Exploration factors on smoking among female adolescents based on the viewpoints of Iranian adolescent girls.
In recent years, the prevalence of smoking in women has increased significantly. This study aimed to explain the effective factors in the tendency to smoke in female adolescents, employing a qualitative method of content analysis in Mashhad, Iran. The data for this conventional content analysis were obtained by conducting semi‑structured interviews with 20 female adolescent smokers. For open coding, integrating codes, creating main category and subcategories, and extracting quotation associated with codes and subcategories, MAXQDA software version 10 was used. Based on the results of the study, one main category and six subcategories were identified to influence the decision to smoke. The main category was interconnection of psychological and gender experiences. The subcategories included self-management weakness, ignoring the side effects, gender orientation, negative psychological experiences, the attraction of cigarettes, and positive psychological experiences. Psychological and gender factors play an important role in initiating people's behavior and tendency to smoke and smoking prevention programs in educational settings need to focus efforts around what is known about young women smokers.


Social and medical impact, sleep quality and the pharmaceutical costs of heartburn in Taiwan.
Little is known about the social and medical burdens of heartburn in Asia. To assess the impact of heartburn in Taiwan. We applied a questionnaire to 2018 apparently healthy adult Chinese receiving a routine health maintenance programme. Costs of heartburn-related prescriptions were obtained from the Bureau of National Health Insurance of Taiwan. Heartburn prevalence (>1 episode/week) was 7%. Smoking and increased body mass index were associated with heartburn occurrence. Heartburn sufferers reported more atypical gastro-oesophageal reflux disease symptoms, e.g. chest pain, dysphagia and globus. They were more likely to consult physicians, and have an increased frequency and number of days of absenteeism, irrespective of upper gastrointestinal or nongastrointestinal-related illnesses. They experienced sleep disturbances more frequently. The 62 heartburn consulters (48%) were more likely to have co-existing globus, visited physicians more, had more absenteeism, suffered from more sleep disturbances and had higher costs for antacids, proton pump inhibitors, hypnotic/sedatives, tranquilizers and antidepressants than nonconsulters. Heartburn prevalence in Taiwan is lower than in Western countries. Nevertheless, heartburn in Taiwanese creates a significant burden in terms of social impact, health resource utilization, sleep quality and pharmaceutical costs. The increased costs of psychoactive drugs in consulters suggest that anxiety/depression affects their health-seeking behaviour.


Acetylcholinesterase is functional in embryonic rat muscle before its accumulation at the sites of nerve-muscle contact.
We have examined the expression, the location, and the physiological activity of acetylcholinesterase (AChE) in developing intercostal muscles in the rat. Although focal accumulations of AChE at developing end plates do not appear until Embryonic Day (ED) 16-17, 16 S AChE is present at ED 14. Experiments with permeable and impermeable inhibitors established that prior to focal accumulation most of the 16 S enzyme is on the surface of muscle fibers, where it constitutes the major species. Intracellular recording from developing muscle fibers showed that as early as ED 14, AChE inhibitors prolonged evoked end-plate potentials. We conclude that prior to its focal accumulation, AChE is present on the surface of muscle fibers and is physiologically active. Histochemical staining of the focally accumulated enzyme demonstrated that the enzyme is concentrated both intracellularly and extracellularly at the sites of developing nerve-muscle contacts.


Myocardial infarction risk is increased by periodontal pathobionts: a cross-sectional study.
To establish the role of periodontal pathobionts as a risk factor for myocardial infarction, we examined the contribution of five periodontal pathobionts and their virulence genes' expressions to myocardial injury (Troponin-I) and coronary artery disease burden (SYNTAX-I scores) using hierarchical linear regression. Pathobiont loads in subgingival-plaques and intra-coronary-thrombi were compared. Troponin-I release increased with one 16S rRNA gene copy/ng DNA of Porphyromonas gingivalis (β = 6.8 × 10-6, 95% CI = 1.1 × 10-7-2.1 × 10-5), one-fold increased expressions of fimA (β = 14.3, 95% CI = 1.5-27.1), bioF-3 (β = 7.8, 95% CI = 1.1-12.3), prtH (β = 1107.8, 95% CI = 235.6-2451.3), prtP (β = 6772.8, 95% CI = 2418.7-11,126.9), ltxA (β = 1811.8, 95% CI = 217.1-3840.8), cdtB (β = 568.3, 95% CI = 113.4-1250.1), all p < 0.05. SYNTAX-I score increased with one 16S rRNA gene copy/ng DNA of Porphyromonas gingivalis (β = 3.8 × 10-9, 95% CI = 3.6 × 10-10-1.8 × 10-8), one-fold increased expressions of fimA (β = 1.2, 95% CI = 1.1-2.1), bioF-3 (β = 1.1, 95% CI = 1-5.2), prtP (β = 3, 95% CI = 1.3-4.6), ltxA (β = 1.5, 95% CI = 1.2-2.5), all p < 0.05. Within-subject Porphyromonas gingivalis and Tannerella forsythia from intra-coronary-thrombi and subgingival-plaques correlated (rho = 0.6, p < 0.05). Higher pathobiont load and/or upregulated virulence are risk factors for myocardial infarction.Trial registration: ClinicalTrials.gov Identifier: NCT04719026.


On spatial periodicity in the formation of cell adhesions to a substrate.
Interference reflection microscopy reveals a fairly regular array of marginal focal contacts in early states of cell spreading. A theoretical explanation of the onset of patchiness is given, based on the positively cooperative binding to the substrate of laterally diffusing receptor molecules.


Population responses of omnivorous arthropods to plant alternative resources suppress prey populations: A meta-analysis.
Omnivory is ubiquitous in ecological communities. Yet, we lack a consensus of how plant alternative resources impact the ability of omnivores to suppress prey populations. Previous work suggests that plant alternative resources can increase, decrease, or have no effect on the magnitude of omnivore-prey interactions. This discrepancy may arise from (1) the ability of omnivore populations to respond to plant alternative resources and (2) identity-specific effects of plant alternative resources. We used a meta-analysis to examine how omnivore population responses and the identity of plant alternative resources affect (1) omnivore predation rates (mainly reported as per capita predation rate) and (2) omnivore impacts on prey population density. Plant alternative resources reduced omnivore predation rate regardless of identity. The suppression of the predation rate by flowers and flowering plants was magnified when pollen alone was tested as the alternative resource. Surprisingly, plant alternative resource availability reduced prey density, suggesting that omnivore predation increased with plant alternative resources. This discrepancy (plant alternative resources not only decreased omnivore predation rates but also decreased prey density) resulted from experimental differences in the ability of omnivore populations to respond to plant alternative resources. In the presence of plant alternative resources, allowing omnivore population responses decreased prey density, while not allowing population responses increased prey density. Because omnivores commonly suppress prey density in the presence of plant alternative resources when population responses of omnivores are allowed, the effectiveness of biological control may depend upon the availability of such resources and the facilitation of population responses.


Cell-based therapies for neurological disorders - the bioreactor hypothesis.
Cell-based therapies are an emerging biopharmaceutical paradigm under investigation for the treatment of a range of neurological disorders. Accumulating evidence is demonstrating that cell-based therapies might be effective, but the mechanism of action remains unclear. In this Review, we synthesize results from over 20 years of animal studies that illustrate how transdifferentiation, cell replacement and restoration of damaged tissues in the CNS are highly unlikely mechanisms. We consider the evidence for an alternative model that we refer to as the bioreactor hypothesis, in which exogenous cells migrate to peripheral organs and modulate and reprogramme host immune cells to generate an anti-inflammatory, regenerative environment. The results of clinical trials clearly demonstrate a role for immunomodulation in the effects of cell-based therapies. Greater understanding of these mechanisms could facilitate the optimization of cell-based therapies for a variety of neurological disorders.


[Traumatic hip dislocations in children].
Traumatic hip dislocation is a rare event in children. Appropriate management remains a subject of debate. The purpose of this study was to investigate the epidemiological, therapeutic features of this situation and the long-term outcome after treatment. This was a retrospective analysis of 15 traumatic hip dislocations collected over a period of 20 years in pediatric patients with at least two years follow-up. We searched for predisposing factors and factors affecting prognosis. The series included 11 boys and three girls, mean age eight years. Dislocation was posterior in 13 hips and anterior in two. Time to reduction was less than 3h in eight cases, 3-6h in five and greater than 6h in two. After reduction, traction was performed in nine children, for 20 days on average, followed in five cases by immobilization for 40 days on average. Five hips were immobilized directly after reduction. We identified two groups by age: group 1 with dislocations in children aged less than six years (seven children) were characterized by low-energy trauma. Dislocation was not associated with other lesions. Predisposing factors (overt ligament hyperlaxity, insufficient superolateral head cover, coax valga) were noted in six children. Reduction was simple. Later treatment consisted in immobilization with a pelvispedious cast for 30-45 days. Group 2 were dislocations in children aged over six years (seven children) victims of high-energy trauma. Associated injuries were frequent. Predisposing factors were not present. At mean 11 years follow-up, all hips are considered normal clinically. The radiograph was normal for 14 hips. In one case, there was a slight coax magna. In three patients, defective femoral head cover persisted. Coxa valga persisted in two patients. Traumatic dislocation of the hip joint is rare in very young children, but results from a minimally traumatic event. This suggests the presence of predisposing factors in this category of patients, particularly capsuloligamentary hyperlaxity. After reduction, immobilization can be recommended. Traumatic hip dislocations in children are different from the adult variety due to their rarity, the general absence of associated fractures, easy reduction and better prognosis. The epidemiological and therapeutic features in children older than six years are however similar to those in adults.


