Identifying characteristics of resistance-based therapeutic exercise interventions for Achilles tendinopathy: A scoping review.
This scoping review describes resistance-based therapeutic exercise intervention characteristics for Achilles tendinopathy (AT) treatment (e.g., therapeutic dose, underlying mechanisms targeted by exercise) and assesses participant reporting characteristics. Seven electronic databases were searched; studies delivering a resistance exercise-focused treatment for individuals with AT were included. The Template for Intervention Description and Replication (TIDieR) and the ICON 2019 'Recommended standards for reporting participant characteristics in tendinopathy research' checklists framed data extraction, and study quality was assessed using the Mixed Methods Appraisal Tool 2018 version. 68 publications (describing 59 studies and 72 exercise programs) were included. Results demonstrate that therapeutic exercise interventions for AT are well reported according to the TIDieR checklist, and participant characteristics are well reported according to the ICON checklist. Various underlying therapeutic mechanisms were proposed, with the most common being increasing tendon strength, increasing calf muscle strength, and enhancing collagen synthesis. While evidence suggests that resistance-based therapeutic exercise interventions are effective in treating AT, more reporting on program fidelity, adherence, and compliance is needed. By summarizing currently published AT exercise programs and reporting key intervention characteristics in a single location, this review can assist clinicians in developing individualized resistance training programs for people with AT.


Caffeine stimulates ventilation in athletes with exercise-induced hypoxemia.
Many athletes with exercise-induced hypoxemia (EIH) show an insufficient ventilatory response to exercise and low resting ventilatory responsiveness. The purpose of this project was to determine whether a moderate dosage of caffeine, a common ventilatory stimulant, could augment resting ventilatory responsiveness, exercise ventilation (V E), end-tidal O2 partial pressure (PetO2), and arterial oxyhemoglobin saturation (HbSaO2) in athletes with EIH. Eight highly trained males (V[spacing dot above]O2max, 69.2 +/- 4.0 mL.[kg.min]) who demonstrated EIH at V[spacing dot above]O2max (HbSaO2, 88.0 +/- 1.7%), ingested in a randomized design a placebo or caffeine (CAF, 8 mg.kg body wt) 1 h before testing. Ventilatory responsiveness at rest was assessed via the isocapnic hypoxic and hyperoxic hypercapnic ventilatory responses (HVR and HCVR, respectively). Dependent measures of metabolic variables, ventilation, and saturation were determined during progressive treadmill exercise to exhaustion. V E was higher at 75%, 80%, and 100% of V[spacing dot above]O2max with CAF (P < 0.05). V E/V O2, PetO2, and HbSaO2 were increased at 75%, 80%, and 90% of [formula: see text] with CAF but were not different at V[spacing dot above]O2max despite an increase in V e. No change in V[spacing dot above]O2max was observed between treatments. HVR and HCVR were not different between the two conditions, indicating that the increased V E likely came from central stimulation or secondary effects of CAF. The failure of HbSaO2 to increase at [formula: see text] despite an increase in V E suggests that mechanisms influencing HbSaO2 other than an inadequate hyperventilatory response may operate to different degrees across individuals as V[spacing dot above]O2max is approached.


Practical recommendations in the obstetrical patient with a COVID-19 infection.
COVID-19 infection also affects obstetric patients. Regular obstetric care has continued despite the pandemic. Case series of obstetric patients have been published. Neuroaxial techniques appear to be safe and it is important to obtain the highest possible rate of success of the blocks before a cesarean section. For this reason, it is recommended that the blocks be carried out by senior anesthesiologists. The protection and safety of professionals is a key point and in case of general anesthesia, so it is also recommended to call to the most expert anesthesiologist. Seriously ill patients should be recognized quickly and early, in order to provide them with the appropriate treatment as soon as possible. Susceptibility to thrombosis makes prophylactic anticoagulation a priority.


New class of 19F pH indicators: fluoroanilines.
The pH dependence of the 19F chemical shift has been characterized for a number of fluorine-substituted aniline derivatives. These compounds constitute a new class of 19F nuclear magnetic resonance (NMR) pH indicators, characterized by single 19F resonance lines with sensitivities ranging from 2 to 7 ppm/pH unit near the aniline pKa; total shifts between conjugate acid and base of 5-15 ppm; and pKas ranging from 1 to 7. One compound, N,N-(methyl-2-carboxyisopropyl)-4-fluoroaniline, has a pKa of 6.8 and a sensitivity of 5 ppm/pH unit. This compound displays significant broadening of its 19F resonance near the aniline pKa (6.8), due to a decreased rate of exchange between conjugate acid and base species. Our results are consistent with slow dissociation of an intramolecular hydrogen bond in the zwitterionic species that limits the exchange rate between protonated and unprotonated forms for N,N-(methyl-2-carboxyisopropyl)-4-fluoroaniline.


Metafabrics for cooling under a scorching sun.
Engineering the spectral response of composite materials in a broad range from ultraviolet to infrared can lead to a significant passive cooling functionality. This principle is applied to the design of a novel type of metafabric for cooling the human body under direct sunlight. Besides cooling effect, the metafabric features other merits including superior mechanical and wetting properties.


Cognitive asymmetries associated with apolipoprotein E genotype in patients with Alzheimer's disease.
The relationship between apolipoprotein E (apoE) genotype and cognitive performance was examined in 200 patients with probable Alzheimer's disease (AD). Differences between composite measures of verbal and nonverbal functioning were used to define asymmetric patterns of cognition. Patients who were homozygous for apoE epsilon4 demonstrated relatively worse nonverbal as compared to verbal cognitive ability. In contrast, participants who were heterozygous for apoE epsilon4 or who possessed no epsilon4 allele demonstrated relatively equivalent verbal and nonverbal cognitive abilities. Although age and dementia severity also contributed to these patterns, apoE genotype appears to have a significant unique contribution to cognitive performance in these individuals. The epsilon4 allele may thus be associated with a specific neurocognitive phenotype among patients with AD, with the overall pattern of cognitive asymmetry dependent upon epsilon4 dose.


Risk factors for hepatitis C recurrence after liver transplantation.
Hepatitis C virus (HCV)-related end-stage liver disease is the main indication for liver transplantation performed in Europe and the United States. Recurrence of hepatitis C in the graft is universal and may lead to chronic hepatitis in most patients and to cirrhosis in 20-30% of patients within 5-10 years of transplantation. The natural history of HCV recurrence is highly variable but leads to a lower survival rate than other recurrent liver diseases. The immunosuppressed status and several other factors have been linked with the pattern and severity of recurrence. What remains controversial are those factors associated with fibrosis progression and how these could be modified to improve outcome of recurrent hepatitis C. No single factor but a combination of several factors is associated with fibrosis progression on the graft. The major factors associated with accelerated disease recurrence include: high viral load pre- (>10(6) IU / mL) and / or early post-transplantation (>10(7) IU / mL at 4 months), donor older than 40-50 years, prolonged ischaemic time, cytomegalovirus coinfection, over immunosuppression and / or abrupt changes in immunosuppression, HIV coinfection, infection by genotype 1b. Cautious follow-up of the pathology of the graft is mandatory including routine biopsies and / or noninvasive monitoring of fibrosis.


Dynamics of the tricuspid valve annulus in normal and dilated right hearts: a three-dimensional transoesophageal echocardiography study.
The tricuspid valve annulus (TVA) is a complex three-dimensional structure that is incompletely understood. Three-dimensional transoesophageal echo (TOE) provides us with the opportunity to examine this structure in detail. Fifty patients were included, divided into two groups: controls (n = 20), and dilated right hearts (DRH, n = 30). Three-dimensional zoom images of the TVA were acquired using an iE33 machine and X7-2t transducer. Antero-posterior (AP) diameter, septo-lateral (SL) diameter, area, circumference, and height were measured at 6 points of the cardiac cycle adapting commercially available software designed for assessing the mitral valve (MVQ, Philips). The eccentricity ratio was calculated as AP/SL. The tricuspid annular area decreases during systole in both groups, and is greatest in mid-diastole. The area is significantly larger in the DRH group (mean 1566 mm(2) DRH vs. 1097 mm(2) controls; P < 0.01). The SL diameter increases proportionately more in the DRH group, resulting in a more circular orifice and lower eccentricity ratios (eccentricity ratio mean 1.01 DRH vs. 1.24 controls; P < 0.01). The dynamic diastolic to systolic change in the SL diameter is lost in patients with DRH, contributing to the more circular TVA orifice throughout systole. Three-dimensional TOE allows us to examine the TVA in great detail. In patients with DRH, the TVA dilates in a SL direction, resulting in a more circular orifice. The dynamic changes of the TVA are lost in patients with DRH, potentially contributing to functional tricuspid regurgitation.


[Psychological aspects of breast reconstruction after breast cancer].
Breast cancer belongs to the most frequent cancer illnesses among women; a surgical therapy of this illness often encloses a complete or partial removal of the breast. Hence, the treatment can be very incriminating physically and psychically. Hencebreast reconstruction is an important step on the way back to a normal female body shape and to a normal life. Certificated breast centres are available nationwide and internationally for the best possible medical care for patients suffering from breast cancer; reconstruction of a natural breast form is looked today as a natural part of breast cancer treatment. The numerous methods which can be tuned individually to the situation of the woman are available for the reconstruction of the female breast.


Remarkable lubricating capabilities of amniotic surfactant.
Surface-active phospholipid (SAPL) extracted from amniotic fluid or elutriated from the chorioamnionic sacs of placentas recovered from normal full term deliveries has been shown to be a remarkable lubricant. Coefficients of kinetic and static friction were reduced to 0.009 by SAPL from amniotic fluid and 0.011 for a membrane extract, even under high load (3 kg/cm2), compared with 0.04 for the best nonbiological boundary lubricants. The antiwear properties were equally remarkable, giving a mean scar diameter under extreme pressure of only 0.76 mm for amniotic SAPL and 1.00 mm for membrane extract compared with 0.85-0.95 mm for aqueous lubricants commercially available. These results support the hypothesis that premature rupture (PROM) is less likely to occur if movement between the fetus and the amnion or between the decidual surface of the uterus and the chorion is well lubricated.


Fluorescent labeling reliably identifies Chlamydia trachomatis in living human endometrial cells and rapidly and accurately quantifies chlamydial inclusion forming units.
Chlamydia replication requires host lipid acquisition, allowing flow cytometry to identify Chlamydia-infected cells that accumulated fluorescent Golgi-specific lipid. Herein, we describe modifications to currently available methods that allow precise differentiation between uninfected and Chlamydia trachomatis-infected human endometrial cells and rapidly and accurately quantify chlamydial inclusion forming units.


