T polymorphisms were genotyped by PCR-RFLP, and the intron 3 VNTR was genotyped by PCR. A standardised ELISA protocol was used to measure the total IgG against PvAMA-1. The cytokine/chemokine levels were measured using a Milliplex multiplex assay (Millipore). All of the subjects were genotyped with 48 ancestry informative markers to determine the proportions of African, European and Amerindian ancestry using STRUCTURE software. Of the 83 patients, 60 (73%) produced IgG antibodies against PvAMA-1. A significant decrease in the percentage of respondents was observed among the primo-infected individuals. No significant differences were observed in the frequencies of genotypes and haplotypes among individuals who were positive or negative for IgG antibodies against PvAMA-1. Furthermore, no significant correlation was observed between the IL-4 polymorphisms, antibody levels, IL-4 levels, and parasitemia. This study indicated that the polymorphisms identified in the IL-4 gene are not likely to play a role in the regulation of the antibody response against PvAMA-1 and IL-4 production in vivax malaria.


Climate Change and Variability Impacts on Agricultural Production and Food Security for the Smallholder Farmers in Rungwe, Tanzania.
Climate change and variability pose serious challenges among smallholder farmers in developing countries. Low adaptive capacity aggravates the challenges to farming activities and ecosystem management. This study employed survey methods to assess the implications of climate variability and environmental changes in agricultural production and food security. The study used different research methods, including literature review, participatory rural appraisal, household questionnaire, key informant interview and field observation for data collection. The data collected were organised, triangulated, synthesised, processed, analysed using thematic and trend analyses for qualitative data and Microsoft Excel and SPSS 20 software programme manipulation for quantitative data. Severe and frequent climatic extremes that include drought, heavy rainfall, temperature variations, and strong winds are smallholder farmers' main challenges in production. As a result, the production trends and productivity of the main rainfed crops decreased significantly. The duration of the growing season also decreased, negatively affecting the local food supplies. The statistical results signify a robust negative correlation between climate variability and the production of the leading food crops (X2 = 6.00 with p = 0.199 and X2 = 10.00 with p = 0.350). In addressing the challenges, improving farming practices such as crop diversification and improved extension services were suggested. However, such options would require appropriate environmentally friendly technologies in an enabling environment both locally and nationally.


Long non-coding RNAs in schizophrenia: Genetic variations, treatment markers and potential targeted signaling pathways.
Schizophrenia (SZ), a complex and debilitating spectrum of psychiatric disorders, is now mainly attributed to multifactorial etiology that includes genetic and environmental factors. Long non-coding RNAs (lncRNAs) are gaining popularity as a way to better understand the comprehensive mechanisms beneath the clinical manifestation of SZ. Only in recent years has it been elucidated that mammalian genomes encode thousands of lncRNAs. Strikingly, roughly 30-40% of these lncRNAs are extensively expressed in different regions across the brain, which may be closely associated with SZ. The therapeutic and adverse effects of atypical antipsychotic drugs (AAPDs) are partially reflected by their role in the regulation of lncRNAs. This begs the question directly, do any lncRNAs exist as biomarkers for AAPDs treatment? Furthermore, we comprehend a range of mechanistic investigations that have revealed the regulatory roles for lncRNAs both involved in the brain and the periphery of SZ. More crucially, we also combine insights from a variety of signaling pathways to argue that lncRNAs probably play critical roles in SZ via their interactive downstream factors. This review provides a thorough understanding regarding dysregulation of lncRNAs, corresponding genetic alternations, as well as their potential regulatory roles in the pathology of SZ, which might help reveal useful therapeutic targets in SZ.


Fetal ependymoma associated with Down's syndrome.
Down's syndrome (DS) is the most common multiple malformation syndrome occurring in humans and is associated with an increased risk of childhood malignancies, in particular leukemias. However, solid tumors seem to be underrepresented in DS patients and brain tumors occurring in association with DS have so far been limited to sporadic case reports, predominantly in children and young adults. We present the first case of an ependymoma associated with DS. This is also the youngest patient with DS suffering from a brain tumor as well as the first case in the English literature of a fetal ependymoma. The tumor was discovered incidentally at autopsy in a female fetus with DS after amniocentesis and termination of pregnancy in the 19th gestational week. Neuropathological examination revealed a tumor of 3x2x1 mm attached to the medulla oblongata rostrally of the floor of the fourth ventricle. Histologically, the ependymoma was moderately cellular and well demarcated with numerous perivascular pseudorosettes. Immunohistochemistry showed strong reactivity for GFAP, in particular of the fibrillary elements of the pseudorosettes, while the neuronal marker synaptophysin was not expressed. The Ki67/MIB-1 proliferation index was 0.5%.