A novel miRNA-based signature as predictive tool of survival outcome of colorectal cancer patients.
It is great significance of identifying valuable biomarkers for early diagnosis and prognostic prediction of colorectal cancer (CRC) patients. This study aimed at developing and validating a miRNAs-based signature as prognostic tool for CRC patients. The miRNA expression profile of 624 CRC samples (613 tumor tissues and 11 normal tissues) was analyzed, and 523 differentially expressed miRNAs (DEmiRNAs) were identified, in which 191 were downregulated and 332 were upregulated. All patients were randomly divided into a training cohort (N = 308) and an internal validation cohort (N = 200). Using the least absolute shrinkage and selection operator (LASSO) and Cox regression model, a prognostic signature of 10 miRNAs (hsa-miR-149-5p, hsa-miR-193b-5p, hsa-miR-193a-3p, hsa-miR-3677-3p, hsa-miR-29a-3p, hsa-miR-200c-5p, hsa-miR-200a-5p, hsa-miR-6854-5p, hsa-miR-216a-5p and hsa-miR-891a-5p) was developed in the training cohort. The risk score was calculated by the product of the expression level and the coefficients of each miRNA. The prognostic value of 10 miRNAs-based signature for CRC patients was tested and validated. Survival analysis indicated that high-risk patients (> 1.10) had a worse overall survival (OS) than low-risk (≤ 1.10) patients (5-year OS rate for training cohort: 59.3% vs. 78.9%, p < .001; validation cohort: 48.3% vs. 69.3%, p = .011). The miRNA-based signature was an independent prognostic factor for CRC patients (HR for training cohort:2.476, 95% CI:1.202-5.098, p = .014; HR for validation cohort:2.050, 95% CI:1.087-3.869, p = .027). The AUC values for 3-year and 5-year OS prediction were 0.718 and 0.784 in the training cohort, 0.659 and 0.614 in the validation cohort, respectively. The 10 miRNAs-based signature provided a proper prognostic stratification for CRC patients, and it might be a promising tool for survival prediction.


Use of Proximal Humerus Locking Plates for Fixation of Pediatric Femoral Neck Fractures: Technical Trick.
Displaced pediatric femoral neck fractures are uncommon and complex injuries which require urgent operative fixation. Owing to the small and variable size of the pediatric femur, implant selection and availability can be difficult. We present a novel technique for the stabilization of these fractures with commonly available implants which provides physeal sparing, fixed angle, and stable fixation.


Australian carybdeid jellyfish causing "Irukandji syndrome".
The Australian carybdeid jellyfish associated with Irukandji syndrome is Carukia barnesi, (Barnes' jellyfish). Other Australian carybdeid jellyfish that may be associated with the syndrome include Carukia shinju, Carybdea xaymacana, Malo maxima, Malo kingi, Alatina mordens, Gerongia rifkinae, and Morbakka fenneri ("Morbakka"). These small jellyfish are difficult to capture and identify. They are located offshore of the coasts of Australian states including Queensland, The Northern Territory, Western Australia and South Australia. The syndromic illness, resulting from a characteristic relatively minor sting, develops after about 30 minutes and consists of severe muscle pains especially of the lower back, muscle cramps, vomiting, sweating, agitation, vasoconstriction, prostration, hypertension and in cases of severe envenomation, acute heart failure. The mechanisms of actions of their toxins are obscure but they appear to include modulation of neuronal sodium channels leading to massive release of endogenous catecholamines (C. barnesi, A. mordens and M. maxima) and thereby to possible stress-induced cardiomyopathy. In addition, pore formation may occur in myocardial cellular membranes (C. xaymacana). In human cases of severe envenomation, systemic hypertension and myocardial dysfunction are associated with membrane leakage of troponin. Clinical management includes parenteral analgesia, antihypertensive therapy, oxygen and mechanical ventilation. No effective first-aid is known. Large knowledge gaps exist in biology of the jellyfish, their distribution, their toxins and mode of actions and in treatment of the Irukandji syndrome.


Some characteristics of the prostaglandin synthesizing system in rabbit kidney microsomes.
The prostaglandin synthesizing system in rabbit kidney microsomes was characterised using a radiometric assay. Three prostaglandins (F2alpha, E2 and D2) were formed form (1-14C)arachidonic acid, a small amount of prostaglandin A2 was also detected but this was formed non-enzymatically. Biosynthesis was stimulated by reduced-glutathione and 1-adrenaline and was inhibited by aspirin-like drugs. The enzyme system was sensitive to small changes in pH. There were substantial differences in drug sensitivity and optimal reaction conditions between this prostaglandin synthesizing system and the one from bovine seminal vesicles.


Communication strategies for effective family-clinician conversations in the intensive care unit: A mixed methods study.
To explore the perspectives of intensive care patients' family members and clinicians on conveying information during family-clinician conversations. Two medical intensive care units of a German academic tertiary care hospital. This study followed a mixed methods design using a digital survey on family-clinician conversations with open- and closed-ended questions, metric scales, and free-text options. Quantitative analysis was performed to determine similarities and differences. Qualitative directed content analysis was conducted to code all free-text responses into themes. The responses of 100 family members, 42 nurses, and 28 physicians were analysed (response rate: 47%). All groups preferred face-to-face communication, the ask-tell-ask method, recipient design, and explaining medical terminology. The groups further commented on empathic communication by advocating the acknowledgement of the large amount of information. Qualitative themes highlighting the importance of bedside manners and written information were unique to the family members. Closed-ended questions were identified as potential trouble sources. Two communication strategies were rated as more suitable by the family members than by the physicians: being offered to choose between a summary or a detailed report at the beginning (p =.012;r = 0.288) and receiving a summary and having all questions answered at the end of a conversation (p =.023;r = 0.240). The shared preferences supported existing expert recommendations, the differing preferences corroborated the importance of relational aspects of communication and additional written information. More research is needed on empathic communication aspects. To facilitate understanding, the clinicians may apply recipient design and the ask-tell-ask method, explain medical terminology, summarise important information, and proactively elicit questions. They may use empathic phrasing, demonstrate a respectful demeanour, and reflect on their current use of closed-ended questions and on the relational messages of their communication.


Elevated CDC45 Expression Predicts Poorer Overall Survival Prognoses and Worse Immune Responses for Kidney Renal Clear Cell Carcinoma via Single-Cell and Bulk RNA-Sequencing.
The main objective of this paper is to analyze the prognostic and immunological value of CDC45 in kidney renal clear cell carcinoma (KIRC) using single-cell and bulk RNA-sequencing approaches. The expression of CDC45 in KIRC was evaluated by the HPA database, the TCGA-KIRC dataset and verified by PCR analysis and single-cell RNA-sequencing. The ability of CDC45 to independently predict prognosis in KIRC was confirmed by univariate/multivariate regression analysis. Gene set enrichment analysis (GSEA) was employed to explore CDC45-related pathways in KIRC. In addition, Relationships between CDC45 and immunity were also examined. Elevated CDC45 expression in KIRC was demonstrated at mRNA and protein levels. The results of the correlation analysis showed that as CDC45 expression increased, so did the histological grade, clinical stage, and TNM stage of the patients (p < 0.05). Univariate/multivariate regression analysis suggested CDC45 as an independent prognostic factor for KIRC. Seven pathways related to CDC45 were screened through GSEA. Meanwhile, we found that CDC45 was correlated with tumor mutational burden (TMB) and microsatellite instability (MSI) but not tumor neoantigen burden (TNB). Regarding immunity, CDC45 exhibited correlations with the tumor microenvironment, immune cell infiltration, and immune checkpoints. Besides, low CDC45 expression was shown to be associated with a better response to immunotherapy. Single-cell RNA-sequencing revealed that CDC45 was differently expressed in T cells (p < 0.05). CDC45 showed potential as a prognostic biomarker and therapeutic target for KIRC. Meanwhile, the CDC45 low expression group was more sensitive to immunotherapy.


A high-value-added application of the stems of Rheum palmatum L. as a healthy food: the nutritional value, chemical composition, and anti-inflammatory and antioxidant activities.
Rhubarb has edible stems or stalks. In this paper, we investigated the nutritional value, chemical composition, and bioactivities of Rheum palmatum stems (SRP) and analyzed the mode of action. SRP exhibited biosafety and had nutritional value, with abundant essential amino acids and minerals. Based on network pharmacology and western blot tests, we found that it showed anti-inflammatory activity via the PI3K-Akt-mediated NF-κB pathway. Out of 20 compounds identified using UPLC-ESI-Q-TOF/MS analysis, cirsiliol and hydrangenol were active compounds and they inhibited NO production in RAW264.7 cells induced by LPS. The alleviation of an inflammatory response is combined with a decrease in oxidative stress, and SRP showed antioxidant activity via attenuating antioxidant enzymes, scavenging free radicals, improving the mitochondrial membrane potential, and decreasing the reactive oxygen species level. These results indicated that SRP, with abundant flavonoids and a good nutritional composition, could be used as a dietary supplement for food applications.


Conceptualizing the Role of Parent and Child Emotion Regulation in the Treatment of Early-Onset Behavior Disorders: Theory, Research, and Future Directions.
Behavior disorders (BDs) are common and costly, making prevention and early-intervention a clinical and public health imperative. Behavioral Parent Training (BPT) is the standard of care for early-onset (3-8 years old) BDs, yet effect sizes vary and wane with time suggesting the role of underlying factors accounting for variability in outcomes. The literature on emotion regulation (ER), which has been proposed as one such underlying factor, is reviewed here, including a brief overview of ER, theory and research linking ER, externalizing symptoms, and/or BDs, and still largely preliminary work exploring the role of parent and child ER in BPT outcomes. Research to date provides clues regarding the interrelationship of ER, BDs, and BPT; yet, determining whether adaptations to BPT targeting ER are necessary or useful, for whom such adaptations would be most important, and how those adaptations would be implemented requires addressing mixed findings and methodological limitations. To guide such work, we propose a conceptual model elucidating how standard BPT may impact ER and processes linked to ER, which we believe will be useful in organizing and advancing both basic and applied research in future work.


Avoiding pitfalls in assembling an equipment failure rate database for risk assessments.
As companies move progressively toward quantifying the risks of releases of hazardous materials, there becomes a greater need for developing the data necessary to populate the risk analysis. Sophisticated mathematical models have been developed to predict the consequences of a hazardous material release. But the effort devoted to the frequency side of the "risk equation" has been very disorganized by comparison, with inconsistent or non-existent definitions of "failure", mixing of incompatible data, application of data from one industry to a completely different industry, and a host of other problems. Nonetheless, through judicious assembly and analysis of a variety of data sources, a useful failure rate database can be developed. Many seminal sources of data are described, with an emphasis on loss of containment failure rates. Pitfalls in interpreting failure rate data are also illustrated.


Alcohol Use Disorders in Adolescents.
Alcohol use during adolescence is an important and modifiable health risk behavior given the significant acute consequences and long-term impacts on the developing brain. Alcohol is the most common substance used by young adults 12 to 17 years old, with binge drinking, polysubstance use, and co-occurring mental health disorders posing particular concerns in this age group. Physicians can play a crucial role in screening and responding to alcohol use, with targeted brief interventions designed to delay or decrease use.