Ribosome binding induces repositioning of the signal recognition particle receptor on the translocon.
Cotranslational protein targeting delivers proteins to the bacterial cytoplasmic membrane or to the eukaryotic endoplasmic reticulum membrane. The signal recognition particle (SRP) binds to signal sequences emerging from the ribosomal tunnel and targets the ribosome-nascent-chain complex (RNC) to the SRP receptor, termed FtsY in bacteria. FtsY interacts with the fifth cytosolic loop of SecY in the SecYEG translocon, but the functional role of the interaction is unclear. By using photo-cross-linking and fluorescence resonance energy transfer measurements, we show that FtsY-SecY complex formation is guanosine triphosphate independent but requires a phospholipid environment. Binding of an SRP-RNC complex exposing a hydrophobic transmembrane segment induces a rearrangement of the SecY-FtsY complex, which allows the subsequent contact between SecY and ribosomal protein uL23. These results suggest that direct RNC transfer to the translocon is guided by the interaction between SRP and translocon-bound FtsY in a quaternary targeting complex.


The application of an electronic particle counter with a mean cell volume computer and an hematocrit accessory to avian hematology.
The accuracy and precision of an electronic cell counter equipped with a mean cell volume and packed cell volume accessory were evaluated for avian blood, and the results were compared with those of "standard" avian hematological techniques. Precision on replicate determinations with the electronic instruments was excellent and the mean results compared well with those of standard methods when the instrument was carefully standardized and calibrated.


A mechatronics platform to study prosthetic hand control using EMG signals.
In this paper, a low-cost mechatronics platform for the design and development of robotic hands as well as a surface electromyogram (EMG) pattern recognition system is proposed. This paper also explores various EMG classification techniques using a low-cost electronics system in prosthetic hand applications. The proposed platform involves the development of a four channel EMG signal acquisition system; pattern recognition of acquired EMG signals; and development of a digital controller for a robotic hand. Four-channel surface EMG signals, acquired from ten healthy subjects for six different movements of the hand, were used to analyse pattern recognition in prosthetic hand control. Various time domain features were extracted and grouped into five ensembles to compare the influence of features in feature-selective classifiers (SLR) with widely considered non-feature-selective classifiers, such as neural networks (NN), linear discriminant analysis (LDA) and support vector machines (SVM) applied with different kernels. The results divulged that the average classification accuracy of the SVM, with a linear kernel function, outperforms other classifiers with feature ensembles, Hudgin's feature set and auto regression (AR) coefficients. However, the slight improvement in classification accuracy of SVM incurs more processing time and memory space in the low-level controller. The Kruskal-Wallis (KW) test also shows that there is no significant difference in the classification performance of SLR with Hudgin's feature set to that of SVM with Hudgin's features along with AR coefficients. In addition, the KW test shows that SLR was found to be better in respect to computation time and memory space, which is vital in a low-level controller. Similar to SVM, with a linear kernel function, other non-feature selective LDA and NN classifiers also show a slight improvement in performance using twice the features but with the drawback of increased memory space requirement and time. This prototype facilitated the study of various issues of pattern recognition and identified an efficient classifier, along with a feature ensemble, in the implementation of EMG controlled prosthetic hands in a laboratory setting at low-cost. This platform may help to motivate and facilitate prosthetic hand research in developing countries.


Soluble oligomeric amyloid-β induces calcium dyshomeostasis that precedes synapse loss in the living mouse brain.
Amyloid-β oligomers (oAβ) are thought to mediate neurotoxicity in Alzheimer's disease (AD), and previous studies in AD transgenic mice suggest that calcium dysregulation may contribute to these pathological effects. Even though AD mouse models remain a valuable resource to investigate amyloid neurotoxicity, the concomitant presence of soluble Aβ species, fibrillar Aβ, and fragments of amyloid precursor protein (APP) complicate the interpretation of the phenotypes. To explore the specific contribution of soluble oligomeric Aβ (oAβ) to calcium dyshomeostasis and synaptic morphological changes, we acutely exposed the healthy mouse brain, at 3 to 6 months of age, to naturally occurring soluble oligomers and investigated their effect on calcium levels using in vivo multiphoton imaging. We observed a dramatic increase in the levels of neuronal resting calcium, which was dependent upon extracellular calcium influx and activation of NMDA receptors. Ryanodine receptors, previously implicated in AD models, did not appear to be primarily involved using this experimental setting. We used the high resolution cortical volumes acquired in-vivo to measure the effect on synaptic densities and observed that, while spine density remained stable within the first hour of oAβ exposure, a significant decrease in the number of dendritic spines was observed 24 h post treatment, despite restoration of intraneuronal calcium levels at this time point. These observations demonstrate a specific effect of oAβ on NMDA-mediated calcium influx, which triggers synaptic collapse in vivo. Moreover, this work leverages a method to quantitatively measure calcium concentration at the level of neuronal processes, cell bodies and single synaptic elements repeatedly and thus can be applicable to testing putative drugs and/or other intervention methodologies.


Electrical cardioversion of atrial fibrillation.
External direct current cardioversion remains the most common and effective method for restoration of normal sinus rhythm in patients with persistent AF. The development of biphasic defibrillators allows for higher success rates of conversion using standard energy levels. For persistent AF, an initial energy of 200 J is recommended for biphasic defibrillators, and 300 to 360 J are recommended for monophasic defibrillators, with the electrodes placed in the anterior posterior position. For refractory cases, alternatives are available such as dual defibrillators or internal cardioversion. Antiarrhythmic drugs may enhance the results of cardioversion by helping overcome shock failure or by preventing immediate recurrence of AF. Thromboembolism is the most important complication associated with cardioversion, but it can be prevented by providing 3 weeks of anticoagulation before the procedure or by excluding the presence of thrombi by transesophageal echocardiography, followed by an additional 4 weeks of anticoagulation.


A heat polyethylene glycol procedure as an alternative method for plasmafractionation.
Polyethylenglycol 4000 was used in a combined process of fractionation at normal temperature for preparing gammaglobulin and albumin in a heat denaturation process. Albumin can be gained from human plasma with a high yield and purity by using a heat procedure at the presence of polyethylglycol 4000 and sodium octanate at 75 degrees C. The concentration of polyethylglycol 4000 varies during this heat procedures from 3-10% W/V.


Day hospital versus outpatient treatment: a controlled study.
This study compares day hospitalization with traditional outpatient treatment effecting rehospitalization, symptomatology, mood, community, and vocational adjustment for 30 recently discharged schizophrenic patients. Results indicate day hospital patients were significantly more involved in work and training activities, but had no significant difference in the other areas of measurement.


Reduction of free fatty acids may ameliorate risk factors associated with abdominal obesity.
Experimental data as well as logical considerations suggest that the increased cardiovascular risk associated with abdominal obesity is mediated primarily by increased levels and flux of free fatty acids. Practical strategies for decreasing free fatty acid levels and/or flux may include: a very-low-fat, low-glycemic-index diet; promotion of insulin sensitivity (via exercise training, chromium, soluble fiber or drugs); anti-lipolytic agents; and stimulation of hepatic lipid oxidation with hydroxycitrate, carnitine and possibly fish omega-3s. Fortunately, many of these measures should also promote a leaner physique. Thus, even when abdominal obesity cannot be corrected, it may prove feasible to mitigate its dangers.


A system for precise analysis of transcription-regulating elements of immunoglobulin genes.
Precise analysis of expression-regulating elements, such as enhancers and insulators, requires that they be tested under reproducible, isogenic conditions. The commonly used methods of transfecting DNA into cell lines and selecting for drug resistance lack the requisite precision, as they yield cell lines in which varying numbers of gene copies have inserted at varying and undefined sites. By contrast, recombination-mediated cassette exchange (RMCE), by which a site-specific recombinase is used to place a single copy of a transgene at a constant chromosomal site of a cell line, offers the necessary precision. Although RMCE is generally applicable, many regulatory elements of interest are tissue-specific in their function and so require cell lines in the appropriate ontogenetic state. As reported here, we have used RMCE in a mouse B hybridoma cell line to establish a system with several additional advantages. To avoid the non-physiological features of prokaryotic DNA, this system uses the immunoglobulin mu heavy chain (IgH) gene from the hybridoma as the reporter. Expression can be measured simply by bulk culture assays (ELISA, Northern blot) and single cell assays (flow cytometry). Expression of the IgH reporter gene varies only 1.5 fold among independent transfectants, and expression is greatly (> 50 fold) increased by inclusion of the IgH intronic enhancer. This system is suitable for precise analysis of the regulatory elements of the immunoglobulin loci.


Sex Differences in the Clinical Features, Risk Factors, and Outcomes of Intracerebral Hemorrhage: a Large Hospital-based Stroke Registry in China.
Intracerebral hemorrhage (ICH) is common in China. However, the sex differences in clinical features, risk factors, and outcomes of ICH remain controversial. Between 2005 and 2014, we recruited patients with primary ICH in Tianjin, China, and evaluated sex differences in clinical features, risk factors, and outcomes at 3, 12, and 36 months after ICH. The 1,325 patients included 897 men (67.7%) and 428 women (32.3%). The mean age at ICH onset was younger among men (59.14 years) than among women (63.12 years, P < 0.001). Men were more likely to have a hematoma in the basal ganglia, while women were more likely to have one in the thalamus. Women had higher frequencies of urinary tract infections, diabetes mellitus, cardiovascular diseases, and obesity. Men had a greater risk of death at 3 months after ICH. However, no sex differences were observed for mortality at 12 and 36 months after ICH or for recurrence and dependency at 3, 12, and 36 months after ICH. These findings suggested that it crucial to strengthen management of AF and complications in patients with ICH, especially management of blood pressure in men for reducing the mortality rates and the burden of ICH in China.


Impulsivity and the role of smoking-related outcome expectancies among dependent college-aged cigarette smokers.
The relationship between trait-impulsivity and smoking expectancies on smoking progression in undergraduate college students was examined over a 48-hour period of smoking abstinence. Participants were forty-nine college-aged dependent cigarette smokers who completed measures designed to assess impulsivity, nicotine dependence, and smoking expectancies. Using a series of multilevel models, impulsivity by time analyses indicated significant differences in positive reinforcement expectancies, [F (2, 94)=3.19, p<.05], but not in negative reinforcement expectancies, [F (2, 94)=0.49, p=.61]. Simple slopes analyses indicated that heightened trait-impulsivity predicted greater increases in positive reinforcement outcome expectancies at 48 h of abstinence. Level of impulsivity, however, was not related to changes in negative reinforcement expectancies. Results indicate that during an abstinence period, college students higher in trait-impulsivity may be more prone to relapse due to stronger beliefs about the positive effects from smoking a cigarette. These findings highlight the importance of understanding the interaction of personality and cognitive factors when working with young adult smokers wishing to quit this health-compromising behavior.