A retrospective study comparing the outcomes and toxicities of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy for the treatment of children and adolescent nasopharyngeal carcinoma.
To compare the clinical outcomes and toxicities of two-dimensional conventional radiotherapy (2D-CRT) and intensity-modulated radiotherapy (IMRT) for the treatment of children and adolescent nasopharyngeal carcinoma (NPC). A total of 176 children with non-metastatic NPC treated at Sun Yat-sen University Cancer Center between October 2003 and September 2013 were included in this study. Of the 176 patients, 74 received 2D-CRT and 102 were treated with IMRT. The clinical outcomes and acute and late toxicities were determined and compared. The IMRT group achieved significantly higher overall survival (OS) (90.4% vs. 76.1% at 5 year, P = 0.007) and disease-free survival (DFS) (85.7% vs. 71.2%, P = 0.029) mainly due to an improvement in locoregional relapse-free survival (LRRFS) (97.9 vs. 88.3%, P = 0.049). After stratification by disease stage, IMRT provided significant benefits for patients with stage III-IV disease in terms of OS, LRRFS and DFS. Multivariate analyses indicated that the treatment group (2D-CRT vs. IMRT) was a prognostic factor for OS, LRRFS and DFS. A significant reduction in Grade 2-4 xerostomia (52.7 vs. 34.3%, P = 0.015) and hearing loss (40.5 vs. 22.5%, P = 0.010) was observed in patients treated by IMRT. IMRT provides better locoregional relapse-free survival and overall survival, especially in late-stage children and adolescent NPC patients, and is associated with a lower incidence of Grade 2-4 xerostomia as well as hearing loss compared with 2D-CRT. Distant metastasis remains a challenge in the treatment of children and adolescent NPC.


Delivery modes and the neonatal outcomes of low birth-weight neonates in a Brazilian reference health center.
This study compared the neonatal results of low weight neonates born by cesarean and vaginal delivery. A retrospective cohort study. Maternity of Hospital - Irmandade Santa Casa de Misericórdia de São Paulo, Brazil. The analysis included the neonates born alive, of unique pregnancy, <2000 g from October 1999 to July 2013. To obtain the information about the neonatal period, as well as their Apgar score in the 1st and 5th min of life, a search in the database of a neonatal intensive care unit was performed. In total, 830 neonates were included as per the study criteria. Of these, 519 (62.5%) were born by cesarean delivery and 311 (37.5%) by vaginal delivery. There was a statistically significant difference in the incidence of neonatal complications, with better results in the neonates born by vaginal delivery, except for the group with neonates <1500 g. In this group, there was a higher incidence of intracranial hemorrhage and death before discharge from the hospital. There was also a higher incidence of respiratory distress syndrome and intraventricular hemorrhage in neonates born by vaginal delivery, in all weight groups. Comparing the Apgar scores, there was a statistically significant difference between the delivery modes, with better results observed in the ones born by vaginal delivery. However, the opposite was observed in the group with neonates <1000 g. There was no indication of cesarean delivery benefits in neonates 1000-2000 g. However, the opposite was observed when the neonates were <1000 g.


Pharmacokinetics of metformin in patients with chronic kidney disease stage 4 and metformin-naïve type 2 diabetes.
The pharmacokinetics of metformin therapy in patients with chronic kidney disease stage 4 (CKD-4) were studied using data from the largest Phase I consecutive cohort trial yet performed in this population. Eighteen metformin-naïve men and women with Type 2 Diabetes and creatinine clearance (CrCl) in the range 18-49 mL/min (eGFR 15-29 mL/min/1.73 m2) were allocated to daily immediate-release metformin of 250 mg, 500 mg, or 1000 mg. A first-dose profile and trough concentrations for 4 weeks were taken on all patients. Pharmacokinetic (PK) parameters were estimated by fitting a first-order compartment model with absorption in a peripheral compartment to concentrations measured 24 hours post-first dose. Single-dose PK parameters time to maximum concentration (tmax) and maximum concentration (Cmax) were consistent with previous observations in patients with normal renal function (healthy and diabetic), as was the association between CrCl and apparent total oral clearance (Cl/F). However, patients with a CrCl below 32 mL/min had trough concentrations that were consistently above the steady-state minimum implied by the population PK model. This suggests the model may not apply to patients with CrCl below 32 mL/min. Metformin in doses of 500-1000 mg/day could be taken by CKD-4 patients. However, the single-compartment model breaks down as CrCl declines below 32 mL/min suggesting that metformin levels should be monitored regularly in progressive stage 4 CKD.