Skin involvement in generalized amyloidosis. A study of clinically involved and uninvolved skin in 50 patients with primary and secondary amyloidosis.
A punch or excisional biopsy of the skin was done in 50 patients with generalized amyloidosis: In 46, clinically normal skin, usually the forearm, was biopsied and in four, only cutaneous lesions. Amyloid was seen in the skin of 21 of 38 patients with primary and multiple myeloma-associated amyloidosis. Sixteen of 34 biopsies from clinically uninvolved skin were positive. Five of 12 patients with secondary amyloidosis had amyloid deposits in clinically normal skin. Overall, amyloidosis was definitively diagnosed on skin biopsy examination in 26 patients. A punch biopsy of clinically involved or uninvolved skin is an innocuous, simple procedure with a high diagnostic yield and can be done in an office setting.


Low levels of hemoglobin associate with critical illness and predict disease course in patients with ANCA-associated renal vasculitis.
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a small vessel vasculitis often leading to critical illness by multi-organ failure. Data for patients with specifically ANCA-associated renal vasculitis requiring intensive care unit (ICU) supportive care are limited and have mainly focused on long-term renal and overall outcome. Particularly, data on critical illness during the initial course of disease are scarce and remain poorly determined. Therefore, the purpose of this retrospective study was to identify predictors of critical illness in a cohort of patients with ANCA-associated renal vasculitis. We retrospectively included a total number of 53 cases with confirmed ANCA-associated renal vasculitis between 2015 till 2020 in a single-center cohort study. We here identified an association between low hemoglobin levels and requirement of ICU supportive care in patients with ANCA-associated renal vasculitis. Furthermore, levels of hemoglobin below 9.8 g/dL at admission independently predicted prolonged requirement of ICU supportive care in critically ill patients with ANCA-associated renal vasculitis. These findings confirm that low levels of hemoglobin negatively affect short-term outcome and could further improve our current understanding for the role of anemia in ANCA-associated renal vasculitis.


Patient outcomes measure home health care accomplishments.
Professional, governmental, and economic stakeholders are calling for more explicit accountability for consistent quality from home health-care agencies. A system oriented toward outcomes for the patient rather than toward service design and distribution is more likely to improve the quality of care and satisfy everyone involved.


Combined atresia of one left-sided and one right-sided cardiac valve in a premature newborn.
Described herein is the heart of a 2-day-old newborn, the product of a 25-week gestation, with atresia of two cardiac valves, one on the right side and one on the left side, apparently a previously undescribed entity.


Cellulose microfiber functionalized with N,N'-bis (2-aminoethyl)-1,2-ethanediamine as a solid sorbent for the fast preconcentration of Cd(II) in flow system analysis.
The present paper describes the synthesis of a new chemically modified cellulose microfiber through oxidation with sodium periodate and functionalization with N,N'-bis (2-aminoethyl)-1,2-ethanediamine for the fast and selective preconcentration of Cd(II) ions in flow system analysis. The new sorbent was characterized by FTIR, SEM, and surface area values. The uptake behavior of Cd(II) ions onto this sorbent was evaluated from kinetic data, pseudo-first-order and pseudo-second-order models, as well as from Langmuir, Freundlich and Langmuir-Freundlich adsorption isotherms. The maximum sorption capacity of 4.59 mg g(-1) was estimated by the Langmuir-Freundlich model with fast kinetics for the sorption of Cd(II) described by the pseudo-second-order kinetic model. After characterization, the sorbent was packed in a mini-column, and a fast flow injection preconcentration system for Cd(II) determination by FAAS was developed. The best Cd(II) preconcentration condition, obtained by means of factorial design and response surface methodology, was achieved at pH 9.36 and a flow rate of 10 mL min(-1) followed by elution with 1.0 mol L(-1) nitric acid. By using 78 s preconcentration time, fast and highly sensitive determination of Cd(II) ions could be achieved with a limit of quantification of 0.20 μg L(-1), preconcentration factor of 26, consumption index of 0.5 mL, concentration efficiency of 20 min(-1), and sample throughput of 39 h(-1). The repeatability for 10 replicate determinations was found to be 7.8 and 2.5% for Cd(II) ion concentrations of 5.0 and 100.0 μg L(-1), respectively. The new sorbent efficiency for the interference-free preconcentration of Cd(II) ions was assessed by analysis of tap, mineral and lake waters, as well as synthetic seawater and normal saline waters. Furthermore, complex samples, such as biological samples, could be analysed by the proposed method in accordance with the accuracy attested by analysis of certified reference materials, TORT-2 (lobster hepatopancreas), and DOLT-4 (dogfish liver).


Integrative transcriptome and proteome analyses provide deep insights into the molecular mechanism of salt tolerance in Limonium bicolor.
Integrative transcriptome and proteome analyses revealed many candidate members that may involve in salt secretion from salt glands in Limonium bicolor. Limonium bicolor, a typical recretohalophyte, protects itself from salt damage by excreting excess salt out of its cells through salt glands. Here, to provide an overview of the salt-tolerance mechanism of L. bicolor, we conducted integrative transcriptome and proteome analyses of this species under salt treatment. We identified numerous differentially expressed transcripts and proteins that may be related to the salt-tolerance mechanism of L. bicolor. By measuring the Na+ secretion rate, were found that this cation secretion rate of a single salt gland was significantly increased after high salinity treatment compared with that in control and then reached the maximum in a short time. Interestingly, transcripts and proteins involved in transmembrane transport of ions were differentially expressed in response to high salinity treatment, suggesting a number of genes and proteins they may play important roles in the salt-stress response. Correlation between differentially expressed transcript and protein profiles revealed several transcripts and proteins that may be responsible for salt tolerance, such as cellulose synthases and annexins. Our findings uncovered many candidate transcripts and proteins in response to the salt tolerance of L. bicolor, providing deep insights into the molecular mechanisms of this important process in recretohalophytes.


Aspects of Romanian Early Jurassic palaeobotany and palynology. Part II. A new species of Pachypteris from Cristian.
The Lower Jurassic (Sinemurian) deposits of Cristian (Brasov County, Romania) contain a well-preserved land flora. Pachypteris gradinarui n.sp., a new species of seed fern foliage belonging to the Corystospermales, is described, figured and analysed. The species has a bipinnate, petioled frond; secondary rachises inserted on the upper side of the primary rachis; rounded, occasionally lobed pinnules without marked abaxial thickening or folding. The material is compared with other Pachypteris species, and with Cycadopteris, a related genus characterised by marginal (cuticular) thickening and folding, as it presents transitional characters between the two genera.


Hyperglycaemia and Ischaemia Impair Wound Healing via Toll-like Receptor 4 Pathway Activation in vitro and in an Experimental Murine Model.
Diabetes mellitus has reached epidemic proportions. Foot ulceration is a multifactorial complication of diabetes associated with marked morbidity and mortality. Innate immune Toll-like receptor 4 (TLR4) mediated inflammation has been implicated in the systemic pathogenesis of diabetes and may contribute to impairment of wound healing. This study investigates the effect of high glucose and hypoxic conditions on TLR4 activation and signalling in vitro and in vivo. Fibroblasts cultured at physiological glucose concentration (5.5 mM) were exposed to glucose concentrations from 0 mM to 25 mM, with duplicates placed in a hypoxic chamber. TLR4 inhibition was assessed in the 25 mM glucose groups. Diabetes was induced in wild type (WT) and TLR4 knockout (KO) C57BL/6 mice by intraperitoneal injection of low dose streptozocin (STZ). Hindlimb ischaemia was induced by femoral artery ligation four weeks post streptozocin, and a full thickness 4 mm skin wound inflicted below the knee. Wound healing was assessed via digital planimetry on days 3, 7, and 14 post surgery. Hypoxic and high glucose (25 mM) conditions led to an increase in TLR4 protein expression, apoptosis, and interleukin (IL)-6 release. Inhibition with a TLR4 neutralising antibody and specific TLR4 antagonist ameliorated the effects of high glucose and ischaemia (p < .05). In vivo, wound healing was significantly impaired in the diabetic ischaemic group at day 14 (p < .05). Diabetic ischaemic wounds in TLR4 KO mice exhibited significantly improved healing rates compared with those in WT mice at all time points. Hypoxia stimulates upregulation of TLR4 protein expression and this effect is exaggerated by hyperglycaemia. In TLR4 KO mice, there is a significant improvement in the healing of diabetic ischaemic wounds compared with WT. It is suggested that a synergistic effect between hypoxia and hyperglycaemia impairing wound healing exists, through TLR4 mediated inflammation.


Windrow composting as horticultural waste management strategy - A case study in Ecuador.
In Ecuador, enormous quantities of vegetable wastes are produced annually from the horticultural industries. Composting can be a feasible treatment to stabilise horticultural wastes and, thus, to improve their properties for use as organic fertilisers. In this study, two different piles were prepared, using laying hen manure and sawdust mixed with broccoli or tomato waste, respectively, and composted by the turned windrow composting system. Throughout the composting process, the temperature of the mixtures was monitored and physico-chemical and chemical properties and the degree of maturity were determined. Also, principal component analysis was used to interpret the data set of compost characteristics. In both piles, the temperature exceeded 55°C for more than 2weeks, which ensured maximum pathogen reduction. Organic matter (OM) losses followed a first-order kinetic equation in both piles. The final composts showed a suitable degree of stability and maturity and an absence of phytotoxins, as observed in the evolution and final values of the total organic carbon/total nitrogen ratio (Corg/NT<20), water-soluble organic carbon (Cw<1.7%), germination index (GI>50%) and cation exchange capacity (CEC>67meq (100g OM)(-1)). As well, the evolution of different humification indexes during composting was a good indicator of the OM humification process. The type of vegetable waste used influenced OM and NT mineralisation and the final properties of the composts, showing the mixture with tomato waste a higher fertilising capacity and less environmental problems.


Intravenous regional anaesthesia (Bier block): review of 20 years' experience.
Our experience with intravenous regional anaesthesia (IVRA) in 1,906 patients over a period of 20 years has confirmed that this technique is safe and effective. IVRA may be used to provide anaesthesia for surgery involving both the upper and lower extremities. The need for supplemental medication is ordinarily minimal, so the technique is particularly suitable for short procedures in an ambulatory surgery centre. Yet, prolonged surgery may be performed using a "continuous technique." Although various local anaesthetic agents may be used to induce IVRA no drug has been demonstrated to be superior to lidocaine. The major cause of failure of the technique or serious adverse effects is technical error. A specific protocol for avoiding technical error is presented. Significantly, over a period of 20 years, there has not been any mortality or major morbidity. The incidence of adverse reactions was 1.6 per cent and consisted of minor events such as transient dizziness, tinnitus or mild bradycardia.