G proteins as regulators of ion channel function.
Virtually unknown just a decade ago, GTP-binding proteins (G proteins) have become a major focus of current research. This family of closely related proteins transduce extracellular signals (such as hormones, neurotransmitters and sensory stimuli) into effector responses (1,2). It is now evident that ion channel permeability is one such effector response. In fact, the striking increase in the frequency of reports that demonstrate G protein-regulated ion channel function suggests that channels whose permeability mechanism can be altered by a G protein-mediated process may be more the rule than the exception. It is well-known that the cAMP-dependent modulation of ion channels is under the control of G proteins that regulate adenylate cyclase activity(3,4). However recent studies demonstrate that G proteins also transduce agonist-induced changes in channel activity that do not involve adenylate cyclase. It is on this aspect of G protein signal transduction that this review will focus.


A normal diffusing capacity of the lungs for carbon monoxide is rare in incidental pulmonary arterial hypertension in systemic sclerosis: Data from the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma cohort.
Our purpose was to determine the frequency of normal diffusing capacity for carbon monoxide defined as ⩾70% predicted, in those diagnosed with pulmonary arterial hypertension in the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma cohort. We compared those with normal diffusing capacity for carbon monoxide to those with reduced diffusing capacity for carbon monoxide <70% in order to better clarify the role of pulmonary function testing as a screening test for pulmonary arterial hypertension and to better understand this population. Entry criteria included a right heart catheterization with mean pulmonary artery pressure ⩾25 mm Hg and pulmonary capillary wedge pressure ⩽15 mm Hg. Demographics, echocardiogram variables, B-type natriuretic peptide levels, right heart catheterization findings, and survival were described for both groups. Of (n = 202), 11 (5.4%) had a diffusing capacity for carbon monoxide of ⩾70% versus 191 (94.6%) who had a diffusing capacity for carbon monoxide <70%. There were no identified statistical differences between the groups. Left atrium size was 4.1 cm in the normal diffusing capacity for carbon monoxide patients compared to 3.7 cm in the low diffusing capacity for carbon monoxide group but did not reach statistical significance. There were no statistically significant differences in survival. On repeat testing, seven patients subsequently developed a diffusing capacity for carbon monoxide <70%. Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma data suggest that it is very rare for a patient to develop pulmonary arterial hypertension with a preserved diffusing capacity for carbon monoxide. The data support the importance of obtaining diffusing capacity for carbon monoxide and that a patient with a normal diffusing capacity for carbon monoxide while suspected to have systemic sclerosis-pulmonary arterial hypertension should be considered critically. Diffusing capacity for carbon monoxide >70% was present in too few patients to find significant differences in B-type natriuretic peptide and atrium size. Future research should seek to confirm abnormal B-type natriuretic peptide, increased left atrium size, and other evidence of myocardial involvement on diffusing capacity for carbon monoxide.


Equal Benefits? An Examination of the Potential Consequences of Later School Start Times for Adolescents and Their Mental Health.
Given the documented benefits of later school start times on adolescents' mental health, the aim of the current study was to examine if the association between school start times and depressive symptoms differed across adolescents from families of different socioeconomic status levels. Using a cross-sectional design, the current study incorporated an online survey for high school students and their parents across the United States, with average sleep duration measured through a 7-day sleep diary. A total of 193 adolescent (Meanage = 15.7 years old, SD = .94; 54.4% female; 71% white) and parent (Meanage = 47.6 years old, SD = 5.4; 80% female; 79% white) dyads participated. Adolescents reported on depressive symptoms, sleep quality and duration, chronotype, and demographic covariates; parents reported on school start times and socioeconomic status. Results suggested that only in adolescents from higher socioeconomic status families (+1 SD) did the association between later start times and fewer depressive symptoms emerge as significant. Although more school start times research is needed to understand its impact across diverse groups of students, current findings suggest a disproportionate benefit of reduced depression for youth from families of higher socioeconomic status with having a later start time.


Athetoid quadriplegia and literacy.
To compare literacy levels in athetoid quadriplegic (AQ) patients born in the 1960s and 1970s with those born in the 1980s and 1990s. Nine patients with AQ born between 1966 and 1972 were compared with eight patients born between 1983 and 1991. Reading difficulties were found in almost all patients with AQ, despite normal intellect. Those in the earlier period were for the most part functionally literate, while those in the later period were functionally illiterate. Specific and intensive reading education may be required in patients with AQ to obtain functional literacy.


Pain acceptance in cancer patients with chronic pain in Hunan, China: A qualitative study.
The purpose of this qualitative study was to describe the experiences of pain acceptance in Chinese cancer patients with chronic pain. Twelve hospitalized cancer patients with chronic pain participated in this qualitative descriptive study from August to November 2017. In-person semi-structured interviews were conducted, recorded, transcribed, and analyzed using Colaizzi's seven-step method. The following four main themes and 15 subthemes emerged. Theme 1 (adaptation): pain is overwhelming and pain relief is a top priority, avoidance of pain-inducing factors, and resignation; theme 2 (emotional reactions to pain): feeling misunderstood, hopelessness, frustration, irritability, and concern for loved ones; theme 3 (functional limitations): daily life activities, social communication, and work; theme 4 (coping strategies): pharmacological therapies, behavioral strategies, social support strategies, and spiritual strategies. This study provides a description of cancer patients' experiences related to the need for pain acceptance. These findings provide insight into the essential role of pain acceptance and underline the need to apply acceptance-based cognitive behavioral interventions as adjunctive non-pharmacological alternatives for chronic cancer pain.


Functional analysis of the glycogen binding subunit CG9238/Gbs-70E of protein phosphatase 1 in Drosophila melanogaster.
The product of the CG9238 gene that we termed glycogen binding subunit 70E (Gbs-70E) was characterized by biochemical and molecular genetics methods. The interaction between Gbs-70E and all catalytic subunits of protein phosphatase 1 (Pp1-87B, Pp1-9C, Pp1-96A and Pp1-13C) of Drosophila melanogaster was confirmed by pairwise yeast two-hybrid tests, co-immunoprecipitation and pull down experiments. The binding of Gbs-70E to glycogen was demonstrated by sedimentation analysis. With RT-PCR we found that the mRNAs coding for the longer Gbs-70E PB/PC protein were expressed in all developmental stages of the fruit flies while the mRNA for the shorter Gbs-70E PA was restricted to the eggs and the ovaries of the adult females. The development specific expression of the shorter splice variant was not conserved in different Drosophila species. The expression level of the gene was manipulated by P-element insertions and gene deletion to analyze the functions of the gene product. A small or moderate reduction in the gene expression resulted in no significant changes, however, a deletion mutant expressing very low level of the transcript lived shorter and exhibited reduced glycogen content in the imagos. In addition, the gene deletion decreased the fertility of the fruit flies. Our results prove that Gbs-70E functions as the glycogen binding subunit of protein phosphatase 1 that regulates glycogen content and plays a role in the development of eggs in D. melanogaster.


Cross-cultural adaptation and validation of the Behcet's Disease Current Activity Form in Korea.
This study was undertaken to perform a cross-cultural adaptation of the Behcet's Disease Current Activity Form (BDCAF, version 2006) questionnaire to the Korean language and to evaluate its reliability and validity in a population of Korean patients with Behcet's disease (BD). A cross-cultural study was conducted among patients with BD who attended our rheumatology clinic between November 2012 and March 2013. There were 11 males and 35 females in the group. The mean age of the participants was 48.5 years and the mean disease duration was 6.4 years. The first BDCAF questionnaire was completed on arrival and the second assessment was performed 20 minutes later by a different physician. The test-retest reliability was analyzed by computing κ statistics. Kappa scores of > 0.6 indicated a good agreement. To assess the validity, we compared the total BDCAF score with the patient's/clinician's perception of disease activity and the Korean version of the Behcet's Disease Quality of Life (BDQOL). For the test-retest reliability, good agreements were achieved on items such as headache, oral/genital ulceration, erythema, skin pustules, arthralgia, nausea/vomiting/abdominal pain, and diarrhea with altered/frank blood per rectum. Moderate agreement was observed for eye and nervous system involvement. We achieved a fair agreement for arthritis and major vessel involvement. Significant correlations were obtained between the total BDCAF score with the BDQOL and the patient's/clinician's perception of disease activity p < 0.05). The Korean version of the BDCAF is a reliable and valid instrument for measuring current disease activity in Korean BD patients.


Prevalence and risk factors associated with low back pain among health care providers in a Kuwait hospital.
A cross-sectional survey among health professionals working in a Kuwait hospital. To investigate the prevalence and factors associated with low back pain (LBP). The literature suggests that health professionals are exposed to occupational risk factors that predispose them to developing LBP. These rates are not well established in Middle Eastern countries such as Kuwait. A self-administered survey was conducted with health professionals in an urban orthopedic hospital. The response rate to the survey was 60% (n = 344). Lifetime prevalence of LBP in the sample was 70.9%, and point prevalence of LBP was 21.5%. Factors associated with acute LBP included direct patient contact (P = 0.015), performing patient lifts and/or transfers (P = 0.016), low job satisfaction (P = 0.039), and poor self-reported health status (P = 0.019). The prevalence ratio (PR) of reporting acute LBP was also found to increase as a function of the number of daily lifts/transfers performed (PR: 1.4; 95% CI: 1.27 to 1.70). Other factors generally associated with LBP, such as age, sex, professional experience, smoking and exercise, were not found to be significantly associated with LBP in this study. No causal relationships can be inferred using these cross-sectional data. However, results suggest that direct patient contact that includes lifting and/or transferring patients may be an important risk factor. Further research is warranted to evaluate effectiveness of back education and prevention programs among hospital staff in Kuwait.