The Local HIF-2α/EPO Pathway in the Bone Marrow is Associated with Excessive Erythrocytosis and the Increase in Bone Marrow Microvessel Density in Chronic Mountain Sickness.
Chronic mountain sickness (CMS) is characterized by excessive erythrocytosis, and angiogenesis may be involved in the pathogenesis of this disease. The bone marrow niche is the primary site of erythropoiesis and angiogenesis. This study was aimed at investigating the associations of the levels of hypoxia-inducible factors (HIFs), erythropoietin (EPO), and erythropoietin receptor (EPOR), as well as microvessel density (MVD) in the bone marrow with CMS. A total of 34 patients with CMS and 30 control subjects residing in areas at altitudes of 3000-4500 m were recruited for this study. The mRNA and protein expression of HIF-2α and EPO in the bone marrow cells was significantly higher in the CMS patients than in the controls. Moreover, changes in HIF-2α expression in CMS patients were significantly correlated with EPO and hemoglobin levels. In contrast, the expression of mRNA and protein expression of HIF-1α and EPOR did not differ significantly between the CMS and control patients. Increased MVD was observed in the bone marrow of the patients with CMS and it was significantly correlated with hemoglobin. Bone marrow cells of CMS patients may show enhanced activity of the HIF-2α/EPO pathway, and EPO may regulate the erythropoiesis and vasculogenesis through autocrine or/and paracrine mechanisms in the bone marrow niche. The increased MVD in the bone marrow of CMS patients appears to be involved in the pathogenesis of this disease.


The colonization cycle of freshwater insects.
This paper summarizes the recent research on problems of the so-called colonization cycle as one aspect of the migration and flight behaviour of freshwater insects. New results are presented and the applied methods described and discussed. In general the research on this phenomenon shows that the colonization cycle can not only be seen as a type of compensatory flight behaviour, but also as an expression of the winter survival strategy of water insects in high mountainous areas. It opens up the possibility of exploiting ecologically different biotopes such as living in coastal streams and oligohaline brackish water estuaries.


Protective effects of l-carnitine and piracetam against mitochondrial permeability transition and PC3 cell necrosis induced by simvastatin.
Mitochondrial oxidative stress followed by membrane permeability transition (MPT) has been considered as a possible mechanism for statins cytotoxicity. Statins use has been associated with reduced risk of cancer incidence, especially prostate cancer. Here we investigated the pathways leading to simvastatin-induced prostate cancer cell death as well as the mechanisms of cell death protection by l-carnitine or piracetam. These compounds are known to prevent and/or protect against cell death mediated by oxidative mitochondrial damage induced by a variety of conditions, either in vivo or in vitro. The results provide evidence that simvastatin induced MPT and cell necrosis were sensitive to either l-carnitine or piracetam in a dose-dependent fashion and mediated by additive mechanisms. When combined, l-carnitine and piracetam acted at concentrations significantly lower than they act individually. These results shed new light into both the cytotoxic mechanisms of statins and the mechanisms underlying the protection against MPT and cell death by the compounds l-carnitine and piracetam.


Tongue protrusion as an indicator of vital burning.
In the forensic assessment of burned bodies, the question of whether the victim was exposed to the fire before or after death is of crucial importance. Several external signs have been used in the past to indicate heat exposure prior to the death of the victim but these did not include tongue protrusion. The internal signs of heat exposure are generally regarded as much more important than those observed externally. No one factor has been found to be totally reliable. This study found a statistically significant dependence between tongue protrusion and presence of soot in the respiratory tract and stomach, the latter being a good indicator of vital burning. The results of this study confirm that tongue protrusion can be used as an additional indicator of vital burning.