Identification of cell-surface glycans that mediate motility-dependent binding and internalization of Pseudomonas aeruginosa by phagocytes.
Phagocytic cells are critical to host defense against Pseudomonas aeruginosa, a Gram-negative bacterium that is an opportunistic pathogen. Accordingly, susceptible individuals frequently have impaired innate immune responses, including those with cystic fibrosis or neutropenia. Previous studies identified that the downregulation, or loss, of bacterial flagellar motility enables bacteria to evade interactions with phagocytic cells that result in phagocytic uptake of the bacteria. However, the mechanistic bases for motility-dependent interactions between P. aeruginosa and host cell surfaces that lead to phagocytic uptake of the bacteria are poorly understood. A recent insight is that exogenous addition of a negatively charged phospholipid, phosphatidylinositol-(3,4,5)-triphosphate (PIP3), promotes the engagement of non-motile strains of P. aeruginosa with phagocytes leading to uptake of the bacteria. Thus, we hypothesized that the engagement of P. aeruginosa by phagocytic cells is mediated by motility-dependent interactions with cell-surface polyanions. Here we report that endogenous polyanionic N-linked glycans and heparan sulfate mediate bacterial binding of P. aeruginosa by human monocytic cells. These specific interactions resulted in P. aeruginosa phagocytosis, bacterial type 3 secretion system (T3SS)-mediated cellular intoxication and the IL-1β response of host innate immune cells. Importantly, the bacterial interactions with the glycans were motility-dependent and could be recapitulated with purified, immobilized glycans. Therefore, this work describes novel interactions of P. aeruginosa with specific phagocyte cell-surface glycans that modulate relevant host innate immune responses to the bacteria, including phagocytosis, inflammation and cytotoxicity.


Chronic Disease Diagnosis as a Teachable Moment for Health Behavior Changes Among Middle-Aged and Older Adults.
To examine the impact of a new chronic disease diagnosis on substance use (i.e., smoking and drinking), utilization of preventive medical procedures, and physical activity among middle-aged and older adults. Individual-level data came from 1996 to 2010 waves of the U.S. Health and Retirement Study. Disease diagnosis was ascertained from self-reports of physician-diagnosed diseases. A case-control difference-in-differences approach estimated in logistic regression was applied to test study hypotheses. After a diagnosis of chronic disease, participants decreased substance use and increased utilization of preventive medical procedures. Physical activity declined after a diagnosis of lung disease, cancer, and stroke. Chronic disease diagnosis may be an important teachable moment that can motivate individuals to adopt multiple risk-reducing health behaviors. Future research needs to elucidate the mechanisms through which disease diagnosis affects behaviors and test the modifying effect of time since diagnosis on intervention effectiveness.


Cutaneous respiration in three freshwater teleosts.
Cutaneous oxygen consumption and oxygen uptake from the external medium were investigated in three species of freshwater teleosts:eel(Anguilla anguilla L.)(silvered stage), trout (Salmo gairdnerii R.) and tench (Tinca tinca L.). The oxygen consumption of the skin is the same in the three species: 4.5 nmol-cm-2-min-1. It accounts for 35% of total Mo2 in the eel; 23% in the tench, which lives in poorly oxygenated water; and 13% in the trout living in highly oxygenated water. Cutaneous oxygen consumption is equal to (Salmo and Tinca) or greater than (Anguilla) cutaneous oxygen uptake from the external medium. Consequently, the skin in these three species is not an oxygen exchange for the benefit of other organs.


6-methylapigenin and hesperidin: new valeriana flavonoids with activity on the CNS.
Valerian is an ancient tranquillizing drug obtained from the underground organs of several Valeriana species. Its active principles were assumed to be terpenoids in the form of valepotriates and/or as components of the essential oil. However, unknown active compounds were not discarded and synergic effects were suspected. We have recently isolated 6-methylapigenin (MA) from Valeriana wallichii and proved that it is a benzodiazepine binding site (BDZ-bs) ligand [Planta Med. 68 (2002) 934]. The present paper is the first report of the presence of 2S(-)-hesperidin in valeriana and describes that it has sedative and sleep-enhancing properties. MA, in turn, was found to have anxiolytic properties and was able to potentiate the sleep-enhancing properties of hesperidin (HN).MA and HN are new members of the growing family of natural flavonoids with activity on the CNS, and their properties suggest that they are promising drug leads in the field.


Palladium-catalyzed synthesis of polysubstituted quinolines from 2-amino aromatic ketones and alkynes.
A palladium-catalyzed one-pot method for the synthesis of quinolines from commercial or readily available 2-amino aromatic ketones and alkynes is reported for the first time. This transformation offers an alternative method for the synthesis of polysubstituted quinoline.


Characteristics, secondary transformation and odor activity evaluation of VOCs emitted from municipal solid waste incineration power plant.
Volatile organic compounds (VOCs) emitted from municipal solid waste incineration power plant (MSWIPP) plays a significant role in the formation of O3 and PM2.5 and odor pollution. Field test was performed on four MSWIPPs in an area of the North China Plain. Nonmethane hydrocarbons (NMHCs) and 102 VOCs were identified and quantified. Ozone formation potential (OFP), secondary organic aerosol formation potential (SOAFP), and odor activity of the detected VOCs were evaluated. Results showed that the average concentration of NMHCs and VOCs were 1648.6 ± 1290.4 μg/m3 and 635.3 ± 588.8 μg/m3, respectively. Aromatics (62.1%), O-VOCs (16.0%), and halo hydrocarbons (10.0%) were the main VOCs groups in the MSWIPP exhaust gas. VOCs emission factor of MSWIPP was 2.43 × 103 ± 2.27 × 103 ng/g-waste. The OFP and SOAFP of MSWIPP were 960.18 ± 2158.17 μg/m3 and 1.57 ± 3.38 μg/m3, respectively. Acrolein as the dominant VOC species was the major odor contributor with a percentage of odor contribution of 65.9%. Benzene and 1,2,4-trimethylbenzene as the dominant VOC species were the main contributors of O3 formation potentials, in which 1,2,4-trimethylbenzene was also the main contributors of SOA formation potential.


Pancreaticoduodenectomy for metastasis of uterine leiomyosarcoma to the pancreas.
Metastasis of uterine leiomyosarcoma to the pancreas is rare. A 46-year-old woman was diagnosed with uterine leiomyosarcoma and underwent surgery. Thereafter, recurrences in the lung and subsequently in the pancreas were diagnosed. These lesions were resected and diagnosed as metastasis of uterine leiomyosarcoma. We report a rare case of uterine leiomyosarcoma with metastasis to the lung and pancreas, both of which were resected using aggressive surgery.


Preferences of young adults on the development of a new digital add-on alcohol intervention for depression treatment: A qualitative study.
To explore the preferences of young adults with regard to the development of a new digital add-on alcohol intervention to complement depression treatment. This qualitative study included young adults (18-35 years) with experience of either problematic alcohol use or depression or both (n = 29). Two rounds of focus groups were conducted, with two focus groups in each round. All focus groups were recorded, transcribed and analysed deductively and inductively on the basis of qualitative content analysis of the intervention type, features and design. Young adults preferred a mobile health application with a clear and simple objective and navigation which was also accessible on a computer. With regard to intervention features, participants indicated a preference for in-depth, gain-framed information on alcohol use and a main feature enabling them to record their alcohol use and mood, which would be rewarded. Other preferences included personal goal-setting and monitoring, an activity list, experience stories, peer contact, guidance from experts by experience or volunteers and receiving notifications from the application. In terms of design, participants preferred short, animated videos and animation figure illustrations to complement written text. Moreover, participants rated the design of the intervention as highly important, yet very personal. Generally, participants preferred a light pastel colour scheme. Once again, participants indicated a need for a clear dashboard using pictograms to reduce the amount of text and fast, easy-to-use navigation. The preferences indicated by young adults with regard to the intervention type, features and design may enhance the development of a new digital add-on alcohol intervention to complement depression treatment.


cDNA cloning, tissue distribution and chromosomal localization of the human ID4 gene.
A cDNA e encoding the human Id4 protein has been isolated from an astrocytoma library. The predicted protein product shares 98% identity with the mouse Id4 protein and is markedly different from that already reported. By FISH analysis, the human ID4 gene was more precisely mapped to chromosome 6p22.3-p23. Northern blot analysis showed that ID4 is mainly expressed in thyroid, brain and fetal tissue and in some nervous system tumor cell lines.


Loss of heterozygosity and immunoexpression of PTEN in oral epithelial dysplasia and squamous cell carcinoma.
Oral epithelial dysplasia (OED) is a risk factor for developing subsequent oral squamous cell carcinoma (OSCC). Loss of heterozygosity (LOH) profiles have been validated as risk predictors of malignant transformation of OED. It is still unclear if Phosphatase and tensin homologue deleted on chromosome 10 (PTEN) allelic loss also occurs in initial stage malignant lesions and if the allelic loss is involved as one of the mechanisms of oral carcinogenesis. Thus, this study objective investigate LOH of PTEN gene and the immunohistochemical expression of the protein in OED and OSCC samples. Formalin-fixed paraffin-embedded samples of 19 OEDs and 16 OSCCs were included to immunohistochemistry and LOH analysis. Two polymorphic microsatellite markers (AFMA086WG9 and D10S1765) located in chromosome 10 were used in this study for LOH analysis. For immunohistochemical analysis, 5 random fields with 400× magnification were evaluated quantitatively and qualitatively in epithelial and neoplastic cells. AFMA086WG9 marker only demonstrated LOH in OEDs cases (10.5%). D10S1765 marker demonstrated LOH in 57.2% of OEDs and 50% of OSCCs. Higher nuclear immunostaining was detected in cases of OSCCs when compared to OEDs (p < .001) and there was strong cytoplasmic immunoexpression in OSCCs (p < .045). We provide evidence that the allelic loss of PTEN is present in premalignant oral lesions and OSCCs, however the LOH of PTEN does not seems to influence its protein expression.


Pathophysiological mechanisms of increased cardiometabolic risk in people with schizophrenia and other severe mental illnesses.
Patients with schizophrenia have increased mortality and morbidity compared with the general population. These patients have a 20-year shorter lifespan than peers without schizophrenia, mainly due to premature cardiovascular disease, suicide, and cancer. Patients with severe mental illness are at increased risk for cardiovascular disease related to increased incidence of diabetes, hypertension, smoking, poor diet, obesity, dyslipidaemia, metabolic syndrome, low physical activity, and side-effects of antipsychotic drugs. Some second-generation antipsychotics (eg, clozapine, olanzapine, quetiapine, and risperidone) are associated with an increased risk of weight gain and obesity, impaired glucose tolerance and new-onset diabetes, hyperlipidaemia, and cardiovascular disease. The mechanisms by which schizophrenia and patients with severe mental illness are susceptible to cardiometabolic disorders are complex and include lifestyle risks and direct and indirect effects of antipsychotic drugs. An understanding of these risks might lead to effective interventions for prevention and treatment of cardiometabolic disorders in schizophrenia and severe mental illness.