The relationship between parents' cognitions, bedtime behaviours and sleep-related practices with their child's sleep.
Certain parental cognitions about child sleep and bedtime behaviours used with their child have been linked to poorer child sleep. However, previous research has focused on mothers and explored only a limited range of sleep-related cognitions and practices. The present study investigated whether parental cognitions and sleep-related practices (both in connection with their own sleep and their child's sleep), alongside the bedtime behaviours used with their child were associated with and/or were predictive of their child's sleep. Mothers and fathers from 44 families (with a child aged 12-24 months) separately completed questionnaires reporting (i) their cognitions (about their own sleep and their child's sleep), (ii) sleep-related practices (used in connection with their own and their child's sleep) and (iii) bedtime behaviours used with their child. Child sleep was assessed through parental report and actigraphy. Both parents' cognitions about their own sleep predicted cognitions about their child's sleep. Mothers' own sleep-related practices predicted the types of practices they used with their child. Different patterns of maternal and paternal variables influenced parental perceptions of their child having a sleep problem. The present findings highlight the importance of including mothers and fathers in child sleep research. Parents' dysfunctional cognitions (their own sleep) and broader sleep-related practices (their own and child sleep) should be considered when exploring influences on child sleep. Results have possible implications for targets of interventions for child sleep problems and also potential implications for theoretical models of child sleep.


Comparison of chronic autoimmune urticaria with chronic idiopathic urticaria.
Chronic urticaria has been described in patients with Helicobacter pylori infection. Despite numerous studies, the correlation between H. pylori infection and chronic urticaria is doubtful. Our study was performed to determine the prevalence of H. pylori infection in autoimmune urticaria and in patients suffering from autoimmune urticaria and autoimmune thyroiditis. The authors widely investigated 48 patients. The examinations were extended principally to autologous serum skin test, antithyroid antibodies, and the presence of H. pylori infection as well as detection of antibodies against H. pylori. Out of the 48 patients, 26 were regarded as having autoimmune origin. The prevalence of antithyroid antibodies was different in the two groups of patients with urticaria. There were 11 patients (42.3%) in the autoimmune group compared with three patients (13.6%) in the nonautoimmune group with antithyroid peroxidase antibody (P = 0.03). The difference in the prevalence of H. pylori infection was significant between autoimmune urticaria with and without thyroid autoimmunity (90.9% vs. 46.7%; P = 0.02). Autoimmune thyroiditis was connected with CagA +H. pylori strains, as the H. pylori- specific IgG antibodies revealed significant differences in a prevalence of 120 kDa (P < 0.05). The authors observed a relationship between autoimmune urticaria and autoimmune thyroiditis. The results strengthen the possibility of cross-reactivity being triggered between CagA plus H. pylori strains and some other organ-specific autoimmune diseases such as autoimmune urticaria and autoimmune thyroiditis. This indicates a possible role of H. pylori in triggering autoimmune urticaria in at least a select group of patients.


A computational method for the estimation of atrophic changes in Alzheimer's disease and mild cognitive impairment.
Early diagnosis and objective monitoring of disease progression are essential for the development of therapeutic strategies in Alzheimer's disease (AD). Current techniques are mainly based on semi-objective measures such as neuropsychological tests and a physician's magnetic resonance imaging (MRI) inspection. We have developed a computational method for automatic and unbiased assessment of the brain's state of atrophy from MRI. Sixty-eight high-resolution MRI scans were acquired from 25 AD patients (age: 69.8+/-7.5), 16 mild cognitive impairment (MCI) patients (67.6+/-9.1) and 27 control subjects (64.9+/-8.8). On the basis of the computations we were able to recognize MCI subjects with a sensitivity of 81% and a specificity of 80% in a group of MCIs and controls using a linear classifier. To date, comparable results have only been received by manual labelling or human inspection. Our calculations are light weighted and can be applied on usual workstations in everyday clinical practice. Each step can be understood and applied by the physicians, independent of their computer knowledge. The applied image analysis process produces visual maps of atrophic changes as intermediate steps of the calculations. These can be helpful for the physician during inspection of the brain. The proposed analysis has the potential to improve AD diagnosis and treatment, especially in early its stages, and could also be used to monitor disease progression in therapeutic trials.


Improved detection of aneuploidy in malignant melanoma using multiparameter flow cytometry for S100 protein and DNA content.
DNA aneuploidy has been demonstrated to be an independent parameter of prognostic significance in malignant melanomas. In order to improve the detection of DNA aneuploidy in malignant melanomas, and to minimize diploid non-tumor cells in the sample, we developed a two-color staining strategy for S100 protein and DNA content in paraffin embedded samples. The ability to detect aneuploidy, defined as DNA ploidy index less than or equal to 0.90 or greater than or equal to 1.10, in 37 stage I malignant melanoma samples by flow cytometry analysis was significantly improved from 10.8% of cases using traditional one-color analysis for DNA content only (propidium iodide) to 32.4% of cases using two-color analysis for simultaneous measurement of both DNA (propidium iodide) and S100 protein (fluorescein conjugated antibody) (Chi-square with Yates' correction; p less than 0.05). The largest increase in sensitivity was found in level I and II melanomas less than or equal to 0.76 mm in thickness. In addition, we report the new observation that multiple S100 protein-positive subpopulations were found significantly more frequently in malignant melanomas (23/37 cases) than in compound melanocytic nevi (5/22 cases) (Chi-square with Yates' correction; p less than 0.01). These findings suggest that there is a previously unsuspected degree of tumor heterogeneity even in thin, presumably early, malignant melanomas.


Activation of thioglycosides under mild alkylation conditions.
Reported herein is the development of a novel method for the activation of thioglycosides and thioimidates using benzyl trichloroacetimidate in the presence of catalytic triflic acid. Excellent yields have been achieved with reactive substrates, whereas efficiency of reactions with unreactive glycosyl donors and/or acceptors was modest.


[Differentiation of various types of varicocele based on their hemodynamic aspects using the ultrasonic Doppler technic].
With the help of bidirectional ultrasonic Doppler technique the inflow as well as the outflow of the venous blood (v. testicularis, v. ductus deferentis, v. cremasterica) in the patients suffering from varicocele can be studied. On the basis of the results two types of varicocele disorders can be identified: a) "Shunt-type" in which cases the inflow is equal to the outflow, b) "pressure-type", in which the outflow is relatively decreased.


Developing and Testing an Electronic Measure of Screening Colonoscopy Overuse in a Large Integrated Healthcare System.
Most existing performance measures focus on underuse of care, but there is growing interest in identifying and reducing overuse. We aimed to develop a valid and reliable electronic performance measure of overuse of screening colonoscopy in the Veterans Affairs Health Care System (VA), and to quantify overuse in VA. This was a cross-sectional study with multiple cross-sections. U.S. Veterans who underwent screening colonoscopy between 2011 and 2013. Overuse of screening colonoscopy, using a validated electronic measure developed by an expert workgroup. Compared to results obtained from manual record review, the electronic measure was highly specific (97 %) for overuse, but not sensitive (20 %). After exclusion of diagnostic and high-risk screening or surveillance procedures, the validated electronic measure identified 88,754 average-risk screening colonoscopies performed in VA during 2013. Of these, 20,530 (23 %) met the definition for probable (17 %) or possible (6 %) overuse. Substantial variation in colonoscopy overuse was noted between Veterans Integrated Care Networks (VISNs) and between facilities, with a nearly twofold difference between the maximum and minimum rates of overuse at the VISN level and a nearly eightfold difference at the facility level. Overuse at the VISN and facility level was relatively stable over time. Overuse of screening colonoscopy can be measured reliably and with high specificity using electronic data, and is common in a large integrated healthcare system. Overuse measures, such as those we have specified through a consensus workgroup process, could be combined with underuse measures to improve the appropriateness of colorectal cancer screening.


Rapid sleep education: If you could tell people one thing about sleep, what should it be?
Informal learning settings such as museums provide unique opportunities for educating a local community about sleep. However, in such settings, information must be capable of immediately inciting interest. We developed a series of sleep "icebreakers" (brief, informal facts) to determine whether they elicited interest in sleep and encouraged behavioural change. There were 859 participants across three cross-sectional samples: (a) members of the local museum; (b) Mechanical Turk workers who responded to a "sleep" study advertisement; and (c) Mechanical Turk workers who responded to a "various topics" study advertisement that did not mention sleep. All three samples demonstrated high interest in sleep topics, though delayed recall of the icebreakers was strongest in participants who expected to learn about the sleep topics. Icebreaker interest ratings were independent of age, gender and race/ethnicity, suggesting that sleep is a topic of universal interest. Importantly, regardless of demographics and sample, the more the icebreakers interested the participants, the more likely participants were to indicate willingness to donate to a sleep exhibit, change their sleep behaviours, and post to social media. Thus, sleep icebreakers can rapidly elicit people's interest, and future outreach efforts should couple icebreakers with opportunities for subsequent personalized learning.


Changing Trends of Cirrhotic and Noncirrhotic Hepatocellular Carcinoma in the Era of Directly-Acting Antiviral Agents.
The impact of direct-acting antivirals (DAAs) for hepatitis C virus (HCV) on burden of cirrhotic and noncirrhotic hepatocellular carcinoma (HCC) has not been examined. We assessed recent trends in liver disease etiologies of HCC and proportion of noncirrhotic HCC since DAAs introduction. Clinical characteristics including presence or absence of underlying cirrhosis were collected from 2,623 patients diagnosed with HCC between 2009 and 2019 at 2 large US centers. Logistic regression was performed to investigate the annual trends of HCC due to different liver diseases and proportions of noncirrhotic cases. In the DAA era (2014-2019), annual decline in HCV-HCC (odds ratio [OR] = 0.93, 95% confidence interval [CI] 0.88-0.99, P = 0.019), without change in trends of other liver diseases-related HCC, was observed. Annual increase in noncirrhotic HCC (OR 1.13, 95% CI 1.03-1.23, P = 0.009) and decline in cirrhotic HCC (OR 0.89, 95% CI 0.81-0.97, P = 0.009) along with similar trends for HCV-HCC-increase in noncirrhotic cases (OR 1.35, 95% CI 1.08-1.69, P = 0.009) and decrease in cirrhotic cases (OR 0.92, 95% CI 0.86-0.98, P = 0.012)-were observed during the DAA era. Compared with the pre-DAA era, HCC resection rate increased (10.7% vs 14.0%, P = 0.013) whereas liver transplantation rate decreased (15.1% vs 12.0%, P = 0.023) in the DAA era. Since introduction of DAAs, proportions of cirrhotic HCC have decreased, whereas proportions of noncirrhotic HCC have increased. These new trends were associated with change in utilization of liver resection and transplantation for HCC. The impact of changing patterns of DAA use on these trends will require further study.