P120-catenin is a novel desmoglein 3 interacting partner: identification of the p120-catenin association site of desmoglein 3.
P120-catenin (p120ctn) is an armadillo-repeat protein that directly binds to the intracytoplasmic domains of classical cadherins. p120ctn binding promotes the stabilization of cadherin complexes on the plasma membrane and thus positively regulates the adhesive activity of cadherins. Using co-immunoprecipitation, we show here that p120ctn associates to desmogleins (Dsg) 1 and 3. To determine which region is involved in the association between Dsg3 and p120ctn, we constructed mutant Dsg3 proteins, in which various cytoplasmic subdomains were removed. The tailless Dsg3 constructs Delta IA:AA1-641Dsg3 and Delta 641-714Dsg3, which do not contain the intracellular anchor (IA) region, did not coprecipitate with p120cn, nor did they colocalize at the plasma membrane. Immunocytochemical analysis revealed that p120ctn does not localize to desmosomes, but colocalizes with Dsg3 at the cell surface. A biotinylation assay for Dsg3 showed that biotinylated Delta 641-714Dsg3 was turned over more rapidly than wild-type Dsg3. These results indicate that the membrane proximal region (corresponding to residues 641-714) in the IA region of Dsg3 is necessary for complex formation with p120ctn, and to maintain free Dsg3 at the cell surface before it is integrated into desmosomes. In summary, we show that p120ctn is a novel interactor of the Dsg proteins, and may play a role in desmosome remodeling.


What can we expect from the CIEMAT/NIST method?
During the last years the CIEMAT/NIST (C/N) method was widely used to determine activities of different radionuclides. The impression is forced that the C/N method could be a universal method for all types of radionuclides. This paper shows under which conditions the C/N method can be used, where its limits are and which uncertainties can typically be achieved.


Withdrawal of collaterals of sympathetic axons to the rat eye during postnatal development: the role of function.
Neurones in the superior cervical ganglion (SCG) of the rat can be retrogradely labelled by injection of Fast blue (FB) into the anterior eye chamber with the maximum number being labelled during the second postnatal week. In adult rats, however, many fewer neurones can be so labelled. In the present study, we have investigated whether this reduction may be due to the withdrawal of collaterals of neurones which project to the posterior eye compartments. For these experiments, we have used either one (FB) or two (FB and horseradish peroxidase (HRP)) retrogradely transported markers injected with a micropipette into the anterior or posterior (vitreous) parts of the eye in rats aged 14, 31 and greater than 50 days. Using FB, we have shown that in 14-day-old rats, 40% of the neurones which project to the eye have collaterals in anterior and posterior compartments while only 1% of neurones maintain dual projections in animals aged more than 7 weeks. Furthermore, there is a reduction in the total number of neurones projecting to the eye between 14 and 31 days postbirth. The presence of significantly greater numbers of cells with collaterals to both eye compartments in the young versus the adult rats has been confirmed using both FB and HRP as retrograde markers. The importance of function on the rearrangement of these projections was investigated by either rearing animals in the dark from the time of birth, or by sectioning the preganglionic nerve trunk to the SCG, soon after birth.(ABSTRACT TRUNCATED AT 250 WORDS)


Neural correlates of social cognition in populations at risk of psychosis: A systematic review.
Social cognition refers to the mental operations governing social interactions. Recent research has highlighted the importance of social cognition in determining functional outcome in patients with schizophrenia and in psychosis risk populations. The aim of this review is to investigate the neural correlates of social cognition in different psychosis risk populations, potentially representing different levels of risk i.e. high schizotypy (SR), familial risk (FR) and clinical high risk (CHR). PsychINFO, Web of Science and PubMed were systematically searched, and 39 papers were included in the final review. Results in FR samples were highly inconclusive. In SR samples, findings showed a tendency towards increased task related activity in frontal cortex regions. The most consistent results come from CHR samples, where findings suggest increased task related activity in frontal and cingulate cortices. Interestingly, all studies of CHR populations also report increased activity in temporal cortex and abnormal response to neutral stimuli during emotional processing tasks. These findings are discussed in relation to dopamine models of psychosis due to temporal cortex abnormality.


In vitro culture medium (IVC) supplementation with sericin improves developmental competence of ovine zygotes.
This study was carried out to investigate the effects of supplementation of potassium simplex optimized medium (KSOM-aa) with various sericin concentrations (0, 0.1, 0.5, 1 and 2.5%) on ovine zygotes. The results indicate that the supplementation of oocyte in vitro culture medium with optimal concentration of sericin (0.1 and 0.5%) may have beneficial effects on developmental competence of in vitro-derived ovine embryos.