Activity-dependent regulation of GABA expression in the visual cortex of adult monkeys.
Levels of the inhibitory transmitter, GABA, and its synthesizing enzyme, GAD, appear to be regulated in the visual cortex of young adult monkeys in an activity-dependent manner. In monkeys subjected to monocular deprivation by eye removal, tetrodotoxin injection, or eyelide suture, the number of GABA and GAD immunoreactive neurons in deprived-eye columns of the cortex is reduced by up to 50%. This effect is unaccompanied by cell death and is reversible. After cessation of TTX injection or reopening of the eyes, the number of immunostained cells returns to normal. The effect appears after 4-5 days of eye removal or tetrodotoxin injection, but only after 7-16 weeks of eyelid suture. In the latter case, it is more severe in the younger monkeys. The reversible reduction in GABA and GAD immunostaining extends out of layer IVC into lay IVA and to neurons around but not in cytochrome oxidase periodicities of layer III. This may indicate selective vulnerability of GABA cells sensitive to high spatial frequency.


Contribution of protein Gar1 to the RNA-guided and RNA-independent rRNA:Ψ-synthase activities of the archaeal Cbf5 protein.
Archaeal RNA:pseudouridine-synthase (PUS) Cbf5 in complex with proteins L7Ae, Nop10 and Gar1, and guide box H/ACA sRNAs forms ribonucleoprotein (RNP) catalysts that insure the conversion of uridines into pseudouridines (Ψs) in ribosomal RNAs (rRNAs). Nonetheless, in the absence of guide RNA, Cbf5 catalyzes the in vitro formation of Ψ2603 in Pyrococcus abyssi 23S rRNA and of Ψ55 in tRNAs. Using gene-disrupted strains of the hyperthermophilic archaeon Thermococcus kodakarensis, we studied the in vivo contribution of proteins Nop10 and Gar1 to the dual RNA guide-dependent and RNA-independent activities of Cbf5 on 23S rRNA. The single-null mutants of the cbf5, nop10, and gar1 genes are viable, but display a thermosensitive slow growth phenotype. We also generated a single-null mutant of the gene encoding Pus10, which has redundant activity with Cbf5 for in vitro formation of Ψ55 in tRNA. Analysis of the presence of Ψs within the rRNA peptidyl transferase center (PTC) of the mutants demonstrated that Cbf5 but not Pus10 is required for rRNA modification. Our data reveal that, in contrast to Nop10, Gar1 is crucial for in vivo and in vitro RNA guide-independent formation of Ψ2607 (Ψ2603 in P. abyssi) by Cbf5. Furthermore, our data indicate that pseudouridylation at orphan position 2589 (2585 in P. abyssi), for which no PUS or guide sRNA has been identified so far, relies on RNA- and Gar1-dependent activity of Cbf5.


Cytotoxicity assessment of functionalized CdSe, CdTe and InP quantum dots in two human cancer cell models.
The toxicity of quantum dots (QDs) has been extensively studied over the past decade. Some common factors that originate the QD toxicity include releasing of heavy metal ions from degraded QDs and the generation of reactive oxygen species on the QD surface. In addition to these factors, we should also carefully examine other potential QD toxicity causes that will play crucial roles in impacting the overall biological system. In this contribution, we have performed cytotoxicity assessment of four types of QD formulations in two different human cancer cell models. The four types of QD formulations, namely, mercaptopropionic acid modified CdSe/CdS/ZnS QDs (CdSe-MPA), PEGylated phospholipid encapsulated CdSe/CdS/ZnS QDs (CdSe-Phos), PEGylated phospholipid encapsulated InP/ZnS QDs (InP-Phos) and Pluronic F127 encapsulated CdTe/ZnS QDs (CdTe-F127), are representatives for the commonly used QD formulations in biomedical applications. Both the core materials and the surface modifications have been taken into consideration as the key factors for the cytotoxicity assessment. Through side-by-side comparison and careful evaluations, we have found that the toxicity of QDs does not solely depend on a single factor in initiating the toxicity in biological system but rather it depends on a combination of elements from the particle formulations. More importantly, our toxicity assessment shows different cytotoxicity trend for all the prepared formulations tested on gastric adenocarcinoma (BGC-823) and neuroblastoma (SH-SY5Y) cell lines. We have further proposed that the cellular uptake of these nanocrystals plays an important role in determining the final faith of the toxicity impact of the formulation. The result here suggests that the toxicity of QDs is rather complex and it cannot be generalized under a few assumptions reported previously. We suggest that one have to evaluate the QD toxicity on a case to case basis and this indicates that standard procedures and comprehensive protocols are urgently needed to be developed and employed for fully assessing and understanding the origins of the toxicity arising from different QD formulations.


Digitally designed surgical guides for placing implants in the nasal floor of dentate patients: a series of three cases.
Insight into the bone volume and position of natural teeth is essential when placing implants to retain nasal prostheses. This paper describes a series of three cases in which a new method was applied for implant placement in the nasal floor of dentate patients using digital planning techniques. With the aid of computer software, digital planning of implants in the nasal floor based on cone beam computed tomography was performed. Next, surgical guides for implant placement were digitally designed and fabricated using rapid prototyping. In all three patients, implants could be placed and nasal prostheses could be manufactured as planned. All anterior teeth remained vital. Analysis of planning and post-implant placement cone beam computed tomography scans revealed high accuracy of implant placement. The applied method allows for reliable implant placement in close proximity to the preoperatively planned implant position.


Iron Trichloride-Mediated Cascade Reaction of Aminosugar Derivatives for the Synthesis of Fused Tetrahydroisoquinoline-Tetrahydrofuran Systems.
A method to obtain tetrahydroisoquinolines (THIQs) fused to tetrahydrofuran rings from aminosugar derivatives has been developed. The procedure relies on a key deprotection of benzyl ethers followed by a double-cyclization sequence, using FeCl3 as the sole reagent. This tandem reaction affords the construction of novel fused polycyclic heterocycles with total stereochemical control.


Managing expectations: assessment of chemistry databases generated by automated extraction of chemical structures from patents.
First public disclosure of new chemical entities often takes place in patents, which makes them an important source of information. However, with an ever increasing number of patent applications, manual processing and curation on such a large scale becomes even more challenging. An alternative approach better suited for this large corpus of documents is the automated extraction of chemical structures. A number of patent chemistry databases generated by using the latter approach are now available but little is known that can help to manage expectations when using them. This study aims to address this by comparing two such freely available sources, SureChEMBL and IBM SIIP (IBM Strategic Intellectual Property Insight Platform), with manually curated commercial databases. When looking at the percentage of chemical structures successfully extracted from a set of patents, using SciFinder as our reference, 59 and 51 % were also found in our comparison in SureChEMBL and IBM SIIP, respectively. When performing this comparison with compounds as starting point, i.e. establishing if for a list of compounds the databases provide the links between chemical structures and patents they appear in, we obtained similar results. SureChEMBL and IBM SIIP found 62 and 59 %, respectively, of the compound-patent pairs obtained from Reaxys. In our comparison of automatically generated vs. manually curated patent chemistry databases, the former successfully provided approximately 60 % of links between chemical structure and patents. It needs to be stressed that only a very limited number of patents and compound-patent pairs were used for our comparison. Nevertheless, our results will hopefully help to manage expectations of users of patent chemistry databases of this type and provide a useful framework for more studies like ours as well as guide future developments of the workflows used for the automated extraction of chemical structures from patents. The challenges we have encountered whilst performing this study highlight that more needs to be done to make such assessments easier. Above all, more adequate, preferably open access to relevant 'gold standards' is required.


Survival to intensive care unit discharge among in-hospital cardiac arrest patients by applying audiovisual feedback device.
Survival rates after in-hospital cardiac arrest remain very low. Although there is evidence that the use of audiovisual feedback devices can improve compression components, there are no data on patient survival. Therefore, we conducted this study to analyse the survival rate of patients with in-hospital cardiac arrest after discharge from the intensive care unit. This study was a secondary analysis of a prospective, randomized, controlled, parallel study of patients who received either standard manual chest compression or a real-time feedback device. Parametric and semi-parametric models were fitted to the data. Different survival time of length of stay was investigated by univariate and multiple analyses. Pearson's correlation between length of stay and hospital length of stay was obtained. A total of 900 patients with a mean survival time of 35 days were included. Intervention was associated with a higher length of stay. Relative time was significant in adjusted fitted log-normal regression for intervention group, female gender, and cardiopulmonary resuscitation in the night shift. A positive correlation between length of stay and hospital length of stay was found. Implementation of feedback device improved survival and length of stay. Cardiopulmonary resuscitation performance during the night shift decreased the survival time, which could be due to the inexperienced staff available outside working hours.


Robotically Assisted Unicompartmental Knee Arthroplasty with a Handheld Image-Free Sculpting Tool.
Although unicompartmental knee arthroplasty may pose a lower risk of perioperative complications and achieve better functional outcomes than total knee arthroplasty, a high degree of accuracy of implant positioning and soft tissue balance are required to optimize durability and implant survivorship. First-generation robotic technology improved implant position compared with conventional methods. This article reviews the next-generation robotic technology, an image-free handheld robotic sculpting tool, which offers an alternative method for optimizing implant positioning and soft tissue balance without the need for preoperative computed tomography scans and with price points that make it suitable for use in outpatient surgery centers.


Localization of neurotensin-immunoreactivity in the spinal cord and peripheral nervous system of the guinea pig.
The mapping of the regional distribution of neurotensin-immunoreactive (NT-IR) fibers and neurons is presented for cervical, thoracic, lumbal and sacral segments of the guinea pig spinal cord. The occurrence of NT-IR fibers in para- and prevertebral ganglia and intramural plexus of viscera is described. It is suggested that NT-IR fibers originating from neurons in the substantia intermedia of the spinal cord are connected with peripheral ganglia.