Outcome of Single-Bundle Hamstring Anterior Cruciate Ligament Reconstruction Using the Anteromedial Versus the Transtibial Technique: A Systematic Review and Meta-analysis.
To compare the clinical outcomes of single-bundle hamstring anterior cruciate ligament (ACL) reconstruction between the anteromedial (AM) and transtibial (TT) techniques. We performed a comprehensive systematic review and meta-analysis of the English-language literature in the PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials databases for articles that compared clinical outcomes of AM versus TT ACL reconstruction. The outcome measures analyzed included postoperative Lachman test, pivot-shift test, International Knee Documentation Committee (IKDC), and Lysholm scores. We included 10 articles from an initial 308 abstracts for the systematic review and included 6 studies for the meta-analysis. The study population consisted of a total of 733 patients, of whom 366 (49.9%) underwent the AM technique and 367 (50.1%) underwent the TT technique for ACL reconstruction. For postoperative knee stability, the AM technique yielded superior results in terms of the proportion of negative Lachman test results (n = 243; odds ratio [OR], 2.98 [95% confidence interval (CI), 1.29 to 6.88]) and proportion of negative pivot-shift test results (n = 238; OR, 3.67 [95% CI, 1.80 to 7.52]). For postoperative functional status, the AM technique yielded superior results in terms of objective IKDC grading (proportion with IKDC grade A) (n = 269; OR, 2.19 [95% CI, 1.23 to 3.88]) but had comparable Lysholm scores (n = 478; mean difference, 1.43 [95% CI, 0.01 to 2.84]). Single-bundle hamstring ACL reconstruction using the AM technique showed superior surgeon-recorded stability according to the IKDC knee score, Lachman test, and pivot-shift test. However, there was no difference in patient-reported functional outcome (Lysholm score). Level III, systematic review and meta-analysis of Level I, II, and III studies.


Characterization and functional analysis of toll-like receptor 4 in Chinese soft-shelled turtle Pelodiscus sinensis.
Mammalian Toll-like receptor 4 (TLR4) recognizes lipopolysaccharide (LPS) in initiating the innate immune responses. Early studies indicate that turtles are more resistant to LPS challenge than mammals. It remains unknown if turtles express TLR4 and why they are more resistant to LPS. In this study, TLR4 gene from Chinese soft-shelled turtle, Pelodiscus sinensis, was cloned and characterized. The full length cDNA of turtle TLR4 (tTLR4) consists of 3396 base pairs with an 2499-bp open reading frame, encoding 833 amino acids. Phylogenetic and syntenic analyses suggest that tTLR4 is to be orthologous to human TLR4. Its mRNA expression was up-regulated in spleen and blood of turtles upon Aeromonas hydrophila infection. Stimulation of turtle peripheral blood monocytes with LPS significantly upregulated tTLR4 mRNA and inflammation-related gene expression, such as Interleukin-1β (IL-1β) and cyclooxygenase-2 (COX-2). In tTLR4-expressing HEK293 cells, higher concentration of LPS exposure could enhance the activity of the NF-κB promoter, but not the INF-β promoter. Such activity required co-expression of turtle myeloid differentiation factor 2 (tMD2) and cluster of differentiation 14 (tCD14). These results provide evidence for a functional TLR4 in reptiles and, together with the syntenic analysis, support the idea that the TLR4 receptor for LPS recognition may have arisen after reptiles.


Organization of posture controls: an analysis of sensory and mechanical constraints.
We analyse two components of posture control in standing human subjects: (1) the mechanical properties which constrain the body's ability to execute stabilizing postural movements and (2) the mechanical and neural properties which constrain the ability of the vestibular system to sense changes in body orientation. Rules are then proposed to describe the central organization of posture controls within the sensory and mechanical constraints. The organizational rules and knowledge of constraints are combined to predict the effects of selective semicircular canal and utricular otolith lesions on postural stability and the patterns of body and head movements used to maintain balance. Our analysis leads to the prediction that semicircular canal and otolith deficits destabilize patients at different frequencies, and force them to use different patterns of body and head movements. These predictions are compared to posture controls observed in patients with different types of vestibular deficits. The additional steps required to prove or disprove the theory are discussed.


Comparative study of diets enriched with evening primrose, black currant, borage or fungal oils on blood pressure and pressor responses in spontaneously hypertensive rats.
The effects of oils enriched with gamma-linolenic acid (GLA) on blood pressure and pressor responses were examined in spontaneously hypertensive rats (SHR). Rats were fed purified diets containing evening primrose (EPO), black currant (BCO), borage (BOR) or fungal (FGO) oils for 7 weeks. Significant reductions in blood pressure were obtained in SHR rats maintained on diets enriched with GLA oils. The antihypertensive effect was not associated with enhanced pressor responsiveness to norepinephrine or angiotensin II. Moreover, no differences were found in blood pressure responses to the calcium channel blocker, verapamil. The results suggest that GLA-enriched oils inhibit the development of hypertension in the SHR rat. The blood pressure lowering effect is not mediated by altered pressor responses to vasoconstrictor hormones or intracellular calcium mechanisms.


Role of protein X in the function of the mammalian pyruvate dehydrogenase complex.
Two lipoyl-bearing subunits--the dihydrolipoyl transacetylase and protein X--form the core of the mammalian pyruvate dehydrogenase complex. Selective removal of the lipoyl domain of protein X results in loss in the activity of the complex with a relationship suggesting the involvement of the lipoyl domain of protein X in a key but not rate limiting step. The dihydrolipoyl dehydrogenase component markedly reduces both the cleavage of protein X and the loss in activity. Using a microplate binding assay, we demonstrate that the lipoyl domain of protein X and the transacetylase component contribute to the binding of the dihydrolipoyl dehydrogenase component. These roles of protein X in the catalytic function and organization of the complex require new reactions and afford an explanation for the unusual stoichiometry of dihydrolipoyl dehydrogenase dimers in the complex.


Applicability of 2022 classifications of acute myeloid leukemia in the real-world setting.
The increasing knowledge of molecular genetics of acute myeloid leukemia (AML) necessitated the update of previous diagnostic and prognostic schemes, which resulted in the development of the World Health Organization (WHO), the International Consensus Classification (ICC), and the new European LeukemiaNet (ELN) recommendations in 2022. We aimed to provide a real-world application of the new models, unravel differences and similarities, and test their implementation in clinical AML diagnosis. A total of 1001 patients diagnosed with AML were reclassified based on the new schemes. The overall diagnostic changes between the WHO 2016 and the WHO 2022 and ICC classifications were 22.8% and 23.7%, respectively, with a 13.1% difference in patients' distribution between ICC and WHO 2022. The 2022 ICC "not otherwise specified" and WHO "defined by differentiation" AML category sizes shrank when compared with that in WHO 2016 (24.1% and 26.8% respectively, vs 38.7%), particularly because of an expansion of the myelodysplasia (MDS)-related group. Of 397 patients with a MDS-related AML according to the ICC, 55.9% were defined by the presence of a MDS-related karyotype. The overall restratification between ELN 2017 and ELN 2022 was 12.9%. The 2022 AML classifications led to a significant improvement of diagnostic schemes. In the real-world setting, conventional cytogenetics, usually rapidly available and less expensive than molecular characterization, stratified 56% of secondary AML, still maintaining a powerful diagnostic role. Considering the similarities between WHO and ICC diagnostic schemes, a tentative scheme to generate a unified model is desirable.


Total structure of the highly modified peptide antibiotic components of thiopeptin.
On the basis of 1H and 13C NMR evidence, the structures of two series of the highly modified sulfur-containing peptide antibiotic thiopeptin were elucidated.


The residential healthcare for the elderly in Italy: some considerations for post-COVID-19 policies.
In Italy, the COVID-19 pandemic and the death of many elderly people have put in evidence the uneven territorial distribution of nursing homes, which have amplified the spread and severity of the pandemic. By applying a pooled OLS model to the Italian regions, over the 2010-18 period, we investigate the demand factors, market forces and institutional drivers of the spatial distribution of residential healthcare for the elderly. Using a fine-grained approach that considers specific regional and age-related elements and the market environment, which can reduce or increase the pressure on regional governments to provide formal assistance, we find that the financial resources and the availability of unemployed women as potential caregivers explain the distribution of expenditure better than the health needs of the elderly. As a result, the expenditure is concentrated in richer and more financially autonomous regions and it is not congruent with the distribution of chronicity, health and frailty factors or income among the elderly. These critical issues of the care services for frail elderly people, related to a highly decentralized governance and resulting in fragmented, market-driven provision, could be attacked only by a national reform.


Associations of technostressors at work with burnout symptoms and chronic low-grade inflammation: a cross-sectional analysis in hospital employees.
Despite the increasing scholarly interest in the phenomenon technostress, associated biological effects on employee health are under-researched. Chronic low-grade inflammation is suggested as a central pathway linking stress experience to disease development. The aim of this study was to assess associations of technology-related work stressors (technostressors) with low-grade inflammation and burnout symptoms. N = 173 (74.6% women, Mage = 31.0 years) university hospital employees participated in a cross-sectional study. Self-report questionnaires were used for the assessment of general psychosocial working conditions (work overload, job control, social climate), a range of different technostressors, burnout symptoms, and relevant confounders. Participants provided capillary blood samples, and high-sensitivity C-reactive protein (hs-CRP) as an inflammatory biomarker was analyzed from dried blood spots. Based on a factor analysis, we identified four underlying dimensions of technostressors: techno- and information overload, techno-complexity, interruptions and multitasking as well as usability and technical support. In multivariate linear regressions, techno-/information overload and techno-complexity were associated with core (exhaustion, mental distance) and secondary (psychosomatic complaints) symptoms of burnout. Techno-/information overload was a significant predictor of burnout core symptoms, even when general work overload was controlled for. The technostressors were not associated with hs-CRP. This is the first study on technology-related stress at work and chronic low-grade inflammation. The results suggest that (information) overload caused by digital technology use is a distinct work stressor with genuine consequences for psychological health. To what extent these effects also manifest on a physiological level needs to be subjected to future studies, ideally with prospective designs.


Synthesis and activity of N-acyl azacyclic urea HIV-1 protease inhibitors with high potency against multiple drug resistant viral strains.
As part of our efforts to identify potent HIV-1 protease inhibitors that are active against resistant viral strains, structural modification of the azacyclic urea (I) was undertaken by incorporating acyl groups as P(1)' ligands. The extensive SAR study has yielded a series of N-acyl azacyclic ureas (II), which are highly potent against both wild-type and multiple PI-resistant viral strains.