Determinants of postnatal care service utilization among married women in rural areas in western Ethiopia.
Worldwide studies have shown that three-fourths of the total deaths during the neonatal period occur in the first week of the postnatal period. However, most of these deaths can be prevented with care during pregnancy, childbirth, and postnatal care. According to the 2016 Ethiopia Demographic and Health Survey report, 17% of women in Ethiopia had received postnatal care after childbirth. This study aimed to identify determinants of postnatal care service utilization among married women in rural areas in Western Ethiopia. A community-based cross-sectional study was conducted among 798 women who had given birth in the past 2 years prior to the survey between 2 and 31 January 2015. A pre-tested structured questionnaire was used to collect the data. Multivariable logistic regression was employed to determine factors affecting utilization of postnatal care. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were used to assess the strength of the associations. The study showed that 188 (23.6%) women utilized postnatal care services during their last pregnancy. Women's educational level (AOR = 3.29, 95%CI = 1.89-5.73), utilization of antenatal care (AOR = 2.07, 95%CI = 1.28-3.36), awareness on the advantage of postnatal care (AOR = 2.10, 95%CI = 1.41-3.13), and knowledge of at least one danger sign during the postnatal period (AOR = 3.04, 95%CI = 2.07-4.46) showed a significant positive association with the utilization of postnatal care. Educating women and creating awareness of maternal health care services during pregnancy increase the utilization of postnatal care services. Health care professionals should provide information on the importance of postnatal care for pregnant women during antenatal care visits.


Weight changes in children in foster care for 1 year.
The aims of this study of predominately racial/ethnic minority children in foster care (N=360, birth to 19 years old) in Los Angeles, CA were to examine the (1) prevalence of obesity (≥ 95 percentile) and overweight/obese (≥ 85 percentile) upon entrance to foster care (T1) and after 1 year in foster care (T2); (2) comparison of high weight categories to national statistics; (3) relationship of changes in weight status to age, reason for entry into foster care, and placement. Chi-square test and McNemar test comparing paired proportions were used to determine whether there were significant changes in the proportion of high weight categories between T1 and T2. Chi-square test or Fisher's exact test were used to evaluate the association between age, placement, and reason for foster care with the change in weight category. Changes in weight were categorized as (1) decreased in weight, (2) remained at overweight or obese, (3) increased in weight, or (4) remained normal. The proportion of obese and obese/overweight children between ages 2 and 5 were significantly lower at T2 than T1. There were no significant changes in the prevalence of obesity for the total population at T2. Children age 6 or older had a higher prevalence of obesity and overweight/obesity compared to national statistics. Of children at all ages, 64.7% of children of all ages entered foster care with a normal weight and stayed in the normal range during their first year in foster care, 12.2% decreased their weight, 15.4% remained overweight or obese, and 7.7% increased their weight. Age and parental substance use was related to change in weight category from T1 to T2. Children did not become more overweight or obese in foster care; however 28% of the children were obese or overweight upon entry into foster care. Children who are 6 years or older and obese upon entering foster care should be targeted for weight reduction. The pediatric community and child welfare system need to work together by including weight percentiles in the foster care file and training/monitoring child welfare caregivers in weight reduction interventions.


Vasopressin mRNA in the cerebellum and circumventricular organs: a quantitative in situ hybridization study.
To answer the question as to whether vasopressin is synthesized in brain structures other than the supraoptic and paraventricular nuclei of the hypothalamus, vasopressin mRNA was detected by in situ hybridization in the pituitary, cerebellum, dentate gyrus, habenula and circumventricular organs. The highest levels (0.3-0.2 pmol/g), measured by quantitative autoradiography, were observed in the pituitary intermediate lobe and the granular layers of the cerebellum and dentate gyrus. Lower levels (0.15-0.08 pmol/g) were found in the medial habenula, adenohypophysis, area postrema, pineal, subfornical and subcommissural organs.


Evidence for Aerosol Transfer of SARS-CoV-2-Specific Humoral Immunity.
Infectious particles can be shared through aerosols and droplets formed as the result of normal respiration. Whether Abs within the nasal/oral fluids can similarly be shared between hosts has not been investigated. The circumstances of the SARS-CoV-2 pandemic facilitated a unique opportunity to fully examine this provocative idea. The data we show from human nasal swabs provides evidence for the aerosol transfer of Abs between immune and nonimmune hosts.