Reverse remodeling in diabetic cardiomyopathy: the role of extracellular matrix.
Diabetic patients are prone to suffer from cardiovascular disease, specifically from ischemic heart disease and diabetic cardiomyopathy, which have a huge impact on morbidity and mortality worldwide. Cardiac fibrosis due to alteration of the extracellular matrix (ECM) remodeling is often observed in diabetes and myocardial fibrosis is an important part of cardiac remodeling that leads to heart failure and death. At single-cell level, the ECM govern, metabolism, motility, orientation, and proliferation. However, in pathological condition such as diabetes, changes in ECM lead to fibrosis and subsequently cardiac stiffness and cardiomyocytes dysfunction. Antidiabetic drugs, particularly sodium-glucose cotransporter-2 (SGLT2) inhibitors have antifibrotic effects and may promote ECM reverse remodeling. In this review, the mechanisms, and the role of ECM remodeling and reverse remodeling as a potential therapeutic target for diabetic cardiomyopathy are discussed.


Meta-analysis of microRNA expression profiling studies in human cervical cancer.
Cervical cancer is one of the most common malignant tumors in women, and numerous studies have associated the disease with changes in microRNA (miRNA) expression. This meta-analysis aimed to consolidate and assess the results of these studies in order to identify potential miRNA biomarkers of cervical cancer. We systematically searched the literature for studies comparing miRNA expression between cervical cancer tissues and normal cervical tissues, and we meta-analyzed the result of 27 studies comprising 1,132 cancer samples and 943 normal samples. We used a vote-counting strategy that took into account total sample and mean fold-change, in order to comprehensively assess associations between certain miRNAs and cervical cancer occurrence and progression. The studies described 195 miRNAs that were significantly up-regulated and 96 microRNAs that were down-regulated in cervical cancer tissues (stage I-IV) relative to normal cervical tissues. Vote-counting analysis showed that up-regulation was most consistently reported for miR-20a and miR-21 (four studies), followed by miR-10a, miR-15b, miR-20b, miR-141, miR-200a, and miR-224 (three studies). Down-regulation was reported most consistently for miR-143 (seven studies), followed by miR-203 and miR-145 (six studies). Fourteen miRNA, respectively, showed a significantly correlated lymphatic node metastasis in eight studies. This meta-analysis has identified several miRNAs whose expression correlates reliably with cervical cancer. These should be probed in further studies to explore their potential as diagnostic biomarkers.


Factors Associated with HIV Testing Among People Who Inject Drugs: Findings from a Multistate Study at the Start of the COVID-19 Pandemic.
Few studies have examined HIV testing among people who inject drugs (PWID) during the COVID-19 pandemic. This study examines factors associated with PWID who have been recently (past six months) tested for HIV during the COVID-19 pandemic. PWID were recruited between August 2020 and January 2021 from 22 drug treatment and harm reduction programs in nine states and the District of Columbia. We used logistic regression to identify correlates of recent HIV testing among PWID (n = 289). Most (52.9%) PWID reported having been recently tested for HIV. Factors associated with recent HIV testing included: having attended college [adjusted odds ratio (aOR) 2.32, 95% confidence interval (95% CI) 1.32-4.10], weekly hunger (aOR 2.08, 95% CI 1.20-3.60), crystal methamphetamine injection (aOR 2.04, 95% CI 1.05-3.97), and non-metropolitan residence (aOR 0.33, 95% CI 0.13, 0.88). Findings suggest HIV testing initiatives should be expanded during times of crisis, such as global pandemics.


Contact system and intrinsic pathway activation in patients with advanced pancreatic cancer: a prospective cohort study.
Despite high risk of venous thromboembolism (VTE) in patients with pancreatic cancer, there are little data on contact system activation in these patients. To quantify contact system and intrinsic pathway activation and subsequent VTE risk in patients with pancreatic cancer. Patients with advanced pancreatic cancer were compared with controls. Blood was drawn at baseline and patients were followed for 6 months. Complexes of proteases with their natural inhibitors, C1-esterase inhibitor (C1-INH), antithrombin (AT), or alpha-1 antitrypsin (α1at), were measured for complexes containing kallikrein (PKa:C1-INH), factor (F)XIIa (FXIIa:C1-INH), and FXIa (FXIa:C1-INH, FXIa:AT, FXIa:α1at). The association of cancer with complex levels was assessed in a linear regression model, adjusted for age, sex, and body mass index. In a competing risk regression model, we assessed associations between complex levels and VTE. One hundred nine patients with pancreatic cancer and 22 controls were included. The mean age was 66 years (SD, 8.4) in the cancer cohort and 52 years (SD, 10.1) in controls. In the cancer cohort, 18 (16.7%) patients developed VTE during follow-up. In the multivariable regression model, pancreatic cancer was associated with increased complexes of PKa:C1-INH (P < .001), FXIa:C1-INH (P < .001), and FXIa:AT (P < .001). High FXIa:α1at (subdistribution hazard ratio, 1.48 per log increase; 95% CI, 1.02-2.16) and FXIa:AT (subdistribution hazard ratio, 2.78 highest vs lower quartiles; 95% CI, 1.10-7.00) were associated with VTE. Complexes of proteases with their natural inhibitors were elevated in patients with cancer. These data suggest that the contact system and intrinsic pathway activation are increased in patients with pancreatic cancer.


Statins: potent vascular anti-inflammatory agents.
Atherosclerosis is a multifactorial condition that can result in cardiovascular disease. Statin therapy is thought to mediate cardioprotective effects that influence endothelial function, inflammatory responses, plaque stability and thrombus formation, processes involved in atherosclerosis. Although reduction in low-density lipoprotein cholesterol (LDL-C) potentially plays a role in all of these effects, several lines of evidence also implicate nonlipidmediated 'pleiotropic' effects. For example, statin therapy confers a lower risk for coronary heart disease than placebo in patients with comparable serum cholesterol levels, and confers a greater magnitude of clinical benefit than expected based on LDL-C levels alone. Moreover, while nonstatin lipid-lowering therapy does not necessarily reduce stroke risk, statins have shown a significant reduction in stroke. Statins exert their pleiotropic effects, in part, by improving endothelial function via up-regulation of endothelial nitric oxide synthase enzyme activity. Markers of inflammation such as high sensitivity C-reactive protein have been also shown to add further prognostic information about patients at risk of cardiovascular disease who may benefit from statin therapy. Further studies are still needed to determine whether statins have direct effects on inflammatory pathways.


Implementing Health Care Technology Research into Practice to Improve Adult Asthma Management.
Use of health technology has shown potential to improve asthma adherence and outcomes. Few studies have looked at the implementation of such research within larger asthma populations. This report examines the process of translating results from a pragmatic trial using speech recognition (SR) in children with persistent asthma into the standard operating procedure within a large health maintenance organization. Medication adherence and outcomes in adults with asthma were examined. The SR protocol was implemented for the total Kaiser Permanente Colorado (KPCO) patient population of 480,142, of whom 36,356 had asthma. Patients had persistent asthma, filled 1 or more inhaled corticosteroid prescriptions in the prior 6 months, and remained continuously enrolled with KPCO for 2 years. Documented exacerbations included the presence of a hospitalization, emergency department visit, or course of oral corticosteroid where asthma was the principal diagnosis. Adherence and exacerbation events were compared 1 year before and 1 year after intervention for 4,510 adults aged 19 to 64. Patient adherence demonstrated a small but significant improvement from 39.5% to 41.7% (P < .0001). Although not significant, data trends suggested greater improvement for patients with lower socioeconomic status. When an outlier month was removed from both the pre- and postintervention time periods, courses of oral corticosteroids decreased. Emergency department visits and hospitalizations were infrequent in both time periods and did not decrease over time. A low-cost SR intervention reminding patients to fill and take their daily controller asthma medication can improve treatment adherence and decrease the need for oral corticosteroids due to asthma exacerbations, but not decrease emergency department visits or hospitalizations.


13q31.1 microdeletion: A prenatal case report with macrocephaly and macroglossia.
We report on a female fetus with macrocephaly and macroglossia harbouring 13q31.1 microdeletion encompassing three genes: SPRY2, NDFIP2 and RBM26. NDFIP2 protein is involved in ubiquitination and in Ras/mitogen-activated protein kinase (MAPK) signaling pathways. SPRY2 protein is part of Sprout protein family and inhibits the Ras/MAPK pathways. Ras/MAPK pathway plays important role in complex cellular programs including cell differentiation and proliferation. Germline mutations in genes encoding protein involved in the MAPK cascade is responsible for a wide family of developmental disorders known as RASopathies. Some RASopathies, such as Costello syndrome, present a phenotype with (relative) macrocephaly as perinatal features. However, prenatal-onset macroglossia are generally absent in this syndrome but rather suggestive of the Beckwith-Wiedemann syndrome for which molecular testing were negative. Phenotype-genotype correlation with patients from DECIPHER defines NDFIP2 and SPRY2 as a possible candidate genes for a RASopathy potentially responsible for the clinical features in the fetus. Finally, this original case of 13q31.1 microdeletion underlines the importance of array-CGH in prenatal diagnosis with sonographic signs such as macroglossia and/or macrocephaly. In this case, genetic investigation should be not limited to the search of well-known genetic causes and other genomic microdeletions should be considered as alternative diagnoses for macroglossia.


Adaptation of the Coping With Stress Course for Black Adolescents in Low-Income Communities: Examples of Surface Structure and Deep Structure Cultural Adaptations.
Black adolescents in low-income communities are at increased risk of developing mental health problems due to the impact of cumulative poverty-related stressors and racial discrimination, yet Black youth have relatively low rates of mental health service utilization, resulting in significant unmet need. The Coping With Stress (CWS) Course is an evidence-based, cognitive behavioral intervention that has been shown to reduce the incidence of anxiety, mood, and conduct problems among predominantly White samples, as well as Asian and Latinx youth. In the past 25 years since the CWS Course was introduced, Black adolescents have either been severely underrepresented or conspicuously absent from program evaluation research on the CWS Course, with few exceptions. The purpose of this article is threefold: (1) to justify the need for cultural adaptations to the CWS Course for Black adolescents from low-income communities, (2) to describe the scientific basis for the specific surface structure and deep structure modifications made to the culturally adapted version of the CWS Course, known as Resilient In spite of Stressful Events or RISE, and (3) to illustrate the deep structure adaptations with a vignette drawn from implementation of the RISE program with Black adolescents in a low-income, urban community.