Effect of cigarette smoke on counts of immunoreactive cells to eotaxin-1 and eosinophils on the nasal mucosa in young patients with perennial allergic rhinitis.
In teenagers with perennial allergic rhinitis, exposure to tobacco cigarette smoke increases the count of eosinophils in the nasal mucosa; the recruitment of eosinophils arises from the combined action of a number of cellular and molecular signals, including eotaxin. To assess the effect of exposure to tobacco cigarette smoke on the count of immunoreactive cells to eotaxin-1 and eosinophils on the nasal mucosa of children and teenagers with perennial allergic rhinitis. In a cross-sectional study, forty-four patients were evaluated (aged 7-19 years old): 22 with and 22 with no exposure to tobacco cigarette smoke. After replying to 2 validated questionnaires, on Asthma and Allergies in Childhood and on the severity of nasal symptoms, nasal mucosal samples were obtained by scraping the middle one-third of the inferior turbinates. Then counts of immunoreactive cells to eotaxin-1 and eosinophils were assessed by immunohistochemistry. Patients with exposure to tobacco cigarette smoke showed higher cell counts of both eotaxin-1 and eosinophils than patients with no exposure to the smoke, with no correlation between the two variables. However, both counts, of eotaxin-1 and eosinophils, were related to the cotinine/creatinine ratio. Exposure to tobacco cigarette smoke can increase eotaxin-1 and the count of eosinophils in the nasal mucosa of young patients with perennial allergic rhinitis.


Development and validation of an improved enzyme-linked immunosorbent assay for the detection of thyroglobulin autoantibodies in canine serum samples.
An enzyme-linked immunosorbent assay to detect thyroglobulin autoantibodies (TGAB) in canine serum was developed and validated. The test result for each sample was derived from the optical density readings (OD) and expressed as an Ab-score(%) calculated from three in-house calibrators. The assay specifically detected TGAB as judged from lack of response in the assay after samples had been incubated with specific antigen. Intra- and interassay coefficients of variation ranged from 2.0-4.9% and 4.6-9.9%, respectively. The detection limit, an Ab-score of 5.6%, was close to the median Ab-score of 10% observed in healthy dogs (n = 132). The median Ab-score of dogs with primary hypothyroidism and lymphocytic thyroiditis (n = 11), skin diseases (n = 35), and non-thyroidal diseases (n = 63) was 340%, 12%, and 8%, respectively. The prevalence of TGAB in hypothyroid dogs with lymphocytic thyroiditis (sensitivity) was 91% (95% confidence limits: 59%-99%). In dogs with dermatological diseases without lymphocytic thyroiditis the prevalence of TGAB was 3% corresponding to a specificity of 97% (95% confidence limit: 85%-100%). In dogs with non-thyroidal diseases and healthy dogs the prevalence of TGAB was 5% and 6%, respectively. The diagnostic accuracy of serum TGAB was evaluated by subjecting the data from 11 dogs with lymphocytic thyroiditis and 35 control dogs without lymphocytic thyroiditis to receiver-operating characteristic curve analysis. The area under the receiver-operating characteristic curve (W = 0.966; 95% confidence limit 87%-100%) was significantly higher than that of a worthless test (0.5) (P < 0.0001), thereby indicating that serum TGAB measurements distinguished between dogs with and without lymphocytic thyroiditis.


Incidence of Coronavirus Disease 2019 (COVID-19) among healthcare workers during the first and second wave in the Democratic Republic of the Congo: a descriptive study.
Healthcare workers (HCWs) are at the frontline of response to the COVID-19 pandemic. Protecting HCWs is of paramount importance to the World Health Organization (WHO). Outbreak investigation which is based on a critical assessment of core components of infection prevention and control (IPC) programs allows for the identification of different sources of exposure to the COVID-19 virus and for informing additional IPC recommendations. To date, the Democratic Republic of the Congo (DRC) is categorized as a high-risk country due to weaknesses in the health system, low capacity for diagnosis, socioeconomic characteristics of the population, and insufficient vaccination coverage. To investigate the burden of COVID-19 among HCWs and identification of IPC gaps to reduce HCWs-associated infection at different levels (facilities, communities, and points of entry) following the WHO strategy for IPC program implementation during the first to the third wave of the pandemic. A retrospective cohort study was conducted using the DRC National Department of Health (NDOH) database and WHO questionnaire suspected and confirmed COVID-19 cases among HCWs from 10/03/2020 to 22/06/2021. The investigation was conducted by a trained IPC response team to identify the sources of the exposures. The questionnaire included demographics, profession, types of interaction between HCWs and patients, and community-based questions regarding family members and other behaviors. These variables were assessed using a multimodal strategy framework. Knowledge and adherence to IPC gaps using WHO guidelines were performed for each COVID-19-positive or suspected HCW. WHO rapid Scorecard dashboard was conducted for evaluating healthcare facilities (HCFs) performance during the COVID-19 pandemic. Cumulative incidence of positive HCWs was 809 /35,898(2.2%) from the first to the third wave of COVID-19 among 6 provinces of DRC. The distribution of the HCWs infected by COVID-19 was predominated by nurses (42%), doctors (27%), biologists (8%), environmental health practitioners (5%), interns (3%), and other categories (15%). Other categories included nutritionists, physiotherapists, midwives, pharmacists, and paramedics. The investigation revealed that about 32% of HCWs were infected from household contacts, 11% were infected by HCFs, 35% were infected in the community and 22% were infected from unknown exposures. The mean score of IPC performance for all evaluated HCFs was 27/42(64%). This shows that IPC performance was moderate. Lower or minimal performance was noted in the implementation of the IPC program at the national and facility level, triage and screening, isolation handwashing and multimodal strategies of hand hygiene, PPE availability, and rationale, waste segregation, waste disposal, sterilization, and training of HCWs. This study revealed that the prevalence of HCWs who tested positive for the COVID-19 virus was high among frontline healthcare workers from 6 provinces of DRC. A high prevalence of nosocomial infection was correlated with insufficient IPC adherence in the context of COVID-19. Strategies to strengthen IPC capacity building and provide HCWs with sufficient PPE stocks and budgets may improve IPC performance in the Democratic Republic of the Congo. This will further allow for adherence to WHO recommendations for successful program implementation to minimize COVID-19 transmission in HCFs, communities, and public gatherings. And this may be transferable to other infectious diseases.


Enhanced acetylcholine release from denervated atria: intrinsic neural supersensitivity.
Atrial tissue from denervated dog hearts was incubated with [3H]choline. When compared with controls, nicotine released more acetylcholine (ACh) from denervated atria at 10(-5) and 2 x 10(-5) M, but not at 5 x 10(-5) M. In parallel contractility studies using tissue from these same atria, the negative inotropic response to nicotine was enhanced at 5 x 10(-6) and 10(-5) M, but not at 2 x 10(-5) or 5 x 10(-5) M nicotine. These results indicate that denervation (i.e. decentralization) supersensitivity of the intrinsic cardiac nerves of canine hearts is characterized by enhanced release of ACh.


Reduced Modular Segregation of White Matter Brain Networks in Attention Deficit Hyperactivity Disorder.
Despite studies reporting alterations in the brain networks of patients with ADHD, alterations in the modularity of white matter (WM) networks are still unclear. Based on the results of module division by generalized Louvain algorithm, the modularity of ADHD was evaluated. The correlation between the modular changes of ADHD and its clinical characteristics was analyzed. The participation coefficient and the connectivity between modules of ADHD increased, and the modularity coefficient decreased. Provincial hubs of ADHD did not change, and the number of connector hubs increased. All results showed that the modular segregation of WM networks of ADHD decreased. Modules with reduced modular segregation are mainly responsible for language and motor functions. Moreover, modularity showed evident correlation with the symptoms of ADHD. The modularity changes in WM network provided a novel insight into the understanding of brain cognitive alterations in ADHD.


The Mammalian Cap-Specific m6Am RNA Methyltransferase PCIF1 Regulates Transcript Levels in Mouse Tissues.
The 5' end of eukaryotic mRNAs is protected by the m7G-cap structure. The transcription start site nucleotide is ribose methylated (Nm) in many eukaryotes, whereas an adenosine at this position is further methylated at the N6 position (m6A) by the mammalian Phosphorylated C-terminal domain (CTD)-interacting Factor 1 (PCIF1) to generate m6Am. Here, we show that although the loss of cap-specific m6Am in mice does not affect viability or fertility, the Pcif1 mutants display reduced body weight. Transcriptome analyses of mutant mouse tissues support a role for the cap-specific m6Am modification in stabilizing transcripts. In contrast, the Drosophila Pcif1 is catalytically dead, but like its mammalian counterpart, it retains the ability to associate with the Ser5-phosphorylated CTD of RNA polymerase II (RNA Pol II). Finally, we show that the Trypanosoma Pcif1 is an m6Am methylase that contributes to the N6,N6,2'-O-trimethyladenosine (m62Am) in the hypermethylated cap4 structure of trypanosomatids. Thus, PCIF1 has evolved to function in catalytic and non-catalytic roles.


"Tent-Pole" for Reconstruction of Large Alveolar Defects: A Case Report.
Severe tridimensional alveolar ridge defects complicate the placement of dental implants, and surgical removal of some oral tumors might not leave adequate bone for dental implant placement. Regenerating an adequate amount of bone vertically and horizontally to achieve a satisfying outcome for well-osseointegrated implants and thus ensure long-term success of implant restoration is challenging. This report describes the clinical feasibility of a simple approach using a screw tent-pole combined with guided bone regeneration to augment complicated tridimensional alveolar ridge defects in a case of extensive bone loss due to maxillary tumor surgery. Titanium screws were arranged in "tented" fashion to provide stable room for bone regeneration. Regenerated bone was achieved and 2 more implants were placed in the regenerated ridge 10 months later, leading to a successful maxillary prosthesis.


Distinct epitope structures of defensin-like proteins linked to proline-rich regions give rise to differences in their allergenic activity.
Art v 1, Amb a 4, and Par h 1 are allergenic defensin-polyproline-linked proteins present in mugwort, ragweed, and feverfew pollen, respectively. We aimed to investigate the physicochemical and immunological features underlying the different allergenic capacities of those allergens. Recombinant defensin-polyproline-linked proteins were expressed in E. coli and physicochemically characterized in detail regarding identity, secondary structure, and aggregation status. Allergenic activity was assessed by mediator releases assay, serum IgE reactivity, and IgE inhibition ELISA using sera of patients from Austria, Canada, and Korea. Endolysosomal protein degradation and T-cell cross-reactivity were studied in vitro. Despite variations in the proline-rich region, similar secondary structure elements were observed in the defensin-like domains. Seventy-four percent and 52% of the Austrian and Canadian patients reacted to all three allergens, while Korean patients were almost exclusively sensitized to Art v 1. This was reflected by IgE inhibition assays demonstrating high cross-reactivity for Austrian, medium for Canadian, and low for Korean sera. In a subgroup of patients, IgE reactivity toward structurally altered Amb a 4 and Par h 1 was not changed suggesting involvement of linear epitopes. Immunologically relevant endolysosomal stability of the defensin-like domain was limited to Art v 1 and no T-cell cross-reactivity with Art v 125-36 was observed. Despite structural similarity, different IgE-binding profiles and proteolytic processing impacted the allergenic capacity of defensin-polyproline-linked molecules. Based on the fact that Amb a 4 demonstrated distinct IgE-binding epitopes, we suggest inclusion in molecule-based allergy diagnosis.