Unusual evolution of a mycotic hypogastric arterial aneurysm after arterial umbilical catheterization.
Report of the 7th case in the literature of aneurysm secondary to catheterization of the umbilical artery; total recovery after surgical removal.


[Functional scintigraphy in the diagnosis of gastroesophageal reflux (author's transl)].
The accepted diagnostical procedures to prove a gastroesophageal reflux by direct or indirect methods do not allow any quantification and are of limited sensitivity. A quantification is possible by use of a gamma-camera with a computer-system after application of a small amount of 99m Tc-DPTA (reflux scintiscan). The high accuracy of this method could be proven by evaluation of 51 patients with suspected gastroesophageal reflux esophagitis or after total gastrectomy. The results were compared with the histological findings. With this method we found after total gastrectomy the expected high incidence of relux. The long-term results after semifundoplication were not as good as after fundoplication. The reflux scintiscan is a less invasive, but reliable method to detect the gastroesophageal reflux.


Costs of reproduction in Nyssa sylvatica: sexual dimorphism in reproductive frequency and nutrient flux.
We examined the influence of differential reproductive frequency between the sexes on tertiary (phenotypic) sex ratios in the the dioecious tree Nyssa sylvatica (Nyssaceae). Reproduction was evaluated in relation to sex, size and canopy exposure using flowering data collected from 1229 marked trees over a four year period. For subsets of each population we used data on flower number, fruit crop size, fruit/flower ratios, and individual flower and fruit mass to compare biomass invested in reproductive structures of males and females. We also examined seasonal changes in stem nitrogen and soluble carbohydrate content in relation to flower and fruit production for trees of each sex. Our results indicate that: 1) Male-biased tertiary sex ratios could be explained by more frequent reproduction by male trees; 2) Estimated secondary sex ratios based on sums of all known males and females were not significantly different from 1:1; 3) Flowering frequency of males and females was significantly related to plant size (DBH) and exposure of the canopy to light; 4) Estimtes of reproductive biomass allocation ranged from 1.36 to 10.8 times greater for females relative to males; 5) Flower production was related to stem nutrient status for both sexes, but nutrient depletion and its effect on subsequent flowering was much more pronounced for female trees. We conclude that less frequent flowering by female trees may result from depletion of stored reserves, and that differential flowering frequency in N. sylvatica may ultimately reduce apparent sexual differences in the costs of reproduction.


Inkjet printing for the production of protein microarrays.
A significant proportion of protein microarray researchers would like the arrays they develop to become widely used research, screening, validation or diagnostic devices. For this to be achievable the arrays must be compatible with high-throughput techniques that allow manufacturing scale production. In order to simplify the transition from laboratory bench to market, Arrayjet have developed a range of inkjet microarray printers, which, at one end of the scale, are suitable for R&D and, at the other end, are capable of true high-throughput array output. To maintain scalability, all Arrayjet microarray printers utilise identical core technology comprising a JetSpyder™ liquid handling adaptor, which enables automated loading of an industry standard inkjet printhead compatible with non-contact on-the-fly printing. This chapter contains a detailed explanation of Arrayjet technology followed by a historical look at the development of inkjet technologies for protein microarray production. The method described subsequently is a simple example of an antibody array printed onto nitrocellulose-coated slides with specific detection with fluorescently labelled IgG. The method is linked to a notes section with advice on best practice and sources of useful information for protein microarray production using inkjet technology.


Approximate prediction of melting point of nitramines, nitrate esters, nitrate salts and nitroaliphatics energetic compounds.
A simple new procedure is introduced to predict melting point of selected class of energetic compounds containing nitramines, nitrate esters, nitrate salts and nitroaliphatics energetic compounds. The number of nitrogen and oxygen as well as the number of nitramine group and the contribution of some specific functional groups would be needed in the new method. Energetic compounds should contain at least one of the functional groups including N-NO(2), C-ONO(2) or nonaromatic C-NO(2). Calculated melting point for 33 nitramines, nitrate esters, nitrate salt and nitroaliphatics are compared with experimental data. Predicted melting points have average deviation of 5.4% for these energetic compounds.