Simple and robust fabrication and characterization of conductive carbonized nanofibers loaded with gold nanoparticles for bone tissue engineering applications.
Bone tissue engineering is a new and applicable emerging approach to repair bone defects. Electrical conductive scaffolds through a physiologically relevant physical signaling, i.e., electrical stimulation, are highly promising candidates for tissue engineering applications. In this paper, we fabricated carbon nanofiber/gold nanoparticle (CNF/AuNP) conductive scaffolds using two distinct methods. These methods are blending electrospinning in which AuNPs were blended with electrospinning solution, and electrospinning/electrospraying in which AuNPs were electrosprayed simultaneously with electrospinning. The obtained electrospun mats underwent a stabilization/carbonization process. The scaffolds were characterized by SEM, XRD, FT-IR, and Raman spectroscopy. SEM characterizations showed improved morphology and a slight decrease in the diameter of the electrospinned and electrosprayed nanofibers (from 178.66 ± 38.40 nm to 157.94 ± 24.14 nm and 120.81 ± 13.77 nm, respectively). Raman spectroscopy showed improvement in the graphitization. Electrical conductivity improved by up to 29.2% and 81% in electrospraying and blending electrospinning modes, respectively. Indirect MTT and LDH toxicity assays directly were performed to assess MG63 cell toxicity, but no significant toxicity was observed, and the scaffolds did not adversely affect cell proliferation. It can be concluded these scaffolds have the potential for bone tissue engineering applications.


Intra-epidermal neutrophilic IgA dermatosis with colitis.
We report the association of an intra-epidermal blistering disease of the skin with colitis. Both the skin and large bowel epithelium were infiltrated by neutrophils and eosinophils, and showed intra-epithelial deposition of IgA in an intercellular pattern. The colitis and the blisters responded well to treatment with dapsone.


Transportation, germs, culture: a dynamic graph model of COVID-19 outbreak.
Various models have been applied to predict the trend of the epidemic since the outbreak of COVID-19. In this study, we designed a dynamic graph model, not for precisely predicting the number of infected cases, but for a glance of the dynamics under a public epidemic emergency situation and of different contributing factors. We demonstrated the impact of asymptomatic transmission in this outbreak and showed the effectiveness of city lockdown to halt virus spread within a city. We further illustrated that sudden emergence of a large number of cases could overwhelm the city medical system, and external medical aids are critical to not only containing the further spread of the virus but also reducing fatality. Our model simulation showed that highly populated modern cities are particularly vulnerable and lessons learned in China could facilitate other countries to plan the proactive and decisive actions. We shall pay close attention to the asymptomatic transmission being suggested by rapidly accumulating evidence as dramatic changes in quarantine protocol are required to contain SARS-CoV-2 from spreading globally. The supplementary materials can be found online with this article at 10.1007/s40484-020-0215-4.


Maintaining homeostasis by controlled alternatives for energy distribution in plant cells under changing conditions of supply and demand.
Plants depend on light energy for the generation of ATP and reductant as well as on supply of nutrients (inorganic C, N, and S compounds) to successfully produce biomass. Any excess of reducing power or lack of electron acceptors can lead to the formation of reactive oxygen species (ROS). Multiple systems are operating to avoid imbalances and subsequent oxidative stress by efficiently scavenging any formed ROS. Plants can sense an upcoming imbalance and correspondingly adapt to changed conditions not only by an increase of ROS scavengers, but also by using excess incoming light energy productively for assimilatory processes in actively metabolizing cells of growing leaves. CO2 assimilation in chloroplasts is controlled by various redox-regulated enzymes; their activation state is strictly linked to metabolism due to the effects of small molecules on their actual activation state. Shuttle systems for indirect transfer of reducing equivalents and ATP specifically distribute the energy fluxes between compartments for optimal biomass production. Integration of metabolic and redox signals involves the cytosolic enzyme glyceraldehyde-3-P dehydrogenase (GapC) and some of its many moonlighting functions. Its redox- and metabolite-dependent interactions with the mitochondrial outer membrane, the cytoskeleton, and its occurrence in the nucleus are examples of these additional functions. Induction of the genes required to achieve an optimal response suitable for the respective conditions allows for growth when plants are exposed to different light intensities and nutrient conditions with varying rates of energy input and different assimilatory pathways for its consumption are the required in the long term. A plant-specific respiratory pathway, the alternative oxidase (AOX), functions as a site to convert excess electrons into heat. For acclimation, any imbalance is sensed and elicits signal transduction to induce the required genes. Examples for regulated steps in this sequence of events are given in this review. Continuous adjustment under natural conditions allows for adaptive responses. In contrast, sudden light stress, as employed when analyzing stress responses in lab experiments, frequently results in cell destruction. Knowledge of all the flexible regulatory mechanisms, their responsiveness, and their interdependencies is needed when plant growth is to be engineered to optimize biomass and production of any desired molecules.


Serum PAI-1 is a novel predictor for response to pegylated interferon-α-2b plus ribavirin therapy in chronic hepatitis C virus infection.
Obesity and insulin resistance have been reported as negative predictors for sustained virological response (SVR) in hepatitis C virus (HCV) genotype 1 infected patients treated with pegylated interferon-α plus ribavirin. They are also known to affect serum levels of several cytokines including adipocytokines. But the association between these cytokines and treatment outcome has not been fully elucidated. We examined pretreatment serum levels of 14 cytokines among 190 patients who were treated with pegylated interferon-α-2b plus ribavirin for chronic HCV-1b infection with high viral load (≥ 5 log IU/mL) and analyzed their contribution to treatment response. Plasminogen activator inhibitor-1 (PAI-1), vascular endothelial growth factor, and 11 clinical factors showed significant association with SVR in univariate logistic regression analysis. Four significant factors in multivariate analysis; serum PAI-1 (odds ratio [OR] = 15.42), body mass index (OR = 4.56), rs8099917 (OR = 4.95) and fibrosis stage (OR = 5.18) were identified as independent predictors. We constructed a simple and minimally invasive prediction score for SVR based on the presence of these factors except for fibrosis stage. The accuracy of this score was 73%, and was confirmed using an independent validation cohort consisting of 31 patients (68%). The strongest correlation was between PAI-1 level and platelet count (r = 0.38, P = 1.8 × 10(-7)), and PAI-1 level was inversely correlated with fibrosis stage. Serum PAI-1 is a novel predictor for the response to combination therapy against chronic HCV-1b infection and may be associated with liver fibrosis.


The American Board of Emergency Medicine Maintenance of Certification Summit.
The American Board of Emergency Medicine (ABEM) convened a summit of stakeholders in Emergency Medicine (EM) to critically review the ABEM Maintenance of Certification (MOC) Program. The newly introduced American Board of Medical Specialties (ABMS) 2015 MOC Standards require that the ABMS Member Boards, including ABEM, "engage in continual quality monitoring and improvement of its Program for MOC …" ABEM sought to have the EM community participate in the quality improvement process. A review of the ABMS philosophy of MOC and requirements for MOC were presented, followed by an exposition of the ABEM MOC Program. Roundtable discussions included strengths of the program and opportunities for improvement; defining, teaching, and assessing professionalism; identifying and filling competency gaps; and enhancing relevancy and adding value to the ABEM MOC Program. Several suggestions to improve the ABEM MOC Program were discussed. ABEM will consider these recommendations when developing its next revision of the ABEM MOC Program.


Validation of a brief version of the Difficulties in Emotion Regulation Scale (DERS-16) with an older Norwegian population.
Emotion regulation is proposed to have a salient role in optimal aging. However, currently used measures of emotion regulation have not been validated for older adults. Therefore, we evaluated the psychometric properties of the Difficulties in Emotion Regulation Scale-short form (DERS-16) in a large Norwegian sample consisting of individuals between 70 and 95 years (n = 2525). Tests of internal consistency, reliability, assessment of intra-domain correlations, and confirmatory factor analyses were performed. Construct validity was further investigated by assessing concurrent associations between DERS-16 and well-established measures of psychological disorders, psychological health, and well-being (five-item version of Geriatric Depression Scale, Geriatric Anxiety Inventory-short form, and OECD guidelines on measuring subjective well-being). All subscales derived from the instrument showed adequate internal consistency. Furthermore, we obtained a theoretically consistent factor structure, in which a bifactor model combining a general emotion regulation factor and five additional domain-specific facet-factors had superior model fit. As expected, difficulties in emotion regulation correlated positively with symptoms of depression and anxiety, and negatively with psychological health and well-being. Associations were generally of moderate strength. We can thus conclude that the DERS-16 demonstrates excellent psychometric properties when used in samples with older adults and may safely be employed in studies of emotion regulation difficulties in the older segment of our population.


Correction of a Class III malocclusion with over 20 mm of space to close in the maxilla by using miniscrews for extra anchorage.
Unilateral closure of maxillary extraction spaces in patients with Class III malocclusion can be challenging. This case report describes the closure of first premolar and first molar extraction spaces in a patient with a Class III dental relationship. Two miniscrews were used for intraoral skeletal anchorage. The Class III dental relationship was corrected; a positive vertical overbite was achieved; occlusion of the canines, premolars, and molars was improved; and the extraction spaces were closed.


One-Year Clinical and Computed Tomography Angiographic Outcomes After Bioresorbable Vascular Scaffold Implantation During Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction: The PRAGUE-19 Study.
Bioresorbable vascular scaffolds (BVS) represent promising new technology, but data on their long-term outcomes in ST-segment-elevation myocardial infarction (STEMI) setting are missing. The aim was to analyze 1-year clinical and computed tomographic angiographic outcomes after BVS implantation in STEMI. PRAGUE-19 is a prospective multicenter single-arm study enrolling consecutive STEMI patients undergoing primary percutaneous coronary intervention (pPCI) with intention-to-implant BVS. A total of 343 STEMI patients were screened during 15 months enrollment period, and 70 patients (mean age 58.6±10.3 and 74% males) fulfilled entry criteria and BVS was successfully implanted in 96% of them. All patients were invited for clinical and computed tomographic angiographic control 1 year after BVS implantation. Restenosis was defined as ≥75% area stenosis within the scaffolded segment. Three events were potentially related to BVS: 1 in-stent restenosis (treated 7 months after pPCI with drug-eluting balloon), 1 stent thrombosis (treated 2 weeks after pPCI by balloon dilatation-this patient stopped all medications after pPCI), and 1 sudden death at home 9 months after pPCI. Four other patients had events definitely unrelated to BVS. Overall, 1-year mortality was 2.9%. Computed tomographic angiography after 1 year was performed in 59 patients. All BVS were widely patent, and binary restenosis rate was 2% (the only restenosis mentioned above). Mean in-scaffold minimal luminal area was 7.8±2.6 mm(2), area stenosis was 20.1±16.3%, minimal luminal diameter was 3.0±0.6 mm, and diameter stenosis was 12.8±11.1%. BVS implantation in STEMI is feasible and safe and offers excellent 1-year clinical and angiographic outcomes.


Predictors of support to legalize a state lottery in Alabama counties.
In Alabama support for a lottery to fund education was correlated with indices of low income.