Identification of amino acids in the N-terminal domain of corticotropin-releasing factor receptor 1 that are important determinants of high-affinity ligand binding.
The aim of the present study was to identify the N-terminal regions of human corticotropin-releasing factor (CRF) receptor type 1 (hCRF-R1) that are crucial for ligand binding. Mutant receptors were constructed by replacing specific residues in hCRF-R1 with amino acids from the corresponding position in the N-terminal region of the human vasoactive intestinal peptide receptor type 2 (hVIP-R2). In cyclic AMP stimulation and CRF binding assays, it was established that two regions within the N-terminal domain were crucial for the binding of CRF receptor agonists and antagonists: one region mapping to amino acids 43-50 and a second amino acid sequence extending from position 76 to 84 of hCRF-R1. Recently, it was found that the latter sequence plays a very important role in determining the high ligand selectivity of the Xenopus CRF-R1 (xCRF-R1). Replacement of amino acids 76-84 of hCRF-R1 with residues from the same segment of the hVIP-R2 N terminus markedly reduced the binding affinity of CRF ligands. Mutation of Arg76 or Asn81 but not Gly83 of hCRF-R1 to the corresponding amino acids of xCRF-R1 or hVIP-R2 resulted in 100-1,000-fold lower affinities for human/rat CRF, rat urocortin, and astressin. These data underline the importance of the N-terminal domain of CRF-R1 in high-affinity ligand binding.


The influence of hydroxypropyl-β-cyclodextrin on the solubility, dissolution, cytotoxicity, and binding of riluzole with human serum albumin.
Cyclodextrin-related host-guest encapsulation is fundamental to modulate the solubility of riluzole (RLZ), promoting its potential pharmaceutical applications. The supramolecular interaction of RLZ and hydroxypropyl-β-cyclodextrin (HP-β-CD) was examined through FT-IR spectroscopy, DSC-TGA, PXRD, (1)HNMR, 2D ROESY, ssNMR, and SEM. The HP-β-CD/RLZ inclusion complex was formed at a molar ratio of 1:1. The stability constant (K=2327 M(-1)) and the corresponding thermodynamic parameters were ascertained through phase solubility studies. The water solubility and dissolution rate of RLZ notably increased in the presence of HP-β-CD, whereas the inclusion complex did not increase the RLZ toxicity toward the LO2 cell line. The influence of HP-β-CD on RLZ-human serum albumin (HSA) binding was investigated via fluorescence spectroscopy. Fluorescence quenching of HSA by RLZ in the presence and absence of HP-β-CD were both static quenching. Data analysis showed that the addition of HP-β-CD weakened the quenching and binding of RLZ with HSA but did not affect the binding site and binding force between RLZ and HSA. Furthermore, molecular models were generated to determine the binding site between HSA and RLZ, and these models were consistent with the experimental data.


Potentiation by substance P of contractions of the isolated vas deferens of the mouse elicited by electric field stimulation and by drugs.
1 Isolated vasa deferentia from the mouse were opened longitudinally and suspended in Krebs solution at 37 degrees C in an organ bath. Contractions of the muscle were elicited by electric field stimulation, noradrenaline (10(-6) M) and acetylcholine (10(-6) M). Continued transmural stimulation evoked a biphasic response comprising a rapid twitch followed about 10 s later by a smaller, sustained rise in muscle tone.2 The amplitudes of nerve-mediated and drug-induced responses were considerably potentiated by substance P (SP) in the dose range 10(-12) to 10(-7) M. Higher concentrations of SP were directly spasmogenic. The sensitizing property of SP was dose-dependent and was usually well maintained, but always disappeared quickly on washing the preparation. In some experiments SP facilitated the twitch, but not the subsequent phase of the electrically-induced contraction or the response to externally applied noradrenaline.3 Phentolamine (10(-6) M) failed to block this effect of SP, but itself potentiated the nerve-mediated twitch, and completely abolished the sustained secondary contraction.4 Desmethylimipramine (10(-6) M) enhanced the delayed contraction but not the immediate contraction.5 The uptake of tritiated noradrenaline (3 x 10(-7) M) by vasa was inhibited by desmethylimipramine (10(-6) M) and increased by nialamide (3 x 10(-5) M), but was not modified by SP (10(-6) M).6 Nerve-mediated release of accumulated radioactivity was accelerated by phentolamine, but not by SP or desmethylimipramine.7 These findings suggest that SP sensitizes the muscle cells to depolarizing stimuli but that it has no facilitatory effect on sympathetic neural elements.


Hotspots mutational analysis of Wilms tumor 1 gene in acute myeloid leukaemia; prevalence and clinical correlation in North Indian population.
The pathogenic role of Wilms tumor 1 gene (WT1) is well known in renal cancer. However, recently, its over expression is been documented in cases of acute myeloid leukaemia (AML), acute lymphoblastic leukaemia (ALL) and myelodysplastic syndrome (MDS). WT1 mutations is found in about 6%-15% of cases of AML affecting mainly hotspot exon 7 and 9, and less frequently in other exon such as 1, 2, 3, and 8. Different studies have shown equivocal findings with few of them depicting poorer prognosis, while others suggesting lack of any significant clinical impact. This study was planned to evaluate prevalence of WT1 gene mutation on exon 7 & 9 in de novo cases of AML and its correlation with their clinical features and disease course. A total of newly diagnosed and treatment naive 100 cases of AML, having blast count of ≥20% in peripheral blood or bone marrow were enrolled. Genomic DNA of all participants was extracted from blood/bone marrow sample using Qiagen® DNA extraction kit. Haematological workup for counts and flow cytometry based immunophenotypes was done. Mutation on exon 7 & 9 were detected with the help of Sanger sequencing. WT1 mutations were detected in both types of cases having normal vs. abnormal cytogenetics. The overall prevalence of WT1 mutation of 2% was found. We have reported one novel mutation on exon 9 of WT1 gene. Twelve cases (12%) among all analyzed AMLs were found to have synonymous single nucleotide polymorphism (SNPs) on exon 7 which has been previously reported in SNP database (rs16754). In our study, presence of synonymous SNP was not associated with any change at protein level. We also evaluated mutational status with deaths during induction remission and concluded that presence of WT1 gene mutation was associated with death during induction therapy.


Kaposi's sarcoma occurring in a dermatome previously involved by herpes zoster.
A 31-year-old black man with a history of intravenous drug abuse developed a mass in his neck, a biopsy of which revealed Kaposi's sarcoma. The patient underwent radiation therapy, and the mass diminished in size. Approximately 2 months later the patient developed a herpes zoster infection in the left T3 distribution. The vesicular eruption resolved, but postherpetic neuralgia remained. Two months after the herpes zoster infection, the patient developed many small nodules in the area of the prior vesicular eruption. Biopsy revealed these nodules to be Kaposi's sarcoma. At this time no other cutaneous lesions were present. We believe that these nodules represent the occurrence of the Koebner phenomenon in a patient with Kaposi's sarcoma and the acquired immunodeficiency syndrome.


Transport behaviors of Cs+ in granite porous media: Effects of mineral composition, HA, and coexisting cations.
The transport of radiocesium (RCs) in granite has attracted great concerns for the consideration of a long-term safety assessment and performance evaluation of the nuclear waste disposal repository. In this study, the transport behaviors of Cs+ in granite were addressed and quantified by column experiments, sequential extraction, and a convection-dispersion equation model. The transport of Cs+ in granite experienced at least two stages including a rapid increase and a slow increase stages. The retardation of Cs+ in granite obviously became higher as biotite content increased. However, a consistent breakthrough plateau and almost overlapped breakthrough curves were observed under different feldspar contents, which suggested that the transport behaviors of Cs+ in granite was quite close to feldspar. Compared to Na+, K+ could effectively inhibit Cs+ adsorption and facilitate the mobility of Cs+ in granite column. In the presence of Sr2+, the transport of Cs+ was provoked in the granite column mainly due to the high competition effects. Humic acid (HA) did not obviously change the transport behaviors of Cs+ in granite column; however, HA could weakly change the adsorption species of Cs+ during Cs+ transport in granitic media. Both sequential extraction and two-site non-equilibrium model suggested that feldspar was the main contributor to the weak adsorption sites and biotite was responsible for the strong affinity sites for Cs+ in Beishan granite. The findings could provide important insights into RCs transport and fate in granitic media.


Neuroimaging of psychiatric disorders.
Psychiatry remains the only medical specialty where diagnoses are still based on clinical syndromes rather than measurable biological abnormalities. As imaging technology and analytical methods evolve, it is becoming clear that subtle but measurable radiological characteristics exist and can be used to experimentally classify psychiatric disorders, predict response to treatment and, hopefully, develop new, more effective therapies. This review highlights advances in neuroimaging modalities that are now allowing assessment of brain structure, connectivity and neural network function, describes technical aspects of the most promising methods, and summarizes observations made in some frequent psychiatric disorders.


An investigation into the detoxification of microcystin-LR by the glutathione pathway in Balb/c mice.
Toxin-producing cyanobacteria pose a world-wide health threat to humans and animals due to their increasing presence in both drinking and recreational waters. The predominant cyanotoxin, microcystin-LR (MCLR), targets the liver and its toxicity depends on the uptake and removal rates in the liver. The role of the glutathione detoxification pathway in protecting the liver from the effects of MCLR was investigated. Mice exposed to a single 75% LD(50) dose of pure MCLR were sacrificed at 8, 16, 24 and 32 h post-exposure (pe). Toxin induced liver damage was observed 8 and 16 h pe as evidenced by raised serum ALT and LDH levels, reduced glycogen levels and liver histology. A significant increase in lipid peroxidation was seen at 16 h pe that decreased after 24 and 32 h pe, the time-points which showed significant increases in GPX activity. An increase in soluble GST activity was noted between 8 and 16 h pe, levels of total GSH increased at 24 h while oxidised glutathione increased throughout the investigation. The increase in activity of both GPX and GST corresponded with increased transcription of these enzymes, as well as the rate-limiting enzyme in GSH synthesis, gamma-glutamyl transferase. In conclusion, this study confirms that an increase in GST activity is critical for the detoxification of MCLR, that this is regulated at the transcriptional level, and that exposure to MCLR induces the de novo synthesis of GSH. Finally, we report the involvement of GPX in the removal of MCLR-induced lipid hydroperoxides.


A prospective, randomized evaluation of effect of ventricular fibrillation duration on defibrillation thresholds in humans.
The effect of ventricular fibrillation duration in humans on defibrillation efficacy as it pertains to the time of intervention of an automatic implantable defibrillator is unknown. If a difference in defibrillation efficacy exists in the early period after ventricular fibrillation onset, it may affect algorithms used by antiarrhythmic devices for arrhythmia detection and therapy. Therefore, a prospective, randomized evaluation was performed of the effect of ventricular fibrillation durations of 10 s and 20 s on defibrillation thresholds in 10 survivors of sudden cardiac arrest undergoing implantation of an automatic cardioverter defibrillator. The initial duration of ventricular fibrillation was chosen randomly. Subsequently, each patient served as his or her own control for the alternate duration of ventricular fibrillation to that chosen initially. The mean leading edge defibrillation threshold voltage was 411 +/- 114 V when ventricular fibrillation persisted for 10 s and 419 +/- 125 V when it persisted for 20 s (p = 0.73). The mean defibrillation threshold current was 11.4 +/- 2.8 A when ventricular fibrillation persisted for 10 s and 11.4 +/- 3.2 A when it persisted for 20 s (p = 0.97). The delivered energy defibrillation threshold was 11.5 +/- 5.9 J when ventricular fibrillation persisted for 10 s and 12.0 +/- 6.9 J when it persisted for 20 s (p = 0.67). These findings show that the defibrillation threshold does not change between 10 and 20 s of ventricular fibrillation in out-of-hospital survivors of cardiac arrest at the time of surgical implantation of an automatic defibrillator. The data may have influence on the programming of defibrillator detection algorithms.


Nanoselenium Foliar Applications Enhance the Nutrient Quality of Pepper by Activating the Capsaicinoid Synthetic Pathway.
Increasing the crop quality through enhancement of plant health is a challenging task. In this study, nanoselenium (nano-Se) was sprayed on pepper leaves, and the pepper components were compared to those of selenite. It was found that nano-Se (20 mg/L) resulted in a greater performance of plant health. It increased the chlorophyll and soluble sugar levels, which could activate phenylpropane and branched-chain fatty acid pathways, as well as AT3-related enzymes and gene expressions. These led to an enhancement for the synthesis of capsaicinoids, flavonoids, and total phenols. The nano-Se treatment also significantly promoted the expression of phyto-hormones synthesis genes, and consequently increased jasmonic, abscisic, and salicylic acid levels. Proline pathway-related compounds were increased, which could decrease the malondialdehyde and hydroxyl radical levels in crops. This study shows that nano-Se activated capsaicinoid pathways by enhancing photosynthesis and raising soluble sugar levels. The capsaicinoid contents in peppers were then increased, which consequently promoted the accumulation of secondary metabolites and antioxidants.


CdS/polymer nanocomposites synthesized via surface initiated RAFT polymerization for the fluorescent detection of latent fingermarks.
Current advances in nanoscience have provided the unique opportunity to utilize nanostructured materials to improve the visualization and quality of fingermark development. Here, we show the facile controlled fabrication of CdS/poly(dimethylacrylamide), CdS/poly(dimethylacrylamide-co-methyl methacrylate) and CdS/poly(dimethylacrylamide-co-styrene) fluorescent quantum dot nanocomposites for use as latent fingermark developing agents on non-porous surfaces. First, CdS quantum dots were capped with 2-mercaptoethanol with subsequent immobilization of a carboxylated C12-chain transfer agent (C12CTA) via an ester bond. A surface initiated reversible addition fragmentation chain transfer (RAFT) polymerization was then performed under a controlled system resulting in nanocomposites containing polymers of low polydispersity. The intrinsic optical properties of the CdS quantum dots were retained throughout the synthetic pathways, which allowed for the successful one-step application and fluorescent visualization of latent fingermarks (fresh and aged) on aluminum foil and glass substrates under UV illumination.


Effect of Photobiomodulation on Structure and Function of Extracellular Vesicle Secreted from Mesenchymal Stem Cells.
The current study intended to evaluate the effect of photobiomodulation on the morphology and function of EVs secreted from mesenchymal stem cells (MSCs) derived from periodontal ligament (PDL) and the adipose tissue (ADSCs) (from buccal fat pad) in vitro. These cells were irradiated at 660 nm or kept in dark as control. EVs were then isolated from each group using ultracentrifugation. EVs were defined by flow cytometry and Western blot. Electron microscopy (SEM) was used to study the morphology of EVs. Then, MTT and wound-healing scratch assays were applied to compare the cell survival and migration of human dermal fibroblast (HDF) cells treated with the EVs obtained from the four groups. According to SEM images, isolated EV were round and cup-shaped in all groups showing no destructive effects of laser irradiation on EV morphology. MTT test results revealed a statistically significant difference between the HDF cells treated with different EV groups from hPDLSCs-Dark in comparison with control (0 μg/mL) (P < 0.05) and treated with exosome from hPDLSCs-Irradiation cells compared with dark group (P < 0.05). However, scratch wound-healing assay did not show a significant difference between various groups (P ˃ 0.05). Further studies with different irradiation protocols are recommended to find an optimal strategy.


Dislocation of a middle lobe torsion-preventing bridging structure with an absorptive sheet and fibrin glue: a case report.
Middle lobe torsion is a rare complication of right upper lobectomy. Middle lobe torsion can be critical; thus, various preventive measures are used. A 77-year-old man underwent thoracoscopic right upper lobectomy with partial middle resection and S6 segmentectomy for right upper lobe lung cancer located at the confluence of the three lobes and lower lobe lung cancer. Inversion of the middle lobe was observed during lung expansion before chest closure. A bridging structure with an absorptive sheet and fibrin glue was placed in the basal section of the middle lobe under lung expansion to prevent torsion. On postoperative day 1, the patient was tachycardic and was found to have decreased lung field permeability. The patient underwent emergency surgery for suspected middle lobe torsion. Dislocation of the bridging structure between the basal segments of the middle lobe was confirmed, and the middle lobe was deviated cephalad. In addition, pulmonary congestion in S4 due to pressure stenosis of V4 caused by the deviation of the middle lobe was observed, and middle lobe resection was performed. The postoperative course was uneventful. This case suggested that the reinforcement method with an absorptive sheet and fibrin glue lacked sufficient strength to prevent middle lobe torsion. Stronger fixation should be considered if the middle lobe rotation is thought to be sufficiently strong when the lung is reinflated before chest closure.


ACTivity as medicine In Oncology for Head and Neck (ACTIOHN): Protocol for a feasibility study investigating a patient-centred approach to exercise for people with head and neck cancer.
Attempts at personalisation of exercise programmes in head and neck cancer (HaNC) have been limited. The main aim of the present study is to investigate the feasibility and acceptability of introducing a remotely delivered, fully personalised, collaborative, and flexible approach to prescribing and delivering exercise programmes into the HaNC usual care pathway. This is a single arm, feasibility study. Seventy patients diagnosed with HaNC will be recruited from two regional HaNC centres in the United Kingdom. Patients will undertake an 8-week exercise programme designed and delivered by cancer exercise specialists. The exercise programme will start any time between the time of diagnosis and up to 8 weeks after completing treatment, depending on patient preference. The content of the exercise programme will be primarily based on patient needs, preferences, and goals, but guided by current physical activity guidelines for people with cancer. The primary outcome measure is retention to the study. Secondary quantitative outcomes are uptake to the exercise programme, different measures of exercise adherence, pre- and post-intervention assessments of fatigue (Multidimensional Fatigue Symptom Inventory-Short Form), quality of life (SF-36), physical activity levels (International Physical Activity Questionnaire-Short Form), and various components of physical fitness. The outcomes of the nested qualitative study are acceptability and feasibility of the intervention evaluated via interviews with patients, health care professionals, and the cancer exercise specialists. Intervention and participant fidelity will be determined using checklists and scrutiny of each patient's logbook and the cancer exercise specialists' meeting notes. Analysis of quantitative data will be via standard summary statistics. Qualitative data will be analysed using thematic analysis. This feasibility study will inform the design and conduct of a future randomised controlled trial. Success will be defined according to a traffic light system for identifying the appropriateness of progression to a randomised controlled trial. International Standard Randomised Controlled Trial Number registry (ISRCTN82505455).


Tau-based therapies in neurodegeneration: opportunities and challenges.
Aggregates of the microtubule-associated protein tau are a defining feature of several neurodegenerative diseases that are collectively known as tauopathies, and constitute one of the hallmark lesions of Alzheimer disease (AD). Given the lack of efficacy to date of amyloid-β-targeted therapies for AD, interest is growing in tau as a potential alternative target. Several drug candidates, which are now in clinical trials, aim to reduce tau levels or to prevent the aggregation or pathological post-translation modifications of this protein. In this Review, we discuss preclinical and clinical studies in light of an increased understanding of the physiological and pathological roles of tau, advances in animal models of tauopathy, the identification of novel targets and the availability of novel tracers to track tau.


Isolation and structure elucidation of flavonoid and phenolic acid glycosides from pericarp of hot pepper fruit Capsicum annuum L.
Hot pepper fruits (Capsicum annuum L.) var. Bronowicka Ostra have been studied with regard to content of flavonoids and other phenolics. Nine compounds were isolated from pericarp of pepper fruits by preparative HPLC. Their structures were identified by chromatographic (analytical HPLC) and spectroscopic (UV, NMR) techniques. Two of the identified compounds, trans-p-ferulylalcohol-4-O-(6-(2-methyl-3-hydroxypropionyl) glucopyranoside and luteolin-7-O-(2-apiofuranosyl-4-glucopyranosyl-6-malonyl)-glucopyranoside were found for the first time in the plant kingdom. Additionally compounds: trans-p-feruloyl-beta-D-glucopyranoside, trans-p-sinapoyl-beta- D-glucopyranoside, quercetin 3-O-alpha-L-rhamnopyranoside-7-O-beta-D-glucopyranoside, luteolin 6-C-beta-D-glucopyranoside-8-C-alpha-L-arabinopyranoside, apigenin 6-C-beta-D-glucopyranoside-8-C-alpha-L-arabinopyranoside and luteolin 7-O-[2-(beta-D-apiofuranosyl)-beta-D-glucopyranoside] were found for the first time in pepper fruit Capsicum annuum L.