Dioxathion (Delnav) residues in milk in Kenya.
Dioxathion residues in milk (expressed as the sum of the cis and trans isomers) have been determined by gas liquid chromatography using the N-P thermionic detector. It was found that dioxathion residues of 0.06 to 2.29 ppm (fat basis) are present in milk and are associated with tick control procedures of spraying cows with 0.05% w/v dioxathion (Delnav) twice weekly. Average concentrations from bulked milk were 0.96 ppm after 10 hours, 0.54 ppm after 34 hours and 0.4 ppm after 58 hours following spraying. The levels of residues in the milk differed greatly in different animals.


TCM tongue diagnosis index of early-stage breast cancer.
This paper investigates discriminating tongue features to distinguish between early stage breast cancer (BC) patients and non-breast cancer individuals through non-invasive traditional Chinese medicine (TCM) tongue diagnosis. The tongue features for 67 patients with 0 and 1 stages of BC, and 70 non-breast cancer individuals are extracted by the automatic tongue diagnosis system (ATDS). A total of nine tongue features, namely, tongue color, tongue quality, tongue fissure, tongue fur, red dot, ecchymosis, tooth mark, saliva, and tongue shape are identified for each tongue. Features extracted are further sub-divided according to the areas located, i.e., spleen-stomach, liver-gall-left, liver-gall-right, kidney, and heart-lung areas. This study focuses on deriving significant tongue features (p<0.05) to discriminate early-stage BC patients from non-breast cancer individuals. The Mann-Whitney test shows that the amount of tongue fur (p=0.024), maximum covering area of tongue fur (p=0.009), thin tongue fur (p=0.009), the average area of red dot (p=0.049), the maximum area of red dot (p=0.009), red dot in the spleen-stomach area (p=0.000), and red dot in the heart-lung area (p=0.000) demonstrate significant differences. The data collected are further classified into two groups. The training group consists of 57 early-stage BC patients and 60 non-breast cancer individuals, while the testing group is composed of 10 early-stage BC patients and 10 non-breast cancer individuals. The logistic regression by utilizing these 7 tongue features with significant differences in Mann-Whitney test as factors is performed. In order to reduce the number of tongue features employed in prediction, tongue features with the least amount of significant difference, namely, maximum area of red dot and average area of red dot, are removed progressively. The tongue features of the testing group are employed in the aforementioned three models to test the power of significant tongue features identified in predicting early-stage BC. An accuracy of 80%, 80% and 90% is reached on non-breast cancer individuals by applying the 7, 6 and 5 significant tongue features obtained through Mann-Whitney test, respectively, while 60%, 60% and 50% is reached on the corresponding early-stage BC patients. The TCM tongue diagnosis can serve as a preliminary screening procedure in the early detection of BC in light of its simple and non-invasive nature, followed by other more accurate testing process. To the best of our knowledge, this is the first attempt in applying non-invasive TCM tongue diagnosis to the discrimination of early-stage BC patients and non-breast cancer individuals.


Sulfate-doped Fe3O4/Al2O3 nanoparticles as a novel adsorbent for fluoride removal from drinking water.
A novel adsorbent of sulfate-doped Fe3O4/Al2O3 nanoparticles with magnetic separability was developed for fluoride removal from drinking water. The nanosized adsorbent was characterized and its performance in fluoride removal was evaluated. Kinetic data reveal that the fluoride adsorption was rapid in the beginning followed by a slower adsorption process, nearly 90% adsorption can be achieved within 20 min and only 10-15% additional removal occurred in the following 8 h. The fluoride adsorption isotherm was well described by Elovich model. The calculated adsorption capacity of this nanoadsorbent for fluoride by two-site Langmuir model was 70.4 mg/g at pH 7.0. Moreover, this nanoadsorbent performed well over a considerable wide pH range of 4-10, and the fluoride removal efficiencies reached up to 90% and 70% throughout the pH range of 4-10 with initial fluoride concentrations of 10 mg/L and 50 mg/L, respectively. The observed sulfate-fluoride displacement and decreased sulfur content on the adsorbent surface reveal that anion exchange process was an important mechanism for fluoride adsorption by the sulfate-doped Fe3O4/Al2O3 nanoparticles. Moreover, a shift of the pH of zero point charge (pHPZC) of the nanoparticles and surface analysis based on X-ray photoelectron spectroscopy (XPS) suggest the formation of inner-sphere fluoride complex at the aluminum center as another adsorption mechanism. With the exception of PO4(3-), other co-existing anions (NO3(-), Cl(-) and SO4(2-)) did not evidently inhibit fluoride removal by the nanoparticles. Findings of this study demonstrate the potential utility of the nanoparticles as an effective adsorbent for fluoride removal from drinking water.


The bronchodilator response in preschool children: A systematic review.
The bronchodilator response (BDR) is frequently used to support diagnostic and therapeutic decision-making for children who wheeze. However, there is little evidence-based guidance describing the role of BDR testing in preschool children and it is unclear whether published cut-off values, which are derived from adult data, can be applied to this population. We searched MEDLINE, EMBASE, Web of Science, and Cochrane databases (inception-September 2015) for studies reporting response to a bronchodilator in healthy preschool children, response following placebo inhalation, and the diagnostic efficacy of BDR compared with a clinical diagnosis of asthma/recurrent wheezing. We included 14 studies. Thirteen studies provided BDR data from healthy preschool children. Two studies reported response to placebo in preschool children with asthma/recurrent wheezing. Twelve studies compared BDR measurements from preschool children with asthma/recurrent wheeze to those from healthy children and seven of these studies reported diagnostic efficacy. Significant differences between the BDR measured in healthy preschool children compared with that in children with asthma/recurrent wheeze were demonstrated in some, but not all studies. Techniques such as interrupter resistance, oscillometry, and plethysmography were more consistently successfully completed than spirometry. Between study heterogeneity precluded determination of an optimum technique. There is little evidence to suggest spirometry-based BDR can be used in the clinical assessment of preschool children who wheeze. Further evaluation of simple alternative techniques is required. Future studies should recruit children in whom airways disease is suspected and should evaluate the ability of BDR testing to predict treatment response. Pediatr Pulmonol. 2016;51:1242-1250. © 2016 Wiley Periodicals, Inc.


Differences in ethidium bromide and 4'-6-diamidino-2-phenylindole staining profiles with regard to DNA fragmentation during apoptosis.
To simply and directly evaluate DNA fragmentation during apoptosis induced in mouse cultured hepatocytes by an anti-Fas antibody, we examined the fluorescence intensity in cell nuclei stained with ethidium bromide and 4'-6-diamidino-2-phenylindole by optiphoto fluorescence microscopy. The intensity of the former staining for the nuclear DNA of apoptotic cells was clearly decreased compared to that of non-apoptotic cells, whereas no difference in the fluorescence intensity for the latter stain between the apoptotic and non-apoptotic groups was observed. Thus, the use of optiphoto fluorescence microscopy, in conjunction with both stains, constitutes a useful tool for the evaluation of apoptotic DNA fragmentation.


Continuous in situ diffusion of ropivacaine for ambulatory congenital hand disorders surgery in young children.
Pediatric ambulatory surgery presents a specific set of challenges to the anesthesiologist. Similarly to adult ambulatory surgery, we report four ambulatory surgical procedures in two young children with congenital hand disorders. For each surgical procedure pain was controlled with continuous in situ infusion of ropivacaine.


Cellular and molecular mechanisms of age-related macular degeneration: from impaired autophagy to neovascularization.
Age-related macular degeneration (AMD) is a complex, degenerative and progressive disease involving multiple genetic and environmental factors. It can result in severe visual loss e.g. AMD is the leading cause of blindness in the elderly in the western countries. Although age, genetics, diet, smoking, and many cardiovascular factors are known to be linked with this disease there is increasing evidence that long-term oxidative stress, impaired autophagy clearance and inflammasome mediated inflammation are involved in the pathogenesis. Under certain conditions these may trigger detrimental processes e.g. release of vascular endothelial growth factor (VEGF), causing choroidal neovascularization e.g. in wet AMD. This review ties together these crucial pathological threads in AMD.


Application of matrix-assisted laser desorption ionization-time of flight mass spectrometry for identification of the fastidious pediatric pathogens Aggregatibacter, Eikenella, Haemophilus, and Kingella.
The accuracy of matrix-assisted laser desorption-ionization time of flight mass spectrometry (MALDI-TOF MS) in the identification of Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, and Kingella (HACEK) species was compared to that of phenotypic methods (Remel RapID and Vitek 2). Overall, Vitek MS correctly identified more isolates, incorrectly identified fewer isolates, and failed to identify fewer isolates than both phenotypic methods.


Vibrational spectra and assignments of 5-amino-2-chlorobenzoic acid by ab initio Hartree-Fock and density functional methods.
The Fourier transform Raman and Fourier transform infrared spectra of 5-amino-2-chlorobenzoic acid (5A2CBA) were recorded in the solid phase. Geometry opitimizations were done without any constraint and harmonic-vibrational wavenumber and several thermodynamic parameters were calculated for the minimum energy conformer at ab initio and DFT levels invoking 6-311G(d,p) basis set and the results are compared with the experimental values with the help of three specific scaling procedures, the observed vibrational wavenumbers in FTIR and FT-Raman spectra were analyzed and assigned to different normal modes of the molecule. Most of the modes have wavenumbers in the expected range, the error obtained was in general very low. The appropriate theoretical spectrograms for the FTIR spectra of the title molecule were also constructed.


Posture and spontaneous motility in fullterm infants.
Posture and spontaneous motor patterns during the first days of life were studied in ten healthy fullterm infants by direct observation and videorecording. The aim of the study was to provide a description of motor and postural characteristics of normal newborns. The infants were recorded for 1 h on their first and fourth day of life, when unstimulated in an incubator. Incidence and duration of the different body postures and motor patterns were scored during the replay of the videorecordings. The preference for the fully flexed posture of arms and legs described in the literature could not be confirmed. There was a large intra- and inter-individual variability in the postural repertoire. No particular posture, characteristic for each behavioural state, existed. Similar postures rarely occurred in the same infant on the first and fourth day. Extended postures more often occurred on the fourth day. Spontaneous motility consisted of several distinct movement patterns, the occurrence of which in states 1 and 2 was computed for day 1 and day 4. Motor patterns were differently related to the states. No differences were noted in the motor activity between the first and fourth days. Large inter-individual differences, but an intra-individual consistency, were found in the rates of specific motor patterns: infants who showed a low or high rate of particular movements on day 1 maintained the same characteristic on day 4. There was no overall low or high motor activity.